Middlebury College Sports Medicine

Nutrition Handbook

The Middlebury College Sports Medicine Staff is dedicated to providing the highest quality of service to all athletes. With so many misconceptions and misinformation in the realm of nutrition we felt it necessary to provide our athletes with the appropriate information. .

This handbook contains current nutrition information and recommendations. The goal of this handbook is to give athletes some direction on proper nutrition, which may have a positive effect on their performance. Proper nutrition can impact each athlete in injury prevention, improved healing from any athletic injury and reaching optimal athletic performance.

Please keep this nutrition handbook for all four years of your athletic career here at Middlebury College. The Sports Medicine Staff will always be available to answer your questions and assist you with any concerns you may have.

Director of Sports Medicine Dave Matthews, MS, ATC

(802) 443-2315

College Physical Therapist Sue Murphy, PT, ATC

(802) 443-2315

Associate Athletic Trainer Kelly Cray, ATC

(802) 443-2315

Assistant Athletic Trainer Rachel Eldredge, MS, ATC, CSCS

(802) 443-2315

Assistant Athletic Trainer Emily Mathews, MS, ATC

(802) 443-2315

Team Physician Dr. Mark Peluso

(802) 443-5135

What is Nutrition?

Nutrition is essentially the nutrients one eats in order to fuel their body. The body cannot function without nutrients. Nutrients are found in both food and many beverages. The nutrients that are consumed are turned into energy for the body to use. This energy is used for such functions as basic breathing, digestion, etc., but is also essential for athletic activity.

Probably one of the most popular words associated with nutrition is diet. The actual definition of diet per Webster’s New World Dictionary is “ what a person or animal usually eats and drinks; daily fare”. When you examine this definition, diet is essentially the food and beverages a person consumes each day. An athlete’s diet should consist of plenty of nutrients to fuel their peak athletic performance.

The greatest confusion for most athletes is, “what is a proper diet for an athlete?” Everywhere we look there are new dieting gimmicks and supplements that promise increased energy, which translates into increased athletic performance. It is sometimes hard to discern what is proper nutrition for athletic performance and what are erroneous, unproven and harmful marketing techniques.

Through scientific studies we know there are six essential nutrients, carbohydrates, fats, protein, vitamins, minerals and water. The body will not function properly without all of the six nutrients. Finding a balance between all these nutrients will not only have a positive impact on your overall health, but also optimize your athletic performance. For instance, muscle cells are made up of 75% water and will not function efficiently if they are dehydrated. As these cells become dehydrated they induce cramping in the muscles and inhibit an athlete’s ability to perform. The Gatorade Sport Science Institute has proven that 1-2% dehydration can decrease one’s performance by 2-5%. This decrease in performance can be the difference between a win or loss.

Three of the essential nutrients carbohydrates, fats and proteins, are considered energy nutrients, meaning they contain calories that are converted into energy in the body. The next section gives a general explanation of each nutrient.

Carbohydrates

Carbohydrates are the sugars and starches found in breads, cereals, fruits, and vegetables, which, during digestion, are changed into a simple sugar called glucose. Glucose is stored in the liver as glycogen until cells need it for energy. Glucose is the body’s primary energy source. During high intensity, short-duration exercise (such as sprinting) and during high intensity, intermittent activities (such as field and court sports) carbohydrate (glucose) is the primary source of fuel/energy for the brain and working muscles.

Carbohydrates are broken up into two major categories. Complex carbohydrates, also known as starches include breads, cereals, pasta, rice, potatoes, fruits and vegetables. Then there are simple carbohydrates, also known as simple sugars, which include table sugar, honey, candies, sweets, cakes, soft drinks, some fruits, and fruit juice. Complex carbohydrates are best used throughout the day to keep energy at a consistent level. Simple sugars increase energy levels very quickly are best consumed prior to an increase in activity or right after long bouts of activity (practice or competition). Complex and simple sugars are ranked within the Glycemic Index as to what kind of affect they have on our blood sugar levels.

Glycemic Index and Glycemic Load

Within the glycemic index white bread with a score of 100 is the standard to which other carbohydrates are compared. The Gatorade Sports Science Institute has studied and broken foods into three different categories within the glycemic index with 100 being the highest score and 0 being the lowest score. They are broken up into high, medium and low glycemic foods. High glycemic foods increase blood glucose rapidly, increasing available energy. These are good right before and right after increased activity in order to be effective. They are most useful in sprint type activities where there are short bursts of energy released at a time or right after increase activity to increase recovery. The next level is the moderate glycemic foods. These foods raise blood glucose more slowly than the high glycemic foods and increase energy a at slightly steadier pace. They should be consumed at least 2 hours before increase activity in order to give the body time to break down the carbohydrates into energy. The last category is the low glycemic index foods. These foods increase blood sugar at a slower pace than the other two categories, but also sustain energy levels for much longer. These foods are best consumed on a regular basis, except for 2 hours before competition, in order to keep a steady level of available energy. The list below is only an example of what types of foods are found in each category.

High Glycemic Index Foods (70-100)
Raisins
Watermelon
Potatoes
Sports Drinks
Bagel, White
White Bread
Rye Bread
Honey/Syrup
Cherrios
Ice Cream
Pretzels

Moderate Glycemic Index Foods(59-69)

Grapes
Banana
Orange Juice
Mango
Green Peas
Rice
Whole Wheat Bread
Spaghetti

Low Glycemic Index Foods(55-under)

Apples
Oranges
Beans
Milk
Yogurt
Peanuts
9 Grain Bread

Fats

This nutrient has several different functions within the body. First fat works as an insulator and protector of our major organs. It also aids in the absorption of vitamins A, D, E and K, as well as assisting in hormonal regulations. Most importantly for athletes fats are the long-term energy source. There are three main types of fat: saturated, monounsaturated and polyunsaturated.

Saturated fats are primarily found in animal products such as butter, beef, pork, lamb, poultry and partially hydrogenated oils. These fats can increase the risks for high cholesterol, heart disease, and arterial disease. Only about 30% of an athletes’ fat intake should come from saturated fat. Mono and poly-unsaturated fats are found in corn oil, vegetable oils, canola oil and olive oil. These are considered the “GOOD” fats because they can help lower cholesterol, and reduce the risks of coronary heart disease.

Protein
Protein is the structural basis for all muscle tissue. In fact, your muscle tissue is about 72% water, 22% protein, 6% fat and other nutrients. They build, repair, and maintain all body tissues (muscles, bones, blood vessels, hormones and hair). Proteins are broken down during digestion into different amino acids. There are 9 essential and 13 non-essential amino acids. The body produces the 13 non-essential amino acids, but must get the other 9 essential amino acids from meat.

There are two types of dietary protein, complete protein and incomplete protein. Complete protein foods include lean meats, chicken, turkey, pork, fish, eggs and dairy products. These foods include all 9 of the essential amino acids. Incomplete protein foods are missing one or more of the 9 essential amino acids. These foods include beans, pasta, bread, nuts, soy products, vegetables and fruits. For vegetarians or people who don’t eat much meat, two or more of the foods in the incomplete category can be combined to make a complete protein containing all 9 essential amino acids.

Vitamins and Minerals

Vitamins and minerals are also an essential part of a healthy diet. They not only assist in optimizing athletic performance, but also aide in the healing process. Athletes are always looking for ways to heal faster in order to get back out on the playing field. By maintaining a balanced diet with plenty of vitamins and minerals an athlete can increase their ability to heal and even prevent some serious infections. Listed below are some essential vitamins and minerals that should be included in an athlete’s diet. Though it is popular to use a multi-vitamin supplement to cover the daily intake of essential vitamins and minerals, it is actually better to get these vitamins from the foods we consume every day. As with most things more is not always better, the body can only metabolize a certain amount of vitamins and minerals at a time. The body dispels any excess above what is necessary. However there are few vitamins like vitamin A that can be stored in the fat and can become a health risk if too much is stored at one time.

Vitamin A: This vitamin is most important because it promotes growth and repair of body tissues and help with bone formation. It also increases cells defense against infections. It is a must have vitamin for all athletes because it can assist in the healing of injuries and infection.

Vitamin D:This vitamin aids in the absorption of calcium, helping to build bone mass and prevent bone loss. It is most important to preventing stress injuries, such as in the shins and feet.

Vitamin C: This vitamin is probably one of the most talked about when fighting infections. It promotes healthy cell development, wound healing and resistance to infections.

Vitamin E: This vitamin is one of the most powerful antioxidants, which is needed for normal growth. It is also thought to protect against heart disease, some cancers and cataracts. It does this by protecting the red blood cells that feed oxygen to muscles from free radicals that are thought to cause some of these diseases.

B-complex: This group of vitamins includes thiamin, niacin, riboflavin, B-6, and B-12, which are all involved with cellular metabolism. They are key to energy output and without them the body would not be able to meet its energy demands, resulting in fatigue.

Calcium: This mineral is essential for developing strong bones and teeth. It also assists in blood clotting, muscle contraction and nerve transmission. Many athletes that sustain stress fractures lack proper calcium in their diet. For women this is especially important because calcium can also prevent osteoporosis.

Iron: This mineral is essential for red blood cell formation. Red blood cells carry oxygen to the muscles, which help to sustain muscle energy. Athletes with low iron may experience extreme fatigue and an inability to keep up with what they consider normal athletic activity.

Zinc: This mineral assists in protein synthesis, insulin utilization, carbohydrate metabolism and the absorption of the B-Vitamin complex.

Proper Hydration

Proper nutrition will not work without proper hydration. Nutrition is usually thought of as the food we consume, but it also includes what we drink. Water is the major component of the human body, accounting for 73% of lean body mass. In fact it plays a vital role in all body processes and functions, including: Cardiovascular function, Metabolism of nutrients and Body temperature regulation.

Drinking fluids before, during and after exercise is essential for top athletic performance. Unfortunately, athletes tend to underestimate the importance of fluid replacements as an integral part of their daily nutrition. Listed below are some general fluid replacement tips:

· By the time the body tells you its thirsty, it’s already dehydrated. The best way to drink a lot of fluids is to carry a PLASTIC WATER BOTTLE with you at all times. Fill the bottle with water or with a nutrient dense beverage (diluted fruit juices or commercial sports drinks)

· Caffeine and caffeinated beverages (coffee, tea, and soft drinks) and alcohol should be used with caution because they are diuretics, which can cause dehydration.

· Despite popular belief, drinking beer is not a good way to carbohydrate load. No alcohol should be consumed before or during an event.

· Potassium and sodium are two electrolytes that are lost in sweat. Their function is to maintain proper fluid balance in the body. During long and hard practices or games it is possible to deplete the body of these essential electrolytes.

· Avoid unfamiliar beverages the day of an athletic event. If you are not acclimated to a particular beverage, it may cause bloating, stomach cramps and diarrhea.

· You should consume beverages that taste great, does not cause stomach cramps or diarrhea and enhances absorption and performance; fluid intake is all a matter of personal preference; what works for one athlete may not work for another athlete.

· It is better to hydrate throughout the day and not just before increase activity.

Below is a chart for proper hydration before, during and after exercise.

NATA Hydration Guidelines

Reference: Casa, D. et al. Journal of Athletic Training 35(2): 212-224, 2000.

Eat to Compete. “The Athlete’s Sports Nutrition Program”; Fluid Replacements For the Athlete. Pg 4A-4D

Meal Spacing Guidelines
Morning Activity

Night before: High carbohydrate meal (Low to medium 
                    glycemic) Sufficient fluid intakes to maintain 
                    hydration; If not planning breakfast in AM, eat 
                    late night snack of low/moderate glycemic 
                    index foods;

Morning of: Light breakfast of complex carbohydrate foods; 
                 Allow at least 2 hours for food to digest; If not 
                 breakfast, eat snack (high glycemic) 1-2 hours 
                 before activity;

After activity: Always consume simple sugar foods of at least 
                   200-400 calories within one hour of activity; 
                   Replace fluid losses (20 fl oz. Water for every 
                   pound lost)

Afternoon Activity

Night before: High carbohydrate snack before bed of complex 
                   carbohydrate foods; Sufficient fluid intakes to 
                   maintain hydration

Day of: Eat hearty breakfast with high carbohydrate foods 
           (complex carbohydrate food) and lighter lunch;
           Allow at least four hours before activity;
           High carbohydrate snack at least 2 hours before 
           activity; Sufficient fluid intakes to maintain hydration;

After activity: Always consume simple sugar foods of at least 
                   200-400 calories within one hour of activity; 
                   Replace fluid losses (20 fl oz. Water for every 
                   pound lost)

Evening Activity

Night before: High carbohydrate meal (low to medium 
                   glycemic foods); Sufficient fluid intakes to 
                   maintain hydration;

Day of: Eat hearty breakfast with high carbohydrate foods as 
           well as a hearty lunch (complex carbohydrates) Allow 
           at least four hours before activity; Eat a light 
           meal/snack 2-3 hours before the event 
           (complex/simple sugar foods); Sufficient fluid intakes 
           to maintain hydration;

After activity: Always consume simple sugar foods of at least 
                   200-400 calories within one hour of activity; 
                   Replace fluid losses (20 fl oz. Water for every 
                   pound lost)

Reference:

Eat to Compete. Chapter 4: Protocols for Developing Diets and Meal Plans; Timing Meals with Event Protocol, pages 136-37.

Gatorade Sports Science Institue. Sports Science Exchange : Round table ; “Sports Foods for Athletes : What Works ?” Volume 9(1998) number 2.

Lafayette Sports Medicine. “Nutrition Handbook”.

Dining Hall Tips For the Athlete

Many athletes rely on the dining halls for at least a few of their daily meals. For some, selecting nutritious meals in the dining halls is a real challenge. Most of the food services offer a large variety of foods and beverages including salad bars, fresh fruit, fruit juices, fresh breads, bagels, whole grain cereals, pancakes, waffles, pasta, rice, beans, grilled chicken and fish, Mexican foods, stir-fry foods but with so much to choose from making the healthiest choices can be overwhelming. Therefore, creating nutritious meals in the dining halls requires just a little planning.

The following are ten dining hall tips:

1. Combine medium/high fat entrees with low-fat side dishes. For example…

· Combine cheese steaks, hamburgers, hot dogs, fried chicken or fish with rice, baked potato, baked beans, tossed salad, vegetables and /or fruit instead of French fries or onion rings.

· Enjoy an Italian sub, ham & cheese or roast beef sandwich with pretzels (hard or soft), salad, rice, pasta, and fruit instead of potato chips.

· Eat your eggs/omelet with whole grain breads, muffins, cereals, pancakes, waffles and/or fruit instead of bacon, sausage and greasy home fries.

1. Replace high-fat condiments (regular cream cheese, butter, sour cream, mayonnaise and salad dressings) with low/non-fat condiments (low-fat and non-fat cheeses, sour cream, mayonnaise, salad dressings, jams, apple butter, honey, syrup, mustard, salsa and ketchup.

1. Drink, non-fat 1% or 2% low fat milk instead of whole milk!

1. Drink more nutrient dense beverages (milk, orange juice, grapefruit juice, apple juice, and cranberry juice) and less “empty” calorie fruit punches, sweetened ice tea and soft drinks.

1. Dessert eaters try low fat frozen yogurts, sherbet, fresh fruits, oatmeal cookies and muffins instead of high fat desserts (cakes, and cream filled and nut covered chocolate candies)

1. Try to trim beef, pork, chicken, turkey and fish of all visible fat (marbling, skin and breaded coatings).

1. Avoid cream and cheese sauces, soups, toppings and casseroles. Instead select red/tomato sauces, soups and casseroles (marinara sauce over pasta, chicken and meats).

1. Eat salads made with regular mayonnaise sparingly (egg, tuna, shrimp and chicken salads). A serving of these salads made with regular mayonnaise may contain more than 50% fat calories.

1. Fill two-thirds (2/3) of your breakfast, lunch and dinner plate with nutrient dense high carbohydrate foods (fruits, vegetables, whole grain breads and cereals, rice, pasta and baked potatoes).

1. Remember “VARIETY IS THE SPICE OF LIFE”

Healthier dining hall items include: Whole grain cereals (Wheaties, Total, Cheerios, Raisin Bran, Special K, etc.) breads and muffins, bagels, English muffins, pancakes, waffles, fresh fruit and fruit juices, grilled lean meats, pork, poultry and fish, rice, beans, pasta, baked potatoes, fresh green salads, yogurt, chicken & beef stir-fry, chicken fajitas, turkey, chicken and lean roast beef deli sandwiches (preferably use mustard, low-fat salad dressings and mayonnaise, vegetable oils and vinegar).

Consume sparingly: Fried/batter coated chicken and fish, fatty meats, hot dogs, hamburgers, cheese and cheese filled entrees/casseroles, regular mayonnaise, cream cheese and sour cream and butter.

Reference: Eat to Compete. “The Athlete’s Sports Nutrition Program”; Dining Hall and Menu Tips. Pg 13A-13D

Choosing Foods for Performance

The chart below will help you when making general food choices to optimize your performance. From prior information you know that decreasing intakes of sugars while increasing fiber is ideal for increasing performance. Also, controlling levels of fats would be prudent for health and performance.

The foods listed below are split into three categories based upon their fiber verses sugar content as well as overall fat content. Choose the foods that will best fuel your engine!!

OK Performers – Foods that will slow you down!! Try to limit or totally avoid these foods since they are high in fat and/or sugar.

• Biscuits, Croissants, Danish, Donuts, Muffins
• French fries, hash browns, onion rings
• Alfredo pasta, fried rice
• Regular crackers, croutons, potato chips
• Cookies, cakes with frosting, pies, milk shakes
• Marbled red meats, corned beef, ribs, breaded/fried meats, hot dogs, sausage/bacon, pepperoni, and bologna
• Whole milk, high fat cheese (brick)
• Cream cheese, sour cream
• Mayonnaise, butter, hollandaise sauce, regular salad dressing

BETTER Performers – These foods contain some levels of fats and sugars and would be ok to use occasionally.

• Corn bread, low-fat muffins, French toast, quick breads (banana/pumpkin/zucchini), pancakes, waffles, tortillas
• Reduced fat crackers
• Stuffing
• Oatmeal raisin cookies, yellow/white cake without frosting, pudding
• Whole eggs, lean red meats and pork (round and loin cuts), reduced fat cheese, Romano cheese/Parmesan cheese
• Low-fat sour cream, low fat mayonnaise, light dressings, olive oil, canola oil, ketchup

BEST Performers – These foods will really help you reach the highest levels of performance and health. Use these foods daily for the highest levels of fiber and/or low to no sugar content.

• Bagels, English muffins, breads/rolls (preferably whole wheat, rye, grain), Cheerios, Cream of Wheat, oatmeal, pasta, rice, baked potato/sweet potato, pita bread, tortillas
• Pretzels, Animal cracker, Newtons, ginger snaps, rye crisps
• Angle food cake, frozen yogurt
• Egg whites, beans, skinless poultry, fish, seafood/shellfish, tuna, tofu, Canadian bacon
• Skim and 1% milk, yogurt, cottage cheese, part-skim ricotta cheese, part-skim mozzarella/string cheese
• Fresh, frozen or canned vegetables, vegetable juice
• All fresh, frozen or canned fruits (canned in juice or water), dried fruit, baked apples

References: Lafayette Sports Medicine. “Nutrition Handbook”.

Eating On The Road

Most athletes will experience being on the road for some games or events. A few things must be kept in mind when eating on the road. Competition venues can be anywhere from an hour to many hours away. This can complicate a team’s ability to eat right on the road. Snacks on long trips may be appropriate to keep athletes energized. It is important to have snacks on the bus that the team enjoys, that way they are more likely to eat them. Also having water or sports drinks on the trip will also help to keep the athletes properly hydrated.

Good snack foods include:

• Apples, oranges, bananas, dried fruit
• Pretzels, whole wheat crackers, animal crackers
• Granola bars, trail mix, mixed nuts, cereal bars
• Water, Gatorade

Many times because of long travel times and the number of athletes, teams will choose to stop at fast food restaurants to eat either before or after competition. Though fast food is usually thought of as unhealthy, the good news is that many places have expanded their menus to include more nutritious foods.

The most important thing to consider when eating on the road is when are the athletes eating. If they are eating before the game or event they should eat about 4 hours before in order to allow for proper digestion. Also the athletes should be eating more moderate to low glycemic index foods that have a slower digestion rate and in turn will provide a more sustainable energy level through the whole game or event. If the team is eating after the game or event, it should be within an hour of the end of the game or event. When eating after the game the athletes should consume more high glycemic foods to replenish the glycogen (energy) that they used up during the game or event. This will increase their ability to recover, and is especially important if the team has another game or event the next day.

When eating at a fast food restaurant, try to follow the following guidelines:

· Allow ample time for digestion when eating before an event (at least 4 hours before activity)

· Have your recovery fuel within one hour after ending your activity

· Adjust your portions in conjunction with your needs – Super size is not needed!!!

· Ask for all sauces or gravies on the side to control your own portions

· Use a low-fat or low-calorie salad dressing

· Choose pizzas with thinner crusts and vegetables or lean meats

· Hold the cheese

Follow the charts on the following page to help guide your food choices when eating on the road.

Reference: Bonci, Leslie. “Fueling With Fast Food” Training and Conditioning. December 2001: 33-43

Nutritional Supplements

The FDA regulates dietary supplements under a different set of regulations than those covering "conventional" foods and drug products (prescription and Over-the-Counter). Under the Dietary Supplement Health and Education Act of 1994 (DSHEA), the dietary supplement manufacturer is responsible for ensuring that a dietary supplement is safe before it is marketed. FDA is responsible for taking action against any unsafe dietary supplement product after it reaches the market. Generally, manufacturers do not need to register their products with FDA nor get FDA approval before producing or selling dietary supplements. ^* Manufacturers must make sure that product label information is truthful and not misleading.

As for the NCAA, their position on supplements is “Neither recommend nor condone the use of nutritional supplements.” The NCAA Banded Substances List and the current NCAA Dietary Supplement Legislation as follows:

Proposal 99-72

Housing and Meals – Nutritional Supplements

16.5.2.3. Nutritional Supplements. An institution may provide only non-muscle building nutritional supplements to a student-athlete at any time for the purpose of providing additional calories and electrolytes, provided the supplement does not contain any NCAA banned substances

The NCAA states that the following Sports Foods/Supplements are permissible:

• Multivitamin/mineral
• Energy bars with <30% protein
• Calorie replacing drinks
• Electrolyte replacing drinks

The NCAA Banned substance list can be found in full text at the NCAA web site:

www.ncaa.org

The NCAA statistics show that 1-3% of all drug tests are positive. They also follow a very strict policy on positive drug tests and virtually have no second chances for those who do test positive. A copy of the Banned Substance List has been provided on the next page. Any questions or concerns should be discussed with your athletic trainer or physician.

Please consult your Sports Medicine department prior to trying/initiating any supplement use. Do not be fooled by the term natural and make sure you look before you leap!! Below are a list of web sites with good information on nutritional supplements.

www.ncaa.org

www.gssiweb.com

www.acsm.org

www.drugfreesport.com

www.mayoclinc.com

www.consumerlab.com

“The use of dietary supplements is completely at the athlete’s own risk”

Calories

Calories provide energy for the body to function, anything from blood circulation to playing sport. The body cannot function without calories. The number of calories in food is a measure of the potential energy it may contain. A number of factors determine how many calories a persons body needs each day. These include…

· Gender
· Age
· Body Weight
· Type of Exercise
· Exercise Intensity
· Exercise Duration

To calculate your daily calories to maintain your present body weight, refer to the following formulas and list of exercise/training activities. These formulas will provide you with an estimation of your daily caloric needs (within a range of 10% high or low). This calculation is your “maintain number”, the number of calories you need each day to maintain your present body weight.

· Males (body weight x 15) + exercise

· Female (body weight x 13) + exercise

Note… An athlete that has difficulty maintaining and/or gaining weight due to heavy training and /or a high metabolism (genetics) may want to multiply their body weight by 18 rather than 15 or 13.

The number of calories and athlete “burns” during exercise depends on the athlete’s body weight and the intensity and duration of the exercise. The following are a list of the approximate number of calories expended (burned) during one hour of various physical activities.

Reference: Eat to Compete. “The Athlete’s Sports Nutrition Program”; Dining Hall and Menu Tips. Pg 1B-1C

Weight Loss and Weight Gain

Weight Loss

In general, weight is a balance between your calories consumed and calories expended. The areas that impact this equation include age, height, gender, weight and activity level. There are occasions when weight loss is appropriate for some athletes; however this should be evaluated by your sports medicine team prior to initiating any weight loss program.

For the average athlete to lose 1 pound of body weight per week, they would have to deficit 500 calories per day. This deficit can come from either a decrease in caloric intake and/or an increase in daily activity. Athletes are better served investing their time and money into safe and effective training and nutrition programs that will promote good health and improved athletic performance.

Weight Gain

The opposite side of the previous equation is that an additional (approximately) 500 calories per day can result in a weight gain of one pound per week. However, weight gain strategies can often require more calories than this due to the demands of building structural protein/muscles which require/burn additional calories. Meaning for every pound of weight gain there will be additional calories required to maintain that pound. Some keys to gaining weight include: an appropriate strength training regimen, consumption of at least 500-1000 additional calories, adequate carbohydrate consumption, more than 6 meals and snacks per day (never skipping breakfast!!!) and overall consistency.

When discussing the topic of weight gain, most athletes may think that proteins are the key to weight gain success. However, carbohydrate balance remains the key to our cellular metabolism and this holds true for successful weight gain. We know that any excess amount of an energy nutrient (carbohydrate, fat, or protein) will be stored as body fat if not used functionally. Most all individuals can adequately achieve appropriate protein intakes with their daily intakes. The energy nutrient most often lacking for appropriate muscle building is the all-important carbohydrate. Think of proteins as the structural components of the car. You can have many pieces large and small that create the best car in the world – however; if you do not have gas for the finished engine then your car is not going to work!

Body Composition

Definitely more important than weight is one’s body composition. Our weight is made up of three components: lean muscle mass, body fat and body water. Our body water should be maintained at a level to achieve 50-60% hydration for women and 60-70% hydration for men. The component of body fat should not be very variable for most segments of the population and is more crucial to maintain a certain level for general body health. Lastly, lean mass (muscle) is the most variable mass for athletes and will evidently lead to an overall higher weight for athletes than the general population. However, this “weight” is also associated with an athlete’s speed, power, strength and overall performance.


Optimal Body Composition

             Women     Men
Essential 12-13%     3-5%
Healthy   17-24%     11-15%

References: Lafayette Sports Medicine. “Nutrition Handbook”.

Female Athlete Triad

Disordered Eating/Eating Disorders

Everyone at one point or another has participated in some form of disordered eating. This includes skipping breakfast, only eating certain foods or even going on a diet to lose weight. It means not having a nutritionally balanced diet. Athletes must be careful to make sure they are getting a balanced diet of nutrients. Though disordered eating starts out as a small thing for some athletes it can turn into an eating disorder.

There are two types of eating disorders; anorexia and bulimia. Anorexia is characterized by rapid and extreme weight loss, distorted body image and intense fear of becoming fat. An anorexic will resort to excessive exercise, the use of laxatives or diuretics and self-starvation to maintain thinness.

Bulimia is characterized by uncontrollable food binges followed with purging by self-induced vomiting. A bulimic may use excessive exercise, laxatives or diuretics or vomiting after meals to decrease the possibility of gaining weight.

Both Anorexia and Bulimia can be life-threatening conditions if untreated. If you are concerned for yourself or another teammate please contact your coach, team athletic trainer and/or Dr Mark Peluso. All information will be taken in confidence.

Amenorrhea

Amenorrhea is when women stop having regular menstrual periods. It is characterized by the deficiency of the female hormone estrogen. Amenorrhea is believed to cause a loss of calcium from the bones and may lead to a higher incidence of stress fractures. Generally it is caused by poor nutrition and is common among female athletes striving to maintain a body weight lower than what is ideal for her genetic make-up. All female athletes should keep in mind that amenorrhea is a serious medical problem and if not treated can cause stress type injuries that could keep them from competing.

Osteoporosis

If amenorrhea occurs and the production of estrogen is disrupted this can lead to osteoporosis. Osteoporosis occurs naturally in life as a woman’s level of estrogen decreases during the time of menopause. In this case, the lack of estrogen causes a sort of early menopause. This occurs because estrogen is crucial for the deposition of calcium in the bones.

Reversing the Triad

To reverse the progression of the female athlete triad one can use a combination of the following: decrease overall activity by 10-20%, increase daily nutrient intakes per body needs, use calcium supplementation of 1500mg per day, track menstrual cycles and consulting with your physician.

If the triad is allowed to progress, and is not reversed in sufficient time, the largest risk factor for female athletes is the development of stress fractures. Only a bone density scan would determine the presence of osteoporosis or osteopenia, the early stages of bone loss.

Eat to Compete. “The Athlete’s Sports Nutrition Program”; Eating Disorders & Amenorrhea: How can you help!. Pg 12A-B

Guidelines For The Use of Sports Foods


Electrolyte Replacement

Characteristics: 6-8% carbohydrates
Multiple carbohydrates with high glycemic index
Before Activity: Beneficial to increase glycogen stores 16 fl oz within one hour of activity
During Activity: 4-8 fl oz every 15-20 minutes
After Activity: 20 fl oz per pound of weight loss

High Carbohydrate Energy Drink

Characteristics: 6-8% carbohydrates
Multiple carbohydrates with high glycemic index
Before Activity: Beneficial to increase glycogen stores 16 fl oz within one hour of activity
During Activity: 4-8 fl oz every 15-20 minutes
After Activity: 20 fl oz per pound of weight loss

High Carbohydrate Energy Drink

Characteristics: Greater than 13% carbohydrates
Usually supplemented with B-Vitamins
Avoid those with herbs
Before Activity: 16 fl oz 2-5 hours prior to activity
During Activity: Not beneficial due to the need for digestion
After Activity: Immediately after activity as recovery fuel (200-400 calories within one hour after activity)

Sports Bars (Less than 30% protein)

Characteristics: Contain greater than 70% carbohydrates
High glycemic index
Minimal fat content
Before Activity: Efficient at least 2 hours prior to activity
During Activity: Not beneficial due to the need for digestion
After Activity: Efficient as recovery fuel (200-400 calories within one hour after activity)

Characteristics: Contain greater than 60% carbohydrates
High glycemic index
Fat should not exceed 25% of total calories
Protein not to exceed 15-20% of total calories
Before Activity: 16fl oz 2-5 hours prior to activity
During Activity: Not beneficial due to the need for digestion
After Activity: Efficient as recovery fuel (200-400 calories within one hour after activity)

Energy Gels

Characteristics: Contain greater than 50% carbohydrates
Avoid those with herbs
Before Activity: 1 packet prior to event
Consume adequate fluid to ensure absorption
During Activity: Maintain adequate fluid intake
At most, 30-60grams carbohydrates per hour
After Activity: Efficient as recovery fuel (1g per kg body weight)

ADDITIONAL RESOURCES

American College of Sports Medicine: (317) 637-9200 or www.acsm.org

Food and Nutrition Information Center: (301) 504-5719 or www.nal.usda.gov/fnic

USDA Recommendations and Food Pyramid: www.mypyramid.gov

Nutrition Counseling Education Services: (800) 445-5653 or www.ncescatalog.com

American Dietetic Association: (312) 899-0040 or www.eatright.org

President’s Council on Physical Fitness and Sports: (202) 690-9000 or www.sg.gov/ophs/pcpfs.htm

Home of the Glycemic Index (click on GI Database)

http://www.glycemicindex.com/

Reference:

Eat to Compete. Chapter 4: Protocols for Developing Diets and Meal Plans; Timing Meals with Event Protocol, pages 136-37.

Eat to Compete. “The Athlete’s Sports Nutrition Program”; Eating Disorders & Amenorrhea: How can you help!. Pg 12A-B

Reference: Eat to Compete. “The Athlete’s Sports Nutrition Program”; Dining Hall and Menu Tips. Pg 1B-1C

Reference: Eat to Compete. “The Athlete’s Sports Nutrition Program”; Dining Hall and Menu Tips. Pg 13A-13D

Gatorade Sports Science Institue. Sports Science Exchange : Round table ; “Sports Foods for Athletes : What Works ?” Volume 9(1998) number 2.

Lafayette Sports Medicine. “Nutrition Handbook”.

Reference: Bonci, Leslie. “Fueling With Fast Food” Training and Conditioning. December 2001: 33-43

Reference: Casa, D. et al. Journal of Athletic Training 35(2): 212-224, 2000.

Eat to Compete. “The Athlete’s Sports Nutrition Program”; Fluid Replacements For the Athlete. Pg 4A-4D