Amy Stephens

MS, RDN, CSSD, CEDS

Licensed dietitian

specializing in sports nutrition

and eating disorders

College athlete

Signs and Symptoms of an Eating Disorder

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signs and symptoms of an eating disorder

  • By Amy Stephens MS RDN CSSD CEDS and Kate Cochran, Nutrition Intern

TW: This content includes references to eating disorders and body image, which may be a sensitive topic to some readers.

Eating disorders can show up in many different ways, making them difficult to recognize at times. There’s a common belief that you have to fit a specific mold or experience every symptom for an eating disorder to be “real.” This can cause people to downplay their struggles, thinking, “I don’t look a certain way,” or “I’m not xx weight, so it doesn’t count.” But the truth is, eating disorders can affect anyone, regardless of appearance or specific symptoms.

Social media also influences how eating disorders are perceived. While some accounts help raise awareness and normalize conversations, they can also create a narrow picture of what an eating disorder looks like. This might make someone question their own experience if it doesn’t match what they see online—whether in terms of appearance, behaviors, or eating patterns. But the truth is, eating disorders don’t look the same for everyone, and every struggle is valid.

 

When it comes to sports nutrition, eating disorder symptoms can be a little harder to spot because certain behaviors—like meal planning and intense training—are often seen as part of being an athlete. But there’s a fine line between dedication and disordered habits. Here are some common signs that might indicate an issue:

  • Obsession with “clean” eating or only sticking to “healthy” foods.
  • Restricting food groups that you once enjoyed.
  • Comparing your body to those of your competitors, teammates, or online influencers. 
  • Skipping meals or eating less than your energy needs require in order to stay light.
  • Constantly thinking about food, training, or your body weight/image.
  • Avoiding social situations that involve food.
  • Viewing training as a way to “burn off” or “earn” food. Food should be seen as fuel for your performance—not something you have to work for or make up for.

Here are some symptoms that results from having an eating disorder or underfueling in general:

  • Frequent fatigue, injuries, illnesses, or slow recovery. 
  • Loss of menstrual cycle (for female athletes).
  • Decreased libido (for male athletes).
  • Decreased concentration.
  • Low heart rate (can often be mistaken for fitness).
  • Decreased strength and power. 
  • Inconsistent energy.
  • Dizziness. 
  • Hypothermia.
  • Sleep disturbances or waking up hungry in the middle of the night.

If any of these symptoms resonate with you, there are plenty of ways to assess whether you might need extra support or professional help. One great tool is the Eating Disorders Screen for Athletes (EDSA), which helps gauge the likelihood of an eating disorder—you can check it out here. Another great screening tool is the SCOFF questionnaire.

The SCOFF questions*

Do you make yourself Sick because you feel uncomfortably full?

Do you worry you have lost Control over how much you eat?

Have you recently lost more than One stone in a 3 month period?

Do you believe yourself to be Fat when others say you are too thin?

Would you say that Food dominates your life?

*One point for every “yes”; a score of ≥2 indicates a likely case of anorexia nervosa or bulimia

Keep in mind, you don’t need to experience every symptom for it to be a concern. Even one or two signs are worth paying attention to. Recognizing an eating disorder early is key to getting the right support, as both short-term and long-term effects can impact your health and performance.

 

If you or someone you know is struggling with an eating disorder, there are several trusted places to turn for help, depending on your needs and location. Talk with your healthcare provider, physician, therapist, or dietitian that specializes in eating disorders. In the US, you can also call or text the National Eating Disorder Association (NEDA) helpline at 1-800-931-2237.

References 

Morgan J F, Reid F, Lacey J H. The SCOFF questionnaire: assessment of a new screening tool for eating disorders  BMJ  1999;  319 :1467 doi:10.1136/bmj.319.7223.1467.

National Eating Disorders Association. (n.d.). Coaches & trainers: What you need to know. National Eating Disorders Association. https://www.nationaleatingdisorders.org/coaches-trainers

 

Eating Disorders Screen for Athletes. (n.d.). EDSA screening tool. https://sites.google.com/view/edsa-screening-tool/

 

Logue, D. M., Madigan, S. M., Delahunt, E., Heinen, M., Mc Donnell, S. J., Corish, C. A., & Warrington, G. D. (2022). Low energy availability in athletes: A review of prevalence, impact, and assessment. International Journal of Sport Nutrition and Exercise Metabolism, 32(4), 317–329. https://doi.org/10.1123/ijsnem.2022-0033

DIY Electrolyte Drink

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DIY electrolyte drink

  • By Amy Stephens RDN CSSD

Here are a couple of DIY electrolyte drinks that are favorites among the NYU Track and Field team:

Makes 1 Liter of Electrolyte Drink

Turmeric Ginger

Ingredients:

  • 4 cups brewed Turmeric Ginger tea 
  • 4 tbsp table sugar 
  • 1 tsp Himalayan salt
  • Juice of 1 lemon

Alternative Herbal Tea Options: Raspberry, peach, mango, or mint (preferably decaffeinated).

Directions:

  1. Bring 4 cups of water to a boil and steep 4  tea bags for about 5 minutes.
  2. Dissolve the Himalayan salt and 4 tbsp sugar, stirring until fully dissolved.
  3. Let the mixture cool and add the juice of 1 lemon or lime.
  4. Combine the ingredients in a pitcher or insulated hydration bottle with ice.

Nutrition (per 8 oz serving): 550 mg sodium, 17g carbs, 60 calories.

 

Lemon & Lime

Ingredients:

  • 4 cups water
  • 4 tbsp table sugar 
  • 1 tsp Himalayan salt
  • Juice of 1 lemon
  • Juice of 1 lime

Directions:

  1. Dissolve sugar and salt in warm water.
  2. Add the freshly squeezed lemon and lime juice.
  3. Combine the ingredients in a pitcher or insulated hydration bottle with ice.

Nutrition (per 8 oz serving): 550 mg sodium, 17g carbs, 60 calories.



Creatine Supplement: Key Factors to Consider Before Use

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Creatine Supplement: Key Factors to Consider Before Use

  • By Amy Stephens RDN CSSD

Many amateur and professional athletes use creatine supplements to enhance their workouts and speed up recovery. Creatine is a naturally occurring compound found in the body and certain foods that provides a quick burst of energy and increases strength. Research suggests that creatine supports muscle strength, improves brain health and can improve mood. By maintaining a steady energy supply of creatine in the muscles, it helps sustain high-intensity exercise. However, creatine isn’t essential for everyone—its usefulness depends on an athlete’s sport, training goals, and overall diet. 

For optimal results, focus on meeting your nutritional needs through food first. Supplements should be used to complement, not replace, a well-balanced diet. 

Note: this blog is not an endorsement but a source of reliable information about the supplement based on the available data. Please speak with your sports dietitian about whether the supplement is best for you.

What is Creatine? 

    • Creatine is a naturally occurring compound found in muscle cells. 
    • It helps produce ATP (energy), which fuels short bursts of high-intensity exercise (e.g., sprinting, weightlifting). 
    • Creatine is made from the amino acids arginine, glycine and methionine (Antonio, 2021) which is found in foods like red meat and fish, but supplementation can increase muscle stores beyond what food provides.

How does it work?

Creatine works by increasing the availability of phosphocreatine (PCr) in your muscles, which helps regenerate adenosine triphosphate

(ATP)—the main energy source for high-intensity, short-duration activities (up to 30 seconds) like sprinting, weightlifting, and jumping. 

Stored Creatine in Muscles 

○ About 95% of your body’s creatine is stored in muscles as phosphocreatine, which can be rapidly used to regenerate ATP. 

Increased Power & Performance 

○ By increasing phosphocreatine stores, creatine allows for more rapid ATP regeneration, improving performance in explosive movements, short sprints, and heavy lifting. 

Muscle Hydration & Growth 

○ Creatine draws water into muscle cells, increasing cell volume and possibly stimulating muscle protein synthesis, contributing to muscle growth. 

Reduced Fatigue & Faster Recovery 

○ It may help buffer acid buildup in muscles, delaying fatigue and improving recovery between sets or intense efforts. 

Who Benefits from Creatine?

✅ Athletes in Sports that involve short, high-intensity bursts of energy lasting up to 30 seconds. 

○ Power sports (weightlifting, sprinting up to 400 meters, gymnastics, football, wrestling, etc.) 

○ Team sports (e.g., soccer, basketball, lacrosse) 

❌ Endurance athletes (marathoners, distance runners) may see little benefit unless they do a lot of strength training.

Is It Safe for College Athletes?

Creatine monohydrate is a well-studied supplement that appears to be safe. NCAA and professional sports organizations allow it.

  • Many studies have confirmed creatine’s safety, though a few have indicated potential worsening of kidney function in individuals with pre-existing renal impairment. 
  • Some may experience water retention or mild bloating, but this usually subsides. 
  • It does not cause dehydration—in fact, it may help with hydration and muscle recovery. 
  • Some athletes in the studies reported gastrointestinal issues while taking it.

Who should not use creatine?

  1. Athletes who get enough creatine from diet: If you eat a lot of red meat and fish, you may already have high creatine stores, reducing the need for supplementation. 
  2. Individuals with a history of kidney disease: Creatine is processed through the kidneys, so those with kidney disease or a history of kidney problems should avoid it or consult a doctor before using it. 
  3. Under 18 athletes without guidance: Young athletes should focus on a solid diet first before turning to supplements. 

Which brands are the best:

Look for third party testing with an NSF or USP certification label on the bottle. 

Here are some of my favorite brands: 

 

Klean athlete

Thorne

Designs for Sport

Recommended Dose:

💊Loading Phase (Optional): 20g/day (split into 4 doses) for 5-7 days 

💊 Maintenance Dose: 3-5g/day or .1 gram/kilogram of body weight 

💊 Best time to take it? After workouts with carbs and protein to maximize absorption.

Bottom Line:

  • Creatine is a natural compound in muscles that helps produce ATP for short bursts of high-intensity exercise.
  • For best results, focus on meeting your nutritional needs through food first. Creatine should complement a balanced diet.
  • Works by increasing phosphocreatine stores, regenerates ATP, boosts strength, hydration, and recovery.
  • Creatine is best for athletes in power and team sports; less impact on endurance athletes.
  • Generally safe, but those with kidney issues or digestive issues should consult a doctor.
  • Dosage & Best Brands Take 3-5g/day creatine monohydrate; choose brands that are third party tested with NSF- or USP-seals like Klean Athlete or Thorne.

References

Antonio, J., Candow, D.G., Forbes, S.C. et al.Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show?. J Int Soc Sports Nutr18, 13 (2021). PMID: 33557850 PMCID: PMC7871530

Gatorade website: The Safety and Efficacy of Creatine Monohydrate Supplementation: What We Have Learned from the Past 25 years of Research. 

Kreider RB, Kalman DS, Antonio J, Ziegenfuss TN, Wildman R, Collins R, Candow DG, Kleiner SM, Almada AL, Lopez HL. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr. 2017 Jun 13;14:18. doi: 10.1186/s12970-017-0173-z. PMID: 28615996; PMCID: PMC5469049.

Sherpa NN, De Giorgi R, Ostinelli EG, Choudhury A, Dolma T, Dorjee S. Efficacy and safety profile of oral creatine monohydrate in add-on to cognitive-behavioural therapy in depression: An 8-week pilot, double-blind, randomised, placebo-controlled feasibility and exploratory trial in an under-resourced area. European Neuropsychopharmacology. 2025 Jan 90;28-35. PMID: 39488067.

BEST foods to eat after a workout – tips from the Martin Coaching Team

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BEST foods to eat after a workout - tips from the Martin Coaching Team

Foods consumed after a workout will impact recovery and sports performance.

We asked the Martin coaching team about which foods they eat after a workout and it was no surprise that we received great responses instantly. At the elite level, nutrition is dialed in and the athletes know which foods to grab after a tough workout to promote recovery. We created this post to highlight the importance of refueling and provide some great options from the pros. 

How exercise affects energy stores

During a workout or run, the body breaks down glycogen into usable energy to supply working muscles. As the workout progresses, glycogen stores become depleted and muscle tissue further breaks down. Once exercise stops, the body will absorb nutrients to start the recovery process (Burke). If nutrients are not available, recovery after a workout can take longer. This can be a problem if you are training again the next day or later that same day.

Food is the best recovery tool

Nutrition can promote faster recovery. Eating the right amount of food immediately after a workout will restore muscle and liver glycogen which is essential for recovery between training sessions or competitive events. Recovery foods are especially important for athletes who work out or compete multiple times per day, as they have limited time for recovery. Carbohydrates and a small amount of protein are necessary to kickstart recovery.

Glycogen window: carbs and protein

Take advantage of the glycogen window by consuming adequate carbohydrates and protein within the first hour of a workout. During this time, the muscles are primed to absorb nutrients at a faster rate, then slows. Aim for about 100 grams carb ( 1-1.2 g/kg)  and 20-30 grams protein post exercise to maximize glycogen resynthesis (Burke). For example, a 150 pound person could eat a bagel with peanut butter and a fruit smoothie. 

These numbers are estimates, your body might require more or less food based on the intensity of the workout and how you feel. Recovery will continue over the next few hours but at a slower rate.

Include high glycemic foods such as honey, syrup or carbohydrate-rich beverages to maximize glycogen uptake for athletes who have limited recovery time between workouts (Donaldson). 

Post-workout nausea

If solid foods are not tolerated after a workout, take small bites from bland foods like crackers, dry toast or cold beverages such as a sports drink, until your appetite improves.

Martin Coaching staff’s favorite recovery foods

Ravenna

I love a loaded smoothie! Go to recipe: plain Greek yogurt, a little honey, blueberries, fist of spinach, tbsp of nut butter (partial to Stoke), banana and frozen mango. Plenty of protein to replenish stores and easy on the stomach.

Brendan and Aubrey Martin

Breakfast burrito with kale, eggs, vegan cheese, whole wheat tortilla, and hot sauce! Carbs + protein + sodium.

Protein knockout from Juice Generation  and everything bagel with tofutti.

Tortilla with hummus, “micro greens” or baby spinach + ranch dressing.

Johannes Motschmann

Fruit
Vegan chocolate protein shake powder with oat milk and bananas. (Within 15 minutes of finishing the workout).

Maurten Solid Bar and regular soda. The consumption of sugar in conjunction with exercise will accelerate glycogen repletion (Kerksick).

Occasionally:
 2L of Fanta from a nearby bodega after a 20 miler along the Hudson in the summer

Johannes Motschmann during the World Athletics Marathon. Budapest, Hungry 2023 Photo: @uyberlin

Luciano Fiore 

Two bananas 🍌 after every run and recently been loving MacroBars post run. Especially if the weight-room is soon to follow. Bananas provide the most versatile fruit in the game and an extra 12 grams plant-based protein boost from the macro bar.

On colder days, Fiore likes oats with chunky peanut butter (Brands - Santa Cruz Peanut butter or Once Again if I’ve got some spending cash) cocoa nibs, cinnamon, banana and honey.

Usually eat half. Leave the second half in my passenger seat. And rationalize eating it after training because of the mandatory metabolic window.

Liam Dee

Like Luciano, I’ve been double-batch cooking my oats so that I can have some pre and post run. Usually, I’ll add honey, milk, raisins, banana and chia seeds for extra texture and omega-3.

If I’m in the mood for something more lunch-forward, I love Hummus sandwiches on a nice Portuguese roll loaded with greens, cucumber and cherry tomatoes and topped with chips and a bit of spicy honey if I have it! More recently I have acquired a rice-cooker which means I can set that going before an evening jog and can quickly stir-fry some veg and tofu and be eating a proper meal in 15 minutes post-run.

Of late, I have been fiendishly eating bananas out of sheer practicality, but my go-to quick satiating snack is yoghurt with cherries or frozen fruit and honey, and some kind of cereal topping.

Amy Stephens, Sports Dietitian 

My favorite food after a workout is avocado toast with a hard boiled egg and red pepper. Avocado provides a great source of healthy fats and eggs  provide high quality protein with all essential amino acids.

 

Some additional recovery food options include:

  • Granola, yogurt and fruit
  • Peanut butter, honey and banana sandwich on whole-wheat bread
  • Chocolate milk
  • Fruit smoothie made with banana, strawberries, mango, and milk. 
  • Sports beverage containing carbohydrate and protein – Skratch Horchata
  • Turkey sandwich on whole wheat bread
  • Peanut butter on crackers
  • Dried fruit and nuts
  • Graham crackers and yogurt
  • Peanut butter and apple slices

References

Burke LM, Hawley JA, Wong SH, Jeukendrup AE. Carbohydrates for training and competition. J Sports Sci. 2011;29 Suppl 1:S17-27. doi: 10.1080/02640414.2011.585473. Epub 2011 Jun 9. PMID: 21660838.

Burke LM, Kiens B, Ivy JL. Carbohydrates and fat for training and recovery. J Sports Sci. 2004 Jan;22(1):15-30. doi: 10.1080/0264041031000140527. PMID: 14971430.

Burke L and Deakin V. Clinical Sports Nutrition, Third Edition.

Donaldson CM, Perry TL, Rose MC. Glycemic index and endurance performance. Int J Sport Nutr Exerc Metab. 2010 Apr;20(2):154-65. doi: 10.1123/ijsnem.20.2.154. Erratum in: Int J Sport Nutr Exerc Metab. 2011 Jun;21(3):262-4. PMID: 20479489.

Kerksick CM, Arent S, Schoenfeld BJ, Stout JR, Campbell B, Wilborn CD, Taylor L, Kalman D, Smith-Ryan AE, Kreider RB, Willoughby D, Arciero PJ, VanDusseldorp TA, Ormsbee MJ, Wildman R, Greenwood M, Ziegenfuss TN, Aragon AA, Antonio J. International society of sports nutrition position stand: nutrient timing. J Int Soc Sports Nutr. 2017 Aug 29;14:33. doi: 10.1186/s12970-017-0189-4. PMID: 28919842; PMCID: PMC5596471.



QUICK AND HEALTHY LUNCH IDEAS FOR COLLEGE STUDENTS

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Quick and Healthy Lunch Ideas for College Students

  • By Amy Stephens RDN CSSD

Eating a balanced lunch offers numerous physical, mental, and emotional benefits, making it especially crucial for college athletes. However, research shows that up to 60% of college students skip lunch due to their busy schedules and budget (Pendergast, 2016). Skipping this meal can negatively impact energy, hunger management, and overall well-being.

 

Here’s why lunch matters:

Sustained Energy Levels

A balanced lunch combines complex carbohydrates, healthy fats, and protein, providing a steady release of energy throughout the afternoon. This helps avoid energy crashes or feelings of sluggishness later in the day.

 

Enhanced Focus and Productivity

Providing your brain with the right nutrients supports better concentration, memory, and problem-solving abilities. Foods like whole grains and lean protein help maintain stable blood sugar, which is key for mental clarity.

 

Hunger Control

A well-rounded lunch keeps you feeling satisfied longer and prevents excessive hunger, cravings or overeating later. Including protein, fiber, and healthy fats helps regulate appetite.

 

Supports Nutritional Needs

A balanced lunch ensures you’re getting key nutrients like carbohydrates, essential amino acids, healthy fats, vitamins, minerals, and antioxidants, which are essential for overall health, strength, and immune function. Lunch is an opportunity to fill in nutrient gaps.

 

Stabilizes Mood

Low blood sugar from skipping or eating an unbalanced lunch can lead to irritability or fatigue. A nutritious meal helps stabilize your mood and keep you feeling positive throughout the day.

 

Improves Metabolism

Eating consistent, balanced meals throughout the day helps maintain a healthy metabolism and promotes efficient energy use.

 

Promotes Long-Term Health

Regularly eating balanced meals reduces the risk of chronic conditions like heart disease, diabetes, and obesity. It also supports good digestive health.

What Does a Balanced Lunch Look Like?

A balanced lunch should include:

  • Protein: Aim to include 20-40 grams (3 oz is roughly the size of a deck of cards) of high-quality protein from chicken, fish, tofu, beans, or eggs for muscle repair and satiety.
  • Complex Carbohydrates: Include 1-3 cups (depending on exercise expenditure) whole grains, quinoa, potatoes, rice, sweet potatoes, or legumes for sustained energy.
  • Healthy Fats: Avocado, olive oil, nuts, or seeds to keep you full, support brain health and reduce inflammation.
  • Fiber-Rich Vegetables: Include 1-2 cups from leafy greens, broccoli, or carrots for digestion and nutrient density.
  • Fruit: Contains a natural source of carbohydrates, vitamins and antioxidants that reduce inflammation.

Meal Ideas

Here are some practical, budget-friendly, and nutritious lunch ideas tailored for college students. These meals are easy to prepare, portable, and perfect for busy schedules:

1. Wraps, Sandwiches and Burritos

  • Turkey and Veggie Wrap: Whole wheat tortilla, turkey slices, spinach, shredded carrots, hummus, and avocado.
  • Peanut Butter and Banana Sandwich: Whole grain bread, natural peanut butter, and sliced bananas (add honey for extra sweetness).
  • Veggie and Hummus Wrap: Whole wheat tortilla, hummus, cucumbers, bell peppers, shredded lettuce, and feta cheese.
  • Falafel pita sandwich: frozen falafel (TJ’s brand or Afia), hummus, sliced tomato and topped with cucumber yogurt sauce.
  • Southwest burrito with grilled chicken, beans, rice, salsa, avocado.
  • Veggie burrito made with roasted sweet potato, black beans, salsa, and avocado. Click here for recipe from the Spruce Eats.
  • Open-faced toast and avocado – add shredded carrots, eggs, salmon, tuna, sprouts (and any veggie you can fit).

2. Grain Bowls

  • Mediterranean Bowl: Quinoa or rice, grilled chicken, cucumbers, cherry tomatoes, olives, feta, and a drizzle of olive oil.
  • Southwest Bowl: Brown rice, black beans, corn, salsa, avocado, shredded cheese, and a dollop of Greek yogurt.
  • Asian-Inspired Bowl: Rice or noodles, sautéed veggies, grilled tofu or chicken, sesame seeds, and a soy-sesame dressing.

3. Meal-Prep Salads

  • Chicken Caesar Salad: Romaine lettuce, grilled chicken, whole-grain croutons, Parmesan cheese, and Caesar dressing.
  • Mason Jar Salad: Layer greens, quinoa, chickpeas, veggies (e.g., cherry tomatoes, cucumbers), and dressing on the bottom for a grab-and-go meal.
  • Power Salad: Spinach, hard-boiled eggs, roasted sweet potatoes, avocado, and sunflower seeds with a balsamic vinaigrette.

4. Pasta or Noodle Dishes

  • Pesto Pasta with Veggies: Whole grain pasta, store-bought pesto, cherry tomatoes, and spinach (add grilled chicken for protein).
  • Ramen Upgrade: Instant ramen noodles with added frozen veggies, an egg, and a splash of soy sauce for a protein boost.
  • Cold Noodle Salad: Rice noodles, shredded carrots, edamame, and peanut sauce.

5. Leftovers Reimagined

  • Rice and Protein Bowl: Use leftover rice and pair it with beans, a fried egg, and salsa for a quick burrito bowl.
  • Stir-Fry Remix: Toss leftover veggies with soy sauce, sesame oil, and any protein (like tofu or chicken) over rice or noodles.
  • Quesadilla: Fill a tortilla with leftover cooked chicken, cheese, sliced avocado and veggies, then heat in a skillet.

6. Grab-and-Go Options

  • Snack-Style Lunch: Whole-grain crackers, cheese slices, deli turkey or hard-boiled eggs, baby carrots, and an apple.
  • Bento Box: Rice, grilled chicken or tofu, sliced cucumber, cherry tomatoes, and a boiled egg.
  • DIY Lunchables: Whole-grain crackers, hummus or guacamole, deli meat, cheese, and fruit slices.

7. Soups and Stews

  • Mason Jar Soup: Layer cooked noodles, veggies, and pre-cooked chicken or tofu in a jar. Add hot water or broth before eating.
  • Chili: Pack leftovers in a thermos or microwave-safe container. Pair with whole grain bread or tortilla chips.

8. Quick Microwave Meals

  • Microwaveable Baked Potato: Top with black beans, salsa, and shredded cheese.
  • Egg Scramble Bowl: Crack eggs into a microwave-safe bowl, mix with spinach and cheese, and cook for a quick protein-packed lunch.
  • Frozen Veggie Bowl: Mix frozen veggies, precooked rice, and soy sauce for a 5-minute meal.

9. Workout Smoothie

  • Green smoothie: Combine a handful of kale, banana, ice, milk, dates or honey, and  peanut butter, optional: top with chia seeds or ground flax seeds. Click here for more smoothie ideas.

 

Pro Tips for College Students

  • Prep Ahead: Make 2–3 meals at once to save time during busy weeks.
  • Stock Staples: Keep items like cooked rice or quinoa, beans, frozen veggies, tortillas, eggs, and canned tuna on hand.
  • Pack Snacks: Pair your lunch with simple sides like fruit, nuts, or yogurt to stay full longer.
  • Invest in Containers: Portable, reusable lunch boxes or jars make meals easier to store and transport.

These meals are affordable, versatile, and packed with nutrients to fuel your day!




Reference

Pendergast FJ, Livingstone KM, Worsley A, McNaughton SA. Correlates of meal skipping in young adults: a systematic review. Int J Behav Nutr Phys Act. 2016 Dec 1;13(1):125. doi: 10.1186/s12966-016-0451-1. PMID: 27905981; PMCID: PMC5133750.

Body Composition Testing: When is it Helpful and When is it Harmful?

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Body Composition Testing: When is it Helpful and When is it Harmful?

  • By Amy Stephens RDN CSSD
    Kate Cochran, Nutrition Intern, NYU Track and Field Athlete

TW: This content mentions eating disorders and body image.

Body composition testing offers a window into the intricate components that constitute our bodies. It surpasses simple weight measurements by evaluating the distribution and proportion of tissues like fat mass, muscle mass, and bone density, providing a detailed profile of physical makeup.

 

Skinfold assessment using calipers

There are a few different ways to measure body composition:

  •  Hydrostatic weighing: Measures body density by comparing a person’s weight on land to their weight submerged in water. Very accurate.
  • Air Displacement Method (Bod pod): Similar whole body measurement as hydrostatic weighing. Computer sensors determine the amount of air displaced by your body. Very accurate.
  • Skinfold assessment using calipers: Measures the thickness of skinfolds at specific sites on the body to estimate total body fat percentage. Less accurate for very lean individuals.
  • Dual-Energy X-Ray Absorptiometry (DEXA scan): Uses X-rays to differentiate among bone mass, fat mass, and lean muscle mass. Expensive and requires specialized equipment. Very accurate. 



Dual-Energy X-Ray Abroptiometry (DEXA scan)

Body fat and its impact on athletic performance

Some sports emphasize the relationship between reduced body fat levels and improved athletic performance. For the majority of athletes, physical appearance does not influence scoring or competition outcomes. Athletes who are frequently featured on social media may feel compelled to achieve a specific physique, which can result in unnecessary stress and pressure, potentially leading to eating disorders among both male and female athletes. 

It’s important to point out that each person has a genetically determined amount of body fat that is unique to them. When athletes strive to lower their body fat below their natural range, it can have adverse effects on their performance, general health, and mental well-being. This can also lead to disruptions in hormones, increased fatigue, susceptibility to injuries, and a compromised immune system. Athletic performance is influenced by a multitude of factors beyond body composition, including genetics, diet, rest, resilience, hydration, overall health, mental attitude, and more.



When Body Composition Testing Could Be Helpful

For endurance athletes, especially those prone to injuries or with low bone density, body composition testing can be valuable. Body composition and fat testing can be helpful to determine if body fat is too low to support proper functioning. It offers insights into muscle mass and overall body composition, aiding in tailored training and injury prevention strategies. 

Beneficial Scenarios for Body Composition Testing: 

  • Athletes recovering from injuries can benefit by understanding muscle and bone health to tailor rehabilitation.
  • Guidance from certified sports physiologists and sports dietitians ensures that testing results are used constructively. 
  • Ensures body fat levels are within a minimim healthy range to prevent issues like low energy availability, amenorrhea, or hormonal imbalances, especially for athletes in sports emphasizing leanness (e.g., gymnastics, running, or swimming).

When Body Composition Testing Isn’t Helpful

The introduction of mandatory body composition testing in collegiate settings has raised concerns. It can feel invasive and exacerbate body image issues, potentially leading to eating disorders among athletes. These psychological challenges can detract from performance by causing fatigue due to inadequate nutrition and increasing injury risks. Rather than focusing on achieving a specific body fat, a great way to improve performance is to focus on overall nutrition and health. Knowing your body fat percentage is just a small part of understanding athletic performance; it is not everything. 

Frequent body composition testing may not offer additional benefits for individuals already maintaining health through exercise and balanced nutrition. Collegiate and high-performing athletes, already under significant physical stress, may not need the added pressure of constant body fat monitoring, as its impact on performance is marginal compared to other training factors. 

Scenarios Where Testing Is Not Beneficial: 

○ Healthy individuals with consistent exercise and nutrition routines. 

○ Athletes susceptible to body image issues or eating disorders, where testing could worsen these conditions. 

In summary, while body composition testing can enhance training precision and injury prevention for athletes, its application should be mindful of potential psychological impacts. Prioritizing factors like hydration, sleep, and diet remains fundamental to improved performance. For those genuinely interested in understanding their body’s composition, exploring such testing can offer insightful perspectives but should be approached with consideration of individual needs and well-being.

 

Alternative Metrics Influencing Sports Performance

Several metrics influence sports performance without necessitating body composition testing:

  • Ensuring adequate macronutrient intake (fueling with carbohydrates, refueling with carbohydrates, protein, and fat). 
  • Ensuring an overall adequate intake of food to fuel training. 
  • Getting enough sleep (8-10 hours per night). 
  • Cultivating a positive mindset towards training. 
  • Maintaining proper hydration levels. 
  • Building a strong support system (coaches, teammates, family). 
  • Incorporating mental training techniques (visualization, mindfulness, goal setting). 

By focusing on these aspects, athletes can optimize performance and well-being without the potential drawbacks of intensive body composition testing. Body composition testing serves as a powerful tool in the realm of sports science, yet its implementation requires careful consideration of both physiological benefits and psychological impacts on athletes. 




References

Beestone C. Body composition testing. Science for Sport. March 1, 2024. Accessed July 8, 2024. 

https://www.scienceforsport.com/body-composition-testing/. 

Kuzma C. Body composition testing – college running programs moving away from body comp tests. Runner’s World. Accessed July 19, 2024. https://www.runnersworld.com/news/a42437488/body-composition-testing-colleg e-programs/. 

Mathisen TF, Ackland T, Burke LM, et al Best practice recommendations for body composition considerations in sport to reduce health and performance risks: a critical review, original survey and expert opinion by a subgroup of the IOC consensus on Relative Energy Deficiency in Sport (REDs) British Journal of Sports Medicine 2023;57:1148-1160. https://bjsm.bmj.com/content/57/17/1148 

Strout E. Why top NCAA triathlon coaches won’t use body composition testing. Triathlete. January 5, 2023. Accessed July 8, 2024. https://www.triathlete.com/culture/news/why-top-ncaa-triathlon-coaches-wont-use -body-compos ition-testing/. 

Body composition: UC Davis Sports Medicine: UC Davis health. Body Composition | UC Davis Sports Medicine |UC Davis Health. Accessed July 19, 2024.




BEST SNACKS FOR ENDURANCE ATHLETES

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Best snacks for endurance athletes

  • By Amy Stephens RDN CSSD

Here’s a list of great snacks for endurance athletes, focusing on fueling energy, aiding recovery, and supporting sustained performance. Keep these snacks on hand to fill in the gaps with nutrition. These options are portable, nutrient-dense, and easy to digest:

Before Training or Competition

These snacks are high in carbs and low in fiber/fat for quick energy:

Best consumed 1-2 hours before

  1. Banana with a smear of honey or peanut butter
  2. Applesauce pouch and handful of nuts
  3. Rice cakes with jam or honey
  4. Pretzels or plain crackers with a little peanut butter
  5. A small handful of dried fruit (e.g., raisins, apricots, or dates) and nut butters
  6. A slice of toast with jam
  7. Nutrition bar such as Clif, Rx or Kind bar

Best consumed within 30 minutes before

  1. Energy chews, gels, or blocks
  2. Sports drink
  3. Fruit leathers
  4. Gummy bears

During Activity (for sessions over 90 minutes)

Easily digestible, high-carb options to keep energy levels steady:

  1. Sports drinks or electrolyte beverages
  2. Energy gels or chews
  3. Small pieces of banana or orange slices
  4. Honey stinger waffles or similar carb-based snacks
  5. Bite-sized pretzels for quick sodium replenishment

After Training or Competition

Refuel within one hour after exercise to replenish glycogen and support muscle recovery:

  1. Chocolate milk (ideal 4:1 carb-to-protein ratio)
  2. Greek yogurt with granola and fruit
  3. Protein smoothie with banana, berries, and protein powder
  4. Cottage cheese with pineapple or berries
  5. Peanut butter or almond butter sandwich
  6. Hard-boiled eggs with crackers
  7. Trail mix with nuts, seeds, and dried fruit
  8. Turkey sandwich on bread or bagel

General Healthy Snacks

Perfect to help maintain energy levels and build muscle throughout the day:

  1. Oatmeal with fruit and nuts
  2. Rice cakes with nut butter and banana slices
  3. String cheese with fruit or whole-grain crackers
  4. Hummus with carrots, celery, or whole-grain pita
  5. Nut butter packets with an apple or pear
  6. Avocado toast on whole-grain bread
  7. Homemade granola bars
  8. Cottage cheese and fruit

EATING DISORDER OR RED-S? THE KEY DIFFERENCES​

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Eating Disorder or RED-S? The Key Differences

  • By Amy Stephens RDN CSSD
    Kate Cochran, Nutrition Intern

TW: This content mentions eating disorders and body image.

Eating disorders are mental health conditions, whereas RED-S (Relative Energy Deficiency in Sport) is a physiological state caused by an energy imbalance. However, these conditions can overlap. For instance, an athlete with an eating disorder may develop RED-S due to intentional caloric restriction. An athlete experiencing RED-S without an eating disorder may adjust their food intake to meet energy needs once under-fueling is recognized. In contrast, individuals with eating disorders may find increasing calorie intake more difficult, often requiring support from a medical team.

The main difference between an eating disorder and Relative Energy Deficiency in Sport (RED-S) lies in their definitions, causes, and impacts, although they can overlap in certain cases. Here’s a breakdown:

Eating Disorder

  • Definition: A mental health condition characterized by disordered eating behaviors and thoughts, such as extreme restriction, binge eating, purging, or obsessive food-related control.
  • Examples: Anorexia nervosa, bulimia nervosa, binge eating disorder, avoidant/restrictive food intake disorder (ARFID).
  • Cause: Psychological factors (low self-esteem, perfectionism, trauma), social influences (media, societal pressure), or biological predispositions.
  • Impact: Affects overall health, including physical, emotional, and social well-being.

Treatment Focus: Psychological therapy, nutrition rehabilitation, and medical stabilization.

Relative Energy Deficiency in Sport (RED-S)

  • Definition: A syndrome caused by insufficient energy intake relative to the energy expenditure required for optimal health and performance, often seen in athletes.
  • Cause: Unintentional (due to misunderstanding energy needs or increased training load) or intentional (associated with disordered eating behaviors).
  • Impact:
    • Affects multiple body systems (e.g., reproductive, bone, digestive, cardiovascular, and immune systems).
    • Can lead to decreased performance, delayed recovery, and increased risk of injuries.
    • Symptoms include menstrual dysfunction, low testosterone in males, fatigue, and impaired concentration.

Treatment Focus: Restoring energy balance through increased caloric intake, reducing training loads, and addressing any disordered eating patterns.

Key Distinction

While eating disorders are mental health conditions, RED-S is a physiological state caused by an energy imbalance. However, the two can coexist. For example, an athlete with an eating disorder may develop RED-S due to intentional caloric restriction. Once under-fueling is identified, an athlete with RED-S will readily increase food intake to match energy expenditure. For an individual with an eating disorder, the addition of calories will be more challenging and may require treatment by a medical team. If nutrition requirements cannot be met, pausing or reducing exercise may be helpful to achieve a positive energy balance.

Addressing either condition requires a multidisciplinary approach involving dietitians, mental health professionals, and medical experts.




Winter Supplements for Runners

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Winter Supplements for Runners

  • By Amy Stephens RDN CSSD, Sports Dietitian

Winter months bring unique nutritional needs for runners, including reduced sunlight exposure, which increases the need for Vitamin D. Meeting nutrition goals through food is ideal, but supplements can be helpful when dietary intake is insufficient. Below are recommended winter supplements and their top food sources. There are other supplements not mentioned that are supportive for performance, please refer to the post, best supplements for runners, for more information on performance. Runners following vegetarian or vegan diets may need to focus on nutrients like Vitamin D, calcium, B12, and zinc because plant-based foods do not contain these vitamins.

Enhance the effectiveness of supplements by ensuring you consume enough food to meet your energy needs. If your diet doesn’t support your current energy expenditure, supplements will be less effective. Athletes should aim for a balanced diet, with supplements serving as an addition to a healthy, well-rounded eating plan.

I had the opportunity to speak with a couple of elite runners about their supplement usage in the winter. Brendan Martin of Martin Physical Therapy who has a marathon PR of 2:15, follows a vegetarian diet and regularly takes vitamin B12 because he cannot obtain this nutrient from foods. Johannes Motschmann who recently placed 9th in the London marathon adds in Vitamin C and Zinc to support the immune system during high mileage weeks.

TIP: To build consistency, try taking supplements alongside daily routines, such as brushing your teeth. 

Supplement Tip: Choose products that are third-party tested (e.g., by USP, NSF), which ensures they are free from harmful ingredients, though it does not guarantee the product’s effectiveness.

Vitamin D

Recommended Dietary Allowance (RDA): 600 IU/day (may need more for athletes).

Function: Vitamin D is essential for bone health and aids in calcium absorption, which strengthens bones. It also helps regulate the immune response, reduce inflammation, and protect against respiratory infections—benefits especially important for athletes during winter when Vitamin D levels often decline. Its anti-inflammatory effects are particularly beneficial for athletes, especially those with a history of bone stress injuries.

Top Sources:

  • Sunlight: UV exposure helps activate Vitamin D in the skin.
  • Food:
    • Cod liver oil (1 Tbsp): 1360 IU
    • Salmon (sockeye, 3 oz cooked): 570 IU
    • Mushrooms (½ cup raw): 366 IU
    • Milk (2%, 1 cup): 120 IU
    • Egg (1 large): 44 IU

Calcium

Recommended Dietary Allowance (RDA):

  • Ages 9-18: 1,200 mg/day.
  • Ages 19-50: 1,000 mg/day.
  • Athletes: 1,500 mg/day, especially if there is a history of bone stress injuries.

Function: Essential for bone health, muscle contraction, and nerve function. Vitamin D aids calcium absorption.

Top Sources:

  • Milk/yogurt (1 cup): 300-400 mg
  • Cheese (1 oz, especially Parmesan): ~200 mg
  • Cooked kale or collard greens (1 cup): 250 mg
  • Fortified orange juice (1 cup): 350 mg
  • Fortified soy milk or almond milk (1 cup): 300-400 mg
  • Tofu (½ cup): 350 mg
  • Dried figs (4-5): 135 mg

Note: Combining food and supplements may be necessary to meet daily targets. It’s important to note that the body can absorb only 500 mg calcium per meal. It’s best to spread calcium-rich foods throughout the day to maximize absorption.

Omega-3 Fatty Acids

Function: Helps reduce exercise-related inflammation by modulating cell membranes and immune responses. Fatty fish are the best sources, though supplements can help when dietary intake is low.

Recommended Intake: 1.1-1.6 grams/day (1,100-1,600 mg).

Top Sources:

  • Salmon, sardines, herring (3 oz): ~1200 mg
  • Ground flax, chia, or hemp seeds (1 Tbsp): ~2300 mg

Vitamin C

Recommended Dietary Allowance (RDA): 75-90 mg/day.

Function: Boosts immunity, aids iron absorption, and is essential for collagen synthesis. Humans need to obtain Vitamin C from food.

Top Sources:

  • Strawberries (1 cup, halved): ~89 mg
  • Oranges (1 medium): ~70 mg
  • Pineapple/Mango/Cantaloupe (1 cup, cubed): ~65 mg
  • Red bell pepper (1 medium): ~152 mg
  • Broccoli (1 cup, cooked): ~102 mg
  • Kale (1 cup, raw): ~80 mg

 

Professional runner, Johannes Motschmann, who recently placed 9th at the London Marathon, adds in Vitamin C and Zinc to support the immune system during high mileage weeks.

Vitamin B12

Recommended Dietary Allowance (RDA): 2.4 mcg/day.

Function: B12 is essential for the production of healthy red blood cells, proper nerve function, and energy metabolism. It also supports neurotransmitter production, playing a key role in mood regulation and cognitive health. Low B12 levels have been linked to memory problems, depression, and mental confusion. B12 is mainly found in animal products such as meat, fish, and dairy.

Top Sources:

  • Salmon (3 oz): ~4.9 mcg (200% DV)
  • Trout (3 oz): ~5.4 mcg (225% DV)
  • Tuna (3 oz): ~2.5 mcg (104% DV)
  • Beef (3 oz): 5.1 mcg (215% DV)
  • Fortified Breakfast Cereals (1 serving): ~0.6–6 mcg (25-250% DV, depending on fortification level)
  • Dairy Milk (1 cup): ~1.2 mcg (50% DV)
  • Yogurt (8 oz): ~1.1 mcg (46% DV)
  • Swiss Cheese (1 oz): ~0.9 mcg (38% DV)
  • Eggs (2 large): ~1.1 mcg (46% DV)
  • Nutritional yeast (1 Tbsp): 2.4 mcg

Professional runner Brendan Martin, with a marathon personal record of 2:15 follows a vegetarian diet and regularly supplements with Vitamin B12.

Hydration with electrolytes

Hydrating during winter is just as essential as in warmer months, even though we may feel less thirsty in cold weather. Here are some tips to help maintain good hydration in winter:

  1. Drink Regularly: Thirst signals decrease in cold weather, so make it a habit to sip water consistently throughout the day. Aim for at least 8 cups (2 liters) daily, adjusting based on activity level and body size.
  2. Warm Beverages: Warm drinks like herbal teas, hot water with lemon, or broth-based soups are great options for hydration when cold water doesn’t appeal. Avoid excessive caffeine and alcohol, as it can contribute to dehydration.
  3. Hydrating Foods: Winter fruits and vegetables like oranges, grapefruit, apples, pears, cucumbers, and leafy greens have high water content, helping you stay hydrated while adding nutrients.
  4. Electrolytes: After exercise or if you’re sweating (even in winter), replenish electrolytes with options like coconut water or a light sports drink. Salty snacks or electrolyte supplements can also help retain hydration when balanced with water intake.
  5. Watch for Signs of Dehydration: Dry skin, fatigue, and dark urine can indicate dehydration. Aim for urine that is pale yellow in color, a good indicator of proper hydration.
  6. Humidify Your Environment: Winter air, especially with indoor heating, can be very dry. Using a humidifier adds moisture to the air, helping you retain hydration naturally.

Should Athletes Use a CGM? A Look at the Benefits and Drawbacks

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Should Athletes Use a CGM? A Look at the Benefits and Drawbacks

  • By Amy Stephens RDN CSSD, Sports Dietitian

A Continuous Glucose Monitor (CGM) is a medical device designed to deliver real-time measurements of glucose (sugar) levels in the body. Although it is mainly utilized by individuals with diabetes to regulate their blood sugar, it has also become increasingly popular among athletes and health enthusiasts. While these devices offer a wealth of data, it’s crucial to consider how that information will be applied effectively. Here’s how it works and its main components:

How CGM Works

  1. Sensor Insertion: A small sensor is inserted under the skin, typically on the abdomen or the back of the arm. This sensor measures glucose levels in the interstitial fluid (the fluid between cells) rather than directly in the blood.
  2. Continuous Monitoring: The sensor continuously measures glucose levels, usually every few minutes, providing a real-time view of fluctuations throughout the day and night.
  3. Data Transmission: The sensor sends glucose data to a receiver or a smartphone app via Bluetooth or other wireless technologies. This allows users to see their glucose levels in real-time, track trends, and receive alerts for high or low levels.
  4. Calibration: Some CGMs require periodic calibration with a fingerstick blood glucose meter, while others do not, depending on the model.

Components of a CGM System

  • Sensor: The small device that is placed under the skin to measure glucose levels.
  • Transmitter: A component that attaches to the sensor and sends the glucose data wirelessly to a display device.
  • Display Device: This could be a standalone monitor, a smartphone, or a smartwatch that receives the data and displays glucose readings.

Benefits of Using a CGM

  • Real-Time Data: Provides continuous monitoring, allowing users to respond quickly to fluctuations in glucose levels.
  • Trend Analysis: Helps identify patterns in glucose levels in response to food, exercise, stress, and other factors.

Popular CGM Brands

Some well-known CGM systems include:

  • Dexcom: Offers a range of CGM products with various features, including a mobile app for tracking.
  • Freestyle Libre: Known for its simple sensor application and a focus on ease of use.
  • Medtronic: Provides integrated systems that often work in conjunction with insulin pumps.

Using a Continuous Glucose Monitor (CGM) can be beneficial for athletes, especially those involved in endurance sports or those with specific dietary and training goals. Here are some key considerations for athletes thinking about using a CGM:

Potential Benefits of Using a CGM for Athletes:

  • Real-time Glucose Monitoring: CGMs provide continuous, real-time glucose data, helping athletes understand how their blood sugar levels fluctuate throughout training and competition.
  • Optimizing Nutrition: By tracking glucose levels, athletes can fine-tune their nutrition strategies to enhance performance, avoid crashes, and ensure they’re fueling adequately before, during, and after workouts.
  • Identifying Patterns: Athletes can identify how different foods, hydration levels, and exercise intensities affect their glucose levels, allowing for personalized dietary adjustments.
  • Avoiding Hypoglycemia: For athletes, especially those in sports with high energy demands, monitoring glucose levels can help prevent hypoglycemic episodes, which can impair performance.
  • Recovery Monitoring: After intense workouts, monitoring glucose levels can provide insights into recovery and metabolic response, helping athletes optimize their post-workout nutrition.
  • Managing Stress Responses: CGMs can help athletes understand how stress (from training, competition, or other life factors) affects their glucose levels, allowing for better stress management techniques.

Considerations and Potential Drawbacks:

  • Cost: CGMs can be expensive, and not all insurance plans cover them, making them a financial consideration for many athletes. Dexcom (Supersapien) may cost $300-400 for the device and $150-200 for the subscription. Freestyle libre (Lingo) costs about $75 per sensor, each one lasting up to 14 days. Additional costs include: $150 per month, plus a one time $60 fee for the reader.
  • Learning Curve: Athletes may need time to learn how to interpret CGM data effectively and integrate it into their training and nutrition regimens.
  • Over-reliance: There’s a risk of becoming overly focused on glucose levels, which might lead to anxiety or second-guessing nutrition and training decisions.
  • Not for Everyone: While CGMs can provide valuable information, they may not be necessary for all athletes, especially those who do not have blood sugar management issues.
  • Lag time: CGMs placed on the arm (Freestyle Libre) measures glucose in interstitial fluid, which can be delayed compared to blood glucose, especially during rapid changes (like after eating or during exercise). This lag is generally about 5-10  minutes, so the device might not immediately capture sudden spikes or drops.
  • Factors Affecting Accuracy: Certain factors, like dehydration, sensor placement, compression (from lying on it or tight clothing), and high temperatures can reduce accuracy. Users also tend to get better readings when it’s kept at a consistent temperature.
  • Stress affects blood sugar readings: Other factors that can lead to fluctuations in blood sugar, apart from food, include stress hormones like cortisol and adrenaline. These hormones may rise during periods of illness, physical or mental stress, medication use (such as steroids), menstrual cycles, or hormonal imbalances. Analyzing CGM data can make it challenging to differentiate between fueling and the body’s normal response to stress.

Conclusion:

Ultimately, the decision to use a CGM should be based on individual goals, health conditions, and the nature of the sport. Athletes interested in using a CGM should consider consulting with a sports nutritionist or a healthcare professional to tailor the use of glucose monitoring to their specific needs and training goals.

optimize health and performance

Amy Stephens, MS, RDn, CSSD, CEDS

Licensed dietiTian

specializing in sports nutrition and eating disorders

[email protected] | Book your Session

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