I think that especially the very early signs of overtraining – when overreaching turns into overtraining – are very easily overlooked. We tend to do more, if our performance level drops. We often prematurely draw the conclusion that we did not train enough. But if our “diagnosis” is wrong than more intensive training sessions can very quickly bring about heavy legs during exercise, and if we ignore this early symptom and continue with high intensity training the consequences may be an overtraining condition that cannot be reversed within a couple of hours.

Heavy sore legs indicate that recovery has not been sufficient and that the inflammatory signs that the muscle needs to undergo to adapt to a higher workload have not been cured yet. If you feel heavy-legged you may also feel sluggish and lethargic, your muscles are sore. Generalized fatigue, diarrhea and headaches are common complaints too. Overall you are not feeling well, which is more a general diffuse feeling. We may wrongly conclude that we are developing a flu, or that some other virus is bothering us. Instead, we are suffering from symptoms caused by the inflammatory phenomena in your body.

The healing process for those inflammations needs an average of 24 to 48 hours, after that these symptoms should have disappeared completely. If this is not the case, then overtraining has already turned into a more severe state. I think it is very crucial to be sensible for situations of this kind, because listening to your body’s signs and taking a rest of only 24 to 48 hours (an easy jog for a few kilometer per day may be allowed ) guarantees that you are back on track on day 3. The first run after the rest should be a real pleasure, legs are feeling light, there are no traces of muscle soreness, you should even run an effortless 30 seconds faster per kilometer than normal.

Of course, if you are really training hard, the legs usually feel stiff and lethargic at the beginning of the run. However this feeling should disappear as the run progresses.

How to recognize whether the level of muscle soreness is inappropriate

Timothy Noakes in “the Lore of Running” advises to score all training runs on the basis of how your legs felt during the run. Muscle soreness that either persists or gets worse during the training run indicates that this particular run should be stopped. You have to give your body a resting period of 24 to 48 hours. Then full recovery should be accomplished.

Exactly in these situation biestmilch with its anti-inflammatory properties is extremely helpful. It is well accepted that high-intensity training sessions may compromise immunity. But it’s your immune system that has got the healing job to do. Therefore, strengthening the immune systems improves recovery. Biestmilch can dampen the inflammations induced by high intensity training sessions.

As I observe it since several years in triathlon “Food” its 4th discipline is flooded by sloppy scientific facts. Study results telling you their truths are available in huge amounts. Critical, controversial and incomplete are the underlying theories, that present the matrix for interpreting the data. Data remains until today fluffy and inconclusive. This applies first and for all for carbohydrates the pillar of nutrition for all athletes.
Since the early 20th century carbohydrates are considered as the fuel for athletes. In the following I don’t want to question carbs as such, I only want to direct your attention to the fact that the scientific foundation on which diets are based is weak and arbitrary. Therefore your personal experience counts more than you may assume. To find the optimal diet and the optimal race nutrition needs you as an experimenter, this is evidence-based research work!

Food – whether a diet works for you or not – is all about experience decorated with some basic scientific facts

The observation that experiences with the same diet regimen among individuals vary on a broad scale underscores this view. What works well for you does not necessarily work another one. During the last months when I was touring through Europe with Chris “MACCA” McCormack from one race to the other I learned about the many gastrointestinal problems such as stomach pain or cramps, nausea, vomiting, diarrhea, cramps etc. that athletes experience during or already shortly before a race. The reasons and explanations given for these problems are in line with the predominant paradigms governing exercise science, it is either salt or/and carbohydrates, or if these explanations don’t work or are unsatisfying it is nervousness about which nobody really knows what it means in the very end.

I was amazed to which extent carbohydrates in form of gels and bars are currently used as race nutrition, be it on the bike or the run. It occurred to me that the gastrointestinal issues may be due to too much of the good, that the quantity of ingested carbs may be too high or the timing may be inadequate. Another thought that popped up was that it might be wrong to narrow all the troubles down to carbs and salt, that the “carbohydrate depletion model” that is the underlying matrix for all the explanatory arguments may be incomplete and insufficient to explain the problems. I think it is justified though to question a model that cannot answer the questions asked anymore.
Beside the whole spectrum from nausea, vomiting, diarrhea and cramping in addition more and more complain about a feeling of distaste for sweet stuff during the race. They are not able to ingest the sweet gels anymore. And many an athlete tells me that it does not occur to them to use gels during training. This feeling may be due to several reasons: the sweet taste as such, the texture of the gel (to my knowledge fluids like coke containing simple sugar don’t induce these reactions), a reflux into the oesophagus induced by the water absorbing carbs, an irritated mucosal lining and disturbances of motility and permeability of stomach and gut, not to forget the additives that they may contain. Especially under stress these may initiate food intolerance. All together this may lead to this feeling of nauseation.
I don’t dare to conclude straightforward that the increasing gastrointestinal (GI) troubles in elite athletes are caused by their race nutrition. But I think it is time to look at these GI health issues that athletes experience in a race in greater detail. Gels are eaten in such huge amounts and their benefits are unquestioned. But the reason why athletes have to eat so much carbs, namely to avoid carbohydrate depletion in muscle and liver in my opinion needs reconsideration.
What I did do now, I went into the literature. If you start digging, you find a huge amount of studies on carbohydrates that are inconclusive not only due to their study design, but also due to the premises they were founded on.

The studies available on carbohydrates are not conclusive, probably because they are extremely difficult to conduct. Most of them have been performed in a laboratory, the athletes tested performed on a steady performance level, and studies have not been controlled and blinded. There are other flaws too such as inter-individual differences, that make data incomparable. The only 2 placebo-controlled double-blind studies for example carbo-loading gave  no indication that carbo-loading is superior to placebo.
The Carbohydrate Depletion Model is so strong per se, that studies that are not double-blinded can easily be flawed from either side, from the investigator’s and athlete’s perspective. If individuals were told that they were ingesting carbohydrates even though they were on placebo, the test results have been as if they had eaten carbohydrates. This is only one more proof on how strong the influence of our mind/belief (one name it) is on performance as such. The results of such studies don’t tell us anything about cause and effect. They tell us more about the investigator’s mindset than giving us answers to our questions. This happens a lot, if you look into studies results.

Glycogen stores, hypoglycemia and fatigue

From the Carbohydrate Depletion Model infers that full glycogen stocks are essential for peak endurance performance. This assumption entails the various approaches to carbohydrate ingestions, be it high-carb diets, carbo-loading or race nutrition. I think there is currently little doubt about the fact that you should enter a race with restored glycogen stores in the muscles and the liver. About how this is achieved a debate may be allowed, moreover about the viewpoints for whatever biological reasons carbohydrates or glucose respectively are needed during a race. Studies have been performed that suggest that the muscles’ glycogen stores even after strenuous workouts are never completely emptied, that general fatigue and finally exhaustion and dropping out of the race occurs before that. If this is the case, then the use of carbs in endurance performances longer than about 90 minutes has to be revisited. By the way, an energy-depleted muscle would develop rigor, this is when muscles become completely stiff.

May be we only need the carbs to avoid hypoglycemia, a notion that is not completely in line with the Carbohydrate Depletion Model. To prevent hypoglycemia may be crucial for sustaining performance over 2 hours. It is the liver’s glycogen stores that are responsible for feeding glucose into the blood stream. Glucose (simple carbohydrate, sugar) is not only fuel for the muscles to move, but for many other body parts/organs that have to function properly. The brain needs glucose badly to perform. Symptoms that occur, if the brain is undernourished are dizziness, fatigue, loss of orientation, movements disorder (coordination), impaired cognition. As soon as blood glucose levels are back to normal the symptoms disappear. You may have experienced this as an athlete! Hypoglycemia during a race may happen due to the fact that glucose intake was inadequate, and the liver supplies do not suffice anymore.

General fatigue is another symptom that violates the depletion model. A couple of studies show that even at complete exertion the muscles are not empty of glycogen. Pacing, for me the fantastic ability of a human mind to anticipate a race, cannot be explained by carbs or glycogen stores either. The decision to quit a race due to fatigue or exhaustion happens in the brain, where the commands for muscle movements come from. Neuromuscular recruitment becomes impaired, temperature may increase due to autonomic nervous system dysregulation in cases of general fatigue. This happens not due to a lack of fuel within the muscle tissue, the brain stops the exercise before this can happen. To replenish glycogen stocks is not the solution, and won’t work. Under stress, and racing is definitely extreme stress for the body, the body does not have time nor power to save stuff for storing, even if you feed it with big amounts of carbs. But what happens if you do so, you start suffering from symptoms of gastro-intestinal distress. There are probably only a few athletes out there who don’t know what I am talking about.

Here some figure to ease your mind: The current consensus is that the fastest initial rates of muscle glycogen resynthesis is achieved when 1.2 g carbohydrate per kg body weight per hour are eaten every 30 minutes over 5 hours (= about 400 g). It is improbable that such a high rate of carbohydrate ingestion could be sustained for much longer than 5 hours without producing diarrhea and gastrointestinal distress. It is usually presumed that optimum carbohydrate loading can be achieved if about 600 g carbohydrate daily is ingested for 2 or 3 days. Data indicate that it may not be of importance whether you eat simple (glucose) or complex (starch) carbohydrate. This applies for a resting condition only, under stress the situation changes completely.

Running on fatty acids not on carbs?

This is were fat comes into the game. I know that it got a bad reputation, for wrong I think. There is a large body of evidence showing that athletes can adapt to high-fat diet without sacrificing endurance performance. Some have even suggested that exercise performance, especially during prolonged exercise, might actually be enhanced following adaptation to high-fat diet. In fact, blood concentration of the protective HDL-cholesterol fraction increased on this diet, whereas unfavorable changes in total cholesterol and triglyceride concentration were measured in the group ingesting a high-carb (about 70%) diet.
Nurture your body from fatty acids spares liver glycogen, and in the end glucose supply. High-fat diet is still very controversially discussed. But to me it is seems to make sense to train the fat metabolism, and test how it works for you, if you rely more on your fat metabolism and fatty acids as fuel. You don’t gain weight and you don’t provoke insulin secretion that may lead to bouts of irresistible hunger episodes that make you gain weight, you may even run into more severe health hazards later.

To cut a very very long story short:
The Energy Depletion Model cannot explain how elite competitors in the Ironman Hawaii triathlon race are able to swim, cycle, and run at more than 65% VO2max for about 8 hours and more without slowing down. Without any doubt you develop already a profound muscle glycogen depletion in your active leg muscles after cycling, and you are still able to run a 2:45 marathon. If muscle depleted of glycogen is unable to sustain a high work rate of about 65% VO2 max, then these performances are physiologically impossible. We all know that this is not the case!

Maybe you run on fatty acids, keep blood glucose levels stable with carbs and save the glycogen stores in the muscles to prevent a premature onset of fatigue or exhaustion. Could this be a recipe!

The whole 4th discipline of triathlon is so incredibly complex, and we know so very little about it, that experiments and studies are still needed. But what is needed too is an open mind that questions the established models, especially when its weaknesses start to become obvious. As an athlete you have to dare to leave the beaten path, if a concept does not work for you. In the end it seems to me that much more has to be taken into the equation than only focusing on carbohydrates to fully understand peak endurance performance on the one hand and fatigue and exhaustion on the other.

The first 20 who filled out the survey form shall receive the Macca base cap special edition. We are going to ask you for your postal address during the next days.

The posts before have shown the dramatic outcomes of too much exercise and training. In between, I would like to take another perspective on the whole topic to encourage your efforts, and perhaps give you more cues at hand to make the detrimental results of too much training and racing more understandable.

Modern exercise physiology and biology put a lot of work into studying the healthy body. That has not been the case for many decades where scientists only looked at sick bodies. Exercise physiology gives an amazing insight into the body’s “normal” way of functioning.

Inflammation is a phenomenon of the healthy body

You are probably used to the view/fact that inflammation is only present in cases of disease such as infections or chronic non communicable diseases (atherosclerosis, cardiovascular disease, cancer, diabetes-type-2, multiple sclerosis, bowel diseases etc.). Since very recent, scientific data talk a different language. Inflammation is a condition of the healthy body, it is a contained process essential for being healthy, a process that keeps our body with all its diverse functions going. Along all the mucosal linings (bronchi, guts, urinary bladder etc.) that connect us with the outside world, minor inflammatory or immune responses respectively take place… always and throughout our whole life. These borders colonized with its very own microflora are areas where controlled inflammatory processes secure the borders and guarantee our survival, where the communication with the environment takes place, often termed as friends (nutrients, bacteria, virus, macromolecules) and foes (e.g nutrients, viruses, bacteria, macromolecules).As you can see from the listing in brackets, whether an agent or a molecule respectively is friend or foe is determined by the environment and the time of encounter at the very place of the encounter. There is no bad or good per se! Inflammation is a physiological/healthy activity/process of the human body! The meaning, whether a molecule is treated as friend or foe, is determined by the condition of the milieu at a given time (e.g. such different conditions may be diseases, the different development stages, we go through; or different situations of stress etc.)
The multiple systemic inflammatory processes ongoing in our body are termed low-grade systemic inflammation and are characterized by a state of perfect well-being. Diseases or discomfort start, if this process deteriorates and gets out of control which is generally spoken the case in all illnesses.

Well, this inflammatory situation is initiated and controlled by the same system, the stress system. I mentioned it already in my former post that it consists of the super system of regulation: nervous system, immune system and hormones (endocrine system). The basic mode of regulation is a loop, many loops connected by positive and negative feedback by structured by circuits on various levels. The context determines whether the system activates or suppresses a process. Under the condition of well-being exists a perfect equilibrium between pro- and anti-inflammatory currents. I name them currents, because you have myriads of molecules with either properties depending on time and place of the encounter.

What has this got to do with physical activity, with you as a high-end athlete racing Hawaii?

Moderate physical activity stimulates the stress system in a very positive way. It helps to avoid the deterioration of systemic low-grade inflammation into chronic systemic low-grade inflammation. Chronic systemic low-grade inflammation seems to be one cause for atherosclerosis, cardiovascular diseases, diabetes-2 and some forms of cancer such as breast or colon cancer. Physical inactivity has been identified as a stronger predictor of chronic illnesses than risk factors such as hypertension, hyperlipidemia, diabetes, and obesity for all-cause mortality. Physical activity protects against these diseases and premature death because of its ability to down-regulate inflammatory states in our body.

As an athlete you find yourself on the path of health and youth ! If you don’t exaggerate!

You are well familiar with the fact that endurance training means stress for your body, positive in the case of overreaching, negative in the case of overtraining. The more you push your body to exertion, the more stressed it gets. The control mechanisms that contain your body’s low-grade inflammation have a hard time to remain under control. If you manage your training within these limits where training stress is not harming your immune system, autonomic nervous system and/or your hormone regulation, then you can be sure that sport is one (please, keep in mind that there are other factors as well such as genetic outfit and nurtition that play a significant role too) preventive measure for a long and healthy life.

If you do otherwise and drive your body permanently over the edge, then pro-inflammatory processes may take over and lead your body into a state of chronic systemic low-grade inflammation, one of the strongest disease predictors identified until now.

A remark at the end: In this post I am not taking about local acute inflammations due to injuries or other traumata. Acute inflammation is a short-term process, usually appearing within a few minutes or hours and ceasing upon the removal of the injurious stimulus. It is characterized by five cardinal signs: rubor (redness), calor (increased heat), tumor (swelling), dolor (pain), and functio laesa (loss of function).

As many of you are heading for Kona and therefore are in their very hot phase of training I assume that the most helpful post would be to summarize the essential but discrete signs you have to watch out for to avoid overtraining.

Especially from studies that dealt with the effects of human growth hormone – a substance that is definitely on the WADA’s list and considered as doping – we know that performance enhancement is very closely related to recovery times. Which means that doping agents, be it steroids or more powerful substances such as growth factors, speed up recovery time. It becomes that short that the training loads you can take on the day after a hard training session are just terrific. Those tested in the study where just startled of its effects, so very tempting to use them. Read more about hGH on the Science of Sport blog.

What I want to say with that is that if you want to avoid overtraining, you need to listen to your body’s needs for recovery. That is easily said, but it is not easy at all to realize the transition from generalized fatigue that is an essential ingredient of proper training (after O’Toole, 1998 termed overreaching) to that bit of more fatigue that indicates the sliding into overtraining.

If you read the literature there is a wide consensus about the fact that we have distinguish between stages of fatigue. The first person who introduced these subtle grades of fatigue into exercise science and coaching was James Counsilman in 1968 (a former swim coach at Indiana University).
Counsilman’s fatigue zones may help you to evaluate your own condition. Zone A refers to an athlete who trains moderately hard and becomes mildy fatigued after 5 days of training. This athlete will barely reach a fatigue zone. During the recovery period on the weekend his fatigue level slightly drops below the previous one observed the week before. Training effects are minor. If you push yourself to the upper limit of the fatigue zone B, then recovery on the weekend lowers your fatigue level conspicuously compared to the observation point before This is what is called super-adaptation. Zone C of fatigue is a result of too hard training. It pushes you into a valley of fatigue. You may need the whole weekend to fully recover. If you start your training before that your level of fatigue will increase further during the following training week. Training is progressing from overreaching to overtraining. The alarm is on!

This inability to produce your best when you are apparently in good form is the first sign of incipient overtraining.

I know pro athletes who do not monitor their training. After many years of experience they know or may only think that they know where they are in training without making notes. Moreover, they may have coaches giving them a feedback on their current condition. But if you are an age grouper who cannot only focus on training, but has got a job and a family, and is left to his or her devices in many ways, then it could be of great importance to monitor your training performance. It makes you see your falls in performance immediately and you cannot cheat on yourself. Please, add to your notes all extra stress factors that happened during the training week. Stress from other than training accumulates and may force you to reduce the workload.
What is needed, I think, on top of a training schedule, is a level of fatigue and stress resistance protocol. For this reason time-trials make sense, even for age groupers. This is where the heart rate comes in, not so much the stopwatch, and the recovery time after the time-trial. As long as you are in zone B your heart rate is the same or lowers compared to before, your recovery time remains the same or goes down as well. All this changes directions, if you are on the threshold to overtraining.

So far so good, there will be more next time. No, one more thing at the end, doesn’t this text, for which I got lots of inspiration from Tim Noakes, the author of the lore of running, thank you!, show the great and overall importance of recovery!

There are only 9 weeks left until Kona. The IRONMAN world championship on the Big Island, Hawaii is for many an athlete the highlight of his or her career that one should enjoy. I am not talking about pro athletes, for them it is an obligation and in many ways not a question of joy. But for the many age groupers racing there should be joy. Be it as it may, it is hard work to get to Hawaii and it is hard work to finish there. Many currently linger along this very thin red line between overreaching and overtraining, and try to solve the riddle how to achieve peaking on time.

Working with biestmilch and being a physician I am confronted with a lot of health issues of athletes and it is exactly now, that I receive these posts and comments talking about the discrepancy, the lacking proportionality between training efforts and performance. You may feel in top form, you worked hard for many weeks, and then when the day comes, you feel sluggish in the swim or toasted on the bike already. Maybe you overlooked the discrete signs that guide you along the path of productive and unproductive workouts. In this post I would like to start writing about the various symptoms that may give you a frame of reference and standpoint of where you are with your training, symptoms that may help you to assess your very personal body condition.

Sebastian Kienle told me before Challenge Roth: “Well, I don’t feel really perfectly prepared, but you know it, if you feel perfectly prepared, then it may as well be the case that you did too much.” You may know that Sebastian got 2nd in his 1st long-distance race and that he raced under 8 hours. To remember his sentence could help in situations of doubts.

To fall prey to overtraining can happen to everybody who loves his or her sport, because sport can actually become an addiction which has nothing to do with being overzealous or doped. The feeling of whole body fatigue as well as the feeling of being able to deliver peak performance are rewarding and seducing. Both extremes can lure us to do more to get more! One day “the more” turns into “too-much” and can bring about overtraining, a sneaky process that may overrun you! A complex phenomenon that needs elucidation still.

Overreaching we need, overtraining we have to avoid

How I see it is that training is the physiological healthy process of improving performance (that applies not only to sport, training is a process of learning to change behavior, be it mental or physical), whereas there are general and individual limits to achievements, of course. With exercise you stimulate and activate the respective parts of the body, including your brain/mind. Without stimuli we become lazy and fall apart, we are losing grounds, and finally develop into losers. We need training, we need exercise to live and survive, but have to learn to respect our very own limits that are rooted in our genetic outfit.
Out there in the real world we observe all transitions from healthy and fit to frail and finally sick. In the beginning the symptoms of decline are very sound, and easily overheard… and if we don’t listen, suddenly the steep fall is there and it may take us weeks, sometimes months, and sometimes for ever to recover.

The very signs that mark the transition from overreaching to overtraining

Generalized fatigue, heavy legs, sore muscles, recurrent headaches, diarrhea, weight loss, sexual disinterest, loss of appetite, problems to sleep and getting up in the morning, inability to relax, listlessness, generalized swelling of lymph glands, worsening of allergies and asthma. Coming down with colds and flus, or respiratory infections that resist to therapy. And very important to pay attention to despite hard training racing performances continue to deteriorate.
This is only an incomplete list that wants to show that the changes you may experience can be emotional, behavioral or physical, and that they are all interconnected. They are all phenomena that depending on their severity are part and parcel of fatigue due to necessary overreaching or an indicator of overtraining.
The symptoms usually should disappear after taking a rest of 24 to 48 hours. If you cannot make it in this time, be cautious it’s overtraining knocking at your door.

Give me the one and only reason!

One more remark I want to make before I close this too long post, and continue to go into the biology of overdoing in greater detail in a later one. Athletes love to go for blood testing, x-rays, MRT etc. They search for the physician and they search for the parameter that is giving them the one and only explanation for their failing. I have to disappoint you. There is none. At the time you will receive concrete results of your bloodwork or other diagnostics you may already be gone over board, which means when your blood shows something you are really sick, and physical workouts are not any longer an option. It is the very characteristic of incipient overtraining that our diagnostic means fail. Overtraining is first of all a phenomenon of a stress system out of balance, a stress system that involves the immune system, the nervous system (central and autonomic nervous system) and hormones such as cortisol and adrenaline. These systems control and regulate our whole body, more about that in another post.
In the end, say good bye to conventional diagnostics, and don’t get lulled by weird interpretations of sophisticated diagnostics. Overtraining is a syndrome that can mimic all kind of diseases, be they mental or physical, and this is due to the systems that are involved – and to cut a long story – it involves our whole body as does training before you crossed the line to overtaining.

Since I am involved with biestmilch/colostrum, the diagnosis of lactose intolerance seems to have spread like an epidemic. Self-diagnosis and the diagnosis made by physicians – sorry to say so – as an easy way out for all kinds of functional gastrointestinal disorders has become so common that one has to develop reservations.
If you take your time and read the latest research done on this topic, doubts about the reliability of this diagnosis appear more than justified. Don’t get me wrong, there is no questioning about people suffering gastrointestinal symptoms, only the given reason may be highly questionable.

The topic is of great relevance for athletes who very often suffer from functional gastrointestinal disorders due to stress, be it mechanical, biochemical or mental. My impression is that these problems are rarely adequately analyzed and diagnosed, but overhastily labelled either as infectious, lactose- or stress-induced (means vegetative). The following paragraphs can only give you a very superficial idea of a complex problem.

Lactose and lactase, what is it about? A more state-of -the art view on intolerance

As far as it is known, lactose has no special nutritional value for adults. It is the most important source of energy during the first year of a human’s life, providing almost half the total energy requirement of infants. Lactose has several applications in food industry. It is used in sweets, confectionery and sausages because of its physiological properties: lactose provides a good texture and binds water and color. To be absorbed it needs to hydrolyzed. This is what lactase is doing. Lactase is found abundantly at the beginning of the small intestines. It is found at the tip of the intestinal villi and is therefore more vulnerable to intestinal diseases that cause cell damage (other enzymes that degrade other sugars are located deeper in the cell lining).  If lactase secretion drops about one tenth or less of suckling level after weaning, then this is referred to as primary hypolactasia. Congenital lactase deficiency is extremely rare. Secondary hypolactasia or maldigestion may be due to operations or damaged mucosal lining of the gut (infections, inflammatory diseases). This is where biestmilch comes in. The minimum amount of lactose that may cause symptoms is not known, and may be a very subjective thing. On average amounts of dozens of grams have to be ingested to cause symptoms (e.g. 50 grams are used in the lactose tolerance test for diagnostic reasons). Don’t forget that you ingest lactose with many kinds of foods!

Biestmilch is low in lactose. It only contains 5% to 7% of the amount of lactose in milk.

Those of you who tolerate lactose in small to moderate amounts without remarkable discomfort, can take biestmilch without any problems. Of course, this only applies, if you are suffering from a proven lactose intolerance which is not part and parcel of a functional bowel disorder (see below). Our experience over many years has shown that in many cases the symptoms of lactose intolerance decrease or disappear. This may be well due to the therapeutic effect of biestmilch on the mucosal lining. Biestmilch works as an anti-inflammatory agent on epithelial cells. Moreover it has got the properties to regulate functional disorders.

The gut has not got so many choices of symptoms presentation

Regardless of the cause abdominal symptoms are loose stools, constipation, diarrhea, abdominal bloating and pain, flatulence, nausea, collywobbles and bowel sounds, dyspepsia etc. Visceral sensitivity and bowel motor abnormalities are very common phenomena in these cases too. The threshold when people with these symptoms perceive pain or discomfort is lower compared to healthy individuals. What’s not painful under normal conditions becomes painful for these people. All these symptoms may be caused by the most different illnesses, ranging form gastrointestinal infections to functional disorders, whereas the majority is suffering from functional gastrointestinal disorders. They are either chronic or recurrent without the findings of structural or biochemical abnormalities. The prevalence of functional bowel disorders in the Western society is very high. Only for irritable bowel syndrome it is around 17%. The symptoms for lactose intolerance are very similar, if not the same.

Recent well-controlled studies have shown that both lactose digesters and maldigesters experience symptoms after ingestion of very low -lactose or lactose-free milk. This suggests that many of the symptoms experienced by lactose maldigesters are not related to lactose digestion. It seems so the subjective lactose intolerance is strongly related with functional illnesses of the guts such as irritable bowel syndrome.

Does lactose intolerance cover up for a more complex illness underneath? Thinking out of the box

Lactose intolerance is not a straightforward simple diagnosis of measuring a lactase deficit. It stands for an underlying complex regulatory dysfunction of the gut. Among those physiological factors that affect the amount of lactose digested and its tolerance are gastrointestinal transit, intestinal lactase activity, visceral sensitivity and the presence of functional bowel disorders, and possibly the composition of the microflora in the colon. On top of this factors related to the sensory and central nervous system modify symptom perception. Just to give you an idea, what this means: Adults who complained a lot about abdominal pain in childhood, seem to be more prone to developing functional gastrointestinal problems later in life.

Reference:
Vesa TH, Marteau Ph, Kopela R: Lactose Intolerance. Journal of the American College of Nutrition, 19 (2), 165-175, 2000

Isn’t it amazing how science and its view on the body changes over the years, decades and centuries. Just to give you some examples: Neurones and nerve tissue were considered to be without any potential for regeneration, the muscle cell was coined as a cell without abilities to multiply and adapt, and adipose tissue still has got this negative flavor of being a burden (aesthetic view) and health hazard (medicinal view) only. Fashion on the one hand and medicine on the other hand stand for these extreme positions.
And now the breaking news: Adipose tissue is an endocrine and immunologically highly active organ. Some of you may know already that the adipocytes are producing and secreting a broad spectrum of soluble mediators that engaged in the regulation of appetite and weight. But what may be brand new to all of us who are not specifically involved in this topic of research, may be the fact that adipose tissue connects the immune system with metabolism, an interesting aspect for athletes by the way, who in many ways got a quite hysterical attitude towards fat. Fat is still seen as an inactive mass of cells that we need as energy supply in austere times only.

And now science comes in, and everything should be different? Yes, it is. More and more scientists realize, that  the body is one functional unit, and so, fat is an integral part of it. Very recent scientific data suggest that adipose tissue secretes a wide variety of hormones and proteins that regulate whole body homeostasis (balance) involving nearly all organs and cells. Scientists discovered molecular pathways that connect the adipose tissue with the immune system, and vice versa. they found out, that so many active molecules that have been assigned to the immune system only are secreted by adipocytes too. Nice to observe for me that step by step scientists who themselves erected the walls within the body are tearing them down themselves realizing that the borders they were defining are artificial, not applicable and suitable to explain the phenomenon body. Now walls have been destroyed between the nervous system and the immune system the process has expanded to the adipose tissue. Maybe fat is getting more positive attention soon.

I am not talking about obesity in this article. I want create awareness and address to those who want to be lean and perform on top level. To talk about the disease-inducing aspects of obesity is of course very important and has to do with the interdependency between body fat and immune system as well. Obesity is pushing the body into an inflammatory condition with a sincere consequence for the vessels and the body’s metabolic situation (diabetes-2 etc.). But now back to physiology, and details on pathophysiology another time.

Adipose tissue is directly connected with innate immunity, it is involved in all inflammatory and healing processes.

It expresses proinflammatory, anti-inflammatory and immunomodulating properties. Until today more than 100 molecules (peptides and proteins) have been identified. All these molecules can be seen as immunologically, metabolically and as neurologically active… all these systems are tightly intertwined. Therefore one can measure immunological alterations (CRP, TNF, IL-6) in various metabolic disturbances (Insulin resistance, important for athletes under stress; diabetes 2, obesity etc.).
The role of adipose tissue should thus been defined as a gateway connecting energy metabolism with immune function, they all influence each other.

Innate immunity is inducing adaptive immunity and is connecting us to the world, in a positive cooperative way like we live peacefully with our microbiota and negatively in the sense that invaders like viruses and bacteria are tackled. Through the pathway between adipose tissue and immune system saturated fatty acids from nutrition or endogenously degraded from triglycerol may have inflammatory potential, if a metabolic dysbalance is obvious. Here unsatured fatty acids enter the game (about these essential nutrients another time).

This was not more than a very rough approach to a complex topic that could easily cover book pages. Nevertheless, I hope I got the message across that we all have to re-instate the importance of fatty tissue. Fat makes fat, no! not true, to much food does so, fat is essential for health, energy supplies, and a proper immune function, and it is of extraordinary importance in endurance performance (about this topic in one of my next articles). To much fatty tissue induces harmful systemic inflammation harming first of all vessels and metabolism, but lack of adipose tissue leads to immunodefiecences and metabolic disturbances too. It is all about balancing our body, a real challenge for all of us to see the whole and not only the parts.

Let’s rethink our attitude towards adipose tissue, it is high time for that. We should not only demonize it.

Reference:
Schäffler A, Schölmerich J. Innate Immunity and adipose tissue biology: Trends in Immunology, 31(6), 228-235, 2010

These are the guys keeping the biestmilch team busy!

These are the avatars of our biest athletes. We painted them to accompany us to the races we go. From the left: Sebastian Kienle, Yvonne van Verken, Chris McCormack, Meike Krebs, Chris McCormack’s backside , Ronnie Schildknecht and Nicole Leder.