Does running mess with your guts?

A tricky and somewhat delicate topic to tackle, but a real problem for some.

Exercise does provide immediate benefits for your gastrointestinal system. There appears to be a dose-response relationship between exercise intensity and health. Mild to moderate levels of exercise can help to protect against colon cancer and constipation, as well as other conditions. It can improve digestion and elimination through strengthening muscles of the abdomen and stimulating intestinal muscles to help move things along more quickly. However, intense exercise has been associated with heartburn, gastric reflux, nausea, vomiting, abdominal pain, diarrhea and even gastrointestinal bleeding. Exercise sometimes slows down digestion as energy is conserved for exercise activity. Gut ischemia, or a lack of blood supply through various causes, is thought to be at the heart of some of the gastrointestinal problems that people experience when exercising.

Research reported in this paper seems to find that those that exercise the most intense – elite athletes – are hit particularly hard by these problems. About 25 to 50% of these athletes are affected so badly by symptoms of gastrointestinal distress that it can put them off training or competing. A dehydrated state can also make these symptoms worse.

Interestingly, the frequency of these symptoms seems to be twice as high for endurance runners than those participating in other endurance sports such as swimming or cycling, and one to three times more frequent in elite athletes compared to those participating in more recreational exercise..

Here’s what you can do to avoid negative side effects of exercise if these are a problem for you:

• To be ultra-safe, allow two hours after a meal before you exercise and do not exercise on a full stomach. I always leave an hour at least, but if you continue to have problems, try longer
• Practice light exercise to improve the efficiency of the digestive system
• Check your meal composition, water intake, and medications – if these aren’t right, it can make the problem worse
• Avoid caffeine before exercise. It can sharpen you up, but loosen you up too – it irritates the bowel
• Light exercise such as yoga and pilates can also improve digestive system functions by reducing stress and anxiety levels, which can cause digestive disorders, too.

Good luck!

Want to live long and prosper? Coffee may be your friend

Coffee can get a bad press. It has been associated with raised adrenaline and cortisol levels which may heighten your attention in the short term, but can cause energy crashes and adrenal exhaustion. Some people say that the raised level of alertness only brings you up to the same level as people who aren’t dependent on that caffeine kick to raise their attention levels. And although coffee is associated with enhanced athletic performance, caffeine can also irritate the bowel lining – with consequent results. This is especially important to note for people about to head out for that long run, or who plan on taking a sports gel for the first time (these can often be loaded with caffeine – beware). However, coffee also contains hundreds of unique compounds and antioxidants that may deliver health benefits. There is also the issue of the entanglement of coffee-drinking and smoking – figuring out which parts of this couple play which part in the documented effects is notoriously difficult.

So, there is mixed evidence as to whether coffee is good for us, which also depends upon what we want from coffee in a functional sense. This study conducted by researchers at the National Institutes of Health in the USA, adds a lot more to the ever-changing picture. They found that frequent coffee drinkers have a lower risk of dying from a variety of diseases compared with people who drink little or no coffee.

The study looked at the information gathered from 229,119 men and 173,141 women who belonged to a retirement association between 1995-96. They were then followed (not literally, that would be creepy and very expensive) until 2008, but which point 52,000 had died. As found before, the researchers discovered that coffee drinkers were more likely to be smokers, ate more red meat, fewer fruits and vegetables, exercised less and drank more booze – all behaviors associated with poor health. But once those risks were statistically controlled, the data showed that the more coffee that a person consumed on average, the less likely he or she was likely to die from a number of health problems including heart disease, respiratory disease, diabetes, stroke, infections and even injuries and accidents.

Overall, the risk of dying during the 14 year study period was about 10 per cent lower for men and 15 per cent lower for women who drank anything from between two to six (or more) cups of coffee a day. And it didn’t seem to matter if it was caffeinated or decaffeinated coffee either.

It is definitely worth noting that this is only an association, not a directly causal effect, and the effect size is relatively modest. But is does perhaps add to the evidence that coffee drinking isn’t just another risk factor. In the meantime, good luck in figuring out which of the 1,000 of more compounds in coffee (or combinations thereof) might be responsible for any beneficial health effects. Rather you than me.

No need to rush

There are times when procrastinating might be a good idea. Not because you are avoiding doing something – though we are all guilty of that at times. But it can be useful when we are trying to figure out the best course of action in a complex situation, or where we are trying not to make critical errors.

There is a lot of pressure in modern life to respond immediately to requests. Email is constantly with us, social networks like Facebook and Twitter ping us with updates – even when we are trying to sleep unless we are disciplined about switching these functions off (Apple have recognized this and seem poised to add a ‘Do Not Disturb’ mode to the next version of the iPhone operating system). Business supply chains rely upon just-in-time management techniques and delivery windows which do not have much margin for lateness. Fast food chains will give you your fix in under two minutes. Even job contracts are getting shorter and focused upon a core set of deliverables – those and those alone, thank you very much – “Now, go and get on with it, and woe betide you if I catch you fiddling around with anything else when you are supposed to be doing this job.”

All this pressure for immediacy. Yet, we also hear things like ‘act in haste, repent at leisure’. We also see online transactions, or credit contracts that have a ‘cooling-off period’ to help us to take another look in the ‘cold light of day’. Maybe creativity also needs time, and perhaps distraction to enable the fusing of new combinations and ideas. Ernest Hemingway once told a fan that the best way to write a novel was to first clean the fridge. And when you plant a seed, you don’t dig it up every five minutes to see how it is doing. Doing that only damages the process, or at least delays it. Some things operate on a different time scale altogether. Immediacy is not a good fit.

In Wait: The Art and Science of Delay, Frank Partnoy argues that too many people fail to recognise that success depends on knowing when to delay, and for how long. Comedians get this, as do people who make a living through public speaking. Sometimes, doing things right is more important than doing it first. Just ask Apple about the iPad and then see what Microsoft has to say about the Tablet computer they had out years earlier.

Delaying also works where critical errors need to be avoided. Airline pilots and surgeons use checklists, even when they have done the procedure many, many times before. The list slows them down and helps them to work methodologically, avoiding the taking of potentially time-saving shortcuts that could lead to catastrophic error, whilst improving quality and consistency of service at the same time.

The wisdom comes from recognising when to think and act quickly (e.g. delaying paying that credit card bill is probably just going to make things worse), and knowing when to act and think slowly. Partnoy thinks that this is a skill that can be learned, and I agree. It also ties in nicely with my to-do list post here.

Speed for its own sake can lead down dangerous paths. The pleasure gained deciding and executing an action can bring a sense of closure and can even be aesthetically pleasing. But the secret of modern life and how are brains have evolved to function is that we need a combination of fast and slow. Deadlines are useful, but there is value in dawdling too.

Sugary drinks can change your muscles in just one month

That cold soft drink sure tastes good on a hot day, right? Maybe that energy drink hits the spot after a long workout too. But we know that too much sugar isn’t so great for us. You probably know it rots your teeth if you’re not careful. You also probably know that sugary drinks can influence your metabolism so that you could run into trouble with how insulin works in your body, possibly increasing risk of developing type 2 diabetes.

But did you know sugary drink consumption that it can also influence how your muscles function? In this study published in the European Journal of Nutrition, it appears that people given an average of 760mls of sugar sweetened drink (Lucozade Energy) every day for 4 weeks showed significant changes in how their muscles used fuel sources. Specifically, their muscles seemed to be able to sense the high sugar nature of their new environment (the participants were selected because they would not usually drink more than 500ml of sugary drinks per week), and changed their functioning to prefer burning sugar instead of fat. This also seemed to influence future functioning of muscles too.

Although it is quite a technical paper, the authors make a good argument that these changes can lead to a reduced ability of our muscles to burn fat, and instead we gain it. They also argue that the body becomes less able to cope with increases in blood sugar levels. Our body adapts to the new sugary environment it finds itself in which leads to changes in gene expression in our muscles. These are the kinds of unhealthy metabolic alterations seen in people with weight problems and type 2 diabetes.

From a performance point of view, especially for endurance athletes, there’s a warning here about how what we drink can influence how your muscles adapt and perform when you run, bike, kayak or swim. Just 760mls of Lucozade Energy a day over 4 weeks. That’s two bottles. Maybe not everyone is drinking in that much sugar, but perhaps more than we would ideally like – especially if you are exercising regularly (though a previous post gives good reasons as to why you don’t need to drink anything other than water if you’re exercising for less than an hour at a time).

If your muscles change so that they start to prefer sugar over fat, this is going to have an impact on your fueling strategy during events, and on how you feel when your body starts to run out of readily accessible sugars. If your muscles are ‘trained’ out of using fat as a fuel source, I think we could expect to see some serious bonking and inefficiency as those sugars get depleted.

Let me know what you think, especially any nutritionists who happen to read this post.

The key to managing your weight is eating less, not exercising more

New research in a hunter-gatherer community seems to indicate that managing what that you eat is more important than exercise in determining how much weight you gain (or lose).

A study into energetics and obesity in the Hazda people of Tanzania revealed that although physical activity levels were much higher for Hazda men and women than their western counterparts, once size and weight were taken into account their metabolic rates were pretty similar. This was something of a surprise, as most people would expect that Hazda people, and others living a hunter-gatherer lifestyle would burn many more calories than their more sedentary equivalents in more ‘developed’ societies. Energy expenditure looks more complex than a simple linear relationship. But what did become apparent was that although physical activity does seem important in keeping you healthy, it won’t keep the weight off. It looks like we need to stick to eating less to do that.

So, if you’re relying on your workout to give you permission to eat more, think again. If your goal is to lose weight, you’re probably not doing as well as you could be.

Thoughts on “The Truth about Sports Products” on BBC Panorama

Last week, BBC Panorama broadcast a very interesting investigation into the claims behind many of the sports products that we are encouraged to use in our pursuits – from high-tech shoes to performance and recovery drinks. If you are in the UK, you can access this via the Panorama website on the internet, but everyone can see this quick summary and video. The show has provoked some quite heated debate on internet fora, and some defensive media statements from companies associated with the production of these sports products – see GSK’s statement here.

The major points for me seemed to be:

• For most people, performance and recovery drinks (e.g. Powerade etc) are pretty pointless – we don’t exercise for long enough or intensely enough to warrant it. For people exercising over 60 minutes, it may be beneficial, but the evidence is pretty thin at best.
• Forget drinking before you are thirsty. There are more dangers associated with drinking too much than too little. Drink when you are thirsty, and unless you are exercising for a long time, stick to water.
• Again, unless you are an elite athlete, or undertaking some serious endurance activity, other supplements don’t seem to have much evidence backing their use with the exception of creatine and caffeine. Stick to maintaining a well-balanced diet.
• Don’t fall for the marketing of running shoes – there is very little evidence that they help reduce risk of injury. Try some on, and if they feel comfortable, use those. Intensity and time exercising play a bigger role in predicting risk of injury. Focus on your running style and your kinetic chain if you want to improve your running and  / or minimize your risk of injury.
• Buying cool stuff doesn’t make you healthier, fitter or sexier. Eating well and exercising often might.

I tend not to take anything other than water if I am exercising for under 60 minutes. Once I know I will be exercising for more than 60 minutes, I start to take on a little fuel at 45 minutes onwards, and then repeat every 30-45 minutes. But that is for pretty long runs. It seems to work for me.

The most disturbing part of the show to me was the marketing to kids and the influence that seems to have. What did you think of the show?

Habits that help you to manage your weight

I was recently away from home for 10 days, on the Auckland Mayoral Pacific Trade mission – which was a very interesting trip, and a privilege to be on, though I missed my family terribly and it was very, very busy.

One of the challenges that I found in being away was a lot of time sitting around in meetings, on coaches and in planes with relatively little opportunity to exercise. I did get out for a run twice, but on one of those I was chased quite effectively by a dog in Tonga, which meant that I ran a little quicker than my target pace. Another challenge was managing my food. When you’re eating out of your home environment all the time, and also have obligations to try at least a little food several times a day so as not to cause political embarrassment by offending your host (sometimes the Prime Minister), it gets pretty hard to stick to any plan at all, let alone a more structured diet.

I can across an interesting paper that helps to spell out the nature of the links between lifestyle factors that seemed important for success in a group of successful weight losers. Here’s the take home messages:

• Eating meals regularly was associated with greater recent weight loss, and eating more fruit and vegetables
• TV related viewing and eating while you do it was associated with greater BMI and greater fat and sugar intake
• More eating away from home was related to greater fat and sugar intake, eating fewer fruits and vegetables, and less physical activity
• Using weight control strategies was most consistently linked to better weight, diet and physical activity outcomes. These included habits like keeping a written log of amount and type of exercise as well as calorific content of food that you eat, planning meals and exercise to manage weight, and using meal replacements to manage weight (though the latter strategy loaded least strongly on this factor in the analysis presented in the paper).

In general, eating away from home and TV related eating and viewing are more related to negative outcomes, and eating regularly and using weight control strategies are more related to positive benefits.

The paper summarizes by saying that lifestyle patterns (like eating regularly) are more important in predicting diet, physical activity and weight that individual behaviors (like eating breakfast) alone. So, try to see the whole picture when you are trying to manage or lose weight. It seems important  to think and act upon sticking to behavioral clusters rather than seeking false solace in solitary positive behaviors, like thinking that by making sure you that eat breakfast acts as a protective factor that forgives all other ills.

I’m enjoying getting my clusters back into my life. Let me know how you get on.

I’ll be back soon

In case you’re wondering about my blog posts, I’m currently on a business trip in the Pacific with limited internet access to upload any posts. But I’ll be back again soon.

You are the sky, not just the weather

When we are troubled by thoughts and feelings that seem to hook us and stay with us, it can be helpful to think about the difference between the observing and thinking self.

Your observing self is like the sky. Thoughts and feelings are like the weather. The weather changes all the time, but no matter how bad it gets, it cannot harm the sky in any way. The mightiest thunderstorm, the most terrible hurricane, the most severe winter blizzards – none of these can hurt or harm the sky. And no matter how bad the weather, the sky always has room for it. And sure enough, sooner or later, the weather always, always changes.

Sometimes, we can forget that the sky is there – but it’s still there. And sometimes we can’t see the sky because it is hidden from us by clouds. But if we can rise high enough above the clouds – even the thickest, darkest, thunderclouds – sooner or later we will reach clear sky – stretching before and around us in all directions – boundless and pure.

More and more, you can learn to tap into this part of you: a safe space inside from which to observe and make room for difficult thoughts and feelings.

Simple ways to be present

Being present in your everyday actions seems to be a key ingredient for good mental and physical well-being. Here are three ways for you to practice being more present – rather than off thinking about one thing – often in the past or the future – while doing something else now. The more you practice, the better you will get.

These exercise will help you to centre yourself and engage with your environment. Practice them throughout the day, especially at times when you find yourself caught up with your thoughts and feelings.

Notice five things

1. Pause for just a moment
2. Look around and notice five things that you can see
3. Listen carefully and notice 5 different things that you can hear
4. Notice five different things that you can feel in contact with your body – perhaps your trousers against your leg, the bracelet on your wrist, the air on your face, your feet upon the floor, your back against the chair
5. Finally, the all of the above at the same time. Notice how much there is going on all around you and in contact with you.

Take ten breaths

1. Take ten slow, deep breaths. Focus on breathing out as slowly as possible until yours lungs are completely empty – and then let your lungs fill up by themselves
2. Notice the sensation of your lungs emptying. Notice them filling up again. Notice your ribcage, rising and falling. Notice the gentle rise and fall of your shoulders
3. See if you can let your thoughts come and go as if they were passing cars, driving outside your house
4. Expand your awareness from your breathing – notice your breathing and your body – then look around the room and notice what you can see, hear, smell, touch and feel.

Drop anchor

1. Plant your feet into the floor
2. Push them down – notice the floor supporting you
3. Notice the tension in the muscles of your legs as you push your feet down
4. Notice your entire body, and the feeling of gravity flowing down through your head, spine and legs into your feet
5. Now look around. Notice what you can see and hear around you. Notice where you are and what you’re doing.

Just a few minutes each day – that’s all it takes. Try it regularly, little and often