Exercising with IBS: How to Fuel Your Workouts Without Triggering a Flare

Jessie (00:00):
Welcome to the IBS Nutrition Podcast, your go- to source for navigating the complex diagnosis of irritable bowel syndrome. Here we dive deep into IBS and discover the power of diet and lifestyle to find freedom from your IBS symptoms. Whether you’re newly diagnosed or have been managing IBS for years, you are in the right place for relief. I’m your host, Jessie Wong, FODMAP dietician and a gut expert. For years, I suffered from debilitating gut symptoms that kept me out of work, feeling constant discomfort in my body and anxious around food. Today, I’m in control of my IBS, able to eat the food I love again, travel whenever I want and spend quality time with loved ones. It is my mission to help you do the same and transform the way you live with IBS. Let’s get started. Hi everybody. Welcome to another episode of the IBS Nutrition Podcast.

(00:54)Today we are bridging the gap between two things that don’t always play nicely together, exercising and a sensitive gut. So to help us cut through the noise and figure out how to fuel our bodies without triggering a flare up, I am so excited to welcome Leslie Bonce to the show. First, a little bit about our amazing guest. Leslie is a registered dietician and sports dietician with serious expertise in digestive health. She’s the owner of Active Eating Advice, Be Fit, Fed, Fearless, and a co-founder of Performance 365. She has worked with everyone from college, professional and Olympic athletes, to performance artists and everyday people looking to hit their health and performance goals. Leslie is an absolute champion of shutting down misinformation online and she’s a fierce advocate for her clients. She’s also a former spokesperson for the Academy of Nutrition and Dietetics and the author of the American Dietetic Association Guide to Better Digestion.

(01:59)Welcome to the podcast, Leslie.

Leslie (02:00):
Jessie, thank you so much for having me here. Thank you for that wonderful introduction. And I think certainly what’s important for everybody, if your gut doesn’t feel good, you don’t feel good, no matter what it is that you do. And so it’s been really, I think, a very unique niche to be able to blend the recommendations for people that are physically active and at the same time some of the GI things that people didn’t even know they had until they start to be physically active and all of a sudden it’s like, “Uh-oh, now what do we do?

Jessie (02:30):
” Absolutely. Well, after that intro, I also want to add a snippet for everybody listening. Leslie was my mentor when I entered the field of dietetics. So when I started my dietetic journey, I was a sports dietician who worked at collegiate level with one of the Big 10 schools for quite a few years. And lastly, her and her amazing resources was what got me into the field and what got me to be very fluent into working with athletes to help them advance their performances. So this is a full circle moment for me to be able to interview Leslie here to help people who are listening, who have GI disorders and get to a better place with feeling their bodies and more importantly is improving their performances. Like what you were saying, when you have GI disorder or you have GI discomforts, you can’t feel properly and you cannot perform properly. So it is such an honor for me to have Leslie here.

Leslie (03:34):
I am delighted to do this. And I think this is definitely a profession that keeps on giving. And even though there are a lot of us, it’s a relatively small circle and the more that we know each other help each other give to, give back, give on, that is what is very unique to this profession.

Jessie (03:52):
Yes, absolutely. Okay. So for audiences here, let’s get started today. There are three topics that we really want to hit on today. First is unintended consequences of food elimination, which is something I see so often and oftentimes people didn’t know that they have to reintroduce food. So we’re going to talk about that first. Second is how timing, volume and form of the food impacts your gut during exercise. And three, this is probably a topic that everybody wants to ask you about supplements. How do you choose supplements for a digestive health perspective, especially for athletes because there are a lot of, what do you say, red tape danger zone for athletes when choosing supplements and let’s chat all about that. I love it. Okay. Now let’s get started with the first one, unintended consequences of food elimination.

Leslie (04:44):
Yes. So a lot of times for whatever reason it is, sometimes it’s because we follow a particular influencer or our favorite athlete or whatever the case is and they’re not eating a food. And so we decide we won’t do that either. We’ll cut out a food. Okay. Now, because the audience that we’re talking about are people that are physically active. So you can’t just cut something out without finding a replacement for is, “Oh, well, I’m not going to consume enough fluid.” Well, that’s a recipe for disaster each and every time because it’s going to impact your strength and your speed and stamina, recovery, injury prevention, all of it. So we can’t do that. Secondly, if somebody says, “Well, all right, I don’t want to eat anything with a face.” It’s fine. We can be plant-based, but we need to be protein optimal. This is not either or.

(05:32)It’s both of those things together. So if somebody says, “I’m not going to eat anything that has eyes,” then whatever you’re going to replace it with has to be the same. And this is especially important when we’re looking at active people because not only do we have to nourish the general muscles, we have to nourish the skeletal muscle, which contracts against the bone. And so if we have deficits, then there’s going to be consequences of increased risk of fracture. We don’t want that. Third is if we’re looking at somebody saying, “But I’ll just cut out the carbs.” And I have to tell you, Jessie, I hear this far too many times in people that are active like, “What are you thinking?” You can’t do that. And typically the reason that they’ll give is, “Well, I want to lose weight.” But you’re losing water and you’re losing performance benefit and you’re not necessarily losing body fat or so- and-so athlete did this and I’ll cut it out too, or I won’t eat gluten anymore.

(06:29)There’s a huge difference. Somebody that has celiac disease or might have gluten sensitivity, then the rest of everybody else who just decides to cut it out for whatever reason would say the same thing about dairy foods. If you’re lactose intolerant, first of all, there’s alternative. If you’re allergic to milk, don’t have it. But other than that, what are we talking about because the replacements are not necessarily the same nutritional. It would be if somebody said, “I’m used to running in a certain pair of shoes and now I’ll run in shoes that have no treads.” Okay, you’re probably not going to get that far because your body doesn’t have the support that it needs. And then oftentimes I find when people eliminate things for whatever reason it is, well, if you don’t eat a food regularly, your body is not going to secrete those enzymes. So then you reintroduce the food and your body’s like, “What were you thinking?

(07:19)Oh no, I’ll never eat that food again.” That’s not what’s happening. It happened because you didn’t give your body that food regularly. Your body gets a little lazy at being able to accommodate whatever that food is and you have to reintroduce it in gradually. So why are we doing that in the first place if we don’t need to? Jessie (07:36):
Okay. Leslie, I love that. You said so much. Let’s unpack this a little bit. And I love how you say that we are seeing a lot this day that people are cutting out foods. What you were saying, one is cutting out carbs or going vegetarian. Let’s break it down. Let’s talk about going vegetarian. What are some essential nutrients we are missing when we go vegetarian?

Leslie (08:00):
Yeah. And then not everybody does. I think the biggest issues are when people just start taking things off their plate and they don’t think about how they’re going to replace it. So none of us are going to optimize whatever we do, optimize our health, optimize performance. If we say, no more protein for me or no more carbohydrate for me, we can’t do that. And quality is really the driver here of everything. So we’re really looking at, doesn’t mean the most expensive. It means when I’m talking about this in particular related to protein, it’s not just what we ingest what we take in, it’s what we digest, how our body breaks it down and know that they’re not all the same. There’s nothing wrong with eating plants, but we might have to eat more of those in order to get the same benefits. So if somebody says, “Well, I’ll swap my dairy milk for a nut-based milk,” you can do that because you can buy them both, but they’re not the same.

(08:54)And that’ really, I think it might not be an all in out elimination, but it might be a minimization, which can also be problematic because now we’re subpar in terms of what our body needs. When it comes to dairy, what we are getting out of dairy is a lot of things, but calcium is a big part of it and calcium is really important for preventing osteoporosis and bone health and protecting athletes’ bone in general because if they’re doing high impact exercise, we are causing our bones to regenerate a lot. So if we are choosing a plant-based meal, say for somebody who is more plant-based, would you recommend choosing something that may be fortified? Is there a percentage of calcium we’re looking for?

Leslie (09:35):
Yes. And a lot of them are. A lot of the plant-based milk are fortified with calcium, but I think even before that is we want to look at the quality of the protein. So truly, if we’re looking at a plant-based alternative, soy is the one a soy milk is going to be the most comparable to using a dairy milk. So again, there’s lots of options like banana milk, okay, or cashew milk or all these other things, but just because it’s sold in a carton that looks similar doesn’t mean that it’s the same. And that’s why. If you want to use those things, use them, but realize then you’re going to have to make it up on the other side with what you’re going to add to get to your body’s quota of what it needs daily.

Jessie (10:14):
Right, absolutely. And for people listening, because this is the IBS nutrition podcast, a lot of people are on the low format diet. So if you want to find something that’s more equivalent, it would be rice milk or almond milk, but make sure they are fortified with calcium and vitamin D so that you can actually swerve to calcium. Okay. Then another thing you touched on earlier is people cutting out carbs. Oh, this is a big no-no for athletes.

Leslie (10:40):
And I think so much of this is so many people are appearance focused. Well, that doesn’t mean that we shouldn’t care about what our body looks like, but we are certainly more than our outward appearance. What is happening inwardly? When I work with athletes all different sports, all different ages, all different abilities, I’ve never ever, Jessie, met an athlete that said to me, “I want to be the slowest. I want to be the weakest and I want to tire before everybody else.” Nobody says this, but yet if they’re eating in a way where, well, I won’t do any carbs or I’ll minimize it, guess what? You’re going to be the slowest, you’re going to be the weakest and you’re going to fatigue as well as taking longer to recover. Now, having said that, this is not an issue of excess and all of us have certain things that we like or certain things that we tolerate better than others, but the answer should never be none on the plate.

(11:35)That is absolutely not going to work. So if somebody says, “I’m eating something for exercise and it’s just beef jerky, but where’s the carbohydrate?” Because it’s not going to be there and that’s that rate limiting step of giving the body the energy it needs consistently.

Jessie (11:53):
Okay, great. And I loved what you touched on about the gluten-free diet because it has become very popular. My feeling with it become main popular is kind of love-hate relationship because it also opens up a lot more options for people with celiac disease or non-celia wheat sensitivity because there’s a lot more certified gluten-free products out there. But we do often see people who put themselves on diet and one is not always helping with their gut symptoms because it’s not necessary. There’s only a small population that may need the gluten-free diet. But when these population need the gluten-free diet, they’re not kidding about it. They really need it. So when there’s a lot of influencers who says they’re gluten-free, but then they don’t care about cross-contact or cross-contamination, it really muddles the message and makes it difficult for surface industry that services this population to think that, well, maybe not everybody needs gluten-free needs to be gluten-free.

Leslie (12:50):
I would absolutely 100% agree. And definitely for people that have celiac, for people that have gluten sensitivity, this is how you take care of your health is that you are extremely careful about what it is that you consume and you have to be vigilant about it. And it does make a difference because if you’re eating things that your body doesn’t tolerate well, you’re not going to feel great. That’s very different than somebody saying, “I’m going to cut it out because so- and-so did so. ” And chances are you’re not even going to notice any difference in terms of your performance, but at the end of the day, again, it’s all about the cutout. When I work with people that have celiac disease, what am I not saying to them? I’m not saying never eat a carb again. It’s like, all right, if you can’t tolerate a regular pasta, then we’re going to think about a bean-based pasta or maybe it’s a potato or maybe it’s some rice.

(13:39)I am not saying to them, never again should those things be on your plate. And unfortunately, I think a lot of time for people who don’t have the underlying medical issues, this is what they do. “Well, carbs are all bad, so I just won’t eat any. “That’s not the message that we are giving at all.

Jessie (13:55):
Yes, that’s great. Now there is one more elimination diet in the GI space I’m sure you’re very familiar with too, is the low FAMAP diet. Now what do you say to people who might be on the low FAMAP diet and they have no plan on reintroducing or didn’t even know that they are supposed to reintroduce food?

Leslie (14:14):
One of the things that I would say is if you are doing low FODMAP, it would be like somebody who said,” I’ve run a mile and tomorrow I’m going to run 26.2. I’m just going to do a marathon tomorrow. “You can’t because your body is like, ” What were you thinking? “And you have to ease in gradually. This is a lot of things to think about simultaneously. We’re looking acros five different categories. We’re looking at quantity of, we’re looking about taking things out and gradually introducing them. So I would say kind of my running analogy as a lot of people have a running coach in some way, shape or form, if you are going to do low FODMAP, you are going to do it with a nutrition coach. You’re going to do it with a registered dietician who is absolutely proficient in knowing how to manage this because it is not an easy thing to do.

(15:01)And you have this big list of, ” Oh, and I can’t. At the same time, what’s your list of you can? Because we just can’t offer it in the avoid. We have to talk more about the include so that you create a list of fuel that works for you.

Jessie (15:17):
Yeah, that’s wonderful. And for everybody listening, we do have a podcast episode on the lofomab diet to kind of break it down for you. That is episode number five of the IBS Nutrition Podcast. And to second what Leslie was saying, the Lvhomabi is complicated. It’s not what you cannot eat, it’s what you can replace with the high FOMAP foods. Well, replace the high FOMA foods with the low FOMA foods. And oftentimes we see people cutting out way too much food. They might experience symptom relief at first, but the longer they cut out the food, the less likely the symptom relief stays on and some symptoms will come back and they cut out more and more food and that’s where we see people getting into trouble. And one of the things to touch on earlier about our ability to break down these foods when we’ve cut them out for prolonged periods actually decreases.

(16:06)And I just want to second that 100%, especially when it comes to high FORMAP foods. So FODMAPs are fermentable carbohydrates. We don’t digest it, our gut microbes digest it. And when you cut it out for prolonged periods, the group of gut microbes that helps you digest these FODMAPs diminishes over time. Actually, research have shown that prolongs elimination and I’m only talking about eight weeks. So it’s not even that long. If you cut out FORMAPs for eight weeks, we are seeing a shift in the gut microbiome and we are also seeing a decrease in the gut microbes that can help you break down FODMAPs. Now, proper ways to do the FOMAP elimination diet is really two to six weeks of elimination with proper reintroduction and personalization. So if you want to learn more about that, go listen to episode five of the podcast. Don’t just cut it out.

(17:00)And it probably will make you more sensitive to the FODMAPs in the long run. And like what Leslie said, if you do need to bring it back, do we gradually work with a trained dietician on it to help you so that you can actually eat more of the food and tolerate more of it instead of being afraid of it?

Leslie (17:17):
The other interesting thing about that, Jessie, is that there certainly have been studies done that some athletes find and we’re talking particularly jostling activity when your gut is moving up and down. Golf is probably not one of them, but running indeed could be is that you might not tolerate certain foods around exercise time. That is not the same as you can never tolerate them. It means that those are the foods that you choose not to have in that hour or so that your body’s physically active and that’s why timing becomes so critically important. So rather than say to people never again, it’s yes, but think about when you have them so it’s not going to interfere with your digestive tract in some adverse way when you are physically

Jessie (17:59):
Active. Well, that is a perfect lead into our second topic, how timing, volume, and form of food impacts the gut during exercise.

Leslie (18:11):
And so one of the things that people don’t realize is, “Well, I’m exercising. So my arms and my legs are moving.” That’s true, but what else is moving? Your digestive tract, it’s muscles. It moves up and down too. So if somebody’s running, we have jostling. If somebody’s swimming in a pool, it might be a little bit less, but my triathletes and open water swim, you’re going up and down with the waves. It just makes me seasick thinking about it. When somebody is on a bike, you’re hunched over the bike or rowers, they’re sitting and the way that their body is moving, the one we eat it, the form of that food, if it’s sitting in the gut too long, that can feel extremely uncomfortable. The most important thing that I always say to all of my athletes is I really like them to cut off their eating about an hour before, really give the gut about an hour for foods to leave the stomach.

(19:08)So it’s not totally on empty, but also we don’t feel like there’s something in there that’s getting in the way of making us feel uncomfortable. And that’s oftentimes why pregame meals, that three or four hours ahead of time, not 15 minutes that you shove food in your face before your body is physically active, then it’s more likely to be out of you in some horrible way than it is to stay in you. So the timing does matter and then the form. So even if somebody is exercising a lot of emphasis, and I’ve been doing this for way too many years, Jessie, but everybody always focuses pregame meal, the pregame meal. Honestly, who cares? If what have you done the five days leading up to your event rather than the pregame meal, because a lot of people are nervous before they compete. That’s not going to be their best eating because they’re too worried about what’s going to be happening.

(19:59)On days that we don’t compete, we’re not nervous and we can eat a little bit better. I really like the pregame things to be happening two or three days prior. And that’s one of the recommendations we give around carbohydrates. When do you increase them in the two days prior to the event, not trying to shove a big bowl of pasta into your face six hours before you’re going to run a marathon. Guarantee that is a recipe for disaster.

Jessie (20:26):
Absolutely. Can you give a specific example? For example, somebody is training for a marathon and they’re running in five days, when would you tell them to start doing the carb loading leading up to the game?

Leslie (20:39):
Yeah. So usually what we would look at, and the way that they used to do this is you would deplete your body, you would eat very minimal amount of carbohydrate. You would do as much exercise as you could. Then you would stop the exercise and bring in all this carbohydrate and end up feeling like SpongeBob square pants because your body’s holding this water and you’re kind of waddling around and that feels dreadful. We don’t do it that way anymore. What typically we say is two days. So let’s say you’re running a marathon on Sunday. So that means on Friday and Saturday, what you’re looking for is anywhere from five to six grams of carbohydrate per pound body weight. That’s not a teeny tiny amount, but it’s also not unlimited because it’s based upon your body weight and not just one huge chocolate cake. It might be over the course of every meal.

(21:28)So okay, I’m having more oatmeal in the morning. I’m adding a little bit more fruit. At lunchtime, maybe I’m having my sandwich on a bagel instead of doing something like bread and maybe I’m having some pretzels with it or a little bit of fruit that’s there and maybe I’m having an extra snack during the day and I’m using something like an oat based cereal, whatever it might be. And for dinner, maybe I’m having a slightly larger potato. So as part of every eating occasion, we’re adding in carbohydrate, not to the exclusion of all else and depending upon what feels comfortable in the gut. So that does two things. One, it allows our body to stockpile glycogen, that stored form of carbohydrate in our muscle and liver and two, that allows our body to hold more fluid. So we’re less likely to dehydrate when we run.

(22:13)So two things are happening and we don’t have to do it for any longer than that. And I think it always feels more comfortable to divide that out over the course of the day rather than just try and get it all in at one meal. That never, ever works.

Jessie (22:28):
Absolutely not. And I did the math. So for somebody who is 150 pounds, we’re talking about 750 grams of carbohydrates to 900 grams of carbohydrates. That’s not something you want to eat in one meal. And like you said, spread it out, make sure you’re feeling your body at every meal and leading up to the games, you want to eat a bit more carbohydrates. And probably for somebody with more GI issues, maybe those other few days to go lower FOTMAP so there’s less irritant in their guts. But then after the game or after the match they order run, they can go back to normal diet.

Leslie (23:04):
Right. I think the other thing for people to realize is so many people, sugar is bad and sugar is bad. Well, we’re really looking at sugar with a purpose and we’re looking at carbohydrate for the benefit. So both of those things together. Ultimately, no matter what carbohydrate we eat, it’s going to become glucose. It’s going to become an available source for the body. What we don’t want to do is overload and say, “Well, let’s just do a copious amount of fiber.” If you’re not used to eating that, you don’t want to do it. We don’t want to bring any other complications into the mix right now. That doesn’t mean that anybody needs to inhale a five pound bag of gummy bears either don’t, but we have to have enough in a form that works. Some of my athletes find that they feel more comfortable if they do things that are more in a liquid form.

(23:52)They’re able to get down more than just trying to eat a huge amount of food and always the closest it is to the time of exercise, we’re looking for things that digest more easily. So it might be that even something like the crayon apple or something like that, a little squeezy pouch. Sometimes that feels more comfortable than I’ll eat a piece of fruit. A piece of fruit feels stuck right here in the esophagus, at least because it’s more liquidy. So these are the things that people need to experiment with and that’s always such a big deal. You are not just training your muscle, you are training your gut for physical activities. So you have to practice. You have to try this in practice. We don’t wait until the day of a marathon and try something new. Never. What are the carbo rules of what not to do and that’s one of them.

Jessie (24:43):
Absolutely. And when you were talking about fiber, fiber maxing has been a trend and I hate to say I’m seeing a lot more in clinic where people are eating a lot of fiber two to three times, sometimes even four times over the recommended limits and they are experiencing GI symptoms. So just want to be clear for everybody here, fiber recommendations is about 25 grams to 38 grams of fiber per day, depending on your gender, depending on your body size and depending on your calorie meat. If you are an athlete and you’re eating more calories, you don’t need to eat more fiber than what your gut needs. What you need is more carbohydrates and probably slightly more protein than normal people. And when we see people eating say 70 to I think over a hundred squams of fiber, your gut is going to suffer because that may just be too much for most normal guts and we do find that when we reduce the fiber amounts to the normal range, their gut symptoms improve drastically.

Leslie (25:48):
And I think certainly as athletes, I want to do the right thing or I need to do it better than everybody else. It’s fine that we want to push our body physically, but better when it’s more is not always the outcome that we’re looking at with food. If you exceed what you need, A, you may be storing it in some way that your body doesn’t want. B, it might cause unintended consequences. So absolutely getting enough fiber. We know it, people need to have enough, but you don’t get brownie points for having an excess of what it is that you need. So there’s lots of different carbohydrates and that’s why we talk about sugar with a purpose. There’s lots of things that can fill that plate, that bowl, that glass that give you that eight to 10 amount, that number of grams of carbohydrate per pound, especially when your body is training.

(26:38)And please, nobody just do that with high fiber foods alone. Don’t do that because it’s going to be incredibly uncomfortable.

Jessie (26:46):
Yes, absolutely. And I love what you said, sugar with purpose. I’ve got kids who does sports and I bring Gatorade. I bring an electrolyte sports drink for the team, but then sometimes when other parents bring it, they bring the zero version and I have to have this conversation with them. Well, when they are running on the field, especially under heats, they really need the sugar. Can you talk a little bit more about that? Why are people choosing the alternative? Why are people who are not exercising drinking electrolytes?

Leslie (27:19):
Yes. And so again, it kind of back to this, whoa, sugar is terrible and we shouldn’t. And when a body is physically active, one of the reasons for that carbohydrate to be there with the electrolytes in the beverage is to help things leave the stomach more quickly. If your stomach is hydrated, that doesn’t help your muscles. It needs to get out of the stomach and to the exercising muscle. That’s one of the reasons. It takes a village. And so it is carbohydrate with electrolytes with fluid together, the trifecta. Now, do we need to have those types of beverages when we’re sitting in a classroom? No, because that is not when a body is physically active. The other thing that I think is very important for people to understand is that even if you pick one that is zero sugar, it doesn’t taste like broccoli. It’s not savory, it’s sweet.

(28:06)So you’re going to add something in there as the sweetener. And depending upon what that sweetener is, that doesn’t always sit well with somebody’s GI tract. So we don’t want to be adding things unnecessarily to the mix that could be problematic. But more important, kids do expend when they are on the field.This is the way it is. Both of my boys played soccer, expended a lot of calories each and every day and zero or water alone wasn’t going to cut it. Now they didn’t have to have a meal when they were on the field, but they certainly needed something other than water. And we always talk about that when exercise is going beyond an hour. You need to have something more than water itself in order to body … I always look at that as a sacrifice fly, Jessie, so that if somebody’s not doing anything other than water, the body still has to generate fuel to get through that exercise.

(28:59)What is it going to do? Well, it may be breaking down a little bit of lean muscle. That should not be the outcome that we’re looking at during exercise. We want to preserve all the lean mass. We want our body to have the energy it needs and that’s why we use that word exogenous or outside fuel. What it is that you’re getting from what you eat or what you drink to make sure that the body doesn’t have to go into its muscle reserves.

Jessie (29:24):
Right. And sports strength can be helpful and/or pouches or gels or gummies. These are things that are easy to digest and release this energy when you are exercising but does not add too much to your GI tract stress.

Leslie (29:38):
Right. And a little bit. I mean, and that’s always the thing is we give big ranges to people. It could be 15 to 30 grams or it could be 90 grams depending upon the number of hours somebody is active. That doesn’t mean you start with 90. That means you start with a little bit to establish a comfort level and you can gradually ramp it up. And I think this is also very true for people with With IBS is certain items that are high FODMAPs. When you’re looking at things that are primarily fructose, that may not sit all that comfortably in your body when you’re physically active. So we can find honey wands and honey stingers and it’s great if somebody works well. Not so great if your gut is compromised because, oh great. Now I’m having a symptom when my body’s physically active. So we really need to be savvy consumers when we are dealing with underlying gut issues.

(30:32)So what’s in a fuel kit for somebody that has IBS is going to be very different than somebody for whom that is not an issue.

Jessie (30:39):
I love that. Yes. And work with your registered dietician who is well versed in both sports and GI to help you create that few kits. All right. Well, now that brings us to our next topic, supplements savvy from digestive health perspective. Tell us everything.

Leslie (30:58):
Okay. So I think supplements have really taken on a world of their own. It’s like the health halo is none of us can be good if we don’t use creatines. Everybody needs collagen, everybody needs all these things. Well, first of all, we don’t because I think the most important thing for people to understand, the way I always explain this to my athletes is when we think of a cupcake with these cute little multicolored sprinkles, the supplements are the sprinkles. If you just ate the sprinkles alone, it would be, yes, we kind of need the cake underneath. And so this is the problem is the supplement is not going to replace the poor diet. It doesn’t work that way. It’s supposed to complement what it is we’re doing in terms of eating. The first thing. The second thing is I think it is critically important for people with underlying gut issues to really be detected.

(31:48)Turn it around and look at it. It won’t have a nutrition fax panel. It’s going to have a supplement fact panel, but there may be things in there that could be problematic. For instance, a sugar alcohol that might be used to sweeten that product. That’s high FODMAP. That is not going to sit well at all. So we really need to take a look at what is there. We also need to think about what else these products are designed to do. For instance, something that is a detox. That’s an absolute NO. As far as I’m concerned, that’s what our liver does. But the other problem with that is, all right, now it might precipitate the need to go to the bathroom more often. And depending upon the type of IBS one has, great. Now more than it was before, which is typically not the goal that somebody has.

(32:37)And many of these things are very expensive. And I do think that it is critically important that we look for some type of third party verification. Now, when I say that to my collegiate Olympic professional athletes, they have to because if they take something and they test positive, not only is it a problem for them, it’s potentially a problem for me. So I’m watching out very selfishly for myself as well, but third party verification is also part of keeping us safe. So we might see NSF certified for sport on a product. We might see the band substance control group. We might see informed sport and they don’t always cost more, but that is giving us the assurance that there’s nothing in there that is not supposed to be there. And I think as well is more is not better. I mean, that’s always a recommendation I give around supplements.

(33:30)Typically when you do that, A, you have some unintended consequence or you have VEU, very expensive urine. That is money down the drain and supplements aren’t inexpensive, so there’s absolutely no reason that we should be doing that.

Jessie (33:45):
Absolutely. I love that. And yes, for collegiate or professional athletes, if there is substances found in their test, that could be career ending for some of them.

Leslie (33:56):
Absolutely. Or it could be a health issue. Well, it’s just a supplement, so there’s nothing in there that could be problematic. Well, there could be. If you are allergic to something, you have to be extremely vigilant about it. If you are taking medications, you have to be extremely vigilant about supplements. And I as a healthcare professional am on a need to know basis. And that’s why I’m asking the questions of my athlet. And if you are seeing your PCP, bring with you the list of what it is that you take. It is really important, especially if you are on any medications at all. We don’t want to have interaction. I don’t like surprises. I do about birthdays maybe, but when it comes to medications and supplements together, those are the surprises we can all do without.

Jessie (34:45):
Yes. And for everybody listening, we are talking about drug supplement interactions. Sometimes it can enhance the absorption of prolongs the period. Depending on the interaction, it can have adverse effect on the person. So make sure when you take anything new, talk to your primary care provider, talk to your dietician if you have one. We are here to look over to make sure everything is correct or works for you. And to be honest, I have seen liver injuries from supplements in my clinic. And here’s the top three things that causes liver injuries in the US. Turmeric, nobody thinks curcumin or turmeric is harmful, but actually it can be harmful. The second one is green tea extracts. Again, something that is really common is in a lot of things and is very easy to overdose on it. It can cause liver injury. And the third thing is ashwagandh, which again is a very common ingredient in a lot of supplements.

(35:42)You have to be very careful what you’re taking and the combination of things that you’re taking because it can easily put you over the limit of safe recommendation and start causing injury, which is why you want to bring it up with your PCP and get your liver enzymes checked regularly if you are taking any of these supplements. I would say liver enzymes, kidney functions, right? These are the things that actually help us detox. So if you do have more tox in your body, the red flags will show up in usually these two places.

Leslie (36:12):
And I could not agree with you more, Jessie. And especially the message is not here. Never use turmeric for cooking. Of course, use it for cooking. That is fine. And if you’re using the turmeric root, you’re getting a more concentrated amount of turmeric than you would even in something like a curry powder. That’s fine. If you’re going to drink a cup of green tea, that is fine. But that’s extremely different than something that’s concentrated in a pill where the dose is that much higher and potentially there might be something else in there that could be problematic as well. And that’s why we are on a need-to-know basis. We need to know what everybody’s doing so that we can be the garment. That’s our job as registered dietician, sports dietician, is to be the garment. We’re going to send you on a different path, a slightly different detour to make sure that you stay safe that is the goal all the time.

Jessie (37:04):
Okay. Amazing. I love that. Now I’ve got five rapid fire question for you. First one, what is your favorite weekday dinner?

Leslie (37:14):
Oh, typically it’s fish. We eat a lot of fish in our house and so it could be a salmon, it could be a halibut, it could be a black cot, something like that. And usually a kale salad with some fruit in it because those are the things that we both really love and we eat. We also do a lot with beans because we like them and we’re empty nesters, so we can kind of keep it on the simple side with a lot of color to what we do. It has to be eye appealing to me first. So that’s typically what it is.

Jessie (37:47):
Well, I love that. You are recommending two types of protein that Americans are not eating enough. Seafood and beans. Love that. Okay. Are you a coffee or tea drinker for an active day?

Leslie (38:00):
I am coffee queen. I am mean without caffeine. I am also bitter and black. That’s the way that it is. I don’t want anything in it. I want it high test. And typically for me, cut off is by 11 o’clock in the morning, otherwise I don’t sleep so I know my limits.

Jessie (38:21):
I love that. Yes. Okay. What is the number on sports nutrition myths you wish would disappear from social media forever?

Leslie (38:29):
Oh my God, there’s so many. I think right now I would say that it’s this overdue with the protein is that again, it’s like the health halo and more is always better and it isn’t. And not even looking just at the dietary guideline, but looking at the consensus paper, which just came out about two weeks ago is when we’re looking 1.2 to 1.6 gram per kilo or basically 0.54 to 0.72 gram per pound. That is it. There is absolutely no benefit to going more than that. We don’t have to obsessively divide it evenly over the course of the day, although most people probably feel more comfortable having it divided than just at one point of the day, but there’s no brownie points for more. We just don’t need it.

Jessie (39:18):
I love that. And we are of course seeing a lot of protein maxing and then also fiber maxing. Again, these are not things that you need to do in excess. Okay. Last question. What is your favorite pre-workout snack that is gut-friendly?

Leslie (39:37):
I actually really like a Greek-style yogurt works for me. I like that and just a very little bit of fruit in it, not too much. So even something like a dried cranberry and just small amount, but it’s small, meaning a couple spoonfuls, not the whole container. That’s enough with adequate amount of fluid and I am good to go, whether I’m outside, whether I’m going to the gym to live or whether I’m hopping on my rower that does it.

Jessie (40:07):
Love that. Thank you so much, Leslie. This is such a pro for all of our listeners.

Leslie (40:13):
Oh, I love being here and it mixes my two favorite topics to talk about is fueling your body for sport and taking care of your gut. And those are not mutually exclusive. I want everybody to be a member of the Good Gut Club and I want everybody to not have your gut get in the way of living you the best life that you can.

Jessie (40:34):
Thank you for tuning into the IBS Nutrition Podcast. We hope today’s episode has brought you closer to understanding and managing IBS. Remember, you are not alone on this journey and finding freedom is possible. For more on IBS, make sure to follow us on your favorite podcast platforms and please leave us a five-star review. We will really appreciate that. You can access links mentioned in this episode in the show notes to learn more about your type of IBS and how to identify your own food or lifestyle triggers. Register for our free IBS Masterclass, Three Steps to IBS Relief for our proven, holistic three-steps approach to managing IBS once and for all. Head to IBSdietician.com/masterclass to register. Until next time, take good care of your guts and hears to your health and happiness.