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Optimizing Big Muscle Health In Athletes

Louise Burke: Sports dietitian

BY PETER BOWES | LOS ANGELES | NOVEMBER 1, 2021 | 0700

As we grow older, frailty becomes an issue due to declining muscle strength. For athletes, muscle fatigue can be a huge challenge at any age, but there is scientific evidence that nutritional interventions can slow down or reverse the process. The LLAMA podcast has previously covered the science behind muscular health and the potential benefits of Mitopure, a pure form of the metabolite compound Urolithin A. According to clinical studies, it boosts cellular function and improves leg muscle strength in people over the age of 40. 

In this episode we explore the latest science. Professor Louise Burke, the Chair of Sports Nutrition at the Institute for Health Research, Exercise and Nutrition Research Program, at the Australian Catholic University, is conducting a study with top athletes to evaluate the clinical evidence for Mitopure in a younger and more athletic populations. Will it help improve performance and what are the implications for non-athletes who want to maximize their muscular strength, as part of a healthy aging lifestyle? 

Recorded: October 7, 2021 | Read a transcript 

This episode was produced in association with the Swiss life science company, Amazentis, which is pioneering cutting edge, clinically validated cellular nutrition, under its Timeline brand.

Connect with Prof. Burke:  Bio | Twitter | Australian Catholic University

Background: Amazentis Pioneers First Sports Nutrition Program with Mitopure™ (Urolithin A)

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TRANSCRIPT AND CHAPTERS

Transcribed using AI. Please check against audio recording for absolute accuracy.

The rate of energy production in the mitochondria and their muscle cells is just extraordinary, and that’s what we’re trying to do with our effort in training to be able to get more mitochondria and train them to be such good power producers.

Louise Burke

Peter Bowes: [00:00:20] Hello again. Welcome to the LLAMA podcast. LLAMA is Live Long and Master Aging. My name is Peter Bowes. This is where we explore the science and stories behind human longevity.

Peter Bowes: [00:00:31] This episode is brought to you in association with Amazentis, a Swiss life science company that’s pioneering cutting edge, clinically validated cellular nutrition under its timeline brand.

Peter Bowes: [00:00:43] Now we have covered in some detail the science behind muscular health, the role of the metabolite compound, Urolithin A and the potential benefits of Mitopure, a pure form of Urolithin A, which, according to clinical studies, boosts cellular function and improves leg muscle strength in people over the age of 40. But what about younger people? What about athletes? As we grow older frailty is an issue, a key issue, due to declining muscular health. But for athletes, muscle fatigue can be a huge challenge at any age. Our guest is Professor Louise Burke. Louise is a sports dietitian with more than four decades of experience in the education and counseling of elite athletes. She is the chair of Sports Nutrition at the Institute for Health Research, Exercise and Nutrition Research Program at the Australian Catholic University. Formerly with the Australian Institute of Sport, she was the team dietician for the Australian Olympic team1s for the 1996/2012 Summer Olympic Games, and she recently returned home from the Tokyo Olympics. Professor Burke, welcome to the Live Long and Master Aging podcast.

Louise Burke: [00:02:01] Thanks, Peter.

Peter Bowes: [00:02:02] It’s good to talk to you. We’ll get to Urolithin A` in a second, but I suppose I’ve got to ask you the 2020 Olympics that I guess became the 2021 games that must have been quite an experience, just to be there.

Behind the scenes at the Tokyo Olympics

Louise Burke: [00:02:14] Look, it was a really interesting event. I’m so glad that we managed to all believe that Tokyo could pull it off because they did a wonderful job. It’s hard to imagine any other country having the the discipline and the self-confidence to do it, but they did under really, really terrible circumstances. They did such a wonderful job and the athletes themselves were so patient and accepting because we were under lockdown in the conditions that were provided for the games. I went to Sapporo, which is where the distance events, the race walking and the marathon events were held and we lived in lockdown in a hotel rather than being in an athlete village. And the athletes could be bused twice a day to a stadium where they had to run around the stadium to do their last training. Can you imagine a marathon runner or a 50K race walker, you know, doing laps of 400 meters for their last training? But it was just a beautifully run and very well-accepted event. You know, the athletes were so happy to be able to do their thing. And I think back at home it gave people a sense that the world is going to get back to normal sooner rather than later. We’re mostly still in lockdown. And so for people to be able to get together and be able to celebrate some of the results of wonderful athletic performance was something that really made the community just have some confidence and some hope again.

Peter Bowes: [00:03:48] It’s interesting, you put it like that because watching obviously from a distance here in Los Angeles, watching the Games, it was really quite gratifying that the shadow of COVID didn’t overwhelm the games. I think a lot of us thought even up until just a few days before thought that it might, but it really didn’t. And there were some really great athletic performances to enjoy, weren’t there?

Louise Burke: [00:04:10] `Ah there were. And look, the athletes have to be given so much. Oh, just our congratulations for the fact that they persevered with their training under difficult conditions to get there. And then even at the games, you know, as I said, we were under lockdown. So a lot of the freedoms and the ability to do that last minute, tweaking the way that you would have liked to was not given to them, but they still did their best and there were some incredible performances, even given that sort of less than optimal preparation, but also the the heat and the humidity where we were was challenging for the athletes doing distance events, but that was just another thing that they managed to do a really good job with.

Peter Bowes: [00:04:54] And then you returned back to Australia and had to, like so many people these days, had to endure quarantine. What was that like?

Louise Burke: [00:05:01] Oh, don’t tell anybody, but I loved it. It was terrific because normally you know, you come back from the Olympics, it’s a very, very busy event. You go in there with a lot of pressure. The events that I worked with were starting at 5:30 or 6:00 in the morning, which meant getting up at one o’clock in the morning, many days in a row to be able to get the athletes ready and all their nutritional preparation completed. And so by the end of it, you’re absolutely exhausted now. Every other time that I’ve been to the Olympics, I’ve had to come straight back and get back into normal life and work and all the family responsibilities. But I had a two week buffer where I could just sit and think about things and watch Netflix and get a bit of work done. All those emails that pile up while you’re busy doing other things and have food brought to you three times a day. So that’s my secret. But don’t let anyone else know

Peter Bowes: [00:05:55] You’re the first person to describe it like that. Someone who’s actually enjoyed quarantine, which which is good to hear. How is the hotel food?

Louise Burke: [00:06:03] Well, we were able to buy in some, you know, click and collect from a supermarket, so I was able to supplement what we were provided with. But what was really interesting for me, it was probably an experience a little bit like some of the research studies that I run, where we take over the lives of our athletes and feed them all their food. And so that whole loss of loss of personal freedom and responsibility about food was taken for two weeks. And it was a really interesting experience to, you know, to have to think about what’s been put in front of you. And is that really what I need? And is that really what I’m going to like? And what can I do to present it to myself so that I’m happy? So it was it was probably good for me to reflect on some of the research that I’ve done where we just expect athletes can do this without any change to their happiness levels.

Peter Bowes: [00:06:57] Yeah, that’s something that’s always struck me and phrasing it like that. It’s interesting that clearly, I mean for me is, you know, very, very – I emphasize the very amateurish athlete that I’ve been for the last few decades doing a few marathons. One of the worst parts of it is the traveling to the venue and the 24 hours before. Because you’re in a strange hotel, often times it’s difficult to get the breakfast that you’ve been training on for the past year if it’s for a long distance event. So that kind of insight is interesting and I suppose must open your eyes in terms of what these really elite athletes go through.

Louise Burke: [00:07:29] Oh, absolutely. And you know, because food is so much more than just the nutritional value that we need, and there’s the whole happiness and cultural and social identity that we enjoy is so much focused around food. So when that suddenly gets out of your control and you’re needing to live somebody else’s idea of what’s good to eat, you can could add up not anxiety, but certainly at that level of, you know, just a bit on edge about what’s what’s going to be happening in my nutritional life today. And for me, that’s a lot about enjoyment and social social interactions with other people. So that was removed, the fact that you’re in a room by yourself eating. But thanks to modern, modern technology, there’s lots of opportunities to be zooming and having meals with other people by remote. And so you can restore some of that element of the eating process for yourself.

Peter Bowes: [00:08:29] Good to hear. Well, Louise, you’ve had and continue to have a distinguished career in your field, and I mentioned in my introduction, let’s say a potted biography of you – I couldn’t get everything in there. And if anyone would like to really delve deep into what you’ve been doing, I put some notes and some links to your bio in the show notes of this episode. But rather than right now, maybe go through chronologically everything you’ve been doing for the past few decades a more general question as a dietitian, I’m curious what has been the driving force behind your work and especially your work with elite athletes? In other words, what gets you out of bed in the morning?

A career in sports nutrition

Louise Burke: [00:09:05] Oh, look, I love food and I love nutrition, and I love the idea that it can be a force to enhance performance. And so there’s been so many different themes that went across my career. It was very early all about the fueling aspect, particularly the focus on carbohydrate. And then at different times, we’ve had interests in protein and recovery. There’s a lot of interest from time to time around, specific competition environments. And so Tokyo brought us back to thinking about calling and whether internally consuming foods that are cold or icy can help with body temperature regulation. There’s the water aspect and rehydration, and now there’s a big interest in what nutrition can do in terms of the recovery or regeneration, or controlling some of the things that are happening at a cellular level. That we may not have had the technology to know about before, so there’s just so many ways you’ll never have nothing to do in this profession if you’re trying to think about all the ways that nutrition can help an athlete go higher, faster, stronger. And so I’m just constantly excited about some new thread and my new life now that I’m in academia is about doing the research that underpins the evidence for the guidelines that we give athletes. So that was a small part of what I did at the AIS. I mean, it was always evidence based, but my day to day work was working with athletes and coaches and helping them plan their campaigns. And now I’m still involved from time to time in that element, but I’m able to take more of a step back and start doing the research at a much more noninvasive but a much more robust level so that I’ve got more techniques and opportunities to work with people who can get to some of those really curly questions that athletes are asking and need have a very solid approach to be able to find answers.

Peter Bowes: [00:11:07] Presumably, the basic principles as they apply to nutrition are not that different between elite athletes and ordinary people, whether they’re amateur athletes or people that don’t consider themselves athletes as all that just simply want to maintain a level of fitness.

The special needs of athletes

Louise Burke: [00:11:24] Well, I think there’s an amplification of what the average person needs. One of the big issues in sports nutrition at the moment is this idea of periodization and that athletes don’t train the same way every day. They don’t have the same nutritional goals each day of what they’re trying to mold their bodies into. And so what they need to do is to periodize their nutritional approaches. Partly, it’ll be about as the training changes, the energy and the fuel requirements for carbohydrate change, then the different ways in which they time their exercise sessions in a day. So the way that they eat before, during and after a session will be different from day to day. And we’ve got different sorts of goals for each session, and we’ve discovered that in some aspects of nutritional support that you can adapt the body to training not by giving perfect nutrition support for that session, but actually by taking away the nutrition support for the session. To make your body have to have an extra stimulus or an extra exposure to whatever mechanism is going to help it adapt. And so we now deliberately have sessions where we have athletes training with low glycogen levels or in a fasted state, so they’re not taking in the carbohydrate that would be good for performance because that’s going to drive the muscle adaptation in a different way. So I think a lot of people think that what elite athletes are doing is finding the perfect diet and then just repeat every day. Once they’ve got it, they just keep doing it. Whereas every athlete’s intake is going to be different from day to day. And we might argue that the average community member might need to eat slightly differently from day to day to match whatever the goals or activities that they’re doing in a day are also, but I think the extremities of what athletes do that is so different to the community person means that the differences from day to day or the very importance of having this meal at this time versus another time, a much more obvious in elite athletes just because they amplify every other aspect that community people are doing and require a much more clever match to what they’re doing with their nutrition.

Peter Bowes: [00:13:49] Just a little aside, you mentioned training in a fasted state there. We did an episode quite recently about continuous glucose monitoring, and I know it’s it’s an area that fascinates a lot of people and that is doing the main bulk of your exercise – I’m talking for laypeople, not necessarily elite athletes here – but doing the bulk of your exercise in a fasted state. So first thing in the morning, before you eat a significant amount of food, you might have had a cup of coffee, but you haven’t had your breakfast. What is what’s the benefit of? Or indeed, what is the benefit if it exists of eating after your exercise?

Louise Burke: [00:14:24] Well, it’s not just the fasted state, it’s also if you’re wanting to get the major benefit of this type of training, it would be to train or put your training sessions together in such a way that one of the sessions depletes the glycogen so that when you do the next session, you’re starting with low muscle glycogen levels, as well as the fasting state, so that there’s what we call low carbohydrate availability. The muscle doesn’t have the carbohydrate fuel that it does best to perform with. And when it trains in those situations, you don’t get a good training session, you’re not going to do a PB or do some of the quality that would be associated with having a bit of fuel support. But that session helps the athlete to adapt by increasing the mechanism of adaptation. It changes the cellular function in the muscle, and it helps it to try and repair and make new mitochondria and make those mitochondria have better capacity to burn fuels because it’s doing everything it can to survive that session. And so what athletes need to do is to periodize that both the training and the nutrition so that over the week or over the month or over the period of time that their periodizing that some of the sessions they do are done with very good fuel support. So the athlete can train with very high quality and they can practice some of the tactics they’re going to use in a race situation. Like you talked about how you need to fuel up for the marathon. So they need to have some of those sessions where they’ve got very high muscle glycogen to practice working at high glycogen levels. They also need to practice taking in carbohydrate and fluid during the event. That’s something they’re going to do on race day so that they learn the behaviors, but they’re also adapting their gut to be able to absorb it and deliver it to the various parts of the body that it needs to go. So some of those sessions will be important for one aspect of performance, but some of the sessions they’ll do, they might deliberately try and amplify this train low situation so that they’ll get a higher training response and putting all those sessions together in the right order and the right frequency will. It’s like having an orchestra. You need to get all the different bits of it, all working in harmony and then on race day, it all pulls together and delivers the best performance.

Peter Bowes: [00:16:54] Produces a nice symphony.

Louise Burke: [00:16:56] Mm-hmm. That’s exactly right.

Why mitochondria matter

Peter Bowes: [00:16:58] So you mentioned mitochondria. Just now, let’s talk in detail, which is what we’re going to do over the next few minutes and talk about Urolithin A, which I mentioned in the introduction. But I’d like to go back to basics, and perhaps if you could explain the importance of mitochondrial health. Clearly, it is something of vital importance for every single one of us, whatever our mode of exercise.

Louise Burke: [00:17:19] Sure. So we think of the mitochondria as the power cells inside the muscle, and that’s where the aerobic production of ATP, where ATP is the fuel that the muscle uses to contract or does so many other things. It’s the way that our body uses a currency of power. And for an athlete, particularly athletes that are doing prolonged and sustained high intensity exercise, you want to have mitochondria that you want have plenty of them to start with. So you’ve got plenty of fuel cells. That means you’ve got to be jet engine in your car. But you also want to have them full of the right enzymes and proteins that help you to burn the fuels. And you can burn fat or carbohydrate in the mitochondria, and you want to be able to burn it as quickly as possible to produce the maximum amount of ATP from each gram of fuel. So the kind of training that elite athletes do, particularly in distance events and team events where aerobic production of fuel is going to be really important for performance. You, you work on making your muscles have as much of the really highly functioning mitochondria as possible and then your nutrition strategies on race day are around providing the fuel in the muscle that the mitochondria will use. So there’s sort of a two pronged approach to making sure you’ve got the the fuel right on the day. One is to have the fuel cells there. But the second thing is in your preparation and your training, you’ve helped the muscle aggregate the biggest engine it can have by having those mitochondria in large numbers. And as is fully ready with the right proteins and enzymes to go to burn the fuel.

Peter Bowes: [00:19:08] And where the science gets fascinating, of course, is in the different ways that we can optimize our mitochondrial health. And I mentioned earlier that obviously, as we grow older, frailty or lack of muscle strength is a huge issue for older people. And often it is the the one issue that – perhaps falling over because of a lack of muscle strength – is sometimes the beginning of the end for some people and could prevent them from actually exercising. But for elite athletes and for younger people, equally, mitochondrial health is crucially important in terms of issues of fatigue and preparing for the next event.

Louise Burke: [00:19:47] That’s right. But even if we go back to the community level, one of the important things that the mitochondria are doing is that’s where we burn our fat and carbohydrate from food. And if? We don’t have enough of the right mitochondria that are very active. Older people don’t have the ability to be able to burn fat and glucose, so then they’re building up the side products of low metabolism, and that’s part of the whole syndrome, this metabolic health syndrome that we worry about in older people. So the mitochondria is not just for function, it’s also for the ability to be able to be using the food that you’re consuming in a way so that it’s not building up the side products that are a part of the the disease profiles. So we call it the metabolic sink, that’s what the muscles is doing in athletes. When the muscles burning all those fuels, what it’s doing is producing work that we like to watch. So it’s the marathon running, getting to the line in less than two hours. It’s the footballer being able to sprint and then have a rest and then sprint back again. So much of the important work of sport is done at very high levels of this aerobic use of fuels. And so when we’re looking at athletes going higher, faster, stronger, a lot of it’s about being able to put fuel through those mitochondria and produce a lot of work, which we see as speed or agility or non fatigue ability, fatigue resistance, we call it in in science speak. So when we’re watching athletes doing their marvelous things and being able to do things that are such a high speed, I mean, people don’t recognize people think the marathon is just about sort of hanging out until you get to the finish line. And that’s what marathon runners are great at doing. They’re able to exercise longer for – than the average person. But what they don’t realize is that the amount of energy that’s being produced to have those athletes running at such high speeds, you know, they’re doing a 400 meters in sort of 68 to 70 seconds and most most people who even just do a little bit of recreational exercise and think that they’re running, if they could do one of those, they’d be pretty happy with themselves. But to do 42 kilometers of them is incredible. So it’s not just that they can go for a long period of time, but they’re moving at such high speeds. The rate of energy production in the mitochondria and their muscle cells is just extraordinary, and that’s what we’re trying to do with our athletic training to be able to get more mitochondria and train them to be such good power producers.

Peter Bowes: [00:22:38] So getting more mitochondria and optimizing mitochondrial health, there’s a process known as mitophagy, which is variously described as the the replacement process, the regeneration process for mitochondria and there’s Urolothin A a which is a metabolite, which we produce to greater or lesser extents in our gut. Could you explain this jigsaw and how it all comes together?

Louise Burke: [00:23:04] Well, the mitophagy part of the process is getting rid of the mitochondria that are starting to get old and not good. And so for athletes, we can’t afford, you know, your muscles only so big. There’s only so many mitochondria that you can have in it. And so you’re trying to get the maximum number of very good ones and you want to discard the old ones as quickly as possible so that there’s room to be able to build new ones. And that’s what the Urolithion A is helping. It’s helping with the getting rid of the old ones. And what athletes are doing with their training is trying to stimulate the muscle to get the new ones. And what we’re hoping the Urolithin A is going to do is to make that process more efficient because it can clear the old ones out more quickly and then allow the athlete to make better use of the training that they’re doing to allow new and more powerful and active mitochondria to take over. So it’s part of the process and all the other things that athletes are doing with their training and their nutrition to try and drive. Now we call the mitochondrial biogenesis is the the business of building the new mitochondria. But the mitophagy is assisting in the background by getting rid of the old ones so that the biogenesis part of building the new ones is going to be more effective.

Studying Mitopure with elite athletes

Peter Bowes: [00:24:30] And so this is what you’re working with Amazentis on – and their pure form of Urolithin A, Mitopure, which, as I mentioned at the beginning, studies suggest there are benefits for people, certainly over the age of 40. But your focus is on elite athletes and perhaps younger elite athletes, and you’re launching a study now. Could you explain the nature of the study, who the subjects will be and what will you be looking for?

Louise Burke: [00:24:55] Yes. So we’ve actually done the first camp of our study. So the way that we specialize in doing our research at Australian Catholic University. And this is a process that I developed when I was at the Australian Institute of Sport, and in fact, we were doing the project back at the AIS, because it has terrific laboratories where we can measure things very precisely. So what we like to do is have these intensified training camps, so we get elite athletes to come and live with us. In this case, it was for five weeks and we have them all training and eating together. And part of the process of doing that is because we know the athletes train better when they’re with a group of other athletes pushing them and some to invite them to come to do a study. You need to always think from the athlete’s perspective, what’s in it for me. So what’s in it for them is that they have an intensified training camp provided for them. So they come. We’ve got elite coaches, we’ve got other elite athletes with whom they can do their five weeks of training. We did a 10 day pre block at the AIS, where we measured a whole lot of things and we did some a couple of races to get a measurement of performance at the beginning of the experiment. And then we took them up to Perisher, which is one of our mountains. We don’t have very high mountains in Australia, but we do have one that has the ability to live at about 1800 meters and so we can do a lot of specialized training that athletes do. This is this is again a bit of a train low experience. So when athletes are going to altitude their training in an atmosphere where there’s a lower oxygen partial pressure, and that means it’s much harder for them to get the oxygen to the mitochondria to do burning of the fuel. And so their bodies try to adapt to that by producing more hemoglobin in their blood to carry oxygen around. And it’s hard to train. They don’t have the same quality training, but they’re adapting in such a way that after three weeks when they come back to sea level again, then they’ve got more oxygen carrying capacity in their in their blood and in their muscles. And so then when we put the fuel in, they’ve they’ve got a better ability to deliver the oxygen to the mitochondria, which is part of the whole burning. I remember I said that the mitochondria is burning fuel oxidatively with oxygen. And so what we’ve hopefully done with our process when we get them back to the AIS for another test block is that we’ll we’re actually taking muscle biopsies. We’re measuring the amount and the quality of the mitochondria in half. Our group and the other half of the group don’t get the biopsies, but they get to race for us. So we get to see what’s happened since the races three weeks earlier in terms of performance. So we’re our model allows us to have a look at the mechanisms of what’s going on, as well as the outcomes functionally for an athlete with what’s happened over that weeks. And what we hope is happening is that the training that they are doing up at altitude was creating new mitochondria as a stimulus. And what we’ve done is in the half of the group that received the Urolithin and they’re all getting pills. So half are getting pills that have got the Urolithin A in then and half are just getting a placebo. We’re hoping that the group that got the Urolithin A is going to have a better response because we’ve been able to clear out those older mitochondria to make way for the newer ones and that when they get back for their post testing, we’re going to be able to measure the muscle and actually see the quality of the mitochondria, as well as have them perform and see whether that’s going to then translate into better ability to do. In our case, it’s a 3000 meter – a 3k track race – and we’re working with some elite middle distance to distance runners. Some of them actually went to the the Paralympic Games, and some of the coaches have been involved with Olympic athletes as well. We didn’t have any of the actual Olympic team in the cohort because of the timing of the first camp. We were hoping to be doing the second camp right now, but we’re in lockdown again, so we’ve had to postpone it until January. But doing the two camps means that we’ll build up enough numbers that we think will provide us with enough of the statistical power that gives us confidence that the results that we’ve got a meaningful. So it’ll be the same process again, just in another group of athletes who will repeat that whole program and just add to our sample size.

Game changer?

Peter Bowes: [00:29:47] And of course, and you mentioned performance and also you said the athletes are motivated by what’s in it for them and clearly for most athletes, it is better performance, whether it’s running for longer or for better or harder, it is ultimately down to results that they can achieve on the track. How much of a game changer do you think this could be for those individuals?

Louise Burke: [00:30:12] Well, look, it is a game changer, a game changer because in sport, a very small improvement in performance, you know, one or two per cent improvement in performance is really meaningful and changing the outcomes of a race. And so it might not be always detectable to the eye if you like, but when we can measure it robustly in the laboratory and on the track and then translate that into the usual performance an athlete does and add another one to two per cent on it, that’s meaningful in changing the outcomes of races.

Peter Bowes: [00:30:45] I think what’s interesting is the quantitative aspect of your research in terms of measurements, because with this kind of research, it’s often a big question for people and especially non-athletes. How do you feel? Do you feel better? And it’s sometimes difficult to quantify whether you feel stronger and for nonprofessional athletes. Measuring their ability to to run or to walk better is actually quite difficult. But when you’re in that very scientific setting that you’re in, you’re going to get data and you’re going to get numbers that can really hopefully demonstrate results.

Louise Burke: [00:31:22] Yes, and we’re lucky we set it up to be able to do this in two ways. One, we have athletes who are very good at what they do, and they’re very reliable in their performance. So when you have the average person who exercises, they often misplace what they’re doing. You know, people go off too fast in a race because they’re excited and then they hit the wall or they don’t go hard enough because they’re frightened to hurt. Whereas athletes, it’s their business. And so we find that athletes can produce their performances very reliably from one day to the next as an outcome of what they learn about themselves. And so then we’re able to measure small changes in performance because we have a very tight range in which they would normally perform against which to look at the new performance. So that’s one thing. We’ve got very reliable athletes, but in the laboratories of the Australian Institute of Sport, we have very good equipment and very good protocols to be able to measure some of the things that we’re looking at.

Why more women athletes are needed in clinical trials

Peter Bowes: [00:32:21] So the group that you’re working with, are they male athletes, females? Are they a mixture?

Louise Burke: [00:32:26] At the moment, we’re just working with male athletes, and I have to say that I’m ashamed of that at one level because I realized that females are underrepresented in sport science research. And that’s a problem, because there may be some ways in which males and females differ. So when we start a new line of inquiry, it’s best to start with a very clean model. And with males, we don’t have to worry about whether there’s a menstrual cycle that’s healthy or what phase of that menstrual cycle it’s in. And so our first studies are done to try and make it as clean as possible. But then we will go on and look at females, and it makes it just a bit more complex because we need to make sure that when we’re dealing with the female athletes that they are regularly menstruating. And we also need to think about whether there might be a change in performance or a change in some aspect of what we’re measuring. According to the phase of their menstrual cycle. So it does make it a bit more tricky to do the kind of research camps that we’re doing where everybody’s there at the same time. If it does turn out that we need to look at measuring performance in the females at a certain phase of their menstrual cycle, then the choreography of our experiments needs to change to be able to standardize for that. So look, it’s a problem with a lot of areas of research that often scientists think, Oh, it’s a bit too hard to do females because of that. But it’s certainly something we need to do to make sure that we do have evidence that whatever we’re looking at does have the same effect in the different sexes. And I’ve become more cognizant about this over the last five years. And when I look back over my own research career, I look at how much more easily I’ve done the work with men. And so I’ve done more studies in men, but I’ve gone on record to say that I really want to address that. And so hopefully we’ll be finding a follow up study with female athletes involved so that we’ve done the right thing.

Peter Bowes: [00:34:38] It’s a fascinating area and is there amongst female athletes – Is there the the understanding of this situation that in terms of gender balance, that more needs to be done to incorporate females into clinical studies like this?

Louise Burke: [00:34:52] Absolutely. Female athletes are becoming understandably quite enraged that they’re being neglected when it comes to this, and sometimes it’s the researchers fault, but sometimes it’s also the female athletes fault that generally my experience has been that it’s more difficult to recruit female athletes to studies, and that might be a reflection that they’re often less well remunerated for being a sportsperson, so they’re working at the same time as doing elite training. And so maybe their time availability is a bit more limited, but both the the culture of the researcher and the culture of the athlete is being changed at the moment. So I hope you’ll see that there’s a lot more research being done on females, and I should just jump in here to say that one of the reasons to do it is not to suggest that everything is different with females, and we need a whole different set of guidelines and strategies for them because I’m quite aware that there’s because of this interest in female athletes, there are people out there trying to promote their ideas to say that females should forget everything they’ve learned and start doing things really differently and take up new strategies or new products. And I think we’re not yet there at the at the confidence that we can say that females need to do everything differently, but we do need to go back and do the research to say this is something we’ve shown clearly in males, and now we can be confident that it works to the same way. Or it may. It may need some tweaking for females, or it may just need some tweaking for an individual. But whatever, it’s really important that we go and do the work consistently and systematically so that we can be really confident that when we do give recommendations, there is evidence to support the specific use of that strategy.

Peter Bowes: [00:36:51] Just in closing, this is a podcast about human longevity. We talk about healthspan a lot, optimizing the number of years that we are healthy, active, involved from a mental, spiritual, physical perspective as opposed to lifespan. And I’m curious how you are a female athlete. You’re a seasoned female athlete, you run marathons and you’ve run triathlons. What are your personal aspirations as far as your own longevity? And how do you apply the science and the knowledge that you’ve acquired over the last several decades to yourself and your own physical activities?

Longevity aspirations

Louise Burke: [00:37:29] Well, look, it’s a bit bold to consider myself an athlete, but with my caliber and training status. But I do consider myself a lifelong exercise and athlete, and I want to be doing this as long as I can. I’m in my 60s now and my goal is to try and slow down the decline in performance that accompanies aging. So and I’m finding so far that I’m doing that and that I’ve never been a very good athlete, but I’m becoming better in my age group because I’m persisting and I’m not slowing down as dramatically as as you’d expect from the normal process of aging. So my goal in life and I love marathons, my goal in life is to start being the age group winner in my event in some of those big marathons I love doing. It might take me till 80 to get to the point where I’m out living and out running those people that I was born at the same time as. But that’s my goal, and it’s interesting that I haven’t declined as I mean, I’m still my my PBs within the last five years or so, and I’ve been doing this for a while. But what that tells me a little bit is that I’m now training smarter and eating smarter, and I’m doing so many more things to improve my performance at 30 years ago I didn’t know about or I didn’t think was important. So it does show how important it is to be more strategic and systematic about life in general, as well as your own performance as you age. And I’m hoping that you know that 60 is the new 30, and I’ll be able to keep doing things that I love doing for as long as I can. It’s about having the best quality of life for the the lifespan that you can manage.

Peter Bowes: [00:39:21] Just to give a little perspective here, I suspect you’re being quite modest about your abilities in your early 60s. What are your times currently for a marathon compared with what you did at your peak?

Louise Burke: [00:39:32] Yes. Well, I didn’t actually do marathons at my peak. In my youth, I was doing triathlons and the marathon was at the end of the Ironman event. So I’m cheating a little bit to say that I’m still running the same times when I haven’t done all the bike and the swimming before it, but I was still able to do a 330 marathon my my PB’s three, twenty six and my goal in life is to keep going around the world. Doing those big city marathons for all the hoopla and the fun, but being able to get some 330 and as many as I can, and so far it’s working. It takes a lot of effort to do it, but I really like that mental and physical challenge, and I love the fact that I can train with some of the athletes that I’m working with. When I’m working with the elite race walkers, their walking speed is my running speed. And so I get to hang out with them during training to help them with their fueling and at the same time as logistically helping them to do what they’re doing and observing, whether it’s working. I’m also getting a good workout myself, and so hopefully I’ll be able to keep doing that for as as long as I’ve got athletes that’ll keep running with me.

Peter Bowes: [00:40:47] I’m glad you mentioned the the fun and the hoopla associated with big city marathons. I was reading your biography. I noticed you’ve run the London Marathon, which was my first marathon back in the early 1990s, and it is just great fun, isn’t it? Seeing all the historical sites and it’s much more than running 26.2 miles?

Louise Burke: [00:41:07] Oh, it is the fun that you have with the people around you. I mean, it’s not fun the last couple of miles, but it’s fun when you hit the finish line again. But it’s all the build up and it’s the culmination of all that sacrifice and organization that you did to get the training in. And then on the day itself, there’s there’s a story, an adventure in every marathon. I have a friend that I meet and we do a lot of them together and we have a little game because it’s 26 miles in the marathon and 26 letters of the alphabet. We spend a mile and each of the agenda items that we’re allowed to discuss in that mile has to coincide with the letter. And so we we play an alphabetical marathon game.

Peter Bowes: [00:41:55] The brain games that we associate with ourselves. While we’re running marathons. Just one final question what do you say to people who would suggest that running marathons or doing a triathlon is really for younger people and that as you grow older, your body isn’t built for it?

Louise Burke: [00:42:10] Oh, well, I think I’m hoping to be living proof that that’s not the case. I mean, I’ve always been careful with my training that I don’t overtrain in terms of the injury side of things. And so my body’s still able to manage it both from the muscle and also the joint point of view in the bones. And you know, I think if you’re careful with the way that you do things and I’m probably lucky to have had the right parents and some genetic background that allows me to keep doing it. But yeah, the idea is to live your life like the the way that you run a marathon that you want to be able to take that last step in the best possible, you know, effort you get to that finish line and then collapse afterwards.

Peter Bowes: [00:42:56] I think that’s sounds perfect. Louise, I’ve really enjoyed this conversation. Thank you very much indeed.

Louise Burke: [00:43:01] Thanks, Peter.

Peter Bowes: [00:43:02] If you’d like to read more about Professor Burke’s work, I’ll put some details along with a transcript of this conversation into the show notes for this episode, you’ll find them at the Live Long and Master Aging website. That’s LLAMApodcast.com LLAMApodcast.com. You can also navigate all of our previous interviews on this subject for a really deep dive into mitochondrial health. This episode of the LLAMA podcast was brought to you in association with Amazentis, a Swiss life science company which is pioneering cutting edge, clinically validated cellular nutrition under its Timeline Brand.  The LLAMA podcast is a Healthspan Media production, we’re available on all of the main podcasting platforms. You can follow us in social media @LLAMApodcast. You can direct message me @PeterBowes. Many thanks for listening and do take care.

The Live Long and Master Aging podcast shares ideas but does not offer medical advice.  If you have health concerns of any kind you should consult your own doctor or professional health adviser. 

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