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Dec 16, 2015 You've probably seen it before. The classic photo of a marathoner bent over the road, puking their guts out. Or a triathlete hunched over with abdominal pain on the bike. Or the bodybuilder wandering around the gym with persistent annoying gas, the weekend warrior unable to get through a single run without bloating or diarrhea, or the health nut who seems to be constantly constipated no matter what they do. Today, we're going to delve into why apparently healthy people, especially athletes and exercise enthusiasts, get broken guts, and what they can do about it.  

Dr. Michael Ruscio is considered a leader in the functional medicine movement, as both a clinician and lecturer. He frequently speaks nationally to health care professionals as well as to the public. Dr. Ruscio has lectured at UC Berkeley, at the Ancestral Health Society and performed numerous interviews. Dr. Ruscio is a post graduate continuing education provider at Life Chiropractic College West. He has a clinical practice in Northern California where he specializes in functional medicine and sees patients both domestically and internationally. He is currently writing a book on digestive conditions and thyroid disease. He is also currently working toward launching a clinical trial in his office in 2015. Dr. Ruscio obtained his Doctorate of Chiropractic from Life Chiropractic College West and has completed post-doctoral specialty training in Functional Medicine. Prior to his specialty training, Dr. Ruscio obtained his B.S. in Exercise Science from the University of Massachusetts at Amherst.

-Dr. Ruscio's personal diet, and what his typical day looks like (including his meal of choice at Whole Foods)...

-The surprising things that happen to your gut when you combine calories and high levels of physical activity...

-Whether athletes should fast, and what happens when an exercise enthusiast "stops the flow of calories" and fasts...

-How an "elemental diet" works to reduce stress on the gut...

-When you actually should consider starving the bacteria in your gut... -Whether you can combat "overstressing" the gut with food by simply using things like digestive enzymes...

-The biggest mistake most people make with cleanses, enemas and detoxing... -How you can heal damage to the valves passing through your gut...

-If you could test anything and everything going in your gut, what you should test...

-And much more!

Resources from this episode: -Dr. Ruscio's website and special gut testing discounts for BenGreenfieldFitness listeners -Study: Exercise and associated dietary extremes impact on gut microbial diversity -Toll-like receptors and their downregulation in exercise enthusiasts -Elemental diet instructions -Digestive enzymes -Iberogast for gut motility -Motilpro for gut motility -Wurn protocol -Interstitial cells of cajal -Three day gut panel (stool test) -The bonus materials Dr. Ruscio and I discuss

More notes:

This study was in the journal Gut in 2014:  This study compared activity level and diet of professional Rugby players to that of non-athletes of similar size, sex and age. ·        Your gut contains many sensors called toll-like receptors or TLRs.  These TLRs are responsible for monitoring “stuff” in the gut; specifically they help us identify good stuff from bad stuff. ·        Exercise may modulate these sensors  and even prevent them from telling your immune system to attack.  Remember too much “attack” signaling can occur in autoimmune conditions.       
It has been shown that hormones releases during exercise, like noradrenaline, stimulate the growth of non-pathogenic, commensal (aka ‘good’) E.Coli, as well as other gram-negative bacteria.
o   E. Coli is often stereotyped as being a bad guy, however there are many types of E. Coli, several are good guys.  In fact some E. Coli probiotics have shown impressive results for treating inflammatory bowel disease (Ulcerative Colitis and Crohn’s disease) o
o   and IBS
However, just because some exercise is good does not mean more is better.  It has been shown that those who perform extreme levels of exercise are at increased risk for infection.  
This is likely because too much exercise can cause immune suppression.  This hints at the importance of balance.  For example other studies have shown moderate exercise may also reduce levels of colon cancer, while excessive amounts may be damaging to your gut.    
Mice who get physical activity show increased fermentation of prebiotics and well as a decreased inflammatory response.
Other animal studies also show exercise reduces intestinal inflammation o
Exercising without a break may be the most stressful on your body.  For example short circuits with not rest or prolonged cardiovascular exercise with no rest may be the more problematic for those trying to recover from burnout or illness. 
The most important factor is ensuring you are exercising enough, but not too much.     If you are ill or trying to recover from burnout, I recommend:        
  • Getting light activity, outside (ideally in a forest-like environment) and preferably with a friend.   
  • Start with 1-2 days a week, around 20-30 minutes and push yourself hard enough to break a light sweat.  Pay attention to the signs of overtraining.  If you do not experience any of these you can slowly ramp up your amount of exercise.          
  • HRV (heart rate variability) is a simple and very inexpensive way to monitor yourself.   
See here for more, ·        Exercise is an example of how we can modulate our internal environment making our bodies a hospitable place for good bacteria to grow.  By obtaining the appropriate amount of exercise you will modulate your immune system to allow more good bacteria to growth, thus optimizing your microbiota and overall health. 


Do you have questions, comments or feedback and why athletes get broken guts? Leave your thoughts at and either Dr. Ruscio or I will reply, and click here if you want access to a consult with Dr. Ruscio!