Updated: 10/08/2018 | Published: 02/08/2018
I approached Tom about 3 months ago. His guidance and approachability have been a godsend. I have never felt like I’m doing this on my own and Tom has actively researched my conditions as well as suggested things based on my symptoms. – Anoushé
Anoushé contacted me around May 2018 to enquire about Climbing Nutrition Coaching to help support the demands of her increasing climbing training as she works towards Team GB selection and beyond.
Anoushé Husain (@anoushehusain) is a remarkable person: para-climber (missing right forearm from birth), cancer survior, conference speaker, multi award winner, and all round role model to many as she navigates the multiple challenges of Ehlers-Danlos Syndrome (EDS), and Postural Orthostatic Tachycardia Syndrome (PoTS).
I will be continuing to work with Anoushé throughout 2018, and wanted to provide a rolling case-study…
Coaching / Programming
If you are interested in working with me: Climbing Nutrition Coaching
Taking on someone with a variety of sensitive health issues is not something I do lightly, and I had never heard of EDS before I met Anoushé. But with the caveat that I am not a clinical dietitian, and anything I recommend needs to be discussed with her supporting dietitian, we decided to focus on two primary goals:
- How to eat to support her increasing training demands and recovery, and how best to fuel for her climbing performance. All this with the understanding of the complications of PoTS (increased heart rate, dizziness, fainting) which often accompanies EDS
- Improving body-composition; losing fat mass gained over the last few years
Unfortunately for Anoushé, she has to manage various gut sensitivities which requires her diet to be gluten-free, FODMAP-free, higher in sodium (for PoTS), and divided into numerous smaller easier digestible meals.
Gut has been awkward for 2 days and that's tiring me out and I had a couple of nights with less than 4h sleep. – Anoushé
My initial focus was to first understand all I could about both EDS, PoTS, and the current clinical dietary guidelines and considerations.
I knew working together was going to require a lot more trial and error than textbook sports nutrition best practice. How could we manage carbohydrate intake if sources and meal volume had to be taken into consideration. Fiber is a problem for Anoushé, along with fruit sugars (fructose), and sugar (sucrose).
From June to August we implemented the following:
- Focused on finding energy balance, and mitigating energy swings, PoTS crashes, and gut flare-ups
- Specific min / max macronutrient targets to be eaten between depending on the day's activity
- Trial and error investigation of using different carbohydrate sources and volume around training sessions
- Trialled micro-dosing sodium bicarbonate throughout the day to manage PoTS sodium intake
- Working on preventing "self-sabotage" on emotionally difficult days. E.g. Dairy icecream which often causes gut flare-ups
- Daily communication and feedback for support and encouragement
Yeah I think you are spot on there, try not to see ice cream as a treat that's worth paying for later. Because it might not just be acutely later you have to pay the cost, but rather it will be spread out over the week or more. For you, you walk such a fine balance, a kind of tight rope with your health and performance, I just want you to spend more time on the wire getting your balance back, rather than having to keep walking back to the beginning and starting again. – Tom Herbert (usefulcoach)
Well hell, guess who just went from a deadlift of 60kg to assisted 75. We also retested presses and I’ve gone from struggling at 3kg to 6 comfortably right arm, left maxed at 10. Given I trained with Thanh, then Tricky, then Campus, then climbed with a friend and nailed an overhang route that was causing me issues I’m damn well pleased :) – Anoushé
After establishing a good base understanding of dietary habits and fuelling strategies we are now:
- Creating a energy deficit to drive fat-loss
- Trailing perodised carbohydrate intake to improve metabolic flexibility
- Trailing supplementation to improve peak performance and recovery
Anoushé is a pleasure to work with, but her situation is honestly challenging. I am constantly learning about how sensitive her body is to food and activity, and how things are often quite unpredictable for her. But we keep pushing forwards and celebrating the periods when she can build upon her health and performance.
I believe that though Anoushé's life may never have consistent balance due to the complexity of her health, but we can put in the best habits and practices to maximise the intermittent balanced times to help her reach her goals.
I look forward to seeing what heights Anoushé can reach going into 2019, and more so how she can influence others to push through life's often too frequent lows.
Exciting news :) I went shopping in my fave leggings place - top is now very comfy medium heading to small and bottom is finally convincingly back in medium. – Anoushé
Got my first 6c! In fact, climbed with the person I started climbing with in the first place. So the one who persuaded me to climb post cancer when 3 incomplete 3+ routes on a slab would leave me for dead, yesterday was the first time I outpaced her energy wise :) and almost matched her on grade! – Anoushé
Coaching Review: August 2018
Anoushé kindly passed me the following review.
I approached you after your Instagram caught my eye. Your willingness to delve into research and optimise performance through nutrition.
Although I have been on diets before to lose weight gained through a sedentary life style with health issues, these were not sustainable and I had never looked at the performance side of things.
Last year I was put on two elimination diets for health reasons. At the same time, I was looking to lose fat and start transitioning my body towards performance sport. Performance was not looked at and I experience a lot of health issues flaring. There was no real strategy on when I should eat and how I should eat for a competition or training vs rest days - my climbing plateaued and I picked up injuries.
I approached Tom about 3 months ago. His guidance and approachability have been a godsend. I have never felt like I'm doing this on my own and Tom has actively researched my conditions as well as suggested things based on symptoms.
It's clear that Tom has no prejudice or bias towards any foods or food groups. Managing my conditions is complicated and knowing I have the ok and support to eat very odd and sometimes seemingly counterproductive or unhealthy options is supported. Instead, he supports me to make better choices where I can.
Since starting with Tom, I have lost cm off my waist and stomach while seeing my performance improve. I have been consistently improving in both strength training and climbing. I have also seen a faster recovery when my health flares and less flares in general.
Want to work with me?