Amy Stephens

MS, RDN, CSSD, CEDS

Licensed dietitian

specializing in sports nutrition

and eating disorders

Performance

HOW TO USE GELS FOR ENDURANCE ATHLETES

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How to Use Gels for Endurance Athletes

  • By Amy Stephens RDN CSSD

Gels are a compact and convenient way to deliver easily digestible carbohydrates during endurance sports like running, cycling, swimming, or triathlons. They provide quick energy to fuel your performance and help you maintain steady energy levels throughout your activity. Here’s a breakdown of the key factors to consider when selecting the best gels for your events.

During exercise, your body relies on glycogen, the stored form of carbohydrate, as a primary fuel source. After glycogen stores are depleted, your body requires additional carbohydrate fuel from gels. Here’s why gels are essential:

  • Prevent “Hitting the Wall”:

Your glycogen stores provide enough energy for about 90 minutes of continuous exercise.

After glycogen is depleted, you experience a significant drop in energy levels, often referred to as “hitting the wall.”

  • Sustain Energy Levels:

Gels provide a quick source of easily digestible carbohydrates to replenish glycogen stores and maintain steady energy.

  • Delay Fatigue:

By keeping your energy supply consistent, gels help delay the onset of fatigue, allowing you to maintain a steady pace during long endurance events.

  • Improve Performance:

A steady carbohydrate intake ensures your body has the fuel it needs for both physical and mental performance, crucial for sustaining endurance activities like marathons, triathlons, or open-water swims.

Differences Between Gels

Carbohydrate Content

Most gels contain 20–40 grams of carbohydrates, usually a mix of fructose and glucose (dextrin) for quick absorption and energy delivery.

Natural gels (e.g., maple syrup or honey) provide the same sugars from natural sources.

 

Rapid Absorption

The combination of fructose and glucose ensures faster energy uptake, helping sustain energy during prolonged exercise.

 

Easily Digestible

Gels bypass the slow digestion of solid foods, reducing the risk of gastrointestinal (GI) issues like nausea or bloating.

 

Electrolytes

Gels vary in their electrolyte content (sodium, potassium, magnesium, calcium), which are crucial for energy generation, blood pressure regulation, and muscle function.

Sodium is the most critical, as it is lost in the greatest amounts through sweat.

Always check labels to ensure the gel meets your electrolyte replacement needs.

 

Taste

Available in a wide range of flavors, from fruity to savory.

Testing different flavors can prevent palate fatigue during long events.

 

Texture

Gels vary in texture:

Aqueous (easier to swallow).

Thick, honey-like (requires more effort to ingest).

Jell-o-like (a unique option for those who prefer a different consistency).

Some newer gels are hydrated, eliminating the need to drink water when consuming them.

Additional products include chews and sports drinks that deliver carbohydrate in a different form.

 

Caffeine Content

Caffeine enhances performance by reducing perceived exertion and delaying fatigue.

Gels may contain up to 100 mg of caffeine per serving.

Recommended daily caffeine intake for performance is 3–5 mg/kg body weight.

Excessive caffeine can cause GI issues, shakiness, or heart palpitations, so it’s essential to read labels and track your intake.

 

Cost

Prices range from $1.50 to $4.50 per gel.

Frequent use during training and racing can add up over time. Consider budgeting for your endurance events.

 

Tips for Choosing the Right Gel

Match the carbohydrate and electrolyte content to your event’s duration and intensity.

Test different flavors and textures during training to find what works best.

Monitor your total caffeine intake if using caffeinated gels.

Why Are Gels Better Than Food During Exercise?

During exercise, blood flow is redirected from the digestive system to working muscles and lungs, making it harder to digest solid foods. Gels provide an advantage because:

  • They require minimal digestion, allowing energy to be absorbed and used quickly.
  • Solid foods take longer to break down, and undigested food can cause GI issues like:
    • Nausea
    • Bloating
    • Diarrhea
    • Vomiting

Gels are designed to fuel workouts efficiently and avoid these digestive problems.

When to Use Gels

Before Exercise: A gel 5–15 minutes before starting can provide an energy boost.

During Exercise:

  • Take your first gel within the first 30–45 minutes of exercise to keep up steady energy levels and prevent early fatigue.
  • Continue by taking one gel every 30–45 minutes during activities lasting longer than 60–90 minutes to sustain energy.

Avoid This Common Mistake:

  • Don’t wait too long to take your first gel. Delaying can lead to an energy deficit that’s hard to recover from, making it difficult to maintain performance.

 

The Best Ways to Carry Gels During Endurance Events

For endurance activities, carry gels in a way that’s both secure and easily accessible. Here are some effective options:




Where to Stash Gels

  1. Pockets:
    • Use the small pockets found in running shorts, tights, or jackets.
    • Many running belts or hydration packs also have gel-specific compartments.
  2. Hats or Headbands:
    • Tuck gels into the band of your hat or headband for quick access.
  3. Gloves:
    • In cold weather, stash gels inside gloves with built-in pockets or tuck them securely into the cuff.
  4. Sports Bras:
    • Many sports bras have hidden pockets ideal for storing gels during long runs.
  5. Shorts or Tights with Gel Loops:
    • Use running shorts or tights designed with loops or slots specifically for gels.
  6. Running Belts or Armbands:
    • Invest in a lightweight running belt or armband to carry multiple gels without impacting your movement.
  7. Use gels provided on the course:
    • Check the race website to see which gels will be offered and how often.
    • If you plan to use them, practice with those gels during training to ensure you can tolerate them. 
    • Take advantage of the gels provided on the course to reduce the number you need to carry. 

Practice

Test During Training: Use your long runs and tempo workouts to practice carrying and consuming gels.

Refine Your Technique: Practice opening gels on the move to avoid fumbling during the event.

Evaluate Comfort: Ensure your chosen carrying method doesn’t cause discomfort, chafing, or shifting during activity.

 

By practicing during training, you’ll develop a system that feels natural and effective, ensuring you’re well-prepared for race day.

 

QUICK AND HEALTHY LUNCH IDEAS FOR COLLEGE STUDENTS

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Quick and Healthy Lunch Ideas for College Students

  • By Amy Stephens RDN CSSD

Eating a balanced lunch offers numerous physical, mental, and emotional benefits, making it especially crucial for college athletes. However, research shows that up to 60% of college students skip lunch due to their busy schedules and budget (Pendergast, 2016). Skipping this meal can negatively impact energy, hunger management, and overall well-being.

 

Here’s why lunch matters:

Sustained Energy Levels

A balanced lunch combines complex carbohydrates, healthy fats, and protein, providing a steady release of energy throughout the afternoon. This helps avoid energy crashes or feelings of sluggishness later in the day.

 

Enhanced Focus and Productivity

Providing your brain with the right nutrients supports better concentration, memory, and problem-solving abilities. Foods like whole grains and lean protein help maintain stable blood sugar, which is key for mental clarity.

 

Hunger Control

A well-rounded lunch keeps you feeling satisfied longer and prevents excessive hunger, cravings or overeating later. Including protein, fiber, and healthy fats helps regulate appetite.

 

Supports Nutritional Needs

A balanced lunch ensures you’re getting key nutrients like carbohydrates, essential amino acids, healthy fats, vitamins, minerals, and antioxidants, which are essential for overall health, strength, and immune function. Lunch is an opportunity to fill in nutrient gaps.

 

Stabilizes Mood

Low blood sugar from skipping or eating an unbalanced lunch can lead to irritability or fatigue. A nutritious meal helps stabilize your mood and keep you feeling positive throughout the day.

 

Improves Metabolism

Eating consistent, balanced meals throughout the day helps maintain a healthy metabolism and promotes efficient energy use.

 

Promotes Long-Term Health

Regularly eating balanced meals reduces the risk of chronic conditions like heart disease, diabetes, and obesity. It also supports good digestive health.

What Does a Balanced Lunch Look Like?

A balanced lunch should include:

  • Protein: Aim to include 20-40 grams (3 oz is roughly the size of a deck of cards) of high-quality protein from chicken, fish, tofu, beans, or eggs for muscle repair and satiety.
  • Complex Carbohydrates: Include 1-3 cups (depending on exercise expenditure) whole grains, quinoa, potatoes, rice, sweet potatoes, or legumes for sustained energy.
  • Healthy Fats: Avocado, olive oil, nuts, or seeds to keep you full, support brain health and reduce inflammation.
  • Fiber-Rich Vegetables: Include 1-2 cups from leafy greens, broccoli, or carrots for digestion and nutrient density.
  • Fruit: Contains a natural source of carbohydrates, vitamins and antioxidants that reduce inflammation.

Meal Ideas

Here are some practical, budget-friendly, and nutritious lunch ideas tailored for college students. These meals are easy to prepare, portable, and perfect for busy schedules:

1. Wraps, Sandwiches and Burritos

  • Turkey and Veggie Wrap: Whole wheat tortilla, turkey slices, spinach, shredded carrots, hummus, and avocado.
  • Peanut Butter and Banana Sandwich: Whole grain bread, natural peanut butter, and sliced bananas (add honey for extra sweetness).
  • Veggie and Hummus Wrap: Whole wheat tortilla, hummus, cucumbers, bell peppers, shredded lettuce, and feta cheese.
  • Falafel pita sandwich: frozen falafel (TJ’s brand or Afia), hummus, sliced tomato and topped with cucumber yogurt sauce.
  • Southwest burrito with grilled chicken, beans, rice, salsa, avocado.
  • Veggie burrito made with roasted sweet potato, black beans, salsa, and avocado. Click here for recipe from the Spruce Eats.
  • Open-faced toast and avocado – add shredded carrots, eggs, salmon, tuna, sprouts (and any veggie you can fit).

2. Grain Bowls

  • Mediterranean Bowl: Quinoa or rice, grilled chicken, cucumbers, cherry tomatoes, olives, feta, and a drizzle of olive oil.
  • Southwest Bowl: Brown rice, black beans, corn, salsa, avocado, shredded cheese, and a dollop of Greek yogurt.
  • Asian-Inspired Bowl: Rice or noodles, sautéed veggies, grilled tofu or chicken, sesame seeds, and a soy-sesame dressing.

3. Meal-Prep Salads

  • Chicken Caesar Salad: Romaine lettuce, grilled chicken, whole-grain croutons, Parmesan cheese, and Caesar dressing.
  • Mason Jar Salad: Layer greens, quinoa, chickpeas, veggies (e.g., cherry tomatoes, cucumbers), and dressing on the bottom for a grab-and-go meal.
  • Power Salad: Spinach, hard-boiled eggs, roasted sweet potatoes, avocado, and sunflower seeds with a balsamic vinaigrette.

4. Pasta or Noodle Dishes

  • Pesto Pasta with Veggies: Whole grain pasta, store-bought pesto, cherry tomatoes, and spinach (add grilled chicken for protein).
  • Ramen Upgrade: Instant ramen noodles with added frozen veggies, an egg, and a splash of soy sauce for a protein boost.
  • Cold Noodle Salad: Rice noodles, shredded carrots, edamame, and peanut sauce.

5. Leftovers Reimagined

  • Rice and Protein Bowl: Use leftover rice and pair it with beans, a fried egg, and salsa for a quick burrito bowl.
  • Stir-Fry Remix: Toss leftover veggies with soy sauce, sesame oil, and any protein (like tofu or chicken) over rice or noodles.
  • Quesadilla: Fill a tortilla with leftover cooked chicken, cheese, sliced avocado and veggies, then heat in a skillet.

6. Grab-and-Go Options

  • Snack-Style Lunch: Whole-grain crackers, cheese slices, deli turkey or hard-boiled eggs, baby carrots, and an apple.
  • Bento Box: Rice, grilled chicken or tofu, sliced cucumber, cherry tomatoes, and a boiled egg.
  • DIY Lunchables: Whole-grain crackers, hummus or guacamole, deli meat, cheese, and fruit slices.

7. Soups and Stews

  • Mason Jar Soup: Layer cooked noodles, veggies, and pre-cooked chicken or tofu in a jar. Add hot water or broth before eating.
  • Chili: Pack leftovers in a thermos or microwave-safe container. Pair with whole grain bread or tortilla chips.

8. Quick Microwave Meals

  • Microwaveable Baked Potato: Top with black beans, salsa, and shredded cheese.
  • Egg Scramble Bowl: Crack eggs into a microwave-safe bowl, mix with spinach and cheese, and cook for a quick protein-packed lunch.
  • Frozen Veggie Bowl: Mix frozen veggies, precooked rice, and soy sauce for a 5-minute meal.

9. Workout Smoothie

  • Green smoothie: Combine a handful of kale, banana, ice, milk, dates or honey, and  peanut butter, optional: top with chia seeds or ground flax seeds. Click here for more smoothie ideas.

 

Pro Tips for College Students

  • Prep Ahead: Make 2–3 meals at once to save time during busy weeks.
  • Stock Staples: Keep items like cooked rice or quinoa, beans, frozen veggies, tortillas, eggs, and canned tuna on hand.
  • Pack Snacks: Pair your lunch with simple sides like fruit, nuts, or yogurt to stay full longer.
  • Invest in Containers: Portable, reusable lunch boxes or jars make meals easier to store and transport.

These meals are affordable, versatile, and packed with nutrients to fuel your day!




Reference

Pendergast FJ, Livingstone KM, Worsley A, McNaughton SA. Correlates of meal skipping in young adults: a systematic review. Int J Behav Nutr Phys Act. 2016 Dec 1;13(1):125. doi: 10.1186/s12966-016-0451-1. PMID: 27905981; PMCID: PMC5133750.

Body Composition Testing: When is it Helpful and When is it Harmful?

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Body Composition Testing: When is it Helpful and When is it Harmful?

  • By Amy Stephens RDN CSSD
    Kate Cochran, Nutrition Intern, NYU Track and Field Athlete

TW: This content mentions eating disorders and body image.

Body composition testing offers a window into the intricate components that constitute our bodies. It surpasses simple weight measurements by evaluating the distribution and proportion of tissues like fat mass, muscle mass, and bone density, providing a detailed profile of physical makeup.

 

Skinfold assessment using calipers

There are a few different ways to measure body composition:

  •  Hydrostatic weighing: Measures body density by comparing a person’s weight on land to their weight submerged in water. Very accurate.
  • Air Displacement Method (Bod pod): Similar whole body measurement as hydrostatic weighing. Computer sensors determine the amount of air displaced by your body. Very accurate.
  • Skinfold assessment using calipers: Measures the thickness of skinfolds at specific sites on the body to estimate total body fat percentage. Less accurate for very lean individuals.
  • Dual-Energy X-Ray Absorptiometry (DEXA scan): Uses X-rays to differentiate among bone mass, fat mass, and lean muscle mass. Expensive and requires specialized equipment. Very accurate. 



Dual-Energy X-Ray Abroptiometry (DEXA scan)

Body fat and its impact on athletic performance

Some sports emphasize the relationship between reduced body fat levels and improved athletic performance. For the majority of athletes, physical appearance does not influence scoring or competition outcomes. Athletes who are frequently featured on social media may feel compelled to achieve a specific physique, which can result in unnecessary stress and pressure, potentially leading to eating disorders among both male and female athletes. 

It’s important to point out that each person has a genetically determined amount of body fat that is unique to them. When athletes strive to lower their body fat below their natural range, it can have adverse effects on their performance, general health, and mental well-being. This can also lead to disruptions in hormones, increased fatigue, susceptibility to injuries, and a compromised immune system. Athletic performance is influenced by a multitude of factors beyond body composition, including genetics, diet, rest, resilience, hydration, overall health, mental attitude, and more.



When Body Composition Testing Could Be Helpful

For endurance athletes, especially those prone to injuries or with low bone density, body composition testing can be valuable. Body composition and fat testing can be helpful to determine if body fat is too low to support proper functioning. It offers insights into muscle mass and overall body composition, aiding in tailored training and injury prevention strategies. 

Beneficial Scenarios for Body Composition Testing: 

  • Athletes recovering from injuries can benefit by understanding muscle and bone health to tailor rehabilitation.
  • Guidance from certified sports physiologists and sports dietitians ensures that testing results are used constructively. 
  • Ensures body fat levels are within a minimim healthy range to prevent issues like low energy availability, amenorrhea, or hormonal imbalances, especially for athletes in sports emphasizing leanness (e.g., gymnastics, running, or swimming).

When Body Composition Testing Isn’t Helpful

The introduction of mandatory body composition testing in collegiate settings has raised concerns. It can feel invasive and exacerbate body image issues, potentially leading to eating disorders among athletes. These psychological challenges can detract from performance by causing fatigue due to inadequate nutrition and increasing injury risks. Rather than focusing on achieving a specific body fat, a great way to improve performance is to focus on overall nutrition and health. Knowing your body fat percentage is just a small part of understanding athletic performance; it is not everything. 

Frequent body composition testing may not offer additional benefits for individuals already maintaining health through exercise and balanced nutrition. Collegiate and high-performing athletes, already under significant physical stress, may not need the added pressure of constant body fat monitoring, as its impact on performance is marginal compared to other training factors. 

Scenarios Where Testing Is Not Beneficial: 

○ Healthy individuals with consistent exercise and nutrition routines. 

○ Athletes susceptible to body image issues or eating disorders, where testing could worsen these conditions. 

In summary, while body composition testing can enhance training precision and injury prevention for athletes, its application should be mindful of potential psychological impacts. Prioritizing factors like hydration, sleep, and diet remains fundamental to improved performance. For those genuinely interested in understanding their body’s composition, exploring such testing can offer insightful perspectives but should be approached with consideration of individual needs and well-being.

 

Alternative Metrics Influencing Sports Performance

Several metrics influence sports performance without necessitating body composition testing:

  • Ensuring adequate macronutrient intake (fueling with carbohydrates, refueling with carbohydrates, protein, and fat). 
  • Ensuring an overall adequate intake of food to fuel training. 
  • Getting enough sleep (8-10 hours per night). 
  • Cultivating a positive mindset towards training. 
  • Maintaining proper hydration levels. 
  • Building a strong support system (coaches, teammates, family). 
  • Incorporating mental training techniques (visualization, mindfulness, goal setting). 

By focusing on these aspects, athletes can optimize performance and well-being without the potential drawbacks of intensive body composition testing. Body composition testing serves as a powerful tool in the realm of sports science, yet its implementation requires careful consideration of both physiological benefits and psychological impacts on athletes. 




References

Beestone C. Body composition testing. Science for Sport. March 1, 2024. Accessed July 8, 2024. 

https://www.scienceforsport.com/body-composition-testing/. 

Kuzma C. Body composition testing – college running programs moving away from body comp tests. Runner’s World. Accessed July 19, 2024. https://www.runnersworld.com/news/a42437488/body-composition-testing-colleg e-programs/. 

Mathisen TF, Ackland T, Burke LM, et al Best practice recommendations for body composition considerations in sport to reduce health and performance risks: a critical review, original survey and expert opinion by a subgroup of the IOC consensus on Relative Energy Deficiency in Sport (REDs) British Journal of Sports Medicine 2023;57:1148-1160. https://bjsm.bmj.com/content/57/17/1148 

Strout E. Why top NCAA triathlon coaches won’t use body composition testing. Triathlete. January 5, 2023. Accessed July 8, 2024. https://www.triathlete.com/culture/news/why-top-ncaa-triathlon-coaches-wont-use -body-compos ition-testing/. 

Body composition: UC Davis Sports Medicine: UC Davis health. Body Composition | UC Davis Sports Medicine |UC Davis Health. Accessed July 19, 2024.




TOP FUELING OPTIONS FOR ENDURANCE ATHELTES​

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top fueling options for endurance atheltes

  • By Amy Stephens RDN CSSD

Here’s a list of the best fueling options for endurance athletes—designed to support energy, facilitate recovery, and keep performance strong. These snacks are easy to digest and perfect for on-the-go fueling. Keep them handy to stay energized throughout your day and training.

Before Training or Competition

These snacks are high in carbs and low in fiber/fat for quick energy:

Best consumed 1-2 hours before

  1. Banana with a smear of honey or peanut butter
  2. Applesauce pouch and handful of nuts
  3. Rice cakes with jam or honey
  4. Pretzels or plain crackers with a little peanut butter
  5. A small handful of dried fruit (e.g., raisins, apricots, or dates) and nut butters
  6. A slice of toast with jam
  7. Nutrition bar such as Clif, Rx or Kind bar

Best consumed within 30 minutes before

  1. Energy chews, gels, or blocks
  2. Sports drink
  3. Fruit leathers
  4. Gummy bears

During Activity (for sessions over 90 minutes)

Easily digestible, high-carb options to keep energy levels steady:

  1. Sports drinks or electrolyte beverages
  2. Energy gels or chews
  3. Small pieces of banana or orange slices
  4. Honey stinger waffles or similar carb-based snacks
  5. Bite-sized pretzels for quick sodium replenishment

After Training or Competition

Refuel within one hour after exercise to replenish glycogen and support muscle recovery:

  1. Chocolate milk (ideal 4:1 carb-to-protein ratio)
  2. Greek yogurt with granola and fruit
  3. Protein smoothie with banana, berries, and protein powder
  4. Cottage cheese with pineapple or berries
  5. Peanut butter or almond butter sandwich
  6. Hard-boiled eggs with crackers
  7. Trail mix with nuts, seeds, and dried fruit
  8. Turkey sandwich on bread or bagel

General Healthy Snacks

Perfect to help maintain energy levels and build muscle throughout the day:

  1. Oatmeal with fruit and nuts
  2. Rice cakes with nut butter and banana slices
  3. String cheese with fruit or whole-grain crackers
  4. Hummus with carrots, celery, or whole-grain pita
  5. Nut butter packets with an apple or pear
  6. Avocado toast on whole-grain bread
  7. Homemade granola bars
  8. Cottage cheese and fruit

EATING DISORDER OR RED-S? THE KEY DIFFERENCES​

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Eating Disorder or RED-S? The Key Differences

  • By Amy Stephens RDN CSSD
    Kate Cochran, Nutrition Intern

TW: This content mentions eating disorders and body image.

Eating disorders are mental health conditions, whereas RED-S (Relative Energy Deficiency in Sport) is a physiological state caused by an energy imbalance. However, these conditions can overlap. For instance, an athlete with an eating disorder may develop RED-S due to intentional caloric restriction. An athlete experiencing RED-S without an eating disorder may adjust their food intake to meet energy needs once under-fueling is recognized. In contrast, individuals with eating disorders may find increasing calorie intake more difficult, often requiring support from a medical team.

The main difference between an eating disorder and Relative Energy Deficiency in Sport (RED-S) lies in their definitions, causes, and impacts, although they can overlap in certain cases. Here’s a breakdown:

Eating Disorder

  • Definition: A mental health condition characterized by disordered eating behaviors and thoughts, such as extreme restriction, binge eating, purging, or obsessive food-related control.
  • Examples: Anorexia nervosa, bulimia nervosa, binge eating disorder, avoidant/restrictive food intake disorder (ARFID).
  • Cause: Psychological factors (low self-esteem, perfectionism, trauma), social influences (media, societal pressure), or biological predispositions.
  • Impact: Affects overall health, including physical, emotional, and social well-being.

Treatment Focus: Psychological therapy, nutrition rehabilitation, and medical stabilization.

Relative Energy Deficiency in Sport (RED-S)

  • Definition: A syndrome caused by insufficient energy intake relative to the energy expenditure required for optimal health and performance, often seen in athletes.
  • Cause: Unintentional (due to misunderstanding energy needs or increased training load) or intentional (associated with disordered eating behaviors).
  • Impact:
    • Affects multiple body systems (e.g., reproductive, bone, digestive, cardiovascular, and immune systems).
    • Can lead to decreased performance, delayed recovery, and increased risk of injuries.
    • Symptoms include menstrual dysfunction, low testosterone in males, fatigue, and impaired concentration.

Treatment Focus: Restoring energy balance through increased caloric intake, reducing training loads, and addressing any disordered eating patterns.

Key Distinction

While eating disorders are mental health conditions, RED-S is a physiological state caused by an energy imbalance. However, the two can coexist. For example, an athlete with an eating disorder may develop RED-S due to intentional caloric restriction. Once under-fueling is identified, an athlete with RED-S will readily increase food intake to match energy expenditure. For an individual with an eating disorder, the addition of calories will be more challenging and may require treatment by a medical team. If nutrition requirements cannot be met, pausing or reducing exercise may be helpful to achieve a positive energy balance.

Addressing either condition requires a multidisciplinary approach involving dietitians, mental health professionals, and medical experts.




Winter Supplements for Runners

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Winter Supplements for Runners

  • By Amy Stephens RDN CSSD, Sports Dietitian

Winter months bring unique nutritional needs for runners, including reduced sunlight exposure, which increases the need for Vitamin D. Meeting nutrition goals through food is ideal, but supplements can be helpful when dietary intake is insufficient. Below are recommended winter supplements and their top food sources. There are other supplements not mentioned that are supportive for performance, please refer to the post, best supplements for runners, for more information on performance. Runners following vegetarian or vegan diets may need to focus on nutrients like Vitamin D, calcium, B12, and zinc because plant-based foods do not contain these vitamins.

Enhance the effectiveness of supplements by ensuring you consume enough food to meet your energy needs. If your diet doesn’t support your current energy expenditure, supplements will be less effective. Athletes should aim for a balanced diet, with supplements serving as an addition to a healthy, well-rounded eating plan.

I had the opportunity to speak with a couple of elite runners about their supplement usage in the winter. Brendan Martin of Martin Physical Therapy who has a marathon PR of 2:15, follows a vegetarian diet and regularly takes vitamin B12 because he cannot obtain this nutrient from foods. Johannes Motschmann who recently placed 9th in the London marathon adds in Vitamin C and Zinc to support the immune system during high mileage weeks.

TIP: To build consistency, try taking supplements alongside daily routines, such as brushing your teeth. 

Supplement Tip: Choose products that are third-party tested (e.g., by USP, NSF), which ensures they are free from harmful ingredients, though it does not guarantee the product’s effectiveness.

Vitamin D

Recommended Dietary Allowance (RDA): 600 IU/day (may need more for athletes).

Function: Vitamin D is essential for bone health and aids in calcium absorption, which strengthens bones. It also helps regulate the immune response, reduce inflammation, and protect against respiratory infections—benefits especially important for athletes during winter when Vitamin D levels often decline. Its anti-inflammatory effects are particularly beneficial for athletes, especially those with a history of bone stress injuries.

Top Sources:

  • Sunlight: UV exposure helps activate Vitamin D in the skin.
  • Food:
    • Cod liver oil (1 Tbsp): 1360 IU
    • Salmon (sockeye, 3 oz cooked): 570 IU
    • Mushrooms (½ cup raw): 366 IU
    • Milk (2%, 1 cup): 120 IU
    • Egg (1 large): 44 IU

Calcium

Recommended Dietary Allowance (RDA):

  • Ages 9-18: 1,200 mg/day.
  • Ages 19-50: 1,000 mg/day.
  • Athletes: 1,500 mg/day, especially if there is a history of bone stress injuries.

Function: Essential for bone health, muscle contraction, and nerve function. Vitamin D aids calcium absorption.

Top Sources:

  • Milk/yogurt (1 cup): 300-400 mg
  • Cheese (1 oz, especially Parmesan): ~200 mg
  • Cooked kale or collard greens (1 cup): 250 mg
  • Fortified orange juice (1 cup): 350 mg
  • Fortified soy milk or almond milk (1 cup): 300-400 mg
  • Tofu (½ cup): 350 mg
  • Dried figs (4-5): 135 mg

Note: Combining food and supplements may be necessary to meet daily targets. It’s important to note that the body can absorb only 500 mg calcium per meal. It’s best to spread calcium-rich foods throughout the day to maximize absorption.

Omega-3 Fatty Acids

Function: Helps reduce exercise-related inflammation by modulating cell membranes and immune responses. Fatty fish are the best sources, though supplements can help when dietary intake is low.

Recommended Intake: 1.1-1.6 grams/day (1,100-1,600 mg).

Top Sources:

  • Salmon, sardines, herring (3 oz): ~1200 mg
  • Ground flax, chia, or hemp seeds (1 Tbsp): ~2300 mg

Vitamin C

Recommended Dietary Allowance (RDA): 75-90 mg/day.

Function: Boosts immunity, aids iron absorption, and is essential for collagen synthesis. Humans need to obtain Vitamin C from food.

Top Sources:

  • Strawberries (1 cup, halved): ~89 mg
  • Oranges (1 medium): ~70 mg
  • Pineapple/Mango/Cantaloupe (1 cup, cubed): ~65 mg
  • Red bell pepper (1 medium): ~152 mg
  • Broccoli (1 cup, cooked): ~102 mg
  • Kale (1 cup, raw): ~80 mg

 

Professional runner, Johannes Motschmann, who recently placed 9th at the London Marathon, adds in Vitamin C and Zinc to support the immune system during high mileage weeks.

Vitamin B12

Recommended Dietary Allowance (RDA): 2.4 mcg/day.

Function: B12 is essential for the production of healthy red blood cells, proper nerve function, and energy metabolism. It also supports neurotransmitter production, playing a key role in mood regulation and cognitive health. Low B12 levels have been linked to memory problems, depression, and mental confusion. B12 is mainly found in animal products such as meat, fish, and dairy.

Top Sources:

  • Salmon (3 oz): ~4.9 mcg (200% DV)
  • Trout (3 oz): ~5.4 mcg (225% DV)
  • Tuna (3 oz): ~2.5 mcg (104% DV)
  • Beef (3 oz): 5.1 mcg (215% DV)
  • Fortified Breakfast Cereals (1 serving): ~0.6–6 mcg (25-250% DV, depending on fortification level)
  • Dairy Milk (1 cup): ~1.2 mcg (50% DV)
  • Yogurt (8 oz): ~1.1 mcg (46% DV)
  • Swiss Cheese (1 oz): ~0.9 mcg (38% DV)
  • Eggs (2 large): ~1.1 mcg (46% DV)
  • Nutritional yeast (1 Tbsp): 2.4 mcg

Professional runner Brendan Martin, with a marathon personal record of 2:15 follows a vegetarian diet and regularly supplements with Vitamin B12.

Hydration with electrolytes

Hydrating during winter is just as essential as in warmer months, even though we may feel less thirsty in cold weather. Here are some tips to help maintain good hydration in winter:

  1. Drink Regularly: Thirst signals decrease in cold weather, so make it a habit to sip water consistently throughout the day. Aim for at least 8 cups (2 liters) daily, adjusting based on activity level and body size.
  2. Warm Beverages: Warm drinks like herbal teas, hot water with lemon, or broth-based soups are great options for hydration when cold water doesn’t appeal. Avoid excessive caffeine and alcohol, as it can contribute to dehydration.
  3. Hydrating Foods: Winter fruits and vegetables like oranges, grapefruit, apples, pears, cucumbers, and leafy greens have high water content, helping you stay hydrated while adding nutrients.
  4. Electrolytes: After exercise or if you’re sweating (even in winter), replenish electrolytes with options like coconut water or a light sports drink. Salty snacks or electrolyte supplements can also help retain hydration when balanced with water intake.
  5. Watch for Signs of Dehydration: Dry skin, fatigue, and dark urine can indicate dehydration. Aim for urine that is pale yellow in color, a good indicator of proper hydration.
  6. Humidify Your Environment: Winter air, especially with indoor heating, can be very dry. Using a humidifier adds moisture to the air, helping you retain hydration naturally.

Should Athletes Use a CGM? A Look at the Benefits and Drawbacks

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Should Athletes Use a CGM? A Look at the Benefits and Drawbacks

  • By Amy Stephens RDN CSSD, Sports Dietitian

A Continuous Glucose Monitor (CGM) is a medical device designed to deliver real-time measurements of glucose (sugar) levels in the body. Although it is mainly utilized by individuals with diabetes to regulate their blood sugar, it has also become increasingly popular among athletes and health enthusiasts. While these devices offer a wealth of data, it’s crucial to consider how that information will be applied effectively. Here’s how it works and its main components:

How CGM Works

  1. Sensor Insertion: A small sensor is inserted under the skin, typically on the abdomen or the back of the arm. This sensor measures glucose levels in the interstitial fluid (the fluid between cells) rather than directly in the blood.
  2. Continuous Monitoring: The sensor continuously measures glucose levels, usually every few minutes, providing a real-time view of fluctuations throughout the day and night.
  3. Data Transmission: The sensor sends glucose data to a receiver or a smartphone app via Bluetooth or other wireless technologies. This allows users to see their glucose levels in real-time, track trends, and receive alerts for high or low levels.
  4. Calibration: Some CGMs require periodic calibration with a fingerstick blood glucose meter, while others do not, depending on the model.

Components of a CGM System

  • Sensor: The small device that is placed under the skin to measure glucose levels.
  • Transmitter: A component that attaches to the sensor and sends the glucose data wirelessly to a display device.
  • Display Device: This could be a standalone monitor, a smartphone, or a smartwatch that receives the data and displays glucose readings.

Benefits of Using a CGM

  • Real-Time Data: Provides continuous monitoring, allowing users to respond quickly to fluctuations in glucose levels.
  • Trend Analysis: Helps identify patterns in glucose levels in response to food, exercise, stress, and other factors.

Popular CGM Brands

Some well-known CGM systems include:

  • Dexcom: Offers a range of CGM products with various features, including a mobile app for tracking.
  • Freestyle Libre: Known for its simple sensor application and a focus on ease of use.
  • Medtronic: Provides integrated systems that often work in conjunction with insulin pumps.

Using a Continuous Glucose Monitor (CGM) can be beneficial for athletes, especially those involved in endurance sports or those with specific dietary and training goals. Here are some key considerations for athletes thinking about using a CGM:

Potential Benefits of Using a CGM for Athletes:

  • Real-time Glucose Monitoring: CGMs provide continuous, real-time glucose data, helping athletes understand how their blood sugar levels fluctuate throughout training and competition.
  • Optimizing Nutrition: By tracking glucose levels, athletes can fine-tune their nutrition strategies to enhance performance, avoid crashes, and ensure they’re fueling adequately before, during, and after workouts.
  • Identifying Patterns: Athletes can identify how different foods, hydration levels, and exercise intensities affect their glucose levels, allowing for personalized dietary adjustments.
  • Avoiding Hypoglycemia: For athletes, especially those in sports with high energy demands, monitoring glucose levels can help prevent hypoglycemic episodes, which can impair performance.
  • Recovery Monitoring: After intense workouts, monitoring glucose levels can provide insights into recovery and metabolic response, helping athletes optimize their post-workout nutrition.
  • Managing Stress Responses: CGMs can help athletes understand how stress (from training, competition, or other life factors) affects their glucose levels, allowing for better stress management techniques.

Considerations and Potential Drawbacks:

  • Cost: CGMs can be expensive, and not all insurance plans cover them, making them a financial consideration for many athletes. Dexcom (Supersapien) may cost $300-400 for the device and $150-200 for the subscription. Freestyle libre (Lingo) costs about $75 per sensor, each one lasting up to 14 days. Additional costs include: $150 per month, plus a one time $60 fee for the reader.
  • Learning Curve: Athletes may need time to learn how to interpret CGM data effectively and integrate it into their training and nutrition regimens.
  • Over-reliance: There’s a risk of becoming overly focused on glucose levels, which might lead to anxiety or second-guessing nutrition and training decisions.
  • Not for Everyone: While CGMs can provide valuable information, they may not be necessary for all athletes, especially those who do not have blood sugar management issues.
  • Lag time: CGMs placed on the arm (Freestyle Libre) measures glucose in interstitial fluid, which can be delayed compared to blood glucose, especially during rapid changes (like after eating or during exercise). This lag is generally about 5-10  minutes, so the device might not immediately capture sudden spikes or drops.
  • Factors Affecting Accuracy: Certain factors, like dehydration, sensor placement, compression (from lying on it or tight clothing), and high temperatures can reduce accuracy. Users also tend to get better readings when it’s kept at a consistent temperature.
  • Stress affects blood sugar readings: Other factors that can lead to fluctuations in blood sugar, apart from food, include stress hormones like cortisol and adrenaline. These hormones may rise during periods of illness, physical or mental stress, medication use (such as steroids), menstrual cycles, or hormonal imbalances. Analyzing CGM data can make it challenging to differentiate between fueling and the body’s normal response to stress.

Conclusion:

Ultimately, the decision to use a CGM should be based on individual goals, health conditions, and the nature of the sport. Athletes interested in using a CGM should consider consulting with a sports nutritionist or a healthcare professional to tailor the use of glucose monitoring to their specific needs and training goals.

Caffeine to improve athletic performance

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Caffeine to improve athletic performance

  • By Amy Stephens RDN CSSD
  • Edited by Amy Gregorek

Studies have shown an improvement in sports performance when caffeine is consumed before exercise (Clarke, 2018). Here are details about how caffeine works and the safe and effective dose that yields the best results.

How it works:

Caffeine blocks adenosine receptors that, in turn, prevent you from  feeling tired. By blocking adenosine receptors, you can feel less pain, increase neuro-excitability, and improve your ability to focus which can lead to ergogenic effects on exercise performance.

Benefits:

  1. Reduces perception of pain and fatigue
  2. Mobilizes fat to use for energy, sparing glycogen
  3. Increasing alertness (reaction time and mood)

Risks:

Effects of too much caffeine can cause jitteriness, shakiness, upset stomach, or reflux. None of these symptoms are ideal before or during a race. Be sure to test out caffeine dose and response before race day.

Dose:

The effective dose of caffeine is 3-6 mg/kg about one hour before competition which is approximately 200-400 mg for a person weighing 150 pounds (70kg) which is equivalent to a tall coffee from Starbucks. 

There is a bigger performance benefit when caffeine is reduced prior to competition (Beaumont). 

Form:

The amount of caffeine in energy bars, gels and medications tends to be standardized, while the amount in coffee and tea can vary considerably. Be sure to read labels and know how much you are consuming.

Some energy drinks or pre-workout beverages might have caffeine listed as one of these ingredients:

Green tea extract

Guarana

Guayaki yerba mate

Guayusa

Cola nut

Cacao

College athletes:

Caffeine is a banned substance by the NCAA. A urinary caffeine concentration exceeding 15 micrograms per milliliter (corresponding to ingesting about 500 milligrams, the equivalent of six to eight cups of brewed coffee, two to three hours before competition) results in a positive drug test.

* Caffeine content varies among brewing methods. See chart below.

Olympic level athletes:

Caffeine is permitted in sports governed by the World Anti-Doping Agency (WADA).

Food-first approach:

The perception of having increased energy from caffeine will not replace the actual energy provided from food. Successful athletic performance is dependent on a nutrition plan that meets your energy and nutrient needs through food first. Caffeine can be used to improve performance and will be most effective if energy needs are met with food-first.

 

References

Beaumont R, Cordery P, Funnell M, Mears S, James L, Watson P. Chronic ingestion of a low dose of caffeine induces tolerance to the performance benefits of caffeine. J Sports Sci. 2017 Oct;35(19):1920-1927. doi: 10.1080/02640414.2016.1241421. Epub 2016 Oct 20. 

Clarke ND, Richardson DL, Thie J, Taylor R. Coffee Ingestion Enhances 1-Mile Running Race Performance. International Journal Sports Physiology and Performance. 2018;13(6):789-794.

Davis JK, Green JM. Caffeine and anaerobic performance: ergogenic value and mechanisms of action. Sports Med. 2009;39:813–832. 

Laurent D, Schneider KE, Prusaczyk WK, et al. Effects of caffeine on muscle glycogen utilization and the neuroendocrine axis during exercise. J Clin Endocrinol Metab. 2000;85:2170–2175. 

McLellan TM, Bell DG. The impact of prior coffee consumption on the subsequent ergogenic effect of anhydrous caffeine. Int J Sports Nutr Exerc Metab. 2004;14:698–708. 

Spriet LL. Exercise and sport performance with low doses of caffeine. Sports Med. 2014;44:175–184. 

Talanian JL, Spriet LL. Low and moderate doses of caffeine late in exercise improve performance in trained cyclists. Appl Physiol Nutr Metab. 2016 Aug;41(8):850-5. 

Wiles JD, Bird SR, Hopkins J, Riley M. Effect of caffeinated coffee on running speed, respiratory factors, blood lactate and perceived exertion during 1500-m treadmill running. Br J Sports Med. 1992; 26:116–120. 

Guide to Carb Loading for a Marathon

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Guide to carb loading for a marathon

  • By Amy Stephens RDN CSSD
    Sports Nutritionist NYC

Plan, Prepare, and Prioritize Your Nutrition

 

Especially during taper week, it’s crucial to stay organized and mindful of your diet, particularly if you’re balancing a busy schedule. Even though we’re running less in the taper, nutrition is just as important as our bodies absorb all the training we’ve put in during our training cycle.

The Importance of a Successful Carbohydrate Loading

 

A well-executed taper can improve performance by 2-3% (as noted by Hawley), but it may also cause anxiety as you decrease your workload and question your readiness. Workouts get shorter, and hunger levels fluctuate, leading to self-doubt. However, trust the process—this reduction in intensity helps your muscles recover and adapt, restoring glycogen to maximum capacity. The greater the amount of glycogen present in your body, the greater your body’s capacity to run faster for a longer period. Fully stocked glycogen stores can significantly enhance your ability to endure the 26.2-mile journey and potentially boost your performance.

As I tapered for my first marathon, focusing on carbohydrates was key. I relied on foods like bagels, oatmeal, pasta, dried fruits, and sports drinks in the week leading up to race day. When I hit the 20-mile mark and still felt strong, I knew my fueling strategy had worked, helping me finish with an Olympic Trials qualifying time. 

 

– Katy Kunc, Professional runner and Olympic Trials Qualifier 2022

 

 

Photo: IG @runninphotog

What is carbohydrate loading?

 

Carbohydrate loading represents the final phase of your marathon training plan. Over the course of a marathon training cycle, you train your body to adapt to running longer distances. Those longer distances are fueled by glucose from carbohydrates, which your body breaks down to provide energy to your working muscles. This glucose is stored within the body as glycogen and serves as the primary fuel source during a marathon and especially during the last few miles of your race. Achieving effective carbohydrate loading involves consuming ample carbohydrate-rich meals in the days leading up to your race to ensure your glycogen stores are at their maximum capacity. This requires careful attention to meal planning and food preparation as the race day approaches. This can be anxiety producing, especially as you must continue eating  while logging fewer miles.

What are the benefits of carbohydrate loading?

Carbohydrate loading allows the body to maximize adaptations, fully restore glycogen levels, and boost overall performance. By prioritizing these factors, athletes can enhance their endurance, ensure glycogen stores are at their highest, and effectively power through the final 10k of a 26.2-mile marathon. It is normal to gain weight during this period of the training cycle. Change in weight when carb loading: 

  • A shift in your body weight is probably a result of rising glycogen levels. Because glycogen retains water, you may observe a minor uptick in your body weight. 
  • Have confidence in your fitness level. A change in weight is not an indication of a decrease in physical activity. 
  • As you get closer to race day, you will be eating more carbohydrates than you’re used to and exercising less. It’s okay for your body to feel different. 
  • Even if you’re not trying to gain fitness, your body is still working to retain muscle which is heavy.
  • Instead of thinking about numbers and weight, think about which nutrients are important to crush your 26.2.

What should you eat during race week?

  • As the week progresses, steadily increase the amount of carbohydrates in your diet. 
  • It’s essential to stick to the foods you usually eat but increase the carbohydrate portion in each meal. There’s no need to change the types of foods in your regular diet. There’s less of an emphasis on post-run refueling because your runs are less demanding. 
  • Consume a carbohydrate-rich diet to fully replenish glycogen stores. Research suggests a guideline of 4-5 grams of carbs per pound of body weight daily. For a 150-pound individual, that equates to around 600 grams of carbohydrates. However, if your usual diet is low in carbs, suddenly increasing carb intake may lead to bloating, distention, and sluggishness. Include: bread, pasta, rice, potatoes, oats, cereals, fruit, beans, and lentils. 
  • It’s okay to gain a couple of pounds this week. Carbohydrates hold on to water which can increase your weight but give you an extra edge when racing 26.2. Each gram of glycogen holds 3 grams of water (Fernandez). 
  • Eat every 3-4 hours to maintain adequate glycogen levels. This can consist of small meals throughout the day or three meals along with three snacks. Doing so will promote tissue repair, maximize muscle strength, and

Race week meal ideas:

Messages Image(783282604)

Breakfast

Eggs with potatoes and toast

Granola bowl with fruit and yogurt

Smoothie – recipes

Toast with peanut butter and banana

Frozen waffles with fruit and syrup

French toast and side of yogurt

Oatmeal with nut butter and fruit

Baked banana oats with fruit

Toast with avocado and hemp seeds

Cinnamon raisin bagel with almond butter or peanut butter

 

Lunch

Wrap with hummus or turkey

Quesadilla 

Burrito bowl

Smoothie and bagel

Pasta with protein

Rice bowl with protein and vegetables

Snack ideas

Bars – cliff, kind, Rx

Toast with peanut butter and banana

Toast with nutella

Crackers with peanut butter

Yogurt with fruit

Tortilla chips with hummus

Rice cake with peanut butter and banana

Trail mix

Fruit or dried fruit

Popcorn

Energy bites – recipes

Dinner 

Grilled salmon or chicken with baked potato + fruit

Sushi

Pasta

Rice and beans

Burrito

Soba noodles 

Chicken or tofu fried rice

Burger (veggie, beef, turkey) on bun with baked potato

Stuffed baked potato (white or sweet potato) topped with yogurt

How do you eat if you’re traveling for a race?

When traveling for the marathon, pack these essentials: 

  • Energy bars (Cliff, Rx, etc.) 
  • Fruits like bananas 
  • Peanut butter for quick snacks 
  • Crackers and pretzels 
  • Favorite breakfast foods (bagels, oatmeal) 
  • Hydration options (water, Gatorade, electrolytes)

 

Book dinner reservations in advance, aiming for places that offer pasta, rice, or potatoes, like Italian, Chinese, or American bistro-style restaurants. A solid meal the night before the marathon can significantly impact your performance.

 

What should you eat the night before a marathon?

  • Aim to eat dinner early so you have plenty of time to digest. 
  • Try to eat familiar foods that you’ve had in the past. 
  • If you are prone to reflux, avoid common irritants such as tomato sauce, fatty foods, dairy or spicy foods. 

Early Dinner 

Pasta, rice, potatoes, bread with protein 

Bedtime Snack 

Salty crackers like pretzels or saltines



 

What should you eat on race day?

3- 4 Hours Before Race 

Have a carb-rich meal with some protein, such as a bagel with peanut butter and a banana, or oatmeal with fruit. 

2-3 Hours Before 

Consume a smaller meal (~100g carbs), like a bagel and banana or a Cliff bar with fruit. 

1 Hour Before 

A small snack like a piece of fruit or a Honey Stinger waffle. 

15 Minutes Before (optional) 

Take a gel, chew, or liquid carb source. 

Trust in your preparation, nutrition, and tapering process—these final adjustments will help you feel strong and ready on race day. 

By following these guidelines for carbohydrate loading and tapering, you can optimize your nutrition and readiness for marathon day. Have a great race!

References

Fernández-Elías VE, Ortega JF, Nelson RK, Mora-Rodriguez R. Relationship between muscle water and glycogen recovery after prolonged exercise in the heat in humans. Eur J Appl Physiol. 2015 Sep;115(9):1919-26. doi: 10.1007/s00421-015-3175-z. Epub 2015 Apr 25. PMID: 25911631.

Hawley JA, Schabort EJ, Noakes TD, Dennis SC. Carbohydrate-loading and exercise performance. An update. Sports Med. 1997 Aug;24(2):73-81. doi: 10.2165/00007256-199724020-00001. PMID: 9291549.

Sherman WM, Costill DL, Fink WJ,Miller JM. Effect of exercise-diet manipulation on muscle glycogen and its subsequent utilization during performance. Int J Sports Med 1981;2(2):114-8.

Stellingwerff T, Cox GR. Systematic review: Carbohydrate supplementation on exercise performance or capacity of varying durations. Appl Physiol Nutr Metab. 2014 Sep;39(9):998-1011. doi: 10.1139/apnm-2014-0027. Epub 2014 Mar 25. PMID: 24951297.

Stellingwerf T. Case study: Nutrition and training periodization in three elite marathon runners. Int J Sport Nutr Exerc Metab. 2012 Oct;22(5):392-400. doi: 10.1123/ijsnem.22.5.392. PMID: 23011657.



Don’t Wait: Understanding Relative Energy Deficiency in Sport (RED-S) and Low Energy Availability (LEA)

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Don't Wait: Understanding Relative Energy Deficiency in Sport (RED-S) and Low Energy Availability (LEA)

  • By Amy Stephens RDN CSSD

By Kate Cochran, Nutrition Intern, NYU Track and Field​

When I first learned about low energy availability (LEA) and relative energy deficiency in sport (RED-S) at twenty-one, I was four years deep into my distance running journey. It was while reading “How She Did It” by renowned female distance athletes Molly Huddle and Sara Slattery, both esteemed Olympians themselves, where I first learned about the syndrome. It was something I wish I knew when I began running at sixteen. I firmly believe it’s essential for every female athlete to familiarize themselves with RED-S early on, considering its potential impact on their athletic path.

LEA, or Low Energy Availability, is a condition where the body lacks sufficient energy to sustain vital physiological functions, jeopardizing overall health. It occurs when caloric intake fails to match the increased demands of intensified training, such as higher mileage or more strenuous workouts. Counting calories, restricting necessary food groups, waiting too long to eat after exercising, running on an empty stomach, and skipping meals can often result in LEA. When your energy availability is low, your performance in sport will likely suffer. In short, being in a constant state of low energy availability will prevent you from reaching your potential in sport.

Some symptoms of RED-S and LEA are:

  • Frequent illnesses (common cold, stomach bugs)
  • Recurring injuries
  • Regularly feeling tired and sluggish in and after training
  • Absent or irregular periods
  • Poor concentration
  • Low mood
  • Underperforming in training and competition
  • Loss of enjoyment from sports
  • Poor sleep

Being in a prolonged state of low energy availability will eventually lead to RED-S. RED-S is a broader syndrome encompassing LEA as one of its components. RED-S involves a spectrum of health and performance issues resulting from prolonged low energy availability, affecting not only physical health but also metabolic, hormonal, and psychological aspects, ultimately impairing athletic performance. In addition to LEA, RED-S may involve disruptions in menstrual function, bone health, immunity, cardiovascular health, and psychological well-being.

Those at risk for RED-S are typically female endurance athletes, and anyone who is cutting calories while playing a high demand sport.

 

How to treat RED-S:

  • Ensure you’re consuming enough calories to meet the energy demands of your training and daily life. This might involve working with a registered dietitian to develop a balanced meal plan tailored to your needs. Generally, you should aim to consume as many calories as you are losing through sport and everyday activities.
  • Make sure you are getting a good balance of macronutrients. Carbohydrates, fats, and proteins support energy production, muscle repair, and overall health. In your diet, aim for about half of your food to come from carbohydrates, around one-third from protein, and another one-third from fats.
  • Incorporate adequate rest, sleep, and recovery strategies into your routine to support overall health and performance.
  • Consider working with a mental health professional or sports psychologist to manage stress, anxiety, or disordered eating patterns.
  • With sufficient rest and energy intake, the majority of athletes can replenish their energy stores and maintain their training at their usual capacity.

optimize health and performance

Amy Stephens, MS, RDn, CSSD, CEDS

Licensed Dietitian Specializing in sports nutrition and eating disorders

info@amystephensnutrition.com | Book your Session

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