Under-fuelling, RED-S and Stereotypes about Running: Conversation with Allison Yamamoto

Episode #98 of Everyday Runners, "Under-fuelling, RED-S and Optimal Performance: Conversation with Allison Yamamoto".

Allison Yamamoto is a New York based running coach and dietician. We got in touch in order to have a conversation about RED-S: relative energy deficiency in sport. 

Allison is a former cheerleader whose main sport now is long-distance running. While there might be certain stereotypes about cheerleading it does require year-round commitment to intense training. Moreover, there is often an intense focus on the physical appearance of the cheerleaders themselves and not just on the skills they are able to execute. An emphasis is place on a particular body shape or type: being lean and slim are the ideals. The year-round nature of cheerleading and its strict ideals about body type means that it shares similarities with middle and long-distance athletic running. Here too are runners - male and female - expected to be as lean as possible. Lighter is largely equated with being faster. 

Some high profile running ‘content makers’ such as Matt Fox of Sweat Elite, are very open about their goals to ‘trim down’ in order to reach higher levels of performance. While he is aware of the difficulties that some people may have regarding mental health and body image, he is also very detailed in talking about his goal to lose a certain amount of kilograms. Fox, importantly, is clear about not advocating under-fuelling or under-eating as a viable strategy.  On the other hand, Jake Smith, a high performing athlete (give times) has over the last year or so been active in promoting his story which has involved recovering from RED-S and gaining weight and performing better. Fox reached his sub-2:20 marathon goal through finding a lighter weight while Smith found his new levels of performance through gaining weight.

I believe being an athlete involves finding one’s ‘optimal race weight’. While doing more exercise often leads to losing weight - which can mean improvements in certain health measurements - it may become dangerous if the fixation on figures is too strong and detracts from the pleasures in running. I regard ‘optimal’ as what supports one’s mental and general health and athletic performance, rather than appearing a certain way. Running related social media accounts perpetuate a singular image of the ideal runner: sunken cheeks, next-to-no stomach fat, taut calves, slim physique. A quick survey of the body shapes that participate in a city-based marathon event, for example, indicates that the ideal shape is rarely found at a running event. We've all got our bodies - and diversity, rather than uniformity is the rule.

Allison points to three main factors that lead to runners developing RED-S: belief that a skinnier body shape suits what an athlete looks like; that pushing-through fatigue is a normal part of the sport and that being lighter enhances one’s actual athletic performances. Her role as coach and nutritionist is to help her clients work through these perceptions and to find their ideal diet which supports their working and sporting lives. In her practice, Allison also extends the idea of who is an ‘athlete’: it is someone who is engaged in a direct physical exercise who seeks to extend the capabilities of their body. It is not someone who has reached a certain level of performance. This is important as the perception as to whether one is an athlete or not may impact one’s fuelling strategies. 

RED-S is not necessarily easy to identify - although some warning signs are more pronounced than others. During Allison’s own struggle with RED-S, her loss of her period, was only regarded of importance if she had been trying to get pregnant at the time. What she came to learn was that losing-one’s period is at the more problematic end of the RED-S spectrum. Her body was cutting out some of its ‘optional’ processes as a means to respond to a lack of caloric intake. Other warning signs are applicable to men too: fatigue, irritability, diminished sex drive, brain fog. 

Many of us probably begin a sport as a way to enhance our bodies and gain more embodied pleasures in our daily lives. As Allison Yamamoto points out in my interview with her, an over-emphasis on ‘discipline’, ‘hard training’ and an unchanging, fixed routine, however, may suck the pleasure out of one’s sporting practice. This attitude, coupled with under-fuelling and restrictive eating can lead to RED-S which compromises all aspects of our lives: sporting, working and personal.