'A few truths about diet and training on an empty stomach'

Last week, I wrote a blog for Running Sweden about training on an empty stomach. Does it work, how does it work and what's it good for? What, if any, performance improvements can you expect? Read the full text here:

http://www.runningsweden.se/a-few-truths-about-diet-and-training-on-an-empty-stomach/

The female athlete triad – also an interesting read for guys

I have one more race and then I call it quits for the season. My motivation is low and my body has been complaining, nagging me with small pains, poor sleep and stiff muscles. 

So I will be writing a few blogs about the end of season and recovery. To kick off properly, I’d like to give an example of what can happen if you don’t give your body enough rest and nutrition. It’s a cluster of symptoms called the Female Athlete Triad and is, indeed, seen most often in women. Nevertheless, men can suffer from a similar condition, so I strongly encourage you guys to read on.

Female Athlete Triad – what is it?

The Triad is a cluster of 3 symptoms that are seen particularly in young female athletes: disordered eating, amenorrhoea (loss of periods) and osteoporosis (loss of bone mass). Its prevalence seems to be higher in sports emphasizing leanness and physique, and where body weight is important for performance (running, cycling, swimming, XC skiing etc). Together these symptoms can obviously pose a serious threat to health.

 

This condition is considered to start with disordered eating. Poor nutrition then triggers the other two symptoms. ‘Disordered’ doesn’t necessarily imply an eating disorder like anorexia nervosa or bulimia, but merely that energy intake and expenditure don’t match. This might be unwilling, when the athlete is eating too little without knowing, or, more seriously, the low energy intake is the result of a diet to lose weight. Since both voluntary and involuntary energy restriction can lead to the other two components of the triad (amenorrhoea and osteoporosis) it is important to realise that someone doesn’t necessarily have an eating disorder to have the other two symptoms. One can think of women on vegetarian or vegan diets, or people who have a bowel disease, food intolerance (lactose, gluten) or food allergy, all conditions that might complicate adequate intake of essential nutrients.

Leanness is considered important for performance in weight bearing sports such as running.

The disordered eating can lead to a fertility problem, reflected in the absence of menstruation for 3 consecutive periods, also called amenorrhoea. Low body mass and/or low energy intake is a signal to the body to go into an energy conserving mode, which, not surprisingly, does not include being able to conceive and grow another little human. Thus, fertility is reduced. Problem is, birth control measures like the pill can mask this symptom very easily. Osteoporosis is the loss of bone mass from the body. Up to the age of about 30, bone mass should be build and bones get stronger and stronger. But, when intake of nutrients essential to bone mass, like protein, calcium and vitamin D, is too low, bone mass will actually decline. Also, the change in hormone levels that accompany menstrual problems compromises bone mass increases. Stress fractures as well as ‘real’ fractures are often a warning sign of low bone mass. Sure, you break a collar bone in a failed attempt to avoid your neighbour’s dog on your bike, but frequent stress fractures and other recurring injuries should get you worried over your bone density.

A stress fracture in the hip bone, surgery was needed. Source: femaleathletetriad.org

While (voluntary) disordered eating can and should be treated with psychotherapy, the loss of fertility and bone mass might not be as reversible, thus potentially leaving huge consequences for the rest of one’s life.

A myth?

Science wouldn’t be science without a controversy. The definition of the Triad as stated by the American College of Sports Medicine is rather broad, meaning that many female athletes (>60%) might fall into this category. And what if an athlete, for example, has disordered eating and no periods, but her bone mass is not (yet) in the danger zone? Studies investigating the prevalence of the syndrome are also ambiguous. The symptoms of the Triad are, after all, also seen in non-active women –and perhaps even as often as in athletes. All in all, some scientists fear that focussing on the negative effects of sports casts a shadow over the positive effects, and might scare women away from activity. In a society where overweight and obesity rates are sky high, this might not be the right direction to take.

The female triad in men

Okay, guys don’t have periods. But they do have sex hormones. And these levels can be disturbed, just as in women, and with similar consequences for fertility and bone health. And, not to mention, adaptations to exercise such as muscle growth, protein synthesis and production of red blood cells. Indeed, male endurance athletes often have lower testosterone values. Problem is that not much research has been done on the prevalence and consequences of disordered eating (or downright eating disorders) in men so it’s hard to say whether disordered eating is a part of this.

Take home message? It’s worth remembering that too much of a good thing might not be...good. Don't restrict your energy just because it makes you a little faster. Ask for a bone scan if you think you are at risk (have had stress fractures, have bowel disease etc). And, dare to talk to a fellow athlete (or his/her coach) if you think someone is at risk. But don’t use this syndrome as an excuse to open another bag of chips.

Interested in reading more? Click on the text for a link.
- www.femaleathletetriad.org

- Andrological aspects of physical exercise and sport medicine.

- American College of Sports Medicine position stand. The female athlete triad.

 

Source: femaleathletetriad.org

Places to run

One of the great things about running, is that you can do it anywhere. So I always throw a pair of running shoes in my travel bag. Whether travels are for vacation or for work. It's a nice way to get to know the city you are in, and, in case of travel for work, it's an excellent way of getting some fresh air in between boring meetings.

For those of you wondering why it's been so quiet on the blog, I have been travelling. And thus, running. Last week I was in Nova Scotia, Canada. The day after I arrived, I went out on a run. I had just recovered from a nasty cold and after 4 days of full rest, it was great to be out and running again. Especially if you consider Nova Scotia's beautiful environment. Snif fresh air and feel strong again. Whilst running, I realised I have run in quite a few places and wondered what my top 5 would be...

So here it is. What's yours?

1. Nepal (Himalaya region)

OK, major cheating here, because strictly speaking I didn't run here, but walked. We were at an altitude of at least 3500m and my body didn't cope with more than a brisk walk. But anyway, it felt as if I was running. Or perhaps it was because of the breathtaking views. Wanna go and run? Nepal has an ultra trail run http://annapurna100.com/

2. Nova Scotia, Canada

As said, what a beautiful place. The same Ice Age appearance as Sweden with loads of rocks, water and pine trees. Every second you expect to see the acorn obsessed squirrel from the Ice Age movie. I saw a few squirrels but they weren't carrying acorns. Very quiet and lots of unpaved roads to run on.

3. Keystone, Colorado, USA

My first real run at altitude - and in snow. How bad can it be, I thought? Well, pretty bad. I suffered throughout the whole 90 mins 'easy run' but the views and runner's high were worth every second of it. I think I slept during the afternoon's conference session, though.

4. Archipelago, Sweden

No place like home. And what better than to spend midsummer with some running buddies? So in between drinking alcohol, playing kubb (forever) and singing songs, we got out in the forest and just ran. We lost the path but who cares, if your on an island it's hard to get lost. Perhaps hangovers from the night before helped in more reckless behaviour?

5. Melbourne, Australia

This was fun because I have never been greeted by so many runners before.  I was still jetlagged (didn't think I would ever get over it, either) so I was running slow for about an hour or so. It struck me how happy people looked. Which was not surprising, given that it was 30C at 10AM (or was it 9PM?), the sun was shining and the ocean was beautiful.

So next time you travel, don't forget to pack your shoes!