How to Fuel for Health

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There is an important movement going on right now in sports nutrition. The trend with top pros—which is filtering down to endurance athletes at all levels—is gut training for higher simple-sugar consumption. It wasn’t that long ago that experts saw 60 grams per hour as the upper limit of the amount of sugar we could eat. Now, some of the biggest names in sports nutrition are promoting 120 g per hour, even on training rides! 

Experts point to this higher sugar consumption as a key explanation for the improved performance level they’re seeing at races like the Tour de France. This leads some to say that it is absolutely necessary for performance, while others believe that we can perform at our best on a high-fat and even ketogenic diet. There are top names on both sides of this debate, and we’ve had this conversation with many of them on this show.  

RELATED: Fast Talk Episode 272—Is There a Place for Low-Carbohydrate Diets? 

The one thing that’s not debated is that high simple-sugar consumption is bad for our health. In fact, the body of research showing sugar’s negative impact on heart disease, cancer, cognitive decline, and diabetes is growing weekly.  

So, while those couple gels may be the difference between winning and losing your next race, the more important question is whether they’re the best choice on your four-hour base ride in winter. Should we be making healthier choices when we’re training? And even when we’re racing?  

To help us answer that question and to offer their suggestions on how to best fuel for health, Trevor Connor speaks with two top experts in sports nutrition: Dr. Mikki Williden and Dr. Paul Laursen. Dr. Williden hosts the Mikkipedia podcast on nutrition, health, and longevity and is the creator of Mondays Matter, a successful fat-loss group program. Dr. Laursen is the owner of Athletica.ai and is a highly respected researcher who has published many studies on sports nutrition.  

They discuss what a health-first perspective looks like and how, in our focus on high-carb/low-carb and high-fat/low-fat, we’ve forgotten about the importance of foods. They also talk about getting enough fiber and micronutrients in our food; healthier sources of carbs, protein, and fat; and finish up by giving their suggestions of healthier things you can eat during your workouts.  

Along with our main guests, we also hear how to fuel for health from Dr. Brendan Egan, a physiologist at Dublin City University; mental performance coach and commentator, Brent Bookwalter; and founder of Cerebral Performance, Dr. Scott Frey. 

So, decide if you want to put a banana or gel in your pocket, and let’s make you fast! 

RELATED: Fast Talk Episode 329—Nutrition Approaches for Ultra-Endurance Events 

Dr. Williden’s Almond Orange Bark Recipe

References:

1. ​Clark, A., & Mach, N. (2016). Exercise-induced stress behavior, gut-microbiota-brain axis and diet: a systematic review for athletes. Journal of the International Society of Sports Nutrition, 13(1), 43. Retrieved from https://doi.org/10.1186/s12970-016-0155-6 
2. ​Frączek, B., & Pięta, A. (2023). Does the Paleo diet affect an athlete’s health and sport performance? Biology of Sport, 40(4), 1125–1139. Retrieved from https://doi.org/10.5114/biolsport.2023.123325 
3. ​Hawley, J. A., & Leckey, J. J. (2015). Carbohydrate Dependence During Prolonged, Intense Endurance Exercise. Sports Medicine, 45(Suppl 1), 5–12. Retrieved from https://doi.org/10.1007/s40279-015-0400-1 
4. ​Hughes, R. L., & Holscher, H. D. (2021). Fueling Gut Microbes: A Review of the Interaction between Diet, Exercise, and the Gut Microbiota in Athletes. Advances in Nutrition, 12(6), 2190–2215. Retrieved from https://doi.org/10.1093/advances/nmab077 
5. ​Kelly, R. K., Tong, T. Y. N., Watling, C. Z., Reynolds, A., Piernas, C., Schmidt, J. A., … Perez-Cornago, A. (2023). Associations between types and sources of dietary carbohydrates and cardiovascular disease risk: a prospective cohort study of UK Biobank participants. BMC Medicine, 21(1), 34. Retrieved from https://doi.org/10.1186/s12916-022-02712-7 
6. ​Ludwig, D. S., Dickinson, S. L., Henschel, B., Ebbeling, C. B., & Allison, D. B. (2020). Do Lower-Carbohydrate Diets Increase Total Energy Expenditure? An Updated and Reanalyzed Meta-Analysis of 29 Controlled-Feeding Studies. The Journal of Nutrition, 151(3), nxaa350-. Retrieved from https://doi.org/10.1093/jn/nxaa350 
7. ​Maffetone, P. B., & Laursen, P. B. (2016). Athletes: Fit but Unhealthy? Sports Medicine – Open, 2(1), 24. Retrieved from https://doi.org/10.1186/s40798-016-0048-x 
8. ​Pase, M. P., Himali, J. J., Beiser, A. S., Aparicio, H. J., Satizabal, C. L., Vasan, R. S., … Jacques, P. F. (2017). Sugar- and Artificially Sweetened Beverages and the Risks of Incident Stroke and Dementia. Stroke, 48(5), 1139–1146. Retrieved from https://doi.org/10.1161/strokeaha.116.016027 
9. ​Perry, C., Pick, M., Bdolach, N., Hazan-Halevi, I., Kay, S., Berr, I., … Grisaru, D. (2013). Endurance Exercise Diverts the Balance between Th17 Cells and Regulatory T Cells. PLoS ONE, 8(10), e74722. Retrieved from https://doi.org/10.1371/journal.pone.0074722 

Episode Transcript

Trevor Connor  00:04

Hello and Welcome to Fast talk. Your source for the science of endurance performance. I’m your host. Trevor Connor, flying solo today. There’s an important movement going on right now in sports nutrition, the trend with top pros, which is filtering down to endurance athletes at all levels, is gut training for higher simple sugar consumption. It wasn’t that long ago that top experts saw 60 grams per hour as the upper limit of the amount of sugar we could consume. Now some of the biggest names of sports nutrition are promoting 120 grams per hour even on training rides. Experts point to this high sugar consumption as a key explanation for the improved performance level they’re seeing at races like the Tour de France, leading some to say that it’s absolutely necessary for performance, while others are saying that we can perform at our best on a high fat and even a ketogenic diet. There are top names on both sides of this debate, and we’ve had this conversation with many of them on the show. The one thing that’s not debate is that high simple sugar consumption is bad for our health. In fact, the body of research showing sugar’s negative impact on heart disease, cancer, cognitive decline and diabetes is growing weekly. So while those couple gels may be the difference between winning and losing your next race, the more important question is whether the best choice on your four hour base ride in February, should we all be making healthier choices when we’re training and even when we’re racing? To help us answer these questions that offer their suggestions on how to best fuel for health. I’m talking today with two experts in sports nutrition, Dr Mickey Wilden and Dr Paul Larson. Dr Wilden hosts the Mickey pedia podcast on nutrition, health and longevity as the creator of Mondays matter, a successful fat loss group program. Dr Larsen is the owner of athletica.ai and is a highly respected researcher who’s published many studies on Sports Nutrition. Today, we’ll talk about what a health first perspective looks like, how in our focus on high carb, low carb, high fat, low fat, we’ve forgotten about the importance of foods. We’ll also talk about getting enough fiber and micronutrients in our foods, healthier sources of carbs, protein and fat. And we’ll finish up by giving all of our suggestions on healthier things you can eat during your workouts. Along with our main guests, we’ll hear from Dr Brendan Egan, a physiologist at Dublin City University, mental performance coach and commentator, Brent buelter and founder of cerebral performance, Dr Scott fry. So decide if you want to put a banana or gel in your pocket, and let’s make you fast. Well, Dr, wild and Dr, Larson, it’s great to have you on the show. I’ve been looking forward to this conversation because, as you know, this is a subject I love. So thank you for joining us.

Dr. Mikki Willide  02:31

It’s great to be here. Thanks,

Dr Paul Laursen  02:32

Trevor, thanks for having us. Trevor. And

Trevor Connor  02:35

I think a good place to start is just to briefly touch on the motivation for this episode. We did have an episode not all that long ago, talking about fueling during rides. And on that episode, it was brought up this trend right now that’s very popular, of consuming 120 grams of sugar per hour, and that that’s really going to help performance and benefit athletes. Interestingly, I wasn’t a host on that episode, but I was interviewed for the episode, so I had a couple minute thing in there, and I just presented a counterpoint of you always have to think about both performance and health, and in my opinion, that might not necessarily be great for health. And I ended up getting a bunch of emails from our listeners saying, Yeah, we agree, but what should we be eating? And that was kind of the impetus behind this episode. So I’ve always said I can tell you about the science and nutrition, but I’m a horrible chef. I don’t know how to make anything, so don’t ask me those questions. So I’m really hoping the two of you can give fantastic suggestions of somebody who’s more focused on health, what should they be eating? What are great ideas so they can maximize health and also helping out their performance? And with that, I’ll throw it to the two of you, but let’s talk a little bit about the balance of health and performance when you’re talking about endurance athletes.

Dr. Mikki Willide  04:00

Yeah, and I love that you sort of bring it back to health Trevor, because, I mean, we all know that you cannot perform at your best if you’re not a healthy athlete. And even though carbohydrate can absolutely help enhance performance to a point, there’s really good research to show that even in endurance athletics, you’re not protected from the effects of sugar, just from the fact that you train and then you put out long hours out there on the bike or running, for example. And you only really have to look at the likes of research from Prins, who showed that 30% of the athletes that they studied on either a high carbohydrate or a low carbohydrate diet actually went into pre diabetic sort of blood sugar ranges when they followed them with a continuous glucose monitor when they were on that high carbohydrate diet. So I think sometimes there’s a thought that if you’re lean, then you’re going to be healthy, regardless of what. You eat as an athlete. And I just really want to, I guess, first point out that that’s not necessarily the case, particularly as you

Trevor Connor  05:06

age. Dr Larson, I know there’s a subject you love,

Dr Paul Laursen  05:10

yes, many Yeah, with Phil mafton, athletes fit but unhealthy, right? And because I was in that camp, right, like I was a fit but unhealthy athlete. So that’s why you know it comes from personal experience. I was pre diabetic, I had high blood pressure, and you know, Dan, please, who Mickey, I know you’re with him right now in Kona as we speak, the two of us working at high performance sport New Zealand, we would rock downstairs in the Olympic center, and we would get our long, flat weight coffee with two sugars and a nice sugary muffin, and that would just kind of be like the way we sort of started things, and wasn’t shortly. That was about the time when I started developing high blood pressure and went through my whole, you know, I’ve spoken about a previous episode with Trevor, but went through that whole process and reversed that. That’s the great news. Is, even though if you are pre diabetic. This is what the Prins study showed, is even after a month of on the low carb diet, the pre diabetic situation in those 30% was reversed. It comes off real fast, which is kind of cool, but I could not outrun my bad diet because, you know, I was training the house down with Dan at that time, and it kind of didn’t matter, and this was as I aged. So this didn’t happen when I was in my 20s that I was aware of, but it crept up to me in my late 30s, and I didn’t think it could. I thought all that, you know, just like probably a couple listeners out there, think it’s all crap, but it happened to me, and this what kind of I’m speaking up about it, so you can be fit but unhealthy, and that was me, so you don’t have to do it that way. To me, that’s the really important message that I hope kind of comes through as I don’t know if the evidence is solid enough to say that you have to do the high carb route and that you have to do the 120 grams an hour route, because I think there’s strong evidence that we can go about going at this a different way, that fat metabolism can be ramped up high enough if you want it to be to meet the same demands of the metabolic carb oxidation. And I think there’s good studies, even the one that we’ll probably talk about a little bit today with Gonzales. Think it was, yeah, it was the 120 gram an hour one, yeah,

Trevor Connor  07:22

and we’ll put all these in the show notes for anybody who wants to see the references, because we’re gonna refer to a bunch of studies.

Dr Paul Laursen  07:27

Sorry, it was the Harris at all study in Morton’s lab, and it was basically the carbon 13 glucose, fructose labeling reveals comparable exogenous carboxidation during exercise when consuming 120 grams per hour in fluid gel, jelly, chew or CO ingestion, and they compared it with a water control group. And it’s interesting how fat metabolism really ramps up when they’re just having the water only because it has to, it has to still meet the demands of that three hours of work that they were doing. And when you know, in the 120 grams an hour situation, it’s just masking that, and it’s replacing it. So it’s interesting, but we are sort of blinded to think that we’ve got to do it this way. I just don’t think we have to do you

Dr. Mikki Willide  08:08

think Paul and I wonder about you Trevor as well, that whenever you talk about low carb people think you’re being extreme. Because I get this a bit like when you talk about low carb people immediately, sort of think, Oh, you must mean 20 grams of carbohydrate or less a day. You know, they’re not putting low carb in the context of an athlete sort of lifestyle, because it is really different. When I talk about low carb with my athletes, they could still be consuming on a day 150 grams of carbohydrate because they have done quite a bit of training or whatever. They’re still in a state that allows the fat metabolism to be up regulated, which is quite different from, say, someone who might be lightly active and won’t be out exercising for two or three hours. You know, I think people mis understand what we mean when we talk about low carbohydrate in athlete context, which is potentially one of the reasons why low carb for an endurance athlete, can get quite a bit of backlash out there. Not sure I

Dr Paul Laursen  09:04

was gonna say anything even higher than that. I could probably get to close to 200 grams a day, with respect to the lower carb fat adapted athlete, especially like, you know, an athlete that’s training 20 hours a week. Context, always right as we say, that was

Trevor Connor  09:17

something I was hoping to bring up, and I meant to say this in the intro. So I’ll say this now, because I do think for this episode is important. I give my bias. Most of our listeners know this, but for anybody who doesn’t, I own another business called the Paleo diet. So I own the trademark and the Paleo diet and all the original science on that. And I get asked all the time, oh, you’re a Paleo Diet fan, therefore you’re anti carbohydrate. And I was going, No, I’m not. Not all. I probably get, you know, around 300 grams of carbohydrates per day, but it’s the source. I don’t eat the goose and the gels and things like that. I eat fruits and vegetables. And everybody goes, there’s carbohydrates and fruits and vegetables. There’s this mindset that the only sources of carbohydrate are bread and gels. And there’s a lot of very healthy. Sources. And that’s one of the things I’m going to really talk about in this episode. Of you don’t necessarily have to be anti carbohydrate. And Dr Larsen, I know you can bring up some great evidence about actually you can perform very well on a ketogenic diet, but if you don’t want to go there, you can get sufficient carbohydrates just eating much better sources of carbohydrates, absolutely

Dr Paul Laursen  10:20

Well, I think you can definitely do it just on more of a whole food approach. And just take the whole, you know, if you’re downplaying it, because it’s a potential fad diet, just take that all out and just go more whole food source, just like you’re saying. If you do that, you’re getting a slow carb kind of approach. And it totally changes the game, because they’re, I know, counter to others that have potentially spoken on your podcast, Trevor, there’s sound evidence for the damaging effects of that sugar and just sugar in itself, it’s not a natural kind of substance. It just is not the same as when you’re getting that glucose release through natural whole food sources. You know, Trevor, we spoke about this on a former podcast as well, when you spoke about the th 17 kamikazes alongside the T reg cells, and the balance between those and the fact that the sugar itself really gets the Kamikaze th seventeens angry and started wreaking havoc on the rest of the body. If anybody’s

Trevor Connor  11:24

interested in that, Dr Lars and I just had a whole conversation about the health impact of sugar. So we’re not going to dive too deep into that today, but that was episode 272, and what I loved is both of you started with this is true in athletes, too, because I don’t think anybody will argue simple, sugar is bad for you. We could pull out 1000 studies of in sedentary individuals all the negative impacts of sugar. But I think there’s a belief that in endurance athletes exercise counters at and something I quickly want to do, there’s always new research coming out. So even since we recorded that episode. Dr Larson, I found two more studies countering that point. And Dr Wildin, you brought up one that I know we’re going to talk more about showing to put continuous glucose monitors on endurance athletes for 31 days, and showed 30% of them were pre diabetic on a high carbohydrate diet. But I have another one that was also a continuous glucose monitor study called blood glucose levels of sub elite athletes during six days of free living. And I’m just going to read the conclusions to you and said, contrary to expectations, high blood glucose appears to be more of a concern for athletes than low blood glucose, even in those with the highest energy expenditure and consuming below the recommended carbohydrate intake. So they were expecting that exercise was going to be protective, and they found the exact opposite, another one that dropped my jaw. This was a heart study in children, so children athletes, age seven to 15, and again, I’m just going to read to you the conclusions the group of children that consume sugar had, on average, a significantly longer duration of the T peak and T end interval. So this is in their EMGs. There’s an association between sugar intake and the duration of the T peak to T end in our case study, it was demonstrated that the benefits of playing sports cannot compensate for the harm of over consumption of sugar. So an important public health target would be to lower sugar intake and sugar in children’s diets.

Dr Paul Laursen  13:25

And we found the same thing. Trevor as well. Luca Ciprian, Czech Republic. Colleague, did a study as well. Similar. It was in just recreationally trained individuals. No, sorry, it wasn’t recreationally trained. It was sedentary individuals. But we basically, we went at it the same sort of way. We looked at a diet intervention, we looked at an exercise intervention, and we looked at a diet and exercise intervention, and it was only the diets. It’s only when the diet kind of came into play, where we actually found reductions in all of the health related markers, or improvements in the health related markers. The exercise as vigorous as it was, it was a hit protocol. It really, it did nothing. It was almost it was right across the board, everything was the same as the control group. So again, to back your point, we also found that you couldn’t outrun the bad diet. So and again, the diet is so principle to the health in terms of what I’m seeing.

Dr. Mikki Willide  14:23

I’ll also add when we talk about sugar, obviously it’s a huge part of what we’re talking about. But I think people also misunderstand what healthy food is actually because there will be a lot of athletes out there who in their mind, they’re not actually having a lot of sugar, but they might be having whole wheat bread or orange juice cereals that your body will just recognize as sugar, you know, and if your diet is formed on the basis of these sort of health halo foods, because we’ve been told for decades that low fat, high carbohydrate diets are healthy, that can be problematic as well. So even sort of understanding. What a healthy diet is comprised of, I think is really important too, because a lot of people can get caught out that way. They’re buying products that they believe to be healthy, but actually the body will just recognize it as sugar, and they’ll be broken down very quickly and dealt with the same way. And I, I don’t know, as a clinician, I see that a lot. I have a lot of athletes come to me and and they’re eating what they believe to be a healthy diet, but in addition to it being more carbohydrate than what I might recommend, they’re also missing out on a lot of other nutrients that are really important, because whenever we eat, it’s opportunity cost. You know, whatever you choose to eat, there’s something else that you’re not eating. And if we follow the typical recommendations for an athlete with that real focus on even quote, unquote good carbohydrates like breads and pastas and cereals, etc, you’re just missing a ton of other nutrients that we really need for our immune system and for repair and recovery and things like that. Love that you

Trevor Connor  15:57

brought that up because that was literally going to be my next question, because when I put together the outline, you reached out to me and said, Hey, you’re simplifying this down into carbohydrates, protein and fat. And I kind of cringe, because I often talk about that. I’m like, we can’t do that simplification. I don’t always like that. We break diets down to high fat, low fat, high carbohydrate, low carbohydrate, and then we group all foods into carbohydrates, fats and proteins. So meats are proteins, breads are a carbohydrate. The problem when you do all this is, candy is also a carbohydrate, broccoli is a carbohydrate. And so when you just talk about high carbohydrate, low carbohydrate diets, you’re kind of lumping candy and broccoli into the same category, and nobody would go, they’re equally as healthy. Nobody would equate those two things. So are have we made a mistake that we’re getting away from just talking about foods and what foods are healthy for you?

Dr Paul Laursen  16:55

Probably, yeah. I think we I think we have, yeah. I mean, it really simplifies the conversation when you just break it down to, you know, carbs versus fats, and it’s so much more nuanced than that, isn’t there? Like, you’ve just brought up the micros are so, so important. I’ve really understood that as I’ve gone down the health thing, like it’s what is coming with this carb dominant food that’s coming into me. Well, what are the micros that are coming with that, or same with the protein content, right? Like so with this protein dominant food that’s usually like a meat, what is the micro nutrient makeup that I’m going to get, and how’s that going to affect my health? That’s been everything for me, and it’s totally changed the way I’ve thought about the food sources that are sitting in front of me. That’s totally how I think when I go to fuel myself, I’m like, is that going to be a source of the micronutrients, the vitamins, the minerals, the phytochemicals that are going to go towards fueling my mitochondria to produce energy efficiently? And

Dr. Mikki Willide  17:55

I similarly think a lot about it. And this is a slight tangent, but, and I know you can absolutely have a healthy vegetarian diet, but I often think about these things when in sort of social media and public health space, this push towards a vegetarian diet means that many people who are health conscious will be trying to further reduce the intake of animal protein, which is a just a fantastic vehicle for zinc and iron and carnitine and cholesterol and creatine and these sort of, what we call zoo nutrients, notwithstanding, of course, the B vitamins and things like that, which you also find in meat. And a lot of athletes are health conscious as well, and so they’ll be trying to sort of do their best on that front. And I just think there are a lot of mixed messages out there as to what truly is a healthy diet, which is why I am a big fan of call it paleo, call it whole food, you know, just a diet that’s appropriate to eat. Again,

Trevor Connor  18:58

I wasn’t planning on bringing up the Paleo diet, except to just express my bias. But when people ask me, what is the short version of it, I say it’s eating just natural, less processed foods. That is it in a nutshell, and you look at the science, it backs that up. Those are the foods that are more nutrient dense, where you’re going to get all the micronutrients that you need. I personally don’t actually care that much about macronutrient ratios.

Dr Paul Laursen  19:22

Yeah, same. I know. I think I probably maybe Mickey’s the same. We might have this keto or something that kind of it follows us around, because maybe we’ve been there for a time, but I know I’ve come a little bit more centered, but with the focus just on the whole food and the body is amazing, or it just kind of figures out the rest. If you can at least give it natural sources. Did this come from Mother Earth some way? And is it as low processed as possible? And you’re just, you’re so far the way there to optimizing your overall health. From the nutrition standpoint, I believe there’s

Trevor Connor  19:55

a bit of a tangent, but I have to share a story with you, and I’ll let the name remain anonymous, but I. Did an interview a long time ago, was somebody who’s very high up in helping the USDA write their guidelines, and she was very critical of us, so I got her in this interview and had a conversation. We spent an hour agreeing on everything. She was talking about micronutrients. What you just said that being vegetarian is actually very difficult. It can be done, but you get a lot of great nutrients. For me, we were agreeing on all these different things. And I finally just said, where do you disagree? She goes, you don’t have a macronutrient ratio, and I can’t take a diet seriously if it doesn’t have a macronutrient ratio. And I just went, that’s really interesting to hear in the nutrition science world, that that’s how focused we are in the macro nutrient ratios. That’s

Dr. Mikki Willide  20:41

interesting. And I feel like, as Paul mentioned, like we’ve gone down the rabbit hole with keto diets, and you sort of almost come back to the center in honesty, where I’ve sort of landed is probably but the needs of what I see most is actually focusing more on making sure people getting their protein actually, you know, all this talk of carbs and fat, and, I mean, everyone’s talking about protein now, actually, so it’s a little bit boring, but that’s where I see a lot of athletes, particularly if they are calorie restricted, because I do still think about calories for them, because, you know, it’s still, it’s an important piece of what goes on in my mind. It’s not necessarily the conversation that I have with my clients, but it’s things that I’m thinking about, but it’s making sure that they’re getting enough protein at the right times. That’s something which I focus a lot on. But I’m not necessarily talking to them about macronutrients per se. I’m just talking to them about food. And you know, how do you actually meet the recommendations with the food choices that they’re consuming?

Trevor Connor  21:37

And actually, so just something to throw at you as a thought, since you brought up the protein A study I just read last night that I’m still processing. It’s a really good study. It was called fueling gut microbes, a review of the interaction between diet, exercise and gut microbiota in athletes. And what they did is they looked at the impact of different types of carbohydrates on the gut, different types of fats and different types of protein. And something that was very interesting was, when they looked at protein, protein powders tended to have a very negative impact on the microbiota, where natural sources of protein seem to actually have a very beneficial effect. So there’s another case of just talking about protein versus what are the sources of those proteins? You’re missing some of the picture.

Dr Paul Laursen  22:21

Yeah. And what do vegetarian athletes normally have to do? How do they get their protein? Often from the powder source, right? If they’re supplementing,

Trevor Connor  22:28

the really good ones do their research. They know about the right types of beans to eat. I mean, it’s actually very difficult to get the right mix of amino acids, but the ones who do it well know the foods they need to eat. Let’s take a minute and hear Dr Egan’s thoughts on performance versus health nutrition.

Dr. Brendan Egan  22:46

Yeah, I think it depends on how much emphasis is placed on competitive performance and nutrition around performance, as opposed to the broader picture around, say, the adaptation to training and general well being. So if we just took a broad brush stroke in terms of needs as we get older, there’s obviously a greater emphasis on protein intake now and recommendations for for older athletes, including a master’s athlete. So if we kind of continue the traditional model of where there’s this very large emphasis on carbohydrate and perhaps, you know, I’m not saying everyone is like this, but some people don’t care about the quality of that source, you know. So even though most broad guidelines would say don’t rely too heavily on very sugary foods, a lot of athletes fall into the habit of relying on very sugary foods. I think it is easy to talk about focusing on performance, hitting targets, doing what athletes do, but that can be at the expense of, in this case, maybe inadequate potent intake or poor food choices from a from a quality point of view. So I think it’s sometimes worth asking, what is performance as we get older? Okay, there’s obviously the medals and the wins and so on. But if it’s at the detriment to health overall or in the longer term, then I don’t see the logic. But there are many athletes who who pushed performance ahead of health. So this has been a problem for quite some time. I don’t think we’ll solve it with one piece of advice, but I do think that the messaging around health as we age, as opposed to still being that athlete, you know, getting all that sugar on board, I think that there is a change we can make

Trevor Connor  24:18

there. So let’s shift gears a little bit. And now let’s frame this in the context, and I’m just going to throw the big question at both of you. We’re talking now to endurance athletes. We’re talking to people that are sold on, yes, I care about my performance, but I care more about my health. And look, all you care about is performance, and you are no, I just need to cram 120 grams of sugar down my throat every hour. We actually have a couple episodes that we did with Dr you can group and those are episodes 83, and 150 please go ahead and check those out. You’ve now heard our bias, but if you care about health, which I think is a lot of our listeners, and I strongly encourage everybody to care about health, let’s talk about how you. To be eating when you’re out on your rides, when you’re out doing your runs, and so we’ll dive into the details and down a few rabbit holes, but I’m just going to throw that broad question at both of you. What are your broad recommendations? Maybe

Dr Paul Laursen  25:12

I’m going to start a little bit if you don’t mind, Mickey, I just want to lay a little bit more science out there, and then I’ll pass over to you for some practical recommendations, but I want to go back to the study that I just mentioned. It was the 2223 paper by Harris at all, and I started talking a little bit about it, but it’s basically where they were looking at the gels, you know, fluids, jelly, chew or CO ingestion at 120 grams an hour, right? So let’s just call this as the new gold standard for how you fuel your carbohydrates. All right, so fine and dandy. They’re doing this study in well trained cyclists, and they’re ingesting all these different versions of it over, you know, three hours, and they’re showing that they can tolerate it. And they’re comparing this with a water control group. We’ll include a link to this paper. But what’s fascinating to me is that it’s a tracer study, so you actually get to see how much of that sugar, the 120 grams an hour, is being oxidized by the muscles, and how much isn’t. And the long and the short of it, if you actually go back and do the analysis, is that you find out that there is, after about three hours, there’s 360 grams that are ingested, right? 120 grams an hour, and 219 of that is actually getting oxidized, so 39% is unoxidized that’s left in the system. Now, what happens with that sugar? Where does it go? It basically winds up hanging out somewhere in the bloodstream. And you know, you kind of do the math, and if you’re continuing on that for even longer, across, you know, Iron Man events, that’s a whole lot of sugar that is just sort of sitting within you, right? And again, back to the th 17 kamikazes. It’s a lot of stress that started sitting in the system. Again. Back to sort of the health standpoint there, and in the non ingested scenario, that has to be met by something else, it’s met by the fat. So my bias is that if you’re caring about your health, maybe you want to consider a different way of going about things, because there’s problems with this too. Now this is where I’ve taken a lot of elite athletes who’ve come to me, and they come to me with a debilitating situation from Iron Man. They’re bloated, that carbohydrate is sitting and hanging around in the gut, and there’s a fermentation process that actually has to occur, and they’re actually not dropping out because they can’t exercise. They’re dropping out due to pain in their gut so, and that’s commonly reported in the literature as well. So it’s a real performance issue sometimes at these really, really high rates, and this is often in the aging athlete. A lot of Ironmans athletes and others want to continue to kick ass through their 30s and into their 40s and even 50s. And that can be a real issue there. Einstein or someone said the definition of insanity is in doing the same thing time and time again and expecting a different result. So you might want to switch things around and maybe go to some alternate ways, and that is becoming more fat, adapted less reliant on that 120 grams an hour philosophy, bringing that down more to 60, and then maybe choosing some alternate strategies of fueling that I’ll hand over to you with Mickey

Trevor Connor  28:35

before you jump in. I just want to quickly read something because that microbiota study that I just cited quite literally answered your question of what happens to all that sugar. So I’m just gonna read this. Athletes focus on maximizing glycogen storage. May ingest high amounts of carbohydrates, but avoid non digestible carbohydrates and fiber evidence. They didn’t say fiber, but I’m adding that because I talk more about that later. Evidence suggests that a high carbohydrate, low fiber, dietary pattern has detrimental effects on intestinal health and microbes, including Ultra intestinal transit times a loss of bacterial diversity and reduce SCFA production. And they go on to talk about basically, those carbohydrates ferment in the gut. They increase intestinal permeability, and they really inflame the gut associated immune system. There’s the answer to your question. It’s hard to interrupt you, please. But

Dr Paul Laursen  29:26

I mean, like Mickey’s in Kona right now, she’s about to watch the Iron Man over the weekend, and I guarantee you she’ll be out there, and she will see a very large number of athletes that are healing over and they’re holding their gut, and it’s because they’ve got too much gas in there, ultimately, because they’ve been doing this all day long, and it’s a real problem, and it is a reason why many will drop out, or at least not perform to their optimum. So it’s not making this up, and

Dr. Mikki Willide  29:53

there’s such a difference as well, Paul, between what you can study and how that translates into the real world as well. So you. Long duration study is three hours, as you just mentioned, and yet people are out on the bike in Iron Man for like, six hours, maybe seven hours for some and the entire race for some people is like 12, 1314, hours. Like you cannot expect your ability to digest carbohydrate in hour two and three to be the same as what it’s going to be in like hour 12 and 13. There’s just fatigue, intensity, palatability, so many other things to consider in the latter part of the race that and I feel like this is a point that’s not acknowledged by so many people out there saying 120 grams of carbohydrate now is a okay. And for what it’s worth, I do think there is a difference between those in the elite end of the sport versus even those who are competitive age group athletes like to be an elite sport like Iron Man or cycling or running. I just think it takes something different, whatever it is and what those athletes can, quote, unquote, get away with, I feel it’s quite different from what some of these competitive age group athletes are also trying to get away with. And to your point, there are a lot of people who struggle with GI issues, but for whatever reason, it doesn’t click with them. They’re like, I always vomit it mile two in the run. It’s just what happens to me, not thinking it’s because they’ve tried to have even 90 grams of carbohydrate an hour, and they haven’t slowed that down. And

Dr Paul Laursen  31:29

yeah, I mean, reflecting on my past as well, I could definitely tolerate a lot more when I was a younger athlete, definitely a lot less when I was an older athlete. Something

Trevor Connor  31:36

that has been pretty clear in the research is you’re seeing athletes who are dealing with these digestive issues going on a FODMAP diet, which is basically just eliminating those fermentable saccharides from your diet. And it’s been demonstrated again and again and again in the research to be quite beneficial to help those athletes. But there was a study that just came out, and I’m just going to read the title to you looking at, do you need to do everything that’s on the FODMAP diet? And the title is a starch and sucrose, reduced diet has similar efficiency as low FODMAP in IBS. And basically the gist of the study is you can eliminate all the things that the FODMAP diet eliminates. But actually, if we just get rid of starch and sucrose, we seem to see equal reduction of the IBS issues in athletes. So interesting. Let’s hear from Brent buelter and Dr Scott fry, who will share their thoughts on balance and nutrition and addressing GI issues.

Brent Bookwalter  32:29

I think again, I would stress the fundamentals and that there’s a low level of activity where a general, healthy, balanced diet can fuel that activity after a certain point after, say, an hour, as a rough amount, you do start to need some calories to sustain that output and that energy. So I think consistency, balance and quality. I think real food can be used for on the bike training, especially for general health purposes. We don’t need a super high density, 100 gram of carbohydrate drink in your bottle that costs $5 at the store, a bunch of crazy gels, especially when you’re exercising at submaximal intensities, you can consume real food that comes from the grocery store and maybe doesn’t even come out of a package, and be completely healthy and also perform well,

Trevor Connor  33:14

what would be some good real food?

Brent Bookwalter  33:16

I like peanut butter and jelly. I like banana you know, if you have the time and effort, make some little like homemade granola bars yourself and a handful of seedless dates are great, easily digestible, high sugar contents, I definitely hype real food, macronutrient, quality ingredient, but when you’re talking about you’re better off to have some calories at a high energy output than None. So I also grabbed the Snickers and the coke off the gas station shelf. If you’re out there for three hours and you don’t have any food, you’re much better off grabbing the candy bar and the soft drink off the shelf to give your body some fuel than depriving it from nothing. And I think those can work just as effectively for a lot of people, especially at lower intensities, and spending an arm and a leg on cutting edge science nutritional products that the professionals need.

Scott Frey  34:03

Yeah, I would just say Brent had a big impact on me in this way. You know, as an athlete who’s kind of coming back to doing bike racing now, in my late 50s, I was working to get all my calories in long races through bottles and gels and having just all these gi problems after races, being really miserable. And this spring, Brent said, I think you should try some solid food, which seemed completely counterintuitive to me, because I kept thinking I had to make it simpler and simpler and simpler. It was a God set. The last three races, I have not felt that good after a raise in decades.

Trevor Connor  34:43

So what other general recommendations would you make for athletes focused on health?

Dr. Mikki Willide  34:49

I normally I’ll just sort of talk you through how I work with my athletes with their training because I mean, not all training cycles is the same, and they’re not all session. Are the same either. So I really focus on a sort of more carb appropriate approach, if you like. So if you do have higher intensity sessions, for example, across either a week or a training cycle, then yeah, maybe we do bring in a little bit more carbohydrate in that instance for those sessions. But otherwise, I try to work with my athletes and get them sort of focused on up regulating their fat metabolism and focusing on calories that don’t necessarily come from carbohydrate for those long duration sessions or those easy training sessions. And to Paul’s point, I can’t recall a time when I would have recommended an athlete go above, say, 60 grams of carbohydrate and now, or sort of depending on where they start from, but that would probably be a max of what I might recommend an athlete as well.

Dr Paul Laursen  35:51

Yeah, and I think you raise a really important point. I know we’re kind of going all over the place, but that periodization of carbohydrates across different sessions in the training periodization, or happenings across a training cycle, that’s really important. I’ve had Christian Meyer and Swain tough on my podcast before. I know Trevor knows these guys as well, and they’re really interesting. How they’ve kind of also gone through this whole process of discovering that too much carb, sugar all the time was not necessarily a good thing. They just couldn’t sort of sustain it, and they really needed to have more fat in their diet. And then they shifted over to more the Keto, low carb approach. But then again, and year after year, I’ve actually got a really cool blog, and I’ll include that in the link, they actually got their power profile data across various different years, and this was measured by their physiologist, Azur, across various different teams, or green edge. And you know, actually showing that once they finally switched to a periodized program with the more of an LCHF kind of focus, they actually didn’t go down too much as much as you’d expect. But the real major gain that they got in their training was when they did what Mickey sort of talking about, where train keep the low sessions low and keep the high sessions a little more high, and that’s when they got their biggest outputs across their power profile. So that was pretty cool. Sorry to interrupt there.

Trevor Connor  37:14

Dr, Wildin, to your point, and I’m sorry I’m being heavy today on reading out of research studies, but there are so many good studies out there. Doctor you can drop is one of the biggest proponents of 120 grams of sugar per hour. And here is part of the conclusions of a 2016 study that he was a co author on where he said, since neither maximal power output nor immunity were better maintained with a high carbohydrate intake and increases in fat oxidation were lower. It could be argued that ingesting a moderate and then in brackets, approximately 20 grams per hour of carbohydrate dose during short term interval training may be more advantageous than a higher carbohydrate dose.

Dr. Mikki Willide  37:58

It’s super interesting, isn’t it, and there are those studies. And I am not too heavy on being able to tell you the year or the author of this, but I know that this research exists, and I’m sure I can hunt it down, looking at cyclists, whereby they do the car rinsing method. So we’ve got enzymes in our mouth that can send signals to the brain to increase motor output merely by the presence of carbohydrate in our mouth. So you take a big gulp of a normal concentrated sports drink, and you swing it around, and then you spit it out, and that’s enough to give the brain what it needs to increase that motor output. Yet by the end of the session, instead of consuming 55 grams of carbohydrate, even in that hour, you may have only consumed maybe 15 grams of carbohydrate by the time you’ve sort of gotten through that bottle. So that’s really advantageous,

Dr Paul Laursen  38:49

suggesting that it’s more of a central nervous system potential helper than any metabolic change per se. That is super cool. Mickey,

Dr. Mikki Willide  38:58

yeah, it’s super interesting, isn’t it?

Trevor Connor  39:00

So here’s a question for both of you. Somebody’s out training. They care about health. Are they better serve bringing more natural foods on the ride? I mean, let’s face facts. Gels are easy to carry. Goos are easy to carry. Sports drinks are easy to carry. Carrying bananas and other foods can be tougher, but is it worth it? Is that what you’d recommend, or is there a third option here?

Dr Paul Laursen  39:21

For me, it’s definitely go the stay away from the gels on your training. Go the small extra step to get that banana. Or could be an apple. Could be anything. It could be like, you know, a handful of cashews. There’s lots of athletes that even make their own sort of coconut bars and these sorts of things with various different natural substances. They make their own. That’s, to me, the better strategy. So as much you can kind of gravitate in the here and now when you’re out riding. That’s better for me than going the lazy route and supporting the gels. I just again, you’re just going to get sugar into the system and. We’ve just been through the health consequences of that. And look, Trevor, you’ve spoken about your AFib before as well, too, right? And I’ll speak about my arthritic hip like there’s potential for these problems down the road. So I’m

Dr. Mikki Willide  40:15

with Paul on that, and there are so many other options. And Paul, you listed off a few of the favorites that some of my athletes would have, but even I think it was Alan Lynn. And I don’t know how either of you feel about Alan, but he’s got like a whole recipe book on, like rice balls even, which may or may not suit some people, but it’s a pretty cool concept of you could do savory, you could do sweet, just putting together some rice and avocado or whatever, and going the extra mile. In that regard, you’ve also got nut butters, like Justin’s nut butter. Here in New Zealand, we’ve got picks peanut butter slugs. To my mind, it’s often it’s a calorie and a hunger issue when you’re out on a long ride, more than anything. And I don’t think you need to avoid carbohydrate completely, but I think that getting those calories on board is for some athletes, is important. And what I will add is that with those sports gels and sports drink, often athletes don’t either tolerate the fructose that is in there or maybe the maltodextrin, even with some athletes. So if I am after sort of quick carbohydrate, I don’t know how either of you will feel about this. And I have an athlete who has a really sense of really sensitive stomach, which might then mean that they’re unable to have a ton of actual real food. Then for that quick carbohydrate hit often, I get them to put just glucose in a small bottle with a little bit of salt, and then they put a bit of water, and it’s literally what they have, and they’re just doing small amounts, like small sips of that, not unlike what we were referring to with the carb rinsing, but that’s giving them the carbohydrate the body’s just going to use in the moment. So they’re not having to deal with the fructose or the maltodextrin, and it’s super easy to do. You can buy glucose powder from the supermarket that is straight carbohydrate, of course, and it is straight sugar, but it’s in small amounts that they’re using at the time, and it’s not necessarily the only thing they’re doing depending on that session. Yeah.

Dr Paul Laursen  42:08

Well, there’s a theory. Again, there’s so much we still don’t know, right? But I know Tim Noakes, and I know he’s really having a good look at a new theory around the fact that really, for any given individual to perform at their best across an endurance or an ultra endurance event. First of all, they’ve got to train for that. But second of all, in terms of their performance optimization, they really need to have a maintenance of that blood glucose. The blood glucose needs to be stable, homeostatic for whatever set point is for them, he’s amounting this pile of data I know right now that’s basically providing a really good argument to the fact that time to exhaustion, or when you’ll actually stop, and fatigue very much relates to when your blood glucose level drops below the set point that You cannot tolerate. Now in a fat adapted ketogenic athlete, I’ve worn continuous blood glucose monitors, and now in my Keto state can be down as low as three millimoles. Normal is at five millimoles, for reference, but it’s just whatever normal point is for any given individual. And if that theory is right, you really just have to do whatever you need to do in terms of an ingestion to keep that level normal, and, yeah, probably, you know, solve any hunger issues, like you said, Mickey, that are kind of going on as you go through your event. We’re all individuals. We’re all going to have to work towards developing our own strategy. The simple one is certainly to go to the gel. But if health is paramount, I think investigating natural sources for you to be able to control hunger and maintain blood glucose is a really good way to think about it. I will add

Dr. Mikki Willide  43:52

that what you do outside of training really impacts how you go in training as well. You know, like if you’re going to have two slices of toast with jelly or jam and orange juice before you go out on your ride, then you’re more than likely going to experience that low blood sugar that Paul was just referring to a lot earlier, and then have to dig yourself out of that low blood sugar hole. So one of the strategies that, of course, I get my athletes working on is not necessarily fasting, but fasting from glucose before training those long sessions as well. So you start training and you’re having scrambled eggs, peanut butter, avocados, something like that. You know, the number of calorie or the size of the meal is really athlete dependent, but they’re giving on protein, they’re giving on fat, and then they’re beginning their rides. They’re not starting waiting to fall off this glucose Cliff the way that they otherwise would if they were to have rice, crispy cereal or toast and jam, which I was referring to,

Dr Paul Laursen  44:53

yeah, because don’t forget the physiology on that, right? You ingest a whole bunch of glucose before you go out, and insulin has to follow. Because we need that central insulin hormone to be able to store that carbohydrate, glucose bolus into your cells. And then, of course, if that insulin kind of hangs around a bit, it’s going to keep dropping it. So to Mickey’s point, you’re going to potentially could have a fall in 30 minute period, and then you’re chasing it with gels basically all the way, and it’s not a sustainable strategy. And I think this is exactly what I do with my athletes as well, and it’s being really sensible about the pre exercise meal. Let’s give us something that is going to slowly release the glucose from the liver, that’s the job of the liver, gluconeogenesis, out into the system for the duration of that training exercise, so that that glucose is stable. He don’t want big spikes and falls in that glucose, it creates a real unstable system, and yet, it’s just not conducive to an optimal performance.

Dr. Mikki Willide  45:52

And not only that, but it’s post training as well. What you’ve just described, Paul, the difference in how the athlete feels post training really makes a difference, because if you do have that roller coaster glucose experience, then you feel more exhausted, you have more cravings, and it’s harder to recover, whereas if we’re able to keep that blood sugar stable, you come in from training feel a little bit fresher. You have a meal post training that incorporates sweet potato or rice or fruit alongside whatever else it is that you’re having, and you just feel better across the day. And I think a lot of athletes think that feeling exhausted is this inevitable part of just being an athlete, whereas, and do feel like a lot of these issues are driven by what’s occurring sort of pre and during training as well.

Dr Paul Laursen  46:41

Yeah, and I’m sorry, Trevor, I know you’ve asked us to sort of focus on the actual exercise itself, and all we kind of keep doing is going back to everything around the exercise and just how important that is, and how that’s going to set you up, to empower you to really be more free of any influence on these sorts of things, relying less and less on the 120 gram per hour. Push

Trevor Connor  47:03

well to back both of you up. And I did warn everybody that we’re gonna have lots of references for this episode. I’ve seen multiple studies, and I’ll put them in the show notes, showing that a eating a higher carbohydrate but low glycemic diet can mitigate a lot of these negative effects that we’re talking about. And so that’s getting your carbohydrates from fruits, vegetables, sources like that, and Dr Wilden, the breakfast that you just described, I mean, that’s a glycemic load bomb that’s absolutely going to spike your insulin levels. Another thing that I’ve seen in multiple studies is they talk about free sugars versus bound sugars, and this kind of answers the question of, we’re constantly hearing that fructose is bad for us, but we’re told an Apple keeps the doctor away, but apples are high in fructose. You don’t see quite the negative impact of eating an apple that you see with just unbound fructose, because the fructose is bound in the apple. Those are important things, and when you’re talking about a lot of what we think of as ride and race food, that’s just all high glycemic index, unbound sugar. This is a good place to hear Dr Egan suggestions on what we should focus on eating when health is a concern. Any practical suggestions on changes they could

Dr. Brendan Egan  48:12

make with older adults, regardless of whether they’re a master’s athlete per se, or whether they’re just someone who is involved in exercise, the guidelines now are emphasizing around 1.2 to 1.5 grams per kg body mass of protein. So to translate that into average numbers, it’s usually somewhere in the region of 100 grams per day for the average person, maybe a little bit more. The reason I bring that up is because, again, traditionally, endurance athletes have not really had an emphasis on on protein in their diet. It’s become more widely acknowledged that they do need more protein than the average member of the population. Do they need as much as a bodybuilder? Probably not. But it’s actually surprising. You know, the numbers typically talked about now for young and middle aged runners and cyclists are somewhere around region of 1.5 1.6 grams per kg body mass. So I think that number is relevant, whether it’s young, middle or older. Age is to is to emphasize that protein intake. So the practical piece of advice I would have is to not sacrifice quality and quantity of protein for the sake of, you know, junk food and sugar, just because that has been kind of traditional message, I think we do need to think more about the protein intake side of things. And to be honest, again, with many athletes I work with, who previously in consuming adequately to launch a protein and they consume more protein, they don’t notice any negative effect on performance in training and races, and in fact, they feel better from a recovery point of view. So you know, there’s that to it as well. Performance is not just performance in race, it’s also recovery and everything that goes with

Trevor Connor  49:43

that. What other recommendations do you have to be eating healthier and glad you did actually talk about outside a workout?

Dr. Mikki Willide  49:51

Well, I like to, as I mentioned earlier, a lot of my clinical work is focused around optimizing protein for athletes, and so I think I’ll just. Give a little context here is that many athletes might not necessarily be low protein across a day, although many are, but often the general eating pattern is to have a lower protein diet during the day and then have an adequate protein later in the day. The dinner meal doesn’t seem to be an issue, but lunch and breakfast often are because protein isn’t that convenient. So it’s hard to have a healthy diet by accident, actually. So I just really counsel my athletes that they have to treat their diet and their food prep the way that they treat their training for their event. So you have to set aside time to hard boil eggs, to pre roast chicken or do a ground beef dish. You know, have these proteins prepped so it’s easy for them to sort of come in the door from the early morning training session, and maybe they’re having like ground beef and eggs with sweet potato for breakfast, for example. You know, I think making those foods convenient can go a long way to actually eating in a way that promotes health, and it’s worth it. It’s worth prioritizing nutrition for that.

Dr Paul Laursen  51:09

And for me, Trevor, when I’m working with an athlete, I am first of all doing just an overall review of what are they eating today, and just checking how they go about their current week. You can usually look at a single week and get a food diary, and quite quickly, you can pick out a few things usually that need to change. And this might sound crazy to you guys, but probably not to Mickey, because I know she works with lots of different athlete types, but yeah, I was working with a world class open water swimmer, top 20 in the world, and literally living on fast food, and it was just about every single diet, and it was amazing. I was like, how do you do what you do? So that’s yeah, basically, I analyze what’s the current situation and then work more towards some of the principles that we have discussed here on the podcast. And the changes don’t happen immediately. They just like, Okay, well, what’s the very first thing that we could potentially do here in this situation, you know? And then can we cook one meal a week yourself and these kinds of things, and keep making it better one step at a time. It’s remarkable what we can get away with, though, and what the bodies can do. I love that

Trevor Connor  52:19

you brought that up because I have learned Sunday is my food prep night. I spend two three hours cooking food, preparing things. I prepare my ride food. I have a trail mix, which I take on my rides, that I put together myself. I do all that on Sunday night, and basically have my food for the week. And I can’t tell you how often that saves me, because I drive down the fast food alley on my way home, and if I’m leaving work at seven o’clock at night, and I know that I don’t have something waiting in the fridge at home, I can’t tell you often, you just kind of look at, well, there’s a crappy Thai place. I’ll get that.

Dr. Mikki Willide  52:54

And you are someone who thinks about health as well. I think people underestimate the pool to convenience when we feel tired despite our best intentions. I’m so pleased you brought that up. Trevor as well,

Dr Paul Laursen  53:06

for sure. And I will admit, even in my context, I’m blessed with a little bit of time and enough time and knowledge to do all of that food prep. But yeah, I know that’s the reality is that it’s difficult to find that time, and it’s so much easier to go the fast food group, but if you can dial back and find that time in your schedule, I guarantee you it is well worth the investment on your health and performance to learn how to cook, learn the foods that you want to cook with. It makes a huge difference.

Dr. Mikki Willide  53:35

People feel a little bit overwhelmed at this idea of cooking and food prep, if it’s really new to them, or the idea of changing their diet can feel really overwhelming, but again, I think it doesn’t take that long to steam broccoli and grill lamb chop, for example. It’s a very easy sort of thing to do, and don’t look at it as changing your entire diet. I would look at it as just changing a few habits, because if you change those habits around your food prep and having food available, your diet will change, really, without you even having that burden of you know, what am I going to do? That’s another reason why I bring it back to food prep, because that just changes everything. Look, I

Trevor Connor  54:14

will give a suggestion. This is coming from the person that A has no time. B is the worst chef on the face of the planet, I can tell you what to eat. Don’t ask me how to prepare it, because you will be highly disappointed. But that said, I’m going to tell you what I do that works with the very limited time. As I said, Sunday is my fruit prep night. I turn the grill on. I grill multiple steaks, a bunch of chickens, some pork and a bunch of salmon. You know, I grow all my meats then and then, some of it gets frozen. Some of it goes into my fridge. But then through the week, I would say, 90% of my meals, I come home, I put some olive oil in a frying pan, I saute some vegetables, and I mix up the vegetables every time I have a whole bunch. And look, I frequently just do frozen. Vegetables, often they’re as healthy, if not healthier, than what you find in the produce section. Then I pick one those meats, just cut it up, throw it in. And then the way I have my unique meal is picking different sauces or picking different spices. And it takes 10 minutes. It’s easy, and you have something different every dinner. I love that. Yeah, me too. It’s not five star chef Michelin star type meals, but it works. You know

Dr. Mikki Willide  55:26

what I will say, lots of clients that I speak to that sort of get on the same path that you’re talking about Trevor, because we talk about it, they’re like, I mean, My food’s really boring, but then they talk through just what you’ve described Trevor, and I’m like, Well, are you bored by your food? And like, Well, no, I’m not bored by it. Then, you know, how is it possibly boring? Because, to your point, doesn’t take much to take exactly the same food make it taste different with like a Mexican flavor or an Indian spice or something like that. So it doesn’t have to be a gourmet Michelin star meal every night of the week. So

Trevor Connor  55:59

we’re getting close to the point where we need to round things up. So I know there were a couple things that both of you wanted to talk about before we finish up this episode. And Dr Larson, you’ve been very interested in the high fat diet, and I know that really got shot down in the research about six, seven years ago, but you’ve been following the newer research, and it does seem like it’s been coming back around. Do you want to take a couple minutes and talk about that? In particular, I know there’s one study that you sent to me that was pretty fascinating. Yeah, so

Dr Paul Laursen  56:28

there’s a series of studies. I think it’s on the same group, but Philip Prins, Andrew kunick, Tim Noakes, are kind of like the central authors on these ones. They’ve had two or three good papers that have come out on this with this cohort, where they’ve adapted them to fat or carbohydrate across about 30 days. So it’s a pretty long term adaptation phase, and it’s super low carb, or super high carb is kind of the different context. Mickey alluded to this initially in the Prins study, when they first presented, 30% of this group that was coming into the study were already pre diabetic with the blood glucose monitors that they were wearing. And again, I mentioned before that when that group went through their low carb adaptation, high fat diet, they reversed their pre diabetic status, meaning they improved their health. But of course, what this always comes back to is those listening to the podcast we care about performance and the important take home point from this was that across all the different markers of performance that they looked at, performance was not impact. In fact, there was trends more for enhanced performance in the low carb condition, high fat condition. So it’s just more backing that it’s not necessarily detrimental. You know, I spoke about this before in the podcast I was on with Trevor, did a study with Steven Seiler and colleagues where we looked at the role of fat oxidation and the role that plays in enhancing your overall performance, and specifically your VO two Max, where we looked at a well trained group versus a really highly trained group of runners, and it was fat metabolism that was related to vo two Max and overall performance, not the amount of carbohydrate that you can burn. So fat has a very important role to play overall. And yeah, I guess if you’re still on the fence with considering bringing more fat adaptation into your persona, into your metabolism, yeah, just really encourage you to reconsider strategies to enhance that, because they’re all over the place, right? Whether it’s fasted training, like we’ve talked about in here, periodized training, or manipulating the diet, or kind of combinations of all these different things, there’s a lot to be said for it.

Trevor Connor  58:38

One of the really interesting things in that study was they recorded the highest rates of fat oxidization ever recorded, and it was at 85% of vO two Max, a point where common belief is you shouldn’t be oxidizing fat at all, and you should be completely reliant on carbohydrate at that point. That’s

Dr Paul Laursen  58:56

right, yeah. And again, this could be probably a whole other podcast that we do in the future, but basically, there’s a big confounder to the substrate oxidation formula. Actually, it’s basically when you’re producing a bunch of lactate, all of this, you know, goes into the bicarbonate system, and out comes a whole bunch of carbon dioxide. That’s the role of that bicarbonate that floats around in your bloodstream, and that masks some of the equations that we’re using in stoichiometry to actually calculate how much carbohydrate and how much fat, and it biases it more towards carbohydrate thinking that we actually have a whole bunch of carbohydrate. And it’s actually not the case. The reality is, and there’s only select few tracer studies that have sort of shown this, and unfortunately, it’s a lot of unpublished data, but the unpublished data that I’ve seen from David Rowlands and others show that there’s a whole lot of fat that is actually being burned at 85 90% of vO two, Max, real high intensity exercise, up to as high as 50% or the. Production is coming from the burning of fat in the mitochondria. Of course, that’s not out there, and it’s maybe a little convenient, I think that it’s not out there. But well, we often think that the body can’t burn fat at intensities towards vo two Max. The reality is, at least in my head, I know it can. And why would the mitochondria throw away the oxidation of a perfectly good substrate. I

Trevor Connor  1:00:22

don’t think it would and Dr Wilder, before we get to the thing, I know you really wanted to talk about just a recommendation to any of our listeners if you want to explore some of these different dietary approach, there’s a great review called efficacy of popular diets applied by endurance athletes on sports performance, beneficial or detrimental in narrative review. So it looks at vegetarian diets, high fat diets, intermittent fasting, gluten free diets, and FODMAP diets, and looks at them both in terms of their impact on performance and their impact on health. It’s a really interesting review.

Dr Paul Laursen  1:00:53

Yeah, it is, and you sent that to me. I read that last night. It was actually quite favorable in the high fat diet, and that’s one of the most recent reviews that are out there, so that was nice to see. So

Trevor Connor  1:01:04

Dr Wilden, you shared a study with us looking at sugar consumption and body size,

Dr. Mikki Willide  1:01:09

yeah, and it seems crazy to me that this hasn’t really been studied a lot to date, because we think about the utilization of fuel in everyday diet according to body size, but not those in training recommendations. And the name of the studies exogenous glucose oxidation during exercise is positively related to body size, and it was published by a group that includes Gareth Wallace and Javier Gonzalez. And essentially, it’s a small study, and it’s just one, but they had two groups of athletes, one with a body mass of 70 kilos and below that also included women in that group, and then another group that were above 70 kilos, and gave them the same amount of carbohydrate, 90 grams of carbs an hour, and got them to sort of ride at a moderate intensity for a couple of hours, and they were consuming carbohydrate at every 15 minutes to get that 90 grams of glucose during each hour. And what they found was that, on average, the larger athletes could burn about 36% more of those carbohydrates than the smaller athletes, albeit, in fact, they only oxidized. I think the small athletes oxidized 36 grams of carbohydrate an hour, and I believe that the large athletes oxidized about 45 or 47 grams of carbohydrate an hour. So despite the fact that the larger athletes could ingest more, neither groups actually could oxidize that fall 90 grams an hour? So I think this just really speaks to obviously, individual differences between the athletes, but that potentially you have lean smaller athletes going out there trying to get a ton of carbohydrate in where, you know, this is sort of the beginning of body research, which might suggest that body size might make a difference as well. So it’s just another thing to bring into the mix when you’re thinking about those individual fueling strategies for athletes.

Dr Paul Laursen  1:03:08

But it’s interesting, Mickey, just like you put it those burning rates, those oxidation rates, 45 for the big guys, 36 for the small guys, and they ingested 90. You said, right, yeah, yeah, crazy, right. So where’s the difference going? Right? Where is it going? It’s going somewhere, and it’s not going to make you healthy folks.

Trevor Connor  1:03:28

No, it’s being fermented. All comfortable, exactly,

Dr Paul Laursen  1:03:31

right? Exactly. So sorry, that’s the science. That’s the math at the end of the day. So be very wary of that, if there’s anything you kind of take from this. So

Trevor Connor  1:03:40

I think we need to round it up. What we normally do is have take homes at the end of our episodes, but I think instead of doing the take homes, this time, I want to do a slight modification, which is we promised our listeners we would give them some good suggestions on things they could consume while doing their workouts, particularly those long rides. So let’s just have each of us give our recommendations, and I’ll start because I think I probably will have the worst recommendations or the least beneficial, because I’m still figuring this out myself. As you know, I am dealing with afib, I have noticed that my AFib is a lot worse when I’m eating those simple, unbound sugars when I’m working out, so I’m really trying to get those out of my diet. So where I have landed personally, I just don’t do sports drinks anymore that contain a lot of sugars. I will on longer rides use noon, which has some electrolytes in it, but doesn’t have any sugars. And then the food that I’ve really landed on is a few bars that are more natural foods, but really have started enjoying I make now a trail mix for myself that has some nuts in it, it has pumpkin seeds in it, it has coconut flakes, and then I put some raisins in it, just to give that little bit of sugar, but it’s still bound sugar, and I find I respond pretty well to that. So that’s what I’ve been doing on my long rides. And. That trail mix gives me a lot of calories. It gets me through a ride. Well, who would like to go next? With their suggestions?

Dr Paul Laursen  1:05:06

Why don’t I go next? Because Mickey’s will be way better than me. She’s the nutritionist. But I’ll give you what I’m using. And these are on pretty long rides as well. You know, a trail mix kind of thing, almond heavy, just my nut of choice. I’ve got a bit of a nut allergy to some of the other ones. So it’s kind of, you know, cashews, almonds. Those are in the safe house for me. And then this one is totally out there, but actually an apple and pepperoni sticks. We’ve got a butcher. So I live in Revelstoke, which is a bit of a hippie town, and we’ve got our own butcher. That’s, you know, we know the pigs, and we know the animals. We can see them around. For some reason, it’s like the salt within that and the apple and the trail mix. I mean, yeah, I can do a full day of training on that kind of fuel, and I feel pretty good after good energy levels. But yeah, context as well, pretty fat, adapted individual. I could almost go with nothing for at least, you know, five hours, and it wouldn’t really faze

Dr. Mikki Willide  1:05:56

1. So I love both. What you guys suggested are excellent. I’ll add to the mix that making your own sort of energy balls, but using almond meal, coconut butter, some sea salt, putting a bit of protein powder in there can be helpful for some people, or just make it a bit tasty, a very good protein powder, and not some awful one that you can get with 1000 ingredients. And there are some good ones around. So something like that can be good. Some of my athletes have the corn thins, you know, the organic corn thins with like almond butter or peanut butter. And they’ll slap them together and chew on that. I mentioned the nut butters, and getting the small pouches like they can be really good for some of my athletes, we have, and I’m sure you have them where you guys are, but pork crack, so pork crackling that you can purchase, and literally, it is like There’s salt and it’s free range pork crackling. There’s nothing else in it, and so it’s heavy on the calories. It’s high fat and high protein, actually, and it’s salty, so that’s really delicious. You mentioned Bill Tong as well. Obviously, Paul. And look, I have some athletes who literally boil baby potatoes and put salt on them and take them out. So there’s a range of different things that people can try.

Dr Paul Laursen  1:07:12

I’ve even used a hard boiled egg a couple times as well, and that’s for some reason, the protein just satisfies me as well. So I know it won’t be for everyone, but that works for me.

Trevor Connor  1:07:20

So Dr Wildin, not to put you on the spot, but would you be willing? You’ve mentioned an energy ball recipe at the beginning. Would you be willing to send us a recipe that we could put up on the website for anybody to download and make?

Dr. Mikki Willide  1:07:32

Of course, 100% sounds great,

Trevor Connor  1:07:35

fantastic. As

Dr Paul Laursen  1:07:36

long as you also visit mickeywilden.com and join her newsletter,

Trevor Connor  1:07:42

along with the recipe, will be the link back to your website.

Dr. Mikki Willide  1:07:45

Amazing. That would be amazing, absolutely. Well, hate

Trevor Connor  1:07:49

to end this conversation, because this is one of my favorites, but hopefully all of our listeners got a lot out of this. I love talking with both of you, so thanks so much for joining us.

Dr Paul Laursen  1:07:58

It was a great conversation. Trevor, thanks so much for having me.

Dr. Mikki Willide  1:08:00

Yeah, thanks so much. Trevor and Paul. It’s been great.

Trevor Connor  1:08:04

That was another episode of fast talk with thoughts and opinions expressed on fast talk are those of the individual subscribe to fast talk wherever you prefer to find your favorite podcast, be sure to leave us a radiant or review. As always, we love your feedback. Tweet us at at fast talk labs. Join the conversation@forums.fastoclabs.com or learn from our experts@fasttoclabs.com for Dr Mickey willadin, Dr Paul Larson, Dr Brendan, Egan Brent buelter and Dr Scott fry. I’m Trevor Connor. Thanks for listening. You.