Podcast Transcript Episode 4 – Nutrition for Cramps

The Ideal Nutrition Podcast

Aidan
00:00:08 – 00:00:33
Hello. Welcome back to The Ideal Nutrition Podcast. Today, we are going to be talking about nutrition for cramps. This is episode 4, and as we’re talking about nutrition for cramps, we are going to specifically be referring to the type of cramps you get related to exercise, training, sports, whatever. Leah, would you like to run us through the two main theories we’ve got in relation to cramps and why they occur?

Leah
00:00:33 – 00:01:07
So, there are two main theories regarding why cramps occur. The first one is the most widely accepted by the general public, and the one you will likely hear about, talking about cramps just with anyone. And that’s the dehydration electrolyte imbalance theory. So, it has been very widely accepted for a while, and it’s only now that research is starting to refute this particular theory. But basically, the definition is that there is some kind of imbalance of electrolytes and hydration of some kind, that occurs during training or during an event that leads to cramping.

Leah
00:01:07 – 00:01:33
The second theory has become more of the predominant theory in the past couple of years, with researchers and professionals working in this space, and that’s the neuromuscular fatigue theory. The theory is that the overuse of a certain muscle beyond what it is capable of or used to, does cause a neuromuscular type of fatigue that results in an imbalance in excitatory impulses that leads to cramping.

Aidan
00:01:33 – 00:02:06
For sure, and I would say that both theories have some form of merit. I would just say that amongst elite athletes and what’s really happening in practice under race conditions and stuff like that, it seems to be more common to be neuromuscular fatigue, but both of them are still relevant, as in both of them can be an explanation for cramps, and they might even both play a role together. So, the first thing we’re going to talk about is kind of support for the electrolyte imbalance theory why certain people believe it exists, and how it could be relevant.

Aidan
00:02:06 – 00:02:39
So, basically, the first thing that is relevant is that cramps are more common to occur when it is humid and hot. And that’s part of how that could play a role in dehydration and stuff like that. Although that is also to some degree supporting the other theory because you get fatigue more easily when it’s hot and humid as well. So, it’s support for both theories. But that’s one of the factors, they are more common when it is hot. Another factor that is also relevant is that when people do have deficiencies of electrolytes in their blood, they are more likely to cramp.

Aidan
00:02:39 – 00:03:20
That is a clear-cut kind of factual statement. Electrolyte deficiencies in blood is a bit rarer amongst elite athletes. So, like, that’s part of why we’re talking about it not being overly relevant for elite athletes. And one of the things that really kind of backs up this in what really, I think, might have been one of the early things that kinds of kicks it off, is in the 1930’s there was a study that came out that basically showed, they basically took their participants to set them up for cramping. They gave them hot baths, made them sweat a lot. Low sodium diets with pretty much no salt, and they got them to drink heaps of water. It’s a really high sweat rate, heaps of water coming in, no electrolytes.

Aidan
00:03:20 – 00:04:06
And basically, everybody in the study started cramping. So, we know, once again as a bit of a factual statement that if you put yourself in those conditions, you’re probably going to cramp, and to make really put a nail in the coffin, within 15 minutes of consuming salt, they stopped cramping. So that’s part of why a lot of people talk about salt or sodium as a factor. So, there is like if you put yourself in really severe conditions like, yes, it’s likely to do that. That’s also another example I hear a lot of people talking about is miners, back in the day, miners working in really hot conditions, if all they were doing was drinking water, they were likely to get cramps. So sometimes they are encouraged to have high salt foods to avoid getting cramps. So once again, under pretty rough situations or circumstances,

Aidan
00:04:06 – 00:04:21
it’s going to happen. But did you want to talk about reasons why it might not be relevant for elite athletes and stuff like that or reasons against the electrolyte imbalance theory being the most predominant theory?

Leah
00:04:21 – 00:04:59
So, in research, athletes who cramp on average do have a similar fluid and electrolyte balance to athletes who don’t cramp, so clearly, it’s not as simple as just being an electrolyte imbalance or a dehydration issue, because we are seeing athletes who are cramping, but their hydration is there and they don’t have an electrolyte imbalance. So it’s really not that simple. If fluid and electrolyte balance was the main issue, the simple answer would just be to consume adequate fluids, get adequate electrolytes in with those fluids, and then cramping would no longer exist. But we know in practice that that’s just not the case.

Aidan
00:04:59 – 00:05:31
Yeah, 100% and something else I was going to touch on a little bit later as well. But jumping the gun on that. It’s like a lot of elite athletes, if it’s an endurance event that we’re talking about, they’re often taking some form of sports supplements. They’re probably having something like Powerade, Gatorade. They’re probably having gels and stuff like that, which don’t contain zero electrolytes. They have some form of electrolytes in there to kind of help from that perspective, and on that topic as well, just thinking it through. If it was that simple solution of just like, you just have more water and you have more electrolytes themselves, this would be an easy win. This would be the easiest job I’d have had.

Leah
00:05:31 – 00:05:39
It would be so easy. Just be like, hey drink some Gatorade and drink the thirst, and you’ll no longer cramp. But we know that’s just not the case.

Aidan
00:05:39 – 00:06:25
Yeah and going at the other end of the spectrum. Like looking at the neuromuscular fatigue theory. There is a lot of support for that, and it seems really obvious once you, not obvious, but like once you kind of understand or think of it from this perspective, you start seeing it everywhere. When training loads increase, cramps are more likely to happen. The best example of this is like preseasons for sports and stuff like that. If you look around sports and you see preseasons, a lot of people cramp in their preseason. There is one study I’m going to reference that involved American football players and four-week training study of training camp and in week 1, 37% of athletes cramped, in week 2, 27% cramped, week 3, 18% cramped and week 4, 4% cramped.

Aidan
00:06:25 – 00:06:44
That’s it, it’s such a clear-cut kind of thing. You see it in the NRL, you’re seeing, like round one people, so much more likely to cramp than in later rounds, like it’s just being prepared for the activity, reducing the likelihood of this fatigue occurring and stuff like that, and also going back to like if it was an easy fix, like it just wouldn’t happen that much in pro sports.

Aidan
00:06:44 – 00:07:08
Like an example, Leah included this when she was writing a blog post on this. But like LeBron James in the NBA, I believe he was in the playoffs, so like during one game he cramped really badly. People talked about it being there’s like a bit of myth, I don’t know if you call it a myth, there’s a bit of a conspiracy theory going around that the San Antonio Spurs, made the building really hot. And that was the day that he cramped. If there was such an easy solution,

Aidan
00:07:08 – 00:07:28
somebody who reportedly spends like a million dollars on his body like, looking after it, surely, he’d like to have a Powerade or something next to him. It was just as easy as, like, electrolytes and hydration like it is a pretty difficult one. Is there anything you want to touch on that Leah? Or do we just want to go straight to the strategies that you could use to try and minimise cramping?

Leah
00:07:28 – 00:08:09
Yes, I think now that we’ve covered both of the things that can cause cramping in certain situations. Probably good to move on to strategies. Outside of nutrition, you really want to prioritise being prepared for this session or the event you are going to do, so it really comes down to training for preparedness. If you’re not prepared, you are likely to cramp. So, from that neuromuscular fatigue theory, we know that a fatigued muscle is more likely to cramp due to the imbalances in those impulses that are sent from the brain to the muscle. So generally, being fit is going to be the best thing you can do to avoid cramping.

Aidan
00:08:09 – 00:08:46
And being prepared for this specific event. Like, for example, if somebody is going to try and run a marathon and they’re fit. But they’re not like marathon level like prepared, probably likely to happen there. These large increases in workloads and stuff like that is where it’s likely to happen. Same, it’s like, seven triathletes where they are like prepared really well for one event, but not for another one. That’s where it’s likely to happen. And one caveat that I also want to add on this and is part of why I personally went down this rabbit hole a little bit quite recently is I’m working with a higher-level cyclist who cramps every second race. He’s obviously doing everything he can to prepare for these races, but he’s still cramping

Aidan
00:08:46 – 00:09:07
and he’s aware of his biggest problem. But it’s still happening, which is why I want him in this rabbit hole to be like, is there anything else we can do? And I don’t think it’s that clear-cut. That’s just like if you’re working hard, you’re preparing, but it still happens. There’s nothing you can do from a training perspective. I think there are still stones unturned, like when I was looking, there’s like a talk about static stretching before events or like maybe even some plyometrics some people talked about.

Aidan
00:09:07 – 00:09:36
Their calves would cramp and then they would start training calves in the gym, literally like there’re stones left unturned and like that’s not our area of expertise. I’m not going to go deep down that rabbit hole and talk about it because I don’t know it myself when it comes to that. But like I always think there are other things to consider, thinking of, like some kind of novel options that, like if we’re looking for stuff that can work, what would you be looking at in terms of, like supplements or stuff like that you could try?

Leah
00:09:36 – 00:09:48
Yes, so there’s definitely not a lot of supplements, and there’s definitely no one quick magic fix to cramping, which is unfortunate. But one thing you might want to try is something like pickle juice.

Aidan
00:09:48 – 00:10:16
The way pickle juice can help is that it’s basically like an agonist, or it acts on like some transient receptor potential ion channels. So these channels are located on the membranes of the sensory nerves in the mouth and ingestion of something like pickle juice. It seems to attenuate cramps through a bit of a neural reflex that’s triggered by the acetic acid in the pickle juice, basically triggers nerves in the mouth that sends signals to the spinal cords, which reduces motor neuron activity to the cramping muscle.

Aidan
00:10:16 – 00:10:35
Pickle juice isn’t the only one that does this, like there are a few other products, like it seems like stuff that leaves like this really strong taste in your mouth, like really spicy stuff seems to do it as well. There’s a product in America called hotshot that Leah got me onto in terms of looking into. Do you want to talk about hotshot at all? Do you know much about hotshot?

Leah
00:10:35 – 00:11:11
Yeah, well, I know a lot about their research. Unfortunately, don’t know a lot about the product. I think you know more about the ingredients than I do, but they are definitely one of the lead researchers in this space in creating this particular product. And there’s some research to suggest that not only can it stop cramping once it is starting to occur or reduce the time that cramp is around, but it may actually prevent cramping for a period of time, which is interesting because you don’t really see that in research for pickle juice. I’ve only ever seen that in research.

Aidan
00:11:11 – 00:11:52
From hotshot. Yeah, so their kind of argument is that there are multiple TRP, so transient receptor potential channels and pickle juice only works on one of them, whereas the ingredients in Hotshot it’s basically got capsaicin, and cinnamon and a few other things in there, which work on multiple channels overall. And that’s one of their arguments. And even with pickle juice it’s pretty hit and miss, like it’s kind of like, this is one of the ones from where I’m like the research is mixed. But if you’re somebody who struggles with cramping, it’s worth a crack. It’s worth a try. Yeah, and on that topic, like there’s one study that we both looked at recently that had 11 participants, and it’s based on like

Aidan
00:11:52 – 00:12:19
it was like electrically induced cramps. And there seemed to be no difference between the pickle juice and just having water I’m pretty sure, like there’s no difference in that, whereas in other studies it seemed like a game-changer, it seemed like it’s the same for Hotshot as well. It seemed like a game-changer, like 30 seconds in the cramps, gone like it seems to be, at least in some of these studies, there’s a reduction in the duration. Sometimes it’s a reduction in the intensity of cramping and stuff like that, and like that’s what I’m saying, like sometimes I’m not, like,

Aidan
00:12:19 – 00:12:55
fully focused on the research, like in terms of it being like sometimes it doesn’t work, sometimes it does, like it’s worth just trying for yourself, like there are times I’ve used it with clients and they’re like, Yeah, 30 seconds and the cramp was gone, and I don’t know how much is placebo? Placebo probably plays a role. But as I said, it’s worth trying and the same thing for the research seems more positive for reducing the cramp once it’s set in. And that makes sense with the transient receptor potential kind of channels, kind of like mechanism. But as you said with hotshot like it, also, it might have the potential to reduce the likelihood of cramps occurring at all.

Aidan
00:12:55 – 00:13:31
Which is relevant for someone who’s cycling. It’s kind of hard to have your pickle juice while you’re cycling, like you can do it. And if you were in desperate need, it makes sense to do it, obviously. But you prefer to just be able to have a product before your cycle that lasts a couple of hours. Yeah, and that’s what hotshot claims. But they don’t say it’s magical or anything like that and the one thing I’m always sceptical of, it’s obviously industry-funded kind of research like it’s, they’re kind of governing organization, whatever they call it, flex farmers like the parent company. That’s what does all their research. That’s what funds all their research. They claim that they and I, haven’t actually read this one, but they claim that they have published a study

Aidan
00:13:31 – 00:13:48
that was not in favour of their product once and all of the other important stuff they’ve published has been in favour. So, they’re using as an example of them being honest, I guess, and like showing all that, but I’m always sceptical of publication bias. I’m always sceptical of the fact that if you’ve got a product to sell, like you want it to look like it works.

Leah
00:13:48 – 00:13:59
They want to sell products; they want to make money. So, it would make sense that anything that is in favour of their product, that would be worth publishing and maybe not so much for things that are not in favour. So, you never know.

Aidan
00:13:59 – 00:14:34
And the way I look at myself, I’m like, if I was an elite athlete and I cramped every second race as an example, and that was what was holding me back. I would be trying this. Team USA uses hotshot. There’s a few, like, particularly in America companies, that do it. It’s harder to get in Australia, but you can just order it online, there’s a section on their website that you can order it from. In Australia, personally, if I wasn’t like too sold on hotshot, like, I wasn’t convinced it was better. I’d just get pickle juice like that’s pretty easy to access, and I would just use it if I wasn’t fully sold on the potential of preventing cramps. I would just use it at the onset of a cramp and just see what happens and see if it helps.

Leah
00:14:34 – 00:15:20
So the next thing that you would want to have a look at in regards to stopping or preventing cramps is the electrolytes and hydration theory. So whilst training and being prepared and possibly having something like pickle juice or hotshot is going to potentially be beneficial if your cramp is caused from muscular fatigue, it’s not necessarily going to help if your cramp is being caused by dehydration or a lack of electrolytes, so you still want to be mindful that it is a potential risk factor in the onset of cramps. So in regards to hydration, generally, you want to avoid losing more than 2% of your body weight in a particular training session or event, so that’s a good guideline to use there. You can weigh yourself pre

Leah
00:15:20 – 00:15:33
your training session and post your training session to get an idea of generally the amount of fluids that you do lose. And if you are losing more than 2% perhaps you have a better focus on adequate fluid intake during your sessions.

Aidan
00:15:33 – 00:16:04
Yeah, I’ll come in and just like add in a little bit on hydration as well, because that is one of the ones that, like usually drinking to thirst, can address that. But it doesn’t always address that, if you routinely lose more than that, it makes sense to try harder to drink a little bit more. But beyond that, something that I always want to add when you talk about this, because that’s my advice as well. I’m always like, try and maintain, because we know that if you lose more than 2%, performance does drop off. But the caveat I want to add is that for marathon runners, the winners typically seem to lose more than 3% of the way.

Aidan
00:16:04 – 00:16:31
And when we are aware of that happening, it’s like this. This isn’t a hard and fast rule. It’s kind of like you strive for that. But like if the winners are doing that and part of the reason they’re winning because they’re not stopping, slowing down their stride so they can drink and everything like that, that’s what being aware of as well. And that also feeds back into why the whole electrolyte hydration kind of imbalance theory isn’t liked, because the people who are winning are the ones who are getting a little bit more dehydrated as well. It’s a fascinating one.

Leah
00:16:31 – 00:16:38
They’re not necessarily the ones that are cramping the first, even though they are losing more fluids. Perhaps then with people.

Aidan
00:16:38 – 00:17:15
But once again, like what if you’re just more prone to cramping like it’s worth paying attention to, like if somebody is cramping all the time, I’d consider that for sure, I’d be looking at that and another thing that I wanted to add on to that is there are different forms of cramps as well. In terms of it, it seems like whole body cramps where, like multiple areas of the body at once, are getting cramps at the same time, seem to be even more related to the electrolyte dehydration kind of imbalance theory. Whereas the isolated like one quad is cramping, for example, seems to be even more to the neuromuscular fatigue theory. And the only reason I’m really adding that in there is just because it’s like if you’re like one of the rare few people who are getting these whole body cramps,

Aidan
00:17:15 – 00:17:24
you can be even more confident that this is important. This section is a little bit more important for you. Anything you want to touch on that, Or do you want to talk about electrolytes and what we’ll do with that?

Leah
00:17:24 – 00:18:06
No, I think that’s a good way of kind of almost diagnosing why the cramps are occurring or could be a good place to start. So sodium and focusing on electrolytes could potentially reduce your risk of cramping. So the general guidelines are so having 0.6 to one gram of sodium per liter of fluids that you’re intaking, then that that seems to be a pretty good target. Anything more than that, it’s probably a bit overkill and anything less, you know, there’s more potential that you may cramp due to an electrolyte and fluid imbalance. Most sports drinks and sports gels, so most of the products on the market are going to cover this quite well. So most things like Gatorade, Powerade,

Leah
00:18:06 – 00:18:17
Cliff shots, they’re all going to contain roughly this amount of sodium. So it’s not something you have to go out of your way to do other than just utilize these products.

Aidan
00:18:17 – 00:18:49
And including that as well. This is where it becomes relevant for the I guess you call it anecdotal evidence for sodium really mattering, and electrodes and stuff like that really mattering, because it says your average Joe takes up running or something like that endurance activity and they go out and they don’t take anything with them. They don’t take gels, they don’t take sport strings, they don’t do anything like that and they build up. This is a serious case, like they start doing a lot of work. Or maybe they do take water. They’re able to drink when they are, but they build up to doing some serious work, and all they do is drink water.

Aidan
00:18:49 – 00:19:22
They probably end up in a similar situation towards what we were talking about earlier about those hot baths and stuff like that, where it’s like master sweat rate, sweat rate is through the roof, only drinking water. And then there’s this massive imbalance, and then suddenly they add salt to the drink or whatever, like they find a solution and it solves it. And then suddenly they’re going around telling everyone that sodium is acute to cramping. But it’s just that, like, extreme situation that they’ve put themselves into that has really caused their cramping. So even though it’s anecdotal. It also like, it makes sense how that could happen in practice as well. And why people start thinking sodium is the key as well.

Leah
00:19:22 – 00:19:33
Sure, you definitely understand why their anecdotal evidence has come about, but it’s not necessarily the key to everybody’s cramps, where you know it could be a mix of things contributing.

Aidan
00:19:33 – 00:20:13
The next thing we want to talk about is magnesium. So, this is an interesting one for me personally, because I’m not going to name the company or anything like that. But a company hired me to do videos promoting their sports gels. And because I’m a believer in sports gels being effective for a variety of reasons and stuff like that for insurance activity, I was down for that. So, I was keen, and they had the standard sports gels, which is pretty standard and like, of course, I’ll promote that. And then they had another one, that was a gel that contained magnesium. And I was being paid for this opportunity. So, I had the incentive to be like, Yeah, magnesium is the best. It’s going to prevent cramps. It’s going to improve performance, all these kinds of things.

Aidan
00:20:13 – 00:20:44
And I really dug into the research before that opportunity, obviously, and I couldn’t find anything, like I couldn’t find any research showing that magnesium supplementation reduced cramps. That was really interesting to me because I heard it. I heard everyone saying, I heard all this stuff going on. There is a lot of anecdotal evidence of people, including magnesium. There is a theoretical mechanism of why it could help, because if you look at the mechanisms of how magnesium works, it makes sense, but that just goes back to the same point of like blood

Aidan
00:20:44 – 00:21:24
levels of magnesium are not often to be deficient. People can have an inadequate intake. They can have a suboptimal intake of magnesium, the nutrient, but their blood levels are not necessarily low, so they’re not deficient. And it’s doing its job in the body, even if they’re not having an optimal level of it. So from the research perspective, whenever they’ve gotten large groups and they’ve tried to induce cramps and stuff like that, and they’ve tried to use magnesium to stop, it hasn’t made any difference. But in some cases, with anecdotal evidence and stuff like that, when I’m of the opinion where, like, it’s not going to hurt. And if you truly believe it works, it makes sense to go for it. Like if you cramped every time you run and then you took magnesium and it stopped it,

Aidan
00:21:24 – 00:21:34
I’d continue like that would be what I would do in that situation. It’s just that, it’s not like research support or anything at this stage, but if it works for you, I’d go for it and it can’t hurt, really.

Leah
00:21:34 – 00:21:56
If I have clients that come to me, and they’re like, I have started taking magnesium and it’s really helped. I’m not going to tell them to stop taking it, not necessary. I’m not going to go out of my way to stop taking it, because it’s not going to cause them any harm. And if they think it’s contributing to preventing cramps or improving performance, then it is what it is. You’ll just continue letting that client take it if they think it’s helping.

Aidan
00:21:56 – 00:22:16
Yeah, exactly. And the next thing we want to talk about is hyperhydration. Some stuff you can do around that, because if we’re trying to prevent that 2% kind of body weight loss, if possible, maybe even being more hydrated at the start of the event or the start of the training session, starting the race or whatever, could help. Do you want to talk about glycerol? You’ll know more about that than I do.

Leah
00:22:16 – 00:22:27
Yeah, glycerol is an interesting one. I have to say it’s only something that I’ve come to learn about recently and like, at least you know, looked into the research around it and how people use it.

Leah
00:22:27 – 00:22:28
In general,

Leah
00:22:28 – 00:23:11
like hyperhydration, can be effective to prevent dehydration during an event, and glycerol can be effective in that it does help you retain more water than what yourself naturally would, so that if you take glycerol in conjunction with a decent fluid intake prior to an event, you’re going to hold on to a greater percentage of that water, in your cells, and then have more of that available to you during an event so you can basically have a greater loss of water weight during an event or a session. And it’s not going to affect you as much as if you weren’t hyper hydrated, so glycerol can work quite well in doing that.

Leah
00:23:11 – 00:23:36
But the issue I have with glycerol is how you actually take it. So, it’s not something that I’ve dabbled in or convinced my clients to do because it’s not actually a sports supplement, or you can’t buy it as a sport supplement. It’s actually like a topical cream or gel, or most so. I’m very sceptical about telling clients to take something like that, that’s not made for consumption. Generally, how do you feel about it?

Aidan
00:23:36 – 00:23:50
Yeah, so, like the fact that it says on there, like, not made for human consumption is a bit scary. To be honest, I’ve ordered some myself that should be arriving soon because every time I recommend something, I want to take it just to see what it’s like. Apparently, it helps you get a sick pump when you’re lifting as well. And I’m like …

Leah
00:23:50 – 00:23:51
it’s just always nice.

Aidan
00:23:51 – 00:24:20
Yeah. So, like, I’m like the worst-case scenario for me. Like, I’ll try and I’ll go lift and get a sick pump. See some arm veins. That’ll be nice. And that way, I’ll be more comfortable telling other people to consume it if I’ve done it myself. But yeah, at this stage, I’ve never recommended to a client, but I’m like, if I’m aware it exists, it could be helpful if somebody was really struggling with cramps and they were trying everything. It’ll be worth checking that into the mix as well. And I guess speaking on that as well if we’re coming back to the concept of this mostly being related to fatigue,

00:24:20 – 00:24:46
something that could help, this isn’t an evidence-based take or anything like that, just a bit of common sense to us and agree, like thinking it through is, fuelling well in general. We know that doing little things like if it’s a long event like carb-loading or if it’s just a standard session, just like having a good pre-workout meal or something like that, or maybe having insurer race or intra workout carbs or whatever. If it is something that you’re really going to cramp in, or something like that,

Aidan
00:24:46 – 00:25:10
could make you be able to perform better, it could improve performance. But that could also mean that you’re doing the same work, for less fatigue as well. So, theoretically speaking, nailing your fuelling in general and just now in your overall nutrition could improve your ability to just improve your work capacity in general. And then that could carry over to reduce the risk of cramps. Is there anything else you want to touch on, or do you reckon that’s it?

00:25:10 – 00:25:26
Yeah, even following on from that, I think, I guess it’s just a brief mention on anything that helps reduce fatigue and improve recovery. So even things like sleep, so it really comes down to all those day-to-day habits that you can do to reduce fatigue in general that is likely going to help with cramping.

Aidan
00:25:26 – 00:25:40
Perfect. So once again, thank you to everybody who has listened. Please subscribe. Please leave a rating and review. We always appreciate that. And if you’re still listening, it’s episode 4. We definitely appreciate that, too. So, thank you.

Aidan
00:25:40 – 00:25:41
Exit soundtrack.