The Hydration Debate - How Much Water Do You Really Need?

The Hydration Debate - How Much Water Do You Really Need?

As we move into the summer, the competitive season for endurance sports hits full swing. Regardless if you’re an experienced runner or novice, you’ve likely been reminded by your run coach or peers “make sure you drink enough water during your run!”

For years the recommendation from run coaches has been to drink beforeyou are thirsty, to prevent dehydration and subsequent decrements in performance. But if you aren’t racing at the front of the pack, do you need this much water?

Read More

5 Foods to Boost Athletic Performance

5 Foods to Boost Athletic Performance

The ancestral diet revolution is in full swing, and, as a result, more and more athletes are choosing to adopt a Paleo-based approach to eating in order to improve their performance. One question I get asked a lot by clients who are thinking about going Paleo or even those already in the community is “Are there specific foods that can help me with my athletic performance goals?” The answer is absolutely yes.

Read More

Endurance Training Dilemma - High vs. Low Carb

Endurance Training Dilemma - High vs. Low Carb

Endurance athletes train hard and train often. Regardless of whether you’re an elite competitor or trying to achieve a new personal best, maximizing your recovery and performance with the right nutrition plan is an absolute “no-brainer.” The problem is, with so much conflicting information out there, how can you find the best approach to meet your goals? Traditionally, endurance athletes have focused on high carb diets and gels during exercise to fuel workout performance. However, recently more and more athletes eating low-carb, high fat (LCHF) and ketogenic diets have promoted the use of fat as the ideal fuel source by dramatically reducing carbohydrate intake.

There are experts on both sides of the “low-carb” versus “high-carb” debate, making it a fine line to tread. How are you supposed to determine the best strategy for you?

Read More

5 Reasons Ectomorphs Struggle To Build Muscle

5 Reasons Ectomorphs Struggle To Build Muscle

One of the most common reasons athletes, Crossfitters and "skinny guys" come to see me in clinic is to add more lean muscle mass to their frame. They'll often complain that “no matter how much I eat, I just can’t gain any weight!” Naturally taller and leaner body types who find it easy to stay slim often struggle with adding more size. There are number of factors that can make it more difficult for you to add 10-15 lb. of additional muscle so you can raise your performance in the gym or on the playing field (or just look good naked).  

Let’s take a closer look at five common roadblocks that prevent you from gaining lean muscle.

Read More

Can You Bank Sleep? (To Improve Future Performance)

Can You Bank Sleep? (To Improve Future Performance)

Today, we just don’t enough sleep. Our modern high-tech society seems to be wreaking havoc on our sleep time (and quality), and ultimately health and performance. The average America adult gets only six and a half hours of sleep per night and alarmingly 33% of the population gets less than 6 hours of sleep per night. One of the most common question I get from clients to offset their sleep debt is “can I just sleep more on the weekends?” It’s an interesting question, but unfortunately the current research suggests no… you need to be consistent with your sleep to reap the health and performance benefits.

Read More

HIIT Sprints & Adults Over-50: The Minimum-Effective Dose

HIIT Sprints & Adults Over-50: The Minimum-Effective Dose

As you get older, it’s more difficult to maintain lean muscle mass. Muscle is not only a crucial factor in physical performance but also a key marker of healthy ageing.(1) After the age of 50 muscular power starts to decline, more rapidly than strength qualities, making it an important factor to focus on during training. Power isn’t just for dynamic sports efforts, your fast-twitch muscles are essential for “catching yourself” as you fall and hip fractures are significant risk factor in older populations. The good news is maintaining muscular power predicts a reduction in future falls, so not only is focusing on power qualities during exercise important for performance, but overall health as well.

Read More

3 Ways Camping Can Reboot Your Circadian Rhythms

3 Ways Camping Can Reboot Your Circadian Rhythms

Sleep problems seem to be the “new normal” these days. Most of the clients I see in clinical practice complain of difficulty falling asleep or staying asleep regularly throughout the week. Sleep quality isn’t the only problem. The average person gets a mere 6.5 hours of sleep per night (a far cry from the 8 hours our grandparents slept two generations ago) and over 33% of the population get less than 6 hours per night. New research shows lack of sleep is also a major factor contributing to blood sugar, insulin imbalances and chronic disease (not to mention poor athletic performance), so rebooting your sleep and recovery are critical. It seems late nights watching iPads, working on your laptop, or scrolling social media is dramatically changing our modern sleep patterns.

Read More

What Is The Minimum-Effective Dose For Hypertrophy?

What Is The Minimum-Effective Dose For Hypertrophy?

When you’re young or have lots of time on your hands, it’s easy to carve out 5-10 hours a week to hit the gym. Getting all your lifts in when you train 5-6 days per week makes achieving your hypertrophy goals quite straight forward. However, as you get older or your time becomes more limited, or if you’re simply looking for the most efficient hypertrophy program possible, the real question is… “how little time can you spend in the gym and still maximize your gains?”

Read More

Strength vs. Size - How Many Reps Are Really Best?

Strength vs. Size - How Many Reps Are Really Best?

Just the other day, a client named Tim came into my office because he was struggling to add lean muscle. He was eating right and training at a CrossFit box 4-5x per week (and getting stronger), but couldn’t seem to pack on the 10 pounds of lean muscle he was looking for. He was stumped. This is a classic case of really having clarity in your goals. Are training to get stronger so that you can perform better in your sport? Or is your primary goal to get bigger and add size to your frame? 

Read More

Vitamin D & Endurance Sport Performance

Vitamin D & Endurance Sport Performance

Vitamin D has been gaining significant momentum recently in the research for its ability to influence over 1,000 different genes in the body and subsequently some important performance parameters. Failing to get sufficient vitamin D regularly can negatively impact many endurance parameters, including maximal aerobic capacity (VO2 max), susceptibility to colds and flu, inflammation, recovery, and stress fractures.

Read More

3-Minute vs. 1-Minute Rest Periods (What’s Best for Strength and Size?)

Tell me is this scenario sounds familiar. You’ve been training in the gym for a while, you made some nice gains and now your progress has stalled. You’re doing all the compound lifts – squats, deadlifts, bench press, chins, etc. – but you just can’t seem to get any stronger, or any bigger.

The answer might not be your exercise selection or rep scheme, but something a lot simpler that you may have overlooked… rest periods.

A new study investigated the effects of long rest periods (i.e. 3-minutes) versus short (i.e. 1-minue) during resistance training. Twenty-one young men who were regular lifters trained three times per week, 3 sets of 8-12 repetitions for seven exercises per session, over the course of 8 weeks. The researchers tested muscular strength, endurance, and thickness before and after the study. The results were eye opening.

The group that rested the had to take “long” rest periods had significantly greater gains in muscular strength (i.e. 1-RM squat and bench press), as well as significantly greater muscle thickness in the legs (and a trend for upper body improvements).(1) It may not surprise many trainers that taking longer rest periods helps with your maximal strength performance, but the fact that it can also increase muscle thickness makes it a great “rest” strategy for athletes or anyone trying to add more lean muscle and size to their frame.

A lot of lifters can get caught up in the burn and build-up of lactic acid as a measure of training success, and therefore shy away from longer rest periods.  This study suggests the longer rest periods you take, the greater loads you can lift, which then translates into greater hypertrophy gains.

How can you make this practical during your training session (so it doesn’t take you 2 hours to train every session)? Your best bet is to superset opposing body parts, or upper and lower body, to maximize your time. For example, you could alternate chest and back exercises, or alternate between a compound leg exercise and upper body push or pull movement.

You might be wondering if your work capacity will be impaired by the longer rest periods? Great question and one the researchers investigated. They found muscular endurance was equal between the two groups, so taking 3-minute rest periods didn’t reduce the work capacity of the lifters compared to their 1-minute counterparts. This goes against a lot of popular thinking, as a 1-minute rest interval has to be the most common prescribed in gyms across the country.

If you’re struggling to get bigger or stronger (or both), and feel like you’re doing all the right things in the gym, the answer overcoming your plateau may be simpler than you think. This groundbreaking new research suggests adding 3-minute rest periods to your compound lifts to ramp up strength and hypertrophy gains. (Just think of how much down time you’ll have for mobility work!)

Happy training.

Dr. Marc Bubbs ND, CISSN, CSCS


Check out more articles in the "STRENGTH" SERIES...


Are Deep Squats Best for Vertical Jump & Sprints?

The current conventional wisdom among strength coaches seems to be that all clients and athletes should focus on a full range of motion (ROM) to promote superior strength and performance gains. While maintaining full ROM is obviously ideal, depending on the type of athlete you’re working with (and their specific goals), new research is shedding some light on how squat depth translates to performance gains.

A new study compared the effects of squat depth on vertical jump and sprint performance.(1) Twenty-eight college-aged male athletes were divided up and assigned to one of the three groups - full-squat, half squat and quarter squat - then performed a 16-week training protocol to assess the impacts on vertical jump and 40-yard sprint time. Interestingly, the greatest improvements in vertical jump and sprint time were found in the quarter-squat group (see Figure 1.0 and 2.0).

Figure 1.0 – Effect of Squat Depth on Vertical Jump

Figure 2.0 – Effect of Squat Depth on 40-Yard Sprint


Researchers believe that joint-angle specific changes to neuromuscular control may be the root cause of the improvements. Studies have found superior improvements in EMG in trained movements, versus those that are untrained.(2) Of course, the first quarter of the squat most closely resembles the hip and knee flexion ranges seen during jumping or sprinting, which is not surprising for most strength coaches. However, it’s interesting that in highly trained athletes, the load in the full squat seems ineffective for promoting gains in the quarter squat. In short, if you’re not doing quarter squats with your athletes who need to jump higher and run faster, you may be missing out on a piece to promote superior adaptation and performance. (However, it should be noted quarter squats also elicit greater anterior shear force that could predispose athletes to overuse injuries, if they’re not periodized appropriately.[3])

Depending on your athlete’s sport, the findings in this new study may be very impactful. Athletes with poor movement patterns or taller ectomorph-type athletes (i.e. basketball, volleyball, etc.) may benefit greatly from periods of training with quarter squats. If you’re performing deep squats with a basketball player, and using their 1-RM to base their training intensity, the work they perform at the quarter squat level will likely not be sufficient enough to overload the athlete and create positive adaptations. This new perspective of joint-angle overload suggests it’s not enough to simply train at different joint angles, you must overload the specific angle that applies specifically to your athlete’s sport (i.e. sprinting, jumping, etc.).

At the end of the day, quarter squats and full squats are very different; your neuromuscular system assesses and adapts to the stresses of varying squat depths differently. Therefore, it would make sense to incorporate more varied squat depth in your training protocols, just like the use of a variety of exercise to promote the greatest gains in strength and performance.

Dr. Marc Bubbs ND, CISSN, CSCS


Check out more articles in the "STRENGTH" SERIES...


7 Smart Snack Options During Travel Days


Eating on the go can be tricky. If you’re trying to trim body-fat, it takes time and effort to develop new eating habits, and it can be stressful when you can’t find an option to fit your new lifestyle. Likewise, if you’re training intensely in preparation for a big event or competition, it’s frustrating if you don’t have time to meal prep and get stuck with no solid nutrition options during the day. Regardless of whether you’re traveling through airports, fueling up at highway gas stations on a road trip, or stranded at the office, finding the right snack can be a challenge.

Before you dial in your snacking strategy, take a step back and examine your goals. Are you trying to get leaner? Are you looking to improve performance? Is upgrading your health your top priority? Your ultimate goal will impact the type of snack you choose, how much you should consume, and if eating a snack is even the best option.

If your goal is to burn fat and shed bodyweight, reach for high-protein, low-carb, and moderate fat snacks. Protein is the key macronutrient for triggering satiety, so it should be your top priority. If performance or hypertrophy is your goal, adding more calories to your day is important for training at intensity. Adding fats to your snacks will increase calorie count the quickest, and eating quality carbs will refill muscle glycogen and accelerate recovery.

Here is a list of my favorite snacks to help you reach your nutrition and performance goals.

#1 Jerky (Beef, Turkey, Chicken, Pork)

Jerky is my favorite high-protein snack option. It’s convenient, easy to carry, and tastes great. Jerky has made a big comeback recently, making it much easier to find antibiotic- and hormone-free brands with no additives, preservatives, red dyes, or MSG. A 1oz serving typically provides 12g of protein with only 5g of carbs. Jerky is typically very lean and contains little to no added fat.

#2 Nuts (Macadamia, Walnuts, Pistachios, Pecans, etc.)

While nuts do contain modest amounts of protein think of them as more of a fat snack. Pound for pound, macadamia and walnuts pack the biggest omega-3 punch.1 Combining nuts with jerky makes a great low-carb, high-protein, and moderate-fat snack between meals. Other low-carb nut options include pecans and Brazil nuts (just over 1g per handful), as well as hazelnuts and peanuts (about 2.5g per handful). If you want more carbs for hypertrophy or performance, go for cashews or pistachios (one handful is about 9g and 6g, respectively).

#3 Mixed Veggies (Bell Peppers, Cucumber, Cherry Tomatoes)

If you’re trying to lose weight, keeping your blood sugars and blood sugar hormone insulin balanced is important for success. A lot of people think veggies are “boring,” but nothing could be further from the truth. They are incredibly nutrient-dense and low in calories, making them an awesome snack option to add to your arsenal. One bell pepper is only 20 calories and provides 134 percent of your daily vitamin C needs, or spice things up with sliced cucumber sprinkled with cumin.2 Grab a party tray at your local grocery store and snack on it throughout the week to mix things up.

#4 Dark Chocolate (70% or more)

It’s 3:00pm, you’re at work, and struggling to get through your day. Rather than reaching for a sugary, high-carb candy bar, switch gears and get a dark chocolate fix. Dark chocolate is a great low-carb alternative, and a great source of antioxidants, fiber, and minerals like magnesium, iron, potassium, and zinc.3 Aim for 1-2 squares to help get you through until dinner.

#5 Berries

Portable, convenient, and delicious, berries are loaded with vitamins, minerals, and antioxidants. Raspberries and blackberries in particular are phenomenal sources of fiber; one cup provides 8-9g to help slow the release of sugars to provide sustained energy throughout the day. Berries also help to fight off chronic diseases like diabetes, heart disease, and various forms of cancer.4

#6 Medjool Dates

For hypertrophy and optimal recovery from intense training, calories count. If you’re on the go, dried fruit can provide a calorie and nutrient-dense carb source to replenish glycogen and offset training-induced elevations in cortisol stress hormones. Medjool dates pack a great carb punch (only four provide a whopping 72g) as well as potassium, b-vitamins, vitamins A and K, iron, magnesium, and trace minerals.5

#7 Protein Bars

If you are trying to lose weight or upgrade your health, I wouldn’t put protein bars on the top of your snack list because they typically contain a significant amount of carbs and sugar to increase palatability. However, if you’re training intensely and performance or hypertrophy is your goal, then a protein bar can be a great option. Aim for 20g of protein per bar to stimulate muscle protein synthesis. Avoid high fructose corn syrup, fractionated palm kernel oil, canola oil, artificial sweeteners like sucralose or acesulfame-potassium, and refined sugars like cane syrup and sugar alcohols (i.e., mannitol, erythritol, etc.) as they can trigger inflammation, weight gain, and disrupt the balance of your gut bacteria.6

Attack Your Snack With a Plan

Convenience is an important factor when choosing snacks. My favorites are jerky, nuts, and veggies for fat loss, and dried fruit, fruit, and high-carb nuts for hypertrophy and performance. The most difficult part of choosing solid travel snacks is ignoring the plethora of processed, refined and high sugar options around you. Have a game plan and you’ll be far more successful.

Dr. Marc Bubbs ND, CISSN, CSCS

(This article originally appeared @BreakingMuscle)


Check out more articles in the SNACKING SERIES...



  1. Ros, E. “Health Benefits of Nut Consumption,” Nutrients 2(2010):652–682.
  2. Vitamin C Fact Sheet for Health Professionals.” National Institute of Health.
  3. Crozier S et al. “Cacao seeds are a ‘Super Fruit’: A comparative analysis of various fruit powders and products,” Chemistry Central Journal 5(2011):5
  4. Basu A et al. “Blueberries Decrease Cardiovascular Risk Factors in Obese Men and Women with Metabolic Syndrome,” The Journal of Nutrition 140(2010): 1582-1587. 2010.
  5. Yasin B et al. “Date Polyphenolics and Other Bioactive Compounds: A Traditional Islamic Remedy’s Potential in Prevention of Cell Damage, Cancer Therapies and Beyond,” International Journal of Molecular Science 17(2015):30075-90
  6. Buyken A et al. “Carbohydrate nutrition and inflammatory disease mortality in older adults,” American Journal of Clinical Nutrition 92(2010):634–43.

Reduce Omega-6s (and Increase Omega-3s) for Better Health & Performance

If there’s one area where the nutrition media seems to sing a different and more confusing tune every week, it’s with their messages about fats.

Low fat was good for us, now it’s not. Saturated fats may not be the heart-clogging poison we thought. And what exactly are trans fats? It’s enough to make us throw our hands in the air and reach for the nearest burger.

Fortunately, one message has been consistent: omega-3 essential fatty acids (EFAs) are extremely beneficial for your overall health.  

The problem is, not all sources of omega-3 fatty acids are created equal.

In fact, in his recent post on multi-generational vegetarians, Christopher Clark explained how poorly the most common plant source of Omega-3s, called DHA, is converted to the form that we use, called EPA. It’s EPA which exerts the majority of the potent benefits of omega-3 fats.

But that’s only half of the story. While omega-3’s benefit our health, too much consumption of its counterpart, omega-6 EFAs, increases circulating levels of inflammatory arachidonic acid (AA) which can promote heart disease, cancer and most chronic diseases. 1

Unfortunately, our bodies can more readily convert omega-6 fatty acids to AA. Especially among some multi-generational vegetarians. That’s why, for optimal health, it’s not enough to just increase your variety of DHA and EPA-rich foods. You need to reduce your intake of pro-inflammatory omega-6 fats as well.  

Decrease Your Omega-6 Intake

The balance of omega-6 to omega-3 is critically important and unfortunately today’s modern diet is loaded with omega-6 fats. The omega-6 to omega-3 ratio of ancestral hunter-gatherer diets was approximately 2:1-3:1, whereas today’s ratio is around 10:1 to 20:1 (and higher among vegetarians). 2

Many people aren’t even aware they consume as much Omega-6 fatty acid as they do. It’s hidden in processed and convenience foods, used in most restaurants (even the expensive ones!) and in your favorite midday treat.

Vegetable and cooking oils are the most common sources. The following is a list of common omega-6 rich oils:

Oil - Omega-6 (%):Omega-3 (%)

Safflower- 75:0%

Sunflower- 65:0%

Corn - 54:0%


Sesame - 42:0%

Peanut - 32:0%

Soybean - 51:7%

Canola - 20-9%

Fish Oil - 0:100%

For multi-generational vegetarians with the genetic variant described in Christopher Clark’s post, reducing these oils in the diet is a must.

But all of us will benefit from cutting out these pro-inflammatory oils in favor of Paleo-friendly fats like beef tallow and duck fat (best for high-heat cooking) as well as coconut, avocado, walnut, macadamia or extra-virgin olive oil (best for moderate-heat cooking).

Increase Omega-3 Intake (EPA/DHA)

Now that you’ve cleared your kitchen of pro-inflammatory omega-6 fats, it’s time to ramp up your dietary intake of the extra-long chain omega-3 fats; DHA and EPA.

A daily intake of just 1g of combined EPA and DHA can have many positive effects. If you’re overweight or struggling with poor health, increasing your intake of omega-3 fats can improve blood sugar and insulin control, help fight off low mood and depression, and protect you from coronary heart disease. 3,4,5

If you’re exercising regularly (or just getting active), the University of Florida found consuming DHA post-training was able to significantly reduce exercise induced pro-inflammatory markers IL-6 and CRP over a two-week period. 6 In the UK, researchers at Cardiff University found that EPA and DHA were able to reduce key proteins that trigger the disease progression in osteoarthritis. 7

Fish: A Great Source of EPA

Terrific sources of extra-long chain omega-3 fats include Atlantic mackerel (2.6g per 3.5 oz. serving), herring (1.8g), tuna (1.6g), and salmon (1.5g per 3.5 oz.). If you like shell fish, blue mussels (0.5g per 3.5oz serving), oysters (0.6g), and squid (0.4g) are nice options as well. Try great recipes like mackerel tartare and spicy salmon with avocado and yams.

Lean Meats: A Less Known Sources of Omega-3s

While most people naturally associate feedlot beef with saturated fats, and look to fish and seafood to get their omega-3s, grass-fed beef is actually a good source of EPA and DHA (0.3g per 3.5oz. serving).  Ancestral staples like wild game meats – elk, bison, venison, etc. – are also good options as they’re naturally low in pro-inflammatory omega-6 with some omega-3s. Try this elk recipe perfect for a summer BBQ or stir-fry beef with veggies at dinner.

Omega-3 Eggs

Pasture-raised eggs are far more nutrient dense than conventional eggs and provide 0.3g of omega-3s per two large eggs.8

If there’s a lesson to be learned, it’s that the balance of omega-3 to omega-6 is what’s crucial for optimal health, as well as mental and physical performance.9,10,11 Focus on both reducing your intake of pro-inflammatory omega-6 fats and increase your intake of extra-long chain omega-3 fats to reverse chronic degenerative conditions and restore health and vitality.

(This article originally appeared on

Dr. Marc Bubbs ND, CISSN, CSCS



[1]  ResearchGate. (March 29, 2016). Human genome shaped by vegetarian diet increases risk of cancer and heart disease. Retrieved from

[2]  Cordain L, Eaton SB, Sebastian A, et al. Origins and evolution of the Western diet: health implications for the 21st century. Am J Clin Nutr. 2005;81(2):341-54.

[3] Delarue J et al.Interaction of fish oil and a glucocorticoid on metabolic responses to an oral glucose load in healthy human subjects.Br J Nutr.2006 Feb;95(2):267-72.

[4] Su K, et al.Omega-3 fatty acids in major depressive disorder. A preliminary double-blind, placebo-controlled trial.Eur Neuropsychopharmacol 2003;13(4):267-271

[5] Okuyama H et al. ω3 Fatty Acids Effectively Prevent Coronary Heart Disease and Other Late-Onset Diseases – The Excessive Linoleic Acid Syndrome. World Review of Nutrition and Dietetics (Karger) 2007, 96 (Prevention of Coronary Heart Disease):83-103. Retrieved From –

[6] Phillips T et al.A dietary supplement attenuates IL-6 and CRP after eccentric exercise in untrained males.Med Sci Sports Exerc 2003;35(12):2032-2037.

[7] Zainal, Z et al. Relative efficacies of omega-3 polyunsaturated fatty acids in reducing expression of key proteins in a model system for studying osteoarthritis. Osteoarthritis Cartilage. 2009 Jul;17(7):896-905.

[8] Karsten H et al. Vitamins A, E and fatty acid composition of the eggs of caged hens and pastured hens. Renewable Agriculture and Food Systems. Volume 25/ Special Issue 01 / March 2010, pp45-54. Retrieved From –

[9] Sheppard, K.W. and C.L. Cheatham, Omega-6 to omega-3 fatty acid ratio and higher-order cognitive functions in 7- to 9-y-olds: a cross-sectional study. Am J Clin Nutr, 2013. 98(3): p. 659-67.

[10] Simopoulos, A.P., An Increase in the Omega-6/Omega-3 Fatty Acid Ratio Increases the Risk for Obesity. Nutrients, 2016. 8(3): p. 128.

[11] Simopoulos, A.P., The importance of the ratio of omega-6/omega-3 essential fatty acids. Biomed Pharmacother, 2002. 56(8): p. 365-79.


Heart Rate Variability & Recovery In Baseball Pitchers

Recovery seems to be on top of every elite athlete and professional sports team’s list of priorities right now. Whether it’s sleep, nutrition, treatment, or strength training the framework has shifted away from the “no pain, no gain” mantra toward how best to ensure athletes recover so they can perform their best on competition day.

Heart rate variability (HRV) has become a popular tool for measuring how well athletes recovers from training, and thus also giving you a tool to predict of how well they may perform in future exercise bouts. What does HRV actually measure? It’s the variation in time interval between heartbeats, therefore giving you information about the autonomic nervous system (ANS).

Your ANS is broken up into two parts; your sympathetic nervous system (SNS) and parasympathetic nervous system (PNS). The SNS is the “gas pedal” that kicks up during training or when you’re busy and on the go throughout the day. It’s your “fight or flight” response. In contrast, your PNS is called the “rest and digest” nervous system because it’s activated during deep sleep and relaxation.

In general, most athletes (and people working at a desk or taking care of kids at home) are stuck in “fight or flight” SNS mode too much of the day. This burns you out and impairs future mental and physical performance.

In short, HRV gives you a measure of an athlete’s neurological fatigue. The less variance in your HRV measurement, the more you’re in “go-go-go” SNS mode (and thus increased likelihood to be rundown in the long-term). The greater the variance, the more active your PNS “recover” mode and thus the more rested your nervous system. It’s a simple measure that can be taken from a heart rate monitor or wearable device that can give you insights into your level of stress.

Recently, a study on professional baseball players was performed to examine the changes in HRV. The small study consisted of eight single-A pitchers that were measured daily over the course of an entire season. The results showed the ONLY day the pitchers had significant changes in HRV was the day after their scheduled start. While it can seem obvious that after a day of pitching a player would be fatigued, it’s interesting to be able to display and quantify and altered autonomic nervous system function.1

Over the course of the year, this has particular implications to all therapies received by the pitchers post-start. Are they travelling and not getting adequate sleep the night of a start? If so, what strategies are in place to mitigate this additional stressor? What changes to a players nutrition can be added after a game in order to blunt cortisol stress release, support inflammation response and transition player into recovery as quickly as possible?

This applies to all interventions, like the common practice of taking an ice bath after a game. Ice baths stimulate the sympathetic nervous system, therefore is this always the best approach after a game?

Of course, if you’re starting pitcher is back to 100% two days after each start, throughout the course of the season then no intervention would be needed. However, as in most sports, athlete’s baseline cortisol stress levels tend to increase as the season progresses and fatigue sets in, making the treatments all the more important as you move toward the playoffs and the most important games of the season.

The research around the use of HRV is mounting and does show promise as a good indicator of future exercise performance.2, 3 However, the data is still equivocal, meaning the results don’t always mean something and you should still take into account your physical and mental symptoms (i.e. keep a journal). You need to use your intuition as a coach or therapist – your eyes, ears and hands – to determine if the information is useful or not.

In the end, you need to choose a method of assessing fatigue in your athletes and HRV shows good promise. Whatever tool you select, you must stick with it and see what the data tells you in the long run. For baseball pitchers, new research confirms what we’ve probably known for a while… the day after a start, pitchers are tired! Only time will tell if its information worth listening to, or if it’s time to opt for another method.

Dr. Marc Bubbs ND, CISSN, CSCS


Check out more articles in the "RECOVERY" SERIES...



1) Cornell D et al. Resting Heart Rate Variability Among Professional Baseball Starting Pitchers. J Strength Cond. Res. June 30th, 2016

2) Furlan, R., et al. 1993. Early and Late Effects of Exercise and Athletic Training on Neural Mechanisms Controlling Heart Rate.  Cardiovascular Research 27 (3): 482–88.

3) Mourot, L., et al. 2004. Decrease in Heart Rate Variability with Overtraining: Assessment by the Poincare Plot Analysis. Clinical Physiology and Functional Imaging 24 (1): 10–18.





Can A Depleted-Glycogen “Sleep Low” Strategy Improve Your Performance?

The traditional nutrition dogma for athletes - in particular endurance athletes - has classically been to consume large amounts of carbohydrates pre- and post-exercise to optimize recovery and trigger maximal training adaptations. The sport nutrition research is very clear; muscle glycogen (the carbohydrate stores in your muscles) is replenished much more readily in the first few hours after training and higher carb (and protein) meals help to replenish glycogen and buffer training-induced increases in cortisol stress hormones.1,2

What did athletes do a few generations ago, before supplements and ready made food were so easily available? Did they ever not eat after exercise? And if so, did it derail their recovery and performance? Not likely. Interesting new research is uncovering how "timing" your carb intake and strategically avoiding replenishing glycogen may actually help improve your future performance (if done correctly).

What is the Sleep Low Strategy?

The "sleep low" strategy is defined as training intensely in the evening (after a typical meal) and then selectively withholding carbs in your subsequent meal after exercise (protein and fats are allowed) before going to bed. This strategy limits glycogen uptake after exercise, and thus your subsequent training session will be done with low glycogen stores, typically the following morning at low-intensity (e.g. light jog or easy lifts). 

For high performing athletes, the idea of purposefully not replenishing glycogen post-training seems to be a bad idea, as it's shown to be a major performance and recovery drain. However, a recent study in France of triathletes highlighted the potential benefits, if done acutely, of a sleep low strategy on performance.

Twenty-one triathletes were divided into two groups: a sleep low group and a control group. They ate the exact same total daily carbohydrates over the 3-weeks, but at different times throughout the day. The control group consumed their carbs across the entire day (i.e. breakfast, lunch and dinner) while the sleep low group consumed all of their carbs at breakfast and lunch, but nothing after their evening training, or before their morning session.

The researchers found after 3 weeks of doing the exact same training protocol, the sleep low group improved significantly more than the control in their submaximal cycling economy, supra-maximal cycling time to exhaustion and 10-km running time, and significantly decreased their fat mass.3

Don’t Cut the Carbohydrates Just Yet

If acutely restricting carbs helps performance, how far should you go? In today's "become a fat-burning machine" media coverage, should all endurance athletes be restricting carbohydrates to upgrade their performance?  

Like most things in life, context really matters. If you want to lose weight and exercise at 65% of your maximum effort, or take 6-18 months to adapt to a ketogenic diet, then a low-carb, high-fat diet is a pretty good approach. However, if winning a gold medal or beating elite competition is your goal then relying on fat for fuel is not going to cut it. (The exception might be "ultra" endurance events).

At high exercise intensities – like what you’d experience in a race – your body runs on about 90% carbohydrate. That’s right, when it’s time to hit the accelerator and pass your competition it won’t be the fats powering you, it will be the carbs. In fact, high-fat diets actually impair the muscles’ ability to breakdown glycogen, thereby limiting your access to the high-octane fuel.4

Individualize Your Plan To Supercharge Performance

Fortunately, it may be possible to get the best of both worlds, if your goal is performance. Use periodic three to four day blocks to “sleep low” and subsequently “train low” the following morning (i.e. low glycogen) to improve your fat-burning potential and ability to finish off a race.

But then avoid this approach when you get closer to competition and performance becomes critical. The research is still very clear that come race day, adding the carbs back in will allow you to perform better.

However, if your goal is to lose weight, boost your energy, and improve your health then the sleep low strategy could be very beneficial. I regularly see very active and experienced cyclists who ride hundreds of miles per week and are still 20-30 lb. overweight because of their very high-carbohydrate fueling.

Furthermore, this focus on fueling enough before, during and after exercise can lead to an excess of simple carbohydrates in the system and subsequent increases in triglycerides and smaller, denser LDL particles which all increase cardiovascular disease risk.5

A sleep low and train low strategy could be a game-changer for these athletes. Not only would it improve cycling performance, but it would also significantly reduce body-fat stores and improve health.

In truth, athletes have been tinkering with sleep low and train low strategies for decades, however now scientists are starting to get an understanding of how these strategies work and who they can potentially impact most. Think of “sleep low” and “train low” as just a few more tools in your tool belt of training strategies. Plan and periodize their use to maximize their benefits and limit their potential shortcomings.

Dr. Marc Bubbs ND, CISSN, CSCS



[1] Ivy J et al. Glycogen resynthesize after exercise: effect of carbohydrate intake. Int J Sports Med. 1998 Jun; 19 Suppl 2():S142-5.

[2] Tipton K et al. Timing of amino acid-carobhydrate ingestion alters anabolic response of muscle to resistance training. Am J Physiol Endocrinol Metab. 2001 Aug; 281(2):E197-206.

[3] Marquet L et al. Enhanced Endurance Performance by Periodization of Carbohydrate Intake: “Sleep Low” Strategy. Med Sci Sports Exerc. 2016 Apr;48(4):663-72.

[4] Stellingwerth, T et al. Decreased PDH activation and glycogenolysis during exercise following fat adaptation with carbohydrate restoration. Am J Physiol Endocrinol Metab. 2006 Feb;290(2):E380-8.

[5] Sachdeva A. Lipid levels in patients hospitalized with coronary artery disease: An analysis of 136,905 hospitalizations in Get With The Guidelines. American Heart Journal. January 2009. Volume 157, Issue 1, Pages 111–117.e2


The Athletic Potential of Vitamin D

It’s the middle of winter, and the days are dark and cold. But you’re still training intensely and eating clean to get ready for your upcoming competition. Unfortunately, there is one vitamin no amount of clean eating can fix, especially in athletes. New research suggests maintaining the right levels of vitamin D may improve several elements of performance, including your VO2 max, sprint capacity, and power production.

A Growing Research Field

Exercise dramatically increases an athlete’s demand for vitamin D, as your muscle, heart, and vascular tissue all contain key vitamin D receptors. Today, studies show more than 50 percent of athletes are low in vitamin D.1 While the direct cause isn’t clear, it’s most likely a combination of things like inflammatory processes, muscular damage, increased protein synthesis requirements, increased immune activity, lack of sun exposure, race, and genetics.2

A clear vitamin D deficiency occurs at blood levels less than 20ng/mL (< 50 nmol/L), while insufficiency for athletes is generally defined at blood levels between 20-32 ng/mL (50-80 nmol/L). Insufficiency simply means you’re not getting enough to meet the demands of your activity. Intense training is demanding. New research suggests that 40-50ng/mL (100-125 nmol/L) seems to be the “sweet spot” for supporting optimal athletic performance, and experts agree the body needs daily replenishment to meet that requirement.3,4

Achieving your ideal vitamin D intake may upgrade six key areas of performance:

  1. VO2 max
  2. Muscular power production
  3. Testosterone levels
  4. Inflammation
  5. Susceptibility to colds and flu
  6. Mood

Let’s take a closer look at each.

1. VO2 Max

You likely spend a lot of time planning and periodizing your training to maximize your efforts, but did you know that not having enough vitamin D could compromise your maximal oxygen uptake, or VO2 max, a classic marker for assessing aerobic fitness? New research in professional hockey and soccer players found a strong correlation between low vitamin D status and VO2 max. If you’re a weekend warrior, this relationship may be even stronger.

Experts will tell you just because there is an association doesn’t mean that increasing the amount of vitamin D in your diet will improve performance. However, a new study in vitamin D deficient rowers found that 8 weeks of supplementation (6,000IU per day) resulted in more than a 10 percent improvement of VO2 max. For elite athletes, improving performance by 2-3 percent is the difference between a podium finish and being in the middle of the pack.5,6,7 Remember, more is not always better. Talk to your doctor and get tested before supplementing with high doses of vitamin D.

2. Power Production

Your muscle tissues have many key receptor sites for vitamin D, and they seem to play a key role in supporting power production. For athletes, increasing power production translates to improved performance on the playing field. Recently, the Canadian Women’s National Hockey strength and conditioning team found athletes with higher power production were more likely to make the final selection for the national team. 

Additionally, a study in soccer players found increasing baseline vitamin D status over an 8-week period resulted in an increase in 10-meter sprint times and vertical jump.8 While not all studies found this relationship, it’s important to ensure you meet the minimal baseline requirements to ensure maximum training benefit.

3. Testosterone Levels

Low testosterone is a common symptom in athletes who are over-reaching and overtraining. Unfortunately, too many people look for a quick fix rather than address why their testosterone levels are low in the first place. Vitamin D is a precursor to testosterone production and may increase the binding efficiency of testosterone to its receptors.4 Low levels are linked to increased protein breakdown, reduced strength, and increased body fat.

If you’re an athlete over age sixty, the connection is even more compelling because low vitamin D levels at that age correlate strongly to low testosterone levels.9 A new study over a 12-month time span found that adding approximately 3,000 IU of vitamin D daily resulted in increased total, bioavailable, and free testosterone.10 For those training through the winter, low testosterone combined with intense training will lead to sub-optimal recovery and increased risk of symptoms of overtraining (i.e., increased muscle soreness, low mood, fatigue, low libido, etc.). This is especially true for athletes who compete in indoor sports year round that limit sun exposure.

4. Inflammation

Inflammation is a natural product of intense training. However, too much inflammation can impair muscular function and future performance. One study showed adding an extra 4,000 IU of vitamin D daily can offset the increased inflammatory reaction with a high-volume training load of 10 sets of 10 reps of compound exercises in men and women.11

Interestingly, the group adding extra vitamin D also noted a mere 6 percent drop in power output over the course of the workout, while the group not supplementing had a 32 percent decrease in power. Amazingly, this deficit lasted for up to 48 hours. If you’re preparing for a competition or the CrossFit Games, maintaining power output during competition is critical to your performance.

5. Colds and Flu

There is nothing worse than catching a cold or flu in the days leading up to a competition. All those hard training days and dedication to be at the top of your game, only to be cut short by a nasty bug. If you’re low in vitamin D, the “foot soldier” immune cells that make up your innate immune system will also be low. If this first-line of immune defense is compromised, you’ll be at increased risk of infection.12

Vitamin D promotes hundreds of anti-microbial proteins in the body that fight off bacteria and viruses and helps keep your immune system robust in the build-up to competition. Research in athletic populations highlights that maintaining optimal levels of vitamin D can reduce common infectious illnesses.13 If your levels are low, your immunity and performance will likely be compromised.

6. Mood

Training intensely isn’t just tough on your muscles and joints. It also takes a toll on your mental game. If you're an athlete, you regularly push that fine line between over-reaching (pushing beyond your limits to grow stronger) and overtraining (pushing too far beyond your limits). Therefore, it’s crucial to maintain a positive mood as you fight through the toughest weeks of your training.

Low levels of vitamin D are consistently associated with low mood and depression, and because many athletes train indoors through the winter months (and sometimes even summer, depending on your sport), deficient levels can impair you sense of well-being.14 Cognitive decline also impacts your decision-making abilities, which are crucial in the heat of competition, yet fatigue and pain make them very difficult.

Sources of Vitamin D

Now that you know vitamin D is key for optimal performance, where is the best place to get it? The sun is far and away your best source of vitamin D. Fifteen minutes of exposure on 5 percent of your skin leads to 10,000-20,000 IU of vitamin D production.4 If you live in a city with a true winter – north of the 42nd parallel – you’ll need more than sun exposure alone to meet your demands, as the sun isn’t high enough in the sky for an adequate dose.

Including vitamin D rich foods in your diet should always be your foundation, and the best dietary sources include egg yolks, pork (yes, bacon!), mushrooms, fortified milk, and yogurt (if you struggle to digest dairy effectively, discontinue).

Of course, if you live in a city with a true winter climate, food alone won’t meet your demands. The general recommendation for supplementing with vitamin D during winter is 1,000-2,000 IU per day. However, this is the case for the general population, not athletes. The research on athletes suggests between 4,000-6,000 IU of vitamin D3 daily is a good bet, however this should only be taken during your intense training phases (up to 8-12 weeks), or from November to March. If you decide to take vitamin D doses greater than 2,000 IU, you must get regular blood tests done with your doctor.

Give Yourself a Winning Edge

Whether your goal for 2016 is achieving a new personal best or finishing on top of the podium, make sure your vitamin D levels are adequate. Assess your vitamin D status, add more vitamin D-rich foods, and find the right supplement strategy to meet your needs.

Intense training requires a robust nutrition plan to meet your body’s demands, and failing to adequately replenish vitamin D can negatively impact too many key systems to ignore. Get your daily dose of vitamin D this winter. The research shows it can make all the difference.

(Read the rest of my article @BreakingMuscle)

Dr. Marc Bubbs ND, CISSN, CSCS



1. Farrokhyar F, et al., “Prevalence of vitamin D inadequacy in athletes: A systematic review and meta-analysis,” Sport Medicine 5 (2014): 365–78.

2. Willis KS, Smith DT, Broughton KS, Larson-Meyer DE. “Vitamin D status and biomarkers of inflmmation in runners,” Journal of Sports Medicine, 3 (2012): 35-42.

3. Ogan D, Pritchett K. “Vitamin D and the athlete: Risks, recommendations, and benefits,” Nutrients 5 (2013): 1856–1868.

4. Dahlquist D et al. “Plausible ergogenic effects of vitamin D on athletic performance and recovery,” Journal of the International Society of Sports Nutrition, 12 (2015):33

5. Koundourakis N et al. “Relation of vitamin D level to maximal oxygen uptake in adults,” American Journal of Cardiology, 107 (2011):1246–9.

6. Forney L, et al. “Vitamin D status, body composition, and fitness measures in college-aged students,” Journal of Strength and Conditioning Research, 28 (2014): 814–24.

7. Jastrz?bski Z. “Effect of vitamin D supplementation on the level of physical fitness and blood parameters of rowers during the 8-week high intensity training,” Facicula Educ Fiz ?i Sport, 2 (2014): 57–67.

8. Close G et al. “Assessment of vitamin D concentration in non-supplemented professional athletes and healthy adults during the winter months in the UK: implications for skeletal muscle function,” Journal of Sports Science, 31 (2013): 344–53.

9. Wehr et al. “Association of vitamin D status with serum androgen levels in men,” Clinical Endocrinology (Oxf), 73 (2010): 243–8.

10. Pilz S, et al. “Effect of vitamin D supplementation on testosterone levels in men,” Hormone and Metabolic Research, 43 (2011): 223–5.

11. Barker T et al. "Supplemental vitamin D enhances the recovery in peak isometric force shortly after intense exercise," Nutr Metab (Lond), 10 (2013): 69.

12. Youssef D et al. “Vitamin D’s potential to reduce the risk of hospital-acquired infections,” Dermatoendocrinol, 4(2012):167-75.

13. Larson E. “Vitamin D supplementation in athletes,” Nestle Nutrition Institute Workshop Series, 75 (2013): 109-21.

14. Polak M et al. “Serum 25-hydroxyvitamin D concentrations and depressive symptoms among young adult men and women,” Nutrients, 6 (2014): 4720–30.

Single-Leg Vs. Back Squats To Improve Strength & Speed?

Back squats have long been considered an essential tool for making athletes bigger, stronger, and faster. By comparison, unilateral exercises like split squats have been relegated to the “assistance” exercise category, the inferior cousin of the almighty squat.

However, the tides might be changing. Recently, a groundbreaking new study in the Journal of Strength & Conditioning demonstrated something that had never been shown before. Strength coaches in the United Kingdom examined the effects of unilateral squat training versus traditional back squats on strength, 40-meter sprint time and change of direction speed. The results were very interesting.

Eighteen rugby players were randomly assigned to two groups - rear-foot elevated split squat (RESS) or classic back squats - for five weeks of lower-body training (twice weekly) to put an old myth to test, are bilateral movements like the back squat truly the “king” of all exercises? The results showed, for the first time, that unilateral training could improve strength, 40-meter sprint time and change of direction to the same degree as back squats. That's right... split squats were JUST AS GOOD AS back squats!

Of course, if your squat movement pattern is very good, there maybe no need to modify your training. However, if you’re an athlete with poor ankle mobility or suffer from low back pain, the confirmation that unilateral exercises like RESS can provide the same benefits as bilateral staples like squats may come as a big relief.

For athletes who need to jump a lot in their sport (i.e. basketball or volleyball players), whose low back are exposed to high torque (i.e. golf and tennis players) or anyone who struggles to effectively load their spine effectively (i.e. ectomorphs) without pain throughout the entire squat movement, this could be a game changer. Unilateral split squats may allow these populations to load their spine more effectively, without pain, thus minimizing risk of injury and achieving a superior training outcomes.

If you feel more pain in your back or neck when squatting, rather than your glutes, hamstrings and quadriceps, a shift to more and heavier unilateral training may be your solution for improved strength and speed.

Dr. Marc Bubbs ND, CSCS

Check out more articles in the "STRENGTH" SERIES...


1) Speirs, Derrick et al. Unilateral vs. Bilateral Squat Training for Strength, Sprints, and Agility in Academy Rugby Players. J. Strength Cond Res. Feb 2016. Vol. 30, Issue 2. p386-92.


Can Creatine Boost Your Physical (And Mental) Performance?

What is creatine? When most people hear the word creatine, they immediately think of high school or college-age jocks trying to get bigger and stronger. But creatine is far more than just a muscle-building supplement.

In fact, its benefits range from improved cognitive function, concussion prevention, autoimmune support and even improvement of some chronic degenerative conditions.

Not quite sure what creatine can do for you? Let’s take a closer look.

What is Creatine?

Creatine is a protein that is produced naturally in the body and is found in abundance in animal protein. It’s a high-energy molecule made up of three amino acids – arginine, methionine and glycine – that helps to produce ATP, the energy currency of every cell in your body. Without ATP, your cells would have no fuel and you wouldn’t even survive!

Animal protein is the best food source of creatine, such as grass-fed beef, wild game meats, ocean-fresh fish and free-range poultry. So, if you’re already following a Paleo approach to eating, naturally rich in animal protein, why would you need to add more creatine via a supplement? Adding a creatine supplement allows your body to store greater than normal levels of creatine in the body, thereby providing an added source of ATP to support your muscles and your brain. While these supra-physiological doses may not be exactly Paleo, there could be certain scenarios where you can get significant benefits.

Can Creatine Boost Your Performance In The Gym?

If you want to improve your performance in any sport, then improving your power, strength and lean muscle mass are key factors. Creatine significantly improves all of these areas, and then some.

Increasing your maximum strength is like adding more horsepower to your car’s engine; the stronger you are, the faster you run. Supplementing with creatine is proven to increase your max strength by 5-15%, which translates to more weight on your squat, deadlift or Olympic lifts. (1)

Creatine supplementation has also been shown to increase sprint performance, as well as endurance during repeated sprints. (2) This can help endurance athletes improve 5k, 10k and marathon times, cyclists upgrade time trial personal bests, and CrossFitters achieve superior WOD times.

If you want to add lean muscle, creatine has been proven to add 2-4 lb. of fat-free lean muscle in 4 to 12 weeks of training.(3) The muscle growth comes from the body’s capacity to increase ATP production from creatine supplementation, allowing you to train harder and recover faster. If you’re not wanting bigger muscles, simply modifying the dose can mitigate these effects.

The benefits don’t stop there. Creatine might just be the best “brain hack” out there!

Can Creatine Boost Performance at Work?

One of the most common questions I get asked by clients in clinical practice is, “How can I improve my mental focus and memory?” If you want to upgrade cognitive function, working memory and intelligence, then creatine may help unlock your true potential.

Creatine has shown significant promise as a potent brain-boosting nutrient. A study at the University of Sydney examined the effects of 6 weeks of creatine supplementation (5g per day) on memory and intelligence. (4) The researchers found those people supplementing with creatine had improved working memory, reduced mental fatigue and increased intelligence. That’s right, not only can you remember more details and maintain your focus for an increased number of hours, you actually get smarter, as well!

More and more research is coming down the pipeline uncovering creatine’s ability to boost brain function, focus and mental productivity. However, you can eat all the meat in the world, but your creatine stores cannot reach these supra-physiological levels without added supplementation.

Tempted to start benefiting from higher creatine and ATP levels in your body? Let’s take a look at whether this stuff is really safe.

Is Creatine Safe?

Anecdotal side effects of creatine often heard in the media include dehydration, cramping, musculoskeletal injury, gastrointestinal distress and kidney damage, yet the research does not support these claims.

While these side effects seem scary, none of this has been shown in the research studies. In fact, research on creatine supplementation of 10 months to 5 years found no negative effects on kidney function (5) and has in fact been linked with improving medical conditions such as brain and spinal cord injuries, muscular dystrophy, diabetes and high cholesterol.

With all the fad supplements out there, creatine is a proven and safe strategy for upgrading your health and your performance. Let me walk you through the approach I typically recommend to my clients.

How Much Should I Take?

If you want to boost your performance in the gym and at work and give creatine a try, here is the best way to start. For men, add a 5g serving every day with a meal; for women, 3g per day. Creatine monohydrate is the most cost-effective form and actually the type they use in all the research studies, so save yourself a few dollars and forget the expensive creatine with supposed “bells and whistles”.

The highest dietary source of creatine is herring, followed by red meat, however this only saturates the tissue to approximately 90%. The addition of a supplement take this to 105-110% saturation, thus providing the brain and body benefits. For vegetarians and vegans, tissue levels hover around 70%, so the addition of a supplement can be even more beneficial.

You can add a powder form (make sure it has no added sugar) into some water and drink it; just be sure to eat a meal at the same time, as elevated blood sugars and insulin help improve absorption. You can also opt for capsules, but it’s a lot of pills to take on a daily basis (typically 6 x 500mg for women and 10 x 500mg for men).

Continue for 8 weeks and see for yourself how you look, feel and perform. If you’re satisfied with your results, you can discontinue it. The washout period for creatine levels to return to pre-supplement baseline is about 30 days. If you want to continue, the research shows you can maintain your dose for 6-12 months, if desired. However, periodic tapers of 2-3 weeks is recommended every 2-3 months.

Just remember that creatine isn’t a quick fix. You still need to eat real, whole food, train properly and get quality sleep if you want to improve brain function and body composition. If your diet and lifestyle are junk, creatine isn’t going to help much.

Dr. Marc Bubbs ND, CISSN, CSCS

(This article orginally appeared @Paleohacks)

Want to learn more? Listen to expert strength coach Keith Norris talk "Mindset Hacks & How To Look Good Naked" on the Dr. Bubbs Performance Podcast...

Are You Suffering From Adrenal Dysfunction?

Did you know that four out of every five visits to the doctor’s office is stress-related? In today’s 24/7 society, stressors present themselves in many different forms: mental stress from a busy work day, physical stress from an intense training session or constantly being on the run, or emotional stress from relationships with family or friends. Although stress is essential for overall health (it provides the mental and physical challenges required to stimulate positive adaptation), if you have chronic or excessive stressors or poor coping mechanisms it may result in adrenal dysfunction and/or altered cortisol rhythm.

Why Are Your Adrenals So Important To Stress?

Your adrenal glands are small triangular-shaped glands positioned on top of your kidneys that secrete specific hormones in response to stressful stimuli. The glands are made up of two parts: the inner medulla that produces the hormone adrenaline in response to stress and the outer cortex that produces cortisol. Let’s take a look at how these two hormones drive your response to stressors in your environment.

When adrenaline is produced, it triggers the breakdown of body-fat for fuel and acts by raising your blood pressure and heart rate to increase your alertness. If you enjoy a cup of coffee in the morning, you’re getting a nice little jolt of adrenaline from the caffeine that helps to increase mental focus and work capacity during exercise. This happens instantly via your sympathetic fight or flight nervous system, which is a direct connection between your brain and adrenal glands.

Whereas adrenaline preferentially catabolizes (breaks down) fat, cortisol breaks down muscle tissue to provide fuel for your body. Like adrenaline, its job is to increase your blood sugar levels to provide energy for the body to overcome the stressful event. From an evolutionary perspective, this was critical for escaping from wild animals or other threats. Nowadays, you experience a boost when you’re in the gym or training hard, but when your session is over, your stress levels should return to baseline. (If you adrenals are out of balance, this isn’t always the case and has significant negative repercussions).

Today’s Stress Response

In nature, a stressor is short-term then subsides. For example, a zebra grazing in the savannah might spot a lion in the distance resulting in a boost of adrenaline and cortisol to increase the heart rate, breath rate, and shunt blood to its working muscles should it need to run for its life! The subsequent chase might last 10-20 minutes, then it would be over and the zebra could go back to relaxing and grazing.

Thankfully, in today’s world we don’t often have to run away from lions or bears, but “modern” stressors actually exert a much more debilitating toll on our body. How is this possible?

Today, stressors last all day long! The emails don’t stop, the deadlines don’t stop, and the commitments don’t stop. Your body – and more importantly your brain – are experiencing constant and prolonged stressors, far longer than would be experienced in nature. This leads to a heavy burden on your adrenal glands and your body.

What is Adrenal Dysfunction?

While the physiological mechanisms have evolved over millions of years, the realities of sitting at a desk and having to juggle all the mental tasks from work and home life can leave your brain (and body) stuck in “fight or flight” sympathetic overdrive. For some this can manifest itself as the over-production of adrenaline and cortisol, while for others the reverse can happen and you may feel sluggish or fatigued.

In years past, clients complaining of prolonged fatigue were often diagnosed with ‘Adrenal Fatigue’, the inability of the adrenal glands to keep up with a person’s busy life or increased number of stressors. Today, we understand this is not the whole story. A new area of medicine called psycho-neuro-endocrine-immunology (now that’s a mouthful!) or PNEI is uncovering that your brain is really the root cause of adrenal dysfunction, and therefore the key player in supporting your adrenals and stress response. In short, the hypothalamus area of your brain is the master switch that tells your adrenal glands to ramp up the production of adrenaline and cortisol (over-performing adrenals), or dial it back (under-performing adrenals).

Do You Have Symptoms of Adrenal Dysfunction?

In clinical practice, I see many patients with either over-performing or under-performing adrenals. There are symptoms on each end of the spectrum that indicate adrenal dysfunction. If you have difficulty waking up in the morning, poor energy during the day, feel better after eating meals, or have diminished libido then chances are your adrenal glands are underperforming.

If you’re a person with naturally high energy levels, have high blood sugars, experience excessive sweating, have difficulty falling asleep, or feel like your mind continually races with a list of tasks and deadlines then you may be suffering from over-performing adrenals. This constant fight or flight sympathetic dominance chronically elevates cortisol levels and may lead to roadblocks in your quest for a slimmer waistline, faster 10k run time or better overall health.

There is one more piece to this complex puzzle. Your daily cortisol rhythm can also get thrown out of balance by stress. In the morning, your cortisol should be at its highest to wake you up from deep sleep and get you ready to attack the day. In the evening, your level starts to lower and should be at its lowest point at bedtime. This allows the sleep hormone melatonin to ramp up and prepares your body for deep, restorative sleep.

If you suffer from general fatigue, poor recovery from workouts, low mood, and your short-term memory is poor (e.g. you often forget what to pick for dinner, where you left your phone, or your client’s name) then poor daily cortisol rhythm may be your area of adrenal dysfunction. If you struggle to get out of bed in the morning, hit snooze multiple times, or feel desperate for a coffee to get going then chances are your morning cortisol rhythm is out of balance. If you struggle to fall asleep at night, wake up throughout the night, or classify yourself as a night owl then you likely have an altered evening cortisol rhythm.

It is important to address adrenal dysfunction and/or altered cortisol rhythm as they can lead to serious negative consequences. These include increased inflammation, poor memory, increased risk of anxiety or depression, reduced testosterone production, slow thyroid function, increased belly-fat, decreased lean muscle mass, poor blood sugar control or insulin resistance, and cognitive decline.1 If you’re not sure whether your adrenals are functioning optimally, you can request a salivary-cortisol test.2

The Adrenal Dysfunction Fix


Diet is the first place to start when correcting adrenal dysfunction. It’s critical to obtain the building blocks essential for supporting a healthy stress response. The Paleo diet is the perfect place to start.

First, increase your intake of healthy saturated fats, such as butter, ghee, or coconut oil. Studies show that fatigued and over-stressed athletes are better able to recover and maintain performance on a high fat diet, in particular when high in saturated fats.3

Next, make sure you are achieving an adequate intake of protein, as high cortisol levels will quickly break down precious muscle tissue and leave you in a catabolic state. Aim for 0.7-0.9g of protein per pound of bodyweight.

Finally, it’s not only what you add to your diet, but also what you remove. If you’re suffering from adrenal dysfunction or altered cortisol rhythm then discontinue your caffeine intake – coffee, black tea, chocolate – for 4 weeks. Sugar and caffeine cravings are classic signs of adrenal dysfunction, so be sure to eliminate all processed sugars and carbs for 4 weeks.


Busy work days or long hours in the gym can leave you burning the candle at both ends and therefore being stuck in the fight or flight sympathetic overdrive. If the root cause of adrenal dysfunction starts in the brain, it makes sense to incorporate techniques that directly impact your central command center.

Meditation is an ancient technique that helps restore your cortisol rhythm and adrenal function by stimulating your “rest and digest” parasympathetic nervous system via the vagus nerve in your brain.

Not convinced? A recent study of medical students showed that those engaging in daily mindfulness meditation practices had much lower blood cortisol levels compared to a placebo.4 Meditation has also been shown to significantly improve anxiety and depression, classic symptoms of adrenal dysfunction.5

Try this simple technique before bed to improve your “resiliency” and capacity to cope with stress:

  • Start by sitting with your eyes closed.
  • Inhale deeply through your nose; let your belly expand for three seconds
  • At the end of your inhale, hold your breath for one second.
  • Exhale deeply through your nose for another count of three seconds; let your belly draw inward toward your spine.
  • Repeat for 5-10 minutes.


Did you know that today we sleep a whopping 500 hours less each year than our grandparent’s generation? This sleep debt places a tremendous burden on our resiliency or capacity to cope with stress.

If you get less than 7 hours sleep per night, struggle to fall asleep, or wake up frequently during the night your cortisol levels will be elevated and you’ll be cutting yourself short on the recovery front.6 To support deep sleep, make sure your bedroom is set up for optimal recovery. How can you improve your sleep quality? Here are some simple tips:

  • Turn down the lights in your house after 9 p.m.
  • Shut off your television or laptop at least 45 minutes before bed.
  • Make sure your bedroom is completely dark. Try using blackout blinds or an eye mask to prevent unwanted light.
  • Keep your bedroom cool and wear loose-fitting clothing or sleep naked

We’ve got a in-depth article on how to get better sleep if you want to know more.

Nutrient Support

There are several herbs that can support adrenal dysfunction, depending on whether you suffer from over-active or under-active adrenals, or cortisol rhythm dysfunction. A key nutrient called alpha-GPC can benefit all types of adrenal dysfunction. Supplementing with alpha-GPC provides the hippocampus with the right building blocks to restore normal cortisol rhythm by supporting the production of acetylcholine, a key neurotransmitter concentrated in the hippocampus that can be depleted by busy work schedules, lacking sleep or high stress.7 Take 500-1,000mg daily upon rising for 8-12 weeks.

Prioritize the fundamentals of diet, sleep, and controlling your stress response (e.g. proper breathing) to upgrade your adrenal function and correct symptoms of adrenal dysfunction. Train your brain and fuel your body correctly to increase your resiliency and keep your stress response system in balance.

Dr. Marc Bubbs ND, CISSN, CSCS

Want to learn more? Listen to Dr. Doug Kechijian talk "Mental Performance In High Stress Situations" on the Dr. Bubbs Performance Podcast...


Check out more articles in the "Cortisol Stress" Series...



Reynolds G. The Hormone Edge. J of Physio. NY Jan 14, 2012.
Manetti L et al. Usefulness of salivary cortisol in the diagnosis of hypercortisolism:comparison with serum and urinary cortisol. 2013. Eur J Endocrinol 168(3):315-21
Antonio, J et al. Essentials of Sports Nutrition and Supplements. Humana Press. New York, NY.
Turakitwanakan W et al. Effects of mindfulness meditation on serum cortisol of medical students. J Med Assoc Thai 2013 Jan;96 Suppl 1:S90-5.
Wurtzen H et al. Mindfulness significantly reduces self-reported levels of anxiety and depression: results of a randomised controlled trial among 336 Danish women treated for stage I-III breast cancer. Eur J Cancer 2013 Apr;49(6):1365-73.
Leproult R, Copinschi G, Buxton O, et al. Sleep loss results in an elevation of cortisol levels the next evening, Sleep. 1997;20:865-870.
DiPerri R. et al. A multicenter trial to evaluate the efficacy and tolerability of alpha-glycerylphosphorylcholine versus cytosine diphosphocholine in patients with vascular dementia. J Int Med Res. 1991. Jul-Aug;19(4):330-41.