Wednesday, April 29, 2015

I saw a sports nutritionist and my mind = blown.

I went to see a sports nutritionist! This post is about that. There will probably be at least a few more here & there, because HOLY INFORMATION OVERLOAD, BATMAN.

Now, you maybe thinking, "Angela. Seriously. The basics of decent eating for runners are not complicated. You are a recreational runner who rarely breaks 50 miles a week, and are so far from achieving anything even *remotely* remarkable it can't even be joked about. What even is the point?"

Short answer: I'm curious. I find the workings of bodies interesting, particularly as they relate to endurance training. In the past when I've shelled out a little money to learn from experts, I've always come away having learned something new and interesting that I hadn't known before.

Longer answer: I kind of want to try optimizing everything I possibly can as I train for Santa Rosa, just to see how it works out. In the past I've tried to learn what I can from reliable (SCIENTIFIC) sources and eat mostly pretty well in terms of running, but I've never had an expert look at what/how I eat and compare that to my life/training & give me feedback.

Also, in general I don't worry about my weight/body fat percentage--I almost never weigh myself and feel like I am totally normal & healthy--but I also know that I've drifted a good 15 pounds or so from the weight I raced best at in my younger days. If there are things I can change that aren't too onerous or complicated in order to have a better race in August, I'd like to give it a shot at least once and see what happens. And hey, I figured, worst case, s/he tells me a bunch of stuff I either a) already know or b) am unwilling to do, and then I can finally say, "Check. Now I know I'm pretty much doing everything I'm willing to." So, I made an appointment with the nutritionist at the Sports Medicine Institute in Palo Alto.

I chose SMI because they & their personnel have a solid reputation in the Bay Area endurance scene and work with many Stanford athletes as well as a number of professionals. The nutritionist has a PhD in biochemistry from Stanford and spends most of his time teaching nutrition courses at the School of Medicine & athletic department there, as well as at the medical school at UCSF, and apparently has worked with a number of big-name pros including Ryan Hall and Lauren Fleshman. (The point being not the star power, but the fact that dude is actually trained in real science and has many years of experience working with people in my sport & getting results.)

Before the appointment, he had me fill out a giant questionnaire about my training and eating habits, including information about my favorite foods, foods I don't like, anything I can't or choose not to eat, and what I eat most often and why. I tried to be as honest as possible, but I still felt a little embarrassed that under "most common dinners," I listed "pizza, burritos, Indian, Chinese, & Thai."

(Not even joking that if I had my way, it would be pizza for dinner every night. #iamtwelve)

He really stressed the importance of filling out everything as thoroughly and completely as possible and erring on the side of adding more detail rather than less and not worrying about whether something seemed relevant or not; as soon as our three-hour meeting began, it became obvious as to why. He didn't waste a single second and we still needed every minute to get through a) explaining the science to me, b) assessing my entire situation based on what I'd written, and c) putting together a program based on my activities & goals.

You guys. Oh my god.

I thought I understood about food and training and eating not-too-terribly/pretty okay. I mean sure, I knew there were finer points where my understanding wasn't great, but by & large, I felt like I had the big picture.

Lordy. I was disabused of that notion in the first 20 minutes.

I did not have the big picture. What I had were fragments of the big picture, here & there, not always the most important ones, & no understanding of how to fit them together.

To be honest, I kind of went in assuming that the takeaways would be:

  • You really have to stop (or at least cut down on) eating x/y/z (where I was pretty sure x, y, & z would be pizza, burritos, & {name of Eastern country} food), and while you're at it,
  • You should probably just eat less of everything in general, which is hard & sucks, so good luck with that, also
  • Show some damn restraint, woman.

But BEHOLD, Things For Which Dr. C Ain't Got No Time:

  • Getting people to stop eating foods they love
  • Getting people to eat "healthy" foods they don't like
  • Talk of anything even remotely like "will power" or "restraint"

He said that for years he tried promoting the "Dr. C Grocery List" with all the best & most nutritious foods he liked to see people eating, but apparently that just does not work and getting people to dump their entire way of eating and start over from scratch with things they aren't used to eating is super hard and complicated and time consuming which SURPRISE! basically sets people up for failure. "I can't even do it," he said at one point.

So instead, his approach is to start with what you already eat and like and can do easily and make small changes to fix what is for the vast majority of athletes the real underlying issue, and that is managing blood chemistry.

Yes, what you eat is important. And how much you eat matters. But far and away, the thing holding most athletes back in terms of nutrition is the timing.

For example: Our bodies absorb CHO (carbohydrate molecules) into our muscles & liver (where we store it) at a certain rate. (I hope it goes without saying that I am grossly oversimplifying, but stay with me.) As long as your body is getting CHO at that rate, you're fueling your muscles, replenishing CHO you've used up in exercise, & storing it for use in future exercise. If, however, the CHO is coming in faster than that rate, though, your body can't keep up, and the extra will get stored as fat, regardless of what the food was.

I think he said most people's baseline for sending CHO to muscles/liver is around 1 gram per minute at rest, but when you exercise, that rate increases dramatically (which is why you can have basically pure sugar during & immediately after exercise without worrying about it going to fat or messing with your insulin sensitivity). This is also why, as soon as exercise is done, the CHO you've used must be replaced immediately (ie, within ~10 minutes). At that point your body is still processing carbs & sending them to muscle/liver *really* quickly, so you can have, say, 200 calories of bread or crackers or whatever and nearly every bit of it will go to refueling.

Wait 20 minutes to have that same amount of CHO, or 40 minutes, or an hour, and your body's ability to process CHO will have dropped precipitously (by half every 20 minutes, apparently), and suddenly a quarter or a third or half of that CHO can't be processed quickly enough to get sent to your muscles, and instead will get stored as fat. So now you have a) not replaced all your lost carbs and b) gained fat unnecessarily.

Similar things happen with dinner. The problem, he said, is not that I eat pizza and Indian food and what have you most of the time. The problem is not that it's too many carbs or too much white flour or too much grease or any of that. It's that at that point in the evening my body can only absorb 1 g/minute of CHO into my muscles (which need it), and starches digest so fast that my body suddenly finds itself trying to deal with 4g/minute of CHO (or whatever, I'm making numbers up). So now my muscles are getting 25% of the carbs I eat (not enough) and the rest gets stored as (unneeded) fat.

(Also, whole grains are apparently not the answer to this, as they only slow down digestion compared to non-whole grains by about 10%.)

BUT WAIT! It gets better.

As we all know, muscle burns fat. One way to burn more fat is to gain muscle. Alas, many athletes find themselves working very hard to put on muscle and barely breaking even.

This, too, I learned, is often a result of blood chemistry in the form of unstable blood sugar. Blood sugar too low -> cortisol spikes -> cortisol starts breaking down muscle to fuel brain & keep blood sugar from falling further. So sometimes athletes are like, "Must lose fat & gain muscle! Must work out harder and create calorie deficit by eating less!" But what actually happens is that blood sugar drops, cortisol spikes, and now, in addition to having just broken your muscles down with exercise, you're doubly breaking them down by causing your cortisol to panic & cannibalize them a bit to feed your brain. GOOD TIMES!

In all likelihood, he told me, these are the main reasons why I can run 30-50 miles a week, lift weights/strength train 3x a week (ok, not lately, but in general...), spend 3 hours a week doing martial arts, eat the right number of calories from mostly healthy foods, and still be 15 pounds & several body fat percentage points over my (previous) ideal performance weight. It's apparently a very common issue, and (I'm told) actually not that complicated to fix.

The best part? When he said: "You don't have to give up pizza/burritos/{Eastern country} food."

So yeah! That's the ground work. Next time I'll talk about the changes he recommended & how it's been going. :)


  1. Wow, that's interesting. And it totally makes sense. And it's probably why I have that little pouchy spot under my belly button. I like his attitude that he's not about to change the whole way you eat and not ban you from your favourites.

    1. Seriously. If he was like, "You gotta limit the pizza," I would've been like, "Thank you for your time, I have to go get some pizza now."

  2. This is fascinating. I'm curious -- does it mean that if I run early in the morning or after work, I shouldn't be having a carb-heavy meal in the middle of the day? (Please don't tell me that... but do if I need to know)

    1. You can -- there are some ways around it, which I promise to expound on! :)

  3. But...but...but....What I have never understood is this business about "carbs turning into fat" or any of these kooky Animorphs-esque lines of one chemical magically "turning it" another chemical. How is that possible? If carbs are carbs, how can they be "stored as fats?"

    The rest of this makes tons of sense to me. I am the laziest eater...I often forget to eat lunch and then eat whatever I can find sitting around, congealed, at my office. So, yeah, I could probably use some of these tips. I'm looking forward to part 2!

    1. Fat is how your body stores any extra energy it can't use right away, because it's very compact and energy-dense (lots of calories packed into small space). I think this article does a pretty good job of explaining how carbohydrate is converted to fat:

  4. Super interesting! The funny thing is, even though it's complex on paper, it's also common sense - and why you should generally take cues from your body. I bet you want carbs ten minutes after a hard workout, and really? I love a big greasy dinner, a lot, but usually I feel terrible ten minutes later. It's like he just explained what we already sense. Really interesting, and I'm looking forward to more on the topic!

    1. Heh, when you think about it, I guess it's kind of true!

  5. So am I right in that you're saying it's better to eat LITTLE and often so your body can process carbs as it needs them, rather than storing them up?

    1. (Shhhh, don't spoil anyone, but you've hit upon one possible strategy. ;) )

  6. This makes a lot of sense. I've always loved my carbs, but I also have that extra weight that I don't love, which I'm sure I can attribute to carbs. Whenever I think about cutting carbs though, it makes me depressed. However, while I was away for my work trip, I ate from a really diverse buffet of salads, veggies, lean protein, and a small amount of carbs, and it made me feel great (surprise, surprise!). I was thinking about writing a blog post about that, so it's good timing that you're also doing this investigative blogging for us. :) Looking forward to part 2!

  7. I'm looking forward to your next post on sports nutrition! In the past I have delayed refueling after runs because I want to shower first or I log my run online and then get distracted by the internets. After reading your post on Wednesday I have been making an effort to refuel immediately after finishing my workout. Thank you!

  8. Thanks so much for sharing this info! It's great to hear that my own experiences align perfectly with the science and with what your nutritionist says. I do almost exclusively cardio and found that at my most "fit," my body was getting noticeably softer (even though I was running more miles per week than ever before and at faster paces). I soon realized I was breaking down muscle for exactly the reasons listed here.

    The timing of CHO absorption rates makes perfect sense and I've read several articles supporting that. For me, this part is especially tough because I find myself completely grossed out by the thought of eating until about an hour after my workout is done, which at that point is when energy starts to get stored as fat.

    I can't wait to read the recommendations you were given and how you feel about them after implementing them!