July 30, 2009

Podcast #53 from https://bengreenfieldfitness.com/2009/07/podcast-episode-53-six-key-performance-factors-every-athlete-needs-to-know-about/

Introduction:                    In this podcast episode: six key performance factors every athlete needs to know, stomach bloating while swimming, carbohydrate loading, running intervals, fat loss for breastfeeding mothers, whether mineral water actually works, more on the HCG diet for fat loss, and what to do to make raw almonds taste better.

Ben: Hey podcast listeners, I am a little bit upset with you because there have not been many comments over on the blog at www.bengreenfieldfitness.com. What I would like for you guys to start doing is as much as possible, rather than emailing me your questions, leave them in the comment box over on the website underneath the podcast episode that you listened to that made you think of the question or in really any of the posts over there because it’s really fun to get conversations going and actually have more comments appearing over there. So I am going to be much more likely to pick your question to answer if it appears as a comment over at www.bengreenfieldfitness.com rather than as a question emailed to me. The other thing that you can do if you have questions and you want them answered on this show is you can call our toll free number that actually has a dedicated line that’s set up for questions and it is in the Shownotes to this podcast. It is 8772099439, you go check that out. Either way, I’ve got tons of questions this week. I’m not really mad at you. I’m not upset. I just want to see more comments over on the blog, less floating into my email inbox.

Podcast listeners, this is Ben Greenfield coming to you once again from www.bengreenfieldfitness.com. And today I want to talk about a very interesting paper that I came across in the past couple of weeks and this paper identifies several key factors that I think every single athlete on the planet should actually know about. It was written by a physician and a gentleman who’s actually an avid athlete himself. He’s got about two decades of experience in preventive medicine and sports performance medicine and has been training and counseling members of the American medical community on nutritional issues for the past 15 years and he really is recognized as one of the leading authorities in biological analysis of athletic performance factors. This gentleman’s name is Dr. Richard Cohen and I have Dr. Cohen on the other line. Dr. Cohen, thanks for joining us today.

Dr. Richard Cohen: Hey Ben, appreciate it. I’m glad to be here and hope we can give your listeners some new and exciting information.

Ben: Oh I’m positive that we can. I’ve read this paper and some of the things in here are just going to be so valuable for people. They were incredibly valuable for me. But before I start to ask you about these key performance factors, specifically these six key performance factors that you have listed in this paper, can you explain how you actually came to identify these factors that you write about as the key factors? Where did you actually come up with these factors as being the ones that are unique or the thing that every athlete should be looking at? In other words, what sets these factors apart?

Dr. Richard Cohen: I think there are two components to them. One is there are some very specific factors that individually for athletes when deficient or not at optimal levels have dramatic effects on your wellbeing. So those factors – these two specific ones just can’t be overlooked and if you’re running low and not paying attention to them they make such a dramatic difference in how you perform and how you feel. So those are very low hanging fruit. In my book, no brainers. The other four have sort of a dual benefit. One is yes, individually they are very interrelated and what’s interesting about these four – I found neat about them – when you put them together, they give you a very nice picture of a general state of performance health or performance wellbeing which is sort of how I like to look at it. So you have a couple of individual factors and four factors that work together and will globally give you a feedback of how you’re doing. They’re derived… I was 10 years in private practice – very sort of progressively nutritionally oriented practice back east in New England and the more I got involved in testing people and trying to understand how people perform at their best – there are just certain things that kept repeating themselves. So these – as I say six factors sort of gave you this nice picture of where people are. I could go on  but I think that answers your question.

Ben: Ok, to this is a way for an athlete to basically have a snapshot of where their body stands from a health perspective or from a performance perspective.

Dr. Richard Cohen: Exactly. Does it tell us every particular feature? No. But two ways to look at it, if these six factors are right on, I would say you’re in real good shape. If a couple of factors are not correct, you can fix them and it just opens up your thoughts processes to what else is going on. The other nice thing about these six factors are they’re factors that you can sort of assess for yourself. So what I try to do is not only say ok, which are important? But which are going to be reasonably inexpensive to access, as well as there are laboratory processes that allow you to collect your sample at home. So you don’t have to go to a lab. You don’t have to go to a physician. These are things you can take control of yourself. So it’s sort of a blending of all these different components to come up with these six.

Ben: Right, well let’s touch on how people can actually test for these. When we finish introducing them. But let’s just jump in to  it right here. You’ve got six factors and I’d like to start with just the very first one that you think is important in terms of being one of the six key performance factors that every athlete needs to know. Metabolically appropriate fuel.

Dr. Richard Cohen: Absolutely.  I think it all starts with what we put in our body. Absolutely.

Ben: Ok, so does this go deeper than just eating healthy?

Dr. Richard Cohen: Absolutely. So if your listeners can understand this one point then I think we’ve done our job. You need to look at food in a new way. You need to look at food… a, food provides nutrients for short term and for long term (inaudible). But even more importantly for an athlete, food is your fuel. So, most people that I know go through the day picking foods that either they like or foods that they’ve heard is nutritious or what maybe the latest research said was good for you – eggs are good, no no, now it’s bad. No wait, eggs are good again. Lean meat is good. No, wait. No it’s not. You just get on this roller coaster ride, but when you begin to understand that you can eat very specifically to fuel your body and every person actually has a unique need for a different type of fuel, the same way you wouldn’t take a diesel Volkswagen and put regular gasoline. Nor would you take a propane car and put diesel fuel in. so everyone’s particular needs for fuel are going to be different and that a lot of times will override – at least on a short term for a performance or a race or for heavy training or just for wellbeing – the nutritious part of it. You want to shoot for both. But if you have a choice, a lot of times it is the fuel that’s going to leave you feeling better.

Ben: Ok, I want to get even more specific about this because you actually have differentiated between the metabolic types for people that need certain types of diets. Can you explain that?

Dr. Richard Cohen: Sure. Metabolic typing or just sort of the general…

Ben: Well in your paper, you talk about fast oxidizers, slow oxidizers and mixed oxidizers and each of those different types of athletes needing different types of fuels.

Dr. Richard Cohen: Got it. So let’s just give you sort of a paradigm. I’ll carry on a little bit further from what we just talked about and I think it’ll make it very, very clear. Oriental or Asian people, culturally and geographically have survived very well for hundreds and thousands of years on vegetables, rice and a little bit of fish and not too much fat. They do very well. Now, let’s go the opposite way. You have Eskimos or Inuits. What do they eat? They do not eat these food. They survive on fat and meat and rare amounts of vegetable. They’ve found a way to get their nutrients. If you switched each of these diets for each of these population bases, they would each not perform well and they would certainly become ill in time. Their own metabolic needs based on their geography, based on their ancestry, their genetics are different. Now we live in a world in which the geographic lines have blurred or cultural lines are blurred. Even up to 100 years ago, you knew where you were from. You knew the foods that you ate. In fact the food that you ate were local or seasonal. You could trace your family line back to one particular area. Well that doesn’t exist anymore. So where people used to eat, where they lived – not only do we have to deal with foods from different parts of the world and foods that are marketed to us and processed food – we really don’t have a grasp anymore of what foods are best for us. There is a way to do that and getting to this fast, slow and mixed oxidizers. There are people who perform well or feel better, such as the Asians, and they would be more of a slow oxidizer – they feel better on lighter foods. You can even start asking yourself, how do I feel better? Can I eat… gosh, just have some fruit in the morning, maybe a bagel and I feel great. I have good energy. I don’t bonk. I’m not hungry. Or are you someone who would be a faster oxidizer such as an Inuit who would feel much better on some eggs, maybe some potatoes and some sausage. You go that’s not healthy, right? Well not necessarily. If one were looking at it as fuel, so how are your fuel needs? So a fast oxidizer typically is going to need a richer…we can get more complicated but very simply they need a richer, heavier diet. Their body burns fuel at a faster rate. In fact they thrive on fuel that is rich, we’ll call it for simplicity. Where a slow oxidizer is going to feel on the same type of food sluggish, heavy, tired. They’re not going to perform well on even a vegetarian or quasi-vegetarian diet. It’s just what their makeup is. That’s very simplistic and there’s variations in there, and then you have your mixed oxidizer who needs a little bit of both. They can go real heavy, but you know what? They need a little more protein. They don’t do as well on grains. They can have some fats but instead of heavier animal fat, they do better on nut butters. They do better on olive oils and such. Go ahead.

Ben: I was going to say it just seems in a nutshell, what we’re saying is that for the Ironman triathlete who’s got a five hour bike ride on a Saturday afternoon, one might have the performance of their lives because they had  an omelet that morning for breakfast and another might have had an omelet but just completely hit a wall when what they really should have had was oatmeal.

Dr. Richard Cohen: Exactly. There’s a balance. I’ll say right out, the majority of people do better with richer fuel. Our ancestry for the most part, getting into… it is more of that sort of paleo type diet which is proteins and vegetables, less grains. But absolutely. The key is making people aware, giving them knowledge of not one size for all. It’s sort of interesting. If you go back to the 20s when if you look at medicine, everything was germ theory and bacteria. We had no clue even 80 years ago. Actually 120 years ago, Louis Pasteur – that’s really when we even understood bacteria caused disease and it wasn’t really until 1930 or so… Francis Pottinger and Royal League, they actually started to pay attention to any nutritional deficiencies and as you go through the years, well then we started to even in the 60s and 70s… well diet and fat may play a role. But we’re not, for the most part, especially in the medical profession. And it’s really understanding that each person is uniquely different and just if you get into the research and the news headlines and one thing is good and they do these mass studies on particular diets and nutrients. They’re misleading because they’re studying groups of people all with different needs. So (inaudible) what your individual need is, especially from a fuel perspective and then if you intuitively follow things such that – you talk about all the time if you stick with things that haven’t been modified, haven’t been processed and existed in nature, you’re so far ahead of the game you can shut off your brain to most of the popular research because you know you’re doing what’s best for you. And then you modify it as new information comes out, but it becomes very intuitive and you go gee if I’m feeling good, if my energy is good and I’m not hungry and I’m performing well, well guess what, something’s right. And that’s what you need to do. And then you can begin to say how do I fine tune this? How do I begin to assess some key factors. Absolutely. Metabolic – understanding how to fuel yourself is crucial.

Ben: When we finish talking about these six factors today, I’ll mention about some of the ways that you talk about how to actually figure out whether you’re a slow oxidizer, a fat oxidizer, a mixed oxidizer. But I want to on to factor two, because in addition to use metabolic appropriate fuels,  you talk about factor two being proper PH balance which I really know not a lot of people think about, but what does that mean? Proper PH balance. What does that mean for the athlete?

Dr. Richard Cohen: Ok, so I guess… PH… just for people, we’ve heard that term. You can go back to chemistry and so forth. PH is the measure of the hydrogen concentration basically. It’s the power of hydrogen actually, is what PH means. So, PH is a measure of acid/alkaline where if PH is less than 7.0 it’s considered acid and there’s more hydrogen. If the PH is greater than 7, you’re more alkaline. Everything on earth has a balance that is crucial between acid and alkaline. The body requires a very tight control of PH to be mildly alkaline. And if you measure blood PH it will be 7.2., 7.3, 7.4. Not much greater than that. Now, the body will do everything it can to maintain that PH level because… we could go on for a long time discussing this but it’s… let it be, the cells require this balance to function properly. There are chemical reactions and if the PH is not appropriate, things are just not going to work well. In fact signs of illness or severe illness occur when the PH in the blood becomes acidic. In fact, death is defined by a very low PH. So acidity is disease. Alkaline, up to a point, is health. There are a number of things that we do to our body that create a greater acid load. And that’s a problem, because as we said, when the body has an acid load, it needs to take some of these resources to try and create that alkaline balance.

Ben: Dr. Cohen, your voice just faded a little bit. I don’t know if you’re mouthpiece might have gone a little far. Go ahead and say something.

Dr. Richard Cohen: The body needs (inaudible) acid/alkalinity. So when it becomes acid, it reaches into its stores and primarily its store of minerals. Calcium, magnesium, so forth, to try and create this balance. And sometimes it can’t do it sufficiently and we wind up maintaining a very acid state. The problem is there’s not an ideal way to measure this. You can measure serum PH, as we talked about. But that doesn’t change very much and is really not practically to periodically three times a day check your serum PH and getting your blood drawn. And the body, like we said, will do everything it can to modify that serum PH. There are ways to look at PH and one of the factors that are important to monitor with our athletes is urine PH. It gives us a sense of a trend of what the body’s acid load is. You just collect the urine sample and there are dipsticks that have PH color read outs and will tell you what your status is.

Ben: So primarily, you would be looking at actually changing the food ratio in your diet based off of whether you were acidic or alkaline?

Dr. Richard Cohen: So let’s get back. So what plays a role in creating a greater acid state? Certainly foods. If you start looking up heavier meats, sugars, grains, citric acid, sodas, energy drinks — II think you just sent a little blurb about that – are one of the major concerns. We see most of these endurance energy drinks are extremely acidic. Stress, overtraining. These all create acidic states in the body. And when the body has enough of its nourishment, when it has a proper balance, when it has recovery status and we’re talking about some of the integrated factors, your body can handle that load up to a point. With regard to diet or foods, like I said, there are traditional foods… it will vary a little bit depending on each person’s metabolic type. So a fast oxidizer can tolerate more animal protein than a slow oxidizer. There’s been a recent book that was published and some more literature that has come out again in the press which will be consuming. So protein is very harmful to you. Yes and no. Excessive amounts of proteins, when someone is consuming lots of sugars and not many vegetables which tend to be alkaline, when they’re drinking sodas, when they’re eating grain and top it off, if they were a slow oxidizer that’s… they’re’ big people. But you take a fast oxidizer who’s eating proteins and typically their proteins are with vegetables or they’re not drinking energy drinks or unclean water, their mineral balance is good, not a problem at all. So here, you can see how you become misled and someone who says, Gosh I’m eating too much protein… well not really. So following this acid/alkaline balance will give you a nice overall clue of how things are going with you. And it’s one of these markers that tie in really directly to mineral status, which is sort of… we’ll call it marker 2a.

Ben: Right, and the mineral balance – that’s basically the third key factor that you talk about in addition to this… the metabolic typing, essentially, and also the acid/alkaline balance. Talk to me about the mineral balance. I should let you know, we talk about magnesium a lot on this show before. I know a lot of people who have listened in or are fans of the podcast have heard a lot about the importance of magnesium but when we talk about mineral balance, is it more than just the magnesium and where does calcium come into play?

Dr. Richard Cohen: Right. So minerals obviously are key. I had the opportunity to listen to the magnesium… and it’s one of the key factors that when I was in full-time practice, the majority of people were outright magnesium deficient. So these are one of these factors that you can do some overviews. Now calcium… there’s minerals, there’s macrominerals and microminerals. Calcium, magnesium, zinc, chromium are some of the macros and then selenium… actually I put chromium in a macro status. So there are a number of them. Then you have trace minerals, which we don’t really want to address at this point. Because those are extremely difficult to monitor. But the two crucial minerals that we want to pay attention to are calcium and magnesium.

Ben: Interesting.

Dr. Richard Cohen: Right. And calcium… it’s sort of a shock for most people. We all think we don’t get enough calcium. The fact is we actually get too much calcium. The problem… we’ve been provided information for years to show that calcium is important for bones. Well, it’s interesting. If you look at literature, the countries that consume the most amount of calcium actually have the most amount of disease, specifically bone loss and other illnesses. The countries that have the least amount of magnesium actually go right along with that. So there is a direct correlation between too much calcium and not enough magnesium. Both of those minerals are essential for the cellular membrane function. The problem is not enough calcium. So you look at some of these… we’ll just pick Asian countries where they consume lots of vegetables. In fact their body tends to be much more alkaline. Their calcium need is not high. Because their calcium which is primarily stored in the bone is not being resourced by the body to balance out that acid/alkaline state. So, it’s this catch-22. Feed more calcium into the system but the body is really losing it because it’s requiring it to balance out the acidity which is created by stress, by energy drinks, by sodas, by too much proteins, by sugars, etc. Does that make sense?

Ben: Yeah, it makes perfect sense. And it’s so funny because so many people, athletes and just the general population… I know they come into my office for nutrition consulting or performance consulting and they’ve got these huge bottles full of their calcium supplements they take on a regular basis…

Dr. Richard Cohen: Right. It’s wonderful marketing.

Ben: Yeah. But in contrast, you describe magnesium as the king of minerals and it’s kind of funny because any of the top respected physicians we have had on this show in the past six months, every single one has listed magnesium as one of the top supplements that their patients and the athletes that they work with should be taking. All of them have reasons that kind of coincide, but when you described magnesium as the king of minerals, that makes you like the fourth or fifth renowned physician that’s come on this show who’s said that. Why do you describe magnesium as the king of minerals?

Dr. Richard Cohen: From an athlete’s perspective, magnesium is involved with more enzymatic… the minerals for the most part in the body are co-enzymes. They sort of promote or are involved with energy processes or other bio-chemical processes. Magnesium is involved in more bio-chemical processes than any other mineral in the body. So without sufficient amount of magnesium, these chemical processes just don’t work well. And magnesium specifically is involved with energy formulation or energy transfer. And take it that much farther, magnesium is involved with muscular function, cardiac function, rhythm, relaxation. It’s the tone of the body. The ability of the muscles to perform, the ability of the muscles to relax and it’s that magnesium-calcium balance which is crucial for cellular function. So if that balance is not there, if there’s too much calcium or the body is losing calcium and it’s deficient in magnesium, things are not going to work. The body is not going to process properly and we know… we’ll take it one step further, magnesium in a traditional diet which we’ve gone away from in modern civilization was abundant. Magnesium is in vegetables. It’s in anything that’s dark and green and leafy. It’s in some grains. Abundant. Not a problem whatsoever if you look at primitive… you look at the diets that existed before modern civilization. So the body doesn’t really have a wonderful way of holding on and replenishing magnesium because they always was there. So when we’re magnesium deficient, our diet… we also on the flip side have a hard time restoring magnesium. It’s funny that magnesium is actually almost as much prevalent in the bone as calcium. You don’t hear much about the importance of magnesium. There is no Magnesium Council. With calcium, we have a Dairy Council. There’s no one pushing magnesium. There’s no one marketing  a particular product or food that can be sold. Unfortunately that’s the main crux of the lack of magnesium PR. If you look straight up, magnesium is more important for wellbeing.  The challenge with magnesium is double. One, it’s a hard mineral once you’re deficient to restore. I’m real interested in the topical. We’ve been working with that recently. And it’s hard to test for. There is a particular interest… cellular acaid, that’s done at a lab out of California, but to specifically look at magnesium, that’s $300, $400 a test. If you go to your doctor and you want to test serum magnesium, it’s like looking, waiting for the yellow light on your gas tank to come up to tell you that you’re low. The only way that your magnesium is going to show low is if you’re severely low. So that’s not really efficient. Some people look at red blood cell magnesium, it’s a little bit better. And some people look at hair and 24 hour urine, that was one that when I was in practice, you could actually load someone up with intravenous magnesium and take a urine before and a urine after and see how much they hold on to. Again, not a very practical way of assessing it for the general population base. When we look at mineral acates as a key factor, I can talk a little bit about this, there is a particular marker and it’s called urinary NTX. It’s a collagen breakdown product of bone. It shows this marker… it gives a global overview of these two key minerals, calcium and magnesium, the status of the body. When your body is acidic, when your body is minerally imbalanced, if you’re losing calcium, if you’re pulling it out, if you’re magnesium deficient, begin to break down bone. Other things will happen in the system. There’ll be lack of energy. You might have muscle spasms and a variety of things relate to magnesium deficiency but one of the things that are easily measured through a urine sample is this increased amount of this NTX molecule. So when NTX is elevated in the urine, one, you know you’re breaking down bone at that point which certainly is not a comforting fact to know and how that’s going to affect you – that’ll be years down the road. But at that one point, when you’re collecting that urine, you’re minerally imbalanced and you’re acidic and you’re going to assume, one, that’s not a state to be, and two, your performance is not going to be optimal. So it’s a real interesting factor and it’s one of these interrelated factors as we talk about because as we’ll learn it relates to vitamin D. It relates to amino acid status. It relates to your PH acid/alkaline balance. And also it relates to are you following the proper diet?

Ben: So, you mentioned the amino acids and I noticed you have that also listed as a factor in addition to the mineral balance. Now, most people are familiar with amino acids as being the things we need to get into our bodies after a workout to make sure that we rebuild muscle or recover properly. When you say that that’s a key performance factor for athletes, what exactly are you referring to when you say the essential amino acids?

Dr. Richard Cohen: Ok, so amino acids are protein building blocks. And basically from a very simplistic form, we eat protein. Your body digests the protein into these particular nitrogen based little sub-units called amino acids and then it absorbs them. The body’s job is then to take these amino acids and recreate like a puzzle – it takes this puzzle, takes them apart, shifts then and puts them back together to create enzymes and proteins and neurotransmitters and hormones, etc. So it’s the structure. So think of protein and think of amino acids as the framework of your body. It’s how you’re building your house and you have to start with a foundation and a structure. Of the amino acids, which there are 22, eight of them are considered essential meaning that your body requires all eight of these pieces to build everything else. So while there’s 22 pieces in all, the other 14 can be made from those eight essential amino acids. Make sense?

Ben: Yeah.

Dr. Richard Cohen: So, the problem that we see is we don’t tend to think of amino acids per se. What’s my amino acid intake? We’re lucky if people are aware of what my protein or even aware of the difference between protein, carbohydrates and fat. And as a nutritional consultant, how do I get enough protein? So our concern is step one is just to make people aware of you need protein for amino acids. Especially for athletes. The greatest source of amino acid need is sort of for an anabolic nature. Anabolic would be repair and restoration for muscle recovery. Every time you’re working out hard, that soreness are your muscles basically breaking down and the body needs to be able to repair them and recover, rebuild, to restore hormones, etc. So, this is my… not too long ago, it’s like ok, get enough protein and this sort of came out from working with a few endurance athletes here in Bend and they were getting enough protein. Yet they were experiencing… and this was one particular one sort of changed my paradigm, she was on protein powders and was eating red meat. She was just not feeling well. She was losing weight. Her muscles weren’t recovering well and we did a serum chemistry on her. And lo and behold, her plasma albumen which is a protein in the blood was deficient. That’s again sort of like she was extremely low. We didn’t even look at amino acids. Her protein in her blood was low. Her hormone status was low, which again was a protein component. And then lastly, she was having some stool problems. We looked at a stool analysis and she had protein fibers in her stool. So it’s like put two and two together there. There’s this woman who was eating enough protein, but she wasn’t absorbing it. Or what she was getting wasn’t doing the trick. As I started to look further into this, you have to understand there’s two limitations. Let’s go, three. One, you need to be eating protein to meet your metabolic needs and to meet your physical needs. So if you’re sedentary, you’re not under stress, you’re not ill, you’re not injured. You’re going to have a lower protein or amino acid requirement. If the proteins you’re eating are not of high quality, and there’s a term called “biological value” and biological value manes the ability of the protein source to be used in an anabolic way for restoration. If protein isn’t used or the amino acids from the proteins aren’t used for an anabolic repair and restoration, they’re basically just burned for energy or they’re actually turned into energy stores. They’re actually used for fat storage. So, here was someone who was getting enough protein but either the protein quality – and she was consuming a lot of protein powders – well lo and behold, we think protein powders are a great source. They can be useful but the biological value of a whey or an egg whey protein is about half of what you get of a red meat or some chicken or the best would be a whole egg. Then take it one step further with this, what’s your ability to digest proteins? You get the catch-22. If you’re under stress and or you’re amino acid deficient or you’re getting older or you’re overtraining, your digestive enzymes decrease. So then you don’t break down even if you’re eating healthy, clean, grass fed bison or fresh wild caught salmon, etc. It’s three-fold and we subsequently went ahead and did a plasma amino acid and she was dramatically deficient in these branch chain amino acids. We needed to restore her amino acid status so even though she was eating metabolically correct for herself, she was deficient and by restoring her amino acid status, everything began to recover. Hormonal recovered, muscle base recovered. Digestion actually improved. She noticed within a few weeks of restoring amino acids, she could begin to break down foods more effectively and one of the more interesting things… there are a couple of wonderful age related researchers on sarcopenia and sarcopenia is the age related loss of muscle and what they found, which sort of blew me away, was when they restored amino acid status – they used IVs for some of these studies – hormonal levels improved and you take people in their 60s and 70s and their muscle mass improved. So the realization is that we used to think it was the hormones defining, affecting perhaps our ability to use proteins and amino acids for muscle recovery. People use testosterone and such to try and bulk up and not all those studies show super benefits because if you don’t have the amino acids or you’re not able to absorb them or you’re not utilizing them properly then it’s not going to work. So you can actually create this strong anti-aging benefit by restoring your amino acids. So it’s a whole new exciting… and I’m really looking forward to following up on people and looking at sort of the other benefits we see with amino acid illustration.

Ben: And you said you did a plasma test on that girl, and that’s something as simple as just like a blood test right?

Dr. Richard Cohen: Right, and that’s why actually it’s one of the key factors is you can assess that by a finger stick believe it or not. So we can talk more about that. So amino acid recovery is truly… or understanding what your amino acid status is, is essentially. I subsequently had another athlete. She’s actually a nationally renowned ultra-endurance runner and she’s doing pretty well. We checked her amino acids and her branch chain amino acids are all low. She’s getting by. At some point, she’s going to crash because you can’t just continue eating up your muscles to fuel your body proteins and to fuel… your natural store of amino acids are your muscles. So the paradigm shift is protein needs really are amino acid needs and you need to understand that eight essential amino acids are crucial and if you’re deficient in one of those pieces, you can’t put the puzzle together in an appropriate way. A lot of foods – vegetarian – people are eating mixed amino acids, especially if their body may be requiring more protein based and metabolic type are going to be in trouble. There’s no… there’s no way they’re going to perform anywhere near their optimal status. Vegetarians do well, not if they’re amino acid status is not balanced, not if they’re not eating according to their metabolic type. Can they get by? Yes. Is it a good thing for the earth? Yes. But not for performance. And ultimate long term health, for sure. Just relates to the amino acids though.

Ben: Yeah, and I think that will come as a shocker to a lot of people who just eat their protein and their recovery drink and think they’re doing just fine. So, it really… I want to move on to the next performance factor but what this really comes down to is if someone’s doing everything right and they’re still feeling crappy or they’re not racing like they want to race or they’re not training like they want to train, then they may need to get a little deeper than just making sure they’re eating enough protein and consuming their vegetables.

Dr. Richard Cohen: Absolutely. And you know what, there are some guys here who do everything wrong nutritionally  and they do well. We have people who have greater genetic reserves…

Ben: You’re fading a little bit.

Dr. Richard Cohen: There are certain people who can do “everything wrong” nutritionally…

Ben: Did your headset just turn down?

Dr. Richard Cohen: No.

Ben: Interesting. So they’re doing everything wrong but they’re still doing ok?

Dr. Richard Cohen: Still doing ok. So the question is could they have done better? And what’s going to happen to them in five years once they stop? So there are people who have genetic resiliency and they do have youth on their side. But then for every one of those, it’s sort of like yeah my grandfather smoked and he died at 92. What about the other people who smoked and died at 50?

Ben: Exactly. They’re an anomaly.

Dr. Richard Cohen: There are always the anomalies of people who have the ability to last and then you can check into them down the road and what happened to you? So, you pay for it.

Ben: Yeah. Now we had Dr. Minkoff on the show from Lifeworks Wellness Center down in Florida, triathlete down there. one of Dave Scott’s friends and we also talked about the recent vitamin D meta-analysis that basically compared vitamin D to almost like a steroid hormone in terms of its ergogenic benefits for athletes. You list vitamin D as your fourth key performance factor. Why?

Dr. Richard Cohen: Gosh, sometimes I think it should be number one. Vitamin D… and the research on vitamin D over the past 10 years is just exploding and you go how did we miss this? And the fact is we really didn’t have a way to easily assess it. We didn’t really truly become aware of one, that vitamin D was such a critically deficient nutrient for many people because we couldn’t test it. And two, even when I was in medical school 20 years ago, it wasn’t understood that receptors for vitamin D have the ability to convert vitamin D into its active form was present in every cell. Let’s back up here. Vitamin D is not a vitamin. That’s one of the misnomers. While it’s called a vitamin, the only reason… it’s interesting if you go back to the history, but vitamin D was thought to be a vitamin because they found dogs who would… there’s a disease called rickets basically and they were trying to figure this out with animals and they found that they found dogs who had rickets or weakening of the bone, basically breaking their bones, they gave them fish oil which had some vitamin D in it, they got better. They didn’t break their bones. So they figured oh ok, here was an essential nutrient that’s present in food and that’s the definition of a vitamin. Something your body can’t make. Well it turns out your body does make vitamin D and it makes it from exposure to the ultraviolet B rays of the sun. There is a cholesterol, basically a steroid cholesterol component found in your skin that gets activated by UVB of sun so it is not a vitamin. In fact the same way that the body creates testosterone, a hormone, out of cholesterol in a different process but it uses a cholesterol product to make vitamin D. So within every cell and muscle there are vitamin D receptors. So, vitamin D yes has strong effects – strong steroid like – because it is a steroid like hormone in the body. It’s really more hormone like. The other thing that’s really incredible about vitamin D is it controls the genetic process. Every cell has the ability to modulate how it sort of uses its genetic machinery and vitamin D manipulates that in a very positive, beneficial way. When vitamin D isn’t present in an adequate amount, that machinery doesn’t activate in an appropriate manner. That’s the general vitamin D scoop. And the other really important factor was with our ability to know test vitamin D relatively easily, finding that deficiencies are rampant. Vitamin D is linked to deficiency for autoimmune disease, cancer… the list goes on. While it’s not our direct topic, it is a globally deficient nutrition. People don’t get the sun that they used to when they worked outside and lived outside. Generally if you look at levels of vitamin D for people who spent times outside…

Ben: You’re starting to fade a little bit there.

Dr. Richard Cohen: Fading again?

Ben: There we go. Ok, so generally it’s 60 nanograms per milliliter. If you look at indigenous populations that work outside, that’s what their levels are, and that’s what our studies show are optimal amounts. The majority of people, if they’re living inside, even if in their warm climates… you don’t get outside sufficiently, their levels can be anywhere from 20 to 30 and that is deficient. With that deficiency causes risk of illness but decrease in performance. What’s amazing is mankind’s been around enough and before we were information loaded, there was intuition. People had time to study the stars and even going back to the Romans and Greeks, they knew that when people had sunshine… just became aware, when people had adequate sunshine they felt better, their mood was improved. They work longer. They performed better. So they would be more resistant to certain illnesses. So actually going back to the original Olympics, they used to have sun. Send their athletes away for sun. And this sort of continued unless it was forgotten, until the Germans and Russians did this through 30s and 50s and that’s where a lot of the research came from. They would show endurance increase, they would show power, strength, muscular, vertical jump, speed in the 100 meter decreased over a second. They showed changes in performance over the year. It makes sense if you’re coming out into spring and you’re living in a dark climate and you haven’t either been traveling and getting sun or taking vitamin D, your performance – if your levels are down are not going to be the same and you’re going to improve throughout the summer so people notice that… or if you go to a sunny location and you’re trying to compete midwinter, even if you’ve been doing your indoor workouts as a cyclist, you’re just not going to be able to compete with someone from the southern hemisphere who’s… it’s their summertime. That’s pretty clear. There’s rises and falls and we see that with cross country teams. They do great coming out of the summer but a lot of them begin to overtrain, not because they’re training too much. Their D levels are slipping. Some of the research we did here in Bend with the local high school cross country and track team, D levels were significantly deficient. So, gosh. Metabolic fuel certainly is something you can do for yourself and I’d say number one… the number one thing I would have people look out for is vitamin D.

Ben: And again, it’s something that you can test for and this is something that people can find out and well again, I’ll say that until we’re done talking about these last two factors. But stress and recovery hormones is what you list as factor five. You talk about testosterone and cholesterol are your two key stress and recovery hormones. Why is that ratio so important?

Dr. Richard Cohen: We talked about… this is one of these interrelated factors and I’ll say I used to look at testosterone and cortisol maybe as a primary factor but we live and we experience and we learn and it’s sort of the fun thing about health and performance and feedback. The ability with anything, to stay open-minded and to put things in perspective and understand… we’re sure we’ll understand more than we even do now. But testosterone is an anabolic hormone, meaning its primary function as we talked about with amino acids is recovery and repair. It has some other benefits, the sexually oriented benefits but from an athletic perspective, you need testosterone for recovery and repair. Cortisol is your stress hormone. Cortisol, while in small amounts for quick recovery is important but cortisol in higher levels is a breakdown. It’s a catabolic hormone. Cortisol levels which occur with aging.. in essence… let’s give people a visual perspective. Take a 17 year old boy, ok? Who can pretty much do anything, run into walls, fall down, eat anything he wants and they’re lean for the most part, muscular and they recover really well. Take one as you get older, about 60 – you’re working hard, your muscles just don’t recover. You’re sore. You got a little fat around your belly and you just don’t handle stress and it takes about 9 months to recover from something that didn’t even bother you when you were 20. Guess what? It’s a testosterone cortisol ratio imbalance and obviously amino acids and vitamin D all play a role. But those two key hormones are crucial. Cortisol is key for acute stress responses. It saves your life. It was the fight or flight hormone when we’re in depth. It’s responsible for other stress hormones for causing our blood to clot, for blocking pain thresholds or for changing our mental acuity and you can see better. So cortisol is very helpful in acute stressful situations. It helps your body recover. It helps you prepare and handle injuries – life threatening or body threatening type responses. But over as we age, as that testosterone-cortisol ratio becomes imbalanced or when we’re chronically under stress and we either deplete cortisol or we cause cortisol levels to rise – blunt immunity, blunt recovery, blunt energy, etc. So looking at a testosterone-cortisol ratio gives you a sense… again it’s a global marker of your recovery status, your ability to… that anabolic/catabolic balance. Anabolic being youth. There’s a way to think about it. Anabolic is youth. Catabolic is you’re getting old. Your body is breaking down. So, the more that testosterone-cortisol ratio is elevated, the more youthful your body is, the quicker it’s able to recover. It’s a marker of stress and wellbeing in a very simplistic way.

Ben: It makes sense. Now what’s the last factor? I know we’ve gone over quite a bit here, but you do have one final factor that people need to be concerned about in terms of it being a key performance factor for athletes. What is that?

Dr. Richard Cohen: Iron. This is partly interrelated because your iron levels are compounded or related to protein intake, dietary intake and so forth. Iron levels – this is the one that actually sort of started this whole paradigm of assessing the athletes – these key factors. I was asked by a local high school coach who had two state… we’re in Bend, Oregon so there’s… it’s endurance… everyone is doing something endurance related here. They had two state champion runners who both had iron deficiencies last year. And he got to the point where he felt he could take a look at people – at these girls primarily – and sort of see if they were low on iron. You can sort of judge how they were training, what the recovery status… almost a glint in their eye. So he asked me to help him out. We went ahead, we tested 20 girls. 17 of them had low iron levels. Why is that important? Well iron is the critical component of heme. Heme being what binds onto oxygen in hemoglobin in your red cells. So if you don’t have enough iron, you’re not going to deliver oxygen to your muscles. Also, if you don’t have enough iron… iron is one of those co-enzymes that’s involved, just like magnesium in energy processes. There is risk with regard to being an endurance athlete, especially if you’re doing a lot of pounding. You can lose iron through the foot actually… the pressure, you can break down your red cells, you can lose iron through your GI tract. A small amount bleeds, the micro bleeds. You can lose iron… in especially young athletes. Women, you lose iron through menstruation so iron loss… actually one other component, your iron levels will be depleted because endurance athletes raise their blood volume. So iron is a crucial mineral that is frequently low especially in women, that will affect your performance. The important thing to understand is that you can have low iron and not be anemic. Again, anemia would be extreme iron deficiency to the fact that your red blood cells are now deficient in number. So you have a significant disability in providing oxygen and muscle fatigue and other complications associated with that. But what we’re finding, and not just us, it’s known for years is athletes’ iron which is measured by something called ferritin and ferritin is just a protein which binds iron – when that ferritin marker begins to become low even before someone is anemic, many runners or athletes will begin to experience decreased performance. Not all, ok… that’s sort of a little bit up for debate. But we will see when ferritin levels begin to dip below 30 your risk of performance deficiency increases dramatically. And it is an early sign of anemia and endurance athletes especially again pre-menopausal women who are bleeding have a much greater risk of low iron, and that’s just something you just shouldn’t miss. It’s a problem and it’s a simple test to do and if you’re susceptible to it, then other factors can be adjusted. You can change your diet, you can add a little iron to it. Now the flipside is why not just take iron? And that’ll prevent it. Well the problem is, iron… you know what happens to metal when it gets wet or exposed, it rusts. Well iron is a free radical promoter. So when there’s… that tends to be a problem more in men since they’re not regularly bleeding. So you really don’t want to randomly take iron without having some sense of what your levels are and then once you know you’re at risk, then you can take enough to recover and then use preventively. But too much iron is not good either. So it’s something that really does require some assessment to see what your status is. Yes, it was amazing. 85%… 17 of the 20 and I think two of the ones were actually iron deficient as well. They both had come off of viruses and the marker actually elevates, it’s (inaudible) reaction meaning that protein artificially increases after a virus. So all of them except one in these young teen girls were deficient in iron which was incredible. So that’s what us got us looking into these other factors. About 65% were vitamin D deficient as well.

Ben: I see from your paper that of everything we talked about today, looks like iron – this iron is really the only thing that you technically have to go to your doctor to get tested, and you can test almost any of this stuff on your own at home.

Dr. Richard Cohen: Correct, actually working… whenever we get testing we’re at that point, but working with the lab… the ability and technology is out there to measure ferritin which is your best single screening marker… to do that by finger stick. And they’ve done that since iron deficiency is globally, worldwide, it’s one of the greatest deficiencies. In under developed countries researchers have used finger sticks to actually collect blood to measure iron and the technology’s out there is just getting a lab to go ahead and do it, so working with the lab actually in the Portland area that will hopefully have that in the next three, four months for us. But yes, you don’t need to go to a doctor but you need to have blood drawn. At this point, you need to have a vena puncture.

Ben: I see. Hey you’re starting to fade a little bit there.

Dr. Richard Cohen: Ok.

Ben: Every time you fade you’re doing something that brings you back in, I’m not sure what.

Dr. Richard Cohen: The connection? I’m still in the same place.

Ben: Interesting. I thought maybe you were just sitting on the volume control to your microphone. I’ll wait for your voice to come back in. For some reason it’s still faded. Ok, I think you’re coming back in now. Go ahead and say something. Ok, now I can hear you ok. Alright so, I had spoken with you a little bit before this interview and just so people in the audience know, I am actually personally in the process of getting every single one of these factors tested for myself. Now, I’m not going out into my local medical community and visiting 8 different doctors and getting all these different salivary and urinary and blood analysis. All is done via kits that are literally sent to my house so I can take the collections myself, send them back out and in terms of price comparison, Dr. Cohen, what would this be? Not to mention the time factor, for me to go out and get all these tests done in my local medical community?

Dr. Richard Cohen: If you were to do them with the kit versus what’s out there? Well it depends, gosh. You can… testosterone-cortisol could cost – depending on who you’re going, what hospital, how they bill it – just that can cost $200. A vitamin D could cost $85. Urinary NTX would be 85 to 90 dollars. Amino acids, $150. You’re over $500.

Ben: Plus driving all over the place trying to get all these tests.

Dr. Richard Cohen: Plus driving, plus seeing a doctor who may… I guess the point is doctors who are looking for these in this assessment, is really we’re looking at optimizing performance so it’s not a medical type of assessment. They’ll be following up with the doctors, seeing them twice, getting them to help you. Maybe they don’t even understand its relationship to performance because they’re more focused on illness.

Ben: Right, and I’ve tried to get some of this stuff tested in my athletes, in the past… it’s like their doctor just checked to make sure they were within range and then called them if they’re not, and that’s it. And within range, like you said that’s ok, you don’t have a disease. Good. But yeah for ideal performance – a whole different planet. So it was about 50% of that or less than half of that for this kit, for everything.

Dr. Richard Cohen: Correct. It’s significantly less, that’s correct.

Ben: So I’m looking forward to actually getting my results and finishing all my testing but I know there’s people out there in the audience who are interested in just going through what is my oxidizing rate? Am I slow? Am I fast, am I mixed? Should I be on an acid diet or an alkaline diet? What are my essential amino acid levels and am I utilizing them properly? What’s my vitamin D status? What’s my testosterone-cortisol ratio? What’s my iron level? You can literally get the answers to all these questions fairly quickly. You could be standing there within… what do you think? Six weeks?

Dr. Richard Cohen: 10 days. 10 days to 2 weeks, you get the results back and the beauty about it and what I love is you start adjusting one or two factors and a lot of the other ones get better because they are interrelated. You fix your vitamin D, all of a sudden your mineral balance can improve. You increase your amino acids, your hormone recovery status… your bone NTX improves. So they’re directly connected with one another. There are a couple of other factors that in a perfect world I would also add in, but those are proving well and a lot of those are just intuitive. The neat thing is it gives you control. Why not take control back for your health? Stop guessing what’s correct for you.

Ben: Exactly. With dozens of hours training, hundreds if not thousands of dollars spent on equipment – why go out and train on an $8000 bike when you’re not performing to 70% of your physical capacity?

Dr. Richard Cohen: Right. Exactly. So the simple thing we know, which we didn’t talk about is obviously hydration is one of those no-brainer biological factors that you want to address. Most people will realize you’re dehydrated and the research shows if you’re dehydrated before a race, 1% which could be a pound and a half – your performance could be 3 to 6% decreased. So a two hour race – what is that? Gosh, 8 minutes. That’s significant. But how many people check their hydration status? I don’t know, is that something you do Ben?

Ben: Not on a daily basis.

Dr. Richard Cohen: Well before a race, right. It’s a simple thing to get a dip stick and you can check specific… or check the color of your urine. So it’s almost – what I’m hoping is to create an awareness and that’s a simple thing to do. Costs virtually nothing. Awareness if we take care of our body, it’s going to be our greatest performance enhancer, our greatest support. We can’t go anywhere without our body. We need to pay a little bit of attention to it and now there’s some tools that make it a lot more practical to be able to do that. That’s cool and that’s exciting.

Ben: Yeah, these tests… this home testing, this method of home testing for this stuff is pretty proprietary and kind of new in terms of its availability to people in their homes. I guess if people in the audience listening in are interested – you have my email, the [email protected]. You know how to get a hold of me. We have our toll free number set up. 8772099439. I’d be happy to tell you exactly how I’m going about arranging, getting all of this tested out of the comfort of my own home and kind of walking you through the process because this information that Dr. Cohen shared with us today – if you really are serious about feeling good, about actually ensuring that all this work that you’re putting into your training is actually paying off, these are some pretty important factors to pay attention to. So I know we’ve been going for a little while Dr. Cohen, we’re probably going to have to start to end our conversation here. But did you have any final words that you wanted to give to the audience? You were pretty comprehensive.

Dr. Richard Cohen: Yeah, I guess it’s just hopefully there are a few key points with regard to food as just fuel, with regard to understanding that there are some key factors that you just don’t want to overlook such as – that don’t require a lot of effort, other than a little bit of cost and some sample collections. For example vitamin D, what could be easier to restoring vitamin D then I’m going to go out in the sun 15 minutes three, four times a week and winter I’ll pop a capsule. Pretty simple for the recovery ability. I’m working with a local professional triathlete who won Ironman ten years ago. He’s coming back and two cool things he told me the other day – he’s been taking vitamin D and amino acids. He is early 40s now, he’s hitting heart rates he hasn’t hit in 15 years. His heart rate which had been maxing out around 160 – he said he’s been hitting 172. That’s like wow.

Ben: This is basically – once you kind of add everything up, all the testing, everything – you’re looking at significantly less than the cost of a wetsuit. The stuff… it’s not marked up or overpriced. This is literally cutting edge medical tests that you can get done on yourself out of your own home to figure out exactly what your body is doing, to look inside your body and suddenly have zero guesswork about where you stand.

Dr. Richard Cohen: Right. And the other key thing is you control it yourself and you can change as much as you need to change and obviously the major change for people would be some of the food choices. But the neat thing about once you change your food as fuel, and as long as you’re open to it and some people just aren’t – but if you’re open to adjusting things, you start to feel good. When I was in practice, the greatest thing I could do is put someone on a cleanse. I say ok, you follow this and they go wow, I feel really, really good – I hope that they would fall off the wagon really quickly because I know they’re feeling great, the majority of their problems have improved and then they go back… oh yeah I didn’t follow it but I feel horrible again. Then I know I had them. Then the choice was theirs. Do I want to feel or perform poorly? Do I want to feel good, do I want to not have headaches? Then it’s a choice and the choice is yours but it’s a lot easier to make that choice once you have the feedback and once you’re fueling your body correctly… it’s not this well I’ll take vitamin E and maybe I won’t get heart disease in 50 years. That’s a leap of faith. This is gosh, I ate… and it’s something simple people can do. Go ahead and eat two different breakfasts – have some cereal, have some oatmeal and some fruit with low fat without much protein – I think we already know versus have some eggs and some lean sausage and a piece of toast or maybe not toast – some vegetable with it. See how you feel? Where are you three hours later? Is your energy good? Are you hungry? Are you lightheaded? Are you spacey? So that feedback will go ok, it will give you a sense of which way you need to go.

Ben: Yeah, and I like to think that I have my nutrition pretty well dialed in but I’m interested to see how my questionnaire and my test results kind of correlate to what I’ve established as what seems to work best for me. Well, you know what, we’re going to have to wrap it up but I wanted to thank you for your time and all the insight and the knowledge that you’ve given us today. And again, folks just email me [email protected] or give me a call at 8772099439 and I’ll fill you in on how you can do this and help you take the guesswork out of your performance. So thank you Dr. Cohen.

Dr. Richard Cohen: Hey appreciate it Ben, I’m glad to share the info. Hopefully it was helpful.

Ben: Alright, so like you heard during that interview, if you’re an athlete sitting there thinking wow, I wonder are my vitamin D levels optimal? Are my iron stores adequate, are my mineral levels balanced? Is my hormonal recovery system strong? Do I know my essential amino acid? Does the food that I eat provide my body with the fuel that it really needs? Am I a fast oxidizer, am I a slow oxidizer – I’m currently in the process of discovering all that about my body. It’s very cool and it’s way easier than I thought it would be. So email me if you want me to help walk you through that process. You spend I don’t know how many hours training, hundreds if not thousands of dollars on gear and this tiny investment in your body to know exactly what’s going on in the clockwork inside your body is not only very cool, but well worth it. Ok, let’s go ahead and move on to this week’s jam-packed Listener Q and A. My first question today comes from Listener David.

David asks: Ben, I appreciate your training and health insights.  I have followed your comments online and on the EverymanTri newsletter and I’ve just subscribed to your podcast. I have a question about trouble I experience with my swim workouts. Virtually every workout is interrupted or shortened by the need for a bowel movement.  I swim first thing in the morning — before breakfast- yet always exit the pool feeling bloated.  What can I do?  I suspect this is a result of gulping too much air but you recently referenced adjusting your diet. I’ve got a race in six weeks.  How can eliminate this discomfort and interruption?

Ben answers: I did mention last week that a lot of times bloating and stomach discomfort, especially prior to athletic events can be the result of too much fiber intake leading up to the event. So that’s one of the first things I would inspect in your diet. Are you on any multivitamin that has a high amount of a vegetable starch type of fiber in it? Are you eating multiple salads during the day? Are you eating more than 2 pieces of fresh raw fruit during the day? Do you have a high intake of thing like legumes, black beans, garbanzo beans, kidney beans – and if you do have a high intake of those, are you soaking them? Aare you doing anything to soften them? Are you mixing a little bit of vinegar with them to help break them down prior to consuming them to allow your body to actually digest them a little better, so they don’t sit and ferment in your stomach. And also you didn’t mention what you’re eating prior to your swim, but if you are eating a food that would tend to ferment a bit in your stomach or metabolize and create gas formation and typically a starchy carbohydrate is the biggest culprit, then I would eliminate that. Now that’s not to say that these are the issues. If you have a food allergy, if you’re intolerant to something like soy, gluten or wheat, caffeine, alcohol, dairy – any number of different things that people tend to be unable to tolerate, you can actually get inadequate digestion of those types of substances, and again they can sit in your stomach, they can ferment, they can cause bloating, they can cause heart burn. So you may want to look into a blood test or a saliva test or a stool test to actually see if you have any food allergies and that’s something if you email me privately, I can help walk you through that process but that’s another thing you would look into. Eating too close to your swim workout, it takes a minimum of two hours for gastric emptying to occur and so if you’re eating a bowl of cereal, strawberry, banana, chocolate, pop tart before you head over to swim, these types of things can actually cause that bloating and stomach discomfort as well. Over-hydration – believe it or not, drinking too much prior to the workout can cause a lot of sloshing in the stomach, you get a lot of bloating and your breathing pattern while you’re swimming could also be an issue. Some people focus too hard on exhaling the entire time that their head is underneath the water and then coming up for one big breath and the amount of activity that takes from the inspiratory and expiratory muscles can cause a little bit of stomach discomfort.. It would be better to let the air naturally escape that’s going to escape anyways when your head goes into the water after you’ve taken your breath. Then exhale anything that’s left with one big final exhalation before you come up for oxygen. The other thing you can do to make sure you’re not breathing in water when you are taking a breath is make sure you’re practicing really using the arm that’s extended out in front of you while you’re swimming as a buoy. The best way I like to describe it is pretend you have $100 bill and you’re trying to trap it between your head and your shoulder. If that arm that’s out in front of you is truly extended, it’s going to create almost like this little trough of a non-water area for you to breathe when you take your breath. So focus on that, do some side swimming drills. Those are the best ways to actually learn how to maintain that type of buoy in the water. And then the last thing – and this is a tip that a lot of Ironman triathletes will use – you can drink a carbonated beverage prior to swimming and that will help you displace any air that’s in your stomach before you get into the water – the next best thing if you don’t have access to carbonated water would be an effervescent tablet like a Nuun tablet, alka seltzer tablet, something that’s going to make you burp a little bit before you get into the water. So hopefully that helps David.

Chuck asks: Hey Ben, Hope everything is going well.  Just had a quick question that I thought about today.  I have a race this Saturday, it’s a run-swim-run. In the sense of preparing for the race, I was going to do as I usually do–focus my higher carbohydrate meals to be Thursday dinner and Friday lunch for the Saturday race.  But the race itself hopefully won’t take me more than around 1:05 which is just as long as most of my workouts.  The difference obviously is that I won’t be holding anything back during the race.  This being said, why does it/ does it all, matter if I eat increased an healthy carbohydrate diet before the race as opposed to eating like that before every day that I train if I plan on going hard?  I hope that makes sense.  I appreciate any insight you can offer.

Ben answers: He’s kind of got a two-part question because he says…

Chuck asks: Again, the shirt is awesome (I think this I the guy that won one of the Ben Greenfield Fitness t-shirts.) I plan to wear it pre and post race this weekend.  Speaking of gear, I currently don’t have any tri jersey or sponsor for that matter.  Does your training company have a team and jerseys for your racers?  It would be cool if I could represent it on the East coast. Thanks again Ben, I look forward to hearing from you.

Ben answers: Let’s address the first part of your question first Chuck. When you are doing a sprint triathlon or if you’re doing any athletic event that you plan on using anything less than two hours to complete, carbohydrate loading isn’t really going to give you that much benefit because your body’s natural carbohydrate stores – for most males, you’re looking at 1800 to 2000 calories, females around that 1400 to 1500 range. That’s enough to get you through a couple of hours of intense exercise. So the reason that you would eat during a race like that is to maintain high blood sugar levels which have been associated with a decreased rating of perceived exertion. Meaning that when your blood sugar levels are high, you actually feel like you’re not working quite as hard and we can even take that another step, there’s been studies that have been done on cyclists that show even when they do something as simple as sloshing a sugar solution in their mouth and tasting sugar, it actually decreases their rating of perceived exertion. So you don’t eat during those races to keep your carbohydrate levels up and you don’t carbohydrate load before those races to make sure your carbohydrate levels are all loaded up. It’s not that necessary. Now, there were a couple of studies – I remember back in exercise physiology during my graduate studies, we did come across one study that showed to a minimal level, creatine is one of the first things that your body uses for quick explosive contraction for anywhere from 10 to 30 seconds and then it switches over to carbohydrate but there was a study that saw that the body was actually using a little bit of carbohydrate during the time it was accessing the creatine so it was depleting the carbohydrate stores even during quick, explosive type of activities. So theoretically, carbohydrate loading might help you a little bit during those short races. But for a lot of triathletes, if you’re doing short races, a few mid-distance races, a few long-distance races over the course of the summer, you’re looking at carbohydrate loading one out of every three weeks and then you want to consider the long term effects of that on your body. Because carbohydrate loading, if you’re doing it correctly means that you’re literally shoving carbohydrate down the hatch on a daily basis – 80, 85, 90% carbohydrate for four to five days leading up to that race after a carbohydrate depleting protocol where you’re on a high protein diet and you’re exercising and you’re not putting that many carbohydrates in – you do that to your body over and over again leading up to the race, multiple races – it might not be that healthy. So I wouldn’t worry about carbohydrate loading before the short races and all you want to do is make sure that during that week, for all of your pre-race workouts, you fuel with a carbohydrate protein blend within about 20 minutes after that workout and that will help you maintain adequate carbohydrate stores on board and then just a little bit to keep your blood sugar levels up during the race like a sports gel.

The second part of your question… you know, I have considered for – I coach a lot of triathletes through a company called Pacific Elite Fitness which I own and we coach athletes primarily online across the country. I have looked into getting cycling jerseys, tri tops, triathlon outfits –I would have to get a minimum of 10 if I were going to do it and right now, I have 23 athletes that I coach and I’ve only got four or five that are really interested in the tri top or the cycling jersey. I haven’t really pushed it that much. I can get 10 sets of triathlon suits – tops and bottoms – for about $1200. So you’d be looking at… if this was something you wanted to do, it’d cost right around $120. A cycling jersey with the cycling bib would be closer to about $130. If you’re a listener listening in to this show and you think it’d be cool to have a Ben Greenfield Fitness cycling jersey, I can get a cycling jersey for 60. And so I imagine that once we factor in shipping and everything, it’s come out to about $70 for a Ben Greenfield Fitness cycling jersey. A triathlon outfit would be closer to 120. Tell you what, if you’re listening in to the show and you want me to actually do this, email me. Tell me if you would like a cycling jersey or if you’re a little bit more serious and you want a triathlon kit – like a triathlon top and a triathlon bottom – if I can get at least 10 people that are interested, I’ll pull the trigger and order. That’s a no brainer. I’ll definitely do it. But just let me know and I can make sure that the design is really cool. So just email me [email protected]. And I’ll do it if there’s enough interest. So we’ll get some jerseys out there and I can probably have them sent out within about four weeks or so.

Scott asks: Ben, I’d like your opinion on how to incorporate intervals into my run.  I’m not much for sprinting, but I’ve read enough articles and research to know how effective intervals are for fat loss.  I’m sure that altering my pace would be a systematic way to decrease my mile times, which is my goal.  I average 2-3 runs per week and like to go for 40-50 minutes.  I have access to a high school track so I can accurately measure my laps.  What suggestions do you have?

Ben answers: Well Scott, I got to tell you I hate tracks with a passion. Never liked them. Didn’t like them in high school, didn’t like them in college. Never enjoyed tracks. Get bored to death on them. And I have started incorporating kind of a double whammy type of interval training session that gives me two different advantages. The first is I will go to a park, just as part of a 10, 15 minute warm up jog and when I get to that park, I will do anywhere from 10 to 20 sprint intervals where I’m just walking between each one. Yeah, you can still listen to your mp3 player when you’re sprinting and you can still hang out, have fun, bring a buddy along, race him, whatever. But usually I’ll do 10 sprint repeats that are around 100 yards in length, all the way up to 20 sprint repeats that are around 50 yards in length. So we’re only talking about 10 to 15 minutes total in terms of amount of work. But it’s hard. And so that’s allowing me to get my fast-twitch muscle activation in, to get some of that hormonal activation in that doesn’t come from a nice easy jog but what I also do is I do it on grass and I do it barefoot. And the economy and the efficiency that you will feel when you put your shoes back on and head back home after you’ve done 10 to 20 barefoot repeat sprints is going to blow your mind. There’s a lot of research out there that shows that barefoot running is really biomechanically favorable for the human body. It keeps us more in that forward center of gravity pose and it actually makes us use muscles that shoes don’t allow us to use. Muscles that are a little bit more springy in terms of the ways we bound off of the ground. So that is my suggestion. That is what I do. I have a blast with it. It’s fun, just running around in your bare feet in a park. What can be better than that? I don’t know. I’m sure some of you are going to say something like ice cream. But yeah, that’s what I would recommend in terms of your sprint intervals. I’ll do ten 100 meters all the way to 20 of 50 meters and just basically take about 10 to 15 minutes. So it ends up being about a 45 minute workout by the time you count 15 minute jog and then 10 to 15 minutes of jog and 15 minute jog home. So hope that helps Scott.

Mindy asks: I have a friend who wants to start Shape21, however, she is nursing a 5 month old baby.  What do you recommend for her as far as calories needed and supplements taken?

Ben answers: So, just to clarify – the Shape21 – that’s the book, DVD that I mentioned earlier. It was not necessarily specifically written for breastfeeding women, however most of the nutrients in it are going to support any human body in just about any state but there are some things you need to realize if you are pregnant. The first is that you’re going to have increased calcium needs when pregnant or breastfeeding and there are lots of sources of calcium that aren’t dairy sources but realize that the entire idea behind Shape21 is that it’s designed to remove food allergies from your diet and actually put your cells in their optimum fat burning state by making sure that they’re not being exposed to anything they don’t like. So cow’s milk and dairy products are worked out of that plan in favor of things like rice milk, almond milk and goat’s milk. Some of the other ways that you can get calcium in is you can take for example any of the hummus recipes or for example the guacamole recipes in that book and you can include a little bit of goat cheese with them to increase calcium intake. A canned fish like a salmon or a mackerel – those actually contain bones that become soft during their processing. Excellent sources of calcium. Whereas in Shape21, in some of the recipes, it calls for one of the more hypoallergenic meats – lamb, to be consumed with some of the salads and some of the dishes. You could instead substitute a canned fish for that lamb. Now whole grains and whole grain flours – those are high in calcium. Shape21 has a high amount of quinoa in it which is a great whole grain, pretty easy to find these days. You can get it at Costco and a lot of commercial grocery stores and that’s going to be something that’s already giving you calcium. That’s in that plan. Green leafy vegetables, spinach, bok choy, kale, broccoli,, all those are present in Shape21 as well and those would be something that you’d want to include in the diet. Almonds and walnuts are very high in calcium. Those also are already included in the diet. So I would say that in terms of increasing calcium intake in Shape21, that the only thing that I would add is maybe a little bit of extra goat’s milk or goat’s cheese and then some canned fish substitutes. You could add to any of the places in the manual where I’m having you make yourself a trail mix or eat seeds – to actually add sesame seeds – which are also high in calcium. Tofu and soy cheese are pretty high in calcium but you got to be careful with the phyto-estrogens in those and the phytic acid. A lot of lime processed corn – Mexican tortillas – those are also pretty high in calcium. But again the whole idea behind Shape21 is that we’re trying to control the glycemic index of it, just a little bit. Now the other thing, interestingly, that can give you a good amount of calcium can be algae, like sea vegetables, fermented foods like miso and a lot of seasoning. And there is as one of the supplements that I include in Shape21 that you actually are given this special discount code for in Shape21. It’s got a high amount of sea vegetable extract in it. It’s that EnerPrime multivitamin. And that’s in Shape21. So that one that’s in there, you’d be fine to take. Now there are a couple of other supplements that you get a discount on in that book that I would actually not take if you’re breastfeeding, specifically the ThermoFactor. That contains something called Advantra-Z which is basically a bitter orange extract and it steps up your body’s fat burning process but because it is an herb that has an effect on the central nervous system in a similar way that caffeine does, I would not take it, in the same way that you shouldn’t be drinking coffee when you’re breastfeeding. And then the other one that I wouldn’t take while you’re breastfeeding is the Lean Factor. It contains something called gugolsterins in it and those support healthy cholesterol levels, cardiovascular health. They help to step up the productivity of your thyroid gland so they can assist with increasing metabolism but again I haven’t seen any safety or long-term studies in breastfeeding mothers with those. So that’s another one that I would avoid in the Shape21 book, and the other supplements that are in there are fine. The other thing to focus on is making sure that you’re getting adequate vitamin D supplementation especially if you’re breastfeeding because it can really help with absorbing calcium into your bones. So making sure that you’re spending enough time out in the sun or that you are consuming for example vitamin D supplements or pre-natal that contains a vitamin D supplement. And then the final thing is realize that your caloric needs when you’re breastfeeding are going to go up by about 300 to 500 calories a day. Now Shape21 gives you caloric ranges that you can use as you go through the program. Choose the higher caloric ranges if you’re breastfeeding, for sure. So, good question Mindy.

Scott asks: Hey Ben, I don’t know how new it is, but at this weekend’s race, they were handing out Aquagenus water. What are your thoughts on it?

Ben answers: Scott, Aquaenus water is basically water that has minerals in it. So in our special topic today, Dr. Cohen was talking about magnesium intake, calcium intake. Even mineral intake. He briefly talked about some of the smaller minerals and these would be the tiny little minerals – I had an interview on it sometime back with a woman named Ambaya – you can go back and listen to that podcast. But essentially all these teeny tiny minerals are sometimes things that we’re not getting from our soils because of modern agricultural products. There are supplements out there that contain these tiny minerals, and the water – the Aquagenus water – actually contains those. The question is it’s a little bit pricey. Are you going to buy 20 packs of that water and use it during the week while you’re riding your bike or you’re out training and every time you’re drinking in your car, you suck down a bottle of it? It gets a little spendy. What I do is since I talked to that Ambaya lady during that interview, I actually have this little dropper bottle that I keep in my fridge and I add it – when I get up in the morning I have a glass of water. I add five drops of that to a glass of water and that’s actually the full mineral profile. I guarantee it’s way more financially viable than buying the Aquagenus water bottles, but that’s what the Aquagenus is. It is minerals and yeah minerals will work for the reasons you heard today in the special interview in the podcast. Go to www.bengreenfieldfitness.com and Google “Ambaya” and you’re going to come across that mineral source that I use in my water in the mornings.

Todd asks: I’ve been listening to your podcasts for a few weeks now and have really been enjoying them. I heard about you through trainingpeaks.com. I heard from one of your podcasts about mixing sea salt and some other seasonings to plain almonds but am having trouble finding it. Do you have any ideas on what to mix to flavor plain whole almonds?

Ben answers: I’ve been known to mix sea salt powder, ginger powder, garlic powder, cayenne pepper, turmeric, curry powders with almonds in little zip lock bags and shake them up. So you have quite a few choices out there. I’m going to give you a recipe Todd that actually combines a whole bunch of stuff that you can do to make your almonds taste better. So what you do is you take about two cups of whole almonds or as many as you want really. You put those into a pan like a sauce pan and then you put about a quarter cup of soy sauce in there, about a tablespoon of brown sugar – if you really want to keep it lower in calories, use Stevia – use about a quarter teaspoon of brown ginger or a few shakes of brown ginger, a few shakes of garlic powder, a few shakes of cayenne pepper and then sprinkle that lightly with a couple of teaspoons of an olive oil. And then what you’re going to do is just bring the entire mixture to kind of a light boil, or just heat it up. It’s about five minutes that you heat it up. Once you’ve heated it up, throw them on a cookie sheet and bake for about 8 minutes or so at right around 250, maximum 300 degrees. Stir them around a little bit, about halfway through the cooking time just put your hand in the oven with a spatula and stir them around a little bit. And it’ll start to smell really good. Pull them out of there before they start to burn, let them cool. You can even sprinkle them with sesame seeds once they’re cooled. Don’t throw the sesame seeds in the oven with them or the sesame seeds will burn,  but that’s really tasty. And all your friends will love you when they come over to watch a movie and you’ve got these homemade seasoned almonds sitting on the table. So that is what I would recommend for the almonds. So, great recipe and very tasty.

Those are all of the Listener Q and As for today. We’ve already listened to our special topic so I’m going to go ahead and close out today’s podcast by really encouraging you to go check out some of the very cool videos that I’ve posted on the Shownotes to this podcast. Scroll down to the special announcements and check those out. A couple of my clients sent in some really great videos that I think were pretty entertaining. And then remember, if you have a question, leave a comment on the Shownotes to this podcast, episode 53. Make sure you subscribe to the Ben Greenfield Fitness newsletter, so you can stay up to date on everything that goes on and if you haven’t gotten your hands on the brand new Shape21 release, surf over to the website and get it, it is a physical book and DVD package that gets mailed to your home. You have the option of getting an e-book as well if you wanted to get the e-book version. So, until next week when we’re going to have an interview with Dr. Carolyn Dean, author of The Magnesium Miracle, this is Ben Greenfield. Email me [email protected] if you’re interested in testing your own body. Wow, a long podcast today. Have a great and healthy week.

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