Topic: Sport Nutrition

Sports nutrition update: Tired, injured, and underperforming in your sport? Your diet might be the cause

I get a wide range of clients in my practice, both for sport nutrition and general wellness. Many are cases of busy people who need simple nutrition strategies to feel better and perform better, either for daily life, or in their sport of choice. But one trend I see perhaps more than any other is athletes who are tired, injured, and struggling with a string of poor performances. They can’t put their finger on what’s wrong, and they are frustrated with what seems like an endless cycle of lost training time and sub-par results.

REDS can not only leave you feeling tired, but prone to injury and illness over time

Low energy availability can not only leave you feeling tired, but prone to injury and illness over time

While not every struggling athlete has the same problem, many do. And, for those who do, it often comes down to something that they might not expect, and that is not how well, but rather, how much they eat. Or, put another way, how much they eat compared with how much they burn. In a world where we are constantly reminded of how easy it is to overeat, it is easy for a highly driven athlete to get caught in the cycle of eating less and training more.

For the record, I’m not talking about someone who is intentionally cutting calories for a short time to meet a weight loss goal, or, on the other end of the spectrum, someone who has developed a full-blown clinical eating disorder. I see my share of those, too, but for many athletes who haven’t been performing well for a while now, the issue boils down to training or exercising with too little gas in the tank for months or even years at a time – not just they days or weeks that a typical diet lasts.

The term for chronically eating less than you are burning is known as having ‘low energy availability’. Energy availability is the amount of energy (measured in calories) your body has leftover to perform its daily functions (like climbing the stairs, walking around, or keeping your heart beating) after you factor in all the energy (measured in calories) burned for training or exercise. Some athletes I work with have an energy availability of close to zero; in other words, virtually every calorie they eat is used to get through training or exercise, leaving the body running on fumes for every other task.

So, what happens if your energy availability is low? If you stop and imagine how your body works, you can probably get a good idea. If you don’t have enough calories for everyday life, your body will start to conserve energy, draw on its reserves, and eventually, break down. Translation? Almost every part of you starts to suffer.

While we know that women who have low energy availability are prone to low bone density (increasing the risk not only for osteoporosis, but also for stress fractures – nasty things that can sap training time and keep athletes out of crucial competitions) and the loss of their menstrual period, we now understand that the effects can be much bigger. We also have good reason to believe low energy availability can also affect men, just perhaps not in as obvious a manner as the loss of a period – for example, via increased injury risk and low testosterone levels.

Men with low energy availability can have low testosterone levels

Men with low energy availability can have low testosterone levels

The term now used by some to explain the far-reaching effects of low energy availability in athletes is Relative Energy Deficiency in Sport, or REDS. REDS was first coined in 2014 as part of an IOC Consensus Report published in the British Journal of Sports Medicine, along with a 2015 update.  Since then, it has been the topic of considerable debate in the academic and sports medicine community, some of whom are concerned it is too new to be given a proper name.

Regardless of what you call it, the symptoms of REDS can include fatigue, poor recovery, loss of lean muscle (and often a higher body fat percentage as a result), low mood, lousy sleep, and a compromised immune system. Not surprisingly, performance starts to decline.

Over time, low energy availability can manifest as loss of bone density, stress fractures, and chronic injuries. Headaches, digestive issues, and infertility are also possible. Mentally, the athlete may feel like their sport has become a chore, and yet they often respond by trying to train more, or in some cases, by eating less, all in an attempt to get back to feeling like their old self again. Of course, the effect is often the opposite.

I have seen the effects of low energy availability in athletes and active individuals all the way up the chain, from a busy mom training for her first half-Ironman, to world-class athletes in running, triathlon, gymnastics, and more. I’ve seen countless hours of training and competition lost for both men and women, and exasperated athletes, coaches, and support staff who don’t know how to prevent the next injury.

And that’s part of the secret of REDS: it doesn’t always show up in very thin athletes. Some are normal weight, and I’ve even seen it in overweight athletes. After all, the body is very clever: low energy availability can cause the body to slow down many processes, like reproductive function and bone mineralization, to save energy. So, while weight loss might slow, leading the athlete and coach to believe the athlete is eating enough, the reality is that the body has simply adapted to being chronically underfueled – often with disastrous results.

While the solution to low energy availability seems simple – eat more, and/or train less, the implementation can be tricky. After all, telling a lean marathon runner that he or she might need to add 5 pounds to get healthy again can be stressful, especially when we tell athletes that, when it comes to performance, lighter is often better. It’s easy to lose an athlete (or coach’s) trust in the process.

But once we get an athlete back into energy balance and feeling like themselves again, it is possible to help them find their fighting weight, so to speak. But the difference this time, is that we encourage them to hit their leanest competition form only once or twice per year. We look at the calendar and build their diet plan and body composition plan according to when they need to be at their best. The concept is part of a broader term known as nutrition periodization, which is basically a way of saying that an athlete’s diet can and should change according to their training load, goals, and competitions. And for an athlete who has fallen into the Triad or REDS, learning to periodize their eating and their weight can be the crucial link to get them back into competition successfully.

Are you an athlete or active individual stuck in a cycle of injuries, illness, and declining performance?  If so, you would likely benefit from taking a closer look at your diet.  If you’re interested in working with a Registered Dietitian who specializes in sports nutrition like myself, please click here to learn more about my one-on-one counselling services.

Sports nutrition update: What we can learn about carbs from Haile Gebrselaisse

Last week, I presented at the PANEX Conference in Toronto.  I sat on a panel with Dr. Stuart Phillips of McMaster University, along with Dr. Trent Stellingwerff of the Canadian Sport Institute Pacific.  I’ve know both for a long time:  Dr. Phillips was my first-ever nutrition professor at McMaster (I was studying biochemistry, but was interested in making the switch to nutrition, and he taught one of two courses in the area), and he even wrote me one of my reference letters to get into grad school.  Trent and I shared lab space in graduate school together at the University of Guelph, and to this day work closely in a number of areas, including athletics, where he heads up our national Integrated Support Team, and triathlon, where he works in physiology, and I work in nutrition.

Yet despite having regular interactions, and having seen both present a number of times over the years, I still manage to take something new away every time I see them talk.  In this case, I was particularly struck by a slide Trent posted that was derived from his work with the world-famous distance-runner, Haile Gebrselaisse.  If you’re not a track or marathon enthusiast, no problem:  Gebreselaisse’s records speak for himself.  He is a two-time Olympic gold medallist, a four-time world champion (in both cases, in the 10,000 m run), and set the world record in the marathon twice, most recently in 2008 at the relatively senior age of 35.  His latter record stood for three years.  To this day, Gebreselassie is regarded as one of the greatest-ever long distance runners.

Trent is not only a world-class talent in exercise physiology, he also knows a thing or two about nutrition.  And in 2008, he was fortunate enough to be part of the team that helped Gebrselaisse set the world record at the Berlin Marathon.  Trent was kind enough to share the details of Gebrselaisse’s sports nutrition plan for the race as part of his presentation at PANEX, and the results might surprise you (they surprised me).  There was no witch-craft, no trade secrets, no sneaky new technology to help the Ethiopian run faster than any human before.  To win Berlin and set the world record, Gebrselaisse drank about a cup (250 ml) of sports drink every 5 km.  From the 20 km mark and onward, he added a sports gel every 5 km (apparently, he likes black currant).  And that was that.  All told, he took in 8o to 100 g of carbs, and 900 ml of water per hour.

So, what can we learn from Mr. Gebrselaisse?  For me, it was a big reminder that carbohydrates fuel fast performance.  In a world where carbs are seen as the enemy, and sports drinks are seen as poison, Gebrselaisse’s sports nutrition plan speaks for itself.  To run at the unfathomable speed that he and other world-class marathoners run, they simply cannot rely on slower-burning body fat stores.

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Trent Stellingwerff talks marathon world records

In marathon and ultra-marathon distances, teaching the body to rely on fat, rather than carbs, is becoming more popular.  The premise is to move the athlete towards a low-carb, high-fat diet, which eventually helps the body to adapt to burning more plentiful body fat stores during endurance performance (while our body only stores enough carbohydrate to get us through about 2 hours of intense activity, even a lean athlete has enough fat stored to get through a day or more of running).  Moving away from carbs allows the athlete to divorce him or herself from the need for sugary sports drinks and icky-sweet gels.  Not only does this cut down on the intake of added sugars, it can also make things easier for the gastrointestinal system, which suffers less distress when not overloaded with sugars – some of which get fermented, causing unpleasant bloating – that need to be digested while the body is working hard.  The result can be a happier stomach and, in some cases, a healthier athlete, when hundreds and thousands of grams of sugar are removed from the training and race-day diet.

I don’t have a problem helping an athlete switch from carbs to fat as fuel.  I have clients I work with who are on low-carb, high-fat diets, and they love it.  Many have had great success and set personal bests with it.  And for athletes who are overweight, at risk for type 2 diabetes, there is evidence that a low-carb, high-fat diet might be the best choice for overall health and weight control.

But that’s where context comes in:  low-carb, high-fat isn’t for everyone, nor should it be for all types of athletes.  The athletes who do well with low-carb, high-fat diets typically do steady-state endurance work.  And while a growing number of top ultramarathon finishers are low-carb, high-fat followers, they still fall into a different category than rowers, basketball players, tennis players, and sprinters.  (If you want to learn more about this debate, read Dr. Asker Jeukendrup’s recent blog on the topic versus this piece from Runner’s World, featuring low-carb, high-fat advocate Dr. Tim Noakes). For healthy, competitive athletes for whom top speed, or bursts of speed, is essential, consuming carbs before or during important training sessions and competition still makes sense.  And, it would seem, if you want to have a shot at a world record in the marathon, then you’d better learn to love the taste of sports gels – black currant sounds like as good a choice as any.

Welcome My Prevention, Performance & Sport Nutrition Blog

Well, it’s about time.  I’ve had enough people ask me about when I’m going to start a blog, and frankly, written enough in my head over the years that it finally became time to do something about it.  Kudos to Hugh Culver, an expert on helping people work more effectively, for the moral support (nagging?) to get me started, and to the good folks at Fusion Studios Inc. (they also designed and maintain my website) for the technical know-how to make this happen.

Those of you who know me well but be aware that I’ve been writing for the National Post for a number of years (eight!), and had my first book, Unmasking Superfoods, come out last year.  And while I often hear people say that they can “hear” my voice in my writing, I’ve never had an informal place (unless you count Twitter?) to share information.  I think that’s what I’ll be looking forward to most with blogging:  a chance to let my hair down, so to speak, and share what’s on my mind, without (gasp!) an editor.

For what it’s worth, there are three areas that I spend the most time on my practice, and so I’m assuming I’ll spend lion’s share of my time blogging about are:

Nutrition for prevention and every day performance.  In a nutshell, that means eating well to be well at any stage of your life, and to perform at your best at work or at play.  I’m a firm believer in the nudge theory of behaviour change, meaning that small changes can go a long way to improving life-long health, but I also know that some people can have major wake-up calls that cause them to drastically change their life.  Either way can work.  The key is to find what works for you.

Nutrition for sport performance.  Sport nutrition has always been a passion of mine.  For better or for worse, however, it’s a topic that is often mired in controversies and conflicting information.  Should I eat carbs?  (That depends.  Do you want to go fast?).  Is salt good or bad for me?  (It might not be as bad as you think). Are sports drinks just sugary junk food?  (Yes.  But that doesn’t mean they don’t work).  Do I need to take protein powder?  (No.  But it might help.).  See?  Clear as mud.  I look forward to spending more time in the sport nutrition grey zone with you in the coming months.

Nutrition trends and controversies.  The sport nutrition world is just one area of nutrition that is stuck in debate these days.  Are saturated fats good or bad?  Is the Paleo diet just a fad?  Should I go low-carb, gluten-free, or vegan?  The answers to these questions aren’t always simple, but that doesn’t mean we can’t have fun debating them.  And I’ll probably spend quite a bit of time talking about the way these controversies – and the people who feed them – drive me crazy, and even push the boundaries of ethics (no, you shouldn’t tell a 14 year-old female gymnast to “go Paleo”, unless you’re really into triggering eating disorders).

In the meantime, I’m looking forward to talking about putting sport science into practice at the PANEX Conference in Toronto this Friday.  I’ll be on a panel with Dr. Trent Stellingwerff and Dr. Stuart Phillips, two researchers  whom I admire greatly, and whose work has changed the way we look at nutrition for performance.  If any of you are in Toronto and attending, by all means, come and say hello.

Until next time,

Jen

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