Demystifying RED-S in Male Athletes with Evan Lynch

Foreign.

I'm charlie redding.

And I'm claire fudge and this is.

The tribe athlon podcast.

I was very, very lean, which I thought was great because I looked great. And again, that's, that's kind of a bias that I have to help a lot of athletes with. You know, they conflate aesthetic image with health and performance, or even virility.

That was Evan lynch and this episode is Reds in Men. Welcome to another enlightening conversation on the triathlon podcast, this time with Evan Lynch, a dedicated nutritionist and educator, as we deep dive into the realm of relative energy deficiency in sport, otherwise known as reds in men in particular, we hear a lot about it in women, but not so much about it in men. So Evan's journey in the field of nutrition is testament to his commitment to helping individuals achieve their best selves through the power of proper diet and nutrition. With a profound passion for assisting others in navigating the complexities of personalised nutrition, Evan has established himself as a guiding light for those seeking to improve their relationship with food, optimize athletic performance or embark on a journey of weight loss. Drawing upon his impressive academic background, Evan's expertise is further enriched by practical experience. Having engaged in international track and field himself, this unique blend of academic knowledge and personal insight equips Evan with a deep understanding of the psychological nuances that underlie optimal nutrition. So in this episode, Claire and I got the chance to unravel the intriguing topic of Reds in men, a syndrome that Evan has personally encountered as an athlete and now seeing becoming more prevalent and more kind of more widely understood in both athletes and active individuals. So from his background in track and field to his extensive experience in the nutritional science world, Evan can shed light on the intricacies of reds, exploring its impact on performance, hormonal balance and our overall long term health. So I know you're going to really enjoy this interview with Evan Lynch. How would you like to grow your business whilst working less and enjoying your work life more? Well, that's how we help people at the Trusted team. We do that through workshops which happen in person and online. We do that through regular online learning that you can just do from your desk at lunchtime. And we do it through in person events that make fun tax deductible things like golf days, dinners, wine tasting, all of that fun stuff. They help you build stronger relationships and enjoy work more. So if you want to know how we can help you grow your business and improve your work life balance, go to thetrusted team to find out. When Our next free taster event or free webinar is so that you can find out how we can help you grow your business and get your work life balance back. That's thetrusted team. Come join us at one of our events.

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Right Evan, welcome to the Tribe Athlon podcast. Really looking forward to this conversation, particularly as I feel like I can sit this one out almost. I'm going to sit back and watch the conversation evolve for those of but just for the listeners benefit, I'm actually dialing in from the St. Agnes Hotel. I've just had my lovely Cornish breakfast which I enjoyed very much and given the conversation that you guys are about to have, I'm glad I've had it before rather than after the conversation because I'm sure I will have enjoyed it more. But I like kicking these podcasts off by by asking a bit about the story. So can you kick things off before I sort of ask Claire to kind of talk? You guys can talk nutrition amongst yourselves and I'll just act like the idiot in the room just to pitch in if you get too detailed at any point. But yeah, let's kick things off by understanding a bit about your background. So how did you get into what you do now professionally but also when you tell us the story around your sporting background as well? Sure.

So first of all, thanks for having me on. I always love getting the chance to do podcasts or interviews, things like that. I think more so than ever it's very important that there are more evidence based nutrition resources out there. As for what I do, like I have a reasonably reasonably large social media profile. I've seen all the misinformation with my day to day work. I hear this misinformation trickle back to me all the time, so I love getting a chance to do stuff like this. How did I end up here accidentally? Actually I wanted to be a physiotherapist initially, so I'll rewind a little bit. I did professional track and field. I was a race walker. For those who don't know what that is, that's extremely fast walk and you can google it if you want. I made it as far as junior and under 23 competing for Ireland, got to a couple of world championships, a few European championships, and I have, I think I still have one or two national records from underage and junior level. I, I don't know. I may or may not be looking at making a comeback to the senior track and field scene. We'll, we'll see. I have two little kids, so they may not allow me to do that just yet. But from, from my time as an athlete, you know, you're always trying to optimize what you're doing. I was always naturally curious, so I gravitated towards nutrition, towards the ancillary things you can do outside of your training to promote performance. And when it came time to go to college, I actually didn't get enough points to do physiotherapy in the University of Limerick. So I put down food science and health as a backup. Did it, ended up really liking it and thought, I wonder if there is such a job as someone who tells athletes how to eat, because I would really like that. And there wasn't a whole lot of opportunities at that time that, that I could see. So I took the clinical route. I went and studied dietetics in the University of Malta, which is random or interesting. And then I went and did my master's degree in the University of Ulster throughout the pandemic while I was working as a private practice dietitian. To my knowledge, I'm Ireland's youngest private practice dietitian or private practice owner, I suppose. And I've just gone and hyper specialized in endurance athletes. So the sports background, the clinical background, it's given me the chance to work with a fair chunk of Ireland's national governing bodies, a good chunk of our international track and field athletes. And I have been able to have clients and patients in the last two Olympic Games. So it's been a pretty interesting eight to 10 years. Definitely never saw it going this way.

So can you tell us a little bit? So for people that don't know. So my background is as a dietitian and high performance nutritionist as well. But often people ask, well, what's the difference between a nutritionist and a dietitian? And you, you touched on that. Doing dietetics in, in Malta. Could you tell us a little bit about the difference between the two?

Yeah, so as far as I can tell, the key difference is the dietitian. You know, we're specifically trained to have someone with a medical condition, whether that be an eating disorder, whether it be heart disease, whether it be diabetes, ibs, gastro. That's supposed to be the delineation. However, I'm sure you see it too, on social media. People very frequently blur that line into the medical field where maybe it's a little bit inappropriate to do so. But that's, that's supposed to be the key difference. It's a regulated profession as well. I'm sure you come across lots of people who say they're nutritionists but have no, shouldn't say that. I suppose I'll be politically correct, but the key difference is the area we can work in, the type of people we can work with, and that regulation, that kind of stamp of approval that there's a certain threshold of knowledge and competence that you have and you're very much held to that standard. And you're, you're held to that standard of continuously developing, like, I, I'm absolutely sick of the CORU CPD log. If that's our kind of national governing body. Those, those credits are, they're weighing heavily on me at the moment. I have to sneak a few in before October, but it keeps you on your toes. I don't know. Do you feel the same?

No, absolutely. And I think, you know, one of those things that you, that you touched on there is that as dietitians we're regulated. And of course, there's some really good nutritionists out there who have a degree and, you know, master's degrees. But one thing that I always say to people is make sure that you check. So for any of these things, you know, actually, Charlie, you know, your background as a financial planner, we should all be checking someone's qualifications and that they say, you know what, what they do is actually they're qualified in that area. So I think it's really important that you, you know, over, you know, when, when people are looking for professional advice that they are looking in the right places. Where, where can people look for if they wanted to check out someone's credentials? So if they were looking for like a performance nutritionist or a dietitian, like, how would, how would somebody know that they were qualified? Where could they check in.

In Ireland? Anyway, you can go on to Indi, find a dietitian and you'll find all the private practice dietitians there. You'll see me on it. Weird fact, I'm actually the Only lad on that register there. There's not a lot of male dietitians in Ireland. I don't, I don't know why. But in Ireland you would check that for private practice dietitians otherwise you'd only come across them in clinical settings and I mean clearly they have their credentials squared off if they're in a hospital setting for the context of sports performance, you can check the senor register. That's the kind of best standard or the seal of approval for sports nutrition. Someone is on a master's degree or they're a dietitian who specializes in sports or they're a researcher working in that area. That would be where I would advise someone to look. And in fact that's, I'm saying our accredited, all of my team are saying or accredited or dietitians about to be seen or accredited for that very reason.

Yeah, no, excellent. And it's good to know you know where to, where to find dietitians. And actually in the UK you can look on the British Dietetic association website and the hcpc. So that's kind of aligns medical professionals as well. So yeah, it's good, good to know where, where to find people. Tell us a little bit about just kind of rolling back a little bit about race walking. So we've had some amazing athletes on and it's not just triathlon that we touch on and we've had ultra runners, we've had. Actually last week we were talking about obstacle racing. So tell us a little bit about race walking because I don't really know anything about it. So tell us a little bit about what your body composition needs to be like to race walk because I'm thinking maybe you need to be like a marathon runner. Maybe I'm, I'm very wrong. But tell us a little bit about the distances and because that's now an Olympic sport, how that, how that works.

Yeah, so not many people do it. It's a bit of a fringement on the athletic scene basically in terms of the body composition you want, you have to have the physiology of really high level marathon runner but you have to have the technical coordination of a hurdler. It's a very technical sport. It's the only sport that you can be disqualified from for non violent reasons. I suppose in, in track and field basically the, the rules are very, very simple. You have to have two feet on the ground at all time or the appearance of two feet on the ground at all time and your front leg has to lock so it has to be 180 degrees or hyperextended. It happens. Anyway, if you, if you're ever trying to get into it, lads, and you're curious, would I be a great race walker? Just think of, keep your arms at 90 degrees and really drive them and walking on your heels and you, you kind of do it. If you, if you think of that. I got into it because my dad did it. I have no idea how he got into it. I just saw a newspaper clipping of him with a national medal when I was 10 and I thought, okay, well that's obviously what I have to go and do now. In terms of distances for underage, you're looking at anywhere from 2k to 10k. It's the longest event in the world Junior championships and the world Youth championships. For example, when you go up to under 23, senior level, then you're doing 20k. And there was a 50k event. It was the longest event in the Olympic games, but they cut it down to 35. To be honest, I'm not really sure why I'm not in that inner circle anymore. It's been a while since I competed professionally. But a lot of people underestimate the sport. Often it's kind of poked fun at because the, the technique is if you're not in the sport, you know, you could think those guys look a bit funny. You, you. Some people suggest that we waddle or kind of you sway a little bit when you're walking. And it's true. But the, the mechanics of it and the reality of it. If you ever want to see would I hack the pace at the front pack of a 20K in the Olympic final, go onto a treadmill dial, turn the dial up to 16, 17 kilometers an hour. And that's the speed that you're trucking away at. In terms of the biomechanics of it. The high level race walkers have the same cadence as a 400 meter hurdler. The whole event step speed is insane. So bringing it back to what, what is a race walker? A marathon runner with insane levels of fast twitch fibers and very, very good technical skills. That's.

I can, I can imagine how many people are now going to go out there and try it. Because I'm just thinking, I'm not sure that I could, not sure that I could. I'm sure we've all had a go at pretending to race walk. But yeah, interesting. And really interesting that you talk about being like a hurdler as well. Because I was thinking marathon runner, but I didn't think about the hurdler sort of aspect of it. And when you were competing under 23s, I'm always interested to find out. You know, in the world of nutrition, it's, it's not new, but actually, I think more different sports and coaches now are on board with actually making sure athletes have the correct nutrition. There is a lot of old school thoughts on nutrition, and certainly there's a lot of old school coaching thoughts that still, you know, out there. Well, what was it like competing at under 23? Did you get any nutritional advice? Like, what was it like at that, at that time?

So it's a bit of a bugbear for me because my career ended prematurely due to what I now see in hindsight was reds relative energy deficiency. I had no nutritional oversight, no education on that front of things. My career flamed out when I was in my second year of college. So halfway through a bachelor's degree, not specialized in sports, I, I really didn't know what I was doing. I tried a low carb diet because a colleague or someone I looked up to said, man, you should try this. And I thought, well, he's better than me at this, and he was in the Olympics. Clearly he's a fountain of knowledge. So I did that and I ended up getting very bad injury that I couldn't shake in my lower left limb. I had all of the hallmarks of grades. I had immunosuppression. I had libido problems. It affected my mental health. It ruined my life, actually, for two years. And it was hard to watch because my plan all along was to be in Rio and I watched it from my couch, which hurt. So my nutritional practices looked something like get up, do fasted training, because I thought that was good, avoid carbs. Because I'd read, I don't know, maybe the Joe Rogan podcast or something like that, and felt maybe I shouldn't be cracking into these carbs here because they're bad. And pretty much the. I did the opposite of what I would advise someone do now. And I, I kind of think that's why I got into the role I'm in now. I advocate heavily for reds and misinformation because I, I suffered from it. I am one of the statistics. I should have been an Olympic athlete, but I'm not.

Can I just ask? Just because I know we've talked about it once on the podcast before, but can you just explain what reds is? You've mentioned it a couple of times, so I think it'd be good for, for an explanation.

Sure. So basically, relative energy deficiency in Sport, if you want to think of, in layman's terms, malnutrition for athletes. If you think of an athlete, their absolute caloric output can sometimes be absolutely insane. Like it's not uncommon for one of my clients or patients to need 5, 6, 7,000 calories a day. The logistics of eating that are hard. And the most common problem a new client or patient will have is when we actually look at, well, here's where you need to be and here's where you are. That shortfall is huge and we can kind of, we can stratify someone's risk factor. So you use kind of energy availability and I'm not going to get too technical into it, but for men and women there are different or there's thought to be different cut off points. So ladies are a little bit more sensitive to lower energy deprivation than lads. The key difference being the energy cost of a reproductive system. And that's why apparently, or superficially anyway, more females suffer from reds or under eating because the symptoms become apparent quicker. Think losing your menstrual cycle, that's your key red flag. I'm starting to make social media content on this and I released a podcast recently on this about reds in men. For obvious reasons, lads don't talk about these things. Definitely in Ireland there's a degree of probably ego and embarrassment, but the male version of losing your menstrual cycle is erectile dysfunction or a loss in libido. And I, I have seen and do work with lads who are under the age of 30. Esthetically, look, they look the picture. I assume girls think they're brilliant. You know, it would be a pretty tough thing for them to say, well actually I'm having this problem because it totally emasculates them. So what's, what's taught at the moment is more male athletes do suffer from reds than we're aware of because they're simply too embarrassed to speak about. But to go back and answer your question, what is reds? It's a multi systemic issue. If you're not eating enough, basically it crushes more or less every aspect of your health and your physiology. Key symptoms would be a loss in performance, your sleep might suffer because you're going to have elevated baseline stress hormones. Basically the symptom constellation. It's very varied. You can go from immunosuppression to stress fractures to infertility to changes in, in your mental health or an odd one. And a lot of athletes get this is changes to gut health and bowel patterns. That's another common symptom as well. So it's, it's an interesting one that we're still learning about. But if you're an athlete and you think maybe I don't eat enough, there's a 100% chance you don't eat enough. And you should maybe talk to someone about what your calorie requirements are and how you can bump those levels up a little bit to avoid these problems. Because one of the interesting things is you can be in an energy deficit for a while before any issues become apparent and you can think, well, I'm fine. And then it's. You get that threshold and it's like being hit by a car. You can't do your training one day or you don't recover. And when you get it, then it takes a while to shake it off so you can. The, the analogy I use at a runner because there's such a low level of inertia to do running or cycling versus say a weightlifter where they have to be able to be 100 all the. An endurance athlete can kind of run, jog or cycle through into their own grave if they're not careful.

Evan, I think it's really important that you raise there not only personal experiences but that it is absolutely present in males. And I think many years ago when we were looking at the female athlete triad, which was the original thinking around this, problems with bone health, lack of menstrual cycles, that's now been encompassed into that relative energy deficiency. I think it's really important that men are educated on it. And you're absolutely right. It's easier if women have a natural menstrual cycle to be able to see it. But of course then there's women on contraceptives and then you don't see the menstrual cycle losses either. So it's an emerging area, isn't it? And I think there's still some discrepancies or big discrepancies about how do we actually measure energy that people are eating. That's such a, it's such a problem, isn't it? Because it's so many estimations there in, in terms of your. You touched on kind of coming out with, coming out from the sport you were doing because of reds. Is that correct? Or was there an injury and that sort of brought you out of sport?

Yeah. So this was never diagnosed. This is totally self diagnosis in retrospect. I went to many doctors with low neutrophil counts, iron deficiency, low vitamin D, the recurring injuries, inability to tolerate high intensity Work couldn't get my heart rate up. I couldn't sleep. And to be fair, this was 2014. The. The consensus on reds itself and the incorporation of male physiology, I don't think it happened at that time. It was a couple of months to a year after that. So in a sense, as far as a doctor was concerned, my problem didn't exist, you know, so no one. Nobody knew what to say to me. But I was textbook. You know, I had low glycogen availability at the low carb intake, long periods of time without food, high energy outputs. I was very, very lean, which I thought was great because I looked great. And again, that's. That's kind of a. A bias that I have to help a lot of athletes with. You know, they conflate aesthetic image with health and performance or even virility, and they're very much not the same thing. But, yeah, that's. I'm very sure that I was a Reds case. It's just unfortunate that I was born in 1995 and hit that when I was that age. In that time. If it happened now, I'd like to imagine that there would be someone else like me who I could reach out to, who might have shed light on, well, if this is what's going on, someone can help, you know.

No, absolutely. And what do you think as a. As a clinical dietitian? I guess this is where some of our skills sit as well, is there's a lot of media attention now on Reds, which is great. It's really raised the profile of education. And also some cases that we've seen in, certainly in British sports, where cases of reds and eating disorders have now sort of come to light with the way that some people are coaching. What are your thoughts on where does. Where does red stop and an eating disorder begin? Because there are these very blurred lines. There's this continuum, isn't there? And I think some people would feel happier to say I've got reds than I've got an eating disorder. Could you just tell our listeners, like, a little bit about. If they were thinking, actually sat here now, oh, God, that sounds a little bit like me. What. What's the main difference between they. Those two. Those two diagnosis?

So it's. It's definitely from. For me, anyway, it's probably a bit of a judgment call or a feeling based on how I typically judge it. Is the intent. What was your intent with this diet? Is it that were you trying to achieve extreme levels of leanness? Do you have this high kind of drive or preoccupation of being 10. If so, why do you feel like that? And you know, if someone clearly displays that they're very obsessed with their body image, it makes up a big part of their headspace and they engage purposely in disordered methods like skipping meals, fasted training. If they have good food, bad food mentality or rigid thinking or compensatory mechanisms at times like I do come across, came across a horrible case not that long ago. A marathon runner whose coach said you must be X kilos or you're not racing. So she resorted to diuretics and ended up in hospital with hyponatremia. And obviously the, the whole build up to that, there's this whole fractured body image of food relationship, total warped view as to what is normal. And I think some athletes don't see their kind of disordered cognitions as a problem as so many of their coaches or their peers think like that. But just to, just to contrast then I have had a lot of athletes who under fuel and have had reds and it's completely not intentional, they're just actually shocked when I go through the maths like buddy, you need to be eating the equivalent of 30 spuds today. Like you're not doing that. And they're there scratching their head thinking, oh my God, I didn't know this. Generally it's, it's very clear if it's disordered or not, but you, you kind of have to delve a little bit deeper. And I, I'm fortunate here as a, as a private practice dietitian, you can be a little bit on your own and there can be that pressure or expectation that you're a GP psychologist and a dietitian wrapped into one. But yeah, I have a counselor who works with me and I have sports medicine physicians who I directly refer to. So if there's a hint of anything disordered whatsoever, it's just a straight referral and we ask them to do their bloods link in with a sports med physician and we do the nutritional support on our end. So it's, I've never, I've never missed one. To my knowledge, an eating disorder does becomes clear as you talk, I suppose. But for, for a listener, I think maybe the, the easiest way to stratify your risk of having an eating disorder is, is the intent of your dietary restriction to achieve low body mass levels. Do you think about that a lot or were you just unaware you had to eat lots?

No, absolutely. Thank you. And I think that, that, that hopefully gives listeners a bit of an idea about some of those signs and symptoms of reds as well. Just, just thinking along along these lines of restriction race walking, endurance sports. We've, we've talked to lots of different people and obviously heavily in the media is about low carbohydrate diets and we have lots of opinions of, you know, people that, that we interview, which is really, really interesting. Just thinking about your background in endurance sport and race walking when you were doing that or what, you know, what are the nutritional strategies for race walking? I appreciate if it's there's short, shorter distance now I've learned and there's longer distance, I was thinking it was just longer distance. What would, what would the nutritional strategy be like for that? And is there a part of it where you do do some glycogen depletion or lower training in a fasted state or a lower carbohydrate state?

So for the 20k 10k, definitely not. Those guys crack away at just under anaerobic threshold for most of us. So that's totally glycolytic for the 50k. You could argue to a degree that getting good at burning fat is, is an important aspect of this because you only have a finite amount of glycogen. But maybe it's my personal bias and fear of under fueling people in. So insofar as I've read if you're already a well trained endurance athlete, your capacity to oxidize fat is already pretty, pretty good. And if you can employ carb loading tactics appropriately, whether it be 20k where you're looking for maybe 8 to 10 grams per kilogram body weight today before or the 50 when you're looking for 12 and if you have good pre tactics and you're able to take on adequate stuff during it. Personally I veer away from doing fasted work because that that load like it and availability, it does have knock on effects. You know with race walkers in particular there just one kind of very niche point with that heel striking you get a lot of foot strike hemolysis. So these guys really struggle to keep their ferretin count up. So if we look at it from that perspective we know that fasted work amplifies the hepcid in response to exercise and it can make it far harder to maintain I suppose balanced iron levels. And from, from what I've seen and again my understanding there's no clear benefit to having an athlete be fat adapted or optimized. And in fact the, the supernova study that Louise Barca did in Australia was done in race walkers and the the outcome was interesting or I'm a nerd. So I obviously thought it was very interesting. I read it a few times. The athletes, they didn't kind of randomize crossover method. They put them on high periodized and low carbohydrate approaches. Interestingly the low carbers had a higher VO2 max but were on average of 10 to 15% slower. And the outcome from that study was you can be fat adapted and you'll appear to be fitter but it's just less efficient. So everything I've read to date suggests that you probably don't need to do fat adaptation or glycogen depletion. Maybe if I worked in the Tour de France my, my mind would change but even with any ironman athlete I work with. And again it might be my bias towards fear of under fueling or elicit an iron deficiency or stress fractures. But we do no fasted stuff.

No thank you. And yeah, for those of you who are listening the supernova trials, I think, I think Louise Burke is now, she's, she's a researcher and a dietitian actually in Australia, isn't she? I think she's now on number four. I think she's just on the, the ketones and low carbohydrates, high fat, isn't she as well. So for anybody that wants to read those journals, there's also snippets out there really interesting about trials in using fat as a fuel source versus using carbohydrate in endurance sports and that the background was in, in race walkers. So really interesting to, to have a, have a read as well. So just thinking about technology, we've been talking a lot about technology and Charlie's probably going to dip in, in a little second because he loves his tech. I also like technology but we have different thoughts on it. So I'd love to know your thoughts on technology in the nutrition space. What you think maybe is useful, not useful and, and whether there's anything that if you were going to make a product like a, an AI product or a tech product. Is there anything you think the nutrition world of sports nutrition needs.

Personally, and this may not be popular opinion, I think there is possibly slightly too much tech and I think what it's done is it'd be like giving an MRI machine to someone with no, no background in radiography or medicine. CGM is a great example. If you do sports nutrition appropriately and you have your high GI carbs before training, your blood sugar will do that. If you are in a CGM and you See that rising sugar you think you don't have, I suppose a clinical nuance to see that that should happen. You can think oh no, I Clearly have type 2 diabetes now. Or you can google my blood sugar is 8 millimoles. What does that mean? And they'll tell you all sorts of horrible things. I'll stick on a CGM for a second. I think when healthy non diabetics use CGMs it pathologizes daily normal fluctuations in blood sugar and it makes them possibly carb phobic or overly fixated on something that is really not, not that important for, for a normal healthy person. So that's popular opinion number one.

Can I just ask, sorry Evan, just to explain what a CGM means for those people listening.

Continuous glucose monitor made initially for people with type 1 diabetes who do need to be able to calculate what their blood sugar is all the time and thus what insulin requirements they have in the sports where people are data crazy. So they felt wouldn't it be brilliant and definitely useful if we can know what our blood sugar is all the time? And I think in research settings, yes, but free living people, I, I just, I think it's a bit ott.

Can I just ask. Sorry, just because I having just read a book called the Glucose Goddess I'm just intrigued by the, the concept of the, the more glucose or blood sugar spikes will get the, the worse the impact is on our long term health. Could you just talk around that? Because that's one of the reasons why having a glucose monitor would, would be.

Useful or considered useful. Yeah. So I suppose it's important to look at this in context. If we're talking about athletic cohorts here, generally we're talking about very well insulin sensitized people who probably are reasonably healthy anyway. So I think glucose spike is probably a dramatization as to what might happen. Like it doesn't, probably doesn't jump to 1112 millimoles. If it does, then you may have, you definitely might have a bit of a problem if it's doing that. Perhaps for let's say the, I suppose the sports nutrition tactics we would talk about pre and post exercise. They're not healthy eating guidelines. They don't look like healthy eating guidelines at all. So I think it's very important to contextualize that if you're looking at 24 hour day you're training there, you do sports nutrition guidelines as in low fiber, high GI carbs around that that is notably not optimal for blood sugar control. The rest of your day would be so the, the slight bump in blood sugar before training where you might get to 6, 7, I would say at most 8 millimoles is not necessarily pathological. A good analogy, kind of a tongue in cheek one. I would use Lucozade Sport is called Lucozade Sports. It's not designed to be drank while you're sitting on the couch watching television. If you applied sports nutrition guidelines for your whole day, you would 100% be type 2 diabetic or have fatty liver disease. I would say within a month, two months, like very easily. Could you imagine eating 30 slices of white bread a day to meet your needs throughout the whole day? That would be a disaster. So I think looking at the timing, the context, the cohort, the actual magnitude of that glucose variability and the actual real impact of that, I think it's important not to over, over pathologize that. And my clients who have had CGMs, they'll come, they'll sit in on a session and they'll say, oh, my blood sugar was 7 millimoles. That's above the threshold you see for fasting glucose in a blood test. And it gives them really bad anxiety. Can you explain? Well, actually that's okay. You don't need to worry about it. Your HbA1c or your average blood sugar over the last three months was well within the healthy range. You're okay.

I think it's useful, isn't it? You talked about things like the CGM in terms of, you need to know how to interpret those results. You referred to like an mri. And actually short uses for education can be quite useful. And I think, Charlie, one of the things that you kind of raised there, you know, actually when you use it in different populations, again, the education behind it would, it would, the profile is likely to look very different to an athlete, you know, so that, so they're very different things that we're talking about, I guess, in using a cgm. And I think it can be quite useful actually in people who are not moving very much, not doing very much exercise and are possibly overeating or living a lifestyle where they're drinking lots of alcohol and, and eating out a lot. Because actually that educational piece on where it is right now and if we make changes. So. Yeah, absolutely. I think if you've got tech technology, know what you're going to do with, with, with the information. Is there anything else that you use in terms of tech in, with nutrition or anything that you'd like to see invented that would help us?

Yeah, well, I use nutritics. A lot with people in Libro. That's, that's kind of how I track people remotely and that, that works pretty well. I'll often transpose that onto someone's training peaks data or I'll get their power meter that will help me to accurately or kind of accurately or as accurate as possible, interpret input versus output. And what, what has been the case for some athletes? You know, if you can use again Nutritics, you can get a really detailed breakdown as someone's daily intake. And sometimes what will happen is an athlete will say I fell short that day. And you might see that, well, you know, the night before you had basically an omelet, there was no carbs in that. You didn't have the funds to pay for your session that morning. Or your calories were slightly down for the two or three days prior to that. So you can have troubleshoot there by looking at ins and outs of what I like to see tech being developed. What is being developed at the moment? What I am very curious about is Hexis, the kind of car periodization for you that's very, very useful because it's a question I get asked by clients. I'm sure you're the same all the time. So I think for sports nutrition anyway, I see that as the, the coolest or most interesting thing that's being developed at the moment. To be honest, I rarely get to spend time delving into the world of tech outside of that. I barely have time to scratch my head these days. So the Texas Nutritics Libro, those are kind of my, my tools that I would use, I suppose.

I think there's going to be just more and more integration. Isn't that, you know, some of these nutrition apps that are becoming, using AI to be able to pick up data from training platforms like Training Peaks or Final Surge or whatever it might be to be able to say this is what training you did, therefore this is what carbohydrate you need. So yeah, I think it's, it's really interesting how all of these pieces of technology are now, you know, all able to talk, talk to each other. Where do you, where do you see? We talked a lot about AI and then what happens to the, you know, what happens to professions and how do we work with it? How do you see with all of these pieces of AI and these technologies, where do you see now like a performance nutritionist or dietitian sitting like where. How can we work with all of these technologies? Because people are gonna wanting to take them on and will obviously Take them on.

I think AI is a fair bit away from having the clinical acuity of a practitioner. Like I think it's great for giving you general, general guidance. I don't think it can be clinical or interpret things. I definitely don't think you can interpret things yet. It also isn't necessarily empathic. It's not personable. I would like to think much like a consultant with a fancy suite of MRI machines, blood work, it'll just kind of add to what we do. I think some people are afraid it'll replace. It's been like a Terminator doomsday scenario. I don't, I don't really see that. I think there's a lot of considerations to make like you know, if, if a client has a bad day training, it's not automatically down to poor nutrition. And I'm, I'm sure you're the same, but when you talk to someone you can see other, other things going on. Like you know, someone might mention that they're having a tough time or they're not sleeping. Great. You open up that line of inquiry. I don't think AI can expand or elaborate bar whatever purpose it's designed. Let's say like the carb periodization. It's not going to ask you how your day was and like delve into what are the non nutritional reasons for, for this poor performance. And I definitely think from personal experience that happens a lot. That's, that's a lot of the conversations we would have where the nutrition appears to be okay. You have to find another answer.

Yep. Yeah, I think it's definitely. Isn't it like working alongside all of those pieces of information and actually that helps us sometimes to do our job and, and those questions questioning as well. What we, what we always like to ask is about books that people have been reading. So it might be a book or maybe it's a podcast. Is there anything that you've been reading recently that you'd like to, to recommend?

Unless people really like to read research papers. To be honest, how, how I stay on top of things is I have a Twitter account under a pseudonym so people don't message me on it, just see what researchers are cranking out. I try and stay on top of that. There are a few key researchers I follow. Esther, you can drop Louise Bark, James Martin, Samuel Impey. If they release something, I read it. Otherwise, Sigma Nutrition Podcast is a very good kind of education for me. To be honest, I learned an awful lot from that because again as a dietitian you can get anything sitting in front of you. Case in point. I have a client at the moment who is an ultra runner with gastroparesis and cyclical vomiting syndrome. There is no textbook for that. Yeah, it's an amalgamation of different sets of clinical guidelines. So alongside the kind of ad hoc reading, a lot of my reading is more or less based on what clients I have. So I'm reading lots into gastroparesis, maybe medium chain triglycerides to see if we can get around that. And it'll differ from week to week. Like I've, I've had people who've had severe ibs. You have to, you have to elicit fodmap diets but try and get them very high carb. And that, that clinical variety is what keeps me on my toes. So my, again, there's not necessarily a book if you're trying to combine clinical dietetics with sports nutrition, which is more so where I live as opposed to absolutely performance. So it can be pretty erratic.

I can clearly there's a lot of noise in this space of what we should eat and what we shouldn't eat and there's a lot of books on it. Are there any books that you do find yourself recommending to your clients that are kind of, that you think is a good sort of base learning level that they can go to?

Honestly, not popular. Not really. Like if you, if you really want to learn about sports attrition, all of the aforementioned people I think bar Samuel Limpy have written textbooks on it. If you really want to get into it, you can 100 do that. Otherwise, I mean you can, you can point people towards educational videos. Like there are some things on YouTube that are educational and evidence based or you can try your best to educate in, in sessions. So I, I would find that as a sports dietitian you're almost half a teacher. And that's, that's where a lot of the education would work with, for, for my clients personally. And if anyone does come on board with us, one of the first things we'll say to them is we wanted that in like three to six months tops. You never need to talk to me again or anyone like me because you'll know what to do. So in that sense I don't really feel the need to recommend books. And again, unpopular opinion maybe number four or five today. A lot of books in the nutrition sphere are, they're kind of self help books that appear to be nutrition books. I don't think they're actually very helpful to be honest. Or I think they give generic guidelines because they have to. And for nutrition, it's all context. And you, you simply can't point someone to a book to say, well this is your context. All of this is for you and no one else.

I think that's a very valid point, isn't it? Is that you can't have or eat the same thing every single day the same as somebody else. Because our days are so, so different. We always have a question from the last person that we've had on the podcast. So we have been speaking to a, an Olympic, an American Olympic triathlete, Katie Zaferes, and she has a question for you. So here goes. What is your most impactful year and why?

My most impactful year, I would have to say it's this year, 2023. Thus far I put a big effort into social media sharing, sharing content and I found that through that maybe not maybe it has connected with quite a lot of people. Like let's say I'll release content on things people struggle with in private but are too embarrassed to talk about, like fecal urgency during exercise or male athletes with libido or if you, you know, if you're not able to sleep at night as an athlete, maybe that's an under fueling thing. Perhaps it could be if you check box A, B and C. So how would I kind of summarize this? Advocating for evidence based sports nutrition in a public way has enabled me to connect with and thus help people either in a one to one basis or they've read the message and said, you know, I need to get this looked at. And I do get messages all the time or the podcast even. We pick kind of niche topics and people say it does help them. So yeah, it would, it would have to be, have to be this year. I'm on a kind of natural curve anyway. Like I'm lucky to be in the position that my, my own business and practice is growing. I've taken on four people this year. So larger we are, the bigger of an impact we can. The thing, the thing I'm most proud of is I, I should figure out the phrase as well. I find that male athletes are not well advocated for and it's, it's kind of, it's the opposite in every other setting from what I can see. You know, generally speaking, there's always a fight for equality between men and women in sports iteration with respect to reds. As a male dietitian who had us coming from a professional sports background specializing in this area, that is the thing that I've Been able to help people the most with. And you see, you see it like, I mean when these guys call me or you're sitting with them first, they're trying to work up the courage to say things downstairs don't work and no one knows why. You talk to them and they, they go through all the things they're doing the under fueling all that jazz and that's been a big thing in 2023. And maybe people don't know, maybe people laugh at Ed because historically it's joked about but low testosterone levels and lads is not a benign thing that can cause low bone mineral density infertility. Imagine if you're trying to have kids and your sperm count is too low and you're not aware that's because you do too much fasted training or you skip carbs like that might never get picked up in a GP surgery. That has been my most impactful thing, deciding to advocate for that one thing specifically.

So like impact on, on you and your own business, but also impact on other people as well. Fantastic. And just really to sort of wind things up today from this fantastic conversation with you, we've also got one last question and we ask our listeners to send a question in and they don't know who we're going to interview, so it could be anything. So we've got a question here from one of our listeners, Kerry, and she said, what belief do you hold that most people disagree with you on?

No one. No one can. Maybe I should rephrase this. Everything is up to you.

Fantastic.

There are, there are tools there to help you. People will wish you well. And this, this came about after my edits career fell apart and the athletics world moved on very quickly without me. There were very few helping hands and it was a very lonely realization that if I ever want anything, it's totally up to me. Can reach out for help, but it's up to me. A lot of people maybe have a narrative that they've spun that when my circumstance is difficult or I have many excuses and generally I find excuses are valid, but it was still a very lonely place. Put my head on a pillow thinking, well, none of this worked out. Even though I had lots of valid excuses, you're still, you still end up in the same place. So that, that mentality, it makes me very hard working and fairly unrelenting. And some people maybe think it's a bit of an over simplistic look at things that, you know, things don't work out or things are out of your control. But I choose not to let them be, I suppose.

Yeah, absolutely. That sounds. Sounds like actually a very sensible piece of. Sensible piece of advice as well. Well, Evan, it's been amazing to speak to you and thank you for sharing all of your information about you and your sport and also your. Your career to date and all the insights and all the technical and more nerdy bits. So hopefully our listeners have had a lot, a lot to think about and you never know, they might be going out there and reading some, some journal papers rather than a book this week. So thanks very much, Evan.

Always my pleasure, Grace.

Thank you, Evan. It was really fascinating and yeah, there's a lot of background noise going on here, so it was absolutely brilliant. But I was very glad to sit and listen to the experts speak about this subject. So thank you very much.

Cheers.

If you want to find out more about Evan, then you can find him on Instagram and he is E. Lynch and that's L, Y, N, C, H Fit Nut. So E. Lynch Fit Nut on Instagram. He's also on LinkedIn and his website is evan lynchfitnut.com we'll put all of those links in the show notes. As always, If you like what we do at the Tribathlon podcast, you've got to register for Tribe Talk. It's an email that comes out every two weeks packed full of everything to do with swim, bike and run, but also nutritional help, business coaching and a whole lot more, whether that's books, videos, TED talks, apps or technologies. It's packed full of ideas that can help improve your sport, your life and your business. So register for it@tribathlon.com and you'll be sure that every two weeks your inbox is full of some amazing ideas and resources to improve your life. So what did you make of the interview with Evan?

It was. Yeah, it was really interesting. Obviously it was right up my street in terms of nutrition. So I would, I would say it was interesting. But no, I really like his. I mean, everyone's talking about relative energy deficiency in sport now, which is a really good thing, but I guess it's become a bit more generic in nature. But it was really good to hear him talking from more on, like the kind of male perspective side of things, which I think is not always talked about. So I really love the fact that, that he's been really kind of getting that message out there and talking about it. What. What did you think actually from a. From a male perspective? You know, I know we've talked about it, haven't we, on the podcast before, but I don't know, as a group of, like, men out cycling, would you. I don't know whether you'd ever discuss anything like that or talk about anything in terms of energy or.

Well, interestingly so, normally, no, I would not be talking about that. And I thought it was really interesting because we obviously, we kind of touched on it briefly with Dr. Nikki K. But we obviously still spent a lot of time talking about reds in females as opposed to males. And so I thought it was really interesting how, you know, previously when he'd done podcasts and things like that, that guys had suddenly kind of come out the woodwork to say, actually, I am having this sort of issue. Anyway, so while I was. I was away at a conference last week and I was chatting to a fellow endurance athlete, and we started talking about something and. And I mean, admittedly we'd both had a few beers, so it was kind of probably an easier conversation to have. But as soon as I mentioned kind of, we started talking about relative energy deficiency, and we weren't talking about any issues that either of us were having. But as soon as I mentioned the symptom, he was suddenly like, what? I need to know more about that. And so I just direct, you know, I said I'd share with him the podcast once it's live, but I think there is a lot more of that. That particular person was doing a lot of fasting as well as a lot of training. I was like, you know, actually, I suspect there is something going on there that he didn't want to say in as many words. But I think there's a much bigger problem than perhaps we realize. And whether it's. Whether it's that or whether it's kind of leading onto osteoporosis, I thought it was a really interesting conversation. I think it's really good to be getting that message out there and trying to. Yeah. Trying to bring awareness to it, because if that's the first sign of a much bigger problem later on, then we need to. You need to know about it and deal with it, don't you?

Yeah, And I think it is. It is that awareness and talking about it. And like you say, there's. There's, you know, been so much focus from a female perspective because generally, but not always it's easier to. To spot in women. And actually, a lot of the research in terms of energy deficiency, right from the female athlete triad, that was the. The kind of old model really, obviously was always talking about women. So the fact that women within the new model which is now being re looked at anyway. But within the new model, you know, there are so many factors that you know that, that it is, it is men involved as well. It's just not so obvious. But if we talk about it more, maybe men will actually think, yeah, actually this is obvious to me now. Now I know all the symptoms. So no, it was really good to have that conversation. And I love speaking about race walking as well. Something I have never had a go at with my long legs. And yeah, just. That was interesting to hear his background, wasn't it? In terms of coming from race walking.

It was. And not only that, the speed of which they're actually race walking. I mean that, that was, I mean I think he was saying about 10 minute miles, wasn't he? For what I think, which I think is amazing. You know, there's, there's a lot of people that be very happy with running a marathon at 10 minute miles. So these guys are walking at that pace is, is quite phenomenal. So yeah, no, I thought that was really interesting. And yeah, maybe we need to explore more about race walking, particularly when you, you know, one of the things that we talk to ultra runners about is the fact that there's a lot of walking in an ultra marathon. So if you could walk but 10 minute miles, then that makes ultra running a hot. You know, makes you a significantly better ultra runner. And perhaps something we could chat to an ultra runner about in future. But yeah, no, I thought it was, I thought it was really interesting. So, so let's rewind this episode up. But another great episode where hopefully you took some really interesting learning points from. I know I did. And yeah, good luck with your training, Claire. Thank you very much. And for everyone else, keep on training. And remember, this episode was brought to you by the trusted team and by fourth Discipline. So if you want to find out more about how the trusted team can help you grow your business and improve your work life balance, go to thetrusted team. And if you want to find out more about how fourth discipline can help take your performance in sport and life to the next level, go to fourthdiscipline.com. If you enjoyed this podcast, please do review it and share it because it helps other people find what we think is really valuable learning lessons from amazing athletes. So please do that. You can also find the whole back catalog@tribathlon.com and you can also find out about the tribeathlon app which helps people find events, find people to train with and enjoy their events throughout through their tribe. So check out tribathlon.com.