New research has added weight to the growing body of evidence linking nutritional deficiency to running injuries. A study examining the dietary habits and injury patterns of competitive runners found that lower energy and fat intakes were strongly associated with a higher risk of injury in female runners — a finding that has implications for how coaches, athletes, and sports medicine professionals approach injury prevention.
The mechanism is well understood in theory but difficult to study in practice. Runners who chronically under-fuel — whether through deliberate restriction, disordered eating, or simply failing to match energy intake to training demands — experience hormonal disruptions that weaken bone density, impair tissue repair, and compromise immune function. The study quantifies this relationship with unusual precision, showing a clear dose-response curve between energy deficit and injury incidence.
Perhaps the most surprising finding concerns dietary fibre. Low fibre intake was associated with an increased risk of bone stress injuries in both female and male runners. The researchers hypothesise that fibre's role in gut health and mineral absorption may influence calcium metabolism and bone remodelling — processes that are critical for runners who subject their skeletons to repeated impact loading. This finding deserves further investigation but suggests that the running community's focus on macronutrient ratios may be overlooking the importance of overall diet quality.
The practical takeaway is straightforward but bears repeating: runners who cut calories or restrict dietary fat in pursuit of performance or body composition goals are likely increasing their injury risk. For female runners in particular, adequate energy availability is not just a performance consideration — it is an injury prevention strategy. The study's authors recommend that all runners track energy availability rather than simply calorie counting, and that coaches be trained to recognise the signs of relative energy deficiency in sport.