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June 15, 2020

Nutrition Supplements for Performance: Fact or Fiction?

Could your triathlon performance be enhanced with the use of an ergogenic aid? In this episode, sports nutritionist Dr. Krista Austin covers an extensive list of supplements intended to enhance training and racing performance. Learn about the potential benefits of sodium bicarbonate, beta-alanine, exogenous ketones, caffeine, and nitric oxide supplements—to name just a few! Dr. Krista also provides recommended uses for each supplement and the potential harmful side effects if used incorrectly.

TriDot Podcast .38:  Nutrition Supplements for Performance: Fact or Fiction This is the TriDot podcast. TriDot uses your training data and genetic profile combined with predictive analytics and artificial intelligence to optimize your training, giving you better results in less time with fewer injuries. Our podcast is here to educate, inspire and entertain. We'll talk all things triathlon with expert coaches and special guests. Join the conversation and let's improve together. Andrew: Welcome to the TriDot podcast everybody.  Hot topic today. There are a lot of supplements on the market that promise to make us stronger and faster in some way in our training and racing. And today we will be talking through what products could be helpful to your performance. Our key guides the nutrition product market is our resident nutritional expert Dr. Krista Austin. Krista is an exercise physiologist and nutritionist who consulted with US Olympic Committee and the English Institute of Sport. She has a PhD in exercise physiology and sports nutrition and a master's degree in exercise physiology, as well as being a certified strength and conditioning specialist. Krista, welcome back to the podcast. Dr. Austin: Thanks, Harley. I'm glad to be here. It's time for segment two on our dietary supplement episodes. Andrew: Yes, if anybody missed it two weeks ago, we launched, we publish an episode all about the different supplements that you can be taking for your general health. And Dr. Austin gives all of her recommendations and thoughts. So go back and listen to that and then jump back into this one. It's going to be great conversation. Also joining us for it is pro triathlete and coach Elizabeth James. Elizabeth came to the sport from a soccer background and quickly rose to the triathlon ranks using TriDot, from a beginner to top age group or to professional triathlete. She's a Kona in Boston Marathon qualifier who has coached triathletes with TriDot since 2014. Elizabeth, are you excited to maybe learn what supplements can take your nutrition to the next level? Elizabeth: Yes, for sure this is going to be a great topic of discussion for today. Andrew: And who am I? I am your host Andrew, the average triathlete, voice of the people and the captain of the middle of the pack. Today we'll get going with our warm up question before moving into our nutritional main set. Then we'll cool down with a nutrition question from one of our athletes in the TriDot family. It's going to be a great show. Let's get to it. Time to warm up. Let's get moving. Andrew: Today's warm up question is inspired by recent social media contests held by our friends at Generation UCAN.  For folks that follow UCAN on social media, they were asking UCAN users to share their best recipe for how they can use UCAN super starch products. We all are used to using our protein powder based nutrition mixes and drinks and smoothies, but if you get a little creative, your favorite sports fuel can be used in many other tasty ways. I saw all sorts of great ideas shared by UCAN on social media and an inspired today's warm up question.  Whether it's UCAN or another favorite product of yours, what is one creative way you have used sports nutrition products in unconventional ways? Elizabeth, I'll start with you. Elizabeth: So I have used UCAN in a couple different creative ways, but I'm sure that you could do this with another sports nutrition product as well. One of my favorites is to make banana pancakes with UCAN and there are a few recipes like on Pinterest that show different variations of UCAN pancakes. I know that you could Google this too. But for me the vanilla UCAN super starch with bananas just kind of tastes like warm banana bread. Andrew: Oh, nice. Elizabeth: It is delicious. Pancakes are kind of a post workout trait for me. And I know that if I'm making them with UCAN it helps me hit some of those macronutrients that I'm looking for in that post workout meal as well. Andrew: Yes, that sounds tasty. I am definitely a big fan of banana pancakes with just a little bit of Nutella or picky bar drizzle on top. Just for a little bit. That's, man, that's so so good. So I've not tried that with UCAN and maybe I'm going to have to now. Dr. Austin, what is something unconventional and different that you do with some of the products that you enjoy using? Dr. Austin: So one of the biggest things I actually do is get people to take their protein powders and incorporate them into things that they usually bake. So if you take a look at a lot of people's diets, they lack protein content, but we also need to get- Yeah, I mean, they don't have the protein content easily in there and they're always asking me for things like “how do I get more protein in?” And so there's a lot of great recipes online that I found that show you how to use your protein powders to make a variety of things including, like sweet potato rosemary bread. I've also seen— Andrew: My goodness. You had my heart at sweet potato. Dr. Austin: Yes, I also have seen a really good one, Andrew, for what's called healthy carrot cake quinoa protein loaf. So a great way just to take those protein powders and maybe incorporate them into your snacks or something that you might put with a bigger meal. That's what I'm always trying to find is how do I get more protein into people's diets. Andrew: Yes, so if people kind of consider you know, what is that baked good that you already like making from time to time and just look for a way to put some protein powder in it instead of doing it otherwise, right? Dr. Austin: Yeah. And I mean, the thing about you know, like a quinoa loaf, you know, like I was talking about is that, you know, if you're on the go, and you're trying to refuel post exercise, you did you work out that morning, you're on your way into the office, it's a great way to actually just fuel your body with carbohydrates and proteins that you need anyway to go in and replenish. So those are the type recipes, I guess I try to get people to look for outside of the typical just like, you know, cookies, bars, pancake type recipes. The other thing that I love to do is to take electrolyte mixes and actually make them into, you know, calorie free, or low calorie gummies. You know, my niece and nephew, both, especially my niece, really loves candy. And one of the things I’ve learned to do is to take those electrolyte mixes and I've got a little, you know, pot that I can heat it up and add my gelatin or pectin, depending on how you're making your homemade gummies and actually make them ones that they think taste good, like candy to actually help them not only recover from any type of light exercise they're doing.  They're not doing anything crazy and just also get that little sweet fix. We take the ice drink- I don't know if you guys have seen that one in stores but I use that as my base to help create the extra flavor and add in the electrolyte mix and then put in my you know, other ingredients and then we freeze them. And the next thing you know you've got very low sugar, if any sugar, candies right to help us off. Handle that sweet tooth but maybe get something a little bit more out of it. So that's another one of my favorites. Andrew: Yes, I know that sounds like an amazing idea. I did see UCAN- One of those suggestions on social media was to take their electrolyte mix, which they call Hydrate, and make popsicles with them. And just like you're talking about Dr. Austin, you can kind of get that dose of electrolytes in a low sugar to sugar free way. The one that I'm going to throw in the ring is that there's a company called Infinite Nutrition that a lot of triathletes are might be familiar with. They have a product called Mud that is a protein powder that has some caffeine in it and is flavored to taste like coffee and I’m a big coffee guy. I like coffee a lot. And, you know, just at this point in my health journey, I won't let myself have Frappuccino anymore. The Frappuccino is kind of the gateway drug into the coffee world in some ways. It's kind of a little coffee milkshake, right? And so just almost like a healthy spin on the Frappuccino is to take Infinite’s Mud, protein mix and kind of blend that into your smoothie and that way it kind of comes out as a nice, kind of frozen, you know protein healthy treat. That tastes like a healthy Frappuccino. On to the main set going in 3, 2, 1. Andrew: Our main set today is brought to you by our good friends at UCAN. Here at TriDot we are huge believers in using UCAN to fuel our training and racing. In the crowded field of nutrition companies, what separates UCAN from the pack is the science behind their super starch, the key ingredient in UCAN products. While most energy powders are filled with sugar or stimulants that cause a spike or crash, UCAN energy powders, powered by super starch deliver a steady release of complex carbs to give you stable blood sugar and provide long lasting energy. UCAN also offer tasty and refreshing hydration mixes and energy bars for when you are on the go. When I was new to UCAN, my first purchase was their perfectly named Tri Starter Pack. It's the best way to discover what super starch powered UCAN products are best for you. So head to their website, generationucan.com and use the code TriDot to save 15% on your entire order. So Dr. Austin tell us what are the dietary supplements that are intended for performance. Dr. Austin: So the dietary supplements that are intended for performance are the ones we actually call ergogenic aids. They're intended to enhance some physiological aspect in order to help the athlete do more work and hopefully do more work in a very safe manner. If you take a look at some of the ergogenic aids that are out there that triathletes are going to jump into using, commonly you'll see ones like sodium bicarbonate. That's like your Arm and Hammer baking soda, beta alanine, which is an amino acid. We can talk about what that actually is, ketone esters, newer one becoming very, very popular, hard to even sometimes get ahold of them at this point. And then there's the more traditional like caffeine, and then others that have come about include ones like beet root, or more commonly, they'll be in dietary supplements as arginine or they'll be advertised is what's called a nitric oxide supplement because that's what you're actually trying to do is to get an increase in the nitric oxide response within the body. Andrew: So we polled our TriDot athletes on kind of what supplements they wanted to hear more about. And we covered a lot of them two weeks ago in our episode on general health, and today, we saved the ones that are a little bit more geared towards sport performance. So let's kind of start with those six or seven that you just mentioned and let's talk about those first. So you mentioned beta alanine. Dr. Austin: Yes, so beta alanine is a non-essential amino acid. It does not synthesize proteins like other amino acids, but it combines with one called histidine to produce an amino acid known as carnosine. Okay Carnosine is stored in your skeletal muscles and it's thought to be a very rate limiting factor and your ability to actually buffer the hydrogen ions that are sitting inside the muscle cell. Okay, so we tend to think of beta alanine as your intracellular lactic acid buffer.  That's kind of a very generic way of approaching it but histidine is usually really high in your muscles and it's the beta alanine that usually low. So that's why supplementation is usually necessary. Elizabeth: Okay, so when you're saying that supplementation is usually necessary for that, does that mean that it would be very difficult to get enough of that just from our day to day nutrition? Dr. Austin: Absolutely, it would take quite a bit. You know, the top food sources for beta alanine are meat, poultry, and fish, but it's hard to eat enough of them to get what the muscles’ actually going to need. So for instance, it's estimated that we would need about 5 lb of red meat in a day to achieve the levels that you get from supplementation. Elizabeth: Oh my gosh, that like gives me a stomachache, just even hearing that. Dr. Austin: Right. So if you think about all the different, you know, nutrition programs that are out there, and even just, you know, kind of the caloric constraints that most athletes do need to operate in, even if you're a high level athlete, you're going to have to use a supplement to get the beta alanine you're looking for. Andrew: So what are the performance benefits of beta alanine? Dr. Austin: So, you know, whenever you think of beta alanine, you’ve got to remember you're trying to provide the body with the rate limiting step in forming that carnosine. And what they have shown about carnosine is that if you can increase the concentrations, it can reduce lactic acid accumulation during exercise and as a result, it appears to reduce fatigue and therefore improve performance, especially anaerobic performance and time to exhaustion. So you might say, “well, Dr. Austin, how does that relate to triathlon?“ and I will tell you that if you're training for your most efficient triathlon, okay, especially in terms of power development on the bike or what have you, you're going to do a good bit of anaerobic work. And time to exhaustion is always something that's really relevant for most triathletes is they're out there slugging away and hoping they just don't quit, right? So at the end of the day, if we're trying to appropriately from my standpoint of view, we're going to be doing some, you know, anaerobic sessions at least once a week, if not, maybe twice a week. And so to have a supplement that enhances our capacity in that regard could be a benefit. When they've tested it out in other forms of training, such as strength training, it does not appear to do a whole lot for you, especially with regards to muscular endurance. It's most effective for athletes training or performances that last one to seven minutes. So typically, I say, you know, look, if you're in a triathlon type situation, you're training the bike like you should, hopefully you train a little bit more like a cyclist (hint hint), you're going to need to learn to sprint, okay, to really develop your power on the bike. And that's where beta alanine could really come in is helping you to develop that anaerobic side so you're very efficient at the actual low end intensities. And I know a lot of people might be sitting there going, “Is she serious? She wants me to train like a cyclist and do a lot of sprinting.” And I'm like, yes, it's actually better for your triathlon performance, at least in Dr. Austin's opinion. Andrew: Yes, athletes training with TriDot are going to be familiar with, you know, TriDot has workouts 30.30s, 30.90s, we have power intervals, we have plenty of things that work that power end of the bike for sure. Dr. Austin: Okay, well, that's good. That's good. We're all on the same page. [laugh] Elizabeth: I mean, thinking about, you know, those workouts and kind of looking for some of these products to give us a performance benefit. So how much beta alanine would I need to obtain a performance benefit? Dr. Austin: So we need to do this relative to the individual and so the dosage is pretty wide. For most people, it's anywhere from 2 grams to 5 grams a day because they recommend 45mg to 65mg per kilogram bodyweight a day. And so, depending on what level of dose you appear to benefit from, and typically we titrate it in, we don't go with all of it all at once, you tend to find that ideal dose for a person. Typically, we recommend taking about 800mg at a time to start the loading process, and to gradually build into it. So you can see if there's any side effects to actually taking it like flushing or, you know, aggravated skin, things of that nature, you might get something like tingling, but tingling usually suggests that it's, you know, working as long as you don't get any additional side effects. And then once we get to the dose that's recommended for your bodyweight if that's doable, we take it for about six weeks, and we do it usually before the peak of the season or during a time where you're heavily focused on that anaerobic training and really want to try and get the most out of it. Andrew: So there's a lot of information out there just regarding essential amino acids and BCAs. In general, for endurance athletes for triathletes, is beta alanine, the primary one we need to pay attention to, or are there other essential amino acids and BCAs that we should consider? Dr. Austin: You know, there are other branched chain amino acids that you should be considering as a triathlete to see if they are needed in your body, okay, and that's typically how I approach it to see if anyone's going to benefit from it. The branched chain amino acids are heavily focused on ones that include leucine isoleucine, and baline. And these are very, very responsible for remodeling your muscles, especially after intense or hard exercise. You know, the weight room is commonly where we're going to supplement with those because of the muscle mass that you're trying to gain. But you'd be surprised at how many people actually don't have enough in their diet to begin with. And so supplementation with BCAs is common in and around key points and times to make sure you're getting the amino acids that will benefit you. Especially if they are a vegan, I find at times that they're just missing a good bit of those branched chain amino acids that are essential for muscle remodeling. At the same time, I will tell you that women use them at times to help alleviate even menstrual symptomology. So prior to their luteal phase, we will dose with anywhere from 5 to 15grams of branched chain amino acids and or a protein supplement to help them alleviate some of the symptoms they experience during that phase of their menstrual cycle and as they go in to their period itself. And it's actually pretty beneficial. There's just a higher turnover of those amino acids during that point in time, and they're needed as precursors for a lot of the stream of training that we do. And so there are some women that when they are symptomatic with regard to their menstrual cycle, we'll put it in to see if it can assist them in that way as well. I would say for most of the women I've worked with, where it does benefit them, about 10 grams of BCAs will do it and they will prefer that even over like a whey protein supplement and get better effects. Andrew: The human body is just so fascinating, you know, when I hear things like that. But tell me this, if someone's looking to supplement branched chain amino acids into their diet because of the workouts they're doing, does it matter if they take those pre post or during their workout? Dr. Austin: You know, in theory, it shouldn't matter when they take it because the amino acid pools are pretty available. You know, it's kind of like you put in the resource and they're supposed to maintain it there. But what's interesting about a lot of people is that if you take a look, and this goes back to my new favorite nutrition app, right, cronometer that we have been talking about, the rate at which they put protein into their body and make those amino acids available is oftentimes very delayed. And so I like to actually put it in before they do a workout and or, you know, after the workout, or sometimes they just say, you know, start drinking it before and carry it with you throughout the workout to make sure you get it in, let it help with your hydration, let it help kind of, you know, fuel you through your strength workout, to just make sure that it's there and available when you do need it the most. So it's really up to you when you want to take it but that's when I have my athletes taking it. Elizabeth: Awesome. Yes. And that's some great insight there about amino acids. Let's kind of move on to caffeine. This is a hot topic for the endurance athlete. Andrew: I love caffeine. Elizabeth: Oh yeahMany, many, many cups of coffee later, for you so far today. Andrew: Three so far. Elizabeth: Okay. So yeah, I mean caffeine, we know that there's an effect there. So how much, when, what form and kind of give us your insights here, Dr. Austin? Dr. Austin: So if you talk to anyone about caffeine, you know, you're going to hear a wide variety of responses as to how well it works for them, and even the type that we're taking in. And what the research literature has shown us is that there's just a very large inter-individual variation as to the ergogenic effects of caffeine and a lot of that has been attributed to your genes. It's mediated from what they can tell by your genotype. And I'm not an expert by any means in genotype, but there is two common SNIPs and SNIP stands for Single Nucleotide Polymorphisms from the CYPIA2 gene and they say, you know, do you have two copies of the A allele, or you carry a C allele. And typically, they say that it's the individuals with the two copies of the A allele that gets the benefit as being a “fast metabolizer of caffeine.” They have suggested that it's very environmentally specific context specific as to how the body responds, but it does appear that there are some individuals who will metabolize caffeine much better back when I was going through school, we didn't have that level of information. Today we do. In fact, then all we knew is that some people would take in the caffeine, and they pee it right out. And they didn't seem to get much of an ergogenic response to it, whereas others took it in and they really didn't lose that much in their actual urine and we considered them to be responders versus the non-responders. And so overall, we've just seen that there's a wide variety responses and that's why you dive into the research literature that says you should take anywhere from 3 to 9 milligrams per kilogram of body weight 60 minutes prior to exercise. And by the way, there happened to be some studies that have shown that less than 3 milligrams per kilogram of body weight appear to benefit you. Or you could just take small frequent doses throughout the, you know, training bout of about one milligram per kilogram body weight every hour, instead of doing it all at once, so there's a lot of different information out there. And what I tell people is, look, you've got to work with caffeine, understand what your body responds to, in order to get the most out of it. And there are some people that just won't respond to caffeine. I mean, they, you know, just seem to be innocuous to its ergogenic effects. And so we have to, you know, we really have to pay attention to how much you need and how much you benefit from, you have to remember that caffeine is going to appear in your bloodstream pretty quickly. And it has a half-life of about three to four hours. So when you're in these really long endurance races, if you are that caffeine responder, you need to keep it coming in during a really long race. And that's where a more titrated effect with the caffeine and the gels is common, or the caffeine and your salt sticks, just because we need to titrate it in sometimes rather than, you know, trying to flush it all in at once because of the half-life of the caffeine Andrew: Is the best way to kind of figure out how we should leverage caffeine in our training, just kind of trial and error? Try different amounts, try different products and see how your body feels? Dr. Austin: Yes, absolutely. I mean, I tell most people to you know, start from the time they wake up and say how much caffeine do I take in naturally, you know, I'm a coffee drinker in the morning, and I'm making a pretty strong cup of my Nescafe and I'm getting a probably about 100mg caffeine at least the way I like to make it. Yes. And so that's going to last me quite a while even through my workout for most days, whereas some people were like, look, I can't take that in, it really upsets my stomach, it causes bloating, distension, and they need to nibble their way through their caffeine, and maybe utilize smaller doses coming in from gels or what have you during strategic training sessions. So it's very individual. I think you got to really start with that smallest dose, which might be what you have at breakfast and see how you respond and then put in 25 mg increments to build it up and understand where your tolerance is. I have some athletes that take 400mg before the start of a race, and they never look back. Just because they're used to-- they do Xterra and they're fast enough that they can get it to last because of how short the time is that they're actually out there. You know, for them, it's short, because they're good at it. And they just go with that. For others, they're like, I could never do that. And they are maybe taking their cup of coffee, and then having small amounts as they go throughout, it just really depends on the individual. Elizabeth: So kind of one more thing on that. I know we were about to wrap it up. But one of the questions that I've had a couple different athletes approached me with is just, you know, how do they know if they've had too much and is there a dangerous level? I mean, we've mentioned you know, some GI distress. Is there anything else that athletes should be cautioned of as they're using caffeine? Dr. Austin: I think they have to be cognizant of whether or not they've got cardiovascular risk factors or any other type of risk factors where high levels of caffeine intake may adversely affect them. And that might be something like high blood pressure or even just like a cardiac arrhythmia, these days, we can actually monitor for that pretty easily with athletes, even with your medical physician, there is like a prescription device out there that you can use to, you know, help assess that with your doctor. I think that's always good to kind of let them know that you may be taking in high levels of caffeine or these energy drinks or pre workouts, and just go ahead and you know, monitor yourself, make sure you're not causing arrhythmias that may long term hurt you, right? I think we've all experienced high levels of stress at some point in time throughout our life, and maybe felt like a twinge of pain in our heart area. I don't know if you guys have, I know I have. And I've sat back and just kind of said, okay, what was that from, you know, and is my caffeine intake, or whatever I'm doing, causing some type of damage that may indicate that I'm going to collapse at some point in time, right. So I think we just need to be conscious that we have the potential with dietary supplements to alter our cardiac function and to be responsible, and I think most doctors want you to kind of bring up or people like myself, you asked me, I'll say, hey, you know, let's go take a look at this and see if we're actually doing something that may be harmful to our body. Elizabeth: Right. Yes. Because I mean, that's the thing, we want it to be helpful for our performance, but certainly not anything that would harm us particularly long term. So I think those are some good things for athletes to think about and be cautioned of as they're using these products in their training and racing. So kind of moving on from caffeine. Could you talk to us a little bit about ketone esters, ketone salts, and maybe why someone would use one over the other? Dr. Austin: Yes, so ketone esters and ketones salts have kind of really ramped into their visibility out on the market here recently. And the biggest one, that is kind of taking over is the actual ketone esters. And the most popular one that I've seen is the actual beta hydroxy butyrate. And it's one of three ketone bodies that are out there on the market that is produced. In comparison to ketone salts, they deliver a much greater amount of ketones. When you look at ketone salts, they only deliver small amounts because they're typically paired to sodium, potassium, or even magnesium. And that formulation approach limits the amount that you can usually take in especially without all the swelling, whereas the ketone esters are formed by binding an alcohol molecule to a ketone body. They're much more concentrated, you consume a large volume of them, despite the taste okay, because quite frankly, everyone tells me they taste horrible, but you can consume a large enough volume of them in a short period of time to actually put the body into deep ketosis. There are a couple brands out there, there is HBMN and then there is ketone8 and they are the ones producing the ketone esters at this point in time. One of the newest ones, it's kind of risen really quickly, but athletes are getting a lot of beneficial effects out of them and the research is starting to be very promising with regards to ketone esters, and its effects on performance, and they're also starting to go down the health road. Andrew: Are ketone esters primarily for athletes that are following a keto-diet or is their benefit for athletes in general, regardless of what your diet is? Dr. Austin: This beneficial regardless of what your diet is if you're looking to somehow enhance your recovery or endurance performance. They've done a study looking at people taking ketone esters daily at about I think it is 20 to 25 grams, and they found that they just had lower levels of like epinephrine, norepinephrine, they recovered better. And at the end of the day, the question is, should you be taking these on a day to day basis? And is it okay to do that? And that's kind of one of my big questions is, you know, do we want to do this daily at that level of intake, or are we possibly not letting an athlete know how hard they've been training? For most of the athletes I work with, we use them to actually help us on race day. We'll take them if it's an Ironman, we'll take it before, mid, and then at the end of the race to help facilitate recovery and performance and it seems to work very well. I also have some people that do like to take them just to put themselves into a slight level of ketosis, but they'll use a smaller amount, just because it helps them feel better. So if it helps them feel better, you know, I just kind of say, hey, you know, that's cool and that might be one approach to it, is to actually say what do smaller doses of the ketones do for us. There are some very contrast studies that are out there with regards to how well the ketone works as a metabolic fuel source, its ability to spare carbohydrates and improve your post exercise glycogen replenishment and impact your metabolic state. So you do want to evaluate it on an individual response. And even one of the scientists with one of the companies, she's no longer there at this point, but she said, you know, we're just finding it really depends on someone's essentially metabolic flexibility as to whether or not they respond to the use of the ketones. Andrew: So maybe this is something that that we try in training and if we find that our body responds well, it helps the way our body feels after a tough session, maybe at that point, we kind of save it for race day, like you talked about. Dr. Austin: Yes, I would say so. Especially because they're kind of hard to get right now. The they become very popular. [laughs] We might be limited in what you can get access to anyway. Elizabeth: So this next part of the conversation we teased a little bit a couple weeks ago talking about sodium bicarbonate. And you know, we mentioned a little bit with Arm and Hammer baking soda, I've also seen this in like amp lotion- What is sodium bicarbonate, and how does it work to enhance performance for a triathlete? Dr. Austin: So sodium bicarbonate is essentially your good old baking soda so you know that Arm and Hammer that probably everyone has, you know, a box of it sitting in their fridge, you know, like using it to help control odors, right? And you never thought that we would tell you to take that same product and put it into capsules. Don't take it raw ‘cause you be in some real trouble. But yes, the sodium bicarbonate on the whole is something that we're probably used to having in the house. It's your Arm and Hammer baking soda in essence and its job when we consume it appropriately, we put it in gelatin capsules, is to absorb hydrogen ions. And these help us you know, by doing this, it helps us to offload what's called CO2. So carbon dioxide, and carbon dioxide is being offloaded whenever we breathe. And you know, when you start breathing really heavy in the middle of a training session is because your body needs to get rid of that, right? And what they've noticed is that one of the benefits that the sodium bicarbonate as your breathing rate actually becomes reduced at a given exercise intensity, predominantly because it is absorbing that CO2, you know, lactic acid, when it breaks down, it creates all those hydrogen ions in the body says, ‘we've got to get rid of this.’ So typically, what I've done with athletes over the years is to actually use it in training versus racing just because some of the side effects with sodium bicarbonate.  You don't want to have any issues on race day, but we'll talk about how to load for race day. Really, it comes by enhancing the quality of your training sessions and the research has shown that. So one of the big areas for endurance performance is that what I call that break point in lactic acid, where you're holding your hands so close to the fire and just saying I do not want to back off, but it would feel really good to back off. Those are typically the sessions that I always say that's where sodium bicarb is going to help you out. It’s going to help you when you've got to do prolonged ones of those, especially if you're a heavy sweater as well. So one of the things we always have to remember about sodium bicarb is that it's going to put some weight on you, predominantly because the sodium says, hey, drink more water, I need this. And so we always have to be delicate with how we're using sodium bicarb because the offset in bodyweight may actually just lead to us getting an equivocal session anyway. So that's where it's important to think about how we're going to load and go about actually utilizing it in a meaningful way. Andrew: So for the athlete, that is interested in using that on race day. What are the primary concerns that they should be thinking through before implementing that into their race routine? Dr. Austin: Well, first and foremost is the potential for some GI distress, okay. It can cause a lot of cramping, gassiness in the stomach and even, you know, sends us running to the bathroom, possibly just because it can act very potently on anything that is in our gastrointestinal system. On the whole, when you take a look at the research literature, there are a different-- some wide variety, I guess you could say, in the types of loading protocols that can be utilized and I think you've got to think about it in terms of am I racing short courses or long courses in order to understand what is best for you. Also, when you take a look at the amounts they recommend, I start at 50% of that with anyone.  Predominantly because most people that are in the studies are like 55 to 80 kilos, which is a very specific weight range. And we have a lot of people that fall below that. And we have a number of people that fall above that, okay. And I realized that very early on when I had some interns at one point that decided to play with sodium bicarbonate and all of a sudden, you know, they weren't too keen on playing with anymore. So I said “What happened?” and they said, “well, we really, we couldn't even get through the exercise that we wanted to do because our stomach got so upset and then we ended up in the bathroom the whole time.” And then I said, you know, and I looked at them, you know, they're more your weight room buffs, right. I said, well, how much do you weigh, and they were between 90 to 100 kilos and they had used the formula that was in the standard textbook. And I think part of what we have to be cognizant about is that you can take too much sodium bicarbonate, and that the research is really reflecting people just within a very specific weight range. So anyway, if you're going to start using sodium bicarbonate, I always say let's start with 50% of what's recommended. And so if you're going to use it acutely, like right before a training session, they say to take it 60 to 90 minutes beforehand and to take 0.3 grams per kilogram of body weight, so I start people at 0.15 grams per kilogram body weight, if they're going to race with it, then I tried to use a loading protocol- and there's a couple different ones out there. I'm a little more biased for Ironman athletes with regards to the loading protocol that I like to see them utilize. And that is a 10 day loading protocol. Where days one through two, they take 25 milligrams per kilogram of body weight, and it's just spread throughout the day, you know, they can take it you know, in however they choose to dose it up. Days three to five is 50mg per kilogram of body weight. Day six to seven is 75mg per kilogram body weight. And then days eight to 10 is 100mg per kilogram of body weight. But you’ve got to do this over a 10 day period, which some people say you know what, that's a lot of work. But it's the one that I have found works the best because you're taking it throughout the day and gradually changing the blood’s pH level. And because you're taking in food, you're taking in your normal hydration, we seem to get the best effects. There's also a recommendation in the literature for a three-day loading protocol where they take anywhere from 0.3 to 0.5 grams per kilogram of body weight and spread it over three to four servings in the day. So again, a little bit gentle, a little more gentle on the body, probably just because the food you're consuming is absorbing some of that and it's a much slower change in the actual pH of the blood. So there are different ways to take it, when you're racing on it, if you want to race on it, or even if you want to train on it, and I think you've got to figure out, you know, what works best for you. But it is very helpful from my experience in terms of getting athletes to optimize performance. Andrew: I know for me, if I'm going to try something like this, that might induce GI distress. I'm 100% going to go for the Dr. Austin 10 day recommended loading protocol method. So essentially, it's tried and true. You've utilized it with athletes. One last question on this though, I know a lot of athletes recently have started trying the AMP lotion that that promises the kind of similar benefits of sodium bicarbonate does using it in a lotion form, kind of mitigate some of the GI distress, does it give the same performance benefit or does or do, we really have to ingest it to get those benefits? Dr. Austin: So it's a pretty new product that's out there. Not a whole lot of research on it at this point to kind of drive the conclusions. But what I will tell you is from talking to athletes who have tried it is that there are those that really seem to benefit from the AMP lotion. And then there are those that say they don't feel anything at all. What I noticed about the ones that really seem to benefit from it is that they are your more aerobic beasts and they struggle a bit more with the anaerobic side. And so I think the dose in the AMP is lower than what you typically take in from the capsule approach that I was discussing. And so I think that's why those athletes that are a little more on the robot side and really need the help anyway on the anaerobic side are benefiting more so from the AMP lotion. So again, it's back to that individual response. And you know, if you've got lactate analyzer and you're familiar with what your blood lactates look like, in key test sets, I would say that's a great way to evaluate it, are you able to actually tolerate a much more anaerobic bout by utilizing a sodium bicarbonate approach to enhancing performance. Andrew: So the next thing we want to cover is, you know, some of those beet products that are- there's a lot of things that are becoming popular and just between beet root and arginine and nitric oxide supplements. Do those three kind of differ at all, and are there any benefits to these for triathletes? Dr. Austin: This is going to be that individual response from me once again. You know, back in the day when they first started out with the whole beet root, it was beet root juice, and beets are very rich and nitrates, which can convert to nitric oxide and the old protocol was to take 70ml of beet root juice containing 6.5ml of nitrate. And if you take a look at studies and this is part of what I think differentiates them, so they’ll have anywhere from five to 11.4ml. And what the study showed was that it increased nitric oxide levels by about 21% just after 45 minutes. And so at the end of the day, the original studies came with beet root juice, when we take a look at targeting, which is again supposedly going to promote an increase in nitric oxide. Those studies do not appear to give us a similar improvement in performance like we've seen in the beet root studies. However, beet root also has had some GI aspects to it and that's one of the reasons they pursued looking at the arginine and in the arginine they were dosing them at about 1.5 grams per 10 kilograms of body weight are about 6 to 12 grams per day to take a look at that, and there was limited effect on their actual nitric oxide production. When you combine arginine with another product called citrulline, it seems to give you a better conversion to nitric oxide. But regardless of you know which approach you choose to utilize, I will just tell you that this area of supplementation really appears to benefit the sub elites, more so than it does elite athletes. And so I think it's really about each athlete, evaluating it for themselves and saying “am I getting any benefits?” You know, some people have shown that, you know, some of the research has shown that it can help you know, blood vessels dilate, resulting in lower blood pressure, and even improved cognition. So at the end of the day, I think you really have to evaluate for yourself. I know athletes who have very low blood pressure, they've tried beet root products, and they just have said, you know, Krista, I did not feel good at all, like I could barely even train. And so I think when they have low blood pressure to begin with, they may actually induce a negative effect because they can't get the level of rise in blood pressure that you would want during exercise to actually drive your performance forward. So it really is individual. I think you have to be careful about using these products, but they're popular in the weight room too-- You look at a lot of the pre workouts, they're going to put some beta alanine in, they're going to put some beet root, they're going to put some caffeine, maybe even some creatine in there. And that is really what is driving a lot of the market with regards to the beet route in the nitric oxide with the pre workouts so it's about evaluating it for yourself. Personally, I just get it from you know, from food. That's the Dr. Austin source and seeing if it can help me be a little bit healthier. Elizabeth: Yes, you mentioned getting it from food. Obviously we've got beets but besides that, what are some other foods that could help us with, you know, increasing that nitric oxide or the arginine? Dr. Austin: Yes, well, I'll give you my favorite one just because I like a good excuse anytime I can have one to take in dark chocolate. Andrew: Yes. Elizabeth: Yes, I'm with you there. Dr. Austin: Dark Chocolate does contain it, but then there are other sources that are out there including red wine, meat, there's always beets right? And then there's watermelon, nuts and seeds, pomegranate and citrus fruits that give you the arginine, the nitric oxide, anyway.  It usually doesn't give you the benefits on performance, but it can help with the health benefits that people should be looking for anyway. So any reason you need to eat dark chocolate, give me a call. I can probably come up with a health benefit. Elizabeth: Like that. [laughs] Dr. Austin: And that's how we should try nutrition forward is finding the health benefits and some of our favorite sweet treats, in my opinion. Andrew: So with so many kind of different performance boosting supplements out there, you know, we just covered a lot of the major ones that you get questions about, but there were a few more than when we polled our athletes that they brought up. So we're just going to kind of run through a few here before we close and just kind of get your thoughts on a few of these that our athletes wanted to hear about. And the first one that I want to mention, that you just brought up is creatine.  Is creatine more for, you know, the muscle guy lifting weights in the weight room, or is there benefit for endurance athletes as well? Dr. Austin: You know, I think there is benefits for endurance athletes just based on some of the research literature that shows even like a gram of creatine prior to doing explosive power sessions in the weight room. It appears to just you know, enhance the amount of work that they're capable of doing. So it's a very acute load. And I think in many endurance athletes, that ATP PCR system is kind of limited anyway. So I think taking a gram of creatine prior to sessions like that, even if it's, you know, maybe it's like 30 second intervals on off, on off, and then a long, long time ago, when they first started developing recovery, drinks or shakes, what have you the powders, there was a company that actually incorporated a gram of creatine into it. They don't make the product anymore and I thought that was pretty smart for hard workout days, where you are going to tap that ATP PCR system. So when athletes turn to me and they say, “I'm just trying to enhance my recovery, what can I do?” Sometimes we take a look at creatine, and we use it much more differently than the average strength and power athlete who's out there loading with it at about 3 to 5 grams of creatine a day. So it depends on your approach. I know some triathletes like to do a lot of CrossFit in addition to their triathlon training and so they may take the more additional approach to create in use and load with it, because they're kind of a dual sport athlete who's looking to gain both sides of the coin. Elizabeth: Awesome. So I'm going end fights there. Another one that our athletes asked quite frequently about was collagen. So thoughts on that? Dr. Austin: Collagen is an interesting one. I, you know, I don't go running down the road and saying, hey, let's have everyone take it because really, you're pursuing the amino acids. It's just a very concentrated form. And at this point, we're not really sure if it's going to matter or not. So my approach with the collagen is to turn around say if that is the form that you desire to take your amino acids in then and you believe it's necessary, then let's go ahead and test it out. As long as it's batch tested, we're fine. Whether or not it’s a powder versus a bar versus a, you know, liquid with collagen in it is going to make a difference, I can't tell you that. But I would think that if you're going to take collagen, you want it in the most concentrated form possible. But on the whole, I think if you're taking your amino acids in the right way that that's the probably the more beneficial dietary supplement pathway to go down. Still a lot out on collagen at this point. Andrew: Okay, no, good to know, good to know. Another product I've seen and I tried this myself personally on the recommendation of another athlete, and I personally didn't feel any effects whatsoever, but there are pills out there that are supposed to work as lactic acid buffers. Is that a viable product that can help some people out or is that just kind of a noise on the market? Dr. Austin: To me for the most part, it's noise on the market. I have seen a few over the course of my career. I can't remember the brand names of them and every ingredient but I will tell you that when it compared to, you know, gradual load with sodium bicarbonate or something of that nature with the beta alanine, it really just dulled in comparison. Oftentimes, what I found is that those athletes who thought they were benefiting from it really needed more sodium, more carbohydrate in training, and they would have performed equivocally well. There might have been a bit of a placebo effect there. So I say you need some solid research before you dive into any of those products, especially because they're oftentimes not batch tested. Elizabeth: Alright, and so another thing that we wanted to make sure that we hit today was like tart cherry juice or tumeric or ginger. Can you give us some insights about those? Dr. Austin: Yes, so tart cherry juice has been around for quite some time. And the biggest question I get about tart cherry juice is the amount of sugar that’s in it. And they say you know, is this of benefit to me, given the sugar content and the fact that I'm really using it to reduce muscle pain and muscle damage, and my answer to that is depends on when you choose to take it. So if an athlete's done a session that's just very exhausting, there has the potential to be high levels of muscle damage, then that's when I would suggest that they take it. Otherwise, I would say you could probably leave it on the shelf and turn around to your everyday cherries that have a lot of additional benefits to give you some of the, you know I'm probably going to miss pronounce this, the anthocyanin that you know help with prevent the formulation of the prostaglandins, which is really what's helping to cause that pain. But at the end of the day, you have to remember that prostaglandins are needed for training adaptations. So what I typically do is tell people just to eat their cherries on a day to day basis, and leave your tart cherry juice maybe for those real muscle damaging sessions like you know, if they're an ultra-runner, take it at the end or take it during the race because maybe that's when it would be most beneficial to you if your stomach can handle it. But on the whole, tart cherry isn't going to do anything extra special for us, I don't think, in comparison to carbohydrates themselves. And muscle pain is a good thing. Sometimes it takes keeps us from doing things we shouldn't be doing. And when we're in pain, we need to acknowledge it. And that's why oftentimes doctors today will turn around even with ibuprofen and aspirin and say, “You're in pain. What did you just do? Oh, you've got a lot of muscle damage. You know what I want you to work through that and I don't want you to take the aspirin or the ibuprofen unless you absolutely need it. I need you to know that you're in pain so you don't go do more damage.” Andrew: No, that's great. I actually tried tart cherry myself as I just saw some buzz going around about it and tried one of the little mini shots of tart cherry juice and so hearing that info from you was super interesting for me. I know it will be for our athletes as well. So the last one we want to bring up. One of our athletes from Denmark asked us to ask you about Spirulina and Chlorella, which are two of the algae is out there that people take for various reasons. Talk to us about the performance benefits there. Dr. Austin: So the approach with those two is that you know, again, you're going down the road of an antioxidant and anti-inflammatory and they also appear to contain vitamins B, one, two and three, iron, magnesium and potassium. So there's some benefit to taking them typically, you know, we take them in a powder form or a condensed liquid form. There's nothing wrong with that. But I would just tell you again, you know, we don't want to overload the body on antioxidants or squelch the inflammation response on a day to day basis because it's our mechanisms for adaptations that signals to the body. So after that really hard workout, maybe where you do need to try and enhance recovery, you know, you might want to take some at that point in time. But on the whole, I would just say that, you know, you don't need it on a day to day basis. That's my personal opinion. It's the same thing with like, you know, these super strong greens that are out there. I just say, you know, hey, look, I could see if you're in a situation where you really do want to kind of control the inflammatory response, why you might look at them. But on the whole, I think it's something better left for the specific occasions that we need it. Andrew: Yes. And that's super interesting, because I think your everyday athlete and I certainly, you know, have always viewed inflammation as a negative, that we should be fighting, right. It's a force on our bodies that is a byproduct of working hard, that we, you know, should be trying to mitigate to enhance our recovery. We forget that there is kind of the perspective you're talking about where there's almost a plus to having some inflammation and knowing that your body has done the work and knowing that that pain there is a result of the work that you've done. So I think that's really good perspective for folks to hear. So thanks for sharing that. So let's move to this, you know, we've talked about a lot of different products. Are any of these things we've covered today, just absolute 100% no brainers that we should all be taking to boost performance or maybe put another way: if an athlete out there wants to try a couple of new things, what would make your short list of recommendations? Dr. Austin: It would be the beta alanine and the ketone esters from the performance side. So I would just tell you, those two are the ones that I try to talk to athletes about these days. They're pretty knowledgeable on caffeine. And if they're going to try two new ones, those are the two that we seem to be trying the most. Elizabeth: So then on the other side of the spectrum, you know, have the popular products on the market, whether it's ones that we've mentioned or others that you're aware of, what are the ones that just aren't worth our time and our money despite all of the marketing hype that they're receiving? Dr. Austin: There's a lot of those. [laugh] I really tell you, when you do a consult with me, I tell people, we're going to know why we do what we do. And if it's making a claim that, you know, seems a little sketch, or seems almost too wonderful to be true, know that it probably is. Andrew: When athletes are trying a new supplement and kind of testing it to see if it will provide a boost for them, what differentiate we actually be able to see in our day to day performance with some of these products? Dr. Austin: You know, I look at a couple different things with triathletes, it's pretty easy because we can always go in and do an FTP test or we can take a look at five second power, five minute power, 20 minute power and see if they're generating even in their files, right, new performances while they're actually on that dietary supplement. The FTP test is kind of my favorite just because it's so simple to administer. I also look at things like, you know, are they handling a higher training load and still reporting improved recovery. If so, then I think we're doing something that benefits them. If they're not, then I turn around say, well, I don't know that we've really done something that's giving you anything. You know, really, supplements, I think, on the performance side are more for those athletes who are advanced and they are kind of plateauing from a performance perspective, and they're trying to look for that next, you know, 0.5% to 1% gains. I know in one of the athletes I'm working with right now, we had a huge jump and FTP Just because of bringing the bike back up, and we did that with your standard multivitamin and mineral and just eating healthy food, having our carbohydrates, and when we get almost a 30-watt improvement in FTP, just from doing that, I think we're going to be hard pressed to find something that's that much better. Elizabeth: Wow. Yes, that's fantastic. Dr. Austin: Yes. So if the trainings right, we can see jumps like that, especially if we're patient enough to actually do the training process that we need, right. So, you know, I would just say that if we do everything right, and the training loads, managed appropriately, we're going to get our gains. Now, the interesting thing will be as we continue to take a look at the athlete, you know, now we're supplementing with beta alanine, what kind of additional gains do we get and is it really worth taking it. I know this athlete had tried some other products, like you know, beet root powders. I think they had also tried l carnitine, just you know, a powdered version all batch tested, but they really came off it and said, you know, I don't think it's actually helping me. So as they get further along their training, we'll take a step back and say, you know, what is this beta alanine doing for us? Is it something that's truly benefiting? Because when an athlete's been, you know, kind of down a path where they haven't gotten a lot out of training, and then all of a sudden training’s restructured and they just get this big jump in power and performance, I sit there and say, okay, now how are we going to better that? Is a supplement really going to give that to us? So I think it's important for athletes to take a step back and maybe appreciate the training process a bit more. Great set, everyone. Let's cool down Andrew: For our cool down today, we have a question from a member of the TriDot family. The more we've had Dr. Austin on the show, the more I started receiving questions from our athletes on people that want to know specifically, some things about their own diets and nutrition plans and things they've heard on the podcast they want clarifying questions on and I love that.  I love getting athlete questions asked on the podcast. I love asking the questions that you, the people, have. And so today we have a question from Jeremy. Jeremy: This is Jeremy from Blowing Rock, North Carolina and I would love to ask Dr. Austin a question. A couple of weeks ago, I ran a half distance for only the second time and felt like garbage afterwards. Very nauseous. And want to avoid extra salt on anything. I might have to rethink that after listening to Episode 30 of the podcast. Can you recommend a pre-race nutrition/hydration plan or template that I can start to consider? Andrew: So Dr. Austin, this sounds like an athlete who listened to your recommendation on really paying attention to taking in enough sodium when we're training and racing and he's kind of recognizing that he probably isn't taking enough. What are your recommendations for athletes that are in that boat that want to kind of start trying to use more sodium in their training and racing? Dr. Austin: Yes, so what I would first and foremost tell him to do is go back to that hydration podcast and listen to some of the recommendations there about rehydration with electrolyte beverages. I think that's actually one of the most crucial steps for any athlete to help get their sodium levels correct. The other thing I have done over the years with people who tend to get nauseous and a lot of that nausea comes from the lack of sodium and all the lactic acid that's generated is to try and hydrate them the night before, with about 1000 to 2000mg of sodium just to do real gentle so it doesn't you know, it won't result in a lot of swelling. And then the morning of, to make sure they've got about 1000mg prior to the races well, and it just tends to give them that extra sodium that keeps the nauseous or the nausea at bay. That's all very individual. Not everyone responds well to it. But it is a strategy. It's an approach. And even for really hot races, I will tell you that I use a sodium loading protocol that you know, the few days going into it, if we're not doing the sodium bicarb loading in the 10 days in advance, I will just use like my salt sticks and have them load with about 5000mg extra and the day beforehand or maybe even a couple of days beforehand, depending on how they respond to it, just so they can get that extra fluid in their body. Andrew: Elizabeth, I know that you're somebody who loves kind of long course racing and that's where electrolyte balance can really especially come into play. What is your strategy for electrolytes and what have you done in your own training to test what works best for you? Elizabeth: And so kind of pointing back to that episode that we did on hydration. I focus a lot of my planning for electrolyte replacement around the sodium replacement. And you know, the other electrolytes like potassium, magnesium that are included in many of the nutrition products kind of just take care of themselves when I'm focusing on the sodium intake. And you know, I won't spend any more time going into all of the science with the, you know, gastric emptying and how that fluid is absorbed through the intestines. I know that we've done a great job covering that before. But I would say, you know, kind of, as we've talked about in a lot of these other supplements, and other nutritional things that we've covered is I've taken the time to experiment with different levels of sodium intake and electrolyte replacement, just to really find where I feel best and perform best. And that's been the greatest way for me to really see what's going to work. Andrew: Well, that's it for today, folks. A big thanks to Dr. Krista Austin and coach Elizabeth James for talking us through performance enhancing supplements. Shout out to UCAN for partnering with us on today's episode. As UCAN slowly takes over my pantry, the newest UCAN product I am loving is their chocolate almond butter energy bar. Head to generationucan.com to check those out. Enjoying the podcast?  Have any questions or topics you want to hear us talk about? Head to https://TriDot.com/podcasts/ and click on submit feedback to let us know what you're thinking. We'll do it again soon. Until then, happy training. Thanks for joining us. Make sure to subscribe and share the TriDot podcast with your triathlon crew. For more great tri content and community, connect with us on Facebook, YouTube and Instagram ready to optimize your training head to TriDot.com and start your free trial today. TriDot, the obvious and automatic choice for triathlon training.
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