I have spent a lot of time studying the diets of elite endurance athletes. My goal has been to identify common patterns that define “best practices” for other athletes to emulate. I have found several such patterns, but perhaps the most striking thing I have noticed is that, almost without exception, elite endurance athletes enjoy and are completely comfortable with their healthy diet. Maintaining high dietary standards is neither stressful nor onerous for them but satisfying and even automatic.

This feature stands in striking contrast to what I see in the recreational athletes who reach out to me as a sports nutritionist for help with their diet. The majority of these folks are fairly healthy eaters, but they are not happy eaters. To the contrary, their relationship with food is tainted by fear and guilt. They fuss and worry unceasingly about their diet.

Healthy eating has two components: healthy food and a healthy relationship with food. You need both to be a fully healthy person. Athletes who eat healthy food but have an unhealthy relationship with food are not fully healthy because their diet tends to become extreme and unbalanced, or else erratic, and because stress and anxiety are as damaging to the body as is bad food.

Most of my clients come to me because they have a physical problem, but the true source of the problem is usually psychological. I help anemic runners whose anemia stems from vegan diets, chronically fatigued cyclists whose chronic fatigue stems from grain-free diets, and triathletes gaining weight, whose weight gain stems from calorie-control diets, among others. But the real issue is the psychology that lies behind these extreme diet choices: a fear of food and a desperate need to control it.

Science backs up my clinical observation that worrying a lot about eating right does not often result in healthier eating or in better health. In 2015, researchers at the University of Canterbury in New Zealand invited subjects to fill out a questionnaire that collected information about their psychological orientation toward food. The subjects were first asked to state whether they associated chocolate cake with “celebration” or “guilt.” The researchers found that those who chose guilt “reported unhealthier eating habits and lower levels of perceived behavioural control over healthy eating when under stress… and did not have more positive attitudes towards healthy eating.”

Other research has demonstrated that people who develop eating disorders tend to share certain psychological characteristics. Specifically, they frequently exhibit low self-esteem and a high degree of neuroticism (or anxiousness). Men and especially women with eating disorders are also far more likely than the average person to have suffered significant adverse experiences in childhood. It is my belief that the same psychological characteristics lie behind the fear-based relationship with food that draws some people to extreme diets, which, while not always resulting in clinical eating disorders, lie on the same continuum.

There is not much we can do to change our personality, and adverse childhood experiences cannot be undone. But this does not mean that an unhealthy relationship with food cannot be fixed. It happens all the time. The first step is simply to recognize that it’s not the food but the relationship that’s the problem.

The current popularity of extreme diets, or diet cults, as I call them, is a major obstacle to the development of a healthy relationship with food. These diets prey upon and exacerbate food fears, nurture food obsession, and serve as stepping stones to the sorts of problems that eventually lead athletes to seek me out for help, as well as to full-blown eating disorders.

I am not a psychologist; I do not treat eating disorders or talk to athletes about low self-esteem, neuroticism, and adverse childhood experiences. My way of helping athletes develop a healthy relationship with food is to encourage them to eat the way that the healthiest people—elite endurance athletes—eat.

There are five key habits that define this way of eating. Virtually all elite endurance athletes eat everything (forbidding no specific foods or food groups), eat quality (prioritizing natural, whole foods), eat carbohydrate (placing high-carb foods at the center of all meals and most snacks), eat plenty (allowing their body’s true energy needs to dictate how much they eat rather than heeding strict calorie limits), and eat individually (customizing their diet to fit their individual needs and preferences).

Elite endurance athletes practice these eating habits because they must practice them to be successful. Running and other endurance sports are so ultra-competitive at the international level that even the most gifted racers cannot win with inferior training methods or dietary practices. The five habits I have identified have become universal across all endurance disciplines and national boundaries because they work better than the alternatives.

Yet these same five habits foster a healthy relationship with food. Eating everything works against a fear of eating particular foods or food groups. Focusing on overall quality is a saner way to maintain high dietary standards than is selecting foods based on some weird conceptual stand-in for quality (such as how long humans have presumably been eating the various food types).

Maintaining a carbohydrate-centered diet promotes a healthy relationship with food because every major traditional cultural cuisine is carb-centered: rice-centered in India and China, potato-centered in the United Kingdom, bread-centered in central Europe, etc. Elite endurance athletes eat in culturally normal ways, but with above-average quality standards. This allows them to continue to enjoy familiar foods they enjoyed in their youth, to share holiday feasts with family and restaurant meals with friends, and to just generally feel as though they are not continuously swimming against the tide with their diet.

Eating plenty is salutary because it is how we are meant to regulate the amount of food we eat. It’s how animals and infants do it. But in the modern world, most people lose the ability to listen to their body and to eat according to its signals. We either mindlessly overeat because the television tells us to or we decide our body cannot be trusted and eat consistently less than our body asks for fear of gaining weight. But the leanest athletes, the pros, let their body call the shots.

Eating individually encourages a healthy relationship with food in a similar way. Nearly all popular diets at least tacitly discourage individuality, forcing all of their followers to start over with a one-size-fits all solution instead of allowing them to simply improve their existing (and presumably preferred) eating habits. Elite athletes allow themselves to customize their healthy diet to satisfy their personal preferences. They also pay attention to how different eating patterns affect their body and tweak them accordingly, not worrying about what everyone else is doing.

If you’re genuinely afraid of meat, or grains, or sugar, or dairy, or some other nutrient or food type; if you worry a lot about eating the wrong things, and feel guilty when you do; if you have a history of trying extreme diets; or if maintaining your current dietary standards feels like work to you, then try something different. Try eating like the healthiest and happiest eaters on earth, who just happen to be the world’s best practitioners of the sport you love.

Originally posted on August 15, 2015. Updated on November 5, 2018.