Last Updated on May 24, 2023 | Published: May 24, 2023 published by Jenny Tomei
Podcast Episode Description
Renee McGregor is a leading Sports Dietician specialising in Eating Disorders, REDs, The Female Athlete, athlete health and performance. Renee has extensive experience of working in clinical and performance nutrition including the Olympic games in London (2012), Rio (2016) and the Commonwealth games (2018). In this episode we speak about why are so many amateur athletes trying to copy how professionals live and train. And what are the dangers to health?
Either listen to the Podcast below or read the transcript of the show.
JenUp Podcast Transcript
Jenny Tomei [00:00:10]:
Hello and welcome to the JenUp Podcast. I’m Jenny Tomei. I’m a qualified nutritional therapist, eating disorder coach and personal trainer. Alongside Sam Woodfield, we have a new co host. So Sam is an elite ex elite cyclist, has recovered from anorexia orthorexia and exercise addiction. This is a brand new series of podcasts focusing on all things sporting performance, mental health, physical health and eating disorders. So you want to ask us anything? You can find us at Ask Jen Up on Facebook and on Instagram. Now I’m going to hand you over to Sam, who is my new co host for the JenUp podcast.
Sam Woodfield [00:00:52]:
So today, with a huge amount of pleasure, we have Renee McGregor with us, who was actually at the forefront of my recovery during the years of 2017 and 2018 and worked perfectly alongside my coach, who I still speak with today, Ali Slater, and it’s great to have her on board. Renee is a leading sports dietitian specializing in eating disorders, red s the athlete health and performance alongside the female athlete triad. Her practice and knowledge is supported by extensive experience of working both clinical and performance nutrition, including working on Olympic Games, Paralympic Games and the Commonwealth Games, and has published five amazing books so far, with her most recent publication being More Fuel You, which we’ll be giving away after this podcast. So stay tuned to find out more at the end of how you can win a copy of Renee’s book. So, the title of today is Renee. Why are so many amateur athletes trying to copy how professionals live and train and what are the dangers to their health? Something, obviously, when we work together, you picked up on me straight away. So it’s something that I’ve experienced trying to live like a professional without being professional, but chasing that goal. So, just a very brief kind of start to this podcast. Why do you think so many people are doing it? And what are the kind of before we go into further detail, what are kind of the very implications of behaving like a professional as an amateur with a full time career, maybe a family, and not having that full support network or even understanding behind you?
Renee Mcgregor [00:02:34]:
Well, firstly, thank you for having me on the podcast. So I think it’s a very big question and I’m just trying to work out where to start with it, because the question is, why do we all strive to be athletes? What is it about being an athlete that is so important to us? Why is it something we strive for and what does it mean in terms of why can’t we get that within ourselves from other places? So that’s kind of like a very broad overview. We’ve always had recreational athletes, we’ve always had individuals who compete at the weekends and evenings and we’ve got club level athletes and that’s always been the case. But it’s interesting that probably since the advent of social media where we have access to people 24/7 that it feels like individuals are not able to manage their expectations as well and strive to be something that is deemed as idealistic is kind of, I suppose where I would start with this question. And obviously then if we are all being achievement focused, if we’re focusing on the outcome of we have to be the very best version of ourselves all the time, then it will lead to dysfunctional behaviors fundamentally because humans are hardwired to avoid discomfort. And when you’re looking at all these images constantly and you’re focusing on well, I’m only taken seriously or it’s my identity or it’s how I attain work or whatever it might be. Why the reason is that you need to be at the top of the game within your sport. Then understandably when you maybe aren’t achieving that or you don’t seem to be achieving that or in your mind you don’t perceive to be achieving that and it’s a really important word that perceive, you’re going to feel uncomfortable. And humans don’t like discomfort. They don’t like the feelings of not being good enough or feelings of criticism or feelings of abandonment or rejection. And we find means and ways of removing ourselves from from those situations. And so then we we kind of think, okay, well, I’ll just push even harder. Because actually, when you’re training or when you’re fixating on a body composition or when you’re fixating on food, you’re basically finding a method of avoiding what’s really going on in the grand scheme of things. So I’m not sure I’ve answered your question specifically but I think fundamentally I think social media contributes to this constant feeling of unworthiness and this sense of like if you think about Instagram or TikTok or whatever it’s almost like every individual who has an account has their own they’re basically promoting their own brand. That’s what you’re promoting. And with that comes a sense of identity and everybody wants to feel like they are the best. I think what I get frustrated with social media is it’s become a platform for people to kind of demonstrate how extreme they are, and that then also leads to disingenuity and more and more sensational posts and more and more sensational stories that are not needed, but yet they’re there. In a way, you’re perpetuating that same message, the message that you are uncomfortable and trying to achieve something by being that person on social media. You’re then perpetuating that for other vulnerable individuals who are seeing it. Which is why I have an absolute love hate relationship with social media. And I think the biggest point which I’ve kind of seemed to have missed until now is that obviously most of these individuals that we’re talking about will be a certain type of personality. They will be this kind of type A personality where they are always striving, they are incredibly determined, incredibly motivated. Perfectionism will have kicked in at some point. Sometimes we’re born with perfectionism, sometimes we’re not. And I think that’s an important thing to discuss. Sometimes perfectionism develops as a method of trying to attain worth. So it’s a complicated picture, it’s not as simple as I want to be the best, I’m going to do this. It’s actually very complicated and I think one of the things that frustrates me the most is the lack of self awareness we teach younger generations. Like if we all had much more awareness of our personalities, if we all had much more awareness of our behaviors, then actually perhaps we could manage them better and it wouldn’t lead to this high number of individuals with mental illness.
Sam Woodfield [00:07:56]:
That was a two and a half year battle that we had back in the day. So just moving very quickly on from that, just a real quick one. I remember having a conversation with you and my coach back in 18 and 19 and going back to that social media thing. I remember seeing something on a post, and I think it was a super high protein breakfast, no carbs. And it said, off to do 4 hours. And I remember sending that to Ali and yourself. And I remember you going you don’t know where they are in their training, Sam. You don’t know what sat to the right or the left. So actually that social media is often just a snippet as well. Obviously there’s 24 hours in a day, there’s seven days in a week, you don’t know where they’re going. So just moving on, obviously I think social media is great, but I also think it’s got a huge amount of negatives. And you’re right, those negatives that you picked on with myself and probably many other people, they pick up on the extreme behaviors and then they try and copy themselves. So I think that’s where the negatives come in into those sort of things. And when you’re going through that phase, that’s where you draw upon, isn’t it? It’s all those small bits where you’re trying to, I guess, find the definition within yourself, isn’t it?
Renee Mcgregor [00:09:17]:
And I was talking about thinking about this this morning because obviously there’s this new BBC documentary, BBC Three documentary on the moment with Zara McDermott investigating eating disorders and disordered eating. And I have to admit I watched it and I was really disappointed. I thought it was very badly done. And I think what frustrated me is that they’ve chosen the presenter who is an influencer. And I get that’s the point, but until we stop using influencers, until brands stop wanting to perpetuate a particular image, these individuals are not going to stop doing what they’re doing because that’s how they get paid fundamentally. So if we are to protect the younger generation, then actually we need to stop having influences fundamentally. That needs to stop being a career because it’s not helpful to anyone, it’s detrimental to people’s health. And the images are often of these very beautiful, very privileged background individuals who can make a living on social media because they look a certain way, they present a certain lifestyle, they have the ideal place where they live, and they don’t have the education or knowledge to realize that what they are presenting is feeding into individuals who are vulnerable and encouraging. That narrative of I’m not good enough, that sense of unworthiness, and I’m not going to be accepted or I’m not going to be good enough unless I have that life. So I think social media is definitely perpetuating this problem and definitely holding people. I don’t think we can ever say it’s the true cause of an eating disorder. I think when you’re looking at people who have eating disorders, fundamentally an eating disorder is a complex mental illness. It is a biological based mental illness in the sense that people will have a predisposition to it. But if you put them in the right psychosocial space, then that is going to create the perfect storm for these dysfunctional behaviors to occur. And I get a bit frustrated when people talk about diet culture. Diet culture, diet culture. Diet culture does not cause eating disorders. It informs us. It informs our external world. But actually if our internal world is not balanced because we’re not sleeping properly or we’re not eating properly or we’re not hydrating properly or we’re not resting properly or our stress levels are high because our jobs are so high powered. If our internal world is not calibrated, it’s not kind of balanced, and we’re not aware of that, then it’s these two worlds, the external and the internal, with that predisposition that leads to these dysfunctional behaviors. I think there’s a lot of people say, what can we do about social media? Well, the responsibility lies with the brands. Responsibility lies with the images they’re trying to create and the fact that they encourage influencers to make this their career. I still find it a very weird world. I left school. I went to uni. I had to do a degree, I had to get a vocation, and I have worked my ass off for 20 years. It’s not once did I ever think that I was going to make a living from selling a product. It’s all weird to me. And call me old, but actually that is real life. And the problem is when you are working in an industry where you’re given everything and it’s all based on image, you don’t really know what hard work is. You don’t actually understand what it means to learn and educate. And there will be times in your career where it is a bit flat and it doesn’t go well or you have to go and do some more studies to move yourself forward. So I don’t know. I have some real issues with social media. Obviously, I appreciate I use it as a platform, but I use it as a platform to try and be the voice against all the noise. I’m not big enough to make a massive difference, but I know I make a difference and that’s why I continue to do it. But I’m really, really mindful of everything I post on social media. Like, I’m very aware of my following, I’m very aware of the messaging, I’m very aware of potentially how that might be interpreted. I’m very conscious that I share nothing personal on social media because actually people don’t need to really know about my life. Like, I’m not here to share my life with the world. I’m here to share my knowledge and my experience. And if you want to know what’s going on in my life, you have to be my friend. And I’m quite private about how many people I let into that as well. So I think maybe that’s an old fashioned way of looking at it, but that’s kind of very much how I look at it. And the more I work in this industry and the more individuals I work with, the more I see this is the problem. We’ve got this constant information coming in. There’s no let up from it. It’s constantly bombarding you. And when the brain is constantly receiving this messaging, of course it’s going to assume that that is factual, that has to be true. I’m only going to be accepted if I look like this. I’m only going to be a good cyclist if I eat like this because the brain isn’t it is an most amazing organ, but it is biologically biased to see things as simply as possible. And when it doesn’t know the answer to something, it either sees it negatively because that’s easy, or it goes back to a place where it might remember that, well, the last time I did this, this happened to me. And so then it just informs you that that’s what’s going to happen again rather than you taking a step back and going, okay, well, yeah, there’s some emotions here that have been invoked to me that remind me of another situation, but this is a really different situation because we don’t give ourselves the time to do that. And that’s a lot of the work I do is helping people to understand their personality types, understand the purpose of their behaviors around food, exercise and training and then put that all together and learn to be a bit more mindful of how they respond to their thoughts. I’m quite good at ranting about this.
Jenny Tomei [00:16:23]:
As you can probably very well said. I’m glad you said that about the influencers, but I’ve always wondered whether that was very good for young people, like seeing all that, because I think I would have suffered with that sort of growing up and whether that’s healthy for young people to be seeing all of that and painting this image of this unrealistic lifestyle. And everyone has good and bad days trying to obtain the unattainable. So, yeah, it’s really interesting that you said that, actually.
Renee Mcgregor [00:16:48]:
Well, I think Jenny, like, I was talking to my daughter, my daughter’s going to be 18 in two weeks and we were chatting about this last night. I was like when I was growing up, yes, we had celebrities and we had film stars and we had pop stars and of course they were aspirational. And you looked at them and you kind of like, wow, look at they look amazing. But there was almost a boundary. Those are people that are that is what they do. They’re over here. They’re not attainable. And so while, yes, you may aspire to think, oh, wouldn’t it be nice to look like that? It wasn’t something that informed you of I have to look like that to be accepted. It was aspiration. So the eating disorders of old, if we want to call it that, were very much around trauma. Like, as somebody who did have an eating disorder, my eating disorder was very much in response to a traumatic event and it was my method of avoiding the difficult emotions around that, avoiding the disappointment I felt because of what had happened. And it was a method of communicating how insignificant I felt. Right. So it was a very different purpose. And I’m not saying people don’t have that now. There’s still many, many individuals with eating disorders is absolutely the case. However, the rise, I think the last statistic was there’s been over 223% rise in prevalence of disordered eating and eating disorders since the pandemic. The rise is actually more about this constant sense of unworthiness everybody is feeling because there is so much noise out there about what ideal looks like. And so even the most robust of us who have got a lovely, loving families and we have received unconditional love and all the things that are important for us to feel fully self worth and fully content with who we are as people, even the most of us are struggling because they’re like, yeah, but that image keeps coming back up. That lifestyle is like, gets a lot of attention or whatever. And so it’s influencing how we feel and it is creating fact from imagery, fundamentally. And I think it’s just something I think is really important for people to understand that our thoughts and our emotions are important. They’re trying to help us to understand what is going on in our world, but they’re not factual. And learning to respond to that is a really big part of just actually surviving being a human in the world.
Jenny Tomei [00:19:40]:
That we live in, definitely just because we’ve got a lot of questions to get through today. I just want to ask you quickly, what would you say, what’s the difference between disordered eating and an eating disorder? Because I see a lot of people on social media saying this is disordered eating and I’m like, really? No, I don’t think it is. So how would you distinguish for them? Because I’ve just seen a lot of misinformation about it.
Renee Mcgregor [00:20:02]:
Yeah, I mean, it’s a difficult one. There’s a very, very fine line between them, if I’m honest. But I suppose if you’re looking at it purely from a diagnostic criteria point of view, eating disorders have specific diagnostic criteria in that in order to be diagnosed with anorexia Bulimia binge eating disorder, to name a few, you have to have certain characteristics and within certain time frames. So that’s how an eating disorder is diagnosed, whereas disordered eating is anything that causes a dysfunctional relationship with food, when it impacts your ability to live, when it creates anxiety, when it’s rules, you feel you have to live by in order to feel this false sense of security. To me, that’s what disordered eating is. And I’d say majority of people fall into this category, but because there’s not diagnostic criteria for it, they often get overlooked and missed because they might not look a certain way, they might not have the symptoms that are often associated with an eating disorder. But that’s not to say they’re not equally as dangerous. And often people will usually go down the road of disordered eating into an eating disorder, because we know, particularly if it’s restrictive eating, if you’re removing food groups and you’re becoming very restrictive in your eating, obviously if there is potentially that will have significant effects to your brain, which can then lead more to sort of anorexic cognition and anorexia thinking. But equally, if you have very rapid weight loss, again, that can also be problematic. So that’s the main difference, I would say. Okay.
Jenny Tomei [00:21:55]:
All right, now, thanks for that.
Sam Woodfield [00:21:57]:
I looked back over some of our notes from 2017, and the first sentence actually said, I don’t believe you have an eating disorder, but I believe you have a strife of perfectionism and disordered eating. And it’s really interesting what you said there. I just want to touch on it a little bit just so some people can get an understanding of kind of how we spotted and how we dealt with it. It was a long process, as we know. But just so people are aware of signs and symptoms, whether it’s family, a coach, for example, who can’t see it, friends, family members. How did I come across to you? What were the kind of signs and symptoms and the explanations I was giving you? I know it’s back in 17 now, but just what was I showing in our initial brief? Food diaries, things like that, just so people get an understanding of where it started and then how it drew out for another, well, three years.
Renee Mcgregor [00:22:56]:
Let’s go with I think the key thing for me was your absolute obsession with getting it right, which obviously feeds into that perfectionism. The most challenging part of working with you was your inability to recognize this was about something much deeper than just food and body image. And no matter how much I tried to explain that to you. You were not prepared to look at it. You just went back to food and body image the whole time did make it challenging working with you because I think for you there’s been so much loss and so much sadness and so much trauma in your life that you just didn’t want to experience that, which I completely understand. And it’s much easier to talk to me about food and body image and training than it is to talk about the stuff that really hurt. And that’s why you were doing it. That’s why you were fixated on body image and training. And that was really clear from day one. And even though we had information about what was going on with you from a physical point of view, because we had bloods on you and we had tangible data, and we were saying, this is what is happening to your body, it still wasn’t enough at that point, in that moment, for you to fully accept that there was a problem. I think it took quite a long time before you were like, when you came to me, you knew something was wrong but I don’t think you were prepared to hear what I had to say initially. It took you a while to basically trust me and to trust the process of actually this is not really about food or exercise at all. This is about something much deeper. And until I sort out that, until I’m aware of what I’m working with I’m probably not going to be able to let go because as I said earlier, food, exercise, body image they’re just the method of communication. They’re not the problem. They’re not the issue. They’re a means of expressing what’s really going on for someone. And I think this is a really important point in terms of I want to make this point now is that when you’re working with a practitioner when you have got disordered eating or an eating disorder if they don’t recognize that, then that practitioner probably shouldn’t be working in the field either because it’s never about food. It’s never about, here’s a plan, off you go. Now, you needed some guidance because you were so under fueling and you were not prepared to give up your training that we had to give you guidance around your nutrition in order to start to reeducate you. And that is a big part of helping someone, is a reeducation process. But depending on what’s put in front of you sometimes actually you have to kind of leave the food off the table and actually start talking to them about their behavior. What is the purpose of this behavior? As a human, if you can start to understand the purpose of all your behavior you’re much more in a much better position to then consider, do I need to carry on with this behavior? And most of the time, human behavior is all about protection. We’re trying to protect ourselves from something that was really incredibly difficult for us. If you think about a small child who lies because they’ve broken something but they don’t want to get told off, they lie and say it’s their brother or it’s their sister or it was the dog or whatever to their parents, all they’re doing there is protecting themselves because they’re worried they’re going to get told off. It’s the same thing. So when we start using food and body image and exercise, that behavior provides a false sense of security in that if I get this right, if I focus on this, it provides you with this false sort of sense of containment. Because if this is right, then everything else will be right. And I think we struggled with you understanding that probably a year before you finally were like, oh yeah, right now I get it. But I think some of that was because we also had to improve your energy availability so that you could actually fuel your brain to understand what was going on. And that’s another big part of people. When you’re under fueled and you are in low energy availability, it does cause your nervous system to be on high alert. You do feel this sense of, and I’m going to say anxiety in inverted commas because I think we overuse the term anxiety a lot. But what’s really happening is that there’s a threat. Your body sees this under fueling as a threat and it’s creating that physiological sign of this threat in the body. But because you don’t know what that threat is, because there’s no way you’d think it’s about food or exercise or not resting enough because of the world we live in, we think, oh, it’s because somebody said this to me, or because that’s expected of me and I haven’t achieved it. We were very good at projecting out all the time instead of going actually physiologically, yeah, I haven’t actually healed properly. That might be the cause of why I’m I’m feeling anxious and again, I wish it was. I wish people would understand that, you know, because unfortunately the human body will respond physiologically to underfuelling in the same way as it would respond to being chased in a strange way.
Sam Woodfield [00:28:45]:
Yeah, it was certainly a learning curve and it did take a long time. We haven’t spoken that much, but I did actually go and seek therapy in the end. We did get there eventually, athlete wise. I don’t know where we’ll go going into next year, eventually still lie ahead. We achieved a fair amount, but just finishing this topic, we fully knew where it came from and it did come from for people that haven’t heard about my story before. I lost my mum in 2015 and everything kind of deteriorated quite fast from that. And that topic has now been addressed and we have moved forward with it slowly, but we’re getting there. I think we know it was always going to be a battle. We still ride and we still just eat plenty of food. So we’re on the right track. Just to cover one more topic from myself, was going over Orthorexia because obviously I think the problem I had and you noticed it was yes, there was limited fueling, definitely, but there was also add on top of that, there was a desire to eat very good food, very clean food in a vertecommas orthorexic tendencies. No very low sugar, no process needed to know the ingredients just so people are aware because it isn’t spoken about a lot. It is getting better. People are opening up to it. Just to keep this one slightly short, what should people look out for if friends, family, teammates especially, that seems to be coming back into endurance sport? What are the signs and symptoms of someone developing that orthorexic tendencies or way of life?
Renee Mcgregor [00:30:26]:
So the definition of Orthorexia is the obsession with eating purely or eating correctly. And so it is very common in athletes particularly because there’s this kind of notion of having to eat, I guess if you want to call it cleanly. I really still don’t personally understand what that means. But this kind of need to keep it pure, this need to keep it kind of free of processed food. But again, I would question what’s the processed food there’s a lot of gray areas in terms of what is this lifestyle? Again, we go back to the messages that are out there. Definitely demonize certain foods and definitely provide other foods with halo effects. And I think that’s where orthorexia kicks in. And it’s not like again, we have now got some quite clear diagnostic criteria for orthorexia. And in fact, the consensus statement came out last yesterday and I’m part of the consensus group. So we were published yesterday, which is very exciting. And it’s the first step, I think, for Ectia to be actually recognized as a problem in its own right. So some of the symptoms you might see will be kind of yeah, some of the symptoms you’d see will be things like avoiding certain food groups. They might be that you avoid things like sugar. You might avoid things like potentially carbohydrate, although I think people are starting to realize the importance of carbs now, particularly in an athletic point of view. But the fear around sugar is still big. You might avoid things like dairy, for example. You may practice certain types of nutritional approaches such as doing detoxing regularly because you feel that might kind of help you reset. There’s a lot of rules. There’s a lot of rules and often somebody who is severely orthorexic will struggle to deviate from these rules because again, the rules provide them with this fault and security that they’re safe in some way. And it’s very much about being healthy. It’s not like with anorexia or even bulimia. It’s not really around body image as such. It’s much more about this. Need to be pure, this need to be healthy, this need to be correct. And we’re definitely seeing it more. And the individual tends to because of this, the individual does tend to be very evangelistic around the way they eat. So when plant like veganism became very, very popular a few years ago, that was very much kind of I’m not saying for one reason, I’m not saying for a reason there’s anything wrong with being vegan. There isn’t. However, we do know that it can be a method of disguising orthorexic traits because obviously it gives you a legitimate reason to avoid certain food groups and you work through when somebody is orthorexic because they’re vegan, because there’s means and ways of being a healthy individual following a vegan diet in that there are certain products you would encourage over other products. So for example, you would encourage them to have soya rather than almond milk because that gives a lot much more protein. However, if the individual is always pushing back on that, you kind of know, okay, there’s something probably deeper rooted going on here rather than it just being about veganism. So I think to kind of simplify it is sort of this very evangelistic, purist way of eating, but often leads to a lot of restrictions that can then start to have quite negative consequences on your health and your performance if you are an athlete.
Sam Woodfield [00:34:19]:
We’re going to touch on that in a few episodes later. You know the dangers of being an endurance athlete and orthorexia but I know one thing Jenny did want to talk about was kind of around that female athlete triad quickly because I know it’s something that is now coming more in the media both socially and on the news. And it’d be really good to hear Jenny’s question on that and what your thoughts on it are and tips and strategies around it.
Jenny Tomei [00:34:44]:
Jen, it’s relative energy deficit syndrome, isn’t it? What are the tips and strategies for a female athlete who has lost their period for greater than six months? What would you suggest for them?
Renee Mcgregor [00:35:00]:
Because you’ve mentioned female athlete triad and you’ve mentioned reds, it’s quite important to kind of explain how they overlap because we don’t use the term female athlete triad anymore at all. We use reds, which is relative energy deficiency in sport. And that’s because we worked out the IOC consensus group came together and they appreciated that this low energy availability that underpins issues to hormones and then bone health actually wasn’t just exclusive to females, it was actually something that happens to both males and females. So the triad no longer exists because we know that actually if you have low energy availability, then that will affect the production of things like oestrogen and testosterone. And if both are low, they start to affect bone health. However, we also know that it’s not just, again, exclusive to bone health and hormones actually affects every single biological process in the body. So it can affect your performance, your body composition, your digestive system, your psychology, potentially, in some individuals, your cardiac health. So it’s a full body system issue fundamentally. And that’s what Red S is. And so in female athletes, one of the symptoms you may get is changes to your menstrual cycle. And it might be that initially the menstrual cycle gets a bit more erratic. So, like, could get shorter cycles, you’d get longer cycles, you might get lighter cycles, and then eventually you might get this complete cessation of cycles. And as you said, Jenny, if you get more than six if you lose your cycle for more than six months, then that in this country is known as hypothalamic amenarrhea. And it’s secondary hypothalamic amenarrhea because you’ve lost your period. And it is a problem because we know actually as little as losing three cycles can start to have a negative effect on your bone health and put you a much higher risk of injury and illness, including like tendon and ligament damage, as well as then potentially bone issues. So you could be at higher risk of stress fractures and also that takes you out for a very long time and it means you can’t be consistent with your training and then your performance. So we know it’s a big issue in terms of helping female athletes restore menstruation. Again, it’s much more complicated than just energy in versus energy out, which is, I think, what is still being pushed out. It’s a multifaceted problem in the sense that the human body obviously works in all these different feedback loops. And fundamentally, everything is controlled by the hypothalamus. So if the hypothalamus detects any sort of stress in the body, it’s going to start shutting down hormonal production, but it will also shut down all sorts of other things as well. So when an individual comes to us with hypothalamic aminerrhea, we do a full assessment and we look at sort of blood levels, we look at training load, we look at nutritional intake, we look at kind of history, like, how long has this been going on for? You look at sort of also like body composition history because actually that tells us a lot about the person. And as we know, a lot of female athletes believe they should fit a certain ideal, but if genetically their phenotype is not that way inclined, then actually there’s no way they’re going to have a menstrual cycle at that ideal. And then the challenge there is helping them to accept that for them to be a healthy and optimal athlete, they probably need to be a slightly different physique than what they deem as ideal. It’s a very complicated picture. It’s not just about eat more and train less. Actually, sometimes we don’t have to change training too much, but we do have to look at nutritional timing and nutritional composition. Sometimes we do have to say, really sorry, but you’re going to have to pull back on your training significantly. And again, a lot of that is dependent on what is presented. And sometimes we get the training and the nutrition absolutely right, but it still takes a long time for menstruation to return, and that might be because there are other factors like poor sleep or emotional stress or work stress or other things that are going on. So it’s quite a complicated picture. And again, one of my big frustrations is how it’s been simplified and dumbed down, that it’s just about energy availability and it’s just about kind of hitting a certain number. And actually that’s not always the case. And that can be quite a dangerous approach if people kind of just go with this. It’s just a certain number of calories that you need to hit because actually that doesn’t help the individual understand goes back to what I was talking about earlier. It doesn’t help the individual understand where the root of the issue is and how to mitigate it in the future, which is kind of what you want to do if you want this athlete to be resilient and robust.
Jenny Tomei [00:40:26]:
Okay, so it was Hypothalamic, Aim and Aria, wasn’t it?
Renee Mcgregor [00:40:30]:
Yeah.
Jenny Tomei [00:40:31]:
So I say that right.
Renee Mcgregor [00:40:32]:
Yes.
Jenny Tomei [00:40:33]:
Okay. And more than six months. Yeah. Okay. Because that’s something obviously I’m interested in that. And everyone knows my story as well on here because I suffered with that. And you’re right, it’s more than it’s not just about there are a lot of factors in my life that was going on in terms of a lot of stress and anxiety and my body being in a constant fight or flight state constantly. And that had a massive impact on my gut where I had to stop training completely. I had inflammation and I was told that I had a very leaky gut.
Renee Mcgregor [00:41:13]:
Yeah, but if you are in low energy availability, then you will have increased permeability of your gut. That is a common symptom. And I think that’s it it’s really important. This is why the whole broad spectrum of symptoms is so important to understand, because some women’s menstrual cycle won’t be affected, but they may still have a leaky gut, they may still have gastroparesis, they may still have increased tendon and ligament damage, they may have autoimmune type symptoms showing. And this is the problem. Like, it’s so much bigger than we first thought. And the fixation on just the menstrual cycle meant that not only did half the population get overlooked, but it also meant that some of the females that didn’t show changes to their menstrual cycle were also being overlooked, and yet they still had problems. So it is a complicated red. S is not a simple condition. It’s very, very complicated and it affects people in many, many ways. And it takes a long time for the body to realign and appreciate the threat of stress. Whatever that stress might be, is no longer apparent.
Jenny Tomei [00:42:21]:
Yeah. Definitely. It’s really interesting. Thanks for sharing that. It makes a lot of sense.
Sam Woodfield [00:42:29]:
Yeah, just the time pressing on. Obviously we can talk about all this stuff for hours. We’ll do one more question and we’ve just got some quick fire questions for you at the end. Renee. Quickfires are based, which is what I know about you, what you like and dislike. So obviously one thing I have noticed very quickly is this 05:00 A.m. Club thing has become a massive thing on social media at the minute. Oh, I must be up at five, I must get my training done and then I’m at my desk for the next 12 hours. Within that, there must be some nutritional issues. I e eating at 05:00 in the morning, first isn’t easy and isn’t particularly enjoyable. So on that, people are training fasted. First, quickly your thoughts on fasted training. And second of all, what are the dangers of fasted training? Because if these are time crunched athletes, it’s not going to be a recovery pace and it’s probably not going to be that low end zone two, very steady hour, it’s going to be something quite high, intense, high intensity even. Sorry.
Jenny Tomei [00:43:36]:
Yeah.
Renee Mcgregor [00:43:37]:
So the issue with, I mean, obviously there’s several issues with training at 05:00 A.m.. One is you’re probably not getting enough sleep and sleep is really important for your recovery process and it’s again, often completely undervalued the importance of sleep on our mental and physical health. I go back to that internal world. If we haven’t slept very well, then actually our internal world will be off kilter. So that’s something to be mindful of. Secondly, we know that when we wake in the morning, our cortisol level, which is our stress hormone, is always at its highest. And if you then add another layer of stress to that, so another layer of physical stress in terms of training, then potentially you could end up with chronically high cortisol levels. And if you have chronically high cortisol levels, number of things happen. One, you tend to actually hold on to more body fat truncally, so you don’t actually get the benefits of training, but also it changes your metabolism of both carbohydrate and fat. And so actually you become less efficient at fueling generally and kind of digestion. I appreciate some people feel that’s the only time they’ve got, but it definitely isn’t something that should be encouraged or recommended by any coaches if they want to be responsible. But obviously people will do what they will do because that is just the nature of humans. And I think if you’re going to do these 05:00 A.m. Clubs, then you really need to be thinking about how to fuel them properly. So if you do these fasted, all you’re doing is adding another layer of stress, particularly if you’re doing these sessions, like more kind of interval based sessions or Hill rep type sessions, or kind of holding a higher zone for a longer period of time, like a tempo type session. All of these are going to add a lot more stress to the body. So you’re fundamentally setting yourself up to fail in the long run because one, you’re not going to progress and two, your performance will start to deteriorate eventually because it just cannot adapt appropriately. And we know that fasted sessions should generally be restricted to more like recovery sessions and they should never really be more than about 60 to 90 minutes max. And really, you should not be doing more than one or two of those a week, to be honest, if you want to be optimal with your performance and your health as well. So some of the ideas I give people I work with is it doesn’t have to be that you have a full breakfast at 05:00 A.m. Or 430 or whatever it is. It’s just making sure that there is energy available. So potentially it might be having sports drink that you take a few sips of before you jump on the bike and then you take that with you and you keep on sipping on it. So actually, at least there’s some energy available to mitigate some of that potential stress or you train your gut. I mean, I don’t do early morning sessions, but I have trained my gut to take fuel before I run, so I can eat and run in half an hour because I’ve trained my gut to be able to do that. So that’s a case of trying to just get used to your body being able to do that. And so that means you have to do it. And yeah, you may have a couple of accidents along the way, but that’s how you train your gut to do it. But like I said, it’s about finding things that can deliver but are not necessarily going to be difficult to digest. So I would never say you need to get a massive bowl of porridge before you go and do a bike ride, but actually, can you have a glass of juice and a banana? Can you have a slice of toast and then have a banana within 20 minutes of being on the bike? It’s just about trying to mitigate the levels of stress in your body.
Sam Woodfield [00:47:48]:
And that was something you and I had to work on because I was so scared of eating before training that I used to have to leave 2 hours whatever I ate. And that’s what I think looking back and I’ve reflected was my main issue with Reds. But actually, yes, I might have had a bowl of porridge, but I was still waiting 2 hours to train. So I probably negated that bowl of porridge in terms of energy availability looking back when I’ve looked over. But that’s all the main questions. I just want kind of the listeners who haven’t tuned in before to just know a little bit more about yourself just a few little teasing questions, just that I know about your personality only from the years we’ve spoken about. So I know the answer to this one. Would you rather go to the beach or would you rather be up in the mountains?
Renee Mcgregor [00:48:41]:
Mountains.
Sam Woodfield [00:48:42]:
Mountains. I thought so. Are you a coffee or a tea person?
Renee Mcgregor [00:48:48]:
Coffee.
Sam Woodfield [00:48:50]:
I know the answer to this. Are you a dog or a cat person?
Renee Mcgregor [00:48:55]:
Dog.
Sam Woodfield [00:48:57]:
And then just a few around nutrition. If you were to go out for a meal, would you rather have a starter or a dessert?
Renee Mcgregor [00:49:04]:
Starter.
Sam Woodfield [00:49:06]:
I’ve got that one wrong. Okay. If you were to have dessert, would you have a chocolate brownie or apple crumble with some custard?
Renee Mcgregor [00:49:15]:
Apple crumble.
Sam Woodfield [00:49:17]:
I thought that might be the answer. Good old that’s everything covered. It was wrong. Maybe I did. Well, you don’t. Anyway, thank you so much, Renee, for coming on today. Have you got any closing words or little bits of advice and then we can wrap everything up?
Renee Mcgregor [00:49:33]:
I think all I’d say is just remember that humans are, I always say this, they are a really fine piece of engineering. And if you focus on outcome alone, you’re going to disrupt that engineering because you don’t often appreciate that fixating on one aspect is going to disrupt something internally somewhere else. So that’s kind of my parting words.
Sam Woodfield [00:50:05]:
I think that’s pretty much spot on. Obviously working before. I know your take on things and your outlook on life and that seems a very nice way to summarize the last hour, really, that just lose a little bit of the control element and just go with life a little bit more and things can be okay.
Renee Mcgregor [00:50:26]:
Yeah.
Sam Woodfield [00:50:27]:
Do you just want to run through the competition, Jenny, and then we can just wrap everything up?
Jenny Tomei [00:50:32]:
Yeah. So we’re going to give away Renee, so it’s more for you. You can find out details. I think we’re going to post it about on Instagram as well. So you can find the link as well to the competition in the show notes as well, which I’m going to put out. So you’ll have all that information there. But just want to say thanks again for Renee for coming on. I really appreciate it. And thanks for listening, everyone, and thank you to Sam for co hosting.
Sam Woodfield [00:50:57]:
Thank you very much.
Jenny Tomei [00:50:59]:
Thank you so much for listening to the Jen Up podcast. It was so great to have Janet on. I hope you learned a lot. I’ve been your host, Jenny. Tonight you can find me on Facebook and Instagram at askJenUp and on my website@jenup.com. If you visit my website, you’ll find lots of different resource is available there. Please like subscribe and share.
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