April 24, 2025 • 51 mins
Isabel Martinez is a Research Sports Dietitian In the Department of Nutrition, Dietetics and Food at Monash University. She is the author of several studies on gut training as well as consults with athletes in this area.
The Effect of Gut-Training and Feeding-Challenge on Markers of Gastrointestinal Status in
Response to Endurance Exercise: A Systematic Literature Review
https://pubmed.ncbi.nlm.nih.gov/37061651/
Development of a low-fructose carbohydrate gel for exercise application
https://www.sciencedirect.com/science/article/pii/S2405844024095288
Additional resources:
https://www.cerebralperformance.com/
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:08):
Trail and ultra runners.
What is going on?
Welcome to another episode ofthe CoopCast.
As always, I am your host,coach Jason Coop, and this
episode of the podcast is abouta hot topic in endurance sports
and sports nutrition.
Today, it is all about if andhow you can train your gut to
tolerate and absorb more foodsduring training and racing.
(00:29):
I don't need to tell you thatgi distress is one of the
leading causes of dnfing in anultra, as well as one of the
most common complaints in ultrarunning, and for years, runners
and coaches and nutritionistshave been trying to solve this
problem with varying products,intake, intake strategies,
advanced formulations like thenewer hydrogels, and what we are
(00:49):
speaking about today, which istraining the gut.
So welcome to the podcast todayIsabel Martinez, who's coming to
us from Monash University,where she is a research sports
dietitian in the Department ofNutrition and Dietetics and Food
.
She is the author of severalstudies in this area, including
a recent systematic review andmeta-analysis on gut training.
(01:10):
Links to all of those will bein the show notes.
Also on the podcast today, wewill hear from CTS coach and
nutritionist Stephanie Howe onsome of the more practical
elements of how and when toimplement gut training and who
are good candidates for it.
All right, so with that out ofthe way, I am getting right out
of the way.
Here's my conversation withIsabel Martinez all about
training the gut.
(01:30):
Isabel, welcome to the podcast.
I appreciate it, as always.
Speaker 2 (01:39):
Hey Jason, Nice to be on the CoopCast.
I'm a big fan so I'm prettyhappy to be on here.
Speaker 1 (01:44):
Thank you for that.
I feel that people in nutritionnow are kind of getting thrust
into the spotlight becausethere's been kind of a
reemergence, so to speak,especially with the carbohydrate
feeding and how much athletescan actually tolerate.
So people like yourself thathave both a research background
as well as a practitionerbackground all of a sudden end
(02:05):
up garnering lots of attention,because you can meld all of
these things together thatathletes are very rapidly trying
to figure out.
Speaker 2 (02:11):
Yeah, that's so true.
Things have changed, especiallywith the current trend with
running.
I'm sure you've noticed theuptick in runners and everything
running, so they're going backto actually looking at fueling
and there's been a lot ofchanges in terms of guidelines.
If we compare that maybe, let'ssay, like 20 years back, so
(02:32):
we've been getting pretty muchthe same questions and more
people are actually a bit morefrustrated because they think
before the advice is actuallycontradictory to what's going on
right now.
Well, that's just science,right.
Speaker 1 (02:45):
Well, it's the evolution of a lot of things
right Before we get into it,just so the listeners can kind
of get to know you a little bitbetter, I mentioned that you
have both of this research andthis kind of practitioner
practical background, but canyou give the listeners an
overview of just who you are andwhere you got to, where you're
at right now and what you'recurrently doing?
Speaker 2 (03:04):
yep, and so I pretty much classify as a sports
dietitian or and or a nutritionscientist.
So that gives you the bothresearch and applied side of
things.
Um, and I pretty much startedout as a nutrition major,
similar to other sportsdietitians, and when you enroll
(03:25):
in a nutrition program it'susually that, especially if
you're coming from a developingcountry, sports nutrition isn't
really a thing, it's so nicheright.
And so that led me to a wholeadventure of going across to the
other side of the world.
So I actually ended up in thevery flat plains of Shambana or
Urbana-Champaign over inIllinois.
(03:46):
That's where I actually studiedexercise physiology.
So I have that background aswell.
So my research has evolvedpretty much from gains to gut.
So I used to work in muscleprotein metabolism, that sort of
stuff.
But my background in sportsdidn't quite that sort of
(04:06):
research, so I eventuallytransitioned into the guts world
.
But a common line that I'veseen is pretty much I like to
make guinea pigs out of cyclistsand runners and I've been force
feeding them anything frompotatoes to nut butters or gels.
That's what I've been seeing interms of research.
In terms of applied work, I'veworked in corporate settings,
(04:28):
academia and research, and I'vealso consulted with various
athletes.
Speaker 1 (04:32):
That's perfect.
So you mentioned that you liketo make guinea pigs out of
cyclists and runners, and Ithink this kind of brings into a
perfect dovetail with some ofthe initial research that we're
going to talk about, because alot of the guinea pig aspect
that athletes are doing onthemselves is trying to figure
out how much they can eat anddrink during the run.
And in an ultra marathonsetting this becomes a really
(04:55):
interesting proposition becausethe competition venue is always
longer in duration and alsomaybe also environmental
conditions.
It's more challenging from anenvironmental condition
standpoint than what they canactually recreate in training
and they're trying to doeverything they can in training
to mimic what they are going toactually do on race day from a
(05:17):
nutrition perspective.
But many times and we see thisplay out in the data where GI
distress is the number one issuecited for for not finishing
ultra marathons is that theyjust simply can't get it right,
even though they know it'sexceedingly important.
So on one side, we know it'sreally important.
On the other side, we kind ofconsistently get it, we kind of
consistently don't get it right,and so it still becomes a kind
(05:39):
of a problem to solve.
So in this first paper that I'mgoing to link up in the that
I'm going to link up in the shownotes.
There's this model of what canactually be trained, and I think
that if athletes firstunderstand how we can actually
do this and what the things thatwe are actually training are,
then we can take a little bit ofa step back and say, okay, how
(05:59):
do we actually problem solvethese things?
So why don't you take thelisteners through that model
first, and then we can gothrough what emerged from the
meta-analysis second.
Speaker 2 (06:08):
Yeah.
So if you ask pretty much anyathlete out there whether they
know the term gut training,they'll probably say, yes, right
, it's a buzzword that's beenthrown around here and there,
but when you actually ask themyour gut the most common answer
you'll get is, oh, I practice myrace day nutrition, right,
right and yes, that is true,right b and what.
(06:31):
It's actually more than that, ifyou do know what you're after
in terms of the adaptations, theterm training itself lends to
the fact that it should be alittle bit more structured,
maybe a little bit morerepetitive, maybe a little bit
more repetitive, and maybe thereare some other factors that you
can actually take into account,rather than just how much you
eat during these trainingsessions.
So that's one thing, and prettymuch when we did this
(06:54):
meta-analysis, it was sort of astepping stone into pretty much
looking more into the differentprotocols of gut training.
So we had to make sure that welooked at what the available
evidence is first.
Right, are there any availableevidence in the first place?
And so what we looked at wasthe internet for anything that
(07:15):
consisted of athletes prettymuch challenging their gut
either through volume or dose ofcarbohydrates, and surprisingly
, or not surprisingly, we onlyfound eight studies back then
wow and a lot of these actuallydid some sort of intervention.
it was kind of like gut trainingor a feeding challenge, but
(07:35):
then again, if you look at theiroutcomes, they weren't actually
measuring gut symptoms, sothere may be they were gut
training, that that sort ofthing.
So the three things that areproposed in literature in terms
of the adaptations is one canyou train your stomach to
actually hold larger volumes offood?
Right?
So if you expose the stomach togreater volume it expands and
(07:57):
with that expansion there's arise in pressure and pretty much
as an individual you'resensitive to that increase in
pressure and once that increasesyou feel full.
That stops you from actuallyingesting your fuel.
That's one adaptation thatyou're after is pretty much
being a little bit morecomfortable with that increase
in pressure when you eat foodwhile you're exercising this is
(08:20):
the eating competition stylelike the joey chestnut, I'm
gonna see how many hot dogs Ican eat.
Speaker 1 (08:26):
This is the adaptation that those I was
going to say athletes but Iwould cringe to giving them that
label but those individualsthat's the adaptation that
they're essentially craving,essentially are trying to train
for.
Speaker 2 (08:36):
That's correct.
So there's actually a studywhere they modeled the stomachs
of these competitive eatingathletes and they did see that
it's actually more the expansionof the stomach rather than how
quickly food leaves the stomach.
That's the main thing thathappens.
But it's also proposed thatthings can move a little bit
quicker outside the stomach.
But the evidence here is mostlyon animal studies and or human
(09:01):
studies, but at rest, so they'renot exercising.
It's a whole different storywhen we start talking about
people who are exercising,because we know that when you
exercise, the gut pretty muchshuts down, so it's a different
scenario.
There are evidence saying thatwhen you supplement with a
certain nutrient whether it'scarbohydrates, fat it can
accelerate that emptying.
(09:22):
So that's one thing that wouldhelp in terms of delivering the
nutrients that we need when weare exercising.
And the last thing and I thinkone of the more important
adaptations is yes, you can getin your fuel, but how much can
you actually get across to thebloodstream to be available to
your muscles, right?
So how much can actually crossfrom your gut circulation?
(09:43):
And eventually your otherbottleneck is how much your
muscle can actually cross fromyour gut circulation and
eventually your other bottleneckis how much your muscle can
actually take up so it's beenwith not absorbing, for example,
carbohydrates is it sits inyour gut and that's pretty much
food for the bacteria there toferment, and it also attracts
water.
So that's what increases yourrisk of gut symptoms.
(10:03):
And there's a cool mechanismwithin the gut wherein if
there's actually nutrients thataren't absorbed in the last part
of your intestine, it actuallyliterally puts on a break on
your whole gut, meaning it slowsdown emptying, it slows down
how food moves along and, ineffect, you also feel a
sensation of fullness, so youactually stop eating.
So those are the three things,three key things I think that
(10:26):
gut training aims to improve sofar.
Speaker 1 (10:29):
Okay, so we have this model and, just to kind of
quickly synopsize what you justwent through, what we're trying
to train is, first off, thestomach to handle larger volumes
.
Second off, to get thosevolumes through the intestinal
tract more quickly, and thethird one is to actually absorb
primarily carbohydrate throughthe, through the intestines, in
(10:49):
order, so in order for theenergy to actually be delivered
into the bloodstream, verysimply, put right All three of
those yes.
And the way that I think aboutit as a coach and being, you
know, very tangentially involvedin some of the nutrition
sciences is we kind of attackall three of those problems via
two primary mechanisms, thefirst of which we're talking
(11:11):
about today, which is justtraining the gut and trying to
train the gut across all thosethree, and that's what we're
going to spend the majority ofthe time talking about.
But, not to be remiss, we'regoing to get into this a little
bit is it also becomes aformulation and a chemistry
problem.
So what types of stuff are youactually ingesting so that those
three elements that you aretraining are not as stressful on
(11:34):
the body because of thecomposition of macronutrients
that you're actually taking in?
And those two things I don'tknow how you would describe it,
but they work hand in hand andthose two things I don't know
how you would describe it, butthey work hand in hand, but they
can almost be treatedseparately to a large extent,
meaning you're thinking aboutthe training side of it.
And then you're also thinkingabout the composition of the
(11:54):
things that you're ingesting andtrying to almost maximize the
training that you're actuallyputting forward.
Speaker 2 (12:00):
Yep, yep, no, that's true.
So when we actually get intothe thick of like the different
protocols, you'll see thatmajority of the factors that
have been explored is prettymuch varying those putting in
more carbohydrates to train thegut, but, similar to what you
said, the composition in itselfcould be another thing that we
could actually vary.
(12:20):
So that's leaped up nicely tothe next study.
Speaker 1 (12:23):
Okay, so let's play a little game here.
Right, we've got these threethings right Hold the stomach,
holding larger volumes, fastergastric emptying rates and the
absorption side of things.
After you scour the literature,what seems to be more trainable
?
Is there an area where we cansay, hey, listen, if we did a
lot of work in this thing, it'sgoing to improve the most?
Because we think, if you kindof can put your physiology hat
(12:46):
back on, going back to you know,way back to your, way back to
your studies as a coach andathletes think about this the
same way.
They tend to think about what'sthe most trainable system.
I have 10 hours per week.
What's the thing that I cankind of train the most?
Or what are the gains?
Going back to your strengthtraining days, right, are the
gains that I can kind of likemake the most?
Is there any one out of thosethree that like fit that bill of
(13:07):
hey, listen, this thing is themost adaptable system, so to
speak?
Speaker 2 (13:11):
yep.
So, based on the very scarceevidence from this study, the
most gut gains that we get arepretty much first one is
training, how you know thevolume of food that your stomach
can hold without you beinguncomfortable.
And the third one, which ispretty much absorption, so
gastric emptying.
Not much evidence as of now,because one it's hard to measure
(13:33):
right.
It's very invasive and I don'tthink athletes want tubes down
their throat in studies.
Speaker 1 (13:40):
So it's interesting because you present this one
thing of the most trainablething is either the stomach
handling larger volumes, or theabsorption side of things.
If we take a really simplisticview of this, the second thing
that you mentioned, theabsorption side, would probably
make a bigger impact forperformance than the former side
(14:04):
, because it kind of doesn'tmatter if you have a lot, if you
can tolerate, you know, ahundred hot dogs in your stomach
, if you can't get thosenutrients through the intestinal
wall to to serve a purposeessentially.
Yeah, how does that get teasedout in the literature as well?
Because those are two.
We're kind of talking about twodifferent things.
We're talking about a comfortthing and then we're talking
about actually deliveringmacronutrients on the second
(14:26):
side of it so I guess it's howyou view the impact of gut
issues on actual performance,right?
Speaker 2 (14:32):
So one is if you don't get enough fuel, then
you're going to bonk, thenyou're not going to perform well
, right.
But at the same time, if youactually get like really severe
issues, when we're talking aboutthe stomach side of things,
that's mostly upper gut symptoms, so, for example, regurgitation
, vomiting, that sort of stuff,that's also going to cost you a
(14:52):
DNF, right?
Speaker 1 (14:54):
So in the early 2010s and he asked finishers and
(15:16):
non-finishers of the WesternStates 100 in Rio do Lago what
affected their performance.
And GI distress comes to thetop of the list, and we know
that can be caused from a numberof different things and a lot
of times we tend to trivializeit as oh well, I just can't
consume, I just don't have thecapacity to consume more food
(15:37):
and fluid.
But in reality, there are alsolike downstream effects that
need to be, quote-unquote,considered and trained for as
well.
We just don't have like thebest, or at least at the time,
we don't have like the bestvocabulary to describe it as the
way that I'm internalizing it.
Speaker 2 (15:51):
Yep, Yep.
So if you want to read up moreon, like that whole mechanism,
it's very actually it's verydetailed and it's called
exercise inducedgastrointestinal syndrome.
It's a whole pathway of whetheror not the function of your gut
shuts down and also in terms ofhow your brain controls the gut
.
There are many factors.
Speaker 1 (16:10):
So let's kind of skip to what the interventions are,
because people are going to wantto know what do I actually do,
and you already mentionedpractice, your rest, race day,
nutrition, and it's likely morecomplicated than that, where we
need to start thinking abouttraining your gut in the same
way we think about trainingother aspects of our physiology
from an overload standpoint.
(16:30):
We overload the system.
It then creates some sort ofcompensatory mechanisms that
start to kick in so that thenext time you have a similar or
the same type of load, it hasgreater capacity to handle
whatever that stress or strainactually is.
Speaker 2 (16:45):
Correct.
So, I pretty much.
I think of it as you know, whenyou're training and then you
have harder sessions actuallyduring training than the actual
competition.
That's how I think of it, asyou know, when you're training
and then you have hardersessions actually during
training than the actualcompetition.
That's how I think of it,because doing gut training
sessions aren't at all pleasant.
Speaker 1 (16:58):
No, they're not, and not a lot of people.
And once again, we work withathletes all the time and once
again, my bias is kind of from atraining standpoint, I'm always
looking how do we maximize thiscomponent?
No-transcript nutrition,although we could start there
(17:39):
but, what are the intervention.
What are like the interventionsthat have tried and what are
the like?
Can we synopsize the outcomesof those?
Speaker 2 (17:46):
so I think we go back to what the literature says.
So the first time that thismanagement strategy has been
proposed is probably in theearly 99 piece, and it was just
termed as the gut being trainedto cope with exercise, not
specifically through nutrition,right, but anyway, there were a
couple of review papers thatwere published in 2000s and
that's where the proposedmethods were actually outlined
(18:07):
by people, however mostly citinganimal evidence, or a lot of
them were actually anecdotalfrom like these competitive
eating competitions.
So one is actually trainingwith a high carbohydrate intake
and that means your daily diet,which one study actually did,
but then they didn't reallymeasure gut symptoms.
The other common thing that'sproposed is training right after
(18:30):
eating a meal, so training witha full stomach, and that's
really is training right aftereating a meal, so training with
a full stomach, and that'sreally not something very new
when you think about cyclistswho are on rides right, they
take a break, they eat theirmeals and then they go on right
yeah, exactly that's somethingvery new.
The third one is what we call asa repetitive eating challenge,
or pretty much training withhigh carbohydrates during
(18:52):
exercise, and that means it'sback-to-back sessions of this.
The other two methods is prettymuch training with a high
volume of fluids, so a lot ofwater and or carbohydrate
solutions.
But those are some of themethods that were actually
mentioned in these studies, butonly three of those have studies
(19:14):
to back them up.
Speaker 1 (19:16):
And what does that practically look like?
Speaker 2 (19:19):
Sorry, the last one is practicing race day nutrition
.
Speaker 1 (19:22):
Yeah, no, we already went on that we think about the
same day, I mean honestly.
So we have a number ofdifferent nutritionists and
registered dietitians that workon our high performance within
our high performance program,specifically for elite athletes,
and a lot of the times that'swhere they're starting, because
it kind of accomplishes twothings is one, they're
practicing the race daynutrition.
(19:42):
But two, that's a challenge inof itself because they're not
taking in.
Let's just say, their goalcarbohydrate per hour range for
a race would be 80 to 90 gramsan hour.
They're normally not doing thatduring training, so you get
this like dual effect ofoverloading the GI system with
their race day nutrition thatthey're actually practicing.
(20:03):
Okay, let's get a little bitmore detail on how to implement
this with CTS coach andnutritionist Stephanie Howe.
Speaker 3 (20:17):
Those specific strategies we use for gut
training are to one back it upall the way until before an
athlete starts a training runand think about their pre-run
breakfast and really dial inwhat they're going to have
before they take off running, tomimic what they would have race
day and playing around with thetiming a little bit here too
(20:38):
and thinking about what it'sgoing to be like race day if
it's a 4 am start.
Obviously that's going to bedifferent than if it's a 10 am
start.
So having the athlete both pickthe type of food they want to
eat and the time they want toeat before they go out and run,
that's going to help get energyin their system but also prepare
their gut for doing it on raceday.
And then during the trainingruns, we really want to identify
(21:01):
the goal in terms of grams ofcarbohydrate per hour and the
type that the athlete's going tobe taking.
And usually it depends on theathlete and what they've
struggled with or what they'vehad success with in the past as
to where we're going to start,but normally it's around 50 to
60 grams of carbohydrate perhour for the average person.
(21:24):
If they've had issues in thepast.
We're going to start a littlebit lower and try to get their
gut a little happier, have themhave a more positive experience
and then kind of titrate it up,but start with the specific type
.
So if they want to use gels,we're going to use gels.
If they want to use blocks,we're going to use blocks.
And then just kind of figureout the timing of what that
(21:44):
looks like every 20 or 30minutes and dial that in in
every single long run they doleading up to their race.
Speaker 1 (21:54):
What we're starting to see is a lot of athletes are
actually moving beyond that.
They're saying okay, if mytarget is X, we're just going to
use 80 grams per hour just tomake the number consistent.
Not that should be the rangefor everybody, but if my target
is 80 grams per hour, here's howI can make that more effective.
I can make that more effectiveby introducing this intervention
(22:15):
or that intervention that youhad just mentioned.
What does that look like?
Practically Like you'reconsulting with an athlete and
they say listen, I want to makethis X grams of carbohydrates
per hour more tolerable forlonger periods of time, with
less GI distress, and I want toabsorb more of the carbohydrate
more quickly.
Practically, what do thoseinterventions actually look like
(22:35):
in the field?
Speaker 2 (22:36):
So in the field, if you are after greater absorption
, the stimulus needs to be alittle bit more chronic.
So practicing race daynutrition whether that means for
most athletes you know, duringlong runs that's when I actually
target 80 grams that might notbe the case.
That can help you tolerate thelarger volumes.
But then if we are after makingthe transporters a little bit
(22:59):
more efficient, that has to be abit more of a chronic stimulus,
which means that you might betrying to eat 80 grams of carbs
even in your shorter sessionsand easy runs, and it has to be
a back-to-back session based onthe evidence.
Speaker 1 (23:17):
I mean, it's almost like an endurance adaptation at
that point, if I'm understandingwhat you're describing
correctly, where we don't justtrain two or three times a week,
we train six or seven times aweek.
Is that the frequency that youwould be advocating for in terms
of trying to create some ofthose initial adaptations?
Speaker 2 (23:36):
So the longest one was a two-week protocol which
pretty much looked like fivedays straight, two days break,
five days straight Not reallyfeasible considering a normal
endurance training program,right, because it's not every
day that you do easy runs.
So this follow-up study that wedid, we tried seven days
straight and when I put thatinto translational relevance,
(23:58):
it's pretty much doable when youactually taper for a race,
right, that's where you fit thatin.
So when you taper, you actuallygo on your easier runs and at
the same time, another goal foryou is pretty much load up on
carbohydrates.
And the problem with trying todefine when these sessions
should occur is one we don'tknow how long these effects last
(24:20):
.
So that's a key gap inknowledge.
So if I'm just practicing raceday nutrition every long run and
then I stop my long runs twoweeks out, I don't know whether
I'll still be able to have thosebenefits come race day.
That's a key thing that wedon't know how long this
adaptation lasts.
And still, we're still kind ofin the gray area on how much.
(24:42):
How long is the duration of theprotocol to be able to get
these adaptations?
Speaker 1 (24:48):
So you already skipped ahead to my next two
questions so you preemptivelyanswered them with we kind of
don't know, but I think you'rekind of getting to like what
most practitioners that I'vebeen working with come to is
just a reasonable, a reasonableextension of the research.
(25:09):
Quickly do these adaptationscome about and how quickly do
they fade away?
How transient are they innature?
And, interestingly enough and Idon't know whether this is just
like hive mind mentality comingthrough or whatever, but this
two weeks ish type of timeframetends to come through a lot when
I actually consult with peopleand they all say that they all
say kind of the exact same thingis like well, we don't know,
but this is kind of what alittle bit of what the
(25:31):
literature teases out and alittle bit of what we actually
see in practice that you needroughly five days per week for
two weeks to create some ofthese initial adaptations and
you want to try to do thatcloser to the race as opposed to
further away.
It's not a chronic adaptation,which is kind of fools a lot of
people because that's what wethink about our traditional
(25:51):
endurance adaptations is takinga long time to produce and then
sticking around for a longperiod of time.
This would be much moretransient in nature.
Speaker 2 (25:59):
Yeah, that's correct.
So I think that five days twodays came from those original
gut training studies.
But a lot of the athletes,interestingly, in that study
actually said that they had ahard time following that
protocol.
It's just not realistic.
So really the next step forthis sort of research is to go
into the nuances of designing afeasible and realistic protocol
(26:21):
within an endurance trainingprogram.
Speaker 1 (26:24):
Let's bring that to light, because a lot of athletes
are thinking, yeah, this isn'tvery realistic for me on a 90
minute run to try to take in 150grams of carbohydrates.
There's a few pieces of thisthat we can kind of like that
back and forth.
But what do you hear fromathletes in terms of, hey, this
isn't realistic for me.
Speaker 2 (26:40):
Yeah, so for one thing cost right.
Speaker 1 (26:43):
Yeah, gels are expensive now.
Like gels are like four bucks apop right now.
It's kind of crazy.
Speaker 2 (26:49):
Exactly so, especially with with athletes,
and there are certain athleteswho are very like, particular
about I want to train with this,because this is what I want,
this is what I'm going to usethat phrase, so cost the
logistics of things as well.
I think sometimes you just wantto go for a run and not worry
about you know, ingesting somuch carbs, but also trying to
(27:10):
plan this out, thinking of yourtraining.
I think this is where coacheswill help, because usually when
you try to think about yourfueling plan for a race, you
want about three to four months.
I'd say three to four months.
Usually, when I take inathletes and coach them in terms
of nutrition, I want at least12 weeks out to think about
(27:30):
everything and to lay out theplan.
So I think that's the mostchallenging part in terms of
translating these findings toactual real life scenario is the
implementation part of it.
Speaker 1 (27:43):
Is the primary.
So we've been thinking aboutgut training challenges from a
minimum effective dose angle.
What's the minimum amount oftime and the minimum amount of
frequency that it takes toproduce the adaptation?
And part of that you mentionedis just that people don't want
(28:04):
to spend that much money on gelsand it's like you just said,
it's just inconvenient to wantto take five gels on an hour and
a half run.
It just kind of gets old.
But are there any otherpotential consequences for
elongating that intervention?
Meaning if you had an athleteand say I don't care, I have a
sponsored athlete, I get all thenutrition product.
Speaker 3 (28:23):
I like taking, all taking all these.
Speaker 1 (28:25):
I like taking them in on runs.
Is there any potential negativethat you would and this is kind
of going outside of themeta-analysis box a little bit,
but it's people are going to becurious about it.
Is there any potential negativefor elongating that very
specific intervention, let's sayover months or an entire
training cycle?
Speaker 2 (28:41):
yeah, well, we all know that, similar to training,
nutrition needs to be periodized, right?
So if you are doing this longterm and you know that there are
benefits to actually sometimestraining with lower
carbohydrates, that'spotentially one thing that could
be impacted by this.
Speaker 1 (28:56):
So just your body's more like reliance on that
particular substrate is whatyou're kind of saying yeah,
specifically for ultras, right.
Yeah, I mean, we ultra runnerstend to be really good fat
burners.
Just as a byproduct of theirhigh training volumes and low
training intensities thecombination of those two, they
tend to just metabolically bepretty decent fat burners.
But I do foresee a world wherethe pendulum swings the other
(29:21):
way and this is what I kind ofget worried about with trends
too.
Right, Typically a trend isstarted with good and healthy
intentions but being kind ofmore obsessive minded endurance
athletes, they tend to takethose trends to the extreme,
because if a little bit is good,if a two week intervention is
good, then a 20 weekintervention is 10 times as good
as the is the typical thoughtprocess and I'm trying I'm just
(29:44):
trying to get some morementality on what would be any
potential negatives of doingsomething for so long, and this
one once again kind of keepscoming up.
As well as that, you justbecome over-reliant on that
particular substrate and yourfat burning capacity gets
diminished to a point to wherethe positives, the negatives,
outweigh the positives, Positive.
Speaker 2 (30:05):
Yep, I guess the other thing.
So gut training is really astrategy that's meant for people
who actually get gut issues.
So I think that's also ameasure or an outcome that once
you see that you actually aredoing a little bit better, it
might be a signal for you toactually lay down or lay off the
golf.
Speaker 1 (30:24):
Yeah, I mean, we all know the athletes that have,
like, the iron gut right.
They can kind of take anythingand huge quantities and they
don't need to quote, unquote,train it, and they're probably
just as curious as would.
Are these interventions any youknow different for them?
And kind of what you're sayingis is yes, it's not.
You already have that kind ofinnate part of your physiology
(30:44):
baked in and it's not somethingthat you either have to focus on
as much or maybe not even focuson at all.
Speaker 2 (30:50):
Yep, that's true.
So usually when we do assessathletes, that's one of the
first things that we ask youactually get gut issues during
exercise and is it recurrent oris it, like this, one fine thing
during this race?
Because that's going todifferentiate our approach when
it comes to fueling right soultimately, if you say yes to
gut issues, then okay, we kindof try to see, all right, what's
(31:13):
going on with your fueling?
What stuff are you eating rightbefore a race or leading up
into a long run?
Speaker 1 (31:18):
the other factors that might actually impact gut
issues what you I think whatyou're trying to say is you're
kind of like titrating thissolution to an appropriate
amount given the problem thatthe athlete is actually
identifying, meaning there's notlike a blanket solution and
saying everybody has to do x?
y or z you're looking at okay,this person has these types of
(31:41):
issues, and then we're eitherfocusing we're either putting a
lot of focus on theinterventions or a little bit of
focus on the interventionsbased on the problem.
That's kind of in front of you.
Speaker 2 (31:51):
Yes, and that pretty much is the comprehensive
assessment of how their gut isdoing during exercise.
Speaker 1 (31:57):
Yeah, exactly Because , like I said, I know people
that for their entire careershave never had any GI distress
at all.
Yeah, lucky them, they do 100grams carbohydrates per hour and
they just kind of get it forwhatever reason, and I'm sure
we'll figure out at some pointthat that's an innate part of
their physiology that has a lotof has a large genetic component
(32:17):
to it.
Uh, just like other aspects ofour physiology that kind of that
tend to be geneticallypredisposed, that tend to be
genetically predisposed.
Okay, one final break in theaction.
Let's go back to CTS coach andnutritionist Stephanie Howe and
hear her thoughts on who aregood candidates for gut training
.
Speaker 3 (32:38):
I think all athletes can be candidates for gut
training.
The ones that are going tobenefit most from it are the
athletes who have struggled withtheir fueling in the past,
maybe don't take in enoughcarbohydrate or they take in the
wrong type of carbohydrate, andthey need to really kind of
strategically plan that and fixit so that they don't have
(32:59):
issues race day.
And then the other end of thespectrum is the athletes who
really want to maximize thegrams of carbohydrate per hour.
So an athlete who's going to betrying to take in, let's say,
90, 100, maybe even 120 grams ofcarbohydrate an hour, they
definitely need to use some guttraining strategies so that
they're able to, one, absorbthat much carbohydrate and then,
(33:23):
two, be able to use it withoutissues absorb that much
carbohydrate and then to be ableto use it without issues.
Speaker 1 (33:32):
I'm going to pivot a little bit, because we've been
talking, naturally, about a lotabout carbohydrate because it's
in the news, it's at theforefront, you know everybody's
trying to like push the envelopethere, yeah, but that's not the
only way that you can train thegut, and you've been at the
forefront of a few studies nowthat looks at different using
different types ofmacronutrients and different
types of basic strategies totrain the gut.
I'm wondering if you could kindof give an overview of those
(33:54):
and then we'll dive into whatthat actually looks like as well
and why you might want to usethat type of intervention versus
an all-carbohydrateintervention.
Speaker 2 (34:01):
So, based on the available studies, the majority
of them use carbohydrates and itdoes make sense, especially in
endurance and ultra endurance,because that's the primary fuel
that we want.
Right?
There is just one study thatlooked at carbohydrate with
protein.
However, it was only inAustralian footy players, so
it's a little bit more of adifferent exercise stress, right
(34:23):
, it's a little bit moreintermittent, so similar to like
American football, I'd say, andyou wouldn't expect a lot of
gut issues to actually happen inthat sort of scenario.
So, in terms of endurance andultra endurance, it's mostly
carbohydrates.
Some of the other things thathave been observed were whether
you use carbohydrate solutions.
So one study actually looked ata non-repetitive protocol.
(34:46):
So they just drank largervolumes of carbohydrate drinks
in five repeated trials.
So that's sort of more likesimilar to what you'll do when
you practice your race day.
Nutrition, right form ofcarbohydrates, whether you get
(35:08):
it from gels or solids, andequally they improve gut
symptoms, but in terms ofabsorption, it was only seen in
the carbohydrate gels.
So that shows you that thecomposition as well of what you
intake also impacts thoseoutcomes.
And, interesting, if youactually put in a placebo,
nothing happens.
So even if you have that samevolume, but there's no nutrient
in it.
You actually don't getimprovements in gut symptoms.
Speaker 1 (35:28):
So you can't trick your body into.
It is what you're trying to sayno it's pretty smart.
Well, I mean, it's important toknow because, like placebo
effect in a lot of compounds andespecially medicine and things
like that, is actually very real.
But here you're actually sayingthere needs to be a stimulus of
delivering the nutrients inorder to see, in order to see
the outcome that you actuallywant same thing.
Speaker 2 (35:47):
If you actually ask me, can I just drink a lot of
water with drink a lot of water?
Speaker 1 (35:51):
yeah, no, and I can see I know athletes that that
think that they're doing thatbecause they've seen how, going
back to the hot dog eatingcompetition, they're going back
to how joey chestnut wouldchange train by drinking a whole
lot of water to, you know,expand the of his stomach, which
you're saying is that's a poorstrategy for endurance, athletes
.
Speaker 2 (36:08):
Yes.
Speaker 1 (36:10):
Okay, let's talk a little bit about composition.
One of the limiting factors witha lot of athletes that we
previously mentioned that wantto train their gut and they find
that there's some sort ofbarrier is just the cost of the
products, and this is just areality I work with.
I'm very fortunate.
(36:31):
I work with a lot ofprofessional athletes that don't
have this barrier in front ofthem because they have all their
nutrition products provided forthem.
But I also work with a lot ofreal athletes that look at the
proposition of spending 20 or$30 a run and do they want to
fork over that kind of cost, andthe solution that they've come
back to is trying to formulatetheir own stuff, which you guys
(36:51):
kind of did in one of yourstudies, and when I was reading
it with my research assistant,fred, this is exactly what I was
thinking is is the athletesthat are at home that are trying
to buy a lot of this stuff inbulk and trying to formulate and
try to formulate their own gels, and I'm wondering if we can.
I'll link that paper, I'll linkthat paper up, but I'm
(37:11):
wondering if there's anythingthat we can kind of like take
take from that that the athletesthat are trying to do this at
home can actually kind of likelike learn from, because you
guys were doing it for purpose.
Speaker 2 (37:19):
You were like building to suit, so to speak
yeah, and so funny you mentionedthat paper, because when that
paper come out it was rightabout the time that you actually
had that little expose on oneof these gels.
Speaker 1 (37:29):
Oh funny.
Speaker 3 (37:30):
You're like oh perfect.
Speaker 2 (37:32):
And then your follow-up paper recently was a
perfect like it was the sametheme with this paper.
Speaker 1 (37:38):
Yeah, yeah.
Speaker 2 (37:38):
And so my idea behind that and even runner myself,
I've always tried to reducecosts.
Even runner myself, I've alwaystried to reduce costs and I
know that these products areeasy to make and you can make
them using readily availableproducts in your supermarket,
right?
So in this paper we sort ofbuilt a pathway it's sort of
like a guide for athletes andpractitioners to create their
(38:01):
own gels if they think that thegels out there in the market do
not suit their needs.
So this is in terms of liketaste, flavor or the blend of
carbohydrates, or even like theactual texture.
So in this way you can actuallycustomize it to what you
actually want.
So in that pathway it's like asix-stage process, but you
pretty much look at number one,especially the ingredients that
(38:25):
you put in, and what is the goalwith your own formulation?
Do you want something thatdoesn't have a taste?
Do you want something that'svery sweet?
Do you want something that'sfruity or maybe salty?
Yeah, so in that way you canactually make your own
preferences and the in terms ofthe ingredients.
So the gel that we made in thatstudy, all the ingredients were
(38:49):
bought from a grocery store, soit is actually possible amazing
and this is what I tell peoplethat you can actually mix it.
If you have the time andpatience to actually mix your
own gels, you can absolutely doit and that will help you also
train your gut if you plan touse that during races.
Speaker 1 (39:07):
And so I'll link that study up with that six stage
process, and whether or notathletes want to go to their own
grocery store to try to figurethis out or not, it's kind of
like up to them.
But I guess what I'm trying tosay is it is possible and you
can actually build it to suit.
There are also companies outthere that are realizing this
and almost acting as like anintermediate.
(39:28):
I mean, the original companythat did this they've been
around for a long time beforethis got popular was Infinite,
where you could go and you couldkind of customize your own, you
know, your own kind of whatever.
Yeah, exactly, but since thenI'm actually pulling it up on my
phone right now, pulling it upon my phone right now.
There's this company in the USthat you might not, may or may
(39:48):
not be familiar with, calledbulk supplements, where you can
buy all of these in bulk onlineand then put them together in
your kitchen, kind of like,however you want to, yep.
Speaker 2 (39:55):
So all these sugar powders are available online and
, mind you, if you actually makeyour own gels, it's probably
going to cost maybe 20 cents apop.
Speaker 1 (40:03):
It's crazy.
It's crazy and I'd be remissnot to mention.
I actually like the nutritionmanufacturers.
Like they're all my friends andyou know I like their products
and I think they do a good job.
I think they do a good job withproduct formulation.
But more and more and this hasonly been within the past like
three or four years I'm runninginto more and more resistance
against those because theconsumption part in part, I
(40:26):
guess, because the consumptionrate is coming up so much and
I'd be remiss to say that goingto your local run store and
buying a gel for three dollarsis the only solution out there.
There are also other solutionsthere.
Speaker 2 (40:37):
Exactly, and like these carbohydrate gels.
You know, even before they came, like people were running and
eating solid foods like right.
They came like people werealready running and eating solid
foods like right, exactly.
So it's not your only optionand there are ways to like
navigate this issue.
Speaker 1 (40:53):
When it comes to cost , like not all athletes are
sponsored, unfortunately yeah,okay, let's bring it back full
circle, because we started outwith training the gut.
Let's go back to training thegut.
I kind of want to go.
I kind of want to leave thelisteners with a few steps that
they can take away to try toimplement this during their
training.
This podcast is going to comeout in April.
(41:14):
The racing season is starting toheat up.
If we're looking at anintervention that's kind of
meant to be close to the closeto race time, this is the
perfect time of year to try torelease this to race time.
This is the perfect time ofyear to try to release this.
So can you leave the listenerswith a just a very quick
overview of if you want to dosomething like this?
Here's where you'd stop.
This is how much you would doand this is where you would end,
(41:36):
so that they have some initialframework to go off of and then
they can dive into this podcastand the resources that'll be
linked up if they want to getmore specific.
Speaker 2 (41:43):
Yeah, the first thing you ask yourself as a runner
and endurance athlete is onewhether you get gut issues.
I'm not going to recommend guttraining at all if you're not
suffering from this and if yes,it might be worth looking at
what sort of gut issues you get,because that's going to
pinpoint what sort ofintervention you want.
For example, you get a lot moreof belching or things coming up
(42:06):
when you're running that sortof stuff.
Well, that's going to targetmore of your upper gut.
So that means that's wherevolume comes in.
So how much you put in andwe're trying to train that
capacity of your stomach andthat can be trained again based
on protocols.
It can be across repeated trials, so not back-to-back.
(42:26):
So every long run you actuallyincrease your volume in terms of
carbohydrates and or fluids.
If you're getting a little bitmore of lower gut symptoms so
lower bloating, flatulence, thedreaded run to find a port-a-loo
, that sort of stuff well,that's going to be a little bit
more of a different approach,because we think that a lot of
(42:49):
this has something to do morewith the absorption of
carbohydrates, right?
So in this scenario, youprobably want a bit more of a
stronger stimulus, meaning thatthe duration and the frequency
of your gut training sessionshould be a little bit longer.
So back-to-back sessions, atleast from what we see right now
(43:09):
.
10 days works withcarbohydrates.
Speaker 1 (43:14):
You're speaking my language on the back-to-back
sessions because that'ssomething I do, that from an
interval protocol, and peopleused to criticize me a lot.
Now we're seeing it more andmore often, so we'll also
advocate for back-to-back guttraining sessions, just to keep
the theme consistent.
Speaker 2 (43:26):
So, when you pinpoint this, also try to discuss as
well with your coach how you'regoing to fit this into your
program, because we don't wantthese sessions to be the reason
why you don't get the trainingadaptations that you want from
your race as well.
So it's working hand-in-handwith your coach.
Consider consulting a sportsdietitian as well to help you
try to plan out and even try tofigure out which products, if or
(43:51):
whether or not you want to makeyour own.
So, yeah, there's a lot of helpthat you can seek, perfect.
Speaker 1 (43:58):
I think that's a brilliant place to stop the
official like intellectualdialogue.
I have one more question foryou.
This is not on the outline.
I always like to surprisepeople kind of at the very end,
just for a little bit of banterand for a little bit of fun.
Where do you think that thisultimately goes?
Because you and I we've beenI've kind of tracked your, you
(44:19):
know career and you know howlong I've been coaching, for
We've gone seemingly from 60 to90 grams of carbohydrates per
hour to 90 to 120 grams per hour.
And I was seeing in the propeloton where some of those
athletes are pushing 140 and 150, yeah, 150, even 150, and I
always like to, I always justlike to.
What's next?
(44:39):
You know, I always like to tryto figure that.
What like?
What do you think?
What do you think it's like itdoesn't have to be a rate?
You know we've been kind oflike focusing on that, but what
do you think?
What do you think it doesn'thave to be a rate?
You know we've been kind oflike focusing on that, but what
do you think is next in thewhole evolution?
Speaker 2 (44:47):
here.
I think it depends on the sportfor one thing.
So if we're just talking aboutrunning, I think that's going to
cap out at around 120.
I can't imagine people actuallycarrying that amount of
carbohydrates, especially inroad running, to be able to
actually feasibly get thatamount of carbohydrates.
But again, with science italways swings from one side to
(45:10):
the other.
Maybe now we're in the highcarbohydrate trend and who knows
?
Speaker 1 (45:19):
later on, in 20 years , maybe fat will come back again
.
It will Trust me it will.
I've seen this is my thirdswing of the pendulum Right
Possibly it will.
Speaker 2 (45:25):
I've seen this is my third swing of the pendulum.
So maybe people are going to beso good at handling
carbohydrates and then you knowsomething else within the body
changes.
Maybe it's your I don't knowmicrobiome or whatever and then
we start seeing things that arenot good and then we point back
oh, it's because we ate too muchcarbs.
And then we go back straight tozero, which is I can see why
(45:48):
it's frustrating for individualsto follow nutrition and science
, but at the same time, it'salso exciting, because there's
always more questions to answer,right?
Speaker 1 (45:58):
yeah, no, it's great.
I I appreciate you putting upwith a little bit of the banter
in the in, in the theory.
Speaker 2 (46:02):
Here, finally, is my question jason, my question to
you is years back or now, thatyou've seen athletes get faster
and faster?
Speaker 1 (46:12):
No, what you the first part of that cut out,
you're going to repeat it again.
Speaker 2 (46:15):
Or have you the trend of athletes getting faster,
that you see that 10 years or 20years back, or is it now with
the high carbohydrate?
Speaker 1 (46:23):
Well, I mean, somebody actually asked me this
just the other day, so I've hada little bit of time to think
about it, to think about it andI'm prefacing how, maybe how
good this answer is going to be,with the fact that it's not
quite going to be off the tip ofmy tongue.
But athletes are always gettingbetter across all facets, and
athletes across all sports stickand ball sports, endurance
(46:46):
sports and things like that andalongside that we always have
technology to help us along theway.
The shoe revolution was a bigpiece of technology.
There's nutrition technologythat comes along in cycling.
We have, you know, technologythat helps us analyze training
better.
We also have technology thathelps kind of in real time, so
(47:07):
to speak, perform at a higherlevel.
All of those things arehappening concurrently, all to
the benefit of athletes andperformances.
So it's never just one thing,like a lot of people will say.
Oh well, it's this quoteunquote revolution.
Sure, that might take a littlebit of a little bit of a
disproportionate amount of thespotlight at the time, based on
(47:30):
everything else that's going on.
But make no mistakes that thisphysical evolution and
technological evolution hasalways happened in sports since
sports have kind of been aroundand that's why you see the
improvements.
It's never linear, it's alwaysin a stair-step type of fashion,
but it's kind of always present.
So I wouldn't chalk it up, andI would never chalk it up to
(47:52):
just this or just that.
Everything's happeningconcurrently, it's just a
different proportions.
Speaker 2 (47:58):
Exactly Now, just to see you saying technology and
development of evidence.
I think the future really isactually going into more
personalized nutrition.
I think that's where it is like, where some people will be
doing better with highcarbohydrate and maybe some
people will be doing better withhigh fat and maybe then by then
we'll be able to have someobjective measures and actually
(48:21):
reliable measures of being ableto say whether or not someone
can purely fuel with x, y or zyeah, it means it's interesting.
Speaker 1 (48:29):
Now we're really going off the rails.
It's really interesting thatyou say that because there have
been any number of attempts atthat personalization and you can
look at the ways that we'vetried to do that.
It's been from tracking things,that are things metabolically
that are happening, like the useof CGMs or even metabolic
(48:50):
testing or even sweat sodiumtesting.
That is a way ofindividualizing things.
We can look at the geneticlevel and what an athlete might
be more predisposed to in termsof higher volume, higher
intensity, more frequency andthings like that.
Higher volume, higher intensity,more frequency and things like
that there have been all theseproposed mechanisms that certain
genotypes are going to respondto certain types of workload or
(49:10):
a frequency of workloaddifferently, and then we get to
the outcome piece of it, whichis kind of what I rely on the
most is you have an athlete do acertain thing and they respond
to that certain thing better.
That's a level ofindividualization as well.
If you're looking at thetraining and you're looking at
the interventions and you'reputting it under a high level of
scrutiny, you can individualizeit in arrears, so to speak,
(49:32):
after you've actually done theintervention.
And I don't know which one ofthose is going to and there's
probably a few more permutationsthat I'm not thinking of off
the top of my head.
I don't know like mix of thoseis going to kind of like
dominate the landscape, justlike the technological piece.
We've seen the genetic piecestart to try to get a foothold
(49:52):
and it really didn't kind oflike pan out.
Some of the bio, some of thereal-time bio monitoring has
kind of come in fits and starts,so to speak, and you know, I
just look at it as something towhere I agree with you on the
individual side of things.
That's always what we're tryingto do, but it's just how we go
(50:13):
about doing and what tools wedeploy within our arsenal of
tools to actually figure thatout.
Speaker 2 (50:18):
I see them as sprinkles honestly sprinkles on
top of the cake.
Your basics will always holdout, right yeah?
Speaker 1 (50:23):
exactly 100% percent.
Awesome.
Let's not go off the rails toomuch more.
Although we could do this allday, maybe we'll bring you back
and we'll just have a completeopen conversation about gels.
Oh, geez, and we'll do it Bringin Nick.
Yeah, we'll do that.
We'll bring in Nick, we'llbring in all the people who make
the gels I mean, I know thosequite well at this point and we
can go over the hydrogels andthe different types of fructose
(50:47):
to glucose ratios and theirclaims.
And then do you add sodium, doyou add amino acids, or you
could just go make your owngrocery store stuff like you did
.
Links to everything is going tobe in the show notes, but where
can people go to find just moreabout you and the work that
you're doing?
Speaker 2 (51:04):
I'm on Instagram, facebook and LinkedIn pretty
much as Isabel Martinez.
I'm not yet very active withsocial stuff because I'm
currently writing mydissertation.
It feels like an open marathonwriting to think so I haven't
really science calmed a lot ofthings, but I will get there
once I finish this race.
Speaker 1 (51:25):
Well, we look forward to it.
I look forward to seeing thefinish line of that race kind of
published.
I can't wait to see more ofyour work because it's been just
fantastic so far and we'll haveto bring you back on the
podcast to talk more practicalstuff.
Like I said, I've just reallyappreciated your work.
Trail and ultra runners.
What is going on?
Welcome to another episode ofthe CoopCast.
As always, I am your host,coach Jason Coop, and this
episode of the podcast is abouta hot topic in endurance sports
and sports nutrition.
Today, it is all about if andhow you can train your gut to
tolerate and absorb more foodsduring training and racing.
(00:29):
I don't need to tell you thatgi distress is one of the
leading causes of dnfing in anultra, as well as one of the
most common complaints in ultrarunning, and for years, runners
and coaches and nutritionistshave been trying to solve this
problem with varying products,intake, intake strategies,
advanced formulations like thenewer hydrogels, and what we are
(00:49):
speaking about today, which istraining the gut.
So welcome to the podcast todayIsabel Martinez, who's coming to
us from Monash University,where she is a research sports
dietitian in the Department ofNutrition and Dietetics and Food
.
She is the author of severalstudies in this area, including
a recent systematic review andmeta-analysis on gut training.
(01:10):
Links to all of those will bein the show notes.
Also on the podcast today, wewill hear from CTS coach and
nutritionist Stephanie Howe onsome of the more practical
elements of how and when toimplement gut training and who
are good candidates for it.
All right, so with that out ofthe way, I am getting right out
of the way.
Here's my conversation withIsabel Martinez all about
training the gut.
(01:30):
Isabel, welcome to the podcast.
I appreciate it, as always.
Speaker 2 (01:39):
Hey Jason, Nice to be on the CoopCast.
I'm a big fan so I'm prettyhappy to be on here.
Speaker 1 (01:44):
Thank you for that.
I feel that people in nutritionnow are kind of getting thrust
into the spotlight becausethere's been kind of a
reemergence, so to speak,especially with the carbohydrate
feeding and how much athletescan actually tolerate.
So people like yourself thathave both a research background
as well as a practitionerbackground all of a sudden end
(02:05):
up garnering lots of attention,because you can meld all of
these things together thatathletes are very rapidly trying
to figure out.
Speaker 2 (02:11):
Yeah, that's so true.
Things have changed, especiallywith the current trend with
running.
I'm sure you've noticed theuptick in runners and everything
running, so they're going backto actually looking at fueling
and there's been a lot ofchanges in terms of guidelines.
If we compare that maybe, let'ssay, like 20 years back, so
(02:32):
we've been getting pretty muchthe same questions and more
people are actually a bit morefrustrated because they think
before the advice is actuallycontradictory to what's going on
right now.
Well, that's just science,right.
Speaker 1 (02:45):
Well, it's the evolution of a lot of things
right Before we get into it,just so the listeners can kind
of get to know you a little bitbetter, I mentioned that you
have both of this research andthis kind of practitioner
practical background, but canyou give the listeners an
overview of just who you are andwhere you got to, where you're
at right now and what you'recurrently doing?
Speaker 2 (03:04):
yep, and so I pretty much classify as a sports
dietitian or and or a nutritionscientist.
So that gives you the bothresearch and applied side of
things.
Um, and I pretty much startedout as a nutrition major,
similar to other sportsdietitians, and when you enroll
(03:25):
in a nutrition program it'susually that, especially if
you're coming from a developingcountry, sports nutrition isn't
really a thing, it's so nicheright.
And so that led me to a wholeadventure of going across to the
other side of the world.
So I actually ended up in thevery flat plains of Shambana or
Urbana-Champaign over inIllinois.
(03:46):
That's where I actually studiedexercise physiology.
So I have that background aswell.
So my research has evolvedpretty much from gains to gut.
So I used to work in muscleprotein metabolism, that sort of
stuff.
But my background in sportsdidn't quite that sort of
(04:06):
research, so I eventuallytransitioned into the guts world
.
But a common line that I'veseen is pretty much I like to
make guinea pigs out of cyclistsand runners and I've been force
feeding them anything frompotatoes to nut butters or gels.
That's what I've been seeing interms of research.
In terms of applied work, I'veworked in corporate settings,
(04:28):
academia and research, and I'vealso consulted with various
athletes.
Speaker 1 (04:32):
That's perfect.
So you mentioned that you liketo make guinea pigs out of
cyclists and runners, and Ithink this kind of brings into a
perfect dovetail with some ofthe initial research that we're
going to talk about, because alot of the guinea pig aspect
that athletes are doing onthemselves is trying to figure
out how much they can eat anddrink during the run.
And in an ultra marathonsetting this becomes a really
(04:55):
interesting proposition becausethe competition venue is always
longer in duration and alsomaybe also environmental
conditions.
It's more challenging from anenvironmental condition
standpoint than what they canactually recreate in training
and they're trying to doeverything they can in training
to mimic what they are going toactually do on race day from a
(05:17):
nutrition perspective.
But many times and we see thisplay out in the data where GI
distress is the number one issuecited for for not finishing
ultra marathons is that theyjust simply can't get it right,
even though they know it'sexceedingly important.
So on one side, we know it'sreally important.
On the other side, we kind ofconsistently get it, we kind of
consistently don't get it right,and so it still becomes a kind
(05:39):
of a problem to solve.
So in this first paper that I'mgoing to link up in the that
I'm going to link up in the shownotes.
There's this model of what canactually be trained, and I think
that if athletes firstunderstand how we can actually
do this and what the things thatwe are actually training are,
then we can take a little bit ofa step back and say, okay, how
(05:59):
do we actually problem solvethese things?
So why don't you take thelisteners through that model
first, and then we can gothrough what emerged from the
meta-analysis second.
Speaker 2 (06:08):
Yeah.
So if you ask pretty much anyathlete out there whether they
know the term gut training,they'll probably say, yes, right
, it's a buzzword that's beenthrown around here and there,
but when you actually ask themyour gut the most common answer
you'll get is, oh, I practice myrace day nutrition, right,
right and yes, that is true,right b and what.
(06:31):
It's actually more than that, ifyou do know what you're after
in terms of the adaptations, theterm training itself lends to
the fact that it should be alittle bit more structured,
maybe a little bit morerepetitive, maybe a little bit
more repetitive, and maybe thereare some other factors that you
can actually take into account,rather than just how much you
eat during these trainingsessions.
So that's one thing, and prettymuch when we did this
(06:54):
meta-analysis, it was sort of astepping stone into pretty much
looking more into the differentprotocols of gut training.
So we had to make sure that welooked at what the available
evidence is first.
Right, are there any availableevidence in the first place?
And so what we looked at wasthe internet for anything that
(07:15):
consisted of athletes prettymuch challenging their gut
either through volume or dose ofcarbohydrates, and surprisingly
, or not surprisingly, we onlyfound eight studies back then
wow and a lot of these actuallydid some sort of intervention.
it was kind of like gut trainingor a feeding challenge, but
(07:35):
then again, if you look at theiroutcomes, they weren't actually
measuring gut symptoms, sothere may be they were gut
training, that that sort ofthing.
So the three things that areproposed in literature in terms
of the adaptations is one canyou train your stomach to
actually hold larger volumes offood?
Right?
So if you expose the stomach togreater volume it expands and
(07:57):
with that expansion there's arise in pressure and pretty much
as an individual you'resensitive to that increase in
pressure and once that increasesyou feel full.
That stops you from actuallyingesting your fuel.
That's one adaptation thatyou're after is pretty much
being a little bit morecomfortable with that increase
in pressure when you eat foodwhile you're exercising this is
(08:20):
the eating competition stylelike the joey chestnut, I'm
gonna see how many hot dogs Ican eat.
Speaker 1 (08:26):
This is the adaptation that those I was
going to say athletes but Iwould cringe to giving them that
label but those individualsthat's the adaptation that
they're essentially craving,essentially are trying to train
for.
Speaker 2 (08:36):
That's correct.
So there's actually a studywhere they modeled the stomachs
of these competitive eatingathletes and they did see that
it's actually more the expansionof the stomach rather than how
quickly food leaves the stomach.
That's the main thing thathappens.
But it's also proposed thatthings can move a little bit
quicker outside the stomach.
But the evidence here is mostlyon animal studies and or human
(09:01):
studies, but at rest, so they'renot exercising.
It's a whole different storywhen we start talking about
people who are exercising,because we know that when you
exercise, the gut pretty muchshuts down, so it's a different
scenario.
There are evidence saying thatwhen you supplement with a
certain nutrient whether it'scarbohydrates, fat it can
accelerate that emptying.
(09:22):
So that's one thing that wouldhelp in terms of delivering the
nutrients that we need when weare exercising.
And the last thing and I thinkone of the more important
adaptations is yes, you can getin your fuel, but how much can
you actually get across to thebloodstream to be available to
your muscles, right?
So how much can actually crossfrom your gut circulation?
(09:43):
And eventually your otherbottleneck is how much your
muscle can actually cross fromyour gut circulation and
eventually your other bottleneckis how much your muscle can
actually take up so it's beenwith not absorbing, for example,
carbohydrates is it sits inyour gut and that's pretty much
food for the bacteria there toferment, and it also attracts
water.
So that's what increases yourrisk of gut symptoms.
(10:03):
And there's a cool mechanismwithin the gut wherein if
there's actually nutrients thataren't absorbed in the last part
of your intestine, it actuallyliterally puts on a break on
your whole gut, meaning it slowsdown emptying, it slows down
how food moves along and, ineffect, you also feel a
sensation of fullness, so youactually stop eating.
So those are the three things,three key things I think that
(10:26):
gut training aims to improve sofar.
Speaker 1 (10:29):
Okay, so we have this model and, just to kind of
quickly synopsize what you justwent through, what we're trying
to train is, first off, thestomach to handle larger volumes
.
Second off, to get thosevolumes through the intestinal
tract more quickly, and thethird one is to actually absorb
primarily carbohydrate throughthe, through the intestines, in
(10:49):
order, so in order for theenergy to actually be delivered
into the bloodstream, verysimply, put right All three of
those yes.
And the way that I think aboutit as a coach and being, you
know, very tangentially involvedin some of the nutrition
sciences is we kind of attackall three of those problems via
two primary mechanisms, thefirst of which we're talking
(11:11):
about today, which is justtraining the gut and trying to
train the gut across all thosethree, and that's what we're
going to spend the majority ofthe time talking about.
But, not to be remiss, we'regoing to get into this a little
bit is it also becomes aformulation and a chemistry
problem.
So what types of stuff are youactually ingesting so that those
three elements that you aretraining are not as stressful on
(11:34):
the body because of thecomposition of macronutrients
that you're actually taking in?
And those two things I don'tknow how you would describe it,
but they work hand in hand andthose two things I don't know
how you would describe it, butthey work hand in hand, but they
can almost be treatedseparately to a large extent,
meaning you're thinking aboutthe training side of it.
And then you're also thinkingabout the composition of the
(11:54):
things that you're ingesting andtrying to almost maximize the
training that you're actuallyputting forward.
Speaker 2 (12:00):
Yep, yep, no, that's true.
So when we actually get intothe thick of like the different
protocols, you'll see thatmajority of the factors that
have been explored is prettymuch varying those putting in
more carbohydrates to train thegut, but, similar to what you
said, the composition in itselfcould be another thing that we
could actually vary.
(12:20):
So that's leaped up nicely tothe next study.
Speaker 1 (12:23):
Okay, so let's play a little game here.
Right, we've got these threethings right Hold the stomach,
holding larger volumes, fastergastric emptying rates and the
absorption side of things.
After you scour the literature,what seems to be more trainable
?
Is there an area where we cansay, hey, listen, if we did a
lot of work in this thing, it'sgoing to improve the most?
Because we think, if you kindof can put your physiology hat
(12:46):
back on, going back to you know,way back to your, way back to
your studies as a coach andathletes think about this the
same way.
They tend to think about what'sthe most trainable system.
I have 10 hours per week.
What's the thing that I cankind of train the most?
Or what are the gains?
Going back to your strengthtraining days, right, are the
gains that I can kind of likemake the most?
Is there any one out of thosethree that like fit that bill of
(13:07):
hey, listen, this thing is themost adaptable system, so to
speak?
Speaker 2 (13:11):
yep.
So, based on the very scarceevidence from this study, the
most gut gains that we get arepretty much first one is
training, how you know thevolume of food that your stomach
can hold without you beinguncomfortable.
And the third one, which ispretty much absorption, so
gastric emptying.
Not much evidence as of now,because one it's hard to measure
(13:33):
right.
It's very invasive and I don'tthink athletes want tubes down
their throat in studies.
Speaker 1 (13:40):
So it's interesting because you present this one
thing of the most trainablething is either the stomach
handling larger volumes, or theabsorption side of things.
If we take a really simplisticview of this, the second thing
that you mentioned, theabsorption side, would probably
make a bigger impact forperformance than the former side
(14:04):
, because it kind of doesn'tmatter if you have a lot, if you
can tolerate, you know, ahundred hot dogs in your stomach
, if you can't get thosenutrients through the intestinal
wall to to serve a purposeessentially.
Yeah, how does that get teasedout in the literature as well?
Because those are two.
We're kind of talking about twodifferent things.
We're talking about a comfortthing and then we're talking
about actually deliveringmacronutrients on the second
(14:26):
side of it so I guess it's howyou view the impact of gut
issues on actual performance,right?
Speaker 2 (14:32):
So one is if you don't get enough fuel, then
you're going to bonk, thenyou're not going to perform well
, right.
But at the same time, if youactually get like really severe
issues, when we're talking aboutthe stomach side of things,
that's mostly upper gut symptoms, so, for example, regurgitation
, vomiting, that sort of stuff,that's also going to cost you a
(14:52):
DNF, right?
Speaker 1 (14:54):
So in the early 2010s and he asked finishers and
(15:16):
non-finishers of the WesternStates 100 in Rio do Lago what
affected their performance.
And GI distress comes to thetop of the list, and we know
that can be caused from a numberof different things and a lot
of times we tend to trivializeit as oh well, I just can't
consume, I just don't have thecapacity to consume more food
(15:37):
and fluid.
But in reality, there are alsolike downstream effects that
need to be, quote-unquote,considered and trained for as
well.
We just don't have like thebest, or at least at the time,
we don't have like the bestvocabulary to describe it as the
way that I'm internalizing it.
Speaker 2 (15:51):
Yep, Yep.
So if you want to read up moreon, like that whole mechanism,
it's very actually it's verydetailed and it's called
exercise inducedgastrointestinal syndrome.
It's a whole pathway of whetheror not the function of your gut
shuts down and also in terms ofhow your brain controls the gut
.
There are many factors.
Speaker 1 (16:10):
So let's kind of skip to what the interventions are,
because people are going to wantto know what do I actually do,
and you already mentionedpractice, your rest, race day,
nutrition, and it's likely morecomplicated than that, where we
need to start thinking abouttraining your gut in the same
way we think about trainingother aspects of our physiology
from an overload standpoint.
(16:30):
We overload the system.
It then creates some sort ofcompensatory mechanisms that
start to kick in so that thenext time you have a similar or
the same type of load, it hasgreater capacity to handle
whatever that stress or strainactually is.
Speaker 2 (16:45):
Correct.
So, I pretty much.
I think of it as you know, whenyou're training and then you
have harder sessions actuallyduring training than the actual
competition.
That's how I think of it, asyou know, when you're training
and then you have hardersessions actually during
training than the actualcompetition.
That's how I think of it,because doing gut training
sessions aren't at all pleasant.
Speaker 1 (16:58):
No, they're not, and not a lot of people.
And once again, we work withathletes all the time and once
again, my bias is kind of from atraining standpoint, I'm always
looking how do we maximize thiscomponent?
No-transcript nutrition,although we could start there
(17:39):
but, what are the intervention.
What are like the interventionsthat have tried and what are
the like?
Can we synopsize the outcomesof those?
Speaker 2 (17:46):
so I think we go back to what the literature says.
So the first time that thismanagement strategy has been
proposed is probably in theearly 99 piece, and it was just
termed as the gut being trainedto cope with exercise, not
specifically through nutrition,right, but anyway, there were a
couple of review papers thatwere published in 2000s and
that's where the proposedmethods were actually outlined
(18:07):
by people, however mostly citinganimal evidence, or a lot of
them were actually anecdotalfrom like these competitive
eating competitions.
So one is actually trainingwith a high carbohydrate intake
and that means your daily diet,which one study actually did,
but then they didn't reallymeasure gut symptoms.
The other common thing that'sproposed is training right after
(18:30):
eating a meal, so training witha full stomach, and that's
really is training right aftereating a meal, so training with
a full stomach, and that'sreally not something very new
when you think about cyclistswho are on rides right, they
take a break, they eat theirmeals and then they go on right
yeah, exactly that's somethingvery new.
The third one is what we call asa repetitive eating challenge,
or pretty much training withhigh carbohydrates during
(18:52):
exercise, and that means it'sback-to-back sessions of this.
The other two methods is prettymuch training with a high
volume of fluids, so a lot ofwater and or carbohydrate
solutions.
But those are some of themethods that were actually
mentioned in these studies, butonly three of those have studies
(19:14):
to back them up.
Speaker 1 (19:16):
And what does that practically look like?
Speaker 2 (19:19):
Sorry, the last one is practicing race day nutrition
.
Speaker 1 (19:22):
Yeah, no, we already went on that we think about the
same day, I mean honestly.
So we have a number ofdifferent nutritionists and
registered dietitians that workon our high performance within
our high performance program,specifically for elite athletes,
and a lot of the times that'swhere they're starting, because
it kind of accomplishes twothings is one, they're
practicing the race daynutrition.
(19:42):
But two, that's a challenge inof itself because they're not
taking in.
Let's just say, their goalcarbohydrate per hour range for
a race would be 80 to 90 gramsan hour.
They're normally not doing thatduring training, so you get
this like dual effect ofoverloading the GI system with
their race day nutrition thatthey're actually practicing.
(20:03):
Okay, let's get a little bitmore detail on how to implement
this with CTS coach andnutritionist Stephanie Howe.
Speaker 3 (20:17):
Those specific strategies we use for gut
training are to one back it upall the way until before an
athlete starts a training runand think about their pre-run
breakfast and really dial inwhat they're going to have
before they take off running, tomimic what they would have race
day and playing around with thetiming a little bit here too
(20:38):
and thinking about what it'sgoing to be like race day if
it's a 4 am start.
Obviously that's going to bedifferent than if it's a 10 am
start.
So having the athlete both pickthe type of food they want to
eat and the time they want toeat before they go out and run,
that's going to help get energyin their system but also prepare
their gut for doing it on raceday.
And then during the trainingruns, we really want to identify
(21:01):
the goal in terms of grams ofcarbohydrate per hour and the
type that the athlete's going tobe taking.
And usually it depends on theathlete and what they've
struggled with or what they'vehad success with in the past as
to where we're going to start,but normally it's around 50 to
60 grams of carbohydrate perhour for the average person.
(21:24):
If they've had issues in thepast.
We're going to start a littlebit lower and try to get their
gut a little happier, have themhave a more positive experience
and then kind of titrate it up,but start with the specific type
.
So if they want to use gels,we're going to use gels.
If they want to use blocks,we're going to use blocks.
And then just kind of figureout the timing of what that
(21:44):
looks like every 20 or 30minutes and dial that in in
every single long run they doleading up to their race.
Speaker 1 (21:54):
What we're starting to see is a lot of athletes are
actually moving beyond that.
They're saying okay, if mytarget is X, we're just going to
use 80 grams per hour just tomake the number consistent.
Not that should be the rangefor everybody, but if my target
is 80 grams per hour, here's howI can make that more effective.
I can make that more effectiveby introducing this intervention
(22:15):
or that intervention that youhad just mentioned.
What does that look like?
Practically Like you'reconsulting with an athlete and
they say listen, I want to makethis X grams of carbohydrates
per hour more tolerable forlonger periods of time, with
less GI distress, and I want toabsorb more of the carbohydrate
more quickly.
Practically, what do thoseinterventions actually look like
(22:35):
in the field?
Speaker 2 (22:36):
So in the field, if you are after greater absorption
, the stimulus needs to be alittle bit more chronic.
So practicing race daynutrition whether that means for
most athletes you know, duringlong runs that's when I actually
target 80 grams that might notbe the case.
That can help you tolerate thelarger volumes.
But then if we are after makingthe transporters a little bit
(22:59):
more efficient, that has to be abit more of a chronic stimulus,
which means that you might betrying to eat 80 grams of carbs
even in your shorter sessionsand easy runs, and it has to be
a back-to-back session based onthe evidence.
Speaker 1 (23:17):
I mean, it's almost like an endurance adaptation at
that point, if I'm understandingwhat you're describing
correctly, where we don't justtrain two or three times a week,
we train six or seven times aweek.
Is that the frequency that youwould be advocating for in terms
of trying to create some ofthose initial adaptations?
Speaker 2 (23:36):
So the longest one was a two-week protocol which
pretty much looked like fivedays straight, two days break,
five days straight Not reallyfeasible considering a normal
endurance training program,right, because it's not every
day that you do easy runs.
So this follow-up study that wedid, we tried seven days
straight and when I put thatinto translational relevance,
(23:58):
it's pretty much doable when youactually taper for a race,
right, that's where you fit thatin.
So when you taper, you actuallygo on your easier runs and at
the same time, another goal foryou is pretty much load up on
carbohydrates.
And the problem with trying todefine when these sessions
should occur is one we don'tknow how long these effects last
(24:20):
.
So that's a key gap inknowledge.
So if I'm just practicing raceday nutrition every long run and
then I stop my long runs twoweeks out, I don't know whether
I'll still be able to have thosebenefits come race day.
That's a key thing that wedon't know how long this
adaptation lasts.
And still, we're still kind ofin the gray area on how much.
(24:42):
How long is the duration of theprotocol to be able to get
these adaptations?
Speaker 1 (24:48):
So you already skipped ahead to my next two
questions so you preemptivelyanswered them with we kind of
don't know, but I think you'rekind of getting to like what
most practitioners that I'vebeen working with come to is
just a reasonable, a reasonableextension of the research.
(25:09):
Quickly do these adaptationscome about and how quickly do
they fade away?
How transient are they innature?
And, interestingly enough and Idon't know whether this is just
like hive mind mentality comingthrough or whatever, but this
two weeks ish type of timeframetends to come through a lot when
I actually consult with peopleand they all say that they all
say kind of the exact same thingis like well, we don't know,
but this is kind of what alittle bit of what the
(25:31):
literature teases out and alittle bit of what we actually
see in practice that you needroughly five days per week for
two weeks to create some ofthese initial adaptations and
you want to try to do thatcloser to the race as opposed to
further away.
It's not a chronic adaptation,which is kind of fools a lot of
people because that's what wethink about our traditional
(25:51):
endurance adaptations is takinga long time to produce and then
sticking around for a longperiod of time.
This would be much moretransient in nature.
Speaker 2 (25:59):
Yeah, that's correct.
So I think that five days twodays came from those original
gut training studies.
But a lot of the athletes,interestingly, in that study
actually said that they had ahard time following that
protocol.
It's just not realistic.
So really the next step forthis sort of research is to go
into the nuances of designing afeasible and realistic protocol
(26:21):
within an endurance trainingprogram.
Speaker 1 (26:24):
Let's bring that to light, because a lot of athletes
are thinking, yeah, this isn'tvery realistic for me on a 90
minute run to try to take in 150grams of carbohydrates.
There's a few pieces of thisthat we can kind of like that
back and forth.
But what do you hear fromathletes in terms of, hey, this
isn't realistic for me.
Speaker 2 (26:40):
Yeah, so for one thing cost right.
Speaker 1 (26:43):
Yeah, gels are expensive now.
Like gels are like four bucks apop right now.
It's kind of crazy.
Speaker 2 (26:49):
Exactly so, especially with with athletes,
and there are certain athleteswho are very like, particular
about I want to train with this,because this is what I want,
this is what I'm going to usethat phrase, so cost the
logistics of things as well.
I think sometimes you just wantto go for a run and not worry
about you know, ingesting somuch carbs, but also trying to
(27:10):
plan this out, thinking of yourtraining.
I think this is where coacheswill help, because usually when
you try to think about yourfueling plan for a race, you
want about three to four months.
I'd say three to four months.
Usually, when I take inathletes and coach them in terms
of nutrition, I want at least12 weeks out to think about
(27:30):
everything and to lay out theplan.
So I think that's the mostchallenging part in terms of
translating these findings toactual real life scenario is the
implementation part of it.
Speaker 1 (27:43):
Is the primary.
So we've been thinking aboutgut training challenges from a
minimum effective dose angle.
What's the minimum amount oftime and the minimum amount of
frequency that it takes toproduce the adaptation?
And part of that you mentionedis just that people don't want
(28:04):
to spend that much money on gelsand it's like you just said,
it's just inconvenient to wantto take five gels on an hour and
a half run.
It just kind of gets old.
But are there any otherpotential consequences for
elongating that intervention?
Meaning if you had an athleteand say I don't care, I have a
sponsored athlete, I get all thenutrition product.
Speaker 3 (28:23):
I like taking, all taking all these.
Speaker 1 (28:25):
I like taking them in on runs.
Is there any potential negativethat you would and this is kind
of going outside of themeta-analysis box a little bit,
but it's people are going to becurious about it.
Is there any potential negativefor elongating that very
specific intervention, let's sayover months or an entire
training cycle?
Speaker 2 (28:41):
yeah, well, we all know that, similar to training,
nutrition needs to be periodized, right?
So if you are doing this longterm and you know that there are
benefits to actually sometimestraining with lower
carbohydrates, that'spotentially one thing that could
be impacted by this.
Speaker 1 (28:56):
So just your body's more like reliance on that
particular substrate is whatyou're kind of saying yeah,
specifically for ultras, right.
Yeah, I mean, we ultra runnerstend to be really good fat
burners.
Just as a byproduct of theirhigh training volumes and low
training intensities thecombination of those two, they
tend to just metabolically bepretty decent fat burners.
But I do foresee a world wherethe pendulum swings the other
(29:21):
way and this is what I kind ofget worried about with trends
too.
Right, Typically a trend isstarted with good and healthy
intentions but being kind ofmore obsessive minded endurance
athletes, they tend to takethose trends to the extreme,
because if a little bit is good,if a two week intervention is
good, then a 20 weekintervention is 10 times as good
as the is the typical thoughtprocess and I'm trying I'm just
(29:44):
trying to get some morementality on what would be any
potential negatives of doingsomething for so long, and this
one once again kind of keepscoming up.
As well as that, you justbecome over-reliant on that
particular substrate and yourfat burning capacity gets
diminished to a point to wherethe positives, the negatives,
outweigh the positives, Positive.
Speaker 2 (30:05):
Yep, I guess the other thing.
So gut training is really astrategy that's meant for people
who actually get gut issues.
So I think that's also ameasure or an outcome that once
you see that you actually aredoing a little bit better, it
might be a signal for you toactually lay down or lay off the
golf.
Speaker 1 (30:24):
Yeah, I mean, we all know the athletes that have,
like, the iron gut right.
They can kind of take anythingand huge quantities and they
don't need to quote, unquote,train it, and they're probably
just as curious as would.
Are these interventions any youknow different for them?
And kind of what you're sayingis is yes, it's not.
You already have that kind ofinnate part of your physiology
(30:44):
baked in and it's not somethingthat you either have to focus on
as much or maybe not even focuson at all.
Speaker 2 (30:50):
Yep, that's true.
So usually when we do assessathletes, that's one of the
first things that we ask youactually get gut issues during
exercise and is it recurrent oris it, like this, one fine thing
during this race?
Because that's going todifferentiate our approach when
it comes to fueling right soultimately, if you say yes to
gut issues, then okay, we kindof try to see, all right, what's
(31:13):
going on with your fueling?
What stuff are you eating rightbefore a race or leading up
into a long run?
Speaker 1 (31:18):
the other factors that might actually impact gut
issues what you I think whatyou're trying to say is you're
kind of like titrating thissolution to an appropriate
amount given the problem thatthe athlete is actually
identifying, meaning there's notlike a blanket solution and
saying everybody has to do x?
y or z you're looking at okay,this person has these types of
(31:41):
issues, and then we're eitherfocusing we're either putting a
lot of focus on theinterventions or a little bit of
focus on the interventionsbased on the problem.
That's kind of in front of you.
Speaker 2 (31:51):
Yes, and that pretty much is the comprehensive
assessment of how their gut isdoing during exercise.
Speaker 1 (31:57):
Yeah, exactly Because , like I said, I know people
that for their entire careershave never had any GI distress
at all.
Yeah, lucky them, they do 100grams carbohydrates per hour and
they just kind of get it forwhatever reason, and I'm sure
we'll figure out at some pointthat that's an innate part of
their physiology that has a lotof has a large genetic component
(32:17):
to it.
Uh, just like other aspects ofour physiology that kind of that
tend to be geneticallypredisposed, that tend to be
genetically predisposed.
Okay, one final break in theaction.
Let's go back to CTS coach andnutritionist Stephanie Howe and
hear her thoughts on who aregood candidates for gut training
.
Speaker 3 (32:38):
I think all athletes can be candidates for gut
training.
The ones that are going tobenefit most from it are the
athletes who have struggled withtheir fueling in the past,
maybe don't take in enoughcarbohydrate or they take in the
wrong type of carbohydrate, andthey need to really kind of
strategically plan that and fixit so that they don't have
(32:59):
issues race day.
And then the other end of thespectrum is the athletes who
really want to maximize thegrams of carbohydrate per hour.
So an athlete who's going to betrying to take in, let's say,
90, 100, maybe even 120 grams ofcarbohydrate an hour, they
definitely need to use some guttraining strategies so that
they're able to, one, absorbthat much carbohydrate and then,
(33:23):
two, be able to use it withoutissues absorb that much
carbohydrate and then to be ableto use it without issues.
Speaker 1 (33:32):
I'm going to pivot a little bit, because we've been
talking, naturally, about a lotabout carbohydrate because it's
in the news, it's at theforefront, you know everybody's
trying to like push the envelopethere, yeah, but that's not the
only way that you can train thegut, and you've been at the
forefront of a few studies nowthat looks at different using
different types ofmacronutrients and different
types of basic strategies totrain the gut.
I'm wondering if you could kindof give an overview of those
(33:54):
and then we'll dive into whatthat actually looks like as well
and why you might want to usethat type of intervention versus
an all-carbohydrateintervention.
Speaker 2 (34:01):
So, based on the available studies, the majority
of them use carbohydrates and itdoes make sense, especially in
endurance and ultra endurance,because that's the primary fuel
that we want.
Right?
There is just one study thatlooked at carbohydrate with
protein.
However, it was only inAustralian footy players, so
it's a little bit more of adifferent exercise stress, right
(34:23):
, it's a little bit moreintermittent, so similar to like
American football, I'd say, andyou wouldn't expect a lot of
gut issues to actually happen inthat sort of scenario.
So, in terms of endurance andultra endurance, it's mostly
carbohydrates.
Some of the other things thathave been observed were whether
you use carbohydrate solutions.
So one study actually looked ata non-repetitive protocol.
(34:46):
So they just drank largervolumes of carbohydrate drinks
in five repeated trials.
So that's sort of more likesimilar to what you'll do when
you practice your race day.
Nutrition, right form ofcarbohydrates, whether you get
(35:08):
it from gels or solids, andequally they improve gut
symptoms, but in terms ofabsorption, it was only seen in
the carbohydrate gels.
So that shows you that thecomposition as well of what you
intake also impacts thoseoutcomes.
And, interesting, if youactually put in a placebo,
nothing happens.
So even if you have that samevolume, but there's no nutrient
in it.
You actually don't getimprovements in gut symptoms.
Speaker 1 (35:28):
So you can't trick your body into.
It is what you're trying to sayno it's pretty smart.
Well, I mean, it's important toknow because, like placebo
effect in a lot of compounds andespecially medicine and things
like that, is actually very real.
But here you're actually sayingthere needs to be a stimulus of
delivering the nutrients inorder to see, in order to see
the outcome that you actuallywant same thing.
Speaker 2 (35:47):
If you actually ask me, can I just drink a lot of
water with drink a lot of water?
Speaker 1 (35:51):
yeah, no, and I can see I know athletes that that
think that they're doing thatbecause they've seen how, going
back to the hot dog eatingcompetition, they're going back
to how joey chestnut wouldchange train by drinking a whole
lot of water to, you know,expand the of his stomach, which
you're saying is that's a poorstrategy for endurance, athletes
.
Speaker 2 (36:08):
Yes.
Speaker 1 (36:10):
Okay, let's talk a little bit about composition.
One of the limiting factors witha lot of athletes that we
previously mentioned that wantto train their gut and they find
that there's some sort ofbarrier is just the cost of the
products, and this is just areality I work with.
I'm very fortunate.
(36:31):
I work with a lot ofprofessional athletes that don't
have this barrier in front ofthem because they have all their
nutrition products provided forthem.
But I also work with a lot ofreal athletes that look at the
proposition of spending 20 or$30 a run and do they want to
fork over that kind of cost, andthe solution that they've come
back to is trying to formulatetheir own stuff, which you guys
(36:51):
kind of did in one of yourstudies, and when I was reading
it with my research assistant,fred, this is exactly what I was
thinking is is the athletesthat are at home that are trying
to buy a lot of this stuff inbulk and trying to formulate and
try to formulate their own gels, and I'm wondering if we can.
I'll link that paper, I'll linkthat paper up, but I'm
(37:11):
wondering if there's anythingthat we can kind of like take
take from that that the athletesthat are trying to do this at
home can actually kind of likelike learn from, because you
guys were doing it for purpose.
Speaker 2 (37:19):
You were like building to suit, so to speak
yeah, and so funny you mentionedthat paper, because when that
paper come out it was rightabout the time that you actually
had that little expose on oneof these gels.
Speaker 1 (37:29):
Oh funny.
Speaker 3 (37:30):
You're like oh perfect.
Speaker 2 (37:32):
And then your follow-up paper recently was a
perfect like it was the sametheme with this paper.
Speaker 1 (37:38):
Yeah, yeah.
Speaker 2 (37:38):
And so my idea behind that and even runner myself,
I've always tried to reducecosts.
Even runner myself, I've alwaystried to reduce costs and I
know that these products areeasy to make and you can make
them using readily availableproducts in your supermarket,
right?
So in this paper we sort ofbuilt a pathway it's sort of
like a guide for athletes andpractitioners to create their
(38:01):
own gels if they think that thegels out there in the market do
not suit their needs.
So this is in terms of liketaste, flavor or the blend of
carbohydrates, or even like theactual texture.
So in this way you can actuallycustomize it to what you
actually want.
So in that pathway it's like asix-stage process, but you
pretty much look at number one,especially the ingredients that
(38:25):
you put in, and what is the goalwith your own formulation?
Do you want something thatdoesn't have a taste?
Do you want something that'svery sweet?
Do you want something that'sfruity or maybe salty?
Yeah, so in that way you canactually make your own
preferences and the in terms ofthe ingredients.
So the gel that we made in thatstudy, all the ingredients were
(38:49):
bought from a grocery store, soit is actually possible amazing
and this is what I tell peoplethat you can actually mix it.
If you have the time andpatience to actually mix your
own gels, you can absolutely doit and that will help you also
train your gut if you plan touse that during races.
Speaker 1 (39:07):
And so I'll link that study up with that six stage
process, and whether or notathletes want to go to their own
grocery store to try to figurethis out or not, it's kind of
like up to them.
But I guess what I'm trying tosay is it is possible and you
can actually build it to suit.
There are also companies outthere that are realizing this
and almost acting as like anintermediate.
(39:28):
I mean, the original companythat did this they've been
around for a long time beforethis got popular was Infinite,
where you could go and you couldkind of customize your own, you
know, your own kind of whatever.
Yeah, exactly, but since thenI'm actually pulling it up on my
phone right now, pulling it upon my phone right now.
There's this company in the USthat you might not, may or may
(39:48):
not be familiar with, calledbulk supplements, where you can
buy all of these in bulk onlineand then put them together in
your kitchen, kind of like,however you want to, yep.
Speaker 2 (39:55):
So all these sugar powders are available online and
, mind you, if you actually makeyour own gels, it's probably
going to cost maybe 20 cents apop.
Speaker 1 (40:03):
It's crazy.
It's crazy and I'd be remissnot to mention.
I actually like the nutritionmanufacturers.
Like they're all my friends andyou know I like their products
and I think they do a good job.
I think they do a good job withproduct formulation.
But more and more and this hasonly been within the past like
three or four years I'm runninginto more and more resistance
against those because theconsumption part in part, I
(40:26):
guess, because the consumptionrate is coming up so much and
I'd be remiss to say that goingto your local run store and
buying a gel for three dollarsis the only solution out there.
There are also other solutionsthere.
Speaker 2 (40:37):
Exactly, and like these carbohydrate gels.
You know, even before they came, like people were running and
eating solid foods like right.
They came like people werealready running and eating solid
foods like right, exactly.
So it's not your only optionand there are ways to like
navigate this issue.
Speaker 1 (40:53):
When it comes to cost , like not all athletes are
sponsored, unfortunately yeah,okay, let's bring it back full
circle, because we started outwith training the gut.
Let's go back to training thegut.
I kind of want to go.
I kind of want to leave thelisteners with a few steps that
they can take away to try toimplement this during their
training.
This podcast is going to comeout in April.
(41:14):
The racing season is starting toheat up.
If we're looking at anintervention that's kind of
meant to be close to the closeto race time, this is the
perfect time of year to try torelease this to race time.
This is the perfect time ofyear to try to release this.
So can you leave the listenerswith a just a very quick
overview of if you want to dosomething like this?
Here's where you'd stop.
This is how much you would doand this is where you would end,
(41:36):
so that they have some initialframework to go off of and then
they can dive into this podcastand the resources that'll be
linked up if they want to getmore specific.
Speaker 2 (41:43):
Yeah, the first thing you ask yourself as a runner
and endurance athlete is onewhether you get gut issues.
I'm not going to recommend guttraining at all if you're not
suffering from this and if yes,it might be worth looking at
what sort of gut issues you get,because that's going to
pinpoint what sort ofintervention you want.
For example, you get a lot moreof belching or things coming up
(42:06):
when you're running that sortof stuff.
Well, that's going to targetmore of your upper gut.
So that means that's wherevolume comes in.
So how much you put in andwe're trying to train that
capacity of your stomach andthat can be trained again based
on protocols.
It can be across repeated trials, so not back-to-back.
(42:26):
So every long run you actuallyincrease your volume in terms of
carbohydrates and or fluids.
If you're getting a little bitmore of lower gut symptoms so
lower bloating, flatulence, thedreaded run to find a port-a-loo
, that sort of stuff well,that's going to be a little bit
more of a different approach,because we think that a lot of
(42:49):
this has something to do morewith the absorption of
carbohydrates, right?
So in this scenario, youprobably want a bit more of a
stronger stimulus, meaning thatthe duration and the frequency
of your gut training sessionshould be a little bit longer.
So back-to-back sessions, atleast from what we see right now
(43:09):
.
10 days works withcarbohydrates.
Speaker 1 (43:14):
You're speaking my language on the back-to-back
sessions because that'ssomething I do, that from an
interval protocol, and peopleused to criticize me a lot.
Now we're seeing it more andmore often, so we'll also
advocate for back-to-back guttraining sessions, just to keep
the theme consistent.
Speaker 2 (43:26):
So, when you pinpoint this, also try to discuss as
well with your coach how you'regoing to fit this into your
program, because we don't wantthese sessions to be the reason
why you don't get the trainingadaptations that you want from
your race as well.
So it's working hand-in-handwith your coach.
Consider consulting a sportsdietitian as well to help you
try to plan out and even try tofigure out which products, if or
(43:51):
whether or not you want to makeyour own.
So, yeah, there's a lot of helpthat you can seek, perfect.
Speaker 1 (43:58):
I think that's a brilliant place to stop the
official like intellectualdialogue.
I have one more question foryou.
This is not on the outline.
I always like to surprisepeople kind of at the very end,
just for a little bit of banterand for a little bit of fun.
Where do you think that thisultimately goes?
Because you and I we've beenI've kind of tracked your, you
(44:19):
know career and you know howlong I've been coaching, for
We've gone seemingly from 60 to90 grams of carbohydrates per
hour to 90 to 120 grams per hour.
And I was seeing in the propeloton where some of those
athletes are pushing 140 and 150, yeah, 150, even 150, and I
always like to, I always justlike to.
What's next?
(44:39):
You know, I always like to tryto figure that.
What like?
What do you think?
What do you think it's like itdoesn't have to be a rate?
You know we've been kind oflike focusing on that, but what
do you think?
What do you think it doesn'thave to be a rate?
You know we've been kind oflike focusing on that, but what
do you think is next in thewhole evolution?
Speaker 2 (44:47):
here.
I think it depends on the sportfor one thing.
So if we're just talking aboutrunning, I think that's going to
cap out at around 120.
I can't imagine people actuallycarrying that amount of
carbohydrates, especially inroad running, to be able to
actually feasibly get thatamount of carbohydrates.
But again, with science italways swings from one side to
(45:10):
the other.
Maybe now we're in the highcarbohydrate trend and who knows
?
Speaker 1 (45:19):
later on, in 20 years , maybe fat will come back again
.
It will Trust me it will.
I've seen this is my thirdswing of the pendulum Right
Possibly it will.
Speaker 2 (45:25):
I've seen this is my third swing of the pendulum.
So maybe people are going to beso good at handling
carbohydrates and then you knowsomething else within the body
changes.
Maybe it's your I don't knowmicrobiome or whatever and then
we start seeing things that arenot good and then we point back
oh, it's because we ate too muchcarbs.
And then we go back straight tozero, which is I can see why
(45:48):
it's frustrating for individualsto follow nutrition and science
, but at the same time, it'salso exciting, because there's
always more questions to answer,right?
Speaker 1 (45:58):
yeah, no, it's great.
I I appreciate you putting upwith a little bit of the banter
in the in, in the theory.
Speaker 2 (46:02):
Here, finally, is my question jason, my question to
you is years back or now, thatyou've seen athletes get faster
and faster?
Speaker 1 (46:12):
No, what you the first part of that cut out,
you're going to repeat it again.
Speaker 2 (46:15):
Or have you the trend of athletes getting faster,
that you see that 10 years or 20years back, or is it now with
the high carbohydrate?
Speaker 1 (46:23):
Well, I mean, somebody actually asked me this
just the other day, so I've hada little bit of time to think
about it, to think about it andI'm prefacing how, maybe how
good this answer is going to be,with the fact that it's not
quite going to be off the tip ofmy tongue.
But athletes are always gettingbetter across all facets, and
athletes across all sports stickand ball sports, endurance
(46:46):
sports and things like that andalongside that we always have
technology to help us along theway.
The shoe revolution was a bigpiece of technology.
There's nutrition technologythat comes along in cycling.
We have, you know, technologythat helps us analyze training
better.
We also have technology thathelps kind of in real time, so
(47:07):
to speak, perform at a higherlevel.
All of those things arehappening concurrently, all to
the benefit of athletes andperformances.
So it's never just one thing,like a lot of people will say.
Oh well, it's this quoteunquote revolution.
Sure, that might take a littlebit of a little bit of a
disproportionate amount of thespotlight at the time, based on
(47:30):
everything else that's going on.
But make no mistakes that thisphysical evolution and
technological evolution hasalways happened in sports since
sports have kind of been aroundand that's why you see the
improvements.
It's never linear, it's alwaysin a stair-step type of fashion,
but it's kind of always present.
So I wouldn't chalk it up, andI would never chalk it up to
(47:52):
just this or just that.
Everything's happeningconcurrently, it's just a
different proportions.
Speaker 2 (47:58):
Exactly Now, just to see you saying technology and
development of evidence.
I think the future really isactually going into more
personalized nutrition.
I think that's where it is like, where some people will be
doing better with highcarbohydrate and maybe some
people will be doing better withhigh fat and maybe then by then
we'll be able to have someobjective measures and actually
(48:21):
reliable measures of being ableto say whether or not someone
can purely fuel with x, y or zyeah, it means it's interesting.
Speaker 1 (48:29):
Now we're really going off the rails.
It's really interesting thatyou say that because there have
been any number of attempts atthat personalization and you can
look at the ways that we'vetried to do that.
It's been from tracking things,that are things metabolically
that are happening, like the useof CGMs or even metabolic
(48:50):
testing or even sweat sodiumtesting.
That is a way ofindividualizing things.
We can look at the geneticlevel and what an athlete might
be more predisposed to in termsof higher volume, higher
intensity, more frequency andthings like that.
Higher volume, higher intensity,more frequency and things like
that there have been all theseproposed mechanisms that certain
genotypes are going to respondto certain types of workload or
(49:10):
a frequency of workloaddifferently, and then we get to
the outcome piece of it, whichis kind of what I rely on the
most is you have an athlete do acertain thing and they respond
to that certain thing better.
That's a level ofindividualization as well.
If you're looking at thetraining and you're looking at
the interventions and you'reputting it under a high level of
scrutiny, you can individualizeit in arrears, so to speak,
(49:32):
after you've actually done theintervention.
And I don't know which one ofthose is going to and there's
probably a few more permutationsthat I'm not thinking of off
the top of my head.
I don't know like mix of thoseis going to kind of like
dominate the landscape, justlike the technological piece.
We've seen the genetic piecestart to try to get a foothold
(49:52):
and it really didn't kind oflike pan out.
Some of the bio, some of thereal-time bio monitoring has
kind of come in fits and starts,so to speak, and you know, I
just look at it as something towhere I agree with you on the
individual side of things.
That's always what we're tryingto do, but it's just how we go
(50:13):
about doing and what tools wedeploy within our arsenal of
tools to actually figure thatout.
Speaker 2 (50:18):
I see them as sprinkles honestly sprinkles on
top of the cake.
Your basics will always holdout, right yeah?
Speaker 1 (50:23):
exactly 100% percent.
Awesome.
Let's not go off the rails toomuch more.
Although we could do this allday, maybe we'll bring you back
and we'll just have a completeopen conversation about gels.
Oh, geez, and we'll do it Bringin Nick.
Yeah, we'll do that.
We'll bring in Nick, we'llbring in all the people who make
the gels I mean, I know thosequite well at this point and we
can go over the hydrogels andthe different types of fructose
(50:47):
to glucose ratios and theirclaims.
And then do you add sodium, doyou add amino acids, or you
could just go make your owngrocery store stuff like you did
.
Links to everything is going tobe in the show notes, but where
can people go to find just moreabout you and the work that
you're doing?
Speaker 2 (51:04):
I'm on Instagram, facebook and LinkedIn pretty
much as Isabel Martinez.
I'm not yet very active withsocial stuff because I'm
currently writing mydissertation.
It feels like an open marathonwriting to think so I haven't
really science calmed a lot ofthings, but I will get there
once I finish this race.
Speaker 1 (51:25):
Well, we look forward to it.
I look forward to seeing thefinish line of that race kind of
published.
I can't wait to see more ofyour work because it's been just
fantastic so far and we'll haveto bring you back on the
podcast to talk more practicalstuff.
Like I said, I've just reallyappreciated your work.
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