Dr. Hanjabam Barun, Sports & Exercise Medicine Specialist

14/04/2026

The kinetic chain describes the human body as a series of interconnected joints, muscles, and tendons that act together to produce movement, transferring energy from large, proximal muscles to smaller, distal segments. Proper function requires an unbroken chain, ensuring efficient movement, while disruptions can cause compensation, injury, and pain.

Key Concepts of the Kinetic Chain:

-Proximal-to-Distal Sequencing: Power is generated in the lower body (legs/hips), transferred through the core, and released through the upper extremities (arms/hands).
-Closed Kinetic Chain (CKC): The distal segment is fixed (e.g., foot on the ground during a squat or hand on the floor), which is generally more stable and better for rehabilitation.
-Open Kinetic Chain (OKC): The distal segment is free to move (e.g., throwing a ball or doing a leg extension), focusing on isolating specific muscles.
-Interdependence: Dysfunction in one segment, such as weak hips, often manifests as pain in another, such as the knees or lower back.

Benefits of Understanding the Kinetic Chain:

-Improved Performance: Understanding how to stack joints and muscles helps maximize speed and power.
-Injury Prevention & Rehab: Identifying the "weakest link" in the chain allows for targeted, functional rehabilitation rather than just treating symptoms.

14/04/2026

Combined strength and aerobic training vs. aerobic training alone in patients with heart failure: A systematic review and meta-analysis

doi.org/10.1016/j.jshs.2026.101136

14/04/2026

10/04/2026

"Take vitamin C with your iron." You have heard it a thousand times. The mechanism behind it is real. The clinical benefit for supplements is not what you think.

Non-heme iron from food arrives at the gut wall as Fe3+ (ferric iron). It cannot cross the enterocyte membrane in that form. An enzyme called DCYTB sits on the brush border and uses vitamin C as an electron donor to reduce Fe3+ to Fe2+ (ferrous iron). Only Fe2+ can be transported through DMT1 into the cell. Without vitamin C at the membrane, dietary iron from plants, grains, and legumes is poorly absorbed. This is especially true in meals high in phytates and polyphenols, which chelate ferric iron and further reduce availability.

This is where the advice originated, and for food iron it is well supported.

But common oral iron supplements (ferrous sulfate, ferrous bisglycinate, ferrous fumarate) are already in the ferrous form. The iron was never ferric. The reduction step that vitamin C facilitates was never needed.

A 2024 meta-analysis by Deng et al. tested exactly this question in clinical practice. They pooled 11 studies with 1,930 patients diagnosed with iron deficiency anemia. Iron plus vitamin C versus iron alone. The hemoglobin difference was 0.14 g/dL. Statistically significant, but in the authors' words, "small and likely clinically insignificant." Ferritin increased by 3.23 mcg/L. Also marginal. A separate 2023 meta-analysis by Loganathan et al. reached the same conclusion from a different pool of studies: no meaningful benefit of adding vitamin C to iron for anemia treatment.

One caveat: the Deng analysis had significant heterogeneity across studies (I² = 86%), reflecting differences in formulations, dosages, and populations. The pooled estimate should be interpreted with that in mind.

The practical distinction: vitamin C matters for iron absorption from food, particularly plant-heavy meals where all the iron is non-heme Fe3+ and inhibitors are present. It does not appear to meaningfully improve outcomes when stacked on top of a ferrous iron pill. The mechanism is not wrong. The context it gets applied to usually is.

Deng et al., Blood Vessel Thromb Hemost, 2024.

Loganathan et al., Clin Nutr ESPEN, 2023.

09/04/2026

As a medical school professor, the protein recommendation I was taught -- 0.8 g/kg body weight -- is actively harming older adults. New data proves it.

A 2025 Frontiers in Nutrition trial randomized 126 elderly women with sarcopenia into two groups for 12 weeks:

-- Standard protein (0.8 g/kg/day) vs. moderately high (1.2 g/kg/day)
-- The higher protein group gained significant muscle mass on MRI
-- Thigh and calf cross-sectional muscle area increased measurably
-- Intermuscular fat decreased -- meaning muscle QUALITY improved
-- Handgrip and knee flexion strength both improved significantly

For a 150-lb person, the difference is just 82g vs 55g of protein per day. That is one extra chicken breast.

The current RDA was set to prevent deficiency, not to optimize health. Older adults eating 0.8 g/kg are losing muscle, gaining fat, and sliding toward metabolic dysfunction.

Full breakdown coming on the Health Longevity Secrets podcast.

Source: https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2025.1547325/full

09/04/2026

Current definitions of an athlete range from loosely defined to overly restrictive, rely on qualitative subjective descriptors, and fail to capture the majority of physically active patients. To improve the understanding between exercise and health metrics a more standardized and granular classification of exercising patients is required. We propose a simplified algorithm to categorize and define exercising patients based on the: (1) intent of exercise, (2) volume of exercise (hours/week), and (3) level of competition. Further classification of physically active patients can be derived based on the intensity and volume of activity using metabolic equivalent-hours per week. In conclusion, a formal framework to classify athletes and quantify both the volume and intensity of exercise will enable more precise and meaningful associations between exercise and health outcomes

Current definitions of an athlete range from loosely defined to overly restrictive, rely on qualitative subjective descriptors, and fail to capture the majority of physically active patients. To improve the understanding between exercise and health metrics a more standardized and granular classifica...

07/04/2026

*3rd International Conference of Indian Society of Sports and Exercise Medicine (www.issem.in) 2026 at Sports Injury Centre, VMMC & Safdarjung Hospital, New Delhi from 10th to 12th April 2026*. *Registration*: https://www.issemcon2026.com/registration_details.php *For details*: www.issemcon2026.com *Email*: issemcon2026@gmail.com

03/04/2026

GLP-1 receptor agonists are increasingly used to treat type 2 diabetes and obesity, and trials have shown reductions in cardiovascular risk and slowing of kidney failure. Adverse events are mostly gastrointestinal.

03/04/2026

For decades people have believed that simply providing better information will successfully change someone's mind or behavior. This concept is known as the information deficit model and it has been completely disproved by behavioral scientists. When you present someone with facts that contradict their worldview their brain does not evaluate the data logically. Instead it recruits cognitive resources to defend its existing beliefs because changing them feels like a severe threat to their social identity. Over 90 empirical studies show that people are far more likely to change when they see trusted peers adopting a new behavior. Empathy and a sense of belonging will always be much more persuasive than an expertly crafted argument.
Shared for information purpose only.
Source: Fast Company and The Oxford Research Encyclopedia of Climate Science

02/04/2026

A study of nearly 96,000 people published today in the European Heart Journal has found that just 15 to 20 minutes of vigorous physical activity per week is linked to a 63% lower risk of dementia, a 60% lower risk of type 2 diabetes, and a 46% lower risk of death. The key finding overturns the assumption that total exercise time is what matters most — researchers discovered that how hard you move, not merely how long, is the decisive factor for several of the most feared diseases of aging. During vigorous activity, the kind that briefly leaves you breathless, your heart pumps more efficiently, blood vessels grow more flexible, and inflammation throughout the body measurably drops. Think of it this way — running to catch a bus, taking stairs two at a time, or playing hard with a child for a few minutes counts as medicine your doctor currently cannot prescribe. The research team, led by Professor Minxue Shen of Central South University, noted that intensity appears especially critical for inflammatory conditions such as arthritis and psoriasis, where the duration of activity mattered far less than its intensity. These findings open the door to personalized activity recommendations based on individual disease risk rather than one-size-fits-all weekly step targets.
Shared for information purpose only.
Source: Wei et al., European Heart Journal, 2026. DOI: 10.1093/eurheartj/ehag168.

02/04/2026

As a medical school professor, I've recommended metformin to countless patients. But a new double-blind trial just revealed something alarming.

Metformin BLUNTED the insulin-sensitizing benefits of exercise in adults at risk for metabolic syndrome.

The findings from a 16-week RCT:

-> Exercise + placebo improved VO2max, insulin sensitivity, and reduced inflammation
-> Exercise + metformin? Those gains were significantly blunted
-> Fasting glucose, TNF-alpha, and vascular function improvements -- all attenuated

The researchers found metformin interfered at every level -- from large arteries down to capillary blood flow.

This doesn't mean metformin is "bad." But it raises a critical question: if exercise is the most powerful metabolic medicine we have, are we undermining it with a pill?

As I wrote in Lies I Taught in Medical School -- we need to rethink which interventions we stack and why.

Full breakdown coming on the Health Longevity Secrets podcast.

Source: https://pubmed.ncbi.nlm.nih.gov/41160096/