Reductions in training load and dietary carbohydrates help restore health and improve performance in an Ironman triathlete

While most endurance athletes and coaches recommend higher training loads and high-carbohydrate low-fat diets, some studies report benefits of lower intensity training for performance improvements and a low-carbohydrate high-fat eating plan. We present the case of a 38-year-old female professional/elite Ironman triathlete who presented with decreased performances, alongside severe gastrointestinal distress, excess fatigue, and severe daytime hunger. Training load was reduced from 30 to 18 h before a gradual increase to 24 h. Dietary recommendations included reducing carbohydrate and increasing dietary fat intake. Over a six-week period, daily carbohydrate content was gradually decreased from 73% (475 g) to 12% (78 g) of total calories, while fat content increased from 14% (40 g) to 75% (217 g), and protein levels remained constant at 13% (85 g). Within two months, the athlete reported increased perception of daily energy during and between training sessions, less perceived hunger and fatigue, and reduced ...