If You Are An Athlete with IBS, You Should Know Kathryn Adel
Kathryn Adel has joined the FODMAP Everyday® Success Team and we are thrilled to have her. She is both a Registered Dietitian and Kinesiologist. Her specialty and focus is on sports nutrition, which we know will be of interest to many of you, as well as weight-loss, diabetes, heart health and of course, general gastrointestinal health. She herself is an accomplished athlete, having run track and cross-country at a national level.
As we do with all our Success Team colleagues we present a Q&A so that all of you can become more familiar with our team members.
Dédé Wilson: Kathryn, let’s start at the beginning – tell us why you wanted to become a RD and how you developed your chosen focuses.
I went to college with the goal of becoming a sports dietitian. As an athlete, I have always been interested in nutrition and how it affects health and sports performance. When I was a track and cross country athlete in high school, I was told by teammates and coaches all kinds of things like not to drink milk or to take supplements and I was so confused, I wanted to know the truth!
I did not have access to a sports dietitian at the time, so it was hard for me to determine what I should eat to optimize my performance. Additionally, I strongly believe that many health conditions can be prevented with optimal nutrition. I once read the following and thought it was very powerful: ‘’Our genes are not our destiny, but rather they determine our potential.’’Our genes are not our destiny, but rather they determine our potential. Click To Tweet
That is a fantastic quote! So, how did you develop your dual focus on sports nutrition and general gastrointestinal health?
I love being active and practice many sports. Nutrition is an important determinant of sports performance, but it is often not optimal in athletes. I believe that my experience as an athlete and dietitian allows me to understand the day to day reality of athletes and provide personalized nutrition advice to help them achieve peak performance.
We know you have mentioned to us that you had observed particular digestive issues in endurance athletes. Can you tell us about that?
By working with a lot of athletes, mostly endurance athletes, I had noticed that many of them experience GI issues during exercise, which is how I became interested in gastrointestinal health in the first place. I also became really interested in the low FODMAP diet when I became aware of how many people actually struggle with IBS and learned that diet modifications is one of the most effective way (with stress management) to alleviate symptoms. I feel like as a RD, I can really make a difference in the life of people that suffer from GI issues, which is very rewarding.
Can you help us understand kinesiology?
Kinesiology is defined as the science dealing with the interrelationship of the physiological processes and anatomy of the human body with respect to movement. It more simple words, it is the science of exercise. Kinesiologists usually work in one of the 3 following areas: wellness and exercise promotion, physical rehabilitation and athletic training.
It makes so much sense that you have pursued this as well. It brings all of your interests together. Also, please explain what your CSSD certification means.
CSSD means Certified Specialist in Sports Dietetics. In order to obtain this certification, a Registered Dietitian needs to have at least 2 years of experience as a RD as well as a minimum of 2000 hours of sports dietetics practice experience and successfully pass an extensive national exam in sports nutrition.
We found you through SOS Cuisine, which provides diet specific meal plans, including the low FODMAP diet. Tell us a little bit about SOS Cuisine and what you do for them.
SOS Cuisine is an online company that provides smart meal plans, including low FODMAP meal plans, which can be personalized according to one’s individual food preferences, intolerances, health issues, lifestyle and budget. Through SOS Cuisine, I provide nutrition counseling via video conference to clients in various areas including sports nutrition, gastrointestinal disorders (including IBS and the low FODMAP diet), weight management, diabetes and heart disease. I also write articles and make nutrition videos for the company’s blog.
Tell us why you moved to the U.S. and where you are located now. Do you find any particular regional challenges for you in regards to your clients and the low FODMAP diet?
I moved to the U.S. because my husband is from South Carolina and he obtained a great work opportunity in Charleston, SC, which is where we currently live.
I have experienced some regional challenges in regards to my clients and the low FODMAP diet. I have clients located all over South Carolina. In general, there is not the greatest selection of low FODMAP breads and cereal products or lactose-free dairy products, at least compared to big cities like Montreal where I used to work, so this can be challenging for clients.
However, I can say that the market is definitely growing and the selection is slowly improving. Additionally, Southern cuisine is typically high in fat and includes a lot of fried foods. Eating a lot of fat can trigger GI symptoms in some people that have IBS. The way people cook in the South is part of their culture, so it can be challenging for them to change their ways. There are also some common local foods that are high in FODMAP such as peaches, watermelon and beans.
You are Monash University trained (as are Diana, Vanessa, Erica and myself). Tell us why it was important to you to go through that training process.
To be honest, before taking the course, I did not feel very confident when helping clients with the low FODMAP diet, especially since there is all kinds of information found online and elsewhere. I found that the low FODMAP diet was quite complicated and hard to teach and I did not always have answers to all questions that my clients would ask me.
Monash University is the birthplace and the best reference for information about the low FODMAP diet, so I definitely thought that it was important for me to take their course. As a Registered Dietitian, I strive to practice evidenced based nutrition, which can sometimes be challenging since nutrition is an evolving science, so it is important to go through training regularly to keep up with the most recent research and guidelines. This course provided me the confidence I needed to work with my IBS clients and also gave me more credibility to promote my services, market the low FODMAP approach and interact with gastroenterologists and other health professionals.
What are some of the broad reasons why athletes have their own set of GI issues?
I would say that stress is a big one. Stress has a huge influence on GI symptoms during exercise for 2 reasons. First, high intensity or prolonged exercise induce stress to the body, and second, it can be extremely stressful to compete at high levels. Some athletes are able to deal with competition related stress better than others, and stress management is an aspect that athletes can work on as well.
Next I would say improper nutrition before, during and after exercise. Both food choices and timing can influence digestion and how an athlete will feel during exercise. Fat and protein are harder to digest than carbohydrate. Some people need a longer delay to process food, while others can tolerate eating closer to the start of their exercise. The type of fuel and timing also vary according to the type of exercise.
Thirdly, dehydration can increase gastrointestinal issues during exercise by reducing blood flow to the gut and delaying gastric emptying. A lot of people don’t drink enough water and don’t realise the importance of proper hydration, both during exercise as well as in the hours prior to exercise. Studies show that proper hydration before and during exercise can reduce the frequency of GI symptoms and reduce malabsorption. Exercising in the heat can also enhance GI symptoms.
I would say failure to practice racing fueling strategies during workouts is another key factor. Gels and sports drinks are commonly used for endurance exercise. However, if the gut is not used to absorbing and processing carbohydrate during exercise, this can cause malabsorption and lead to gastrointestinal symptoms. It is important to train the gut to increase carbohydrate tolerance during exercise using a structured gut-training protocol.Gels and sports drinks are commonly used for endurance exercise. However, if the gut is not used to absorbing and processing carbohydrate during exercise, this can cause malabsorption and lead to gastrointestinal symptoms. Click To Tweet
And finally, simply lack of experience. Everyone’s body is different. Less experienced athletes are not always aware of what foods and fueling strategies are best for them. There are tons of information on fad diets and sports supplements online and everywhere else. Athletes get stressed out and can easily be tempted to try new things to improve their performance. In sports nutrition, there are two popular pieces of advice that mean a lot: ‘’Never try something new on race day’’ and ‘’what works for one person may not work for someone else’’.
Another great quote from you! It seems so simple and obvious and yet so many of us do not always follow common sense. We need RDs like you to keep us on track.
If someone is attempting to lose weight and then has to also follow a low FODMAP diet, what are some of their unique challenges?
A lot of my clients actually lose weight while following the low FODMAP diet. This is probably because they cut out a lot of the bread, pasta, fried foods, sweets and sweet beverages from their diet and eat out less as well. From what I observed in my practice, they are also more restricted on what they can eat, so tend to snack less.
For some people that want to lose weight it can be good, but for others that already have a low body weight it can be challenging to actually maintain their weight during the elimination phase. Finally, for people who are attempting to lose weight but struggle with an eating disorder, the low FODMAP diet can be too restrictive, increase obsession and anxiety towards certain foods and cause them to maintain a bad relationship with food, and is therefore not always recommended.
We have two articles focused on weight management our readers might be interested in. Weight Management Series: How to Gain Weight on the Low FODMAP Diet and Weight Management Series: How to Lose Weight on the Low FODMAP Diet.
What are some of the general challenges that you find with clients when introducing them to the low FODMAP diet? Any particular sticking points that you see again and again?
I always challenge myself to try my best to teach the low FODMAP diet in a way for it not too sound too restrictive. I don’t want clients to leave my office feeling discouraged, confused or overwhelmed. Overtime, I found that one of the best ways to prevent that is to focus on the foods that are allowed on a low FODMAP diet rather than on the foods that are not permitted.
Being able to recommend websites such as FODMAP Everyday which provide all kinds of recipes and practical tips is also extremely helpful and saves me a lot of time. When I first started teaching the diet a few years ago, there were not many resources like that out there which made it more difficult for clients. Eating out and finding low FODMAP products is also always a challenge for clients that are not able or willing to cook a lot, especially those who live in smaller cities.
Download our Low FODMAP Supermarket Shopping Lists and a super helpful wallet card you can show to waiters to help communicate your dietary restrictions and this one to tell them what you can eat.
What do you most love about working with clients?
I love when I can make a difference in a client’s life, whether it’s by helping someone get rid of their GI issues, improving their sports performance, increasing their energy levels, reducing their hemoglobin A1c or cholesterol level or whatever it takes for them to become the best version of themselves!