Last year, endurance dietitian and ultra-runner Alex Cook ran the iconic The North Face Lavaredo Ultra Trail race – 120km and 6000m of ascent – where she finished 6th GB female, despite suffering agonising knee pain on the descents.

Alex, whose day job as a dietitian includes working with elite athletes, has run more than 40 marathons and ultras, winning a myriad of them, including Race to the Stones and Endurance Life Snowdonia Ultra. We chat about her ultra-running experiences, sleep deprivation during Laveredo, and fuelling mishaps (even experts make mistakes!

How old were you when you started running?
I ran at school but started really getting into it when I was 19. Back in 1999, I decided to change degrees from Nursing to Sports Science. I had 9 months between courses. Someone at my gym was running the marathon running for a charity and out of luck his friend dropped out so I took their place! I raced my first marathon in London 2000.  When I started at Birmingham University I was lucky enough to be coached by the amazing Bud Baldaro who is renowned in the running world. He helped my confidence grow and my running progressed from there.  After London 2000 I managed to get Good For Age places.  I was hooked and 3 years later I earned a place on the championship start at the London marathon amongst the elite women. It was an amazing experience.

You started running ultra events in 2015 – and achieved three wins straight away! Did longer distances feel natural to you?
I decided to turn to ultra distance as I needed a break from chasing times and PBs. I had my children in 2010 and 2011. My husband was in the army and away on operations a lot, therefore I needed my running to be holistic and not about times and competing. I craved escapism and adventure. My last marathon had been Berlin in 2008, before I had my children, so I didn’t even know if I could complete an ultra-distance event let alone win.

My first race back – and first ever trail race – was the Endurance Life Exmoor marathon. I estimated I would be finished in 6 hours. I got in at 4:15 with a course record. Totally unexpected but of course that sowed the competitive seed again, giving me hope for my first ultra. I ran my first ultra two months later and was thrilled with a win.  I do think years of having a solid endurance base stood me in good stead for ultra-marathons.

You’ve run a lot of tough ultras. Is there one that sticks out as being most challenging?
I’d say they’ve had their own challenges for different reasons. My last ultra in October was in Exmoor. Despite winning it, it was a terrible race from the start. I was so unmotivated. This was not helped by the fact that it was the most disorganised race I have ever done. Signs going missing, check points not being open when I got there… cheese Doritos as food!

I was on my own for over half of the race and I actually stopped still on the coastal path wondering what I was doing and how I could keep going! I simply could not be bothered. My body was fine but my mind was not there. This is disastrous for an ultra as so much of it is mind over matter. I plodded on to the end and was very thankful to finish. I think it was this race that made me realise I needed to change my training for a while, get back to the road and pick my pace up away from the ultra plod for a bit.

You advise athletes on nutrition. During a race have you ever made any fuelling mistakes yourself?
Yes! Almost every race. No matter how much you practice in training, you always have to be prepared on race day; it’s unlikely to go 100 percent to plan, especially in ultra races when you’re on your feet for so many hours. I always go into a race with a strategy. I know exactly what I need to do, but you have to be flexible. I’ve ended up drinking meat broth – I’m a vegetarian – drinking coke when I normally hate the stuff and eating bread covered in salt!

At the Reading half-marathon, my plan was to have a gel at mile 5 and 10. It’s really hard to take on carbohydrate when your heart rate is high; by mile 11 I still hadn’t had my second gel. Despite feeling incredibly uncomfortable, I forced it down. It did give me strength for those last 3 miles. The point is, when you’re running races, you have no idea how your body will feel or react at that point to the environment. My advice is have plan but be flexible.

What’s your fuelling strategy for your ultras?
I tend to aim for anything between 30-50g carbs an hour depending on the distance. I know in a 50km race I can just about manage 50g carbs per hour which is generally achieved through a sports drink and a gel or bar each hour. For the longer stuff, it’s definitely less. I always use a sports drink as a base for all of my nutrition strategies. It covers all areas: carbohydrate, electrolytes, and of course hydration. On top of that, I’ll carry gels and chocolate bars as emergencies – Snickers are my favourite.

I also carry a small plastic bag which I fill up [with food] at each checkpoint and use this food between each checkpoint. I’ll try and fill it with a variety of savoury and sweet. During a longer race, it’s best practice to use check point nutrition as much as you can as it limits the weight in your backpack. For road marathons, I simply use gels, and water and sports drinks from the checkpoints.

Last year you completed the 120km Lavaredo ultra trail for the first time – how was it?
There were so many aspects of this race that were unknown to me: the distance, the elevation, the terrain, the county. However, it is the unknown that is exciting but also terrifying at the same time. I didn’t have a good period up to the race with illness and endless niggles so even making the start line was incredible.  So many factors that I simply could not train for.

Despite this the overall race experience was amazing. I think because I had reduced my expectations, every step felt like an achievement. I was just so thankful to be there and doing it finally. Although I did suffer knee problems, every point of that race was amazing. Yes, I did suffer at many points but I was so thankful to simply be there taking part.

The race started at 11pm. How did the sleep deprivation affect you?
I’m a creature of habit and tend to have the same sleeping pattern every night, apart from my children waking me up, so this was something I was concerned about. I knew I’d manage one night awake but would struggle if I was still running into the next night.

Starting at 11pm was quite exhilarating. As the night went on we were lucky to have clear skies. The air was so cold but so fresh it kept me alert. There were so many runners around me during the night, which helped keep me awake. I was literally buzzing for sunrise and the hope for this natural rise in cortisol everyone speaks of. The birds starting singing before we saw then sun. And then, slowly as the dark dissipated, the warm glow of the sun showed us all where we were. From within the forest I saw glimpses of the mountains. It did wake me up, and I did then push my pace on but the buzz didn’t last long.

By 9am I went through a really tough phase of sleepiness. A rare part of the race I was alone and hiking up another ascent. All I wanted to do was curl up on the side of the track for a snooze. My husband is a military man and I asked myself what he would tell me to do. He would say: ‘Move faster and stop feeling sorry for yourself!’ So I broke into a run giving myself a stern talking to at the same time. I got to the medical checkpoint and pleaded with them for coffee. I had banked on the fact that I was in Italy so everyone would have a supply, but no, only Coke! I had heard so many ultra-runners swear by this stuff during their races. I’d never tried it and kept thinking of the golden rule I tell my athletes: don’t try anything new on race day. However, any ultra runner will know sometimes need must. Rocket fuel it was! It fired me up and there started my cola addiction for the next 10 hours.

Physically, how did you prepare for running 120km and 6000m of ascent?
I’ve been distance running for almost 20 years, so I have a pretty good endurance engine as a base. What I needed to improve on was my strength so I would have the ability to withstand the brutal ascents, and more importantly for me, the descents. It’s not really the distance that is a problem for me in these races but the terrain. I live in the Chiltern hills, which is hilly but climbs and descents are no longer than 3-4 minutes compared to some in the race that could be up to an hour at least. I’m lucky enough to be a good climber but terrible at coming back down. All too often in races I pass runners on the up only for them to sail past me on the descents. This race was no different!

I followed an intensive strength programme which really made a clear increase in leg strength. However, nothing really beats training on the terrain you’re actually going to race on. From half-way into the race, I started experiencing incredible pain on the outside of my right knee on the downhills. I would power past people on the up and the come to a grinding halt and hobble at the top. My running poles became crutches. It was agonising and mentally tough. There were points where I thought I was beaten but I managed to adapt how I ran and descended with probably what looked like running with a peg leg! It looked strange but it got me round.

Mentally, do you use self-talk or any other strategies to help during times like this?
In ultras I have hour upon hour of self-talk and debate and inner monologue.  Endless strength trying to keep those demons from telling you ‘It’s too hard’. I took one step at a time and really made the effort to keep in the moment.  Each step was a step closer to success. It really helped.

In such a long race you can get overwhelmed with the thought that you have run 10 miles with 70 still to go! That is just mind boggling. I broke it down into checkpoint to checkpoint. I got to each one, refuelled, refreshed and set my mind to reaching the next one safely and in one piece. In races that long you can never take it for granted that you will reach the end, so breaking it down keeps you sane!

You worked with sports psychologist Dr Josie Perry ahead of Lavaredo – how did this help?
Naturally, I had a lot of anxieties leading up to this race. I think it was the fear of the unknown that was playing on my mind the most. Josie gave me coping strategies to be able to deal with any problems that arose when I was racing. There were many things I was worried about – bad weather, getting lost, injury, being alone, falling over. From working with Josie I had strategies in place to deal with all of these things if they arose. It made me feel in control of events that I felt I had no control over. I had a nasty fall 80km in and used her coping techniques to deal with it and carry on. Luckily, no injuries apart from a sore neck. The success of ultra racing is just as much about mind as it is body. Some say even more so. It was an invaluable time working with Josie and it really contributed to the success of my race.

What are the most common mistakes you see runners make around nutrition?
Two opposite ends of the scale. Number one, not having a plan in place and not practicing it early enough in training to get your gut trained to get used it. Number two, having a plan and sticking to it no matter what the race is throwing at you.

The key message is: make a plan 3/4 months away from your events as your long runs are starting to increase. Try different products and see what works for you. Once you have an established routine, practice it in every long run. However, when it comes to race day be prepared to be flexible. Don’t panic if you can’t manage what you normally can. Be flexible and listen to your body.

You have two young children – how do you fit training around work and family life?
It’s easier now they’re at school but it has been a struggle. When my husband used to go away a lot, I’d push one in the buggy and put the other on the balance bike and tie a rope around my tummy and pull her. I can’t do the mileage I probably need to do as a result of my time as a mum, but that’s OK. They’re my priority and I have to keep grounded for them.

I will always feel guilty leaving them to race or to do a long run at the weekend but I also do remember that it’s good for them to see me doing these things, pushing myself out of my comfort zone. Additionally, letting them see that I don’t always succeed even though I try my hardest and that is OK. I need them to know that we can’t always win, we can only be ‘our best’ and that is good enough.

What does a typical week of training look like for you at the moment?
I tend to do about 45-50 miles a week with at least one complete rest day a week. Monday is an easy run of about 45 minutes, plus 90 minutes of strength and conditioning set by my physio (and international marathon runner) Anna Boniface.  Tuesday, I do a speed session set by my club coach (Wycombe Phoenix Harriers), Matt Whiting. Wednesday is a medium-length easy run of 10-12 miles. Thursday is an easy 30 minutes and again S&C.

The rest of the week will either be an easy run and long run or a threshold/marathon paced session and long run. The difference in my training now is no more long slow plods. My long runs tend to consist of progression pace or marathon pace. This is tough, as I’m more used to backpack runs on and off on the trails for the day! It’s going well though, and I’m enjoying the change in training.

What’s next for you this year – any races on the horizon?
After my last ultra in October, I decided to have a break from ultras and trail [running] and get my legs running faster again. I still have a lot of business left with the marathon so I’m retuning to London this year after 16 years! One main reason is in memory of my wonderful coach, Robin Dixon. My last London marathon in 2002 did not end well. I hit the wall at mile 21 and collapsed into the arms of one the marshals. This marshal was Robin. I didn’t know him but he looked after me. He took me to St John’s Ambulance and when I had the all clear, took me on the tube back to the finish line where my parents were waiting. I thanked him very much and off he went.

When I moved to London in 2005 I joined a club called Thames Hare and Hounds. I turned up to my first track session and Robin was standing there. He was the coach. From that point he loyally supported me. We had a very special bond. When I got married I moved around the country a lot but he continued to support me as much as he could. My family finally got a posting back down South and I was so excited that I’d get to train with him again.

Robin, though, sadly fell very ill with a heart problem. I managed to see him in hospital the day before he died. He was never very keen on all this ultra running and wanted me to keep my speed and tackle the marathon again. I promised him that day I would go back to London and I would go for my sub 3 hours. So that’s what I’m doing in 6 weeks’ time. Running past mile 21 will give me strength as I know he will be there in spirit pushing me on. I WILL NOT STOP this time.

What are your favourite items of kit for racing and training?
I’m loving the Salomon road shoes at the moment. Salomon are known as a trail running brand but they’re moving into the road running world as well. I love racing in the Salomon Sonic RAs and I use the new Predict [shoe] for my easy recovery runs as they’re so comfortable. I’ve also just received the new Salomon XA shorts, which are perfect for races as they have space in the waist belt for 4-5 gels – perfect for the marathon when you don’t want to wear a hydration vest!

Are you sponsored by anyone right now?
I joined the Salomon ambassador team this year which is great fun. I love the brand’s philosophy of Time To Play. It really resonated with me as to why I really run. Yes, times and performance are important but actually what’s more important is time to be free, away from computers, work and stress. I’m also just on board with a RoadID. I feel very passionately about safety out running, especially when running alone. I really want to promote this and get people to think more about safety when they’re out.

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