Episode 482: What Performance Fueling Shows Us | Dr. James DiNicolantonio
Dr. James DiNicolantonio is a cardiovascular research scientist and Doctor of Pharmacy and has worked with professional athletes across sports. We cover the topic of fueling sport, and what to make of the extremes often discussed online.
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[00:00:00] Alright, James, welcome to the show. Thanks for having me, Zach. Yeah, no, I think it's gonna be fun to chat. I, I wanted to have you on to talk a little bit about just some of the more recent kind of information that's been around the internet from just fueling and kind the low carbohydrate to the high carbohydrate stuff with respect to endurance and performance.
And it's been kind of an interesting world to be in as an endurance athlete because we've sort of had this big wave of like really high carbohydrate and with it, like higher than historical averages of like inner, inner race fueling, sort of driving a lot of the performances out there. And then as soon as that starts getting momentum, you see like the, the low carb side of the endurance world come out with their own set of studies and analysis and, uh.
Essentially kind of say, Hey, wait a second here, maybe we should go the other direction. And then we're, I think of like the person just kind of watching, it's like they [00:01:00] may see like a 10 x variance in, in race fueling recommendations between the two groups, right? Yeah. Yeah. Um, well, I think, so I think the biggest thing that you and I kind of noticed is that the two studies that the Nos and Prince group did, and Andrew Knick, weren't elite athletes performing in their competitive sport.
Mm-hmm. So I find it highly unlikely that like an elite athlete who's playing a full soccer game, a full basketball game, a full tennis match, or five rounds of MMA is going to perform equivalent, which is what they were claiming, um, if they're on a ketogenic diet versus like a moderate to high carb diet.
I just find that extremely hard to believe. And, you know, their studies obviously don't show that, right? They didn't test that type of scenario where you're pushing over 85% VO two max many, many times, like in a soccer match, you're gonna, you're gonna sprint [00:02:00] 30 to 50 times all out. And so, you know, even their one study that did 85% of O2 max, that was in 40 year olds, 99% of those people would've already retired.
Um, and again, none of the studies were actually adequately powered to, to even claim, um, basically, you know, equivalence, so to speak. So that's the key. The key difference here that we need, that a lot of people don't really understand, is that, yes, when you go on a ketogenic diet, you're a better fat burner, but there's a cost to that.
You are not as good at oxidizing carbs. So fat oxidation goes up by two or three fold, but carb oxidation goes down by, by the same fold, two to three fold. So you're less metabolically flexible and. When you go above 70% VO O2 max, that's a problem because you're no longer able to go through the muscle glycogen breakdown pathway as well.
Because the main enzyme, [00:03:00] pyruvate dehydrogenase, which takes pyruvate, converts it to acetyl coal. So the pyruvate is coming from breaking down glycogen and putting it into the TC cycle for a TP, that enzyme function is decreased on a ketogenic diet. So about 60% decrease at baseline and about a 30% decrease in that enzyme function during sub maximal exercise.
Not even like, you know, a high intensity. So you're not able to push muscle glycogen breakdown through the full ATP pathway as well on a ketogenic diet. So once you start going above 70% VO O2 max, there's that cost. So you're a good fat burner, but you're not good at carboxy sedation. And eventually when you get, especially when you get over 85% VO two max, you really start having to push that carb ox sedation higher.
And that's why being metabolically flexible on a moderate carbohydrate intake is better, in my opinion, than a ketogenic diet. Yeah, no, I mean it makes sense to me and it's, the other thing I always wonder about studies like this too, is along [00:04:00] the lines of what you mentioned, where it's not really capturing true competition, it's also not capturing true training cycles in blocks and things like that where, you know, I've played around with low carbohydrates, even ketogenic diets for ultra marathon stuff, which we can get into there too.
Maybe the variance there between something like that and you know, like a 60 minute soccer match or a shorter race, like a half marathon or 5K or something like that. But one of the things I first noticed was like. If you had me go and do a short interval session, which is gonna be higher on the aerobic intensity spectrum, I could do one good quality session like that, that would match what I would typically do when I was high carb.
But the repeatability of that, over the course of 2, 3, 4 weeks, when I'm trying to do maybe two or three quality sessions like that per week, you start to see diminishing returns later on, not necessarily in that first session. So like even with my own like personal experience, it kind of mapped on to just like, [00:05:00] okay, well these studies are kind of maybe showing at best what could happen under like a single session type of effort versus what you're likely gonna see in any actual like rigorous training protocol that an endurance athlete or a soccer player is gonna undertake.
E exactly like. You're not gonna, I highly doubt you'll ever see someone on a ketogenic diet, especially not using glucose or any type of glucose fructose during a marathon when they're running at 85 to 95% VO two max, like mm-hmm. The elite marathon times of two hours, two hours and 15 minutes. Good luck trying to hit that time on a ketogenic diet.
There's no way that's gonna happen. You're gonna cook. There's just, it's, it, the machinery isn't there for you. Now, it's possible that if they start utilizing and fueling with glucose and we don't exactly know above 10 grams right, per hour, what that could look like. But I highly doubt that they would still be able to hit elite marathon time.
So yeah, people like Sean Baker can perform well on [00:06:00] acute sprints, like short sprints. But doing that for two hours at a 85 to 95% VO two max, like I highly doubt that's ever gonna happen. Yeah. Yeah. I had a conversation online kind of about that too, where it's like you get someone like Sean where, and I think I maybe ruffled some feathers with this comment just in general, not necessarily with Sean, but with people in general.
I just said, that's a low output lifestyle. And I think people took that as like, oh, he is lazy. It's like, I didn't mean lazy as in like low output at the moment. 'cause it's obviously super high output when he gets on a compact two trainer, or when someone gets on an assault bike and does sprints and things like that.
But because it's so hard and acutely high demand, there's a very limited amount of time you can do that. So when you look at someone's energy output over the course of, say, a 24 hour period, or even three days in congestion. With all the training that's going on there, they're actually at a relatively low physical activity level compared [00:07:00] to their basal metabolic rate.
Whereas you take like an endurance athlete, now all of a sudden you're seeing physical activity levels of like two to maybe three times their basal metabolic rate. And that really high output lifestyle I think is really sometimes what drives a lot of times just like your ability to rely on things like gluconeogenesis or, you know, other, other ways of getting your fuel, your fuel to you quick enough in order to, to maximize.
And I mean, even in that context, like I'm, I feel like I'm granting a lot by saying that someone could do a zero carb diet and maximize their potential even in these short duration things. Because I think even when we look at the top end of sprinters and things on the world stage, they're still not necessarily engaging in anything that would resemble a strict ketogenic diet in most cases that I'm aware of anyway.
No, I agree. The Anna Clara Aian meta-analysis also showed that compared to ketogenic diets, even one rep max is improved on high carb diets. But also time trials were improved in fat-free mass as well. So, and there's [00:08:00] many other meta-analyses and systematic reviews comparing these ketogenic diets to higher carb diets and typically on numerous outcomes, moderate to higher carb intakes always outperform the ketogenic diet.
Mm-hmm. Yeah, and I think this is where sometimes the conversation gets complicated for people too. 'cause I think they think, alright, well we're looking at these world-class professional athletes and their lifestyles and their workloads and it's just so unrelatable to the average person just going about their day trying to exercise as best they can.
And I can see that being something where it's like, okay, well. I'm sure it helps them or if they perform better. But what about me? And I think that's a fair question to some degree, but the problem I find when studies and analysis come out like this one is there seems to be this like system or this process that goes, alright, we have this study now we wanna promote it.
How do we promote it the best, make an extreme claim. And the extreme claim oftentimes has some sort of performance aspect to it. 'cause that's got [00:09:00] that kind of catchy like, oh, I better check this out. Performance, that's a fun word. And then as soon as someone like you pushes, pushes us back on that, then they kind of retreat back to the, oh well we're just talking about the average person.
We're not really, this isn't maybe something that we would necessarily say is advantageous for like the best marathoners in the world. And it's like, okay, well now you just, you sort of just retreated as something much more defensible, potentially defensible. And. We kind of don't even get to have that conversation in a lot of cases.
'cause there's like, there's all the noise around the initial claim that is kind of getting back end backdoored into the, into the, the discussion. Yeah. And I, I think they weren't open about any of the limitations really, of their study. So, you know, it's not really fair to compare, uh, a ketogenic diet to a high carb diet when you're doing it in a fasted state.
B, you're not allowing them to consume carbs within three hours and 15 minutes of the study. So we have many studies showing that giving one to [00:10:00] two grams per kilogram of carbs one to three hours prior to performance improves performance. So why, why are you restricting them from doing that? They did not use the gold standards, you know, 60 to 120 grams per hour of carbs.
So that's a limitation too, because you're, that's how you know elite athletes are fueling themselves. You're not allowing them to do that. Of course, a ketogenic diet might be quite unquote equivalent. Um. At the same time, they also allow them to consume significantly more amounts of salt. Even after three weeks, a high carb diet has actually been shown to lose more salt than a low carb diet.
So the low carb diet, at least the studies that I've looked at, yeah, there's an extra sodium loss but only occurs for two to three weeks. And afterwards, actually total sodium loss is actually higher on the high carb and the outcomes were compared four to five weeks later. So it, it, to me, it didn't make sense to overly salt load compared to the other group.
It's fine to have them both get good amounts of salt. Fine, that's, but you can't tell them the other group to consume up to four grams more sodium and, and call it like a fair comparison. [00:11:00] And so with all that being said too, is if you actually run like a power calculation on their studies. It depends on what type of effect you think you're gonna get between a keto diet and a high carb diet.
So if you think it's only gonna be a small effect size, when you do an 80% power calculation, you actually need almost 400 people in each group to actually be able to show a statistically significant difference at a small effect size. So if it's a moderate effect size, you would need about 64 participants per group.
If it's a large effect size, you'd need about 34 per group. They only had 10 people, quite unquote, in the ketogenic diet. So of course there's gonna be no significant difference when you're not even powered to be able to show a statistically significant difference. Even at. A large effect size. So they saw no significant difference between the high carb and the ketogenic group, and they called it equivalent.
But that's 'cause you're not even powered to be able to even have a P value, that's gonna be significant. So, you know, you're supposed to run an 80% power calculation when you're designing clinical studies to figure out how many participants with [00:12:00] 15 or 20% dropout rate at at the end, how many are needed to have the 80% power based on a small effect size, moderate or large, what you expect to happen.
They didn't do that. And if you run the numbers, they're way underpowered. The other problem is, six out of 10 people in their 2025 paper weren't even in ketosis on day 35, and about half of them weren't even in ketosis on day 42. Those are the two times that they compared the groups. So you're claiming a ketogenic diet did this when over half of the participants weren't even in ketosis though, you can tell people to go in, go on a ketogenic diet all day, but.
That doesn't mean they actually did. And so when you looked at the ketone levels, they weren't in nutrition. Most of them weren't even in nutritional ketosis, which tells me they were consuming more carbs than what the study authors thought they were consuming. So again, like there's just so many flaws to these papers that to me, the only thing you can take away is that, yeah, adding 10 grams per hour on a ketogenic diet might improve a ketogenic diet performance.
But beyond that, to [00:13:00] compare it to a carb, how someone's feeling with carbs, those two studies to me have literally no relevance in my opinion. Mm-hmm. Yeah. And I think if they had framed it that way, it would've gone over much smoother for me anyway, if they had looked at it. This is like, alright, we are the, the way I looked at it was if there are gonna be people who decide, you know what?
I prefer being on a low carb or ketogenic diet, and that's. What I wanna do, and I also wanna participate in this endurance sport or this sport in general. What are my recommendations for fueling, given those, that framework versus what we would typically prescribe to someone on a high carbohydrate diet?
I mean, I think that's, it's, it's, it'd be great to have an answer for those people, or at least a starting point. So I think if we got anything from the study, or the way I would've framed it would've been like if you're on a ketogenic diet and you're participating in sport, you can see a pretty noticeable improvement by introducing 10 grams of carbohydrate per hour.
Now, we don't know whether 20, 30, 40, [00:14:00] maybe even 50 grams per hour would produce even more benefits, or if we could somehow also look at that in the context of someone's workload and where that number kind of ends or starts. From a performance standpoint too. And I, if they continue to look at this stuff, I do hope they kind of do that in the future where they look at like staging it like 20 to 30 plus grams and see, 'cause for all we know that same group that had that time to failure improvement on 10 grams per hour would have another additional improvement at 20 grams or 30 grams.
Yeah. And I mean I offered, I said, why don't you guys bring on some high carb advocates to help you design these studies? I was like, I'm happy to come on board as a co-author, so, so we can kind of show you how high carb athletes actually utilize carbs. So it's like a more fair comparison and they weren't very keen on bringing on me or anyone else, which I think is, when you're in an echo chamber, you're gonna hear the same thing over and over again and you're never going to kind of like test out the flaws that people on the other side of the, the space are saying are flaws.
So there were two main flaws in my opinion as well. [00:15:00] One is the group, basically, I think it was Andrew, who has been the most, you know, outspoken on, basically kind of summarizing the studies. And he said 30% of the people in the high carb group had pre-diabetic levels. The problem is, number one, they were average age 40 years old.
They were only running on average six miles a day, five days a week. That's pretty, that's not that intense. Mm-hmm. And they were eating 400 grams of carbs. That is way too many grams of carbs, in my opinion, for just running six miles, five, uh, five days a week. They should have been probably consuming on an exercise day, maybe 250, and on a non-exercise day, 150 to 200.
So, of course, if a 40-year-old who's running six miles five days a week is consuming 400 grams of carbs, including on non-exercise days, yeah, I, I definitely believe that they could go into pre-diabetic, uh, glucose levels, but that's not how they, you're, you're supposed to fuel based on the, the workload and, and, and basically, you know, fuel for the work that's required, right?
Mm-hmm. We've heard that many times in this space, [00:16:00] and there's a certain group of authors that have, have looked at that. But basically what I'm trying to get at is like, it was. An older population over consuming carbs and not consuming them appropriately for the work that they were performing.
And the second thing is, I didn't really like the hypothesis that muscle glycogen all of a sudden is no longer important, which is what they were claiming. And it all has to do with the liver glycogen fueling the glucose. And then it all has to do with hypoglycemia and preventing hypoglycemia. And I had pointed out to the group that, well, you guys didn't do that, you didn't look at muscle glycogen.
And so how can you claim that it's not important? You didn't do biopsies of muscle glycogen. And when you look at the studies by Bergstrom in the, in the late sixties when they looked at mixed diets, high carb diets and ketogenic diets, all of them had depleted muscle glycogen upon exercise cessation.
And there was no hypoglycemia in the high carb group. So at least make, make that statement in your paper clear that this has [00:17:00] nothing to do with a high carb diet. You are not going hypoglycemic typically, um, in those studies. And so it's, it's muscle glycogen depletion, at least when you're running at, let's say like a 77% VO two max for like two hours at exercise cessation.
No hypoglycemia, but there is significant muscle glycogen depletion. Now, on the contrary, on the mixed diets and the ketogenic diets, they didn't, they didn't even make this clear that the muscle glycogen was also depleted in those groups. But yes, hypoglycemia also occurred. So is it the chicken or the egg?
Because they didn't look at any of these studies. Continuously looked at blood glucose versus muscle glycogen. In my opinion though, the body's going to preserve the blood glucose with the muscle glycogen it's going to utilize. And once you, once you basically deplete the muscle glycogen, then the blood glucose is gonna go low.
To me, that makes more sense. Why would you go hypoglycemic but have all this muscle glycogen stored? So I didn't like what they were trying to say, it's all about hypoglycemia and preventing hypoglycemia and now all of a sudden muscle glycogen [00:18:00] isn't important. When no's own papers showed as well too that, and they didn't do this either.
Basically when you, when you go on like more of a lower carbon intake for let's say, let's say like three days before competition, you train and you train like. Two grams per kilogram of carbs and then you supers saturate, right? You go from typically six grams per kilogram to 10 and a half nos show this.
When you do that for three days and you super saturate, you can significantly improve, you know, like power output and et cetera. They didn't do that in those studies either. And so like you're not maximizing how people have in this space for decades have learned how they can supers saturate muscle glycogen and you can basically have twice the amount of muscle glycogen compared to a ketogenic diet if you do those things.
And the Bergstrom studies also showed that baseline muscle glycogen significantly predicted how long these people were able to run. In other words, muscle glycogen is of course important. Even if you don't believe any of this. Clearly muscle glycogen can fuel the [00:19:00] liver. By, you know, the lactate production, when you're breaking down muscle glycogen through the Horry cycle, it can convert the lactate to glucose, which can then fuel the blood glucose.
So like to just say that blood glucose is only based on liver glycogen makes absolutely no sense because the muscle can fuel the li So of course, muscle glycogen is important. And then I tried to show them mechanistic studies too, that when you deplete the muscle glycogen near the sarcoplasmic reticulum, like the calcium release and the contraction goes down.
And so like there's a, there's, there's a clear reason why physiology is. Has glycogen, right where it's needed. It makes complete sense, like in the intra myofiber, fibrous, in order for that calcium to be released well and to have that good contraction. So from a mechanistic perspective, from the biopsy studies, to me, their whole hypothesis, I just didn't like that they were trying to completely now bash muscle glycogen as being important for performance.
Yeah. Yeah. To me, that almost felt like the world of endurance is [00:20:00] looking at how are we go, how are we assessing the impact of certain things that we haven't found a great way to be able to measure, like in competition or on a frequent enough basis to really have hard data points for, in a lot of cases.
And we can be informed by some of that by just simply looking at performance. And this is where I really like when you get these sports, like pro marathoning at the majors or the Olympics or the Tour de France where there's so much money and attention and, and just basically incentive to be the person who knows what they're doing.
If a process has already been introduced to that, it's gonna get tried. And if it works, it's gonna, you're gonna see it start showing up on the podiums. If it doesn't work, it's just gonna end up getting tossed on the wayside like everything else that didn't work in the past. And to me it's like, I'm not saying that there's nothing like novel things that we don't know about yet that could revolutionize performance.
I'm sure there'll be something that comes up in the next 10 years that all of a sudden moves the needle of performance that just hasn't got put [00:21:00] through that rigor yet. But the ketogenic diet's just not one of those. And that's something else that I think is oftentimes missed with this is a lot of times when I have conversations with people about this, they just assume, oh, well the reason why Pro Marathoners and Olympians and Tour de France podium finishers aren't using ketogenic diets is because they just haven't tried it yet.
And if they would try it, they would perform even better. And I'm just like, no, they have tried it. And that's the problem with that is like if you actually know the world, you know that this has been tried. And we can get into nuance and talk about things like long ultra. And stuff that's performed at below 70% VO two max.
With respect to, is there a window for this? But when we're talking about these highly pressurized, highly competitive events that are performed above that, in a lot of cases it's been put through the, through the test and got spit out. And if we take the opposite end of that, if we go to higher than prescribed fueling strategies, like above 120 grams per hour, that is something that we don't have great evidence to suggest that 150 grams per hour is necessarily gonna be advantageous for [00:22:00] performance.
But we see almost every pro cyclist doing that now. And one of the reasons why that is, is because when that got put through that system, it actually produced results. So now everyone else is like, well, we have to do that if we wanna compete, because the margin of finishing first and 10th is gonna be like a small sliver.
And something as simple as going from fueling suboptimally to fueling optimally if there's a performance advantage there of even a percent or two is gonna be a very big mover at that point. Yeah. And what people kind of fail to remember, 'cause what you were saying is, well, they should just try a ketogenic diet on the Tour de France.
There's many times where you are pushing that VO two max, right? Where you're, you're, you're really cycling extremely hard, uphill, et cetera. So there's a lot of sprinting happening in those types of events. At the very maximum acutely have we ever seen someone be able to oxidize fat is two grams per minute.
And, and this doesn't, you can't do that for hours. Two grams per minute times nine calories [00:23:00] per gram. That means you, if you are fully fat oxidizing, you can only produce 18 calories per minute. When you are pushing, sprinting, et cetera, you can easily hit 30 calories per minute. That shows you that you can only derive half of that energy from fat.
You have to derive the other half of that energy from glucose. So you can't just burn fat to fuel you on intense exercise, you know, sprints. And so the other half has to come from glucose. And if you are on a ketogenic diet, you cannot oxidize carbs nearly as well as someone that's eating a moderate to high carb diet.
So when you are pushing those higher intensities, you are going to have a performance decrease on a ketogenic diet. Yeah. You know, that makes sense. And I mean, I, even when I was doing low carb in broke records on the hun at the a hundred mile distance with that, I was still doing about 40 grams per hour, is what I found worked really, really well for me in that state where it was like my fat ox was high enough where at my aerobic threshold, [00:24:00] which is about where I would be racing at for a hundred miles, is what was adequately supplied by 40 grams.
And I mean that's, that's really looking at it purely through the oxidation side of things, which I think now we're starting to realize it's more than just an oxidation question. So, you know, that's where I think you would maybe try to pivot off of a lower carb or ketogenic diet. Even with these, these longer races are what sort of benefits we are getting from a performance standpoint, from a carbohydrate ingestion at these higher numbers that can't be achieved at lower numbers when we're just simply trying to replace on an oxidation side of things.
Yeah, and I, I remember you had said too. When you, when you run for 12 hours, burning about a thousand calories per hour, that requires 1.85 grams of fat to be oxidized per minute. Mm-hmm. Now, the faster study, which was individuals on low carb diets for 20 months, they were only oxidizing 1.5 grams. Mm-hmm.
I highly doubt someone's gonna be able to oxidize 1.85 grams per hour for 12 [00:25:00] hours straight. So you're going to have to oxidize carbs too, um, when you're, your output is what you're doing. And so just from a physiological standpoint, like when you start to kind of piece it together in regards to how much calories are required to fuel X amount of performance, and then you look at what's the maximum amount that you can sustain, like fat oxidation for.
You realize that for these higher intensity exercises, fat oxidation is never going to be able to fuel on that performance usually might, it might only be able to fuel like 50% of that, at least for the more explosive parts of that performance. Do you think when we start getting into the world of longer events than that, or people running similar distances, but at much lower paces where their workload is maybe half of mine or two thirds of mine, that there's more of a window for a lower carbohydrate approach?
100%. Like if you're running at 70% BO two max or less, uh, you know, ketogenic diet might actually outperform, um, you [00:26:00] know, moderate carb. Uh, but once you start going above 70% BO two max, I highly doubt that you're gonna have an advantage with a ketogenic diet versus moderate carb. Mm-hmm. And I think it's, it, it comes be, it becomes something where I always try to ask myself with these things is, or I, what I try to assume anyway is everything has a trade-off.
And if you look at it like what are the trade-offs that I'm likely looking at here, or the pros and the cons, do those line up for me personally? Set of variables in a way that's positive or negative. So the one thing I always tell people, and what I considered myself when I was doing low carb, is that there is the competition that I might be doing at 70% of VO two max or lower, but there is also.
The training required to get ready for that event. And it's easy to look at races like that and like, oh, it's just a lot of long slow running. They're probably doing a lot of long slow running in their training. It's true, we do a lot of long slow running in our training, but we also do things like short intervals at VO O2 [00:27:00] max, long intervals at lactate threshold and moderate intensity stuff.
And that's where I think you also have to be kind of considerate of what type of person you are bringing to that starting line. So if the training gets impacted by your dietary strategy to the degree where now you're just less fit at the starting line, yeah, maybe you can fuel that race in a state of ketosis, but did you get to the start of that race with the best possible version of yourself with that approach in training?
And that's where I think it really gets a little bit more tricky and individual at that point is if you're gonna be doing long ultra marathons and you wanna use low carb ketogenic diet, um, at some point you probably wanna play around with how is that is impacting your actual training when you're doing things like short intervals and long intervals in the training itself.
Yeah. Yeah. And I mean there's other things, beyond just performance too. Like I've seen hundreds of anecdotes of individuals going on low carb, including myself too, where they have both clinically low, like free T three, significantly elevated [00:28:00] reverse T three and actual clinical symptoms of hypothyroidism.
And because insulin helps to actually convert the inactive T four to T three, that's important. So some people are much more susceptible than others. So genetics do play a role here, in regards to who benefits from low carb or not. But also if you're consuming a more alkaline high carb diet that helps to offset the acidosis of ketosis and also, um, you know, higher animal protein diet.
So it's not the same acidosis as. Severe diabetic ketoacidosis, but it does put you in a more acidic state. And there have been studies showing that if you compare a more alkaline diet versus a more acidic diet, that the alkaline diet time trial performance has improved. So there are other advantages in regards to alkalinity, thyroid.
You don't have to use as much pro dietary protein because you know, when you're in a ketogenic diet, you have to use some dietary protein to form the glucose. Um, so it's, it's dietary protein sparing just consuming 20 to 40 to 50 grams of carbs. [00:29:00] Um, and it has been shown just 50 grams of carbs has been shown to prevent the low T three in the, in the elevated reverse T three on, on a ketogenic diet.
So just getting 50 grams of carbs plus can, can kind of offset some of those harms. Yeah. Yeah. And I think that also feeds into something I'm curious about too, which is just how the body responds to the lifestyle in general when you are doing it, but you're doing it in a fed state versus an unfed state.
And when we look at a lot of low carb, ketogenic, endurance athletes, it's like, well, they're not taking in a lot of carbohydrate, or in some cases, any carbohydrate. So you have these scenarios where you now have possibly a two, three hour training session where you're putting out a. Ton of energy, but you're taking in next to none.
So like what? Like I, I mean, you could eat fats and proteins during those runs and I know some people do that, but my thought is like, if someone is going to do that, they probably do wanna be consuming something just [00:30:00] from the standpoint of the, the energy requirements of that lifestyle and the signs you're kind of sending your body through just huge amounts of energy out without a, necessarily a, a return to that.
I think there's probably some value there in having some of that fed workout, regardless of whether it's carbohydrate or fat. But carbohydrates are the one we tend to look at and study. So we know that things like recovery and things like that improve when you're, when you're consuming foods during these training sessions.
No, totally because fats and protein slow digestion, they sit in the stomach longer. They take much longer to digest. That's why a lot of athletes, you know, you know, Conor McGregor has said this, and Novak has said this, that when they consumed a lot of red meat, they felt sluggish because it just sits in the stomach for a, for much longer than than carbs.
So carbs are the, the faster fuel in regards to both digestibility, but also the speed at which you can produce a TP, um, is so much faster than fat oxidation and, and the, you know, you're 10 to 15% [00:31:00] more oxygen efficient when you are burning glucose versus fat. And so the perceived exertion can start increasing when you are, you know, using more fats versus glucose for that very reason.
Just fats just, you just can't burn 'em fast enough when you're at higher VO O2 Maxxis to, to give you that energy that you need. Yeah. And that kind of goes back to what you were saying before when you're like, there's not, you're, you're not gonna see a pro marathon runner podium him at the Olympics, or even just engaging with the sport on a ketogenic diet because you get that kind of perfect balance of distance and intensity where that, that oxygen demand becomes such a premium.
You need to have the fastest acting fuel source in order to command it for, for the durations that they're looking for. So, I mean, I got asked this question a lot actually, when I broke some records on low carb, was like, the people would always wanna know, like, well, you know, do pro marathoners do this?
Why don't they do this? And things like that. And I I, I generally would just say like, I don't think they're. There, the intensity they're [00:32:00] optimizing for is different enough from the intensity I'm optimizing for that. I just don't think there's a way forward for them. Whereas there may be for me, and like you take someone who's world class like a low two hour marathon or put on a ketogenic diet, they'll still be very fast.
They'll just probably run like a two 10 to 2 2, 2 15 marathon instead. Which, but when your, your alternative is running a 2 0 2 2 0 3 and being truly world class, that's a, it's a big hit to take. Yeah, exactly. And a lot of people too kind of say, well, you know, when you ingest carbs, it's not really searing muscle glycogen.
And you can have similar starting muscle glycogens on keto versus high carb diets, and you can have similar glycogens at the end of exercise. And of course that depends on the type of exercise. But what they fail to understand is. There's a difference though, in the full flux pathway once that glycogen is broken down, because PY rve dehydrogenase is decreased on a ketogenic diet, a lot of that pyruvate is going to lactate on a ketogenic diet and not [00:33:00] going into the TCA cycle for a TP production.
So there's a difference where you can run muscle glycogen through the TCA cycle much faster and better on a high carb diet versus a ketogenic diet. So if you're looking at just muscle glycogen, oh, it's similar to Star. Oh, it's similar at the end, but you were able to put that through and create more TP from the muscle glycogen because of the better pyruvate dehydrogenase activity.
In someone who eats like a moderate to high carbon intake. And that's the key. Most people don't really understand that. Yeah. You know, I actually talked to Luis Burke a little bit about some stuff along that, along those lines where, 'cause a lot of times the faster study will get referenced with that, where they'll say, oh, they had similar muscle glycol because they actually did muscle biopsies for that one.
And they're like, oh, they had similar muscle glycogen after the treadmill test. And Luis Burke said that, like, that's the only study that has, like, that goes completely counter to every other bit of research we have that looks at that. [00:34:00] Mm-hmm. So like her thought was like, I don't know, like what happened.
Maybe there was an error in lab measurements or something like that that didn't get, didn't get caught. Or like, I think there's at least some suspicion as to, I'm not saying like it was. Like the, the finna and volek were looking at it as a way to try to trick people. I think it just may have been some sort of like, we need to reconfirm this versus assume that this is true versus what we've seen happen in prior studies.
Yeah, and I think too, the VO two max was pretty low. It was 64% of VO two max, so, um, yeah. Mm-hmm. You're obviously not gonna capture more muscle glycogen when you're just going at that slow of a pace and it wasn't, uh, you know, people on a low carb diet on average 20 months. So, so, so maybe there's some, a little bit of better adaptation, but regardless.
Even looking at that has nothing to do with how good those keto dieters were able to oxidize carbs. And it didn't, doesn't matter really at 64% VO O2 max on performance. Mm-hmm. But does start to matter once you go above 70% VO O2 max. [00:35:00] Yeah, absolutely. And I, I think if I remember right, my data from the faster study at that 64% VO O2 max, I think I was like close to 90% fat ox.
So it's like, yeah, I'm not gonna dip a whole lot into liver and muscle glycogen at that point. And the other thing too that you had mentioned with your kind of assessment of the analysis was the protocols. And if I remember right, with the faster study they did have, the way, the way they did is they gave fuel to both groups.
Before the training session. So I think it was like 300 calories of basically like a fat solution for the low carb group and 300 calories of a carb solution for the high carb group. But then during the treadmill session, there was no fueling at all. It was just water. So again, you're looking at it through the lens of something that a high carb athlete isn't gonna engage with.
They're never gonna be in competition, even if it's a low intensity competition and go three hours without taking in any carbohydrate sources. Right. So you kind of have a, like a, almost like a misplaced assessment in terms of what that's actually gonna show. It's [00:36:00] certainly not looking at performance at that point.
And, and keep in mind too, the faster study was not a ketogenic diet, it was low carb, but I think on average they were consuming like 90 grams of carbs. Mm-hmm. So, I mean, there's days I consume 90 grams of carbs, so like that's not, yeah, that's not ketogenic. And that could explain it too. Mm-hmm. Yeah. Yeah.
'cause I wanna say it was something like the threshold was 10% of your diet from carbohydrate going into the, into the test. So yeah. So it was, it was, it was probably more low carb than certainly in strict ketogenic. Yeah, exactly. So, and it, the, the, the things that happen at less than 50 grams of carbs is a lot different than less than a hundred.
Mm-hmm. So if you can stay above 50, that can give you a lot of benefits compared to truly ketogenic, in my opinion. And so that, that, that probably plays a role into it as well. But like you said, I mean, we still, there's still a lot of things we don't know. I think going low-ish, carb has certain benefits in regards to training low and then performing high.
And especially with [00:37:00] you and I have kind of discussed this a little bit too, using low carb states to then super saturate the muscle glycogen and to give you, you know, better performance that way. Yeah. Yeah. Yeah. And that kind of almost goes back to kind of some of the original carb loading protocols where you would do a lower carbohydrate set of days before you get within a couple days or a few days of competition and then you kind of overcompensate for a while.
And somewhere along the way that kind of got bastardized into just like super high carb all the time. Yeah. And then the low carb group came in and just decided to do none of it at all. Right. And if they were just me in the middle, that's actually probably the best performance set. Yeah. If we could all just get along, we'd have a great protocol.
Exactly. And I think too the, the older studies I think looked more at like two or three days of very low carb, but like some of the newer studies came out, if you just train low, like do a training, like a pretty intense training session, just one or two grams per kilogram, that'll deplete your muscle glycogen enough and give you the signal to super saturate.
And so you don't have to be so extreme then. [00:38:00] And so like, I think that's where a lot of interesting things can happen is utilizing certain low carb sessions to deplete muscle glycogen to then supers saturate and perform better. Yeah, that's interesting. So would you think of that in terms of like how you would implement that, would you think like if you did like one of your training sessions per week where you intentionally do that and time it in a way where then you overcompensate in the next day or two before what would end up being a very high quality session and you kind of sort of treat it the same way as like a race in that sense?
Exactly. Like train low and then let's say four days prior to competition, like, like day four, you do a training session at only one or two grams per kilogram of carbs to deplete yourself. And then the next three days you just consume 10.5 12 grams of. Carbs per kilogram that will help you supers saturate because you don't really wanna be Right.
Performing very hard two or three days before a race. I, I, I, mm-hmm. I would assume. Mm-hmm. And so you use that time to really super saturate. And, and [00:39:00] so that's something that I think could help out a lot of individuals. It's just kind of like, um, dehydration, acclimation, like you, you do wanna kind of put yourself into a little bit of a dehydrated state that will cause your body to over attain sodium and expand blood volume even more.
So you train low and then you, you're able to perform higher when you bring back the salt and the fluid. Same thing with carbs. You deplete the glycogen to then re supersaturate afterwards. Yeah. Yeah. It's really interesting when you look at how you stress the body in certain ways to get it, to make improvements.
It's kind of the same as just training adaptations at the end of the day. Yeah. Or even, um, going into the sauna, like after a a, a session. Mild dehydration sessions have been shown to improve like time trial performance. If someone goes into the sauna for about three weeks, about four times a week after a mild dehydration session, that's producing more of a moderate dehydration.
And so then the blood volume expands even more to compensate for [00:40:00] that. But then if you do it too long, it takes more and more to actually be in the sauna, let's say, to actually deplete you. And so you start, you start actually losing the benefits of heat acclimation after three weeks because your body has become accustomed to it so much that it takes a lot more heat to hit that same critical core temperature.
Um, and it probably has a lot of similar effects with training, right? Mm-hmm. Like if you just keep training at the same amount, your body adapts and it's like you have to now go even, even higher. And so that's where actually. I was discussing this with Chris, master John A. Little bit, like he didn't really think that lactate threshold or measuring lactate threshold was important, but I was kinda like, well if you don't, you don't have to.
But, it's kind of cool because it'll tell you when you've pushed the system to a point where you have to create more mitochondria now. 'cause you push the system to the limit where now lactate is increasing. Mm-hmm. And so I think even, you know, lactate training and, and measuring lactate threshold in people may help performance as well.
Yeah. Yeah. I think there's some interesting stuff. I think [00:41:00] what the hard part with a lot of that is as soon as we find something we can measure, we oftentimes over account for it to some degree because it's something that looks very objective and you run into, you run into a situation of potentially ignoring things that in combination would be, uh, a larger mover because you're over fixated.
But that just comes with putting it in its place versus leveraging it as the end all be all. Exactly, and like you said, like you wanna train those slower zone twos, but you also want to train at higher intensities too, because you wanna push both systems and cause those adaptations. And basically training low can help you when you perform high because it'll take you longer to start tapping into the more of the glycogen if you are a better fat burner too.
So it's kind of like you can train one system, it actually helps the other system out, which is kind of interesting. Mm-hmm. Yeah. Yeah, it is. I did wanna ask you, uh, one other thing too that you had mentioned, and then I think it's just in general, kind of an interesting component. It was the [00:42:00] sodium loading side of things where in this analysis or in their, in their study they, they had the low carb group do a larger amount of sodium in their diet.
And I, my suspicion is the reason they did that is because there were kind of two things going on. One was, I know when Luis Burke did, I think it was the Supernova study where they looked at like the 10 K race walkers and which I think is like, like the people think race walking is like low intensity.
'cause like how could walking, it's not like I had a guy on the pocket, Evan Dunphy, who's a medalist at the Olympics in the 50 K race, walk in like the 10 K and he's, he's ripping workouts where his heart rate is like 180 and it's like, so it, they, they get the full intensity spectrum, um, with that too. So it's actually probably a little better of a look into that than what maybe it seems when you think of walking.
But uh, the interesting thing about that was the criticism of a lot of her studies there was that there wasn't a long enough adaptation period for the low carb group to see the [00:43:00] benefits and then that on top of it also, that they didn't have enough sodium to account for like that lifestyles demand. And it sounds like what you're saying is.
If you do employ a longer duration adaptation phase, that sodium piece to the puzzle isn't something you should necessarily need to control for in the sense where you're giving that group more than the other group. 'cause if you do, you run the risk of giving them an advantage that wouldn't be there otherwise.
And it's maybe the only scenario in which you'd probably do that was if you had someone with keto adapting for a very short period of time versus like four plus weeks or whatever they ended up doing for this, this low carb study. Exactly. So I think, I mean, ideally, you're measuring 24 hour urinary sodium if what you really, truly wanna see is one group losing more sodium in the urine versus not.
And then you can, you know, match diet, you know, increase, you know sodium and take in one group to try to offset that. Most people aren't gonna do that. So if it's only a two week study, yeah, [00:44:00] it maybe makes sense to have the low carb group consume more than the high carb group. But after two weeks, in particular by after three weeks, which is when the two nos studies were performed, they were performed at like day 35, day 42.
Your studies have shown that actually the high carb group has lost more sodium in the urine. So it seems to only make sense from, like a two week perspective. And then the, the key here too is yes, a lot of what you said is, okay, a ketogenic diet, if it's three weeks or less, or maybe even four weeks or loss isn't gonna be, but if you go beyond four weeks, it is, but the problem is, is there's been at least two studies that have gone six weeks.
And then Karen Zinn's study went for 10 weeks. And the Karen Zinn study, she showed like a two minute decrease in time to exhaustion, which was very clinically significant. In order for it to be statistically significant, the effect size must have been probably over one, which is insane. And so it just shows you that the evidence in the literature shows that even if you go out 10 [00:45:00] weeks, it doesn't seem that, you know, your benefit, the ketogenic diet is all of a sudden as good.
You're still seeing that significant decrease in performance. And they also specifically stated in Karen Sin's study, which was the 10 week ketogenic study of a per perceived exertion at higher intensity exercise, which matches the whole physiological difference that we've talked about. And then Matthew Carpenter did a study on ketogenic diets.
They were on, on the ketogenic diet for on average, uh, 25 months. And when you gave 60 grams of carbs an hour before the 16 kilometer, um, race, it improved their time trial performance. And so even people that are adapted to keto for two years plus giving them carbs, improves their performance. So I still have yet to see any literature on ketogenic.
Diet more time that that somehow is magically changing their physiology to where now they're going to be equal to or better than someone consuming carbs. I've yet to see that study. Yeah, that's interesting. 'cause I was gonna, my follow up question [00:46:00] was gonna be, 'cause this, this is how this always goes.
Kind of like, well if 10 weeks is what we have, how much more do we punt that down the road and say, well, what about six to 12 months or what about two years? Sounds like Matt's been looking at that. He's been on the podcast in the past, so maybe I'll reach out to him and see if he wants to chat a bit more about that.
I think it's a fun topic. He seems to be one of the guys in that space that is interested in looking at low carb. That is pretty reasonable. He's not out there making a whole lot of, uh, kind of, uh, really large, bold claims that go beyond what he's found. I agree. Um, if anything he's to me almost like a low carb proponent in, in a way.
I think he almost sides a little bit. How can we improve low carb with glucose, either, you know, before training or during training, which is fine. Which, um, I still don't think it'll, I personally just don't believe that at higher intensity, you know, exercise, even dosing ketogenic diets with 60 grams per hour of glucose versus someone [00:47:00] who's, you know, has been on a moderate to high carb diet.
I just don't think the machinery is there to utilize it as well as someone who's been consuming carbs for well over two weeks. Mm-hmm. Yeah. Yeah. And then in that framework too, it gets back to what we were saying too, where it also has to be, it, it also has to create a, a big enough benefit in your training protocol to, to account for whatever performance you're gonna lose or gain by doing one version or the other in the weeks and months leading up to whatever your key competition is.
Right. And I mean, we don't, we don't have any human population that was ever in chronic ketosis. I mean, specifically the Inuit have physiology that prevented them from going into ketosis, despite them being the most carnivorous population that's ever existed. So it's just a complete question mark. Is this actually healthy for someone long term?
And for me, when it comes to recommending something for someone long term, I would like to see at least one human population that has done that long term. And we just don't [00:48:00] have that. So it's a complete experiment. And typically when you run an experiment, you're gonna find issues with that experiment.
And so if you look at the Inuit two, there were issues with having such a high amount of protein they had, you know. Actually osteoporosis a full decade prior to, uh, age matches Caucasians. There's, there's benefits to consuming whole food fiber, like in clinical studies in humans that are given like meat meals.
When you add fiber, it decreases DNA ads in the colon. And so I personally think that that whole food fiber helps to offset some of the harms of red meat. And it allows you to tolerate red meat better. So from an overall health perspective too, I just simply think of crowding out all carbs for just fats and proteins, which is something we never even did.
Even the most carnivorous group, um, the Inuit, actually ate the contents of their stomachs. They pass it around like appetizers and they would go in and consume any arctic plant that was available to them. And they were able to store berries and stuff even in the winter. And so [00:49:00] they were able to consume carbs actually year round.
Not a whole lot, but. They did consume at least five different types of berries, and that gives you more vitamin C. And there's been many actual, most people don't realize this. There's been many publications of scurvy in ketogenic diets, particularly in kids. But there's been even case reports published of, of actual scurvy in, um, adults too, on, on not well formulated carnivore diets.
But again, you're just not optimizing nutrition too when you're crowding out carbs, you know, with the vitamin C, very low calcium, not enough magnesium B one if you're just sticking to muscle meat, not a lot of folate. So adding the carbs really helps to round out the overall nutrients too. Yeah. And then like if you wanna broaden out, just like the topic as a whole, that's where it gets problematic is when you have a dietary protocol where there you're removing such a large grouping of something, whether that be carbs or something else.
And then it's like, okay, maybe there's a path forward here if everything is designed just right, [00:50:00] but how is that actually gonna get engaged with at the population level? And I think if we've learned anything about population level advocacy, when it comes to specific diet types, the adherence rate's incredibly low.
So even if we said for whatever reason ketogenic diets are better than all other diets, therefore we should recommend everyone go on a ketogenic diet. How many people are gonna go and actually engage with that in a way where it doesn't have some of those pitfalls that you mentioned when it's actually practiced in real life versus the way it would have to be constructed in order for it to be optimal.
Right? And, that nuance is always lost. So there, there's only been one really well performed carnivore study. That was the Bellevue study back in 1928. And it was a, it was a partial metabolic ward study, and it was in Anderson Home Stinson. So both of those two arctic explorers that, um, actually lived with the Inuit and, and were very big proponents of a meat-based diet and the entire time of balances, they [00:51:00] were both in significant negative calcium balance.
And so they were eating muscle meat, some organs, and the associated fat. And there's been at least seven metabolic board studies in humans that have shown how much calcium you actually need on a carnivore to be in positive balance. And it's over 500 milligrams of calcium. So basically anyone who's consuming a just muscle meat plus egg carnivore diet is not going to be in calcium balance because it's not gonna give you over 500 milligrams of calcium.
So nobody ever hears that though. No one ever. Talks about the nuance of this carnivore diet. If you're just eating meat and eggs and the associated fat and even organs is not enough to keep you in positive calcium balance, it just simply doesn't contain enough calcium and the acid load causes bones to break down, causing more calcium to be lost out in the urine.
So again, if you're going on a ketogenic diet, you really need to be consuming at a minimum 600 milligrams of calcium. But some studies showed you need at least 1200 milligrams of calcium to remain in positive balance. And then, like I said, the vitamin C, the B one, folate, magnesium, manganese, and if you're not [00:52:00] eating liver copper's going to be deficient as well.
All of these nutrients are super important to health and you can get a lot of them through just eating some carbs. Avocados too are a decent source of copper as well. Mm-hmm. Yeah, it's kind of interesting. Just way things play out because like even if you wanted to go and say, alright, well I'm gonna supplement my way out of this problem.
It seems like the low carb carnivore group tends to be more skeptical of that approach versus say like the vegans. The vegans seem very open to supplementation. They're like, who cares? Gimme the sun. Well, I'm, I shouldn't say all of them, but I think that group has gotten a little more, I think, optimistic about trying that approach where it's like, okay, here's the flaws or the gaps in this way of eating that I wanna do.
I'm just gonna supplement to account for that. Whereas like the low carb carnivore group seems to be resistant to that in a lot of cases. Yeah, I think because they're very much into them, I need to follow the ancestral diet, and that didn't include supplements, so I don't need that. Sure. Mm-hmm. But they [00:53:00] don't, what they don't realize is that the meat that we used to eat is completely different from today's meat.
So basically a lot of the meat that we consumed was fresh and that actually would contain a lot of bicarbonate and, and the fluids of the animal in the meat. But the bicarbonate goes away after about six hours. So that helped balance out the acid load that you no longer get with grocery store meat.
Meat is typically hung for two to three weeks, which breaks down heme in, in the porphyrin ring and heme, and causes a tremendous release of free iron ions, which oxidizes the Omega six arachidonic acid and linoleic acid in meat. It also oxidizes the proteins and it also oxidizes besides the fats and the proteins, those are, those are the two main, but it's been shown that the Malindi aldehyde, which is aldehydes, formed from Omega six.
Can, can five x simply through what's called wet storage, basically in a refrigerator for two weeks. So even before we eat it, most meat nowadays is over the toxic threshold of Melony Hyde before you even grill it. And once you grill it, that, that three xs that as [00:54:00] well. So a lot of people are anti carnivores, antis seeded oils.
You're getting the same melon aldehyde that oxidizes in the, you know, with seed oils that will oxidize in meat when you consume it three weeks, refrigerated versus wild meat. So there's no free lunch here. Like you're not a wild carnivore and you're not like, you know, hunting and just instantly like eating the liver and the organs frosh.
You are now consuming grocery store meat and it's completely different if you look at it. Yeah. I guess if you, if you want an ancestral worldview in its entirety, you gotta head out to the back country and set up shop. Yeah. Right. And, and so like, I, I think that. Just because, you know, we consumed animals even back in the day, doesn't mean that supplementation wouldn't have helped those individuals.
Right. Or, or that they didn't have nutrient deficiencies. They probably did. Mm-hmm. And at the same token too, if you look at like, um, the studies on the nutrient composition of Whole Foods, 50 to 50 to a hundred [00:55:00] years ago compared to today, there's been significant decreases in almost every micronutrient anywhere.
On average, about 30%. But for copper, for example, in milk and in cheese. It's down upwards of 90%. And in a lot of the plant foods it's down too because CO2 levels, as that goes, have gone up. Nutrients have gone down. And when you grow food for high yield, it doesn't have the time to take up the nutrients. So we're no longer consuming foods as well that have the same nutrient status as we did back then.
So supplementation makes a ton of sense, especially if you're an athlete because you, it's not just what you lose through sweat, but like when you exercise, the muscle cells themselves push out things like magnesium and potassium that you end up losing in the urine, and you don't even really understand that.
So nutrient needs go up dramatically when you're an athlete. And so I think supplementation makes a ton of sense. And I just don't like the whole thing that if we didn't do it back in ancestral times, there's no benefit to that. There's proof or no studies to actually suggest that. In fact, the opposite would be shown in studies, supplementation, [00:56:00] studies.
Mm-hmm. Yeah. Yeah. And to some degree, like if you look at it through that lens where essentially the human body is. Put it, this layering on top of things. It's not like it's going back to square one and optimizing. So it's kind of similar to like, you get a, a city that grows really fast and there's ways they would probably construct it differently if they could start from the very beginning, but they can't 'cause they're building on top of something that was there already.
So that in and of itself drives away from optimization and more towards survival and yeah, when we're talking about performance and pro sports and things like that, then you know, optimization is gonna probably come with some non-natural things with respect to supplementation and everything else. Yeah, and this is interesting too, like you see a lot of MMA fighters, um, end up breaking their bones and I'm a huge proponent of offsetting the acid load of animal foods with bicarbonate.
There's, or citrate. There's been many human studies actually showing when you give alkaline supplements, it significantly improves bone mass, bone density, bone microarchitecture. So if those, [00:57:00] if those MMA fighters had actually taken, let's say bicarbonate or citrate and alkalinize themselves. Not only has that shown to significantly improve MMA performance, by the way, like consuming bicarbonate waters and recovery, but their bone mass would've been much stronger.
And who knows if they would've even broken their bones had they not done this. So, don't think supplementation doesn't have a place, especially for elite athletes. Yeah, that's an interesting one. 'cause I get, bicarb has gotten popular, well it, I shouldn't say just gotten popular, it's been around for a long time, but it's gotten like a new surge of popularity recently because they've formulated in ways that's a little more tolerant from the digestive.
Some of the early bicarb research on endurance athletes came along with, uh, nice little gut, uh, disruption type of stuff in a good portion of the participants. So it was kind of one of those things where like you kind of gotta try it and see if it works for you, whereas now I think they've got the, the formulations and the products dialed in a little bit better and it's a little more available to, to most athletes if they wanna play around with it.
Exactly. So like [00:58:00] the older studies gave really high doses, 21 to 28 grams, like an hour before performance. That's just like gonna destroy you. Okay, so the newer studies are kind of showing, if you take it multiple times a day, a lower dose is much more tolerable, especially around the time of eating.
Like animal protein, you're offsetting a lot of the acid load and then you don't need as high of doses. So if you are sort of drinking bicarbonate waters or taking bicarbonate supplements throughout the day, then you might only need half or a quarter of the dose. So you no longer need 30 grams of sodium bicarbonate before you might only need like seven to 10 prior to performance.
Are you noticing when people do those protocols that they're retaining more fluids and things like that? Just from the sodium load that comes with it? So I would say you can, there probably is some benefit to both the fact that you're getting some sodium and you're boosting blood volume potentially through that mechanism.
But they've actually done studies comparing salt to sodium bicarbonate. Okay. And the sodium bicarbonate has shown benefits [00:59:00] where the salt didn't, so there's oh interest. So there is something there to it, you know, it's called peak hitting. Peak alkalosis prior to performance has been shown to improve performance.
But you gotta, you have, typically the pH needs to go to like 7.45 to 7.5. And now because of the tremendous, you know, acidosis that happens during high intensity exercise, you're offsetting that. Mm-hmm. And also recovery is better too because we used to think it was the lactate that was causing the right, the muscle poorness, but it's actually the hydronium ions, which makes the body more acidic that comes with the lactate.
So, you know, even for recovery, these are being used now to improve recovery as well. Yeah. Interesting stuff. Well, James, I don't wanna keep it too long because I know you got stuff coming up today, but it's been awesome to chat and unpack some of this stuff. Before I let you go though, if you want to share anything else or let everyone know where they can find you, happy to throw anything in the show notes.
Yeah, just my website, Dr. James denic.com [01:00:00] is, you know, I have a newsletter there if you wanna sign up for it, but I appreciate the nuance that you bring Zach to the table, and that's why I wanted to have this conversation with you, because I think if you're not questioning, like I try to just, I, I try to question all, I have no preconceived notions.
I try not to be in a camp and I feel like you're the same way and we're never gonna learn if we don't learn the other side's points. Mm-hmm. And so I always try to learn the low carb points as well. And to me that just keeping an open mindset is important, but in that open mindset, it has led me to believe that, uh, a ketogenic diet just for overall health too, but particularly for exercise performance is not optimal.
Yeah. No, I think it's the way to go. I think if you, if you make your performance, then you tend to lean towards what's gonna work versus making compromises unnecessarily. So I appreciate you sharing that. Yep. Thanks for having me on. Yeah. Take care. Okay, you too.