Podcast #143 http://www.bengreenfieldfitness.com/2011/04/episode-143-can-

prolotherapy-make-your-injuries-vanish/

Introduction: In this podcast, can prolotherapy make your injuries vanish, eating

algae oil, increasing testosterone, frankenfoods, how to raise HDL,

recognizing if your nervous system is overtrained, making a home

gym, does the brand of fish oil matter, training for a marathon on a

low carb diet, does stevia and artificial sweeteners elevate insulin,

how to get off a weight loss plateau, compression gear, rotator cuff

exercises, is bottled water healthy and is Ironman training bad for

you?

Ben Greenfield: Hey, Ben Greenfield here. As you may have just heard, we do

have a jam-packed podcast today, and our special guest is Dr. David

Minkoff and David has been on the podcast a few times, the guy is

amazing; he’s a complementary and alternative medicine physician

down in Clearwater, Florida. He’s done almost 40 Ironman

triathlons. He’s been on the show before talking about the 3 main

causes of illness and poor performance and also did the show called

“The Peek into the Life of an Ironman Physician”. I’ll put a link to

both of those previous shows that he’s done in the show notes to

this episode, Episode # 143, and he’s always just a wealth of

interesting content, so you don’t want to miss his interview today

which is on something called Prolotherapy and as I mentioned last

week, over the next couple weeks, I am responding to more

questions during the Q & A sessions to kind of catch up to the many

questions that we have in the question database, so let’s go ahead

and jump right in to this week’s content.

Special Announcements: Well, you may have heard last week, if you listen to

the special announcements, that I am accepting designs now for the

new BenGreenfieldFitness t-shirt. And several people emailed me

this week and all I do is respond to that email and just give you a

big collection of different logos and graphics that you can use to

make your designs so if you want to be involved in the

BenGreenfieldFitness t-shirt design contest, all you need to do is

submit your design to Ben@BenGreenfieldFitness.com. If your

design wins, we’re going to do a special blog post and podcast

talking about how you put it together and why you designed your t-

shirt the way that you did. So a couple of other announcements:

still sending out free copies of KC Craichy’s book: “Super Health:

The Last Diet That You’ll Ever Need”. All you need to do to be

eligible to get that book is post a video telling me why that book

would help you over at Facebook.com/BGFitness , and if you have

no clue what that book is, listen to Episode #139 and 140. And then

finally, if you happen to have an extra dollar lying around, I’ve got a

couple things you can do with it. First of all, you can donate 1 dollar

to keep the BenGreenfieldFitness podcast going, and all you need to

do is go to BenGreenfieldFitness.com and there’s a button there

that you can push to donate 1 dollar to keep this podcast going. You

can also, if you have a dollar to spare, go check out the

BenGreenfieldFitness Inner Circle. It costs one dollar to get a 14-

day sneak peak at the tons of videos, seminars and forum Q & A’s

that my wife and I are running on teaching you how to re-invent

your life and put together a healthy life style for you and your

family, that’s the Ben Greenfield Fitness Inner Circle. I’ll put a link

to that $1 sneak peak in the show notes as well. Well let’s go ahead

and move on to this week’s listener Q and A.

Well remember, if you have a question for the podcast, you can use

the handy-dandy “Ask Ben Form” over at

BenGreenfieldFitness.com. You can call, toll free, to 877-209-9439;

you can ask your question via Twitter too, at BenGreenfield, or if

you happen to be one of the 8000 people going down to the

Wildflower Triathlon this weekend, I’ll be down there in the

athlete’s lounge, from 2-3 o’clock in the afternoon. Both days,

answering your questions. Friday and Saturday, so there you go.

Armi says: I had a question about algae derived DHA and its benefits. One of

your podcast guests talked about how fish oil is best, but what about

something like Udo’s choice DHA? Also, have you heard of

Astaxanthin?

Ben answers: Well, DHA is something that we’ve talked about on the show

before, it is one of the Omega 3 fatty acids which not only has anti-

inflammatory properties but is super rich in terms of its brain-

building capabilities and its ability to lower your risk of

degenerative diseases of the nervous system like multiple sclerosis

and it’s fantastic for your joints, for your brain, for your body, for

your immune system, ton of different things that DHA has going on

in it or for it and it is part of fish oil. However, you can also get a

DHA from algae that produce this DHA and you can get in like a pill

form. So the big problem though is basically the idea of the dosing

with DHA, so if you go out, you get one of these algae oils, the

problem is that, it typically comes in somewhere around like 200

milligrams of DHA in a capsule, and the issue is that if your

essential fatty acid levels, like most people’s are, are way off base

and your Omega 6 fatty acids are way up and your Omega 3 fatty

acids are too low, you’re typically looking at needing to take,

somewhere in the range of 1500 to 2000 milligrams of DHA EPA

blend, to get your essential fatty acids levels back up to where they

should be. And with 200 milligrams of DHA in most servings of

like either algae-based DHA or another source of DHA which is

called krill, it’s meaning that you got to take a lot of it and buy a lot

of it, so you’re typically looking at happen to spend almost a

hundred dollars a month on a DHA capsule in order to get enough

DHA. So it’s well absorbed; it is a sustainable source of DHA; it’s

non-toxic, this algae oil, but the problem is that it’s just very low in

DHA or I mean, the amount of DHA that you would actually need.

You asked a follow-up question about something called astaxanthin

and actually it’s something that Dr. Richard Cohen recently talked

about in the live seminar that we did called “The Shocking Truth

about Vitamin D and fish oil”. Astaxanthin is something that

actually compliments quite nicely of the addition of fish oil to the

diet; it’s a naturally-occurring red pigment, it’s actually found in the

tissue of wild salmon, a lot of crustaceans like lobster and shrimp;

krill is another source of it; and it is an anti-oxidant and a very rich

source of carotenoid which would be things like Vitamin A, Vitamin

C, Vitamin E, and astaxanthin kind of falls into that category. So it

gives some really good anti-oxidant property, it helps to neutralize a

lot of the free radicals that can take place when you’re exercising or

even when you’re just digesting food or living, and it is something

that tends to compliment very nicely the use of fish oil. The

interesting thing about astaxanthin is it also crosses the blood brain

barrier so if you’re taking something like a fish oil for you brain

health, astaxanthin kind of gives you a 1-2 combo with that as well.

Plus, the reason that it’s packaged and included with a lot of fish

oils, I will put a link to a fish oil astaxanthin kind of 1-2 combo in

the show notes for you, Episode #143 show notes, it’s the same one

that Dr. Cohen talked about in the live seminar that we did, in case

you missed that seminar. So that is the deal with the algae DHA

and the astaxanthin.

Graeme asks: What are your thoughts on ab wheels? The type where you have a

handle on the other side of a single wheel and you roll out to a plank

position and then roll back in. Is this good for ab recruitment or

just a waste of time?

Ben answers: Well, I can tell you one thing it’s good for - it’s good for wanting to

punch your friends in the face if they make you laugh the day after

you did this because this thing leaves your abs sore. It’s also a great

shoulder workout, and if you kind of roll your elbows up and keep

your elbows high as you do the exercise, it hits a lot of the lat and

swimming type of muscles as well. So, it goes by a couple of

different names; the ab wheel, the other one that I’ve heard most

frequently is a power wheel, and yeah, like Graeme says, you hold

on to it, you roll your body out, your entire body is supported

between the wheel and your knees, then you roll the wheel back in

and there’s quite a bit of abdominal recruitment that needs to take

place in order to roll that wheel in and out. And they actually did a

study on this and compared it with a hanging knee-up and a reverse

crunch which are also considered to be fairly difficult abdominal

exercises so they hooked up electromyographic patches to assess

the muscle activity on the upper and lower abs, on your bleaks, on

the rectus femoris, on the lats, on the lumbar pair spinal muscles

which are basically your lower back muscles and they compared

which of these using the ab wheel, using the hanging knee-up with

the straps, using the reverse crunch, elicited the greatest amount of

muscle activity in all of these muscles and there is a huge amount of

activity in the ab wheel compared to these other traditional

abdominal exercises and I can personally attest to that just based

off of the fact that my core’s in pretty good shape and I still get

fairly sore if I do like say, three sets of 20 repetitions with this ab

wheel. The issue is that the electromyographic study also showed

that there is a very large amount of hip flexor recruitment when

using the ab wheel, and for a lot of people, it’s not an issue but for

anybody that has low back pain, one of the primary issues of low

back pain aside from sacroiliac joint misalignment is very tight hip

flexors and if your hip flexors are super tight, and you’re doing an

exercise that involves a massive contraction of the hip flexors,

you’re significantly risking your propensity to get low back pain

during the abdominal exercise, so I highly recommend the ab wheel

if you’ve got good flexible hip flexors and you don’t get low back

pain frequently. If you do get low back pain frequently, I would

make sure that your hip flexors are stretched out first by doing lots

of like lunging type of stretch exercises and then eventually work

the ab wheel into your program. Alright!

Tony says: I read an interesting article about frankenfoods. How does

something like this fall into your morals and teaching?

Ben answers: I put a link to this franken foods article, and the title of the article

is “Franken Foods in Your Natural Food Store: Whole Foods or

Whole Hypocrisy” and the idea behind this article is that there are

organic grocery stores like whole foods selling tons of genetically-

modified foods in their stores and still advertising themselves as

being very natural food stores, you know, Whole Foods, Trader

Joe’s is another example, and in the article, there is a quote from

one of the guys who stands behind what’s called the “Millions

Against Monsanto: Truth in Labelling Campaign” and for those of

you who don’t know what Monsanto is, it’s one of the primary seed

producers in the US that uses genetically-modified foods or

genetically-modified seeds, and what this quote says from this

gentleman who directs that strategy behind the anti-Monsanto

campaign, is that it says “Over 90% of Americans want genetically-

modified foods labelled. Why? So that we can avoid buying these

foods. This is a major reason why millions of us are buying certified

organic products which preclude the use of genetically-modified

ingredients as well as toxic chemicals and animal drugs. Since the

politicians in Washington apparently prefer to listen to Monsanto

rather than their constituents, we need to put our efforts where we

currently have the most power in our local communities, especially

at the retail grocery store level where 15 million of us are regularly

buying certified organic and natural foods or so called, natural

foods. What most consumers don’t understand yet is that most of

the so called naturally- processed food and animal products which

make up 2/3 of the sales at whole foods market, we are still buying

GMO contaminated. Either they contain genetically-modified

ingredients like soy corn, canola cottonseed oil or sugars deep

sweetener or else the animals have been forced fed a steady diet of

GMO grains and drugs. We need to clean up our act and walk our

talk in the green and natural product sector, we need to tell natural

food giants like Whole Foods or Trader Joe’s that you can’t claim to

support GMO labelling and then proceed to sell billions of dollars of

unlabelled GMO food in your stores, green washed as natural”.

That quote basically sums up what I think about this entire franken

foods concept. I agree 100%, we should be told what we are eating

and if a company is going to genetically modify its ingredients, we,

as consumers, have the right to be able to find out about that. And

I’m not going to get any more political than that but I do have to say

that I do agree with this idea that you really do need to know what

you are eating, especially if you’re walking into a natural food store

and expecting that everything you grab is going to be healthy, when

in fact, it could be heavily genetically-modified.

Dawn asks: My husband was told today by his doctor that his HDL was too low,

and that he should exercise and take Niacin. Anyways, my question

is, would more strenuous exercise raise his HDL? And what do you

think of Niacin?

Ben answers: Well first of all, just we make sure that we’re on the same page, the

HDL or High Density Lipo proteins, they’re very good for you;

they’re made by your liver; they carry cholesterol and fats from your

tissues, from your organs, back to your liver where those tissues can

basically be, or those fats and lipids can be recycled or degraded

and multiple studies have shown that having these high levels of

HDL can lower your risk of getting clogged arteries or getting heart

disease. It’s basically a fat transport mechanism, and studies have

shown that moderate exercise will raise your HDL cholesterol

levels, where I say something like smoking would lower your HDL

levels. Another thing interesting that can raise your HDL levels is

moderate drinking. They had one study that shows that HDL levels

would go up significantly when you had about 1 to 2 drinks on a

daily basis, so one drink, remember being about 12 ounces of beer

or 4 ounces of wine, so basically about half as much as what most of

us actually considered to be a drink, but drinking alcohol can raise

HDL as well. The answer to your question is yes, moderate exercise

can raise HDL, and extensive exercise can actually technically lower

HDL especially if you’re eating a low fat, high sugar diet along with

a bunch of exercise so there’s kind of a caveat to that. Now

remember, of course, on this show we believe or I believe several

things. First of all, that cholesterol is not an issue; it’s not

dangerous by itself; having high cholesterol could reflect an

unhealthy condition or could be totally innocent. High blood

cholesterol, what they tell you is that it promotes atherosclerosis,

that it promotes coronary heart disease, but there have been many

studies that have shown that just how many people have high blood

cholesterol get heart disease as people that have low blood

cholesterol get heart disease. Your diet can influence cholesterol.

It’s not the only thing that can influence cholesterol because your

body produces about 3 to 4 times more cholesterol than you

actually eat, so lowering cholesterol doesn’t just come down to diet,

it does have a lot to do with your activity levels and the way that you

live, and there is zero evidence that animal fat and cholesterol or

too much animal fat and cholesterol would promote atherosclerosis

or heart attacks. There have been tons of studies that have shown

people who have a heart attack have eaten more fat of any kind than

any other people and that this high cholesterol or this degree of

atherosclerosis rather, is really not related necessarily to a high fat

diet, unless that high fat diet is paired with a lot of other unhealthy

dietary habits. So I could go on and on but remember, most

physicians are going to just try to go after cholesterol with a

shotgun, bring HDL way up or LDL real low and it could be even

healthier to just bring cholesterol as a whole up and just decrease

the amount of inflammatory sugar that are being consumed. Now

as far as this Niacin goes, Niacin really doesn’t have many horrible

side effects. There could be a little bit of flushing, basically what’s

called a Niacin flush that comes along with taking Niacin in high

doses like taking more than a thousand milligram and it’s annoying

but it’s not really harmful. What Niacin does is it’s a B-vitamin, it’s

used by your body to essentially turn carbohydrates into energy, it

supports a healthy nervous system, digestive system, good skin,

good hair, and it can raise HDL and as a matter of fact, it can raise

HDL by 15 up to over 30 %, so Niacin can bring up your HDL levels

and there’s not a lot side effects with it, so it’s something that I

wouldn’t worry about. The only issue is that I would make sure that

you’re purchasing Niacin from a certified good manufacturing

practices facility that is somewhat regulated, they’re never as

regulated as prescription medications but somewhat regulated so

that you know what you’re getting.

Danny asks: I have been training with weights and I recently lost a lot of muscle

weight, I’m not too happy about that. As a result, I’ve been reading

about “Overtraining” and this whole CNS or central nervous system

response is something that is unfamiliar with me. Do you have a

couple of minutes to discuss this on an upcoming podcast? How

does one know if their CNS is fully recovered and ready for more

weight training?

Ben answers: Well, this is a really good question because traditionally

overtraining really isn’t considered as big of an issue for the central

nervous system compared to what’s called the peripheral nervous

system. So, there’s kind of 2 different types of overtraining. We’ve

talked about overtraining before in the show, we haven’t talked

about the 2 different types of overtraining, so basically, the first

type would be an overtraining on what’s called your sympathetic

nervous system, and then there is the type of training that would be

considered a parasympathetic overtraining. So, usually what

happens is that if somebody’s going to be overtrained, endurance

athletes typically tend to experience this parasympathetic nervous

system overtraining and people who are like weight trainers,

football players, power athletes, they tend to experience more of

these sympathetic nervous system type of overtraining. So for like

an endurance athlete, what happens is that when you’re always

going out and exercising, getting a lot of volume in, you work your

sympathetic or kind of your fight or flight nervous system quite

heavily and when that happens in that system, it kind of burns out,

your parasympathetic nervous system begins to dominate and your

parasympathetic nervous system would be kind of like your rest and

digest part of your nervous system and so, what happens is an over-

trained endurance athlete or someone who’s overtrained because of

a high volume of kind of, low intensity exercise would get decreased

testosterone levels, decreased testosterone to cortisol ratios,

decreased resting what are called catecholamines, and we’ll discuss

those in a second, but those are really linked quite highly to the

central nervous system, and then increased levels of inflammatory

markers in the bloodstream, specifically stuff like creatine kinase,

and a lot of times they’ll be unable to produce as much lactic acid or

get to as high as the heart rate during exercise as well, although a

lot of times like post workout, there’s kind of an even more rapid

drop in the heart rate so the heart rate is just like always low cause

your parasympathetic rest and digest type of nervous system is

always predominating. And so with an aerobic or with kind of

power sprint athletes as well as with people who tend to just have a

lot of emotional stress, anxiety, whether it’d be like social stress, or

school stress or family stress, they tend to get a lot more of this

sympathetic type of overtraining which is kind of just the opposite

where the parasympathetic nervous system is kind of getting burnt

out and so the sympathetic nervous system is still operating okay

but what happens is that you don’t see the same type of decrease in

testosterone or increase in cortisol and you don’t see a ton of the

same effects that you get with parasympathetic nervous system

overtraining but what it comes down to is that either way you define

overtraining, most of the time, it’s focused on what would be

considered your autonomic nervous system, and not your central

nervous system which would be like your brain and your spinal

cord, but the idea behind the central nervous system is that because

your brain and your spinal cord are acted upon by things like

neurotransmitters and catecholamines, specifically Serotonin and

what’s called dopamine, what can happen is that if there’s an

imbalance in these neurotransmitters, so a big rise in serotonin or

big drop in dopamine levels, that would be considered an example

of central nervous system fatigue and there’s been some studies that

suggest that overtraining results in this big spike in serotonin and a

big drop in dopamine levels and that, along with some of the other

effects that I kind of just described on the almost called autonomic

nervous system or the peripheral nervous system, would be

responsible for kind of this total overtraining so typically it’s not

like central nervous system fatigue, or this big rise in serotonin or

drop in dopamine, is the only thing that happens when you’re

training too much. It’s typically like a cluster of symptoms between

your peripheral nervous system and your central nervous system.

But of course, the most important thing that comes down to is, what

can you do about it? How do you know when it’s okay to go back to

training? And really, the only really good treatment for

overtraining syndrome for like being full blown overtrain, a big

drop in testosterone, big increase in cortisol, unable to get your

heart rate, anywhere near where you used to get it, immediate rise

in blood lactate levels when you start to exercise, complete drop in

motivation to train, loss of sleep, and GI distressed, ton of the

things going on. You got to rest, and the longer you’ve been over-

trained, the more you typically have to rest. I knew a body builder

who literally was bed-ridden for a few months and then he still

didn’t workout or do much at all or very light activity for almost 2

years, that’s how long it took for his nervous system to completely

recover from full blown overtraining. The good news is that when

most of us are feeling kind of down in the dumps and not too

motivated to train or maybe our bodies aren’t doing what we want

them to when we go out and exercise, we’re technically not

overtrain, we don’t fall into the category of OTS or overtraining

syndrome. We’re usually simply overreached and a couple days of

rest or light activity combined with kind of rebuilding yourself

nutritionally is all that it takes. But full blown overtraining, can

require a lot of things, combination with rest, doing some

nutritional therapies, stepping up the fat in the diet, doing a lot of

stress reduction techniques, I mean, it’s kind of a discussion for

another day, what you can do to recover from overtraining, but

ultimately what it comes down to is that, this idea that a big rise in

serotonin, drop in dopamine and effect on the central nervous

system could cause overtraining, definitely has something to it, but

I don’t think that that’s the only reason that someone can become

over-trained. I think that, combined with a cluster of other

problems, would result to the overtraining syndrome, so hopefully I

didn’t create more questions and I answered with my response to

that. Okay!

Cathy says: I am an active 46-year old woman who is recently fit, but working to

improve fitness, strength and my running. I wanted to focus more

on strength training so I invested in dumbbells to workout at home.

However, I’m a little worried or it’s just I’ve decided to invest in

some dumbbells, however I’m a little worried that I might over

underbuy, not to mention some practical space considerations. I’ve

narrowed my choices down to either a 10 to 35-pound set of rubber

hex dumbbells with a rack or a set of adjustable dumbbells with 5 to

75 pounds. The difference in price between these two options is not

as big of a deal as getting something that I can get maximal use of

over the years. What would you recommend? Thanks.

Ben asnwers: I actually don’t really see a huge need, if you’ve got a variety of

things to work out with, of having more than about three different

dumbbell selections. I personally, in my home gym, I have a set of

40-pound dumbbells and a set of 10-pound dumbbells, and that’s it.

But I’ve got other stuff. I’ve got a yoga mat; I’ve got a pull-up bar;

I’ve got a gym stick which is basically like a couple of elastic bands

that are adjustable that attach to this kind of aluminum stick that

you can do a bunch of different exercises with; I’ve got some elastic

tubes and elastic bands, both the short kind and the long kind and

what else do I have? I’ve got a stability ball and what’s called the

bosu ball. I’ve probably got about, right around 400, maybe 500

dollars invested in our home gym, that’s about it. Because frankly

you tend not to use that entire range of dumbbells when you’re

lifting weights, if you have access to a bunch of other body weight

exercises, elastic tubing exercises, stability ball exercises and any

other little toys that you may happen to pick up along the way. So,

rather than getting into a huge range of dumbbells, and limiting

yourself to just doing free weight exercises, I would get fewer

dumbbells and for females I recommend that you get something

like a 10-pound set, a 15-pound set or maybe a 25-pound set, and

then grab yourself a pull-up bar, or dip bar, or get yourself a

stability ball, maybe a bosu ball for some balanced work, get some

elastic tubing or gym stick or both and that would get you basically

equipped with the ability to do lots of different exercises rather than

just free weight exercises which are good but it’s kind of like, if

you’re just going to body build then free weight would be good but if

you’re going to total functional fitness, don’t limit yourself with just

free weight, cause this means different varieties of things you can

are going to help you as may as different movements as possible,

keep your workouts as fresh and as varied as possible and that’s the

direction I would take rather than just focusing on free weights. So

for females, most of the females, I’d recommend again, somewhere

in the range like 10-pound dumbbells, 15-pound dumbbells, 25-

pound dumbbells, that will allow you to do a ton of different things.

Kim asks: If I can only afford cheap fish oil, should I take that or just not take

fish oil?

Ben answers: Okay, good question. So I talked a little bit about regular

supplements versus expensive supplements or what type of fillers is

going to cheap supplements and in the case of fish oil, there’s some

issues, so when you extract EPA and DHA, which are those two

Omega 3 fatty acids that you get from fish oil, it involves or can

typically involve, especially when you’re getting the less expensive

forms of fish oil, the use of hexing, which is a petrochemical solvent

that they use to extract and purify the oil and that can make the

EPA and the DHA very prone to oxidizing, and that’s another

reason that they’ll throw anti-oxidants in there along with it like

that astaxanthin I mentioned earlier but a lot of lower quality fish

oils, when they use an anti-oxidant, they use something called

alpha-tocopheral which is really not that great of an anti-oxidant.

Better anti-oxidants you should be looking for would be like that

astaxanthin I mentioned, another good one would be like a

rosemary extract, the gamma tocopherol is a good one but the type

of antioxidant used in the fish oil and the amount of exposure to

hexing that occurs in the formation of fish oil is something that is

going to be affected by the actual price of the fish oil, and you could

be getting free radicals, ransom fish oil, sub par oils, when your

consuming a fish oil that would be considered just like a cheaper

off-the-shelf version and although fish oil manufacturers, a lot of

times they’ll say that their products are chemical free, it’s

unfortunately not always the case. They did that study that tested

like 15% of consumer fish oils and found that all of them we’re

contaminated with PCBs. So you want to look for fish oil that’s

been certified free of toxins by independent testers and then the

other thing comes down to the actual type of fats that you’re going

to get in that fish oil. So fish oil supplements that have the natural

triglyceride form of fish oil are going to be way more advantageous

than the ethyl ester form in terms of the amount of absorption and

utilization in your body, but the ethyl ester form, because it’s a lot

cheaper to make, is what’s used in most of the less expensive fish

oils and there really hasn’t even been done a bunch of research on

the potential toxicity of the ethyl ester form of the fish oils. So,

what this comes down to is that, to answer your question, I would

not take a fish oil unless you’re taking a good brand. Just don’t go

out and buy any fish oil off the shelf because what you’re getting

may do you more harm than good.

Lisa asks: Hi, Ben. I heard that a weight plateau is due to apoptosis of

omentum body fat. I can’t find any references to learn more about

this. Do you think cell apoptosis explains why a weight loss

stagnates for a short while?

Ben answers: Well apoptosis, for those of you who aren’t familiar with that term,

is basically cell death. And the omentum that is mentioned here is,

think of it like a drape, you split it into a couple of parts or greater

and the lesser omentum, and it’s a layer of fat tissue that drapes off

your stomach and hangs down underneath the muscles and kind of

partially attaches to the colon and it serves a bunch of different

functions. It supports your organs, it stores visceral fat which is

supplied from your small intestines, it secretes a bunch of immuno-

response factors to protect you from infection, it can bind to

cortisol, that stress release hormone, it has stem cells in it so it’s got

some regeneration properties, it supplies fat to the liver via the

portal vein, from the omentum to the liver for energy, and when

surgeons do stomach surgeries, they’ll even use parts of the

omentum to wrap around injuries or incisions. So the omentum is

basically a storage depot, when you have excess fat. It has the

potential to have a ton of fat globules that swell up to maximum

capacity and give you a fat belly just because it is that abdominal fat

depot and of course, because the liver has direct access to your

omentum via the portal vein. That’s nice when you need energy,

when you need fat-based energy to burn, but if you’ve got a bunch

of fat stores coming in and a bunch of fat in your omentum, your

essentially setting yourself up to have some serious liver issues in

terms of fat and also, to have a great, big belly. Now the omentum

also has a lot of cortisol receptors in it and, remember, that cortisol

is secreted from our adrenal glands. It’s decent, kind of wakes you

up in the morning and balances your sleep-wake cycle but when you

are chronically stressed or training too much or basically, you’re not

taking care of your body, your cortisol levels get elevated and the

omentum helps to clear the cortisol by binding to it and uptaking

the cortisol and what happens is that it can increase the omentum’s

ability to store fat when we get all this cortisol uptake. So we’ve got

stress, we’ve got increased fat intake and we got increased belly size

and the omentum is basically part of that process. The omentum

can also pull a lot of the insulin from the bloodstream, so it can

impair some of the ability of your body to take a glucose and

nutrients stored just because the omentum that has a lot of fat in it

will have greater insulin requirements and of course, you also just

get the idea that your organs are squished up against the omentum

when it becomes full of these fatty globules and the omentum can

secrete a lot of inflammatory chemicals through the abdomen and

directly into the liver, again via the portal veins so it can be

responsible for part of this systemic inflammation that occurs as

well. So it’s got some good services, the omentum does in

moderation, in terms of delivering healthy fat energy to your body,

but it can also, in over fat individual, cause belly fat and a lot of

other issues. Now you asked if apoptosis or cell death of omentum

belly fat could cause a plateau in weight loss and the only link that I

could see between this is because your omentum can serve as a

portal from your omentum and your storage belly fat to your liver

for your liver to convert the fat into usable energy. If for some

reason there was some type of apoptosis or cell death or

malfunction of the omentum, it could inhibit its ability to mobilize

belly fat stores and lie to lose belly fat and if belly fat is the main

weight on your body, it could potentially cause a weight loss

plateau. However, I haven’t seen any research that looks into a link

between cell death and the omentum inhibiting delivery of belly fat

stores to the liver and thus, causing a weight loss plateau. But if it

were going to cause something like this, that’s basically how it

would work because your liver would not be able to get the fats that

it needs to burn via the portal vein and thus, you would have a

much harder time burning off belly fat or specifically, the

omentum-based belly fat, that causes the protrusion of the

abdomen. So, interesting thought, interesting question.

Ginette asks: Presently I’m reading Art De Vany’s New Evolution Diet that you

recommended. It’s a very interesting read. I teach a unit on

evolution and nutrition and my degree’s in biochemistry so the

book is a nice fit. But of the many interesting things that I came

across was the mention of artificial sweeteners elevating insulin

levels. Is this true? And will stevia have the same effect?

Ben answers: Well, the talk kind of goes back and forth about whether artificial

sweeteners could induce basically, insulin secretion by the

pancreas. And so, if we look at the different artificial sweeteners, if

we take aspartame, they’ve done some studies on that and

aspartame has really not been shown to have much of an effect at all

on insulin levels in the studies that have been done on it and there’s

really not much going on at all when it comes to aspartame. As far

as saccharine or sweet ‘n low, there have been studies where they

had people swish around different taste solutions and then spit

them out without swallowing and the solutions that had sucrose

and saccharine did cause an insulin release even without them

being swallowed. So by just tasting that artificial sweetener, you

could get an insulin release. There’ve been other studies that didn’t

happen with the swishing and the spitting and so, it kind of goes

back and forth. Acesulfame potassium, how does that affect

insulin? It does appear to affect insulin levels. They’ve isolated

pancreatic cells that produce insulin and found that artificial

sweeteners like acesulfame potassium could cause an insulin

response if there was some glucose present. It would basically

augment the response or increase the response if glucose was

present. So, if you’re having artificial sweeteners like a diet coke

with a meal, you could get a greater insulin release than if you

didn’t drink the diet coke. There was another study that found that

in a rat pancreas cells, that has acesulfame potassium also, could

cause a little bit of insulin secretion and direct transfusions of

acesulfame potassium also cause insulin secretion in rats and that

was basically a study where the more acesulfame potassium that

gave them the greater insulin levels would rise so there was kind of

a dose response effect to that. So insulin could be affected by

acesulfame potassium and then if we look at sucralose, sucralose in

most studies, hasn’t really done much in terms of insulin. There

was one study that showed that it may stimulate the release of

what’s called the “incretin hormones” and those could increase the

secretion of insulin. That’s basically kind of like, the taste receptor

hypothesis that because artificial sweeteners taste sweet; they might

actually cause an increase in the production of these gastric

hormones which could stimulate the pancreas to produce insulin.

So, it’s not like there’s hard and fast research on this. There’s some

suggestive evidence that some artificial sweeteners, specifically like

acesulfame potassium and sucralose, could affect insulin levels and

then as far as stevia goes, yeah, stevia could definitely have a mild

insulin effect and specifically, that’s why it’s been used in some

cultures to lower blood sugar and people with diabetes, because

what it can do is actually cause a little bit of a release of insulin

which causes your body to store blood glucose as energy and this

kind of comes full circle to the whole issue with this question is that

you need to look more at whether or not something has the

propensity to cause deleterious health effects than whether it causes

a rise in insulin. Because a lot of times, it’s not the high levels of

circulating insulin that are the issue, it’s the high levels of

circulating glucose that are the issue, in terms of causing nerve

damage and cell vessel damage. Now granted, if you’re constantly

consuming something that’s ampping up the insulin levels, you’re

eventually going to become insulin insensitive and that is an issue

because then, you’ll always have high levels of glucose, no matter

what type of sugar you eat because the insulin won’t be able to take

the glucose and put it where it belongs. But artificial sweeteners,

you know, elevating insulin isn’t necessarily my reason that I would

avoid artificial sweeteners. There’s a host of other potentially

neurotoxic effects of artificial sweeteners, it affects some of the

neural system, and the fact that they’re simply chemicals, that’s the

reason that I personally don’t ingest them. I think the insulin effect

isn’t really much of an issue, and as far as stevia goes, yeah, there is

a little bit of insulin release with that as well, but it’s an insulin

release that has a blood sugar-lowering effect and it’s a very mild

and sudden release that it’s not going to be something that would

cause insulin, the insensitivity, unless I suppose, if you’re

consuming lots and lots of stevia on a frequent daily basis, it could

be an issue, but ultimately, not something that I would worry about

too much in terms of insulin insensitivity. So, good question and

what this comes down to, in my opinion is, if you’re going to

sweeten something and you want to use a non-sugar-based

sweetener, then use stevia and use it in moderation and stay away

from artificial sweeteners.

Andre asks: Hi Ben! What do you think about compression gear? Does it really

work?

Ben answers: I personally have been using compression gear recently. I’ve been

using something put up by a company called the 110% and it gives

you this tight, compressive effect on your calves, those got calf

sleeves. They make another one that’s a little better like full-body

tights, they’ve got some that are shorts, they’ve got an upper body.

Thing I like about this is they’ve got ice pockets in them too, so you

can literally put these special ice sleeves that come with the

compression gear into the compression gear as you’re wearing it

and if you’re wearing it for recovery, then you get both compression

and ice, which can reduce inflammation and speed up recovery.

And many studies have shown that compression gear actually works

to enhance recovery and decrease soreness so, very good for that.

As far as increasing performance, there hasn’t been a ton of data on

whether or not anything can happen with compression socks.

There was a study done, back in 2007, where they measured max

oxygen uptake, heart rate, blood lactate, ventilation, you know, with

compression socks versus without. Didn’t find any effects. In

another study in 2009, they tried a bunch of stuff: compression

socks, compression tights, full-body compression gear - didn’t find

any effect on performance but some people swear by them, basically

saying that long-term, like used over the course of something like

an Ironman triathlon, they can decrease the amount of muscle

jostling that occurs and thus, decrease the amount of muscle

damage and improve time to recovery. So for that, they might be

good and definitely good, in terms of improving recovery.

Performance, jury’s still out on that, but I personally have started

using compression socks when I race long distance triathlons and I

use compression gear very frequently for recovery. You’ll find me a

lot of times sleeping in compression tights or wearing compression

calf sleeves that are in the house and a lot of times, directly after

workout, those also have ice in them and what that does, it puts

pressure on the blood vessels; it constricts the blood vessels; forces

the blood to flow up to your heart and basically prevents blood and

fluid from pooling in your lower extremities. So, that’s how it

would decrease soreness, increase the movement of the metabolic

by-products of hard exercise out of your muscles and back up to

your heart, and I’m a fan for recovery, if it’s something that you can

include, it will definitely help. As far as performance, you just got to

use yourself as a case study of one, and see if it works for you.

Okay!

Zack says: I injured my shoulder doing dumbbell swings improperly. It’s

healing, but it’s a long, slow process. My question is what are some

ways that can speed healing and still get a good effect of upper body

workout without putting too much strain on the shoulder? It seems

like every good upper body exercise all stress the rotator cuff to 1

degree or another.

Ben answers: Well, the idea is that, the reason all of these exercises you

mentioned are stressing the rotator cuff is because they all include a

component where you’re holding your arm out and away from your

body. Anytime your arm is elevated away from your body or

specifically, anytime the weight that you’re holding is far away from

the shoulder, you’re going to increase torque on your shoulder, just

like if you’re holding a box and you hold it close to your body, you’re

going to decrease torque on the low back, so as you hold the box out

away from your body and not hug it in your body, you’re going to

increase torque on the low back. So, all muscles kind of work on

this concept of torque, and it’s the reason that a dumbbell held at

your side is a lot easier to hold than a dumbbell held at arms length.

You increase what’s called the leverage arm or moment arm of that

weight that you’re holding and it increases torque in the joint that’s

supporting that weight. So based on that concept, the trick is to

choose exercises that work your upper body, that do not involve

holding a weight far away from the body, which basically or more

specifically, holding a weight far away from the shoulder. There’s

certainly exercises that you can do that are decent upper body

exercises that aren’t going to put the same type of stress on the

rotator cuff. That would include something like a narrow grip

pulldown. So when you’re doing a pulldown, a cable apparatus

rather than holding a wide grip which puts the weight farther away

from your shoulders, you move that center of rotation closer to the

axis of your shoulders and do a narrow grip pulldown. Shoulder

shrugs could be another example; you’re holding the dumbbells

close to your body, shrugging your shoulders up and down; not

putting a huge torque on the shoulder muscles, that because again,

the weight is held in tightly to the body when you’re doing a

shoulder shrug. Bicep curls, where most of the weight occurs

around the elbow joint as long as the upper arm is held stationary,

those would be okay. Cable bicep curls or dumbbell bicep curls,

same goes for tricep pushdowns. Those, again, are more of a

rotation around the elbow joint; most of the torque is on the elbow

joint, not on the shoulder joint. A partial motion flies using

something like a fly machine that you sit down in; you can do

partial motion of a fly machine basically, you know, directly in front

of your body and not go through a full range of motion and those

can be great for working the chest without putting all the stress on

the rotator cuff, keeping those distress on the pecks. If you’re doing

lower body work, I mentioned this in the previous podcast episode,

but doing something like instead of a barbell squat or a squat where

you’re holding the weight out away from the body, you do a goblet

squat where you take a dumbbell and you just clutch it in towards

the chest and you do a squat with a dumbbell or a medicine ball

clutched into your chest and of course, you can do high intensity

interval training, cardio-interval training that doesn’t involve a lot

of swinging of the arms like bicycle. You can definitely do lower

body work, you can do things like lunges, you can even use

machines like leg extensions and leg curls and there will be some

crossover effect up into the upper body and so yeah, there’s a lot

that you could do for your rotator cuff, just make sure that you

aren’t holding a weight out away from your body. As far as

speeding healing of the rotator cuff, listen in to the interview that’s

coming up here pretty soon with David Minkoff, that’d be one

perfect way to do it. Alright!

Dale asks: In part 2 of the interview with KC Craichy…

Ben: And that’s come up a couple of times. I’ll put a link to that in the

show notes; I’ll put it with everything that I talked about. If you’re

listening in, you want follow-up on some I talked about, just go to

Episode #143 at BenGreenfieldFitness.com.

Dale: Plastic bottles leaks chemicals into the water in the bottle. My

bottle says it’s ‘BPA Free’. Do I need to throw it out?

Ben: Well, the idea is that yeah, plastic bottles do contain harmful

chemicals, those can leak out the contents and they can cause some

serious health issues. And there are numbers given to each type of

plastic that’s used in soft drink bottles and some of these plastics

are less likely to leach compounds that basically mimic the hormone

estrogen, so they can increase your risk of cancer and cause some

estrogenic effects in your body. Too much estrogen circulating

around in your body, it’s not a good thing. So, plastics 1, 2 and 4, if

you look at a bottle and then they all have the numbers on there, all

bottles have the numbers on there, it’s usually in the bottom.

Plastic 1, 2 and 4 are considered relatively safe. They’re high

density, low density forms of polyethylene and for example, there’s

the rule that go along with each one like a lot of soft drinks and

water, they’re sold in number 1 plastic bottles. Lower levels of

estrogen from those, generally recognized as safe, I still don’t

personally use them. But those of you consider like, single-use

bottles. So what research has found is that if you use them more

than once, they release DHEA which is a known carcinogen. I play

it safe and I just try not to use them, at all. Number 2 plastic, that’s

used in a lot of different like milk and yogurt and juice containers,

it’s recyclable, they say you can reuse it. It’s called a high density

polyethylene. And then number 4 is like a low density polyethylene

and it’s used also in a lot of plastic water bottles, it’s considered

recyclable as well. The type of plastics that are considered unsafe

would be number 3, number 6 and number 7. And number 6

would be basically, Styrofoam. Definitely, don’t use Styrofoam.

You can get away with it. Yes, that means that your take out from

the restaurant is not something that you should be eating out of or

heating with food in it. Keep the food in there for a shorter time as

possible. Now, what KC recommends in his book are several

different types of water bottles or bottled water that would be

considered safe, and he recommends in his book Mountain Valley

Spring Water, which is made from a glass bottle and it doesn’t

include this plastic that’s considered unsafe. VOSS or VOSS

Artesian Water also comes in a glass bottle, and it’s sold in a

number 1 clear plastic bottle as well. That would be another one

that would minimize the chemicals leaching out from the plastic.

Penta Water is another one. Penta Water, being something that’s

highly purified, available in the number 1 plastic bottles and

ultimately, what it comes down to is if you look for that number and

you see number 1, that’s good, number 2 is better, number 4, not

quite as good. Ultimately, I just try not to use plastic at all when I

can afford it. I drink out of glasses from the water filter in my own

home or take my water bottles where I go. If water bottle says “BPA

Free” though, that’s really good. You do want to look for the BPA-

free bottles. So hopefully, this helps to give you a little bit of

reaction in terms of checking for your plastic and what type of

plastic could be considered more dangerous. Okay! These last 2

questions are very related so we’re going to answer them in kind of

a one-tell swoop.

Josh says: I recently got a ton of tests done from the Naturopathic doctor as I

was constantly feeling lethargic, having sleep problems as well as

having a noticeable decline in my training performance. Everything

came out great except for my testosterone levels, which is the main

reason I got the testing done. I had a hunch they were low. I also

had an excessive amount of enzymes being produced and I’m only

22 years old and currently training for Ironman or for Half-

Ironman, putting in around 20 hours a week. I’m pretty sure I hit a

phase of overreaching or overtraining so I took a few days off due to

the symptoms I described earlier. My doctor prescribed me to try

out coconut oil and flax seed oil for a few months to see if that

would help increase my testosterone and decrease inflammation. I

also bought some tribulus to help as well. Is there anything else

that you would try, if you were in my shoes? P.S. I know you’re an

advocate of high intensity training but I have some extra time at the

moment so long sessions work fine for me and I love lengthy

sessions outside, not really willing to give that up.

Ben answers: Okay! So, let’s follow that up with this question from Jerry.

Jerry asks: Hey Ben, this is Jerry in Missouri. I was getting caught up on my

Ben Greenfield podcast addiction and came across the interview

with Art De Vany and you’ve mentioned something in that interview

that sort of struck me and I wanted to, maybe you could help me

understand a little bit better about what the point was and maybe

clarify something for me. You’ve mentioned at the end of the

interview that you are a tri-athlete and I am a tri-athlete and that

you realize that your training and racing was actually taking months

or even years off of your life and it sort of struck me, I’m a tri-

athlete myself and it caught my attention when you said that. I’ve

always realized that training and endurance training and really

anything that puts the body through hard training, had a catabolic

effect on the body, but I’ve always considered that I can manage it

through proper sequencing of training, maybe help balance

hormonal disruptions and along with supplementation and that

everything would work out okay and that my body would recover

and so forth. When you made that comment in the interview with

Art, it really got my attention because I thought well, if Ben is

acknowledging that he’s taking months or even years off of his life,

then I certainly, I’m no better than Ben so it sort of struck me. I

wanted your comments, your clarification and maybe your thoughts

to expand upon that process. Are we tri-athletes actually destroying

our bodies? Are we really taking years off of our life? If that’s the

case, then it makes me wonder if I need to restructure my priorities

but anyway, I’d appreciate your thoughts and comments and,

thanks Ben.

Ben answers: Well, the reason I chose to answer these questions is kind of, one

answer is because my main recommendation that Josh would be to

significantly cut his hours down, to about 8-10 hours a week, from

20. And that is for several reasons, including some of these issues

that Jerry brought up about this chronic high level training because

there’s a few things that happen when you’re training with a type of

training that these Ironman athletes or Half Ironman athletes do

and I just want to go through some issues with you that you may

want to think about. So first of all, when you’re always training,

you’re always depleting your body’s glycogen or storage

carbohydrate levels and your body, to a certain extent, no matter

how much you’re eating, it’s going to incur to a certain extent, your

body has to cannibalize muscle tissue in order to help make blood

sugar. It’s a process called gluconeogenesis and whereas

gluconeogenesis, in a resting or lightly active individual, it’s not that

big of a deal. Once you start tearing down muscle, what happens is

you get a big release of the adrenal hormone cortisol, and this

chronic cortisol release can suppress your immune function, so it

opens up the door for you to have lots of infections, lots of sickness

and potentially more serious issues like chronic, degenerate

diseases or asthma, cancer, heart disease, and this cortisol release

also, it limits the ability of your bones to re-uptake calcium so, you

get low bone density along with that. That’s why a lot of female

athletes who train a lot have this issue with low bone density. So,

the other thing that happens that increases cortisol, it’s kind of this

1-2 combo with people who are training a lot is that carbohydrates,

or just meals that are high in calories in general, can also cause this

bump up in cortisol suppression of the immune system and some of

these other issues that I just discussed. So, we also can look at the

burning of fats. Beta-oxidation of fats is completely healthy, it’s

how your body metabolizes fats. But beta-oxidation of fats also

produces free radicals and the amount of oxidation of fats that has

to occur, during the amount of training that takes place for

Ironman, creates a ton of oxidative or free radical damage,

sometimes 10-20 times of what you would normally get if you were

just, say, oxidizing fat at rest. So, you get all these free radicals

circulating around, damaging DNA, damaging protein, damaging

cell membranes and participating in this gradual destruction of a lot

of your cells in your body’s tissues and so, this again, can be a huge

contributing factor to a lot of diseases that could cut years off your

life like cancer or heart disease or aging and yes, your body does

have anti-oxidants and you can take anti-oxidants but you can only

control this oxidative damage so much. One big correlative factor

with your longevity is your amount of lean mass or your lean

muscle. So, what happens when your organs fail and you die? As

your organs basically lose their functional capacity and they lose

what’s called their organ reserve, and their lean tissue. And there’s

a direct correlation between your drop in organ reserve and your

drop in skeletal muscle mass. So, if you look at most endurance

athletes or Ironman athletes, they’re pretty dang skinny. They have

a lot less muscle mass just because of this gluconeogenesis I

mentioned earlier, and even though they’re exercising and many of

them may appear to be fit, more often than not, you get a lot of very

skinny, kind of atrophied, endurance athletes and basically, the

amount of muscle you go into the latter years of your life with is

what you’re stuck with. So if you’ve cannibalized a lot of that from

long training, and large amounts of gluconeogenesis, you’re really

limiting your organ reserve. The benefits of low amounts of

physical activity, like really life physical activity, they’re great. So if

we look at like, somebody walking, somebody farming, they’re going

to be developing all these blood vessels to burn fatty acids, to fuel

muscles into developing lots of the enzymes responsible for fat

burning so we’re not getting a lot of like plaque formation. They’re

improving their cardiac muscle efficiency, improving their cardiac

capacity, basically giving the body a lot of benefits and so we hear

about that in the endurance world and we think “Well, I’m doing

that too”. It’s like I’m going out and I’m farming or I’m hunting for

3 or 4 hours a day during my Ironman training. Well, the problem

is, you’re in nowhere near what farming and walking is; you’re

putting your body under stress. When you’re out on a 3-hour bike

ride, you’re easily exceeding or doubling up the amount of activity

from what would really be considered low-level training, and you’re

doing that over and over and over again. So, you’re decreasing your

muscle mass, you’re decreasing your immune system, you’re

decreasing your testosterone, you’re increasing your cortisol, you’re

ampping up the insulin levels, you’re just getting a ton of free

radical formation and don’t fool yourself into thinking that you’re

doing the same thing that our farmers or say like our evolutionary

Palaeolithic ancestors did. Very few of them even go out and do like

an endurance hunt. Those things are very stressful, that’s why not a

lot have tried to really do hunts, where they hunt down the animal.

A lot of it is very easy tracking and then taking the animal down as

quickly as possible. So, you’d only look at it from like an

evolutionary perspective. Now, I want you to combine this with

Episode #133, where I talked about all of the acute effects, what

happens to the body for about 1-3 weeks after you run a marathon

or do an Ironman triathlon and think about what happens if you do

20 or 30 of those in your life. I’m not going to repeat what I said in

Episode #133 but I gave you a huge laundry list of what happens to

you when or right after you do a marathon or an Ironman. Jury’s

out on how well you actually recover from that type of activity. So

what this comes down to is number 1, there are things that you can

do to limit the damage. Yes, you can take a full spectrum anti-

oxidant. Yes, you can get a ton of your dietary intake from things

that aren’t going to increase the cortisol and the insulin quite as

much like Omega 3 fatty acid-rich foods, just the high fat, high lean

protein fat intake in general. You can monitor your blood levels

and monitor your hormone levels and do things like the bioletic

testing on a yearly or, even if you can afford that every couple of

years, go out and get things like your cortisol and testosterone levels

and your ferritin levels tested and check out what your blood

glucose and your insulin is at and maybe go out and look into things

like how saturated your blood is with oxygen, your hematocrit

levels. Look into as many things as you can, you know, doing

something like the complete athlete profile through something like

bioletics; I’m not saying as being commercial for them, but you

want to track. And then, then other thing that you do want to think

about is how much you’re going to train and race. I personally, if I

really could, I could probably find the time to train about 4 hours a

day. I cut myself short, even on the weekends, of doing no more

than 2 hours, right now. Now, if I qualify for the Ironman World

Championships for Hawaii in October, that will increase to a

maximum of 4 hours on a weekend of training and I will max out

the most hours that I’ll do in a week would be about 17, 20, 25, 30,

35 hours, wouldn’t even approach it. And I still think that I’m

probably doing a little bit of damage to my body, even going out and

doing my 10 to 15-hour training week, versus doing an easier, 6 to

8-hour training week which is some high intensity intervals and

stay active and eat healthy. So, I guess what this comes down to,

and I kind of just say this in a way of the fact that the physician that

we’re about to interview has done 37 Ironman triathlons, I guess

what this comes down to is, if that’s what you’ve chosen to do with

your life, and you don’t mind the fact that there may be some

increased oxidative damage or a decrease in your organ reserves

and some other issues that are going on, that’s fine. I don’t think

that we have this moral prerequisite to try and live as long as

possible. However, if that is your goal, you’re not serving it by

doing an Ironman triathlon, and don’t fool yourself into thinking

that you’re extending your life through your participation in

endurance sports because that is probably not the fact; the fact is

probably quite the opposite. Okay, I did not mean to depress you,

remember, I’m a tri-athlete; I love to train, I love to race, but I will

be the first to admit that it is not the healthiest sport that I could be

participating in and I am probably taking a couple years off my life

by doing it. But again, I don’t believe that your goal in life should

be to live as long as possible; I think that’s grasping in straws.

Alright, let’s go ahead and wrap this up and move on to the

interview with Dr. David Minkoff. I’m sure I generated a lot of

questions and you can ask them over on the show notes for this

podcast, Podcast #143.

Ben: Hey folks, this is Ben Greenfield. I’m here with Dr. David Minkoff

who you may have heard of before if you’re a long-time listener to

BenGreenfieldFitness.com. He’s one of the celebrity physicians that

joins us, he himself having finished 39 Ironman triathlons and he

runs a very cutting-edge facility down in Clear Water, Florida and

that’s called the LifeWorks Wellness Center and he also owns Body

Health, which is basically a really helpful website as well and he’s

one of the guys that developed the amino acids that I take on a daily

basis, the Master Amino Pattern and today, he’s here to talk to us

about Prolotherapy which I actually get a lot of questions about and

because I know that Dr. Minkoff actually has a lot of experience

with this himself, I figured that he’d be the perfect person to ask so

Dr. Minkoff, first of all, thank you for giving your time and coming

on to the show.

David: It’s great to talk to you again Ben.

Ben: Well, tell us about Prolotherapy. What is Prolotherapy?

David: Well, the term was coined by a physician in Ohio or Illinois named

Hemwall and he was looking for a way to help people who had

chronic body pain, especially joint pain and he coined this word

prolo, which is short for the word “proliferate” which means to

make something grow or expand or increase in number and so, he

coined its term prolotherapy which the idea was, you could get soft

tissue or connective tissue, it’s the stuff that holds us together, the

ligaments and tendons in the body that hold the structure together,

that you could get them to grow and heal when they weren’t healing

before and the typical thing that happens to an athlete is either

from overuse or injury or malnutrition. They get... what occurs in

their ligaments and tendons is that they stretch out or they get

partially torn and those are the structures that are supposed to hold

joints together and keep them in a very specific range of motion. So

let’s sample a few, at a knee joint, and you stretch the lateral

ligaments so that the knee joint now isn’t, you know, the hinge on

the joint isn’t holding right and on the lateral side, it’s weak and so

the joint is now starting to move a little bit out of the range that it’s

supposed to. You will get a wear and tear on the cartilage which is

abnormal. You may or may not get pain but you will get wearing

down of the joint in an abnormal pattern and it could be after an

injury, let’s say you twist it or you’re tackled by someone or you

make a quick turn on the basketball court or you’re a soccer player

and you go one way and a guy tackles you and you get the joints

stretched out. The ligament is stretched or partially torn; there may

be pain and swelling, there may not be. In older folks, there may

not be an acute injury, it’s just that their nutrition hasn’t been good

and their connective tissue breaks down and usually what people do

is they do RICE. They’re supposed to rest it and ice it, compress it

and elevate it and they usually take anti-inflammatories like Advil

or Motrin or Aspirin, and what occurs is that the healing response

gets blocked, and the normal thing that’s supposed to happen to

heal that connective tissue gets blocked by that drug, because

they’re anti-inflammatories and the way the body heals an injury is

by inflammation. Inflammation, it means it sends in there white

blood cells and little things called “fibroblasts” which re-grow the

connective tissue so that they can heal it up. And for one or another

reason, the ligament never quite heals or it heals in a condition

where it’s too long and you end up with a joint that’s got too much

motion, and when you get too much motion, it wears funny and

then you get pain or you then tear cartilage or the original injury,

maybe a torn the cartilage or you get arthritis because now, the

body is trying to get, it’s laying down calcium deposits to try keep

the motion the way it should be, and then since the motion isn’t

right, the body doesn’t like the extra motion that it’s got. It’s trying

to use muscles to hold the joints still and so, you get resting change

in the muscle tone, which is too high; that causes painful muscles,

and usually, the complaint we see from someone, is pain. It’s either

chronic joint pain or chronic muscle pain and it’s an athlete and

they need help and the idea that in what we do often is

prolotherapy.

Ben: Okay!

David: And so, the idea of prolotherapy is that if you inject into where the

ligament attaches to the bone, something that isn’t irritant that will

set off a new inflammatory response, the ligament will shorten and

thicken and get stronger, and the cartilage in the joint will re-grow

and you then, you can rehab a joint that before was causing you

chronic pain and, once the joint structure is now normal because

the ligaments are shortened, the cartilage re-grows, the muscles

around the joint will relax and the chronic pain will go away.

Ben: Okay, so, in terms of how it actually works, is it like an injection? Is

it something that you smear on top of the joint? How does

prolotherapy actually work when someone goes in? What do they

expect?

David: Ben, it’s an injection. It’s actually multiple injections so, if I’m

doing a knee joint, I will inject about 10cc of a mixture of the stuff

we call a “proliferant”, it’s the stuff that does it. And for most cases,

it’s a 15% sugar solution with a local anesthetic, with usually I put in

some homeopathics which help in the healing response, something

called Traumeel or Zeel, these help joints to heal. And I’ll put about

10cc into the knee joints base, and then I’ll put another 10cc, I will

trace where the ligaments that hold the knee together are, so it’s on

both sides, it’s in the front, and I will inject about a 10th to a quarter

of a cc in multiple places around the joint so that the ligaments, and

where I inject it is where the ligaments attach to the tibia which is

the lower leg bone, the main lower leg bone and the fibula, the other

leg bone and the femur, and around the knee cap where all the

ligaments attach and then, for about 24–48 hours the guy will feel

kind of a heatness and maybe a little pain, maybe a little swelling,

and then over about 3-4 weeks, the stimulation of that will cause

those ligaments to shorten and thicken and the joints base cartilage,

to re-grow. And during this time, we keep people off of any kind of

anti-inflammatory medicine; we don’t use ice, we use heat; we don’t

have them doing any kind of ballistic motion because I don’t want

them to irritate it so, no jumping, no running, no heavy squats; they

can do an elliptical, they can ride a stationary bike but I want to give

it a couple of weeks so that it can heal and then we check them in 3

weeks and see how they’re doing. Usually there is improvement

and most guys, somewhere between 1 and 6 treatments, the pain

will go away and the joint will rehab and then it’ll feel really good,

and that can be a shoulder, it can be a knee, it can be a neck, it can

be a low back, it can be an ankle, it can be a chronic plantar fasciitis;

it seems to work, probably 80% of the time in most people. I’ve had

it done myself a couple of times. It’s not a fun treatment because it

hurts if you get the shot, but it’s a very effective treatment for most

people because if you compare it to like, a guy who has a knee injury

and he gets an MRI, and there’s partially torn ligaments and there’s

torn cartilage and the orthopedic goes in there with the scope, and

he wants to clear things up, I would say that most guys won’t do

that yet. Come in, do a bunch of prolotherapy treatments. He has

to rehab it by itself because the chances that are working are

probably in the 80% range and they won’t need to have somebody

go in there with a scope and open it up. There’s really no downside

other than the pain in the treatment, which lasts about 10 seconds

because there’s a local anesthetic in it, it takes the pain away. And

it’s a brilliant treatment. I love doing it because the success rate is

really high and a lot of people will come back and they’ll say “You

know man, you’ve fixed me. I’m good.” and then I just say, if it

hurts again, if you re-injure it, if you re-overuse it, come back. I put

them on…

Ben: Oh, go ahead.

David: I beef up their nutrition; I put them on MAP, Master Amino Acid

Pattern, because they need extra amino acids to re-heal their

cartilage; usually, most guys are Vitamin D deficient; I put them on

some extra Vitamin D; I put them on some fish oil; I put them on a

multi because they need these extra things because their nutrition

hasn’t been good. I try to get them off the drug anti-inflammatories

and if you’ve travelled at all, I was flying this weekend and if you

look in an airline magazine, there is a picture in there, it’s usually

an elbow joint where they show a guy with an elbow joint before

and there’s almost no cartilage pad and then they call a joint

rehabilitation therapy as an advertisement and then, they showed

the elbow joint 3 or 4 treatments later and they showed that the

cartilage is re-grown on the elbow joint and now they got a good

joint and they’ve been advertising it for some guys who are doing

prolotherapy, that isn’t what they call it, but that’s what they’re

doing.

Ben: I think it’s interesting that you actually can mix other things in with

the elements that you’re injecting into the joint like traumeel, you

mentioned, that’s something that people would normally put on as

a topical anti-inflammatory and you can literally just inject that into

a joint huh.

David: Yeah! The company that makes it as an injectible homeopathics.

So, we usually use a combination of traumeel, which is common,

and there’s zeel which is another one, which is, it rehabs joints

cartilage so I mixed a unitrol vial in there and sometimes, on a

resistive case, we might inject some growth hormone into a joint, to

get it to stimulate, sometimes guys need extra other stuff, you know,

their testosterone’s low or their, they needed other stuff depending

but for most guys, it’s pretty simple. It’s the local injection repeated

from 1-6 times, if after 1 time, on the knee joints, most guys, 1 time,

sometimes 2 times, the pain’s gone. And they’re ready to go again

and then they’ve done it. They have trouble again, they can come

back and get another one. I had my groin done. I tore my

abductors, which is the muscles that move your leg from outside to

in; I got up, and I caught my leg on my desk and I tore my

abductors and it was 10 days I couldn’t run. It was painful to walk.

I had the prolotherapy done. Within 7 days, I was running. The

pain went completely away. It was great! So, for low backs, it can

be terrific. A lot of guys with chronic low back pain, they’ve got

loose ligaments in their low back. They go to the chiropractor.

They get adjusted. It feels better for 2 hours and then they move

and it goes out, that is a symptom of ligament laxity. And ligament

laxity, the ligaments are not holding the bones in place where they

should be and prolotherapy is a solution to it, disk surgery isn’t.

And, it can stabilize the low back or it can stabilize the pelvic and it

can really help so, I love doing it because it’s really good. There’s a

lot of guys around the US who do it. There’s a website which is

GetProlo.com, which has a bunch of guys who do it so, you can find

somebody in your area who are experienced. You know, all the

theories, in all the research; there’s been actually quite a lot of

literature now on it’s scientific literature. It’s an orthopedic

nightmare because most of them don’t like it because it’s so

effective, it reduces really the amount of surgery that has to be done

because a lot of times it helps and I’ve done a lot of pro-athletes like

skateboarders where they’ll twist ankles and they’ve got chronic

pain or knees, or baseball players with elbow pain or shoulder pain,

or a guy with low back pain or chronic neck pain, or sometimes

people with chronic headaches. It’s muscle spasm in their neck

trying to hold their neck straight, that’s causing the chronic

headaches and if that’s the right thing, it can help them out.

Ben: Wow, interesting. And, does insurance cover something like this all

the time?

David: Mostly not. It’s not super expensive like, to do a knee joint in our

office, it’s a hundred and fifty-five bucks; it’s pretty reasonable, and

if we do 2 joints, I think we had 55 bucks for the 2nd joint so if you

need both knees, or if you need a knee and a hip, it’s not going to

break anybody’s bank and send you to a couple of them; it’s usually

doable.

Ben: Yeah, that’s not bad.

David: Yeah. I mean, you get a sculpt knee, it’s going to be in the multiple

thousands, at least.

Ben: Yeah, interesting.

David: So, there’s a couple of books that, if people want to look at it or even

on the website, the GetProlo.com. There’s lots of things that people

can educate themselves and you know, talk to somebody, cause

usually in most big cities, there are guys that are doing it and for

athletes, I think it’s fantastic because your down time is short. You

don’t even really have to be down all the way. So, if it’s a knee or an

ankle or a hip, you can still ride; you could do an elliptical and if 1

or 2 treatments, you know, in 6 weeks, you could be on your feet

again and you could be running. So, it won’t put you out for a

season and when the pain’s gone, it’ll just feel a lot better so, I really

like it.

Ben: Got it. So, if you’re in the Florida area, obviously Dr. Minkoff’s

LifeWorks Wellness Center would be the place to go, otherwise,

check out that website that he gave GetProlo.com. These sound like

it could be really good for a lot of people who have some of these

issues so, Dr. Minkoff, thanks for your time and for explaining that

to us today.

David: Absolutely Ben, my pleasure.

Ben: Well, folks that is going to wrap things up. Remember, you can

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healthy week.

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