Maurten Sodium Bicarb, interview with Dr. Jason Siegler from "Science of Getting Faster" podcast

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00:00

Our buffering agents, such as sodium bicarbonate and sodium citrate, enhancing our performance in previously unrecognized ways. Welcome to the Science of Getting Faster Podcasts, where we cut through the headlines, talk directly to the researchers to find out what their study suggests, what they don't, and where their research is heading.

00:18

My name is Sale Laverty, and with us on the podcast today we have Dr. Jason Siegler. Welcome to the podcast, Dr. Siegler. Hi Sarah. Thanks for having me. Yeah, thanks for coming on. So today we're going to be discussing your research paper, The Hyperhydration Potential of Sodium Bicarbonate and Sodium Citrate.

00:40

Could you start by telling us what is a buffer? Sure. Um, so really, uh, a buffer is something that's naturally produced in the body. Um, we have a number of different ways of producing buffers, uh, that handle a lot of, uh, excess protons or the acid that you might feel that burn, that you might feel during high intensity exercise.

01:05

Our kidneys are responsible for maintaining a certain amount of blood buffering, uh, in the body. Uh, and that's really the focus of a lot of my research, uh, is on that blood buffering capacity. Um, but there's other ways of handling that as well. Uh, you can increase your respiration or decrease your respiration to try to blow off the excess, uh, carbon dioxide.

01:26

Um, those are the two main ways that are, uh, referred to as extra cellular buffering. Uh, we have an intercellular inside the muscle cell, uh, means of buffering as well. There's a couple other ways. Um, you might be familiar with beta aine. That's another supplement that's used to try to mitigate.

01:42

Or reduce the amount of, of acidity that you might be experiencing in the muscle. Okay. And so am I right in saying then we're trying to keep the blood within a certain pH range with these, Is that the function of these buffers? That's that, Sure, sure. So what we're trying to do is, is, is trying to, to keep the self-functioning really.

02:03

So during high intensity exercise, oftentimes, uh, the, the metabolic pathways that are responsible for providing energy to the, to the system or to the body or, um, are oftentimes stressed, right? And so a lot of that stress, uh, results in, in a production of this excess acid. And so that acid has to be removed from the muscle.

02:26

And one of the ways it's, uh, facilitated out is through, uh, the means of buffering and, and being tracked it out and picked up by this flood by carpet. And so that, Response is, is, is, is that is exactly what you're trying to, to explain there, and that's to try to maintain our, our body's pH or just keep us in a homeostasis.

02:48

Okay, That's helpful. So I'm aware that chemistry might intimidate some of our listeners, , perhaps me include . Um, but I do think it would be helpful to understand how does that happen? How does our blood become more acidic during exercise? So it's, it's, it's basically a function of, of protons and cat or cat ions and, and, uh, an ions.

03:13

Um, so you've got your pluses and minuses, the charge associated with that, and that will increase or decrease the blood acidity levels. And so we just try to maintain a, a balance between, um, what, where the body normally sits at, around 7.4 in terms of blood pH. Uh, and then during exercise, obviously with you, we have that excess acidity that's coming out of the muscle.

03:35

And so what we try to do is try to balance that and try to try to get that blood pH back up to around 7.4. So we can do that. Um, sometimes it takes a little bit longer. It depends on, on how long you're exercising for, how long, how intense the exercise is, uh, and that that will dictate how, how quickly you're able to recover and able to return to the pH of, uh, of what the body is normally, uh, expecting to be at around 7.4.

04:00

Okay. And can we train that capacity, um, or buffering capacity? Good question. . Um, certainly, uh, there have been a few studies that have shown muscle buffering capacity to be improved with training. Um, the blood itself, uh, probably stays around the same regardless of your trained status. So, you know, you and I will sitting in the room whether I'm not training and you are training, we're probably gonna sit at the same around in terms of blood buffering capacity.

04:30

We'll probably sit at around the same level. Um, but so that part really doesn't get trained so much. Uh, diet can influence it a little bit, not so much, but diet can influence it a little bit. Um, but really it's the, the muscle blood buffer, or mu excuse me, the muscle buffering capacity that, that, that can be trained to an extent.

04:51

Um, but yeah, so that not so much the target of, of something like sodium by carbon and a sodium citrate, a couple of the buffers that we use, uh, to mitigate that acidity level, so that, that's slightly different to that. Um, more focused really on the training capacity and the training adaptations associated with the muscle that can improve that muscle buffering capacity.

05:12

So that first line of defense, if you. And how do we train that? Is there a specific session That's a whole nother podcast. Probably . Oh, OK. . Okay. No, I think it's, it's really just dependent upon, uh, the individual and, and sort of the training load, um, or, or block that you're, that you're undertaking at any given time.

05:34

Really it's about, you know, looking at trying to increase that anaerobic capacity or, um, improve your, something like your lactate threshold or working above threshold or in certain zones that sort of sit you above critical power. Those kinds of, um, those kind of, uh, threshold markers or indices really.

05:52

Um, and it's kind of yo-yoing back and forth. I think any, any number of different training strategies can work to improve muscle buffering capacity, but really it's, it's probably related to making sure, or ensuring that you're stressing the muscles sufficient. Uh, above what it's sort of normally able to, to, um, or what it's normally able to, to, to handle in terms of acidity coming out of the muscle and metabolic demand.

06:16

Uh, and so that, yeah, so I guess there's, there's a whole host of ways of doing that, for sure. Yeah, definitely. How long, without supplementing with sodium bicarbonate or sodium stitch rate, how long does it take for our muscles or our blood to get back to that more, um, that physiological range where we're trying to, um, get back to? How long does that take? So I guess it, it depends on, on how long you're, you're exercising for.

06:46

So I guess in a normal, um, really highly stressful bout, you know, you can probably go for anywhere between 2, 3, 4, maybe even five minutes, as, you know, at sort of a, uh, if you're at a C level, in a C level environment, um, uh, at. Sort of an all out pace, right? So once you reach that limit, and again, that will be dictated by your training status, how your muscles are coping with that increased metabolic demand, uh, once you reach that sort of state, um, the amount of, well, not just acidity, there's a whole host of other factors that are involved in fatigue

07:25

or muscle fatigue, but, uh, the acidity level is just one contributing factor. Um, but once you reach a certain point, um, you know, you, your body will, will pretty much tell you when to stop. And once you, once you reach that point, whether it's two minutes or four minutes, or five minutes, maybe even seven minutes, depending on who you are.

07:45

If you've gone to, to extreme levels and you've got, and you've really exhausted the system, and it, it can take, uh, anywhere from probably, well, I'd say five to 10 minutes for the blood pH to recover. And that doesn't mean that, um, your muscle function is recovering. Uh, it just means that your body is come back to at least a level, uh, that's sort of commensurate with before the state that it was at, before the exercise.

08:10

So in terms of, of blood acidity, uh, there's all sorts of mechanical issues that can come about with, with stressing the system to an extent, uh, like this or, or, or really stressing the, the, the system to its anaerobic capacity. But in terms of blood pH recovering, we usually see it recovering, um, probably by about 15 minutes as long as you're just sitting, sitting still and recovering.

08:39

Okay, You're blood by carbonate, which is that buffering mechanism that, that we refer to. Um, that, that takes about, yeah. 15 minutes I'd say, or so, 15, 20 minutes to come back. Okay. So looking at your blood by carbonate and your pH levels, that would give you an indication as to whether you've recovered or whether you're, how sate your muscles are? I think so.

09:06

I mean, it's one indication, right? I think, you know, really to look at, at, at how well your muscles are recovering, you can do a lot functionally and just measure the functional, uh, return to, to baseline that. Um, you know, in terms of, you know, there's other ways of looking at neuromuscular function or, or even strength or strength recovery or power recovery.

09:27

Um, so that may be a pretty good gauge. Um, you know, measuring just, just measuring the blood. I, I probably wouldn't lean towards using that as a gauge of recovery necessarily. It's just a reflection of what's going on metabolically, I think is probably a better indicator. Um, yeah. Okay. And you mentioned how foods can interact with someone's buffering capacity household.

09:54

Yeah, I should, I mean, to a, to a, to a, to a small extent . I shouldn't get too far down the rabbit hole here, but, um, a lot of times when we measure, uh, baseline blood by carbon at or baseline pH in the lab, uh, uh, if our, if our participants are, are heavily into the protein side of things, sometimes they're slightly more acidic.

10:19

Um, nothing that I would quantify or qualify as being, um, you know, significant, but it, you, you do see a slightly, uh, decreased or more acidic, uh, pH. But again, you know, once, I don't think that has anything, any real impact on, on performance, uh, per se. I know that, um, there has been some work done on food substances, like, uh, alkaline greens.

10:45

We've done a little bit of work in that space, not a whole lot, um, and haven't seen a lot change in the blood, uh, in terms of, of, of those food products, you know, resulting in some kind of, at least acutely changing in the blood. So, your body's pretty good at regulating pH and, and certainly the, the blood buffering capacity and, and keeps it pretty, pretty clean.

11:09

So it might have a, an implication on your research, but doesn't have much of a practical application. I think more anecdotally is how we've noticed it. I, you know, over the years you've probably been in this field for about 15 to 16, 17 years of looking at, um, blood buffering capacity. And I, I, I guess I, I would say I've just noticed it, um, rather than, you know, look at, looked at it specifically.

11:33

Definitely. So we were describing there the natural buffering system, so that explains why we might, uh, use some supplements to buffer. Um, Sure. What is the purpose then of supplementing with those buffering agents? So, um, I mentioned the blood buffering capacity and, and your body, uh, regulates that quite tightly.

11:58

And so you'll sit at around 25 millis per liter. Um, most people will sit at around 25 milli milli, uh, millis per liter. In terms of the, the measured amount of bicarbonate in the blood. Um, so the idea really is that that blood bicarbonate helps draw out those protons or that acidity out of the muscle.

12:20

So it detracts, it grabs hold of it, brings it up, and you're able to blow it off as carbon dioxide. Um, and so the idea behind it basically is that if we can increase that, Then potentially we can exercise for longer, right? So we can keep facilitating those protons coming out of the cell, maybe keep metabolic function, uh, going for a little bit longer, drawing those protons out, blowing those that carbon dioxide off, uh, for a little bit longer period of time.

12:48

So, so basically the, the theory behind it is you're able to exercise for longer at that given intensity. So at a really high intensity or a really high rate. Um, when you ingest studying bicarbonate, um, at the levels that we typically do at around 0.

13:12

3 grams per kilogram body weight, we generally see, uh, around a seven to eight milli increase in the blood. Uh, and that increase will, uh, it, you know, it could, it can occur quite rapidly depending on whether or not you're in a fed or a fasted. Uh, we can see increases, uh, upwards of within 20 to 30 minutes if in a fasted state, uh, in a fed state probably takes a little bit longer to get through the gut, but generally we see the same sort of peak responses at around, uh, between five to seven millimoles per liter.

13:43

And so basically what you have is you have a, a larger tank, right, to handle that acidity that's coming out of the muscle. And so in theory, you're able to handle more of that acidity and exercise for longer. So that's, that's sort of the premise behind it. And, um, blood by carbonate is relatively easy to measure in the blood.

14:03

Uh, and so we're able to track hit quite quickly. And so we do have, we can verify that our blood by carbonate levels are increased. Um, whether or not that direct increase is, is, is a direct result, uh, of increased performance that's been measured is, is I guess, a little bit debatable, but, um, That's the premise behind it.

14:26

Yeah. You mentioned, uh, very high intensity. Mm-hmm. , what are we talking there? How high are you talking? Yeah. Yeah. I'd say probably 110, 120% of vo, two max maybe. Um, so really, really maximal efforts, um, that can be sustained for, like I said, a period of probably two to, to seven to eight minutes.

14:47

So a typical exercise bout that we would use in the lab might be a two k, uh, rowing or time trial that's, that sort of falls within that window. Or you've seen a lot of research in the space of 18 or 800 meters to, to 1600 meter races. Uh, those kinds of sustained anaerobic pushes that, that really require the body to function at a really high level, uh, and, and really push yourself to the limit.

15:17

So, you know, the use of sodium bicarbonate is probably, I guess, probably something that we should talk about , because, you know, the, you're talking about very, very small margins of, of performance improvement, right? So one of the reasons why it's not very widely used is because it does come with some side effects, uh, or it, it traditionally has come with quite a few side effects or potentially anyways.

15:45

So to mitigate or to reduce those side effects, oftentimes you, you need to be very regimented in how you load. Uh, you need to be very systematic. You need to, to make sure you, you're, you're consuming enough fluid and carbohydrate to try to reduce some of the GI symptoms. And so that becomes probably a two, maybe even a three hour process depending on the person prior to exercise.

16:10

So quite often that will sort of negate the use of sodium bicarbonate, um, or your sort of recreational user. Um, and I, and I would probably argue that it's not necessary for the recreational athlete. I think you really need to consider it if you're, uh, competing at a pretty high level, uh, and you, and you feel as if you're sort of tapping out that anaerobic side of, uh, of your ability before you would consider consuming sodium bicarbonate prior to race, and certainly not prior to a competition, before

16:46

trialing it out, uh, in training because it does come with some side effects. Um, the reason I can explain that real quickly, one of the reasons why it comes with such a, a, a, a high amount of GI stress is because basically you're, you're ingesting a, a, a very, very high amount of sodium. And that big charge, if you will, that gets into your stomach, causes a very big, um, carbon dioxide shift into your stomach.

17:13

And so that is what can cause the cramping, bloating, uh, even diarrhea in some instances, depending on, uh, on the individual really. So symptoms is something that we really look out for and then really work to, to try to reduce. Okay. And what, um, buffering agents are typically used then? You said sodium bicarbonate is there? Yeah, Sodium bicarbonate and sodium CI are probably the most common sodium ci, um, has probably gained a little bit more traction in the literature over the last couple years and I think that's really due to, it doesn't seem

17:48

to cause quite as many, uh, GI issues. Um, but the sodium by Carbonate is probably the most researched in terms of extracellular buffers. I'd say they're, you know, I certainly didn't start start the process, so it was going probably, I, I think the earliest of, of, of trials in terms of exercise performance we're in the mid to late seventies.

18:10

And then it's been really sort of heavily researched ever since, uh, in various contexts. Um, looking at, you know, different ingestion protocols, looking at different usages, um, in terms of, you know, athletic events, certain events, maybe at different applications at altitude or at, or not, or under, under various, uh, different contexts.

18:35

You're raising a lot of questions now and I'm trying to find that to make sure I hold onto them. . That's ok. Sorry. Yeah. So you said, um, between two to eight minutes is when you can sustain that. Mm-hmm. , Yeah. Would it be helpful in, say, a bike racing scenario where you have multiple surges, so, Sure.

18:58

Or is it only beneficial for one? Well, that's a good, that's a good question and something we've thought about looking at in the lab, but really difficult to do. Um, because certainly if you, if you think of the theory behind sodium bicarbonate, right? So it's, it's, it's, it's meant to help sustain high intensity exercise, really.

19:19

Right? And so, exactly what you just said in, in long. Cycling events where there might be a hill or a, or a breakaway or something to that effect. Um, you, I would say certainly you could consider it. Um, one of the things that soybean by carbon, um, will do is when you ingest it at the suggestive levels, it will stay in your blood for, I mean, we've monitored it for 12 to 24 hours before, and it'll stay, it'll keep your blood by carbon elevated for, I'd say significantly elevated into, into what we would,

19:54

would sort of call an orogenic window. I'd say upwards of six hours post before it starts to drop out of that. So, you know, if you think about the context with which you could use it, then that kind of opens up a lot. Right? So if you have a, a road race, right, for example, that may last 2, 3, 4 hours, then you know, there'd be no reason why you wouldn't consider.

20:15

Um, I don't think, um, measuring that in the lab is, is quite difficult and I don't think it's been done. Um, just probably due to the logistics of, of performing a, an extended race, multiple hill climbs, et cetera, repeated by X number of subjects, and my head starts to spin with the amount of time you'd have to spin in the lab to do that in a controlled, in a controlled scenario.

20:40

I, I do, I am aware of, of, of cyclists using it in that context though. Uh, and I have spoken with a few, uh, dieticians and, and sport nutritionists that, that, that do implement that strategy, uh, with some of their distance riders just for the pure fact that, you know, if it is in the blood, if it's there, you know, for them to use and there is a breakaway or there is a hill climb, then potentially, yeah, it could benefit them for.

21:08

Would you expect, uh, the GI symptoms to last as long as the potential orogenic impact that's having? Yeah, no, that's a good point that you raised. I think, um, you know, the GI symptoms, if we do see them, are generally pretty quick. So within the first 10, 15 minutes, uh, but most of the time, by 30, 45 minutes or so, they are reduced to a level that is sort of, um, you know, non significant, I would say.

21:39

And, and, and I, you know, again, going back to the individuality of it that some people can tolerate. A whole lot of soaping by carbon and not have any issues with their, with their GI system. Others really respond poorly to it. And so, you know, you really, this idea of trialing an error or trialing it out and training and, and sort of, you know, uh, non-competitive situations is, is really where you need to start because, um, you know, like I said, we've seen people with that are, it's become symptom limiting and, and others that it doesn't bother.

22:14

And so, on that note, on the, um, on the loading side of things, you know, there's, there's been a, a few papers out that have, that we followed actually, uh, when we use the OR as guidelines for, for loading, um, including a little bit of carbohydrate, about a gram to a gram and a half per kilogram body weight when you start to ingest, uh, or, um, the sodium bicarbonate, uh, along with, you know, about seven to 10 nos of fluid per kilogram body weight and.

22:44

The other thing you can do is stagger the, the ingestion period. So one thing that we used to do in the lab, um, because it's, it was a quick and dirty way to do it, was we would go to the supermarket, buy, buy some sodium by gar or baking soda off the shelf, bring it back to the lab, mix it up with some cordial, about 500 meals of fluid, and then have our participants sug it back within 10 minutes.

23:07

Right? So in a fasted state, So oftentimes that was sort of the, the benchmark for GI disturbance, right? And then we've, we've gotten kinder over the years, but actually, you know, that, that's situation is, is certainly not something that you would, would, uh, introduce to an athlete, right? Or a competitive athlete.

23:26

Right? So, uh, a lot of the work over the years is, is focused on, you know, different intake, um, uh, formats such as pills. So oftentimes, we'll all the time we'll put it in pill form. Now, uh, which obviously can mitigate some of the flavor, uh, the, the issue of flavor or adverse flavor, , when you drink it.

23:47

Um, and then we'll stagger those pills out. So if you, you know, if you're a 70 kilo person, then you, you know, you're probably looking at around 21 grams and we'd break that up into three or four different 15 minute ingestion phases, if you will. Couple that with some carbohydrate and some fluid.

24:06

And, and more often than not, you know, if we've got 90 minutes to, to. To give our, our athletes prior to exercise. The, the symptoms are, are quite low, if, if not, um, really non-existent. So that's one format I know. Now also, there's some empirically coated, uh, pills that go, that bypass the stomach and go straight into the intestine, and that seems to really eliminate, uh, any sort of GI distress.

24:32

Um, yeah, so, so, so there's different strategies to do that. And getting back to your original question is, you know, if you, if you, if you can overcome those symptoms, if you do have symptoms at the beginning, they certainly will be gone, um, by about an hour into it. So if you think about that, then you know, your blood buffering capacity will be elevated for another three or four hours after that as well.

24:54

Um, another strategy that's used, um, a bit is, is topping up. Um, so some athletes will, you know, they'll do an initial load and then, you know, two or three hours in, they'll, they'll take a small amount again. Just to top up that buffering capacity. Um, so that's, that's, that's certainly something that you could consider.

25:14

And that's then you're taking a very low dose that second go around, um, and probably not experiencing any side effects in that case. Got it. Okay. And the differences between sodium citri and sodium bicarbonate are the different mechanisms of action? Yeah. So slightly different mechanisms of action and it, it can get quite complex.

25:35

And sodium citrate, I don't think has really been studied to the extent of sodium by carbonate. By carbonate, we'll change the blood by carbonate levels. In, in that we spoke about earlier, citrate really has, I believe, more of an effect on the plasma positive and negative charges or those cat cata, cat , those positive and negative charges.

25:56

I won't even bother saying that this morning. , um, in the plasma. So there may be it once, once the sodium and the citrate disassociated in the plasma. There, there's more of a, um, a, an effect on what we call the strong eye on difference. Um, and so that, that, that's sort of the theory behind what sodium citrate is doing.

26:13

It also takes a little bit longer for that to occur, for that to change. But yeah, slightly different me. Okay. You mentioned that one of the constituents of both of these buffering agents is salt. Is that what has prompted your, this research question? Yeah. What question did you have? So let me give you a little bit of context behind that, that paper.

26:35

Um, so that study occurred when I was back in Australia, spent 10 years in, in Australia prior to coming back to the states a couple years ago. Um, so that study was, was an arm, if you will, of a much larger multi-center study that was, um, sort of the brainchild of Meg Ross and Louise Burke down in the, at the time they were at the Australian Institute of Sport, very well known sport nutrition dieticians, um, in that space.

27:06

And so what they were looking at was, was revisiting. Hyperhydration guidelines or the substances that the institute or the sporting institutes were using as recommendations for Hyperhydration, uh, leading up to the Tokyo 2020 games. So there was a number of different. Centers or research groups around the country looking at different aspects of, of that, of those hyperhydration strategies.

27:32

So the buffering, uh, study that, that we ended up running along with Amelia car down in Deacon was, was really the only one that looked at using or implementing the, the, the sodium bicarbonate. Sodium citrate into that strategy. And that was something that's relatively novel, uh, a novel piece on, on, on this.

27:53

Um, you know, there's been a few papers out looking at rehydration with, with sodium citrate, but, and I believe one with sodium bicarbonate, but nothing really, um, looking on, on the buffering side of things. And so, so that, um, so the, the actual buffering side is, uh, was the reason why it was included was exactly what you, you mentioned there was because of the sodium that's, that's, that goes along with the, um, the buffers and so, That component.

28:24

There's, there was another arm of the study that, not, not that we ran, but another arm of the study that looked at, at just sodium itself, uh, and some of the other research that's been done. So, so the whole premise was really just kind of revisiting what was, what, what the recommendations were within the institute.

28:41

And that study kind of came out of that. And so basically what we were, we were framing. Uh, research around was, was some of the sodium work that's been done already, uh, in the past in terms of how much sodium is used, when it is used in that hyperhydration context. And then all we did was try to match that sodium load with our levels or the amounts of sodium by carbonate and sodium citrate that, uh, to see whether it was comparable and to see whether or not those loads or those amounts really would

29:14

induce, uh, a similar sort of buffering response or in terms of buffering capacity as, as a normal load would be. And so when we were doing the, the sort of sodium equivalent calculations, um, it, it, it works out so. Uh, a lot of the studies using hyperhydration in terms of sodium obviously are focused around salt to salt intake.

29:36

So we just had to equate the sodium in the, in, in that sodium chloride equation, uh, with the sodium, the same amount of sodium in the sodium by carbonate levels. And so what we ended up with was just a slightly lower level of, of, of sodium bicarbonate and sodium citrate that would normally be taken, but that was only done just, just so that we could match what was already, what had already been, uh, published in, in, in, in the research.

30:03

So we had some comparable, um, benchmarks to, to look at and compare. Right. So you're effectively trying to see, with this being the goal of hyperhydration, can we also get a double whammy effect of That's that's, that's exactly it. That's exactly it. Okay. So it, you know, if you're, if you're going to introduce it, then is there any benefit of introducing it in the form of sodium bicarbonate or sodium citrate? Right.

30:29

And so that's exactly what we're looking at. . Um, ok. The only difference really was probably, you know, the amount of fluid. Uh, that we, um, had the participants in Jess was because it, we were trying to match that hyperhydration strategy that was already, um, that was already out there. We, uh, it probably doubled the amount of fluid that we would normally have our participants consumed.

30:56

Not that thought that that matters a whole lot, but that that was probably the only difference. Along with that slightly lower level of, of sodium bicarbonate and sodium citrate, that, that an athlete might be recomme. So the, it was double the fluid intake that you would normally recommend with normally yeah, but you know, oftentimes we're not very, we don't limit the fluid because some, you know, it, it helps, like I said before, mitigate some of the side effects.

31:22

Um, obviously there, there might be a slight concern about body weight. Um, but you know, if you've got enough time then, then, you know, we've seen a little bit of changes in body weight, but not a whole lot. Um, so, you know, we, this is just something that we did for the study just to try to again, be able to match it with some of the published data out.

31:40

Definitely. So what is hyperhydration? Just so that we can come back and make sure that we understand what it is. It's kinda like buffering, uh, capacity or increasing your buffering capacity. Right. So the idea behind Hyperhydration is basically to increase your body's total body water content prior to an event where it might be really hot, which is what the Tokyo games were, uh, um, which is what they were, right.

32:05

Really extra extreme heat conditions. And so basically what you're trying to do is provide, provide yourself with a little bit more fluid, uh, so that you're able to sustain things like cardiac output or cardiovascular function or sweat rates or, or these kinds of things that keep the body cool and, and keep the body functioning for longer periods of time in, in maybe endurance context.

32:28

So Hyperhydration is really, again, just kind of to, to increase that amount of fluid that's available to the system really. Got it. How, what are the current strategies for hyper hydrating. Um, it, it, I guess, you know, I don't spend a whole lot of time in this area, but, you know, to my knowledge I would say, you know, the use of salt is certainly one that's common in the literature.

32:51

Glycerol is another one that has come and gone. Um, so there was a lot of research in the nineties, uh, with the use of glycerol as a hyper hydrating agent because it does a really good job of, of, of attracting water into this fell and sort of tricking your kidneys, if you will, to, to not recognize that increase fluid load quickly.

33:13

Um, but then it. Uh, was placed on the band substance list for a little while for not, not so much as a hyper hydrator, but it ma seemed to mask, I think, some other diuretics to my knowledge. Um, but then now it's back off the list so that the last couple of years we've seen a few more papers come out, uh, with glycerol back, back in the, in the fold as far as a hyperhydrate go, goes.

33:36

But, um, people have used water. I think one of the issues with water though is that you end up, um, urinating a lot of it out. Okay. So the addition of the salt or the addition of some other, um, osmotic constituent will help keep that water in, um, into the cell as opposed to to, to being, um, excreted out in the urine.

34:00

Got it. Okay. So that gives us a good overview, um, to dive into this study that, um, allowed you to answer this question. So, who were the participants that you had for this study? Um, they may be offended by this, but they certainly weren't highly trained athletes, and that was, that was the purpose, .

34:21

Um, so again, to go back to the, to the purpose of the study, it was really just to revisit, um, what was happening with some of the current recommendations of the institute in terms of hyperhydration and, and whether or not if we tailored that or, or changed that subtly, what would happen in terms of the physiological responses to the, to the body, right? So there was no exercise c.

34:42

And they were also in an environment where it wasn't hot. So those are two sort of limitations, um, in terms of, of efficacy, right? In terms of effectiveness. So again, we were just simply tracking some of the changes in terms of, of body water content, or at least in terms of plasma volume, uh, expansion.

35:00

So the participants, um, were volunteers. Most of them coming from the lab or, or having spent a lot of time in the lab. Um, and they also ranged in, in size. And, and that was on purpose because we have a, you know, just to, to make sure that we had a wide range of, of body types, uh, in, in, uh, in, in our measurements just to, to, to ensure that, that the changes that we were seeing were pretty robust across different body size.

35:28

And you had different, you had males and females participating. Yeah, we had males and females, yes. And um, another sort of limitation of the study was, was the fact that we didn't control from menstrual cycle, which could, could certainly affect it. Um, but yeah, so that, that is, we did have males and females in the study, but it also increases the application so that women Yeah, absolutely.

35:51

You're right. And, and there's certainly a trend probably long overdue and certainly long overdue for more women to be included in, in, in research studies now. Um, yeah, another podcast, which . Yeah. Well thanks for including them, . So, prior to attending the laboratory, uh, what were the participants' instructions? Yeah, so we just had a standard, a standardized approach to, to them coming into the lab.

36:17

Um, Uh, the budget was limited. Um, we had to make a few recommendations. We did, uh, have them standardize their fluid intake before they came into the lab, and we ensured that they had an adequate level of hydration coming in. So we did measure some hydration indices when they came into the lab. And if they needed to, they would've been given more fluid.

36:39

They, they, they didn't in this case, uh, but they would've been given more fluids so that we could start with an adequate baseline. Um, so, so the, the, um, in terms of the diet, um, basically what we did was we had them track what they ate. What they consume for dinner. Uh, what, And then we standardized what, because they came in fast and we gave them a, a couple pieces of toast , um, for the, for the ingestion.

37:07

But basically what we, we had them monitor what they, they, um, they ate the day before the, the night before, just so that they could replicate it the next time they came in. More so than, than having the, the funds to control for, for the actual food, uh, diet itself. Right. And the participants, uh, they all came in for all three trials, is that correct? Correct.

37:31

Yep. Yep. So it was a repeated measures design, uh, and we randomized the, the trials, um, that they undertook. And so because it was a multi-center, uh, study, um, we, and we were part of the buffering condition, we. So Amelia and I both split that. She, uh, had some sodium bicarbonate, sodium stitch trade trials, along with, uh, the control trial, which was just flavored water.

37:58

And then we did the same, uh, up at Western Sydney. So with that, we ended up with almost 20 participants in that, in covering a wide range of, again, like I said, body types, body sizes, and males and females. Great. And what baseline measurements then were you taking to get a sense of their hydration and, Yeah, so we did, uh, urine specific gravity, which can tell us a lot about hydration.

38:23

Um, we did urine color, uh, which is a simple functional way of, of looking at, there's a lot of, um, urine scales that are out there that any athlete can use or any trainer can use to, to get a good idea of how hydrated they are prior to exercise. So urine color, uh, U s G, uh, we weren't able to measure plasma vol, or sorry, plasmas modality, which is another common measure when you're looking at hydration.

38:48

Um, and we measured body weight, but that was more so at the beginning so that we could monitor how much the fluid influenced that over the course of. Okay, the urine color, how reliable is that as an indicator of hydration? Uh, it, it's pretty reliable. I, I, I, I couldn't quote any of the studies off the top of my head, but I know there have been a few reliability studies looking at the use of, of urine, urine color scales.

39:16

And I think, you know, it's not so much the scale itself, it's how it's administered. So the instructions that are given, the standardization that's given, uh, and the, um, and the compliance of the individual that's monitoring it. But I think, you know, if all of those things are controlled quite well, then it can be a quite accurate indicator of, of, of hydration status.

39:40

If. This is, um, a very rudimentary question, but I'm just interested. So if we are aiming to absorb more water and the urine color indicates how much water is coming out, does that doesn't necessarily indicate how much water is coming out? Uh, it will just, it give you a bit of an indication as to whether or not there's adequate fluid in your body.

40:10

Right. Got it. So you could be hyper hydrated or over hydrated and you'll have the same color of urine as you would if you are normally hydrated, if that makes sense. It doesn't get any clearer after a certain point, . Right. Okay. Got it. Thank you. So it doesn't tell you how much you've got in there.

40:27

It'll just tell you your sort of status at that moment if you in time, if you will hydrated or not. Yeah, that makes sense. Thank you. Yep. Mm-hmm. . So the procedure then you took for the three experimental trials, Can you run through that for us please? Sure. So, um, we, uh, incorporated a, again, kind of a standard loading sequence where we gave them, uh, some carbohydrate in the form of toast.

40:57

Um, we had a standard fluid amount that was based on their body weight, and we did that. Again, that amount was based off of previous literature, not necessarily something that we, uh, designed ourselves. And that again, was because we wanted to compare our changes in the blood and changes in hydration status to, to the published literature.

41:18

Um, do you know how much that was? Yeah. How much fluid? Uh, 20, I believe it was 20 mils per kg body weight. Um, Okay. And then it was not in just water, it was a flavored cordial. Uh, non caloric cordial, so that, that was the fluid and that was spaced out over the course of an hour, uh, along with the pills, which, with which they took the sodium bicarbonate or the sodium citrate in.

41:45

So we evenly spaced the pills out. Those, um, pills equated to the amount of sodium that was equivalent to that seven grams of salt that we were equating the, the sodium load to in the previous literature, depending on the size, you know, maybe they had six or seven pills per person, or maybe it was four if they were really light person, but those were spread out evenly over the course of the hour.

42:08

Uh, again, trying to mitigate the side effects, um, with that load. Um, but also try to, uh, sometimes we would push that out a little bit further. Like I was saying before, you know, if this was, if there was an, a competition or an. Post ingestion, we probably would push that time period out a bit further.

42:28

But again, that wasn't the aim of the study. The aim was simply to look at the fluid changes in the body and the hydration status of the body over this over 180, 180 minute window. Um, so again, really controlled, you know, um, as opposed to maybe what we would do with an individual athlete where we would space it out a little bit more.

42:50

How much more would you typically space it out if you're working with an individual athlete? Uh, de I mean, if it was buffering that I was, uh, trying to improve or buffering capacity, if I was trying to improve that, I would say I, I, you know, I'd push it out to 90, maybe even two hours prior to I would say you'd be okay.

43:07

Um, because we were looking at whether or not by carbonate or citrate was changing the hydration status and we wanted to shorten that window out a little bit. So getting as much fluid as in as we could to see what kind of retention we were getting over a shorter period of time. So the focus was slightly different.

43:27

Um, and because it hadn't been done before, we were looking at, we were trying to profile something, uh, and sort of the initial attempt was just profiling it over a shortened window of time. Would that timeframe then reflect, uh, hyperhydration protocol? Uh, more similarly, I think yeah. You generally will see that sort of 60 minute hyperhydration, uh, in a lot of the studies, in a lot of the, the sort of salt studies in the glycerol studies will be maybe 60 to 90 minutes in terms of the window.

44:01

Yeah. I mean, you ha you know, you're kind of balancing the, the, you're, you're, you're balancing out the, the. Practicality of it versus the, you know, the, the, the mechanism side of things, right. Trying to look at various things, right? Because you're trying to, you want to understand something in the context that it might be used, but you have to control it to an extent, right.

44:23

And keep it realistic. So it's kind of a, you know, it's a fine line cuz if you think about, you know, hyperhydration is for endurance events in the heat, right? With those endurance events might are probably 90 minutes, two hours, maybe three hours, whatever that might be, Right? Extended periods of time.

44:41

So I think, you know, tacking on another 60 to 90 minutes prior to it, it, you know, the shorter you can get it in the, the more applicable it might be. Right? Yeah. Definit. Yep, definitely. And you were measuring bloods as well? What were you looking for in their, Yeah, so with the bloods, we, we used the bloods for two reasons.

45:07

We wanted to obviously measure buffering capacity because like I said before, we, we, the participants were taking slightly lower doses than what we would normally recommend, and by slightly, um, you know, maybe five to 10% lower. Um, but we did wanna see if that had an effect on blood buffering capacity in any way, or changes in blood buffering capacity.

45:30

The other thing we used the bloods for was to measure hemoglobin and hematocrit so that we can get an estimation of, of changes in plasma volume or the expansion in plasma volume. That's often looked at in, in measure in studies. Involving hydration. Got it. And you were measuring these throughout the trial as well? Yeah, so because it costs quite a bit , we, you know, the profile of this is, is a little bit less robust.

45:57

I mean, the measures that we could do in terms of urine output, urine color, us g um, you're in specific gravity. Um, you know, measuring the fluid volume of the that's taken in and the fluid that's, that's, um, excreted out, that's quite easy to do. And that's why we measured it, you know, in, in the time sequence that we did the bloods, we had the budget to measure them every hour on the hour.

46:23

Um, which is, which is not atypical, I don't think. I mean, oftentimes, you know, there's enough research literature out there now that, you know, profiling, uh, changes in, in blood buffering capacity. After you ingest sodium by carboning or sodium citrate, you kind of have a pretty good idea after an hour.

46:43

And certainly after, you know, 120 minutes, you know, you'll, you'll be elevated. And, and so really it was more the, the, the absolute change that we were looking at. We didn't really need to profile the, the, the kinetics, if you will, uh, of the change. Definitely. So just to recap, then, we had the participants, um, exp uh, participating in the three trials, which were sodium bicarbonate, sodium citrate with the water, um, or the fluid, and then the placebo, which was the fluid on its own.

47:16

Is that correct? Yep. Correct. Okay. And what did you find then? So, um, what we saw was, Really, we saw typical changes in the blood buffering capacity, um, slightly lower in the sodium citrate in terms of improvement in blood buffering capacity, but I think that was more related to the timeframe of our measurements.

47:39

We had extended that measurement out. I think sodium citrate probably would've been, um, just as elevated in terms of blood buffering capacity as, as bicarbonate. Um, so that was encouraging because we did give them lower, slightly lower doses. Um, the other sort of main finding that we saw was in terms of fluid 10, uh, retention are the sodium bicarbonate.

48:02

So citrate trials, uh, although they're slightly different, uh, the retention was around 10 to 11 mils of fluid per kilogram body weight, uh, which is, which is comparable to some of the, the, so, Or the salt hyperhydration studies. Um, we saw, again, similar to, to other studies using just salt, we saw, um, plasma volume expand, uh, to a similar extent around, I believe it was, um, around six to 8%, uh, in terms of the expansion.

48:33

And that's very similar to, to some of the, the salt trials that are out there. So I think, you know, for me it was, it, it kind of confirmed what we had thought, right? So if you, if you equate the amount of sodium, sodium, uh, across these trials, then you would expect, and you give them the same amount of fluid you would expect to see similar findings.

48:52

I guess the, the real novel aspect was, was, you know, just as you mentioned at the beginning was, you know, getting more bang for your buck, right? So you could actually then also increase your buffering capacity if, if you wanted to, if you were looking to the hyperhydrate, keep the fluid. And you're, and you may have an event where there are, you know, breakaways or anything to that extent in the, uh, you know, in an endurance context.

49:15

Then my, my, my question would be, why not, You know, why not use it instead of salt? Um, and what did you find with regard to the GI discomfort? Yeah, so that's, that's what I was just gonna mention. , Um, Oh, so No, no, no. It's okay. I, I think I was gonna qualify what I just said with, as long as your, your athletes are, are able to handle the disturbance, and I guess, you know, we, we did measure, uh, quite extensively, uh, subjective measures of, of discomfort.

49:48

Um, and, you know, on a Likert scale, zero to 10, we probably averaged around two to three, uh, scores in terms of, of, of how people were rating it. And again, you know, you might say that's, that's nothing. It's minimal. Or, you know, if you're an athlete that is very sensitive, then maybe that is, you know, scoring two or three or four on the likerd scale of 10 in terms of discomfort.

50:13

Sure. Then that's something that you would want to consider. So again, um, I guess it just comes back to the, all the different combinations that you could change based off of this study. Right? So you could, you can look at extending out the loading time, right? Or you could look at changing some of the fluid, uh, volumes.

50:30

Um, you know, ultimately you're probably gonna end up with the same amount of, or comparable amount of, of say, plasma expansion. Um, you know, maybe it's not for quite as long, or maybe it's for longer periods. It depends. Right. But if you know really what your goal is to try to increase a bit of.

50:49

And your system increase your buffering capacity, then potentially, you know, working from there, you know, you can, you can work towards reducing any of those GI symptoms by including a little bit more food. Um, Right. Because, you know, like I said before as well, you know, you're not gonna come into a competition fasted or only having two pieces of toast, Right.

51:10

. Um, so I think it's something that you, you could certainly trial, uh, prior to, to competing in, not in college as you. Yeah. So as you mentioned, you can try to mitigate some of those, um, effects of GI discomfort, um, by consuming, maybe altering the water or the fluid that you consume with it. And then yeah, AB absolutely.

51:35

. Yeah, absolutely. So I think, yeah, and, and you know, again, going back to the, the premise of this study was really the ultimate goal was reevaluating prior to, to the Olympics, right? Reeva reevaluating the strategies that were given to, to athletes by the institute. And so, you know, there they are, just that the recommendations, right? And so those recommendations can always be tailored to the individual.

52:02

Okay. You, you're looking at the mean responses from a group of non-athletes, right? And although you could argue it probably would be the same for athletes in terms of the conditions that we put them under, um, you know, might not be. So I think, you know, the, the individual variability is something that you, you can work from.

52:18

So I, you know, take what we've published and what others have published and look at that. And then go from there. Right. Tailor it to, to, to meet your needs. You know, maybe you, you, you know, you, you love drinking water, so to have a little bit more water to it, right? Or, you know, there's, there's all sorts of different combinations that you could consider.

52:38

Definitely. Did you notice any patterns with regard to sex or body mass in res Their response to the gi Oh, honestly, honestly, no. And, and, and that, um, not, that's, I would say not just, uh, in this study, but in all of the studies that I've conducted over the years, I, you know, something that you watch for, right? You watch for people how they're feeling, you know, you're giving them a substance that can cause them a little bit of gi distress, right? So it's something that you, you know, you're constantly sort of monitoring.

53:10

If you're not monitoring it, you know, systematically you're, you're, you're physically there in the lab talking to them. And I'd say over the years, You know, he probably had hundreds of subjects in the lab and I, and I can't really tell you who will feel it and who won't. Um, you know, you could have a large person, big body type that has to take a lot of, of sodium bicarbonate or sodium citrate, not feel a thing.

53:37

Others, because of the load will really not, not feel very well. So, um, yeah. I've yet to sort of pinpoint a body type or, or a certain personality, if you will, that will tolerate. Um, better or worse. So it, it really does come down to the individual in, in trialing and error and trial and error. Do you know if many of those, you're saying that this was reevaluating the hyperhydration strategies mm-hmm.

54:03

um, prior to the Olympics, did many athletes, um, utilize this process? So, yeah. So that's, that's a good question. Um, this, so the, the buffering arm of this study that we conducted, we completed just prior to Covid coming , which shut everything down, right? So the 2020 Olympics obviously became the 2021 Olympics.

54:28

Um, and so at that stage, uh, the data was really too new and too late to implement into these games. Um, the, um, strategies that were in place were in place. You know, a while beforehand, uh, in terms of, of prior to the, to the games, um, whether or not, you know, it's gonna be reevaluated in the next instance where there's, where there's competition in, in really hot climates.

54:58

I, I know that, that, that, that, those discussions are ongoing for sure. Um, but as far as, as increasing, uh, I should say, uh, introducing the sodium bicarbonate or the buffers themselves into that hyperhydration strategy, to my knowledge, no, not in, not in these games. Um, there's other, this, there, there are other elements of this study that's still sort of, are ongoing.

55:24

Um, one of the interesting, um, bits that we were able to partially complete was we did add another arm in there that had bicarbonate and glycerol in it, which didn't make it into the paper because it wasn't a complete data set. So there's, there's other combinations that we're still looking at.

55:44

. Um, you know, and again, really more so, uh, looking at the main outcomes, right? So it that, you know, if you, in introduce two hyper hydra, uh, hyper hydrating osmotic agents on top of each other, you know, people have looked at glycerol and salt, uh, together. What happens if you introduce glycerol and sodium bicarbonate or CI or sodium citrate together? What does that do? Does it change anything? So I, I'd say those questions are still out there being looked at.

56:11

Um, but yeah, in terms of the application for those games, um, I, I would argue that the sort of tried and true salt or some of the other hyper, hyper hydrating, um, strategies were implemented prior to those games, and certainly in those camps leading up to them. Yeah. Well, it sounds like a really exciting and novel area of research with lots to explore still.

56:34

Yeah, I think it, I mean, you know, it's just kind of looking at something that's been used for quite a while in a different context. Right. And just kind of exploring some of the different ways of, of implementing it. You know, we've, I've probably spent the last seven or eight years, um, at looking at different ways of implementing sodium bicarbonate, uh, into different sort of non-traditional sports, right? So, for example, we've looked at it, um, uh, and the effects of, of buffering and,

57:02

and creating a real alkaline condition in the body to, to improving explosive. Certainly, and then in a fatigue state. So then that kind of introduces a whole nother context with which potentially you can use it. Um, so there's other, there's other instances, um, in which you need to kind of consider.

57:19

We've also looked at it or are looking at it in terms of the effect on, on some of the effort or the feedback mechanisms going up into your brain and, and your ability to pace. So there's, there's all sorts of different applications that I think that, that still need to be explored in, in this context beyond the, the hyperhydration concepts or idea.

57:37

Well, we might need to get you back on for that. Sounds fascinating. So if we were to conclude, what does this research see and what doesn't it see? I think, you know, if I was going to, to summarize, um, both sodium biocarbon and sodium situate together, I would say that, you know, if you. Interested in, in incorporating a hyperhydration strategy into training or into a competition.

58:08

Uh, and you wanna look beyond just using salt, or if you've used glycerol in the past, I think, you know, it's something that you can consider. And I think the reason why you would consider it is because of that added buffering capacity or increase in buffering capacity that you would also get in, um, uh, with the, with the buffer ingestion.

58:30

So I think, but again, you know, Sarah, just to reiterate the context, you know, that you're, you're looking at are, are really sort of your high level performers, right? Not your, not me going out on the. Doing a couple of intervals right in the heat here in Phoenix. Um, I don't know if I would notice much of a difference, uh, or, or, or get much of a, a, a gain, a physical gain from that.

58:56

So I think it's just, you know, looking at who you, who you are as an athlete, what, what sort of position you're in, what you know, what, getting all the other aspects of training right, right before you, before you dive into the, to the realm of the, the quagmire that is supplements. And I, and I guess the only other thing I would add to that was, you know, I mentioned off the cuff really the, the buying the sodium bicarbonate off the shelf.

59:20

And, and when we have done studies with athletes and certainly, um, competitive, you know, Olympic level athletes, we've always had the buffer third party tested. So I think that's something that you really need to, to look into because, you know, if you're just measuring blood, uh, buffering capacity in the lab and changes in, uh, as such, It's fine.

59:44

It's, it's safe to do in the lab with, with your non sort of athletic population. But if you're actually competing, then it, it, it is certainly something that you'd want to consider. Uh, and I would highly recommend is make sure you're getting your bicarbonate from a, from a certified source.

59:59

Definitely. Thank you very much. That's super helpful. Mm-hmm. . So where can our athletes, uh, keep up with your work or, um, learn more about you? Oh, you know, that's a good question. Um, I, I think I missed the boat on the social media front. I, a number of years ago I had, I was told by my institution to create a Twitter profile, which I do have.

1:00:21

I'd have to look up what that is. . Um, I think I follow you. I can find it. Yeah, I did notice that. So that would be great. Um, I'll, I'll, I'll let you, uh, disclose what that Twitter handle might be. I don't tweet that often. I think for me, I've kind of used it as, uh, Go back and forth between the, you know, there's some good stuff out there and there's a lot of waiting through a lot of the bad stuff.

1:00:44

Um, certainly, um, you know, my position right now I'm at Arizona State University. You can find me on the faculty webpage. Uh, I'm in the, I'm actually sitting as director of human performance in this focus area that we have within the, uh, the College of Health Solutions. Um, so I'm easily, easily found that way by my email and I am given my age, always responding to emails still , . So that would probably be the best way.

1:01:12