Friday, July 27, 2007

An email exchange with William Sichel

Those of you familiar with the ultra endurance world will no doubt have heard of William Sichel, a very accomplished international ultradistance runner based in Sanday, Orkney, Scotland ( The following is an email exchange I recently had with William:

WS: Dear Dr Stoddard.

Very much enjoyed your article "A Pain in the Gut" which I stumbled on during some research. Wish I'd found it a few years ago. A couple of queries if I may?

Do you consider fructose a GI irritant even when combined with another carbohydrate?

Me: Absolutely. Regardless of what you ingest it with, it has the potential to cause GI upset.

WS: Reference sports drink pH. Wouldn't it be better if sports drinks had a pH of 7 like water especially as we are trying to buffer excess stomach acid?

Me: A substance with a pH of 7 would not buffer anything, because it is neutral. It would have to have a pH greater than 7 to buffer acid. But, you raise a good point in that any substance with a pH of 7 if far less likely to irritate your GI tract, much like water has a very low chance of doing this. So, the goal would be to create a sports drink with a pH of 7. This is difficult to do as some ingredients in sports drinks are acidifying, such as citric acid, which does contribute substantially to enhancing the flavor of the drink. So, the goal is to get as close to 7 as possible, while of course making it taste good. Taste and acidity are competing properties that need to be balanced.

WS: With regard to pH, in my 24 and 48 hour events I am experimenting with calcium carbonate tablets (500mg per tablet), one every hour or two, to address pH issues.

Me: Sure, this is fine. But, if you choose products already formulated with pH in mind, you are less likely to need this measure.

WS: With regard to caffeine's tendency to irritate the GI system - would you recommend guarana as a better alternative.

Me: For events less than 24 hours, I don't feel you need anything else in your racing diet but carbs, water and electrolytes. For events greater than 24 hours, added protein can help stave off muscle wasting. Anything else is surplus and unnecessary, and gives your gi tract too many things to contend with during a time of compromise. Guarana does nothing for your performance, and may in fact complicate digestion due to this fact.

WS: With regard to taste/acidity, is there a role for very small quantities of sodium bicarb e.g.1.5g/L to push the pH nearer to 7 or 8?

Me: That research was done years ago, and it was found that this compound irritates the gi tract. Again, if you are choosing products formulated with pH in mind, these steps are not going to be required. Our products are always formulated with this in mind-very few, if any others, are.

WS: In events lasting longer than 24hrs, namely 48hrs and 6 day races you suggest that additional protein (presumably whey or soya) would be beneficial to stave off muscle wasting/catabolism. In these longer events at what time point would you start to introduce the protein i.e. during the first day or later?

Me: This is debatable, with no clear answer. It also varies with one important thing, and that is how successful you have been in fueling yourself with carbohydrate, as optimal carb fueling will reduce your need to catabolize protein for energy, as one of the biggest determinates of protein catabolism during exercise is carbohydrate usage. Assuming that this aspect is optimal, I would consider starting some protein intake by the end of the first 24 hours and beyond.

WS: Would liquid meal replacement products be a good idea to introduce the protein and a little fat every 4hrs or so? Or just use a good protein/carbohydrate recovery drink.

Me: I am a big believer in liquids for ultra events, as these again reduce demand on the gi tract. From an energy perspective, fat, however, is not needed at all, even for ultras, as even the leanest person has days and days worth of fat stores in their bodies for use as energy. Whether or not certain types of fat, or more specifically, fatty acids, have any 'soothing' effect on the mucosa (the lining of the gi tract), or other as of yet unknown benefits, is not yet known. Fats also may improve the palatability of what you are ingesting, which days into it can be important as you are dreaming of real food, but fat intake can just as easily be nauseating as your gut has to contend with what usually is a complicated process, that being the digestion of fat. So, based on what is known at present, a protein/carb recovery drink is fine for this purpose.


Tuesday, July 10, 2007

Join me...

On Friday August 24, please join me at Ironman Canada as I conduct my annual IMC talk.

This Year's Topic: "Painful Food": Understanding what helps, and what hinders, your gastrointestinal tract in the heat.

Place: 101-324 Westminster Ave, Penticton V2A 1K2 BC Canada (Beside the Bike Barn)

Time: 2:00-3:30 pm local time

This talk will focus on the current thinking around how your nutritional intake during training and racing, especially in the heat, can predispose you to stomach cramps, nausea, bloating, diarrhea, flatulence, headaches, hyponatremia and hypoglycemia. Your training and racing diet is strong contributor to all these issues-find out why!

For more information, email me at

See you there!

Tuesday, June 05, 2007

e load and Children...

The following was an email exchange from our 'Ask the Heatdoc' section at that I thought would be interesting to publish here:


Our son is 11years old, weighs approximately 85lbs and plays rep soccer. He has a tendency to overheat and then after the game has a headache and throws up. (It makes for very long days at his soccer tournaments) Is e load appropriate for children? Thank you!


Dr. Douglas Stoddard:


Yes, e load is 100% safe, and effective, in children. As long as your son's symptoms are confined to situations where he 'overheats' related to sport, a trial of e load would be a good idea as a way to help prevent this probable manifestation of heat intolerance. However, if he also gets these symptoms at other times, then a consultation with your doctor is the first step.

A sport/heat specific issue is not only related to dehydration and electrolyte losses through sweating, but also to energy defiency i.e. he may need to eat more during the day between games, preferably easily digestable carbohydrate sources like breads, pastas, rice, cereals, granola/sport bars and also gels. Nutritional recovery between games, including food and fluids, is of utmost importance to help prevent these post game reactions. Your son needs to start this process early in the day, soon after his first game, and continuing throughout. Along this line of thinking, a consultation with a good sport dietician or sport minded naturopath is usually helpful to facilitate this process.

Finally, one other thing that may help him stay cooler in the heat is applying small bags of frozen peas on his head, underneath his armpits, in his groin and on his breastbone just underneath his chest. These are the most common heat losing sites in the body, and cooling these areas can aid in the dissipation of excess body heat. We use these sites often at sporting events where athletes are suffering from heat illness.

For more information, please see Heat Related Illnesses.

Tuesday, May 15, 2007

An excerpt from Simon Whitfield's blog:

I had an email exchange with Simon Whitfield the other day, copied below:

Simon wrote:

G'day Dr. Stoddard, I appreciate you getting back to me (I emailed him to see if I could pick his brain). I had a couple questions re your product. I've had some stomach issues on and off through out my career. Figuring out the fructose thing was huge but trying to get a handle on the electrolyte question is my current challenge. I've been using @#$%$## and really like it but the electrolyte profile is really low, I had used your eload product in the past but to be completely honest a your labels and directions are a little confusing. I imagine either A) I'm just not reading it right or B) you wrote it in a context that you are very familiar with and would like to see other companies use but when trying to compare it to other products it's actually a little confusing.

Dr. Stoddard wrote;

Fair comment. We have changed our directions over the years and I think that they are easier to follow now. The customization directions in our earlier years I think may have been a little hard to follow-this has all been simplified now. Regarding comparison, we have made that really easy by setting up comparison charts for all of our products at

Simon wrote;

I'm thinking you're wondering if I graduated high school... but what's the difference between sodium citrate and sodium chloride (is that salt?).

Dr wrote;

Hah-that's funny, but don't worry about it. I didn't know the difference either until I got really stuck into this stuff a few years ago prior to us launching e load. Sodium chloride is table salt. Sodium citrate contains sodium just like table salt, but instead of chloride, it's attached to citrate, a different molecule that has different properties than chloride. Citrate is a great because it buffers acid in your stomach, plus, it is converted to bicarbonate inside your body, thus helping buffer lactic acid in your blood.

Simon wrote;

For the Des Moine race in June it's predicted to be a very humid race, I'm a very light sweeter and avg. in the heat (no advantage no disadvantage). My usual "game plan" is 120cals on the bike with around 500mg of sodium and various other electrolytes (I've been using @#@#@#@#@#@#@@ but so far it hasn't agreed with me).

Dr. wrote;

Hard to comment unless you tell me your average times for each of the three events-let me know more here and I can help evaluate.#$#$#%#%#%#% maybe giving you problems because it is a very acidic drink, having 12 x more acidity than e load. This extra acid irritates your stomach. Also, their electrolyte mix is a little wonky. Sodium:potassium ratio is way off, as is their Calcium:magnesium ratio-again, see the comparison chart specifically at

Simon wrote;

I rarely if ever take calories on the run as the intensity is so high it's a little impracticle.

Dr. wrote (I like this part :) Yeah, I've seen you tear it up several times running and I agree, it isn't necessary here, as long as you have appropriately topped up on the bike.

Simon wrote;

I also feel I'm not doing a good job of hydrating pre event and in the travel to the events.

Dr. wrote;

That's pretty common, and in my mind, is one of the biggest issues facing endurance athletes. Since most races start early am, people rarely arrive on the start line adequately hydrated-see for additional thoughts on this one.


eload is making a new gel I'm keen to try and Dr. Stoddard hosts a REALLY interesting blog at

...and check out Simon's cool blog at

Friday, May 11, 2007

e load Energy Gel

Spring, and the launch of our new gel...

Taking advantage of the latest information on why gels are so irritating to the gastrointestinal tract, this gel is about as irritating as baby food...

The reasons why most gels are so irritating are:

1. Too sweet, too flavorful
2. Too thick

Both of these reasons affect the psychology of eating gels i.e. your head starts to object, so your gi tract soon follows. e load gel is subtle on sweetness and flavor.

3. Too acidic

All gels on market that we know of are very acidic. This is because their manufactureres put preservatives in them, and preservatives only work in acidic enviroments. So, most gels have pH's around 4-5.

Turns out your stomach is a very acidic enviroment during exercise, due to all that stress your body experiences during exercising times. So, the less acidic your sport nutrition products, the better.

e load energy gel uses no preservatives-we figured out a way to keep the product sterile and safe, without using them. So, it doesn't have to be acidic at all. Our pH level is around 7, meaning it has no acidity whatsoever, like water.

4. No resistant starch

This is an interesting topic. Turns out that maltodextrin, the common carbohydrate used in every gel we are aware of, if derived from dent corn, the most common type of corn grown on the planet, may contain undigestable chains of carbohydrate called resistant carbohydrate or resistant starch. Ultimately, these chains come from amylose, one of two plant based starches found in dent corn (the other starch is amylopectin). Waxy maize corn, another corn varietal, contains only amylopectin, and no amylose, so using this corn as your base is a better choice for producing easily digestable maltodextrin. e load energy gel uses maltodextrin derived from waxy maize corn.

5. No fructose

The carbohydrate fructose continues to be a common, cheap sweetener used in many sport nutrition products, and is derived from fruit sugar. It is also a known gastrointestinal irritant. Most gels contain this carbohydrate. e load energy gel does not.

6. Dextrose

Dextrose is a great carbohydrate for adding to a gel, because it adds a pleasant, subtle sweetness to the product (less so on a gram for gram basis vs fructose), plus, it facilitates the absorption of sodium-good in the heat.

Check out

On sale now...

Monday, April 09, 2007

Warning...Beware of 'warnings'...

I'm not overly political, or controversial, and to date have not used my blog to discuss anything but nutritional science, heat related clinical syndromes in athletes and product development, all topics I am passionate about...but,

we've known for sometime now about some of the 'warnings' that are listed on our competitors' labels...well, actually, on the labels of one specific competitor-the only competitor who has the 'public interest at heart' by being kind enough to warn them at all...

This particular company warns their consumers against the evils of combining their products with any other competitor products that contain 'simple sugars', warning the unweary that they may suffer, ahh, well...I don't know what they are warning against! I have been practicing sports medicine for years, and have never come across any scientific information that supports this 'warning', despite consistent and thorough reviews of the science we have to date. I have seen 17000 patients as a sport medicine physician and not once have I EVER come across any problems in athletes that were due to the consumption of 'simple' sugars. And, certainly no harm could ever come of combining the products of said company with those of any other company, simple sugars or not, despite their 'warning'.

Not a week goes by when a consumer doesn't email me wondering if this 'warning' is actually based on anything other than marketing hype. I congratulate said company on their marketing savvy-a great way to scare people into using their products, or, rather, into not using the products of their competitors. Besides fear, surely there must be some good, solid scientific reasons why said company thinks their products are worthy of use...

Those of us who manufacture sports nutrition products have an obligation to stick to the science, followed by clinical experience, if there is any. Unfounded 'warnings' directed to consumers trying to make sense of the myriad of scientific data and marketing hype out there are just plain irresponsible. Warnings can be taken way out of context, instill needless fear in people who may not be well versed on the science, and in the end, to the other companies trying to make and market good quality products based on defensible platforms, are a disappointment to see.

Surely, said company can, and should, think of a more honest approach to their marketing tactics.

Thursday, March 15, 2007

Painful food...

I have recently done a few pod casts for Walker, the gracious host, coined the phrase 'painful food' during one of our discussions, and we are to cover this topic in more detail tomorrow as we record our third podcast on gastrointestinal intolerance in the athlete.

What a great way to describe food and beverages that irritate your gut during training and racing, especially in the heat. My sport medicine practice is full of patients who struggle with stomach and intestinal upset, and I am grateful to these patients for giving me real life stories to shape my thinking on this topic. Combine that with some of the science currently out there, and the golden rules of 'PainLESS food' are thus:

1. No fructose-fructose is natural fruit sugar, a common cheap sweetener used in most sport nutrition products. Some manufacturers are even happily putting this sugar in many of it's products, with the back up of one study that suggests that using fructose with one other sugar in the product enhances absorption and utilization of the carbs. Great, as long as your not on the verge of vomiting due to fructose ingestion, if it's true at all...

2. No resistant starch-which most gels contain due to the fact that their maltodextrin components are derived from dent corn, a variety of corn that contains indigestible carbs called resistant starch, which merrily pass into your colon, contributing to gas, bloating, pain and dehydration due to their osmotic effects. In effect, this starch behaves like fibre...which you definitely don't want in your competition diet.

3. As neutral pH as possible-pH measures acidity. Water has a pH of 7-lower is more acidic, and higher is more alkaline (or, basic). The stomach is a pretty acidic place to begin with, but the stress of endurance activity, especially in the heat, turns on the acid pumps in your stomach even more, increasing your stomach sensitivity to ingested acid. Therefore, the products that are closest to pH of 7, or, even slightly alkaline to help buffer stomach acid, are usually best tolerated. Who cares about pH and acid? Not many manufacturers do.

4. Simple is better-your body needs three things for most endurance events-water, electrolytes and carbs. That's it-nothing protein, no vitamins, no fat, no artificial sweeteners...give your body only what it needs, as your gastrointestinal tract has enough troubles processing even these things, let alone complicating it with non-necessary stuff.

That's a good start. Check out the podcast for more...