Fast Physiology with Dr. Phil: Magic Bullets and Marginal Gains, what actually works?

Summary
In this episode of Fast Physiology, Dave and Phil discuss ergogenic aids or performance-enhancing substances. They cover various types of aids, including caffeine, beetroot juice, sodium bicarbonate, beta-alanine, and creatine. They emphasize the importance of focusing on the fundamentals of training, nutrition, and recovery before considering the use of supplements. They also touch on the topic of ketones and highlight the lack of clear evidence for their effectiveness. Overall, they recommend prioritizing the big rocks of training and using supplements sparingly.

Takeaways

• Focus on the fundamentals of training, nutrition, and recovery before considering the use of supplements.
• Caffeine, creatine, and beta-alanine may have some benefits for performance, but their effects are individual and should be used in moderation.
• Beetroot juice and sodium bicarbonate may have some positive effects on endurance performance, but the evidence is not conclusive.
• Ketones are expensive and their effectiveness is unclear, so they are not recommended for most athletes.
• Prioritize the big rocks of training and use supplements sparingly.

Transcript

Dave S (00:01.006)
Welcome back to the Training Bible Podcast. I'm your host, Dave Schell, and we are back for another episode of Fast Physiology with Dr. Phil. Phil, thanks for coming again.

Phil Batterson (00:10.215)
Thanks for having me on the show Dave, I appreciate it.

Dave S (00:13.103)
So if you're not up to speed with this, we've been doing fast physiology, which is kind of a mini episode. And we alternate between Phil's podcast, which is Critical Oxygen, and Training Babble. And we just try to pick one aspect of physiology or training and then do a semi deep dive on it. So far we've covered things like VO2 max and FTP and Maximal Electrics, steady state and heat training and altitude.

Today, we're gonna talk about the magic bullets. And when I say magic bullets, we're talking about ergogenic aids or things that you can take that can improve your performance by perhaps modifying or enhancing some aspect of your physiology. So that's my quick explanation of it. How would you explain an ergogenic aid?

Phil Batterson (01:06.02)
Yeah. So I was reading a good meta analysis that was talking about the difference between like a nutritional supplement and an ergogenic aid and a nutritional supplement seems to have some level of like a caloric intake associated with it. So carbohydrates and we'll talk about ketones in a sense of, of maybe being an ergogenic aid, but ketones also provide some level of energy through calories. Um,

Dave S (01:29.742)
Okay.

Phil Batterson (01:32.132)
But it's the difference between something that is going to provide some level of nutrition and something that doesn't necessarily provide nutritional or nutritional benefits, but does modify physiology or could be modifying your physiology to allow you to perform better. And I will say, before we talk about ergogenic aids and supplements and all this other stuff, by and large,

If you're not getting enough sleep, if you're not training properly, if you're not doing like the getting the big rocks out of the way for your training and you're trying to put band -aids on it by taking ergogenic aids, you're really missing the boat. Like you're really missing the target. Don't rely on the supplements, rely on the things that are actually tried and true. Proper training load, proper training load management, stress management, those sorts of things, proper sleep and recovery.

Uh, actual like eating enough. Um, that's one of the best things for your performance and refueling, um, or feeling properly during, during your workouts. And I know there's a few other ones probably, but, um, I would say that if you're looking at like a pyramid of, you know, like, like what's the most important to least important on the bottom, actually probably like the, the top two thirds is probably like all of those big things. And then at the very, very tippy top, right. Are your supplements. So.

Dave S (02:52.172)
Right.

Phil Batterson (02:57.119)
That's what I think.

Dave S (02:58.573)
Yeah, and I agree. And I just want to clarify something, just hearing you talk about it, that ergogenic aids, it sounds like something you ingest, but could it also extend to things like, I know there's some lotions and stuff out there that you rub on your legs. So would you include those under ergogenic aids? And if not, then we're going to throw those in anyway, because I want to talk about them.

Phil Batterson (03:20.125)
Yeah, I would say I would say ergo denikade is really anything that you're trying to consume, put on your body. It could be an injection, which I know those are actually illegal in terms of, you know, like, like, like sanctioned sporting events and stuff. But it's just worth mentioning. So yeah, it could be it could be anything like the the the application method of it doesn't just have to be consuming.

Dave S (03:37.516)
Yeah.

Dave S (03:50.252)
Cool. So let's jump into this because I think we're going to have quite a few and we want to spend a little bit of time on each one. So I think probably the most common and one of the most well researched is caffeine. That's one that definitely works. However, I think there's some caveats that maybe people don't understand. It's like the right circumstances have to be in place for it to be effective in enhancing performance.

Phil Batterson (04:04.667)
Mm -hmm.

Phil Batterson (04:20.027)
Yeah, absolutely. I think, uh, one of the things that, uh, people, well, for caffeine to really work, you have to take enough of it. That's, I think that's like the, the number one thing. And I can't remember exactly what the, what the amounts are. And there's, there are limitations to how much you can actually take in and use in a racing situation. Um, but I think anywhere from three to five milligrams per kilogram of body weight.

uh, is, is kind of like the, the quote unquote sweet spot for, for gaining the benefits of caffeine. And I think from what I've read, the benefits of caffeine seem to lower ratings of perceived exertion. There is an increase in a lipolysis or breakdown of fat. So you actually get higher fat oxidation rates when you consume caffeine. Um, and then you just have a greater ability for maximal force output as well.

And that seems to be mediated by caffeine's ability to actually release more calcium within your muscles. Yeah, so that's pretty cool that somehow caffeine is triggering more calcium release, which then results in higher force outputs because calcium kind of triggers the ability to actually create myosin actin cross bridges and then force contraction from there.

Dave S (05:22.54)
Oh, interesting.

Dave S (05:41.644)
Now, my understanding too with it to be effective, at least in the studies I read, and it's been a long time.

People can't have been habituated. They can't be habitual coffee drinkers or caffeine drinkers because then they're not gonna like, or they might get a much lesser impact.

Phil Batterson (06:00.792)
I am not 100 % sure on that because there's now other studies, one of one that I was actually a part of during my master's degree that was looking at it was a it was a really niche sort of topic of kind of like simulated hemorrhagic shock. So like if a soldier or somebody had their leg like taken off and they were bleeding out.

there was no difference between habituated caffeine users and caffeine users on their ability to tolerate something like that. So there is a lot of caution in the literature about like habituated caffeine users versus non habituated caffeine users. And I would say if you're somebody who is non habituated caffeine user, then well on you.

If I had to take any, if I had to take the amounts that they were giving to people in these studies, the three to three to five milligrams per kilogram of body weight, my head would probably explode and I would be an anxious mess. So, so there there's that aspect of it. And I also think that I think to some extent, right, you know, being a little bit lower on the caffeine side and then bumping it up is going to confirm more benefits.

Dave S (07:25.259)
Yeah.

Phil Batterson (07:26.263)
But I think that, you know, it's again, it's kind of, it's perhaps splitting hairs in terms of like the differences. It's not like, oh, if you're a habituated caffeine user, you're not gonna get any effect. You're still gonna probably get some effect if you raise the amount that you're actually in taking.

Dave S (07:43.819)
Okay, so I guess that's a distinction there. I just, I know that I raced with people in the past and for like two to three weeks before they raced, they'd like try going off caffeine and then the morning of they're like pounding it, you know? And yeah, so.

Phil Batterson (07:55.575)
Yeah. But I also, I also think too, so there's a, there's another challenge that you have with, uh, too much calcium release within the muscle. So there seems to be a threshold for calcium release. If you, if you just release all your caffeine or sorry, all your calcium right away, there seems to be a disbalance or dysregulation and then calcium reuptake and the ability to signal over time.

So if you just dump all of your calcium based on too much caffeine intake right away, then you actually accelerate fatigue and then it takes you longer to recover from that fatigue afterwards. So that's always something that I've cautioned people like who are racing. I say, hey, it's okay to drink your morning cup of coffee because that's like just normal for you. But then try to avoid.

Dave S (08:33.195)
Interesting.

Phil Batterson (08:47.735)
like gels that have caffeine in them until later on in the race. Like if you're doing an Ironman or a longer race, because we essentially want to use that caffeine to ring the pieces of the muscle that hold the calcium out a little further. So then we can eke out a little bit more contraction later on in the race when we're actually getting tired.

Dave S (09:01.547)
Interesting.

Dave S (09:06.795)
That's really interesting. I have a guy that, uh, race Ludville mountain bike race last year. And that's one of the strategies we tried is like, wait for the caffeine until later in the race. I was thinking about it more from like a mental standpoint, but there's actually a physical physiological reason that you would do that too, which is interesting. But he, he said he felt way better and that like is a winning strategy and he kind of like changed the way that he handles it going forward so that you, you know, like you said, like wait till later in the race and.

Phil Batterson (09:20.535)
That too.

Dave S (09:36.939)
than have that. So that one's well established. I think another one that's pretty well established is a beetroot juice, but more specifically what's in the beetroot juice. So tell us about that one.

Phil Batterson (09:38.135)
Mm -hmm.

Phil Batterson (09:49.783)
Yeah. So, so beetroot juice, the, the active ingredient are nitrates and nitrates are.

important for activation of capillaries to be able to distribute blood flow into the muscle and those sorts of things. Um, there's some evidence to suggest that increases in nitrate allow for sparing of oxygen. So you actually become quote unquote more efficient, uh, for a, a certain power output. Um, it's what's interesting is, is that you say that nitrate is fairly well established. And I would say that it's, it's highly dependent on, on who you're looking at and.

how much dose you're giving them because there's some people, and this is probably the same with every supplement out there is there's responders, there's non responders, and then there's negative responders like caffeine. I like speaking from experience, if I take too much caffeine, like I'm a wreck, like I feel just like a jittery mess and it's just absolutely awful. So it's the same thing with with beetroot juice or nitrates. One thing that is super interesting is that if you don't have

Dave S (10:38.507)
Mm -hmm.

Phil Batterson (10:57.453)
the bacteria in your mouth that actually converts nitrate to, I believe it's nitrate, but somebody can correct me if I'm wrong there. It's just a different, you know, step in nitric oxide, because that's what you're trying to get is more nitric oxide. If you don't have the bacteria that starts converting that in your mouth, because you do too much mouthwash, or you do other things like that, then you actually don't get any benefit from ingesting beetroot juice.

Uh, it's the same thing. Like, like beetroot juice is touted as like lowering blood pressure, but it doesn't work with people who don't have that bacteria that's, that's available. Um, so, so that's a caution to be had. If you are going to be taking beetroot juice, I would highly recommend probably not, uh, you know, switching with mouth, mouthwash or other antiseptics in your mouth. Um, you can still brush your teeth obviously, but, uh, if you want to get full advantage of, of the actual beetroot juice, then you.

you got to try to actually avoid that. And another interesting thing is that females might be differently affected by beetroot juice ingestion compared to males. In males, it seems to improve endurance capacity, whereas caffeine is a little bit more on like the, it's RPE endurance capacity and a little bit more of that high end power. Beetroot juice is just more of that lower end endurance sort of power.

But in females, because females have a more slow twitch endurance style phenotype, they actually, it doesn't seem like they're as positively affected compared to males. Obviously that's highly inter individual. Like you were saying, Dave, you know somebody who every time they took it there, they felt super weird because their blood pressure dropped a ton, probably because they were just like, like vasodilating everything.

Dave S (12:46.763)
Yeah.

Phil Batterson (12:51.565)
and then not able to really maintain mean arterial pressure. So, again, it's like highly inter -individual, but there is some good evidence to suggest that it may have a positive effect.

Dave S (13:08.491)
Okay. Now, this one I think is related, and I'm not even sure what the science behind it is or if you've read anything on it, but there's, um... I don't even know if it's still around, but at least, like, three to five years ago, there was, like, PR lotion, or I think they changed the name once, but it was essentially like this lotion that you would rub on your legs, and it was supposed to either help with lactate or lactic acid, or something. I can't even remember what it was. But to me, it just seemed crazy, like, how much...

would you have to actually rub on your legs for it to have any impact at what's subcutaneous, you know?

Phil Batterson (13:43.939)
Oh yeah. No, I have no, I have no idea. And it's probably a reason why they're not around anymore because you know, people found it to be snake oil, but I will say that there are ways of increasing your buffering capacity. And one of those is sodium bicarbonate. So, you know, you have like the, the, the, the yellow box in your refrigerator, right? It's literally that stuff. And what that has been shown to do as long as you don't overdo it is it actually allows your.

blood to buffer, uh, hydrogens better. Um, so you essentially, uh, you would take sodium bicarbonate. I don't even know the amount, but, uh, you'd take it a certain amount of time before your race. It would elevate in your blood and then you'd be able to buffer, uh, protons or hydrogens a little bit more readily. Um, the only problem.

Dave S (14:16.811)
Right.

Phil Batterson (14:38.177)
is actually it was outlawed by Wada and Yusada for a little while and I think you can take it now. But if you take too much of it, then you're gonna be leaving streaks everywhere. It is, it, I don't, yeah, I don't really know because I've never really messed around with it. But.

Dave S (14:53.636)
And you have to take a lot, don't you? I thought it was quite a bit.

Phil Batterson (15:03.424)
Yeah, there was some promising studies that were like, Oh, yeah, you know, this is extremely like pretty beneficial to, you know, races that were anywhere between, you know, like 1500 meters to, you know, maybe even shorter to like 3k 5k, sort of sort of benefits for that.

Dave S (15:19.653)
And what do you mean by you're gonna be leaving streaks everywhere?

Phil Batterson (15:22.912)
You're going to have bad stomach issues. That's the yes. No, no, you're not going to be leaving positive streaks on the course. They're only negative ones at this point.

Dave S (15:24.836)
I thought you meant maybe racing stripes or something.

Dave S (15:33.316)
Okay, that's interesting. Yeah, and I'd have to look this up, but I want to say it was like several tablespoons or something, but it was like it sounded like more the baking soda than I would want it in just

Phil Batterson (15:46.496)
Yeah. And it's, it is interesting because it definitely does show positive effects, you know, for, for individuals. Um, but it's, it's, it's again, it's one of those things where it's like, I don't think it's necessarily worth it because it's really hard to actually practice with it. Um, I mean, you could like, you know, practice before simulated longer runs or other things like that. Um, another way that you can actually improve your buffering capacity is by using beta Alanine.

Um, beta alanine is really common in pre -workout supplements. Um, like, so like the powders that people, you know, like that all the gym bros have. Um, but there's a reason why beta alanine is pretty much in every single one. And if you take it for extended periods of time and you take enough of it, I think it's like, it's quite, it's quite a lot. It's like between three to six grams of it as like a dose.

It increases the carnosine within your muscles. And then the carnosine actually acts as a buffer within the muscles. So it's going to be scavenging, um, protons and allowing for less. Acidity to be building up the muscle, especially during high intensity exercise. So, um, so those are, those are other ones that have been shown to help improve a high intensity exercise. Um, and then the last one I want to touch on.

is creatine. And I know that a lot of endurance athletes are like, like greatly against creatine because they're like, Oh my gosh, creatine is going to make me gain weight because there is a correlation with more held water with creatine supplementation. And that increased weight is then going to, you know, make it harder for you to run and stuff like that. There's research out there that is looked at ingestion of creatine and

There is no negative effects of creatine ingestion on endurance performance. So, so from the research, there seems to be no negative effects. If anything, there might be slight positive effects for again, high intensity stuff. Um, but overall it's probably, you know, it's like, you're not going to take creatine and all of a sudden be, you know, go from like a 20 minute, five K runner to a 15 minute, five K runner. If anything, you're just going to be a 20 minute, five K runner still.

Phil Batterson (18:06.713)
Um, so I would say creatine is, is probably one of those things that's not going to help you with endurance, but it's, there is a reason why it's one of the most studied supplements on the market. There's a lot of other benefits. If you are low in creatine, um, that are just going to help potentially help you stay healthier, uh, for longer. So I would say if anything, um, if you are going to take any sort of supplement, getting a good sourced creatine.

Dave S (18:28.324)
interesting.

Phil Batterson (18:36.664)
Um, could be actually beneficial, um, especially if you're somebody who, you know, wax on their protein quite a bit, um, because there's some evidence to suggest that people with low protein load have lower creatine and it actually helps cognitively. Um, if you, if you supplement with it.

Dave S (18:58.501)
Oh, then I could use some of that. Yeah. Yeah, exactly. So just to follow up question on that, with the water retention, I feel like at one point, like one of the big concerns, so you said there's no detriment to endurance performance or maybe no benefit, but I also thought that it could be harder or hard on your kidneys.

Phil Batterson (19:00.183)
Yeah, especially right now, right? You're saying how tired you are.

Dave S (19:26.02)
and lead to dehydration or something because there is the water retention and so like is that false?

Phil Batterson (19:31.767)
that that's probably based off of, you know, people who are like, Oh, if five grams of creatine is good, 20 grams is going to be better. Just like just like with with too much protein, right, you can you can get issues. But that's because people are like, Oh, if one to two grams per kilogram of body weight is good, then four to five grams per kilogram of body weight is going to be better. It's

Dave S (19:42.244)
Yeah.

Phil Batterson (20:00.694)
it a lot of I think these myths come from people who, you know, unfortunately overdo it. And then it just gives kind of like a bad reputation to everybody else. What's really happening is that because creatine requires water to be, you know, kind of stored in your muscle for easy ATP resynthesis, it just pulls more water into your muscle. So it's not like

you're just having like bad water retention because of inflammation and stuff. You're actually pulling more water into your muscles because of the differences in um, creating, just having to have water around for it to exist.

Dave S (20:40.674)
Now the last one I want to touch on, because I feel like it's a flavor of the moment, and maybe not as much now, but it definitely was like last year, is ketones or ketone bodies. Yeah, I guess my take is that essentially that it's not really clear if there's an effect and...

Phil Batterson (20:46.422)
Oh yeah.

Dave S (21:05.762)
in order to get that effect you have to take a lot and it's really expensive and so for most people it's just not worth it. What's your take on it?

Phil Batterson (21:13.748)
Oh, no, that's exactly, that's exactly how I think of it. And I think Jason Coop did a really, really good summary of this. He said, you know, there was like, there was a study that came out that, you know, some individual took like an absurd amount, like 30 grams per hour of ketones during like a, like a trail marathon or something along those lines. And for any of you who are familiar with how many ketones are in like one bottle, one bottle costs like seven to $10. So they're essentially spending.

$30 per hour to intake ketones for the course of their race. So a races are already expensive in terms of the time investment and the money investment and all of that. And then you're adding on, you know, hundreds of dollars in ketones. But you know what's also really good for performance and maintaining, you know, or reducing issues related to inflammation after long races, intake of carbohydrates.

like, and we know that high intake of carbohydrates is is actually beneficial. Like, I think what they were looking at in this study was something along the lines of like cognitive decline, and they showed less cognitive decline with ketone supplementation rather than not. But if you're taking in enough carbohydrates, then you're also going to reduce cognitive decline, you're going to reduce recovery time, you know, following these races and those sort of things. So we know that carbohydrates are good. And

are beneficial to endurance performance. Ketones are still a little bit lacking. They taste awful and they're expensive. So like, I don't really recommend them to many people if any. Just just for that reason is it's just kind of, it was touted as this like super fuel and other things like that, because it's like, quote unquote, more efficient to burn ketones or something. And I think that was also based off of kind of like BS science.

Dave S (22:56.417)
Yeah.

Phil Batterson (23:11.823)
But carbohydrates have actually been shown in numerous studies to be beneficial.

Dave S (23:18.656)
and way more affordable, cost effective, yeah.

Phil Batterson (23:21.487)
Yeah. Yeah. You can eat gummy bears and you can probably get a 10 pound bag of Haribo gummy bears, not the sugar free kind, the sugar kind, um, for like 20 bucks. So it's yeah.

Dave S (23:32.8)
Yeah, exactly. So what are your takeaways for this episode on performance enhancing drugs?

Phil Batterson (23:39.79)
Yeah. Well, we didn't even talk about EPO, which is, uh, I think like the biggest one, but, um, we can, we can touch on that at some other point, but I would say that for ergogenic AIDS, um, you know, if you're, if you're trying to use them as a bandaid to get, to get better performance, you're better off doing, um, the, doing the big rocks, focusing on your training, your recovery, your nutrition. Um, if you are going to take some level of supplement, uh,

Dave S (23:44.353)
Yeah.

Phil Batterson (24:07.468)
what seems to be the best is caffeine, creatine from like a more of a lifestyle perspective, if you're kind of lacking in that. And then, you know, something along the lines of like beta alanine, bicarbonate or beetroot juice could move the needle just a little bit, but those are, those are even kind of on like the questionable at best sort of side. And there, those also can kind of get a little bit expensive too. So I would say,

you know, focus on the big rocks. That's gonna get you way more bang for your buck.

Dave S (24:43.039)
Yeah. And I think that's, those are all a great takeaways. I would say my takeaway is most of it is snake oil. If it wasn't, then everybody be using it or it would be illegal. And so, like you said, it's like caffeine, I think is effective. And especially like for me late in a race, I'd love to have a Coke like waiting for me. And it's like just that last push home. Um, so that can both psychologically, but also, um,

Phil Batterson (25:04.075)
Mm -hmm.

Dave S (25:13.022)
Physically, and I guess one thing we didn't talk about too was the placebo effect and so that might be another episode but yeah, I think like you said just focus on your training first and doing all the big things, right and then add these proven things to Maybe get that last little bit of the nudge All right, so Again, this has been an episode of fast physiology

Phil Batterson (25:19.115)
Yeah.

Phil Batterson (25:34.731)
Yep, absolutely.

Dave S (25:40.35)
We're alternating episodes, so we do one week on Training Babble and the other on Critical Oxygen Podcast, which you can find on Spotify or wherever you find your podcast. And you can also find Phil at criticaloxygen .com.

Phil Batterson (25:53.256)
Mm -hmm. And critical02 on Instagram. That's actually where I typically talk to most people. So head over there and ask me questions if you have them.

Dave S (26:00.51)
There you go, yeah, we would love to hear what questions you have and help inform future episodes. So thanks for your time and look forward to doing it again.

Phil Batterson (26:09.191)
Thanks for having me, Dave.