A recent study published in the Journal of Science and Medicine in Sport has found that lower energy and fat intakes are strongly associated with a higher risk of injury in female runners.

Running is very much still having its moment. While it’s always been popular, in part, thanks to its accessibility and affordability, running has grown exponentially in recent years. You’ll rarely scroll social media without seeing some kind of running content, whether it’s an advice video or a #RunningFitCheck – and according to Strava’s Annual Year In Sport Report, running club participation increased by a whopping 59% globally in 2024.

Women’s participation in the sport is also rising. The 2025 edition of the London Marathon was the most gender equal in history – 45% of the 56,640 participants were women and women also made up 49.55% of UK applications for the 2026 ballot. While we’re totally here for it – long may the running boom continue – it’s important to ensure you’re adequately preparing your body for the additional physical activity. As the study points out, almost half of adult runners sustain running-related injuries, so it’s vital you’re doing all you can to protect yourselves against them.

What did the study find?

While there isn’t currently much concrete scientific evidence about the risk factors involved with developing a running-related injury (RRI), experts have pointed to several potential factors. Having a previous RRI is seen as the strongest predictor. However, sudden training load changes and poor sleep quality may also heighten RRI risk, with female sex and menstrual dysfunction also having been linked to increased risk of lower extremity bone stress injury.

In this study, researchers wanted to look at how dietary intake specifically might influence the risk of running-related injuries. They reviewed data from 15 existing studies exploring associations of dietary factors, risk of disordered eating, and running-related injury. Running levels ranged from recreational up to elite.

Following their analysis, the researchers found that lower energy and fat intakes were strongly associated with a higher risk of injury in female runners, and that a low-fibre diet increased the likelihood of bone stress injuries in both female and male runners.

More specifically, injured female runners consumed 450 fewer calories (~1900kj) and 20 grams less fat per day than their uninjured counterparts, and both injured female and male runners had three grams less fibre in their diet per day, compared to those who remained injury-free.

What does this mean for us?

We know that underfuelling can put runners at risk of low energy availability (LEA) – when your calorie intake doesn’t match your energy expenditure, and ultimately, Relative Energy Deficiency Syndrome (RED-S), which is characterised by low energy caused by an ongoing or long-term deficit of calories. The results of this study also now highlight how inadequate fuelling might increase injury risk.

‘Nutrition is key to optimising athletic performance, providing the energy, recovery support, and injury prevention needed to maintain both endurance and overall health. Many long-distance runners underestimate their energy needs,’ says sports dietitian and the study’s lead author, Erin Colebatch.

‘When runners don’t consume enough energy, their body’s needs go unmet, which over time can lead to issues like skeletal demineralisation, loss of lean body mass, fatigue, and stress fractures,’ adds senior researcher Dr Alison Hill, who also worked on the study.

Why fat isn’t the enemy

It’s something celebrity personal trainer Michael Baah has seen. ‘Runners often under-eat without realising. Sometimes it stems from outdated diet myths or the pressure to “eat clean,” but not getting enough energy forces your body to break down muscle. Recovery suffers, and the risk of injury goes up,’ says Baah, who has more than 20 years’ experience coaching high-performing women. More generally, he feels that low-fat diets ‘are quietly sabotaging recovery’.

‘Fat isn’t the enemy,’ he says. ‘It’s essential for hormone production, especially oestrogen, which protects bones and regulates your menstrual cycle. When fat intake is too low, oestrogen can drop. This makes bones more fragile and slows recovery. It’s a big reason why many female runners experience recurring injuries, stress fractures, or disruptions to their period.’

Why is fibre good for runners?

As mentioned, the researchers found that injured runners had three grams less fibre in their diet than those who remained injury-free. Fibre is a key part of any healthy, balanced diet and can have far-reaching health benefits, including lower cholesterol and blood sugar levels.

Inadequate fibre intake can lead to poor gut health, which can go on to affect immune function, metabolism, and, as is increasingly being highlighted, mental health. Therefore, while there’s no evidence dietary fibre directly prevents physical injury, its role in supporting overall health (including potentially reducing inflammation) may help reduce injury risk.

Current government guidelines recommend adults get 30g of fibre a day, with the NHS highlighting that it can help lower your risk of heart disease, stroke, type 2 diabetes and bowel cancer.

The bottom line

While this research provides interesting and important new insight for runners, the study did have practical limitations. Only a small number of studies could be identified and included (of which the quality varied), and definitions of RRIs were inconsistent, meaning the experts’ confidence in their findings could not be 100%.

However, when statistics suggest more than one in five athletes of all types are underfuelling, it highlights an important topic, underlining specific areas of nutrition for runners (especially women) to consider.

Meal and snack ideas for runners

If you’re stuck on where to start, Baah has some ideas for runner-friendly, nutrient-dense meal and snack ideas below:

• Pre-run snack: Oats with chia seeds and a spoonful of peanut butter. A great source of slow-release energy that won’t sit heavy.
• Post-run snack: Greek yoghurt, mixed berries, crushed pistachios, and a drizzle of honey. Ideal for muscle repair and gut health.
• Lunch or dinner: Grilled halloumi or salmon, quinoa, roasted veg, and avocado. Rich in healthy fats, anti-inflammatory, and satisfying.
• Evening option (if needed): Cottage cheese, dark chocolate nibs, and walnuts. Supports overnight recovery and keeps hunger at bay.

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