120. High Performance Nutrition, Supplementation, Myths, and Emerging Trends | Lauren Link, MS, RD

Hello everyone, I'm Dr. Darsha, and I'm Dr. Altamash Raja, and welcome to Medicine Redefined. A podcast where we will explore the often overlooked but necessary components of health, what we consider to be the fundamentals. We will investigate topics and practices that can give you and your patients the best chance to optimize a healthy lifestyle. It's time to move the needle forward and put the health back in healthcare. Our guest today is Lauren Link. Lauren is the Assistant Athletics Director for Sports Nutrition for Purdue University Athletics. She oversees the Sports Nutrition Program and specifically works with football, men's basketball, volleyball, and soccer. Her primary duties include individual and team nutrition education, providing counseling, evaluating supplements for legality, safety, and efficacy, body composition, and identifying athletes at high risk for injuries, and managing seven-figure budget to provide all teams with adequate and appropriate supplementation. For her education, she graduated from Purdue University with her Bachelors in Dytetics and Health, Nutrition, and Fitness, she also received her Masters in Health and Kinesiology. She stuck around to complete the coordinator program in Dytetics at Purdue University, and during her time at Purdue, she was a member of the Women's Soccer Team with Academic All Big Ten Honors from 2008 to 2011. In 2017, she also published her first book, The Healthy Former Athlete, which is a perfect resource to help athletes bridge to becoming, quote, normal humans. In this episode, we talk about a lot. Starting off with Lauren's top pet peeves in the current mainstream nutrition landscape. We then dev right into the meat of this episode and discuss high-performance nutrition and how she caters to the unique needs of elite athletes. We discuss specific macro nutrients for high-performance athletes and also weaken warriors for providing some specific examples to give you some guidelines on creating your perfect nutrition plan for your optimal performance. Lauren also shares some strategies and tactics for monitoring team-based athletes' nutritional needs and how to keep young athletes accountable when they are on their own for the first time. Now, high-performance isn't just limited to a physical aspect. So we do spend some time talking about nutrition and its role with cognitive performance. Lauren shares her insight into how she thinks about optimizing this fast-setter performance with nutritional intervention. Of course, performance isn't just for sports, so we wrap up by covering some key lessons that can be extracted for the rest of us who aren't elite athletes. Lastly, you'll want to stick around for the very end to hear some of Lauren's favorite supplements keeping in mind that they are supplemental. Don't worry, she'll tell you. Now, without further delay, please enjoy this discussion with Lauren Link. Lauren, welcome to the show. Thanks for having me. So I thought it started by talking about pet peeves. I've been following your work for some time, and I've heard you speak. And I know that this is probably a topic that we could do a whole separate podcast on. So I'm going to give you some guardrails, okay? And I'd like to hear about, currently, what are the top three nutritional trends at this time that really grind your gears? Man, it is hard to pick just the three because I could probably pick 30 at any given time. I know that's why I gave you that. But I mean, I think honestly, I could make a couple kind of big buckets. It probably will always be the case, the quick fix supplements going around. And again, I could pick a dozen right now that are popular on social media and things. But that is frustrating for lots of reasons, in part because there's not science to back them up, generally speaking. And so not only are people probably wasting some money on something like that. They go out and buy the supplement and think it's going to solve all their problems. But what people don't realize is that supplements are very poorly regulated as well. And that's a big point that I try to emphasize to people that I talk to is that they're really poorly regulated. And so not only are you probably wasting some money, you're probably maybe, not probably maybe putting yourself in a predicament in terms of if you're taking a medication or you're taking another supplement, there could be interactions. There could be negative health consequences. So that's a big one. It's just the supplement craze that's going around right now and all the quick fixes that come along with them. So that's one. And that's a big bucket. Another pet peeve, again, a huge bucket, but people getting their nutrition information from influencers and folks that have no credentials. And that's probably one of the more frustrating things about art profession is that people are more willing to listen to the random gym person on Instagram or on TikTok that have five million followers, despite them having no education. So that's a huge pet peeve. And honestly, the only reason probably that I really spend the time to do social media is I feel like I have to fight the good fight and try to try to put science back to information out there. And then a third pet peeve, it's a little bit similar to number one. And these are like really pretty big topics. But similar to just like the diet, the diet fads that we just recycle, you know, every few years. If we had a dollar for every different low carb diet that was out there, we would retire. But yeah, we people just keep beating it up, right? And you talk about wasting money in that trend or the cycle that ultimately leads to probably more weight gain, unfortunately. So I'm digressing a little bit. But those three very large topics are big pet peeves of mine and encompass a lot of what frustrates me in regards to nutrition online, especially. Yeah, I love that. No, and I think that the other important piece with the supplements, particularly in your world, right, when you're working with high performance individuals, high performance athletes at the collegiate level, professional level as well, the drug to drug interactions is a big one for people in my clinic. But when you're working with athletes, you also have to be very mindful that anything you put in your body, you're taking full responsibility. It could be, you know, NSF sport certified and all that kind of stuff like that. And we've seen this. How many times have we seen an identify athlete who got positive, was, you know, tested positive or something and said, oh, it was a supplement that I took or something like that. And maybe that's true. Maybe that's not true. But the onus is on that individual that, hey, you're making that decision. So that's like another really important thing. I am going to come back to influencers at the very, very end because I do think that that's somewhat of a double ed sword. And I would say that both of us are in that category too because we are on social media. And I am podcasting that kind of stuff. But let's shift to talking about really the stuff that you get excited about, the stuff that one of the things that's your level of expertise, right? And as nutrition for high performance individuals, particularly collegiate athletes, elite high school athletes, and maybe even the level beyond that, Olympic level athletes. What differentiates, you know, folks at that level, like their nutrition requirements for, let's just say, the weekend warrior or the general population, quote, unquote? Yeah, it's a good question. And it's maybe a little bit hard to objectify, but I usually define, if you will, an elite level athlete as someone, it's almost like a job, right? These people are spending on the low end a couple hours a day, on the high end, three, four, five, six hours a day, training for their sport. And that can, you know, encompass, of course, practice and skill development, but it also encompasses weightlifting, conditioning, even film, you know, time spent in film study and things like that. So I think people overlook that, even at the collegiate level, our athletes here, it practically is a 40 hour a week job. And they're doing that on top of their studying and social life and all that other stuff. So that's one of the big things, I would say, is just the pure amount of time spent going into it. And then I guess, I mean, to some degree, right, you can talk about, are they competing at an elite level? Are they, yeah, you know, are they participating in a league against other elite level players? But I honestly, I think the time is the biggest one. That's what I come back to a lot. It's just the pure amount of time that these people are putting into betterment of their sport and their physical abilities. Yeah, yeah, not all of us have the luxury, which is why it's so challenging to have a conversation with somebody who can't designate that much time because they're, you know, external responsibilities, other priorities, right? Offline, we were talking both of us have, you know, kind of a toddler and there's only a certain amount of time that we have, it can allocate to our recovery, our nutrition or, you know, exercise and that kind of stuff. And you're just not at some point going to get the results. And that's okay. We just have to prioritize as you kind of go through different phases of life, what's the most important thing? And so the challenge that becomes is, you know, when you do follow your idol or if you're a high school athlete and you're not sleeping well, or I'm not even talking about physiology wise, like a high school or fall in a professional athlete, but you just can't put in and so you can't expect to get the same thing out. And that's why you have to individualize a protocol, which leads me to, and at that important question, you know, as you know, I'm a sports medicine doctor and we do a lot of us skill scale of medicine. And one of the things that we often talk to people about, and I was actually listening to this last night, are you familiar with Eric Cressy? Not well. I've heard the name, but yeah. So, so yeah, he's a, he's a pretty, a pretty popular, a strength and conditioning coach, really big in the baseball world. And I think he's like the head, the consultant for the Yankees at this time. But somebody who's a brilliant that I've looked up to for quite some time, he was on the Tim Farr, Ferris podcast yesterday, and we were just talking about just nutrition and your movement quality and that kind of, how they were just so closely intertwined. You know, people like Kelly Starrett with this new book, they've always been talking about what we put into our body really drives performance recovery as well. And I'll often find myself talking to my patients and my athletes about, hey, what you eat or like how you feel yourself, right, feels your performance, but also dictates your recovery and how you experience pain and all that stuff. But I'm going to be honest with you, I don't really think the science is quite clear that at least nutrition and performance and injury recovery, right? We have these ideas of inflammation and whatnot and we talk about facial oil and supplementation coming back to that. But it's really hard to tease that out. So as somebody who does this full time and does at a high level, how do you think that your nutrition impact your performance in terms of athletic performance, but also recovery and injury prevention? Yeah, it's a good question and you're right. It's really hard to quantify and it's a really hard thing to study, right? Because what do you do follow a group of athletes and hope that somebody gets hurt along the way and then try to figure out, you know, what went wrong for that person or what happy? So, and of course, there's a ton of factors that go into injury, unfortunately, a lot of which might be bad luck or bad timing or so forth. So it's really hard to quantify, but I think absolutely we see that it factors in to performance and a lot of it might be anecdotal, but that's part of what I love about my job is hearing that kind of feedback from athletes, you know, working with, let's say, a female team. I love getting them to buy into, for instance, carbs. We all, for whatever reason, actually, we know the reason social media have this kind of inherent fear of carbs anymore because we've heard they're fattening, they're toxic, they're bad, I mean, pick a word. And so our athletes hear the same things and I love seeing when athletes can kind of buy in and start to understand like, no, okay, I need to fuel, I need to put, you know, regular fuel in my body, irregularly fuel my body. And I hear them come back and say, I have so much energy. Oh my gosh, I'm running faster. Oh, I got my best time. I lift it in the most weight that I've ever lifted, I mean, I hear that all the time with athletes who have started to really kind of buy into this idea and they'll make comments too. Like, it's probably the food, right? And I'm like, yes, it probably is. And it's not to say it's only the food, right? And that's what makes it challenging is that it's sleep, it's just how hard you go in the weight room and in your effort level and all kinds of things. But it absolutely makes a difference. We see it anecdotally, at least in like day in and day out where athletes are fueling with like how we want them to fuel and seeing results on the end. And then similarly, you mentioned like recovery and injury prevention. We talk about that a lot. And it's another kind of those anecdotal examples, but we often find that the athletes who don't get a lot of sleep, right? They're up late, they're not managing their time well, so they're cramming for the test right before or they're up on their phones until the wee hours. And those same athletes are usually the ones that break down a little bit more. They just say, have those nagging injuries, they get sick a lot more often. And so that's just sleep as an example, but nutrition, I feel the same way. It's like those athletes who are habitual bad hydrators, habitually skipping meals. Never grab the post workout recovery shake. Same ones, often are the ones that have those nagging injuries or they're just like never quite 100% and what pans out from that is they're not on the field as much, right? And if you're not on the field at practice, you're not on the field for the game. And so it trickles along into these bigger impacts. And so I think that's a big thing that I try to have athletes understand is it's all about habits and it's about consistently doing those things. It's not about doing like a really great job one day. It's about not missing meals every day. It's about hydrating every day, consistently having protein and carbohydrate. And if you do those things over and over and over, you're going to feel better, you're going to perform better. And if you perform better at practice, you're more likely to win the starting spot and you're more likely to have success in the game. And so it builds on itself. So that was kind of a long-winded answer, but that's, I agree with what you said. Yes, we see it pan out in all those aspects of performance and it's something that we're consistently trying to get our athletes to understand and buy into because if you have a whole team do that consistently, that's when you start to see teams that win championships. No, I love that you mentioned that because I think the other point about studying it prospectively in a longitudinal study is which person, which high level athlete, whether it's an Olympic athlete, collegiate athlete, kind of where you're working with, professional is going to sign up and say, yeah, we're only going to control for my nutrition and I'm not going to be attention to my sleep and soft tissue work and, you know, training in the weight room and stuff like that. You know, when you have so much on the line, it's pretty hard to limit to that. So that's that's one other challenge of it. You know, what you're talking about is brilliant because as a saying goes, right, the best ability is availability, right? So the more often you're there for practice, the more you're available, the likelihood that you're going to perform at a high level and speaking of availability, you know, what we've seen over the last 20 years, it seems like is more and more high level athletes tend to be available for their teams for longer periods of time. Let's use two prominent examples, LeBron James, Tom Brady, Tom Brady is retired, we hope for good. But LBJ, right? So he just 38 year olds, last game. I don't know if you got a chance to watch that, but 40 point performance is just remarkable. And it seems that a lot of players are playing into their late 30s, early 40s. I'm wondering what your experience with this is and how much you think, right, I'm thinking about Tom Brady for, sorry, to digress, Tom Brady to talk about avocado ice cream and it's like, yes, nutrition has to do with everything and stuff like that. And people like, oh, man, I got to eat avocado ice cream. And therefore, I will perform better and I will be, you know, longer in the game and that kind of stuff. But understanding that maybe they hate avocado ice cream and that's not actually feeding their goals. How do you have that conversation? Well, two part, what are your thoughts about that nutrition for longevity, particularly for high level sport? And then how do you have that conversation for these people is that, hey, listen, maybe that's not the way to go. Maybe that's not the best way to be consistent. And it's actually about the principles with your high level athletes. Yeah. So, I mean, I definitely agree that nutrition can promote longevity in sport. It is something, again, that we talk to our athletes about and especially the athletes that aspire to play at the next level. I'm really trying to get them to understand that, I mean, you want to get to that next level, but you also want to stay there, right? Because if you want the big paychecks, those come down the line. So I do think it's important for sure. And I think that a lot of times it really does kind of build on itself early in their career. And I don't know Tom Brady's injury history, you know, verbatim, but I think you could pick lots of examples where oftentimes the guys, and I'm just using football as the example, a lot of times the guys that make it 8, 10 plus years in the NFL are guys that didn't have a lot of injuries in college. And why didn't they have a lot of injuries in college? Again, very multifaceted, but they were probably fueling pretty well. They were probably making smart choices off the field, you know, not doing a ton of partying, not doing a ton of recreational things in terms of drugs, alcohol, whatever you want to put in that category, because those things do add up. I think the other thing maybe to think about injury that we talk a lot about is that, you know, if we're not fueled, let's use carbohydrate as an example. If I don't have enough carbohydrate on deck, that affects my energy levels, yes, but it also affects my cognitive ability. So if I'm a football player, the difference of me being fueled and having, you know, glucose on deck for my brain to use is huge. It might be a split second that I'm late to a hit, and then I take it weird. It might be that I, you know, I'm not as explosive, and that can be a different tweak on the joint. I mean, it's a matter of so many teeny little details, and it's not that nutrition's going to fix them or prevent them all, but we see it all time. An athlete who's hung over or an athlete who's high is way more likely to get injured. And we do know that. Like, they're good studies out there to show that. And so I think, again, just to kind of bring a full circle, it starts in high school and starts in college. Those athletes who have had better habits and who are consistent with those things are probably building more muscle mass. They're probably better conditioned, and they're probably, you know, learn in the playbook better. They're probably paying more attention. And all of those things set you up to be less likely to get injured and sick. And those things that you have for later as well, it's just like so intertwined the whole kind of journey that these athletes go on. So absolutely to close that thought, I do think it involves or attributes to longevity for sure. Speaking of athletes being high, did you see what Levy and Bell said recently? No. You're familiar with Levy and Bell, correct? I am, yes. Yeah, I met a redness somewhere that he talked about how he would smoke a bunch of marijuana and then go out and play right before, literally right before games and just see if like I'd run 150 yards and score two test sounds or something like that. I don't know how much truth there is in that statement, but I thought it just reminded me that you mentioned that. But yes, no question about it. Nobody's endorsing that. And again, going back to you are not Levy and Bell, so we cannot endorse that anyway whatsoever. But you brought up carbs a couple of times now. You seem to be a fan of them for good reason, right, who isn't, right? So let's talk about some macronutrients. So carbohydrates for those of those of the big macronutrients we have carbohydrates, proteins and fats, really those three main ones, right? What some key macronutrient considerations for the high performance athlete will say high-level collegiate athletes, professional athletes in terms of optimal balance for carbs to proteins and fats, if there is even such a thing? Yeah, it's a good question. And it's incredibly involved, depending on lots of different factors. But from a really general standpoint, I mean for sure athletes need lots of protein, right? We know this, and I think protein often gets the most hype or attention when it comes to athletes, because people think protein, muscles, they need lots of it, and okay. And so that's true, we do need more protein as an elite level athlete, especially depending on the sport, but we're starting to understand that even endurance athletes need more protein than maybe we once thought. And so what I often recommend athletes think about versus, you know, thinking about how many grams per kilogram, and some of that's just not very realistic, especially for the athletes I work with, who are also college students, and, you know, thinking about lots of things they don't necessarily want to be thinking about their macros. I think, or I tell them to think about it in terms of what's going on their plate. So if you think about, this is a very basic principle, but it works across lots of levels. If you think about your plate and divide it into thirds, for instance, I recommend that as a good baseline, athletes should be looking to have a third of their plate from carbohydrate, a third of their plate from protein, and a third or so from fruits or vegetables. So from a protein standpoint, that's important. And actually, most people, especially within America, or within America, excuse me, we get enough protein. We get lots of protein, but our biggest problem is that it's not spaced out well. It's not timed very well. So maybe I don't have any protein for breakfast because I grabbed my piece of toast or my pop tart or something on the way out the door. Maybe I have some at lunch and then I have a whole bunch of dinner because I have two chicken breasts and I don't know, pick the rest of the plate. What I would rather my athletes think about is, am I getting protein every time I eat? Because muscle protein synthesis is happening all day long. It's not just happening at our lift or at practice. And so I want there to be protein available to support that process throughout the day. So again, thinking back to the plate, like every time I'm making a plate, I want there to be protein on it and it should be about a third, let's say. Same thing from a carbohydrate standpoint, I want there to be carbohydrate consistently in my diet so that I'm making sure my glycogen stores, which I often refer to as our fuel tank. I want to make sure that my fuel is topped off, heading into practice. And so that's again a really basic way to look at it to start. And then there's of course going to be lots of instances where that changes, right? But the biggest thing is that our amounts might change. Maybe my carbohydrate needs to just be closer to a fourth of my plate because I have a lower expenditure right now or I'm injured or whatever, have it off week, fine, it goes down. Maybe it's actually the opposite. Maybe I'm doing a ton of activity. Maybe I'm a high school athlete playing two sports or I'm in preseason camp and we're doing two a days and I need half my plate carbohydrate because I'm burning through a ton of energy. All of these things can change where I'm going with this is I never tell an athlete to get rid of any one of those components. You always need some amount of carbohydrate on your plate. You always need some amount of protein on your plate. So I've now forgotten if I'm answering your question, but that's kind of where I take macronutrients to start from an athlete standpoint is how can we make this really relatable and easy to think about throughout the day and I want for sure carbohydrate and protein on the plate always, but we could tweak how much we're talking based on what they've got going on. Fat, I do not make a special place on the plate for. We tend to work it in pretty naturally in other foods, but if it was an athlete who's having a hard time keeping up with their energy needs or trying to gain weight, like we might strategically use extra fats in the diet to get those calories up. So tell me why I did answering that question. No, no, no, no, no, it was great. It was the perfect answer from a practitioner, right? I think that sometimes we, folks such as myself and you know, we get to be highly analytical and we get to, yeah, we start, you know, majoring in the minors and people, you can tell like who is often working with real people who are crunched for time, as you mentioned, and so you're trying to simplify the process, which is why from time and time again, I've given a shout out to precision nutrition because I think that's something that they've excelled at, which has made them so successful, I'm sure you're familiar with their work, right? It's like we're talking about, you know, fist size of this is how you measure it. Not everybody has the luxury of putting it on a scale, waiting for it, like that's just obtrusive to everybody's natural life and you're not going to have, you know, you might have efficacy, but it's not going to be effective, right? So that's a key point. I do find it interesting that you think that most people are appropriately dosing protein because I think as the conversation has ramped up with the whole longevity piece, there are people out there who say, oh my god, we need to actually curtail back on the protein because, you know, empty activation and blah, blah, blah, this and that and it's not going to be optimal for lifespan. And I think the current RDA recommendation of 0.8 grams per kilogram, I mean, I think that's ridiculous to begin with, you know, again, now I'm shifting from the high performance athlete, the collegiate athlete, you know, the people that you work with, but I'm talking to the general population where we have four to five out of every 10 people are actually clinically obese, you know, with a BMI greater than 30, where they could increase the protein intake and feel more satiated and perhaps curtail back on the other macronutrients, right? I think it's going to be better for, you know, just long term overall general health. The other piece I want to get your take on is your female athletes. You know, when I was in a prior career when I was working with, as I said, the conditioning coach working with a lot of my female athletes, I found that they did struggle more getting adequate protein. I'll describe adequate protein as the, so I think it's 1.4 grams per gram, 1.42 grams per kilogram is the isoscent recommendation, right? So in that range, which could be like a pound per body weight is the easier way to, that I remember it. What's what's your thought in your female athletes? Like, do you feel like they struggle a little bit more and you have to find some strategies to sneak that in? Yeah, so for what it's worth, it's a totally fair point, it is a big generalization to say like, everybody gets an unprotein or, you know, but I do think generally speaking because of the portion sizes in America and things like that, people often do get a lot of protein, but it's usually dosed like in some enormous amount at once, but I hear what you're saying too. To the female point, yes, it depends. So with female athletes and getting enough protein in my setting, I definitely do see some struggle with it, especially for instance, like freshman year, they get here and now all of a sudden they're eating at the dining halls and they don't like how it's prepared and it's not like mom makes it in your name it. So I do think it can be a challenge like a little bit more so in that group, but I find it's more because of the setting, at least for the athletes I work with, but I guess I would add to that too, more commonly we see a female athlete wanting to be vegetarian and or vegan and so that can be a challenge as well. So like so many things are so many situations that can warrant this, but I guess where I would maybe leave my thought is that I do think the dosing of protein is like one of the most important aspects and really, especially if you're including meat and things like that meat, dairy products, it can add up to be to meet that RDA pretty reasonably if you're including it frequently. Let's put some numbers on it. Let's say you have a 200 pound athlete, whatever position, whatever sport and you want them to like what would be your target for that person and how would you dose it throughout the day? So when they're going to make me do like quick math in my head, that's a challenge. I agree with the general range you gave, right? So I usually for an athlete participating in like a power or strength based sport would say on the higher end of that range, probably like 1.8 to 2 and so 280 grams to 200 grams in there. And in terms of dosing it, I usually, again, these are total guesstimations, but I live in guesstimation world because I work with 18 to 22 year olds. I usually advise them to try to get at least 40 grams a meal. That often ends up equaling kind of what we're talking probably close to 200 grams by the time they eat over, you know, few meals, few snacks. So that would be, I guess, one part of it and then post workout. We are trying to make sure that we're really cognizant that they're getting protein post workout. And so I'm advising them to get at least 20, if not upwards of 40 grams in that post workout timeframe. And that depends a little bit on their schedule. If they're going to have like a quick shake and they're heading to dinner next, I'm not so worried about them getting it right then, but if they're maybe finishing their workout in the morning and they're going to class and they're going to sit in class for two hours, then I'm like, all right, let's grab a couple of these shakes or a shake. And this is this to make sure that we get maybe upwards of about 40 grams. Yeah. Gotcha. You know, the other thing we were earlier talking about kind of how you have to drill into the details further and further as somebody gets to be higher level, but also perhaps, you know, as we get closer to our goals, right? So for instance, let's just take, let's take wrestler, right? Because I think that that's a weight-based sport and we have to be very, very specific. We of course want to preserve as much lean mass as possible and they're trying to cut weight like crazy. I mean, those people are impressive, right? And so you want to be extremely strategic and smart about how you do it and you also want to be aggressive at the same time. So those are the people that I worry about sometimes in terms of the hydration piece, the micronutrient and that kind of stuff. If you're longitudinally following some of your wrestlers at the elite level, how do you track their macro and micronutrients and stuff like that? Just kind of, I'm thinking about logistically with you and your team, you guys have an app or something that you use, is it frequent check-ins, phone calls, like what kind of system does an institution like yours use or really any high-level institution? Sure. Yeah. So we do, we use a couple different apps, probably the big one for something like this is a program called NoteMail that allows kind of on both ends, allows the dietician to create a meal plan for an athlete and then on the athlete's side allows them to see that meal plan track what they're taking and it shows like whether they're meeting those targets. We also are lucky at our level to be able to provide our athletes with a lot of meals. So it's not that they're not having any meals on their own but we do provide a lot of meals and so I can tell you, I haven't worked with wrestling in a while but I have it some point while I've been here. The dietician on my staff who works with wrestling right now is very involved and so it is a very specific conversation with our chef on staff to say, okay, this guy needs this, this guy needs this and it does get pretty nitty gritty, not even just down to, you know, of course calories, it also is looking at macronutrients, it's looking at sodium, she's accounting for how much weight they swing overnight, looking at hydration, their hydration testing, I mean it's incredibly involved and I feel like it has to be to do it well because to your point, I mean it's craziness what those guys and girls do. So I think it's really important and I know it's not realistic across the board but I think it's really important for athletes in weight-based sports like that to have a very purposeful approach with it because again it can be dangerous, right? If you're not cutting weight appropriately, if you're taxing your system, your all your organ systems with inappropriate cutting of the weight and things like that. So it's a very involved process for sure with an athlete like that and it's I guess the last thing I'll say too is that the other hard part is it's this delicate balance of being incredibly specific and helping those athletes meet their weight goal in an appropriate way but also like letting them live their life and trying not to foster disordered eating habits and things like that because the other piece of this is that it takes some really meticulous counting of you know macros and things but we don't want them doing that all the time and so again having a dietitian involved is very helpful in that but I recognize not everybody has the ability to do that. It's truly an art that I've learned to appreciate over time. I remember I mean to your point you know when people are leaving a lot of times is the first time people get to 18 girls get to leave their home and don't have oversight of their parents right and they've got the quote unquote freedom and you know thinking about all everything else all the extracurriculars the the lack of oversight everything that comes with that and really getting dialed into this full-time job that you talked about. I mean heck I just think about my first time going to campus and just being there and just had unlimited meal and meals were so good and I was eating three plates and within three months I had not even three months two months I had put on my freshman 15 and it's the heaviest I had ever been and you know again I I wasn't nobody like it was holding me accountable. It didn't really matter other than the stretch marks that I have forever but I digress but you know for these athletes you you highlighted about the challenges and one of the pieces that you you mentioned is just really a time investment that people feel to appreciate. I remember working with the the Rutgers football team for some time and it was like it was a machine right how these these guys would they have two practices to starting five o'clock in the morning then they would like they would have the breakfast and stuff laid out and then go to class and then they would have practice afterwards and they could by the time like their day structure day was done I don't know it was like it was like a 30 and one of my friends who initially I knew this because he he wanted to go to medical school and he would start it and I was just thinking I was like I was already struggling not having all those requirements to get good grades to get a high enough GPA to be a good med school and so the appreciation that I have for anybody who plays at a division one level and especially like I like one of those good division one schools such as your school and then gets into medical school like that that's next level stuff right and that's not easy to do so I'd love to kind of hear some other challenges to quote unquote healthy nutrition that in your experience athletes face that I think the general folks don't have a good appreciation for maybe you could dive a little bit into that and then how do you how do you help them navigate that particularly early on first time 18-year-old 19-year-old like okay listen this is really important and here's how we're practically gonna do it yeah so I mean schedule for sure is one of the big ones it can be a doozy because I think we between you and I have mentioned a lot of the instances right but they have practiced they have lifts they have conditioning sessions they might even have extra conditioning or weightlifting depending on their goals they have film often you know some kind of meetings with their coaching staff regardless of sport a lot of our sports have that not just football and then you cut to the academics so they have their academic requirements so they're going to class they have probably tutors and things because they don't have the ability to maybe make the recitation or you know whatever that they might have had if they weren't busy with with all their athletic stuff so they have their academic stuff and then you know you and I have been in college they also want to try to have some symptoms of a social life and so there are just so many requirements that take up their time and we actually we didn't even talk about pre-hab rehab I mean hopefully you're not injured but if you are I always feel for our athletes who are in the training room a lot because it's like oh my gosh like you just lost another hour or two of your day because you're in here rehabbing your injury so a lot of time goes into those things I think the other thing that's an enormous chunk of time that people don't recognize is the travel and so when you're in season and of course this depends a little bit on your sport when you're in season you're traveling a lot and some of our sports for instance our outdoor sports that play in the spring so softball baseball I mean they'll spend their first four to eight sometimes weeks traveling to the coasts because they're warm enough to play and so imagine starting your spring semester and you're trying to learn your classes and get a hold of you know like whatever's going on in them and you're also spending at least three days a week if not a week at a time sometimes in another state playing you know of course our athletes have a lot of resources right they have tutors and they have the ability to have exams proctored on the road and so there's a lot of kind of perks in that way but the reality is too that like they're gone a lot and they're traveling a lot and they're trying to do this stuff in a hotel room after they just played a game maybe after they just lost a game and they're not in a good mood and the last thing they want to do is frickin study for that exam um so the travel's pretty crazy I think people don't really grasp that and like um you know postseason especially if you're a basketball team playing in March Madness you hope that you have lots of weekends of that and you could be getting home you know late Sunday night early Monday morning depending on what time your game was played and then you turn around and leave the following Tuesday or Wednesday depending on when you're playing I mean it's just constant sometimes so our athletes spend a lot of time on planes buses all all the above and it can definitely it's just an exhausting lifestyle sometimes and the TV has made it worse um the TV is great because it generates money and we all like the money but um the TV times you have to have enough time slots to get all these games in and so we're seeing a lot more 7 30 p.m 9 p.m uh I feel for the West Coast teams that ended up playing at very odd times because or actually sometimes it's for us you know like our our teams will sometimes play in tournaments on the West Coast and it's like 11 midnight our time yeah so it's just kind of crazy yeah I mean I don't I hate traveling my wife's originally from the West Coast from California and so mad love California but but I hate the time different stuff because I get there and you know you're seeing family and stuff and I'm it's like 11 30 my time and I'm like guys hey heck I don't even want to I don't even stay up to watch the finals last night because I was like lesson I'm too tired right right so I can't imagine having to perform at such a high level physically emotionally cognitively and the other interesting piece that that strikes you know it's interesting to me as I think you know with the traveling of the professional athletes yes professional athletes have the same well probably greater physical demands because they're playing more games throughout the year as well as you know the cognitive demand and the time stuff but when they're studying they're doing the film sessions you know that cognitive burden the attention piece that you talked about after having lost you're still invested in your craft right so you're you're watching your mistakes and stuff and so it maybe doesn't hurt as much but the last thing you do after you maybe haven't had a good performance and go is maybe write a paper on some arbitrary topic in your English class or some engineering class or whatever topic is like you're like I'm not gonna do this like it's so hard and then you're expected to get good grades right I mean I don't I mean I don't even know what that's like but but it definitely gives me it makes me pause and a lot of respect for for those high level athletes but I do want to talk a little bit about the cognitive piece right we know maybe it's just as critical we talk about decision making how important is that to your sport right I think a lot of times people when they think about athletes they're just focused on the physical aspect but the cognitive might be just as important how do you have the conversation about nutrition and just optimal cognitive performance are there certain metrics that you look at any specific things you think about fueling for that aspect of performance? yeah probably the biggest one again is just carbohydrate and making sure that athletes are consistently including it and it's not that it's not that you need like gobs of carbohydrate to to fuel cognitive performance but when you have an athlete who is under fueling in general and especially with carbohydrate you know so they're not eating carbs consistently that really can cause some of that you know quote brain fog just inability to focus and to retain and so we we do talk about that a lot just you know your brain prefers to use glucose and you gotta have some carbohydrate on deck to have that available so that's probably the biggest talking point that we talked to our athletes about from a cognitive standpoint other than that it would be just you know brain health and making sure we're talking about omega-3 fatty acids and some of us have creatine is starting to be more and more exciting on that front and so we might have those kind of conversations but probably from a like baseline level it's just that like consistently fueling making sure that you have food on on deck and that it includes some carbohydrate to help fuel the mental aspect not just in the classroom but for your sport too right like I I'm always shocked that our football players can learn the playbook when I see I'm just like having been a soccer player where you like hardly have plays per se I'm like I don't know how you retain that so that's probably the biggest talking point that we would bring up so I didn't want to go down this hole but I'm sure some people are at this point are probably thinking well what about cute tones right we know that glucose is the preferred fuel source but there's lots of discussion out there about how you know ketogenic diet and ketones and people can perform really well after you get through that phase of withdrawing from carbohydrates you have this clarity and all these buzzwords that people will use right so I don't know if you got a chance to see the limit list series with Chris Hemsworth right where he was like fasting for three days and all of a sudden he was in the water I was trying to catch fish and he had this like I forget what he said but he had a lot of clarity right so you're now your ketones are wrapped up and whatnot and then there are real people like I'm talking about endurance based athletes right these ultra marathoners can't think of this guy who was on I can't think of it but but um but these some of those marathoners ultra marathoners who will say you can become fat adapted that term right and so be on a ketogenic diet and still perform as well um if you have athletes or individuals who come it from that angle what's the conversation like for you yep so this is a soap box so you started it um so what I would say is that it is true and it is fair to say that you especially you mentioned like endurance ultra endurance those folks can um function fairly well with a ketogenic diet if they are actually following the ketogenic diet and they keto adapts and all the things um the research though I like to point out the research really shows that they can perform as well there is really not great research at this point to show that they can perform better and that's from an endurance and ultra endurance standpoint so mostly aerobic capacity exercise so that is fair to say um with that said I should have put this one in my pet peeve pile but one of my biggest pet peeves is people saying that they are in ketosis um but they have a cheat day or I mean ketosis but I see them you know eating easily 60 grams of carbohydrate in there or something or other and so what I like to make sure people understand is age is understanding what ketosis really is or what a ketogenic diet really is which is not only is it very low carb very very low carb 30 to 50 grams generally max a day which is like a cliff bar um it's also very high fat and it's low protein uh that's another pet peeve people in the ketogenic diet that are just like smashing protein um and I like to alert them of this process in our body called gluconeogenesis and I'm like your body's turning that protein into carbohydrates but that's neither here nor there so I like to make sure that people understand that process because a lot of people are not actually in ketosis in my opinion that are you know they have their giant bowl of berries and they are eating a ton of protein and what have you with that said or maybe the turnover crowd eating tons of steak yes yes yes um so when I have an athlete come to me about keto um diets which is not unusual it definitely happens with summer irregularity the my biggest thing is that I need them to understand like it's probably not realistic for your lifestyle and that it just kind of like is what it is for most of our sports I mean we have of course across country and we have like endurance swimmers um but most of our sports are not I apologize my digging in the back um most of our sports have very much an anaerobic component right soccer volleyball football um the track events I mean most of our sports wrestling there's so much of an anaerobic component and the research is not good to support that a ketogenic diet can improve performance for anaerobic sports um so essentially I'm like if you have if you're playing sport or a position where it involves pushing jumping diving hitting like explosive things ketogenesis is not your friend like we need carbohydrate to fuel that activity so that's a big education component I think for them and then just even talking through again I work with 18 to 22 year olds that live on a college campus when I really explain to them like okay if you wanted to do this how would we get to ketosis and then explain like no you can't have that beer on the weekends can't what are you gonna do when your team's traveling right like are we gonna be able to pull this off um I never want to come at it from like a judgy standpoint like I said there are some people um some people like it some people feel better on it or they claim to at least um and I can't take away anybody's lived experience right and that's one of the harder parts about nutrition is that so much is anecdotal and people try to shove their anecdote down a million people's throats but um the hardest part though for my for my setting and I would say it applies to a lot of people is it's just not very realistic to really carry out ketosis and especially when you consider that it takes a good usually like four to six weeks to keto adapt you can do it quicker but generally um and you kind of feel like shit in the meantime what are we doing if we're if we're like ebbing in and out of this state uh you're probably not performing your best during that time and we only have so much time to work with in your training period or or off season or what have you so that was a really long answer but I told you you started it um those are my thoughts on ketosis no I love it it's a I thought it was important to take that detour because I know people are thinking get and I get that question often enough and you're clearly better equipped to answer it than I am so um we will be sure to point them more towards your social media and follow you if they have further questions and um and you can educate them there I I'd love to see selfishly I want to know about right so now I'm not definitely professional either not maybe in a high level athlete not sure ever was but um a lot of people who are listening might not be high level athlete but I do think they're high performance in some capacity a lot of medical trainees and people who just have to be their optimal self maybe it's being apparent maybe it's being a business executive whatever it might be what are some strategic or tactical things that we can extract that maybe that you could tell us that we might be able to extract with your your experience from working with high level athletes that we might be able to employ into our daily lives yeah so I think I think my first thought would be to encourage people to think about like the foundational nutrition things that we can do and I talk to high level athletes about this too um you know people want to get the next best supplement they want to get that fancy new you know whatever approach but my my best analogy is you know if you're if you're not eating regularly if you're not hydrated if you're not doing foundational things but you're trying to get this supplement it's like putting really nice rims on your piece of shit car like what are we doing right you gotta have the foundational stuff there the the habits to to then maybe yeah maybe a supplement does make sense but not if we're not eating food right um so with that said I would say like everybody practically can benefit from some of those foundational things to me those things are eating frequently like not skipping meals that can be really helpful from my metabolic standpoint it helps promote building muscle it helps promote having energy um so like aiming to eat every three to four hours something you know it could be a meal it could be a snack uh I think that's a really good habit I think um I mentioned that plate earlier I think that is a very good foundational habit that a lot of people could do better with is just thinking about like do I have a carbon and protein am I including some kind of fruit or veggie even if it's um you know a canned fruit or a canned veggie or frozen or apple sauce I mean there's lots of ways we can do that I think some people get intimidated by like what am I gonna do have steamed broccoli at lunch or you know no I mean grab an apple grab a banana have a mandarin orange cup whatever um so I think that's a really good foundational habit is just checking those boxes do I have a carb do I have a protein do I have a fruit or veggie um hydration am I drinking water consistently throughout the day or am I showing up to practice or so you know whatever obligation I have and then chugging a bunch of water because I realized I have my all day um those are probably a few big ones coming immediately to mind um I'm sure there are others I'm trying to think off the top of my head those are my big ones from like again a foundational standpoint love that no base of the pyramid right take care of the the basics first basics over time um is and consistently by that keep that keep coming up um which reminds me you know uh an amazing resource that somebody I'd listen to a lot is easy sink house key consistency project there's a reason why that's named that way um all right I promised you that I would ask you about influencers again and maybe not in the sense that you might be expecting but I've been thinking about this a lot right so with NIL right name image likeness for people who don't know I think a lot of people understand that college athletes are now getting paid for for basically their brand okay and you know I think uh growing up you know you had all these professional athletes and um you know you you had serial companies taking the professional athlete putting them on the box and just you know if you're if you're a kid growing up and you see your your favorite athlete the bronze angels or somebody on the box of the cereal you you think that's a the breakfast of a champion right and and don't get it all I love cereal okay it's just not the breakfast of a champion um and and I think about college athletes now with NIL and their branding and stuff and and different food organizations and companies and coming to them to use that for branding and and uh for and compensating them appropriately do your athletes ever come to you to talk about that because sometimes it is an internal struggle okay maybe you know maybe if we're trying to as you mentioned fight the good fight and to combat bad information with good information maybe uh promoting this message that x y and z is a healthy nutrition food and stuff like that is not the best thing um how do you think about that how do you counsel your 18 or 20 year old young minds how do you influence them in that regard? yeah so we we do have that conversation with some frequency um you know our athletes are being approached by all kinds of companies and products wanting them to endorse their product in some way and I I love when athletes do at least ask the question you know like is this okay like can I be taking this and so our role really is just to educate them on like I'm not here to say like yes do that deal or no don't do that deal um but I can educate around whether I would recommend that product right um and even you know I don't have a good example but I can think of a couple times where an athlete was like well like what if I like what if I don't even use it though what if I just like do the deal and like endorse it but I'm not actually using it and I think that's a good lesson for everyone listening and I don't you know again I don't think we have a lot of people doing that but I guarantee there's a lot of people out there doing that not just athletes we're talking influencers right I think it's a good reminder that people can say they're using all kinds of stuff and I think that frequently when I see influencers um touting whatever product might be probably not even using that but okay um so I think that's a good reminder for people but my message to them is always I mean you know yeah you could do that but think about like you're putting your name on that brand and if you don't even feel confident enough to use it who's to say that they you know maybe they'll have an issue that company maybe maybe another athlete's using it who does pop for a drug test and then what's that gonna is that gonna put a bad connotation on you um and so again I'm not here to tell them like yeah do or don't do that but I do think it's been in those couple times to come up like a good thought process of like oh yeah like that's I would be putting my name with this you know um so it's definitely an interesting conversation and I mean I think NIL for the large part has been great it like with anything else there's always gonna be probably some bad ways you can take it um but overall it's been a really good opportunity for our athletes to you know get compensated for their brand uh which they hadn't been able to do but there is kind of that risk if you will that these companies want to take advantage of them and especially when you've got young athletes who are just kind of excited to have any opportunity like that um it can be really easy for them to say like oh sure you know and a lot of it too like the brands just want to send them free product it's not like a cash deal or anything you know just like here's a box of free product and so my advice is always like is that worth a risk you know just for a box of their shakes or a box of their energy drinks or whatever um in my opinion no but you have to make that call totally yeah and the other piece of it is you know we're talking about people saying they're using products and not using the flip side too right we have these before and after transformational pictures with a lot of coaching folks and they'll say oh look you know after whatever two months or six weeks you you look xy and z and it's like because I use this method to get there and no actually you might have used some products right legal or illegal to move to get there and so that's the other piece of it it's like are you getting to your results the outcomes that you're promoting by the methods that you say you're getting them without any assistance um we'll say yeah um I also want to get your thoughts on we talked about pet peeves and I wanted to kind of um ask you about misconceptions and common myths but it's similar enough to pet peeve unless you think that that's a different question and there are some common misconceptions or current nutrition myths that you want to debunk again we could probably be here for hours which neither one of us have so are there some certain myths for high-level performance athletes I think one thing you've touched the time time against carbs are bad for you and they're not they're actually critical for high performance whether some other like one or two that people immediately come to you that you have to be like that's a myth doesn't apply maybe I mean supplements come to mind I think sometimes you know elite level athletes think like I need a supplement because I'm an athlete um and it's true to say that athletes do have some micronutrient needs that are higher than the lay person because they're using a lot more energy I want to ask yeah I was going to say are there any supplements there is I can think of two supplements all the top mind by when I have my athletes talk to me or anybody or really any general population for health and longevity that they are inexpensive enough and I think the the reward to risk ratio is just proportion enough when I'm like I think it's a great idea I could think of two off the top might and I know you've talked about this in the presentation were we connected but are there any supplements like that for you yes so I guess I'll I'll tie the bow on the last thought which was purely that there are some things that athletes need more of right there are different micronutrients but the other thing you have to remember is that they're hopefully generally they should be eating more food too and so a lot of times the higher micronutrient needs are met by eating more calories with that said yes there are some things again I always I keep coming back to the population I work with because people can take a lot of things and go a lot of different ways with it but in the population I work with my college athletes like do I think a multivitamin is a helpful thing for a lot of people yes yes I do because the reality is they're not generally eating a totally balanced diet that's hitting all the micronutrients that they might need so I frequently recommend a multivitamin vitamin D is one that I frequently recommend we also have the luxury of testing vitamin D levels so that makes it easier to do that but I even like a low dose vitamin D I think can be really helpful for female athletes I think iron can be very helpful but I would not dose iron unless I had gotten it tested but I do think it's a good idea for female athletes especially especially endurance female athletes to get their iron tested because that can really impact performance if it's low and then past that a couple others and not maybe across the board but generally speaking omega-3 fatty acids I think are great to supplement the reality is that a lot of athletes aren't getting a lot of foods that are high in those and aren't eating a lot of seafood and things like that and we're starting to understand a lot more about neuro protective qualities of omega-3s and so especially in a sport that's concussion prone I think that's important for them to at least be considering that and maybe the other one is creatine can be really helpful and I think historically people in myself included honestly like when I was you know in college I would have said oh yeah you know creatine's good for building mass but it can be dangerous depending on certain situations and not really good for endurance and now we're the more we understand about creatine the more we're understanding that like it really applies in so many ways to brain health female athletes can really benefit from it endurance athletes can benefit from it so I'm not here to say like I would be like everyone listen and go take creatine but for a lot of athletes in a lot of situations a good creatine monohydrate can be really beneficial totally it's funny that that's the last one that that's the first one I'll think of and I'll tell you why I recently had one of the residents ask me because we were talking about this stuff it's like what are the top five supplements you would recommend I was like okay well first of all I need to ask you 10 questions before I can answer the quote right and as you highlight it's so incredibly contextual like person to person to person that aside you know oh yeah growing up we learned about creatine you associated with hypertrophy and strength right and then power development all that kind of stuff but the data on cognitive health as you talk about traumatic brain injury and just memory the data on mood related stuff and depression stuff it's just so incredibly promising the other thing it's dirt cheap right and so I tell I tell the people that I work with is probably a side from caffeine there's no other supplement out there that has better data than creativity and considering how cheap it is your good old creatine monohydrate I think any exercising individual it couldn't hurt to be able to take that but again no medical advice here none of us are recommending it's very contextual that's the other thing to keep in mind but I think just the supplement just because I would lose sleep at night if I didn't say it out loud I'm a big proponent of making sure people understand that supplement backs labels are not well regulated in our country so if you're seeking out a supplement it's so so so so important that it has third-party testing because that essentially allows us to know that the label is accurate and I think people don't have nearly enough of a grasp on how inaccurate the labels can be so that third-party testing that I recommend our USP is a great one for vitamins especially NSF for sport is kind of our gold standard and then informed choice and informed sport are probably like my those four are the ones I consistently look for so no supplement like there's no way to 100% guarantee safety but we feel really good if a supplement carries one of those third-party testing labels because yeah without it I mean I don't know right I don't know if the label is accurate I don't know if the ingredients are accurate it might be contaminated and people kind of scoff when I say that but it's actually like wildly common when you look at the studies that just randomly test off the shelves do you look for the good manufacturer practices approval like the CGMP part of it or is this sufficient before that you mentioned right here I don't personally in my opinion if if a product has third party test and that I just mentioned it would be a no-brainer that it also has good manufacturing practices got it awesome I would also want to ask you about emerging trends you know we recently had a conversation we're going to be releasing very shortly about CGMs and that kind of stuff we'd love to get your thoughts on that not necessarily for the high performing athlete collegiate athlete I think I probably know where you stand but if you'd like to share I'd love it but bringing back to the general population talking about metabolic ill health is at all time high 50% obesity rates probably in about seven years in the United States at least right cardiovascular all the kind of stuff and the role of CGMs and maybe other emerging trends slash cutting edge nutritional tactic strategies technology that you're excited about what can you think about what do you want me to hit first CGM or take it wherever you please yeah I think the thing I'd say just briefly about CGMs I think it can be helpful for folks I don't love that it has created some problems for those who like live and die by it or diabetic folks yeah at least at some point and it might have been correct in the meantime but I know that was problematic for a while I think it could be helpful to kind of gain some insight for people but I almost I think a bit similar to like you know an exercise tracker or various things that we have where it can get really obsessive really quickly and so do I think somebody should like live with a CGM that doesn't need a CGM per their diabetic diagnosis for long lengths of time no personally I don't I think it becomes a bit obsessive and a bit much and could kind of fall down some some disordered eating rabbit holes but I do think it can be helpful to show insight and help people understand a kind of similar vein I think it's a little bit to me too like almost like we were talking about like athletes want to jump straight to the supplements like I'd want to know like have you made some good lifestyle changes you know are you active are you kind of paying attention to what you eat or rebalancing our plate a little bit better things like that before I'm just like slapping a CGM on and trying to really fine tune before I maybe have foundational stuff down and the last thing I'll say about it is that I do think it's important for people to understand too that like it's normal to have fluctuations in blood glucose blood glucose excuse me I have started to see some some trends I don't know if that's the right word but people essentially in sinewating that like you should have this like perfect maintenance of your blood glucose and you know it needs being this really narrow window all the time but it's important to like understand that our body has these hormones that affect our blood glucose for a reason and yes you don't want to spend a ton of time hyperglycemic obviously or hypoglycemic but it also is normal to have some fluctuations and I've seen some people get really stressed about that and that can be just as unhealthy so maybe that's where I'll leave that topic is just to say in in general I think people oftentimes forget that like the stress of some of these things that is caused for some people is for sure in my opinion worse than some of what they're trying to monitor stress can be really detrimental that'll mess up your glucose no doubt other trends I mean I think I'm excited to see where some of the like personalization can go we're like just scratching the surface what we know about the microbiome I think that by the time I retire I imagine that'll be like a whole a whole different world um similarly with we're just starting to understand genetic variations um and there's you know some really helpful genetic stuff we already know but again I mean I shuttered to think what we'll know in um 50 years or something so I think that'll be interesting I do think it's probably a double edged sword just kind of like the CGM like I was saying it's probably good in some ways and it's probably too much in some ways for people to be honing in on every little detail of of their nutrition because at some point you just have to live your life too and enjoy the things that um we're we're eating and doing and whatnot so those are probably a couple I think exciting hopefully not too scary um developments that I think will continue to hear more and more about yeah no I love that I mean we we've been talking a lot about health technically and to your point about the stress thing I think and I've talked about this before you know I had the auroring for a while and at some point the um the behavior of getting up in the morning and running to go check my score uh I realized it was was more detrimental right and once I learned the actionable think about how to adjust my temperature with my chili pad um with my uller like I got that information then I knew that it was it was time to kind of just put on the back and I haven't charged it in months and I don't know if I need to go back to it so um I certainly agree there um as we come to a close there are two more things that I do want to talk to you about because um I think that the when when you've you have that lecture you talked a little about about people staying in their lane and this comes up from time and time again right everybody feels like they are a nutrition expert because it's involved in most of our lives everybody eats multiple times a day you think you have a say you've had an experience and all of a sudden your anecdote becomes addict data right and um you know and then the other piece of it like you you talk about nutritionist versus dietician and stuff and so everybody's giving nutrition advice everywhere you go and including healthcare practitioners right physicians um physical therapists and stuff like that and and not everybody's equipped to and everybody should and if that was the case I think we probably wouldn't be as in much of a medicine like nutrition would not be the most polarizing health topic out there what do you tell people about staying in your lane particularly my healthcare colleagues like you know yeah I'll just leave it at that yeah I think I guess maybe I would lead with saying I get it in terms of why it happens so frequently it's partly partly what you just alluded to right like everybody eats and maybe you made a change that really helped you and so you want to tell the next person um so that's part of it the anecdotal thing is it's kind of nightmarish in the way that it can so quickly spread and and the reason it doesn't work for everybody is that everybody's a living a different life right your lifestyle and your stressors and your schedule I mean it's all different um but so is everything I also just mentioned right genetics and my microbiome and all these things that like quite literally what you succeeded with could be a disaster for me um so so we we don't love the anecdote but I get why people are sometimes eager to share um healthcare prediction practitioners or not um the other hard part at least in our setting especially athletics is that like you might not have a dietitian right down the hallway or in a lot of cases people were doing our jobs before we existed you know in athletics the dietitian has only really been like a kind of core person on staff for the last like five to ten years um and so somebody had to be answering the questions before you know it might have been the athletic trainer it might have been the strength coach and so I only say that to say I get it in terms of why it happens so much but with that said I think like one of the bus analogies um that's in my brain and that I've shared with with some of my physician friends and other healthcare practitioners is you know like as a dietitian I took lots of lots of science right took lots of anatomy I took exercise fees I took all the biologies and you name it we took all the science um I have a pretty good understanding of the cardiac anatomy and how you know stroke volume and heart rate vary but I mean all the things but if I made a cardiac recommendation that would be absurd right and people would be like what like you're you're a dietitian like why would you possibly make that um and even if I turned around and said oh well but I studied it and I got a certificate in it and I you know and I I actually even minored in cardiology it's not a thing but you get the idea um they would still think that's ridiculous right but a physician can literally say like whatever nutrition thing off the cuff and people will like go change their entire lifestyle around that one little thing you know um and it might not be backed in science at all for one and um and I guess maybe the other piece of that too is that you wouldn't expect a physician to stay up to date on nutrition stuff right because you're staying up to date on your own stuff um and so a lot of the nutrition knowledge that's being shared in a healthcare setting is often very outdated um definitely not personal it's not taking into account things that we might take into account because we're trying to do that specific skill set um so just ends up being like kind of this big hot mess in a lot of ways um so I think again that analogy I think can be helpful for people of like yeah I get that you know some things about nutrition right and I get that you understand metabolism and all those things but the reality is that like just like you spent x number of years studying this really specific thing so did we and that's why we're the best person to be giving out advice because we're taking all these different um considerations in that you wouldn't necessarily think about because it's not your area of expertise um so I might have derailed again did I answer the question no you did oh what I would just add is yeah it would that part really grinds me curious because to be honest with you I don't you know when it comes to nutrition type stuff everything that we've talked about people will pick up it's far less important to understand metabolism and it's far more important to understand behavior and context every single thing that's it's so contextual and and I think the most successful people are the ones who can really just step back and when somebody asks this question like like you said is when somebody asks you hey what do you think about this learn like well okay let's take a step back and it's all about education and unfortunately the the system that we work in is just not the time and you know I hate bashing my former colleagues I do sometimes and because I just think that we're just not equipped in the system that we're working and we certainly can can continue going on the this pathway and we have been for last couple years on how we can make it better but but I want to be respectful your time I do know we're coming up on it and I'd be remiss if I didn't ask you about the healthy former athlete and for those who don't know this is the awesome book that you wrote I love the subtitle here it says nutrition and fitness advice for the transition from elite athlete to normal human okay and so we're talking about uh you know your collegiate athlete that 22 year old who's kind of going on maybe taking the next step but the next step isn't professional sport right now all of a sudden they've got the drop off I've had a couple of folks I've had a couple of my students who were college athletes and now they're in medical school and they've quickly realized that um it's a different life from everything that you've talked about and they've had to make some serious changes and so what what did like first of all what was the genesis of this this is this from your own journey to be able to write this book and and what are some some key takeaways that you will sit down with like on their exit interview for your athletes and talk about okay listen you're about to embark on a different journey in life and your previous habits so with your experience and your relationship with nutrition is going to change quickly um it's a whole book so people can pick up for all of that but just maybe some pearls if you could share with them yeah yeah well it definitely spawned in some ways from my own experience um I felt pretty equipped compared to most people because I you know been studying nutrition and exercise um so I felt more equipped in that way but I just remember so many times thinking like gosh this is just bizarre because I've spent my entire life practically being an athlete and then one day it's just gone right you wake up and you're like damn I don't have to go to practice today like I don't I don't know any of that stuff that I had um so I definitely thought it was strange I thought about it a lot just how how I'd not like really thought about what that was going to be like um and then when I started practicing in the sports nutrition setting I was hearing it a lot athletes were coming to me saying like okay so like what do I do now you know like how how should I transition and I remember early on it really the genesis was I sat down and thought like okay you know we we got to do more for our athletes in this way we helped them so many ways to be ready to be a college athlete but we do like we're just like good luck see you on the way out so I felt really passionate that I wanted to do something in that way and I remember sitting down and thinking like okay I'm just gonna look up some resources because there's got to be like a lot of good resources out there for this topic and I found none um I mean like quite literally I think none and so that was the moment where I was like well maybe I'll make one um so it was kind of it was a passion project over a couple years um and yeah I mean that's I think really how it came about was just seeing this total gap in it I will say from then to now um you can find a lot more resources still not many um at all on the nutrition aspects specifically but starting to be more on the mental health and and just all their considerations that go into it so I think that's really cool that more and more people are talking about it um a couple of the big things I mean I think I always tell athletes one of the best things they can do is just start thinking about it because that's like one of the hardest parts is that you almost actively don't think about it because you don't want to um or you have the unfortunate scenario where you aren't prepared for it the season or career ending injury um it's the getting cut at the professional level or the collegiate level um so I think one just thinking about it that can be like a really healthy step because it feels a little less traumatic um from a nutrition standpoint I often just encourage athletes to start thinking like there shouldn't be any huge shift but the reality is that our expenditure is going to change at least for the majority of people right I mean some people stay really active and but like you and I talked about you start to have a family you are working a full-time job and the time gets really slim and you start to really appreciate that time block that you had in the middle of your day um so I just encourage them to like be really honest with themselves like it's really hard to keep up that expenditure and that's okay and nobody like it's not realistic for most people to even try but what are we gonna do instead of coming from here to here like how are we gonna make how are we are gonna stay active and I'll come back to that in a sec but also if our intake has been here how are we gonna try to bring it down without affecting like without making these huge sweeping changes um so that's a lot of what I talked about it's about is like small sustainable sustainable is a keyword um changes that they can make that can help kind of bridge that gap in this new expenditure um some meal prep little tips and things like that as well and then um the activity piece is the other one like how are you gonna stay active because you gotta stay active in some way not just from an expenditure calorie standpoint but also just from a health standpoint uh how are you gonna maintain some muscle um your body's gonna change like it or not you're not gonna have that same physique forever but how can you maintain muscle and how can you kind of age gracefully if you will um if we don't do all of these things at once like it can really smack people in the face um and the last thing I'll say that because this was the biggest piece for me is just um and my book only briefly hits on it because I am not a psychologist um but just starting to think about like the mental health piece and the identity I really stroke that like if I'm a soccer player what am I um and the friend's piece that was like by far the biggest part for me is just like you're almost your whole life constantly surrounded by this peer group that has this really key thing in common with you um and that you know my college teammates were my best friends still are like you're just like always together and then all of a sudden you like all move across the country and you're like whoa like how do I even make friends in the real world it feels like dating a little bit um so that's kind of my like in a nutshell things that I that I talk about in the book and that I try to highlight to athletes that I talk to in real life as well yeah that last piece is probably the most interesting to me the conversation that I find myself having time and time again with the collegiate at least that I've seen or even the high school athletes who are not going to play at the next level right now they they've established these this bond with with people and they've been playing since Pee Wee and now they're like after high school they're going to college across the country and it's just something that I think about that I'm sure you and I can talk about for hours but we might have to save that for part two uh resources aside from your book um other resources that you think would be good for people to to tune in to to get good nutrition advice right uh people to point to that you like that you think are doing good work what comes to mind i were talking like social accounts anything um well i was just from uh this is like a throwback book but Nancy Clark one of the like OGs and sports nutrition her book is super digestible like a really easy read um and it's meant for like from the athlete's perspective so I think that one is a nice super easy read um there's also fueling young athletes i want to say um i don't want to butcher the title but those are a couple um great resources that um people could check out and then um some people online that i think do a great job um Jessica is one of my former interns um Jessica the sports are D she's doing a great job on social and um in a really fun relatable way um who else from her sports nutrition standpoint there's so many um trying to think social um soccer nutritionist i'm gonna but i'm gonna botch these names i should have i should have made a list i'm gonna i'm gonna find it and i'm gonna plug it in you can send to me later how about that okay um what about yours tell tell people your social media yes and definitely follow my social media it's at link to nutrition um lots of myth busting going on there cool we're gonna link all of that in the uh show notes well Lauren thank you so much for sitting down for educating me for educating the listeners um i love everything that you do um all the the way that that you think about it and all the context you provide something that Darshan I have really become a fan of is the seeing that the context over content is so important um and i think that uh you know it holds more true in the the field of nutrition than it does in anything else the last important question that we like to ask people uh as you are a health care provider is we're all about putting the health back in health care so in maybe a hundred wars or less how do you think we can do that put the health back in health care i don't know how to um concisely say this but i'll try but i think in our setting and nutrition um some we could make all the recommendations we want but if people don't have access to food how are they carrying it out so you know food insecurity i think is a really pressing issue for a lot of people and um it really affects their ability to carry out a lot of what we would like them to do um so i don't know how we solved it i wish i did in this moment but i think if we can focus efforts towards that making sure people have access to healthy food and water and clean water um that's a huge step and solves a lot of the problems right there i love it we're gonna get there thanks Lauren yeah thanks for having me thanks for listening to another episode of medicine redefined if you enjoyed this episode please be sure to check out some of the additional resources in the show notes please also check out our social media platforms where you can find more content like this you can follow us on instagram twitter and tiktok at medireedefine we want to take a moment to thank our team for the production of this podcast specifically ethan jiu and herita yipri lastly please remember the important disclaimer that everything of this podcast is for educational purposes only it does not constitute the practice of medicine nor should it be construed as medical advice no physician patient relationship is formed and anything discussed in this podcast does not represent the views of our employers we recommend that you seek the guidance of your personal physician regarding any specific health-related issues however if you enjoy the show please be sure to subscribe review and share with anyone who you think will gain value from this as well until next time thank you for listening