We have now been operating for five years.

We provided $130,000 of scholarships to 31 women from five different schools in those five years.

We've had a sold out event every year.

Yeah, and we're really proud of it.

Hello, I am Jeff Zankoff and I am the Tridoc, an emergency physician, triathlete, triathlon coach and multiple Ironman finish.

And this is the December 12, 2025 edition of the Tridock Podcast and it's coming to you as always from beautiful sunny Denver, Colorado.

The voice you heard at the top of the program was that of my guest for today's episode, and that is Jess Sarah.

Jess has a fascinating background doing all kinds of things, including making energy bars from her kitchen that became a wildly popular food item that many cyclists wanted to use.

She herself was a professional cyclist, but she's now the co founder of Mont Last Best Ride that is a very popular and still growing gravel race that is held in Montana every year.

And it's also a 501c3 organization that funds scholarship for women and underrepresented youth.

We had a fascinating conversation.

It's one that I really look forward to bringing you and that's going to be coming up a little bit later on in the program.

Before that though, of course there will be the Medical Mailbag segment in which I am joined by my friend and colleague Juliet Hoffman.

We are not going to be answering a listener question today.

Instead, we are going to be expanding on the subject that I wrote about recently in Triathlete Magazine.

Specifically, that subject is vagal nerve stimulators.

This is a new technology that is used in medicine for a variety of different aspects and variety of different indications, but has kind of come to the fore in endurance sport as a means of improving recovery.

These are expensive little devices.

They range around 4 to $600 a piece, and some early research, very preliminary at, suggests that it may be helpful in allowing for athletes to improve their parasympathetic outflow and offset the sympathetic tone that comes with hard training.

Well, does it work?

Does it allow athletes to recover and rest better than they would be able to without it?

We'll take a look at the evidence as it exists today and let you know if this is a toy you should be considering for your loved one or for yourself for the holiday season.

That's coming up very shortly.

Before I get to that, though, I do want to spend this monologue addressing a review that I came across recently when I was looking at the ratings and reviews for the Tridark podcast on Apple Podcasts.

As you know, I recently have asked a couple of different times if people would take a moment to go out there and leave me a rating and a review, especially if you enjoy the program, because it's important for making this show more visible and for getting it to more ears.

And recently I came across a new review that was left back in September and I wanted to address it because it brought up some points that I think are worth addressing here at this time.

Gus Catt.

That's the name that was used.

Gus Kat didn't feel obligated to leave his full actual or her full actual name.

You'll understand why I'm referring to it as a he, because I think it's more likely a he.

But Gus Catt wrote back in September of this year, specifically in reference to episode 166.

That was the episode in which we discussed the BRO peptides, the Wolverine stack.

You'll remember we talked about whether or not there was any merit to using those peptides as recovery aids and performance enhancers, he wrote.

What a lazy podcast.

I don't disagree with the premise of the episode, but it was mostly slander without any real science behind it.

You dismissed peptide research by claiming that there's, quote, no science, yet animal studies are science, and you cited nothing showing lack of efficacy.

Then you pivoted to say you were fine taking fruit that showed no benefit.

The kicker, though, was when you claimed semaglutide can't be taken orally because it would be broken down in the stomach.

Ever heard of Rybelsus?

That level of oversight isn't skepticism, it's just laziness.

Well, I wanted to address this because as I've said many times on the show, if you find problems or if you have comments about anything that we discuss, I hope that you'll reach out to me so that I can correct them and address them here on the program.

Goss Cat didn't feel the need to do that, but rather took to the reviews where he accused me and my interns of being lazy, which I can't really abide by.

I think if you've been listening to this podcast for any amount of time, you know that there's a fair amount of work that goes into producing it each and every couple of weeks.

So lazy is probably not the best adjective, although Gus Kett is entitled to his or her opinion.

Now, slander by definition is a false and malicious spoken statement.

There was nothing slanderous spoken in that episode's medical mailbag.

That medical mailbag went into great detail of all of the science that has been done on these peptides.

The peptides being specifically BPC157 and TB500.

At least those were the two I discussed on the program.

Now, to be said that I did didn't discuss the science on the program is a little bit preposterous because we spent the entire episode talking about what very limited science there actually was.

I never said there was, quote, no science, end quote.

I simply said there was no human science there.

I would argue that the reviewer Gus Cat is maybe a little bit lazy in just accusing me of saying there was no science because I never said that.

And when I talked about the fact that there was no human science, what I was suggesting was that anybody who is willing to take these things based on what science there is, is basically willing to accept the fact that these things have shown some very, very preliminary benefits on cell cultures, on zebrafish and on the dissected tendons of rats.

Now, if you believe that that's good enough for you to compare yourself to the dissected tendon of a rat or to the cell cultures from a zebraf, have at it, I'm not going to stop you.

But to suggest that that is somehow extrapolatable to human beings and how these chemicals will react in human beings I think is preposterous.

And it is something that I have said on this program many times.

There are levels and degrees of quality of science and how we should apply the findings of those science to what we interpret and how we are going to make a decision as to whether or not something is likely to work in us and athletes.

And when I see science that has been limited to the kinds of science that we've seen with these peptides, I feel quite comfortable saying there is pretty much no evidence whatsoever when it comes to actually proving that these things do anything for human beings.

And I stick by that.

And I'm not going to change it based on what Gus Cat feels now.

Did I say I was fine taking fruit with no benefit?

I never said that.

I did, however, say that I do take things like tart cherry juice, which has shown benefit in human beings, and I will continue to do so.

I have also said that if people want to take other things that I have reviewed on this program that show some benefit, things like New Zealand black currant, I don't have a problem with that.

It's a natural substance, it's not going to cause any harm.

And there is some evidence that suggests it may have some benefits in Human not compelling enough for me.

But if you want to take it and if you're finding you're benefiting from it, why not?

Where I draw the line is things like these peptides, which clearly have no biological principles by which they should be exerting benefit.

And by that I mean the second you put them in your mouth, they're not going to do anything because they're going to be broken down in your stomach.

Now, the example of Rybelsus was brought up.

It is true.

Rybelsus is a form of oral semaglutide.

Semaglutide is the same peptide that is found in Ozempic.

Now, Rybelsus is not just semaglutide that you swallow in pill form, because if you did, it would be broken down, none of it would be absorbed into your bloodstream and it would not work.

So Rybelsis was not an oversight.

The reason I didn't bring up Rybelsus is that it's simply not relevant to the conversation on these bro Peptides, which cannot be taken orally.

Rybelsis, you see, is a combination of semaglutide with another chemical that stops the peptide from being digested.

Actually, what it really does is it uses a special absorption enhancer that protects the peptide just long enough for meaningful uptake through the stomach wall.

And it does this in a couple of ways.

It reduces the amount of stomach acid locally to where the tablet is sitting, not globally.

It also reduces the activity of the digestive enzymes that we work to break down the peptide.

And the way it does this is by packaging this semaglutide with a chemical called snack sodium N hydroxybenzoylamino caprylate.

Don't worry about it.

It's not important that we get into all of the weeds about how it works.

But basically, when you swallow these peptides encompassed with this snack, what happens is that where the tablet sits in the stomach, as it starts to get broken down, the semaglutide around the stomach, the snack around the stomach will actually impact the stomach wall and allow the semaglutide to be absorbed right there within the stomach.

Most of the things we eat actually gets absorbed further down in the intestines.

This is one example of something that gets absorbed within the stomach.

And it's entirely attributable to the fact that the semaglutide is packaged with the snack.

Now, the things you need to know about Rybelsis is that even with the snack as the chemical snack combined with the semaglutide, less than 1% of the pill's content of semaglutide actually makes it to be absorbed somewhere in the range of 0.5%.

The rest of it, completely broken down and digested, never has any impact.

The only reason it works is because semaglutide is such an incredibly potent peptide.

When you inject semaglutide, you're injecting an amount of the peptide that will last for an entire week.

So you only have to inject it once for a week.

The rybelsis has something like 10 times the dose and you have to take it every single day because so little of it is actually making it into your bloodstream.

You have to take it on an empty stomach with no more than 4 ounces of water.

You can't eat or drink anything for 90 minutes afterwards.

So a lot of drawbacks to this oral pill now snack is not combined with any other peptides at this time, especially not any of these bro peptides like this BPC157 or TB500.

So if you took these oral versions of these different bro peptides, you're getting significantly less than 1% absorption.

You're probably getting 0% absorption because as I said, they are all getting completely digested in the stomach.

None of it is making it to your intestine and none of it is going to be absorbed.

So that is the science of rubelsis.

That is what I actually said on the program.

I did not dismiss the animal science.

I simply said the animal science was very preliminary, very small studies and not applicable to human beings.

So if you have anything that you feel is incorrectly stated on this program, I hope that you will do the right thing, as many other listeners have done over the years, and email me because I am more than happy to be proven wrong.

I will admit it on the program.

I will make corrections and I will update my recommendations.

If you bring to me actual science that shows that you have a point and that I have missed something thing.

And I will point out that Gus Cat did no such thing.

He brought no evidence, he brought no new science or no new revelations that prove that BBC 157 works or proves that anything I said in that episode was actually false.

So slander.

That's a bit much.

Lazy also probably a bit much.

And Gus Cat, thank you for your contribution.

I really appreciate it.

But next time, maybe spend a little more time thinking things through.

Send me an email first.

Be happy to have that dialogue.

All right, let's move on to this episode's medical mailbag.

We're going to be talking about vagal stimulators.

I don't think it'll be anywhere near as controversial.

But let's see.

It's that time again, when I am joined by my friend and colleague, Juliet Hockman.

Juliet, coach at LifeSport Coaching, former Olympic rower, and always a fine contributor here on the Medical Mailbag.

Wow.

What a buoyant introduction.

Hi, Jeff.

How are you?

I'm doing great.

How are you, Juliet?

You had a fantastic trip.

I did.

I had a great trip.

I spent eight days in around.

It was very spontaneous in and around Bologna with my husband.

And then just this weekend, I actually popped back east to see my ailing father with my siblings.

So we did a mini family early Christmas.

I'm telling you, it's really.

It was really nice, just the five of us.

Not like with the spouses and all the grandchildren, just the OG5 Thompsons.

It was really fun.

It was filled with emotion, but it was also really nice.

Do you.

One of my.

One of my favorite movies is Best in Show.

Have you ever seen Best in Show?

That's the dog one, right?

That's the dog one.

Yeah.

It's Christopher Gast.

It's all improv.

And there's a line, a throwaway line in there where they're talking about going to Philadelphia and they say, oh, I can't wait to go to the cream cheese factory.

So since you were.

Since you were in Bologna, did you go to the Oscar Mayer Factory?

That's so interesting, because I hate bologna.

I hate it.

And the big thing in Bologna is mortadella, that meat.

Yeah.

And I. Mortade.

And I.

And so I.

It doesn't look very appetizing because there's.

All those pieces of white in it, which is basically.

And.

But that's what makes it so good.

I know, but to me, it just tastes like bologna.

I didn't eat a lot of bologna or a lot of mortadelli and bologna, but I had a lot of other yummy things.

I know.

I saw it.

I enjoyed the feed.

Welcome back.

It's good to have you back.

Thank you.

And we don't have a question today, but we do have a topic.

So what are we going to be discussing?

We do.

So it was interesting.

I just read this article that you put out in Triathlon magazine all about these vagal nerve stimulators, which are supposed to aid recovery.

And in the article, you gave a really good background on what the vagus nerve does and why it's been used.

This might be one of those applications that crosses over from the medical field and could be good for endurance athletes.

But is it.

And I'd be really.

I thought it'd be a good idea or you thought it'd be a good idea.

We all thought it would be.

To bring this article to our listeners to talk about these vagal nerve stimulators and if they do have potential for enhancing and speeding recovery for endurance athletes.

Yeah, it's something that we hear a lot about.

How can we, when we think about the different technology and the different things that we review on the program, they go into three buckets.

There's the things that help you train better, the things that help you race better, and then the things that help you recover better.

Help you recover better.

And we've.

Yeah, I don't know that things have fallen into those exact thirds, but I'm always interested about things that help you recover better because I think, especially for us in our age group, recovery is everything.

It's a challenge.

Yeah.

So it's always nice when you see something new.

Now I think it's nicer when it's something a little bit less expensive.

As we'll get to.

These are not inexpensive things, but even if they are expensive, if they're worth their salt, then I think that it's something we should explore and something that we should certainly let our listeners know.

Now, this was something that my editor at Triathlete magazine came to me and said, look, we're hearing a lot of buzz about these.

We are interested to know if there is any science or any evidence to back that up.

Because if there is, we want to let readers know, and if not, we also want to let them know that they shouldn't pull the pin on these just yet.

And it was news to me that these were being used in this way.

So just to let you know, in medicine, vagus nerve stimulators are implanted devices.

They're used to treat intractable seizures.

They're used to treat intractable pain from the spine.

They can be used for gastrointestinal things.

So a variety of different uses.

And there is science to suggest that they have important effects and can be very beneficial to patients.

But the vagus nerve has other important roles.

And when we think about a external vagus nerve stimulator, as is the principle that's being used here, it's leveraging a completely different thing that the vagus nerve does.

So the vagus nerve emanates from the brain stem, which is up high in your back of your neck, and it comes down and it actually spreads out.

Its fibers go to a variety of different places.

It's one of the longer nerves in the body.

Now when we think about the nervous system, we have the, the motor system, which is the system that allows us to control.

It's the voluntary system that allows us to move.

And then there's the autonomic system, which is the system that controls, that basically innervates all of our organs, our heart, our stomach, our liver, all of those things, and will provide nociceptive or pain fibers back from those organs, but also will control things like heart rate, will control the peristalsis or the motion of the gut, things like that.

And that is really what the vagus nerve does.

The vagus radiates fibers to all of these organs in the abdomen, to the heart especially, and to the visceral organs in the chest and everywhere else.

And so it's got these really important role, especially for the parasympathetic nervous system.

We've talked about heart rate variability in the past.

We've talked about its maybe limited.

Iffy, right?

A little bit iffy, a little bit limited in terms of its metric use.

There are still a lot of adherence to it and a lot of people really believe strongly in its usefulness.

But heart rate variability is essentially showing you the balance.

I'm doing this, I'm always giving my kids a hard time now, because when we do this now, it's 6, 7, 6, 7.

Anyways, if you don't have kids, you're not going to know what I'm talking about.

But heart rate variability is giving you the balance between sympathetic and parasympathetic systems.

And we know that when you're going out and training hard, you're getting a big sympathetic overload.

So your cortisol is rising, your adrenaline is rising, and it puts a big stress, a big toll on our overall system.

And the parasympathetic system goes down in response.

And you will see that if you follow heart rate variability, you'll see that variability decreases in those states when you have higher sympathetic tone.

The theory is that if you stimulate the vagus nerve, you can restore that balance and bring the parasympathetic system back up, turn down the sympathetic system and enhance recovery.

Because when we rest, when we do an easy day, when we do any of the things that we normally do to recover, that's essentially what we're doing, is we're giving time for the sympathetic drive to come down and the parasympathetic system to come back up and so using a vagus nerve stimulator, or so the theory goes, is just enhancing that process and making it go faster.

The problem is, as I mentioned just before, is that vagus nerve stimulators are implanted.

Right.

And to get to the nerve, you have to do a surgery to put this little.

It's a device about the size of a fist.

It goes underneath the skin, and then these electrodes are tunneled down to the nerve.

Obviously, that's not what we're talking about.

We're talking about external stimulators.

These external stimulators access the nerve in one of two ways.

You can put, like a collar on around your neck where there will be electrodes that target the nerve on the sides of the neck, where it's a little bit closer to the skin.

And then the other way, which I think is really interesting, is this clip you put on your ear so you can actually stimulate the nerve through an auricular stimulation, which I think is pretty cool if it works.

So we found a few studies, and I owe a debt of gratitude to my intern, Cosette Rhodes, who did the research on this.

She thought it was pretty interesting as a theory, anyways.

And the first of these studies is non invasive vagus nerve Stimulation and exercise Capacity in Healthy Volunteers, a randomized trial.

And the study here, pretty small, 28 athletes, 14 of them are women.

So we have a nice breakdown.

Yeah, it's not too often.

We see 50, 50.

So it was nice to see that here they were using transcutaneous vagal nerve stimulation versus a sham device.

And as we've talked about on the program, when you have a placebo, it's really important that you are blinded to that placebo.

So that's the best kind of research.

And so using a sham device, so that person doesn't know if they're using a real device or a sham device is a very powerful way of blinding the study.

So that was good.

They gave blood samples, they did cardiopulmonary exercise testing and then looked at ECG waves.

They looked at heart rate variability.

They did all kinds of things.

And the result here was that the people using transcutaneous venous nerve stimulation saw an increase in their VO2 Max by 3.8% compared to the placebo.

But the statistics that they looked at when they were reporting this were a little bit complicated.

And they didn't report whether or not that 3.8% was statistically significant.

They don't actually say if that 3.8% came about purely by chance.

Or if it was a true result.

And that's very unusual for research.

We've talked in the past about statistical significance and clinical significance.

So one thing is, is a 3.8% VO2 max increase, is that clinically significance?

I would argue that sounds pretty good.

Yeah, I think so.

But we need to know if that result was a mirage or was it true.

And the way you know that is when they report if it was statistically significant and they didn't do that, which is very unusual for a paper that's reported in the scientific literature.

So not really sure what to take from that.

In terms of the other things that they looked at.

There were no significant differences in heart rate measurements.

There was no significant differences in heart rate variability.

There was no significant differences in any of the recovery metrics they looked at.

The only thing they found was this small, but I would argue potentially important change in VO2 max over the seven days.

Now, these are obviously not elite athletes.

You're not going to see a 3.8% increase in VO2 max in elite athletes.

But these were obviously untrained individuals.

So interesting potentially to be continued as to whether or not that's a reproducible study.

Second study, Effects of a single session of non invasive auricular vagus nerve stimulation on sports performance in elite athletes.

An open label randomized control trial.

So here is an example of a study that is not blinded to the athletes.

It's open, they know what's going on.

The study design here is that the athletes were randomized.

There were 30 in the treatment group, 30 in the control group.

They got a single.

Vagal nerve stimulation and then they basically did pre and post treatment.

Isometric quadriceps muscle strength exercise, heart rate and lower extremity balance and grip strength.

Now I don't really know what to make of a study like this.

Is one treatment really gonna make a difference?

And also that's recovery from a strength move, not a.

An endurance move.

An endurance move.

I think it's not surprising to say that this study found no difference of any measure.

And I was like, this is a weird study to me because there are so few things that would have such a big impact in one treatment.

One try.

Yeah.

They had to believe that this was gonna be pretty miraculous to do one.

But anyways, we didn't find a lot of studies so we wanted to include this.

That's what you have to have.

Yeah, yeah.

Another study.

Oh, so this is not a study, but this is actually one of the devices.

So pulsetto is the name of the device they have on their website, they have, we've talked about.

When you're looking at these devices, be careful to look at the website, look for a tab that says our science how it works.

They actually, to their credit, they do have a page dedicated to their science, but they don't actually list any studies.

They only say there's ongoing and upcoming studies.

And I think this is really the important kind of take home message on vagal nerve stimulators is that it is super preliminary that a lot of the science is ongoing and upcoming.

But this hasn't stopped the makers of the devices from getting out ahead of the evidence and marketing these things as actually proven quantities.

Right.

Which I think is disingenuous and.

Unfortunately very typical of what we see these days.

And is for a $600 device like particularly ethical?

I don't know.

Yeah, no, at least on the website they're not claiming that studies have been done and they're just not naming them.

They're just saying, hey, these are coming.

And so it's kind of.

Well, but they are saying it works though.

They're saying it works and they're saying we have ongoing studies that show it works.

Now they're not claiming, they're not claiming specifically, hey, it works to do X percent but they are saying this thing will improve your recovery.

And we have science that's ongoing to back that up.

And I'm like, that's a weird.

Normally when we talk about foam rolling or massage or something like that, the very fact or normatec, the fact that you are sitting down and relaxing, probably when you wear this thing you've got to be lying down or something like that.

You probably can't be charging around doing the gardening and taking out the garbage.

That is true.

And so maybe that enhances recovery just by virtue of the fact that you have to sit around when you wear it.

I don't know.

And you're right.

We talked about that with cold water immersion.

We talked about that with the boots.

Right.

The fact that it forces you to stay still is probably not a bad thing.

But do you need to spend this kind of money and do you need to stick this thing on your ear?

I don't know.

Also I don't know if there's any negatives to this.

I don't know.

It sounds bizarre to me to have a.

It almost sounds like you're getting little mini shocks or something.

Yeah.

Another, the final study we found was tragus based vagus nerve stimulation for stress reduction.

So another way that the Vagus nerve can be helpful.

And we know that vagal nerve stimulators are used in mental health applications as well.

It really does have a lot of promise as a therapy for different kinds of medical applications.

And that's why it's getting this cause as could it be used for other things.

So tracheus based vagus nerve stimulation for stress reduction.

This was not a published paper, but rather it was an abstract that was taken from a conference.

And this.

So it's hard.

There's not a whole lot going on here.

This is a very small study.

Randomized crossover.

So this is an example where there were five people in the study.

They basically randomized them to start with one, either the experiment or the placebo.

And then after a period of time they cross over to the other.

So everybody acts as their own control, which is a good way to do a study.

Usually you want to see more than five people, but yeah, anyways, whatever.

They looked at just heart rate variability and used that as a way of measuring stress and found that there seemed to be a decrease in stress using this versus the sham.

But again, too small study to really make any great.

There were no P values again reported in this abstract.

And the P values, it's hard to believe with a group of five.

It's very.

Unless you had a very large difference, the P values would not be statistically significant.

So I think the important thing here is that this is preliminary science.

And is there a signal here that suggests that this might be beneficial at some point?

I think possibly.

I think this is something we might need to come back to at some point.

But I don't think this is anywhere near primetime.

Certainly I was amazed to see how many manufacturers there are that are making this stuff.

And recently I came across.

I've shared with you at least one reel by Dr. Ids.

That's the British doctor who likes to debunk disinformation out there.

And recently he had a reel where he was seeming very despondent, he was very sad.

He basically went out there and he put out this reel where he was saying, like, I'm at my wit's end.

Because people can go out into a grocery store, they can basically walk down the aisle, they could say whatever they want and people click and people listen and.

And then I come out and I've got all of this research and all of this stuff to tell them that.

What are you talking about?

You're crazy.

No, this isn't true.

And.

We want to hear the person telling us the garbage because it's like they usually do so in a much more flamboyant manner and stuff like that.

We want to hear the quick answers.

That's it.

We want the quick fix.

I think it's human nature to want the quick answer and the quick fix and not have to do the hard work sometimes around getting what we need.

It's a recurring theme in the Mailbag, I'm afraid.

And it's a little bit depressing.

I'm a little sad.

I don't know.

But we'll keep doing what we're doing because I think it's important to let our listeners know, we've said from the beginning we're here to try and help people make wise decisions about how to spend their cash dollars.

That's right.

And there are things that work.

We're not sort of the negative Nellies who are saying nothing works at all.

Yeah.

And I do think, as I said, I do think there's possibilities here.

But not now.

Not now.

Don't spend four to six hundred dollars on these things.

I just, Even if you have the money, there's other places to spend it, right?

Yes, absolutely.

Absolutely.

We have a couple of fun episodes coming up.

We have a listener question to answer on the next one.

But then after that we are going to finally get to the why question, as in what is your why for doing this?

How has it changed over time?

And how are you dealing with the fact that your why might be changing?

And we have had some really fantastic input on the Facebook group and I want to encourage people, if you have given this any thought or if you are interested in contributing to the conversation, please go on there or send me an email.

We would love to hear your thoughts on this and we promise we're going to incorporate it because it's really been very thought provoking to see people's thoughts on this.

And how are you reading what you've seen there and thinking about how it's going to formulate.

Yeah, I know.

I'm almost wondering, I'm almost wondering if we should tree wire a little bit and separate the conversation into buckets.

In terms of.

There's there are a number of people who say their why is this reason?

And then there's people over here say it's this reason and their people it's this reason.

And there is some transition between.

Yeah, crossover, of course.

And then sometimes once chapter of your life you're doing it for this reason and then you move on.

But I do feel like we need a way to put.

Not a little put A little bow on it, because that would be disrespectful.

But somehow to categorize and to make sense of what people are saying, to see if there's commonality and crossover and where those points are and if there is a commonality in age group.

Yeah, too.

Yeah.

Yeah, that would be interesting.

Yeah, I agree with you.

Because that was something that I've been watching and been interested in and seeing.

It seems like the same way.

There is this kind of histogram almost of where triathletes, in terms of numbers are in the age groups.

You see that as people's family lives evolve and kids get older and they have more time to train, that's when they become the most competitive.

And then as they get a little bit older and triathlon maybe takes a different meaning and a different importance in their life, they start to think, oh, no, I'm back to where I was at the beginning of this journey, which is now I'm in it again, just to be fit and to enjoy the experience.

And yeah, it's.

I agree.

I think that's a really.

It would also be.

It would also be fun to get a little bit forensic in terms of looking at people's responses of did their why change?

If they achieved a certain goal or achieved a certain level of success, whatever that means, however success is defined, did they stop doing it?

Did they move to a different discipline?

Did they redefine the goal?

Did they what does success look like?

And what do people do if they reach that definition of success?

And then where did they go from there?

We've had a couple of great answers from a couple of our women listeners who have been longtime listeners of the show.

I really appreciated that.

And if there are other women out there who are listening and want to contribute their why, you can do as I said in the Facebook group.

Head over to Facebook, search for Tridoc podcast, answer the three easy questions to join the group.

We'd love to have you there.

If you want to do so privately, just send me an email.

Tridocloud.com Again, it can be private.

We don't have to share your name, but we would love to know your why.

And if you don't want to talk to Jeff, you can talk to me.

That's right.

So, Juliet, how can they reach you?

Juliet J U L I E T Like Romeo and juliet@lifesportcoaching.com and I won't tell Jeff who sent it, I promise.

There you go.

The other thing I wanted to say is that we at the tank is run empty on listener questions.

Yeah.

So folks, if you've got something you want us to answer for you here on the medical mailbag, please do drop us a line in one of those ways.

Email Juliet, email me or put it into the Facebook group.

We would love to know as I'm happy to come up with questions, so is Juliet.

But if there's something pressing that you're interested in, please do let us know.

And it can be about injuries, it can be about training questions.

It can be.

And we do have a training question.

There is something, a device that I was asked about, so we are going to look into that.

But yeah, if there's anything that you're thinking about, we definitely want to look into it for you.

So let us know.

I have interns champing at the bit to get into the research and look into it.

We are coming up on the end of the year.

Remember our holiday hacks episode?

How to enjoy, to eat, to drink and be merry, not sacrifice your training.

And of course the resolutions.

There you go.

The small plates.

I love it.

The small plates, the crackers and kiwis.

Yep.

And of course the resolutions which are not hugely important for us because we have them all year round.

So just want to echo that what we've said in the past.

Great.

That's right.

With all of that said, I think we've come to the end of another medical vagal nerve stimulators.

To be continued potentially as more science comes out.

But for now we are not going to recommend that.

Do not recommend.

Juliet, thank you so much for being here.

Always a pleasure to chat and I look forward to picking it up in a couple of weeks time.

Thank you so much Steph.

Thanks.

My guest on the podcast today is Jess Sarah.

She is the force behind Joe J Bar.

I'm excited to hear about that.

An energy bar that started in her kitchen and is now part of elite active nutrition.

After a 12 year professional cycling career, she went on to combine her Master's of science in exercise physiology with hands on culinary and athletic experience, serving as Vice president of product and community development for brands like Bonk Breaker and Salt Stick.

She's driven by making nutrition approachable and enjoyable for athletes, especially women navigating the complex world of fueling for performance.

Jess Also Co founded Montana's last best ride, a gravel race and 501C3, funding scholarships for women and underrepresented youth.

Her unique perspective covers everything from science behind endurance, nutrition, nutrition to building community and supporting inclusivity in sport.

I am really Excited to speak with her.

Jess, thanks for making time and joining me on the Tridark podcast today.

Thank you so much for having me.

I am really interested in a lot of the things in your bio, but let's begin first with learning a little bit about that 12 year professional cycling career.

Tell us where and what format that was and what you got out of that.

Yeah.

So I am currently here in my home in Whitefish, Montana, where I grew up.

So definitely an outdoor community.

People live here because they love the outdoors.

Access to expensive sports like cycling and skiing were a little tricky for me when I was growing up.

We were pretty low income.

So despite being outdoorsy and hiking and being exposed to it, I didn't actually gravitate towards cycling until grad school.

And it's happened by accident through some research that I was participating in.

And we were having elite cyclists come into the lab.

We had an environmental chamber, and we were actually looking at calcium lost in sweat and how that impacted bone health and bone density.

So it was through that study that I ended up doing a VO2 Max test in the lab, on the lab bike, in my tennis shoes, and had a very high, nearly olympic level of VO2 max for a woman.

And my mentor professor was a mountain biker and she let me borrow her mountain bike and I actually ended up buying that bike.

I think it took me two years to pay for that bike through grad school, but that's how I got into cycling.

And it was very natural for me.

And I started racing, winning races, getting on podiums, and the bulk of my career after I started mountain biking was in the road racing discipline.

So I raced on two UCI road teams and primarily in the us Traveled some in Europe and throughout the world.

But yeah, so really amazing experience that came a little bit later in life, and that experience transformed what came next for me.

Okay, so as is appropriate for a podcast where I'm the host, I have questions.

How did you.

Did you not have an inkling that you had this incredible aerobic capacity until you did that VO2 max test?

I did have an inkling and for years I knew it was in me, but I didn't know.

I didn't have an outlet and I didn't have the right mentor.

And it was like endurance sports.

I was gravitated towards endurance sports.

And I would run and I would hike a lot on my own.

And I think I knew that I was special, but it was intimidating to me because I just.

I didn't have the background and I didn't have anyone to show me the ropes side point.

I'm glad that there are a lot of things that are breaking down those barriers for people now and why I'm so passionate about that.

But yeah, I just, I needed that mentor.

I needed that person to.

To show me.

I think that's so interesting.

So like in high school, you never played soccer or cross country running or anything like that?

I played volleyball and softball and I. Oh.

So neither of which would have leveraged it.

Yeah.

I remember seeing the women's cross country team in the locker room as we would get ready for practice after school and I would be like eyeballing.

I wanted to be on the cross country team, but I didn't think that I qualified for it for whatever reason.

And I told no one, so just went with me.

Okay.

My other question has to do with mountain biking, because I own a mountain bike, but I am loath to get on it because it's not long before I end up lying on the ground looking at it because I just find it technically to be something that I love to climb.

But as soon as there's an obstacle or as soon as the trail goes downhill, it's like I'm close to death.

How did you figure out the technical parts of mountain biking to be able to leverage that incredible aerobic capacity like you?

That's how I felt at first.

And funny story, and this will age me a little bit, but this first bike that I had 26 inch wheels, 3 by 9 drivetrain, rim brakes, and.

A quick release seat post and probably no shocks.

It did have suspension, so it was like really fancy for the time period.

It was an Ellsworth Truth which was manufactured down in Southern California where I was going to grad school.

Or it wasn't manufactured there, but the company was in Southern California.

So when I first started going out with this mountain biking team, I would just smoke them going uphill and I'd wait at the top.

I quick release my seat post, slam it down.

I guess at least I was forward thinking as far as what dropper posts could do for center of gravity.

And I would toodle down the hill and they would all wait for me at the bottom.

So again, it was just like, I guess when you have a natural ability, people kind of gravitate towards that and.

And I didn't take it for granted, but they helped me with everything from gear to mentorship to help helping me learn how to descend.

And I have a really good friend named Tammy who was a world downhill champion and she would make me roll my Bike off rocks and watch it do it on its own.

And show me that, like you, you can ride anything.

So again, I think it's like riding with people who are better than you that can show you the limit that you feel comfortable with, but without getting hurt.

And I was lucky to have a lot of that.

Yeah, seriously.

You're obviously now very much into gravel riding, which is a discipline I have found as well that I love.

I also a little bit intimidated at first in terms of descending and corner.

I've come to get a little bit better at it.

So what is that?

Pretty much the main thing you're doing now is gravel riding or do you continue to ride mountain bikes?

What is your focus for cycling these days?

I do a little bit of every discipline.

Honestly, the gravel riding here in Whitefish is amazing.

I would love to have you come up and race in our event.

It's super beautiful.

We have grizzly bears, which be a little bit challenging.

There's a lot.

It's a way to.

That's a way both to thin the herd, but also to make sure people ride fast.

Exactly.

Just bring a friend that's slower than you.

You'll be fine.

So, yeah, gravel riding here is stunning.

We have amazing mountain biking here.

Like, I can go right out my door and I'm on the trails.

I can ride all the way to the summit of the ski resort.

And I ride on the road a lot just because I think that will always be my favorite discipline.

And my husband races professionally on the road, so we do that together when he's home.

But yeah, I was just down in Colorado where you live, on a little mountain bike trip that was very fun.

And I find the Colorado riding to be a little more technical.

It's different than the riding here.

And so that was a good brush up on skills, for sure.

Thank you for saying that.

I appreciate it.

Pretty.

I borrowed my friend's bike because I don't have a big travel bike anymore and I didn't want to ride my 100.

And by travel, you're talking about the amount of travel on the suspension.

Yeah, exactly.

Yep.

Tell us about the gravel ride you were just talking about Montana's last best ride.

Where did it come from and how is it involved in funding scholarships?

So during COVID my husband and I were still down in SoCal and I had retired from road racing in 2019.

But I had attended my first gravel race called Rooted Vermont, which was launched by some friends of mine, Ted and Laura King.

And I snuck off to that race in 2019.

Because when you race on the road, it's really frowned upon to do things that are out of that realm that might get you hurt.

So I snuck off to their gravel race over in Richmond, Vermont, and it opened up my eyes to light the discipline that was going to be up and coming.

And I knew it in that moment, in the way that they ran that event, it was like a whole weekend experience of all of these different things.

And it felt so inclusive and so welcoming.

And it felt like every person that was there could see another person that looked like them or came from their background.

And I was like, why doesn't whitefish have something like this?

So that planted the seeds.

And then the next year, we went into Covid, and my husband and I decided that we wanted to move back here, build a house and live in Montana and not be house poor in California anymore.

And in doing that, we had a lot of time, a lot of downtime during COVID where we schemed up this event.

And it took a lot of work.

We have nine different land permits, so that was.

Was the first challenge.

But, yeah, we dreamed of an event that was serious.

Like, it was related to that rooted event, and it was very inclusive and, yeah, offered something for everyone.

Our goal is for people to feel like they've made friendships and done all of the things before they even get to the start line.

Because I think start lines are.

I don't think getting to a finish line is hard, but I think getting to the start line can be even more challenging a lot of the times.

So, yeah, that was the goal of the event.

We also have a location that wins.

Like, people want to come up here.

Glacier park is on the bucket list for a lot of people.

We're nestled right outside of Glacier park, so we knew we could win with that.

And then riding the coattails of our professional careers and having a lot of connections in the industry with media and athletes, so just bridging all of that together.

My secret dream that I had been carrying for a long time was, like I said, growing up in this community, lower income.

I had a lot of access to community programs and then local scholarships when I went to college.

And there's a story about my guidance counselor at the time opening my eyes to the fact that I could go to college and I could afford that, and I wanted to pay tribute to her, and I wanted to start my own scholarship.

And so we decided that we would make the event a nonprofit, and the mission would be providing money to local women with financial need, often underrepresented.

Local women, sometimes women that think that they wouldn't deserve a scholarship or maybe they don't have the GPA because they're unhoused or working full time to help their family pay their bills.

And so that became a big part of the event.

And we have now been operating for five years.

We provided $130,000 of scholarships to 31 women from five different schools in those five years.

We've had a sold out event every year.

Yeah.

And we're really proud of it.

In fact, I have a little thank you card here that I have the pictures of all of the women that I had just dropped sitting here.

I need to go back just a step here.

That $131,000 was funded entirely by this race.

Entirely by this event.

Yep.

That is fantastic.

And these women have all now gone off to college with in part funded by scholarships provided.

Tell me a little bit more.

I want to come back to that because that's just a fantastic story.

But the race itself is when the race, we've shifted.

It started originally in August, which became sadly our smoke season.

So we've moved it into July.

So next year it will be July 26th.

This year the weather was beautiful.

It was perfect.

And how long a race is it?

We have two courses.

Our long course is called the Bighorn sheep.

It is 92 miles and 8,000ft of climbing with a hike, a bike to the top of the ski resort that's become iconic.

And then the short course is called the Mountain Goat.

And it's a tough short course.

It's 48 miles with about 4, 800ft of climbing.

But I didn't want it to be a throwaway.

I wanted those riders to have, like, enough of a challenge that and the views.

And I don't like it when short courses are just like we put it in there because we need something for those people.

Yeah, yeah.

No, that's a legitimate short course.

It is.

Now, I do want to ask because I've talked a lot locally.

Here we have the SBT gravel, which in the past was a sensational event and has over time become less of a sensational event because of the pressures being brought to bear by locals along the course who seem to have an outsized voice in determining the race.

I'm glad to say that next year the race seems to be returning to its more traditional kind of structure with a full weekend of racing and routes that look a little bit more like it has in the past.

But the organizing committee has really had to thread the needle between what the greater community seems to want and what a very small vocal group of ranchers have been able to somehow have an outsized influence on the race and everything else.

And I wonder, do you have the same kinds of issues?

And if so, how have you navigated them?

And if not, why do you think you don't where the Steamboat group does?

Yeah, that's a great question.

And I know Amy was very well because we raced at the same time on the road.

And actually she did a like female race organizer team this year that I really wanted to be a part of.

But it is hard for me to get away in the summer with this event.

It's a big undertaking with a full time job.

One thing that's different with TLBR is because a lot of our land is Forest Service land.

The Forest Service and there's two districts that we use.

They do like a biological and ecological evaluation of the land.

And we have core grizzly habitat.

We're one of the only places in North America that has core grizzly habitat.

We also have wolverine habitat that is protected.

And so they will evaluate every permit.

If there's an ATV permit, maybe they will only allow 10 to go in.

And then they say the number of cyclists that they're comfortable with on that land and it is significantly less than the number of people under a thousand that go to sbt.

So I think that is one piece of it.

It's just not as large as that event.

I think the other piece of it is potentially the approach with the nonprofit and how we have activated the local community and businesses and we've empowered them to feel like they have a presence and an impact in the event, whatever way that is, whether we incorporate them in using their business as a business that comes to the event and profits from it, or if they're volunteering or if they know a family that maybe has a kid that's getting the scholarship.

So there's, that's a little bit different growing up here.

There's.

There's something you learn when you grow up in a very small town that has a economy based on tourism.

And it's that everybody is very tribal.

And there, there's just a way that approach that in my opinion, and I don't know about SBT because I think we have less of a farming and ranching community and we don't have roads on our event that go through those areas.

We're using public, public land and then we're using private land that is part of the lumber organization.

So we're faced with different challenges.

And we're really lucky.

Every year I touch base with the landowners and the police department and the county, and they only hear good feedback and good things about our event.

Yeah.

I don't know.

Different challenges, different folks, maybe.

Yeah.

It is frustrating because as I pointed out when I had.

It wasn't.

It might have been Amy, but I had somebody on to talk about SPT gravel and I pointed out those roads are public.

Those roads don't belong to those ranchers.

They don't belong to those ranchers.

I'm not sure why they seem to have this outsized voice.

But anyways, another story for another time.

But I'm really glad that you have had that success.

You've mentioned grizzlies now a couple of times.

I would be remiss if I didn't ask how exactly is that managed for the cyclist who might be riding on their own along the road, Never mind the wolverines, who I think are a little more shy and probably not as much as not the fearsome creatures that we might think about, but a little more resurrected.

Yeah.

But grizzlies not benign.

So how is that managed?

So our.

It's managed in a couple of ways.

We do a lot of communication to riders about this.

We sell bear spray.

We teach people how to use it, and we list basically like the educational resources on our website of what people can look at before the event.

Because we don't want to scare people, but we want to equip people with the tools.

It's unlikely with a lot of people and a lot of noise.

Bears don't like that either.

They're going to hear that and they're probably going to move away from that.

But it is.

It'd be like if a herd of people came through your living room.

It could be very startling.

And that's essentially what we're doing.

So, yeah, one of the other things is we work with our medical and safety plan with the Forest Service.

We do a course sweep.

We.

To make sure there's no carcasses on course.

That's really important.

To be clear, the carcasses you're referring to are not cyclists.

No.

Hopefully not other animals.

Yeah.

Make sure you'll often go for a hike here and you show up at a trailhead and there's a sign that's like carcass on trail clothes.

And it's like, wa, wa.

I just drove all the way out here and that's that.

So we do a sweep for that.

And yeah, we get the information.

We've never had any encounters.

We have had a little black bear once running around on course.

But that was just cute and silly.

Luckily.

Luckily.

Wow.

Okay.

One of the things I enjoyed about my trip to Colorado was not having to worry about yelling hey bear.

Every time you cruise around a corner.

That's right.

That's.

That is true.

Although I have to say it's a little bittersweet.

Right.

The absence of things that used to be here.

But anyways.

Yeah, not right now.

Here too.

But we won't get into that.

Hopefully they.

We can keep them around.

Yeah.

Tell me about Joe J Bar.

What was the story behind that?

So also, yeah, not part of the plan.

And it came from the cycling era of my life, obviously.

Like I have background, I studied physiology, know a lot about nutrition.

I actually started a small private chef and catering company that I ran for the 12 years that I was racing.

And that's how I supported myself.

So pretty handy in the kitchen.

And I had a coach that was diagnosed with lyme's disease.

In 2010 she got bit by a tick at a triathlon on the east coast and was really struggling.

Finally was diagnosed, was told to go on a gluten free diet and was completely devastated because we loved to eat cookies while we were training.

And I said, why don't I just make like a gigantic pan of gluten free cookies and we'll cut it up and it'll be like our own bar.

And I first had to learn how to make gluten free cookies because that wasn't really a thing back then.

Thumbs up for that and look at that.

My computer does a lot of fancy things.

And we started eating those.

Our training buddies started handing those.

We were racing the Xterra circuit at the time, the Xterra off road triathlon.

So we were doing that and before I knew it, people were ordering them from me.

And so I was like up all night long baking these bars, sending foil wrapped bars to people across the country.

The local bike shop started to sell them like just behind the desk without a.

Or behind the counter without a barcode or anything.

Locally knew like you can get Jess's bars on Friday.

And so they, yeah, they became a thing.

And some of my private chef clients were in the food industry and they helped me with the next step, which is what I decided to do was get a small co manufacturer because we had a small co manufacturer in that area that would literally make a minimum order quantity that was like a pan of product.

So that's really uncommon.

It doesn't even exist.

Anymore.

But that helped me take it to the next step.

And then eventually I went from Clear label slap bars that I was label slapping on my own in the living room to real packaging to eventually getting into rei.

And so that was the big scale up there.

And my husband's, my father in law, my husband's dad came on as a business partner during COVID when things started to get really weird.

Our kitchen, our coma manufacturer closed.

We moved to another one.

We kept the REI thing going.

They moved us into all of their stores and things were getting really overwhelming.

My husband and I were basically doing everything with the help of friends who would come over when we had huge orders and help us with things in exchange for free bar.

Free bars.

And at that time, this company that bought Joe J, the CEO, reached out to me and explained a little bit about the model that they were trying to create a sports nutrition platform.

And they thought that JOJ would be a really cool sort of boutique bar.

And if the timing was perfect, the company was a good match with my values and what I wanted.

And it gave me more stability because it offered me a full time job that wasn't me pursuing cooking or being an entrepreneur anymore, which was.

Had been a really hard, fulfilling, but very hard grind for the last 12 years.

So I said yes, and I joined this team and they acquired JOJ Bar.

And Joe J bars are still out there, still available in all the places you mentioned.

No.

Let'S look at the Triwire.

I know.

Here's where the story changes.

So this company is called Elite Active Nutrition.

They first acquired Salt Stick, which you probably know, maybe used it at Kona.

But I've heard of it.

Okay.

That's where I first found Salt Stick because I was Cervelo's chef for five years at Kona and Cervelo was a huge brand at Kona.

And so I used to take Salt Stick capsules so I could cook for these athletes and the staff.

It was so hard being there.

So that's how I first heard of it.

But Salt Stick was the first brand that was acquired.

And Salt Stick has a sister brand that's a medical food product called Vitassium for people with pots and dysautonomia and other medical conditions that would require large amounts of electrolyte.

And then they acquired JOJ Bar and then they also acquired Bonk Breaker.

And so we were on our way to potentially acquiring a gel.

And that's when after Covid, the landscape of all of this started to shift in several ways.

The financial aspect of how co manufacturers and ingredients, all of that.

That landscape was shifting and things were changing, becoming more expensive, smaller facilities were going away.

So that became challenging.

And then what people and what athletes are eating changed.

And we're in this like, like gel and nutrition revolution, which is awesome, and I'm fully taking advantage of it, but people just aren't eating bars as much.

So what ultimately we did is we decided to sunset joj.

We announced this week that we're sunsetting.

Sunsetting Bonk Breaker also.

But the energy chews from Bonk Breaker will become part of the salt stick portfolio.

So we're just.

We're laser focused on the current climate, which is electrolytes and just easier to eat quick energy, which is the chews.

And we make a really good chew, which I've been.

Because I lead the product development, I've been part of several rounds of innovation for those.

All right, if I can get to Montana's last best ride, can I get a private tasting of a JoJo bar?

I could make a pantry.

I can make you a pan.

And you know what?

You don't even have to come here.

I'll send you a care package of the other products.

Obviously, like, you need this stuff.

You train all the time.

I just want to try the JoJo bar now that I've heard so much about it.

So anyways, they're really good when they're.

Hot out of the oven.

Yeah, it sounds like it.

There you go.

All right.

Many reasons to come up that way.

Yes.

Jess, I can't thank you enough for taking time to chat with me.

You've had a fascinating career, many lifetimes packed into that short career that you've had.

And I think that your work with the scholarship is, in my mind, probably the most wonderful thing that you're doing.

And the fact that you're tying it together with this gravel race is just the icing on the cake.

I think it's just fantastic.

Kudos to you for everything that you've done.

And you've mentioned your husband a couple of times.

I really do want the segment to be about you, but I am fascinated who he is because my son and I are both avid professional cycling fans.

I'm curious if we might know who he is.

You might know him.

His name is Sam Boardman.

He raced for Legion for three years.

He now races for Project Echelon, sometimes writes for Escape Collective, and it has not been announced publicly by the team yet, but I think everyone knows he's racing for the new Handcapi team.

Next year.

I do know that name.

Yes, I do know that name.

So now.

Oh, I'm very excited.

I can make these the tie together.

There we go.

Go.

Excellent.

Yeah.

Jess Sarah is the force behind the no longer available Joe J Bar, but she's also the founder or co founder of Montana's Last Best Ride, which is gravel race and 501C3 funding scholarships.

Sorry, let me say it properly.

She is the co founder of Montana's Last Best Ride, a gravel race that funds scholarships for women and underrepresented youth in her town of Whitefish, Montana.

Sending now how many 130 women have gone to college based?

130,031 women.

$130,000 to spread across 31 women who have been able to go to college with that money.

Congratulations to you.

Congratulations to your organization.

It's been a real pleasure chatting with you.

I hope to be able to get up there someday.

I know it's beautiful country and not to meet a grizzly bear while riding around.

Totally.

Thanks again for being on the Tridoc Podcast.

It's really been a pleasure.

Likewise.

Thank you.

Hi, my name is Rebecca Adamson and I am a proud Patreon supporter of the Tridock Podcast.

The Tridock Podcast is produced and edited by Jeff Sankoff along with his amazing, amazing interns Cosette Rhodes and Nina Takashima.

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