[pct-l] Remedies for loss of appetite

[Josh]

Clint,
>Thank you for all your comments, several of which I would never think of.
>

That's really funny!  But I know what U mean!  Chemo Meds???  WTF??? lol

Personally, I think if U just 'play' with different things & not give up
U'll eventually find something that'll work for U.  IMHO, Protein is best
for dinner where U have 8-12hrs to completely digest it.  That's NOT to say
that 0g Protein during the day is something to shoot for, just not a bunch
of High Protein Bars all day long.  Also, I do NOT think that there is one
SINGLE thing 'wrong' with U but more likely several smaller things: Too Much
Protein during the day + Ibuprofen + Electrolyte Imbalance + Altitude
Sickness.

The last of which I didn't see anyone mention, but U may actually be
suffering slightly from Altitude Sickness & that, in combination with other
factors, could be causing UR problems.

http://en.wikipedia.org/wiki/Altitude_sickness

Just something to read-up on.

I seriously doubt UR dehydrated as Urine color is quite a good indicator of
hydration.
Clear = Over hydration
Pale Yellow = 'Normal' Hydration
Dark Yellow = Dehydration

One thing that U may consider doing in the near future, is to plan multiple
vigorous 3-5day trips which will give U multiple opportunities to zero-in on
what works for U b4 planning a long section/thru hike where having to
drop-out would really suck!

Josh


-----Original Message-----
From: pct-l-bounces at backcountry.net [mailto:pct-l-bounces at backcountry.net]
On Behalf Of Clint Kaul
Sent: Wednesday, June 17, 2009 8:12 AM
To: pct-l at backcountry.net
Subject: Re: [pct-l] Remedies for loss of appetite

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
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