Episode #157 – Full Transcript

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Podcast#157 from https://bengreenfieldfitness.com/2011/08/episode-157-the-death-of-gatorade-should-you-stop-using-electrolytes-during-exercise/

Introduction:  In this podcast, should you stop using electrolytes during exercise, do oats have gluten, gluten-free cereal, how hot should you get coconut oil, mysterious leg cramps, is 2% or 1% milk better, training with osteitis pubis, when should you use glucosamine-chondroitin, is pulsed electromagnetic field therapy effective.

Ben:                Hey, folks, it’s Ben Greenfield here.  Hydrating with my cup of black coffee. Beautiful morning!  Today we are gonna be talking about hydration and electrolytes, and you’re going to get some ground breaking news about electrolytes, about hydration, and about companies like Gatorade.  So whether you’re out exercising or you’re just sitting back and listening in, be ready for some brand new information that you probably haven’t heard before.  In addition, we’ve got a great Q and A, and a few special announcements, so let’s go ahead and jump right in to this week’s content from BenGreenfieldFitness.com.

Special Announcements:

Ben:                Alright folks, so it has been a busy past couple of weeks with me being in hospital 2 weeks ago from a strange infection that spread out in my arm, to traveling all last week and I finally feel like I’m back here home base with you, podcasting and bringing you the information that I love to bring you.  So, really there’s not too much in terms of special announcements.  So I just wanna tell you about a few things.  First of all, I did release my brand new Rev Diet and that’s available over at RevDiet.com.  What that diet is, it’s designed to clean out your system, initiate fat loss, kind of reinvent your eating and then gradually bring you through a series of meal planning phases where you end up being able to progress the diet to the point where you could go and do higher levels of activities like a marathon or Ironman triathlon or something in that nature.  So, in addition to that, I’ll be shooting all the photos at the end of this month for my new 400+ page manual on strength training for triathlon.  Really, it’s going to reinvent the way that you approach your strength training in your weight training if your involved in endurance sports.  The next thing is that I am also working on another book that will be done on the September 20th that’s gonna be put out by a Macmillan Publishing.  The title of that book is under wraps for now but I can tell you right now that is a huge project.  The biggest book I’ve ever done in terms of publicity, so that should be interesting.  Will still wait for that to come out.  And then finally, for those of you who are part of my VIP text club, I’m involved in a little side project that I’m gonna let you guys know about next week end.  So if you’re not part of the VIP text club yet, you wanna make sure you’ll join that for free.  Alright, we are gonna jump right in to this week’s content after a quick special announcement that tells you about the VIP text club.

Listener Q & A:

Rishon:          Hi, Ben! My name is Rishon & I was calling about oats and gluten and my question is whether or not oats have gluten.   And I’ve heard it’s only from a contamination at the mill or something like that that oats don’t really have gluten.  But they get it from milk that has processed wheat.  And if so, then does that amount of gluten matter for information and stuff like that?

Ben:                Ok, it’s a great question. I actually cut Rishon off right there   because he proceeds to give me his phone number and email address and personal contact information.  Remember folks, when you leave a question for the podcast, you don’t have to leave that stuff because all I have to do is cut it out.  So, Rishon to answer your question, you are correct.  Oats do not have gluten in them but they might have gluten on them, and what you mentioned about the milling is correct.  A lot of people have thought that oats have gluten.  There was one time or I think I even mentioned on this podcast that oats had trace amount of gluten and really it’s not that the gluten in the oats, it’s that the gluten is on the oats.  They’re a major agricultural product, they are handled by the same mills, the same processing plants, the same grain elevators that handle things like wheat and barley and rye, which does have gluten and if you have celiac disease, there’s enough gluten contamination of the oats that could cause an allergic reaction or an inflammatory reaction if you have celiac disease.  In addition to the milling and the processing, there is a possibility that if oats are grown in a field, that previously had other gluten containing grains growing in it, some of the other gluten containing grains would naturally grow in the oat field the next year and so that could cause the oats that are harvested from that field to be contaminated.  So, that could be in issue, as well as the possibility of the actual harvesting equipment used to process the grains having gluten and generating inflammation but, ultimately, folks, we’re talking about trace amounts that are really only an issue if you have celiac disease.  It was the same reason that celiacs have to be careful with things like corn containing products like corn chips or corn tortillas because these are also processed around gluten containing grains and around products that have a lot of gluten cross contaminants.  So, if you’re trying to go a 100 % gluten free, because you’re convinced that there’s something right the paleo diet is the way to go, oats aren’t that big of a deal if you are doing this because of gluten.  If you’re trying to be gluten-free because of celiac disease that would be something to avoid.  So, great question.  And we have another kind of gluten related question that came in from Craig.

Craig says:     I am looking for a gluten free cereal that I can just dump in my cereal bowl in the morning.  I’m adding blueberries and almonds to my cereal now.

Ben:                Well, there are certainly gluten free cereals out there.  Some of them might surprise you like General Mills.   If you get any of General Mills rice check cereals, those are gluten free.  You can get it in chocolate or cinnamon or honey nut or regular flavor, or anything you’d like.  Another cold one, a cold cereal that you know you’d pour milk over would be like natures path.  Nature’s path does a lot of kind of health products and they do make a gluten free cereal.  It’s sweetened with fruit juice, you can get like maple sunrise or vanilla sunrise or honey corn flake or any of those other sunny healthy sounding flavors and they also have a line of organic gluten free kids’ cereals like frosted flakes and stuff like that.  Fruity pebbles and coco pebbles, those are also gluten free eat your heart out and there’s also a manufacturer called Glutino that makes gluten free cereals.  Now in addition to that, you heat a gluten free granola, place like Trader Joe’s and maybe health food stores they make gluten free granola, but folks I am not pretending that any of this stuff is healthy.  It is loaded with sugar and still has in many cases a high amount of preservatives in it, and other things that are simply gonna put your blood sugar through the roof just because this gluten free does not mean that they don’t use a process free radical laden vegetable oils in it so you need to  be careful.  If you look at the Trader Joe’s granola, it’s got corn flour, evaporated cane juice, juice sugar, rice flour, rice bran, raisin juice, canola oil, a bunch of seeds and nuts that I can’t guarantee haven’t been roasted and heated and processed thus producing a lot of these rancid free radical type of products and it’s made on equipment that also processes things like milk and eggs and peanuts and tree nuts and soy, and I am not a food Nazi.  I’m really not a food Nazi.  I record my daily diet for all my clients and all the people in the Ben Greenfield Fitness Inner Circle.  I take a photograph of everything I eat and people will tell you.  You know, there’s lasagna and beer and wine and pizza and all sorts of things like that that show up on my diet, completely not a food Nazi.  But, it is a pet peeve of mine if you’re trying to eat healthy, if you’re choosing products that are simply “gluten free” or healthy or fat free, but then you turn around and they’re loaded with sugar and loaded with vegetable oil so if you’re trying to go for gluten free cereal, we just got talking about oats go find a gluten free oat product and you can buy gluten free oats at Amazon and heat that up and that’s all I do almost every morning.  I have oats.  I include some protein powder that I actually stir in.  I put a little bit of almond butter in there, I put a little bit of coconut milk in there, throw a handful fruit in there, and that’s about it.  Maybe a little bit of cinnamon, and that’s my breakfast almost every morning and that would technically be gluten free granted it’s a hot cereal, but that’s a lot better way to go than buying a lot of these sugar laden processed  gluten free cereal that really are not that  healthy.  So, I get off my self facts now and move on to a question from Ben.

Ben (Caller): Hi Ben!  This is Ben calling from Boise.  I just have a question for you regarding supplementations with glucosamine or specifically the Capraflex product.  What kind of protocols you would recommend as far as recoveries from an injury, say a cartilage tear in the knee versus a more chronic condition such as osteoarthritis of the knee?  And how would you recommend taking that product short term versus long term use?  And if you had the injury in the past, is that a product that should be on the take forever list.  And if so, is it safe to do so? Thank you very much, I appreciate all the information you put out there.  It’s great stuff.  And I’ll look forward to an answer.  Thank you and goodbye!

Ben:                So, we’ve talk a little bit about glucosamine chondroitin on the show before, and it’s traditionally used in the treatment of osteoarthritis in some cases and made up of 2 primary ingredients.  You’ve got your glucosamine which is extracted from shellfish and then you have your chondroitin which is extracted typically from some type of cartilage product like a chicken cartilage.  So, the way that these 2 compounds act together is technically to help rebuild cartilage and decrease some the inflammation that occurs within the joint.  Question is, whether or not they actually work?  And whether you’d use them long term if they actually did?  Studies go back and forth on glucosamine chondroitin.  There was a big review back in 2007 about glucosamine and chondroitin, after the treatment of knee osteoarthritis and hip osteoarthritis and that concluded that both of these can act as valuable therapies for osteoarthritis disease and may actually help to modify some of the structure of the cartilage to reduce some of the pain associated with osteoarthritis.  Now remember, osteoarthritis is a lot different than you simply going for running coming back and being stiff and sore.  That’s not necessarily the reason that you take something like glucosamine chondroitin.  There was another study done in 2009, this was also a review that showed that based off all the studies to date that glucosamine and chondroitin have shown inconsistent efficacy when they’re individualized, or when they’re taken in their individual forms, but you can get pain relief when you combine them.  So, ultimately it kind of depends whether or not it works for you.  I’ve had a lot of clients who tried it and say it didn’t work for them, and it’s one of those things were you may want to try it in terms of risks.  Obviously, if you have a shellfish allergy, the glucosamine is gonna be in issue.  In some cases you can get a little bit of stomach upset or diarrhea when you take heavy amounts of glucosamine chondroitin.  There is a possibility that it could increase blood pressure so if you have hypertension that’d be something to think about before you take something like this.  You asked about Capraflex, which is actually what I take when I’m injured.  And I do not take that year round but I do take Capraflex when I’m injured.  Now Capraflex is a compound and you can find it over a pacificfit.net.  I’ll put a link to it in the show notes. Capraflex is a compound that contains glucosamine and chondroitin.  However, the reason that I think it works so well is because it doesn’t just contain those compounds.  It’s got alfalfa juice, cherry juice, ginger, turmeric, white willow bark, feverfew, valerian, lemon powder.  All of what are called the proteolytic enzymes like Bromelain and Papain.  And it’s also got enzymes in it like prodiase, cellulase and peptidase that help you to absorb and digest these components a lot more completely and what I find is that when you mix all this whole foods and herbs and enzymes with glucosamine chondroitin it tends to be very effective at pain management or managing inflammation associated with like a chronic repetitive motion injury.  So I probably use something like Capraflex, I keep a big bowl in my fridge.  I probably use it about 7 weeks out of the year when I happen to be really beat up or injured, you know, I get hit on my bike a couple of months ago and I was using it then, so it’s not something that I use year round but I do take about 9 capsules a day when I’m injured and I personally find that it helps.  But I have talk to a lot of people who don’t find that glucosamine chondroitin does anything for them.  Usually, in most cases those people haven’t actually tried glucosamine chondroitin mixed with kind of this cocktail of other ingredients.  So that is answer to that question and I will put a link into the Capraflex stuff in the show notes.  We’re gonna move on to a question from Christy.

Christy says: I just listened to Episode #127 where you interviewed Udo Erasmus.  What is the temperature were you start to damage saturated fat?  Udo mentioned not heating fat to frying temperature, but I’m not sure what that means.  Is the temperature of boiling water too high or steam?  I think deep fat fryers work at about 350 degrees which is baking temperature as well so is baking as bad as frying?

Ben:                These are all great questions when it comes to fat.  And if we step back and look at the big picture, when we’re talking about fat, Christy, there are certain oils that are not all that great when you heat them. They become damaged.  They become oxidized.  They transform into free radicals.  Those can harm our cells and our cell membranes.  And Udo Erasmus and I talk about that quite a bit in that episode, Episode #127.  And so what you’re looking at is every oil that is out there has what’s called the smoke point and when you get up to that smoke point, the oil begins to deteriorate from a chemical stand point.  So as an oil decomposes based on that oil’s individual type and temperature, it’s going to create a lot of water called hydroperoxide and that can result in increasing levels of water called aldehydes.  And what can happen with these aldehydes is they’re basically toxic compounds in our body.  They suck in a bunch of free radicals.  And you begin to create that cellular damage.  Now the best thing that you can do to make sure that this doesn’t happen is to find a smoke point chart.  And you can find smoke point chart for oils all over the place on the internet.  There are many that are out there.  But essentially once you get a list of oil smoke points you’ll know how hot you can actually get an oil before it begins to decompose.  Now Udo Erasmus, the guy that we’re talking about earlier is much stricter on this.  He doesn’t believe that fat should be heated at all.  I disagree with that.   I think that fats are essential for cooking and many of them can enhance both the flavor and the quality of food when heated.  Big picture is you look at saturated fats like a palm oil.  And those are really ideal for cooking at higher temperatures.   Unsaturated fats like an olive oil, those actually don’t do too bad in like medium to high heat.  But you’ll lose a lot of flavor of the olive oil.  And then if you look at like a low heat oil, like an oil that’s derived from a nut, usually you’re just going to want use those in like salads and cold dishes.  So if you look at the smoke points of oils like one of the highest is avocado oil which has a smoke point of 520 degrees Fahrenheit.  I personally don’t cook a lot with avocado oil.  But that’s one example of oil that’s actually fairly stable at high temperatures.  This will surprise some people but an olive oil like an extra virgin olive oil actually has slightly higher smoke point up around 400 degrees than a coconut oil which has a smoke point of 350 degrees.  So the difference is that coconut oil retains its flavor a little bit better at that higher smoke temperature whereas olive oil does not.  So, once you get your hands on like a smoke point chart, then you’ll know what you can approximately heat these oils up to.  I’m not saying that every oil on the smoke point chart is all that great.  But the smoke point is the place to start.  If you’re using a refined oil that’s already been exposed to high amounts of processing like a canola oil, you can guarantee that the oil has already been exposed to high amount of pressure and temperature in the extraction process and so it already has a lot of free radicals in it.  So that’s why we’d avoid something like a canola oil not because we’ve necessary heated in our kitchen.  But that has been heated before it even got there.  And then remember that when you’re heating in oil, if you end up reheating it, the second time around its smoke point’s gonna be lower.  So just bear that in mind.  If you’re using a micro wave or frying pan to reheat food that’s already been heated, the smoke points are going to be lower on that.  So hopefully that helps you out a little bit.  Get your hands on a smoke point chart.  And you know what I will do for you.  I’ll put a link to a good smoke point chart in the show notes to this episode, Episode #157 over BenGreenfieldFitness.com.  I’ll put a link right underneath your question in the Q and A section, Christy.

Jen:                I have a question about night time leg cramps.  For the past few weeks I’ve been awakened several times at night with extremely painful spasms in my calves, shins, and feet.  They subside when I get up and stretch but are a serious disturbance to my sleep and leave me achy and tired in the morning.  I am a fit 38 year old former marathoner.  I’m a daily commuter cyclist.  I work out at gym 3 to 5 days a week at a fairly high intensity.  I do 2 to 3 yoga classes a week.  My hydration and potassium intake are good.  I have in the last 6 months switched to a diet lower in carbohydrate.  And I have dropped about 10 pounds in that time.  It makes me wonder if it could be a particular nutritional deficiency that could be causing these cramps.

Ben:                Well, you know whenever I get a question like this about some mysterious issues that somebody is having I always want to be sure to let you know I am not a doctor.  And this is not considered a medical advice.  And the reason that I specially want to tell you that in my response to this question is there are many metabolic problems and medical issues that can cause night time leg cramps, everything from diabetes to kidney failure to hypothyroidism.  So my very first piece of advice for you if you haven’t recently gone in and gotten a physical and done some blood work out go check in on what’s going on with like your thyroid, your blood sugar levels, levels of enzymes.  Basically everything you that would want to do for complete health check up.  And that being said, the only thing that kind of leaps out at me here is that you did switch to a low carbohydrate diet and if you were eating lots of grains, grains are really high in magnesium.  Like barley and buck wheat and oat bran and rice and wheat flour, all of these have really decent levels magnesium in them.  And we had somebody on the podcast Dr. Carolyn Dean, who talked about magnesium.  And she did talk about leg cramps and how deficiency in magnesium tends to be a common cause of night time leg cramps.  And that’s basically because what happens is the way that your body moves and the way that it causes your bones to actually move through space is it contracts the muscles that join the bones together.  So what that requires in order for that to happen is that these contract dial proteins inside the muscles called actin and myosin, these fibers, they slide toward each other and away from one another.  And that causes the contraction and the relaxation of the muscle.  So when those proteins, the actin and myosin become locked into one another, that’s basically what a cramp is.  And so what happens is that the enzyme that’s required to unhinge the actin from the myosin that depends on the steady supply of magnesium in order for it to function effectively.  And magnesium plays an important in the body.  It plays a role in the function of over 300 enzymes.  So it’s no surprise that it is required to make sure that a cramp does not occur.  So if you’re magnesium deficient, you know you’re sweating all day, high levels of activity which are going to deplete magnesium a little bit, low levels of carbohydrate intake, which again, sources of magnesium includes things like grains and even fruit.  It’s possible that you’re magnesium deficient.  What would you do if you were?  You could grab something like natural called magnesium.  Take 250 or 500 milligrams.  Basically as much as you want take in until you get loose stool.  You can also try like topical magnesium.  You can get like a topical magnesium.  It’s not oil but it feels like oil.  And you could rub that in your legs like 10 or 15 sprays on each leg before you go bed, rub that in.  And you can see if that helps.  That’s what I would do if I were you.  I’m not saying that this isn’t some type of medical issue.  But I would certainly experiment with magnesium before you turn to a bunch of other stuff if that’s something that you want to just try out.  I mean you’d see results almost right away if you did that.  So that’s what I would recommend.  As far as sources for magnesium, I’ll put a couple of links for you in the show notes.

Kamal            :           I just wanted to know which milk is better for us, 2% or 1%?

Ben:                Now this is a really interesting question.  Let’s leave aside the issues of you know where you are getting your milk, the hormones on the milk or antibiotics or things of that nature issue.  And let’s just talk about what would be better, the higher fat like 1% or whole milk, or a lower fat like a 2% or a skimmed milk.  So the fact is that even a non fat milk can support muscle recovery following exercise which is kind of the main reason you want to take milk.  It’s got lots of insulin like growth factor in it.  It’s got proteins in it.  It’s got sugars in it.  It is nice for muscle recovery beverage.  Back in 2009 in the International Sports Nutrition Journal, there was this study called cereal and not fat milk support muscle recovery following exercise.  I know I’ve vilified cereal a little bit in this podcast.  But really I mean if you’re going to have high amounts of sugar mixed with some protein, after work out is really the time to do it.  So this study showed that there was a favorable response to even something like fat free milk when it came to muscle recovery.  However, there was another study that was done back in 2008 and this study was in the medicine in science in sports and exercise journal.  And this actually also looked at the ability of muscle to enhance recovery.  But it specifically followed uptake of amino acids specifically phenylalanine and threonine uptake which are very representative of your total ability to synthesize and repair muscle fibers.  And what this found was that compared to a fat free milk, a whole milk has much better capability to improve muscle protein synthesis.  So the reason for that is probably simply that when you look at the anabolic or the muscle growth properties of whole milk, they’re simply preserved by keeping whole milk whole.  So when you take all the fat out of the milk, it’s kind of similar to taking the yolk out of an egg.  You can lose a lot of the basic effectiveness of the food anytime that you isolate and remove components from the food.  A lot of times you’re not gonna see that it works quite as well especially it comes to something like recovery.  So in my opinion more often than not when you take fat out of a food it becomes slightly less valuable.  Especially when we consider that the only reason to do so would be if you’re concerned about fat making you fat or fat giving a heart disease which actually has been proven not to be really all that much of a concern.  So ultimately if it was up to me and I was choosing between 1% and 2% milk, I would go with the 1%.

Jeff says:        I’m in age grouper triathlete.  I’ve recently been diagnosed with osteitis pubis.  Initial scan detected a small inguinal hernia.  But further investigation revealed osteitis pubis which is causing me grief in my groin.  I’ve been advised to layoff of running for 2 months but I can swim and bike.  Do you have any advice to aid my recovery?

Ben:                Well, I want to respond to this question because I had the same issue.  In my junior year in college I was playing volleyball.  I was doing a lot of water polo.  I was teaching spin classes.  I was body building.  I was incredibly active.  And then I got these osteitis pubis witch is basically just an inflammation of your pubic bone, the small bone that comes across your pubic bone.  A lot of times it is misdiagnosed as a hernia.  And really all it is just kind of a bony issue that if you rest similar to stress fracture, it works itself out.  Now I personally didn’t run for 6 months. That was how long it took me.  But yeah, I did a ton of swimming and cycling.  I found that a recumbent bicycle, because it was not seated directly on the pubic bone, caused me to be able to bicycle a lot better than sitting on an upright bicycle.  Upper body weight lifting and especially using like an upper body weight training circuit where you’re moving from exercise to exercise with minimal rest can really help to maintain your cardiovascular status.  You can certainly do exercises in the weight room for the lower body that do not aggravate the pelvic bones.  We’re talking about like calf raises, leg extensions, leg curls, and things of that nature.  Ultimately this type of injury responds really well to some R and R combined with non impact exercise or exercise for muscular skill or components of your body that aren’t related to the injury itself like upper body work.  But you know it does take a rest.  Ultimately I respond to this question to encourage you because in the next year I was getting in the triathlons.  So once it goes away, you know it’s not something that I’ve ever had to deal with again.  But ultimately you know high levels of activity can definitely cause this.  If you are listening in and you have a bunch can like groin pain that you think might be a hernia, I definitely rule out osteitis pubis because you don’t wanna go in for hernia operation and find out you just had a little bit of inflammation in your pubic bone and needed to layoff for a little while.  Good question.  And then we have one more question before we go into our interview with Dr. Noakes today and that question is from Paul.

Paul says:      What are your thoughts on PEMF?

Ben:                Now for those of you who don’t know about PEMF stands for, it’s Pulsed Electro Magnetic Field Therapy.  And what that is it is a type of therapy that uses an electrical current to direct these magnetic pulses through injured tissue.  So that’s supposed to stimulate cellular repair, improve blood flow, suppress some of the inflammation, improve the heat in the areas so you improve a little bit of range of motion.  And this is not one of those quack devices that is sold on the internet for thousands of dollars but has no research behind it.  This has been used by Olympic athletes for a long time.  It is approved by the FDA and widely available on many medical facilities for patients to use in rehab.  There are many studies that go beyond its ability to enhance a muscular skeletal repair.  And indicate that it could be useful for everything from assisting with cognitive rehab in people with Alzheimer’s to helping to break up some tumor issues, with some specific types of cancers, assisting with erectile dysfunction, fibro myalgia, migraines and headaches.  I mean there’s a whole list.  There’s a huge amount of research on pub med that suggest that this Pulse Electro Magnetic Field Therapy may actually be something quite effective for a wide variety of conditions.  Now although  I would recommend that if you’re gonna do something like this, you actually go to a physical therapy institute or medical establishment that actually has experience with Pulse Electro Magnetic Field Therapy.   You can buy actual Pulse Electro Magnetic Field Therapy units online.  They’re usually going to be anywhere in the range like $2000 to $4000.  And, of course, before you spend that type of money on something like this, really know what you’re getting into.  Research the unit that you’re getting.  And ultimately it’s very interesting.  You know, I did some research on it before.  I respond to this question on the podcast because I didn’t know that much about Pulse Electro Magnetic Field Therapy.  But I was actually very surprised at the number of studies that suggest its effectiveness or even prove its effectiveness in some cases.  The length of time it’s been used for.  In fact, it has been used by professional athletes for therapy.  And I think that is certainly something to look into if you have chronic pain or if you have some of these other conditions that Pulse Electro Magnetic Field Therapy may be indicated for.  So, there you go.  It was a great question.  I’m glad you brought it up.   Occasionally I get a question that I don’t know about something but I got to go research it.  And I was pleasantly surprised with what I’ve found out about PEMF.  So that being said let’s go ahead and move in to this week’s interview with Dr. Tim Noakes after one quick special message.

Special Message

Ben:                Hey, folks, it’s Ben Greenfield here, and for those of you who have listened to the podcast for a little while, you may remember back to podcast Episode #138 in which you learned a ton of valuable information about how do really tap into your body’s muscle potential while training and while racing by using the concept that’s something called the central governor and the individual who we interviewed in that post was Dr. Tim Noakes who is a South African Professor of Exercise and Sports Science over at University of  Cape Town.  He himself has done a ton of marathons and ultra marathons.  He wrote one of the best books out there on running called The Lure of Running which if this type of step interest you, you really should check out.  And he’s really considered one of the top sports science researchers on the face of the planet.  So, we’re very privileged to have him here with us today.   And today, we are going to be discussing electrolytes and hydration and how what you think you know right now about electrolytes and hydration may actually be wrong.  So, Dr. Noakes, thank you for coming on the call to day.

Dr. Noakes:   Thanks, Ben.  Great to be with you again.

Ben:                So there is a lot of information floating around out there about how much you should drink during exercise and how many salt or electrolytes you should consume during exercise and you being kind of at the forefront of exercise physiology research have you formed some definite opinions on the way that people should be using water and electrolytes during exercise.  So, can you kind of go into what type of research and studies you’ve seen on this and where you stand right now?

Dr. Noakes:   Sure, Ben!  I started running in 1969, and we were told at that time that is was very dangerous to drink during exercise.  And we were further taught that only weak people drank.  So, if you saw someone drinking during a marathon, it was because he was weakening, and the idea was that was when you should attack and should run away from the athlete who was drinking because they were in distress.  So, that was the idea.  Then in 1969, two South Africans came out with a publication, which suggested that if you didn’t drink enough, your body temperature would be elevated.  And they published a paper in the South African medical journal saying that the dangers of inadequate water intake during marathon running.  And I started my medical career in 1969 and I happened to cross this article in 1970.  And she has completely convinced me that you needed to drink a lot more.  They said you should be drinking about a liter of fluid every hour that you run.  And then I ran my first marathon in 1972 and again we were restricted in how much water you could take in.  There was usually one seconding station during the race it was usually about 20miles.  And then if you wanted more that you have to provide it by, people would have to help you provide it.  And in the next year I run the comrade marathon which is a 90kilometer race in South Africa and to run that race, there was no fluid available, you have to provide all your own fluids.  So for 90 kilometers you somehow had to find fluids.  And we used to have what we call seconds.  And the seconds would drive in a car but because there were a couple of thousand people running in the race, and it stretched over 90 kilometers.  You were very lucky if got a drink every 10 or 15 kilometers.  So that was the drinking plan and it struck me that this was wrong.  And so I started promoting the idea that you needed to drink much more.  And I’ve made presentations and in fact wrote articles. And I tried to check this in books which were published by runners as well during the 1970s.  And I can recall in 1981 writing a column saying that the most important component of your performance was what you drank during a race.  And you could never drink enough, etc.   So that was the last time I ever said that was in May 1981.  And in June 1981, I received a letter from the lady who described how she collects during the 90-kilometer comrade’s marathon.  Now 1981 was the first year when they had drinking station every mile in the race.  So they had 56 drinking stations in the 56 mile race.  And she told me that at 40 miles she did not recognized her husband.  He was watching on the side.   And he decided she wasn’t in good shape.  So he took her off the course.  He put her in the car then drives her to the finish.  And there she arrived to the finish and the doctors examined her.  And they said well, of course, she’s dehydrated.   So they gave her 2 liters of intravenous fluids.  And she said water didn’t make me feel better.  It made me feel worse.  And she got back in the car.  And her husband said maybe I should take you to a hospital.  So he drove her back down the course towards the start which was in Durban.  It was 56 miles away.  And half way there she had an epileptic seizure and went unconscious.  And she was unconscious for 4 days.  And when she was examined in the hospital they found out that her blood sodium concentration was very low.  And so they diagnosed hyponatrimia.  And they treated her as the best they could at that time.  Fortunately, they didn’t make any major errors.  And she survived.  She then wrote to me and asked what happened.  I told her I have no idea because it has never happened.  It has never been reported.  And as a consequence, I decided that I better look into this because it’s clearly something that’s never been described before.  It’s my responsibility to find out.  And I was at school over the next 3 years to find another 3 cases like that.  And we described them and we published them in the American Journal in Medicine and Science and Sports and Exercise.  And we called the condition water intoxication because we’ve worked out by then that you couldn’t lose enough sodium to develop water intoxication.  And in fact one of the keys was one of the ladies who developed the condition I knew very well.  And she had anorexia.  And she would measure herself all the time.  And she told me that she put on 4 kilograms during this particular race in which she developed hyponatremia.  And I knew that she was a good witness.  And if she said she put on 4 kilograms, she put on 4 kilograms.  And of course at that time, people would say that it’s impossible to put on weight during a marathon or ultra marathon.   You have to lose weight and become dehydrated.  So we wrote it up and described it.  And that was the first case.  And then I began to say that maybe it’s possible to drink too much.

Ben:                Interesting.  Isn’t there still a huge risk of dehydration though?  I mean, what do you see when you’re looking at studies because I know they’ve done hydration studies on people running marathons or doing Ironman triathlon.  What do you see in terms of what the fast people are doing, what the people who end up in the medical center are doing?  Is there some type of happy medium?

Dr. Noakes:  I’m glad you asked that question because I think we have to continue the story a little bit further.   And then you’ll see what happens.  So what happened in 1985 was that Quacker Oats bought the product Gatorade.  And at that time, it was a very small product selling about a hundred million dollars a year.  And it was clear to me that someone at the industry decided that they needed to make this product get big.  And over the next year up to 2004, the product arose from selling $100 million a year of sales to over $4 billion a year.  Now, when you think that Gatorade contains sugar or some constituent salt and water for that product to sell $4 billion a year, it’s quite an achievement.  For a product that contains stuff that you’d find in the kitchen.  And you could make up yourself.  For it to become such an iconic product, something happened.  And I don’t want to make too many contentious statements and go to jail.  But in my view, what happened was that they developed the thing called the science of hydration.  The industry developed the science of hydration.  And one of the components of the science of hydration is that there’s this medical disease called dehydration.  And if you don’t drink enough during exercise, you’ll develop dehydration.  Now as a biologist, dehydration means to me that there’s less water in the body than the body needs at its homeostatically regulated point.  And what happens as you become dehydrated, your blood sodium concentration rises.  That stimulates your brain and it tells you to go and drink.  And that is the only single symptom of dehydration.  It’s thirst.  So if I go out and drink and I reverse my thirst, I am not by definition dehydrated.  So the only people who can never be dehydrated are those who have incredible thirst.  And if you’ve ever become thirsty, then you’ll know what thirst really is.  Go and get lost in the desert for two days.  And then you’ll understand what thirst is.  It is like all encompassing symptom that drives you to find water.  And it will actually stop you from exercising.  That’s what dehydration is in real terms.  Now what the industry had to do was convince people running a marathon where there’s more fluid available than in any other place in the entire planet, more free fluid available.  They had to convince people that athletes were finishing races dehydrated.  In other words, they were not drinking enough despite the fact that there were tens of thousands of gallons of fluid available.  And that’s what they managed to convince the United States population.  It was a major achievement.  So then they said that whenever you collapse you’re dehydrated and that is nonsense.  We’ve shown for a long time that people who collapse at the end of races are no more dehydrated than the race winner.  And in fact they’re usually a lot less dehydrated.  Dehydration has got absolutely no part to play in causing people to collapse at the finish line of races.  And we know that because 85% of people who collapsed in marathons collapse after they finish.  And therefore, it can’t be dehydration because if they were dehydrated, and their heart was strained, they would collapse before the finish when the heart is working hard.  They don’t.  They collapse afterwards.  And that’s because they stop.  And it’s the stopping that is cause of the collapse and nothing else.  And we showed years ago that if you lift the guy’s legs and their pelvis above the level of their heart, within 30 seconds they are completely normal.  And they are fully recovered.  Although they still couldn’t stand up because as soon as they stand they’ll get the same problem.  And that is called exercise induced postural hypertension.  And that is what is supposedly called dehydration.  And then the next point is there is absolutely no evidence whatsoever that drinking during exercise influences your risk of developing heat stroke or so called heat illness.  None whatsoever.  So anyone who tells you one is to develop heat stroke by drinking fluids, there’s actually no evidence for that.  And the other point I would make is that heat illness is a broad term which is largely wrong because most of it is exercise induced postural hypertension which isn’t due to dehydration.  So when heat stroke occurs, it has absolutely nothing to do with fluid balance.  And we know that because most causes of heat stroke occurs in one hour, the first hour of exercise.  And you can’t be dehydrated under those conditions.

Ben:                So are you saying that people should not be drinking during exercise?  Or are you saying that the current recommendations are too high?  Or what exactly are you getting at when it comes to hydration?

Dr. Noakes:   Okay.  So if we move forward then remember I said that was 1985 when we showed that some people can have a drink.  In 1987, the American College of Sports Medicine came up with some new drinking guidelines which for the first time gave actual volumes that you should drink.  They said you needed to drink between I think 100 and 300 mL every 10 or 15 minutes or every 3 kilometers, I think it was.  And it worked out that they meant therefore you should drink between 600 and 1.8 liters per hour.  So this is the first time that there was a number put to it.  Then what happened was that in 1996, the American College of Sports and Medicine revised that guidelines.  And they said that you must drink as much as tolerable and that should be up to 1.2 liters per hour.  So then this value of 1.2 liters per hour came along.  And that was a real problem because that is way an excess of what most people can safely drink.  And thereafter, this condition of hyponatremia became epidemic throughout the North America and Europe.  And the only countries where it didn’t happen were in South Africa and New Zealand.

Ben:                So for our American listeners who are listening in that’s right around 40 ounces.

Dr. Noakes:   Correct.  That is absolutely correct.  And so that guideline then caused major problems because then the incidence of these hyponatremia due to water intoxication increased dramatically.  And I’ve traced 1,700 cases in the medical literature.  Now if that’s the number of cases reported in the medical literature, can you imagine how many cases occurred outside of the medical literature.  And people said there’s non-academic published conditions that absolutely was.  And they were 12 days from over drinking.  Again of course it’s all avoidable.  Now what happened in 2003 was that a marathon medical organization came to me and said we’re not happy with the guidelines.  Please would you draw up your guidelines?  And I gave much of the story that I’m telling you now.  And I said people should drink to thirst.  That’s all you have to know.  Just drink to thirst.  And if you lose a lot of weight but you’re drinking to thirst, that’s completely safe.  Those guidelines that were then accepted by the United States track and field for all races held by them and to a limited extent by some marathons in North America.  And then finally in 2007, the American College of Sports and Medicine revised their guidelines and said that you should drink to thirst but you shouldn’t lose more than 2% of your body weight.  Now that’s a confusing message because it still suggest you must go and weigh yourself and work out how much you should drink.  But the reality is that humans evolve in a very hot arid environment.  And we have all the evolution controls developed through over the last 3 million years to make sure that we drink when we need to drink.  And we drink exactly the amount we need to.  And what the sports drink industry did, very effectively, was to say you can’t believe your subconscious controls.  You have to do it consciously.  And that is absolute nonsense.  If that was true then no mammal would be surviving.  There would be no living animals because they would’ve all gone dead because they don’t have a conscious brain to tell them when to drink.  At thirst is all you need to know is drink to thirst.

Ben:                You hear a lot of the time and I’ve read this is in multiple books.  And I believe even in some sports nutrition manuals that if you wait until you’re thirsty to drink that you’re probably already risking dehydration.

Dr. Noakes:   That was developed by the Sports Drink Industry as a selling option for their product.  It’s got no biological basis whatsoever.  If you ask any thirst expert, any person that studies thirst, they will tell you that it’s nonsense.  Provided into thirst you’re fine because that’s how we’re designed.  We don’t have to think about drinking.  If your mind tells you to drink just go and drink.  And if it doesn’t, don’t drink.  That’s how we’re designed.  You don’t tell your dog when to drink or your cat when to drink.  So how do they survive?  It’s because they’ve got exactly the same controls that we have.  And that’s all you need.

Ben:                Do you find that from a practical perspective like say during an Ironman triathlon that simply following thirst is something that puts an athlete at risk of dehydration because they’re so focused on other aspects of the race versus drinking based on timer or something of that nature?

Dr. Noakes:   Firstly, there’s a report now in the British Journal of Sports Medicine in which they analyzed all the studies that have been currently done.  It shows that either a ahead of thirst or below thirst, you stop perform sub-optimally.  So if you’re drinking ahead of thirst you’re impairing your performance.  And I’ve just reviewed another paper from a group in Switzerland, showing that if you drink ahead of thirst, you develop edema of your legs.  Now anyone who’s running during an Ironman and once have an edema of their legs to carry extra weight that they don’t need at the end of that Ironman should realize that’s exactly what they’re doing if they’re drinking ahead of thirst.  So the people who are telling us to drink ahead of thirst unfortunately have got a lot to answer for because it’s completely unnecessary.  Now, we’ve also looked at Ironman finishers.  And it has always been shown that there’s an inverse relationship between how much weight you lose and how fast you finish.  Those people who lose the most weight are usually the winners or run the fastest, which is the opposite of those who claim that you’ve got to drink a lot to win the race.  The reality is that the very best athletes in an Iron9man lose between 6% and 12% of their body mass at the finish.  Now in the past, you’d say that you’re going to die if they lose that, well they don’t.  They happen to win the races.  And again the argument is that is what humans evolve to do.  We evolve to hunt in the heat, drinking very little.  And the best Ironman triathletes, the best marathon runners are those who contain those genes which force them or encourage them not to drink very much when they’re running.  And as a consequence they have a biological advantage because they’re not carrying as much weight.  So that’s what people have to get into their head.  That if you drink to thirst, you optimize your performance.  If you drink ahead of thirst, you’re just retaining water which you don’t need.  If you drink less in thirst, your performance will be impaired.  But in my view, it’s because of the symptoms that you develop, you don’t feel well if you’re thirsty.  And that’s what impairs your performance rather than the fact that the body has got a little bit less weight.

Ben:                So people who drink according to thirst, if we say like  pro triathlete doing Ironman triathlon or say one of the subjects in one of these studies, there’s got to be kind of a range that you see.  Like for human beings in terms of ounces per hour or liters per hour, when people do drink according to thirst because I’m sure the listeners listening in still, if you go out and drink according to thirst, they probably want to kind of know approximately how much water you’re going to drink according to thirst.

Dr. Noakes:   Well, we showed already in 1988.  We looked at people doing lots of different events in South Africa.  And it turned out that most people drink about 400 mL to 500 mL per hour.  And you’ll have to convert that, it’s about 18 ounces an hour.

Ben:                And what type of conditions were those in?

Dr. Noakes:   That wasn’t any condition.  And it’s remarkable how common that is.  I will make some other comments.  Firstly, we had studied also Haile Gebrselassie when he set the world record.  And he finished when he ran 2 out of 3 marathons, he lost 10% of his body weight at the finish.  So just to confirm and that’s historically the same way it has always been.  The fastest runners lose enormous amounts of weight.

Ben:                Will you say that there’s a value to self experimentation though?  And the reason that I ask that, Dr. Noakes, is in anticipation of our call over the weekend, I went for a bike ride in about 90 degrees.  And I rode for 3 hours.  And I drink according to thirst.  And by drinking according to thirst, I consumed approximately 28 ounces per hour of water.

Dr. Noakes:   Okay.  Well, so it’s a little bit ahead but it was hot that day.  And it’s less than 40 ounces.  It’s less than 1.2 liters.

Ben:                Yes.  It’s significantly less.

Dr. Noakes:   That would be entirely appropriate.  We have in fact just published a paper where we looked at military personal exercising at 40 degrees centigrade.  That’s 112 degrees Fahrenheit.  In South Africa, they were fully armed.  They were in battle dress.  They were carrying a rifle.  And they were carrying a 25 kilogram pack.  And they had to race over 25 kilometers or 14 miles.  And they did it perfectly and comfortably in just under 4 hours without any problems.  And they drank substantially even more.  They drank up to 1.2 liters.  They drank up to 40 ounces per hour.  But they needed it.  That was the key.  They needed the fluids.  And they drank to thirst.  And they drank that amount.

Ben:                So it’s possible that someone racing Ironman Hawaii may actually drink close to that?

Dr. Noakes:   It would.  It’s possible, yes.  But again, you have to listen to thirst.

Ben:                Well, this is very interesting because I think I saw this study on these military individuals who went on this race.  I thought most interesting was the electrolyte issue which I do want to make sure that we cover.  And I know we spent a lot of time on water.  So maybe this is kind of a good segue into that.  How much salt did they consume?

Dr. Noakes:   Nothing.  And they didn’t need to because your body is so well designed to regulate its body’s sodium concentration.  The only thing that can affect your body sodium concentration is if you drink too much water.  That is it.  So, this is another myth that has been developed by the industry, unfortunately.  And it’s called the salty sweat myth.  And this myth holds that if you have a lot of salt in your sweat, you are losing so much that you’re going to become deficient.  Now that contradicts completely everything we know about the biology of salt metabolism in the human body.  So what’s astonishing is that the industry managed to confuse an entire nation or an entire population of athletes.  What happens if you take in a lot of salt is your body has to get rid of it.  And it gets rid of it in urine and in sweat.  And what you find in sweat is the excess that your body is trying to get rid of.  So if you have salty sweat, it’s because your diet already has too many salt in it.  Now an American, Dr. Jerome Conn in the Second World War, he was asked when America entered the Second World War, they knew they were going to fight in the Pacific.  And they knew it was hot.  And the military people came to him and told him to study a climitazation and what we need to do.  And he chose to measure salt balance.  So he took a bunch of subjects.  And he made them exercise for 6 hours a day.  And he gave them different salt intakes.  And he went down to 2 grams of salt a day which is about 1/5 of what any of all your listeners will be using.  If you are taking 2 grams of salt a day, your diet will be so bland that you will hate it.  He got them down to exercising for 6 hours a day in the heat taking 2 grams of salt a day.  And their body was still balanced.  So you can get your salt, the salt concentration of your sweat almost down to nothing.  And the salt concentration of your urine almost down to nothing, if you have to.   And so that’s why you can’t conserve salt even in a very low salt diet.  Now there’s no Ironman triathlete who is drinking under 2 grams of salt a day.  And my point is that it’s impossible to become salt deficient.

Ben:                What about people who are on this paleo diet or vegan diet?  Those diets are fairly low in sodium.  Would you think that those type of people would have low storage sodium levels and maybe take in more salts during exercise?

Dr. Noakes:   That’s right because if they need to, their body will tell them.  Again, the desire for salt is very high.  You’ll never allow yourself to become salt deficient on a normal diet.  There were studies also in the 1930’s where they tried to produce salt deficiency.  And they found that it was impossible.  The only way they could do that is they would put people in a laboratory.  And they feed them.  They would feed them food that actually had zero salt content.  Anyone who lives freely will never develop salt deficiency because we’ve got such a salt drive that you will always find the extra salt.  Salt deficiency as I’ve said is that you have to be in an experiment where you are given no salt.  And that’ll never happen.

Ben:                So let’s say you put somebody in an Ironman triathlon.  I think you would agree that maybe a rate of sweat loss or sodium loss maybe 1½ grams per hour, something along that nature.  Now if you look on like the Gatorade Sports Science institute website or if you go look at the amount of sodium that people kind of have available storage wise to burn through during something like a triathlon.  It’s somewhere in the range of 8000 to 10000 milligrams or 10 grams.  So wouldn’t you just run out of salt at about 5 or 6 hours?

Dr. Noakes:   No.  I’ve looked at that Gatorade model.  And what Gatorade did was they got some scientist to put together a model that would produce what they wanted which is exactly what you’ve told me.   And therefore, they could justify taking lots of salt.  But just let me remind you that the models that they use.  A model is made to describe what already is known to happen.  We had already shown in 1988 and it was published in 1991.  We studied 8 athletes who developed serious hyponatremia.  Three of them were unconscious and close to death.  And we showed that their sodium deficit was no greater than people who finished the race without developing hyponatremia.  So we proved in 1991 published it in the Scientific literature that hyponatremia has got nothing to do with sodium loss.  And it was written part of the literature because it was inconvenient.  It was inconvenient because sports drinks were trying to say they were better than water because they contained salt.  And the magic ingredient that made them better was salt.  And they didn’t want someone in South Africa coming along and saying you actually don’t need the salt to prevent hyponatremia.  So that’s when the developed this whole salty sweat story.  And that’s when they came along with this model developed by the United States Army Research Institute for Environmental Medicine which said that you could lose so much salt during a marathon or an ultra marathon that you become hyponatremic.  If that was the case, humans would not be humans.  We would’ve died on the Savannah 2 million years ago.  The reality is that we have incredible capacity to conserve sodium.  And they never brought that into their model.  They didn’t put into their model the fact that if you were to become sodium deficient, you would secrete a hormone called aldosterone which would cut down sodium excretion in your sweat and in your urine to zero.  And that hasn’t happened.  So if you are losing 1.2 grams of salt every hour that you’re exercising, it’s because your diet has too much salt in it. And that’s where it’s coming from.  And you would try to excrete the previous day’s excess.  That’s what you’re doing in the Ironman.  You’re excreting the excess that you’ve accumulated the day before.  And if you understand that then you’ll understand that you are not developing a deficit.  You’re trying to get rid of this excess that you’ve got the day before.  It goes even further because David Coslin in 1976 showed that the sodium you take in your drink comes out in your urine.  And it has to because you already got an excess of sodium.  If you take in more salt in your drink, it has to go out in the urine.  So the reality is that there could be people doing the Ironman who are losing 0.0001 gram of sodium every hour in their sweat.  And those are the people who might be at risk of developing sodium deficiency.  Not the ones who are losing 1.2 or 1.5 grams an hour.  That’s the paradox.

Ben:                So can people store more than what you’ll see on the Gatorade website in terms of storage sodium levels.  I would think that that would have to be the case.

Dr. Noakes:   Absolutely.  And there’s in hot days an internal sodium store which again the Gatorade scientists have tried to suggest doesn’t exist.  It doesn’t exist because we’ve spoken about it.  And I’ve said that that doesn’t exist.  But that’s not true.  In the 1950’s, there were studies with radial labeled sodium.  And they showed that the space in which sodium is distributed is much bigger than just the volume that is normally in the blood stream.  There’s an intracellular sodium store which is probably larger than the rest of the body’s sodium.  So when you for example take a cadaver and measure their sodium, they have much more sodium in the body than is accounted for by our usual calculations.  And the calculation you’re giving me underestimates the total sodium content substantially.  And the sodium is sort to be stored in bone and cartilage in a different form.  It’s tied in with other proteins.  And what seems to happen is that when you need the sodium, it’s released from that store and becomes available.  Conversely, we are convinced that some people who develop hyponatremia do the opposite.  They take sodium which is circulating in the blood stream.  And for some reason they drive it into their cells.  And as a consequence, their blood sodium drops dramatically.  And in the past, people said that they have lost it into their sweat and into their urine.  But it happens so quickly that they will have disappeared into their cells.  And this has been noticed for a long time.  If you give people a lot of sodium, you can’t account for where it all goes to.  And it must be going into the cells in a compartment that isn’t readily measurable.  So to summarize, there’s much more sodium in the body than it’s ever calculated in the Gatorade website.  And there are mechanisms to retain sodium in your body if you were to become deficient.  The only people at risk of being sodium deficient are those who have got almost no sodium in their urine or in their sweat.  If you have vast amount of sodium in your urine and in your sweat, it’s the excess from the day before that you’re still trying to get rid of.

Ben:                Now, to my knowledge there are zero professional triathletes racing something like Ironman Hawaii who aren’t using electrolytes whether in capsule or in some type of beverage form during the race.  If they were to stop taking those electrolytes, what would happen?

Dr. Noakes:   That’s a great question because if you force the body beyond its normal physiology, it develops abnormal adaptations.  And you have to adapt slowly back to before you can do that.  Now for example, you’re quite right because there’s a hundred mile race in California.  Well, clearly some people are developing low sodium even though their taking a lot of sodium.   And it doesn’t make sense to us and they’re not becoming over hydrated.  And I think if you stuff your body with even more sodium, it will try to get rid of it.  And if you suddenly withdraw it, you may become sodium deficient acutely over a day or two.  So I think that if you’re taking additional sodium, you are stressing the system.  And it could make maladaptations which could be detrimental for a short time whilst you withdraw the sodium.  So my advice is that there’s absolutely no evidence that these athletes need sodium.  There’s no scientific evidence that they need the sodium.  If they are taking it and I would not advise them to stop it immediately and continue to race without it.  You have to do it slowly because we don’t know what the body will do in turn.  The sodium may work in a different way.  For example, if you take Vitamin C in high doses, it no longer acts as Vitamin C.  It acts as a different chemical.  It may be that if you take sodium at high doses during an Ironman, it has some roll that we haven’t yet described or understood.  But based on scientific evidence published to date, there’s absolutely no scientific reason why you should take that extra sodium.

Ben:                Are there any studies or research planned or in the works that look at something like a marathon or Ironman triathlon without sodium or without electrolyte intake?

Dr. Noakes:   That’s been done since 1900.  When they started running marathons, no one took sodium and nothing happened.  So that has always been found.  And you mentioned our study in the military where we had these guys exercise in 112 degrees Fahrenheit.  And they didn’t take any sodium.  Their blood sodium concentrations were absolutely normal.  And they were absolutely normal because their water content was normal.  They weren’t over hydrated.  They weren’t severely dehydrated.  And if you let the brain control it, it’ll do a fantastic job.

Ben:                Now for the people who are listening in who like me depend on electrolyte capsules or have used them for a very long time frequently during something like a half Ironman or an Ironman triathlon.  If we were to try to wing ourselves off them, and I’m sure that any electrolyte manufacturer is going to cringe when they hear me say that.  Is there a certain period of time that you think we should allow before our body gets used to less sodium intake during exercise?  Or is there no way to really put a timeline?

Dr. Noakes:   In the studies by Jerome Conn, it was about 3 days.  Within 3 days you’ll be conserving sodium.  In other words, your excretion of sodium in sweat and urine will go down.  And it will stabilize at the new level.  So within 3 days you will be perfectly normal again.  So let’s talk about placebos.  You see the problem is, if you believe that the sodium is going to make a difference, it’ll make a 2% difference.  And so the fact that you have used it, you may well believe it helps.  And if you have that belief, it will help.  And therefore I will be reluctant to tell you to stop taking it because of the placebo effect which is massive.  But looking for a biological explanation, if we give it to people without them knowing what it is, then we don’t find a reason why we should give it.  So it has to understand that it may be acting as a placebo in which case they’ll continue using it.  But biologically, the body is too clever.  And we’ve got too much sodium in our diets anyway to need additional sodium.

Ben:                Now, another question is that a lot of these gels have sodium and electrolytes in them so that even if someone were to stop taking electrolyte capsules, they’re still getting salts coming in from other sources.  Is there any evidence that suggests that there would be a deleterious effect from taking in 150 milligrams of sodium in a gel that you’re consuming every 20 minutes or 30 minutes?

Dr. Noakes:   The reality is that the amount of sodium present even in a sports drink is homeopathic.  I mean it’s really irrelevant.  So absolutely carry on.  It makes no difference at all.  And it’s only if you are hypertensive or at risk of high blood pressure that a high sodium intake is probably not good for you.  But very few athletes will be on that state.  So that little amount is really going to make no difference whatsoever.

Ben:                If people want more resources on this or want to go research it themselves, do you have anything you can point them towards in terms of literature?

Dr. Noakes:   Yes.  Well, I’ve written a book about this whole story about the fluids and the sodium.  And it’ll be coming out in June next year hopefully.  And I don’t want to mention names or titles or anything like that.  But just to let you know, I’ve spent 30 years studying this problem.  And I have written the definitive book on the whole issue, how it evolved and what you should be doing.  If people can look by accessing my name on google or google scholar, and typing in hyponatremia, and then they’ll the full story on studies we’ve done on the role of sodium or not in preventing hyponatremia.  And there’s a lot of very powerful stuff I’ve written there which have been highly critical of the sports drink industry.  That would be helpful.  The definitive chapter on the sodium story will be written and publish in this book which will come out next year.  And then people can see where the salty sweat mythology developed.  And how humans are incredible sodium conservers.  So, again to make the point that as we’re going back to the Paleolithic diet which I’m a very strong advocate of, I’m really enjoying my Paleolithic diet.  It has really helped my athletics.  I’m really enjoying running again.  I’m much lighter.  And I feel much better using this diet.  My running times are back to what they were 20 years ago.  So I’m 62 now and I’m running as fast as I was when I was 42 years old.  And I feel fantastic.  And I’m only training 40 kilometers a week.  So, the Paleolithic diet for me works.  But the other point of the Paleolithic theory is that humans evolve in a dry arid salt free environment.  And we’ve evolved as runners under those conditions.  And if we hadn’t been were able to run without drinking very much water and without access to salt we wouldn’t be humans.  We won’t be around today.  And we learned to survive on the fringe with little access to water and little access to salt, yet we survived.  Now we live in an environment where there’s too much water and there’s too much salt.  And my advice is that if you want to be a real Paleolith, listen to your body.  And it’ll tell you how much you need to drink.  And it’ll tell you how much salt you need.

Ben:                Well, I’m sure that people will have questions and comments about this.  And folks, you know that you can go to the show notes for this podcast episode with Dr. Noakes.  And you can leave your comments, questions, and feedbacks there.  And you can generate discussions because I know that this stuff is new and probably a little bit different than what you’ve heard in the past.  So Dr. Noakes, I want to thank you for taking the time today to come on and talk to us about this.

Dr. Noakes:   It is my pleasure.  And I do apologize to everyone because I know there are many upset people out there.  And I do apologize.  But it wasn’t me who said you must drink a lot.  And it wasn’t me who said you must drink a lot of salt.  But I think what you have to do is when you look at the real science, you’ll find that there’s just isn’t anything to support this advice.  And I’ve looked at the science for 30 years.  And I’ve researched it intensively.  And these are the conclusions I’ve come to.  As I’ve indicated I’ve written the book which is utterly evidence-based.  There’s nothing there that’s not evidence based.  And what I’m telling you today are evidence based.  And unfortunately, it may upset a lot of people.  But at the end of the day, we just have to do what’s good for the body.  And I hope I’m telling you what is good for the body because at this moment what I’ve told you is what science tells us.

Ben:                Well, I’m a big fan of self experimentation.  So I’m going to play around with this a little bit between now and Ironman Hawaii.  And I’ll see what happens.  So alright, that’s going to wrap it up.  And folks, you can check out more of this discussion over at BenGreenfieldFitness.com.  Thank you Dr. Noakes.

Dr. Noakes:   Thank you very much Ben.

Ben:                Well, folks, that’s going to wrap up this week’s podcast.  I will put links to everything that I talked about today over in the show notes to Episode # 157 at BenGreenfieldFitness.com, including my new book the Rev Diet at RevDiet.com.  The Capraflex that I talked about, the magnesium, the smoke point chart, I always put everything on the show notes.  And of course within a couple of weeks after each interview is released, it is fully transcribed and available for you over there at BenGreenfieldFitness.com where remember, you can also donate a dollar or anything you want to keep the show going and to support the cost of everybody downloading this podcast.  Finally, remember to text the word fitness to 411247 if you want in on that special little project that I’ve been working on.  And have a great and healthy week.  This has been Ben 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

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