Over the years, especially in recent years, I’ve had a recurring problem with painful leg and foot cramps first thing in the morning, sometimes so severe that when I stood up my big toe would be pointing 80° up in the air. If you search Google for cramp remedies, you’ll find things that work like magic for some people but are no help at all for others. Often the reported solution is either supplementing with an electrolyte, drinking more water, or stretching, massaging, and/or strengthening the affected muscles.

I think I’ve figured out, tentatively, that increasing my sodium intake works for me, or at least it seems to have worked over the last couple of months.

From experiment and observation, I’m pretty sure I’ve identified caffeine as the likely cause, or at least one strongly implicated precursor to my cramps. Whether this is because caffeine interferes with electrolyte absorption, or it has a dehydrating effect, or it’s some combination or some other mechanism entirely, I don’t know. All I know is, based on evidence so far, I seem to get the cramps when I’ve been consuming caffeine, and not when I haven’t.

The problem is, I sometimes have a hard time functioning without the stimulant effect of caffeine. I mean a really hard time. Do I “need” caffeine? That’s debatable. Certainly I have a strong wish not to abstain entirely.

I tried replacing my regular salt with “Morton Lite” salt, which is half sodium and half potassium. That didn’t help. I tried magnesium supplements. That didn’t help either.

Then for grins I tried drinking cups of broth made with bouillon. Broth is sometimes recommended for people who get the “keto flu” when they try a low-carb diet, because one of the first things that happens is that your body loses sodium. I hadn’t gotten the keto flu when I started eating low-carb, and I thought I was eating plenty of salt, so it hadn’t occurred to me that I needed more sodium. But wouldn’t you know, on days when I consume caffeine, a cup or two of bouillon seems to stave off the cramps the next morning.

That said, I don’t want to declare victory prematurely. Let’s see how things look over the next few months.

The brand of bouillon I use is Herb-Ox. I get the packets rather than the cubes, because the granulated form dissolves much more easily. Usually I combine it with water in a mug, and I heat the mug in the microwave. I use the chicken flavor. I’ve tried the beef flavor and don’t care for it.

I’ve been having leg cramps over the last couple of days. I get them in the shins and toes, usually in the morning while lying in bed. I used to get similar cramps a while back but a year ago they went away. My theories for why they’ve returned include:

• Ill-fitting shoes. Last year I stopped wearing a worn-out pair of sneakers that seemed correlated with the cramps. I don’t know if that actually helped, but I note that I recently bought a new pair that I’ve been wearing quite a bit.
• Muscle weakness. I’ve ignored fitness for years, and am only now getting back into it.
• Electrolyte imbalance. A “usual suspect” whenever cramps are discussed.
• Combinations of the above. For example, my recent increase in exercise could have exacerbated the effects of shoes that aren’t right for my feet, and/or could be causing me to sweat out sodium that I’m not replacing fast enough.

In terms of the electrolytes, I was thinking mostly potassium for some reason, probably something I read. Last year I started using Morton’s Lite salt, which I’d seen recommended by commenters on Peter Attia’s blog. No idea if that contributed to the relief from cramps, but today I bought some more, since I ran out of my original supply a couple of months ago.

I have been salting my food generously to taste, since low-carbers tend to lose sodium, and in recent months I’ve gone even lower-carb than I had been before. I bought some bacon today (uncured, no sugar) so I’ll get even more sodium. Will see what happens.

[UPDATE: The cramps went away over the next day or two. No idea if it was the potassium and/or sodium that helped. I will also keep in mind calcium and magnesium, as my friend Chase suggested in comments.]

I signed up for an online “carnivore study” being run by Dr. Shawn Baker at NEqualsMany.com, with software development support by Matt Maier. Participants will try their best to eat only meat and water for 90 days. We post numbers and notes on the web site, and at the end we will see whether people were able to stick with it, and what outcomes people had, for better or worse.

For some people this is a new experience and may be surprisingly hard, surprisingly easy, or somewhere in between. Others, like me, will require very little change to our existing diets.

This does not purport to be a randomized controlled trial. Participants are self-selected (hence biased); there is no control group; there is no blinding; we’re self-reporting all our data; and so forth. It’s a different kind of experiment. The following, from a blog post about ethics and oversight, serves as a good description of the motivation for this exercise:

With the explosion of social media and the ever increasing popularity of bio-hacking and N=1 experimentation, it is very easy to find countless public examples of human experimentation, often with hundreds of thousands of exposures. Do these add to the general knowledge base? […]

What about a very popular public Facebook group that has several members that all follow a common dietary or medical protocol and then record their progress and their results? Does this contribute to the general knowledge base and is it thus considered human research? […]

At this point nequalsmany.com is not planning to engage in research publication, nor is it seeking federal funding. We are facilitating and providing a location for biohackers and n=1 experimenters to get together and share in a common experience. If this information leads to further formalized research utilizing more traditional methods to include IRB oversight, then that is a good thing.

Today (August 18, 2017) is day 4 of the study. Some people have already reported feeling great, while others have had some discomfort. I had already been eating almost 100% meat for a couple of months, and low-carb for 18 months before that, so it’s been easy for me. In practice the biggest change has been cutting out the diet sodas. I’m trying to drink only water and unflavored seltzer.

In her latest blog post, Georgia Ede discusses the science around plant-based diets, both in general and specifically with respect to brain health. She says no one has all the answers yet, but certainly everyone should eliminate refined carbohydrates, whether they choose an omnivorous or plant-based diet. She explains why she believes this, and why it’s relevant to brain health.

(“Refined” is a tricky term — she links to another post where she provides a definition.)

Dr. Ede also says some important things about how we should approach such discussions:

If we truly care about the health and well-being of our fellow human beings, we owe it to ourselves and others to stay curious and open-minded. We must take the time to learn and appreciate how the foods we choose to eat operate within the human body, to understand and be honest about the real risks and benefits of the diets we personally eat and professionally recommend, and to acknowledge the limitations of our knowledge.

In my personal life, I am considered crazy–“orthorexic,” to use the clinical term–for eating a mostly-meat diet by a good many people, including some of my best friends and most highly-educated colleagues. As a result, my instinct is to rush to the defense of vegetarian and vegans who are similarly judged for their dietary choices.

In my clinical experience I have certainly worked with people with obsessive-compulsive tendencies and/or eating disorders who adopted a vegan diet because removing meat appealed to their desire to feel in control, virtuous, safe, or perfectly clean and healthy. However, with the slowly rising popularity of low-carbohydrate, Paleo, and elimination diets, I have witnessed the very same motivating factors among some who are using extreme versions of these diets to optimize their body composition, sense of safety, macronutrient ratios, or ketone readings, sometimes to the detriment of their well-being.

You may have seen the recent “Presidential Advisory” from the American Heart Association making some strong and definite claims about saturated fat and heart disease. Two years ago I’d have found their assertions pretty compelling. Nowadays I don’t blindly trust any organization’s nutrition advice. If history tells us anything, it’s that closer looks must always be taken.

I’m going to need time to figure out what I think about this report (yes, I’ve seen Gary Taubes’s rebuttal), and maybe write a follow-up post later. For now, here are a few things to know that might not be clear from the headlines that have been circulating:

• The “Presidential” in the title refers to the president of the AHA, not the United States. This is not like the Presidential Fitness Challenge. Don’t be influenced either way by the presence of that word.

• The report doesn’t merely advise that we reduce saturated fats. The specific recommendation is to replace saturated fats with other kinds of fats, and not with carbohydrates as one might have guessed. The report says the data currently available on replacing saturated fats with carbohydrates shows no significant benefit.

• The report has nothing to do with any new research, at least in the sense you might assume. They didn’t conduct any new experiments or gather any new data. Rather, they took a fresh look at existing research, and thought hard about which studies to consider “core studies”. There’s nothing inherently wrong with this — it’s done all the time — but it’s worth understanding that this is what they’re doing. It means the report has to be very much judged on the criteria they used for deciding what’s “core”. Some very large studies were excluded from their core list, and a lot depends on the reasons for that exclusion.

Note that I don’t like distrusting health and nutrition authorities. I don’t wake up every day looking for some institution to be paranoid about. But the historical evidence has me feeling betrayed.

Compare this to other sciences. NASA has never given me a reason to doubt them if they say star X is distance Y from Earth and contains gases A, B, and C — and heck, those would be claims about a ball of fire billions of miles away. I’d love to have that same automatic trust in the American Heart Association, the American Diabetes Association, the US Dietary Guidelines, and so on, when they say “food X will do thing Y”. But as things stand, I can’t.

Finally kicking off this blog. After months of agonizing about this, I decided to put nutrition posts in a dedicated blog instead of lumping them in with my general all-purpose blog. We’ll see how it goes.

At some point I’ll try to fill in details about where I’m coming from and why I write these posts at all. For the moment I’ll just say I’m a computer programmer, not a doctor or nutrition researcher, and my strong bias is toward a low-carb diet.