Tag Archives: athlete

Athletes Avoiding Gluten and Grains: Is There Good Evidence?

Foods high in carbohydrateThe gluten-free trend is a popular one, and many athletes have hopped on the bandwagon thinking it might improve their health, digestion, and athletic performance. People with celiac disease (about 1% of the population) need to absolutely avoid gluten because it damages their intestines; others believe they are “gluten sensitive,” which is a debatable condition that recent studies have called into question.

A new study reveals that about 40% of of athletes without celiac disease have diagnosed themselves as “gluten sensitive” and try to follow a gluten-free diet.  Although many people report feeling better without gluten, evidence shows this is likely the result of people paying more attention to their overall diet, a strong placebo effect, or choosing healthier options (for example, eating an orange instead of a bagel provides many more nutrients and fewer calories – a healthful substitution for many, but that doesn’t mean you need to avoid bagels altogether . . . ).

A gluten-free diet can be quite healthy

colorful vegetables
Many people eat more vegetables and fruits when they eliminate gluten

People who adopt a gluten-free diet often discover a variety of other healthy grains. Also, someone who adopts a gluten or grain-free diet could be eating better than their previous diet if they are replacing grains with more nutritious food choices.  Most of these diets recommend limiting processed foods and refined carbohydrates and eating more fruits and vegetables, habits that can improve diet and health tremendously.

If a person notices health benefits after eliminating gluten or wheat, they will attribute the benefit to going gluten/grain/wheat free. But it’s almost impossible to attribute any benefits to the absence of a specific grain or gluten, since so many other dietary variables change with this elimination (overall calories, ratio of fat/carbohydrates/protein, fiber intake, dietary glycemic index, and intake of many other nutrients not related to  a specific food).

Also, when people pay more attention to food labels and to what they are eating, they are more likely to eat better and may lose weight;  weight loss can lead to a host of benefits unrelated to gluten/grains/wheat (although most people attribute all benefits to eliminating a food).  If you feel better after eliminating gluten, your new healthy habits likely don’t need to be at the expense of limiting a wide array of foods with known health-promoting properties.

But, a gluten-free diet can also be less nutritious

Many gluten-free foods aren’t fortified with iron or folic acid. Also, when manufacturers remove gluten from foods they may add additional sugars, sodium, and unhealthy fats. Many gluten-free products use a refined gluten-free flour that lacks the fiber of other grains. Consumer Reports provides several examples of gluten-free foods that are unhealthier than their gluten-containing counterparts (see their report for specific examples).   One preliminary study suggests that a gluten-free diet may decrease the count of beneficial gut bacteria.

Another issue is that some of the most popular anti-gluten books promote low-carbohydrate diets, which can leave endurance athletes short on fuel for their workouts compromise recovery, and suppress their immune system. For example, the diet advocated by “Grain Brain” is  low-carbohydrate, high-fat, and high cholesterol, which has raised concern about health among researchers.

Also, this research found that people avoiding grains and gluten are at higher risk for heart disease, and another study suggests that  those who consume too many rice-based products and rice may be at risk for harmful levels of arsenic and mercury exposure.

Examine the evidence

While gluten can cause problems in a minority of the population, there is no good evidence that gluten is problematic for most people.  Many individuals are getting their information from popular anti-grain or anti-wheat books (e.g., Wheatbelly, Grain Brain), which are not based in good science and have been widely criticized by most academics and nutrition experts (see extra reading, below). For example, here is how McGill’s Joe Schwarcz describes the lack of science behind Wheat Belly:

“But if you are scientific minded, it is worthwhile to read this book just to see how masterfully Davis blends cherry-picked data, inflammatory hyperbole, misused science, irrelevant references and opinion masquerading as fact into a recipe for a cure-all. Some of the “science” is just absurd.”

Are you avoiding gluten to improve your athletic performance?

Some athletes erroneously believe that eliminating gluten from their diet will make them faster or stronger. There is no evidence to support this claim, and the available research shows that gluten doesn’t influence performance. A recent study (illustrated by Yann Le Meur in graphic below) found that a gluten-free diet has no influence on performance (15 km cycling time trial), GI symptoms, well-being, and a other inflammatory markers or indicators of intestinal injury in non-celiac endurance athletes.

Infographic by Yann Le Meur
Infographic by Yann Le Meur

Are you avoiding gluten because of stomach issues while you exercise?

You’re not alone. Studies suggest that 30-50% of athletes experience gastrointestinal problems during endurance events. It’s important to recognize that GI issues can be very complex, and although “gluten” is a popular villain, it’s likely not the cause.

Consider my advice on what to eat before working out, and consult this recent review with recommendations for gastrointestinal complaints during exercise.

  • Avoid high-fiber foods in the day before competition or before strenuous workouts (but keep fiber in your regular training diet!).
  • Avoid aspirin and NSAIDs such as ibuprofen.
  • Avoid high-fructose foods (in particular drinks that are exclusively fructose); fructose and glucose combination may be better tolerated.
  • Avoid dehydration, which can make stomach symptoms worse. Start your race (or training) well hydrated.

The authors also recommend ingesting carbohydrates with sufficient water or choosing drinks with lower carbohydrate concentrations. Always experiment with nutrition strategies before race day. (Sports Medicine Online May 2014)

The benefits of whole grains for athletes

Athletes (especially endurance athletes) require more carbohydrates than nonathletes so that they can fuel their muscles for activities.   Of course, many other foods besides grains contain carbohydrates (for example fruits and vegetables, especially starchy vegetables), but including grains can help you get a wider range of vitamins and minerals and improve the overall quality and diversity of your diet.  Including more fruits and vegetables in your diet is likely a good idea for most people, but it’s probably best if you don’t do it at the exclusion of whole grains. (And if you’re an athlete with high calorie requirements you might have difficulty meeting your carbohydrate needs).

Whole grains are linked with many health benefits including lower risk of heart disease, stroke, improved insulin sensitivity, reduced risk of some cancers, and reduced risk of diabetes. For your everyday diet, it’s best to focus on whole, unprocessed grains.

Bottom Line

There is little evidence that avoiding gluten or wheat will improve your health or athletic performance. In fact, whole grains have many health benefits and gluten-containing grains are an integral component of some of the best-studied and healthiest diets in the World.

More reading about gluten-free diets and health:

More Sports Nutrition Articles


Updated May 29, 2017

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Healthy or Hype? Chocolate Milk for Recovery

The Claim

Drinking chocolate milk after exercising will help you recover from your workout.

The Evidence

Chocolate milk contains fluid that you need after a workout, plus carbohydrates and protein in a ratio shown to enhance recovery (4 grams of carbohydrate for each gram of protein). The carbohydrates and added sugars in chocolate milk will help replenish glycogen (your body’s carbohydrate stores), and the protein in milk helps repair muscles.  Chocolate milk also contains sodium and potassium that can help replace electrolytes lost in sweat, as well as calcium, vitamin D, and B-vitamins (not necessarily important for recovery, but good for overall health!). Studies examining chocolate milk’s potential to promote recovery have shown that it outperforms commercial sports drinks or water, improving performance in subsequent intense workouts, and enhances muscle repair processes. Research has also shown that the main protein blend of milk (80% casein and 20% whey) is optimal for muscle repair and synthesis. Soy milk, which contains a different blend of protein, may not be as effective at repairing muscle.

Isn’t added sugar bad? For most people, added sugars and foods that raise blood sugar levels aren’t desirable, but after a strenuous workout simple sugars can help you recover more quickly by replenishing glycogen stores: so go ahead, and indulge your sweet tooth when it will have some benefit! You can drink regular milk, but you won’t get enough simple carbohydrates.

 Smoothie made with strawberries and bananasWhat about other foods? Chocolate milk is convenient, but it’s certainly possible to help your body recover with other foods, which might also help you meet other nutrient needs that are important for good health. For example, cereal with fruit and milk, yogurt and fruit, or a fruit smoothie would be good recovery foods. I have other ideas listed here. Following up your workout with a well-balanced meal that contains proteins and complex carbohydrates will also help you recover from your workouts.

Do you even need a recovery drink? If you have exercised for less than an hour at moderate intensity, you probably don’t need anything beyond water to “recover” from your workout: and if you don’t need the extra calories or sugar, it’s probably not what’s best for your overall health.  Athletes who are exercising more intensely, or who have another workout planned later in the day, can benefit from recovery beverages or foods.

Bottom Line

Chocolate milk consumed after a strenuous or long workout can help enhance recovery; other foods/beverages with a similar carbohydrate to protein ratio (4:1) will also likely work. For everyday nutrition (meals outside of training) regular milk is a better choice (since you don’t need the added sugars).


>>You can view other foods in the Healthy or Hype? series here

About the Healthy or Hype? series:

In this series, I’ll be looking at popular foods to see if they stand up to the hype or health claims behind them.

Media reports, company marketing efforts, and self-proclaimed experts can make interpreting nutrition and health news confusing. These outlets recognize that people are drawn to exceptional or miraculous stories that elicit an emotional response. Beyond stories and anecdotes, many “experts” are now citing studies (often out of context) to back up their claims, making it even more difficult to separate fact from fiction.

Finding out “what works” isn’t usually the result of a single study, but often years of research from various disciplines. It’s critical to synthesize all the scientific evidence to create a coherent picture. Good science is the best tool that we have to figure out how something is influencing our health.


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This Week in Food, Health, and Fitness

This week, find out if kinesio taping is effective, why you should be choosy about your breakfast cereal, the best way to exercise to control blood sugar, why athletes shouldn’t avoid carbs, and see great illustrations of why correlation doesn’t imply causation.

Does kinesio taping work? You may have seen bright “kinesio” tape on Olympic athletes, professional cyclists, and more recently on recreational athletes.   Kinesio taping is a popular treatment that physiotherapists and trainers use to help treat musculoskeletal conditions and various athletic injuries. But is it effective? Researchers set out to answer this question by reviewing the results of 12 randomized trials that compared kinesio taping to other treatments (sham taping-placebo, no treatment, exercises, manual therapy, or conventional physiotherapy). They found that overall, kinesio taping had no significant benefit, and the current evidence doesn’t support its use as a treatment modality. (Journal of PhysiotherapyApril 2014).

Breakfast cereals can be sugar bombs. For anyone who’s wandered down the cereal aisle, this is no surprise. A recent analysis for more that 1,500 cereals shows that a child who eats a daily  bowl of cereal could be consuming up to 10 pounds of extra sugar a year.  If you like breakfast cereal, unsweetened hot cereals are your best nutrition bet (e.g., oats – not instant though, which are heavily processed and sweetened). For commercial cereals look for whole grain cereals with less than a teaspoon (4 grams) of sugar per serving, and top with nuts and fresh fruit for added nutrition.  The cereals you definitely want to avoid for breakfast are listed here. (Environmental Working Group)
Multiple intense short exercise sessions best for blood sugar control.  Any exercise helps control blood sugar, because working muscles use sugar from your bloodstream to help you move. But a recent study showed that timing and intensity can make a big difference.  Researchers compared short intense bursts  of activity before meals to one 30-minute exercise session in pre-diabetics.  The 30-minute session was at moderate intensity, and improved blood sugar temporarily;  but the short/intense workouts improved blood sugar for 24 hours.  The short sessions lasted 12 minutes, alternating one minute hard effort with 1 minute easy effort: apparently the study volunteers enjoyed it more than the 30-minute continuous session.   (Diabetologia, May 2014).
Are you an athlete who’s avoiding grains, “going paleo” or trying to avoid carbohydrates? Popular books and fad diets have convinced many active people to limit carbohydrate-rich foods. While sedentary and less active people don’t need to rely as much on carbohydrates, athletes need carbs to train and perform at their best. Nancy Clarke does an excellent job explaining how efforts to eat better by limiting grains or other carbohydrates can backfire, leading to a poor diet for athletic performance.
Have you ever heard the phrase “correlation doesn’t imply causation?”  If you’re not sure what it means, or want to see great examples, check out these spurious correlations.
Photo Credit: Image courtesy Flickr/Team SpiderTech p/b C10
See previous Weeks in Food, Health, and Fitness
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What Should I Eat Before I Workout?

Eating before exercising can be tricky: figuring out how to fuel for workouts in the early morning, lunch breaks, or supper-time takes some planning and practice. But it’s definitely worth finding a plan that works for you, since the food you eat before your workout has many benefits besides curbing hunger: it can help fuel your muscles and brain, top off your glycogen stores, increase motivation, decrease perceived exertion, boost your endurance and performance, and set the stage for faster post-workout recovery. On the other hand, what you eat (or don’t eat!) can also lead to lightheadedness, fatigue, cramping, or gastric distress.

Here are some tips to help you do it right. . .

What to Eat

Carbohydrate-rich foods or beverages are your best bet before exercise. These foods tend to digest well and quickly, so you won’t have as much in your gut while you’re exercising. Carbohydrates are an athlete’s main source of energy, stored in muscles as glycogen, or circulating in your bloodstream as glucose.

What not to eat: Limit heavy proteins and fatty foods before exercising (meats, greasy foods, cheeses) since they take longer to digest. Spicy foods and very high fiber foods are also best to avoid (whole grain breads, cereals, and most fruits are probably fine – and preferable to refined foods – for most, but best to avoid gas-producing foods like beans/legumes and cabbage).

Won’t carbohydrates cause my blood sugar to crash and make me tired?  While it is true that carbohydrates will increase insulin and blood sugar, followed by a decrease in blood sugar at the beginning of exercise, studies have shown that this dip in blood sugar is short lived and doesn’t affect overall energy levels. The performance benefits of ingesting carbohydrates far outweigh the small and temporary decrease in blood sugar. However, some individuals are more sensitive than others to increases in insulin. These individuals should try consuming carbohydrates with a lower glycemic index (i.e.,slower digesting carbohydrates that cause less of an increase in blood sugar). Also, consuming carbohydrates (e.g., sports drink) during activity can offset drops in blood glucose.

Protein.  Research suggests that including a small amount of protein in your pre-workout meal can help support muscle repair and growth. Good choices for most athletes that are well-tolerated before exercise include low-fat or non-fat dairy products like yogurt and milk, nut butters, or eggs. Decrease the protein content of your meal in favour of carbohydrates as you get closer to your workout time.

Fluids. Start your exercise with optimal fluid levels. Water, milk, soymilk, or unsweetened fruit juices are good options. Liquid/blender meals (e.g., fruit smoothies) can cover fluid and carbohydrate needs, are convenient, and tend to digest well.


Here’s a scenario for timing pre-workout meals and snacks.

  • 3-4 hours before training: eat your last big meal– which should favour carbohydrates but also include protein and fat.
  • Within 2 hours of training: eat a carbohydrate-rich snack and/or beverage.
  • 60 minutes to start of workout – drink sports drink or water and a very light snack

When this timing isn’t practical, pay more attention to your food choices and portions. Generally the closer you are to your workout time, the fewer calories you should consume. Stick to higher carbohydrate foods or liquids that you tolerate well.

woma eating apple_MSMorning Workout: While you sleep, liver glycogen can deplete by as much as 80 percent. Eating something before morning workouts will help stave off fatigue – even a light snack will help. Some people can tolerate a decent-sized breakfast with no ill effects. If you don’t have time, or you can’t stomach food before early workouts, be sure you consume something like a sports drink during exercise to provide the fuel and liquids you need.

Evening Workout: If your last meal was at noon, you’ll need to eat before heading out to exercise. Depending on the intensity and time of the workout, a full meal might not be possible. Be sure to consume a healthy carbohydrate-based snack, or a smaller portion of more traditional supper foods that you know sit well. If possible, you might want to change your meal time to benefit your workout. For example, if your evening workout is at 6:30, try to eat lunch at 2:30, have a light snack at 4:30, and sports drink, diluted juice, or water and another light snack within an hour of your workout.

This study found that athletes performed poorer at night when they didn’t eat breakfast  – something to consider if you’ve got an evening workout or race.

Here’s a graphic to help you figure out what to eat before intense training or racing. Athletes vary quite a bit in what they can tolerate, so be sure to practice in training or time trials so you can figure it out before important events.

eat before workout 3Pre-workout Snack Ideas

These types of foods are popular with many athletes and suitable to consume within 2 hours of a workout. Experiment and find out what works for you.

  • Peanut butter and banana sandwich on whole grain bread or bagel
  • Banana topped with 1 tbsp. nut/seed butter
  • 1 cup breakfast cereal topped with lowfat milk or soymilk and ½ cup fruit
  • Fruit smoothie: Blend 1 cup milk or soymilk, 1 banana, ½ cup frozen strawberries or blueberries
  • 1 cup yogurt with 1 cup chopped fruit or berries
  • Pita with hummus, vegetable juice
  • Whole grain bagel or bread topped with tomato slices and low-fat cheese

Foods to avoid before hard efforts

Tummy Troubles?

Intense exercise diverts blood flow from the stomach to the working muscles, which can interfere with digestion. This can lead to cramping, bloating, and nausea in some individuals. If you suffer GI problems during activity, consider the following:

  • Choose your pre-workout foods carefully, limiting high fiber foods, spicy foods, heavy proteins, and fatty foods.
  • Allow enough time between eating and exercising – experiment with different time windows
  • Eat familiar foods that you know won’t upset your stomach (e.g., low-fiber cereals with lowfat milk, applesauce, low-fat yogurt, bread or bagels and jam, or bananas)
  • Stick to small portions of easily digested carbohydrates like breads, pasta, and rice
  • Liquid meals are generally well tolerated and empty the gut quicker than solid foods (e.g., blend milk, banana, other fruit).
  • Sports drinks are also generally well tolerated, especially in the hour before training since they exit into the small intestine sooner and are absorbed quicker.

Also, you might want to consult this recent review on gastrointestinal issues in athletes.

Race Day Nerves

track photoEven with practiced eating routines, pre-competition nerves can wreak havoc on the heartiest of stomachs.  In addition, high intensity efforts often require modifying your pre-exercise diet. Generally, follow the guidelines above for “tummy troubles,” and when in doubt eat less, and opt for liquid calories.

Finding what works for you

Use these pre-workout eating strategies as a guide, but keep in mind that food preferences and tolerances vary quite a bit among individuals. Also, what you can eat may depend on the activity (e.g., cyclists can generally tolerate more food in their stomachs than runners). Intensity has a great influence too: you can get away with eating more food and a variety of foods before an easy workout compared to a time trial or intervals. Try out different foods, portions, and timing in training, and find out what works best for you.

Also, beyond your pre-workout foods, remember that your overall diet is critical to good health.

Although engineered products (e.g., sports drinks, bars, gels) are convenient and well-formulated forms of fuel for exercise, they are mostly refined carbohydrates and not the foundation of a good diet.

Aim for an overall diet that includes plenty of vegetables, fruits, whole grains, legumes, and healthy fats. These foods are important for good health, will help fight disease, and boost your immune system.

For optimal recovery, follow-up your activity with healthful post-workout foods.


This infographic by exercise physiologist Yann Le Meur provides a nice summary of eating before exercise, based on a fact sheet by the Australian Institute of Sport.

Eating Before Exercise_YLM

More Sports Nutrition Articles


Track Photo by COD Newsroom

Updated April 7, 2015


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