Yesterday, I featured Part 1 of this interview with Rick Cohen, MD, the president and founder of Bioletics. Today, we pick up where we left off.
EC: Please tell us about the tests you use to determine mineral levels. For what specific minerals are you testing, and what are some of the common findings you’re seeing that can make a big difference in how someone feels and performs?
RC: Our daily diet must contain adequate amount of macro minerals, which are necessary for all biochemical processes in the human body. These minerals include calcium, chloride, magnesium, phosphorus, potassium, sulfur and sodium. Among these, the most important are calcium and magnesium. Calcium helps to neutralize acidity, clear toxins and build bones; it also increases alkalinity and muscular flexibility. And while calcium receives a lot of media attention, the true king of all minerals is magnesium.
Magnesium is not only the single most important mineral in sports nutrition, but it is also one of the most critical elements in our body. About 350 enzymatic functions depend on magnesium, including ATP, the key factor that creates energy for every cell. Optimal magnesium levels enhance athletic endurance and strength by increasing metabolic efficiency. Magnesium promotes muscular contractility, decreases oxygen consumption, and improves cardiovascular efficiency.
Unfortunately, magnesium deficiency is very common. Inadequate dietary intake, sweat loss, physical and psychological stress and acidic beverages-such as energy drinks and sodas-cause the body to extract both magnesium and calcium from the bones and tissues in an effort to maintain proper blood pH. This combination of mineral loss and acidity in the body will decrease athletic performance and prolong recovery. It will also increase bone turnover and the resulting risk of stress fractures. This is exactly what we were seeing in younger female athletes with accelerated bone loss.
Despite magnesium’s pivotal role in energy production and muscular health, many athletes are completely unaware of its critical importance. Part of the problem is that there is not an easy or inexpensive test available for intracellular magnesium levels. While it may seem easy enough to assess levels of minerals - especially of magnesium and calcium in the blood - it’s not.
We have overcome this problem by using a functional marker of mineral balance called NTx. Bones are living tissues that are constantly breaking down and rebuilding. When they break down faster than they can rebuild, the body excretes increased amounts of NTx. While NTx is not specific indicator of low magnesium, it tells us when an athlete has an intracellular calcium/magnesium imbalance as well as poor amino acid and/or vitamin D status.
EC: What’s your take on the most effective way to combat a magnesium deficiency that’s discovered?
RC: That’s where the other issue with magnesium comes into play: oral supplements work slowly; it can take more than a year to adequately restore your levels. In the past, intravenous infusions were considered the most effective way to go. But this was expensive and impractical for most athletes. Based on our research at Bioletics, we have found that the use of a topical magnesium oil spray to be very effective at restoring low magnesium levels after only two to three months of use.
EC: What about the hormonal panel you guys run? What does it include?
RC: As athletes, we want our body to have a positive anabolic to catabolic ratio. In simple terms, anabolism is the process of growth and repair. Your anabolic state is at its highest in your teens. Testosterone is the key anabolic hormone. Catabolism is the process of breakdown and destruction. Your catabolic state is as its highest after injury and illness, and increases as we age. Cortisol is the key catabolic hormone. By measuring your saliva, it is possible to create a snapshot of both an athlete’s testosterone and cortisol balance as well as their anabolic/catabolic status. Unfortunately, we frequently find low T/C ratios in athletes.
Testosterone is an important health and performance hormone-for both men and women. It plays a key role in directing muscle growth and repair; it is what enables the body to generate optimal power and recover fully after such a hard effort. Testosterone contributes to an athlete’s ability to stay focused, motivated and positive. A premature decline in testosterone levels can be attributed to a number of different factors: poor diet, lack of sleep, excess body fat, nutritional deficiencies, environmental estrogens, and/or the use of medications, alcohol, and drugs.
Cortisol is a major steroid hormone produced in the adrenal glands. It allows the body to cope during times of stress. Without proper cortisol response, you will not be able to effectively meet the daily challenges of life. Cortisol levels exhibit a natural rise in the morning and fall at night. If this rhythm is disrupted, the body’s mineral balance, immune response, blood sugar and stress responses will all be negatively affected.
While it is very difficult to reverse the natural age-related decline in testosterone, the effects of stress and training on testosterone can be minimized. Since even “positive” stress can deplete testosterone, those who participate in endurance-related sports are especially at risk for having lower than optimal levels.
Research shows that testosterone levels are temporarily decreased as a result of overtraining, while serum cortisol levels increase. These changes in testosterone to cortisol balance are sometimes disastrous for an athlete, as they lead to elevated resting heart rate, poor performance, slow recovery, sore muscles, poor appetite, lethargy, muscle loss, irritability and a low sex drive.
Periodic assessments of both testosterone and cortisol are important when it comes to uncovering a potential hormonal deficiency or to simply fine tuning your training program.
EC: I’m curious about the essential amino acid test. In particular, I’m wondering if you’re seeing issues in this regard not only in people who don’t consume enough protein, but also in folks who DO eat a lot of protein and for whatever reason don’t utilize it properly.
RC: Of all the Bioletics assessments, the widespread deficiency in essential amino acids was the one that surprised me the most. Almost every athlete knows that they need to eat protein and most athletes supplement their diets with additional protein powders. Yet, 90% of the athletes whose plasma amino acids we’ve tested were essential amino acid deficient.
Essential amino acids are the building blocks of protein. They allow the body to build and maintain muscle, neurotransmitters, hormones and key digestive and metabolic enzymes. Research shows that the lack of just one essential amino acid can significantly interfere with these processes.
What I’ve come to realize is that athletes don’t have a protein need; they have an essential amino acid need. And it’s not how much protein we eat that is critical; it’s the biological value of the protein we eat that counts.
It’s a common belief that one protein is just as effective as another when it comes to rebuilding tissue. But dietary proteins all contain a different mix of the eight essential amino acids we need. Therefore their biological value-their ability to be utilized anabolically by the body-differs.
Research indicates that approximately 40% of the protein in high biological foods such as whole eggs, meat, fish, poultry is used by the body for anabolic purposes. Only about 20% of that found in low biological food such as whey, soy, egg whites, beans and nuts is used for growth and repair. So, vegetarians and those who consume much of their daily protein as a bar or powder should know that these proteins are not well utilized by the body.
And the problem gets even more complicated. Even if you are careful to consume only high quality proteins, you still may not be utilizing them effectively. Stress, age, the use of medications, and/or certain cooking methods can reduce your body’s ability to fully digest the protein you’re eating.
Athletes need to be aware that competition, training, and injury all damage structural proteins. As a result, the athlete’s body naturally requires greater amounts of essential amino acids for repair, recovery, and growth. An amino acid deficiency will prompt the body to break down body tissue-primarily muscle-in an attempt to access the missing essential amino acid(s) it needs.
Because of all these issues, we strongly recommend that all athletes use an essential amino acid supplement formula. These formulas do not require digestion and are almost 100% utilized for anabolic purposes. While many of us have come to rely or believe protein powders will cover our protein needs-and I was one of them-we now understand that protein supplements are just not as effective as we once thought.
EC: Lastly, you’ve just added an essential fatty acid (EFA) panel. What are you looking for on this?
RC: Yes, I’m very excited about this new assessment, as the benefits of optimal essential fatty acid status are numerous and it brings us closer to our goal of being able to conveniently and inexpensively assess EVERY key, biological process in the athletic body.
Essential fatty acids perform many physical functions. No cell, tissue, gland, or organ can function normally without them. Optimal EFA levels are critical to reducing overall inflammation in the body. They help you work harder and recover faster; they protect your joints, improve your mood and promote deeper sleep.
Our EFA status becomes stronger when we eat foods that are similar to those eaten by our primitive ancestors - lean meats, antioxidant-rich fruits and vegetables, and fats with a high omega-3 to omega-6 EFA ratio.
Over the past 50 years, we’ve developed an unfounded fear of healthful fats. And we’ve started over-consuming processed fats. Most Americans consume very little natural omega-3 fats, which can be found in fish, grass-fed meats, seeds and nuts. Instead, we eat processed omega-6 fats: corn, soy, canola, and safflower oil. As a result, we’ve created a very unhealthy omega-3 to omega-6 fat ratio in our bodies. Recent research has shown that this low omega-3 to omega-6 ratio (Omega-3 index) is not only the most powerful marker of inflammation, but the strongest predictor of sudden, cardiac death.
Last year, when Bend suffered the loss of a 39 year-old world class athlete and the cause of his death was attributed to unknown cardiac cause, I became very motivated to find an affordable, at-home EFA assessment for athletes. I am excited to say that we now offer athletes the opportunity to assess inflammatory status and their critical Omega 3 index with just a single drop of blood.
EC: Very cool. Nothing like some cutting-edge stuff to wrap this great interview up! Thanks for taking the time today, Dr. Cohen.
For more information on Dr. Rick Cohen and Bioletics, head over to their websit e. And, don’t forget that they’ve arranged a sweet discount for all EricCressey.com readers. Enter the coupon code ECCPP25 at checkout, and you’ll receive $25 off the cost of your initial basic or complete panel.