When I first met Cierra Sullivan, I had been preparing for a year abroad in Japan to continue my Japanese language studies, and she was working on her Bachelor’s in Molecular, Cellular and Developmental Biology at the University of Colorado in Boulder. We didn’t have much of a chance to connect before I left the country, but through social media, we were able to follow each other’s passion for extreme sports and the remote outdoors. I ended up in Japan for several years while Cierra graduated from CU, finished a Master’s in Nutrition and Metabolism at Boston University School of Medicine, grew a career as a competitive athlete and high country adventurer, and found a deeper path into Naturopathic and Chinese medicines, in which she is completing a Doctorate and Master’s respectively.

Her resume is an impressive timeline of contributions to every aspect of her academic experience, and studies and volunteering have taken her from both US coasts, South America, Africa and back, working with underprivileged communities in several languages, providing aid, health care, and opportunities for children of underrepresented demographics, just to name a few of the projects on the long list.

Now that we’re both back in the continental US, we’ve had more opportunities to share about our mutual passions, and I was finally able to get some time with her over the phone to really talk about her philosophy of health care and how she represents that in her active outdoor life. In addition to her experience playing basketball, rugby and golf, she continues to compete nationally for Team USA as a duathlete, and is currently seeing her fourth consecutive year of having skied every single month.

Why Naturopathic and Chinese Medicine?

Her background in Western medicine made her aware of the lack of focus on nutrition in the United States, which she believes is essential not only to healing, but more importantly to disease prevention. Naturopathic medicine “is a focus on healing from the inside out,” she tells me. “I really value the patient-physician relationship,” she continues. The ever-looming presence and power of insurance companies means the interaction between physicians and their patients is constantly restricted by time and money.

She says her experience in Naturopathy and Chinese medicine has put more emphasis on the mind-body experience, first doing no harm, and the importance of doctor-as-teacher philosophy. When it comes to health, there are some fundamental similarities; Western and Eastern medical practitioners both recommend exercise and drinking plenty of water. The main difference, she speculates, may be in the definition: “What is it to ‘eat healthy’ and ‘stay hydrated’?”

The essence of her philosophy of nutrition is simple. Even in preparation for the many physically strenuous expeditions she trains for, she tries to maintain a minimally-processed, plant-based lifestyle. Even the companies that sponsor her as an athlete create products that adhere to her strategy of nutrition. Being so particular about the products, both what she puts on her body and in it, she looks for products that value the same things that she does, products that are more beneficial to the body, with no extra colors, preservatives or fillers. Ultimately, she wants to be able to reduce recovery time and enhance performance.

The Mental Game

Cierra tells me she wasn’t always so passionate about the outdoors, having been more immersed in playing basketball when she was younger. But she had always been competitive, and playing sports her whole life, gradually shifted from traditional indoor sports to the wild outdoors. She started climbing and cycling when she was in Boulder, then did a duathlon (running and cycling). “You do a few races, then you get hooked. You see results on the board and it motivates you.”

Her growing experience being an athlete in the outdoor arena fostered the idea of being present in any moment, whether it’s inside, or out with nature. “Ultimately, you learn to set boundaries and cut out all the noises and distractions of social media.” Now, after a brief hiatus from all of that, she has a renewed relationship with her online presence, motivated by the opportunity to share her lifestyle and philosophy and stay in touch with friends and family, which she says is better portrayed in photos than in words.

But her mental strategy remains a strong part of her training, preparation, and execution when it comes to the outdoors and altitude.

“For high altitude excursions, decision-making and mind set are always going to be the challenge. Knowing when to turn around when conditions aren’t right, constantly watching the weather, [being aware] if someone’s not keeping up.” She tells me this is the most difficult aspect of her career right now. And I completely appreciate it. For all the trekking our research team does at altitude, I agree every time she says “you’re only as strong as your weakest team member,” an old proverb we’ve both learned to live by. Although when it comes to the high altitude excursions we’re talking about, I don’t think either of us would use “weak” to describe any member of our team.

She tells me she’s bailed on plans to ascend Mt. Hood for not having fallen asleep by the time their alarms went off before 3 am. “[You] can’t let your ego supersede the safety of everybody in the group. You have to push yourself outside your comfort zones, but you have to do it smart. Even expert backcountry rescuers get stuck.” And it’s not because they’re inexperienced. It’s because conditions outdoors can easily overwhelm even the most experienced bodies.

The Physical Game

Staying active, consistently challenging her body, and consistency are large parts of her strategy when it comes to optimizing her condition at altitude. She says she pays more attention to self-care and exercise than some of her more stressed colleagues in her Naturopathic and Chinese medicine programs, which, for her, looks like a lot of time outside over weekends and breaks.

“Live high and train low might be best for the access to oxygen,” she recommends. I’ve heard the phrase before, but honestly, I’d never really put much thought into it. I’d just always assumed it was most efficient to live and train at altitude. But the way she puts it, having more access to oxygen at lower elevations allows you to train longer and harder, so you’re more physically prepared for long treks at higher elevations. Combine that with the oxygen deficit during recovery and you have a recipe for hard training and increased red blood cell production to maximize performance. And I do admit, training at 9,000 ft. in Summit County is grueling, even for a resident, and I can definitely go longer and harder when I’m at a lower altitude, especially sea level.

She ski tours for hours to train for cycling and running events, saying, “if you can sustain a low Zone 2 workout for 5 or 6 hours [at altitude], you’re set at sea level,” referring to the heart rate zones. (I’ve found a great description of the five zones on Pivotal Fitness’s website.)

The hardest part of acclimation for Cierra, she says, is “being patient for your body to catch up.” She’s really conscious about continuous snacking and water. “I sweat easily, so I switched to Merino wools, adjust layers, and avoid being soaked and getting cold.”

When she prepares for the monthly ski trips, she carb loads, increases fats, does lots of endurance training, stays hydrated and nourished, and makes sure she gets enough quality sleep.

The Gear Game

I ask her what tools or resources she most consistently relies on. I’m expecting some top trade secrets, but, luckily for us, they’re pretty standard and more or less obvious:

“When it comes to winter-time skiing, definitely get to know your [local] avalanche forecasters; avalanche reports are key. Apps like Gaia and Caltopo are great for route planning, but having a GPS spot and being competent with a compass and a map are way undervalued in our tech-loaded society. Of course a good dose of common sense goes a long way, even if the avy report is green, make sure you have your avalanche gear, headlamps, and enough water. Extra high-fat bars that can get you through a 24-hour emergency, confidence in who you’re going to be out with. Layer appropriately. Don’t go above the skill of your weakest member. Food is my comfort thing. Snacks.”

We’re hoping to get some of her time and expertise in the Ebert Family Clinic and on the high altitude research team next summer, but in the meantime, you can follow Cierra’s minimally-processed, plant-based, outdoor adventures on Instagram.

Roberto Santos is from the remote island of Saipan, in the Commonwealth of the Northern Mariana Islands. He has since lived in Japan and the Hawaiian Islands, and has made Colorado his current home, where he is a web developer, musician, avid outdoorsman and prolific reader. When he is not developing applications and graphics, you can find him performing with the Denver Philharmonic Orchestra, snowboarding Vail or Keystone, soaking in hot springs, or reading non-fiction at a brewery.