Eating disorders and sports nutrition

There is great concern from leading figures of sports governing bodies, including psychologists and other experts in eating disorders, that a whole generation of athletes could be exposing themselves to a whole host of health problems associated with their inadequate dietary consumption.

This type of behaviour is believed to stem from an obsessive desire to win, as well as pressure from peers, coaches, and our society's overwhelming obsession with body image.

In sports like distance running, a high percentage of female athletes are excessively thin. This is because lower body weight can give a competitive advantage, but only up to a point.

This condition, particularly in women, has come to be known as 'the female athlete triad'. This includes:

• disordered eating
• amenorrhea (loss of menstrual cycle)
• osteoporosis

Thinner, however, doesn't generally mean faster. The body will respond to a calorie deficit by slowing down the metabolism and burning muscle tissue. That leads to weakness, sluggishness, and yes, slower times.

The bodily processes that are not essential to staying alive, such as reproductive function and growth, will get less energy. They are not prioritised by the body.

The lack of nutrition resulting from disordered eating can cause the loss of several or more consecutive menstrual cycles. This then causes calcium and bone loss, which puts the athlete at a greatly increased risk for stress fractures of the bones.

If the female body is not producing oestrogen, it will be unable to maintain enough levels of calcium in the bones. This depletion is called osteopenia. Osteopenia occurs when there is a thinning of bone mass. Osteopenia is also considered to be the precursor of osteoporosis, which is sometimes referred to as the brittle bone disease. Osteoporosis is caused by a loss of bone mass caused by a deficiency in calcium, vitamin D, and magnesium, as well as other vitamins and minerals.

Bones can break more easily and often do not heal very well in females who are also struggling with anorexia. This can cause irreversible damage to the younger athlete.

How do you know if you have an eating disorder?

It is estimated that around 1.25 million people in the UK have an eating disorder of some type. It can take various forms:

• anorexia
• avoidance/restrictive food intake disorder (ARFID)
• binge eating disorder
• bulimia
• other specified feeding or eating disorders (OSFED)

I have, below, defined the characteristics of 'under-eating'.

1. An eating disorder is defined as a mental illness. The person often has a high level of body dissatisfaction and will attempt to regulate their body mass by restrictive eating, over-training/sports, or vomiting.
2. It is displayed by a loss of control of normalised eating habits. This typically leads to over or under-eating and variable body weight.
3. Women develop eating disorders more often than men, though the prevalence of male eating disorders seems to be rising.

Disordered eating, which is not classed as a disease, can often be how it all starts. This type of eating would normally be described as an unhealthy diet. The person is likely to worry about calories and their body, train obsessively, and perhaps show initial signs of a malnourished body. Unfortunately, there are many people in this grey area.

It is very easy to think that by cutting calories - and this often means cutting out all fats - that we can lose weight quicker. Or, in the case of the athlete, run faster, better, etc. However, we need to understand the concept that our body is a machine that needs the correct fuelling/energy, to run at its most efficient level.

Eating disorders, such as anorexia nervosa and bulimia nervosa, can have a devastating effect on the health and performance of an athlete. Compared to non-athletes, both female and male athletes are at a much higher risk of developing an eating disorder. It is only the well-nourished athlete that will perform better and can also perform far better for much longer.

Many athletes fail to make the link between their restrictive dietary intake and their eventual losses in performance. They may peak but then experience a rapid decline. Most athletes wouldn’t dream of missing a training session, but they wouldn’t think twice about missing a meal if they had gained some extra pounds.

A fit-looking athlete may have been training hard and making good progress; yet suddenly their appearance may change and they appear weak, unable to manage a pace that was once easy for them. Occasionally the runner may faint, collapsing near the finish. So, what could be wrong? It could be almost anything from a lack of sleep, a viral infection, emotional stress, menstrual disruptions, etc. However, one of the most common causes of a deteriorating performance is simply because the runner/athlete hasn't eaten enough calories/energy.

To avoid this, runners need to pay attention to getting enough calories, spreading food intake evenly throughout the day, and eating the right kinds of foods. They should be eating three meals and three snacks a day, including one snack before bed, to replenish, rebuild, and keep the metabolism buzzing.

Understanding your nutritional needs - getting enough calories, protein, calcium, iron, etc - is so incredibly important. We are all different and so what works for one individual, may not work for another. To learn what your body needs, consult a nutrition professional.