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Olympic Athletes & Gut Health

  • Writer: digitalflynn
    digitalflynn
  • Jul 15, 2021
  • 9 min read

The Olympics are coming! After a one year delay and some controversy over whether they should go ahead, the games are starting next week, Friday 23rd July and I'm super excited to be watching (from my laptop and not in Tokyo, sadly..). There is a lot of pressure on the athletes not only to perform well on the day, but to avoid getting sick or injured in the run up to the events. Acute illness is one of the biggest factors that can prevent athletes from successful performances, and upper respiratory tract infections (URTI) are the most common illnesses reported by Olympic and Paralympic athletes. In elite athletes, having fewer illnesses and completing more than 80% of planned training sessions in the 6 months prior to the event increases the likelihood of achieving their pre-defined performance goals. (Keany et al, 2019).


Back in 2019, I attended the Yakult Study Day: Latest Insight into the Gut Microbiota and Health: From Research to Practice at the Wellcome Collection. It was a packed day learning about gut microbes, their role in the immune system, neurodegenerative diseases, cancer treatment and much more. Sports Nutritionist Michael Naylor, who is head of performance nutrition at the English Institute of Sport (EIS) delivered an interesting talk titled Challenges faced by athletes: is there scope for taking microbiota research to a new league? Of course, 2 years have progressed, research will have developed further and strategies may have changed somewhat what with COVID-19 around, but I thought I'd share some of the considerations needed when helping an elite athlete prepare for some of the biggest events of their lives.


Within the EIS there is a team of 23 nutritionists (again, this may be different now), delivering to over 25 sports, supporting 93% of GB medalists in the Olympics and Paralympics. There's huge diversity in the sport they cover and a range of nutritionists with different expertise.


In elite sports, there are a variety of challenges to face:


Travel - a lot of travelling is expected from athletes and the whole team

Sports demands - for example changes within the team, changes within the training demands etc

Injury - nutritional strategies are needed to both prevent injury and help them recovered if they do get injured

Athlete/Staff knowledge - amongst the athlete and the staff as a whole - including the coaches etc, there are varying degrees of nutritional knowledge

Catering/Food availability - going abroad there is always uncertainty as to what foods will be available

Learning/working styles - everyone has a different style of learning and working depending on personality

Weather/environment - extreme temperatures can impact how the athletes perform



All these different scenarios can have an impact on the gut health of the athletes and the team need to figure out which priorities to focus on to improve their health and maximise their opportunity of success in winning medals - which is what a lot of the funding of the Olympics athletes is based on - they need to turn up and perform at their peak. So the team have a saying: Performance Backwards, Not Nutrition Upwards. They work with a performance solution mindset so they understand what are the problems and demands of the sport, what will work to improve performance and how can their nutritional strategies be adapted to match this. A lot of the time performance comes down to two things: adaptation and wellness.


PERFORMANCE --> ADAPTATION --> WELLNESS


How can they maximise the adaption of the training program they're on? This might be looking at their recovery strategy, looking at ways to improve endurance, ways to influence body composition such as increasing lean mass and reducing body fat %, and maximising performance on the day of competition, such as carbohydrate fuelling or different caffeine supplementation strategies. To maximise wellness, risk of injury needs to be reduced as does risk of illness. If they do get sick, or injured, how can nutrition be used to ensure they recover quickly and efficiently to facilitate their return to play? Sufficient calories, protein, carbohydrates, supplements such as vitamin D can all play a role in injury recovery (Close et al, 2019; Tipton et al, 2015). There is research to say that the more training sessions an athlete misses, the less likely they are to be successful during their competitive performances, so wellness is essential for the final goal.


Some research by Jamie Pugh (2017) was shared. Pugh was undertaking his PhD in gut health and the athlete at the time at Liverpool John Moore's University and discovered that 30-90% of athletes had reported the following symptoms revolving around their gut health:


Upper abdominal pain

Heart burn

Acid reflux

Hunger pains

Nausea

Borborygmi (rumbling or gurgling sounds from the intestines)

Bloating

Belching

Flatus

Constipation

Diarrhoea

Loose stools

Hard stools

Urgency

Incomplete evacuation


Whilst most of these are fairly normal symptoms, they can all have a negative impact on athletic performance and more research is needed in understanding how the gut microbiome works to offer solutions. Exercise itself can cause disruptions in the microbiota, but more research is needed to determine how and why.


However it's not just nutrition alone..


Psychology + Nutrition + Exercise


The athletes are performing in high pressure situations. For the Olympic Games, the amount of pressure when you've been training for 4 years and it comes to the day, you need to deliver your absolute best, any nerves or doubts in performance can have an impact on your GI. (Think how nervous you get before an exam, before public speaking, or just watching footballers taking a penalty..). Then there is the stress of different exercise and the nutritional strategies that go with it.



This slide, taken from the talk highlights how nutrition can affect performance through the gut health. For example, endurance athletes consume a lot of carbohydrate on the day of performance and some may have varying reactions to the excess fibre and FODMAP foods. There can be issues with food poisoning, particularly when travelling in which case a quick recovery strategy is vital and hydration plays a big role.


Different supplements are also utilised. Sodium bicarbonate has been shown to increase performance by buffering lactate, particularly for swimmers, but it can cause issues such as diarrhoea and abdominal cramps. (If you've ever watched a swimmer get to the end of a 400m race and jump out the pool quickly, they're most likely running to the toilet.) The risks and benefits need to be carefully assessed to ensure performance isn't compromised, nor is the health of the athlete.


The main causes of GI issues are:

Allergies/Intolerance - 5% of adult population have lactose intolerance or coeliac disease

Fibre

FODMAPS (e.g apples, asparagus, mushrooms, cow’s milk, dried fruit, honey, legumes, wheat)

Unaccustomed nutritional strategies

Food poisoning

Macronutrient composition and timing


What Do We Know About Tokyo?


First off, we know it's hot! It'll get to around 31ºC and the humidity compared to London is much higher. So straight away there's a huge change in environment that the athletes and the rest of the team are having to work in. Dehydration and cooling strategies can affect gut health so strategies need to be developed to work around this. Work has been done in collaboration with Brighton Uni and Mike Tipton from Portsmouth Uni who's interests lie in looking at the physiological response of athletes in extreme environments. They've been looking at different hydration solutions, and more individualised electrolyte solutions based on sweat rate and sweat composition. Navigating the Tokyo environment to discover what knowledge is needed by the EIS to support Team GB will be essential so the factors such as heat won't be seen as a challenge, but something that can be overcome. It's an opportunity to get an edge over other countries and try things that no one else is doing.


There's going to be a lot of travelling. At the Rio Olympics in 2016, the EIS collaborated with Gordon Ramsay's company so when they turned up at the airport (let's face it, you never know what you're gonna eat there), the meals had been pre-prepared as well as takeaway meals for the plane - all with their nutritional values considered. The travelling doesn't stop when they get to Tokyo - all the events are spread out, different food options may not be available in all the different places so preparation is key. In Rio, EIS took their own chef with them so all meals were bespoke to the athletes and were foods they were familiar with.


Hand hygiene. This will be a given now in the COVID-19 era, but this message was already being pushed hard (The Power Is In Your Hands), as hand sanitiser is effective at reducing the spread of germs and risking illness.




Pictured above is the Olympic Village food hall. Pretty chaotic! Some of the high profile athletes from Team GB can't walk in without being hassled for selfies. By the time they've got to their food (an hour later), they may be left with food that they're unfamiliar with. The solution in Rio was to build their own base. So they took over a British school and set up their own training area, physio area and had special equipment catering to the different sports, such as a boxing ring. This helped them have control over their food and was much less stressful for the athletes. The food was labelled with its nutritional values, allergies and related to how it could help performance, so athletes knew exactly what to choose depending on whether they were re-fuelling, recovering, or eating to make weight.


So from 2019 EIS were gathering intelligence from the Recces over in Tokyo with the nutrition team going to and from Tokyo to ask questions about how they translate the menus and what kind of food will be available. So far, they've spoken highly about the quality of the food. Collaborating with chefs will once again be part of the strategy to ensure consistency and make sure the team are fed for their needs. However a lot of support is needed for the chefs who are working extremely long hours and are also under pressure to deliver.


Paralympics

EIS has just employed Terri Paulson who has more expertise in the Paralympics world. She has been doing more to looking into bladder and bowel issues in the more impaired athletes and has been involved in webinars collaborating with nurses to gather more information to produce a better understanding of how gut health for able-bodied athletes can translate to the Paralympic athletes. Higher environmental temperatures can aggravated discomfort from rubbing in missing or prosthetic limbs, so more work is being done to offer solutions. Paralympic competitors may also have more compromised immune systems, so extra consideration needs to be in place.


Current Adopted Strategies

Strategies used more regularly in sport and adopting strategies around gut health is the use of probiotics, especially in the 2-8 weeks leading up to Game Day. Work is being done to discover the best probiotic strains to use and the timing to use them. Some work on short term use of colostrum and glutamine around training needs to be explored in more detail as it is currently being trialled in different sports but the scientific evidence isn't out there yet.



The work never stops and ultimately the goal is to ensure all athletes are healthy, happy and successful when it comes to performing, but you can see just how much work goes in to making sure this happens!


We wish Team GB and of course all the athletes taking part the best of luck, I cannot imagine the pressure they're facing now, particularly after a one year delay, and hope they all stay in good health before, during and after Game Day!


COVID-19

Not all athletes will be vaccinated apparently. Some are opting out by choice as they are concerned about any side effects hampering their performance. This could potentially be problematic when you think about the numbers and the travelling...we'll see what happens!




References & Further Reading












 
 
 

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