Most diets concentrate on the macronutrients: carbohydrates, fats and proteins. And for good reason, these are important. However, water, and the micronutrients it carries throughout our body, are equally, if not more important! The human body can survive for weeks without food, but only days without water. Just like our survival, our ability to function optimally depends more on hydration than it does on food.
Water plays a crucial role in nearly every bodily function and dehydration is the #1 reason for fatigue. Although water is not nearly as fun of a topic as sugars, fats, or proteins, it cannot be overlooked when aiming to reach optimal health!
As endurance athletes, we understand the importance of staying hydrated. But have you ever considered your sodium intake (and reabsorption) as a key factor to your hydration status?
In this article, I dive into what it means to be truly hydrated, the importance of sodium for the endurance athletes, and how to understand your sodium needs and how to meet those requirements.
WHAT IT MEANS TO BE TRULY HYDRATED
Before diving into sodium for training and race day, let’s go back to the beginning so we can cover what it means to be truly hydrated.
With water being the largest component of the human body, you can imagine how important its role is in obtaining optimal health. Water creates our bodily fluids which aid in digestion, blood circulation, circulation of nutrients, absorption, and regulation of body temperature. When our body fluid levels become depleted, we run the risk of dehydration.
Dehydration occurs when you use or lose more fluid than you take in, and your body doesn't have enough water and other fluids to carry out its normal functions.
When we sweat, we not only lose water but we lose electrolytes as well and that includes sodium. While we may think that more water is what we need, an overabundance of water during training and racing can lead to hyponatremia.
Hyponatremia is a condition that occurs when the level of sodium in your blood becomes abnormally low. The over consumption of water causes a dilution of blood sodium levels. Symptoms of hyponatremia include:
At the end of the day, to be truly hydrated you have to make sure you’re taking in an appropriate amount of fluid AND sodium!
Sodium is considered an essential electrolyte mineral (essential meaning you must get it from your diet rather than relying on your body to produce it). Along with other electrolytes, sodium helps regulate the body’s fluid balance (which also contributes to your blood pressure levels, another important marker athletes need to pay attention to).
Sodium promotes carbohydrate and water uptake in the intestines and reduces the volume of urine post exercise. Both sweat and blood contain high concentrations of sodium. Therefore, if you under-consume sodium, your body has no choice but to shrink your circulating blood volume to compensate.
Same is true if you are a heavy sweater. You will lose higher amounts of sodium, and run the risk of your blood volume decreasing if it is not replaced. This will result in lightheadedness, sluggishness, and potentially unconsciousness.
THE SALTY REALITY FOR ENDURANCE ATHLETES
Most of us have been told to minimize sodium intake. Since sodium has been associated with high blood pressure and cardiovascular events, the FDA recommends less than 2300 milligrams per day. But even FDA admits that overconsumption of sodium is typically the result of the overconsumption of packaged and prepared foods.
However, as endurance athletes, our sodium needs are typically higher. As previously mentioned, due to the nature of our sport, we can experience a higher level of sodium loss due to sweating, which means we need to prioritize replacing lost sodium to ensure our body is getting the required amount.
Although I personally believe that ALL athletes should be monitoring their blood pressure, those of us who have a history of hypertension, stroke, or heart disease should be particularly vigilant about monitoring your blood pressure. By monitoring your blood pressure regularly, you can dial in the appropriate sodium intake for your body.
Athletes’ needs for sodium vary greatly from the general population but they also vary greatly across athletes. This is because our sodium levels are impacted by concentration (i.e., how much sodium is present within sweat) and volume (i.e., the total amount of sweat).
According to the American College of Sports Medicine (ACSM), athletes can lose up to 5g of sweat in a single high intensity workout! That’s a lot of sweat, and a lot of electrolytes lost (more than 2x the amount the FDA recommends we consume in a single day!).
And this is why taking in salt is crucial during training and race day. My general rule for athletes is to get an idea of their sweat rate by doing an at home sweat rate test (more on that below). Then, rather than forcing water down, athletes should drink to thirst, while keeping in mind that you need to get in as close to as much of the fluids that you lose, alongside sodium.
The ACSM recommends that athletes take in fluids that include sodium with a concentration of 0.5-0.7g/L.
So how does one make sure they are meeting their sodium requirements? Let’s get into that...
MEETING YOUR SODIUM NEED
As I already mentioned above, hydration and sodium needs vary across athletes. So step number one is finding out approximately how much water and sodium YOU need, personally.
The best way to learn your sweat rate is to get a sweat rate test completed in a lab. You can check out Precision Hydration to learn more about testing centers near you. They also offer an online questionnaire to help you dial in your specific sodium and hydration needs.
Lastly, and an option I suggest even if you get tested in a lab, is to perform an at home sweat rate test.
How to calculate your sweat rate:
1. Empty your bladder. Weigh yourself before exercise or sauna with minimal clothes on.
2. Perform moderate exercise or sauna for a given number of minutes (15-60). Keep track of the ounces of water consumed during this time.
3. After exercise or sauna, towel off the sweat and re-weigh yourself with minimal clothes on. Your weight loss reflects your fluid loss. For example, if you weighed 150 lbs to start, then weighed 148 pounds after 60 minutes of exercise, then your net weight loss (and therefore fluid loss) is 2 pounds (or 32 ounces fluid) per hour. This should be replaced (both water and minerals) within 2-6 hours after finishing exercise/sauna. If you consumed any water during the test, make sure to add that back into your calculation.
Once you know your personal sweat rate, here are some things you can do to ensure you are meeting your sodium needs:
Workouts less than an hour: in this case, there is no need to worry about consuming anything special DURING the training session. Instead, focus on consuming nutrient dense foods or just add a generous amount of unrefined sea salt to your post workout meal.
Workouts that are more than an hour: in these situations, it would be smart to ingest sodium. I believe that keeping electrolytes, fuel, and hydration separate is ideal. This way, if (and when!) conditions change on race day (ex: hotter than expected, more humid than planned for), you can adjust one or more of these things without affecting the other.
For electrolyte replacement during these training sessions, I recommend you stick to salt tablets. They are highly measurable which makes dosing so much easier (vs. salt licks which makes dosing very challenging as every lick is different). If you prefer to add sodium and other electrolytes directly to your water instead, the two brands of electrolyte tablets/powders that I trust are Nuun and Ultima.
If an all-in-one fuel is easier for you, there are many over-the-counter beverages to consider when trying to replace your calories, water and electrolyte loss during exercise. My personal favorite is Skratch. I have used both Skratch Hydration Mix and Skratch Superfuel and recommend them both, depending on the race situation. As mentioned before, you need to keep in mind that by using an all-in-one fuel, hydration, electrolyte mix, you lose control over increasing or decreasing one of those elements based on your particular needs in training or on race day. To prepare for this, I still recommend carrying electrolytes, fuel and water separately, or at least have them available in your special needs bag in case you need more of one but not the others.
It has been suggested that an electrolyte sports drink with a 4-6% concentration (4-6g carbohydrate/100mL of water) is optimal for proper absorption.
A HOMEMADE ELECTROLYTE RECIPE TO TRY
Want to save some money and make an electrolyte sports drink at home?
No matter what, the best thin you can do with this information is use your training as practice so that once you make it to race day, you know exactly what you need (AND have extra supplies on hand in case the conditions are different than expected).
HOW TO KNOW IF YOU NEED MORE OR LESS ELECTROLYTES IN TRAINING OR ON RACE DAY
You might be wondering what signs to look for when it comes to staying properly hydrated. First off, always be sure to come into a hard session or race well hydrated. That doesn't mean with coffee. That means drinking AT LEAST 16 ounces of water with a pinch of sea salt before your session, especially if you train in the early mornings.
During training or racing, start sipping your water or electrolyte drink immediately and drink at a rate that is comfortable.
If you feel nauseous, you likely have over-done electrolytes or under-done your water intake. Either way, the electrolytes in your belly need to be dilutes. At this point, consuming more PLAIN water may help.
If you feel sloshing of water in your belly, you have likely over consumed water and not taken on enough electrolytes. Consuming more electrolytes may help as they can pull the water from your belly into the tissues. In this case, I'd highly recommend taking your electrolytes in pill form as to avoid adding more fluids into the belly.
If you feel like things are all of sudden getting really hard, this can also be a sign that sodium is low. Consider more electrolytes (and maybe more calories too!).
Cramping can be caused from many different factors, including overworked muscles. From a hydration perspective, cramping can be from too little electrolytes and/or too little water. In this case, I would advise you to take a salt capsule and open it into your mouth. The body, especially your taste buds, have an amazing way of telling you what your body needs. If the salt tastes good, I would start by taking more electrolytes. If the salt burns your mouth or tastes bad to you, then you likely don't need more electrolytes and should consume more plain water.
MY PERSONAL ELECTROLYTE PLAN
While your plan may be different from mine, I thought sharing my approach would help you understand how to approach your own training and race day.
No matter how cold it is, I always take 1 Salt Stick Cap at the top of every hour during training or racing that is longer than 90 minutes. I have an alert set up on my watch to help me remember.
As the temperature and/or humidity rise, I consider more Salt Stick Caps. At Ironman Arizona in 2014, I took on 1 Salt Stick Cap every 15 minutes on the bike and every mile on the run. This resulted in 24 Salt Stick Caps on the bike and 25 Salt Stick Caps on the run, totaling 49 salt caps on race day (that’s 10,535 mg of sodium from the Salt Caps alone).
In hind-sight, this was a lot. I have done more testing since then and have found less sodium still does the trick and I chafe a lot less! But I never felt bad and finishing in 11:37 and in 17th place for my first ever Ironman wasn’t too shabby either.
The bottom line is I tested this amount over and over in training and I knew it worked for me.
TYING IT ALL TOGETHER
Staying hydrated is something that we all know, as athletes, is important. But now you should understand that true hydration is the result of maintaining an adequate level of electrolytes, mainly sodium.
With so much variability across athletes when it comes to sodium needs, performing a sweat rate test and constantly testing your personal sodium intake during training is the sure fire way to set you up for success on race day!
Mountain SJ, Cheuvront SN, Lukaski HC. Sweat mineral element responses during 7 hours of exercise-heat stress. Int J Sport Nutr Exerc Metab. 2007. 17(6): 574-82
Buono MJ, Ball KD and Folkhorst FW. Sodium ion concentration vs sweat rate relationship in humans. J Appl Physiol. 2007. 103:990-4
So you’re thinking about trying out keto. Or maybe you’ve already tried it but feel confused if you’re even doing it “right.” Or maybe you’ve been doing it “right” but felt like it is complicated and unsustainable. Well...I’m here to tell you that it doesn’t have to be that way. Keto can be sustainable, very simple, delicious and also incredibly healthy!
Before I jump into how to make keto simple, let's talk about what it means to truly be “keto”. While many focus solely on eating “all the fat”, there is actually a biological process, known as ketosis, happening. Ketosis is a state in which your body favors fat metabolism over glucose metabolism. To know whether or not you are in ketosis, you would use a monitor which tells you if the ketones in the blood are elevated above baseline.This means that “eating keto” may not be the same for everyone.
In other words, there is no “right” or “wrong” ketogenic diet.
Your ketogenic diet is right when you are burning fat which can be measured with a blood ketone meter. (Just a side note: there are breath ketone meters on the market but as of this publishing, their accuracy is still in question.) This also means that the right ketogenic diet for your neighbor may not be the right ketogenic diet for you.
Just willy nilly eating less than 50g of carbohydrates per day, which is a common recommendation, may or may not get you into a state of ketosis. And believe it or not, some people can eat over 100g of carbohydrates per day and still be in a state of ketosis.
What matters most is that you are burning fat and you’ll know if you are when you can measure ketones in your blood!
So, how do you make that happen...easily?!?
Here are three ways you can get started down the path to becoming a fat burner without a lot of fuss.
Healthy Adrenal Function
Phase 1: Hyper-Cortisol This is the first sign that the body is not handling the stress load optimally. On test results, you see high levels of cortisol throughout the day. Symptoms are typically: anxiety, low immunity, restlessness and insomnia.
Phase 2: Resistance Response This phase is often called the “wired and tired” phase. Here, additional hormone irregularities are seen (especially with blood sugar, electrolyte imbalances and low sex hormones) which can lead to mood and sleep issues along with frequent energy crashes.
Phase 3: Hypo-Cortisol Often described as exhausted, at this phase people are typically feeling completely wiped out. Simple tasks become difficult, motivation across the board is lacking, and people are often described as being “tuned out.” Symptoms are typically: depression, chronic pain all over the body, low immunity and additional hormone imbalances.
It can not be emphasized enough that certain supplements can make your stress pattern worse if they are used incorrectly. If adding supplements to your daily routine to help ease mental stress and support healthy adrenal function is important to you, talk to a knowledgeable practitioner about your symptoms before starting a protocol.
With that said, some of the more common supplements used are:
LICORICE ROOT- For people who do not produce enough cortisol. It has been found to improve energy levels and help regulate cortisol levels.
CURCUMIN- a compound with antioxidant qualities found in turmeric. It has been found to enhance mood and reduce inflammation (especially in the brain). Note: Curcumin extracts are the most potent form of turmeric supplements that will give you the most curcumin compound. Concentrated extracts pack up to 95% curcumin, whereas turmeric in powder form usually contains around 3% curcuminoids.
PHOSPHATIDYLSERINE- a phospholipid found in cells that influence immune function and muscle metabolism. It has been found to help rebalance cortisol levels following exercise.
ASHWAGANDHA- an adaptogenic adrenal supplement. It has been found to improve resistance to stress along with decreasing depression and anxiety.
In an athletes off-season, taking more down time can be critical to recovery. Pay attention to the signals your body is giving you as you take more time doing more relaxing activities (like paddleboarding, yoga, walking, etc) can help you learn where your balance point is.
One athlete may be completely fine doing 3-4 interval sessions per week, where another athlete may become completely exhausted doing that. You can learn to identify what triggers a stress response in you and how to take care of yourself physically and emotionally in the face of these stressful situations and the off-season is a perfect time to do that.
We call it recharging the battery and it’s important! So next time your body is screaming for a nap, listen. It’s okay to skip a few training sessions to allow your body to recover from life's chronic stressors. It doesn’t make you lazy...it makes you smart.
You’ll be surprised how much harder you can hit your next training session (or even your entire next season) when you learn how to find a better balance between your life’s stressors and relaxation!
Take for example the infamous sleep deprivation experiment in 1959 by New York DJ Peter Tripp. He locked himself in a glass booth located in Time Square and made it 201 hours (8.4 days) before falling asleep (the last 66 hours he required stimulants to remain awake). On day 3, Tripp was found laughing hysterically at nothing, and following that day, he continued to hallucinate, reporting mice and kittens running around the room. By the end of the experiment, Tripp was convinced that he was no longer himself, but an impostor. After the experiment ended, Tripp’s family reported permanent changes to Tripp’s personality, including moodiness and depression.
Sleep has been shown to have a direct impact on overall health, lifespan, productivity, safety and ability to learn. Sleep is one of the top five reasons that patients visit a clinic for care every year and lack of sleep has been associated with an increased risk of type 2 diabetes, cardiovascular disease, Alzheimers disease, and even cancer. Along with being an integral part of the recovery and adaptive process between bouts of exercise, accumulating evidence suggests that increased sleep duration and improved sleep quality in athletes are associated with improved performance and competitive success.
This week, we’re focused on sleep. Why? Because it’s something that everyone, especially athletes, tend to neglect when we get busy. We think that shortening our sleep by just one hour will help us get more done, and won’t really affect our health and/or performance. But will it? With COVID thrusting many athletes into an early off season, now is the PERFECT time to start working on finding YOUR perfect sleep routine. To convince you why this is so important, we’re going look at the physiology of sleep, but also the consequences of not getting enough quantity and quality sleep, how to get more (and better) sleep, what to do if your life isn’t set up for optimal sleep, and why prioritizing sleep is something you want to do right now to help your performance in the future!
The Science Behind the Circadian Rhythm
Since our circadian rhythm affects everything from our digestion and appetite, to blood pressure and sleep, a circadian rhythm disruption can have some serious consequences on recovery after exercise and overall health. A study on mice published in 2005 showed the health effects of mutations to a gene that aids in regulating the circadian rhythm in mice, known as Clock. In the study, Clock gene mutant mice were shown to have a greatly altered diurnal feeding rhythm, were excessively hungry, became obese, and developed many metabolic syndromes including hyperlipidemia (an abnormally high amount of fats in the blood) and hyperglycemia without proper insulin production (the hallmark of type 2 diabetes). These results indicate that the circadian Clock gene network plays an important role in mammalian energy balance that involves a number of central and peripheral tissues, and disruption of this network can lead to obesity and the metabolic syndrome in mice.
There are several studies that have looked at how a disrupted circadian rhythm can affect endurance performance, most of which have demonstrated that sleep deprivation inhibits performance. In a small study of 11 male subjects who completed a 30 minute self-paced treadmill test after a normal night sleep and again after 30 hours of sleep deprivation in a randomized order, the subjects distance covered was decreased after sleep deprivation, without differences in thermoregulatory function or oxygen consumption. Several other studies on endurance athletes have found a decrease in time to exhaustion along with an increased rate of perceived effort after just one night of reported poor quality sleep. Preexercise muscle glycogen stores have also been found to be decreased after sleep deprivation, suggesting an alteration in endogenous fuel availability that could translate into impaired performance in endurance sports.
With so much evidence leaning towards optimizing sleep to improve athletic performance and optimized health, there is no reason why learning more about how you can optimize your sleep routine shouldn’t be a focus of your off-season. The off-season is a perfect time to test different activities, methods, foods, workouts, etc to find what works best for your body. N=1 couldn’t be more true in this situation. For one person, eating dinner at 7pm may not affect their sleep whereas another person may not get into deep sleep if they eat after 5pm. Use the quality time you have WITHOUT a race on your calendar to fine tune your sleep routine.
The Sleep Cycle
Non-REM Stage 1
Starts at the onset of sleep and lasts for approximately 20 minutes. In stage 1, our heart rate slows down, our temperature begins to drop, and our brain transfers learned muscle memory into permanent memory. Stage 1 of Non-REM sleep is very light sleep and one can be easily woken in this stage.
Non-REM Stage 2
This is the transitional period between light and deep sleep.
Non-REM Stage 3
This stage is considered complete deep sleep. In stage 3, Delta brain waves are produced which help move blood to the muscles to initiate recovery and repair, the parasympathetic nervous system is stimulated which supports immune function, and human growth hormone is produced.
REM Stage 4
Stage 4 is considered REM sleep and the stage in which we dream. In stage 4, the hippocampus (part of the brain) transfers information to the neocortex and our memories are formed.
These are just some of the reasons that Dr. Matthew Walker, head of the Sleep and Neuroimaging Lab at the University of California, Berkeley, and other sleep experts say that sleeping from midnight until 8am is not the same thing as sleeping from 10pm-6am because the shift from non-REM to REM sleep happens at certain times of the night regardless of when you go to bed. If improved memory and tissue growth/repair isn’t enough of a reason to get to bed early, maybe learning more about the consequences of poor sleep will be.
Consequences of Poor Sleep
Here are a few studies, which are reminders that things like blood sugar, weight, and memory are not affected from our diet alone!
Blood Sugar/Insulin Resistance
A study performed at the Leiden University Medical Center took 9 healthy individuals, with healthy blood sugar response, and restricted sleep for one night (subjects were allowed to sleep from 1am to 5am). The result was insulin resistance in multiple metabolic pathways in all subjects.
Data from large published studies, including: Sleep Heart Health Study; Finnish Type 2 Diabetes Study; Quebec Family study; Behavioral Risk Factor Surveillance System; National Health Interview Study; and Isfahan Healthy Heart Program, have all demonstrated that middle-aged to elderly subjects with self-reported short sleep duration are approximately twice as likely to be diagnosed with type 2 diabetes and are at higher risk for impaired glucose tolerance.
A 2004 study took 1,024 volunteers from the Wisconsin Sleep Cohort Study, a population-based longitudinal study of sleep disorders, and looked at morning fasted blood samples for serum leptin and ghrelin (two key opposing hormones in appetite regulation), adiponectin, insulin, glucose, and lipid profile. Results showed that participants with sleep shorter than 8 hours per night had reduced leptin (the satiation hormone) and elevated ghrelin (the hunger hormone) as well as higher BMI.
A study published in 2009 took 153 healthy men and women and had them report on sleep duration and sleep efficiency for 14 days. Subsequently, participants were quarantined, administered nasal drops containing a rhinovirus, and monitored for the development of a clinical cold for 6 days. Results showed poorer sleep efficiency and shorter sleep duration in the weeks preceding exposure to a rhinovirus were associated with lower resistance to illness.
A study published by the University of Bristol which examined working men and women looked for the associations between sleep duration, cardiovascular disease risk factors and mortality, while also taking into account the perceived stress of the individuals. The findings: the men and women who reported sleeping fewer than 7 hours in a 24 hour period had greater risk of dying from any cause over a 25 year period than those who reported sleeping 7-8 hours in a 24 hour period.
9 Foundations of Sleep
To ensure the right quantity and quality of sleep, there are some sleep foundations you should follow:
Follow a sleep schedule. Every single night at the same time, you should start a series of actions that should stay the same from night to night. The sun setting can be a good trigger to start this routine in the winter, however, in the summer when days are long, setting a standing alarm can help remind you that it’s time to finish eating, put on your blue light blocking glasses, turn off all screens and start winding down.
Eat a diet that promotes quality sleep at the right times.
- Eat a dinner full of melatonin rich foods, such as: tart black cherries, almonds, walnuts, corn, rice and ginger root.
- Avoid caffeine, including chocolate after 12pm
- Avoid alcohol before bed
- Avoid large meals and beverages 2 hours before bedtime
Avoid intense exercise 2-3 hours before bedtime. If your fasted morning blood sugar is higher than ideal, choose 20-30 minutes of a relaxing activity before bed, like gentle walking.
Get your daily dose of natural sunlight for a minimum of 30 minutes per day. If you work in front of a computer all day and wear blue light blocking glasses, make sure you take them off periodically throughout the day and allow your eyeballs to see the natural sunlight. If you can not get out into the natural sun, consider morning exposure to artificial light for at least 1 hour.
Only nap before 3pm.
Schedule time for relaxation for at least 20 minutes before bed. Espom salt baths, foot soaks, reading and meditation are all great options.
Create a bedroom that is most conducive for proper sleep.
- Avoid electronics in the bedroom
- Create complete darkness
- The general suggested temperature for an ideal night's sleep is between 60-67 degrees Fahrenheit.
- Invest in comfortable and non-toxic clothing, pillow, mattress and linens.
Avoid medications that cause stimulation before bed. Some examples of these medications are hypertension, allergy, and thyroid medications. Consult with your doctor about options for taking these medications at earlier times of day in order to optimize your ability to sleep.
Don’t stay in bed if you haven’t fallen asleep after 30 minutes. Instead, move to another room and do something relaxing, like read a paperback book. Avoid jumping onto your phone to check social media, emails or play games. Once you start to feel tired again, move back into bed.
If you are consistently following the 9 sleep foundations above, and are still experiencing constant fatigue and irritability during the day after getting 7-9 hours of sleep, waking up several times during the night, staying awake for more than an hour without being capable of falling back to sleep, or taking longer than 30 minutes to fall asleep, it might be time to seek out a sleep specialist for help.
Helpful Tools for a Good Night's Sleep
For more info on the topic of sleep, I love Matthew Walkers book, Why We Sleep: Unlocking the Power of Sleep and Dreams. He also did a really great podcast with one of my favorite doctors, Dr. Peter Attia which you can find HERE.
If you think you’re getting enough quality sleep, but aren’t quite sure, definitely look into getting an Oura Ring. The Oura Ring is exactly that, a ring that you wear every day and every night that tracks everything from heart rate, body temperature, HRV, sleep cycles and more. Oura interprets these signals while you sleep so you can wake up to the insights you need to take on the day. With the data, you are empowered to understand and define your health on your terms, based on your personalized data. I have personally been using an Oura ring now for over a month and have already been surprised at how small changes to my evening routine have had a profound effect on my deep and REM sleep (and therefore my recovery).
Temperature has a pretty pronounced effect on your sleep cycles. If you share your room and/or household with someone who doesn’t love the bedroom between 60-67F, consider getting a Chili Pad. This pad lives between your mattress and your sheet and can help control the temperature on your side of the bed. You can even set the temperature to increase in the early morning hours to wake you up peacefully. Say goodbye to the BEEP BEEP BEEP alarm. That’s a terrible way to wake up!
By taking the time now (while you have it), to learn more about what helps you get better sleep (which translates into better performance) you can apply your own best practices when it matters most.
Sure, eating dinner at 5pm may not be your reality year around, but if you find that eating early unlocks more deep and REM sleep, don’t you want to make that a priority during your hard training weeks and leading into your future events?
Now’s the time to start playing and tracking some metrics. If you can’t afford a trackable device like an Oura ring, start a journal.
Change 1 thing for 7 days in a row and see if you notice a difference in how you feel the next day in regards to your energy, recovery, mood and hunger levels. You might be surprised how small changes can have a big impact on your health and performance!
- Mesarwi, Polak, Jun and Polotsky, Sleep disorders and the developments of insulin resistance and obesity. Endocrinology Metab Clin North Am. 2013 Sep; 42(3): 617-634
- Taheri S, et al. Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index, 2004
- Cohen S, et al. Sleep habits and susceptibility to the common cold, 2009
- Heslop P, et al. Sleep duration and mortality: the effect of short or long sleep duration on cardiovascular and all-cause mortality in working men and women, 2002
“I want to fit into my skinny jeans again.”
“I want to feel stronger.”
“My doctor told me I need to be more active.”
“I want to be able to play with my grandkids when I’m 90+ years old.”
Whatever your initial reason was for starting, most of us continue to participate in our favorite sport because we have fallen in love with the feeling we have doing it, and hopefully, it makes us a healthier, happier version of ourselves!
Unfortunately, somewhere along the way, many of us became event driven. My circle of training friends had a running joke for years that you never completed an event without having already signed up for at least one other (usually it was like 3-4 other events). This is completely fine to be motivated by races on the schedule, however, let’s not lose sight of why we do all of this. With most of the races being wiped off the calendar in 2020, it’s a fantastic opportunity to reframe your lens and refocus on why you are an athlete.
There's More to Life Than Training!
It involves many other aspects of your life like nutrition, sleep, recovery, strength, mobility, relationships, and so much more.
But the reality is we ALL only have 24 hours in a day. And despite what you may be trying to convince yourself of, we ALL need 7-9 hours of sleep each night. That means that when we get into the thick of training, in order to thrive in one area (our athletic goals), oftentimes other areas are neglected.
In the peak of an ironman training block, I can guarantee you’re giving up time with your non-triathlon friends or family members to get in the long days of training. Hopefully you’re not sacrificing sleep, but some athletes do.
With loads of swimming, biking and running on the schedule, family dinners are often sacrificed for strength training and mobility sessions. This is all fine and dandy for a period of time, but at some point, balance has to be achieved.
Keep focusing on swimming, biking and running and neglecting your strength and mobility (especially as an aging athlete), I can guarantee your risk of injury goes up! Same thing for athletes who only have friends within their training circle. What happens when you get hurt and you can’t join your friends for runs anymore? Your social life disappears? No! We need to have people in our lives who understand, love and support our efforts as endurance athletes, but DO NOT like to play our game.
The Most Common Areas of Neglect
The most common areas of neglect I have seen over the years with endurance athletes are:
- Strength and mobility
This month, I’m giving my tips on how to use this time to be productive to improve your health and wellness and avoid taking massive steps backwards!
You do these sports because you want to be healthier, right?! Throwing in the towel because your events have all been canceled is most definitely NOT my advice. Sure, take some time off if you haven’t done that already but then use this time to optimize your health and athleticism so you can come back in 2021 (or whenever we’re getting back to racing) a better version of yourself.
Honestly, do you really want to start all over again?
Strength & Mobility
Majority of our resiliency is terrible. It seems like every time I hear about someone taking a training break due to an injury, it’s from some regular daily life event, like lifting a grand kid, or trying to get up off the floor, or my favorite from last week was driving a boat.
Seriously people...we are supposed to be “fit.” And if you want your fitness to apply beyond the moments in your life where you are doing your specific sport, you have to be strong and mobile!
During the season, most of us are afraid of taking what limited time we have for training away from our specific sport and using it for strength training. But with no specific race on the calendar, now is the perfect time to focus on strength and mobility.
Areas like the core, glutes and hamstrings (the posterior chain), lower back, and upper body seem to be “weak spots” for most endurance athletes. By replacing 3-4 workouts each week with a strength training session, athletes can see a significant improvement in power and resiliency when they get back to pre-season training next season.
Easy Workouts You Can Do at Home
To make things easier for you, here are 4 workouts (1 in each category) that you can try:
- Dumbbell Bench Press 4x10 with 90 seconds rest between sets
- Superset: Dumbbell Lateral Raises 3x12 - Tricep Dips- Max Effort (no more than 15)*
Rest 2 minutes between supersets
*If 15 is easy, add weight to your lap or put on a weight vest to make it more challenging.
- Single Arm Dumbbell Bent Over Rows on a Bench 4x10 with 90 seconds rest between sets
- Superset: Dumbbell Bent Over Reverse Fly 3x15 - Max Effort Pulls Ups (no more than 15)*
Rest 2 minutes between supersets
*If 15 is easy, add weight by putting on a weight vest or adding weight around your waist with a weight belt.
- Single Leg Dumbbell/Kettlebell Deadlift- 4x8 each leg with 90 seconds rest between sets
- Superset: Weighted Glute Bridge Ups- 3x15 - Weighted Toe Raises- 3x15 - Banded Lateral Monster Walks- 3x20 each direction
Rest 2 minutes between supersets
- Dumbbell Front Squat- 4x8 with 90 seconds rest between sets
- Superset: Single Arm Dumbbell Overhead Walking Lunges- 3x10 each leg- Squat Jumps- 3x10
Rest 2 minutes between superset
You Don't Have to Do This Alone!
So if any of these movements make you uncomfortable or you’d prefer to have someone with training in strength training watch you do it, then you should find a professional to help you!
So many personal trainers have been forced to become creative during this unusual time when many gyms are closed. I have distance clients who are using the strength training programs that I personally have created for them and hired personal trainers in their home town to meet them at an outdoor park and walk them through it.
There are also tons of personal trainers and coaches (including myself) who have their clients video themselves doing a movement and send it to them for critique. Honestly, you don’t have to be face to face with a trainer or coach to get help with strength training. So no more excuses. Start picking up heavy shit and become a better athlete!
Obviously as a coach I’m a huge believer in following a structured program (both for endurance training, strength training, AND nutrition). It is the best way to optimize health and your future performance.
Don't Look Back on 2020 and Wish You Did Something Differently
If it’s not, I can still help point you in the right direction so you feel like you used your “off time” in 2020 wisely and don’t look back at this time in 2021 and wish you had done something different.
“I don’t regret the things I’ve done, I regret the things I didn’t do when I had the chance.” -Unknown
Iron deficiency is near and dear to my heart because I struggled with it for YEARS (and still do if I’m not being mindful and proactive with my iron intake). The fatigue I struggled with was no joke. I chalked it up to over-training, but even after days off, I still felt horrible. And I know I’m not alone. Endurance athletes, especially female runners, have been identified as being high risk for developing iron deficiency. A recent review from The University of Western Australia, Edith Cowan University, and the WA Institute of Sport found that up to 35 percent of female athletes are iron deficient compared to about five percent in the general female population. Male athletes were also iron deficient by approximately 11 percent compared to one percent of the general male population.
Exercise can inhibit the body's ability to absorb iron which puts athletes at a higher risk for iron deficiency than those that don’t exercise regularly. This poses a large concern for athletes because iron deficiency can leave you feeling lethargic and fatigued, it can hinder your ability to recover properly from exercise and in general, it reduces your athletic performance.
THUMBS DOWN to that!
SIGNS OF DEFICIENCY
Iron deficiency is a condition resulting from too little iron in the body. It is the most common nutritional deficiency and the leading cause of anemia in the world.
Anemia is a condition in which you do not have enough hemoglobin in your red blood cells. Hemoglobin is the protein molecule in red blood cells that is responsible for carrying adequate oxygen from the lungs to the body’s tissues and returns carbon dioxide from the tissues back to the lungs. Iron plays a role in the production of hemoglobin in the body, which explains why iron deficiency and anemia are so closely related.
So if you want to breathe easy during exercise, you can see why having enough iron is important! You can also see why one of the leading symptoms of iron deficiency and iron deficiency anemia is shortness of breath.
Other symptoms include:
- Heart palpitations
- Hair loss
- Cold sensitivity (or low body temperature)
- Loss of interest in daily activities such as work, recreation and relationships
- Restless leg syndrome
- Pica (the desire to chew ice)
Vegans and vegetarians are also at high risk for iron deficiency and iron deficiency anemia. This is because the most absorbable form of iron is mostly available in animal products. What limited iron is available from plant based foods is limited in its absorption due to the phytic acid found on these foods. Soaking, sprouting and/or fermenting can help make the iron in plant foods more bioavailable.
Any condition that results in blood loss can lead to iron deficiency and iron deficiency anemia, including heavy menstruation, pregnancy, frequent or excessive blood donation, fibroids, digestive tract disease (including infections), surgeries and accidents.
Alcohol and aspirin abuse have also been shown to reduce iron levels in the body.
- Hemoglobin- commonly found on a standard blood panel called a CBC. Hemoglobin is the iron-containing protein in the blood that carries iron and oxygen to cells. Functional ranges for hemoglobin should be between 13.5-14.5 for females and 14-15 for males.
- Hematocrit- also found on the CBC, this marker provides the percentage measures of red blood cells in the blood. Functional ranges for hematocrit should be between 37%-44% for females and 39%-55% for males.
- Serum ferritin- which is often included in a standard iron panel, is the most reliable indicator of total body iron status and reflects the body’s iron stores. This marker helps medical professionals distinguish between two common forms of anemia: iron deficiency anemia and anemia of chronic disease. Functional ranges for ferritin should be between 60-122 for females, between 60-263 for postmenopausal women and 33-236 for males. However ranges between 60-80 are most ideal for proper thyroid function.
- Serum iron- part of an iron panel and measures the amount of circulating iron that is bound to transferrin and serum ferritin. This is a better marker for iron overload. Functional ranges for serum iron should be between 85-130.
- Total iron-binding capacity (TIBC)- part of an iron panel and measures the blood's capacity to bind iron with transferrin. Functional ranges for TIBC should be between 250-350.
A diagnosis of iron deficiency can only be made by a medical professional when a person has both low hemoglobin and hematocrit, low mean corpuscular hemoglobin (MCH) (functional ranges should be between 27.7-32), low serum ferritin and high red blood cell distribution width (RDW)(functional ranges should be between 11.7%-15%). Iron deficiency without anemia is diagnosed when a person has a normal hemoglobin, but below normal serum ferritin.
It is not uncommon to see a CBC ordered on a standard annual blood panel, but no iron panel ordered. If you check your latest blood panel and you don’t see an iron panel, check your CBC for both hemoglobin and hematocrit. If one or both are low, it is in your best interested to talk to your doctor about ordering an iron panel.
If you need help ordering or interpreting your blood work to see if you show signs of iron deficiency or iron deficiency anemia, reach out to me. I’m happy to review your blood panel and help point you in the right direction. You should never self-diagnose an iron deficiency.
There are many reasons your iron panel can look off on paper and just taking an iron supplement without consulting a professional can result in iron overload, which is a very dangerous condition. Iron overload can cause hepatic cirrhosis, diabetes, hyperpigmentation of the skin and cardigan failure.
While I am a huge advocate of incorporating lots of plants into your meals, it has been found that those with iron deficiency should reduce their intake of all plant based foods and instead focus their meals around iron-rich foods.
If you are a vegetarian due to ethical reasons, then some of the foods you can focus on to up your iron levels include:
- Sprouted legumes
The Recommended Dietary Allowance (RDA) of iron for all age groups of men and postmenopausal women is 8 mg/day; the RDA for premenopausal women is 18 mg/day. Here is a list of some iron rich food sources:
- 3.5 ounces of canned clams- 29.45mg (the iron content in canned clams can widely vary, so be sure to check the label before purchasing)
- 6oz beef- 9.3mg
- 3 ounces of oysters- 7.8mg (also high in zinc!)
- 1 cup white beans (soaked)- 6.6mg
Additionally, the level of iron will increase in your foods if you cook them in a cast iron skillet. This is especially true for high-acid foods such as applesauce, eggs, and tomato-based recipes as these foods encourage the leaching of iron out of the pan. The greater the acidity of the food and the longer you cook it, the more iron is transferred. Generally speaking, one cup of acidic foods cooked in a cast iron pan will gain about six to eight milligrams of iron. Note that highly acidic foods, like tomatoes and citrus juices, should not be cooked in a brand new cast iron pan until the cookware has been highly seasoned.
You can achieve a higher bioavailability of dietary iron by increasing the content of food components that enhance iron absorption, such as ascorbic acid, and by decreasing the content of inhibitors, such as phytates and tannins found on unsoaked plant foods. As previously mentioned, aim for 500-1000mg of vitamin C per meal to optimize the absorption of iron.
The body has a remarkable ability to regulate the uptake of iron through the intestines, so overdose with food consumption is rare and usually only occurs when people take supplements.
One more reason to also optimize your diet before jumping to taking a supplement!
Iron is present in two forms: heme iron and non-heme iron. Heme iron is absorbed from the gut with greater efficiency. Therefore, when supplementation is necessary, look for a natural form of heme iron, like this one.
When taking iron supplements, try to avoid taking it with meals or other supplements as this can decrease the absorption of the iron. Since iron supplements can have unwanted side effects, I typically recommend clients take their iron supplement at least 2 hour after their last meal of the day, right before bed.
There are many causes of iron deficiency which include poor iron intake, menstrual losses, gastrointestinal bleeding, foot strike hemolysis, and even sweat losses. For these reasons, athletes are a higher risk for iron deficiency than sedentary people. Female athletes, runners and vegan/vegetarian athletes are also higher risk.
If you have or are experiencing shortness of breath (especially with every day activities like walking up a flight of stairs), fatigue, heart palpitations, hair loss, dizziness, depression, cold sensitivity (or low body temperature), loss of interest in daily activities such as work, recreation and relationships, restless leg syndrome or pica (the desire to chew ice), you should get your iron levels tested. Either talk to your doctor about testing options, or reach out to me for testing and a comprehensive evaluation of your blood results.
As with ALL the minerals we’ve discussed this month, iron doesn’t work independently to itself so exploring lifestyle factors and other iron cofactors can have a significant impact on your iron status. Don’t sit back and be fatigued when you can make a few changes to your diet and lifestyle and feel energized again!
Zinc is also required to convert vitamin A into its active form which is required for proper vision, especially at night.
Although a blatant zinc deficiency is rare in the United States (it is estimated that approximately 10% of the adult population in the US is deficient), studies have shown that zinc loss through urine increases by 10-45% after moderate exercise.
Zinc, like many of the other minerals we have been discussing this month, is also lost in sweat.
With many athletes' diets being low in mineral density and an increased rate of mineral loss during exercise, it is no wonder why we see thousands of reported clinical trials and studies devoted to exercise performance and mineral status.
And the findings are clear.
Magnesium, zinc, calcium, copper, and iron appear to be the leading minerals impacted by exercise, with magnesium and zinc impacted the most.
Zinc is a key micronutrient for proper cell division and cell growth, so it’s needed to maintain strength in the muscular and skeletal systems. It also helps with the release of growth hormone, testosterone and insulin-like growth factor-1, all of which build muscle mass and help you maintain a healthy metabolism.
Zinc deficiency has been shown to lead to chronic fatigue and low energy levels because it is a key nutrient when it comes time to absorbing both protein and carbohydrates from our food.
There is no question about the increased needs for minerals in athletes, especially zinc. So let’s take a closer look at the signs of deficiency, risk factors, some real food options for optimizing uptake, testing and even best supplementation practices.
SIGNS OF DEFICIENCY
It is not uncommon to see patches of dry skin that lead into acne and/or blisters if the deficiency isn’t resolved.
Other more severe signs of zinc deficiency include:
- Increased infections
- Unable to heal from wounds
- Mood disturbances
- Loss of lean tissue (aka muscles!)
- Hair loss
- Reduced appetite
- Dysregulated sex hormones (especially low testosterone)
- Reduced athletic endurance
- Loss of glucose tolerance
- White spots on your fingernails
There are many plant based foods that contain zinc, but the bioavailability of the zinc is quite low.
This is because of the plant's natural chemical protector, phytic acid. Phytic acid binds to zinc and reduces it’s absorption in the intestines.
Athletes and those that sweat a lot are also at a higher risk for a zinc deficiency because zinc is lost in sweat.
Both inflammation and poor absorption in the digestive tract are also common reasons of zinc deficiency. Therefore, if a zinc deficiency is suspected, both digestive health and overall inflammation should be looked into.
Interestingly, low zinc status has also been shown to affect PMS symptoms in menstruating women.
A small study which measured blood levels of zinc and copper in 10 PMS patients (compared to 10 women without PMS, aka the controls) found that zinc deficiency occurred in PMS patients during the luteal phase (typically days 15-28 of your cycle).
Although this study was small, the differences found in zinc levels in the PMS patients compared to those who did not experience PMS during the luteal phase were significant.
When zinc is not present in adequate levels pre-menstruation, it is not uncommon for women to experience cravings.
If this is you, try adding more zinc into your diet from days 15-28 of your cycle and see if the food cravings reduce and/or disappear.
For a list of foods that can help you identify which nutrients you may be low in, check out my free food cravings list available HERE.
Functional ranges for a plasma zinc test should be between 100-120 mg/dL.
Alternatively, if a blood test is not possible, you can do a zinc taste test (and I HIGHLY recommend doing this!).
The zinc taste test is an easy, inexpensive, at home testing method to assess zinc status based on studies of taste and smell.
To do this test, you will need 5-10mL of aqueous zinc (like Zinc Tally from Metagentics).
Here is how it’s done. Place approximately 2 teaspoons (10mLs) of aqueous zinc in your mouth and hold for 30 seconds. Describe your initial taste according to the following categories (for accurate results, refrain from eating, drinking or smoking for at least one hour prior to the test):
Response 1: No specific taste or other sensation is noticed after the solution has been held in the mouth for up to 30 seconds. This strongly suggests a zinc deficiency and foods rich in zinc and zinc supplementation should be considered.
Response 2: No immediate taste is noted, however, after a few seconds a slight taste develops, variously described as “dry”, “mineral”, “furry”, “sweet”. This suggests a zinc deficiency and foods rich in zinc and zinc supplementation should be considered.
Response 3: Definite, though not strongly unpleasant taste is noted almost immediately and tends to intensify with time. This suggests that zinc is likely inadequate and a strong focus on increasing zinc rich foods and it’s cofactors is strongly suggested.
Response 4: A strong unpleasant taste is noted almost immediately. This suggests that zinc status is sufficient and no zinc supplementation is needed.
The liquid can be swallowed or spit out once the test is completed.
There are many plant based foods that contain zinc, but due to high phytate content in those foods, the zinc has a low bioavailability.
Soaking your nuts, seeds and grains prior to consumption can help decrease the phytic acid and increase bioavailability to the zinc.
Therefore, if you are relying on plant rich sources of zinc, be sure to soak your grains, nuts and seeds first.
The recommended daily allowance (RDA) of zinc is 15 mg for a healthy adult. You can easily get your daily needs by eating any of the following food:
- 6 medium oysters (32 mg)
- 100g watermelon seeds (10.24 mg)
- 4 oz lamb (9 mg)
- 100g pumpkin seeds (7.81 mg)
- 4 oz grass fed beef (5 mg)
If after these have been addressed, a zinc deficiency is still suspected, consider supplementation. Always talk to your doctor about taking any over the counter supplements to ensure they are safe for you and will not interact with any other medications.
According to Chris Masterjohn, PhD, zinc acetate, gluconate, sulfate, citrate, or methionine should be used when supplementing with zinc, and not zinc oxide or zinc picolinate.
Ideally, zinc should be taken on an empty stomach, but if this causes nausea it should be taken with some food and should be taken as far away from phytate-rich meals as possible. The zinc should be spread out as much as possible to ensure better absorption. For example, 15 milligrams three times per day five hours apart is much better than taking 45 milligrams once per day.
Zinc supplementation higher than 45mg per day should never be used unless under medical supervision. Excess zinc consumption can cause a copper deficiency as they compete for the same receptors in the body.
According to a study published in Sports Medicine in 2001, endurance athletes who follow a higher carbohydrate, lower protein and lower fat diet often leads to suboptimal zinc intake in 90% of those athletes. Mild zinc deficiency can be difficult to detect because of the lack of definitive indicators of zinc status. This can put athletes at risk for reduced endurance, loss of muscle mass and at greater risk of stress fractures. Zinc deficiency has been shown to reduce muscle strength and power, so inadequate zinc levels could affect performance during exercise.
The bottom line is you need to get tested. If a plasma blood test is out of the question, get your hands on aqueous zinc and do your own at home zinc taste test.
You don’t want a mineral deficiency hurting your overall health or athletic performance!
2. Chuong and Dawson, Zinc and copper levels in premenstrual syndrome, FERTILITY AND STERILITY, Vol. 62, No.2, August 1994
3. Sports Med. 2001;31(8):577-82.doi: 10.2165/00007256-200131080-00002. Zinc status in athletes: relation to diet and exercise. A Micheletti, R Rossi, S Rufini
Like many, if you are an athlete who spends time recreating outdoors, you might suspect that your vitamin D levels are adequate.
Maybe. But maybe not.
The latest research being done on vitamin D levels and sports performance is finding that athletes, even those that regularly workout outdoors, have vitamin D levels that are comparable to those of the general population (aka- low).
Vitamin D is known as the sunshine vitamin. It is a fat soluble vitamin whose main role is to help the body absorb calcium, magnesium and phosphate through the intestines.
For decades, we have known vitamin D’s role in bone health, but in the last decade, more and more research is being done on vitamin D and the science is finding the importance beyond just bone health.
For example, the evidence is showing that vitamin D also plays a role in:
- Immune function
- Protein synthesis
- Muscle function, especially in fast twitch, type II muscle fibers
- Cardiovascular function
- Inflammatory response
- Cell growth
- Musculoskeletal regulation
In plain English, all things that affect sports performance!
Vitamin D has been shown to improve muscle mass and strength, accelerate the recovery of muscles from intense exercise, prevent muscle degeneration, improved oxygen exchange in the lungs, and improve the structural remodeling of cardiac muscles.
A meta-analysis completed in 2011 that grouped together 23 different studies and was composed of 2313 athletes found that 56% had insufficient levels of vitamin D!
So please don’t assume that just because you regularly workout outside, that you are vitamin D sufficient. Read on to learn more about testing so you can find out exactly what your vitamin D levels are and take action, if needed.
It is not uncommon for people with vitamin D deficiencies to have musculoskeletal pains that are misdiagnosed as fibromyalgia or chronic fatigue syndrome.
Muscle strength, or lack thereof, can also be a sign of a vitamin D deficiency.
Two separate studies from 2011 and 2013 found that low vitamin D levels were negatively associated with muscle strength markers.
That means that the lower the vitamin D levels, the weaker the muscles!
Because the majority of our vitamin D is obtained via sun exposure, things like atmospheric pollution (which decreases the UVB rays from reaching the Earth's surface), the use of sunscreens, latitude, weather and lifestyle will all affect our vitamin D levels.
Athletes who have darker skin are also at a higher risk for a vitamin D deficiency since the pigmentation of the skin can block UVB rays from reaching the skin cells.
One study showed that athletes with darker skin need up to 10 times longer exposure to UVB radiation to obtain the same levels of vitamin D as lighter skinned athletes.
This test was developed in 2017 and measures the concentration of unbound vitamin D which is the biologically active form that can pass through the cell membrane and actually carry out its intended function.
This test also measures vitamin D obtained from all sources (sun, food and supplements).
Protein bound vitamin D levels can also be measured by a blood test.
However, the issue here is that your body can have a problem converting the bound vitamin D to unbound vitamin D. If that is the case, and you only measure the protein bound vitamin D levels, you may get a “normal” result but still have inadequate active vitamin D., but if there is dysfunction in the unbinding process, this test will be irrelevant.
When getting a vitamin D test done, you should refer to the functional 25(OH)D range for optimal vitamin D which is between 30-40 ng/mL.
Since levels of vitamin D are highly affected by sun exposure, I highly recommend all athletes get their vitamin D levels tested twice per year.
One time in the winter and again in the height of summer.
These results will be suggestive of your high and low levels of vitamin D throughout the year and can be used to put together a proper supplementation protocol specific for your body.
Once obtained in the body, both forms must undergo activation within the liver and/or kidneys to be biologically available to our tissues (this is the process I referred to earlier that people may not realize is not working properly. This is why it is important to measure your free or unbound vitamin D levels).
The main source of vitamin D obtained by humans is vitamin D3.
It is created endogenously, primarily through the interaction of sunlight (specifically UVB rays) with our skin. However, a very small amount of vitamin D can also be obtained exogenously through diet.
Consuming adequate levels of vitamin D through the diet is difficult because very few foods contain it naturally. The exceptions are:
- Cod Liver Oil (1 tbsp = 1,360 IU)
- Sockeye Salmon (3 ounces = 645 IU)
- White Mushrooms (½ cup raw = 366 IU)
- Canned Sardines (2 sardines = 46 IU)
- Egg Yolk (1 yolk = 44 IU)
- Beef Liver (3 ounces = 42 IU)
Traditionally, many people obtain vitamin D through foods that have been fortified with it, such as milk, breads, and cereals.
Getting out into natural sunlight without sunscreen or clothes that cover your skin for a short time each day is the best way to increase your vitamin D naturally.
If lifestyle changes still don’t increase your vitamin D levels, and you are consuming foods rich in vitamin D regularly, it may be time to consider supplementation.
The recommended daily allowance of vitamin D for adults ages 19-70 years old is 600 IU daily.
However, testing is critical before supplementation.
Excess vitamin D intake can increase your risk for soft tissue calcification. And for many, 600 IU of vitamin D will not be adequate to bring their vitamin D levels into a functional range.
Keep in mind that like all micronutrients, vitamin D status is not independent to itself.
Calcium levels, sun exposure and inflammation will all have an effect on your vitamin D levels and need to be addressed if vitamin D status is low.
When supplementing with vitamin D3, one should look for a supplement that also includes vitamin K. Like vitamin D, vitamin K is also a fat soluble vitamin. It is found naturally in leafy greens, fermented vegetables, egg yolks, liver and cheese.
Vitamin D and vitamin K work together in the body as a team.
Vitamin D ensures that your blood levels of calcium are adequate, however, it does not control where the calcium ends up within the body. That is the role of vitamin K.
Vitamin K promotes calcium accumulation in the bones, and reduces the risk of calcification of calcium in the soft tissues, such as your kidneys and blood vessels.
My favorite vitamin D supplement is made by Designs for Health and is called Vitamin D Supreme. Just remember, before just ordering and taking any ol’ vitamin D supplement, test your levels first and consult with your medical provider over the results.
Given the evidence of high incidence of vitamin D deficiency, the relatively few sources of vitamin D in the food supply, and the environmental factors that limit an athlete’s ability to synthesize vitamin D, proper supplementation may become one of the most essential parts of an athlete’s nutrition protocol.
If testing and crunching numbers isn’t your thing, set up a free discovery call to talk to me about how I can help you look at not just your vitamin D status, but how all of your blood markers are working together to create optimal health for you.
1) Role of Vitamin D in Athletes and Their Performance: Current Concepts and New Trends, Nutrients. 2020 Feb; 12(2): 579. Published online 2020 Feb 23
2) Forrest K.Y., Stuhldreher W.L. Prevalence and correlates of vitamin D deficiency in US adults. Nutr. Res. 2011;31:48–54. doi: 10.1016/j.nutres.2010.12.001.
Not only can having an active movement routine leave you short on calories if you aren’t being mindful of your true calorie/energy needs, but it can have a serious effect on your micronutrient status as well.
Micronutrients aren’t called “micro” because they are less important than our macronutrients.
They are called micronutrients because we need them in smaller quantities than our macronutrients, but they are equally, if not MORE important.
If you have an active movement routine, you are certainly at a higher risk of becoming micronutrient deficient!
The most common sign of a deficiency are food cravings!
These can come from high stress, low caloric intake, high intake of processed foods (which are void of natural micronutrients) and low protein intake.
When your body becomes micronutrient deficient, you might experience a whole slew of symptoms, including numbness and tingling in hands, legs or feet, balance problems, anemia (which is NOT just an iron deficiency problem!), swelling, weakness, fatigue, impaired immunity, higher risks of injury and even paranoia!
Ugh, no one wants ANY of that! Especially if you are trying to move your body to PROMOTE health, not make it worse!
If you are experiencing any of these symptoms, especially food cravings, you should check out my free food cravings chart to learn which foods you should be targeting to increase in your diet!
This week, we are diving into the details on calcium deficiency, including the signs of deficiency, risk factors, what role calcium plays in athletic performance, real food options for optimizing uptake, testing and even best supplementation practices.
AND, I’m focusing on NON-dairy sources of calcium since dairy tends to be a top allergen for many people (and most don’t even know it!) and we don’t need dairy to be calcium sufficient!
We know that it is essential for the formation of bones and teeth, but it is also critical for optimal athletic performance!
Besides aiding in healthy bones and teeth, calcium aids in:
- proper muscle contraction
- activation of the enzyme lipase which breaks down fat stores to produce energy
- blood clotting when injuries occur
- proper blood pressure stabilization
- insulin sensitivity so you can optimally use glucose during training and racing
- creating normal heart rhythm
Approximately 99% of the body’s calcium is stored in the bones, but cells, particularly muscle cells, and blood also contain some calcium.
There are 2 main hormones in the body that help very precisely control the amount of calcium in the blood: parathyroid hormone and calcitonin.
If you do not consume enough calcium in your diet, these hormones will steal calcium from the bones to meet the needs of the blood and can result in much higher risk of stress fractures.
Since early signs of calcium deficiency are not apparent, a DEXA scan is the best and most accurate way to learn if you have decreased bone density or osteopenia (the less severe form of osteoporosis).
I have to say, I have seen a lot of DEXA scans in my private practice and I am always saddened by the lack of bone density in endurance athletes, especially compared to the DEXA scans I see from strength based athletes. Beyond just a lack of weight bearing activities, this can be one of many signs that there may be a calcium deficiency.
To maintain a proper level of calcium in blood without weakening the bones, it is recommended to consume at least 1,000 to 1,500 milligrams of calcium each day from real food sources.
When you're consuming and absorbing enough calcium, your need for vitamin D will go down.
The opposite is true for phosphorus, where when you over consume it, it will drive up your need for both calcium and vitamin D! This is an important reminder that just willy-nilly taking random supplements without really knowing if you truly need them can actually drive a deficiency in other micronutrients!
The goal with micronutrients is about finding balance: not too much and not too little. This is especially true with Vitamin D, calcium and phosphorus!
If your head is already spinning just wondering how you’re going to be able to figure out your own balance and needs, don’t worry! Tailoring diet, supplement, and lifestyle changes based on bioindividual needs is what I love to do. So if you’re looking for some help, you can schedule a discovery call to learn about how I can support you!
- Heart palpitations
- Raised blood pressure
- Achy joints
- Tooth decay and brittle nails
However, since these signs appear under more extreme calcium deficiencies, getting a DEXA scan to assess bone density levels can be a helpful first step in discovering potential calcium deficiencies.
Female athletes who have developed amenorrhoea (loss of menstrual periods) or other menstrual irregularities due to low estrogen levels are at greater risk for reduced bone density, fractures and osteopenia. This is because low estrogen levels lead to low calcium levels and can result in bone loss.
25-hydroxyvitamin D is a standard blood test you can obtain from your medical doctor. This marker will measure your serum vitamin D levels. If your results come back low, this can be the result of a calcium deficiency or presence of excess phosphorus.
Functional 25-hydroxyvitamin D levels should be between 30-40 ng/mL.
Parathyroid Hormone, or PTH, can help you understand your Vitamin D, calcium and phosphorus levels. A deficiency in either calcium and/or vitamin D levels can raise your PTH levels above normal values.
Functional parathyroid hormone levels should be between 10-55 pg/mL.
Calcitonin, the hormone that is responsive to calcium levels in the blood, can be measured in the serum. Excess consumption of calcium will raise this marker. This marker can be especially useful when someone is supplementing with calcium to ensure excess calcium isn’t being consumed and absorbed.
Function calcitonin levels should be less than 10 pg/mL.
It is always critical when you have testing completed that you work with a practitioner who understands the individual values in addition to how they all work together to create optional health. Having the knowledge about your own body is one thing, but knowing how to use that knowledge to optimize your health is another. Always consult with a knowledgeable medical provider when obtaining and reviewing testing!
If you need help interpreting your lab tests, reach out to me for help!
- Canned fish with bones (sardines, anchovies, salmon with bones)
- Collagen powder (especially marine collagen)
- Collard greens
- Turnip Greens
- Bok Choy
- Soaked white beans
- Broccoli Rabe
Spinach, which is often thought of as a good source of real food calcium, is purposefully left off of the list of recommended foods because spinach is particularly high in a substance called oxylate. Oxylate reduces absorption of calcium!
Another substance that adversely affects calcium absorption is phytate, found in many plant foods and especially legumes, nuts and seeds
Phytates are considered by some to be “anti-nutrients”. They are a plants defense mechanism since, unlike animals, plants cannot run away from their predators! So they have these compounds that help them survive.
Unfortunately for us, phytates can be irritating to our GI system and they can bind minerals in the digestive tract, preventing them from being fully absorbed.
This is why it is recommended to soak and rinse your beans, nuts and seeds prior to consumption, as this can help breakdown the phytates.
Since many plant foods have limited ‘bio-availability’ of calcium, this means that you need to choose several different foods on the list above to meet your calcium requirements if you don’t consume dairy products or animal products with bones!
Vitamins and minerals work in close balance with one another. When one is too high, it can easily deplete another.
So prioritizing a nutrient rich whole food diet that is varied in many different types of foods is always your best approach to nutrient sufficiency. However, there are times when we can’t consume enough food to meet the demand of our nutrients (for example, during times of high training or stress). It is during these times that proper supplementation can be helpful.
If you avoid dairy products, I highly recommend you get a free Cronometer account online and track your calcium intake for a few days. If you find that you are consuming under the daily RDA of calcium (1,000-1,500mg daily), you might want to consider a calcium supplement.
800-1,200 milligrams of calcium citrate should be considered.
Since calcium relies heavily on Vitamin D and phosphorus status, you will also want to keep a close eye on those levels. High levels of phosphorus will deplete calcium levels. A diet high in processed foods is the largest risk factor for excess phosphorus intake. Therefore, avoiding processed foods, especially soda which is high in phosphoric acid, is your best defense against high levels of phosphorus and low levels of calcium.
If you don’t want to miss it, or any future posts or announcements, be sure to sign up for my Wednesday Wellness email where each week I’ll send helpful nutrition tips right into your inbox!
- ¼ cup organic olive oil
- 1 cup of avocado oil mayo (no canola or safflower oil)
- Zest from 1 lemon
- Fresh lemon juice from 1 lemon (about ¼ cup)
- 3-6 anchovies from a can, oil drained
- 2 cloves of fresh garlic
- 1 tsp fresh ground black pepper
- 1 cup fresh Parmesan cheese, optional
- 1 tsp local honey
- Add all ingredients to a high powered blender and blend until smooth.
- Place the dressing in a glass jar and store in the fridge for at least 2 hours. The dressing will thicken as it rests in the fridge.
- Pour over your favorite Caesar salad ingredients (I personally love romaine lettuce, roasted brussel sprouts, grilled chicken and homemade gluten free sourdough croutons).
But calories aren’t the only thing you need more of!
Micronutrients are also needed in larger quantities by those who use their body more regularly than the average person, and this is especially true in more extreme weather, like very hot summer days. Nutrient deficiencies are more common than you might think in athletes and these deficiencies can lead to poor performance, injuries, sickness and long term health issues.
This month, I’m focusing on the 5 most common nutrient deficiencies seen in athletes:
- Vitamin D
Each week, we are going to dive into the details on each micronutrient including the signs of deficiency, risk factors, what role each plays in athletic performance, real food options for optimizing uptake, testing and even best supplementation practices.
Get ready to fine tune your diet to optimize your health, performance and recovery...starting with magnesium.
As an athlete, magnesium is particularly important as it is known as the “muscle relaxing” micronutrient. It also aids in protein synthesis, cellular energy production, proper nerve and muscle function, proper immune system function, proper blood glucose levels and calcium absorption (another common deficiency in athletes!).
If you have gone through the “fat adaptation” process, magnesium plays a key role in creating energy (ATP) from fatty acids. So if you live a low carb, high fat lifestyle, this nutrient is critical for you to feel great!
The Recommended Daily Allowance (RDA) for magnesium ranges from 400-420mg for males ages 14-70 years old, and 310-320mg for women ages 14-70 years old.
It is estimated that approximately 60% of adults in the US do not consume the RDA for magnesium.
Since athletes are typically putting a higher demand on their bodies and are losing magnesium more quickly through sweat and urine than the average Joe, it is recommended for athletes to consume between 500-800mg of magnesium daily.
- Weakness and fatigue
- Muscle twitches and spasms
- Low blood levels of calcium
- Low blood levels of potassium
- Vitamin D deficiency that is resistant to standard treatments
If you’ve ever felt like you have ants crawling under your skin, it’s likely a magnesium deficiency!
Another sign of magnesium deficiency is a craving for chocolate! Chocolate has one of the highest concentrations of magnesium so it is no surprise that we crave the stuff if we are deficient.
(There are other food cravings that can indicate a nutrient deficiency, download my FREE Food Cravings Chart to learn what your food cravings mean!)
The most commonly reported diseases which involve magnesium deficiency are all associated with chronic inflammatory stress conditions. With athletes of all types putting high stress demands on their bodies, this should make magnesium sufficiency a top priority for long term health, optimal performance and adequate recovery!
Protein pump inhibitors and antacids also block the absorption of magnesium, which will cause a deficiency.
Any medication or disease (such as insulin resistance and type 2 diabetes) that increases the rate of urination will increase the rate of magnesium lost and will create a deficiency.
All regular sauna users and all athletes are at high risk for magnesium deficiency, especially if they workout in hot conditions. Magnesium is lost in sweat, which means summer months or athletes who workout in warm indoor environments are more at risk for a deficiency.
Numerous studies have been conducted over the years on athletes and their nutritional status of magnesium. Time and time again, results come back with a low dietary intake of magnesium across all ages and athlete types. Other tests have also indicated a link between magnesium deficiency and low antioxidant status, suggesting that magnesium plays a role in antioxidant production. Antioxidants are critical to reducing oxidative stress, promoting recovery and enhancing performance, so you want to make sure you have enough magnesium on hand to optimize this.
Other testing methods include:
- Red Blood Cell Magnesium test- which is best for detecting early signs of magnesium deficiency.
- Magnesium Loading Test- which is the gold standard for magnesium testing. However, this test can be impractical for some people as you are required to collect your urine over a 24 hour period.
All 3 tests can be ordered from www.DirectLabs.com. However, having a practitioner trained in reading test results is critically important to setting up the right protocol. If you're interested in exploring testing options, click here to schedule a free discovery call to learn about how I can help you choose the test that's right for you AND evaluate it.
All minerals and vitamins have cofactors, so a low or high test result can be an indication of more than just magnesium status. For example, red blood cell magnesium may be low in a test result which can be an indication that the cofactors needed to drive the magnesium into the cells are missing.
So just taking more magnesium may not help you if you don’t have the nutrients required to get it into the cell.
- Sunflower Seeds ¼ cup (without the shell)= 119mg
- 1 ounce almonds= 80mg
- ½ cup steamed spinach= 78mg
- 2 tbsp sesame seeds= 60mg
- ½ cup cooked black beans= 60mg
- 1 cup avocado= 44mg
- 3.5 ounces of cooked potato (with skin)= 43mg
- ½ cup cooked brown rice= 42mg
Pure Encapsulation Magnesium Glycinate- magnesium glycinate is the most absorbable form of magnesium. Therefore, if you are feeling twingy muscles, palpitations or just a general unsettling in your muscles, this is the best option.
Pure Encapsulation Magnesium Citrate- magnesium citrate is less absorbable by the gut than glycinate and will be more likely to cause loose stool. If constipation is a concern, this is your best option. Start slow (1 capsule in the AM) and slowly increase your dose until more regular bowel movements are obtained regularly. Keep in mind that hydration, and other factors, play a HUGE role in regularity. If you’ve increased your dose to 350mg per day and are still not seeing any regularity in your motility, speak to someone who can help you explore additional options.
Trace Minerals Topical Magnesium Spray or cream- It is not uncommon, especially for athletes, to need a large amount of magnesium to maintain sufficient status and avoid symptoms associated with deficiency. It is also not uncommon to need more magnesium than your GI system can handle without causing loose stool. If you suspect this might be your problem, or you already struggle with loose bowel movements, try applying magnesium topically instead. You can apply a spray or cream to your affected muscles, or take a nice long epsom salt bath. Your skin is the largest absorptive organ in the entire body, so use it to benefit your magnesium status! If you're not into soaking in a epsom salt bath, soak your feet instead. Our feet have over 7,000 nerve ending and the largest pores on our skin surface, so you're able to absorb efficiently through them.
Excessive oral supplementation of magnesium will result in loose stool or diarrhea as magnesium is a laxative. For someone who suffers from constipation, this might sound nice, but keep in mind that you are losing much more than just magnesium when your body flushes like that. Diarrhea is never good long term and is an indication that something is not right in the body.
When it comes to supplements, it’s always a good idea to consult a professional.
How to Know if You are Getting Enough
My favorite free online micronutrient tracker is Cronometer.
If you find that you are not reaching 500-800mg daily, or that you still have any of the signs of magnesium deficiency mentioned earlier, consider taking a clean supplement for a few weeks and see if you notice a difference!
As mentioned above, a magnesium deficiency can impact more than just your magnesium status. Since all minerals are connected to each other, and there are cofactors in the body that work alongside magnesium, a deficiency in one area usually means an imbalance elsewhere.
Next week, I will be talking to you about Calcium. Although so many of us believe we are getting enough calcium in our bodies, the fact is that we don’t OR we are deficient in the cofactors that help our body absorb and utilize this micronutrient.
Make sure you don’t miss next week’s blog by signing up for my weekly newsletter here.
1) Magnesium and the Athlete. Volpe, Stella Lucia PhD, RD, LDN, FACSMAuthor Information
Current Sports Medicine Reports: July/August 2015 - Volume 14 - Issue 4 - p 279-283
2) Altura BM, et al. Magnesium depletion impairs myocardial carbohydrate and lipid metabolism and cardiac bioenergetics and raises myocardial calcium content in-vivo: relationship to etiology of cardiac diseases. Biochem Mol Biol Int 1996 Dec;40(6):1183-90.
I know this is not EVERYONE’s situation, but it is starting to happen around the world.
I certainly don’t want to get into a debate on whether or not gyms should be reopening, but whatever you believe, one thing is FOR SURE...we are not starting back up where we left off!!!
Our body is in a different place now then it was pre-quarantine.
And listen closely: THAT IS OKAY!
It’s okay to have lost some momentum during this time. But PLEASE do not re-enter the gym, guns blazing, thinking you’re going to be able to lift or move in the same way you once did without injuring yourself.
I know that can be a frustrating concept to take in but:
- You’re not alone (we’re all in this together!)
- This is a great chance to start all over and work your way up properly.
So instead of getting frustrating and feeling down on yourself about “everything you lost while in quarantine,” here are some tips to help you get back to regular movement safely:
TIP #1 - Cut your workouts in half
If you have had the ability to keep working out at the same capacity, then this may not apply to you. But since the majority of us lost access to equipment and spaces, we likely had to scale back a ton even if we did work out during lockdown.
So, if you were swimming 3,000 yards before quarantine, consider swimming 1,500 yards the first few times you jump back into the pool.
Again, I know you may want to just get right back to your old distances, weights, and reps but I promise if you start low you can build up, without injuring yourself, in no time! Plus, something tell me that half of a your old workouts is still more than your quarantine workouts so look at it as a step forward.
If you are still concerned about getting in enough volume, try tip #2.
I realize that some people can’t logistically make this happen, but if you can, you should.
Since you might not be used to the volume you were doing pre-COVID, allowing your body some reset time between sessions by splitting them up into 2 smaller sessions is wise.
Instead of reinforcing bad form, which can develop when you get tired, allow some rest, maybe even eat a meal or two, and finish up your session later in the day when you are more fresh again.
Then you get to say you’re doing 2-a-days ;-)
This is another one that might be difficult to do for some of you. But rest is crucial, whether you have been consistent with your workout routine or not.
If you were used to only resting 10-20 seconds between sets, consider doubling that for a few weeks.
This will give the muscles a fighting chance of repeating your movement with good form. There is no sense in continuing a workout when your form is completely gone. This will just reinforce improper movement and greatly increase your risk of injury.
Whether you’re going back to the gym or going outside for more frequent workouts, please keep these tips in mind. The last thing you need is to jump into something too aggressive only to find yourself back on the couch due to injury.
We all want to get back to a normal workout routine, but let’s do it safely so that we can ensure long term physical health.
If you’re looking to get back into a regular routine but are not sure where to start or are nervous that you may do it incorrectly, let’s chat! I offer training support alongside nutrition coaching so that you can find what works best for you and allow your body to thrive!
Tiana Rockwell is a certified nutritional therapist, avid endurance athlete and dark chocolate lover. She believes that by eating REAL food, we can balance our body and reach optimal health and wellness!