Online Health Chat with Kate Patton, MEd, RD, CSSD, LD

May 8, 2015

Description

For some runners, spring is the kickoff to marathon season. May 17 is the Rite Aid Cleveland Marathon. While logging many miles is a priority to many runners, that training means nothing without optimal nutrition. Whether you are a rookie or a veteran marathon runner, adjusting what you eat before, during or after a race can have a big impact on your performance and recovery. Hydration is also an important component of a successful race. Appropriate intake of carbohydrate, protein, fat and fluid before, during and after your marathon or half marathon will be discussed.


About the Speakers

Kate Patton, MEd, RD, CSSD, LD, is a registered dietitian who works in the Department of Nutrition Therapy, Preventive Cardiology and Sports Health at Cleveland Clinic. She has a Masters of Education in Exercise Science degree from Cleveland State University and a Bachelor of Science degree from the University of Dayton. She completed her dietetic internship at Cleveland Clinic, and she is a Certified Specialist in Sports Dietetics through the American Dietetic Association. Her specialty interests include fueling for endurance athletes; weight, lipid and diabetes management, and disease prevention. She provides nutrition counseling to a variety of patient populations, from adolescents to professional athletes. She has run four marathons and numerous half marathons.


Let’s Chat About Nutrition and Marathons

Moderator: Welcome to our chat about “How to Fuel-up Before, During and After a Marathon” with Cleveland Clinic nutrition specialist, Kate Patton, MEd, RD, CSSD, LD.
Ms. Patton, thank you for taking the time to be with us and share your expertise concerning nutrition and marathons.

Let’s get started with our questions.


Helpful Hydration Tips

roberta: How do I know if I am well hydrated before the race?

Kate_Patton,_RD,_CSSD,_LD_: Hydration is key throughout training, but especially leading up to race day. You can assess your hydration status by paying attention to the color of your urine. A clear, pale yellow color signifies being well hydrated, while a darker, concentrated yellow is sign of dehydration. Leading up to race day, hydrate as usual and drink according to your thirst. Consuming drinks with sodium and/or salty snacks will help stimulate thirst and retain fluids consumed. Avoid alcoholic beverages in the days prior to the race because they can increase urine output and delay optimal rehydration. Over-hydration can lead to the need to urinate during the race.

bud: How much should I drink before the race?

Kate_Patton,_RD,_CSSD,_LD_: On race day, start hydrating as soon as you wake up. Drink slowly. After you urinate, continue to take small sips of water or sports drink, but avoid over-hydrating, which can lead to the need to urinate during the race.

bud: How much should I drink during the race?

Kate_Patton,_RD,_CSSD,_LD_: Hopefully, you have already been hydrating during your long runs and have developed a hydration schedule, because every runner’s hydration needs are unique to his or her body. What we do know is that runners need 30g to 60g of carbohydrate per hour of running, and a sports drink is an excellent way to hydrate and consume the glucose we need. Therefore, 16 ounces of a sports drink per hour would provide 30g of carbohydrate.

Foodie: Is water or Gatorade® a better option to have during and after running a marathon?

Kate_Patton,_RD,_CSSD,_LD_: A combination of both [Gatorade and water] is good during and after a marathon. A sports drink like Gatorade is formulated to hydrate you by replenishing the sodium and potassium you lose through sweat, while at the same time giving your body some energy from carbohydrate. Research shows that drinking a sports drink during exercise allows you to perform longer. However, you do not need to drink a sports drink the entire time. Water will help hydrate you, too. After a marathon, focus on rehydrating with a sports drink first, then water.


Food for Fuel

CLEman: What should I eat during my marathon?

Kate_Patton,_RD,_CSSD,_LD_: Fueling during a marathon is necessary in order to maintain blood glucose levels to allow you to keep moving and to prevent your body from depleting the stored energy in your muscles. It is recommended to consume 30g to 60g of carbohydrate per hour of exercise. Sports drinks and products like gels or chews are a good option because they contain a combination of different forms of carbohydrate. Research shows products like gels are ideal during endurance events because they are easy to digest and are well tolerated. You can also use whole foods like pretzels, crackers or candy. It is important to practice consuming these foods during your runs to ensure they are well tolerated.

Foodie: What is the best type of food to eat right after running a marathon?

Kate_Patton,_RD,_CSSD,_LD_: CARBS, CARBS, CARBS! Initially, you want to choose quick-digesting forms of carbohydrate to allow your body to replenish its stored carbohydrate in your muscles. That is why a sports drink is a great start, followed by fruit, crackers and bread. Within the first 30 to 60 minutes after the race, it is crucial to consume some protein to help repair all your worn and torn muscles. Low-fat chocolate milk has the perfect combination of carbohydrate and protein to help you refuel. A fruit smoothie with some form of protein (milk, yogurt or protein powder) is a good option, too. Or for convenience, an energy bar with protein is a good choice, or grab a sandwich or slice of pizza, whatever you are craving that has plenty of carbs plus some protein.

Jules: Should I eat breakfast before the marathon?

Kate_Patton,_RD,_CSSD,_LD_: Yes! Eat what you typically eat before your long runs. You may need to wake up a little earlier in order to give yourself time to digest the meal since marathons start so early. Include carbohydrate either from cereal, bread, a bagel or fruit plus a little protein such as milk, yogurt, peanut butter or cheese. If solid foods don’t work for you, try a smoothie – fruit, milk/yogurt/non-dairy milk/peanut butter/oats.

brodmar: Good afternoon. I'm interested in our speaker's recommendations for favorite foods to eat pre-marathon (would a CLIF Bar and 16 oz. of Gatorade/PowerAde® one to two hours before suffice), and then post-race. During training, it seems post-run most everyone likes chocolate milk. Is that something you support for most training runs? And does the nutrition strategy change based on the intensity of the runner? (I know if I'm expending more calories, then I need to try to match that expenditure, but I'm more curious as to how the intensity with which I run may impact the ratios of the carbs/protein/fat with which I need to take in.) Thank you.

Kate_Patton,_RD,_CSSD,_LD_: Yes, a CLIF Bar and 16oz of a sports drink are an excellent pre-race marathon meal. Yes, I support chocolate milk as a post-run recovery drink or any drink or bar that contains carbohydrate and protein in a 3:1 ratio. For example 1 cup chocolate milk has about 30g of carbohydrate and 8g of protein. Your nutrition strategy during the race should not change too much compared to your long training runs. Plan to follow your normal fueling strategy during the race, but it would not hurt to pack an extra gel or fuel source in case you feel like you are crashing toward the end of the race. If it is hotter than expected on race day, then definitely plan to grab a few extra cups of sports drink along the course.


Preparation and Planning

DeniseL: Is there a good meal plan that you would suggest for the two weeks leading up to a marathon? Thank you.
 
Kate_Patton,_RD,_CSSD,_LD_: A good meal plan two weeks leading up to a marathon would be to continue eating as you normally do. One week before the marathon, I suggest increasing your intake of carbohydrate and slightly decreasing your intake of protein and fat. For example, at breakfast, increase your portion of cereal or add a slice of toast OR at dinner increase your portion of rice/pasta/potato and slightly cut back on meat OR if you typically choose protein-rich snacks like nuts or cheese, add fruit or crackers with those snacks.

Whmx2: I have two weeks before my half marathon and I am very interested in learning more about pre-race nutrition. I recently read an article talking about kale as it helps get oxygen to the muscles. I am on a plant-based diet without added oils and am thinking that you are familiar with this diet and Dr. Esselstyn? One year ago, I received five stents shortly after being told I had a heart attack that I was unaware of. I would also like to add that I have a lipoprotein(a) of 199, which is off the charts. Sorry, I just got those labs. Thank you.

Kate_Patton,_RD,_CSSD,_LD_: The good news is that since you are on a plant-based diet, you are likely consuming enough carbohydrate from starches/grains (ideally whole grain), fruit and vegetables. All of these are quality, nutrient-dense whole foods that provide lots of vitamins, minerals and antioxidant, plus carbohydrate, which is your body’s main energy source as a runner. On a plant-based diet, it is also important that you are getting enough quality protein from sources like quinoa, soy, beans and lentils. Be sure to choose balanced meals and snacks that provide both carbohydrate and protein in order to maintain your blood glucose levels leading up to the race and for your pre-race meal to ensure you are optimally fueled.

jayscott: Can you list a few essential dos and don'ts as far as diet is concerned when training for a marathon?

Kate_Patton,_RD,_CSSD,_LD_:
Do:

  • Eat beforehand when running more than an hour during a training run.
  • Practice drinking water and a sports drink of your choice during your weekly long run. Also, eat a carbohydrate source to ensure you are tolerating the fluids and carbohydrate because these are necessary to hydrate and fuel you.
  • Eat a carbohydrate and protein-containing meal or snack within 30 to 60 minutes after any run. If it is only a snack, be sure to have a meal within two hours after a race.

Don't:

  • Eat too much protein, fat or fiber before a run. These take longer to digest and, therefore, can cause gastrointestinal upset during your run.
  • Go more than four to six hours between meals. It is important to fuel your body consistently throughout the day so that you can maintain your energy levels especially prior to a run.

General Information

jayscott: I drink three to four diet cola sodas a day. Is this harmful and would I expect improvement in my marathon time if I cut them out? Thanks.

Kate_Patton,_RD,_CSSD,_LD_: The verdict on whether diet cola is harmful is not exactly clear, but there is no evidence to suggest that not drinking soda will improve your marathon time.


Closing

Moderator: That is all the time we have for questions today. Thank you, Ms. Patton, for taking time to educate us about the importance of proper nutrition and marathon training.

On behalf of Cleveland Clinic, we want to thank you for attending our online health chat. We hope you found it to be helpful and informative. If you would like to learn more about the benefits of choosing Cleveland Clinic for your health concerns, please visit us online at http://my.clevelandclinic.org.
 
Kate_Patton,_RD,_CSSD,_LD_: Thank you for all of your great questions! If anyone has any other questions or is interested in one-on-one nutrition counseling, I am happy to help. Please call 216.444.3046 to schedule an appointment.

For Appointments
To make an appointment with Kate Patton, RD, CSSD, LD, or any of the other specialists in our Digestive Disease and Surgery Institute, Department of Nutrition at Cleveland Clinic, please call 216.444.3046 or toll-free at 800.223.2273, ext. 43046, or visit us online at www.clevelandclinic.org/nutrition.


For More Information

Cleveland Clinic
The Center for Human Nutrition provides evaluation, education and treatment to people who have disease-related nutrition problems. Additionally, the Center is involved with a multitude of programs to promote health and wellness. Both of these efforts are driven by a dedicated team of registered dietitians, dietetic technicians, nurses, pharmacists, physicians and surgeons who work together to provide comprehensive support for patients with specialized nutrition needs.

Cleveland Clinic Health Information
For additional health information, visit clevelandclinic.org/health.

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