Episode #194 – Full Transcript

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Podcast # 194 from https://bengreenfieldfitness.com/2012/05/episode-194-how-to-avoid-sudden-heart-attacks-while-running/

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

Brock:  Hey everybody, welcome to the BenGreenfieldFitness podcast on this great dreary day in Toronto. What’s it like where you are Ben?

Ben:  I think we flipped.  I think last time I had the whole rainy gray day thing going on down here in Spokane.  But it’s actually pretty nice.  It’s much cooler than it was in Dubai.  It’s like 85 or 90 degrees here.  I went for a run when I was over there in Dubai.  I literally had my life flash before my eyes.  They have that Abu Dhabi Triathlon over there every year in March.  And I here lots of feedback that that’s a really hot race.  And apparently it’s significantly hotter during the month that I was just there during May than it is in March.  And I went running in noon.  And I literally had a full-on liter of water with me.  And it was gone within 45 minutes.  And I was just toast.

Brock:  Well, you were what they as only mad dogs in Englishman.

Ben:  Yeah, it’s just out there.  And it’s exposed desert.

Brock:  And the triathletes I guess.

Ben:  Yes.  So, Dubai went well.  I taught a conference over there.  Basically, I was really delving into lots and lots of geeked out topics on performance, digestion, fat loss recovery, brain, sleep optimization, and hormone optimization, to a group of mixed personal trainers and folks over there who just wanted to learn more about their bodies.  And it was good.  And that’s why we didn’t have a podcast last week was because I was doing the podcast live.

Brock:  Yeah.

Ben:  But yes, it was a cool place.  And I’ll probably go back there in March for that Abu Dhabi Triathlon.

Brock:  Nice.  That’s awesome.

Ben:  Yeah.  And then I’m shoving off tomorrow to play in our local regional tennis tournament.  So, I got to pick up the tennis racquet which I’ve been neglecting for the past couple of weeks.  Then after that, I’ll be heading out to Hawaii for the Hawaii 70.3 race and a week long camp leading up to that.  So, if there are any listeners going down to do the whole new triathlon in Hawaii, come say hi.  I’ll be somewhere out there in the lava fields.

Brock:  Excellent.

Ben:  Yeah.  And probably the other quick thing I wanted to mention to folks was Getfitguy.com.  There’s a brand new book.  My book is available now in kindle form and hard copy form at a bookstore near you or at a computer near you.  And that is the full-on guide to getting fit for your body types.  So, you can check that out if you want to find out what kind of body type you are from endomorph to an ectomorph to a meso endomorph and a bunch of other tongue twister terms and determine how you should be exercising and eating for your body type.

Brock:  Yeah.  I’ve seen lots of positive feedback on Twitter and on Facebook about it so far.  So, it’s awesome.  Get a copy while you can folks.

Ben:  That’s right.  And then start getting fit for your body type.

News Flashes:

Brock:  Alright.  Let’s jump into the news flashes.  There have been all kinds of stuff going on Twitter as usual and some awesome stuff on Google+.  And I’m sure you want to highlight some of them for us.

Ben:  Yes.  As usual, our point in the show where we mention some of the latest greatest stuff I’ve been coming across in my scouring of the research.  And one thing that I wanted to mention was a study that was actually back in January.  But I just noticed it.  The title of the study is Experience with the High Intensity Sweetener Saccharin impairs glucose homeostasis and GLP-one release in rats.  The basic interpretation of that is that they took rats and they gave them artificial sweetener.  And what they found was that the artificial sweeteners could actually cause a release in gut hormones, a rather rapid release in gut hormones that affected blood sugar even though the artificial sweeteners themselves were calorie void or relatively calorie void.  So, the basic idea is that you’ve got this group of gastrointestinal hormones.  And they’re called incretins.  And those can cause insulin to get released from your pancreas and cause actual initiation of this hormonal surge that you’d normally associate with eating something.  And it happened with consumption of artificial sweeteners.  Interestingly, it can also happen through the action of just thinking about carbohydrates.

Brock:  Oh no.

Ben:  Yeah, I know.

Brock:  That’s all I think about.

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

Brock:  I think we should change the name of this podcast to bad news with Ben Greenfield.  He can’t even think about it now.  Never mind, don’t eat it.  Don’t even think about.

Ben:  That’s right.  No pink elephants, no biscotti, no scones.

Brock:  Stop it.  You’re making me fat.

Ben:  No.  But again, I’ll emphasize that this is the whole thinking about carbohydrates isn’t a big deal unless somebody is really having some blood glucose issues.  It’s having more of an issue of obese people shouldn’t be hanging out at buffets even if they’re not eating the foods.  It’s just not a good idea.

Brock:  I got you.

Ben:  Next up is a study that looked into losing fat and gaining muscle at the same time and looked at the effect of two different weight loss rates on body composition and strength and power performance in athletes.  So, they took people who were going after performance goals.  And they tried to figure out if you try and take somebody who’s trying to become faster, more powerful and stronger, and you try to let them gain strength and lose fat at the same time.  What’s the maximum amount of body weight you can lose in terms of primarily body fat that you can lose and still maintain performance gains?  And in this case they were measuring one rep max test for strength, 40-meter sprint.  Counter movement jumps which are all decent measurements of your basic performance capabilities.  And they found that the best weight loss rate was about 0.7 percent of your body weight per week.  And that’s going to vary highly from individual to individual.

Brock:  0.7 percent of your body weight.

Ben:  Yes, 0.7 percent.  So, I’m 180 pounds.  So, that’s 1.26 pounds or so.  Somebody like me on a weekly basis would be the maximum amount I’d really want to lose if I wanted to maintain performance gains.  And obviously it’s going to change from person to person.  0.7 though is the range.  If you’re losing weight a lot faster than that and you’re trying to have performance gains, you may not be doing yourself any favors unless you’re biggest loser size or morbidly obese.

Brock:  Yes.  I guess there’s always been a rule of thumb of one to two pounds a week was one of the safe amount that you should be losing if you wanted to keep the weight off.  If you lose weight too quickly, you’re rebound is way quicker.  And maybe that’s what ties in.

Ben:  Exactly.  And this tie in for 140 pound female at 2.0 per week is probably going to do you not many favors in the performance department versus the 0.7 percent.

Brock:  Yeah.  So, you’re skinny but you’re lying on the couch all day because you’re exhausted.

Ben:  Yes.  If you’re light, it might be that one pound a week is too much for you if it is performance that you’re going after.  And also it’s another reason that I recommend that people who are trying to lose weight and gain performance at the same time.  Try and split the two up in different times of the year.  So that maybe you’re trying to lose weight from January through March and not worry about performance at all.  So, you can lose weight at a rate that’s faster than 0.7 percent per week and just not even care because you do not have to go out.  And you aren’t signed up for a bunch of triathlons or other performance improvements.  Or you’re not trying to set a cross fit record or something like that.

Brock:  Yeah.  It makes sense.

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

Brock:  That’s awesome.  I keep a foam roller in my office with me.  It’s just one of those little travel-ins so I could pull it out every once in a while if I’m feeling stiff.  I think we’ve talked before that I use a standing desk.  So, it’s often after five or six hours of standing there typing, it’s nice to roll out some of the stiff spots.

Ben:  Yeah.  And that’ll probably end up being in the global sign of a BenGreenfieldFitness podcast listener is any woman walking around with a foam roller coming out of her purse.

Listener Q and A:

Brock:  Alright.  We’ve got some awesome questions.  The questions kept piling up even though we didn’t have a show last week.  It’s nice that people didn’t get upset and stop writing to us.  And especially it didn’t stop phoning us because we’ve got a ton of audio questions like this one from Chris.

Chris says:     Hey Ben and Brock.  I’ve got a question for you for a podcast topic.  We frequently hear about fellow athletes having these profound medical events where they crash.  And it is determined they have 80 to 90 percent blockage in an artery.  I personally know two fellow runners in their 40’s and 50’s who have had this occurrence.  Fortunately both survived after open heart surgery.  I am amazed that we continually hear about active, well-trained athletes who experience this near death occurrences in spite of being active.  It makes me wonder about all the efforts of preventative health care.  I understand much of this can be hereditary but am surprised when a well performing athlete crashes with no previous indicators.  I am sure that the listeners would be interested if there are test available to screen for life threatening blockages since it appears that it can strike athletes who are training and performing and show no signs in advance.  Would a stress treadmill test be an indicator test?  Either way, this seems like a topic that would be very informative to all the listeners out there.  Take care and thanks for your help.

Brock:  So, a lot of this has been in the news lately.

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

Brock:  Somebody actually passed away this weekend in Toronto at a 10k.

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

Brock:  I’ve heard you mentioned them before.  But I haven’t actually heard them outside of this show.

Ben:  Okay.  Advanced glycation end products, the abbreviation for those is AGES.  And basically the way that those form is you take a sugar from food like glucose or fructose or whatever.  And what happens is that sugar can react with proteins.  And a lot of people don’t realize this but it can also react with fats.  There’s what’s called a nitrogen group or an amino group on proteins and an amino group on fat.  And that can react with sugar especially at higher temperatures.  And it can create what’s called this advanced glycation end product.  And that in particular can really aggravate this coronary plaque formation.  So, there are two different ways that you can get exposed to advanced glycation end products.  And one would be through what’s called endogenous glycation.  And that’s glycation inside your body.  That tends to be a bigger issue in people who have diabetes.  They get a lot of what’s called endogenous glycation.  It’s when these sugars are reacting with the proteins to form these advanced glycation end products.  In people who aren’t diabetics, that’s really not as big of an issue because most of us don’t have the huge amounts of blood sugar fluctuation that the diabetics can get.  But it’s usually large fluctuations in blood sugar that can cause endogenous glycation.  For most people, it’s what’s called exogenous glycation that tends to be more of an issue.  And that’s a chemical reaction that occurs when you deep fry or you broil or you do high temperature baking at 350 degrees or more.  Barbequing can be an issue.  I cringe saying that right here in the middle of the summer when barbequing is big.  But barbequeing a lot and having that type of high heat cooking would be a really big part of your food preparation methods versus steaming and poaching and stewing and boiling.  So, when you’re looking at advanced glycation products from food, the biggest culprits are basically baked goods and meats that have been cooked really heavily.  And yes, that would include fried bacon unfortunately.  But being really careful with advanced glycation end products is a good way to help out that calcium score.  So, you minimize fluctuations in blood sugar.  And then you minimize the amount of high heat cooking that you do.  The whole issue with this tracking the plaque and that being the main reason why healthy people have heart attacks is that even though that’s the reason that a lot of healthy people can have a higher risk for a heart attack.  When you actually look at folks who are dying during extreme endurance exercise, they actually looked into this in the New England Journal of Medicine.  And this was last year.  It was actually six months ago I think.

Brock:  Wasn’t it just after the New York City triathlon?

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

Brock:  So, you’re not talking about trying to lower the stress during the actual activity or during the race but doing it for the rest of your day or the rest of your week?

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

Brock:  I think we just put all the listeners into a state that they’re now ready to hit the starting line and have a heart attack because we’ve totally stressed them out with his answer.

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

Brock:  Pretty much every question that we’ve had since I can remember that’s revolved at all around overtraining.  The same advices have really been given.  Like just keeping the stress low, and keeping those cortisol levels low.  And this is just a further extent for exemption of that.

Ben:  And it’s not rocket science.  Probably the most significant take what I would say is start tracking your heart rate variability at least start with that.  If you’re concerned about this, I personally do it now.  I track my heart rate variability.  I’m on there.  I plug the thing up to my earlobe.  It takes me five minutes.  And I can do that a few times a week and know whether or not my body is in a really stressed out state.  And like I mentioned over on the website, it was actually on an article I put out about my Wild Flower Triathlon.  It’s how I recognize my heart rate variability was low leading up to that race and what I did to fix it in terms of some of the measures I took to prevent over training.

Brock:  Cool.  I guess the one thing at the very beginning of this whole talk you said that New England Journal of Medicine Study that they found was 40 or 50 people over the year had a cardiac event.

Ben:  Something in that range.

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

Ben:  I agree.  And coming at this from a piece of mind issue, it’s just so easy to give yourself that piece of mind so why not do it.

Brock:  Yes.  It’s like looking both ways before you cross the street.  Like I probably won’t get run over but you really won’t get run over if you’re extra careful.

Ben:  So, I’ll put a link to that article in the show notes.  Is this episode number 195?

Brock:  194.

Ben:  194, okay.  So, in the show notes for episode 194, I’ll put a link to the heart math that I use for heart rate variability and also what I did before wild flower to adjust that and get it back up before I raced.

Brock:  Alright.  Let’s move on to the next question.  It’s another audio question from Tony.

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

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

Ben:  Yeah.  I think so.

Brock:  That is awesome.

Ben:  It’s like something from the 14th century.

Brock:  That is so cool.

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

Brock:  That is awesome, good, and delicious news.  Alright, let’s go onto our next question.  It’s another audio question from Josh.

Josh says:  Hi Ben, this is Josh.  I got a question for the podcast.  I’ve been having some trouble ever since I started triathlon.  It seems to be mainly during hard efforts in races.  Last year, I did a half iron man.  I thought I maybe drank too much water during the swim.  I got on the bike and had a lot of phlegm and gunk come up.  I really couldn’t breathe.  It didn’t affect me too bad though on the bike for the 56th mile.  But then, I got on the run.  And it all just flared up.  It started coming up.  It’s really big mucus type stuff.  It’s pretty gross.  And as far as thinking back because this happened last year and it’s happening again this year.  When I’m red lion it during hard efforts and doing quick workouts and stuff like that.  And when I get on the run, it really flares up.  After a while I apparently had to stop because I just cannot breathe.  I ended up having to walk about eight miles in my 70.3 because I couldn’t breathe.  So, I’m not really sure what’s contributing to it.  I was thinking back as far as dietary or supplemental stuff.  Nothing is static.  So, I don’t think that anything I’m doing as far as stuff I’m eating that’s contributing to it because everything has been different that I do on a training and race basis.  I switched up some stuff.  And supplemental, I mean there’s nothing static with that either or prescriptions.  I don’t do any prescriptions.  I don’t really know.  I don’t think it was the drinking all the water because it happened without drinking water.  So, I’m not really sure.  I’m at a loss.  And the only thing I could think of to do is pseudoephed.  But I know that that’s considered dopine for Ironman to have dopine.  So, I was just wondering if you might know.  Thanks a lot Ben.

Brock:  I’m with Josh.  I get that gunky phlegmy stuff in the back of my throat when I’m swimming especially in the pool.  And I always assume that it was coming from chlorine.  And it doesn’t usually last that long after I finished swimming.  But it’s certainly at the last half of my swim there’s just a thick gunk going on.

Ben:  Yeah.  And that could be a little bit of an allergic reaction to the combination of the chlorine with the dead skin cells that come off of people’s skin when their swimming.  It’s a similar way that sugar can combine with the amino acids in something that I just got done explaining with the advanced glycation end products.  You get chlorophene combining with these chloromines and creating allergenic compounds.  I’m actually interviewing doctors who’re really knowledgeable in water.  I’m interviewing him on Monday.  And I’ll be releasing that interview sometime in the next couple of weeks and we’re specifically going to talk about chlorine and swimming.

Brock:  Awesome.

Ben:  But mucus is your protective secretion.  It’s the slippery secretion that is secreted by and also covers your mucus membrane.  So, your stomach lining, your esophagus, pretty much anything that needs protection is going to have some mucus produced.  And mucus contains immunoglobulins to fight against allergenic compounds and things that you might be exposed to.  It’s got glycoproteins or what are called mucins that help to protect and build the lining of your gastrointestinal track, your respiratory track.  And it’s really important stuff.  But its basic primary function is to protect you against infectious agents.  So, any time that your body is under the impression that the exposure to infectious agents is going up, you’re going to get increased mucus production in your nasal, in your airway, and anywhere else that you normally produce this.  And that’s what phlegm is.  Phlegm is basically mucus that gets produced in your respiratory track as a response to some type of immune reaction.  So, any time you’re looking at some mucus production especially in the nasal passages, especially when it presents as phlegm.  Usually that’s because there is some type of allergenic response to something that you’re exposed to in the environment like dust or pollen or pollution.  And in many cases, this is called rhinitis, the inflammation of the mucus membrane.  That can be aggravated especially by other auto-immune issues going on.  So, mucus production is this auto immune response.  And one of the main things that can aggravate auto-immune responses even more is diet.  And so, this is something that I recommend to all the runners that work with especially the ones who struggle with allergies during the competitive season holding them back and mucus production holding them back.  It’s to be careful with dairy.  Be careful with wheat is another big one.  Soy is another one.  Any of these foods that would be considered a traditional immune system stimulating foods because they cause this pronounced immune response.  It would also be the same type of foods you’d want to avoid if you want to avoid this increased mucus production especially prior to exercise.  So, peanuts, shell fish, wheat, dairy, soy, those are really the biggies.  And that’s the standpoint I would come at this from rather than trying to fight the mucus itself.  You got everything from xylotol sprays to essential oils that you can steam and breathe in and teas that you can drink.  But when it comes down to this, what you want to look at is the underlying cause which is usually some type of auto-immune reaction and the production of mucus, the body’s natural increase in mucus production because of that.

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

Ben:  Yeah.  I mean anti-bodies like gliadin-based anti-bodies to something like gluten.  You can get a rebound effect from that for two to three weeks sometimes.

Brock:  Okay.

Ben:  So, the bread that you had earlier in the month can affect the mucus production.  That happens when you’re out running two weeks later.  So, that’s something that’s really important to remember with diet.  Usually if you’re going to make dietary changes, you want to give yourself two to four weeks sometimes a little bit more before making the final judgment about whether or not it helped hurt you.

Brock:  Okay.  So, it’s not like the stomach problems that you might experience during a race or something.  That can be a little more directly linked to the last couple of meals.  But this can go back like days or weeks.

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

Brock:  I got you.  Okay, let’s move on to the next question.  It’s another audio question and it comes from Chuck.

Chuck says: Hey Ben, this is Chuck.  And I have a question for the podcast.  It’s more than a couple of questions and they all sort of have to do with fasting.  First, I wanted to see your take on the new protocol that’s out called carbohydrate back-loading.  It’s where you essentially eat most of your carbohydrates after a pm workout.  But the quality of the food is a little bit less.  And you do your fast workout in the morning.  But there’s some eating around it.  And I’m not sure in the details.  I was wondering if you could elaborate on it a little bit and why it would work.  The second part of that is you often recommend doing fasted workouts in the morning before eating anything to help burn essentially belly fat.  And I wanted to see how long should you be fasted for that workout to have that benefit.  And also, if you’ve got any take on whether or not you ate a meal and immediately working out but then fasted.  For a while after that I’ve seen studies on the benefits of fasted or fasting after a workout too.  And I was wondering what the take on that would be.  So, it’s kind of a long question and good luck at Wild Flower this weekend.  I met you there last year.  And have fun in Dubai. Right on man!

Ben:  Cool.  First of all, as far as how long you can fast or how long you should fast, the whole idea behind exercising in a fasted state is you’re exercising with relatively low liver glycogen stores.  So, your liver isn’t breaking down its glycogen and mobilizing that via glycogenolysis to spike the blood glucose.  So, you’re burning blood glucose rather than fats specifically say if you are trying to lose weight or trying to improve your metabolic efficiency or trying to improve your efficiency in burning fatty acids.  So, you’d want to look at this and say well, how much liver glycogen I have on board and if I’m not eating anything, how fast is that going to be exhausted.  And it’s going to vary from person to person.  It’s starts off by finding your metabolic rate or how many calories you’re burning per hour.  For example, like my website Getfitguy.com where I just wrote that book, we have a metabolic calculator over there where you can figure out how many calories that you’re burning at rest, just sitting around and doing nothing during the day.  You could go and get what’s called an indirect calorimetry test.  That’s like an exercise physiology lab.  You could use one of these body tracking devices like a fit bit or a body bud.  But in my case, I know that just sitting around or sleeping, I’m burning right around 3000 calories in a 24-hour period.  For me, I know that I’m burning about 125 calories per hour or so.  So, it’s right around in that range.  So, your liver can store about 100 grams of carbohydrates.  And that’s about 400 calories of carbohydrate.  So, let’s say that I have my typical dinner.  And my typical dinner is say 600 calories.  And I know I’ve got another 400 calories of already stored carbohydrates in my liver.  It means I’ve got, when I hit the sack, around 1000 calories or so that my body can utilize.  So, it’s immediately utilizable calories from diet or calories from carbohydrate.  So, at that rate knowing that my metabolic rate is around 3000 calories in a 24-hour period which is 125 calories in an hour.  I know that for me to exhaust most of my energy stores, it’s going to be a minimum of about eight hours which is 1000 calories divided by 125 calories per hour.  So, for me if I’m going to exercise in a fasted state, that means I will have needed to have gone about eight hours or so without having to eat.  So, that’s the basic math if I can figure it out.  It’s going to vary from person to person.  But anywhere in the range of eight to 12 hours is typically sufficient for exercising in a fasted state.  So, that’s that.  And as far as this carbohydrate back-loading thing, it’s simple and at the same time it’s sort of complex.  Basically, the idea behind carbohydrate back-loading is that you don’t eat vary many carbohydrates early in the day.  And later on in the day, you lift heavy weights or you exercise or you do a hard workout.  And then after that, you get a higher glycemic index carbohydrates or higher carbohydrates later on, post workout.  And so, the science behind this and it’s really sales-y in terms of if your go and look at Carbbackloading.com and look at the big long sales they have on their.  Basically, what you’re doing when you do that is your giving the body carbohydrates when it’s in this really sensitive state and more likely to take the carbohydrates up into the muscle and store them away.  And then use them to build muscle or to restore energy levels for the next days workout which many people understand is the whole idea behind post workout nutrition anyways.  The other thing is that by eating high carbohydrates, you’re doing this carbohydrate back-loading.  Eating high carbohydrates after you workout with lower carbohydrates earlier on in the day is that it amps up what’s called this regulator of tissue growth called the mammalian target of rapamycin.  Or it’s the MTOR pathway which is one of the ways that our body generates growth.  It’s its pro-growth pathway that builds muscle and triggers this repair growth response.  So, the idea basically when you step back and look at it is you don’t eat many carbohydrates when your body doesn’t need that much carbohydrate.  And then right after the workout, you load up with a bunch of carbohydrate.  This all makes pretty good sense.  But there are some concerns about this.  In my case, the first would be that in the late afternoon or in the evening, eat a bunch of higher carbohydrate containing meals.  That’s going to up-regulate pro-growth.  It’s going to cause you to gain muscle more rapidly.  And it’s going to up-regulate this mammalian target of rapamycin. It’s MTOR pathway.  The issue is that that same pathway is also associated with decreased lifespan.  So, a down regulated mammalian target of rapamycin observed in fruit flies, mice, laboratory animals, when you down regulate that, the caloric restriction and the carbohydrate restriction.  You significantly increase lifespan.  It’s one of the best ways to increase lifespan.  That and adequate sleep.  So, one thing to think about is by using a carbohydrate back-loading protocol to put on muscle as quickly as possible or to cause muscle growth or repair as much as possible.  You’re also potentially stripping years off your life by eating a bunch of carbohydrates in the evening after a workout like that.  The other issue is that this whole thing is based off of research that’s been done that shows this type of carbohydrate re-feeding to really do a good job in folks at rebuilding muscle and at restoring energy levels.  But those are in people who were fasted for eight plus hours prior to the actual workout and then working out and then re-feed it.  And so, how many of us are going into our late afternoon or early evening workout having not eaten for eight hours.  I mean, pretty much nobody who’s had lunch.  So, the idea is that the amount of benefit that you’d get from something like this is vastly over stated.  It’s because it’s based off of research and that is was done in fasted individuals or starved individuals and not in people who were living lives like most of us live which is eating lunch.  And if we’re going to do an afternoon or early evening workout, maybe you’ll have a snack before that.  There’s a reduced need for post exercise dietary carbohydrate in that situation.  And then finally, the last thing and we’ve talked about this recently when I interviewed Dr. Peter Attia about staying in a ketogenic state and the benefits of burning fatty acids as a fuel vs. constantly burning carbohydrates as a fuel.  It’s that in somebody who is fatted acted and somebody who has been eating fat and lower carbohydrate diet and been really controlling blood sugar fluctuations.  Just from an energy level and quality of workout standpoint, the need for taking in carbohydrates is going to be vastly reduced.  It’s because your body is able to more efficiently burn more ketones and fatty acids as healthy energy sources vs. having those high blood sugar fluctuations that come with this type of carbohydrate re-feed.  So, if I were trying to put on muscle as quickly as possible, I’d be giving myself some pretty decent carbohydrates post workout and really going after that anabolic response.  But the fact is that there are other health considerations that go in my opinion above and beyond simply building muscle as quickly as possible.  So, the reason I’m not a huge fan of this type of diet is the reason I’m not a big fan of body building as a healthy lifetime sport.  There are always trade-offs that you make when you start to incorporate a protocol like this.

Brock:  Alright, cool.  Let’s move on to the next question.  We have one more audio question from Jenny.

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

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

Brock:  Now, as a matter of semantics, when you say gut, you’re not referring to just the stomach, are you?  Like that’s including the intestines and everything else as well, right?

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

Brock:  I got you.  It’s kind of like the core.  When people say the core, they don’t mean just your abs, right?

Ben:  Right.

Brock:  It’s the whole encompassing bits.

Ben:  All those bits.

Brock:  All those bits and pieces.  Okay.  Let’s go onto our next audio question from Shane.

Shane says:   Hey Ben, Shane here from Clallam, Washington.  I know you’re not a doctor.  So, I’ll save you the disclaimer for me.  But I’m a recent recipient of a rotator cuff tear.  And I’ve heard lots of horror stories about how long it takes for recovery of that injury.  And so, I want to get a head start on this.  And so, what I’m doing is ice-heat protocol.  In addition to that, I’ve had some people suggest a few things that I want to get your opinion on.  One is using a Tens Unit and two, using Bio Tools by Advocare.  Looking at that, it looks like they talk about using epigenomics.  So, I would appreciate any feedback you have or any additional suggestions for quick recovery.  I love your show Ben.  I appreciate all the time you put into it.

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

Brock:  Yeah.  The accommodation of tennis and swimming is a bit deadly on the rotator cuff.

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

Brock:  Cool.  Well, good luck to you Shane.  Good recovery and healing.  Okay.  Our next question comes from Shaun.

Shaun says:   I’m a fairly healthy person but by no means an elite athlete.  I find whenever I make a conscious effort to stick to a six week workout program by week three I often get sick with cold or flu.  I am curious to understand whether or not this is a result of the increased workout causing my body to work overtime in repairing my muscles etc. and therefore making me more exposed to germs etc, or is it just a coincidence.

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

Brock:  I use to have the same problem.  And I found actually when I went from buying the scheduled workouts.   Like getting the 16 weeks to a full marathon and just following that diligently because it said that I needed to run x amount on x day.  And I followed it religiously.  And I’d get sick all the time too.  As soon as I started actually coaching myself and taking more of the onison on me to sort of go you know what I felt pretty crappy after this run.  I’m going to move this run around again.  I’m going to make this a little shorter.  And even more so, when I started working with professional coaches that would only give me my workouts one week in advanced or pile it all on top of me.  This problem went completely away.  I actually find that I rarely ever get sick anymore.  It’s actually the opposite.  So, it’s interesting the way the body reacts.

Ben:  Yup.

Brock:  Okay.  So, our next question comes from Brenden.

Brenden says: For some reason, I have very high sweat rate.  It’s ridiculous in the warmer months.  You can’t draft behind me.  I know most likely a genetic item, yet wanted to ensure there wasn’t something homeopathic or completely safe and natural I was missing.  I’m clear on how I simply need to hydrate more, supplementing electrolytes and minerals, yet would love to find something that helps me retain this stuff in the first place.  Very costly and significant disadvantage in comparison to my more sweat efficient competition, you get the picture.

Ben:  Yeah.  So, you’re the guy I’m riding a bike behind which I’m getting a free shower from.  High sweat rate can be an issue.  I’m actually in the middle of a really good book.  Tim Noakes new book called Water Log in which he discusses things like sweat rate and hydration very comprehensively.  I highly recommend that book.  I’ll link to it in the show notes for you Brenden.  But when it comes to sweat rate, it’s almost all genetic.  A big part of it is your actual metabolic rate.  But that of course is also genetic.  And there’s not much you can do aside from botox injection.

Brock:  Oh, yeah.

Ben:  It’s kind of your sweat rate and lowering it.  And then surgery can clip some of the nerves that are involved with sweating.  Obviously, both of those procedures also mean that you’re completely shutting down your ability to cool yourself which is where this sweating mechanism comes from in the first place.  So, pretty much any homeopathic remedies that are going to decrease sweat rates.  First of all, I’m not aware of any.  And second of all, if there are any, that probably means they’re going decrease your ability to cool yourself adequately.  And so, I would be really careful with anything like that just as it’s going to shutdown performance.  I would instead simply focus on making sure that you are keeping your mineral levels really taking care of.  Like I use a trace mineral supplement now, I’ll double up on that during something like the week of a hot race.  And it’s just like liquid trace minerals.  So, that’s not like a salt capsule.  That’s like all of these little micro minerals that your body needs for daily metabolic function.  That can get exhausted more quickly if you tend to sweat more because that’s one of the main ways that you lose minerals in addition to respiration.  That could be a good idea getting on a good trace mineral supplement.  So, as far as competition goes, just making sure that you’re not driving a high loss of sodium.  Or perhaps even a higher sweat rate by consuming lots of salty foods, sports drinks, ton of salt capsules, things of that nature.  As we learned when we interviewed Tim Noakes a few months ago, the more electrolytes that you consume during competition, the greater your rate of acute sodium loss is going to be.  And that may drive an increase in sweat rate or urine rate.  That’s something else to be careful with.  Ultimately though, there’s no real way to make you sweat less without also deleteriously affecting your body’s ability to cool itself.

Brock:  When you did which race was it, Las Vegas last year and you used that ice vest and those crazy gloves and the hat like the painters hat.  Could it be something that he could be looking at as well?

Ben:  That is a good point.  Obviously, sweating is one of a human beings primary method of cooling in addition to, and I learned this in Tim Noakes’ book that I just mentioned.  Simply being an animal that walks on two feet, when the sun is at its high point, that reduces your sun exposure by something like 40 percent.  It’s just being on two feet instead of four.  So, it’s interesting how much sun exposure affects this.  But introducing some little bio hats that you can use to keep your body cooler that could help.  A palm cooling device for example which are like these frozen devices.  They’ll stay cold for 40 or 50 minutes.  You hang on to them when you’re exercising in hot weather.  And they cool blood as it passes through your hand.  That can help.  A cooling vest, cooling sleeves or hats, they’re infused with xylotol that drops your body temperature by about ten to 15 degrees when water hits these things, which can help keep you cooler.  And that would potentially decrease your actual need to sweat.  The question is from a logistical standpoint is how much of this do you want to use when you’re just out on the average training session, maybe not that much.  But during a race or hot event, these things could certainly help as well.  So, thanks for bringing that up Brock.  It’s a good point.

Brock:  I remembered all your crazy stuff that you had lined up for that race.  I don’t know if you used everything.  But it sounded like you were going to look like a bit of a rodeo clown.

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

Brock:  Awesome.  Well, we’re really dragging this out.  So, we should probably move on to our final question from Doug.   And Doug actually has a question for Graeme Turner.  Graeme, you may remember, was on the show a while ago.  He was on the podcast.  And he is also one of the coaches at Pacific Elite Fitness.

Ben:  Graeme was the guy who came on and did a podcast.  And I’ll link to it in the show notes for you about running drills and why running drills are bad.  And he basically gave some alternatives to popular running drills that are better running drills.  He’s a great guy, a knowledgeable coach.  He’ll actually be with us on the Thailand Triathlon trip.  He’s going to be there with some of the athletes he works with.  And I guess you can go ahead with the question Brock.

Brock:  Yeah.

Doug asks:    I have a question for Graeme Turner.  There was a podcast done with Ben and Graeme concerning running drills.  One of the comments that Graeme mentioned was that he had all the cartilage in his knee removed and is now running better than ever.  My question concerns my wife, who due to tears and arthritis has either none or little cartilage left in her knees.  Graeme is running while my wife can barely walk due to the pain and swelling.  What I am trying to find out is how and why.  Drills are not really an answer, as I would like to get her walking pain free first.  Her knees are really swollen.  Steps or angles are really painful to negotiate.  Any chance you can give me information of treatments or procedures that you went through.  The consultants are saying that full knee replacements are the only option.  I have looked at Prolotherapy, but it seems to be more repair of muscles and cartilage which you need cartilage first.  Grafting appears to also be out as again you need to have something to graft too.  I have also read about cartilage replacement, using cadavers.  However in the UK, the NHS is not the most forward thinking organization.  At age 43, she is too young for replacements, as I believe they would wear out too quickly due to the amount of movement she would do.  The average knee replacements seem to only last a maximum of 10 years, and you can only have it done twice.  We appear to running out of options, but I’m trying to resist replacements.

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

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

Brock:  Well, alright.  That wraps it up.  I enjoyed having a third accent on the podcast too.

Ben:  We’re the globe between US, Canada, and Australia on this one.

Brock:  Awesome.

Ben:  And again, we’ll link to everything that we talked about over in the show notes for this episode, episode number 194 right?

Brock:  Right.

Ben:  At Bengreenfieldfitness.com.  So, head over there to check that out.  It’s nice to be back.  It shouldn’t be skipping too many podcast in the future.  But again if you’re going to be down at Hawaii 70.3 the next weekend, be sure to say hello.  And we will be back to our normal podcasting routine and back with another podcast next week.  So, thanks for listening.  Leave a review over at iTunes if you get a chance.  And until next time, this is Ben and Brock signing out from Bengreenfieldfitness.com.

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



In this May 16, 2012 free audio podcast: How To Avoid Sudden Heart Attacks While Running Also: heating saturated oils, thick phlegm during exercise, fasted workouts and back-loading carbs, treating celiac disease naturally, healing rotator cuff tears, getting sick during training, very heavy sweat rates, and knee cartilage removal.

Do you have a future podcast question for Ben? click Ask a Podcast Question at the bottom of this page, Skype to “pacificfit” or scroll down on this post to access the free “Ask Ben” form…

Remember, if you have any trouble listening, downloading, or transferring to your mp3 player just e-mail [email protected]. Also, please don't forget to leave the podcast a ranking in iTunes – it only takes 2 minutes of your time and helps grow our healthy community!


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Special Announcements:

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Listener Q&A:

As compiled and read by Brock, the Ben Greenfield Fitness Podcast “sidekick”.

Audio Question from Chris:
We frequently hear about fellow athletes having these profound medical events where they “crash” and it is determined they have a 80-90 percent blockage in an artery! I personally know of two fellow runners who have had this occurrence. Fortunately both survived after open heart surgery. I am amazed that we continually hear about active, well trained athletes who experience near death occurrences in spite of being active. Makes me wonder about all the efforts of preventative healthcare. I understand much of this can be hereditary but am surprised when a well performing athlete crashes with no previous indicators. I am sure that Listeners would be interested if there are test available to screen for life threatening blockages since it appears that it can strike athletes who are training and performing and show no signs in advance. Would a stress treadmill test be an indicator test?

~ In my response to Chris, I mention the HeartMath emWave2. I also mention this article. And (of course) the New England Journal of Medicine's Cardiac Arrest during Long-Distance Running Races.

Audio Question from Tony:
Udo Erasmus talks about how when you heat saturated fat you damage them and even if you have a good diet you can't reverse the damage from heated oil. What is your opinion on using it for cooking?

Episode #127: Why Saturated Fat Won't Kill You But Vegetable Oil Will

Audio Question from Josh:
Trouble during hard efforts during races. Thought he drank too much water during the swim because of thick phlegm and gunk on the bike and run. Doesn't think it is dietary, doesn't take meds, doesn't want to take pseudoephedrine.

Audio Question from Chuck:
What is your take on the new protocol “carb back-loading”? Also, you often recommend fasted workouts in the morning to burn fat. How long should you have fasted for that to be beneficial? Can you fast after a workout instead?

Audio Question from Jenny:
Went to a GI (gastrointestinal) Doctor for stomach problems and found out that she is celiac and has acid reflux. Was prescribed medication for an entire year and doesn't want to take it (and hasn't been taking it). Is there a supplement or natural food to help with this, rather than taking the meds?

Audio Question from Shane:
Recent recipient of a rotator cuff tear and is worried about the length of recovery. Would you use a Tens Unit or Bio Tools?

~ In my response, I mention the injuries section of my recommendations page.

Shaun asks:
I am a fairly healthy person but by no means an elite athlete. I find that whenever I make a conscious effort to stick to a 6 week workout program by week 3 I often get sick (cold/flu). I am curious to understand whether or not this is a result of the increased workout causing my body to work overtime in repairing my muscles etc and therefore making me more exposed to germs etc, or is it just coincidence.

~ In my response, I recommend Restwise.

Brenden asks:
For some reason, I have a VERY high sweat rate. It's ridiculous in the warmer months. You can't draft behind me. I know most likely a genetic item, yet wanted to ensure there wasn't something homeopathic or completely safe and natural I was missing. I'm clear on how I simply need to hydrate more, supplementing electrolytes and minerals, yet would love to find something that helps me retain this stuff in the first place. Very costly and significant disadvantage in comparison to my more sweat efficient competition. You get the picture.

~ In my response, I recommend Noakes book Waterlogged. I also recommend these Trace Mineral.

Doug asks:
I have a question for Graeme Turner. There was a podcast done with Ben and Graemeconcerning running drills. One of the comments that Graeme mentioned was that he had all the cartilage in his knees removed and is now running better than ever. My question concerns my wife, who due to tears and arthritis has either none or little cartilage left in her knees. Graeme is running while my wife can barely walk due to the pain and swelling. What I am trying to find out is how and why. Drills are not really an answer, as I would like to get her walking pain free first. Her knees are really swollen. Steps or angles are really painful to negotiate. Any chance you can give me information of treatments or procedures that you went through. The consultants are saying that full knee replacements are the only option. I have looked at Prolotherapy, but this seems to be more repair of muscles and cartilage, which you need to have cartilage first. Grafting appears to also be out as again you need to have something to graft too. I have also read about cartilage replacement, using cadavers. However in the UK the NHS is not the most forward thinking organization. At age 43, she is too young for replacements, as I believe they would wear out too quickly, due to the amount of movement she would do. The average knee replacement seem to only last a maximum of 10 years, and you can only have it done twice. We appear to be running out of options, but am trying to resist replacements.


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