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Nutritional Supplements
June 2000

Q. I've been working out since January and have been on nutritional supplements as well. Over the past four days, I have been experiencing this strange "cramping" feeling in my upper abdomen. It usually only aches if I fully inhale. Also, if i don't hold in my gut, it tends to pull on whatever muscles are aching. I think it might be the millions of crunches I've been doing... Or I've also theorized, that since I've been adding so much protein (through supplement protein shakes), my kidneys might be the problem... any theories?

A. The pains you describe sound pretty disturbing. The first consideration is whether they are even related to your exercise and diet. If the pains are severe or persistent, accompanied by fever or other symptoms such as nausea or vomiting, a visit to your doctor is needed. If the pains are milder and just related to exercise, then training factors may be the primary concern.

Crunches of any other repetitive exercise may certainly cause delayed-onset muscle soreness. Delayed-onset muscle soreness (DOMS), refers to pain occurring some time after the exercise, often the day after. This is distinctly different from an acute injury in which the pain occurs instantly and prevents further exercise. DOMS has been an active area of research for exercise scientists. We know that resistance exercise (weight lifting) and impact (shock-absorbing) activities show evidence of actual muscle cell injury as we can measure an increase in the muscle enzymes the next day. We can also measure markers of the immune system responding to repair the cell damage.

From a practical standpoint, what does this mean? Some muscle soreness is to be expected. Your diet and water intake should be good as this will help the healing process. Massage treatment is of value to many athletes in recovering from injury. You may need to allow more recovery time between intense exercise bouts. Non-impact aerobic exercise might be a good mix, and of course just a few rest days as well. Staying current with general medical check-ups including basic lab work would give assurance that nothing else needs attention. If you haven't done this for awhile, I certainly recommend it. Since your pain peaks right after exercise, you may need to get some lab work done that day to check for muscle damage (elevated levels of muscle enzymes). Another consideration would be anything impairing blood flow during exercise, since this can cause intense pain also, as occurs in a heart attack. Your doctor can lead the way in this investigation.

Now, about those protein supplements. Metabolic studies show that the basic requirement for dietary protein is only about 1 milligram per kilogram of body weight per day. Even for athletes involved in strength training, the requirement only increases to about 1.5 mg/kg/day. For a 110 pound woman this is 2-3 ounces of meat or other protein per day! A boneless piece of chicken the size of your palm is about 4 ounces, so indeed for most Americans this amount is easily met or exceeded. The excess will be converted to fat, not muscle. The protein is also what is called an "osmotic load", drawing water into the gut during digestion, so cramping can result from this as well. Sticking to the protein limits described will help you avoid this.

So definitely keep up the training, but follow the guidelines for a healthy training diet, drink lots of water, and mix aerobic work with the weights to give your muscles some recovery time. And of course any severe or persisting pains deserve medical attention.

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