Endurance Planet

[sponsor image="http://www.enduranceplanet.com/wp-content/uploads/PerfectAminoXP_Short_WEB_grande.png"]This episode is brought to you by BodyHealth, the makers of PerfectAmino, an athlete's secret weapon featuring eight essential amino acids in the exact ratios needed to ensure proper protein synthesis in the body. PerfectAmino has been tested and approved for in-competition athletes and professional sports; and all of us over at EP have used in in our athletic careers.

BodyHealth also recently debuted Perfect Calm, a new well-formulated magnesium powder supplement to round out an athlete's needs in particular getting good sleep and stress management. And did you know that BodyHealth also offers well-formulated natural vitamins and supplements to meet your other needs including their Body Detox, Healthy Sleep Ultra, Intestinal Cleanse, weight loss aids, and more. Plus, PerfectAmino now comes in a sugar-free powder form that's great for those who don't like pills and/or want something tasty to mix in your workout drink![/sponsor]

On this episode of Ask the Coaches:

• Coffee talk - cold brew, mycotoxins and more. Read Tawnee's "full report" on coffee over at LPC (new members use code "lpc4me" to get your first month free).
• When downhill running causes heart rate to spike and can't even hold MAF - what gives!? What to do: slow down to keep it low, or just let go up on the downhills?
• Study mention: Changes in Run Economy Following Downhill Running.
  • "Downhill running induced reductions in maximal isometric strength of the knee extensors, a three- to six-fold increases in plasma creatine kinase activity (inflammation) and myoglobin concentration (muscle damage), and muscle soreness for 4 days after the downhill run. Oxygen consumption increased immediately to 3 days after downhill running. There were also increases in heart rate, minute ventilation, RER, RPE, blood lactate concentration, and stride frequency, as well as reductions in stride length and range of motion of the ankle and knee. The results suggest that changes in running form and compromised muscle function due to muscle damage contribute to the reduction in running economy for 3 days after downhill running."
• Hydration/fuel strategy issues for a male ultrarunner--or something else going on?
  • "Over the past few months I have begun to get dehydrated on my runs and seem to run out of energy earlier than i have in the past. I have started supplementing with more solid foods and upping my water intake while I run but it is difficult to digest more solid foods with the sloshing of the stomach in running versus cycling. The solid foods seem to help me run strong or with more energy for a bit, but tend to ultimately lead to stomach cramping unless I drastically slow the pace."
  • Also eats a very clean plant-based diet, has been keto and low carb.
  • What to do to find the optimal fueling and hydration strategy?
  • Could gut issues be at play hindering ability to process any nutrition?
  • Mention of low-FODMAP diets for athletes with GI issues during training and racing.
  • Listen to our podcast with Dan Lis PhD on research with low-FODMAP diets in athletes.
• Issues with MAF HR and LT being "too close" and lacking a solid lactate threshold. For a running wanting to compete in 10ks to marathon distances, what workouts to do to improve lactate threshold?
• Is there any benefit to holding a pace slightly faster than threshold or are those workouts just a total waste of time? Such as running about 20 seconds per mile below threshold pace for 5 miles?
• Since running translates nicely to the bike, If I have a run heavy training schedule, can I get away with a little less time on the bike?
• If training for shorter distance running events (5k- HM), would it be more advantageous to run most of your non-quality runs at MAF or at MAF+10 pace?
• How to know if you should add 10 bpm to your MAF--it may work, it may not. Depends!

[sponsor image="http://www.enduranceplanet.com/wp-content/uploads/UCAN-logo-rev-nutrition.jpg"]This episode is brought to you by Generation UCAN Superstarch, the incredible fuel of choice for endurance athletes and health enthusiasts looking for burn more fat for fuel, optimize sports performance and keep blood sugar in check. EP fans get 15% of UCAN, shop now. You can also use the code "enduranceplanet" if you're shopping at generationucan.com for that 15% discount. Join the revolution. You can burn more fat for fuel. Oh, and be sure to check out UCAN's new bar made with coffee beans![/sponsor]

Dana Lis, PhD, is a Registered Dietitian, researcher, lifetime athlete and has a huge knowledge base on sports nutrition for optimizing athletic performance. Dana's been involved in current research examining gluten-free and low-FODMAP diets for athletes, especially endurance athletes, which is the focus of this episode. You can reach Dana at www.summitsportsnutrition.com or on Twitter: @dlisforrest.

Intro & Why Our Guts Are At Risk

• Dana's background and how she got involved in this area of research.
• The research shows perhaps we need to think twice about gluten as the cause of GI issues, and perhaps look more to FODMAPs as the problem.
• FODMAPs = Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols.
• "Available literature suggests that it is the reduced fructan and GOS quantity in a gluten-free diet that modulates GI symptoms and not gluten itself (Gibson and Muir 2013; Gibson et al. 2015)."
• The Monash FODMAP app and online resources
• Why does endurance exercise run the risk of causing gut issues (a refresher) and can we train ourselves to have a stronger gut?
  • Takes 4 to 5 days for epithelial cells (the gut) to repair after a bout of endurance exercise; but athletes train more frequently than that.
  • Increased intestinal permeability from exercise may lead to excessive absorption of gluten-derived peptides in NCGS, which could lead to immune-related responses.
  • Dehydration and heat further compromise intestinal integrity.
  • Altered digestion of short-chain carbohydrates may augment GI symptoms triggered during exercise.
  • Despite some GI-adaptions in trained individuals, splanchnic blood flow is still reduced by up to 80% at 70% V02max (Qamar & Read, 1987).
• How common are GI issues? "Gastrointestinal (GI) symptoms are common in up to 70% of endurance athletes (de Oliveira & Burini, 2009), and aside from mechanical, psychological and physiological triggers, several dietary factors are believed to influence symptoms (de Oliveira et al., 2014)."

Gluten Research on Athletes

• Takeaways from the review article: "Commercial Hype Versus Reality: Our Current Scientific Understanding of Gluten and Athletic Performance."
• "This diet has not been shown to affect either positive or negative competitive performance or symptoms of GI health and inflammation and/or nutritional status in NCA (non-celiac athletes)."
• But, in NCA, what if a GFD (gluten-free diet) makes someone feel better even if the science says "no difference?"
• What about athletes with subclinical conditions and reports showing how gluten increases inflammation, intestinal permeability, leaky gut and so on?
• "Exploring the Popularity, Experiences, and Beliefs Surrounding Gluten-Free Diets (GFD) in Non-Celiac Athletes (NCA)" show positive outcomes with a GFD, even if the placebo effect aka "belief effect" is at play.
  • 910 athletes
  • 59% follow a GFD less than 50% of the time (GFD
  • 41.2% follow a GFD 50–100% of the time (GFD > 50), including 18-world and/or Olympic medalists. Predominantly endurance sport athletes.
  • 84% of the GFD > 50 group indicated symptom improvement with gluten removal.
  • Reasons why athletes adopted this diet (self-diagnosed vs medical condition); risks of the diet; positive outcomes reported; and conclusions.
• Meanwhile Dana's study, "No Effects of a Short-Term Gluten-Free Diet on Performance in Non-Celiac Athletes" showed no difference and no positive effects of a GFD in healthy well-trained athletes.
  • How this study was conducted and outcomes.
  • Was the intervention possibly not long enough to see an effect?
  • What did the GFD consist of and how did you control to make sure athletes didn't know as well as control for adequate calories and carbs.
• Are there really any downsides to going gluten-free especially if you're able to ensure proper calories, carbs, etc.
• Perhaps a better approach for pre-competition special diets may be a low-residue diet, especially to hit race weight goals and attenuate any potential gut distress.
• On being cautious of "orthorexic" behavior towards food and special diets like GDF and low-FODMAP.

Low-FODMAPs for Athletes

• While gluten and GFDs are pretty well known and trendy, FODMAPs seem to just be getting more attention in the athletic community.
• Will low-FODMAP diest be the "next big thing?" They already are Down Under, with low-FODMAP foods labeled on shelves of stores.
• What's the potential negative issue with FODMAP foods and why these foods could be even more risky for athletes than gluten alone?
  • "Fructans and other FODMAPs are poorly absorbed in the small intestine where they increase luminal fluid content and possibly affect gastric motility. Poorly absorbed, they subsequently transit to the colon as products for fermentation by colonic bacteria, resulting in GI symptoms such as diarrhea and flatulence. Although no data are published yet in athletes without IBS, it is conceivable that residual FODMAPs in the small intestine (ileum) and colon or intake of FODMAPs during training potentiates GI distress during and after strenuous exercise."
• So maybe it's not the gluten, it's the FODMAPs!?
  • "Available literature suggests that it is the reduced fructan and GOS quantity in a gluten-free diet that modulates GI symptoms and not gluten itself (Gibson and Muir 2013; Gibson et al. 2015)."
• Is gluten is technically a FODMAP?
  • Gluten is a protein in wheat, barley, and rye. Gluten and fructans are not the same thing. Fructans are a type of carbohydrate in these same foods (and more). Research is hinting that perhaps it is the fructans (a type of carb) in these foods, not the gluten that is causing the issues in people!
• What are some common FODMAP foods sports nutrition supplements/products.
• Dana's case study on 31 y/o male multisport athlete with a history of exercise-induced GI symptoms especially in running:
  • Single-blinded approach; 6-day habitual diet compared to a 6-day low FODMAP intervention diet (81 ± 5g vs 7.2 ± 5.7g FODMAPs.day-1) for their effect on GI symptoms and perceptual wellbeing. Training was similar.
  • Symptom improvement with low FODMAP diet prior to and throughout 3 d of strenuous running training. "Although there are limitations associated with self-report data, these initial findings from our group suggest that perceived gluten-triggered GI symptoms in athletes might be due to FODMAPs, particularly fructans and lactose as potential symptom modulators."
  • His statement: "symptoms were remarkably better compared to habitual period and were basically non-existent during exercise or during the day throughout the intervention period."
• In the case study, what did his low-FODMAP diet consist of and how did you control to make sure he didn't know?
• Based on research, what FODMAPs appear to be biggest offenders and why?
  • Fructans, lactose, and fructose.
  • Fructose may be incompletely absorbed and causes bloating, abdominal pain/discomfort, and flatulence. Fructose combined with glucose can be problematic too.
  • Lactose was the most common trigger reported in Dana's survey (86.5%, n = 402 of 465, of the 92.8% attributing high FODMAP foods to GI symptoms); yet, it is so commonly consumed by athletes, including whey protein powders.
  • Lactose and gluten combines were most frequently attributed to GI symptoms by 52.7% (n = 245 of 465).
• Thoughts on adopting a low-FODMAP diet? Do arbitrarily or only if a condition present
• Should we test the state of our gut health as well, in order to partake in a healing protocol to build back a stronger gut?
  • IBS, SIBO, Candida, leaky gut, etc., are all seemingly becoming more widespread in athletes and non-athletes with all sorts of side effects. Should we be weary of these foods to begin with if training (i.e. gluten, FODMAPs), or wait until there's a problem whether clinical or subclinical?
• Training the gut to handle the sports nutrition you need.
• How often should you do training sessions to build a strong gut and during which sessions
  • Only necessary once a week - do it during your "big" key session each week (long ride, long run or long brick).
• Low-FODMAP sports nutrition sources.

Conclusions

• Closing thoughts on special diets and how to make use of this information for your own sports nutrition needs.

References

1. Lis D, Stellingwerff T, Shing CM, Ahuja KD, Fell J. Exploring the popularity, experiences and beliefs surrounding gluten-free diets in non-celiac athletes. Int J Sport Nutr Exerc Metab. 2014; 25:37–45.
2. Lis D, Stellingwerff T, Kitic CM, et al. No effects of a short-term gluten-free diet on performance in non-celiac athletes. Med. Sci. Sports Exerc. 2015b; 47:2563-70.
3. Lis D; Fell J, Ahuja K, Kitic CM, Stellingwerff T. Nutrition and Ergogenic Aids. Volume 15 & Number 4 & July/August 2016 .
4. Lis D, Ahuja KDK, Stellingwerff T, Kitic CM, Fell J. Case Study: Utilizing a Low FODMAP Diet to Combat Exercise-Induced Gastrointestinal Symptoms. International Journal of Sport Nutrition and Exercise Metabolism. 2016; http://dx.doi.org/10.1123/ijsnem.2015-0293.
5. Lis D, Ahuja KDK, Stellingwerff T, Kitic CM, Fell J. Food Avoidance in Athletes: FODMAP Foods on the list. Appl. Physiol. Nutr. Metab. 41: 1002–1004 (2016); dx.doi.org/10.1139/apnm-2015-0428.
6. Pfeiffer B, Stellingwerff T, Hodgson AB, et al. Nutritional intake and gastrointestinal problems during competitive endurance events (Med Sci Sports Exerc. 2012;44(2):344–51.
7. Soares FL, de Oliveira Matoso R, Teixeira LG, et al. Gluten-free diet reduces adiposity, inflammation and insulin resistance associated with the induction of PPAR-alpha and PPAR-gamma expression. J Nutr Biochem. 2013;24(6):1105–11.
8. Uhde M, Ajamian M, Caio G, et al. Intestinal cell damage and systemic immune activation in individuals reporting sensitivity to wheat in the absence of coeliac disease. Gut 2016;65:1930-1937.
9. Halson SL, Martin DT. Lying to win—Placebos in sport science. Int J Sports Physiol Perform. 2013;9:597–9.
10. Hadjivassiliou, M., Sanders, D.S., Grunewald, R.A., Wood- roofe, N., Boscolo, S., & Aeschlimann, D. (2010). Gluten sensitivity: from gut to brain. The Lancet. Neurology, 9, 318–330. PubMed doi:10.1016/S1474-4422(09)70290-X.
11. Loucks, A.B. (2004). Energy balance and body composition in sports and exercise. Journal of Sports Sciences, 22, 1–14. PubMed doi:10.1080/0264041031000140518
12. Despain, D. 2014. The surprising reason gluten-free diets actually work. [Online.] Available from outsideonline.com/1923951/surprising-reason-gluten-free-diets-actually-work.
13. Golley, S., Corsini, N., Topping, D., Morell, M., and Mohr, P. 2015. Motivations for avoiding wheat consumption in Australia: results from a population survey. Public Health Nutr. 18: 490–499. doi:10.1017/S1368980014000652.

[sponsor image="http://www.enduranceplanet.com/wp-content/uploads/Screen-Shot-2016-09-15-at-8.25.33-PM.png"] If you're looking to take the holistic healthy life a step further but you're not sure how to start head to Life Post Collective, an inner-circle community created by Tawnee Prazak Gibson. At LPC you'll find Tawnee's resources on holistic health, wellness, nutrition, fitness and more to help you on your path to optimization--the same resources and tools she uses for her athletes and clients. No gimmicks at LPC , Tawnee created this community for your wellbeing and as a home to share practical evidence-based and experienced-based ways to kick more butt. Through LPC 's integrative forums and features on the site, you can learn from not only Tawnee but also like-minded people all working toward common goals. As a special offer for EP fans, we're giving you your first month FREE at Life Post Collective using code "ep2017" - we'll see you in the LPC ![/sponsor]

On this episode of Ask The Coaches:

• Tainted supplements and safe supplementing
  • IVs for athletes - know the rules and what's allowed
  • L-Carnitine?
• Followup from ATC 228 on sleep needs before late-night or all-night competitions; more from the research:
  • Active Voice: Does Banking Sleep Before Sleep Deprivation Improve Physical Performance?
  • "In each condition, subjects performed six nights of either EXT or HAB at home followed by an assessment of motor performance and neuromuscular function at baseline (D0) and after one night of TSD, i.e., 34–37 h of continuous wakefulness (D1)."
  • "The main finding of our study is that physical performance was improved in the sleep extension condition. Indeed, the time to exhaustion (test of sustained isometric muscle contraction) was increased compared to the control condition. Altogether, the findings suggest that "banking" sleep improves motor performance in a manner mediated by perceptual and cognitive factors. The longer the exercise (endurance activity), the more beneficial sleep extension may be—especially in a particular sport competition where sleep deprivation tends to prevail, e.g., as in ultra-endurance races where sleep can be a limiting factor. We also believe that the beneficial effect of sleep extension would be accentuated in people who are chronically sleep deprived for multiple reasons."
• Study mention; comparing high-intensity vs. aerobic training on mitochondrial development:
  • Superior mitochondrial adaptations in human skeletal muscle after interval compared to continuous single-leg cycling matched for total work
  • "High-intensity intervals compared to moderate-intensity continuous training in cycling elicited superior mitochondrial adaptations in human skeletal muscle despite equal total work. HIIT = 4 x 5 @ 65% max watts; aerobic = 30min @ 50% max watts."
  • Volume was the same in both conditions - aerobic training would require more volume than HIIT to get the same gains.
• Is there a way to determine which of the four triathlon race distances you're built to perform the best in? Long course vs. short course, etc. Can you use past results to judge what distance triathlon is the strongest?
  • Also factoring in what you're able to do with training given other life obligations and how that plays into ideal distance to focus on.
• Ironman veteran taking on her first stand-alone marathon, specifically the Glacier 3000 in August in Switzerland, on a glacier and up a mountain with 1,900 meters of elevation gain.
  • Should I also add leg extensions and gym workouts?
  • Hiking and running combos?
  • Trail running over or at MAF?
  • Using a high altitude tent; when to start sleeping in that?
• Female runner having trouble with health and weight issues. Also dealing with grave's disease, IBS, depression and taking a progesterone-only BC pill. Question on weight loss; despite decent miles and eating well weight is not budging. What to do?
  • Our episode on natural healing for depression with Dr. Tamsin Lewis.
• All the focus on female amenorrhea on the podcast lately: is this really that common?
  • Meanwhile, it seems like overfat athletes is more of a problem; what are the effects of training too much with impact while too heavy?
  • Tawnee's blog response to this question and outlining the real deal with amenorrhea.
  • Our podcast with Nicola Rinaldi, PhD, on healing amenorrhea.
  • Matt Bach will be joining Life Post Collective to talk about the male version of this.
  • More resources for female athletes dealing with hormonal issues over atLPC.
  • Use code "ep2017" for your first month free on LPC!
• Question on training for Boston, followed by an ultra four weeks later, and then later this year another marathon and ultra - how to structure training and where to fit in long runs while accounting for recovery that'll be needed and mitigating stress.

[sponsor image="http://www.enduranceplanet.com/wp-content/uploads/Screen-Shot-2016-09-15-at-8.25.33-PM.png"] Head over to our Shop Page where we've added even more awesome products that we love and use, including Lakanto Monkfruit Sweetener, Vital Choice seafoods, and Vital Proteins (their collagen is top notch!). Everything we offer is centered around helping you achieve the ultimate in health and performance and you can also feel safe that you're getting the best-quality products and services available today, we've done the research for you. Also don't forget to shop Amazon via EP (click that big yellow banner to the right) to further support the show. [/sponsor]

Dr. Richard Maurer is a naturopathic physician, author, and expert in metabolic recovery and health. His 2014 book, The Blood Code, demystifies blood test results & body fat measurements to reveal the primal diet and fitness needs that lead toward health and longevity and also that correct weight problems, hypothyroid symptoms, prediabetic conditions and type 2 diabetes. he's also a triathlete and comes from a family of endurance athletes. Get the book here.

Get out your pen and paper to take notes on this special episode:

• Richard's story and why he chose to be a naturopathic doctor and write this book to empower us, the patient.
• The Blood Code empowers us with tools to be our own expert, use metabolic to assess our health, and prevent or reverse health issues including:
  • Type 2 Diabetes
  • High blood pressure
  • Weight issues
  • Cholesterol and lipids
• Dr. Maurer's family history of diabetes and his personal ordeal becoming pre-diabetic, even as an athletic doctor. How he turned this around and "manages" his genetics to avoid disease.
• Getting into insulin, glucose, the lipid panel, and HbA1c.

Insulin

• We want to be insulin sensitive, but going too LCHF all the time can lead to too much insulin sensitivity, which can be a bad thing. Why this is the case.
• Read more from Dr. Maurer on why too much insulin sensitivity can be harmful as well.
• HOMA IR: Calculating insulin resistance vs. insulin sensitivity based of blood tests.
• Use the HOMA IR calculator here.
• How to fix IR.
• To clarify: What's the deal with LCHF people or athletes still having high blood glucose even fasting? Is it genetics....stress.... IR....some or all of the above?
• On monitoring BG throughout the day
• Metabolism is burning excessively and not able to keep up with glycogen requirement))
• When to recommend LCHF diets vs. when to avoid them.
• On men and LCHF, using Dr. Maurer's experience.

Cholesterol

• It seems like we're still conditioned to think we should just want to see lower cholesterol but this isn't always true. What are the key things we should assess and consider when looping at a lipid panel?
• Can triglycerides (TG) and HDL be too low and why?
• A LCHF diet can lead to too low triglycerides/cholesterol, why?
• What Dr. Maurer considers to be ideal cholesterol numbers for men and women separately, and the answer might shock you!
• TG:HDL ratio, don't go less than 0.5 (TG divided by HDL).
• More on the TG:HDL ratio here.
• On LDL and particle size and number.
• With conventionally "high" cholesterol, how Richard will guide a patient and make recommendations.

Supplements

• Dr. Maurer's thoughts on using supplements for certain conditions, including BG regulation.
• Supplement as little as possible.
• What he takes.

Thyroid

• Defining thyroid conditions, in particular hypothyroid issues.
• Perhaps hypothyroid is not as bad as it sounds.
• More on Dr. Maurer's thoughts on thyroid.
• Defining TSH, what ranges he uses for TSH (i.e. what's his definition for high TSH that could be indicative of hypo), and why is TSH not enough to assess thyroid health, and
• Free T3 is the most active form of thyroid and we want good thyroid health to convert into active T3..... but diet can screw this up.
• T3 can drop with too much insulin sensitivity/LCHF; this slows down metabolism.
• T3/thyroid also sensitive to the exercise and temperature in which we exercise.
• Overheating = hypothyroid, it's fast to react

Words of wisdom

• There's often a tradeoff some exercise is great, but too much exercise starts to extract from our health. What do you think the threshold is for this and how to manage it?

[sponsor image="http://www.enduranceplanet.com/wp-content/uploads/IST-Logo-Stacked-CMYK.jpg"]Head over to enduranceplanet.com/shop to check out some awesome services we love and recommend for athletes. Like Inside Tracker, where athletes can get up to 30 biomarkers tested, learn the true state of your health, and use this information to better your health and performance by making the right diet tweaks for your needs and so on. Use code "enduranceplanet" for a 10% discount off your next Inside Tracker test.

Also if you're not already, you need to start shopping at Thrive Market, which is basically Costco meets Whole Foods meets Amazon. Sign up for an annual membership using our links at EP.com on the show notes or shop page, and start saving on healthy food, personal care products and clean products for the home. Shop conveniently from your home computer or your smartphone. The membership is not something you will regret, take it from me. I've saved hundreds since becoming an member and have saved time too that I can invest back into the rest of my life and well-being.[/sponsor]

Ben Greenfield is back for another edition of Sports Nutrition:

Meal Frequency

• Dandelion tea
• Is it better to have more or fewer feedings throughout the day? Can eating more often have a beneficial effect on blood markers, as long as it's healthy and moderate portions? How does this compare to the benefits seen in intermittent fasting/LCHF trends of late.
• JISSN position statement on meal frequency, "Increased meal frequency appears to have a positive effect on various blood markers of health, particularly LDL cholesterol, total cholesterol, and insulin."
• Alan Aragon et al meta-analysis on meal frequency that is mentioned.
• More from Aragon.
• Slight correlation with eating more leading to weight loss (i.e. metabolic advantage).
• But are there tradeoffs to frequent feedings?
• Protein absorption - we can absorb about 30-40g max per feeding for proper protein synthesis.
• Sweet spot is 3 meals a day.
• Wired to Eat by Robb Wolf

Supplements For Strength and Endurance Competition

• What are specific supplements for an athlete trying to compete at a high level in both triathlon and strength competitions like Crossfit.
  • Creatine
  • HMB
  • ATP
  • Beta-Alanine - Listen to SN 235 for more in-depth talk on beta-alanine.
  • BCAAs - such as PerfectAmino.

How Much Fat Can We Absorb in a Meal?

• Is there a general rule for the amount of fat someone can absorb in a single meal? Assuming one can consume excess fat in a meal, when does too much dietary fat have negative consequences like gut upset of fat mass gain?
• Fat oxidation during exercise can be up to 60g per hour, but a big portion come from endogenous fat.
• The speed at which fat moves through GI tract is about 2 hours (from eating to emptying).
• We can eat 1,000 calories of fat maximum (~110g), BUT it's better to keep it at 60g fat per meal, maximum, and any more may be a stress on GI tract, uncomfortable, etc.

Carb 'Sensitivity' & LCHF/Keto

• Over a long period of time following a LCHF diet, does the body lose its ability to handle carbs? Are we doing harm by not eating a diet balanced in carb/fat/protein?
• On one hand, no reason to believe that low-carb affects ability to digest carbs.
• But on the other hand, maybe low-carb can affect our ability to use carbs...
• New review in the Strength and Conditioning Journal titled "A Case for and Against Ketogenic Diets in Athletes."
  • With long-term keto, glycogen levels in muscle and the liver may or may not be compromised but "the athlete will likely lack the metabolic machinery needed to fully use them as fuel sources."
  • "Although ketone bodies may serve as a substitute for CHO, they may also paradoxically reduce endogenous CHO availability through inhibition of hepatic glucose output, therefore lowering the capacity to sustain higher intensity efforts (6,9). These findings emphasized the point that although glycogen levels in muscle and the liver may or may not be compromised with long-term KD, the athlete will likely lack the metabolic machinery needed to fully use them as fuel sources. It also suggests that while long-term KD may allow time for adaptation, short-term (i.e., 4 weeks) CHO restriction may compromise muscle glycogen stores."

[sponsor image="http://www.enduranceplanet.com/wp-content/uploads/UCAN-logo-rev-nutrition.jpg"]This episode is brought to you by Generation UCAN Superstarch, the incredible fuel of choice for endurance athletes and health enthusiasts looking for burn more fat for fuel, optimize sports performance and keep blood sugar in check. EP fans get 15% of UCAN, shop now. You can also use the code "enduranceplanet" if you're shopping at generationucan.com for that 15% discount. Join the revolution. You can burn more fat for fuel. Oh, and be sure to check out UCAN's new bar made with coffee beans![/sponsor]

[sponsor image="http://www.enduranceplanet.com/wp-content/uploads/Screen-Shot-2016-09-15-at-8.25.33-PM.png"] If you're looking to take the holistic healthy life a step further but you're not sure how to start head to Life Post Collective, an inner-circle community created by Tawnee Prazak Gibson. At LPC you'll find Tawnee's resources on holistic health, wellness, nutrition, fitness and more to help you on your path to optimization--the same resources and tools she uses for her athletes and clients. No gimmicks at LPC, Tawnee created this community for your wellbeing and as a home to share practical evidence-based and experienced-based ways to kick more butt. Through LPC's integrative forums and features on the site, you can learn from not only Tawnee but also like-minded people all working toward common goals.

As a special offer for EP fans, we're giving you your first month FREE at Life Post Collective using code "ep2017" - act now and make this the best year ever![/sponsor]

On this episode of Ask the Coaches:

• Tawnee's "experiment" drinking FitVine wine the night before this recording.
• On reading books instead of social media, and this article.
• Click here for the book that Tawnee's currently reading.
• Lucho gets "called out" on his eating habits (i.e. low food intake and inability to gain weight) by a respectful fan offering constructive criticism, and gives his response.
• Is their ANY benefit from doing "out of order" brick workouts? Such as run-bike or bike-swim, or other combos. What would be potential pros and cons, and benefits?
• One of Tawnee's old favorite workouts was a run-bike-run-bike for as long as you need to go, keeping the intervals relatively short.
• How do people deal with the guilt associated with training? In particular when you have little ones at home that you want to be with as much as possible, but you also want to make sure you stay healthy and fit.
• Transitioning out of orthotics for athletes with a history of Achilles tendinitis.
• Transitioning to minimalist shoes and how Tawnee went about it (taking years to do it safely).
• For 2017, Xterra has changed their point system to be total cumulative points versus only scoring points from your top four race finishes. So competitive athletes may choose to up their quantity of races, such as racing 8 or 9 races in a 14 week time frame, including USAT Nationals and ITU Worlds. How can one race this often while maintaining fitness and recovering well. What to monitor to stay on track for optimal performance, how to prioritize races, and what too do between races.
• JISSN Study on beer drinking post-exercise and its effects, mentioned by Tawnee.
• Ron's story leading to his current problem:
  • I ran track and cross country in high school but wasn't very good.
  • Was mostly sedentary for 20+ years after that
  • In 2010 at 39 years old I weighed 327 lbs and was on all kinds of blood pressure and cholesterol meds and had frequent gout attacks
  • I lost 150 lbs from March to December 2010, basically following Atkins induction (less than 20 g carbs/day)
  • I started working out on a recumbent stationary bike during that time, all of this was doctor monitored and approved
  • Once I hit 180 lbs my doctor suggest I start running so I signed up for a trail half marathon for my first race J
  • 11 months later I ran my first marathon and finished my first half ironman five months later
  • Now I have finished 3 ironmans, 4 half irons, 1 50k, 15 marathons and I've lost count on all the other distances.
  • But now, something's not right... he describes symptoms of burnout (mental, physical), erratic heart rate issues including a high heart rate when running, and is always just feeling like something is off. Doctor says he's fine, but is he really? Is it overtraining? HPA Axis dysfunction? How to dig deeper to get solid answers and who to go to for help.

[sponsor image="http://www.enduranceplanet.com/wp-content/uploads/iStock_000021378425_Large.jpg"]Head to enduranceplanet.com/shop for a bunch of cool products and services we've come to love, use and endorse. Everything we offer is centered around helping you achieve the ultimate in health and performance. Also when you shop through endurance planet you directly help support the podcast so we can continue to provide you with great content always for free...

You can also support EP when you shop online! Simply open Amazon via enduranceplanet.com to do your online shopping—it's just one extra click to link to Amazon through the banner on our sidebar or click theAmazon links in the show notes.[/sponsor]

On this show we're joined by Nicola Rinaldi, PhD, an expert on hypothalamic amenorrhea and author of No Period Now What, who's here to talk all about why we lose our periods, how to regain a missing period and how to live a healthy, fertile life whether or not kids are a goal. This talk dives heavily into the research that's available as well.

Defining hypothalamic amenorrhea (HA) and risk factors

• The network of hormones that communicate and control our cycles and fertility starting with our actions and the hypothalamus.
• Variables that lead to decreased communication in reproductive hormones.
• Quote from the book, highlighted by Tawnee: "No matter what our conscious minds think, if our hypothalamus senses an unfavorable nutrient balance or stress environment, it will shut down the ability to cycle and procreate."
• Nicola's story of losing then regaining her period and fertility.
• It's important to point out this doesn't just happen to high-level athletes!
• What are tall-tell signs one is at risk whether it's an unhealthy approach to exercise, food, body image, stress or all of the above - maybe some women don't even realize they're harming themselves.
• 5 risk factors:
  • Low body fat
  • Decreased food intake
  • Constant hunger
  • Stress
  • Exercise
• Is the #1 factor in HA is lack of energy availability?
• HA women have higher levels of perfectionism.
• Exercise obsession - how much is too much?
• How come some girls can handle more and still get a period?

HA vs. PCOS

• What is PCOS, how does it differ from HA, and how women can figure out if they have PCOS or HA. Similarities and differences.
• Must have two of three specific symptoms for it to be PCOS.

Why is HA unhealthy as is using BC to "fix" it?

• The potential consequences beyond brittle bones and infertility.
• Predisposition to heart disease.
• Cognitive decline.
• BMI numbers associated with losing a period.
• Birth control (BC) pills are not an accurate indicator of health.
• Thoughts on using BC to get and maintain a period that might not be present otherwise.
• Nicola's take: Be on BC and get an "artificial" period or get off BC and have no period? (For those gals aren't quite ready to do the work to get back the period naturally.)

HA recovery

• The recommended steps for women to take.
• Who to see: a conventional doctor, naturopath, health coach, etc.? Healing on your own?
• Eating recommendations for healing and how to adopt a healthy mindset and ditch restrictions in the process.
• Thoughts on supplementing with bioidentical progesterone or other supplements like estrogen, chasteberry, etc., as a way to speed the recovery process?
• Is hormone testing of some kind is needed?
• In healing phase, thoughts on decreasing exercise and by how much? Some studies show if food is adequate (thus EA) maybe a decrease in exercise isn't as necessary.
• Tawnee's personal story on regaining her period and how she had to decrease exercise to not just because of the phyiscal stress but the mental stress she had toward sport at the time.
• What other variables go into healing such as stress management. How can girls like us ditch the stress when it's so programmed in our blood and DNA??
• What if it's not working - still no period?! What to do?
• Thoughts on Clomid or Femara as treatment for normal menstruation and ovulation.
• What's the normal BMI for women to get to for having a period with normal ovulation and luteal phases, and if it's a goal, pregnancy?

Making a return to training/exercise

• Women who've recovered from HA: What's next?
• Are we able to resume an exercise program and keep a normal period?

Fertility

• Other issues like ongoing low progesterone and luteal phase defect.
• How does a history of HA affect future fertility? Do women with history of HA struggle to get pregnant? Does the duration of HA make a difference i.e. 6 months vs 10 years of HA?
• How long should you recover from HA or what signs should you see before it's time to try to get pregnant?
• Doing all we can for the health of the unborn baby - what can we do to make sure we're building a "palace" for our little ones and not letting our own exercise/food addictions take over and cause us to stay too lean before/during a pregnancy?
• More and more women are exercising during pregnancies at levels even doc's didn't traditionally advise, but if you have history of HA should you be more careful with exercise before/during pregnancy?

[sponsor image="http://www.enduranceplanet.com/wp-content/uploads/UCAN-logo-rev-nutrition.jpg"]This episode is brought to you by Generation UCAN Superstarch, the incredible fuel of choice for endurance athletes and health enthusiasts looking for burn more fat for fuel, optimize sports performance and keep blood sugar in check. EP fans get 15% of UCAN, shop now. You can also use the code "enduranceplanet" if you're shopping at generationucan.com for that 15% discount. Join the revolution. You can burn more fat for fuel. Oh, and be sure to check out UCAN's new bar made with coffee beans![/sponsor]

[sponsor image="http://www.enduranceplanet.com/wp-content/uploads/Screen-Shot-2016-09-15-at-8.25.33-PM.png"] If you're looking to take the holistic healthy life a step further but you're not sure how to start head to Life Post Collective, an inner-circle community created by Tawnee Prazak Gibson. At LPC you'll find Tawnee's resources on holistic health, wellness, fitness, nutrition (including her custom recipes) and more to help you on your path to optimization--the same resources and tools she uses for her athletes and clients. No gimmicks at LPC, Tawnee created this community for your wellbeing and as a home to share practical evidence-based and experienced-based ways to kick more butt. Through LPC's integrative forums and features on the site, you can learn from not only Tawnee but also like-minded people all working toward common goals.

As a special offer for EP fans, we're giving you your first month FREE at Life Post Collective using code "ep2017" - act now and make this the best year ever![/sponsor]

On this episode of Ask the Coaches:

• Follow-up on cold workouts and HR issues covered in ATC 227. Some athletes find their RPE lower and heart rate takes longer to increase in cold weather. We talk further on the individual nature of how weather affects our training.
• On MAF volume and how much you need, probably the #1 question we get...
  • Take a listen to past shows on this topic here.
  • Lucho chimes in with some wisdom and why not to cut corners or try to do the least amount possible.
• Building a home gym, what would be included, what would be omitted and also hear the difference between Tawnee and Lucho's home-gym vision.
  • How do you recommend building it over time? It seems like it'd very easy to go over board.
  • Of these which are necessary: Kettlebells, dumbbells, barbells and plates, trap bar, pull-up bar, medballs, swiss ball, TRX, sled...? If you were starting out fresh, what would you buy first?
  • Kettlebells vs. dumbbells.
  • Tawnee mentions she has a detailed post on home gyms over at LPC (with pricing breakdown), check that out here.
• Pro triathlete sings the praises of MAF training.
• Why, at the start of his runs, would one experiences a sharp spike in HR, even a very easy jog. His MAF HR is 140 but he will spike into the 150s easily in those initial 20 minutes.
• Late-night or midnight race start questions:
  • Advice regarding sleep for a night-time ultrarunning race, in this case a 100k that starts at 7pm.
  • An OCR event that begins at midnight with 8 hours to complete as many laps of the course as possible. Recommendations for what to do and eat during the day before the race start? Also how to tackle sleep; sleep in as late as possible or wakeup at normal time? What meals are most important?
• MAF training for Leadville success. An EP listener chimes in on his experience going 8:39, ranking 59 out of 550 for age category 40-49, with a body that performed flawlessly thanks to dedicated MAF conditioning. Meanwhile he says that all his buddies are sugar burners and they did well but with higher heart rates; although, they are 10 years younger and don't get the whole metabolic/fat adoption/MAF concept.
  • How to go sub 8 this year?

[sponsor image="http://www.enduranceplanet.com/wp-content/uploads/iStock_000021378425_Large.jpg"] Head over to our Shop Page where we've added even more awesome products that we love and use, including Lakanto Monkfruit Sweetener, Vital Choice seafoods, and Vital Proteins (their collagen is top notch!). Everything we offer is centered around helping you achieve the ultimate in health and performance and you can also feel safe that you're getting the best-quality products and services available today, we've done the research for you. Also don't forget to shop Amazon via EP (click that big yellow banner to the right) to further support the show. [/sponsor]

[sponsor image="http://www.enduranceplanet.com/wp-content/uploads/Screen-Shot-2016-09-15-at-8.25.33-PM.png"] If you're looking to take the holistic healthy life a step further but you're not sure how to start (and let's face it, there is an overwhelming amount of information on the interwebs) head to Life Post Collective, an inner-circle community created by Tawnee. At LPC you'll find Tawnee's resources on holistic health, wellness, nutrition, fitness and more to help you on your path to optimization--the same resources and tools she uses for her athletes and clients. No gimmicks at LPC, Tawnee created this community for your wellbeing and as a home to share practical evidence-based and experienced-based ways to kick more butt. As a special offer for EP fans, we're offering a New Year's deal where you can get your first month FREE at Life Post Collective using code "ep2017" - act now and make this the best year ever![/sponsor]

On this show we're joined by Jae Gruenke, GCFP, a Feldenkrais practitioner and founder of The Balanced Runner™. For the past 14 years she has helped runners from beginner to Olympian learn to run pain-free, efficiently, and fast. She specializes in helping those whose problems have not resolved with medical treatment and those transitioning to natural running form, minimalist footwear, and barefoot running. She teaches in the US, the UK, and Germany and also offers The Balanced Runner Online Running Technique Camp and other online programs, find out more at www.balancedrunner.com.

Topics we cover:

A different way to tackle things:

• Jae's background in dancing and becoming a runner.
• Jae thinks and operates a bit differently than most when it comes to how to build a solid runner. She explains her philosophy, techniques and what makes her different.
• She teaches neuromuscular education techniques using the Feldenkrais Method - retrain the brain.
• The mind-body connection to running.
• Why classic workouts/strength training are often not enough for runners especially to resolve injury.
• Why a lot of experts, physios, coaches, etc., still can't help people resolve reoccurring running injuries.

Specific running issues and remedies:

• When running we want our hips to shift - a little - and not be too stiff, why this is and how it should all work in the kinetic chain...
• "The one thing that works is learning to shift your pelvis so your weight goes all the way over your right leg so your gluteus medius doesn't need to overwork nor your knee turn inwards. This requires a movement of your pelvis and spine, and this brings us back to core stability and the more effective alternative, core action."
• What would prevent someone from moving their hips adequately? i.e. Tight hips: causes and solutions
• How to fix a runner with chronically sore quads - more in Jae's blog here.
• Importance of arm swing (if we don't get to it above)
• Improving hip extension - is the couch stretch enough? ;)
• Correcting R/L imbalances and why the R side is always dominant no matter if your left- or right-handed
• Glutes: are the usually overworked or underdeveloped?
• Mention of the book "The Talent Code" and how its themes tie in.
• And much much more in this episode!

[sponsor image="http://www.enduranceplanet.com/wp-content/uploads/UCAN-logo-rev-nutrition.jpg"]This episode is brought to you by Generation UCAN Superstarch, the incredible fuel of choice for endurance athletes and health enthusiasts looking for burn more fat for fuel, optimize sports performance and keep blood sugar in check. EP fans get 15% of UCAN, shop now. You can also use the code "enduranceplanet" if you're shopping at generationucan.com for that 15% discount. Join the revolution. You can burn more fat for fuel. Oh, and be sure to check out UCAN's new bar made with coffee beans![/sponsor]

On this episode of Ask the Coaches:

• Followup on strapless HRV app: There is on! Check out HRV4TRAINING if interested, which uses the iPhone camera (and does not need a separate heart rate strap).
• Lucho drools over a fan selling his 2000 Litespeed Saber frame.
• Is MAF affected by COLD temperatures? Whether freezing temps or temps in the 40s (F) for SoCal folks, can cold weather cause our pace to slow down in order to hold MAF?
• Swimmer's ear - "doctor Lucho" shares his remedy.
• If a swim injury (or swimmer's ear) has you out of the pool, how to redistribute that training volume if you're a triathlete? (caution against adding too much extra running too quickly).
• Are aerobic benefits the same regardless of sportwhen using the same heart rate ranges (i.e. 180 Formula)? Not looking for sport-specific gains, rather, for my general aerobic health.
• In ATC 222 we basically say, "Metabolic Efficiency Testing is the new MAF… (The testing) is a scientific approach to Maffetone's principles." Explaining the philosophy behind this statement.
• How to interpret ME test results from a super efficient fat burner - is it now time to focus on getting faster and not get overly obsessed with how much fat burning can happen?
• Using your Metabolic Efficiency Test to determine HR zones and training needs, being specific to your race goals.
• Explaining and clarifying some basics of Jack Daniel's method with real-life application:
  • Intervals should be done at 95-100% of V02MAX or 97-100% of MHR
  • Using VDOT score, what happens if it's hard to get HR that close to max using the VDOT interval pace, as well as having a hard time getting HR close to Threshold using the VDOT Threshold pace.
  • Good post by Steve Magness on VO2max