Amy Stephens

MS, RDN, CSSD, CDCES

Licensed dietitian

specializing in sports nutrition

and eating disorders

Refueling After a Workout When You’re Not Hungry

Refueling After a Workout When You're Not Hungry

Why is eating after a workout important? 

Eating after a workout is important to optimize recovery, performance and overall health. Eating within one hour after a workout enhances recovery. This period of time is known as the glycogen window, during which nutrients are maximally absorbed into the body. Over the next 6-12 hours, absorption will continue, but at a slower rate. Consuming carbohydrates within the first hour after a workout aids in glycogen repletion while protein prevents further muscle breakdown. Nutrients consumed after a workout are important to facilitate adaptations during a training block and prevent injury. However, meeting nutritional requirements can be difficult if you’re experiencing nausea or have a decreased appetite.

Fueling after a workout is especially important if you have high energy demands such as training on consecutive days. Food will help your body recover faster in time for the next workout. Protein consumed after a workout helps damaged muscles rebuild and get stronger. In addition, food will keep up energy levels for the duration of the day so you can start your next workout feeling ready to train.

What causes a poor appetite and nausea? 

Nausea or poor appetite develops as a result of stress hormones released during a training session. These hormones, cortisol and adrenaline, are necessary to produce power during a workout. While these hormones are elevated, other hormones that are responsible for hunger are suppressed. As a result, you may experience a poor appetite or even nausea after a workout. However, once exercise is completed, your hormones will reset and normal hunger cues will return eventually. 

Dehydration and electrolyte imbalances can also cause a poor appetite and nausea. 

How do I eat if I’m not hungry? 

In the post-workout period, you may need to override your body’s natural cues so that you eat even if you don’t feel hungry. This is crucial for staying ahead in fueling your body’s recovery process. 

Here are some tips if you feel nauseous:

  • Hydrate by sipping cold recovery beverages such as Skratch Horchata or chocolate milk that also contain essential nutrients to kickstart recovery. 
  • Obtain electrolytes from foods or liquids to accelerate hydration.
  • Choose colder foods like smoothies, yogurt or cut-up fruit. 
  • Avoid high fat foods until the nausea improves.

Here are some tips if you have a poor appetite:

  • Begin eating by eating bland foods like crackers and toast, and hopefully, this will signal to your brain that it’s time to eat. 
  • Select your favorite foods that you can look forward to eating such as pancakes with syrup. 
  • If you’re still not feeling hungry, try having smaller meals and plenty of fluids throughout the day to make sure you’re keeping up with your refueling schedule.

If nausea continues or worsens despite nutrition changes, reach out to your healthcare provider.

 

 

 

References 

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. 

Murray B, Rosenbloom C. Fundamentals of glycogen metabolism for coaches and athletes. Nutr Rev. 2018 Apr 1;76(4):243-259. doi: 10.1093/nutrit/nuy001. PMID: 29444266; PMCID: PMC6019055. 

Kerksick, C. M., Arent, S., Schoenfeld, B. J., Stout, J. R., Campbell, B., Wilborn, C. D. International society of sports nutrition position stand: nutrient timing. Journal of the International Society of Sports Nutrition. 2017. 14(1). https://doi.org/10.1186/s12970-017-0189-4.

Fast track recovery: How to eat when you’re injured

Fast track recovery: How to eat when you’re injured

If you’re an athlete dealing with an injury, adjusting your diet can aid in recovery and overall health. The best nutrition to support healing from soft tissue injuries like pulled muscles, strained tendons or damaged cartilage will differ from the best nutrition for hard tissue injuries like fractured or broken bones. Regardless of the type of injury, and whether your recovery period lasts a few days or a few months, and can be treated simply with rest or rehabilitation or even surgery, nutrition plays an important role in getting you back to your sport.

Nutrition through a period of injury can be particularly challenging for athletes with a history of eating disorders, as lower levels of activity may trigger negative thoughts or behaviors. If you find yourself overwhelmed by your eating plan or constantly thinking about food, it’s essential to reach out to a qualified sports dietitian for additional support. 

The following dietary considerations will promote healing and strength through an injury:

  1. Maintain a Positive Energy Balance: the most important factor to consider. Ensure you are consuming enough calories to support your daily expenditure. This means, you need to eat enough to prevent weight loss which is a sign that healing is delayed. Aim to eat in a calorie surplus to aid in healing. It’s important to note that using crutches, physical therapy (PT), and cross training require additional energy. 
  2. Increase Protein Intake: Protein is crucial for muscle repair and recovery. Endurance athletes in particular may find they need to shift from a carb-focused diet to one that prioritizes more protein as they focus on rehabilitation and muscle building. Glycine is an amino acid that becomes essential during injury. It acts as a precursor for a variety of metabolites involved in inflammation.Foods with glycine include meats, seeds, and salmon. Other high quality proteins can be found in sources like eggs, dairy, legumes, and plant-based protein sources like tofu or seitan. Aim for 1.5-1.7 grams protein per kilogram of body weight. For example, if you weigh 140 pounds, aim for 25-35 grams of protein per meal which is about 4-5 ounces of chicken or salmon. 
  3. Incorporate Collagen: Collagen is a protein that helps maintain and repair tendons, ligaments and other connective tissues. Consuming collagen-rich foods like bone broth or adding a collagen supplement to your diet may support both soft and hard tissue health. Vital Proteins collagen supplement can be easily dissolved in a glass of water or juice before or immediately after exercise. 
  4. Focus on Anti-inflammatory Foods: Foods rich in omega-3 fatty acids, such as salmon, walnuts, and flaxseeds, can help reduce inflammation, which may lengthen healing time if left alone. Including plenty of fruits, vegetables, whole grains, nuts, seeds and fish can also support the body’s healing process by reducing inflammation.
  5. Stay Hydrated: Drinking plenty of water is essential for overall health and healing, even though you may be sweating less during injury. Proper hydration supports tissue repair and helps maintain muscle function. Aim to have 10-20 oz fluids per meal and extra when you are sweating. 
  6. Consider Vitamin and Mineral Supplements: Certain vitamins and minerals play a role in muscle function and recovery. Vitamin C, vitamin E, and zinc are important for tissue repair, while calcium and vitamin D support bone health. However, it’s best to consult with a healthcare professional before starting any new supplements. 
  7. Stimulate Bone Growth: Bone growth requires adequate calories overall as well as high-quality protein, Vitamin D and calcium. Consume at least three servings of the following: dairy (yogurt, milk, cheese), salmon, fortified cereals, fortified OJ and egg yolks.
  8. Reduce Processed Foods and Sugars: Processed foods and added sugars can contribute to inflammation and may hinder the body’s healing process. Additionally, consuming too many processed foods displaces more nutrient dense foods that can aid in healing. 
  9. Pay attention to your body: During injury recovery, it’s important to stay attuned to how your body feels. It’s normal to have a decreased appetite, so you may find that you need fewer snacks in your meal plan. Since everyone’s body is unique, it’s important to pay attention to your body’s signals and adapt your diet accordingly to prioritize healing and recovery.
  10. Seek Rehabilitative Support: Collaborate with a skilled physical therapist to safely return to your sport and determine how continuing sessions might help prevent future injuries. 



Best Protein Bars, according to a Sports Dietitian

Best Protein Bars,
according to a Sports Dietitian

Protein bars can be a convenient and portable option for adults and teens looking to supplement their protein intake, especially for those who are active in sports or physical activities. It’s important to remember that food is always the best option and protein bars are useful when food is not available. When choosing protein bars, it’s essential to consider factors such as the ingredients, nutritional content, and taste. Here are some tips for selecting the protein bars:

Look for Whole Food Ingredients: Choose protein bars with a short and recognizable list of ingredients. Opt for bars that contain whole food ingredients such as nuts, dates, egg whites, or honey. 

 

Incorporate Carbohydrates: Carbohydrates play a crucial role in recovery alongside protein. They aid in replenishing glycogen stores, allowing protein from food and bars to be utilized for muscle building. If your protein bar has a low carbohydrate content (<15 grams), consider supplementing with a fruit or another form of carbohydrate to ensure you meet your nutritional requirements. 

 

Consider Protein Content: Choose protein bars that provide a moderate amount of protein per serving, typically ranging from 10 to 20 grams. This amount of protein can help support muscle repair and growth, especially for active teens engaged in strength training or sports. The best sources of protein that contain all essential amino acids are from whey, casein, egg whites, or soy.

 

Pay attention to the Sugar Content:  Select bars sweetened with natural sources of sugar like cane sugar, honey, agave, or from real fruit like dates.

 

Check the Fiber Content: Fiber in protein bars can help promote satiety, support digestive health, and regulate blood sugar levels. However, too much fiber can lead to bloating and gastrointestinal discomfort which can negatively affect performance for an athlete. Aim for bars with about 3-5 grams of fiber per serving.

 

Consider Dietary Restrictions: Take into account any dietary restrictions or preferences you may have, such as allergies, intolerances, or dietary preferences (e.g., lactose intolerant, vegetarian or vegan). Choose protein bars that align with your specific dietary needs.

 

Consider Taste and Texture: Sample different protein bars to find options that you enjoy both in terms of taste and texture. Choosing bars with flavors and textures that are appealing can increase the likelihood that you will incorporate them into their diet. 

Best time to eat a protein bar​

The best time to eat a protein bar is following a strenuous workout or as a snack paired with a carbohydrate.

  • Post-Workout: Consuming a protein bar within 30-60 minutes after a workout can help kickstart the recovery process by providing your muscles with the necessary amino acids to repair and rebuild. Pairing the protein bar with carbohydrates can also help replenish glycogen stores and support muscle recovery.
  • On-the-Go Snack: Protein bars are ideal for on-the-go snacking when you don’t have access to a full meal or when you need a quick and convenient source of nutrition. They can be kept in your bag, car, or desk drawer when you feel hungry.

Here are a few of my favorite options

RX Bar – 220 calories, 23g carbohydrates, 12g protein, 4g fiber

GoMacro Bar – 270 calories, 39g carbohydrates, 12g protein, 3g fiber

Rise – 280 calories, 20g carbohydrate, 20g protein, 4g fiber

Perfect bar – 340 calories, 27g carbohydrate, 17g protein, 3g fiber

Aloha bar, 220 calories, 26g carbohydrates, 14g protein, 10g fiber*

*contains a significant amount of fiber

NUTRITION GUIDELINES FOR COLLEGE ATHLETES​

nutrition guidelines for college athletes

As a college athlete, proper nutrition is crucial for fueling your performance, supporting recovery, and maintaining overall health and well-being. It’s important to remember that your bodies are still developing and getting stronger. Nutrition has to be adequate to fuel you as a human, exercise, recovery and commuting to class. It’s important to pay careful attention to ensure you are fueling your body to stay healthy and prevent injuries. Additionally, as training volume and intensity increase over a training period, dietary needs evolve. Athletes must adapt their food intake to align with workout intensity and duration throughout the semester to avoid underfueling.

Here are some tips on how to nourish your body as a college athlete:

  • Eat on a Schedule: Establishing a regular eating schedule is essential for college athletes to maintain energy levels, support performance, and facilitate recovery. Eat meals every three-to-four hours and snacks as needed to ensure that your body has a steady supply of fuel to support athletic performance
  • Prioritize Balanced Meals: Aim to eat balanced meals that include a mix of carbohydrates, protein, healthy fats, fruits, and vegetables. This provides your body with the necessary nutrients for energy, muscle repair, and overall health.

 

  • Fuel Before Workouts: Consume a carbohydrate-rich meal or snack 1-3 hours before workouts or practices to provide your body with the energy it needs to perform. Choose foods that are low in fat and fiber. Some easily digestible options include: oatmeal, whole grain toast with nut butter, or a banana.
  • Stay Hydrated: Proper hydration is essential for athletic performance and overall health. Drink water throughout the day and especially before, during, and after workouts. Carry a reusable water bottle with you to ensure you’re staying hydrated throughout the day.
  • Plan Ahead: With a busy schedule of classes, practices, and games, it’s important to plan your meals and snacks in advance. Pack healthy snacks like nuts, fruit, yogurt, or granola bars to have on hand between classes and workouts.
  • Optimize Post-Workout Nutrition: Consume a combination of carbohydrates and protein within 30-60 minutes after workouts to support muscle recovery and glycogen replenishment. Foods after a workout are especially important to prevent injuries. Options include chocolate milk, a smoothie, or a sandwich on whole grain bread.
  • Choose Nutrient-Dense Foods: Focus on nutrient-dense foods that provide a wide range of vitamins, minerals, and antioxidants to support overall health and performance. Include plenty of fruits, vegetables, whole grains, lean proteins, and healthy fats in your diet.
  • Listen to Your Body: Pay attention to your hunger and fullness cues, as well as any signs of fatigue or sluggishness. Eat when you’re hungry and stop when you’re satisfied, and adjust your nutrition plan based on your individual needs and training demands.
  • Practice Portion Control: While it’s important to fuel your body adequately, be mindful of portion sizes to avoid overeating. 
  • Seek Support: Take advantage of resources available to you, such as nutrition counseling services offered by your college or university. A registered dietitian can provide personalized guidance tailored to your specific dietary needs and athletic goals.
  • Balance Social and Dietary Needs: While it’s important to prioritize healthy eating habits, it’s also okay to enjoy occasional treats and meals out with friends. 

By following these tips and prioritizing proper nutrition, you can fuel your performance as a college athlete and support your overall health and well-being.

5 TIPS TO build MUSCLE

5 TIPS TO build MUSCLE

Building muscle is a process that requires strategic nutritional and workout practices. Rather than focusing on losing body fat, focus on what you can do to increase muscle growth. Here are some helpful tips that can help you achieve your muscle-building goals more effectively. 

1. Eat Enough Calories

You need to be in a calorie surplus to gain muscle. This means you need to consume more calories than your body burns throughout the day. It might be helpful to pack extra snacks to fill in gaps between meals. This ensures you consistently have the energy to fuel your workouts and promote muscle growth.

2. Eat Often, Every 3-4 Hours

In order to maximize muscle growth, it’s recommended to spread out your protein intake throughout the day. According to a study by Schoenfeld (2018), aim to eat three meals and a couple of snacks each day to reach your nutrition targets. This ensures your body always has the nutrients it needs to repair and build new muscle tissue.

3. Target 20-40 grams Protein per Meal

Protein is key to muscle growth. That’s about 3-5 oz of chicken, fish, turkey, 3 eggs, 6 oz of tofu, or a serving of Greek yogurt with nuts. Use a food-first approach and incorporate protein supplements only when reaching your targeted protein amount is not feasible. Aim for .2 grams protein per pound per meal and .1 per pound for snacks.

4. Eat Carbs & Protein After Workouts

After a workout, your muscles are primed to absorb nutrients. Include 20-40 grams of high-quality protein within the first hour after a workout to improve muscle growth and recovery. Additionally, carbohydrates replenish glycogen stores, further promoting recovery and growth. Aim for a 3:1 ratio of carbs to protein.

5. Take Recovery Days

Muscle growth happens outside the gym. In order to gain muscle, your body needs time to recover and repair damaged muscle tissue. Therefore, it’s crucial to schedule recovery days into your workout regimen.

 

 

Common Questions:

To grow muscle, do I need to use pre-workout protein drink?

Pre-workout drinks can give you an energy boost because many contain caffeine however, they aren’t necessary for muscle growth. The keys to growing muslce is a consistent workout regimen, proper nutrition, and adequate rest.

When is the best time of the day to eat to build muscle?

Eat high-quality protein within one hour of finishing a workout to maximize muscle growth. Then continue to eat every 3 hours to facilitate muscle recovery and growth. Remember that protein supplements are more effective when your calorie balance is correct.

I’m a runner, should I take creatine?

The American Pediatric Association does not recommend use for individuals under 18 years old. Creatine works by converting carnosine in muscle at a faster rate, resulting in increased muscle strength. For runners, creatine can aid in short, high-intensity sprints and lifts lasting 0-30 seconds. Currently, creatine is being studied for use with endurance athletes. For more information on creatine such as dosing, click here.

What protein supplements are the best?

When food isn’t readily accessible, such as at a gym, field or track, protein supplements are a convenient option to meet protein needs. Along with a balanced diet,  protein supplements are a great way to fill in the gaps to reach protein targets. However, the “best” supplement varies based on individual needs, dietary restrictions, and preferences. Protein supplements derived from animal protein tend to be complete proteins. This means they contain all essential amino acids in which the body cannot make. Some examples are whey, casein, and egg.  A great plant-based option that are also complete proteins are soy and pea protein.

Follow @amystephensnutrition for more tips on how to effectively build muscle and improve your athletic performance.

References

Schoenfeld, B.J., Aragon, A.A. (2018). How much protein can the body use in a single meal for muscle-building? Implications for daily protein distribution. J Int Soc Sports Nutr 15, 10.

The Illusion of Perfect Eating: Why Celebrity Diets Are Unrealistic

The Illusion of Perfect Eating: Why Celebrity Diets Are Unrealistic

In today’s age of social media, it’s nearly impossible to scroll through our feeds without encountering a celebrity-endorsed diet plan or the latest trend in healthy eating. From Hollywood stars to Instagram influencers, everyone seems eager to share their secrets to achieving the perfect body through diet. But behind the glossy facade lies a harsh truth: many of these eating plans are not only unrealistic but also potentially harmful.

It’s no secret that celebrities and public figures face immense pressure to maintain a certain image. Whether it’s for a movie role, a photoshoot, or simply to keep up appearances, the pressure to look a certain way can be overwhelming. As a result, many turn to extreme diets or restrictive eating plans in an attempt to achieve the unattainable standards set by society. 

The problem with these celebrity-endorsed diets is that they often promote unrealistic expectations and unhealthy habits. From juice cleanses to extreme calorie restriction to eliminating carbohydrates, these plans may promise quick results but rarely deliver sustainable long-term benefits. Be skeptical of celebrity endorsed plans, especially if they promote quick results. What’s more, they perpetuate the harmful notion that thinness equals health, ignoring the importance of nourishing the body with wholesome, balanced meals. 

Dangers of celebrity diets

Celebrities have an opportunity to promote healthy eating behaviors however many do not. Recently, I was asked to review Kelly Ripa’s diet that was posted on Yahoo. After reviewing her typical day of eating, here’s what I discovered; she consumes about 1,600 calories and less than 50 grams of carbohydrates. The rest of her diet consists of green juices, nuts, and microgreens. This is not an appropriate amount of food for anyone, especially for an individual exercising one hour a day, as she claims. The average female that exercises one hour a day requires at least 2,200 calories and 300-400 grams of carbohydrates to meet nutrition needs. This amount is necessary to prevent injuries, optimize hormone production, keep up energy levels and prevent cravings. Consuming too few calories and carbohydrates can trigger increased hunger, cravings, moodiness and fatigue. 

Younger individuals who are in the midst of their growth and development can be particularly susceptible to the influence of such information, which has the potential to cause even greater harm. They may try to mimic this type of eating despite being at a different stage of development. Calorie restriction can have both short and long-term consequences for this population. In the short term, younger individuals may experience mood swings, low energy and have trouble focusing in school. Longer term consequences can cause delayed or poor growth, hormonal changes and negative impact on mental health.

Social media

One needs only look at the rise of social media platforms like Instagram and TikTok to see the influence these diets can have on impressionable followers. By posting inappropriate diet messages, celebrities and influencers can reach millions of people, many of whom may be susceptible to the allure of quick-fix solutions for weight loss or improved health. But the reality is that these diets are often based on pseudoscience or anecdotal evidence, rather than sound nutritional principles. Celebrities have an opportunity to promote healthy eating and lifestyle.

It’s important to remember that what works for one person may not work for another, and that there is no one-size-fits-all approach to healthy eating. Being healthy is about nourishing your body with nutrient-rich foods, staying active, and prioritizing your mental health and overall well-being. The number on the scale does not equate with health or athletic performance.

 

Where to seek reliable information

As consumers, we must be critical of the content we consume and question the validity of so-called “expert” advice. Just because someone has a large following or appears on a talk show, doesn’t mean they’re qualified to dispense nutritional guidance. Instead, we should seek out reputable sources and consult with registered dietitians or qualified healthcare professionals for evidence-based information on healthy eating. 

The best way to determine a reputable source is to check an individual’s credentials and look to see if they have proper training or a license to give nutrition advice. Merely offering advice doesn’t guarantee that the individual is properly trained or qualified to do so. Untrained “experts”  can delay treatment or worsen a medical condition.

Registered dietitians (RD) hold a master’s degree from an accredited university and complete a 1,200 hour internship. Dietitians are governed by the certification on dietetic registration and can specialize in areas which require additional training for example, diabetes, sports nutrition, oncology, etc. 

Medical doctors (MD) attend an accredited four year medical school and then train for a minimum of four years in a speciality area. Medical doctors are licensed and take multiple board examinations during training. They hold the highest level of education and training of any healthcare professional. The American Medical Association (AMA) is the governing agency. Doctors have privileges to prescribe, diagnose and treat medical conditions in their area of specialty. 

It’s important to note that chiropractors are not MD’s and they cannot prescribe medications to treat medical conditions. Chiropractors treat bodily aches, pains, and conditions by using their hands and small instruments. They attend a four year chiropractic school and train for an additional 2-3 years. Chiropractors typically sell supplements.

In conclusion, the next time you come across a celebrity-endorsed diet or the latest trend in healthy eating, be skeptical. Ask yourself if the information is from a reliable source. Remember that being healthy is about balance, moderation, and nourishing your body —not deprivation or self-denial. Let’s shift the focus away from unrealistic expectations and toward sustainable, realistic approaches to nourishing our bodies and living our best lives.

UNDERSTANDING EATING DISORDERS: INSIGHTS FOR COACHES, FAMILIES AND FRIENDS​

Understanding Eating Disorders:
Insights for Coaches, Families and Friends

Eating disorders are complex conditions influenced by a combination of genetic, biological, environmental, psychological, and sociocultural factors. It’s important to note that these factors interact in complex ways, and not everyone with risk factors will develop an eating disorder. Additionally, eating disorders can affect individuals of any age, gender, socioeconomic status, or cultural background. An eating disorder is not visibly apparent. An individual may appear healthy but may be struggling. It’s important to note that eating disorders are a mental illness.

Addressing eating disorders early can improve the likelihood that individuals will be able to pursue their academic career and physical goals. A comprehensive approach to treatment that addresses physical, emotional, and psychological aspects is crucial for recovery

Prevalence

Among the general population, an estimated 9% of the U.S. population, or 28.8 million Americans, will have an eating disorder in their lifetime (Deloitte, 2020).

95% of people with an eating disorder are between the ages 12-25 years old (Bratland-Sanda, 2013).

Eating disorders are a mental illness with the highest death rate, higher than depression, bipolar or schizophrenia (Arcelus, 2011).

Among athletes, eating disorders may be particularly hard to detect due in part to secretiveness, stigma, and symptom presentation (Eichstadt, 2020).

Athletes may be less likely to seek treatment for an eating disorder due to stigma, accessibility, and sport‐specific barriers (Flatt, 2021).

13.5% of athletes have a diagnosable eating disorder (Goch, 2013). 

Up to 47% of female athletes, versus 19% of male athletes have an eating disorder (Brantland-Sanda, 2013). 

Causes

There is no single cause for eating disorders, but several factors may contribute to their development:

Genetic Factors:

  • Research suggests a genetic predisposition to eating disorders. Individuals with a family history of eating disorders may be more susceptible.

Biological Factors:

  • Abnormalities in brain chemistry and neurotransmitter imbalances, such as serotonin and dopamine may play a role in the development of eating disorders.

Psychological Factors:

  • Personality traits, such as perfectionism, low self-esteem, and high levels of anxiety or depression, are associated with an increased risk of developing eating disorders.

Environmental Factors:

  • Societal pressures, cultural ideals of beauty, and exposure to thinness-promoting media can contribute to body image dissatisfaction, leading to disordered eating behaviors.

Traumatic Experiences:

  • Traumatic events, such as childhood abuse, bullying, or other significant life stressors, may contribute to the development of eating disorders as a coping mechanism.

Dieting and Weight Concerns:

  • Strict dieting or extreme focus on weight loss can trigger disordered eating behaviors. Dieting may disrupt normal eating patterns and lead to the development of unhealthy relationships with food.

Athletics and Performance Pressure:

  • Athletes, especially those in sports that emphasize leanness or specific body types, may be at increased risk. The pressure to perform and meet certain body standards can contribute to the development of eating disorders.

Family Dynamics:

  • Family factors, such as dysfunctional family relationships, communication problems, or a history of parental eating disorders, can contribute to the development of disordered eating patterns.

Social Influences:

  • Peer pressure and the desire to fit in with a particular group may contribute to the adoption of unhealthy eating habits.

Signs and symptoms

Recognizing if someone has an eating disorder can be challenging, as individuals with these disorders often try to conceal their behaviors. However, there are signs and behaviors that may indicate the presence of an eating disorder. It’s essential to approach the situation with empathy and sensitivity, avoiding judgment. Here are some common signs that someone may have an eating disorder:

Changes in Eating Habits:

    • Frequent dieting or a sudden switch to restrictive eating patterns.
    • Excessive focus on calories, fat content, or specific food groups.
    • Eating alone or avoiding meals altogether.
    • Consuming an inadequate amount of food before or after a workout.
    • Denying or minimizing behaviors related to food, body image or weight.
    • Evidence of binge eating, like finding large amounts of food wrappers.

Physical Signs and Symptoms:

      • Significant weight loss or fluctuations in weight.
      • Noticeable changes in appearance, such as a pale complexion or brittle nails.
      • Fatigue, weakness, or dizziness.
      • Frequent fluctuations in energy levels.
      • Evidence of self-induced vomiting, laxative use, or excessive exercise.

Emotional and Behavioral Changes:

    • Preoccupation with body image, weight, or food.
    • Avoidance of social events that involve food.
    • Anxiety or distress around mealtime.
    • Frequent comments about feeling fat or expressing dissatisfaction with one’s body.

Social Withdrawal:

    • Isolation from friends and social activities.
    • Desire to be alone.
    • Changes in relationships, especially if they involve food-related activities.

Mood Changes:

    • Increased irritability, mood swings, or signs of depression.
    • Emotional distress before, during, or after eating.

Denial of the Problem:

    • Dismissing concerns about weight loss or changes in eating habits.

Physical Health Issues:

    • Menstrual irregularities or the absence of menstrual periods in females.
    • Digestive problems, such as constipation or bloating.
    • Frequent complaints of feeling cold or wearing layered clothing to hide weight loss.

The presence of one or more of these signs does not necessarily confirm an eating disorder. However, if you notice several of these behaviors persisting over time, it may be an indication that further evaluation is needed.

How to help

Early intervention has been shown to improve outcomes. Treatment provides an opportunity for individuals to learn and adopt healthy eating habits, coping mechanisms, and stress management skills. If you suspect an individual has an eating disorder, express your concern in a nonjudgmental and caring manner. Encourage them to seek help from a healthcare professional, therapist, or dietitian who specializes in eating disorders. Remember that though eating disorders share commonalities, everyone is unique. You might need to bring up this issue several times before the person is willing to seek help. 

References

Arcelus J, Mitchell AJ, Wales J, Nielsen S. Mortality Rates in Patients With Anorexia Nervosa and Other Eating Disorders: A Meta-analysis of 36 Studies. Arch Gen Psychiatry. 2011;68(7):724–731. doi:10.1001/archgenpsychiatry.2011.74

Bratland-Sanda S, Sundgot-Borgen J. Eating disorders in athletes: overview of prevalence, risk factors and recommendations for prevention and treatment. Eur J Sport Sci. 2013;13(5):499-508. doi: 10.1080/17461391.2012.740504. Epub 2012 Nov 13. PMID: 24050467.

Deloitte Access Economics. The Social and Economic Cost of Eating Disorders in the United States of America: A Report for the Strategic Training Initiative for the Prevention of Eating Disorders and the Academy for Eating Disorders.June 2020. Available at: https://www.hsph.harvard.edu/striped/report-economic-costs-of-eating-disorders/.

Eichstadt, M., Luzier, J., Cho, D., & Weisenmuller, C. (2020). Eating disorders in male athletes. Sports Health: A Multidisciplinary Approach, 12(4), 327–333. https://doi.org/10.1177/1941738120928991 

Flatt, R., Thornton, L., Fitzsimmons‐Craft, E., Balantekin, K., Smolar, L., Mysko, C., Wilfley, D. E., Taylor, C. B., DeFreese, J. D., Bardone‐Cone, A. M., & Bulik, C. M. (2021). Comparing eating disorder characteristics and treatment in self‐identified competitive athletes and non‐athletes from the National Eating Disorders Association Online Screening Tool. International Journal of Eating Disorders, 54(3), 365–375. https://doi.org/10.1002/eat.23415 

Ghoch M, et al. Eating disorders, physical fitness and sport performance: a systematic review. Nutrients. 2013 Dec 16;5(12):5140-60. doi: 10.3390/nu5125140. PMID: 24352092; PMCID: PMC3875919.

Paul A. Krebs, Christopher R. Dennison, Lisa Kellar, Jeff Lucas, “Gender Differences in Eating Disorder Risk among NCAA Division I Cross Country and Track Student-Athletes”, Journal of Sports Medicine, vol. 2019, Article ID 5035871, 5 pages, 2019. https://doi.org/10.1155/2019/5035871




5 Myths You Hear as a College Athlete

5 Myths You Hear as a College Athlete

TW: This content mentions eating disorders and body image.

1. Thinner = faster

It is crucial for an athlete to fuel their body for performance. A stronger athlete is a better athlete. Many athletes believe that in order to be in peak condition performing  as fast as possible, they need to sit at a very low body fat percentage or lose weight. Being in a state of low energy availability is extremely harmful to an athlete’s physical and mental well being. 

When an athlete focuses on weight loss and the external “aesthetics” of their body, they may believe that weight loss is always a good thing. Unfortunately, that same athlete may be in an unnecessary state of low energy availability due to malnourishment, causing their body to focus its metabolic and physiological energy primarily on survival, rather than its other natural processes. In a study by Melin, Heikura, Tenforde, and Mountjoy, an athlete training for over 90 mins per day can even fall into a low energy availability state of survival if they are consuming less than 2,300 calories a day (depending on the athlete/training session). Prolonged weight loss or maintaining a low body weight that inhibits the body’s ability to carry out its processes can be dangerous. Low energy availability results in hormonal imbalances, menstrual dysfunction, decreased bone mineral density, immune system dysfunction, and threatens cardiovascular health and organ function. 

 

2. I have to be strict about my nutrition to achieve my goals  

 A balanced diet is a healthy diet. When you are eating enough, every food fits. Athletes do not need to miss out on social experiences to stick to a strict nutrition regimen. Due to societal ideas of a positive correlation between low body weight and increased success in sports performance, many endurance athletes are subject to low energy availability, developing eating disorders, and further damaging their health. In a survey by Tenforde et al. in 2015, out of 748 runners surveyed, 23% of females and 8% of males reported skipping meals or dieting to lose

weight during their youth, or early years in the sport (Watson, 2017). This suggests that false ideals around body weight and performance are instilled in athletes at a very young age, who may then grow and become entrenched in the mindset that they need to be extremely rigid around their nutrition. Rigid or restricted manipulation of caloric and nutrition intake may sacrifice an athlete’s long-term health. 

3. I should eat the same as my non-athlete friends

Your friends may not be putting in 7+ hours a week of training like you are. Most people eat intuitively, listening to their own body’s hunger cues. If they don’t feel like eating breakfast, they won’t. If they are not hungry within 3-4 hours of eating a meal, they will not force themselves to eat a snack. Everybody’s needs are different, but it is important for athletes to note that they should absolutely not compare their own eating habits to their non-athlete peers. For an athlete, even a sustained energy deficit of ~300 calories per day can lead to a variety of health issues (Cialdella-Kam et al., 2014). While athletes absolutely do not need to constantly be thinking about food or how to fuel their training properly, comparing themselves to their peers and attempting to follow an eating pattern that doesn’t fit their personal goals may result in low energy availability, hindering their health and ultimately their performance as an athlete.

4. Not having a regular period is normal for high intensity female athletes  

Even if your teammates talk about their irregular menstrual cycles, this is not normal. Healthy hormones are crucial for an athlete’s overall health. Exercise related menstrual dysfunction is associated with compromised bone health such as risk of osteoporosis and stress fractures. Additionally, exercise related menstrual dysfunction is also associated with a variety of other health issues, such as cardiovascular dysfunction, endothelial dysfunction, increased cortisol levels, and higher risk for muscular injuries (Ciadella-Kam, 2014). Although it sounds convenient, a missing period poses the risk for many health consequences.

5. Sleep is not important

While it is hard to balance college sports, academics, and a social life, it is crucial not to neglect sleep. Sleep is an integral part of recovery and many studies suggest evidence that sleep deprivation negatively affects performance. Sleep deprivation raises the risk of injury and illness in addition to hindering recovery from practices or workouts (Watson, 2017). Athletes need at least 8-10 hours of sleep per night.

References

Cialdella-Kam L, Guebels CP, Maddalozzo GF, Manore MM. Dietary intervention restored menses in female athletes with exercise-associated menstrual dysfunction with limited impact on bone and muscle health. Nutrients. 2014 Jul 31;6(8):3018-39. doi: 

10.3390/nu6083018. PMID: 25090245; PMCID: PMC4145292. 

Melin, A. K., Heikura, I. A., Tenforde, A., & Mountjoy, M. (2019). Energy Availability in Athletics: Health, Performance, and Physique, International Journal of Sport Nutrition and Exercise Metabolism, 29(2), 152-164. Retrieved Jun 19, 2023, from 

https://doi.org/10.1123/ijsnem.2018-0201 

Watson AM. Sleep and Athletic Performance. Curr Sports Med Rep. 2017 Nov/Dec;16(6):413-418. doi: 10.1249/JSR.0000000000000418. PMID: 29135639.

FUELING AN INDOOR WORKOUT: A GUIDE

FUELING AN INDOOR WORKOUT: A GUIDE

Providing your body with the essential energy for powering through exercises is crucial during a gym or indoor track workout. This guide provides tips on how to effectively fuel and hydrate your body during indoor workouts. The focus is on the right timing and type of nutrients to avoid energy crashes or gastrointestinal issues, and to keep energy levels up.

before

One-to-two hours before your workout, it is important to have a pre-workout snack that is rich in carbohydrates and protein to give you the energy you need to perform at your best. Some great pre-workout snacks include a banana with peanut butter, toast with peanut butter, rice cakes or a nutrition bar such as Clif, Nutrigrain or Maurten bar. If you need a quick snack right before you start your workout, opt for quick acting carbohydrates. Excellent choices include fruit snacks, sports drinks, or energy gels.

Target about 40-60 grams of carbohydrate and 8-12 oz fluids.

during

During your workout, it is important to stay hydrated by drinking water or a sports drink to replace the fluids lost through sweat. Consider adding electrolytes if you find yourself sweating excessively. If your workout lasts longer than an hour, consider having a small snack such as an energy gel, fruit, or sports drink to keep your energy levels up.

Hydration needs during the workout depend on its duration and intensity. A common recommendation is to drink about 4-10 ounces (about 100-300 milliliters) of water every 10-20 minutes during the exercise.

after

After your workout, it is important to refuel your body with a post-workout snack or meal that is rich in protein and carbohydrates. This will help to replenish your energy stores and aid in muscle recovery. Some great post-workout snacks include chocolate milk, a piece of fruit with a protein shake, trail mix and dried fruit, a turkey and avocado wrap, hummus wrap, or fruit and granola.

Rehydrate after the workout by drinking fluids (water or sports drink). A general guideline is to consume about 16-24 ounces (about 500-700 milliliters) of water for every pound (0.45 kilograms) of body weight lost during exercise.

Remember, fueling and hydration requirements can vary from person to person based on individual preferences and dietary restrictions. It’s essential to listen to your body and find what works best for you. Proper fueling before, during, and after your indoor workout is key to achieving your fitness goals and maintaining a healthy body.

Fueling for winter training

Fueling for winter training

During the winter months, nutrition priorities shift towards hydration, foods that generate body warmth, and those that boost the immune system.

 

Hydration

1. Hydrate even if you don’t feel thirsty. Your body loses water through both respiration and perspiration. This becomes particularly crucial during winter months and even more so if training at altitude. Performance can be impacted by dehydration, so maintain hydration by consistently sipping fluids throughout the day. If you tend to sweat heavily, consider incorporating electrolytes as well.

2. Layer your clothing to avoid overheating. Aim to dress for temperatures that are 10-20 degrees warmer than the outside temperature. If the temperature is 32℉ (0 ℃), dress for 40 or 50℉ (4-10℃). As your body temperature rises during activity, you can gradually remove layers to prevent overheating. Wearing too many layers can lead to increased sweating, potentially hastening dehydration.

3. Replenish fluids immediately after a workout. Kickstart recovery and hydration by choosing warm fluids like soups, teas or hot chocolate. 

4.  Do not let the need to remove layers for restroom breaks lead to intentional fluid restriction. Stopping and removing extra layers to urinate can be time-consuming and inconvenient. Nevertheless, athletes should be mindful that dehydration can significantly impair sports performance. 

Fuel

  1. Take advantage of food’s thermic effect, eating can increase body temperature and help the body warm up before a workout. Along with warm fluids (coffee or tea), eat a banana or a warm bowl of oatmeal 30-60 minutes before a workout to help your body warm up. 
  2. Refuel after a workout to continue to experience the thermic effect of food. Refueling will also help replenish glycogen stores and repair damaged muscle tissue. Choose meals that have plenty of complex carbohydrates, proteins and fats. 

Recovery foods

  1. Be conscious of Vitamin C consumption to keep the immune system working at peak level. Include seasonal foods such as frozen fruits, beets, broccoli, avocado, sweet potato and citrus fruits.
  2. Incorporate foods with Vitamin D. Sunlight is our bodies natural form of Vitamin D however in winter months, we don’t get nearly enough sunshine to activate Vitamin D. Best foods to choose are salmon, sardines, herring, eggs, and yogurt. 
  3. Choose warmer meals that are rich in carbohydrates and protein. Some great choices are soups, stews, hot chocolate, warm sandwiches, pasta with meatballs and bowls. Eat enough to replenish glycogen and promote recovery. 
  4. Eat the same amount of food in colder temperatures. Energy expenditure doesn’t change too much in winter months unless you are carrying extra gear (i.e. skis, hiking gear, or large hydration vests).

Sample winter meal plan

Breakfast 

Oatmeal made with frozen blueberries, topped with sliced banana, nut butter and cinnamon 

Snack

Trail mix with dried fruit and salted almonds

Lunch 

Homemade soup or stew

carrot ginger, winter vegetable and farro, chicken noodle, lentil, beef stew 

Snack 

Homemade muffins (apple and carrot superhero muffin recipe)

Chamomile or turmeric tea 

Dinner 

Salmon with roasted sweet potatoes, and a kale salad with feta cheese, pumpkin seeds, dried cranberries and lemon vinaigrette dressing



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