By Leslie Bonci
Leslie Bonci, MPH, RD, is Director of the Sports Medicine Nutrition Program at the University of Pittsburgh Medical Center Health System, and a consultant to the University of Pittsburgh Department of Athletics, the Pittsburgh Steelers, Pittsburgh Ballet Theater, and several Pittsburgh-area high schools.
Training & Conditioning, 11.4, May/June 2001, http://www.momentummedia.com/articles/tc/tc1104/images.htm
Most people don’t eat optimally. But it can also be said that most people aren’t sure—or simply don’t care—what constitutes eating optimally. You probably think your student-athletes are a step ahead of the norm, considering all the nutrition information you pass on to them. Yet, despite being aware of what optimal nutrition is, many athletes continue to ignore it.
Often, this results from unhealthy relationships with food. For women in particular, these usually take the form of restricting total calories. This can be dangerous for anyone, but especially so for athletes.
From nine-year-old female soccer players to elite figure skaters, the issue of allowing oneself to eat enough to perform continues to be a problem. Not only does minimizing food intake negatively affect athletic performance, it can have detrimental mental and physical consequences as well.
Is it possible to be active, attractive, and still eat enough to properly fuel one’s body for sport? Of course. But, it may not be enough to simply provide your athletes the facts about eating right—there are some athletes you have to sell proper nutrition to. The good news is you can easily do that in a hundred subtle ways.
A Positive Environment
The pressure to look good and perform well can be overwhelming whether it is self generated or comes from an outside source, such as a family member, coach, teammate, or boyfriend. In addition, female athletes of all ages are bombarded with media messages that do not always equate attractiveness with fitness. For young girls, all female cartoon characters are very thin and not necessarily engaged in sports. The role models for adolescents and young adults are ultrathin women who appear as if they rarely participate in regular exercise and are never shown eating.
Images of active women, including Marion Jones, members of the U.S. women’s soccer team, and various female golfers and tennis players, have helped to spread the message that one can be fit, successful, and beautiful. If we are going to successfully encourage female athletes to nurture and cherish their bodies, it is important that they be surrounded by positive messages. All females, but especially female athletes, need to hear the messages that a very thin body does not equal a perfect body and it certainly does not lead to a perfect life. They should also know that the supposedly “ideal” woman represents less than one percent of the entire female population.
To help create a body-friendly environment, ban scales from the athletic training areas. There are cases where having a scale is warranted, such as for measuring water weight loss after exercise; in such cases, keep it in a private place. To provide a wider range of role models for your female athletes, you can have photographs of active women of all shapes and sizes in your office and on the walls of your athletic training facility.
Encourage athletes to refer to their bodies using only positive descriptors, and actively discourage them from using self-deprecating critiques of body parts. I consider the words “fat,” “ugly,” “large,” and “diet” off-limits. I make it a point to compliment my athletes regularly and encourage them to say something positive about themselves every day. After all, we can be either our own best friend or own worst enemy.
A reality check can also provide some perspective for an athlete who is dissatisfied with her body. When my female athletes start to complain about the size of their hips or legs, I gently remind them that those same hips and legs allow them to compete in their sport. This can be very helpful for the athlete to hear, and takes the emphasis off the negative thoughts. At the preseason physical, I always ask my athletes to list three things that they like about their bodies and what their bodies allow them to do.
Have a team discussion about some of the facts and myths surrounding nutrition. Encourage your athletes to submit various questions, anonymously if desired, and have a sports nutritionist talk with the team. If this is not possible, assign a nutrition question to two or three team members, let them research the answer, and have each group present their findings as part of a subsequent training session. This can be quite eye opening, gets everyone involved, and reaches the entire team at one time.
Everyone who works with female athletes will face individuals with major body image and disordered eating issues. It’s important to obtain a nutrition history on all of your athletes as part of a preseason physical, including questions on food likes and dislikes, number of meals consumed daily, past eating habits, body satisfaction, and supplement use. This information can help to identify athletes who may be at risk.
Eating concerns may be voiced by the athletes themselves, coaches, teammates, roommates, parents, or friends. The pressures of school, work, training, and competition can be difficult for any female athlete, but particularly so for someone who feels that her body doesn’t meet the expectations set by herself or others. Early intervention is critical and far more effective than hoping the problem will simply resolve itself. At different times you may find yourself in the role of providing suggestions, making appropriate referrals, or just offering a shoulder to cry on.
Whenever an athlete comes to you with concerns about eating, provide an appropriate setting to talk to her about her goals, and help her reframe and reset those goals so they can be accomplished in a healthy way that does not detract from performance. This is a wonderful time to point out her unique and special characteristics, including her drive, strength, guts, talent, and determination. A little cheerleading goes a long way for someone who is feeling down about herself.
For athletes who are interested in lowering their weight or body fat, perform a body composition analysis to obtain appropriate baseline data. Female athletes need to know that weight loss alone does not translate to an improvement in performance, and that a loss of water and lean mass will almost always impair performance. Athletes who insist on losing weight should be referred to a sports nutritionist who will be sensitive to the unique needs of the exercising female and can develop an individualized meal plan that is realistic and achievable.
As the person most likely to have regular contact with the athlete, you should work with her and the sports nutritionist to define goals. Most individuals work better with a plan that has very clear and well-defined expectations. Short- and long-term goals can help keep the athlete who’s trying to lose weight or alter body composition motivated and positive. Since success so often seems to hinge on measurements from a scale or a set of calipers, it is important to define other non-weight-related measures of success. Although not as quantifiable as a number or percentage, quality of life indicators, including more energy, better sleep patterns, increased happiness, and feeling in control, are just as important signs of success.
It also helps to focus on the role of food for athletic performance. I remind my athletes that eating is as important in training as the actual physical exercise, and that the training and conditioning will suffer if the fueling is not optimal. Remind your athletes that they are a special group with unique needs and that their bodies need more fuel to allow them to perform at the highest level. Reiterate that proper fueling provides both a mental and physical edge over opponents.
The standard tables listing recommended daily values for calories and the number of grams of carbohydrate, protein, and fat may be a helpful starting point to improve your athletes’ eating habits. Beware, however, that a female athlete concerned about the way her body looks may tune out this information immediately, assuming that this standard type of eating pattern will lead to fat thighs. These tables can be used for long-term goal-setting, but other strategies need to be used to attain short-term success.
The daily calorie recommendation for a female athlete is estimated to be their weight in pounds times 20. Thus, a distance runner weighing 110 pounds would require a minimum of 2200 calories per day, which could increase as training intensifies. If this athlete is currently consuming 1200 calories per day, she will be very reluctant to add an additional 1000 calories to her daily intake. In these cases, a compromise, incorporating small, gradual changes, is a better approach. Recommending a 200-calorie increase through a food or beverage may be more acceptable. And, slowly, this number can be bumped up to an optimal level.
Because of their busy schedules, the timing of meals is a problem for most student-athletes. But some female athletes also have other concerns about when they eat—such as the effect that night eating has on their body shape—and are more likely to skip meals in order to lose weight. The athlete who eats only once a day is not going to be willing to immediately switch to five small meals a day, but she may be convinced to try two meals instead of one. Also, ask the athlete to report any changes she notices (less hunger, more energy, etc.) after changing her eating habits.
Female athletes are also vulnerable to skimping on protein or fat intake, thinking that these foods can lead to weight gain. But, the athlete who does not get enough protein may suppress immune system function, which can manifest in conditions like nagging upper respiratory tract infections. This can, of course, prevent the athlete from competing at optimal levels.
Thus, you should encourage athletes to eat some type of protein at each meal, whether from an animal or vegetable source. In addition to supporting a healthy immune system, foods containing protein can provide a greater sense of satiety, helping curb appetite between meals. For the athlete who chooses not to eat red meat, it is important to point out that poultry, fish, eggs, low-fat dairy products, dried beans, and soy are all excellent protein sources. For the athlete who does not consume any animal products, or is a very picky eater, a protein-containing sports bar or beverage can help to meet the protein requirements.
When athletes tell me they strive to maintain a minimal fat intake, I gently remind them that fat is used as fuel substrate during any exercise, with the exception of an all-out sprint, and that restricting fat intake can result in earlier fatigue. I recommend that my athletes increase fat intake gradually, perhaps only five grams at a time. This would be equal to:
• one thumbnail-sized serving of oil, margarine, peanut butter, or mayonnaise;
• one thumb-sized serving of salad dressing or cream cheese;
• or a piece of cheese with five grams of fat.
Fluid intake can also be an issue. Female athletes tend to be more conscientious regarding the need to drink water than males; however, water alone may not be the best solution. Female endurance athletes are at higher risk than males of having a lower blood sodium level, which can be due, in part, to the fact that many women drink more than they sweat. Encouraging the consumption of sports drinks, pretzels, spaghetti sauce on pasta, or soy sauce added to rice is an easy way of helping a female athlete maintain normal blood sodium levels. Educate athletes on the fact that sodium does not contain calories and that including salty foods will not cause an increase in body fat, but may prevent problems associated with hyponatremia.
Although you may have your own opinions about which foods work best for you, try to keep your discussions with athletes neutral and inclusive, not exclusive. Avoid talking about good versus bad foods, or referring to particular foods as weight-promoting. If you believe it, chances are your athletes will too, and the results can be devastating to a vulnerable athlete.
Being at the top of one’s game requires both optimal fitness and optimal fueling. The responsibility the athlete has to herself is to bring the best trained, best nourished self to practices and competition. Work with your athletes to get the message across that eating is a part of training, and those athletes who fuel well are also the most likely to play well. It’s not enough to just tell them what optimal nutrition is, you must also sell them on the importance of eating right.