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March 28, 2008

PHYSICAL ACTIVITY AND HEALTH

Women runners: Let fat be the fuel that helps you cross the finish line

CELIA MILNE
Globe and Mail

Women who run regularly should make sure they eat enough fat. A recent study has shown what Neety Panu found out the hard way: Female runners who eat too little fat in their daily diet are more susceptible to injuries.

As a competitive marathon runner, Dr. Panu was trying to avoid fat altogether, anticipating that would improve her performance.

"You think the lighter you are, the better you do. So the first thing that is out is fat," she said. "It will work for a while, but ultimately you pay a price."

In 2000, Dr. Panu, who was still in her 20s, suffered a "debilitating" injury to her groin called an inferior pubic ramus stress fracture. She hadn't fallen down; the fracture was caused by running itself. It was an injury so severe she had trouble walking or even putting her clothes on.

Scientific research published this January in an issue of the Journal of the International Society of Sports Nutrition supports what Dr. Panu found out through personal experience: Your body is more likely to rebel if you skimp on fat. Researchers studied 86 women who ran a minimum of 32 kilometres a week. The women completed a food frequency questionnaire and reported any injuries they had over the one-year period of the study.

More than half of the women in the study reported running-related injuries, most commonly to the ankle or foot. The study found that eating less than 30 per cent dietary fat left female runners 2½ times more likely to suffer from a related injury.

"Sometimes female runners don't eat enough for their activity level," says Kristen Gerlach, lead author of the study and a physical therapist in Minneapolis, Minn.

Though it is not known exactly why dietary restriction may lead to injuries, more and more research is finding a link between the two. Runners who restrict food intake have less fuel or energy available to help their bodies with normal functions such as menstruation, reproduction, tissue healing after tough workouts and bone growth, the authors reported.

In addition, it is thought that insufficient intake of good fats, called polyunsaturated fatty acids, could result in a heightened inflammatory response and thereby increase injury severity.

"Fat isn't an all-bad thing," Dr. Gerlach says. "It is okay in moderation and has some benefits. Perhaps protection against running injuries is one of them."

Dr. Gerlach says her message pertains not only to elite runners, but also "people competing in local 10Ks." She suggests female runners add more healthy fats to their diet. Her tips include eating a handful of almonds as a snack, adding avocado to a sandwich at lunch time and eating omega-3 rich salmon for dinner.

When Dr. Panu first felt pain in her groin, she was in her third year of medical school and preparing for the Toronto marathon. She tried to ignore the pain and keep running, but ultimately she couldn't even walk.

"Once I knew I had a stress fracture, I thought 'Okay, this is a sign. But why?' " A sports medicine doctor helped her realize that she needed to increase her fat intake.

As an endurance athlete, Dr. Panu had developed an aversion to fat. "There is a Type A personality among high-end athletes that is quite prevalent. There is a big taboo on fat."

Dr. Panu took eights weeks off before she could gingerly start to run again on a treadmill. To add fat to her diet, she started eating a little butter, olive oil and almonds. Rather than eating just egg whites, she now eats the yolks as well. Instead of no-fat dairy products, she now chooses cottage cheese and yogurt with some fat in them.

"Screw the fat-free yogurt," she says. "Go for the 1 per cent or 2 per cent. That's not going to throw you off. That's a healthy amount of fat."

Dr. Panu, who is a radiologist in Thunder Bay, has recovered fully from her injury. She thinks nothing of going out for a five-hour run, cross-country ski or an all-day hike. She is passionate about fitness and determined not to get injured again.

"I've come to the realization I don't want this ripped away from me. That's what makes me happy."

With more good fats to fuel her way of life, she is in full gear. "I feel 110 per ce

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