~ Annie Bothma, Elite Athlete, IOPN Performance Sports Nutritionist (EQF Level 7. Masters), Running & Strength Coach
Endurance athletes understand the commitment needed to train for events such as the Boston Marathon. But what if a key element affecting race performance and health is as straightforward – and as intricate – as properly fueling your body?
A pivotal study from the 2022 Boston Marathon highlights the vital importance of energy availability in endurance sports. In this blog post, I will explain it to you and provide practical tips to enhance your performance as an athlete.
The Study in a Nutshell
This research analyzed 1,030 runners (evenly split between men and women) who completed surveys assessing low energy availability (LEA) indicators, including eating behaviors, training history, and symptoms. It linked these findings with marathon performance data and medical records during the race.
The goal of this study was to understand how insufficient energy availability – either intentional or unintentional – affects performance and the risk of medical issues. Below I summarize some of the key findings and insights we can take aways from this study.
Prevalence of LEA
42.5% of women and 17.6% of men were at risk of LEA.
Athletes with LEA risk were more likely to experience disordered eating patterns or symptoms of energy mismatch.
Impact on Performance
Athletes without LEA risk indicators had significantly faster marathon times and better division placements.
Proper fueling allowed athletes to maintain consistent training, which led to stronger race-day performance.
Health Risks
Runners with LEA had nearly twice the risk of medical incidents during the race, including dehydration, nausea, and hypothermia.
Major medical events, such as severe dehydration or electrolyte imbalances, were nearly three times more common in the LEA group.
Younger Athletes at Greater Risk
LEA risk was higher in younger athletes, potentially due to lack of education about the energy demands of endurance sports.
BMI Doesn't Matter
Contrary to outdated beliefs, BMI did not correlate with performance or LEA, challenging the "lighter is faster" myth.
The Bigger Picture: Why Fueling Matters
What makes this study stand out is how it challenges cultural narratives about endurance sports. For decades, athletes have been told that thinness equals speed. This study proves otherwise. Instead, adequate fueling – ensuring the body has enough energy to meet training and recovery demands – emerges as the key to unlocking both performance and long-term health.
Training Consistency: LEA can lead to injuries and illnesses that disrupt training. Proper energy availability allows athletes to train harder, recover better, and perform consistently.
Adaptation and Recovery: Fueling isn’t just about race day; it’s about enabling the body to adapt to the demands of training and grow stronger over time.
What Athletes and Coaches Can Do
Recognize the Signs of LEA
Symptoms can include fatigue, frequent injuries, mood changes, and disrupted sleep.
Disordered eating or appetite suppression post-exercise may also contribute to LEA risk.
Prioritize Nutrition
Regularly eat balanced meals that include enough carbohydrates, proteins, and fats, along with sufficient fruits and vegetables, to ensure adequate macronutrients for optimal health.
Match your energy intake to your training load, especially during high-intensity or high-volume weeks.
Embrace Individual Strength
Forget the "one-size-fits-all" mindset. Your strongest version may not look like someone else's, and that's okay.
Focus on fueling your unique body to achieve your personal best.
Education and Screening
Screening for LEA indicators in endurance athletes can prevent medical complications and improve performance outcomes.
Younger athletes, in particular, benefit from guidance on how to meet their energy needs.
Final Thoughts: Fueling Is Training
This study highlights a simple yet profound truth: Fueling is training. Without enough energy, athletes can't perform, recover, or even stay healthy. Adequate fueling leads to consistent training, and consistent training is the foundation of success.
As endurance sports continue to evolve, so must our approach to how we prepare for them. Let this be a reminder that the key to conquering a marathon isn’t just in the miles you run but also in the meals you eat.
Your strongest self starts with a fueled self.
Reach out to me at anniesathletes@gmail.com if you are struggling to meet your energy needs as an athlete.
References
Whitney KE, et al. (2024). Boston Marathon athlete performance outcomes and intra-event medical encounter risk associated with low energy availability indicators. British Journal of Sports Medicine. doi:10.1136/bjsports-2024-108181.
Roche, D. (2024, November). Boston Marathon Study & Fueling as a Key to Success. Some Work, All Play Podcast. Retrieved from https://podcasts.apple.com/za/podcast/some-work-all-play/id1521532868?i=1000678311423.
Mountjoy M, Ackerman KE, Bailey DM, et al. (2023). International Olympic Committee Consensus Statement on Relative Energy Deficiency in Sport (REDs). British Journal of Sports Medicine, 57, 1073–1097. doi:10.1136/bjsports-2023-107397.
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