With temperatures expected to be in the mid to high 80’s, there are lots of concerns surrounding the health of the marathon runners on Monday. Laura Judd, MS, RD, LDN, CSSD, has some recommendations for marathon runners in the heat:

As a marathon runner, you want your glycogen stores to be as high as possible and the best way to achieve that is to refuel with carbohydrates almost immediately after training runs. In the days leading up to a marathon, a runner can continue on a diet high in carbohydrates with moderate amounts of lean proteins and fats. Hydration is important throughout training but especially the few days before a race.

The morning of the marathon, runners should consume a breakfast consisting of mostly carbohydrates in an effort to top off their glycogen stores for the long race ahead; kind of like you would top off your gas tank before a road trip. The Boston Marathon presents some pre-race challenges as runners are bused out to the start line (Hopkinton, Mass) and often have to wait for a considerable amount of time before the race actually starts. Having a few snacks on hand such as small granola bars, Gatorade, or any other high carbohydrate snack that won’t bother your stomach may be good idea just in case you get hungry.

During the race the body pulls energy from those built up glycogen stores. It’s a good idea to drink a combination of both water and Gatorade throughout the race, making sure that you’re blood sugar never gets too low and you remain hydrated. This is especially important if it’s a hot day.

What sort of physical problems can a marathon runner experience during a race (vomiting, collapsing, etc.) and why do they happen? Are there ever health issues that require treatment after a race?

The biggest problems that can happen from a nutritional stand point are:

1. “Hitting the wall” – hitting the wall is the point at which your glycogen stores have almost been exhausted and your body is starting to run on fumes. For many marathoners this can happen around mile 20 where the race can become most challenging. The easiest way to avoid “hitting the wall” is to make sure that you fuel properly with a high-carbohydrate diet leading up to the race, maximizing your glycogen stores. Also, taking in  Gatorade, sports gels, candy, etc. throughout the race helps keep your blood sugar stable.
2. Dehydration – Dehydration is the major cause of muscle fatigue and muscle related injuries.
3. Hyponatremia – Hyponatremia or low blood sodium levels can be extremely dangerous to a runner. Hyponatremia is caused by over- hydration which off-sets the sodium balance in the blood. In addition, you lose sodium when you sweat so not only is the sodium concentration diluted but there is less sodium in the blood to begin with. This is why it is so important to mix hydrating with water and Gatorade to help keep sodium levels from falling too low.

Thanks Laura!

A key take-home message: make sure to replenish fluids during the race! Drink plenty of water and Gatorade to keep your fluid and electrolyte status balanced.

In an interview on NPR this morning, the medical director for the marathon said that the best advice he can give runners for Monday is to slow down from their normal pace.

Good luck to anyone running Monday!