Latest / Find Your Edge: Training, Nutrition + Longevity for Endurance Athletes / Bone Health for Athletes: Performance Today, Longevity Tomorrow Ep 147

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Bone Health for Athletes: Performance Today, Longevity Tomorrow Ep 147 · Find Your Edge: Training, Nutrition + Longevity for Endurance Athletes

• 0:37
  Coach Carlie: All right, welcome back, friends.
• 0:39
  Coach Carlie: A fun topic for you today.
• 0:41
  Coach Carlie: Uh, we are on the Find Your Edge podcast.
• 0:43
  Coach Carlie: My name is Coach Chris, and I'm here with my amazing dietetic intern, Emily Q, who has been a machine cranking out some great information for all of you folks out there who are active and doing amazing things in the endurance community and here to talk about bone health, something that we probably don't talk enough about.
• 1:03
  Coach Carlie: So, bone health for athletes.
• 1:05
  Coach Carlie: So, Emily, what's up?
• 1:08
  Coach Carlie: How's how's the internship going?
• 1:10
  SPEAKER_01: Hi, Chris.
• 1:11
  SPEAKER_01: It's been going so well.
• 1:13
  SPEAKER_01: And I'm not just saying that because you're right here.
• 1:16
  SPEAKER_01: I was gonna say that's a little canned.
• 1:19
  SPEAKER_01: I've been I've been really loving it.
• 1:21
  SPEAKER_01: I've been learning, learning a ton and just getting to see a lot of super cool things.
• 1:27
  SPEAKER_01: So it's been such a cool experience.
• 1:29
  SPEAKER_01: Good.
• 1:30
  Coach Carlie: We have had her doing everything from deep dives into various sports nutrition things, integrative and functional nutrition.
• 1:37
  Coach Carlie: You've been seeing lactic testing and VO2 testing and all the things.
• 1:43
  SPEAKER_01: So I've been I've been working out with you guys too.
• 1:46
  Coach Carlie: So of course, how could I forget?
• 1:48
  Coach Carlie: She's also doing strength training.
• 1:50
  Coach Carlie: Speaking of bone health, Emily, that was such a great segue.
• 1:52
  Coach Carlie: It's like we planned it or something.
• 1:54
  Coach Carlie: Yeah.
• 1:56
  Coach Carlie: Why athletes need strong bones.
• 1:58
  Coach Carlie: I feel like this is a topic where most people are like, oh, this is only for like growing children, right?
• 2:05
  Coach Carlie: So tell us about why athletes, no matter what their age, need strong bones.
• 2:10
  SPEAKER_01: For sure.
• 2:11
  SPEAKER_01: I feel like we are always talking about our muscles mainly, like how to build muscle, how to maintain it, and whatever.
• 2:17
  SPEAKER_01: But we need to remember that the framework for all those wonderful muscles are our bones.
• 2:23
  SPEAKER_01: And so if we want to generate the most power and speed from our muscles, we need to have strong bones.
• 2:29
  SPEAKER_01: And we're not all necessarily thinking about this at every moment, but in addition to bones being important for growing, like you said, in the growing children, um, in our older age, strong bones really help us prevent injuries and detrimental falls and things like that.
• 2:49
  Coach Carlie: Yeah, for sure.
• 2:50
  Coach Carlie: I love this little tip you give down below in terms of bone mineral density.
• 2:55
  Coach Carlie: Tell us about that, like peaking in early adulthood, and then what?
• 3:01
  Coach Carlie: And then slowly declines.
• 3:04
  SPEAKER_01: Yeah.
• 3:04
  SPEAKER_01: This is something I didn't learn until a few years back in one of my nutrition classes.
• 3:08
  SPEAKER_01: But bone mineral density is basically the indicator of how well your bones are doing and how healthy they are.
• 3:15
  SPEAKER_01: If you have a higher bone mineral density, that's a good thing.
• 3:19
  SPEAKER_01: And we actually build our peak bone mineral density in early adulthood, like 20s.
• 3:24
  SPEAKER_01: It usually peaks around the age of 30.
• 3:27
  SPEAKER_01: And then just there's a natural decline, like a slow decline as you keep aging, which is why you see a lot of osteoporosis and things like that in your older age, because it kind of like has this shape of it, it peaks and then it slowly comes down.
• 3:42
  SPEAKER_01: And there's not too much you can do after a certain point to bring it back up.
• 3:46
  SPEAKER_01: So the more you build your peak bone mass, but bone mineral density, like in your early adulthood, I guess the further it has to decline before hitting the danger zone of osteoporosis, if that makes sense.
• 3:59
  Coach Carlie: Yeah, for sure.
• 4:00
  Coach Carlie: I love for folks if you don't have access to one, try to find one.
• 4:05
  Coach Carlie: A DEXA scan is not only so great from a body composition perspective, because you know, I'm all about the metrics, and especially folks who are looking to, they want to lose some body fat and they want, you know, and the scale's not moving and what the heck.
• 4:20
  Coach Carlie: And then they get super frustrated.
• 4:22
  Coach Carlie: Having that additional metric of knowing how much lean body tissue do you have and how much fat mass you have.
• 4:31
  Coach Carlie: But also part of a DEXA scan is what is your bone mineral density.
• 4:36
  Coach Carlie: And then especially tracking that after the age of 30, in my mind, allows us to be more proactive about the food choices that you're making, about the activity choices that you're making.
• 4:49
  Coach Carlie: Because, you know, I have some people who, in their genetics, it shows that their bone health is of greater concern, but they're getting adequate vitamin D and calcium.
• 5:00
  Coach Carlie: We're gonna talk about that here in a minute, and they're doing super heavy lifting and they're running.
• 5:07
  Coach Carlie: It's like, okay, well, you're doing the things and your desk says that you're fine.
• 5:13
  Coach Carlie: So, you know, but then there's like, but I'm gonna get osteoporosis because my family had it.
• 5:18
  Coach Carlie: I'm like, no, that's not a guarantee because you are literally doing the things to mitigate that process.
• 5:25
  Coach Carlie: So, yes, I I hear you saying how there's a natural decline, but we can be part of the process to slow that decline.
• 5:34
  Coach Carlie: Exactly.
• 5:36
  Coach Carlie: You know, because bone, bone is turning over all the time.
• 5:39
  Coach Carlie: We take it out, we put it back in, we take it out, we put it back in.
• 5:42
  Coach Carlie: Anyway, stop me on the soapbox.
• 5:46
  SPEAKER_01: No, it's great.
• 5:47
  SPEAKER_01: I would have the same soapbox.
• 5:49
  SPEAKER_01: I think, especially in our athlete population here, this is not just something you have to keep in mind for your older age, but maintaining your peak uh bone mineral density and trying to slow that decline plays a huge part in prevention of stress fractures, which I'm sure a lot of you have dealt with and have suffered.
• 6:08
  SPEAKER_01: Yeah.
• 6:09
  Coach Carlie: Yeah, for sure.
• 6:10
  Coach Carlie: And we get so many PTs who are sending us athletes who are have repeated stress fractures.
• 6:16
  Coach Carlie: And, you know, they're obviously looking at it from a mechanical perspective.
• 6:19
  Coach Carlie: Like, are their mechanics such that they're moving in a way that is saving, quote unquote saving their bones or s or preserving them, but also what's going on on the inside?
• 6:33
  Coach Carlie: Like, what does their nutrition look like?
• 6:35
  Coach Carlie: Are they too acidic?
• 6:36
  Coach Carlie: Are they getting enough vitamin D?
• 6:38
  Coach Carlie: What is their nutrient statics, etc.?
• 6:40
  Coach Carlie: But um yeah, I know the slide that we're on, if you guys are watching this on YouTube, we're talking about building that peak bone mineral density.
• 6:47
  Coach Carlie: So this is probably not news to our folks, but you know, we can put in the general recommendations anyway.
• 6:53
  Coach Carlie: So what do you got, Emily?
• 6:55
  Coach Carlie: Yeah.
• 6:56
  SPEAKER_01: So the number one thing you can do to like make sure you're building your peak bone mineral density is weight-bearing exercise.
• 7:04
  SPEAKER_01: And I want to emphasize this specifically for female athletes, because I feel like generally there's less of an emphasis on strength training in a lot of women, but your most impactful activity to build your bone mineral density is going to be impact activities, kind of against going against gravity.
• 7:24
  SPEAKER_01: So that can include running, that can include jumping, stairs, anything where you're kind of you're pounding a bit.
• 7:30
  SPEAKER_01: Yeah, pounding and like you're really your bones are feeling that absorbing that impact, and they're going to adjust and strengthen because of that.
• 7:40
  SPEAKER_01: Yeah.
• 7:40
  SPEAKER_01: Non-impact things are also very important.
• 7:43
  SPEAKER_01: Weight lifting, if you're like constantly like lifting things that are like resist the resistance training, that's really, really good for your bones as well.
• 7:52
  SPEAKER_01: That's just an example.
• 7:54
  SPEAKER_01: The recommendations say that you should be doing weight-bearing aerobic exercise three to five times a week and resistance exercise for about two to three times a week.
• 8:05
  SPEAKER_01: So a combination of both is the best.
• 8:08
  Coach Carlie: Yeah, for sure.
• 8:08
  Coach Carlie: And of course, those ACSM recommendations are more general population.
• 8:13
  Coach Carlie: And I know all of you out there are probably exceeding that by like a lot.
• 8:18
  Coach Carlie: For sure, for sure.
• 8:19
  Coach Carlie: Which, which is great.
• 8:21
  Coach Carlie: But I do want to point out is that from a non-impact perspective, if you are a cyclist only, you are at greater risk of losing bone density.
• 8:33
  Coach Carlie: So I know that you're going to whine and complain at this statement, but your rear end needs to be in the weight room.
• 8:39
  Coach Carlie: Like, please don't argue with me.
• 8:42
  Coach Carlie: Just go lift heavy things, you know.
• 8:45
  Coach Carlie: I mean that I don't get 250 miles this week.
• 8:48
  Coach Carlie: Shut your face and go to the gym.
• 8:51
  Coach Carlie: Like it will help your cycling specific strength.
• 8:57
  SPEAKER_01: It will improve your performance and it will save your bones because cyclists only, and this is in comparison, the research I've seen is in comparison to runners, they have a greater decline in their bone density than And if you yeah, if you think about it, it's because you're sitting on the bike and your your legs are going, but you're not really the pounding that we talked about earlier isn't just isn't there.
• 9:20
  SPEAKER_01: No, it's not happening.
• 9:21
  Coach Carlie: And I get it.
• 9:21
  Coach Carlie: Some people are like, oh, well, I've got, you know, a knee replacement or hip replacement, like I can't run anymore.
• 9:26
  Coach Carlie: That's fine.
• 9:28
  Coach Carlie: You can still pick up heavy things that are gonna stress the bones.
• 9:31
  Coach Carlie: There's also very interesting research that I've seen.
• 9:35
  Coach Carlie: Emily, have you heard of and something called heel drops?
• 9:38
  Coach Carlie: Yeah, like in your shoes.
• 9:40
  Coach Carlie: Yeah.
• 9:40
  Coach Carlie: Yeah.
• 9:41
  Coach Carlie: So not necessarily like a like a heel, you know, cup or something like that.
• 9:45
  Coach Carlie: But if you stand barefoot, that this is research-based, promise you guys.
• 9:51
  Coach Carlie: And you stand like a cute little old lady or man on the back of a chair, or it doesn't matter, matter where you stand, and you you have to be barefoot and you have to be on a hard surface.
• 10:02
  Coach Carlie: So, you know, a hardwood floor is is fine, just not a carpet or something like soft and squishy.
• 10:09
  Coach Carlie: And you lift up onto your tippy toes.
• 10:11
  Coach Carlie: Maybe I'll do this in strength class tomorrow.
• 10:13
  Coach Carlie: And you stand up on your tippy toes, and then you literally drop your heels forcefully on the ground, and then you rise up onto your tippy toes and then drop your heels forcefully onto the ground.
• 10:24
  Coach Carlie: And then you do that over and over again.
• 10:26
  Coach Carlie: That will build your bone that you are stressing your spine and your pelvis in a way that helps with this turnover, even if you can't physically run or jump or do stairs.
• 10:39
  Coach Carlie: But if you can do heel drops, and we're talking like 20 to 50 a day.
• 10:45
  Coach Carlie: So it's it's not this extraordinarily time-consuming thing.
• 10:49
  Coach Carlie: So I cannot wait to see cute little cyclists in their kits sending me videos of them doing heel drops instead of going to the gym.
• 10:58
  Coach Carlie: It actually will support your bone density.
• 11:01
  SPEAKER_01: So your body will thank you later.
• 11:03
  Coach Carlie: It totally will.
• 11:04
  Coach Carlie: It totally will.
• 11:05
  Coach Carlie: Okay, nutrition's role.
• 11:07
  Coach Carlie: I love nutrition, of course.
• 11:10
  Coach Carlie: So what uh tell us about nutrition's role in bone health.
• 11:14
  Coach Carlie: So, what are nutrients we have playing around in here?
• 11:17
  SPEAKER_01: I mean, you guys probably all heard this growing up.
• 11:20
  SPEAKER_01: The calcium is probably the most important.
• 11:23
  SPEAKER_01: The second most important is probably vitamin D because it helps absorb calcium.
• 11:29
  SPEAKER_01: So your bones are primarily made of calcium.
• 11:32
  SPEAKER_01: Like 99% of your body's calcium is stored in your bones and teeth, actually.
• 11:38
  SPEAKER_01: But beyond that, calcium is also required for uh muscle contraction and nerve transmission and blood clotting.
• 11:45
  SPEAKER_01: So it's doing a lot for you.
• 11:47
  Coach Carlie: Uh the your out there, especially now that it's hot, is hearing that because muscle contraction is massive.
• 11:53
  Coach Carlie: If you are having issues with cramping, usually most people are gonna go to magnesium, but you gotta make sure you're getting enough calcium in there too.
• 12:00
  Coach Carlie: Like it's really critical.
• 12:02
  SPEAKER_01: Yeah, it's not just kids that need to be drinking milk, but we're we're taught, we'll talk about that in just a little bit.
• 12:08
  SPEAKER_01: Yeah, for sure.
• 12:09
  SPEAKER_01: Um Vitamin D, like I said, it helps you absorb the calcium, and then it also regulates your calcium and phosphate levels in your blood, which is super important for all that other function, the muscle contraction and whatever else.
• 12:25
  SPEAKER_01: Yeah.
• 12:25
  SPEAKER_01: So those the primary like adequate consumption of those two are probably the most important in bone health.
• 12:33
  SPEAKER_01: There are some other nutrients that also play play some roles here.
• 12:37
  SPEAKER_01: Vitamin K is one, vitamin C is one, protein as well.
• 12:42
  SPEAKER_01: That's important for just building bone.
• 12:45
  SPEAKER_01: Yeah.
• 12:46
  Coach Carlie: So many people are like, oh, if I eat too much protein, I'm gonna hurt my bones.
• 12:49
  Coach Carlie: No, it's actually the opposite.
• 12:51
  Coach Carlie: Yeah.
• 12:51
  SPEAKER_01: So there are also a lot of other like smaller micronutrients that play some roles.
• 12:57
  SPEAKER_01: Just some examples are like copper, potassium, phosphorus, magnesium, you know, vitamin A.
• 13:04
  SPEAKER_01: The list goes on.
• 13:05
  SPEAKER_01: But a lot of these foods like have overlap, the foods that are rich in these like prime more primary nutrients also have a lot of the micronutrients.
• 13:14
  SPEAKER_01: So it's not like you need to like revamp your entire diet to account to account for your bone health.
• 13:20
  Coach Carlie: Yeah, yeah.
• 13:21
  Coach Carlie: Good point there.
• 13:23
  Coach Carlie: Okay, so now getting into what nutrition pitfalls that are harming, potentially harming your bone health.
• 13:32
  Coach Carlie: So let's go.
• 13:34
  Coach Carlie: What you got?
• 13:35
  Coach Carlie: Yeah.
• 13:36
  SPEAKER_01: All right.
• 13:36
  SPEAKER_01: One of the that you might have seen this coming, but one of the uh if you guys have heard of the newer-ish diagnosis called REDS, relative energy deficiency in sport, that low energy availability.
• 13:49
  SPEAKER_01: If your body's not getting enough energy to do its like most important work in like the immediate present, then it's probably gonna focus less on things like bone formation because it might not be relevant to what you're doing like right at that second.
• 14:05
  SPEAKER_01: So if you're not getting enough food, period, you're also probably not getting enough calcium or vitamin D or all those other nutrients that we talked about.
• 14:13
  SPEAKER_01: So make sure you're eating enough for what you're doing.
• 14:16
  SPEAKER_01: Going along Yeah, let's see.
• 14:19
  SPEAKER_01: Low carb intake.
• 14:20
  SPEAKER_01: What do we got?
• 14:24
  SPEAKER_01: That kind of that kind of goes with the low energy availability because chances are you're not consuming enough carbs if you're not consuming enough overall.
• 14:33
  SPEAKER_01: And we know from research that eating enough carbs prevents bone resorption, which is basically like degrading.
• 14:40
  SPEAKER_01: It it prevents that from happening.
• 14:43
  Coach Carlie: Okay.
• 14:44
  Coach Carlie: Carbs do more than just give you energy, you guys.
• 14:47
  Coach Carlie: So cool.
• 14:49
  Coach Carlie: They're very important.
• 14:50
  Coach Carlie: Yep.
• 14:50
  Coach Carlie: Yeah.
• 14:51
  Coach Carlie: And then low vitamin D intake.
• 14:54
  SPEAKER_01: Yes.
• 14:54
  SPEAKER_01: This is more common than than you think it might be.
• 14:58
  SPEAKER_01: We I think it's about like a third of adults in the US, maybe a little bit more, don't intake enough vitamin D.
• 15:05
  SPEAKER_01: And a lot of us are indoors all day, not really out in the sun.
• 15:10
  SPEAKER_01: And there's just not a lot of foods that have vitamin D naturally.
• 15:14
  SPEAKER_01: So it can be hard.
• 15:16
  SPEAKER_01: So that's just one of them.
• 15:18
  SPEAKER_01: And we'll again talk about some more of those food sources in just a little bit.
• 15:23
  Coach Carlie: Yep.
• 15:24
  Coach Carlie: And then calcium and sweat losses.
• 15:26
  Coach Carlie: Just like I was saying, look out, all you heavy sweaters, where you at?
• 15:32
  Coach Carlie: I know you're out there.
• 15:34
  SPEAKER_01: We know that we lose calcium and sodium through sweat, like we just mentioned.
• 15:38
  SPEAKER_01: And when you lose calcium and the levels in your blood go down, your body is actually going to pull extra calcium from your bones to maintain the right levels in the blood.
• 15:49
  SPEAKER_01: So you don't really want that to happen.
• 15:52
  SPEAKER_01: So you want to make sure you're getting in enough calcium so that so that your body doesn't turn towards the bone for that source.
• 16:00
  Coach Carlie: Yeah.
• 16:00
  Coach Carlie: Yeah.
• 16:01
  Coach Carlie: And then what do you have here for that last bullet point there?
• 16:04
  SPEAKER_01: Yeah, we touched on this a bit earlier, actually, but running, cycling, swimming, and ballet are associated with lower bone mass than other sports.
• 16:15
  SPEAKER_01: And it's because we talked about how cycling is not really, you're not getting that weight-bearing pounding impact.
• 16:22
  SPEAKER_01: But and same thing with swimming when you're just like when you're in the water all the time.
• 16:26
  SPEAKER_01: But I think swimmers are better in general about making sure that they lift than they do strength training.
• 16:32
  Coach Carlie: What we see at the Triangle Aquatic Center, which is the Titans team, I mean, you know, our lab is located inside their gym.
• 16:39
  Coach Carlie: So obviously, we see them doing their dry land quite a bit, and they obviously put a big emphasis on it.
• 16:45
  Coach Carlie: But that being said, that facility is freaking amazing.
• 16:49
  Coach Carlie: And not every swimming organization has access to something like that or are necessarily putting an emphasis on it.
• 16:57
  Coach Carlie: So, because swimming is non-weight bearing.
• 16:59
  Coach Carlie: Great for great cardiovascular exercise, amazing cardiovascular exercise, but not load-bearing at all.
• 17:06
  Coach Carlie: So you have to balance.
• 17:19
  Coach Carlie: Yeah.
• 17:19
  Coach Carlie: So yeah, better way of saying that for sure.
• 17:22
  Coach Carlie: In our world, low energy availability, but in their world, you ain't eating enough, y'all.
• 17:27
  Coach Carlie: To put it in simpler terms, exactly.
• 17:29
  Coach Carlie: Right.
• 17:30
  Coach Carlie: Same thing.
• 17:30
  Coach Carlie: I do see a lot of, you know, because all of those sports, and you know, perhaps we could add gymnastics to this, we could add diving to this, we could add some of those more body-focused sports that tend to want to achieve a certain look or like in cycling a certain power to weight ratio, especially when you're looking at pros, for example, um, especially the pro men, you know, who have like these little tiny sticks for arms and these like massive quads, you know, they are they're trying to achieve as much power to weight ratio as they possibly can.
• 18:09
  Coach Carlie: So, you know, there is a degree to which they are manipulating their diet and their training to try to be the best performer they can.
• 18:21
  Coach Carlie: And, you know, I feel like we've come quite a long way with nutrition, especially in professional sports and just sports in general.
• 18:27
  Coach Carlie: You know, we were like people to pay attention to nutrition.
• 18:30
  Coach Carlie: And now I feel like they're, you know, they're paying attention, which is great.
• 18:35
  Coach Carlie: But, you know, to what end are you benefiting yourself in the long run?
• 18:38
  Coach Carlie: Because man, your bones gotta last a long time, you guys.
• 18:41
  Coach Carlie: Yep.
• 18:43
  Coach Carlie: So performance is part of the equation, but then longevity is massive.
• 18:50
  SPEAKER_01: Yeah.
• 18:50
  SPEAKER_01: And I feel like that kind of the concern for longevity kind of falls to the wayside sometimes if you're really like training for the right now.
• 18:58
  SPEAKER_01: But I think a lot of people might not be thinking about what certain like dietary patterns of not eating enough might be doing to their chance of injury, which could affect the right now and then their bone health later on.
• 19:11
  SPEAKER_01: So just things to think about for sure.
• 19:14
  Coach Carlie: Things to think about, totally.
• 19:16
  Coach Carlie: And again, DEXA scans are great so that you can actually see metrics on what is my bone mineral density, what is my lean mass, and then what can I do to actually um impact that, which is real cool when you know people are eating more of their protein.
• 19:31
  Coach Carlie: And oh, which speaking of supportive foods, love it.
• 19:36
  SPEAKER_01: Yes.
• 19:37
  SPEAKER_01: Yes.
• 19:37
  SPEAKER_01: So what do we got for all of our sources?
• 19:41
  SPEAKER_01: All right.
• 19:42
  SPEAKER_01: For calcium, we've got a lot of fish are high in calcium, but here's the kicker.
• 19:48
  SPEAKER_01: You need to be eating fish with bones, kind of like canned salmon or sardines or something like that.
• 19:54
  SPEAKER_01: And I'm guilty of not eating these myself.
• 19:58
  SPEAKER_01: I just didn't gr I didn't grow up really eating fish with bones inside.
• 20:03
  SPEAKER_01: Like, so it just didn't really like occur to me.
• 20:05
  SPEAKER_01: But the cal the there, but the fish bones, like our human bones, is where the calcium really is.
• 20:11
  Coach Carlie: Yes.
• 20:11
  Coach Carlie: So don't like choke on a bone.
• 20:14
  Coach Carlie: Right, right.
• 20:15
  Coach Carlie: Be careful with them.
• 20:17
  Coach Carlie: Yes.
• 20:17
  Coach Carlie: Usually it's like the um, like if you get a can of salmon, um you and oftentimes it will say it on the on the label, but you know, you'll you'll see them in there.
• 20:28
  Coach Carlie: You know, they're usually little.
• 20:30
  Coach Carlie: Um, they're not the spiky ones that you're gonna like, you know, choke yourself or something.
• 20:35
  Coach Carlie: But um uh yeah, there it's a different texture.
• 20:40
  Coach Carlie: We'll just call it that.
• 20:41
  Coach Carlie: We'll call it that.
• 20:42
  Coach Carlie: And uh there have got to be ways around this, but you know, keep going for what we have of good calcium sources.
• 20:49
  SPEAKER_01: Um we know that there that dairy has a lot of calcium.
• 20:53
  SPEAKER_01: You grew up hearing about needing to drink milk, yogurt and cheese also have a great, great calcium content.
• 20:59
  SPEAKER_01: Uh, we don't think about this, but our leafy green vegetables also have some calcium in there and some nuts and seeds as well.
• 21:06
  Coach Carlie: Yeah.
• 21:07
  Coach Carlie: Um tahini, which are sesame seeds.
• 21:11
  Coach Carlie: So if you're sprinkling sesame seeds, or they're like sesame seeds in your whole grain bread, or you're using eating tahini in a smoothie, or um tahini in your hummus.
• 21:25
  Coach Carlie: Um, okay, so here's one for you.
• 21:28
  Coach Carlie: Let's say we've got a vegetarian or somebody who's just like hard pass on fish, and maybe they're lactose intolerant.
• 21:36
  Coach Carlie: So they're not gonna do dairy.
• 21:38
  Coach Carlie: Yes, you've mentioned leafy green vegetables, nuts, and seeds, but is there anything else that we can do to get our calcium?
• 21:45
  SPEAKER_01: This is a great hint for our next slide, which is you know, yes, fortified food.
• 21:50
  Coach Carlie: We're gonna go back and forth because we're gonna go.
• 21:53
  Coach Carlie: Okay, so here.
• 21:55
  SPEAKER_01: So uh there's luckily all your milk alternatives, your soy milk, almond milk, oat milk, there's probably more that are all fortified with calcium.
• 22:04
  SPEAKER_01: They I think they fortify milk out of, honestly.
• 22:07
  SPEAKER_01: I know, I know.
• 22:08
  SPEAKER_01: I think in my food science class last fall, we had a tasting of a ton of different plant-based milks.
• 22:15
  SPEAKER_01: Uh-huh.
• 22:16
  SPEAKER_01: There were so there were some of them were so strange.
• 22:18
  SPEAKER_01: There was like macadamia nut milk and pea milk and um hazelnut milk.
• 22:27
  SPEAKER_01: Uh-huh.
• 22:28
  SPEAKER_01: There were there were all these things I've never heard of.
• 22:31
  SPEAKER_01: Cashew milk.
• 22:32
  SPEAKER_01: Uh-huh.
• 22:33
  Coach Carlie: Yeah.
• 22:34
  Coach Carlie: And it because you would you say you're a self-proclaimed picky eater?
• 22:38
  SPEAKER_01: I would.
• 22:39
  SPEAKER_01: Yeah.
• 22:39
  SPEAKER_01: 100%.
• 22:40
  unknown: Okay.
• 22:41
  SPEAKER_01: I'm amazing.
• 22:41
  Coach Carlie: But did you try them all?
• 22:43
  Coach Carlie: I did try them.
• 22:44
  Coach Carlie: I'm always willing to try.
• 22:46
  Coach Carlie: Yeah.
• 22:46
  Coach Carlie: Yeah.
• 22:47
  Coach Carlie: And what and like did you have any favorites?
• 22:49
  Coach Carlie: Or it sounds like several of them were just weird.
• 22:52
  SPEAKER_01: It's they a lot of them were just weird.
• 22:54
  SPEAKER_01: I think I remember really disliking the pea milk.
• 22:57
  SPEAKER_01: I think I remember the cashew milk wasn't that bad.
• 22:59
  SPEAKER_01: But not P-E-E milk, you guys.
• 23:01
  SPEAKER_01: P-E-A milk.
• 23:03
  SPEAKER_01: P-E-A milk.
• 23:04
  SPEAKER_01: Like the the little green bean.
• 23:05
  SPEAKER_01: Yeah.
• 23:06
  SPEAKER_01: Or I don't know.
• 23:07
  SPEAKER_01: Yeah.
• 23:07
  SPEAKER_01: Yeah.
• 23:08
  SPEAKER_01: Um, I'm I'm usually, I I don't mind like soy milk, almond milk, oat milk, all those like big ones.
• 23:14
  SPEAKER_01: I don't mind those usually.
• 23:16
  SPEAKER_01: So I was just really curious.
• 23:17
  SPEAKER_01: I think that, yeah, the cashew milk, I think I liked.
• 23:20
  SPEAKER_01: Um I probably had coconut milk.
• 23:22
  SPEAKER_01: The hemp milk.
• 23:23
  Coach Carlie: But not the canned, right?
• 23:24
  Coach Carlie: The dairy aisle coconut milk.
• 23:26
  SPEAKER_01: Yeah, coconut milk.
• 23:27
  SPEAKER_01: I uh remember liking the hemp milk.
• 23:30
  SPEAKER_01: I don't know if anyone's ever tried hemp milk with like hemp seeds and stuff.
• 23:33
  SPEAKER_01: But it was it was pretty that one was pretty good.
• 23:36
  Coach Carlie: Okay.
• 23:36
  Coach Carlie: Okay, cool.
• 23:37
  Coach Carlie: So milk alternatives, generally speaking, are uh fortified with additional calcium.
• 23:43
  Coach Carlie: Right.
• 23:43
  Coach Carlie: And vitamin D for that matter.
• 23:45
  Coach Carlie: So, and you have a couple other things that are listed in here.
• 23:48
  SPEAKER_01: Yeah.
• 23:49
  SPEAKER_01: So your uh typical breakfast cereals, orange juice, those are also fortified with calcium usually.
• 23:55
  SPEAKER_01: One big, one big one is tofu.
• 23:57
  SPEAKER_01: Tofu usually is packed with calcium when and the they like fortify it.
• 24:02
  SPEAKER_01: It's really good.
• 24:03
  Coach Carlie: Yeah.
• 24:04
  Coach Carlie: Okay.
• 24:04
  Coach Carlie: Um, I'm gonna flip back because now we need vitamin D supportive foods.
• 24:08
  Coach Carlie: I like how you call them supportive foods.
• 24:10
  SPEAKER_01: Yeah.
• 24:11
  SPEAKER_01: Yeah.
• 24:12
  SPEAKER_01: Okay.
• 24:12
  SPEAKER_01: So revisiting fish for this one.
• 24:15
  SPEAKER_01: There's a lot of vitamin D in fatty fish.
• 24:17
  SPEAKER_01: You've probably heard like trout, salmon, sardines, tuna.
• 24:21
  SPEAKER_01: Like these ones aren't as important.
• 24:23
  SPEAKER_01: Like you don't need to have the bones with these necessarily.
• 24:26
  SPEAKER_01: And fatty fish, like, they're really great because you're also getting your omega-3s from them too.
• 24:32
  SPEAKER_01: Anti-inflammatories, yeah, so good.
• 24:34
  SPEAKER_01: Uh-huh.
• 24:35
  SPEAKER_01: Egg yolks have a lot of vitamin D.
• 24:37
  SPEAKER_01: Um beef liver.
• 24:40
  SPEAKER_01: A little controversial there.
• 24:43
  Coach Carlie: I'm a hard pass on beef liver.
• 24:45
  SPEAKER_01: So there's that.
• 24:46
  SPEAKER_01: Beef liver is like beef liver basically has everything.
• 24:49
  SPEAKER_01: Yeah.
• 24:50
  SPEAKER_01: They have everything, but they're a little off-putting.
• 24:52
  SPEAKER_01: So I'm just putting it out there, but and red meat also has some vitamin D.
• 24:58
  SPEAKER_01: Cool.
• 24:58
  SPEAKER_01: But again, you you run into the issue of like, you know, you you don't eat meat, you're lactose intolerant, whatever.
• 25:04
  Coach Carlie: Uh so you're and then, of course, there's the good old-fashioned sun.
• 25:08
  Coach Carlie: So, and I exactly, if I had a dime for every time I've heard this, but I'm outside in the sun all the time.
• 25:16
  Coach Carlie: Why is my vitamin D low?
• 25:19
  Coach Carlie: So there is a genetic component for which when you get it from the sun, it absorbs through your skin, and then you have to convert it on the level of the kidneys.
• 25:28
  Coach Carlie: Genetically, some of us don't do that well, which means that you are gonna be chronically low in vitamin D.
• 25:35
  Coach Carlie: And then that's a whole host of other issues.
• 25:38
  Coach Carlie: So, either fortified andor most likely uh supplemental form is gonna have to be your route to go.
• 25:46
  Coach Carlie: But how do you know unless you test it, you guys?
• 25:53
  Coach Carlie: Soapbox, you gotta know your metrics.
• 25:56
  Coach Carlie: Uh, I have the perfect client who is popping in my head right now.
• 26:00
  Coach Carlie: She has probably one of the worst genetics I've seen in terms of life.
• 26:04
  Coach Carlie: She has like all the markers of poor vitamin D absorption.
• 26:09
  Coach Carlie: And I believe we have her up to about 6,000 IU per day to get her into like the lower range of normal and you know, runs in the family, obviously, because it's genetic.
• 26:21
  Coach Carlie: But how would you know unless you tested that we and then we recently got her numbers back, and that's when we made another tweak to her uh supplement strategy.
• 26:33
  Coach Carlie: And of course, the sun varies uh throughout the seasons, especially we're like right in the line, we're like right in the middle.
• 26:40
  Coach Carlie: Um, North Carolina, that is, is right along the line of we're probably gonna be okay getting most sun that we need throughout the entire year, but anybody who's north of us is uh gonna have a harder time getting enough vitamin D from the sun to have a lot of things.
• 26:57
  Coach Carlie: I was just gonna mention that.
• 26:58
  SPEAKER_01: Yeah.
• 26:59
  SPEAKER_01: If you live in like Alaska or Canada, like you're gonna have a you could stand out all day and you still might struggle because the sunlight's just not as direct.
• 27:07
  SPEAKER_01: Yeah.
• 27:07
  Coach Carlie: And then there's that whole skin cancer thing.
• 27:10
  Coach Carlie: Oh yeah, oh yeah.
• 27:13
  Coach Carlie: So yeah, it's like, okay, so I can get because you can't overdose from vitamin D from the sun, but you can overdose on uh too much sunshine that's gonna cause cancer, obviously.
• 27:27
  Coach Carlie: Yeah.
• 27:27
  Coach Carlie: Um anyway, so we need more vitamin D supplemental uh or fortified foods, Emily, because I keep interrupting you.
• 27:35
  Coach Carlie: So you're welcome.
• 27:36
  Coach Carlie: Oh, you're fine.
• 27:37
  SPEAKER_01: I mean, the the vitamin D fortified foods are very similar to the calcium fortified foods because they they you know go together.
• 27:45
  SPEAKER_01: The milk and then the milk alternatives, as we talked about, yogurt, breakfast cereal, and orange juice come back again.
• 27:53
  SPEAKER_01: But yeah, a lot of people just need to to supplement instead.
• 27:59
  SPEAKER_01: Yeah, definitely.
• 28:00
  Coach Carlie: And then I know you mentioned here oversupplementing.
• 28:03
  Coach Carlie: Yeah.
• 28:04
  Coach Carlie: Yeah.
• 28:05
  Coach Carlie: That can be that can be an issue.
• 28:06
  Coach Carlie: Okay.
• 28:07
  Coach Carlie: Whereas calcium, like, so you mentioned here oversupplementing can cause GI distress, especially calcium carbonate, which is Tums.
• 28:16
  Coach Carlie: Whoa.
• 28:17
  Coach Carlie: Yeah, right.
• 28:18
  Coach Carlie: So, like, or I mean, not to call out a specific brand, but like any sort of uh antacid in general.
• 28:27
  Coach Carlie: And uh some of your milk alternatives.
• 28:30
  Coach Carlie: You just have to check what kind of calcium and what kind of vitamin D they're for they're fortifying with, because calcium carbonate is cheap.
• 28:37
  Coach Carlie: But yeah, and then it it if you are prone to kidney stones, then we can have another potential issue on our hands there.
• 28:44
  Coach Carlie: So there are different types of calcium.
• 28:46
  Coach Carlie: Oh my gosh, I feel another rant coming on.
• 28:49
  Coach Carlie: But not a not a rant, but like an educational opportunity because so many people are like, oh, I don't get enough calcium, therefore I'm just gonna take tums, or I'm gonna take um antacids, which then affects the nutrient absorption of other things further on down the line and neutralizes some of that stomach acid, which is important for intrinsic factor to do its magic on iron absorption and B12, which we need adequate amounts of B12 to do exercise.
• 29:22
  Coach Carlie: Like all of you athletes out there, you need to be getting enough B12 because it unlocks the energy from food.
• 29:27
  Coach Carlie: We need it.
• 29:28
  Coach Carlie: So there are different types, lots of different types of calcium options that are not just carbonate that don't necessarily have to be super expensive, that can also be, you know, good quality.
• 29:41
  Coach Carlie: And maybe that's another, maybe that's another podcast.
• 29:44
  Coach Carlie: Anyway, tell us about magnesium and vitamin K.
• 29:48
  SPEAKER_01: Yeah.
• 29:48
  SPEAKER_01: So it's if you're if you're deficient or maybe you don't think you're eating enough from food, magnesium and vitamin K supplements can be great supporters as well because they are both cofactors for bone mineralization, which is the process that we just we want to keep continuing.
• 30:05
  SPEAKER_01: So for sure.
• 30:07
  Coach Carlie: Do you remember the amounts that adults we'll focus on adults because that's most of the folks that we are working with of what they need in terms of their optimal daily daily value in vitamin D and in calcium?
• 30:21
  Coach Carlie: Do you remember these?
• 30:22
  SPEAKER_01: Um, I believe magnesium's like 400 milligrams.
• 30:26
  Coach Carlie: For men, it's like 400, 420.
• 30:28
  Coach Carlie: Yeah.
• 30:28
  Coach Carlie: Okay.
• 30:29
  Coach Carlie: Yeah.
• 30:29
  Coach Carlie: So which honestly is a lot of leafy greens.
• 30:32
  Coach Carlie: And every time I say that to men, they kind of look at me like I have six heads because it's like six servings of leafy greens.
• 30:40
  Coach Carlie: It's a lot.
• 30:40
  Coach Carlie: And then on top of that, then they're sweating.
• 30:43
  Coach Carlie: Right.
• 30:43
  Coach Carlie: So then they need to make sure they're getting enough magnesium.
• 30:46
  Coach Carlie: So magnesium, I feel like, has been hotter in like more popular in the news as of late, which again, I'm I'm here for.
• 30:54
  Coach Carlie: Like I think that's great.
• 30:55
  Coach Carlie: It's good for cardiac function too.
• 30:57
  Coach Carlie: So is calcium.
• 30:58
  Coach Carlie: So are we doing the right?
• 31:00
  Coach Carlie: Are we doing a little?
• 31:01
  Coach Carlie: Do we need to do a little bit of both, depending on what's happening in your diet?
• 31:05
  Coach Carlie: Right.
• 31:06
  SPEAKER_01: I think calcium, calcium's like 1,000 milligrams or something.
• 31:11
  SPEAKER_01: Yeah.
• 31:11
  Coach Carlie: Yeah.
• 31:12
  Coach Carlie: So, you know, that's not a little.
• 31:15
  Coach Carlie: We'll just call it that.
• 31:17
  Coach Carlie: Because a glass of milk is like about 400.
• 31:22
  Coach Carlie: And then I hear, okay, but what about what about me if I'm lactose intolerant?
• 31:27
  Coach Carlie: What about me if I'm allergic to dairy or can't do any dairy?
• 31:31
  Coach Carlie: Again, we talked about all those milk alternatives.
• 31:33
  Coach Carlie: You're pretty much gonna get the same amount in there.
• 31:37
  Coach Carlie: But then, you know, it just takes an eye to look at like a broader view, like a bigger picture of what are you getting on a more regular basis for your bone health nutrients?
• 31:48
  Coach Carlie: And then also what are the demands of your sport?
• 31:51
  Coach Carlie: Right.
• 31:52
  Coach Carlie: And you know, just the overall quality of your diet.
• 31:55
  Coach Carlie: And then again, looking at your metrics.
• 31:58
  Coach Carlie: What's your vitamin D?
• 32:00
  Coach Carlie: Where are you getting it from your food?
• 32:02
  Coach Carlie: Are you wearing sunscreen?
• 32:03
  Coach Carlie: Are you not wearing sunscreen?
• 32:05
  Coach Carlie: Like, what are you doing with that?
• 32:08
  Coach Carlie: What's your um uh dentition like?
• 32:11
  Coach Carlie: What's the health of your teeth?
• 32:13
  Coach Carlie: And I know I was telling you this, Emily, a couple of a couple of days ago.
• 32:18
  Coach Carlie: I had in some x-rays by a chiropractor.
• 32:22
  Coach Carlie: And, you know, I think there is a certain assumption that, like, oh, you're a dietitian, you must know.
• 32:29
  Coach Carlie: You must, you must A, eat perfectly if that is true.
• 32:32
  Coach Carlie: Just not true.
• 32:33
  Coach Carlie: Which is it?
• 32:34
  Coach Carlie: It's like not, it's not a thing, you guys.
• 32:36
  Coach Carlie: I'm sorry.
• 32:36
  Coach Carlie: No, it's a thing.
• 32:38
  Coach Carlie: So nutrition varies throughout the life cycle.
• 32:40
  Coach Carlie: It also varies based on the demands of your sport.
• 32:43
  Coach Carlie: So make a good friend with a dietitian.
• 32:46
  Coach Carlie: Make sure you're checking in on somewhat of a regular basis to align your supplement strategy, your food strategy, any like functional foods, genetics, and you know, we're like the the the secret miracles, uh, I think, of the healthcare community to sort of on your yeah, well, of course, you know, that's where you're going into this field.
• 33:07
  Coach Carlie: I love it.
• 33:07
  Coach Carlie: So uh man, all the soapbox today.
• 33:09
  Coach Carlie: It's great to like take that zoom out of what's going on in my diet, what's going on in my um body.
• 33:17
  Coach Carlie: But then I saw x-rays, and my chiropractor was pointing out like, hey, do you see in this neck of your greater truncenter?
• 33:27
  Coach Carlie: So, like the the femur bone, which is one of your largest bones in the body, which is that thigh bone, and then it comes up and uh attaches to your hip joints, and there is what's called your neck of your femur bone.
• 33:41
  Coach Carlie: So it's between the hip capsule uh and the rest of the bone.
• 33:44
  Coach Carlie: And she was like, I'm seeing some little striations there, which means that you're starting like your bones are starting to weaken there.
• 33:53
  Coach Carlie: And then I was like, wait, what?
• 33:55
  Coach Carlie: And then I had to kind of step back and be like, okay, well, where are my calcium vitamin D sources coming from?
• 34:01
  Coach Carlie: Am I getting enough?
• 34:02
  Coach Carlie: And is this something that maybe I need to tune into?
• 34:05
  Coach Carlie: Because I also have a history of uh anemia.
• 34:09
  Coach Carlie: So if you're focusing on one nutrient, it's hard to stay focused on other nutrients.
• 34:14
  Coach Carlie: So, and in that case, it's iron and calcium, and those two compete for the same binding sites.
• 34:20
  Coach Carlie: So you can't take them together.
• 34:23
  Coach Carlie: So it's it's not ideal to take them together because somebody's gonna win.
• 34:26
  Coach Carlie: And then, like, you know, now we're just going in circles of are we trying to benefit bone health?
• 34:31
  Coach Carlie: Are we trying to, you know, prevent anemia?
• 34:33
  Coach Carlie: So, anyway, all that to say is work with a dietitian.
• 34:37
  Coach Carlie: It doesn't have to be a good thing.
• 34:38
  Coach Carlie: Work with the dietitian, exactly.
• 34:40
  Coach Carlie: Like it like find somebody who is versed in your sport who can support you in terms of overall energy intake, in terms of nutrients, and we take a genetic lens, we look at that too, and then looking into various metrics and all that kind of stuff.
• 34:57
  Coach Carlie: So um, anyway.
• 35:00
  Coach Carlie: Oh, Emily, you just got me started.
• 35:02
  SPEAKER_01: I'm so hey, I'm I'm here for it.
• 35:06
  SPEAKER_01: I'm here for it.
• 35:07
  SPEAKER_01: We don't have a we don't have a script to follow.
• 35:09
  SPEAKER_01: We don't know.
• 35:09
  SPEAKER_01: We don't know.
• 35:10
  SPEAKER_01: We're just chatting.
• 35:11
  Coach Carlie: I know.
• 35:12
  Coach Carlie: Uh poor Emily's like, wait, so am I?
• 35:15
  Coach Carlie: I'm like, no, we're just gonna pretend like we're, you know, we're just having a cup of coffee.
• 35:18
  Coach Carlie: Or in this case, we're sitting around having a cup of plant milk.
• 35:22
  Coach Carlie: So yeah.
• 35:23
  SPEAKER_01: Take your pick.
• 35:24
  SPEAKER_01: Take your pick.
• 35:25
  Coach Carlie: Take your pick of plant milk.
• 35:27
  Coach Carlie: So I don't want to overcomplicate it, but at the same time, like zoom out what's the quality of your diet, what do your metrics look like?
• 35:33
  Coach Carlie: Get your DEXA scan, uh, make sure you're taking care of your bones, you're doing that heavy lifting, literally, so that you can support your bones.
• 35:41
  Coach Carlie: Because this becomes even more important for any of our perimenopause and menopausa women, like that.
• 35:48
  Coach Carlie: Uh, you know, begins like this, this sort of steep decline.
• 35:52
  Coach Carlie: And, you know, pick up heavy things, y'all.
• 35:54
  Coach Carlie: So, Emily, anything else you want to say as it relates to bone health and athletes and energy and calcium and vitamin D and vitamin K and all the things.
• 36:04
  SPEAKER_01: I mean, you kind of hit the nail on the head.
• 36:06
  SPEAKER_01: If you're unsure about any of these things, go work with the dietitian.
• 36:10
  SPEAKER_01: They'll help you take the guesswork out of it in like terms of how much you should be eating in general, how much of each nutrient you're getting, if there are any contraindications to supplementing, you know, all that good stuff.
• 36:23
  Coach Carlie: Yes, for sure.
• 36:24
  Coach Carlie: Definitely.
• 36:25
  Coach Carlie: And then, of course, you know, shameless plug, you can check us out at theendurancehedge.com.
• 36:29
  Coach Carlie: We're licensed in multiple states and available to work with you for a quick 30-minute start.
• 36:36
  Coach Carlie: And we ask you to fill out a lot of paperwork beforehand because I just don't want to spend 30 minutes asking you questions.
• 36:42
  Coach Carlie: No offense, you guys.
• 36:44
  Coach Carlie: I wanna do I want to do my homework beforehand.
• 36:46
  Coach Carlie: I want to go in and get all the information about you.
• 36:49
  Coach Carlie: And then when we sit down and have a serious conversation about what what metrics do you need to be doing?
• 36:55
  Coach Carlie: What do you want to get out of our session?
• 36:58
  Coach Carlie: How do you want to be best supported?
• 37:00
  Coach Carlie: And like, you know, do your homework first.
• 37:02
  Coach Carlie: That way we can like get at it because y'all's time is valuable.
• 37:06
  Coach Carlie: So anyway.
• 37:09
  Coach Carlie: Yay, Calcium.
• 37:10
  Coach Carlie: Thanks, Emily.
• 37:11
  Coach Carlie: That was fun.
• 37:12
  Coach Carlie: Of course.
• 37:13
  Coach Carlie: So fun.
• 37:14
  Coach Carlie: Yes.