The Food Medic - S6 E4: Maximising recovery in sport and exercise with Dr Marc Bubbs

Episode Date: July 27, 2021

Dr. Marc Bubbs is the Performance Nutrition Director for Canada Basketball and performance nutrition consultant for a portfolio of professional and Olympic athletes preparing for Tokyo 2021. Marc is the author of the highly-acclaimed and best-selling book PEAK – The New Science of Athletic Performance That Is Revolutionizing Sports which highlights the tactics and strategies of elite athletes and performance staff in professional sport. His upcoming new book PEAK40 – The New Science of Mid-Life Health for a Leaner, Stronger Body and Sharper Mind has just come out this May. Marc is also the host of the Performance Nutrition Podcast.This episode covers:- Marc’s background and current projects - Overtraining vs under recovery - The recovery pyramid - Recovery nutrition: The big 3, micronutrients, supplements - Alcohol and recovery- Exercise and immunity - Strategies to monitor recovery - biomarkers, HRV, wearables- Popular recovery strategies; Cryotherapy, Cold + hot therapy, percussive massage guns, CBD oil.- Sleep and performanceIf you loved this episode make sure to give it a review, rating (hopefully 5 stars) and share it with your friends and family. instagram/twitter/facebook: @thefoodmedicwww.thefoodmedic.co.ukThis podcast episode is sponsored by WHOOP. Right now, you can get your first month free when you checkout through join.whoop.com/thefoodmedic Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit podcastchoices.com/adchoices

What's better than a well-marbled ribeye sizzling on the barbecue? A well-marbled ribeye sizzling on the barbecue that was carefully selected by an Instacart shopper and delivered to your door. A well-marbled ribeye you ordered without even leaving the kiddie pool. Whatever groceries your summer calls for, Instacart has you covered. Download the Instacart app and enjoy $0 delivery fees on your first three orders. Service fees, exclusions, and terms apply. Instacart. Grocer $0 delivery fees on your first three orders. Service fees, exclusions and terms apply. Instacart, groceries that over deliver. Hey everyone and welcome back to another episode of the Food Medic podcast. I'm your host as always,

Dr. Hazel Wallace, medical doctor, nutritionist, author and founder of the Food Medic. Now today I am super excited to be joined by Dr. Mark Bubbs who is the Performance Nutrition Director for Canada Basketball and Performance Nutrition Consultant for a portfolio of professional and Olympic athletes preparing for Tokyo 2021. How exciting! Mark is also the author of the highly acclaimed and best-selling book Peak, the new science of athletic performance that is revolutionizing sports which highlights the tactics and strategies of elite athletes and performance staff in professional sport. His upcoming new book Peak 40, the new science of midlife health for a leaner, stronger body and sharper mind has actually just come out this May. And Mark is also host of the Performance Nutrition Podcast. So

what better guy to have on the podcast to talk all about maximizing recovery in sport and exercise. So this episode covers Mark's background and his current projects but we also talk about overtraining versus under recovery the recovery pyramid recovery nutrition exercise and immunity and popular recovery strategies so things like cryotherapy cold and hot therapy massage guns CBD oil and of course we can't talk about recovery and not talk about sleep again so sit back take notes and i hope you enjoyed this episode today's podcast is brought to you by our sponsor whoop whoop is one of the most popular fitness wearables right now it's a 24 7 digital fitness and health coach that provides actionable insights to help

you recover faster, train smarter and sleep better. Whoop is unlike most other wearables in the sense that it doesn't just tell you what you've done but it tells you what you really need to know. So I've been using my Whoop for a few months now and I am so impressed with the amount and level of insight it can provide you. So each morning when you wake up you get a recovery score from Whoop based on your sleep and other recovery metrics such as heart rate variability and resting heart rate. That score helps to guide your day whether you should push yourself and go all out, pull it back a little or actually just take a rest day. The greatest feature for me is the built-in sleep coach, which lets you know how much sleep you should be getting based on your expected activity for the

following day. It also tracks all four stages of sleep, so you can get a breakdown of how much REM and slow-wave sleep you got. It's allowed me to figure out ways which work for me to optimize my sleep. Whoop can help anyone perform better. Whether you're preparing for a 5k, training for an event or just looking to build healthier habits, Whoop can help you make smarter lifestyle decisions with data that is personalized to you. Right now you can get your first month free when you check out through join.whoop.com slash thefoodmedic. So I guess, first of all, Mark, I would just love to hear a little bit more about you and your background and also what you're doing at the moment,

because I know you're doing some really exciting things. Yeah, absolutely. Listen, thanks for having me on. And it's been quite a journey over the last sort of 20 years of working in sport and nutrition. For me, it was really being at university, thinking about nutrition and exercise and how it impacts health. Of course, at that time, nutrition wasn't really at the forefront of a lot of people's

minds, whether it was in medicine, even in sport. Sport dieticians weren't even a thing in the late 90s, early 2000s. I pursued more you know, more studies in nutrition and exercise and worked as a trainer and started working in the field of working with Canada basketball now as a performance director and getting our team ready for the, our Olympic qualifiers this, this summer for, for Tokyo 2021. And then I also consult with, you know, various athletes, professional athletes, a group called Altus out in the USA, which is an elite group of sprinters. And so there's that performance side of things and then work in general practice as well.

So helping people feel better and lose weight and improve their blood pressure and things like that. Cool. And just before we started recording, we were chatting about your book. So you already have one book out. You've got another one coming out this month. Yeah, the first book was Peak, and that was a deeper dive into athletic performance and what we see on the front lines of, again, elite and professional sport. And the new book is really on the a lot of the coaches and performance staff being in midlife and how busy and stressful things can be and trying to find more simple rules and heuristics to guide people through that busy period. And so that's where Peak 40 is the new book. And we look at how to simplify things and support people in that really hectic time of life.

Yeah, absolutely. And probably a time of life that gets less attention when it comes to sports and performance. So it's good to have that available. So obviously, you have this wealth of knowledge that I'd love to tap into. But for the purpose of this podcast, it would be great to focus around recovery from sports and exercise. And I think that's something that people really undervalue. But I think, first of all, I'm just going to ask you the question, why is recovery important? And what are some of the signs that we are under-recovering or over-training?

It is a fascinating area and definitely one that's exploded over the last decade in terms of the science of recovery. And when you ask researchers and recovery experts like Dr. Shona Halston down at Australian Institute of Sport, the general working definition is that recovery is what allows athletes to train at their highest level and also to compete at the best of their abilities. And so it's not just the recovery from the training session that you've just done, but also the nutrition, the recovery modalities, et cetera, that you're going to do in order to prepare for that next session. And so when we look at the elite side, we can definitely get into, I mean,

the goal is to stress the body in training. And so we elicit that adaptation and, and that's what we call functional overreaching, which is pushing the body just beyond what it can do. So we can elicit that positive adaptation. But of course, we can push a little bit too far over the line and we can get into some what's called non-functional overreaching, which is when we're pushing a little too hard. And if you do that long enough, then you end up into this overtraining situation where that impacts mood, immune system, system energy levels all these types of things and that's something that we're gonna you know see more in those elite recreational elite type athletes whereas when we swing over to the general

population it can definitely feel like we're over training but typically what we see is just under recovery and again if we think of all the things that go into someone's training plan, well, the rest of your life, the busyness of your life, how long your work days are, the amount of sleep you get, mental, emotional stress, all of these things add up as well. And so that idea of, and since we know, you know, most of the general population, unfortunately, you know, it's getting less than seven hours of sleep. You know, I think it's up to 30, is getting less than seven hours of sleep. I think it's up to 30% are getting less than six hours of sleep. And so that notion of under-recovery is really at the crux of it with the general population.

Yeah, that's a very good point. We often forget about the other kind of things that are happening in our life and the external stressors that exist as well outside of training. So what are the fundamental principles when it comes to recovery? I know that you talk about the recovery pyramid in your book, and I think that's a really great way to frame the conversation. Yeah. I mean, when we think of recovery, I think automatically, you know, even athletes will start to think of the tip of the pyramid, which is the recovery modalities, you know, even athletes will start to think of the tip of the pyramid, which is the recovery modalities, you know, whether it's using a Norma tech or massage or

hot and cold tubs, things like that. But really when we think of recovery, this, the idea of a pyramid, and this comes from, I mean, it's used extensively in sport, but one of the experts that I interviewed for the book, Lachlan Penfold, who was the performance director for the Golden State Warriors in the NBA, and of course, works over in Australia for the Melbourne Storm. You know, this idea that sleep, nutrition, and mental, emotional health, and that third one being something that's actually quite new in the performance space of really accounting for, you know, how someone's actually feeling, because that is a load on the body. It is a stress load. And so those are really the big buckets in the base

of that pyramid. And if we're struggling with sleep, you know, if we're not getting that minimum seven hours for athletes, we try to push up towards that eight hours a night or 50 to 56 hours per week. If we want to think about it that way if the nutrition is not on point in terms of the total energy protein etc if we're struggling to cope with the stressors then you know it doesn't really matter at that point if you're doing hot versus cold or or these other recovery modalities because we've missed you know those bigger rocks in someone's regime yeah it's so important it's very easy to get bogged down by you know theiae, which we'll come on to a little bit later on in terms of popular recovery strategies. But focusing maybe on recovery nutrition first, talking about kind of the main macronutrients, micronutrients, and then maybe some supplements that you'd recommend when it comes to just kind of the fundamental recovery nutrition principles? Yeah, absolutely. I think the biggest one is just energy intake, you know, aka calories. And

typically with clients like to reframe that conversation a little bit away from the term calorie because it can, you know, it does bring a lot of baggage with it, depending on the individual and whatnot. So when we talk about energy, I mean, yeah, that's the amount of fuel that we're consuming. And that is the biggest signal. You know, if we think about signal versus noise, and, you know, right now we can hear each other really clearly, but if there was lots of background noise,

then all of a sudden, you know, that signal isn't heard. And so when we're thinking recovery, we want that signal that's going to promote that recovery best. And that really is the total energy intake. And so, again, at the highest level, if we're talking basketball players, football players, etc., all that stopping and starting accelerations, decelerations, the amount of energy required is tremendous. And so you're getting up to 4,000, 4,500 calories potentially on certain days of the week. And so that's one where,

you know, if we're not eating frequently through the day, inherently anybody, if general population or athlete, if you start to get run down or tired, it's tough to, you know, your appetite tends to follow. And so we can fall into what we call a state of low energy availability, which is basically saying, you know, we're not consuming enough calories to meet those demands. And that's where, you know, things can start to go wrong. We can start to experience some dips in immunity and be more immunocompromised, potentially catching more colds and flus. Muscle soreness can be more prolonged, these types of things. So that first one is definitely the total caloric intake.

From there, we want to think about protein. Use the analogy with athletes. If they're a house, then protein is the bricks. And so the more active somebody is the more bricks we're taking out of the house we've got to put those back in with the protein intake and so you know the minimum intake being around 1.2 grams per kilogram per day and again when you're in an energy surplus you can get away with that minimum as you're training more intensely and you know more elite athletes are getting ready for, let's say, a national competition or an international competition like the Olympics.

That's when we start swinging that pendulum up higher towards that 1.6 or up to 2.2 grams per kilogram per day. Now, for your listeners who are on that sports side of things, this is where it can get a little bit tricky because sometimes our athletes tend to focus so much on protein that then it fills them up, right? Because it's more satiating. And now we can actually struggle to get enough total fuel in. And so it does take a little bit of having that coach's eye on the nutrition intake to be able to see generally where our athletes are at. And the last one really is carbohydrate. And that's the one that's providing the bulk of the energy and of course the one that online these days is the

most polarizing around you know whether it's low carb high carb etc and for athletes this can swing anywhere from three grams per kilo all the way up to you know 10 grams per kilo which is a massive massive swing and so at that point it really depends on the individual the sport if there's body composition requirements etc and then i guess moving into any particular like supplements that you'd recommend on top of that is i know that we touched on protein as one of the kind of big three and i guess when you're talking about people who are at elite level you're probably going to utilize supplementation there to make sure that you're getting good sources of protein but is it something that you think is essential in in recovery for recreational athletes you know

the gym goers that might be listening to this podcast yeah and that's where even if we circle back to the big three there i mean i think this is where if clients are, you know, the right now two thirds of the population in Canada or the U S or the UK are, you know, unfortunately overweight or obese. And so the training is to get fitter and to build muscle, but it's also to lose weight. And so this is where we need to be strategic with trying to get into a little bit of a deficit so that we can facilitate that weight loss, but not so much so that we then start to impact energy levels and progressions really. Because one of the things that's always tricky with clients is we're so focused on the scale that, you know, the steeper you reduce caloric

intake, the more muscle mass you're going to lose and muscle mass weighs a lot, right? And so this is where the scale will move down, but unfortunately it's not the kind of weight we're really trying to lose. And with that, of course, comes glycogen and water. And so really having that long view is so key when we're looking at improving body composition or weight loss, because even if you're losing, you know, half a percent to 1% of your body weight per week, that's a really nice clip for weight loss. There's always going to be that distinction of, you know, who are we talking about in the conversation? Is it more that recreational or that athlete? Or is it that person who's, you know, trying to lose 15, 20 pounds and improve their health? Yeah, of course, context is really important there. But I guess thinking about over in the

recovery period, which I guess extends in the 24 hour window anyway. Is there any supplements that you think are key, like magnesium for sleep or anything like that? Is there anything that you'd recommend for the general population or focus on food first and worry about supplements later? I think a great place to start is to think about supplements as portable nutrition. So again, if we're trying to achieve that minimum protein intake of 1.2, or as you go up that curve, that sweet spot where you really get the most bang for your buck without having to go all the way up the ladder is that 1.6 grams per kilo. All of a sudden it makes it much easier if you can have a protein shake, whether it's whey or plant-based,

that's going to give you 30 or 40 grams to provide a nice dose all at once. And it's convenient and it tastes nice. And so that's probably the first place to start would be protein. And if we circle back to even dietary protein, when you increase protein in your diet, one of the overlooked things is that you then get a concomitant increase in your vitamins and minerals. And so it's like consuming a multivitamin as you increase that intake. So protein would be one. From there, more on the athletic side, we would think more carbohydrates. And that could be in a supplement form. It could be the use of things like even juice, which again, this gets to be a little bit polarizing in a sense that for athletes,

it can be quite essential and important. Yet for the general public, we would probably tell them, well, we don't want juice. We don't want those extra calories. Let's consume water only, depending on the exercise, et cetera. And then one that gets often overlooked really, and it's impact on recovery versus actually, we always think of muscle mass and building muscles when we think of creatine, but it's tremendous for recovery. And so for clients who are training for a marathon or training for a triathlon or an Ironman or what have you, creatine can be really beneficial for reducing exercise-induced muscle damage, for reducing inflammation, for reducing these things that are going to make you

make it feel as though you're not recovering well and make it harder for you to get out there the next day and compete and train again for those types of long events yeah interesting and then I guess before we move on from nutrition I want to quickly touch on alcohol I think you know a lot of people I know who go to the gym and even like people are quite big into CrossFit and maybe compete at local events and things like that still love alcohol and love going out in the events and things like that still love alcohol and love going out the weekends and things like that. And, you know, you got to live a little. Personally, I feel like as I'm getting older, I really don't recover after drinking even one or two drinks in terms of my sleep, my heart rate. And I guess I wanted to touch on that. How does alcohol impact recovery?

What's happening in the body? This is a fascinating one with all the new technology we have to assess one's, let's say even heart rate overnight, because we know that alcohol is a powerful suppressor of REM sleep, which is that deeper form of sleep where even cognitively we're making all those connections and synergizing a lot of the information that we've taken into the day. But from that central nervous system standpoint, when we look at your resting heart rate through the night, so let's say, you know, a client might have a resting heart rate of 60, let's say. And then after a glass of wine, they realize that through the night after that, their resting heart rate was 70 or 72 beats.

So we had an increase in more demand on the nervous system. And of course, it gets even more pronounced when we start to see that two or three glasses and now rather than 60 beats per minute, you're up to 80 or 85. And so we can then really start to appreciate and clients can, you know, it turns the lights on pretty quick in terms of the realization that, yeah, it is having an impact on how well you recover. And so, you know, it's about finding that middle ground so that certain individuals who like to have that one glass of wine every single night of the week, they might start to realize oftentimes when we get them to maybe try Monday, Tuesday, Wednesday, no alcohol. And all of a sudden we can stack a few nights in a row of some better sleep quality and then start to make those connections around, you know, finding the right balance because definitely that work hard, play hard and taking the edge off in the evening with some alcohol, which we know is unnerving. So it will help to have that sensation of relaxation. But of course, once we go beyond, you know, a glass and all of a sudden it's going

to compromise recovery. And then next morning, all of a sudden we're waking up and now because we're groggy and we're slow, we're going to be looking for more caffeine. And some really interesting research out of Bath University there, Dr. James Betts found that if you've had a really bad night's sleep, if you reach for that coffee first thing in the morning, it really exaggerates your, you know, your glucose response and your inflammatory response. So it's interesting how, you know, our natural reaction, if you've had a bad night is to reach for that pot of coffee. But if you can actually delay that a few hours and maybe it's a green tea

or maybe you just have a bit of breakfast beforehand, you can actually improve that response. Yeah, so interesting. It's interesting that you mentioned the straps. I recently only started wearing a whoop over the last couple of months. And during our last lockdown here, I wasn't drinking alcohol at all and then as things

started opening up I started going meeting friends for a drink here and there and the impact it's had on my recovery and my sleep that's I'm kind of measuring via my whoop has been just every single time it's you can predict that it's going to be like red recovery my heart rate will be higher my heart rate variability will be lower and so it's so hard to ignore that data I mean it's kind of encouraged me to take a step back and you know if it's a weekday night and I know I've got a big day of work the next day I'm like I'm not gonna not gonna have a drink tonight because I know I'm it's gonna impair my sleep make it tough the next day. I'm like, I'm not going to have a drink tonight because I know it's going to impair my sleep. Make it tough the next day, right?

Yeah. Yeah, absolutely. And so kind of speaking of trackers like Whoop, and I know that lots of smart watches now track sleep and heart rate and things like that. What do you think are the best strategies for monitoring recovery? Do you recommend getting these devices

or are you seeing any biomarkers? I mean, it's a great question and definitely one, you know, at Canada Basketball, we use a variety of tools over the years. And, you know, so we have objective measures like the HRV or subjective metrics, like just asking the athlete

or the individual how they feel. And, you know, it's interesting because when we look at the science around recovery, there still is no one biomarker that's going to tell us for certain that an athlete's recovered. And so we're always looking at this constellation of blood biomarkers to give us, you know, the best possible chance of seeing what's going on. And of course, we need to pair that with the subjective perception, which is actually pound for pound stacks up pretty nicely still against the objective so it's really interesting to see that we've got to marry the sort of art of the practice of the coach's eye with the subjective data that we're also getting and so it is valuable to have you know to know what

your resting heart rate is in the morning or if people want to measure hrv i would suggest and when you talk to experts you know like dr andrew flat i had on my podcast a few years back and talking about whenever we're tracking of trying to start with the question, why? Like, why are we wearing this device? What is it that we're trying to improve? So we can always have that North Star because it's easy once we get into looking at these things to start making acute decisions. You know, like one night of bad HRV and all of a sudden the next day we're going to change our training plan and so the experts recommend that we do take a couple of months and just observe right see what's going on don't make any changes try to see if you notice any patterns that emerge

and they'll tend to use if we use example of hrv a seven day rolling average so you're looking at your weekly averages to see how things are are playing. And of course, you know, HRV does track nicely with longevity. And so it is a valuable thing to look at, but it does have a bias more obviously towards the cardiovascular system and endurance sport. So when we look at the data around team sport, it gets much more noisy. And so we've always got to check ourselves a little bit with some of these things and make sure that we're not over-interpreting. And I think that's probably more cause for concern in the general population. I think because at Elite Sport, they've been doing these things for so long, that's probably one of the lessons they've learned of tracking too many things.

And now you see a lot of teams and organizations trying to pare that down to saying, what are the few key markers that we really need to keep our eye on without sort of overwhelming even the data collection staff and everything else. So I find it fascinating that that objective markers and still the subjective of just asking an athlete how they're feeling or how they recover, you know, on a scale of one to 10 is still a pretty darn good way to see, you know, how you're doing. Yeah, I completely agree. And just before we move on for people who aren't maybe familiar with HRV or heart rate variability, what actually is it measuring? What does it tell us? And what are some of the things that might impact it? Yeah, so HRV heart rate variability, if you think of if someone had a heart rate of 60 beats per minute, so that's one beat per second for a minute,

there's actually quite a bit of variability between each of those beats. And. So that's one beat per second for a minute. There's actually quite a bit of variability between each of those beats. And so, you know, as we're more recovered, this sounds a bit counterintuitive, but as we're more recovered, we get greater variability. And that is generally a reflection of better recovery. You know, as we're lacking sleep, as we're pushing to, you know, quite hard in training, or if we're not consuming enough energy in the diet, then that's going to be a bigger stressor and we start to see lower scores in terms of HRV. Now, again, on a day-to-day basis,

there can just be some noise in there because it impacts, you know, did you get a nasty email from someone or did you have a tough day at the office or what have you? All these things can impact. And so you do have to take a longer view of it, but it is a nice thing that can collect passively these days. You can just be having it on your ring or your whoop watch.

And then preferably if you have a coach or a practitioner or a doctor who can help you make sense of some of that data, just as another piece of information to add to what you have to then say, okay, what does this tell us about the individual? What is this, the picture that it's starting to paint? And then we might be able to say, okay, that training plan, you're, you know, you're pushing too hard, or perhaps we have a lack of feeling here or there. Yeah, absolutely. And then earlier on, we mentioned some kind of recovery strategies that people are really becoming fascinated by at the moment, like hot and cold therapy, cryotherapy.

For sure. You know, the list is endless. And I'm seeing them more and more, and I'm being asked about them more and more. And when I told everyone that you're coming on the podcast and we were going to be discussing recovery, these were the topics that were coming up. Like, is there any evidence for this?

Should I be doing this? And so I think it'd be interesting to kind of go through them maybe one by one, perhaps starting with cryotherapy, which has recently become quite popular in London. Yeah. Cryotherapy is definitely, you know, the last five years has sort of exploded in North America as well. And, you know, this is where you're standing up in a tank and effectively being blasted with sub-zero temperatures. You're getting into like the minus 100 Celsius. Now this only lasts for a couple of minutes, but you do get this effect of seeing the steam rising

up. And so it has a real sort of visual impact. The interesting thing with cryotherapy is that's actually happening, that's air that's being being displaced and so when we think of conductivity so thermal conductivity air doesn't conduct nearly as well as water and so the interesting thing is despite these really ridiculous temperatures that we're being exposed to the core temperature is no different than taking an ice bath and whilst we've seen some there is a little bit of data that'll show three sessions four sessions five sessions of cryotherapy we can get reductions in perception of pain. We can improve things like muscular strength. And, you know, it's a short session and only last two or three or four minutes. So that might be a benefit. And at the highest level, you know, in the EPL, the English Premier

League, you do see some teams that have the cryotherapy devices. I would say, you know, the ultimate stumbling block for you know the rest of us so to speak in the general population is the cost as well right so you're you're having to pay a lot for this recovery therapy and when we look at when it's how it stacks up head-to-head against something like cold water immersion which is you know that scientific term for just taking an ice bath yeah the ice baths tend to come out on top and you see better results around things like muscle soreness. When we look at those biomarkers of muscle damage, like creatinine kinase, CK, if we look at muscular power indices in various exercises.

And so from a cost perspective, it's a lot more cost effective to be doing a cold water immersion, you know, 11 or 15 degrees Celsius water, which water which you know the toughest part with that is always getting people to actually do it so i would recommend you know having friends or people around or making a bit of an event of it because it's not always easy to dip yourself into those temperatures and maybe you're lucky enough to have a lake or a sea or something near you where you can just really just run and dive in. But it does have some really nice benefits on that pain front, inflammation. And when we look at cold water immersion and even mood, and obviously coming out of lockdown life, mental health is front and

center. And that can be a really interesting way of rewiring the nervous system and helping to lift mood. Yeah, absolutely absolutely and there's some evidence for you know boost in immunity as well isn't there yeah it is uh it is pretty fascinating and actually you know when we look at the other side of the coin even of hot water immersion which is going for a hot tub which is from a behavior change standpoint always a little bit that gap's a little smaller it's easier to tell someone to take a hot tub than it is even an ice bath. And for someone who's struggling with high blood pressure or poor glucose control, that's actually a pretty nice method as well. And again, it's, you know, 11 to 15 minutes and a temperature of like 100 to 104 Fahrenheit. And you can also get

some pretty nice changes. So if someone is struggling with those, you know, that can sometimes be a place to start before they muster up the courage to to go for a polar polar dip in the sea is there kind of instances where you choose cold over hot or is it again down to those kind of factors that you mentioned whether it's what someone can tolerate well this gets really interesting when we get down you know a bit more granular around what we call periodized recovery, which is depending on where someone is in their training plan. Do we apply cold? Do we apply hot? Now, you know, for the, again, for the general population, just being consistent with whatever you're doing is always the first place to start.

But it is interesting that we see, you know, immediately after a training session, if you're adding in a cold bath, that can actually blunt some of the training adaptations. So when you're trying to build up an aerobic base or build up your training volume, you know, that's typically not the therapy you want to be going to. You want to be going to more heat based. And as you, you know, those really quality sessions where you're really going to push yourself hard or, you know, competition, you know, again, if you use the NBA or the premiership as an example, you know, if you you know, again, if you use the NBA or the premiership as an example, you know, if you're playing multiple games in a week, we do need to just, you know, really blunt that, that inflammatory response, that's when the cold therapy can be really helpful. So those quality sessions, those competitive, really high intensity sessions. Yeah. Okay, interesting. And

next up, I've got Dan, like percusscussive massage guns which are really trendy at the moment um and i guess this is just mimicking like normal massage or foam rollers except obviously a bit more intense yeah these are definitely popular and it's uh you know if you think of how foam rolling and using lacrosse balls and whatnot has gained a lot of popularity over the last decade, this is almost the next level up, if you will, of just being able to sort of sit there, relaxing a little bit, if you will, and being able to use one of these massage guns on your quads or your low back or your upper neck and traps just to help dull some of that tonicity, that tension that builds up typically for the most of us because we're sitting all day in that position. And so we're not taking our muscles through full ranges of motions. And I think people, again, obviously the day-to-day nine to five, we feel it. But I think with all the zooming everyone's done in the last year during lockdown, it's kind of amplified the impact of sitting because there's no more walking

to the cooler the water cooler at work or chatting with friends and standing up for colleagues you know you're really just almost sat for even longer periods of time and so you definitely seen the massage guns seemingly making the rounds more so those can be helpful as well i wouldn't say they replace you know if you can still do a bit of mobility work taking your body through some different ranges of motion some dynamic or some static stretching you know all those little pieces really help and the nice part is you don't have to commit you know half an hour to even these things even if you can start with five minutes and start to feel those beneficial effects then you can you can start to build up from there yeah do we have any research on the effects of kind of massage guns versus

normal massage therapy i i mean i haven't seen anything to date but uh yeah i'm sure there'll be i'm sure there'll be a lot coming down the pipeline that's for sure yeah the only reason i'm asking is because lots of the brands make big statements it's just wondering if i could back them up but no no for sure and the benefit they always have is that initial kind of awe feeling you get when you you know when you go for a massage or use these kind of things and if people still have benefits or like to go for a massage I mean the one big benefit you get with a massage as well as just the fact that you're having that you're basically taking a nap for a half an hour or 60 minutes so you kind of get

your double bang for your recovery buck there yeah absolutely i guess the final thing i wanted to cover in terms of the kind of popular recovery strategies is cbd oil and your thoughts on it there obviously there's you know cbd oil is promoted for multiple different benefits but if we just focus on recovery because it's a minefield if we go into everything else. Yeah, no, it definitely is. And I would say at the highest level with professional sport or Olympic sport, the challenge is just in finding products that aren't potentially cross-contaminated. And so there's only a handful of products that are NSF or informed for sport. And so this makes it challenging even beyond, you know, we'll get to sort of the level of evidence, but that in and of itself makes it difficult to want to implement. When you look at the,

again, the research around recovery, it's still pretty sparse. And unfortunately, the doses that you see in the studies where there is an effect, the doses are actually quite high, you know, to the point where when you start again, running the numbers of how much you're spending on the oil. And again, as a, you know, as a performance nutritionist, you always think to yourself, well, wait a minute, if we spent that 100 pounds on your grocery bill, what could we get in terms of the foods we could buy? And how would that impact your recovery? And so that cost balance there doesn't really add up for CBD oil. Now, I know people get excited about it and potentially really believe in it. And so if it's someone in the general population, they feel better and there's no real potential harm,

then they obviously may want to give it a try, but it's still really early days when we look at the research. Yeah, absolutely. I think I kind of have the same line. And as you mentioned, in terms of regulation and just making sure it's not contaminated is actually really difficult because the supplement industry is very poorly regulated and doesn't go under the same stringent checks that a medicine would. 100% and there's you know there's certain stamps of approval that people can look for with supplements and again things like the NSF are informed for sport but it is just really difficult then for the consumer because they're it's hard for them to navigate but those at least those stamps will let people know that you know it's going to be free of contaminants but it is again hard to find a CBD specific product that has those those labels absolutely and I guess we already touched on sleep but I'd love to kind of circle

back to it because it's so important for recovery and performance and basically general well-being. Are there any sleep strategies that you implement with your clients or your athletes that, you know, to help maximize that area of recovery? Yeah, I mean, sleep is a fascinating one, because when you go back to the middle O's, when, you know, again, an interview I had with Dr. Sherry Ma, who did a lot of this initial research at Stanford, they were actually investigating the cognitive effects of sleep extension in athletes. So adding more sleep to athletes, how would it impact their decision-making and cognitive function? And as a side effect of that, they would come into the lab with Sherry and say, Hey, I just,

I just lifted a personal best, or I just swam a personal best, or I just had the score the most points I've ever scored in a game. And so all of a sudden, you know, the lights went on and they said, well, we got to study these performance outcomes. And so all of a sudden we're seeing, you know, sprint times, shooting accuracy, you know, reaction time, all these things improving. And so it is really compelling when we think of sleep is free, you know, it doesn't cost anything. And then yet, despite even the last decade of sleep science really showing us what it can do from a physical and mental standpoint it's still difficult to actually get athletes and even frankly the general population to get enough sleep because it's always that thing that just you know if we're struggling to get enough hours in the day then of course

sleep takes the brunt of it so i think for again this would be for athletes or the general population is almost thinking of your sleep in a weekly total versus just that nightly total. So, you know, sometimes depending on your work or commitments at home, you can only get six and a half in one, in one go. And despite that recommendation for seven to nine for the National Sleep Foundation, we say, well, how could we squeeze some little naps in, in, potentially, even very short naps of 20 minutes or so. You're not actually falling asleep, but we see that alpha brainwave activity goes up, which is this restorative brainwave activity and beta brainwaves, which are the more stressful start to decrease. And so that's a nice way to

refresh yourself and be more sharp at work or at home. And then maybe on the weekends, if there's a chance to carve out naps that are longer in duration, maybe more towards that 90 minute mark, you can start to add towards your weekly total. Combined with maybe reducing the alcohol, like we talked about earlier, you can start to really realize the impact it has on all those effects. Yeah, absolutely. And then I guess finally, I would love to chat a bit about whether there's any sex differences when it comes to recovery. You know, do we need to take in the menstrual cycle into consideration? Do we see any changes across that with fluctuating hormones? What's the research saying? This is a really fascinating area of research. And it's amazing that it's only just coming on now, really. Historically, especially in sport sport research the added

dimension and variables of the menstrual cycle was something that was you know we wanted to eliminate that to just be able to see what was caffeine was doing to the system and so what we get by proxy is just all these studies on men really and of course uh you know again as a dad with three daughters at home i think this is pretty fantastic that we're actually you know again as a dad with three daughters at home i think this is pretty fantastic that we're actually you know see what's happening in female athletes and in women's physiology because we are seeing changes in hydration status from pre and post menses we see even in terms of how you might lay out a training plan so if you have a client or an athlete who struggles with premenstrual symptoms then that's potentially not a week that we want to be, that training plan, we don't want to be increasing that volume or intensity as much, or we don't want to be pushing as hard if we're, whether it's tracking body weight or

progress in the gym or some of the pieces of tech that we just talked about, you know, we need to be able to give ourselves some permission to just observe what's happening in the system here so that you can, you know, better plan plan month to month because that's ultimately always the toughest thing and again regardless if it's an athlete regardless of the general population it's just being patient it's just saying you know we're going to take not 30 days to to lose weight and improve your health let's take six months or a year let's let's build the habits because those are always the most challenging thing to do is to just repeat things enough that it just becomes automatic because ultimately you know we can't be making food decisions all day long we can't be making

training decisions at the last minute you know we need to be able to ingrain these things and so you know in terms of the research side of things it is pretty exciting when we look at you know even the research on low energy availability that we talked about earlier. Classically, that would just be an endurance athletes. But now we see female sprinters, male sprinters, even around this idea of not really fueling to the level that we need to be able to recover effectively, but then ultimately perform when it's a competition day. Yeah, absolutely. And I guess with that low energy availability, that often manifests as menstrual disturbances, which is one of the telltale signs

in females. So that's another, I guess, marker if we are under fueling or under recovering. And thinking about sleep and recovery as well well and we see that increase in body temperature after ovulation i can imagine that as well would have a knock-on effect and how people are recovering especially like when you're at that really high level and you want everything to be perfect that i'm sure there's changes going on there and something that we need to factor in. A hundred percent. I mean, this great Dr. Susan Kleiner works a PhD in the West of the US, renowned dietician performance nutritionist. You know, we have data now that'll show that women who maintain menstrual function

throughout their training at the highest level perform better on competition stage. So to your point, if we're experiencing changes in menstruation or amenorrhea, then that's definitely a sign that, you know, we need to circle back to how we're fueling and the training plan and everything else, because that's a key sign that, you know, we've got to make some changes. Yeah, 100%. What a lot of information that we've just gotten through. And that's just one small section of your book um and some of the things that you're chatting about so if people do want to you know learn more about the things that you're talking about and your work where are the best places to find you for sure yeah for the you know

for the athlete side of things the books the first book's called peak so you can check that out and there's a podcast called the performance nutritionrition Podcast, where we dive deeper into these things with experts from around the world. And my website, the general population is drbubbs.com. My new book is called Peak 40. And again, this is where we dive into just those simple rules and heuristics that we can use to be able to make the changes, build the habits that we need to be able to feel better. So you can perform at work or at home or whatever your performance goals are and so you know people have questions on social media I've got a unique last name so at Dr. Bubbs you can find me on all the social channels as well yeah it is a unique second name and I also always see you popping up on my Instagram and doing IG lives all the time. So clearly, this has been a new thing. So I'm learning, I'm learning as we go. So people can jump on. And we'll actually be launching a peak 40 podcast as well, which is going to be a short form podcast. So again, that that idea of the hurricane of midlife when time is short, what can we do to be able to improve ourselves? Yeah, absolutely. I'm sure lots of people will be tapping into that.

Well, thank you so much for giving us your time today. Appreciate it. Yeah, thanks so much for having me on. Okay, guys, that was Dr. Mark Burbs. Hopefully you're going away from this podcast feeling a little bit more confident in identifying when you may be under recovering from your training sessions and how to improve that from nutrition, sleep and all of the other strategies that we discussed. If you did enjoy

this episode you know the drill, please leave a review, a rating and share it with your friends or family. If you want to find out more from me you can find me on instagram twitter or facebook at the food medic or www.thefoodmedic.co.uk and I'll see you again next week