The ATC Diet

January 29, 2015
If you're like many athletic trainers, following a nutritious meal plan during a typical hectic day doesn't easily happen. In response, we offer the ATC Diet.
By Dr. Jackie Buell

Jackie Buell, PhD, RD, CSSD, ATC, is a Sports Dietitian for the Ohio State University athletic department and Director of Sports Nutrition
in the Medical Dietetics division of the School of Health and Rehabilitative Sciences. She is also an athletic trainer and can be reached at: [email protected].


Along with evaluating injuries and doing rehab, athletic trainers often engage in a little parenting of the students they interact with. That can be a great thing, of course, for young people who need some mentoring. The downside is that athletic trainers can become so busy taking care of "their kids," they don't take equal care of themselves. This is especially true when it comes to nutrition.

Despite all the education athletic trainers provide to athletes on the topic, that knowledge seems to be forgotten when it comes to meeting their own needs. However, to be at your best throughout the day, you need a nutritious diet as much as athletes do. A donut at 11 a.m. followed by a bottle of Gatorade two hours later can leave you hungry and may prevent you from making good decisions. It can also lead to unhealthy eating patterns.

DAILY GAME PLAN
The most frequent nutrition mistake athletic trainers make is going for long periods of time without eating. Due to the hands-on work of athletic training and the lack of downtime during a typical day, there are not natural breaks for meals. Sometimes we don't eat for six to eight hours, convincing ourselves we are not hungry, or even falling out of touch with hunger cues.

We don't really miss eating until late in the day, and at that point, it's tough to not pig out. When we get too hungry, it is more difficult to make healthy food choices and exercise portion control. So after finishing a long day of tending to everyone's needs, hunger starts to surface in a big way without us even realizing it.

When we finally get home, that frozen pizza looks good and easy to make, so we throw it in the oven. While it cooks, a bag of potato chips gets opened and one handful leads to another. However, that doesn't diminish our appetite. The entire pizza is devoured soon after it's cooked.

Even if you eat a healthy dinner, big-time hunger can lead to consuming large portions. As a result, you may grab three dinner rolls instead of one and have an additional helping of pasta that you don't need.

Not only does this pattern promote unhealthy choices, but it wreaks havoc on our metabolism. Nutritionists call it backloading--being somewhat restrictive all day and consuming most of our calories in the evening hours. Studies have shown that this behavior leads to being less sensitive to insulin and having less ability to manage weight. While our bodies are undernourished during the morning and afternoon, our metabolism slows down, and we will not burn as many calories. Instead, we want our metabolism to work well all day so our body uses calories as it should.

The best way to stop this pattern is to eat small, frequent meals throughout the day and include enough fat and protein among the carbs. People who eat every two to four hours throughout the day can usually control dinner portion sizes better.

If you chronically overeat at dinner, evaluate your eating habits earlier in the day. Do you eat breakfast? Do you take time to eat a healthy and balanced lunch? Do your snacks satisfy your hunger? Getting on track with a solid meal plan is an important step to managing consumption.

OFF TO A GOOD START
Breakfast is still considered the most important meal of the day. There is now quite a bit of research showing that people who eat a mixed breakfast of protein, fat, and carbohydrate are more likely to manage their weight, do better at school or work, have fewer behavioral issues, and be less hungry throughout the day.

When we eat primarily carbohydrate in the morning with nothing to slow gastric emptying, we end up hungry again in a shorter period of time. Including two to three ounces of protein at breakfast and a little bit of healthy fat will help us avoid that rebound hunger.

The problem is that busy people--like athletic trainers--often hit the ground running in the morning instead of prioritizing this meal. They say they don't feel hungry and would rather spend the time sleeping in or getting to work early. So how can you make breakfast a priority?

If you have a routine in the morning, examine where you might fit in a meal. If you hop on your computer first-thing, why not eat while checking your e-mail? If you are a news watcher, associate breakfast with this morning habit.

Eating in the morning does not have to be time-consuming, and it does not have to involve typical foods like cereal or pancakes. Here are some ideas for quick and easy recipes that have a good carb/protein/fat mix:

Blend It: Smoothies are a great way to get all of your breakfast nutrition quickly and easily. Invest in a single serving smoothie blender and throw a little yogurt, milk, fruit, and some veggies into it.

Sandwich Lovers: How about a sandwich where you scramble an egg, throw it in the microwave, place it on a toasted English muffin, and add a slice of cheese? Pour yourself a glass of milk and breakfast is ready.

Going Greek: Add a handful of granola to a Greek yogurt, and this is a super easy breakfast that can be enjoyed quickly.

No Time: If nothing else, make yourself a peanut butter and jelly sandwich the night before, leave it in the fridge, and eat it with a glass of milk the next morning.

SUCCESSFUL SNACKING
With a solid breakfast getting you going, the next step is fueling throughout the day. The key to implementing the "small, frequent meals" plan is controlling food availability. It stands to reason that if no food is available, you can't eat. If only junk food is available, you are likely to eat it when you get hungry enough. Learning to make the snacks you want to consume available is the strongest habit you can form. Plan ahead to have healthy foods on-hand when you get hungry.

Packing a wide variety of snacks allows you to follow your mood with the right foods. Just like you plan for what to have in your sideline kit to take care of injured athletes, you should plan to have the foods you want to consume with you.

Of course, it's up to you to make the right food choices. You can fill up your bag with apples, bananas, and string cheese, or you can fill it with Snickers bars. An incentive to choose healthy snacks is that your student-athletes will be watching you. Think of the message you send to them when you snack on an apple and string cheese while the team is warming up instead of a candy bar.

Time your snacks so that you are eating every three hours or so. It can be a good idea to plan this out ahead of time, so you don't suddenly realize you haven't eaten in five hours. For example, you might plan a late morning snack while looking over rehab paperwork, an early afternoon snack just before you start pre-practice taping, and a late afternoon snack while watching practices on the sidelines.

Like your breakfast, each snack should be balanced in terms of carbohydrate, protein, and fat. I also find that folks who crave sweets will have fewer cravings if the protein in their diet is high (around 1.7 g/kg).

The most desirable balance for a snack would be:

Fat: less than 2 exchanges of fat (<10 grams)
Carb: no more than 1-2 exchanges of carb (15-30 grams)
Protein: 1-3 ounce equivalents of protein (7-21 grams)
Vitamin and mineral nutrient density: 25 percent daily value of most vitamins and minerals.

Here are some suggestions for good snacks that meet these criteria:

- Small banana with 1 tablespoon of peanut butter
- Greek style yogurt with 1/4 cup granola
- Trail mix with 2 tablespoons of soy nuts, 2 tablespoons of raisins, and 6 to 8 almonds or walnuts
- Pita bread or baby carrots with 1/3 cup of hummus
- An apple with one cheese stick.

CRAVINGS
Changing eating patterns can be difficult. Following the above suggestions is easier said than done. One of the biggest downfalls for most of us is fending off cravings.

Food cravings are likely the body and brain talking to us about our nutritional balance and habits. Evaluating your frequency of eating and the variety of foods you consume can lead you to fewer cravings.

In other words, our diet needs to include foods that taste good and help us avoid feeling punished by our choices. The daily menu also must provide protein to help us feel satiated and stave off hunger. When we eat simple carbs in solo, we get a little sugar rush that lights up our brain and is somewhat addicting, which is why it's important to eat some protein and fat at the same time to slow it down. Of course, this likely means the amount of carb needs to be small to prevent the snack from becoming a meal.

Anytime you deprive yourself of something you like to eat, you risk "falling off the train" and bingeing on the very foods you eliminated. This binge-deprive cycle can be tough to break. Letting yourself have a small, sweet snack to satisfy a craving can sometimes work well. Eating a couple of cookies during the day might save you from consuming a whole bag of Oreos later.

Another way to fight off cravings is by asking yourself why you want certain foods. Often, it is the simple fact that they give us pleasure. What other activities do you do that light up the pleasure centers in your brain? Are you craving a reward? Life balance and psychological health are instrumental in helping us deal with other people as we go through the day. Sometimes food serves as an antidote to the negative aspects of our day. Recognizing this is an important step in changing one's diet.

Exercise is also an important tool. The "runner's high" you can get from proper exercise stimulates your brain and is much better for your waistline. You know you should prioritize exercise into your day. If you are not, what is holding you back?

For some individuals, cravings are even an addiction. If you consistently find yourself craving sweets, consider that addictive brains are addictive brains regardless of the desire. If you need help with depression or eating addiction, seek professional counseling, just like you would suggest for your athletes.

COUNTING CALORIES
Any eating plan works only if the overall calorie consumption equals your body's needs. The Harris-Benedict equation is a good way to estimate your resting metabolic rate and daily calorie requirements and can easily be found with a Google search. Listening to your body also works well. If we eat small, balanced meals all day long, we usually know when we are satiated.

If you want to lose weight, that can take a little more focus on the numbers since you need to be in energy deficit. Many dieters make the mistake of eating too few calories and running a larger deficit than what is necessary to promote loss. This will actually decrease metabolic rate and increase loss of lean body mass as your body tries to accommodate the starvation with energy efficiency.

A healthier way to lose weight is to eat 300 to 500 calories less than what is needed per day, and to remain at your current energy level. That can be as simple as taking a smaller portion at dinner or changing your snacks from calorie-dense packaged food to fruit and yogurt.

One of the biggest stumbling blocks for athletic trainers can be eating too many carbohydrates. We see our athletes consuming carbs and follow suit. But while many athletes need those carbs for training, our manual work throughout the day does not come close to the calorie requirements or intensity level of a young athlete (who also may still be growing).

For example, if your body requires around 1800 calories per day, you only need 6 to 8 ounces of carbohydrate per day. Having a four-ounce bagel at breakfast covers half of your daily requirement. Having a plate of pasta (2 cups) and a breadstick with the team would likely ring up a full day's supply of carbs.

One last point: Be careful when eating with your athletes. It can be positive to eat with them for the camaraderie and knowledge of their habits but can lead to overeating, especially of carbs. I often say to athletes, "Just because food is free, does not mean you have to eat it." Not eating those French fries that come with your meal can be an investment in your health.


Sidebar: In an Emergency

Even if you plan out your eating for the day, it's good to have some emergency snacks. They can be a lifesaver for those days you end up working later than planned or have to take an injured athlete to the hospital.

This is where a box of granola/energy bars can be helpful, stashed in your car or office. However, it's important to read labels and choose bars that provide a good mixture of carbs/protein/fat with some vitamins and minerals. Here are some brands that fit the bill:

- Pure Protein
- EAS Lean 15
- Luna Bars
- Simple Truth
- Balance
- Special K
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