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Hey everyone, it's Mikki here. You're listening to Mini Mikkipedia. And this Monday, I wanna chat about the athlete gut. On the back of a couple of conversations with both friends and colleagues and clients talking about their GI related issues with their training. And this can look like a number of things. One of my friends,

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described the gut related issues as farting like a trooper and needing to go to the toilet three times before going out on a run. This was another conversation I had with a client who despite changing up what she ate before exercise, avoiding food, avoiding certain foods, she still had loose stool on her runs and she even had to change the time that she ran in order to help offset some of the symptoms

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but it didn't actually resolve much for her. And then of course, it sort of goes without saying that there is this emergence from the sports nutrition companies to sort of plough us with carbohydrate in doses of 90 grams an hour, 120 grams of carbohydrate an hour, and then just telling us to train the gut and you'll be fine. Really in my practice,

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20 years, have I seen this to sort of be the case? And in fact, there are certain reasons why some people are more susceptible to experiencing issues with their gut. And there are other dietary things that can be done to help manage some of these gut related symptoms. Because GI symptoms are super common, particularly with an endurance based athlete. Indeed, most competitive.

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recreational, which is what we would come into, not just recreational, and elite athletes do experience gut complaints at some point in either their training or their racing. And for some of them, it's super sporadic and it poses no consequences, but for other, it's repetitive. And when it is something that occurs time and again, it does compromise their ability to train.

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their potential and then of course it compromises their ability to show up the way that they could on race day. And even if we just think of something super simple which is often overlooked, and that's the presence of bloating. A lot of people think that bloating is sort of normal, and indeed some level of bloating is by no means debilitating for all people, but one of my clients expressed that he was bloated for like 16 years.

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Yet he would continue to train and compete in this state. And it almost just became part of his normal day to day. It never sort of dawned on him that it was something that could have been resolved with diet. And if you think about bloating, it has such a mechanical consequence on your ability to run properly or sit in a cycling position properly or anything like that. Like you can't.

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possibly engage your core muscles to the same extent. So outside of the potential GI issues and the subsequent inflammation that can occur when you're not digesting and absorbing your food well, you've also got the potential injury risk of not being able to engage your core effectively, of then this over reliance on other muscles to hold you in place, and the potential for them to be chronically overworked.

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So there is so much that can occur because of these GI issues, exceeding just that sort of in the moment of loose stool or diarrhea or bloating or anything like that. And it's interesting, there are several factors that do influence the diversity and severity of gut complaints. And they predominantly arise from

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normal physiological changes that occur to the GI and immune system in response to exercise. It does go without saying that because of the mechanics of running and the additional sort of effects of foot strike and stuff with running, it is more likely that you will experience GI issues when you run as opposed to swimming or cycling. But there is a large body of exercise that does link changes in both blood flow and the stress response when initiating exercise.

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to subsequent gut complaints. And when we exercise, blood is diverted into the muscles to provide nutrients and oxygen to the working muscles and also skin to keep the body cool, which then does reduce blood flow to the gut. And if this persists for a long time, then the GI barrier may become damaged. And it also becomes highly permeable to unwanted and pathogenic microorganisms.

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such as bacteria and bacterial endotoxins, lipopolysaccharides. These are naturally present along the GI tract as part of the gut microbiota, but the localized damage along with the permeability of microorganisms into the circulating bloodstream does prompt local and overall immune responses, which we know as inflammation.

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There is also growing evidence that a third physiological change in the mechanical such as foot strike, jarring, jolting and sudden impact may also be linked to athlete gut changes as well, leading to increased GI barrier damage and also reduced gut function. The stress response of exercise does also promote a reduction in overall gut function, including reduced gastrointestinal motility,

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nutrient digestion and absorption. This does increase the risk of nutrient malabsorption, such as carbohydrate malabsorption. Therefore, exercise per se naturally impedes an athlete's ability to provide nutrients and water at a time of increased requirements. You can imagine then that to then have a lot of sports nutrition companies promote the addition

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are over and above what you would normally sort of take in in a session or a race can then be even more problematic for the athlete. So it is also important to note that the stress of exercise, the mechanical effects, and also of course just the blood diverted away from the gut, they're not independent of each other and they interact dynamically. So the GI tissue damage may reduce the function of the gut.

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and reduced gut function may increase tissue damage, and both of these may increase the risk of nutrient malabsorption and inflammation. And the malabsorption of the carbohydrate can result in bacterial fermentation along the intestinal tract that will result in increased gas and water content. All of that to say, these three things are all just related to exercise, but there are other factors related to exercise

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that can impact on gut related issues. And it may well be exercise intensity, the duration, the longer you go, the more fatigue you get, the modality, I mentioned how running is more likely to result in GI issues compared to cycling, the temperature, so if you're in a hot environment, you're more vulnerable to gut related issues compared to either being warm or cooler, circadian variation,

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like exercising at night might bring about more gut related issues compared to during the day. Hydration status is a huge one. If you go into a session dehydrated, it can paradoxically result in more loose stool and diarrhea. Pre-exercise dietary habits and what you have just before exercise. Feeding tolerance, like how used to taking on board fuel you are. The impact of taking

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non-steroidal anti-inflammatory drugs versus taking none. And also if you are predisposed to any sort of gut related disorders and also your gut microbiota composition. So these all really are to do with exercise itself, but there are other factors that play a role as well. Like there are people who just in their everyday life do not tolerate dairy or do not tolerate

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have an issue with FODMAP containing foods. And FODMAP refers to a type of carbohydrate in these seemingly unrelated foods that can irritate the gut and cause inflammation and malabsorption. And this may be in foods in your everyday diet that then impact on what your gut does during exercise. So these are all potential risk factors.

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for gut related challenges and they may explain why the type or the incident and severity may alter within and between exercise bouts. I.e. you feel fine and cool weather as soon as it gets hot, you have gut related issues. And it does sort of show the importance of being able to audit what you do in and around sessions and your sort of level of stress and fatigue because

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that in itself can certainly play a role with your gut issues. And I know that, as I said, this is real push towards training the gut in order to get you used to taking on board more carbohydrate based foods or gels in your training session. But you know what, despite the fact that this is something that is talked about far and wide in the sports science field by some researchers.

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just not a ton of science to support it. And I do find it super interesting how the same scientists who tell us we need to train the gut dismiss the body of evidence that suggests that we need to be more fat adapted so we rely less on carbohydrate. And they don't see that as a sort of worthwhile pathway to explore if you've got gut related issues. Yet the body of evidence that exists for fat oxidation is probably more robust.

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than the body of evidence to suggest that we can all train the gut. Another argument, if you like, towards training the gut in this instance comes from these anecdotes of elite athletes that can easily take on board 120 grams of carbohydrate an hour and have no gut related issues, and they're almost given this sort of superhero status, or at least their gut is. And whilst they might be able

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Is that really necessary? For most of us to do that, we would be probably having to forex the amount of money that we spend on our sports nutrition products. Who wants to do that? But also more importantly, it then has implications for our metabolic health. Yes, this is a bit of a tangent, but if we're talking about the athlete, it is always going to be worth talking about this. Taking on board amounts of carbohydrate beyond

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90 grams of carbon hour, like up to that 120 grams of carbon hour, suppresses your own fat oxidation pathways. And whilst this might not really matter if you do a one and done, if you do it during a race, the recommendation to train yourself to be able to do this and do this multiple times throughout that training cycle will just further impede your ability to utilize the hundreds and thousands of calories that you've got already stored on your body as fat. Thereby,

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delaying your requirement for carbohydrate until you really need it. Almost no one really needs 120 grams of carbohydrate an hour. So why would you try to train yourself to be able to take that on board? I have spoken to a number of athletes who cannot understand why they seem to be fine in their training cycle. They get to race day, they're taking on board even 75 grams of carbohydrate an hour, and I'm thinking about my female athletes. And they…

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have a terrible race because they are either vomiting, they are in the port-au-lou, and their stomach can't cope with that amount of carbohydrate. Racing will always ramp up your central nervous system and you'll get anxious, and it'll also ramp up the intensity in ways that cannot be replicated in a training situation for most people. This is why trying to be more strategic with your carbohydrate intake and

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potentially have 50 to 60 grams of carbohydrate an hour can go a long way to up regulating your fat oxidation, relying more on your endogenous fuel sources, and then using your carbohydrate more strategically to maintain your blood glucose across your race or your event, rather than just downing the carbohydrates just because this elite athlete can do 120 grams of carbohydrate an hour.

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If you are someone that is pushing high amounts of sugar and you experience bloating, and flatulence, diarrhea, then that is definitely something that you need to look at. That gut dysfunction in the short term will impact on your ability to train at your best, but also long term you may well be sort of setting the scene for this chronic inflammatory state, which might not be an issue when you're 28.

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could well catch up with you when you're 38, 42, or older. And many of the athletes who are now in their late 40s, sort of early 50s, if you were to look at them, despite their sort of amazing careers that they may have had as an elite athlete, as Professor Grant Schofield called it, when I chatted to him about this the other day, they just look a bit oxidized. And what he means by that is the metabolic cost of

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breaking down and oxidizing all of that carbohydrate that you use to fuel your training and your sort of racing has really impacted on the overall health of your cells and your mitochondria. And again, it befuddles me as to why this is now overlooked in the sort of face of pushing these higher carbohydrate amounts and quote unquote training the gut.

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nutrition space with the gut related issues is absolutely the dehydration one. This definitely came up for a client of mine when we were talking about it. She sort of revealed that she had coffee and a cup of tea, another cup of tea, maybe a glass of water after training, and then another cup of tea, and that was it. Yet she was training, doing double training days, and she was training for an ultra-endurance running event. She's experiencing loose stool.

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So this is another thing to consider if you have gut related issues. Hydration really impacts on your gut and being dehydrated negatively impacts on your gut function. So when you're ticking the box and ruling out all of these things, make sure that your hydration status is also accounted for when you're trying to uncover what's going on. Another consideration, as I mentioned earlier, is the dairy and the grains. And look, I understand

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as an athlete with high energy requirements, it can be challenging to meet these without utilizing foods that are quick go-tos like milk, like bread, pasta, things like that. However, it is still possible and I think if you are having challenges understanding how to meet your energy requirements and getting to the bottom of your gut related issues, you need to see a practitioner to help you with that.

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And one of my friends asked me, you know, what kind of testing would be good to understand better what's going on with the gut? And I've got to tell you, you could spend thousands of dollars looking at this. There is of course the standard stool related tests to look for parasites that could definitely be worthwhile. You can get them done through your doctor. There is PCR testing, which is genetic testing related to the gut, which may also give you some insights. And I was speaking to my

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friend Lara about this and she's a naturopath and knows a ton in this area. But both Lara and I agreed that the best way to assess what's going on is really the elimination diet. That is the gold standard when it comes to gut related issues. And as an athlete, I mean, that could just well be you and that might be what you need to do. So you just want to spend a period of time removing some of the low hanging fruit like dairy and gluten. Four to six weeks.

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acute or immediate impact this has, and then reintroduce and to see whether or not you can still, you are in fact able to tolerate these foods, or actually you realistically have to find a solution to meet your energy requirements outside of them. And believe me, it's totally possible, but you just have to understand better the negative impact that they might be having on your gut, and it has to be worth it for you to do it.

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In addition, I did mention the FODMAP diet. So FODMAPs are a class of poorly digested carbohydrates, including wheat, milk, onions, garlic, stone fruit, many legumes, avocados, mushrooms. Like these are all foods that you may want to consider minimizing in your diet to see what impact that has. And this might well be for the athlete who

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tends to have gut related issues despite the avoidance of, for example, bread, but not really avoiding other things. In addition to exploring the FODMAP diet further, you would want to try and put into your diet substances that might help heal the gut alongside. NutriLife do a good gut health product that has marshmallow, pectin, glutamine, curcumin in it that a lot of clients see some resolution of symptoms with.

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the addition of collagen, I think would be worthwhile. And then just being really consistent with that elimination approach. So you allow your gut the opportunity to heal. But in addition to that, really be mindful of the sugar intake as well. I mean, I think an elimination diet is definitely worth exploring, but I would be really surprised if you could do it in the presence of a high sugar intake as well, because the sugar will...

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continue to promote that inflammatory response. Another thing worth mentioning with gut related issues is that when you finish your exercise session, despite the sort of prevailing message that you must get in food to recover as soon as you possibly can, in fact, if you do struggle with gut related issues, then it's probably better for that stress response to settle down and

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to allow your blood to return to the gut area from the working muscles before you actually take on board any food. Because if you just immediately finish a hard session, quickly have a shower and then gulp down breakfast, tell you what, that is gonna do nothing for your gastrointestinal issues. Instead, wait for your body to come out of that sympathetic state, relax into that parasympathetic rest and digest state.

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and then can eat your foods. That I think is gonna be an important part of the sort of gut related puzzle for most athletes. So yeah, these are my thoughts for gut health related to the athlete. Outside of the sort of mechanical and the stress related and the exercise related issues, then things like dairy, gluten on grains, hydration and sugar are all considerations.

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that you might need to explore further to get on top of your gut related issues. And of course, you know, if you are someone experiencing it, then I would recommend working with a practitioner to help you get to the bottom of it. So you can train and raise your potential basically, and protect your metabolic health for future. All right, team, that's the gut and the athlete. You can catch me over on Instagram and threads and Twitter @mikkiwilliden, Facebook @mikkiwillidennutrition

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head to my website mikkiwilliden.com and book a call with me. All right guys, you have the best week. See you later.