Why You Need A Sports Dietitian On Your Sports Medicine Team

Contributed by Lara Gray, MS, RD, CSSD,

Director of Education at Drug Free Sport, Inc.

Full disclosure: I am a sports dietitian (RD). But that is not the only reason I feel compelled to write a brief post on this topic. Through our work and educational outreach at Drug Free Sport, I have observed that the role of sports RDs on the sports medicine team is still largely misunderstood, under-budgeted, missing—or all of these at once. So, let me make a few points to elaborate on why you need a sports RD in your athletic program. If you are a sports RD reading this, use this information to strengthen your case on why you are essential to any athletic programs’ success, and the health and safety of the athletes they serve.

Most athletes have little to no nutrition knowledge.

o   Even a basic understanding of which foods provide carbs, proteins, or fats is primarily absent. A lack of basic nutrition principles immediately limits an athlete’s potential to make adequate fueling decisions for performance. This, in conjunction with issues pertaining to budget, often predisposes athletes to selecting high fat, high sugar options from cheap, grab’n’go conveniences (e.g., fast food, fried foods).

Lack of awareness of food-based solutions leads to increased reliance and trust in potentially harmful dietary supplements.

o   This generation of athletes will not shy away from using technology to source ways to “treat” sports performance issues (read: Google, Facebook, Twitter searches and online influence are at an all-time high). Enter dietary supplements. An athlete's lack of awareness pertaining to nutrition solutions for performance and recovery, and the results of their web search, often leads to dietary supplement products with questionable contents. They are often unregulated, contaminated with prohibited substances, contain heavy metals or toxic pesticides, or fall short of all of these and merely contain almond or soy flour—yet charge $30-$100 per bottle.

To deter supplement use in sport, athletes must receive practical and effective food solutions.

o   Current research estimates the prevalence of dietary supplement use in sport to be within a wide range of 40-75%; higher among those at more elite levels. The expertise of the sport RD can not only provide sound guidance on supplement safety and efficacy, but most importantly, also offer food-first solutions that provide safe, sustainable, and highly effective alternatives.

University of Texas Sports Dietitian, Amy Culp, RD, CSSD, LD, creates teachable moments where most effective—in front of the food.  UT Athletics is an example of a high functioning and collaborative sports medicine team that effectively incorporates sports nutrition for shared success. Photo courtesy of  UT Athletics. 

Sports RDs make nutrition decisions highly approachable, visible, and easy for athletes.

o   Sports RDs are educated and trained in food service operations. This makes them a primary asset when negotiating and determining pre-/post-game meals, stocking and maintaining refueling stations, navigating food options while teams are traveling, and working with catering and food service managers to create/enrich training table meals.

The sports RD can save both time and money.

o   Food costs money. Consider the time saved in human resources if you have someone working with teams, caterers, operations staff, and food service staff who can confidently set menus while competition is both home and away. Recognize cost savings from a professional experienced in ordering and stocking only the appropriate amounts and types of nutrition resources.

Sports RDs effectively support the collective success of any multidisciplinary sports medicine team.

o   The team physician’s efforts in athlete post-surgical care;

The athletic trainer’s efforts to support recovery, injury prevention, and immunity;

The sport psychologist’s efforts addressing athletes with disordered eating;

The coach’s efforts in achieving optimal body composition for performance;

—are all elevated and improved by the work of a sports RD.

Make sure to set their place at the table!

For additional guidance on adding a sports dietitian to your team, or to find a certified specialist in sports dietetics (CSSD) in your area, please email me at lgray@drugfreesport.com. Drug Free Sport advocates for all professional disciplines that support athlete health, performance, and safety. To learn more about the impact of sports dietitians on high performance teams, and experience a new sports industry conference that focuses on maximizing collaborative success of “the team behind the team”, visit www.sportexchangesummit.com.

What impact has a sport dietitian had on your team or athletic program? PLEASE USE THE COMMENTS TO SHARE!

Drug Abuse and Addiction

As a student-athlete, you may know of someone who is struggling with drug abuse and addiction. It may be a close friend, a teammate, classmate or family member. Substance abuse and addiction can cause problems in the classroom, on the playing field and at home. It can often times leave individuals feeling alone and helpless, a potentially dangerous combination. It is for these reasons, that it is important to have a good understanding of the signs and symptoms of drug abuse and addiction.

Common signs of drug abuse and addiction:

-          Skipping class or flunking class, missing practice, and neglecting other day-to-day responsibilities

-          The use of drugs and/or alcohol during high risk situations (drinking and driving, before practice or a game)

-          Mood swings (fights with friends and/or family members, partners)

-          Legal issues (DUI, selling of drugs, possession charges)

-          A built up tolerance to drugs

-          Withdrawal symptoms

-          Constantly thinking about drug use

-          Understanding the risks of drug use, but continuing to participate

-          Losing interest in sports, socializing and other hobbies

Physical, behavioral and psychological warning signs:

-          Deterioration of physical appearance, grooming habits

-          Tremors, slurred speech

-          Bloodshot eyes, larger than normal pupils

-          Changes in appetite or sleep patterns

-          Sudden weight loss or gain

-          Always a need for extra money

-          Acting secretive about everything

-          Sudden change in friends

-          Lack of motivation

-          Anxious, fearful and paranoid

-          Angry outbursts and easily agitated

Recognizing that you or someone you know has a drug abuse or addiction problem is the first step, and often the most difficult step, on the road to recovery. Seeking help and finding support is crucial to any addiction recovery, and it takes a tremendous amount of courage to recognize that you or someone you know may need help.

If you feel that you or someone you know has an addiction problem, be proactive and contact any of the following individuals for support:

-          Family member

-          A close friend

-          A therapist or counselor

-          Your health care provider

-          Your athletic trainer, coach and/or another administrator

 Always remember, you are not alone and there are individuals that are willing to help!

 For more information on drug abuse and addiction, please visit the following resources:

http://www.mayoclinic.com/health/drug-addiction/DS00183 

http://www.drugabuse.gov/publications/drugfacts/understanding-drug-abuse-addiction

http://www.nlm.nih.gov/medlineplus/drugabuse.html

My first week at Drug Free Sport: Dietary Supplements

Well… My first week at Drug Free Sport was anything but typical. I have been in the Anti-Doping industry for three years now, working primarily with collection protocols, field staff training and athlete testing plans. I have developed a solid foundation in the Anti-Doping movement, but have to admit that I feel like a rookie when it comes to the complex world surrounding dietary supplements, drugs, alcohol and other doping methods in sport.

Barely scratching the surface on information related to the topics presented above now seems like an understatement after a week’s worth of work at Drug Free Sport. For instance, who would have thought that someone could make a dietary supplement out of the back of their car and sell it to consumers like you or I? Wait… What? dietary supplements that I’m putting into MY body could potentially be manufactured in the trunk of a car? According to the U.S. Food and Drug Administration, dietary supplements are regulated under the 1994 Dietary Supplement Health and Education Act (DSHEA). Under this act, manufacturers of dietary supplements or their ingredients “DO NOT need to register their products with the FDA nor get FDA approval before producing or selling dietary supplements” (FDA, http://www.fda.gov/Food/DietarySupplements/default.htm).

Regardless, these supplement companies or manufactures have to be regulated at some point, right? Well that’s actually correct. These companies must comply with cGMPS, which means “Current Good Manufacturing Practices.” These practices are in place essentially for quality control purposes. They act as a measure to ensure that companies are processing supplements in a consistent manner and meeting standards. Under what the FDA calls the “Final Rule,” supplement manufacturers must adhere to the following conditions (not limited to these conditions):

-          The design and construction of physical plants that facilitate maintenance

-          Cleaning

-          Proper manufacturing operations

-          Quality control procedures

-          Testing final product or incoming and in process materials

-          Handling consumer complaints

-          Maintaining records

(FDA, http://www.fda.gov/Food/DietarySupplements/default.htm)

The FDA deploys inspectors to ensure these rules are being followed, but on average, only about 5 inspections take place during a given month. Just go to your local supplement store and see how many different supplements and manufacturing companies there on the shelves; 5 inspections a month doesn’t even make a dent!

Taking this into consideration, how could a supplement that I put into MY body be created in the back of a trunk? Dietary supplements do not have to be approved, show effectiveness or be proven safe before being marketed, as long as they avoid health claims and ingredients that are not GRAS (I also, learned that this means Generally Recognized As Safe).

The point is that dietary supplements are under-regulated and in some cases, we have no idea where these dietary supplements and their ingredients are coming from. I would recommend watching this clip from Dateline’s Chris Hanson on dietary supplements:

(http://www.msnbc.msn.com/id/3032600/vp/46766278#46766278)

It’s only been one week and I could go on and on about some of the things that I’ve learned thus far. If there is one thing to take away from my first week with Drug Free Sport, it’s that no matter how much I’ve learned in my three years of Anti-Doping experience, it’s not enough and every day brings new surprises!

Until next time!

Why does the NCAA recommend against the use of dietary supplements?

Every time a student-athlete or a trainer asks us a question about a dietary supplement, we attach a standard warning, regardless of whether the listed ingredients are banned or not. Often, we are asked the questions, “why do you give this warning,” “what does it mean”, and “why do you suggest that student-athletes not use dietary supplements?” Below, is the standard warning we give, with an explanation of the statements.

“Products labeled as dietary supplements sold over the counter, in print advertisements and through the internet are under-regulated by the U.S. FDA. Whether a product is classified as a dietary supplement, conventional food, or drug is based on its intended use by the manufacturer.  Please be aware that some companies manufacturer dietary supplement and conventional food products*. Dietary supplements are at risk of contamination or may include ingredients that are banned under your drug testing policy.    Studies have found 12-25% of dietary supplements contain unlisted steroids, stimulants, or trace metals.” – Why are dietary supplements at a risk for contamination? Consider these points, (1) Manufacturers do not have to prove the safety and effectiveness of a dietary supplement before it is marketed. (2)Manufacturing facilities are virtually unregulated, they are required to adhere to Current Good manufacturing Practices (CGMPs) , but  unfortunately only an average of 5 inspections take place a month (consider the total number of products sold today…thousands!) (3)  A number of company’s contract manufacture their products and leave the sourcing of ingredients to the contracted company.  So the true identity of the ingredients can be cut or changed without the parent company ever knowing.  This was solidified by the FDA’s Brad Williams participating in an education program at Supplyside West, and he said the number one issue with companies inspected under the supplement GMP program has been failure to adequately test ingredients for identity. 

“We cannot guarantee the safety or purity of any dietary supplement product. Also, the claims made by manufacturers may not be backed up with reliable, scientific research. Student-athletes take any dietary supplement at their own risk.” Without proper testing of the finished product, there is no way to know if the ingredients, and their amounts, listed on labels are correct. You could be getting too much, too little, or none at all of the so-called “active” ingredients. Remember, products do not have to prove their level of safety or effectiveness before they are sold. Often, the “research” a company cites is not reliable, has been done by a party that has interest in the success of the product, or is not scientific in nature. Below are a few tactics used by Supplement Company’s:

·         Misrepresented clinical studies (results out of context, “University tested”, inappropriately referencing research results)

·         False, exaggerated, or purchased endorsements (How much money is the athlete making for saying he takes a product?)

·         Media distortion and false advertising (planted stories online, Company reps posing as local gym guy online in forums, “As seen on Oprah”)

·         Omitting relevant Facts (Product marketed to men but all research done on women)

“The REC does NOT recommend the use of any dietary supplement or manufacturer; please submit all dietary supplement questions to the REC.” While we realize that not all companies are trying to dupe consumers or engaging in dishonest practices, there is no easy way to tell between the “good” and “bad” companies.

“Please be aware that some companies manufacturer dietary supplement and conventional food products.  Products produced in the same manufacturing plant or by the same company could potentially have contamination issues.” Be aware that we have no way to know for sure that a product labeled as a conventional food product but still manufactured by a dietary supplement manufacturer is 100% safe, unfortunately.  If a company is manufacturing meal replacement bars, and shakes, but also manufactures DHEA, you could have a potential problem.

“Remember to report all medications and supplements to your sports medical staff, no matter how insignificant you believe them to be, it could save your life.” Your sports medicine staff needs to know what you are taking, even if it is something as simple as a vitamin. Medications and dietary supplements could pose health risk for some if combined. Those in charge of your health need to know everything you take to give you the best care, especially in case of an emergency.

Again, we realize that there may be benefits to some dietary supplements and that not all manufacturers engage in dubious practices. However, our first commitment is protecting the health and safety of student-athletes. Lastly, we are dedicated to helping protect the integrity of sportsmanship in all sports, and at this time that includes not suggesting dietary supplements.

Preventing and Overcoming the Female Athlete Triad

Female athletes are at risk of developing the Female Athlete Triad, which includes disordered eating, loss of menstrual periods (amenorrhea), and osteoporosis. The loss of calcium and bone associated with the triad can increase the risk of stress fractures and other injuries. The triad affects all aspects of the individual’s health and can lead to life-threatening situations.

What can you do to avoid the triad or overcome it?

1. As an athlete, your body NEEDS fuel to perform. Do not skimp on foods or skip snacks. Be sure to eat calorie dense and nutritious foods to help your body fuel its daily processes and your training. Keep in mind, as a female, you probably need to eat more than you currently think you should and definitely more than your non-athlete peers.

2. For an athlete, the scale does NOT give an accurate picture of how healthy your weight is. Muscle weighs more than fat. As an athlete, you may weigh more than you think you should, but have a very low percent of body fat. Use body composition as an indicator of how healthy your weight is.

3. Work with a registered dietitian to determine how many calories you need a day and to get help choosing foods to meet these needs.

4. It is easy to forget about your menstrual cycle, especially when you have the busy life of a student-athlete, but don’t. Pay attention and track your cycles to be sure they are regular. If you miss more than 3 in a row, or they become very irregular, talk with your trainer and a doctor. Irregular cycles or loss of cycle (amenorrhea) can lead to a host of health issues.

Resources:

http://www.femaleathletetriad.org/

http://www.drugs.com/cg/female-athlete-triad.html