My immunity used to be dreadful. Working in a hospital I am constantly exposed to a variety of bugs so in my first few years as a junior doctor, when I was run ragged working full time and trying to run 90-100 mile weeks, I caught it all. Probably best there wasn’t a global pandemic at that stage.

When I started training hard and running lots of miles I didn’t appreciate the importance of protecting my immune system and spent at least a year with illness after illness.

One of my first England vests was in Leeds to run the 10km. The days before I left I was working on a medical ward with an outbreak of norovirus (winter vomiting bug). When I arrived at the hotel I felt a bit iffy but thought “probably just nerves” the next day maybe felt a little worse but it wasn’t until I started that I realised something was not right then a mile in dropped into a heap on the side of the road.

It was mortifying, especially wearing my England kit and feeling like I had let the team down. It took more than 10 hours to drive back home to Cornwall, incredibly bleak. Needless to say, I never shared the grapes in the Doctor’s office again (wrapped quality street choccie remains ok though).

A learning curve 

Over the years I have read lots of research and sought professional advice on how better to look after my immune system. As runners, getting ill is rather inconvenient. It means setbacks in training, missing races, increasing injury risk etc etc.

So I thought for my first Fast10 blog I’d share a bit about my experience and how I’ve managed to support my immune system the best I can. I’m by no means an expert but I am a doctor with a particular personal interest in avoiding infections as an athlete. Plus I must be doing something right as I’ve survived a year working on and off covid wards illness free!

If I’m honest I kind of hope this level of PPE stays in the hospital, infection outbreaks seem to come at the worst possible times. Before my wedding there was a Norovirus outbreak on the ward and before my last marathon a flu outbreak. As if marathonoia isn’t enough, a week of exposure to flu is less than ideal a week out from a marathon.

A bit of luck and maybe a more experienced approach on both occasions meant no D+V for my wedding and no flu running, so a huge PB of 2.33. 

Burning the candle at both ends

A big turning point for me was cutting my work to part time. I used to have the mentality that what doesn’t kill you makes you stronger, I even go as far as saying I got a kick out of flogging myself both at work and in training.

But I was constantly knackered. I dread to think what my cortisol levels were during that time.

Needless to say it did come crashing down as after a year of constant illnesses, culminating with my first stress fracture. Since working part time (still roughly 30 hours a week) I have time to do all the extra bits that are important, rest, mobility. Small changes, like not having to eat my lunch at 5pm in a cupboard on the ward quickly.

Goes without saying my stress levels plummeted too and stress can be another negative factor to health. I also just feel like a better doctor and runner. I’m able to give my patients a better version of myself and I am able to enjoy my running instead of fighting to keep my head above water. 

40 winks for the win

The value placed on sleep, both duration and quality of, is something that has changed too. Sleep is restorative and it’s when your immune function is at its best and our bodies repair. I read a book last year called “Why we sleep” by the sleep scientist Matthew Walker.

It’s so interesting and there is lots of eye opening research out there. The advice is at least 8 hours a night but athletes tend to need more than this. I normally aim for 9-10 and if I’m unable for any reason try and find a window to nap.

Also probably important to mention I used to be a bit of a boozer too, medical students have a bit of a reputation for this. Don’t get me wrong, I still love a nice cold beer or glass of wine of an evening but moderation is key here. Boozing too much has negative effects on sleep and hydration, hence affecting ability to recover. 

Variety and balance with your food

Before meeting my wife there was always the same three meals on rotation. Fast forward to now and it’s a much more well-balanced, varied diet and it makes a big difference. I still treat myself to pizzas and takeaways but in-between those we enjoy cooking new recipes, with fresh ingredients and it feels like we’re getting more of the vitamins and minerals, and calories, I need.

This includes iron, vitamin c, magnesium as some of the key things to include that might have been lacking in the past, when my diet was a little less… interesting.

Cooking foods with fresh ingredients, from scratch where possible, will help keep things nutrient rich. In addition, after getting some advice from the well-known and brilliant sports dietician Renee Mccgregor I also started taking some probiotics.

It feels like the amount of upper respiratory tract infections I got halved and went from getting three colds a year to one at most. This is obviously anecdotal and could have been coincidence but there is a lot of evidence behind gut health and immunity which is beyond this little blog so I will leave it to the experts and for you to read up on at your leisure.  

Help your body do it’s job

That being said, all of the above is good for general illness avoidance but it is by no means a bullet proof way to protect yourself from Covid (There was certainly some luck involved for me there).

The closest  you will get to that is the vaccine, so a quick note on vaccines, I made sure I had good night’s kip after it for a few days, you want to get the best immune response possible and like I said most of this is when we sleep. I also avoided training hard for a few days to give my body chance to focus on the job at hand! 

I hope this is of help to some people, it’s nothing ground breaking but it took me a long time to start properly looking after myself and we’re all still learning.

The post Staying healthy as a doctor and a runner appeared first on Fast Running.

I blame Jeremy Harries. The highly experienced Preston based coach, whose leading elite luminaries included developing the likes of John Nuttall and Helen Clitheroe (both well established at top flight coaching in their own right) had become a leading light in England Athletics coach education and was grilling me on “my coaching philosophy”. A heavy matter.

We were seated in the cafe at Lee Valley Athletics Centre, still not fully recognised as a leading hub in western intellectual development but nonetheless a brilliant hotbed of fast twitch fibres. Although not at our table.

He was pulling apart my third draft. I should have said “Jeez Jezza, it’s just about helping some runners get from A to B a bit quicker and they and I have some fun amidst all the hard graft in the process.

If you want true philosophy then then get a PPE degree from Oxford, become a cabinet minister and tell people to stay at home and wash their hands a lot. You’ve had fricking months to tell me to ditch my Pfitzinger and Douglas and Bud’s session plan notes, and to sort out Plato and Voltaire. Why now?” I didn’t say that though, I wanted not to alienate myself more than was necessary

The Who, Why and How

What he was trying to tease out was the WHO one is as a coach; which will lead neatly into WHY one coaches, in the round ; and the HOW you go about doing what you do to achieve your objectives.

Yes, yes, the person who suggests you bang out a session of 5 sets of 1200 and 400 metres with a miserly recovery between reps and a Scroogeish break between sets may be either a very reserved humble altruist or have a monstrous ego largely channelled to gouging whatever cash is available in the sport, but how that person has evolved their coaching will probably have some influence on how you do and respond to that session, never mind how you fulfil and enjoy yourself in the sport. For the better, in most cases.

Endurance coaches are a really diverse bunch. The whole span of arts mixed with science probably goes a long way to explaining this; nobody is blocked by having the “wrong” background, experience or qualifications. On the surface, in the UK currently, it is disproportionately white and still predominantly male, but drill into the characters, and it’s a full array of humanity, like The Canterbury Tales but with much more accurate watches and less angst about the Pope.

Your host Mr Craggs, the doyen of EA endurance webinars (well it’s good to be a doyen at something) raised on air the question of whether ‘philosophy’ was really a suitable word for something as, relatively, narrow as running coaching. It’s like having a philosophy about Belgian buns, or shoplifting. He didn’t say that in the webinar, to be clear. Just as well really when the subject was Aly Dixon’s tempo sessions.

Because the sport is athlete focused, we are all aware that to get to the kernel of the athlete’s motivation we want rather more than “I’m really keen to improve ” or ” I want a few more ground records on Strava”. (Though if you get the 3000m ground record for the Rieti track, that should cover off the high motivation point). It will in all likelihood be a medley of factors, some weighing more heavily than others.

Varying motivations

So a coach who offers the time worn cliche about “putting something back into the sport” is likely trotting out the baseline, but rarely the full shebang. The specifics of coaches’ motivations and objectives vary immensely across the sector. Once you become heavily committed in it, it can soon become about trying to keep some balance in what is by most standards an unbalanced life.

Yup, like the runners themselves, particularly the ones who will casually refer to 60 mile weeks as ‘just ticking along, not really training for anything particularly’. Arguably male coaches are most vulnerable to this unbalancedness, what with our genetic inability to multi-task.

Is there a message here? Perhaps that for runners being coached it might be enlightening at some stage to learn a little about what makes your coach tick. Their Philosophy even.

David Chalfen is the owner of Run Coach 1-2-1 and coaches at Serpentine

The post Coaching “Philosophies” appeared first on Fast Running.

Recent research from the Federal University of Sergipe, Brazil, looked into hyper-hydration strategies. This is where you essentially pre-load water before a race so there is less risk of dehydration during the event. 

To do this you have to increase the electrolyte levels in your water, rather than just drinking a huge amount. This would just increase your visits to the toilet and potentially put you at risk of hyponatremia.

The researchers actually added a huge amount of sodium to the water the athletes were drinking. Solutions of 2400mg/l (not too dissimilar to a saline drip) or just plain water were given to the athletes to drink as they desired the day before their testing.

Their findings were interesting

Whilst one might expect performance to be improved by greater hydration at the start, for 10km no performance benefits were noted in the study. Over this distance, dehydration may not be a huge performance factor. The additional water weight carried may have led to a zero-sum gain. 

They have hypothesised that over a longer distance, where dehydration might be a bigger issue, the results could have been different. Other studies in cycling, however, have shown some benefit in shorter races, in warm or hot conditions.

Ask the expert

We spoke to Andy Blow of Precision Hydration about the study and it is something they monitor closely. “The added sodium in hyper-hydration drinks is what allows your body to pull more water into the bloodstream and hold it there,” said the hydration expert.

“The problem with concentrations as high as 2400mg/l a drink is that it can cause real GI troubles in some athletes.

“We tend to recommend lower concentrations like our 1500mg/l products. The aim is to get people amply hydrated for their event, not always significantly hyper-hydrated.”

There was a study into electrolyte concentrations that looked at effects of drinks containing plain water, 1,380mg/l, 2,750mg/l and 3,680mg/l of Sodium. The higher the concentration the better the hydration of the subjects, but the two higher concentrations caused more issues with diarrhoea. Hence PH going with 1500mg for their highest concentration.    

Especially in an unusually hot summer such as 2018, many people are partially dehydrated on a regular basis. We’re not as physiologically adapted to the heat and not accustomed to rehydrating properly after exercise. It can take the body 24-48 hours to reach an equilibrium after a heavy workout the heat.

A study in 2017 showed that as many as a third of runners turned up to competition dehydrated. Then other studies showed that many also turned up hyponatremic. University and club athletes had drunk large quantities of water to avoid dehydration but forgot to add electrolytes. 

Adding electrolytes to your water can help your body with absorption and you’re less likely to be exercising the next day in a dehydrated state. 

Hydration before, not just during races

“When people talk about hydration, most of the time it’s about what and how much athletes should drink during exercise,” said Blow, raising another interesting point. “Performance is also massively influenced by hydration at the start line.

“When you’re racing in a hot environment you’re generally fighting a losing battle with water and electrolytes. So you may as well give yourself the best chance by pre-loading, as you would with carbohydrates.”

The day before an athlete shouldn’t take on huge amounts more than usual. Ensuring a significant sodium concentration in the fluids you drink will mean that your body will absorb more of that water. 

It’s something to consider if you’re an athlete running twice a day too. Taking even a small level of dehydration into your second session can affect performance. So considering your hydration levels can make a big difference on a daily basis too.

Is hyper-hydration for you?

So the study that prompted this article did find an improvement in hydration levels over a 10km trial. But, interestingly, not performance levels. If you’re expecting to run in an extremely hot environment or are a particularly prolific sweater then there is still a good chance it will make a difference.

The study also showed there was less need for water taken on board during the race. If you knew your race didn’t have water stations then it might lead to more benefits of hyper-hydration.

Then if your race is longer the benefits start to increase. For a marathon or an ultra, especially hot conditions, there could be large benefits. 

Really many of us should focus on being amply hydrated, rather than hyper-hydrated, to start. As Blow pointed out, just getting to the start line in a healthy state should be your first aim. As with all of the marginal gains, start simple before worrying about the little things. 

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The post Is hyper-hydration the answer to racing in the heat? appeared first on Fast Running.

Cod liver oil, co-enzyme Q10, Glucosamine, Vitamin D, Vitamin B complex, whey protein; they have all made the list. However how many of these are actually useful to us? As a runner do you need additional supplementation?

For the majority of athletes, eating a balanced diet of whole grains, lean protein, fruits, vegetables and essential fatty acids should be sufficient to meet all your nutritional requirements.

When I work with any athlete, the first step is to optimise their nutritional status in order to prevent deficiencies. Additional care and advice will also need to be considered to those following vegetarian or vegan diets. Vegans, in particular, may need to think about supplementation with B12; whilst both vegetarians and vegans will benefit from taking an Omega 3 fatty acid.

With so many claims, how do you decipher which are true and which not? Whilst the internet can be useful, it is also a place where, if you want to find an answer, regardless of its authenticity, you will. For every study that demonstrates, that a particular nutrient or ingredient, correlates with improved performance and health, there is another opposing study to deny any link.

So how do you know what to take? The following supplements have enough significant evidence to encourage their use:

1. Vitamin D

In the UK and Ireland, we can only absorb the right wavelength of sunlight to make vitamin D between the months of April to September, between the hours of 11-3pm. This means that majority of the population tend to have sub-optimal Vitamin D levels. And particularly during the winter months.

Studies have demonstrated that a low Vitamin D level has been associated with a depressed immune function, poor skeletal muscle recovery and increased fatigue.

If you find you struggle with repeated illness over the winter months or that you are not recovering optimally, it is worth having a blood test to check levels. If deficient, (Levels under 75 nmol/l) then this is one supplement that you would benefit from because can be a difficult nutrient to get through your diet alone.

2. Probiotics

A number of studies have been associated with a reduced incidence of upper respiratory tract infections in athletes during winter months when probiotics are administered. The recommended dose is a 12-week course of high dose probiotics prior to a major competition.

Further research also implies that probiotics can also improve GI distress in runners.

3. Magnesium

Magnesium is involved in numerous processes that affect muscle function including oxygen uptake, energy production and electrolyte balance. Strenuous exercise results in an increased loss of magnesium through sweat and urine, increasing requirements up to 20%. It has been demonstrated that

Studies show that magnesium supplementation or increased intake of dietary magnesium can improve exercise performance in those that are magnesium deficient only.

4. Beetroot Juice

Beetroot is an excellent source of nitrate. When ingested, nitrate is readily converted to nitric oxide in the body. It is well documented that nitric oxide has a positive impact in vasodilation and regulating blood pressure. This knowledge has lead to a lot of research based on the theory that increasing nitric oxide prior to exercise could be advantageous in aiding oxygen delivery to the muscles and this improving exercise efficiency.

It has been determined that beetroot juice, shots or 200g of cooked beetroot may help improve your performance in activities lasting 4-30 minutes or in high-intensity intermittent exercise. However, the evidence is only for those who are new to support or recreational athletes; there is no evidence for the case of beetroot juice in elite athletes.

The ideal dose suggested is 0.6g of nitrate (2 x 70ml “shots), 2-3 hours pre-exercise, loading 3-7 days prior to race day.

5. Tart Cherry Juice

Tart cherry juice comes from the Montmorency cherry and is a potent source of flavonoids and anthocyanins, boasting antioxidant and inflammatory effects. The research suggests that by using this tart cherry compound it promotes muscle recovery following intense exercise. It is thought that the high flavonoid content reduces oxidative damage to muscles.

The recommended dose is 30ml cherry juice concentrate 4-5 days prior to and 2 days after a strenuous event.

New research is also emerging about the potential benefits of tart cherry juice and sleep as it is believed that it may be a good source of melatonin, which is a molecule necessary to induce sleep. This could be of real benefit for those who have disturbed sleep or for athletes that need to manage jet lag.

About the Author
Renee McGregor RD SENr is a Performance Dietitian and author who works with elite athletes, coaches and sport science teams to provide nutritional strategies to enhance performance and manage eating disorders. She is the author of Training Food, Fast Fuel books and Orthorexia, and soon to be released Healthy eating goes bad.

The post 5 trusted supplements for runners appeared first on Fast Running.