HPN 17: Don’t Let Runner’s Diarrhea Ruin Your Mojo, Plus: Carb Periodization vs. Chronic LCHF and Managing ‘Calorie Quality’ For High Energy Needs

May 15, 2020
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Welcome to episode 17 of Holistic Performance Nutrition (HPN) featuring Tawnee Gibson, MS, CSCS, CISSN, and Julie McCloskey, a certified holistic nutrition coach who you can find over at wildandwell.fit.

On this episode:

Intro:

Julie is using this book: Training for the Uphill Athlete for her 50k training plan.

Sarah asks:

Managing caloric intake

Hey all, I have a question about caloric intake during ultra training – I started running 50ks in 2017, and never really went with a meal plan or was even well informed about my caloric needs; I actually did my first 50k race after 28 days of strict keto, didn’t eat anything during the race and had one of my best performances to date. I’m now in the midst of training for my second 50 miler and my first 100k this spring, and have started to pay closer attention to overall energy balance – mainly for performance reasons and not due to any negative hormonal symptoms. Throughout this entire process (even the keto, which continued for another year and a half) I never lost my cycle (though its been harder to track with an IUD). With 50+ mile weeks, daily caloric needs break 3700kcal, which can be really really difficult to get (I’m a 27 year old female, 5’10”, 17% body fat, 60kg of lean mass).

My question is this: if your only two options are low-quality foods or no food, do you eat lower quality foods to get your daily calories? Obviously all high quality calories are ideal, but if that’s not an option is it better to eat a cookie or two to get the calories or skip things like processed flour, sugar, or simple carbs and finish the day in a deficit. I would consider high quality to be unprocessed, natural foods without added sugar. Thanks!

What the coaches say:

Article – UM study finds diverse diet as effective as sports supplements for female athletes

  • Study – Males and Females exhibit similar muscle glycogen recovery with varied food sources
    • 8 males and 8 females
    • 90-minute glycogen depleted cycle
    • 2 carbohydrate feedings afterward with either the sports supplements or potato-based product
    • Muscle biopsies (glycogen) and blood samples (glucose, insulin) were taken during recovery
    • Conclusion: “These results indicate that food items, such as potato-based products, can be as effective as commercially marketed sports supplements when developing glycogen recovery oriented menus and that absolute carbohydrate dose feedings (g kg−1) can be effectively applied to both males and females.”
    • Summary: The researchers found no difference in the efficacy between Gatorade and Mcdonald’s hashbrowns at recovering glycogen stores. Both products were low quality, but there doesn’t seem to be a difference between the liquids and solids, and that the more obsessed we get with finding the optimal option, the less likely we are to recover properly.
  • Since you’re eating really well most of the time and are struggling to meet your energy needs, eat the cookies. Our bodies are resilient and will know what to do with the contents of the cookies and put it to good use.
  • A more light-hearted approach to refueling can be incredibly beneficial as the stress is low, and you’re more likely to meet your needs because you’re not “waiting to make something healthier” a couple of hours later when you get home.
  • Meal quality doesn’t have to be perfect! Meeting your caloric need is more important.
  • In the middle of nowhere and stuck without food? Find a gas station and look for hardboiled eggs, fruit, cookies.
  • Ditch the keto! There is no need to be doing keto, especially during your in-season.

Marco asks:

Questioning ongoing LCHF vs periodizing carbs

Hi. Marco, 32 yo from Belgium. I’ve been a MAF and LCHF enthusiast for many years. I’m even Primal Health Coach certified. I’m also an avid marathoner (PB of 3h05 and currently training to BQ). However, I’ve been questioning the LCHF approach for a while. Let me explain.

During my last training cycle (end of 2019), I was training 4-5x a week (about 50 km/week), including a weekly long run and another hard workout on the week (threshold or HIIT). The rest was aerobic training. I was eating LCHF pretty much all the time. However I often had lingering soreness and fatigue, especially the days after hard workouts. My body weight was around 68-69 kg but by the end of the training cycle it was lowering to 65-66 kg (which may or may not be a good thing). However, at the end of the training cycle I tried UCAN products after hard workouts and I noticed that I was recovering faster (no soreness the days after and I was feeling more energized).

Right now, during my current training cycle, I’m still paying attention to avoiding refined carbs and junk food but I’m more indulgent on carbs (refined or not) than before. My training volume is higher, I train 6x/week for a weekly volume of about 80 km. I usually have 3 hard workouts a week (1 long run, 1 HIIT session and 1 threshold workout), the rest being aerobic training. The training  load is the highest I’ve ever had and I’m making great progress towards my goal of BQ. My MAF tests have been improving a lot  (from 4:35/km to 4:15/km) as well as other markers. My body weight is remaining around 68-69 kg, which is higher than during my previous training cycles where I was progressively lowering to 65-66kg. I don’t know if it’s because of an increase in muscle mass or not, but I’m in the best shape of my life. No lingering soreness or fatigue after hard workouts. I don’t consume UCAN but I’m sure to eat enough proteins after these workouts and consume carbs when I feel the need to (not always natural ones though). Thus my approach wrt the diet is more one of a periodized carbs that pure LCHF.

Last week I decided not to eat any refined carbs or grains, so I was back to a LCHF diet. My hard workouts were harder (increased RPE) and for the first time during this training cycle I had lingering soreness and fatigue the following days. Yesterday I ate a big pizza and I feel that my body just absorbed it all. I was just really hungry. Even though I have a hard time to admit it, my feeling is that a periodized or more indulgent approach to carb eating is the way to go. I’d like to add that I’m quite fat adapted (I’ve run a full marathon fasted in my MAF zone without any problem). What do you think about it?

What the coaches say:

  • Find a more balanced approach – a way of eating that doesn’t lead you to eat a big pizza because you were so hungry from restricting all week.
  • Using the carbs around your workouts to fuel and recover properly
  • One of the great debates in sports nutrition these days: more traditional carb fueling that is well supported in the research? Or a more innovative LCHF approach that is just emerging?
  • There are many studies we could site arguing one way or another, but from what Tawnee has learned over the years that it comes down to this:
    • Develop your metabolic efficiency (aka “metabolic machinery”), so you’re not overly carb/sugar dependent, your blood sugar rocks, and you can use fat for fuel.
      • This process could come in many forms from temporary LCHF diets or keto in offseason to carb timing in season.
      • Keep in mind as an athlete, the winner is not determined who is burning the most fat for fuel! We still need to properly fuel for performance (and recovery, etc.), as you’ve seen with using UCAN, for example.
      • Once the metabolic function is healthy, you don’t have to keep restricting carbs or stay keto, etc.
    • You’re already improving fat utilization just by training.
    • Don’t restrict a whole macro group from your diet and stay that way. Ever.
    • Energy & carbohydrate needs are relative.
      • One big mistake is athletes not knowing their energy needs relative to training. You’re burning through more than the average human. Eat like it.
      • If you’re training a lot as most endurance athletes are, you’re still “low carb” at 100-250g day. The more your training goes up, the more carbs/calories you need and this will not necessarily hinder your fat adaptation and health markers.
        • Ex) sedentary person needing 2000 kcal/day as 30% CHO, 20% PRO, 50% fat – 150 grams CHO/day. But take an athlete needing 3500 kcal/day still only taking in 30% CHO, and that boosts to about 260g CHO a day.
    • Too many fasted workouts will mess up your health. Don’t be afraid to eat!
    • But to be sure–test test test!
    • You are an individual.
      • What diet works for you is the one that keeps you healthy and performing well. Don’t force a diet that doesn’t feel good. And also, be open-minded that your dietary needs will change, and you have to evolve with it and not get too stuck in one way. There is no one correct way.

Corey asks:

Runner’s diarrhea – is it the coffee?

Hello. Recently started listening during quarantine. I’ve been getting most of my miles on the local streets and developed a new bad habit: I often need to loop around back home for the bathroom. I dont want to take imodium since my runs are local, and rather save them for races and long runs. My coffee ranges from hours before to close to heading out. Havent found any timing that fixes this problem. Is there something else to try?

What the coaches say:

Things to consider:

  • Coffee can stimulate colonic motor activity (in around 29% of people); it has naturally occurring chemicals that may stimulate muscle contractions in the lower colon, promoting bowel movements as quickly as 4 minutes later.
  • Acute or chronic diarrhea issue?
    • Do you have diarrhea outside of your runs?
    • A study on runner’s diarrhea says: “It is unlikely that individuals running at low intensity or for short durations will present with diarrhea.” Unless you’re running hard all the time (e.g., tempo or higher, but not MAF), it could be a gut issue being triggered by runs.
  • Diet
    • If LCHF/keto diet, we discussed diarrhea on HPN 4 
    • What’s your general diet like? Inflammatory foods, macros, restrictions, high sugar, refined junk, etc.?
    • What are you eating & drinking the night before and morning pre-run?
    • What’s in your coffee, how much, etc?
    • Skip FODMAPs pre-run
  • The intensity of runs.
    • Usually higher intensity causes bigger problems.
  • Study: Runner’s diarrhea: what is it, what causes it, and how can it be prevented?
    • The main causes of diarrhea in runners are:
      • Ischemic
        • “Blood is shunted from viscera to active tissues, such as skeletal muscles, the heart, lungs, and the brain [23,24], which leads to a decrease of approximately 80% of splanchnic blood flow, at 70% of VO2max [24].”
        • Both gastrointestinal ischemia and reperfusion cause mucosal injury, which leads to gut barrier function loss, increasing permeability and bacterial translocation [27], and resulting in the generation of endotoxins [11] that can cause diarrhea [1,5], though this is controversial [4,12& ,28,29].
        • Although endotoxemia seems to be an important cause of diarrhea, more studies are necessary to evaluate the effect of bacterial translocation as a causal factor in runner’s diarrhea.
      • Mechanical
        • More likely during a run vs. swimming/cycling?
      • Nutritional factors
        • Pre: FODMAPs? Gluten? Hydration state
        • During: CHO ingestion, types of CHO, amount, osmolality, gel vs. liquid.
      • KEY POINT: For the prevention of diarrhea, it has been recommended to avoid:
        • Dehydration, pre-run ingestion of high-fiber, highly concentrated carbohydrate beverages (hyperosmolar), FODMAPs, caffeine, bicarbonate (baking soda), and nonsteroidal anti-inflammatory drugs.
  • Gut dysbiosis
    • Issues outside of running?
    • Stress: GI problems highly prevalent in runners, high-intensity training, those under high general life stress, etc.
    • Gut permeability/leaky gut
  • Healing!
    • L-glutamine has some promising evidence though not conclusive.
    • Start more general with supplements: GI Revive, Restore for Gut Health, probiotics with lactobacillus and bifidobacterium strains (food sources of probiotics too!), Restore: a soil-derived mineral supplement to strengthen gut wall; promotes good bacteria.
    • Anti-inflammatory foods
    • Limit refined carbs (white flour, etc), sugars
    • No NSAIDs
    • Ongoing Imodium use is a bad idea.
  • Podcast mentioned: Dana Lis PhD: New Research on Gluten-Free and Low-FODMAP Diets For Athletes, and Takeaways For Your Needs
    • A low-FODMAP diet improved a male athlete’s GI symptoms.
  • Bottom line: What you eat, how you exercise, how you’re recovering, it all matters. Poor diet, even outside of when you run, is not helping gut, gut barrier function, etc.