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.

Hot Cross Buns {gluten + dairy-free, sourdough option}

As I opened my daily planner this morning, I was reminded that I had originally been slated to be teaching a lesson today about healthy breakfasts and how to tell when one is hungry and full to several kindergarten classes I work(ed) with.

Of all the nutrition and cooking lessons I teach in public schools, that particular one is my favorite. And because the funding source leaves me tied to teaching particular curricula that I often find wanting in terms of what we should actually be teaching our children about nutrition (i.e. developing a healthy relationship to food more than focusing so much on all the food groups), this particular lesson is one I really look forward to. Hunger presents itself in numerous ways beyond just a painful, rumbly tummy, and food and nutrition is far more than just calories in/calories out, macro and micronutrients, and following the ‘right’ plan until whatever prefabricated goal is reached. If I could fill out my entire kindergarten series with this topic of developing a healthy relationship to food alone, I think my students would be far closer to having the basis of a firm foundation in healthy lifelong eating than most of us have ever gotten.


One thing I’m noticing a lot in the last couple weeks as we all go into isolation and quarantine is a few different but similar conversations about food. Panic-buying and hoarding as lack of clear leadership, lack of control over life situations, and messages about what to do change nearly daily. Bingeing or overeating on a kitchen full of food, or stress not-eating as we stay home and navigate a completely different routine. Stress-baking to put at least our hands in motion, and choosing comfort foods when nothing else is comfortable. And then stacking guilt on top of our already stressed and anxious systems as we berate ourselves for not having some willpower or not taking care of ourselves adequately, etc.

One of the questions I like to ask, not to my kindergarteners, but in clinical practice, is ‘what’s that about?’ When our minds go into worry and circular thinking about whether there’s any flour, yeast, eggs (or TP) to be found at the store. When we find ourselves needing a comfort food or snack while working from home when we’re not actually hungry. When we skip a meal or two and are ‘not hungry’ when we’ve clearly not eaten much in the last day or days. When our hands at the grocery reach for ice cream, cookies, chips and crackers, or the ingredients to make something sweet / salty. When we panic at the thought of missing a workout or being sidelined from normal training due to this situation. When we’re anxious. When we wake every night at 3am.

In any or all of these instances, ask yourself, ‘What is that about?’ What’s the underlying feeling, belief, or reason I’m doing this thing? Ask yourself without judgement, and just be okay with whatever answer comes. And if there’s no immediate clear answer, that’s okay too.

As an adult, having an awareness and lack of judgement at the reason for our actions is incredibly helpful in navigating uncertainty and beginning to form trust in yourself that you are strong and able to deal. For even when we judge our actions and ourselves incessantly, there are always fairly wise reasons for them that we are somehow protecting ourselves against.

Today as I’m writing this, it is also the beginning of Holy Week, a special solemn few days in the Christian calendar before Easter, and given the state of the world right now, the solemn state of things appears to run parallel to it. Hot Cross Buns are also a traditional specialty this time of year, at least in parts of the US, and for sure in the UK and Ireland. It you’ve never enjoyed them, they are a spiced and fruit-filled yeast bread roll, often made quite a bit richer due to extra butter/oil, added sweetener and perhaps an egg. They were traditionally eaten on Good Friday, which is also a traditional day of religious fasting. If you like to delve into the history of food traditions like me, you can learn more about hot cross buns on Good Friday in this short article and its fascinating discussion/comments.

Otherwise, may you work on asking yourself this week, ‘What’s that about?’, and if you’ve the inclination, try baking hot cross buns.


Hot Cross Buns {gluten-free and vegan, sourdough method}, makes 5
This recipe appropriately fits the needs for those avoiding all (or some) of the most common food sensitivities and allergies, and because my nutrition-brain is always on when developing recipes for this space, these are a delicious, slightly enriched and sweetened whole-grain bread option that doesn’t get too far into the super decadent category.
As you’ll note, I’ve created two options to make these, with a sourdough starter, and without. I’ve made and enjoy them both ways, and because I don’t do away with the yeast in the sourdough option or dramatically change the method, they both turn out fairly similar. Instead, I tend to use my sourdough discard for the recipe and reduce the other flours and liquid.
If you’re finding gluten-free flours difficult to source right now, substitutes work well. Sorghum flour subs in well for either brown rice or millet, oat flour made from ground up oatmeal will likely work well in part, and any of the starches (arrowroot, tapioca, potato, or corn) can be used in place of the arrowroot and tapioca combination. As always when baking and especially when using substitutions, it’s always best to measure by weight.
There are a few ways to make the cross on top, either with a bit of icing after baking, by cutting a cross in the dough before baking, or by making a flour and water paste and drizzling it on top before baking. I meant to cut my dough before baking but then forgot, and decided to use a quick couple spoonfuls of cashew, vanilla and honey ‘frosting.’ I haven’t added that in here because I think it’s too fussy and these don’t need a sweet finish. They taste great on their own!

Wet Ingredients:
6 Tbs. non-dairy milk
2 1/2 Tbs. water
1 1/8 tsp. dry active yeast
¼ cup mixed dried fruit (raisins, golden raisins / sultanas, orange peel)
2 Tbs. orange juice or tart cherry juice or water
1 Tbsp. ground flax seeds 
1 Tbsp. psyllium husk (or use ground chia seeds OR flaxseed meal)
2 Tbsp. coconut oil, melted
½ Tbsp. apple cider vinegar
1 Tbsp. honey or maple syrup

Dry ingredients:
130 grams / ~1 cup gluten-free all purpose flour
(or 13 g buckwheat flour, 19 g tapioca flour, 20 g arrowroot flour, 26 g each sorghum, brown rice, and millet flours)
100 grams / ~ 1 cup gluten-free sourdough starter (equal parts flour and water)
1.5 tsp mixed spice  (1/2 tsp. cinnamon, ¼ tsp. allspice, ¼ tsp. nutmeg, 1/8 tsp. cloves, 1/8 ginger, 1/8 tsp. coriander, 1/8 tsp. cardamom)
¾ tsp. baking powder
¼ tsp. baking soda
¼ tsp. sea salt

  1. Warm up the non-dairy milk and water together until lukewarm or at about 100 degrees F / 38 degrees C. Whisk in the yeast and allow to froth up for about 10 minutes.
  2. While waiting combine the dried fruit and juice or water. Warm for a few seconds in the microwave and set aside to let the liquid soak in and soften up the fruit. I use about 1 Tbs. finely diced orange peel in this mix to make these extra festive and more traditional.
  3. Add the ground flax, psyllium, oil, vinegar, and honey to the frothy yeast liquid. Whisk together and set aside so it can thicken a little.
  4. In a large bowl, stir together the dry ingredients. Dump the wet ingredients and fruit into the middle of the flour mix and stir. Your dough will begin to look scrappy. Keep stirring with your spoon or hands until the ball of dough becomes somewhat smooth.
  5. Put a cloth over your bowl and let rest / rise for one hour.
  6. Next stir the dough well again, and then divide into 5 equal balls. Lay parchment in a small baking pan and then roll or shape each of the dough balls into rolls. Place them on the dish, cover with cloth again, and rise again for 1 hour in a warm, non-drafty space in your kitchen. These should rise enough to be touching each other in the pan, but will not double in size.
  7. Preheat your oven to 375 degrees F / 190 C. Bake for 2025 minutes or until the edges have firmed up. Place the pan on a wire rack to briefly cool down.

EXTRA NOTES

1. Tastes best when eaten warm and straight out of the oven.
2. Store in an airtight container and keep for about 3 days.
3. The dough can be made ahead of time. Simply place in the fridge during the second rise time and allow to sit overnight. Baking time might need to be longer.

Hot Cross Buns {gluten-free and vegan, regular non-sourdough method}, makes 5

Wet Ingredients:
6 Tbs. non-dairy milk
6 Tbs. water
1 1/8 tsp. dry active yeast
¼ cup mixed dried fruit (raisins, golden raisins/sultanas, orange peel, etc.)
2 Tbs. orange juice or tart cherry juice or water
1 Tbs. ground flax seeds 
1 Tbs. psyllium husk (or use ground chia seeds OR flaxseed meal)
28 grams / 2 Tbs. coconut oil, melted
½ Tbs. apple cider vinegar
1 Tbs. honey or maple syrup

Dry ingredients:
180 grams / 1 ½ cups gluten-free all-purpose flour
(or 18 g buckwheat flour, 27 g tapioca flour, 27 g arrowroot flour, 36 g each sorghum, brown rice, and millet flours)
1 1/2 tsp. mixed spice
(1/2 tsp. cinnamon, ¼ tsp. allspice, ¼ tsp. nutmeg, 1/8 tsp. cloves, 1/8 ginger, 1/8 tsp. coriander, 1/8 tsp. cardamom)
¾ tsp. baking powder
¼ tsp. baking soda
¼ tsp. sea salt

  1. Warm up the non-dairy milk and water together until lukewarm or at about 100 degrees F / 38 degrees C. Whisk in the yeast and allow to froth up for about 10 minutes.
  2. While waiting combine the dried fruit and juice or water. Warm for a few seconds in the microwave and set aside to let the liquid soak in and soften up the fruit. I use about 1 Tbs. finely diced orange peel in this mix to make these extra festive and more traditional.
  3. Add the ground flax, psyllium, oil, vinegar, and honey to the frothy yeast liquid. Whisk together and set aside so it can thicken a little.
  4. In a large bowl, whisk together the dry ingredients. Dump the wet ingredients into the middle of the flour mix and stir. Your dough will begin to look scrappy. Keep stirring with your spoon or hands until the ball of dough becomes somewhat smooth.
  5. Put a cloth over your bowl and let rest / rise for one hour.
  6. Next stir the dough well again, and then divide into 5 equal balls. Lay parchment in a small baking pan and then roll or shape each of the dough balls into rolls. Place them on the dish equally apart, cover with cloth again, and rise again for 1 hour in a warm, non-drafty space in your kitchen. These should rise enough to be touching each other in the pan, but will not double in size.
  7. Preheat your oven to 375 degrees F / 190 C. Bake for 2025 minutes or until the edges have firmed up. Place the pan on a wire rack to briefly cool down.

EXTRA NOTES

1. Tastes best when eaten warm and straight out of the oven.
2. Store in an airtight container and keep for about 3 days.
3. The dough can be made ahead of time. Simply place in the fridge during the second rise time and allow to sit overnight. Baking time might need to be longer.

If you enjoyed this, I’ve been sharing a few practical resources and video posts over on my E+O Facebook page about how to navigate these times with resiliency and less anxiety / fear. For new nutrition clients, I’m currently offering a package of three consults for half off. Be well.