Are You Eating Enough For Your Activity Level, Part II

If you read running websites or magazines, view social media accounts of various athletes, and perhaps overhear conversations in your run community, in the past few years you may have noticed an increased attention to a topic called RED-S (pronounced reds), or relative energy deficiency in sport, which can also be called low energy availability. 

Low energy availability is most accurately calculated by removing the energy cost of your daily exercise from your total dietary caloric (energy) intake, and then having what is left not being enough energy (calories) to support the body’s normal physiological function, such as bone metabolism, endocrine/hormones, reproductive system, etc. Low energy availability is associated with downregulation and impairment of key physiological processes due to the lack of adequate energy support. 

That’s the scientific definition. I simply call it “Not eating enough for your activity level.” Even simpler, that translates to not eating enough.

Not Eating Enough

For a couple decades, one piece of the larger puzzle of relative energy deficiency was known in the sporting community. That piece is the Female Athlete Triad, in which female athletes present with a pattern of low energy availability with or without an eating disorder, in relationship with amenorrhea (lack of menstrual cycle), or irregular menstrual cycle, and low bone density leading to osteopenia and osteoporosis. What we now know is that the Female Athlete Triad is just one section of a larger picture of pathophysiology that can present in athletes with long-term low energy availability. And it is not just a female athlete concern. 

When active individuals are not eating enough for their on-the-move lifestyles – the body, because it is wise, makes decisions about where it is going to prioritize its precious calories. So if you’re going to go for a long run in the forest for several hours, followed by an evening hike or weight session, and then follow with something similar tomorrow and the next day, and throw in a weekend of back-to-back long runs,  AND you’re routinely not eating enough to meet your caloric needs, the body is going to choose where to spend those nutrients—because when this precious energy is used for one function, it is not available for another one. 

Essentially, you are putting your system into survival mode.

And it plays out along these lines as your body says,  “Well, if you’re going to make me go do these workouts, I’ll put my energy here, though maybe with a little less pep, energy, and high-intensity ability, but I’ve got to compromise somewhere, so I’ll make a trade-off  over here with bone metabolism, or over here with female reproductive hormones or thyroid health, or immune function, or over here with the GI system and the ability to break down nutrients in food (because digestive enzymes are made of proteins which may be lacking in the diet), or muscle and tissue repair or”…. and the list goes on.

On Our Radar

So why is this topic suddenly on more people’s radar? One, we have more research and knowledge on the expanded umbrella of RED-S and the widespread physiological consequences of being at a long-term energy deficit. But also because it’s fairly common for active individuals to not realize they’ve adopted many of the beliefs of the diet industry into their eating habits over the years. Or they may simply be eating to hunger levels, and still not be eating enough.

And, just eating to hunger can sometimes be misleading for us as highly active folks. For instance, many athletes have a suppressed appetite after long or intense workouts or races. In those cases, it’s ideal to replace nutrients after exercise—but when digestion is compromised, the body won’t metabolize the food as it should—hence the potential for working with a nutrition professional to help get the digestive system back to balance. Alternatively, we might need to learn to recognize the symptoms of hunger that often go beyond an empty stomach.

Within-Day Energy Balance

The other side of that low energy availability coin can also mean within-day energy balance. Meaning we don’t stack the majority of our calories into one meal or couple of hours of the day. Eating to fullness, or 80 percent of fullness, is recommended, but if you ever notice you get to the point of overeating after exercise by having excessively large meals that seem to top you up beyond fullness, it is often because of low energy intake throughout the day fueling a need for more food spread throughout the hours. This can often occur after a long run. In this case, you can train your body to tolerate more fuel during a run, and then you’ll likely both recover better, but also will have stressed your body less with the huge energy deficits and then subsequent deposits. 

 With a more even or adequate energy intake before and during a long workout, you can avoid that ravenous feeling of needing to eat quickly and impulsively.

A Self-Assessment to Help Navigate Your Energy Needs

If this topic has kindled your curiosity about meeting your own energy needs, my suggestion is to start with a self-assessment rather than calculating calories and meticulously tracking meals—those can be highly inaccurate and lead to neurotic food obsession. Ask yourself these questions:

– Am I frequently sick more than a couple times per year?
– Do I struggle with fatigue frequently?
– Have I stopped improving in my performance – either have plateaued or gone backwards despite training?
– Have I had a lot of injuries?
– How’s my overall health? Basic bloodwork results hold a plethora of data on how the body is ‘performing’ internally.
– How is my menstrual cycle and/or sex drive? Women have a little advantage here in that any menstrual symptoms or irregularities* are symptoms telling you to heed warning because there’s a larger health imbalance.
– Do I have a lot of gut upset / discomfort, or food intolerances?
– Am I routinely irritable, depressed, anxious, or have decreased concentration?
– Am I sleeping well?
– and if you have teammates or friends/family that you work out with regularly: Do I eat less than my teammates but have a higher body fat? This is subjective of course because every body is different, but higher body fat and eating less is also a tell-tale sign, since lower metabolic rate occurs with lower energy availability, meaning you might be eating less but weighing more or having more “cushion” than previously.
– and one more because it can become prevalent with long-term low energy availability: Am I thinking about food ALL THE TIME? We know from eating disorder and starvation studies that chronically deprived individuals become obsessed with food, far beyond just being interested in food.

Where to go from here?

Above all, food and exercise should make you feel good. The goal is to be aware and in tune with yourself and your body’s ability to show you signs that something may not feel right or as great as it should.

And you may benefit from professional guidance. If you’re confused or concerned about your needs, or would like a professional opinion, I invite you to reach out to me for more personalized support.

*Women on hormonal birth control will not have the same ability to use their menstrual cycle to gauge abnormalities, since it is designed to eliminate ovulation and the normal hormonal fluctuation that occurs. If symptoms or irregularities occur without birth control, that is a vital sign that your body has an imbalance somewhere.
The  information shared in this article does not intend to treat, diagnose, cure, or prevent any disease.

 

Mini-Meals to Keep You Going

Ideally we spread our meals out throughout the day and leave time in between them for full digestion to occur, so we’re not throwing more food in when the last meal hasn’t fully digested. This causes more problems over time in other ways. In an ideal routine, aim for eating at intervals of four to six hours after a full meal, and two to four hours after a light meal instead of snacking continuously all day. The above article is featured over on the Territory Run Co. run journal, along with three snack recipes for those in-between times, featuring iron and vitamin C-rich Wonder Woman Bars, William’s Oatmeal Raisin Bites, and Sweet Potato Spanish Tortilla. Get the recipes here.

References:

2018 UPDATE: Relative Energy Deficiency in Sport (RED-S)
Fahrenholtz, IL., Sjodin, A., Benardot, D., Tornberg, AB., Skouby, S.,…and Melin, AK. (2018). Within-day energy deficiency and reproductive function in female endurance athletes.
Jeukendrup, A. (2013). The New Carbohydrate Intake Recommendations. Nutritional Coaching Strategy to Modulate Training Efficiency. Nestlé Nutrition Institute Workshop Series,63-71. doi:10.1159/000345820 
Jeukendrup, A. E. (2017). Training the Gut for Athletes. Sports Medicine (Auckland, N.z.), 47(Suppl 1), 101–110. http://doi.org/10.1007/s40279-017-0690-6
McKay, A.K.A., Pyne, D.B., Burke, L.M. and Peeling, P. (2020). Iron Metabolism: Interactions with Energy and Carbohydrate Availability. Nutrients, 12: 3692. https://doi.org/10.3390/nu12123692.
Torstveit, MK., Fahrenholtz, IL., stenqvist, TB., Svlta, O., Melin, A. (2018). Within-day energy deficiency and metabolic perturbation in male endurance athletes.

Veggie Rainbow Cool Noodles

In a quest to cook more in community, and educate in a hands-on format again, I’ve been leading routine cook-a-longs this summer. I’ve been cooking both with my local running group and as part of my public health nutrition role, my side gig when I’m not working one-on-one with nutrition clients.

I love cooking with both groups–but especially the cook-a-longs with my running ladies because we share similar interests and chat more as we’re making the recipes. And because I get to choose recipes that I routinely make in my everyday and know will make meals and workout recovery easier for others.

This is one such recipe that we made together last week.

It’s a cool noodle dish, served either warmish or at room temperature, but ideally not truly ‘fridge-cold’ or with raw vegetables, because that makes it extra difficult to digest. At a time (summer / hot weather) when our natural digestive ability is already weaker.

It features an Asian-inspired sauce and is kept super easy and quick by utilizing a protein and carbohydrate source in one with legume-based pasta noodles. If you don’t prefer tahini, choose almond butter instead. There are several legume-based pastas on the market. Banza is a good one. If you don’t prefer that, you can add two cups of edamame, your choice of other protein such as grilled fish, chicken, or tofu, and use a whole-grain noodle, such as brown rice noodles or whole-wheat fettuccine. 

Happy cooking and summer training / adventuring / eating / digesting! :)

Veggie Rainbow Cool Noodles
Prep:  15 minutes  | Cook: 15-25 minutes  | Serves: 4

Ginger Turmeric Tahini Sauce:
¼ cup tahini
½-inch fresh ginger, finely grated
1 Tbs. low-sodium tamari or soy sauce
½ tsp. turmeric
2 Tbs. lime juice
1 tsp. pure maple syrup
1 Tbs. light miso 

Noodle Salad:
8 oz. chickpea or legume-based noodles
3-4 large carrots (about 500 grams), sliced thin
1 bunch (240 grams) radishes, sliced
2 cups green peas, fresh or frozen
½ cup (packed) cilantro, plus more for garnish
Toasted sesame seeds, for garnish

  1. Make the sauce: Mix the sauce ingredients, along with 4-8 Tbs. water until completely smooth. Taste and adjust seasonings as needed and then set aside. 
  2. For the Noodles: Bring a pot of water to a boil. Add the noodles and any hard vegetables (such as carrots or radishes) and cook half way through. Add the peas and any softer vegetables, and cook the remaining few minutes until the pasta is al dente. Drain and rinse with cold water to stop the cooking process. 
  3. In a medium-serving bowl, toss the pasta and vegetables with the sauce and cilantro. Top with some toasted sesame seeds and serve. 

Notes: Change up the vegetables depending on what is in season near you! When you vary it up, choose one to two root vegetables or starchy vegetables and one or two leafy green vegetables or more pungent vegetables.
Roots/Starchy Examples: Peas, fresh corn, carrots, summer squash, zucchini (spiralized to add to the noodles (not in replace of!) is what I’ve done in the photo above)
Green/Pungent Examples: Broccoli, cabbage, kale, spinach, radishes, daikon radishes (what I’ve used in the photo), asparagus

Want to Know More?

Within my nutrition practice, I specialize in digestive imbalances, often within endurance athletes. When we’re experiencing chronic GI distress, fatigue, and/or malabsorption of foods and nutrients, there will often be imbalances in several systems of the body simultaneously. I shared more about this topic in the nervous system’s role in part 1, the immune response and subsequent inflammation in part two, gut microbes and dysbiosis in part three and the importance of chewing our food in part four. Check those out or reach out to me for more personalized support for gut healing, increased energy, performance, and feeling good in your everyday life.


Salad Sandwich

In the last year, the amount of questions I’ve gotten about food confusion–confusion about what to eat, how much to eat, what is intuitive eating vs. what is actually just following cravings, what makes up an ideal proportion of meal components–has increased a lot. I don’t know if it’s a cumulation of way too much focus on nutrition-ism, fad diets and sensationalism in the media, an increase in individuals transitioning to vegetarian or plant-based ways of eating, long months of COVID stay-at-homes, or something else.

But just know, if you’re confused about what a healthy way of eating looks like, or you struggle a lot with food and your body, or you’ve followed so many restrictive ways of eating in order to heal but are still in chronic illness, you are definitely not alone.

But also, settling for an unhappy status quo or giving up is not the answer.

One thing that’s safe to say is that most of us are better at making little changes gradually rather than making sweeping overhauls in how we eat. And another is it’s likely you eat less vegetables than you think. As much as exotic and trendy superfoods seem so much more exciting, most vegetables are actually the real superfoods on our everyday plates.

So as you wind down your summer, have a few meals on the go after active summer adventures, or transition into a more structured back-to-school / back-to-work schedule, here’s an update on a fairly standard mid-day lunch. The Salad Sandwich.

There are many ways to go about making this, but the idea is that you’re eating a balanced plate meal in sandwich form. Whole grain bread, shredded root vegetables, lots of leafy greens and a hummus spread. Condiments to add texture, the six flavors to satisfy taste buds and to help digest the meal, and if you can’t stuff your sandwich quite so full to add *enough* veg, a side salad with the remaining filling components to balance the meal out.

That’s the idea anyway. Every summer of late, I’ve had an ideal repeat meal. Below is a brief list of some of my past ones. This salad sandwich is the 2021 rendition.

Roasted Zucchini and Crookneck Squash with Pumpkin Seeds, Oregano and Olives
Sourdough Pizza
Cooling Kitchari
All-Healing Anti-Inflammatory Green Soup and Sourdough
Zucchini Noodles, Crookneck Squash, Garlic, and Pesto using All-The-Greens Interchangeable Pesto

Salad Sandwich, Serves 1

1 cup Hummus, my favorite recipe below
1 medium beet, finely shredded
1 large carrot, finely shredded
2 cups romaine or other leafy greens
1-2 Tbs. herbs of choice – Mint, Basil, Fennel Tops, finely minced
1-2 tsp. Dijon mustard, optional
1-2 Tbs. of something pickled, such as quick-pickled onions or radish, sliced olives, or sauerkraut
2-4 tortilla chips, optional
2 slices thick, whole-grain (preferably sourdough) bread

  • Wash hands with soap and water.
  •  Prepare your toppings. Then make the sandwiches by either toasting the bread to start, or leaving untoasted.
  • Spread the bread with a thick layer of hummus on each side, and a little Dijon mustard, as desired.
  • Then layer the shredded roots, herbs, pickled condiments, and greens. Top with a couple crunchy chips and then finish with your other slice of hummus-ed bread.
  • Combine any extra filling components in a small bowl and combine together. If you’d like a little dressing to finish it off, a little drizzle of olive oil and vinegar or lemon juice is often super nice.

Easy to Digest Hummus, serves 4

1 tsp. ghee (or use untoasted sesame oil)
2 tsp. untoasted sesame oil
1/2 tsp. mineral salt
1 tsp. kombu, wakame, or bladderwrack seaweed (dried)
1 tsp. ground cumin
1 tsp. ground coriander
1/2 tsp. ground fenugreek
1/4 tsp. ground black pepper
1 cup whole mung beans (soaked at least 6 hours)
3 Tbs. tahini
Juice from 1/4 lemon, or more to taste
Water

  • Wash hands with soap and water.
  •  Heat the ghee and sesame oil in a pot over medium heat.
  • Then add the salt, dried seaweed, and spices. Simmer until an aroma is present. Then add the soaked and drained mung beans; stir and simmer for another minute or two.
  • Add water to above the beans by a couple inches. Then bring to a boil; reduce heat, cover and simmer for about 25 minutes, until the beans are soft and breaking apart.
  • Remove from the heat and allow to cool for 5-10 minutes.
  • Then blend the beans and their cooking liquid with the tahini and lemon. Add additional water to thin if needed.