Dietitian Marisa Michael on Disordered Eating and RED-S in Climbers

Date: January 15th, 2020

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About Marisa Michael

Marisa Michael is a dietitian, a personal trainer, and an athlete. She’s been a dietitian for 17 years and has a private practice at RealNutritionLLC.com where she helps athletes optimize nutrition for sports performance, from recreational to elite. While she has mainly focused on running and triathlons, 5 years ago when her son got into climbing, she followed suit.

The reason I wanted to speak with Marisa is that she has a lot of knowledge about eating disorders in athletes and she’s done some research on Relative Energy Deficiency in Sports (RED-S) syndrome. RED-S is basically when an athlete doesn’t consume enough calories to support the activity they do, and therefore they stop menstruating and/or have decreased bone density. They can also suffer from fatigue, anemia, poor recovery, and many other things. This used to be called the Female Athlete Triad, but it was renamed to include males.

RED-S in the Climbing Community

Many climbers have been coming forward and talking openly about their struggles with RED-S, eating disorders or both of those issues, and I wanted Marisa to shed a little more light on the topic. Specifically, Mina Leslie-Wujastyk has written about her recent RED-S diagnosis and her current campaign to heal her body. She’s been open about it on her Instagram account, which I respect immensely. She’s personally responsible for 2 of my female nutrition clients finally being willing to go see a doctor about losing their periods.

In this interview we go over the research that Marisa and her colleagues have done on eating disorders in climbers and other athletes, as well as a discussion about RED-S. We use Mina as an example throughout the conversation, and I have Mina’s permission to publish this interview.

I hope this interview helps you understand the nuances of RED-S and disordered eating a little bit better. Even if you don’t suffer from either, I think it’s helpful for all of us to be aware of these very prevalent issues so we might encourage others to get the help they need.

Marisa Michael Interview Details

  • Kids climbing team survey results on disordered eating
  • How to talk to kids about weight
  • Correlation between BMI & climbing ability in kids
  • RED-S explanation
  • Study on prevalence of eating disorders in 600 climbers
  • How Mina was a normal weight and still RED-S
  • Signs of RED-S besides loss of period
  • How to choose health practitioner for RED-S

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Transcript

Neely Quinn: Welcome to the TrainingBeta podcast where I talk with climbers and trainers about how we can get a little better at our favorite sport. I’m your host, Neely Quinn, and I want to remind you that the TrainingBeta podcast is actually an offshoot of a website I created, trainingbeta.com, which is all about training for rock climbing. Over there we have regular blog posts, we have training programs for boulderers or route climbers or people who just want to train finger strength or power endurance. We also have online personal training with Matt Pincus as well as nutrition consulting with myself – I am also a nutritionist.

Hopefully one or more of those resources will help you become a better rock climber. You can find us at trainingbeta.com and you can follow us on social media @trainingbeta.

Welcome to episode 141 of the podcast. Thanks so much for joining me. I didn’t do a podcast for about a month and that’s because I was in Florida. I was looking at manatees and playing mini golf and playing cards and pool with my family and teaching my mom to deadlift and weight lift in general so that she can help her bone density. I’m super psyched that she’s actually excited about it and has continued to do it. It was great.

Now I’m very happy to be home in my own home and back to climbing, although I can’t climb that much right now. I actually have kind of an injury and I might take you through the process of that a little bit because I’ve had it for a few months. I injured my forearm training on a hangboard, actually, before I went to the Red. I did it while I was doing those long repeaters that I think I mentioned on one of the episodes. I would do 7 seconds on/3 seconds off for two minutes. One of those times I pushed it. I did more sets than I was normally doing and I felt this burning pain in my forearm. 

I climbed through it in Kentucky and it was generally fine but it hurts to open jars and to climb and rest is not making it any better. I’m actually going to see this physical therapist named AJ Cohen. It’s called Up and Running PT and he works out of Whetstone, the climbing gym in Fort Collins. The reason I’m going to see him is his philosophies are very similar to Tyler Nelson’s, who I’m sure you’ve heard on the podcast. He’s been on like a hundred times. I’m hoping he can diagnose it and help me through this so I’ll take you through that process. I’ll just do little updates here and there on that to show you how PT can be a little bit different. Hopefully it will work for me.

Today’s episode is with Marisa Michael. She is a registered dietician. She’s also a trainer and she’s an athlete. She is a climber and she also has a long history with triathlons and running but the reason I asked her to be on the show is she has a lot of knowledge on RED-S, which is Relative Energy Deficiency in Sport. It used to be known as The Female Athlete Triad but they changed the name to include men. 

Basically, what it is is when you don’t eat enough food to nourish yourself and the amount of activity that you’re doing as an athlete, and your body responds by either losing your period or decreasing bone density or you can feel fatigue or you could become anemic or you could have slow recovery from your workouts – there’s a bunch of different symptoms to this syndrome. It goes along with disordered eating behaviors and full blown eating disorders. 

We all know that climbing and weight are very much tied together. The lighter you are, in theory, the easier it is to get up the wall because we’re fighting against gravity. We see a lot of calorie restriction in climbing, especially in elite climbers, and I know that this is becoming more and more common to talk about on social media and in articles in magazines and stuff. One in particular really struck me and that was Mina Leslie-Wujastyk. She came out and said that she had been diagnosed with RED-S and she talked about what her symptoms were, what her doctor found, and how she was going about treating it which is basically resting more and eating more. I have linked in the show notes to her article that she wrote about it and her Instagram account. We talk about Mina in this interview.

That was one of the biggest reasons I wanted to have Marisa on. We talk about RED-S, the description of it, how you get over it and all of the nuances of it, and then some about disordered eating in general. We also talk about some research that she’s done on kid climbers, like on kid team athletes who she surveyed to see what kind of behaviors they’re exhibiting. There is some other research that we talk about that she did and that some of her colleagues did.

So here is Marisa Michael. I will talk to you on the other side. 

Neely Quinn: Welcome to the show, Marisa. Thanks very much for talking with me today.

Marisa Michael: Thank you for having me.

Neely Quinn: Of course. This is a super interesting and necessary conversation right now, I think. Why don’t you tell us about yourself?

Marisa Michael: I’m a dietician. I’ve been a dietician for about 17 years and I live in Portland, Oregon. I specialize in sports nutrition so I help people with performance nutrition, sports nutrition – athletes and active people.

Neely Quinn: Nice. You’ve been doing this for awhile. That’s awesome. You have a lot of letters behind your name. Do you want to tell us about those?

Marisa Michael: Sure. My first letters are a master’s degree in sports nutrition. I’m also a registered dietician/nutritionist and I hold the IOC diploma in sports nutrition which is a two-year post graduate program through the International Olympic Committee. I also am a board certified specialist in sports dietetics. 

Neely Quinn: Okay. That sounds like a lot of schooling.

Marisa Michael: Yeah, it is a lot of schooling. The other letters that don’t show up because they’re not official is certified personal trainer and I’m also a group exercise instructor.

Neely Quinn: Oh, okay. So you have a lot of different hats.

Marisa Michael: Yeah, but I like the way nutrition and fitness kind of come together with the sports and nutrition.

Neely Quinn: What does your typical day look like? Or is it really varied?

Marisa Michael: It’s really varied. That’s a great question. I actually have three children. They’re aged 15, 13, and 10. My goal is not to be a full time dietician so I’m pretty flexible. I own my private practice and I just see clients on a really flexible basis. I schedule them and decide when I see them and how many I see. The rest of the time I am a mom and running the household and just training and exercising and doing fun things.

Neely Quinn: That’s not typically what you think of when you think of a dietician or somebody with your credentials. You think of them working in a hospital or at some sort of clinic. I’m assuming you did have some years doing that kind of stuff?

Marisa Michael: Yes, I worked for home health for 11 years in the Bay Area and when I moved to Portland about five years ago I wanted to make a switch. I’ve always been interested in sports nutrition but having kids and trying to raise them, as little kids, made it hard for me to grow my career. When I moved here I decided to make a pivot because they were old enough. I decided to open up my own private practice and get a little more training in sports nutrition.

Neely Quinn: And actually use that information. I have a feeling you didn’t work too much with it when you were working with home health.

Marisa Michael: No, it was homebound patients so it was a lot of geriatrics. Very different.

Neely Quinn: Not much sports there.

Marisa Michael: No.

Neely Quinn: What’s your typical client like now?

Marisa Michael: It ranges, actually. I see a lot of clients that are just active and they want to know how to fuel themselves, they want to figure out how to eat to perform their best, and a lot of them are recreational athletes. I see some collegiate athletes and I see some professional athletes. The other half of my clientele is a lot of intuitive eating and disordered eating clients, so trying to help them heal their relationship with food and body. The age range is all the way from as young as 13 to even people in their 60s.

Neely Quinn: It’s really varied for you, then.

Marisa Michael: Yeah, but it’s fun. It keeps it interesting. I really like that.

Neely Quinn: For sure. The reason that we’re talking today is that you’ve also done some research. Do you want to talk about that?

Marisa Michael: I would love to talk about that. For part of my master’s degree I had to do a research project and a thesis. My son has been on the rock climbing team for about five years, our local team, so I wanted to research climbers. There’s not a lot of nutrition research on climbers and I felt like there was a void that I could start to at least fill a tiny bit. 

I actually took my son’s rock climbing team and I asked them certain questions. We gave them surveys and I interviewed each one of the kids and asked them what they ate, their health history, and then I also gave them a survey called ‘The Eating Attitudes Test.’ It’s called ‘The Eat 26’ because there are 26 questions and it basically asks a lot of different questions about their eating attitudes and their behaviors toward eating and their attitudes about that. Then I just looked at all the data. 

We were really interested to find out a lot of things that I feel are unknown in the climbing world like if you are lighter, are you a better climber? Or if you eat less are you a better climber because you are lighter? Or if you eat more are you a better climber because you’re fueling your climbing? Or are these adolescents at risk for disordered eating? They’re kind of at a vulnerable time where they’re growing, their bodies are changing, and they’re also in a sport that has that high strength-to-weight ratio where a lot of people are encouraged to stay light and lean. I wanted to just look at that and see if that affected our youth athletes in any way.

Neely Quinn: That’s awesome. First of all, thank you for doing that. There definitely needs to be more research done on this so that’s pretty cool.

Marisa Michael: I agree.

Neely Quinn: One question: when you say, “If you’re lighter are you a better climber?” I’m assuming you mean light BMI-type lighter, not just weight?

Marisa Michael: Yeah, we looked at BMI. When we were looking at all this information I was wondering – I had a lot of questions I wanted answered. Things like: does x correlate with y? If they were lighter/if they had a lower BMI, were they better climbers? Things like that.

Neely Quinn: What was the average age of them?

Marisa Michael: They were between 11 and 17. I think their average age, I would have to look at the numbers again, was 13?

Neely Quinn: How many of them were there?

Marisa Michael: There were 22 climbers so it was a small sample size. That was just all of the climbers I had access to. Thirteen were male and nine were female.

Neely Quinn: Are they competitive?

Marisa Michael: Some of them are and some of them aren’t. They average 11 hours a week of training and they are pretty good, actually. We looked at their climbing ability. We wanted to see if climbing ability correlated with disordered eating patterns or with their BMI and things like that so we did take their climbing ability into account as well. 

Are you familiar with the International Rock Climbing Research Association? They have a scoring system. You know how in the climbing world there are a million different ways to rate routes? Like there’s Yosemite and there’s the French and all of that. The IRCRA has a system where it kind of unifies all of those and it gives them a number.

All of these kids were climbing – they know their rating based off the Yosemite Decimal System – based on the IRCRA score, they were averaging between advanced and elite for most of them.

Neely Quinn: Oh nice.

Marisa Michael: Their average climb was a 5.12.

Neely Quinn: Cool. That’s an interesting sample size and make-up. So what did you find?

Marisa Michael: We found a lot of information. Just knowing what you know about climbers and eating disorders and adolescents, what do you think your hypothesis would be if you took this sample size and you thought, ‘Well, how much disordered eating do they have?’

Neely Quinn: I would say a lot.

Marisa Michael: Yeah, that’s what I thought, too. There were other sports we compared it to also, like there’s a lot of research on dancers and weight-class sports like wrestling and boxing where you have to be a certain weight in order to compete. In weight-class sports, like 30-35% of those athletes have eating disorders. Ballet dancers it’s 83%. Collegiate swimmers it’s 27%. So it’s quite high. I thought that climbers would kind of fall in that range but good news with our cohort is we only had one kid out of our entire cohort who triggered for risk for disordered eating.

Neely Quinn: Woah.

Marisa Michael: It was like 4%. 

Neely Quinn: That’s crazy. So all of them were just normal? Healthy? 

Marisa Michael: Yeah. What was interesting with that is I did this with a couple other researchers. One is Doctor Oliver Witard. He is out of the University of Stirling. He’s since switched over to King’s College in London. And also Doctor Lanae Joubert. She’s done a lot of climbing research. We were thinking, ‘I wonder why they’re so low?’ 

I think it would be interesting to study a swath of youth climbing teams throughout the country or throughout the world and see if there’s any other different patterns we pick up. Like I wonder if different climbing teams might have a higher risk for disordered eating if the culture is different. For example, my son’s climbing team that I surveyed, they’re pretty low key. They’re pretty laid back. The coaches are really supportive. They can say, “Do a comp. Don’t do a comp. Do as many comps as you want. It doesn’t really matter. We’re cool with whatever you want to do and we support you in that.” I like that about his team. 

I know there are some other teams. I presented this research at a conference in Berkeley this past summer and a lot of people in attendance were associated with other youth rock climbing teams throughout the country. I got some interesting feedback from them where they said, “Well my climbing team is totally different. The coaches tell them to lose weight, they weigh in, they talk about nutrition all the time, and it’s really cutthroat and competitive.” I would bet, just based on what I know, that maybe they would have a higher risk for eating disorders.

Neely Quinn: Yeah, right?

Marisa Michael: That was pretty interesting to me. I didn’t really think about that going into the research, that maybe coaching style or culture might play a role. It would be interesting to study that.

Neely Quinn: This is anecdotal but I was on Instagram recently and Chelsea Rude put a post up that was very…

Marisa Michael: Oh yeah. I saw that.

Neely Quinn: Did you see it? She was super vulnerable about her eating disorder history and she said that it started partly when her coaches were doing caliper testing on her body fat and telling her maybe she needed to lose weight. I can imagine, as an impressionable young girl, you’re like, ‘Oh, well obviously there’s something wrong with me.’

Marisa Michael: Yes, and that is true and that’s been researched in other sports. We just don’t have it in climbing yet but I can bet, based on what we know of other sports, as soon as the coach is doing weigh ins or body composition scans or data is broadcast to the whole team or there’s kind of a culture of ‘thinner is faster’ or ‘thinner is better,’ that’s usually where things can lead to trouble.

Neely Quinn: Yeah. I have so many questions about this. If you have a super competitive team and you want your kids to be the best and it is a strength-to-weight ratio sport, then how do you impart to them in a healthy way – I don’t know. What do you say to them, if anything?

Marisa Michael: That’s a great question. I have some ideas. I don’t have any good answers, partly because there’s not a lot of good research behind it, but I think one of the things we could do as a climbing culture and as an athletic culture is to really look at the evidence and say, “Is it really even true that you are a better athlete if you’re thinner?” Obviously with climbing it probably is to some extent. It’s pretty clear. You’re just working against physics if you’re heavier going straight up a cliff, but there’s probably diminishing returns. The thinner you get probably you’ll lose some performance and some lean mass. We don’t really know that in climbing yet, like what is that point where there’s this optimal strength-to-weight ratio?

I was looking at Beth Rodden. She’s been posting some really amazing things on Instagram. She posted something about how she couldn’t climb a boulder – I can’t remember what the grade was – when she was really, really thin and then she came back several years later and 15 pounds heavier and just sent it. You’ve just got to wonder, especially in these adolescent climbers. Adolescents are supposed to be growing. They’re going through puberty. If you start out as a skinny little 7-10 year old climber and you’re really, really tiny and you climb through puberty up to age 18 or something, your body is going to change and you’re going to get heavier. 

Female adolescents usually gain 40 pounds just within puberty within a couple years so a coach might look at that and think, ‘Oh my gosh, she’s getting fluffier, she’s getting heavier, this isn’t good. She needs to lose weight to climb better.’ That’s actually not the case. Her body is just growing and it needs to grow. That’s okay, but maybe you can help them learn different skills or different training tactics or help them be able to just climb in their new body. I think that might be a solution. 

Neely Quinn: Yeah. Right. What did you find in your study about being lighter and being stronger and those correlations?

Marisa Michael: It didn’t correlate at all, which was mind blowing. [laughs] The thing that was most relevant, which has actually been backed up by some other climbing studies – there’s other climbing studies but there’s not a really good one yet about if weight correlates with climbing, which is another area of research. There are so many anthropometrics, which just means your body weight and height and body composition and things like that. Those studies and also my study found that training techniques and years climbing was more highly correlated with your climbing ability, so the kids that were climbing longer were obviously better. The kids that were heavier or lighter, it didn’t matter. It was just how long you had been climbing.

Neely Quinn: Were there two things you said? Years climbing and something else?

Marisa Michael: Their training load. The kids that had a longer training load, like there were kids that only climbed a couple hours a week and there were kids that were climbing 15 hours a week. The ones that climbed more were better, which totally makes sense.

Neely Quinn: Right. It essentially is a skills-based sport.

Marisa Michael: Yeah.

Neely Quinn: That’s encouraging. Let’s tell all the kids that.

Marisa Michael: Yeah, ‘Just climb more and climb appropriately. Also, take rests and periodize your training so you don’t have to be thin. You just have to have experience.’ The other study is [unclear] is adults, which is super interesting as well.

Neely Quinn: Have you ever seen – it’s not research, it’s more just collecting data from 8a that Tom Randall and Ollie Torr did? What do you think about that?

Marisa Michael: I was looking at a little bit of that. I haven’t looked a ton at all of their data. I was actually looking at one about the ape index. That was something that I wanted to have a data point on and we decided to skip it but there’s some other research on ape index and if that correlates with climbing. I want to dig more into that website, though, because I think it has a lot of good information on there.

Neely Quinn: One of the things that they found was the average of the BMIs of all the elite climbers. For sport climbers I want to say it was like, I don’t really remember, but it was definitely lower than the boulderers and it was definitely on the lower end of the healthy BMI. I guess what I’m wondering is what was the average BMI of these kids? If you’re a 22 or a 19 it doesn’t matter but if you’re a 26 that’s a totally different story.

Marisa Michael: That might matter, yeah. BMI was 20.

Neely Quinn: So it is pretty low.

Marisa Michael: And then if you’re a comp climber, especially at the elite level, like the International Federation of Sport Climbing, they measure BMI. When we were doing this research we were in communication with them because we wanted to know if they had a BMI cutoff, like a solid cutoff where they wouldn’t allow people to compete. They were sort of avoiding our question. [laughs] They didn’t really say straight out like, “Yes, at a certain BMI,” but they did indicate around 17 or lower you can’t compete. Don’t quote me on that because they didn’t really say an actual number but they sort of implied that.

Neely Quinn: I thought they did. I thought they were doing that.

Marisa Michael: They were doing it and I think if you look into the competition rule book they do mention that. I was like, ‘Do you not let them compete if they’re under 17?’ and they were kind of like, ‘We look at individual climbers.’ I’m not sure on that one. I’m glad they’re measuring and I’m glad they’re looking at that and considering that, like wondering if these people are safe to climb and if they’re healthy and are they okay.

Neely Quinn: But how are they even measuring that? I don’t think they’re weighing people before comps, are they?

Marisa Michael: I have no idea. I wonder if it’s just self-reported? That’s a good question.

Neely Quinn: For people who don’t know anything about the BMI do you want to just tell them a little about it?

Marisa Michael: It’s just a ratio of height to weight. BMI in the United States is used a lot to determine if it’s normal weight or if you’re underweight or if you’re obese or overweight. There’s a lot of flaws with the number so you kind of have to take it into context. A BMI of 20 is kind of thin. It’s kind of normal-ish thin side. Then 25-30 is considered overweight and over 30 is considered obese. If you’re under 20 you’re pretty thin. If you have a BMI of 17 that’s very thin.

Neely Quinn: And I think underweight is 18.5 and lower, right?

Marisa Michael: Yeah, and that’s actually one of the things the IOC looks at. If you have what’s called Relative Energy Deficiency in Sport, if your BMI is too low or if your bodyweight is too low, that is a concern for health implications.

Neely Quinn: And the IOC is the International Olympic Committee, right?

So let’s talk about RED-S. That’s part of why I wanted to talk to you, for sure, because it’s a really much-needed conversation. Tell me what you know. [laughs]

Marisa Michael: I could talk for a long time about that. Relative Energy Deficiency in Sport – people listening might have heard the term Female Athlete Triad before. In the sixties and seventies there was a lot of research emerging. They started to notice in female athletes three separate things: one is osteoporosis or low bone density, a lack of a period like they had lost their period or maybe they never had got their period, and also eating disorders. That was called the Triad. Eating disorder, bone density, and lost period. That was a big concern. They were like, ‘Well this isn’t good. This isn’t healthy. They’re not eating enough.’

Now, over the years, they’ve researched more and they’ve discovered there is actually a whole spectrum. It’s not just these three things. There’s a lot of health effects that happen if you are not eating enough. You might not be eating enough just because of an eating disorder but maybe, inadvertently, just not fueling for your sport the way you need to. Maybe you’re not understanding that or maybe you’re trying to lose weight on purpose but not fueling enough and then getting Relative Energy Deficiency in Sport. 

It’s also called Low Energy Availability sometimes and it just basically means there’s a mismatch between the calories that you’re eating, the energy that you’re taking in, and the energy that you’re putting out. 

Neely Quinn: It doesn’t just affect females, right?

Marisa Michael: No, it affects males as well. There’s a whole slew of health consequences. There’s cardiovascular consequences, you can have a higher resting heart rate, you can have lower cardiovascular adaptations to training, you can have decreased immunity, lost period or irregular periods, or maybe your period is normal but your hormonal phases aren’t quite right and you have decreased fertility and ovulation. For children you can have stunted growth or they can grow delayed, like delayed puberty. You can have mood disturbances, mental health kinds of issues, decreased hormones so decreased testosterone and decreased estrogen. You can have decreased muscle strength, no training gains, all of these sorts of things. It does affect both men and women but it originated from research in women. 

Neely Quinn: It seems like it could be really hard to diagnose.

Marisa Michael: Yes, it could be sort of vague. If an athlete comes to you and they say, “Well I kind of feel tired and I thought I’d be better trained this far into my training schedule than I am,” you’re like, ‘I don’t know. Is that overtraining or are you not eating enough? What’s going on?’ You can look at a number of different variables to see if it is RED-S. 

I look at if they are eating enough based on their food records and then I calculate out their energy needs, their macronutrient needs, and I look at their body fat. If it’s too low that’s a concern. For females I of course look at the period. For males you can get testosterone tested and see if that’s low. Sometimes a simple fix for low testosterone is actually eating enough [laughs]. You can look at their bone density. If it’s more severe there would be more symptoms like maybe their EKG is abnormal or their resting heart rate is abnormal. There’s something called ‘being orthostatic’ where if you’re seated you’re at a normal heart rate and if you stand all of a sudden your heart rate just skyrockets disproportionately and you can’t even tolerate standing very well. That happens a lot in eating disorder clients. 

There are a lot of things you can look at to decide if Relative Energy Deficiency in Sport is happening or if it’s some other underlying problem.

Neely Quinn: One very high profile climber, Mina Leslie-Wujastyk, just came out and said, “I have this,” and described it in this big article, which I thought was very brave of her.

Marisa Michael: Yes, very brave. I was really impressed with her courage because it’s a very vulnerable thing. 

I’ve written a book on rock climbing nutrition. It should be published in a couple months through Fixed Pin Publishing. I interviewed several athletes and climbers and a lot of them – actually, not a lot, I shouldn’t say that – two of them told me they had been diagnosed with RED-S and that was really interesting for me. 

Neely Quinn: Did you write about them in the book?

Marisa Michael: No, I didn’t want to disclose that for privacy reasons. Some of the names aren’t even in the book for the people that told me that they have RED-S but I did get to interview Beth Rodden and Sasha DiGuilian about their climbing because they’ve been very open about body image in the sport and how it’s hard to be vulnerable and how it’s hard to be in a sport where you always feel like you have to be thinner. They’re awesome. They had some really good insights. I got to interview Adam Ondra and Hans Florine as well.

Neely Quinn: Did you find any similarities between the men and the women in their eating behaviors or approach?

Marisa Michael: No, they were all really different. It was kind of interesting. Adam Ondra had a different way where he just said, “Well, I eat a lot of whole grains, I eat a lot of fish, I eat a lot of vegetables,” and he just told me what he liked to eat while climbing, before, and after, and he mentioned Chinese Medicine a lot. He is interested in that and really subscribes to that philosophy so he was talking about that a lot. Beth and Sasha – well, I sort of asked them different questions because they had been public about body image and climbing so I asked them more along those lines rather than eating for climbing. Then Hans Florine just told me a lot about what he likes to eat and what he likes to take on really long multi pitch climbs.

Neely Quinn: Yeah. I mean, it seems like – I know a lot of guys in climbing and I know a lot of elite athletes and I think a lot of guys have not quite the body image issues that maybe the females have but they’re definitely restricting food.

Marisa Michael: Yes, and that’s actually something I looked at in my research, too. I wanted to see if males and females in my cohort had different eating disorder patterns and different eating patterns. My whole group overall weren’t different for males and females but a lot of them were undereating. 82% of them didn’t even meet their estimated energy needs, which is a ton. It’s alarming for adolescents. They need to be eating enough calories. 86% under ate on carbohydrate needs. 

Doctor Lanae Joubert, she’s out of Northern Michigan University, did a study on 604 climbers. She just sent out a survey to members and affiliates of the Rock Climbers’ Research Association. She asked them the same thing I did with that eating attitudes test: is there risk for disordered eating? She looked at differences for males and females, too.

Neely Quinn: And what did she find?

Marisa Michael: She found that overall, there was a 9% prevalence for the risk of disordered eating out of 604 climbers. That’s like 45 climbers that had disordered eating or eating disorders. Then the males had a lower prevalence, though. They were at 6% and the females were at 17%.

Neely Quinn: Oh, wow.

Marisa Michael: The more elite they got the more at-risk they were for eating disorders. The higher climbing ability had more disordered eating. 

Neely Quinn: Did she look at the BMIs of people? 

Marisa Michael: She did not. She just sent out the climbing ability survey and the eating attitudes test. She didn’t collect any data on anthropometrics or on their nutrition intake.

Neely Quinn: What was the age of these climbers?

Marisa Michael: It was older. I think the average age was 30.

Neely Quinn: Oh, okay. So it was like climbers from random climbing gyms around the country?

Marisa Michael: Internationally.

Neely Quinn: Oh, okay. Any other things that she found?

Marisa Michael: She found – let’s see. I know she found some other stuff. Oh, she looked at what type of climbing they identified as. Out of 604 climbers, 498 were lead climbers and then 115 were female and 393 were male so it was quite a bit of male climbers. She had more of a male sample size. I can give you more. I need to look it up. I don’t have it right in front of me.

Neely Quinn: Does she have this study published?

Marisa Michael: No, not yet. [laughs] She has her manuscript accepted but it’s not published yet so it’s not available to look up yet but I co-presented this research with her in July in Berkeley so that’s why I have her data. [laughs]

Neely Quinn: How do you spell her name?

Marisa Michael: Lanae Joubert. She’s Northern Michigan University.

Neely Quinn: Does she have other research out?

Marisa Michael: Yes, she does. She has a few published studies on climbers. One was I think back in 2008 with adolescent climbers. She went to the National Youth climbing competition and took anthropometrics on all of them. She wanted to see basically what their body type was like. How tall are they? How heavy are they? That was interesting because back in 2008 and older studies – there’s a few of them from the early 2000s from other researchers – they always showed that climbers are shorter and leaner and lighter than other athletic counterparts. Now I’d like to get some research to see if that’s changing. I feel like the sport is changing and the way people climb is changing. 

You just had that podcast about how it’s a challenge to be a shorter climber, which I thought was really interesting because the research from 15-20 years ago shows that the better climbers were shorter climbers.

Neely Quinn: But what is ‘shorter?’ A lot of us are shorter than average Americans but…

Marisa Michael: So shorter compared to another athletic counterpart. If you take a group of climbers and you say, “Well how tall are all these climbers in this group?” versus a group of runners or soccer players or something like that.

Neely Quinn: Any other findings that we want to talk about with Lanae’s stuff?

Marisa Michael: I think that was about it. That’s all that I have. I wish I had more. I’m looking forward to her manuscript being published.

Neely Quinn: Yeah. Cool. Well then maybe we could go back to RED-S? 

I’ve recently had two elite female athlete nutrition clients who have been motivated to go see a doctor because of Mina, basically. Thank you, Mina. It’s so amazing. 

Marisa Michael: The world owes her one.

Neely Quinn: I know. They’re not getting their period and they’re not eating enough but the interesting thing about Mina is that she was a pretty normal weight. That’s why this was so shocking, even for me. When I look at Mina she looks like a normal person. She’s not and she wasn’t super thin. When she came out and she said, “I have this,” I was like, ‘Wow. I wouldn’t have expected that.’ I think that’s part of why it’s such a good lesson, because you can look any kind of way and still be undernourishing yourself. What do you have to say about that?

 

Marisa Michael: That is such a good point. I’m really glad you brought that up because there might be a misconception that if you’re thin or too thin or appear thin something may be wrong but if you appear whatever a ‘normal’ weight looks like, maybe you’re fine. With RED-S weight is only one data point/one consideration. 

I also want to distinguish between an eating disorder and disordered eating versus RED-S. Those are not the same thing. If you have an eating disorder and you are not getting enough nutrients it can result in RED-S but if you have RED-S that doesn’t mean you have an eating disorder. It means maybe you do and that’s why you’re not getting enough fuel or maybe you’re just inadvertently not eating enough. 

The period is considered a vital sign so if you’re thinking in those terms, no matter if you are at a normal weight, if something happens with your period where it’s irregular or it’s spotty or it goes away even if you appear healthy or you think you’re okay that’s a big red flag. There are other things that might be happening in your body that you might not even be aware of like you might be losing bone density and not even realize it, you could be having low hormones and not realizing it, so there are a lot of things that could be happening under the surface that aren’t visible or even able to be recognized unless you have something that happens where you’re like, ‘Oh my gosh! Maybe I’m not eating enough!’ Maybe you’re not making training gains the way you thought you would and that’s something to look at, you know? 

It is important to go to a sports physician or doctor that is really informed in this. A lot of doctors don’t really know what it is or if they do know what it is they’re still calling it Female Athlete Triad and they don’t know about the new research. Also, find a professional that is well informed in it like a nutrition professional. That would also be a sports dietician in most cases. If you do have eating disorders or you suspect disordered eating in someone you love, or even if you don’t have a diagnosable eating disorder but you have kind of disturbed eating patterns or feel like you need some help with that, seek out a physician and a dietician and a therapist that are informed in eating disorders. You don’t want to see just anyone. It needs to be someone that really has that background and training in it.

Neely Quinn: Going back to something you said a little earlier, you said that the period is sort of a beacon in this. Part of the problem, with Mina at least, is she was on the pill for so long that she didn’t even know that she had lost her period. 

Marisa Michael: Yep. That’s a really common thing.

Neely Quinn: It seems like it would be extremely common because so many people are on the pill and the pill sort of makes you have a period even if you wouldn’t normally have one and sometimes people are on the pill and it makes them not have a period.

Marisa Michael: Exactly, or if you have an IUD. The period might not be a good indication for you but you might notice other things happening in your body like you’re just not making those training gains, maybe you’re losing muscle mass, a common one is frequent injury or frequent illness. If you feel like you’re getting injured all the time and you’re not quite sure why – well, first look at your training program and see if it’s appropriate but you just might be undernourished. Stress fractures are really common, especially in runners and those weight-bearing sports where you’re going to get stress fractures. They think they’re fine and they think they’re a normal weight but really they’re just not getting enough to eat so there are some other indications that you can look for.

I love your point that weight isn’t necessarily a good indication because you might look normal. I’ve had clients with anorexia in the past that are 200 pounds but they have all these symptoms of malnourishment because they’re just not getting enough to eat, even though visibly you would never guess that they have anorexia. 

Neely Quinn: They’re not losing weight either?

Marisa Michael: Sometimes they do lose weight but they’re still in bigger bodies and it doesn’t look like, from a normal person just looking at them, they have anorexia but there are other things going on like their heart rate, for example. I mentioned going from sitting to standing. If your heart rate is too high or if your resting heart rate is too high when you wake up in the morning or higher than it usually is for a long period of time, decreased mood, decreased libido, maybe you’re getting ill a lot like you’re getting a lot of colds or you just can’t seem to overcome an illness or injury – those are signs that you’re underfueling. 

Neely Quinn: These are all signs of overtraining, too.

Marisa Michael: Yes. It’s really interesting because those really intersect so it’s like, ‘Well, which one is it? Or is it both? Are they both playing a role in that?’

Neely Quinn: I’m sorry to keep bringing up Mina but because her story is so public, she was basically saying that she was training a ton and she has the personality type of like, ‘I will do more,’ or you’ve got to get that last rep in even if you’re totally exhausted. It wasn’t like she was totally depriving herself of food but she was doing a whole lot of exercise.

Marisa Michael: Yes, so go to someone that knows what they’re talking about. They can help you. A nutritionist or a sports dietician. You can get a work-up and just say, “I want to make sure I’m doing okay. Am I eating enough for my training load? Am I eating enough and the right kinds of food to support this tremendous amount of activity I’m doing?” All RED-S is is a mismatch in that energy availability. You’re just not eating enough for one reason or the other to support that training, and that’s what happened with a lot of these kids that I studied in my son’s climbing team. I found out that they just weren’t eating enough to support their training and then I had a little workshop and said, “Kids, you need to eat more and here is how you do it.”

Neely Quinn: But then that’s my next set of questions: what happens next? For instance, I have a youth female athlete who is a very elite competition climber. We were working together and it came up that she had lost her period. I knew that she was undereating. She was feeling tired and so she had a lot of the signs of what we were talking about. Of course, my job is to try to get her to nourish herself properly but the thing is, if I had said to her, “This is how many calories you need to be eating and these are the macros you need,” it would have made her gain weight. She was two weeks out from a huge competition so for her she made the choice of, ‘I don’t want to do that. I’m not going to gain weight.’ For the next five years, because she’s 17, she said, “This is my priority. I don’t want to gain weight so I’m going to keep doing this and I don’t care what happens.” 

What do you do?

Marisa Michael: There are some interesting ethical considerations there. I feel you. [laughs] We’re always here to support the athlete, right? If you’re a professional working with athletes you’re there to support the athlete so you have to decide: what does that mean? 

Athletes across the board, climber or no, are known for being able to have a higher pain tolerance, suffer through it, and sacrifice a lot for their sport. Sometimes there is a disconnect there where they would willingly sacrifice health if it means they would perform better for a short period of time. We’re all human and we all have the right to choose what we do with our bodies and our diets so of course she has the final say, but I think it’s important to educate and help her understand the long term consequences. If someone doesn’t fuel enough, especially as an adolescent, they will not build enough bone density. You’re done building bone density by your early 20s so you can have osteoporosis at age 30, 40 – really, really young. You’re at more risk for a lot of different health complications. You could be infertile. 

There’s a lot of different really profound health complications from not only eating disorders but RED-S if it’s severe enough, especially in the adolescent years, so just having that conversation and probably multiple conversations with that athlete. Especially if they’re an adolescent have conversations with their parents as well because they’re still a minor. Help them understand what they’re really choosing and then also just periodizing it. If she has a competition, making sure that she can get through that competition okay but then periodizing it so that maybe she has a little bit of an off-season where she can regain some weight and get a little healthier. 

Also, have a conversation about how underfueling your body doesn’t actually do any good for performance. If you gain a little bit of weight, which is a big fear for a lot of climbers and a lot of athletes, have the conversation that weight isn’t everything. There are other ways that you can enhance your performance like a good training regime, enough sleep, things like that where weight might not be the final answer.

Neely Quinn: There’s a lot to consider here. 

Marisa Michael: Yeah, it is. It’s really hard to just be able to serve these athletes well and give them good information but also help them perform in their sport well. 

One of the people I was interviewing during my book disclosed to me that he had been diagnosed with RED-S. He said, “Well, I wanted to stay thin during the climbing season but if I gained weight during the off-season it was just so hard to try to lose weight again. It was such a struggle.” He decided to basically always be chronically thin and he did that for years. Then he was diagnosed with RED-S and he realized that actually wasn’t the right way to go. He said, “I should have actually allowed myself to gain some weight in the off-season. That would have been okay and been healthier for my body and then reassess: do you even need to lose weight to be a better climber?” 

If you look around at climbers, none of them are really in bigger bodies that I’ve seen. If you just go to the local climbing gym or the crag you don’t see a lot of people climbing in bigger bodies so you have to ask, “Why are we driving ourselves to lose weight? Is this even relevant?”

Neely Quinn: Yeah. It’s like the hardest n=1 experiment where you’re like, ‘I’m just going to gain 10 pounds and see what happens.’

Marisa Michael: Then you’ll feel different. You’ll feel heavier. You’ll be like, ‘Well now I’m not as good of a climber,’ but is that really true? It’s complicated and I wish there was more research on it. I feel like there’s a lot more that we could do.

Neely Quinn: As far as going about healing from this, Mina again, has been very open about this and about how she has said that she’s gained a lot of weight and it’s really hard for her. She’s not climbing super well and she’s climbing and exercising much less. How do you recommend people go about this? For me, I know that I have them do it very incrementally in very small steps, like eat a bit more and let’s see how this feels, then eat a bit more. What do you do?

Marisa Michael: I would take it case-by-case. It depends on how severe their symptoms are and what they’ve got going on. There’s kind of a clinical assessment tool that the IOC put out where there’s different levels of, ‘Should you return to play or not?’ You can look at that and it kind of gives you some guidelines, like if you don’t have a period and you have a 17 BMI and you have a stress fracture, no, you can’t exercise. That’s not appropriate. There’s a whole spectrum. If you’ve just been diagnosed with it or if you just feel a bit overtrained, dial it back a bit or a little bit more and see if you feel better. 

It depends on the symptoms and the severity of what’s really going on, but sometimes it really is appropriate to do what Mina did and just really stop and gain some weight and let your body rest. Again, the athlete has to weigh their value system. What’s more important to them? What makes sense to them in that phase of their training or their life? Do they need to dial it back and eat more or do they just need to push through for a month or two for a competition phase and then they can eat more at that point and stop exercising?

You don’t always have to stop exercising, though. You can train through things like this and be fine. It just depends on what’s going on. It’s not like you can never climb again if you get a RED-S diagnosis.

Neely Quinn: With kids it’s harder. I have this one athlete who is only 14 and she definitely has this going on and she’s lost like 25 pounds in the past four months or something.

Marisa Michael: Oh that’s alarming.

Neely Quinn: The temptation for her mom is to be like, ‘You’re not climbing anymore until you fix this,’ and that is the worst punishment possible. Any words of advice?

Marisa Michael: If she has an eating disorder and that’s what is causing the weight loss she needs an eating disorder informed dietician, a therapist, and a doctor all on board. If it’s not an eating disorder and she’s just underfueling, 25 pounds in that short of time for a 14-year old is alarming. I would say don’t exercise until she can regain it and then have therapy work around what’s going to be a hard process for her, mourning that loss of climbing, developing some coping skills for being able to manage that loss of climbing while she’s gaining weight and her body is changing. 

That’s a severe example. Even within the eating disorder world, if someone is diagnosed with an eating disorder and they have severe medical issues, if they’re medically-stable they’re usually cleared for exercise, even if it’s only 15 minutes a day. Basically you have to refuel so you make a contract with the client and say, “You are allowed to exercise lightly for 15 minutes three times a week and then you have to have this 300-calorie snack afterwards.” It teaches that concept of fueling the exercise and recovery so that they can match the energy availability.

Neely Quinn: Man. If that 14-year was told that she can only exercise for 15 minutes, three times a week she would freak out. Luckily for her, her vitals are okay and her doctor has cleared her for exercise. She’s not that underweight. She’s mildly underweight so yeah, exactly – every situation is different. It’s not black and white about how to treat these things. 

Marisa Michael: There’s always nuance in it. In her specific situation or with other similar clients you could teach her, ‘Since you are climbing and you’ve lost this weight you need to be able to replenish and refuel during that climbing session so these are some snacks you can use to do that,’ or whatever, just to make sure that she understands, ‘Oh, if I expend energy I then need to replenish my energy.’

Neely Quinn: Right, and I think that my most important job with her is to reeducate her with what is healthy and what carbs, protein, fat, and calories do for her exactly. Then she can make better choices. I see this happening a lot where people are like, ‘These foods are bad, these foods are good, no cookies, no cake, no sugar, no carbs, no bread, no pasta,’ and that’s why you lose 25 pounds in four months.

Marisa Michael: Yes, and then you’re under fueled and then that leads to black and white thinking instead of more nuanced and more food acceptance so it leads to a distorted relationship with your food. Restriction has been shown time and time again in the body of research in eating disorders to lead to bingeing, so if you feel restricted or if you put an artificial restriction on yourself like, ‘I cannot have carbs,’ you will want those and you will end up eating them or binge eating them and that’s not a healthy relationship for your food or your body, anyway. Having more of the moderation and measured approach is also supported by what we know about nutritional science and what your body needs.

Neely Quinn: You see this all the time, too, where people restrict and then they binge and then they feel guilty so they restrict and they binge and it’s this vicious cycle. Like you’re saying, having moderation is the way. 

Marisa Michael: And to say, “I can never have carbs,” or, “I can never have desserts,” really ignores that food is more than just for energy or for nourishment or nutrients. It’s also for enjoyment or for pleasure, it’s a big part of our culture, and it’s also ignoring that food is a part of our mental health. There are interesting studies about how people who restrict actually have decreased mental health and decreased mood simply because they are restricting. Eating a cookie or whatever it is could actually be healthier for you, for your mental and your physical health, than not eating it. Certain stress hormones increase when you’re trying to restrict and you want something. It’s just a losing battle. I fully embrace my cookies. [laughs]

Neely Quinn: That’s a really interesting point. Your stress hormones increase and that decreases your overall health. 

Marisa Michael: It can actually decrease your ability to absorb nutrients in your gut as well which is super interesting.

Neely Quinn: It’s so counterintuitive.

Marisa Michael: A really interesting study about this – I’ll see if I can find it for you – is a researcher described how there’s a plate of cookies in front of you in a conference room. Like you’re in a meeting and someone brings in a plate of cookies. You can either think, ‘Oh, I want the cookie,’ and then take the cookie or you don’t want the cookie and you take the cookie, or you want it and you sit there stewing about it and deciding whether to eat it. They measured salivary cortisol levels. Cortisol is the stress hormone. People that wanted the cookie and denied themselves the cookie had increased cortisol throughout the meeting. Just eat the cookie! [laughs]

Neely Quinn: It’s funny and we laugh but at the same time, it’s a daily struggle for so many people. Then it’s like: well, how many cookies is a good amount of cookies? It’s so nuanced. 

Marisa Michael: It is so nuanced. Obviously I’m not promoting cookies as a health food but I think there needs to be balance and moderation and food acceptance.

Neely Quinn: Yes, there does. I wish we could give people cut and dry advice about this kind of thing but I think that’s why it’s so rampant. It’s not like a rash where you get a rash, you put some cream on it or whatever, and it goes away. RED-S and all of this stuff is so multifaceted.

Marisa Michael: Yeah, it’s very complex and we’re still learning more things about it. I think it needs a more personalized approach so if you are suffering from this or you think you might be, or you know a loved one or a friend or a teammate who is, it’s important to find someone who understands what is going on and can also give you a personalized approach. Find a healthcare provider that you feel supported by and listened to because this is a tricky thing to navigate.

Neely Quinn: How do you know if a health practitioner is right for this? 

Marisa Michael: That’s a great question. I think that most clients that reach out to me sometimes want to have a phone call first and they say, “What’s your philosophy or what do you do to work with people?” I think you can always do that with a health practitioner. You can always reach out and just ask them a few questions about how they might approach your individual situation. If you like what they say I think that’s great. You can also look for their credentials or their background and see if they’re trained in what you’re looking for. For example I wouldn’t go to a doctor or therapist that had no idea what RED-S is or had never heard of eating disorders if that’s what you’re going through. You would look for someone who is really informed and trained in that.

Neely Quinn: It’s hard to know.

Marisa Michael: It is.

Neely Quinn: People don’t think to call up a doctor and say, “Hey, do you know about this?” Most assume that doctors know everything.

Marisa Michael: Yeah, and that’s a really common thing and I found that some of the worst nutrition advice has been given by doctors. Doctors have their role and they’re really, really important but other practitioners have their role so if you find the practitioner that meets your requirements, like if you do need nutrition help go to someone trained in nutrition. You wouldn’t go to a doctor for nutrition help. That’s why there are other resources available. Or you wouldn’t go to a doctor for physical therapy. You would go to a physical therapist. I think it’s important to gather your healthcare team for what you need and make sure they have appropriate training. If a physical therapist or a chiropractor or a doctor starts telling you about nutrition, maybe that’s not a good fit for you because you’d rather go to someone who is actually trained in nutrition.

Neely Quinn: Right, and only nutrition.

Marisa Michael: Exactly. 

Neely Quinn: Anything we missed on these topics? I know that’s a big question.

Marisa Michael: No, I think we’re good. I know, that is a big question. Is there anything for you that you were wondering that I didn’t explain well enough?

Neely Quinn: No, I think you explained things very well. I guess one question would be: how can people learn more about this stuff? About RED-S?

Marisa Michael: There are a few resources available. Full disclosure, I’m not associated with any of these. There’s a book by Rebecca McConville called Finding Your Sweet Spot: How to Avoid Relative Energy Deficiency in Sport by Optimizing your Energy Balance. This is written by a sports dietician. She literally wrote the book on RED-S. I think this is the only book available on it and it’s written in a way that is based in science but it’s not too science-y to read. It’s written for anybody that would need a good resource on it. That’s always a good resource. 

I’m also looking at healthcare practitioners that are informed in this and reaching out to other climbers or other people in your world that might be going through the same thing. Sometimes it’s really helpful for people to have a support group in place or if they’re not going through the same thing, reaching out to a friend or a spouse, a family member, anybody like that that you can kind of talk through these issues. Of course, a well-trained therapist would be helpful as well, especially if you’re dealing with things like some dissonance between wanting to climb well but also maybe being told that you need to gain weight and being scared about that or any anxiety around what the treatment might entail. It’s just always good to reach out to people who can help you manage those emotions and have some good coping skills to kind of get through it.

Neely Quinn: Great. Can people find your research online?

Marisa Michael: Yeah. I have two published papers. One is in Frontiers in Nutrition. It’s called ‘Assessment of Dietary Intake and Eating Attitudes in Recreational and Competitive Adolescent Rock Climbers.’ The other one is ‘Physiological Considerations and Nutrition Considerations for Olympic-Style Rock Climbing.’ That one is found on Taylor and Francis. Those are two manuscripts that I’ve published. The first one has the data on my son’s rock climbing team and the second one has more nutrition implications for if you’re doing bouldering, lead, or speed, that comp-style climbing.

Neely Quinn: Oh no! We didn’t even talk about that. We wanted to talk about that.

Marisa Michael: [laughs] That’s okay. I can hit it really quick if you wanted me to.

Neely Quinn: Yeah, let’s hit it really quick.

Marisa Michael: Okay, so I did this kind of review paper looking at anthropometric data and whatever little nutrition data we have for comp climbing. I wanted to create a go-to resource for professionals and coaches and trainers about how you even eat for comp climbing. What’s the current state of evidence there? That can be found online. We don’t have a lot of research. We know that climbing usually burns 10-11 calories per minute of active climbing. If you’re going for just a normal 60-minute session it’s probably around 200-300 calories that you’re burning. If we’re talking in the context of RED-S then you want to think: ‘If I’m climbing for 60 minutes maybe I would need a 300-calorie snack after that to refuel.’ 

Carbohydrates is pretty moderate, so 3-7 grams per kilogram and protein is around 1.2-1.8 grams per kilogram per day but it also kind of depends on what phase you’re in. If you’re in a strength training phase you would need more protein. There’s not a lot of research into whether you need to cut weight or lose weight for competition, or if that matters. In speed climbing it might be more relevant than lead or bouldering so that’s an area for future research.

Neely Quinn: You think speed would be the one that would require cutting weight more?

Marisa Michael: Maybe. We don’t really know. This is all conjecture. If you think about it, you’re moving your body up a vertical wall. What are the elite climbers at now? Sub-8 seconds I think? If you think about that and you’re matched to an opponent, how much does weight have to do with it in those eight seconds? You could get a slight performance gain possibly if you’re lighter. If you’re a tenth of a second faster you win so I don’t know if that’s relevant or not but that’s something to think about.

Neely Quinn: That’s so interesting. I think of speed as more of a power sport and it’s been shown that boulderers have higher BMIs. You would wonder if it would behoove them to have more muscle.

Marisa Michael: I wonder that, too. That’s why I’m like, ‘I don’t know. It’s just conjecture.’ If you had more muscle and you were more powerful and explosive, maybe that’s more important than weight for speed climbing. I don’t know. I don’t think anybody knows yet. We haven’t studied that but that was something to think about when I was doing this nutrition review. I touched on supplements a little bit so if you want to use creatine it helps with power and explosive moves but some people also have water weight gain. Is that negating any benefits? Is that actually helpful for you? Especially if you’re trying to do a speed route. I don’t know.

Neely Quinn: Sometimes people will use creatine in their training and they’ll taper off of it for their performance so maybe people could do that.

Marisa Michael: So you could use creatine for the strength training phase or for training and then that would help you build the muscle during that phase and the taper. Even losing a couple of pounds before the comp might be more helpful without losing performance, but we don’t know. Nobody knows.

Neely Quinn: Is there a website that you have where all of this research lives?

Marisa Michael: You can find me online. My business is called Real Nutrition so my website is realnutritionllc.com. You can find me on Instagram @realnutritiondietician and on my website you’ll find a link to the research that’s being published there. I have online courses on endurance, fueling, rock climbing, supplements, carb loading, hydration, and I also do one-on-one consultations so you can find me there.

Neely Quinn: Nice. Such a resource. Thank you.

Marisa Michael: You’re welcome. Thank you for having me.

Neely Quinn: Yeah, this has been great. I really appreciate it.

Marisa Michael: Thank you.

Neely Quinn: Alright, take care.

I hope you enjoyed that interview with Marisa Michael. You can find her, like she said, at realnutritionllc.com and she has some really useful resources over there. You can also find her @realnutritiondietician on Instagram. I just want to thank her again for coming on this show and shedding some light on this very important topic. I hope you learned something from this interview. I definitely did.

Coming up on the podcast I have Zahan Billimoria. He is a trainer out of Jackson, Wyoming and we did an interview all about core training for rock climbers. He has a new program specifically for core training for rock climbers. I’ve never focused just on this in an interview so I thought it would be interesting. He’s got some new ways for training your core for climbing that he’s discovered and I thought it was really interesting. A lot of it is done without any equipment whatsoever, which is different than what we’ve been told about TRX and all that sort of stuff. Stay tuned for that.

I thought that since this is the first episode of the year I would give you some stats on the podcast. I really appreciate you listening. I really do. When I first started this podcast I didn’t know if anybody would listen to it and now – I think I’ve been doing this since late 2013 – we have gotten 2.9 million downloads, which is amazing. In this past year, 2019, there were 636,000 downloads. That is sort of mind-blowing for me. 

Again, I really appreciate you listening and continuing to listen. As always, I love hearing your recommendations and suggestions for who I should have on the podcast. You can always email us and let me know who you want to have on the show. That’s at info@trainingbeta.com.

As always we have training programs for you. We have training programs for boulderers of all abilities and for route climbers, and that includes a six-week power endurance program that we have and also our route climbing subscription program which gives you three workouts every week. They come to you every week and you have a dashboard online. They were created by a climbing trainer named Kris Peters. They have served thousands of people and have helped a lot of people get stronger. If you want to find that or our bouldering program that is really similar you can go to trainingbeta.com/programs. If you want more individualized attention you can always train with Matt Pincus. You can find him at trainingbeta.com/matt.

I will let you go now. Thank you so much for listening all the way to the end. I’ll talk to you next week.

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