In this episode of Athletes Compass, hosts Paul Warloski and Dr. Paul Laursen welcome Dr. Jeff Sankoff—emergency physician, triathlon coach, and host of the TriDoc Podcast—for a refreshingly honest and science-based discussion about the often-misunderstood relationships between body composition, fueling, and performance in endurance sports. They tackle the dangers of under-fueling, especially in athletes trying to lose weight, explore the myths around fat oxidation, and explain how endurance training can both enhance physical and mental resilience. Jeff shares actionable advice on balancing training and nutrition while addressing the psychology of chasing marginal gains and the mental health benefits of endurance sports. A must-listen for any athlete navigating the complex intersection of performance, health, and wellbeing.

Key Episode Takeaways

• Fuel your workouts properly: Inadequate fueling leads to poor training outcomes and disrupted body composition changes.
• Carbohydrates are essential for performance, especially above Zone 2 efforts.
• Fat oxidation is overhyped for competitive endurance performance; carbs are king.
• Protein intake is often too low in everyday athletes; increasing protein helps with satiety, recovery, and preserving lean mass.
• Body composition should follow performance, not lead it.
• Disordered eating risks are real, especially in women; watch for menstrual irregularities and other signs of under-fueling.
• Marginal gains are overrated for most age groupers; focus on the big gains—training quality, sleep, and recovery.
• Mental health and resilience are deeply supported by consistent physical activity.

• TriDoc Podcast - Triathlon and health in one place
• Tempo Talks Podcast
• Paul Warloski - Endurance, Strength Training, Yoga
• Marjaana Rakai - Tired Mom Runs - Where fitness meets motherhood.

doing physical work, doing physical activity is just, I have found one of the most amazing ways to stabilize and to level set when you have.

other areas in your life that are so

Hello and welcome to the Athletes Compass podcast where we navigate training, fitness and health for everyday athletes. Today on the Athletes Compass podcast, we're joined by Dr. Jeff Sankoff, better known as the Tri-Doc. Jeff is an emergency physician, triathlon coach and the host of the Tri-Doc podcast where he brings a critical eye in the scientific perspective to the latest training trends, nutrition strategies and endurance myths.

Jeff blends medical expertise and real world triathlon know-how to help athletes train smarter, stay healthier, and perform at their best with more than two decades of racing experience, including two Kona qualifications. Jeff, we wanted to start our conversation by talking about body composition for everyday triathletes and other endurance athletes.

In your episode with Alex Laursen and Juliette Hockman on Fast Talk, you discuss some of the risks of under-fueling. Could you share some of the key takeaways for triathletes who might be struggling with balancing fueling body image and performance? That's kind of a big question.

Yeah.

It's a big question and it's a tough one to answer. think a lot of athletes and coaches struggle with it. There is a lot of conflicting evidence on this because we know just with our eyes, as we watch elite athletes perform, we can see that there is a very specific look that athletes bring with them when they perform well. You don't see a lot of normal looking people out there.

Certainly not at the highest level. Uh, if you look at the Olympics, if you look at professional sports, if you look at professional triathlon, most of these athletes are lean. They are, they tend to be tall. They tend to be very muscular, but they, really don't have a lot of body fat on them. And for those of us who are striving to live a normal life and also do as well as we can in

this sport that we love so much. And that can be triathlon, it could be running, biking, it could be whatever it is. We often aspire to be like the people that we watch and in emulating to be like them, we can have this unhealthy focus on that kind of body image. And that can lead to a lot of problems. The most basic of those is just not being able to perform in our training because we start to prioritize body composition or.

what we should look like as opposed to what we should actually be eating to be able to perform in our everyday training. And the reality is, that if you want to be able to perform in training, you have to be able to fuel. You cannot subsist off of what's already been stored within your body because we know that in order to perform at the levels we have to, in order to gain fitness, in order to gain performance, we have to be able to perform in a

In a zone that requires us to be burning carbohydrates, we can't do it burning fat and we have to therefore be taking in fuel because we just don't store enough carbohydrates. so the most common error that I see and that I hear from athletes is that they are trying to change their body composition by doing these kinds of sports, this kind of training. And as a result, consequently, they don't fuel adequately and therefore.

they're get into this vicious sort of cycle where they are frustrated by the fact that they can't perform and duly frustrated by the fact that they're not seeing any change in their body composition.

Hmm.

So Jeff, what do you advise athletes that ⁓ are going through this? Like what if they, you we've heard that fat oxidation is an important component of successful performance. How do you balance the, I guess the, you take in the stance where carbs are important, where do you kind of draw the line in terms of, I guess, the insulin response that you're gonna get from that?

alongside of the need to enhance your fat oxidation as one contributor in the overall global delivery of energy ultimately at the end of the day to deliver that performance.

Really depends

on what your goals are. If your goals are to be doing triathlon, which is where you are really performing at a high level of your aerobic capacity, fat oxidation is not a big part of what you need to be doing metabolically. I know I keep hearing a lot of this like, zone two stuff, which is great. If people want to do zone two, that's fine. They're going to be completers. But for people who want to compete,

They need to be doing a lot more than zone two. And once you get out of zone two, you are leaving fat oxidation in your rear view mirror and you need to be able to metabolize carbohydrates. And you need to be able to be getting in carbohydrates in order to sustain that metabolism. So I tell people that they have to learn to fuel for their training. They have to learn to be able to be sure that they're taking in adequate calories for their training.

And then the trick is, is to then be careful about the calories they take in around their training, the kinds of calories they take in. If you're looking to change your body composition while training for a big race, don't do so by restricting your calories on a daily basis. Do so instead by changing what and how you eat, but be sure that you continue to fuel for your workouts. That's the big thing that I tell people.

And as far as fat oxidation goes, you know, I keep hearing a lot of these people who keep talking about how, we need to train our bodies to oxidize fats, or we need to do all these things. That's going to teach you. don't need to train your body to do anything. Your body has millions of years of adaptations and evolutionary skills behind it. You in your lifetime are not going to train your body to do anything that it can't already do. What you're going to do instead is you're going to shift different metabolic.

needs or metabolic processes based on what you're actually doing in that moment. If you want to metabolize more fat molecules, you have to be exerting yourself at a very low aerobic potential. So you have to be sticking around that zone one kind of low zone two kind of effort. But if you want to gain fitness, if you want to gain speed, you can't sit in zone one, zone two for particularly long amounts of time. You have to do a certain base amount for sure. But

you're going to be limited in terms of what you can accomplish there. So yes, we all are able to oxidize fats. No, you're not going to be able to change your body composition appreciably by just sticking in that area. And you're not going to be able to improve your performance by sticking in that area either.

Hmm.

You mentioned ⁓ switching the diet can be really important. Can you give an example? What do you typically see someone coming to you and then what's the before and after picture on that? With respect to calories, really, right? I 100 % agree with you. definitely, calories are so key, but the type of calorie can matter, right?

Mm-hmm.

Yeah, right.

Yeah. So I, I am not a dietician. don't pay play one on TV, but I do, ⁓ defer to my colleagues who are dieticians. And I do have some training as a physician as well. And of course, as an athlete and coach. So I will generally look at what people are eating and I can easily spot the things that they can generally kind of cut out. And I mean, obviously anybody who's taking in a high percentage of fats, that's an easy one. Right? So junk foods.

.

refined snacks, cookies, know, all the typical things that are high in fat, those are the easy ones to cut out and they can often be replaced by protein. We don't generally see people with a shortage of carbohydrates. Usually I find that people come to me, they're very high on carbs, very high on fats, and they tend to be a little bit low on protein. So it's just a matter of trying to shed some of the excess calories because often people are taking more calories than they need to. So let's try to

get that down a little bit in terms of our total intake of calories. And then the other thing is shifting the calorie focus away from carbs and fat and a little bit more into protein because protein we know is very helpful for maintaining satiety. So if you get good high protein in your meals and it makes you feel full, it takes a longer time for our body to digest that. It will maintain muscle mass, especially for women and older men and keeps us from

Auto metabolizing and losing muscle mass. And then also, will allow you to go longer without feeling hungry and having to eat more in between meals and snacking, things like that. So those are the shifts I generally try to help people make. then often, a big thing is, is, is, is can be really simple, like just soda. Right? I can't tell you how many people come to me and are drinking two or three, you know, three is probably a lot, but, often people are drinking one or two sodas a day.

Yeah.

I love that answer.

Mm-hmm.

Just cutting that out is a large amount of calories and carbohydrate right there.

Yeah, and sugar and like the type of carbohydrate too, right? So yeah. So yeah, love that answer, Jeff. ⁓ I'm reflecting back on the podcast we did with Dr. Mickey Willedon, who's a nutritionist, dietitian. And she said exactly the same thing. Like ⁓ we have all this battle with carbs and fat, but the big player you really want to kind of focus on, the bullseye with is your protein intake.

Exactly. Yeah.

When you do that and you start replacing calories with the protein, ⁓ you really start to see, make a difference. And like you said, yeah, getting out the key junk food items. yeah, so key, so key. Paul, I'll leave it to you for the next question.

Yeah. So how do you, how do you have these conversations with athletes? How do you guide athletes through these conversations about, you know, body composition without veering into unhealthy territory? What do how do you, how do you start that?

I emphasize first and foremost that body composition should not ever be the primary focus or goal. That instead we are going to focus on being healthy. We are going to focus on being strong and we are going to focus on our athletic pursuit and getting to the results that we want to get to there. And body composition inevitably will follow. We can make some conscious efforts towards

Mm.

trying to improve body, and listen, some people come to me and have very different body compositions when they come to me. Some people come to me with very high percentage of body fat where they can make simple changes that will result in dramatic changes in their body composition, even as they're training and eating normally. It's just a matter of getting them to eat more normally. Other people will come and their body composition is already a little bit closer to a point where it's going to be very hard. If you're

Body fat is in the 10 to 12 % range. It's going to be really tough to get that down. And I am very frank with those kinds of athletes and say, look, I understand where you want to get to, but let's just recognize that that cannot be the primary focus. And it is incredibly important with women, especially younger women who have already a predilection towards disordered eating. want to be very, very careful with them. track.

Mm-hmm. Mm-hmm.

Any of my women who are in reproductive age, I want to be sure that they continue to menstruate because if you know, the first thing that's going to become problematic is going to be menstruation history. So I want to be sure that we're watching that. In older women, that's harder to do because they're not menstruating or their menstruation is not as regular already, but we can still focus on other things, emotional wellbeing, sleep quality, ability to recover from training, things like that. But the conversation always begins with look, body composition.

great, we're going to try and follow that. But that has to be what I like to call a following indicator, not the leading indicator. The leading indicator is going to be your fitness, it's going to be your results, it's going to be your metrics and your body composition will come along, but it's going to be a longer term kind of thing. It just doesn't happen right away.

We had a listener question about body composition from, from Kimber. ⁓ she did an Ironman last fall and she self reports that she ate well to refuel. She does strength training. She says that she lost some fat overall, but kept a lot as well. She asks, how should I go about losing the excess non muscle, non lean, non helpful jiggles? That's her quote.

⁓ I'm not looking for the quick go-to of low carb keto, just cutting out processed foods, et cetera. I did keto for a long time quite successfully, but it's sadly not a one size fits all and in the end didn't work for me. I already don't eat a lot of processed food and I'd love Jeff's holistic thoughts on my options and approaches.

Well, without knowing a lot about Kimber, I'll make this as generic as possible. Just in reference to keto, I don't think keto goes particularly well with endurance sport simply because as I mentioned, we really do need carbohydrates. And if you want to be able to push yourself, you really need that abundance of carbohydrates. So I don't love keto. Keto also, you know, a lot of the science shows that

Hmm.

Yes, keto can really help with weight loss quickly, but it doesn't stay off because it's not a sustainable weight loss diet. ⁓ that's one thing I'll say, but in terms of just, you know, also without knowing Kimber's age, it's kind of hard, right? Because hormonal influences for women have a lot of say in terms of what you can lose and what's going to stick around.

genetics also play a big role in that. So sometimes it can be really, really difficult and really frustrating to lose that last little bit. I know that I deal with that. I eat quite well. I train as a lot as much as a lot of other people do. And yet I still have those jiggles too, Kimber.

I definitely sympathize.

In the same bowl.

think that all you could do is do your best and you can continue to try and monitor what you eat.

When you are out of season, it's okay to try and go into a bit of a caloric deficit. And that means that you are continuing to fuel your workouts, but then in between your workouts, you can cut down on carbohydrates, keep the protein high, but keep the carbohydrates and fats maybe a little bit lower so that you are net deficit. And you want to work with a dietician to figure out exactly what that means in terms of your calories in and out. But if you are

in off season time and are able to do a little bit of a caloric deficit, you may start to see some of that weight come off and some of, but, as long as you maintain again, critically important, you fuel for your workouts, meaning you take in adequate fuel during your workouts to make sure that you're working out fueled. And then also you keep the protein high so that you're recovering after those workouts and you're just reducing carbs, reducing fat. may see changes in body composition.

You know, what are the, what are the warning signs that, that we might be under fueling, you know, like if Kimbers in a caloric deficit and is not necessarily fueling the workouts, what, what are some of those red flags that might occur before it hurts performance or health?

So the big one that women, all women of childbearing age have to watch for is menstrual irregularities. I mentioned that before, I'll mention it again, it's very, very important. So any woman of childbearing age who starts to notice menstrual irregularities should think first and foremost that they're under fueled and address that right away. For men and for women who are no longer menstruating, you have to look for some other things. So often it becomes, ⁓

inability to recover or inability to push yourself in workouts, you may start to feel that over-training kind of thing. Even though you're not over-trained, you'll feel like you're over-trained, meaning that you just can't find that next level to push yourself on a run or on the bike, or you're just running out of energy all the time. You may feel like you're not sleeping as well. You may be emotionally more labile. That,

you know, the hangry sort of ⁓ idea that you've heard about, it's a very real kind of

phenomenon. So...

All of those things are subtle, but important warning signs. And that's why it can be important if you're actually trying to do this, that you journal these things. And if you're on a platform like TrainingPeaks or something like that, you can add those little metrics to each day tile where, how am I feeling today? How did I recover? How did I sleep? Those things are really useful to follow and keep track of as you are in a caloric deficit.

Nice. Paul, do mind if I ask a question that pivots a little bit? ⁓ Well, I was looking at Jeff's profile and obviously as a doctor, you probably see some athletes with AFib and arrhythmias. I know this seems almost to be becoming more more prevalent. I'm not sure, but what are you seeing in there and what can you advise? Where do you even begin with that topic?

No, not at all.

Yeah, it's a tough one. atrial fibrillation in athletes is a, I'm not sure that it's becoming more prevalent. I mean, the only reason we're seeing more of it is just because we see more people pursuing athletic pursuits as we have more leisure time and more resources. The, you know, we're just seeing an athlete's heart, which is just a hypertrophy and dilation of the heart that comes with doing these kinds of sports. But.

you

You know, it's the, it's the, it's the old story of this reverse J curve. don't know why it's called a reverse J curve. really looks like a normal J, but anyways, ⁓ so for anybody who doesn't know what I'm talking about, basically we know that being active physically active and, and, and when I talk about physically active, I'm talking about high intensity activities. So similar to what you talk about a lot, Paul, with high intensity interval training, if you do high intensity.

athletics for a certain, you know, as you increase the volume of high intensity athletics per week, your risk of cardiovascular disease or cardiovascular, all cause cardiovascular mortality goes down quite dramatically. So there's a linear relationship there, but eventually there's like this tipping point where as you start to do more and more hours of high intensity efforts, that number starts to return back to the zero line. So instead of getting protection,

You start to lose some of that protection. You start to see some of this mortality benefit start to disappear. And so the curve that you trace looks like a J. I don't know why they call it reverse J, but anyways, um, kind of looks like a U really anyways. So the. The point seems to be around 10. So if you're doing more than 10 hours of really high intensity efforts per week, then you start to lose that benefit. But I want to be very clear that number never crosses zero.

Yeah.

does.

a lot.

So you're still better off doing 10 or more hours of high intensity efforts than doing nothing, because you're still getting a benefit over the people doing nothing. You're just not getting as much benefit as the people doing less than 10. That makes sense. But we know that some of the causes of the issues that are where we're losing some of that benefit is related to this dilation of the heart and the resultant cardiac arrhythmias that come about.

One of those arrhythmias is atrial fibrillation. And it, it's, there's not a whole lot you can do to identify who's at risk or, or what's what to do about it. ⁓ many people are able to continue being athletic just by treating that with medications. Some people can get ablations, electrophysiological ablations to take care of it. And some people unfortunately are.

not able to, they end up having to give up their endurance pursuits because of it. Fortunately, that's a pretty small number. I have not worked with too many athletes that have been affected by this, but I have heard from many who are. And as I said, most of them go the route of either medications or ablation or both and are successful in dealing with it, but it does take some time. unfortunately, there's just no real good way of knowing who's going to be.

who's going to find themselves in that boat and how to prevent it.

Any comments there Paul? ⁓

Yeah, you know,

I've had, you know, several ablations or two ablations for ventricular tachycardia. And my cardiologist thinks that the VT is definitely gone, but there's still some arrhythmias that show up, especially in one thing we noticed was that caffeine.

Mm.

You know, I had a lot of caffeine before a race and had a lot of arrhythmia that, know, some kind of arrhythmia that during the race. And I recently did one, a gravel race where, um, it was like 95 or, you know, some ridiculous temperature. And I had a blip during the race. The cardiologist says that we're okay and that I can continue. uh, there's no danger in what I'm doing.

but I'm certainly very aware of it.

Yeah, yeah, it's not a pleasant feeling. And we know that there are certain things that tip people over. Caffeine is well known as one of those things that if you take too much, it can be a stimulant. there are other stimulants that supplements that people take that act as stimulants as well. So people need to be aware.

Have you heard of anything about sugar as a stimulant, as a thing that kicks off arrhythmia?

I mean for my kids, but not so much for the heart, no. Sugar on its own, as far as I know, I've never seen anything that links it to arrhythmias.

Hahaha

Hahaha

Yeah.

Okay.

What are the general symptoms that a person, an athlete would experience where they should go and ⁓ knock on your door or their local GP to get this looked at?

So the biggest thing that I think, you know, when we look at deaths in sudden deaths in endurance sport, inevitably when you talk to the families or the friends, you find out that none of these came about without any kind of warning. And invariably the person was mentioning that they had something amiss before and they kind of ignored it. Now,

Chest pain is obviously the big one. Chest pain or palpitations. Palpitations is the feeling of your heart racing. These days, everybody's wearing a heart rate monitor. So, I mean, if your heart is racing and you look at the number and it's something crazy, that's an indication you probably need to go get checked. If you're not wearing a heart rate monitor, just take your pulse. But that tends to be the minority. Most of the time, what people will complain of before something bad happens is that they felt fatigue or shortness of breath.

At levels of exertion far below than they would normally expect to. And they just kind of swept it under the rug because they attributed it to, ⁓ I, I just had a busy day or, ⁓ I was overtrained or, I'm just anxious about this race coming up. And these are really subtle things, but they can be incredibly important. And so I always warn people if something doesn't feel right, if you're out doing a workout, you're doing a very easy kind of pace on your run and you just.

cannot, you just feel like you can't push it to the next level when you should be able to, or you feel weirdly out of breath, or you look at your heart rate and your heart rate, instead of being 120 where it normally is, it's 150, and that doesn't make sense. That's a warning sign. That's a red flag. And that's something to consider getting checked out, especially if you have a family history or if you have any of the known risk factors.

Hmm.

for heart disease, those risk factors being, well, smoking, don't expect too many. Endurance athletes will be afflicted with, but family history is big one. ⁓ Cholesterol or lipid levels, hypertension, those are the main ones that might afflict people who are still endurance athletes. Male sex and advanced age.

you

Yeah.

So Jeff, on your podcast, you have recently explored trends like cold plunges, shark deterrents, and cooling recovery blankets. What kind of framework or criteria do you use to assess whether a new tool or a trend is legitimate or just hype?

Yeah, that's a good question. So I go into everything. I, we get a submitted a lot of questions. A lot of the questions are around things that you put in or put on your body and people want to know is the marketing hype worthwhile? Like, should I get this thing? And basically we always start with looking at whatever published evidence there is. And my criteria for looking at evidence and sort of gauging whether or not the evidence is worth its salt is.

What's the quality of the research? In other words, has the research been published in peer-reviewed journals? It doesn't have to be big highfalutin medical journals like the New England Journal of Medicine, but there are a lot of exercise science-based journals that are peer-reviewed. So has it been published there? Has the study been reproduced? Just because somebody publishes a one-off study, that doesn't mean anything. If it's been reproduced and shows the same results, that's a little more compelling.

Is the study independent? In other words, if the maker of product X is also the person who's doing all the studies, that generally suggests that there may be some bias in the results. And while it doesn't mean the results are not correct or accurate, it does make me kind of look at it a scant a little bit and with a little bit more of a jaundiced eye. I want to know if the studies are large. So if a study is done and it's, you know, it's, they're telling me that based on a study of five people,

our product is fantastic. That's not great. If a study is a large randomized control double-blinded study, which is the best possible research study, then I'm going to give that a lot more weight than the study that's done on like five people who self-identified. So there's lot of understanding of how research is done that goes into my interpretation of these studies that I bring forth on the podcast.

I will present these studies and explain why I like one over the other or why I think that these studies are great or why I think they're not so great. But the, the, the big thing is the studies need to be untainted by whoever it is, is making the product. And I want to see a good repeated quality of evidence that makes me think that, yeah, this is actually worth what it's worth. And I will say that in almost 200 episodes, I think we're, we've kept track. I think we're at about 10 things that have.

turned out to be worthwhile.

10 out of 200. Yeah.

Something like that. I think 10

Yeah.

is

overstating it, but yeah, it's around that.

Well, what's the shortlist? Yeah. Yeah.

Well, what? Yeah.

It's a short list. Yeah.

So not all the 10 things are like that. Listen, here's the problem. If you go to like Huberman, he's going to tell you everything is life changing. He's going to, he's going to blow smoke up your butt and he's going to tell you use this protein, this Wolverine stack. It's going to change your life and you're going to wake up tomorrow. It's so much better than you were today. That's not what I do.

What I do is I unfortunately tell people, know what, the science shows that X doesn't work and that Y, while Y actually does work, it really doesn't work that much. It gives you a tiny little benefit because at the end of the day, what really works is putting in the effort yourself. And all of the things that I have found that actually show some benefit, they're

They're small benefits. They're not dramatic. They're not anywhere close to what the influencers will tell you or the people who are being paid by whatever will tell you. So the short list is short and they're mostly natural things and things that you can do without making a whole big change. So for example, sleep, you get good quality, good quantity of sleep. can improve your performance and training and in racing dramatically tapering do a

Good taper, a good one to two week taper has been scientifically proven by our friends at McMaster University of all places, the first people to show it. They showed it very, very clearly that a good solid taper will improve your performance in a race by as much as 25%. Now 25 % is probably overstating things, but still we know that a good solid taper works really well. Caffeine.

Caffeine definitely gives you a boost. Now the boost is small. And the thing about caffeine is that it's not so much that if you take caffeine, you're going to get a boost. It's more that if you don't take it, you're kind of putting yourself at a disadvantage because everybody is taking it. So caffeine's a big one. and it's the opposite of sleep. So that's kind of also a weird one. ⁓ your microbiome, take care of your microbiome.

You

Yeah.

⁓ turns out that the bacteria that live in your gut are vitally important, not just to your overall health, but to your performance in endurance sport. We reviewed a couple of very, very interesting studies that showed that taking antibiotics for whatever reason wipes out your microbiome and impacts your ability to perform endurance sport because it impacts your ability to digest the kinds of long chain carbohydrates that you need in order to perform.

So microbiome, very, very valuable to performing well in endurance sport. Spirulina. Spirulina is a blue-green algae that has been shown to actually confer quite a few benefits in endurance sport. Not totally clear how exactly. It seems to be one of these magic sort of plants, but ⁓ it's very healthy.

Chalk full of B vitamins and iron and all kinds of good things and honestly, even if it doesn't give you any kind of boost, it's nutritionally really a good thing. So spirulina, very good for you.

Yeah.

Tarte cherry juice. So if you are a fan of cycling, you know that every time a cycling stage finishes, one of these soigneurs is very quick to hand over a bottle that is this deep red colored juice. And the cyclist will quickly down a bottle of that. Well, it turns out that's loaded with tart cherry juice, which is the juice of the Montmorency cherry. It's full of...

It's.

chemicals that are polyphenols and works very well to help with recovery. It's also full of melatonin, also very good for recovery. Melatonin itself is not a performance enhancer, but melatonin has been shown to help with helping with jet lag recovery. So if you're traveling to different time zones,

using melatonin has been shown to be helpful for some people, not across the board. Beetroot juice. Beetroot juice is limited in its ability to help people. First of all, it helps men. It does not help women so much. I interviewed a Canadian scientist from the University of Guelph who told me all about her research on women cyclists who were using beetroot juice. And it turns out that women already have

naturally high circulating levels of nitric oxide, is the chemical that beetroot juice helps you sort of liberate. So men get a bit of a boost with beetroot juice, but only when they are doing sort of short activities. So crit cyclists, for example, or a short sprint triathlon, something that's within an hour, maybe two hours, because beetroot juice is metabolized so quickly that it doesn't really stick around for very long. So.

Beat reduce can be helpful for men doing short activities where they need big boosts of power.

And then the other thing that we found in the science on this one is a little bit mixed, but I, but it was good enough that we thought it was worthwhile because it's a natural plant derived product. It's called Quercetin. And basically when you do a very hard workout.

Like it's well known that if you do like an Ironman or an ultra that the just doing that kind of hard workout suppresses your immune system for about 24 to 48 hours and makes you susceptible to viral illnesses. Now it doesn't mean you're going to get sick. You have to be exposed to something. Like if you were to sequester yourself, then you wouldn't get sick. But if you were get on an airplane or to be around other people who happen to be sick, then you would be more likely to get.

whatever they had because your immune system, especially the system that fights off viruses tends to be suppressed in that 24 to 48 hour window. Well, taking a quercetin supplement actually seems to confer some protection to athletes, but not to non athletes. Interestingly, to prevent that kind of, to support your immune system so that you are less likely to get an upper respiratory tract infection. Quercetin is not terribly expensive.

Hmm.

I don't take it year round, but once the cold season starts, I start taking it because when I have hard workouts and my kids are always coming home from school and bringing things home, I just figured why not? It's one of those things that doesn't really hurt. It's a, it might help. don't promise it will. And you know, with regards to all these things, it's like I said, all of them, it's really marginal, tiny little benefits in terms of training outcomes. And I interviewed somebody on my podcast names Chris Bagg He's a coach in the Northwest.

lives in Bend and he came on my show and he brought to me this concept of, know, are you going to chase antelopes? You're going to chase mice. And the idea being that, you know, if you're a professional triathlete or professional athlete of any kind, and you're operating in the 98 to 99 % of your physiologic capacity, then it makes sense to spend a lot of time looking for a marginal gain, a mouse to expand all of your energy on whatever it takes to get that tiny little fractional improvement. But if you're like me.

And most age groupers who work a regular job, who have a family, have all these responsibilities and instead are spending all of, know, or maybe operating at 70 % of our physiological capacity. we're lucky, then why are we looking for these tiny little one or 2 % benefits that we get from hunting a mouse? Instead, we need to expend our energy hunting the big game, go for the antelope, get something that's going to bring us a lot of return on our investment.

And it's not going to be supplements. It's not going to be any kind of little, you know, device or gizmo. Instead, it's going to be investing in ourselves. Put in an extra hour a week of training, get yourself a coach, do this, do your training at a higher quality. Don't just put in the hours, but put in the hours at a higher quality and investing in yourself is the way to get a much higher return on investment than any of these other things that people like to spend their money on. So antelopes.

Not mice.

that is awesome. That's so good. I mean, I even think about it sometimes with the amount of money that people spend on bikes, right? And sorry for all the bike owners or bike company owners that are sort of out there, right? But it's like, you know, if you invest more time in tuning the engine versus the aerodynamic efficiencies and all these various things, know, granted there's some one percenters to be gained there, especially at the elite level, but yeah, engine first.

Love it. Love it.

I'm not going to disagree with you on that, but I am going to disagree with you on that because, ⁓ because I'm, I, know, when I got into the sport, one of the first things that someone said to me was like, look, the amount of money you spend and the amount of benefits you get when you buy a bike, it's ridiculous. It's like you're spending all this money. You're getting no benefit, you know, spend it on the other thing, shoes and you know, whatever a hell, a Aero helmet, that kind of stuff. And I'm like, yeah, yeah. And I went out and I bought a bike anyways. Right. And the thing is, is like, what makes you feel better?

Okay.

Mm-hmm.

Ha

ha ha!

looking at the helmet or looking at the bike. And now I have a son who's into the sport and he's starting to ride. And the kid is, I mean, he's so strong. He's like, he's, he's, he's a cross country runner. So he's bringing this amazing aerobic engine, weighs a buck 20, he gets on a bike and he just shoots up mountains and he's just amazing. And, you know, I gave him.

That's true.

Hmm.

Yeah, yeah.

I had a really nice bike, which he's now riding and he loves, but he sends me reels every day about how he needs a new bike. And, and I get it because you know what? There is a psychological benefit and we know that our mindset has a lot to do with how we perform. And I, I tell my athletes all the time, please do not go out and spend money on a bike, but if it's going to make you feel better, if you have the resources and it's

Yeah ⁓

gonna, you know, if it means that much to you, I'm not going to stand in the way because I know how good it feels to show up and be really excited about your bike. So I don't disagree with you at all, Paul. I totally get what you're saying, but at the same time, I also know, you know, I know how we all are.

Yeah.

For sure.

But you let off around bias and these sorts of things. I'm biased with, it's kind of been my life.

life's journey is researching, training. So I'm going to come with that bias. But nevertheless, I do still enjoy riding a good bike as well. So I take your point equally.

Yeah.

Definitely.

Jeff, you've talked in the past about how triathlon has changed your life and became a pillar for mental health, particularly during the tough times like during the pandemic. Can you expand on the connection between mental resilience and physical training?

yeah. I love talking about that. Thanks for asking. So I mean, in my, I left clinical medicine, ⁓ back in November, I now have a work from home job still in medicine, but I don't see patients anymore. And that has been a great mental health thing. But, when I was working in the emergency department is incredibly stressful job. It was a really, really hard job. And, you know, I would come home after those shifts and.

for me to be able to get out on my bike or go for a run. That was my time to be in the quiet, to be in my own head space and to really just decompress completely. doing physical work, doing physical activity is just, I have found one of the most amazing ways to stabilize and to level set when you have.

other areas in your life that are so stressful. And even now that I'm not in that kind of world anymore, where I'm not working in a very stressful job, having the ability to then go out and do the physical activity just brings me immense joy. It's helped me learn how to adapt in all kinds of situations. It's helped me be a role model for my kids. My kids have incredible amounts of

dedication and work ethic. And they continually say they got that from watching me, from watching me do the things that are hard when I didn't want to. I was tired and yet I said, I have to get this workout done. And so I just went and got the workout done. And now they're the same way. And they're incredible students, incredible athletes, and just incredible human beings. And I just, the, the way that

Triathlon has brought so much to me in terms of my health, my overall state of mind and my family life. It's just been an absolute joy. I, I always encourage people to remember that as much as what we do in endurance sport is a selfish pursuit because we are doing it on our own time, we are taking away from others when we do it. It's still a team sport.

Get your family involved as much as you can. Make sure they're on board with what you're doing. Make sure they understand the why. Make sure they understand the when. Make sure they can be involved in as many ways as possible because when they are, it is so rewarding and just such a joyous part of your life. And I just can't say enough about how it's just made my overall wellbeing and my family's wellbeing that much better.

And then you could just send me an email, t-r-i underscore d-o-c at iCloud.com. I'd love to hear from you.

Amazing. We'll include all of those links in the show notes. ⁓ yeah, just, Jeff, thank you so much for coming on. You've just been an absolute legend. And I those topics that we covered. I learned a heap.

it's my pleasure.

Thanks, Jeff. And thanks for listening today to the Athletes Compass podcast. Take a moment now, subscribe, share, and let's keep navigating this endurance adventure together. Improve your training with the science-based training platform, Athletica, and join the conversation at the Athletica Forum. For Dr. Jeff Sankoff and Dr. Paul Laursen I'm Paul Warloski and this has been the Athletes Compass podcast. Thank you so much for listening.