Bone Health for Athletes: Performance Today, Longevity Tomorrow Ep 147

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All right, welcome back, friends.
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A fun topic for you today.
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Uh, we are on the Find Your Edge podcast.
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My name is Coach Chris, and I'm here with my amazing dietetic intern, Emily Q, who has been a machine cranking out some great information for all of you folks out there who are active and doing amazing things in the endurance community and here to talk about bone health, something that we probably don't talk enough about.
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So, bone health for athletes.
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So, Emily, what's up?
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How's how's the internship going?
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Hi, Chris.
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It's been going so well.
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And I'm not just saying that because you're right here.
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I was gonna say that's a little canned.
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I've been I've been really loving it.
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I've been learning, learning a ton and just getting to see a lot of super cool things.
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So it's been such a cool experience.
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Good.
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We have had her doing everything from deep dives into various sports nutrition things, integrative and functional nutrition.
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You've been seeing lactic testing and VO2 testing and all the things.
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So I've been I've been working out with you guys too.
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So of course, how could I forget?
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She's also doing strength training.
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Speaking of bone health, Emily, that was such a great segue.
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It's like we planned it or something.
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Yeah.
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Why athletes need strong bones.
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I feel like this is a topic where most people are like, oh, this is only for like growing children, right?
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So tell us about why athletes, no matter what their age, need strong bones.
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For sure.
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I feel like we are always talking about our muscles mainly, like how to build muscle, how to maintain it, and whatever.
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But we need to remember that the framework for all those wonderful muscles are our bones.
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And so if we want to generate the most power and speed from our muscles, we need to have strong bones.
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And we're not all necessarily thinking about this at every moment, but in addition to bones being important for growing, like you said, in the growing children, um, in our older age, strong bones really help us prevent injuries and detrimental falls and things like that.
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Yeah, for sure.
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I love this little tip you give down below in terms of bone mineral density.
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Tell us about that, like peaking in early adulthood, and then what?
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And then slowly declines.
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Yeah.
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This is something I didn't learn until a few years back in one of my nutrition classes.
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But bone mineral density is basically the indicator of how well your bones are doing and how healthy they are.
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If you have a higher bone mineral density, that's a good thing.
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And we actually build our peak bone mineral density in early adulthood, like 20s.
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It usually peaks around the age of 30.
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And then just there's a natural decline, like a slow decline as you keep aging, which is why you see a lot of osteoporosis and things like that in your older age, because it kind of like has this shape of it, it peaks and then it slowly comes down.
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And there's not too much you can do after a certain point to bring it back up.
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So the more you build your peak bone mass, but bone mineral density, like in your early adulthood, I guess the further it has to decline before hitting the danger zone of osteoporosis, if that makes sense.
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Yeah, for sure.
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I love for folks if you don't have access to one, try to find one.
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A DEXA scan is not only so great from a body composition perspective, because you know, I'm all about the metrics, and especially folks who are looking to, they want to lose some body fat and they want, you know, and the scale's not moving and what the heck.
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And then they get super frustrated.
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Having that additional metric of knowing how much lean body tissue do you have and how much fat mass you have.
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But also part of a DEXA scan is what is your bone mineral density.
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And then especially tracking that after the age of 30, in my mind, allows us to be more proactive about the food choices that you're making, about the activity choices that you're making.
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Because, you know, I have some people who, in their genetics, it shows that their bone health is of greater concern, but they're getting adequate vitamin D and calcium.
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We're gonna talk about that here in a minute, and they're doing super heavy lifting and they're running.
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It's like, okay, well, you're doing the things and your desk says that you're fine.
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So, you know, but then there's like, but I'm gonna get osteoporosis because my family had it.
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I'm like, no, that's not a guarantee because you are literally doing the things to mitigate that process.
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So, yes, I I hear you saying how there's a natural decline, but we can be part of the process to slow that decline.
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Exactly.
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You know, because bone, bone is turning over all the time.
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We take it out, we put it back in, we take it out, we put it back in.
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Anyway, stop me on the soapbox.
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No, it's great.
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I would have the same soapbox.
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I think, especially in our athlete population here, this is not just something you have to keep in mind for your older age, but maintaining your peak uh bone mineral density and trying to slow that decline plays a huge part in prevention of stress fractures, which I'm sure a lot of you have dealt with and have suffered.
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Yeah.
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Yeah, for sure.
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And we get so many PTs who are sending us athletes who are have repeated stress fractures.
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And, you know, they're obviously looking at it from a mechanical perspective.
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Like, are their mechanics such that they're moving in a way that is saving, quote unquote saving their bones or s or preserving them, but also what's going on on the inside?
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Like, what does their nutrition look like?
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Are they too acidic?
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Are they getting enough vitamin D?
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What is their nutrient statics, etc.?
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But um yeah, I know the slide that we're on, if you guys are watching this on YouTube, we're talking about building that peak bone mineral density.
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So this is probably not news to our folks, but you know, we can put in the general recommendations anyway.
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So what do you got, Emily?
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Yeah.
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So the number one thing you can do to like make sure you're building your peak bone mineral density is weight-bearing exercise.
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And I want to emphasize this specifically for female athletes, because I feel like generally there's less of an emphasis on strength training in a lot of women, but your most impactful activity to build your bone mineral density is going to be impact activities, kind of against going against gravity.
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So that can include running, that can include jumping, stairs, anything where you're kind of you're pounding a bit.
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Yeah, pounding and like you're really your bones are feeling that absorbing that impact, and they're going to adjust and strengthen because of that.
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Yeah.
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Non-impact things are also very important.
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Weight lifting, if you're like constantly like lifting things that are like resist the resistance training, that's really, really good for your bones as well.
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That's just an example.
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The recommendations say that you should be doing weight-bearing aerobic exercise three to five times a week and resistance exercise for about two to three times a week.
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So a combination of both is the best.
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Yeah, for sure.
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And of course, those ACSM recommendations are more general population.
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And I know all of you out there are probably exceeding that by like a lot.
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For sure, for sure.
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Which, which is great.
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But I do want to point out is that from a non-impact perspective, if you are a cyclist only, you are at greater risk of losing bone density.
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So I know that you're going to whine and complain at this statement, but your rear end needs to be in the weight room.
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Like, please don't argue with me.
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Just go lift heavy things, you know.
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I mean that I don't get 250 miles this week.
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Shut your face and go to the gym.
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Like it will help your cycling specific strength.
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It will improve your performance and it will save your bones because cyclists only, and this is in comparison, the research I've seen is in comparison to runners, they have a greater decline in their bone density than And if you yeah, if you think about it, it's because you're sitting on the bike and your your legs are going, but you're not really the pounding that we talked about earlier isn't just isn't there.
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No, it's not happening.
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And I get it.
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Some people are like, oh, well, I've got, you know, a knee replacement or hip replacement, like I can't run anymore.
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That's fine.
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You can still pick up heavy things that are gonna stress the bones.
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There's also very interesting research that I've seen.
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Emily, have you heard of and something called heel drops?
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Yeah, like in your shoes.
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Yeah.
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Yeah.
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So not necessarily like a like a heel, you know, cup or something like that.
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But if you stand barefoot, that this is research-based, promise you guys.
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And you stand like a cute little old lady or man on the back of a chair, or it doesn't matter, matter where you stand, and you you have to be barefoot and you have to be on a hard surface.
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So, you know, a hardwood floor is is fine, just not a carpet or something like soft and squishy.
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And you lift up onto your tippy toes.
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Maybe I'll do this in strength class tomorrow.
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And you stand up on your tippy toes, and then you literally drop your heels forcefully on the ground, and then you rise up onto your tippy toes and then drop your heels forcefully onto the ground.
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And then you do that over and over again.
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That will build your bone that you are stressing your spine and your pelvis in a way that helps with this turnover, even if you can't physically run or jump or do stairs.
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But if you can do heel drops, and we're talking like 20 to 50 a day.
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So it's it's not this extraordinarily time-consuming thing.
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So I cannot wait to see cute little cyclists in their kits sending me videos of them doing heel drops instead of going to the gym.
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It actually will support your bone density.
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So your body will thank you later.
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It totally will.
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It totally will.
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Okay, nutrition's role.
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I love nutrition, of course.
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So what uh tell us about nutrition's role in bone health.
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So, what are nutrients we have playing around in here?
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I mean, you guys probably all heard this growing up.
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The calcium is probably the most important.
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The second most important is probably vitamin D because it helps absorb calcium.
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So your bones are primarily made of calcium.
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Like 99% of your body's calcium is stored in your bones and teeth, actually.
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But beyond that, calcium is also required for uh muscle contraction and nerve transmission and blood clotting.
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So it's doing a lot for you.
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Uh the your out there, especially now that it's hot, is hearing that because muscle contraction is massive.
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If you are having issues with cramping, usually most people are gonna go to magnesium, but you gotta make sure you're getting enough calcium in there too.
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Like it's really critical.
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Yeah, it's not just kids that need to be drinking milk, but we're we're taught, we'll talk about that in just a little bit.
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Yeah, for sure.
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Um Vitamin D, like I said, it helps you absorb the calcium, and then it also regulates your calcium and phosphate levels in your blood, which is super important for all that other function, the muscle contraction and whatever else.
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Yeah.
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So those the primary like adequate consumption of those two are probably the most important in bone health.
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There are some other nutrients that also play play some roles here.
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Vitamin K is one, vitamin C is one, protein as well.
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That's important for just building bone.
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Yeah.
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So many people are like, oh, if I eat too much protein, I'm gonna hurt my bones.
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No, it's actually the opposite.
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Yeah.
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So there are also a lot of other like smaller micronutrients that play some roles.
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Just some examples are like copper, potassium, phosphorus, magnesium, you know, vitamin A.
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The list goes on.
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But a lot of these foods like have overlap, the foods that are rich in these like prime more primary nutrients also have a lot of the micronutrients.
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So it's not like you need to like revamp your entire diet to account to account for your bone health.
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Yeah, yeah.
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Good point there.
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Okay, so now getting into what nutrition pitfalls that are harming, potentially harming your bone health.
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So let's go.
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What you got?
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Yeah.
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All right.
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One of the that you might have seen this coming, but one of the uh if you guys have heard of the newer-ish diagnosis called REDS, relative energy deficiency in sport, that low energy availability.
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If your body's not getting enough energy to do its like most important work in like the immediate present, then it's probably gonna focus less on things like bone formation because it might not be relevant to what you're doing like right at that second.
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So if you're not getting enough food, period, you're also probably not getting enough calcium or vitamin D or all those other nutrients that we talked about.
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So make sure you're eating enough for what you're doing.
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Going along Yeah, let's see.
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Low carb intake.
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What do we got?
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That kind of that kind of goes with the low energy availability because chances are you're not consuming enough carbs if you're not consuming enough overall.
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And we know from research that eating enough carbs prevents bone resorption, which is basically like degrading.
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It it prevents that from happening.
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Okay.
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Carbs do more than just give you energy, you guys.
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So cool.
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They're very important.
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Yep.
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Yeah.
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And then low vitamin D intake.
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Yes.
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This is more common than than you think it might be.
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We I think it's about like a third of adults in the US, maybe a little bit more, don't intake enough vitamin D.
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And a lot of us are indoors all day, not really out in the sun.
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And there's just not a lot of foods that have vitamin D naturally.
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So it can be hard.
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So that's just one of them.
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And we'll again talk about some more of those food sources in just a little bit.
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Yep.
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And then calcium and sweat losses.
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Just like I was saying, look out, all you heavy sweaters, where you at?
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I know you're out there.
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We know that we lose calcium and sodium through sweat, like we just mentioned.
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And when you lose calcium and the levels in your blood go down, your body is actually going to pull extra calcium from your bones to maintain the right levels in the blood.
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So you don't really want that to happen.
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So you want to make sure you're getting in enough calcium so that so that your body doesn't turn towards the bone for that source.
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Yeah.
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Yeah.
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And then what do you have here for that last bullet point there?
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Yeah, we touched on this a bit earlier, actually, but running, cycling, swimming, and ballet are associated with lower bone mass than other sports.
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And it's because we talked about how cycling is not really, you're not getting that weight-bearing pounding impact.
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But and same thing with swimming when you're just like when you're in the water all the time.
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But I think swimmers are better in general about making sure that they lift than they do strength training.
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What we see at the Triangle Aquatic Center, which is the Titans team, I mean, you know, our lab is located inside their gym.
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So obviously, we see them doing their dry land quite a bit, and they obviously put a big emphasis on it.
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But that being said, that facility is freaking amazing.
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And not every swimming organization has access to something like that or are necessarily putting an emphasis on it.
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So, because swimming is non-weight bearing.
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Great for great cardiovascular exercise, amazing cardiovascular exercise, but not load-bearing at all.
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So you have to balance.
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Yeah.
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So yeah, better way of saying that for sure.
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In our world, low energy availability, but in their world, you ain't eating enough, y'all.
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To put it in simpler terms, exactly.
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Right.
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Same thing.
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I do see a lot of, you know, because all of those sports, and you know, perhaps we could add gymnastics to this, we could add diving to this, we could add some of those more body-focused sports that tend to want to achieve a certain look or like in cycling a certain power to weight ratio, especially when you're looking at pros, for example, um, especially the pro men, you know, who have like these little tiny sticks for arms and these like massive quads, you know, they are they're trying to achieve as much power to weight ratio as they possibly can.
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So, you know, there is a degree to which they are manipulating their diet and their training to try to be the best performer they can.
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And, you know, I feel like we've come quite a long way with nutrition, especially in professional sports and just sports in general.
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You know, we were like people to pay attention to nutrition.
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And now I feel like they're, you know, they're paying attention, which is great.
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But, you know, to what end are you benefiting yourself in the long run?
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Because man, your bones gotta last a long time, you guys.
00:18:59.629 --> 00:19:00.269
Yep.
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So performance is part of the equation, but then longevity is massive.
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Yeah.
00:19:08.750 --> 00:19:15.789
And I feel like that kind of the concern for longevity kind of falls to the wayside sometimes if you're really like training for the right now.
00:19:16.269 --> 00:19:29.710
But I think a lot of people might not be thinking about what certain like dietary patterns of not eating enough might be doing to their chance of injury, which could affect the right now and then their bone health later on.
00:19:29.869 --> 00:19:32.269
So just things to think about for sure.
00:19:32.589 --> 00:19:33.950
Things to think about, totally.
00:19:34.109 --> 00:19:49.629
And again, DEXA scans are great so that you can actually see metrics on what is my bone mineral density, what is my lean mass, and then what can I do to actually um impact that, which is real cool when you know people are eating more of their protein.
00:19:49.710 --> 00:19:54.670
And oh, which speaking of supportive foods, love it.
00:19:54.829 --> 00:19:55.149
Yes.
00:19:55.389 --> 00:19:55.549
Yes.
00:19:55.710 --> 00:19:58.430
So what do we got for all of our sources?
00:19:59.069 --> 00:19:59.629
All right.
00:19:59.950 --> 00:20:05.710
For calcium, we've got a lot of fish are high in calcium, but here's the kicker.
00:20:06.349 --> 00:20:12.190
You need to be eating fish with bones, kind of like canned salmon or sardines or something like that.
00:20:12.430 --> 00:20:16.109
And I'm guilty of not eating these myself.
00:20:16.349 --> 00:20:20.829
I just didn't gr I didn't grow up really eating fish with bones inside.
00:20:20.909 --> 00:20:22.990
Like, so it just didn't really like occur to me.
00:20:23.069 --> 00:20:28.829
But the cal the there, but the fish bones, like our human bones, is where the calcium really is.
00:20:29.069 --> 00:20:29.309
Yes.
00:20:29.629 --> 00:20:31.710
So don't like choke on a bone.
00:20:32.589 --> 00:20:33.309
Right, right.
00:20:33.789 --> 00:20:34.909
Be careful with them.
00:20:35.149 --> 00:20:35.549
Yes.
00:20:35.710 --> 00:20:46.430
Usually it's like the um, like if you get a can of salmon, um you and oftentimes it will say it on the on the label, but you know, you'll you'll see them in there.
00:20:46.750 --> 00:20:48.190
You know, they're usually little.
00:20:48.509 --> 00:20:52.990
Um, they're not the spiky ones that you're gonna like, you know, choke yourself or something.
00:20:53.230 --> 00:20:58.029
But um uh yeah, there it's a different texture.
00:20:58.190 --> 00:20:59.230
We'll just call it that.
00:20:59.389 --> 00:21:00.190
We'll call it that.
00:21:00.349 --> 00:21:06.670
And uh there have got to be ways around this, but you know, keep going for what we have of good calcium sources.
00:21:07.549 --> 00:21:10.829
Um we know that there that dairy has a lot of calcium.
00:21:10.909 --> 00:21:16.990
You grew up hearing about needing to drink milk, yogurt and cheese also have a great, great calcium content.
00:21:17.149 --> 00:21:23.869
Uh, we don't think about this, but our leafy green vegetables also have some calcium in there and some nuts and seeds as well.
00:21:24.190 --> 00:21:24.750
Yeah.
00:21:25.069 --> 00:21:29.230
Um tahini, which are sesame seeds.
00:21:29.869 --> 00:21:42.990
So if you're sprinkling sesame seeds, or they're like sesame seeds in your whole grain bread, or you're using eating tahini in a smoothie, or um tahini in your hummus.
00:21:43.629 --> 00:21:46.269
Um, okay, so here's one for you.
00:21:46.509 --> 00:21:54.029
Let's say we've got a vegetarian or somebody who's just like hard pass on fish, and maybe they're lactose intolerant.
00:21:54.269 --> 00:21:56.029
So they're not gonna do dairy.
00:21:56.190 --> 00:22:02.509
Yes, you've mentioned leafy green vegetables, nuts, and seeds, but is there anything else that we can do to get our calcium?
00:22:02.909 --> 00:22:08.269
This is a great hint for our next slide, which is you know, yes, fortified food.
00:22:08.509 --> 00:22:10.269
We're gonna go back and forth because we're gonna go.
00:22:11.069 --> 00:22:12.670
Okay, so here.
00:22:13.309 --> 00:22:22.269
So uh there's luckily all your milk alternatives, your soy milk, almond milk, oat milk, there's probably more that are all fortified with calcium.
00:22:22.349 --> 00:22:25.149
They I think they fortify milk out of, honestly.
00:22:25.470 --> 00:22:26.190
I know, I know.
00:22:26.349 --> 00:22:33.389
I think in my food science class last fall, we had a tasting of a ton of different plant-based milks.
00:22:33.789 --> 00:22:34.109
Uh-huh.
00:22:34.269 --> 00:22:36.509
There were so there were some of them were so strange.
00:22:36.670 --> 00:22:45.309
There was like macadamia nut milk and pea milk and um hazelnut milk.
00:22:45.549 --> 00:22:45.869
Uh-huh.
00:22:46.190 --> 00:22:48.829
There were there were all these things I've never heard of.
00:22:49.149 --> 00:22:50.029
Cashew milk.
00:22:50.190 --> 00:22:50.509
Uh-huh.
00:22:51.549 --> 00:22:51.789
Yeah.
00:22:51.950 --> 00:22:55.389
And it because you would you say you're a self-proclaimed picky eater?
00:22:56.190 --> 00:22:56.829
I would.
00:22:57.149 --> 00:22:57.389
Yeah.
00:22:57.710 --> 00:22:58.109
100%.
00:22:58.670 --> 00:22:58.750
Okay.
00:22:58.990 --> 00:22:59.389
I'm amazing.
00:22:59.629 --> 00:23:00.909
But did you try them all?
00:23:01.230 --> 00:23:02.029
I did try them.
00:23:02.430 --> 00:23:03.710
I'm always willing to try.
00:23:03.950 --> 00:23:04.190
Yeah.
00:23:04.349 --> 00:23:04.670
Yeah.
00:23:04.909 --> 00:23:07.389
And what and like did you have any favorites?
00:23:07.470 --> 00:23:09.710
Or it sounds like several of them were just weird.
00:23:10.029 --> 00:23:11.869
It's they a lot of them were just weird.
00:23:12.029 --> 00:23:14.909
I think I remember really disliking the pea milk.
00:23:15.069 --> 00:23:17.309
I think I remember the cashew milk wasn't that bad.
00:23:17.629 --> 00:23:19.549
But not P-E-E milk, you guys.
00:23:19.710 --> 00:23:20.589
P-E-A milk.
00:23:20.909 --> 00:23:21.789
P-E-A milk.
00:23:21.950 --> 00:23:23.549
Like the the little green bean.
00:23:23.629 --> 00:23:23.789
Yeah.
00:23:24.190 --> 00:23:24.750
Or I don't know.
00:23:24.909 --> 00:23:25.230
Yeah.
00:23:25.389 --> 00:23:25.710
Yeah.
00:23:25.950 --> 00:23:32.589
Um, I'm I'm usually, I I don't mind like soy milk, almond milk, oat milk, all those like big ones.
00:23:32.750 --> 00:23:34.109
I don't mind those usually.
00:23:34.269 --> 00:23:35.470
So I was just really curious.
00:23:35.549 --> 00:23:38.509
I think that, yeah, the cashew milk, I think I liked.
00:23:38.670 --> 00:23:40.349
Um I probably had coconut milk.
00:23:40.509 --> 00:23:40.990
The hemp milk.
00:23:41.149 --> 00:23:42.269
But not the canned, right?
00:23:42.349 --> 00:23:43.789
The dairy aisle coconut milk.
00:23:44.029 --> 00:23:45.549
Yeah, coconut milk.
00:23:45.869 --> 00:23:48.190
I uh remember liking the hemp milk.
00:23:48.269 --> 00:23:51.149
I don't know if anyone's ever tried hemp milk with like hemp seeds and stuff.
00:23:51.470 --> 00:23:53.710
But it was it was pretty that one was pretty good.
00:23:53.950 --> 00:23:54.269
Okay.
00:23:54.509 --> 00:23:55.149
Okay, cool.
00:23:55.309 --> 00:24:01.069
So milk alternatives, generally speaking, are uh fortified with additional calcium.
00:24:01.309 --> 00:24:01.470
Right.
00:24:01.629 --> 00:24:03.230
And vitamin D for that matter.
00:24:03.549 --> 00:24:06.269
So, and you have a couple other things that are listed in here.
00:24:06.670 --> 00:24:06.990
Yeah.
00:24:07.149 --> 00:24:12.909
So your uh typical breakfast cereals, orange juice, those are also fortified with calcium usually.
00:24:13.069 --> 00:24:14.909
One big, one big one is tofu.
00:24:15.149 --> 00:24:20.349
Tofu usually is packed with calcium when and the they like fortify it.
00:24:20.509 --> 00:24:21.149
It's really good.
00:24:21.549 --> 00:24:21.869
Yeah.
00:24:22.029 --> 00:24:22.349
Okay.
00:24:22.509 --> 00:24:26.430
Um, I'm gonna flip back because now we need vitamin D supportive foods.
00:24:26.509 --> 00:24:28.589
I like how you call them supportive foods.
00:24:28.829 --> 00:24:29.230
Yeah.
00:24:29.470 --> 00:24:29.869
Yeah.
00:24:30.109 --> 00:24:30.430
Okay.
00:24:30.829 --> 00:24:33.069
So revisiting fish for this one.
00:24:33.149 --> 00:24:35.470
There's a lot of vitamin D in fatty fish.
00:24:35.629 --> 00:24:39.309
You've probably heard like trout, salmon, sardines, tuna.
00:24:39.549 --> 00:24:41.149
Like these ones aren't as important.
00:24:41.309 --> 00:24:44.109
Like you don't need to have the bones with these necessarily.
00:24:44.349 --> 00:24:49.309
And fatty fish, like, they're really great because you're also getting your omega-3s from them too.
00:24:49.950 --> 00:24:52.029
Anti-inflammatories, yeah, so good.
00:24:52.269 --> 00:24:52.589
Uh-huh.
00:24:52.909 --> 00:24:55.069
Egg yolks have a lot of vitamin D.
00:24:55.389 --> 00:24:57.789
Um beef liver.
00:24:58.349 --> 00:25:00.029
A little controversial there.
00:25:01.230 --> 00:25:02.990
I'm a hard pass on beef liver.
00:25:03.069 --> 00:25:03.950
So there's that.
00:25:04.509 --> 00:25:07.149
Beef liver is like beef liver basically has everything.
00:25:07.309 --> 00:25:07.950
Yeah.
00:25:08.349 --> 00:25:10.509
They have everything, but they're a little off-putting.
00:25:10.750 --> 00:25:15.149
So I'm just putting it out there, but and red meat also has some vitamin D.
00:25:16.029 --> 00:25:16.509
Cool.
00:25:16.670 --> 00:25:22.349
But again, you you run into the issue of like, you know, you you don't eat meat, you're lactose intolerant, whatever.
00:25:22.589 --> 00:25:25.710
Uh so you're and then, of course, there's the good old-fashioned sun.
00:25:26.349 --> 00:25:33.869
So, and I exactly, if I had a dime for every time I've heard this, but I'm outside in the sun all the time.
00:25:34.029 --> 00:25:36.190
Why is my vitamin D low?
00:25:36.909 --> 00:25:46.430
So there is a genetic component for which when you get it from the sun, it absorbs through your skin, and then you have to convert it on the level of the kidneys.
00:25:46.670 --> 00:25:52.829
Genetically, some of us don't do that well, which means that you are gonna be chronically low in vitamin D.
00:25:52.909 --> 00:25:55.950
And then that's a whole host of other issues.
00:25:56.109 --> 00:26:04.269
So, either fortified andor most likely uh supplemental form is gonna have to be your route to go.
00:26:04.509 --> 00:26:08.829
But how do you know unless you test it, you guys?
00:26:11.389 --> 00:26:14.750
Soapbox, you gotta know your metrics.
00:26:14.829 --> 00:26:18.349
Uh, I have the perfect client who is popping in my head right now.
00:26:18.589 --> 00:26:22.349
She has probably one of the worst genetics I've seen in terms of life.
00:26:22.430 --> 00:26:26.990
She has like all the markers of poor vitamin D absorption.
00:26:27.230 --> 00:26:39.710
And I believe we have her up to about 6,000 IU per day to get her into like the lower range of normal and you know, runs in the family, obviously, because it's genetic.
00:26:39.789 --> 00:26:50.909
But how would you know unless you tested that we and then we recently got her numbers back, and that's when we made another tweak to her uh supplement strategy.
00:26:50.990 --> 00:26:57.789
And of course, the sun varies uh throughout the seasons, especially we're like right in the line, we're like right in the middle.
00:26:57.950 --> 00:27:14.829
Um, North Carolina, that is, is right along the line of we're probably gonna be okay getting most sun that we need throughout the entire year, but anybody who's north of us is uh gonna have a harder time getting enough vitamin D from the sun to have a lot of things.
00:27:14.990 --> 00:27:15.950
I was just gonna mention that.
00:27:16.509 --> 00:27:16.670
Yeah.
00:27:16.990 --> 00:27:25.389
If you live in like Alaska or Canada, like you're gonna have a you could stand out all day and you still might struggle because the sunlight's just not as direct.
00:27:25.470 --> 00:27:25.629
Yeah.
00:27:25.869 --> 00:27:28.509
And then there's that whole skin cancer thing.
00:27:28.829 --> 00:27:30.430
Oh yeah, oh yeah.
00:27:30.909 --> 00:27:44.670
So yeah, it's like, okay, so I can get because you can't overdose from vitamin D from the sun, but you can overdose on uh too much sunshine that's gonna cause cancer, obviously.
00:27:44.990 --> 00:27:45.549
Yeah.
00:27:45.869 --> 00:27:53.149
Um anyway, so we need more vitamin D supplemental uh or fortified foods, Emily, because I keep interrupting you.
00:27:53.230 --> 00:27:53.789
So you're welcome.
00:27:54.029 --> 00:27:55.069
Oh, you're fine.
00:27:55.309 --> 00:28:03.470
I mean, the the vitamin D fortified foods are very similar to the calcium fortified foods because they they you know go together.
00:28:03.629 --> 00:28:10.589
The milk and then the milk alternatives, as we talked about, yogurt, breakfast cereal, and orange juice come back again.
00:28:10.909 --> 00:28:15.869
But yeah, a lot of people just need to to supplement instead.
00:28:16.909 --> 00:28:17.950
Yeah, definitely.
00:28:18.190 --> 00:28:20.750
And then I know you mentioned here oversupplementing.
00:28:21.549 --> 00:28:21.950
Yeah.
00:28:22.349 --> 00:28:22.670
Yeah.
00:28:22.990 --> 00:28:24.430
That can be that can be an issue.
00:28:24.750 --> 00:28:24.909
Okay.
00:28:25.069 --> 00:28:33.069
Whereas calcium, like, so you mentioned here oversupplementing can cause GI distress, especially calcium carbonate, which is Tums.
00:28:34.750 --> 00:28:35.230
Whoa.
00:28:35.629 --> 00:28:36.670
Yeah, right.
00:28:36.829 --> 00:28:43.470
So, like, or I mean, not to call out a specific brand, but like any sort of uh antacid in general.
00:28:45.869 --> 00:28:48.349
And uh some of your milk alternatives.
00:28:48.430 --> 00:28:54.750
You just have to check what kind of calcium and what kind of vitamin D they're for they're fortifying with, because calcium carbonate is cheap.
00:28:54.909 --> 00:29:02.349
But yeah, and then it it if you are prone to kidney stones, then we can have another potential issue on our hands there.
00:29:02.430 --> 00:29:04.589
So there are different types of calcium.
00:29:04.829 --> 00:29:07.549
Oh my gosh, I feel another rant coming on.
00:29:07.710 --> 00:29:40.109
But not a not a rant, but like an educational opportunity because so many people are like, oh, I don't get enough calcium, therefore I'm just gonna take tums, or I'm gonna take um antacids, which then affects the nutrient absorption of other things further on down the line and neutralizes some of that stomach acid, which is important for intrinsic factor to do its magic on iron absorption and B12, which we need adequate amounts of B12 to do exercise.
00:29:40.269 --> 00:29:45.389
Like all of you athletes out there, you need to be getting enough B12 because it unlocks the energy from food.
00:29:45.549 --> 00:29:46.109
We need it.
00:29:46.269 --> 00:29:59.309
So there are different types, lots of different types of calcium options that are not just carbonate that don't necessarily have to be super expensive, that can also be, you know, good quality.
00:29:59.470 --> 00:30:02.509
And maybe that's another, maybe that's another podcast.
00:30:02.670 --> 00:30:05.389
Anyway, tell us about magnesium and vitamin K.
00:30:06.029 --> 00:30:06.430
Yeah.
00:30:06.670 --> 00:30:23.549
So it's if you're if you're deficient or maybe you don't think you're eating enough from food, magnesium and vitamin K supplements can be great supporters as well because they are both cofactors for bone mineralization, which is the process that we just we want to keep continuing.
00:30:23.710 --> 00:30:25.069
So for sure.
00:30:25.309 --> 00:30:39.069
Do you remember the amounts that adults we'll focus on adults because that's most of the folks that we are working with of what they need in terms of their optimal daily daily value in vitamin D and in calcium?
00:30:39.389 --> 00:30:40.190
Do you remember these?
00:30:40.509 --> 00:30:44.349
Um, I believe magnesium's like 400 milligrams.
00:30:44.829 --> 00:30:46.349
For men, it's like 400, 420.
00:30:46.430 --> 00:30:46.589
Yeah.
00:30:46.829 --> 00:30:47.069
Okay.
00:30:47.149 --> 00:30:47.389
Yeah.
00:30:47.549 --> 00:30:50.190
So which honestly is a lot of leafy greens.
00:30:50.349 --> 00:30:58.269
And every time I say that to men, they kind of look at me like I have six heads because it's like six servings of leafy greens.
00:30:58.349 --> 00:30:58.750
It's a lot.
00:30:58.829 --> 00:31:00.909
And then on top of that, then they're sweating.
00:31:01.230 --> 00:31:01.470
Right.
00:31:01.549 --> 00:31:04.670
So then they need to make sure they're getting enough magnesium.
00:31:04.829 --> 00:31:12.269
So magnesium, I feel like, has been hotter in like more popular in the news as of late, which again, I'm I'm here for.
00:31:12.349 --> 00:31:13.230
Like I think that's great.
00:31:13.309 --> 00:31:14.829
It's good for cardiac function too.
00:31:15.069 --> 00:31:16.109
So is calcium.
00:31:16.269 --> 00:31:17.950
So are we doing the right?
00:31:18.190 --> 00:31:19.230
Are we doing a little?
00:31:19.309 --> 00:31:22.750
Do we need to do a little bit of both, depending on what's happening in your diet?
00:31:23.549 --> 00:31:23.950
Right.
00:31:24.190 --> 00:31:28.829
I think calcium, calcium's like 1,000 milligrams or something.
00:31:29.309 --> 00:31:29.629
Yeah.
00:31:29.869 --> 00:31:30.190
Yeah.
00:31:30.349 --> 00:31:32.750
So, you know, that's not a little.
00:31:33.470 --> 00:31:34.990
We'll just call it that.
00:31:35.309 --> 00:31:40.029
Because a glass of milk is like about 400.
00:31:40.509 --> 00:31:45.309
And then I hear, okay, but what about what about me if I'm lactose intolerant?
00:31:45.549 --> 00:31:49.149
What about me if I'm allergic to dairy or can't do any dairy?
00:31:49.230 --> 00:31:51.309
Again, we talked about all those milk alternatives.
00:31:51.549 --> 00:31:54.909
You're pretty much gonna get the same amount in there.
00:31:55.069 --> 00:32:05.789
But then, you know, it just takes an eye to look at like a broader view, like a bigger picture of what are you getting on a more regular basis for your bone health nutrients?
00:32:06.269 --> 00:32:09.149
And then also what are the demands of your sport?
00:32:09.869 --> 00:32:10.190
Right.
00:32:10.430 --> 00:32:13.149
And you know, just the overall quality of your diet.
00:32:13.230 --> 00:32:16.109
And then again, looking at your metrics.
00:32:16.509 --> 00:32:17.869
What's your vitamin D?
00:32:18.029 --> 00:32:20.109
Where are you getting it from your food?
00:32:20.349 --> 00:32:21.549
Are you wearing sunscreen?
00:32:21.629 --> 00:32:22.829
Are you not wearing sunscreen?
00:32:22.990 --> 00:32:25.789
Like, what are you doing with that?
00:32:26.349 --> 00:32:28.990
What's your um uh dentition like?
00:32:29.149 --> 00:32:31.309
What's the health of your teeth?
00:32:31.549 --> 00:32:35.950
And I know I was telling you this, Emily, a couple of a couple of days ago.
00:32:36.109 --> 00:32:39.389
I had in some x-rays by a chiropractor.
00:32:40.109 --> 00:32:46.829
And, you know, I think there is a certain assumption that, like, oh, you're a dietitian, you must know.
00:32:46.909 --> 00:32:50.109
You must, you must A, eat perfectly if that is true.
00:32:50.509 --> 00:32:51.149
Just not true.
00:32:51.389 --> 00:32:51.869
Which is it?
00:32:52.349 --> 00:32:53.950
It's like not, it's not a thing, you guys.
00:32:54.029 --> 00:32:54.269
I'm sorry.
00:32:54.430 --> 00:32:56.190
No, it's a thing.
00:32:56.269 --> 00:32:58.670
So nutrition varies throughout the life cycle.
00:32:58.829 --> 00:33:01.309
It also varies based on the demands of your sport.
00:33:01.470 --> 00:33:04.190
So make a good friend with a dietitian.
00:33:04.269 --> 00:33:24.909
Make sure you're checking in on somewhat of a regular basis to align your supplement strategy, your food strategy, any like functional foods, genetics, and you know, we're like the the the secret miracles, uh, I think, of the healthcare community to sort of on your yeah, well, of course, you know, that's where you're going into this field.
00:33:24.990 --> 00:33:25.389
I love it.
00:33:25.629 --> 00:33:27.549
So uh man, all the soapbox today.
00:33:27.710 --> 00:33:35.309
It's great to like take that zoom out of what's going on in my diet, what's going on in my um body.
00:33:35.470 --> 00:33:45.230
But then I saw x-rays, and my chiropractor was pointing out like, hey, do you see in this neck of your greater truncenter?
00:33:45.629 --> 00:33:59.230
So, like the the femur bone, which is one of your largest bones in the body, which is that thigh bone, and then it comes up and uh attaches to your hip joints, and there is what's called your neck of your femur bone.
00:33:59.309 --> 00:34:02.589
So it's between the hip capsule uh and the rest of the bone.
00:34:02.670 --> 00:34:10.829
And she was like, I'm seeing some little striations there, which means that you're starting like your bones are starting to weaken there.
00:34:10.909 --> 00:34:12.510
And then I was like, wait, what?
00:34:13.309 --> 00:34:18.829
And then I had to kind of step back and be like, okay, well, where are my calcium vitamin D sources coming from?
00:34:19.470 --> 00:34:20.590
Am I getting enough?
00:34:20.750 --> 00:34:23.150
And is this something that maybe I need to tune into?
00:34:23.389 --> 00:34:27.150
Because I also have a history of uh anemia.
00:34:27.389 --> 00:34:32.510
So if you're focusing on one nutrient, it's hard to stay focused on other nutrients.
00:34:32.670 --> 00:34:37.389
So, and in that case, it's iron and calcium, and those two compete for the same binding sites.
00:34:37.950 --> 00:34:40.349
So you can't take them together.
00:34:40.909 --> 00:34:44.349
So it's it's not ideal to take them together because somebody's gonna win.
00:34:44.510 --> 00:34:48.990
And then, like, you know, now we're just going in circles of are we trying to benefit bone health?
00:34:49.150 --> 00:34:50.990
Are we trying to, you know, prevent anemia?
00:34:51.150 --> 00:34:55.710
So, anyway, all that to say is work with a dietitian.
00:34:55.869 --> 00:34:56.590
It doesn't have to be a good thing.
00:34:56.750 --> 00:34:58.190
Work with the dietitian, exactly.
00:34:58.590 --> 00:35:15.070
Like it like find somebody who is versed in your sport who can support you in terms of overall energy intake, in terms of nutrients, and we take a genetic lens, we look at that too, and then looking into various metrics and all that kind of stuff.
00:35:15.230 --> 00:35:16.989
So um, anyway.
00:35:18.349 --> 00:35:20.269
Oh, Emily, you just got me started.
00:35:20.349 --> 00:35:23.869
I'm so hey, I'm I'm here for it.
00:35:24.029 --> 00:35:24.909
I'm here for it.
00:35:25.150 --> 00:35:27.230
We don't have a we don't have a script to follow.
00:35:27.469 --> 00:35:27.789
We don't know.
00:35:27.869 --> 00:35:28.269
We don't know.
00:35:28.349 --> 00:35:29.070
We're just chatting.
00:35:29.469 --> 00:35:29.789
I know.
00:35:29.949 --> 00:35:32.829
Uh poor Emily's like, wait, so am I?
00:35:32.909 --> 00:35:36.429
I'm like, no, we're just gonna pretend like we're, you know, we're just having a cup of coffee.
00:35:36.509 --> 00:35:39.869
Or in this case, we're sitting around having a cup of plant milk.
00:35:40.029 --> 00:35:41.309
So yeah.
00:35:41.630 --> 00:35:42.429
Take your pick.
00:35:42.590 --> 00:35:43.150
Take your pick.
00:35:43.389 --> 00:35:44.909
Take your pick of plant milk.
00:35:45.150 --> 00:35:51.230
So I don't want to overcomplicate it, but at the same time, like zoom out what's the quality of your diet, what do your metrics look like?
00:35:51.389 --> 00:35:59.710
Get your DEXA scan, uh, make sure you're taking care of your bones, you're doing that heavy lifting, literally, so that you can support your bones.
00:35:59.789 --> 00:36:05.389
Because this becomes even more important for any of our perimenopause and menopausa women, like that.
00:36:06.269 --> 00:36:10.110
Uh, you know, begins like this, this sort of steep decline.
00:36:10.269 --> 00:36:12.190
And, you know, pick up heavy things, y'all.
00:36:12.349 --> 00:36:21.869
So, Emily, anything else you want to say as it relates to bone health and athletes and energy and calcium and vitamin D and vitamin K and all the things.
00:36:22.269 --> 00:36:24.349
I mean, you kind of hit the nail on the head.
00:36:24.429 --> 00:36:28.110
If you're unsure about any of these things, go work with the dietitian.
00:36:28.190 --> 00:36:41.070
They'll help you take the guesswork out of it in like terms of how much you should be eating in general, how much of each nutrient you're getting, if there are any contraindications to supplementing, you know, all that good stuff.
00:36:41.309 --> 00:36:42.110
Yes, for sure.
00:36:42.269 --> 00:36:42.750
Definitely.
00:36:42.909 --> 00:36:47.550
And then, of course, you know, shameless plug, you can check us out at theendurancehedge.com.
00:36:47.630 --> 00:36:54.429
We're licensed in multiple states and available to work with you for a quick 30-minute start.
00:36:54.509 --> 00:37:00.590
And we ask you to fill out a lot of paperwork beforehand because I just don't want to spend 30 minutes asking you questions.
00:37:00.750 --> 00:37:01.869
No offense, you guys.
00:37:02.110 --> 00:37:04.429
I wanna do I want to do my homework beforehand.
00:37:04.509 --> 00:37:07.309
I want to go in and get all the information about you.
00:37:07.389 --> 00:37:13.309
And then when we sit down and have a serious conversation about what what metrics do you need to be doing?
00:37:13.469 --> 00:37:16.190
What do you want to get out of our session?
00:37:16.429 --> 00:37:18.110
How do you want to be best supported?
00:37:18.190 --> 00:37:20.110
And like, you know, do your homework first.
00:37:20.269 --> 00:37:24.110
That way we can like get at it because y'all's time is valuable.
00:37:24.590 --> 00:37:26.029
So anyway.
00:37:27.150 --> 00:37:28.190
Yay, Calcium.
00:37:28.349 --> 00:37:28.909
Thanks, Emily.
00:37:29.070 --> 00:37:29.630
That was fun.
00:37:30.029 --> 00:37:30.590
Of course.
00:37:30.989 --> 00:37:31.550
So fun.
00:37:31.949 --> 00:37:32.429
Yes.