It is estimated that running a marathon involves taking approximately 55,000(i) steps, with some individual variation to account for height, stride length etc.
That is 55,000 times in one event that a significant amount of your body weight will be brought to bear on the bones, joints, tendons, ligaments and cartilage of your lower body….and for some people they may run several marathons in a single event.
We run because we love to run, and while it can be hard on some parts our bodies, we know that it is so good for other parts such as our minds, our emotions (when it’s over!), our hearts and our lungs.
The ability of our joints to absorb the repeated shock of impact with the ground depends on the strength of our bones, the muscular strength of our lower body, the resilience of our cartilage and the health of our “synovial fluid” which is the fluid that lubricates our joints and reduces bone on bone friction.
We want to keep running for as many years as possible, so what can we do nutritionally to support the health and longevity of our bones and joints for the years to come?
Given most runners already have the exercise piece covered and assuming we also include strength training in our workouts (resistance training is important for maintaining bone density) the best thing we can do is supply our bones and joints with the nutritional building blocks necessary for their maintenance and repair.
Some of the main building blocks include protein, calcium, magnesium, phosporus, vitamin D, vitamin C and Zinc. Other nutrients that are often talked about are omega 3 oils and supplements such as glucosamine, chondroitin and methylsulfonylmethane (MSM)….the list of supplements is ever growing.
A balanced diet that includes some good quality meat, fish and dairy products in addition to fruit and vegetables usually supplies most, but not all of these nutrients. Despite the obvious ethical and environmental positives of following a vegetarian or vegan diet, be under no illusions that without careful dietary planning and taking certain nutritional supplements, a vegetarian/vegan diet will not provide adequate quantities of some of the above nutrients, not to mention other nutrients required for other aspects of health. If carefully planned however, with supplementation, then this is certainly possible.
Then there is a matter (for everyone no matter what the diet pattern) of gut health and whether the nutrients taken in in the diet are properly absorbed, or whether undigested foods are getting into the bloodstream and causing inflammation in the joints and tissues, which are larger topics that I will deal with separately in the future.
So assuming a reasonably balanced diet and decent gut health already, let’s touch on some food categories we might consider including or increasing in our diet to help maintain and improve the health of our bones and joints:
Bone broth: This true “superfood” contains many of the building blocks of healthy joints such as collagen, gelatin, glutamine, chondroitin and glucosamine, minerals such as calcium and phosphorus, plus a range of vitamins. It is best made at home in a slow cooker using organic chicken or beef bones. There are some commercially available bone broths on the market but I would argue that they are vastly inferior to what you could make at home. Making a stew in a slow cooker with lamb on the bone over many hours will also provide many of these benefits. As an alternative use bone broth can also be really helpful for healing the lining of an inflamed gut.
Oily fish: Oily fish such as salmon, mackerel, trout and sardines contain the omega 3 fats which have been shown to help promote a healthy and balanced inflammatory response. If you don’t like fish you can get fish oil supplements but do avoid the supermarket and other cheaper brands as the quality tends to be poor. When it comes to vegetarians and vegans flax oil is a reasonably decent substitute for fish oil when it comes to joint health. Buy flax oil (any oils for that matter) in dark glass bottles as opposed to clear plastic containers.
Calcium: It is well known and accepted that adequate intake of calcium is vital for healthy bones and this is no different for athletes than the general population. Dairy is an obvious source of calcium but not the only source. Other sources include soy containing foods such as soybeans/tofu, beans, lentils, almonds and broccoli. Vitamin D is needed for absorption of calcium from the gut into the bloodstream (see below)
Vitamin D: It is very difficult to get adequate vitamin D from foods, with sun exposure being the best natural source in the summer months. Mushrooms are one of the best food sources of Vitamin D but even so, the amount of mushrooms required in order to get an adequate quantity of vitamin D make it impractical. This means that supplementation is necessary for the majority of people living in climates such as the UK and Ireland for at least the autumn and winter months. Vitamin D home tests are cheap and easy to use. It is always worth testing vitamin D levels to see what your levels actually are, and this will then help you to know what supplement dosage you will need to get back into the healthy range. Research(ii) from Liverpool John Moores University showed that 62% of athletes living in northern climates such as the UK and Ireland had inadequate vitamin D levels (<50 nmol/L) and that inadequate vitamin D levels are "detrimental to musculoskeletal performance in athletes". 2 other studies(iii) with over 6,000 combined participants showed that low levels of vitamin D were associated with increased risk of stress fractures in both men and women. This is particularly relevant to athletes given the pounding that our bones and joints take on longer runs.
“Eat the Rainbow”. This one is nothing new, but increasing your intake of colourful fruit and vegetables will help provide you with a wide array of inflammation reducing antioxidants that will help with repair of the damage done from pounding your joints on long runs. The more colourful the better. Think beets, carrots, squash, berries, purple cabbage, red grapes in addition to your staple greens.
Other supplements: There is a decent amount of research out there on 3 key nutrients required for joint health- Glucosamine, Chondroitin and methylsulfonylmethane (MSM) and how they might be used in supplement form in people with arthritis and other inflammatory joint conditions. These nutrients help form the building blocks for important components of our joints. Homemade bone broth is probably the best food we can supply to our joints that will do a similar job, but supplement versions of these nutrients are an option for those who do not wish to consume bone broth and do not want to wait until they have joint problems before considering doing something about it. Always take professional advice before starting a new supplement regime as some supplements can interact with certain medications, and staying on any supplement long term is often not a good idea.
I hope that you found this article useful. If you have any questions or comments or would like personalised support on any of the topics mentioned above, please feel free to get in touch for a free introductory call.
Paul Kinsella,
Registered Nutritional Therapist
BANT Registered Nutritionist
Copyright, 2023.
www.optimal-health.ie
[ii] Close, G.L. et al. (2013) “Assessment of vitamin D concentration in non-supplemented professional athletes and healthy adults during the winter months in the UK: Implications for skeletal muscle function,” Journal of Sports Sciences, 31(4), pp. 344–353. Available at: https://doi.org/10.1080/02640414.2012.733822.
(iii) Ruohola JP, Laaksi I, Ylikomi T, Haataja R, Mattila VM, Sahi T, Tuohimaa P, Pihlajamäki H. Association between serum 25(OH)D concentrations and bone stress fractures in Finnish young men. J Bone Miner Res. 2006 Sep;21(9):1483-8. doi: 10.1359/jbmr.060607. PMID: 16939407.
(iii) Välimäki VV, Alfthan H, Lehmuskallio E, Löyttyniemi E, Sahi T, Suominen H, Välimäki MJ. Risk factors for clinical stress fractures in male military recruits: a prospective cohort study. Bone. 2005 Aug;37(2):267-73. doi: 10.1016/j.bone.2005.04.016. PMID: 15964254.
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