How to best support an exercise routine with IBD

By Claudia Cramer

About the Author

Claudia Cramer holds a Bachelor of Nutrition and Exercise Science and a Masters of Dietetics from the University of Queensland. Claudia has also completed her Sports Nutrition qualifications. An area of particular interest and passion for Claudia is helping people optimise their gut health, ignited after she was diagnosed with an auto-immune disease (UC) in 2014. Her practice focuses on using food functionally to ease anxiety, depression and other mental health issues, plus improving the body’s overall wellbeing. Claudia likes to practice what she preaches; you’ll often find her at the gym, getting creative in the kitchen or brunching at a local cafe.

Having an inflammatory bowel disease (IBD), such as ulcerative colitis (UC) and Crohn’s disease, has its challenges. Many of the challenges may be more physical, such as bowel may be more physical, such as bowel discomfort and urgency, lack of appetite, and general malaise and fatigue.

There are also other challenges with having IBD which may be more invisible to the outside eye, and that is the mental toll of having a chronic disease. Mental
health conditions such as depression and anxiety are more common in people with UC and Crohn’s disease than the normal population.

This makes sense from a biological perspective, as most of our serotonin(feel-good chemical) is made in our gut (digestive system), and UC and Crohn’s disease are inflammatory disorders that affect the digestive system. With that said, one thing we know that can help to manage IBD is regular exercise.

There are many benefits of physical activity when you have IBD, such as maintaining a healthy weight (which may help other comorbidities) and improving bowel regularly (if you are more prone to constipation). There are also mental health benefits. Regular exercise can improve our psychological health by reducing feelings of anxiety and depression and relieving stress. Despite the challenges that come with having an IBD, it can be reasonable to recommend incorporating regular physical activity into our weekly routines. When we are exercising, we can also utilise nutrition principles, to maximise our exercise efforts.

So, what are some things we can do to help support our exercise routine? Let’s look into some of the nutrition-exercise fundamentals.

Pre-workout nutrition
Before we exercise, we have a few goals. They include making sure we have enough energy for the exercising muscle to sustain the activity and that we are adequately hydrated. The primary fuel we use for our exercising muscle is carbohydrates. Therefore, our strategy will look at including a source of carbohydrate prior to exercise. Overall, we want to choose a food that is:

• Rich in carbohydrate to prime your fuel stores
• Low in fibre, especially if you have issues with your gut or feel very nervous
• Easy to digest – avoid foods overly high in fat or protein as these are slower to digest
• Familiar – practise your options in training and do not try anything new on an event day!

By including a small, carbohydraterich snack in the hour leading up to exercise, it can help to provide us with some immediate fuel (while not leaving us feeling too full, which would be uncomfortable during exercise).

Some ideas for pre-workout snacks
• A piece of fruit (for example a whole banana or an apple)
• Some yoghurt and berries
• A muesli bar
• Rice cakes with some honey
• Fruit smoothie
• Raisin toast with jam
• Tub of creamed rice with canned fruit

It is worth keeping in mind your individual tolerance to foods, and what might work for you in helping to manage your individual IBD condition.

Post-workout nutrition
We know the period after exercise is important nutritionally, and paying particular attention to nutrition recovery immediately after a training session or event has been shown to positively affect subsequent exercise performance.

We’re looking to:
• Replenish fuel (glycogen) stores used during the training session or competition with a carbohydrate rich food
• Deliver some lean protein to assist with muscle repair and synthesis
• Restore fluid and electrolytes lost in sweat.

Research has shown that co-ingestion of protein with a small amount of carbohydrate is a sweet spot in playing a critical role in muscle glycogen synthesis post exercise. What we would be looking for is around 14-28g protein and 56g carbohydrate in a post-workout meal.

What this might look like, specifically, is:
• 2 tubs of yoghurt and 2 cups of fruit salad
• A salad roll with 60g lean sandwich meat and a banana
• Lean chicken and salad roll
• A bowl of muesli with yoghurt and berries
• Spaghetti with lean beef bolognese sauce
• Chicken burrito with salad and cheese
• Spinach quiche with sweet potato crust
• A small tin of tuna on crackers, plus a banana

While I have provided some general recommendations for nutrition around exercise, it is important to tailor these recommendations to suit you and your condition. If you are experiencing a flare up of your IBD symptoms, perhaps choosing foods that you know are safe is more important than following a stricter nutrition plan. Similarly, at those times, perhaps you might reduce your exercise routine to some gentle exercise for your mental health. You can always pick it back up when your symptoms are more controlled.