Aug 26, 2016Closing the Gap
When athletes switch positions, change sports, or suffer an injury, their old nutrition plans don’t always meet their new needs. The three case studies in this article explain how to fill any fueling holes and ease the transition.
This article first appeared in the September 2016 issue of Training & Conditioning.
When Brady Hoke was hired as the Defensive Coordinator for the University of Oregon football team last January, he brought a 4-3 defensive scheme to a program that had long used the 3-4. Transitioning from one to the other meant some of our outside linebackers had to become defensive linemen. And since defensive linemen typically go up against 300-pound offensive tackles, our 215-pound linebackers making the switch needed to get bigger and stronger.
They had very little time to do it, too. Coach Hoke wanted to see how players performed in the new scheme with their added size during spring ball. This gave the Sports Nutrition staff about nine weeks to design, implement, and monitor nutrition plans for the players who would be switching positions.
One of these players was “Shaun,” a 6-foot-3-inch, 217-pound outside linebacker. To create Shaun’s weight-gain plan, I first met with Coach Hoke and Defensive Line Coach Ron Aiken to talk about their expectations for him. They wanted him to gain 20 to 30 pounds of mass and increase his strength.
Next, we measured Shaun’s frame score-a collection of measurements such as wrist girth, hand length, knee size, arm length, etc.-along with his body composition, height, and weight. By comparing these metrics to some of our current and former defensive linemen’s, we could predict Shaun’s ceiling for weight, which we determined to be between 245 and 250 pounds.
Shaun typically required anywhere from 4,000 to 5,000 calories per day to maintain his old weight, so we figured he needed 4,500 to 6,000 calories per day to reach his new weight goal in the time allotted. We started him at the bottom of the range. The goal was for him to gain one to two pounds per week, and when he reached a plateau, we would bump up his daily calorie intake by 500 with snacks and increased meal portions.
Of course, just because Shaun was trying to gain weight didn’t mean he could eat everything in sight. We wanted him to put on as much muscle mass as possible while minimizing his fat mass gains. To help Shaun stay on the right path, we gave him some basic dietary guidelines to follow:
• Take advantage of all the resources provided by the school
• Bookend all workouts with carbs and protein
• No skipping meals
• Eat every three to four hours
• Build adequate meal performance plates
• Eat calorie-dense snacks
• Hydrate throughout the entire day based on fluid loss and needs
• Supplement with a standard multivitamin and vitamin D3
• Eat a consistent amount of calories throughout the day-don’t make dinner the largest single meal of the day.
We also revamped Shaun’s meal plan to give him a more specific idea of what to eat on a daily basis. Much of it remained similar to his diet as a linebacker, except we included more calories earlier in the day-especially before a lift or practice-and bulked up his dinners and evening snacks.
To make things easier for Shaun logistically and financially, we structured a lot of his fueling around what our department could provide. For example, we offer a breakfast/brunch, grab-and-go midday snack, pre- and post-workout snacks, and an evening training table meal.
Below is an example of Shaun’s weight-gain eating plan for a day when he had a morning lift or practice:
Pre-lift/pre-practice: Whole wheat bagel with peanut butter and jelly or one cup of oatmeal with fruit and two tablespoons of peanut butter, Greek yogurt, strawberry nutrition shake, 12 ounces of sports drink, and a multivitamin and vitamin D3
Post-lift/post-practice: 24 ounces of a blended weight-gain shake
Breakfast: Omelet or egg scramble (two whole eggs, four egg whites, spinach, tomato, mushrooms, onions, cheese, and ham), one cup of hash browns, a waffle with peanut butter and syrup, one cup of sliced fruit, and 16 ounces of chocolate milk
During class: Hydrate with water based on average sweat losses from training
Midday snack/small lunch: One packet of trail mix or a peanut butter and jelly sandwich, 1.5 ounces of beef jerky, and 16 ounces of fruit smoothie
Dinner: Eight ounces of lean protein (chicken, steak, or fish), one to two cups of starch/whole grains, two or three servings of vegetables, and 16 ounces of chocolate milk or 100 percent fruit juice
Pre-bed snack: One cup of flavored Greek yogurt with one to two tablespoons of peanut butter, one cup of oatmeal or two peanut butter and jelly sandwiches, and eight to 16 ounces of milk.
As Shaun started following his new meal plan, we monitored his progress to make sure he was gaining the right kind of weight. The Sports Nutrition staff conducted weekly weigh-ins prior to lifting, and the strength coaches and sport coaches put Shaun through a variety of physical tests in the weightroom and on the field. His results were then compared to his previous scores and benchmarks from other defensive linemen to ensure he was progressing and performing adequately at his higher weight.
Before spring ball began, we conducted a body composition assessment to see how far Shaun had come in nine weeks. Overall, he gained 23 pounds, which included 15 pounds of muscle and eight pounds of fat.
Although Shaun was successful in gaining the weight needed to play defensive lineman, it was by no means easy. Early on, he had trouble getting comfortable with being uncomfortable-and by uncomfortable, I mean stuffing his face all day. To help him push through this, I’d watch him eat and tell him to get more food/fluids if what he consumed was insufficient.
Shaun didn’t like to eat much early in the day, either, so getting him to fuel before morning lifts and practices was difficult at first. I’d always remind him to grab his pre- and post-workout recovery items, and I’d bring them to him if he forgot. After a few weeks, however, he got used to eating early and began to slowly incorporate more food in the morning.
In addition, weigh-ins were occasionally problematic because Shaun experienced some discouraging results over the nine-week span. To keep his spirits up, we reminded him that results wouldn’t come overnight. Plateaus would happen, and he had to power through them.
When Shaun struggled with any of these challenges, I found the most helpful thing to do was just be there for him and keep him motivated. Depending on what he needed, I’d answer questions, provide necessary education, take him to the grocery store, send him recipes, and respond to picture messages of his meals and snacks when he was away from our facilities. I also offered daily meal coaching at breakfast and dinner to make sure Shaun’s weight gain performance plates were adequate.
I wasn’t alone in supporting Shaun, though. There were a lot of people involved in his transition, and constant communication was key to quickly resolving problems. For instance, Shaun got sick a few times, which made it difficult for him to maintain his caloric intake. When this happened, the Sports Nutrition staff collaborated with the sports medicine staff to switch Shaun to liquid calories, while also encouraging him to get plenty of sleep, fluids, protein, vitamin C, iron, zinc, and probiotics.
Gaining weight to switch positions seems like a simple concept on paper. But when put into practice, it can be a difficult goal to achieve. Athletes can be successful if they are provided a plan that works within their schedule, adequate resources are available, and all involved staff members can effectively collaborate, communicate, and provide support.
A NEW COURSE
By Kayli Hrdlicka
Kayli Hrdlicka, RD, LDN, CSSD, is the Sports Dietitian at the University of Pennsylvania. She can be reached at: [email protected].
A lot more goes into switching sports than simply trading one jersey for another, and many of these inherent changes will affect an athlete’s fueling strategies. When the athlete in question is a collegiate female cross country runner transitioning to the role of a coxswain on the rowing team, her nutrition plan must account for new levels of physical activity, training schedules, and weight expectations.
“Amy” started her athletic career at the University of Pennsylvania on the cross country team. She was 5 foot 4 inches tall and weighed 116 pounds, with 17 percent body fat. Each week, she ran 65 miles and had two interval workouts, as well as two strength training sessions.
Naturally, she required a high number of calories to fuel this level of activity. A sample day’s intake included around 2,400 calories, 325 grams of carbohydrates, 115 grams of protein, and 70 grams of fat.
After two seasons, Amy chose to end her distance-running career and become a coxswain for the rowing team, instead. A coxswain’s role is very different from their shell-mates. They are in charge of steering the boat, providing guidance and rhythm for the rowers, and executing the race strategy, but they do not actually pull an oar. Coxswains will also often attend strength training sessions with the rest of the team, but any other physical activity must come outside of scheduled practice times.
Because of this, a big factor to consider when putting together Amy’s coxswain nutrition plan was figuring out her new activity level. She came up with a workout regimen consisting of 30 to 45 minutes of cardio four days a week, in addition to the team’s twice weekly strength sessions. Coming from her cross country background, this represented a significant reduction in overall training volume, so Amy’s revised nutrition plan had to include decreased calories, carbohydrates, protein, and fat. The proportions of calories from each of the macronutrients needed to change, as well.
Another consideration was how Amy’s switch from a cross country runner to a coxswain affected her meal and snack timing. Penn’s cross country team practices at around three in the afternoon, while the rowing team typically meets at 6:30 a.m. Although Amy was not physically active during the early morning session, she still needed to fuel beforehand to perform optimally. She then had to dutifully space her meals every three or four hours for the rest of the day for maximum performance and recovery both on the water and in the classroom.
The third issue that affected Amy’s new nutrition plan was the coxswain position’s weight expectations. U.S. Rowing rules require coxswains to weigh at least 110 pounds for women’s events and at least 120 pounds for men’s events. Although they can weigh more, most are expected to stay as close to the minimum as possible, since the other rowers in the boat have to carry their weight.
Putting everything together, Amy’s revised nutrition plan took into account her new sport’s training load, schedule, and weight expectations. She decided to set a goal of losing four pounds over the course of seven weeks. This expectation was tailored to her ability to safely obtain and maintain the weight, and she planned to drop between half a pound to a pound each week.
To support Amy’s reduced training and assist with her weight loss goals, her daily intake was reduced to 1,700 calories, 100 grams of protein, and 55 grams of fat. Her carb consumption also decreased from six grams per kilogram of bodyweight per day to four.
Here’s a comparison of what Amy’s meal plan looked like as a cross country runner and how it changed when she became a coxswain:
Cross Country Runner
Breakfast: Greek yogurt, two hard-boiled eggs, one cup of oatmeal with two tablespoons of raisins and five almonds, and water
Lunch: Whole wheat pita stuffed with three ounces of chicken, bell peppers, spinach, one quarter of an avocado, and one tablespoon of feta cheese; baby carrots; an apple; a handful of almonds; a handful of pretzels; and water
Afternoon snack: Banana and two tablespoons of peanut butter, one part skim string cheese, and water
Dinner: Three-ounce grilled turkey burger on a whole wheat bun, medium baked sweet potato, side salad with balsamic dressing, one cup of grapes, and water
Bedtime snack: Half a cup of cottage cheese, half a cup of pineapple, and two tablespoons of flaxseed
Pre-practice snack: One slice of whole wheat toast with peanut butter, Greek yogurt, and water
Breakfast: Two hard-boiled eggs, one cup of oatmeal with two tablespoons of raisins and five almonds, and water
Lunch: Whole wheat pita stuffed with three ounces of chicken, bell peppers, spinach, a quarter of an avocado, and one tablespoon of feta cheese; baby carrots; and water
Afternoon snack: Banana, one part skim string cheese, and water
Dinner: Three-ounce grilled turkey burger on a whole wheat bun, side salad with balsamic dressing, one cup of grapes, and water.
Amy was quick to adjust to her new meal plan because it focused on fundamentals that she was already familiar with. It emphasized getting a good balance of food groups, as well as including a mix of protein, carbohydrates, fats, fruits, and vegetables into each meal. No food group was eliminated or off limits to her-the proportions of certain foods were simply adjusted when needed. This overall approach helped Amy view the changes in a more positive light and put the focus on improving her performance rather than weight loss and calorie restriction.
After following the revised meal plan for seven weeks, Amy met her weight loss goal. She is now thriving with the rowing team and has fully integrated her new fueling strategies into her everyday life.
EAT TO HEAL
By Maureen Namkoong
Maureen Namkoong, MS, RD, runs a private nutrition counseling practice in Williamstown, Mass., working primarily with clients on weight maintenance and sports performance nutrition. She can be reached at: [email protected].
When an athlete is injured, their whole routine gets turned upside down as they transition to the long, arduous road of rehab. Nutrition must play a key role in this journey, both to promote healing and ensure the athlete returns to activity in peak shape.
I started to work with “Kelly,” a high school soccer player, one week after she suffered an isolated tibia fracture midway through her sophomore season. At the time, she was scheduled to be in a long leg cast for four weeks, using crutches to get around, before switching to a walking boot for another six weeks.
Kelly came to see me at her parents’ urging, so she wasn’t very comfortable with the idea of seeing a dietitian. As a result, our initial visit moved slowly. I started by discussing the basics of nutrition for injured athletes. I explained that there are three phases of healing-inflammation, proliferation, and remodeling-and described what each one entailed. To promote a successful progression through each of these phases, I also covered the importance of increased intake (focusing on protein), as well as micronutrients such as vitamins A, C, and D; calcium; and zinc.
After that, I got a general idea of what Kelly’s diet had been since her injury. Based on a rundown of her typical daily meals, I determined that she was under-fueling, consuming inadequate protein and spacing it incorrectly throughout the day, and eating too many refined carbohydrates. In addition, she wasn’t eating enough vegetables, which meant she was at risk for being deficient in micronutrients.
Armed with this information, I set two goals for Kelly’s nutrition plan while she was injured. First, I wanted to educate her on the importance of keeping her calorie and protein intake high to aid in healing and tissue-building. This took some convincing. Kelly feared that increasing her calories while she was inactive would cause her to gain weight, leaving her in even worse shape when she returned to play.
To put Kelly at ease, I explained why her body needed the additional calories and protein for healing. Plus, I pointed out that she was using crutches to get around, which required much more energy than normal walking and would burn enough calories to keep her from gaining any unwanted weight.
Furthermore, I encouraged Kelly to look at her new nutrition plan as a way to establish good fueling habits that would benefit her in the years to come. She aspired to play soccer in college, so I emphasized that it was the ideal time to start training and eating for muscle growth. This helped Kelly see beyond her injury and helped her buy in to what I was suggesting.
Once she was on board, we discussed changing her diet to increase her calorie and protein intake. When making adjustments to an injured athlete’s meal plan, the ideas and strategies should come from them, as this makes the changes seem more achievable and realistic. With Kelly, we started by looking at her current routine one meal and snack at a time. Then, we determined if there was room to easily add a protein- and/or calorie-rich food that she enjoyed.
For instance, before we started working together, Kelly regularly skipped breakfast. But we brainstormed a few high protein and calorie options that she was excited about, including nonfat Greek yogurt with cereal; a hard-boiled egg, toast with peanut butter, a small piece of fruit, and glass of low-fat milk; and a homemade smoothie made of nonfat Greek yogurt, frozen berries, and peanut butter.
We also came up with a list of grab-and-go protein- and calorie-rich meals and snacks that Kelly could eat in a pinch. Some of her favorites were a pre-made protein shake and fruit or a high-protein meal bar with fruit.
My secondary goal with Kelly was to better space her protein intake throughout the day-she struggled with eating too little protein at some meals and too much at others. Our bodies are in a constant state of breaking down and rebuilding tissues, and it is essential to continuously supply protein for these processes. If we don’t consume enough protein, we end up breaking down more tissues than we build. In Kelly’s case, this would prevent her leg from healing properly and regaining muscle strength.
When recovering from her injury, Kelly necessitated 1.2 to 1.5 grams of protein per kilogram of bodyweight per day. Therefore, at 125 pounds, she needed roughly 70 to 85 grams daily or 15 to 20 grams at each meal and snack.
We worked together to build a list of protein-rich foods and appropriate serving sizes that would meet these requirements. Once we came up with a bunch of options, we re-evaluated the list by considering how easy and enjoyable the foods would be for Kelly. If she thought they were too challenging to prepare or bring to school, they were cut from the list.
These two goals proved to be a lot for Kelly to focus on at once. Adding more would have definitely been too much for her. So although I had also hoped to concentrate on increasing her micronutrient intake with real food, I added a multivitamin to her routine instead.
After my initial meeting with Kelly, her follow-up sessions centered on analyzing what worked, what didn’t, and what we could add to her routine as she progressed through rehab. The biggest challenges for Kelly were finding breakfast and snack options that fit into her schedule. For example, she loved homemade smoothies for breakfast but rarely had time to make them in the morning before school. Therefore, we decided pre-made shakes were a better breakfast option for Kelly during the week, and she could save her homemade smoothies for the weekends.
For snacks, we had to find options Kelly could prep quickly and keep in her locker to eat between classes. We discovered that items like hard-boiled eggs took too much prep, while Greek yogurt was too difficult to eat at school. However, half a turkey and cheese sandwich, a handful of almonds, or a snack bar all worked well.
As Kelly moved forward with rehab and her metabolic demands for healing decreased, her activity slowly increased, keeping her weight in a steady state. To be sure her body composition remained constant, we monitored her weight and how her clothes were fitting. Four months post-injury, Kelly was cleared for sport-specific activity, and she returned to full activity at five months.
My advice to anyone working on a nutrition plan for an injured athlete is to always factor in how they are handling the setback emotionally, as the connection between food and emotional health is very strong. Like Kelly, some athletes may be fearful of gaining weight while they are sidelined and want to restrict calories, not realizing the cost to their healing. Others may take the opposite approach-eating through their emotions and making poor food choices. In either circumstance, engaging the injured athlete by addressing their nutritional state, giving them some control over the situation, and educating them on the impact nutrition has on their return to play can help to overcome these emotional challenges.