Tag: Diet & Nutrition

Dr. Taraneh Nazem, a reproductive endocrinologist and infertility specialist for RMA of New York, recently watched a TikTok video claiming that eating raw cacao daily could completely balance your hormones and cure PMS. “The creator made sweeping statements without any scientific backing, and the comment section was filled with people eager to try it—despite cacao’s known potential to cause insomnia and anxiety if consumed in large quantities,” says Nazem.

Social-media is rife with posts like this, pushing superfoods and supplements to boost your hormonal health and improve your low energy, poor sleep, bad acne, and so many other ills in the process. “Every day, another influencer on TikTok claims that superfoods can change our hormonal balance,” says Dr. Caroline Messer, an endocrinologist with Northwell Health at Lenox Hill Hospital in New York City. The myths that especially irk Messer: apple cider vinegar helps women with PCOS, green tea is the secret to better insulin sensitivity, and butter supports healthy estrogen levels.

Do you even need to “balance your hormones,” as many on social-media tout in their hashtags? Experts share what foods can—and can’t—do for your hormonal health.

The connection between diet and your hormones

The foods you eat can affect your hormone production and secretion by creating small changes throughout your gut, says Perri Halperin, a registered dietitian who is a clinical nutrition coordinator at Mount Sinai Hospital. Some foods also contain hormones or compounds that are similar to or imitate them. (For example, soy contains phytoestrogen, which mimics estrogen.)

But a person’s big-picture way of eating—not any single food included in their diet—is what can truly affect hormonal health, experts agree. “An unhealthy diet high in processed foods and saturated fats can lead to conditions like metabolic syndrome, diabetes, and polycystic ovary syndrome [PCOS],” says Messer. That’s because a diet high in sweets, dairy, refined grains, red meat, and processed foods can raise estrogen levels and promote insulin resistance due to higher body fat, she explains. Research has linked a Western diet with high estrogen in women, low testosterone in men, insulin abnormalities, and imbalanced cortisol levels.

Read More: You Don’t Need to Balance Your Hormones

It’s also possible to have hormone-based medical issues that can be helped by a dietary overhaul. Kaytee Hadley, a functional dietitian in Richmond, Va., recently worked with a young woman experiencing unpleasant gut symptoms along with irregular cycles, PMS, and ovarian cysts, which would rupture regularly and cause excruciating pain. “It was clear she had hormonal imbalances,” says Hadley. After running a few tests, it was also determined that she had nutritional deficiencies and poor gut health exacerbating these issues.

Hadley had the client focus on a “food-first approach” by adding more nourishment and gut-friendly foods, addressing her vitamin deficiencies, and developing a consistent eating schedule with foods she enjoyed. “In less than six months, she had no more symptoms of PMS or cysts, her acne cleared up, her cycles became more regular, she had more energy, and her bloating and gas were completely gone,” says Hadley.

But this success story doesn’t apply to the average person—and no “magic” superfood touted on TikTok can have these effects. It wasn’t, say, the beans or tofu she started eating more regularly that “cured” her sex hormone imbalances, but sweeping lifestyle changes that focused on a healthy diet, exercise, stress-reduction techniques, and improving her sleep, Hadley says.

Read More: 8 Eating Habits That Actually Improve Your Sleep

“While a single food won’t address the underlying cause of hormonal imbalances, nutrients are important building blocks for hormones and affect their production, transportation and elimination,” says Hadley. “If you aren’t getting the necessary vitamins, minerals and macronutrients, making positive long-term changes to your diet can help to optimize thyroid, stress and sex hormones.”

Others echo that outlook. Making lifestyle changes for the long haul can significantly improve hormonal issues. “But a teaspoon of apple cider vinegar or a cup of green tea won’t fix everything,” Messer says.

“This kind of misinformation can lead to unmet expectations and potential health issues,” says Nazem.

Hormonal health is often more about what you don’t eat

Consider testosterone, a sex hormone made from cholesterol. Some studies suggest that healthy sources of cholesterol such as eggs and avocados can support testosterone production, says Dr. Alex Robles, a reproductive endocrinologist at Columbia University Fertility Center. Other nutrients important for testosterone production include zinc, magnesium, and vitamin D.

But eating foods rich in these nutrients “likely won’t cause a massive boost to your testosterone levels,” says Robles. “Rather, the lack of these nutrients (or being deficient in them) can negatively affect your body’s ability to produce certain hormones.” (You may see on social media that zinc deficiencies are linked to low testosterone, but such deficiencies are uncommon in the U.S., where people regularly consume zinc from sources like poultry, beans, oats, eggs, and nuts.)

Read More: What Alcohol Does to the Gut

With testosterone and many other hormones, maintaining the right levels is more about what you don’t eat—too many processed foods, refined carbohydrates, and saturated fats, and alcohol—rather than putting a health halo on any one food.

What foods can help your hormones?

Most people do not need to stress about “balancing” their hormones through food or supplements. Your body does that complicated task for you, says Halperin.  “The truth is, [hormones] are incredibly complex, individualized, and they fluctuate,” she says. There’s no “magic bullet” that will create optimal hormonal health.

Messer agrees. While it’s true that foods can impact our metabolic health, our bodies are “pretty resilient,” says Messer, and individual food choices don’t usually create drastic hormonal changes. Eating a well-rounded diet rich in whole foods will cover your bases. 

However, certain foods can sometimes slightly influence your hormones. Here’s how.

Thyroid hormones

Thyroid hormones regulate energy levels, temperature, weight, and metabolism. Called triiodothyronine (T3) and thyroxine (T4), they are also involved in skin, hair, and nail growth.

“Chances are your thyroid and its hormones are working just fine, unless you have a diagnosed thyroid condition like hypo- or hyperthyroidism, for which you should consult a doctor for medication managed treatment,” says Halperin.

Foods that may help thyroid health

Including foods rich in minerals such as iron, selenium, zinc, and iodine in your diet may be beneficial for thyroid health. These include shellfish such as shrimp and oysters, seaweed, Brazil nuts (which are particularly rich in selenium), and fortified foods like iodized salt, cereals, and dairy products. 

Cortisol

The body releases cortisol when it’s physically or emotionally stressed (earning its reputation as the “stress hormone.”) Cortisol normally peaks in the morning to help you wake up and declines throughout the day so you can fall asleep at night. When this natural rhythm is disrupted, people tend to become fatigued, gain weight, and get sick more often. 

As with most hormones, to optimize cortisol levels, dietitians recommend eating a balanced diet and not restricting food intake, as severe calorie restriction may increase cortisol levels. (This is because not getting adequate energy from food and calories is stressful for your body.)

Read More: Should I Take Supplements to Sleep? What Experts Think

Another thing to note: When we’re stressed, our bodies use up certain vitamins and minerals faster. “Focusing on magnesium and B vitamins during these times is especially important for helping your body combat stress and rebalance cortisol,” says Hadley. As long as your doctor or dietitian isn’t recommending you take these supplements, the best way to get those is through a balanced diet.

Foods that may lower cortisol levels

Oily fish rich in omega-3 fatty acids, such as mackerel, may help lower cortisol levels. That in turn can decrease cortisol-sensitive symptoms like fatigue.  

Some studies have also shown that other omega-3 rich foods like avocado oil and dark chocolate may support healthy cortisol levels. Decreasing added sugar—by cutting out soda, for example—is also key for healthy cortisol levels.

Read More: For Better Well-Being, Just Breathe

Recently, a study showed that following a Mediterranean style diet lowers cortisol levels. In general, adhering to a plant-filled, nutrient-rich diet may keep cortisol in check. An ultra-processed diet composed of refined carbohydrates and sugary beverages can lead to a constant release of insulin, which can result in insulin resistance, weight gain, and inflammation. Because of this blood-sugar roller coaster, you can end up boosting cortisol, which Dr. Simran Malhotra, an internal medicine and lifestyle medicine physician in Bethesda, Md., says may worsen the vicious cycle of eating highly palatable but nutrient-depleted foods.

Melatonin

Often called the “sleep hormone,” melatonin promotes a proper sleep-wake cycle. “Healthy habits, like giving yourself time to wind down and not drinking caffeine or alcohol before bed, can increase melatonin production,” says Halperin. As with other hormones, what you avoid may impact levels as much as what you consume.

Foods that may help produce melatonin

Some studies suggest that tart cherry juice may increase melatonin levels, beneficially impacting both sleep duration and quality. And tryptophan is an amino acid that supports the production of melatonin. Tryptophan-rich foods include turkey, tuna, and quinoa. 

Serotonin

Scientists have discovered a close link between the stomach and the mind known as the gut-brain axis, a two-way communication system between the central nervous system and the enteric nervous system in our gut. Research indicates that 95% of the body’s serotonin—the so-called “happy” hormone that plays a key role in mood—is produced in the gut. 

Foods that may boost serotonin levels

Tryptophan is a key protein building block used to make serotonin. “Meats such as turkey are rich in tryptophan, but our bodies struggle to convert it to serotonin due to competing amino acids,” says Malhotra. Scientists have found that high-carbohydrate meals help by triggering insulin, which aids your muscles absorbing the competing amino acids; this makes it easier for the tryptophan to cross into the brain and boost serotonin levels, she explains. “That’s why a high animal-protein diet can limit serotonin production, whereas tryptophan-rich whole-plant foods such as oats, walnuts, pumpkin seeds, tofu, spinach, and dark chocolate (more than 70% cacao) can boost serotonin levels and promote feelings of calm,” explains Malhotra.

What about “fertility” diets for women?

Sex hormones like estrogen, progesterone, and testosterone impact fertility for men and women in different amounts. On social media, the so-called “fertility diet” is presented as a way for couples (especially women) who are trying to conceive to improve their chances. Experts like Nazem believe that while some aspects of these diets are rooted in scientific evidence, others are exaggerated or lack sufficient scientific evidence. “It’s essential to approach such diets with a critical mindset and understand that individual health and fertility depend on a complex interplay of various factors,” she says.

While there’s no one-size-fits-all approach to eating to optimize fertility, reproductive endocrinologists—doctors who specialize in hormonal health as it relates to fertility—tend to endorse eating a fiber-rich, whole foods diet. Sound familiar? That’s because it’s the same research-backed eating approach science says is best to promote overall health, such as through a Mediterranean or plant-based diet.

Read More: The Silent Shame of Male Infertility

One key reason these diets are so healthy is because they emphasize fiber. “Fiber from fruits, vegetables, beans, and whole grains not only helps to keep you regular, but it is also important for maintaining healthy estrogen levels,” says Hadley—a sex hormone that can negatively affect fertility if it’s too high. The nutrient acts like a broom to sweep excess estrogen out of the body through bowel movements. Large-scale, longitudinal studies have also shown that women who eat more fiber have a reduced risk of breast cancer. 

Nazem counsels female patients to focus on foods rich in antioxidants, healthy fats and folate to support hormone balance and improve egg quality. “Avocados, nuts, seeds, leafy greens and whole grains are excellent choices,” she says. She’s also a fan of flax seeds and cruciferous vegetables such as broccoli, cabbage, and cauliflower; they all contain phytoestrogen, which can improve estrogen metabolism.

The bottom line 

For Hadley, the key takeaway is that making nutrition changes for the sake of your hormones should only be done based on your body’s unique needs. “While there are foundational strategies that anyone can implement, knowing what’s going on with your hormones will allow you to take a more individualized approach and address those imbalances specifically,” she says.

The body is incredibly smart and likes to maintain equilibrium, so unless you have a diagnosed hormone condition, Halperin says there is a good chance your hormone levels are where they need to be. “Small dips or spikes in hormone levels can cause unpleasant symptoms like difficulty losing weight or sleeping, but can generally be managed through a balanced diet, regularly scheduled meals and snacks, weight maintenance, adequate sleep, and stress management,” she says. “If you’re living your best life, but still not feeling your best, your actual best bet is to get checked out by your doctor or RD, versus believing what you see and hear on social media.”

About 1 in 3 Americans say they’re sleep deprived, and these deficits are linked to serious illnesses like heart disease, stroke, diabetes, cancer, and depression. Certain patterns of eating could lead to more nightly rest, translating into healthier, more satisfying lives.

Good sleep also stabilizes the body’s hunger hormones for less impulsive snacking the next day. “It’s a cycle,” says Marie-Pierre St-Onge, an associate professor of nutrition and director of Columbia University’s Irving Medical Center of Excellence for Sleep and Circadian Research. “If you eat better, you’ll sleep better and be more refreshed. And that helps you make better decisions for your diet.”

Here’s what to eat for better sleep.

Have tryptophan the right way

Key to improving nighttime rest is picking an eating regimen with plenty of compounds that promote sleep. This doesn’t come down to any one food or ingredient. “It’s more of a holistic profile with various helpful components,” St-Onge says.

One of those is tryptophan, a building block of protein. The body doesn’t make any of it. Rather, we get tryptophan from food: yes, turkey, but also fish, eggs, yogurt, and nuts like walnuts, among other examples. Once eaten, tryptophan passes from the blood into the brain and becomes melatonin, the hormone that triggers sleepiness for nighttime shuteye.

There’s a hiccup, though: not much tryptophan enters the brain if other substances are competing to get in. But when we pair foods that have tryptophan with healthy carbohydrates, such as lentils or fruits, the cells throughout our bodies gobble up the competitors, clearing tryptophan’s path.

“We need tryptophan in combination with carbohydrate-rich foods,” says Arman Arab, a postdoctoral fellow at Harvard Medical School who specializes in nutrition.

The Mediterranean diet is one regimen loaded with both tryptophan and healthy carbs—those with plenty of fiber. Like carbs, nutrients such as zinc, B vitamins, and magnesium play key roles in converting tryptophan into melatonin for better sleep, and the Mediterranean diet delivers each of these components. Spinach, barley, and whole wheat are great mates for tryptophan-rich foods. Arab recently found that people who follow the Mediterranean diet have better sleep quality and less insomnia. St-Onge has researched similar associations.

Avoid foods that cause inflammation

An ideal diet leaves out foods with substances that could spoil your slumber. They include less healthy carbs like low-fiber, high-sugar cereals, bagels, and fruit juices. People who eat unhealthy carbs tend to wake up more frequently overnight, according to St-Onge’s research. 

When frequently consumed, foods high in saturated fats (for instance, beef and chicken with the skin) also contribute to sleep problems. 

A common denominator between unhealthy carbs and saturated fats is that they both produce inflammation across the body, an issue linked to lower sleep quality and duration, Arab says. A diet packed with these foods may also lead to excess weight gain, which can cause sleep apnea and pressure on the diaphragm, further disrupting sleep.

Read More: Should I Take Supplements to Sleep? What Experts Think

People can use the Dietary Inflammatory Index to score their daily consumption of inflammatory foods. Scores improve with plenty of healthy, unsaturated fats, like the ones in salmon, nuts, and seeds. These foods are anti-inflammatory and prevalent in the Mediterranean diet—another reason this diet promotes sleep. 

Having a wide variety of fruits and vegetables is optimal, says Erica Jansen, an assistant professor of nutritional epidemiology at the University of Michigan. The diversity can “spread out exposure to any one toxicant” such as pesticides or heavy metals—which may disrupt sleep—and it ensures plenty of polyphenols and micronutrients that support sleep partly by lowering inflammation. Jansen found that when women increased their daily fruit and vegetable consumption by three servings, they dramatically improved their sleep quality and insomnia symptoms.

Try other approaches with sleep “superfoods”

Although the Mediterranean regimen is backed by the most research, other approaches could be just as beneficial if they offer the same sleep-promoting nutrients and compounds. Aim for diets with many vegetables, lower-sugar fruits, plant-based proteins, and unsaturated fats. “Such patterns probably influence sleep in the same way” as the Mediterranean approach, St-Onge says.

These strategies include the USDA’s Healthy Eating Index and the Dietary Approaches to Stop Hypertension diet, or DASH. Arab didn’t find a strong link between DASH and having fewer insomnia symptoms, but some other research suggests it’s helpful. The Chinese Healthy Eating Index, another eating pattern with many sleep-supportive ingredients, is also associated with good sleep.

Some effects differ across individuals, so plug-and-play items to find what boosts your sleep, even if they’re not staples of a particular diet. A line of research points to Montmorency tart cherry juice, for example. It’s full of melatonin, as are kiwis, nutritional yeast, pumpkin seeds, edamame, tofu, and dairy products. 

Many ingredients high in fiber can also be found beyond the Mediterranean diet. These sleep-promoting foods include black beans, split peas, sweet potatoes, chia seeds, and flaxseeds.

Start eating early, stop eating early

Like most things in life, timing matters. Research shows that having meals too close to bedtime can hinder sleep. It’s important to wrap up eating for the day a few hours before turning in for the night. 

This final meal could feature a plant-based protein such as tofu—which is filling, contains tryptophan, and keeps inflammation low—and a healthy carb like chickpeas to support tryptophan’s passage into the brain. Time it 2-4 hours before bed; that’s how long it takes for tryptophan levels in the body to peak. 

Foods that are heavy or have too much sugar or spice, when eaten before bed, are especially likely to cause bloating, blood sugar spikes, and a night of tossing and turning, Jansen says.

Sleep is also disturbed at the other extreme: being really hungry at bedtime. To avoid this scenario, get a headstart on nutrition in the morning. “Wherever we look, individuals who have breakfast, sleep better,” St-Onge says. Keep the same timing each day as much as possible, Jansen adds. “Maintaining a consistent pattern is really important for sleep.”

Try the liquid loophole

There is an exception to the rule about wrapping up nutrition several hours before bed. Pouring through this loophole could be some of your favorite liquids. The research isn’t conclusive, but a variety of teas, such as chamomile and lemon balm, have relaxing compounds that seem to improve sleep, at least for some “super responders,” St-Onge says. Low-fat milk, rich in tryptophan, may help as well. “There’s no harm in trying them” about an hour before bedtime; they’re absorbed faster than food.

Melatonin supplements are another matter. While these pills may help with occasional bouts of insomnia or jet lag, even small doses “go beyond what’s needed for sleep,” an excess that may cause health problems with regular use, Jansen explains.  

Feed your gut bugs

Food affects the bacteria in the digestive tract, known as the microbiome, and the right bacteria may help reduce inflammation. In theory, “If we can improve our microbiota, it could reduce inflammation in the body and lead to better sleep,” Arab says. 

Some early research suggests that certain gut bacteria play a role in converting tryptophan into sleep hormones. A study in 2022 found that mice given prebiotics had more rapid-eye movement and other relaxing forms of sleep. According to a recent research review, consuming prebiotics and probiotics improves sleep quality in humans. 

Instead of probiotic supplements, though, eating yogurt, kimchi, and other fermented foods will support the microbiome as part of a natural, healthy diet. More research is needed on “sleepbiotics,” whether pills or food, to know their effect on slumber, Jansen says.

Be consistent

People who follow these dietary patterns regularly have better sleep outcomes than those who merely dabble in them, several studies show. Whichever sleep-promoting diet you choose, stick with it. For the biggest improvements in sleep, “make sure you have a healthy diet day in, day out,” St-Onge says. “Give it a week or two” before expecting to see benefits.

Have a vegetable before breakfast

The relationship between food and sleep goes both ways. Just as a healthy diet with sleep-promoting compounds leads to better sleep, better sleep leads to healthier food choices. By the same token, less sleep changes hunger hormones for worse decisions. “After sleeping poorly, you should be extra vigilant about a healthy diet to get back on track,” St-Onge says.

Jansen is a good example. With her one-year-old interrupting sleep, “I keep in mind that, because I was up all night, I’ll crave more energy-dense foods,” she says. “So I try not to give in to that.”

She also has a healthy breakfast to “get off on a good nutritional foot.” A related strategy when sleep-deprived is to begin the day with a veggie starter. When people have a salad or other vegetable before a carb-heavy breakfast, their appetites and blood sugar tend to be more stable the rest of the day. This could prevent a cycle of several nights of bad sleep and poor nutrition. “You can break the cycle,” St-Onge says.

This Independence Day, competitors at Nathan’s Famous hot dog eating contest may gulp down as many as 76 wieners in about the time it takes to read this article. Like ultramarathoners hoofing 50 miles or football players shaking off big hits, “speed-eating” entails natural resilience, dedicated training, and serious risks to health.

Some may see the annual Coney Island, N.Y., contest as an act of defiance, capturing the holiday spirit. When the British taxed our sugar, we fought for independence. When modern-day doctors tell us to eat fewer carbs that turn quickly into blood sugar, we devour as much as possible on ESPN—and walk away seemingly unscathed. 

But this gastric rebellion could damage the body, during competition and over the long haul. 

A dangerous trek through the body

Mouth

Competitors typically fast before the event, says Miki Sudo, the winningest female champion in the history of the sport with nine Nathan’s titles in the women’s division. “You want the stomach to be empty and hungry” on gameday, she says.

After a rousing national anthem, a horn signals participants to eat as many hot dogs as possible in a breezy 10 minutes. Thus begins a blur of chewing and swallowing with a physicality that’s half-shark, half-snake. According to the ESPN documentary series 30 for 30, competitors train to strengthen their jaws so they can rip apart food with fang-like efficiency and desensitize their gag reflexes to gulp large pieces that would make the rest of humanity retch.

Esophagus

Just five seconds into this self-proclaimed “Super Bowl of competitive eating,” bits of hot dog arrive in the esophagus, the tube that goes to the stomach. Because they’re not chewed enough, though, chunks can slide into the airway, which can cause choking. Paramedics stand ready to assist, but across all speed-eating contests, choking is the biggest risk, and can result in death.

Read More: Why Your Diet Needs More Fermented Pickles

As hot dogs accumulate in the body, so do more risks. The stomach can’t accept the food as fast as it’s coming, so it piles up in the lower esophagus. This traffic jam could cause the food to come back up forcefully, which can lead to choking, rips in the esophagus, and surgery to fix them, says Dr. David Metz, a retired professor of gastroenterology at the University of Pennsylvania who has studied the effects of speed-eating.

Stomach

In just two minutes, some participants may have already packed ten hot dogs into their stomachs. To accommodate this barrage, the stomach begins to expand. Normally, our stomachs enlarge like a balloon, with greater pressure as the meal goes on—and this pressure triggers a newsflash to the brain that we’re full. But speed-eaters have trained with increasingly large food quantities to increase the elasticity of their stomach, so it stretches more like spider silk. Without the same pressure build-up, their brains receive no “drop your hot dog” message—only the crowd’s roar to keep gorging.    

Small intestine

Seven minutes into the contest, some pioneering pieces of hot dog have already raced through the stomach to explore the small intestine, an organ dedicated to further digesting food and absorbing nutrients. However, this important job may be sabotaged when dealing with as many as 22,800 calories in a single meal.

One issue is that way too much glucose—the broken down form of all those hot dogs, especially their buns—could get dumped into the small intestine, Metz explains. The influx would send the body into panic mode as it seeks to avoid organ damage. This stress response, known as “dumping syndrome,” involves heavy sweating, rapid heartbeat, nausea, and diarrhea.

More research on dumping syndrome is needed, Metz says. For his study, Metz took X-ray images of one speed-eater in action and found that rapid feasting was enabled by “remarkable” stomach expansion, not by food dropping quickly into the small intestine to make room for more. This suggests dumping syndrome may not be a risk, though some competitive eaters report symptoms of the syndrome, such as profuse sweating.

Read More: Why You Sweat So Much at Night—And What to Do About It

Another problem: many hot dog pieces stay mostly undigested even after making it through the stomach’s churn, says Kathleen Melanson, a professor of nutrition and director of the Energy Balance Laboratory at the University of Rhode Island. These chunks may be fermented by bacteria in the small intestine, which could cause bacterial overgrowth, Melanson says, leading to abdominal pain and diarrhea, among other symptoms.

Examples of debilitating symptoms, such as severe pain requiring a five-day hospitalization, have been documented, albeit rarely. “That doesn’t mean more haven’t happened,” Metz says. Not helping matters: the feast can stay in the digestive tract for multiple days before it’s finally expelled.

Destined to devour 

Thinking you can eat scores of hot dogs because you saw it on TV is like trying to climb El Capitan without ropes because you saw Free Solo. “No one at home should try this,” Metz says.

Professional gluttons gradually increase their intake of food over long periods of time. (They do not practice by chugging water, which can lead to brain swelling.) “There’s clearly a training effect,” says James Smoliga, a sports medicine researcher at Tufts University. He found that elite competitive eaters reliably enhance their performance with years of practice, such that their rate of scarfing resembles grizzly bears.

The improvement likely builds on physiologies uniquely suited to speed-eating, Smoliga says. Sudo thinks she’s always had “natural stomach elasticity,” and Melanson notes that twin studies suggest some people are biologically faster eaters than others. This inborn “talent” could confer some protection from the harms. 

Unknown long-term harms

Far from being overweight, many speed-eaters appear healthy. “They’re physical specimens,” Metz says. “There are no physical side effects for me yet from doing this,” other than some discomfort and sweating right afterward, says Nick Wehry, who is a competitive eater ranked fourth worldwide (and Sudo’s husband). “Many of us have a love for fitness,” Sudo says—a passion reinforced by the desire to reduce the risks of competitive eating, she adds.

Whether this strategy will result in healthy aging is yet to be seen, since the “sport” (and the study of it) is relatively new. (Major League Eating, the body that oversees pro contests, including Nathan’s, did not respond to a request for comment about whether they track the long-term effects of competitive eating.)

One long-term concern is that their stomachs have permanently expanded, so they’ll never feel full again, no matter how much they consume. “We don’t know if or how you can train it back after you’re done competing,” Melanson says. To avoid obesity, former competitors could simply remind themselves to stop eating, without relying on their stomach’s signals. But this is “challenging and takes practice,” explains Melanson, who studies people trying to slow their rate of eating, which may help with weight loss and overall health. 

Eating champ Takeru Kobayashi may have disabled his stomach’s signals after decades of competition, according to the recent documentary Hack Your Health. “I overeat because I’m a competitive eater,” he says in the film. “When you eat too much, you don’t savor the taste or fully enjoy the smell of the food. You ignore your body’s signals, like fullness.”

However, Sudo and Wehry say that after many years of competing, they still have normal appetites. 

Read More: What’s the Least Amount of Sleep You Need?

A permanently stretched stomach could also result in gastroparesis, where the stomach takes too long to empty, resulting in chronic nausea, pain, and vomiting.

Tim Janus, a 47-year old ex-competitive eater who Metz has studied in scientific research, quit the sport in 2016 after 11 years “out of an abundance of caution” partly based on Metz’s findings about the risks. He was also concerned about the harms of throwing up following competition, a practice that he describes as widespread. “When you’re eating that much food, you can’t digest it all,” he says. “Your stomach is too full to move things along. Throwing up after the contest is a necessary part of the sport.” 

Janus tried to collaborate with other pro eaters to share and track their health to better understand the effects of competing, but he couldn’t rally their interest. He’s now a foreign service officer in Mexico City in good health. Most of his former competitors say they’re healthy, too, but he “didn’t want to continue and realize I made a mistake.”  

Speed-eaters may develop other illnesses associated with unhealthy diets, such as heart disease and diabetes. The American Medical Association has recognized speed-eating as an unhealthy practice. But Sudo and Wehry are trim and muscular. Their weights spike during contests but, afterward, they eat less than normal to recover their health. (Another incentive for fasting beforehand or after: belly fat can block the stomach’s expansion, some competitive eaters have found.) Wehry says he drops about 20 pounds in just a few days after contests. They say they avoid regurgitating food following competition. So do many other pro competitors.

Outside of competition, Sudo and Wehry exercise daily and eat nutritiously. Wehry estimates that 70% of his calories per year are highly nutritious; training and contests account for only 30%. His blood pressure is slightly elevated, but his cholesterol has actually improved since he started competing, he says. Sudo’s doctor has given her a clean bill of health. She gave birth without any complication at age 35. Even with the contests, “we still have a healthier lifestyle than 95% of the population,” says Wehry, a former competitive bodybuilder.

Another speed-eating couple, Rich and Carlene LeFevre, are longevity role models. After competing since the mid-80s, the LeFevres have reached old age in good health, Sudo says. (Rich is 80 years old.)

Can these speed demons eat their 9.25 cakes in eight minutes and have their health, too? Perhaps with the right genetics and behavior strategies, Melanson says. “You can’t assume it’s going to work for the general population.” Research suggests that other extreme competitors, ultramarathoners, are faring better than some scientists had expected, with many of them living into their mid-80s, Smoliga notes.

In addition to training as a dental hygienist, Sudo enjoys speed-eating for the thrill of competition and “putting on a good show.” At the same time, she and Wehry want long lives to watch their son grow up and meet their grandkids. “I’m going to do everything I can to stick around for a while,” Sudo says.