Fast Talk Femmes Podcast: An Athlete’s Guide to Gut Health with Dr. Allen Lim

Sports scientist Dr. Allen Lim details the direct correlation between gut health and athletic performance.

FTF EP 123 with Dr. Allen Lim

In this week’s episode, we talk with Dr. Allen Lim, sports scientist and founder of sports nutrition company Skratch Labs. Dr. Lim created Skratch Labs due to the demand for prevention of and solutions to GI issues with the many athletes with whom he had worked.  

Tune in to hear about how optimizing an athlete’s gut health can positively impact an athlete’s performance. Learn a basic overview about the function of our gut, how we digest and absorb nutrients, how the GI tract responds to different circumstances, possible causes of GI distress, possible preventions and solutions for GI distress, ways to optimize the gut microbiome, and valuable advice on what we can do to improve our gut health and performance.   

Catch up on previous episodes of Fast Talk Femmes and subscribe for episodes on Apple PodcastsGoogle PodcastsOvercastSoundcloudSpotifyStitcher, or wherever you listen to your podcasts!

Episode Transcript

Dede Barry  00:05

Hi and welcome to Fast Talk Femmes with Dede Barry and Julie Young. Our guest on this episode is Dr. Allen Lim.

Dede Barry  00:12

Allen is a sports scientist who received his doctorate from the University of Colorado Boulder, and he’s the founder of Scratch labs, a sports nutrition company based in Boulder, Colorado. Allen is a longtime friend and mentor of mine, but he has also helped coach and advise several of the best endurance athletes in the world. Allen’s doctoral work focused on adaptations to extreme stress that work range from studying porters carrying extraordinary loads in the mountains of Nepal to quantify the physical demands of professional cycling.

Dede Barry  00:42

After graduating from CU Boulder, Alan worked in the pro cycling world tour as a sports scientist and coach for the phone act Tia CRAF, Garmin, and Radio Shack professional cycling team. Specializing in Grand Tour events like the Tour de France, he helped usher a wide range of innovations that included using biological markers to detect doping, the use of portable power meters, and GPS enabled computers to quantify training load, a host of strategies to better manage body temperature and extreme heat, and a wide array of sports nutrition innovations.

Dede Barry  01:16

After leaving the pro tour in 2012, he founded scratch labs because so many athletes he was working with in professional cycling had been experiencing GI problems, and he had developed solutions that he wanted to share with the larger endurance athlete community. While Allen no longer coaches athletes professionally, he continues to volunteer as a coach, mentor, cook, and sports scientists for several professional and Olympic endurance athletes. Our discussion with Allen will focus on how to optimize gut health to positively impact performance. Allen, thanks for joining us on Fast Talk Femmes.

Trevor Connor  01:51

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Dede Barry  02:30

Alan, thanks for joining us today. Yeah, thanks so much for having me. Our intro barely scratched the surface of all the cool projects you’ve been involved with over the years, but I was hoping we could kick off with you telling us about what you’ve been up to most recently,

Allen Lim  02:43

most recently, I have been learning to take a little bit of a back seat and let my team do what they do, which is, you know, run and operate this sports nutrition brand scratch labs, it’s my day to day, it’s what I spend, you know, 100% of my time on. We also recently opened up a scratch labs cafe, downtown boulder this January. And that serves as kind of not just our retail flagship, but also a place where we wanted to plant a flag for our community have a place where athletes, runners, cyclists could come and start their days and end their days and really showcase the idea that sports nutrition isn’t just what you tear open in a package but it’s also what you make in your own kitchen. And it’s also the value of connecting over food and overactivity right that, you know, when I think about sports nutrition, I don’t just think about it as carbohydrate, fat and protein, I think about it very much holistically as part of being in a community. And so I’ve been spending a lot of time in the cafe lately. And beyond that, riding my bike and just still doing a little bit of coaching. Alan,

Julie Young  03:49

I can’t wait to visit your cafe. Sounds amazing. Yeah.

Allen Lim  03:52

I can’t wait for you guys to come. We need to do a little summer camp JT.

Dede Barry  03:57

Yeah, definitely. It’s on my bucket list. Yeah,

Julie Young  04:00

we’ll get together the new generation. So Alan, to start off our conversation today and just provide some context, would you provide a basic overview of the anatomy and function of the gut?

Allen Lim  04:12

Yeah, so let’s talk about digestion and sports, nutrition and GI distress and all these different topics. But to begin, you have to really understand how the whole GI system works, right. And the gastrointestinal system is one of the biggest organs in the entire body, right? It’s probably one of the most important and it can fatigue and failed during exercise. And so there’s some important implications. But the GI tract, it basically starts with our mouth, right. And the GI tract is basically a continuous organ from our mouth down to our anus. It starts in our mouth, and that’s is where digestion begins. digestion begins when we either chew or swallow food. And as for example, when we’re chewing food as we begin to masticate that food, there are digestive enzymes in our mouths, that starts to get released. primarily something called amylase, which breaks down carbohydrate. From there, this chewed up food or bolus goes into the stomach, the stomach, which is connected to the mouth via the esophagus, the stomach is basically a big reservoir, okay, and it is more than anything, storage vesicle, where all of the food and water is mixed. And we’re digestion continues where effectively hydrochloric acid and other digestive enzymes are released to liquefy. Anything we might have eaten, by the time something is digested, it is turn, essentially completely into a liquid. And from there, there’s a little connector between the stomach and the small intestine, called the spinal cord sphincter. And that little sphincter slowly trickles or releases empties got liquefied foodstuff, into the small intestine. And in the small intestine, you can continue to get some level of digestion, there are still digestive enzymes that will continue to break anything apart. But now, you’re not just liquefying things, you’re breaking things down into single little sugar units or fat units or protein, amino acids, right. So you’re going say, for example, from a very complex carbohydrate, with potato, or bread or rice, all the way down to the very single glucose units that make up those starches. And it’s those single units that are then transported across the small intestine into the bloodstream, into the liver, and then from the liver out into the rest of our circulation, right. So there are a lot of steps from drinking or eating something for it to literally enter into our bloodstream to go to our muscle cells, or our brain cells or any of our other cells, there’s still a lot of excess stuff that doesn’t get absorbed right by the small intestine. The small intestine absorbs electrolytes, the micro and macro nutrients. It also is the place where water is absorbed. But all the excess fiber things that aren’t absorbed, that eventually turns into feces. It goes down into the colons and then it’s later excreted. Right? So that’s effectively the process. I think that for me, where people get confused, is this distinction between the stomach and the small intestine, right, or the stomach and the gut is the stomach where things are held up and ultimately digested, liquefied, but it’s really the small intestine, where all of this food stuff is transported into the body for, you know, to nourish us. That’s the really quick overview. That’s perfect.

Julie Young  07:54

And let’s just take a deeper dive into the function. And if you can help us understand individually, like the digestion, absorption and emptying process, so like for example, with digestion, how are the different macronutrients digested? Yeah,

Allen Lim  08:11

so you have fat, basically, you have carbohydrate, and you have protein digestion occurs, both through eating, chewing, that mastication that breaking literal, physically breaking apart is part of that step. But then there are enzymes and or acid in both the mouth and the stomach, which continue to break apart big molecules into smaller molecules. So for example, you take something like, I don’t know, spaghetti, or typical noodle, right? This might be comprised of, you know, 1000 to 5000, individual glucose units, right, and think of each glucose unit as a Lego piece. And so when you eat, you know, a thing of pasta, what you’re really eating is, you’re eating this thing that is built up with a bunch of different Lego pieces into one big solid piece. And the act of digestion is breaking apart that object into the individual Lego pieces. The same is true for protein, right? You have this very complex protein that’s constructed out of these different types of Lego pieces, and you’re breaking down that protein into individual amino acids with fat. Same thing, you know, you’ve got big, big chains of fat molecules that are effectively packed in a way where they can be soluble in water, they can actually be transported across the gut. In any case if digestion is breaking apart the big object into the distinct Lego pieces emptying is the emptying of that liquefied or pre digested material from the stomach into the small intestine. Uh, there’s still some digestion that occurs in the small intestine. But principally, the small intestine is now responsible for what’s called absorption. And absorption is when you actually get those macro and micronutrients from the outside world into the inside world. So one thing to clarify, you know, as much as we might think of putting something in our mouth, as if we’re putting it inside of our body, the reality is, is that the gastrointestinal tract is a big tube that is continuous with the outside environment. If you’ve ever taken one of those little water toys, it’s like a little thing you try to hold, it’s filled with water, but it’s strapped in on itself, and it keeps on sliding out of your hand, right, because it just keeps on rolling over. So effectively, you know what our GI tract is, the GI tract is the inside of that. And so we could literally roll ourselves inside out through our GI tract, which would be really, really weird. But the inside of our mouth, the inside of our stomach, the inside of our small intestine, is still the outside world, even though it might be internal to us. So absorption is when things actually cross a membrane, the intestinal barrier gets into our bloodstream enters something called the portal vein, which goes to the liver. And then the liver spits out these nutrients. You know, as an example, you know, we can absorb a few types of simple sugars, glucose, we can also absorb fruit sugar, or fructose, we can also absorb a sugar called galactose. But by the time it hits our main circulation, after it goes to the liver, the liver converts all of those sugars into one single sugar, which is glucose. And it goes from there.

Julie Young  11:47

Are there any differences in terms of the macronutrients and how they empty or absorb? Yeah,

Allen Lim  11:54

we’ll probably need to include water in this conversation as well, right? I think that the main differences are going to be speed of digestion, and then likely the speed of absorption carbohydrate, for the most part, there are a lot of pathways for that absorption, fat absorption is going to be a little slower, it’s going to be the slowest amino acid absorption is going to be somewhere in between. So there is some speed difference in terms of how quickly you’ll absorb amino acids, break them down, etc. I think with respect to exercise and exercise performance, we’re really just concerned about carbohydrate absorption or interested in water absorption. What’s unique about maybe carbohydrate absorption is that at the end of the day, we’re really pulling in either fructose through fructose transporter, or we’re transporting glucose through another transporter. And so there’s effectively a different door for both glucose and fructose. And so when we give athletes or athletes are given carbohydrates that have a combination of fructose and glucose, we get a higher net absorption of carbohydrates because we’re using both doors for that active transport than a single door I’m not really aware of there’s a combination of certain amino acids that heightened that absorption. Protein is not immediately available for use as a fuel source anyways, and so it’s never really mattered. And most athletes that I know, especially endurance athletes aren’t using much protein to fuel activity, they’re using it for recovery, etc. And at that point in time, while it might take longer, I don’t think the timeframe is all that relevant. More relevant is also the impact of carbohydrate absorption, sodium absorption on water absorption. So normally, water will move passively across the small intestine via a process called osmosis. And Osmosis is simply the movement of water across a semi permeable membrane from a gradient of low to high. So water is very attracted to moving in a direction where it’s diluting the other side or moves towards the more concentrated side. This also assumes that this membrane allows water to move across it but doesn’t allow other molecules to move across it. Right. So if I drink plain water, there’s this natural gradient for water to move into our body because the blood on the other side of that membrane is pretty concentrated, right? It’s got a molecular concentration of about 280 joints with 90 whereas plain water has no concentration. As long as whatever I drink has a molecular concentration that is lower than blood, water will passively move across, right. And so if I drink something, and it has, you know, a pretty low molecular concentration, then that water will move across that being said, another way that water can move across the small intestine is through a process called facilitated transport. This was a mechanism that was discovered in the 1950s or so by a US Army captain who was trying to understand you know how to hydrate individuals with different intestinal diseases or viruses like cholera, where diarrhea can be a real real issue. What he discovered was that if you have some carbohydrate, and some sodium, that the CO transport of sodium and glucose opens up a water channel that moves a ton of water across the, I think exact stoichiometry something like for every two molecules of sodium that you have, and one molecule of glucose, you open up a channel that can move about 210 220 molecules of water, right, so this is called facilitate transport of water. And this is why oral rehydration solutions like Pedialyte have so much sodium, and a little bit of carbohydrate. This is also why a lot of sports drinks have both carbohydrate and sodium because the addition of carbohydrate, and sodium will help move water across a small intestine faster than osmosis alone. One last thing to recognize is that if I drink something with a bunch of carbohydrate, even if it has a concentration that is higher than blood, that as my small intestine is transporting the carbohydrate molecules from one side to the other, that drops the molecular concentration, and eventually water will follow towards that higher concentration. So all of this stuff is happening in real time. It’s all interrelated, and it’s all dynamic. And so just because you might drink something that is highly concentrated doesn’t mean that that water will eventually absorb just means it might take some time.

Julie Young  16:53

So is there like a ratio, I guess, when you’re working with athletes in terms of getting this absorption, so they’re coupling it with sufficient fluids?

Allen Lim  17:02

Yeah, I think that one way to think about it is that all we’re really trying to do is not cause a traffic accident, the small intestine does have a really big absorption capacity. It’s like a big highway. But if you dump too many cars onto a highway, in any given one spot, or in any given timeframe, there is the possibility that you’re going to get an acute traffic jam. And it’s this acute traffic jam. And it’s too many traffic jams happening, that eventually causes GI distress, where all of a sudden, you have so many molecules or things in the small intestine, that you’re forcing water from inside your body, into the intestinal lumen to try to help dilute that stuff as it’s getting absorbed. If too much water moves into the intestinal lumen. That’s when you can get things like, you know, this bloating or distension, that sometimes athletes feel when they’re consuming too much while they’re exercising. At the same time, you know, in worst case scenario, there could be enough water that then doesn’t get reabsorbed, it moves further down the large intestine into the colon. And that’s where you get some exercise associated diarrhea. I think one thing to recognize about exercise, which makes all of this a little harder or hampered, is that there’s not as much blood flow going to the intestinal membrane or the small intestine during exercise, because a lot of that blood is being diverted to working muscle or to cooling. In addition, as body temperature increases, the intestinal barrier itself can get less effective and even begin to fail. So the intestinal barrier is a very, very, very thin barrier, keeping the outside world from coming into the inside world, right. And it’s formed with these cells that form these really tight junctions against one another. As body temperature increases, there can actually be some failure of the intestinal barrier, such that those tight junctions between cells ends up getting a little leaky, right. And when that happens, there’s no longer organized movement of nutrients, one direction versus another becomes a bit of a free for all in terms of where things are going. So what we try to do with athletes is more than anything, to try to be really, really consistent about their eating and their drinking, so that they’re not trying to get everything in at once. If they if we know they need, for example, 100 grams of carbohydrate over the course of an hour. Whether that be by food, or you know solid food or by liquid. We’re going to do our best in either situation, to make sure that things happen evenly. The problem is, is in racing competition, you might only get finite periods of time to drink and eat. In this case or the scenario. For example, when I was working Grand Tours What we found was that solid food worked really well in this circumstance. Because in one given period of time, someone could eat a bunch of solid food, that solid food would be held up in the stomach, the stomach would serve almost like a traffic light at the beginning of a highway. And as the stomach metered the emptying, that would allow digested food to consistently trickle into the small intestine, where it then could be evenly absorbed. If we tried to put too much calorie in liquid form, we would then bypass the stomach, we will load up the small intestine with all of this extra carbohydrate, which still need to get broken down or if it digested too fast. Now you have basically too many things to absorb at once, this was a case that could cause osmosis cause water to go the other way that could cause GI distress. And so what I tell athletes is, you know, if you have these kind of maybe finite periods of time to get food in, make sure it’s solid food, if you are using liquid calories, to make sure that you try to meter that liquid, so that you’re not trying to drink the whole bottle at once, if it was super high in calories, and or what we have found over the last few years that there are some very, very complex carbohydrates that are still soluble, like this carbohydrate called highly branched cyclic dextran, that we use in our super high carb product that does allow you to drink more of it at once, without causing a lot of GI distress, because it breaks down slowly enough in the small intestine, not to overwhelm the gut, or the small intestine. So there are a lot of ways to skin this cat, right. And it does take some experimentation at its simplest form, I recommend low concentrated sports drink with plenty of salt, right enough salt, replace what you lose in your sweat, and then just eat regular solid food. That’s like the simplest solution, if somebody has GI distress, rely on solid food with a very low concentrated sports drink. But as we become a little more sophisticated, and athletes get a little more sophisticated, they learned that there is some combination of liquid versus solid that they can get away with. A lot of it maybe depends on temperature as well. So like in really cold conditions in the classics, for example, most of those athletes just rely on liquid food, because they don’t actually need to drink as much, their water demand is less so they can load up the calories. And then you know, basically one bottle with 100 grams of carbohydrate is sufficient for the whole race and hotter temperatures like in the tour, you know, they might go back to using a lower concentrated sports drink. But because they’re drinking so much, they actually make up for the calories that they need. But it’s at a lower concentration, they’re just consuming so much more of it. And then a little bit of additional food to supplement that. There’s a very interesting kind of origami here. But in terms of an overall visualization, you need to think of trying to control the traffic jam of what you put onto the highway. That’s

Julie Young  23:17

that’s a really interesting perspective. Because I’ve, I’ve read studies that basically say it doesn’t matter that if it’s liquid or solid in terms of how it absorbs and empties. But I think what you’re saying is the liquid definitely does absorb and empty quicker.

Allen Lim  23:32

Yeah, by the time you get to the level of absorption at the small intestine, it’s all liquid anyways. But when you’re starting out with a liquid versus a solid food, what you’re skipping is the digestion and the emptying phase. Right? And so liquid carbohydrates, they will empty very fast from the stomach. And maybe what we’re really talking about here between solid versus liquid is we’re talking about gastric emptying or stomach empty. We’re talking about one thing having a very high rate of gastric emptying, which can put a lot of load on the small intestine, and a time period versus solid food, which has slower gastric emptying, which spreads out the demand on the small intestine. Interesting.

Dede Barry  24:19

Oh, what do you think contributes most to the individual variability in terms of being able to tolerate liquids versus solids, especially while exercising, for example?

Allen Lim  24:31

Yeah, I think a lot of it has to do with variance in intestinal surface area. The small intestine is already very large surface area, say on average, that of a tennis court, right? So you have a lot of room for absorption, but somebody who is bigger, taller, etc. who just has a bigger torso, physically larger small intestine is going to have much larger surface area than somebody who is smaller. I don’t know if the caller needs, though, are in proportion. So someone bigger may have proportionally more surface area, but doesn’t need the same number of calories in proportion to that increase in surface area, right, as we increase like an inch, the surface area of the small intestine can, you know, increase at a much more exponential rate than say energy expenditure does. And so I think smaller individuals, smaller people might have more of a disadvantage, when it comes to just the total surface area for absorption, another issue is going to be your fitness level, right? Somebody who’s very, very, very fit, unless they’re exercising all out there, distribution of blood flow is going to be relatively different than somebody else, right, they’re gonna have more blood flow going the small intestine, because they can afford it, because they have a greater cardiac output, they have a greater blood flow, I think the another third is going to be your environment, right? When it’s hot, you’re going to be redistributing a lot of that blood to cool you off. And that’s going to force more competition in terms of blood going to the small intestine. So, you know, hotter temperatures are usually when you see a lot of GI distress, not just because of the stress failure of the small intestine, but because of temperature. But because, you know, you now have a competition for where blood flow is going. All of that can add up to a lot of variance. And then the other side of that is going to be, you know, hey, how many how many calories you’re actually trying to put into yourself? Right? And does that match your need? And what I tend to see is that I see a lot of athletes, especially amateur athletes, they think that they can eat their way into fitness, reading, they know they’re going into a competition or event and that they’re undertrained. And so they think that by just consuming more food, they’ll have a better chance of surviving it. But the reality is, is they just make the situation worse. Yeah. So overconsumption is a big issue, especially when people are scared. Yeah,

Dede Barry  27:01

I hadn’t really thought about it from the perspective of like, body size and size of your small intestine. But I guess that may contribute to why women have a higher likelihood of experiencing GI distress, right. Are there other factors? Is there any correlation to the times of the menstrual cycle that affect gastric emptying, for example?

Allen Lim  27:22

Yeah, I don’t know. There could very well be, yeah, that could affect blood flow that obviously affects the function of so many different organ systems. I don’t have a clear answer. And I haven’t read a lot on that particular topic. Because it’s really, really hard to study, right? It’s hard to, outside of an animal model, actually look and observe absorption during exercise. And so a lot of what we understand is more symptomatic and big picture than it is little picture. I would be interested to know even from your perspective, do you feel that they’re within your menstrual cycle, that you feel that you can tolerate more carbohydrate or more fuel than in other times? I

Dede Barry  28:05

feel like there’s certain periods where I need more fuel. Julie, what about you?

Julie Young  28:09

Yeah, I mean, I think I would agree with that. Like, there’s times where just feel voraciously hungry, and can’t seem to get enough fuel. Yeah.

Allen Lim  28:18

Does that affect how you absorb? Let me know, how about this asked another question. Are there times where you guys feel like, you’re more prone to GI distress?

Dede Barry  28:29

That I haven’t noticed personally? What about you, Julie?

Julie Young  28:32

I have not I feel fortunate because I don’t feel like I’m very sensitive to GI issues. I feel like I can basically eat anything. And I just don’t seem to be that sensitive.

Dede Barry  28:42

Yeah, I would say I’m really similar. But I know a lot of women that like a lot of former teammates, and women athletes that I know, struggle a lot with GI issues, but it hasn’t been a problem for me personally. Yeah,

Allen Lim  28:55

I think another issue is going to be inflammation, right? And what is your inflammatory load, that can be a little harder to measure sometimes, right? There are easy, simple ways to measure how inflamed somebody is. But certainly, in the same way that you know, you’ve got this large surface area of skin on your body, the small intestine, your whole entire GI tract is continuous with that skin, it’s the skin within within you that skin is inflamed or irritated. It’s not going to function as well. This is where you have situations like irritable bowel syndrome, or you know, Crohn’s disease and other factors that inhibit absorption and digestion.

Dede Barry  29:39

So coming back, you spoke to how cyclists kind of mitigate or manage their fuelling practices to avoid GI issues. But is there any difference between how runners do that versus cyclists because I know you’ve worked with a lot of runners as well. Yeah.

Allen Lim  29:54

I think that it’s a bigger issue in runners than it is in cyclists. Cyclists are are generally static, you know, in terms of what their torso is doing, they can drink a lot, they can eat a lot, they can carry stuff with them, they have water bottles on bicycles, etc. So they actually even logistically have access to things. But runners don’t have the same ability to carry as much food and drink as cyclists do. And they’re usually in areas, especially the sale of, let’s say, an ultra runner where, you know, it’s more remote, right? The other part of it is that they’re bouncing up and down. And that physical jostling can really affect some of that comfort level, it affects the comfort level in the stomach, which is trying to digest and now you’re just having food and stuff sloshing around and affects things even within the small intestine, the large intestine in the colons, runners, for example, have a greater or higher total fecal rate turnover, right. And so their transit rate, their transit fecal rate is actually much higher than other athletes, because they’re running so much. And their physical motion literally pushes things out of the system, that actually decreases the risk of colon cancer, because you don’t have feces, sit up the walls of your colon for long periods of time, the stuff moves literally out of there quicker. But I do think that this presents a lot of different issues. For me, my advice to runners has been that you end up having to choose your battle between fuel and speed. And that sometimes, by just stopping, taking the time to then eat and drink, you can potentially go faster than if you’re trying to eat and drink on the fly. And so for many of the runners that I work with, we kind of count the difference between blazing through a feed zone and trying to gather their supplies, and eat and drink versus what’s the total difference in time if you just took two minutes to stop, drink, eat, reload, and then continue. You know, a lot of these issues came to kind of the forefront for me when I was working with Gwen Jorgensen. He was the Olympic gold medalist in triathlon at Rio in 2016. And then she went to Nike to become a runner, her goal was to run in the marathon. And even at the intensity that they run at, there wasn’t enough time as they were trying to get oxygen in her ventilation rate was so high, that she couldn’t even take a time time to drink, right. And so what we ended up doing was we ended up doing a lot of pre loading right before the start of the marathon, and also in the week ahead of the marathon. And so the week before the event became really, really critical in terms of extra carbohydrate loading, the amount of glycogen that you can hold in your legs is fairly plastic, so the more carbohydrate you eat, a week before competition, the more glycogen you will load, right? While carbohydrate loading sounds old fashioned, it really isn’t. And it’s still one of the kind of biggest performance boons because it then decreases how much you have to actually eat during competition or a race, you need about 2600 calories of carbohydrate to get through a marathon and average person only can store about 2020 200. So the marathon is so interesting, because it’s about 300 to 500 calories, short of a happy meal, what you can do, what’s stored there, what we would do is like the night before, the morning of, we would basically have her drink water with a concentration of sodium in it that was equal to saline, to effectively get her to hold more water in her bloodstream and have her pee less for the water that she was drinking. While that might make an athlete feel heavy and bloated, that’s extra water that you don’t have to then consume when you’re competing for racing. And that we develop the super high carb product with these really complex carbohydrate, specifically for when to drink. About five minutes before the start, we would combine that with a ton of salt as well to help with absorption. And so she was effectively drinking half a liter with about 1700 milligrams of sodium in it with about 80 to 100 grams of carbohydrate, drinking all of that five minutes before the start. That was kind of the recipe for her and it worked for her. I know it’s worked for a lot of other runners and cyclists who you know, then have a lot more buffer to work with.

Dede Barry  34:41

That’s fascinating. Hey, Alan,

Julie Young  34:42

I’ve heard some of the elite marathoners are habituating themselves to dehydration. Have you heard about that? I mean, it’s kind of like they there’s this give and take, they’re dehydrated, but they also feel like they’re lighter. Yeah,

Allen Lim  34:56

well, there’s this kind of idea. I’ll maybe talk about two sides of that. plane. One is this idea, I call it it’s kind of the helicopter hypothesis, which is this idea that, at a certain point, you can’t put too much fuel on a helicopter, because it gets so heavy that it won’t fly. And so helicopter pilots are always trying to optimize their fuel load. Because there’s how much mass you that optimize the flight and the performance of that flight? Versus Do you have the fuel, right to actually fly. And one of the issues or one of the thoughts with any cyclist or runner or athlete who thinks that there’s a power to weight advantage to be gained this idea that if I dehydrate, and if I have less total body water on board, maybe I’ll be lighter, and my performance will ultimately be optimized. There are two ways that you can think of that particular dehydration, you can think of that dehydration as either intracellular dehydration or extracellular dehydration, you know, are you dehydrating the cells themselves in the water they hold or you dehydrating for the water around those cells? I think generally speaking, when you’re talking about an aerobic performance, it’s the water around cells is the water in your bloodstream, that is determined of your cardiac output. And so if you can find a way to have a little less total body water, but still maintain blood volume, then yeah, this hypothesis might work because you might be lighter, but you’re preserving your cardiac output. I don’t know how to measure this variable, right? It’s really difficult to measure intracellular versus extracellular water content. So anyone who’s figured it out,

Dede Barry  36:36

they’re freaking genius. And how could you manipulate it, you can

Allen Lim  36:40

manipulate it by the ratio of potassium to sodium that you would take, okay, so you would probably be driving a higher sodium diet with lower potassium because there is an every cell, a sodium potassium pump, that pumps sodium outside of the cell, and potassium into the cell. And the ratio of potassium to sodium, in terms of concentration is always the same. And so if you were to have less potassium in your diet, you would end up having less water in your cells, you would be dehydrating your cells by consuming less potassium, you could be getting more extracellular hydration if you had more sodium. But all of this has a finite amount of manipulation, because your kidneys are the great referee of your sodium potassium balance and your electrolyte balance. And at some point, your kidneys be like What the hell are you doing and try to create some level of equilibrium in terms of body water, total body water, intracellular water versus extracellular water? So yeah, it’s weird, right? But these conversations are had and people are trying to manipulate things. I don’t know if it’s, if it works, or if it doesn’t work or whatnot. But you know, it’s kind of extremists to me, I tend to be under the belief that the more hydrated you are, the more total electrolyte you have, the more total body water, the more resilient the system is going to be. And the faster the system is going to be. That being said, there’s a whole nother thing that has happened in the running world where you see equivalent performances, and some people who stay well hydrated versus people who dehydrate a lot. So let’s say you have two people who exact get the exact same time in a marathon, one person dehydrates to 10% of body weight, right? Another person, you know, G hydrates to 3%, you can see some situations where someone teach hydrates to 3%, and they fall apart and someone else to hydrates by a huge amount and they don’t fall apart. I think that one of the issues is that dehydration across people is not the same, meaning that if I lose a liter of water versus another person, for some people, that causes a bigger drop in blood volume than others. And the reason it does, the difference in these individuals is how much salt they lose. So somebody who loses a huge amount of salt in a liter of sweat, as they lose all of this salt out of their bloodstream. The concentration difference between sodium and potassium inside of cells is smaller. And so by osmosis, they don’t move as much water from inside of cells into their bloodstream. And we maintain our cardiac output in our blood flowing during exercise. By shifting water from inside of ourselves to outside of ourselves, somebody who loses very little salt in their sweat, primarily water. When they sweat a little bit. They get a big osmotic gradient for shifting water from the inside of cells to the outside of cells, because that loss of water causes a relatively higher increase in sodium concentration. So now There’s a greater gradient, let’s just say this. Depending upon how much salt you lose, if you lose a lot of salt, dehydration affects you more than if you lose a little bit of salt. And because how much salt somebody loses in their sweat isn’t something that is commonly measured, we see a lot of variability and how dehydration affects performance without knowing why. And Julie to your original question, this might be why some people won’t drink or find that they don’t need a drink when they’re doing an intense performance right and not be at the same detriment because they can tap into their water reserves to maintain their blood volume and their cardiac output. So while I think it’s very true that some people can get away with not drinking during exercise, and still maintain performances, it’s likely that those people also don’t lose a lot of salt in their sweat.

Dede Barry  40:56

And is that tradable? Like is there elasticity that you could train? It’s a

Allen Lim  41:02

little bit trainable. The literature shows that when we adapt to the heat, that our sweat is more dilute, meaning it’s not as salty. Just like any variable that is trainable, he got to talk about what the genetic baseline is. And the variability in the genetic baseline for sodium loss. And sweat is probably the top three of most variable genetic traits. The gene set that controls how much salt we lose in our sweat is something called CF one. It’s named after the disease cystic fibrosis, because cystic fibrosis patients, they have sodium sweat, that is equivalent to the sodium in blood, they have no ability to spare salt, right and losing all of that salt on a day to day basis. And sweat for those patients creates a lot of physiological issues and problems and a weakened disease state. On the flip side, you know, you’d have cystic fibrosis patient loses 3500 milligrams of sodium and a liter of sweat, you can have someone who’s just mutated to the point where they only lose 200, or 300 milligrams of sodium in a liter of sweat. So it’s real big variance. And depending upon where you are, in terms of shirt size, small, medium, large, extra large, I don’t think training is moving you into another category. You’re not going from an extra large to a large, maybe. But you’re definitely not going from extra large to small.

Dede Barry  42:29


Julie Young  42:30

Alan, do you think sweat testing is valuable? Yeah,

Allen Lim  42:33

I think it’s really valuable. I think it’s super valuable. Because it is such a variable trait. If you are having issues, it’s a problem. If you’re not having issues than likely, whatever you’re doing is okay. And I think that it’s valuable for those athletes who, you know, are having problems with staying hydrated and finding that their performance suffers in the heat, them losing more sodium could be one of the reasons for it. But you have a whole nother crew of athletes who don’t lose a lot of salt. And they probably are like looking at their peers and saying, Well, what’s your issue? Like, just grab a bottle of water, drink it when you’re thirsty? And don’t worry about it with those

Julie Young  43:15

test results vary if done in a cold environment versus a hot environment? Or is it pretty steady,

Allen Lim  43:21

I think that you have to normalize for sweat rate. So whether it’s hot or cold, you need to do an intensity of exercise that achieves the same sweat rate, or you have to medically induce you can drug and use the sweat rate to be at a certain threshold, I think that you know, to the idea that our sweat becomes a little more dilute when it’s hot out that has bearing on it too. So are you heat adapted, not heat adapted? is maybe a better question, then is it hot or cold? Yeah, I tend to find that, you know, once we find the right t shirt size for someone that they generally stay within that size. And for the most part, if we make sure that the food and the drink that they eat, replaces the salt that they lose in their sweat that they perform really, really well. And I’ve seen individuals who lose a lot of salt, who, you know, aren’t typically good at stage racing, because after a couple of days, they’re just not in taking enough salt or were ignorant to that, that their body starts to fall apart, who when they do become aware of it and start replacing that sodium end up performing much, much better and become equivalent to those who don’t lose a lot of salt. So I think that it’s an important thing that measure in so much that it’s really easy to fix. Like, you know, you go and get a vo to max test is that important to measure? I don’t know because depending on your genetics, it’s not so easy to fix or change. So while we can’t change the genetics of how much salt somebody loses, we can intervene in a way where that variable doesn’t matter anymore.

Trevor Connor  44:52

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Dede Barry  45:35

So coming back to GI distress and athletes that are struggling with it, do you think pinpointing symptoms can help determine specific causes? And then help them and turn figure out the best specific interventions? Yeah,

Allen Lim  45:50

I do. I think that those symptoms are really important. So for example, if I have an athlete who has a type of GI distress, where they’re throwing up, I know that there’s something going wrong with their stomach, because at that point, it’s all above pyloric sphincter, right? You’re never going to throw up anything that is already down in your gut. If they’re having exercise associated diarrhea, then I know it’s something happening at the intestinal level, right or below this topic. And so, yeah, is it coming out of your mouth? Or is it coming out of your butt? That’s a big important question. And it does pinpoint things. Usually when it is this exercise associated with diarrhea, going to solid foods, or shifting the complexity of carbohydrate and liquid form helps a lot when it comes to, you know, the GI distress that might cause some vomiting. It’s more about managing intake before a competition and making sure that they go into a race with an empty stomach. And in that situation, that person may not actually do well with solid food, right? Because they’re either so nervous, or, you know, there’s so much adrenaline that their stomach can’t handle digestion at that point. And so they’d be better off going with a liquid fuel source, as an example. So

Dede Barry  47:05

what is happening physiologically in terms of GI distress, when athletes experience psychological stress? And like, how can you mitigate it to?

Allen Lim  47:14

I mean, here’s the bottom line, right, we have our sympathetic response, we have our parasympathetic response, sympathetic response is this fight or flight type of response. And the parasympathetic is this relaxation response when we’re resting and our heart rate goes down. So sympathetic nervous system increases our heart rate, you know, parasympathetic brings down our heart rate. And the paradox about fueling during exercise is you can only digest and absorb under a person pathetic state. And so in some ways, there is this tension between the adrenaline of exercise versus being able to settle down and relax yourself, drop your heart rate enough, if you will, so that and digest and absorb fuel, they’re totally intention to one another, right. And if someone was so nervous, or had so much exercise excitation, that they could not call themselves enough to relax, absorb, digest, etc, then they’re gonna have issues with GI distress. And they might think about doing events that are under two hours, or two and a half hours. Because the most intense exercises, if you’re just burning carbohydrate, you probably can load up enough glycogen and be totally fine. And then just rely on having a very simple sports drink that helps to keep up your blood sugar, because at that point, you know that something is going to absorb pretty easily without any real need for digestion. So I’ll add that to another variable. Why is there a difference in terms of, you know, GI distress, it might just be whether or not, you can relax. In the midst of that stress. You know, obviously, there are certain sports that are so intense that you would never fuel or eat, and that you need three or four hours post meal before you actually do that. You don’t often see somebody in a sandwich before they do the 100 meter, Sprint, or even like events like the mile run, you would never eat anything before a mile run, right? You might have a little bit of sugar just to increase your blood sugar. But you wouldn’t be eating a full meal before something that intensive. It would come up both ends. But cycling is weird, right? Endurance Sports are weird.

Dede Barry  49:24

Yeah, for sure. I mean, for you look at the Tour de France, for example, like you wouldn’t be able to get through it if you weren’t able to stay in a relaxed state throughout much of those six, seven hours stages, right.

Allen Lim  49:36

That’s what people don’t understand is there’s a lot of just sitting in the pack where you are trying to take care of yourself and you’re literally taking little lunch breaks throughout the day. And if you can’t relax during that period of time, if you’re too tense, you’re going to have some real issues and you know if I reflect about the athletes who had good stomachs and bad stomachs, it by and large was like whether or not they could relax. Somebody who was really good at relaxing in the peloton was Christian Vandevelde, he was strangely good at chilling out to the point where he could enter stages where he would eat so much when he was like in this down period during like a flat stage, and he would radio back to me like, Dude, I needed to adapt. I literally want to get off my bike now and just take a nap. But I’d be like, Christian, you need to go harder. You need to get some of that exercise excitation going.

Dede Barry  50:35

Funny. Interesting. So

Julie Young  50:36

Alan, we’ve talked about causes. Now I’d love to talk about solutions and prevention to GI distress. Just to start things off, how about types of foods to avoid?

Allen Lim  50:47

Yeah, I think that you want to avoid anything during exercise with a lot of fiber, you know, you want to keep the carbohydrate as simple as possible. This is where you know, boiled potatoes, white bread, white rice, any of the carbohydrates that are historically bad for you terms of diabetes risk tend to be good for GI distress, when you’re exercising anything that offloads that fiber. I think a lot of athletes have recognized and learn and you can’t do this too often because fiber is essential. But they recognize that for big events, even decreasing their fiber intake a day before the event, and the morning of the event can help them a lot too, right, that’s just decreasing a lot of any of the excess things that don’t absorb by the small intestine, getting that out of the GI tract to help any extra fiber is going to effectively increase the osmotic pressure on the on the gut. Anytime you’re moving water into the gut, during exercise, you can get some feeling of GI distress. So that’s one thing to do, I think another thing to do is actually figure out how much you need to consume. There is I think, a lot of overconsumption, and a lot of panic eating, that happens in competition, just because you’re hurting so much. And you get these little periods of time where you can just like, ah, and you just start dumping as much stuff into your, into your body as possible. So figure out what you need and have a plan. And I think that sometimes people are surprised that they don’t actually need as many extra calories as they think they they need for a given event. And sometimes I think they’re surprised the other way. They’re like, Oh, wow, I’ve been actually under feeling. So having a plan and doing some simple math. You know, for example, whether you run or walk a mile average person, it’s about 100 calories. It’s just that when you run a mile, those 100 calories get burned faster than when you walk. So if you are not capable of running 10 miles an hour, don’t think that you’re burning 1000 calories and alpha is not happening. Right? And I talked to a lot of people who are just like, yeah, you workout burden, like 1000 calories an hour. And I asked them, well, that must mean that you can run 10 miles in an hour. They’re like, No, that’s not possible. Right? Generally speaking, you want to replace about half the calories you burn an hour. That’s a really, really good rule of thumb, for events lasting between three and seven hours. So think about how many miles you could run in an hour. Take that and divide that by two, that’s probably how many calories you need for events between three and seven hours, under three hours. Not as much. Because you know, you can burn through glycogen, right? After three hours, you’re starting to spend a lot of that so that external food matters a lot more. After seven hours. This is where it gets really tricky, right? Because the only way that you really survive that is to decrease your intensity and rely more on fat as a fuel source. And then all of a sudden the mixture of food that you take it changes where instead of taking just pure carbohydrate, you’re now probably taking in some mixture of real solid food, carbs and fats, maybe even sitting down at some point and having a sandwich. What else can you do to mitigate this stay cool. This is a huge one. Because staying cool, allows more blood flow to go to the small intestine, right which can help absorption and staying cool decreases the risk of your small intestine failing. So I Sachs drinking plenty of fluid pouring water over yourself. You can stay cool not just by drinking more or staying hydrated but you can stay cool literally by pouring cold water over yourself because that can have the same important effect as sweat.

Julie Young  54:40

So interesting. How prevalent that ice fests have become

Dede Barry  54:44

you brought that to the pro tour. Yeah, that was an Alan Lim innovation. Nice. Yeah,

Julie Young  54:50

good signature.

Allen Lim  54:51

That was another way of saying hey, how do we prevent GI distress? Right and cooling was a big part of it. Like, I think that we all recognize that it’s easier to eat and consume and absorb when we feel less sick when we’re doing it when we’re cooler than when we’re too hot. It’s really, really hard to eat when we’re super, super hot.

Julie Young  55:12

It’s interesting. When I see riders with that ice vest on, I wonder how long that effect persists into the ride? And of course, I would imagine it depends on the climate, how hot it is.

Allen Lim  55:23

Yeah, for me, on average, it helped for about five to 15 minutes in that range. Interesting, depending upon the temperature in the environment. But you know, what you’re effectively doing is you’re changing the environment for someone for five to 15 minutes of an hour event, if it’s a a time trial, and holy moly, right. That’s like a huge percentage of time that you’re changing the environment. Yeah, even if it’s only five minutes. Yeah, yeah. So it’s not a marginal gain. So

Julie Young  55:54

Alan, what do you think about FODMAPs? are relatively new term, I’m not even going to try to pronounce the words that make up that acronym. I’ll let you do that.

Allen Lim  56:03

Yeah, you know, I think that it’s interesting, right? This is where maybe some of the decreasing and fiber has come from for athletes, right? Or they just offload on all that. Because if you’re avoiding foods with a lot of fiber, the onions and the garlic, and all the other things that make food taste great. You’re also I think, from what I understand meeting a lot of the requirements of the FODMAP diet you’re trying to create, or decrease the excess fermentation of of all those sugars in the gut. But I’m not an expert on this realm. I think that when I think of FODMAP, I’m not thinking about GI distress during exercise. I’m thinking about people who, generally speaking, have gastrointestinal health issues, a lot of inflammation and a lot of absorption issues, and a lot of sensitivity and a lot of allergy. And that’s a whole nother realm. If we want to kind of group inflammation and your immunological response to food as a whole nother reason why some people may or may not have issues, right. And I think that for a lot of people today in our own food system, we’re all scratching our head about why there are so many sensitivities that are occurring, that range of a whole gamut from full on allergies, like with celiac to maybe just gluten insensitivity. Seems

Julie Young  57:24

like there’s kind of a risk with the FODMAPs, for example, where I think athletes especially can be pretty severe in their approach, and they cling on to that and then start avoiding certain foods, which can probably in some cases, be more detrimental than helpful.

Allen Lim  57:39

Yeah. You know, well, one thing I always ask myself to, and the situation is what’s what’s the overall eating behavior of the athlete. And, you know, I think that a lot of these diets and diet trends are simple ways to mask eating disorders. And we need to have very, very frank conversations and check ins with people about how they’re feeling about the food that they eat. And if they’re having any discomfort, or shame, or feeling weird about eating this much food in front of other people, you can often see at the dinner table with other athletes, where there is a reticence to consume or eat because they’re trying to make weight. And they feel badly about that. And for me, I’ve found that the best way to deal with that situation to say, hey, look, I feel like you’re having some discomfort around this meal and about, you know what you’re eating? Is that true? And if it is true, know that you’re not alone, and that it doesn’t have to be like this. There’s a big psychological component to all of this as well. And there is a ton of eating disorder on both the men’s and women’s side of endurance sports.

Dede Barry  58:38

Yeah. How do you feel about like the general trend towards Wayne food? I know a lot of endurance athletes are doing that now. And I

Allen Lim  58:47

bought into it. I’m not into it, because I do really believe that it grates against this other side of being an athlete and being a human being which is intuition, and that we have so many well designed feedback systems within our own body around food and drink, around thirst around hunger around what is satiating what is not satiating. That changes depending upon what our bodies need. So for example, when you sodium deplete somebody for a while, their sodium appetite goes way up, they literally have desire to eat salty foods. And when we start to ignore the intuitive drives that we have around food, I think we in real time also disturb our own homeostasis, because there is no measurement tool available in real time that can tell us exactly what we need, whether it be a scale or other measurement devices. And until we get to that point, or that feedback loops are really, really tight or better than our own intuition, then I think that behaviors like weighing food can be dangerous. Now, I’ll make a contradictory statement and say that if an athlete has so lost touch with their intuition that you need To make them weigh their food to show them that they need to eat and enough, that’s a totally different story. And sometimes that appropriate hard feedback is needed to break people back into intuitive eating. So maybe the answer is why are they weighing their food? Versus? I am for or against it.

Dede Barry  1:00:20

That makes sense? Hey, Ellen, we

Julie Young  1:00:21

hear a lot about training the gut. Now. And I would imagine that that helps in the the processes of digestion, absorption and emptying, but also to help mitigate the GI distress. And one question that I have is Inuit alluded to this when we first started talking about like eating real food. But I also feel like there’s a side of it that we should be training the exact foods we intend to eat in a race situation, especially like for the sake of intensity. But how do we reconcile these two strategies? Well,

Allen Lim  1:00:52

I think that we maybe believe the same thing for different reasons. So I don’t think that there is actually a training adaptation to eating during exercise, I don’t think that there is an improvement in blood flow, or an increase in surface area or an improvement in absorption or digestion or even a change in gastric emptying. I think all the physiological mechanisms around digestion, emptying and absorption all stay the same, depending upon the environment and the conditions. But I think here’s what is important, and why this training is important, is you have to practice your routines. And you have to know what your routines are. And you have to know if they work or if they don’t work so that you can modify them ahead of your race. Right. And so, I don’t think it’s about training our gut, I think it’s about practicing our strategies and our tactics. And we need a lot of time to experiment with ourselves to figure out what works for us are what doesn’t work for us. And it’s in that training our quote, unquote, training our gut, that that practice occurs. So I think it’s more important to have a plan and to experiment with that plan in your training. And then to commit to that in your race. Eventually, you’ll get to a point where you have enough experience, that a lot of race days, depending upon the environment, the conditions, the tactics can be largely improvised. But even in an improvisational state, you need to be prepared, the pockets still need to be full, whether you grab it use the food or not.

Julie Young  1:02:24

What about I mean, with there is so much discussion now about we use just like the World Tour riders and pushing the carb intake to 120 grams per hour and that, you know, everyone should be 3060 90. What are your thoughts on that? Yeah,

Allen Lim  1:02:39

I think it depends. I mean, even for those guys, it depends on the race day, how much they’re going to consume. And they’re certainly not going to want to consume that on days where they’re not going to use it. I think it is really, really hard. And the intensity needs to be really, really high, you take that much food, or carbohydrate in where the intensity isn’t low, you’re actually you know, for those athletes might actually get an insulin response. And they might go hypoglycemic in the middle of a race. Right. So it is very situational. I do think that blood glucose monitors have really helped inform this. And if anything, what the blood glucose monitors have shown is that it’s highly contextual. And it’s never on a given day, one particular plan. But I think that what the peloton has learned is they have learned to prepare in a way where they have the maximal amount of fuel available to them, if needed. There were a lot of situations back in the day, when I was on the world tour where we just didn’t make enough bottles, we just didn’t have enough food available. We just didn’t have enough carbohydrate ready to go. Right. And then all of a sudden of the race went in a different direction. And what we thought was the need for the day wasn’t and so I think there is this knowledge that you just prepare, as if these guys are going to consume 100 120 grams, every race, and it’s better that baby in those situations have wastes than it is to not worry,

Julie Young  1:04:04

does it take time for athletes to build up to that quantity of intake,

Allen Lim  1:04:08

it takes athletes more time to build that level of exercise intensity. But once you’re already there, if you’re feeding the system, I think that the system will respond if you’re fit enough. So if you were just going so hard that you needed that carbohydrate, but you had no room in terms of your fitness ceiling, and you were right at your ceiling, I don’t think that it would work. Because just fueling things does not lift that ceiling, you still need a little bit of buffer. And you need to be able to kind of come down from those intense attacks in a way where you can actually absorb that food or those calories. Right. So I would say that there is a fitness adaptation that maybe trumps any kind of adaptation that’s happening in the gut. And I would also say A that there is a lot of behavioral changes that are learned, when can I actually consume it? How frequently? Do I have to consume it? When do I go back to the cars? Who’s feeding me? For example? Right? I think a big job of domestiques these days is just had these high carb fuels to the riders who are meant to perform. Yeah,

Dede Barry  1:05:21

it seems like along with that training, and kind of getting to that fitness point comes the intuition that you need to be able to manage that better as well. Right? I think it just sort of goes hand in hand. Right?

Allen Lim  1:05:35

That’s right. And I think that they feed each other literally, because what athletes are finding is, oh, I normally never consumed carbohydrate when I train. And thus, my training is never as hard as it could be. But now that I’m feeling myself better, and training, I can do more high intensity workouts, which then in turn, allows my ceiling to be lifted a little bit. And there is this kind of incremental dance, whether or not the gut itself is adapting as well, I’m not sure of, but I do know this simply eating more carbohydrate alone, without intervening on the training plant is not going to do anything. Because if you’re still doing zone to training, and now you’re just consuming 120 grams of carbohydrate to change your gut to absorb that. I don’t think that’s going to work. Yeah, you better also be doing a lot more interval work and a lot more high intensity and a lot more voter basing on certain days.

Dede Barry  1:06:26

Yeah. Alan, I want to shift the conversation a little bit now to talk about microbiome and gut health. So what is meant by gut microbiome? And what’s the function of microbiota? Holy cow?

Allen Lim  1:06:38

Yeah, there’s so many ohms these days, right? There’s your genome, which is your DNA. There’s the proteome, which is the proteins that you produce that are active and available in your body. Now, there’s this whole microbiome, which are all the contributing bacteria that are necessary for life, right? Across our skin, inside of our gastrointestinal tract, which is part of that continuous skin, there are untold number of different species of bacteria that live with us that produce all manner of of important chemicals that are important to our overall health. I mean, it’s wild, right? Like, there’s so much being linked to the secondary organism that lives within us. You know, for example, some people are even hypothesizing that the reason why Parkinson’s disease exists, is because there is some acute disruption in the microbiome, right, and some dysfunction in it, which then leads to this neural disease, there’s knowledge that if you look at all elite athletes is a study being done at entreats. Right now that the biome of elite performers looks different than you know, those who don’t perform well. There are a lot of different health conditions that are associated with this bio, but a question about how we manipulate it and how we affect it. It’s still a big unknown, or what damages it, what hampers it, right. And so there are things that we might be able to do in terms of our diet and nutrition, whether it’s eating fermented foods, whether it’s eating a wide variety of foods, whether it’s eating a wide variety of fruits, vegetables, and plants that give this biome its nutrient needs in order to survive and be healthy. But then there also might be things that we might be consuming, that are damaging, right? So you know, is alcohol damaging to the biome? Maybe, right? What other toxins or environmental stressors, so replacing ourselves under that might be hurting our bio is being too hygienic, for example, hurting our bio, so it’s really, really complex, especially from a practitioner standpoint, because there are things that might enhance our biome. And they’re also things that might be hurting our biome, and we need to be able to figure out both. Yeah,

Dede Barry  1:08:58

so a lot of athletes can be like rigid or absolute about their diet. Do you think that having an extreme diet or like eliminating certain food groups can affect your microbiome and gut health? Yeah,

Allen Lim  1:09:12

I do. Because I think that the one thing that we do know about the microbiome is that diversity matters. And every day you’re hearing about another strain of bacteria that has some important role to play. And I’m sure that there are untold number, a bacteria that have some important role to play, the issue becomes, well, if that’s the case, then we can’t be so rigid in how we eat, because that rigidity, or that lack of diversity in our own foodstuffs, probably impacts the diversity of the bile. I don’t know if that’s true. I don’t know if there’s this perfect correlation between somebody’s biome diversity versus their, you know, the diversity of foods that they intake. But that’s what my intuition Should tells me right now, you see this maybe even with animals, right, like, you know, animals that are raised, you know, using industrial farming practices where they only eat one type of food are probably not as healthy because their biome is not as healthy.

Dede Barry  1:10:14

And what about over fueling or under fueling? Do you think that that would affect your gut microbiome?

Allen Lim  1:10:20

I don’t know. I do know that over fueling or under fueling puts a stress on our system. And anytime our systems are stressed, we’re probably in some sort of symbiotic relationship with all of this bacteria. And that anything we do the harm ourselves might be something that harms that biome and vice versa.

Dede Barry  1:10:37

Does exercise influence your microbiome?

Allen Lim  1:10:40

I don’t know. I would like to think so. If only in so much, that exercise allows most people to eat more, and potentially gives them a chance to have a more diverse diet. Yeah,

Dede Barry  1:10:53

that makes sense. And what about eating habits like eating fast versus slow? I mean, I think there’s been some studies to show that there’s different enzymes that are released when you eat slower, and you spend more time masticating or even when you eat socially. Do you think that that affects your gut health and your microbiome?

Allen Lim  1:11:13

Yeah, absolutely. Maybe wasn’t mentioned before, when we first started this whole conversation about digestion and when digestion begins, digestion actually begins when we first walk into the kitchen, and we smell a beautiful meal being made, right, that moment where you’re like, Whoa, what’s going on in here, the smell, the sight of food, in and of itself, will start the digestion process. If we are so emotionally connected, affected by the food, we if that has a real physiological consequence, then I do think that you have to account for our behavior and how that behavior feeds back on our own physiological processes. You know, for me, I’ve always been intrigued by these associations between our own psychological well being our mental health, intentionality, our behavior, and how that affects these health outcomes that are thought of to be currently black and white, you know, so for example, you talk about a variable like cardiovascular disease, and we normally associate things like high cholesterol and say smoking with risk factors for heart disease. But in the Framingham Heart Study, one of the longest longitudinal studies on heart disease, self reported loneliness, was also a huge correlate to that, right? Whether direct or indirect, there are cycles, social cues and the way we behave around food that I think affects how we digest and our overall well being. And I think this is why in the feed zone table cookbook that sharpies you and I wrote, we were so hard pressed to encourage people to eat with one another. Because even sharing the food and how we socialize around food can impact its I think nutrition, and its impact on our lives.

Dede Barry  1:13:01

That’s super interesting. It definitely kind of speaks a little bit to how hard it can be for athletes that are trying to stick to a rigid diet and maybe feeling like uncomfortable in social environments because of that.

Allen Lim  1:13:15

That’s right. I think that if I work to identify the question that I almost always use to try to identify athletes, young athletes with eating disorders, as I asked them a very simple question, I say, how many meals do you eat by yourself versus with others? And if an athlete comes back and says, Well, the only way that I can do what I do, is to eat by myself. I know that they may be jumped to an extreme that isn’t healthy.

Dede Barry  1:13:41

Yeah, it seems like that would be a bit of a red flag, for sure.

Allen Lim  1:13:44

It’s a major red flag to measure red flag. So I do think that there’s a lot of unknown in terms of our of our intentionality around things. And I also think that there’s maybe just wisdom out there, if you listen to people about, you know, how to behave around food, and some of that wisdom for me comes around sharing meals with Davis Finney, who has Parkinson’s. And he’s one of the most soothing individuals to eat with, because he has to go slow. He has to savor every bite, and he does, and you can see it, and it’s really nice to eat with him. Hmm.

Dede Barry  1:14:20

So coming back to the gut microbiome, do you think that the composition of macro nutrient intake has an influence a positive or negative influence on gut microbiome?

Allen Lim  1:14:32

I don’t know, I would generally think that you need to have that diversity of macronutrient intake. You know, obviously, as an endurance athlete, you’re going to be weighing more towards carbohydrate than some balance of protein and fat. I think that for me, from what I understand about the microbiome, it’s more going to be what you consume on the plant, fiber and carbohydrate side of the equation. So maybe it’s not even about does the macro nutrient composition affect this? I would more say, does the plant composition of what you eat effective? The answer is yes. And then the conversation then drives to do you even eat plants?

Dede Barry  1:15:16

Yeah. Yeah to what about different types of proteins like animal proteins versus vegetable based proteins?

Allen Lim  1:15:25

I don’t have a clear answer to that. It’s hard for me to say like, I have my own biases around what, how and when I feel my best. And every one is different. Right? And I think that it’s probably harder to change how somebody eats than it is to change their religion.

Dede Barry  1:15:42

Yeah, sure. Very true.

Allen Lim  1:15:46

I would say like, for me, I feel my best when I’m actually eating animal protein. And I don’t know why that is. And maybe the microbiome is part of that answer.

Dede Barry  1:15:55

I would say that’s the same for me, I feel the best when I’m eating animal protein. And I know I perform the best to when I’m eating animal protein. So but I would imagine there’s a lot of individual variability with that. Yeah,


you can’t necessarily. Yeah, I

Dede Barry  1:16:11

definitely can’t, I don’t feel like I can pinpoint it affecting my microbiome in any way. So. But maybe it’s just because I like red meat, too.

Allen Lim  1:16:24

We have both cultural biases, we have personal biases, we have all these things that are informing us. And at the end of the day, we have to make some type of decision, you know, ask ourselves, do we feel good, we not feel good. And if we don’t feel good, hopefully, have the presence to ask others for help in terms of how to change that. And to experiment a little bit.

Dede Barry  1:16:43

Do you think that gut microbiome affects the muscles ability to absorb carbohydrate?

Allen Lim  1:16:49

I don’t know, I do think that there is probably some good data out there already that I’m not aware of around insulin sensitivity. And ultimately, your insulin sensitivity and how much insulin you need to lower your blood sugar is principal to whether or not those muscles are absorbing carbohydrate. And anytime your blood sugar is better regulated, by de facto, you are better absorbing sugar, your muscles are working better. One thing that I’ve learned from using a continuous blood glucose monitor is how confusing it is. Because it’s not just exercise that affects that variable. It’s also your sleep. It’s also your mood. It’s also factors like jetlag, or travel, right, it’s how stressed you are somebody emails you got that day, they all collide. And given how big of a role the gut microbiome, we’re learning is playing in everything. I can’t see how it’s not also playing a role in that variable. I just don’t know how yet. But I also know that that variable is not a single variable factor, where we used to think that, hey, just walk it off, walk off that high blood sugar, you know, not the only piece of the pie. Yeah.

Dede Barry  1:18:04

Do you think that being under over hydrated can affect your microbiome? Likely?

Allen Lim  1:18:10

I think that there is a ecosystem and environment that is probably optimal. But I would also say this, that being over under hydrated is hard to measure. And it’s hard to say what is optimal or optimal. I very much would maybe say either paying too much, because you’re drinking too much. Or always being thirsty and not doing anything about it might be bad, right? So there’s maybe more of a border that I would put around saying, do you know if you’re hydrated or not hydrated, right? And I do think that, despite all of the Pooh poohing that happened around the first mechanism ever since I was in elementary school, like I remember being on the blacktop playing Foursquare, and like teachers being like, drink before you’re thirsty, you know. They’re like, wailing on a Foursquare cord. You know? I’m thinking to myself, like, wow, oh, no, I want to drink whatever I’ve got. Yeah. Like, no one’s stopping me from drinking. I’m not like, Yeah, I’m not an idiot here. Like, I do think the more I read about the thirst mechanism, and the more I read about what regulates the thirst mechanism in our body, the more more I think it’s an amazing system. And it’s a system that people will literally kill for. If you’re really thirsty, you will do whatever it takes to quench that thirst. Right? So, yeah, just don’t be thirsty, is what I would say about this thirst for life. Just don’t be thirsty. But I also think, too, that people get so concerned about their hydration that they’ve always got that Nalgene bottle with them. They’re constantly drinking, and what ends up happening is they’re like getting up to use the bathroom like every 10 or 20 minutes, right? And then you’re like, What is going on? Are you diabetic? Like, there’s like I just like never stopped drinking water. Hey, speaking

Julie Young  1:20:08

of that, Elon, do you think like during the hot, especially, I guess the hot months? Do you think it’s advantageous to drink some electrolytes during the week? So like off the bike, for example? Yeah,

Allen Lim  1:20:21

I do think it is advantageous. Yeah. Especially when it is really hot. I think that pre loading for your events can be helpful, because I do think that your sweat rates end up needing to be higher than what you can actually consume to keep you cool. And that even though our thirst mechanism works, we just can’t carry enough to meet that demand. And so we do have to rely on what we store and being resilient. And drinking plain water is not enough to increase those water stores, you need to have a combination of a good diet with plenty of electrolytes, plenty of specifically potassium and sodium. And that water. So drinking water with a meal is an adequate way to take care of that, right, because that meal is effectively your plate of electrolytes. Or during the day, you could also be drinking something with electrolytes in it. In the extreme case, like right before a big, big event in the heat, I’ll have athletes drink something saline before they go to bed. First thing when they wake up, and then, you know, along with an ample amount of carbohydrate right at the start line. And that’s simple, because it just increases the resiliency of the of the body before you go into the event. Ellen,

Julie Young  1:21:40

I’d like to move on to the gut health. And we’d love to hear your thoughts on improving and optimizing gut health and how that optimal gut health contributes to improve performance.

Allen Lim  1:21:51

Yeah, you know, I think this goes back to like all of these other issues around inflammation and different disease states and allergies and sensitivities, and why and what do we need to maintain a healthier gut, I think it also bears to our lifestyles and whether or not we’re so stressed out that we’re not relaxed enough to allow our guts to function properly. So there is a nervous system component. And then there’s actually what is happening at the level of the gut itself in terms of its ecosystem, that ecosystem also includes the gut microbiome. So if I were to throw the kitchen sink at this, and just go towards solutions of what you can do to have a healthier gut, first thing I would say is one, sleep enough, right. Because if you’re not sleeping enough, your whole hormonal environment, the balance between your cortisol, adrenaline, etc, it’s always going to be off. And the gut being such a big organ system, it’s going to be affected, like any other organ system, right. So try to make sure that you have ways to cope with the stress that you have in your day to day life. One of those biggest coping mechanisms is that you get enough sleep, as once you fall into the trap that you’re so stressed out that you have to work more you have, you can’t sleep as much, then you don’t become as efficient in your day to day work, which makes you sleep less. And that causes a negative cycle as opposed to a positive cycle of becoming more efficient and more resilient to the stress. I don’t think that we’re going to magically change society, or the demands that society is putting on us. But we can learn to cope with that stress. And sleep I think is a big part of that. Number two, I do think it’s really, really important that we have really, very diet. And think that for me, instead of saying that my goal is to have a very diet, I am more kind of just food interested. And I’m culturally interested in going to eat at many different places that prepare foods that I never prepared for myself. Right. And so maybe the luxury or the treat that I give myself to try to increase my food variety is going out to eat at really weird places and checking stuff out. And picking things up at the grocery store that I’ve never cooked before and experimenting and seeing it as fun rather than an obligation or responsibility for me. You know that diversity is fun. I do think that like understanding your caloric needs during exercise and feeding yourself hydrating yourself. It’s weird, like people have been on this whole like, why is my gut not healthy for a long time? around 1905 or so there was this Japanese man and his son had irritable bowel syndrome or Crohn’s disease some sort of Gi health issue and he found that whenever he took muscles, like clams muscle walls and boil them into a broth and fat his son this broth that his son’s symptoms would all go away. And so he was really fascinated by this and took this to a bunch of scientists of his day, the best scientists you could find, to try to identify what was it about muscle broth that made his son feel better. And what this one scientists identified was that this muscle broth was very, very high. And glycogen, muscles have a lot of glycogen inside of the meat. And when you boil it, that glycogen leaks out as a whole. And glycogen is a carbohydrate molecule with about 10,000 Lego pieces in terms of the structure, it’s a really magnificent complex and dead structure. And it was thought that it was the size of this structure on this on the gut wall that was a natural bomb acted as an anti inflammatory. So he started a company to try to manufacture glycogen figure way to do it. And I got him all into the realm of carbohydrate chemistry and sugar chemistry. And in order to fund this, they started a candy operation. This candy operation ended up making this thing that is famous in Asian culture called the Paki stick, which is a chocolate dipped, little cracker stick thing. company is called glyco, it became the biggest candy manufacturer in all of Asia. And they never gave up on this mission to synthesize glycogen. And in 2010, they finally fricking did

Dede Barry  1:26:28

  1. Wow. Yeah, amazing. That’s

Julie Young  1:26:30

endurance right there.

Allen Lim  1:26:32

Exactly. And they did it with all of this crazy recombinant technology. There’s an enzyme in muscle when we eat a big meal after exercise. And the extra glucose goes into the muscles, there’s a thing called branching enzyme that links glucose units into glycogen. And they are able to recombinantly synthesize that branching enzyme, and literally turn cornstarch into glycogen cells for about $1 A gram right now. But it’s being used in all of these medical trials, for gut health. And for irritable bowel syndrome and the same issues that this guy’s kid and 1905 dealt with. That’s

Dede Barry  1:27:15

fascinating. Has it been used in any sports products? Yeah, that you’re aware of, not

Allen Lim  1:27:20

that I’m aware of. I have used it myself, TD. And I don’t know if it helped me or didn’t help me. But I will tell you this, I’m a very in tune with my body person. And I did this with my lab assistant at the time. And the next day, we both very shyly reported to one another, that we probably had the best shit of our life.

Dede Barry  1:27:45

So it has cleansing properties,

Allen Lim  1:27:49

the most profound cleansing property ever, but it’s also $1 a gram. Talking, if this was in the Tour de France, it’d be $100, just for the product.

Julie Young  1:28:02

Is it potent, though? And that like, is it one gram can do the trick. No, one

Allen Lim  1:28:06

gram is still one gram, okay, it’s just that it’s a super complex gram. And the idea might be that maybe you could drink this stuff, and never worry about GI distress, because it would digest in the small intestine at a rate that would match the absorption, or it wouldn’t digest out at all, because it’s too big to digest. And you’d have all the stuff that was leftover, that never absorbed that would go down in the colon, that would just lubricate your ship. You know, you’re also talking about the other reality, which is it might be too complex to actually all be absorbed. With respect to gut health, you have to have consistency in your diet, such that your bowel movements are also consistent. And even though we joke about it, I think that the consistency of your bowel movements is a huge indicator of whether or not your gut is healthy or not healthy. There’s a balance of relaxation, parasympathetic versus sympathetic tone. And you got to be able to chill out in order for this to happen. I agree

Julie Young  1:29:07

with you. Like, I feel so many of our physical ailments, stress is the culprit. And we don’t we so rarely talk about that feel like we’re so like looking after like the pharmaceutical solution, whatever the case may be, and not really reflecting on our lifestyles.

Allen Lim  1:29:24

That’s right. And even though we’re talking about gut health, as a single part of our body, the thing is, is that I think anything that makes you healthy overall, is going to make that particular organ system healthier as well. Right. So in the same way that diversified and consistent diet is going to help your overall health, it’s also going to contribute to your gut health, right, your stomach. Yeah, I’d also say like, avoidance of toxins, too. I think that, you know, it’s easy for me to say because I’m not a big drinker, but I do think that a lot of alcohol can Have can be really, really hard on the intestinal lining of the stomach and the small intestine, right, just as a compound. I mean, like, there’s nobody that I know who has a skincare program that is based upon pouring whiskey on their skin every night before they go to bed. And outside of alcohols effect on our nervous system, you know, I think that it can have effect on our skin and on our gut health, which is a bummer, because yeah, I like a cocktail like anyone else. Yeah,

Julie Young  1:30:28

everything in moderation, though, right? Everything in moderation. Exactly. Hey, Ellen, is it worth asking you about probiotics, prebiotics and polyphenols?

Allen Lim  1:30:39

I think it can be. But I also think, too, that I become a little scared about probiotics, learning how many different bacteria and then I start to worry that I’m overpopulating? One particular bacteria, right. So yeah, I think it’s we’re talking let’s talk Hey, guys, do you guys take a probiotic because we’re talking about,

Dede Barry  1:30:58

I actually just drink the probiotic drinks.

Allen Lim  1:31:02

Here’s what I’ve seen in the probiotic world, I have seen that more and more probiotic drinks and formulas have more and more diverse formulations. And that even in the yogurt world, there are more and more bacteria that are being used to colonize and ferment these products, which I think is really, really cool. Because I do think that we’re ultimately learning that there is a host of different bacteria, that they all have different roles and functions, and that maybe just properly feeding them is all we really need. And going for many different types of fermented foods from different regions of the world. You know, I’m very, very sure that the kimchi we ferment in Boulder is a total different bacterial strain than the kimchi in LA, versus the kimchi that’s fermented in Korea versus anywhere else. And yet, it’s all kimchi. And so maybe what helps us is to eat a lot of fermented foods from a wide array of places. And that if you’re going to end up taking a probiotic, to maybe choose probiotics that have more than one strain. And my advice would be, don’t use one particular strain for too long without making sure that you’re also getting other strains.

Julie Young  1:32:27

What about prebiotics and polyphenols?

Allen Lim  1:32:30

I think the prebiotics seem like a good idea, because what you’re doing is just giving material to feed the microbiome that’s already there. I don’t know too much about poly phenol. So I can’t really answer that question off the top of my head without studying that more. So I don’t know. Alan,

Dede Barry  1:32:48

are there any specific supplements that you think would be beneficial for athletes to take for gut health and or improving their microbiome?

Allen Lim  1:32:56

Yeah, maybe dirt. I know, it sounds funny. But I know that there are some companies out there that are literally working on ecosystems of dirt, different strains of dirt from different places in the world. And that it may be this exposure to the natural bacteria that is in dirt that gives people their overall health. So I think that there is this evolution from being able to say, hey, we’re going to colonize certain strains of bacteria that we think are important to say, there’s an entire ecosystem in this field. And we’re just going to basically, comb out all the things like the Giardia that might kill you. Right, and give you everything else. Yeah. So that’s a marketplace that I’m really interested to see evolve. It’s weird, right, like when you’re drinking from all those fountains on one hand? Yeah, I think that you probably exposed yourself to some some bad stuff. Right? Clean water is everything. But the other hand, you probably also expose yourself to more good stuff, too. It’s just one or two bad things.

Dede Barry  1:34:01

Yeah, the parasites and yeah, I had a couple of those. Yeah, exactly. Exactly. So

Allen Lim  1:34:09

I do think that there’s this really interesting burgeoning market of, if you can scoop up a scoop of dirt from some hillside and Drona, Spain’s, and pull out all the parasites, the bacteria that are known to be bad, and get people everything else. This is also where maybe hygiene matters, right? Because it’s like cheese. Do you wash your vegetables? I do because I’m worried about E. Coli. But at the same time, I’m also probably missing out on some diversity there. Yeah,

Dede Barry  1:34:40

sure. Are there any supplements that you would suggest avoiding because they might have adverse effects on your GI or contribute to GI distress? Because I mean, there are a number of kind of just basic legal performance enhancing supplements that people take and are there any that you can think of off The top of your head like

Julie Young  1:35:01

bicarbonate maybe? Yeah,

Allen Lim  1:35:03

I mean, acutely, if you talk about something like bicarbonate, you have certain things that have this really high osmolality, or this high molecular concentration that, you know, just hard to absorb anyways, that might have some performance advantage. But, you know, for a lot of people can give you GI distress. I think that caffeine is another one, right? Like in very high doses that can affect how well somebody absorbs and can kind of rot somebody’s got, if you will. I do think that there are many different types of stimulants, I think that we don’t know the impact on on gut health to like, all these non nutritive sweeteners, I think are really interesting. And these alcohol based sweeteners are really mysterious and weird to me. I think food colorings are a little weird to me, in terms of I don’t know, if they’re having an impact or not an impact, right? I do know this, like, any molecule that takes up space in water is going to exert some osmotic force on the gut. From an acute exercise perspective, that’s going to be not so good. From a general overall health perspective, I think that the body is pretty capable of coping with a lot of these, a lot of these things and, you know, maybe outside of eating anything in too high of a concentration for too long, I would say pay beware, even like consuming magnesium can be beneficial. But, and too high of a dose of magnesium citrate, you know, is a very strong laxative, and there’s some risks there. It’s funny, because I don’t necessarily ever think directly about any food or drink, whether consuming or avoiding, as something that affects my gut health directly. I’ll go back to the statement that I think about it as how does it affect my overall health. And if it affects your overall health in a positive or negative way, given how big that organ system is, and given how poorly innervated that organ system is the GI tract, that’s going to have an impact. And so, maybe think of it this way, anything that you would eat that, or any kind of behavior that you would undertake, that you feel is good for your skin is probably good for your gut, because your whole entire gastrointestinal tract is nothing more but inside skin.

Dede Barry  1:37:24

That’s a good way to think of it. Yeah, I

Julie Young  1:37:26

like that.

Dede Barry  1:37:27

Alan to wrap up. Can you give our listeners your top three pieces of advice on how to optimize gut health to positively impact performance?

Allen Lim  1:37:35

Yeah, one, relax, and get enough sleep to eat as much weird and diverse plant life as possible. Make sure a lot of it is sour, and fermented and smelly. And number three, be consistent about your eating and share your food with others. Don’t discount the social and behavioral impact of how you eat, being as important as what you eat. I love

Dede Barry  1:38:04

  1. That’s awesome. Love it. Thanks.



Dede Barry  1:38:08

Alan, thanks for being so generous with your time and knowledge.

Julie Young  1:38:12

Yeah, definitely.

Dede Barry  1:38:15

That was another episode of Fast Talk Femmes. Subscribe to Fast Talk Femmes wherever you prefer to find your favorite podcasts. Be sure to leave us a rating and review. The thoughts and opinions expressed on Fast Talk Femmes are those of the individual. As always, we’d love your feedback, and any thoughts you have on topics or guests that may be of interest for you. Get in touch via social. You can find Fast Talk Labs on Twitter and Instagram @fasttalklabs where you’ll also find all our episodes. You can also check them out on the web at for Allen Lim and Julie Young. I’m Dede Barry. Thank you for listening!