Sports Nutrition

Are You Training Your Gut?

Are You Training Your Gut?

 

Athletes tend to do a good job of training their muscles, heart and lungs. But some of them (particularly endurance athletes and those in running sports) commonly fail to train their gut. As one marathoner reported, “I was so afraid of getting diarrhea during long training runs that I did not eat or drink anything beforehand. I really struggled after 14 miles…” A high school soccer player admitted, “I’m so afraid I’ll throw up if I run with food in my stomach.” He ate only a light lunch at 11:00 and then practiced on fumes at 3:30. No wonder he had a disappointing season.

An estimated 30-50% of endurance athletes (including up to 90% of distance runners) have experienced gastro-intestinal (GI) issues during and after hard exercise. They fear bloat, gas, nausea, stomach cramps/pain, side stitch, diarrhea, vomiting, and urge to defecate. These issues arise during long bouts of exercise because blood flow to the gut is reduced for an extended period of time. When combined with dehydration, elevated body temperature and high levels of stress hormones, normal intestinal function can abruptly end.

If you are an athlete with a finicky GI tract, restricting your diet before and during exercise will not solve the problem. You want to learn how to train your gut to accommodate performance enhancing carbs and water. That way, you can train better—hence compete better—without stressing about undesired pit stops.

Thankfully, the gut is trainable. Competitive eaters have proven this point. Google Nathans’ Hot Dog Eating Competition and watch the video of a champ who stuffed 72 hotdogs into his stomach in 10 minutes. Clearly, he had to train his gut to be able to complete that task.

Competitive eating is unlikely your goal, but you may want to be competitive in your sport. That means you need to fuel wisely in order to perform optimally. While some “keto-athletes” choose to train their bodies to rely on fat for fuel (fat is less likely to cause GI distress), training the gut is a far easier alternative for most of us.

The following tips can help you exercise with digestive peace.

 

  • Drink enough fluids. Dehydration triggers intestinal problems. Your goal is to drink enough to prevent 2% dehydration (sweat loss of 2 pounds per 100 pounds of body weight from pre- to post-exercise). If you are a “big guy” who sweats heavily, this can be a lot of fluid. For example, a 200-pound football player could easily lose 4 pounds (a half-gallon) of sweat in an hour of exercise. He needs to train his gut to handle fluid replacement during training. He could need as much as 12 to 16 ounces every 15 minutes during a two-hour practice.

 

  • Feeling “full” and “bloated” during exercise indicates fluids (and foods) have not emptied from the stomach. This commonly happens during really hard exercise, when reduced blood flow to the stomach delays stomach emptying. Hot weather and prolonged exercise in the heat can also reduce stomach emptying.

 

  • You want to dilute highly concentrated carbs (i.e., gels), so be sure to drink enough water during exercise (i.e. 16 oz. water per 100 calories gel). This will help speed up gastric emptying.

 

  • If you plan to eat a peanut butter on a bagel before you compete, you want to routinely eat that before important training sessions. This helps train your gut to accommodate fat (sustained energy) as well as carbs (quick energy).

 

  • Once carbohydrate (such as sport drink, gel, banana, or gummi bears) empties from the stomach, it enters the small intestine and is broken down into one of three simple sugars (glucose, fructose, galactose). These sugars need “taxi cabs” to get transported out of the intestine and into the blood stream.

 

  • Too many gels or chomps without enough transporters can lead to diarrhea. By training with your race-day carbs, you can increase the number of transporters.

 

  • If you typically eat a low-carb Paleo or keto-type diet and then on the day of, let’s say, a marathon, you decide to fuel with carb-rich gels and sports drinks, your body won’t have the capacity to optimally transport the sugar (carbs) out of your intestines and to your muscles. You could easily end up with diarrhea.

 

  • When planning what to eat during extended exercise, choose from a variety of carbs with a variety of sugars (i.e., sport drink, gum drops, and maple sugar candy). This helps prevent the glucose transporters from getting saturated. Too much of one kind of sport food can easily create GI problems.
  • “Real foods” such as banana, raisins and cereal, have been shown to be as effective as commercial sport foods. Your body processes “real food” every day and has developed a good supply of transporters to deal with the carbohydrate you commonly eat. By experimenting and learning what works best for your body, you can fuel without anxiety about undesired pit stops.

 

  • For exercise that lasts for up to two hours, research suggests about 60 grams (240 calories) of carb per hour can empty from the small intestine and get into the blood stream. Hence, that’s a good target. For longer, slower, events, the body can use 90 g (360 calories) carb per hour from multiple sources, as tolerated. Again, train your gut!

 

The bottom line  

  • Train with relatively large volumes of fluid to get your stomach used to that volume.
  • Routinely eat carbohydrate-based foods before training sessions to increase your body’s ability to absorb and use the carbs.
  • During training, practice your race-day fueling. Mimic what you might eat before the actual competitive event, and tweak it until you find the right balance.
  • If you are concerned about diarrhea, in addition to preventing dehydration, limit your fiber intake for a few days pre-event (fewer whole grains, fruits and veggies).
  • Reducing your intake of onions, garlic, broccoli, apples, and sorbitol might help reduce GI issues during exercise.
  • Meet with a sports dietitian to help you create a fueling plan that promotes intestinal peace and better performance.

 

Sports nutritionist Nancy Clark MS RD CSSD has a private practice in the Boston-area (Newton; 617-795-1875). She helps both fitness exercisers and competitive athletes create winning food plans. Her best-selling Sports Nutrition Guidebook, and food guides for marathoners, cyclists and soccer are available at nancyclarkrd.com. For online workshops: www.NutritionSportsExerciseCEUs.com.

References:

Jeukendrup, A. Training the Gut for Athletes. Sports Med 2017; 47 (Supple 1): S101-S110

Prado de Oliveira E., Burine, R, Jeukendrup A. Gastrointestinal Complaints During Exercise; Prevalence, Etiology and Nutritional Recommendations. Sports Med 2014 (Supple 1): S79-S85.

Food & Health: Updates from the Academy of Nutrition & Dietetics

Food & Health: Updates from the Academy of Nutrition & Dietetics

 

Nutrition misinformation and food confusion surrounds today’s health-conscious athletes. To arm myself with knowledge to better educate my clients, I (along with 10,000 other registered dietitians) attended the Academy of Nutrition & Dietetics annual convention (FNCE) to learn the latest food and nutrition updates. Here is some information that might help you on your health journey.

  • Stress fractures are a common sports injury. Among 42 Division-1 cross-country runners, 35% of the male and 41% of the female runners reported having had a stress fracture. Inadequate nutrition could have contributed to the problem. Their diets tended to be low in calories, calcium and/or vitamin D. If you are going to push your body to the limits, at least fuel it optimally!
  • If intestinal distress sidetracks you during exercise, try reducing your intake of apples, onion, garlic and broccoli —particularly for 2 to 3 days before a competitive event. These are just a few commonly eaten foods that are high in fermentable (gas-producing) carbohydrates; they might contribute to undesired pit stops. You could also meet with a sports dietitian to help you systematically discover triggering foods. The referral network at www.SCANdpg.org can help you find your local sports food expert.
  • Exercise increases harmful free radicals within muscles that can lead to oxidative damage and inflammation. Should athletes supplement with anti-oxidants to counter this? No. The better bet is to let the body adapt to these higher levels (and eat abundant anti-oxidant rich fruits and vegetables). Adaptation creates a change for the better in an athlete’s physiology.
  • Alcohol contributes to hypoglycemia (low blood glucose) by suppressing the release of glucose from the liver into the blood stream. If an athlete hasn’t eaten much food (as can easily happen after an event), alcohol in an empty stomach can easily lead to hypoglycemia (a lack of glucose for the brain) and a drunken stupor. The same happens when a person with diabetes has low blood glucose; he or she can get mistaken for being drunk (when the brain just needs food).
  • In contrast to recreational marijuana, which is used with the intent to impair normal functioning, medical marijuana (MM) is used to relieve pain, reduce nausea and vomiting, and to overcome loss of appetite (as with cancer). If you have parents or friends who are new to using MM, caution them about using edibles. When MM is eaten, its pain relieving benefits are delayed for 30 to 120 minutes, as opposed to smoked MM, which offers immediate benefits. The problem with the delayed response with edibles is that a patient can easily overdose while waiting to feel an effect…
  • Meal timing affects circadian rhythms —as well as weight management. A study (Garaulet, 2013) with 420 subjects who ate an early lunch or a later lunch reports the early lunch eaters lost more weight, despite consuming the same number of calories and getting the same amount of sleep. Your best bet is to eat more food earlier in the day. As you have undoubtedly heard before: Eat breakfast like a king, lunch like a prince, dinner like a pauper.
  • We compromise our well-being every time we have a mis-match between the environment and our internal biological clock. (Think jet lag, shift work, sleep apnea, and watching late-night TV.) Every cell has a biological clock; all these cellular clocks need to be synchronized. If not, bodies become unhealthy. For example, shift workers experience more high blood pressure, heart disease and diabetes than people who work 9:00 to 5:00. For athletes, jet lag means poorer performance. Sleep is restorative and helps synchronize cell’s biorhythms. If you have trouble sleeping well: Avoid caffeine at least 4 hours before bedtime and limit it to 2 mugs (400 mg. caffeine) a day. Turn off your computer screen/TV an hour before bed.
  • Consumers are self-defining “healthy food.” It needs to be organic, natural, non-GMO, free of dyes/additives/ colors, and have a “clean” label with no strange words. Will this trendy definition lead to unintended health consequences as food producers try to meet consumers’ demands? Likely yes. If you make your food decisions based on trends rather than science, you might want to take a step back and look at the whole picture. For example, enriched foods offer added nutrients that can make a label look “dirty” but the extra ingredients are good for your health. Added iron reduces your risk of becoming anemic; folic acid reduces the risk of birth defects; iodine reduces the risk of goiter. Preservatives that have been generally regarded as safe help bread stay fresh for longer, reduce the growth of mold on cheese, and reduce the amount of food you waste. These ingredients can be beneficial for you and for the environment.
  • Sugar-sweetened beverages are the biggest source of dietary sugar in the US diet. Hence, research on sugar and health has focused on soft drinks. The question remains unanswered: Is sugar added to nourishing foods a health hazard? That is, is sugar added to spaghetti sauce (to make it less acidic) bad for you? What about the sugar added to bread (to help make the dough rise) — Is that a cause for concern? Doubtful. Yet, too many consumers freak out when a product lists sugar on the food label. Please note: sugar is just one of many nutrients listed on the label. Please look at the whole nutrient package. For example, chocolate milk has sugar (that refuels muscles) but it also offers protein (to repair muscles), sodium (to replace sweat loss), calcium & vitamin D to enhance bone health.

Dietary guidelines say 10% of total calories can come from added sugar. That’s 200 to 300 calories a day for athletes. Do you really need to freak out about a little sugar that makes that spaghetti sauce taste better? I think you can find bigger things to worry about.

Sports nutritionist Nancy Clark MS RD CSSD has a private practice in the Boston-area (Newton; 617-795-1875), where she counsels both fitness exercisers and competitive athletes, teaching them how to eat to win. Her popular Sports Nutrition Guidebook, and food guides for marathoners, cyclists and soccer are available at www.nancyclarkrd.com. For online workshops, see www.NutritionSportsExerciseCEUs.com.

Are you good enough?

Are you good enough?

Are you good enough? If you listen to the voice that rattles around in your brain and constantly reminds you that you are inadequate, too fat, too slow, and too dumb, you will never be good enough. For some competitive athletes, their drive to be not just good enough, but perfect (perfectly lean, a perfect student, a perfect employee, and of course, a perfect athlete) can drive them crazy, if not drive them into an eating disorder. At what cost will you achieve perfection, including having the perfect body? At what point will you become unhappy enough to seek help?

Speaking at the MEDA (Multi-Service Eating Disorder Association) Annual Breakfast on Nov 2, 2017, Kate Ekman, a plus-size model (that’s all of size 6, mind you) talked about her struggles to rise above her “I’m not good enough” voices. She heard that message from not only herself but also from many others in the fashion industry.

Today, Kate has overcome those negative thoughts and she reminds us that we can be happier letting go of perfection and instead striving to be “good enough.” We can spend our lives comparing ourselves to others and always come up short—to compare is to despair—or we can start each day by saying “thank you” to our bodies.

Your body is the home to your heart, your soul, your brain and all the wonderful things your friends truly like about you. Your friends don’t care if your hair looks great, or if you look phenomenal in a dress. That’s not why they like you. Your appearance does not determine your self-worth. An imperfect body is perfectly OK.

As a sports dietitian, I spend way too many hours helping athletes take better care of their bodies. I remind them: there is no proof the thinnest athlete is the best athlete. The best athlete is genetically gifted, well trained, well rested, and well fueled. The thinnest athlete commonly sits on the bench, injured again.

If you struggle to find the perfect balance of food, exercise and weight, please check out www.MEDAinc.org — and well as the books, excellent podcasts, and information at www.EDcatalogue.com. As Beth Meyer, executive director of MEDA, Inc. says, “Wouldn’t it be nice to wake up every day and not have food or your body make decisions for you?” Your body is indeed perfectly good enough the way it is. Enjoy the day!

Tips for Binge Eaters

Tips for Binge Eaters

Athletes get hungry. Sometimes they need to devour very large portions to satisfy their appetite. Sometimes they binge eat in a way that feels out of control. There’s little doubt that dieting athletes who deny themselves of their favorite foods can easily end up “eating the whole thing.” Emotions also contribute to binges; smothering your feelings with ice cream and chocolate sauce can quickly distract you from pain and sorrow. Fatigue plays a role as well; a tired brain is unlikely to make smart food choices.

If you find yourself routinely binge eating, you want to work with a registered dietitian (RD) who can help you find peace with food. Put aside your shame and embarrassment (RDs have heard this all before), and use the referral network at www. SCAN dpg.org to find a local sports dietitian. This health professional can help you stabilize your eating so you will enjoy better sports performance as well as sanity and less time thinking about food.

If you want to try to resolve binges on your own, here are a few tips gleaned from the book Running in Silence: My Drive for Perfection and the Eating Disorder That Fed It by Rachael Rose Steil.

• Keep notes about your binges. Write down some of the reasons for your binge. Are they emotional? Psychological? Physical (due to extreme hunger)?

• Have you ever tried to find a “cure” for your binge eating? Make a list of everything you have tried. How well did it work?

• If you are binge eating “quality foods” that are nutrient-rich, your body is probably hungry and needs fuel. Give yourself permission to eat these foods—and enough of them to resolve hunger. Don’t stop eating just because you “think you should.”

• Think about a food you desperately wanted but didn’t allow yourself to eat. Could you have enjoyed a small amount of that food when you first craved it—and then observed how it made you feel? (Maybe that donut wasn’t as wonderful as you had thought?)

• Is your “perfect diet” contributing to food obsessions? Write down your fears about eating certain foods? Separate fears from facts.

• Draw a horizontal line and write binge eating on the far left and restricting on the far right. Where do you think you are along this spectrum? How close are you to the middle (eating in a balanced way)? What can you do to work towards that happy medium?

• What would your life look like without thinking about and obsessing over food? Is your binge-eating life consuming? Is your drive for eating a perfect diet actually taking you down the path to self-destruction?

• Write down what you learn from each binge. The binge is not a failure but rather an event you can use as means to better understand yourself and your body, and to move forward.

With best wishes for finding peace with food,

Nancy

www.NancyClarkRD.com

Chocolate and Hungry Athletes: A Dangerous Duo?

Chocolate and Hungry Athletes: A Dangerous Duo?

“Between Halloween and New Year’s Eve, I feel surrounded by chocolate. It’s everywhere!!!” reported a self-proclaimed chocoholic. “I try so hard to not eat it, but I inevitably succumb, and I inevitably gain weight. Thank goodness for January First!!!” If you share the same love-hate relationship with chocolate, keep reading. And be thankful this so-called “bad food” offers benefits. Continue Reading

For people who teach sports nutrition…

For people who teach sports nutrition…

If you are asked to give a sports nutrition talk, don’t panic —and don’t re-invent the wheel. You can use my tried-and-true, readymade sports nutrition teaching materials. They are available on my website at an affordable price and will make your job easier.

A nice part about my ready-made presentations is you have my permission to tweak the content to suit your audience. That is, if you are giving a talk to the women’s cross-country team, you can insert photos of female runners. When talking to the football players, you can change the photos to football players. You can use school colors, insert some of your own slides, delete slides that may not fit for your audience, etc. You get a ready-to-use program with flexibility. Continue Reading

Why am I not getting leaner…

Why am I not getting leaner…

“I religiously track my food and exercise. I’m eating 1,300 calories (the number my tracker told me to eat if I want to lose 2 pounds a week). I’ve been following a strict diet and the scale hasn’t budged. My friends tell me I am eating too little. I think I must be eating too much because I am not losing weight. I feel so confused… What am I doing wrong?”

I often hear this complaint from weight conscious people who don’t know if they are eating too much or too little. They believe fat loss is mathematical. Exercising 500 calories more, or eating 500 calories less, per day will result in losing 1 pound (3,500 calories) of fat per week, correct? Not always. Weight reduction is not as mathematical as we would like it to be. Continue Reading

What exactly are carbohydrates…?

What exactly are carbohydrates…?

Nancy, I hear so much talk about carbohydrates—and I’m not even sure that they are. My doctor said I should eat a low carbohydrate diet to help with a medical issue. I don’t know what to eat. Thanks for answering this embarrassingly basic question…

Answer: While your question “What are carbs?” may seem very basic, you are not the only person who is confused. Case in point, a client who said he had stopped eating carbs – but then reported he ate oatmeal for breakfast and whole wheat bread with his lunch. Both of those foods are “carbs.” He was actually trying to say he had given up eating refined white flour and sugar.  Continue Reading

2017 Sports Nutrition News from the American College of Sports Medicine

2017 Sports Nutrition News from the American College of Sports Medicine

In this era of highly competitive sports, more and more runners, cyclists, soccer players and other serious athletes are eagerly seeking information on how to fuel optimally. Performance nutrition is also of interest to Marines, special operations troops such as the Navy Sea, Air and Land (SEAL) teams, and others in the military who need to perform at a very high level to both survive and to carry out their missions. Hence, effective fueling practices are a topic of great interest and research for the US Armed Forces.

At this year’s annual meeting of the American College of Sports Medicine (the nation’s largest group of sports medicine professionals, exercise scientists, and sports nutrition researchers; www.acsm.org), civilian as well as military exercise scientists presented the results of their recent nutrition research, some of which I have highlighted below. This information might be of interest to you, whether you are a competitive athlete or soldier who trains for hours in the summer heat, winter cold, at high altitude, or for in preparation for a strenuous event—be it a military mission, Ironman triathlon, or an adventure race. Regardless of your reason for exercising, fueling your body wisely and well can greatly impact your ability to perform optimally today as well as invest in your future health and well-being.

Highlights of research on nutrition for military performance:

  • To become a Navy SEAL, you have to go through SEAL Qualification Training. A survey of 264 of these serious “military athletes” indicates their diets rated only 56 out of 100 on the Healthy Eating Index. This is slightly lower than the score of 59 for the general US population. To the disadvantage of these trainees, their dietary patterns were low in health-protective fruits, vegetables, whole grains and fish, but high in health-eroding refined foods with added sugar, fat and alcohol. This type of eating pattern promotes inflammation. By improving their food choices (more colorful fruits, vegetables, whole grains, healthy fats), they could reduce systemic inflammation, which could enhance recovery from training, boost immune response, and help them maintain better health. As you know, an injured or sick soldier or athlete is not an asset to any team.
  • Marines in training for acceptance to Special Operation Forces exercise extremely hard during their training program. One might think they would suffer from long-term undesired weight loss. Not the case. After each period of intentional severe food deprivation, the trainees manage to restore the significant amount of weight they lost. For example, in the toughest part of the 261-day training program (days 115-123), the men burned about 6,400 calories a day. They had access to only 2,400 calories of food. That’s about 4,000 calories a day less than they needed! They lost, on average, 11 pounds (4.9 kg). The Marines intuitively returned to their baseline weights after that training period, when they had access to adequate fuel. As an athlete who has dropped weight, only to regain it, you may have seen first-hand how the body works hard to defend a genetic weight. Weight is more than a matter of willpower.
  • Speedy recovery from strenuous exercise is of key interest to military personnel. Beta-hydroxy-beta-methylbutyrate (more commonly called HMB; a natural by-product of protein/leucine metabolism) has been shown to enhance muscle recovery from high intensity exercise. Would HMB with supplemental probiotics (gut microbes that enhance protein absorption) be a way to enhance soldiers’ muscle recovery? To find the answer, soldiers took HMB + probiotics during 2 weeks of intense military training (carrying ~77 pounds (35 kg) of equipment while marching 16-19 miles (25-30 km) per night in tough terrain). Results of this study suggest that HMB supplementation reduced the inflammatory response to intense training. Combining HMB with the probiotic Bacillus coagulans was even more beneficial than HMB alone in maintaining muscle integrity during the intense military training.

The question now arises: Can athletes who eat a high quality diet with leucine-rich food (meat, fish, chicken, cheese, whey) + probiotic-supporting fiber-rich food (vegetables, fruit whole grains) reap the same benefits? Sounds like a winning combination to me!

 

  • Staying healthy is important for soldiers and athletes alike; neither have time for illness due to upper respiratory tract infections (URTIs) such as colds. Would taking a high does of Vitamin D, which has been shown to improve immune function, offer protection? To answer that question, Marines in basic training received daily for 12 weeks either 1,000 IUs of Vitamin D-2 (the RDA is 600 IU) or a placebo. The majority (72%) of recruits reported getting a URTI during the 12 weeks. The high dose of Vitamin D did not offer a protective effect in this highly stressful environment. Perhaps you could instead focus on having clean hands and getting adequate sleep.
  • Now that women can perform combat duty, a question arises: How well can the women perform physically compared to the men? To find the answer, 302 marines underwent comprehensive testing including strength, flexibility, balance, power, agility, and physical fitness tests (pull ups, push ups, sit ups, bench press, 2-mile run, etc). They then were stratified into three groups according to the test results, regardless of sex or body fat: best (all men), middle (mostly men), worst (mostly female).

When compared by sex, the men, understandably, tended to have less body fat—except when compared to the best performing women. The amount of the male or female marines’ muscle-mass determined athletic performance more so than their body fatness. The best-performing men and women in groups one and two had significantly more muscle than the men and women in group three. The researchers concluded that muscle mass may have a stronger association with performance during strength, aerobic, and anaerobic tests than does percent body fat. This is a good example of how the leanest athlete is not inherently the best athlete. For some athletes, building more muscle might be more important than losing body fat.

 

Sports nutritionist Nancy Clark MS RD CSSD has a private practice in the Boston-area (Newton; 617-795-1875), where she counsels both fitness exercisers and competitive athletes, teaching them how to eat to win. Her popular Sports Nutrition Guidebook, and food guides for marathoners, cyclists and soccer are available at www.nancyclarkrd.com, as well as information about her online workshop and teaching materials.

 

 

Questions about chocolate milk

Questions about chocolate milk

Dear Nancy,

I have a lot of questions about chocolate milk as a recovery drink. Thank you for your answers.

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