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Carnival Belly, Running, and a Digestive Health Survey

Lately, William and I have been taking weekend adventure runs, meaning we’ve been getting out of town for a good part of the day to run somewhere new. Often this is followed by a picnic with a very runner-favorite spread: PB&J sandwiches, fruit, and tortilla chips. A couple weekends ago, the route I chose was based on being new and not far to drive, and as such it was on a course that’s designed more for mountain biking. After three miles of steady running upwards amidst the giant forest foxgloves and complete peace that is running away from civilization, we got to our summit and the single-track mountain biking descent. It started out as a really fun, fairly technical terrain with lots of creek rocks, tree roots, twisty trails and garden-gnome spotting. But there were also steady, heavy mountain biking moguls, making every bit of downhill come with nearly the same in little uphill rollers.

By about halfway through the downhill, I had this experiential memory of being on a carnival ride, and I was unsurprised to find my digestive system was feeling jostled in just the same way. By the end of the fourth and final mile of downhill, I realized I’d taken for granted that the norm for runners is to cruise and ‘wheee!’ downhill once the climbing is done. And I’d gladly take that steady climb over the tumbling in my lower GI and the muscle fatigue setting in from all those rollers.

My carnival belly largely went away for the day once I stopped running and had a meal, but it was mildly painful and upset for a day or two afterwards. Relatedly, this week our annual relay team has taken the very different challenge of racing the 2020 relay race virtually, and because this race coincides with the hottest stretches of heat year after year (and no different this year), I had that same mild carnival belly throughout the day yesterday after a hard race effort in the morning heat that was quickly becoming uncomfortable. Similarly to the week before, the discomfort was mostly gone again within a few hours.

So What’s With the Carnival Belly From Exercise, and in Running Particularly?

When we exercise, our body directs blood flow away from the gastrointestinal tract and to the working muscles. This reduction in blood flow, accompanied by an increased release of stress hormones during higher intensity or long exercise efforts, as well as the high impact of running (just visualize the internal organs being jostled up and down as we run), all combine to cause damage to the cheesecloth-thin lining to the gut, leading to all sorts of uncomfortable symptoms, as well as impaired digestion and absorption of food and drinks.

And yes, all of this is fairly normal in small amounts given the nature of doing long or hard exercise bouts. When we are dehydrated (a big topic in itself for another day) and/or exercise in the heat or to an extent that we have a high body temperature, we further reduce blood flow to the GI system, increasing stress hormone release, and develop a higher likelihood of digestive distress. But what might be a small amount of discomfort and upset sometimes should not lead to or be confused with frequently occurring and/or greater than mild GI symptoms.

Despite the serene views, this was taken at the point in the day when the sun was getting hot, the water bottle was running low, and my fun to need-to-be-done ratio was starting to tip directions.

What Can We Do For MILD GI upset?
Rather than grimace and bear it, there are many nutritional and training strategies we can do to minimize GI distress. Primary strategies include being properly hydrated in the 24 hours before / after exercising, especially in the summer heat, as well as training the gut. Just like other aspects of the body, we can train our gut to tolerate different types of foods, fuels, and amounts. Other helpful tactics include avoiding NSAIDS around exercise (as frequent use negatively impacts the gut), and eating and drinking smaller and more frequent amounts during exercise–this method alone helps alot with optimizing absorption and reducing upset.

But what about when that GI ‘offness’ or tummy upset isn’t just mild, and it continues long-term or occurs frequently?

That’s what I’d love to ask about today. Having chronic or frequent digestive symptoms including nausea, GI pain or cramping, reflux, lack of appetite (in general or after exercise), bloating, gas, diarrhea, constipation, loose stools with undigested food, or limited food choices due to reacting to many foods are all big warning signs, kind of like our body’s version of a flashing yellow or red light telling us to proceed with caution, or just plain stop and seek to understand what’s going on.

Rather than address any of those symptoms individually or all together, I’d actually first like to know how common those symptoms are–so I’ve created an anonymous survey for you to tell me about them.

If you’ve followed along here longer term, you’ll know I write about digestion a lot as it’s one of a few factors that finally pushed me into clinical nutrition, and it’s honestly my favorite nutrition topic to help others with–partly due to my own challenges over the years, but also because it can be complicated and I love a good challenge.

So if you’d please, fill out the quick survey for me and I’ll see if I can share about any of those flashing yellow or red symptoms that can cause us distress in or out of exercise in the coming weeks.

Best summer post-exercise treat / summer snacking — all the berries!

References:
Costa, R.J.S., Miall, A., Khoo, A., Rauch, C., Snipe, R.,…and Gibson, P. (2017). Gut Training: The Impact of two weeks repetitive gut-challenge during exercise on gastrointestinal status, glucose availability, fuel kinetics, and running performance.
Costa, R.J.S., Snipe, R., Kitic, C.M., and Gibson, P.R. (2017). Systematic Review: Exercise-induced gastrointestinal syndrome-implications for health and intestinal disease.
Snipe, R. (2018). Exertional heat stress-induced gastrointestinal perturbations: Prevention and management strategies.

Potato + Artichoke Frittata and summer guidance

It seems that time is getting away from me this summer. In the midst of this tough year, I’ve found I’ve needed more of a break from the virtual world these last few weeks. In the midst of doing some checking in with myself, I retook a character strengths test around the time of my last post in late June from the Via Institute on Character. Having last took the same test in early grad school, I found that most of my top character strengths are truly mine and have hardly changed, but having moved into my own nutrition clinical work, some of the strengths that were lower as a student have truly risen to the top. The results highlight how much we become what we practice. From that assessment, my top character strength is spirituality, as it has nearly always been. What the institute means by the Spirituality character strength is:

Having coherent beliefs about the higher purpose and meaning of the universe; knowing where one fits within the larger scheme; having beliefs about the meaning of life that shape conduct and provide comfort.

All of which has guided the majority of what I’ve written here this year and for the last several.

But the too-much-online-all-the-time and never-ending negative news cycle has gotten in the way of that a bit this spring and early summer. My internal guidance has gotten harder to hear and less obvious. On the daily, I have often felt torn between too many demands and not enough complete alone time. And so, in early July, I took a time out. I took a week off completely, from my public health job, from nutrition clients, from running, and from all technology. If I’m honest, what I hoped to gain from it was a flash-bang inspiration and guidance, if only for a moment, to make me feel better about all of this we’re living through.

But I didn’t get it.
It’s often said that God speaks in the whispers of the heart. That his guidance for us dwells in the silent spaces.

One of the things I’m coming to over the last few months is directly on this topic. When I work with individuals with nutrition, I provide guidance and of course my opinion, but I see each encounter with each client as a true collaboration; because as much as I have the professional training and knowledge of nutrition and its impact on physiology, we are each experts on our bodies, or should be. And I think each of us has the intuitive feels right for me knowledge about our bodies hidden underneath the clutter of all our everyday stimulation and egotistical desires.

This year, so many of us have been going through hard things, personally, professionally, with health, and more. It’s been my intention to start writing and sharing more here on the everyday aspects of that that are applicable. Frustratingly, that everyday application has only come easily when working individually with each person. Instead of resisting against this frustration, or forcing something that I’m finding difficult, the right answer for me today is to follow the strings and share here what comes with more ease. All that’s to say, I’m practicing having more grace with myself. And hope you can do the same with you.

And also,
If you are struggling with your relationship to your body this year, or finally beginning to address it, I hear you.
and If you are struggling with your digestion and/or are in the midst of a long frustrating battle with it, I hear you.
and If you are overwhelmed and/or losing hope with this pandemic and lack of true normal or return to it in the foreseeable future, I hear you.

Perhaps I’ll soon begin to provide more concrete words on those topics soon, like I have been meaning to. In the meantime, I’m leaning in to feeding myself and William wholesome meals lately, like this potato and artichoke frittata, and trying to keep the quiet spaces open to allow in the guidance I prefer.
Hope you are taking care.

Potato + Artichoke Frittata, serves ~3
I’ve never been much of a potato person, except the year-ish I lived in Ireland, but William insisted on growing potatoes this year. He chose a variety from Row 7, a seed company founded by chef Dan Barber, whose intent is to work with farmers who are developing vegetable varieties with flavor in mind, a notion that realistically is not done when it comes to developing commercial / commodity foods. It’s clear to me now that good potatoes make all the difference. If you can, I encourage you to buy locally from a farmer near you. I promise, they will taste infinitely better than anything in a standard supermarket.

300 gr. / 2-3 medium potatoes, unpeeled, medium-diced.
a dab of coconut oil or ghee, to cook
6 large eggs, whisked
a dash of black pepper and 1/4 tsp. salt
200 gr. / 1/2 a can of artichoke hearts, drained, rinsed, chopped
1 tsp. olive oil
1/4 tsp. turmeric
1/4 cup fresh basil, finely minced

  • Over medium-high heat, warm a little coconut oil or ghee in a medium-large heavy skillet that is oven-safe. Stir in the potatoes and sprinkle with a bit of salt. Cover and cook until they are tender, stirring occasionally, about 8-10 minutes.
  • Whisk the eggs along with the remaining salt and black pepper. Turn down to medium-low heat and pour the eggs into the skillet with the potatoes, along with the chopped artichokes.
  • Cook for a few minutes, until the eggs are just set and there isn’t a lot of liquid running around the pan on the top. To help with this, you can run a spatula underneath the sides of the frittata, and tilt the pan so the uncooked eggs run ot the underside.
  • Remove from the heat and place in the oven under the broiler for a couple minutes, until the top has puffed up and set. If your broiler has two settings, choose the low setting.
  • Remove from the broiler and let it sit for a minute or two. In the meantime whisk together the remaining olive oil and turmeric. Drizzle the turmeric mixture over the top, and sprinkle with fresh minced basil.
  • Serve warm or at room temperature with fresh greens or other meal accompaniments.


Are you in need of extra nutritional support?
If so, I invite you to reach out to me for more personalized support. Conditions I often work with include digestive health and food intolerances, meeting needs of endurance athletes, vegan/vegetarian diets, intuitive eating, and autoimmune disorders.

Radish + Hazelnut Grain Salad

This is the type of meal situation that’s my bread and butter. It’s the sort of thing I’ll bring to a potluck or picnic-style situation, and it makes a routine visit in our regular meals much the same way tacos do – i.e. same concept, different ingredients depending on what’s on hand and seasonal. Over the years, I’ve also found that William usually takes some of the leftovers for his work lunch the next day – which only happens if it meets his slightly different than mine taste-bud standards. It also helps when I add raisins, which in our house grace many a main dish. We are both lifelong raisin affectionados. :)

While everything is fairly interchangeable here, you’ll note I only list gluten-free grains as options. I don’t tend to be outright against gluten-containing grains for those that can tolerate them, but many individuals tend to be at least slightly sensitive – especially those with pre-existing autoimmune conditions (since inflammation in the gut significantly contributes and/or is part of the cause, and gluten is inflammatory to everyone to a certain degree). I also find that many individuals running long miles, particularly in the summer heat, suffer from more achy tummy – not hungry – can’t tolerate lots of foods symptoms. That’s because these kind of long or hard workouts in stressful physical conditions contribute to damage of the endothelial tissue in the gut, which by design is very thin (one cell thick!) to allow for absorption. If you eat gluten and wheat products regularly, purchase a few non-gluten grains next time you’re out shopping. And if you do avoid wheat and gluten, try to find one or two new to you or haven’t tried in a while gf grains next time. Dietary diversity is also imperative for good long-term gut health.

One last note I’ll make here is that I left out a protein-rich ingredient to this. If you tend to follow a vegan or vegetarian way of eating, and especially if you’re active, please add one to your meal. You can read more here about the importance of protein, particularly for plant-based, active folks. Often I’ll add cooked beans such as garbanzos to make this type of salad a one-dish situation, but a side of seasoned/baked/grilled tempeh or tofu, grilled salmon or similar, a couple fried eggs, or whatever else is your protein of choice will round this out nicely into a true meal. Enjoy!

Radish + Hazelnut Grain Salad, serves 4
1 cup mixed grains (like millet, quinoa, buckwheat or any combination of these)
1 onion, thinly sliced
a large handful of baby spinach or kale leaves
1 cup radishes, thinly sliced
1/4 cup raisins
1/4 cup dried apricots, sliced into small pieces
1 cup parsley leaves, minced
1 cup mint and / or basil, minced
2 Tbs. olive oil
2 Tbs. white wine or raw apple cider vinegar
1/4 cup hazelnuts, toasted
salt and pepper to taste

  1. Place the grains in a medium saucepan and add 2 cups water. Bring to a boil, reduce the heat to low, and then cover. Cook for 20-25 minutes until the water is absorbed, and then set aside to cool slightly.
  2. While the grains are cooking, saute the thinly sliced onions in a skillet with a little of the olive oil. Cook them until they are soft and translucent, bordering on being caramelized. Pull off the heat and transfer them to a large serving bowl.
  3. Tear or slice the spinach or kale leaves into small pieces and then pile them on top of the the onions.
  4. Add the slightly still warm cooked grains to the mixing bowl on top of the greens. Stir through to wilt them slightly. Then mix in the radishes, dried fruit, and herbs.
  5. Add in the olive oil and vinegar, 1 Tablespoon of each at a time, and stir through. Add additional as needed to make it the right consistency for you, i.e. add more oil and vinegar if you like a wetter mixture. Also taste as you go, since you might need more vinegar to bring a little more acid flavor for balance. Salt and pepper to taste at this time as well. You might need up to 3/4-1 tsp of salt and 1/8-1/4 tsp. black pepper.
  6. Serve slightly warm or at room temperature.