. NUTRITION.

I

ike was a very successfulhigh school defensive backwho was offered a fullscholarship to a highlyranked NCAA Division Icollege football program.Throughout high school,

his coach had told him that bigger wasbetter, so he decided to eat more atevery meal and spend more time in theweight room. This resulted in anincrease in mass, strength, and per-formance.

The summer before his freshmanyear at college, he sustained a kneeinjury in a pick-up basketball game.His activity decreased dramatically,but his eating didn't, and by the timehe reported to the first day of trainingcamp at college, he was 25 poundsheavier than his playing weight. Hewas told to lose the weight fast, doing

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whatever it took, and to exercise afterpractice by doing some extra runningor stationary biking.

Worried that he wouldn't see play-ing time if he didn't lose the weight,Mike started skipping breakfast andlunch and eating a large salad and twogrilled chicken breasts for dinner. He

BY LESLIE BONCI

"...

..I

went to bed hungry, woke up irritable,and was extremely tired and lighthead-ed during practice. His weight droppedbut his performance suffered- and theextra activity aggravated the kneeinjury. He saw very little playing time.

Obviously, this is an example ofwhat not to do when an athlete needs to

lose weight. The timing was wrong,there were no realistic goals, and com-munication was almost nil.

Weight management is difficultfor all involved, and it needs to betreated with care. The individual who

is trying to change his or her weight isvery sensitive and may feel pressure todo it quickly. The individual who is

Leslie Bonci, MPH, RD, is Director ofSports Nutrition at the University of Pitts-burgh Medical Center and serves as a con-sultant to the Pittsburgh Steelers, Pitt ath-letics, and several area high schools.

ATHLETICBID.COM . T&CMARCH 2004 . 27

. NUTRITION.

TABLE CNE1!'">

T he measurements listed below correspond to a medium frame forthe given height. If elbow breadth is less than the numbers listed

here, the athlete has a small frame. If elbow breadth is greater than thenumbers listed here, the athlete has a large frame.

To measure elbow breadth the athlete should be standing, with dom-inant arm extended forward and palm down. Bend elbow to a 90 degreeangle so that the back of the hand faces the athlete. Measure the distancearound the narrowest part of the elbow joint.

FOR A MALEHeight5-2 to 5-35-4 to 5-75-8 to 5-116-0 to 6-36-4 to 6-7

FOR A FEMALEHeight4-10 to 4-115-0 to 5-35-4 to 5-75-8 to 5-116-0 to 6-4

Elbow Breadth (inches)2-1/2 to 2-7/82-5/8 to 2-7/82-3/4 to 32-3/4 to 3-1/82-7/8 to 3-1/4

Elbow Breadth (inches)2-1/4 to 2-1/22-1/4 to 2-1/22-3/8 to 2-5/82-3/8 to 2-5/82-1/2 to 2-3/4

Source: "Elbow breadth as a measure of frame size for US males and females,"

by Frisancho AR, Fle'gel PN. AJCN Vol. 37, 311-314, 1983.

making the recommendation may bewell intentioned, but misinformed-hence, a disconnect develops thatresults in an uncomfortable and some-times confrontational situation.

In order to do best by the athlete,you must help him or her put a plan inplace, with very specific goals, a time-line; and a strategy for assessingprogress. The process also requirescommunication and an understandingthat each athlete and each weight-losssituation is unique.

THE RIGHT QUESTIONS

When an athlete is interested in losingweight, it is a good idea to sit downwith him or her and gather some infor-mation prior to goal setting. Questionsto ask might include:.Why are you interested in losingweight?.Has anyone told you that youhave to lose weight?.Do you have particular healthconcerns?

.Have you lost weight in the past?If so, how?.What do you expect to notice inyour performance as a result of weightloss?.How much time do you have tocommit to working on weight goals?.What are obstacles that may hin-der your efforts to lose weight?.Do you have a support system inplace?.Do you have a time frame forweight loss?

It is important to ask these ques-tions so that you start a dialogue withthe athlete on what mayor may not berealistic goals. Athletes should knowwhat they can change in their bodies:fluid balance, muscle mass, and bodyfat. And they should know what theycannot change: height, frame size, andbody shape.

The athlete who diets to havebroader shoulders or smaller hipsneeds to be educated about realisticbody goals. With changes in exercise

28 . T&CMARCH 2004 . ATHLETICBID.COM

and diet, one can change their size, butnot their body type.

The red flag is when someone isoverly concerned about the look oftheir body. These individuals mayemploy drastic measures to changetheir bodies, such as dehydration, star-vation, and the use of supplements, lax-atives, or diuretics. The outcome is not

body fat loss, but a change in fluid bal-ance and lean body mass, both of whichmay adversely affect performance andhealth. The athlete who seems overlyobsessed with his or her body should bereferred for counseling.

GOAL SETIING

In the absence of any red flags, theprocess of weight loss can begin withrealistic goal setting. To do this, you'llneed to assess the athlete through base-line measurements. I believe the most

important baseline measurement totake is the athlete's body fat percent-age. Why focus on body fat and notweight? The goal is enhanced perform-ance, and that will not be achieved bya decrease in body weight alone. It isthe loss of body fat- withoutloss ofmusclemass- thatwillleadto a betterathlete.

If an athlete loses five pounds aweek, it does not indicate fat lossalone, but also fluid and muscle massloss, which will have a negative effecton performance. In addition, becausebody weight can fluctuate severalpounds in the course of a day due tofluid changes, it can be extremelydemoralizing to the athlete who hashad a "good" week only to see thescale read higher.

To start out, you'll need a baselinemeasurement of the athlete's body fatpercentage. Underwater weighing andDEXA (Dual Energy Xray Absorpt-iometry) provide the best measure-ments, but you can also use skinfoldcalipers or bioelectrical impedance.

For some athletes, another impor-tant baseline measurement is framesize. Even if you explain the impor-tance of body fat measurement, someathletes will still obsess about theirweight and want their numbers tomatch those on a standard height-

weight chart. For these athletes, it maybe helpful to make frame size a part ofthe equation, since someone with alarger frame size should expect toweigh more than someone of the sameheight with a small frame. (An assess-ment of frame size can be computedusing elbow breadth as illustrated inTable One, on page 28.)

Once you obtain baseline meas-urements, how do you set goals forreducing body fat? I usually start withgoals of reducing 10 to 15 pounds ofbody fat over a period of six mOl!ths.That would equal about two pounds ofbody fat a month-a small number fora goal-oriented athlete. Long-termgoals are important, because in order toavoid losing muscle mass, an athleteneeds to lose weight slowly.

Measure body fat at six-weekintervals, looking for body fat reduc-tions of three to four pounds. Also askathletes to assess success in non-scalerelated ways such as energy levels, bet-ter sleep patterns, and improved per-formance. This is the best way I've

. NUTRITION.

THE FOLLOWING TIPS CAN HELPWITH WEIGHT LOSS:

CUTTING CALORIES:

8 Use a smaller plate, bowl, or glass to control portion sizes.8 Look at the serving sizes on packages of foods to keep the portions in

check.

8 Do not reduce carbohydrates, but decrease the serving size.8 Understand that fat-free and sugar-free foods are not necessarily calorie-

free.

8 Be aware of calories in condiments.

8 Use a smaller amount of real salad dressing, peanut butter, or mayonnaiseinstead of large amounts of fat-free versions.

8 When eating out, order half-size portions or have an appetizer and salad,or soup and half a sandwich.

H

EATING HABITS:8 Try to eat more early in the day to prevent overeating in the evening.8 Always eat breakfast.8 Eat something every three to four hours.8 Be consistent with the number of meals a day, seven days a week.8 Sit down when eating.8 Put all foods, even snack foods, on a plate.8 Try to eat when hungry, and on a fullness scale of 1-10, stop at about a 5.8 Try not to eat when at the computer or watching television.8 Put tempting foods out of sight, or better yet, out of the house,

apartment, or dorm room.

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. NUTRITION.

EAT?

hen starting a weight-loss plan, ask athletes to write down next toeach 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 reducestress, when hanging out, or as a quick meal solution.

CARBOHYDRATE-CONTAINING FOODS

- Bread- Bagels- Cereal- Pasta_Rice- Fruit- Vegetables- Juice- Sports drinks- Soda- Candy- Cookies- Cakes/pies- Pastries- Crackers- Pretzels- Chips- Potatoes- Yogurt- Ice cream/frozen desserts

PROTEIN-CONTAINING FOODS- Beef_Veal- Lamb- Pork

found to keep the athlete motivated andthe goals performance-based.

If your athlete needs some short-term goals to keep motivated, be sureto add them in. A good goal to startwith is 1/2 to 3/4 pound of body fat lostper week, which might equal twopounds per week on the traditionalscale. Again, ask about energy levelsand mood.

It is also important to start anyweight-loss program at the end of theseason with the final goal to beachieved by the following preseason.Too often, the athlete may wait untilthe start of the season, or until the sea-son is already under way, to work onweight goals.It is extremely difficult tofocus one's undivided attention on therigors of training, conditioning, com-

_Fish- Shellfish- Chicken- Turkey- Eggs- Cheese- Nuts- Nut butter- Dried beans (kidney,

lentil, etc.)- Soy products (tofu,

soy milk, veggie burgers)_Milk

,XogurtFAT-CONTAINING FOODS

- Margarine- Butter- Salad dressing- Mayonnaise_Oil- Bacon- Cream cheese

HIGH-CALORIE DRINKS- Alcohol- Beer_Wine- Mixed drinks

petition, and academic demands, whilesimultaneously addressing body goals.Timing is a key component of weightloss and trying to lose weight in-seasonmore often than not leads to decreased

performance.

CHOICES & BEHAVIORS

It would be impossible to adequatelyaddress weight management withouttalking about diet. However, do realizethat one's diet is composed of twoareas: what and how much actuallygoes 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 nottranslate to a decrease in strength,speed, stamina, or mental clarity.Therefore, athletes should not adopt an

30 . T&CMARCH2004 . ATHLETICBID.COM

eating pattern that eliminates or severe-ly restricts an entire macronutrient,such as carbohydrate- or fat-containingfoods. Nor should they skip meals. It isimportant to remind athletes that car-bohydrate and fat are the primary fuelsubstrates for the exercising muscles.Protein is essential for tissue growthand repair and supporting a healthyimmune system, but it is an inefficientfuel substrate for exercise. One maydrop some pounds by using a high-pro-tein diet, but will pay the price bybeing too tired to make it through apractice or conditioning session.

What about the actual food choic-es? Is there one sports diet? Besideseating the proper balance of carbohy-drates, proteins, and fat (60/15/25 forthe endurance athlete, 50/20/30 for thepower athlete), the answer is no.

Overall, you want to reducecaloric intake, but there is not one mealplan or calorie level that will be appro-priate for every athlete. The idea is forthe reduced calorie level to result in thedesired changes in the body while stillproviding enough energy for thedemands of exercise.

To determine appropriate caloriereduction, first figure out the athlete'sResting Metabolic Rate (RMR), whichis body weight multiplied by 10, plus70 percent of that number (to as;countfor an athlete's activity). That gives

you the number of calories for w~ghtmaintenance. Then, subtract 20 percentfrom the equation for weight loss. So,for a 150-pound athlete, the equationwould be:

150 x 10 + .7(1500) =2550;2550 - .2(2550) =2040.

The athlete should consume 2040 calo-

ries for weight loss to occur withoutnegative energy levels. (If an athlete isnot exercising, the 70 percent of RMRshould go down to 20 to 40 percent.)

There is absolutely no advantagein cutting calories to a minimum. Inthis example, if our 150-pound athletehad a goal of 130 pounds and decidedto eat only 1200 calories a day forweight loss, he or she would end upvery hungry, tired, and irritable, andwould most definitely notice a declinein performance. Too low is not betterwhen it comes to calories for weight

loss. Although most athletes don'tknow the calorie cost of foods con-sumed, there are some on-line tools

. such as the Interactive Healthy EatingIndex (www.usda.gov/cnpp). whereone can log food intake and get a print-out of calories consumed daily.

The next step is to take intoaccount the psychological side of foodconsumption. Eating is supposed to bea pleasurable experience, thus the ath-lete's meal choices need to be based onhis or her food preferences as well aswhen and where he or she likes to eat.

A simple concept, but one that peopleforget to take into account!

To help athletes figure out how tochange their diets, I give them a chartthat lists many popular food items. Iask them to circle the foods they eatfrequently, then list how often they eatthem. I also ask them to indicate "trig-ger foods," things that they pig out onor eat for stress reduction, as well asfoods they never consume. (See TableTwo on page 30.) From looking at thechart, I can see if they are consuming

. NUTRITION.

I also ask them to describe their

eating patterns: Do they eat a lot atanyone meal? Do they use snacks asa way to reduce stress, get through along night of studying, or when hang-ing out with friends? This helps todetermine troublesome times of theday and hungry times, and allows usto concentrate on problem areasrather than the entire day. I want tounderstand how to take away thecalories that have little meaning,while leaving in the calories that dohave meaning.

A final tip on setting weight-lossgoals: make sure the athlete has input.The athlete must be ready and willingto change, which can more readilyhappen if he or she has had a thought-ful dialogue about the dieting process.The most superb meal plan will onlybe effective if the athlete perceives thevalue of it. Ultimately, it is the athlete,not the coach, health professional, orathletic trainer, who decides what,when, and how much he or she isgoing to eat and drink.

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too much or too little of one thing, andwhether there may be some psycho-logical factors behind their food choic-es. For example, if an athlete eats pri-marily carbs or protein, I would havehim or her look at the food choices inthe other categories and develop a planthat would include a mix of nutrients ateach meal and snack.

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Request No. 21ATHLETICBID.COM. T&CMARCH2004 . 31

. NUTRITION.

SUPPORTTEAM

Along with having goals and an overallplan in place, some thought must beput into who will monitor the athlete. Ifthere is not a nutritionist on staff, theathletic trainer is an ideal person tomeet regularly with the athlete.

Accountability is a huge part ofgoal setting, so be sure to check bodyfat percentages or go over eating planswhen you say you will. Most athletesneed to know that someone is monitor-ing them for their efforts to be success-ful. It is also important to build inincentives so that the athlete perceivesthe value in going through the effort.Ideas for incentives might include pos-itive comments, talking about effectson performance, an effort award, andeven letting a successful weight-loserbe a peer counselor for athletes juststarting out on a weight-loss plan.

Some additional tips for those onthe support team:.Always focus on what works forthe individual. Even if you have person-

ally found a meal plan and lifestyle pat-

.Remind athletes that weight loss

is a series of steps, not a slide, so thereare going to be weeks when theirweight doesn't change. Explain thatthis is the body's adaptation to theprocess of weight loss, and it is notnecessary to eat less or exercise more.. Suggest that the athlete takepride in what he or she has accom-plished so far and what they notice interms of performance. Tell them thereis no such thing as perfection. When anathlete hits a plateau, it is a good ideato encourage him or her to monitorintake for a few days to see if perhapscalories are on the high side, or perhapsthey just need to have patience.

Weight loss does not occurovernight, and so far, no magic pill isavailable. It takes time, effort, and com-mitment on everyone's part. The under-lying goal is performance enhancementand positivebody changes.If weightloss is approached in a healthy way, theathlete will be proud of his or heraccomplishment and see the results inhis or her performance..

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tern that works for you, you should notassume it will work for someone else..Take a positive approach. Losingweight can be much more difficult forsome athletes than lifting a heavierweight or learning a new play. Do notbelittle or criticize, or else your effortsmay backfire. The environment andsupport system need to be positive.

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