Certificate of Integrative Sports Nutrition - Module 2 musings

I’m recently back from London, where I delivered module two of the Certificate of Integrative Sports Nutrition course.

Like module one, it was a really good week, with really good interactions with my ‘students’ – I say students, but they are mostly all practitioners in their own right, specialising further within the field of sports nutrition.

On day one, we delved into the subject of calories, which in my mind is totally over relied upon within sports nutrition – the errors of calorie counting (in and out) are massive and they don’t adequately account for the sheer complexity of the human body. Our live consultation was a case in point – she volunteered because she was having issues with weight management, but when we analysed her diet over two days, she was taking in around 2000 calories, but according to conventional equations (measured three ways), she actually needed somewhere between 2,500 and 2,800 calories for her basic metabolic functions, spontaneous activity, and structured exercise. Viewing this client through the lens of calories in versus calories out, she does not make any sense. However, we were able to delve into her life stresses and her diet in the way that a nutritional therapist would do, resulting in some really proactive dietary and lifestyle intervention strategies for her.

On day two, I explored the topic of macronutrients. We live in an era of very black and white thinking, often meaning that practitioners either exist in the high carb low-fat camp or the high-fat low-carb camp, without consideration for much in between. After a review of the sports nutrition literature from the 1970s to the present day, through the high-carb era and into the high-fat era, I made a plea for a moderation in the way that we think about macronutrients. We can certainly use particular macronutrient manipulation strategies for a particular individual who has a particular set of nutritional requirements for a particular period of time, but we certainly shouldn’t mean mapping these strategies out to every athlete under any circumstance. In addition to myself creating a balanced viewpoint on this topic, I also brought in Alessandro Ferretti on day four of the course, who discussed ketogenic applications in relation to heart rate variability and blood glucose control. I also really appreciate the fact that Alex works in a very individual way, and avoids one-size-fits-all approaches.

After all; there is a lot more to the picture than simply our energetic nutrients (carbohydrates, fats and proteins) – we also need to consider our micronutrients and phytonutrients, which was the job of nutritional therapist Ryre Cornish, who delved into dietary software that was capable of analysing micronutrient intake, plus she also educated us on the topic of functional testing; in particular, organic acid and amino acid testing. She shared all this information within the context of a really interesting case study of a female cyclist.

Next up was the discussion of what we eat or drink before, during and after exercise training or competition sessions. I revisited the topic of nutrient timing, which is been around since 2004, when Ivy and Portman popularised the concept of consuming nutrients according to how and when we exercise. This theory has been challenged in more recent times, with scientists suggesting that what is most important is our general food consumption throughout the day. However, my own point of view is that by being an athlete who is training hard, we actually need to consume a few more nutrients than if we were sedentary, and there may not be a better time to do this than in and around an athlete’s actual exercise sessions. In particular, sports drinks have been demonstrated to improve endurance exercise performance since the 1970s, but most modern sports drinks are simply a combination of water sugar, flavourings, colourants, and artificial sweeteners – hardly the fuel of athletes. In contrast, my view is to make your own sports drinks out of nourishing ingredients, which I term DIY sports drinks. If you like to view a webinar on this topic, click here and pick option 3.

Following on from sports drinks, we had a presentation from Andy Blow on hydration; you would never think that a talk about water and salt could be so interesting! In line with the focus of this course on athletic individuality, he told us that sweat rates and the concentration of salt in the sweat is highly variable between athletes. This is another area where we need to individualise our nutrition interventions.

On the final day of module two, after I delivered a talk on overtraining, we got the opportunity to put all of our weeks learning into practice with a live consultation. Our client was an extremely busy gastroenterologist, who was competing in half Ironman and full Ironman competitions, but experiencing gut problems during these races. Rather than rushing straight into his race day nutrition, we actually spent the whole session looking at his lifestyle, his training patterns, his stress levels, his sleep, and of course his base diet. Ironically, his wife was a nutritional therapist, so it almost became a reminder for him to ‘listen to his wife’! We will be monitoring him all over the coming weeks, and we are planning a race specific nutrition follow-up consultation well in advance of his next Ironman event in August.

To wrap up the learnings of model two, I certainly emphasise the importance of base nutrition, day-to-day lifestyle, individuality, along with an excellent understanding of the person’s integrative physiology, which we studied in depth during module one. Only when these base requirements of health are in place can we then get into our specialised performance nutrition strategies. Sir Dave Brailsford from Team Sky talks about the concept of marginal gains – I will step further forward and emphasise the fact that if we get all these base elements right, our athletes will benefit from more than just marginal gains.