Resources Archives - Athletes Sanctuary

woman running with hands in the air and smile

Marathon pacing – it’s a skill that requires understanding, planning and practice. Pacing is a challenge that most marathoners have grappled with at some point.

As we explore in Master Marathon Pacing Part 1, a 2021 study revealed that 17% of women and 28% of men tend to “hit the wall” during a marathon. This struggle is not limited to specific ability levels or age-groups, making it a common hurdle for all of us.

As a fellow marathoner, I’ve grappled with the struggles of pacing so I understand the frustration and the many factors that can impact your ability to hold a consistent pace for the full 42.2kms. As we outlined in part 1, once you have gained a sound understanding of marathon pacing, it’s time to put it into practice. Here’s how:

Marathon-specific training

Incorporating specific marathon pacing sessions into your training plan can help improve your ability to sustain a steady pace over long distances. Alternating between high-intensity effort and recovery periods can enhance your endurance and develop a better sense of pacing. Running shorter distances at the marathon target pace is an easy way to do this.

Example 1. 10-12km at your target race pace.
Example 2. 30km run including 5-10km at target race pace.
Example 3. 30 minutes at target marathon race pace, 15 minutes at ½ marathon pace.

The key to race preparation is gradually building up your distances over 12–16-week weeks, including ample recovery between marathon pacing sessions, and avoiding overdoing key sessions.
The key to running your best doesn’t only hinge on your sessions. Adaptation to your sessions, overall stress levels and health are important factors to consider in a balanced marathon program.
Visualisation: Mental preparation is equally important to physical training regarding marathon pacing. Uncharted territory can be difficult for anyone to navigate.

A good sports psychologist can provide tools to help execute your pacing strategy. Visualisations can help build confidence and mental resilience, keeping you focused and disciplined on race day. I always had a mental race plan that I discussed with my sports psychologist and coach well before race day.

I frequently visualised a mental and physical race plan. This didn’t always result in my races going according to plan, but it certainly helped me get the most out of myself and maintain mental focus and determination even when things went sideways.

Race-Day Rehearsal

Practice your pacing strategy during long training runs leading up to the marathon to familiarise yourself with all aspects of your race, such as nutrition, hydration, routine, and your target pace. Connect with how it feels to maintain your target pace over an extended period. Consider participating in shorter races or time trials as race-day rehearsals to fine-tune your pacing strategy and build race-day confidence.

In conclusion, mastering marathon pacing is essential for endurance runners seeking to achieve their goals and maximise their performance. You can confidently optimise your performance and conquer the distance by understanding your target pace, implementing effective pacing strategies, and utilizing tools such as marathon calculators.

At the Athlete Sanctuary, we encourage our athletes to listen to their bodies, trust their training, and embrace the journey toward becoming stronger, more resilient athletes.

Whether you’re a seasoned marathoner or preparing for your first race, prioritising pacing can make all the difference in your marathon experience. If you are keen to better understand how to enjoy the thrill of crossing the finish line strong, contact us to discuss your next marathon goal.

References
Hanley, Brian, (2018), Pacing Profiles and Pack Running at the IAAF World Half Marathon Championships. Journal of Sports Sciences, vol. 36, no. 20, pp. 2339–2345.
De Leeuw, A. W., Meerhoff, L. A., & Knobbe, A. (2018). Effects of pacing properties on performance in long-distance running. Big Data, 6(4), 248-261.
Oficial-Casado, F., Uriel, J., Perez-Soriano, P., & Priego Quesada, J. I. (2021). Effect of marathon characteristics and runners’ time category on pacing profile. European Journal of Sport Science, 21(11), 1559-1566.
Renfree, A., & Gibson, A. S. C. (2013). Influence of different performance levels on pacing strategy during the Women’s World Championship marathon race. International journal of sports physiology and performance, 8(3), 279-285.
Smyth, B. (2021). How recreational marathon runners hit the wall: A large-scale data analysis of late-race pacing collapse in the marathon. PloS one, 16(5), e0251513.
Muñoz, Iker, et al. (2018). The Influence of Different Pacing Strategies on Marathon Performance and Fatigue: A Computer Simulation Study. European Journal of Applied Physiology, vol. 118, no. 9, 2018, pp. 1757–1769.

Woman athlete running with her arms above her head

Let’s face it, pacing is a challenge that most marathoners have grappled with at some point. In fact, a 2021 study revealed that 17% of women and 28% of men tend to “hit the wall” during a marathon. This struggle is not limited to specific ability levels or age-groups, making it a common hurdle for all of us.

As a fellow marathoner, I’ve had my fair share of pacing struggles. Many of my earlier marathons were approached with a “go for broke” mindset, only to find myself dropping off my initial pace by over 30 seconds per kilometre in the later stages of the race. The final kilometres were a grind to keep my legs moving in the right direction. I understand the frustration and the many factors that can impact your ability to hold a consistent pace for the full 42.2kms.

Inadequate carbohydrate intake and glycogen depletion, dehydration, mindset and mental focus, physiological issues such as gastrointestinal issues or cramping and pacing strategies (or lack thereof) are all factors that can influence your finishing time.

With the right approach and understanding, you can optimise your pacing strategy and run the race of your life.

A well-paced runner outperforms those who start too fast or too slow.

In part one of this blog we explore your target pace using marathon pacing calculators, adjusting pace for race conditions and negative split concepts.

Understand Your Target Pace:

Before embarking on your marathon journey, it’s essential to have a clear understanding of your target pace. Utilise a marathon calculator to determine the pace required to achieve your desired finishing time. By knowing your target pace, you can establish a realistic pacing strategy and avoid starting too fast, which can lead to early fatigue. Some of our favourite marathon pacing calculators include Strava’s Race Pacing Guide and Garmin Connect’s Race Predictor. Both provide a convenient way to gauge your fitness level and plan your pacing accordingly.

Estimating your target pace will be influenced by your overall health, level of fitness and experience, race conditions, and the marathon course itself. I have always found it useful to base my race pace on the feedback from key long runs and marathon-specific sessions.

Understand the conditions and racecourse:

Studying the racecourse, including undulations and likely race conditions, is always recommended to build confidence in your race pacing strategy. Going over the course prior to race day can be helpful, but if this isn’t possible, seek out videos of the course from previous years and speak to runners who have completed the course.

Practice Negative Splits:

One effective pacing strategy for marathon runners is to aim for negative splits, where the race’s second half is faster than the first. Research published in the International Journal of Sports Physiology and Performance suggests that runners who implement a negative split strategy often achieve faster overall race times and experience fewer performance declines late in the race.

By starting conservatively and gradually increasing your pace, you can conserve energy for the later stages of the marathon, enabling you to finish strong. Don’t forget to consider potential congestion in the first 5km if competing in a big city marathon. Negatively splitting long runs can be a useful way to practice this strategy. Generally speaking, if you are competing in a flat marathon with limited wind, aim to run the second part of the race 1-2 minutes quicker than the first half.

At the Athlete Sanctuary, we encourage our athletes to listen to their bodies, trust their training, and embrace the journey toward becoming stronger, more resilient athletes.

References

Oficial-Casado, F., Uriel, J., Perez-Soriano, P., & Priego Quesada, J. I. (2021). Effect of marathon characteristics and runners’ time category on pacing profile. European Journal of Sport Science, 21(11), 1559-1566.

Renfree, A., & Gibson, A. S. C. (2013). Influence of different performance levels on pacing strategy during the Women’s World Championship marathon race. International journal of sports physiology and performance, 8(3), 279-285.

woman running through a field with a stormy sky in the background

Whether you’re running marathons, lifting weights, or participating in team sports, your bones bear the brunt of your intense physical activity and constant training regime. While we all know the importance of calcium and vitamin D for bone health, we often forget the roll magnesium has in bone health.

The Magnesium-Bone Connection

Research suggests 20% of individuals constantly consume lower quantities of magnesium than recommended. So why is magnesium so essential for athletes? The answer lies in the intricate relationship between magnesium and various bone-related processes:

Mineralisation: Magnesium is a cofactor for the enzymes responsible for bone mineralisation. It helps convert vitamin D into its active form, which is crucial for calcium absorption, the primary mineral in bones. Lower levels of magnesium are related to osteoporosis in menopausal women. One study, suggested 30–40% of women are deficient in magnesium.
Bone Density: Athletes often put their bones under repetitive stress. Magnesium plays a vital role in maintaining healthy bone density and structural integrity. Low levels can decrease bone density, making athletes more susceptible to fractures.
Bone Turnover: Magnesium helps regulate the balance between bone formation and bone resorption. This is crucial for athletes as it ensures their bones adapt to training demands without becoming brittle or porous.

For Athletes

Apart from its direct impact on bone health, magnesium offers several other benefits for athletes:

Muscle Function: Adequate levels are essential for proper muscle function. It helps muscles contract and relax, preventing cramps and promoting efficient performance.
Energy Metabolism: Magnesium is a co-factor for enzymes involved in ATP (adenosine triphosphate) production, the primary energy source for athletes during exercise.
Immune Support: Intense physical activity can temporarily weaken the immune system. Magnesium aids immune function, helping athletes recover from workouts and training stress.
Recovery and tightness: Magnesium helps with restless legs, tight muscles, headaches and insomnia.
Hormonal Balance: Magnesium helps reduce fluid retention, menstrual cramps, anxiety, mood swings and cravings related to the menstrual cycle

Meeting Your Needs

As an athlete, meeting your nutrition requirements to ensure optimal bone health and overall performance is crucial. Here are some dietary sources of magnesium to consider:

Nuts and Seeds: Almonds, peanuts, cashews and pumpkin seeds are excellent.
Dark Leafy Greens: Spinach and kale are a rich source to add to your diet.
Whole Grains: Choose whole grain options like brown rice and sourdough bread.
Legumes: Beans and lentils are magnesium-packed additions to your diet.
Cocoa and brewer’s yeast also contain magnesium.

Supplements can be considered in cases where dietary intake may fall short, but it’s always advisable to consult with a healthcare professional or sports nutritionist before taking any supplements.

Magnesium is an essential yet often overlooked mineral for bone health in athletes. From mineralisation to bone density and regulating bone turnover, magnesium is pivotal in maintaining strong, resilient bones, making it a crucial element in an athlete’s nutrition regimen. So, next time you plan your meal, don’t forget to include magnesium-rich foods to keep your bones strong and support your overall athletic performance.

Contact the Athlete Sanctuary and learn how we can help you increase your bone health, well-being, and performance.

References

Health Direct (2023).

Orchard TS, Larson JC, Alghothani N, Bout-Tabaku S, Cauley JA, Chen Z, LaCroix AZ, Wactawski-Wende J, Jackson RD.(2014). Magnesium intake, bone mineral density, and fractures: results from the Women’s Health Initiative Observational Study. American Journal Clinical Nutrition. 2014 Apr;99(4):926-33

Rondanelli, M., Faliva, M. A., Tartara, A., Gasparri, C., Perna, S., Infantino, V., & Peroni, G. (2021). An update on magnesium and bone health. Biometals, 34(4), 715-736.

About the Author: Kate Smyth is a Sports naturopath, nutritionist and female-centric running coach. She founded the Athlete Sanctuary- a holistic healthcare clinic for athletes of all levels and sporting codes. Kate thirsts for knowledge and has two bachelor’s degrees and a master’s degree under her belt. She has been involved in sports for many decades and competed for Australia in the Commonwealth Games and Olympic Games marathons with a personal best time of 2 hours 28 minutes.

Photo of a female athlete kneeling down on the ground as she is exhausted.

Training fasted involves exercising without food and/or energy drinks for a period of time. The most common fast lasts for 8/12 hours or extended to 16 hours as an overnight fast. During this period, we tap into fat stores in the form of ketone bodies and stored glycogen.

Runners often train fasted unconsciously as a morning run or gym session before breakfast.

This practice has gained popularity due to its potential effects on fat loss, and overall performance. However, it also comes with its share of pros and cons and is not for everyone. Here’s a list of some of the potential pros and cons:

Pros of Training Fasted:

Weight management: Training fasted may increase the body’s reliance on using stored fat for energy. Over time this aids fat loss and contributes to the maintenance of lean muscle mass, beneficial body composition and weight management.

Weight management: Reduced body fat, contributes to the maintenance of lean muscle mass and beneficial body composition. This can be beneficial for athletes competing in weight categories or sports dependant on body composition such as body sculpting.

Insulin Sensitivity: It can improve insulin sensitivity. When you do eat after exercise, the body absorbs nutrients more efficiently, which is beneficial for overall health and weight management. This assists with blood sugar control, energy levels and management of insulin resistance and diabetes.

Hormonal Responses: Training fasted can lead to increases in human growth hormone (HGH) key to muscle growth. Muscle growth is important to athletes in strength and body sculpting related sports.

Metabolic Adaptation: Proponents will argue that training fasted makes them more efficient at using fat stores for energy. In recent times the belief has gained traction in the endurance running community (especially ultra running).

Cons of Training Fasted:

Performance Impairment: Fasting and then training can lead to decreased performance, especially for high-intensity workouts. Without readily available carbohydrates athletes experience lower energy levels during and post exercise. Recovery, strength, and endurance are also impaired.

A recent review of 46 studies concluded eating before exercise prolongs aerobic performance. The debate becomes clouded in practice as endurance athletes can feel ok during low-to-moderate intensity training when training fasted. A runner can feel good on an easy 6km recovery run but rubbish doing 1km reps.

Muscle Breakdown: Training fasted could potentially lead to increased muscle breakdown due to the lack of readily available energy sources. This is detrimental to muscle gain and repair.

Hydration and Electrolyte Imbalance: Fasting can lead to dehydration and electrolyte imbalances, which can negatively impact workout performance and recovery.

Additional adrenal gland stress: It can increase adrenaline levels and cortisol levels. This is not a great scenario for those athletes with already high levels of stress.

Lower hormones: reduces male sex hormones (androgens) and negatively impacts libido and metabolic health. This is non-beneficial for men but beneficial for women with polycystic ovarian syndrome (PCOS). Training fasted does not appear to have any effect on estrogen or prolactin levels in women.

Training fasted may also reduce thyroid hormones -thyroid stimulating hormone (TSH) and T3- active thyroid hormones. This may contribute further to thyroid hormone imbalances.

Risk of Overeating Post-Workout: Some individuals compensate by consuming larger meals after exercise. Sugar and carbohydrate cravings increase as the day progresses. Poor food choices and excessive sugar intake peaks towards the end of the day. This can then result in disturbed sleep and reduced energy levels the following day.

Lack of Nutrients for Recovery: After exercise, your body needs nutrients for muscle repair, glycogen replenishment, and overall recovery. Fasted training can limit the availability of these nutrients at a critical time and delay recovery.

Individual Responses: Fasted training might be suitable for some individuals but not for others. Factors like genetics, training goals, and personal preferences can greatly influence the effectiveness and comfort of training fasted.

Increased Perceived Effort: For some athletes, training on an empty stomach can make training sessions feel harder. This can impact motivation and adherence to the training routine.

In summary, training fasted can have potential benefits such as increased fat loss and improved insulin sensitivity. However, training fasted also comes with potential downsides like impaired performance and muscle loss. Athletes are also at risk of reduce hormone levels, dehydration and nutrient deficiencies with prolonged fasting.

Your training goals, preferences, and how your body responds to fasted training is important to observe. We always recommend seeking professional help from a sports naturopath or nutritionist to ensure training fasted aligns with your specific circumstances.

Sources:

Aird, T. P., Davies, R. W., & Carson, B. P. (2018). Effects of fasted vs fed‐state exercise on performance and post‐exercise metabolism: A systematic review and meta‐analysis. Scandinavian journal of medicine & science in sports, 28(5), 1476-1493.

Cienfuegos, S., Corapi, S., Gabel, K., Ezpeleta, M., Kalam, F., Lin, S., & Varady, K. A. (2022). Effect of intermittent fasting on reproductive hormone levels in females and males: a review of human trials. Nutrients, 14(11), 2343.

Kim, B. H., Joo, Y., Kim, M. S., Choe, H. K., Tong, Q., & Kwon, O. (2021). Effects of intermittent fasting on the circulating levels and circadian rhythms of hormones. Endocrinology and Metabolism, 36(4), 745-756.

Hackett, D., & Hagstrom, A. D. (2017). Effect of overnight fasted exercise on weight loss and body composition: A systematic review and meta-analysis. Journal of Functional Morphology and Kinesiology, 2(4), 43.

Hansen, D., De Strijcker, D., & Calders, P. (2017). Impact of endurance exercise training in the fasted state on muscle biochemistry and metabolism in healthy subjects: can these effects be of particular clinical benefit to type 2 diabetes mellitus and insulin-resistant patients?. Sports Medicine, 47, 415-428.

Vieira, A. F., Costa, R. R., Macedo, R. C. O., Coconcelli, L., & Kruel, L. F. M. (2016). Effects of aerobic exercise performed in fasted v. fed state on fat and carbohydrate metabolism in adults: a systematic review and meta-analysis. British Journal of Nutrition, 116(7), 1153-1164.

Zouhal, H., Saeidi, A., Salhi, A., Li, H., Essop, M. F., Laher, I., & Ben Abderrahman, A. (2020). Exercise training and fasting: current insights. Open access Journal of sports medicine, 1-28.

Want to know more? Contact the Athlete Sanctuary and learn how we can help you to increase health, wellbeing and performance.

About the Author: Kate Smyth is a Sports naturopath, nutritionist and female-centric running coach. She is the founder of the Athlete Sanctuary- a holistic healthcare clinic for athletes of all levels and sporting codes. Kate has a thirst for knowledge with two bachelor’s and a Master’s degree under her belt. She has been involved in sports for many decades and competed for Australia in the Commonwealth Games and Olympic Games marathons with a personal best time of 2 hours 28 minutes.

Photo of a female athlete wearing a hoody on a dark gloomy day

Seasonal Affective Disorder (SAD), also known as seasonal depression or seasonal mood disorder, can have many impacts to your way of life, including your athletic performance. While SAD’s prevalence in Australia may differ from other regions, it is still important to explore the experiences of female athletes living with SADs. In this blog post, we will delve into the symptoms and unique challenges faced by female athletes in relation to SAD, and strategies to navigate through it.

SEASONAL AFFECTIVE DISORDER

It’s vital for female athletes to recognise the intersection between their mental health and athletic performance, and acknowledge that working on mental health can positively impact their overall performance and condition.

SAD is suggested to be linked to the circadian rhythms (‘body clock’) adjustments at certain times of the year and in response to variations in exposure to sunlight. This is thought to impact the hormones melatonin and serotonin, which affect sleep and mood.

Those most at risk are younger females, those with a family history of depression, bipolar disorder, or SAD. The risk increases the further away from the equator. Vitamin D deficiency is also linked to SAD and people with SAD may produce less Vitamin D. As Vitamin D plays a role in serotonin activity, Vitamin D deficiency and insufficiency have been associated with depressive symptoms.

SAD frequently co-occurs with other disorders including attention-deficit hyperactivity disorder (ADHD), addiction, and eating disorders.

RECOGNISING SEASONAL AFFECTIVE DISORDER

Awareness of Seasonal Patterns
Athletes experiencing SAD may notice seasonal patterns to their moods.

Winter
Common observations over winter include:

Decline in mood, sadness and depression
Fatigue without explanation
Reduced motivation
Hopelessness
Social withdrawal
Overeating and carbohydrate cravings
Excessive sleeping

Summer
In summer SAD may look more like sleep issues, not feeling hungry, losing weight and feeling agitated and anxious.

By recognising these patterns and symptoms, athletes can better anticipate and prepare for the potential impact on training and performance.

ADJUSTING TRAINING SCHEDULES

Athletes and coaches may need to modify training schedules to accommodate SAD symptoms. This could mean adjusting the timing of workouts to coincide with optimal sunlight exposure in the middle of the day, incorporating more indoor training during the darker months, or allowing for flexibility in training intensity to accommodate fluctuations in mood and energy levels.

USING SUPPORT NETWORKS AND RESOURCES

Communication
Openly communicate with coaches, supporters, friends and family about your experiences with SAD. By sharing your challenges and seeking understanding, you can foster a supportive environment that promotes positive mental health and helps alleviate the burden of SAD symptoms.

Seek Out a Mental Health Professional
Support from a mental health professional who specialises in sports psychology can be incredibly valuable. These professionals can provide tailored strategies to manage SAD symptoms, including cognitive-behavioural techniques, mindfulness practices and stress management tools.

In some cases your doctor may recommend light therapy.

SELF-CARE AND WELLBEING

Sunlight Exposure
Spend time outdoors during daylight hours, as sunlight exposure has a positive impact on vitamin D levels, sleep, mood and energy levels. Including outdoor activities, such as training sessions, walks and other outdoor hobbies, can help combat the effects of SAD.

Rest and Recovery
Prioritise sufficient sleep and establish consistent sleep routines to support your mental health and physical wellbeing.

Stress Reduction
Implementing stress reduction techniques, such as meditation, deep breathing exercises, or taking time with hobbies, people etc that bring joy, can help to alleviate SAD symptoms and promote overall mental wellbeing.

Vitamin D
We recommend athletes who suffer from SAD check their vitamin D levels every 6 months. Maintaining regular sunlight exposure and intake of vitamin D rich foods is essential to the prevention of deficiency. In many cases vitamin D supplementation is required.

Managing Seasonal Affective Disorder requires a comprehensive approach that integrates mental health and performance considerations. By recognising the unique challenges you face and implementing strategies such as adjusting training schedules, tapping into support networks and prioritising self-care, you can affectively navigate SAD while maintaining fitness and performance.

About the Author: Kate Smyth is a Sports naturopath, nutritionist and female-centric running coach. She is the founder of the Athlete Sanctuary- a holistic healthcare clinic for athletes of all levels and sporting codes. Kate has a thirst for knowledge with two bachelor’s and a master’s degree under her belt. She has been involved in sports for many decades and competed for Australia in the Commonwealth Games and Olympic Games marathons with a personal best time of 2 hours 28 minutes. For more information visit our website.

References
1. Armstrong, S. L., & McVeigh, D. (2019). A systematic review of athletes’ experiences with self-talk. Frontiers in Psychology, 10, 1518.
2. Fenton, G., McPherson, A., & Kinnafick, F. (2019). Qualitative inquiry into the lived experiences and coping strategies of female athletes with eating disorders. Psychology of Sport and Exercise, 42, 100-108.
3. Gulliver, A., Griffiths, K. M., & Christensen, H. (2012). Perceived barriers and facilitators to mental health help-seeking in young people: A systematic review. BMC Psychiatry, 12.
4. Pargman, D., & Wiese-Bjornstal, D. M. (2003). Examining links between emotional states and physical activity among individuals with high physical activity levels. Journal of Applied Sport Psychology, 15(4), 300-317.
5. Melrose S. Seasonal Affective Disorder(2015): An Overview of Assessment and Treatment Approaches. Depress Res Treat. doi: 10.1155/2015/178564.
6. Murray, G. (2004). How common is seasonal affective disorder in temperate Australia? A comparison of BDI and SPAQ estimates. Journal of affective disorders, 81(1), 23-28.
7. https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/symptoms-causes/syc-20364651
8. https://www.psycom.net/depression.central.seasonal.html
9. https://wayahead.org.au/get-the-facts/seasonal-affective-disorder/
10. https://www.healthdirect.gov.au/seasonal-affective-disorder

Photo of a bowl of pumpkin and ginger soup with a spoon.

We all know that winter weather calls for delicious, heart warming soups. This delicious pumpkin soup recipe has the added bonus of ginger – an ingredient that aids digestion and is packed with antioxidants that help prevent arthritis, inflammation and various types of infection. There are so many health benefits of ginger!

Ingredients

1kg pumpkin, peeled, seeds removed and cut into 4cm pieces

75g ginger, roughly chopped

2 garlic cloves

2 tbs extra virgin olive oil

1L (4 cups) vegetable or chicken stock

2 tbs finely chopped dill

1/3 cup (50g) toasted hazelnuts, chopped

Method

Preheat your oven to 180 degC.

Place your pumpkin, ginger and garlic on a large baking tray and drizzle with oil. Season, then toss to coat. Roast for 30 minutes or until the pumpkin is soft (don’t let the garlic burn).

Puree mixture in a blender or food processor with 2 cups (500ml) of stock, then season. If there are lumps then strain through a fine sieve. Place the soup in a large saucepan with remaining 2 cups (500ml) of stock and warm over a medium-low heat.

Divide the soup between 4 bowls and serve with dill and toasted hazelnuts and what ever other toppings you love on your soup – if you wish a dollop of marscapone.

Enjoy x

Photo of a female lying down on the ground with her hands to her head in discomfort.

Premenstrual Dysphoric Disorder (PMDD) is a health concern best described as a form of severe premenstrual syndrome (PMS). PMDD affects 3-8% of women worldwide but is not well understood or researched.

What are the symptoms?

PMDD symptoms include anger, irritability, depressed mood, anxiety, lack of pleasure, a sense of overwhelm, difficulty concentrating, fatigue, changes in appetite or food cravings, sleep changes, and physical symptoms such as breast tenderness, bloating or headaches.

These symptoms emerge in the luteal phase of the menstrual cycle, one to two weeks before periods commence, and typically subside within a few days of bleeding.

Over 64% of women experience some kind of mood changes a few days before the onset of menstruation. For women with PMDD these changes are more extreme. Despite having normal hormonal fluctuations during the menstrual cycle, women with PMDD experience an abnormal mood response to these fluctuations. Rage, anger, irritability, intolerance to others, anxiety and depression are commonly reported in women with PMDD. Our patients with PMDD sometimes say extreme statements along the lines of ” I get so mad I feel like I want to kill my husband before my period.”

It is suggested these more extreme changes in mood may be attributable to the effect estrogen and progesterone have on the serotonin, GABA and dopamine systems. These can also alter the renin-angiotensin-aldosterone system, which could explain some of the bloating and swelling that occur during the luteal phase.

Conventional intervention typically involves the contraceptive pill, anxiety medications and anti-depressant medications. For some women this relieves problematic symptoms but may also contribute to other side effects which become more of an issue than the PMDD itself. For those women, considering complementary solutions may be a good option. In traditional medicine practice, herbal medicines have been used to manage PMDD. Some of these natural medications support GABA levels, reduce extreme emotions, reduce depression, minimise physical symptoms and promote relaxation.

Other options often included in a herbal prescription such as withania , ginseng and rhodiola are considered serotonergic – i.e. they support level of serotonin in the brain. Nutrients such as vitamin E, vitamin D, zinc, vitamin B6, 5-HTP, calcium or inositol may be prescribed to help support healthy mood, reduce pain and support hormonal balance.

In naturopathic medicine we consider the individual’s unique presentation and symptomatic picture, rather than the diagnosis. Therefore, our treatment plans are also always tailored to the individual and consider their health history and current lifestyle demands. For some women anger is their key concern, while for others their depression is debilitating.

It helps to be realistic about what changes you can expect and appropriate timeframes. To get the best results we recommend an in-depth assessment and consultation for women with PMDD along with regular reviews to allow for modifications and adjustments of formulas and dosages.

Always seek medical care if you think you may have PMDD.

Want to know more? Contact the Athlete Sanctuary and learn how we can help you.

About the Author: Kate Smyth is a Sports naturopath, nutritionist and female-centric running coach. She is the founder of the Athlete Sanctuary- a holistic healthcare clinic for athletes of all levels and sporting codes. Kate has a thirst for knowledge with two bachelor’s and a Master’s degree under her belt. She has been involved in sports for many decades and competed for Australia in the Commonwealth Games and Olympic Games marathons with a personal best time of 2 hours 28 minutes. For more information visit www.athletesanctuary.com.au

References
Hantsoo, L., & Payne, J. L. (2023). Towards understanding the biology of premenstrual dysphoric disorder: From genes to GABA. Neuroscience and biobehavioral reviews, 149, 105168. doi.org/10.1016/j.neubiorev.2023.105168

Hofmeister, S., & Bodden, S. (2016). Premenstrual Syndrome and Premenstrual Dysphoric Disorder. American family physician, 94(3), 236–240.

Kashanian M, Mazinani R, Jalalmanesh S. Pyridoxine (vitamin B6) therapy for premenstrual syndrome. (2007) Int J Gynaecol Obstet;96(1):43-44.

Tartagni, M., Cicinelli, M. V., Tartagni, M. V., Alrasheed, H., Matteo, M., Baldini, D., De Salvia, M., Loverro, G., & Montagnani, M. (2016). Vitamin D Supplementation for Premenstrual Syndrome-Related Mood Disorders in Adolescents with Severe Hypovitaminosis D. Journal of pediatric and adolescent gynecology, 29(4), 357–361. doi.org/10.1016/j.jpag.2015.12.006

Cerqueira, R. O., Frey, B. N., Leclerc, E., & Brietzke, E. (2017). Vitex agnus castus for premenstrual syndrome and premenstrual dysphoric disorder: a systematic review. Archives of women’s mental health, 20(6), 713–719. doi.org/10.1007/s00737-017-0791-0

Photo of jars of watermelon and orange in glass jars ogf water with straws.

Most athletes consider the balance of electrolytes when thinking about hydration and recovery, especially over endurance events. But are salt tablets and electrolytes really necessary?

Before we answer this question, let’s recap on electrolytes and the role they perform in the body.

Sodium is the key electrolyte responsible for controlling extracellular fluid balance while potassium controls the fluid within the cells. Potassium also helps with muscle contraction and supports blood pressure. Electrolytes such as potassium can also impact iron absorption. Potassium (along with other nutrients such as zinc and B vitamins) is essential for hydrochloric acid (HCL) production in your stomach. Without adequate HCL a condition known as achlorhydria can develop where your ability to absorb dietary iron and the successful coordination of iron uptake, export, and iron storage as ferritin is reduced. This can lead to iron deficiency and anaemia as explained in this article.

Magnesium is well known for its role in nerve function, heartbeat regulation, energy metabolism and blood sugar stabilisation. Your muscles, brain and heart rely heavily on magnesium to do their job. As an electrolyte, magnesium sits both inside and outside cells and binds to water and interacts with other electrolytes. Calcium is well known for its role in bone health, heart and nerve function and less recognised as an electrolyte. Calcium sits within both intracellular and extracellular spaces. Other electrolytes include phosphates, chloride and bicarbonates.

Sodium and chloride are the two electrolytes lost in large quantities through sweat. The losses of these electrolytes are regulated in response to the balance of sodium consumed in the diet and recent sweat and urine losses.

So is the ingestion of electrolytes or salt tablets really necessary to enhance performance? Well yes and no. Confusing hey!

Why you should consider electrolytes.

Research suggests sodium added to drinks before exercise may improve the amount of that fluid retained, rather than lost through urination and potentially reduce the risk of dehydration. Sodium can also improve the flavour of drinks and encourage consumption when consumed during exercise. This could be handy in warmer conditions and when exercising for two or more hours. Sodium during exercise can also reduce the potential risk of developing hyponatraemia. It is suggested sodium can assist with fluid and carbohydrate absorption from the gut. If you are a heavy sweater with above average sodium loses (>1g/L) identified through sweat testing, then you may benefit from sodium ingestion during exercise if you are exercising for several hours.

The good news is that most sports drinks and gels contain sodium so it is unlikely the majority of athletes will need to take on additional electrolytes in the form of tablets. Ultra runners and ironman participants may be an exception to this rule.

Keep in mind the body has large stores of sodium that are released into the bloodstream as needed so it is unlikely you will ever run out of sodium unless severely dehydrated. The key reason why sodium is included in sports products is to balance out fluid intake and losses and maintain an appropriate osmolality, while improving the taste and increasing the palatability and consumption of the product, rather than preventing an actual sodium deficit.

And what about cramping?

Cramping is caused by multiple factors that can lead to changes in the nerves that control muscle contraction and muscle fatigue. Therefore, it is a little simplistic to suggest a single nutrient such as sodium or magnesium will prevent cramping. Further scientific research is required to give us clear guidance around cramp prevention. Many athletes do respond well to magnesium and a suitable hydration protocol.

Don’t forget you can also obtain electrolytes through wholefoods nutrition.

Sodium is easily found in most processed foods such as crackers, sardines, smoked foods, pickled foods, roasted seeds and nuts, cheeses, table salt and sauces.
Magnesium is found in pumpkin seeds, chia seeds, almonds, spinach, cashews, black beans, peanuts, oats, brown rice, and yogurt.
Potassium-rich foods include potatoes, sweet potato, dried apricots, and raisins, beans lentils, spinach, broccoli, avocado and bananas.

So before you reach for more artificial sports products consider if this is really necessary and if there are alternative ways you can provide your body with the electrolytes it requires.

Need specific guidance? We would be delighted to help.

About the Author: Kate Smyth is a Sports naturopath, nutritionist and female-centric running coach. She is the founder of the Athlete Sanctuary- a holistic healthcare clinic for athletes of all levels and sporting codes. Kate has a thirst for knowledge with two bachelor’s and a Master’s degree under her belt. She has been involved in sports for many decades and competed for Australia in the Commonwealth Games and Olympic Games marathons with a personal best time of 2 hours 28 minutes. For more information visit www.https://https://athletesanctuary.com.au/wp-content/uploads/2023/03/normatec-3-lower-body-system-thumb_720x-1.webp.com.au/wp-content/uploads/2020/05/Seed-Cycle-Blends-scaled-1.jpg.com.au

References

Miller KC. et al. An Evidence-Based Review of the Pathophysiology, Treatment, and Prevention of Exercise-Associated Muscle Cramps. J Athl Train. 2022; 57(1):5-15.

Lau WY. et al. Water intake after dehydration makes muscles more susceptible to cramp but electrolytes reverse that effect. BMJ Open Sport Exerc Med. 2019; 5(1):e000478.

Maughan RJ. & Shirreffs SM. Muscle Cramping During Exercise: Causes, Solutions, and Questions Remaining. Sports Med.2019; 49(Suppl2):115-124.

Photo of a female runner with sunglasses on running in the Zurich marathon.

With any goal or challenge, a holistic approach to race preparation can help. It is never too early to start planning. Training for a key event is no different, and you may just be surprised at what else you learn about yourself along the way.

As discussed in an episode of “On Purchase” podcast (with Jay Shetty), growth comes through the process of becoming uncomfortable in situations which challenge and stretch us. Being comfortable with being uncomfortable is a skill everyone needs to work at in order to achieve any goal. It isn’t the goal that satisfies our thirst necessarily but rather what we become as a person in the process of working towards a goal.

Jay suggests being too comfortable or casual may lead to complacency and “crashing”. The opposite is also true.

Building curiosity around new experiences and challenges that take you out of your comfort can lead to competence. When speaking to retired elite athletes, 99% suggest it was building the competence in their chosen sport, inner strength and resilience that paved the way to a fulfilling career, not the medals or accolades they received for their achievements.

“You don’t have to be great to start but you have to start to be great” Zig Ziglar

In our Holistic Health and Performance Women’s Mentoring Program we ask the hard questions – what are you willing to consider that will take you out of your comfort zone? What are you curious about but haven’t acted on just yet?

There’s so much more that goes into race preparation, and the earlier you can start the better. A holistic approach ensures all the building blocks are in place ahead of time.

So, what do you need to think about? A holistic approach will consider your overall mental and physical health, work/life balance, nutrition, training and much more. Let’s break it down:

Start by examining your nutrition

This is a great place to start. Time to be self-reflective.

Through our diet, we are either feeding inflammation or fighting it. We are also either eating for performance or inhibiting performance through poor food choices. There are some great online food diaries to help you track your nutritional profile such as My Fitness Pal, or Cronometer. Some of the key questions to ask yourself are:

Are you getting enough quality protein, carbohydrate and fats in your diet?
Is your overall energy intake adequate for your training requirements?
Are you lacking in any food groups e.g. dairy. If so how are you compensating for this?
Are you restricting or overeating food intake or lacking overall balance in your diet?
Are you taking note of how you feel after consuming different foods? e.g bread makes you feel tired

Work/Life Balance

This is always key. Training for big events can involve a lot of sacrifice, not only for you but for those around you. It takes time and energy, and the physical demands are high. Finding work/life balance can be incredibly tricky -particularly when you’re trying to fit your training and prep around a busy work and family life.

Some key points to help you navigate this and keep stress levels as low as possible include:

Communicate your goals and plan openly with your family and friends,
Try to be flexible with your training regime to meet other commitments that you may have,
Avoid being obsessive with your training and event performance, include flexibility in your mindset and focus on progress over perfection
Factor in adequate downtime for yourself. This may be as simple as rest time, an hour with a good book or some time with friends.

Work on preventing illness

Our immune system is equipped with a multi-tiered response to do battle with foreign invaders 24/7 but a poor diet, stress and overtraining can significantly reduce our immune system’s ability to fight infection. This leads to more frequent colds and missed training and racing opportunities. There are many ways to keep your immune system robust.

(Read our blog > How Robust is Your Immunity?)

Manage your mental health

This one is vital. Training for a big event can becoming all consuming, especially when you’re juggling multiple demands of your time. Stress can be compounded if you’re dealing with unexpected disruptions to your training plan, such as illness or injury.

It’s so important for you to master ways to manage the stresses of each of the elements of your life – including your training regime. Some days that means accepting you simply can’t do everything you’d like to in a day.

Build resilience

Let’s get real- some days will be hard. Working on building resilience and perseverance are key elements of meeting those long, sometimes hard, training sessions – and the road to meeting your goals.

“Resiliency is the ability to face setbacks, failures, crises, and pain (both emotional and physical) with confidence and courage. It is the ability to quickly bounce back from our trials and tragedies. It’s the quality that keeps us from giving up, even when the going gets rough. It’s the ability to stick with something through thick and thin and the power to overcome the temptation to bail out when things stop being easy.” (from “Building Your Resiliency”)

Perseverance is the continued and steadfast effort towards a goal despite difficulties and setbacks. Resilience is what makes you pick yourself up; perseverance is what keeps you moving forward.

Are you ready to take on a holistic approach to performance?

Our Women’s Holistic Health and Performance Mentoring Program designed for endurance runners encompasses all of the elements that align for success – whether it be your next main event or life. Want to know more about this? I’d be really happy to have a chat with you in readiness for the second half of the year.

About the Author: Kate Smyth is a Sports naturopath, nutritionist and female-centric running coach. She is the founder of the Athlete Sanctuary- a holistic healthcare clinic for athletes of all levels and sporting codes. Kate has a thirst for knowledge with two bachelor’s and a Master’s degree under her belt. She has been involved in sports for many decades and competed for Australia in the Commonwealth Games and Olympic Games marathons with a personal best time of 2 hours 28 minutes. For more information visit www.https://https://athletesanctuary.com.au/wp-content/uploads/2023/03/normatec-3-lower-body-system-thumb_720x-1.webp.com.au/wp-content/uploads/2020/05/Seed-Cycle-Blends-scaled-1.jpg.com.au

Photo of a female with long hair standing on a beach with her hands over her face.

Iron is well known for the transportation of oxygen throughout the body as previously discussed, however, the link between iron deficiency and ADHD is not as well understood.

Attention-deficit/hyperactivity disorder (ADHD) is a condition affecting 12% of school-aged children and a growing number of adults. Impulsive behaviour, hyperactivity and/or inattention are common issues with ADHD. The prevalence of ADHD in student and elite athletes is suggested to be as high as 8% in certain sports. Athletes with ADHD may naturally excel in sports that require quick movements and reactive decision-making such as basketball, netball and baseball due to these athletes’ inherent impulsivity. Physical activity through playing sports also improves the symptoms of ADHD such as inattention, depressive mood, anxiety and impaired cognition.

Managing ADHD

In most cases, psychosocial interventions are used to manage ADHD. Medications (methylphenidate and amphetamine compounds) may also be used to activate dopamine and noradrenergic neurotransmitter pathways in the brain. This activation may lead to improved attention and concentration but also often come with side effects including increased heart rate and blood pressure, abdominal pain, headache, anorexia, sleep impairment, weight loss, jitteriness and constipation. If not addressed these side effects can impair performance and/or threaten athlete safety.

As both iron and zinc deficiencies impact neurologic functions (poor memory, inattentiveness, and impulsiveness), finicky appetite, and mood changes (sadness and irritability), nutritional adequacy is especially important in ADHD patients. Altered levels of iron and zinc increase the susceptibility, aggravation and progression of ADHD. In children, the severity of iron deficiency has been linked to a 30% increase in inattentive, impulsive, and hyperactive behaviours.

Evidence suggests patients with ADHD may experience lower stores of iron (ferritin) in the liver. This is proposed to be due to higher levels of hepcidin in ADHD patients. In our previous blog, we explain how Hepcidin is a peptide hormone that acts as the master regulator in iron metabolism and storage in the liver. Hepcidin also tightly influences red blood cell production.

Ferritin levels below 30ng/mL are related to sleep disturbances and a higher incidence of restless leg syndrome which may further compound behavioural issues in ADHD patients. Another mineral which shares the same carrier protein as iron is zinc. Zinc deficiency is also linked to inflammatory prostaglandins, essential enzymes and changes in melatonin and dopamine.

Whilst a food-first approach is preferred, individuals with high nutrient demands may benefit from targeted supplementation. Iron-rich foods such as kangaroo, red meats, chicken, salmon and zinc-rich foods have been extensively discussed in relation to immunity, anaemia and plant-based athletes.

Supplementation has been shown to be effective in individuals with iron deficiency, especially in the inattentive subtype of ADHD. Iron supplementation has also been shown to decrease the risk of cardiovascular events during treatment with ADHD drugs. A combination of iron and zinc supplements has been shown to be superior to iron alone in alleviating ADHD symptoms, as well as improvement in performance in IQ tests.

Hundreds of athletes have used our handy anaemia tool to help determine the likely risk of having low iron or anaemia. This short quiz is handy if you have experienced iron deficiency in the past and are unsure if your iron stores may be declining.

Want to know more? Contact the Athlete Sanctuary and learn how we can help you.

About the Author: Kate Smyth is a Sports naturopath, nutritionist and female-centric running coach. She is the founder of the Athlete Sanctuary- a holistic healthcare clinic for athletes of all levels and sporting codes. Kate has a thirst for knowledge with two bachelor’s and a master’s degree under her belt. She has been involved in sports for many decades and competed for Australia in the Commonwealth Games and Olympic Games marathons with a personal best time of 2 hours 28 minutes. For more information visit www.https://https://athletesanctuary.com.au/wp-content/uploads/2023/03/normatec-3-lower-body-system-thumb_720x-1.webp.com.au/wp-content/uploads/2020/05/Seed-Cycle-Blends-scaled-1.jpg.com.au

References

Robberecht, H., Verlaet, A. A., Breynaert, A., De Bruyne, T., & Hermans, N. (2020). Magnesium, iron, zinc, copper and selenium status in attention-deficit/hyperactivity disorder (ADHD). Molecules, 25(19), 4440.
Han, D. H., McDuff, D., Thompson, D., Hitchcock, M. E., Reardon, C. L., & Hainline, B. (2019). Attention-deficit/hyperactivity disorder in elite athletes: a narrative review. British Journal of Sports Medicine, 53(12), 741-745.
Conant-Norville DO, Tofler IR. Attention deficit/hyperactivity disorder and psychopharmacologic treatments in the athlete. Clin Sports Med 2005;24:829–43
Hamilton RM, Rosenthal E, Hulpke-Wette M, et al. Cardiovascular considerations of attention deficit hyperactivity disorder medications: a report of the European Network on hyperactivity disorders work group, European attention deficit hyperactivity disorder guidelines group on attention deficit hyperactivity disorder drug safety meeting. Cardiol Young 2012;22:63–70
Konofal, E., Lecendreux, M., Arnulf, I., & Mouren, M. C. (2004). Iron deficiency in children with attention-deficit/hyperactivity disorder. Archives of pediatrics & adolescent medicine, 158(12), 1113-1115.
Yazici, K.U.; Yazici, I.P.; Ustundag, B. Increased Serum Hepcidin Levels in Children and Adolescents with Attention Deficit Hyperactivity Disorder. Clinical Psychopharmacology Neuroscience. 2019, 17, 105–112.
Abou-Khadra, M.K.; Amin, O.R.; Shaker, O.G.; Rabah, T.M. Parent-reported sleep problems, symptom ratings, and serum ferritin levels in children with attention-deficit/hyperactivity disorder: A case control study. BMC Pediatrics 2013, 13, 217.
Arnold, L.E.; DiSilvestro, R.A. Zinc in Attention-Deficit/Hyperactivity Disorder. J. Child Adolesc. Psychopharmacol. 2005, 15, 619–627.
Soto-Insuga, V.; Calleja, M.; Prados, M.; Castano, C.; Losada, R.; Ruiz-Falco, M. Role of iron in the treatment of attention deficit-hyperactivity disorder. An. Paediatrician . 2013, 79, 230–235.
Parisi, P.; Villa, M.P.; Donfrancesco, R.; Miano, S.; Paolino, M.C.; Cortese, S. Could treatment of iron deficiency both improve ADHD and reduce cardiovascular risk during treatment with ADHD drugs? Hypotheses, 2012, 79, 246–249.
El-Baz, F. M., Youssef, A. M., Ramadan, D., & Youssef, W. Y. (2019). Association between circulating zinc/ferritin levels and parent Conner’s scores in children with attention deficit hyperactivity disorder. European Psychiatry, 62, 68-73.
Tan, L.-N.; Wei, H.-Y.; Zhang, Y.-D.; Lu, A.-L.; Li, Y. (2011). Relationship between serum ferritin levels and susceptibility to attention deficit hyperactivity disorder in children: A Meta analysis. Zhongguo Dang Dai Er Ke Za Zhi. 13, 722–724.
Öner, P.; Dirik, E.B.; Taner, Y.; Caykoylu, A.; Anlar, O. (2007). Association between low serum ferritin and restless legs syndrome in patients with attention deficit hyperactivity disorder. Tohoku J. Exp. Med. 213, 269–276

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Why you should consider electrolytes.

And what about cramping?

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