MDAE E51 – The Metabolic Dangers of Too Much Protein – with Ian Cramer

Article written and reviewed by Cyrus Khambatta, PhD and Robby Barbaro, MPH
Published January 8, 2019

Podcast Transcript

Ian Cramer: My smoothie this morning, after my hour bike ride, just kind of soft pedaling for an hour, getting good sweat going, was a quarter of a beet, carrots, bananas, blueberries, cherries. I didn't have any green, so I added a few florets of broccoli, a cup of orange juice, and some water. And so, it tasted great. Great for recovery. I mean, just think about bathing yourself in this anti-inflammatory soup. And if you do that, along with sleep, along with good hydration, making sure you're stretching properly. That is the recipe for a successful recovery.

Cyrus Khambatta, PhD: Welcome to the Mastering Diabetes Audio Experience, where we teach you how to sit in the driver's seat of your diabetes health for the rest of your life. We'll teach you how to reverse insulin resistance, achieve your ideal body weight, gain energy and get your best A1c following more than 85 years of evidence-based research in the Mastering Diabetes Program.

Robby Barbaro: Our program teaches you how to reverse prediabetes and type 2 diabetes, and how to simplify your life with type 1 diabetes by maximizing your insulin sensitivity, using food as medicine.

Cyrus Khambatta, PhD: We're on a bold mission to reverse insulin resistance in 1 million people. We're glad to have you joining us.

Cyrus Khambatta, PhD: Today's Podcast episode is an interview with Ian Kramer, the plant-based cyclist. Now, Ian has a Bachelor's Degree in Athletic Training, and he has a Master's Degree in Kinesiology.

He himself is a competitive cyclist, and he's a plant-based eater, and he's ridden his bike all the way across the United States. Him, and a team of 3 other individuals, rode 3200 miles across the United States in 7 days, 16 hours and some change.

In today's episode, he’s going to tell you why he decided to be a plant-based eater while riding across the United States, what the benefits are that he experienced, and he's going to talk about the fallacies, and the myth of a high protein diet, because it's very pervasive in the world of athletics.

You see, the concept of eating protein, and eating more protein, and eating animal based protein, and the question of “where do you get your protein?”, you know, this is a very common subject in the world of athletics. Everywhere you go, you see it, people talk about it, and it really is the focus of a lot of athletes. You might have also had a similar experience with this conversation about protein, even not being an athlete, just being a plant-based eater, or somebody who's considering a plant-based diet.

In today's Podcast episode we're going to talk a lot about athletics, but we're also going to talk about the function that protein serves in the world of athletics, in an athletic body, both for performance and recovery. And will also touch on a little bit about why food manufacturers, specifically print the word “Protein” on their labels, because food manufacturers have an obsession with the word protein, because they know it is a very valuable marketing tool.

So, we'll go into detail about that, and a whole bunch more. But before we go any further, let's dive right into it. So, Ian you have a really interesting story. Can you give our audience a little insight here in how you got involved in whole-food, plant-based eating in the first place? What are some of the influences that helped you make the transition from your previous diet, to a whole-food, plant-based diet?

Ian Cramer: Sure. So, my whole-foods, plant-based story started in 2012, I think that's when the movie came out. Basically, the movie was Forks Over Knives, Forks Over Knives planted the seed for what is whole-foods, plant-based nutrition, and why it can help us.

So, at the time I was in my first year of grad school at Miami University in Oxford, Ohio. And I was at the time, I had gotten into competitive cycling with the club team that they had there. And before that, I had had an interest in cycling, but I wasn't serious about it until grad school.

So, I think it was Christmas of 2011. Got the movie, watched it in January, and watched it back to back, watched it two times in a row, because I thought this was, it was unbelievable and amazing, and I needed to watch it again to gather even more of this information, and absorb it. And to me, although I didn't have a chronic disease that ran in my family, I wasn't unhealthy at the time, I thought, if I could be a better athlete, and if I can drastically reduce the chances of getting a chronic disease in my 60s, and 70s, and 80s, why not eat more this way, why not integrate more of this plant-based lifestyle.

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So, I gave it a try. And, you know, again, something I encourage all people to do is experiment. So in my experimentation, over the next two, or three years, to really dial in what I knew worked for my body, you know, for the first month I tried raw, ate a lot of salads, a lot of smoothies. And basically, long story short is I saw increases in my training, I was getting faster, I was getting leaner, I dropped, you know at the time I was like 190 pounds, 6 feet tall, I dropped 10 or 15 pounds easy, without even trying, and not seeing a decrease in my power output.

And so, I guess, to answer your question, is more of the influences by, certainly, Forks Over Knives, Mac Danzig, which I'd like to meet him someday, kind of an MMA fighter who's in Forks Over Knives, was one of my influences. And I'd also have to say a couple other people, a little bit later on I found Rich Roll, who I enjoy following, and Scott Jurek. And athletes who are really doing a lot of good on social media, and paving the way, and showing people that not only can you survive eating no animal products, but you can thrive, and we would even make a strong argument that you would be a better athlete if you ate more plant-based diet.

Cyrus Khambatta, PhD: Got it. So, this is super interesting, because what you just said is that you got into this lifestyle, not because you were trying to reverse or overcome some kind of chronic disease that you were already living with, it wasn't in your family, it's not in you, you went into plant-based, whole-food eating, it sounds to me like from a purely athletic perspective/thinking.

Okay, well, this is probably going to make me a better athlete, or this has the potential to make me a better athlete, I might be able to perform a little bit better, I might be able to recover a little bit better. But also because you understood inherently, that into the future, if you were to eat this way and follow this whole-food, plant-based lifestyle, that you could avoid developing a chronic disease into the future. Is that right?

Ian Cramer: Right, right, right. And I think, that's a good point to flesh out because, again, you would agree with me that in this culture, in this society, as time goes on, generation after generation are looking more short term. We're not looking long term into the future. And I don't know where that comes from within me.

I mean, maybe it just comes I guess, you know, I'm very methodical, I'm very objective, I like to say that I am very efficient. And to me, not only on the bike with my athleticism, if I was consuming dirty fuel, like if you put dirty fuel, diesel fuel into your Ferrari, it's not going to run very well. So, I guess in efficiency, I saw was the fuel I'm putting into my body for cycling, for recovering, if that's not peak fuel, then I'm not performing at my best.

And the same thing goes for living into my… I say, jokingly, I want to be setting records on my bike when I'm 100, I want to be my own centenarian here, and that the only way that's going to happen is changing my diet in a big way, and continuing, of course, continuing to exercise, and get a lot of sleep, and all those lifestyle factors. So yeah, that's a good observation.

Cyrus Khambatta, PhD: I actually really like what you're talking about here, because taking this preventative approach is something that's very atypical in the Western world. You know, you said to yourself, I don't have anything that I'm trying to overcome, I don't have a pre-existing chronic disease right now, what I'm trying to focus on, is avoiding the development of a chronic disease into the future. Which is very atypical, I mean, it makes perfect logical sense, and Eastern philosophies have been based off of preventative medicine for thousands of years. However, in the United States, we practice a much more reactive form of nutrition, or reactive form of medicine.

Most people usually wait until they develop some type of chronic disease, and then they say, “Oh, wait a minute, now I have to make a change, because if I don't, my risk for premature death goes up.” And it's actually a very backwards philosophy, because it's not preventative, it's reactive.

So, I'm actually really glad to hear that you took a much more preventative stance, and you decided that you were going to put plant-based, whole-food nutrition into your philosophy at an early age. It's a very refreshing philosophy. And I'm really glad to hear this.

Ian Cramer: Thanks, thanks. And again, my mission now in my spare time, is to try to spread this message to 30, or 40, or 50 year olds, or younger or older, to try to get them to understand that we have a lot of power and our hands, I think the number is 80 to 90% of the chronic diseases that we see that develop in people are because of our own behaviors. It's that last, we’ll say 10 to 15%, where maybe it is purely bad luck, maybe it is really bad family genetics, or some genetic mutation, but in the vast majority of the cases, we can take our health into our own hands, and it doesn't have to be hard, we need to keep it really simple. And I hope to convey that message.

Cyrus Khambatta, PhD: Great. Okay, so this is awesome. So, what I want to do over the course of the next 45 minutes or so, is drill down into the details about what you are eating before exercise, what you eat during exercise, and what you eat after exercise. And specifically why you're choosing these particular foods, because I'm very confident that you have a strategy behind this entire process.

But, before we get there, let's talk a little bit about the Race Across America, because you and a team of cyclists rode across the United States, not just across one state or two states, literally, across the continuous United 48 states. And you rode 3200 miles in 7 days, 16 hours, and some change.

So, correct me if I'm wrong, but you guys rode around the clock, no stopping at all. So, if somebody is riding their bike, the other people are sleeping and eating, and then you sort of take turns one of the time, is that exactly how this went?

Ian Cramer: Yeah. So, the race is called the Race Across America, and it was in the summer of 2015. And by that point, I was plant-based for four or five years or so, give or take. And to start off with kind of a caveat, I do want to say that I didn't do all 300 miles by myself. So, some people do though, there is a category, there is a solo category, and a two man team category, I was in the four man team.

So, it was me, Dustin, Lisa. And Nelson. When I went to grad school in Oxford, Ohio, one of the time stations for the Race Across America was right in Oxford. And so, when I was there for two years, I was heavily involved in a club cycling, and in the summers, when Race Across America came through Oxford, I learned about it, and I said, this is pretty cool. Like, someday, I kind of put it in the back of my head, someday I want to do this.

And on from grad school, I moved down to Atlanta, Georgia for a couple years, and then I moved back up to New York, where I got a job, with actually my undergrad, and it was in 2015 that Lisa, who was kind of the unofficial team captain, contacted me and said… Yeah, this must have been 2014, and said, “Let's do this. Let's do this in the summer of 2015.”

So yeah, I mean, my training, I guess, started in roughly… Well, I've been training for it for, really the last 7 or 8 years, but October 2014 is kind of when my training calendar started. Putting in really low, really slow base miles on the bike, trying to build up that deep aerobic base. And then, you know, so I was training in upstate New York, in Alfred, New York. So, I tried to get out as much as I could. I remember this was late February, early March, I was starting to get out, I was bundled up.

And so, as the weather got warmer, I progressed to, pretty much the months of April and May, I averaged 2000 miles a month, leading up to the race, which was in June. And then so, when the race took off from Oceanside, California, in mid-June, my average was about 125 miles a day, for seven days straight. And all of the racing, and all of the training was done on a whole-foods, plant-based vegan diet.

And so yeah, I mean, in a nutshell, that was the race across America. And so like you said, we had follow vehicles that were part of our team, there was always one rider at a time making headway, making forward, you know, eastward progress. And the way we split up our team was, you know, there's many ways of doing it, we split it up into two teams of two. So, it was me and Dustin.

We rode from 6am to 6pm, Lisa and Nelson rode from 6pm to 6am. And there were reasons for that. So, Dustin and I traded off, we really weren't on the bike for any longer than like 30 to 45 minutes at a time, to keep the legs fresh. It was a strategy, because we didn't really want to win, we just want to finish. And so of course we did.

So, there's many ways you can do it. And that's the way we did it. And it worked out great. I knew, I had a feeling by the first day that we were going to make it, because we are running ahead of schedule. Dustin had created this time sheet with all the time, I think there's something like 50 times stations, from West Coast, East Coast. And he took the times of a previous team that was similar to ours, I think it was a four man team, there were three guys and one woman and said, how did they do crossing the country, you know, they got to time station 16 in so many days, and so many hours. And they finished in eight full days.

So we said, “Okay, if we want to finish in eight days or less, here's what we have to do.” And by the first day, we were several hours ahead of schedule, which on a bike that's 10, 20, 30 miles. So, we knew we were doing very well by the first day. And so yeah, 7 days, 16 hours, 27 minutes is when we cross the country, and a lot of memories, a lot of memories.

Cyrus Khambatta, PhD: You know, actually, as you're talking about this, you're conjuring up memories of a bike event that I did about a decade ago called the death ride. It happens here in California, and it's basically 129 miles of riding in one day, with 16,000 feet of elevation gain. So, they say that it's the equivalent of climbing half of Mount Everest in one day, along with 129 miles.

And I gotta be honest, it took me six months to train for this single event, because there was so much climbing involved in the training program. And I did it as a purely plant-based athlete. It was right after I transitioned to a plant-based diet. And so, there was a certain amount of time that I required in order to become familiar with how much to eat, when to eat, what to eat, and how to manage my blood glucose, and nutrition, while on a long endurance ride.

Now, I recognize right off the bat that there was no question that eating a plant-based diet was allowing me to cycle for a longer period of time, and to resist fatigue. And it was allowing me to recover much quicker than I would have recovered if I was on my previous meat centric and dairy centric diet. Because of that, I was able to go out and ride my bike quicker than I had, or than I would have been able to if I was on a previous diet.

But, what I'm curious with, here with you, is when you started becoming a fully plant-based cyclist, was it obvious to you at the time there were performance gains as a result of eating this way? Or were you just kind of hoping, and wishing, and praying that by eating this way, it would actually help you out while you were cycling, and doing the Race Across America?

Ian Cramer: Well, I guess coming into this in my previous diet, I don't think it was that bad in terms of foods that we advocate against foods that we know could be, you know, acid forming or inflammatory, or not entirely conducive to anti-inflammatory environment, and athletic recovery. So beforehand, I ate a lot of Greek yogurt, I drink about a gallon milk a week, and I had, you know, maybe three to five servings of a meat per week. And with minimal, because as a college student, I'm not going to go out and buy a whole lot of junk food, minimal junk food.

So, my diet when I started wasn't that bad. So with that said, I think if it was really bad, I could very well say, I noticed a humongous improvement. Now, with that said, I want to be fully transparent and honest with people. I noticed some improvement, but I think, I want to emphasize is that if you're an athlete, and whether, you know, no matter where you're starting, you're going to see some improvements. So, let's kind of dive into the improvements, I guess.

I noticed that I was recovering faster, and we can kind of go into that a little deeper. It has to do with, mainly, it’s antioxidants, and getting the building blocks you need from the food you're eating. I noticed I was sleeping better, because of just eating more unrefined whole-foods. And also because my diet was composed of more carbohydrates, I was also noticing longer endurance as well. Is there one of those areas that you want to dive in a little deeper to?

Cyrus Khambatta, PhD: Yes, all of those areas I want to dive into. Let's dive into the recovery side of things. You know, I've heard a lot from athletes, myself included, that your ability to be a good athlete is dependent not only on how you perform, but more importantly, on how well you can recover.

A lot of athletes, and a lot of trainers think that recovery is actually potentially more important than the actual performance, I mean, not more important, but equally as important as your performance itself. And because of that, I think there's a lot of people that are transitioning towards diets that foster enhanced recovery, and quicker recovery times. Is that right?

Ian Cramer: Right. Yeah, I mean, so with that said, I'm sure there's athletes listening, you'll know that the gains you make, are not while you are exercising, it's while you're resting. And the analogy that I like to make is that, if there are competitive athletes out there, no matter your sport, if you recover better, let's say this athlete is able to fit in six workouts in a seven day week. That's pretty phenomenal. But, if your recovery strategies aren't as dialed in, you may only be able to fit in four, or maybe five workouts in a given week, because those other two days you have to devote to rest, because you're sore, because you don't have a lot of energy, because you need to recover.

So, if you extrapolate that extra one or two days, over the course of 20 weeks, 30 weeks, 40 weeks, and times multiple years, that's a lot of extra training you're getting in that your competitors aren't because their recovery strategies aren't as good.

And so, the main thing that I point to, with regards to recovery is antioxidants. So, when we are metabolizing human beings, there is some level of inflammation that's happening within our bodies, because of just basically breathing and metabolizing. So, if we smoke, and if we live in a really toxic environment, we can have more of that inflammation. And if we eat really bad foods, the foods we eat are a huge form of this inflammation within our bodies. And if you are athletes, it causes more of these reactive oxygen species in our bodies, basically this cellular metabolism, because of aerobic metabolism, because of just breathing a lot because of sports.

So, our bodies produce these endogenous antioxidants, which basically, our bodies produce these antioxidants to fight the inflammation within our bodies. Now, there is a way that we can affect this inflammation from the outside. And one of them is, the biggest one in my opinion, is our diet. So, if we are eating lots of brightly colored fruits and vegetables, with a high antioxidant content, we can effectively, kind of an analogy is, put out the fire quicker, put out that inflammation quicker, so our bodies can, in a sense, start the recovery process sooner. And so, if we start that recovery process sooner, we're able to recover to a higher degree until the next time when we need to work out, and then it just kind of perpetuates on itself.

My smoothie this morning, after my hour bike ride, just kind of soft pedaling for an hour, getting good sweat going, was a quarter of a beet, carrots, bananas, blueberries, cherries. I didn't have any green, so I added a few florets of broccoli, a cup of orange juice, and some water. And so, it tasted great. Great for recovery. I mean, just think about bathing yourself in this anti-inflammatory soup. And if you do that, along with sleep, along with good hydration, making sure you're stretching properly. That is the recipe for a successful recovery.

Cyrus Khambatta, PhD: I love what you just said here about bathing yourself and an anti-inflammatory soup. I think that's actually one of the more brilliant analogies I've ever heard in this world of low-fat, plant-based, whole-food nutrition, because effectively, what you're saying is that by eating the most nutrient dense foods you can find, according to what the research shows, which is whole fruits, whole vegetables, whole legumes, whole grains, and minimize or completely eliminate animal based products, and refined processed foods, you are maximizing your ability to suck the nutrition out of these foods and use it, both for athletic performance as well as for chronic disease reversal.

Now, you take these foods and blend them up into a smoothie. And then boom, there's literally nothing more powerful in terms of nutrient density, especially antioxidant content. But here's the problem. Most athletes, and even a lot of non-athletes, people who are just sort of trying to be athletic, they've heard over, and over, and over again, as soon as you're done exercising the most important macronutrient to put into your body is this stuff called protein. Protein, protein, protein, protein, protein, protein, protein, protein. And you know, the questions are like, “Where do you get your protein? How much protein are you eating? Is it whey protein? Is it pea protein? Did you get at least 30 grams of protein after your workout?” Let's go into little bit of detail here about the fallacies of a high protein diet, and the metabolic dangers of consuming too much protein. So many people seek out foods specifically, as they’re high in protein. What can you tell us about what you know about how high protein diets affect your ability to recover from exercise?

Ian Cramer: So, initially when I was embarking on a plant-based diet, plant-based nutrition, I had heard all the same messages from people who I followed, but like most people, I didn't trust them that much. I wanted to make sure I was getting enough. So, in the first several years of training really hard, going plant-based, I, on occasions, not regularly consumed an isolated protein powder. It was the Brendan Brazier’s brand of vegan protein powders. But as I trained, and as I learned more, and as I listened to my body, and as I went weeks without ever consuming this protein powder, I said, “I feel great, I'm recovering well, and I haven't eaten this protein powder in weeks, I don't really think I need it.”

So, you know, I can approach this from several angles. Number one is, although we are fed this information, although we consume this information every day that we need to focus on protein, and again, this is coming from commercials, and media, and social media, and seeing your favorite sports star with a milk mustache and beef, “This was for dinner”, and seeing all of our foods, all of a sudden, the last five years have a little like added protein sticker, and 14 grams of protein. It's the focus. But that's not because our nutrition guidelines have changed. That's all marketing. It's all marketing put out by the companies of these foods.

One thing I say in my public presentations is that food companies with rare exceptions, don't care about your health. They care about selling more of their products. So, I mean, put yourself in the shoes of meat, or dairy, or the egg industry, what do their products have? And you’ve seen this experiment, it was done on, I think, Forks Over Knives. What does meat have? Protein, you know, meat and dairy, protein, and let's say meat has some iron, and dairy has some calcium. After that, it gets pretty sparse.

So, let's just, okay, grant them the benefit of the doubt and say, “Okay, it has protein in it”, you know, that protein, if you ask yourself, do those foods have component parts that are known to be beneficial to our body? Sure, our bodies can use and consume, and assimilate protein, and calcium, and iron, and use those for metabolic processes. But if you ask that question, you also, you by default, have to ask the question, do these foods and food groups also have component parts in them that are known to be harmful? And of course, the companies are never going to tell you yet. “Yeah, yeah, you know, our product has a lot of protein in it. It's great for building muscle. But it's also great for the promotion of cancer cells.” They're never going to say that.

So again, these companies want to promote these component parts in their products, they have a lot of protein, they have a lot of calcium, but they care about making more money. So, I'm kind of getting lost in the weeds here. So, let's bring it back here, you never hear about people having a protein deficiency. You know, you'd think that if we are hearing every day that we need to consume more protein, you'd think that we know at least half a dozen, or a dozen of our friends or family who've been admitted to hospitals with a diagnosed protein deficiency. But it doesn't happen, because we're not protein deficient.

You know, especially in a standard American diet, we are consuming way more protein than we need, because we're consuming a lot of animal products, which are high in protein. So on a plant-based diet, the main thing I encourage people to do is not think about consuming enough protein, that's what I say is that downstream concern, consuming enough protein. The upstream concern, but the primary things that athletes should worry about is, number one, consuming enough calories, and number two, consuming a variety of foods. If they do those two things, it's guaranteed that they're not only going to be consuming enough protein, but they're also going to be consuming a ton of the more beneficial, of the very beneficial micronutrients, and phytochemicals, and antioxidants that their bodies also need on top of the protein.

Something that we talked about a little bit off camera about how I'd love to make this presentation in the future called “There's more to recovery than protein.” And it's a huge misconception among athletes. And I guess it's only if you have access to a sports registered dietitian, that you really understand these things. But listen, you know, people are getting by and people are doing what they can, but it's my goal, to try to spread this message and say, more plants is going to make you a better athlete.

Cyrus Khambatta, PhD: I think that's actually a phenomenal response. Because you're right, in the sense that food manufacturers are going to tell you what you want to believe, rather than the things that may actually be true. Like you said, by now, the evidence-based research has clearly documented that foods that are high in protein from the animal world, things like meat, cheese, eggs, fish, these foods also contain in addition to a high amount of protein, and a high amount of saturated fat, things like trans fats, naturally occurring trans fats. They also contain leucine, heme iron, sodium, nitrates, advanced glycation-end products, and beyond. And these nutrients can actually play a causative role in the development of chronic disease.

But of course, product manufacturers, food manufacturers, they don't want you to know that information, they're not going to tell you that, they're not going to print that on a label on a product. So instead, all they put on the label, or the words that are most prominently shown, are things like this product contains 15 grams of protein, a great protein source, added protein. And I think through other research that I've read online, that when consumers see a bottle, and it has the word protein on it, there's something like a 30 to 40% greater chance, or greater likelihood that they will buy that product, just because it has the word protein on it.

Ian Cramer: Right? And here's something else just to springboard off of that, that people don't think of. So now, okay, so they're saying, well, okay, Cyrus. I hear what you're saying, and maybe these things aren't the best for long term health. But here's another way to look at it. My argument is that not only are these things not good for long term health, but the foods that we think are the best for this short term athletic recovery, like, you know, chocolate milk and lots of chicken breasts, these foods in the short term may also be leading, be perpetuating this inflammatory state within our bodies, that has been caused by this three hour bike ride, or this 90 minute run.

So, we think we're consuming foods that are helping in recovery, and an argument can be made that okay, maybe they are, but the foods that you're eating are also playing into this inflammation, which, again, it's going to slow recovery. So, why not ask another, the follow up question to this is, are there foods out there, where I can obtain the beneficial components of animal products, while also skipping the negative side effects of consuming said animal products? And the answer is yes. It's whole, plant foods.

Now, let's kind of get into, if you don't mind, the whole, let's get a little bit more into protein. And people say, well, okay, the research does show that animal proteins, such like, I know whey protein and casein do provide a more rapid muscle protein synthesis. So, basically growing muscle at a quicker rate. Now, one of the reasons that is so, is because animal products contain higher amounts of certain amino acids. So, therefore, you can kind of extrapolate that and go back and say, well, so plant-based sources generally have lower amounts of some amino acids. And again, this is kind of where the whole food combining comes in. People say you're eating an incomplete protein.

And I did a little experiment, I looked at the top 10 fruits and the top 10 vegetables in the United States, and I looked at each one, and the individual amino acid, it was mainly, it was the essential amino acid breakdown. And out of those, so, we had 20 total fruits and vegetables, out of that list of 20, there was one that had a, kind of like a hash, or a zero in a column for an essential amino acid, and I think it was papaya. So, again, okay, okay, it doesn't mean papayas are unhealthy, just probably don't depend on it for a robust plant-based protein source.

So, you were mentioning before about lysine. There are a couple amino acids that we should be aware of, that plants are generally lower in, and I think the list is leucine, lysine, and methionine. Now, without getting too deep into this, the bottom line that I think your listeners should know about is, what I would recommend if they are a competitive athlete, and they want to get the most bang for their buck in regards to athletic recovery, they need to consume foods, and incorporate food groups like soy, like beans, like lentils, like quinoa, nuts and seeds, because these foods generally have higher amounts of the leucine, lysine and methionine.

So, if you incorporate those foods in your meals, along with the colorful fruits and vegetables, high in antioxidants, the non-starchy vegetables, you're going to be all set. And again, if you go by the number one, and number two rule, is getting enough calories, and eating a variety of foods, there's going to be no issues with getting enough protein, or with athletic recovery.

Cyrus Khambatta, PhD: I love this. I love this. This is great. So let me piggyback off of that here for a second. There's two amino acids, cysteine and methionine. And both of them contain sulfur. They’re the only two amino acids that actually contain a sulfur atom. And these sulphurated amino acids tend to be more prevalent in animal based foods, then you would find in plant-based foods. And so, when you eat animal based foods, you get more of these sulphurated amino acids, de facto. And when you eat these sulphurated amino acids, what ends up happening is that the free sulfur group on these amino acids, when they become present in your blood, can mix with water, which generates a small amounts of H2SO4, otherwise known as sulfuric acid.

So, this free sulfur group that mixes with water is actually, it stimulates a chemical reaction that ends up creating a small amount of endogenous sulfuric acid production, which over the course of time, ends up dropping your blood pH. Now, your blood pH is supposed to be set at about 7.4, and as you continue to eat these quote unquote, acid forming foods, foods that contain sulphurated amino acids, then your blood pH can drop from 7.4 to 7.37, to 7.33, to 7.30. We're not talking about very large changes in blood pH, because it's a very tightly controlled system. And acid-base balance inside of a human being has a number of redundant mechanisms to make sure that your blood is maintained as close to 7.4 as possible. But when you're eating these foods, you end up generating endogenous sulfuric acid, which then makes for a more acidic blood pH.

Now, in this situation, one of the things that your body has the ability to do is basically buffer your blood against the continually falling pH. Then, one of the ways that it does this, is by dumping calcium into your blood. And this sort of prevents a further decrease in blood pH, the question really becomes, “Well, where is this calcium going to come from?”

Now, researchers used to believe, or they guessed that, well, because most of the calcium stored in your body is stored inside of your skeleton, inside of bones, that when your blood pH starts to drop, that your bones would actually leach calcium, or release calcium into your blood to prevent against that falling pH.

It turns out that that's actually not right. And there have been some very interesting, very elegant, and extremely innovative experiments using radioactive tracers that have shown that another incredibly large storehouse of calcium in your body resides in your muscles.

So, in a situation where your blood pH begins to drop, your muscles are actually, they contain a more labile, or a more freely movable form of calcium, that they can dump into your blood and prevent against a falling blood pH.

Now, researchers are beginning to believe that it’s this continual dump of calcium from your muscles into your blood every single time you eat food, over, and over, and over, and over, and over again, that can and may contribute to sarcopenia, or muscle wasting in older individuals.

And for athletes, if you're constantly taking a super large dose of animal based foods, that then causes this problem over, and over, and over again, then what you're doing is you're effectively forcing calcium out of your muscle tissue, and into your blood, simply to buffer against the foods which you're eating. And you're actually doing a disservice to your muscles, and you're certainly impairing their ability to recover.

Ian Cramer: Yeah, yeah, I mean, that makes a lot of sense. Now that you've said that, and what I was thinking in my head was, as we were talking off microphone a bit before we started was, my day job as a certified athletic trainer, and I see, you know, more in the fall, one of my main obligation is football, JV football, varsity high school football. And a trend that I've been seeing, and I worked, I also work collegiately in a division three University, a trend that I'm seeing is that more, and more athletes are getting, are cramping.

And so, if I'm going back to kind of my human physiology classes in undergrad, where we learned about the physiology of muscles, and we have, of course, the myosin, and the actin, and the calcium are acting as the bridges, and kind of the fibers are slipping over each other. And I guess when the muscles contract, these actin, and myosin, and fibers are kind of sliding over each other. And one of the components that we need within our muscles to have them relax, contract and relax, is calcium.

And so, I think also sodium and some phosphorus as well, maybe you can chime in. But if we don't have that, if we are eating a really poor diet, then we're going to get some cramping to go on. So, I say to my athletes, man, muscle cramp is a really slippery slope. As soon as you start feeling the initial pangs of like, “Oh, my calf is cramping up”, you better start stretching and getting in some electrolytes in your body, or else you're not going to be playing the second half.

Cyrus Khambatta, PhD: Yeah, that's a valid point. And, if you look at the way most athletes behave, you know, a lot of athletes eat these protein rich foods as their recovery meals. They made down some hamburgers, some hot dogs, maybe some bacon, have some meatloaf, and as a result of that, they end up increasing the rate at which calcium leaves their muscles, in the recovery state, going into their blood to buffer against the falling pH, which is decreasing their muscle calcium content overall, and it's impairing their ability to recover for the next time they go and perform exercise.

So, the next time they go and perform exercise, they're actually at an increased risk for cramping, simply because there's a net deficit of calcium. And then as a result of cramping, the next time they're exercising, they go and consume a drink that has a lot of electrolyte salts in it, like Gatorade, or Powerade. And as a result of drinking those drinks, sometimes there's artificial sweeteners in it, like high fructose corn syrup, or dexterous, and as a result of that now you end up with artificial sweeteners as well.

So, you're using a drink that's quote unquote electrolyte rich in order to prevent against cramping, but the cramping itself was actually caused by the foods that you ate for your previous recovery meal. So, it turns out to be this vicious cycle that tends to get worse, and worse, and worse over time. And I know a lot of people in the athletic world, just chalk it up to the fact that you're exercising hard, and they say, “Oh, well, you know, you're using your body a lot, of course, you're at an increased risk for cramping”, which is a true statement to a certain extent. And then they'll say, “Well, don't worry about it. Just have some more salt, just have some more Gatorade, just have some more electrolytes, because that's going to solve your problem.”

Ian Cramer: Yeah, yeah, I hear you. I hear you.

Cyrus Khambatta, PhD: Okay, cool. So, let's slightly change the subject here. You know, there's a lot of people in our audience living with type 1 diabetes, prediabetes, type 2 diabetes, type 1.5 diabetes, and we talked a lot about food, you know, what foods do we recommend eating, and what foods do we recommend minimizing, what foods do we recommend eliminating all together for maximum insulin sensitivity.

But in addition to that eating, to maximize your ability to move your body and exercise is also very important. And we know just how valuable proper nutrition can be for exercise, and we know that it's one of the most powerful insulin sensitizers the world has ever discovered, the world will ever discover. And given that you're in a position where you know a lot about exercise with your exercise physiology background, if somebody came up to you, who doesn't currently have an active exercise regimen, and they say, “Hey Ian, I want to start exercising. I understand, theoretically, that's a very good idea. I get the science, fine. But I'm having a difficult time starting. I'm a little intimidated by the prospect of being active on a daily basis.” Could you give our audience a little bit of tips here about how to start an exercise regimen that actually they can sustain over the course of time?

Ian Cramer: Well, I guess I would start off by saying, think about, put yourself back when you were 10, or 12, or 14, what sport, what activity did you really like to do, and do that now, try to do that now. Now, again, for some people, maybe they're battling morbid obesity, maybe they're battling sort of orthopedic musculoskeletal injuries, because of their weight or whatever. Maybe it's not possible for them to play five on five pickup basketball. All right.

My point in saying this is, we need to focus on the activities that bring us the most pleasure. One question that I'm asked often is, what activity should I participate in that burns the most fat, and I say, and I kind of took this from someone else, but I think it's a really good point, it's the activity that you're going to do every day. So whether for me it's cycling, another one of my mentors really enjoys jujitsu, swimming, running, whatever. My younger brother enjoys playing squash, the racquet sport, whatever it is, do more of it. Whatever brings you the most enjoyment.

So, that's number one. Number two, I wouldn't get to, just like this lifestyle, don't overthink things, if all you can do is get out for a walk, that's great. We have to celebrate the small victories along the way. If you have a patient, if someone says if I snap my fingers and go five years into the future, one of your patients has lost 50, 100, 150 pounds, you know, along that five year road, we have to celebrate the small victories to get that weight off. And one of those small victories is “Wow, I walked for 30 minutes. And I did it.”

And so, you know, whether it's walking, or going for a bike ride on a path near your house, or even perhaps going to a gym, and just getting on the treadmill, or the elliptical, not really my cup of tea, but if it's something that you enjoy, put in your earbuds, listen to a Podcast or something like that.

So, I guess the biggest thing is just starting slow. And starting within yourself, you're not trying to compare yourself to anyone else. Compare yourself to you, and keep track of rating of perceived exertion. Basically, a zero to 10 scale. Zero is I didn't work very hard at all, 10 is I was puking my guts out. Keep the rating of perceived exertion low. So that way, you'll want to do it for the next day.

You know, if you want to incorporate strength training, don't lift like a madman on day one, because then you're going to be sore for a week. So, you know, I think physical activity is really important. Some people at various points in their lives, they find it hard to incorporate. So, take it at your own pace, try to integrate every day some sort of physical activity, don't be intimidated by you know, people in this movement, who have ridden their bike across the country, or done Ultraman or whoever, you know, ran 100 miles. That's not you, most likely, but it could be later on, down the line. Just start slow, get out there, and get moving and just focus on you, not anyone else.

Cyrus Khambatta, PhD: Yeah. That's sage-like advice right there. Keeping it simple, is always going to work. Simple, simple, simple. You know, I remember back in the day, when I had transitioned to a plant-based diet, my body felt very different. In some aspects, I felt like my body was able to perform more work, and I could certainly recover quicker. But in some aspects, I also felt like I had lost a little bit of power, and a little bit of strength. And coinciding with that, I actually was losing a little bit of weight, and so I had to figure out why that was happening. And it turns out, I just wasn't eating enough food. I didn't know how much food I was supposed to be eating. And I didn't really know that much about calorie density. So, the foods that I was eating weren't necessarily providing an optimal number of calories for my active lifestyle.

But I remember approaching this very systematically. And I said to myself, “I don't have to come up with the answer to this problem right away. I don't have to solve this tomorrow.” Instead, I took it one day at a time. And I said, “Okay, I'm going to perform one experiment today. And then I'm going to see what happens. Then I'm going to learn from this experiment. And I'm going to apply something that's similar, but maybe a little bit different tomorrow. And then I'm going to learn from that. And I'm going to continue to do this process until I feel like I've really mastered this lifestyle.”

And so, a very simple thing that people can do is literally just perform a series of experiments, and approach this lifestyle as though you have an opportunity to learn about yourself once again. Set it to be super simple. “You know, what if I go for a walk today?” That's it, just go for a half an hour walk, and see what that does. How does it affect your blood glucose? How does it affect your energy levels? How do your muscles feel? Do you need to stretch beforehand, do you not? And then maybe two days later, get on your bike, and go do a quick other experiment, and see what does it feel like to ride your bike for 30 minutes? Did your heart rate get higher? Was it easier? Were you sweating more? Did you feel tired from the previous workout? Etc., etc.

And then over the course of time, the goal is for you to be able to enjoy what you're doing, because you're learning yourself, because you're getting a benefit from it, and because you're creating a long term sustainable exercise regimen that's going to last with you for months and years. And we tell people this all the time, we say it is imperative to create an exercise regimen that you enjoy, because if you don't enjoy it, it's not going to stick.

Ian Cramer: It's one of the main reasons why we see so many, you know, the gyms are chock-full in January, and then in February there's no one in there, because they try to get in there to set a new year's resolution, and for whatever reason, they they're not sticking with it, because basically, maybe, you know, one of the reasons is because they don't really enjoy it.

But if they were just more realistic, I think that's another thing, we set these huge goals, these unrealistic goals of “I want to lose 100 pounds in six months”, when you got to think about how long did it take you to put on this weight. It probably didn't take six months, it might have taken six years, or a decade. So don't expect for all this way to come off in a year. We got to set these realistic goals and again, just everyday heck away at the goal.

Learn, make mistakes, it's okay to make mistakes, learn from those mistakes, so that hopefully you don't make them as often, and the net sum, the net total hopefully with lifestyle, with exercising, along with eating really well, nourishing your body with the foods that it needs, you will lose this weight, your body won't need it anymore, and you'll get a lot healthier.

Cyrus Khambatta, PhD: Ian, tell our audience about how they can learn more about you. You have an incredible Podcast. How can people find your podcast? How can they become a groupie of yours, like I have already become, and how can they learn more about what you do?

Ian Cramer: Alright. So, this morning I did a live session on my Facebook page that I'm going to try and get back into the habit of doing every Tuesday, at 9 o'clock AM Eastern. The Facebook page is called Plant Based Cyclist. I am sort of, kind of trying to distance myself and get away from that online alter ego, and just go with my name Ian Kramer.

So, probably the best way to find out more about how athletes can integrate plant-based nutrition you can go to ianmcramer.com, or plant-basedcyclist.com. It'll bring it to the same website. And on plant-basedcyclist.com, you can find all of the Podcasts that I have made. And again it's my Podcast has a very niche focus on interviewing doctors, and scholars of lifestyle medicine and plant-based nutrition, i.e Dr. Cyrus Khambatta in episode, I think it was 53, 52. That was a great one.

And so, and a bunch of other doctors too. I'm sure your audience is aware of Dr. McDougall, Dr. Esselstyn, and many, many others. I like learning, I like learning from people who are smarter than me, I asked pretty good questions, and people really have benefited, and will continue to benefit from these conversations.

And this is, we were talking off microphone at the beginning, this is really what I'm passionate about. I love pointing people in the right direction and saying, walk down this road, here's how to get healthier, read this book, listen to this Podcast, or this resource. I'm all about this, very passionate.

But also, my main message is becoming and living as responsible ambassadors to this movement, compassionate ambassadors to this movement, I think there's a lot of, and maybe you'll agree with me Cyrus, there's a lot of hate, and a lot of bitterness, and a lot of fighting, whether it's infighting or fighting within groups, and that's not productive. So, my Podcast is discussion base. And I, I urge that people just, you know, learn, make mistakes, and keep learning, and just eat more plants, live as responsible ambassadors to this movement.

Cyrus Khambatta, PhD: I love that. And just to touch on what you just said here, there's a lot of hate. There's a lot of confusion. There's a lot of frustration. And there's a lot of conflict in this world of nutrition. There's three subjects which I think are the most conflict ridden subjects in our world today. And they are number one, religion, number two, politics, number three, nutrition.

But here's the thing, nutrition does not have to be a conflict ridden subject. We tend to come at this from a perspective of just trying to educate, and inspire, and motivate people to transition towards a plant-based diet as do you, and that's exactly why we get along so well.

So, I would encourage people listening to this that, you know, if you're at a stage where you're trying to make decisions for yourself, about trying to reverse a chronic disease, like diabetes, or maybe even prevent diabetes in the first place. Maybe you're trying reverse cancer, heart disease, hypertension, high cholesterol, stroke, you name it. Rather than focusing on the conflict, and the he said, she said, I watched this YouTube video about a guy talking crap about another guy, all of that, distance yourself from it and do it immediately. It doesn't serve you. What serves you is to gather the most effective evidence-based information you can possibly find, and surround yourself with other people that are going through the same process as you. When you do that your chances of success are guaranteed.

Ian Cramer: Yeah, 100%. Well, and I feel like the other stuff too. A lot of the YouTube stuff is entertainment. It's entertainment. This doctors fighting against this doctor, but I guess I don't really, I hope I don't market my Podcast, or the content that I produce as entertainment. It's more of learning. It's learning in a way that's productive, civil discussions that I'm all about.

And again, if people don't resonate with that, fine, go to YouTube, and watch the entertainment. People got to resonate with it. People have to have a reason to watch it. But this is what I'm about. This is me, this is my true self. And I know that you definitely resonate with that as well.

Cyrus Khambatta, PhD: 100%. I loved our discussion today, any conversation related to athletics performance, recovery, plant-based nutrition to me is pure gold. So, thank you for spreading the word. Thank you for doing what you do. Thank you for Podcasting. Thank you for being active on social media. Thank you for being a conduit for evidence-based information, because there are millions of people around the planet searching for it.

And thanks for taking the time to be here with me today, to educate our audience about your personal experience, your perspective, and your educational background about what you know to be extremely effective for disease prevention and reversal. I personally appreciate everything that you do, and keep up the good work, and we will certainly see you next time.

Ian Cramer: Very good. Thank you, Cyrus. Take care.

Cyrus Khambatta, PhD: We hope you enjoyed this episode, and can apply some of these principles to your personal life. Now, we have an Online Group Coaching Program that has helped thousands of people living with all forms of diabetes, reverse insulin resistance, drop their A1c, lose weight, and gain tons of energy. And also reduce their need for oral medication and insulin using, their food as medicine.

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About the author 

Cyrus Khambatta, PhD and Robby Barbaro, MPH

Cyrus Khambatta, PhD, and Robby Barbaro, MPH are the coauthors of the New York Times bestselling book Mastering Diabetes: The Revolutionary Method to Reverse Insulin Resistance Permanently in Type 1, Type 1.5, Type 2, Prediabetes, and Gestational Diabetes. They are the cofounders of Mastering Diabetes, a coaching platform that teaches people how to reverse insulin resistance via low-fat, plant-based, whole-food nutrition. Cyrus has been living with type 1 diabetes since 2002, and has an undergraduate degree from Stanford University and a PhD in Nutritional Biochemistry from UC Berkeley. Robby was diagnosed with type 1 diabetes in 2000, and has been living a plant-based lifestyle since 2006. He worked at Forks Over Knives for 6 years, and earned a Master’s in Public Health in 2019.