Rob Sturridge thought he was doing everything right, yet was feeling nothing but wrong. He had qualified for Kona multiple times, was performing well in training, and didn’t seem to have trouble maintaining a lean frame into his 30s. “I should have been feeling great, but something was just ‘off.’ I didn’t know if it was because Lara and I were having fertility struggles or if I was generally depressed.” After spending some time with a therapist, he was shocked when she suggested he see a nutritionist. Although Sturridge had been convinced that his incredibly controlled diet was responsible for his success, it turned out that it was the cause of both his altered mood and the low testosterone levels that had made it impossible for him and his wife to conceive. “It wasn’t easy to admit that my idea of a perfect athlete’s diet was actually wrecking me.”

Sturridge is not alone in discovering a disconnect between what is considered to be an ideal diet and the reality of what is required for a healthy mind. Many of us tweak our nutrition using tips we pick up on social media or from training partners, with the goal of dropping a bit of weight for race season or, lately, shaving off a few pandemic pounds. We feel good when we have initial success, but could we be affecting our mental health when we continue the diet long term?

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Your under-fueled brain

Chronic under-fueling happens more often than we think, even in age-groupers, and will seriously affect physical and mental health. Low Energy Availability (LEA) describes a situation in which insufficient energy is available to support the body functioning. This lack of proper energy intake will cause physiological decline affecting the endocrine, skeletal, muscular, immune, digestive, and reproductive systems. You have likely heard of this condition referred to as Relative Energy Deficiency in Sport (RED-S), which affects all genders and is caused by a lack of sufficient caloric intake. Unfortunately, the psychological decline associated with LEA is less understood by athletes, though it may have an equally dramatic impact on not only their training but their entire life.

The primary cognitive effect of LEA is impaired brain function due to a lack of fuel. The brain and its working neurons rely on glucose for energy or else brain function suffers. Without enough glucose, memory and concentration may be compromised, while other psychological symptoms such as depression, irritability, nervousness, mood swings, social isolation, obsessive thoughts, and loss of sexual drive may also develop. One recent study shows that athletes with LEA may also experience more stress and poorer sleep. Another study on male cyclists who were fueling inadequately shows that they were more likely to feel crushing pressure as well as declining moods.

There are secondary cognitive effects to LEA as well, since injury, loss of menstruation, infertility, and the compromised performance that may all develop will likely cause athletes to feel unhappy and dispirited. In Sturridge’s case, those secondary effects were enough to make him deeply worried about his mental health. That’s one heck of a downside to following a “perfect athlete’s diet.”

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Stop eating like an influencer

Although most athletes make dietary changes with the best intentions, the outcome isn’t always positive. It might be a question of where they are getting the information. “Athletes tend to look to each other for advice and inspiration, preferring to follow the diet of a person who has either the performance or the body that they want to achieve, without attention to whether or not that diet is appropriate for them,” said Stephanie Roth-Goldberg, a psychotherapist and founder of Intuitive Psychotherapy NYC who specializes in eating disorders and disordered eating in all genders, particularly in athletes. “They have the idea that if they eat like a certain person, they will look like that person or perform like that person and we know that is simply not true.” She says that much of the advice is anecdotal, not based in science, and could be coming from full-time athletes who do not have the same lifestyle, commitments, or nutritional needs as the reader. Yet, the tendency to compare ourselves persists as well as the impact on our mental health.

Any diet plan can turn insidious when it begins to consume an athlete’s thoughts and dramatically influence how they manage their life. Roth-Goldberg says that some concerning behaviors to look for would be declining moods, spending hours planning when and what to eat, putting off eating until designated times, choosing to eat alone and not engage with others during meal times, and preparing specific and separate foods from other family members. Of course, clear signs like stress fractures that develop as a result of inadequate caloric intake are harder to miss. Whether the breaking point is physical or behavioral, athletes need to believe that adequate nutrition is the answer.

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The secret to athletic success: a fork and knife

Roth-Goldberg emphasizes that athletes often need to be convinced that increasing caloric intake will not adversely affect their performance, but will enhance their overall quality of life. It typically requires working on undoing beliefs about body image, certain types of foods like carbohydrates, and even deeper issues of success, value, and identity. Many athletes equate success with a certain level of performance or body type, therefore when faced with the prospect of needing to eat more, many will balk. “Acknowledging that the fears around gaining weight can be helpful as a motivator for athletes to recognize and dispute some of their beliefs, which may not be conscious until they are forced to consider why they might not want to fuel adequately. It’s helpful for them to see how it affects how they view themselves as people, as athletes, as professionals,” she said.

Athletes are generally energetic, positive people, so it can be hard to recognize when a diet has become problematic for mental health. If we look at faster times or a leaner body as the markers of success, we may not be getting the whole story. We need to consider how those dietary changes are affecting our cognitive function as well. If you’re not sure, ask a friend or family member how you’ve been acting lately. Don’t like what you hear? It just might be time to eat up.

Primary cognitive effects of LEA

• Memory and concentration compromised
• Depression
• Anxiety
• Irritability
• Nervousness
• Mood swings
• Social isolation
• Obsessive thoughts
• Loss of sex drive

Secondary cognitive effects of LEA (resulting from underfueling)

• Depression due to injury
• Stress of maintaining body image
• Depression due to infertility and/or amenorrhea
• Declining mood due to poor performance