TRAIN WITH FFS
Coach Sinead explains why underfuelling and RED-S happens in female athletes and how to fix it for improved health and performance.
Welcome back!
I hope you enjoyed my previous blog on Fuelling Female Performance - Part 1, where we covered ‘What is Low-Energy-Availability’ and Why it matters’. In part 2, I will cover’.
If you haven’t read it already, then I would encourage you to do so before we crack on with today’s blog, which discusses ‘Why it happens’ and ‘How to fix it’.
If you aren’t bothered to read Part 1 (tsk tsk), here are the highlights:
Not consuming enough food and particularly, not consuming enough food, around your training is one of the main contributors to being in a negative energy balance, and the resulting menstrual disturbance and poor performance.
The ideal threshold is 45kcals per kilogram of fat free mass. Say that again?
For most of us, we won’t know what our fat free mass is (unless we have had a DEXA scan or BOD POD), nor do we want to spend time figuring out exactly what 45kg/ffm per day looks like.
For the majority of women who are active throughout the day (eg. walking to work, working on your feet) it is going to be around 2,000-2,500 calories per day BEFORE EXERCISE.
I know, I know I can hear you know “but {insert app or wearable technology here} tells me that I should be eating 1,200 calories a day to lose weight…..”
But, if we want to be HEALTHY athletes and women who are fertile, then our reproductive systems like our body fat % to be in and around 20-23% body fat (Rinaldi, 2019; Loucks et al, 2011; Institute Of Medicine, 2005).
Here is what that 20-23% looks like according to Precision Nutrition’s handy infographic
For most of us this is going to be sufficiently lean in a way that allows us to fit our exercise and nutrition plans into our day-to-day lives without sacrificing too much
Remember 23-25% body fat is still considered ‘fitness’ and 25-30% considered within the healthy range, as is 16-19%, but if you are on the lower end of the body-fat percentage scale you will need to up the calories as your lean mass is greater.
So, what if you do want to get down to 16-19%, either for your sport or as a goal for a specific event? This leads us to our second reason.
Thanks to the ever-present diet culture, we are bombarded with messages that smaller is better, skinnier is better, leaner is better. We are told to measure our portions, weigh out our macros, sip coffee or water to stave off hunger etc. etc.
We essentially trick ourselves into an extreme calorie deficit that is too large and too drastic in a bid to shed pounds quickly. Add in our new found zeal, we add a new exercise regime and now we are in a double-whammy situation. This large calorie deficit shocks our system into shut-down mode and we can burn out
If we want to get down to the ultra-lean category for a short term goal, you are best to do it in a slow and sustainable way.
Reduce calories slowly, say by 250cals, or add on an additional training session, but only pick one and build on it each week, don’t go hell for leather at the start.
Also make sure to prioritise eating nutrition, well-balanced meals of carbs, proteins and fats in and around your training sessions. You can then reduce some of the starchy carbohydrates in the evening to elicit a calorie-deficit (as long as it isn’t around intense training sessions)
Which leads us on to the next reason.
In a bid to lose weight, we often turn to fasted training or intermittent fasting. This can work well for males, particularly overweight, deabetic males, but women, this can lead to hormonal disruptions and increased cortisol levels, which actually causes us to store fat around our mid-line…..the complete opposite of what we want.
Then if we are skipping our breakfast after our morning training session because we have to hop in the shower and then leg it to work (either in person or online) we a missing a window of opportunity to give our bodies the energy it needs to build lean muscle and support the training adaptations that we want.
Furthermore, by not fuelling correctly around training, we are putting ourselves at a higher risk of menstrual cycle disturbance due to RED-S - Looking at a group of high level athletes in Sweden who ate approx 3,500 cals a day and burned approx 1,000 through training, Farenholtz et al. found that the only difference between those with and without a healthy cycle was those without a period were in an energy deficit for approx 4 hours longer during the day.
This highlights the importance of fuelling regularly if you are someone who trains regularly and prioritising your intake around your training sessions.
The two big players when it comes to appetite regulation are Ghrelin (the hunger hormone) and Leptin (the satisfaction hormone).
A study in 2012 found that ghrelin was muted and leptin increased in menstruating athletic and non-athletic women after exercise (Ackerman et al. 2012). In normal english, this means that although we need to fuel ourselves post exercise are hunger hormones are often upside down, meaning we don’t feel hungry.
Stress hormones, particularly cortisol, also have a big impact on the menstrual cycle. According to Dr. Rinaldi, numerous studies “found that women with hypothalamic ammenorhea (period loss) have elevated cortisol levels in their blood and spinal fluid”.
Cortisol levels are increased by high intensity interval training and when training in a fasted state. A study found that exercising at 60% (moderate intensity) increased cortisol levels by 40% and exercising at 80% intensity (high intensity) raised cortisol levels by 83%(Hill et al, 2008).
According to Dr. Stacy Sims, training fasted in the morning is counter-intuitive as our cortisol levels are already raised and then we compound it by putting our bodies under stress from the exercise. Cortisol not only promotes fat storage around the midline but also uses the same building blocks as your other steroid hormones, oestrogen and progesterone. This often leads to us cutting calories and upping the training, which further compounds the issue.
Note: Some stress is good and we need it to adapt, but having chronically elevated stress levels or ONLY doing crazy high intensity means we are missing a trick and missing out on strength and body composition gains.
There is a difference between being at risk of low energy availability and full-blown period loss.. Both require an increase in energy intake (eg. food) but they need slightly different approaches.
If you have completely lost your cycle for more than 2-3 months are not pregnanct, it is important to go and talk to your GP and go to see a registered dietitian to create a strategy for regaining your cycle. Nevertheless, there are some strategies that can help if you are at risk of underfulling or have lost your period.
Top Tip: Have a protein shake with you in your bag for straight after sessions
Please remember, if you have lost your period then it is important to go and speak to your GP to rule out any other underlying issues.
Sinead is passionate about female health and performance. She holds regular workshops on the topic of menstrual cycle health, fuelling female performance, and working in sync with your cycle, as well as working with 1:1 clients.
If you are interested in learning more, follow her instagram account dedicated to research backed information on how to work with your body, not against it - @gowiththeflow_workwithyourbody
If you would like to attend a workshop or work with Sinead, fill in this interest form or email her at sinead@ffs.ie
Please see sources listed in previous blog (here)