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<p><span style="font-weight: 400;">Welcome to episode 39 of Holistic Performance Nutrition (HPN) featuring </span><a href="http://coachtawnee.com/"><span style="font-weight: 400;">Tawnee Gibson</span></a><span style="font-weight: 400;">, a holistic health & endurance coach, and Julie McCloskey, a certified holistic nutrition coach and personal trainer, who you can find over at </span><a href="http://wildandwell.fit/"><span style="font-weight: 400;">wildandwell.fit</span></a><span style="font-weight: 400;">.</span></p>
<p>There is so much goodness in this episode that we&#8217;ve decided to split it into two parts, today is part 1:</p>
<h2>Jaclyn says:</h2>
<h3><b><a href="https://enduranceplanet.com/hpn-38-holistic-approach-to-building-bone-density-and-lifestyle-medicine-part-3-a-fresh-perspective-on-physical-movement-and-nature-immersion/">HPN 38</a> // </b><b>Follow-Up Comment on Bone-Density Factors</b></h3>
<p><span style="font-weight: 400;">I’ve been a listener since I was a college track and cross country athlete in 2016. I would listen while working a cleaning job on the weekends haha. I am now a physical therapist and first time mom and continue to love your content. I especially love the balance between family, long term health, and athletic goals. </span></p>
<p><span style="font-weight: 400;">Anyways I am writing in follow up to <a href="https://enduranceplanet.com/hpn-38-holistic-approach-to-building-bone-density-and-lifestyle-medicine-part-3-a-fresh-perspective-on-physical-movement-and-nature-immersion/">HPN episode 38</a>. I am in complete agreement with all of your recommendations and appreciate the well rounded response you provided. However I wanted to share a resource that has dramatically impacted how I think of and treat bone injuries and bone density. The podcasts and articles are specific to bone injuries but I had never had the science of how bone works explained to me like this. It brought a lot of clarity on why do runners often have issues with bone density and bone injuries when running is weight bearing (obviously energy deficiencies and overtraining play a role in many cases but I have also worked with individuals where these aren’t major factors).</span><b> The variability of stimulus on the bone seems to be a missing piece in a lot of bone density/injury recovery plans. </b></p>
<h3><span style="font-weight: 400;">The paper that outlines this:</span></h3>
<p><a href="https://www.jospt.org/doi/abs/10.2519/jospt.2021.9982"><b>Optimal Load for Managing Low-Risk Tibial and Metatarsal Bone Stress Injuries in Runners: The Science Behind the Clinical Reasoning</b></a></p>
<p>&nbsp;</p>
<h2><strong>Par asks:</strong></h2>
<h3>Timing of Supplements (Food, No Food, Combos and Circadian Rhythm)</h3>
<p><span style="font-weight: 400;">Regarding supplements, such as Omega 3 fish oil, vitamine D and the usual suspects. Is there any way that is better or worse in how you take them during the day? And I´m not referring to sticking them up your butthole. Are you supposed to spread them out, take all at once, is there a common supplement that has to be taken alone or together with something?</span></p>
<h3>What the coaches say:</h3>
<ul>
<li>Supplement protocols can get very intricate and involved. Depending on the season you’re in this can be beneficial but in other times it can be too much to manage and stressful. So in this answer we’re just going to address some of the more common supplements that people are more likely to take regularly and ongoing:<span class="Apple-converted-space"> </span></li>
<li>We buy most our supplements on <a href="https://us.fullscript.com/welcome/eplanet">Fullscript, shop through EP for a discount here</a>!</li>
<li>Easy rule of thumb:<span class="Apple-converted-space"> </span>
<ul>
<li>Fat soluble = with food (and together). This includes A/D/E/K/Fish Oil<span class="Apple-converted-space"> (or <a href="https://rositausa.com/?oid=2&affid=297">Rosita Cod Liver Oil</a>)</span></li>
<li>Spread out other supplements. Ends up being:
<ul>
<li>Fat soluble AM</li>
<li>Vitamin Bs, C, etc at lunch;
<ul>
<li>Bs, C are water soluble but may cause upset tummy, so might be good to take around a meal (we usually do after lunch)</li>
</ul>
</li>
<li>Magnesium before bed, perhaps your probiotic, etc.
<ul>
<li>Other forms of Mg may be taken at different times of day depending on form and its benefit.</li>
</ul>
</li>
<li>Overall, spreading supplements at certain intervals throughout so we don’t give the body too much to process at once and help with absorption.<span class="Apple-converted-space"> </span></li>
</ul>
</li>
</ul>
</li>
<li>Tawnee says, “We typically do our fat-soluble vitamins in the morning with/after breakfast eg <a href="https://rositausa.com/?oid=2&affid=297">CLO</a> or fish oil/A/D, we have pretty high-fat meals so that fits great, and gets it done with for the day. But also with the potential of Vit D to influence circadian rhythm it makes sense to do in the AM. Though sometimes we don’t take till lunch. Then, as we coffee, if we haven’t taken these vitamins by lunch time or around 12-1pm, I’ll usually skip them for that day.”</li>
<li><b>Fish Oil</b>
<ul>
<li>Take with food, preferably at least 1 tsp worth of fat in the meal to maximize absorption, and preferably with or after your meal (not right before on empty stomach).</li>
<li>Or try <a href="https://rositausa.com/?oid=2&affid=297">Rosita Cod Liver Oil</a> (simplifying the number of supplements you take and food-first)!</li>
</ul>
</li>
<li><b>Vitamin D</b>
<ul>
<li>Take with a meal (fat). All fat soluble vitamins (ADEK) should be taken with fat.<span class="Apple-converted-space"> </span></li>
<li>Vit. D is better absorbed with Magnesium, Vit K, and calcium. So can take it alongside some yogurt.</li>
<li>Some evidence that taking Vit D in morning is beneficial for circadian rhythm and subsequently for better sleep, whereas taking before bed can interfere with quality of sleep.</li>
<li><a href="https://pubmed.ncbi.nlm.nih.gov/32156230/">https://pubmed.ncbi.nlm.nih.gov/32156230/</a>
<ul>
<li>“Vitamin D has both a direct and an indirect role in the regulation of sleep.”</li>
<li>“Vitamin D is also involved in the pathways of production of Melatonin, the hormone involved in the regulation of human circadian rhythms and sleep.”</li>
</ul>
</li>
<li>Consider that if you get adequate sun exposure to keep up Vitamin D levels (and labs reflect that) them maybe you don&#8217;t know to be supplementing so much with it, even in winter, as we can store it up in summer season, etc.</li>
</ul>
</li>
<li><strong>Vitamin A</strong>
<ul>
<li>Generally take with D and/or your fat solubles or get from <a href="https://rositausa.com/?oid=2&affid=297">CLO</a>, beef liver, etc.</li>
<li><a href="https://rositausa.com/?oid=2&affid=297">Rosita Cod Liver Oil</a> can be a natural alternative for fish oil, D, A &#8211; Tawnee’s family doing more of this as of recently and less reliance on synthetic forms of D, A, etc.</li>
<li></li>
</ul>
</li>
<li><b>Iron</b>
<ul>
<li>Better absorbed when paired with vitamin C and an hour away from caffeine or calcium.</li>
</ul>
</li>
<li><b>Magnesium</b>
<ul>
<li>Take 1-2 hours apart from any supplement containing iron, zinc, folate or fiber.</li>
<li>Mg glycinate and some other forms of Mg best before bed for calming effect and sleep help.</li>
<li>But know your form of Mg and its role!
<ul>
<li>Eg, <a href="https://us.fullscript.com/welcome/eplanet">Smidge Morning Mag</a> is something we have and it has 3 different forms (orotate, taurinate and malate with boron) that are good for taking in the morning (hence the name) as well as for heart and cardiovascular benefits;</li>
<li>Designs for Health <a href="https://us.fullscript.com/welcome/eplanet">NeuroMag,</a> with Magnesium L-threonate, can be taken daytime for cognitive benefits;</li>
<li>or even LMNT has Mg malate for electrolytes, which most people probably take during the day.</li>
</ul>
</li>
<li>Still loving <a href="https://crucialfour.com/?rfsn=7402623.b16822">Crucial Four MagBicarb</a> in the mix but also sticking with tried and true forms like Mg glycinate.</li>
</ul>
</li>
<li><b>Multi-Vitamin or Prenatal</b>
<ul>
<li>Take with food to prevent GI upset and optimal absorption of the fat-soluble vitamins.</li>
<li>Some can be energizing so might be best to take earlier in the day.</li>
</ul>
</li>
<li><b>Creatine</b>
<ul>
<li>Take any time of day, but I like a little before and a little after a workout.<br style="font-weight: 400;" /><br style="font-weight: 400;" /></li>
</ul>
</li>
</ul>
<h2><b>Lifestyle Medicine & the Roots of Wellness </b></h2>
<h3><b>Part 4: #8-10</b></h3>
<p>First, a refresher (listen to these first is you haven’t already!):</p>
<ul>
<li><a href="https://enduranceplanet.com/hpn-36/">HPN 36 &#8211; Intro + #1-3</a></li>
<li><a href="https://enduranceplanet.com/hpn-37-sweet-sweet-victory-and-lifestyle-medicine-part-2-evidence-based-wellness-practices/">HPN 37 -The Research + #4</a></li>
<li><a href="https://enduranceplanet.com/hpn-38-holistic-approach-to-building-bone-density-and-lifestyle-medicine-part-3-a-fresh-perspective-on-physical-movement-and-nature-immersion/">HPN 38 &#8211; Continuing with #5-7</a></li>
</ul>
<h3><strong>Overall, our Top 10 Pillars are:</strong></h3>
<ol>
<li>Emotional health & self-awareness</li>
<li>Resilience to stress</li>
<li>Community</li>
<li>Nourishing nutrition</li>
<li>Physical movement</li>
<li>Connection to nature</li>
<li>Sleep, sun and circadian rhythm</li>
<li>Spiritual connection</li>
<li>Enjoyment / play</li>
<li>Environment</li>
</ol>
<p><strong>Wrapping it up with the last few&#8230;</strong></p>
<h3>7. Sleep, sun and circadian rhythm</h3>
<ul>
<li>Life is flat without this! Ties into the previous two (movement, outside/nature/sunshine)</li>
<li>Circadian rhythm is not just sleep, it’s a 24-hr internal clock</li>
<li>Regulates many bodily functions &#8211; hormonal secretions, metabolic function, immune system, etc.</li>
<li>Start here:
<ul>
<li>SUN! Morning light and UVA/UVB light!</li>
<li>Sunlight in eyes (outside not thru window which blocks certain wavelengths) in the morning upon waking helps CAR (cortisol awakening response) and this is the healthy balanced kind of cortisol we want in the morning to set us up for success; I recommend to all my clients esp those with adrenal fatigue/HPA axis issues​​</li>
<li>CAR is the swift elevation in cortisol level upon the first hour of waking. The CAR is integral in regulating circadian rhythms, as well as improving adrenal fatigue more quickly. Get outside shortly after waking up and expose yourself to the sun—even when cloudy or in the winter time. Even an overcast day will stimulate your body with the intended effect. For circadian rhythm, this morning sun helps set a timer in a way to help melatonin production later on for best sleep</li>
<li>UVA rise, about an hour after sunrise and lasts 60-90min; has similar benefits
<ul>
<li>Specifically when sun is 10-30deg above horizon</li>
<li>Can help set up our skin for better protection against sun burning and damage… in other words, we can allow skin to adapt with proper sun exposure at the right times!</li>
<li>Some people call this ability to better tolerate sun a “Solar callus” but medical fields do not recognize this term as something valid and some doctors will just say it’s made up Spring is coming, and after that summer…. I’d at lesat s=consider this concept if you plan to be in the harsh sun in peak summer hours this year, and see if building up your tolerance helps. Tawnee says, &#8220;I wouldn’t avoid sun! Just do it right, don’t go from 0 to 100!&#8221;</li>
</ul>
</li>
<li>UVB
<ul>
<li>Get this during peak daytime hours</li>
<li>Bright light is great, but not night! Not after sunset! Especially not after 10pm… and not at 3am lol…</li>
</ul>
</li>
<li>Circadian app helps detail these things specific to your location.</li>
<li>It’s funny because we’ve been taught to villainize the sun and exposure to it… but, should we question this?</li>
<li>Really cool podcast on more of this subject: <a href="https://www.westonaprice.org/podcast/still-sick-the-sun-can-help/#gsc.tab=0">Still Sick? The Sun Can Help</a></li>
</ul>
</li>
<li>Then nighttime and sleep itself:
<ul>
<li>Beating a dead horse, so this time I want to read these stats from IFM: <a href="https://discover.ifm.org/sleep">https://discover.ifm.org/sleep</a></li>
<li>Set up the sleep hygiene routine almost nightly.</li>
<li>Obsessed with lighting in our house, one of the first things I did at new home was change bulbs and set up red lights and dim lights for evening and night.</li>
<li>And if I do wake up in the middle of the night (this happened a few times right before we moved!) I NEVER EVER look at my phone, that is the death of me and chances of going back to sleep</li>
<li>AVOID UVB/Light exposure at night (between 10pm-4am) which will wake you up even more, suppress melatonin and suppresses dopamine and can affect everything from mood to blood sugar
<ul>
<li>Eg don’t check what time it is, read or scroll… instead check your breath and focus on getting back to sleep</li>
</ul>
</li>
</ul>
</li>
<li>3 more factors for good sleep:
<ul>
<li>Go for a walk after dinner</li>
<li>Have a consistent wake-up time to regulate sleep cycle naturally because we tend to use the same amount of energy throughout the day</li>
<li>Waking up to pee?
<ul>
<li>Drink sufficiently during the daytime, 8oz every hour for the first 10 hours of the day</li>
<li>Reduce fluid intake at night (5-8oz between 10 hours after waking and bedtime unless super thirsty)</li>
<li>Sip don’t gulp your final beverage of the evening. The speed in which you ingest fluid, and not just the total amount, helps dictate the urination response</li>
</ul>
</li>
</ul>
</li>
</ul>
<h3>8. Spiritual connection (religion or non-religious)</h3>
<ul>
<li>Not here to tell you what the specifics of this should be just here to say it’s important factor in our health, and to follow what feels right in your life and needs.</li>
<li><i>“Functional medicine recognizes the importance of the mental-emotional-spiritual connection to physical health and addresses these concerns as a core clinical imbalance of the functional medicine matrix. Through empathetic listening and retelling of a patient’s health story and recommending ways they might reconnect to their own purpose in life, addressing spiritual needs can strengthen the therapeutic partnership and open up new avenues of healing for the patient.”</i> &#8211; IFM</li>
<li>Tawnee and Julie share personal stories of where they are each at in their spiritual journeys and the role in their lives, very two different POVs.</li>
</ul>
<h3>9. Enjoyment / play</h3>
<ul>
<li>At least an hour of unstructured, non-competitive, no-risk play</li>
<li>Recreational sport, playing with kids, riding bikes to get ice cream, shuffleboard at a dive bar, doing a happy dance, climbing a tree, acting like a carefree kid, pickleball, waterparks&#8230; it doesn&#8217;t matter!</li>
<li>“Joyful”  &#8211; Play is a facet of Joy.</li>
</ul>
<h3>10. Environment</h3>
<ul>
<li>Are you surrounded by toxic energy (people or otherwise?), where do you spend most your time and what is this place/ are these places like?</li>
<li>Take an energy audit, did that person or place leave you feeling energized or depleted? And is that a pattern?</li>
<li>There are a lot of human performance experts right now talking about how the only thing in life we can control is where we put our Attention. Feel like that could tie in to this one. Where is our attention going? And to whom?</li>
<li>Build your community as we talked about in episode <a href="https://enduranceplanet.com/hpn-36/">HPN 36</a>.</li>
</ul>The post <a href="https://enduranceplanet.com/hpn-39-part-1-supplement-timing-wrapping-up-our-top-10-of-lifestyle-medicine-and-roots-of-wellness/">HPN 39 (Part 1): Supplement Timing, Vitamin D and Circadian Rhythm – Is There A Link? Plus: Food-First Supplements, Magnesium’s Many Roles, and More</a> first appeared on <a href="https://enduranceplanet.com">Endurance Planet</a>.

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