Episode #194: How To Avoid Sudden Heart Attacks While Running

In today's podcast, how to avoid heart attacks while running. Also heating saturated oils, thick phlegm during exercise, fasted workouts and back loading carbs, treating celiac disease, naturally healing rotator cuff tears, getting sick during training, very heavy sweat rates and removal of knee cartilage.

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Hey. Hey everybody. Welcome to the Ben Greenfield Fitness podcast on this, well, sort of gray, dreary day here in Toronto. What's it like where you are, Ben?

I think we flipped. I think last time I had the whole rainy gray day thing going on down here in Spokane, but it's actually pretty nice. It's much cooler than it was in dubai. It's like 85, 90 degrees here. Yeah, I went for a run when I was over there in Dubai, in Dubai and literally like had my life flash before my eyes. It's, you know, they have that Abu Dhabi triathlon over there every year in March and I hear lots of feedback that that's a really hot race and apparently it's significantly hotter during the month that I was just there during May than it is in March. And I mean I went running at noon and literally had like a full, full on liter of water with me and it was gone within 45 minutes and I was just toast, so.

Well, you were. What do they say is only mad dogs and Englishmen?

Yeah, it's just out there in an.

Exposed desert and the triathletes, I guess that's.

Yep. So yeah, Dubai went well. Taught a conference over there basically really delving into lots and lots of geeked out topics on performance digestion, fat loss recovery, brain sleep optimization and hormone optimization to a group of kind of a mix of personal trainers and folks over there who just wanted to learn more about their bodies. And yeah, it was good. And that's why we didn't have a podcast last week was because I was kind of doing the podcast live. But yeah, cool place. And I'll probably go back over there in March for that Abu Dhabi triathlon.

Oh, nice. Awesome.

Yeah. And then shoving off tomorrow to play in our local regionals tennis tournament. So gotta pick up the tennis racket, which I've been neglecting for the past couple of weeks and then after that be heading down to Hawaii for the Hawaii 70.3 race and kind of a week long camp leading up to that. So if there's any listeners going down to do the Honu Triathlon in Hawaii, come say hi. I'll be somewhere out there in the lava fields.

Excellent.

Yeah.

And that's probably the other quick thing I wanted to mention to folks was getfitguy.com brand new book, my book is available now in Kindle form and hard copy form at a bookstore near you or at a computer near you. And that is the full on guide to getting fit for your body type. So you can check that out if you're, if you're wanting to kind of figure out what kind of body type you are. You know, from an endomorph to an ectomorph to a meso endomorph and a bunch of other kind of tongue twister terms and determine how you should be exercising and eating kind of for your body type.

So seen lots of positive feedback on Twitter and Facebook about it so far, so awesome. Get a copy while you can, folks.

That's right. And then start getting fit for your body type. News flashes.

All right, let's jump into the news flashes. There's been all kinds of stuff going on on Twitter, as usual, and some awesome stuff on Google and I'm sure you want to highlight some of them for us.

Yep, as usual. Our point in the show where we mentioned some of the latest, greatest stuff I've been coming across in my scouring of the research and one thing that I wanted to mention was a study that it was actually back in January, but I just noticed it. The title of the study is Experience with the High Intensity Sweetener Saccharin Impairs glucose homeostasis and GLP1 release in rats. Kind of the basic interpretation of that is that they took rats and they gave them artificial sweeteners. And what they found was that the artificial sweeteners could actually cause a release in gut hormones and a rather rapid release in gut hormones that affected blood sugar, even though the artificial sweeteners themselves were calorie void or relatively calorie void. So the basic idea is you've got this group of gastrointestinal hormones and they're called incretins, and those can cause insulin to get released from your pancreas and cause actual kind of initiation of this hormonal surge that you normally associate with eating something. And it happened with consumption of artificial sweeteners. Interestingly, it can also happen through the action of just thinking about carbohydrates. So. Oh, no. Yeah, I know.

That's all I think about.

Tracing your bike ride to work to avoid the bakery. Now, not. Not very significant, and especially for an active individual, not that big of a deal. But for somebody who is really trying to lose fat as fast as possible, or perhaps try and break a cycle of carbohydrate addiction or artificial sweetener addiction, this important to know that it's not as simple as these things. Simply maybe saccharin, for example, having an effect on your gut flora or on your nerve cells in terms of having a little bit of neurotoxicity. It also actually acts on a hormonal level in your gut. So important to know.

I think we should change the name of this podcast to Bad News with Ben Greenfield. You can't even think about it now.

Don't eat it.

Just don't even think about it.

That's right. That's right. No pink elephants. No biscotti. No scones. No. Stop it.

Stop it. You're making me fat.

Okay, no, but again, I mean, like, I'll emphasize this is, you know, the whole thinking about carbohydrates thing isn't a big deal unless somebody is really, really having some blood glucose issues. So that'd be more of an issue. You know, like, obese people shouldn't be hanging out at bu even if they're not eating the food. It's just not a good idea. Next up, a study that looked into losing fat and gaining muscle at the same time and looked at the effect of two different weight loss rates on body composition and strength and power performance in athletes. So they took people who were going after performance goals and they tried to figure out if you try and take somebody who's trying to become faster, more powerful, stronger, and you try to let them gain strength and lose fat at the same time. What's the maximum amount of body weight that you can lose in terms of primarily body fat that you can lose and still maintain performance gains? And in this case, they were measuring one rep max test for strength, 40 meter sprint and counter movement jumps, which are all decent measurements of kind of your basic performance capabilities. And they found that the best weight loss rate was about 0.7% of your body weight per week. And that's going to vary highly from individual to individual.

0.7% of your body weight.

Yeah, 0.7%. So, like, I'm 180 pounds. Ish. So zero points. Was that 1.26 pounds or so.

Okay.

Somebody like me on a weekly basis would be the maximum amount I'd really want to lose if I wanted to maintain performance gains. And obviously it's going to change from person to person. 0.7%, though, is kind of that range. And if you're losing weight a lot faster than that and you're trying to have performance gains, you may kind of not be doing yourself any favors. Unless you're like Biggest Loser size morbidly obese.

Yeah, I guess there's always sort of been a rule of thumb of like one to two pounds a week was sort of the safe amount that you should be losing if you wanted to keep the weight off. They always said if you lose weight too quickly, your rebound is way quicker and maybe that ties in.

Exactly. And the way that this ties in for 140 pound female, two pounds per week is probably going to not do you many favors in the performance department versus 0.7%.

So you're skinny, but you're laying on the couch all day because you're exhausted.

Yeah. So if you're light, it might even be that one pound a week is too much for you if it is performance that you're going after it. Also, it's another reason that I really recommend that people who are trying to lose weight and gain performance at the same time try and split the two up in different times of the year so that maybe you're trying to lose weight from January through March and not worrying about performance at all so that you can lose weight at a rate that is faster than 0.7% per week and just not even care because you're not having to go out and, you know, you aren't signed up for a bunch of, you know, whatever triathlons or other performance improvements or, you know, you're not trying to set a CrossFit record or something like that. So.

Yeah, makes sense.

Yup. And then one other thing I wanted to mention was about foam rolling and, you know, what is termed in the literature self myofascial release, which is basically foam rolling, or using a lacrosse ball or a golf ball or a tennis ball or whatever, anything that works on your fascia. What they found was that in terms of range of motion, with the use of a foam roller in this study, you could increase your range of motion by 12% or more simply by using a foam roller for about two minutes in the area where you wanted to improve the range of motion. So, as I've alluded to before in this podcast, when I make recommendations to folks who are having Trouble maybe feeling really stiff during a run or wanting performance improvements right before they go out and do an event like say my tennis match this weekend. If I were going to go out and want increased shoulder range of motion so that I could get a little bit more reach on a serve. Foam rolling for the upper back, rhomboids, scapula, muscles, that type of area would be super useful as a soft myofascial release technique. And same thing like if you've been sitting at your office all day, it's going to help you if you do some foam rolling before you head out on a run. There was recently some suggestions on the Internets that foam rolling wasn't all that hot, but it actually is a pretty good idea and I'll put a link to that study in the show notes.

That's awesome. I keep a foam roller in my in my office with me. Just one of those little travel ones just so I can pull it out every once in a while if I'm feeling kind of stiff. I think we've talked about before, I use a standing desk, so it's often after, after like five or six hours of standing there typing, it's nice to just sort of roll out some of the stiff spots.

Yeah, and that'll, that'll probably end up being the global sign of a Ben Greenfield Fitness podcast listener. Is any woman walking around with a foam roller kind of coming out purse? Did you know you can get personalized nutrition and fitness consulting from Ben Greenfield no matter who you are? If you want to run a triathlon, lose a few pounds, reinvent your diet, or have Ben create a training program.

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Listener Q and A. All right, we've got some awesome questions. The questions kept piling up even though we didn't have a show last week. It's nice that people didn't get upset and stopped writing to us and especially didn't stop phoning us because we've got a ton of audio questions like this one from Chris.

Hey Ben and Brock, I got a question for you for a podcast topic. You know, we frequently hear about fellow athletes having these profound medical events where they crash and it's determined that they have 80 or 90% blockage in an artery. I personally know of a couple of fellow runners in their 40s and 50s who have had this occurrence and fortunately both of them have survived after open heart surgery. But I'm amazed that we continue to hear about active, well trained athletes who experience these near death occurrences in spite of being very active and at high level of performance. And it makes me wonder about all the efforts of preventative health care. I understand a lot of this could be hereditary, but I'm surprised when we hear about well performing athletes crashing with no previous indicators. So I thought listeners might be interested to know if there are tests available to screen for life threatening blockages. Since it appears that can strike athletes of any age who are training and performing and who show no signs in advance. One thought wondered if a stress treadmill test might be a good indicator test. Either way, this seems like a topic that would be very informative to all the listeners out there. Take care. Thanks for all your help.

Alright, so there's a lot of this has been in the news lately.

Yeah, there's that ultra runner, Mike Itroux, and he figured quite heavily in the book Born to Run and they found him apparently having died of a cardiac event during some type of a run or a hike or something of that nature up in the mountains. And yeah, he among a rash of other folks who have unfortunately and tragically passed away during training runs or in many cases during marathons. So it's certainly an issue.

Somebody actually passed away this weekend in Toronto at a 10K.

Yeah, yeah. And it's scary because I know that a lot of listeners who listen to this show, they're out there running 5Ks, 10Ks half marathons. Marathons. I've had it on my mind, thought about it during Wildflower definitely passed through my mind during that triathlon just because I'd been thinking about Micah. True. And it's like, you know, how much do we need to worry and is there anything that we can do, you know, especially for endurance athletes. Way back in podcast episode number 60, I did a podcast about why healthy people have heart attacks. And it was an interview with Dr. William Davis before he wrote the book Wheat Belly, for which he's more famous now, he had written a book called Track youk Plaque. And in that interview we talked about how doing something like a treadmill test to look at blood flow to the heart muscle is often not the best way to check and see whether or not you have a high risk of having a heart attack. Even if you're a healthy individual, because a treadmill test is going to show whether or not there's poor blood flow to a specific part of your heart muscle. And that may indicate that there is blockage in a coronary artery, but it doesn't necessarily indicate whether there's what's called silent plaque in the coronary artery, because a lot of times there can be minor plaques that don't block blood flow and are undetectable by a stress test, but they can still be a major issue if they rupture and taking something like a cholesterol test or a lipid panel, or doing something like an exercise stress test on a treadmill. Two of the more popular ways at this point in modern medicine to track your risk of a heart attack. Both of those methods aren't very good at anticipating events that are caused by minor plaque buildup in the arteries. And, you know, Dr. Davis and I talked about this a bit in podcast number 60 about, you know, about this plaque issue. So what he recommends is what's called a heart scan, which is basically this special machine that does about 30 to 40 different cross sectional scans of your heart from the top to the bottom, and it gives you what's called a calcium score. And that calcium score tells you how much plaque you have in your coronary artery. So the higher your score, the more plaque you have. And basically reducing your heart score comes down to actually targeting that plaque. And the typical recommendations you're going to see for reducing risk of heart attack by reducing plaque that Dr. Davis has done research on that you can find on his website over@trackyourplaque.com are things like using omega 3 fatty acids or specifically making sure that your omega 3 to omega 6 fatty acid ratio is really good. So you're not doing a lot of vegetable oils, roasted seeds and nuts. And those are kind of two primary sources of omega 6 fatty acids. And you're including a good high quality fish oil supplement and doing fish walnuts in moderation, things of that nature, making sure that your vitamin D is high, meaning if you were to go out and do what's called a 25 hydroxy vitamin D blood level test, which is super easy to do, any doctor can do that for you. You'd want your vitamin D to be like 60 to 70 plus in terms of the score that you get. And then the other thing that they're really big on in terms of reducing your calcium score is to be really, really careful with what are called advanced glycation end products. Have you heard of those before? Brock Are you familiar with those?

I've heard you mention them before, but I haven't actually heard them outside of this show.

Okay. Yeah. Advanced glycation end products. The abbreviation for those is ages. And basically the way that those form is you take a sugar from food like glucose or fructose or whatever, and what happens is that sugar can react with proteins. And a lot of people don't realize this. It can also react with protein fats. There's what's called a nitrogen group or an amino group on proteins and an amino group on fat. And that can react with sugar, especially at higher temperatures. And it can create what's called this advanced glycation end product. And that in particular can really aggravate this coronary plaque formation. So there's kind of two different ways that you could get exposed to advanced glycation end products, and one would be through what's called endogenous glycation, and that's glycation inside your body. That tends to be a bigger issue in people who have diabetes. They get a lot of what's called endogenous glycation going on where these sugars are reacting with the proteins to form these advanced glycation end products. In people who aren't diabetics, that's really not as big of an issue because most of us don't have the huge amounts of blood sugar fluctuation that the diabetics can get. But it's usually like large fluctuations in blood sugar that can cause endogenous glycation. For most people, it's what's called exogenous glycation that tends to be more of an issue. And that's a chemical reaction that occurs when you deep fry or you broil or you do high temperature baking at 350 degrees or more. Barbecuing can be an issue. I cringe saying that right here in the middle of the summer when barbecuing is big, but barbecuing a lot and having that type of high heat cooking be a really, really big part of your food preparation methods versus steaming and poaching and stewing and boiling. When you're looking at advanced glycation end products from food, the biggest culprits are basically baked goods and meats that have been cooked really heavily. And yes, that would include fried bacon, unfortunately. But being really, really careful with advanced glycation end products is a good way to help out that calcium score. So you minimize fluctuations in blood sugar and then you minimize the amount of high heat cooking that you do.

The.

Whole Issue with this tracking the plaque and that being the main reason why healthy people have heart attacks, is that even though that's the reason that a lot of healthy people can have a higher risk for a heart attack, when you actually look at folks who are dying during extreme endurance exercise, they actually looked into this in the New England Journal of Medicine, and this was last year, actually. It was less than a year ago. It was like six months ago, I think. Ish.

Isn't it just after the New York City triathlon?

Yeah, it wasn't that long after New York City. I guess New York City is. That's November. So, yeah, it was like December or January. So fairly recently, they looked at all the cardiac arrests that had taken place during every single marathon or half marathon in the entire country in the United States that had more than 100 people competing. So a lot of folks that they looked at. So they found it was like 40 or 50 cases where people had died of cardiac arrest during a marathon or a half marathon. And what they found was that in most cases, ruptured plaques were not an issue like ruptured plaques producing this blood clot that causes the sudden death. In most cases, the cause of the death was related to what's called hypertrophic cardiomyopath. And that can be a genetic condition. It can also be caused by a bunch of exercise. But you've got this ventricle in your heart called your left ventricle, which is where blood gets pumped out to your body after kind of being oxygenated by your lungs coming back into the heart through your left atria, it gets gets pumped in your left ventricle and then out to the rest of the body. Well, it's called athlete's heart. When you get a really, really significant thickening of the heart tissue around that left ventricle, it gets thicker and thicker in the same way that if you lifted weights and worked a muscle, that would get thicker and larger. And what they found was that in marathoners, particularly in these endurance athletes who were dying, and they found the same to be the case with this Mike True fellow as well, that it was cardiac hypertrophy, or athlete's heart, you know, normal response to healthy exercise that results in this increase in the heart's muscle mass. But in some cases, that increase can be really, really significant to the point that there can be basically like a block in blood flow or a failure of the heart, basically a degradation of the heart due to that hypertrophy or that significant increase in muscle growth. So now we're looking At I'm sure lots of podcast listeners are thinking, oh, crap, I'm in good shape. And I personally haven't been tested to see if I have left ventricular hypertrophy, but I wouldn't be surprised if I did for as long as I've been a triathlete. And I wouldn't be surprised if a lot of folks actually had something like that going on. You can get, like, a heart imaging. I'm not sure if it's a CAT scan. I don't remember which measurement can look at the size of the left ventricle, but you can almost kind of assume, if you've been an athlete for much of your life or you do a lot of endurance sports, that you've got a little bit of this hypertrophy going on. The issue here with left ventricular hypertrophy is that it increases susceptibility to mortality during endurance events. And there's kind of a few different reasons that this can happen during endurance exercise. But one of the most prevalent reasons that literature has found that left ventricular hypertrophy causes heart attacks during endurance exercise is because of what's called sympathetic dominance, or too high of what's called sympathetic tone. So what happens is you get an abnormal electrical response of your heart rate in response to increased signaling from your sympathetic nervous system and the increased amounts of norepinephrine and what's called sympathetic tone that's created from that overstimulation of the sympathetic nervous system. And you can find this in multiple research journals, like the Journal of Cardiovascular Research has a really, really good, really, really good article about regression of left ventricular hypertrophy and how to kind of reduce cardiovascular morbidity and mortality based off of controlling a lot of the factors that are involved with left ventricular hypertrophy. And sympathetic tone is kind of the biggest one. So when you've got all this increased sympathetic nervous system activity, it puts you at increased risk once you actually start driving even more sympathetic activity by putting yourself in kind of run from the lion mode as you would during a marathon. And at that point, all this stress kind of comes together to cause that heart failure or the kind of the malfunctioning of the electrical activity in the heart. What I would be coming at this from, in terms of reducing your risk of having a heart attack during something like endurance exercise, would be coming at it from a standpoint of trying to reduce sympathetic nervous system activity as much as possible. And one of the main ways that you can do that is to Control stress. You tend to see an overworked sympathetic nervous system in someone who is high on mental stress and low on sleep. It's interesting. It's actually the reason that sleep apnea puts someone at a very, very high risk of heart attack later on in the day is because of increased sympathetic nerv nervous system tone due to that sleep apnea. But mental stress can do the same thing as can simple lack of sleep or poor sleep habits.

So you're not talking about trying to lower the stress during the actual activity or during the race, but to do it for the rest of your day or rest of your week.

I'm talking about trying to reduce sympathetic tone so that heart rate variability and your heart rate's response to the sympathetic nervous system is not in this overactive state when you actually do run your marathon or do your triathlon. I actually recently did an article over@BenGreenfieldFitness.com about how I use heart rate variability to track how well my body is responding to the combination of signaling from my sympathetic nervous system and my parasympathetic nervous system. And that's something very like I use this unit called the EM wave 2 hooks up to your earlobe and you plug that into a computer, you look at your score. You can do it on a daily basis, on a weekly basis, whatever. And if what's called your cohesion score is low, meaning that the feedback from your sympathetic and your parasympathetic nervous system into the sinoatrial node of your heart via your vagus nerves, if those are not coordinated properly, then what happens is you can get increased dominance from one or the other. And in a high stress fight or flight, low on sleep, difficult interpersonal relationships type of situation, you'll notice that sympathetic nervous system activity tends to dominate. The cohesive score goes down and you can actually track this. I personally, if I were concerned about getting a heart attack and I were tracking heart rate variability, I wouldn't go near the starting line of a marathon if my heart rate variability was low. And the reason for that would be because of that increased risk of heart failure due to the left ventricular hypertrophy. So super important number to track here. And interestingly, it's also one of the numbers that Dr. William Davis over at trackyourplaque.com recommends tracking for even non marathoners and non endurance athletes who just want to make sure that they're not increasing the risk of plaque rupture. Because sympathetic nervous system dominance also increases your risk of that plaque rupture. As well. So lots of stress control techniques focusing on sleep, including some yoga or some meditation or some other form of relaxation. We've talked about this on the show before. But focusing on very positive thoughts of love and gratitude and appreciation all can reduce sympathetic tone. And basically not going into your marathon or your triathlon or whatever it is in a big tizzy. From a lifestyle standpoint, you cannot be running from a lion in your day to day life and then show up at the starting line of a marathon and expect your heart not to be in that overworked state. And the fitter you are, the longer you've been doing endurance sports, the higher your risk is going to be. If you're high on stress, especially from a lifestyle standpoint, low on sleep, and you're arriving at the starting line of a triathlon or marathon or whatever, that's basically overstressing your heart. And so that's really the skinny on reducing your risk of a heart attack. If you're a runner or an active person who doesn't want to have one of these type of cardiac events.

Okay, I think we just put all the listeners into a state that they're now ready to, to hit the start line and have a heart attack because we've totally stressed them out with this answer.

Yeah, I mean, you know, it's simple. I mean, it makes sense. You basically just need to fix other issues in your life before you go, stress your body from that standpoint. And you know, like over@BenGreenfieldFitness.com there's this new section of the page I have called Ben Recommends. And you can get it by signing up for the newsletter or you can just go and read one of the most recent posts that I did. But one of the things I covered there is adrenal exhaustion and that really ties hand in hand with this too. Just how to reduce stress, how to use things like Chinese adaptogenic herbs to lower cortisol levels, how to ensure that you're getting enough sleep, basically how to take charge of some of these factors. But yeah, I mean, super important in terms of reducing your risk of having a heart attack during exercise.

Yeah, pretty much every question that we've had, well, since I can remember, that's revolved at all around overtraining. The same advice has really been given, like just keeping the stress low and keeping those cortisol levels low. And really that's just. This is just a further extent or extension of that.

And it's not rocket science. Probably the most significant takeaway, I would say, is start Tracking your heart rate variability. At least start doing that if you're concerned about this. I personally, I do it now. I track my heart rate variability. I'm on there. I plug the thing up to my earlobe. It takes me five minutes, and I can do that a few times a week and know whether or not my body's in a really stressed out state. And like I mentioned over on the website, it was actually in an article I put out about my Wildflower triathlon and kind of how I recognized my heart rate variability was low leading up to that race and what I did to fix it in terms of some of the measures I took to prevent over training. Cool.

I guess one, one thing at the very beginning of the. This whole, this whole talk, you. You said, like in that New England Journal of Medicine study that they found, was it 40 or 50 people over the year had.

Had had a cruise event in that range? Yeah, yeah.

So we're talking like 40 or 50 people out of hundreds of thousands of people who ran races that year. So, like, as much as, as this is a serious thing and everybody really needs to. To make sure that you're in. In the right state to be able to run these races. It's not like you're guaranteed to have this problem if you've been running long enough. It's still a very low percentage, wouldn't you say?

Yep, I agree. And so, I mean, come at this from just like a peace of mind issue. You know, it's just like, you know, it's so easy to give yourself that peace of mind. Why not do it?

Yeah, it's like looking both ways before you cross the street. Like, sure, you probably won't get run over, but you really won't get run over if you're.

I'll just put on your seatbelt. So I'll put a link to that article in the show notes. Is this episode number 195?

194.

194. Okay, so in the show notes for episode number 194, I'll put a link to the heart math unit I use for heart rate variability and then also what I did before Wildflower to kind of adjust that and get it back up before I race.

All right, let's move on to the next question. It's another audio question from Tony.

Hi, Ben, this is Tony. This is a question for the podcast. Go back and listen to your interview with Udo Erasmus. And on that podcast, he was talking about how if you heat up your saturated fatty oils like butter and such, you Damage them. And then even with a diet rich in omega 3s and 6s, you can't reverse the negative effects of those saturated fats like the sticky platelets and such like you talked about. So my question is about what's your opinion on cooking with these saturated fat oils, like butter or. I'm not sure if the coconut oil is saturated or not, but like is frying an egg pretty bad or what about like putting some oil down on a pan? I mean on like a dish and bacon, fish on it. So that's my question. Really psyched about the podcast. I can't thank you enough. And Brock as well. And since I've been listening to you, my nutrition's on track. I ran my PR of 113 for the trail for a trail half marathon last week. And then a couple weeks ago you got me stacked up with good nutrition for my long trail, fastest known attempt. So, man, I'm so psyched. So thanks again and any thoughts on this? I really appreciate it. Take care.

Okay. First thing since you've actually spoken to him, is Udo Erasmus really his name?

Yeah, yeah, I think so.

That's awesome.

Like something from the 14th century.

That is so cool.

Yeah, yeah.

So yeah, Udo was on the show and I wish I could remember which show number it was. Try and put a link in the show notes to that episode with Udo. But basically he's got this oil and it's a mix of some different basically high essential fatty acid oils. And he wrote this book called Fats that Kill and Fats that Heal. And it's a book that has some really good information about it about fats and oils. And the issue is that Uto Erasmus is really, really biased towards what are called polyunsaturated oils. And I think that a big reason for that is because that's what he sells. His company specializes in selling cold pressed vegetable oils which do have some great benefits when it comes to their anti inflammatory properties and their importance on many levels when it comes to your diet and your cardiovascular health. But he's very against saturated animal fats and very against tropical oils. And one of the things that he states is that the major fatty acid in coconut oil is this saturated palmitic acid which doesn't have a ton of health benefits. But the fact is that that's simply not true. And coconut oil is actually somewhat low in palmitic acid, but extremely high in lauric acid, which is one of the really, really important fatty acids in coconut oil that has the antimicrobial and antiviral benefits and kind of the gut healing benefits and has a lot of other good things going for it. Udo Rasmus also says that butter is kind of a neutral fat that can be dangerous. But butter is actually a really, really good source of like fat soluble vitamins, like, you know, grass fed butter for your vitamin K. It's got a lot of really good anti carcinogenic substances in it. It's similar to coconut oil, high in antimicrobial fatty acids and it's also not that big of a deal to eat in similar manner as coconut oil. Now Udo Erasmus does admit that those are going to be less damaged when or less damaging for you when they're heated compared to say like, you know, canola oil or some other really volatile oil like extra virgin olive oil. But I think that some of what he says needs to be taken with a grain of salt simply because he sells cold pressed vegetable oils. And so he's always going to be a little bit biased towards, towards just using those and avoiding heating fats, period. Now the thing is that as I mentioned earlier when we were talking about heart disease, frying and high heat cooking can create these advanced glycation end products as a result of the combination of the amino groups with the heats adhering to the sugars. But in, in this case, the issue in my opinion is not that you shouldn't ever heat up coconut oil and you should never heat up butter because of that risk of oxidation or the risk of advanced glycation end products. To me, the advice is similar to the advice that I give anyone eating a higher fat diet, that there's no evidence to show that the consumption of saturated fat is linked to heart disease unless the consumption of that saturated fat is at the same time in the presence of a diet that is high in carbohydrates. And so you need to have both components, both the match and the dynamite, in order for there to be an issue here. So if you aren't doing a lot of bread starches, sugary compounds, juices, things of that nature, you can get away more with doing something like higher heat cooking with coconut oil or butter or other stable oils like olive oil or macadamia nut oil or avocado oil. And while I don't recommend that high heat cooking period be a staple in your diet, there are much, much bigger fish to fry, pun intended. And worrying about heating coconut oil for whatever, maybe every other day when you're making some eggs or something like that, it's not that big of a deal. You can Go to Wikipedia, you can type in smoke point on Wikipedia and you can get a really, really great chart of the smoke points of all the different oils that are out there, whether unrefined or semi refined or extra Virginia unrefined, and kind of see which ones have the higher smoke points and use those for your higher heat cooking. And I do think that Udo Erasmus does make a really, really good point in his book and you know, for example on his website over@udoerasmus.com that, you know, there's really, really high amounts of benefit to cold pressed oils and oils that are really, really lightly treated, you know, like an extra virgin olive oil and that we have to be careful with excessive heating of other oils. But at the same time, I don't think that saturated fats are going to be an issue. Butter, dairy, fats, pork, beef, you know, coconut oil, et cetera. And I think the other thing you really got to be aware of is that even to adequately absorb fish oils, to even adequately absorb flaxseed oils, to adequately absorb any of these essential fatty acids, acids, you're not going to be able to do it unless about 40 to 50% of the total fats in your diet are of the saturated variety. And so saturated fats are necessary for the proper absorption of these other fats. So yeah, that's kind of my take on it. And I think that all this stuff needs to be stepped at or stepped back from and looked at from like, you know, kind of an unbiased perspective. And you know, while Udo Erasmus is a great guy and I love the stuff that he produces, you always got to remember he is selling cold pressed vegetable oil. And so whatever he says is going to be skewed slightly towards, you know, you using as much of that as possible versus like a coconut oil or a butter.

That is awesome. Good and delicious news.

Mm.

Alright, onto our next question. Another audio question from Josh.

Hi Ben, this is Josh. I got a question for the podcast. I've been having some trouble ever since I started triathlon. It seems to be mainly during hard efforts and races. Last year I did a half ironman. I thought I maybe drank too much water when I. When I was during a swim, I got on the bike and had a lot of Flemish gunk come up. I really couldn't breathe. It didn't affect me too bad though on the bike for the 56 mile. But then I got on the run and it all just really flared up. Started coming up like, you know, it's just really thick mucus y type stuff, it's pretty gross. And as far as thinking back, because this seems. This happened last year and it's happening again this year, really, when I'm really, like, redlining it during hard efforts and doing brick workouts and stuff like that. And when I get on the run, it really flares up. After a while, I pretty much have to stop because I just cannot breathe. I ended up having to walk about 8 miles on my 70.3 because I couldn't breathe. So I'm not really sure what's contributing to it. I was thinking back as far as diet, dietary, or supplemental stuff, nothing's static. So I don't think that there's anything I'm doing as far as stuff I'm eating that's contributing to it because everything's been different that I do on a training and race basis. I've switched up some stuff. And supplemental. I mean, there's nothing that's static with that either. Or prescriptions. I don't do any prescriptions, so I don't really know. I don't think it was the drinking all the water because it. It's happened without, you know, drinking water. But. So I'm not really sure. I'm kind of at a loss. And the only thing I can think of to do is Sudafed, but I know that that's considered doping for Ironman if they would have doping control. So I was just wondering if you might know. Thanks a lot, Ben.

You know, I'm with Josh. I get this same, like, I get that gunky, phlegmy stuff in the back of my throat when I'm swimming, especially in the pool. And I always assumed that it was coming from chlorine. And it doesn't usually last that long after I finish swimming. But it's certainly like in the last half of my swim, there's just some thick gunk going on.

Yeah. And that could be a little bit of an allergic reaction to the chloramines or the combination of the chlorines with the. Basically, and this is really nasty, the dead skin cells that come off of people's skin when they're swimming binds with the chlorines. Similar way that sugar can combine with the amino acids in that. I just got done explaining, with the advanced glycation end products, you get chlorine combining with these chloramines and creating allergenic compounds. I'm actually interviewing a doctor who's really, really knowledgeable in water. I'm interviewing him on Monday, and I'll be releasing that interview Sometime in the next couple weeks. And we're specifically going to talk about Chlo and swimming. Awesome. But yeah, I mean, mucus is your protective secretion, right? It's this slippery secretion that is secreted by and also covers your mucous membrane. So your stomach lining, your esophagus, pretty much anything that kind of needs protection is going to have some mucus produced. And mucus contains immunoglobulins to fight against, against allergenic compounds and things that you might be exposed to. It's got glycoproteins or what are called mucans that help to protect and build and the lining of your gastrointestinal tract or your respiratory tract. And it's really important stuff. But I mean, its basic primary function is to protect you against infectious agents. So anytime that your body is under the impression that, that the exposure to infectious agents is going up, you're going to get increased mucus production in your nasal, in your airway, anywhere else that you would normally produce this. And that's what phlegm is. Phlegm is basically mucus that gets produced in your respiratory tract as a response to some type of immune reaction. So anytime you're looking at excessive mucus production, especially in the nasal passages, especially when it presents as phlegm, usually that's because there is some type of allergenic response to something you're exposed to in the environment, like dust or pollen or pollution. In many cases, this is called rhinitis, the inflammation in the mucous membrane that can be aggravated especially by other autoimmune issues going on. So mucus production is this autoimmune response. And one of the main things that can aggravate autoimmune responses even more is diet. And so this is something that I recommend to all the runners that I work with, especially the ones who struggle with allergies during the competitive season, kind of holding them back and mucus production holding them back is to be careful with dairy, be careful with wheat is another big one. Soy is another one. Any of these foods that that would be considered traditional kind of immune system stimulating foods because they cause this pronounced immune response, would also be the same type of foods you'd want to avoid if you want to avoid this increased mucus production, especially prior to exercise. So peanuts, shellfish, wheat, dairy, soy, those are really the biggies. And that's the standpoint I would come at this from. Rather than trying to fight the mucus itself. I mean, they've got everything from xylitol sprays to Essential oils that you can kind of steam and kind of breathe in to teas that you can drink. But when it comes down to this, what you want to look at is the underlying cause, which is usually some type of autoimmune reaction and the production of mucus, the body's natural increase in mucus production because of that.

So he did mention that they talked about how his diet is very well variable. I guess there's no sort of constant thing that he's eating very often. I guess that doesn't necessarily rule out the fact that he's got some sort of an allergen in each one of those meals.

Oh, yeah.

I mean, you know, antibodies like gliadin based antibodies to something like gluten, those, you know, you can get a rebound effect from that for two to three weeks sometimes. So, you know, the bread that you had earlier in the month can affect the mucus production that happens when you're out running two weeks later. So that's something really important to remember with diet. Usually if you're going to make dietary changes, you want to give yourself a good two to four weeks, sometimes a little bit more, before making the final judgment about whether or not it helped or hurt you. Okay.

So it's not like the stomach problems that you might experience during a race or something that can be a little more directly linked to the last couple of meals, but really, this can go back like days, weeks.

Yeah. And you know, when it comes to decreasing the propensity for undigested food particles or components in your diet that you may be intolerant or allergic to, crossing the single cell layer in your gut tract, winding up in your bloodstream, causing an autoimmune reaction that can lead to things like mucus production. A lot of times, the gut healing protocol that can be necessary to actually fix a damaged gut is a six month to one year process of literally cleaning up your diet, eating foods that are really clean, while taking supplements that help to heal the gut. I think we have a question about celiac disease in this podcast and talk about that in a little bit more detail. But sometimes it can be taking a year of your life to fix your gut. And then once you do that, a lot of times you can get away with eating some foods that maybe a year ago would have been really, really aggravating. But a lot of times this is stuff that can be a big fix that's necessary initially. Gotcha.

Okay, let's move on to the next question. Another audio question comes from Chuck.

Hey, Ben. This is Chuck and I have a question for the podcast. There's kind of a couple questions in one, and they all sort of have to do with fasting. First, I wanted to see your take on the new protocol that's out. It's called carb backloading, where I guess you essentially eat most of your carbohydrates after a PM workout, but the quality of the food matters a little bit less. And you do a fast workout in the morning, but then there is some eating around it and I'm not sure in the details in the morning. If you could elaborate on it a little bit and why it would work. The second part of that is you often recommend doing fasted workouts in the morning before eating anything to help burn essentially belly fat. And I want to see if that how long you have to have fasted for that workout to have that kind of a benefit. And also if you had any take on whether or not you ate a meal and then immediately went and worked out, but then fasted for a while after that. I've seen different studies on the benefits of fasting after a workout too, and was wondering what the take on that would be. So sorry for the long question. Good luck at Wildflower this weekend. I met you there last year and have fun and bye. Later on, man.

Cool. So first of all, as far as that, how long you can fast or how long you should fast, the whole idea behind exercising in a fasted state is that you're exercising with relatively low liver glycogen stores, so your liver isn't breaking down its glycogen, mobilizing that via glycogenolysis to spike the blood glucose so that you're burning blood glucose rather than fats. Specifically, say if you were trying to lose weight or trying to improve your metabolic efficiency, trying to improve your efficiency in burning fatty acids. So you'd want to look at this and say, okay, well, how much liver glycogen do I have on board? And if I'm not eating anything, how fast is that going to be exhausted? And it's going to vary from person to person. I mean, it starts off with finding out your metabolic rate or how many calories you're burning per hour. So you could, for example, like my website, getfitguy.com where I just wrote that book, we have a metabolic calculator over there where you can figure out how many calories that you're burning just at rest, sitting around doing nothing during the day. You could go and get what's called an indirect calorimetry test that's in like an exercise physiology lab. You could use one of these body tracking devices like a Fitbit or a Bodybug. But you know, in my case, for example, I know that just sitting around or sleeping, you know, I'm burning right around 3,000 calories in a 24 hour period. So for me I know that I'm burning about 125 calories per hour or so. So right around in that range. Now most people, your liver can store about 100 grams of carbohydrate and that's about 400 calories of carbohydrate. So let's say that I have my typical dinner and my typical dinner is say 600 calories. And I know I've got another 400 calories of already stored carbohydrates in my liver means I've got when I hit the sack, around 1,000 calories or so that my body can utilize of just like immediately utilizable, you know, kind of, you know, calories from diet or calories from carbohydrate. So at that rate, knowing that my metabolic rate is around 3,000 calories in a 24 hour period, which is 125 calories in an hour, I know that for me to exhaust most of my energy storage is going to be a minimum of about eight hours, which is 1,000 calories divided by 125 calories per hour. So for me, if I'm going to exercise in a fasted state, that would mean I will have needed to have gone about eight hours or so without having eaten. So that's kind of like the basic math of how you can figure it out. It's going to vary from person to person, but anywhere in the range of 8 to 12 hours is typically sufficient for something like that for exercising in a fasted state. So that's that. And then as far as this carb backloading thing, this it's kind of, it's kind of simple and at the same time it's kind of sort of complex. Basically the idea behind carb backloading is you don't eat very many carbs early in the day and then later on in the day you lift heavy weights or you exercise or you do a hard workout and then after that you kind of get higher glycemic index carbs or higher carbs later on post workout. The science behind this, and it's really, really kind of salesy in terms of if you go and look@carbackloading.com and look at, look at the whole big long sales that they have on there is that basically what you're doing when you do that is you're giving the body carbohydrates when it's in this really, really sensitive state. And more likely to take the carbohydrates up into the muscle and store them away and use them to build muscle or to restore energy levels for the next day's workout. Which many people understand is kind of the whole idea behind post workout nutrition. Anyways, the other thing is that by eating high carbohydrates, you're doing this carb backloading. Eating high carbohydrates after your workout with lower carbohydrates earlier on in the day is that that amps up what's called this regulator of tissue growth called the mammalian target of rapamycin or the MTOR pathway, which is one of the ways that our body kind of generates growth. It's this pro growth pathway that, that builds muscle and triggers this repair growth response. So the idea basically when you step back and look at it, is you don't eat many carbohydrates when your body doesn't need that much carbohydrates. And then right after the workout you kind of load up with a bunch of carbohydrate. This all makes pretty good sense, but there are some concerns about this. In my case, the first would be that in the late afternoon or the evening, eat a bunch of higher carbohydrate containing meals. Yes, that's going to upregulate progrowth, it's going to cause you to gain muscle more rapidly, and it's going to upregulate this mammalian target of rapamycin, this MTOR pathway. The issue is that that that same pathway is also associated with decreased lifespan. A downregulated mammalian target of rapamycin observed in fruit flies, mice, laboratory animals. When you down regulate that via caloric restriction and via carbohydrate restriction, you significantly increase lifespan. It's one of the best ways to increase lifespan, that and adequate sleep. So that's one thing to think about is by using a carb backloading protocol to put on muscle as quickly as possible or to cause muscle growth and repair as much as possible. You're also potentially stripping years off your life by eating a bunch of carbohydrates in the evening after a workout like that. The other issue is that this whole thing is based off of research that's been done that shows this type of carbohydrate refeeding really, really do A good job in folks at rebuilding muscle and at restoring energy levels. But those are in people who were fasted for eight plus hours prior to the actual workout and then working out and then refeeding. And so how many of us are going into our late afternoon or early evening workout having not eaten for eight hours? I mean, pretty much nobody or anybody who's had lunch. So the idea is that the amount of the benefit you'd get from something like this is vastly kind of overstated because it's based off of research that it was done in fasted individuals or starved individuals and not in people who were living lives like most of us live, which is kind of eating lunch. And if we're going to do an afternoon or early evening workout, maybe even having a snack before that, there's really very, very reduced need for post exercise dietary carbohydrates in that situation. And then finally the last thing, and we've talked about this recently when I interviewed Dr. Peter Attia about staying in a ketogenic state. And the benefits of burning fatty acids as a fuel versus constantly burning carbohydrates as a fuel is that in somebody who is fat adapted, in somebody who has been eating a higher fat, lower carbohydrate diet, been really controlling blood sugar fluctuations just from an energy level and quality of workout standpoint, the need for taking in carbohydrates is going to be vastly reduced because your body is able to more efficiently burn ketones and fatty acids as healthy energy sources versus having those high blood sugar fluctuations that come with this type of carbohydrate refeed. So if I were trying to put on muscle as quickly as possible, yeah, I'd be giving myself some pretty decent carbs post workout and really going after that anabolic response. But the fact is that there are other health considerations that go, in my opinion, above and beyond simply building muscle as quickly as possible. So the reason I'm not a huge fan of this type of diet is the reason I'm not a big fan of bodybuilding as a healthy lifetime sport. There are always trade offs that you make when you start to incorporate a protocol like this.

All right, cool. Well, let's move on to the next question. One more audio question from Jenny.

Hi, Ben and Brock, this is Jenny and I have a question. I went to my doctor, that's a GI doctor about, I guess the end of December because I was having a lot of stomach problems, which I'd been having for a long time. One thing I learned is that I have celiac Disease, which is one thing. And I've got a handle on going gluten free very strictly. But I also had acid reflux. My GI doctor recommended that I take Prilosec for a few months, which I did do, and then he recommended that I take a previsit for a whole year. It's preventative. I just don't like the idea of doing that and have not been doing that. But it still comes up here and there, this heartburn. And I wanted to see, Ben, what you thought about that if there was a supplement or a natural way through food or something to do that. It's odd because I don't seem to have the problem with the typical answer of oh, don't eat spicy food and that kind of thing. I love spicy food, but that doesn't seem to bring it on. It just kind of comes around randomly. But I don't like the idea of being on a medication like that for a whole year. I know you're not a doctor, but I still wanted to get your opinion and see what you think. So I appreciate it and thanks a lot, guys. Also, great job on Wildflower, Ben. I've done it a few times and really respect the time that you got. That's amazing. So good job to you and your wife. Thank you. Bye.

So I alluded to this a little bit earlier about kind of the gut and healing the gut, but celiac is an autoimmune disorder of your small intestine. And specifically it's a reaction to gliadin, which is a gluten protein that you're gonna find in wheat. And you can find some of these similar proteins in grains like barley or like rye. But what happens is your immune system cross reacts with with your gastrointestinal tissue and causes an inflammatory reaction when you consume these type of foods. And the issue is that once you've got this inflammatory autoimmune reaction going on, your body not only can be kind of sensitive to wheat, but you can start to have issues with lots of other foods as well. And this net inflammation when you go into a typical doctor is kind of they're going to try to shut it down with the typical type of anti inflammatory drugs that are prescribed in the case of celiac, like prednisone and cortisone and all these other type of hormones that are designed to shut down inflammation but don't necessarily address the underlying issue, which is the gut basically not working in the way that it's supposed to. And this stuff can start from the time that you're a tiny little baby, for example, if you were, if you were fed on formula versus being fed on breast milk, breast milk is higher in colostrum than formula, which has pretty much no colostrum. And colostrum is one of the ways that the gut of a baby actually develops. And when a baby is first born, it has lots and lots of holes in the gut lining, this single cell layer that separates your intestinal lumen from your bloodstream. Colostrustation has lots of holes in it when you're a developing baby. And colostrum from mother's breast milk is one of the ways that this is healed up. So that can be an issue simply not getting enough breast milk. And another issue could be, for example, if your mother, when she gave birth to you, had poor gut flora. A lot of times that influences the amount of beneficial gut flora that you're exposed to as you come through the vaginal tract. And that can also, kind of, right off the bat, affect your gut health. So these are issues that can start from birth when it comes to the potential for autoimmune reaction against food. And a lot of this can be fixed. For example, if you've got imbalanced gut flora, you can get on a really, really good probiotic protocol with lots of fermented foods. If you've got gut lining that needs healing, you can do something like a colostrum supplement to help to decrease gut permeability and help to kind of seal up the gut lining. There is a protocol that I've talked about before on the show called the GAPS diet. And the GAPS diet is basically a diet that's designed to reduce the number of foods that are going to aggravate the lining of the gut. And that's not just wheat. In the celiac, you're going to need to focus on a lot of other foods too, especially things like long chain carbohydrates. Those can be an issue whether or not they have gliadin protein in them. What are called polysaccharides or disaccharides. Those can really be an issue if you've got imbalanced gut flora or not enough good bacteria in your stomach. The other things that, for example, the GAPS diet does is, is in addition to removing a lot of those polysaccharides that can irritate the gut lining and only really allowing for really well cooked vegetables that have a lot of their fibrous parts removed. It provides nourishment for your gut lining by doing things like having you consume lots of bone, broths which have gelatin and glucosamine and collagens and lots of these other gut healing compounds in them. Doing like I mentioned, lots of fermented foods. Using fish oil for example, and using vitamin A is another one. Digestive enzymes are also recommended. I would highly recommend that with something like celiac that you just go buy the GAPS diet book or go over to GAPSdiet.com and just read through the outline of that particular diet. That'd be a really, really good place to start. And that'd be my recommendation initially would be to kind of start there.

Now, sort of just as an aside, as sort of a matter of semantics, when you say gut, you're not referring to just the stomach, are you? Like that's including the intestines and everything else as well. Right.

I would start at the esophagus, which the health of the esophagus is going to be influenced by whether or not it has a non acidic or an acidic environment. The esophagus is designed to be an alkaline non acidic environment. And if you've got backflow of stomach acid, which is due to either not digesting carbohydrates completely or due to basically kind of like a gastroesophageal reflux or like a pressure coming up from the gut due to an imbalance in gut flora, then you know, gut issues can start there. Gut issues can start in the stomach from inadequate hydrochloric acid production, meaning that you're not going to digest proteins well because you need hydrochloric acid to activate pepsin, which is what digests proteins. So you know, it could be a stomach issue, in which case you'd need to take more hydrochloric acid and then down to the small intestine, which is where especially most people with the leaky gut and there it's usually a gut flora issue or it's a digestive enzyme issue or it's like an actual damaged villi issue, which are these little hair like projections in the small intestine that help you to absorb food and help to protect the layer of the small intestine. Usually it's an issue there in the large intestine and the colon you can also have issues if you've got, for example, inadequate production of fatty acids in the colon, excessive fermentation going on in the colon from too much fiber intake. I mean, you know, so we're talking about esophagus, esophagus all the way down to the large intestine is really being the Gut. So, yeah, gotcha.

It's kind of like the core. When people say the core, they don't mean just your abs. The whole encompassing bits.

All those bits.

All those bits and pieces. Okay, onto our next audio question from Shane.

Hey, Ben. Shane here in battleground Washington. I know you're not a doctor, so I'll save you the disclaimer for me, but I'm a recent recipient of a rotator cuff tear, and I've heard lots of horror stories about how long it takes for recovery of that injury. And so I kind of want to get a head start on this. And so what I've been doing is ICE Heat protocol, but in addition to that, I've had some people suggest a few things I want to get your opinion on. One, using a TENS unit and two, using bio tools by Advocare. Looking it up, it looks like they talk about using epigenomics, so would just appreciate any feedback you have or any additional suggestions for quick recovery. Love your show, Ben. Appreciate all the time you put into it.

So, yeah, first of all, real quick, the whole TENS versus electrical muscle stimulation.

Thing.

For an issue with your muscles, usually you want to use electrical muscle stimulation. So TENS stands for transcutaneous electrical nerve stimulation. They'll prescribe that a lot of times for people who have back pain, because what a TENS unit does is it stimulates your neurons through your skin and it like, overrides your pain receptors. And that's great if you're in pain and you want to override pain, but it's not necessarily going to heal a muscle faster because electrical muscle stimulation actually stimulates the muscle fibers themselves. So there you're getting an increased blood flow or increased healing response, whereas TENS is just like, you know, override the pain and help me get through this thing. So EMS machines or units, like, you know, Compex unit, for example, is what I use that stimulates your muscle motor nerves, and a TENS device is going to stimulate your sensory nerve endings. So that's the difference between the two. So I wouldn't use a TENS unit unless you're just in a ton of pain. You know, usually rotator cuff is not. It's usually low back pain or something like that that you would use a TENS unit for. And yeah, definitely for a rotator cuff proper pad, placement of the pads that you'd use for electrical muscle stimulation. And yeah, that. That can definitely help. And I've used it before with some shoulder issues I've had with tennis, and it can definitely speed up healing. I especially like to combine it with ice. So you go electrical muscle stimulation and then you put like an ice pack on top of that and that helps out quite a bit. Over on my Ben recommends page and I'll link to that in the show notes. I have a ton of other kind of things that I recommend in terms of massively speeding up healing time from a soft tissue muscle injury. So you can use like a, like a home handheld low level cold laser unit. You can get one of these like off Amazon or a lot of other places and you can just like circle that around the injured area for 10 to 15 minutes a couple times a day. That can work really well. Using topical anti inflammatory. I really like topical magnesium. Taking like a transdermal magnesium oil and rubbing that into the injured area that can improve your blood flow. It can also displace a lot of the calcium that tends to cause some of the soreness and inhibit some of the healing in the area. Using like a natural oral anti inflammatory. I'm a big, big fan of one called phenocaine. It's kind of like my alternative to using an ibuprofen or a non steroidal anti inflammatory drug. And that's just basically curcumin, phenylalaniline and nattokinase. And all of those are really really good natural anti inflammatories that don't do damage to the stomach like ibuprofen does. There are a few other things you can do like a good whole foods antioxidants. Take them like a proteolytic enzyme to break up a lot of the fibrinogen and to make sure that the scar tissue doesn't get formed in a really kind of like, like in a manner that makes your shoulder less mobile. Avoiding lots of inflammatory foods like high sugar foods, high carbohydrate foods. I'll put a link in the show notes to all of my different recommendations and kind of all the different things that I'd pull out to get some to heal as fast as possible. But that's where I'd come at this from as far as that bio tools thing that was asked about. Biotools is just something that's put out by the Advocare company and that's kind of like a multi level marketing sales company that does herbal cleanses and energy bars and all this kind of stuff. And it's just a mix of some anti inflammatories. It's got some green tea leaf extract and grapeseed extract and you know, stuff like that in it. I'm a Bigger fan of phenocaine really for something like that rather than using this amino acid herbal support through Advocare, I guarantee because it's not multi level marketing. Phenocaine is probably going to be cheaper too. But that's where I'd come at this from is using something like electrical muscle stimulation, some ice, some phenocaine, topical anti inflammatory, maybe a little bit of cold level cold, low level laser and yeah, that should help you out. I tend to injure my rotator cuff about once every two or three months just from swinging a tennis racket really hard. The stuff I do.

Yeah, the combination of tennis and swimming is a bit deadly on the rotator cuff.

It's killer. I really try and keep my external rotators as strong as possible too. I do lots of, you know, like shoulder retracted, you know, seated rows, pull ups, pull downs, you know, shoulder stabilized push ups, stuff like that. So.

All right, well good luck to you Shane. Good recovery and healing. Okay, our next question comes from Sean. And Sean says I'm a fairly healthy person, but by no means an elite athlete. I find that whenever I'm make a conscious effort to stick to a six week workout program, by week three, I often get sick with the cold or flu. I'm curious to understand whether or not this is a result of the increased workout causing my body to work overtime in repairing my muscles, etc. And therefore making me more exposed to germs, etc. Or is it just a coincidence?

Yeah, big, big problem with lots of people who work out and find themselves coming down with a cold or flu every once in a while. And that's just basically your immune system getting overloaded with the amount of training that you're doing. And no offense Shaun, but just you not recovering properly. So I interviewed the guys from restwise on a previous podcast. I'll put a link to that podcast in the show notes. But they track multiple markers of recovery. Now I talked about heart rate variability as one that, that I personally track. But you can track your morning resting heart rate. You can look at fluctuations in your body weight, meaning if you're losing more than about 2% or so of your body weight on any given day, that's an indicator of potential lack of recovery and a potential that you could be getting sick if you're not careful and you don't start backing off. They measure sleep, they measure oxygen saturation, which is this little fingertip thing that you can put on your finger and measure how much your oxygen saturation is every morning. If it's less than 95%. That's a red flag. Hydration and just like peeing yellow or orange is another red flag. Lack of appetite, high muscle soreness, low energy level, low mood state and low well being. Those are all the things that restwise track tracks. I'm not saying that you got to go like use the restwise system every day to try and predict when you're going to get sick, but just by being aware of some of the basic markers, doing something like taking your morning resting heart rate or paying attention to your body mass, or seeing how you're sleeping, these are the type of things that can indicate whether or not you're going to get sick. And the whole fitness deal is a process of breakdown and recovery. But if the breakdown happens over and over again to the point where you're not able to bounce back adequately, you'll start to see some of the red flags pop up. And some of these markers that I just mentioned, and that would be the indication that if you're not careful, your body is going to get sick pretty soon. And that's where you back off. You throw in some easy rest days, you let your body recover and then once you're recovered, you go back into it. And that's really how you go through a stair stepping process of getting fitter and fitter as weeks or months or years progress. So that's where I come at this from, is start testing and tracking some basic markers of recovery. And when you begin to see those markers show some red flags, that doesn't mean that you're sick, but it means that your immune system is getting to a state where you could get sick if you're not careful. And so you adjust accordingly and move on. And so you're kind of using a predictive process rather than just kind of waiting until you get sick. There's a ton of other things that we could touch on like nutritional deficiencies and whether or not you've got proper gut health, which is where most of your immune system is, et cetera. But that's really where I'd start, is just begin tracking what point is your body getting to that broken down state and beginning to back off accordingly when that happens.

I used to have the same problem, Sean and I found actually when I went from buying the scheduled workouts like getting the 16 weeks to full marathon and just following that diligently because it said I needed to run X amount on X day and followed it religiously, I'd get sick all the time too. As soon as I started, actually Coaching myself and taking a little more of the onus on on me to sort of go, you know what? I felt pretty crappy after this run. I'm going to move this run around. I'm going to make this one a little shorter and even more so. When I started working with professional coaches that would only give me my workouts like one week in advance and never like sort of pile it all on top of me that this problem went completely away. I actually find that I rarely ever get sick anymore. It's actually kind of the opposite. So it's interesting. Interesting the way the body reacts.

Yep.

Okay, so our next question comes from Brendan. And Brendan says, and Brendan, I am totally with you, man. I have a very high sweat rate. It's ridiculous. In warmer months you can't draft behind me. I've been there. I know most likely it's a genetic item. Yet wanted to ensure there wasn't something homeopathic or completely safe and natural I was more missing. I'm clear on how I simply need to hydrate more, supplementing electrolytes and minerals. Yet would love to find something that helps me retain this stuff in the first place. Very costly and significant disadvantage in comparison to my more sweat efficient competition. You get the picture.

Yeah. So you're the guy I'm riding a bike behind who getting like a free shower from so high sweat rate can be an issue. I'm actually in the middle of a really good book, Tim Noakes new book called Waterlogged in which he discusses things like sweat rate and hydration very comprehensively. Highly recommend that book. I'll link to it in the show notes for you Brendan. But when it comes to sweat rate, it's almost all genetic. I mean a big part of it is your actual metabolic rate but that of course is also genetic and there's not much you can do aside from like basically like Botox injection kind of your sweat rate and lower it and then like surgery can clip some of the nerves that are involved with sweating. Obviously both of those procedures also mean that you're completely shutting down your ability to cool yourself, which is, is where this sweating mechanism kind of comes from in the first place. So pretty much any homeopathic remedies that are going to decrease stress rates or sorry, sweat rate, first of all, I'm not aware of any. And second of all, if there are any, that probably means they're going to decrease your ability to cool yourself adequately. And so I would be really, really careful with anything like that. Just, just as it's going to shut down performance, I would instead simply focus on making sure that you're keeping your mineral levels really taken care of. I use a trace mineral supplement now. Double up on that during something like the week of a hot race. And it's just like liquid trace minerals. So that's not like a salt capsule. That's all of these little micro minerals that your body needs for daily metabolic function that can get exhausted more quickly if you tend to sweat more, because that's one of your. One of the main ways that you lose minerals in addition to respiration, that can be a good idea. So getting on like a good trace mineral supplement, and then as far as competition goes, just making sure that you're not driving a high loss of sodium or perhaps even a higher sweat rate by consuming lots and lots of salty foods, sports drinks, tons of salt caps, things of that nature. As we learned, we interviewed Tim Noakes a few months ago, the more electrolytes that you consume during competition, the greater your rate of acute sodium loss is going to be. And that may drive an increase in sweat rates or urine rates. That's something else to be careful with. Ultimately, though, there's no real way to make yourself sweat less without also deleteriously affecting your body's ability to cool itself.

When you did. Which race was it? Las Vegas last year. And you used that ice vest and those crazy gloves and the hat with the painter's hat, Would that be something that he could be be looking at as well?

You know, that is a good point. I mean, obviously sweating is one of a human being's primary methods of cooling, in addition to, interestingly, and I learned this in Tim Noakes book that I just mentioned, simply being an animal that walks on two feet when the sun is at its zenith at its high point, that reduces your sun exposure by something like 40% just being on two feet instead of being an animal that crawls on all fours. So it's interesting how much sun exposure kind of affects this, but yeah, introducing some little bio hacks that you can use to keep your body cooler, that could help. Palm cooling device, for example, which are like these frozen devices, they'll stay cold for like 40 or 50 minutes. You hang on to them when you're exercising in hot weather, and they cool blood as it passes through your hand. That can help. Cooling vest, cooling sleeves or hats, they're infused with xylitol that drops your body temp by about 10 to 15 degrees when water hits. These things that can help to keep you cooler, and that would potentially decrease Your actual need to sweat. The question is, from a logistical standpoint, how much of this do you want to use when you're just out on the average training session? Maybe not that much. But yeah, during. During a race or during a hot event, these things could certainly help as well. So, yeah, thanks for bringing that up, Brock. It's a good point.

As I remember all your, all your crazy stuff that you had lined up for that race. I don't know if you used everything, but it sounded like you were going to look like a bit of a rodeo clown.

I did. I used everything during that race. I had a. Well, I was writing an article for Lava magazine and so I was just totally geeked out. I had the, this ice vest and palm cooling device and the hat and the arm sleeves and everything. And then I was doing ice slushies at every stop. And yeah, hell, it's kind of this fine line between enjoying what you're doing and not being so preoccupied with cooling your body that you're just not enjoying the process of just being out there and racing and competing. And that's where I certainly felt like I got to that level. So a month later when I did Ironman Hawaii, I ditched the palm cooling device, I ditched the ice vest. I just wore arm cooling sleeves and then this hat with the xylitol infused in it. And that was something that certainly doable, helped to keep me cool, but didn't take quite as much management and didn't look quite as propeller head ish as wearing ice cooling vest and the cooling device.

Awesome. Well, we're really dragging this out, so we should probably move on to our final question from Doug. Doug actually has a question for Graham Turner. Graham, you may remember, was on the show a while ago. He was on the podcast and he's also one of the coaches at Pacific.

Elite fitness.net yeah, Graham was the guy who came on and did a podcast and I'll link to it in the show notes for you about running drills and why running drills are bad. And he basically gave some alternatives to popular running drills that are better running drills. Great guy, knowledgeable coach. He'll actually be with us on the Thailand triathlon trip. He's going to be there with some of the athletes that he works with and. Yeah, I guess you can go ahead with the question, Brock.

Yeah, so the question from Doug is, I have a question for Graham Turner. There was a podcast done with Ben and Graham concerning running drills. One of the comments that Graham mentioned was that he had had all the cartilage in his knees removed and is now running better than ever. My question concerns my wife, who, due to tears and arthritis, has either none or little cartilage left in her knees. Graham is running while my wife can barely walk due to pain and swelling. What I'm trying to find out is how and why. Then he goes on a little bit more here, but basically just comes down to the fact that at age 43, she's too young for knee replacements. And they believe that it'll probably wear out too quickly anyway because the average knee replacement only lasts a maximum of 10 years and you can only have it done twice. So they feel like they're running out of options. And just wanted to get some feedback from Graham and also from you, Ben, if you had any. Anything to throw in before we let Graham answer.

You know, I. I decided to just send this one over to Graham's direction because he has a really cool story. You know, he really, really was able to overcome this same cartilage type of degradation in his knees. And he does a ton of triathlons now. He's training for a marathon. So turned it over to him and let's see what he has to say.

Hi, Doug. Ben has asked me to have a look into your question. And in the situation with the arthritis and the lack of cartilage in the knee, I'd really suggest looking at it from three different angles. The first one would be from a dietary perspective. Now, one of my clients, who's actually in her 70s, has recently dropped her arthritis medication. And the way we did this was by changing her diet. And we changed that in two ways. First of all was to take out the inflammatory foods within her diet, because arthritis is basically an inflammation within the body. So to keep it simple for them, the rule was don't eat white. So we took out all the white sugar, white flour, white rice, white pasta, even white potatoes, just to take all the inflammatory foods out of her diet. Secondly was to increase the fats within her diet. Fats are used to transport calcium around the body. And what this allowed us to do was to reduce a lot of the build up around the joints. So from one perspective, we're reducing the build up. From the other perspective, we're reducing the inflammation. And we found that after about eight weeks, the. The pain had actually subsided to the point where they could stop taking their medication. The second direction I'd come at this from is around strengthening the muscles around the knee. So by the sounds of it, your wife would struggle for your traditional, like, leg extensions and Things like that. So what I'd look at is things like straight legged, raised, where you attach a theraband to an object, you attach the other end to the ankle and then you raise the leg in front of you, but keeping it straight rather than bending it. And what this does, it actually creates an isometric contraction around the knee. And that will help strengthen the knee basically by providing a bit more support to it. The third area that I'd look at after diet and also the strengthening is around trying to create some range of motion. Obviously things like walking is quite painful. What I would look at is doing some light things like for example, on an exercise bike, but standing up. So what that's going to do is still give a small amount of movement within the knee, but not as drastic as say, sitting down on the bike. The other thing to look at, and this is kind of my go to tool when it comes to injuries, is an elliptical trainer because obviously that gives us a similar motion to walking or running, but obviously without the impact. The one thing that I'd really highlight though is not all elliptical trainers are the same. And a number that I've seen actually highlight the extension of the foot out in front of the body. So it's really important when you're looking at elliptical trainers to actually look at them from the side in motion and look at are they actually mimicking the natural running stride in terms of, of keeping the foot underneath the center of gravity, or are they actually extending out in front? And like I said, a lot of trainers, elliptical trainers actually have quite incorrect motions for people. So if you can get one that is actually basically rotating in the right angles for you, it's going to be a good low impact way of creating that range of motion. So again, there are three areas. Reduce the inflammation within the joints by removing the inflammatory foods in the diet. In simple terms, cutting out the white, strengthening the knee and doing that using isometric contractions rather than knee bends to start with and then looking at increasing range of motion using an exercise bike, standing up or using a correct form of an elliptical trainer. Hope that helps. Let us know how you go.

All right, well, that wraps it up. I enjoyed having a third accent on the on the podcast too.

Covered the globe between us, Canada and Australia on this one. So thanks to. And again, we'll link to everything that we talked about over in the show Notes for this episode. Episode number one, right?

Yep.

@Bengreenfoot.Com so head over there to check that out. It's nice to be back. Shouldn't be skipping too many podcasts in the future. But again, if you're gonna be down at Hawaii 70.3 next weekend, be sure to say hello. And we will be back to our normal podcasting routine and back with another podcast next week. So thanks for listening. Leave a review over on itunes if you get a chance. And until next time, this is Ben and Brock signing out from BenGreenfieldFitness.com.

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