Prioritizing Wellness
- U.S. Olympic swimmer Katie Ledecky, who initially chose not to go public with her blood disorder diagnosis of Postural orthostatic tachycardia syndrome (POTS), has shared how she eats well and prioritizes nutrients to maximize her practice sessions.
- Postural orthostatic tachycardia syndrome (POTS), according to John Hopkins Medicine, is a disorder of the autonomic nervous system and a very common diagnosis, as the condition affects approximately one to three million Americans.
- As per the Dietary Guidelines for Americans 2020–2025, a healthy eating plan consists of fruits, vegetables, whole grains, fat-free or low-fat milk and milk products, a variety of protein foods, and a diet low of added sugars, sodium, saturated fats, trans fats, and cholesterol.
- It’s also important to understand that being overweight or obese is clearly linked to an overall increased risk of cancer, according to the American Cancer Society. One of our experts say “losing weight is a great way to reduce one’s risk” for cancers.
Ledecky—who previously kept her blood circulation disorder known as Postural orthostatic tachycardia syndrome (POTS) private to avoid any distractions, something she shared in her memoir “Just Add Water: My Swimming Life”—spoke with Eating Well in a recent interview about how she chooses to nourish herself.
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“It’s constantly fueling and trying to be ready for the next workout, to make sure that I can stay on top of everything that I need,” explained to Eating Well.
As for what she chooses to eat on a daily basis, Ledecky admitted that once she discovers something successfully fuels her before and after practice, she’ll “stick with it.”
She said, “I found that with my omelet that I make myself in the middle of the day. Of course, I mix up what vegetables I’m throwing in my omelet or what kind of toast I’m having, but for the most part, I get into a routine and I’ve found what works.
“I would say the only thing I really switch up every day is dinner.”
Ledecky also noted that she now enjoys “learning about what fuels my body the best.”
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Referring to how she hydrates, she said, “you can never have too much,” explaining further, ” I know what I need at this point, and I also live and train in Gainesville, Florida.
“It’s very hot and humid here, especially in the summer, so I really just have to keep up with my hydration. Core Power has electrolytes as well, so it really adds to that. I don’t have a specific number, but I always have water nearby and am just constantly hydrating throughout the day.”
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Ledecky, who recently competed at the Singapore 2025 World Aquatics Championships, said, “It’s pretty much the same competition as it is at the Olympics. I don’t know if people always recognize that. It’s not the Olympics, but it’s still a really big meet for us.
“It’s always an honor to represent Team USA as well, so I don’t take it for granted.”
In Singapore, Ledecky etched another chapter in her storied career, claiming her seventh world crown in the women’s 800-meter freestyle.
She swam impressively, fending off fierce challenges from rising Canadian star Summer McIntosh and Australia’s determined Lani Pallister.
Ledecky shared photos recapping the event on Instagram, writing alongside them, “Thank you Singapore for the memories and for putting on a great World Championships, and a big thank you to our @usaswimming coaches and support staff for all the hard work over the past month!
“Your passion and energy kept everyone moving forward. Thank you to my teammates, coaches, family, and friends for the continued support.”
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Ledecky’s Journey With Postural Orthostatic Tachycardia Syndrome (POTS)
Ledecky has explained in her 256-page book, a New York Times bestselling memoir, as per an E! News report last year, that prior to her POTS diagnosis, she experienced symptoms of lightheadedness and feeling “extremely hot” at a team dinner at the World Aquatics Championships in Russia about 10 years ago.
She initially dismissed her what she was feeling as being tired, until she was training for the 2016 Olympics in Rio de Janeiro and felt “weird.”
“I was swimming okay. But I was super inconsistent. I would have a couple of good practices, and then I would have a day or two when I had absolutely no energy. Some days I couldn’t walk around without dizziness. I remember wrapping practice and struggling to get back to the locker room,” she explains in her book, according to E! News.
“Every swimmer has peaks and valleys in training, but to be so strung out? My desire to work hard was there. I just had no juice. I kept wondering, Am I sick. And if so, with what?”
Her coach at the time was the one who advised her to see specialist at Johns Hopkins—ultimately leading to her POTS diagnosis.
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Ledecky said, “Because I have POTS, I pool blood in the vessels below my heart when I stand. My body then releases extra norepinephrine or epinephrine, which adds additional stressors on my heart, making it beat faster. Which, in turn, bring on dizziness, fainting and exhaustion
“The good news was that I could treat my POTS nutritionally. I needed to up my sodium intake and increase my hydration. Studies also show that reclined aerobic exercise, such as swimming and strengthening your core can provide relief. Which is kind of funny. What are the odds that the prescriptive exercise for my particular disease would be…more swimming?”
As for why she chose to keep her diagnosis private, Ledecky admitted she “didn’t want something quote/unquote ‘wrong’ with me to become the narrative around Rio or Team USA.
She added, “I wasn’t eager to become a distraction or to be distracted myself. I simply wanted to treat my condition as best I could and get back to going hard in the pool.
“Gradually, following doctor’s orders, I started feeling better.”
She also spoke with Self last summer, saying, “It feels good. It’s not like I was ever hiding it; it just never felt like it was something I needed to share. I’ve had it under control completely.
“I really just had to add salt to my diet and wear compression gear. Whenever I get sick and when I go to hot environments, I need to be especially careful to stay on top of my salt and hydration.”
She continued, “I thought it was important to tell my whole story, and that was a part of my story, especially leading up to the 2016 Olympics. It was a new thing that I had to acknowledge and be aware of, something that was always in the back of my mind.
“I wanted to share how that’s impacted me at different points and how I’ve been able to push through that and take control of that part and live a healthy lifestyle.”
Understanding Postural Orthostatic Tachycardia Syndrome (POTS)
Postural orthostatic tachycardia syndrome (POTS), according to John Hopkins Medicine, is a disorder of the autonomic nervous system and a very common diagnosis, as the condition affects approximately one to three million Americans.
POTS is described as a blood circulation disorder characterized by the following factors:
- Specific symptoms that occur often when standing up.
- An increase in heart rate from a horizontal to a standing position “of at least 30 beats per minute in adults, or at least 40 beats per minute in adolescents, measured during the first 10 minutes of standing.”
John Hopkins explains, “The symptoms of POTS include but are not limited to lightheadedness (occasionally with fainting), difficulty thinking and concentrating (brain fog), fatigue, intolerance of exercise, headache, blurry vision, palpitations, tremor and nausea.
“Researchers don’t fully understand the causes of POTS, but it is more common in women than men and is more likely to develop in adolescents and young adults.”
This condition is diagnosed by a 10-minute standing test or a head-up tilt table test, and people living with this can usually resolve their symptoms through combinations of diet, physical therapy, medicine, and other treatments.
Symptoms of POTS are different depending on the person, but may include:
- extreme fatigue
- lightheadedness when sitting or standing for a long period of time
- difficulty focusing
- heart palpitations
- nausea or vomiting
- headaches
- sweating excessively
Additionally, John Hopkins explains that symptoms may worsen in a hot environment and a lack of fluid and salt intake.
Recommendations for a Healthy Lifestyle
Although Ledecky didn’t battle cancer, her choice to be healthy and prioritize her nutrients and hydration, remind us how the experts we have spoken with have all made it clear that there is no “cancer diet,” meaning there are no guidelines that are recommended for every person with cancer.
The general recommendations for a healthy lifestyle are the same whether you have cancer or not. But Dr. Ken Miller, the Director of Outpatient Oncology at the University of Maryland Greenebaum Cancer Center, has some guidelines for cancer survivors who are concerned about a recurrence:
- Exercise at least two hours a week — and walking counts.
- Eat a low-fat diet. The Women’s Intervention Nutrition Study, which looked at early stage breast cancer patients, found that a low-fat diet was associated with reduced risk for cancer recurrence, particularly in those with estrogen receptor-negative cancers. Other studies have found that foods with a high glycemic index that are digested quickly and cause a spike in blood sugar may lead to tumor growth in lung cancer patients.
- Eat a colorful diet with lots of fruits and vegetables. The American Cancer Society recommends aiming for two to three cups of vibrant vegetables and fruits each day.
- Maintain a healthy weight. Studies have shown that being obese can increase your risk for several types of cancer.
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Dr. Andrea Tufano-Sugarman of NYU Langone Health explained to SurvivorNet the benefits of losing weight.
“While all cancers cannot be prevented,” she said, “losing weight is a great way to reduce one’s risk.”
Dr. Tufano-Sugarman said that this is especially true for women; they lower their risk of developing breast cancer and endometrial cancer when they lose weight and keep it of.
Even without losing weight, adopting a more nutritious diet can help.
“Food choices, independent of weight loss, may also help to reduce risk,” Dr. Tufano-Sugarman said.
“Research has shown that the Mediterranean diet (rich in fruits, vegetables, nuts and legumes, fish and olive oil) is associated with a decreased risk of cancer. Whereas diets rich in red meat may be associated with an increased risk of colorectal and prostate cancer.”
Additional research published in “Cancers” last year noted that “Physical activity has been shown to reduce the side effects of treatment and fatigue in cancer patients.”
“Lack of exercise actually begets fatigue,” Dr. Marleen Meyers, a medical oncologist and Director of the Cancer Survivorship Program at NYU Perlmutter Cancer Center, told SurvivorNet in a previous conversation about how to deal with some of chemo’s most challenging side effects.
“So the best treatment for fatigue is exercise. And what we have to do is get people over the hump, to get initial exercise going.” Dr. Meyers treats patients with breast cancer, but she said her advice applies to many other cancers as well.
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Contributing: SurvivorNet Staff
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