I'm at the gym from 5:30 to 7:00 pm and feel exhausted by the end of my workout. What can I do to prevent fatigue?"

"I'm training for a marathon ... I dread the long runs. I'm dragging after 12 miles. Any suggestions for how to boost my energy?"

"I'm whipped by the end of my after-school soccer practices ..."

Sound familiar? Preventing fatigue is the No. 1 concern of active people who exercise for more than an hour.

This article can help you enjoy high energy and enhanced stamina during long, hard exercise sessions. (For shorter exercise sessions, a pre-exercise snack and some water should fuel you well.)

To prevent fatigue during extensive exercise that lasts for more than 60 to 90 minutes, you have two nutrition goals:

1. To prevent dehydration

2. To prevent your blood sugar from dropping

The following tips can help you reach those goals.

Sweat and dehydration

When you exercise hard, you sweat. Sweating is the body's way of dissipating heat and maintaining a constant internal temperature (98.6°F).During hard exercise, your muscles can generate 20 times more heat than when you are at rest.

You dissipate this heat by sweating. As the sweat evaporates, it cools the skin. This in turn cools the blood, which cools the inner body. If you did not sweat, you could cook yourself to death.

A body temperature higher than 106°F damages the cells. At 107.6°F, cell protein coagulates (like egg whites do when they cook), and the cell dies. This is one serious reason why you shouldn't push yourself beyond your limits in very hot weather.

When you sweat for more than an hour, you lose significant amounts of water from your blood. The remaining blood becomes more concentrated and has, for example, an abnormally high sodium level. This triggers the thirst mechanism and increases your desire to drink.

To quench your thirst, you have to replace the water losses and bring the blood back to its normal concentration.

Unfortunately for athletes, this thirst mechanism can be an unreliable signal to drink. Hence, you should plan to drink before you are thirsty. By the time your brain signals thirst, you may have lost 1 percent of your body weight, the equivalent of 1.5 pounds (24 ounces) of sweat for a 150-pound person.

This 1 percent loss corresponds with the need for your heart to beat an additional three to five times per minute. This contributes to early fatigue.

Thirst sensations change with age and older people, even athletes, become less sensitive to thirst. For example, 56-year-old hikers became progressively dehydrated during 10 days of strenuous hill walking. The younger, 24-year-old hikers remained adequately hydrated. This means older people, in particular, should carefully monitor their fluid intake.

Light-colored urine, in significant volume, is a sign of adequate hydration.

Most athletes voluntarily replace less than half of sweat losses; thirst can be blunted by exercise or overridden by the mind. To be safe, always drink enough to quench your thirst, plus a little more.

If you know how much you sweat, you can then replace those losses according to a plan. To learn your sweat rate (and fluid targets), weigh yourself naked before and after a workout. For every pound (16 ounces) you lose, you should strive to replace 13 to 16 ounces (80 to 100 percent of that loss) while exercising.

This requires training your gut to handle this volume. Do not drink more water if your stomach is already sloshing; enough is enough!

You might find it helpful to figure out how many gulps of water equate to 16 ounces, and even set an alarm wristwatch to remind you to drink on schedule. You'll also need to plan on having the right quantity of enjoyable fluids readily available. Do not be in such a rush to start your workout that you fail to bring with you the sports drinks and fluids that will enhance your efforts.

Carbohydrates and blood sugar

As I?ve mentioned above, you can significantly increase your stamina by consuming a pre-exercise snack that provides fuel for the first hour of the workout and by drinking adequate fluids during exercise.

The third trick to enhancing endurance is to consume carbs after an hour of exercise. Depending on your body size and ability to tolerate fuel while you work out, you'll want to target 100 to 250 calories of carbohydrates per hour of endurance exercise.

The larger you are, the more calories you need. For example, if you weigh 180 pounds, you should target about 250 calories per hour, such as 8 ounces of a sports drink every 15 minutes, or a 250-calorie energy bar plus water.

During a moderate to hard endurance workout, carbohydrates supply about 50 percent of the energy. As you deplete carbohydrates from muscle glycogen stores, you increasingly rely on the carbs (sugar) in your blood for energy. By consuming carbohydrates such as sports drinks, bananas, or energy bars during exercise, you can both fuel your muscles as well as maintain a normal blood sugar level.

Because your brain relies on the sugar in your blood for energy, keeping your brain fed helps you think clearly, concentrate well, and remain focused. So much of performance depends on mental stamina; maintaining a normal blood sugar level is essential to optimize your workouts and boost your stamina.

Your body doesn't care if you ingest solid or liquid carbohydrates, both are equally effective forms of fuel. You just have to learn which sports snacks settle best for your body: gels, gummy bears, dried figs, animal crackers, defizzed cola, whatever.

Despite popular belief, sugar can be a positive snack during exercise and is unlikely to cause you to "crash" (experience hypoglycemia). That's because sugar feedings during exercise result in only small increases in both insulin and blood glucose. Yet, too much sugar or food taken at once can slow the rate at which fluids leave the stomach. Hence, "more" is not always better.

Because consuming 100 to 250 calories per hour of exercise (after the first hour) may be far more than you are used to taking in during exercise, you need to practice fueling while exercising to figure out what foods and fluids settle best.

You'll learn through trial and error which snacks help prevent fatigue, boost performance and contribute to enjoyment of your long, hard workouts

Want energy? Time your eating and exercise

By Deborah Shulman, Ph.D.

For Active.com 10/3/2003

"To give me energy." This is the usual response when I ask why someone has eaten an energy bar or other food in the hour or so before starting exercise.

In fact, the opposite is true. Eating an hour or even half an hour before exercise is likely to make you feel tired and sluggish.

Twenty-five years ago, if a food or drink label proclaimed "high energy," it would have sounded a death knell for that product. In contemporary times though, people interpret that to mean that it will give them high energy.

Red Bull drinks proudly display that they are high-energy drinks. Sports bars are high-energy foods. Consequently, people eat or drink them so they have high energy during exercise.

In the nutrition world, "high energy" is synonymous with "high calorie." The way that the body deals with high calorie, particularly high sugar, is by releasing insulin. Insulin is a storage hormone. When you eat a high-calorie, high-sugar food an hour before exercise, you will start exercise with high insulin levels.

This has two important results. First, it will change how you perceive exercise. You feel sluggish and it feels hard. This is called the rating of perceived exertion, or RPE. Your RPE is higher when you start exercise with high insulin levels.

Second, you will burn a lower amount of fat for fuel. Insulin lowers fat removal from the fat deposits and reduces fat metabolism inside the muscle. Consequently, you rely more on carbohydrate for energy.

Obviously, if you are trying to increase fat metabolism, it is counterproductive to eat an hour or half an hour before exercise.

In general, during the day, it is better to time your last meal or snack to be two hours before the start of exercise. If you wait too long, however -- say, three or four hours after eating -- you'll spend the whole exercise session hungry and fantasizing about food.

In fact, the best time to exercise is after an overnight fast. At his time, blood levels of fat, growth hormone and testosterone are all high. Under these conditions, fat metabolism will be at its highest. Even better if you've had some coffee beforehand.

Those who have low fasting blood sugar in the morning may want to eat a banana, a sports gel or some juice within five minutes of starting exercise. You know who you are: you feel dizzy and shaky in the morning until you've had something to eat. If you eat a small amount a few minutes before starting, you won't get a substantive insulin response.

Instead of eating before exercise, eat within 30 minutes of finishing your exercise session. It is common for people to make the mistake of not eating after exercise, either because they think the increased metabolic rate will help them lose weight or just because they're not hungry. In reality, during exercise you are breaking down protein from the muscles, liver and kidney. This catabolic state persists after exercise.

The more intense the exercise -- such as a heavy strength training session at the gym or an interval workout at the track -- or the longer the exercise lasted, the more muscle breakdown will occur.

This when insulin is your friend. Insulin is a growth hormone and stops muscle breakdown. This is the best time to get larger doses of carbohydrate. Your glycogen storage tanks will be low and the combination of insulin and carbohydrate will refill them to be ready for the next exercise session and will help your muscles grow.

Soccer: 7 nutrition myths

By Dr. Don Kirkendall

For Active.com, 10/24/2003

Think nutrition is an easy topic? See if you have the answers to these myths common in soccer.

1. Your performance in a game is not affected by what you eat

You would think this is true, from reading the scientific literature on just what soccer players eat. Nutritional recalls from the 1970s to the present show that soccer players choose a diet that is around 40% carbohydrates, 40% fat and 20% protein.

Virtually every study on athletic performance, be it a team sport or an individual endurance sport, shows that a diet rich in carbohydrates improves running performance. The more carbohydrates you eat, the more and faster you run, especially late in the game.

What is discouraging is that in the very early '70s, the Swedes showed that soccer players with low muscle fuel (glycogen) walk about 50% of the game. And that was 30 years ago. What might be even more discouraging is that over half of a national team in the 1994 World Cup thought food had nothing to do with their game. Players eat what is put in front of them.

2. Sports drinks are just a product of marketing; they are no better than water

No question that water is well understood by the active public. The days of fluid restriction during sports are long gone. But researchers have been looking at improving on water ever since the advent of Gatorade. The timing, volume, temperature and components of sports drink have been under continual study.

For example, a drink does no good if it stays in the stomach, so the concentration of sugars is limited. A drink does no good if it doesn't get from the small intestine into the blood, so there is an optimal concentration of salt in the drink. And a drink isn't all that effective if it doesn't stay in the body -- meaning that the volume of drink and salt concentration, again, are critical.

Plain water doesn't have these advantages. A well-formulated drink has the proper concentrations of sugars, salts, and micronutrients, making it more effective than water alone.

3. All sports drinks are alike, so just buy any of them

A lot of people think this, and the marketing of different drinks can lead to this perception. But a close look at labels will show vastly different drinks.

To start with, there are basically three completely different types of drinks: fluid replenishment drinks, carbohydrate replenishment drinks and energy drinks.

Fluid replenishment drinks are formulated to provide optimal concentrations of sugars and salts, leading to rapid absorption and retention of fluids in order to prevent dehydration and improve performance.

Carbohydrate replenishment drinks are designed to provide a fast source of carbohydrates that are rapidly absorbed by the intestines. These can be used during a game for extra fuel as well as right after play to start storing energy for the next day or game. The best drinks have a little protein in them that speeds the uptake and deposit of fuel into the muscle.

Energy drinks are highly caffeinated drinks that deliver a small bump in energy due to caffeine's effect on the central nervous system, not by adding any more fuel to the muscles. Plus, caffeine is a diuretic, so it can increase urine volume, and any urine loss of water during exercise is not good.

4. It doesn't matter what players eat after games

I go to games and tournaments and see some of the worst post-game feedings possible: soda, sweet drinks in soft packaging, potato chips, other salty snacks, chocolate, fries. You've seen it.

The smart team supplies food that will start refilling the muscles with carbohydrates at just the time that the muscles are most ready to receive a fresh supply of fuel; the first hour to two after exercise. And that food probably doesn't come in a bag.

A good supply of carbohydrates is needed, and it can come from a carbohydrate replenishment drink or other high-glycemic foods like bagels with jam/jelly, the ingredients for "chex mix" (not the premixed boxes from the store, but the ingredients minus the oil and toasting), pretzels, raisins (or other dried fruit). This is even more critical between tournament games when time is even shorter.

5. All athletes get enough protein from what they eat, so there's no need to look for other sources

While most every survey of the athletic diet shows that they get all the protein they need from food, there is a problem. The vast majority of protein is consumed in conjunction with fat. Marbled meat, ground beef, fried chicken in the skin all are examples of protein that is combined with lots of fat.

Red meat should be trimmed of fat, ground beef should be very lean, chicken should have the skin removed. But one place protein is often lacking is the immediate post-exercise meal. A little protein helps in storing new fuel in the muscles faster than when there is no protein. You can try to figure out a protein source (NOT from a fast food chain) or simply buy one of the carbohydrate replenishment drinks that contain protein.

6. I just coach; what the players eat is their problem

While I have already stated that most all studies show that players are not eating properly, there is an implicit question. Who tells the athlete what to eat?

There have been plenty of surveys asking where athletes get their information and the top two sources are the coach and teammates. Now, from what we know, teammates are probably pretty unreliable. That leaves the coach as the primary source of information. But should the coach tell the player or the parents?

As the player eats what is put in front of them, that means the parents are now the assistant coach in charge of fuel. They need to know what to serve and when to serve it. Your new assistant may think the various versions of the Atkins diet are good for themselves, but those high-protein diets do the athlete no good when it comes to providing fuel. Make sure your parents know the facts.

7. Your body is the best indicator of when to drink

Now, that is true ... if you are a donkey, or a dog. The thirst mechanism of humans isn't as good.

In fact, the human thirst mechanism doesn't even kick in until you have lost about 2% of your body weight from sweating; a level where performance decrement begins to become evident.

Drink early (before play), every 15 - 20 minutes during play, and at halftime. Put water bottles along the sidelines, in both goals, supply during stoppages. Remember that playing in the cold is also dehydrating, so don't forget to push fluids even in cold weather.

There are likely more myths coaches, players and parents may be following, but by following some of the guidelines mentioned here will put your team at a significant advantage over the opposition.

Soccer recovery: Bounce back faster after games

By Dr. Don Kirkendall

For Active.com, 10/24/2003

A soccer game can take a lot out of you. When the final whistle blows, you are tired and sore, as expected. But there are things you can do to bounce back quickly from games.

If you do them, you will have plenty of energy and less leftover muscle soreness by the time you practice again. If you don't do them, you might stay sluggish and tender a lot longer.

Nutrition tips

Nutrition is an important part of recovery. Nutritional recovery has three components:

1. Rehydrate

During games, you sweat, and when you sweat, you lose two important substances that your body needs: water and selected minerals called electrolytes (the stuff that makes sweat taste salty).

After games, you need to put these substances back into your body, in a little greater amounts than what you lost, sooner rather than later. Until you rehydrate, your body will have a hard time keeping cool and you may be prone to cramps and other problems.

Drinking water is just a start because it does not contain electrolytes. You're better off drinking a sports drink that has both water and electrolytes. Try to drink at least 12 ounces of sports drink in the first half-hour after the game ends. If it's a hot day, you may need to drink even more.

The goal is to drink 1.5 pints for every pound of weight lost over the next 24 hours, before the next workout. Your urine should be no darker than diluted lemonade.

2. Re-energize

You also burn a lot of energy fuel during games. The main energy fuel used in high-intensity sports like soccer is carbohydrate, which is stored in your muscles, liver, and blood. The human body cannot story very much carbohydrate. In a hard game, you can easily burn most of the carbohydrate fuels in your body.

It's important to quickly replace this carbohydrate. Until you do, you will not have much energy. Most sports drinks contain carbohydrates, so a convenient way to put energy back into your body is to get it from the same place you get your water and electrolytes.

You can also get carbohydrate from foods like fruits, breads, starches and certain vegetables. Muscles refill with carbohydrate the fastest immediately after exercise. Don't wait even as little as two hours after exercise to start, as the rate of refilling becomes slower.

3. Rebuild

Your muscles are mostly made of proteins. During games, some muscle protein can be damaged; this is a main reason your legs feel sore and weak after games. The good news is that your body is able to build new muscle proteins at two to three times the normal rate after hard exercise. All you need to do is supply the building blocks -- protein -- to do the job in the first couple hours after the game is over.

Most sports drinks do not contain protein, but some of the new ones are adding it. Using a sport drink with protein is a good way to go because of the convenience. You can get the water, electrolytes, carbohydrate, and protein you need for recovery all from one source.

You can also get protein from foods like meat and cheese, but these foods also tend to be high in fat. When you eat a lot of fat after hard exercise, or even too much protein, it takes longer for the nutrients to get through your system to your muscles. This slows down the whole recovery process.

So a sport drink that contains protein is a better choice for post-game nutrition. It contains everything your body needs to bounce back fast, and without anything unneeded to get in the way.

Get a head start on recovery

Using a sport drink with protein during games is also a good idea for two reasons. First, it will delay fatigue so you can play harder, longer. In one experiment, athletes who drank a sports drink with protein were able to exercise 24% longer than athletes who drank a regular sports drink with no protein.

Second, the protein in the drink will reduce the amount of muscle protein breakdown that happens during the game, so there is less rebuilding to be done afterward.

Other tips

While your muscles are still warm after a game, stretch your muscles. This will keep your blood flowing, helping to deliver nutrients to your muscles and to clear away built-up wastes. You can start drinking your sports drink while you stretch. Later in the day, you can massage your legs using your thumbs, and this will also help with blood flow.

After you play a game, try not to do anything too strenuous for the rest of the day. Your body requires rest in order to rehydrate, re-energize, and rebuild the muscles. At the very least, be sure to get plenty of sleep that night. During sleep, your body releases hormones that help your muscles rebuild.

The recovery checklist

After every game:

Stretch while your muscles are still warm

Drink at least 12 oz. of a sports drink containing protein

Monitor your urine color

Take it easy

Get a good night's sleep

Recovery Nutrition for High School Athletes
Jacqueline Berning, Ph.D., R.D.
for Gatorade Sports Performance News 10/20/04
It's 8:45 p.m. on a school night and you and 35 athletes are loading on a bus and heading back to school after an away game. Like many high school athletes, your team didn't eat much before the game, and now they are complaining that they're hungry and thirsty. As a coach, what do you do? If you stop to eat on the way home, it will take another hour to get there. Some of the athletes have homework to do, while others need the extra sleep. If they don't eat, you know that they're performance will suffer. Research shows that the decision you make will have an impact on their ability to play and compete at their peak.

Recovering from Exercise
Not eating and drinking after competition and training can have negative consequences on future athletic performance. For instance, many coaches don't realize that it can take up to 36 hours to reload the muscles of athletes who delay refueling their bodies. Such a delay means that the athletes will not have the energy to meet the demands of their sport. This is especially true for sports that have repeated competitions such as tournament play in volleyball, basketball, soccer, swimming or tennis. Parents and coaches need to recognize that an intense game or a hard interval-training session can be just as exhausting as running a marathon. Athletes who fail to refuel and/or rehydrate during these activities will not have the optimal level of energy the next day.

What to Eat
Carbohydrates
Muscle glycogen is the predominant fuel for energy during exercise. As carbohydrate (glucose) is the primary source of muscle glycogen, it is the most efficient source of energy for the body and should make up approximately 60 percent of an athlete's diet. Depending on the size of the athlete, that could amount to anywhere between 300 to more than 600 grams of carbohydrate each day. Carbohydrate-rich foods include whole-grain breads, rice, pasta, fruits, vegetables and sports drinks.

A carbohydrate snack consumed within 30 minutes after the competition or practice will allow the body to start the recovery process faster. In addition, players need to consume a carbohydrate-rich meal within two hours after the recovery snack. This ensures that the muscles continue to load with carbohydrate energy. For most high school athletes, that means eating a meal soon after they get home from competition or practice.

Protein
Protein also plays an important role in recovering from exercise. Although carbohydrates are the primary source of energy for muscles, consuming a small amount of protein shortly before or after exercise may help the body recover from exercise in a different way, by stimulating muscle repair and growth. This is backed by research that found that adding protein to the recovery snack does not enhance the muscle's ability to store energy, but instead, this extra protein is used by the muscles to rebuild after exercise.

Note that it does not take large amounts of protein to get these results. In fact, when athletes eat a combination of carbohydrates and protein post-exercise, the carbohydrates are used to refill the muscles with fuel, while the protein is used to help build and repair muscle tissue.

What to Drink
Athletes need to replace the fluids they lose through sweat to fully recover from exercise. The easiest way to do this is to consume a sports drink, as sports drinks have flavor to encourage drinking and contain electrolytes, such as sodium and potassium to maintain fluid balance in the body. For instance, if an athlete drinks plain water and does not eat any salty foods for the two hours after exercise, a significant portion (25 to 50 percent) of what they drink will be excreted as urine. However when an athlete rehydrates with a drink that contains both sodium and potassium at the proper levels, then 65 to 80 percent of the fluid is retained by the body, helping to better rehydrate the player.

A Coach's Story
Like many high school coaches, Chad Allen, who coaches the men's soccer team at Douglas County High School in Castle Rock, Colorado, was frustrated with the amount of time it took to feed his players after an away game. While the Huskies' road trips are generally not over an hour, stopping and feeding both the JV and Varsity teams added another hour to the trip. A late afternoon game with travel and eating would mean the bus did not arrive back at school until nearly 8:00 p.m.

To solve this problem, Chad implemented a strategy where parents provide snacks for his players to consume on the way home, thus eliminating the late trips and the problem of finding someplace to eat after the game. The strategy is working, as he has noticed an improvement in their performance. Their attitudes and moods are also better. “It used to be that the kids were so hungry and thirsty that they were quite irritable,” states Chad. “Now, we have the chance to relax on the bus ride home, knowing we will have something healthy and satisfying waiting for us to eat.”

Recovery Foods
Here's a sample of healthy foods to help athletes recover from exercise:

Sports drinks, like Gatorade Thirst Quencher
Granola, energy or breakfast bars
Bagels with peanut butter
Sub sandwiches
Crackers and cheese
Burritos
Fresh fruit like apples, bananas, oranges, grapes
Vegetables such as carrots and celery
Fruit smoothies (prepackaged)
Rice cakes or trail mix
Chocolate milk
Animal crackers

Jacqueline Berning, Ph.D., R.D., is a nutrition consultant for the Denver Broncos and Cleveland Indians as well as an associate professor at the University of Colorado at Colorado Springs.

Quick Tips

Athletes who fail to refuel and/or rehydrate during and after activities will not have the optimal level of energy to play at the same intensity the next day.
To help in the recovery process, athletes should eat a high-carbohydrate snack within 30 minutes after practice or competition and a healthy meal two hours later.
Carbohydrates are the most efficient source of energy for muscles and they should make up approximately 60% of an athlete's diet.
Sports drinks are an ideal way for athletes to rehydrate during and after exercise.
Having parents provide snacks and sports drinks for the bus trip home after an away game is an excellent way to help athletes recover from exercise.

Iron Depletion: What you and your doctor need to know

by Jeff Hess
2005, Track & Field News

Before you read on and decide that the following is either gospel or garbage, let me suggest that it's neither. I'm addressing a medical issue, but I'm just a high school track coach with degrees in English and Physical Education. I have no medical training, but I have watched enough athletes fade mysteriously from super-fitness to super-misery that I started researching the possible causes.

More than anything else my questions led to the same answer: Iron. Too often we've attributed declining performances among high school athletes (especially girls) to structural changes relating to puberty or injuries resulting from overtraining. It's my belief-and I'm not alone here-that a great many of those cases are caused directly from iron depletion and could be remedied with proper nutrition and supplementation.

But don't take my word for it. Do your own research; talk to you coach, parents and doctor and make an informed decision about what's right for you. For starters though, you can continue reading and find out what I've learned over the last few years.

Iron is a particularly important mineral for endurance athletes due to its role in binding oxygen, which is circulated through the lungs and to the working muscles. Unfortunately, our bodies absorb only about 15% of the iron we ingest, and distance runners do just about everything possible to deplete the iron that they do consume.

Iron is lost through sweat and gastrointestinal irritation. It is temporarily lost through "footstrike hemolysis" (bursting blood cells through foot impact with the ground). Iron absorption is inhibited by calcium, coffee, tea, carbonated beverages and non-steroidal anti-inflammatories (all that ibuprofen some of you swallow). Women lose a substantial amount of iron through menstruation, making them more susceptible to iron depletion, but it is a concern for all distance runners-male and female.

Anemia, clinical iron deficiency, is not rare among runners, but even more common than iron deficiency is "iron depletion" due to low ferritin stores. Ferritin is an iron-containing protein that is primarily responsible for iron storage in the bone marrow. It is common among distance runners to have acceptable hemoglobin and hematocrit counts even when ferritin levels are severely depleted. For less active people, low ferritin levels are much less significant and don't often draw the attention of medical professionals.

However, the results of low ferritin levels for distance runners are significant. While iron depletion rarely results in the general lethargy associated with true iron-deficiency anemia, distance runners with low ferritin will likely experience abnormal exhaustion, increased blood lactate, slow recovery, declining performances, heavy legs, muscular tightness, loss of motivation, and substantially increased risk of injury. Does any of this sound familiar?

And there's more. Overuse injuries (the type of injuries distance runners get) double with ferritin levels under 20 and triple with levels under 12. I think it's safe to suggest that iron depletion is rarely considered to be the root cause of these injuries. Instead we focus on mileage, running surfaces, shoes and the other usual suspects. If you were nodding your head thinking the previous symptoms sound like a checklist of your most recent season, go get your serum ferritin tested.

People within the medical and running communities have been aware of anemia for decades, but the prevalence and severe impact of iron depletion (low ferritin) is still far too much of a secret. The normal range for serum ferritin levels depends on whom you talk to. I have read everything from 50-150 nanograms per milliliter (ng/ml) to 10-300 ng/ml. However, we know that the lower the ferritin level, even within the "normal" range, the more likely a person is iron depleted. Virtually all female distance runners who have been training for a year or more are well below 50 ng/ml unless they take supplemental iron.

At South Eugene High School, we became aware of the consequences of low iron in the spring of 2001 when three of our female distance runners all came back from blood tests with ferritin levels below 10 ng/ml. All three had all run their best times two years before but had been plagued with injuries and frustration since. During those two years, they had multiple blood tests, but the doctors never checked their serum ferritin levels.

Within four weeks of beginning an aggressive supplementation program, all three felt substantially more energy while running; their enthusiasm and joy for running returned, and they began to run much faster. Within two months, their levels were between 35 and 55 ng/ml. All three went on to compete collegiately and ran times far superior to what they ran in high school.

Since that initial experience, we have suggested that all the girls on the team have complete iron tests. Only five out of the dozens who have been tested, have been within the acceptable range for serum ferritin, and those five were either big meat eaters or had been taking supplemental iron for years. Half of the girls tested have been below 12 ng/ml.

Most of those tests were conducted at the beginning of the year, giving the girls enough time to boost their levels by the end of the season. It makes better sense to have everyone tested (boys and girls and absolutely all vegetarians) long before the season begins, so that any deficiencies can be addressed before the more strenuous training begins. Obviously, the best attack against this problem is not allowing it to occur in the first place. Those taking supplemental iron and eating an iron rich diet will most likely never develop an iron deficiency.

When a blood test reveals that iron supplementation is called for, there are many options for correcting the deficiency. Begin by increasing the amount of iron-rich foods and foods high in Vitamin C in your diet, avoid caffeine with meals, use cast iron cookware, and consider taking supplemental iron.

With our athletes, we have noticed significantly faster and more dramatic results among those who are supplementing with ferrous sulfate or ferrous gluconate elixir and ascorbic acid than with those who have taken iron tablets. Obviously, this is something that should be undertaken only after consulting with a physician, but many doctors still appear to be unaware of the problem of iron depletion. You may need to educate your doctor before your doctor can help you.

As a competitive distance runner, you should know about the importance of iron, but it's not a cure-all, and it should be a blame-all either. I've had a few athletes develop instant cases of iron depletion the day after a hard workout or a late night of homework. It doesn't work that way. Iron consumption is only one piece of the big nutrition puzzle, and nutrition is only one piece of the enormous How-to-be-the-best-runner-I-can-be puzzle, but if you're truly devoted to completing the enormous one, you might help yourself get there by giving your doctor a vial of your well-pumped blood.

(Jeff Hess grew up in Eugene when it was the running mecca and states that he is looking forward to "being part of its renaissance". Jeff coached 25 state champions at Glendale High School (OR) between 1990 and 1999. He then came back to his alma mater, South Eugene High, in 1999 and served as an assistant track coach and co-head cross-country coach until taking both head positions in 2003. The SEHS girls team was the Oregon State XC champs in 2001, runners up in 2002 and 2005, and the boys were runners-up in 2004.

Jeff's Personal Running Stats:

4-time Oregon high school state champion
Junior National Champion - Steeplechase 1979
High School National Record Holder - Steeplechase 8:50.1
US Olympic Trials finalist 1984 - Steeple PR of 8:25.41)

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