Episode 216: Fueling for the Female Athlete - Part 2- with Kyla Channell and Stevie Lyn Smith
Follow the Purple Patch Podcast at:
Kyla Channell (L) and Stevie Lyn Smith (R) Discuss Nutrition for Female Athletes
Matt welcomes back Kyla Channell and Stevie Lyn Smith, for Part Two of a discussion around nutrition for female athletes and fitness enthusiasts.
Listen to Part One HERE.
Both Stevie and Kyla bring with them a wealth of expertise, passion, and decades of experience in this particular area of fueling for the female.
Stevie Lyn Smith, MS, RDN, CSSD, CDN, is one of the lead dieticians with our partner, InsideTracker. She's an experienced Registered Dietitian, board-certified in Sports Nutrition, with a history of working with both individuals and groups in clinical settings. She is wonderfully skilled in sports nutrition, and weight management, and, through her work at InsideTracker, brings a great backbone of understanding biomarkers as a tool to help people focus and hone in their nutrition needs.
Kyla Channell, MS Nutrition & Human Performance, is also the owner and founder of Nutritional Revolution, where she specializes in elite athlete fueling for each unique sport and sex differences between athletes. She is a longtime nutrition partner of Purple Patch and has worked with countless athletes of all levels from beginner to pro.
Matt, Kyla, and Stevie provide guidance on:
Definitions and distinctions between oligomenorrhea and amenorrhea
Are these symptoms exclusive to women with eating disorders, or is it more broad than that?
"Many times, we'll see the loss of a menstrual cycle or just irregular cycles in our endurance athletes because there is an energy deficit to some extent, and that could be unintentional, meaning maybe they're in a bigger training block and they're pushing out a ton of calories to hit longer sessions, harder efforts, etc. But they're not matching the the energy intake."
The (unintended) difficulties women often feel with not fueling enough based on training load and intensities
Why these are often red flags and symptoms of greater problems
"Anytime we're getting irregular cycles or losing the cycle for a period of time, it does result in low estrogen and that's a big player in our bone health, of course, among many other physiological functioning things we need going on in the body."
What biomarkers or blood test results can be used to identify potential red flags in overall female health and performance?
"I've never seen an athlete with overtraining and overreaching, who doesn't have elevated cortisol levels."
Consequences of low energy availability on both health and performance
"Our strength might decline, we might hit the wall a little bit faster, because again, we don't have those carbs on board. So glycogen stores are inadequate. This increases our risk for injury, you might notice more things like depression or lack of motivation to train, and you might feel a little bit more irritable."
Actions for an athlete if they are experiencing elevated stress and biomarker levels?
How to help female athletes who have a fear of carbohydrates and clean-eating obsession
"Starting small, getting those wins, making the person feel comfortable, and working on helping them trust their bodies a little bit more."
Ways to provide validation and proof of success when eating for performance
Impacts of birth control on female athletic performance
"We might have a harder time recovering from training sessions. We might have a decreased drive to hydrate, right? Being dehydrated absolutely can impact our performance. Some people notice more regular sleep disturbances, or even slight weight gain water retention."
Why there is such a negative connotation around perimenopause and menopause and advice on working with this life change.
How to vet a reliable coach or nutritionist in your quest for health and performance improvement
Episode Timestamps
0:00-012:30 Introduction and Matt's Personal Picks
Purple Patch Blog -How to Turn Stress into an Advantage
Purple Patch Podcast - Stress is not a Dirty Word
Hop on the Interest List for our Upcoming Fall Training Camps, including St. George - email: info@purplepatchfitness.com
Purple Patch Website and Newsletter
12:40- The Meat and Potatoes - Fueling for the Female Athlete and Fitness Enthusiast, Part 2
Purple Patch and Episode Resources
This episode is sponsored by our collaboration with INSIDE TRACKER. Inside Tracker and Purple Patch- Receive 20% off their services with code: PURPLEPATCHPRO20
Ask Matt Anything - Leave a voicemail question for Matt
Learn more about Purple Patch Squad High-Performance Training Program
Join Bike Squad - Don’t just exercise and work out; learn to train with our structured online cycling program
Join Run Squad - Increase your running performance through our progressive, multi-sport approach to running
Learn more about Purple Patch Fully Customized 1:1 Coaching
Learn more about Purple Patch Strength Programming
Stay Up-to-Date with Purple Patch News and Events
Full Episode Transcript
216 Fueling for the Female Athlete - Part 2
SUMMARY KEYWORDS
athletes, female athletes, kyla, people, ocp, perimenopause, calories, eating, training, carbohydrates, coach, cycle, fueling, estrogen, performance, purplepatch, protein, hydration, menopause
Matt Dixon 00:00
I'm Matt Dixon, and welcome to the Purple Patch Podcast. The mission of Purple Patch is to empower and educate every human being to reach their athletic potential. Through the lens of athletic potential, you reach your human potential. The purpose of this podcast is to help timestarved people everywhere integrate sport into life.
Matt Dixon 00:20
Alright folks, Matt Dixon here, and we've got a cracker for you today. But just before we get going, I want to make a couple of points. The first is that over the last few weeks, we've pushed out what I feel is some really important educational content that I know is going to help a lot of folk. We've got today's show, which is part two of our nutrition and health for female athletes, last week's blog and podcast on how to turn stress into your advantage. And of course, even the guide to helping triathletes with a smart approach running off the bike. And we do this because we love providing educational content, we want more and more folks to be able to learn and benefit. And you as a loyal listener, and follower of Purple Patch, you've got a role to play, you can help. You see, you can give the gift of performance. You can help your team, your family, your friends, and there's a couple of ways. The first is to follow us. Head to your favorite place where you consume the show, and follow or subscribe, it's really, really simple. Well, I had to have Baxter show me, but it is pretty simple. Subscribe or follow, it's going to make the show much more easy for others to find. And, of course, you can always share as well. Feel free to grab a link to the blog on the website or the podcast, send it across to folks that you feel might benefit. And of course, when you do that, remind them to follow along as well either via our newsletter, or of course, on the podcast, I promise you, it really, really helps. And it empowers our efforts. And I'll tell you what - I and all of Purple Patch would be really grateful.
Matt Dixon 01:53
Now while I'm at it, we are able to keep providing this content to you free because of our partnership with InsideTracker. And you've heard me talk a lot about the partnership. What it's a timely reminder, the insights education personalized recommendations that you receive from working with insidetracker is an empowering science drench path to you improving your approach to eating training, positive habit creation. So if you want to amplify your performance, just head to insidetracker.com/purple patch and use the code purplepatchpro20 That's purplepatchpro-two -zero, you get 20% of everything on the store. Now several folks have gone all in amplify their pathway by getting a personal consultation with myself or one of the team. And if you want to do that you can it's highly recommended and it really amplifies the outcome. But we would much rather you just reach out directly to us for that so that we can ensure that you get with the right person for your situation and needs. That's just info@purplepatch fitness.com Alright, enough for me. Should we get going fasten your seat belts, guys, this one's a cracker. Let's get on with the show.
Matt Dixon 03:08
And welcome to the Purple Patch podcast as ever. Your host Matt Dixon. Guys, we are back. It is part two of our discussion on nutrition with a special focus on female athletes and fitness enthusiasts. Joining me once again, Stevie Smith, one of the lead dieticians with our partner InsideTracker. She is an experienced registered dietitian, board certified in sports nutrition with a demonstrated history of working with individuals groups, and of course in clinical settings, her skill sports nutrition, weight management, and she even does a little bit of writing public speaking and a lot of nutritional counseling. And then in addition, on the third stall, Kyla Channell, the founder of Nutritional Revolution, Kyla is a degreed nutritional practitioner. She specializes in elite athletes fueling for unique sports and the sex differences between the athletes. She is one of the partners of Purple Patch under the big banner of nutrition. And she has worked with countless athletes from all levels -beginner to pro. Today, what we do the three of us is continue our conversation we lead on from part one that is episode 213 Goodness me - that leaves a lump in my throat when I think about 213 episodes, but episode 213 which I should mention, if you miss that episode, I really encourage you to go back. Don't skip over it. Go back, have a listen and then come back and listen to today's episode.
Matt Dixon 04:39
Now, on today's show, what will you learn? Well, Stevie and Kyla provide really clear guidance that cast through that blizzard of confusion and misinformation about female athletes are really important listen, and the episode is going to leave you with a really empowering framework of how you can build an empowering relationship with both your fueling habits and ensuring that you're getting enough of the right calories to support everything that is important for you as a female, not just as an athlete, but as a female. And finally, this whole discussion should inform you about the corrections that allow you to bypass many of the pitfalls that female athletes fall into. We want you to navigate paths, the quackery, the misinformation, the confusion, it is hard hitting it is simple and effective.
Matt Dixon 05:30
Now, before we get going, we're not going to do Word of the Week. This week, we're going to pretty meaty conversation in our meat and potatoes, pardon the pun. But I do want to crack on with a few things that I've been noticing lately. Remember that part of the show that doesn't have a title, guess what, it still doesn't have a part of a title. But anyway, we're gonna keep going with that. A couple of things that I wanted to highlight this week. The first is a little bit of a, "in case you missed it." Because last week, we put out two, in my mind, major pieces of educational content. And I want to draw your attention to it again. The first was a blog, it's up at purplepatchfitness.com, you just head to the Education tab, you'll see blog there. And the title of it quite simply is "How to turn Stress into an Advantage." Really important piece, not just for athletes, in fact, not really even written for athletes per se. It's written for parents, leaders, employees, people that are looking to leverage the situation of strain and demand that so many of us feel into an advantage so that you can really thrive and perform. Now the sister piece of content to that was last week's podcast, it's kind of the brother and sister thing. And it was all around that word "stress." If you missed those, I really encourage you to go back. Leaders, parents, employees, whatever your load is, ultimately, we all carry our accumulation of stresses. And I believe this is a really important and timely anchor of education. I think it's going to help your perspective. I think it's going to empower you. And it's a biggie. And like I started the show, this is one of those pieces that I would love you to also share with others. Anyone that you think might benefit your team, your friends, your fellow athletes, because it's a biggie Send the blog on the link to last week's show. And think about. It is your gift of sharing that might just help them. As we all come together to thrive through these uncertain times.
Matt Dixon 07:35
What else is going on? Well, a lot of folks have asked a lot about our training camps, South Carolina and Napa. I'm afraid both of those are now at capacity and closed. We are full to the brim and I have to say we care too much about the immersive experience to be able to provide really high quality education and feedback to each camper. So we can't add any more to those camps. But, with the popularity of camps this year, we are looking to add one if not two camps later in the year. The first one is probably going to be in St. George, Utah, September, probably mid September. And that acts as ideal preparation for both the Ironman World Championships which are set to be in Hawaii Kona, back to the old familiar ground on that. And also the Ironman 70.3 World Championships which will be in St. George in October. So we're looking at a mid September date there, we're looking to logistics, we should be able to release that camp very, very soon. Now, these are camps and this camp particularly I think is gonna go quickly. So if you're interested, let us know. We're going to cap this to under 20 athletes. And I would recommend your email us info at purple patch fitness.com. If you're interested, no commitment needed. But,what we will do, is we will send you a little bit of an insider before we post it and say "hey, this is going to be the camp you want it?" You're the insider you are first to act so that we can build a little bit of a list and then we'll pop it on the website. My guess? This one's probably going to sell out within 48 hours of it going live. Okay, final thing - a little bit of fun before we get going on this conversation. Recently, I noticed our own Purple Patch athletes having a little bit of a powwow around "Dixonisms." Yeah, that's me and my isms. And they started to have a conversation in our internal athlete forum about what are your favorites? Because I guess when they hear me coach a lot live on the video coach sessions, those bike sessions, they get a little accustomed to my style. Now, what I'm trying to do is get across the mission of the workout, how to execute, holding to account, maybe even provide a little bit of inspiration. Oh, but sometimes I really do despair with the output. Now, these types of sayings. This is not "no pain, no gain," "When the going gets tough, the tough get going," "Good job." This is not that. So today I'm going to reveal some of the group's favorites. This might just confuse you. Number one.
Matt Dixon 10:13
"Ladies and gentleman, here comes the vicar, Mrs. Jenkins, pop the kettle on, it's time for tea." Number two. "All right, guys, you're keeping it up. Now it is time -unleash the governor." Number three -normally to a boy named Scott, I should point out. "Don't worry. This is America. There's always another chance in America." Number four, "strong like bull." Number five. Typically I go back there with this guy called Henry. "But come on, then. Take a break. Let's have a ciggy behind the bike sheds," and of course our favorite "drunken donkey." Ladies and gentlemen, that really relates to the three legged donkey. Yes, lower zone three. Now, if you're listening here, and you don't understand, don't worry, I don't expect you to, and you won't. You're never going to understand unless you're on the inside. It's all built around helping you find your own brand of excellence. And so for my team at Purple Patch, keep it up, folks. I'll try and keep it interesting. And finally, a quick one here - a quick reminder that coming up in a couple of weeks time we do have another "Ask Matt Anything" session and this time we are building all of the questions around running. Are you frustrated by a run plateau? Are you frequently injured? Do you label yourself run unable? Let me help. All you have to do is head to the podcast page at the website. Leave me a nice little voicemail there. We will play that and I will give you my very best answers in an upcoming show. All right. No 'word of the week' this week. Barry, quite frankly, well, he banged his head and he can't remember the words. But I will tell you it is not "serious with a wig." It's "serious with a wink". Goodness me. Barry. Anyway, regardless, ladies and gentlemen, I give you part two, Stevie Smith, Kyla Channell. Ladies and gentlemen. It is time it is the meat and potatoes.
Matt Dixon 12:46
Alright guys, it is the meat and potatoes. And we continue on. Welcome back Stevie and Kyla, thanks so much for joining us again for part two, around female nutrition and beyond. Lovely to have you back, guys.
Kyla 12:59
Thanks for having us.
Stevie 13:00
Yeah, glad to be back.
13:02
All right. So we are marching on after part one for folks that missed part one of the show, I highly encourage you to go back it was a couple of episodes ago at the Purple Patch podcast. And it was a deep dive into nutrition. But we're going to evolve our conversation a little bit today. And I want to launch into an area that is particularly important, I think, for female athletes, oligomenorrhea and amenorrhea, or the absence or the infrequent menstrual cycles, very, very common in high training athletes and beyond. And so I guess to kick us off in this subject, this area. These symptoms are clearly prevalent in athletes who are also challenged with an eating disorder. And we might we'll get into that I'm sure a little bit, but I guess Kyla, Is it exclusively destined for people with just eating disorders? Or does it go beyond that?
Kyla 13:59
Definitely not exclusive to people with just eating disorders or disordered eating. And I do want to preface to that there is kind of break down what oligomenorrhea is and actually different forms of amenorrhea. So oligomenorrhea is defined as kind of having irregular cycles. So maybe they're, you know, one day it's 40 days in between and then you might skip a cycle, or and then it's you know, 18 days, so there's irregularness there, right? And then we have amenorrhea. But, there are a couple forms of amenorrhea. So there's primary amenorrhea. And that's defined as actually not starting your very first period. So as a as a teen or you know, you should be starting a cycle typically between the age of maybe 12 to 16 years old. If you're not starting your cycle, that is considered primary amenorrhea and then we have secondary amenorrhea which is losing your cycle for somewhere between three or six or greater months potentially. And the most common form of secondary amenorrhea is probably what we're going to be hitting on today, is that functional hypothalamic amenorrhea, or FHA is what many people will call it as well. So when we're talking about amenorrhea, today, I think that's probably the preface that that's probably what we're diving into, is that secondary form for sure.
Matt Dixon 15:27
And what are the situations if we, sort of, park for the moment, disordered eating, and that's a whole channel, which is obviously a huge stressor and a catalyst for it. But it's very, very common amongst athletes, not just small team, gymnasts. So what are the contributors? I know it's a pretty basic questions, but paint the profile for me?
Kyla 15:52
Yeah, so many times, we'll see the loss of a menstrual cycle or just irregular cycles in our endurance athletes, really, just because there is an energy deficit to some extent, and that could be unintentional, meaning maybe they're in a bigger training block. And they're just, they're pushing out a ton of calories, right to hit these longer sessions, harder efforts, etc. But they're not matching the the energy intake coming, you know, into the body, right. So that can be a situation, we can also see it in individuals who, you know, are on an OCP. So maybe they're on an OCP. For those listening is oral contraceptive pill, hormonal birth control. If you are taking an OCP, some women lose their cycles, some people will be on an OCP. I've even had clients where they're on an OCP, or getting a regular cycle, but similarly to someone maybe not on an OCP gets in a hard training block, and then loses their cycle still even while on an OCP. So that could be a potential situation as well. Again, typically, the the leading factor into all of this is many times just mismatched energy out with energy coming in a low energy availability. And I think we touched a little bit at the end of the last podcast or RED-S, relative energy deficiency in sport. There can be other situations like someone might have PCOS or polycystic ovarian syndrome that can cause irregular cycles. You might be going through perimenopause, if you're an older athlete, and not realize that the the randomness in the cycles is actually perimenopause. And then, of course, there could be, you know, genetic or even chromosomal issues, or structural situations going on. So someone might have like a tumor on your pituitary that's affecting sex hormone production at the level of the ovaries. So there can be situations like that, but primarily with athletes, we're looking at a mismatch between fueling and energy out.
Matt Dixon 17:51
I want to go back a little bit, because we certainly touched on this in the last show when we talked about RED-S. But I want to highlight again, how emotionally stressful and tough it can be for athletes in heavy training blocks to actually support their training. And, do you guys find that many athletes and women are really surprised or anxious? If you tell them, you need to consume this many calories to support your training? Is it one of the big hurdles for female athletes to sort of navigate.
Stevie 18:35
Yeah, absolutely. And I think a lot of it is just the voices saying to eat more, or we need to eat more. It's kind of like the shrink it and pink it that you you spoke about in the first episode, it's that idea that women are supposed to eat less, we're smaller, we don't need as much, and it's just kind of one of those social constructs that, you know, thankfully, there's a lot more sports dietitians, and professionals like Kyla, and her business partners that are helping break the noise that no, we need to eat a lot more than we've been trained or conditioned to think we need to eat. And that's not even getting it down into like, different macronutrients, right. It's just the overall energy intake. It's like the hierarchy of the athletes needs, you know, everybody gets so caught up on the smaller things like supplements and caffeine during workouts, but if you're not addressing that overall energy needs, and so I don't usually typically tell my female athletes exactly numbers, at least not to start, because if I tell them you need to be eating 3000 calories a day they will lose their mind. So it's just something that I think like I said, a lot of us awesome dieticians and nutrition professionals like Kyla, I just need to keep making it normal for females to eat more and unforced. Sometimes it's kind of just like a trust fall, when someone feels comfortable with a provider or a coach who can give them the appropriate and proper guidance that you need to eat more calories, you need to just eat overall more. And then they start to do it and see their performance improve. And you know, if they've lost their menstrual cycle, I've had people who have lost their menstrual cycle started eating more working together, and they got their menstrual cycle back. And it's like one of the greatest gifts, I think that you can give a female athlete for sure.
Matt Dixon 20:32
I can't help but go on a little tangent here, which is just really a source of interest. It's less about this subject, but very interesting. Recently, I was doing a webinar with Andy Blow, who's the founder of Precision Hydration. And he was revealing some of the observational data around their elite athletes, their elite amateur and their pro athletes for half Ironman and Ironman athlete distance races. One of the more surprising things, particularly for the listeners, that they have seen amongst their elite athletes, is this very small, if any, discrepancy on absolute calories an hour that their professional female athletes are consuming relative to male athletes. Again, this is during racing, this isn't anything to do with the real subjects on hand. But I find that really interesting that the Stevie you talked about the smaller athlete, they must need less, they only need to have a gel an hour and they'll be fine even in racing. But in fact, high performing professional athletes forget about size and weight male or female, they are consuming a heavy amount. And on those athletes, it's 60 70,80 up to 120 grams of carbohydrate every hour, which is pretty staggering. A big unit like me, it might not be surprising, but but the elite female pros, they are as well. Anyway, back to the subject at hand. Because I grew up with amongst a generation of coaches of which I was always confused and horrified, amused might be the word where it was wholly accepted. And in fact, almost a badge of performance if the female athlete was not experiencing regular cycles, it was assumed. And so I can't, with many high performing athletes going through multiple cycles without a period. Is this a red flag? An obvious question?
Kyla 22:30
Yes, this is a red flag. So hopefully, many of the listeners know that. Yes, that's a red flag. And reason being is anytime we're getting irregular cycles or losing the cycle for a period of time, it does result in low estrogen and that's a big player in our bone health, of course, among many other physiological functioning things we need going on in the body. But you know, you may see people increase their injuries or stress fractures or things like that to when they are in a state where they're not having their cycle. And, again, this might be something to where people who are on an OCP. And I think we'll probably hit on this a little bit more as they don't realize that they're maybe losing their cycle either naturally. So yeah, red flag.
Matt Dixon 23:20
So Kyla, you talked before about the the predominant, contributing factor towards this situation or scenario coming up. And of course, it's energy in and energy out so far as heavy training loads, etc. As a coach, I'll also sort of add in here, the accumulation of too much stress globally. So having athletes follow a training program within the context of their life or on how much they can physically absorb which is too elevated or under recovered. So not enough sleep, not enough recovery, not enough easy training, and everything that fits up the big bucket of too many stresses. And I think that's really important. So Stevie, as you are looking at an athlete's bloodwork, but beyond the obviously tracking of cycles and realizing that it's infrequent, different pattern, or of course, so are there any markers when you're looking at an athlete's blood or beyond blood and their biomarkers, any trackers that we can start to identify this as a potential cause or a big problem?
Stevie 24:30
Yeah, absolutely. Of course, first one that always comes to mind is cortisol levels, which I know we talked a little bit about in the first episode. But insidetracker does test cortisol levels as part of the ultimate plan. And we will, I can't say I've ever seen an athlete with overtraining overreaching, who doesn't have elevated cortisol levels. That's usually one of the big ones and even you know if We're not quite at overreaching overtraining, it's a good biomarker to check in on to make sure that we can go back and reevaluate, okay, are we managing stress? And you know, you talked about the training load stress, I always like to remind people to when we look at cortisol levels, that under fueling is also a form of stress on the body. So that will impact your cortisol levels. A few other things for that, that overtraining overreaching, looking at biomarkers that are related to muscle breakdown, muscle damage, your creatine, kinase, ALT AST, it'll also often see HSCRP are very specific marker of general inflammation, elevated a bit, sometimes it's very high. Other times, we just kind of see it on the slow upward trend with the under recovery. And these are all of the big red flags. And also, part of our testosterone group that we look at it inside tracker can help indicate if we're on that path of overtraining, under fueling. Particularly in females, we're looking at a marker called DHEAS and SHVG. DHEAS is a biomarker, super important for women's health and physiology. And it does naturally decrease as we age. It plays an important role in the muscle bone health, which I know Kyla mentioned, when we're not having our menstrual cycle, those are already impacted, you know, DHEAS has a role and that also will impact your fitness performance and longevity, of course, you know, DHEAS is, you know, created from cholesterol. You know, DHEAS is a stored form. And it is used to make different steroid sex hormones, including estradiol and testosterone, as well as other kind of precursor molecules for that, like I said, really important for the energy, muscle, bone health, etc. So it's also an important one to kind of, you know, when I look at somebody's InsideTracker results, I try to piece all those things together, you know, if I'm seeing a high cortisol, low DHEAS, SHVG, which is sex hormone precursor. When I see something like that high, it'll be high and under fueling -SHVG. So seeing how these biomarkers fall and then having the individual do what I call, like a gut check, or a feelings check, like, are you fueling your workouts? Are you getting enough sleep? Are you really being able to maintain this training load? Or is it too much because you have deadlines at work? Or a lot of life or family stressors, doing that feelings check and checking in on these numbers before you wind up with some of those injuries and kind of negative outcomes that Kyle mentioned earlier.
Matt Dixon 28:02
Yeah, if if I distill it to super basic, and use sort of you getting these results of which it's showing, under a broad context, elevated stress, elevated inflammation, it's really important, I guess, what should the athlete do there? Because it's a point of reflection. Yeah, the important part is to actually pause and come up a level and probably look at everything in a broad context, which is, okay, let's actually look at my fueling and my nutrition, let's look at my training. And does that integrate into life? Let's look at my habits around sleep and rejuvenation. And I guess that's, that's, which we'll come on to a little bit later. That's the real value of leaning on an expert to help with that perspective, whether it's a coach, whether it's a Kyla, nutritionist, or RD etc. Is that sort of the, the key point here?
Stevie 29:08
Yeah, absolutely. And it's, it's one of the things where, you know, I talked to an individual and they're like, Oh, well, yeah, I just, you know, unfortunately lost my job, whatever. Like, we can usually identify like, are some of these more sleep related? Oh, I have two toddlers, right? So we can, you know, just kind of taking like you said that 30,000 foot view. Doing that gut check. Like, are we are we skipping the fuel? Could I be better at this aspect of my training? Is my training load something I could do six months ago, no problem. But my life has changed now and I need to kind of adapt and overcome is what I like to say just readjust my expectations as an athlete and back off a little bit because I have these extra stressors in my life. So during that zoom out and the nice thing about InsideTracker is the optimized zones or ranges that you get are based on you as the individual, based on, you know, your nutrition habits, your lifestyle, your exercise habits, but they're also designed to take you from good to great. So it's kind of like being on the offense is how I like to look at InsideTracker bloodwork versus what you might get from your doctor is that these optimized zones are much tighter than clinical ranges. So we can identify and address something before it becomes a clinical problem before it becomes an injury, illness, etc.
Matt Dixon 30:31
As a coach, one of the things in your highlighting here, we're talking about female athletes today. But I think you just absolutely put a peg on the biggest challenge for time starved athletes where they, they treat training like a battering ram. And in fact, if we really pause and think about what training is, you're applying a stressor, so that the body can have a stress response, in other words, have the initial adaptation . And so positive training is applying a stressor and achieving a positive adaptation that has to come within the context of the framework of your life. And it's only going to happen if you've got the energy availability to facilitate those. And so, Kyla, that is my segue into low energy ability, because when you have, coming back to how you really started this conversation, you talked about the energy out with training, particularly like heavy training loads, et cetera, et cetera, in the context of the stress of the situation for the athlete, and then the very common component of an athlete not supplying deliberately or not deliberately enough energy. So what are the consequences? Because this is very real. And I want to divide this into two things, because I think it's important for listeners, number one performance. But number two, health, that's much more important, because performance is built on top of it. So let's do the easy side. First, what happens? What are some of the symptoms of of LEA or low energy availability?
Matt Dixon 32:10
Yeah, so low energy availability, as we've mentioned, is we're not meeting the calories in for what we're expending. I will kind of add to that to that, some of the literature is that the primary thing in addition to calories being under is actually carbohydrates tend to be unders -also the primary macronutrient. So with that, if you think about an athlete and endurance athlete, where carbohydrates are one of the primary fuel sources for what you're trying to do. If we don't have enough of that and enough calories coming on board, we're going to definitely see a decrease in our performance, typically, our ability to probably adapt to our training response, we're probably going to see more muscle tissue breakdown, right, because we don't have enough calories coming in. So our strength might decline, we might hit the wall a little bit faster, because again, we don't have those carbs on board. So glycogen stores are inadequate. This increases our risk. As I mentioned, for injury, you might notice more things like depression or lack of motivation to train, you might feel a little bit more irritable. So those kinds of things, of course, will will play a role from a performance perspective. And then, you know, from that health side, if you think about lack of calories coming in, you're also missing the mark on some of your micronutrients, right? Your vitamins and minerals, if you're not hitting your total calories, how are you going to hit your total vitamins and minerals. And if we're not hitting all of those things, it's going to play a role on several physiological functionings of the body, right? Whether that's bone menstrual cycle health, your your growth, if you're younger, your immune system, your gastrointestinal system, and digestive enzymes cardiovascularly, it can play a role as well, as we mentioned, the psychological component of it. And then with your labs, you know, I'm sure Stevie, you will kind of hit on that a little bit as well. But, you know, for underconsuming things like your iron might be low, right. And that's also a big player and ties back into that performance piece and delivery of oxygen to tissues. So yeah.
Matt Dixon 34:16
What action what are the actions facing this challenge? It's what are the actions that athletes should? How should How should athletes approach this? Yeah, all too common?
Kyla 34:28
Yeah, I mean, if there is low energy availability, that Stevie mentioned is trying to get them to eat more calories, if it's especially if it's done kind of unintentionally, kind of, you know, helping them get more food in finding ways to do that. I think I was talking to an athlete the other day and we're talking about her big weekend training days in the nutrition I program for her and she's like, I literally don't have enough time to eat all this stuff. And, and so many times the conversation becomes like, yes, like you're training for this end goal. And that is taking obviously a big priority, but eating kind of needs to become your second job to get those calories in and, and maybe it's finding ways where we can condense the calories. So I think many times I even see this in my athletes too, is there's there's the carb fear, right and, and we see that in the literature too is the most underconsumed macronutrient is carbohydrate. So trying to figure out ways to get more calories in them, letting them know that it's okay to consume a little bit more processed carbohydrates on these bigger training days to hit their caloric goals. I mean, if you are out training for six hours on the bike on a Saturday, and you come home at, you know, one or two in the afternoon, you want to get to bed early because you're tired, you know, that maybe gives you time to get an afternoon snack and dinner, potentially, how are you going to hit all those calories? You're, you're probably not going to want to rely on a giant salad that day. Maybe a big grain bowl, you know, something with, you know, different forms of of higher carbohydrates. I mean, even before that big training day, get some bagels in you like that is okay, put some nut butter on those throw banana on top of some honey, you know, I think we have that carb fear. And I think it's kind of educating them on ways to get more calories in. And and it's okay to get them from a little bit more processed carbohydrates on those bigger training days.
Matt Dixon 36:24
I guess a lot of it is the is the absolute requirement to separate and look at themselves as an athlete. If someone's consistently exercising and consistently training, it is a different need and requirement because and I guess, a question I was going to ask later, but how do you manage? Or, how do athletes manage the influx of clean eating and in voodoo pseudoscience and quacks that sort of come in with these quirky diets? How do you help an athlete navigate, sort of some of the pull away from carbs are bad for you, they kind of straight to your hips, love and all of that.
Kyla 37:10
You know, definitely educating them on the importance and what, you know, literally all of the literature says on endurance athletes, carbohydrates really are across the board. You know, still are the way to go, you know, as opposed to like a Keto approach, for example, the kind of opposite side of the spectrum. So educating them on what we're seeing in the literature, but also just from a general health person perspective, how many, you know, how much carbohydrates you need, just for general health? And then if you're trying to ask yourself to, again, go on a six hour bike ride? How do you expect yourself to do that if you're potentially under consuming calories, maybe by like, 600 grams less a day than where you should be at? You know, so that's a that's what does that, you know, that's a ton of calories, right? So we have, we have room to definitely improve that. And the education, I think piece is really helpful with anybody. I mean, if you understand the why that something is necessary, as opposed to be just saying, Hey, eat 600 grams of carbs per day, someone's gonna, like, Screw you. You know, they're, I'm gonna feel bloated, or, you know, it's, it's giving them that background and, you know, helping them understand the reasoning and the science and, and starting slow with it too, you know, if you're, you know, really low on your carbohydrates. Now, maybe you just bump it up by, you know, one banana, you know, prior to training than you're used to. And some people notice a difference right there from that by including a little bit more carbohydrates, then that kind of starts to gain, they gain that trust, right. And they can expand a little bit from there. But I do think people get stuck into like, right now people are, you know, ramping up training, but they're coming from maybe eating the same exact breakfast they were doing in their offseason. Just sticking with that all the way through to these, you know, key sessions, and maybe it's some veggie based omelette or something like that. That's very low and carbohydrates. Maybe that's great for the offseason, but you should really throw some additional carbohydrates in there. Put that in between some pieces of toast or something, you know, to bump that up and change that nutrition as the season trend changes as well.
Matt Dixon 39:12
Anything to add Stevie
Stevie 39:15
Yeah, no, Kyla hit on the point I was gonna say is just starting small, right and working up and I think that's the big thing. And I'm sure Kyla, sees it with the athletes she works is just starting small, getting those wins, making the person feel comfortable, including whether it's carbohydrates are just getting, you know, more calorie dense foods in you know, avocados, those nut butters, etc. And just working on helping them trust, you know, their bodies a little bit more. And, you know, it's always I'm sure you hear this a lot too. On the rest days. People are like, starve themselves, because they're actually feeling hunger cues that might be blunted on their harder workout days. And I will tell you I ate a bagel yesterday in I took an unplanned rest day. And it was glorious. And I felt so much better, right? It's just those little things that sometimes it's just helping the athlete to trust themselves trust what their body is saying, but also giving them like, yes, you might not feel hunger before you go ride six hours, but you need to eat just helping guide and delineate between what I call business feedings, and listening to our hunger cues, just being flexible, and a little bit less rigid with some of those rules, particularly around carbohydrates, like Kyla mentioned.
Matt Dixon 40:34
Can I ask about validation a little bit? And what I mean by that is, I tend to see a lot of athletes that sort of validation cue over this work in this getting on the scale, and it is there. You mentioned, it was hugely psychological. And so is there a path of the mini victories of adding a little bit of carbohydrate of the validation of that in how they feel, how their consistency is? How do you frame sort of success for someone that is under fueling?
Stevie 41:09
Well, of course, it depends on the athlete, I'm laughing because some of my nutrition coaching clients say I'm too positive. And I'm sure Kyla does this too. And they'll beat themselves up because they had half a bagel. And maybe the goal was a full bagel and peanut butter before you know, whatever workout it was, or whatever they're eating it. But they went from doing fasted runs to half a bagel, it's just encouraging them finding that as a win, where they're beating themselves up, and I'm like, This is great, we hit 40 grams of carbs per hour during this workout, like, yes, our goal is much higher, but showing them the progress and then telling them like, you know, of course, we say yes, you should feel like you recover better after your long runs when you're fueling. And usually, it takes a little bit of time for that aha moment. But I'll get that message on a Sunday. And they're like, Wow, I do feel so much better. It's just guiding them at like, it's not normal, that every workout hurt, right? Like every workout shouldn't be awful. Some people I think, just don't know, if they don't have a great coach like you, Matt or someone in their corner, that they think every day, everything should be awful, and they should always hurt. And they should have low energy or be winded going up the stairs, that also telling them like, Hey, these are signs that you might be under feeling or falling short on X, Y or Z nutrient. Let's take a closer look. See what we can adjust. And then when they start to feel like Kyla said, with a banana example like that could be night and day for an individual depending on where they're coming from. So you know, as a coach and provider is always, you know, bringing them back to "Yes, but remember where you are and look how far you've come. Let's keep working towards this next goal and building up." And of course, I'm sure Kyla does this too, like leading by example? I think that's a really big, big, big thing as providers and kind of voices in this space is showing I'm like, Yes, I'm telling you to do this, but I also practice what I preach. People were absolutely floored that I do 75 grams of carbohydrate per hour and exercise as a tiny human. But I was like, Yeah, you just, you know, just training and practicing and getting yourself there finding what works for you. And you know, it's nice to go out there and not feel like garbage.
Matt Dixon 43:32
Exactly it is very nice. Let's let the listeners have a little moment and enjoy. I am wonderful. And so that by the way for for you two guys that are American that was called British irony. And but anyway, I want to move on. And and it's very important because this is a subject that I think is so important. There's a lot of confusion around this from coaches as well as athletes birth control. We can't leave today without talking about birth control and the impact on female athlete performance. So who would like to take this? What are the risks and the performance impacts of birth control? Some of the considerations, please.
Kyla 44:18
Okay. Yeah, I mean, with birth control, there's a couple different I mean, there's several different types of birth control, right. There's an oral contraceptives, it's the pill you take every single day. There's IUDs, there's the little patch, you put in your arm, and then I think there's shots and there's all kinds of there's patches. But what I'll hone in on today is like the OCP, the oral contraceptive and the IUD. Typically when you're getting or taking an OCP daily, right, that is putting hormones exogenous hormones throughout the whole body systemically, right? Where versus an IUD is going to be more localized to the uterus. So the hormones aren't actually going throughout the whole body and it actually will still allow your ovaries to naturally cycle many times. With an OCP, possibly even an IUD is some women will lose their cycle or with an OCPD might have regular what feels like regular cycles. But I think what's important kind of tying this into our Oligomenorrhea and amenorrhea conversation is that the bleed that you have when you're on birth control is not a true reflection of a true bleed. It is a withdrawal bleed from the hormones that you are taking. So many times women will maybe have what seems like a regular cycle when they're on birth control, but then they stopped birth control and realize, Oh, my goodness, I am not having my period anymore. And it's likely because they were in this functional hypothalamic amenorrhea state all along, and that the oral contraceptive was giving them this kind of like false withdrawal bleed each month. So I think that's important that we just mentioned that in combination to the national conversation, but it does appear with these OCPs, more so than IUDs is that there is a performance impact for many people. So if you think about it, you're putting these exogenous hormones into your system, and it's almost replicating a little bit of what we'd call that high hormone phase when you're naturally cycling, or the luteal phase is what it's also called to when your estrogen and progesterone are elevated. So you potentially are noticing maybe PMS symptoms like 30 days of the month, instead of you know, five to seven days before your natural cycle for some people.
Kyla 46:39
So when that's the case that can impact our performance for many reasons. Because of these elevations in estrogen and progesterone having impacts on our dosage, I should say exogenous estrogen and progesterone. So the hormones you're getting from a birth control are not the same form of hormones that you are naturally cycling with. So these can have an impact on your ability to, you know, build muscle and have that anabolic stimulus, and if that's the case, right, we might have a harder time recovering from training sessions. We might have a decreased drive to hydrate in our first drive, right? So we want to be a little bit more on top of that, you know, being dehydrated, absolutely can impact our performance. Some people notice more regular sleep disturbances, things like that on an OCP or even slight weight gain water retention. So yeah, the OCBs can impact performance. But of course, there are certain reasons why some people maybe need to be on an OCP or an IUD. So, of course, you know, always speak with your OBGYN first. Yeah, those are some of the things I would kind of watch out for from a performance perspective.
Matt Dixon 47:50
What about something that I've heard before about leveraging birth control to manage menstrual cycles? Seems like a bad idea. Yeah, particularly for athletes that obviously struggle as as they sort of compete or race across the cycle?
Kyla 48:09
Yeah, I would, I would agree with that. I would also add to that, what I have seen and heard most recently, in the literature, when it comes to like, if you're not having the cycle, many, much of the concern, right is maybe we're not getting enough estrogen that's gonna affect our bone health. So let's put you on an OCP. And when we look at the literature on OCP, use and bone remodeling, bone health, bone density, it's kind of a wash, like, it's not clear whether the OCP actually supports bone health. But an estrogen based patch seems to help both bone health. So the OCP is it's unclear. There's some literature that says it doesn't. There's some literature that says it's, again, kind of, you know, even right, that there was not necessarily a benefit, but there wasn't a decrease in bone density. So again, kind of a wash with the OCP. But the patch appears to be the way to go and depends on why the athlete is doing that, you know, but if it's for bone health reasons, likely the the patch may be the way to go.
Matt Dixon 49:18
Alright, so let's, let's march on. And I think that a big broad subject as well that I while I had you guys, I couldn't bypass perimenopause and menopause, I would say, want to finish on this topic. It's a really important topic. And one of the things that I have noticed maybe in my mature age now with a wife who is is navigating this at the moment. Why do you think there's such a negative connotation? A lot of people almost feel like that, that almost a sense of I don't want to say shame, but whatever. It's a real sort of negative connotation around the word perimenopause, which is ultimately an animal avoidable part of life is no different than going through puberty, puberty, etc. What do you think that is? Or how would you encourage folks to look at that part and chapter of life.
Kyla 50:15
But I have personally heard clients say that they don't feel as feminine. You know, once they've lost their menstrual cycle, or they feel like it's like a really true sign of them aging, which kind of can get people down a little bit. But you mentioned the term puberty. I have heard some people call perimenopause and menopause, like the second puberty, which I kind of like that. And so I do think those are kind of some of the reasons maybe people aren't super keen on on talking about it. Because they, they feel like it's an a negative, kind of like, I'm getting older. I'm not, you know, as feminine and young anymore kind of thing. But with that being said many times. Also, if you're going through perimenopause, and you have symptoms, maybe you're not feeling super great. With that being said, though, you know, once you get through perimenopause, some women report feeling much better, obviously, once they've gotten rid of the symptoms. So there's there is light at the end of the tunnel is what I what I always tell my my female athletes as well.
Matt Dixon 51:24
And what are the key considerations? I guess it's a big subject. It absolutely is worthy of his own show, by the way, which we will have. But, but as we can cover off in the rest of the time that we do have together today. What are some of the key considerations for female athletes around perimenopause?
Kyla 51:42
Yeah, so perimenopause can last for two to even up to 12 years and some women and so I think it's important to to define perimenopause versus menopause. Many people say I'm going through menopause or you're actually going through perimenopause. And then once you've ceased your menstrual cycle for a year, then that is defined as being in menopause. So during that perimenopause, it's phase that two to 12 years, that's typically when the symptoms are most prominent. And that's when it's a problem for many female athletes, right? Because the estrogen levels are kind of riding this roller coaster and progesterone, you're kind of calming hormone is declining. And now these ratios between estrogen and progesterone are kind of all over the place. What we do know for sure, from a, like a nutrition perspective and considerations for the female athlete is that protein requirement is likely going to increase as we get older, again, because we don't have that anabolic effect from estrogen because it's just not nearly as high to stimulate muscle protein synthesis. So we do want to make sure not only are we hitting our end of day protein targets, but we're really sandwiching the protein well, before and after our training sessions to support or minimize protein or muscle oxidation or breakdown during our sessions, but support that muscle protein synthesis or reparation post training as well. And then many times too, we will see for our opponent a puzzle athletes is that maybe blood sugar responses become a little bit more erratic as well. And protein again, is one of those things, if we add it to each of our meals is going to help kind of balance essentially that blood sugar response from our meal. So I would say protein is many one of the things I really see lacking in my pre menopausal and menopausal athletes for sure.
Matt Dixon 53:31
So what else can female athletes do to optimize their performance as they navigate this time? And the first thing that you mentioned is protein. Let's expand I've got a couple of thoughts on this, by the way, so believe it or not, but but I'd love to hear from you guys.
Kyla 53:49
So how can protein help with performance you're saying?
Matt Dixon 53:53
What else beyond obviously an increase in a requirement of protein? What are the other considerations for female athletes to optimize their performance as they never go? Yeah,
Kyla 54:02
So there can be that decreased drive to drink for sure. So making sure you're staying on top of your hydration whether that setting a timer on your Garmin, something like that to just remind you to sip and stay hydrated. There can also be quite a bit of maybe changes in mood, irritability, things like that. And many times because of the fluctuations in the estrogen, we can actually increase our intake of cruciferous veggies is one of the things it's rich in DIM or di indole I'm gonna mess it up. Do you know this one Stevie? Diane doll methyl. Sorry, I put you on the hotsdeat. I'm gonna call it dim for now, but dim and sulforaphane are rich and cruciferous veggies so you're brussel sprouts, cabbage, cauliflower, things like that. And that's a really helpful tool actually in helping with estrogen metabolism and excretion from the body and then you Increasing your for getting enough fiber but can be one of the things too to help bind with that excess circulating estrogen and we evacuated as a bowel movement. So those estrogen fluctuations are really the primary thing that's leading to these symptoms that many people notice like the hot flashes is when estrogen is up, and then it quickly drops. We have that vaso vasovagal response right. And so we can manage these big high estrogen peaks with helping basically with estrogen metabolism.
Matt Dixon 55:33
I'm going to add as a coach here that I think there are two things I just want to highlight. And let me preface number one, every endurance athlete should integrate strength and conditioning into their program. Every athlete as they mature, male or female should integrate strength and conditioning into their program. When it comes to perimenopause, the earliest start that you get on a consistent build of strength and conditioning into your program, the better it is, people often think, Oh, I'm 45, I should start thinking about I should consider starting strength and conditioning. Well guess what, if you start in your 20s, you're setting it up for there. So I would highlight strength. A second thing that I would highlight for particularly seasoned athletes, athletes that have been consistently exercising consistently coming now starting to emerge into this phase of life is a shift of mindset. And this is particularly prevalent for pretty high performing amateurs or ex pros, where what used to work for you as your approach might have been wonderful. But it might not be the thing that works for you anymore. And so being really open to shifting your mindset of what appropriate training is, and to end eating, I should say, because that's the focus that helped me navigate is really, really important. Stevie any any thoughts on this?
Stevie 57:05
Yeah, no, I mean, Kyla, really covered it all. I mean, the biggest thing, and I think it's just, you know, she already mentioned prioritizing the protein, right? You might need and you mentioned with training, the training volume, the training load, you know, the potential to need to increase a little bit more recovery time. And of course, going with the, with the strength training. Another thing that I also do love to add is some tart cherry juice, and there are tart cherries as well. I think that's good for any athlete at any age, but especially in these pre menopausal athletes as well.
Matt Dixon 57:41
Interesting. So guys, I wish we had two more hours to carry on talking about this stuff. But I want to finish up just with a couple of components. Do you guys have any any thoughts or advice to listeners that may be a seeking out a prospective coach that they might work with? To help them determine their needs? Or a dietitian or registered dietician or nutritionist? Is there any particular approach that listeners should take to ensure that their coach, their practitioner, really understand the needs of female athlete?
Stevie 58:23
Number one, do your research. Learn as much as you can about the person on the internet? You know, look at their background, look what their degrees are in, you know, Kyla is excellent. She doesn't have her rd right, if I have that correct, but he is an excellent very well qualified provider and I would be happy to refer her, you know, refer people to her. So looking at their education, avoiding the online certifications. You know, I know even like Cornell has an online certification, where people would see Oh, Cornell this person is definitely qualified, but it might not be the best fit for you. It also depends on the athlete's needs. Like if you're looking for just like very general coaching and support and encouragement, there definitely are some nutritionists with a little bit less education and training than Kyla or myself, and that might be a good fit for you. But if you're going through perimenopause, menopause, etc. Then looking for someone who has a little bit better understanding of the science behind it, and more experience working with female athletes and ask a lot of questions before you start working with them. That's a big one. Kyla, I'm sure you have more to add.
Kyla 59:43
Yeah, I would. I would. I would echo everything you just said. And then like people who are members of SCAN or ISSN you know, there's, they have requirements annually to get so many hours of continuing education, which I think is so incredibly import And because especially right now, the research on women is it's we're getting more information, and it's changed so much than even from just five years ago or two years ago. So to have someone who is continuing to stay up to date, whether that's a requirement or not, but making sure that they are staying up to date in what the new research is coming out with or attending conferences, things like that is, I think important. So yeah, keep, you know, ask them questions, many, I think practitioners, or coaches have the option to do like a comm call with them. So you can feel it out and ask them questions and see, see if they're a good fit.
Matt Dixon 1:00:41
I will add this. As for coaches that are listening, you are not burdened with needing to be the expert on this. And I think this is really important across any field. In fact, so many coaches take on the fact that they need to have the answers to every question whether it's tissue health or equipment knowledge, or this broad spread spectrum of female athletes. I think that powerful coaching has been open, it's been open and surrounding yourself with really smart experts. And that's why we work with insidetracker. That's why we work with kila. That's why we work with the few with the guys from fuel in because I know enough to be dangerous, but I empower myself and ultimately my athletes, which is what we all want, which is athlete evolution, athlete, health, athlete improvement, by surrounding myself with really, really smart people like Steve And Kyla. And I think that's really important. I think it's a coach's role and responsibility to continually educate and evolve as much as they can. But, but also realize that they don't need to go deep, deep, deep into every subject. And so if you're looking for a coach, or a program, I would really encourage you to, to seek out someone that's really open to surrounding themselves with experts as well, because they don't know everything. Team, thank you so much. That was a fantastic couple of sessions. So informative. I know that we will do this again, because it was empowering and so much fun. I really, really appreciate it Stevie from InsideTracker and Kyla Nutritional Revolution for listeners at home we will of course give you guys all of the information on on both of our guests, but I really want to thank you both for joining us and bringing your expertise and knowledge. I really appreciate it. Thanks for having us. Yeah, thank you take care guys thanks so much for listening.
Matt Dixon 1:02:50
This has been the Purple Patch Podcast. If you like what you hear, we'd really appreciate it if you share with your friends and even go the extra mile and head over to Apple Podcast subscribe, rate, and review the show. The Apple podcast link is in the show notes. Your support and positive reviews go a huge way in increasing our visibility and also the exposure to time staff people everywhere who want to integrate sport into life and ultimately thrive. Don't forget, you can also follow us on Instagram, Facebook and Twitter. Cheers