Jan 29, 2015
On Top of Their Diet

Three athletes, three different dilemmas. Here’s a look at how a specific nutrition prescription got each one past their problem and back on top of their game.

By Michelle Rockwell

Michelle Rockwell, MS, RD, is the former Coordinator of Sports Nutrition at the University of Florida and now serves as a nutrition consultant for several sports teams and athletes from U.S. Soccer, Major League Baseball, and the World Tennis Association. She can be reached at: [email protected].

Most athletes realize that good nutrition and hydration habits are crucial for optimizing athletic performance. But when sport-specific issues in nutrition arise, athletes can easily become overwhelmed. Getting the most out of what one puts on their plate can vary from sport to sport and athlete to athlete.

In this article, I provide examples of three athletes who encountered unexpected training or health issues and needed to alter their nutritional intake. I’ll explain their struggles, goals, nutritional strategies, and end results. Because each of these athletes was open to making nutritional changes, they ultimately saw a big difference in their athletic careers. (Note that the names used here are not the athletes’ real names.)

Volleyball Weight Gain

Jasmine was a freshman volleyball player in a top-10 college program. She was heavily recruited due to successful junior and senior high school seasons, and her coaches believed she had great potential at the college level. Jasmine’s only problem was that, at 6-foot-1 and 142 pounds, she lacked strength and power. She was red-shirted for her freshman year in order to build strength and lean mass.

She had always had a very thin, lanky physique and was skeptical about “bulking up.” Her high school team never lifted weights, so the concept was new to Jasmine. The college team’s strength coach designed an aggressive lifting and conditioning program aimed at building strength while keeping body fat low. He explained that her total body weight should increase by 10 to 15 pounds, but that her body fat and overall fitness would improve. He emphasized that good nutrition would be an essential component of the plan.

Jasmine was a picky eater who struggled to adjust to dining hall offerings. She was particularly reluctant to eat meat she hadn’t cooked herself and didn’t like most of the vegetarian entrees served. Sometimes, Jasmine ate a bowl of cereal and dessert for lunch and dinner. Jasmine also snacked between meals, typically on animal crackers or Skittles from a vending machine.

Goal One: Increase lean body mass while decreasing body fat. Jasmine, her strength coach, and her sports dietitian worked together to establish a nutrition plan. Overall, Jasmine was consistently taking in about 3,100 calories a day, which was higher than the approximate 2,500 calories she was expending. The composition of these calories, however, needed adjustment.

Mostly, Jasmine needed more protein. Because she was initiating a weight-training program to gain lean mass, her needs were estimated at about 135 grams of protein per day. Through her current diet, she was only getting about 50 grams per day. Satisfying protein needs without eating much meat is certainly possible, but takes some work.

Jasmine was willing to eat the grilled chicken breast served at training table dinner and also the turkey deli meat served at lunch, which would greatly improve protein consumption. In addition, she agreed to add several other foods that she already liked, but didn’t realize were good protein sources: chick peas, kidney beans, and hard boiled eggs from the salad bar, cheese or peanut butter on bagels and apples, scrambled eggs at breakfast, black beans and refried beans in tacos and quesadillas, and yogurt or sunflower seeds as snacks. The strength coach also started providing a nutrition shake after weightroom workouts for an additional 20 grams of protein.

Goal Two: Provide optimal energy for rigorous workouts. Although volleyball is primarily an anaerobic sport, carbohydrates are still the primary fuel. Additionally, carbohydrates are important in the muscle-building process. Jasmine’s original diet had plenty of carbohydrates (about 60 percent of her total calories), but they were from low fiber, low nutrient, and typically high sugar sources (sugary cereals, dessert, animal crackers, plain bagels). Improving the quality of these carbohydrates would not only provide optimal energy for workouts and muscle-building, but also help sustain a high energy level.

Jasmine said she could not resist the dining hall dessert bar, so it was agreed that she allow herself one dessert each day. This fit in easily with the other changes she was willing to make: whole grain cereal instead of high sugar cereal, wheat bread, lots more fruit, and more vegetables. She agreed to choose the baked potato bar, fresh salads, and broccoli whenever they were served.

By winter break of her freshman year, Jasmine had gained eight pounds and decreased her body fat by 3.5 percent. Her lifting maxes had shot up tremendously, to her coach’s delight. Jasmine’s biggest struggle was adjusting to a whole new body and a very different eating regimen. But she felt confident it would pay off on the court in the fall when she would begin her college career. She was starting to feel stronger and more powerful during practices and felt her stamina had also improved.

Football Surgery Rehab

Korey was a running back in his first season with an NFL squad. He’d had an excellent summer of training with several teammates and made significant gains in strength, speed, and size. Although nutrition was unimportant to him during college, he had buckled down and eaten very well during the summer, eating five meals per day, hydrating regularly, eliminating fast food, using recovery shakes after workouts, and learning to cook for himself. He was up to 225 pounds, which was his goal weight, and he felt very confident reporting to training camp.

Unfortunately, during the first scrimmage of training camp, Korey had a fluke injury and tore his ACL. Surgery was scheduled for two weeks after the injury since coaches wanted to get him back to training as soon as possible the following spring or summer.

Korey’s spirits were deflated. He had dreamt his whole life of a chance to play in the NFL. He lost his appetite, likely due both to severely decreased activity and also feeling depressed. It was difficult for Korey to get around on crutches, so when he did eat a meal, it was typically fast food or something a friend or teammate brought to him.

Following his surgery, when it was even harder to get around, Korey ate whatever people brought by his apartment, mostly junk food and fast food. His mom and girlfriend kept him supplied with brownies and cookies to cheer him up. Two weeks after surgery, Korey was down to 207 pounds and felt tired and weak.

Goal One: Maintain muscle mass and weight during rehab. After surgery, the body is in a catabolic state. Thus, even though his hunger level was reduced, Korey needed just as many calories as he did pre-injury (about 3,700 per day) to maintain his weight. It was essential that Korey return to his eating regimen of five meals per day. With such frequent meals, he wouldn’t have to eat a large amount at any particular setting, which was helpful since he didn’t often feel hungry.

Korey felt particularly nauseated first thing in the morning (maybe due to his medications), so he drank a meal replacement shake rather than solid food for breakfast. He ate a snack mid-morning, then lunch, dinner, and a snack before bed. Because Korey had the greatest appetite at lunch time, he ate his largest meal at mid-day. Korey completed his rehab with the athletic trainer in the evenings, then consumed the same recovery shakes he used to drink after weightroom workouts.

In terms of food choices, it’s relevant to consider how difficult it was for Korey to get around. He stated that he “felt terrible eating all that greasy fast food,” but because the fast food restaurant was convenient, the sports dietitian specified several healthier options. For example, the double cheeseburger, large fries, and large milkshake he had been getting has over 90 grams of fat. Replace that with a quarter pounder (no cheese), chicken nuggets, and lemonade and there are only 35 grams of fat and significantly more protein. Korey was happy to learn there were healthier choices that still sounded appealing to him.

In addition to eating healthier fast food, he asked his roommate to take him grocery shopping once a week to stock up on easy-to-prepare foods such as sandwiches, canned turkey chili, eggs, cereal and milk, peanut butter and crackers, yogurt, stir fry, canned veggies, and fresh fruit. Prioritizing an eating routine made Korey feel more confident and helped his energy level return.

Goal Two: Eat foods that support healing. Some foods play a special role in healing from surgery. Because of this, Korey was taught to include protein in each meal along with eating important micronutrients such as Vitamin C (citrus fruits and juices, strawberries, broccoli), Vitamin A (milk and dairy products, eggs), and zinc (beef and poultry, beans, nuts, dairy products, fortified cereals) throughout the day. Korey’s mom was especially helpful as she stopped bringing baked goods and started bringing fresh fruit salads and homemade casseroles (using chicken or lean beef).

Korey developed a knee infection a month into his rehab, causing a second surgery. Although this was a blow to his enthusiasm, he was grateful to have already begun a diet plan that was helping him gain weight and heal. He started back to upper body lifting and was at 218 pounds two months after the second surgery.

Runner With Irritable Bowel Syndrome

Allison is a high school long-distance track athlete who logs between 45 and 55 miles per week. After a year of gastrointestinal problems, she visited a family doctor who diagnosed her with Irritable Bowel Syndrome (IBS). Common in runners, IBS is a diagnosis of exclusion, given when there is abnormality in bowel movements, but no other specific etiology. It almost always involves periods of constipation alternating with diarrhea, although there are individual differences between patients. Dietary intolerances are big triggers.

Allison’s specific symptoms included feeling bloated in her abdominal area, sometimes feeling constipated but more often having loose stools or diarrhea, and feeling “stomach cramps so bad that I couldn’t complete workouts.” Symptoms seemed inconsistent and Allison felt a lot of anxiety about not knowing what to expect. She reported a significant worsening of cramping and diarrhea on race days.

Allison’s symptoms had a negative impact on her nutritional habits. She felt that whatever she ate before races made symptoms worse, so she often consumed very little on these days. On training days, Allison found that she could usually handle a light breakfast (a plain bagel or a cereal bar), but rarely ate lunch to avoid “getting diarrhea and embarrassing myself during practice.” She was extremely hungry after practice and ate a sports bar, cookies, and other snacks when arriving at home.

By the time her family ate dinner, which was healthy, she was full from the snack and typically just nibbled at the food on her plate. Although she was hungry before bedtime, she tried to resist eating because she felt late-night eating would cause weight gain. She felt the whole regimen of inconsistent eating had negatively affected her body composition, which she was very sensitive about.

Goal One: Minimize gastrointestinal issues. For two weeks, Allison kept a food diary, which also included a detailed account of her IBS symptoms. From this, it became apparent which specific foods and eating habits caused an increase in symptoms. She had thought that milk and dairy products caused her to have an increase in diarrhea, but in the two weeks, she never had problems with these foods. However, salads, mayonnaise, creamy sauces, and fried foods caused an increase in cramping and diarrhea.

She consistently reported stomach spasms and diarrhea between 10 and 11 a.m., which she attributed to the coffee she drank around 8 a.m. She had switched to decaffeinated coffee, knowing that caffeine is ill-advised in IBS. However, it seemed that the decaffeinated coffee was just as problematic, so she eliminated coffee altogether. At the suggestion of her sports dietitian, Allison cut out sugar-free and fat-free products, which eased some symptoms—sugar alcohols, some sweeteners, and fat substitutes can easily trigger the GI tract.

After the two weeks, Allison felt confident she knew which foods to avoid, but this left her wondering what foods she could and should eat. The sports dietitian gave her a list of foods high in soluble fiber, which can help normalize stools. This included oatmeal and other oat-based cereals like Cheerios, along with white rice, pasta, potatoes and sweet potatoes, bananas, oranges, pears, carrots, broccoli, and beans. Although foods high in insoluble fiber (also called “roughage”) are quite healthful, they can trigger diarrhea in IBS patient, which was the case with Allison. So she stayed away from whole wheat breads and cereals, brown rice, fruits and veggies with skin, and nuts.

Lean proteins were also recommended since they are not only important in the diet of runners, but are unlikely to trigger IBS symptoms. Some IBS patients have problems consuming dairy products, but since Allison did not, she was encouraged to eat them as a good source of protein, calcium, and Vitamin D.

Allison’s food diary also revealed an increase in symptoms when she ate large amounts of food, especially when she hadn’t eaten for several hours. Thus, she initiated a meal plan that involved eating once every three hours. She had breakfast, lunch, a post-workout snack, dinner, and a before-bed snack. She worked hard until she was able to follow this regimen consistently from day to day. Regular, small to moderate-sized meals are often recommended to IBS patients and Allison was willing to try eating lunch before training once she had identified trigger foods to specifically avoid.

Goal Two: Improve overall nutrition. Adding high-fiber foods, even if they are soluble fiber, leads to an improved consumption of vitamins and minerals, so Allison’s new food choices set her up for a better overall diet. Additionally, she began packing a healthy snack (an orange and cereal bar) to have right after practice so she wasn’t extremely hungry when arriving home. This helped her enjoy a modest portion of the healthy dinner her father prepared.

Goal Three: Develop a pre-race nutrition plan. Although she felt much more confident eating on training days, Allison was still reluctant to eat before races. Anxiety and nervousness increased symptoms, which is typical. The strategy that worked was to eat a little more the day before a race, eat a packet of oatmeal and a banana three hours before race time, and continually sip a sports drink until the race. She usually tolerated this fairly well and reported a higher energy level at race time.

Goal Four: Support a desirable body composition. After following these dietary changes—more fiber, fewer trigger foods, smart snacks after practice, and consistent small meals—Allison actually decreased her body fat by three percent without specifically trying. This gave her lots of positive reinforcement to continue the diet.

Over time, Allison still had occasional flare-ups of IBS, but she was almost always able to make dietary changes to minimize them. She has continued to run successfully. Her physician offered her medication to help control symptoms, but she declined it since focusing on nutrition had proven to be so effective.

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