RED-S Syndrome – What Athletes Need to Know

Mimmi Kotka (far left) at the start of the 2020 Transgrancanaria – (c)iancorless.com

Mimmi Kotka broke silence just last week after a string of below par performances and has acknowledged it is time to take a break from sport. In an open and honest post on social media, she clarifies:

“I have been suffering with my body since the end of 2018. I have finally connected the dots between my low immune system, anaemia, fatigue, stomach problems, lack of menstrual period, inability to run fast and my body always running in reserve: it is RED- S, Relative Energy Deficiency in Sport.”

Now for many, RED-S may well be a new term, however, the list of symptoms and problems Mimmi lists are not. In recent years we have witnessed the rise of many a runner, particularly in the ultra-world for them only to slowly disappear.

Caroline Chaverot at Limone Extreme, Italy – (c)iancorless.com

Recently, Caroline Chaverot, a dominant force and some would have said unbeatable in trail running, slowly removed herself from the sport with a string of below expectation performances. In an interview with Damian Hall for IRunFar, Caroline said, “…I want to be better. Everyone else is training a lot, so I will train like them.’ Maybe I did too much? Or maybe too soon? If training becomes like a competition, then you get tired. I probably trained too hard and fast.”

The story of Geoff Roes and his dominance, for a period over the 100-mile distance, who now runs for fun, forever fighting a battle with fatigue. “It seems like I take two steps forward and one step back. I can’t really do what I want physically, I still get pretty fatigued.” said Roes talking with Justin Mock in an article on IRunFar dating back to just April 2020.

To be clear, I am not saying that Caroline or Geoff had RED-S, I am merely pointing out that our sport, the challenges it brings, without close attention can be far more negative than positive. No runner or athlete intends to get RED-S or OTS, quite the contrary. As Mimmi says:

 “I never had the intention to lose weight, nor do I have an eating disorder. I ended up with RED-S by mistake.”

The great thing about trail and ultrarunning is that it is a sport for all. All body types are welcomed and RED-S can happen to anyone at anytime. It can creep up without your realising.

“But a mysterious training condition is suddenly plaguing its ranks, robbing a generation of top athletes of their talents and forcing victims to wonder: Is it possible to love this sport too much?”

Mike Wolfe at The Rut, he is co race director with Mike Foote – (c)iancorless.com

The above is from an article, “Running on Empty” by Meaghen Brown that starts with the story of Mike Wolfe at the 2012 Transvulcania. I was there, I witnessed the day unfold. The article goes on to say:

“The past seven years have seen the rise and decline of at least a dozen elite competitors, including Anna Frost, who won the women’s division of the North Face Endurance Championship in 2011; Anton Krupicka, two-time winner of the Leadville 100; Geoff Roes, who set a new record at the 2010 Western States 100; and Kyle Skaggs, who demolished the Hardrock 100 record in 2008. Each of them reached the pinnacle of the sport only to mysteriously struggle to repeat their best results. Transvulcania was the start of Wolfe’s own precipitous fall.”

Now the context of the above article was OTS, (Overtraining Syndrome,) but the similarities with RED-S are noticeable.

What is RED-S?

Relative energy deficiency in sport, known as `RED-S `is the result of insufficient caloric intake and/or excessive energy expenditure. For Mimmi, it was the latter, excessive energy expenditure. The condition can alter physiological systems such as metabolism, menstrual function, bone health, immunity, protein synthesis, and cardiovascular and psychological health.

For many, RED-S was known as the Female Athlete Triad and is often directly related to not eating appropriately for the amount of energy one extends. This can be a particular problem for the ultra-distance runner. “Furthermore, the RED-S model includes both male and female athletes – so if you are a male athlete, please do not stop reading! Low energy availability can impact male and female exercisers of all levels and of all ages.”

Food restriction is a worrying scenario, both for male and female athletes. A simple analogy is taking a car and restricting the fuel you add to the car. Do not add enough fuel and the car will eventually grind to a halt, the body is no different. While the condition was often thought to be one for female athletes, medical professionals are now seeing similarity in male athletes and the usage of the RED-S term now applies to male and female.

Mimmi continues to write, “I have plunged myself into this condition over the last few years. I have simply put in more and more hours of training without adjusting my calories accordingly, dragging me towards incredible fatigue.”

Mimmi was eating healthy and good quantities, however, the balance was off. Her training volume was too high and calorie intake insufficient. It was not an eating disorder of any sorts, more a miscalculation of energy burnt/ calories in.

Mimmi, was the winner of CCC and TDS and for a period of time, was considered unstoppable. A force to be reckoned with. But as she says, since 2018 she has continually suffered to find the same performance levels. This in turn brings a negative cycle that only perpetuates the problem.

I will train more.

I will lose weight.

Two common scenarios that gradually add more issues and one cannot ignore pressure from peers, fans and sponsors. In the case of Mimmi, she trained more to get better. She had no intention to lose weight.

While eating habits are an indicator of RED-S, the overall picture is much more complex and of course, the differences between male and female are marked.

The BMJ (British Medical Journal) list several key notable factors as an indicator, the first is missed periods or no menstrual cycle. Now of course, this is specific to women, but what other factors should be considered?

Stress Fractures.

Low BMI.

Strange eating habits.

Increase training.

Inability to recover.

The long-term impact if unchecked can be devastating with affects on the health system staying with the body for the rest of the athletes life.

When hormone levels are altered, the impact is potentially far reaching and why it may be common to know and understand that immunity is impacted, recovery, growth, concentration and an impact on endurance, the cardio vascular system can also be impacted which could lead to heart disease.

This is not a condition just for the “elite” of the sport, quite the opposite. We look up to our idols and we copy them. We hear stories of mega training sessions, we hear about fasted runs and we hear stories of specific diets to maintain race weight… A picture builds and is one that many try to copy and emulate. For some and in the case of Mimmi, it was about being fitter, therefore adding more training. But for others, the pressure to be thin is very real and fad diets contribute leaving a myriad of question marks that few find the answer to.

Going back to the car analogy, sports people need energy and that energy comes from food full of nutrients and variety. One should not have a troublesome relationship with food but unfortunately, sport is littered with athletes who do. How often have you heard someone say, “I need to run to earn my calories!” 

This mindset is the start of a potential problem and it needs checking.

As Mimmi says in her honest post:

“…I’ve dragged myself deeper and deeper into this condition during the last years. Just loaded on more training hours, not adjusting my calories accordingly and slugged through incredible fatigue. Being able to ignore the physical body is what makes a good ultra runner but it’s also what brought me down.”

Nutrition specialist, Dr Nicky Keay confirms in an article, “Fundamentally there is a mismatch between food intake (in terms of both energy and micronutrients) and the demand for nutrition required to cover expenditure, both of exercise training and for basic “housekeeping” tasks in the body to maintain health. If there is insufficient energy availability, then the body switches into an energy saving mode. This “go slow” mode has implications for hormone production and metabolic processes, which impacts all systems throughout the body.”

We train to get fitter, faster and stronger. But a complete athlete should look at all aspects to make a perfect picture. Food and nutrition is a key building block and without it there will be an inability to improve as expected in response to training and the risk of injury will increase. It´s a downward spiral we have seen all too often in the sport of ultra-running.

Counting calories rarely has a benefit in the long-term, however, in the short term, keeping a training diary that records food intake v expenditure can be useful. If an athlete consumes fewer than 2500/2000 calories (male/female) after taking energy expenditure in to account, your intake is likely to be inadequate

There are many fad diets out there but find a balance with nutritious food that has plenty of variety. Periodise food intake to coincide with training. For example, there is a time and a place for carbohydrate. Equally protein and fats. Eat fresh, minimally processed foods that include plenty of servings of vegetables and fresh fruit. Try not to avoid certain food groups unless advised otherwise by a medical professional and if vegan or vegetarian make sure you understand how to maximise calories paying attention to Protein, Fat, B12, Iron, Zinc, Calcium, Iodine and D Vitamin. “The No Meat Athlete Cookbook” by Matt Frazier is a great resource for all sports people

Post exercise, make sure you replenish your body with protein and carbohydrate. Protein will help repair lean muscle and carbohydrate will help restore glycogen for the next training session. How much carbohydrate you eat depends on what training you have coming up… This is where the help of a coach and nutritionist will help keep you honest.

Be sensible with training volume, less is sometime more!

To conclude, who is at risk of RED-S?

The reality is, RED-S can occur in any age or level of athlete but the greatest risk comes for those who are involved in sports that require high power. Power to weight ratio is a fickle beast and those most at risk are cyclists, climbers, triathletes, runners – yes, runners!

Ultimately, find a healthy balance between training, nutrition and rest. Go through the warning signs below and be honest with yourself. If in doubt, ease back, eat healthy and seek the advice of professionals who can help get you back on the correct path.

Warning signs:

  1. Fatigue
  2. Illness
  3. Repeated injury
  4. Mood changes
  5. Broken sleep
  6. Below par performances
  7. and of course, an unhealthy relationship with food.

 

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10 Top Tips for Multistage and Multi-Day Racing

Running is running yes? Anyone can do it! Well I guess the answer is yes. However, variables come in to play. Running is broken down into many different distances, from 100m to 100-miles and beyond. The longer we run, the more the challenges and requirements on a runner change. Running for multiple days or running a multistage race on mixed terrain throws up many different scenarios. Over the years I have spoken with many champions who have raced in the sands of the Sahara, the forests of Costa Rica and the mountainous paths of Nepal. They all provide me with similar hints ’n’ tips to a successful multistage race.

TOP 10 TIPS FOR A MULTISTAGE

1 – RUNNING IN THE SAND

Desert races are very popular. Marathon des Sables for example is the father of multistage racing and over the years, many races have followed in the MDS format. A desert race is never all dunes but some races have more soft sand than others, so, be prepared. To avoid getting tired it’s important to read the terrain. Carve your own path running on fresh sand and when possible, run along the ridges. In smaller dunes (dunettes) it can be beneficial to run in tracks left by others, at all times, run light as though running on ice – you don’t want to sink in the sand!

2 – HYDRATION

Dehydration is a real risk in any race, particularly a self-sufficient race where water is rationed. The risks of dehydration increase when the mercury rises and a lack of cover comes. A desert for example will be open, have intense heat but humidity will be low. By contrast, a jungle such as those found in Costa Rica may well have plenty of tree cover and streams to cool off in but the humidity will be through the roof. In both scenarios it’s important to drink regularly. Take small and regular sips of water and supplement lost salt with salt tablets. Races like Marathon des Sables provide salt tablets at aid stations and they recommend dosage. Other races you will need to think of this and plan accordingly. Also think about food choices on the trail and when in camp – food rich in minerals and salts will also help you. Importantly, multistage racing is about management from day-to-day and this is what can trip people up. Think about the event as a whole and make sure you recover after each day – rehydrating is as important post a run as when running.

3 – BLISTERS

Many a multistage race is ruined by bad personal management of feet. Think about this well in advance of the race by choosing socks and shoes that work for you. Also choose shoes appropriate for the terrain you will be racing on. A shoe for MDS will be very different to a shoe for the Himalayas for example. By all means take advice on shoes from previous competitors BUT you are unique and your needs are unique. Do you pronate? Do you supinate? Do you need a low or high drop? Do you prefer a cushioned shoe or a more minimalist shoe? What about grip, do you need any? Do you need to fit gaiters? The questions can go on and on and only you can make a choice. If all this is new to you. Go to a running store that understand runners and can provide expert and impartial advice. They will assess you and your run style and provide advice. One consideration for multistage racing is that your foot ‘can’ possibly swell due to variables such as heat, running day-after-day and so on. Your foot will not go longer, but it may go wider. So, think about shoes that have some room in the toe box. Don’t purchase shoes that are 1 or 2 sizes larger – this is poor advice. Larger shoes will only allow your foot to move… a moving foot causes friction, friction increases the risk of soreness and soreness will lead to a blister. Also think about walking. Many people choose a shoe because they are good to run in… But how do they feel when you walk? Remember, a multistage race can involve a great deal of walking!

Do you have sensitive feet? If so, you can prepare your feet in the run-up to an event. Also make sure your nails are trimmed back. While racing, if you have blisters, stop and get them treated as soon as possible. Take responsibility and learn basic footsore before an event. You need to make sure you can make any necessary treatments. Finally, many races have a medical team that are provided to look after you and your feet. Don’t hesitate to use them, but remember, there may be a big line waiting. Self-care is an excellent way to make sure that you are ready to run in your own timeline.

4 – BALANCED PACK

Not all multistage races are the same. The Coastal Challenge in Costa Rica, for example, is not self-sufficient so a runner only needs to carry liquid, snack food and any ‘mandatory’ kit. By contrast, a self-sufficient multistage race requires you to carry everything. A simple rule is keep everything as light as possible and keep your pack balanced. Luxuries really are luxuries in a race over multiple days so really ask yourself, do I need to take that? You will need mandatory kit as specified by the race and in addition you will need (as a guide):

  • Sleeping bag
  • Sleeping matt
  • Warm layer
  • Spare socks
  • Food (minimum calories are specified per day)

Clothes, shoes, hat, sunglasses –  but you will be wearing these so they don’t go in the pack.

That’s it. Keep it simple and if at all possible, get your pack with its contents as close the minimum weight as specified by the race.

By general consensus, a luxury item is considered a music player (or 2) such as an iPod shuffle.

Also remember that minimum pack weight will be without water, so, if your pack weighs 6.5kg, you will have to add 1.5kg on the start line on day 1. This is where a front pack or a pack where bottles sit on the front works really well. Bottles on the front help balance the front and the back and provide a greater running experience. Also, think about items your need whilst running… it’s not a good idea having them in the back, they need to be at the front so you can access them ‘on-the-go!’

Many packs are available to choose from and you will see two or three are very popular – WAA, Ultimate Direction and Raidlight. Choosing a pack is light choosing shoes; we are all personal. However, keep a pack simple, make sure it’s comfortable and make sure it has little or no bounce when running/ walking.

Consider joining a multistage/ multi-day training camp HERE

5 – PROTECT FROM THE SUN

The sun can be a killer in any race, single stage or multistage – use sun protection and apply it daily. Also use products like arm coolers, a hat and a buff. At aid stations or whilst racing, you can keep these wet which will help cool you. Particularly the buff. If you overheat, slow down and apply cold/ water to the back of the neck. Use UV protective clothing and the jury is out on if clothing should be tight or loose. This often comes down to personal preference.

6 – EAT WELL

Any multistage race is quickly broken down into three phases – running, eating and sleeping. Food is a really important part of any race as it has to perform many functions. Most importantly, it has to sustain you so you will need carbohydrate, protein and fat. Individual requirements will vary but carbs will restore energy, protein will repair and fat is essential as this is one of the primary fuel sources for a multistage race. Remember though, our bodies have an unlimited reserve of fat. It’s important to understand that your diet whilst training may well be very different to when racing. In training you may well have eaten less carbs to teach your body to use fat, but when racing, you need to recover and be ready to run/race again the next day. Have variety in your food as your palette will change with fatigue, dehydration and heat. Real foods are good but dehydrated food also has a place. You also need to decide if you will require a stove for heating water? Don’t think twice about stepping up a little on the organization’s requisite minimum daily dose of 2,000 calories a day, remember though, it’s all weight!

7 – REST

Rest is crucial and how much you get will depend on how fast you run. Front runners have no shortage of rest time, however, those at the back of the race get minimal rest. Make sure you have a good sleeping bag that is warm enough for you and is as light and packs small as possible. You can save weight by not carrying a sleeping matt – general consensus says that carrying one is worthwhile as sitting and sleeping is much more comfortable. Matts come in two types: inflatable or sold foam. Inflatable matts work really well, pack small but you run the risk of a puncture without diligence. Foam matts won’t puncture but they can be bulky.

Make sure you have a warm layer for comfort, temperatures drop with darkness. A jacket (usually down) will also allow you to add warmth while sleeping if required. A lightweight sleeping bag and down jacket is preferable (by general consensus) over a combination sleeping bag that turns into a jacket. A jacket and bag offers flexibility, weighs less and packs smaller but will be considerably more expensive.

8 – PACE

Remember that you have entered a race that lasts multiple days. Spread your effort and have the big picture in mind – pace yourself. Don’t set off too quickly and consider race profiles, distances and cut-off times. YOU take responsibility of when you need to be at checkpoints. A day with a great deal of climbing, soft sand or technical train will take longer, allow for this and be prepared. Most multistage races have a long day and it’s fair to say it is the most feared day – keep some energy back for that day. Remember, the long day often has a generous time allowance so don’t be worried by taking a sleep break midway through.

9 – KEEP ON TRACK

Most races will have markers for you to follow but be sensible and self-aware of the challenge. If a race requires you to carry a map and compass, then please understand how to use them. Carry a Spot Tracker for safety and if you use a GPS such as Suunto or Garmin, remember that these watches plot a route that you can use to backtrack. In a race like MDS it is difficult to go off course due to the volume of people, remember though that dunes are not way-marked and you will be given a bearing to run off. If you are alone or in the dark, an understanding of how this works is a positive.

10 – ENJOY IT

A multistage journey often offers so much more than any single-day race. It’s an experience like no other and friends made in the desert, jungle or mountains will stay with you forever. Also remember that this journey is a hark back to a more primitive and simple time – embrace that. Leave gadgets at home and live a simple life for a week – I guarantee it will change you!

contributions from

Elisabet Barnes, Danny Kendall, Jo Meek, Nikki Kimball and Laurence Klein

Race Day Nutrition (Part Six) – Marc Laithwaite

©iancorless.com_TCC2015_Day1-9778

Having discussed carbohydrate, fluid and salt intake, I thought it would be prudent to focus a little more on application. We’ll take a look at the specific products used during endurance events and whether they can fulfil your requirements in terms of nutrition intake.

There are 3 common sports products used during endurance racing:

  1. Drinks powders
  2. Gels
  3. Bars

Aside from the ‘big 3’ there is also a selection of jelly shots or chews, in addition to traditional favourites such as jelly babies, malt loaf, flapjack and bananas. For the purpose of this blog, we’re going to focus on the big 3 and examine what they provide and what’s the difference between them?

Energy Drinks

Energy drinks generally come in powder form and you mix with water to create a solution. In past blogs we’ve discussed the isotonic issue and how it impacts upon digestion. Based upon that, a 10% solution or less is ideal (7% is isotonic). To create a 10% solution, mix 60g of powder in 600ml of water.

What’s in the powder?

Almost all energy powders are maltodextrin, this is a ‘glucose polymer’ and made up of between 3-17 pieces of glucose in a chain. It is very rapidly absorbed (almost as quickly as pure glucose) and therefore gives a rapid sugar spike and insulin response (good if you need it during racing, but not good if you don’t need it, such as steady training or just using during the day as part of your diet). All energy drinks tend to be based on maltodextrin, but they often have small amounts of glucose and fructose.

Electrolytes

We discussed sweating and hydration last week, which included salt intake. You can go back and read in full if you wish, but as a recap, salt and sodium are 2 different things. Salt is 40% sodium and 60% chloride. You need to know this as some products give ‘salt’ content and others give ‘sodium’ content. Remember also from last week we said that you are likely to sweat up to 1g of sodium per hour (1000mg). There’s multiple thoughts on salt replacement, regarding how much and whether you need it. I’m not going to go into depth on the matter because this is meant to be a simple and easy to read blog. If it’s warm and you sweat a fair bit, aim for 500-1000mg SODIUM per hour. If you take a bit too much, you’ll just sweat it out anyhow so don’t overly panic.

Let’s presume that you are aiming to take all of your energy by using sports drinks. So remember, our targets are 60g of carbohydrate per hour and 500-1000mg of sodium per hour, presuming its warm and you sweat. Here are some options:


SIS GO Electrolyte 60 grams of powder

Includes 55 grams of carbohydrate, primarily maltodextrin

360mg sodium

 

Powerbar Iso Active 60 grams of powder

53 grams of carbohydrate, primarily maltodextrin

756mg sodium

 

H5 Energy Source 60 grams of powder

57g of carbohydrate, includes maltodextrin, but 33% fructose

312mg sodium

 

H5 Energy Source Xtrem 60 grams of powder

57g of carbohydrate 33% fructose

306mg sodium

Approx. 175mg caffeine

 

Some key points:

  1. We said your target is 60g of carbohydrate, not 60g of powder, but as you can see above, 95% of the powder which goes into your bottle, is actual carbohydrate.
  1. The sodium levels vary quite widely, you can see that Powerbar Iso Active has considerably more than others (756mg) and is the only one to fall within the 500-100mg range.
  1. H5 Energy Source is the only one which uses fructose in large quantities. They use a 2:1 formula (66% maltodextrin and 33% fructose). The reason for this is that the 60g per hour rule is based on the fact that only 60g of GLUCOSE can be absorbed per hour (maltodextrin is a glucose chain). However, that doesn’t account for fructose, which is absorbed in a different manner. So basically, if you take 90g of powder per hour, that contains 60g glucose (the maximum amount of glucose you can absorb) and 30g fructose which is absorbed separately. You can use this drink to take on more carbohydrate per hour than the normal guidelines.
  1. H5 Extrem also has caffeine, approx 175mg per 60g powder. To put that into perspective a pro-plus tablet has 50mg and a filter coffee has between 50-100mg per cup. People think caffeine is a ‘pick up’ or ‘kick’, when in fact it’s real purpose is a pain killer. Caffeine can mask your effort if taken in significant quantities, it changes your perception by acting on the nervous system to make things feel easier.


What about electrolyte tablets?


H5 Zero Tabs 4g tablet

260mg sodium

Power Bar 4g tablet

250mg sodium


Some key points:

The electrolyte tablets don’t contain any energy, they are purely flavoured salt replacement. If you’re drinking a bottle every hour in warm weather and sweating, then you probably need to double them in the bottle. If you’re using energy gels and bars to get your ‘energy’ during your event, you could use the electrolyte tablets to reach your sodium target. You can generally always get water during a race, so add 2 tabs to each bottle and drinks throughout the hour in addition to taking your gels and or bars.

I hope that basic overview of drinks helps you to practically apply what you’ve learned over recent weeks, feel free to call into the store and we can talk you through it before your big day.

Next week we’ll look at energy bars and gels, which one’s to choose to best suit your needs, that’s part 7, honestly the end is in sight.

– Marc

About Marc:

Sports Science lecturer for 10 years at St Helens HE College.

2004 established The Endurance Coach LTD sports science and coaching business. Worked with British Cycling as physiology support 2008-2008. Previous Triathlon England Regional Academy Head Coach, North West.

In 2006 established Epic Events Management LTD. Now one of the largest event companies in the NW, organising a range of triathlon, swimming and cycling events. EPIC EVENTS also encompasses Montane Trail 26 and Petzl Night Runner events.

In 2010 established Montane Lakeland 50 & 100 LTD. This has now become the UKs leading ultra distance trail running event.

In 2010 established The Endurance Store triathlon, trail running and open water swimming store. Based in Appley Bridge, Wigan, we are the North West’s community store, organising and supporting local athletes and local events.

Check out the endurance store HERE

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Race Day Nutrition (Part Four) – Marc Laithwaite

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So last week (part three HERE) we discussed carbohydrate absorption and the role of insulin, this week, we are going to look at how to take foods on board whilst competing, to avoid stomach problems and maximise performance.

I’m having issues getting energy, what’s the solution?

Your stomach and gut acts a little like a sieve. If you pour water into it, the water passes straight through without any problems. If you pour a milkshake into the same sieve, it will pass through, but will take a little more time and will slowly drip. If you throw solid food into a sieve, it stays exactly where it is. The only way to pass solid food through a sieve would be to mix it up with water and make a thin enough solution, which could then start to drip through.

The solution which enters your stomach, is therefore very important in terms of performance. During endurance events, we eat and drink to get energy, but if the food sits in your stomach, then you aren’t actually getting any energy into your bloodstream. Not only are you receiving less energy, you are also likely to get some kind of stomach problems.

Isotonic is just the tonic

Isotonic refers to a solution which is a similar concentration to fluids in the body. Solutions of 7% are generally referred to as isotonic, this means that 7g of carbohydrate in 100ml of water is isotonic. You can count grams and millilitres as the same thing, so the calculation is simple, 100ml / 7g = 7%.

Drinks bottles generally come in 2 different sizes, 500ml and 750ml so based on the 100ml / 7g rule, the calculations would be as follows:

500ml water + 35g carbohydrate = Isotonic

750ml water + 52.5g carbohydrate = Isotonic

Some solutions are less concentrated than isotonic fluids. For example, water has no carbohydrate in it and no calories, this is classed as hypotonic (hypo = low / less than). Solutions which are more concentrated than isotonic fluids, are classed as hypertonic (hyper = high / more than). An example of a hypertonic solution would be a smoothie.

That’s fine for drinks but what about solid food?

Many athletes choose to eat solid food during their event. As stated above, anything which is above 7% solution is hypertonic. Therefore, all energy bars and solid food is hypertonic. This means that if you wish to absorb solid food effectively, you must add sufficient water to make a 7% solution. For example, a standard energy bar is approximately 50-60g in total weight. We said earlier that 7g in 100ml of fluid would be a 7% solution, so that means you would have to drink 7-800ml of water with each energy bar to make at isotonic solution (56g is 7% of 800ml). In ultra running events, there’s often solid food such as sandwiches at feed stations, so get into the habit of estimating the portion size, e.g. what does 60g of cheese sandwich look like! Eating sandwiches, pasta and cake can very quickly result in a large mass of food gathering in your stomach. As for gels, they work the same way. A single gel contains 20-30g of carbohydrate (you need to read the packet). A gel with 21g would require 300ml to make a 7% solution.

Why is solution an issue?

Taking energy bars, gels and other solid food provides energy, but you have to take a lot of fluid to create an isotonic solution in your stomach. If you fail to take sufficient fluid you will have a thick ‘hypertonic’ solution in your stomach which may not digest and may well lead to stomach problems.

Don’t forget the 60g per hour rule

As we’ve said in previous blogs, it’s unlikely that you can absorb more than 60g per hour of carbohydrate so eating too much food can have a negative impact upon digestion. Eating too much may lead to food gathering in the stomach and leading to feelings of bloating or sickness. The carbohydrate ‘maltodextrin’ seems particularly prone to doing this and all carbohydrate drinks and gels tend to consist of maltodextrin (pretty much every energy drink on the market is the same, it’s flavoured maltodextrin).

It’s known that when you get an accumulation of carbohydrate in the stomach, due to excess food intake, the body is forced to dilute the solution. The strong solution sitting in the stomach starts to draw water other parts of the the body, into the stomach, to dilute the solution and aid digestion and absorption. This action of drawing fluid into the stomach is termed ‘osmosis’.

It’s important to remember that if you do take too much energy, coupled with a lack of fluid, not only are you likely to get stomach issues, the energy will also fail to reach your blood stream and exercising muscles where it is needed. In simple terms, more food may provide you with less energy.

Practical advice:

  1. You need to stick to the 60g limit for carbohydrate intake
  2. A solution of 7% is not always attainable, aim for 10% as a minimum start point for intake:

60g energy powder + 600ml water per hour
60g energy bar + 600ml water per hour
60g of gels (2-3) + 600ml water per hour

  1. You can mix the above, e.g. 30g carbohydrate powder and 30g gels every hour, plus 600ml of water.
  2. Think about what’s the easiest to calculate and what the easiest to obtain during the event. Knowing how much energy is in drinks which are handed up at aid stations or adding your own powder on the go is not really feasible so gels and bars are often simpler to use and to quantify. In truth, you really have no idea what’s being handed up in the drinks bottles, so water is always the safe option.
  3. Feeding is easier when cycling compared to running, so if you’re doing Ironman triathlon, the bike feeding is critical to set you up for the run. If you’re running an ultra, the slower pace can help, but little and often applies.
  4. Little and frequent works best for digestion. A gel every 20-30 minutes or half a bar every 30 minutes is better than a full bar every hour. You still need to drink the correct amount of water to account for solution.
  5. Drinking water only with bars and gels has the benefits of ‘freshening your mouth’. Energy drinks, gels and bars can leave you with a constant sticky taste.

What about the food content?

There is circumstantial evidence to suggest that eating too much carbohydrate may also impact upon digestion and potential stomach problems. If you are prone to stomach issues, then gels with a higher fat content may well work best. There are some very scientific high fat gels on the market, mainly in the US, but if you Google for peanut butter flavour gels, that’s a simple option and you can easily get those in the UK. If you don’t like peanut butter flavour, there’s not much option!

The final step

Ok, so here’s your homework. Go and purchase gels or bars, which you intend to use for your event and take a look at the wrapper. What’s the total weight in grams of the product and what does the content add up to? Remember, a gel may have added water, so a 40g gel may contain 20g of carbohydrate. Don’t just use the actual product weight, you need to check the weight of the ingredients and use that as your gauge. Work out how many you will need and how often you will eat them. If your event uses specific products e.g. Ironman use Powerbar, it’s a lot easier to use these on the day and save yourself the hassle of carrying a lot of product.

Hydration?

That’s coming next week

About Marc:

Sports Science lecturer for 10 years at St Helens HE College.

2004 established The Endurance Coach LTD sports science and coaching business. Worked with British Cycling as physiology support 2008-2008. Previous Triathlon England Regional Academy Head Coach, North West.

In 2006 established Epic Events Management LTD. Now one of the largest event companies in the NW, organising a range of triathlon, swimming and cycling events. EPIC EVENTS also encompasses Montane Trail 26 and Petzl Night Runner events.

In 2010 established Montane Lakeland 50 & 100 LTD. This has now become the UKs leading ultra distance trail running event.

In 2010 established The Endurance Store triathlon, trail running and open water swimming store. Based in Appley Bridge, Wigan, we are the North West’s community store, organising and supporting local athletes and local events.

Check out the endurance store HERE

Endurance Store Logo

Race Day Nutrition (Part Two) – Marc Laithwaite

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So last week (Part One Here)we finished by talking about how many calories you use during an event and how to make a quick calculation of fat and carbohydrate contributions. To recap, we said:

80/20: If you are struggling to ride 50 miles / run 15 miles even when fuelling yourself throughout, then apply the 80/20 rule. That means 80% of your fuel is carbohydrate and 20% is fat.

65/35: If you can ride 50 miles / run 15 miles comfortably using fuel, then apply the 65/35 rule. That means 65% of your fuel is carbohydrate and 20% is fat.

50/50: If you can ride 50 miles / run 15 miles comfortably without using any fuel whatsoever, then apply the 50/50 rule. That means 50% of your fuel is carbohydrate and 50% is fat.

Let’s give ourselves a simple scenario. Tom is 43, weighs 82 kg and is racing Ironman triathlon, he falls into the 65/35 category and his main objective is to complete the event without major disaster and to run as much of the marathon as possible. When Tom is riding at his Ironman pace, he is using 820 Kcal per hour, so the calculation works like this:

Fat contribution:  820 Kcal x 35% = 287 Kcal

Carbohydrate contribution: 820 Kcal x 65% = 533 Kcal

Step 1: Discard the Fat

The calories which come from fat do not need to be replaced, even the leanest athlete has ample fat stores for the longest endurance events. Step 1 is therefore to discard the Kcal from fat and focus on the carbohydrate contribution. Carbohydrates is the fuel which must be replaced!

Step 2: Focus on the carbohydrate

For Tom, our calculated figure is 533 Kcal of carbohydrate per hour, so this is our target to replace during the ride. It’s often easier to work in grams as most foods are also measured in grams. Each gram of carbohydrate contains 4 Kcal, so we calculate grams of carbohydrate as follows:

533 Kcal per hour / 4 = 133 grams per hour

Step 3: Apply the maximal intake rule

You may remember from the last couple of weeks, we discussed that the maximum amount of carbohydrate you can take during exercise is 60g per hour. Tom is using 133 grams per hour (just to clarify, that’s not excessive and is realistic). If the maximum Tom can take is 60g per hour, that means there’s 73 grams (133-60) that he’s losing and can’t be replaced every hour.

Step 4: Work out the race total

Tom’s bike time is estimated to be 6.5 hours. If he’s losing 73 grams of carbohydrate per hour which can’t be replaced, what does that add up to over the total bike ride? Well, the calculation is simple: 6.5 x 73 = 474.5 grams. That means that Tom will lose 474.5 grams of carbohydrate, which he can’t replace, by the end of the 6.5 hour bike ride.

Step 5: Work out your time to collapse

The big figure missing here is the actual amount you have got stored in your body, is losing 474.5 grams a big problem? The average human stores 400 grams of carbohydrate stored in the muscles,  and 100g is stored in the liver. There’s also approx 25g circulating in your blood at any given time. For the astute amongst you, the problem has already struck you squarely between the eyes. Tom, sadly, will not be running the majority of the Ironman marathon.

Does this happen in the real world?

Definitely, take a look at the photo below. This is some data for an Ironman athlete taken this week, male veteran, approx 68 kg with a long history of endurance competition. There’s 12 minutes of data on the screen, the first column shows the power output (watts) and the third column shows time in minutes. Prior to this the rider warmed up for 10 minutes at 100-120 watts. Now look at columns 11, 13 and 14 on the far right hand side, they show Kcal per hour, fat% and carbohydrate%. Consider that 120/150/170 watts is not high intensity, despite that and the previous warm up, you can see that the carbohydrate use is very high. Take into account that our athlete is only 68 kg and that Kcal per hour will be greater in larger athletes.

IMG_0534

Would these fugures be similar for running?

Yes, pretty much. The Kcal usage is slightly higher when running at a similar intensity, but the fat usage tends to be a little higher also. I’d suggest that the fat usage is slightly higher as running requires less ‘fast twitch’ fibre contribution, cycling requires a cretain amount of ‘stregth’. Running intensity also tends to be a bit more consistent. Cycling can be hard on the uphill and then rest and freewheel on the downhill, but running is less so.

Should Tom withdraw his entry right now?

Hang on… we know that people can ride the full Ironman bike and then run the marathon. We also know that people run 100 miles, so there’s got to be a catch, these calculations can’t be correct. Will Tom be completely depleted of all carbohydrate even when taking in the recommended 60g every hour?

No, indeed he won’t and the calculations are not so clear cut as above. Your body is pretty clever so it will make some changes along the way to help you out. Throughout the event, your metabolism will switch, so it’s reasonable to suggest that by the time the bike has ended, 50-60% of Tom’s energy will come from fat, rather than the 35% contribution at the start point. That means he’ll only be using half the amount of carbohydrate every hour, compared to when he started.

That’s good right?

In some ways yes it is, it’s saving your carbohydrate stores by halving the amount used every hour. But you need to consider why this change occurs. Your body switches to use a larger amount of fat because it’s ‘RUNNING OUT OF CARBOHYDRATE’ so whilst every cloud does have a silver lining, let’s not look too positively on this change.

As most people struggle to metabolise fat, having to rely upon it will lead to a drop in pace and performance. If we continue our theme of ‘clouds and silver linings’, at least the slower pace means you will be using less Kcal per hour (slower pace = less energy required) so that also helps to reduce the amount of carbohydrate required.

Is anyone else getting concerned here or is it just me?

It’s ok, there is an answer. The 2 key areas for improvement are economy (Kcal per hour) and substrate ulilisation (fat or carbohydrate). If you are aerobically fit, you will be more economical than most people. In fact, for endurance performance, economy is perhaps the most important thing. We can define economy very simply as ‘how much energy do you need to ride or run at any given speed?’

If you take your unfit pub mates for a run, you may well trot along at 8 minutes per mile and hold a comfortable conversation. Your mate on the other hand, may be breathing like a bulldog in a hot car, blowing out of most parts of his body. He will be using far more energy, require far more oxygen and use far more calories. People are like cars, some can go a long way using only a small amount of fuel and some require a regular filling due to their poor economy.

The second thing to consider is substrate utilisation. This simply refers to the relative contributions of fat and carbohydrate towards your total energy need. We’ve discussed this above and in pretty much every blog in the last 6 weeks, so hopefully you’re already familiar with this concept. If more of your energy comes from fat, you’re less likely to run out of carbohydrate. The best athletes in the world require a small amount of energy (Kcal) to ride or run at race speed. If a large chunk of that energy requirement comes from fat, their total carbohydrate use is very small indeed.

The new Tom… we can rebuild him

By making changes to Tom’s training and diet, the new version arrives for the Ironman triathlon using only 700Kcal per hour and 55% is being provided by fat. A quick maths calculation reveals the following:

1. He’s using 315 Kcal of carbohydrate per hour on the bike, compared to the previous figure of 533

2. With his intake of 60 grams per hour (240 Kcal), he now only has a deficit of 75 Kcal per hour compared previously with 292 Kcal (73 grams)

3. As a consequence, Tom runs the whole marathon and Tom becomes a LEGEND…..

Do you want to become a legend? If so, do the calculations and work it out for yourself, then let’s go forwards from here.

– Marc Laithwaite

About Marc:

Sports Science lecturer for 10 years at St Helens HE College.

2004 established The Endurance Coach LTD sports science and coaching business. Worked with British Cycling as physiology support 2008-2008. Previous Triathlon England Regional Academy Head Coach, North West.

In 2006 established Epic Events Management LTD. Now one of the largest event companies in the NW, organising a range of triathlon, swimming and cycling events. EPIC EVENTS also encompasses Montane Trail 26 and Petzl Night Runner events.

In 2010 established Montane Lakeland 50 & 100 LTD. This has now become the UKs leading ultra distance trail running event.

In 2010 established The Endurance Store triathlon, trail running and open water swimming store. Based in Appley Bridge, Wigan, we are the North West’s community store, organising and supporting local athletes and local events.

Check out the endurance store HERE

Endurance Store Logo

Race Day Nutrition (Part One) – Marc Laithwaite

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In recent articles, we’ve discussed the 2 main fuel sources for endurance exercise (fat and carbohydrate) and how you should optimise your body to burn fat, thereby allowing you to save precious carbohydrate stores. When it comes to race day then the game and the rules change completely. As a recap, when training you should:

1. Ride or run at the correct intensity or follow a specific protocol such as Maffetone
2. Avoid fluctuations in intensity, remember that average heart rate or power output are NOT the critical figures, it’s TIME IN ZONE that counts
3. Eat foods which are balanced with low GI carbohydrates and fats to encourage fat usage and avoid sugar spikes
4. Avoid gels and sugar products based on point 3 above

If you follow the above guidance, over a 12-16 week training period, you can teach your body to utilise a greater amount of fat as fuel and also to use less calories overall, making you more economical. The important thing to remember is that ‘training’ and ‘racing’ are 2 separate things and your fuelling approach should reflect this.

What happens during the race?

Okay, let’s presume that you have trained correctly and maximised your fat burning potential and fuel economy. You reach the first event of the year and when riding or running at race pace you are using 700kcal per hour, 50% of which comes from carbohydrate and 50% of which comes from fat. You only need to worry about the carbohydrate loss as that’s the one which is critical, so let’s focus on the 350kcal of carbohydrate which equates to 88 grams of carbohydrate (4 kcal per gram).

The limitation of carbohydrate intake

Here’s the big problem, you can only absorb approximately 60g of carbohydrate per hour. Imagine that there are small boats, which ‘ferry’ carbohydrate across the intestine wall into your blood stream. Unfortunately you only have so many ‘ferry boats’ so no matter how much carbohydrate you throw in there, the amount which can be ferried is limited to a pretty standard 60g. For our example above, that means that you’re going to fall short. You’re using 88 grams per hour and you can only replace 60 grams per hour. That’s a 28 gram / 112 kcal per hour deficit.

So I can’t just eat more?

Unfortunately not. If you eat more, it’s unlikely to be digested and will simply sit in your stomach or intestines without providing energy. There are a lot of people who suffer from gastric problems during long distance events and this is generally caused by eating too much food which they are unable to digest. It’s really important that you understand, eating more food doesn’t mean you’ll have more energy and it may well mean that you’ll face stomach upsets. I stress this point knowing how obsessed Ironman athletes in particular become with regards to feeding on the bike.

A deficit of 112 Kcal per hour doesn’t sound too bad

No, it doesn’t. But that is based on the presumption that you are only using 700kcal per hour, bigger people and less efficient people may be using more. It’s also based on the assumption that 50% is coming from fat and that may not be the case at all, in fact, as much as 80-100% may be coming from carbohydrate. What makes this worse is that bigger people can’t necessarily take on board more fuel, the 60g limit still pretty much applies. It’s a gut issue, it’s not about how big your muscles are and how much you can store in there.

So the 3 things you might want to know are:

1. How many calories do I burn per hour?
2. How many of them come from fat and carbohydrate?
3. How much should I be taking in as a consequence?

As a start point, you can probably work out your calorie usage by using a heart rate monitor or power meter. Run or ride at race pace and it’ll do the calculation for you, although the power meter is a lot more accurate than the heart rate monitor, it’s still a start point. Warm up, then do an hour at your ‘race pace’ and work out the figures. It’s amazing how many people who consider their training and racing to be ‘serious’, still have no clue how many kcal they use when racing. How can you have any grasp of nutrition requirements without knowing this figure? Once you’ve calculated that figure, apply the following rule:

80/20: If you are struggling to ride 50 miles / run 15 miles even when fuelling yourself throughout, then apply the 80/20 rule. That means 80% of your fuel is carbohydrate and 20% is fat.

65/35: If you can ride 50 miles / run 15 miles comfortably using fuel, then apply the 65/35 rule. That means 65% of your fuel is carbohydrate and 20% is fat.

50/50: If you can ride 50 miles / run 15 miles comfortably without using any fuel whatsoever, then apply the 50/50 rule. That means 50% of your fuel is carbohydrate and 50% is fat.

Are those figures accurate?

Absolutely not, I just made them up. They are by no means 100% accurate but they will give you a good start point and will allow you to calculate an approximate figure. The running figures are less ‘straight forwards’ than the cycling, as the impact of running can really fatigue your legs, so you may find 15 miles difficult, even if your fat burning and fuel economy is good. for cycling, the impact is low, so it’s more likely governed by metabolism and fuel.

Ok, so what’s the next step?

Here’s what we’re going to do. Prior to next week you are going to do a 1 hour ride or run at your ‘race pace’ and then using your cycle power meter, GPS or heart rate monitor, calculate how many calories per hour you are using when exercising at that intensity. I feel this is a pretty important thing for you to understand if you are to race successfully. It’s easy with a power meter for cycling, it does the maths for you. Most heart rate monitors will use your age and weight to work out kcal per hour. There are some tools on the internet such as: http://www.braydenwm.com/calburn.htm which can help to give you a basic idea.

Go forwards my endurance friends and do the maths, next week, we will be looking at planning your intake.

Until then, stay healthy.

– Marc Laithwaite

About Marc:

Sports Science lecturer for 10 years at St Helens HE College.

2004 established The Endurance Coach LTD sports science and coaching business. Worked with British Cycling as physiology support 2008-2008. Previous Triathlon England Regional Academy Head Coach, North West.

In 2006 established Epic Events Management LTD. Now one of the largest event companies in the NW, organising a range of triathlon, swimming and cycling events. EPIC EVENTS also encompasses Montane Trail 26 and Petzl Night Runner events.

In 2010 established Montane Lakeland 50 & 100 LTD. This has now become the UKs leading ultra distance trail running event.

In 2010 established The Endurance Store triathlon, trail running and open water swimming store. Based in Appley Bridge, Wigan, we are the North West’s community store, organising and supporting local athletes and local events.

Check out the endurance store HERE

Endurance Store Logo