And I can absolutely say I've seen people with 24 packs that look like garbage on the inside. There's so many different measurements of health, but what we have decided health looks like doesn't really have anything to do with how healthy someone is on the inside. as we get started, we wanted to let you know that this is a rerun of our discussion with sports dietician Ashley Reaver. In this episode, Ashley breaks down five key biomarkers that every endurance athlete should know about. And she helps us understand why they matter and what we can do to keep them in check. We learn so much from this conversation that we wanted to bring it back for another lesson. Whether you're new to it or hearing it again, we think you'll find it's just as helpful as we did. Enjoy. We've been supported by John G for a few years now and there's a reason why John G loves trail runners and the design gear our tribe actually loves to wear. If it's been a while since you've visited John G dot com, take another look because they're always rolling out fresh prints and innovative gear. Their new fall collection just dropped and it's worth checking out. Now I've been traveling a lot for work lately and my go-to bags are the Revy Pack and I pair that with the multi-pass mini. It's durable, functional, they're great for travel. That's the John G. Diffrance, founded by Runners. They make fun gear that performs and lasts. And here's the best part, John G. Diff 2% of every purchase and all John G collective membership fees go directly to clean water

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And as a bonus for listening to TRN, you can get 10% off your order by using the code TrailRunner. Sometimes your adventures outlast your gear. Well, not anymore. We're excited to announce the new Amazefit T-Rex 3 Pro. This thing is built for runners who want a smart watch that can actually keep up. Yeah, it's more than a sports watch. It's like your personal guide to the trail. The first thing that blew us away, the 27 day battery life. That's almost a month without worrying about a charge. With over 170 sport modes and now the new AI personal assistant. The T-Rex3 Pro has you covered. Plus it's rugged. It's award-winning design means it looks just as good at the office It does on the trail no wonder 42 million users around the world already trust a maze fit Adventure is calling and answer it with the amaze fit T-Rex 3 pro simply go to amazefit.com slash trail and use the code trail, and check out for 15% off. That's Amazfit.com slash trail and use the code trail at checkout for 15% off. That's amazfit.com slash trail code trail for 15% off today. Welcome to another edition of trail renonation. My name is Don Freeman and I'm Scott war and today we're going to talk about what's inside your body and how that inside stuff and we'll define that stuff a little bit better here But how that inside stuff can affect your genetic potential and your physical Performance today we have Ashley Reaver who is a registered sports dietician with a master's in nutrition science and policy She offers nutritional counseling in her private practice in Oakland and she she's a full-time teacher of nutrition and diatetics at the University of California Berkeley. And she's also, this is how we got to know her, the lead nutritional scientist at Inside Tracker. And she's going to teach us about what's inside and why that matters. Welcome to the podcast, Ashley. Thank you. Happy to be here. Hey, we're going to try to put a little structure to this because we've been known to kind of wander through conversations, but this isn't an important one. And we're going to get a lot of information and we want to try to keep it structured. And as a instructor over there at Berkeley, you probably appreciate a syllabus here. So we're going to lay it out how we're doing it. We're going to look at four biomarkers and four five or five We just learned that Ashley's bringing a fifth one because she was torn on just which ones to talk about so we're going in for all five And we're going to lead off each biomarker and kind of separate them and we think about them this way. Number one Is there a gender difference? Is this gender specific? Should this apply to me as a

female or a male more than the other? Is it age related? If I'm 20, should I worry about it? If I'm 60, where should I think about it with age and fitness levels? Some of us are out running on the weekend, some of us are racing for a podium. So we'll kind of characterize each one of them in that case. And And then we'll ask her what it is, why it's important,

what happens if the level is outside of normal,

and then how do we fix it?

So. characterize each one of them in that case. And then we'll ask her what it is, why it's important, what happens if the level is outside of normal, and then how do we fix it? So Ashley is an expert in this area, and we look forward to hearing about it, Scott. Let's get to things started with a definition. What is a biomarker, Ashley? Sure, so it is a marker that kind of gives us information on your body. That's as broad as you can be. We can have a biomarker in your blood. It could be, you know, your heart rate, your max heart rate during a run, the amount of time you spend in REM sleep. It could be something that we get from your DNA. Essentially, it's just a bit of information that tells us what's going on with or inside your body. How many biomarkers are there then? It sounds like there's probably a whole lot. Thousands and thousands, yeah. I would say of those probably what we know about the most physiological markers, like what you can get from a smart watch is probably the smallest. There's hundreds of blood biomarkers you could find. and DNA is, you know, we're getting there, but there's still so much we don't know about it. Tons and tons of ones that you could find there too. It could be as simple as a mother putting her hand on your forehead and saying you have a temperature. I mean, that's a simple biomarker that we've all used or experienced. Absolutely. And today what we've done is we have twisted Ashley's arm to come on and talk about what are the five most important biomarkers of all these thousands? What are the five most important for endurance runners? That's really tough. I know that of the thousands to say, okay, these are five.

Remember that there's many, many others, and these are just the top five. And I will say I've made it easier for myself. I'm not an exercise physiologist, so I'm not going to touch the physiology. I'm also not a geneticist, so I'm not going there either. I'm a stick with blood biomarkers, which is really what instant trackers kind of bread and butter was so to speak before we added in a lot of these other biomarkers.

I'll make it simple for you. We're a bunch of trail runners and we're currently looking up what those people are that you just described to us. So we're ready to go for a ride. The only thing that we know that it's inside us is like a gel that we just squirted inside us. That's all we know. So anything beyond that is going to be a little bit of help for us. Yeah, what's our first biomarker? I think we're ready to roll. What do you have? Let's start off with name it and then let us know if it's specific to any gender, age or fitness level. Okay, awesome. The first one that I think is super important is cortisol. And cortisol, you were kind of familiar with it. It's our stress hormone, but it is a marker that you could test both in your blood or in your saliva. It increases in periods of stress. And if you were to get a saliva test taken, typically that's when you're going to see, you know, I'm stressed right at this moment. My cortisol has increased your blood. What it can show you is chronic elevations in your cortisol levels. And typically your cortisol is the highest right before you wake up in the morning. It's something that helps us to wake up and then it tapers off throughout the day. Importantly, I'd say for cortisol, it's really, really key to get it tested at the same time throughout the day so that if you're trying to compare or see if you've made improvements or if it's gotten worse, you're at least comparing apples to apples.

There. to get it tested at the same time throughout the day so that if you're trying to compare or see if you've made improvements or if it's gotten worse, you're okay, at least comparing apples to apples. There is not necessarily anything that would make it more important or would kind of change what we would expect normal to look like based on age or gender or activity level. Some of the other markers that we'll talk about there are, but for cortisol, that's something that regardless of where you are in your health span or where you are, as far as activity goes, we still want this level kind of to be in check. Unless we're testing you like the second before you're about to go off on a 50k trail run and it's good to be a little bit nervous because that can help your body a bit. So how does cortisol actually help us in any way? We have certain things that elevate because our heart rate could elevate because we have something approaching us, we need to get out of harm's way or temperature could increase because we're trying to get rid of some bacteria or something attacking us. But what about cortisol? What's the purpose of that? Yeah, so cortisol is that fighter flight hormone. It is something that our body releases in response to some sort of a stressor. So, you know, evolutionarily, this was a great thing for us to have if you're walking along and a lion hops out at you. You want this big excretion of cortisol to hopefully either outrun the lion or hide it and win. Good luck to that. Most of us aren't chased by wild animals, maybe on the trails that's much more common than regular life, but our body is really hard-wired to respond in the same way. And cortisol's main role in the body is it really kicks in to gear our sympathetic nervous system which is that fight or flight nervous system where few things can happen. Our eyes get super focused. Our inflammation levels tend to be pretty blunted if you're trying to outrun a lion, you don't want to deal with an inflamed ankle. We shut off blood flow to our digestive tract. It mostly goes to our muscles and to our brain because that's what we need to escape that situation. It helps increase our respiratory rate, helps increase our heart rate. And something else that it does is it helps us tap into fuel sources in particular our muscles. So cortisol can, especially if you're really running for long periods of time, it can break down our skeletal muscle and our skeletal muscle is made up of amino acids. Those are the building blocks. About two thirds of those amino acids can be converted into glucose. That glucose is the primary source of energy that your muscles, as well as your brain wants to use in these high stress, high intensity situations. So you know, we have our glycogen stores, which I'm sure all your listeners are used to. We have exogenous glucose that you certainly eat from your shoes and your gels to get some of that. But in those situations where your body needs more of that, you also can break down that muscle mass to convert it to glucose as a continued fuel source. Our fat, very, very small amount, I won't get super technical, but the backbone of triglycerides can convert into glucose, but it's a tiny, tiny amount. So for athletes, it's something that's really, really important to consider because we do so much work with our muscles in mind. You're trying to train, we're trying to rest them, allow them adequate times to recover. But all of these stressors, if you're also not paying attention to them, are kind of counteracting all of that work that you're doing. And the things that really can increase that cortisol level, there's really four big buckets to focus on. We have mental and emotional stress for sure. These are things that could be real, but certainly our response to them, how will we deal with them mentally has a really big impact on increasing that cortisol level, amount of energy that we take in. So if you're underfueling for trail runners in particular, eating enough calories is not something that normally

happens naturally. It takes effort and intention to be able to take enough energy both within your workouts and outside of your workouts to have enough fuel to propel your muscles however far you're asking them to go. Not sleeping enough is another big one as well as if you have a lot of high intensity activity stacked up one after the other without adequate recovery and rest time in between. Enough time to bring that heart rate back down and to let your body switch from that fight or flight mode into rest and digest, which is that parasynpathetic nervous system. Actually, as you're talking about this, Do you see that athletes are subject to chronic high cortisol levels because they're putting their body into this flight or fight situation more than somebody that is just a walk a day office person? Yeah, so it depends. It takes a specific type of person to sign up for a 50 mile race. Those typically are more type A people that have a lot of expectations on what they want to achieve and maybe put a lot more pressure on themselves that probably feeds over into a lot of other things. So type A individuals tend to be more stressed anyways, especially if you're thinking about that mental and emotional stress of deadlines constantly being on a hamster wheel, maybe feeling inadequate or like you have to perform to a certain standard. I do think that there's a pretty strong connection there with endurance athletes and just being the type of person that has a lot of responsibilities. But on the flip side, definitely you have to pay so much more attention to fueling, to sleeping, and to getting adequate amounts of recovery when you are placing these really big demands on your body. So it definitely can be influenced from both sides. And as I mentioned before, just taking in enough energy is difficult. I like trail running. I wouldn't say I'm doing a lot. I've done anything longer than maybe five miles, but I have done half iron man's. And those are, you know, the fourth sport of a triathlon is food, is eating. It is really, really important to take in enough energy and in particular enough carbohydrates to fuel that energy. So it's really easy, especially as your mileage increases, to get just into that big calorie debt that your body can't get out of necessarily if you don't feed it. And that's because you don't eat those nutrients. Does not mean that your body doesn't need them. It will do whatever it needs to be able to find them. And one of those is spiking that cord is all to free up that glucose that your certain amino acids can be converted into. Before we hit record, you said you had five biomarkers to go through and Scott and I don't know them and it wouldn't have helped us if we knew them. But you said one of them you have a relationship with and it was cortisol and you have a story that you can share with us. So I'm interested in hearing it. Yeah cortisol cortisol is really what made me want to work it inside tracker. It's a dietician. I'm very familiar with glucose, with cholesterol levels, with liver health enzymes. But cortisol was the first time that I could actually really visualize what I was doing to myself. And what I mean by that is, you know, as a type A person, I like to say I'm recovering type A, I'd give myself an A minus now. I credit that to being able to visualize my cortisol. You know, I knew that I stressed myself out a lot. You know, I knew that I liked to replay events in my mind all the time, or that I specifically liked to go places that I knew would stress me out on the stress junkie.

And seeing that cortisol result come back, it was sky high, it was super, super like what the heck is this? That was the first time that I really saw what my thoughts were doing to the rest of my body. That doesn't stay in your brain. That's a, you know, that those cortisol levels are impacting me just as if I were being chased by a lion for a really long time, you know, because of what I thought before I went

to sleep.

And that had a really big impact on me, and just really highlighting how important these blood biomarkers are. And, you know, we've worked with pro athletes in a lot of different sports. And I love cortisol for young NBA players that we've worked with because they would sit up all night playing video games. And nobody could tell them you need more sleep. But when you could see that you're, you know, sleep debt or your lack of sleep was causing this spike in cortisol and then explain that connection to, you know, maybe why they were injured or why they were feeling more fatigued in practice, then, you know, it clicked. You can really get that. So for me, it was a good way for me to break up with being a stress junkie and really take those recommendations of meditation or yoga or just stopping that that doom spiral to heart and really put a lot of effort there. So obviously, Ashley, you don't have to just run many miles and put yourself through physical stress. Somebody can just have a lot of emotional stress and and have a that's very difficult or a home environment that's difficult. There's many ways to end up with high quarters all. And then you stack that with lots of running, trying to get away from your stress and now you have a double edge sword to deal with. But I was thinking as you were talking, I wonder if Ashley could walk through a group of people and locate based on their actions and and their habits the way they moved around, how about you, that person has high quarters all? Have you ever matched that when you're working with somebody? Do you ever predict markers before they happen? Yeah, for sure, especially when you learn about, you know, you just learn people in their lifestyle, things that go into it, how their brain works. I don't typically like to judge someone's health by looking at them, but as I accumulate more information, some people are just like, okay, you clearly fit this mold. And even without knowing that biomarker, I'm still going to encourage them to really focus on some of the things that can cause that cortisol to spike. There is a certain level I assume where most of us should fall within to be normal with our cortisol levels. And we've been talking about going over that. And I want to get into that in a minute. But it just occurred to me. Is there a danger of being too low on the cortisol? Yeah. And that's a medical condition called Addison's disease where your body just doesn't produce a lot. It's a, I don't know, Instagram, age, buzzword, this adrenal fatigue that happens. If your body can't produce cortisol, it's a condition you should go talk to someone about it. Because you've got cortisol has good, it does good things for the body. There's a reason that we have it. But a normal person couldn't be so zen that their cortisol level is low. So is there anything we can do to help move that

if we're elevated?

Obviously we can try to get out of a hostile environment. We can make sure we get plenty of rest and we watch our miles, but you're a dietician as well as many other things that qualifies you to tell us about this stuff. Is there something we can eat? I know the answer's always dark leafy green vegetables. That's all I knew in my nutrition class.

But what can we do?

I would actually argue that dark leafy green vegetables

in this case are not necessary. Oh, good. If anything, they could take you further away from where you want to be for cortisol. For endurance athletes, again, eating enough calories is hard. It takes a lot of effort. Maximize that space in your stomach with something that's gonna give you calories. Eating a big spinach salad is gonna take up space and time that you could be using to actually help you reach your calorie goals. And it's surprising, but you know, for a lot of endurance athletes, I tell them to steer clear of as many raw vegetables as they're eating, try and have vegetables that are cooked, that have some in them most likely can contribute to calories but also take them a lot less space in your stomach. Importantly I would say figuring out which of those four things for you is likely causing or combination of those four is likely causing that elevated cortisol and focusing on that. If you know that you're sleeping enough, if you know that you're eating enough and you know that you have enough rest days planned in there where your heart rate is not hitting that max zone, then it's really time to focus on some of those other stress management techniques that are derailing all of these things. And I like to call those four things like the softer sides of training because we know that they're important, but they're less fun to do or to measure than, you know, how fast you ran or how many miles you accumulated. And for all of us, it might be different, but really focusing in being honest with yourself about which one of those you could improve on is the best place to start to bring those back down. Love it. I'm ready to hear about the next four. Based on that recommendation, I am a believer in you Ashley. Let's go to the next one. Which one of you selected that's important for endurance athletes? Sure. So this one was the add-on. And that would be measuring testosterone or DHAS levels is something you could measure in women. And these are primary sex hormones. So testosterone's a pretty easy one to measure for men. It's pretty consistent. We do also measure it and females have have it as well, just in much, much smaller amounts. But sex hormones and women, especially premenopausal women, are cyclical, meaning that, you know, wherever you are on day one of your cycle could look very different for that hormone based on day 14. So for that reason, Anseltalkortas DHA, which is a pre-curse to all these sex hormones for females, and knowing those numbers can also be really important for athletes. Very similar to cortisol, the same things that can cause a spike in cortisol can cause these values to be down. So not taking enough energy is really key, not sleeping enough, too much high intensity exercise without any rest and recovery in between. And then that mental and emotional stress, these hormones are super, super important for building new muscle. They're anabolic hormones. They help to take these little building blocks of nutrients and turn them into bigger things like muscles. They help make those adaptations in our muscles to increase, you know, let's say mitochondria for endurance athletes so that we can process energy more efficiently. And they also help to repair muscle damage, which is super important too. And all of these sex hormones are nice to have. They are not required to keep you alive. And if your body is deciding between keeping your heart beating and your lungs breathing, in addition to all of these miles, it's going to sacrifice putting resources towards things that are nice to have. So they're going to keep you alive. That's what your body is going to do. And having lower levels of these sex hormones could be a really good indication that, again, similar to Fort Azale, something of those four is just really off. You're not giving your body all of the resources that it needs to be able to produce these hormones that can not only help you perform optimally, but also recover optimally and really be able to take advantage of your training because you're only training to get those adaptations that happen. So if you're not focusing on all those things that also support those adaptations, you're benefiting 50% from your training and it's kind of not really worth doing it if your body can't take advantage of all of the stress you're putting on it. Actually for women, pre-menopausal women because it's cyclical, is there a certain time that you should be tested, or do you just make sure that if you're subsequently testing that you're doing it at the same point in the cycle? Actually, before you answer that one, just for clarification, Scott, you said pre-mental-posal women, but I think it's cyclical for all women and clear that up. Maybe I misheard your statement earlier and I apologize. Scott, if I stepped on your question, when it was right, no, no. So straighten that out and then let's hear your answer. Sure. So postmanopause, there's no longer menstrual cycle. So we don't see that fluctuation in estrogen, progesterone to stosterone that we would see in premanopausal women. But we test this marker of DHA-AS for women in particular because it does not change based on where you are in your cycle. Okay. For pre-mentopauseal women, most cycles aren't just 28 days, but in the textbook they should be. So, it doesn't matter where you are on day one to 28, that DHA-AS level is pretty stable. We did try to require all women to test days one through five of their cycle, which is

really inconvenient and wasn't super popular. So that's why we found this marker of DHAS. I can still give us a proxy measurement of where a lot of these hormone levels are without putting so many constraints on removing five, six of the month. But for postman-apausal women, these shouldn't fluctuate. They should be pretty consistent no matter what day, anyways. It's great if you can test on the same day or roughly within the same phase of your cycle because certainly other things can be impacted as well. Your iron level could be slightly different based on how much blood loss you have. Your cholesterol levels might tweak a little bit, but they're not massive deviations on a really big scale. We see with the big fluctuations in hormone levels. I have a question that you said men are very consistent with testosterone. This next question you may push down the hall to your other folks at Berkeley. So maybe I'm unfair to ask this. But if I'm a female, is there a better time in the month that I should want to be running a race? Is there a peak period of my, if I'm peaking on my hormones, is that going to affect me in a positive way for a race? Yeah, again, so your testosterone level is definitely peak right before our

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