Episode #91: Cramping – Everything You Need to Know

In this podcast episode, cramping insulin, exercising your calves, Apple cider vinegar for fat loss, the Spark energy drink, Analyzing supplement quality bike tire choices, car bloating, staying fit through injuries, and more on mini fasts.

Welcome to the BenGreenfieldFitness.com podcast. We provide you with free exercise, nutrition, weight loss and wellness advice from the top fitness experts in the nation. So whether you're an Ironman triathlete or you're just trying to shed a few pounds, get ready for non run of the mill cutting edge content from BenGreenfield Fitness.com.

Hey podcast listeners, this is Ben Greenfield. Spring is rolling around, which means summer is almost here. And if you have not yet checked out the website this week you'll notice that I am launching the 2010 Summer Body Challenge. Not only am I going to be giving away 300 bucks to the person who shows me in photos the best progress between May and August, but but I'm gonna be shooting you a free gym stick. You'll get an hour of fitness and nutrition consulting with me, a free year long membership and access to all the past archives of my body Transformation Club. A lot of cool stuff and all you have to do is join the Body Transformation Club. So it's basically a $7 entry fee and then from there on out you send your photo, you send your video, front photo, side photo, and then, and then the video is just a short 30 to 60 second clip and from there on out you will be getting postcards from me every week between May and August. And at the beginning of August you'll send in your follow up photos, follow up video, I will judge and then I'll put 300 bucks in an envelope, send you a free gym stick, hook you up with the hour of fitness and nutrition consulting and give you the free membership. And that's all you have to do. So check out the 2010 Summer Body Challenge. Just click on the link in the show notes. So this episode podcast episode number 91. Wow, we're almost to 100. And in today's episode, the special guest is gonna be Dr. Pascal. Pascal. Pascal. I think I called him Dr. Pascal. I don't know, I hope I called him by his correct name. But he is going to be talking about cramping. He's coached a lot of world class athletes. I get a lot of questions about cramp. Now you're going to find out exactly what the doc has to say. A lot of good questions today as well. So we're going to jump right into this Week's content from BenGreenfieldFitness.com.

Special Announcements.

Well, I already told you about the 2010 Summer Body Challenge, so you know about that special announcement. Just a couple of other things. Remember that you can text the word Fitness to 411247 as an information 24. 7 text word Fitness to 411247. You'll be a member of my VIP text club for free. And that club goes way beyond in terms of some of the free stuff and the discounts that I sent out. If you're a member, you already know you've gotten 50 to 75% discounts on a bunch of stuff free books from me that I usually sell and also send out a huge discount on my camp, my triathlon camp just the other day as well. So if you don't have a phone and you want to sign up for the VIP Tax Club, just go to the Show Notes for this podcast episode number number 91 and you'll be able to do that. It's right there in front of you. As far as other special announcements, I am going to put a link in the Show Notes that show you exactly what it looks like when you send me your swimming video, your biking video, your running video, and I analyze that live and give you feedback. I'll put a link in the Show Notes where you can check and see what that feedback actually looks like. I recently have done a few coaching sessions and I'll pick one of those videos, shoot you a link so you can check it out. Let's go ahead and move on to a big Listener Q and A today. And as you're listening in, remember if you have questions you can email Ben greenfieldfitness.com you can call to 877-209-9439 and that's toll free. Or you can Skype to Skype Username Pacific Fit.

Listener q and a.

The first question for this week comes from Listener BJ and BJ says, I've found through both blood tests and saliva tests that my fasting insulin level and insulin level after a meal are both so low as to be undetectable. My endocrinologist gave me a glucose meter, which I've used to check my blood glucose level at various times before and after meals. I've never gotten a reading that was abnormal for the time it was taken in relation to a meal, so it seems I'm producing enough insulin even though my insulin levels are low. My doctor suggests I may have insulin hypersensitivity and that I just don't need much insulin to keep my blood sugar regulated. I know that insulin is important in building muscle. Can having low insulin, such as I do, hinder my athletic performance? Is it common for generally fit people to have low insulin levels? And should I be concerned about this or just consider it normal for me? Great question. And let me first of all say that insulin gets a really bad rap, and I've probably even been guilty on this show of making you think that all insulin does is make you fat. But insulin is technically an anabolic hormone. And when I use the word anabolic, that means that it promotes things like cellular growth, repair, recovery, tissue, basically tissue formation, such as of muscle fibers, because it stuffs nutrients like amino acids and carbohydrates that you eat into muscle cells. Now, insulin is actually released into your bloodstream by an organ called your pancreas, and that's one of the main functions of your pancreas. Now, insulin functions as basically a storage hormone, which means that it acts to transport carbohydrates such as glucose or sugars, as well as amino acids from the proteins that you eat and the fats from the food that you eat into the cells of your body. And if you happen to be completely overstuffed or have lots of carbohydrates or lots of calories floating around, then the muscles will get stuffed pretty quickly. And after that, insulin ends up moving most of those compounds into the liver, where they can be converted, for example, into triglycerides and stored as fat. So if you could actually eliminate all of the insulin in the body, you would completely eliminate your ability to store energy in your muscle and, well, basically you would die. I mean, that's what a type 1 diabetic is, is they can't produce that insulin. And if that's left untreated, they do die. They have to take insulin. But if you could get rid of insulin, you would basically not be able to ever recover from any of your exercise sessions. Now, if your blood insulin levels are too high, on the other hand, that can be an issue. And multiple clinical studies have shown that chronic elevation of your insulin levels, such as the type that you would get from eating lots of starches and sugars and eating too much food in general can, can lead to obesity, cardiovascular risk, and most importantly, type 2 diabetes. So don't get me wrong, you need insulin, but you have to learn how to balance the effects, and specifically the anabolic or the muscle growth effects of insulin, with the fat storage effects of insulin. So before we address the issue of insulin sensitivity with you, let's Talk about the problem that more people have, and that's insulin resistance. And what insulin resistance is, is when the cell surface receptors for insulin specifically on your muscle cells, or most importantly on your muscle cells, don't respond to the effect of normal levels of insulin, so they resist the effect of insulin. And then what happens is your pancreas just releases more insulin and more insulin to try and get these cells to store the nutrients. You get chronically high levels of circulating insulin, and that is insulin resistance. It can be genetically based. It can also be induced by constantly high circulating levels of blood sugar. But either way, it eventually leads to type 2 diabetes. Now, insulin sensitivity, on the other hand, is actually a pretty good thing. The reason is because your muscle cells will respond to very small levels of insulin. So it's not like you have a problem with producing insulin, it's just that you don't need very much insulin to get into that anabolic state, that state where your muscles take up the carbohydrate and the amino acids very efficiently. So at the muscle level, high insulin sensitivity is, it's a very good thing, and you don't need to be concerned about that. Now, the amount of insulin sensitivity that individuals have can be manipulated, meaning that you could genetically be born with high insulin sensitivity, but exercise makes you sensitive to insulin. And that's why in about the 20 minutes after you exercise, you're essentially bulletproof to a lot of the things that you could take in. And there's even research that goes beyond that and shows that people for several hours after exercise, and one study up to 22 hours after exercise, had better sensitivity to insulin and were able to get away, so to speak, with eating either higher sugar based meals or just more calories in general. That's why another thing that you need to place importance on, if you're listening to this, is not just exercising once and then sitting around the rest of the day, but getting up, moving around, being physically active as much as possible. Sometimes I'll split an hour and a half long exercise session into three half hour sessions throughout the day. So I'm just amping up my insulin sensitivity throughout the day frequently. And if I'm eating frequently, there's that much more energy getting uptaken into my muscle. So both aerobic training and weightlifting are going to increase your insulin sensitivity. Things in your diet can increase your insulin sensitivity. Specifically omega 3 fatty acids like the flax oils or the fish oils, chromium or vanadium. Those are two supplements that are in a fat burning supplement I recommend called Thermo factor, those will improve insulin sensitivity. Alpha lipoic acid is another supplement that can increase insulin sensitivity. And any diet that has a lot of fiber in it can also help out quite a bit. And the interesting thing is that there's actually some research that shows that a low carb, high fat diet, like a super high fat diet, can actually decrease insulin sensitivity.

So there you go.

If you're really concerned about your insulin sensitivity and you want to get it to go down, just start eating really low carbs and really high fat meals. So basically what the ultimate answer to your question is is that if you're actually producing enough insulin, then the fact that your body is very sensitive to it is not a red flag for me. I'm not a doctor, but insulin sensitivity is great for muscle growth and response. Now you ask, can having low insulin hinder athletic performance? Yes, it could. But your problem isn't low insulin. Your problem is insulin sensitivity, and that's not a problem. As far as your other question, is it common for generally fit people to have low insulin levels? Yes. People who exercise will have low insulin levels because they're more sensitive to the circulating levels of insulin. So the pancreas just produces less. I would, if you're not experiencing problems with your blood glucose levels, not be too concerned about your issue. Again, I'm not a doctor, but I'm really not that concerned. And insulin sensitivity, for the most part, is a good thing. And I would actually like to congratulate you, bj, because even though you're the first question I responded to, I'm nominating you as the top question for this week's podcast. So you're going to get a free month of membership to my Body Transformation Club. If you're listening in, email me and I will give you full access to the club's secret video page. A life changing mail from me every single week with fitness and nutrition tips. And you can just send me an email and I'll hook you up. So we're going to move on to a question from listener Thomas. And Thomas says, I recently signed up for your podcast and I'm finally all in for this fitness push. I've recently had tremendous problems with my calf muscles. My calf muscles are approximately 20 inches in circumference, and for those of you listening in, that's huge. I'm constantly straining them and pulling them as I start to push myself with exercise. I'm signing up for your 2010 Summer Body Contest in May. Can you make any suggestions? Absolutely. As you lose weight, you'll put a little less stress on your calves. But anytime that you're exercising, there's a certain phase of exercise that actually causes the micro tears which can lead to discomfort, soreness as well as strains. And that's called the eccentric phase of exercise. Anytime you're lowering yourself or slowing yourself down or producing impact, you are engaging in an eccentric contraction. If I were you, I would completely avoid those type of contractions on your calves until your weight has dropped to the point where either your calf muscles are smaller in circumference or you weigh. So what are some of the things you should be avoiding? Avoiding high impact running light jogging or walking would probably be okay. Interestingly, the treadmill versus running outside is going to decrease the ground reaction forces just a little bit. Give a little less strain on your calf than running outdoors would. I would avoid stepping down. I would avoid the lowering phase of squats and the lowering phase of calf raises.

I would.

I would be careful with anything that involves jumping and landing. If you're doing any type of plyometrics, I would limit those and I would focus instead on upright, bicycling, recumbent bicycling and elliptical for your cardiovascular modes. Swimming, if you do swim, would also be fantastic. And then I would focus when you are lifting on any exercise that uses your calf muscle. Don't worry about controlling the lowering phase of that lift. Actually let your body accelerate through it pretty quickly. So avoid those eccentric activities for the calves and that will help you out quite a bit with the strains and you'll still be able to lose weight without actually doing a lot of that impact based stuff. Just save that for until you weigh a little less. Now listener Phil asks. I'm currently training for Ironman Coeur d' Alene in June. Last week I had unexpected surgery on my abdominal area and the surgeon has grounded me from anything except spinning on a trainer for two weeks. What should I be doing to keep as strong as possible during this time? I can lift weights as long as they aren't too heavy. First of all, let's talk about what you should not be doing, Phil. And that would be anything that places a stress on the abdominal area, any type of abdominal flexion, crunches, V ups, things of that nature, as well as any heavy weights that will cause you to hold your breath and put more pressure internally on the area in which you, I'm assuming, herniated so well herniated, you might have torn your abdominal muscle as well. But either way you need to avoid those type of things, which means that most of the core exercises you do are going to have to kind of be put on hold, especially core exercises that take you through an active range of motion that shorten and lengthen that muscle versus an isometric range of motion which under no pressure or body weight pressure might be okay. So front planks, side planks, those type exercises, if given clearance by your doc, would be okay. Crunches, V ups like I mentioned, not such a good idea. If I were you and I were in your shoes, I would be putting together a machine based circuit where you're sitting down where the exercises are controlled. So you would pick for example, eight machines at your gym like the chest press, the shoulder press, the pull down, the seated row, leg extension, leg curl, leg adductor and leg abductor. And you go through those eight exercises with minimal rest, focusing on using a lighter weight and doing about three to four circuits. So you're really hitting a lot of your cardiovascular endurance while at the same time maintaining some of that lean muscle, which is going to be super important. I would also recommend that you, of course, as you mentioned, keep on spinning. And I'm assuming because of any surgical wounds you need to avoid swimming, but the light weightlifting will help out with that quite a bit. So that's what I would do if I were in your boots. Listener Chuck asks I read an article recently that talked about a new way of carbo loading. It did not mention what distance it was referring to, but the article suggested that instead of doing a traditional load over a few days to instead do a very hard 3 minute exercise bout followed with 30 seconds at maximal speed 24 hours before a race. Then for the next 24 hours eat only 10 grams of carbohydrate per kilogram of body weight leading up to the race. Let's see, 10 grams of carbohydrate per kilogram of body weight. So that's still a lot of carbs. It's like 2,500 calories of carbs for or a day. Not bad. I guess that is loading. I was wondering what your thoughts on this were and if I got it right, what was the article saying? Well, that's a great question. I actually haven't talked about carb loading for a little while on this show, although I have mentioned that study that you refer to Chuck in previous episodes of the podcast. So basically let's talk a little bit about this. And actually you had a follow up question that I'll address in my answer to this question and your follow up question asked what type of carbohydrates should be used during training versus after training. So as far as carbohydrate loading goes, kind of the classic carbohydrate loading model would be about three days of not taking in many carbohydrates at all, about 60 to 100 grams per day, which for those of you who want to do that gram conversion, there are 4 calories per gram. So we'd be talking about 240 to 400 calories of carbohydrate per day. Very low. And you combine that with exhaustive exercise that takes you to the point where you've depleted your carbohydrate stores. And then once you've got all of your enzymes responsible for taking up carbohydrate into muscle tissue super starved and ready to suck up lots of carbohydrate, you do three days or or up to six days of a very high carbohydrate intake, up to about 85 to 90% of your total caloric intake. While you at the same time taper and reduce your training volume, you get what's called glycogen super compensation. And that allows you to store up to 60% more carbohydrate than you'd be able to under normal conditions. And of course the benefit to this is that means you can go longer and possibly harder in your training. Now when you look at recent studies, they've not only found that you can get similar carbohydrate absorption without going so deep into that depletion phase, and they've also found, as you mentioned in the study that you referenced, that you can just do a day before the race, a super hard series of 30 second sprints and then go into a high, high amount of carbohydrate intake after those sprints. So what this comes down to is there's more than one way to skin a cat. I personally, just because it's almost become like a traditional thing for me, getting ready for a race, maybe almost a little bit superstitious, but I like to do the depleting load a week before the race and then go low carb for about three days and then start to amp up my carbohydrate intake for four days, works like a charm for me every time, so I just keep doing it. But your method or the other method that I, that I mentioned, just increasing the carbohydrate intake without going through that depletion phase could also work just fine. Now as far as your pre exercise and your post exercise carbohydrate Intake. Most of the recent research doesn't really show that there's going to be a huge issue in taking in like a high glycemic index carb versus a low glycemic index carb. But typically you'd want to take in about 150 to a little over 300 grams of carbohydrate three to four hours before a race and. Or I'm sorry, before an endurance performance event. Now, the issue with that is that's what the research shows. But I find with most of my clients that they get hungry if they wait three, three to four hours at that point. And so what I recommend is closer to two hours, which still gets you that gastric emptying and then just a quick snack right before the race. And I'm not too particular on whether it's high glycemic index or low glycemic index. I'm a bigger fan of getting in if you're going to take in a 600-calorie meal two hours before the race, of going after something that's not just like chocolate and fruit juice, just because I find that for me, my energy levels drop. Research may not show that that hypoglycemic response to the high blood sugar gives you problems, but it sure does in me. And I have a lot of other people I've talked to who just feel like they get that sugar high going and then they're at a low before the race. So I go after the sweet potato, yam, that type of carbohydrate pre race and then post. That's when the sweeter sugars really feel like they give you a quick, quick boost in sugar and the higher glycemic index carbohydrates are definitely encouraged. Although you're so insulin sensitive right after an exercise event, we already talked about that, that you could still do like the sweet potato, the yam, or a super low glycemic index carbohydrate, a quinoa, a legume, and still get really good glycogen absorption and amino acid uptake. So ultimately what it comes down to is big meal two hours before, get the blood sugar levels up with, for example, a gel directly beforehand. And if you find that you're sugar sensitive, try and keep that pre race or pre event meal, low glycemic index, and then go with the sweeter sugars, the high glycemic index foods after. But if you want to do the beans and rice instead, probably not going to be that big of a deal. So hopefully that helps out. And of course make sure you get your protein in post race or post event as well. And you can also throw in my little secret weapon. I use like a concentrated branched chain amino acid proteolytic enzyme source called recoveries. I throw that in as well and it works wonders. So I got a question from Greg and Greg asks, I was wondering if you could provide some advice on what type of wheels I should get for my trip. I recently demoed a pair of high end carbon tubular wheels and was blown away by the performance. But many folks that say that I shouldn't use tubulars for racing since they're difficult to repair and could cost you the race if you flat. I will never podium, so I'm willing to take the risk. But others are saying I should go with a clincher tire since the performance gap is not that big anymore. Any thoughts? Well, just a real quick clarification for those of you listening, the tubulars are also called the sew ups. Those are the tires that have the tubes kind of already inside of them and you pre glue them and then put them onto your bike. They attach to the rim of your bike wheel. And then for your flat repair on the tubular, you carry another pre glued tire and you basically rip the entire tubular tire off when you want to change it after you flatted and put that new preglued tire on. And then keep your fingers crossed that that glue is gonna hold onto the rim well enough for you to be able to corner without tire slippage. And you know, they can actually be, if you really get the method down, quicker to change than a clincher. And the other thing about the tubulars is that even though they're more expensive and a little bit harder to change, they're lighter. They tend to have a higher inflation limit than most clinchers, so you can get better rolling resistance. They do get fewer flats because you don't get that tube pinching against the tire like you do in a clincher. And I find that it's a little bit more comfortable ride. What I do during a race is rather than messing around with changing the entire tubular, I just carry this stuff called Vittoria Pit stop, inject some foam followed by a little bit of CO2 into the tubular and that does the trick. I've had it work once and I've had it be a complete failure another time. So there is always a risk, but that's racing. And then with the clinchers, you know, the clinchers can be easier intuitively to change because you just Rip out the tube, put in the new tube and fill it up versus doing all the pre gluing, fitting and fretting type of thing that you have to do with the tubulars. Clinchers are definitely less expensive. A lot of them are like half the cost of a tubular and it's easier to carry what you need for a flat. A tubular tire takes up a lot more room than a clincher tube, but the clinchers are heavier. Some of them you can't fill up quite as high and some people say they're not quite as comfortable. You can also get that pinching between the tube and the tire which can cause a second flat right after you get your first flat. Now the high end clinchers, from everything that I've read in terms of the reviews on the new clinchers, those are almost just as good as the new tubulars. And I'm actually very tempted myself to to switch to the clinchers just based on the I I think they're easier to change personally, and I'm probably going to switch to using a power tap power meter, which means I'll be using the same wheels for training as I am for racing and I really don't want to be using tubulars in my training, so I'm probably going to switch to the clinchers. You know, ultimately if you go for a high end clincher, you're going to get the same benefits as you do from a tubular. If you don't decide to go with a tubular, make sure that you know how to change it and carry some of that vittoria pit stop with you and you should be good to go. So good question. Tina asks I've been using your recommended greens supplement Enerprime for about two months now and I'm really enjoying the energy and the feeling of wellness I get from it. As you mentioned on your podcast, I did experience about four weeks of very itchy skin and a mild rash as I released the toxins from my body, which eventually subsided. Since Enerprime can be expensive, I decided to try another green supplement from Trader Joe's that was more cost effective. However, shortly after taking the Trader Joe's version, I experienced the same itchy skin and rash symptoms. Would I have had to detox again if I was already taking the Ener prime but then switched to another green supplement? Does the other green supplement release different toxins and and how do I tell the quality in the or the difference in the quality between the green supplements? It is not necessarily completely due to detoxification, Tina, that you experience an itch and a rash. It could also be an allergenic response to something that your body was not quite used to. There's a lot of kind of hay and grass type of additives to these green supplements. And it's possible that the second one that you took contains some elements that the Enterprime did not contain. So the detox effect is not the only culprit when it comes to like a, like a rash or an itchy skin. It can just be the new nutrient or the new compound that you're putting into your body that it basically just doesn't know how to deal with and eventually develops a tolerance to as you take more of it. Now, as far as analyzing the quality, it's very simple. What you need to look for is that the company that makes your supplement is GMP certified. And when a company is GMP certified, that simply means that they are held to certain standards and they're actually, they're quality management standards and supplements. Company has to jump through several hoops to actually get GMP certified. So you can check for GMP certification on the label. If you don't see on the label, look for the manufacturer of the product. Check out their website, call them on the phone. I did some research on Enterprime and it is produced by one of the world's leaders in what's called microalgae technology. They use a very, very high quality spirulina out of Hawaii and all of the ingredients are high, high quality. That's why a lot of times this stuff goes into backorder, because I happen to know the company that puts it out, Impacts, refuses to use any other sources other than the sources that they currently use. And so sometimes if, you know, let's say they get a low batch of spirulina, then that means they just don't make the supplement until they get the quality of the ingredient that they put into the Enterprime. So ultimately what I'm saying is that your supplement from Trader Joe's, it doesn't necessarily mean that because it's less expensive that it's, that it's inferior. But I would do some research and check and see what lab makes it, make sure they're GMP certified and then go from there. And I really haven't found any other green supplement that I, that I feel like I can feel the effects of Enterprime. And that's why I continue to take that either in the powder form or the capsule form, pretty much whatever I can get my hands on. And then you have a follow up question. You say you talked about mini fasts with a 30 to 45 minute aerobic cardio session to burn extra fat. Would you recommend this mini fast if you were also doing weight training? I like this concept, but I only work out in the early mornings and I'd like your opinion on how to do workouts and use these mini fasts optimally. Well, physiologically, the mini fasts were done with an aerobic workout, meaning that subjects and if you didn't hear about the mini fast, listen to podcast number 90. But subjects did a mini fast. They included an aerobic exercise session of about 45 minutes during the mini fast. And aerobic means that your body is primarily using fat as a fuel and you're not in an oxygen deprived state. Weightlifting is typically just the opposite of that weightlifting. You're using almost purely muscle glycogen and you are in an anaerobic state the entire time. Now, I suppose there's a little bit of an aerobic effect because your heart rate is high between sets and you kind of go aerobic when you're not actually lifting the weight itself. But the minifast study didn't look at weightlifting, so I can't say from a research perspective whether or not you're going to see the same effect. The only issue that I have with weightlifting is that if you're in a glycogen depleted state state, you're able to lift a lot less and produce a much lower contraction. So you're not doing yourself any favors if it comes to getting stronger if you're lifting starved. I do not recommend weightlifting for fat loss in the direct sense that I don't recommend you go weightlift when you're super energy depleted to burn a little extra fat. Use a light aerobic session for that. Make sure that you weightlift when your body has something in it or is going to get something in it immediately after. And that kind of returns to the other part of this is that in the mini fast they continue to fast for a couple hours after they did that aerobic session. And with weightlifting, you fast for a couple hours, you completely miss your glycogen and amino acid window for refueling and you essentially just get much, much lower benefits than you would normally be able to out of the weightlifting. So I wouldn't recommend it. I would recommend if you're going to weightlift, do this, go to bed, get up, go do your weightlifting and then get something into your body within 20 minutes after. So a little bit of a modification of that mini fast. But if you get a good solid post workout meal in, you'll be okay. Just don't be too starved. And if you're super hungry, as soon as you start weightlifting, sign that you're probably pretty hypoglycemic. I wouldn't be weightlifting in that state just because of the performance or the detrimental performance effects. So Deanna asks, I have a question. I just recently tried a sample of an energy drink called Spark, made by a company called Advocare. Is this an okay energy drink? Because I really liked it better than any of the energy drinks and it seems to be better for me. Well, you guys have heard me kind of rip into a lot of energy drinks on this show before based off the ingredients that they have. And if you didn't listen to the interview I did on Red Bull last week week, go to BenGreenfieldFitness.com, scroll down just a few posts below this episode, episode number 91 and check out the shocking interview that I did on Red Bull. But this Spark energy drink, you know, it has a lot of the ingredients that a lot of the other energy drinks do in it. It's got the B vitamin complex, it's got the taurine, the tyrosine, some of those energy boosting amino acids. It's got the choline caffeine. I'm looking at the label right here. Caffeine, 120 milligrams, about four times what I take in my energy drink. So you're getting the caffeine kick, the central nervous system stimulation, the potential for adrenal fatigue. That's one red flag. But not as big a red flag for me as the fact that it says no sugar. My red flags go off as soon as I see that advertisement. And sure enough, you go to the label and they've added sucralose into it, folks. I just don't recommend that you take in artificial sweeteners. Sucralose is a kind of a glucose molecule that has chlorine added for a couple of the hydroxy groups. And there's been some research done in rats per se, but research that shows that it can damage some of the good bacteria in your stomach. And the other issue with the sucralose is it's a chemical. And I, you know, it's not like I never eat chemicals, but if it's something you're going to be taking on a regular basis, you know, if you're going to shoot this once a week as a little bit of an energy boost before you I don't know, you know, go do your hardest workout of the week. Not a big deal, but this is again, not something I would be taking in every day, frequently due to the high caffeine content and the level of artificial sweetener. So hopefully frequent listeners are learning how to analyze energy drinks. Question from Kelly. Kelly is a very long question, but ultimately what her question comes down to. If you want to read her entire question, go listen to the show notes. But she says after going on and on about this weight loss plateau that she's on, if she uses a natural supplement like apple cider vinegar, would it help her to lose weight? So apple cider vinegar, which I happen to have in my pantry and I use it when I'm congested actually, because it's, it tends to break down the snot that kind of collects around in your ducts and in your throat. Apple cider vinegar, it's basically kind of a dark cloudy vinegar. It's made by breaking down the bacteria and the yeast in apple cider and turning into alcohol and then into vinegar. And it's been used kind of as a cure all holistic folk medicine type of remedy for a long time. It's really rich in potassium and a lot of people swear by it in terms of destroying harmful bacteria in the digestive tract or using as a digestive tonic. And you know, I gotta admit, when my stomach hurts a little bit, I take a probiotic. I also will shoot a couple shots of apple cider vinegar and it seems to help out now as far as fit fat loss. Apple cider vinegar has also become pretty popular as a fat burner and as an appetite suppressant. I think it works as an appetite suppressant just because the stuff tastes so nasty. You don't want to eat anything else after you've tried it out. But the idea is that some of the enzymes, the vitamins, the potassium in it are supposedly supposed to help with weight loss. And there's a really small study done a few years ago that found that people that ate a piece of bread and then ate some vinegar with it felt more full and more satiated than the people who ate the bread and didn't eat any vinegar. And it's possible that that's due to the lowering of the glycemic index of the carbohydrate by the vinegar. And there was a more recent study done in Sweden where people consumed two tablespoons of a vinegar with a high carb meal and their blood Sugar was about 23% lower than when they skipped the vinegar. So there's some anecdotal research here, not even anecdotal research, some small studies that suggest that, that apple cider vinegar could have an effect on your blood sugar levels, which could indirectly affect your weight. The other thing about the apple cider vinegar is even though it tastes acidic or you would think it's acidic, it's actually a quite alkaline food once you consume it. And so if you're looking at an acid alkaline balance perspective type of issue, trying to balance out your cortisol levels, trying to reduce inflammation, it would be considered another one of those alkalinic foods that you could consume. So ultimately, apple cider vinegar is going to be one of those things that might give you a little extra percentage here, an extra percentage there. Usually I find when I do nutritional consultations with people, and that's just, you know, people hire me to do 20, 30 minute nutrition consultations where they send me their diet logs and, and I break down their diet. I also do month long nutritional overhauls with people where we do four phone calls during the week and I just go or during the month and I go over everything with them. Typically, I find out that these little things like supplements are very, very small compared to some big red flags that we find, like testing people for allergies and finding out they're allergic to half the things that they're eating, or finding out that there's a severe amount of overtraining going on and the testosterone cortisol ratios are off. So usually a little supplement is not a culprit. Now, there can be some big red flags like you're not taking any magnesium, you're not taking any vitamin D, and you're deficient in both of those, which tends to really affect energy levels and weight. And when you start to add up stuff like that, that tends to be an issue. But a little thing like apple cider vinegar, I'm guessing there's some bigger issues going on that that's not going to completely eliminate. So. Good question. That about wraps up our questions for this week. So remember, you can email me ben greenfieldfitness.com if you have a question, Skype, Pacific Fit, or call toll free to 877-209-9439. And we're going to move on to this week's interview on cramping with Dr. Pascal.

Featured topic.

Hey podcast listeners, this is Ben Greenfield and I'm here today with Dr. Pascal and he's a graduate of UCLA and Palmer Chiropractic College and he's licensed as A primary healthcare physician, he's also a former world class runner and has a very good reputation as a leader in healthcare. He's been in Time, Newsweek, Sports Illustrated, Bicycling Magazine, and multiple newspapers and radio and television specials. He's been the treating doctor at hundreds of athletic events including the Olympic Games, the World Track and Field Championships, the World Gymnastics, Gymnastics Championships, European Track and Field Championships, PGA Golf Tour, US Olympic Track and Field Trials, Pro Beach Volleyball Tour, and the US National Track and Field Championships. He knows quite a bit about exercise and the problems that athletes face. And he also knows quite a bit about cramping, which is what we're going to be talking to or talking about today. So, Dr. Pascal, thanks for coming on the call.

You're very welcome. Thank you for having me.

Well, I suppose we should just cut straight to the chase because this is something that baffles some people. And that would be exactly what the cause factors are for cramps. So when someone's out exercising, what exactly causes the muscle to cramp or what multiple factors could cause the muscle to cramp?

Yeah, the two most common causes of cramping are, is dehydration, not enough fluid on board, and then an imbalance in your electrolyte. So the bad news is when you get a cramp, it can definitely affect your physiologic function, your athletic performance. But the good news is most cramps can be totally prevented if you take a little pretty prophylactic care before you work out.

Okay, so if electrolyte imbalances cause cramps, do you think that would be the only issue that could cause something like a cramp? Or is there anything else that an athlete should be aware of in your opinion?

That's a great question. Of course, electrolytes are key and we will certainly get into that. But the other thing is just being well hydrated. Most people do not drink enough water during the course of the day. They may be drinking fluids all day long, thinking that fluid intake is the same as water intake. But the typical person drinking fluids is drinking sodas which are loaded in salts, and that is going to be throwing off your electrolyte and balance. And also they're drinking caffeine, which again is going to actually make you more dehydrated since it tends to act as a diuretic. So when we talk about proper hydration, we're talking about you as a normal person should have at least 1 ounce of water for every pound of body weight per day.

One ounce of water for every pound of body weight per day. So a guy like me at 175 pounds, I should be focusing on 175 ounces of water.

Absolutely. So you're going to be drinking a lot, all the time. And of course on a hot day, you're going to want to drink even more.

Now this seems to be a little bit contrary to what I've heard. In terms of taking your body weight different, dividing that in half and drinking that many ounces per day, you're saying that people should have almost twice as much.

That is true. People that are exercising need to have a lot of water on board. And you have to realize that 70% of your body is water. And the way that all the nutrients get into every single cell is through food fluid. And the way that all the waste products get out of all the cells is also through that fluid medium. And so it's very important to try to shoot for that. If you can get over that 50% level, more toward 1 ounce per pound, you're going to be a lot better off.

Interesting. Okay, now when someone is drinking the soda and caffeinated beverages, obviously like you say, that's going to be a causation factor for cramps and someone who may even feel like they're hydrating properly. But what about certain foods? Are there foods that you're aware of that would raise or lower your risk of cramping that you might want to avoid before athletic activity?

That's a great question. If you have food that is high in calcium, high in potassium, high in sodium, those are the things that tend to throw up that ratio. Because you have to realize the main factor for muscle contraction is calcium. And the electrolyte or the mineral that causes the muscle contract to relax is magnesium. And so the more calcium that you have in your diet, then the more you will throw that balance out.

Interesting. So there could actually be an issue if you're taking a lot of calcium supplements or have a lot of calcium sources in your diet and you're not balancing that out with other mineral sources.

That's absolutely correct. So food that is fairly high in calcium, of course is going to be like milk products, cheeses, those are all pretty high. And if you're going to look at trying to bring down that acidic rate, that acidic balance, and get a little bit more magnesium, then that's going to be those green, green foods. So your dark green vegetables are going to be a lot better for you.

Now what about, and this might be just an old wives tale, but what about pickle juice? I've actually Seen that come up every once in a while and been asked by a couple of people whether pickle juice would actually assist with cramping. Do you have an opinion for something like that?

Yeah, there are a lot of trainers, athletic trainers that use pickle juice to prophylactically, let's say, take one or two ounces of pickle juice, because what it is going to do is it's going to pickle juice is very acidic. It's way down there at about 3.2, 3.7. Water, of course, is neutral at 7.0. The exact mechanism of why that makes such a huge difference isn't known. What I personally think is that when you take in all that pickle juice, then your body's going to have to try to balance it so it's going to hold more water and so try to neutralize that acidity that you just did to your body by drinking the pickle juice. And so then that goes back to the first thing that I said about hydration level. So when you drink the pickle juice, it's going to make your body hold in more water. That's going to help, you know, those muscles be better hydrated and then that's gonna decrease that risk of cramping.

Dr. Now, in addition to pickle juice, salt pills are also something that I know a lot of people utilize. Is the actual ingredient profile on the salt pill that you use important? In other words, should somebody be looking for something beyond sodium chloride or is just, you know, like table salt okay, or what exactly should you look for?

I don't really like table salt to handle cramping. I found that the biggest factor besides hydration for cramping is that you don't have enough magnesium in the body. Magnesium is responsible for over 350 different physiologic functions in your body. And it's actually the stress mineral. So when your body is under physical stress, like you're training a lot, it's under chemical stress. You drink a cup of coffee or you drink a beer or you're out running and breathing in all our wonderful air pollution. Those are all sorts of chemical stress or under emotional or mental stress. It's a very stressful planet. All of those things cause the body to burn more magnesium. Most people then become deficient in magnesium and then you start to cramp. I like to put my athletes on a magnesium supplement. So we use calm from natural vitality. Sometimes if they're like most women will put them on a pure magnesium for men. For male athletes, I put them On a little bit of calcium as well, like calm plus calcium. So it's two thirds magnesium, one third calcium.

Now, do you ever have any of your athletes go out and do a competition where they actually have to have salt out there in the competition with them, like a long bike ride or something of that nature?

Yeah, I have, like the winner of the New York City Marathon is my patient, and he's actually going to be running in Boston on Monday. And so that would be a good example. You know, marathon runner, you need to look at maintaining those electrolytes so out on that course than everything that he takes into his body. Or you have a cyclist that's out on a couple hour bike ride. It's very important that you are supplementing the thing that gets most overlooked, because people will be taking sodium and potassium. Potassium is very often overlooked. But the last thing are your trace minerals. We have these little tiny electrolytes with all those fancy names that people tend to forget about, like cadmium and boron to take a trace mineral supplement. Typically it's packaged as cell salts.

Or.

Like Natural Vitality has a liquid trace mineral supplement that works very well.

And you're simply mixing that mineral in with the liquid that the athlete is consuming during exercise. Or are they carrying that in a small vial with them while they're out there?

Yeah, like my athletes that are out on a. That are working out on a track, for example, they'll mix their own. They'll make their own version of Gatorade. I don't really like Gatorade because there are some things in there that can actually, although they help with your electrolyte balance, they can block cellular repair, Although it prevents you from cramping and it rehydrates you and handles your electrolyte and imbalances. It also slows down your recovery and your repair. So it helps you in some areas, it hurts you in others. So I have the athletes that I work with make their own concoction of a multivitamin. Again, like with Natural Vitality, they have a product called Organic Life vitamin. So it's a multi. Multivitamin liquid multivitamin. And then they'll add natural life minerals, which is the liquid trace minerals, and also add a little bit of the calm plus calcium. So that's the magnesium with a little bit of calcium. And they just mix it all into a big thing of water and they drink that as they work out.

Awesome. Well, you know, I'm a big fan of the natural calm products. I have Those over at PacificFit.net, one of the websites where I coach athletes as something I encourage my athletes to use. But do you ever incorporate like salt capsules or pills specifically? Two of the ones I know that are used on the market are enduro lites and athletes. Have you ever had an athlete or do you yourself know much about those?

I don't. I haven't had my athletes use those products. I don't have them go out of their way to supplement salt. But I don't work with like maybe if you're an ultra marathoner, something like that then. But those aren't the athletes that I typically work with, you know.

Yeah, gotcha. But you have found liquid mineral supplementation to be effective in staving off cramps for endurance athletes.

Absolutely.

Interesting.

Now, as far as the cramp goes, I know we talked a little bit about dehydration being a factor for cramping, but I also get the question about whether there can be factors related to muscle fatigue. Like if a muscle is contracting over and over again, firing being activated, is there anything that could happen at the muscle level or the cellular level that could cause that cramp even if an athlete were well hydrated?

Yeah. Well, of course another associated factor with cramping that's well known is that muscle fatigue. But when you have a muscle that's low in glucose and you've worked out all of this energy and all that ATP and it's totally dead, it doesn't tend to cramp. But when you have a muscle that's been overused and it's dehydrated and you burn through all those electrolytes, it does cramp. When you say, when a person says whelp, overuse of a muscle causes muscle cramping, on the one hand, yes, it's true. But what's going on? Is it the overuse and you've gone through all the energy source, all the ATP is gone, or is it a hydration and electrolyte issue?

It makes sense.

And so from my experience, you're back to those electrolytes and fluid ratios.

Gotcha. Now, the calcium leakage that occurs while someone is out exercising, it's been proposed in many studies that that's responsible for not only the post exercise soreness, but also some of the fatigue that occurs during exercise. If you have a bunch of calcium leaking into your tissue as you're working out, is that something that can be controlled? I know you talked about magnesium being a co factor for calcium, but would something like magnesium help with calcium leakage?

Absolutely. Because magnesium Binds to calcium. So, as a matter of fact, when we look at bone density, when we compare the American population and. And their typical diet with England and their calcium intake in the United States, the typical person has a much, much higher calcium intake in their diet. And yet our levels of osteoporosis, you know, bone loss, decreased bone density, is much higher. And you would. You would think that if we're having more calcium in our diet, that we would have a lower level of osteoporosis, a higher amount of bone density. But what happens is when you take in calcium and you don't have magnesium to bind with it, then the body actually looks around and says, okay, this person just ate all this calcium, ingested all this calcium. We need magnesium to bind with it. So it looks around the body for a magnesium source. The magnesium is in the bone. It will go and literally pull the magnesium out of the bone to bind with the calcium that was just ingested. In our effort to take more calcium to increase bone density, we are actually ultimately leaching more calcium out of the body because we're losing that binding agent of the magnesium.

Gotcha. So basically, I guess returning full circle to the question about muscular fatigue, even if a muscle is tired and it's not necessarily a problem with the athlete being dehydrated, they could benefit from some type of mineral at that point, or prophylactic mineral up to that point.

That's right. And so I found since calcium is that main factor, like you said, when it leaks into the tissues, it makes them very sore. Then we want to supplement with that magnesium to help bind that calcium, help metabolize it out of those tissues.

Now, in terms of the transport of fluids into muscle, muscles being inhibited, or somehow delivery of the electrolytes to the muscles being inhibited, Is that a valid theory? I mean, could something like that actually happen in an athlete where they're taking in electrolytes or taking in water, but there's something going on that's not allowing muscle to actually get what you're giving it?

Well, that's a little bit tougher. You know, the body works very hard to maintain balance, to maintain this homeostasis. And that gatekeeper of the cell wall is that sodium potassium pump. So the potential exists, I guess, if your sodium potassium levels are so off that then that door cannot open and close properly that you are going to inhibit that absorption of water.

Now, have you ever come across in your practice any type of factor that would predispose an athlete to something like that? If someone's Thinking, well, gosh, I hydrate and I take my electrolytes. Maybe I have some type of medical problem with my pumps, so to speak.

I have not seen that. What I have seen is like in our practice, although we have a fairly large sports medicine practice, I had 43 of my athletes competed in Beijing and they won 10 gold medals, five silver medals, by bronze medals. So we're pretty used to seeing elite athletes. One of the things that even those guys have are allergies. About a third of my practice are allergy patients. And what we found, and the technique of allergy elimination that we use is we found that a person can actually be sensitive to or allergic to any substance. You can have a person that is sensitive to calcium, just like you can have a person that's sensitive to a peanut, or they can be sensitive to eggs. They eat an egg, they get blotches all over their face, or they eat a peanut and they go into anaphylactic shock. Those are allergic reactions. Well, you can have a sensitivity issue like with calcium and then, and the body is unable to properly absorb calcium, or they're sensitive to magnesium and the body cannot properly absorb magnesium or any electrolyte, any mineral. Then if your body can't properly absorb, metabolize its basic nutrients, then you can get a deficiency there which would then develop into that would be more that medical, underlying medical condition. The problem with going to your typical MD to get tested though, is they're going to be doing a blood test for that classic allergy reaction, allergic reaction, antibody reaction. And that test is not sensitive enough to detect underlying sensitivity to a mineral. So seeing a doctor that uses a more sensitive, energetic type diagnostic test that's using applied kinesiology muscle testing to test out the body's sensitivities to these different minerals would uncover that.

Okay, that makes sense. Now moving on to kind of the logistics of the, the actual cramp occurring. Let's say it's actually happened regardless of whether or not the athlete has taken on some of these measures to make sure it doesn't happen, it happens. Now, what do you recommend to your athletes? Stop and massage, completely stop and stretch. Take electrolytes right then and there. What are the strategies that an athlete could utilize?

Right. It depends on the situation. You know, if you're in a workout and it's not that big of a deal that you stop, then you need to stop and stretch. Do a passive elongation of that muscle to break its spasm. That's going to be the best, quickest way to stop that spasm, and they usually will stop in five to 30 seconds. If you've got some magnesium right there or some pickle juice right there, then take that right away. Of course, it takes a little while for the body to absorb it, so put it under your tongue, keep it there for 30, 60 seconds, then swallow it. That will handle that individual cramp right then. Now, if you're racing, let's say it's the Olympic trials or the big meet that you've been or competition that you've been working toward for the last six months, that is not really a place where you want to stop, right? So if it's an abdominal cramp, one of the most effective things is to kind of try to stretch the abdominal muscles by rolling. So, like leaning to one side, trying to lean back, lean to the opposite side, bend over a little bit all the time while you're running, or if you're on a bike, sit up in that saddle and try to rotate that torso. You're going to slow down, but slowing down is better than stopping. And usually if you'll do that for 10 or 20 seconds, it'll break that spasm. If it's in a leg and you're running or in some competition where you don't want to stop, if you've got some magnesium nearby, hopefully you've got it in your water bottle on your bike, or the water that you're running with, or you go by a station, then get those electrolytes on board as quickly as possible. Whether you stop or not depends on how important it. Now, of course, if you keep running, you run the risk of tearing a muscle. I had one athlete. We were at the world championships for track and field in Helsinki in 2005. He was running the 10,000 meters, and he cramped up and felt like, hey, this is a world championship. I'm trying to get a medal here. And he kept running, and he ended up tearing the muscle and being out for a year. But, you know, that's the risk you take.

Now, this is an interesting question that I've gotten, but I'm wondering if this would help at all. If you're stuck out there without any salt, let's just say you find yourself between a rock and a hard place. What if you lick your skin or you wring a piece of clothing that had some sweat on it and get a little bit of that under your tongue or something like that? Can that actually help? Is there any credence to that?

That's a great question. I haven't heard that one Before. But, you know, if you're out there and there's nothing there, then certainly that would be better than nothing you might get. Obviously, when you're sweating and you've got that salt caked on your arm that those are, you know, that's what you've lost. So you can get a little bit more on board. Is that enough to make a difference? I don't know. You know, if you're cramping up and you're rolled up in a ball out in the middle of the desert, then certainly that would be better than doing nothing.

Gotcha. So basically what this comes down to is setting yourself up pre events to actually profil. Get not just salt into your body, but also the entire spectrum of minerals. And then during the event, continue to take in something if it's an endurance event that gives you that full spectrum of minerals beyond just sodium. And if you do cramp, be careful because you could tear a muscle. But if you gotta stop, you can, you can try taking minerals, try massage, something of that nature. Is that kind of where we're going with this?

Absolutely. An ounce of precaution is worth a pound of cure.

All right. Oh, and then finally, I did have one other question. Let's say somebody is glycogen depleted and they're cramping. Could doing something as simple as taking in sugar help? Or at that point would they need to be taking in electrolytes along with that sugar?

Yeah, it's a different mechanism. So if they're cramping up, it's usually that goes back to that question. Is it from the muscle fatigue? I don't believe that it's from the energy from the glycogen. I think that it's a hydration and electrolyte issue. But if that's all you have, take it.

Because there are usually trace amounts of minerals in those gels anyways, right?

Yeah, usually a lot of those energies gels, they've thought about that and they put a fair amount of minerals in them.

All right, cool.

Well, just a couple of questions to kind of wrap things up. What's your fastest mile that you've run before, Dr. Pascal?

I ran 359.

Nice.

And you're coaching a bunch of world class athletes, obviously one for Boston. And you know, your bio is a million miles long, so you've worked with a lot of athletes. But is cramping an issue that you run into much with your athletes?

I don't run into it much because we make a big deal about it.

Because you're Just very into these trace minerals and prophylactic measures, Right?

Because with these athletes, they can't. This is what they do for a living. This is what they train for, you know, for decades, 24 hours a day. That's their only thought. And so when we go to a U.S. championship or an Olympic Games or World Championship, you know, I wake up in the morning and I'm sending them a text. Hey, you know, take your products. You know, when I see them for breakfast, hey, did you take your stuff? All right. You know, when we're on that bus out to the stadium, him, hey, I'm always on them. Always, always, always. Because the worst thing in the world would be for one of my guys to get out there, cramp up, not do well, and then come back and go, oh, I forgot to take such and such. And if he says that he forgot, then that's on me, too, because it would be such an easy thing to have reminded them. And I don't want to have someone lose a chance of winning a medal for such a simple thing. So we're always on them.

Well, prior to our discussion today, I actually didn't really know that you were a fan of these Peter Gillum Natural vitality supplements as one of the measures that you take. But it's interesting because I've interviewed a couple other people on electrolytes and magnesium, and they've all mentioned, you know, the natural calm, some of the other products made by the Peter Gilliam. So that's. That just kind of. Kind of confirms my suspicion that the natural vitality stuff is one of the better things out there. So that's interesting. We didn't actually plan this, if you're listening, but I'm just coming across that now.

Well, you know, along those lines, let me say this. I could use any product that I want. I'm not bound to any person or company or group or anything, but I am bound to my athletes. I want them to compete as well as possible. This past summer, we had the latest World Track and Field Championships in Berlin. One third of all the medals that the U.S. team won were my athletes. And so I take my responsibility quite seriously, and I research what I feel will put them in the best position to perform well. And to that end, the majority of the products that I have my athletes on happen to be Gillum's product. And that's because their quality control is so good. Their products are as natural as they can be, and they work. And that's the bottom line, is they have to work.

Fantastic. Well, thank you for your time. And I'll put a link to everything that we talked about in the show notes for this episode so you can go check those out. And until next time, this is Ben Greenfield and Dr. Pascal signing out.

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