SPEAKERS

Dr. Nick Barringer, Dr. Gabrielle Lyon

Dr. Gabrielle Lyon [0:00:01]

Welcome to the Dr. Gabrielle Lyon Show, where I believe a healthy world is based on transparent conversations.

I’m so excited to bring you this episode of The Dr. Gabrielle Lyon Show. I sit down with Nick Barringer. He is the very first at what he has done. He previously served as an assistant professor at the United States Military Academy at West Point and as a regimental nutritionist. As a member of the Ranger Athlete Warrior Program at the 75th Ranger Regiment, Nick is an Army Ranger and an Army Ranger dietitian. He’s an expert on nutrition and performance for the tactical athlete. Nick Barringer currently serves as the program director for the Army-Baylor University’s master program in nutrition. He has a doctorate degree in kinesiology from Texas A&M. He’s received his undergraduate degree in dietetics from the University of Georgia. He previously worked at the United States Army Research Institute of Environmental Medicine, and he has researched in depth warfighter nutritional requirements in various environments, including those deployed special operators.

Nick has a very unique perspective as a researcher, as a teacher, and as someone who has been deployed in all of it, as well as having been deployed in both Iraq and Afghanistan. He understands both academic and applied demands of the tactical athlete. If you are not a tactical athlete, there is still so much for you to learn from this episode because we are all trying to be the best version of ourselves. Here is what you can take away from this episode. Number one, what everyone should do for performance, whether you are technical or not. Number two, the best ways to design your macros, whether you are trying to lose weight, optimize performance, you name it. Number three, what supplements everybody should take. Please take a moment to subscribe, rate, comment, and share it with a friend. Let’s get the word out there. Let’s do right. Let’s do good science. Here we go.

A very special thank you to LMNT for sponsoring this episode of the show. As you know LMNT is an elite hydration pack. Though it’s spelled L-M-N-T, but it sounds like element. I typically use one pack a day. I’ve increased it now to a pack and a half because I’ve increased my training, and nobody told me that Houston was so hot that you literally sweat out of every orifice, probably even including my ears. LMNT is science-backed, which you know I love. It has 1,000 milligrams of sodium, 200 milligrams of potassium, 60 milligrams of magnesium. I’ve really been into the spicy habanero. I have a very exciting project coming up. I was actually asked to be on the cover of STRONG magazine. That means that my training has taken a little bit of an uptick. LMNT has been very helpful. I get a little bit of that restless leg. It’s really important that you replace your sweat, not with water but with electrolytes. That is one reason why I absolutely love LMNT. Right now, LMNT is offering my listeners, you guys, a free sample pack with any purchase, that’s eight single-serving packs of LMNT free. It’s a great way to try all the flavors. Share it with someone. You can go to drinklmnt.com/drlyon. You will get a no-questions-asked refund. Again, that’s drinklmnt.com/drlyon. I know you guys are going to love it. And there you go.

Thank you to House of Macadamias for sponsoring this episode of the show. I love this product, which is why I have agreed to partner with them. Now I have increased my diet tightness, and especially when you do that, you want to eat things that you shouldn’t, which is one reason I absolutely love House of Macadamias. They have a chocolate dipped macadamia nut, which is absolutely amazing. They also have a raspberry white chocolate dipped macadamia nuts. If you travel a lot or if you are very busy, you can get the small packs, throw it in your bag. You’re probably thinking, geez, chocolate dipped macadamias, there’s probably a lot of carbohydrates and sugar. We’re talking about 9 grams per serving of total carbohydrates, almost no sugar, and 3 grams of fiber. Fiber is also important in a diet. They have more healthy monounsaturated fats than any other popular nut, including olive oil and avocado. They’re rich in Omega-7s. They are very focused on also partnering with small farms. They’ve chosen 94 of the best farms in Africa. It is amazing for anybody who is on whatever diet. They have great reviews. If you head on over to their website, go to houseofmacadamias.com/drlyon. Use the code DRLYON for 20% off your first order. Go to houseofmacadamias.com/drlyon. Use the code DRLYON for 20% off on your first order.

==========

Dr. Nick Barringer, you laughed when I said doctor, but you are an unusual breed. You have your PhD. You are a PhD dietitian, Army Ranger, laughing about that, and you have published multiple papers. In fact, I have one right in front of me, and this is the International Society of Sports Nutrition position stand on tactical athlete nutrition. Also, program director of, is it nutrition?

Nick Barringer [0:05:48]

It’s the Army-Baylor master’s program in nutrition.

Dr. Gabrielle Lyon [0:05:53]

Father of three and husband?

 Nick Barringer [0:05:55]

Father of three and husband, I try to do those as well as others. Some days, you have to talk to my wife.

Dr. Gabrielle Lyon [0:06:02]

What don’t you do? That’s such an impressive resume and human. I have to say, I really was excited that you were open to coming on because you are somebody that everybody should know. You are extremely well-studied, well-published, and the contribution that you have made to the military is profound, so thank you.

Nick Barringer [0:06:27]

Thank you for that.

Dr. Gabrielle Lyon [0:06:30]

First, I want to talk about how you got to where you are, where you came from, as it relates to the very unusual path that you have.

Nick Barringer [0:06:38]

I grew up in North Georgia, and I went to the University of Georgia, which is having a pretty good run in football right now. I thought I wanted to be a strength coach, so I started in the weight room there for the Georgia football team and learned a lot. There was a guy, Keith Gray, great strength coach, learned a lot from him. But I just had a calling to do something more indifferent, so I joined ROTC. Then September 11th happened, and the rest is history. I was a nutrition major, so I came into the Army as a dietitian and had been doing that since.

Dr. Gabrielle Lyon [0:07:15]

When September 11th happened, did you feel that you just had to do something?

 Nick Barringer [0:07:20]

Even looking back, it was a weird feeling. I didn’t really know what was going on. I remember exactly where I was, which I think everybody does. I was sitting in the dining facility at the University of Georgia watching the screens. It had just come on, the first plane had hit. And while I was watching, the second plane hit. I had a test. I did not do well on that test that day. I had already joined ROTC, so we didn’t know what was going on. They didn’t know. Should we take our uniforms off? All these things in that chaos, but I think for a lot of Americans, galvanized that sense of purpose of there’s a reason we have this uniform on. It’s time for us to do our job.

 Dr. Gabrielle Lyon [0:08:07]

For the listener, what’s ROTC?

Nick Barringer [0:08:11]

The Reserve Officer Training Corps. If you are a college student, and you want to become an officer, most universities have those programs. It’s great because, for me, it was a scholarship. I had my school paid for by committing to the military. I’d have to go do summer trainings at different locations. We would meet up, and we’d have classes that we would do and physical training that we would do through the week. Every so often, a weekend, we would spend doing field training exercises. But then when you graduate, you have a job, which is really nice as well.

Dr. Gabrielle Lyon [0:08:48]

Is ROTC Army?

 Nick Barringer [0:08:50]

They have air force. They have Navy ROTC. It depends on where you’re at. I did Army ROTC. There was an Air Force, and there still might be at the University of Georgia as well. Whatever branch you want to get into, find a school with an ROTC program. I’d recommend it.

Dr. Gabrielle Lyon [0:09:07]

ROTC, 9/11 hit, changed your trajectory of what you wanted to do.

Nick Barringer [0:09:14]

Right. I, again, started off the strength conditioning route. Then I took a nutrition class, I really was just all in. I had been interested in nutrition, but it just fascinated me. It’s like, I need to change my major. I did that, and when I found out the army had dietitians, I chose to go that route.

Dr. Gabrielle Lyon [0:09:34]

Most people don’t know that.

Nick Barringer [0:09:35]

I know, they don’t. It’s very small, probably only about 150 of us.

Dr. Gabrielle Lyon [0:09:40]

In the entire army?

Nick Barringer [0:09:41]

In the entire army.

Dr. Gabrielle Lyon [0:09:42]

How many people are in the army?

Nick Barringer [0:09:45]

I think our in-strength right now is maybe around 500,000.

Dr. Gabrielle Lyon [0:09:48]

500,000 people and 150 dietitians.

Nick Barringer [0:09:54]

Right. Those numbers, they’re ballpark, give or take. That was also interesting when I talk to some of my colleagues in collegiate or professional sports, they talk about the dietitian to athlete ratio, and they want to complain to me about it. I’m like, trust me, because you’ll have a dietitian for an entire brigade of soldiers. You’re talking several thousand soldiers and one dietitian.

Dr. Gabrielle Lyon [0:10:22]

When you went from ROTC, how did you end up in the Ranger school? What’s a Ranger for the people that don’t know? I think my audience is pretty up to date.

Nick Barringer [0:10:37]

That was a weird space in terms of how it happened. I was lucky. When I came in as a dietitian, dietitians were always at the hospital. They were never at operational units. So I volunteered to deploy, and I was at a combat support hospital, so it’s a hospital downrange. We’re in Iraq, outside of Baghdad during the height of the Iraqi War. I was working there, and I got a call from the chief dietitian that the Rangers were looking for a dietitian. They were standing up a human performance program. This is around 2006, 2007. Would I want to try out? And I said yes. I didn’t even know what a Ranger was at the time. But I remember these individuals showed up at the hospital in the middle of the night and wanted to talk to me. They’re like, I go to the dining facility. They talk to me, they leave. I don’t know. Did I get the job or not? Then they’re like, okay, let’s try it out.

For the audience, I’ll give it. There’s Ranger School, which is a TRADOC that you can go through and you can become Ranger qualified. Then there’s the 75th Ranger Regiment, which is a special operations unit, which is the Army’s premier raid unit. If you want to seize an airfield and control space, you send those folks. If you wanted direct actions, and you have bad guys, you need, for lack of a better word, hunted down, you call the 75th. As a dietitian, it’s really unique. I went through Airborne School, I went through the Ranger Assessment and Selection program and got selected. Then I went on to Ranger School.

Dr. Gabrielle Lyon [0:12:11]

From Ranger School, what did you do after that?

Nick Barringer [0:12:15]

I went back to the 75th because the 75th, although it’s a different entity than Ranger School, to be a leader in the 75th, you need to have your Ranger tab to get respect. I always would tell some folks, because they were like, why is a dietitian going to Ranger School?

Dr. Gabrielle Lyon [0:12:32]

How many dietitians have gone to Ranger School and then gone back to the 75th?

Nick Barringer [0:12:38]

Currently, I’m the only one that’s ever served on active duty in the 75th. We just had our second dietitian get a tab.

Dr. Gabrielle Lyon [0:12:48]

Can you say that again?

Nick Barringer [0:12:49]

We just had our second dietitian—

Dr. Gabrielle Lyon [0:12:51]         

No, before that. How many in the history of the Rangers, Ranger dietitians, there is one. You’re very humble by nature. The individuals that come on to this podcast are leaders, innovators, and mavericks in their fields. You just shrug it off and say you’re doing what anyone else would do. But in fact, you are the only one. You were the first.

Nick Barringer [0:13:21]

I was the first. They got me. But it was just unbelievable times standing up that human performance program and working with that level of, as we were talking a little bit before show, professionals you see in Special Operations community. The SEALs are the same, just unbelievable individuals.

Dr. Gabrielle Lyon [0:13:39]

You know you’ve got to say that, right?

Nick Barringer [0:13:40]

I knew I’d better had to say it, and I’ll go ahead and get it out of the way. For the Rangers, what we modeled our Special Operations Human Performance Program after was the SEALs. The SEALs had it first. So I’ve got to give credit where credit is due. We went and looked at what they were doing there in Virginia.

Dr. Gabrielle Lyon [0:13:58]

When you first saw what they were eating and their nutrition, so you’d gone through school and you’d become a dietitian. Then later, did you circle back to get your PhD?

Nick Barringer [0:14:07]

Yes.

Dr. Gabrielle Lyon [0:14:08]

Okay, so you circled back to get your PhD. Why don’t you lay out that story first, because I do have some questions? As a military spouse, we joke that the breakfast of champions is a lot of caffeine, nicotine, and a Rip It.

Nick Barringer [0:14:20]

Yes.

Dr. Gabrielle Lyon [0:14:21]

I suppose the Rip It and caffeine are the same, but you have your espresso and then your nicotine gum or a dip, whatever someone is doing. I am sure that the nutrition was shocking to you and had changed. But before we get to that, why don’t you finish telling us this journey of yours?

Nick Barringer [0:14:38]

As I was coming to the end, I had been at regiment, I think, four years. Around the first or second year, I started looking and the army has something called the long-term health education and training program. Unbelievable program. You get paid to go to school and get your PhD. You’re an officer and you’re still on active duty, but your full-time job is to get your doctorate. Now you have three years where most PhD programs are five years, but it’s your full-time job. I knew I wanted to do that, so I was planning for that. As I was leaving Ranger Regiment, I applied, and I was accepted. I knew which program I wanted to go to. I wanted to study under Dr. Richard Crider, creatine expert. He had been at Baylor. He just went to Texas A&M, so that was where I did it and no complaints. Texas A&M, College Station, it’s a great location. I got to work in the exercise sport and nutrition lab, and do research on dietary supplements, things I was interested in fitness. I spent three years in A&M, graduated, and then was able to teach in the master’s program in nutrition for the first time as an instructor. Then I went to the US Army Research Institute of Environmental Medicine, where we research the nutritional needs for warfighters. I was there for a few years. Then I got to be another first dietitian at West Point teaching in the Department of Physical Education thanks to Colonel Nicholas Gist, who hired me. I was able to teach nutrition at West Point, and now I’m back as the program director at the US Army master’s program in nutrition.

Dr. Gabrielle Lyon [0:16:14]

So incredible, so much knowledge that I know that you’re going to share with us. When you got to the Ranger Regiment, what did you think about their nutrition?

Nick Barringer [0:16:26]

It’s tough finding my niche. Before that, if I want to back up, most of the needs of the army was weight loss or fat loss. It was a lot of my job, a lot of my hours I’d spent. I’d been stationed at Fort Hood. I spent my time trying to help soldiers how to lose weight.

Dr. Gabrielle Lyon [0:16:46]

Were they war fighters?

Nick Barringer [0:16:48]

War fighters, right.

Dr. Gabrielle Lyon [0:16:49]

I was just looking at that, what percent are now overweight? Do  of war fighters? I know it’s at least, I don’t want to butcher it, but I know it’s at least 30%.

Nick Barringer [0:17:00]

It’s a high number, but I never read through it.

Dr. Gabrielle Lyon [0:17:02]

I was just looking at the numbers.

Nick Barringer [0:17:03]

I don’t want to throw it out. The military is a reflection of society.

Dr. Gabrielle Lyon [0:17:10]

Even though only 1% of individuals actually are part of the military.

Nick Barringer [0:17:17]

I know it’s less than 2%, and I know 75% of the current folks who are eligible cannot serve. We struggle, just as society struggles with weight loss and obesity, military’s going to struggle with that. That’s going to affect readiness. That was where a lot of my time was spent. Now I come over to the 75th, they didn’t really have issues with weight loss. I spent more time trying to keep weight on people just because of the energy expenditure. It was a little bit different, but what I tried to sell the individuals on was performance nutrition, yet you still need to eat your fruits and vegetables, even though you have a six pack, for overall health and longevity. So we worked with the dining facility there at 3rd Ranger Battalion and did some choice architecture where we took the fruits and vegetables and put them up front. The stuff maybe we didn’t want Rangers to have, we put them towards the back. That way, they would load up their plate, then they look at it, and at the end, oh, I don’t have enough room for that cinnamon roll. My plate’s already full of fruits and vegetables.

Dr. Gabrielle Lyon [0:18:32]

Turn away from the light. when you were doing weight loss with the warfighters, how did you approach it? People who listen to podcasts are always interested in fat loss and body composition. What was your first approach? This is the, say, potentially not the elite warfighter. It’s what we would consider more of the general population recreational athlete. Would that be fair to say?

Nick Barringer [0:18:55]

Yes.

Dr. Gabrielle Lyon [0:18:57]

What did you do for them? What was the approach?

Nick Barringer [0:18:58]

Well, let me go ahead and tell them myself, my first approach didn’t work. I just gave them information. I have all this knowledge. I’m going to dump it on you.

Dr. Gabrielle Lyon [0:19:08]

That’s a rookie mistake, by the way.

Nick Barringer [0:19:09]

Rookie mistake. That was Lieutenant Barringer, brand new, who has all this knowledge out of school. I noticed I started seeing the same faces coming back and realized this is not working. I need to figure this out. How I did that was I would look at that individual soldier and try to find out what resonated with them. For instance, if I had a chief warrant officer coming in to lose weight—

Dr. Gabrielle Lyon [0:19:32]

Which is what?

Nick Barringer [0:19:34]

One officer is usually a specialist in the military. They’re either your pilots or maybe work in food service. A lot of them were prior enlisted, so they’re going to be a little older. They’re going to be more experienced, more seasoned tactical athlete, if you will.

Dr. Gabrielle Lyon [0:19:49]

More mature.

Nick Barringer [0:19:50]

More mature, if you will. I would talk to him and be like, hey, chief, do you want to play with your grandkids? Well, certainly. Well, hey, if you go down this road, it’s going to affect your ability to play with your grandkids and be present. So then that would resonate with them, and then we could coach them up and start talking nutrition. Whereas the young kids, the specialists, the privates, that doesn’t resonate with them. They’re not thinking far ahead. I remember the first day I clicked with that was when you’re flagged for being overweight, you can’t get promoted.

Dr. Gabrielle Lyon [0:20:20]

Are they using BMI or body fat percentages?

Nick Barringer [0:20:23]

Body measurements, the tape test.

Dr. Gabrielle Lyon [0:20:25]

Perfect.

Nick Barringer [0:20:26]

They’re getting taped, and so their waist is above.

Dr. Gabrielle Lyon [0:20:29]

Is it a waist-hip, or just waist circumference? Do you remember?

Nick Barringer [0:20:33]

Now we’re going to just do a waist circumference. Back then, it was neck and waist for the males. For the females, it was neck, waist, and hips at the area where the buttocks protrudes the most, like that spot at the rack. They can’t get promoted. They’re flagged. So I would calculate how much money they’re losing by not getting promoted. I would go in and say, hey, is this worth $3,000 in the bank? What are you talking about? This is free. I’m like, no, you’re basically paying this a month because you’re not taking care of your nutrition. Are you ready to take care of your nutrition, and we’ll get you that money? With them, it would resonate. It was finding, and I’m sure in your practice you do the same thing, what resonates with people? Nutrition knowledge usually isn’t the culprit. If I put broccoli and pizza in front of somebody and say, hey, which one should you probably eat most of the time? They’re going to know. But it’s more finding those motivating factors.

Dr. Gabrielle Lyon [0:21:30]

Did you design diets? If you did, how did you prioritize macronutrients, if you were to lay something out for people? How did you do it to get the maximum amount of fat loss while maintaining lean tissue? I say lean tissue because we’re not directly measuring skeletal muscle at this time.

Nick Barringer [0:21:48]

Right. It’s going to be very similar to Dr. Bill Campbell’s is I start with protein. I like to start with protein for the satiety, the same reasons, and the as far as I want to preserve that lean muscle mass, particularly in warfighters. From that, we build around. Now, I’ll still keep the carbohydrates a little higher just because of the tasks that they have to do. But a lot of it is I would use something as simple as the plate method where I would cut a plate into a quarter, and I’d be like, alright, put your protein in one corner. If you’re going to do a hard rucker run, half your plate’s carbohydrates. If it’s not a hard rucker run day and you’re just lifting weights, a quarter of it, and then put a non-starchy vegetable in there. You just give them simple tools like that because most of these, particularly young soldiers, they’re at a dining facility. What’s their tray going to look like? So I would do it that way.

Dr. Gabrielle Lyon [0:22:46]

On the back end, did you calculate? For example, if you were to give them a protein recommendation of grams per kg, did you do that? Did you think about it?

Nick Barringer [0:22:56]

Yes, anywhere from basically about point gram per pound, because I wouldn’t do kgs, so point eighth of one. Folks that are going to be in a—

Dr. Gabrielle Lyon [0:23:11]

Gram per pound, which is double the RDA, which I want to circle back in terms of nutrition got it’s footing from the warfighter.

Nick Barringer [0:23:19]

Right. Going higher protein, especially in those tactical athletes in a caloric deficit, is shown to preserve lean muscle mass. Dr. Stefan Pasiakos and Dr. Jessica Gwin at USARIEM, they’ve done great work. [Dr. Arnie Ferrante 0:23:36] who have done great work. They’ve done particularly studies where they’ve put soldiers in caloric deficits of up to 30% deficit, and they show that when they take in more protein, they’re able to preserve more lean muscle mass. Based on that, that’s what I’m going to do, and then along with the satiety factor.

Dr. Gabrielle Lyon [0:23:55]

What about carbohydrates, in terms of how much you recommend per pound?

Nick Barringer [0:24:00]

For that, it’s usually, and I don’t know if I can do a conversion per pound in my head, but it’s around 5 to 6 grams per kilogram of body weight for most people. You can go up to 10 or 12, but that’s in ultra runners. It varies on what they’re doing, but for most people, probably around that 6, if you’re more active, 8 grams per kilogram of body weight.

Dr. Gabrielle Lyon [0:24:31]

The final macronutrient, fat, is it just whatever falls within there?

Nick Barringer [0:24:35]

That’s how I would fill it in, then whatever’s left. I’m doing fat, but then I’m obviously prioritizing monounsaturated fat. I want some olive oil. I want some fatty fish, get the Omega-3s in there, and then avoiding as much as possible trans fats, even though I know trans fats are supposed to be banned, they’re still out there. You can still find them particularly in the meals that are ready to eat.

Dr. Gabrielle Lyon [0:24:56]

And especially on post. They’re everywhere.

Nick Barringer [0:25:00]

So just educating soldiers on that, and then respecting saturated fat as well. But besides that, that’s pretty much how I build the diet.

Dr. Gabrielle Lyon [0:25:10]

Simple, straightforward, easy to execute, I love it. When you think about the history, have you thought much about the history of World War I and World War II in terms of nutrition and reflected back on how we came to where we are now? I’ve spent two years writing this book. One of the things that was so profound was that the protein recommendations that they gave was just understanding that the warfighter, that really a lot of the nutrition that we see today was based on making sure that the warfighter could survive and recover.

Nick Barringer [0:25:43]

Right. We just celebrated over 100 years of having nutrition specialists in the army. What’s interesting, though, about that, we were talking a little bit before the podcast, is back then, World War One, it was about feeding people more to get them up to weight so they could go and fight, so they could they could sustain that performance. Even before we figured that out, Napoleon said an army marches on its stomach. He knew. That’s where canning came from Nicolas Appert. But now, it’s taken a little bit of a turn in that we’ve got to help soldiers get to that correct body composition. But we also want that protein intake relatively higher because we want to preserve that lean muscle mass. We don’t want to have somebody who’s skinny fat. They make the standard, but then they’re not going to do very well under load when you put a heavy rock on them.

Dr. Gabrielle Lyon [0:26:44]

Have you looked at any of the numbers during World War II, the average weight for a woman, I believe, was 125 pounds. The average weight of a man was around 145 pounds. The rations were around 3,000 calories. The idea of rationing is we’re just going to give you this much. The soldiers were given, at least they were rationed at least 1 pound of animal protein beef for recovery. I don’t know if you’ve read some of those very old papers, but it was amazing to see that we placed all this importance on the soldiers’ nutrition. At home, they were encouraged to build victory gardens. Have you read about that?

Nick Barringer [0:27:31]

Yes. I’ve read about that.

Dr. Gabrielle Lyon [0:27:33]

Yeah, victory gardens at home where we would send all the high-nutrient dense foods overseas to feed these soldiers.

Nick Barringer [0:27:40]

Yes, and that’s still something today where the concern is large-scale combat operations. You might hear a military person say LSCO, so now you know what they’re saying. In Afghanistan and Iraq, we had control of the air. We can send resupplies. If anybody who’s listening to this was at a dining facility in Iraq, they were unbelievable. We’re getting lobstered over there.

Dr. Gabrielle Lyon [0:28:09]

How is that possible?

Nick Barringer [0:28:11]

Because we had the logistics, and then Afghanistan. Now some of the combat outposts in Afghanistan had a lot more austere food, not more MRE-type foods. But for a large-scale combat operation where you might not have that, how do we feed them? Particularly, where weight becomes an issue, because you want to carry ammo, are we going allow the rations? Combat feedings work on this right now with a higher fat content to get it more calorically dense. But a concern is, how do you get fruits and vegetables? That’s something that combat feeding is looking at. One of the things that has been pitched and thrown out there is microgreens. Could you have a Conex greenhouse in a box for these warfighters in these austere environments? They could grow something a little bit like the Martian and get those nutrients because otherwise, we might not be able to get them in those supply channels because there’ll be in contested areas.

Dr. Gabrielle Lyon [0:29:11]

I guess the question is, how important is day-to-day nutrition on performance recovery? Now we’re moving into there’s the warfighter that you were dealing with that was overweight, getting their body recompositioned. Now you’re moving towards the more tactical athlete. I’d love for you to define what a tactical athlete is, and why I think this is really good for the general population as well is because they’re always searching for what does it mean to be the best version of themselves? I think that when we look at extremes, we can take extremes and take information of the things that make those individuals that are operating at extremes and move it into our own life.

Nick Barringer [0:29:47]

Yes. I couldn’t agree more. For tactical athletes, the simple definition I use is if you rely on your body for your work, you’re a tactical athlete in a way, and that might be a loose interpretation. The individuals we typically consider is obviously the military, police, firefighters, EMS, and I’m so happy that there’s now that term and that focus on it. It was relatively recent, around 2007, I think, the National Strength Conditioning Association stood up the tactical side. What I saw coming in, especially from the experience I had at the University of Georgia with their football team and having colleagues working in the professional athlete setting, they would know how long a quarterback needs to be back in the pocket before they release before they get sacked. They have all these numbers and stats. I look at the military where we do this from, we don’t have any of that. The three- to five-second rush, we don’t even know how fast a soldier should run to maximize them not getting shot. When you say, I’ll get up and run for three to five seconds, that’s not really definitive in terms of how many meters and so forth. Now that there’s a focus, we’re getting more science. We’re getting more scientific towards that. That’s where it’s really exciting is honing in on these tactical athletes. There is a spectrum in terms of the basic soldier or warfighter or police officer, all the way to more elite, which would be special operations, SWAT, etc, and so the needs are going to change for both those spectrums.

Dr. Gabrielle Lyon [0:31:26]

When you are identifying and building out a plan for the tactical athlete, the elite warfighter, how is that built? Is the foundation in hydration or nutrition? What are some of those numbers? I will link to all these papers, especially this one, this International Society of Sports Nutrition for the stand on the tactical athlete. How do you think about priorities for their nutrition first? I suppose we’d start with nutrition and then maybe move over to supplementation.

Nick Barringer [0:31:57]

Right. One, and I was given this by a great coach and mentor, Martin Rooney, who was always like, the best ability is availability. Let’s focus on a basic nutrition plan that they’re getting plenty of fruits, vegetables, or plenty of good color on their plate, so they stay healthy. We can talk about performance, but if you get sick, and you can’t go out on target, you’re no good to the team.

Dr. Gabrielle Lyon [0:32:25]

I want to stop you for a second. You’re saying fruits and vegetables are healthy for you.

Nick Barringer [0:32:31]

Yes.

Dr. Gabrielle Lyon [0:32:31]

Yes, I agree. They have fiber, and there is a place for them.

Nick Barringer [0:32:35]

Yeah, that could be a whole another one as far as when I first started nutrition to now, if you told me back then I would have to try to convince somebody that not just eating meat all of the day is probably not the best idea would interesting.

Dr. Gabrielle Lyon [0:32:53]

I always had that experience in terms of in this space. We weren’t really talking about the qualities of protein. It was never a big discussion. It wasn’t a big discussion when you were going through, is that true?

Nick Barringer [0:33:04]

Right. No, it was food guide pyramid, I’ll date myself, RDA. Carbs were king, and carbs are great. I love carbohydrates, but it was very focused on that. Creatine would dehydrate you. It might make you more susceptible to heat injury. We now know that it actually can help preserve it. It doesn’t dehydrate you. Too much protein will hurt your kidneys. You have all those things. Now, I think we’ve come a long way from that. But the basic of a healthy diet we want to have, because again, if you’re more resistant to get sick, all those factors, you have a health gut microbiome—

Dr. Gabrielle Lyon [0:33:47]

We’re definitely going to talk about that. That, I believe, is the next frontier.

Nick Barringer [0:33:50]

Right, because one of the things that’s still very pervasive in the military is traveler’s diarrhea. I did a paper with Dr. Will Conkright, and we looked at a special operations group in Afghanistan. A lot of them reported traveler’s diarrhea. Then we asked them, how long do you think it affected your performance? Some said up to 20 days. Then we asked them, how many of you went to see medical attention? Zero. How many of you didn’t go out on target because of it? Zero. They’re in a compromised state going out on target. When I say target, these are where the bad guys are. These are where they’re doing their job, where they could make contact with the enemy night after night, and they could be in a compromised state. Something as simple as making sure we maximize the gut microbiome to make you resistant to that, getting fiber, getting all that in is very important. I start off with health.

Dr. Gabrielle Lyon [0:34:53]

Do you have a recommendation that you give the tactical athletes, just how many servings? Are they even thinking like that if they’re not eating that? Are they having some kind of green or red powder? Now, this is interesting. We’re not even talking about macronutrients so much. We’re talking about the phytonutrients.

Nick Barringer [0:35:14]

That’s one of the things with the MREs, they’re high in most of the micronutrients. They have a lot. But vitamin K is one of the ones that they’re low in because there’s not a lot of ways to package those leafy greens. What is vitamin K important for? Clotting. That can be very important in a combat situation. How do we get that in? That’s where the discussion with the microgreens again, we’ve been, I don’t want to say lucky, but in terms of in our recent operations, we’ve been able to get fruits and vegetables to two locations, probably not as much as some locations that we like, but we can still get those there. If they cannot get those there, then that is where I would consider some sort of green, dehydrated product.

Dr. Gabrielle Lyon [0:36:09]

I use one all the time.

Nick Barringer [0:36:09]

If we could get it because it’s convenient. Much better if you could eat a salad, eat a salad. When people talk to me about protein powder or eating a chicken, can’t you just eat a chicken? Yeah. Is grilling a chicken always convenient after a workout? No. Shakes can be good.

Dr. Gabrielle Lyon [0:36:24]

Yeah, or if you have three kids, and you’re running a business.

Nick Barringer [0:36:27]

Right. It’s the same with this is dehydrated fruits and vegetables, whatever you can pack in, getting those in is a lot of it. From there, once I have the overall healthy diet, we start looking at performance optimization. But the base of a performance pyramid is a good diet, sensible training program, sleep is another huge factor I see we’ve talked a lot. I know, sleep when you’re dead. No, that is that is a huge factor. Once you get all those dialed in, now we can start talking about supplements. But what I’ve found, and the Special Operations community is very guilty of this, and I’ll tell this story. I was down at 3rd Ranger Battalion looking at wall lockers, I was walking around. I can’t remember why I was there. But there was a wall locker that looked like a GNC store, all the supplements, and there was like a Burger King bag in front of it. It’s like we’ve got to prioritize. Get all those right. If you’re not focusing on those, focus on those. Get all those right, and then let’s talk about dietary supplements.

Dr. Gabrielle Lyon [0:37:38]

The calorie need for a tactical athlete is could be anywhere from an extra 3,000 calories a day, depending. How do you balance? When you’re talking to them about macronutrients, is it about overall volume? Do you say, 40% is going to be protein, 40% is going to be carbohydrates? How do you balance with them in terms of meeting their needs? What are those needs, and how do you even think about that?

Nick Barringer [0:38:05]

Great question. There are a lot of different variables in terms of what’s going on. If they are in a school scenario or a training scenario where the energy expenditure is just going to be through the roof, that just becomes a game of just getting enough calories and keeping that caloric deficit to less than 30%. We find that once you get like a 30%, the wheels fall. No matter how much protein you take, you’re going to go catabolic.

Dr. Gabrielle Lyon [0:38:33]

For the listener at home, a school or training, they’re training up for deployment. They’re acquiring a skill, or they’re practicing.

Nick Barringer [0:38:42]

Right. Those type of scenarios, they can be on their feet 16, 17 hours a day, which unless you’ve done that, you burn a crazy amount, and you’re carrying anywhere between 50 pounds to 120 pounds depending on what’s going on. The energy expenditure is through the roof, 5000 to 7000 calories a day. That becomes a chore, and particularly when you’re talking about you’re moving that long to eat. The strategy is just get as many calories as you can, which is hard. Otherwise, I’m calculating the protein, giving them what that looks like and how to get it in. Then for most of the tactical athlete, I’m going 50 depending on what they’re doing. It could be 60% carbs depending on how much aerobic work they have. The physiological facts, unless someone knows different that’s listening, is you get more ATPs per liter of oxygen from carbohydrates. You can’t get around that. There’s been multiple studies that have looked at that where, yeah, it’d be great if we could get athletes to run off fat.

Dr. Gabrielle Lyon [0:39:54]

That was actually a question that my husband had. You’re absolutely correct. One of the things he was asking was that he said ask Nick this. For those of you don’t know, my husband just ran the Boston Marathon, and he was a SEAL for 10 years. He said Zone 2 nutrition for endurance athletes, he said, the military are supposed to be the most trained in Zone 2. This was his statement whether he’s right or not. One of his questions was most marathoners prefer a carbohydrate fuel source, but there’s a minority of these highly trained athletes who are optimized to do so using fat as a fuel source. One, he wanted to know, is that true? Where is the confusion, because there’s a lot on social media, a lot with the influencer space where it has demonized carbohydrates, which I agree with you, I am not anti-carb at all.

==========

Thank you to 1st Phorm for sponsoring this episode of the show. Let’s talk creatine. Creatine is critically important, especially as it relates to brain health and muscle function. It is one of the most well researched supplements on the market. Creatine has absolutely made a name for itself. It’s been proven since the ‘90s. 1st Phorm makes a great Micronized Creatine Monohydrate. You can head on over to 1stphorm.com/drlyon. If you have never tried it, I would seriously consider it. It’s easy, 5 grams a day, whether you are male or female, whether you are postmenopausal, whether you are andropausal, you name it, or if you are just trying to improve explosive power and strength, increase muscle cell volume, this is for you. Head on over to 1stphorm.com/drlyon. I strongly encourage you to add creatine to your program. Give it a try. See how it works for you, and let’s see what we can do.

A special thank you from InsideTracker to you for listening to the show. InsideTracker is incredible. It’s an incredible service. It offers a way in which you can look at up to 47 biomarkers through the blood. It is incredibly comprehensive. There are multiple different plans, people age, and have different experiences. This is reflected in bloodwork, and the only way to figure it out is to measure your blood, take a look at it, and pivot if you need to. InsideTracker is offering you as a thank you 20% off. I recently had this done. It was such a good experience. I had Scarlet come and draw my blood. I got my InsideTracker panel. I was able to look at where I am, where I need to go and my age, not chronological age, but my health age. I got a daily action plan. It had guidance on exercise, nutrition, you name it. It was absolutely incredible. If you have not done this yet, I strongly suggest that you do. For a limited time only, you’ll get 20% off the InsideTracker store. They are frequently adding new biomarkers, which is absolutely incredible. They recently added ApoB. This is critical to understand your risk for heart disease. It is a biomarker that is going to be coming to the forefront more and more as we think about heart health and aging. Don’t wait. Head on over to insidetracker.com/drlyon.

==========

How do we put those pieces together? You have had a lot of experience dealing with the warfighter and the tactical athlete. I realized that tactical athlete falls under a huge umbrella, but the most elite that are protecting our world, so you better get it right. No pressure.

Nick Barringer [0:43:40]

Thanks, Shane. You can fat adapt. You can train your body to oxidize more fat, and you can get better at it. Dr. Jeff Volek has shown us. He’s one of the experts in that area. However, going back to my earlier statement about ATPs per liter of oxygen, carbohydrates are going to give you the most. If you want to go fast, you have to use carbohydrates. Dr. Louise Burke out of Australia, she did a study I point a lot of people to with racewalkers where she took elite-level racewalkers and put them on a higher fat diet and looked at their performance versus when they were on higher carbohydrates. When they were on the higher fat diet, they were closer to their VO2 max. They had to consume more oxygen to use that, so they fatigued more quickly. They were slower. To put it in simple terms, Kipchoge ain’t going high fat. I can tell you when he broke that marathon, he’s eating carbohydrates. The fastest people in the world are eating carbohydrates. I also have friends who work in the professional athlete space, the NFL, and they’re not putting those guys on high-fat diet, have them run on fats during the game. No, they’re giving them carbohydrates. To me, I haven’t seen any way to get around that. If you want to run, and you want to avoid carbohydrates and run off of fat, that’s fine. Will you break any world records? Probably not.

Dr. Gabrielle Lyon [0:45:19]

I agree with you. What are some carbohydrate sources that you recommend?

Nick Barringer [0:45:25]

It depends on the situation. If just eating normal diet throughout the day, I want some more complex carbohydrates, I want some fiber in there, those sort of things. When we’re getting closer to a competition or an event, I want it to be simple. Obviously, when it’s during the event, I want it to be as simple as possible. I mean, that’s why with some of these ultra runners, you’ll see them drink flat Coke during an ultra. We’re talking beyond a marathon, people are, I don’t understand them, masochist. You do those, but I had a few buddies who’ve done those. At that point, again, it’s getting those simple carbohydrates in. Now, throughout the day, should the average person be eating much simple carbohydrates? No, that’s going to lead down a bad road. But for the most part, I want whole grains with some fiber in there throughout the day, whether that’s brown rice, whether that’s whole wheat bread, whether that’s some sort of pasta, quinoa, bulgur, it’s going to depend on what you like.

I like a variety of it all. Sometimes I like to eat a little pasta. I like pizza, a really good pizza, not a fast-food pizza, but one of the places with the woodfired oven-type places. I’ll do that on occasion. It just depends on what you like. Again, we’re humans. I really liked what you and Dr. Bill Campbell were talking about as far as with the diet breaks throughout, in terms of, yeah, it’s really hard. I can structure you a meal plan. It’s really easy to structure somebody’s meal plan to lose weight. It’s really easy to do it. To follow it and to have compliance and to do it day in day out, psychologically, that’s the challenge. So I think we got to be reality based. Like he said, he ain’t giving up his chocolate chip cookies, I can tell you, I’m not giving up my pizza.

Dr. Gabrielle Lyon [0:47:22]

When you think about mixing a meal, do you talk to your athletes about ratios? Do you want them to have carbohydrates? Let’s say they’re not in an active situation. They’re not running a marathon at the moment, but they’re at home on a weekend, do you teach them about how they would structure the meals? Do you recommend a solo macronutrient, for example, I don’t know, snacking on a bowl of pasta, or do you recommend mixing it?

Nick Barringer [0:47:51]

I like mixing it. I wouldn’t recommend, again, if you’re sedentary, just snacking on carbohydrate because you’re not getting satiety out of it. You’re not getting a lot of bang for your buck in terms of those calories. So I might replace that with something like almonds in terms of now you got some protein, now you got some fat, you’re going to get some satiety out of that. Whereas we’ve all probably been guilty of it, I know I have, you get some chips in front of you, next thing you know, the bag disappears and you’re like, what happened? I want some protein and some good fat spread throughout in all those kind of snacks and then also just getting the protein to maximize protein synthesis, if we’re trying to really promote either muscle preservation or gaining muscle mass for a lot of people.

Dr. Gabrielle Lyon [0:48:43]

Especially as the warfighter ages, it’s interesting when we think about it, the aging warfighter, I would say that their trajectory for aging is faster just because of the amount of load and exposure that they have over a lifetime. That’s interesting to see the warfighter. Now, if you were to pick, would it be sleep or supplementation? We cover nutrition. We think about a well-designed training program. Is it sleep or supplementation?

Nick Barringer [0:49:16]

That’s an easy choice for me, and I’m going to give a shout out to Dr. Allison Brager, great neuroscientist of sleep, I’m going to pick sleep. That’s me as a dietitian because sleep drives so many of your decisions. I’ll tell the story real quick. When I was at regiment, I had a ranger brought to me, and he was falling out of runs. His team leader brought him to me and he was like, we need to do something with his nutrition. As I was talking to him, he wasn’t sleeping. He was staying up in the barracks because sleep was a crutch.

Dr. Gabrielle Lyon [0:49:46]

What was he doing? Was he playing Xbox?

Nick Barringer [0:49:49]

Yeah, all of the things.

Dr. Gabrielle Lyon [0:49:51]

Did he have sleep apnea?

Nick Barringer [0:49:53]

He did not have sleep apnea. He wasn’t what we’d call over fat or anything. He just wasn’t getting sleep. So I was like, look, we’re not even going to talk about nutrition. But they thought it was a nutrition issue, because he fell on these physical events, so they thought maybe he’s not eating right. I said, I don’t even want to talk to you about nutrition. Here’s what I want you to do. I want you to go and get seven hours a night this next week. Do it. Roger that, sir, whatever. He comes back to me, and he’s like, I feel amazing. This is great. I’m eating better. He was making all these poor habits. He’s staying up late, so then he’s eating this stuff out of a vending machine, all these factors. I mean, sleep’s big. If you’re not sleeping, don’t talk to me about creatine, unless you’re in a situation where you don’t have a choice. That’s a different animal.

Dr. Gabrielle Lyon [0:50:40]

A season. If you have a five-month-old or—

Nick Barringer [0:50:43]

Right, and now I’m talking to you about creatine to maybe improve your cognitive benefits while you’re sleep deprived. We’re talking about caffeine, so you don’t leave your toddler somewhere and forget, and get your car and drive off. We can talk about supplements to maximize your performance as much as you can when you’re sleep deprived. That’s a different topic. But if it’s a self-inflicted wound, they need to address that first.

Dr. Gabrielle Lyon  [0:51:10]

Do you recommend seven to eight hours?

Nick Barringer [0:51:11]

Yes.

Dr. Gabrielle Lyon [0:51:12]

More?

Nick Barringer [0:51:13]

Depending on what you’re doing, it could be more. I think LeBron James sleeps 11 or 12 hours at the height of the season. On our deployment to Afghanistan, I was working in the operation center. I was basically doing a job behind a screen where I’m trapped to things. I was sleeping probably 10 hours a night. I just work out and sleep. I felt like I was on, not that I’ve ever been on, but if you told me what a performance-enhancing drug would feel like, I thought I was on one. I’d go to the gym. It was amazing. For some athletes, if you’re really hitting it hard, I think yeah, you probably need some more sleep. Just sleep until you wake up, if you don’t have to set an alarm. I track mine. I’ve got, as you see, different tracking devices.

Dr. Gabrielle Lyon [0:52:04]

I see a Whoop on there. We love Whoop.

Nick Barringer [0:52:06]

Yeah, I’ve got my Whoop. I just started using that. I track with Oura. I track it, and then I work with a few folks on the outside like athletes, one professional athlete in particular. Every day, when I get up, I’m looking at the sleep data and be like, hey, what happened? It’s that important.

Dr. Gabrielle Lyon [0:52:24]

What about supplementation?

Nick Barringer [0:52:27]

I personally supplement. As a dietitian, I get asked, what do you use? Should I jump to that?

Dr. Gabrielle Lyon [0:52:33]

I’m sure everybody wants to know.

Nick Barringer [0:52:36]

I take vitamin D. The reason I take vitamin D is we have vitamin D receptors in our muscle and in our brain. If you look at a lot of literature, most of us are maybe not deficient to get rickets, but we’re insufficient.

Dr. Gabrielle Lyon [0:52:50]

Where do you like to see vitamin D numbers in the blood?

Nick Barringer [0:52:55]

At least 50 to around 80 nanograms per deciliter.

Dr. Gabrielle Lyon [0:52:58]

I totally agree with that.

Nick Barringer [0:53:02]

I take 2,000 IUs, nothing too crazy, sometimes up to 5,000. This isn’t medical advice. I’m just throwing out what I’m doing. I know 800 IUs is the–

Dr. Gabrielle Lyon [0:53:16]

We recommend it. In the practice, we recommend between 2,000 to 5,000. If someone is deficient, we go higher.

Nick Barringer [0:53:21]

Right. I’ve seen somebody who was even up to 50,000 IUs. There are even some arguments that if you have enough vitamin K on board, if you’re taking them concurrently, it would be hard to OD. I’m not doing that as a challenge. I take vitamin D in that range. I take Omega-3 fatty acids for the eicosapentaenoic acid, docosahexaenoic acid, one for muscle, which Dr. Jeffery Heileson has done a lot of great papers on. I got Dr. Mike Lewis who’s done a lot of stuff with brain health, and he turned me on to that with his work with Dr. Julian Bailes of the concussion fame.

Dr. Gabrielle Lyon [0:54:03]

How many grams of Omega-3s?

Nick Barringer [0:54:05]

I’m taking 3,000 to maybe some days, 5,000 milligrams per day. Most studies, you see benefit at 2 grams per day. Dr. Jonathan Oliver, he’s a friend, he did a study out of Texas Christian University where they followed football players throughout the season. They had lower top proteins on those that took the 2 grams per day. It’s really hard to do a control brain injury study, but the animal models, it’s quite compelling. I’m taking a high-quality Omega-3 supplement, keep it in my refrigerator.  I tell everybody don’t take your rancid Omega-3s. I’m taking creatine monohydrate 5 grams. I think the International Society of Sports Nutrition, 0.3 milligrams per kilogram of body weight. I think around there, but 5 grams for most people’s probably in there.

Dr. Gabrielle Lyon [0:54:58]

No loading dose.

Nick Barringer [0:54:59]

No loading dose. If somebody had a task that was coming up and they weren’t on creatine and they wanted to get to that level, then maybe a loading dose seems beneficial. But you’re going to reach saturation within 30 days. It’s from what I’ve seen. I take magnesium.

Dr. Gabrielle Lyon [0:55:19]

Any particular form?

Nick Barringer [0:55:21]

I had been taking the bisglycinate. Now, I’m on the threonate because I read it’s more absorbed throughout the brain to pass the blood-brain barrier. I take a little collagen, and that’s just not so much for my great skin, but for joints based on the research with Dr. Keith Baar, if I can take  10 grams before with 48 to 50 milligrams of vitamin C to help. That’s pretty much it. I think I’ve hit it. I’ve used Beta-alanine before as well if I have a hard anaerobic training coming up. I don’t use it regularly, but that might be something.

Dr. Gabrielle Lyon [0:56:20]

You know what I think is going to be the next big thing, which is just as big as fish oil is urolithin A. Have you heard of urolithin A?

Nick Barringer [0:56:28]

No. 

 Dr. Gabrielle Lyon [0:56:29]

I will send you some literature, 20 years of research, urolithin A helps with mitophagy, 500 milligrams a day. Shane uses 1,000. I use it. I’ve never seen a compound be this promising since fish oil, since Omega-3 fatty acids.

Nick Barringer [0:56:50]

All right. Well, I have to get on that.

Dr. Gabrielle Lyon [0:56:53]

I think that there’s something new, Ursolic acid. It’s a compound in apple peels. I haven’t taken a real deep dive, but I think that there’s a lot of promise to that with body fat, weight, somewhat of weight reduction. I think it’s a TBK1 inhibitor or something like that. I’ll let you know back on the Ursolic acid, but this urolithin A, I’ll send you some literature on it. It’s pretty amazing.

Nick Barringer [0:57:21]

I’ve also taken Nicotinamide riboside. Have you done any NAD?

Dr. Gabrielle Lyon [0:57:25]

I haven’t because I just don’t know about the half-life and the utilization of the half-life, whether it’s the oral absorption is adequate. What about glutathione? Do you ever use glutathione?

Nick Barringer [0:57:39]

I’ve taken it. I don’t take it religiously currently. That might be just because of the chaos in my life right now. I don’t know if I can do anything else. I’m shifting. I’m 43 now.

Dr. Gabrielle Lyon [0:57:56]

Congratulations.

Nick Barringer [0:57:57]

Thank you. I made it. But it is funny because when I first started nutrition supplementation, it was all bigger, faster, stronger, bigger, faster, stronger. That’s all I cared about. What would make you bigger, faster, stronger? Now I’m like, I got my youngest. I’m going to be 60 when he graduates high school. I need to be healthy. So I’m just now getting into looking at the NAD, the glutathiones, the longevity side of the supplementation.

Dr. Gabrielle Lyon [0:58:23]

I would say urolithin A, methylene blue, and then there’s a couple nootropic-type supplements that I think are amazing, or I don’t even want to say supplements, compounds. I want to switch gears to something that’s really been on my mind. This is the gut muscle access. I don’t know if you’ve thought much about it. I did a very interesting interview with this guy named Dr. Gregory Lutz. Have you heard of him?

Nick Barringer [0:58:52]

I listened to it on the way down here.

Dr. Gabrielle Lyon [0:58:54]

How interesting. I was blown away.

Nick Barringer [0:58:56]

Microbiome in the discs.

Dr. Gabrielle Lyon [0:59:00]

It made me think we see a lot of these young guys coming in with injuries that don’t recover or seem to get worse. It made me think about it as I was listening to some of your lectures. I’ll link it; you do a great job speaking, phenomenal. One of the things that you bring up that I think the operators, the military misses quite a bit is this gut health issue. I think it’s a blind spot because we don’t have great ways of testing it. Using PCR testing misses at least 50%. We see guys in the practice that have recently transitioned out. We take care of special operators, recently retired, and their family members. What we almost always see or what we hear is that a guy comes back from deployment, he’s fine. His wife all of a sudden gets some kind of major GI issue that looks like traveler’s diarrhea or something of the sort. We treat her and treat him, everybody gets better. We just don’t have great ways of testing. We used to use infectious disease individuals that we’re doing stool samples, looking under the microscope. There is something there. And then we see guys that from one platoon come home, and two years later, they all have their gallbladder out. It’s not per se, the environmental exposure that you would think from any kind of chemical, but it’s these bugs. I don’t know where the army is going or where the dietetics lane is going. Are you guys making an effort? Is there capacity availability to look more at this gut health situation?

Nick Barringer [1:00:43]

Yes. There’s one individual, I’m going to say his name, that got me interested in all this is Dr. Phil Karl. He’s at the US Army Research Institute of Environmental Medicine, and this is what he studies. He studies the gut microbiome, and so deals with a lot of poop.

Dr. Gabrielle Lyon [1:00:59]

Poor guy, gross.

Nick Barringer [1:01:03]

I usually always have him talk to my students. The Army is trying to figure out ways to make folks more resilient to that. To your point, I did a stool sample test. It might have been about a year ago now. It was interesting because one of the questions before I sent him a sample was talking about antibiotic use, like how many times. I really haven’t had a lot of infections in my life, so I was like, I’m good. But then when I got my sample back, I think it was beta diversity [beta diversity? 01:01:33], there were some things that were flagged because it looked like I’d used antibiotics a lot. Then it hit me. My entire time in Afghanistan, the anti-malarial, I’m taking Doxy. I think there’s something there with that as well. It’s not just the environment that we’re in and some of the gut the microbes you might get exposed to, but the anti-malarial of choice is Doxycycline. So all of these warfighters, if you’re anywhere where malaria might be, you’re taking that the entire time. There’s no protocol that we have to try to eat yogurt and kefir, and in a lot of those locations, you don’t even have that. I think there could be something there as far as the chronic use of antibiotics throughout the military, and then you come back, and now we have all these folks with these gut issues.

Dr. Gabrielle Lyon [1:02:21]

I think that that’s where I’m hoping things will move because again, just with this conversation of the microbiome in the spine makes me think, well, that probably is the same thing in muscle and the same thing and fascial tissue. Now I want to tell you how I first heard about you, and this is a shout out to our mutual friend, Dr. Andy Galpin. I reached out to Andy because I was having guys come in to the practice that were trying to screen up or go through BUD/S, and the selection process BUD/S, and I wanted to know what do we do for hydration? How does that work? And so he said, you got to talk to my buddy, Nick. This is his wheelhouse. How important is hydration when it comes to performance? For the guys out there listening who are potentially thinking about trying to get through BUD/S or trying to get through Ranger school or I guess it’s Ranger selection.

Nick Barringer [1:03:16]

Yeah, and Ranger School as well. Not to overstate it, but it’s everything right in the moment. When we talk about, you’re dehydrated, we know that can affect your fine motor skills, so now marksmanship, those things can be off. Decision-making processes can be off. You affect your blood volume. Now your heart’s got to work harder. You’re at a higher heart rate than you normally would be, so maybe you fall out of that run, or you don’t make that ruck you would normally make during train up. The other end of the spectrum is now if you become a heat casualty, that can take you out of training, go into Rhabdo,  do permanent damage to your to your health and to your systems. Being on top of hydration is extremely important, particularly in the selection environments. We were doing selection in Ranger Regiment in Fort Benning, Georgia, I don’t know if you’ve been there. It’s really hot and humid.

Dr. Gabrielle Lyon [1:04:15]

No, I’ve just been to Texas, and I’ll tell you what.

Nick Barringer [1:04:17]

Yeah, it’s up there. I don’t know if you want to talk about what I did.

Dr. Gabrielle Lyon [1:04:25]

Yeah. I’m so curious because people always talk about hydration and how much water should I drink? Does it matter? Should we be replacing electrolytes? Should we be replacing other things? Is straight water adequate?

Nick Barringer [1:04:37]

For most of us just hanging out today or whatever, straight water is adequate.

Dr. Gabrielle Lyon [1:04:43]

You didn’t know that we’re doing a 10-mile run when we get to the park with the kids?

Nick Barringer [1:04:48]

That might change. I might need some electrolytes then. But I dealt with this problem when I got to Ranger Regiment. One of the first problem sets as a dietitian I got to deal with was for their, it was at the time, the Ranger Indoctrination Program or RIP, which is now RASP 1, so if you are an E-5 or below, it’s what everybody’s coming into. The vast majority of rangers are coming through that program. The culminating 12-mile road march, they had a lot of heat injuries. So the commander came to me, alright, dietitian, do your dietitian thing. Figure this out. I looked at the situation, and the first thing I noticed was, it was on a Monday, so they’re coming out of the weekend. That was that was one. The other piece of it, I was like, well, let me see how I want to track hydration. I called a good friend and colleague, her name is Karen Daigle. She was at the Olympic Training Center at the time, and they used the refractometer. Because again, this is 07, and people might be using it more. But a lot of people are using refractometers handheld to look at urine specific gravity. She gave me a protocol.

Dr. Gabrielle Lyon [1:05:56]

What’s that for the people listening?

Nick Barringer [1:05:59]

It’s a little handheld device. It looks like a scope almost. You put a drop of urine on it. Then based on the light passing through, it’ll give how much solute is in the liquid. Based on how much solute, that’s your hydration status.

Dr. Gabrielle Lyon [1:06:21]

Is that something that people could order online?

Nick Barringer [1:06:23]

Yeah, they’re probably like $60, $70. I ordered that not knowing that was going to require me to test a lot of ranger urine.

Dr. Gabrielle Lyon [1:06:32]

Yeah, I was just thinking. You realize now that it was a bad choice.

Nick Barringer [1:06:37]

I got some medics. I talked, and then I looked at the literature on rehydration. If you’re dehydrated, how long does it take? We laid it on around 48 hours, to give them 48 hours. I talked to the commander, and I got him to agree. I said, hey, I’m going to test these guys on Friday. I’m going to pull out the people who are below a certain level. I’m going to tell them all, I’m going to retest you. This is what you need to do to get hydrated to adequate level. Then, oh, by the way, on Monday, if I test you and you fall below this level, you can’t do the 12-mile ruck march, which means you can’t be in Ranger Regiment.

Dr. Gabrielle Lyon [1:07:10]

Oh, that hurt. And everybody passed?

Nick Barringer [1:07:13]

That was it. Everybody passed. 60% of them were dehydrated on Friday. The other piece was talking to them about alcohol over the weekend and all those things. Look, gentlemen, you can celebrate after you pass this event. Let’s not sell it this weekend. Let’s hydrate.

Dr. Gabrielle Lyon [1:07:32]

What did you give them, sodium, potassium? What kind of hydration solution were you using?

Nick Barringer [1:07:38]

Nothing magical in terms of this whatever we could get through class VIII, which is the medical supply. You get rehydration beverages. In the military, we can get them through class VIII, which is medical. I won’t name the specific products, but there was a rice-based oral rehydration beverage. There were some other oral rehydration beverages, some sodium, some carbohydrates, some potassium, nothing fancy. People ask me, what’s your go to choice? I’m like, whatever one you like to drink. Because there was a military, and it was literally oral rehydration salts or whatever. Horrible. Nobody wanted to use it. So again, it wasn’t beneficial. Yeah, if you drank it, it gave you all the right stuff. But it didn’t taste good. So we gave them stuff that had some flavor to it, and they drink that throughout. You do also have to worry about the military hyponatremia. We’ve had a few cases of hyponatremia. There was a case, I think it was around 2017 in Ranger school, they had a ranger pass, and then they have since got a high stat where they can do blood sodium on the spot.

Dr. Gabrielle Lyon [1:08:47]

Basically, he drank too much plain water because you essentially want to rehydrate with what you’re sweating out, which you’re not sweating out water, you’re sweating out sodium and all kinds of things. That’s really helpful. Where do you think that– okay, so before I ask this question, I’m not sure exactly how to ask this question. Do you think that there are ways in which we can prep people to pass selection? How do we tell? Do we have more capacity to look at who is going to get through selection? I know we’re talking about biomarkers. It’s so interesting. You mentioned a little bit about global strength. Do you have any thoughts personally on it? Does it help if we identify early the people that are going to get through or perhaps weaknesses where we can help them up? Or maybe is that not the point? Is it really just whoever is toughest and most capable gets through? I know this is a hard question because from some of the guys’ perspectives, they’re like, well, if they can’t hang, we don’t want them next to us during war. So they shouldn’t get the help, right? I know this is a tough question because from some of the SEAL guys that I take care of, they’re like, well, if he can’t do it eating potato chips or whatever, then he shouldn’t be, and I don’t want him next to me. They don’t say that exactly, but you know what I mean.

Nick Barringer [1:10:16]

It’s tough because I’m scared if we keep going down that road, there might not be anybody next to him, right?

Dr. Gabrielle Lyon [1:10:25]

It’s a really good point.

Nick Barringer [1:10:29]

Not all, and I think it’s getting better, the way I see some selection programs is much like the old Soviet model for athletes, is you throw them against the wall, whichever ones don’t break, those are your Olympians. That works if you have a very huge group that everybody wants to be Olympians to get out of poverty or whatever. You can throw China in the same scenario. But we’re not going to have that luxury very soon, so we need to be smart about it. If we have an individual who is fit, strong, intelligent, tough, but gets shin splints and falls out because you’re running him 20 miles a day, even though you’ll never do that operationally, some of the stuff you do in selection that aren’t operationally relevant, yeah, it shows mental toughness, you can say that, but if you’re breaking them, then why not do it? We can have that person in the fight. So for me, I think we should approach it a little more intelligently, not trying to besmirch any assessment or selection process. I don’t need those folks mad at me. I don’t need that smoke in my life. Back to the question about biomarkers and things that might make people more likely to pass, I would never want to screen out individuals ahead of time based on a cheek swab. What I think we could do is take those and then figure out how we can close the gap. One, how we can close the gap in individuals as they’re coming through the program, but then let’s look out to the broader army, can we close the gap and get them closer to Special Operations?

Dr. Gabrielle Lyon [1:12:12]

That’d be incredible.

Nick Barringer [1:12:13]

That’s the way why I’m interested in this research and all these different things. Like I said, there’s a researcher, Dr. Emily Farina who’s done a series of papers. The lead author was actually Dr. Jesse Stein on this most recent paper I was reading, where they’re looking at biomarkers, but it’s looking at people in the Special Forces Assessment selection program who passed or didn’t pass. They found that those that are more fit are more likely to pass. Those that eat a healthier diet, they did a diet quality, a healthy eating index, are more likely to pass. The biomarkers of those that eat more fruits and vegetables tend to show that those are going to be the ones that are going to pass the selection.

Dr. Gabrielle Lyon [1:12:57]

What are biomarkers?

Nick Barringer [1:12:59]

Some of the markers in the blood, do you want the specifics or the ones they’ve been on?

Dr. Gabrielle Lyon [1:13:04]

No, I was just wondering, was it hsCRP? We’ll take a look.

Nick Barringer [1:13:11]

Yeah, we can look. No, it wasn’t just that. These were metabolites from the things that they had consumed. Yeah, it was a really nice pair. I think it looked like 130 metabolites. But Dr. Jesse Stein, and we can link the paper.

Dr. Gabrielle Lyon [1:13:27]

Yeah, we’ll link it.

Nick Barringer [1:13:29]

I think it came out in April.

Dr. Gabrielle Lyon [1:13:30]

We’ll get that person on the show. Put in a good word for me.

Nick Barringer [1:13:36]

Emily would be the one. She’s the one that oversaw that. She’s similar situation to you. Her husband comes from that environment. She’s really done a lot of research there, and it’s just great in terms of looking at these special operators because it cost a lot of money to make a special operator.

Dr. Gabrielle Lyon [1:13:56]

Don’t you dare tell those guys.

Nick Barringer [1:13:58]

I know. I make them feel special.

Dr. Gabrielle Lyon [1:13:59]

I feel I’m a national hero, a doctor.

Nick Barringer [1:14:03]

It takes a lot of money.

Dr. Gabrielle Lyon [1:14:03]

Yeah, that’s a lot of money and a lot of investment.

Nick Barringer [1:14:05]

And guess what, if you lose them in the pipeline, that’s still a lot of cost. So any way we can do that, just from a cost-benefit analysis, not even the human side of it is good.

Dr. Gabrielle Lyon [1:14:14]

I love what you’re saying. It is about making individuals who are capable, even morally, but also what you’re saying is, how do we make those that show great potential and bring up those who have great potential, which I think there are so many other people that have that. I think that shows a lot of wisdom, non-rookie over here, Dr. Nick, non-rookie.

Nick Barringer [1:14:40]

It took a while.

Dr. Gabrielle Lyon [1:14:41]

He’s got a lot of wisdom. It’s interesting that the information that you’re sharing with us is information that can be taken and implemented into the life of the person who’s non-military, who wants to get the best out of their life, the best out of their athletic performance. We use a lot of biomarkers when it comes to nutrient metabolism, and it’ll be interesting to see how those line up to what Emily is using. How do we close the gap to make people even more exceptional? Because we need to everybody. The more amazing humans that we have, the more capable, strong humans we have, the better we’re all going to be.

Nick Barringer [1:15:20]

Yeah, not everybody can just come off the couch or run a marathon. So you need some of those folks that might struggle to do that, but again, they’re mentally resilient. They have all those factors. How can we get them to a physical capacity that they can pass those assessments and selection?

Dr. Gabrielle Lyon [1:15:37]

I love that. And where are you now? To tie up this episode, which I’m so grateful for you to spend time, and I’m hoping that you’ll come back. Hopefully, you will come back to talk more about training and some of the other areas of your wide expertise. Where are you now? Where are you going?

Nick Barringer [1:15:58]

The second part is going to be difficult. I am at the Army-Baylor master’s program in nutrition, where we produce the dietitians coming into the army. If you are a student listening to this or you are a soldier or were a soldier, and you’re passionate about nutrition and helping people, go look, I can’t think of our website, but if you Google Army-Baylor, that will link it. You can look and come. It’s two years, and you get your degree from Baylor. It’s a pretty good deal. I might be biased, but that’s where I’m currently. Within the next year, summer 2024, I will retire from the military and to be determined.

Dr. Gabrielle Lyon [1:16:38]

Are you ready?

Nick Barringer [1:16:40]

It’s going to be weird not waking up and shaving. I think it’s the little things. I don’t know for your husband how it was, but it’ll probably be a little weird. Actually having to dress myself for this podcast, I was like, oh, wait, I got a shirt, and does the belt have to match the shoes? I don’t know. So I’ll work through those. I’ve loved serving in the military, but I’m excited to do something outside of it. I’m very excited to look at the different opportunities and then to take what I’ve learned in the military and apply it in the civilian sector to hopefully help more people.

Dr. Gabrielle Lyon [1:17:14]

Well, the world needs you. I’m hoping that you will have a lot more opportunity to speak, and you will come back here. Thank you so much for everything that you’ve done for our country and for the soldiers. Thank you so much.

Nick Barringer [1:17:28]

Thanks for having me on. I appreciate it.

==========

Dr. Gabrielle Lyon [1:17:32]

The Dr. Gabrielle Lyon podcast and YouTube are for general information purposes only and do not constitute the practice of medicine, nursing, or other professional healthcare services, including the giving of medical advice. No patient-doctor relationship is formed. The use of information on this podcast or YouTube or materials linked from the podcast or YouTube is at the user’s own risk. The content of this podcast is not intended to substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professional for any such conditions. This is purely for entertainment and educational purposes only.