April 21, 2010

Podcast #91 from https://bengreenfieldfitness.com/2010/04/episode-91-cramping-everything-you-need-to-know/

Introduction: 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, carb loading, staying fit through injuries and more on mini fasts.

Ben: 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 Web site this week, you’ll notice that I’m 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 I’m going to be shooting you a free Gym Stick, you’ll get an hour of fitness and nutrition consulting with me, a free yearlong membership and access to all the passed 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 photos, side photo 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 now 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 that 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 Shownotes to this episode, podcast episode number 91. Wow, we’re almost to 100. And in today’s episode, the special guest is going to be Dr. 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 cramping, now you’re going to find out exactly what the doc has to say. Lots of good questions today as well, so we’re going to jump right in to this week’s content from www.bengreenfieldfitness.com.

The first question for this week comes from listener BJ.

BJ asks: 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 levels at various times before and after meals. I’ve never gotten a rating 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 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?

Ben answers: Great question, and let me first of all say that insulin gets a really bad rep, and I’ve probably even been guilty of 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. 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. 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 the insulin in the body, you would completely eliminate your ability to store energy in your muscle and basically you would die. 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 you would get from eating lots of starches and sugars and eating too much food in general 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 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. What insulin resistance is when the cell surface receptors for insulin – specifically on your muscle cells or most importantly in your muscle cells don’t respond to the effects 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 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 that 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 carbohydrates 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 have 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 bullet proof to a lot of things that you could take in. There’s even research that goes beyond that and shows that people for several hours after exercise – in 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 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 an 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 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. 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 top 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.

Thomas asks: I recently signed up for your podcast and am 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?

Ben answers: 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 and soreness as well as strains. And that’s called the eccentric phase of exercise. Any time 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 types 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 less. So what are some of the things you should be 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 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.

Phil asks: I’m currently training for Ironman Corti’lane 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 I should be doing to keep as strong as possible during this time? I can lift weights as long as they aren’t too heavy.

Ben answers: 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 would cause you to hold your breath and put more pressure internally on the area in which you – I’m assuming – herniated. Herniated… you may have torn your abdominal muscle as well. But either way, you need to avoid those types 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 put you through an active range of motion that shorten or lengthen that muscle versus an isometric range of motion in which under no pressure or body weight pressure might be okay.  So front planks, side planks – those types of exercises if given clearance by your doctor 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 can 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 weight lifting will help out with that quite a bit. So that’s what I would do if I were in your boots.

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 three 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. That’s like 2500 calories of carbs for 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?

Ben answers: 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 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 carbohydrate should be used during training versus after training?”

So as far as carbohydrate loading goes, kind of the classic carbo 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 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. Then 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 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 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 carbohydrates there to four hours before a race. 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 to four hours at that point. And so what I recommend is closer to two hours which still gives you that gastric emptying and then just a quick snack right before the race. 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 – the high blood sugar – gives you problems, but it sure does with me. And I have a lot of other people I’ve talked to who just feel like they have that sugar high going and then they’re at a low below a 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 they 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 the sweet potato, the yam or 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 low glycemic index and then go with the sweeter sugars, the higher 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 a concentrated branch chain amino acid protolytic enzyme source called Recoveries. I throw that in as well and it works wonders.

Greg asks: I was wondering if you could provide some advice on what type of wheels I should get for my tri-bike? I recently demo-ed a pair of high end carbon tubular wheels and was blown away by the performance, but many folks say 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 race but others are saying I should go with a clincher tire since the performance gap is not that big anymore. Any thoughts?

Ben answers: Well, just a real quick clarification for those of you listening. The tubular 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’ve flatted and put that new pre-glued tire on and then keep your fingers cross so that glue is going to hold on to the rim well enough for you to be able to corner without tire slippage. They can actually be – if you really get the method down – quicker to change than a clincher. And the other thing about the tubular 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 method 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 it’s a little bit more of a 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 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’s always a risk, but that’s racing. And then with the clinchers – 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 tubular – clinchers are definitely less expensive. They’re like half the cost of a tubular. It’s easy 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 tubular and I’m actually very tempted myself to switch to the clinchers just based on the – 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 tubular in my training so I’m probably going to switch to the clinchers. 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 decide to go for 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 ago 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 greens supplement from Trader Joe’s that was more cost-effective. However shortly after taking the Trader’s Joe version, I experienced the same itchy skin and rash symptoms. Would I have had to detox again if I was already taking the EnerPrime but switched to another greens supplement? Does the other greens supplement release different toxins and how do I tell the quality or the difference in the quality between the greens supplements?

Ben answers: It is not necessarily completely due to detoxification, Tina, that you experienced 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 hay and grass type additives to these greens supplements and it’s possible that the second one that you took contained some elements that the EnerPrime did not contain. So the detox effect is not the only culprit when it comes to a rash or an itchy skin. It can just be a new nutrient or a 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. When a company is GMP certified, that simply means that they are held to certain standards and they’re quality management standards and the 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 it on the label, look for the manufacturer of the product. Check out their Web site, call them on the phone. I did some research on EnerPrime and it is produced by one of the world’s leaders in what’s called micro-algae technology. These are 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 back order because I happen to know that the company that puts it out IMPaX refuses to use any other sources other than the sources that they currently use and so sometimes if 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 EnerPrime. So ultimately what I’m saying is that your supplement from Trader’s Joe, it doesn’t necessarily mean that because it’s less expensive, 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. I really haven’t found any other greens supplement that I feel like I can feel the effects of EnerPrime 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.

Tina asks: 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.

Ben answers: Well, physiologically, the mini fasts were done with an aerobic workout meaning that subjects – and if you didn’t hear about the mini fasts, 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 just typically 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 mini fast 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 I have with weightlifting is that if you’re in a glycogen depleted 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 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. That kind of returns to the other part of this, is that in the mini fast they continued to fast for a couple of hours after they did that aerobics session and when weightlifting, you fast for a couple of 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 go get something in 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, it’s a sign that you’re probably pretty hypoglycemic I wouldn’t  be weightlifting in that state just because of the detrimental performance effects.

Diana 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 other energy drinks and it seems to be better for me.

Ben answers: Well you guys have kind of heard me rip into a lot of energy drinks on this show before based off the ingredients they have. If you didn’t listen to the interview I did on Red Bull last week, go to www.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 and 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 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 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. It’s not like I never eat chemicals, but if it’s something that you’re going to be taking on a regular basis – if you’re going to shoot this once a week as a little bit of an energy boost before you, I don’t 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 listening how to analyze energy drinks.

Ben: A question from Kelly. Kelly has a very long question but ultimately what her question comes down to… if you want to read her entire question go listen to the Shownotes, 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 tends to break down the snot that kind of collects 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 in the yeast in apple cider and turning it 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 it as a digestive tonic. And I got to 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. As far as 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. 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 research study done in Sweden where people consumed two tablespoons of vinegar with a high carb meal and their blood sugar was about 23% lower than when they skipped the vinegar. So there is some anecdotal research here – not even anecdotal research – some small studies that suggest 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 that even though it tastes acidic or you 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 I break down their diet. I also do month long nutritional overhauls with people where we do four phone calls 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 that 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, things 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 are 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 [email protected] if you have a question. Skype Pacific Fit or call toll free to 8772099439 and we’re going to move on to this week’s interview on cramping with Dr. Pascal.

Ben: 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 health care physician. He’s almost a former world class runner and has a very good reputation as a leader in health care. 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 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 about today. So, Dr. Pascal, thanks for coming on the call.

Dr. Pascal: You’re very welcome. Thank you for having me.

Ben: 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?

Dr. Pascal: Yeah, the two most common causes of cramping are dehydration – not enough fluid on board – and then an imbalance in your electrolytes. 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 prophylactic care before you work out.

Ben: Okay. So if electrolyte imbalance 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?

Dr. Pascal: Yeah. That’s a great question. Of course electrolytes are key and we’ll 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 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 one ounce of water for every pound of body weight per day.

Ben: One ounce of water for every pound of body weight per day. So again like me at 175 pounds, I should be focusing on 175 ounces of water? Wow.

Dr. Pascal: Absolutely. So you’ve got to be drinking a lot all the time, and of course on a hot day, you’re going to want to drink even more.

Ben: Now this seems to be a little bit contrary to what I’ve heard in terms of taking your body weight, dividing that in half and drinking that many ounces per day. You’re saying that should be having almost twice as much?

Dr. Pascal: 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 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 one ounce per pound, you’re going to be a lot better off athletically.

Ben: 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 in someone who may even feel like they’re hydrating properly. But what about certain foods? Are there foods you’re aware of that would raise or lower your risk of cramping that you might want to avoid before athletic activity?

Dr. Pascal: 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 off that ratio because you have to realize the main factor for muscle contraction is calcium. And, the electrolyte or mineral that causes the muscle to relax is magnesium and so the more calcium that you have in your diet then the more you will throw that balance out.

Ben: 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?

Dr. Pascal: That’s absolutely correct. So food that is fairly high in calcium of course are 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, that’s going to be the green, green food. So your dark green vegetables are going to be a lot better for you.

Ben: Now what about – and this might just be an old wives’ tale – 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?

Dr. Pascal: Yeah, you know, there are a lot of trainers – athletic trainers – that use pickle juice prophylactically. They’ll say take one or two ounces of pickle juice because what it is going to do is it is 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. And the exact mechanism of that why 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 is going to have to balance it, so it’s going to hold more water to try and neutralize that acidity that you just did to your body by drinking the pickle juice. So then that goes back to the first thing that I said about hydration level. When you drink the pickle juice, it’s going to make your body hold in more water. That’s going to help those muscles be better hydrated and then that’s going to decrease that risk of cramping.

Ben: 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 table salt okay? What exactly should you look for?

Dr. Pascal: Yeah, that’s… 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. 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 breathing and running in all our wonderful air pollution – those are all sorts of chemical stress or under emotional or mental stress. This is a very stressful planet. All of those things cause the body to burn more magnesium. So most people than become deficient in magnesium, and then you start to cramp. So I like to put my athletes on a magnesium supplement. So we use Calm from Natural Vitality. Sometimes if they’re – like most women, we’ll 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.

Ben: 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?

Dr. Pascal: Yeah, I have. Like the winner of the New York City Marathon is my patient. That’s Keflezighi and he’s actually going to be running in Boston on Monday. So that would be a good example. A marathon runner, you need to look at maintaining those electrolytes. So out on that course, everything then that he takes into his body or you have a cyclist that’s out on a couple hours bike ride, it’s very important that you are supplementing. And the thing that gets most overlooked, because people will be taking a sodium and potassium – potassium is very often very looked. 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 is typically it’s packaged as cell salts or like Natural Vitality has a liquid trace mineral supplement that works very well.

Ben: 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?

Dr. Pascal: Yeah, like my athletes 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. So although it prevents you from cramping and it rehydrates you and handles your electrolyte 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 with like Natural Vitality, they have a product called Organic Life Vitamins. So it’s a liquid multivitamin and then they’ll add Natural Life minerals which is a 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.

Ben: Awesome. Well, you know, I’m a big fan of the Natural Calm products. I have those over at www.pacificfit.net, one of the Web sites where I coach athletes as something I encourage my athletes to use. But do you ever incorporate salt capsules or pills, specifically two of the ones that I know that are used in the market are Endurolytes and Athlytes. Have you ever had an athlete – or do you yourself know much about those?

Dr. Pascal: I don’t. I haven’t had my athletes use those products. I don’t have them go out of their way to supplement salts but I don’t work with… maybe if you’re an ultra marathoner and thing like that – but those aren’t the athletes that I typically work with, you know?

Ben: Gotcha. But you have found liquid mineral supplementation to be effective in staving off cramps for endurance athletes?

Dr. Pascal: Absolutely.

Ben: 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?

Dr. Pascal: Yeah. Well, of course another associated factor with cramping that’s well known is that muscle fatigue. But you know, when you have a muscle that’s low in glucose and you’ve worked out all of its 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 burned through all those electrolytes, it does cramp. So when a person says, well 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 or electrolyte issue?

Ben: It makes sense, yeah.

Dr. Pascal: And so from my experience, you’re back to those electrolytes and fluid ratios.

Ben: 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 that you talked about magnesium being a co-factor for calcium but would something like magnesium help with calcium leakage?

Dr. Pascal: 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 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 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 magnesium sources and the magnesium is in the bone. So it will go in and literally pull the magnesium out of the bone to bind with the calcium that was just ingested. And so in our effort to take more calcium to increase bone density, we are actually ultimately leeching more calcium out of the body because we’re losing that binding agent of the magnesium.

Ben: Gotcha. So basically I guess we’re returning full circle to the question about muscular fatigue. That 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.

Dr. Pascal: That’s right and so I found that 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 and help metabolize it out of those tissues.

Ben: Now in terms of the transport of fluids into muscles being inhibited or somehow delivery of the electrolytes to the muscles being inhibited – is that a valid theory? 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?

Dr. Pascal: Well, that’s a little bit tougher. 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.

Ben: Now have you ever come across in your practice any type of factor that would predispose an athlete to someone 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.

Dr. Pascal: 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 compete in Beijing and they won 10 gold medals, 5 silver medals, 5 bronze medals so we’re pretty used to seeing elite athletes. One of the things that even those guys have are allergies. And so, about a third of my practice are allergy patients and what we’ve 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. So you could have a person that is sensitive to calcium, just like you could have a person who’s sensitive to a peanut or they can be sensitive to an egg. 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 sensitive issue with like calcium and then the body is unable to properly absorb calcium or they’re sensitive to magnesium and the body cannot properly absorb magnesium for any electrolyte, any mineral. And so then if your body can’t properly absorb, metabolize its basic nutrients than you can get a deficiency there which would then develop into – that would be more that 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, antibiotic reaction and that test is not sensitive enough to detect an underlying sensitivity to a mineral. So seeing a doctor that uses a more sensitive energetic type diagnostic test like that’s using applied kinesiology muscle testing to test out the body’s sensitivities to these different minerals would uncover that.

Ben: Okay, that makes sense. Now moving on to kind of the logistics of 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 there and then? What are the strategies that an athlete could utilize?

Dr. Pascal: 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. Then they usually will stop in five to 30 seconds. If you’ve got some magnesium right there or there’s some pickle juice right there, then take that right away too and that 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. And that will handle that individual cramp right then. Now, if you’re racing, let’s say it’s the Olympic trials or this big meet 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 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. So whether you stop or not depends on how important it is. 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’s running the 10,000 meters and he cramped up and he felt like “Hey this is the 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 that’s the risk you take.

Ben: 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 rang a piece of clothing that had some sweat and get a little bit of that under your tongue or something like that? Can that actually help? Are there any claims to that?

Dr. Pascal: That’s a great question. I haven’t heard that one before. But you know, if you’re not out there and there’s nothing there, then certainly then 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’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.

Ben: Gotcha. So basically what this comes down to is setting yourself up pre-events to actually prophylactically 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’ve got to stop, you can try taking minerals, try massage, something of that nature. Is that kind of where we’re going with this?

Dr. Pascal: Absolutely. An ounce of precaution is worth a pound of cure.

Ben: Alright, and oh 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?

Dr. Pascal: 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? And I don’t believe 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. You know?

Ben: Okay, because there are usually trace amounts of minerals in those gels anyway.

Dr. Pascal: Right. Yeah. Usually, a lot of those energy gels, they’ve thought about that and they put a fair amount of minerals in them.

Ben: Alright, 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?

Dr. Pascal: I ran 3:59.

Ben: Nice. Nice. And you’re coaching a bunch of world class athletes, obviously. One for Boston and 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?

Dr. Pascal: I don’t run into it much because we make a big deal about it.

Ben: Because you’re just very into these trace minerals and prophylactic measures.

Dr. Pascal: Right. Because with these athletes, they can’t – this is what they do for a living. This is what they train for, for decades, 24 hours a day. That’s their only thought. So, when we go to a US Championship or an Olympic Games or World Championship, I wake up in the morning and I’m sending them a text. “Hey, you know, take your products.” When I see them for breakfast, “Hey did you take your stuff? Alright.” When we’re out on that bus to the stadium, “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 that he forgot, then that’s on me too because it would be such an easy thing to have reminded him and I don’t want to have someone lose a chance of winning a medal, you know, for such a simple thing. So we’re always on them.

Ben: Well, prior to our discussion today, I actually didn’t really know that you were a fan of these Peter Gillham Natural Vitality supplements as one of the measures that you take. It’s interesting because I’ve interviewed a couple of other people on electrolytes and magnesium and they’ve all mentioned the Natural Calm, some of the other products made by Peter Gillham. So that 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.

Dr. Pascal: 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, you know? This past summer we had the latest World Track and Field Championships in Berlin. One-third of all the medals that the US team won were my athletes.

Ben: Wow.

Dr. Pascal: 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 Gillham’s products and that’s because their quality control is so good. Their products are as natural as can be and they work. And that’s the bottom line, is they have to work.

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

For personal nutrition, fitness or triathlon consulting, supplements, books or DVD’s from Ben Greenfield, please visit Pacific Elite Fitness at http://www.pacificfit.net