Running a marathon

Running a marathon
While exercise is good for you, if you do not eat enough to fuel the exercise, your health may be at risk. Nicole Springle is a Registered Dietitian and Sports Nutritionist at Cleveland Clinic Canada who specializes in helping runners enhance their athletic performance. We discussed the serious issue of active people under-eating.

Jennifer Brenton: What do runners need to know about nutrition to run well and stay healthy overall?
Nicole Springle: Without a good training diet, your race day nutrition isn’t going to make much of a difference. I see too many runners concerned about what to eat the day before a race, without taking the time to invest in a healthy diet leading up the event. Here are my top nutrition and hydration tips to ensure that a runner’s training diet prepares them properly for the best race they can run:


1. Eat a diet rich in healthy carbohydrates. Runners need the energy provided by carbohydrate-rich foods. Examples of good carbohydrate choices are fruits, vegetables, whole wheat and multigrain breads, cereals, pastas, and rice. Consume about 60% of your calories from carbohydrates, while limiting refined sugars like white breads, pastas, rice, and foods high in added sugar as much as possible.

2. Eat plenty of fruits and vegetables. We’ve all heard this before, but the fact is that there is no other food out there that provides the same health benefit. They are also good carbohydrate sources and contribute fibre to your diet. Finally, as a runner, the anti-oxidant qualities of fruits and vegetables can help repair some of the damage that your body incurs during training. As a rule, aim for at least two or three servings of fruit and four or more servings of vegetables per day.

3. Get enough protein, including red meats, poultry, fish, most dairy products (not ice cream, cream cheese, sour cream, or butter), nuts, peanuts, peanut butter, beans, soy and tofu, and other legumes (lentils, chick peas, etc.). Eat about 20% of your calories from protein, or 0.8 to 1.0g of protein per kg of your body weight per day. For example, a 70kg male would require approximately 56-70g of protein. If you training steadily throughout the year, four to five days per week, your protein needs could increase to 1.5 g/kg/day or more.

4. Eat frequent, small meals, and combine protein and carbohydrates for lasting energy. Instead of three large meals, eat five or six small meals and snacks per day. Try not to go for any longer than four hours without eating; otherwise, your blood sugar will drop and you could start to feel tired and cranky and have sugar cravings. Eat every two to three hours. Try this: Breakfast, snack, lunch, snack, dinner, and then an optional snack in the evening. By combining a protein source with carbohydrates at each meal and snack, you will help your energy last longer.


1. Hydration is essential to your success as a runner. Once you are thirsty, you are already dehydrated. You’ll need to “think to drink,” so bring a water bottle with you every day.
2. Drink eight glasses of non-caffeinated fluids per day, not including water you take in during or immediately after your run.
3. Drink during your run or during any intense physical activity. If you’re exercising longer than 20 minutes, you’ll need to start drinking water to make sure you don’t start to fatigue, slow down, and dehydrate.
4. Aim to pee clear. You know you’re drinking enough water if your urine is consistently clear throughout the day — except first thing in the morning.

JB: How do I know if I suffer from the “Female Triad”? What can be done to prevent it?
NS: Not supplying the body with enough overall calories for daily activities plus exercise creates an energy drain, which results in problems in both overall health and performance for athletes. In women, this condition is known as the female athlete triad. It has three components: energy availability, menstrual function and bone health. Athletes suffering from the triad may experience problems in any one of these three areas, but all are related to not taking in enough calories.
Low-energy intake can result in loss of muscle mass, menstrual dysfunction, loss or failure to gain bone density, and increased risk of fatigue, injury and illness. Research with female athletes who were amenorrheic, meaning they lost their menstrual function for three months or more, showed that simply adding enough calories to meet energy needs resulted in the return of menstruation.

Increasing energy intake will also lead to improvements in overall nutritional status, energy, and performance. Low energy availability is not always the result of actively restricting food intake. Many women simply don’t realize that they are not eating enough to sustain their energy needs. It can happen in recreationally active women and is not restricted solely to those involved in high-level athletics.

Prevention of the triad involves fuelling the body with enough calories for exercise. Women should focus on eating frequent balanced meals and snacks throughout the day, but should also be aware that hunger doesn’t always increase with higher training volumes. Know the symptoms associated with the triad and respond by increasing food intake as needed.

Women can watch for the following risk factors, but the presence of one of these markers may not be enough to indicate low energy availability. [The points starred (*) indicate that an individual with any one of these symptoms should follow up with a qualified health professional such as a sports medicine doctor or a registered dietitian specializing in sport nutrition.]

» Stress fractures*
» Low bone mineral density*
» Presence or history of an eating disorder or disordered eating*
» Persistent low energy
» Difficulty recovering from workouts, races or games
» Frequent muscle strains/sprains
» Reoccurring or persistent illness
» Sleeping disturbances
» Poor concentration and focus
» Lack of improvement or strength gains despite increased training
» Early fatigue during exercise, decreased endurance during longer workouts
» Increased fat storage in the abdomen despite reduced dietary intake
» Absence of menstrual cycles for more than three consecutive months, or failure to begin menstruating by age 15, or skipping menstrual cycles during high volume or high intensity training*

While the symptoms of the female athlete triad apply specifically to women, research indicates that 83% of male athletes are dissatisfied with their weight. More research is being done to explore the effects of low energy availability in males. Eating disorders and disordered eating are becoming a growing concern for males as well as females.

JB: If we are not in training — exercising moderately for 60 minutes per day — do we need a special nutrition plan?
NS: The same recommendations given above in question 1 apply for someone who is exercising moderately or training for a race. Portion size and attention to exact carbohydrate and protein amounts increase for individuals wanting to fine tune their diet for competition. But all active individuals require a balanced healthy diet to perform at their best.

JB: How can mindful eating relate to sports nutrition?
NS: Mindful eating encompasses listening to your body and responding appropriately to the signals that it gives you. Athletes and active individuals need to respond to hunger signals, but also should pay attention to additional signs like recovery time, aches and muscle pain, fatigue, improvements in strength and endurance, sleep patterns and overall energy or fatigue. I always tell my athletes to look at food as their fuel for exercise. If they are not responding to their hunger or aren’t eating the right foods, they could be jeopardizing their health and not getting the full benefits of their workouts.

JB: To start eating healthier right now, what would you recommend we do?
NS: Fruits and vegetables are always at the top of my list when it comes to optimizing your diet. They’re nature’s perfect food for athletes! Getting the seven to 10 recommended servings can be challenging, but its well worth the effort.

To contact Nicole, email her at: or visit the Cleveland Clinic Website:

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