It's Marathon Monday here in Boston! With the Boston Marathon underway and endurance athletes partaking in one of the year's most grueling events, we decided to catch up with a dynamic duo we love: Tracy Owens, Sports Dietitian at the University of North Carolina at Greensboro, and her client, professional distance runner Andrea "Andie" Cozzarelli, have made some pretty big strides using InsideTracker. As an athlete, Andie knew her nutrition was critical to her performance, but she wasn't quite sure what needed tinkering or how to do it: "I knew I was eating healthy, but I didn't know how much to eat; the protein, the carbs, I didn't understand that part." Andie's dietitian, Tracy Owens, has an impressive background in optimizing nutrition for performance; but even the brightest clinicians can benefit from the power of science and technology.
Tracy explains, "Andie came with a list — she had celiac disease, struggled with iron deficiency, had issues digesting soy, issues with her blood sugar and had tried to race on low carbs but that didn't work...anytime I'm working with an athlete who trains hard as she does, you're always dealing with exhaustion, fatigue, dehydration, recovery. Sometimes it's hard to figure out which is which. That's where InsideTracker really came in."
We love Tracy and Andie's story of working together using our platform, because there's a happy ending for both of them — watch the video to find out how Andie changed her body and her performance!
Video outline:
01:30 Why Tracy and Andie turned to InsideTracker to improve performance
03:20 Seeing an impact through Andie's bloodwork
05:20 Knowing what to focus on as an endurance athlete
06:00 How training affected Andie's biomarkers
08:10 Focusing on recovery nutrition
09:40 What surprised Andie the most with training and her biomarkers
11:30 How Andie went from struggling with races to setting P.R.s
13:00 No more guessing games; using data to improve markers
Get an inner edge by training based on your biomarkers. We've created this FREE e-Book to help you understand how!
Erin: Hi everyone. I'm really excited to have our very first interview with two people sitting in one room. And they are a dynamic duo. We have Tracy Owens who is a sports dietitian and you are the first sports dietitian we've actually interviewed here on Inside Tracker, on our little series. And one of your clients who is a professional distance runner, Andie [inaudible 00:21]. So it's great to have you both here. And I'm going to let you guys the talking. So why don't you tell everybody what your backgrounds are, how you met, how you work together, all that good stuff.
Andie: So as professional distance runner I ran in NC state and I was a 10K runner so I was conditioned on the longer events and those were my favorite. And then after graduating I joined [inaudible 00:50] and initially was on their volley team and I moved up to the [inaudible 00:57] team after getting the Olympic trials qualifying times in marathon. And around that time I started working with Tracy just to kind of refine things because I had felt like that was the one thing that I was missing in my training was my nutrition, having that kind of more refined because I knew I was eating healthy but I didn't knew how much to eat. And you know, the protein part, the carbohydrates, I didn't understand any of that stuff. So I got in touch with Tracy and that was how we kind of started our working relationship and it's been great.
Tracy : Yeah. And my name is Tracy Owens, I'm a sports dietitian. And my job as a sports dietitian is to help athletes figure out how they can maximize their performance so keep them healthy at the same time. And Andie came with – I wrote down a list, it was really interesting because she has celiac disease, she had struggle with iron deficiency, had issues digesting soy, had some issues with her blood sugar that she would have times when she felt like it was too low and she was kind of shaky. And then she'd also tried to race on low carbs and that didn't work.
So she really had a lot of things that we had to work on to try to figure out. And anytime I'm working with an athlete that really trains as hard as she does, they are always dealing with exhaustion, fatigue, dehydration, recovery. And sometimes it's hard to figure out which is which. You know, is it the glucose? Is it the dehydration? And that's where Inside Tracker really came in and gave us some great inside peaks as to what we really needed to focus on
Erin: That's right. We always say you can't measure what you don't know, right?
Tracy: Exactly.
Erin: So it's super important. And by the way I have the exact same list as you for whatever that's worth. Literally the exact same list, except I’m a sprinter, I don't run. Ask our friend Jonathan, he'll laugh if you ask him if I run. But yeah, absolutely.
So for somebody who has got such a heavy physical burden like a physical load, you constantly need an actual trainer and a coach and then of course you need someone controlling the diet. So what were some of the I guess maybe more effective changes that you made after seeing what your blood was like? And I'm assuming you’ve tested multiple times now so you were able to make a number of changes. I'd love to know like from the athlete perspective what your takeaway was and then from the clinician's perspective how that opened your eyes sort of in terms of helping make your client more efficient.
Andie: Oh, so since I had had iron issues in the past I kind of when I saw that my iron was low when we first did the Inside Tracker. I kind of put two and two together and I was like oh well, that would make sense. It wasn't as evident as it had been in the past because in the past I had had it so low that it was just like I knew it was low. But I mean this time I was kind of in the thirties so my ferritin was. So I was like oh well, that makes sense because I was feeling this terrible feeling towards the end of the races but otherwise not so bad.
And then the other thing, the big change that I also made with my training was that knowing from the blood work you can see whether or not you're overtraining, if you're kind of tensing the muscles too much and all that kind of stuff, knowing that you could see that from the blood work and that it was more of a biological thing when you kind of start stressing your body too much, the impact that it can make on everyday training that how it can last and last and last and last and it's a biological thing, I started to kind of take down the pace of some of my runs. Make them easier, not always be trying to go hard, hard, hard because that for me it always seemed like if I was tired then I needed to be working harder and then I wasn't doing enough and I wasn't as fit as I could be. And where it could be on the other side it could be more so that I needed that recovery period.
So I think that was the biggest thing that I learned from it that being able to balance my iron and see what other levels I was I low in and actually having better recommendations from Tracy on what vitamins to take in and the type that are better absorbed by the body which I – was just buying your generic, cheap, whatever I can get. Yeah.
Erin: And so from the clinician's perspective I'm assuming this has got to be a super helpful tool instead of just sort of just a stab in the dark or looking at tons of random lab work, right?
Tracy: Oh, exactly. It made my job so much easier. We knew exactly what we needed to focus on. And especially knowing you can't have any athlete at her level – any athlete at any level but especially her level trying to go out there and run with low iron levels. So by us knowing that we could pinpoint that and then I was able to recommend some iron supplementation that I know was better absorbed than what she was doing. And we got a really great response. So it was really fun to actually get that [cross-talk 05:43] and repeat tests on and we could see “wow, it's working.”
Erin: Yeah I know. Isn't it great when you get your second test results and you see all of the markers and you can sort by improved markers? That's my favorite part.
Andie: Yeah, I've done it 3 times now to kind of go back and forth and I had...
Erin: With consistent improvement?
Andie: Well, yeah. Well I actually went down a little bit during the marathon cycle. And no there had been a wider gap in testing. So we had tested it in July? No.
Tracy: June I think.
Andie: June. And then we tested it again I think in October or something like that. And then I didn’t get tested again I think until January. So it was kind of – I mean I guess there wasn't that much of a gap but the difference in the training, in the higher mileage and all that stuff I think that kind of affected some of my levels differently. And the most where we saw things [inaudible 06:38] like my iron went down a little bit I think with the increase in mileage but the rest of the levels were good. Everything looks good. I think I have a little bit more higher liver enzymes than I had before which is probably due to the excess volume.
Tracy: And then she was really like good about taking her B supplementation.
Erin: Compliance.
Tracy: Then we saw her B12 was really high so it's like okay, let’s pull the brakes on that one
Erin: Yeah, that's right. That's something that people don't really think about enough I think is that just because something is good for you for a time or could be good for you generally, it doesn't mean that taking it every single day for the rest of your life is going to be beneficial, right? At some point that cup could overflow. So that's the other thing I happened to like about it.
I'm really interested from a clinician's perspective, especially as a female who is also active and we get this question all the time. And for the men listeners I'm sure this is applicable to you in some ways but women in particular struggle with low iron, low ferritin has always been something. I mean like I have the same issues as Andie. So I'm really curious as what you have done with her and even with some of your other patients because I know that you're using side tracker in your practice. How you were able to correct that? Because just the act of running is going to deplete your iron, I mean literally your feet hitting the floor, right? This is one of the scientific proven effects. So how do you address that? Especially in a body that's already – to be scientific – that's menstruating so you're losing blood anyway and then you’re constantly having to replace that blood store.
Tracy: Right. We were going to make sure that her protein level was where it needed to be and we were spreading protein throughout the day, really focused on recovery nutrition, added in a really good whey protein for her to have. Bu the biggest thing is we switched her supplementation from ferric sulfate. I think you needed to take some ferric sulfate but we added in iron diglycinate. And just in the formation of iron diglycinate instead of ferric sulfate, it's absorbed so much better and you get a really, really good response and it's super easy on the stomach while ferric sulfate for a lot of people can be very, very upsetting to their stomachs. Stomach pain, constipation and then there's a desire to not take it when it doesn’t make you feel good. So I think that was a huge switch, it was getting her over on the iron diglycinate
Andie: I think I was taking two different supplements that kind of counteracted at the same time not knowing. I was taking [inaudible 09:03], I don't know what it was but there was something because we started switching up when I was taking it so that there wasn't any interaction with them. But I don't remember which...
Tracy: Calcium and iron can compete so it might have been a calcium and vitamin D supplement. They're both competing for the same spot for absorption so you never want to take those at the same time.
Erin: Right. Yeah. That's another important thing to consider which is why we have people like you Tracy. So was there anything that you were really surprised by? I always ask people what the most surprising thing was because 9 times out of 10 something that you're pretty sure you're totally fine in, you're not.
Andie: I think I was actually pretty surprised that my – all the biomarkers that indicated I guess like towards overtraining I was actually surprised the first time when we did it that it wasn't bad. I had assumed but I think because I was really tired, that was what was causing it and not my iron as much as it was. And then I kind of felt like I was trying to run too hard anyway on my workouts. And so I had assumed that I was going to see some sort of issues with that. And I think when me and Tracy were going through stuff she was telling me if this level is high like then we'll know like maybe it's a little bit of overtraining and this and this and this. And I don't think we had really come to the fact that thinking that it might have been my iron at that point because I had had iron issues and I didn't put it together at that point. So I was just like who knows? But I think that was really the only big thing that I was super surprised by – yeah, I wouldn't say...
Tracy: I would say the same thing for me. I was like happy surprised for her. Her [inaudible 10:51] level was good
Erin: But it told you something else. That's she wasn't pushing herself as hard as she thought she was or that she could.
Andie: Yeah.
Tracy: And I think that's the struggle that a lot of athletes get into. They've got such a great mindset to push themselves hard that sometimes they don't know if it's, you know mentally they're pushing themselves when they should be pulling back because of their thinking or mentally trying to push through when like she said it's just biological that you know, hey, let's make sure we got more oxygen floating around to get that iron level up and you'll be amazed. And she really was amazed at the change in how she felt.
Erin: So it was super positive change then, huh?
Andie: Yeah, it was huge, it was huge. I was struggling over the summer races and I did a 10K in May and it was like I think I run 33-43 or something and then later that fall after I got my iron levels up everything was going really well, I ran that same time in the 12K on the roads. So it was I ran 33-43 while racing a 12K on the roads which is a lot harder because it's not flat on the track and there's [inaudible 11:54].
So that was crazy to see kind of that improvement. I had a minute PR in my half marathon. Yeah, so it was, I had a really good fall coming off of the working with Inside Tracker to come up with – fix all the inadequacies that I had and then having Tracy being able to recommend what I was missing, really made a big difference. And I would say because looking through those results when I looked through them by myself, a lot of the stuff I wouldn't have been able to decide without Tracy breaking it down for me.
Erin: That's great. And Tracy, in your practice you're using this tool now with Andie and with another athletes. Is there a trend that you've seen that you're particularly surprised by? Or is there anything that's sort of illuminated for you as a dietitian that you maybe weren't able to see before
Tracy: I think the biggest thing is just the guesswork. You know, instead of guessing at people’s symptoms you now have data to go by. And then you know what to tweak. And I love the fact that on Inside Tracker it helps me too because it shows what foods you need to change, either increase or decrease to improve that marker. So I'm not having to dig as hard as a dietitian. It's like hey, it's right here.
Erin: If only you had that while you were getting your degree. Just bring your phone into the test. I'm just kidding. Cool. Well, thank you so much for sharing your story. I really appreciate it. We love to – this is exactly why we do what we do because we love to hear these kinds of things. So best of luck to you both, obviously. And whatever you're running next I'm sure you'll be faster than me so… but all kidding aside, congrats on improving everything. Really happy to hear that. Thanks guys.
Tracy: Thank you.
Some other blog posts we think you'll love:
- Tired of Being Tired: How I Optimized My Iron Levels
- Getting Back on Track: Laura Ingalls' InsideTracker-Fueled Journey Back to Holistic Health
- Avoiding The Crash: How Monitoring Iron Levels Can Save Your Season
- Stress Fractures: The Relationship Between Biochemistry, Nutritional Screening and Biomechanics
