Why ‘Wellness’ Isn’t Working for Runners: The Truth About Health Trends and Performance

While not every runner falls into this category, many of us tend to define ourselves as Type-A, high achieving, goal-oriented people. We set our minds to something, and we go after it. These can be amazing traits to have, allowing us to set high standards for ourselves and the things we care about. 

However, it doesn’t always work in our favor. In the pursuit of faster times, better recovery, or a stronger body, runners, like everyone else, are regularly targeted by wellness marketing and diet culture. But unlike the average person, runners have specific and often very different needs, making us uniquely vulnerable to health and nutrition fads that empty our wallets and ultimately do more harm than good. Today, with social media and the internet, it's harder than ever to escape the constant message that we should always be doing more to improve our health and performance. We’re told that a new diet, supplement, or diet will be the key to our next PR, and it can be so tempting to jump on the bandwagon without pausing to ask: Is this actually evidence-based? Does it make sense for someone training for a big race? Who profits if I buy (into) it?

The truth is, when we’re pushing our bodies to run long distances, perform at high intensity, and recover quickly, our nutritional needs change and differ from the average person's. For perspective, only 24.2% of adults in the U.S. meet the Physical Activity Guidelines for both aerobic and muscle-strengthening activity. Carb-loading, fast-acting sugars, and ultra-processed foods all have a place in a runner’s life. Just because something is marketed as “healthy” doesn’t mean that it is, especially if you take into account your specific lifestyle factors, such as being in a demanding training cycle. So let’s break down some of the most popular wellness trends currently circulating in the running space, and look at what actually holds up against science and research.

Ketones: The $40 Fuel Shot You (Probably) Don’t Need

Ketones are natural compounds produced by the liver when the body needs an alternative fuel source, typically due to a lack of carbohydrates. This process, known as ketosis, enables the body to burn stored fat for energy. The concept has inspired the popular ketogenic diet, where carbohydrate intake is restricted to encourage the body to enter this fat-burning state. In an effort to mimic this effect without restricting carbs, ketone supplements have emerged, promising improved energy and performance, particularly for athletes.

However, the scientific evidence supporting these supplements is limited and inconsistent. Most studies show that for non-elite endurance athletes, ketone supplements offer minimal benefit, and any performance advantages are highly individual and context-specific. A 2020 meta-analysis concluded there is insufficient evidence to support their effectiveness in athletic performance. In fact, research has shown that while keto-adapted athletes may increase fat oxidation, they often experience reduced performance in high-intensity endurance events due to limited glycogen availability, the body’s most efficient energy source.

As a result of these research findings, experts in the field remain skeptical. Chiel Poffé, a postdoctoral researcher at KU Leuven in Belgium, stated that “in our opinion, there is currently no evidence that acutely ingesting ketone supplements during exercise provides a benefit for an athlete.” This was seconded by Martin Gibala, a professor of kinesiology at McMaster University in Canada, who agreed with Poffe, stating that “I suspect some athletes would drink battery acid if someone told them it would improve performance.” To add insult to injury, ketone supplements are notoriously expensive - around $5 per serving, frequently cause GI distress, and taste so unpleasant that researchers have struggled to develop a convincing placebo.

High-Protein Diets: Important, but Not at the Expense of Carbs

Protein is an essential macronutrient, especially for athletes. It’s critical to build and repair muscle tissue, especially after intense exercise, and to support overall recovery and performance. However, too much of a good thing can become a bad thing. In the protein-crazed era that we’re currently in, many runners are being encouraged to eat bodybuilder-level quantities of protein, often at the expense of carbs. 

As stated above, carbs are our body’s preferred source of energy for all activities, including running. First, carbs replenish glycogen stores after exercise, which is essential for recovery and preparing for future runs. A deficiency can slow the recovery process, increasing the likelihood of injury and fatigue in future workouts. Eating a diet that’s too high in protein and low in carbs can also create a deficiency in essential vitamins, minerals, and fiber. This doesn’t just affect performance, it takes a toll on your overall health. 

For athletes that menstruate, carbs also support hormone health and ensure that periods are regular throughout the training cycle. While runners do need protein (especially post-run), overemphasizing protein can lead to under-fueling, lower energy availability, and slower recovery.

Intermittent Fasting & Fasted Workouts

Intermittent fasting and fasted workouts have become increasingly trendy amongst runners in recent years, largely due to diet culture’s glorification of “fat burning” and the pursuit of a lean “runner’s body.” This trend can largely be traced back to the rise of keto diets and the hype around ketones, as previously mentioned. For people that have sensitive stomachs, it can also be more convenient than forcing themselves to eat before an early morning run.   

However, fasted running also increases cortisol, the body’s primary stress hormone. Cortisol alone is not bad, but when it’s chronically elevated without adequate fuel to balance it, the result is more muscle breakdown, poor recovery, suppressed immunity, and greater injury risk. This risk becomes even higher when fasted runs are combined with high mileage or intensity, which is common during training blocks

While this stress-response impacts all runners, it can be especially harmful for female athletes, hormonal systems are more sensitive to low energy availability (LEA). Skipping fuel before a run, especially in the morning when glycogen is already low, can contribute to irregular or missing periods, disrupted thyroid function, and decreased bone density, all symptoms of a condition called Relative Energy Deficiency in Sport (RED-S). 

Ultimately, runners perform better, recover faster, and stay healthier when they’re consistently fueled, with intake spread evenly throughout the day. Skipping meals or waiting too long to eat can leave your body in a constant state of catch-up, which increases stress, impairs recovery, and makes training feel harder than it needs to be. Intentional fueling, before, during, and after runs, is one of the most effective tools to support both performance and long-term health. 

The Nuance of “Clean Eating” and Ultra-Processed Foods 

While there has been a cultural shift away from more traditional diets, subtler food rules such as “don’t eat processed foods” or “limit carbs” are on the rise. This is particularly prevalent in the running community, where “clean eating” is often framed as a sign of discipline and dedication to performance. The problem is, these food rules are still forms of restriction, whether it’s limiting how much you’re eating, what you allow yourself to eat, or both. 

Fruits, vegetables, and other plant-based foods are idolized in our current culture, and they indisputably are an important source of vitamins and minerals. But, like protein, it’s still possible to overdo them, especially for athletes. Endurance athletes typically need more calories than the average person, it’s easy to fill up quickly by eating too much of these large volumes of these high-fiber foods, making it more difficult to meet your energy needs for training. Additionally, if most of your carbs come from fiber-heavy sources, you may not be absorbing enough usable fuel, given that fiber moves through the digestive tract largely undigested.

Processed foods, especially ultra-processed foods (UPFs), are often vilified in wellness spaces, a narrative that gained even more traction in recent years. However, for athletes, UPFs can be incredibly useful. While whole foods generally should make up the foundation of a nutrient-dense diet, there’s no need to eliminate, or fear, processed foods completely. For example, processed carbs are low in fiber and easier to digest, making them ideal before and during workouts. A sports gel (a UPF) provides quick glucose for energy, whereas the fiber in an apple could slow digestion and cause GI distress. Similarly, processed protein sources like powders and bars can make it easier to hit daily protein goals, especially for busy athletes or those with smaller appetites. UPFs can also support consistent fueling throughout the day, even when you’re short on time or on the go.

The obsession with “clean eating”—often referred to as orthorexia—is increasingly common, particularly in athletic communities. Orthorexia is characterized by an unhealthy fixation on eating only foods perceived as “pure,” “clean,” or “healthy,” and it often leads to rigid food rules, fear around certain ingredients or food groups, and anxiety when those rules are broken. Athletes may be especially vulnerable, as they’re often encouraged to prioritize nutrition, but when that focus becomes obsessive, it can backfire. Striving to eat healthfully should never come at the cost of mental well-being, and when food choices become a source of fear, stress, or social isolation, the behavior is no longer supporting your health.

Should we say "Bye-Bye-Bye" to Bi-Carb?

Sodium bicarbonate, or "bi-carb," is a chemical compound most commonly known for its use in baking and cleaning. Recently, it's gained popularity online as a legal supplement among elite and endurance athletes, particularly runners, to improve their performance. The concept isn't new: bi-carb has been studied as a potential performance enhancer since the 1980s, and today it's one of the most well-research supplements in sport. Yet despite the decades of study, there's still no scientific consensus on how it works or whether it truly delivers results.

The basic idea behind bi-carb is that when you work out at a high intensity, especially in short bursts, acid builds up in your muscles. That buildup makes it harder for your muscles to keep going, so you start to slow down. Because baking soda is very alkaline (the opposite of acidic), the theory is that it helps balance out the acid, letting you push harder for longer.

But this only seems to work for certain types of exercise. Research shows that sodium bicarbonate mostly helps with short, intense efforts that last from about 30 seconds to 10–12 minutes, such as sprinting, high-intensity intervals, or sports like boxing and rowing. But for longer efforts like running a marathon or doing an easy 5K, it doesn’t do much. Some experts argue that it can still help with a final sprint at the end of a race, but there are also downsides that might make people think twice.

Bi-carb can cause bloating, nausea, vomiting, and abdominal pain. It can also make you retain water and feel heavier. Some athletes try to reduce these effects by taking it in capsules or spreading out smaller doses over a few days, but there’s no guarantee these methods will work for everyone.

Bi-carb is also an extremely expensive supplement. One of the most popular brands on the market, Maurten Bicarb System, costs approximately $16-$17.50 per serving or $70 for a four-serving pack. For a supplement that may give a 1-3% improvement (if it works), it's a steep price to pay.

So, is it worth it? If you're competing at a high level, doing short, all-out efforts and willing to experiment (and deal with potential side effects), maybe. But if you're an everyday runner training for longer races, have a sensitive stomach, or are on a budget, bi-carb probably isn’t the miracle supplement the internet makes it out to be.

The Importance of Balance 

As much as most runners would love for there to be a “perfect” diet to follow, and as comforting as it can be to see things in black and white, nutrition doesn't work that way. What’s effective for one runner might not be right for another, and even for the same athlete, needs can shift across different training phases, stages of life, and (for those who get a period) even across different weeks of a single menstrual cycle. Nutrition is deeply personal, and trying to force a one-size-fits-all approach often creates more stress than success.

There also has to be a balance between physical performance and mental well-being. Discipline is important, but so is finding joy, flexibility, and community in food. Food is fuel, but it’s so much more than that. In a world obsessed with optimization and self-improvement, and with the rise of gym bro culture and wellness influencers, it's easy to fall into the trap of believing that more control always equals more progress. But the truth is, when food becomes a source of anxiety, shame, or rigidity, it’s no longer serving you. 

Being a strong, healthy athlete isn't about meticulously counting macros or weighing out grams of protein, it’s about having a sustainable, positive relationship with food and your body. Balance means honoring your hunger, fueling for performance, and creating a balance between discipline and treating yourself. The best diet for a runner is never going to be the cleanest, trendiest, or most restrictive one, and that’s okay. 

Sources:

Burke LM, Sharma AP, Heikura IA, et al. Crisis of confidence averted: Impairment of exercise economy and performance in elite race walkers by ketogenic low carbohydrate, high fat (LCHF) diet is reproducible. Martinuzzi A, ed. PLOS ONE. 2020;15(6):e0234027. doi:https://doi.org/10.1371/journal.pone.0234027. 

Byrne C. Eating “Healthy” Might Be Hurting Your Performance. Outside Online. Published March 20, 2022. https://www.outsideonline.com/health/nutrition/eating-healthy-might-be-hurting-your-performance/. 

CDC. FastStats - exercise or physical activity. CDC. Published December 15, 2022. https://www.cdc.gov/nchs/fastats/exercise.htm. 

Clark N. Athletes Kitchen - Ultra-Processed Foods: Beyond the Headlines. Run Ohio . Published May 16, 2024. Accessed May 9, 2025. https://www.runohio.com/index.php/news-features/features/559-athletes-kitchen-ultra-processed-foods-beyond-the-headlines-by-nancy-clark-ms-rd-cssd. 

Cleveland Clinic. Ketosis. Cleveland Clinic. Published August 15, 2022. https://my.clevelandclinic.org/health/articles/24003-ketosis. 

Coleman, A. Are carbs more important than protein for recovery? www.precisionhydration.com. https://www.precisionhydration.com/performance-advice/nutrition/should-you-use-carbohydrates-or-protein-for-recovery/. 

Dunn H. Fasted Training in Women. Holly Dunn Nutrition . Accessed May 9, 2025. https://hollydunn.co.uk/blog/fasted-training-in-women. 

Eidel S. Runner’s Diet. www.hopkinsmedicine.org. Published July 5, 2022. https://www.hopkinsmedicine.org/health/wellness-and-prevention/runners-diet. 

Kadey M. Sodium Bicarbonate for Athletes: What You Need to Know. Triathlete. Published October 3, 2024. https://www.triathlete.com/nutrition/race-fueling/sodium-bicarbonate-athlete-supplement/

Kaufman M, Nguyen C, Shetty M, Oppezzo M, Barrack M, Fredericson M. Popular Dietary Trends’ Impact on Athletic Performance: A Critical Analysis Review. Nutrients. 2023;15(16):3511. doi:https://doi.org/10.3390/nu15163511. 

Louw M. Ketones for running – Do they help? Sports Injury Physio. Published January 3, 2025. Accessed May 9, 2025. https://www.sports-injury-physio.com/post/ketones-for-running-do-they-help#viewer-l5fv9908. 

Louw M. Sodium bicarbonate for runners – Does it work? Sports Injury Physio. Published January 27, 2025. Accessed August 21, 2025. https://www.sports-injury-physio.com/post/sodium-bicarbonate-for-runners-does-it-work#viewer-y4n0f10970

McGregor, R. Should you run fasted? Runner’s World. Published April 14, 2022. https://www.runnersworld.com/uk/health/a39712489/fasted-cardio/. 

Reynolds G. Athletes swear by ketone drinks. A new study says they don’t work. Washington Post. https://www.washingtonpost.com/wellness/2023/06/21/ketone-drinks-athletic-performance/. Published June 28, 2023.

Robinson J. Explainer: Why athletes are taking sodium bicarbonate supplements. Chemistry World. Published August 8, 2024. https://www.chemistryworld.com/news/explainer-why-athletes-are-taking-sodium-bicarbonate-supplements/4019967.article

Valenzuela PL, Castillo-García A, Morales JS, Lucia A. Perspective: Ketone Supplementation in Sports—Does It Work? Advances in Nutrition. 2020;12(2):305-315. doi:https://doi.org/10.1093/advances/nmaa130. 

--

About the Author: Sophie van Leeuwen is the Podcast and Social Media Assistant at Running Explained, where she helps manage behind-the-scenes content, research, and production. A lifelong runner, she got her start going on neighborhood runs with her dad when she was seven and has since completed multiple marathons and her first 50k. She’s currently aiming to explore more trail and ultrarunning.