While some athletes have cast iron stomachs and few concerns about what and when they eat before they exercise, others live in fear of pre-exercise fuel contributing to undesired pit stops during their workouts. Be it stomach rumbling, a need to urinate or defecate, reflux, nausea, heartburn, or side stitch, how to prevent intestinal distress is a topic of interest to athletes with finnicky guts. Here are tips to help you fuel well before/during exercise while reducing the risk of gastro-intestinal (GI) distress. For more in-depth information, you might want to read The Athlete’s Gut by Patrick Wilson or listen to this podcast.

• Stay calm. Being anxious about intestinal issues can exacerbate the problem. Think positive. Trust that your gut is adaptable and trainable. Record what, when, and how much you eat, as well as the duration and intensity of your exercise. Use that data to help you figure out what foods and fluids settle best. Building body trust can reduce anxiety—and that can reduce GI issues. That said, precompetition nerves can affect any athlete, regardless of GI hardiness!
• Athletes in running sports are more likely to suffer GI issues than, say bicyclists or skiers. With running comes intestinal jostling; the longer the intestines are jostled, the higher the risk of upset. Ultra-runners know this too well…
• If you experience gut issues every day—even when you are not exercising, you want to talk with a GI doctor. Celiac disease, Crohn’s, ulcerative colitis, and blood in your stool need to get checked out now! They are serious issues and differ from exercise-induced GI problems.
• The higher the intensity of exercise, the higher the risk of intestinal distress. Add heat and anxiety to intense exercise, and many athletes experience transit trouble. During hard workouts, blood flow diverts away from the gut to transport oxygen and glucose to the working muscles and carry away carbon dioxide and waste products.
• Low intensity training that can be sustained for more than half an hour is less problematic. The GI tract gets adequate blood flow, can function relatively normally and is able to digest, absorb, and metabolize pre-exercise fuel. Athletes tend to have fewer GI issues on easy training days, given better blood flow to the intestines, lower body temperature and less anxiety.
• Carbohydrate is the easiest-to-digest fuel before and during exercise. Carbohydrate gets broken down into simple sugars in the stomach, then absorbed into the bloodstream from the small intestine. Specific transporters carry each sugar molecule (such as glucose or fructose) across the intestinal wall. Hence, consuming a variety of carb-based fuels helps minimize a “backlog” if all the transporters for, let’s say, fructose get called into action.
• With training, the body creates more transporters to alleviate any backlog. That’s one reason why you want to practice event-day fueling during training sessions. Your body gets the chance to activate specific transporters. The foods and fluids you consume before and during training should be the ones you’ll use for the event. Some popular carb-based pre-and during-exercise snacks include fruits (banana, applesauce), vegetables (boiled potato, roasted carrots), and grains (sticky rice balls, pretzels, pita)—as well as commercial sports foods (sport drinks, gels, chomps).
• Athletes who experience gas and bloat want to familiarize themselves with FODMAPs —Fermentable (i.e., gas-producing) Oligo-, Di-, Mono-saccharides And Polyols. These are sugars and fibers that some people have trouble digesting. Commonly eaten sport foods high in FODMAPs include milk (apart from lactose-free milk), bread, pasta, onions, garlic, beans, lentils, hummus, apples, and honey.
  • • By choosing a low FODMAP diet for a few days before an important event, an athlete might be able to reduce, if not avoid, digestive issues. (Of course, first, experiment during training to be sure the low FODMAP foods settle well!) Low FODMAP foods include bananas, grapes, cantaloupe, potato, rice quinoa, cheddar and Parmesan cheeses, and maple syrup.  For more information on FODMAPS, refer to KateScarlata.com.
• Fatty foods (butter, cheese, nuts) tend to slowly leave the stomach and are metabolized slower than carb-rich foods. If you will be exercising for only one to two hours, think twice before reaching for a handful of nuts or a chunk of cheese for a quick fix before you exercise. A banana or slice of toast will digest quicker and be more available for fuel.
  • • Eating fatty foods on a regular basis can speed-up gastric emptying a bit but you won’t burn much pre-exercise dietary fat during your workout unless you are an ultra-athlete who will be exercising for more than three hours. In that case, a bagel with nut butter or cheese will offer long-lasting fuel.
• Some athletes chronically under-eat during training. This includes dieters trying to lose weight, and athletes with anorexia. Under-eating can impair GI function; the gut slows down with inadequate fuel. Delayed gastric emptying means food stays longer in the stomach and can feel “heavy” during exercise (as well as is less available for fuel). Slowed intestinal motility easily leads to constipation, a common problem among under-eating athletes.
• Highly active athletes, such as Tour de France cyclists and ultra-runners, need to consume a large volume of food to support performance. If they are eating “healthy” foods before and during endurance exercise, they can easily consume a lot of fiber —and that can easily contribute to rapid transit. Endurance athletes needing a high calorie diet often benefit from eating some so-called less-healthy foods (such as white bread, white rice, cookies, candy) for low-fiber muscle-fuel.
• Given each athlete is has a unique GI tract, be sure to experiment during training to learn what works best. Eat wisely—and enjoy miles of smiles.

Sports nutritionist Nancy Clark, MS, RD counsels both casual and competitive athletes in the Boston area (Newton; 617-795-1875). Her best-selling Nancy Clark’s Sports Nutrition Guidebook (6^th edition, 2019) can help you eat to win. For more information, visit NancyClarkRD.com.

Among athletes, “turning vegan” (or vegetarian) is not a passing fad. Given the most popular ages for embarking upon a vegan lifestyle are 19, 20 and 21, many college athletes are asking me how to eat a meatless sports diet.

First, I want to understand why they are choosing to cut out animal-based foods. The standard reasons are:

1. Vegan and vegetarian diets tend to be healthier than a diet based on burgers and bacon. Indeed, plant-based meals with beans, veggies, and whole grains are nutrient dense, fiber-rich, and abundant in healthful phytochemicals and healthy fats. (Yet, vegan diets are not always healthier. Coke, Oreos, Skittles, Doritos are vegan-friendly…)

2. Vegans/vegetarians are leaner than omnivores, so some athletes embark upon a vegan lifestyle in hopes of losing weight. That might happen if your vegan/vegetarian diet coincides with limiting your intake of calories. Knocking off 300 calories of ice cream and replacing it with 100 calories of berries creates a significant calorie reduction.

3. Plant-based diets address concerns about animal rights and the environment. Hence, vegan/vegetarian diets appeal to animal lovers and folks who want to help save the planet. Reducing animal agriculture is one small way to curb global warming (and every little bit helps). But according to Frank Mitloehner PhD professor and air quality specialist at UC-Davis, industry and transportation are far bigger polluters— as is wasted food. (Forty percent of food we produce never gets to the table.) This podcast with Dr. Mitloehner offers science-based climate-change facts.

4. Though not verbalized as a reason to go vegan, meatless diets, unfortunately, are a popular way for athletes with anorexia to cut out chicken, beef, fish, eggs, dairy… to the point they are living on little more than fruits and veggies. Eating disorders can change healthy vegan meals into diets deficient in not only protein, but many nutrients, including iron, calcium, zinc, B-12, vitamin D, iodine, and omega-3 fats. Within a few months, good health can dwindle into injuries, hair falling out in clumps, low energy, and poor athletic performance.

Considerations when building a vegan sports diet

The busy lifestyle of vegan athletes can create nutrition challenges. For example, when eating on the run, vegans may find Oreos are more readily available than, let’s say, roasted chickpeas. Grab-and-go snacks of just a bagel or a banana should get balanced with some protein — but is hummus or soymilk readily available? All this means vegan athletes have to be responsible and plan ahead.

When listening to my vegan/vegetarian clients, I often hear “red flag” statements that signal misinformation. Let’s take a look at some common misconceptions and correct some myths related to vegan/vegetarian sports diets.

“Carbs” are fattening, a waste of calories? False! 

Plants are carbs! While you want to limit nutrient-poor carbs (like Frosted Flakes, Pop-Tarts, ramen), wholesome carbs (preferably called grain-foods) should be the foundation of every meal to fully fuel muscles. Athletes who train one to three hours a day can easily end up with needless fatigue if they try to thrive on fruit and salads. Grains (and all “carbs”) are NOT inherently fattening. Excess calories of any food can be fattening.

As a vegan/vegetarian athlete, you would be wise to eat grains (such as oatmeal, whole wheat bread, brown rice) as the foundation of each meal/snack. Combine them with a colorful assortment of fruits and/or vegetables for more muscle-fuel, and of course, a dose of protein.

Lunchtime salads are a healthy vegan meal? Sometimes.

While salads can be nutrient-rich, they can also be protein and carb-poor—but high in calories given a “little bit” of olive oil on a big salad ends up being a lot of dressing. Filling up on calories from fat will not refuel depleted muscle glycogen. Vegan athletes could better refuel their muscles with a grain-protein combination such as a hummus wrap or beans and rice.

Quinoa can be the “protein” in a vegan meal? No!

Quinoa is reputed to be a protein-rich grain, containing all the essential amino acids needed to build muscle. It is not a stand-along protein-rich food. If you compare quinoa to other grains, you’ll see it offers only 6 grams of protein per 200 calories, similar to rice (4 g), and less than pasta (7 g). Most athletes should target 15 to 25 grams of protein at each meal. That means, you want to add more than just quinoa to your salad. How about tofu? beans? lentils?

Almond milk is a replacement for dairy milk? No way!

Almond juice (it is not milk) has far fewer nutrients than dairy milk. Milk’s 8 grams of high-quality protein is life-sustaining. The 1 gram of low-quality protein in almond beverages is not. Soy or pea milk are acceptable dairy-free alternatives to cows’ milk.

Soy causes cancer and man-boobs? Wrong.

The latest research indicates soy is cancer preventive and is safe— even for women with breast cancer. As for man-boobs, the one case study about unusual male breast development refers to a person who routinely drank three quarts of soymilk a day. That is a LOT of soymilk. For the latest soy updates, enjoy this podcast.

Protein bars and powders can replace real foods? Not really.

Protein-rich foods are preferable to highly processed bars and shakes. Nutrients in natural foods interact synergistically Instead of yet-another bar or shake for a meal or snack, how about cereal + (soy) milk, crackers + hummus, or banana + nut butter? Aren’t these real foods more in keeping with the spirit of veganism?

Sports Nutritionist Nancy Clark, MS, RD counsels both casual and competitive athletes in the Boston-area. Her updated (2019) Sports Nutrition Guidebook can help you optimize your eating. Visit NancyClarkRD.com for information about appointments, books, and teaching materials.

Once upon a time (before WWII), daily life revolved around structured meals: enjoying a hearty breakfast, dinner (at noon), and supper (at night). When women entered the workforce, eating patterns changed — lighter breakfasts and lunches, with bigger family-focused dinners. Fast forward to pre-COVID 2020, youth sports and life’s busy-ness totally disrupted dinner-times; structured meals got lost in the shuffle.

Today (week #8 of COVID shut-down), our stay-at-home lifestyle has gifted many of us with time to cook breakfast, enjoy lunch, and have family dinners. Yet, many athletes are feeling confused and/or uneasy about how they are eating:

“I’m sleeping until 11:00 a.m. Should I eat breakfast — or lunch — when I get up?”

“I now have easy access to food given I’m working at home. I spend too much time grazing. Seems like I am hungry all the time.”

“My eating habits are weird. How should I be eating? What is “normal” eating?”

Sound familiar? To add a supportive framework, joy to meals, and answer the question What is normal eating?, I turn to eating authority Ellyn Satter, author of Secrets of Feeding a Healthy Family (a book every parent should read; EllynSatter-Institute.org).

Here is her definition of “normal eating”:

Normal eating is going to the table hungry and eating until you are satisfied. It is being able to choose food you like and eat it and truly get enough of it — not stopping eating just because you think you should.

That is, did you stop eating breakfast today because the oatmeal in your bowl was all gone? Or were you truly satiated? At the end of lunch, did you stop at your one-sandwich allotment, even though you wanted more? If you are “feeling hungry all the time,” you likely ARE hungry; your body is requesting more fuel. Trust it. You’ll end up eating more sooner or later, so please honor that hunger and eat more now.

Normal eating is being able to give some thought to your food selection so you get nutritious food, but not being so wary and restrictive that you miss out on enjoyable food. That is, have you put yourself in food jail and banned “fun foods” like cookies, cupcakes, and chips, out of fear of over-eating them? Ideally, your meal plan includes 85-90% quality foods, with 10-15% fun foods. You need not eat a perfect diet to have an excellent diet. Some “fun food” in the midst of a pandemic can be, well, fun!

Normal eating is giving yourself permission to eat sometimes because you are happy, sad, or bored, or just because it feels good. Yes, food is a way we celebrate, mourn, and entertain ourselves. Sometimes we even need a hug from food, despite being not hungry. One bowl of ice cream will not ruin your waistline nor your health forever. That said, routinely overindulging in ice cream as a means to distract yourself from life’s pain will not solve any problem. If you are using food as a drug, to not start eating can be easier than stopping once you have started.

Normal eating is mostly three meals a day, or four or five, or it can be choosing to munch along the way. Most athletes require fuel at least every 3 to 4 hours. Those who “graze all day” commonly under-eat at meals. If you stop eating because you think you should, not because you are satiated, you will feel the urge to graze. Solutions: eat the rest of your breakfast-calories for a mid-morning snack, eat an earlier lunch, or better yet, give yourself permission to eat enough satiating food at breakfast. Living hungry all the time puts a damper on your quality of life, to say nothing of impairs athletic performance.

Normal eating is leaving cookies on the plate because you know you can have some again tomorrow, or it is eating more now because they taste so wonderful. If you are banning fun foods from your house because you can’t eat just one cookie, think again. Denying yourself permission to enjoy a few cookies boosts the urge to eat the whole plateful. I call that “last chance eating.” You know, “last chance to have cookies, because tomorrow I am back on my cookie-free diet.” Depriving yourself of cookies leads to binge-eating. Try planning in forbidden foods every day. They will soon lose their power.

Normal eating is overeating at times, feeling stuffed and uncomfortable. And it can be undereating at times and wishing you had more. Normal eating is trusting your body to make up for your mistakes in eating. Yes, even normal eaters overeat. It’s normal to have too much birthday cake, too much Sunday Brunch, too much ice cream. When competent eaters overeat, they listen to their body’s signals – and notice they take longer to get hungry again. That is, if you have a hearty brunch, you will be less hungry that evening. Trust me. Rather, trust your body.

Hunger is your body’s way of telling you it has burned off what you gave it, and now it is ready for more fuel. You want to honor hunger and eat intuitively, like kids do. Kids eat matter-of-factly; they stop eating when they are content. Adults (especially weight-conscious athletes), don’t eat when they are hungry, then don’t stop when content. Rather, they “cheat” and guiltily stuff themselves with forbidden foods —last chance before the diet starts again!

Normal eating takes up some of your time and attention, but keeps its place as only one important area of your life. If you are spending 90% of your time thinking about food, you are likely hungry 90% of the time. (If humans didn’t think about food, they would never think to eat.) If you eat until you are satisfied, you will stop incessantly thinking about food. That said, food-thoughts can be a way to distract yourself from stuff you really don’t want to think about. In that case, talking with a counsellor might be helpful. Smothering your feelings with chocolate will not solve any of your problems.

In short, normal eating is flexible. It varies in response to your hunger, your schedule, your proximity to food, and your feelings. Many athletes very rigidly eat the same foods every single day. A sports nutritionist can help add variety (more nutrients), flexibility, and more joy to eating. Food can and should be one of life’s pleasures, both when training and in the midst of the pandemic.

Boston-area sports nutritionist Nancy Clark, MS, RD counsels both casual and competitive athletes, helping them learn how to eat competently. Her best-selling Nancy Clark’s Sports Nutrition Guidebook is a helpful resource. For more information, visit NancyClarkRD.com.

As I write this column, the date is April 10th, 2020, three weeks into the coronavirus shut-down here in Boston. I continue to counsel clients from my virtual office. I am talking with gym rats and athletes alike who are stuck at home, hating what they see when staring at themselves during Zoom meet-ups, and are spending too much time fighting with food (Do I eat? Don’t I eat? Am I hungry—or just bored?). They are feeling anxious and self-critical.

When life feels out of control, athletes commonly end up trying to control other things, such as food, exercise, and weight. Some may be striving to chisel themselves into a perfect body (no excess body fat) and eat a perfect diet (no fun foods). Unfortunately, the same dedication and discipline that help them be top athletes are the same traits that foster eating disorders. For example, perfectionism is common to both athletes and people with anorexia. How else could figure skaters or gymnasts rise to the elite level without demanding perfection from themselves?

Yes, discipline, dedication, and perfectionism are driving forces that help good athletes become great. But genetics is fundamental, as is adequate­—but not necessarily perfect—fueling. That is, eating a cookie will not contaminate an athlete’s health nor ruin one’s ability to perform well.

If you are relentlessly pushing yourself hard right now out of fear of getting fat and losing fitness, please consider being gentler on yourself. This is a difficult time for many folks. Little is wrong with a bit of comfort food in the midst of chaos and crisis. Perhaps you can allow yourself to be “bad” and do something out of character, like bake cookies and enjoy some for an afternoon snack. Giving yourself permission to enjoy some comfort food is normal, assuming you also have other coping skills, such as writing in a journal and relaxing yourself with yoga.

When food has power over you

If you are spending too much time trying not to eat (Fill in the blank) ____ (cookies, cheese, ice cream, chips?) because you can’t eat just one serving, think again. Depriving yourself of your favorite foods makes them even more enticing. They can needlessly become too powerful. To take the power away from a “binge food,” you need to eat it more often. (Trust me!) Here’s the analogy:

Pretend you are caring for a four-year-old boy. You take him into a room filled with toys and tell him he can play with all of the toys except for the green truck. You leave the room and then look through the two-way mirror. What is he playing with? The green truck, of course! The same analogy holds true with food.

If you give yourself permission to eat, let’s say, some Oreos every day, after a few days, you’ll either have little interest in yet-another Oreo (because other foods actually make you feel better) or you will be able to eat just one Oreo; it will no longer have power over you. Yes, to gain control over foods that have power over you, you have to allow the food back into your life and eat it more often. Be curious; give it a try.

When the mirror makes you feel sad

Are you spending too much time these days critically evaluating your body in the mirror? Or hating what you see in the Zoom meet-up? Please, just, stop the body-hatred talk. Few humans have a perfect body. The imperfections you see are perfectly beautiful and acceptable.

Instead of being self-critical, be grateful that you are healthy. Grateful that you have two strong legs that help you be a good runner. Grateful that you have two hands that help you row crew. Grateful that you have a body that produced healthy babies that are now your beloved children. You could even apologize to your body for having tortured it with skimpy diets and excessive exercise in your efforts to control how it looks.

Rather than focus on how your body looks, turn your attention to how your body feels throughout the day, particularly before, during and after you exercise. Does your body feel hungry? Tired? Sore? Respond appropriately to that feeling by nourishing it with food, rest, a warm bath. Daily killer workouts that feel like punishment for having excess body fat inevitably end up with the athlete being injured and depressed.

Now is a good time to practice looking in the mirror (or the Zoom screen) and saying nice things about your body, such as, “I have pretty blue eyes.” “I like my silky hair.” “I have strong legs.” You can intentionally pay less attention to the crooked teeth, frizzy hair, and “too big” tummy. Do you really think others care about that stuff?

Note: For more information on making peace with your body, visit RealFoodWholeLife.com, JessieHaggerty.com, and Julie Duffy Dilllon’s podcast Love, Food.

When mindless eating gets out of control

If you find yourself grazing on snacks incessantly throughout the day and have fears about getting fat, try scheduling regular meals and snacks. Also give yourself permission to eat enough breakfast and lunch, so that you are fully satiated. Don’t stop eating those meals just because you think you should but rather because you actually have had enough to eat. Athletes who graze all day rarely feel fully fed.

Hunger is a physiological request for fuel. Hunger does not mean “Oh no, I’m going to eat and get fat. Rather, hunger is your body’s way of saying it has burned off what you fed it and now needs more fuel. Yes, food is fuel, not the fattening enemy. Honor hunger.

Another way to bring control to your eating is to eat only when 1) you are sitting in a specific place (kitchen table?), 2) the food is on a plate, and 3) you are tasting it mindfully. (i.e. you are not standing in front of the open cupboard, wolfing down handfuls of chocolate chips.)

My hope is the above tips will help you find peace with food and your body. Enjoy food for nourishment and survive the coronavirus shut-down with sanity.

Boston-area sports nutritionist Nancy Clark, MS, RD CSSD counsels both casual and competitive athletes, helping them eat to win. The new 6th edition of her Sports Nutrition Guidebook is a best-selling resource. For more information, visit NancyClarkRD.com.