Showing posts with label Nutrition. Show all posts
Showing posts with label Nutrition. Show all posts

Thursday, March 31, 2011

The “Science” behind “Bonking”

It has long been “common knowledge” that endurance exercise is fuel-limited. This is most familiar to general populations as a commonly observed limitation on foot races that says that you will run out of energy, “hit the wall,” or “bonk” at around 20 miles. For common race distances, the effect is most frequently observed in the marathon (26.2 miles). The standard explanation is that you can only store a limited amount of carbohydrate fuel in the form of muscle and liver glycogen, and that you will bonk when the supplies run out. Management of the “problem” is variously accomplished by “carb-loading” before the race to super-fill (“super-compensate”) the glycogen stores, and by various refueling strategies during the race (which support a large industry that provides special drinks, gels, bars, and the like).


At the same time, there is a growing body of evidence that there is no reason to depend on stored carbohydrate fuel which is limited in quantity if you can mobilize your fat stores as a source of fuel. The problem seems to be that anyone who is accustomed (adapted) to eating a high-carbohydrate diet tends to preferentially burn carbohydrates as fuel and does not utilize the energy available from fat in a way that spares carbohydrate use during endurance exercise. These are the so-called “sugar burners” as compared to “fat burners.”


There are a few possible strategies to enhance fat burning. The most commonly discussed strategy is to train at slower, more aerobic paces, to train the body to optimize using fat as fuel. This approach was discussed by Alan Couzens. Although carbohydrate was also restricted, the main emphasis was on low intensity training, with pretty amazing results from the combined approach.


A second strategy, perhaps even simpler, is to change to a low-carbohydrate diet. Maintaining glycogen supplies in a partially depleted state encourages the development of aerobic apparatus via the action of AMP Kinase (increased mitochondria and associated fat burning enzymes such as carnitine palmitoyltransferase, necessary to help transport fatty acids across the mitochondrial membrane). People with deficiencies of carnitine palmitoyltransferase are unable to utilize fat for fuel efficiently, and can even suffer damaged muscles and rhabdomyelosis resulting in kidney failure. There is also evidence that people suffering from obesity and diabetes may have impaired mitochondrial function, which inhibits their fat burning and at least partially explains the origins of their condition. Similarly, a deficiency of carnitine can result in impaired mitochondrial function and even lead to symptoms of metabolic syndrome.


There is an adaptation period of a few weeks to lowering carbohydrate intake during which the appropriate metabolic pathways and aerobic enzymes and cofactors are up-regulated to better utilize fat as a substrate, allowing blood glucose levels during exercise to be more easily maintained. As Alan Couzens explains, lower carb intake should result in a 20% increase in fat burning in a few weeks. Numerous scientific studies bear this out. A recent study, for example, concludes that a high fat diet increased the rate of whole-body and muscle fat oxidation while reducing the rate of muscle glycogenolysis during submaximal exercise, even after restoring high carbohydrate intake. In this study, a high fat diet was followed for up to two weeks (which we know is just long enough to see significant adaptation), during which usual training was followed. A high carbohydrate diet was restored for the last few days along with a taper before racing. The athletes were able to maintain the increased fat oxidation even after reinstating high carbohydrate intake.


There is at least one supplement (Vespa) which is alleged to improve fat-burning during exercise. There is also some evidence that, all else being equal, the athlete that has the most efficient fat-burning ability can consistently beat the athlete with the higher raw power output (higher VO2 max) in endurance competition.


An article in Running Times last year discussed the strategy of carb cutting to increase endurance, though the article suggests mainly forgoing carb supplementation on training runs, not going low carb in the training diet. The Ethiopian runners again are cited as evidence that a high carb diet is necessary to fuel runs, and there is speculation that they are somehow training themselves not to use glycogen as the predominant fuel by not consuming carbs while actually training. This conclusion seems unlikely to us, since it is well known that exercise causes an increase in blood sugar (due to action of epinephrine and glucagon), effectively mimicking the result of taking in supplemental carbohydrate while exercising. A marathoner does not “hit the wall” until they have run ~20 miles at race pace anyway, a condition not likely encountered during routine training runs for most of us.


Despite all that is known about “the wall,” people persist in believing that a high carbohydrate diet is necessary if you hope to be a good runner. A high carbohydrate diet may work well for Ethiopian runners, who are known for running prodigious mileage and training three times per day. At this training intensity, we seriously doubt their glycogen stores are ever completely full, and they may effectively be training in a perpetually glycogen depleted state, which would upregulate the same enzyme systems that occurs in the low carbohydrate condition. Perhaps what they are mainly training is the rapid replenishment of glycogen stores. However, for most of us amateur or older runners, we’re only fooling ourselves if we think we need to fuel exercise with a high carb diet. David does quite well on very minimal carbs (less than 50 g/day), while Cynthia prefers closer to 100 g/day. Since we generally only run once per day and even then usually less than 10 miles, there is no reason to consume any more carbs to fuel our exercise habits.


David has been a low-carb runner for more than two years now, keeping carbohydrate consumption low before, during, and after endurance exercise. While he won’t brag about his speed and has no plans to challenge any course records, he consistently finds that he has even energy levels and rapid post-event recovery with minimal muscle aches and pains. Fat fueling works for him! However, until very recently, while he refueled less often than is typical, he did routinely refuel using protein and fat for any event of more than 3–4 hours.


He was prompted to revisit the issue when he heard about a recent study (“Metabolic Factors Limiting Performance in Marathon Runners”) by Ben Rapoport when he had his fifteen minutes of fame on NPR in October 2010. Ben was attempting to model bonking in the context of marathon runners. David subsequently exchanged e-mail with Ben whose initial reaction was to interpret David’s personal experience as simply confirming Ben’s model, arguing that fat-fueling works, and that you don’t bonk as long as you run sufficiently slowly. David pointed out some flaws in Ben’s interpretation of the scientific data he analyzed and challenged him to define a performance that David might personally be able to achieve that he might consider sufficient to disprove his model, but he never responded to the challenge. We summarize here both a couple of the criticisms of Ben’s model and analysis and some more recent personal experience and experiments.


A key part of the experimental data that Ben used in building his model came from Romijn AJ, Coyle EF, Sidossis LS, Gastaldelli A, Horowitz JF, et al. (1993) “Regulation of endogenous fat and carbohydrate metabolism in relation to exercise intensity and duration,” Am J Physiol 265: E380–E391. That paper shows (in Fig. 8) the relative amount of particular substrates which are used in short-term exercise at three different intensities. The subject’s dietary habits were not identified, and any changes that might take place over more than a few minutes were ignored. The data show that more intense efforts use primarily muscle glycogen as fuel. They do not show the pathways that feed the muscle glycogen. Glycogen and glucose are rapidly interconverted, and over longer periods of exercise, new supplies of glucose are made by the liver. The liver, in turn, is capable of using any available fuel source via gluconeogenesis to keep blood glucose levels up. These fuel sources include ingested carbohydrates, protein, and fat as well as lactate, glycerol from liver and adipose tissue fat stores, and even body protein stores such as in muscle tissue. Which source predominates depends on availability. Some of the necessary up- and down-regulation of different metabolic pathways can take place on a short time scale to respond to instantaneous demand for fuel from the muscles and other bodily functions. However, there are also some key adjustments that respond more to average demand and supply to deal with changing diet, exercise demand, starvation, and the like, and these are events that tend to have time constants measured in days or weeks, not minutes or hours. The adaptation processes may be numerous and complex (or at least, we fully admit that we don’t understand all of them) and likely include adaptations in the skeletal muscles as well as in the liver. However, we think it is clear that the data extracted from Romijn do not actually show the underlying consumed fuel source for various levels of endurance exercise, and the data cannot reasonably be extrapolated to model and predict bonking.


One factor which Ben cites in favor of the importance of carbohydrate and fueling is the relative stoichiometry of oxygen consumption for each substrate. He states that carbohydrate oxidation typically generates approximately 120 kcal per mole of respired oxygen, whereas fatty acid oxidation typically generates only approximately 100 kcal per mole of oxygen. We would argue that this, while probably correct, is irrelevant in that the difference is relatively small, and the availability of oxygen is never a limiting factor at a typical aerobic marathon pace. There is always an excess of oxygen available. In any case, regardless of the underlying fuel used to generate blood glucose/glycogen, the immediate muscle activity (except for very short term bursts of power) is fueled by glucose.


Notwithstanding the possible flaws, Ben’s model does make predictions as to whether one is likely to bonk in a marathon. In particular, he has provided a calculator for the marathon. Putting in the best estimates David has for his personal situation, the calculator predicts that he should not bonk for finishing times over about 3 hrs. Since he can only sustain a 3-hour marathon pace for about 1 mile or so, he may never be able to really challenge the model experimentally using himself as a test subject.


However, David was inspired to test his need for refueling during running, and now has a significant number of test results that, if not sufficient to explicitly challenge Ben’s model, are at least startling to many people. For some time now, David routinely runs training runs of up to 4–5 hrs without refueling (water alone). This is still true when he runs with his son at faster speeds who typically chooses to refuel using at least a couple of energy bars or gels. David first pushed the envelope a bit on what was supposed to be a planned 18-mile run that stretched to about 26 miles when the route was blocked by an impassable rain-swollen river crossing. That run extended over about 7 hours including some significant rest breaks, so it was not at a strenuous pace, although it did include some significant elevation change. David consumed only water. The next experience was a 50K (31-mile), mostly flat run, again at a very modest pace, finishing in 6:50, again on water alone. Two weeks later, he completed a much more strenuous 50K on rough rocky trails with about 6000 ft of elevation gain (and loss) in 7:28 on water alone. In all three of these runs, David started with a breakfast of a two-egg cheese omelet and bacon about two hours beforehand. He felt some minor hunger around normal lunch time, but otherwise did not experience any significant fluctuations in energy level, and he certainly did not bonk. His overall weight was down about 3–4 lbs at the end of the day compared to the beginning, but looking at beginning-of-day weights across several days, any weight change was pretty much lost in the noise. Of course, it only takes about a pound of fat to fuel a 50K run, anyway. Another week later David ran yet another moderately hilly 50K event which was slower (8:04) due to snowy trail conditions. Due to a late start (10 am), he chose to eat a little at around the 6-hour mark, mostly because it was a long time since breakfast. However, the ability to do three 50K runs in four weekends, certainly confirms that post-event recovery was rapid.


So what’s the take-away message from all this? It’s interesting to compare our reaction and the experiments that David decided to try to others. Greg Crowther also blogged on Ben’s article. Greg’s big concern was inter- and intra-personal variability, and he questioned the validity of extrapolating from some sort of average measurement of performance to the needs of one individual on one particular day. He didn’t ask (as we did) if too many runners are needlessly afraid of bonking but rather, “if ingesting extra carbohydrates before and during a marathon might help you avoid ‘hitting the wall,’ why wouldn’t you do it? Especially after investing all of that time and effort in training, traveling to the race, etc.?” Hey, we’ll even go further: if ingesting fuel (whether carbohydrate, protein, or fat) during a race might help you maintain a faster pace for whatever reason and for whatever limited portion of the race, even it’s just a placebo effect (or tricking your Central Governor), then by all means go for it! But we also stand by our basic conclusions that (1) carbohydrates are simply not necessary before, during, or after endurance exercise, (2) they’re probably not even particularly beneficial, at least if you are suitably adapted to efficient fat-burning (and may be harmful to your long-term health) and not logging very high miles at high intensity, and (3) unless you’re able and motivated to run, say, an entire marathon at a high percentage of your VO2 max, consuming much of any food immediately before, during, or after the event is entirely optional. Moreover, there may be some benefit to having the stomach completely empty while racing, in order to avoid stomach upset, intestinal discomfort/diarrhea or nausea when running at high intensity. (David does continue to believe in significant protein consumption sometime in the 12 hours or so following strenuous exercise as an aid to muscle repair and recovery, but the timing of even that refueling does not appear to be nearly as critical as some authors suggest.) David will probably resume modest consumption of fat and protein on longer events, just because he’s not big on skipping meals entirely, anyway, but it’s reassuring to know that he can easily keep going without any fuel if for any reason he needs to.

Friday, October 15, 2010

Rio Del Lago 100 Mile—A DNF

If you’ve read my previous entry about all my injuries and travails in the past year, you might think it a silly thing to sign up for a 100-miler, and you’d probably be right. But life is short, and sometimes you just have to go for something, even if wiser heads would counsel you otherwise. This attempt was not successful, and not even all that impressive as a first attempt, but has lots of lessons that might be of interest to some.

Prologue
I remember running a series of marathons in the 1980s and hearing about the first running of Western States 100. I was awe-inspired at the difficulty and epic-ness of such a journey and fantasized about someday trying it myself. Life got in the way of such aspirations, but ever since, it’s been in the back of my mind that I wanted to do a 100-miler. I’m now also interested in exercise physiology, and diet and exercise effects on health, and am intrigued by how the body manages energy, so experiencing the highs and lows of energy in ultra events is fascinating to me. So kind of on the spur of the moment, I decided to give Rio del Lago a try.

Now tackling a 100-miler for someone like me is no easy matter. In addition to having a bum and finicky foot, I’m not particularly fast, robust, or tolerant of heat, and my feet get easily blistered (OK, I’m old, frail, slow and whiny, especially if it’s over 70º F). I consulted with Don and Gillian http://www.zombierunner.com/ about strategy and was told to 1) get lots of sleep prior to the race, 2) be comfortable with night running, 3) keep the pace down, walking the hills, and 4) resolve not to give up. Don warned me it would be warm, but I was still glowing from the unseasonable cold front that had just gone through a few days prior. The pace chart indicated that the paces necessary to complete the race are not even that fast—for more than half the race, an 18-minute pace is good enough to make the cutoff times. I felt pretty confident I could manage those factors and that pace and decided to go for it. David agreed to be my crew and pacer if needed, even though his Achilles was not really up to running long distances, but he felt that with the pace I’d be keeping late in the race, it would likely be easy enough that he could pace me without aggravating his injury.

Since I signed up on the last possible day (Thursday) before the race, I didn’t have a lot of time for the reality to sink into my head. As a consequence, Thursday night I barely slept—I dutifully lay there inviting sleep, but my mind had other ideas, namely processing the shock of actually trying to “run” 100 miles (Ok, we all know it’s not all running, but lots of hiking or walking too). This insomnia was unusual and was the first strategic error of many. We drove up on Friday afternoon after frantically trying (and failing) to find our night-running lights, arriving late for the check-in, and then had to go shopping for flashlights. I was such a wreck that my blood pressure and heart rate were abnormally high at the check-in. Of course they were—I was about to do a really challenging and stupid thing, I was terrified! (But at least my valves checked out healthy.) We found several cheap LED flashlights that seemed suitable for the night running portion in a hardware store and proceeded to dinner and finish preparations for the morrow’s race. Dinner was at Denny’s (I had tilapia and mashed potatoes—that and some yogurt with fruit and granola was the extent of my carb loading on Friday). We got my breakfast for the next morning (eggs, sausage, hash-browns and pancakes) as take-out so we would be all set to go.
After dinner, it was time for a shower and foot preparations. I opted for kinesio tape around the balls and heels of each foot and a couple of toes each (but no tincture of benzoin). The middle toe on my left foot seems to blister without fail of late and I was most worried about it, so I taped it and the adjoining one for good measure, and did the same for the right foot. We were in bed by 9:30 and I fell asleep quickly, being already sleep deprived, only to wake up at midnight unable to fall asleep again. Not only could I not sleep, I began to get a nagging headache that I could not ignore. By 4 AM I started in on ibuprofen, and by 5 AM when I was supposed to be eating my hearty breakfast, I was nauseous and unable to eat more than a couple of bites of egg and hashbrowns. This was unpleasant, but not necessarily terrible, since I am used to running fasted or having eaten little. I would have to make do with the Gu in my bottle for fuel (and a few gels) until the aid stations.



A blur of one of the fast runners


The Race
Standing around before the start, I said hello to Stacey and Misty (they looked so cute in their race outfits) and looked around for other people I knew. But conversation would have to wait because in moments we were out the door with our flashlights in the pre-dawn gloom. The first section was nice and cool, and easy with rolling hills on wide trails. I tried to walk the hills, but occasionally ran them anyway since they were shallow and I was way too excited to slow down. It began to warm up as soon as the sun peeked over the other side of Folsom Lake, and I realized then that it was indeed going to be HOT, not just warm. My T-shirt came off and I decided to pick up the pace a little to get as far as possible before being reduced to melting slug pace. This worked for the first few miles, and I ran with a few other runners, trying to navigate the poorly marked section (someone had been removing ribbons). The Twin Rocks section proved difficult—stepping up and over boulders and roots, then back down, never too much elevation change, but tricky footing nonetheless. I ran with Tracy Youngstedt for a while and commented that I knew I was supposed to get through the first third of the race without doing anything stupid (according to Olga), this after nearly doing a face plant from kicking a root. Finally the Twin Rocks section was finished and I finally saw David for the first time at Rattlesnake Bar (mile 11.9). He offered me breakfast, and I took the rest of the eggs and hash-browns in a cup, and attempted to eat them during walking breaks (of course after dropping the cup and spilling the food a couple of times, didn’t manage to eat all that much). On past the power plant and toward Cardiac, all seemed well until the trail began to really heat up in the strengthening sun. At one point I came across a stream and just stared at it incredulous—coolness. I untied by T-shirt, dunked it in the water and draped it across my shoulders—instant relief! At another creek crossing, I refreshed the wetting and so was kept somewhat cool until reaching the aid station at the foot of Cardiac (where ice and Coke was provided). It was now full blown HOT and all I could do was trudge forward toward the flume trail, chewing on bits of ice. The flume provided more shirt wetting and relief, and I managed to jog a bit now and then toward Maidu and then Auburn Dam Overlook. At Maidu (mile 21.2), the aid station volunteer gave me a juicy PB & J sandwich, of which I again only managed to eat half (though it was delicious).



Maidu aid station and the flume trail


I reached Auburn Dam Overlook (mile 22.7) well within the cutoff time (well, 40 minutes to spare), got weighed and was maintaining weight ok, so presumably hydration was ok. David handed me V8 juice in my water bottle, well diluted with ice. I took coke with ice as well, wetted my T shirt again, and proceeded down what I expected to be an easy bit of downhill to No Hands Bridge aid station. Unfortunately, this stretch of trail was not all downhill, not easy, and HOT. There are numerous uphills which appear as innocent little jiggles on the course profile. I was amazed to see both Jean Pommier and Sean Lang already returning from Cool at this stage! They looked so light and fresh trotting up the hill to Auburn Dam Overlook. I set my Garmin to re-charging on this section and so could not see how long it was taking, but it seemed to take forever even though it was net downhill (800 feet).



trotting towards Auburn Dam Overlook

I finally dragged myself into No-Hands Bridge aid station (mile 26.7), barely able to muster a trot on level ground over the bridge in the oppressive heat. One fellow runner sitting at the aid station looked to be suffering from heat exhaustion, as he was trembling and pale and limp. The sympathetic volunteers loaded me up with ice—in my hat, bra and bandana—for the long climb up K2. I got more iced V8 from David and took some grilled cheese sandwich pieces (which I again did not manage to eat). I was prepared for this steep climb and its numerous false summits, and it wasn’t too bad. There was some shade at least and my ice kept me cool enough to keep moving, but slowly. I did pass my first “conquest” at this stage—a man who had been nauseous for the last ten miles, he said. He described himself as an “urban polar bear” and bemoaned the fierce heat radiating up from the trail (if only the clouds from the few days prior had remained), with which I agreed wholeheartedly. I was still moving ok, though mostly just at a walk towards Cool, and passed S Baboo on his return from Cool, all smiling and making it look easy. At this point, my stomach too was beginning to feel funny. There was a suspicious pain and when I pushed on it I realized that my entire belly was distended with liquid—I wasn’t processing fluids anymore! Trouble seemed to be brewing.



unknown runner coming across No Hands Bridge

Finally at Cool (mile 29.8), I switched to ice water only and sucked it down like a fiend. I’ve never experienced thirst like that, and could not get enough water. I also got this idea in my head that I might be getting too much potassium from the V8 juice and was worried about developing a heart arrhythmia (don’t know where this idea came from but it was probably wrong). I tried again to eat some solid foods when David gave me a cup full of “beef bowl” (beef, broth and rice that we brought with us) which I badly needed for fuel. I left this aid station nursing my cup of coke and ice (mostly ice), then drinking ice water. There was very little shade, and at one point I just sat down on the trail in the shade of a tree for a moment. I believed I had plenty of time and just needed to get through the loop without mishap, and hopefully things would be cooling off by the time I had to head back to the hot canyon. There was one other runner that I played leap frog with here. He got ahead of me after the aid station, because he ran while I walked (lazy me), then when I was getting desperate for more water, I ran and passed him again. Finally refilled with ice water at the Knickerbocker Hill aid station (mile 35.3), I ran briefly on the 1.5 mile road section, but just couldn’t bring myself to keep running, even though there was a nice breeze by now and it was plainly cooling off. I practiced a power walk instead and was pleased that it wasn’t too bad.

Refilling with food, ice and water at Cool again (mile 36.9), I left at a leisurely pace crunching on ice, drinking coke and slurping a small cup of beef bowl (only had two hands or I’d have carried more food!), then upon reaching the downhill, trotted along as expeditiously as possible, watching for the trail markers, afraid I would miss the turn like one runner I saw coming the wrong direction down K2. This section was relatively fast and easy, but upon reaching the No-Hands Bridge aid station (mile 40.4) realized that I had run out of buffer time and was going to have to run my tail off back up to Auburn Dam Overlook, 4 miles with an 800 foot climb in a little over an hour! While this section was my least favorite on the way out, it became my favorite on the return trip. Even though it was a long climb, it was broken by brief downhill segments (uphill on the way out), and much of it was of a runnable grade, plus it was cooling off by now. I pulled into Auburn Dam Overlook aid station (mile 44.3) as the volunteer was yelling a three minute warning at me, quickly weighed myself (only 2 pounds down), then had to leave immediately for Maidu. I followed the flume trail feeling good, jogging and passing a couple of other runners, then met David again for another refill on food at Maidu (mile 45.8). This time he added coconut milk with chicken broth to my beef/rice bowl, and the feeling of actual calories going down my throat was amazing. To this point (45 miles) I had eaten a half PB&J sandwich, 3 gels, a few bites of egg leftover from breakfast, 2 bites of grilled cheese, a couple bottles of Gu, 3 bottles of V8 juice, and several small cups of Coke, and I had been on my feet for 13 hours! I guess I was starting to get tired and hungry. David offered to pace me, but I told him I felt surprisingly good and declined his offer (this would turn out to be a mistake). He asked me if I wanted to take a dry T-shirt and I said I was still hot, but at least I didn’t need to wet the T-shirt anymore!



View of American River Canyon

Off along the flume trail again, I turned down the wrong trail (getting behind again) and had to backtrack. It was now becoming dark and the flashlights were necessary, and it was really hard to see the marking ribbons. Going down Cardiac in the dark was also much, much harder than the climb up had been. I couldn’t see far enough ahead on the twisting rooty trail to have any confidence in my footing, so inched down slowly like an old lady (which I guess I am!). There were numerous trail junctions that I hadn’t even noticed on the way up, and each required careful searching for ribbons, which took additional time. At the bottom, all I wanted was to sit and doze for a few minutes as the effects of the sleep deprivation suddenly hit me. But when I got there, the trail sweepers were waiting for me (last again!), and I had to keep moving. I tried to keep the pace up, jogging along occasionally, but the blisters on my feet, which until now had not really been much of a factor, suddenly became noticeable. I was trying to jog along on this overgrown trail, which I could see only poorly with my ghostly LED illumination, when I stumbled on a few rocks and several blisters tore open at once on my right foot. The pain was excruciating, and I suddenly realized for the first time in the whole race that I might not be able to finish, might not want to finish. The pain slowly faded, but now I was afraid of the slightest misstep setting off more blister pain. My jogging became more intermittent. Still, I managed to pass a couple of other runners and tried to keep my pace up, but this section seemed interminable, even though I had been looking forward to it as one of the more runnable sections from before. Finally after passing the power plant again, I encountered David coming in from Rattlesnake bar AS to find me. I had lost track of time, because my Garmin power had run out again and since I neglected to charge it again, it shut off. I didn’t realize it until he told me, but I was too far behind schedule and would not be able to make the cutoff time at Rattlesnake Bar (mile 55) and continue past the AS to finish the race.

Afterwards
I wasn’t too disappointed to have to quit because exhaustion and pain have a way of changing one’s priorities. We left Rattlesnake Bar aid station and returned to Cavitt School for some food (all they had that seemed remotely appetizing was watermelon) and a real bathroom (I was tired of peeing in the bushes). Then David just wanted to get us home. The drive home was uneventful and I slept pretty hard. Upon arriving home, I needed to use the bathroom as soon as I got out of the car, and discovered what exploding diarrhea was all about (just in time to the bathroom)! I don’t know what caused the diarrhea—whether it was a side effect of heat exhaustion and dehydration or a sign that my stomach and intestines just couldn’t absorb fluids as fast as I shoved them in. Perhaps the fiber and minerals in the V8 juice were the problem. A comment from one of the AS volunteers seemed to presage the event, as she pointed out that tomato juice gives her diarrhea. Finally home and cleaned up a bit at 3 AM, I had to eat some real food and opted for a large chicken breast poached in the rest of the coconut milk and chicken broth remaining from our supplies. It was delicious and nourishing and I finally slept, with my burning feet on icepacks.

The next morning, my weight was down a full pound and a half (it was down a pound before eating and drinking more before sleep). The real problem was my blistered foot. Only one foot was in a bad way, though I had taped them both the same. It was hot and inflamed and I finally resorted to just soaking both feet in cool water with a little salt and ice added—for TWO days! The blisters were two layers of skin deep, which is more than I usually experience. The plantar fasciitis as expected was not particularly noticeable. I discovered I had chafing over much of my body, wherever I had neglected to put Vaseline. So I had odd scabs on much of my back from the chafing from the water bottle and clothing. Finally three days after the event, my weight had spiked up two pounds, before the compensatory fluid retention passed. Once my weight declined again, I had lost a full pound of body weight, presumably fat, which stayed off. (For some reason, I’ve continued to lose weight in the aftermath and am now down to 138, a new low since going “low carb.”) However, I don’t recommend running 50 or 100 miles just to lose weight!

Postmortem
I now understand the addictive quality of 100-mile races. The lower key pacing throughout (for us back-of-the-pack-ers at least) was just fun and low stress. I only felt I was close to running hard on one segment (making it back to Auburn Dam Overlook)—the rest was easy going (with heart rate at least 10 bpm below my usual race paces). Instead of a race, it felt like an epic adventure, or a trail party. I always think about Aragorn and company chasing after the Orcs and captured hobbits in ultra events. It always feels like a challenge and an adventure, 100-milers even more so. So even though it was much hotter than I hoped, I had a great time.

Running in the heat is still a huge weakness for me, and even though I’m a lot lighter than I used to be, that problem remains. See the Science of Sport posts for some interesting discussion of the effects of heat on performance. Basically, your brain controls how much muscle gets activated when exercising: it senses the heat accumulation and sets the pace accordingly so that your core temperature doesn’t exceed ~40 C (~102º F). Slender, lightweight people can cool themselves much more efficiently, and accumulate heat more slowly, and so can perform at a higher intensity in the heat than heavier people. I guess I’m still too well insulated to perform well in the heat! It shouldn’t have been a deciding factor in this race, however—if I had managed all the other factors better, I could have made all the cutoffs and finished despite the slower pace. Someone like David with a BMI of 25 still performs much better than me in the heat even though theoretically he should overheat more, but perhaps he has the advantage of so much additional muscle that he only needs to activate a fraction of his muscle fibers to keep a comfortable pace.

I was completely prepared to feel crappy at some point in the event, then to come back to life with the sunrise or coffee or something. I wasn’t prepared at all for how quickly my energy levels could go from “I feel surprisingly good” to “I just wanna take a nap.” Neither was my crew. Advice for crew/pacers out there: don’t listen to your runner when they tell you everything is great. They are in denial and a bad patch is inevitable. So do the thinking for your spaced-out runner and try to foresee what they will need before they fall in a hole.

Even though I only made it to 55 miles, it was much harder on me and especially my feet than any 50 mile race I’ve ever run.* I attribute this to the total “time on the feet” fatigue from the slow pace, the drain of heat on salt and energy stores, and the accumulated damage to the feet (blistering is much worse in the heat), not to mention the sleep debt before the race. It’s also possible that I had not eaten enough calories to keep my energy levels high, since I estimate I’d eaten at most 2230 calories during the whole day (less than half the calories burned). Some of that difficulty was due to extreme thirst during the hot hours of the day, when I craved water, pure cold water, and my stomach was having trouble processing the input as it was.

I am intrigued with the energy requirements of these events. I’m not advising anyone to eat as lightly as I do in ultras, but I wonder why we need all this food. I wonder if it’s not mostly just to trick the body into thinking all is well and to trigger reward systems in the brain (like the study that found that just swishing a sweet drink in your mouth, but not actually drinking it, can improve performance). For myself, I know that when I get hungry while running, which certainly happens, eating some small amount of food fixes the problem, but if I don’t eat, nausea will occur and will not be easy to fix once started. Salty or starchy foods, sodas, protein, even fatty foods such as smoked salmon, cheese or nuts—they all seem to help. But this is more to keep the stomach happy than to provide fueling (though I was once revived by a tamale). Not everyone needs huge amounts of calories to get through ultras, for example, Jean Pommier wrote an account of Skyline 50K where he basically ran on nothing but sports-drink and Vespa (which is supposed to enhance fat burning). But again, fast runners just aren’t out there that long, and perhaps that is an important factor in total energy needs in an event.

In my case, a confluence of factors (getting dark, poor visibility, anti-climax from enduring the hot part of the day, accumulated fatigue and pre-existing sleep debt, blisters) suddenly outweighed all the race enthusiasm and improved conditions that came with the cool of night. It would have been helpful to anticipate these energy level fluctuations. We actually had caffeine pills and energy drinks, but elected to save them for later. Unfortunately, they were needed far sooner than expected. I can also say that night-running in a 100-mile race is not like night-running on familiar trails close to home. The dark makes everything more difficult—finding things that you need (especially if you drop something), keeping track of time, seeing far enough ahead to plan running segments and walking breaks, finding course markers.

I recommend this race to anyone contemplating running a 100-miler. The course is excellent, and the volunteers were amazing—experienced runners themselves, they were helpful and truly wanted runners to succeed. Unlike some races where cutoff times are rigidly enforced, in Rio, they are willing to bend them a little if they think it will help runners succeed. However, they could have improved the race by making sure enough trail markers were present, and that glow lights or reflective/phosphoresecent markers were used on the sections run at night, but if you’re not as slow as me or as slowed down by the heat, this problem could be avoided (the wider trails past Cavitt School would have obviated some of this problem too). On the other hand, if you struggle with heat as I do, perhaps you should wait to run this one on a cloudy day.

Gear
Drymax socks, Montrail Continental Divides, GoLite running shirt and skirt, Kinesiotape, hat, saltstick caps, sunscreen, bandana, ankle braces, Garmin 405, USB battery and charging cable.

What worked:
1. Ice in the hat and clothing cavities really helped in the heat- it offset some of the blast radiating off the sunburnt trails, though my legs and feet were always hot.
2. V8 juice really hit the spot, but perhaps less of it would have been better or I should have waited until later
3. Lubing all moving/touching parts
4. Eating food (most anything works for me) to keep the stomach from getting touchy and queasy. The beef with broth and rice went down well and kept the stomach demons at bay. Liquid calories (Gu) and caffeine (Coke) went down well too (though I don’t advocate for their healthfulness—still fructose intake in the context of exercise and low glycogen reserves is likely to rapidly replenish liver glycogen, so maybe in this limited context, fructose is ok).
5. USB battery successfully charged Garmin 405 on the run, and it continued to take data
6. Except for blisters, I didn’t fall down or get injured (I had sore leg and abdominal muscles a couple days later, but nothing extraordinary). I used about 1 Ibuprofen and 1 saltstick cap per hour, especially after 20 miles.
7. I was successful at not wearing myself out on the initial faster portions of trail or early climbs. I was aiming for an overall 12 minute pace on the “flat and easy” portion up to Cardiac at mile ~20, but this section turned out to be anything but flat and easy and my pace was more like 13–16 min/mile, which was still well within the pace estimated by the pace charts. More walking than running in the heat of the day was good enough to keep to the necessary pace.
8. My crew was excellent, attentive and supportive (Thanks David!).


What didn’t work:
1. My taping job sucked, at least on one foot.
2. My brain—I got serious brain fog once it got dark and the accumulated fatigue and sleep debt hit. I couldn’t seem to think straight or solve problems.
3. Signing up late and going into a panic, getting sleep deprived more than usual.
4. I didn’t leave enough time for any deviation from the plan. You need to keep a bigger buffer of time for shoe changes or brief naps etc. even if it seems you have plenty of time, because it can evaporate quickly on you. I should have pushed harder on the loop at Cool and not just waited until the downhills or the evening to do more running than walking.
5. On paper it may appear to be an “easy” 100-miler, but it was (and is often) too HOT to be easy for the vast majority of people. In my case I managed the heat well enough not to get heat exhaustion, but couldn’t quite muster the energy to move as fast as I wanted to.
6. Inadequate night-time lighting. My 60 lumen LED emitted a ghostly diffuse light that provided very poor contrast and texture, making it difficult to estimate distances and surfaces and slowed me down even further. (I had a second better light but was too spaced to think of using it.)
7. Apparently I had some issues with my intestines not absorbing fluids, though I don’t know whether it was due to fiber in the V8 juice or the heat and dehydration itself impeding intestinal absorption. If I had continued on the trail, it could have become very unpleasant.
8. Going it alone when I was getting tired. I should have accepted the aid of my pacer who could have helped me find the trail and keep to the required pace.
9. Not lubing enough skin surfaces—some nasty abrasions and chafing resulted.

* Well, Firetrails this year beat me up pretty bad too.

Thursday, December 11, 2008

We’re improving! Yea!

Well, it seems as if something is improving, albeit slowly. We just completed the Woodside 50K and were pleased to handily beat the cutoff times and bring in a PR (6:31), especially given the difficulty of this course (see profile) relative to our last 50K PR (Skyline-to-the-Sea, previous PR 7:02). The other amazingly cool thing is that I didn’t fall down during this race (though David took a roll instead, thankfully with no injuries). We’ve also benefited from some eye-opening information from using the Garmin 405. Despite its inevitable inaccuracies, it has helped me come to terms with the unpleasant reality of my basic physical condition, what I’m capable of or not, and being realistic about my current status. This allows for focusing on (or trying to focus on, anyway) effective training. Needless to say, I will not be challenging the winners (newcomer Keith Bechtol who smoked the course in 3:36 and destroyed the previous course record of 4:14), but I did come in only ten minutes behind the previous woman in my age group. David was kind enough to pace and encourage me, even though his heart rate monitor revealed that he was consistently performing at a rate about ten beats per minute below mine—in other words, he could have worked a lot harder and gone a lot faster. Thanks Sweetie!

We started out with the pack and just tried to cruise the initial downhill and subsequent climb, which became steeper eventually. David kept telling me I was pushing too hard, and he was right of course—with a heart rate in the mid 160s, I couldn’t sustain that pace the whole way, but I was going to do my best to meet the first cutoff at Bear Gulch (18.9 km, 2:50). We did fine, running up the hills, and slowing to a walk when necessary, and made it to the first aid station (King’s Mtn) about ten minutes faster than I had estimated. I had added an antioxidant tablet (vitamins A, C, and E) and Nuun (for electrolytes) to my water bottle on the way up. (Apparently all the oxidative stress from running generates free radicals that deplete plasma peroxide neutralizing capacity—See for example, the review “Vitamin C for preventing and treating the common cold,” a review of 29 trials involving some 11,000 participants which, while finding minimal effects in general populations, found significant benefit of Vitamin C supplementation in “persons exposed to brief periods of severe physical exercise and/or cold environments.” See also, “Antioxidant supplementation prevents exercise-induced lipid peroxidation, but not inflammation, in ultramarathon runners.”) I added Conquest to the mix at the aid station and guzzled some Coke (for the caffeine and sugar), and tried to choke down a couple of Cliff blocks. There followed the undulating Skyline Trail, deceptively difficult and seemingly unending, before reaching Bear Gulch aid station in 2:30 (well ahead of the cutoff time—I was so thrilled, since our training runs were not so successful). I used one Gu before this aid station, though it’s unclear whether it did any good. By this time, the speedy 35K runners who started 30 minutes after we did had started to pass us—showing us how it is supposed to be done.

The descent into Wunderlich was an enjoyable respite, even though the trail is rough in places and my quads were starting to complain after we’d descended about 1000 feet. We met the front runners heading back up, smiling and making it look easy, and I just tried to keep it steady and not trip or sprain an ankle or something. I trudged back up the hill munching on my sandwich as best I could (it’s hard to eat solid food when there is no saliva!) and washing it down with my antioxidant/electrolyte supplemented sports drink. I conserved energy and fought off an urge to pull over and sleep, and put in some halfhearted jogging at David’s urging. We made it back to the Bear Gulch aid station (33k) by 4:30, and plunged back onto the Skyline Trail for the return trip. The next descent on the Chinquapin trail was heavenly, but they routed us back up the Dean trail (another slow-to-a-walk stretch) before flying down the road to the finish.

I tried to keep up the pace throughout the race, but after a few hours, my body seemed willing to function only at its solid aerobic level (AKA slow). For example, in the descent into Wunderlich, I averaged something like a 9 min mile pace at a HR of 145–150; while during the descent in Huddart I averaged a HR of 140 at the same pace, at least as far as I can tell from my Garmin data, in contrast to the initial part of the race.

What about nutrition during this race? We started out with a Vespa sample that Peter Defty gave us at the Zombie Runner store opening. I supplemented somewhat with carbs (2 Gu’s total, half a ham sandwich, handful of potato chips, few small cups of Coke, sports drink with sugar). I figure since I was pushing into the glycolytic realm (judging by my generally heavy breathing and high heart rate—at least initially, later on I was too tired for that nonsense and HR stayed mostly below 150), I may well be limited by glycogen depletion and some carb supplementation could help. I don’t know that it does, but I did it anyway. David did the entire race on essentially no carbohydrate, using his home-brew protein shake, this time based on coconut milk instead of cow’s milk; he has become a firm believer in running on fat as fuel. Certainly his energy level was more constant than mine (I really wanted a nap on the way back up Wunderlich), but it’s not clear whether that was because I was pushing my limits harder than he was, or his nutrition was superior. I do know that some food is necessary—I’ve experienced nausea with no food (which could, however, be controlled with just a little chicken broth), but I’m not convinced that Gu’s and sugar are really all that helpful.

So what changed? How did our times get better? Since we’ve been doing ultra runs, the weight loss has stalled. I think that some fat loss is still occurring, and there is increased muscle and blood volume and sometimes even swelling and water retention that accounts for some of the stall. But as there has been no further weight loss, that cannot be the reason for improvement. Since the Firetrails 50 miler and SF One Day, we decided it was time to focus on some basic running skills, and actually “train” on occasion. Having run track as a sprinter in my youth, I knew enough to design some simple intervals to see what various paces feel like. It was a pleasant reminder to feel what a 7- or 8-minute pace is like again, and strangely addictive (I want to keep doing it, even though I can’t keep it up for long, unfortunately). We’ve started timing our runs so we can see what might be working, and are including some fartlek segments and some hill sprints in addition to occasional track workouts. I think the most important improvement has come from running on roads, since trail runs inevitably make me stop to walk, if only to admire a beautiful view, or for hills, while road running provides fewer interruptions, allowing you to work on cadence and breathing and consistency, what I’ve been sadly lacking.
So we’ll keep it up and see where it goes!

Saturday, July 26, 2008

Fruit is Good for you, Right?

We've all been taught that we should eat plenty of "fruits and vegetables." Fruits and vegetables are rarely separated out in nutritional guidelines. They are separated but paired in the USDA food pyramid which recommends eating about equal parts "fruits" and "vegetables." (A more detailed version of current USDA recommendations can be found at mypyramid.gov and health.gov.) Parents are typically happy if they can get their children to eat lots of fruit juice and fruit products (typically with added sugar) when they won't eat much in the way of vegetables.

Even among those who are supposedly being more discriminating about their food choices, fruits are almost always treated as something to eat in large, if not unlimited, quantity. For example, the Paleo Diet, which attempts to recommend a diet alleged to be similar to that of our hunter-gatherer ancestors, recommends consuming "all the fruit and non-starchy vegetables you can eat." (You are warned against eating too much dried fruit—most fresh fruits are about 80–90% water, so removing most of the water can dramatically increase the total quantity you can eat. Similarly, some people warn against drinking too much fruit juice which is another way you can consume a lot more fruit very quickly.)

Fruits are alleged to be good for you, because they contain a lot of essential vitamins and minerals as well as fiber and such newer necessities as "phytochemicals" and "antioxidants." So what's really in fruit? Even those of us who habitually read nutrition labels tend to be unfamiliar with the nutritional content of most fruits, since, as typically sold fresh, there aren't any nutritional labels. The following table gives some data for a lot of common (and a few less common) fruits.

Fruit Protein Fat Carb Fiber Sugar Fructose Glucose Sucrose Other
All based on 100 gm serving
Apple 0 g 0 g 13 g 1 g 10 g 6 g 3.2 g 0.8 g 7% C

Apricot 1 0 11 2 9 0.9 2.4 5.9 39% A, 17% C, 7% Potassium
Banana 1 0 23 3 12 4.9 5.0 2.4 15% C, 18% B6, 10% Potassium, 13% Mn
Blackberry 1 0 10 5 5 2.4 2.3 0.1 35% C, 32% Mn
Blueberry 1 0 14 2 10 5.0 4.9 0.1 16% C, 24% K, 17% Mn
Breadfruit 1 0 27 5 11


48% C, 7% Thiamin, 6% Mg, 14% Potassium
Cherry (sour) 1 0 12 2 8 3.5 4.2 0.8 26% A, 17% C
Cherry (sweet) 1 0 16 2 13 5.4 6.6 0.2 12% C, 6% Potassium
Cranberry 0 0 12 5 4 0.6 3.3 0.1 22% C, 6% E, 6% K, 18% Mn
Date 2 0 75 7 66 32.0 33.7 0.5 8% Niacin, 12% B6, 8% Pantothenic Acid, 6% Ca, 14% Mg, 6% P, 20% Potassium, 18% Cu, 15% Mn
Fig 1 0 19 3 16


6% K, 6% B6, 7% Potassium, 6% Mn
Grapefruit (pink) 1 0 11 2 7 1.8 1.6 3.5 23% A, 52% C
Grape (red or green) 1 0 18 1 15 8.1 7.2 0.2 18% C, 18% K, 5% Potassium, 6% Cu
Guava 3 1 14 5 9


12% A, 381% C, 6% B6 12% Folate, 12% Potassium, 11% Cu, 8% Mn
Kiwi 1 1 15 3 9 4.4 4.1 0.2 155% C, 7% E, 50% K, 6% Folate, 9% Potassium, 6% Cu
Lemon 1 0 9 3 3


88% C

Lime 1 0 11 3 2


48% C

Mango 1 0 17 2 15


15% A, 46% C, 6% E, 7% B6
Melon (honeydew) 1 0 9 1 9 3.0 2.7 2.5 30% C, 7% Potassium
Nectarine 2 0 15 2 11 1.4 1.6 4.9 7% A, 9% C, 6% Niacin, 6% Potassium
Orange 1 0 12 2 9


75% C, 7 Thiamin
Papaya 1 0 10 2 6


22% A, 103% C, 10% Folate, 7% Potassium
Passion fruit 2 1 23 10 11


25% A, 50% C, 8% Riboflavin, 7% Niacin, 9% Fe, 7% Mg, 7% P, 10% Potassium
Peach 1 0 10 1 8 1.5 2.0 4.8 7% A, 11% C
Pear 0 0 15 3 10 6.2 2.8 0.8 7% C, 6% K
Pineapple (sweet) 1 0 13 1 10 2.2 1.7 6.5 94% C, 6% B6, 6% Cu, 41% Mn
Plum 1 0 11 1 10 3.1 5.1 1.6 7% A, 16%, C
Pomegranate 1 0 17 1 17


10% C, 6% K, 6% Pantothenic Acid, 7% Potassium
Raspberry 1 1 12 6 4 2.4 1.9 0.2 44% C, 10% K, 34% Mn
Rhubarb 1 0 5 2 1


13% C, 37% K, 9% Ca, 8% Potassium, 10% Mn
Strawberry 1 0 8 2 5 2.4 2.0 0.5 98% C, 6% Folate, 19% Mn
Tamarind 3 1 63 5 57


6% C, 29% Thiamine, 10% Niacin, 7% Ca, 16% Fe, 23% Mg, 11% P, 18% Potassium
Watermelon 1 0 8 0 6 3.4 1.6 0.1 11% A, 13% C

(All data from nutritiondata.com. Vitamin and mineral content are given as % daily value. 'K' is Vitamin K; potassium is spelled out.)

As you can see, fruits are mostly sugar and water. There's typically about 1% protein, no fat, a modest amount of fiber, and a very small amount of more complex nutritive carbohydrate. Some fruits are admittedly good sources of particular vitamins and minerals, but you get a pretty generous "spoonful of sugar" with your daily dose of vitamins and minerals if you get them mostly from fruit. If you're after the trace nutrients, you'd be better off with vegetable sources anyway. Compare the following (the first three of which are arguably "fruits" in the botanical sense, although we usually call them "vegetables," because of the ways we tend to serve them).

"Vegetable" Protein Fat Carb Fiber Sugar Fructose Glucose Sucrose Other
Tomato 1 0 4 1 3 1.4 1.2 0.0 17% A, 21% C, 10% K, 7% Potassium, 6% Mn
Cucumber 1 0 4 0 2 0.9 0.8 0.0 21% K
Green Bean 2 0 7 3 1


14% A, 27% C, 18% K, 6% Thiamine, 6% Riboflavin, 9% Folate, 6% Fe, 6% Mg, 6% Potassium, 11% Mn
Broccoli 3 0 6 2 2 0.7 0.5 0.1 12% A, 149% C, 127% K, 7% Riboflavin, 9% B6, 16% Folate 6% Pantothenic Acid, 7% P, 9% Potassium, 10% Mn


There doesn't seem to be any good reason to eat fruits for their higher vitamin content; the vegetables have more vitamins anyway! Vegetables provide generous amounts of fiber as well.

So then maybe fruit sugars are somehow better for you? Certainly many "natural foods" advocates seem to believe that "natural" and "unrefined" sweeteners are somehow OK when table sugar is not. But the sugar in most fruits is nutritionally almost the same as that of table sugar. Table sugar is sucrose which is a disaccharide made up of equal parts fructose and glucose. Most fruits also have approximately equal amounts of fructose and glucose either separately or combined as sucrose. The body breaks apart the sucrose right away. Fructose and glucose are metabolized somewhat differently. While fructose has an apparently lower glycemic response, it appears to be more harmful overall resulting in elevated triglyceride levels and fat storage much more than does glucose. So focusing on apples and pears with their higher fructose content is probably even worse than going for the fruits with more balanced sugar content. A more detailed discussion of the metabolism of fructose and glucose can be found in Basciano et al., "Fructose, Insulin Resistance, and Metabolic Dyslipidemia," Nutr. & Metab., 2005, 2:5.

So my conclusion from all this is that fruits are not health food! They're by no means terrible, especially when consumed in moderation as whole fruit, but as macronutrients, they are primarily bags of flavored sugar water. Particularly if you are trying to cut back on total carbohydrate consumption and on sugar consumption in particular, you should seriously consider limiting your fruit intake and increasing your vegetable intake instead, or at least focusing on lower-sugar fruits such as raspberries, blackberries, and cranberries. For us, fruit is relegated to the role of dessert, to be consumed once or twice a day in ~½-cup portions, to alleviate carb cravings. This way, the sugar loading from fruit is kept to a minimum of 20–25 g.