Higher intramuscular lipid content in endurance athletes is an adaptation for fuel availability near mitochondria, distinct from the intramuscular lipid seen in insulin resistance.

“isn't that an adaptation to his endurance training where he wants to have more intramuscular lipid because he wants to have more logs near the fire he's burning those logs totally yeah yeah and and you wouldn't have to dig hard to find support for that yeah and I think that's different from the intramuscular lipid we see in the diabetic for example or in the insulin resistant there's a level when you cross right when there when there's no exercise there then there's a different reason that that happens”