Nutrition for Maintaining Strength All Season Long

Some athletes who come in for a nutrition consult might have some kind of body composition goal - usually these athletes come in with the goal to gain lean mass (muscle) or lose fat mass. Body composition goals are set for many reasons, and may be related to improving performance, but many athletes aren't setting these goals at the right time of the year, so they're sacrificing their performance.

• The off-season is a good time to solidify an eating routine with better nutrition habits, and to meet goals such as losing weight/body fat or gaining lean mass. 
• Once the season starts, athletes should focus on maintaining their weight for the most part, but many athletes have a hard time with this because of their busy schedules and high energy needs. 
• Some athletes work hard during the off-season to increase their muscle mass and strength, but end up losing weight throughout the season, which can result in losing that hard-earned lean mass, increase injury risk, cause fatigue, and decreased performance during the most competitive part of the season.
• Some weight loss may be expected early in the season as the practice schedule may increase, but if athletes are skipping meals and failing to recover properly, they will likely run into problems later in the season. 
• Other athletes might have a goal to lose weight during the season, but this is more easily done in the off-season or early in the season and athletes who want to lose weight often aren't advised on how to lose weight without sacrificing performance. 

Athletes can follow these 3 tips to maintain weight and strength and perform well all season long:

1) Start the day with a well-balanced breakfast.

Many young athletes can get into the habit of skipping meals, and claim it's because they're not hungry in the morning, don't have enough time, or just don't know what to eat.

Breakfast skippers usually can't make up for those calories they skipped by eating more later in the day, which isn't good news for keeping body weight stable and maintaining lean mass. Some athletes can make up for the calories, but they usually end up overeating the wrong things at meals, or grabbing any convenience foods they can find after they've gone too long without eating.

Choose a breakfast that contains carbohydrates (toast, oatmeal, whole grain cereal), protein (eggs, milk, Greek yogurt, peanut butter, nuts, meat), and a piece of fruit or vegetable for extra nutrition.

An easy breakfast that can be modified based on an athlete's nutrition needs is a fruit smoothie. To make an easy smoothie, add the following ingredients to a blender and enjoy:

-Fruit: 1 cup frozen blueberries, strawberries, or peaches or 1 banana (try freezing slices for a thicker smoothie)
-Protein: 1 cup plain Greek yogurt, cottage cheese, or 1 scoop protein powder
-Healthy Fat: 1 Tbsp peanut butter, ground flax seeds, or chia seeds (adding extra nut butter/healthy fats helps add calories easily if athlete has experienced weight loss in the past)
-Liquid: 1-2 cups milk and/or water (milk adds protein + extra nutrients).
-Extras: Add a couple handfuls of spinach for some added nutrition. Ice cubes and frozen fruit will help make the smoothie colder/thicker. Adding oatmeal before blending will also add some fiber and make the smoothie thicker.

Smoothies are a great way to add nutrition easily (for instance, if you don't like vegetables, you can easily hide several handfuls of spinach in here...), and they're simple to make and modify based on your needs.

2) Choose energy-dense/high-calorie foods, but make sure they're high-quality foods as well!

Sports training and competition isn't an excuse to eat whatever you want. Instead, eating a meal or snack every few hours and choosing high-quality foods is a better way to get in plenty of calories and good nutrition during the day.

The best snacks contain a mix of carbohydrate + protein or fat, so instead of reaching for candy bars, fast food, cookies or sports bars and powders, grab a whole food option such as:

• Apple and peanut butter
• Mixed nuts and raisins
• Small bowl of cereal
• Greek yogurt with berries
• Hardboiled eggs and hummus
• String cheese and grapes
• 1/2 a peanut butter and jelly
• Tuna on whole grain crackers

For high calorie options, choose foods such as nuts and nut butters, avocado/guacamole, cheese, eggs, and whole fat dairy. Jill Castle, the dietitian and author behind the book "Eat Like a Champion" (great nutrition reference book for parents of young athletes) recommends that snacks be 100-250 calories to help athletes meet their overall calorie needs for the day, but also be high in nutrients to help kids meet their vitamin and mineral needs for the day. This is a good guideline when searching out snacks (containing a certain amount of calories, but also being high in nutrition) because, for example, 250 calories of apple and nut butter is going to contain a lot more nutrition than 250 calories of chips or cookies. 

3) Prioritize recovery

Athletes who prioritize post-workout recovery are the athletes who stay strong all season long, maintain their weight, and can continue to play at a high level.

Recovery should be an all-day process, but post-workout, athletes should focus on 3 things:

• Hydrating with fluids and electrolytes: drink plenty of fluids post-workout/competition and monitor urine color (lighter = well hydrated). 
• Refueling with carbohydrates (body weight divided by 2 in grams)
• Repairing with protein (15-20 grams post-workout)

If athletes are going home after practice, they should aim to get a balanced dinner that contains some sort of protein (chicken, beef, fish, beans, eggs, dairy) and carbohydrates (whole grains such as brown rice, quinoa, whole grain bread, whole grain pasta/spaghetti/noodles, or starches like potatoes and sweet potatoes). If they won't be home within an hour after practice or competition, the athlete should definitely pack a snack that contains a healthy carbohydrate and protein (see tip #2!) and eat a real meal whenever possible. 

4) Meet with a dietitian!

Athletes of all ages and from all sports can benefit from meeting with a dietitian. From picky eaters, to special dietary needs, to body composition goals and knowing how many calories, protein, carbohydrates and fat they need in a day - a dietitian can help athletes set a nutrition goal that will help them perform better in their sport. 

Make an appointment today with the Sanford Sports Science Institute Dietitian by calling 605-312-7878 or e-mail her any questions at Elizabeth.Kuckuk@SanfordHealth.org

Back-to-School Nutrition for Active Kids

This article was featured in The 'Hood Magazine in June, so it is worth posting here now that some kids are going back to school and starting sports, and because August is Kids Eat Right Month.

Back to school time is a great "fresh start" for things like school supplies and clothing, but it can also be a great chance to get kids into new habits, like packing snacks, making their own lunches, and eating breakfast on a regular basis. 

Returning to school can also mean returning to busy schedules filled with extra curricular activities and sports for kids and teens. Don’t forget to make good nutrition a part of that back-to-school routine to support growth and development, and help fuel your kids throughout the day.

Good nutrition has benefits beyond healthy growth and development. Breakfast, in particular, has been linked to better school performance, less weight gain, and lower body mass indexes (BMIs) in kids. A healthy breakfast sets kids up for healthy meals and snacks the rest of the day, and reduces the likelihood of overeating or choosing junk foods to curb their hunger later in the day.

Kids involved in sports have even greater nutrient needs. They require extra calories to fuel exercise or training schedules in addition to calories and nutrients needed to maintain normal growth and development. Plan for three balanced meals, healthy snacks, and plenty of water during the day.

Create balanced meals by including as many of these food groups as possible at each meal. For example, if your child likes toast for breakfast, add a piece of fruit and a source of protein, like eggs, to make the meal complete.

• ·        Lean protein (meat, seafood, poultry, eggs, beans, nuts and seeds): Better options are usually grilled, baked, or roasted.
• ·        Vegetables and fruit (mostly vegetables): Eat at least one serving per meal and snack.
• ·        Whole grains (bread, pasta, rice, cereal, oatmeal, etc.): Choose products that say “100% whole grain” for more fiber and nutrients, and help your child feel fuller for longer.
• ·        Dairy products (milk, cheese, yogurt): These foods are a good source of protein and carbohydrates, and contain calcium and vitamin D to promote healthy bones.
• ·        Water is important, especially if kids are exercising. Encourage kids to carry a refillable water bottle and refill it several times per day. Sports drinks should really only be consumed if kids are exercising for  a long duration, or very intensely, in a hot/humid environment - water should be the drink of choice most of the time. 

Because snacks can make up a significant part of kids’ diets, suggest healthier snacks that combine protein with a complex carbohydrate (whole grain, fruit or vegetable). For example, instead of traditional chips or cookies, go for mixed nuts and an apple, half a peanut butter and jelly or Greek yogurt with berries and granola. It’s okay to eat sweets or snack foods once in a while, but there are more nutrient-dense options kids should be eating most of the time to fuel their active bodies. 

Check out these 5 school lunches kids can make themselves, or these 10 back to school lunches, which are great for kids and adults with busy schedules. 

This article on Sports Nutrition for the School-Aged Athlete talks about making sports nutrition part of your daily ROUTINE, which is an important topic. Good nutrition only works when families are in a nutrition routine, where meals and snacks are either planned ahead of time or they know which options are healthy when eating out or throwing together a quick meal with what's available.

Sports Fueling for Kids is a fun infographic that emphasizes the importance of breakfast, snacks, and post-game meals!

Training Talk: What Female Athletes Need to Know About Fueling Their Bodies

At the 10th Annual Sanford Sports Medicine Symposium last weekend, I spoke about nutrition's role in injury prevention and recovery. One of the main topics of the presentation was low energy availability in athletes. Energy availability is the amount of calories left over for the body to use for normal physiological functions (heart beating, walking around, lungs breathing, thermoregulation, growth, etc.) after accounting for calories burned during training or exercise.

Food intake - Energy Expended During Exercise = Energy Availability

Athletes who have heavy training schedules can be living in a chronic state of low energy availability, where every calorie they eat at meals is burned off during exercise, leaving little to no calories for the body to perform those regular bodily functions.

When calorie intake doesn't match energy expenditure, this low energy availability can not only have negative effects on training and athletic performance, but can put athletes at risk for other health problems.

For female athletes, this low energy availability can lead to other health issues, such as low bone mineral density and menstrual function disorders in what is called the Female Athlete Triad. Physically active girls and women can experience any one of the 3 components, which are interrelated and occur along a spectrum of healthy to unhealthy (see picture below).

Source: 2014 Female Athlete Triad Coalition Consensus Statement on Treatment and Return to Play of the Female Athlete Triad.
De Souza MJ, et al. Br J Sports Med 2014;48:289

Female athletes won't always know the signs of female athlete triad because they won't necessarily lose weight if they have low energy availability (many athletes have a stable weight despite not meeting their calorie needs)...but they might notice if  they're training hard and lose their menstrual period. An estimated 20% of active women has missed 3 or more consecutive menstrual periods, called amenorrhea. This can lead to a loss of calcium from bones, a much higher incidence of stress fractures and poor bone health...but some athletes might believe that losing their period is just a normal part of hard training.

Regardless of body fat and weight, athletes' low energy availabliy can trigger amenorrhea, and appropriate treatment depends on why the athlete is under-fueling.

• Unintentional fueling due to low appetite from heavy training, or they may have a hard time fitting in meals and snacks around a heavy training schedule. 
• Some athletes are caught up in the diet culture of their sport (or society in general), trying to lose weight, with the goal of being better at their sport. They may take this too far and develop disordered eating habits, restricting intake of foods such as carbohydrates or animal protein, which can cause under-fueling and nutrient deficiencies. 
• Some athletes' restrictive eating patterns and disordered eating can lead to eating disorders, which puts athletes at a greater risk for health problems, and requires a different approach to recovery. 

Treatment of female athlete triad requires correcting the energy imbalance - increasing calorie intake and resting from exercise. 

Female athletes are often surprised when they find out how many calories they need to be eating to fuel their bodies, and how few they are currently eating. Very active individuals usually need at least 3 meals and several snacks per day. To get a better idea of current intake, athletes can track their food using popular apps, such as MyFitnessPal or tools like the SuperTracker.

Although these tools give athletes an idea of what they're doing now, working with a registered dietitian can take the guess work out of meal planning and give them more guidance to how many calories they really need to support training, and which foods they should be focusing on to really optimize their workouts and recover properly.

The total calories aren't the only thing that matter - girls and women can be deficient in several key nutrients:

• Vitamin D: spend more time outdoors, fortified breakfast cereal, milk, fatty fish like salmon, egg yolks or a vitamin
• Calcium: dairy such as milk, cheese, yogurt
• Iron: it's important to get screened for iron status, as many women, especially endurance athletes, tend to have low iron
• Healthy fats: focus on eating plenty of nuts (including peanut/almond butter!), seeds (flax, hemp, chia), olive oil, avocados, salmon
• Adequate protein: 20-25 grams per meal, 10-15 grams per snack in the form of lean protein (chicken, fish, lean beef), nuts, yogurt, milk, beans, peas and soy
• Energy-enhancing carbohydrates: the amount of carbs an athlete needs depends on their weight and what kind of sport they're in, but because carbs are our muscles' main fuel source, eating plenty of fruit, vegetables, whole grains, and potatoes is necessary to perform well and recover adequately. 

When speaking with female athletes, it's important to emphasize that food is fuel!

It's a good thing to eat when you're hungry and to enjoy food.  Eating more food doesn't necessarily equate to weight gain, and many times, it can actually lead to improved sport performance. If an athlete or parent of an athlete suspects they are having any of the issues discussed, they should talk to their doctor. There are other causes for amenorrhea, so it's important to consult with your doctor to rule out other causes! A Registered Dietitian can help athletes fuel their bodies properly to avoid issues related to female athlete triad and under-fueling for their sport.

NPR || To Thrive, Female Athletes Need a Lot More Food

The Informed Appetite || Drink Milk, or Don't. But Maybe Read This First (#Science!)

New York Times || After 'The Biggest Loser,' Their Bodies Fought to Regain Weight

Yeah...Imma Eat That || The Hunger and Fullness Scale (AKA How to Stop Dieting)

How To Enjoy a Healthier Halloween

Because Halloween is fast-approaching and the grocery store has an entire aisle dedicated to giant bags of candy, this post is going to be all about enjoying a healthier Halloween. Whether your family celebrates Halloween or not, you can't miss the candy fest in the grocery stores during this time of year. Although Halloween is only one night a year, the giant bag of candy may linger around the house for much longer.

I've gathered some healthier  Halloween tips to help your young athlete enjoy a healthier Halloween (without ruining all the fun).

1. Focus on other seasonal activities.

Kids and adults alike may associate this time of year with candy, and kids are usually thinking about candy a LOT, but there are many local seasonal events, like pumpkin picking and carving, apple picking, hay rides, corn mazes, haunted houses...the list goes on. 

2. Cook a healthier meal to enjoy before trick-or-treating/before eating candy.

We all know how good a candy bar tastes when you allow yourself to get super hungry...but it's usually pretty hard to stop at just one piece because candy may have a lot of calories, but doesn't fill us up and doesn't contain the nutrients our bodies really crave at meal time. What about something seasonal, like pumpkin chili? 

Choose a meal with plenty of filling vegetables, whole grains and a little bit of protein and encourage kids to drink a glass of water with dinner to hold them over during the night and to prevent them from choosing handfuls of sweet treats as a dinner substitute. 

3. Choose your candy wisely.

Even those bite-sized treats can pack a huge calorie punch, especially if you're grabbing for several pieces a day, and it's those extra 100-200 calories each day in addition to your normal calories that result in weight gain over time. One peanut butter cup is ~100 calories and those mini chocolate bars are usually around 40-50 calories each. Chocolate candies have more fat and usually more calories than fruity candies.

If you're passing out candy at your house, make sure you're choosing the miniature options or some of the non-candy options listed below.

4. Set some limits.

As far as HOW MUCH candy to eat, in an ideal world, kids, teens and adults would eat a piece or two and forget about it. This isn't always the case...but over-restricting the candy jar can often times make the candy more desirable and kids can develop tendencies to obsess over/sneak/hoard the candy.

Don't give the candy so much attention and eating the candy won't become such a big deal.

A good tip for kids (and adults!) is to choose a couple favorite pieces of candy after trick-or-treating (2,3,4,5...whatever number you both set) to enjoy, and make sure to put the candy jar away and help kids practice moderation by only choosing 1 or 2 pieces as they please a day. It goes along with the "out of sight, out of mind." Put out a bowl of fruit, cut up some vegetables - have some healthy snacking options available that are more easily accessible than the candy. 

5. Pass out non-candy options.

I know this is a total "dietitian" tip, but hear me out! There was a research study that showed that kids between 3-14 years old were just as likely to choose non-candy (toy) options just as much as candy options on Halloween. 

Because almost ALL houses will be handing out candy on Halloween, passing out non-candy options will be something new for kids.

Non-food ideas ideas from The Teal Pumpkin Project.

This is a pretty cool project  - because a lot of Halloween candies contain allergens, this project promotes passing out non-food options for trick-or-treating to ensure kids with allergies can still enjoy trick-or-treating!

Some options include: glow sticks, stickers, temporary tattoos, small toys like slinkies, bouncy balls, art supplies (crayons, paintbrushes, markers), noisemakers, bubbles, fancy erasers...the list goes on.

If you want to hand out some non-candy healthier food options, there's a lot of good individually-wrapped options in the stores:

Cereal bars, snack mix, single-serve cereal boxes, microwave popcorn or little bags of popcorn, snack-size bags of Goldfish or animal crackers, pretzels, boxes of raisins/dried fruit, sugar-free gum...

You might also like:

Greatist || 20 Healthier Halloween Candy Choices

Greatist || 16 Healthier Halloween Candy Recipes to Make at Home (Fun for older kids!)

Food Allergy Research & Education || Teal Pumpkin Project

Nutrition 411 || 8 Halloween Tips for Trick or Treat Night

Eat Right || Enjoy a Healthy and Happy Halloween

Real Simple || 4 Nutritionist-Approved Tips for a Healthier Halloween

FDA || Halloween Food Safety Tips for Parents

Contact the Sanford Sports Nutritionist for answers to your food and nutrition questions, additional tips, tricks, recipes and menu-planning ideas!

The Quick Guide to Fueling Young Athletes

Consistent good nutrition can support a child or teen's growth, development and immune system, and can also help them be a stronger athlete and a more attentive student. If this is the case, why is the sports environment filled with fast food? Why are athletes choosing supplements to help them perform better when they're choosing junk food for meals and snacks?

We've all been to a youth sports game or tournament where they're serving hot dogs, candy and soda and the half-time snack for the young athletes is a bottle of sports drink and some sort of fast food or prepackaged snack. A busy sports schedule can result in reliance on fast food or pre-packaged snacks and meals, which can be convenient, but don't support your athlete in feeling good and performing well.

If I were to make it really simple, I would tell kids to do these things to have the best "athlete's diet":

1. Don't skip meals. This means eating breakfast, lunch, dinner and snacks, every day.
2. Drink water throughout the day - carry around a water bottle and fill it up throughout the day. Drink more the day before a competition/game/race.
3. Eat snacks! Eating a snack with protein after exercise can help promote muscle repair and growth.

Source: Teen Being & Choices Magazine 

How many calories does a young athlete need?

This chart can help you determine how many calories your young athlete needs based on their age and physical activity levels. You can see the difference between a sedentary and active been might just be 400-600 calories, the equivalent to a few extra snacks throughout the day (not a free pass to eat whatever they want). 

Moderately active = walking to school
Playing a soccer game = vigorously active

You may feel as if your child is ALWAYS hungry - they may need to add more snacks throughout the day, or even an extra meal during the day. Again, this all depends on how active they are and if they're having a growth spurt.

What foods should young athletes focus on?

A common mistake among young athletes make is thinking they can eat TONS of protein to build muscle, but they're often not meeting their calorie needs. Young athletes need to focus on eating enough calories in addition to exercising (especially strength training) to build muscle.

An easy way to talk about good nutrition to a young athlete is to talk about food being fuel for their activities. Kids usually know that junk food doesn't make them feel good, so help them make the connection that when they eat healthy foods, they feel good!

Of course, if they have the choice to eat junk food at home, they may choose cookies, candy and chips over fresh fruit and vegetables because it's convenient (and tastes good). Make the healthy options convenient by cutting up extra fresh fruit and vegetables and making the junk food unavailable in the home.

Carbohydrates are our muscles' main fuel source, so they should make up the majority of the diet (55-75% of total calories coming from carbohydrates). Carbohydrate foods include: whole grain bread, pasta, and cereal, grains such as oatmeal and rice, vegetables and fruit. Aim to make half of all grains whole grains for added fiber and nutrients (brown rice vs. white rice, whole grain bread and rolls vs. white bread).

Protein helps with muscle repair and growth, but it doesn't need to be the biggest focus. Although athletes need more protein on their plates, they can meet their needs by including protein at each meal and snack. Good sources of protein include meat, poultry, Greek yogurt, beans, nuts, seeds, milk and eggs.

Protein

8 years old: 4 oz 9-13 years old: 5 oz 14-18 years old: 5 oz (Female)                            6.5 oz (Male)

One-ounce equivalent: 1 oz. meat, poultry, fish, ¼ cup beans, 1 Tbsp nut butter, 1 egg, ½ oz nuts/seeds

Healthy fats should be part of your athletes diet - we're talking about nuts, seeds, olive oil and avocados. Avoid trans fats in fried foods (menu items that say "crispy" or "crunchy") and pre-packaged baked goods and snack foods.

Use avocado instead of mayo on sandwiches/wraps. 

Is breakfast really that important?

Children and adolescents need to be eating breakfast every day, especially if they're involved in sports. Skipping breakfast has been attributed to more weight gain, and eating breakfast can help kids have more energy and pay attention more during the school day. We're not talking about a bowl of sugary cereal here - even if breakfast is small and on-the-go, try to choose foods from more than one food group. Good examples include:

• Granola bar and a banana
• Hard boiled egg and an apple
• Greek yogurt with granola and blueberries
• Dry cereal and nuts
• Apple with peanut butter and raisins
• Egg sandwich with 2 eggs and cheese
• Fruit smoothie

Should young athletes drink sports drinks?

The American Academy of Pediatrics reports sports drinks contain extra calories and sugar that children don't necessarily need and that for children participating in normal exercise activities, plain water should be the drink of choice. Children and adolescents should really never be drinking energy drinks, and should only drink sports drinks during prolonged, vigorous physical activity (similar to adult recommendations). 

Children are more susceptible to becoming dehydrated because they sweat less than teens and adults, so young athletes should aim to consume 4-8 oz. (several large gulps) of water every 15-20 minutes of physical activity. They may need even more if they're sweating a lot or wearing protective equipment.

What about sports supplements?

The supplement industry loves to make things exciting and make promises about enhancing performance, helping you lean out, make strength gains or give you energy with little scientific evidence to back up these claims.

Young athletes, especially high school students, can get caught up in these exciting messages pushing protein supplements to enhance muscle growth and athletic performance. In reality, there is no magic pill - all children and adolescents can meet their protein needs through real food sources and there are many real food sources of the same supplements they're spending so much money on.

You can't take supplements to replace hard work or good nutrition. 

You (or your young athlete) might enjoy:

USA Swimming || Growing Swimmers May Need a 4th Meal 

Kids Eat Right || 6 Healthy Ways to Manage Weight for Sports || 8 Gameday Nutrition Tips

Jill Castle, MS, RDN, CDN || Eat Like a Champion
***This book was a great resource in writing this article!

Mark Bittman @ The New York Times || Getting Your Kids to Eat (Or At Least Try) Everything 

Sally Kuzemchak @ Teen Being || Are You Being Snacked to Death?