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Nourishing Young Runners for Optimal Bone Health

Professor Michelle Barrack

As a competitive runner in high school and college, I recognized the significant effect food choices had on my energy and ability to perform. What I didn’t realize was how much food was needed to adequately fuel a long distance runner and the risks associated with chronic under-fueling.

My passion for running led me to enter a graduate program, working as a research assistant for one of the largest studies to date on the prevalence of the Female Athlete Triad, a condition of chronic low energy availability, amenorrhea, and low bone mass in high school athletes. Through this project, our group identified female high school endurance runners as a population exhibiting an elevated prevalence (~40%) of low bone mineral density (BMD), a condition increasing risk of osteoporosis later in life. This is particularly concerning for high school runners, as adolescence represents a critical window of opportunity to develop up to 50% of adult bone mass. Runners also exhibit a higher risk of developing bone stress injury (i.e. stress fracture), with low BMD increasing fracture risk, recovery time, and return to play.

The body of literature addressing low bone mass in runners suggests that the low BMD associated with higher running volume is not caused by running itself, but instead a chronic energy deficit, despite adequate intakes of other bone-building nutrients, such as calcium. Furthermore, an energy deficit often develops due to a lack of knowledge of the high energy, and particularly carbohydrate, needs of endurance runners logging 30, 50, 80, or even 100 miles per week. At this level of training, runners can require more than 600 grams of carbohydrates per day, a challenge for any student athlete balancing the demands of their sport with a rigorous class schedule, social events, and other extracurricular activities.

login screen for run fueld app

Login Screen for Run Fueled App

Therefore, over the past five years, my primary research efforts have focused on developing and implementing nutrition education curricula aimed at optimizing energy and nutrient intake in runners. I am working as Nutrition Coordinator in collaboration with Sports Medicine physicians from UCLA and Stanford University on a six-year prospective study aiming to reduce the incidence of bone stress injury in collegiate runners through a nutrition intervention. To facilitate delivery of the intervention, I led the development for the content of a smart-phone based application, “Run Fueled”, which administers an eight-week, goal-specific, nutrition education program. Additionally, this year, I began delivery of a 4-week, interactive, face-to-face nutrition education program, aiming to optimize energy and carbohydrate intake among high school runners.

It is my hope, through our efforts and those of other research teams, that we can develop evidence-based strategies that support the optimal nourishment, health, and continued training of young runners striving to perform their best.

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