connecting the gut and the nervous system

I had an emotional couple of days last week. If you know anything about the Enneagram personality archetyping, I’m most definitely a type 4, so deep and vast emotions are a familiarity for me. That aside, I was emotional. I cried a fair bit and felt my own little volcano of melancholy come out in periodic waves. One such wave was on a run last Thursday morning. Most long-term runners know certain runs can be incredibly therapeutic and where we work through challenging emotions. This was one of those.

When I returned to the house after finishing and began my cool down stretch, I had a familiar mild, dull pain in my abdomen set in, and it continued throughout the day. As an old familiar, I knew exactly the cause of the pain when I first noticed it. As a sensitive child, I grew up with routine anxious ‘tummy aches,’ on Sundays before a new school week began, couldn’t eat before stressful events, and generally would feel knots in my middle when emotionally distraught.

Unsurprisingly, there’s a reason for this.

For anyone that likes to show up to an athletic race early in the morning, stand in line at the porta potty, and then hope to put your best foot forward in your event of choice, or perhaps engage in a similar nervous-inducing event in another area of life like a job interview, you know that when you’re anxious, nervous, or otherwise stressed, digestion is quite a bit off. That’s because the gut and the brain are intimately connected. The nervous system has several branches and one section, the enteric nervous system (ENS), is often called ‘the second brain.’ The ENS is the section that runs through our digestive system and is connected to the actual brain through a large nerve that runs through are central body and communicates in both directions. This is called the vagus nerve.  When we have a really emotional episode, like I did, our brain can send chemical messages to the gut that change our gut bacteria, leading to low-grade gut inflammation and possibly GI distress. Similarly, if we have a particular imbalance in the gut itself—through food that doesn’t sit well or isn’t best for us, or inflammation and excessive permeability to the gut lining for another reason, we often notice behavioral changes as well. For example, persons that have chronic GI distress often also experience one or several mental health symptoms, including anxiety, depression, fatigue, confusion, brain fog, poor memory, migraines, and more.


When we have continued stress, whether in our body or in our mind, the nervous system slows down or impairs digestive function. This is why it’s best to not eat when we’re in a stressful mindset or running out the door in the morning before work or while rushing between meetings. And why one simple way to improve digestion is to single-task while we eat. That is, eat in a quiet, peaceful environment and do only that. Just eat, enjoy, and actually chew the meal. And its why major stressful life events often precede major health symptoms and then diagnoses. If you struggle with digestive conditions such as one of the Irritable Bowel Diseases (Crohn’s, Ulcerative Colitis, Diverticulitis, etc.), IBS, GERD, ulcers, chronic constipation or diarrhea, and any autoimmune disease, your condition will often respond favorably to stress-reduction techniques. For athletes with any of these conditions, we often argue that our physical activity is our source of stress reduction. That may be true—in theory—but often our activity load is contributing stress when our physical and mental systems are way out of balance.

True rest and relaxation, such as spending an hour or more per day doing absolutely nothing, deep breathing, meditation or prayer practices, spending quiet time in nature, gardening, yoga, painting, or other quiet activities without a screen are sometimes exactly what we need most to begin digestive healing – not a fancy, stressful, rigid new eating plan. (Gasp! I know; how dare I say that as someone that works with people on food!)

Otherwise, I love to work with herbs for the nervous system. In fact, nervines, the category of herbs that work on the nervous system, are by far the ones I work with and recommend the most. Lavender in this blueberry lavender smoothie bowl, and skullcap, tulsi / Holy Basil, lemon balm, and lavender in this stress-reduction tea or herbal latte are just a couple relax-inducing herbal ideas to consider.

The nervous system is one of the five primary categories of digestive imbalances I look for when working with individuals clinically. Often when we’re experiencing chronic GI distress, there will be imbalances in several categories, and we begin working on the areas that appear most pertinent. I’ll explain the other categories of digestive imbalance in future articles. And If you’re tired of dealing with your wonky GI, I invite you to reach out to me for more personalized support.

References:
1: Lipski, L. (2012). Digestive Wellness (4th ed.). New York, NY: McGraw Hill.

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.