Latest / VOOM Performance Podcast / Understanding Athlete Nutrition: Insights from Renee McGregor

Transcript

Understanding Athlete Nutrition: Insights from Renee McGregor · VOOM Performance Podcast

• 0:00
  SPEAKER_00: If you're somebody who has higher sodium losses, you're going to need to replace those in an event.
• 0:05
  SPEAKER_00: Otherwise, you're going to get to a position where you are hyponeatremic.
• 0:10
  SPEAKER_01: What does reds and what does low energy availability actually mean?
• 0:14
  SPEAKER_00: This is something I really want to bring to light because what we're seeing in clinic more and more is almost that that message about fueling is slowly filtering in, slowly, but the message about rest is not.
• 0:26
  SPEAKER_00: The more muscle mass someone has, the more power they're going to have, the more speed.
• 0:29
  SPEAKER_00: And that seems to be more closely linked to really positive outcomes in performance, particularly in endurance.
• 0:35
  SPEAKER_01: Here's a question I want you to sit with for the next 45 minutes.
• 0:38
  SPEAKER_01: You know the science, you've read the articles, you understand that underfueling wrecks your performance, wrecks your hormones, wrecks your recovery, but we still do it.
• 0:49
  SPEAKER_01: Why?
• 0:50
  SPEAKER_01: That's not a rhetorical question.
• 0:52
  SPEAKER_01: My guest today has spent more than 20 years asking it clinically, personally, and sometimes right in the middle of an ultramarathon.
• 1:00
  SPEAKER_01: Welcome to Voom Performance Podcast.
• 1:02
  SPEAKER_01: I'm Mel Berry and I'm very excited to launch episode one with the wonderful Renee McGregor.
• 1:08
  SPEAKER_01: She is the mum of two wonderful daughters, is a sports dietitian and eating disorder specialist who's worked with some of the most elite athletes in this country, many weekend warriors achieving extraordinary things.
• 1:21
  SPEAKER_01: She's a person Team GB, Commonwealth Games England, the English and Scottish National Ballet, and the GB 24 hour Ultra Running Team have trusted with their nutrition.
• 1:32
  SPEAKER_01: She's the author of six best-selling books, including More Fuel You, a book that changed how a lot of people in sport think about food.
• 1:42
  SPEAKER_01: She's also done Lakeland 50 twice.
• 1:45
  SPEAKER_01: But what makes Rini genuinely unusual?
• 1:49
  SPEAKER_01: And the reason I wanted to open this series is she's separated what she knows clinically from what experience as an athlete.
• 1:58
  SPEAKER_01: She's not standing outside the problem.
• 2:00
  SPEAKER_01: She's inside.
• 2:02
  SPEAKER_01: Reanie, welcome to the Voom Performance podcast.
• 2:06
  SPEAKER_00: Thank you so much, Mel.
• 2:07
  SPEAKER_00: And I'm very honoured that I have made it to episode one.
• 2:11
  SPEAKER_00: That's very exciting.
• 2:12
  SPEAKER_00: So thank you so much.
• 2:14
  SPEAKER_01: You're welcome.
• 2:14
  SPEAKER_01: And and I wanted to take that kind of step back.
• 2:17
  SPEAKER_01: And I um have watched Unfiltered and I watched the kind of film and I wanted to take everybody back to your childhood and understand better why you got into running and your relationship that you had with food in those very early days in Stain's.
• 2:34
  SPEAKER_01: Wow.
• 2:35
  SPEAKER_00: I'm not sure I can link it all back, but I guess my childhood was probably very atypical of any child of colour growing up in the 80s.
• 2:48
  SPEAKER_00: You know, there there was a lot of racism, there was a lot of prejudice, and I guess I grew up in that bubble, always knowing that I didn't really belong.
• 2:59
  SPEAKER_00: And that's quite hard when you're a kid.
• 3:02
  SPEAKER_00: On top of that, like I had some very uh tricky events that happened to me.
• 3:06
  SPEAKER_00: You know, I was sadly a victim of sexual abuse.
• 3:10
  SPEAKER_00: And I think it's a difficult one, isn't it?
• 3:12
  SPEAKER_00: Like, I don't want to um, I don't want to blame anybody, but it just wasn't dealt with very well, shall we say?
• 3:19
  SPEAKER_00: So I guess that again also just compounded that I was the problem.
• 3:23
  SPEAKER_00: I'm I'm I'm to blame for all of this.
• 3:25
  SPEAKER_00: And I think we do that as children when we we have no appropriate support, we don't have that guardianship, we don't have that nurturing, we don't have that understanding.
• 3:33
  SPEAKER_00: We try and make sense of it.
• 3:35
  SPEAKER_00: I mean, as humans, that's what we do.
• 3:36
  SPEAKER_00: We make sense of meaning, like we try and make sense of everything that's going on for us.
• 3:40
  SPEAKER_00: And when you're a kid, you you're not gonna turn on your family because they are, you know, they are your they're meant to be your safety, even if they haven't kept you safe.
• 3:51
  SPEAKER_00: But also by blaming them, you would then be completely without.
• 3:56
  SPEAKER_00: So I think it's very common for a lot of sufferers of trauma when they're younger years to absorb that blame, and then it's something you kind of carry with you all the way through.
• 4:07
  SPEAKER_00: So, so I mean, as a kid, I was always very active, but I wouldn't say I was really into running at all.
• 4:14
  SPEAKER_00: Running came at a much, much later point in my life.
• 4:17
  SPEAKER_00: Like I've always been, like I said, always been really sporty.
• 4:20
  SPEAKER_00: I did loads of dance.
• 4:21
  SPEAKER_00: Like dance was my thing.
• 4:22
  SPEAKER_00: I was a I used to do uh a dance class twice a week, and then we competed, you know, in competitions and and and it was like a kind of a combination of contemporary, disco, rock and roll, you know, like it was it was brilliant.
• 4:37
  SPEAKER_00: I loved it.
• 4:38
  SPEAKER_00: It was my way of, I guess now I can see it was probably my way of somatic therapy.
• 4:45
  SPEAKER_00: You know, it was my way of like letting go of all the things that were feeling hard, and I absolutely loved it.
• 4:51
  SPEAKER_00: But for those people who don't know me or know my story, when I was 13, I did develop an eating disorder.
• 4:56
  SPEAKER_00: And and and again, it's now I know it's it was in hind, it was all related to those very difficult experiences I've just spoken about.
• 5:03
  SPEAKER_00: Like it was my way of trying to, I suppose, contain myself.
• 5:08
  SPEAKER_00: It was a way of expressing how insignificant I felt.
• 5:12
  SPEAKER_00: It was a way of trying to avoid this sense of not being good enough.
• 5:17
  SPEAKER_00: You know, it there's so many reasons.
• 5:20
  SPEAKER_00: And at that age, I basically had to stop all sport because I was not allowed to do it.
• 5:25
  SPEAKER_00: So it wasn't until, like I said, several years later, it was actually when I went to uni that I got back into sport.
• 5:31
  SPEAKER_00: I started playing netball, which was ridiculous because I'm only five foot two, but I loved playing centre and and I actually we had a great time.
• 5:38
  SPEAKER_00: And it was more, it was definitely fun.
• 5:39
  SPEAKER_00: It was definitely not at the elite end, right?
• 5:41
  SPEAKER_00: We were not, we were definitely not one of those teams.
• 5:44
  SPEAKER_00: We were just having fun, very much a recreational team.
• 5:46
  SPEAKER_00: And I suppose I did what most people do as they go through their adulthood in my early 20s.
• 5:51
  SPEAKER_00: I got into the gym, did a lot of spinning, did a lot of walking.
• 5:55
  SPEAKER_00: Um, and then eventually it was actually I started running, properly, properly running, after I'd had my second daughter.
• 6:02
  SPEAKER_00: She was 11 months old.
• 6:05
  SPEAKER_00: And I we lived on a boat, so I had the tow path on my doorstep, and she she would get up really early, have a feed, and then go back to sleep, but I could never get back to sleep.
• 6:16
  SPEAKER_00: And I had this kind of tiny little time frame between her going back to sleep and then both girls waking up again.
• 6:22
  SPEAKER_00: And I was like, oh, I could it would be so nice just to do something for myself.
• 6:25
  SPEAKER_00: And I guess living on the boat, being on the toe path, it just felt like it just felt like something to do.
• 6:31
  SPEAKER_00: So I, yeah, I remember putting on a pair of very old battered trainers and some, I don't know, some, I think it was might not even have been my my shorts, but my my ex-husband's like old P shorts or something.
• 6:43
  SPEAKER_00: I didn't have any kit at all, and I just went for a run.
• 6:46
  SPEAKER_00: And I literally ran to the first bridge and then turned back and ran back again.
• 6:50
  SPEAKER_00: But in that moment, I was like, oh, this feels good.
• 6:53
  SPEAKER_00: And again, maybe it goes back to that somatic release.
• 6:56
  SPEAKER_00: I don't know.
• 6:56
  SPEAKER_00: But it just, it was like really, really it was time for me.
• 7:00
  SPEAKER_00: It was time where I was reiny again.
• 7:01
  SPEAKER_00: I wasn't, I wasn't Marionella's mum, I was reiny, and I I literally had a bit of peace.
• 7:08
  SPEAKER_00: You know, no one was having any demands on me, and I could connect with the water and the trees and birds, and I and now, even now, I'm su I love nature so much, like it's so important to me.
• 7:19
  SPEAKER_00: And it kind of went from there.
• 7:20
  SPEAKER_00: You know, I I I I I did that.
• 7:23
  SPEAKER_00: I ran maybe two or three times a week, no more than half an hour, 40 minutes.
• 7:28
  SPEAKER_00: And over the years it slowly built.
• 7:30
  SPEAKER_00: And I say slowly because it really was slowly.
• 7:33
  SPEAKER_00: It wasn't like I started running and then a year later I was doing, you know, big distances.
• 7:38
  SPEAKER_00: I I didn't do my first really I didn't do my first marathon.
• 7:42
  SPEAKER_00: I think, I mean, I'd been running eight years before I did a marathon.
• 7:46
  SPEAKER_00: Like, you know, I I really did take my time.
• 7:48
  SPEAKER_00: So so I guess, yeah, running came later.
• 7:51
  SPEAKER_00: And I can see how it fits with my story now.
• 7:54
  SPEAKER_00: But at the time there was no real connection, if that makes sense.
• 7:57
  SPEAKER_01: Yeah, and thank you for sharing that.
• 7:59
  SPEAKER_01: And I hope that for many listening, that's a very relatable story.
• 8:02
  SPEAKER_01: You didn't suddenly become somebody that could go and do, you know, the Lakeland kind of 50 with very little kind of, I guess, background and training.
• 8:11
  SPEAKER_01: And and and for you, you've obviously been working in sports nutrition for over 20 years.
• 8:16
  SPEAKER_01: What's the one thing that you think athletes still struggle with repeatedly, either from a clinical point of view or people that you've seen over that 20 years?
• 8:25
  SPEAKER_00: I think there are there are there are probably three main things that I see still being a problem.
• 8:30
  SPEAKER_00: One is not appreciating just how much fuel they do need to do what they're asking their bodies to do.
• 8:37
  SPEAKER_00: Two is not recovering enough.
• 8:39
  SPEAKER_00: And sometimes that's not in their hands, particularly in looking at the like on the professional end.
• 8:44
  SPEAKER_00: Like I, you know, I work with a lot of procyclists and uh, you know, thinking about some of the other other sports I work with, the competition schedule doesn't always allow for enough recovery between each, each, each competition or each, you know, each race.
• 8:59
  SPEAKER_00: So that there's the there's really a lack of recovery.
• 9:02
  SPEAKER_00: And I don't think, I don't think it's widely discussed in the sporting world just how much stress is placed on the nervous system when you're racing at these high intensities all the time, and then how long it takes for our bodies to recover.
• 9:16
  SPEAKER_00: So, you know, I think that's the other big thing I see.
• 9:19
  SPEAKER_00: And then the third thing is particularly in female athletes, more than males, but particularly is very much kind of holding their body composition at a place that's just not appropriate for them.
• 9:31
  SPEAKER_00: That's not saying that it's not appropriate for other people, but it's just not appropriate for them.
• 9:36
  SPEAKER_00: You know, like we all have like this genetic component to what we're gonna look like.
• 9:41
  SPEAKER_00: And yes, we can absolutely fine-tune that, but it's still within a parameter.
• 9:46
  SPEAKER_00: And I think too many people go too far.
• 9:50
  SPEAKER_00: Um, because that narrative of lighter makes you faster is still very pervasive, even though actually we know that that's not actually strictly true.
• 10:01
  SPEAKER_00: You know, it's it's not like there's there's a there's a very good study that came out in the BMJ, I think a couple of years ago now, and it was basically talking about how we shouldn't be using weight as a way of even like, you know, think about using weight even as a way of kind of predicting what someone's endurance performance is going to be.
• 10:19
  SPEAKER_00: Actually, what they found is the more muscle mass someone has, the more power they're gonna have, the more speed.
• 10:25
  SPEAKER_00: And that seems to be more closely linked to really positive outcomes in performance, particularly in endurance, which is really interesting because I think we associate that with power sports, but we don't always associate it with endurance sports.
• 10:36
  SPEAKER_00: And yet this it still is really, really relevant.
• 10:39
  SPEAKER_01: Yeah, and we're gonna go and talk about obviously the issues that that that exist within women's sport uh in the next 10 minutes.
• 10:46
  SPEAKER_01: But for you, writing more fuel you, you wanted to look at obviously highlighting fundamentally nutrition, but overlooked population.
• 10:55
  SPEAKER_01: So women, women's health, menopause, et cetera.
• 10:58
  SPEAKER_01: And when we spoke earlier, you know, you talked about the journey that you've been on in the last six months.
• 11:04
  SPEAKER_01: And just tell me more about how you've had to deal with your own, I guess, understanding of how your body's changing in the last six months and probably last 10 years.
• 11:16
  SPEAKER_00: Yeah, I I'd be honest, it's really I want to say this, it has really thrown me, right?
• 11:23
  SPEAKER_00: As someone who has quite a lot of knowledge, I've worked with women of different ages across different sports, across different levels for many, many years.
• 11:32
  SPEAKER_00: I have a really good understanding of hormonal health.
• 11:35
  SPEAKER_00: I work with some of the top names in hormonal health in the country.
• 11:39
  SPEAKER_00: So I've learned a lot.
• 11:40
  SPEAKER_00: I I I understand it.
• 11:41
  SPEAKER_00: And as much as I thought I was gonna be prepared, I remember, I do remember a consultation I had several years ago with we do we uh Nikki Kay and I do a joint clinic and we know we'd we'd gone through the consultation with the with the with the client and then you know we'd we'd finished.
• 11:56
  SPEAKER_00: And I've afterwards I said to her, I was like, I am not gonna hesitate.
• 12:00
  SPEAKER_00: Like I am going to, I'm gonna go on HRT, I'm gonna do like just from listening to everything.
• 12:05
  SPEAKER_00: And I thought I thought I had it sussed, you know, like from an education point of view, I thought I had it sussed.
• 12:11
  SPEAKER_00: And so I started on HRT actually back in 2024 because I I just noticed a real kind of change in anxiety.
• 12:25
  SPEAKER_00: I was waking up with like palpitations and I just didn't feel that great.
• 12:31
  SPEAKER_00: It wasn't there was nothing physical.
• 12:33
  SPEAKER_00: I just didn't feel great.
• 12:35
  SPEAKER_00: And I'm very lucky, I've got an amazing GP and she is she's trained, you know, she's highly trained in she's a menopause specialist GP and she was brilliant.
• 12:45
  SPEAKER_00: And she it took us a few attempts, but eventually we got to where, you know, got to a point where I was like, okay, this feels really comfortable.
• 12:51
  SPEAKER_00: And so this was back, you know, when I was 48.
• 12:53
  SPEAKER_00: And yeah, like I just thought, okay, cool, problem solved, big tick box.
• 12:58
  SPEAKER_00: And obviously, I then did Lakeland 50 that year, and then of course I did Lakeland 50 last year, and I was able to train really hard and had the capacity to train really hard, knocked off 46 minutes of my previous year.
• 13:09
  SPEAKER_00: Like, I was like, okay, cool, this is awesome.
• 13:12
  SPEAKER_00: If this is what getting older feels like, bring it on.
• 13:14
  SPEAKER_00: Like I was absolutely up for it.
• 13:16
  SPEAKER_00: And then, you know, like fast forward to I suppose it was December, January time, and I turned 50 in January.
• 13:23
  SPEAKER_00: And um, I wasn't looking forward to it, I'll be honest.
• 13:27
  SPEAKER_00: I had this real sense of grief about the fact that, well, I've lived most of my life now, and I really struggled with that.
• 13:36
  SPEAKER_00: Like I know it was like my belief and it was my grief, but I really struggled with it.
• 13:41
  SPEAKER_00: And even though my husband was saying, don't be silly, like you're only as young as you, you know, you're as old as you feel, and you're you're so active, and we've got loads of years ahead of us.
• 13:48
  SPEAKER_00: I don't know.
• 13:49
  SPEAKER_00: It just it felt like a real grief.
• 13:51
  SPEAKER_00: That's all I can say to you.
• 13:53
  SPEAKER_00: And my mood really plummeted.
• 13:55
  SPEAKER_00: Like, this is the first time I'm sharing this because it hasn't been something that I've I've advertised because I'm I'm not that kind of person, generally speaking.
• 14:03
  SPEAKER_00: And I've my mood really plummeted.
• 14:05
  SPEAKER_00: I remember waking up on my 50th birthday and I was in floods of tears for no reason.
• 14:10
  SPEAKER_00: Like there was nothing wrong.
• 14:11
  SPEAKER_00: I was in Paris.
• 14:12
  SPEAKER_00: You know, I was with my husband, I was with my daughter.
• 14:15
  SPEAKER_00: Like I was, there was no reason.
• 14:17
  SPEAKER_00: I just felt awful.
• 14:20
  SPEAKER_00: And as the weeks went on, I started to feel worse and worse and worse.
• 14:23
  SPEAKER_00: I was exhausted, I started to feel really heavy.
• 14:26
  SPEAKER_00: I started to feel a real discomfort in my body, which reminded me of when I was a teenager and my eating disorder, I guess it was the precursor to my eating disorder.
• 14:37
  SPEAKER_00: Now back then, I just remember feeling like I was feeling this because my body wasn't good enough and I needed to fix it.
• 14:45
  SPEAKER_00: Obviously, I have now had many, many years of education and therapy and everything else, and I knew it wasn't that.
• 14:50
  SPEAKER_00: Like my clothes still fit me in exactly the same way.
• 14:53
  SPEAKER_00: So it wasn't, it wasn't a physical change.
• 14:55
  SPEAKER_00: It was just I physically I just felt this real deep unease is the only way I can describe it.
• 15:01
  SPEAKER_00: So I, after crying a lot, I went back to my GP and just said, I don't feel good at all.
• 15:09
  SPEAKER_00: And she's like, okay, well, let's just do some blood tests.
• 15:11
  SPEAKER_00: Now she's great, and and I want to really c like caveat this.
• 15:15
  SPEAKER_00: It's not actually very helpful to do blood tests when you're in perimenopause because you're the whole point, the whole reason why we feel so shit is the fact that our hormones are so unpredictable, right?
• 15:26
  SPEAKER_00: Sometimes they're high, sometimes they're low, sometimes they're doing this every like even across the day.
• 15:30
  SPEAKER_00: And so, but we just thought, okay, let's do because I think in her mind, she thought maybe my levels had dropped because it'd been a couple of years of being on the same amount, and I was on a very small dose of estrogen because I've never been on a high dose.
• 15:43
  SPEAKER_00: She's like, let's just check, make sure your oasin levels are not plummeted, and that's why you're feeling like this.
• 15:48
  SPEAKER_00: And actually, what came back was my oasterine levels were really high.
• 15:51
  SPEAKER_00: And I was like, Well, if they're really high, I don't need this.
• 15:54
  SPEAKER_00: I mean, that was a really stupid decision.
• 15:56
  SPEAKER_00: Yeah.
• 15:56
  SPEAKER_00: And I'm the and my GP did not encourage me to stop.
• 15:59
  SPEAKER_00: But I was really like, Oh, I don't, I don't want to feel like this.
• 16:02
  SPEAKER_00: This is the reason I feel so shit.
• 16:04
  SPEAKER_00: I'm coming off the HRT.
• 16:07
  SPEAKER_00: That was literally the most stupid move I have ever made in my entire life.
• 16:11
  SPEAKER_00: So I came off the HRT and for the first week I felt like, oh yeah, this is good.
• 16:15
  SPEAKER_00: I feel good.
• 16:16
  SPEAKER_00: I feel better.
• 16:16
  SPEAKER_00: I feel calmer.
• 16:17
  SPEAKER_00: This is all good.
• 16:18
  SPEAKER_00: And then five weeks later, I was I was out for a run with a really good friend of mine.
• 16:24
  SPEAKER_00: And I had been feeling terrible again, like really bad.
• 16:28
  SPEAKER_00: The anxiety had come back.
• 16:30
  SPEAKER_00: I was crying all the time.
• 16:32
  SPEAKER_00: And I remember saying to her, we were just, we were just like climbing, we were up in, we were actually in the Howlgills and we were going up the calf, which was a really big climb.
• 16:40
  SPEAKER_00: And I remember saying to her, I was like, I just don't want to be here.
• 16:42
  SPEAKER_00: And she turned around to me because what you mean here in Howl Gills?
• 16:44
  SPEAKER_00: I was like, no, I just I just don't want to be here.
• 16:46
  SPEAKER_00: I was like, I was like, Sam, I don't want to be here if this is how I'm going to feel for the foreseeable.
• 16:52
  SPEAKER_00: And it wasn't, it wasn't suicidal, and I want to make that really clear.
• 16:55
  SPEAKER_00: It was just, I just don't, I can't do this.
• 16:58
  SPEAKER_00: I'm so tired of feeling terrible when actually my life's really good.
• 17:03
  SPEAKER_00: And that's what I that's the thing.
• 17:05
  SPEAKER_00: I can I can see how good my life is, but I'm just not feeling it.
• 17:09
  SPEAKER_00: And I think it, you know, we spent a lot of that day talking things through and and and like she listened to me.
• 17:15
  SPEAKER_00: And then eventually I went back to my GP again and and I admitted that I'd come off the HRT.
• 17:20
  SPEAKER_00: And she said, I think she should go back.
• 17:22
  SPEAKER_00: And so we went back on it, and we're here now, probably three months later, and I feel better again.
• 17:30
  SPEAKER_00: I feel calmer.
• 17:31
  SPEAKER_00: And what she explained to me was my GP explained was that often in in perimenopause, we can have months where we don't ovulate at all, and then we can have months where we double ovulate or even triple ovulate.
• 17:42
  SPEAKER_00: And so we suddenly get this massive rise in estrogen, which doesn't meet, doesn't like match our progesterone.
• 17:48
  SPEAKER_00: And so we get this estrogen dominance.
• 17:50
  SPEAKER_00: And that can often be why women feel so terrible and particularly feel sensitive to estrogen, which again is going into like doing loads of research and reading loads, realizing that actually women who have had low body weight in the past, who've suffered hypothalamic ammonia, who have had difficult trauma like relations like traumas, they often are more sensitive to estrogen.
• 18:13
  SPEAKER_00: And so they often experience those kind of negative feelings more.
• 18:16
  SPEAKER_00: So it kind of all started to make a bit more sense to me.
• 18:20
  SPEAKER_00: But I I I just I guess I wanted to, yeah, I just felt so thrown by it all.
• 18:26
  SPEAKER_00: But the other thing was that I just had no desire or motivation to run at all.
• 18:31
  SPEAKER_00: And then I'd beat myself up because I'd be like, well, there's all these women on social media and they're all in their 50s and they're all going, how amazing they are, and like how they're managing to do like all these brilliant runs.
• 18:41
  SPEAKER_00: And and I got caught up in that.
• 18:43
  SPEAKER_00: I was like, God, I'm really, really rubbish.
• 18:47
  SPEAKER_00: I can't do this, I don't feel good.
• 18:49
  SPEAKER_00: And it was a real, it was a real reckoning for me.
• 18:52
  SPEAKER_00: I had to sit there and I had my my husband has been incredible through all of this.
• 18:58
  SPEAKER_00: Like I really want to give him a shout out because it's not easy for the guys.
• 19:01
  SPEAKER_00: And he he has really not known what to do or say, and he's often had his head blown off.
• 19:07
  SPEAKER_00: So, but he was brilliant through all of this, and he was just like, but you don't have to, you don't have to do what you've been doing.
• 19:14
  SPEAKER_00: Like you just there's there's no reason, like you're not training for anything.
• 19:17
  SPEAKER_00: Like I've decided this year I wasn't gonna race, so there'sn't you're not training for anything, and and it and I think it's because I've always been so capable and I've had to overcome so much adversity, and I've always had the resilience and I've always had the strength and the determination to keep going and to keep pushing.
• 19:36
  SPEAKER_00: But for some reason that was not there.
• 19:39
  SPEAKER_00: And I and I I I really struggled with that disparity between who I've always been and who I know I need to be now.
• 19:47
  SPEAKER_00: So it took a while to kind of go, okay, actually, it's okay.
• 19:53
  SPEAKER_00: It's okay.
• 19:53
  SPEAKER_00: And so I have, I've massively pulled back, just for anyone who's listening and is feeling the same as me.
• 19:59
  SPEAKER_00: I've massively pulled back on my training.
• 20:01
  SPEAKER_00: I I am running a little bit now, but I had I I've also had months where I've done hardly anything.
• 20:07
  SPEAKER_00: I have engaged in more things like yoga, Pilates, I've done loads of walking and hiking.
• 20:13
  SPEAKER_00: I've just listened.
• 20:14
  SPEAKER_00: I've actually I've listened to my body and gone, I just can't do this.
• 20:19
  SPEAKER_00: And do you know what?
• 20:20
  SPEAKER_00: Like I said, it's been three months since I've made all these changes.
• 20:23
  SPEAKER_00: And I'm not saying I'm out of the woods and I'm not saying life is perfect, and I still have to manage things on a daily basis, but I definitely, definitely feel more like me again.
• 20:34
  SPEAKER_00: But I'm happier at not pushing so much.
• 20:38
  SPEAKER_00: You know, I guess for me, running has never been, it's never been about my worth.
• 20:42
  SPEAKER_00: I think running has always been about my connection, my connection with people, my connection with the earth, my connection with my body to a certain degree.
• 20:52
  SPEAKER_00: Like I think, like I said, that somatic response.
• 20:55
  SPEAKER_00: And so I've had to find a different way to regulate.
• 20:58
  SPEAKER_00: I've had to find different ways to connect with my body inwards, you know, so that I can I can listen to it.
• 21:04
  SPEAKER_00: And and I I'm actually really grateful that I've had this experience because I think so, I you know, I see it in my clinic every day.
• 21:12
  SPEAKER_00: Women and men, but particularly women, who uh can continue to deplete themselves, continue to beat themselves up for not doing enough and don't listen.
• 21:22
  SPEAKER_00: They're trying to control their bodies, and actually we don't need to control our bodies because our bodies know what they need.
• 21:27
  SPEAKER_00: We just need to learn to listen.
• 21:28
  SPEAKER_00: And that's been my message.
• 21:29
  SPEAKER_00: I mean, you know, from Morpheal U, that's been my message all the way through.
• 21:33
  SPEAKER_00: But it was really interesting that I went through this phase where it was hard for me to listen because it felt so different to where I'd always been.
• 21:42
  SPEAKER_01: I think it's that identity piece, isn't it?
• 21:44
  SPEAKER_01: And I was kind of laughing as you tell the story because I know two years ago we both did Grysdale, Half Marathon U a lot faster than I.
• 21:50
  SPEAKER_01: I went back this year to do it with a significant amount of stress, had a cold, and then after it I just went, Oh, you know, I don't think I need HRT anymore.
• 22:00
  SPEAKER_01: I'm not going to do it.
• 22:01
  SPEAKER_01: I had the same feeling.
• 22:02
  SPEAKER_01: I was like, oh, the first week, I was like, great.
• 22:04
  SPEAKER_01: I'm doing strength training.
• 22:06
  SPEAKER_01: I'm doing the everything.
• 22:07
  SPEAKER_01: And then, oh my God, gluteol and hamstring tendinopathy, aka, a significant pain in the arse appeared.
• 22:16
  SPEAKER_01: And I went through the same kind of process.
• 22:18
  SPEAKER_01: And I went, I know that my body needs estrogen.
• 22:22
  SPEAKER_01: I know that it needs that, as well as all the strength training, as well as, you know, I then went and went down that kind of collagen route as well.
• 22:29
  SPEAKER_01: And again, feel a kind of million dollars.
• 22:31
  SPEAKER_01: And I think the important thing listening to you, and hopefully, you know, sharing a very basic part of my kind of story is it's okay not to be okay.
• 22:39
  SPEAKER_01: Even when you like someone like you that has all of that knowledge and expertise, it's still having to process that under a spotlight of society because you click on social and somebody's lifting their own body weight and doing 20 pull-ups and they're the same age as you and you you feel that you're not good enough.
• 22:59
  SPEAKER_00: Yeah, totally.
• 23:00
  SPEAKER_00: And I and I think I also just want to say, like, obviously for Mel and I, having oestrogen and being on HRT has been a big part of the puzzle.
• 23:09
  SPEAKER_00: But that doesn't mean that is for every woman.
• 23:10
  SPEAKER_00: And I think that's really important as well.
• 23:12
  SPEAKER_00: It's like we all have to find our way.
• 23:14
  SPEAKER_00: And for some women, it's not possible to be on HRT.
• 23:17
  SPEAKER_00: And, you know, you have to find your, you have to find a different route and in in how to kind of connect with yourself.
• 23:23
  SPEAKER_00: But that that societal pressure that we feel probably at every level of our life, you know, from what we eat to how we train to what we look like to what jobs we have, it it is the beast.
• 23:38
  SPEAKER_00: And it is what causes most suffering in people.
• 23:41
  SPEAKER_00: And I think for me, that's what I think that's what I think I feel lifted, is that while I was pushing against it, my suffering was increasing.
• 23:49
  SPEAKER_00: While when I kind of was like, okay, it's not, it's not how I expected life to be, but it is where it is.
• 23:56
  SPEAKER_00: We are where we are.
• 23:57
  SPEAKER_00: And I always remember this.
• 23:58
  SPEAKER_00: Like when I went to Nepal for the first time, there was a saying we just had all the time, which was, it is what it is.
• 24:04
  SPEAKER_00: You can't, you can't, you can't change things.
• 24:06
  SPEAKER_00: Like if the donkeys don't turn up, the donkeys don't turn up.
• 24:09
  SPEAKER_00: If we can't go on that plane, we can't go on it.
• 24:11
  SPEAKER_00: Like it just is what it is.
• 24:13
  SPEAKER_00: The weather's not playing ball, it is what it is.
• 24:14
  SPEAKER_00: And I used that quite a lot.
• 24:16
  SPEAKER_00: And I think I just, I was like, I had to be reminded of it is what it is, Raini.
• 24:20
  SPEAKER_00: And you are where you are.
• 24:21
  SPEAKER_00: And you can either push back against it and increase your suffering, or you can take a moment and you can just go, okay, we'll see what happens.
• 24:28
  SPEAKER_00: Now I don't know whether where I am at the moment is temporary or permanent, but I'm okay with that.
• 24:33
  SPEAKER_00: I'm okay with the not knowing.
• 24:35
  SPEAKER_00: And, you know, like I said, I'm running is not my worth.
• 24:38
  SPEAKER_00: It is also, I was only talking to my husband about it this morning.
• 24:41
  SPEAKER_00: I was like, I I went for a really nice run this weekend with some friends, and I had a really brilliant time.
• 24:45
  SPEAKER_00: And it's the first like longer run I've done in a while.
• 24:49
  SPEAKER_00: Like an in a long while.
• 24:50
  SPEAKER_00: And and I say longer, not that long, but you know, long enough.
• 24:54
  SPEAKER_01: What does that look like in terms of distance?
• 24:56
  SPEAKER_00: I mean, it was it was 16k, but it was two hours, but we were going up and down fells.
• 25:01
  SPEAKER_00: So, you know, it was it was, you know, and and I just felt so happy at the end of it, but not because I'd done the run, but because I'd had such a great time being in the fells, being with my friends.
• 25:12
  SPEAKER_00: We stopped at Chester's.
• 25:14
  SPEAKER_00: So if anybody doesn't know, Chester's is brilliant.
• 25:15
  SPEAKER_00: It's a really amazing cafe in in the Lake District.
• 25:19
  SPEAKER_00: We had cinnamon buns.
• 25:21
  SPEAKER_00: It was just, it was just the whole experience for me.
• 25:23
  SPEAKER_00: And I said that to my husband, I was like, I don't need to race again.
• 25:26
  SPEAKER_00: Racing is not something I really enjoy, if I'm being honest.
• 25:32
  SPEAKER_00: I but I do, I do love running.
• 25:36
  SPEAKER_00: I love being outside, I like being with my friends, I like having adventures, and I think that's the piece for me is more just that exploration and that connection with the earth.
• 25:48
  SPEAKER_00: I don't care if I never race again, if I'm honest, it it wouldn't, it doesn't define me in any form or manner.
• 25:54
  SPEAKER_01: Yeah, and yeah, I agree with so much on that.
• 25:56
  SPEAKER_01: And let's go back to part of the conversations that you have a lot of knowledge and expertise, and obviously red S and low energy availability.
• 26:05
  SPEAKER_01: It's a well-discussed subject, but let's just take it back.
• 26:09
  SPEAKER_01: What does reds and what does low energy availability actually mean?
• 26:14
  SPEAKER_01: And what are some of the signs that somebody might be seeing or seeing someone else around them?
• 26:19
  SPEAKER_00: Okay, so reds stands for relative energy deficiency in sport, and it's probably not the best term to describe what's really going on, but but it is what we use, so we'll go with it.
• 26:30
  SPEAKER_00: And reds is a presentation, okay?
• 26:34
  SPEAKER_00: So reds is a physical and psychological presentation, generally speaking.
• 26:39
  SPEAKER_00: Definitely physiological, and sometimes there's a psychological element to it.
• 26:44
  SPEAKER_00: Low energy availability is when there's not enough energy available once the body has used what it needs for movement.
• 26:51
  SPEAKER_00: And it's all movement.
• 26:53
  SPEAKER_00: It's not just what you do for training, it's all movement.
• 26:55
  SPEAKER_00: So if you're running up and down the stairs, or you've got an active job, or you're walking the dogs, or you're commuting to work, all of this counts as movement.
• 27:03
  SPEAKER_00: So the body will always prioritize energy for movement first, and then whatever is left over is used for biological function.
• 27:10
  SPEAKER_00: And of course, even that has a hierarchy system, right?
• 27:12
  SPEAKER_00: So it will kind of keep you trying to keep your brain going, your heart going, your lungs going, and then it will move into like your hormones, your digestive system, your circulatory system, your nerve, nervous system, right?
• 27:24
  SPEAKER_00: So, so so this is where it gets interesting.
• 27:27
  SPEAKER_00: Low energy availability underpins reds.
• 27:32
  SPEAKER_00: So if you are in low energy availability for a period of time, it is very likely, not always, but it is very likely that at some point, if you don't rectify that situation, you will end up in reds.
• 27:45
  SPEAKER_00: Okay.
• 27:46
  SPEAKER_00: But it's not the only cause.
• 27:48
  SPEAKER_00: The other causes, as we talked about earlier, is when you have under-recovery.
• 27:52
  SPEAKER_00: And this is something I really want to bring to light because what we're seeing in clinic more and more is almost that that message about fueling is slowly filtering in, slowly, but the message about rest is not.
• 28:03
  SPEAKER_00: So you're getting people who are trying to train like professional athletes, but they have full-time jobs and they have families.
• 28:10
  SPEAKER_00: But also the other thing about rest is it's not just about the rest day to day and through your training, it's actually the rest in between events.
• 28:17
  SPEAKER_00: And so many people are doing these very big, long, ultra-distance events and trying to do several races a year.
• 28:25
  SPEAKER_00: And this is what we're seeing.
• 28:26
  SPEAKER_00: We are seeing the repercussions of this.
• 28:29
  SPEAKER_00: So people are presenting with red symptoms in clinic maybe 18 months down the line, but in that 18 months, they have done 400 milers, or they've, you know, they've not had enough rest for their body to recover from from from the from the, I guess, the the stress and the load that gets placed on.
• 28:48
  SPEAKER_00: So re so rest is another really big part of the of the puzzle.
• 28:52
  SPEAKER_00: And then the final one is obviously overall stress.
• 28:55
  SPEAKER_00: So again, if you are someone who is trying to hold your body at a place that's not appropriate for you, then that is going to be stressful to the body.
• 29:03
  SPEAKER_00: The body sees that as threat.
• 29:05
  SPEAKER_00: Okay.
• 29:05
  SPEAKER_00: So all these things, or even if you've got psychological stress going on.
• 29:08
  SPEAKER_00: So again, we're talking about people trying to train like an athlete, but have full-time jobs and families, like these other aspects of our life, families and work, they also add a certain amount of load.
• 29:22
  SPEAKER_00: And what people don't often realize is that you've got this, they've got too much of a load.
• 29:26
  SPEAKER_00: So, you know, you have people with really high, high, you know, high stress jobs, high profile jobs, and long hours.
• 29:35
  SPEAKER_00: And then they're going home to their families as well and trying to be mums and dads and and and all that comes with that.
• 29:40
  SPEAKER_00: And then they're trying to train, and there just isn't enough hours or enough recovery time to do it all.
• 29:46
  SPEAKER_00: And that's when we tend to then see red.
• 29:49
  SPEAKER_00: So some of the symptoms around reds are in females, we do often see a change to hormonal health and menstrual cycle.
• 29:56
  SPEAKER_00: Now, that's not to say it's always the case, and I want to make that really clear, but sometimes one of the most common signs is that the menstrual cycle changes.
• 30:04
  SPEAKER_00: So it can go from being a regular 28, 32-day cycle or whatever it might be, down to sort of more like a 22, 23-day, you know, cycle.
• 30:14
  SPEAKER_00: Or it can get much lighter in flow, because that again kind of relates to how much oestrogen has been produced in ovulation, you know, or it stops completely, or it can get longer in distance.
• 30:25
  SPEAKER_00: So any significant change is change that needs to be observed.
• 30:30
  SPEAKER_00: And of course, and we'll come back to this, but of course, in women who are in perimenopause, some of this can happen anyway, whether you've got reds or not.
• 30:36
  SPEAKER_00: That's one of the signs that some women will experience the changes to their menstrual cycle.
• 30:40
  SPEAKER_00: So it can be a bit confusing.
• 30:41
  SPEAKER_00: Other signs of reds, recurrent injuries, and I'm not just talking about bone injuries.
• 30:45
  SPEAKER_00: I think again, people tend to just associate bone stresses and stress fractures, but actually we're talking about connective ligament tendon issues.
• 30:54
  SPEAKER_00: Digestive issues is a big one we see, like really, really significant is we see, we see what we're actually seeing is something called gastroparesis, but gastro, but what it but actually what it is is is the slow, slow movement of food through the gut.
• 31:10
  SPEAKER_00: And so people assume that is IBS, and then they go down that whole IBS route, trying to exclude, and of course it makes the whole thing a lot worse.
• 31:19
  SPEAKER_00: So we do see this a lot.
• 31:21
  SPEAKER_00: We see a lot of gastro problems, and then you can get like you can get increase of uh urinary and tract infections because again, particularly when Eterne is low, you get a higher risk of urinary tract infections, you can get peripheral nerve damage, and sometimes you get one of these, and sometimes you get a collection of them.
• 31:40
  SPEAKER_00: And that's the thing, everybody presents really differently.
• 31:43
  SPEAKER_00: So this is the thing about reds, there's no, there's no kind of one size fits all.
• 31:46
  SPEAKER_00: And then obviously, finally, you just you just don't perform.
• 31:49
  SPEAKER_00: So other things that you might notice is that your performance starts to stagnate and then actually deteriorate.
• 31:54
  SPEAKER_00: Or you are doing all this training, but you're not seeing any adaptation, whether that's body composition adaptation or training adaptation, you just don't get any, you know.
• 32:04
  SPEAKER_00: So, and the reason being is because there's just there's not, there just isn't the capacity in the body to do so.
• 32:11
  SPEAKER_00: So when the body is under threat for whatever reason, it will start to to kind of turn on compensatory behaviors and downregulate to keep you safe.
• 32:21
  SPEAKER_00: It's in survival mode.
• 32:22
  SPEAKER_00: So it it this is why hormones downregulate.
• 32:26
  SPEAKER_00: This is why our digestive system slows down, this is why we might not produce as many red red blood cells and you start having low iron levels for no reason.
• 32:34
  SPEAKER_00: This is why you might find you're getting more and more niggles because your the bone the body hasn't got the capacity to renew the connective tissue or to renew the bone bone cells, right?
• 32:46
  SPEAKER_00: So everything in our body takes energy.
• 32:49
  SPEAKER_00: And of course, if we don't have that energy, then it can't do it.
• 32:52
  SPEAKER_00: And if we don't have the rest to recover, it can't recover fully.
• 32:56
  SPEAKER_00: So the reds is is a complicated, and there's then there's there's two types, although if I'm honest, there probably is only one, and it's probably more on a spectrum.
• 33:05
  SPEAKER_00: But fundamentally, we we say that you've got either got unintentional reds or intentional reds.
• 33:11
  SPEAKER_00: And unintentional reds is when you unintentionally are in low energy availability.
• 33:16
  SPEAKER_00: You don't really realize how much you need, maybe you don't appreciate how much rest you need.
• 33:20
  SPEAKER_00: But the the benefit of this, or I said a benefit, the benefit of working with people in this place is that they're very receptive to input.
• 33:29
  SPEAKER_00: So they don't have any problem changing up things.
• 33:32
  SPEAKER_00: So if you say to them you need to eat more, they'll eat more.
• 33:34
  SPEAKER_00: If you say to them you need to rest more, they'll rest more.
• 33:37
  SPEAKER_00: If you say we need to modify your training for six months to get you back on track, they'll do it.
• 33:41
  SPEAKER_00: And there's no pushback.
• 33:42
  SPEAKER_00: It's all, it's all fine.
• 33:44
  SPEAKER_00: Whereas intentional reds is much more complicated because there is a big psychological element to it.
• 33:49
  SPEAKER_00: And people really struggle to take on the advice because often they do have an exercise dependency, or they have disordered eating, or they have an eating disorder.
• 33:59
  SPEAKER_00: And of course, these are all, these are all just kind of coping mechanisms.
• 34:03
  SPEAKER_00: They're protective mechanisms we have learnt in order to feel safe.
• 34:08
  SPEAKER_00: And often what I talk about feel safe, feel safe from emotions and feelings and experiences that have been very difficult for us, right?
• 34:15
  SPEAKER_00: So it's complicated.
• 34:16
  SPEAKER_00: And this is where I spend most of my time working, is in these very complex presentations of Reds.
• 34:24
  SPEAKER_00: And it's it's hard work because you can't, you know, people like we were talking earlier about kind of things we can do in the future, and obviously education is a really big important piece.
• 34:36
  SPEAKER_00: And there's a lot of education about Reds online now.
• 34:39
  SPEAKER_00: Lots of people are doing red's education, Reds awareness.
• 34:42
  SPEAKER_00: That that's pointless if you can't help someone change their belief system.
• 34:47
  SPEAKER_00: And you can't change someone's belief system just by telling them to change it.
• 34:50
  SPEAKER_00: And that's where that's where the work happens, and that's why I've spent so many years doing more than just dietetics.
• 34:56
  SPEAKER_00: You know, I have, I have, I have, you know, got so many other courses and qualifications I've done in trauma, in mindfulness, in, you know, parts work.
• 35:07
  SPEAKER_00: Like, because that's the only way I can help someone is if I can get them to really understand what's happening and then slowly, slowly help them to let go of the coping mechanisms that are keeping them stuck.
• 35:21
  SPEAKER_01: Yeah, and it's very complex, but it's also hugely psychological, isn't it?
• 35:24
  SPEAKER_01: And the nuances of each individual.
• 35:26
  SPEAKER_01: And and we talked a lot about obviously kind of fueling and and a lot of the things that you see coming through your clinic.
• 35:31
  SPEAKER_01: But one of the conversations that I find is not talked as much as it should do is hydration.
• 35:36
  SPEAKER_01: And again, the importance hydration plays with food and the ability to, you know, help from a fueling point of view.
• 35:43
  SPEAKER_01: Just talk through why, why hydration is really, really critical in your day-to-day existence as well as taking on kind of events.
• 35:53
  SPEAKER_01: Why should you why do you need it?
• 35:55
  SPEAKER_00: Well, I mean, I mean I mean, the thing about hydration is is that when we're hydrated, our brain works better, right?
• 36:01
  SPEAKER_00: So if we're dehydrated, then we know that can have like a up to, I think it's like so like 2% dehydration can provide 10% decline in our performance, whether that's cognitive performance or physical performance.
• 36:15
  SPEAKER_00: So we need water, yeah?
• 36:18
  SPEAKER_00: Our bodies need it, our brains need it.
• 36:20
  SPEAKER_00: And also our all them, all the biological processes in our bodies work better if we're hydrated.
• 36:24
  SPEAKER_00: So even things like replenishing your glycogen stores, we know that's much more optimal if you're hydrated.
• 36:31
  SPEAKER_00: Whereas if you try and replenish your glycogen stores and you're dehydrated, it's just not as optimal.
• 36:36
  SPEAKER_00: Okay, so so we we all need, we all need fluid.
• 36:39
  SPEAKER_00: And then again, where it gets confusing is when we are doing these big long-distance events, there's just so much information, like how much water you need, how much salt you need, how much carbohydrate you need, and people get really confused.
• 36:52
  SPEAKER_00: And I I don't blame them.
• 36:54
  SPEAKER_00: It's really confusing.
• 36:56
  SPEAKER_00: And and there isn't a one size fits all.
• 36:58
  SPEAKER_00: This is definitely something that you have to start working out for yourself, right?
• 37:04
  SPEAKER_00: So, firstly, we all have different rates of loss of fluid.
• 37:10
  SPEAKER_00: So, you know, you could be doing exactly the same event, you know, you and I could be out doing exactly the same event, same conditions, and you will lose more liquid maybe than I will, or vice versa.
• 37:20
  SPEAKER_00: And that's a that's a genetic thing.
• 37:22
  SPEAKER_00: So that's the first thing.
• 37:24
  SPEAKER_00: Similarly, we all have different sodium losses.
• 37:27
  SPEAKER_00: So again, and again, that's not about being fitter or not being fitter.
• 37:31
  SPEAKER_00: It is a genetic, it's genetically predisposed, whether you have a higher sodium loss or a lower sodium loss.
• 37:36
  SPEAKER_00: So again, if you're somebody who has higher sodium losses, you're gonna need to replace those in an event.
• 37:42
  SPEAKER_00: Otherwise, you're going to get to a position where you are hyponeatremic.
• 37:47
  SPEAKER_00: And of course, that's when we know things can get problematic and you can also start to feel sick and and not take on fuel, etc., etc.
• 37:54
  SPEAKER_00: So it's it's it's you know, it's not, it's not a it's not a simple thing.
• 37:57
  SPEAKER_00: But where people get lost is well, how do you pull this all together?
• 38:01
  SPEAKER_00: And it's not easy, and even when I'm working with athletes, we do a lot of groundwork.
• 38:05
  SPEAKER_00: So I've got, I'm actually heading out to Andorra on Thursday because I'm crewing for an athlete at Andorra hundred.
• 38:14
  SPEAKER_00: And we've been doing so much homework over these last few months.
• 38:17
  SPEAKER_00: So we know what her sweat rate, her sweat losses are because she did have a sweat test, so we know what she loses, but also she's been doing loads of runs where she's weighed herself before and after and in different conditions, so that we can start to map that out as well.
• 38:33
  SPEAKER_00: So in hot conditions, we know she loses quite a lot of fluid per hour.
• 38:38
  SPEAKER_00: Um but actually in her case, even in cool conditions, she loses quite a lot of fluid per hour.
• 38:42
  SPEAKER_00: So it's so so it's interesting.
• 38:43
  SPEAKER_00: So, and then when it comes to how much sodium you replace, we know that it's it's sodium per liter of fluid.
• 38:52
  SPEAKER_00: So it's not sodium per hour, which is where so many people make mistakes and usually end up then overdoing it.
• 38:57
  SPEAKER_00: It's sodium per liter of fluid.
• 38:59
  SPEAKER_00: So let's say, for argument's sake, you lose a liter of fluid per hour, then that's a nice easy equation.
• 39:05
  SPEAKER_00: And then you roughly know how much sodium you lose per hour, then you go, okay, so every hour I need to take on a liter of fluid with whatever 700 milligrams of sodium.
• 39:16
  SPEAKER_00: And if you do that, you keep the internal environment stable, which means you can then absorb carbohydrate without any issue.
• 39:25
  SPEAKER_00: But the problem is if you tip the balance, if you become too dehydrated, then it's more difficult to absorb carbohydrate.
• 39:32
  SPEAKER_00: And if you become too hyper hyponeutremic, you also then you start to feel sick and you don't want to take on the carbohydrate.
• 39:39
  SPEAKER_00: So, so that triangle is really important.
• 39:43
  SPEAKER_00: And you don't have to necessarily go and do a sweat test.
• 39:45
  SPEAKER_00: I know that's what people would say, I don't want to go and do a sweat test.
• 39:47
  SPEAKER_00: You start with a ballpark.
• 39:49
  SPEAKER_00: Like, so the average we know from lots and lots of lots and lots of studies is most people, most people sit somewhere between a loss of 700 to 900 milligrams of sodium per liter of fluid.
• 40:02
  SPEAKER_00: So if you're somebody who, when you go running, you notice that your eyes start to sting, you probably got white crystals on your on your vest and on your t-shirt, you're probably on the higher end.
• 40:12
  SPEAKER_00: So you start with 900 and you see how you go in your training.
• 40:16
  SPEAKER_00: That's why we do training, that's why we do training runs, that's why we practice our nutrition, right?
• 40:20
  SPEAKER_00: Because this is how you learn.
• 40:22
  SPEAKER_00: And you see, and you think, okay, yeah, that I feel, I feel good if I do that.
• 40:25
  SPEAKER_00: Or actually, I still don't feel great.
• 40:27
  SPEAKER_00: I still feel like my stomach's like a bit like a washing machine.
• 40:30
  SPEAKER_00: So then you up it, you go to a thousand.
• 40:33
  SPEAKER_00: Similarly, if start you don't really notice much sweat, you're not, you know, you might start on the lower end.
• 40:39
  SPEAKER_00: And even then you might be like, everything tastes really salty.
• 40:41
  SPEAKER_00: So you'd reduce it again.
• 40:43
  SPEAKER_00: So you don't have to necessarily do the sweat test, but you do need to play around with it to make sure it works for you.
• 40:48
  SPEAKER_00: But you've also got to remember the environment you're going to be in, the conditions you're going to be in, because that also has an impact on the amount of fluid you lose.
• 40:56
  SPEAKER_00: So your sweat rate never changes, but the amount of fluid lost does change.
• 41:00
  SPEAKER_00: And of course, if we get dehydrated, we don't make very good decisions either.
• 41:04
  SPEAKER_00: So that also doesn't help.
• 41:05
  SPEAKER_00: It's often when people get lost or fall over a branch.
• 41:07
  SPEAKER_01: Yeah, and it's that as that cognitive function, isn't it?
• 41:10
  SPEAKER_01: And we talked a lot about sodium, but if you kind of bring that into probably what people know more electrolytes, and electrolytes are often made up of many of the things that you've just spoken about.
• 41:21
  SPEAKER_01: What's the role of electrolytes and why is it really important?
• 41:25
  SPEAKER_01: Because a lot of people go, well, I'm just drinking uh water because it's good for me.
• 41:29
  SPEAKER_01: Why do you need electrolytes when you're doing, I guess, anything from an hour plus of some kind of activity?
• 41:36
  SPEAKER_00: So I so sodium is one of the key electrolytes in most electrolyte mixes.
• 41:42
  SPEAKER_00: And I would say that electrolytes become really important once you're in that two-hour plus situation, particularly if it's warmer.
• 41:51
  SPEAKER_00: If you're only running for an hour, you probably get away with it also because you come back and you you would, you know, you would hydrate and you'd eat food and you'd probably get your salt back in.
• 42:01
  SPEAKER_00: So the reason we're talking about electrolytes is that obviously we lose salt and other other other salts like potassium and magnesium in our sweat.
• 42:09
  SPEAKER_00: And these need to be replaced because if they're not replaced, they make it more difficult for us to absorb water, particularly sodium.
• 42:17
  SPEAKER_00: It's really important for absorbing water back into the muscles and back into the body.
• 42:21
  SPEAKER_00: So again, if you get too depleted, then you can't draw water in.
• 42:25
  SPEAKER_00: So you feel thirsty and you keep drinking, you keep drinking, and you keep drinking.
• 42:28
  SPEAKER_00: You're just drinking water and you're not replacing sodium, you then that's why we end up becoming hyponeic and you end up feeling like you've got this washing machine going around in your stomach.
• 42:38
  SPEAKER_00: So this is why electrolytes are useful.
• 42:41
  SPEAKER_00: Do you need electrolytes on a daily basis?
• 42:43
  SPEAKER_00: Like I know there are a lot of high-profile individuals pushing having electrolyte every morning before you even get out of bed.
• 42:50
  SPEAKER_00: And I'm like, no, you do not.
• 42:52
  SPEAKER_00: Like I think when it's warm, so right now, when it is warmer, I am noticing I come back from a run and I'm I've sweat quite a bit.
• 42:58
  SPEAKER_00: And I, or if I'm even doing like a strength session or something, you know, or I've been on the bar, whatever.
• 43:04
  SPEAKER_00: I notice I sweat quite a bit and I know I have high losses.
• 43:06
  SPEAKER_00: So at the moment, I probably do add electrolyte to my water after after an activity.
• 43:13
  SPEAKER_00: But in the winter I don't because I don't sweat as much.
• 43:16
  SPEAKER_00: So I don't use it as much.
• 43:17
  SPEAKER_00: I'd still use it on longer runs.
• 43:19
  SPEAKER_00: I'd still use it if I was doing a lot of indoor training, but I just don't, if I'm not sweating as much, I just don't need it as much.
• 43:26
  SPEAKER_00: So again, it's not something that we need on a daily basis necessarily.
• 43:30
  SPEAKER_00: It is very much like on a needs basis.
• 43:33
  SPEAKER_00: But definitely if you're doing a big long run or a big long bike, or you know, you're out and it's really warm.
• 43:40
  SPEAKER_00: And I say really warm, it doesn't have to be that warm, but you know, it's you it's warm enough, then you you would definitely benefit from keeping on top of your electrolytes.
• 43:50
  SPEAKER_01: Yeah.
• 43:50
  SPEAKER_01: And it's again, it's that balance.
• 43:51
  SPEAKER_01: And ultimately, it's finding what works for you.
• 43:54
  SPEAKER_01: It's the importance that when you go to do events, you know, again, I know for me I've only done 150k.
• 44:00
  SPEAKER_01: Ultra, but again, I felt nauseous.
• 44:02
  SPEAKER_01: I knew that I needed sodium, sodium, and started taking colour salt tablets to then be able to kind of help on that.
• 44:07
  SPEAKER_01: So, you know, you it's about finding what works for you.
• 44:11
  SPEAKER_01: And fueling generally through your day, again, that's the biggest place that you can make the biggest game, right?
• 44:18
  SPEAKER_01: Eating well, hydrating well, day in, day out for an athletic performance, because a sports nutrition is almost the icing on the cake, isn't it?
• 44:27
  SPEAKER_01: Because if you're underfueled and underhydrated to start with.
• 44:30
  SPEAKER_01: So advice what what should or what could a good day of nutrition look like for women and men?
• 44:38
  SPEAKER_00: I think like ultimately it does depend on what you're doing.
• 44:42
  SPEAKER_00: So if you are somebody that likes to do activity most days, you know, of some, and I'm not saying it has to be like really hardcore, we're just talking some activity, then you are you are going to need to think about your carbohydrate stores.
• 44:56
  SPEAKER_00: So my advice would be actually having you know three really well-balanced meals where you are having good sources of carbohydrate, good sources of protein, good sources of vegetables.
• 45:06
  SPEAKER_00: It's it's not it's not rocket science.
• 45:08
  SPEAKER_00: And then, and then of course, on top of that, depending on your activity level, depending on your job, you'll probably need to add some snacks.
• 45:16
  SPEAKER_00: And that might vary between one and five, depending on how busy you are and what you do.
• 45:22
  SPEAKER_00: Like, you know, when I'm in when I was in the height of training last year for Lakeland 50, I was I had big volume weeks and I was definitely eating maybe seven or eight times a day, because it's the only way I could keep on top of making sure that I always was recovering from a previous run and and getting ready for the next run type thing.
• 45:42
  SPEAKER_00: Now I'm not doing quite as much volume.
• 45:46
  SPEAKER_00: So I still eat carbohydrate at every meal.
• 45:49
  SPEAKER_00: I still snack, but I probably don't snack quite as much.
• 45:52
  SPEAKER_00: I probably again, I'm I'm kind of led by appetite a little bit on that.
• 45:55
  SPEAKER_00: But but again, what I will say about that is you do also need to sometimes be a bit mechanical too, because especially when we've done a hard session or a long session or you've you've run in the heat or whatever, your appetite can drop.
• 46:09
  SPEAKER_00: And so then you sort of think, oh, I don't need anything.
• 46:11
  SPEAKER_00: Because if you if you're listening to your hunger cues, you won't need anything.
• 46:14
  SPEAKER_00: And that's again a classic opportunity to end up underfueled because you haven't replaced your nutrition at the right time.
• 46:22
  SPEAKER_00: So that's where, like, you know, recovery drinks can be really good because you can just have them ready in the fridge and you get in and you drink them and you're kind of replenishing yourself and you don't even think about food.
• 46:33
  SPEAKER_00: And even if you can't eat for another hour or two, that's okay because you've already started that recovery process.
• 46:38
  SPEAKER_00: So, like for me, it's it's not about you must eat porridge for breakfast and you must eat a jacket potato for lunch.
• 46:45
  SPEAKER_00: It's not that, it's more just being really consistent with your choices, but not underdoing the carbs.
• 46:52
  SPEAKER_00: Because I think people still are so fearful of carbs.
• 46:57
  SPEAKER_00: People are so like carbs are still so demonized and they don't need to be because they're really good for you, particularly if you are someone who is active, because you you need carbohydrate not just for the energy, but you also need carbohydrate then for the recovery, because that's what helps those bone cells recover.
• 47:17
  SPEAKER_00: That's what helps your muscles repair the tears.
• 47:20
  SPEAKER_00: That, you know, carbohydrate combined with protein helps those muscle tears.
• 47:24
  SPEAKER_00: But the carbohydrate element also helps you to translate that signal of the training into progress, right?
• 47:32
  SPEAKER_00: So this is that's the key thing is I think it's not again, we can't really give a one size fits all because we're all so different and we're, you know, our lifestyles are different and our activity levels are different.
• 47:44
  SPEAKER_00: And even even the fact that like our body compositions will be different.
• 47:47
  SPEAKER_00: So if you have a higher muscle mass, your requirements will be higher because you will be using more energy per minute just sat around.
• 47:56
  SPEAKER_00: Okay.
• 47:57
  SPEAKER_00: So, you know, so it's it's I I'm not I'm not gonna sit here and give any example menu because I think it it's not particularly helpful in the sense of everybody will be different.
• 48:07
  SPEAKER_00: But what I would say is, is it is that regularity and the consistency and not skimping on any any food group, really.
• 48:16
  SPEAKER_01: Yeah, and the importance that carbohydrates has.
• 48:18
  SPEAKER_01: I I I laughed, listened to one of your podcasts where you said that you were listening or you were reading an athlete's diary and on day X there was no carbohydrates in, and you said, But why?
• 48:27
  SPEAKER_01: And she said, Well, it was a rest day, so I don't need kind of carbohydrates.
• 48:31
  SPEAKER_01: I think it's the if you take one point from this, it's about consistency.
• 48:36
  SPEAKER_01: You consistently eat well and hydrate well through the week.
• 48:40
  SPEAKER_01: And again, understanding kind of your body is the critical thing to do, isn't it?
• 48:44
  SPEAKER_00: Yeah, absolutely.
• 48:45
  SPEAKER_00: And and I think just don't be, just don't be fearful.
• 48:48
  SPEAKER_00: Like I was I was doing a podcast the other day with like a it was a female athlete panel, and one of those female athletes had been part of a study, and she is elite level, so I'm not gonna say that it's you know, it's the same for everybody.
• 49:03
  SPEAKER_00: But the concept is the same for everybody in that she is a marathon runner, she had always underfueled in especially like during the the marathon, but even around around the her training.
• 49:16
  SPEAKER_00: And this study, she had to go back repeatedly and take on 60 grams of carbs, 90 grams of carbs, and 120 grams of carbs and run at her threshold, like run at her marathon pace on the treadmill for two hours.
• 49:29
  SPEAKER_00: So pretty decent, pretty decent session.
• 49:32
  SPEAKER_00: And at 60 grams, her she actually she became really dehydrated because she lost so much like glycogen stores.
• 49:41
  SPEAKER_00: And obviously, with glycogen stores, you also lose liquid.
• 49:43
  SPEAKER_00: And so that also affected her performance.
• 49:45
  SPEAKER_00: Whereas at 120 grams, even though there was like she had to learn to train her gut to cope with that, she was actually utilizing.
• 49:53
  SPEAKER_00: I mean, yes, she's an elite level.
• 49:54
  SPEAKER_00: I'm not saying we're all the same, but at her in her sort of capacity, she was using two grams of carbohydrate per minute, but she was using it, she was absorbing it, she was taking it, and she was utilizing it.
• 50:08
  SPEAKER_00: Whereas at 60 grams, she was under giving her body what she needed.
• 50:12
  SPEAKER_00: So she was able to maintain her speed for so much longer without getting fatigued because she was actually giving her body what she needed.
• 50:20
  SPEAKER_00: So I'm not saying everyone should go out and eat 120 grams of carbs.
• 50:22
  SPEAKER_00: I'm not saying that.
• 50:23
  SPEAKER_00: I'm just saying that what we utilize, what we like, what we we utilize a lot more carbohydrate than we think we do when we're running.
• 50:31
  SPEAKER_00: But if we don't give our bodies that carbohydrate, we won't utilize it.
• 50:34
  SPEAKER_00: So we won't feel the benefits of it.
• 50:36
  SPEAKER_00: So, you know, I think like when a lot of people do, oh sorry, I'll just I'll make it up afterwards.
• 50:42
  SPEAKER_00: I'll go and have that pizza and I'll go have it, have both.
• 50:45
  SPEAKER_00: You know, eat, eat, eat the fuel enduring, and then go and have the pizza as well.
• 50:50
  SPEAKER_00: Because that is how you train your gut, but you also use more carbohydrate when you're running.
• 50:55
  SPEAKER_00: And it means you can hold those faster paces for longer, and that is how you're going to progress.
• 50:59
  SPEAKER_01: Yeah, and uh there's huge amounts of kind of information.
• 51:02
  SPEAKER_01: And and then as we could come to a close on this very uh informative podcast is right, let's talk about the running industry.
• 51:11
  SPEAKER_01: And this is a question if you could change one thing about the running culture and how it talks about food and body image, what would it be?
• 51:18
  SPEAKER_00: I only one thing.
• 51:20
  SPEAKER_00: Okay.
• 51:21
  SPEAKER_00: You can have two.
• 51:22
  SPEAKER_00: I think I would change two things.
• 51:24
  SPEAKER_00: I would change running influences so they just didn't exist, and I would change the narrative around lighter makes you faster.
• 51:34
  SPEAKER_01: Yeah, yeah, two uh great points.
• 51:36
  SPEAKER_01: And and if you were to look at sports nutrition now, do you believe sports nutrition is actually now catching up with the way that people then apply it?
• 51:48
  SPEAKER_01: So you're starting to see people on the trails being more knowledgeable, being more informative.
• 51:53
  SPEAKER_01: Are you starting to see that cultural shift as well?
• 51:55
  SPEAKER_00: I think people are trying.
• 51:57
  SPEAKER_00: I think we've still got a long way to go to educate new and recreational runners.
• 52:03
  SPEAKER_00: I think there's a lot of information about eat the carbs, hydrate, but like the way which we've tackled it today, like giving that sort of absolute kind of this is why you need to worry about your sodium, this is why carbs are really important.
• 52:15
  SPEAKER_00: That takes time, right?
• 52:17
  SPEAKER_00: You have to absorb that information.
• 52:18
  SPEAKER_00: You then got to go and try it out yourself and work it out for yourself.
• 52:21
  SPEAKER_00: So I think the longer you're in the running world and the more you are happy to try things out, appreciate that you're gonna have runs where it doesn't go down well, but you learn from that, I think the more we can progress.
• 52:33
  SPEAKER_00: So I do think sports nutrition is progressing massively.
• 52:37
  SPEAKER_00: I I don't want sports nutrition to try and be more clever than it needs to be.
• 52:42
  SPEAKER_00: That would be my thing I would say is I think a lot of brands are trying to make it cleverer than it needs to be.
• 52:48
  SPEAKER_00: And I don't think it needs to be because ultimately what we need is just a really easily digestible source of energy that can help us to maintain our performance for as long as we want to be out there.
• 52:59
  SPEAKER_00: And I don't think we need to go much further than that, personally.
• 53:03
  SPEAKER_01: Yeah, and thank you for your views on that.
• 53:05
  SPEAKER_01: And inclusion, you've obviously talked a lot over probably the last 10 years around advocacy, the importance for diversity and accessibility for obviously minority groups in the great outdoors.
• 53:18
  SPEAKER_01: Are you seeing a change?
• 53:19
  SPEAKER_01: Are you seeing greater representation now out on the trails?
• 53:23
  SPEAKER_00: I think in certain situations, yes.
• 53:26
  SPEAKER_00: I would say up here in the lake district, it's still quite limited.
• 53:31
  SPEAKER_00: But but I don't but I but that's not that's not that's not a criticism.
• 53:35
  SPEAKER_00: It's more that the Lake District, I mean, and I was talking about this with my friend who I who came to stay this weekend.
• 53:40
  SPEAKER_00: The Lake District is really quite a technical terrain and it's a brilliant, brilliant, brilliant training base.
• 53:48
  SPEAKER_00: Like it's fantastic.
• 53:49
  SPEAKER_00: But it I think there are a lot of people who train, they live and they train down south, and they they're really good runners down south, and they think that that's transferable up to the Lake District, and it's not.
• 54:01
  SPEAKER_00: You have to kind of live up here and train up here and really get to know.
• 54:05
  SPEAKER_00: And I know that in the three years I've lived up here, my you know, my descending has significantly improved, even though I'm 50, but I'm I'm a pretty decent descender.
• 54:13
  SPEAKER_00: But that's only because I get the opportunity to throw myself down a hill every weekend, twice a week if I want to, right?
• 54:20
  SPEAKER_00: So, so of course you're gonna get more confident.
• 54:22
  SPEAKER_00: And I think, so I think I understand why there's still a little bit of barrier, because there is definitely more diver I think I definitely see more inclusion.
• 54:32
  SPEAKER_00: And I know like I'm part of the Felrunning Association up here, and I know they're really trying to encourage more people of colour to to be part of fell running, but it's scary.
• 54:44
  SPEAKER_00: Like I've been up here three years and I've only done two fell races, and they are they are they are hard.
• 54:50
  SPEAKER_00: So unless you live up here and get that opportunity, I think it's quite tricky, but I'm I'm really hopeful that we can still encourage people to come and at least have a have a hike and learn to experience it in that way.
• 55:03
  SPEAKER_00: You don't have to come and run necessarily, just come and experience it, see it first.
• 55:08
  SPEAKER_00: You know, it's like that kind of, I don't know, I I think everybody's rushing.
• 55:13
  SPEAKER_00: Everybody wants to, you know, they've done, I don't know, they've done London Marathon and they want to go to Lakeland 50.
• 55:18
  SPEAKER_00: There's a massive, massive difference in the two.
• 55:22
  SPEAKER_00: And I just think you've got to build yourself up there slowly and do all the steps in between.
• 55:28
  SPEAKER_00: And that helps you to not get injured, but it also then makes the experience way more, yeah, just way more pleasurable.
• 55:35
  SPEAKER_01: Yeah, and I mean, I was recently at Ultra Trail Snowdhony and I saw great groups like obviously Black Trail Runners.
• 55:40
  SPEAKER_01: I know you supported extensively in the past of four, you know, the Muslim runners group that are kind of there, and it's great to see that representation.
• 55:47
  SPEAKER_01: But I do laugh.
• 55:48
  SPEAKER_01: I remember sitting down at breakfast with one of the women that was doing it, and she talked about where she ran, e.g.
• 55:54
  SPEAKER_01: on the flat, and said, Well, I've I've been to the countryside twice.
• 55:57
  SPEAKER_01: And I was thinking, uh, it's going to be a long day at the office.
• 56:00
  SPEAKER_01: And unfortunately, she did DNF from probably a kind of multitude of reasons, and she had an ITB, you know, issue that I think that jump from road running to trail running has been perceived to be easy, and people go from one to the other and they don't understand the conditions.
• 56:16
  SPEAKER_01: And ultra trail Slodonia, the conditions were pretty bad on both a Friday and Saturday, so it's kind of overcoming that.
• 56:22
  SPEAKER_01: But it's great that you are seeing a greater representation.
• 56:25
  SPEAKER_01: I definitely see a better representation, which is brilliant to be able to see.
• 56:30
  SPEAKER_01: And to bring this podcast to a close, we've talked a lot about culture, we've talked a lot about your personal kind of journey as well as solutions.
• 56:37
  SPEAKER_01: But if you were to simplify down two or three pieces of advice to somebody that's listening to this, what would they be?
• 56:45
  SPEAKER_01: Simple takeaways from you.
• 56:46
  SPEAKER_00: I would say don't rush.
• 56:48
  SPEAKER_00: Remember, running's meant to be fun.
• 56:51
  SPEAKER_00: And don't ever let running become your worth.
• 56:54
  SPEAKER_01: They're brilliant.
• 56:55
  SPEAKER_01: Greene, thank you very much for taking the time and being very honest.
• 57:00
  SPEAKER_01: I know the journey that you've been on is one that has huge amounts of complexity from your teenage years all the way through to your 50s.
• 57:07
  SPEAKER_01: We'll connect people with the ability to pick up your books.
• 57:11
  SPEAKER_01: I can't wait to go for a run with you next time.
• 57:15
  SPEAKER_01: Thank you as always for your time, your passion, and your support.
• 57:18
  SPEAKER_01: It is hugely appreciated.
• 57:20
  SPEAKER_01: Thank you so much.