Pace Setter : October 2025

The Athlete's Kitchen

Topic 1: The Sugar Debate: Friend or Foe?

 • I've cut out sugar. Gurus on social media say it's fattening, a waste of calories, and toxic.
 • I have a sweet tooth. Given the choice of eating more dinner or having dessert, I'll always choose dessert!!!
 • Is Coke healthier if made with cane sugar instead of high fructose corn syrup?

If you are like most of my clients, you are confused about the role of sugar in your daily sports diet. The anti-sugar "experts" (who speak to the general public, not specifically to runners) report sugar is health-erosive. Sports nutrition researchers claim sugar enhances performance. Does that leave you wondering: Is sugar friend or foe for athletes?  This article addresses both sides of the sugar debate.

Sugar: Avoid it!

• Limiting sugar intake does not harm anyone. Sugar is not an essential nutrient. Our bodies can make sugar (glucose) by breaking down muscle and fat tissue, or by converting fat and protein that we eat into glucose.

• The average American consumes about 17 teaspoons of added sugar a day (60 pounds a year). That's a lot of empty calories. Populations with a high intake of added sugars tend to have health issues. By reducing added sugar to less than 10% of total calories, they can reduce tooth decay and the risk of overweight, obesity, and associated health issues.

• Dietary sugar can drive up blood sugar. The risk of diabetes increases by 1% in those who routinely consume the sugar-equivalent of a can of soda a day.

• Drinking Coca-Cola made with cane sugar is no better for you than Coca-Cola made with high fructose corn syrup.
 —Cane sugar (also called sucrose) is comprised of 50% glucose, 50% fructose.

—High fructose corn syrup is 45% glucose, 55% fructose.

Both are metabolized similarly. Although President Trump says all-natural cane sugar "is just better," science does not support that belief. Both contribute to health problems. Drinking Coke made with cane sugar will not make America healthier.

• With very high sugar consumption (sports drinks, gels, soda, candy), one could become nutrient depleted. Empty calorie sugar offers no nutritional value yet displaces nourishing food, which can make a lackluster sport diet.

Sugar and rowers: Moderation!

• Sugar consumption increased from less than 10 pounds per person a year in the late 1800's to about 100 pounds per person a year by 1945. It remained relatively flat until 1980. Yet, our health improved between 1880 and 1980. We can't blame just sugar for health problems. Low exercise, high stress, and poverty are also health-erosive.

• Sugar (a "carb") is in breast milk, dairy food, fruit, vegetables, honey, potato, corn, quinoa, and all grains. People around the globe have consumed these foods for years. So why now are sugar and "carbs" deemed responsible for creating human obesity and diseases?

• The fear-mongering terms of unhealthy, poisonous, toxic are simply unscientific. People who lack knowledge of physiology fail to understand sugar is not inherently fattening, nor is one food healthy or unhealthy. Note: An apple is a healthy food; a diet of all apples is a very unhealthy diet.

.• Our present state of poor health is not because we consume sugar and our diets are unhealthy. Rather, we are physically inactive. Too little exercise reduces our ability to metabolize sugar optimally. That, along with environmental factors, endocrine disrupters, stress, etc., explain the fundamental causes of obesity and metabolic disease.

• In terms of diabetes prevention, you should be concerned about blood sugar, not dietary sugar. A rise in blood sugar that occurs after eating is not pathological—unless unfit muscles and liver fail to take up the sugar. It's not what you eat, but what your body does with what you eat.

• With inactivity, the body becomes less able to transport sugar out of blood and into muscle. This erodes metabolic health. Also with inactivity, a person can easily overeat because energy intake gets dissociated from energy expenditure.
 Remember: athletes' bodies are metabolically very different from sedentary bodies. You want to stay active to preserve your ability to enjoy some sweets without hurting your health!

• Sugar cravings happen when the body needs fuel. If you eat before you run out of fuel, you will tame your sweet tooth. Enjoy a second lunch when you are droopy and low on energy in the afternoon instead of devouring sweets in the evening. That said, a desire for sweets can also be a genetic preference.

Concluding comments

              Lack of physical activity is the bigger threat to health than sugar. For people who are overfat and underfit, a diet low in sugar and starch is likely a wise idea. But for athletic people like runners (who are at lower risk for heart disease, diabetes, and obesity), sugar and carbs are not toxic; they are an important fuel for enhancing athletic performance.

              The one size diet does not fit all. No one is suggesting that athletes should eat more sugar. Rather, understand that as a runner, you can embrace a sport diet that includes an appropriate balance of sugars and starches (carbohydrates) in each meal.  Strive for a healthy eating pattern that offers 85% to 90% quality foods and 10% to 15% fun foods, such as apple pie instead of an apple.

              If you are fearful sugar will harm your health, note that fear-mongering relies on cherry-picked research that can prove what the "expert" wants to prove. Fear-mongering "experts" have created distrust of the food industry and have shaped opinions that support raw foods, super foods, whole foods, organic foods, and clean eating.  Confusion reigns!
              My suggestions are:
 —Enjoy a variety of foods to get a variety of nutrients.
 —Limit added sugar to less than 10% of your total calories (~250 sugar-calories/day for an active woman; ~300 sugar-calories for an active male).

 —If you currently limit your sugar intake to a weekly "cheat day," try this experiment: Enjoy a small sweet daily as a part of lunch or afternoon snack. This can curb your urge to binge on sweets in an unhealthy way on a cheat day. Sugar binges are what gives sugar a bad name...

Topic 2 - Sport Supplements: What you should know

              As a sports dietitian, I get asked many questions about supplements. What's the best protein powder? pre-workout energy booster? recovery drink? Are these products all they are promoted to be? To address that question, I scoured an article by Jose Antonio PhD and colleagues in the Journal of the International Society of Sports Nutrition: "Common questions and misconceptions about dietary supplements and the industry—What does science and the law really say?" This summary of some key points comes with a concluding suggestion: be an informed consumer.       
              For trusted supplement information, your best bet is to not believe all you read on Instagram and TikTok! Rather, choose to get personalized information by meeting with a registered dietitian nutritionist (RD or RDN) who is a Certified Specialist in Sports Dietetics (CSSD). A simple Internet search "sports nutrition RD near me" can help you find a local RD CSSD. (Nutrition consultations commonly get covered by health insurance, so don't let money be a barrier. An RD CSSD might even save you money if you are currently buying needless supplements.)
              Here's some background information about sport supplements to help you become an informed consumer.

• Supplements are a big business. In 2023, the US dietary supplement industry (includes vitamins, minerals/electrolytes, herbs, botanicals, amino acids, enzymes, etc.) was valued at more than $54 billion dollars. Amazon.com alone sold $12.6 billion in vitamins, minerals and related supplements. In comparison, prescription medications had thirty times more sales—about $670 billion.

• Are all commercial supplements safe and effective? That is, how well regulated is the dietary supplement industry? The answer is debatable—and also confusing for the average consumer. For example, the FDA regulates Red Bull not as a supplement but as a food/ beverage. Red Bull contains caffeine; FDA regulations limit caffeine content in the food/beverage category to less than 400 mg/serving. That's the safe upper limit per day for adults. Yet, restaurants and coffee shops do not have to declare the caffeine content of their  products. Regardless, any athlete can consume an unlimited number of energy drinks or cups of coffee in a day. That's problematic, because the dose is the poison. Very high doses can lead to heart arrythmias and trips to the  ER.

 • Unlike pharmaceutical drugs, dietary sport supplements (recovery drinks, protein powders) do not need to be pre-approved by the FDA. The manufacturers need to ensure safety, comply with labeling laws, and include specific information on the Supplement Facts Panel. But, unlike the Nutrition Facts Panel for food, the Supplement Facts Panel does not have to include specific amounts of ingredients, such as grams of caffeine or protein. Many supplements claim to  have a mysterious proprietary blend. Who knows what's in that pre workout drink, fat burner, or metabolic booster?

 • A supplement is deemed safe if it is reasonably expected to be safe when used as intended. This means, adverse reactions get reported and dealt with after having caused harm. (This differs from a food additive that is reasonably expected to cause no harm and has to be proven safe prior to being listed as Generally Regarded As Safe). A supplement manufacturer is required to submit to the FDA all serious adverse events associated with the product and record all non-serious reported events. If anything, these adverse incidents can be under-reported.

 • The label of a sport supplement cannot include a claim to cure, mitigate, treat, or prevent a disease. That's why you see vague "structure and function" claims that describe how a supplement might affect body structures (bones, fingernails) or functions (digestion, circulation). Common claims include supports heart health (as opposed to a drug that might claim lowers cholesterol).

• Supplement companies often pay researchers to study their products. For example, Gatorade has funded numerous research projects related to dehydration. Beet Elite has funded research on beets/nitrates as performance enhancers. Does that mean their research results are biased and questionable? Unlikely, given respected researchers want to protect their integrity and reputations. They sign agreements that allow them to design the project objectively, have the results reviewed by their peers, and report both positive and negative findings. Believe me, neither a company nor their research scientists want to promote false claims about a product that will damage their credibility and reputations. 

• Despite being regulated for safety, dietary supplements can be contaminated with heavy metals, microplastics, or other undesirable substances. To avoid banned, contaminated, or risky ingredients, be sure to buy a product that verifies its quality and safety. You'll see on their label a third-party certification icon from NSF Certified for Sport, Informed-Choice, Informed-Sport, Banned Substances Control Group (BSCG), or USP. The Department of Defense has Operation Supplement Safety with a tool you can use to check your supplements for contaminated and banned substances. These resources are far better than any (mis)information from TikTok, Instagram, or AI.

 • Most sport dietitians recommend a Food First approach to enhance performance—but that does not mean Food Only. If you are restricting your food/calorie intake, eliminating foods (dairy-free, no red meats), or "making weight" for a sport, you are at increased risk for nutrient deficiencies. If you are eliminating ultra-processed grain foods ("refined carbs"), you can miss out on fortified foods, with added iron or zinc, or enriched foods that replace nutrients lost during processing, such as B-vitamins and fiber). There is a time and a place for supplements in an athlete's diet. For example, athletes need about 3 to 5 grams a day of creatine for performance benefits. That's the amount in about 2 to 4.5 pounds of meat. While that's possible for a carnivorous body builder to ingest, it's unlikely for most athletes.

Topic 3 - Sports Nutrition News from the American College of Sports Medicine

              The American College of Sports Medicine (ACSM) is a professional organization with more than 14,000 members who are sports medicine doctors, sports dietitians, exercise scientists, sports psychologists, and other health professionals who work with athletic people. ACSM’s annual convention is a hotspot for the latest sport nutrition research. Here are a few highlights that might be of interest.

• The Female Athlete Triad—with three key symptoms: loss of monthly menstrual period (amenorrhea) + eating disorder + stress fracture—was first recognized in 1992. Since then, sports medicine professionals have educated female athletes that amenorrhea can be a sign of being unhealthy, chronically under-fueled, and at high risk for stress fractures. Despite educational efforts, the prevalence of eating issues has increased. Prevalence rates vary depending on the sport. An estimated 2% to 25% of female athletes have an outright eating disorder; 7% to 61% have disordered eating; 10% to 59% have irregular menses;  2% to 75% have low bone mineral density, and 2% to 100% consume inadequate calories to optimize performance. These numbers are disturbing! All athletes (males and females alike) who struggle with food and weight should seek guidance from a sports nutritionist (RD CSSD) so they can fuel better, perform better, and reduce their risk of injury. 

• Consuming too few calories is a problem not just for female athletes. Male athletes are also known to undereat. In a study with collegiate cross-country runners, 57% of the men presented with symptoms of low testosterone, suggestive of having too little energy available to support both exercise and normal body functions.

• A study comparing physique-focused sports (such as gymnastics, figure skating, dance) to non-physique-focused sports (football, rugby, hockey) surprisingly showed similar prevalence of disordered eating. Even power athletes had signs of being poorly fueled. Please notice your brain chatter that suggests food is fattening and reframe the thought to food is fuel, fundamental for enhancing performance.

• Deep-colored red, blue, and purple fruits (purple grapes, black currants, blueberries) are rich in anti-inflammatory polyphenols called anthocyanins. These bioactive compounds can positively impact athletic performance. For example, a female endurance runner who consumed a high dose (420 mg) of blackcurrant anthocyanins for a week had substantially lower lactic acid levels upon completion of a one-hour run. Other research supports positive performance benefits from anthocyanins. Enjoy a lot of deeply colored fruits and veggies!

• Cocoa powder is another good source of health-protective polyphenols called catechins. Cocoa powder can easily be added to (sweetened) milk for a recovery beverage. To make cocoa into chocolate milk, dissolve 1 tablespoon cocoa powder and 1 tablespoon (brown) sugar or sweetener of your choice in 1 cup of milk that has been heated in the microwave oven. Drink to a healthful recovery! 

• A survey of college athletes assessed supplement use, confidence in the effectiveness of those supplements, and perceived safety of the supplements. No surprise, those who took the most supplements perceived them to be safe and effective. Not always the case. Look on the label for NSF Certified, USP Verified, or Informed Choice.

 • A survey of male and female athletes from a variety of sports reports 72% took some form of sport supplement, with caffeine being the most popular. Athletes commonly get (expensive) supplement information via social media. A sport dietitian can help athletes find less costly alternatives to high-priced commercial brands at a grocery store. 

• An enticing blend of supplements containing ashwagandha, arjuna, rhodiola, beetroot, and cayenne showed no benefits (compared to placebo) for CrossFit athletes. What sounds good can be a waste of money.

• Swishing a carbohydrate mouth rinse is a strategy known to improve endurance performance. Carbohydrate activates receptors in the mouth that stimulate reward centers in the brain, making  exercise seem easier. Mouth rinses can be bothersome to carry during exercise, plus the act of rinsing the mouth disrupts normal breathing. Preliminary research suggests carb-containing strips that dissolve in the mouth can do the same job as a mouth rinse, resulting in a faster 8-mile time trial compared to a rinse with just plain water. Carbs feed both brains and muscles.

 • Eating before and during a round of golf helps maintain normal blood glucose, which reduces mental and physical fatigue, thereby helping golfers play better. All athletes should plan ahead to make sure the right foods are in the right place at the right times.

• High school (HS) runners commonly assume they will improve as freshmen at college. Not always the case. The average 800-meter run-time of the top 50 HS seniors improved about 0.45 seconds during freshman year. Only 51% of the runners ran faster. Statistics from 2013 to 2016 report three of the four HS graduating classes averaged slower times. Could sports nutrition education change this trend?

• Caffeine is known to enhance cycling performance, but it's unclear if it can simultaneously help with a strength test—and what would be the best dose? Subjects consumed a beverage with no caffeine (decaf coffee), a moderate (220 mg) dose, or a high (450 mg) dose) of caffeine. (Starbuck's 16-oz Grande has about 300 mg caffeine, for a frame of reference.) The high dose contributed to better performance for both aerobic and anaerobic exercise. Each athlete has differing sensitivities to caffeine, so learn the dose that works best for you. More is not always better!

• Habitual coffee drinkers who enjoy a moderate dose of caffeine are able to maintain normal hydration levels. Caffeine is not as dehydrating as once thought. Both moderately (but not highly) caffeinated beverages and water have similar hydration properties.

•Alkaline water is unlikely better for athletes than plain water. Following 10-hours with no food or water (to induce under-hydration), subjects drank 500 ml of alkaline or regular water, then one hour later did an intense exercise test. The alkaline water did not buffer the lactic acid generated during the subsequent intense exercise, showing no differences in blood lactate or level of hydration. However, the athletes did report the alkaline water made them feel more fatigued. No magic bullet there!

 

Nancy Clark MS RD CSSD counsels both fitness exercisers and competitive athletes in the Boston-area (617-962-4382). Her best-selling Sports Nutrition Guidebook is a popular resource. Visit NancyClarkRD.com for more information.