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Great intuition. I don't do much with endurance sports, so I didn't have a great intuition for that number. His reference to a study or studies in the podcast was a little difficult to follow, and I didn't actually look it up. My first interpretation was that he mentioned two separate studies, one that was a six week intervention, where he spelled out that they had three fifteen minutes "bouts" on a stairmaster at 65% VO2Max. Then, I thought he referred to a different study and said "a single 45 minute bout", which I just tried to interpret as "in a different study, instead of doing three fifteen minutes bouts, we had them do one 45 minute one" (and I only mentioned what I thought was the latter study in my comment). But now I think that interpretation was wrong. I think I found the study, and I think it's just the one study (that is not to say that I have any knowledge of replication/failure or whether there he's a man of one study; just that what I thought was two separate studies is just one study). It looks like in that same paper, they reported data after one session (that is, one day of doing three fifteen minute bouts) as well as data after the full six week intervention. So, I think he just misspoke to use the term "bout" ambiguously. From the paper, it looks like they had a five minute rest between each fifteen minute set. Does this seem more reasonable to you?
Three sets of fifteen minutes seems much more doable (although the original might not be out of the question), and it looks like they scaled it up over the six weeks as fitness improved. It would be interesting to see how much, but I didn't see that in a quick skim.
It doesn't seem that surprising to me generally: endurance exercise uses a lot of energy from blood sugar (and also from fat), and everything I've read suggests that the liver has a huge role in regulating that. I've also heard plenty of anecdotes about diabetes improving (or at least being easier to regulate) with exercise. The idea that reducing blood glucose without using insulin (exercise!) might improve insulin sensitivity sounds pretty reasonable: abstaining from caffeine for a while makes a cup of coffee hit harder when you do have one.
Exercise definitely does things to your insulin system. One of the interesting findings is that taking in sugar while exercising doesn't cause an insulin spike. Normally during exercise at that level you'd be using a combination of muscle glycogen, liver glycogen, and fat. Taking in sugar reduces liver glycogen use in favor of the newly introduced sugar. Then when you're done exercising, insulin sensitivity is increased, which helps replenish muscle glycogen.
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