Are You Eating Enough For Your Activity Level, Part II

If you read running websites or magazines, view social media accounts of various athletes, and perhaps overhear conversations in your run community, in the past few years you may have noticed an increased attention to a topic called RED-S (pronounced reds), or relative energy deficiency in sport, which can also be called low energy availability. 

Low energy availability is most accurately calculated by removing the energy cost of your daily exercise from your total dietary caloric (energy) intake, and then having what is left not being enough energy (calories) to support the body’s normal physiological function, such as bone metabolism, endocrine/hormones, reproductive system, etc. Low energy availability is associated with downregulation and impairment of key physiological processes due to the lack of adequate energy support. 

That’s the scientific definition. I simply call it “Not eating enough for your activity level.” Even simpler, that translates to not eating enough.

Not Eating Enough

For a couple decades, one piece of the larger puzzle of relative energy deficiency was known in the sporting community. That piece is the Female Athlete Triad, in which female athletes present with a pattern of low energy availability with or without an eating disorder, in relationship with amenorrhea (lack of menstrual cycle), or irregular menstrual cycle, and low bone density leading to osteopenia and osteoporosis. What we now know is that the Female Athlete Triad is just one section of a larger picture of pathophysiology that can present in athletes with long-term low energy availability. And it is not just a female athlete concern. 

When active individuals are not eating enough for their on-the-move lifestyles – the body, because it is wise, makes decisions about where it is going to prioritize its precious calories. So if you’re going to go for a long run in the forest for several hours, followed by an evening hike or weight session, and then follow with something similar tomorrow and the next day, and throw in a weekend of back-to-back long runs,  AND you’re routinely not eating enough to meet your caloric needs, the body is going to choose where to spend those nutrients—because when this precious energy is used for one function, it is not available for another one. 

Essentially, you are putting your system into survival mode.

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

On Our Radar

So why is this topic suddenly on more people’s radar? One, we have more research and knowledge on the expanded umbrella of RED-S and the widespread physiological consequences of being at a long-term energy deficit. But also because it’s fairly common for active individuals to not realize they’ve adopted many of the beliefs of the diet industry into their eating habits over the years. Or they may simply be eating to hunger levels, and still not be eating enough.

And, just eating to hunger can sometimes be misleading for us as highly active folks. For instance, many athletes have a suppressed appetite after long or intense workouts or races. In those cases, it’s ideal to replace nutrients after exercise—but when digestion is compromised, the body won’t metabolize the food as it should—hence the potential for working with a nutrition professional to help get the digestive system back to balance. Alternatively, we might need to learn to recognize the symptoms of hunger that often go beyond an empty stomach.

Within-Day Energy Balance

The other side of that low energy availability coin can also mean within-day energy balance. Meaning we don’t stack the majority of our calories into one meal or couple of hours of the day. Eating to fullness, or 80 percent of fullness, is recommended, but if you ever notice you get to the point of overeating after exercise by having excessively large meals that seem to top you up beyond fullness, it is often because of low energy intake throughout the day fueling a need for more food spread throughout the hours. This can often occur after a long run. In this case, you can train your body to tolerate more fuel during a run, and then you’ll likely both recover better, but also will have stressed your body less with the huge energy deficits and then subsequent deposits. 

 With a more even or adequate energy intake before and during a long workout, you can avoid that ravenous feeling of needing to eat quickly and impulsively.

A Self-Assessment to Help Navigate Your Energy Needs

If this topic has kindled your curiosity about meeting your own energy needs, my suggestion is to start with a self-assessment rather than calculating calories and meticulously tracking meals—those can be highly inaccurate and lead to neurotic food obsession. Ask yourself these questions:

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

Where to go from here?

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

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

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

 

Mini-Meals to Keep You Going

Ideally we spread our meals out throughout the day and leave time in between them for full digestion to occur, so we’re not throwing more food in when the last meal hasn’t fully digested. This causes more problems over time in other ways. In an ideal routine, aim for eating at intervals of four to six hours after a full meal, and two to four hours after a light meal instead of snacking continuously all day. The above article is featured over on the Territory Run Co. run journal, along with three snack recipes for those in-between times, featuring iron and vitamin C-rich Wonder Woman Bars, William’s Oatmeal Raisin Bites, and Sweet Potato Spanish Tortilla. Get the recipes here.

References:

2018 UPDATE: Relative Energy Deficiency in Sport (RED-S)
Fahrenholtz, IL., Sjodin, A., Benardot, D., Tornberg, AB., Skouby, S.,…and Melin, AK. (2018). Within-day energy deficiency and reproductive function in female endurance athletes.
Jeukendrup, A. (2013). The New Carbohydrate Intake Recommendations. Nutritional Coaching Strategy to Modulate Training Efficiency. Nestlé Nutrition Institute Workshop Series,63-71. doi:10.1159/000345820 
Jeukendrup, A. E. (2017). Training the Gut for Athletes. Sports Medicine (Auckland, N.z.), 47(Suppl 1), 101–110. http://doi.org/10.1007/s40279-017-0690-6
McKay, A.K.A., Pyne, D.B., Burke, L.M. and Peeling, P. (2020). Iron Metabolism: Interactions with Energy and Carbohydrate Availability. Nutrients, 12: 3692. https://doi.org/10.3390/nu12123692.
Torstveit, MK., Fahrenholtz, IL., stenqvist, TB., Svlta, O., Melin, A. (2018). Within-day energy deficiency and metabolic perturbation in male endurance athletes.

chamomile + dried plum nut butter bars

Last week I shared about the connection between the gut and the nervous system. After hearing from several that it was helpful, I’ve been thinking about the use of herbs in particular for nervous system and gut support.

Herbs in the category called nervines really shine here. They are the herbs that specifically affect the nervous system. While there is a giant list of herbs that can be used for nervous system support depending on where and what type of symptoms are showing up for an individual as well as the person’s energetics, chamomile, skullcap, lavender, holy basil / tulsi, lemon balm, and California poppy are some of my personal favorites. When we get to the point of really using herbs medicinally to promote balance, we often need them in larger amounts such as at least three cups of tea daily for several weeks, or an herbal tincture, large amounts of herbal powders, etc. It becomes like taking medicine, only with no side effects, nutritional interactions or depletions (when administered correctly).

But before we get to that stage where it’s best to have either more personal experience or guidance by a trained professional to take herbs at a medicinal level, many of us can benefit from incorporating more herbs into our everyday foods. This is what a lot of our ancestors did by collecting herbs that grew nearby and incorporating them into household remedies and cooking. And that’s what I’ve done here.

This is a base recipe for a nut/seed butter and dried fruit bar that I routinely make to enjoy as a snack. In this particular version, I added chamomile flowers and dried plums, two foods with a particular affinity for gut health. Many individuals enjoy chamomile as an evening wind-down tea but if you steep it long enough or bite into a whole chamomile flower, you’ll notice a definite bitter taste. That bitter component is important for gut health! We need bitter flavors to help the digestive system function properly, since the bitter taste stimulates the digestive system by activating gastric juices and the liver so we can break down and absorb our food.

Additionally, you might have noticed the strong, fragrant smell of chamomile in freshly brewed tea. The volatile oils in herbs which have an intense smell gives them an action that is called carminative, giving them the ability to promote a healthy digestive system by soothing inflamed tissues, giving relief from GI cramps and spasms, and helping relieve indigestion, bloating, gas, and nervous/anxious tummys. A couple other of my favorite carminative herbs/spices are fennel seeds, cardamom, and lemon balm, which can all be added to these bars instead of and/or in addition to the chamomile (amounts would need to be adjusted for taste, however).

A couple other ways to incorporate more chamomile into your days is in chamomile tea with ginger and licorice, chamomile tea simply by itself, and chamomile added to morning oatmeal. This apple, walnut, chamomile version is pretty outstanding. Overall, I highly encourage you to incorporate more nervous and digestive system supporting herbs into your meals.

Chamomile + Dried Plum Nut Butter Bars, makes 4
This is a great base recipe to experiment with different flavor combinations and incorporate various herbs into your daily snacks. If you’d rather skip the protein powder, try an equal amount of hemp seeds instead since they’re high in protein compared to many other nuts and seeds. Remember, protein is important in small to medium amounts throughout the day, and helps to balance out the heavy sugar and fat that most snacks contain. These also work great both before and after athletic activity as a quick fueling option, as they’re balanced in their carbohydrate to protein ratio.

3 Tbs. / 50 grams nut butter of choice (cashew or coconut work great here)
1/4 cup / 45 grams dried plums
1/3 cup / 45 grams dates, pitted
3 Tbs. / 30 grams hemp protein (or similar unflavored protein powder, such as plain pea protein)
3 Tbs. loose chamomile flowers
1 cup / 30 grams crispy rice cereal (or 1/3 cup oatmeal)
1 tsp. honey or maple syrup
1/8 tsp. salt

  • In a food processor, combine all ingredients except for a small amount of the rice cereal or oatmeal. Puree all the ingredients until they come together and are slightly sticky to the touch. You might need to add up to 1 Tablespoon water.
  • Then add the final amount of cereal or oatmeal and pulse until it is incorporated but not finely pureed.
  • Turn out into a small rectangular dish and press in. Cut into bars and eat, or store in the fridge and cut and eat as needed. Otherwise, you can certainly make these into energy balls instead if you’d like a circular shape.
  • These keep well for at least a couple weeks.

The nervous system is one of the five primary categories of digestive imbalances I look for when working with individuals clinically. Often when we’re experiencing chronic GI distress, there will be imbalances in several categories, and we begin working on the areas that appear most pertinent. I’ll explain the other categories of digestive imbalance in future articles. And If you’re tired of dealing with your wonky GI, I invite you to reach out to me for more personalized support.

Tahini, Date + Turmeric Bars

Tahini, Date + Turmeric Bars

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Over the summer, I learned about 30 herbs and/or spices that are commonly used in western herbal medicine in my second herbal medicine class, and I really relished the opportunity to both broaden and deepen my understanding of natural plant medicines. In addition to learning that skullcap, the plant I had chosen to focus on learning about for an entire term in my first class, is the most popular herb sold through my university’s herbal dispensary, I spent the summer delving into a lot of research about specific herbs for treating inflammation and allergies due to my project for a client with seasonal allergies. I was limited to working with only the herbs in our class list, however, and because of that I chose a fairly non-traditional approach to working with allergies. Turmeric was among the herbs we studied, and though I did not end up recommending turmeric for allergies, I realized I easily could have and was probably expected to.

Though I know a lot more about the benefits of turmeric than I did before, there is much research to suggest that the curcumin compound it contains has extremely strong anti-inflammatory and anti-oxidant abilities and it is beneficial in all manner of disorders and imbalances. Among others, it has antibacterial, anticancer, anti-rheumatic, anti-tumor, antiviral, anti-phlegmatic, and anti-parasitic properties. I’ve recommended it to my mom who has arthritis, runner friends for pain, and have taken it myself for (nearly instantaneous) relief after slamming my knee into a door. Though my knee incident was an exception, I take a different approach to using herbs than we would for pharmaceutical drugs; I don’t take them for their quick effect. Instead, herbs work to slowly and gently bring the body back into balance, and they work better in conjunction with other lifestyle supports, like getting enough rest, a balanced diet, exercise, etc.

Turmeric is extremely trendy right now, and while there is good reason for it to be, I also like this article about practicing caution with it, as with all herbal medicines. Too much of anything, even a supposed health food, can push us into imbalance. While I came to this conclusion on my own and no longer pop a curcumin supplement for running recovery “insurance” on a regular basis, I do tend to use it in small amounts frequently–and mostly because I really enjoy its flavor.

What I really enjoyed about the class is that we delved into the research on a number of common herbs and spices–ones we are already using and that aren’t the new trendy superfoods–like the ginger and cinnamon these bars contain. After 14 weeks of reading a ton of research articles, I finished the class even more in support of the importance of eating healthfully as the norm and using herbs and spices in small amounts throughout the day in whatever foods we’re eating so perhaps there’s a little less need to use any medicines–herbal or otherwise–to “fix” imbalances.

 

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Tahini, Date + Turmeric Bars, makes 8
I regularly rely on bars for after workouts and for busy afternoon snacks on the go. While I have a few versions of granola or energy bars on this blog that I do go back to, for the last few months I’ve been opting away from oats and grains as a main ingredient. Instead, I’ve been adapting a new favorite packaged bar. It has taken many renditions but now that I’ve finally gotten the base consistency to my liking (actually better than the packaged bar which I find a little too sweet,) I’m excited to begin delving into a few different flavor combinations, especially as William doesn’t favor my heavy affinity for the ginger/cinnamon/cardamom/turmeric spice combination and prefers the berry/fruity realm instead. For these bars, don’t forego the black pepper, as it helps the turmeric to be become more bioavailable. Additionally, for the options I’ve listed, the first is my favored ingredient but I also enjoyed the other options listed. Enjoy!

1/4 cup tahini
1/4 cup cashew or almond butter
3 medjool dates, pitted
6 Tbs. hemp protein powder or hemp seeds
1/4 tsp. sea salt
1 tsp. pure vanilla extract
1/2 tsp. turmeric
1/2 tsp. cinnamon
1/4 tsp. ginger
1/4 tsp. cardamom, optional
dash of black pepper
1 Tbs. brown rice syrup, apricot jam, maple syrup or honey
1-2 Tbs. water, as needed
1/4 cup raisins
1/4 cup dried figs or apricots, diced
2 cups crispy rice cereal or 2/3 cup oats, finely ground

  • Puree the tahini, nut butter, dates, hemp, salt, vanilla, spices, and syrup in a food processor until completely combined. Add 1-2 Tbs. water as needed to bring it together, if it’s a little dry. You can also a little more syrup or another date but I found that option a little too sweet.
  • Then add the raisins, diced figs or apricots and crispy rice or finely ground oats. Puree a couple more times until these last ingredients are just incorporated but not completely broken down.
  • Turn out and press into a 8×8-inch baking pan, or something of similar size. Chill in the fridge for at least 30 minutes, and then cut into individual bars, store, or eat as needed. They will last in the fridge for at least two weeks with no change in texture/consistency.