Muscle health for athletes. Interview with Prof. Burke

Interview Professor Louise Burke, the chair of sports nutrition at the Institute for Health Research, Exercise and Nutrition Research Program.

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Live Long and Master Aging

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In this episode Peter Bowes explores the latest science around muscle health and recovery for top athletes with Professor Louise Burke. Louise is the Chair of Sports Nutrition at the Institute for Health Research, Exercise, and Nutrition Research Program, at the Australian Catholic University, and is conducting a study with top athletes to evaluate the clinical evidence for Mitopure in a younger and more athletic population. 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?

Transcript
Louise Burke
The rate of energy production in the mitochondria in 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
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. 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
Now, we have covered in some detail of 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.
Peter Bowes
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 dietitian for the Australian Olympic teams for the 1996, 2012 Summer Olympic Games, and she recently returned home from the Tokyo Olympics.
Peter Bowes
Professor Burke, welcome to the Live Long and Master Aging podcast.
Louise Burke
Thanks, Peter.
Peter Bowes
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.
Louise Burke
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 discipline and the self-confidence to do it, but they did under 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.
Louise Burke
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 doing lapse of 400 meters for their last training? But it was just a beautifully run and very well accepted event.
Louise Burke
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.
Louise Burke
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
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
Ah, there were. And the athletes have to be given so much... just our congratulations for the fact that they persevered with their training under difficult conditions to get there. And then even at the games, as I said, we're 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 less than optimal preparation, but also 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
And then you returned back to Australia, and like so many people these days, had to endure quarantine. What was that like?
Louise Burke
Oh, don't tell anybody, but I loved it. It was terrific because normally, 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 was starting at 5:30 or 6:00 in the morning, which meant getting up at 01:00 in the morning, many days in a row to be able to get the athletes ready and all their nutritional preparation completed. So by the end of it, you're absolutely exhausted.
Louise Burke
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
That you're the first person to describe it like that, someone who's actually enjoyed quarantine, which is good to hear. How was the hotel food?
Louise Burke
Well, we were able to buy in some 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 the whole loss of personal freedom and responsibility about food was taken for two weeks.
Louise Burke
And it was a really interesting experience to have to think about what's being put in front of you. And is that really what I need? 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 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
Yeah. That's something that's always struck me, phrasing it like that. It's interesting that clearly... For me, I emphasized 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. Oftentimes, 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 you must open your eyes in terms of what these really elite athletes go through.
Louise Burke
Oh, absolutely. Because food is so much more than just the nutritional value that we need. 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 leave somebody else's idea of what's good to eat, you can add up, not anxiety, but it certainly at that level of, just a bit on edge about what's going to be happening in my nutritional life today. And for me, that's a lot about enjoyment and social interactions with other people.
Louise Burke
So that was removed, the fact that you're in a room by yourself eating. But thanks to modern technology, there's lots of opportunities to be Zooming and having meals with other people by remote, so you can restore some of that element of the eating process for yourself.
Peter Bowes
Good to hear. Well, Louise, you've had to continue to have a distinguished career in your field. And I mentioned in my introduction, let's say, a potted biography of you couldn't get everything in there. And if anyone would like to really delve deep into what you've been doing up with 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?
Peter Bowes
In other words, what gets you out of bed in the morning?
Louise Burke
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 the fueling aspect, particularly the focus on carbohydrates. And then at different times, you'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 cooling and whether internally consuming foods that are cold or icy can help with body temperature regulation.
Louise Burke
There's the water aspect and rehydration.
Louise Burke
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.
Louise Burke
So that was a small part of what I did with the AIS. 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, not invasive, 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 a very solid approach to be able to find answers.
Peter Bowes
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 who don't consider themselves athletes as all, that just simply want to maintain a level of fitness.
Louise Burke
Well, I think there's an amplification of what the average person needs. And 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. So what they need to do is to periodize their nutritional approaches. Partly, it will be about, as the training changes, the energy and the fuel requirements, the carbohydrate change. There will be different ways in which they time their exercise sessions in a day.
Louise Burke
So the way that they eat before, during, and after a session will be different from day to day.
Louise Burke
And we've got different sorts of goals for each session. 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 an extra stimulus or an extra exposure to whatever mechanism is going to help 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.
Louise Burke
I think a lot of people think that what elite athletes are doing is finding the perfect diet and then just repeat, and 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. 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 also.
Louise Burke
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, 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
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 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.
Peter Bowes
Indeed, what is the benefit if it exists of eating after your exercise?
Louise Burke
Well, it's not just the fasted state. It's also, if you wanted 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.
Louise Burke
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 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.
Louise Burke
And so what athletes need to do is to periodize both the training and the nutrition, so that over the week or over the month or over the period of time that they're 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.
Louise Burke
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, if 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.
Louise Burke
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
Produces a nice symphony.
Louise Burke
That's exactly right.
Peter Bowes
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 Uroltithin A, which I mentioned in the introduction. But I 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
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 we want to have plenty of them, to start with. So you've got plenty of fuel cells. That means you've got to be get engine in your car.
Louise Burke
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 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.
Louise Burke
So there's a two-pronged approach to making sure you've got the fuel right on the day. One is to have the fuel stalls there, but the second thing is in your preparation in your training. You've helped the muscle aggregate the biggest engine it can have by having those mitochondria in large numbers and is fully ready with the right proteins and enzymes to go to burn the fuel.
Peter Bowes
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 one issue that's perhaps falling over because of a lack of muscle strength, is sometimes the beginning of the end for some people. It could prevent them from actually exercising. But for elite athletes and for younger people, equally, that mitochondrial health is crucially important in terms of issues of fatigue and preparing for the next event.
Louise Burke
That's right. But if we go back to the community level, one of the important things that the mitochondria 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 product of low metabolism. And that's part of the whole syndrome, this metabolic health syndrome that we worry about in older people.
Louise Burke
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 disease profiles. We call it the metabolic sink. That's what the muscle 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.
Louise Burke
It's the footballer being able to sprint and then have a rest and then sprint back again.
Louise Burke
So much of the important work of sport is done at very high levels of this aerobic use of fuels. When we're looking at athletes going higher, faster, stronger, a lot of it is 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 science speak.
Louise Burke
So when we're watching athletes doing their marvelous things and being able to do things at such a high speed... People think the marathon is just about hanging out until you get to the finish line. That's what marathon runners are great at doing. They're able to exercise longer 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. They're doing 400 meters in 68-70 seconds. And 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.
Louise Burke
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 in 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
So getting more mitochondria and optimizing mitochondrial health, there's a process known as mitophagy, which is variously described as the replacement process, the regeneration process for mitochondria. And there's Urolithin 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
Well, the mitophagy part of the process is getting rid of the mitochondria that are starting to get old and not good. For athletes, we can't afford... Your muscle is only so big. There's only so many mitochondria that you can have in it. 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 Urolithin A is helping. It's helping with getting rid of the old ones.
Louise Burke
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.
Louise Burke
It's part of the process and all the other things that athletes are doing with their training and the nutrition to try and drive. Now we call the mitochondrial biogenesis is 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.
Peter Bowes
So this is what you're working with Amazentis on, and the pure form of Urolithin A might appear, 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. 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
Yes. We've actually done the first camp of our study. 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 Spor. And in fact, we were doing the project back at the AIS because it has terrific laboratories where we can measure things very precisely.
Louise Burke
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. 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.
Louise Burke
And 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. They come, we've got elite coaches. We've got other elite athletes, which 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 a couple of races to get a measurement of performance at the beginning of the experiment.
Louise Burke
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, again, a bit of a train low experience. So when athletes are going to altitude, they're 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.
Louise Burke
So their bodies try to adapt to that by producing more hemoglobin in their blood to carry oxygen around.
Louise Burke
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 blood and in their muscles. And so then, when we put the fuel in, 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.
Louise Burke
What we've hopefully done with our process when we get them back to the AIS for another test block is that 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.
Louise Burke
So our model allows us to have a look at the mechanisms of what was 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 were doing up at altitude was creating new mitochondria as a stimulus. 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 them, and half are just getting a placebo.
Louise Burke
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. 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 help them perform and see whether that's going to then translate into a better ability to do, in our case, it's a 3000 meters or 3K track race.
Louise Burke
We're working with some elite middle distance to distance runners. Some of them actually went to 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 during the two camps means that we'll build up enough numbers that we think will provide us with enough of the statistical power.
Louise Burke
That gives us confidence that the results that we've got are meaningful. So it'll be the same process again, just in another group of athletes who repeat the whole program and just add to our sample size.
Peter Bowes
You mentioned performance. 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
Well, it is a game changer because in sport, a very small improvement in performance, one or two percent improvement in performance is really meaningful in changing the outcomes of a race. It might not be always detectable to the eye if you like, but 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 1-2 percent on it. That's meaningful in changing the outcomes of races.
Peter Bowes
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 sometimes, it's difficult to quantify whether you feel stronger. And for non-professional athletes, measuring their ability 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
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. When you have the average person who exercises, they often misplace what they're doing. 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 frightened to hurt. Whereas athletes, that's their business.
Louise Burke
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. 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.
Peter Bowes
So the group that you're working with, are they male athletes, females, or are they a mixture?
Louise Burke
At the moment, we're just working with male athletes. And I have to say that I'm ashamed about it one level because I realized that females are underrepresented in sports science research. That's a problem because there may be some ways in which males and females differ.
Louise Burke
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, it'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.
Louise Burke
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. 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 the menstrual cycle.
Louise Burke
So it does make it a bit more tricky to do the kind of research camps that we're doing where everybody is 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.
Louise Burke
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.
Louise Burke
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. 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 some female athletes involved, so that we've done the right thing.
Peter Bowes
It's a fascinating area. Is there amongst female athletes, is that 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
Absolutely. Female athletes are becoming, understandably, quite enraged that they're being neglected when it comes to this. And sometimes it's the researcher's fault, but sometimes it's also the female athletes fault. 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 sports person. So they're working at the same time as doing elite training. Maybe the time availability is a bit more limited. But both the culture of the research and the culture of the athlete is being changed at the moment.
Louise Burke
So I hope you'll see that there's a lot more research being done on females.
Louise Burke
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... 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.
Louise Burke
And I think we're not yet there 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 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
Just in closing, this is a podcast about human longevity. We talk about health span a lot, optimizing the number of years that we are healthy, active, involved from a mental, spiritual, physical perspective as opposed to life span. 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?
Louise Burke
Well, it's a bit bold to consider myself an athlete with my caliber and traning 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. And I'm finding so far that I'm doing 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 you'd expect from the normal process of aging.
Louise Burke
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 outliving and outrunning 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. I'm still in my PBs within the last five years, 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 that 30 years ago, I didn't know about or I didn't think was important.
Louise Burke
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. I'm hoping that 60 is the new 30. 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 life span that you can manage.
Peter Bowes
Just to give a little perspective here. I suspect you've been 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
Yes. 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. But I was still able to do a 3:30 marathon. My PB is 326, 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 sub 3:30 and as many as I can. And so far, it's working.
Louise Burke
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. At the same time, it's logistically helping them to do what they're doing and observing whether it's working. I'm also getting a good workout myself. Hopefully, I'll be able to keep doing that for as long as I've got athletes that will keep riding with me.
Peter Bowes
I'm glad you mentioned 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? It's much more than running 26.2 miles.
Louise Burke
Oh, it is the fun that you have with the people around you. 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 a story and adventure in every marathon.
Louise Burke
I have a friend that I meet and we do a lot of them together. 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 play an alphabetical marathon game.
Peter Bowes
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
Well, I'm hoping to be living proof that that's not the case. I've always been careful with my training, that I don't over-train in terms of the injury side of things, and so my body is still able to manage it both from the muscle and also the joint point of view in the bones. I think if you're careful with the way that you do things... I'm probably lucky to have had the right parents and some genetic background that allows me to keep doing it.
Louise Burke
But the idea is to live your life like the way that you run a marathon, that you want to be able to take that last step in the best possible effort and get to that finish line and then collapse afterwards.
Peter Bowes
Oh, yes, sounds perfect. Louise, I really enjoyed this conversation. Thank you very much, indeed.
Louise Burke
Thanks, Peter.
Peter Bowes
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, L-L-A-M-A podcast.com.
Peter Bowes
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. 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.

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These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease. References: *Nutrition studies: 500mg Mitopure® have been shown to (1) induce gene expression related to mitochondria function and metabolism and (2) increase the strength of the hamstring leg muscle in measures of knee extension and flexion in overweight 40-65 year olds. Data from two randomized double-blind placebo-controlled human clinical trials. **Nutrition NOURISH Study: 500mg Mitopure® have been shown to deliver at least 6 times higher Urolithin A plasma levels over 24 hours (area under the curve) than 8 ounces (240ml) of pomegranate juice in a randomized human clinical trial.

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