[pct-l] Remedies for loss of appetite

[Clint Kaul]

Hello,

I have received lots of suggestions for remedies for loss of appetite.
Since most of them were off-list, I will summarize them here.  Thank
you all for your suggestions and own personal stories of similar events.

### Several people "admonished" me to listen to my body.  Yeah ... well ...
Point taken.  Their example was the fact that I started feeling better
after 3 days of rest in Agua Dulce.  Basically back off so my body isn't
fighting itself so hard.  This can be done as:
- take more zeros at my resupply locations.  recover from calorie loss.
- reduce my baseweight so I don't expend as much energy carrying a large load
- hike at a slower pace so that you are breathing easily.  this helps
  increase the oxygen to the muscles as well.
- look at varying the rest breaks (duration and how often) to see what
  works best for me.
It may mean very long days, but that is preferable to "killing myself".
Eventually your body will adjust (become trained) and things will pick up.

### Several people talked about eating and taking breaks.  The background
is that blood flow is "prioritized" according to activity.  If you set the
standard for "oxygen and energy to the legs" by constantly walking then
that is where the blood goes. Things like upper digestive track activities
are a low priority.

A few people mentioned that if they tried to eat anything while hiking
it was much harder to swallow and keep down.  Several people mentioned
the following type of break:
- stop (in shade) and rest for about 20 minutes or until your heart rate
  settles down to a resting rate.
- eat your snacks/lunch/dinner/...
- continue to rest another 20 minutes after eating and drinking.  This
  allows the stomach to start digesting before you re-prioritize the
  blood flow back to your legs.
It was also suggested to eat meals at the top of hills.  Eat tiny snacks
at the bottom and on the way up hills.  I think the idea is to minimize
hiking exertion right after eating large meals so you can properly
digest them.

I'm not sure I can afford such long breaks at the frequency I need to
eat.  My normal hiking style is to snack for 2-3 hours.  When my snack
pocket is empty I take a 20-30 minute break, eat from the pack and reload
my snack pocket.  Repeat until it gets dark.  I'm not sure I can move
the snacking to the break period and eat more then.

Perhaps a mixture of more easily digested snacks while hiking mixed with
"healthy" larger meals during the long breaks will work.  Several people
suggested sport gels, carbonated drinks, hard candies, pedialite mixes are
okay while walking.  Anything heavier you need to rest before eating

Along these lines was an idea of a more liquid based diet.  For example
drink Carnation Instant Breakfast instead of cereal.  Hot chocolate seems
to be a favorite as well.  (Avoid coffee/tea since they are acidic).
Also look at what endurance athletes consume: Sustained Energy, Hammergel,
Perpetuem, ... drink it down and keep it down.

### Someone mentioned that I might have lactose intolerance issues.
I was throwing-up cereal/milk for breakfast.  I started having a
similar suspicion.  Eating bars in the morning was usually better.
I never felt nauseous while eating cheese based lunches though.
And once in town I had no problems with ice cream/milk.

Still it could be an issue.  Perhaps it only occurs under over-exertion
conditions.  I was planning on getting rid of cereal/milk in the morning
because it slows me down too much.

### Someone mentioned it might be celiac disease (gluten allergy) where
your digestive system will start attacking itself and you get all kinds
of really awful digestive system symptoms.  Although I am not allergic to
gluten in "civilian life", perhaps massive increase in calories pushed me
over the edge.

### Someone suggested I gain 10 pounds before my next big hike.  I had
gained some weight (5 pounds) before leaving Campo.  The idea is to build
up a fat reserve which can act as a buffer against my fast metabolism.  It
is unrealistic to think I can carry enough calories so I don't lose weight.

### Several people mentioned that the correct carb:fat:protein balance
varies greatly between people.  Some people need lots of protein, others
need lots of carbs.  So the PackLightEatRight article stating 50:40:10
may not work for everyone.  One diabetic said his doctor suggested a
75:15:10 ratio with most of the carbs coming from simple fast acting carbs.
The National Institute of Health recommends a 70:15:15.

Simply change my food ratios to see what works for me.  There is no one
"magic" formula.  Most commonly, high fat foods look really disgusting
in warmer desert environments.  Although it's hard to pack in as many
calories without fats, some people find the carbs are easier to handle.

I finally found one decent article "Pack Light Eat Right" at:
        http://thru-hiker.com/articles/pack_light_eat_right.php
It is proposing a 50:40:10 (carb:fat:protein) ratio for food.
Going through what I was eating, it was more like 50:30:20.
It appears I was eating too much protein which the body has to
really work at to digest.  I bought a bunch of high carb/high fat
foods (focused on low protein) to augment my food supply.
Later I found Erik The Black's Junk Food Diet page:
        http://www.eriktheblack.com/blog/junkfood-hiking-diet/
which seems to bolster this.  Unfortunately I never got a chance to
test the new balance; food poisoning the first day out of Tehachapi ;(

### By far the largest number of people suggested electrolyte deficiencies.
Hyponatremia is a cause of nausea/vomiting and is caused by drinking too
much water or excreting too much salt.

Even though my urine was clear it was a false sign of being properly
hydrated.  Given that I sweat a lot I was probably losing too much
salt.  I didn't drink much gatorade figuring I would get the salts
through my food.

Make sure you are getting enough sodium/salt in your diet.  If you are
using an 'electrolyte replacement', make sure it's heavy on sodium,
not potassium.

### A few people provided ideas on reducing the stomach acid and nausea
symptoms.  Taking things like antacids or Pepcid.  There is also a natural
substance that is available by prescription that has significant anti-nausea
effects and is even prescribed for that express purpose to folks undergoing
chemo.  One hiker suggested digestive enzymes such as Zand's QuickDigest
to help digestion and reduce heartburn.

Perhaps my original high protein diet was causing my stomach to produce
too much acid.  (The stomach uses acid to break down the protein before
absorbing it).

### It is well known that Ibuprofen (or similar NSAIDs) is very irritating
to the gastric lining, especially if taken frequently.  One solution is to
take a histamine-blocker (like Zantac/Ranitidine) or a proton-pump inhibitor
(like Omeprazole/Prilosec).  You could also try using Tylenol instead of some
or all of the Ibuprofen doses to minimize gastric irritation


Thank you for all your comments, several of which I would never think of.
I now have lots of variables to play with to see what works for me.
Being "unscientific" I'll probably change several variables at once ;)

clint