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.

Are you eating enough for your activity level?

Today’s topic is one that’s been on my mind a whole lot lately. A nutrition question that is frequently asked is:  Should I be eating intuitively when I’m hungry or tracking what I eat and going off the numbers?

Before I tell you my answer, I’d like you to think about this question for a moment. No really, take a moment and think about what you’d say if someone asked you. (Humor me please, this is the educator in me.)

From my instagram a couple weeks ago: as mileage and/or time on feet goes up, eating becomes almost another part-time job. the last few days I felt like I wasn’t quite eating enough, and not surprisingly, today’s long run felt a little extra challenging.
low energy availability is extremely common in athletes, and long term, it can cause widespread physiological and psychological imbalances.
so the short story is if you’re moving a lot, you need to be eating a lot.

Now, my answer:  YES, eat intuitively!! Tracking numbers often leads to becoming reliant on the numbers rather than recognizing your own body’s needs. Your body is incredibly wise and those tracking websites and apps are all using estimates. They’re estimating your energy needs and using nutrition data done in a lab on a random sample item of the food tested. And that’s not to mention that your estimates of portion size, etc. are usually not entirely accurate either.
So random sample food that may not reflect the actual nutrition of the food you ate, formula estimating your energy needs, and, unless you’re a super type-A person that weighs every morsel ingested to the nearest gram (also please don’t do this), inaccurate food measurement. Yes, they can give you an idea if you might be in the ballpark with your nutrition needs, but as above, it can vary so much. And yes, some individuals can go into a lab and get their metabolic rate measured to determine a more accurate picture of energy needs, but most of us don’t have access to or need that data.

AND also my answer: It depends. Many active individuals are actually not eating enough for their on-the-move lifestyles – and the body, because it is wise, makes decisions about where it is going to prioritize its precious calories. So if you’re going to go for a trail run in the forest for the day followed by an evening bike ride or weight session, and then follow with something similar tomorrow and the next day, and throw in a weekend long couple workouts, AND you’re routinely not eating enough to meet your caloric needs, the body is going to choose where to spend those nutrients because when this precious energy is used for one function, it is not available for another one. Essentially, you are putting your system into survival mode.

And it plays out along these lines as your body says,  “Well, if you’re going to make me go do these workouts, I’ll put my energy here, though maybe with a little less pep, energy, and high-end ability, but I’ve got to rob Peter to pay Paul, so I’ll compromise over here with bone metabolism, or over here with female reproductive hormones or thyroid health, or immune function, or over here with the GI system and the ability to break down nutrients in food (because digestive enzymes are made of proteins which may be lacking in the diet), or muscle and tissue repair or”…. and the list goes on.

Why am I bringing all this up? Because it’s actually common for active individuals to be eating to hunger levels and still not be eating enough.

While intuitive eating means we should honor our hunger, many athletes have a suppressed appetite after long or intense workouts, and we still need to replace nutrients quickly after exercise, and learn to recognize that symptoms of hunger go beyond simply an empty stomach.

While intuitive eating means we should respect our fullness, if you get to the point of overeating by having excessively large meals, it is often because of low energy intake throughout the day or because you did some seriously strenuous exercise. With more even or adequate energy intake before and during a long workout, you can avoid that ravenous feeling of needing to eat quickly and impulsively, which means you’re paying more attention to fullness.

A SELF-ASSESSMENT TO HELP YOU NAVIGATE YOUR ENERGY NEEDS

So what to do if tracking all your meals isn’t very accurate (and not to mention time-consuming and takes the joy out of eating and deciding what to eat), and eating intuitively might be a little faulty, especially at the beginning?

My suggestion is to start with a self-assessment. Ask yourself these questions:
– Am I sick more than I should be?
– Do I struggle with fatigue more than I think I should?
– Am I improving in my performance?
– Have I had a lot of injuries?
– How’s my overall health?
Basic bloodwork results holds a plethora of data on how the body is ‘performing’ internally.
– How is my menstrual cycle and/or sex drive? Women have a little advantage here in that any menstrual symptoms or irregularities* are symptoms telling you to heed warning because there’s a larger health story.
– Do I have a lot of gut upset / discomfort?
– Am I more irritable, depressed, anxious, or have decreased concentration?
– Am I sleeping well?
– and if you have teammates or friends/family that you work out with regularly: Do I eat less than my teammates but have a higher body fat? This is subjective of course because every body is different, but yep, higher body fat and eating less is also a tell-tale sign, since lower metabolic rate occurs with lower energy availability, meaning you might be eating less but weighing more or having more cushion than previously.
– and one more because it can become prevalent with long term low energy availability: Am I thinking about food ALL THE TIME? We know from eating disorder and starvation studies that chronically deprived individuals become obsessed with food, far beyond just being interested in food.

So where to go from here?
Above all, food and exercise should make you feel good. The goal is to be aware and in tune with yourself and your body’s ability to show you signs that something may not feel right or as great as it should.

And you may benefit from professional guidance. If you’re confused or concerned about your needs, or would like a professional opinion, I invite you to reach out to me for more personalized support.

*Women on hormonal birth control will not have the same ability to use their menstrual cycle to gauge abnormalities, since it is designed to eliminate ovulation and the normal hormonal fluctuation that occurs. If symptoms or irregularities occur without birth control, that is vital sign that your body has an imbalance somewhere.
This information does not intend to treat, diagnose, cure, or prevent any disease. 

References:
2018 UPDATE: Relative Energy Deficiency in Sport (RED-S)
Bronwen, L., Rowe, G., and Girdlestone, C. (2020). Low Energy Availability – an imbalance that impacts more than performance. CompeatCon Nutrition Conference.
Fahrenholtz, IL., Sjodin, A., Benardot, D., Tornberg, AB., Skouby, S.,…and Melin, AK. (2018). Within-day energy deficiency and reproductive function in female endurance athletes.
Torstveit, MK., Fahrenholtz, IL., stenqvist, TB., Svlta, O., Melin, A. (2018). Within-day energy deficiency and metabolic perturbation in male endurance athletes.
Tribole, E. and Resch, E. (2003). Intuitive Eating: A revolutionary program that works. (2nd ed.). St. Martin’s Griffin.


Walnut Butter with Blueberries, Goji Berries + Vanilla

I received free samples of California Walnuts mentioned in this post. By posting this recipe I am entering a recipe contest sponsored by California Walnuts and am eligible to win prizes associated with the contest. I was not compensated for my time.

There was a conversation going around the last few weeks about using up what’s in the cupboard, finding random stowed-away forgotten, stale, and outdated ingredients, and actually making a meal of them. As that went around, I truthfully had the thought of Ha, well that doesn’t apply to me.
I also remember a few years ago, a friend that first got to know me as a study abroad/international student and came to visit. He remarked at how elaborate the collection of ingredients in my pantry were. At the time, it felt like a moment of baring my soul, for what’s in your pantry and fridge tell as much or perhaps more about someone as taking a look in their medicine cabinet.

I tend to have a fairly vast collection of cooking ingredients simply because I love to experiment and create, and I like the flavors of a lot of different places. My kitchen is perhaps the [adult foodie] version of my dear grandmother’s elaborate dress-up closet that we loved as a kid.

Lately, I’ve also been making meals inspired by Heidi Swanson’s Near & Far cookbook, though I’ve particularly been drawn to the Near section, meaning Northern California cuisine. In the springtime particularly, this means I’ve been making meals with plenty of greens and herbs, and with flavors and ingredients that are pretty close to home here in Oregon’s southern Willamette Valley. In other words, as the stay-at-home recommendations went into effect, I craved even more the flavors that come from closer to home.

And…when I finally dug through the pantry and fridge to inventory what’s there, I discovered I’m not the outlier with no outdated or forgotten foods in the pantry like I’d convinced myself to be.

A jar of freeze-dried wasabi powder
An untouched jar of Rhubarb Cordial which I made during cordial-making week in Herbal Pharmacy class four years ago
A few blooming teas and flavored teas and extra-floral teas that various individuals have gifted me – love tea, kinda picky about which ones I’ll drink on the regular
A package of pizza spice mix
A jar of jalapeño jelly I made a long time ago that appears still good – the gift of high sugar content
A big pack of spring roll wrappers I’ve only needed in small amounts
A couple dried habaneros – before I realized only a smidge in a recipe will singe the hairs off, clear the mucus membranes, and help me breathe fire like the dragon I sometimes claim to be. ;)

And, not outdated at all and in constant rotation, an entire third of my fridge and a shelf on the pantry dedicated to the nut, seed, and dried fruit collection. Because I like to start from the equivalent of primary colors when making recipes, I usually purchase raw, unroasted nuts and seeds, and dried fruit with no added oils or sweeteners. This also means their amazing nutrients are retained without adding extra oils, salt, or sugar. Despite a few other ingredients that clearly need to be tossed or regifted – that cordial did not look good and went down the drain this morning – this preference for having diverse and fresh ingredients on hand came in real handy the last few weeks.

So let’s turn to this particular recipe, shall we?

One of the components of total health and overall diet that is important is the ratio of omega-3 to omega-6 polyunsaturated fatty acid types in our daily diets. Both omega-3s and omega-6s are essential, meaning we have to get them from our foods to have adequate health, but their ratio is perhaps just as important. In traditional diets, our evidence shows that peoples were likely eating a 3:1 or even 2:1 ratio of omega-6 to omega-3s, and this is still optimal. In a standard Western diet, that ratio is often skewed to a 20:1 or more ratio. Anything above a 5:1 ratio begins to be more of a pro-inflammatory state for the body.

Omega-3 fats are primarily found in fatty fish like salmon, herring, mackerel, anchovies and sardines.
But they’re also found in plant-foods including walnuts, chia, flax, and hemp seeds, as well as edible wild plants – a major source for our ancestors.

Omega-6 fats, though essential, are ones we usually don’t have to work at getting because they’re prolific in our food supply – primarily through corn, soy and other-vegetable oils, but also in most of the other nuts and seeds not mentioned above.

One important note is that no food has just one type of fatty acid profile – foods contain varying amounts of all types of fat, both monounsaturated, polyunsaturated (those omega-3s and 6s), and saturated fats. Our body thrives with a balance which is another reason it is wise to eat diversely and seasonally.

Working a little of that Near & Nearer concept into my meals and snacks lately, this recipe primarily features California walnuts, which I love because they offer a rich, sophisticated flavor, and they’re the only nut to provide an excellent source of the plant-based omega-3, ALA (2.5g/oz).

And a handful (or spoonful) of California walnuts is a versatile snack and can satisfy any taste preference, from savory to sweet.​ As far as this walnut and berry nut butter goes, it works that slightly sweet angle with blueberries that were grown by one of our local farmers, a handful of antioxidant-rich goji berries, and just enough sunflower seeds to balance out the stronger flavors that walnuts on their own in a nut butter provide. I particularly enjoy this as a snack or alongside apple slices as a little after dinner treat. And if you make it, whether you have to go source a few ingredients or work that Far angle of the Near & Far concept, I promise you will too. :)

Walnut Butter with Blueberries, Goji Berries + Vanilla, makes 240 grams (about 8 oz.)
1 ¾ cups / 175 grams California Walnuts
¼ cup / 35 grams sunflower seeds
2 Tbs. / 20 grams unsweetened dried blueberries
2 Tbs. / 10 grams dried goji berries
1/8 tsp. vanilla
a dash of salt and up to 1/8 tsp.

  1. Set the oven to 160°C / 320°F.
  2. Spread out the walnuts and sunflower seeds on a baking tray and roast for 15-18 minutes until they begin to turn a slightly darker, toasted hue.
  3. Transfer to a food processor and mix on high speed for approximately 10-15 minutes or until it starts to become smooth and perhaps a little runny (stopping and scraping down the sides every now and then). 
  4. Add in the dried berries, vanilla, and salt.
  5. Puree again until the berries are mostly incorporated but might still have some small pieces.
  6. Pour into a 8 oz. jar and store extra in the fridge.