Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
2 Apr

Dear Mark: Marathon Fuel, Muscle Cramps, and Another Dr. Oz Miracle

A few months ago I wrote an article on How to Fuel a Marathon. In this week’s Dear Mark, I answer a reader’s question on how to improve a hydration recipe I recommended in that article. Then I cover a somewhat related topic: muscle cramps, and how to fix them and how to prevent them. Finally, I discuss Dr. Oz’s latest supplement miracle product – raspberry ketones. Sounds delicious, doesn’t it? Let’s go.

Hi Mark,

I am in training for my first ever marathon and have read your how to fuel a marathon. I did try the homemade hydration drink on my training run last week of 24km. I had 2 bottles of hydration and 2 bottles of plain water. I found the drink very sweet and you can definitely taste the black slat molasses. Swigging water straight after did help but it wasn’t overly pleasant.

I thought I would give it a try as I plan to use it on my race day which is July 1st. I was thinking of reducing the black slat molasses to just 1 tablespoon to see if it reduces the very sweet taste and perhaps increase the raw honey to 3 tablespoons, to see if it’s more palatable. Would this have any effect on keeping hydrated?

Also what can I use to keep hydrated on my long training runs? I find water is just not enough and I get thirsty and start to hit the wall around 17km. So basically, how do you fuel your training runs?

It would be great if you could give me some advice on this.

Many thanks.


Cut the sweeteners in half. One tablespoon of each should work great and provide plenty of absorbable sugars, electrolytes and other minerals. I would caution against adding extra honey, as it’s actually far sweeter than the molasses, which has a distinctive taste but little outright sweetness. The honey, while imbued with plenty of phenolic compounds that may aid in general health, is really there to provide quick and easy sugar for your muscle glycogen stores. It’s not really giving you much hydration. The molasses is there mainly because it’s rich in calcium, magnesium, and potassium – all important electrolytes – and you don’t really need much more than a tablespoon to do it. To cut back on the sweetness, you could also use plain water instead of coconut water. And don’t forget the pinch of salt.

I don’t really fuel my training runs, because I don’t do them anymore. I’ll bring along a bottle of water, preferably mineral water or otherwise dosed with a pinch of salt, when I go for a long hike, but many times I’ll forget to even take a sip. If I had to choose something for pure hydration, water with a pinch of high-mineral sea salt and a pinch of potassium salt (often sold as “lite salt”) works. My old hangover pre-hab cure, which was designed to hydrate and which I’d always take before going to sleep after a night of drinking back in my younger days, consisted of water, sea salt, potassium salt, and the juice from one lime or lemon. I’d be willing to bet that would work really well, too.

I’ve always had muscle cramps in my legs and feet, but the more I eat PB, the more frequent the cramps get. This is the only thing that isn’t better in how I feel on this diet/lifestyle. Can you explain why this is happening? And possibly offer a suggestion to ease the cramping? Sometimes the cramping is so severe that it wakes me out of sleep and demands I immediately get up and try to stretch out the cramping muscle. Then it will hurt for days.


My first guess is that you’re just deficient in electrolytes. How’s your potassium intake? Your magnesium intake? How about calcium and sodium? Our interstitial fluid – the fluid that envelopes our cells, enables intercellular communication, and delivers materials to and from the cells – contains all four minerals. Properly controlled muscle contractions require good balance (especially of sodium, calcium, and potassium) in the interstitial fluid, while an imbalance of these minerals can lead to excessive muscle contractions, which can manifest as cramping. So, first off, monitor your electrolyte intake.

Good sources of potassium include avocados, sweet potatoes, potatoes, bananas, chard, spinach, and many more. Fruits and vegetables are pretty much the best sources. Fresh meat has potassium, too, but opt for rarer meat over well-done meat, as the potassium is found in the juices. Potassium, then, is really easy to get through food. You just have to eat some plants. Animals are important too (it’s “plants and animals,” after all), but Primal Coconut water is another good (and delicious) source.

Good sources of magnesium include leafy greens, nuts, halibut, pumpkin seeds, but some people find it difficult to get enough magnesium through food. In your case (lots of cramping), taking a good supplement is probably warranted. It seemed to help pregnant women with pregnancy-related cramping in one study. As for which form to use, most people stick with one of the magnesium “-ates,” like citrate, glycinate, or malate. This guy, on the other hand, had great success with sublingual liquid magnesium.

Sodium intake must also be considered. When people switch from a diet high in refined, processed foods to a diet high in whole foods that must be prepared at home, salt intake usually drops. Furthermore, some newly Primal people assume that Primal means “no added salt.” This isn’t the case at all, but the end result is that many people who go Primal end up taking in less sodium than before. Sodium is found in, well, salt.

You also have to watch your calcium intake. Leafy greens like spinach and collard greens are excellent sources, as is dairy, if you’re into that sort of thing. Yogurt is probably the densest source of calcium, and (in my opinion) it’s also the “safest” way to eat dairy – fermented. Bone-in sardines will also provide a nice whack of calcium, as will real, homemade bone broth (try to simmer it till the bones fall apart to ensure you’re getting all the minerals).

See the answer to the previous question and the referenced post for an electrolyte-rich drink that you can make for a quick remedy.

Are you very low carb – say, under 40 grams a day, enough to be a in a near-constant state of ketosis? Remember, ketosis has a diuretic effect, especially during the initial transition. With the water flush goes electrolytes, and if you never replenish them you’re likely to experience cramping. I’d also be curious about your activity levels. If you’re exercising a lot and really working up a good sweat, you’ll be losing even more water and more electrolytes. Carb intake should be tied to activity levels, as I always say.

You might also try getting more taurine. It’s a non-essential amino acid, meaning we make it ourselves, but supplementary taurine has been shown to help cirrhosis patients with excessive muscle cramping. As the best source of taurine is beef heart, this is the perfect opportunity to explore the wonderful world of offal!

Another, slightly more obscure possibility is the use of certain medications. Diuretics, statins, and long-acting beta-adrenoceptor agonists (or LABAs, used to treat asthma and chronic obstructive pulmonary disease) have been linked to an increased incidence of nocturnal leg cramps. If you’re taking any of those medications, they could be making the problem worse (or creating it altogether).

So, in summation:

  1. Eat leafy greens (and yogurt if you can).
  2. Use salt.
  3. Supplement with magnesium.
  4. Try knocking yourself out of ketosis; consider a carb refeed.
  5. Try taurine.
  6. Tie your carb intake to your activity level.
  7. Track your current meds and see if there are any potential conflicts.

I repeatedly notice that the Primal eaters who have the most problems are the ones who eat little to no plant material. While certain individuals can tolerate (or even thrive on) a total lack of dietary plant, the vast majority do better as omnivores.

Hi Mark,

Like many women, my wife is a Dr. Oz fan and has me view select bits that she finds interesting. Instead of constantly pointing out every flaw I see, I find it more productive to praise Dr. Oz (in front of my wife) for what he gets right.

We saw his segment on Rasberry Ketones and it sparked my interest. Have you looked into this? Can this supplement enhance ketosis for someone already in the 50-80 gram/day carb intake mode? Can it do anything for people with higher carb intake? Thanks.


Ah, the eminent Dr. Oz! If he says it, generally, I take it as gospel.

Seriously, though, it’s not total bunk. A study in rodents found that raspberry ketone supplementation both prevented fat gain on a proven obesogenic diet and helped already fattened rats slim down a bit. Sounds good, right? I mean, sure, we’re not big hairless, tailless rats, but we’re both mammals, and we can glean a lot of hints about our own physiology by studying rodents. Eh, not so fast: the rodents’ diets were up to 2% raspberry ketones. Yes, it wasn’t quite a supplement, it was a sizable component of their diets. That would be like if you swapped out polyunsaturated fat for resveratrol. When you’re measuring a supplement in calories, rather than micrograms, milligrams, or IU, I think it’s time to step away and reevaluate your relationship with the compound.

I suppose you could replicate the rat dosage and get 2% of your calories from raspberry ketones and hope for a result, but that would get pretty expensive really fast. The typical bottle has 60 capsules with anywhere from 100 to 500 mg per capsule, and you’d be taking at least half the bottle a day to hit the heroic dosages. Good luck.

That’s it for this week, folks.

You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. Apple cider vinegar is great for cramps !!!!

    Evan The caveman wrote on April 4th, 2012
  2. I only got cramps in my calves after a cheat day when I ate to much sugary junk foods. It ruined my night and the day after. The cramps were a blessing in disguise, because it became so much easier to stop eating junk.

    Bob wrote on April 5th, 2012
  3. If you find your home-brew hydration a bit too sticky syrupy try adding a teaspoon or so (adjust to taste) of Apple Cider Vinegar this makes it far more palatable when you are under pressure trying to keep the pace going. Drink earlier in ther race, more frequent sips. Use the plain water at drinking stations to pour over your head to help keep cool.

    Poserunner wrote on April 5th, 2012
    • That is exactly what my coach had us drink back in 1976 when I was on the cross country running team. A mix of honey, molasses and apple cider vinegar. I forget the ratios. But I have been meaning to try it again, this motivated me. I wonder where that coach got that idea. Also, before gel or gu was invented my mom used to give me a little tube of honey to shoot prior to getting in the starting gate of an alpine ski race. If only we could have capitalized on that idea!!!!

      Colleen wrote on April 6th, 2012
  4. I, too, followed Dr. Eades’ advice about the water. I keep a bottle of water on my night stand, and when I get a leg cramp, I drink some water and the cramp just goes away.

    Sandy wrote on April 5th, 2012
  5. Strange question, but would these tips for leg cramps apply to colon cramps? I’ve done all the treatments for IBS, but my colon still goes into spasm on a daily basis (namely, after every #2). Should I look at my electrolyte levels? I think my blood tests have showed they’re fine. I am grasping for new ways of treating this.

    Renee wrote on April 10th, 2012
  6. i sometimes got horrible cramps — calves, shins, toes, archese, hamstring, thighs would take turn cramping. the worst it took a good 30 mim. woke me up from sleep.
    occaionally, it was so painful i could not even move without triggering spasm of the antagonist muscle. so walking off does not work well.

    soaking in magnesium salt has taken care of it. i have not had cramps for months now. (supplement magnesium does not work too well — tummy cramps)


    pam wrote on April 12th, 2012
  7. I remember being on the swim team when I was younger and a guaranteed way to prevent a muscle cramp was to eat a banana before the meet (or take a potassium pill).

    My father also suffers leg cramps frequently when he is lying down or sleeping. He was able to cure it with a doctor’s suggestion of drinking a glass of quinine (tonic) water before going to bed. Don’t know how it work, but it does.

    Pat S wrote on April 13th, 2012
  8. I hate the taste of salt, I try to eat it, but… yuk…. with that said, I have occasionally suffered from leg cramps in the middle of the night. I get up, mix a teaspoon of salt in a shot glass of warm water, gag it down, and my cramp is gone before I even walk out of the kitchen. No soreness and no more cramps for days, even weeks.

    Linda Grant wrote on January 30th, 2013
  9. I think this is one of the most significant info for me. Annd i am glad reading your article.
    But wanna remark on somme general things, The site style iis perfect, the
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    to increase sales wrote on October 25th, 2013
  10. I have an odd situation. I exist mostly in nutritional ketosis, but every now and again I go on vacation and cheat. Between 4 and 7 days after going back to the standard American diet, I get mysterious cramps in my lower body accompanying even mild activity (walking, biking, etc). They do not respond to stretching; the only way to make them stop is to cease all activity and stay completely still. The last time it happened, it lasted 3 weeks and I ended up in rhabdomyolysis! According to what I’ve read, this should be much more likely in ketosis than out of it. Any ideas?

    Lauri wrote on February 12th, 2015
  11. just a quick question Mark. am a big fan of your write ups.
    i have a question though did Grok eat salt. how would he know how to add it to meat.

    Usman Shaikh wrote on June 21st, 2016

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