Female Athlete Triad (FAT)….do you know what it is or what the potential health and running performance implications are of this syndrome? You are not alone…many runners, and athletes in general, have very little knowledge of FAT and how nutrition and energy availability may impact its development. So, here we update you on the current research into FAT syndrome and outline some recommended nutritional approaches to help reduce the risk of it becoming a concern for you!

A BIG thank you to our Show Sponsor AMAZING JANE ACTIVE WEAR. Please use discount code RHH10 for 10% off ALL purchases at www.amazingjane.com



Outlining WHY we are talking about this subject:

  1. FAT is a syndrome that is known to be prevalent in runners
  2. To educate our listeners and followers on this condition and the signs and symptoms to observe for, in themselves or in fellow runners, so they can take action
  3. FAT focuses on JUST the female athlete…therefore research is carried out on female athletes only, which is rare
  4. To highlight a 2022 research paper, which focuses on aspects of FAT in RECREATIONAL female runners, which is also rare! 


Defining FAT, which is a syndrome that was first acknowledged in 1992. At this time, it was understood to be a condition found in girls and women and consisting of THREE interrelated conditions


Outlining some of the key findings from recent research into FAT Syndrome. Some of the observations include:

  • Low energy availability could occur intentionally or unintentionally
  • Early recognition of LEA in female athletes and an understanding of FAT syndrome and its progression is really paramount in preventing the short- and longer-term health consequences of it
  • Only one component of the Female Athlete Triad needs to be evident in order for FAT to be established 


Outlining the highlights from a 2022 research paper looking at FAT in recreational runners, all of which were related to menstruation. The researchers found that female recreational runners: 

  • Had fewer regular monthly cycles per year
  • Their menstrual bleeding was shorter
  • They had slightly more spotting between menstrual periods
  • They had cycles every 24 days (which was more than the control group experienced)



The only observation the 2022 research paper mentioned was that:

  1. Older runners are less likely to experience menstrual disorders besides their younger counterparts 
  2. The difference was quite significant at 67% of younger runners vs only 9% of older runners experiencing menstrual disorders
  3. The study did not state at what age the participants were recognised as “old” but the oldest participants were approx. 40yrs of age 


Highlighting some dietary and nutritional observations from the 2022 research paper on female recreational runners including: recreational runners following a “special diet” e.g. paleo, ketogenic, vegetarian showed higher incidence of amenorrhoea (absence of menstrual cycle) besides those following a “normal” diet


Looking at ideas and strategies to put into place to help limit the risk of FAT Syndrome becoming a concern for you including:

Think about the following questions:

•           Do you frequently train and forget to eat immediately afterwards?

•           Do you restrict your caloric intake to try and attain/maintain a lean physique?

•           Are you under pressure to keep below a certain weight for your sport?

•           Do you frequently skip meals but train hard?

If you have answered ‘yes’ to any of these questions you may be at increased risk of suffering from LEA and falling within the realms of the FAT diagnosis

Our advice is to work with a sports nutrition professional who can guide you regarding nutrient intake to support your goals whilst still ensuring sufficient energy for your running training



  1. Just as a reminder; Female Athlete Triad (FAT) is defined as a syndrome where there is an interdependence of low energy availability (LEA) with amenorrhea, decreased bone mineral density, and osteoporosis – with LEA being evident either with or without the presence of any eating disorders
  2. LEA may occur intentionally or unintentionally. Despite this, early recognition of LEA and the FAT in a runner is paramount to prevent the short…and long-term…health consequences of it
  3. Different components of FAT may occur with a different intensity and could appear at different times depending on a runner’s diet and training load. As a result, only one aspect of this syndrome needs to be apparent in order for FAT to be established. 
  4. Current research suggests that within the recreational running community there is a general lack of knowledge about the specific dietary needs of a runner and the need to replace a potential energy deficit from their run training This lack of knowledge could potentially lead to the inadvertent development of FAT
  5. We highly recommend you work with a sports nutrition professional as they can guide you regarding nutrient intake to support your goals whilst also ensuring you are eating appropriately to fuel your running training and void LEA and the development of FAT
  6. Finally, consider using our Athlete’s Plate Concept as a tool to guide your food intake, especially your carbohydrate intake to help maintain energy balance for your running

Download our FREE E book TOP Running Snacks and Nutrient Timing to Fuel Peak Performance


Related Topics:

Eating Enough To Run

Performance Effects of Overtraining Syndrome

Athletes Plates in Practice


The suggestions we make during this episode are for guidance and advice only, and are not a substitute for medical advice or treatment. If you have any concerns regarding your health, please contact your healthcare professional for advice as soon as possible.

A BIG thank you to our Show Sponsor AMAZING JANE ACTIVE WEAR. Please use discount code RHH10 for 10% off ALL purchases at www.amazingjane.com

​Also, when you’re ready, here are FOUR ways that we can help you:

1) Join Easy Nutrition For Healthy Runners HUB. Please join our FREE private facebook group for education, tips, inspiration with like- minded female runners.

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3)Find out if you are the right fit for our Healthy Woman Healthy Runner Programme. Please book a free Discovery Call.

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We love to hear from our listeners – what are your nutrition and running goals, challenges and successes, please drop us a line at hello@runnershealthhub.com


Best Wishes and Happy Running!

Karen and Aileen