Exactly what, why, how much and how I eat to fuel long runs as a type 1 diabetic runner
In the past weeks I’ve been testing several nutrition strategies for my long runs, with the aim of simulating race conditions: it’s marathon day, what should I have eaten yesterday to perform well? What should I eat for breakfast? Should I have breakfast at all?
There is no right answer, it is all trial and error and a very subjective business. For some people slamming down a pizza seconds before the 42k is no problem, for others even thinking about food will cause a urge to visit the toilet. I want to understand in which bucket I fall, while also making sure that everything diabetes-related goes as smoothly as possible.
Here are the results of my own tests on myself, so far.
If you fancy a video instead, there you go:
What I eat
Simple answer here: refined carbohydrates.
Typing these words makes me cringe because in a normal day refined carbs would not even make it into my shopping cart. But this is a particular circumstance (I explain more in the next paragraph), and particular measures are required. So all I eat the day before is refined carbs.
I have tried having salads and all types of legumes and whole-intact grains, but they simply do not resonate well with my stomach during a long run. To rephrase it with less elegance: with too much fibre in the system I feel a big urge to poop.
Since that is not a pleasant situation to be in in general - even less so on the big race day - I’ve decidedly steered towards a relatively less healthy but more functional option: white pasta or white rice.
Last week I went all in with plain white pasta, the only fibre being a tiny amount of tomato sauce just to see some colour and make the dish a bit more pleasant to the eye. It was ok, but gluten is a tricky variable which I wanted to take out of the equation, and so this week I switched to plain white basmati rice. Other than having a great taste of its own, it also proved much more stomach friendly in general.
On the morning of the run, around two hours before the start, while I sip my coffee I top up my glycogen stores with two or three rice cakes and a zero-sugar blueberry jam, just have some kind of micronutrients and antioxidants.
During the run I also eat one running gel per hour, around 30-60 grams of carbs per hour, depending on the length (the longer I run, the higher will be my carb/hour requirement).
One note here: “refined carbs” does not mean I go to McDonald’s and order all the junk food I can possibly imagine. “Refined carbs” means a relatively more processed form of something I would eat anyway: white rice instead of brown rice, white pasta instead of whole grain pasta, and so on. Don’t turn carb loading into an excuse to hurt yourself.
Why I eat it
There are two reasons behind my leaning on more refined carbs.
One as I have already mentioned, is to simply limit the amount of fibre for 24 hours in order to lower the risk of stomach issues while running.
The second reason is that hitting the ideal amount of carbohydrates implies a rather impressive amount of food, and I want to make sure I fill my carb tank without overdoing my total calorie intake. An excess in calories will compromise your overall blood glucose stability and it is surely not a great idea in terms of body composition.
This is why I focus all my eating on simple carbs, without any other calorie dense food such as soy products, chocolate and other fatty foods which would add up on the calorie count without contributing to the carb goal.
That has been my thinking so far, but as I am writing this I am sure I need to review this strategy somehow. It seems impossible to me that 100% carbs is the only solution, but hey, it’s an experiment after all! If you have any experience to share, drop a comment!
How much I eat
No hesitation here, the formula is quite simple: 10 grams of carbs X Kg of bodyweight. I weight 65Kg, so my target is 650 grams of carbohydrates. The reason behind this is intuitively simple: your body will tap into glycogen stores as its source of fuel. The longer the distance, the more the amount available in these stores becomes important. If they are not filled, your tank will be empty somewhere in the middle of the race (called “bonking”, or “hitting the wall”), and you’ll likely not cross the finish line, or cross it in some miserable condition.
How does all this food look like? First of all it looks monotonous. It’s either only rice or only pasta. Second, it looks like a lot more than you would imagine.
Not ideal, but it has its time and place. And it does the job.
For any type-1 diabetic, this is the tricky part: how can you possibly take in all these carbs without your blood sugar being over the ceiling at all times? How can you preserve your time in range while preparing for an endurance effort?
How I eat
I eat slowly, I eat in small amounts and I eat earlier in the day.
These three tips allow the answer to the above question to be “it is possible”.
Eat slowly: the slower you eat, the lower the glycemic impact of the food on your system. This is true for any type of food, and especially for refined carbohydrates that have close to no fiber - fiber are essential to tame the blood glucose spike. So eating slowly, chewing properly, and allowing some time between one spoonful and the other is your first must.
Eat small amounts: eating small amounts is functional to slow eating. When I carb load, I do not eat my usual three meals (breakfast, lunch, dinner). Rather, I start eating at around breakfast time and continue to eat small amounts all throughout the day. I never stop eating, and this helps me spread the otherwise huge quantities into smaller chunks that my body can handle.
Plain white basmati rice (turmeric made it yellow, and I added some herbs just because). I ate it slowly!
Practically speaking: instead of slamming down 200g of carbs at breakfast, at lunch and at dinner (which will surely skyrocket blood glucose), I start eating a spoon at 8am, then another, and another…all at regular intervals so that I fill the tank but the glycemic impact is never too drastic. Sure, I tend to bulk a bit more around the usual meal times, but I always try to spread the amounts during the morning and afternoon, taking smaller insulin doses instead of a big one.
Eat earlier in the day: lastly, I make sure I reach dinner time that I am only left with a small amount to eat. Eating the bulk of your food in the morning and afternoon, when you are more active, will make sure that you’ll burn off some of those calories, stabilize your blood sugar by normal activities like walking, and preserve the quality of your sleep because you will not force your digestive system to work hard during the night to process a heavy dinner.
Catches
First catch: I only do this when I know there’s a big endurance effort on the horizon. 90% of my diet is whole food and plant based for 90% of the time. I “sacrifice” the whole food bit only because I don’t want any digestive problems caused by fibers. Once I am done with my pasta or rice bowls, I quickly come back to my leafy greens, fruits, legumes and all the rest of the good stuff.
For instance, my post-run smoothie is: bananas, spinach, arugula, beetroot, blueberries, chia seeds, unsweetened soy milk, turmeric, black pepper, cinnamon and lemon juice. There’s nothing better than a powerhouse of antioxidants and micronutrients to restore a body under stress.
Ugly, but packed with taste, micronutrients and antioxidants. Everything your body needs to recover and be ready again, soon.
The second catch is that, because I eat whole food plant based all the time, I have a safety margin that allows me to eat more processed foods and get away with it without major consequences in terms of blood sugar ups and downs. Because the food I eat (again: whole plant based foods naturally rich in carbohydrates and low in fats) is promoting insulin sensitivity, by the time I slam down 800 grams of white rice my body is like “Ok, this is not ideal but I can handle it”.
The third catch is that, of course, this is a learning curve and there are multiple factors coming into play. I am still making plenty of mistakes and analyzing them.
For instance, while I was carb loading, I was in range 100% of the time, I woke up to a wonderful 103 and went out running with my gels, and no insulin. I ate three gels (100 grams of pure super sweet carbs), and that caused a spike I did not see coming. While long runs usually tame any spikes for me, this particular run was quite slow and the metabolic stress was rather low. In other terms, I overdid my carbs during the run. The bad part is that I came home to a 241.
The good part is that I now know that when I run slow I probably need less carbs than I think. And in any case, I consider it safer to eat one extra gel and to continue running in hyperglycemia than having to stop due to a severe hypoglycemia (which not only interrupts the training, but is extremely, extremely dangerous if you’re out there alone).
Trough trial and error we learn so much, and I am always amazed to discover new things about my body, analyze them and factor them in to refine my strategy as I move forward.
Anyway, the bottom line of this post is: always eat whole foods to maximize insulin sensitivity, use refined foods with caution and eat them slowly to tame blood glucose spikes, and go out there for a run because it is the most beautiful thing in the universe.
With that, The Curious Diabetic salutes you. See you next week!
