Focus on Fitness: Intuitive Eating Principles for Athletes

April 2024 Issue

Focus on Fitness: Intuitive Eating Principles for Athletes
By Angie Dye, MS, RDN, CSSD, LDN
Today’s Dietitian
Vol. 26 No. 4 P. 34

Discover guidelines to help navigate athletics and disordered eating.

With the growing popularity of intuitive eating (IE), there’s a greater likelihood that athletes may seek the guidance of sports RDs who are well-versed in IE concepts, especially if they have a history of disordered eating or chronic dieting. IE has amassed more than 2.1 billion views on TikTok and appeared in over 2 million Instagram posts, demonstrating that people are curious about IE’s guiding principles.

While the term “athlete” may have different definitions, this article discusses those who engage in purposeful training for an hour or more per day. They may include athletes participating in team sports, power sports, or those preparing for endurance events such as triathlons or marathons. Learn more on how athletes can apply key principles of IE throughout training to perform well while improving their relationship with food and body, reducing injury risk, and enhancing health.

The Guidelines
Now available in its updated fourth edition, Intuitive Eating—written by Evelyn Tribole, MS, RD, CEDRD-S, and Elyse Resch, MS, RDN, CEDS-S, Fiaedp, FADA, FAND—is built on the following 10 principles1:

• reject the diet mentality;
• honor your hunger;
• make peace with food;
• challenge the food police;
• discover the satisfaction factor;
• feel your fullness;
• cope with your emotions with kindness;
• respect your body;
• movement—feel the difference; and
• honor your health with gentle nutrition.

Athletes are at higher risk of disordered eating and eating disorders than the general population due to body weight pressures, increased rates of body dissatisfaction, and perfectionist tendencies.2 Participation in sports, such as dancing, long-distance running, swimming, and diving, which carry the perception that leanness may improve performance, also put athletes at increased risk.3 While there’s limited research on using IE with athletes, it’s an evidence-based approach that’s negatively associated with disordered eating.4 In addition, a recent survey published in the Journal of the Academy of Nutrition and Dietetics shows that most sports-focused RDs interviewed incorporate IE into their practices with athletes and find the following IE principles most helpful: reject the diet mentality, challenge the food police, and respect your body.5

Reject the Diet Mentality
The desire to lose weight is the strongest predictor of developing disordered eating.6 Restrictive weight loss diets carry independent risks that can become exacerbated when coupled with the demands of athletic training. An athlete who’s dieting is at a greater risk of being in a state of low energy availability, which can result in poor performance, illness, and injury.2 Stevie Lyn Smith, MS, RDN, CSSD, CDN, owner of Stevie Lyn Nutrition in Buffalo, New York, agrees: “Intuitive eating can be powerful for athletes, as it challenges them to break away from the common focus of manipulating their bodies to fit a certain mold. By rejecting the diet mentality, rather than forcing their bodies to be smaller or leaner, IE can be an invaluable tool to shift and reframe their thoughts and beliefs to support their bodies to perform at their best and their healthiest, both on and off the field.”

RDs using an IE approach can counsel athletes on the risks of low energy availability and keep the focus on weight-neutral fueling for training, games, performances, and races. Instead of creating fueling plans with the goal of body composition change, the focus instead can stay on sport-specific nutrition recommendations to support training and recovery.

Challenge the Food Police
The pervasive nature of diet culture can lead athletes to associate foods as “good” or “bad” and inhibit proper fueling for sport. Marni Sumbal, MS, RD, CSSD, LDN, owner of Trimarni Coaching and Nutrition, based in Greenville, South Carolina, believes that IE can help athletes develop a better relationship with food. “Intuitive eating can be extremely helpful for athletes who’ve been misinformed by diet culture, and as a result, follow food rules or restrictive eating patterns,” Sumbal says. RDs can help athletes learn to challenge the food police by uncovering common food fears or food rules.

Some examples of food rules include reducing or eliminating foods like bread, pasta, cereals, and other carbohydrate-rich items that are foundational to athletic performance. Athletes also may fear that processed foods and sugar are damaging to health and performance, while in reality, their calorie and protein needs may be difficult to obtain with whole foods alone. Processed sports nutrition products, such as sports drinks and gels, are formulated to provide the most appropriate types of carbohydrates to fuel athletes during lengthy training sessions and competitions. In addition, processed foods such as precooked legumes, microwavable rice, peanut butter, and yogurt can be staples that allow time-starved athletes to meet their nutritional needs in a quick and convenient manner.

Respect Your Body
Body appreciation and IE are both positively associated with eating disorder recovery.7 Talking to athletes about respecting their bodies by appreciating all that they do for them as athletes can further shift focus away from eating for appearance to eating for performance. RDs are uniquely qualified to translate sport-specific nutrition guidelines into daily fueling plans to help clients reach performance goals. RDs can emphasize that body respect relies on consistent nutrient intake, not only in and around workouts and competitions but also throughout the day to optimize energy availability.

Examples of daily fueling with body respect in mind may entail helping clients do the following:

• prioritize three meals with adequate energy to support training;

• consciously time preworkout meals or snacks;

• consume sports nutrition products or whole foods to replenish carbohydrates, fluid, and electrolyte losses during lengthy training sessions; and

• prioritize a recovery meal or snack within 45 minutes of completing training to promote recovery.

Honoring Your Hunger
Perhaps one of the most nuanced concepts of IE for athletes is honoring hunger. While RDs want athletes to listen to their bodies and eat according to hunger cues, that’s only one part of applying the principle. IE is defined as “a self-care eating framework that integrates instinct, emotion, and rational thought,”1 and RDs can help athletes merge these three components to support performance. “As athletes, sometimes we need to eat, even when we don’t biologically feel hungry,” Sumbal says. This can include systematically eating during an endurance event when appetite isn’t present, but energy needs are high, and glycogen depletion is a risk. Another example may be refueling carbohydrate and protein to optimize recovery, even in the presence of postexercise appetite suppression, which is common after a vigorous workout.

“There are many nutrition guidelines established for athletes, depending on sport, intensity, and duration, to help optimize performance while also keeping the body in good health,” Sumbal says. “If an athlete only eats when she/he is [physically] hungry or eats when she/he wants because it feels good in the moment, that may sabotage performance and health.” Dietetics professionals can help athletes understand how honoring their hunger may look different from that of nonathletes, especially when training and performance goals are on the line.

Counseling Strategies for RDs
When using an IE-approach with athletes, consider the following best practices:

• Inquire about dieting and disordered eating history.

• Discourage the notion that body manipulation (ie, making attempts to precipitate weight loss or fat loss) will improve performance, and help athletes see and feel the difference when training with an adequately fueled body.

• Be an advocate for body respect by reminding athletes of the incredible things their bodies do for them in their athletic endeavors and daily lives.

• Identify fear foods or avoided food groups; encourage athletes to eat the most robust diets possible.

While all the principles of IE may benefit athletes, they’re not as straightforward as they may seem without a deep understanding of how to apply them to an athletic population. Familiarizing yourself with the unique metabolic demands of clients can help ensure their nutritional needs are met with the proper guidance. And applying IE in practice may decrease the incidence of disordered eating and eating disorders.

If dietitians want to use an IE approach for their athletes, they can consider becoming a Certified Intuitive Eating Counselor by applying on the original IE website at intuitiveeating.org.8

— Angie Dye, MS, RDN, CSSD, LDN, is the owner of Carpe Diem Nutrition, a private nutrition practice in Hershey, Pennsylvania, where she specializes in sports nutrition, intuitive eating, and digestive health. She’s an Ironman finisher and continues to enjoy training for multisport endeavors as an intuitive eater.

References
1. Tribole E, Resch E. Intuitive Eating: An Anti-Diet Revolutionary Approach. 4th ed. New York: St Martin’s Essentials; 2020.

2. Wells KR, Jeacocke NA, Appaneal R, et al. The Australian Institute of Sport (AIS) and National Eating Disorders Collaboration (NEDC) position statement on disordered eating in high performance sport. Br J Sports Med. 2020;54(21):1247-1258.

3. Mancine RP, Gusfa DW, Moshrefi A, Kennedy SF. Prevalence of disordered eating in athletes categorized by emphasis on leanness and activity type – a systematic review. J Eat Disord. 2020;8:47-63.

4. Schaefer JT, Magnuson AB. A review of interventions that promote eating by internal cues. J Acad Nutr Diet. 2014;114(5):734-760.

5. Galvin M, Eck K, Tullio K, Bodzio J, Howard L. Sports dietitians’ use of intuitive eating when working with athletes. J Acad Nutr Diet. 2023;123(10):A23-A23.

6. Barrack MT, West J, Christopher M, Pham-Vera AM. Disordered eating among a diverse sample of first-year college students. J Am Coll Nutr. 2019;38(2):141-148.

7. Koller KA, Thompson KA, Miller AJ, Walsh EC, Bardone-Cone AM. Body appreciation and intuitive eating in eating disorder recovery. Int J Eat Disord. 2020;53(8):1261-1269.

8. How to become a certified Intuitive Eating counselor. The Original Intuitive Eating Pros website. https://www.intuitiveeating.org/about-us/how-to-become-a-certified-intuitive-eating-counselor-or-lay-facilitator/