Up to Speed

Proper sports nutrition is a must for today’s competitive athletes, but myths and misconceptions on the topic abound. Here are the latest updates, from the top experts, on fueling for performance.

By R.J. Anderson

R.J. Anderson is an Assistant Editor at Athletic Management.

Athletic Management, 16.6, October/November 2004, http://www.momentummedia.com/articles/am/am1606/uptospeed.htm

When student-athletes at Georgia Tech go to the dining hall, they don’t just see friends and teammates as they fill up their plates. They also see a sports nutritionist hanging around—someone they can ask, "How’s my plate look?" Someone who might say, "You need more fluids with your meal," or "How about putting back those fries and grabbing an apple?"

Rob Skinner, the Director of the Sport Performance Center at Georgia Tech, is certified as a strength and conditioning coach and is also a registered dietician. The school also employs a staff sports dietician and uses Chris Rosenbloom, a well-known sports nutritionist, as a consultant.

Although Georgia Tech may be ahead of the curve in sports nutrition, most coaches and athletes want—and need—an increasing amount of advice on fueling for performance. But, because the field is evolving so quickly, it can be tough to keep on top of the most important trends. In addition, news about nutrition in the mainstream press is often not applicable to competitive athletes, making it hard to separate fact from fiction.

In this article, we’ll update you on the most important new ideas in sports nutrition that have come out over the past year. They include ways to both keep your athletes safe and boost their performance.

TEACHABLE MOMENTS
Whether you have a sports nutritionist on staff or not, one of the keys to improving performance through nutrition is educating your athletes about the topic. Many schools are finding, however, that the typical annual seminars and posters in the locker room just don’t do the trick, and so they are coming up with more creative methods for nutrition education.

At the University of Florida, Michelle Rockwell, Coordinator of Sports Nutrition for the Gators, meets individually with every freshman student-athlete and provides them with a personalized nutrition plan. "We sit down with every athlete and look at their class schedule, their training schedule, and any body goals they have," Rockwell says. "Then we look at what kinds of food they like to eat and where they like to eat, and put it all together in an individualized plan." The personalized plans tell athletes everything from when they should be eating to which types of foods and specific nutrients they should focus on in order to meet their energy needs and accomplish their goals.

Next, Rockwell works with the cafeteria staff. "I’ve asked them to label food options with different colored dots, depending on each food’s nutritional content," she explains. "So when I am working with someone individually, I’ll say something like, ‘You should always have two servings of a yellow dot for your protein, and three blue dots for your carbohydrates.’ It’s practical, it’s easy, and it’s right in front of them."

At the University of Arizona, Nutrition Counselor Gale Welter is putting together a guidebook devoted to teaching student-athletes how to eat well on and around the Arizona campus. The guide will provide basic nutritional information for everything from the entrees at the dining halls and at popular restaurants in town, to the snacks available in dorms. Welter believes the guidebook will help connect the dots for athletes who understand the balance of nutrients they need, but may not know how to apply that understanding to actual meal choices.

A similar idea is already employed at the University of Nebraska to help student-athletes choose wisely when they’re away from campus. James Harris III, Coordinator of Sports Nutrition, provides all Husker athletes with a menu guide offering information on the best—and worst—food choices at many restaurants around campus.

To prepare the guide, he worked with his student assistants in the athletic department to evaluate menus at local restaurants and determine which options were the healthiest and least healthy for athletes. They used calorie totals and protein, carbohydrate, and fat content as basic criteria.

To make the information easy for athletes to use, Harris designed his guide using the same labeling system for nutritional content that he uses for all the items at Nebraska’s training table. "We use a ‘stoplight’ system. Things that are labeled green are all good choices, yellow means they are decent choices, and red tells athletes that something is not a very good choice for them," he says. "They can take the guide to the restaurant with them, and it tells them the worst five and the best five choices on the menu, so they’re not on their own having to guess."

At Georgia Tech, Skinner is a big believer in being hands-on with his athletes and using the "teachable moment." Thus, the presence of himself or Leah Moore, Georgia Tech’s Sports Dietician, at the cafeteria training tables is a big part of his nutrition education program.

"If someone is there for them to ask, a lot of athletes will come with questions. The one I get most often is, ‘How’s my plate?’" Skinner says. "And that’s my opportunity to tell them how they’re doing, as well as offer some suggestions on how to do even better."

Skinner also offers individual diet analysis in the form of one- and three-day personal evaluations. To be evaluated, an athlete journals everything that he or she ingests over a given time period, along with compiling a list of his or her physical activity. Skinner says that these records can be a very effective eye-opener for athletes, who may see for the first time that the long gaps between meals sap their energy level, or realize the amount of unwanted extra calories they consume every day in the form of between-meal snacks and beverages.

May May Leung, a former Sports Nutritionist at the University of Massachusetts who now works as a Nutrition Counselor at the University of Pennsylvania, also believes in being hands-on with student-athletes. While at UMass, she took student-athletes on grocery-store tours to talk nutrition.

"You can teach a lot more in the actual shopping environment than in a classroom or locker room," she says. "After going on a tour, the student-athletes were able to go into the supermarket and see things in a totally different way—and they were more confident that they could get what they needed and make the right choices."

On a typical tour, Leung and other UMass nutritionists would meet a team at the local supermarket, divide the athletes into groups of five to seven people, then lead them down each aisle, covering topics like how to choose the healthiest type of bread and how to read a nutritional label. As they walked, athletes could point out foods that they would normally buy, and Leung would go over the nutritional makeup of those items. She also often pointed out foods that were healthier alternatives to what the athletes had been choosing.

In addition to taking the tours, UMass athletes were provided with a cookbook specially designed for them. The book was peppered with nutritional facts and information, and even provided a shopping list of 15 basic items everyone should have in their kitchen.

"With those ingredients, they could prepare just about anything in the book in under 15 minutes," Leung explains. "And they were all the types of foods students like to eat, all made with ingredients that ensure the meals were nutritious and appropriate for athletes."

TAINTED SUPPLEMENTS
Another area student-athletes need education in is nutritional supplements—especially the issue of contaminated supplements. Even when student-athletes believe the supplements they are taking contain no banned substances, contamination can catch them off-guard, with disastrous consequences. Professional sports teams, Olympic committees, and the NCAA are working hard to rid athletics of steroids, but caught in the wake of these efforts are a handful of athletes who are being suspended for taking what they believed to be legal products.

Freestyle swimmer Kicker Vencill is one example. A former swimmer at Western Kentucky who was on the path to making the 2004 Olympic team, Vencill was preparing for the 2003 Pan Am Games when he tested positive for a steroid precursor banned by the USOC and received a four-year suspension from the U.S. Anti-Doping Agency (USADA). Vencill was shocked by the test results. He maintains he never knowingly took a banned substance, but ingested it in his multivitamins, which had apparently been tainted with the steroid precursor.

His claims were buttressed by the low amounts of the banned substance—four nanograms per milliliter—found in his blood. The suspension was reduced to two years, and a USADA official told the LA Times that the positive test result likely stemmed from contamination.

Dietary supplements are not classified as drugs, so they are not subject to FDA regulation. This means manufacturers are not required to register their companies or their products with the FDA, and there are no minimum manufacturing standards they must comply with. As a result, supplements may contain more or less of an ingredient than the label says—or they may even contain an ingredient not listed on the label at all.

"There is a risk when taking any dietary supplement," says Cindy Thomas, Marketing and Account Director for the National Center For Drug Free Sport, Inc., a Kansas City-based organization that oversees drug testing for the NCAA. "It can relate to the quantity of ingredients listed or the presence of substances in the bottle that aren’t listed on the label."

A 2001 International Olympic Committee study found that 15 percent of tested supplements from around the world contained steroid precursors that weren’t listed on the label. Among products sold in the U.S. or over the Internet, 19 percent were found by the study to be tainted.

Not all contamination is necessarily intentional. Companies may inadvertently contaminate products by using the same mixing machine for multiple kinds of supplements, for example. When contamination occurs, trace amounts of a banned substance may be carried in an otherwise legal supplement. These miniscule levels are probably not enough to enhance an athlete’s performance, but they can be enough to produce a positive test result.

The good news is that a handful of organizations are starting to test supplement manufacturers for contaminated products—for both banned substances and purity of ingredients. (See "Resources" below.) It’s also a good idea for coaches and athletes to familiarize themselves with problematic ingredients.

Sports nutritionists suggest looking out for the following red flags:

• Anything labeled as prohormones.

• Potential fat burners, such as Xenadrine, EFX, and Hydroxycut, which may contain ephedrine or synephrine.

• Discrepancies in names for a particular ingredient such as caffeine—a substance banned above a certain level by the NCAA and IOC—which can be listed as guarana, kola nut, maté, paullinia cupana, or tea extracts.

• Anything that says "You may experience heart palpitations, nervousness, or anxiety."

• New ingredients, especially when there is a lot of hype around them and demand may outstrip supply.

• Multivitamins that have a long list of ingredients and contain unfamiliar names.

To make sure your athletes are in the know, Rosenbloom suggests beginning with policy. "Get everyone on the same page with an institution-wide policy regarding supplement use—what is allowed and what isn’t," she says. "Athletes should be made aware of the policy the minute they walk in the door. That way, if they run into the contamination problem, they only have themselves to blame."

Rosenbloom initiates policy awareness when a student-athlete takes a preseason physical. "At Georgia Tech, we ask athletes what they are taking and follow up with a question asking whether they know what substances are illegal," she says. "Then we ask for some examples of banned substances—a lot of them can’t give any." After the physical, each Georgia Tech athlete meets with the school’s nutritionist to discuss the supplements they are taking.

Purdue University provides its athletes with one-on-one discussions and group meetings on supplements. "At the beginning of each year we explain that the NCAA says that ignorance is no excuse," says Dennis Miller, Head Athletic Trainer at Purdue. "So we appeal to them, ‘Please, don’t get caught up in what you read, and don’t fall for advertising that talks you into taking a supplement. If you’re taking something that is not endorsed by our department, please bring it to us so we can sit down together and evaluate what the claims are, what the ingredients are, and what the potential hazards are.’ We make sure our athletes don’t feel that we’re going to ostracize them or penalize them for getting into supplements on their own, and that increases the level of honesty."

MAN IN THE MIRROR
One of the reasons nutritional supplements are so popular among male athletes is today’s focus on looking muscular. As a result, some of the body image dissatisfaction that female athletes have struggled with are also affecting today’s male athletes. This is an area just beginning to be recognized by sports medicine professionals, but one with dire consequences.

The technical term is muscle dysmorphia, which happens when a person becomes preoccupied with the misperception that their muscles are too small. Often referred to as reverse anorexia nervosa, muscle dysmorphia is classified as a body image disorder and primarily affects males. Individuals with the condition are often driven to spend countless hours in the gym, to the detriment of their relationships, social lives, and physical well being. No matter how much or how hard they work out, men with muscle dysmorphia never feel muscular enough. But that doesn’t stop them from trying.

"Male athletes who have muscle dysmorphia tend to compulsively lift weights, ignoring signs of physical distress to their ligaments and joints," says Dr. Roberto Olivardia, a clinical psychologist at McLean Hospital in Belmont, Mass., and muscle dysmorphia researcher, as well as co-author of The Adonis Complex: The Secret Crisis of Male Body Obsession. "Even when their bodies tell them to stop, they continue working out, thinking that more is better. They also tend to not pay attention to other physiological needs like hydration and food intake. And a number of them will use anabolic steroids or have eating disorders."

Experts lay much of the blame on the media’s increased glorification of the male physique. "Women have been subjected to images of thin models for a long time and now men are subjected more and more to these hugely muscular icons and imagery," says Olivardia. "There’s definitely a pressure that boys today feel, which they didn’t feel as much 15 years ago, to look fit and toned."

At Ohio State University, Dr. Jennifer Carter, a psychologist at the school’s Sports Medicine Center, is working with varsity athletes to study the problem. "The difficulty with this topic is that men do not voluntarily discuss it," says Carter. "Occasionally an athletic trainer might refer an athlete to me who they suspect might have this problem, but I don’t think it is being recognized as a huge problem as of yet."

Olivardia explains that, because body image disorders are largely viewed as only affecting women, most men are ashamed to admit they may be suffering from them. "The shame is enormous," says Olivardia. "I’m often the first person, or the only person, that a lot of men disclose this problem to—and that’s because they know I’m an expert in the field and I’ve written about it."

Because research within this disorder is in its infancy, not much is known about its origins or exactly how many people are affected. "We do know that muscle dysmorphia is associated with either a mood or an anxiety disorder," says Olivardia. "Most men with muscle dysmorphia tend to have an underlying depression or anxiety. But we don’t know what comes first.

"A lot of men I work with who have muscle dysmorphia say that working out is a way of taking control," Olivardia continues. "It is similar to what you hear from women who have eating disorders, except women use food as a way of controlling their lives and managing their emotions, while men with muscle dysmorphia rely on exercise to take control. If they are at the gym for five hours a day and the only thing they have to focus on is their body, it can serve as a distraction away from other things in their life that might be completely falling apart."

As with eating disorders, there is a wide range of severity. "Just like when we talk about eating disorders being a continuum in the female population, the same is true for muscle dysmorphia," says Heidi Skolnik, a nutritionist for the New York Mets and the New York Giants. "There’s a range of eating patterns and body dissatisfaction that is occurring. It doesn’t have to be a full-blown dysmorphic phase, but many men are beginning to take on characteristics of the disorder that are definitely not healthy."

The warning signs are excessive mirror checking, restrictive eating, extra time in the weight room, and an extreme consciousness about the body’s appearance. Other signs include skipping meals with the team, preferring to eat alone, wearing baggy clothing to cloak perceived inadequacies, and not wearing shorts or short-sleeved shirts. Carter adds that substance abuse often accompanies eating and body image disorders among college athletes.

An athlete with muscle dysmorphia should be approached with care. "The most important thing is to take a stance of concern and empathy for that person as opposed to saying, ‘What are you doing to yourself?’" says Olivardia. "You might start by simply saying, ‘I think you’re overdoing it in your workouts.’"

The idea is to engage the athlete in a preliminary conversation about his habits and fears to glean how serious the problem is. If the athlete’s focus on body image seems fairly minor, there are many ways to steer him away from full-blown muscle dysmorphia.

"Basically, just give a lot of positive reinforcement for the steps he is taking to overcome the problem," says Olivardia. "Definitely do not use critical language, because men with muscle dysmorphia are hypersensitive to criticism. Focus on his strengths, not his weaknesses."

If an athlete’s behavior or habits reach a level of becoming obsessive or self-destructive, they should be referred to a sports psychologist. Treatment usually includes cognitive behavior therapy, which examines the underlying assumptions an athlete has about himself and how he believes the rest of world sees him.

CONFUSED BY CARBS?
The final area coaches and administrators might want more knowledge on is the low-carb diet craze and how it relates to competitive athletes. In a nutshell, it doesn’t.

While hoards of Americans are jumping on the low-carb diet regimen, the same diet does not work for athletes. "Very-low-carbohydrate diets were designed for people who are very overweight," says Welter. "They were not designed for a population of college athletes.

"Carbohydrates are the primary source of fuel for working muscles," she explains. "Athletes trying to eat very-low-carb diets are taking away their primary fuel and making their bodies jump through additional hoops. They’re at greater risk for losing lean mass. I tell them, ‘Sure, you may lose some weight—you’ll lose some water and some muscle—weight you didn’t want to lose.’"

"By limiting their carbohydrates, they’ll limit their glycogen stores, which will limit their ability to exercise at a high intensity," agrees Susan Nelson Steen, Director of Sports Nutrition at the University of Washington. "And if they can’t train at a high intensity, they won’t be able to perform at a high intensity, and they’ll be more prone to injury because they’re fatigued."

Instead of limiting carbohydrates to lose weight, most athletes need to better assess the carbohydrates they are consuming. "When we tell athletes ‘high carb,’ they tend to hear ‘high sugar,’" Nelson Steen says. "I think the best message is, ‘It’s important to eat sufficient carbohydrates, but you’ve got to think about the kinds of carbohydrates you’re eating.’"

"They may not be eating chips and cookies, but they may be living on white bread, bagels, and cereal," says Welter. "If that’s the case, they probably don’t realize how many calories they’re taking in, and that could be the source of the unwanted weight.

"Cutting back on simple sugars will facilitate weight loss without sacrificing energy, so I advise them to make some substitutions," she continues. "Instead of two big bowls of cereal, how about whole wheat toast with peanut butter and a cup of yogurt or some scrambled eggs?"

Along with eating carbs throughout the day, nutritionists have suggestions for what to consume during the time immediately surrounding practice. Pre-exercise, athletes need foods high in carbohydrates along with some protein, Welter says, and during practice, she suggests a small amount of a high-carb food.

Post-workout meals and snacks should contain about 6 grams of protein, along with about 35 grams of carbohydrate, Nelson Steen says. "It’s also important for them to eat their post-workout carbs within 15 or 30 minutes, because there is an enzyme active in their bodies at that time that encourages glycogen repletion," she explains.

SELLING IT
Most athletes know that, in theory, healthy eating is important and can boost performance. But they often need a lot of help in wading through the myths and misconceptions. Taking the time to educate athletes, coaches, and the sports medicine staff on the latest news in sports nutrition can go a long way toward making your athletic department the best it can be.

Rockwell says she finds that once athletes start to see their performance improve, they often choose to prioritize nutrition on their own. "I thought when I started doing this that I was going to have to sell people on the fact that what I’m telling them is important," she says. "But when they realize that it’s going to make a difference, they really want to learn."

Text in this article has appeared previously in Athletic Management’s sister publication, Training & Conditioning.



Sidebar: RESOURCES

www.nsf.org
NSF International has partnered with the National Football League and the NFL Player’s Association to provide a seal that certifies a dietary supplement safe to be ingested by NFL players. The NSF/NFL/NFLPA seal is the only certification that verifies a product has been tested for banned substances. The Web site also details NSF’s agreement with the National Nutritional Foods Association (NNFA) to provide a testing program that screens dietary supplements for ingredient purity, bioavailability, label accuracy, and good manufacturing practices (GMP).

www.ConsumerLab.com
This site lists manufacturers that meet ConsumerLab.com’s standards for ingredient purity, label accuracy, and bioavailability. Unlike other drug-testing companies, ConsumerLab.com also lists those manufacturers that don’t meet its testing requirements.

www.usp.org
U.S. Pharmacopeia audits production facilities to ensure good manufacturing practices and screens for ingredient purity, bioavailability, and label accuracy.

www.drugfreesport.com
Click on "Dietary Supplement Education" for background material on sports nutrition and dietary supplements. The group’s "Resource Exchange Center" is a subscription service that provides athletics staff and athletes with accurate and confidential information about dietary supplements and dangerous and/or banned substances.

www.fda.gov
For information on the dietary supplement industry and the FDA’s role in industry regulation, enter "dietary supplements" into the search window.