Category Archives: Alexander Popov

Connection between diet and muscle cramping

Base training starts soon if it hasn’t already which brings on longer bouts of exercise.  The longer you go, you more you need to know how your body’s chemical reactions are happening. This excerpt from Vegetarian Sports Nutrition is reprinted with permission by Human Kinetics.

“If you look at the information presented in most exercise physiology
and sports nutrition books, you will notice an obvious omission of
discussions of muscle cramps. This is probably because little is known
about muscle cramps. Nonetheless, I am a true believer that imbalances
of fluid or the mineral electrolytes—sodium, potassium, calcium, and
magnesium—in the diet should be ruled out as contributors to all
nocturnal and exercise-associated cramps.

Fluid Imbalances and Dehydration
Whether fluid imbalances and mild dehydration can trigger muscle
cramping is open to debate. Although we know that muscle cramps can and
do occur with severe dehydration and heat injury, there is no
conclusive evidence that consuming adequate fluid with or without
electrolytes will prevent typical nocturnal or exercise-associated
cramping. In fact, studies have found that runners, cyclists, and
triathletes who develop cramps during an endurance event are no more
likely to be dehydrated or to have lost greater amounts of bodily water
than are those who do not develop cramps during the same race. In my
practice, however, I have noted anecdotally that maintaining a proper
fluid balance indeed helps many endurance and team athletes avoid
cramps, particularly those that occur after exercise or when sleeping
at night. In one case, I worked with a male tennis player from
Switzerland who had a history of severe cramping and fatigue after
practice that was relieved by a regular and diligent fluid-consumption
schedule. In her book, well-known sport nutritionist Nancy Clark tells
an amusing story about a runner who eliminated his painful muscle
cramps by following the simple postexercise advice to first drink water
for fluid replacement and then have a beer for social fun.

Sodium
Sodium is one of the main positively charged mineral ions or
electrolytes in body fluid. The body needs it to help maintain normal
body-fluid balance and blood pressure, and in conjunction with several
other electrolytes, it is critical for nerve impulse generation and
muscle contraction. Sodium is distributed widely in nature but is found
in rather small amounts in most unprocessed foods. In most developed
countries, however, a significant amount of sodium is added from the
salt shaker (1 teaspoon [6 g] contains 2,325 milligrams of sodium) or
by food manufacturers in processing (as listed on the food label).
Because sodium intake can vary, the typical Western diet contains 10 to
12 grams of salt (3.9 to 4.7 g of sodium) per day.

Because
sodium plays an important role in regulating blood pressure and fluid
and electrolyte balance, the body has an effective mechanism to help
regulate the levels of sodium in the blood on a variety of sodium
intakes. If the sodium concentration in the blood starts to drop, a
series of complex events leads to the secretion of a hormone called
aldosterone, which signals the kidneys to retain sodium. If sodium
levels are too high, aldosterone secretion is inhibited, which allows
the kidneys to eliminate some sodium through urination. Another
hormone, called antidiuretic hormone (ADH), also helps
maintain normal sodium levels in body fluids by signaling the kidney to
retain water and sodium. Typically, levels of both aldosterone and ADH
increase during exercise, which helps conserve the body’s water and
sodium stores.

Actual sodium-deficient states caused by
inadequate dietary sodium are not common because the body’s regulatory
mechanisms are typically very effective. Humans even have a natural
appetite for salt, which helps assure that they take in enough sodium
to maintain sodium balance. Indeed, I have great memories of eating
salty tortilla chips wet with a little water—so more salt would
stick—after long cycling races in Arizona. Thankfully, these
sodium-conserving mechanisms are activated in athletes who lose
excessive sodium and other electrolytes during prolonged sweating.

Although muscle cramps are reported to occur during the
sodium-deficient state, some researchers believe that alterations in
sodium balance are not involved in exercise-associated cramps. This is
despite the fact that significantly lower postexercise serum sodium
concentrations have been found in endurance athletes who experienced
cramps during a race compared to those who did not develop cramps. One
of the reasons this is downplayed may be because serum sodium
concentrations remain within the normal range, despite being
significantly lower in the athletes with muscle cramps.

Nevertheless, it is important for athletes to consume enough sodium to
replace what is lost through sweat. Despite the regulatory mechanisms
discussed earlier, it is possible for vegetarian athletes to be at risk
for muscle cramps and other problems because of low sodium intake. The
reason is most likely because they ignore their salt craving
cues—eating mostly unprocessed and unsalted foods—while continuing to
lose considerable salt through sweating. The recommendation set by the
USDA’s Dietary Guidelines for Americans to keep sodium intake to 2.3
grams or less per day is not appropriate for most athletes because of
their higher sodium losses. Thus, while it is not likely that low
sodium intake is the cause of cramps in most athletes, it is certainly
possible that a vegetarian athlete prudently following a low-sodium
diet for health reasons might experience muscle cramps that would be
relieved with more liberal use of the salt shaker.

Potassium
Potassium is the major electrolyte found inside all body cells,
including muscle and nerve cells. It works in close association with
sodium and chloride in the generation of electrical impulses in the
nerves and the muscles, including the heart muscle. Potassium is found
in most foods, but is especially abundant in fresh vegetables,
potatoes, certain fruits (melon, bananas, berries, citrus fruit), milk,
meat, and fish.

Potassium balance, like sodium balance, is
regulated by the hormone aldosterone. A high serum potassium level
stimulates the release of the hormone aldosterone, which leads to
increased potassium excretion by the kidneys into the urine. A decrease
in serum potassium concentration elicits a drop in aldosterone
secretion and hence less potassium loss in the urine. As with sodium
and calcium, potassium is typically precisely regulated, and
deficiencies or excessive accumulation are rare. Potassium
deficiencies, however, can occur with conditions such as fasting,
diarrhea, and regular diuretic use. In such cases, low blood–potassium
concentrations, called hypokalemia, can lead to muscle cramps
and weakness, and even cardiac arrest caused by impairment in the
generation of nerve impulses. Similarly, high blood–potassium
concentrations, or hyperkalemia, are also not common but can
occur in people who take potassium supplements far exceeding the
recommended daily allowance. High blood–potassium concentrations can
also disturb electrical impulses and induce cardiac arrhythmia.

Even though little evidence is available to support a link between
potassium intake and muscle cramps, it is quite interesting that most
athletes—and non-athletes alike—think that the banana is the first line
of defense in preventing muscle cramps. If only it were that simple.
Furthermore, athletes following vegetarian diets are not likely to
experience muscle cramping as a result of low potassium intake because
the vegetarian diet provides an abundance of potassium. An athlete who
is recovering from an intestinal illness, restricting calories, or
taking diuretics or laxatives should, nevertheless, make an effort to
consume potassium-rich foods, particularly if he or she is experiencing
muscle cramping. Because of the dangers of hyperkalemia, potassium
supplements are not recommended unless closely monitored by a
physician. The recommended daily intake for potassium is 4,700
milligrams per day for adults.

Calcium
As discussed in chapter 6, the vast majority of calcium found in the
body is found in the skeleton where it lends strength to bone. Calcium,
however, is involved in muscle contractions, including that of the
heart, skeletal muscles, and smooth muscle found in blood vessels and
intestines, as well as the generation of nerve impulses. Blood calcium
is tightly controlled and regulated by several hormones, including
parathyroid hormone and vitamin D.

Although impaired muscle
contraction and muscle cramps are commonly listed as symptoms of
calcium deficiency, many exercise scientists feel that low calcium
intake is not likely to play a role in most muscle cramps. This is
because if dietary calcium intake were low, calcium would be released
from the bones to maintain blood concentrations and theoretically
provide what would be needed for muscle contraction. This thinking,
however, does not completely rule out the possibility that muscle
cramping could be caused by a temporary imbalance of calcium in the
muscle during exercise. Certainly, we know that people with inborn
errors in calcium metabolism in skeletal muscle (which will be
discussed later) are prone to muscle cramping.

Despite so
little being known about low calcium intake and muscle cramps, calcium
is one of the nutritional factors people most associate with relieving
cramps, second only to the potassium-rich banana. Although to my
knowledge studies have not assessed whether dietary or supplemental
calcium affects exercise cramps in athletes, a recent report found that
calcium supplementation was not effective in treating leg cramps
associated with pregnancy. On the other hand, anecdotal reports from
athletes are common. Nancy Clark tells of a hiker who resolved muscle
cramps by taking calcium-rich Tums and of a ballet dancer whose
cramping disappeared after adding milk and yogurt to her diet. Because
calcium intake can be low in the diet of some vegans and vegetarians,
inadequate calcium should also be ruled out in vegetarians experiencing
muscle cramps.

Magnesium
In addition
to its role in bone health, magnesium plays an important role in
stabilizing adenosine triphosphate (ATP), the energy source for muscle
contraction, and also serves as an electrolyte in body fluids. Muscle
weakness, muscle twitching, and muscle cramps are common symptoms of
magnesium deficiency.

Limited data have suggested that
magnesium status is indirectly related to the incidence of muscle
cramps. In these studies of endurance athletes, the athletes who
developed muscle cramps were found to have serum magnesium
concentrations that were different from their competitors who did not
cramp. The research, however, presents a confusing story because serum
magnesium was significantly lower in cyclists who cramped during a
100-mile (160 km) bike ride and significantly higher in runners who
cramped during an ultradistance race. In both studies, serum magnesium
remained within the normal range but was low-normal in the cyclists who
cramped and high-normal in the runners. Interestingly, studies in
pregnant women have found that supplementation with magnesium (taken as
magnesium lactate or magnesium citrate in doses of 5 millimoles in the
morning and 10 millimoles in the evening ) show promise for treating
pregnancy-associated leg cramps. Research, however, has not addressed
whether dietary or supplemental magnesium can prevent or reduce muscle
cramps in athletes.

Vegetarian athletes are not likely to
experience muscle cramping as a result of low magnesium intake because
the typical vegetarian diet is abundant in magnesium. Low magnesium
intake, however, is possible for people restricting calories or eating
a diet high in processed foods. Low magnesium intake should be ruled
out in cramp-prone athletes.

Carbohydrate
Inadequate carbohydrate stores have also been implicated as a potential
cause of muscle cramps. Theoretically, it makes sense that hard-working
muscles might experience cramping in association with the depletion of
its power source—carbohydrate. While all athletes should consider the
recommendations presented earlier to optimize performance, athletes
with a history of cramping during prolonged exercise should ensure that
they consume adequate carbohydrate during exercise and in the days
before and days following an endurance event.”

Nutrition truths for endurance athletes

Some practical wisdom on endurance sports nutrition from the book is “Endurance Sports Nutrition“, reprinted with permission by Human Kinetics

“You are responsible for experimenting in training (before the actual
event or race) to discover and build a repertoire of acceptable foods
and drinks, and any other supplements, that you will use to meet your
fluid, energy, and electrolyte needs during long-distance events and
races. You must figure out the basics—what and how much you need to eat
and drink and when you need to eat and drink it. Don’t neglect to put
your strategies to the test in various weather conditions at your
intended race pace or intensity.

  • The only way that drinking and eating on the move become automatic
    on the day of the event or race is by practicing beforehand. Aim to be
    consistent and stick with what you know. When your favorite or old
    standby is no longer working, however, you must be willing to try
    something new. If you’re contemplating tackling ultralength challenges,
    you first need to establish smart drinking and refueling habits in
    longdistance events and races.
  • Consider how your body processes foods during exercise. Blood flow
    to the gastrointestinal tract falls as your pace or intensity
    increases, making it harder to digest and absorb foods that you take
    in. In addition, your ability to consume and absorb calories when
    running (because of significant jostling of the stomach) is far less
    (by as much as 50 percent) than when cycling. Rely on simple
    carbohydrates during high-intensity efforts or when you need a rapid
    energy boost. Choose electrolyte replacement drinks, energy gels (take
    with water) and sport chews, glucose tablets, and  if tolerated, soda
    or juice. During longer efforts of moderate intensity, add  solid foods
    and high-calorie liquid drinks to boost your calorie intake and your
    spirits.
  • Refuel frequently instead of eating a large quantity at any one
    time, which diverts blood away from your working muscles. In other
    words, spread your hourly energy needs over 15- to 20-minute
    increments. Don’t try to cram it all down on the hour mark. The best
    sports drinks, high-calorie liquid drinks, energy gels, and energy bars
    for you are the ones that go down and stay down.
  • Hitting the wall means that you have essentially depleted your
    muscle glycogen stores. Your legs (and other major muscle groups) have
    gone on strike, even though you may have been consuming adequate fluids
    and calories. Your training, or lack thereof, improper pacing, and
    general fatigue can contribute to this phenomenon. You will often be
    able to continue and finish, albeit not with the desired performance.
  • Bonking, when the body completely shuts down because of a severe
    drop in blood sugar, is a much more serious situation. The glycogen
    stored in muscles and the liver is essentially gone. Muscles and, more
    important, the brain are not receiving sufficient fuel. If left
    untreated, you may become increasingly irritable, confused, and
    disoriented. You could find yourself sitting or lying down and could
    possibly lapse into a coma. Stop whatever activity you were engaged in
    and boost your blood sugar by consuming readily absorbable
    carbohydrates, such as sports drinks, energy gels, soda, fruit juice,
    or glucose tablets, if available. Seek or ask for medical attention if
    necessary.
  • The best way to avoid bonking is to create a calorie buffer. Liquid
    calories in the form of electrolyte replacement drinks and high-energy
    liquid products are favored because they tend to be well tolerated and
    require less effort to get down than solid foods do. Large male
    endurance athletes often have to consciously work to consume enough
    calories (for example, as much as 500 calories per hour of prolonged
    cycling as compared to 300 calories per hour for smaller female
    athletes) to stay in energy balance.
  • Athletes who struggle with sensitive stomachs and other
    gastrointestinal problems are advised to learn beforehand what sports
    drink will be served during races and organized events. They can then
    train with that product or, if they will have access to water, carry
    their own acceptable powdered sports drink in premeasured baggies and
    reconstitute it along the way.
  • The less fit you are, the fewer shortcuts you can take. Knowing
    what you can survive on and still perform well with comes with
    experience. If you are less fit or less efficient (a novice rider or
    trail runner, for example), you need to drink and eat on a regular
    schedule. Set your watch or bike computer and train yourself to drink
    every 15 to 20 minutes and refuel every 30 to 60 minutes to keep pace
    with the energy that you’re expending.”