Healthy nutrition habits are critical for having a healthy training experience. The most commonly diagnosed eating disorders are anorexia nervosa (severe calorie restriction) and bulimia nervosa (purging such as self-induced vomiting). Poor nutrition habits (such as restrictive eating, inadequate intake of nutrients such as fat and protein, or abuse of diet pills or laxatives) that do not qualify for the diagnosis of an eating disorder can have a negative impact on training as well.
Depending on the severity of the issue, these disorders or unhealthy behaviors can cause a variety of problems for runners, including stress fractures and poor performance. Eating disorders can lead to very serious effects and even death if not diagnosed and treated appropriately.
It is very important to identify these issues early. Many athletes, however, may not even be aware that there is an imbalance between their nutrition and their exercise. The Female Athlete Triad refers to the relationship between energy availability, menstruation, and bone health. Men can also have problems with hormones that can be hard to identify. Low energy availability occurs when one’s nutrition intake does not match the energy spent exercising. This can occur inadvertently when a runner increases training but fails to eat enough to keep up with the energy output. This can lead to hormone disruption, often seen as missed or lighter periods. Birth control pills can make this difficult to assess and, unfortunately, do not prevent the negative effects on bones. The Female Athlete Triad is a common risk factor for stress fractures. To avoid stress fractures, it is important to gradually increase one’s training, incorporate strengthening, and maintain a healthy balance between nutrition and exercise. If you are concerned about your running partner, you can suggest that she make an appointment with a sports medicine physician and/or a sports nutritionist to make sure she is fueling properly to support her workouts.
Dr. Marci Goolsby is a sports medicine physician and member of the Women’s Sports Medicine Center at Hospital for Special Surgery. She is also a consulting team physician for the New York Liberty and has served as a physician at marathons and triathlons. Her main areas of clinical and research interest are stress fractures and the Female Athlete Triad. She has participated in a marathon and triathlon and enjoys running, spinning, and yoga.