Running and nutrition have long been synonymous, and for a long time runners were told that lighter = faster. Thankfully, runners like Mary Cain, Tina Muir, and Amelia Boone are getting honest about the pressure to stay small, and how it has negatively impacted not only their running performance, but their mental health. With RED-S, the female athlete triad, and eating disorder awareness being so relevant right now, I want to share my own difficulties with nutrition and my experience with counting macros and running.
RED-S Syndrome & The Female Athlete Triad
So, for those who are not engrossed with running news the way I am, you may be wondering, what in the world is RED-S and the female athlete triad. Well, essentially it is a state of unhealth caused by overtraining and under fueling. It is not limited to women, but there are specific negative consequences (like loss of fertility) that only impact women.
RED-S stands for Relative Energy Deficiency in Sport, and essentially is a medical term for athletes who outwork their caloric input. The resulting consequences of prolonged undernutrition can be loss of bone density potentially leading to stress fractures, low metabolic rate, menstrual dysfunction, and cardiovascular disturbances. Pretty significant. It also results in low energy availability, more commonly known as poor performance and fatigue. Or crankiness in my case.
The Female Athlete Triad is a related syndrome in women that is a combination of low energy availability, amenorrhea (irregular or lost periods), and low bone mineral density. Both RED-S and the female athlete triad are a result of not eating a sufficient amount of food in relation to the amount of energy expended in physical activities.
So while you may see a runner, or CrossFitter, or any other athlete eat what seems to be an insane volume of food, it may still not be enough. In my office, I have a reputation of eating an astonishing amount of food; you’ve seen my focus on snacks. Colleagues joke about the expense reports I submit and how it must cost a small fortune for my company to feed me while I travel. And they’re not wrong.
But it’s important to keep in mind that in order for me to CrossFit and run as much as I do and stay healthy, I need to eat around 2500 calories a day on average. I try to eat about 75%-80% whole foods, and it’s not easy to get in 2500 calories a day from natural sources. Unless you eat snacks all the time.
I want to point out that RED-S and the female athlete triad are completely different from cumulative fatigue. Within the Hansons Marathon Method programming, cumulative fatigue is the result of high volume running without the opportunity for full recovery between runs. It is not at all recommended that runners under-fuel, in fact it is strongly discouraged. The fatigue in the training program is a result limited time between runs, not caloric deficiency.
Related Post: Weekly Recap: 11.17.19 – Cumulative Fatigue
Before I get into my personal history with food and nutrition, I want to emphasize that I am not a dietician, and I am not giving nutrition advice to anyone. In fact, I think I honestly have a very long ways to go with my relationship to food and my body. If you are struggling with nutrition, fueling, or body image and have concerns that you might be experiencing RED-S or the female athlete triad, please look into the many resources available to support you. As a mental health therapist, I really want to encourage everyone to who struggles (so everyone) to reach out and seek support.
If you have any questions about counseling or therapy, I am happy to provide some information. I am no longer running my private practice, but I will always gladly assist someone in finding a good therapist, because mental health is not underrated.
Treatment for these disorders is generally a combination of cognitive/behavioral therapy, nutrition education and counseling, decreased training, and nutritional supplementation.
My Body History
I want to start by saying that I have never suffered from an eating disorder, but I am a person who is at a fairly high risk. I am a type-A over-achiever, and I’m a woman. So, I need to be honest with myself and recognize the potential for my personality to latch on to disordered thinking.
While I do not have a history of disordered eating, I do have a history of trauma. Not trauma that I intend to share with everyone on the interwebs, but trauma that resulted in a physical detachment from my body. What I experienced as a young person led me to feel uncomfortable in my own skin, and as a result I took the unhealthy approach of ignoring what my body was telling me.
It took me a long time to learn to listen to my intuition and inner wisdom. Honestly participating in running and CrossFit is a big part of what allowed me to reconnect with it. But after years and years of ignoring what my body was telling me, it became really difficult for me to recognize hunger.
In fact, what I normally recognize is that I am yelling at people more than baseline Andrea does (I’m kinda baseline angry in everyday life). Remember that Snickers ad campaign about how you weren’t yourself when you’re hungry? Well, I am the poster girl for “hangry.”
It’s not uncommon for me to realize that I’m losing patience faster than usual. This is usually a pretty good indicator for me that I am hungry and need to eat. But I don’t often feel the hunger pains that most people probably do when they need to eat, and this can be problematic.
How I Came Upon IIFYM & Counting Macros
My difficulty interpreting cues hadn’t really caused me any significant issues for most of my life. I like to eat, and I love snacks, so I think that despite not really getting hungry, I generally ate enough to stay healthy. I never had issues with stress fractures, low energy, or irregular periods, despite my high levels of physical activity.
Unfortunately, my husband and I had two pregnancy losses before getting pregnant with our son, and these losses only exacerbated my difficulty with anxiety. After we had our son, I noticed that I just wasn’t getting back to regular weight. In fact, I had only gained about 25 pounds during my pregnancy, but still was about 15 pounds above my pre-pregnancy weight after 6 months.
I was in no way overweight, or at an unhealthy weight, but I was a little perplexed that I was eating intelligently and was still at a higher than normal for me weight. I was doing all of the things that are recommended: staying hydrated, only eating when hungry, stopping when I wasn’t hungry, and eating nutrient-dense foods.
I returned to running as soon as the doctor hinted that I might be ok to run, and I just wasn’t feeling good. I knew life was different, but I honestly felt like crap and was at a loss as to why. My kid slept great (after some early battles), I was eating the way I thought I should be, and I was getting exercise, but I felt like crap. At this point, I didn’t have a whole lot of awareness of my difficulty recognizing hunger cues.
That’s when I started to do some nutrition research. I stumbled on a dieting program (and I want to emphasize 100% that it is intended to be a diet) known as IIFYM or if it fits your macros. Essentially, based on your height, weight, age, and energy output, you get a target number of calories broken up into fats, proteins, and carbs. The goal is to hit these targets without going over.
When I first tracked what I was eating I was shocked to see that I was eating an average of 400-500 calories less than what I should be. So I decided to give IIFYM a shot. Within a few weeks I was eating more, I was feeling better, and I was getting back to my pre-baby weight. And I was still eating chocolate every day. I was speechless.
I had no idea I was undereating, and that it was ultimately causing me some health issues. So once I was back to my regular weight, I adjusted my goals to maintenance mode. Over the years, I have adjusted my goal macros as my energy output has increased (for ultra-marathon training and high mileage marathon plans).
Related Post: My Love/Hate Relationship with Turkey Trots
Counting Macros and Running
This is where I am today. I’m still counting macros and running. I’ve taken breaks from counting, and I have found myself returning to unintentionally under-eating. Not because I don’t like food. Not because I want to lose weight. Because I don’t recognize when I am hungry, and if I’m not focusing on eating what I have planned to eat, it becomes easy for me to not eat enough.
I don’t love that I need to track what I eat in order to ensure that I eat enough, and it’s something I think I need to continue to work on. Because honestly, I don’t want to track what I eat for forever. I don’t track when I travel because it’s inconvenient, and I almost always end up feeling more depleted after a long trip. This lets me know I’m still not eating enough when I don’t track.
Being able to recognize when you are hungry before you scream at your loved ones is important. It’s something I’m working towards. But because I train at such a high volume right now, undereating is not something I can afford to do. So until I can trust myself to listen to my body more effectively, I’ll keep tracking.
I do think that calculating macro target goals and tracking food can be helpful for a number of reasons. It can help highlight under-fueling, it can help teach people to learn what a portion of meat or carbs or dairy actually looks like, and it can give someone an idea of what fueling for activity output looks like.
It can also have negative consequences. IIFYM is absolutely not for everyone, and it is usually utilized as a means of dieting. I’m not a fan of diets or diet culture, but I’m self-aware enough to recognize that I don’t have a completely healthy relationship with my body.
Because IIFYM and counting macros is generally utilized as a means of dieting, it’s important to consider who should absolutely not consider IIFYM. Counting macros requires a lot of planning and obviously tracking, so it’s not a good option for anyone who has experienced any kind of food obsession. You spend a lot of time thinking about and planning meals, so if you are already preoccupied with food, it’s not a great idea.
Counting macros is also somewhat dangerous for anyone who struggles with wanting to control things. So, people like me. Yup. I know for a fact that when I feel like things in my life are out of control, I tend to be more focused on what I’m eating. It’s a thing I can control. I think I have some relative insight into this because of my background in mental health, but it’s a fine line.
Food should not be something you turn to to feel more in control. This is disordered eating at it’s core. It can also lend to obsession with perfectionism. If you are someone who has a difficult time extending grace to yourself when you make an error, IIFYM can be a struggle. You’re going to have days where you don’t hit your macros, and guilt should never be associated with food and eating.
Because I want to continue to try to improve my relationship with my body and nutrition, I never let IIFYM or my target macros prevent me from eating more. On the occasion that I can tell I am hungry and want to eat more food than what my macros would account for, I do. I don’t want to feel limited; I want to make sure I am eating enough. It’s too easy to lose sight of that and let IIFYM take a turn into dangerous territory, which is exactly why I don’t limit myself to my prescribed macros.
I don’t think counting macros and running is a long-term solution for me, but it’s something that helps me ensure I am fueling appropriately. It helps me from breaking my body down as a I chase big dreams and goals. I think when utilized with some discernment and honest personal insight, IIFYM can be useful for some people in some ways.
If you are interested in learning more about counting macros as a runner or seeing what your target macros would be for your activity level, please take a look at this article from Runners World on calculating macros for runners. Run To the Finish also has a guest on counting macros as a marathon runner that I found really interesting.