Comrades Marathon 2014 – The Nutrition Factors (Post Mortem)

Comrades Marathon Post Mortem

Comrades Marathon this past Sunday as usual did not disappoint. The elite men’s race was exciting from beginning to end and in the ladies the twins 11 year domination came to an abrupt halt with Eli Greenwood completing an amazing final 10km split one of the fastest on the day. Many viewers looked at the twins walking for the first time and initial comments were that they are past their prime, they are too old and their days are numbered. I also heard many stories of nausea and cramping.

I was supposed to run Comrades 2014 but due to a chest infection and a prolonged course of antibiotics I had to unfortunately withdraw, remember health always comes first no matter what. However my day was incredibly good. I did what I do best, I got into the official Nedbank seconding vehicle with Nick Bester and made sure our athletes were fed & hydrated from start to finish.  I work with Mr. Price Maxed Elite and some of the Toyota athletes as well and I supported and advised all that I could on the tough 90km route. I often get asked what did the elite athletes use, how did they feed and what did they hydrate on. It’s always a very interesting discussion, and in previous years when I have seconded them I have measured fluid and carbohydrate intake along the route to see exactly what goes into a gold medalist’s body. The day itself was an extremely difficult one for most and I will expand in more detail on the pitfalls and reasons many saw nausea, dizziness and cramping on the route.

Let’s first start with the main rule of thumb. If you train a certain way then you race exactly the same. You never ever attempt to try new tactics or nutrition on race day. If you do you only have yourself to blame when falling ill. Not only is race day nutrition critical, BUT the entire week leading up to the event. Eat what you would normally eat, don’t suddenly decide a few days before or the morning of to try a new food or drink that you have never tried before you are truly asking for trouble. Since Comrades I have spoken to 5 athletes who had a very hard first half during the marathon and all 5 had one thing in common, their pre-race meal was not something they had done before. In actual fact it was severely impacting they tried a new beverage or meal on race day. When you prepare so hard and long for a race and in 5 minutes completely throw it out the window it just doesn’t make sense. Train how you would race I cannot emphasize this enough.

What else went wrong on Comrades day?
Race day fuelling was a big factor. Many athletes take in a whopping load of sugar during the first half only to succumb to it later on. I have always said this and will continue to stand by it. Comrades Race is a slower paced race, meaning you will predominantly use your fat stores for energy. There is no need to over consume blood glucose spiking products such as gels early on, if you do well then you are just asking for trouble. In my buildup to the race, my 38-40km runs were done purely on water. I would wake up have a cup of green tea and go out. I would only have some water if I felt like it. There was no need for taking on major fuel, my pace was around 4:45/km – 5:00/km way slower than my marathon pace of 3:45 – 4:10. This only can mean one thing fat is king glycogen is spared :-).

For many however the biggest factor of the day was actually the temperature and humidity factor. I stood at the city hall in Pietermaritzburg at the start of the race knowing this was the warmest race start temperatures I have ever felt. I hate the cold and I recall 2010 while seconding at Ashburton where it was so cold I had 3 layers on, a beanie, gloves, wind proofs and I couldn’t keep warm no matter what. Aside from that my volunteers who were injured sub 6hr Comrades runners were also dressed in thick clothing and running up and down the road just to stay warm. We were all in agreement it was a really cold day.
At 2010 Comrades Marathon the average temperature in Durban was 19ºC (min 14ºC; max 24ºC) with 63% humidity and 3 km/h wind speed. In 2012 the temperatures were around 23ºC with a humidity of around 38%.

On Sunday I stood in a t-shirt with a thin long sleeved top and I was perfect and that was Pietermaritzburg where the temperatures were 8 degrees. Immediately I advised the elite athletes I managed to chat with on the morning to really focus on their fluid intake and drink to thirst not more, because core body temperatures were going to rise and so would the temptation for major fluid intake. Most novices and even some pro’s land up drinking excessively to try to keep cool, however all this does is overload the system with fluid and can lead to over hydration or hyponatremia. By midday the temperature in Durban had soared to a peak measurement of 33ºC with the humidity increasing from 38% – 76% to Comrades cut off. (see below)

From the onset I knew today was the day people would complain of bad water on route, cramping and nutrition used. Basically pointing the finger at anything to try to explain what happened on the day. In the last 20km’s of the race when our elite athletes came through our feeding zone, one in particular was complaining of leg cramping and a little surprised because he never cramps. We assisted him with a quick resolution to try to get him going again and it seemed to work. Post-race analysis showed over consumption of fluid. Bongmusa the Comrades winner took around 30 water sachets in the last 18km’s of the race. However of the 30 water sachets, 28 went over his head only around 2 in the mouth. This was incredibly smart, he was using the water to try to cool his core body temperature from the outside and definitely not on the inside. At that time of day, and taking in excessive fluid, it would have spelled disaster but there was plenty of wisdom in it.

Why should consuming too much fluid cause issues?

Its quite simple, in hot especially more humid conditions a lot of fluid is lost in the form of water and sodium. Taking in excessive fluid at this stage actually starts a process of what is called Hyponatremia which is basically serum sodium concentration of less than 135 mEq/L as a result of an accumulation of total body water greater than the body’s accumulation of electrolytes (sodium + potassium).
In simple terms due to the heat losing a lot of fluid in the form of water and sodium, and then consuming large amounts of water, can lead to low plasma sodium (salt level in the blood)

I was told by one group of athletes that they had been training in hot conditions for the race. However the hot climate they were training in was nowhere near the humid conditions they were racing in and they also succumbed to fluid consumption for core temperature cooling and potentially caused major issues. Another group of runners contacted me stating that with around 30km’s to go they consumed some gels and immediately began vomiting. I had some news for them it wasn’t the gels. With 30km’s to go these runners were in the thick of peak day temperatures and had also landed up over consuming fluid after careful analysis.

The symptoms for over-hydrating are crystal clear:

Nausea
Cramping
Dizziness
Disorientation
Confusion

Generally in athletes nausea and cramping are what is first experienced.

One of the issues with Comrades Marathon is that there are far too many water tables spaced too close to one another. It would be far more beneficial to space them out a little more. When running a marathon or an ultra, one tends to forget about when he consumed last how long ago, and often the mind just goes into a see and grab situation which leads to trouble.
A conversation with the Russian twins afterwards had shown excessive fluid intake. One of them landed up in hospital with close to renal failure symptoms which were declared to be a result of low blood sodium.  What’s incredible from the majority of the cases is that at the line they were diagnosed with dehydration, however results later showed this was completely incorrect. Very often dehydration symptoms are confused with hyponatremia symptoms. Athletes can perform dehydrated quite easily, but slightly overhydrate and you are toast.

During a long event such as Comrades Marathon weather conditions play an extremely critical role. The key elements are always drink to thirst, don’t over drink. If you are feeling very hot then cool from the outside not the inside.  If you are taking in a lot of fluid try consuming the water with carbs and minerals to maximize the fluid uptake. If you train in cooler climates and then suddenly race in a hotter more humid climate you could potentially look at additional sodium intake to try to mitigate this from happening.

Lastly and this is a topic that completely irritates me to no end. The runners that take NSAID’s with them. Yes you, the ones who carry myprodol, ibuprofen or any other pain killer or anti-inflammatory with them during the run. Its a fact that more athletes that have landed up with renal failure, which also starts with major symptoms of nausea, dizziness etc have been a result of consuming these types of medications during an event. In the words of my running coach “If you need to take a pain killer or anti-inflammatory during Comrades, then you should NOT be doing Comrades”. If this is you then understand you are putting your life at risk and what you are doing is absolutely nothing less than very stupid.

Its always tough on the day especially in 90km’s of running and anything can potentially happen. However the more prepared you are and the better you know your body the less chance there is of having any major issues.