Can You Eat What You Want?

Just because you’re a healthy weight and work out every day doesn’t mean you’re not at risk for disease. In fact, athletes may need to pay more attention than others. Here’s why. 

I have one distinct memory of training for my first marathon. I was out logging my first 20-mile run, struggling with the motivation to complete the distance.

What got me through you may wonder? The sense of accomplishment I knew I’d feel upon completing the distance? The knowledge those hard-fought miles would all but guarantee me a triumphant finish at my race in a matter of weeks?

Hardly. My motivation was the delicious food I could indulge in as a reward for my effort. The fact that those 20 miles would allow me to torch enough calories to do so guilt-free was

tantalizing. Visions of salty chips chased down by a pint of Ben & Jerry’s compelled me to power through.

Now, before you judge me too harshly, please note that this was long before I became a registered dietitian. I’m also certain that I am far from alone when it comes to this mentality. All you have to do is observe the post-marathon feasting that runners partake in, often with free beer in hand, to know that many athletes are more than happy to reap the rewards of their efforts by eating whatever they’d like once they cross the finish line.

Unfortunately, this exact attitude can not only hinder an athlete’s performance, but could potentially lead to serious health consequences later in life.

Dave McGillivray, the race director of the Boston Marathon and an avid and accomplished runner and triathlete himself, is a prime example of the limited beneficial effect that exercise alone can have in offsetting the lifestyle and genetic factors that can increase risk for disease.

In 2013, McGillivray, then 59, was diagnosed with coronary artery disease; a diagnosis that had come as a complete shock to him due to his lifetime of endurance running. Then, this past September, 2018, he told Runners World that two of his major arteries were so severely blocked he may have to undergo bypass surgery.

What was to blame?  A family history and—you guessed it—McGillivray’s admittedly terrible diet.  His high volume of exercise had afforded him the ability to eat “like a teenager” with no concerns of weight gain, but internally his poor diet had taken a serious toll.

Exercise: the Best Prevention?

It has been drilled into us that physical activity is a surefire path to good health.  In fact, a recent report asserted that participating in just 150 minutes of moderate-intensity exercise per week is more effective than most medications prescribed for chronic disease prevention and management.  What makes exercise such a potent tool in combatting disease? Its anti-inflammatory potential.

At the root of chronic diseases like atherosclerosis and diabetes is inflammation. No, not the kind of inflammation you experience with an injury. The kind of inflammation that occurs with a sprained ankle or infection is the body’s natural way of promoting healing.

However, when inflammation becomes persistent and chronic it no longer helps the body and, in fact, becomes detrimental to one’s health.  Chronic inflammation involves a slow and steady release of inflammatory chemicals that, left unchecked, have been linked to an increased risk for cancer, obesity, diabetes and heart disease. The benefit of exercise—and why it needs to be a part of a healthy lifestyle—is that exercise combats this condition by releasing anti-inflammatory chemicals that can reduce overall inflammation in the body. 

Concerned that you are falling short of suggested exercise goals?  You are not alone. The vast majority of Americans don’t meet the recommended 150 minutes of physical activity per week, but some exercise is better than none. 

Are you part of the minority who exceed those guidelines? That’s great. A study of over 1,000 elite male athletes found a much lower risk for diabetes, especially among those who participated in endurance sports. The same reduced risk has been seen for cardiovascular disease, lung cancer, kidney cancer and even depression in endurance athletes. 

But, before you assume that an abundance of exercise means that you are invincible, you have to bear in mind that a reduced risk for disease doesn’t equate to being risk-free. That is because as much as our activity can reduce inflammation, our diet can very easily sabotage these effects. Studies have found that consumption of sugar, refined grains and unhealthy fats increases inflammatory markers in the body.

Although no longitudinal studies have examined how much exercise it would take to offset inflammation brought on by a diet high in these foods, it is likely that damage is accumulated over time regardless of how many miles you log running or skiing.

A major problem for athletes who eschew the recommendation to eat healthy is that most of us fly under the radar when it comes to risk factors.  Maintaining a healthy weight and participating in regular exercise checks two boxes for physicians that the majority of the population misses, so why would they bother screening for cholesterol, blood pressure or diabetes? 

Unfortunately, as all of these chronic diseases are progressive. Failure to test early on can give them a chance to advance before the damaging effects are all but irreversible.

All Calories Are Not Equal

The philosophy that you can offset poor dietary choices is based on the premise that all that matters when it comes to diet and exercise is calories-in-calories-out. However, food provides more than just calories. Meeting needs for protein, carbohydrates, dietary fiber, fats, vitamins and minerals is important for everyone to achieve good health.  Taking in enough of these nutrients is essential whether you are an Olympic-level athlete or you prefer to participate in sports by viewing them in HD from your recliner. 

Deficiencies in vitamins and minerals can develop over weeks, months and even years when individuals consume foods that pack a lot of calories with little nutritive value.  These “empty calories” can take the place of more nutritious foods and—with proper exercise—allow individuals to maintain a healthy weight, but compromise their nutritional status.

Take soda as a prime example of a common source of “empty calories.”  A 12-ounce can of Pepsi clocks in at 150 calories and provides absolutely no protein, healthy fats, vitamins or minerals to speak of. Sure, those calories can be burned off with a brisk two-mile run, but what benefit do we get from it? The high sugar content promotes inflammation in the body and causes a spike in insulin that encourages the body to store fat. I’m not suggesting that you never indulge in a soda or other foods more or less bereft of nutrients. What fun would that be? 

A healthy diet should be flexible and not every calorie we take in has to be brimming with nutrition. I aim for the 80-20 rule: 80 percent of your diet should consist of whole foods that are nutrient-dense and the other 20% can be more indulgent foods.
Thanks to that approach I no longer feel the need to reward myself for a long run with an entire pint of ice cream, but a small bowl every now and then still hits the spot!

As the Director of Nutrition at The Edge in Burlington, Jamie Sheahan, M.S., R.D. works closely with athletes to develop customized fueling plans to optimize their health and performance. Sheahan is also an adjunct professor of sports nutrition at UVM. An avid runner, she has completed more than 20 marathons.