Episode 8 - Female Athlete Nutrition: With Angelique Clark
Female Athlete Nutrition: With Angelique Clark
I am so excited to welcome fellow Advanced Sports Dietitian, Angelique Clark to the podcast!
Angie is a female athlete nutrition expert and delivered so many gold nuggets in this episode. Historically a lot of sports nutrition research has been in the male population, so it’s exciting to see the explosion of female athlete papers published in the last 12 months. As an emerging area of research, Angie has her finger on the pulse to translate the deep science into practical nutrition advice.
In this episode we talked about:
- The menstrual cycle and how our hormones change across the month.
- What these changing hormones might mean for our nutrition across the cycle
- Some of the important nutrients for female athletes
- The importance of adequate energy availability
- Should women get different sport and exercise science advice or support than men?
- PLUS so much more!
To find out more about Angie head to www.angeliqueclark.com.au/
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EP 8 – Female Athlete Nutrition: With Angelique Clark
Taryn Richardson 00:00
Welcome to the Triathlon Nutrition Academy podcast, the show designed to serve you up evidence-based sports nutrition advice from the experts. Hi, I'm your host Taryn, Accredited Practicing Dietitian, Advanced Sports Dietitian, and founder of Dietitian Approved. Listen as I break down the latest evidence to give you practical, easy to digest strategies to train hard, recover faster and perform at your best. You have so much potential, and I want to help you unlock that with the power of nutrition. Let's get into it.
Taryn Richardson 00:42
I'm so excited to be talking to Angelique Clark today on the podcast. Angie is a fellow Advanced Sports Dietitian. We met over 10 years ago when we originally did our extra sports nutrition study together at the AIS (the Australian Institute of Sport). We've kept in touch over the years. She's gone down the female physique sort of path and works heavily with gym athletes. Whereas I'm definitely more specialist in endurance sports. So, it's really nice to have a colleague and a friend and a sports dietitian that you can bounce ideas off.
We've had a really good conversation today about the female athlete. Angie is, like me an Advanced Sports Dietitian, a performance nutritionist, and she's also an exercise physiologist and active mom boss. Over the last 15 years or so she's worked really extensively with elite female fitness and figure athletes as well as fitness centres and celebrities for their transformation campaigns. She has a passion for understanding the difference in female physiology, honouring women's health and cleaning up the fitness industry garbage to help active women uncomplicate nutrition for sustainable body composition, raising healthy families and maximising life performance. So let's get into it.
Taryn Richardson 02:05
Hi, Angie, and welcome to the Triathlon Nutrition Academy podcast. I'm so excited that you're here mate. Welcome.
Angelique Clark 02:12
Thank you, thanks so much for having me.
Taryn Richardson 02:15
It's the best. I'm so excited for today's discussion because today we're going to talk about the female athlete, I really think it's an emerging area of research, you know, like females are definitely different to men, we know that. But we're getting a lot of limelight, a lot of heat at the moment, which is so good for us females. But I think it's really important from a nutrition perspective talk about what females might need compared to males. So I'm so excited that you're here.
Angelique Clark 02:43
It's an incredibly exciting time for females to be athletes, and also to shed a light on maybe possibly a direction of research that we haven't looked into previously. And I think, unfortunately, when it comes to Nutrition and Exercise Science, a lot of this information that we've learned as sports dietitians, has come from male participants. First and foremost, because maybe not many females wanted to put their hand up to be a participant. That's probably where the trouble first started.
Then second to that, of course, we understand that there's a few nuances within being a female compared to a male and that, of course, is the menstrual cycle. So when we looked at the menstrual cycle, and when we studied females in particular, we found that we might have been a little bit different, and our results might have been a little bit more inconsistent, which is probably why they fell back on using male data as a reference point. But it's a very much a space of us to sort of have a look at why. Just because we might have been a little bit too hard to study in the past doesn't mean that we shouldn't be studied. So here's the tip of the iceberg in terms of the research, and it's beginning now and I'm super excited to see where it's going to go.
Taryn Richardson 03:50
So good. So good. So before we get too deep, though, can you give me a bit of a rundown of your sort of journey, like pre post uni, where you came from? Why you're the female expert? Let's do it.
Angelique Clark 04:03
Yeah. Okay, so it kind of started the day I left high school. I kind of walked into a female only gym after I left school, and I asked to put on muscle, and they almost fell over backwards. So if you think about this, 21 years ago, a small female walking into a female only gym asking to put on size, and it wasn't something that a lot of females did at the time. I had this sort of fascination with wanting to feel stronger and wanting to know how to do it. So I really have been so fascinated by the physique, and how to manipulate physique through exercise and food. I think that's really what pushed me into first studying Exercise Science.
So I left school and I started in a human movement degree. I majored in Exercise Science, so I was actually an exercise physiologist prior to becoming a sports dietitian. Then I did a lot in the fitness industry. So I can say that I've probably been immersed in that industry for probably the most of my time. Whether it was as a trainer, or as an exercise physiologist. After that, I went into a little bit more musculoskeletal rehab so a bit more clinical stuff. But I was always really practising what I learned through the gym. So I would do heaps of different training, you know, use myself as an experiment. I'd do many different diets, ketogenic included, way back when we all think it's new now, but it definitely has been around for a while. I loved using myself as a guinea pig, a bit of an experiment.
So what I found within that was that there was a lot of knowledge gaps that I couldn't have answered by people that I thought were knowledgeable in the space and unfortunately, a lot of the bodybuilding magazines didn't cut it. So when I was sort of asking a little bit more scientific questions, nobody could really give me those answers. So I went back to study sports nutrition, or dietetics, as it was offered back then, and then specialised in sports nutrition after that. So I've kind of got this exercise background first. So I understood physiology a lot and what I was finding amongst the people that I was hanging out with in the gym culture was that everyone wanted to either put on muscle, and/or simultaneously lose fat at the same time. I thought this is really cool. So I used myself as an experiment. But I also wanted to know why and how I could do that to others as well, because I think that was pretty cool.
Essentially, I went back to uni and I wanted to study the input side of things, which is obviously diet and nutrition. I wanted to pair that with the exercise that I knew worked to develop people's physique. So yeah, the idea behind that was, what can I find out from a science perspective, go back into the research, let's look at university, and to get taught how to do it scientifically, as opposed to just following what trainers say, or what this person says, because they look good. These are the types of things that I was finding in the fitness industry, were the people that were the experts, or the touted experts, and it just didn't cut it with me. So I tried to become the evidence base expert I couldn't find in the fitness industry at the time.
Taryn Richardson 07:05
One of the reasons I started this podcast was to actually get evidence based nutrition information into people's ears, because there's just so much shit out there. And I hate it.
Angelique Clark 07:13
Yeah, absolutely. I agree. And I think it's such a noisy space as well. So we actually don't know now how to separate the true experts from the people that have done the work that have nationally accredited certifications and degrees, because it does take a long, long time to do this and it's not just about studying literature. It's also about the application of that and I found that I had all this knowledge now going through uni, but then I didn't know how to apply it. So I had to work with people to figure that out.
We talk about the nuances, and we're going to talk them about the nuances of the female, but what about just the person as an individual. A lot of these sort of blanket rules that are out there have to be applied to the person that's sitting in front of you and I think not a lot of people know that they are their own experiment, and they can be their own experiment. That's the unfortunate part, they're just blindly following something else that maybe has been successful for somebody else, and they need to do something that's good for them.
Taryn Richardson 08:06
That's a really nice segue then into the female. And you know, whether or not they should be getting separate, specific female advice compared to the males? Like what do you think about that?
Angelique Clark 08:18
I think everybody should be treated as an individual. So I do believe that we should be giving specific advice, whether that is specific to being a female versus a male. Yeah, okay, there's a difference there. But also, you've got to consider that it has to be specific and unique to the females sitting in front of you. So does what we say differ from a male? I guess, an overarching blanket would be that there's still sports nutrition principles, which we have learned as we've gone through Taryn that kind of still apply across both genders, but it's making it specific to that person sitting in front of you, which I think is the real key. So as opposed to just being different from male and female, yes, it is going to be different.
Often, we find that females are smaller in terms of stature, generally, and we particularly have lower muscle mass as a result of that and that might be obviously due to the difference in hormones. But it also requires us to understand the individual and what their output is. So what their lifestyles like and then also what they're trying to achieve in terms of performance. So looking at them as an athlete, too. The short of it is that it has to be personalised and individualised.
Taryn Richardson 09:22
That's the difference between a good practitioner and not a good one is that you have the ability to take that research and apply it to the person in front of you and give them something practical that they can actually implement. There's no point giving them some crazy plan that is so far beyond what is achievable for them. It needs to be something specific to who's in front of you and I think that's really good to be a good practitioner is a skill to be able to do that.
Angelique Clark 09:47
100% and I think also, you know, it's fantastic to have the knowledge and know what the science is and why we're recommending these types of things. But at the end of the day, you've got to think about the client that's receiving that, that has to be really practical for them. So it might not necessarily be that we're telling them the science that's behind the meal plan, or the things that we're asking them to change from a nutritional behaviour standpoint. But it's easy for them to execute and we just take all that anxiety out. Well, what I think a good practitioner does is take all the anxiety out associated with that but we're still applying all the evidence that we know in practice. We're just making it look like it's easy for them to do.
Taryn Richardson 10:24
Alright, Angie. Do you want to set the scene and explain to me a bit about the menstrual cycle and what actually happens with our hormones?
Angelique Clark 10:33
So let's just set the scene first and foremost, because I think unfortunately, even though I'm talking to the female athlete, she might not have a particularly great understanding of her menstrual cycle. So when I talk about a menstrual cycle, I'm talking about somebody that has a regularly occurring menstrual bleed every single month, or there abouts. So a typical menstrual cycle is probably about 28 days, that's a textbook stock standard menstrual cycle. But it can be anywhere between 21 to 45 days, and that would be considered as per normal. So you're kind of looking for a menstrual cycle of about nine cycles per year, to be considered as really quite normal. The reason why we get this is of course because we have the ability to have and create babies, which is pretty cool as a superpower. But there's a few hormones specifically that we want to talk to because this is of course, what's going to affect substrate utilisation in females, and also how we front up to training.
So I want you guys to be familiar with oestrogen, progesterone, follicle stimulating hormone, and luteinizing hormone. So those four and in particular, the first two are probably the most important. So when I talk about a menstrual cycle, and like I said that could be variable for most women. But if we talk about that, in particular, we've got two distinct phases of our menstrual cycle. So the first phase is our follicular phase, then we have ovulation in the middle and then we have the luteal phase. So basically, if you think about day one of your period or your bleed, that's going to be day one of your cycle. So you're entering that follicular phase. Now for most regularly menstruating women, our period will last anywhere between four to seven days, there abouts. So that's quite normal. So we are in this phase called the follicular phase and that lasts up until day 14 and day 14 there abouts is where ovulation occurs. So what happens over the course of this timeframe is the follicular phase is a really low hormone phase up until we reach ovulation.
So the idea with that is that our body is getting ready to release an egg and obviously for that egg to be fertilised if we are going to fall pregnant. Then after which if that egg doesn't get fertilised, we head on to the luteal phase. So there's a build-up phase within this and this is what we termed the high hormone phase. So oestrogen and progesterone then start to rise again, and then they'll dip off if the egg doesn't get fertilised. So the whole idea within this is that we go through this motion in a cyclical manner. So it's going to happen every single month, it's going to occur as it should. Now, in the situations where that doesn't happen, then we need to figure out why. Because for a fully functioning normal female, she should have a fully functioning menstrual cycle.
The hard part is to understand that if that isn't happening, and this is where a lot of my clients used to come in as being, you know, these physique athletes were really interested in being really, really lean. And of course, with you guys in terms of endurance athletes, as well, the idea is if obviously, if you're smaller, you carry less weight, through the course of training, and then competition. So if you are smaller, if you've got a better power to weight ratio, obviously, you might be a better athlete, and you might be quicker and faster. Now that comes at a compromise because of course, you got to remember that if we're trying to be leaner, then we're probably chasing a calorie deficit of some description, in which case, you're going to be reducing your energy or increasing your energy expenditure to get to that point. And that requires you to change possibly the energy availability of your food, which might affect your performance.
Taryn Richardson 14:02
I see a lot of female athletes in clinic who are under eating because they have no idea how to fuel triathlon training. They don't have a cycle and they think it's normal, or they've seen a GP and the GP has gone "Oh, we'll just put you on the pill. That'll fix it." But it's really, you know, not fixing the underlying problem at all. It's just masking what's going on and giving a fake bleed. So I think yeah, in our endurance space, low energy availability is really really common, unfortunately. Everyone needs a bit of education. But if you're a female and you're sitting there and you're listening to this, and you don't have a regular menstrual cycle, and you're not on any oral contraceptive or anything like that, then that should be a red flag that you need to do something with your nutrition.
Angelique Clark 14:44
100% and that's exactly right. So when you don't have a fully functioning menstrual cycle, some athletes and this is the culture within that space at this moment in time, unfortunately. I think we're getting better with more awareness. But the idea is that if you don't have a menstrual cycle, it means you're on track to being really competitive. We definitely want to make sure that that's really clear that you are not functioning optimally at your best if you do not have a regular menstrual cycle for any other reason. So obviously, if you go on the pill, that's a form of synthetic oestrogen and progesterone, so progestin sorry. So if you are taking an oral contraceptive pill, that's going to change the game, so you don't appear to have the same cyclical pattern with your normal hormones. It basically flatlines your hormones because you're taking exogenous hormones.
So the idea between then people losing a menstrual cycle, particularly if you are on the pill, it might actually be masking low energy availability, as Taryn said, if you don't know why you're not getting a menstrual cycle, it's time to look into it. It's time to be going, "Hey, what's happening?" Going to your GP, make sure you get some bloods done and just make sure that you're having a look at the general scope of how you're performing and fronting up with everything because your menstrual cycle, absence is only one sign.
Before you get to that point, I can guarantee that your whole metabolic process has been downregulated and you have had warning signs or symptoms, possibly whether it be maybe increased fatigue, and maybe increased risk of illness, niggling injuries that won't go away. So all of these are signs of what we call low energy availability and if left long, long, long periods of time in that low energy availability state, you're going to end up with what we term a syndrome called RED-S or relative energy deficiency in sport. And we do not want you to be in that by any means. The menstrual cycle itself is important, but it's important that we understand that our hormones are fluctuating at each and every point over the cycle of that time. And then as it relates to performance, then we want to say, Okay, well, how are we feeling at each stage of that cycle? and then how does that affect our performance as an athlete?
Taryn Richardson 16:59
Nice. And I think that's kind of where the research is heading to understanding you know, what to eat at what phase of the cycle? A lot of people, I don't know how to say this in a PC way. But there's a lot of information out there and people are giving quite specifics around what you should be eating in what phase. But do you want to maybe expand on that a little bit further? You're the expert, Angie.
Angelique Clark 17:23
Yeah. Okay. So I guess where this is coming from. So there was a narrative review that kind of revealed, I guess, the physiology underpinning the menstrual cycle, then how that would relate to substrate utilisation or how our body would use macronutrients and then how that would relate to us then prescribing different nutrition for certain phases of the cycle itself. So if you look at the follicular phase, so what happens between like I said day 1 to 14, where the first part of that you're in that bleed phase, early in that and then you move towards ovulation.
So what happens from a metabolic level if we have a look at substrate utilisation. So we have a lower fat oxidation. We have a lower protein oxidation. We have an increased oxidation of carbohydrates. We have a decreased glycogen storage capacity, and we have an increased efficacy of glycogen super compensation, so I know you guys understand the term carb loading, if you're a triathlete, and you have done any events in the past, yes. So that's just basically a fancy word for carb loading. So your ability to basically saturate that muscle glycogen prior to doing competition, which is what you want to do, obviously, when you're getting ready for major events and things like that. So that's the follicular phase.
So if we understand that, physiologically, our body is doing those things, and we have the research to suggest that this is what's happening within the female body within that, well, then what does that mean, from a nutrition perspective? Well, from that element, if your carbohydrate oxidation is going to increase, then we would require you to probably eat a little bit more carbohydrate. So if you're burning through a lot of carbohydrate in that first two weeks of your menstrual cycle, then the idea is that we want to be able to replenish that as you start training. And that means that if we think about carbohydrates, and what that does in terms of energy output, really higher intensity activities or maximal exertion, activities, tempo or pace work for you guys, it's going to require you to burn a little bit more carbohydrate to do that type of activity. So you might be a little bit faster in that follicular phase. Of course, that means that you can then go through a little bit more carbohydrate, which means you might have to replenish with a little bit more carbohydrate. So I guess that's the whole idea within this sort of phase is that it's been touted as the phase where you could push a little bit harder in terms of intensity.
So when it comes to then relating that back to training, you might be able to hit it just a little bit harder. Now that said, the early follicular phase, which is when you're actually bleeding, might not be great for some people. So you got to remember that there's this idea in association between the perceived I guess limitations when you are on your period. So I know particularly for most of my clients, day one to day two, three-ish there abouts, so you know, the first couple of days of their bleed, they often don't actually feel great. They feel, you know, a little bit behind the game in terms of pain threshold. They might experience things such as loose bowel motions. They might have lower back pain. These are the ones to two days of, and also maybe possibly the three to five days preceding that, going into their period. So this is where it becomes really tricky, because of course, we want to be performing at these levels and our body says that we can be doing really high intensity stuff. But how do we feel becomes more of an indication of how we're going to front up to training.
So I think that's a particularly important thing to bring up to make sure that, you know, we understand that everybody's different, and you might just be like, "Oh, my periods, fine. It just happens, it just rocks up and that's totally okay." And others might be like, "Oh, my God, I can't get myself out of bed. I'm really tired. And I really don't want to go to training today." So it was important for us to make mention to that.
Taryn Richardson 21:06
So potentially a different phases of our cycle, we, you know, might have better carbohydrate oxidation or fat oxidation. And, you know, that's starting to emerge in the literature. I don't know, what do you think Ang? Do you think that the literature is there yet to say, you know, definitely, you should do this, or definitely, you should do that?
Angelique Clark 21:26
No, we're not there. In general. I mean, we want to be eating a good amount of carbohydrates anyway. We spoke a little bit about low energy availability. I think even just getting females, in general, female athletes to eat more is a battle in itself. So if anything, what we would like to consider is that carbohydrates are important, yes, particularly for females, and maybe even more so particularly in the follicular phase.
But in general, we can't ever discredit our nutrition foundations and I think that's really, you know, we could fall back on this each and every time. But would there be anything to suggest that females need extra? Possibly not, and when we're talking about the efficacy of that carb load, the efficacy of your body to be able to store that glycogen, if we compare that to males, we might possibly have lower muscle mass, which means we can't take on as much. Doesn't mean that our body is less efficient at doing it, we can still do it. But is it any different gram wise? I would say, just slightly less. The ability for us to then burn through that carbohydrate is totally unique to your training, what you're eating day to day, and then what your goals are, really, isn't it? At the end of the day, like, what do you want to do? How do you want to achieve what you need to do?
Taryn Richardson 22:44
This is assuming that people have carb loaded properly. So a lot of athletes don't actually know how to carb load properly. They think that eating a bowl of spaghetti the night before a race is carb loading. But you know, we both know that that's far from actually loading our muscle with glycogen, and super compensating it up with as much as we can. So you know, females may be not as good at carb loading from a hormone perspective.
It could be that we're smaller, it could be that we're not eating enough carbohydrate and we also need to increase our calorie intake to load effectively as well. So it could be multifactorial, rather than a hormonal shift. But I'll do an episode on carb loading because I don't know anyone that knows how to carb load unless they've seen a sports dietitian and got a specific carb loading plan.
Taryn Richardson 23:29
Midroll: Let me know if this sounds like you. Do you feel exhausted by the end of the training week? Do you crave sweets in the afternoon and feel like you need a nap? Training for three disciplines can be absolutely exhausting if you haven't dialled in your nutrition. It can be frustrating when you can't quite piece together the solid race performance you know you're capable of and confusing when there's so much information out there. But you're not sure what's the right method for you.
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Taryn Richardson 24:37
I want to ask you about the continuum of that low energy availability and what we know as the end point or you know, towards the back end where we starting to get into things like RED-S. I will do a whole podcast episode on RED-S so don't feel like you've got to deep dive, but I guess in the endurance space, a lot of triathletes I see, and maybe I just see the worst of them. But they do come in through a sports physician referral because they've got low energy availability and they've kind of at that end point or the end of the continuum where they've actually got a stress fracture.
So before that point, they were already in low energy availability. And then it's just gone further along the continuum and resulted in what I call the truck analogy. The feather, the brick and the truck, you get a little feather of "hang on, something's not right here" and that might be, feeling tired and fatigued. Starting to get a bit niggly potentially just not performing well in sessions, and then the brick is a bit of a louder message. Maybe a menstrual cycle, you might miss it for a month or something, or yeah, you get more of a serious injury or you're really falling into a heap at the end of the week. Then a truck message is just like, smacks you in the face, you get a stress injury, and it makes you stop, it forces you to stop.
Angelique Clark 25:57
Yeah, so I mean, like I said, there's definitely some things endocrine wise, metabolically wise that your body will show you signs and symptoms. So those little feathers, you need to take extra good note of. So if things are starting to get to the point where you are noticing this sort of thing, and it's funny, because a lot of the time, there's this honeymoon period when it comes to low energy availability, because I think for females in particular, if they start to lose a little bit of weight, they get quicker at what they're doing. Their performance increases marginally to start with, and then they get hit by the backtrack later down the track. So it's very hard for female athletes as well and this is a societal thing, as well as that they probably will get comments. So their coaches might say, "hey, you're doing really well, like you're improving your times". So there's this positive reinforcement all the time that what they are doing is actually working for them.
It's important to differentiate between looking amazing and actually performing. Because these are two very separate things. And, yeah, so in terms of body composition and this is this teetering on this line of, "okay, am I giving myself enough fuel to support my day to day energy plus, on top of that my training", or if "I'm looking good and performing at this moment in time, does that mean that the pattern of or the habits of what I'm doing nutritionally is going to benefit me in the long run". And so for you guys, you got to remember that performance should be your main game, like that should be your main focus. When it comes to body composition, I find a lot of people come into a sport’s dietetic clinic, wanting body composition changes, first and foremost, and then performance second, and I think we need to flip that switch a little bit. We need to say, well, let's just focus on really fuelling your performance, and possibly letting training take a natural effect of changing your body composition towards becoming a better athlete, but not at the expense of having the energy that's available to support the training that you're doing.
So yeah, so RED-S is a really, it's an endpoint like it is the Mack truck. It is the final bit too, hey, you've been pushing yourself very hard for a long period of time. Unfortunately, your body's just going to down regulate everything and, and I like the analogy of just going like your phone going in low power mode. So if your body is really struggling to get the amount of energy, it requires number one to survive day to day, let alone number two to support your training and your activity on top of that, then it's going to send a signal to say, "Hey, you know what, we're going to down regulate everything in our system to make sure that we're in this conservation mode". One of those signs is to have no menstrual cycle.
So lose a menstrual cycle over the course of that time. If you get three consecutive menstrual cycle absences, that is a big red flag that you need to do something right away and don't take that lightly because further on from that, like I said, the culture within the athletes that I have seen in the past has been like, "yes, awesome! If I lose my menstrual cycle, it means I'm on track to, you know, being a good athlete". Absolutely not. So we know that if everything's down regulated from a systemic perspective, you aren't going to be performing at your best. So it will eventually catch up with you is what I'm saying. And RED-S is like I said, the term and the syndrome, that is the endpoint for this, we want to be making sure that we don't have too long, prolonged low energy availability, to make sure that we're avoiding these types of things as well. If that's the case, then guess what, if you're sick and you're injured, that's going to pull you out of training anyway. So it's not actually going to benefit your performance in the long run, too. So you've got to think a little bit more beyond just the day to day stuff, unfortunately.
Taryn Richardson 29:30
Yeah, exactly. I think a lot of endurance athletes, I think they don't have a cycle, which is great for racing. You know, we're always in our togs or we've got to get a race suit on, and some people start the pill just to control when their cycle is around racing. So they'll skip it when they've got a key race. But it's so important to understand that if you don't have your normal flow of hormones, then you're not sort of maximising your body's potential that you get from that anyway, like oestrogen is ergogenic, right? We need to love it and embrace it and not try to get rid of it.
Angelique Clark 30:01
Absolutely, absolutely. And I think that's the biggest key as well is that you mentioned it's ergogenic and it's also anabolic, so it lays down more muscle mass. The more we put ourselves in this low energy available state, the more likely it is that we're going to lose muscle and muscle for us keeps our metabolism high, it makes sure that we are powerful, it makes sure that we are fast. And because of course we are females, we often don't have as much muscle mass as men. So it becomes really important nutritionally, for us to be able to eat to that to make sure that we are sustaining that muscle mass over time. So you know, I mentioned the metabolic changes that happen in the follicular phase. And then of course, there's the luteal phase, right where those hormones start to rise and are in a high hormone state. And that changes a little bit, where it becomes a little bit more important for us to be able to look at things such as like maybe protein, for instance.
So I guess what happens within the luteal phase is as those hormones start to rise out of the follicular phase, after ovulation, we get an increase in fat oxidation. We get an increase in protein oxidation. We get a reduction in carbohydrate oxidation, but our resting energy expenditure actually increases. So you know, we talk about low energy availability and now we're in this luteal phase every single month, that would actually require us to eat slightly more. So it's been touted about 2.5-11.5% extra in terms of total energy required compared to your follicular phase that you need in the luteal phase.
Now, why is that? Well, because we're building a uterus lining to support a pregnancy and that requires energy. So not only are we going out and doing all this extra stuff, with our training on top of our day to day stuff. We're now also every single month trying to have a baby, biologically, right? We had women forget that. So the idea with this is to say, "well, what can we do that nutritionally to support that?" It is to first and foremost, eat more? Yes, possibly, we need to look at the quality of the protein that we're eating. So if our oxidation rate is increasing in terms of our protein needs, then we're going to be wanting to have a little bit more protein within that and so at rest, so this is all, our substrate utilisation, when they've looked at the physiology is always at rest, but then we add exercise on top of that and we actually burn out through a little bit more protein during exercise in the luteal phase, then what we do during the follicular phase. So it might be a bit more imperative for us to get protein a little bit maybe even before we train. And most definitely after we train.
So we talked about this recovery phase where we've got this beautiful window of opportunity where our bodies are more susceptible to taking on nutrients after we've been depleted through an exercise session. The main game, of course, with endurance athletes, as you guys do burn through a little bit more carbohydrate, but don't forget protein, because I think that's a really important key in terms of making sure that we're replenishing those building blocks that are going to support good lean tissue development over time.
If we're constantly under fuelling, then you're not getting enough of those building blocks anyway, in what you're eating day to day. With endurance athletes, I think it's even more important because you're constantly depleting through those carbohydrate stores more than physique athletes. It becomes really important that you are attuned to this as well. I think, particularly as a female, for a fully functioning normal menstrual cycle, most women will probably experience the PMS week, which is that sort of seven days, the late luteal phase or seven days leading into their menstrual cycle, in which case, what happens appetite wise: we all start to crave salty carby, maybe chocolatey type of foods. That's one indication, your body is really struggling to oxidise carbohydrates a little bit more effectively than what it would in the follicular phase.
So that's why our bodies are telling us okay, well, what can we do here? Can you give me a little bit more energy on board? Because I'm not great at burning through carbs, maybe as effectively as my follicular phase. Does that mean we need to change our nutrition prescription? No. But what it does mean to say is that we need to be more sensitive to the fact that we can actually eat through that. So many occasions, I've had clients go, "oh, what can you give me in terms of tips and advice to stop my cravings around my period", and I'm like, well, we don't stop that we want to eat to it, we want to support you and work with your body. And just think about it as a bit of a carbohydrate load before the week after, in which case, when your hormones flatline down again, after you've had your period, then you can go back into that really hardcore fast training, possibly, if you're feeling up to it from that perspective, as well.
It's really an interesting time. I think the other thing to note as well in that period, in that time leading into your period is that we often experience a little bit more inflammation. So with higher progesterone, we get higher prostaglandins and that generates a little bit more of an inflammatory response. So our fat is really important that we can get some anti-inflammatory fats into our diet to focus on that, in particular in combination with our high biologically valuable (HBV) protein, good quality protein in that week leading into our menstrual cycle. I think we often tend to think that there's nothing we can do about that. But there definitely is. And I think once again, it encompasses the individual, whether they are even experiencing symptoms about that, or whether they are totally fine and they don't need to look at that in a little bit more detail, but there are some nutritional strategies we can do. We just might be a little bit more specific and a little bit more aggressive if someone is reporting, you know, these types of symptoms in that phase.
Taryn Richardson 35:28
Yeah, nice. Is there any other nutrients that females should be aware of? Whether it's across their cycle? Or just generally?
Angelique Clark 35:36
Yeah, absolutely. So I think we're going to go right way back to iron. Because now that becomes important is if we are losing blood every single month, and I in particular, is important, and I think that's a big red flag as well to signify, particularly for those in a low energy available state. If they're not even getting enough iron from their food and from their diet in general, this could lead to low iron. Of course, maybe low iron storage, which then might impact their training.
So, you know, some signs and symptoms in relation to that would be tiredness, perpetual tiredness all the time. But obviously, within exercise as well, specifically, shortness of breath is a really good indication that possibly iron might be an issue and it's really imperative that we get a clinical value of what that is. So going back to your GP or a sports physician and asking for bloods that look at this, because we don't want to supplement unnecessarily. But we definitely do need to know if irons stores are being compromised because of that.
Taryn Richardson 36:34
In my experience, GP's have been terrible at managing iron. That's because the general population cut offs, their lab values are different to what our athlete population values are. So if you are feeling symptomatic, I might do a whole other podcasts on iron too. We'll see. Go and ask for iron studies, and then get somebody like a sports dietitian or a sports physician to actually run their eyeballs over it. Because the number of clients I've seen that have come to me with their iron, and they're like, "Oh, yeah, GP said, it was fine". The ferritin is less than 30. I'm like, "oh, gosh, let's sort this out ASAP", because you can't carry oxygen around your body, among other things that iron does so why would you not sort of fix it rather than suffer through that?
Angelique Clark 37:17
Great point. Because athletes are different and athletes doesn't necessarily mean elite, they can be everyday athletes. So you know, if you train with purpose and train with intention, and we've spoken about this before is that, you know, you are definitely classified as an athlete. So you need to be looking at yourself as different to the general population who don't do as much activity as you do. Unfortunately, we'd like to get everyone to do that. But you guys are different. And so those scales might need to be readjusted for that particular athlete that you're looking at, for sure. And then the other thing, I think, from a nutrient perspective is really important, maybe possibly calcium and vitamin D. So what happens as well is, as we start to age, our oestrogen starts to lower.
So we head into perimenopause, and then we head into menopause. And I think menopause is where our hormones progesterone, oestrogen flatline. And so what happens here is it becomes even more important for us to provide a stimulus for us to lay down more bone mineral density, to avoid things like osteoporosis, falls and fractures and fracture rate and risk. So this becomes really imperative. And I think, as we are younger, we need to start thinking about how best we can lay down more bone and looking at calcium and vitamin D as a nutrient that's really particularly important for that. And then going into supporting our later life as still an active woman becomes even more imperative in terms of adding resistance training to help that as well. So yes, calcium is important.
Obviously, vitamin D is very important as well. But in relation to that, then having the stimulus that's going to kind of replace the lowering of oestrogen as we age is super important. So getting in there, I know your endurance athletes have loads of things to do in terms of across all three disciplines. You've got plenty of training to do. But can we add a little element to possibly maybe in the offseason, maybe not so much during into a campaign of any sort of event, but maybe look at some strength or resistance training to counterbalance what we call sarcopenia. So that age related loss of muscle over time, yeah, becomes really important for females.
Taryn Richardson 39:24
I call strength training the fourth discipline of triathlon. A lot of triathletes don't do it until they get injured. But if you have a look at the elites, they're in the gym at least once a week, most often twice building that strength. They're not doing you know, light bodyweight stuff. They're lifting heavy to try and build that strength because as a sport, you've got to train for three disciplines. So you've got to be good at swimming, cycling and running, but you need the strength to carry your body through that. So it's definitely not something to ignore. And you know, from your perspective, from maintaining that muscle mass as you get older, it's one of the biggest drivers of that. In combination with nutrition to support that strength gain or, you know, minimising the loss.
Angelique Clark 40:06
Definitely, it's definitely discredited. And, you know, we need to make sure that that muscle protein synthesis is just as good as the muscle protein or to match the muscle protein breakdown. So your body is in a constant flux all the time. And this is where protein becomes really important. In particular, if we look at leucine, which is the specific amino acid that we have to obtain from one of the specific amino acids, there's nine, that we need to obtain from our diet, we can't assimilate that in our bodies. So we have to be getting really good HBV, like I said before, the high biologically valuable protein sources in regularly drip fed over the day.
So it's more important to get smaller, more frequent doses and protein hits over the day than it is to have one big lot all at once. And I think if we think about most how most people eat, we probably get a good chunk of protein or protein foods at dinner time, but we don't necessarily get a lot of that spaced over the day. So you know, we mentioned recovery nutrition, which is super important and being a little bit more aggressive with that post training.
So possibly getting that in within 30 to 45 minutes, as opposed to 45 minutes to an hour or two hours after that, you know, we want to be really hitting that with a bit more quickness and making sure that we can get that regular drip feed over the day because that of course is going to help that nitrogen balance and the difference between the breakdown and the synthesis when it comes to muscle. So making sure we're really retaining that muscle over time makes a better athlete,
Taryn Richardson 41:35
There's quite a few really important nutrients for females. So we've got iron, you know, particularly because we've got those monthly losses, but I guess endurance athletes, they have really high iron losses. So a female is somebody that's at a higher risk group for that. Then we've got calcium, making sure that you know, we've got really strong bones and teeth, and every single muscle contraction is involved in calcium, needs calcium, so we definitely need that one. And protein which you've touched on a lot there which is awesome.
Angelique Clark 42:03
Onto that, I think it's really important to highlight the protein recommendations for females should be higher than the general population. Again, because you guys are athletes and active, so you got to remember the difference. So what's recommended in terms of daily protein intake for general populations about 0.8g/kg per day. It is definitely way too low for our endurance athletes in general. So if you think about that, the idea with that is we want to bump that up just a little bit. When we looked at male studies, so I guess at least 1.2g/kg body mass would be ideal for the male athlete, but then female on top of that, like I said, we have that increase of protein oxidation in the luteal phase.
So possibly, I'm probably looking at between 1.6-1.9g/kg body mass. Yes, specifically in the luteal phase where our protein oxidation is actually a little bit higher. But maybe across the board, I think we could be doing a lot better with protein and protein needs. Like I said, getting that in in total, and then drip feeding that in through the day as well becomes super important. So yeah, I think it was really nice to make that difference as well that your needs are different and we have to increase protein and most females could warrant increasing their protein across the board, for sure.
Taryn Richardson 43:18
Yeah. Wow, that's awesome. And yeah, I think I need to sit down after all that. That's been amazing. There's so much to talk about and the female space is so exciting and it's so exciting that people like you are a part of it that can push females into the limelight as killer athletes up there with males. We're different, I think we need to eat a bit differently. Whether the research is 100% there for clear guidelines yet, probably not. But it doesn't matter because there's people like you that are out there, waving the flag, reading the literature, condensing it into stuff that's practical and easy to understand. And at the end of the day, you're going to individualise it to the person in front of you anyway.
Angelique Clark 43:59
100%, I couldn't have said it better myself. That's exactly what I am doing. You know, taking that literature. Making sure that you know, in combination with everything that we have known to date, as well. So we don't just lose our brain when something new comes along. We always want to be keeping up with the new stuff that is out there. Like you said, it is definitely exploding at the moment. I'm keeping my finger on the pulse of all this sort of stuff, and then how it relates to applying that because as practitioners, we're not researchers. We don't sit in a research lab. We don't actually direct where that research is going to go, unfortunately, but through practice, and through by listening to our clients and going "Hey, like, what's the answer to this? I'm trying to find solutions that's going to help and benefit this person sitting in front of me." That's when we create the questions to go back into the research and answer that and I think you know that mutual connection between the research coming out, us taking it on board and actually then applying it to the client is a really beautiful skill set for us as sports dietitians, that's what we do in practice, and we can really just make that specific to the person sitting in front of us.
Now on top of that, looking at the nuances of the female, so, you know, sports nutrition in general is so specific to whatever sport that you do. But encompassing that is also treating that person as an individual and making sure that you're very well aware of your menstrual cycle, what that is, how it fronts up for you, what your subjective feelings are about that. So I would recommend if anything I'm going to leave you with today would be to track your cycle, and to figure out what is normal for you. So you know, look at it a minimum of three month period, and there's some apps that you can use to do this, like FitrWoman, Wild AI. There's a few other ones that I think you knew Taryn as well.
Taryn Richardson 45:49
Just a general one, like Flo, to track your cycle, or if you're old school use paper, just something to track it, it doesn't need to be you beaut.
Angelique Clark 45:57
Absolutely. And if any of you guys are specific, talking to triathletes, and really love their specificity, you might also be recording your training data in some other area, training peaks, and there's room for you know, writing in menstrual cycle and things like that as well within your training scope, and to match it with your training and your performance and also maybe your nutrition. So you might want to say okay, well, now I’m tracking my food journey, I'm also tracking my sleep and my fluid and my training on top of that, then over overlaying that is now I'm tracking my menstrual cycle on top of that and having a look of any signs or symptoms that appear quite regularly and that happen every single month. So by doing that, you're going to get a really beautiful picture of what your body goes through each and every month and then you can start to get a feeling of what's coming up and pre-empt this sort of thing, and maybe readjust some of those training sessions, based on how you feel or readjust your nutrition based on how you're feeling as well.
So that becomes super important and valuable information for your sports dietitian, because then we can take that knowledge and go "Okay, well, this is what we'd suggest having or do here, here and here because you've been experiencing these symptoms. Let's give this a whirl."
So in particular, I know we did mention iron and calcium, I think particularly if you are a female that has a fully functioning regular menstrual cycle, things such as magnesium and zinc become particularly important, maybe looking at some omega three fatty acids, in terms of supplementing an already good diet. So you have to make sure that those nutrition foundations are set in motion first before you start to look at supplementation. But then possibly these sorts of little things.
You know how to build a pyramid, we start at the base and the base of that is our nutrition foundations. What you eat day to day breakfast, lunch, dinner snacks. On top of that we build on from that, and we look at your training nutrition. So sports specific, what are we doing pre, during and post training very, very important. And then of course, on top of that, and I call this the sprinkles on top of the icing on top of the cake is that supplementation. So that's going to make you know, between a 1-2% difference with what you're doing day to day, if you've done all the other things correctly, and you built that pyramid really well.
So you know, on top of that we can look at, okay, is there a certain time leading into my cycle that I might be warranted or benefit, having a little bit more supplementation on top of that as well. So like I said, it's all something to consider with your sports dietitian. But the more data, the more info that you can get on you, as your own experiment so n=1, the better off that we have to make those nutrition related decisions based on what it is that you're after and developing you as a high performing athlete.
Taryn Richardson 48:34
Yeah, unreal. I think training peaks, you can measure a lot of those metrics and Garmin you can certainly track your cycle now too. So people are starting to listen to the female athlete and putting that stuff in which is awesome. Angie, that has been so good. I can't tell you how amazing you are. Where can people find you if they want to hear more about you, you know, follow along the female athlete journey?
Angelique Clark 48:56
A couple of different platforms. First and foremost, you can jump onto my website. So that's just www.angeliqueclark.com.au. And so yeah, so jump on there, pop your details in, I always have something that would be of benefit in terms of a download. At the moment, I have some pretty cool and amazing female superpower, super fuel recipes in there. So pop your details into that if that's something that you're after. Otherwise, you can follow me on Instagram. My Insta handle is angeliqueclark_nutrition. And then of course Facebook is Angelique Clark Nutrition to Soar.
Taryn Richardson 49:32
I'll put those links in the show notes for people if they want to check you out and do a bit of stalking. Thank you so much for joining me, Angie. It's been so good. We'll have to get you back soon because I feel like we could talk forever get us at a coffee shop together and its hours. We start getting texted by our husbands saying where are you and what are you doing? Come home. But I think that's so useful for athletes to get some information and start to actually think about it like as a female athlete. If you've been listening along and there's a few sort of really good gold nuggets in there, just at least start tracking your cycle if you're not already doing that and seeing if there's anything that you can learn from yourself based on that. But that's been so good to have you, Angie, and I'll chat to you soon.
Angelique Clark 50:15
Absolutely. Thanks for having me.
Taryn Richardson 50:17
Thanks for joining me for this episode of the Triathlon Nutrition Academy podcast. I would love to hear from you. If you have any questions or want to share with me what you've learned. Email me at [email protected]. You could also spread the word by leaving me a review and taking a screenshot of you listening to the show. Don't forget to tag me on social media at @dietitian.approved so I can give you a shout out too. If you want to learn more about what we do, head to dietitianapproved.com. And if you want to learn more about the Triathlon Nutrition Academy program, head to dietitianapproved.com/academy. Thanks for joining me and I look forward to helping you smashing it in the fourth leg - nutrition!