Lowcountry GI Gut Health Blog

Posts for tag: Happy Gut Healthy Life with Dr. B

By Will Bulsiewicz, MD MSCI ("Dr. B")
March 29, 2017
Category: Nutrition

After months of training, lacing up those shoes even on the cold mornings and the long days, it’s finally time to go out there and accomplish your goal. You want to roll out the best version of yourself, nutritionally optimized and fueled up for peak performance. Follow these 4 steps and you’ll be sure to UNLEASH THE ELITE ATHLETE on race day:

1. Start your carb load nice and early.

Glycogen is the body’s stored form of sugar that will be rapidly mobilized for energy during the race. Unfortunately, 40% of marathon runners experience severe and performance-limiting depletion of their glycogen reserves, a phenomenon known as ‘hitting the wall’ or ‘bonking.’ In order to avoid accidental bonking, we need to build up healthy glycogen stores.

During the week leading up to your race, taper your running (to reduce glycogen consumption) while increasing your carbohydrate intake (for glycogen production). Carb loading isn’t just for the last 2 days, it’s best done all week! Aim to make about 70% of your calories come from fairly simple carbs.

Beyond pasta, you should look at bread, rice, cereal, potatoes, and fruit. Other calories should come from nutrient dense foods like fruits, vegetables, whole grains, beans, legumes, nuts and seeds. Avoid empty calories from processed foods, fast food, refined sugars and hydrogenated oils that can only slow you down.

By giving yourself all week to carb load, you won’t need to make radical changes to your diet in the last 2 days that could end up backfiring on race day, and you certainly won’t be bonking.

2. Hit the hydration sweet spot.

Chug-a-lug! Chug-a-lug! As entertaining as it is to watch, downing massive amounts of water during race week isn’t as helpful as you would think… Excessive water consumption can dilute down electrolyte levels to the point that your muscles won’t function properly. Even worse, it could lead to hyponatremia, a dangerously (potentially fatal) low level of sodium in the blood.

That said, a little extra water is needed for a proper carb load. For every gram of stored glycogen, the body stores 3 grams of water. So it’s okay to increase your water intake, just don’t overdo it…

Checking the color of your urine may not be something you do regularly, but it can be a helpful habit for race week. If your urine is dark yellow or has a strong odor, you may need more water. Alternatively, if it’s clear and you’re going every hour you may be overdoing it. The sweet spot is light yellow urine that comes every 2-3 hours.

And if you normally drink coffee or tea, there’s no need to stop. Now is not the time to withdraw from caffeine!

3. No need for any eleventh hour drama!

Last minute nutrition is about ensuring your body has everything needed to perform and trying to avoid the pitfalls that can hold you back. There’s no need for dramatic changes in the last day before the race.

Everyone hears about people devouring super-sized bowls of spaghetti the night before the race, but if you’ve been carb loading all week why take the risk of upsetting your stomach? That said, if you feel absolutely compelled to do a large carb meal I’d do it at lunch the day before the race just to make sure you’re not up all night with indigestion.

Fiber is one of the healthiest things you can consume most of the time, but it should be avoided in the last 24-72 hours because it can give you bloating and gas during the race. Similarly, leave the fatty, spicy and acidic foods for after the race when you treat yo’ self.

4. Race day nutrition demystified.

Breakfast before the race is important! Once again, don’t try anything new here. Eat something that you’ve been eating all week, ideally 2-4 hours before race time (smaller portion size if it’s 2 hours). Drink your coffee or tea as you normally would.

For hydration purposes, you should drink about 16 oz. of water two to three hours before the start. You can have one more cup of water at race time or take a shot  (maybe even two) of concentrated beet juice.

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Beet juice??? Absolutely! Beets contain a precursor to nitric oxide, a signaling molecule in the body that has been shown to improve exercise performance. This graph shows how incrementally larger amounts of beet juice led to increased nitric oxide levels when compared to water consumption.[1]

Note that the peak level is about 2 hours after drinking it, which may be relevant for when you choose to time your beet shot. Also, make sure to test run with beet juice a few times before the race to insure that you tolerate it without undue side effects (ahem, diarrhea).

During the race, your energy comes from glycogen and blood sugar. Therefore, you can give your body an energy boost by keeping your blood sugar levels up. Simple carbohydrate solutions such as gels can be used throughout the run to maintain a consistent blood sugar supply.

And finally, a little caffeine during or right before the race has been shown to improve concentration and performance, particularly for longer runs. Similar to the beet juice, be sure to do a few test runs beforehand to make sure you have the right dose.

Best of luck on race day!

[1] J Appl Physiol. 2013 Aug 1;115(3):325-36

Dr. Bulsiewicz is a gastroenterologist in Mount Pleasant, SC. He believes that all health begins in the gut, and that only by eating the proper foods and taking care of the friendly microbes can we achieve our fullest potential. His clinical practice includes the full spectrum of gastroenterology including colon cancer screening, colonoscopy and upper endoscopy, GERD, Barrett’s, and hemorrhoids. Follow Dr. B on Instagram (@happygutmd) and Facebook (Lowcountry Gastroenterology) for gut health tips to achieve a “Happy Gut, Healthy Life.”


The entire content of this article is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare professional. Copyright 2017.


By Will Bulsiewicz, MD MSCI ("Dr. B")
August 21, 2016

Imagine your favorite supermarket. You walk through the front door, and – BOOM – there are the juicy strawberries, watermelons, and blueberries. Have you ever noticed that every supermarket puts their produce right out front? Seriously, I can’t think of a single time in my entire life that the produce section was hidden in the back. It makes sense though; the produce section is filled with vibrant colors that are easy on the eyes, inviting you into their store that you now associate with freshness and (hopefully) quality.

When I asked you to imagine your favorite supermarket, you probably thought of the one with the best produce section. High quality fruits and vegetables are inherently refreshing and satisfying when you get them just right.  By the end of this article you will be the master of the produce section, ready to go out there and find the sweetest fruits and ripest vegetables without breaking the bank.

1. Organic matters!!!

Organic food refers to the way agricultural products are grown and processed. In order to qualify as organic, the crops cannot be grown with bioengineered genes (GMOs), synthetic pesticides, or petroleum-based or sewage sludge-based fertilizers. Pesticide exposure can lead to leukemia, lymphoma, brain, breast and prostate cancer. You had me at no genetically modified organisms, let alone sewage-based fertilizers.

But there’s more… Organic food is often fresher because it lacks the preservatives that allow it to last longer. Therefore, organic produce will generally need to be produced on smaller farms that are closer to the store where it is sold. Additionally, organic farming practices have a myriad of environmental benefits, including reducing pollution, conserving water, increasing soil fertility, and limiting exposure of the nearby birds and animals to chemical pesticides.

2. If the skin is thin, buy organic to win.

If we lived in a perfect world with unlimited money and resources, I would buy organic produce every single time. Unfortunately, that’s just not reality. Like most everyone else, I work very hard to provide for my family and must be judicious with my spending.

Thankfully, we have the Environmental Working Group to sort things out for us. They are a nonprofit organization that analyzes U.S. government pesticide testing results. Their findings allow us to objectively separate foods into those that we should always buy organic (the “Dirty Dozen”) versus those that we can feel more comfortable buying non-organic (or “Clean 15”).

Beyond the Dirty Dozen, buyers should also purchase leafy greens (kale, lettuce, etc.), blueberries, raspberries, pears and carrots in their organic form. The general takeaway here is that thin-skinned plants should always be bought organic. On the flip side, if you have to peel away an outer layer to get to the fruit or vegetable, then you’re probably okay to buy it non-organic.

3. Look for signs of freshness.

For most plants, the outward appearance is important. Yellow bananas are ready for consumption, while green ones need to ripen and brown ones may be past their prime. For thin-skinned fruits like apples, blueberries, cherries, grapes and strawberries you’re going to want your fruit to have a deep color and natural shine without wrinkles or bruises. Pineapples and honeydew melon are best when they look golden rather than green. Watermelons that matured long enough before harvest should have a yellow or light spot on the bottom, a sign of being ready to eat. Corn is best when the husk is green and moist. The ideal broccoli head is dark and tightly compacted. Leafy greens start losing their nutritional value when they wilt and start turning yellow. And finally, the color of a mango just flat out does not matter, so when it comes to mangos fuggedaboudit!

4. Toss your produce in the air then squeeze it.

There are two things to look for when feeling your produce. First, if the produce is watery then the weight of it is important. You want it to be heavy for its size, which indicates inherent juiciness. So pick up your orange, lemon, watermelon, pineapple, celery, squash, tomato or even cabbage. Get a feel for the weight among a few of them, and go with the one that feels a little heavy.

Second, if produce has “meat” to it, your goal is to find one that is firm but slightly soft to the touch. So give your apples, peaches, pears, potatoes, and avocados a little *honk honk*. With time you will get the feel for it and can pick out the better produce with your eyes closed, a unique skill that has the possibility of impressing your friends.

5. Buy local!

The farm to table concept has gained traction in recent years, and with good reason. Locally grown crops have less travel time, which means they can be picked at the peak of their flavor before delivery. Shorter time between harvest and consumption means increased preservation of nutrients.

The added benefit of buying local is that it supports local families and helps the environment and wildlife. The Mount Pleasant Farmers Market is every Tuesday from April until the end of September at the Moultrie Middle School on Coleman. The Sullivan’s Island Farmer Market ran from April until the end of June on Thursdays. Shopping at a farmers market allows you to connect with the person growing your food. You can ask questions, get advice, and in most cases will save some money in the process.

Dr. Bulsiewicz is a gastroenterologist in Mount Pleasant, SC. He believes that the gut is the root of all health and wellness and therefore food is medicine and that we can unlock our innermost potential with healthy gut bacteria. His clinical practice includes the full spectrum of gastroenterology including colon cancer screening, colonoscopy and upper endoscopy, GERD, Barrett’s, hemorrhoids, and liver disease. Follow Dr. B on Facebook (Lowcountry Gastroenterology), Instagram (@happygutmd), and Twitter (@happygutmd).

The entire content of this article is for informational purposes only and is not intended as medical advice. Please consult with a qualified health care professional. Copyright 2016.

Have you ever been peacefully snoozing when a loud sound startles you from your sleep? One Sunday morning a few years ago the shredding sound of a chainsaw shot me out of bed. I rubbed my eyes and went out to the kitchen to see what was going on. There was my wife cramming a giant cucumber into a motorized stainless steel cylinder like she was loading a torpedo into the shoot. She did the same with some carrots, apples, kale and a lemon. Out of the spigot came the different colors in order, mixing together in the glass pitcher to produce green juice that was surprisingly delicious and refreshing. Afterwards, I felt energized, clean, and wanting more.

Fresh juice is a great way to unleash the power of plants. Heart disease, cancer, stroke, Alzheimer’s disease, and diabetes are five of the most common causes of death in our society. Yet, study after study has shown that consuming a plant-based diet can prevent and in some cases even reverse these illnesses.

This comes as no surprise. Organically grown plants are densely packed with health-promoting nutrients including vitamins, minerals, antioxidants and phytochemicals. They also lack the harmful components of processed foods: refined sugars, artificial flavors and colors, MSG (monosodium glutamate), high fructose corn syrup or synthetic trans fats just to name a few. In short, organic plants have all of the good stuff and little to none of the bad stuff!

My personal favorites are the phytochemicals. These are the naturally occurring compounds in plants with varying health promoting qualities: preventing cancer, optimizing the immune system, or healing blood vessels just to name a few. So far there are over 120 drugs derived from plant compounds, including aspirin, morphine and digoxin. But that is a fairly small number considering there are more than 5,000 phytochemicals that we’ve identified (so far), most of which we know very little about. Beta-carotene, caffeine, and resveratrol are just a few examples of the phytochemicals that we have started to study.

Sadly, only 1 in 10 Americans actually meet the goal of five cups of fruits and vegetables per day. As you can see in the pie graph, our diet is dominated by processed foods including fats, flour products, and sweeteners. We are also substantially outpacing our fruit and vegetable consumption with animal products including meat, dairy, and eggs. The pathway to better health is fairly straight forward, and it involves reversing these trends and increasing our fruit and vegetable consumption.

Juicing is a great place to start. You can pack all of the vitamins, minerals and phytochemicals from a couple pounds of produce into a few glasses of juice. By playing with different combinations, you can create juice that tastes great and features a diverse variety of plants. For example, kale, garlic and turmeric offer tremendous health benefits but are individually difficult to consume. Not so fast, my friend! Just mix in a few apples, carrots and some lemon to make yourself a refreshing and tasty beverage.

There are some limitations to drinking juice. For one, the fiber is separated from the juice. Therefore, you miss out on the health benefits of fiber including lower blood sugar and cholesterol, prevention of diverticulosis, and prebiotics for a healthy gut garden. Second, if you add a lot of fruit to your juice you can end up with a beverage very high in sugar. Third, there can be loss of nutritional value during the process of creating the juice due to oxidation.

My recommendation is to use fresh juice as a way to add even more plant nutrition to your diet. Don’t cut out the salads or fresh vegetable dishes and don’t use juice as a meal replacement! Instead, keep getting those plants the old-fashioned way but crank it up even more by adding fresh juice or a smoothie a few times per week. To maximize the nutritional value, I recommend drinking the juice immediately after it is produced. In the very beginning, you may want to incorporate more fruit to assure sweetness. Over time you can increase the vegetable to fruit ratio to maximize the nutritional value of your beverage as your taste buds adapt.

If you decide to take the plunge and get juiced, below is your first recipe to help you get started:

  • 6-8 large leaves of kale with stem
  • 1/2 large cucumber
  • 1/2 bunch parsley (or cilantro)
  • 1/4 to â…“ pineapple meat, no skin
  • 1 medium apple (either yellow or green)

Dr. Bulsiewicz is a gastroenterologist in Mount Pleasant, SC. He believes that the gut is the root of all health and wellness and therefore food is medicine and that we can unlock our innermost potential with healthy gut bacteria. His clinical practice includes the full spectrum of gastroenterology including colon cancer screening, colonoscopy and upper endoscopy, GERD, Barrett’s, hemorrhoids, and liver disease. Follow Dr. B on Facebook (Lowcountry Gastroenterology), Instagram (@happygutmd), and Twitter (@happygutmd).

The entire content of this article is for informational purposes only and is not intended as medical advice. Please consult with a qualified health care professional. Copyright 2016.