Thursday, August 15, 2013

Yet Another Piece of Mistaken Dietary Advice

I thought it might be beneficial for everyone to say something about a problem that we may have finally figured out.

I've always had a bit of a problem with muscle cramps, especially in my toes and legs.

This has become more pronounced, and frequent, since going into ketosis.

We've tried supplements of magnesium, potassium, etc. You know, the usual suspects for muscle cramps, and nothing helped. As a matter of fact, the potassium actually seemed to make it worse.

Then Kristen saw something in a blog post by Peter Attia that suggested the problem was actually another bad piece of dietary advice that I've followed ever since I was told I had high blood pressure (hypertension).

It's actually in the comments

I will write about this in much more detail in the future, but I can say the two biggest mistakes I was making were: 1) I was eating too much protein (north of 200 gm/day), and 2) I was not supplementing enough sodium. There are many other little nuances I’ve learned since, but once I fixed those two, within 3 days I was humming along. I haven’t looked back since.

We knew that excess protein wasn't the problem, as we've been carefully limiting my protein intake, as well as carbohydrates, but salt deficiency? Yeah.

I've become so used to not salting anything at all, because I was told that salt causes high blood pressure, that I was massively deficient in salt.

The reason that it got so much worse when I into ketosis was apparently twofold. From the book The Art and Science of Low Carbohydrate Performance, chapter 9, the first two bullet points.

  • Low carbohydrate diets increase the loss of sodium and water by the kidneys.
  • Failure to adequately replace sodium adversely affects potassium balance and has several negative effects (e.g., fatigue, fainting, headache, loss of lean mass).
  • The easiest solution is to consume an extra 1-2 grams of sodium per day in the form of 2 bouillon cubes (or home-made broth).
  • Most muscle cramps are due to magnesium depletion in cells.
  • Adequate magnesium intake helps prevent cramps.
  • A 20 day course of slow-release magnesium supplementation effectively treats most muscle cramps.
  • Dietary magnesium and potassium (as well as other micronutrients) can be increased by appropriate preparation of meats and vegetables.
Excerpt From: Volek, Jeff. “The Art and Science of Low Carbohydrate Performance.” Beyond Obesity LLC

The hard part has been that I've mistakenly trained myself to eat low salt. Thanks again to yet another piece of conventional wisdom dietary advice that is so completely off base it's not funny.

This change has made all the difference in the world. And, now that I have a better idea of what's going on, any time I start having cramps, especially in my toes, I go dissolve a quarter tsp or so of salt in water and just drink it! It has made all the difference in the world.

As they say though, your mileage may vary. I have to say though, that since I've lowered my carbohydrate intake, my blood pressure has never been better.

Salt ... HAH! Talk about being off base. And since increasing my salt intake to eliminate cramps, hasn't budged up in the slightest, so, a big raspberry to conventional wisdom of lowering salt intake to lower blood pressure.



  1. Awesome insight. I started taking salt about 8 months ago or so. Please allow me to make a recommendation. I ground out a half teaspoon or so of himalayan seasalt into a glass of water every morning. I wake up, drink a glass of this, which is usually about 30 minutes or so before eating. That's a good thing, not particularly good for digestion to pound too much water before eating.

    I ran out of seasalt literally two days ago and whether it's psychosomatic or not, I have cramps in my feet. Nice blog.

    1. Thank you.

      I have actually been adding about 1/2 tsp. to my Camelbak (750ml) every morning when I fill it, just to make sure I'm getting enough. I generally finish this off sometime before lunch.

      Except for coffee with cream, that's about all I get before lunch.

      The muscle cramps have definitely gone away.