An
athlete in need of weight loss is vulnerable in many ways. A sports
nutritionist explains how to develop a sane weight-loss plan with
measured goals.
By Leslie Bonci
Leslie Bonci, MPH, RD, is
Director of Sports Nutrition at the University of Pittsburgh Medical
Center and serves as a consultant to the Pittsburgh Steelers, Pitt
athletics, and several area high schools.
Mike was a
very successful high school defensive back who was offered a full
scholarship to a highly ranked NCAA Division I college football
program. Throughout high school, his coach had told him that bigger was
better, so he decided to eat more at every meal and spend more time in
the weight room. This resulted in an increase in mass, strength, and
performance.
The summer before his freshman year at college, he
sustained a knee injury in a pick-up basketball game. His activity
decreased dramatically, but his eating didn't, and by the time he
reported to the first day of training camp at college, he was 25 pounds
heavier than his playing weight. He was told to lose the weight fast,
doing whatever it took, and to exercise after practice by doing some
extra running or stationary biking.
Worried that he wouldn't
see playing time if he didn't lose the weight, Mike started skipping
breakfast and lunch and eating a large salad and two grilled chicken
breasts for dinner. He went to bed hungry, woke up irritable, and was
extremely tired and lightheaded during practice. His weight dropped but
his performance suffered--and the extra activity aggravated the knee
injury. He saw very little playing time.
Obviously, this is an
example of what not to do when an athlete needs to lose weight. The
timing was wrong, there were no realistic goals, and communication was
almost nil.
Weight management is difficult for all involved,
and it needs to be treated with care. The individual who is trying to
change his or her weight is very sensitive and may feel pressure to do
it quickly. The individual who is making the recommendation may be well
intentioned, but misinformed--hence, a disconnect develops that results
in an uncomfortable and sometimes confrontational situation.
In
order to do best by the athlete, you must help him or her put a plan in
place, with very specific goals, a timeline, and a strategy for
assessing progress. The process also requires communication and an
understanding that each athlete and each weight-loss situation is
unique.
THE RIGHT QUESTIONS
When an athlete is
interested in losing weight, it is a good idea to sit down with him or
her and gather some information prior to goal setting. Questions to ask
might include:
o Why are you interested in losing
weight?
o Has anyone told you that you have to lose
weight?
o Do you have particular health concerns?
o Have
you lost weight in the past? If so, how?
o What do you expect to
notice in your performance as a result of weight loss?
o How
much time do you have to commit to working on weight goals?
o
What are obstacles that may hinder your efforts to lose
weight?
o Do you have a support system in place?
o Do you
have a time frame for weight loss?
It is important to ask these
questions so that you start a dialogue with the athlete on what may or
may not be realistic goals. Athletes should know what they can change
in their bodies: fluid balance, muscle mass, and body fat. And they
should know what they cannot change: height, frame size, and body
shape.
The athlete who diets to have broader shoulders or
smaller hips needs to be educated about realistic body goals. With
changes in exercise and diet, one can change their size, but not their
body type.
The red flag is when someone is overly concerned
about the look of their body. These individuals may employ drastic
measures to change their bodies, such as dehydration, starvation, and
the use of supplements, laxatives, or diuretics. The outcome is not
body fat loss, but a change in fluid balance and lean body mass, both
of which may adversely affect performance and health. The athlete who
seems overly obsessed with his or her body should be referred for
counseling.
GOAL SETTING
In the absence of any
red flags, the process of weight loss can begin with realistic goal
setting. To do this, you'll need to assess the athlete through baseline
measurements. I believe the most important baseline measurement to take
is the athlete's body fat percentage. Why focus on body fat and not
weight? The goal is enhanced performance, and that will not be achieved
by a decrease in body weight alone. It is the loss of body fat--without
loss of muscle mass--that will lead to a better athlete.
If an
athlete loses five pounds a week, it does not indicate fat loss alone,
but also fluid and muscle mass loss, which will have a negative effect
on performance. In addition, because body weight can fluctuate several
pounds in the course of a day due to fluid changes, it can be extremely
demoralizing to the athlete who has had a "good" week only to see the
scale read higher.
To start out, you'll need a baseline
measurement of the athlete's body fat percentage. Underwater weighing
and DEXA (Dual Energy Xray Absorptiometry) provide the best
measurements, but you can also use skinfold calipers or bioelectrical
impedance.
For some athletes, another important baseline
measurement is that of frame size. Even if you explain the importance
of body fat measurement, some athletes will still obsess about their
weight and want their numbers to match those on a standard
height/weight chart. For these athletes, it may be helpful to make
frame size a part of the equation, since someone with a larger frame
size should expect to weigh more than someone of the same height with a
small frame. (An assessment of frame size can be computed using elbow
breadth as illustrated in Table One, on page XX.)
Once you
obtain baseline measurements, how do you set goals for reducing body
fat? I usually start with goals of reducing 10 to 15 pounds of body fat
over a period of six months. That would equal about 8 percent of body
weight if no muscle mass is lost. Long-term goals are important,
because in order to avoid losing muscle mass, an athlete needs to lose
weight slowly.
Measure body fat at six-week intervals, looking
for body fat reductions of three to four pounds. Also ask athletes to
assess success in non-scale related ways such as energy levels, better
sleep patterns, and improved performance. This is the best way I've
found to keep the athlete motivated and the goals
performance-based.
If your athlete needs some short-term goals
to keep motivated, be sure to add them in. A good goal to start with is
1/2 to 3/4 pound of body fat lost per week, which might equal two
pounds per week on the traditional scale. Again, ask about energy
levels and mood.
It is also important to start any weight-loss
program at the end of the season with the final goal to be achieved by
the following preseason. Too often, the athlete may wait until the
start of the season, or until the season is already under way, to work
on weight goals. It is extremely difficult to focus one's undivided
attention on the rigors of training, conditioning, competition, and
academic demands, while simultaneously addressing body goals. Timing is
a key component of weight loss and trying to lose weight in-season more
often than not leads to ineffective performance.
CHOICES
& BEHAVIORS
It would be impossible to adequately address weight
management without talking about diet. However, do realize that one's
diet is composed of two areas: what and how much actually goes into
one's mouth; and the when, where, and how of eating.
Let's
start with the "what" of the diet, the food. A meal plan should not
translate to a decrease in strength, speed, stamina, or mental clarity.
Therefore, athletes should not adopt an eating pattern that eliminates
or severely restricts an entire macronutrient, such as carbohydrate- or
fat-containing foods. Nor should they skip meals. It is important to
remind athletes that carbohydrate and fat are the primary fuel
substrates for the exercising muscles. Protein is essential for tissue
growth and repair and supporting a healthy immune system, but it is an
inefficient fuel substrate for exercise. One may drop some pounds by
using a high-protein diet, but will pay the price by being too tired to
make it through a practice or conditioning session.
What about
the actual food choices? Is there one sports diet? Besides eating the
proper balance of carbohydrates, proteins, and fat (60/15/25 for the
endurance athlete, 50/20/30 for the power athlete), the answer is no.
Overall, you want to reduce caloric intake, but there is not
one meal plan or calorie level that will be appropriate for every
athlete. The idea is for the reduced calorie level to result in the
desired changes in the body while still providing enough energy for the
demands of exercise.
To determine appropriate calorie
reduction, first figure out the athlete's Resting Metabolic Rate (RMR),
which is body weight multiplied by 10, plus 70 percent of that number
(to account for an athlete's activity). That gives you the number of
calories for weight maintenance. Then, subtract 20 percent from the
equation for weight loss. So, for a 150-pound athlete, the equation
would be:
150 x 10 + .7(1500) = 2550;
2550 - .2(2550) =
2040.
The athlete should consume 2040 calories for weight loss
to occur without negative energy levels. (If an athlete is not
exercising, the 70 percent of RMR should go down to 20 to 40
percent.)
There is absolutely no advantage in cutting calories
to a minimum. In this example, if our 150-pound athlete had a goal of
130 pounds and decided to eat only 1200 calories a day for weight loss,
he or she would end up very hungry, tired, and irritable, and would
most definitely notice a decline in performance. Too low is not better
when it comes to calories for weight loss. Although most athletes don't
know the calorie cost of foods consumed, there are some on-line tools
such as the Interactive Healthy Eating Index (www.usda.gov/cnpp), where
one can log food intake and get a printout of calories consumed
daily.
The next step is to take into account the psychological
side of food consumption. Eating is supposed to be a pleasurable
experience, thus the athlete's meal choices need to be based on his or
her food preferences as well as when and where he or she likes to eat.
A simple concept, but one that people forget to take into
account!
To help athletes figure out how to change their diets,
I give them a chart that lists many popular food items. I ask them to
circle the foods they eat frequently, then list how often they eat
them. I also ask them to indicate "trigger foods," things that they pig
out on or eat for stress reduction, as well as foods they never
consume. (See Table Two on page XX.) From looking at the chart, I can
see if they are consuming too much or too little of one thing, and
whether there may be some psychological factors behind their food
choices. For example, if an athlete eats primarily carbs or protein, I
would have him or her look at the food choices in the other categories
and develop a plan that would include a mix of nutrients at each meal
and snack.
I also ask them to describe their eating patterns: Do
they eat a lot at any one meal? Do they use snacks as a way to reduce
stress, get through a long night of studying, or when hanging out with
friends? This helps to determine troublesome times of the day and
hungry times, and allows us to concentrate on problem areas rather than
the entire day. I want to understand how to take away the calories that
have little meaning, while leaving in the calories that do have
meaning.
A final tip on setting weight-loss goals: make sure the
athlete has input. The athlete must be ready and willing to change,
which can more readily happen if he or she has had a thoughtful
dialogue about the dieting process. The most superb meal plan will only
be effective if the athlete perceives the value of it. Ultimately, it
is the athlete, not the coach, health professional, or athletic
trainer, who decides what, when, and how much he or she is going to eat
and drink.
SUPPORT TEAM
Along with having goals
and an overall plan in place, some thought must be put into who will
monitor the athlete. If there is not a nutritionist on staff, the
athletic trainer is an ideal person to meet regularly with the athlete.
Accountability is a huge part of goal setting, so be sure to
check body fat percentages or go over eating plans when you say you
will. Most athletes need to know that someone is monitoring them for
their efforts to be successful. It is also important to build in
incentives so that the athlete perceives the value in going through the
effort. Ideas for incentives might include positive comments, talking
about effects on performance, an effort award, and even letting a
successful weight-loser be a peer counselor for athletes just starting
out on a weight-loss plan.
Some additional tips for those on the
support team:
_ Always focus on what works for the individual.
Even if you have personally found a meal plan and lifestyle pattern
that works for you, you should not assume it will work for someone
else.
_ Take a positive approach. Losing weight can be much more
difficult for some athletes than lifting a heavier weight or learning a
new play. Do not belittle or criticize, or else your efforts may
backfire. The environment and support system need to be
positive.
_ Remind athletes that weight loss is a series of
steps, not a slide, so there are going to be weeks when their weight
doesn't change. Explain that this is the body's adaptation to the
process of weight loss, and it is not necessary to eat less or exercise
more.
_ Suggest that the athlete take pride in what he or she
has accomplished so far and what they notice in terms of performance.
Tell them there is no such thing as perfection. When an athlete hits a
plateau, it is a good idea to encourage him or her to monitor intake
for a few days to see if perhaps calories are on the high side, or
perhaps they just need to have patience.
Weight loss does not
occur overnight, and so far, no magic pill is available. It takes time,
effort, and commitment on everyone's part. The underlying goal is
performance enhancement and positive body changes. If weight loss is
approached in a healthy way, the athlete will be proud of his or her
accomplishment and see the results in his or her
performance.
Table One:
Elbow
Breadth
The measurements listed below correspond to a medium
frame for the given height. If elbow breadth is less than the numbers
listed here, the athlete has a small frame. If elbow breadth is greater
than the numbers listed here, the athlete has a large frame.
To
measure elbow breadth the athlete should be standing, with dominant arm
extended forward and palm down. Bend elbow to a 90 degree angle so that
the back of the hand faces the athlete. Measure the distance around the
narrowest part of the elbow joint.
For a
male
Height Elbow Breadth (inches)
5-2 to
5-3 2-1/2 to 2-7/8
5-4 to 5-7 2-5/8 to
2-7/8
5-8 to 5-11 2-3/4 to 3
6-0 to
6-3 2-3/4 to 3-1/8
6-4 to 6-7 2-7/8 to
3-1/4
For a female
Height Elbow
Breadth (inches)
4-10 to 4-11 2-1/4 to 2-1/2
5-0
to 5-3 2-1/4 to 2-1/2
5-4 to 5-7 2-3/8 to
2-5/8
5-8 to 5-11 2-3/8 to 2-5/8
6-0 to
6-4 2-1/2 to 2-3/4
Source: "Elbow breadth as a
measure of frame size for US males and females," by Frisancho AR,
Flegel PN. AJCN Vol. 37, 311-314, 1983.
sidebar:
Quick Tips
The following tips can help with weight
loss:
Cutting Calories:
o Use a smaller plate, bowl, or
glass to control portion sizes.
o Look at the serving sizes on
packages of foods to keep the portions in check.
o Do not
reduce carbohydrates, but decrease the serving size.
o
Understand that fat-free and sugar-free foods are not necessarily
calorie-free.
o Be aware of calories in condiments.
o
Use a smaller amount of real salad dressing, peanut butter, or
mayonnaise instead of large amounts of fat-free versions.
o
When eating out, order half-size portions or have an appetizer and
salad, or soup and half a sandwich.
Eating Habits:
o Try
to eat more early in the day to prevent overeating in the evening.
_ Always eat breakfast.
o Eat something every three to
four hours.
o Be consistent with the number of meals a day,
seven days a week.
o Sit down when eating.
o Put all
foods, even snack foods, on a plate.
o Try to eat when hungry,
and on a fullness scale of 1-10, stop at about a 5.
o Try not to
eat when at the computer or watching television.
o Put tempting
foods out of sight, or better yet, out of the house, apartment, or dorm
room.
Table Two:
What Do You
Eat?
When starting a weight-loss plan, ask athletes to write
down next to each food item how many times they eat that food per week.
Also ask them to put a TF next to any "trigger foods" they eat to
reduce stress, when hanging out, or as a quick meal
solution.
Carbohydrate-containing
foods
Bread
Bagels
Cereal
Pasta
Rice
Fruit
Vegetables
Juice
Sports
drink
Soda
Candy
Cookies
Cake/Pies
Pastries
Crackers
Pretzels
Chips
Potatoes
Yogurt
Ice cream/frozen
desserts
Protein-containing
foods
Beef
Veal
Lamb
Pork
Fish
Shellfish
Chicken
Turkey
Eggs
Cheese
Nuts
Nut butter
Dried beans (kidney, lentil,
etc)
Soy products (tofu, soy milk, veggie
burgers)
Milk
Yogurt
Fat-containing
foods
Margarine
Butter
Salad
dressing
Mayonnaise
Oil
Bacon
Cream
cheese
High-calorie
drinks
Alcohol
Beer
Wine
Mixed
drinks