Do Calories Really Matter? The Truth About Fat Loss, Metabolism & Why Diets Fail – Douglas Kalman PhD
If you’ve ever felt confused by nutrition… you’re not alone.
Calories matter.
Calories don’t matter.
Carbs are the problem.
Carbs are essential.
In today’s world, nutrition advice is louder than ever—but rarely grounded in real science. In this episode of the Crackin’ Backs Podcast, we sit down with Douglas Kalman PhD to break down what decades of research actually say about calories, metabolism, diet trends, and supplements.
This is not another diet conversation.
This is about understanding how the human body actually works—so you can make decisions based on physiology, not opinions.
In this episode, we explore:
Do calories really matter, or do hormones drive fat loss?
Why most popular diets (keto, carnivore, intermittent fasting, plant-based) can all “work”—and what they’re missing
The difference between food quality vs calorie balance
Why so many people are following “healthy diets” and still not seeing results
The real science behind creatine—safety, performance, brain health, and misconceptions
How to filter nutrition advice in a world full of conflicting information
If you’ve ever searched:
“Do calories matter?”
“Best diet for fat loss”
“Is creatine safe?”
This episode gives you evidence-based clarity from someone who has spent decades studying these exact questions.
About Dr. Douglas Kalman
Douglas Kalman, PhD, RD, FACN, FISSN is a globally recognized nutrition researcher, registered dietitian, and scientific expert in sports nutrition and metabolism.
Involved in 100+ clinical trials across nutrition, medicine, and performance
Published dozens of peer-reviewed studies and hundreds of scientific articles
Co-founder of the International Society of Sports Nutrition
Worked with Olympic athletes, professional sports teams, and elite performers
Faculty member and scientific leader in the field of sports nutrition and supplementation
Dr. Kalman is known for his ability to translate complex metabolic science into real-world, actionable strategies—bridging the gap between research and what actually works.
Learn More About Dr. Douglas Kalman
🔗 LinkedIn:
🔗 ISSN (International Society of Sports Nutrition): HERE
We are two sports chiropractors, seeking knowledge from some of the best resources in the world of health. From our perspective, health is more than just “Crackin Backs” but a deep dive into physical, mental, and nutritional well-being philosophies.
Join us as we talk to some of the greatest minds and discover some of the most incredible gems you can use to maintain a higher level of health. Crackin Backs Podcast
Dr. Spencer Baron (00:00)
yeah, today if you search the internet for nutrition advice, you'll find thousands of confident voices telling you what to eat, but very few of them are scientists. Calories don't matter, calories matter more than anything, carbs are poison, carbs are essential, with all the noise. How do we know what real science actually says? Today we are talking to Dr. Douglas Kalman.
who has spent decades researching the answers. Welcome to the show.
Douglas Kalman PhD RD (00:31)
Thank you for having me on. It's a pleasure. Decades makes me sound much older than I like to feel.
Dr. Spencer Baron (00:37)
yeah, don't you worry. If you only knew you would feel a lot younger. So, all right. Let me ask you, just to start off from your perspective as someone who has spent quite some time, how about that, researching in sports and nutrition, where do you see some of the biggest gaps between what the science actually says and what the internet is telling people to believe?
Dr Terry (00:39)
Well, we're all decades here.
Douglas Kalman PhD RD (00:39)
you
There are, well, the biggest gap really is educational gap. So there, unfortunately, you can't govern or regulate misinformation, disinformation, versus right information on a platform like the internet, right? ⁓ And whether that's on whatever form of social media is hot at that moment, seems to be things that are short.
get short that fit short attention span kind of things. ⁓ And really, that is a barrier for education about anything and everything. So I'll give you an example. I'm a professor at Nova Southeastern University. I teach a I'm a nutrition professor. Most of my courses are either in the neurosciences or in
other areas, sport nutrition and some other areas, ⁓ pathophysiology. so, but the point that I'm trying to get at it outside of those that know how to use PubMed and other, you know, sources through the internet that you could get to. If you ask, where do you do your research? You know, I've heard a Snapchat, a Snapchat and TikTok and YouTube, YouTube reels or YouTube. So.
Not that you go even to PubMed or you go to AI or you go to the free that your tuition paid for medical library, right, or any library that's on campus on your computer. So I think those are barriers to overcome.
Dr. Spencer Baron (02:43)
Yeah, you know it. sorry.
Douglas Kalman PhD RD (02:44)
You know, so like you could
both of you are involved in sports, right? And working with athletes and I'm sure you get tons of questions that come your way about being either bigger, faster, stronger, leaner, you know, depending on the age, you know, recover faster, all of this stuff. they're going to some people may say things what they just heard.
Right? And others you could tell have, you know, done some, at least some basic reading and understand what a carbohydrate, a protein, a fat is. And that doesn't matter what supplement you're using. If you're not getting sufficient nutrient intake, which includes quality calories, quality carbohydrates, proteins, et cetera, then your gas tank is still empty.
Dr. Spencer Baron (03:29)
Yeah, yeah. Well, I we exceptionally love when somebody comes in and we can refer to them as Dr. Google because they heard it on. They did a Google search. They they start telling us what they need to know or what you should know. But anyway, it's always been it's always fun.
Douglas Kalman PhD RD (03:41)
you
Well, that comes
from a variety of different psychological areas, right? ⁓ Curiosity. And like, for example, I have a friend who ⁓ medical stuff going on in the family, and I've coached her to stay off the Internet because she'll go down rabbit holes.
And it's okay, I tell her if you can go down the rabbit hole, bring your questions to me. I'll help you sift through them. And then if something, you can always go to the neurologist or the physician, right? So, but point being is like sometimes it's bad, it's negative going down these rabbit holes that people do.
Dr. Spencer Baron (04:27)
yeah, very, very much. in fact, when a patient, when we identify someone as having like something as easy as facet syndrome, if you go on Google and you pull up an image, it shows a big needle going into the low back and we go, no, no, no, that's not how it's no, that's, that's just an image of in the medical perspective. So we have to just, just an image can lead someone down the wrong direction, you know? Yeah.
Douglas Kalman PhD RD (04:53)
This is true. This is very, very
true. That's why image is all important in marketing. The colors that are chosen, the font that's chosen, the word that's chosen. I'll give an example of a very popular allergy medicine that we all know, Claritin. That was chosen because it was close to clarity.
Dr. Spencer Baron (04:58)
Yeah, yeah.
catch your eye.
Douglas Kalman PhD RD (05:17)
And ⁓ so the marketing agency that worked with the original pharmaceutical company at the time in deciding names and doing what they do, know, Claritin, Clarity, and their commercials, Director Consumer TV, what was, would always show, you know, clear skies. Even if there was clouds, you can breathe, you had Clarity, you know, like, aha, Clarity, no more sneezes.
Dr. Spencer Baron (05:17)
Interesting.
Dr Terry (05:39)
All
you
Dr. Spencer Baron (05:44)
Well,
thank you for that story, because what I read about that what I read about Adderall is the guy who the chemist that created Adderall named it as ad for all Adderall for all Adderall. And that's how it's gone haywire. That is probably the next big epidemic epidemic in sports is, you know.
Douglas Kalman PhD RD (05:48)
That's a pretty good question.
Dr. Spencer Baron (06:11)
people take an Adderall for an event. But let me bring it back to something like a calorie, say calories versus hormones and so on. Like from a physiological and metabolic standpoint, like what does the research really say about calories versus food quality and where do most people misunderstand that relationship between the two?
Douglas Kalman PhD RD (06:36)
Well, let's talk about food quality to start with. Unfortunately, six to seven and half people out of every 10 are either overweight or obese. Right. So that's usually indicative of an over consumption of calories or the caloric intake is greater than caloric expenditure over time. So what is the makeup of and why do I mention that?
Dr. Spencer Baron (06:40)
Yeah.
Douglas Kalman PhD RD (07:04)
because the amount of overweight and obesity has skyrocketed in the last 40 years as compared to 100 years ago. And we know that there's been ⁓ the industrial revolution times a gazillion for the amount of different foods that are on market. So for example, nutrient density for the foods matter.
and we get a lot of empty calories in a diet. And I'll use name brand just for ease of example, not calling anybody out. If you look at...
the amount of Gatorade that's consumed in youth sports, where they play a 30 minute, youth being like entry level, they play 30 minute games max, and they get water breaks every 10 minutes. you know, they're given Gatorade. So it adds up, right? Those are not carbohydrate calories that are actually really needed to do anything at that time. And rehydration is actually better spent by water at that time.
And then so those I'm trying to get to a point where we know that when you have diets that are more predominant higher in ⁓ monosaccharides, right, simple sugars, ⁓ processed foods, right, low in fiber, and concurrently, there's a little maybe more saturated fat in the diet.
Right? That it increases your risks of mild cognitive impairment in Alzheimer's by significant, you know, degrees over the lifetime. So that's just lifestyle. And that's talking about diet composition from one perspective. So nutrient density is something that I really like. And ⁓ that goes back to work that's really was put forth by Barbara Rolls, R-O-S-S, R-O-2-L-S, rather. ⁓ And ⁓ it's looking at
the nutrient when you look at food right you could weigh food right 100 grams a little over three ounces let's say so of how many calories per gram are you getting how many grams and what part protein carb fat fiber vitamins mineral and you can kind of see the nutrient content of that kind of food the quality in one way and you know along with the water content actually so ⁓
That may or may not answer your questions, but I think that diet styles matter. And for example, if you're working with youth sports or people that think that they're youth, us, that still like to do some type of sport or exercise, but might not really have an education or background in nutrition beyond that, maybe they can cook, they know what to, they go out and eat, but they don't necessarily know the ins and outs.
Dr. Spencer Baron (09:47)
Right.
Douglas Kalman PhD RD (10:01)
Having a basic understanding of the different types of carbohydrates, fiber, ⁓ protein, that not all proteins are equal, know, things like this become important.
Dr Terry (10:14)
Hey, hey, doc, you work at a university and and especially I work at universities as well. And one of the things I've been seeing a lot of our athletes are coming in and they say, I need more calories and more calories. And they're hitting the junk food places. They're hitting the the chick filets or the whatever. And they're getting all these calories. But then they're saying, I'm always hungry. And and they're always tired or they're they they can't focus and and they're they're scrolling their phones more because they're focused as
maintain but they just keep consuming calories. Can you talk the difference you mentioned earlier? Can you talk the difference between empty calories and functional calories?
Douglas Kalman PhD RD (10:54)
Sure. So you can easily get ⁓ calories having a bag of Funyuns and a Slurpee, right? ⁓ Just for an example, but the amount of all the different B vitamins, vitamin C, various carotenoids, essential fatty acids, essential amino acids, protein, fiber, et cetera.
Dr. Spencer Baron (11:01)
You
Douglas Kalman PhD RD (11:22)
is not there. So those empty calories that are actually higher in mono and saccharide, simple sugars, are not going to be something that is useful for an athlete because they're not providing any of the building blocks or rebuilding blocks of what the body needs because you are engaging in athletic endeavors. So maybe they're meeting a calorie need, but they're not getting the nutrient quality.
So they feel lethargic, they can't concentrate, they're not getting enough of the precursors. So for example, ⁓ and let's say that that athlete happens to be vegan or vegetarian.
then you actually start to worry about protein intake because of the amount of quality of essential amino acids, because these are used for precursors of serotonin, dopamine, or epinephrine, epinephrine, your neurotransmitters, things that we like and things that are useful from short-term memory, long-term memory, locomotion, right? And things like this, which athletes need to be on point for, all of us need to be on point for.
quality impacts the integration of nutrition for physiology and then for outward performance. so that's where education, whether it's possible to work if the athletes have their own part of the dining room, whether they're on their meal plan, whether there's a sport nutritionist on staff to help tailor some things for more one-on-one.
When I used to do university nutrition, we would always have team nutrition for everybody. People got books or handouts or things on apps that had all the info for eating at restaurants, cooking at home, food shopping, all this stuff. And we would do some live stuff too. But you know, then you had some athletes that did need one-on-one.
Dr Terry (13:16)
Have you, have you, yeah, go ahead. Yeah. I wasn't going to switch.
Dr. Spencer Baron (13:16)
Terry, wait a minute. I wanted to ask him about nutrient rich foods before you switch.
All right, go ahead then.
Dr Terry (13:25)
I was just going to say,
mean, yes, you're right, but a lot of these processed foods, almost put like fake flavors and it seems like the athlete gets hooked on, these taste good and real food tastes bad. And then you have nutrients rich foods that Spencer is going to talk about. I mean, how do we get these athletes to go, ⁓ that tastes really good. It's almost like being addicted to candy almost. How do you help these athletes get changed your taste buds, I guess is a better term.
Douglas Kalman PhD RD (13:53)
Well,
part of that is maturity and part of that is exposure. So for some athletes and some teams, we'll have interaction with cooking so they can see what fresh cooking, fresh food, fresh taste like, you know, how to use spices. ⁓
I personally used to take various teams on first the supermarket tour and then helping them put together how to understand it, you know, with my other team of dieticians that would help for that kind of stuff. So there is education, you know, that's really needed. ⁓ It's hard to give a quick answer on something like that. There is methods of delivering that.
Dr. Spencer Baron (14:35)
think it's the parents.
I think the parents need the education more to retrain the kids.
Douglas Kalman PhD RD (14:41)
Well, I think there's
something to be said for, ⁓ I know years ago, ⁓ I would think that there's something to be said for, ⁓ home education, nutrition in the household, ⁓ along with the whole other slew of things and in the schools, which it doesn't really happen. But when I remember going to school that we had at least, you know, one course and that included, ⁓ basic nutrition as I guess, eighth grader or something. ⁓ you know, so.
I don't have a quick easy answer Dr. Terry.
Dr Terry (15:15)
That's OK.
Dr. Spencer Baron (15:16)
I'll tell you what though, there was an opinion ⁓ article in New York Times several years ago that really struck me. was, is obesity ⁓ just a food consumption problem? Is it an emotional thing? And what they talked about was exactly where you're leading to about nutrient dense foods. So the example the writer used was,
If you took a tomato from 40 or 50 years ago and compared it to a tomato today, the tomato from 50 years ago was smaller, much more dense, and it would satiate the body's appetite or need for certain nutrients. Whereas the tomato today, you'd need two of them to make up the nutrients that were in the tomato from 50 years ago. And I thought, wow, because your body is what's talking. your need to balance some of the chemistry
that you might be lacking. Any thoughts on that? I mean, you can go across the border to Canada and the eggs taste like eggs there. It's just completely different.
Douglas Kalman PhD RD (16:25)
I'm wholeheartedly
with you in the sense that agricultural practices have been influenced of course by business, right? If you own, and you're selling meat, you own cows, you're selling meat, right? You wanna...
be able to get the most pounds out of that cow that you could sell because you're getting paid per pound or you know along those lines and that's why different things are used to increase the marbling of the meat, increase the size of that animal. Even like you said with fruits and vegetables. I just bought grapes last night in the supermarket that are I don't know size of golf balls if you ask me. All right.
And the cashier and I were laughing about it. I asked like, whatever you're putting this fruit on, where do we get it? know, like. ⁓ So what happens with that is you're getting less nutrient dense foods because it's not in proportion. It's not the same. And what you said where you go outside the US and food systems are different.
you go out to eat or you go to the markets to buy food, eat it, even breads, the tastes are cleaner, more vibrant, ⁓ which is like the impact here of what we have with these agricultural practices. I do know that there's a movement, may or may not be part of Maha, but to try to increase regenerative farming, to try to...
you know, to do things that can be more back to nature and also better for agricultural practices. I don't know if that's going to change the size of a tomato, but.
Dr. Spencer Baron (18:12)
So
if you were, Dr. Common, you were to take someone around the grocery store, and yes, of course, you would tell them about the perimeter being the more nutrient-oriented foods, but like, how would you tell, what would you tell the audience that they can do now to find more nutrient-dense foods? Do you go look for farm to table places that, I mean, what would you suggest that someone could do?
Douglas Kalman PhD RD (18:40)
You know, so a few different things. ⁓
when it comes to fruits, fresh fruits, right? When it comes to vegetables, fresh vegetables. However, one thing that should not be diminished at all is that frozen vegetables more often than not have greater nutrient quality than fresh.
In farming practices, typically within an hour of it being picked from the field, it's already gone through an initial wash and is starting the flash freezing process, right? Which if you compare, when you go to any supermarket, the fresh produce that's there came on a truck from somewhere, right? Now, whether that truck was refrigerated or not, I don't know, but
And some things cross state lines and cross countries. So some things could be just a couple of hours. Some things could ⁓ be, you know, maybe a couple of days if it's Florida oranges going up to the Northeast, because, you know, right. So things like this also impact ⁓ choices. So meaning I don't diminish vegetable frozen whatsoever because knowing the practice of of that. ⁓ So.
Dr. Spencer Baron (20:07)
great advice.
Douglas Kalman PhD RD (20:08)
⁓ Then, you know, of course fish, ⁓ poultry, red meat, those are, you know, choices too. In the supermarket, I also like to give 30,000 foot views of things. If you're looking at grains, look for whole grains, whole wheat, you know, not the white pasta, try to get the wheat pasta, not the...
White rice, maybe brown rice, if you really can't stand it, you can always make a mix, 50-50 of the two. You know, like things like this. ⁓ Experimenting with beans, you know, that have, you know, one of the things that are no different with athletes in the big picture than society is that almost...
70 percent, if not more, of Americans don't get the recommended amount of fiber, right? And fiber plays a role, you could argue probably the, maybe the strongest role with the different types of fibers in influencing our microbiome, our gut health. And people that have a healthier microbiome, which often does coincide with athletes, but with
Your microbiome is greatly influenced by your diet and which then influences your sleep quality, which then influences your immunity, which then influences your recovery. So as an athlete, there's an interrelationship for sleep and microbiome. There's also a diet relationship. We know that athletes or anybody that gets at least one and a half grams of protein per kilogram has better sleep quality than those people that get less.
There's been research published on that, looking at controlling for protein, looking at the impacts on sleep quality. ⁓ So there are things that we try to coach to teach and also to read food labels. know, ⁓ if you're going to be some things are kept into the obvious to some of us and not to the others because they don't have exposure.
So for example, I love pasta, but then they want to make it with Alfredo sauce, which might not be the best thing if you're going to have a 90 minute soccer game, you know, five hours later for your midday meal. Right. So all of these things come into play.
Dr. Spencer Baron (22:29)
right on.
Yeah.
Dr Terry (22:35)
You know, that kind leads into the next thought, which is obesity. That's one of the research things on the Internet, as we were talking earlier. And there's so many, every camp has their, the keto camp, the carnivore camp, intermittent fasting, plant-based, and they all say that they're backed by science. If you step back and look at each system, what are some of the advice you give to your students?
Douglas Kalman PhD RD (23:02)
Well, this is a great question. And there actually have been a handful of studies that have grouped these popular diets and put them head to head over a six month or a one year or a two year duration period. Right. And one of the findings that's ubiquitous is that
Many of them help you get to the same amount of weight loss. However, the impact on mood states and the impact on cognition is different, as well as nutrient quality. not picking because all the various diets have nutrient gaps. And that's one way reason that why supplements were invented to help fill the nutrient gaps. Now, what we forget.
in science, in education, and in society, is that we supplement the diet from the time of birth. Babies born in hospitals are given two vitamins within the first two days, typically of life. Vitamin K injection, right? It's an injection, but it's still supplemental and it's meant for a purpose, and vitamin D. And then they're usually discharged on D drops or some type of liquid D.
right? Because there's many different reasons. Then if you think about it, supplement. Okay, foods. wow, we have fortified foods and we have enriched foods. So fortify. Why do when you're making from the field to bread
you know, the vitamins, minerals and fiber is stripped out and we end up getting white bread. And then the vitamins are put back for it. Right. And then certain things, if you wanted it to be at higher levels and when naturally occurs, it's enriched fortified. You're adding it to. So in these both instances, you know, if you go look at a cereal box, that cereal.
in that processing to ultimately make that cereal, all those vitamins and minerals were taken out. And then that content that you see on that food label is through enrichment or fortification. So you're supplementing every time you open up, ⁓ anytime that you open anything that comes from a package, really, right? Milk has extra A and D in it. Water has, ⁓ you know, fluoride in it.
Dr. Spencer Baron (25:40)
I think of Wonder Bread. Wonder Bread was always, the commercial was always ⁓ fortified with eight essential vitamins. thinking, well, what happened to the original stuff that was in there?
Douglas Kalman PhD RD (25:54)
Well, I mean, on a cereal, again, just easy to pick out, and I think I have this right, total, you know, they would market 100 % of 12 vitamins and minerals. Where your total need, total cereal. So supplements have always been part of the human, in recent times, experience, last 100 years or so.
And now we have other varieties of supplementing the diet with nutrients that we've learned about, ⁓ you know, that can aid in recovery, that can aid in supporting longevity, or for variety. Even medically, we use supplements, right? Supplemental nutrition is used for people with poor appetites. Okay, now we tell them to eat more and give them a can of ensure. Check, we did it. Doesn't mean they ingested it, but...
They're around and they have utility.
Dr Terry (26:52)
So when you have, so are you saying when you have, when people decide to go on these carnivore diets, these Keto's, whatever the camps they are, what they are lacking is that they have to figure out what they're missing out of that?
Douglas Kalman PhD RD (27:06)
Yeah, anytime you cut out a whole food group from your diet, how are you not also cutting out all the nutrients that occur in that food group? So you are. So those become your own personal gaps. Then if you ever go to a registered dietitian or somebody else that can take a look at like a food log to do an analysis of what you say that you're eating, they can also look by analysis what vitamins, minerals, fiber, amino acids, protein, etc. essential fatty acids are lacking in the diet.
But we know that, for example, if you go on a keto diet, already know by 70 % fat or higher, 10 % or less carbs, and then the rest from protein, we already know what nutrients that's gonna be low in. It's been well published. So those people that if they wanna do it, and that's what they choose to eat, then they should be also educated on what their nutrient gaps are going to be.
So for example, we are seeing in those people that eat a lot more meat, carnivore and similar, an increase, believe it or not, here in the United States of ⁓ scurvy, a vitamin C deficiency. And if you think about it, if, you know, not making a joke out of it, but all of you are basically eating is meat, you're not getting any vitamin C in your diet. So you're not having citrus, right? To any great degree, a great vitamin C source. So these things are real world.
You know, I presented earlier this week on a case of a woman that developed hyperpigmentation of the knuckles, right, which is an early physical ⁓ sign of B12 deficiency. And ⁓ because of ⁓ B12 does play a role in melanin production. And so...
Luckily that person then had a blood test. Yes, it confirmed that they were B12 deficient. lo and behold, she's been a vegetarian since childhood, right? And then she was cheated therapeutically and everything ⁓ returned back to normal, including her skin pigmentation around her fingers, her knuckles especially. So education for any of these camps, diets, tribes.
is still important. can't think that, I can say from a longevity standpoint, right, that the mind diet seems to have the most evidence for cardiovascular health and cognitive health over the lifetime.
It's called the MIND, M-I-N-D, which has ⁓ been studied at various universities, but it's easy to think of as a mashup of the Mediterranean diet, along with the dietary alternatives to stop hypertension, popularly known as the DASH diet.
Dr. Spencer Baron (29:45)
Which diet was that?
Douglas Kalman PhD RD (30:05)
So those two diets have been put together and studied by various universities, Northwestern University, Rush Medical Center, and others on younger people and older people that if you eat this way, what is the impacts on cardiovascular health and cognitive function in different age groups? And they've all been beneficial.
Now, one thing I could tell you as somebody that's definitely not caffeinated at the moment, but one thing that I could tell you is from work in sport nutrition is that sport nutrition...
on the most serious basis is performance nutrition. And performance nutrition is not always about health. It's about performing for that sport.
So a big example would be football players, depending upon your position. If you're a lineman, they like you big. The bigger you are, as long as you can move fast, fine.
So a lot of the linemen that are 325, 350, they eat to keep their weight up. They're doing a lot of that physical activity so they can keep their explosiveness, right? The NFL average player has average of three years in the league, so not for long, right? And what happens is they don't always get education about, how do you eat when you're not training four or five hours a day and you have to be this weight?
And then they have like they have a in that world ⁓ a significant amount of diabetes and obesity with the average age of death for an NFL players 20 years before all of us. Right. Is in the mid fifties. So now about 24 or 23 years less than the rest of us, which is why do I bring that up is
that sport nutrition is for on some levels is about performance. But if you also want to get in to educate the athlete, what about when you're not doing this? And we could see it in the real world when you see former athletes that ⁓ have changes and they talk about it. Well, yeah, I don't train as much and now I gained all this weight and all right, now I'm getting back in shape.
with medicine or without these days. So I think that's also something on the college level, because not everybody gets to go pro in all of the different sports at universities. So being able to teach some of that is also important.
Dr. Spencer Baron (32:52)
The epitome of what you're saying is in the world of bodybuilding, the way they prepare to look amazing on stage is probably the most unhealthy moment of their entire life, but they look chiseled out. And not to mention whatever anabolic steroids they're on or any kind of diuretics and things like that. I you're absolutely right.
Douglas Kalman PhD RD (33:17)
Well, you know,
it's interesting. Part of my sport nutrition career is ⁓ I was a performance coach, performance nutritionist on season 21 of The Ultimate Fighter. And that was when we filmed The Black Zillions. was a team versus team versus America top team.
You know, and ⁓ so there we're talking for some people, the way that the TV show is filmed is it was ⁓ filmed over 24 hours a day for six weeks. And then when it goes to TV, they break it up into a 13 week season or something like that, right? Because we would have a certain amount of fights per week and all of this stuff. And, you know,
I bring this up because in a conversation with somebody that now no longer ⁓ competes, longer fights, is another part of their life, has moved on. I recently was talking to him and he's easily 50 to 70 pounds heavier than what he used to be. And I asked him, I said, you know, like, okay, dad life, what's going on? Right. And he said, no, he said, truthfully,
In my mind, I still can't get past ⁓ going to sleep hungry so many different nights. So and with the sport of bodybuilding.
One of the things that's not talked about like about that is that that's an appearance sport. So they want to look at and lean as ripped and whatever, whatever category that they're in. And they do these extreme things. And ⁓ while the other aspects of what they're doing, the exercise and all that stuff is about health, sometimes the physical appearance stuff is not about health. It's just about looking amazing. Right. Then you have athletes that do weight based sports.
⁓ that sometimes will cut 10 % of their body weight in the last 12 hours before weigh-in and that wreaks all sorts of havoc. That's not good either. And I remember having another conversation with one of the UFC fighters actually. And ⁓ one day he came back, we're at the gym and he comes up to me and he says, hey, guess what I did last night?
And I thought, you know, you're from the UK, you're living in Boca, you know, maybe you went to something, you know, Meissener Park or something, right? And he said, no, I went for a 10 mile run. And then I, so he's like, what's that look on your face, doc? And I said, are you training for a marathon or a three round fight? All right, your sport is 15 minutes long.
So, sometimes, not that everything that you have to do has to be sport specific, but you have to be aware of what you're doing, not always more is better. So for him, it was just getting an understanding, okay, maybe he needed to do that for his head, because sometimes ⁓ exercise is cheaper than a therapist.
But was it. But it never happened again. Then he understood like training for a fight versus running because, know, you just feel like opening it up, you know, and there's a difference, you know.
Dr. Spencer Baron (36:44)
Perfect. ⁓
Douglas Kalman PhD RD (36:47)
You know, one of the things that I could ask you, if you don't mind, is do you find a difference in the type of questions you get from patients if that patient is just, let's say, a regular person versus a teenage athlete or somebody that is physically active in their 20s, 30s? What are some of the questions that you guys get?
Dr. Spencer Baron (36:50)
sure.
Well, we definitely, you know, they ask what to eat before a competition and it depends on if it's, you know, endurance or strength. ⁓ Well, or more importantly, is there any ⁓ kind of ⁓ eating or food protocol or diet protocols that would help with healing? Any thoughts on that?
Douglas Kalman PhD RD (37:35)
⁓ If you cut a Mexican yam in half and you put it on the injury and it's iced, that will work really well.
Dr. Spencer Baron (37:46)
my
Dr Terry (37:46)
I was expecting that! ⁓
Douglas Kalman PhD RD (37:49)
No, so
Dr. Spencer Baron (37:49)
I did not expect...
Douglas Kalman PhD RD (37:53)
foods for recovery, instead of saying specific foods, I have to keep you on your feet, you know. Instead of saying specific foods, I'd rather say foods that are rich in omega-3 fatty acids, right? Because omega-3 fatty acids have what main function in the body? They act as an act to promote anti-inflammatory. And when you're
Dr Terry (37:59)
Hahaha!
Dr. Spencer Baron (38:00)
That was a good one.
Douglas Kalman PhD RD (38:18)
Looking for recovery typically you're dealing with some type of inflammatory state either from a heavy training or you train You train quite frequently. So your stress load is high, right? All these different things so omega-3 fatty acids then I also look for a variety of naturally occurring Antioxidants so colorful vegetables colorful fruits the more colorful typically the more polyphenols, right? And with the more different type of polyphenols
and phenolic acids, they have a variety of antioxidant effects and immune supporting effects. So when you support normalization of oxidation in the body, oxidative stress, right, you help actually tamper the inflammatory response and the immune response. Because when we have high reactive oxygen species or high oxidative stress, the same interleukins that get secreted
as in response to that stress, the pro-inflammatory ones, impact immunity and impact inflammation. So omega-3 fatty acids help tamper that and polyphenols and antioxidants help tamper that a different way.
Right? So all of that put together and then of course quality protein and the other things that are important. Again, you have to be eating enough calories for what your body is looking to do in recovery and heal. It's different if you're getting ready for a physique show or you're getting ready for a weight based. Then you want to make sure that the nutrient quality of what you're eating is the highest it can be.
And then you also look at what supplements can be ingested that also may help support that kind of recovery. Food first approach, omega-3 fatty acids, a variety of polyphenols from colorful vegetables and fruits, Quality protein. You know, we're talking somewhere in between at least 1.4 and 2 grams per kilo.
Right? ⁓ If you're a vegetarian or a vegan, you need one and a half times the amount of protein as a meat eater to get the same nitrogen value from that protein because of the inefficiency of lysine and methionine that's ubiquitous throughout vegan and vegetarian protein sources. So for vegans and vegetarians, they need to get one and a half times amount the total protein to kind of equal the amount of nitrogen that omnivores get.
And research shows that to be true in terms of the ability to maintain muscle and gain muscle even while dieting.
Dr. Spencer Baron (40:54)
You know, you just reminded me, years ago, when a patient would come in with an injury that was preparing for any kind of competition or even a hard practice, I would tell them to be cautious of how much red meat, because of the purines that would be pro-inflammatory. Is there still any truth to that, or is that old stuff that I was talking about?
Douglas Kalman PhD RD (41:18)
Well,
in a way ⁓ you have some good what you're saying there. Red meat ⁓ can be high in certain kind of fatty acids that cause more of a pro-inflammatory response, arachidonic acid usually, right? ⁓ And a few others. Now, purines.
At one time, people would restrict red meat intake because it's high in purines and people that have gout because gout is a manifestation of a defect or something disrupted in purine metabolism. These days, medical nutrition therapy
is as long as that gout patient is on like allopurinol or whatever today's treatment is, then they can have, they don't have to exclude red meat or other high purine foods, which there are some dark green leafy vegetables that are also high in purines. ⁓ to give you a kind of a different answer, red meat is just one protein source. ⁓ There is.
chicken, there's turkey, there's fish. ⁓ I've seen other animals also sold in markets here in South Florida. there's a ver- and there's eggs. There's a variety of protein sources. ⁓ Red meat intake that's frequent does have a higher correlation with ⁓ colon cancer and cardiovascular disease. So there is some type of happy medium.
Maybe once or twice a week, but not every day. Kind of thing. And then there's so many different protein choices that you can have different proteins at a remu.
Dr. Spencer Baron (43:06)
You refer to good proteins. Is there something specific behind that versus a bad protein?
Douglas Kalman PhD RD (43:15)
Well, proteins
that contain, of course, all of the essential amino acids in proper quantity and quality ratios, as meats do and fish does, compared to vegetarian and vegan sources of proteins would be good or better. ⁓
I may have also meant that red meat is a good protein source, but when I say better alternative, mean that we also have fish, also have poultry, we also have all the others. You don't need red meat as the staple of a diet. Just if you enjoy it, have it every now and then, or just a couple of times a week, but not every day saying, I'm a bodybuilder, I need the red meat to grow.
Yeah, 300 was a movie. You don't need to eat the brain of your opponent to get it smart, you know?
Dr. Spencer Baron (44:17)
That is one of my favorite movies, by the way.
Dr Terry (44:18)
Damn it.
Douglas Kalman PhD RD (44:20)
It's a great one.
Dr Terry (44:23)
You know, you ask a question, what kind of questions we get from patients and I've some of the stuff that I've been getting lately is, you know, we'll run blood on somebody and we'll put them on a strategy and they look at the strategy and they're like, yeah, that looks like too much work. Is there just a pill I can take or is there just a mix I can do or a powder I can do and
and I always laugh because I'm like you take better care of your car than you do your body but you know it's like they always want the fastest strategy to the quickest solution. What's your advice on that?
Dr. Spencer Baron (44:48)
Yeah.
Douglas Kalman PhD RD (44:57)
I think that's an age old problem. I honestly, I'm not walking away from that, but ⁓ you can't fight logic with emotion and you can't fight emotion with logic. And so some of those people are reacting emotionally. know, logically they might think about and say, okay, I need these lifestyle habits, but it'd be much easier to take a Lipitor with my Big Mac, right?
⁓ And so I don't have like a real good answer for that. I think that comes with if we can get better as a society about talking about not preventative medicine, but just good health, public health, good health practices in starting when kids are in elementary school, middle school, high school, somewhat in college. So that as they grow up and have to be responsible for themselves and in homes too, if we can.
then we'll have much healthier generations. I don't think we could blame everything on the food supply. When it comes down to it, nobody makes you stop at the local bodega and grab a Twix bar, right? There's nobody saying you must have it. So, and I'm not saying that everything is will, but there is choice. You know, so there's a lot to unravel, I think there. So.
Dr. Spencer Baron (46:20)
I was going to ask him a fun question, and it's more from a practice perspective when people find out that you have this special understanding of nutrition. Do they come up to you and go, hey, can you put me on a diet? And what's your response?
Douglas Kalman PhD RD (46:39)
That's happened, of course, in my life. And, you know, just like you guys get asked a million questions by friend and family and somebody that you just met, you know, or a friend of a friend somewhere at a social gathering. And ⁓ for most people, you know, the answer is no. ⁓
Dr. Spencer Baron (46:40)
Of course, hell yeah.
Yeah.
Douglas Kalman PhD RD (47:07)
But
if you're actually, no, but if you're actually serious and want to accomplish your goal, then we can work together and this is how I do it. If not, I'm happy to refer you to somebody else if you're serious. A lot of people are in the pre-contemplation stage or small talk stage, right? Making small talk with you because they like you, they want to stay friendly with you, but they're not yet really ready to commit to you know, to even a first appointment.
Dr. Spencer Baron (47:21)
Yup.
Dr Terry (47:37)
Good night.
Dr. Spencer Baron (47:38)
One of the tricks of the trade is that, because I've done it so many times for people where I'll set them up with a diet and it's really planned out, I'll go over it with them and I'll ask them in a week from then and they'll go, I haven't started yet. So now what I do is I'll tell them to give me a five day diet log, what you eat, when you ate it, and you can eyeball the quantity. If they do that, then they're usually pretty serious.
Douglas Kalman PhD RD (47:55)
Sure.
Right. Yeah, I mean, that's
that's when I say to somebody, if you're serious, this is my checklist. It includes, you know, keeping a log that has similar to what you said, because that shows at least all right. Yeah, they are showing some seriousness about it. They're more likely than not, if they're bringing it to you, they're going to want to try to follow through. Right.
Dr Terry (48:22)
Hey Doc, before we get too far into the time, there is something I do want to ask you. want to get back into something. You mentioned earlier supplements. One of the topics right now is the resurgence of creatine. What's your thoughts on that?
Douglas Kalman PhD RD (48:39)
Well, ⁓ creatine ⁓ is already part of our diets. So we get creatine through food. It's most found in red meat and it's found in some fish, mackerel, salmon, toro. So some of the fattier fish naturally have creatine. And again, ⁓
anything that's red meat and other proteins. So we get some from the diet. Then creatine is a tripeptide. It's an amino acid made up of three amino acids. If you get those amino acids in sufficiency in your diet, and one of them tends to lack in vegans and vegetarians, methionine, our bodies can synthesize the tripeptide that is creatine.
Our bodies use creatine as part of the phosphagen energy system, which is basically the energy system that you use when in all-out exercise for the first like 8 to 12 seconds, it's primarily driven by the phosphagen energy system. And then creatine is used of course as phosphocreatine for when you break down energy, ATP.
All right, you liberate a phosphate, energy is released, liberate another phosphate. So ADP becomes ADP becomes AMP. So phosphocreatine from creatine will donate that phospho group, phosphate group to build back up energy too. So creatine has the ability to help influence energy processes in the body and our ability to recharge. Right. And so we already know that ⁓
We store a certain amount of creatine in muscles and different organs throughout the body, your brain, your eyes, your testes, your spleen, your muscles, your heart, right? And that it's used for a variety of different neurologic processes and energy processes, right? So much so that in our brains, in our nervous system, if you will, glial cells, astrocytes, ⁓ and even oligodendrites, right? Part of neuron.
all use creatine or can synthesize creatine for its use when it needs. Showing creatine plays many different roles. Now for years it's used been used for athletes to help ⁓ increase lean body mass, to help increase athletic performance, which it does typically by five percent or so, right? And ⁓ you know, now we're learning
even though there's 30 years worth of research, other benefits for as you age, helping to reduce sarcopenia, for perimenopausal women to help maintain bone mass, right, to also help maintain muscle mass. Studies even show that when creatine is added on to a standard anti-depression treatment, that you get an increase in the response rate.
for those people on creatine plus their SSRI versus SSRI alone because creatine does play a role in neurotransmission. So creatine has become much more fascinating and looked as a life cycle nutrient and a longevity nutrient. And I mentioned life cycle because creatine is used, right? When a woman contracts, right? Giving birth, they're contracting what? A muscle. And that muscle
is using creatine. And when a woman is going through contractions, right, uterine contractions, that's a lot of creatine that's being used. Creatine's been shown, ⁓ so we, it has even an effect on birth. And then we also know that in neural development, creatine plays a role in brain development as well. So, and we know that because there are inborn errors of creatine metabolism. If they're not caught,
early in life that end up with ⁓ cognitive and mental retardation. So creatine is a fascinating nutrient that's a lot more than, hey, give this to my gym bro, it's white powder. You know, ⁓ it's really a life cycle nutrient. ⁓ If you really want more information on that, if you don't mind, I recommend a website that's called creatine for health. And it has a plethora of
peer-reviewed, published, ⁓ literature uncreated, interviews, videos, ⁓ all about these different areas, more than just sports. It's global.
Dr. Spencer Baron (53:29)
fantastic for that.
Douglas Kalman PhD RD (53:30)
Also, one
other thing, I am a co-founder of the International Society of Sports Nutrition. So we are in our 23rd year, we have annual conferences, regional conferences. So for people that are interested in that, they can look up for the ISSN.org or International Society of Sports Nutrition and see our conferences, see our PubMed index journal, Journal of the International Society of Sports Nutrition. And in our journal, we publish position stands and those position stands
are meant, these are evidence-based guides that have been distilled from the literature using standard means so that a practitioner could then tease out what can I learn from this, what can I use. We have for a variety, ultra endurance athletes to a variety of topics and you'll see that in the journal, over 20 of them.
Dr. Spencer Baron (54:26)
That is great information. So you mentioned creatine and I wanted to ask you, if you were asked what three nutrient principles that you would likely believe that would exist in the next 50 years from now, would one of them be creatine or are there others that you would feel would be an important?
Douglas Kalman PhD RD (54:50)
So if you're asking if we were coming back 50 years from now, would creatine still be a thing and be a nutrient of utility? And I would say yes. I would say yes, both within normal health and within certain medical conditions.
Dr. Spencer Baron (55:12)
Are there others?
Douglas Kalman PhD RD (55:15)
I do think that there are a variety of others. I think that there's always going to be a need for a good quality multivitamin mineral. I do think that because we do have some important nutrient gaps, I'll mention DHA, especially for any woman of pregnancy age. I'd mention choline, again, especially for any woman of pregnancy age.
I'd mention fiber for all of us, but food first approach. It's okay, eat your broccoli guys. You're better off for it. ⁓ Some of those. In the sports supplements, ⁓ proteins are always gonna be a play because that's also about convenience. Most people today and tomorrow are gonna be living on somehow an on the go lifestyle.
Right? We don't have three square meals at home. Some people are lucky to have one meal at home and sometimes it's from takeout or it came from a box. Right? So, you know, I would love to see more food prep being done by individuals. It's a healthier way to live.
Dr. Spencer Baron (56:31)
Terry, you wanna go into the rapid fire? All right. All right, Dr. Kalman, got, well, you answered one of the five rapid fire questions and that was one of them, would creatine still be something that would be evidence-based even in the next, very good, beta-alanine. All right. What food is that found in?
Dr Terry (56:33)
You betcha.
Douglas Kalman PhD RD (56:42)
Okay.
I would also add beta alanine to that. Yeah.
Beta-alanine
actually ⁓ is a dipeptide. So it's a dipeptide of histidine.
I'm blanking on the other amino acid, but it's found in foods that have proteins. The richest actually would be chicken and chicken soup.
Dr. Spencer Baron (57:22)
Good old chicken soup. Jewish penicillin. Got it.
Dr Terry (57:23)
There you go.
Dr. Spencer Baron (57:29)
All right,
so I want to jump right into question number two. And of course, the most brief answer is best, but we get carried away sometimes. So if you're ready, here we go. You've been involved in research and position stands for well, there's that decades again, but for a long time. How about that? What is one nutrition myth that refuses to die, even though the science has already settled it?
Douglas Kalman PhD RD (57:37)
Sorry. Yes, sir.
that caffeine is a diuretic. That is a myth that refuses to die. It's been shown in a multitude of different studies that caffeine is not a diuretic. Caffeine does not inhibit antidiuretic hormone.
It does not induce a greater volume of fluid output or urine output over a 24 hour period as compared to non caffeinated intake. There have been studies done in athletes, non athletes, healthy young adults, middle age adults and older adults. And caffeine does not induce dehydration. Caffeine does and does not as a diuretic. That's a myth that deserves to be shot.
Dr. Spencer Baron (58:44)
That is great. I did not expect that. All right. Next question. You've worked Olympic games, professional athletes and major research labs. When Dr. Kaman walks into his own kitchen, what's the one food, man, that you'll never give up?
Dr Terry (58:47)
That was golden.
Douglas Kalman PhD RD (59:04)
ice cream.
Dr Terry (59:07)
He didn't even hesitate.
Douglas Kalman PhD RD (59:09)
No,
I may have changed the kind of ice cream that I eat, but I've been eating ice cream since childhood and it's never lied to me. So I continue to eat it.
Dr. Spencer Baron (59:15)
Yeah.
Dr Terry (59:19)
I've never lied.
Dr. Spencer Baron (59:22)
That's great
because that was part of my next question. That was part of my next question. Let's settle it scientifically. Is ice cream a recovery food or a cheat food?
Dr Terry (59:27)
you
Douglas Kalman PhD RD (59:35)
It could be either. I tend to have my ice cream, mix in a scoop of creatine and mix in usually about 10 grams of whey protein. And that's how I eat it. Now that's a lot different than I ate it at 15 years old, right? But that's how I eat it. So I get the best of both, is way I look at it.
Dr. Spencer Baron (59:38)
Of course you say that.
Dr Terry (59:58)
That's hilarious. That's
Dr. Spencer Baron (1:00:03)
that that is a beautiful answer. Man, when we were,
Dr Terry (1:00:04)
a- That's aw- I've been creatine with my ice cream. That's great.
Dr. Spencer Baron (1:00:10)
I think I might try that myself.
Douglas Kalman PhD RD (1:00:11)
I could tell you a story that
back in my dating life, going years ago when I was living in New York City, somebody was over and they went to my freezer and they went to go take out some ice cream. They wanted something to eat and they're like, your ice cream has freezer burn. I'm like, no, no, that's just a little bit of whey protein left on top of the ice cream there. It's not freezer burn.
Dr. Spencer Baron (1:00:21)
you
That's awesome. That is, that is right. It was for the ice cream. Yeah. Yeah. That's outstanding.
Douglas Kalman PhD RD (1:00:36)
She did come back for another date.
It was. She's like, you're on to something. Can you make it in frozen yogurt style? This is back in the 90s, you a long time back.
Dr. Spencer Baron (1:00:54)
That's given me new meaning to bluebell cookies and cream. love that. All right. All right. Last question. my gosh. I don't even know. I don't even think I want to answer. Ask him anything else. All right. You've helped shape the science behind how athletes fuel their bodies and how clinicians guide their patients. But beyond the research papers and the conferences, what part of this work has meant the most to you personally?
Douglas Kalman PhD RD (1:00:57)
Yeah.
You know, the answer to that really is, when work with individuals that have had a variety of issues and see them resolve or have that person come up and share their enthusiasm and appreciation for whatever I may have helped them with, you know, ⁓ that.
You know, one of the things that I take very serious is that, you know, nutrition can impact quality of life. So when you improve somebody's quality of life, that's meaningful. It's very hard, ⁓ follow this diet, it's gonna help lower your cholesterol. People, if they don't have an experiential experience with something,
It's harder for them to grasp. OK, this is what I need to do. But in answering your question, I'm going to give you two answers. One from having various patients or clients in my life thank me for things I've helped them with. watching students that have mentored either for their bachelor's, master's or doctorate go on to achieve great things and accomplish their own.
overcoming of obstacles and, you know, seeing them grow. That gives great satisfaction.
Dr. Spencer Baron (1:02:51)
Well, you're truly a mentor and an inspiration to those students you've taken care of and one of them is a patient of mine who Norma referred me to you because of how bright and talented you are and you get the point across. Yeah, very good. Thank you so much for being on the show today. We totally appreciate that.
Douglas Kalman PhD RD (1:03:03)
I'm grateful to her. She knows that.
yeah, today if you search the internet for nutrition advice, you'll find thousands of confident voices telling you what to eat, but very few of them are scientists. Calories don't matter, calories matter more than anything, carbs are poison, carbs are essential, with all the noise. How do we know what real science actually says? Today we are talking to Dr. Douglas Kalman.
who has spent decades researching the answers. Welcome to the show.
Douglas Kalman PhD RD (00:31)
Thank you for having me on. It's a pleasure. Decades makes me sound much older than I like to feel.
Dr. Spencer Baron (00:37)
yeah, don't you worry. If you only knew you would feel a lot younger. So, all right. Let me ask you, just to start off from your perspective as someone who has spent quite some time, how about that, researching in sports and nutrition, where do you see some of the biggest gaps between what the science actually says and what the internet is telling people to believe?
Dr Terry (00:39)
Well, we're all decades here.
Douglas Kalman PhD RD (00:39)
you
There are, well, the biggest gap really is educational gap. So there, unfortunately, you can't govern or regulate misinformation, disinformation, versus right information on a platform like the internet, right? ⁓ And whether that's on whatever form of social media is hot at that moment, seems to be things that are short.
get short that fit short attention span kind of things. ⁓ And really, that is a barrier for education about anything and everything. So I'll give you an example. I'm a professor at Nova Southeastern University. I teach a I'm a nutrition professor. Most of my courses are either in the neurosciences or in
other areas, sport nutrition and some other areas, ⁓ pathophysiology. so, but the point that I'm trying to get at it outside of those that know how to use PubMed and other, you know, sources through the internet that you could get to. If you ask, where do you do your research? You know, I've heard a Snapchat, a Snapchat and TikTok and YouTube, YouTube reels or YouTube. So.
Not that you go even to PubMed or you go to AI or you go to the free that your tuition paid for medical library, right, or any library that's on campus on your computer. So I think those are barriers to overcome.
Dr. Spencer Baron (02:43)
Yeah, you know it. sorry.
Douglas Kalman PhD RD (02:44)
You know, so like you could
both of you are involved in sports, right? And working with athletes and I'm sure you get tons of questions that come your way about being either bigger, faster, stronger, leaner, you know, depending on the age, you know, recover faster, all of this stuff. they're going to some people may say things what they just heard.
Right? And others you could tell have, you know, done some, at least some basic reading and understand what a carbohydrate, a protein, a fat is. And that doesn't matter what supplement you're using. If you're not getting sufficient nutrient intake, which includes quality calories, quality carbohydrates, proteins, et cetera, then your gas tank is still empty.
Dr. Spencer Baron (03:29)
Yeah, yeah. Well, I we exceptionally love when somebody comes in and we can refer to them as Dr. Google because they heard it on. They did a Google search. They they start telling us what they need to know or what you should know. But anyway, it's always been it's always fun.
Douglas Kalman PhD RD (03:41)
you
Well, that comes
from a variety of different psychological areas, right? ⁓ Curiosity. And like, for example, I have a friend who ⁓ medical stuff going on in the family, and I've coached her to stay off the Internet because she'll go down rabbit holes.
And it's okay, I tell her if you can go down the rabbit hole, bring your questions to me. I'll help you sift through them. And then if something, you can always go to the neurologist or the physician, right? So, but point being is like sometimes it's bad, it's negative going down these rabbit holes that people do.
Dr. Spencer Baron (04:27)
yeah, very, very much. in fact, when a patient, when we identify someone as having like something as easy as facet syndrome, if you go on Google and you pull up an image, it shows a big needle going into the low back and we go, no, no, no, that's not how it's no, that's, that's just an image of in the medical perspective. So we have to just, just an image can lead someone down the wrong direction, you know? Yeah.
Douglas Kalman PhD RD (04:53)
This is true. This is very, very
true. That's why image is all important in marketing. The colors that are chosen, the font that's chosen, the word that's chosen. I'll give an example of a very popular allergy medicine that we all know, Claritin. That was chosen because it was close to clarity.
Dr. Spencer Baron (04:58)
Yeah, yeah.
catch your eye.
Douglas Kalman PhD RD (05:17)
And ⁓ so the marketing agency that worked with the original pharmaceutical company at the time in deciding names and doing what they do, know, Claritin, Clarity, and their commercials, Director Consumer TV, what was, would always show, you know, clear skies. Even if there was clouds, you can breathe, you had Clarity, you know, like, aha, Clarity, no more sneezes.
Dr. Spencer Baron (05:17)
Interesting.
Dr Terry (05:39)
All
you
Dr. Spencer Baron (05:44)
Well,
thank you for that story, because what I read about that what I read about Adderall is the guy who the chemist that created Adderall named it as ad for all Adderall for all Adderall. And that's how it's gone haywire. That is probably the next big epidemic epidemic in sports is, you know.
Douglas Kalman PhD RD (05:48)
That's a pretty good question.
Dr. Spencer Baron (06:11)
people take an Adderall for an event. But let me bring it back to something like a calorie, say calories versus hormones and so on. Like from a physiological and metabolic standpoint, like what does the research really say about calories versus food quality and where do most people misunderstand that relationship between the two?
Douglas Kalman PhD RD (06:36)
Well, let's talk about food quality to start with. Unfortunately, six to seven and half people out of every 10 are either overweight or obese. Right. So that's usually indicative of an over consumption of calories or the caloric intake is greater than caloric expenditure over time. So what is the makeup of and why do I mention that?
Dr. Spencer Baron (06:40)
Yeah.
Douglas Kalman PhD RD (07:04)
because the amount of overweight and obesity has skyrocketed in the last 40 years as compared to 100 years ago. And we know that there's been ⁓ the industrial revolution times a gazillion for the amount of different foods that are on market. So for example, nutrient density for the foods matter.
and we get a lot of empty calories in a diet. And I'll use name brand just for ease of example, not calling anybody out. If you look at...
the amount of Gatorade that's consumed in youth sports, where they play a 30 minute, youth being like entry level, they play 30 minute games max, and they get water breaks every 10 minutes. you know, they're given Gatorade. So it adds up, right? Those are not carbohydrate calories that are actually really needed to do anything at that time. And rehydration is actually better spent by water at that time.
And then so those I'm trying to get to a point where we know that when you have diets that are more predominant higher in ⁓ monosaccharides, right, simple sugars, ⁓ processed foods, right, low in fiber, and concurrently, there's a little maybe more saturated fat in the diet.
Right? That it increases your risks of mild cognitive impairment in Alzheimer's by significant, you know, degrees over the lifetime. So that's just lifestyle. And that's talking about diet composition from one perspective. So nutrient density is something that I really like. And ⁓ that goes back to work that's really was put forth by Barbara Rolls, R-O-S-S, R-O-2-L-S, rather. ⁓ And ⁓ it's looking at
the nutrient when you look at food right you could weigh food right 100 grams a little over three ounces let's say so of how many calories per gram are you getting how many grams and what part protein carb fat fiber vitamins mineral and you can kind of see the nutrient content of that kind of food the quality in one way and you know along with the water content actually so ⁓
That may or may not answer your questions, but I think that diet styles matter. And for example, if you're working with youth sports or people that think that they're youth, us, that still like to do some type of sport or exercise, but might not really have an education or background in nutrition beyond that, maybe they can cook, they know what to, they go out and eat, but they don't necessarily know the ins and outs.
Dr. Spencer Baron (09:47)
Right.
Douglas Kalman PhD RD (10:01)
Having a basic understanding of the different types of carbohydrates, fiber, ⁓ protein, that not all proteins are equal, know, things like this become important.
Dr Terry (10:14)
Hey, hey, doc, you work at a university and and especially I work at universities as well. And one of the things I've been seeing a lot of our athletes are coming in and they say, I need more calories and more calories. And they're hitting the junk food places. They're hitting the the chick filets or the whatever. And they're getting all these calories. But then they're saying, I'm always hungry. And and they're always tired or they're they they can't focus and and they're they're scrolling their phones more because they're focused as
maintain but they just keep consuming calories. Can you talk the difference you mentioned earlier? Can you talk the difference between empty calories and functional calories?
Douglas Kalman PhD RD (10:54)
Sure. So you can easily get ⁓ calories having a bag of Funyuns and a Slurpee, right? ⁓ Just for an example, but the amount of all the different B vitamins, vitamin C, various carotenoids, essential fatty acids, essential amino acids, protein, fiber, et cetera.
Dr. Spencer Baron (11:01)
You
Douglas Kalman PhD RD (11:22)
is not there. So those empty calories that are actually higher in mono and saccharide, simple sugars, are not going to be something that is useful for an athlete because they're not providing any of the building blocks or rebuilding blocks of what the body needs because you are engaging in athletic endeavors. So maybe they're meeting a calorie need, but they're not getting the nutrient quality.
So they feel lethargic, they can't concentrate, they're not getting enough of the precursors. So for example, ⁓ and let's say that that athlete happens to be vegan or vegetarian.
then you actually start to worry about protein intake because of the amount of quality of essential amino acids, because these are used for precursors of serotonin, dopamine, or epinephrine, epinephrine, your neurotransmitters, things that we like and things that are useful from short-term memory, long-term memory, locomotion, right? And things like this, which athletes need to be on point for, all of us need to be on point for.
quality impacts the integration of nutrition for physiology and then for outward performance. so that's where education, whether it's possible to work if the athletes have their own part of the dining room, whether they're on their meal plan, whether there's a sport nutritionist on staff to help tailor some things for more one-on-one.
When I used to do university nutrition, we would always have team nutrition for everybody. People got books or handouts or things on apps that had all the info for eating at restaurants, cooking at home, food shopping, all this stuff. And we would do some live stuff too. But you know, then you had some athletes that did need one-on-one.
Dr Terry (13:16)
Have you, have you, yeah, go ahead. Yeah. I wasn't going to switch.
Dr. Spencer Baron (13:16)
Terry, wait a minute. I wanted to ask him about nutrient rich foods before you switch.
All right, go ahead then.
Dr Terry (13:25)
I was just going to say,
mean, yes, you're right, but a lot of these processed foods, almost put like fake flavors and it seems like the athlete gets hooked on, these taste good and real food tastes bad. And then you have nutrients rich foods that Spencer is going to talk about. I mean, how do we get these athletes to go, ⁓ that tastes really good. It's almost like being addicted to candy almost. How do you help these athletes get changed your taste buds, I guess is a better term.
Douglas Kalman PhD RD (13:53)
Well,
part of that is maturity and part of that is exposure. So for some athletes and some teams, we'll have interaction with cooking so they can see what fresh cooking, fresh food, fresh taste like, you know, how to use spices. ⁓
I personally used to take various teams on first the supermarket tour and then helping them put together how to understand it, you know, with my other team of dieticians that would help for that kind of stuff. So there is education, you know, that's really needed. ⁓ It's hard to give a quick answer on something like that. There is methods of delivering that.
Dr. Spencer Baron (14:35)
think it's the parents.
I think the parents need the education more to retrain the kids.
Douglas Kalman PhD RD (14:41)
Well, I think there's
something to be said for, ⁓ I know years ago, ⁓ I would think that there's something to be said for, ⁓ home education, nutrition in the household, ⁓ along with the whole other slew of things and in the schools, which it doesn't really happen. But when I remember going to school that we had at least, you know, one course and that included, ⁓ basic nutrition as I guess, eighth grader or something. ⁓ you know, so.
I don't have a quick easy answer Dr. Terry.
Dr Terry (15:15)
That's OK.
Dr. Spencer Baron (15:16)
I'll tell you what though, there was an opinion ⁓ article in New York Times several years ago that really struck me. was, is obesity ⁓ just a food consumption problem? Is it an emotional thing? And what they talked about was exactly where you're leading to about nutrient dense foods. So the example the writer used was,
If you took a tomato from 40 or 50 years ago and compared it to a tomato today, the tomato from 50 years ago was smaller, much more dense, and it would satiate the body's appetite or need for certain nutrients. Whereas the tomato today, you'd need two of them to make up the nutrients that were in the tomato from 50 years ago. And I thought, wow, because your body is what's talking. your need to balance some of the chemistry
that you might be lacking. Any thoughts on that? I mean, you can go across the border to Canada and the eggs taste like eggs there. It's just completely different.
Douglas Kalman PhD RD (16:25)
I'm wholeheartedly
with you in the sense that agricultural practices have been influenced of course by business, right? If you own, and you're selling meat, you own cows, you're selling meat, right? You wanna...
be able to get the most pounds out of that cow that you could sell because you're getting paid per pound or you know along those lines and that's why different things are used to increase the marbling of the meat, increase the size of that animal. Even like you said with fruits and vegetables. I just bought grapes last night in the supermarket that are I don't know size of golf balls if you ask me. All right.
And the cashier and I were laughing about it. I asked like, whatever you're putting this fruit on, where do we get it? know, like. ⁓ So what happens with that is you're getting less nutrient dense foods because it's not in proportion. It's not the same. And what you said where you go outside the US and food systems are different.
you go out to eat or you go to the markets to buy food, eat it, even breads, the tastes are cleaner, more vibrant, ⁓ which is like the impact here of what we have with these agricultural practices. I do know that there's a movement, may or may not be part of Maha, but to try to increase regenerative farming, to try to...
you know, to do things that can be more back to nature and also better for agricultural practices. I don't know if that's going to change the size of a tomato, but.
Dr. Spencer Baron (18:12)
So
if you were, Dr. Common, you were to take someone around the grocery store, and yes, of course, you would tell them about the perimeter being the more nutrient-oriented foods, but like, how would you tell, what would you tell the audience that they can do now to find more nutrient-dense foods? Do you go look for farm to table places that, I mean, what would you suggest that someone could do?
Douglas Kalman PhD RD (18:40)
You know, so a few different things. ⁓
when it comes to fruits, fresh fruits, right? When it comes to vegetables, fresh vegetables. However, one thing that should not be diminished at all is that frozen vegetables more often than not have greater nutrient quality than fresh.
In farming practices, typically within an hour of it being picked from the field, it's already gone through an initial wash and is starting the flash freezing process, right? Which if you compare, when you go to any supermarket, the fresh produce that's there came on a truck from somewhere, right? Now, whether that truck was refrigerated or not, I don't know, but
And some things cross state lines and cross countries. So some things could be just a couple of hours. Some things could ⁓ be, you know, maybe a couple of days if it's Florida oranges going up to the Northeast, because, you know, right. So things like this also impact ⁓ choices. So meaning I don't diminish vegetable frozen whatsoever because knowing the practice of of that. ⁓ So.
Dr. Spencer Baron (20:07)
great advice.
Douglas Kalman PhD RD (20:08)
⁓ Then, you know, of course fish, ⁓ poultry, red meat, those are, you know, choices too. In the supermarket, I also like to give 30,000 foot views of things. If you're looking at grains, look for whole grains, whole wheat, you know, not the white pasta, try to get the wheat pasta, not the...
White rice, maybe brown rice, if you really can't stand it, you can always make a mix, 50-50 of the two. You know, like things like this. ⁓ Experimenting with beans, you know, that have, you know, one of the things that are no different with athletes in the big picture than society is that almost...
70 percent, if not more, of Americans don't get the recommended amount of fiber, right? And fiber plays a role, you could argue probably the, maybe the strongest role with the different types of fibers in influencing our microbiome, our gut health. And people that have a healthier microbiome, which often does coincide with athletes, but with
Your microbiome is greatly influenced by your diet and which then influences your sleep quality, which then influences your immunity, which then influences your recovery. So as an athlete, there's an interrelationship for sleep and microbiome. There's also a diet relationship. We know that athletes or anybody that gets at least one and a half grams of protein per kilogram has better sleep quality than those people that get less.
There's been research published on that, looking at controlling for protein, looking at the impacts on sleep quality. ⁓ So there are things that we try to coach to teach and also to read food labels. know, ⁓ if you're going to be some things are kept into the obvious to some of us and not to the others because they don't have exposure.
So for example, I love pasta, but then they want to make it with Alfredo sauce, which might not be the best thing if you're going to have a 90 minute soccer game, you know, five hours later for your midday meal. Right. So all of these things come into play.
Dr. Spencer Baron (22:29)
right on.
Yeah.
Dr Terry (22:35)
You know, that kind leads into the next thought, which is obesity. That's one of the research things on the Internet, as we were talking earlier. And there's so many, every camp has their, the keto camp, the carnivore camp, intermittent fasting, plant-based, and they all say that they're backed by science. If you step back and look at each system, what are some of the advice you give to your students?
Douglas Kalman PhD RD (23:02)
Well, this is a great question. And there actually have been a handful of studies that have grouped these popular diets and put them head to head over a six month or a one year or a two year duration period. Right. And one of the findings that's ubiquitous is that
Many of them help you get to the same amount of weight loss. However, the impact on mood states and the impact on cognition is different, as well as nutrient quality. not picking because all the various diets have nutrient gaps. And that's one way reason that why supplements were invented to help fill the nutrient gaps. Now, what we forget.
in science, in education, and in society, is that we supplement the diet from the time of birth. Babies born in hospitals are given two vitamins within the first two days, typically of life. Vitamin K injection, right? It's an injection, but it's still supplemental and it's meant for a purpose, and vitamin D. And then they're usually discharged on D drops or some type of liquid D.
right? Because there's many different reasons. Then if you think about it, supplement. Okay, foods. wow, we have fortified foods and we have enriched foods. So fortify. Why do when you're making from the field to bread
you know, the vitamins, minerals and fiber is stripped out and we end up getting white bread. And then the vitamins are put back for it. Right. And then certain things, if you wanted it to be at higher levels and when naturally occurs, it's enriched fortified. You're adding it to. So in these both instances, you know, if you go look at a cereal box, that cereal.
in that processing to ultimately make that cereal, all those vitamins and minerals were taken out. And then that content that you see on that food label is through enrichment or fortification. So you're supplementing every time you open up, ⁓ anytime that you open anything that comes from a package, really, right? Milk has extra A and D in it. Water has, ⁓ you know, fluoride in it.
Dr. Spencer Baron (25:40)
I think of Wonder Bread. Wonder Bread was always, the commercial was always ⁓ fortified with eight essential vitamins. thinking, well, what happened to the original stuff that was in there?
Douglas Kalman PhD RD (25:54)
Well, I mean, on a cereal, again, just easy to pick out, and I think I have this right, total, you know, they would market 100 % of 12 vitamins and minerals. Where your total need, total cereal. So supplements have always been part of the human, in recent times, experience, last 100 years or so.
And now we have other varieties of supplementing the diet with nutrients that we've learned about, ⁓ you know, that can aid in recovery, that can aid in supporting longevity, or for variety. Even medically, we use supplements, right? Supplemental nutrition is used for people with poor appetites. Okay, now we tell them to eat more and give them a can of ensure. Check, we did it. Doesn't mean they ingested it, but...
They're around and they have utility.
Dr Terry (26:52)
So when you have, so are you saying when you have, when people decide to go on these carnivore diets, these Keto's, whatever the camps they are, what they are lacking is that they have to figure out what they're missing out of that?
Douglas Kalman PhD RD (27:06)
Yeah, anytime you cut out a whole food group from your diet, how are you not also cutting out all the nutrients that occur in that food group? So you are. So those become your own personal gaps. Then if you ever go to a registered dietitian or somebody else that can take a look at like a food log to do an analysis of what you say that you're eating, they can also look by analysis what vitamins, minerals, fiber, amino acids, protein, etc. essential fatty acids are lacking in the diet.
But we know that, for example, if you go on a keto diet, already know by 70 % fat or higher, 10 % or less carbs, and then the rest from protein, we already know what nutrients that's gonna be low in. It's been well published. So those people that if they wanna do it, and that's what they choose to eat, then they should be also educated on what their nutrient gaps are going to be.
So for example, we are seeing in those people that eat a lot more meat, carnivore and similar, an increase, believe it or not, here in the United States of ⁓ scurvy, a vitamin C deficiency. And if you think about it, if, you know, not making a joke out of it, but all of you are basically eating is meat, you're not getting any vitamin C in your diet. So you're not having citrus, right? To any great degree, a great vitamin C source. So these things are real world.
You know, I presented earlier this week on a case of a woman that developed hyperpigmentation of the knuckles, right, which is an early physical ⁓ sign of B12 deficiency. And ⁓ because of ⁓ B12 does play a role in melanin production. And so...
Luckily that person then had a blood test. Yes, it confirmed that they were B12 deficient. lo and behold, she's been a vegetarian since childhood, right? And then she was cheated therapeutically and everything ⁓ returned back to normal, including her skin pigmentation around her fingers, her knuckles especially. So education for any of these camps, diets, tribes.
is still important. can't think that, I can say from a longevity standpoint, right, that the mind diet seems to have the most evidence for cardiovascular health and cognitive health over the lifetime.
It's called the MIND, M-I-N-D, which has ⁓ been studied at various universities, but it's easy to think of as a mashup of the Mediterranean diet, along with the dietary alternatives to stop hypertension, popularly known as the DASH diet.
Dr. Spencer Baron (29:45)
Which diet was that?
Douglas Kalman PhD RD (30:05)
So those two diets have been put together and studied by various universities, Northwestern University, Rush Medical Center, and others on younger people and older people that if you eat this way, what is the impacts on cardiovascular health and cognitive function in different age groups? And they've all been beneficial.
Now, one thing I could tell you as somebody that's definitely not caffeinated at the moment, but one thing that I could tell you is from work in sport nutrition is that sport nutrition...
on the most serious basis is performance nutrition. And performance nutrition is not always about health. It's about performing for that sport.
So a big example would be football players, depending upon your position. If you're a lineman, they like you big. The bigger you are, as long as you can move fast, fine.
So a lot of the linemen that are 325, 350, they eat to keep their weight up. They're doing a lot of that physical activity so they can keep their explosiveness, right? The NFL average player has average of three years in the league, so not for long, right? And what happens is they don't always get education about, how do you eat when you're not training four or five hours a day and you have to be this weight?
And then they have like they have a in that world ⁓ a significant amount of diabetes and obesity with the average age of death for an NFL players 20 years before all of us. Right. Is in the mid fifties. So now about 24 or 23 years less than the rest of us, which is why do I bring that up is
that sport nutrition is for on some levels is about performance. But if you also want to get in to educate the athlete, what about when you're not doing this? And we could see it in the real world when you see former athletes that ⁓ have changes and they talk about it. Well, yeah, I don't train as much and now I gained all this weight and all right, now I'm getting back in shape.
with medicine or without these days. So I think that's also something on the college level, because not everybody gets to go pro in all of the different sports at universities. So being able to teach some of that is also important.
Dr. Spencer Baron (32:52)
The epitome of what you're saying is in the world of bodybuilding, the way they prepare to look amazing on stage is probably the most unhealthy moment of their entire life, but they look chiseled out. And not to mention whatever anabolic steroids they're on or any kind of diuretics and things like that. I you're absolutely right.
Douglas Kalman PhD RD (33:17)
Well, you know,
it's interesting. Part of my sport nutrition career is ⁓ I was a performance coach, performance nutritionist on season 21 of The Ultimate Fighter. And that was when we filmed The Black Zillions. was a team versus team versus America top team.
You know, and ⁓ so there we're talking for some people, the way that the TV show is filmed is it was ⁓ filmed over 24 hours a day for six weeks. And then when it goes to TV, they break it up into a 13 week season or something like that, right? Because we would have a certain amount of fights per week and all of this stuff. And, you know,
I bring this up because in a conversation with somebody that now no longer ⁓ competes, longer fights, is another part of their life, has moved on. I recently was talking to him and he's easily 50 to 70 pounds heavier than what he used to be. And I asked him, I said, you know, like, okay, dad life, what's going on? Right. And he said, no, he said, truthfully,
In my mind, I still can't get past ⁓ going to sleep hungry so many different nights. So and with the sport of bodybuilding.
One of the things that's not talked about like about that is that that's an appearance sport. So they want to look at and lean as ripped and whatever, whatever category that they're in. And they do these extreme things. And ⁓ while the other aspects of what they're doing, the exercise and all that stuff is about health, sometimes the physical appearance stuff is not about health. It's just about looking amazing. Right. Then you have athletes that do weight based sports.
⁓ that sometimes will cut 10 % of their body weight in the last 12 hours before weigh-in and that wreaks all sorts of havoc. That's not good either. And I remember having another conversation with one of the UFC fighters actually. And ⁓ one day he came back, we're at the gym and he comes up to me and he says, hey, guess what I did last night?
And I thought, you know, you're from the UK, you're living in Boca, you know, maybe you went to something, you know, Meissener Park or something, right? And he said, no, I went for a 10 mile run. And then I, so he's like, what's that look on your face, doc? And I said, are you training for a marathon or a three round fight? All right, your sport is 15 minutes long.
So, sometimes, not that everything that you have to do has to be sport specific, but you have to be aware of what you're doing, not always more is better. So for him, it was just getting an understanding, okay, maybe he needed to do that for his head, because sometimes ⁓ exercise is cheaper than a therapist.
But was it. But it never happened again. Then he understood like training for a fight versus running because, know, you just feel like opening it up, you know, and there's a difference, you know.
Dr. Spencer Baron (36:44)
Perfect. ⁓
Douglas Kalman PhD RD (36:47)
You know, one of the things that I could ask you, if you don't mind, is do you find a difference in the type of questions you get from patients if that patient is just, let's say, a regular person versus a teenage athlete or somebody that is physically active in their 20s, 30s? What are some of the questions that you guys get?
Dr. Spencer Baron (36:50)
sure.
Well, we definitely, you know, they ask what to eat before a competition and it depends on if it's, you know, endurance or strength. ⁓ Well, or more importantly, is there any ⁓ kind of ⁓ eating or food protocol or diet protocols that would help with healing? Any thoughts on that?
Douglas Kalman PhD RD (37:35)
⁓ If you cut a Mexican yam in half and you put it on the injury and it's iced, that will work really well.
Dr. Spencer Baron (37:46)
my
Dr Terry (37:46)
I was expecting that! ⁓
Douglas Kalman PhD RD (37:49)
No, so
Dr. Spencer Baron (37:49)
I did not expect...
Douglas Kalman PhD RD (37:53)
foods for recovery, instead of saying specific foods, I have to keep you on your feet, you know. Instead of saying specific foods, I'd rather say foods that are rich in omega-3 fatty acids, right? Because omega-3 fatty acids have what main function in the body? They act as an act to promote anti-inflammatory. And when you're
Dr Terry (37:59)
Hahaha!
Dr. Spencer Baron (38:00)
That was a good one.
Douglas Kalman PhD RD (38:18)
Looking for recovery typically you're dealing with some type of inflammatory state either from a heavy training or you train You train quite frequently. So your stress load is high, right? All these different things so omega-3 fatty acids then I also look for a variety of naturally occurring Antioxidants so colorful vegetables colorful fruits the more colorful typically the more polyphenols, right? And with the more different type of polyphenols
and phenolic acids, they have a variety of antioxidant effects and immune supporting effects. So when you support normalization of oxidation in the body, oxidative stress, right, you help actually tamper the inflammatory response and the immune response. Because when we have high reactive oxygen species or high oxidative stress, the same interleukins that get secreted
as in response to that stress, the pro-inflammatory ones, impact immunity and impact inflammation. So omega-3 fatty acids help tamper that and polyphenols and antioxidants help tamper that a different way.
Right? So all of that put together and then of course quality protein and the other things that are important. Again, you have to be eating enough calories for what your body is looking to do in recovery and heal. It's different if you're getting ready for a physique show or you're getting ready for a weight based. Then you want to make sure that the nutrient quality of what you're eating is the highest it can be.
And then you also look at what supplements can be ingested that also may help support that kind of recovery. Food first approach, omega-3 fatty acids, a variety of polyphenols from colorful vegetables and fruits, Quality protein. You know, we're talking somewhere in between at least 1.4 and 2 grams per kilo.
Right? ⁓ If you're a vegetarian or a vegan, you need one and a half times the amount of protein as a meat eater to get the same nitrogen value from that protein because of the inefficiency of lysine and methionine that's ubiquitous throughout vegan and vegetarian protein sources. So for vegans and vegetarians, they need to get one and a half times amount the total protein to kind of equal the amount of nitrogen that omnivores get.
And research shows that to be true in terms of the ability to maintain muscle and gain muscle even while dieting.
Dr. Spencer Baron (40:54)
You know, you just reminded me, years ago, when a patient would come in with an injury that was preparing for any kind of competition or even a hard practice, I would tell them to be cautious of how much red meat, because of the purines that would be pro-inflammatory. Is there still any truth to that, or is that old stuff that I was talking about?
Douglas Kalman PhD RD (41:18)
Well,
in a way ⁓ you have some good what you're saying there. Red meat ⁓ can be high in certain kind of fatty acids that cause more of a pro-inflammatory response, arachidonic acid usually, right? ⁓ And a few others. Now, purines.
At one time, people would restrict red meat intake because it's high in purines and people that have gout because gout is a manifestation of a defect or something disrupted in purine metabolism. These days, medical nutrition therapy
is as long as that gout patient is on like allopurinol or whatever today's treatment is, then they can have, they don't have to exclude red meat or other high purine foods, which there are some dark green leafy vegetables that are also high in purines. ⁓ to give you a kind of a different answer, red meat is just one protein source. ⁓ There is.
chicken, there's turkey, there's fish. ⁓ I've seen other animals also sold in markets here in South Florida. there's a ver- and there's eggs. There's a variety of protein sources. ⁓ Red meat intake that's frequent does have a higher correlation with ⁓ colon cancer and cardiovascular disease. So there is some type of happy medium.
Maybe once or twice a week, but not every day. Kind of thing. And then there's so many different protein choices that you can have different proteins at a remu.
Dr. Spencer Baron (43:06)
You refer to good proteins. Is there something specific behind that versus a bad protein?
Douglas Kalman PhD RD (43:15)
Well, proteins
that contain, of course, all of the essential amino acids in proper quantity and quality ratios, as meats do and fish does, compared to vegetarian and vegan sources of proteins would be good or better. ⁓
I may have also meant that red meat is a good protein source, but when I say better alternative, mean that we also have fish, also have poultry, we also have all the others. You don't need red meat as the staple of a diet. Just if you enjoy it, have it every now and then, or just a couple of times a week, but not every day saying, I'm a bodybuilder, I need the red meat to grow.
Yeah, 300 was a movie. You don't need to eat the brain of your opponent to get it smart, you know?
Dr. Spencer Baron (44:17)
That is one of my favorite movies, by the way.
Dr Terry (44:18)
Damn it.
Douglas Kalman PhD RD (44:20)
It's a great one.
Dr Terry (44:23)
You know, you ask a question, what kind of questions we get from patients and I've some of the stuff that I've been getting lately is, you know, we'll run blood on somebody and we'll put them on a strategy and they look at the strategy and they're like, yeah, that looks like too much work. Is there just a pill I can take or is there just a mix I can do or a powder I can do and
and I always laugh because I'm like you take better care of your car than you do your body but you know it's like they always want the fastest strategy to the quickest solution. What's your advice on that?
Dr. Spencer Baron (44:48)
Yeah.
Douglas Kalman PhD RD (44:57)
I think that's an age old problem. I honestly, I'm not walking away from that, but ⁓ you can't fight logic with emotion and you can't fight emotion with logic. And so some of those people are reacting emotionally. know, logically they might think about and say, okay, I need these lifestyle habits, but it'd be much easier to take a Lipitor with my Big Mac, right?
⁓ And so I don't have like a real good answer for that. I think that comes with if we can get better as a society about talking about not preventative medicine, but just good health, public health, good health practices in starting when kids are in elementary school, middle school, high school, somewhat in college. So that as they grow up and have to be responsible for themselves and in homes too, if we can.
then we'll have much healthier generations. I don't think we could blame everything on the food supply. When it comes down to it, nobody makes you stop at the local bodega and grab a Twix bar, right? There's nobody saying you must have it. So, and I'm not saying that everything is will, but there is choice. You know, so there's a lot to unravel, I think there. So.
Dr. Spencer Baron (46:20)
I was going to ask him a fun question, and it's more from a practice perspective when people find out that you have this special understanding of nutrition. Do they come up to you and go, hey, can you put me on a diet? And what's your response?
Douglas Kalman PhD RD (46:39)
That's happened, of course, in my life. And, you know, just like you guys get asked a million questions by friend and family and somebody that you just met, you know, or a friend of a friend somewhere at a social gathering. And ⁓ for most people, you know, the answer is no. ⁓
Dr. Spencer Baron (46:40)
Of course, hell yeah.
Yeah.
Douglas Kalman PhD RD (47:07)
But
if you're actually, no, but if you're actually serious and want to accomplish your goal, then we can work together and this is how I do it. If not, I'm happy to refer you to somebody else if you're serious. A lot of people are in the pre-contemplation stage or small talk stage, right? Making small talk with you because they like you, they want to stay friendly with you, but they're not yet really ready to commit to you know, to even a first appointment.
Dr. Spencer Baron (47:21)
Yup.
Dr Terry (47:37)
Good night.
Dr. Spencer Baron (47:38)
One of the tricks of the trade is that, because I've done it so many times for people where I'll set them up with a diet and it's really planned out, I'll go over it with them and I'll ask them in a week from then and they'll go, I haven't started yet. So now what I do is I'll tell them to give me a five day diet log, what you eat, when you ate it, and you can eyeball the quantity. If they do that, then they're usually pretty serious.
Douglas Kalman PhD RD (47:55)
Sure.
Right. Yeah, I mean, that's
that's when I say to somebody, if you're serious, this is my checklist. It includes, you know, keeping a log that has similar to what you said, because that shows at least all right. Yeah, they are showing some seriousness about it. They're more likely than not, if they're bringing it to you, they're going to want to try to follow through. Right.
Dr Terry (48:22)
Hey Doc, before we get too far into the time, there is something I do want to ask you. want to get back into something. You mentioned earlier supplements. One of the topics right now is the resurgence of creatine. What's your thoughts on that?
Douglas Kalman PhD RD (48:39)
Well, ⁓ creatine ⁓ is already part of our diets. So we get creatine through food. It's most found in red meat and it's found in some fish, mackerel, salmon, toro. So some of the fattier fish naturally have creatine. And again, ⁓
anything that's red meat and other proteins. So we get some from the diet. Then creatine is a tripeptide. It's an amino acid made up of three amino acids. If you get those amino acids in sufficiency in your diet, and one of them tends to lack in vegans and vegetarians, methionine, our bodies can synthesize the tripeptide that is creatine.
Our bodies use creatine as part of the phosphagen energy system, which is basically the energy system that you use when in all-out exercise for the first like 8 to 12 seconds, it's primarily driven by the phosphagen energy system. And then creatine is used of course as phosphocreatine for when you break down energy, ATP.
All right, you liberate a phosphate, energy is released, liberate another phosphate. So ADP becomes ADP becomes AMP. So phosphocreatine from creatine will donate that phospho group, phosphate group to build back up energy too. So creatine has the ability to help influence energy processes in the body and our ability to recharge. Right. And so we already know that ⁓
We store a certain amount of creatine in muscles and different organs throughout the body, your brain, your eyes, your testes, your spleen, your muscles, your heart, right? And that it's used for a variety of different neurologic processes and energy processes, right? So much so that in our brains, in our nervous system, if you will, glial cells, astrocytes, ⁓ and even oligodendrites, right? Part of neuron.
all use creatine or can synthesize creatine for its use when it needs. Showing creatine plays many different roles. Now for years it's used been used for athletes to help ⁓ increase lean body mass, to help increase athletic performance, which it does typically by five percent or so, right? And ⁓ you know, now we're learning
even though there's 30 years worth of research, other benefits for as you age, helping to reduce sarcopenia, for perimenopausal women to help maintain bone mass, right, to also help maintain muscle mass. Studies even show that when creatine is added on to a standard anti-depression treatment, that you get an increase in the response rate.
for those people on creatine plus their SSRI versus SSRI alone because creatine does play a role in neurotransmission. So creatine has become much more fascinating and looked as a life cycle nutrient and a longevity nutrient. And I mentioned life cycle because creatine is used, right? When a woman contracts, right? Giving birth, they're contracting what? A muscle. And that muscle
is using creatine. And when a woman is going through contractions, right, uterine contractions, that's a lot of creatine that's being used. Creatine's been shown, ⁓ so we, it has even an effect on birth. And then we also know that in neural development, creatine plays a role in brain development as well. So, and we know that because there are inborn errors of creatine metabolism. If they're not caught,
early in life that end up with ⁓ cognitive and mental retardation. So creatine is a fascinating nutrient that's a lot more than, hey, give this to my gym bro, it's white powder. You know, ⁓ it's really a life cycle nutrient. ⁓ If you really want more information on that, if you don't mind, I recommend a website that's called creatine for health. And it has a plethora of
peer-reviewed, published, ⁓ literature uncreated, interviews, videos, ⁓ all about these different areas, more than just sports. It's global.
Dr. Spencer Baron (53:29)
fantastic for that.
Douglas Kalman PhD RD (53:30)
Also, one
other thing, I am a co-founder of the International Society of Sports Nutrition. So we are in our 23rd year, we have annual conferences, regional conferences. So for people that are interested in that, they can look up for the ISSN.org or International Society of Sports Nutrition and see our conferences, see our PubMed index journal, Journal of the International Society of Sports Nutrition. And in our journal, we publish position stands and those position stands
are meant, these are evidence-based guides that have been distilled from the literature using standard means so that a practitioner could then tease out what can I learn from this, what can I use. We have for a variety, ultra endurance athletes to a variety of topics and you'll see that in the journal, over 20 of them.
Dr. Spencer Baron (54:26)
That is great information. So you mentioned creatine and I wanted to ask you, if you were asked what three nutrient principles that you would likely believe that would exist in the next 50 years from now, would one of them be creatine or are there others that you would feel would be an important?
Douglas Kalman PhD RD (54:50)
So if you're asking if we were coming back 50 years from now, would creatine still be a thing and be a nutrient of utility? And I would say yes. I would say yes, both within normal health and within certain medical conditions.
Dr. Spencer Baron (55:12)
Are there others?
Douglas Kalman PhD RD (55:15)
I do think that there are a variety of others. I think that there's always going to be a need for a good quality multivitamin mineral. I do think that because we do have some important nutrient gaps, I'll mention DHA, especially for any woman of pregnancy age. I'd mention choline, again, especially for any woman of pregnancy age.
I'd mention fiber for all of us, but food first approach. It's okay, eat your broccoli guys. You're better off for it. ⁓ Some of those. In the sports supplements, ⁓ proteins are always gonna be a play because that's also about convenience. Most people today and tomorrow are gonna be living on somehow an on the go lifestyle.
Right? We don't have three square meals at home. Some people are lucky to have one meal at home and sometimes it's from takeout or it came from a box. Right? So, you know, I would love to see more food prep being done by individuals. It's a healthier way to live.
Dr. Spencer Baron (56:31)
Terry, you wanna go into the rapid fire? All right. All right, Dr. Kalman, got, well, you answered one of the five rapid fire questions and that was one of them, would creatine still be something that would be evidence-based even in the next, very good, beta-alanine. All right. What food is that found in?
Dr Terry (56:33)
You betcha.
Douglas Kalman PhD RD (56:42)
Okay.
I would also add beta alanine to that. Yeah.
Beta-alanine
actually ⁓ is a dipeptide. So it's a dipeptide of histidine.
I'm blanking on the other amino acid, but it's found in foods that have proteins. The richest actually would be chicken and chicken soup.
Dr. Spencer Baron (57:22)
Good old chicken soup. Jewish penicillin. Got it.
Dr Terry (57:23)
There you go.
Dr. Spencer Baron (57:29)
All right,
so I want to jump right into question number two. And of course, the most brief answer is best, but we get carried away sometimes. So if you're ready, here we go. You've been involved in research and position stands for well, there's that decades again, but for a long time. How about that? What is one nutrition myth that refuses to die, even though the science has already settled it?
Douglas Kalman PhD RD (57:37)
Sorry. Yes, sir.
that caffeine is a diuretic. That is a myth that refuses to die. It's been shown in a multitude of different studies that caffeine is not a diuretic. Caffeine does not inhibit antidiuretic hormone.
It does not induce a greater volume of fluid output or urine output over a 24 hour period as compared to non caffeinated intake. There have been studies done in athletes, non athletes, healthy young adults, middle age adults and older adults. And caffeine does not induce dehydration. Caffeine does and does not as a diuretic. That's a myth that deserves to be shot.
Dr. Spencer Baron (58:44)
That is great. I did not expect that. All right. Next question. You've worked Olympic games, professional athletes and major research labs. When Dr. Kaman walks into his own kitchen, what's the one food, man, that you'll never give up?
Dr Terry (58:47)
That was golden.
Douglas Kalman PhD RD (59:04)
ice cream.
Dr Terry (59:07)
He didn't even hesitate.
Douglas Kalman PhD RD (59:09)
No,
I may have changed the kind of ice cream that I eat, but I've been eating ice cream since childhood and it's never lied to me. So I continue to eat it.
Dr. Spencer Baron (59:15)
Yeah.
Dr Terry (59:19)
I've never lied.
Dr. Spencer Baron (59:22)
That's great
because that was part of my next question. That was part of my next question. Let's settle it scientifically. Is ice cream a recovery food or a cheat food?
Dr Terry (59:27)
you
Douglas Kalman PhD RD (59:35)
It could be either. I tend to have my ice cream, mix in a scoop of creatine and mix in usually about 10 grams of whey protein. And that's how I eat it. Now that's a lot different than I ate it at 15 years old, right? But that's how I eat it. So I get the best of both, is way I look at it.
Dr. Spencer Baron (59:38)
Of course you say that.
Dr Terry (59:58)
That's hilarious. That's
Dr. Spencer Baron (1:00:03)
that that is a beautiful answer. Man, when we were,
Dr Terry (1:00:04)
a- That's aw- I've been creatine with my ice cream. That's great.
Dr. Spencer Baron (1:00:10)
I think I might try that myself.
Douglas Kalman PhD RD (1:00:11)
I could tell you a story that
back in my dating life, going years ago when I was living in New York City, somebody was over and they went to my freezer and they went to go take out some ice cream. They wanted something to eat and they're like, your ice cream has freezer burn. I'm like, no, no, that's just a little bit of whey protein left on top of the ice cream there. It's not freezer burn.
Dr. Spencer Baron (1:00:21)
you
That's awesome. That is, that is right. It was for the ice cream. Yeah. Yeah. That's outstanding.
Douglas Kalman PhD RD (1:00:36)
She did come back for another date.
It was. She's like, you're on to something. Can you make it in frozen yogurt style? This is back in the 90s, you a long time back.
Dr. Spencer Baron (1:00:54)
That's given me new meaning to bluebell cookies and cream. love that. All right. All right. Last question. my gosh. I don't even know. I don't even think I want to answer. Ask him anything else. All right. You've helped shape the science behind how athletes fuel their bodies and how clinicians guide their patients. But beyond the research papers and the conferences, what part of this work has meant the most to you personally?
Douglas Kalman PhD RD (1:00:57)
Yeah.
You know, the answer to that really is, when work with individuals that have had a variety of issues and see them resolve or have that person come up and share their enthusiasm and appreciation for whatever I may have helped them with, you know, ⁓ that.
You know, one of the things that I take very serious is that, you know, nutrition can impact quality of life. So when you improve somebody's quality of life, that's meaningful. It's very hard, ⁓ follow this diet, it's gonna help lower your cholesterol. People, if they don't have an experiential experience with something,
It's harder for them to grasp. OK, this is what I need to do. But in answering your question, I'm going to give you two answers. One from having various patients or clients in my life thank me for things I've helped them with. watching students that have mentored either for their bachelor's, master's or doctorate go on to achieve great things and accomplish their own.
overcoming of obstacles and, you know, seeing them grow. That gives great satisfaction.
Dr. Spencer Baron (1:02:51)
Well, you're truly a mentor and an inspiration to those students you've taken care of and one of them is a patient of mine who Norma referred me to you because of how bright and talented you are and you get the point across. Yeah, very good. Thank you so much for being on the show today. We totally appreciate that.
Douglas Kalman PhD RD (1:03:03)
I'm grateful to her. She knows that.