Coachcast Ep22 Stacy Sims Blog 1200×675

CoachCast: Optimizing Physiology with Stacy Sims

BY Evan Moore

Dave sat down with Dr. Stacy Sims to discuss how training should differ between men and women and much more.

Coaches should always strive to build training according to their athletes’ unique physiology, but how many of our training practices are weighted toward the male experience? Are you thinking about how nutrition and hydration affect performance? What about even coaching practices to increase beneficial bacteria in the gut?

Dave sat down with Dr. Stacy Sims to discuss the topics above and many more. They spoke about bad and outdated science that has led to one-size-fits-all training, how hormones affect training in performance in both men and women, and about resources that can help coaches and athletes get to the bottom of claims from supplements and nutrition claims.

Stand-out Quotes

  • “And the more I got into it and the more I started looking into it, the more I realized that everything that we know in nutrition and sports science and ex-phys is based on a male model. So need to think about, most of half the population really is not male and definitely not 18- to 22-year-old college male athletes. Right?”
  • “If you do fasted training, you increase your reliance on free fatty acids. Sure you do because your body’s in the stress state, it needs metabolism. But, you look at the performance outcomes, the results are equivocal. When you look at the health outcomes, it’s an no-goer and people don’t talk about that.”
  • “[Endurance athletes’] gut microbiome makeup is very, very much the same as a sedentary obese American following the standard American diet. And the reason for that is when you are exercising in that hot, hypoxic environment that your gut is in and you’re feeding it sugar, it encourages the growth of the bacteria that fosters itself on simple sugars. So even if you’re eating clean the rest of the time, you’re just really damaging your gut microbiome and having such an impetus for change when it’s under such distress.”

Resources

Episode Transcript

Introduction:               

On today’s episode of the TrainingPeaks CoachCast, your source for the latest information about the art, science and business of coaching. Are your training principles based on a one-size-fits-all methodology that don’t take your athletes’ unique physiology into account.

Dave Schell:                 

Hey guys, Dave Schell here and on this week’s episode of the TrainingPeaks CoachCast, I sat down with Dr. Stacy Sims, the foremost expert on gender differences in exercise science and nutrition. Some of the things we discussed were how to train female athletes differently than your male athletes, some of the common misconceptions with hydration and nutrition, and the gut biome, which I found extremely fascinating. If you do enjoy my conversation with Stacy, be sure to check her out at this year’s Endurance Coaching Summit in September in Boulder, Colorado. Stacy is one of our keynotes along with Alex Hutchinson, Christie Rwandan, Andy Blow, and much more. Use ECSCoachCast20 for 20% off your ECS registration.

Dave Schell:                 

Welcome to the TrainingPeaks CoachCast. I’m your host Dave Schell and today I have the pleasure of being joined by exercise physiologist, nutrition scientist and author Stacy Sims. Stacy, thanks for joining me today.

Stacy Sims:                  

Thanks for having me.

Dave Schell:                 

So you’ve come to be known as one of the leading experts, if not the leading expert, in sex differences in training, nutrition and health. Um, can you tell us a little bit more about that and what led to your, um, inspiration for studying that?

Stacy Sims:                  

Uh, Gosh, I, you know, I think it’s kind of funny that I’ve been pegged this because I’ve been talking about it for so many years. Um, and I think it’s now just bringing awareness, but when I was kid, I was one of those kids that always asked why, and you just grew up that way. Right? You know, like, why can’t I do that? Why can’t I do that? And as I got involved in sport and started seeing some things that didn’t make sense to me, like, you know, some of the guys were recovering better from certain training programs and me and some of my teammates, and then things by going to Kona, um, and doing the same heat acclimation program as of my other female, um, teammates. And they did fine and I didn’t because they were in a different phase of menstrual cycle. Uh, so there are a whole bunch of different questions that kept coming up that I just kept getting no real reasonable explanation for it from the people that I was asking who were supposed to be the experts. And the more I got into it and the more I started looking into it, uh, the more I realized that everything that we know in nutrition and sports science and ex-phys is based on a male model. Um, and we need to think about, you know, most of half the population really is, uh, not male and definitely not 18 to 22 year old college male athletes. Right? So that’s kind of the drive. It was all selfish, it was definitely selfish. I tried to make myself better, try to make my teammates better, but then I realized that it’s not just about that it’s making everyone who puts hard effort in able to maximize their potential.

Dave Schell:                 

Gotcha. And so you, um, authored the book ROAR: How to Match Your Food, Fitness, um, Food and Fitness to Your Unique Female Physiology for Optimum Performance, Great Health and a Strong Lean Body for Life. So I feel like you just kind of answered what my next question was going to be, which, what was the motivation for that? And it sounds like it was just you wanting to optimize your own performance and realizing that there were some shortcomings, but in researching the book and in your own research, what were some of the biggest surprises to you that like from my perception, I would say that a lot of endurance sport, especially coaches is predominantly male, but they may be coaching a middle-aged woman doing their first IRONMAN. And so what are some of the things that those coaches should know? Like if you could only tell them one thing, what is the biggest thing they need to know about coaching that woman?

Stacy Sims:                  

Uh, so gosh, there’s so many things. I don’t know if I can disseminate down to one. I mean basically start with the typical three week on, one week off training model. That’s not appropriate for women. It was researched and designed on male athletes and their inherent sex differences from birth, from muscle enzyme activity to recover availability from a time standpoint, nutrient timing, um, adaptations, even things like heart rate variability is different between menstrual cycle phases. And when you get to like the mid- to late-forties where hormones really start to purr debate, this is where you’ll see the biggest issues that come up. And the fact that you might have a training program you think is dialed in for your athlete, then all of a sudden they’re not responding. So the undercurrent there is really tracking menstrual cycle for one, understanding how the woman that you’re working with recovers, and it’s not that she’s being lazy or she’s tired. There’s just certain days during the menstrual cycle phase where they’re spot on because physiology is letting them be that way. And other times where they’re really just fighting against a brick wall because of these perturbations in hormones that aren’t going to allow them to access top end, they’re not going to recover as well, their sleep’s going to be interrupted. And if you start looking in a patterning over two to three months, you’ll be able to dial in training versus the physiology. So on a really fantastic push through days, you’d get in some fantastic training sets, which is what you want for adaptation. And then, you know, like around ovulation or the few days before a period starts when when women feel a bit flat, you know, not to push the high intensity. You can work with it and get some really gains without overtraining or over pushing your athlete.

Dave Schell:                 

So again, going back to these males who may be coaching a woman, I feel like this is kind of probably an uncomfortable conversation to have, but it’s definitely an important conversation to have. So do you have any tips on how to kind of broach the subject?

Stacy Sims:                  

Yeah. So, um, last week the same question came up when I was presenting to the New Zealand Rugby Union high performance coaches. And I’m in a room full of guys that are very much in a patriarchal system. So the idea of asking their athletes, oh, do you have a menstrual cycle? So it’s really, you know, when you have the intake form for your athlete, one of the questions is, is your cycle regular? Right? And so it’s not necessarily the conversation you’re having, it’s just a point to note. Um, if that even feels uncomfortable, then you can even put down do you track your cycle because there’s apps out there. And the one that I’m sure people have heard me talk about is a favorite is the fitter woman app because it was designed for their recreational to sub-elite female athlete. But there’s also coaches version. So the coaches version, you can look in and see all your athletes who are tracking and see what phase they’re in, how their mood is, how they’re, um, sleep metrics, or heart rate variability, all their wellness. So you can see if they’re not doing well or if their period is misaligned or they’re not recovering well without having to go into that really in depth conversation that is a bit uncomfortable. Um, but yeah, it’s more of getting the awareness out there. So the male coaches know that this is a significant issue to discuss. Um, and having the awareness out there where women don’t feel uncomfortable having that conversation with a male coach. Because one of the other things, especially in endurance athletics is when a woman becomes amenorrheic or loses her period and that is the first sign that something is amiss between training and nutrition is when you get into a low energy state or you’re not recovering well, you have too much cortisol, then your periods becomes irregular. Because your endocrine system is the first thing to go see your hormones really start to flat line and bottom out and then you lose your menstrual cycle. And if you’re keeping track and you can see that happening, then you can look and see, well I need to back down a little bit here. Maybe I need to increase my recovery food intake here. So it’s a really powerful tool to keep athletes healthy because if they’re amenorrheic they’re more susceptible to poor performance, injury, bone stress fractures, a soft tissue injury, poor sleep, um, just all sorts of things that, that we think is over training in the endurance scope. But really it comes down to there’s this misstep and this is low energy availability and there’s this hormone dysfunction. And if we can stop it before it gets too far down in the track then we don’t go through all that, oh my gosh, I’m glad I’m tired and I need to take a significant time off to recover.

Dave Schell:                 

So you mentioned the menstrual cycle and kind of working with that in training, and you’ve kind of touched on it a little bit, but I guess can you just tell us what is, what would be the proper way to approach that? Um, both leading up to ovulation and post ovulation.

Stacy Sims:                  

So we’re, we’re assuming that people are tracking and they know that, um, the length of their cycles. So if we look, textbook period is day one is the first day bleeding and leading up to around day 13, which is around, ovulation with the upsurge of estrogen. Uh, and then you have a little bit of estrogen. Progesterone and estrogen start to come up until day 28, which is the last day of the cycle because the hormones dropping, you start to bleed. But we know that a period can, or a cycle is anywhere from 32 or 28 to 32 regular to 28 to 40 days. And if you haven’t had an a period in 40 days, then you know there’s something wrong. Um, and it’s a misnomer that a woman has a period every month. Like most women will skip a period every once while. So it’s more like there’s eight periods in a typical year. So it’s not like you’re going to end up being on a regular basis, having one every 28 days. But knowing how regular you are, even if it is a little bit irregular, so your regular irregularity can really help you get insight. Um, and that’s the first thing. It’s like when you know that your cycle is 32 days, right? Boom, 32 days, then you can track it in the first two weeks leading up to ovulation is low hormone phase. This is where you can access carbohydrate, well hit high intensity, your core temperatures lower. You have more sodium circulating in the body. Um, your recovery time is, is less than in the high hormone phase. Then as estrogen goes up for ovulation, some women feel bulletproof and if you’re a woman who feels bulletproof, they can use that day, right? Get in the gym, get on the bike and do hard VO2 efforts. Get on a track, do your 10, eight-hundreds, you know, just really maximize that day for that really super strong training, stress and recover because that’s a, you know, it’s like a bulletproof day where you’re like, I’m going to nail everything. And the idea of training is to go out, stress the body and overcome that stress. And then when you start to get into the high hormone phase where estrogen is inhibiting carbohydrate utilizations, you can’t quite hit those high intensities estrogen. Also up regulates Serotonin in the brain. So you start to get some brain fog. Progesterone increases the core temperature. So your time to fatigue is, is shortened. Um, heat tolerance is a little bit less. You have less water in the blood, so your, your ability to get enough blood to the working tissues a little bit dampened. Um, so understanding that physiology can help you dial in the training to hit those really hard days. But the flip side of it as well is understanding the physiology means that when you get to those five to seven days before the period starts where physiologically you’re little bit impeded from performance. You can put in specific nutrition practices and recovery practices to overcome that. So you shouldn’t think of it as, I can’t race am I, you know, the day before my period, I can’t hit these intervals. It’s just knowing what’s happening. So you can do things like take a glucose tablet on the, on a, on the track when you’re in those few days before your period starts. So, yeah, it’s, it sounds complex, but when you start really looking from that high point and seeing what the cycle is and, and over the course of three months really understanding the days that you feel good and the days you feel a bit flat, then you can match the training to that.

Dave Schell:                 

Okay, awesome. So beyond periods and menstrual cycles, what are some of the other major differences between men and women’s physiology that coaches should be aware of?

Stacy Sims:                  

Um, so I mean like when we think about it, we have sex differences from birth, but the first conversation that should be happening is around the onset of puberty. Because this is where you start to really see these changes happen. These sex differences happen. So when you get the exposure of testosterone, boys lean up, they get fitter, they get faster, stronger, they have more hemoglobin, their lung size is increased, their heart is increased, cardiac output is greater. So when you look at it from the estrogen and progesterone aspect for women, their Q angle, the angle between the hip, the knee, that widens. So learning how to rerun and running mechanics, it’s really super important because the center of gravity changes that bone in, in girls grows a lot faster but not yet quite as dense. The muscle stability isn’t quite there. So you’ll see people who don’t know how to run very well when they start going through puberty. And maybe that’s a learned habit all the way through. So looking at running mechanics, super important to prevent injury, um, knowing that like with swimming and such, the shoulder girdle and the angle of the shoulders to the hips is narrower in women than men. So the rotation aspects, center, gravity aspects, all those things, the technique becomes really important. And then we’ll, let me think about recovery as well. So we know that in that acute recovery phase, it takes about 45 minutes for women to come back down to baseline. But men have between three and 18 hours. So really nailing down that recovery window from nutrient point of view. And the reason for that is we always hear about getting some protein and carbohydrate in right after exercise, right? For muscle protein synthesis, glycogen rate replenishment, and I’ve always prefaced and looked at the research saying if you get the protein in first, then it opens your window up a little bit longer because of insulin sensitivities that you can pull more carbohydrate and for your next meal. But the other critical sex difference is that women need more leucine circulating in the brain because the feedback mechanism for muscle protein synthesis starts in the brain and it’s a bit dampened if leucine levels are lower in a woman’s brain than in the men’s brain. So even if you’re getting an adequate hit, a protein with amino acids circulating in the blood, it still doesn’t trigger that muscle protein synthesis as strongly as if you were to have a really significant amount of leucine circulating and hitting the brain and and replenishing the brain stores. So this is where that recovery window becomes really important, getting that big hit of protein for women so that you’re getting it in circulation into the brain. Whereas that recovery window that’s a little bit longer in men, they can afford for a little bit of delay, smaller amount of protein, and smaller doses across the way, we’ll still get into the muscles and trigger that muscle protein synthesis. But for women, you need a larger amount in a shorter period of time for the brain and the muscle.

Dave Schell:                 

Wow. That’s fascinating. I had no idea.

Stacy Sims:                  

Yeah.

Dave Schell:                 

That’s pretty crazy. Um, some other things, like in reading your book, I saw some other things that I wasn’t sure if it was sex specific, so I wanted to ask you about some of those things. Um, first off you talked a little bit about fasted training and that’s very en vogue right now. Lots of people doing fasted training. You advise against it in the book saying that, if I recall correctly, it kind of wreaks havoc on your hormones. Is that just for women or for men as well?

Stacy Sims:                  

So, remembering also that, and I’ll take a step back before I really get in depth with this question, that the fasting research and the low carbohydrate, high fat research, all that started in the clinical population. So we know it works really well in obese individuals who need to lose weight for surgery. We know it works really well for people who need insulin control cause they’re prediabetic or their diabetics without control. And then the misstep is that research has been called into the athletic environment. Now when we look at the athletic environment, the research that’s coming out now does not include exercise. So they’ll take individuals and they’ll have them do, you know, intermittent fasting, but they won’t look at the effects of exercise on that intermittent fasting. Because when we were doing fasting, the idea is to change the telomere length, to have some autophagy so that your body’s repairing itself. But these are exact same things that happen in exercise. So for doubling it up, we don’t know if it is an additive effect where they cancel each other out or if it’s a negative effect. So that’s the first thing to think about. Now the second thing to think about is this hormone millea. So when we talk about fasting and going exercising without eating, your baseline levels of cortisol are already elevated. Um, now for women with elevation of Cortisol, you are really playing with this interchange of estrogen and progesterone, and to a point testosterone. In order to keep cortisol elevated, estrogen and progesterone start to be flat lined so that the steroids can come over and work to get that cortisol going and to keep going. And when you have that elevation in Cortisol, it can interact with thyroid, thyroid function, downregulation of thyroid. If you have a downregulation of thyroid, um, then you also have a, a reduction in your resting metabolic rate. You also have this flat lining of your sex hormones again. And we think you know, this leads to a amenorrheic. So that all comes down to this energy availability standpoint. So for women it’s really critical not too fast because the outcomes of low energy availability for exercise is significantly more detrimental to overall health than it is in men. Now we look at in a male model and we see fasting and it’s not quite as detrimental because men don’t need as much carbohydrate circulating as women do in a daily basis. So if you’re going fasting and you’re doing some fasted training, what we do know is in the general scope, if you’re trying to lose weight as a man, if you go and do a fasted cycling session, then you eat. We do know for sure that you won’t overcompensate and you’ll actually stay in an energy deficit. So if you’re trying to lose weight, that’ll be okay. But for this high level of all these endurance athletes that are perpetually teetering on this energy availability standpoint, to me it’s a stop gap. No one should be doing that fasted training, male or female. For women, primarily the hormone aspect and the down regulation of thyroid and resting metabolic rate. But for men getting into low energy state, it reduces testosterone. So as difficult as it is for conversation for women to say, I don’t have a period or I do have a period, men do not talk about testosterone. So if they get into this low energy state and their testosterone starts to drop, rarely do they bring it up. And we know that with lower testosterone, you’re not going to recover well, you’re going to put on body fat, you’re going to get tired, fatigued, you’re not going to adapt. So when we look across the board at fasting, the outcomes of fasted training in the exercise, in particular exercise for a race point of view, neither sex benefits and you can read Volak’s stuff, right? And it’s like, well, if you do fasted training, you increase your reliance on free fatty acids. Sure you do because your body’s in the stress state, it needs metabolism. But you look at the performance outcomes, the results are equivocal. When you look at the health outcomes, it’s an no-goer and people don’t talk about that.

Dave Schell:                 

Thank you. That’s, uh…

Stacy Sims:                  

Long winded.

Dave Schell:                 

No, that’s fantastic. It’s, it’s again more information that, you know, there’s so many trends and everybody wants to hop on whatever the latest and greatest, I don’t know if I want to say fad, but whatever the, whatever the going thing is at the moment. And so it’s, it’s great to hear that, you know, maybe there are some downsides to it. And it sounds like there are. Um, so another question I have for you, and this is another thing that is definitely something I’ve dealt with in the past and it’s the need for salt supplementation and taking salt tablets. And somewhere in the book you say that you emphatically say no. Regardless of where the race is, it’s hot, humid. So are there any situations where you would say salt supplementation is necessary or would you say no, your body does a good enough job at regulating that, that you don’t need to supplement outside of a sport drink.

Stacy Sims:                  

A sports drink doesn’t have enough sodium to actually help. And so when you think about it from a high touch of nutrition, if you pay enough attention to your nutrition, like you do your bike fit, your running shoes, you are training right then you should be fine. It, we see this upsurge of I need sodium, I need sodium, I need salt tablets. Because when people get on a race course, they tend to use what’s on the race course or they tend to use what so and so told them to use. And most of the time it’s engineered nutrition, right? So we hear the gels, the chomps, the typical sports drinks, none of those hydrate. A lot of them effectively dehydrate because they’re too concentrated. So they sit in your small intestines and increase the pressure and your body’s response for increased pressure is to pull water into the small intestines. So then people are like, oh gosh, I feel really awful. I don’t want to eat. I feel bloated. Oh, I must be retaining water. I need a salt tablet because I’m going to cramp. I need to redistribute this water. Then they’re adding the salt tablet into the situation and the sodium chloride is an issue in the exercise and the state as well. The body has a tenfold decrease in its ability to absorb chloride during exercise, so you’re contributing extra ions that can’t necessarily be absorbed and you’re increasing the amount of pure sodium that the gut necessarily can’t handle. So you’re adding onto this bloatedness and extra effective dehydration from carbohydrate. You’re adding the sodium onto it and it can definitely shoot you right to the porta potty and cause the cramping. So when we look at it from that high point, the body is really good at regulating and unless you have, you know, the syndrome for inappropriate or aldosterone secretion predisposed to hyponatremia. So yeah, if you know that or you’ve experienced hyponatremia in the past, then there can be a time and a place, but if you are using food and fluid that has sodium in it, then you are fine. It’s when you don’t match your nutrition for what your physiology needs. So that’s what I mean. Like a typical sports drink doesn’t have enough sodium in it to help with all that fluid absorption. It’s too high in carbohydrate. And then when you’re looking at the gels and the chomps, they have a little bit of sodium, but not enough to counter what your body needs. And a lot of people like, oh, I’m a heavy sweater. I sweat X amount of sodium per hour. That doesn’t mean anything. Like these sweat rates and the sweat composition, that doesn’t mean anything. If you had a salty meal the night before, your sweat, sodium is going to be higher. If you’re in the high hormone phase as a woman, your sweat sodium is going to be higher. If you are a trained athlete who just starts to go to the heat, your sweat sodium is going to be higher because your body is, you know, trying to get into this equilibrium state. Um, so again, if you know that you have syndrome of inappropriate aldosterone secretion, which is what Tim Noakes talks about, you know, all the water logged stuff, it’s a small population, but people do have it. And then again, if you’re a woman in the high hormone phase and you’re tetering right on that hyponatremic, salt your food that you’re eating leading into race, make sure that you’re eating salted food while you’re racing and then you don’t need salt tablets.

Dave Schell:                 

And when you say salted food with like pretzels, a lot of times that IRONMAN pretzels on course, and is that enough salt?

Stacy Sims:                  

Yeah, you can suck the salt right off the pretzel if you want to. But you know, like, um, uh, yeah, the soft pretzels that a lot of people have. Like I have athletes in T-2 before they start running, they’ll have a soft, really salty pretzel they take with them. So then they get like that pretty bland, easy to digest white bread with lots of salt and they’re like best thing ever.

Dave Schell:                 

Oh, I bet. What is, you said that um, sports drinks, especially a lot of the most popular ones on the market, they don’t do a good job at hydration. But you also said that the, they don’t have enough sodium to help anyway. So what is the role of sodium in a sports drinks? Let’s say that, let’s say Osmo, which you created, correct?

Stacy Sims:                  

Yep.

Dave Schell:                 

Okay.

Stacy Sims:                  

A while ago. I’m not involved with them anymore. But anyway, yeah, so that’s not a typical sports drinks. So if you look at Scratch, you look at Osmo, you look at the Nuun Endurance, those aren’t what I call the typical sports drinks. They’re designed to be functional hydration where it’s lower carbohydrate, a little bit higher sodium and some potassium. So it works with your physiology for fluid absorption. And the mistake people make with those types of drinks is they’ll double up the scoops trying to think about it as calories and then it’s a moot point. It’s not a functional hydration anymore. All they’re doing is they’re having calories in the bottle and that’s not what it’s about. It’s about functional hydration. The reason why they took off is because people weren’t experiencing bloating. They weren’t feeling overly dehydrated because what they were drinking was actually going to hydrate them. When we think about a typical sports drink, you know, Gatorade now sponsors IRONMAN. So you have have Gatorade Endurance on the course. That’s a five to six percent solution. Now when you look at a five or six, five to six percent solution, um, the carbohydrate content in those are more about exogenous carbohydrate, their worry is that we’re going to hit the wall so we need carbohydrate. So there’s a little bit of sodium in there to enhance the palette because your palette changes as you become dehydrated and you start to crave salt. So the sodium in there isn’t for fluid absorption. It’s to encourage you to drink more. So they want you to drink more of their drink. But if you’re drinking more of their drink and putting more of this excess carbohydrate in the gut, you get that sloshing. So when you’re thinking about what am I drinking, is it functional for my physiology? You go with the lower carbohydrates, higher sodium, and that’s all about working with the gut for fluid absorption. Then your body’s not overly stressed. Cause we also forget that when you start exercising, you have such a huge blood flow diversion away from the gut. So you have a hot and low oxygen environment that your cells are trying to work in. So if you’re putting stuff in that doesn’t work with physiology, again, you’re doing yourself a disservice. Your body’s going to have to work even harder while you’re exercising to get the nutrition that it needs.

Dave Schell:                 

So why won’t pain water just work as far as hydration?

Stacy Sims:                  

So this is where we get into the nuances of the small intestine. The small intestine is where 95% of all your fluid absorption takes place. And it’s very particular to the solution that comes in it. So from a science standpoint, the optimal pressure in there comes from a solution that’s 200 to 250 milliosmoles. When you start gravitating below or above that, you start having some dysfunction. So plain water, yeah, there’s almost no pressure exerted from it. So you’re pulling in something that might be 10 or 11 milliosmoles, doesn’t exert pressure. Your body’s like, what do I do with it? It pulls out from other places to bring the pressure up so that it can be absorbed. And then when you’re looking at the other side of the things and you’re taking in a typical sports drink that sits around 300, 360 milliosmoles, it’s way above what it can do. So then the body responds by pulling water into dilute it. Plain water doesn’t hydrate because your body has to find sodium or excrete it because it’s like, whoa, it’s too much because we don’t have plain water in the body. You think about it, we all a solution of, of electrolytes and glucose, amino acids. And then when you have too much your body’s like well I don’t know what to do with this, I better dilute otherwise, you know, it’s just going to sit here. And the longer something sits in the gut, the more predisposed you are to having gut issues.

Dave Schell:                 

So one of the things that I, and maybe I’m off, but I think one of the things you’re famous for saying is hydration in the bottle, food in the pocket.

Stacy Sims:                  

Yep. That’s pretty much it, yeah.

Dave Schell:                 

And so one thing that I’ve always wondered about is I feel like, okay, well, so I’m drinking hydration, I’m drinking, uh, a solution. That’s what is it? Four percent is what we’re aiming for

Stacy Sims:                  

At the most, yeah. One and a half to four. Yup.

Dave Schell:                 

Okay. So I’m drinking something that’s going to hydrate me, but then I’m eating real food, but once it gets in my stomach, it’s all kind of mixed together. So how does your body deal with that is one thing I’ve always been curious about, is it separating that fluid out and then digesting the solid food separately?

Stacy Sims:                  

Sort of, so we have different pressure response and pressure sensors in the stomach and those pressure sensors are responsible for what is allowable into the small intestines. So if you have a big bolus of fluid, then you’re going to have a very strong stimulus to dump it into the small intestines. When you have this mix of food and fluid, the receptors of pressure aren’t quite stimulated. But then you had the sensors for protein, fat, and carbohydrate. So your body titrates out those macronutrients at a rate that won’t overwhelm the intestines. So if you’re drinking, that’s one type of receptor that activates things to get into the small intestines. And when you’re eating, the macronutrients affect other feedback mechanisms to titrate into the small intestines. So the stomach is very smart, it’s like the gateway to the intestines and you don’t want to like break down the gate. So it’s like, okay, we’ll have a little bit here and a little bit there and a little bit here and a little bit there, not to overwhelm. And in the sports sports market, you’re overloaded with the same amount of carbohydrate, right? Maltodextrin, fructose, glucose. And so those macro nutrient receptors are like, whoa, we got to get rid of some of this. So it over overloads the gates and then overloads the intestine.

Dave Schell:                 

All right. I guess I’ll start eating real food.

Stacy Sims:                  

Good.

Dave Schell:                 

You have convinced me. Yeah, definitely. So while we’re on the subject of the gut, um, one thing that I’ve just recently heard about and then I, uh, read a little bit about it in your book is the gut biome and this idea of these, these, um, beneficial bacterial colonies and it, it sounds like science fiction, like it sounds crazy that you could have these little bacteria that influence your mood and your cravings and things like that. And that’s real, that’s what we’re finding. Is that correct?

Stacy Sims:                  

Yeah, yeah, for sure. I spend two full lectures on this in my nutrition class and I get all the kids, I shouldn’t say kids cause they’re university students, but they get all excited because like your typical gut microbiome makeup is stable by the time you’re age three. And then what you can do is you can alter the ratios. And we know that endurance athletes who have a high sugar intake of training food end up with the same gut microbiome, low diversity, high incidents of what we call from acuities, which is associated with the obesity. Um, so their gut microbiome makeup is very, very much the same as a sedentary obese American following the standard American diet. And the reason for that is when you are exercising in that hot hypoxic environment that your gut is in and you’re feeding it sugar, it encourages the growth of the bacteria that fosters itself on simple sugars. So even if you’re eating clean the rest of the time, you’re just really damaging your gut microbiome and having such an impetus for change when it’s under such distress. So we know that again, eating real food is going to help with that diversity and the more diverse your food, the greater the diversity of the gut. If you have a very diverse microbiome, then you’re less susceptible to injury, less susceptible to anxiety, less susceptible for chronic public burdens diseases like cardiovascular disease, obesity, diabetes. Um, and I mean, one of the famous case studies that came out a couple of years ago was about this woman who had a lot of c-difficile infections and antibiotics weren’t working, so she had to have a fecal transplant and she had her daughter as a donor and before the transplant she was very thin and had been whole life. But afterwards she gained 30 pounds she couldn’t lose. And she kept gaining weight and they’re like, what is going on? And it’s because her daughter was obese. So the bacteria that she, um, actually had transplanted in her was in the ratio to perpetuate obesity. And she can’t change that unless she has another fecal transplant. So it is so interesting and the science is changing so rapidly and most of it again, is in clinical population. But what we know is exercise perturbs things so much. So you do have to be super careful what you’re eating and drinking and started to feel yourself during exercise to have that overall good health.

Dave Schell:                 

Wow, that’s, that’s pretty unbelievable. I, you can’t really see my here because I’ve got the mic in front of my face, but I’ve just been sitting here slack jawed because, for the record, what is a fecal transplant?

Stacy Sims:                  

So when people need to have like complete microbiome change, then the donor donates a stool sample and it gets spun down and cleaned and then, um, is transferred through the anus to the next person. So it really is a transplant of fecal matter from one person to another in a very medical clean way. Um, and it’s the last resort really for people have such severe bacterial infections of the gut.

Dave Schell:                 

Wow. That’s, that’s crazy. And it’s exciting to see what will come of it in the next five years, you know?

Stacy Sims:                  

I know.

Dave Schell:                 

Wow. Um, so just have a couple more questions for you before I let you go. Um, the other thing that I was really interested in is the effect of antioxidants on recovery. It’s like, yeah, that’s one of those things where it’s like you look around, you look at all the packaged food and they’re touting uh, antioxidants, antioxidants, and it seems like the best thing going right now. But it sounds like it might be counterproductive for adaptation.

Stacy Sims:                  

Yup. So, um, when we’re looking at adaptation, again, the whole reason we go training is to stress the body, right? So we’re stressing everything from the oxidation system, the inneraerobic system, everything that has to do with creating change in the muscle and the lungs and the heart and everything. And one of the critical adaptations is in the Mitochondria. So the oxygen powerhouses of the cells and in order to get quote stronger, they need to understand what oxidation is and put into place steps to overcome it rapidly. If you take an antioxidant, the Mitochondria doesn’t learn that because it has an exogenous thing that’s going to come and remove the free radicals. So you are dampening down your adaptations, just going to take you longer to get fit. So if you’re thinking about, you know, all these post-exercise smoothies and supplements, then everything that has such high concentration of antioxidants, you’re like leaving so much performance potential on the table. Have it like five, six hours after you exercise. Sure. But don’t have it right after exercise because again, you’re reducing your body’s adaptation process and when you’re looking at getting antioxidants, get it from food, because there’s a study that came out three weeks ago looking at people who used real food to meet their recommendations for antioxidants, phytonutrients, magnesium, selenium, all those things versus supplements and those people who used supplements had a greater incidence of cardiovascular disease, muscle wasting, upper respiratory track infections, all of these things that people take supplements for, those people who got it at a real food, were healthy as. So again, we are not as smart as Mother Nature and we don’t know what the cofactors are in food that make things work. So when we start nutrient sciencing it and putting it in a pill form or powder form, we really don’t know the longterm effects of how it’s going to know going to affect our bodies are adaptations or responses or overall health. Um, so yeah, at the antioxidant thing has been really interesting cause it’s been around for lots and lots and lots and lots of decades. But it’s starting to get that trigger and pull because there’s such as push now of, you know, improve your gut health, improve, m, you know, your telemere, get a antioxidants in, get these certain supplements, get prebiotics, probiotics, all these things that come in pill form. We should be getting it from real food.

Dave Schell:                 

On that note, going back to the gut biome probiotics, that’s a big industry now as well.

Stacy Sims:                  

I know.

Dave Schell:                 

So are there any reputable sources for getting them in a pill form or what is the best way to get them via food?

Stacy Sims:                  

Nope.

Dave Schell:                 

Wait a minute. No? There is not a good pill form?

Stacy Sims:                  

Not a good pill form. No, for many reasons. Many reasons. So, you know, we have all this, um, antibacterial resistance, right? Because there’s all these antibiotics that are out there and people are developing resistance. So the probiotics that are out there, there are a few things that aren’t well known. One, most of the strains are coming from maybe two or three companies. So they’re very much commonplace. The other thing are things like, um, the bacteria longus, which is a very common, uh, bacillus strain that’s in so many over the counter probiotics actually causes chronic fatigue in women. Um, and then the other thing to remember is when you take it in a pill form, it gets in the stomach acid. It doesn’t really get into the gut. It goes through such a large digestive process that where you want to make instigated changes mid colon and that doesn’t even get there. The way that you get there is by real food. So you are eating probiotic fermented foods, right? And then you’re also eating really fiberous prebiotic food that is food for the bacteria that’s in your gut. And the more diverse your food sources are, the better diversity there is in your gut. Because the digestion and the nutrient uptake is in that mid colon aspect and that’s where the, the precursor of good gut biome comes from. So taking a pill, does nothing.

Dave Schell:                 

Wow. Okay. So a ton of yogurt. Are the standard yogurts out there, like some of the big names, tout that they have probiotics and prebiotics and I guess just probiotics. Are those good sources or do I need to find something that’s like not raw milk but something more organic or like really seek something out that’s not just on my standard store shelf?

Stacy Sims:                  

Um, no, you can use the standard yogurts that’s fine. They all have the same bacterial strains because that’s what feed on the milk sugars. So you know, if you were to leave milk out and it becomes yogurt, which is how you make yogurt at home, right? You heat the milk and then you let it sit overnight. The bacteria that eats the milk sugar lacto bacillus and the bifidus stuff that’s already in all the yogurts. So it’s a natural production of the milk sugars, which is great. But you also want to look for more diversity. So you can go for something like Kefir or Sauerkraut, Kimchi or the other fermented foods where the bacteria that’s fermenting are a little bit different.

Dave Schell:                 

Okay.

Stacy Sims:                  

Um, so yeah, again, that’s the real food aspect. Right?

Dave Schell:                 

Very cool. That is awesome. So before I let you go, I like, I’ve learned so much already and I can’t wait to see you at the Endurance Coaching Summit in September. Um, but before I let you go today, I’m just curious if you have any recommended reading or podcasts for the coaches that are listening, um, to learn more about some of the things we talked about today, besides your own book.

Stacy Sims:                  

Besides my own book, um, so like to vet things if it works or not, right. You’re looking at all the different caffeine, probiotics, prebiotics, all the supplements that come up, techniques that come up. The website examine.com is fantastic. Examine.com. Um, it’s a group of scientists that were doing their Ph.D. together and they started writing these reviews. So it’s very, you have the deep science and then it has what the human nature is. So it gives you that quick look. So it’s a really good one. Um, they don’t do sex differences, which is unfortunate, but they’re working that way. So that’s a really fantastic resources. Um, we’re starting to put more stuff out through the female athlete health symposiums and conferences. There’s one in Boston that I am presenting at and going into next week. So there are a lot of resources through the Harvard Med and through, um, Whispa, which is a working group in New Zealand. So there are lots of resources of information there too. Um, and then my social media, I’m always putting stuff up that is little short tidbits or um, new new research that’s coming out.

Dave Schell:                 

Okay. And so you have your own Facebook page?

Stacy Sims:                  

And Instagram and Twitter.

Dave Schell:                 

And so where would people find you on Twitter?

Stacy Sims:                  

Um, all across the board, it’s just Dr. Stacy Sims.

Dave Schell:                 

Perfect. Awesome. Thank you very much. We’ll put that in the show notes so that people can find you and follow you. Thank you for your time. I learned a ton and like I said, see you in September.

Stacy Sims:                  

Yeah, thanks for having me.

Dave Schell:                 

Yeah. Take care.

Dave Schell:                 

Hey guys, Dave here again. I hope you my conversation with Stacy. I have to say that I learned so much from her. It’s going to be really exciting to hear her at this year’s Endurance Coaching Summit. Again, use “ECSCoachCast20” to get 20 percent off your registration. Hope to see you there. Until next time.

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About Evan Moore

Evan Moore is a content editor at TrainingPeaks specializing in coaching content. Previously, he worked in marketing in the outdoor industry and higher education. He enjoys running, mountain biking, triathlons and many other outdoor activities.