DOI: 10.

1079/ECEP200430

Equine and Comparative Exercise Physiology 1(4); 249253

Diet intake and endurance

performance in Kenyan runners
Dirk L Christensen1,2,*
1

Department of Epidemiology, Institute of Public Health, University of Copenhagen,

Blegdamsvej 3, Building 2, DK-2200 Copenhagen N, Denmark
2
Copenhagen Muscle Research Centre, Rigshospitalet (National University Hospital),
Copenhagen, Denmark
*Corresponding author: d.l.christensen@pubhealth.ku.dk

Review Article

Abstract
Training and competing at elite as well as sub-elite level requires an optimal functioning of the body. This review
looks at the case of the Kenyan runners, who consume a relatively high-quality diet based on vegetable sources
with maize and kidney beans as the staple foods. The diet is high in carbohydrate and total protein, but low to
borderline in a few essential amino acids. The timing of diet intake immediately after training sessions is optimal for skeletal muscle glycogen resynthesis that is enhanced without the help of insulin up to 60 min after cessation of exercise. Whether the total energy intake of the Kenyan runners is adequate is debatable. However,
chronic undernutrition is not possible for athletes who engage in daily high-quality and -quantity physical exercise
throughout most of the year. It is suggested that Kenyan runners participate in well-controlled, laboratory studies
to investigate the quality of local foods and performance, as well as possible physiological adaptation mechanisms
among athletes with a high habitual energy turnover.
Keywords: Kenya; runners; macronutrient intake; performance

Introduction
Training and competing at elite and even sub-elite level
in the middle and long distances (800 m to marathon)
requires an optimal functioning of the body, which
relies on a nutritionally adequate diet providing sufficient energy, as well as an adequate content of macroand micronutrients. Until a few years ago, little was
known about the dietary intake of Kenyan runners
despite them having been a dominating force in international athletics for several decades. Only anecdotal
information and no scientific data on this subject were
available until a decade ago, when Mukeshi and
Thairu1 evaluated the dietary intake of elite male
Kenyan athletes including male long-distance runners.
Unfortunately, the study was based on questionnaires
only. However, a substantial body of dietary investigations in general have been carried out in Kenya over
the past , 80 years24. These studies revealed several
cases of malnutrition especially proteinenergy and
micronutrient malnutrition indicating a very limited
availability of high-quality food sources. This indicates
potential performance problems for Kenya-based
athletes in training and competition. Based on the
above, the present paper addresses the carbohydrate,
protein and energy intakes of Kenyan runners to

investigate whether they are adequate and to elucidate

subsequent implications for physical performance.
Food and macronutrient intakes
The only investigation that has looked at the macronutrient intakes of Kenyan runners in detail, including collection and analysis of food samples, showed that their
diet was based on a relatively small range of food items
from mainly vegetable sources5. The staple foods were
maize and kidney beans, both of which contributed
essentially to protein intake. Furthermore, cabbage,
curly kale, wheat bread, milk, coffee and meat were
the remaining sources of daily food intake5. This investigation was carried out over a two-week period at
Marakwet High School (formerly Marakwet Secondary
School), a typical Kenyan boarding school situated in
the western highlands at 2600 m above sea level.
The adolescent male student-runners participating in
the study (n 12) were all Kalenjin, a Nilotic subgroup, and the most successful ethnic group in running
from Kenya over time. All runners competed at the subelite level in the middle and long distances. The energy
intake of the runners was mainly derived from vegetable sources, but surprisingly meat and milk
qCAB International 2004

90
85
97
65
10
15
3
35
4
5
5
3
1
1
0
0
1
2
0
0
0
1
0
0
6
4
3
13
4
11
0
22
17
13
19
8
b

Table modified from study published by Christensen et al.5.

Including food sources which each contribute less than 1%.

64
61
74
52
11 86014 648
8096
405538
39.950.6
283
1.8
11.7
1.0
13211
88
476
45.2
Energy (kJ)
Protein (g)
Carbohydrate (g)
Fat (g)

Vegetable
sourcesb
Animal
sources
Wheat
Cabbage
Kale
Coffee
Milk
Meat
Beans
Maize
Range
SE
Amount

In the literature there is an abundance of evidence

showing that a high daily intake of carbohydrate is
advantageous in post-exercise recovery as well as in
performance (for recent reviews, see Burke et al.9,10).
However, some authors have questioned the official
dietary guidelines11, stating that the recommendation
for carbohydrate intake (6070% of total energy
intake) is not consumed by athletes in training and
that the carbohydrate intake of athletes has not
increased over the past 50 years12. This implies that
athletes do not need such high carbohydrate intakes.
While the statement is true for athletes in industrialized countries in general, at least the first part of the
statement is not true when it comes to athletes in
the developing world, as shown by studies carried
out among ultra-distance runners in Mexico13 and
Kenyan middle- and long-distance runners1,5. It is,
however, important to emphasize that a high intake
of carbohydrate, expressed as a percentage of total
energy intake, is crucial only when the diet is low in
energy (such as shown in many studies on female
endurance athletes) in order for the athlete to replenish his/her liver and skeletal muscle glycogen stores
(for review, see Burke14). More important is a high
carbohydrate intake in relation to body weight, for
which there are guidelines for short-term/single
events as well as for long-term or routine situations15,16. The Kalenjin runners from our study had
a daily carbohydrate consumption of 8.7 g kg21 body
weight, which is well above the 67 g kg21 body
weight thought necessary for replenishment of liver
and skeletal muscle glycogen stores after an hours
O2max17. In spite of the fact
daily training at 75% V
that the Kalenjin student-athletes ran a daily average

Food sources (%)

Carbohydrate intake, glycogen resynthesis

and performance implications

Nutrient

consumption comprised only 10% of total energy intake

(Table 1). Historically, the Nilotes have depended primarily on milk, but also on blood and meat as their
staple foods. However, it is a misconception to regard
Nilotes as pure pastoralists since most of them have
supplemented their diet with grain foods, historically
as well as presently6,7. This is especially true for the
Kalenjin8. Still, we expected milk intake to play a
more prominent role in the diet of the runners at
Marakwet High School. But it was only a few weeks
prior to important competitions that they were supplied with extra milk. As it turned out, the study
made by our group showed that maize and kidney
beans alone made up 81% of the total energy intake
of the student-athletes at Marakwet High School.
Furthermore, the energy distribution of their macronutrient intakes was 71% for carbohydrate, 15% for fat
and 13% for protein5.

DL Christensen
Table 1 Nutrient intakes and major food sources of nutrients of Kalenjin runners (n 12) as a percentage of daily energy intake. Data are expressed as mean values and ranges with their
standard errors (SE)a

250

Nutrition of Kenyan runners

of only 10 km at the time of our study, the intensity of

O2max.
their training was probably higher than 75% V
This is indicated by an earlier study on Kenyan runners, also including student-athletes based at Marakwet
High School, who trained at intensities between 72%
and 98% in nine out of ten training sessions18. It is
reasonable to assume that the very high training intensity elicits glycogen depletion to the same extent as
exercise of longer duration and lower intensity.
The most optimal glycogen replenishment after training is obtained within the first 3060 min after exercise19, due to initial post-exercise synthesis of skeletal
muscle glycogen that does not require the presence
of insulin20. Interestingly, we found that the Kalenjin
runners were fed breakfast and dinner immediately
after their early morning run and late afternoon training
session, respectively5, indicating optimal conditions for
skeletal muscle glycogen replenishment. Furthermore,
maize has a high glycaemic index21, and as this food
source was consumed at almost all main meals and
alone made up 64% of total energy intake, the glycogen
resynthesis conditions may be close to perfect for the
adolescent runners while based at the boarding school.
Intakes of protein and essential amino acids
There is disagreement in the research literature concerning the protein intake necessary for an endurance
athlete. Using amino acid oxidation, nitrogen balance
or metabolic tracer methodology, several studies2224
but not all25,26 indicate an enhanced protein
requirement of greater than the 0.8 g kg21 body
weight per day recommended by the Food and Agriculture Organization/World Health Organization/United
Nations University (FAO/WHO/UNU)27. In a study
using strict energy balance control, Forslund et al.28
showed that an increased energy turnover after aerobic
exercise was not due to increased rates of urea
production and/or protein synthesis. In our study on
adolescent Kalenjin runners, the total daily protein
intake was 1.6 g kg21 body weight, or twice the
amount recommended by FAO/WHO/UNU27. This
was higher than the amount suggested by studies that
investigated the effect of aerobic training on protein
oxidation and protein requirements23,24,29,30, indicating that the total protein intake of the Kalenjin runners
was more than sufficient to cover their needs. High
intakes of total protein were also found in the studies
of elite Kenyan runners1 as well as ultra-distance
Mexican runners13. Thus, for runners based in
developing countries, including Kenyan athletes,
there was no malnutrition at the total protein level.
While the total protein intake was adequate, the
intake of essential amino acids, especially isoleucine
and histidine, was low to borderline among the adolescent Kalenjin runners5. This is based on the fact that

251

adolescents are growing and therefore have higher

needs than adults. However, currently there are no recommendations on essential amino acid requirements
for the adolescent age group above 12 years of age
and younger than 1827. The deficit of some essential
amino acids could be a limiting factor in performance,
but it is also possible that a physiological adaptation to
low essential amino acid intakes has taken place, in
which a high protein turnover has resulted in an
enhanced re-utilization of essential amino acids5.
Such a physiological compensation might have been
necessary only for limited periods throughout the
year, since the runners were supplied with extra
milk prior to important competitions, thereby adding
extra isoleucine and histidine as well as other essential
amino acids to their diet.
Physiological adaptation to low energy
intake?
The first diet study including Kenyan elite male runners reported a very low energy intake (9790 kJ)1.
Unfortunately the authors did not report data on
energy output during the study period, which covered
six days over a three-month period. This makes it
impossible to verify energy balance. But even at an
estimated low body weight of 5560 kg, there is not
much energy left for training at the elite level assuming
the runners are in energy balance. It is therefore
tempting to theorize that these runners had adapted
physiologically to low energy intakes in order to
carry out their high-quality and -quantity training as
reported by Saltin et al.18. However, one has to
approach such a theory carefully, especially if chronic
undernutrition is assumed to take place. Only during
the first 23 weeks of energy restriction does a
marked decrease in basal metabolic rate (BMR) occur
that can be attributed to an increase in metabolic efficiency of the active tissue mass (for a recent review,
see Shetty31), and hence an indication of metabolic
adaptation. With continued energy restriction, however, any further decrease in BMR is accounted for
by the loss of active tissue (i.e. protein)31. The latter
seems very unlikely considering the quality and quantity of training required at the elite athlete level.
This is supported by several studies showing that
O2max and maximal aerobic power were reduced in
V
undernourished compared with well-nourished young
adults3234. Marginally undernourished adolescents
in Brazil working on a cycle-ergometer showed
uncompromised gross mechanical efficiency35. However, this was achieved at the expense of a higher
percentage of their maximum work capacity,
i.e. higher heart rates for the same level of oxygen
consumption. The blood lactate levels were also
higher during exercise35. The same compromising

252

physiological response could not be seen when adolescent and adult elite male Kenyan runners were compared with Scandinavian elite male runners in Kenya
(altitude) and Denmark (sea level) during treadmill
tests in the laboratory18. Furthermore, the study on
Kalenjin runners dietary intake carried out by our
group showed that the runners were in energy balance
based on measurement of energy intake and an estimate on energy output over a two-week period5.
Based on the above, this author therefore suggests
that Kenyan elite runners are in energy balance at
least during times of heavy training and competition,
and at worst temporarily undernourished.

DL Christensen

van Hall, Leif Hambraeus, Henrik B Larsen and Bengt

Saltin. This work was supported, in part, by grants
from the Team Denmark Research Foundation.
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1
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3
4

Conclusions
Distance runners from Kenya consume a diet based on
a small range of food items primarily of vegetable
origin that has been shown to provide sufficient carbohydrate and total protein intake for endurance athletes. Only essential amino acid intake may be in the
low to borderline range, at least for limited periods
of time. Based on the two studies published so far
on the dietary intake of Kenyan runners there is controversy concerning their energy balance. However,
this author suggests that the diet provides for energy
balance, and at worst temporary undernourishment,
otherwise training and competing at the elite level
would not be possible. It is important to keep in
mind that sophisticated dietary studies (for example,
using tracer methodology) carried out in the laboratory have not been done so far for Kenyan runners.
The discussions in this paper concerning the physical
performance of Kenyan runners have therefore been
based on extrapolations of results from other studies
done in laboratory environments. It is hoped that, in
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intake and performance. This way we will acquire a
better understanding of the quality of local diets in
the developing world, and add to our knowledge of
potential physiological adaptation mechanisms in
general among athletes with a high habitual daily
energy turnover.
Acknowledgements
The author is grateful to the runners, athletics coach
Samson Kimobwa, the cooking staff and school
administration at Marakwet High School in Kenya for
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