One of the most common issues I see in female runners is that they simply are not fueling enough to support their training. The consequences of underfueling can range from poor performance, low energy, injuries, infertility, insomnia, even anxiety and depression. Depending on the severity of underfueling, lab values can be affected too, like elevated hemoglobin A1C (a measure of blood sugar over time), liver enzymes and cortisol. Here are some common reasons why runners may be lacking in the fueling department.
Diet culture
Diet culture is the worst, and runners are definitely not immune to its influence. What I see most often is the normalization of substitutions or “light” versions of foods or ingredients, which tend to have less energy (or calories). I am not one to harp on calories, but dammit, runners NEED them! What we don’t need is fat free yogurt, cauliflower rice instead of regular, “oil free” recipes, spaghetti squash or zucchini noodles instead of pasta, lettuce instead of a burger bun, high protein, low calorie ice cream… I could go on. Maybe there is a time and a place of some of these, but if you’re running regularly and/or training for a race, zucchini noodles for dinner are not going to satisfy you nor provide you with adequate energy and carbs.
Underestimating needs
It’s also really common for runners, especially female runners, to underestimate just how much they need to eat in order to support their training. Fitness and nutrition trackers are not useful here - they ALL greatly underestimate calorie and nutrient needs. I think this, the popularity of 1200 and 1500 calories diets (not nearly enough for mostly anyone let alone a runner), and diet culture again leads to a lot of confusion about how much we should be eating. I see a lot of female runners who easily need more than 3,000 calories per day, and I say this again not because I focus on calories as a clinician but because it’s such a notable difference from the “norm” women think they should be eating.
Disordered eating
Disordered eating is extremely prevalent in women, and may be even more common in female runners where there is a big emphasis on appearance and leanness (though I *think* this is improving slowly but surely). It can take many forms and include some of the diet culture behaviors I’ve already listed, in addition to restricting, bingeing, rigid food rules, hyperfocusing on eating only what you think is “healthy”, etc. Disordered eating not only leads to underfueling, but it can have a serious impact on hormones, bone health, mental health, fertility, and of course, running performance. Runners who fit into this category need and deserve professional guidance.
Crappy advice
I had to include this one here not only based on my experience working with runners, but from news stories like this one about body shaming and ridiculous nutrition advice at the University of Oregon’s track and field program, or Mary Cain’s story involving pressure to lose weight and eat less from coaching staff as a professional runner. I know there were registered dietitians involved in the Oregon story, which does go to show that just like any profession there are some not so great RDs out there, but in Mary Cain’s case her coaches were also her nutrition counselors. And they were really shitty ones at that - not just because they had no education or training, but because they held really outdated beliefs that runners have to be one certain body type and eating less was the way to get there. While I do think coaches, PTs, trainers, etc. should have basic nutrition knowledge, staying within scope of practice is important for the health of the athlete. As a dietitian, I don’t try to give clients PT exercises, a strength routine or training plan because I’m totally not trained to do any of those things. It should go both ways.
Running too much
RED-S, or relative energy deficiency in sport, which we will talk A LOT more about in future newsletters, can happen when an athlete is not eating enough, and/or running too much. Here, what I mean is that a runner could have a good relationship with food and their body, eat regular meals and snacks but still not be eating enough to support their running if mileage is really high or their bodies are easily stressed from heavy training.
Now what?
There are lots of things you as a runner can do to nip underfueling in the bud and start fueling well, which I’ll get to in future posts. Underfueling can all be turned around by recognizing symptoms or behaviors, taking the steps you need to focus fueling more and better, and seeking help from a professional if you need it.
I can't get enough of your newsletter, Kelly! I enjoyed the fire in your voice in this one because I share it!
The inundation of diet plans from social media and especially ‘fitness trackers’ leads many of us runners to under eat. As a long time runner approaching 60, I still need this reminder to properly refuel.