COVID-19 and Obesity-A Link Too Dangerous To Ignore

Obesity and overweight

More than one-third of U.S. adults have obesity, which is defined as having a BMI > 30. According to the World Health Organization, obesity has nearly tripled worldwide since 1975. In 2016, > 1.9 billion adults, 18 years and older, were overweight. Of these over 650 million were obese. A staggering 38 million children under the age of 5 were overweight or obese in 2019. Most of the world’s population live in countries were overweight and obesity kills more people than underweight. Do I have your attention yet? If not, did you know that 39% of adults aged 18 years and over were overweight in 2016, and 13% were obese. Over 340 million children and adolescents aged 5-19 were overweight or obese in 2016. All the aforementioned facts are per the WHO . Obesity is preventable. We need to wake up and do better, not just for ourselves but the next generations to come. The COVID-19 pandemic has forever changed our lives and we must revisit our lifestyle choices in honor of health and disease prevention.

This article will highlight the association of obesity and Covid-19. First and foremost, for adults, the WHO defines overweight as BMI > or equal to 25; and obesity is a BMI > 30. BMI provides a rough measurement tool to correspond fatness in different individuals. It is not the best indicator of health as it is a population-level measure which is the same for both sexes and all ages and adults. BMI does not tell us bio-metrics, energy levels, sleep, relationship with food and other areas that predict health. However, it does provide a common way to classify

overweight or obesity in adults. BMI is defined as a person’s weight in kilograms divided by the square of his or her height in meters (kg/m2).

Causes of Obesity

  • Imbalance of calories from physical inactivity or surplus of calories consumed chronically over time
  • Family history and genetics
  • Medications: Some anti-seizure medications, antidepressants, steroids and beta blockers can lead to undesirable weight gain
  • Environment: Surrounding yourself with friends and family who may be overweight making poor food and beverage choices can lead to greater risk of obesity
  • Too little sleep which can increase appetite and desire to consume low nutrient foods

Why is obesity a risk factor for Covid-19?

Obesity is considered a large risk factor for risk of severe COVID-19 because of the respiratory dysfunction. Those with obesity have a greater likely hood of experiencing restricted airways, decreased lung volumes, and weaker respiratory muscles which are an essential defense against COVID-19. Such factors make an individual more susceptible to pneumonia, and experience additional cardiac stress. Furthermore, obesity is also linked with diabetes, heart disease, and kidney disease, which overall increase the risk of developing pneumonia. Other ailments like hypertension, hyperlipidemia, and pre-diabetes enhance the susceptibility to infection.

The current science:

  •  Data from 383 patients showed that having obesity was associated with a 142% higher risk of developing severe pneumonia associated with COVID-19.
  •  A larger study of over 4,000 patients with COVID-19 in New York City found that severe obesity was a major risk factor for hospitalization, second only to age.
  • Analysis of critically ill COVID-19 patients in Seattle found that 85% of patients with obesity required mechanical ventilation, compared to 64% of patients without the condition. Moreover, 62% of the patients with obesity died of COVID-19, compared with 36% of those without obesity.
  • Limitation: Study only assessed 24 patients, all of whom were critically ill, making it difficult to draw attention to the conclusions from the data.
    • Another analysis of 124 patients in Lille, France, found that patients with obesity were more likely to require invasive mechanical ventilation.

Collectively this evidence suggest that obesity may be a significant risk factor for COVID-19. Dr. Norbert Stefan, of the German Center for Diabetes Research stated that “obesity may put people infected with Covid-19 at more severe risk and possibly risk of death.” Many of the recent articles published in the last 2 months regarding comorbidities and the association with COVID-19 did not produce data surrounding body composition or metabolic health. The gap in data warrants further research to investigate how body composition, waist circumference, and blood glucose levels play a role in contraction and recovery from the virus, specifically metabolic syndrome.
Metabolic syndrome is a serious health condition that affects roughly 23 percent of adults and increases their risk of cardiovascular disease, type 2 diabetes, stroke and diseases related to fatty buildups in arterial walls according to the American Heart Association. The overall underlying cause of metabolic syndrome includes being overweight, obese, inactivity along with other genetic factors associated with aging.

However, given the limited studies there is not sufficient evidence to definitively say that those with obesity at higher risk for more severe COVID-19. The limited literature does suggest a connection and we can note that obesity is indeed a risk factor for worse outcomes in regard to health. Research does support the notion that those who are obese tend to experience more severe forms of infections according to a publication in the International Journal of Obesity .

Strategies to Overcome Obesity: Tips for a Healthier Tomorrow

Now that we are aware of the connection obesity has with disease and infection let’s talk about practical strategies and tips to improve body composition and overall health! First and foremost, obesity prevention begins at a young age. It’s important to help young growing adolescents maintain a healthy weight without a focus on the scale.

Obesity prevention for children

  • Help your toddlers learn appropriate portion sizes. The American Academy of Pediatrics states children from the ages of 1 to 3, every inch of height should equate to approximately 40 calories. As children age you can teach them what appropriate portion sizes look like.
  • Eat healthy foods as a family and create a healthy experience with eating at the table with no distractions like tablets, computes, phones and other games.
  • Encourage eating slowly and eating only when hungry. Eating out of boredom can lead to excess calorie consumption. If you find yourself eating out of boredom be sure to have healthy snacks like fresh cut fruits and veggies available to snack on.
  • Limit unhealthy foods that lack nutrients in the household. If it ends up in your cart at the store, it will end up in your mouth and eventually your tummy. Stock the fridge and pantry with healthy foods, and limit low nutrient foods as a “treat” that is not consumed daily.
  • Establish a healthy sleep routine and focus on managing stress. Those that tend to sleep more heave a healthier weight and crave less unhealthy foods that are often low in nutrition. Higher stress is also associated with weight gain due to poor coping mechanisms.
  • Incorporate regular physical activity which includes at least 60 minutes per day. A byproduct of being more active is less time in front of the screen.

Obesity prevention for adults
It is no secret obesity prevention tips are the same for losing or maintaining a healthy weight. Consuming a healthy diet, sufficient sleep and participating in regular physical activity can help prevent obesity.

  • Consume plenty of healthy fats. A study published in the Nutrition Journal illustrated that intake of healthy fats, such as polyunsaturated fats, can attenuate cholesterol levels and decrease obesity risk.
  •  Eat regular meals on a schedule. Eat a proper breakfast, lunch and dinner that has appropriate portion sizes. Make half your plate fruits and vegetables. Adults should consume five to nine servings of fruits and veggies each day.
  • Granola, oats, yogurt and fruit with coffeeFruits and veggies are low in calories, high in nutrients, water and full of dietary fiber that supports satiety. Research shows dietary fiber plays a key role in maintaining a healthy weight. A 2019 trial published in Journal of Nutrition found that dietary fiber intake promotes weight loss and dietary adherence in adults with overweight or obesity consuming a calorie-restricted diet.
  • Consume less processed and high sugar foods. According to a study published in the American Journal of Clinical Nutrition, processed and ultra-processed foods are linked to increased risk for obesity. Most processed foods are high in fat, sodium, and refined sugar which can promote over-eating.
  • High calorie, high sugar foods often contain limited nutrients and tend to promote over-eating. Processed foods that should be limited to avoided include cereals, white bread, potato chips, cookies, ice cream, granola bars, crackers and other snack foods. Be mindful of marketing claims for certain snack foods that may list “low-fat” or ‘low-carb” but still contain a significant amount of sugar and limited nutrients. Should you choose granola bars or grains ensure they are whole-grain.
  • Participating in regular activity that includes both strength training and aerobic activity. Regular physical activity of 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity is encouraged per week according to the CDC . Find a movement that you enjoy doing and set a goal to complete it each week with the family. Establish smart goals and hire a coach that can assist you in completing appropriate exercise safely to prevent injury. If you’re new to exercise, begin by walking, stretching and strive to improve your time spent exercising each week.
  • Focus on meal prep and have a plan. It is much easier to shop for healthy foods when you have a list that meets your budget. If you walk into a store with a list you are less likely to be tempted by unhealthy foods. Avoid walking down the aisles looking for items that are not on your list. A good grocery list should contain plenty of fruits, vegetables, fish,  healthy whole-grains, lean proteins, healthy fats and spices. Be sure to make a regular list and post it on the fridge for items as you run out.
  • Eat more protein and veggies as snacks. Higher protein intake is associated with better weight management, glycemic index and bone health according to several studies.  A review published in the Journal of Food Science specifically illustrates the metabolic advantages of higher protein diet and benefits of dairy. Higher protein intake is associated with greater satiety and healthier better composition. Some great high-protein options include eggs, Greek yogurt, beef, chicken, fish, lentils, wild game and other dairy products. A study published in the European Journal of Obesity examining the effect of a high-protein diet versus a standard protein diet on weight loss and biomarkers of metabolic syndrome found significantly greater weight loss with higher protein diet.

Many are looking for ways to stay calm during one of the most unprecedented health crises our country has ever seen. Shift your focus to these 3 areas to improve your health during the pandemic.

Establish a routine:

Which includes regular wake, bedtime, movement, mealtimes, schoolwork, work projects and “leisure time” built in to create stability. Eat breakfast every day! Those that consume the majority of their calories early on are less likely to be overweight and obese. Be sure to incorporate a high-quality protein, fiber and fluids. By getting into the habit of completing tasks on a regular basis along with mealtimes you set yourself up for a new normal.

Nutrition 101

Be mindful of fluids, what you are eating at meals and snacking on. High-stress situations can lead to an impact on our ability to make healthy choices. By stress eating high-calorie and low nutrient foods you are more likely to put on undesirable weight. By creating a schedule of mealtimes and having a calendar of meals you are less likely to eat out of boredom.

  • Have fruits and veggies cut and prepared in the fridge should you be hungry and snack on nutrient dense foods versus processed food.Grocery shopping is critical, be sure to have a list prepared ahead of time and stock up on plenty of frozen along with fresh fruits and veggies.
  • Eat the rainbow and incorporate as many whole foods as possible. By eating colorful fruits and vegetables you can support a healthy immune system. Vitamins and minerals support a healthy immune system which are found in pigment rich foods (color!).
  • Be sure to also incorporate unsalted, nuts, seeds, lean proteins and healthy fats can truly help optimize your immune function land even support good sleep. What we eat has a direct impact on our sleep which can also help keep unwanted pounds at bay!

Supporting positive mental health with movement and meditation!

Getting plenty of regular movement, aerobic activities like walking, biking, hiking, swimming along with resistance training with household items or weights at home. Exercise boosts physical, mental and emotional health which can help reduce stress overall. By reducing stress, you are also fighting off the risk of disease and illness. 30-40 minutes a day of yoga, meditation, walking, running or biking is a great way to stay healthy! Many apps, videos and programs are available on demand online.

Work with a Dietitian to Fight Off Obesity and Establish Healthy Habits

Many find great success working with a registered dietitian nutritionist. Research indicates that a few sessions with an RDN can lead to healthier habits, optimal food choices and successful weight loss. As an RDN I personally work with many on improving their relationship with food, eating more fruits and veggies, selecting high-quality proteins, and preparing foods at home. RDN’s can assist in developing a calorie-controlled plan and calculating out energy needs that support appropriate weight loss, weight maintenance goals. Additionally, a personal trainer or fitness coach can also assist you in setting goals for routine physical activity. I work with several individuals on creating a periodized program for appropriate progression of physical activity. The goal is to move more and to feel good about the exercise you are doing. The journey to 100 miles begins with taking that first step. I am here to help you and support you, join me and take that first step to a healthier tomorrow!

In good health,

Wendi Irlbeck, MS, RDN

 

Wendi Irlbeck, MS, RDN is a registered dietitian, nutritionist, and fitness coach. Wendi utilizes evidence-based science to tailor nutrition programs for those looking to improve their health and energy. Along with supporting athletes desiring to optimize performance, minimize health risks, and enhance recovery from training while focusing on injury prevention. Wendi partners with parents, sports performance staff, special needs and recreational athletes to offer nutritional guidance and optimal athletic performance & lifestyle plans. Wendi is based in East Lansing, Michigan and is very active on social media platforms such as facebook , twitter and Instagram.

6 Necessary Tips to Maintain Health and Conditioning During Quarantine

Baseball and softball diamonds are empty. Soccer fields and tracks lay desolate. High school sports’ championships are cancelled. Indefinite halt in practices, games, and tournaments have left many coaches, parents and young athletes devastated. A whole new pain has developed around the world when the term “cancelled” is used due to the novel Coronavirus (COVID-19). For many, their outlet for stress, health, social time and joy has been halted with short notice. The all-around impact when sports and organized recreation resumes, remains uncertain. The big question remains: “When will this end, and when can we return to our normal lives again?” The reality is, we will not return to how things were. How do we adapt, overcome, and conquer the many challenges of unknowns and uncontrollable modalities? This article will aim to provide clarity, support and motivation, and simple tips to stay healthy and conditioned during the COVID-19 pandemic.

There are many things sport athletes cannot control, such as weather conditions, their opponent, playing fields and, now, a pandemic! Ultimately one thing that athletes of all ages (adults too) can control is themselves. Being involved in a sport creates routine through practice and preparation. Routines were carried out and executed pre-pandemic and they should now be established during the coronavirus to prevent further declines in health, wellness, and overall athletic performance. Creating structure in life is more important than ever. Many young athletes may find themselves feeling “abnormal” or “off” and it is important for coaches and parents to check in with them. During these first few weeks of the “Stay at Home Order” here in Michigan many of my young athletes and clients have been faced with a different way of life and schedule. Schedule and routine should be the second most important priority after the shelter in place. Health hack: You can still maintain your fitness at home with regular walking, body weight exercises, light weights with greater volume and of course proper nutrition. -Please Schedule a consultation with me if you’re desiring further assistance in any area of your health, I am here to help.

5-6 Simple Suggestions to Keep You Healthy & Conditioned During the Pandemic:

  • PLAN Your Day. Set your alarm to wake up to the same time each day, eat regular meals & snacks, hydration goals, when you will train, complete school-work, watch your favorite show, read, walk the dog, study, and complete chores. Without a routine, your energy, nutrition, water or fueling goals will be affected. Structuring your day will benefit your mental health and athletic success post-virus. Utilize this time to focus on taking care of your body, schoolwork, mental health, and maintaining overall optimism. It is okay to live by the “one-day-at-a-time” mantra. Do not undo all the hard work put into your training. Take a breath, stay motivated, and conditioned.
  • PLAN Your Bedtime. Establish a bed-time routine to carve out time to brush teeth, wash your face, and prepare for rest. Research supports more restful sleep when we limit phone use prior to bed. For example, establish a bedtime of 10 pm. Begin getting ready for bed at 9:15 pm. Put your phone away, meditate, limit time around books and activities that would decrease your ability to relax. Be in bed by 9:45 with time to quiet your mind and fall asleep by 10 pm.
  • PLAN Your Intent. What does this mean? When you wake up, write down what you want to accomplish for the day. This simple act is powerful, it creates structure and meaning to our day. If we start our day being mindful of what we want to accomplish and the intent of our actions, it will facilitate the motivation and drive to tackle them.
  • Body Composition. Many are concerned about gaining weight due to less activity. This applies to not only young impressionable athletes but adults as well. Do not overdo it with exercise trying to “earn calories” or “burn off what you ate”. For some young and older athletes, this time at home may mean more activity because of “extra time”. It may be wise to limit intensive training to what your coach or trainer has prioritized. Be sure to enjoy light, mindful movement with your family such as going on walks together. It is key to remember that supporting proper growth, development and maturation needs, are all priorities for young athletes. To learn more, please read one of my previous blogs here. Reminder: young athletes eat first and fuel second. This concept is also illustrated in a blog I recently wrote for strength coaches at the high school level.
  • PLAN Your Meals. By no means should young athletes be cutting out food groups, meals or critical calories because schedule changes. Meal planning and usual eating habits are likely to be affected if they are less active and not training as intensely. Pandemic or not, young athletes still need the fundamental three to four high-quality meals that contain the basics (lean protein, fruit, vegetable, whole-grain and dairy). The snacks consumed in-between meals may decrease due to less activity, training and events. I have always encouraged my athletes to consume a protein and carbohydrate source as snack. However, with less activity than usual, a lower carbohydrate snack may be a better option (such as string cheese with cucumber slices). For many, eating nowadays may be similar to “off-season” eating or rest days. However, the athletes training more intensely or adding in addition cardio sessions, may need to increase their protein and carbohydrate snacks following training. This a very important concept for people to understand. Ultimately, an athlete’s plate needs to support the training and work that is being done. See the performance plate guidelines which provide clear illustrations of building a plate to reflect the type of training day.
  • PLAN to be Creative. Food access, security, safety, and overall availability impacts how we eat. Now is not the time to try out a rigid diet, dirty dozen, 21-day fix in the house. Foods may be available in limited amounts and many families are going shopping for one to two week’s worth of groceries. Meeting nutrition needs perfectly is not necessarily the reality, but it is a good goal to keep front and center. When shopping, pick up canned veggies, canned beans, frozen fruits, frozen vegetables, and consider buying meats in bulk that can be placed in the freezer. Keep in mind you can freeze many food items! Please navigate to my social media platforms such as twitter and Instagram for more instructions and ideas. A quick online search will also show you some creative ideas. It is critical to continue avoiding overly processed foods that are high in sugar and low in nutrition, such as chips, pastries, sweets, etc. All foods fit, but keep in mind good nutrition is the foundation for good health. Focus on consuming a variety of foods that are nutrient dense to support a healthy immune system to fight off disease, decrease exercise induced inflammation, promote healing of tissues and overall health. Eating an abundance of nutritious foods will provide stable energy levels, cognition, athletic performance, injury reduction, self-confidence, healthy body composition, and heart health. I encourage my athletes to continue to pursue a healthy relationship with food despite the challenges we currently face.

If you’re interested on some specifics check out what the Food and Drug Administration has to say regarding food availability during the novel Covid-19 virus in a recent article.

This unexpected challenge is our opportunity to define our new normal. Stay at home, wash your hands, create a routine, limit discretionary calories, keep training, prioritize your hydration, eat well and fuel accordingly. This is the ultimate chance to learn from professionals, peers, and family, to move forward with different and healthier habits. And, this is exactly what we will do. Opportunity favors the prepared. Don’t miss this opportunity to optimize your health and training. What controllable behaviors are you willing to work on daily to set yourself up for your next power play?

 

**The Academy of Nutrition and Dietetics has helpful tips on keeping your family healthy and safe at home. They can be found here. Avoid misinformation online regarding COVID-19. Rely on credible, accurate sources such as the CDC, FDA ,and the NIH .

**I recently delivered a presentation on “The Importance of a Routine During Uncertainty” on a recent webinar with the West Virginia Soccer Association. The webinar will be available on demand on the WVSA Beyond the Pitch Podcast in the next week.

“Nutrition is your athlete’s secret weapon to out compete their competition. Nutrition can make a good athlete great or a great athlete good.” (SM)

 

– Wendi Irlbeck, MS, RDN

Wendi Irlbeck, MS, RDN is a registered dietitian, nutritionist, and fitness coach. Wendi utilizes evidence-based science to tailor nutrition programs for athletes to optimize performance, minimize health risks, and enhance recovery from training while focusing on injury prevention. Wendi partners with parents, sports performance staff, special needs and recreational athletes to offer nutritional guidance and optimal athletic performance & lifestyle plans. Wendi is based in East Lansing, Michigan and is the founder of Nutrition with Wendi, LLC. Wendi is active on Twitter and other social media platforms as Nutrition_with_Wendi.

 

Creatine: Not Just for Men or Muscle

If you’re a man or woman reading this, excellent. It applies to both genders. Are you an aging adult, or someone who has experienced a traumatic brain injury (TBI)? Then yes, keep reading. Next, if you’re an athlete or non-athlete reading this, even better because it applies to you as well. Still aren’t with me, do you have a beating heart? If this answer is no, please seek medical attention at once. All jokes aside, if you’re a living breathing homo sapiens (homo = genus , sapiens = species) this article is for you.

If you’re a parent of a young athlete, coach, athlete or bodybuilder you likely have read up on creatine and have supplemented with creatine monohydrate before. Creatine is one of the most well-research and effective supplements to date. Creatine can support exercise performance by quickly producing energy during intense activity. Furthermore, creatine may also provide cognitive benefits, but further research is warranted. Studies have consistently illustrated how creatine supplementation increases intramuscular creatine concentrations that can help us understand the observed improvements in high-intensity exercise performance and overall training adaptations at large. We know creatine supplementation can bolster post-exercise recovery, decrease risk of injury and support injury prevention, expedite rehabilitation, thermoregulation, concussion and or spinal cord neuroprotection. Additionally, clinical applications of creatine supplementation have been investigated in neurodegenerative diseases like (muscular dystrophy, Parkinson’s Huntington’s disease), diabetes, aging, osteoarthritis, brain and heart ischemia, adolescent depression and even pregnancy as cited in the International Society of Sports Nutrition (JISSN) Position Stand on Creatine Supplementation in Exercise, Sport and Medicine . Studies are demonstrating short and long-term supplementation (up to 30 grams per day for five years) is not only safe, but well-tolerated in individuals and a range of clinical settings from infants to the elderly.  So, creatine is not just for male athletes trying to build muscle and facilitate recovery. It is beneficial to all given the wide range of benefits associated with supplementation that have been documented in literature and several that are currently under investigation in a clinical setting.

Let’s review and clear up a common myth regarding creatine:

“Creatine is a steroid” Incorrect, please stop this nonsense from making its way into 2021 please. In my professional experience as a registered dietitian nutritionist , this must be one of the most obnoxious fallacies to date. Possibly behind “protein hurts my kidneys”, also false but that’s a whole other subject for a different blog. However, I am happy to direct you to the literature that dispels this myth publish in 2016 in the Journal of Nutrition and Metabolism compliments of Dr. Jose Antonio and colleagues . Now back to creatine, let’s clear this up quickly, creatine is not a steroid. It has no relation to a steroid structurally or with its mechanism of action. Why? Well, by scientific definition a steroid is any compound that possesses a common structural feature like 3 cyclohexane rings and a cyclopentane ring make up the structure that by definition is a steroid molecule. In fact, eggs contain a steroid compound which is called cholesterol and it is naturally produced in the body that become steroid hormones like testosterone and estrogen. But no, creatine is not a steroid.

What is creatine?

Creatine is a naturally occurring compound made up of three amino acids, which we would call a tripeptide (tri meaning three). Three amino acids (L-glycine, L-methionine and L-arginine) make up creatine. Creatine is largely made in the liver and to a limited extent, the kidneys and pancreas. It deposits high-energy phosphate groups in the form of phosphocreatine which are given to ADP, regenerating it to adenosine triphosphate (ATP), the sole energy carrier in the human body which can be called “energy currency” for cells to execute their functions. For example, in conditions of short-term high-energy demand activities (< 30 seconds) with limited recovery time, ATP runs out quickly, which brings us to creatine that is stored in muscles in the form of creatine phosphate explained here . Creatine phosphate can help restore ATP, giving muscle cells the ability to produce greater energy. The greater creatine you have, the greater energy your muscle cells can yield during high-intensity exercise, thus leading to increased exercise performance. Even though the most well documented and primary benefit is higher energy production this mechanism also supports muscle gain and strength increases explained here.

Creatine is naturally found in several of the foods we consume like, eggs, milk, tuna, salmon, herring, cod, shrimp, beef and pork.  Consuming enough creatine from the diet is challenging given the total creatine pool available according to an article published in the Frontiers in Nutrition Sport and Exercise Nutrition via Candow et al., 2019 . Which suggests, the body needs to replenish about 1.0–3.0 g of creatine per day to maintain normal (un-supplemented) creatine stores depending on muscle mass. Creatine improves numerous factors including strength, power, sprint ability, muscular endurance, resistance to fatigue, muscle mass, recovery, cognition, and speeding up muscle growth.

More women should use creatine:

I am a female who participates in regular strength-training (4-5 times per week) along with (2-3 cardiovascular sessions per week). I eat a whole foods diet, supplement with 2,000 IU of vitamin D3, whey protein isolate, 1,200 mg of fish oil and a multivitamin. Those are my supplements; these are not recommendations for “you”, your “young athlete”, “teammate” or “your friend”. I make this clear because there is no one-size-fits all in nutrition, health and fitness. What works well for me, does not mean it will work well for you. I see too many mistakes made with people trying to adapt the same diet, training and lifestyle of those in their cohort when it simply is not sustainable or appropriate. As individuals we have different genetics, hormones, environment stimulus, training styles, body composition, sport and performance goals, resting metabolic rate, and the list goes on. It would be absurd to eat and train the same way as someone else and anticipate the same outcome with the previously listed differences as humans.

One certainty is we can all benefit from eating real food, but given the benefits of creatine supplementation it is an undervalued and written off supplement among my fellow ladies. Hear me out ladies, creatine will not make you fat, bulky, retain water, turn you into a man or any of the other nonsensical claims that exist on the web these days. I don’t care what Linda at the gym said about “creatine making you fat or how it is a steroid that will make you a man”. I hear these claims often, and not only are they flat out wrong, they misinform my fellow ladies out there trying to gain strength, lean mass and other health benefits that would occur with appropriate creatine supplementation.

Here is a side by side comparison of me, roughly 10 years ago when I ate too many carbohydrates, inadequate protein, some strength training and an abundance of cardiovascular exercise. I ran lots of miles. Now, ten years later, I am happy to report I engage in strength training sessions no greater than 45-minutes, 4-5 times per week with some sprints and daily walking. I supplement with 5 gm of creatine monohydrate post-workout , w

hey protein isolate, take a multivitamin and consume 2 gm/kg/body weight per day in protein. I infrequently track calories because I fuel my body with high-quality protein, as many fruits and veggies as I can get my hands on. Creatine won’t make you fat, bulky or manly ladies. It will help support a lean body composition. Let me be more specific to my fellow ladies, creatine can may help you improve your health, fitness, recovery and overall physique.

Trying to turn up the intensity of your workouts? Use creatine! Creatine is like a Koenigsegg Agera RS , the fastest vehicle in the world. Creatine is a vehicle for producing ATP, which as you have learned drives muscle contraction. Kind of important when trying to sprint, lift heavy weights, jump and train with max output? By regularly supplementing with creatine monohydrate (3 -5 gm/day) for 8 weeks or greater can help maximize the body’s stores of phosphocreatine, the necessary compound to product ATP. Thus, allowing for skeletal muscle to produce more energy, bolster power output and exert more work overall. Fitness hack: The greater the intensity expressed fourth the greater your muscles grow stronger, bigger and faster should you train appropriately. Therefore, creatine supplementation is a highly underrated supplement among the female population. I encourage and empower my fellow ladies reading this article who have been on the fence about using creatine to take note of its effectiveness. Creatine has shown to bolster muscular size, power and strength. More muscle equates to more energy burned, healthier body composition, bone mineral density and a decreased risk for musculoskeletal disorders. Not to mention the link between muscle mass and risk of cardiovascular disease. Keeping aging muscles fit is also linked to better health later on in life according to a study published in the Journal of Epidemiology and Community Health .

Even sedentary women who utilized creatine long-term experienced increases in maximal muscle strength during resistance training by 20 to 25% when compared to women who were given a placebo in a study published in the Journal of Applied Physiology . Another study examined the effects of long-term creatine supplementation (12-weeks) combined with resistance training on one-rep max strength, motor functional performance tests and body composition in eighteen older women. The creatine group gained significantly more fat-free mass, muscle mass and were able to efficiently perform submaximal-strength functional test than the placebo group. Special note the creatine group was also able to increase training volume and one-rep max bench press. Creatine contains no calories and does not lead to fat gain. The increase on the scale you may see from use is drawing water into the cell which is a desired response with training.

Many benefits of creatine

A number of studies have shown creatine supplementation can increase brain creatine content by roughly 5-15% along with reducing mental fatigue, and improving cognitive function according to research referenced in the ISSN’s Position Stand on Creatine. Another study carried out by Rawson & Venezia, 2011 reported creatine supplementation of (20 g/day for 5 days or about 2g per day for 30 days) resulted in increased skeletal muscle creatine phosphocreatine which lead to the enhancement of high-intensity exercise tasks. Moreover, there is well documented benefits of creatine supplementation in young adults, increased strength, lean body mass and delayed onset fatigue during resistance training. All of which are critical for older adults striving to maintain cognition, bone mineral density and overall health.

Research is scant but, a randomized, double-blind, placebo-controlled trial was carried out in using creatine in type 2 diabetes subjects that was published in Medicine and Science in Sports and Exercise . The study illustrated creatine supplementation improved glucose tolerance in healthy subjects. When creatine was supplemented in the diabetic subjects that participated in an exercise program the results lead to an improvement in glycemic control. The underlying mechanism could be contributed to the increase in GLUT-4 recruitment specific to the sarcolemma. More research is warranted in diabetics, but the current literature is promising. Functional foods for brain health go mainstream

Another study examined the potential of creatine or phosphocreatine supplementation in cerebrovascular disease and in ischemic heart disease . The study illustrates the ability high-dose creatine supplementation has on cerebral creatine content and that it may have the capacity in humans to protect against stroke due to increasing not only the neuronal but also the endothelial creatine content. Emerging evidence also suggest that creatine supplementation with and without resistance training has the potential mechanistic effect to influence bone biology according to a study carried out by Candow & Chilibeck, 2010. A more recent study published in Experimental Gerontology examines pre-exercise and post-exercise creatine supplementation has similar effects on aging bone mineral density and content. A meta-analysis carried out by Forbes et al., 2018 illustrated creatine supplementation did not lead to greater bone mineral density during resistance training in older adults > 50 years of age.

Research in animals also suggested creatine supplementation to support managing Alzheimer’s disease, epilepsy and brain or spinal cord injuries. Furthermore, a study was conducted examining creatine supplementation following sleep deprivation, with mild exercise, on cognitive and psychomotor performance, mood state and catecholamines. The study eludes to creatine supplementation decreasing the negative effects, like mood, focus, impulse and emotional reactions that are reliant on the prefrontal cortex.

Creatine is safe and easy to use

As you have learned creatine offers many diverse benefits beyond muscle. It is one of the least expensive and safest supplements available on the market. It has been studied for over 200 years and an abundance of literature supports is safety, efficacy and no reported adverse effects in healthy individuals as referenced in the ISSN’s Position Stand: Creatine Supplementation and Exercise.

A good dose to begin with is simply taking 3.0 to 5.0 grams of creatine monohydrate post-exercise to support recovery, muscle growth and decreasing fatigue. If you’re a vegetarian or new to using creatine you may wish to start with a loading phase by taking (0.3g/kg/body weight/day). For example, if you’re a 60 kg female = 18 g total for the day but broken up into 4 doses for 5-7 days. This would mean a (4.5 g dose of creatine 4x/day) for 5-7 days. Then onto a maintenance phase of 5 g per day for 12 weeks. If you’re interested in looking at different phases of cycling creatine (short-term and long-term) you can refer to the literature in the Creatine Position Stand paper I have referenced throughout this article. For example, supplementing with (5g/day) for 12 weeks during training to truly help increase intramuscular creatine stores and support health and performance benefits outlined in this article. Dissolve the creatine in water or your protein-carb drink post-workout for best results. Take a break from supplementation after using for 12-16 weeks. Where to order creatine? I strongly advise supplements that are Informed Choice Certified, meaning they are free of any banned substances and ensure the product has been tested from any unsafe substances. Here is a comprehensive list of certified products updated March, 2020.

If you’re parent or coach of adolescent athletes and are considering creatine supplementation. Take note, limited research is available in this population highlighting the safety and efficacy of creatine supplementation in young athletes < 18 years of age. Jagim et al., 2018 published a review examining the limited studies in the adolescent population as a means to identify use of creatine in young athletes. The review suggests that adolescent athletes using creatine tolerated supplementation well, had no reported adverse events or incident. Ethically, we do not have enough research to recommend creatine monohydrate to young athletes, but many are using despite direction from professionals. My advice as a sports dietitian is to provide the literature and suggestions to support best interest of my athletes.

As registered dietitian nutritionist and sports nutrition specialist, I advocate for whole foods first and prioritizing nutrition to optimize your health, wellness, physique and performance goals. Creatine is a great supplement to incorporate in addition to great nutrition, enough hydration, adequate sleep and proper training. Creatine works best when paired with resistance training. I hope reading the science outlined in this article surrounding creatine has given clarity. Creatine can benefit everyone, if you have a beating pulse that’s you. Train hard, eat well and stay healthy my friends.

In good health,

Wendi Irlbeck, MS, RDN

Wendi Irlbeck, MS, RDN is a registered dietitian, nutritionist, and fitness coach. Wendi utilizes evidence-based science to tailor nutrition programs for athletes to optimize performance, minimize health risks, and enhance recovery from training while focusing on injury prevention. Wendi partners with parents, sports performance staff, special needs and recreational athletes to offer nutritional guidance and optimal athletic performance & lifestyle plans. Wendi is based in East Lansing, Michigan and is the founder of Nutrition with Wendi, LLC. Wendi is active on Twitter and other social media platforms as Nutrition_with_Wendi.

Vitamin D and the Athlete: An Overlooked Element in Exercise Performance

Athlete warming up for run

An estimated 1 billion people worldwide, across all ethnicities and age groups, have a vitamin D deficiency according to a review published in the Journal of Pharmacology & Pharmoacotherapeutics . Vitamin D is a steroid hormone that regulates > 1,000 processes in the body, and it has been well known as the “sunshine” vitamin playing an important role in preventing illnesses like, osteoporosis and rickets . Winter days are often dark and sun exposure is limited leading to an increased risk for vitamin D deficiency and infections. Vitamin D is a hormone but is most widely known as a fat-soluble vitamin. Vitamin D promotes calcium absorption in the gut. Vitamin D supports muscle function, cell growth and immunity. Vitamin D is obtained from supplements, sun exposure and consuming vitamin D-containing foods like, wild salmon, eggs, mushrooms, fortified cereal and dairy products.

How Much Vitamin D Is Needed?

One confusing element of understanding vitamin D guidelines to correct deficiency can be challenging. Currently, there is no consensus definition of vitamin D deficiency according to the U.S. Preventive Services Task Force recently reviewing vitamin D screening. The Institute of Medicine (IOM) guidelines for vitamin D use a blood level of 20 ng/ml o 25-hydroxyvitamin D as a benchmark for deficiency because it is the minimum level that meets the needs for good bone health for at least 97.5% of the population (1). However, the Endocrine Society recommended that people aim for a level of 30 ng/mL or higher . A more comprehensive table of Vitamin D concentrations and health are found here via the National Institute of Health.

Current Recommended Dietary Allowances (RDA) for Vitamin D:

  • Birth to 12 months: 400 IU
  • Children 1-13 years: 600 IU
  • Teens 14-18 years: 600 IU
  • Adults 19-70 years: 600 IU
  • Adults 71 years and older: 800 IU
  • Pregnant and breastfeeding women: 600 IU

Vitamin D Deficiency Signs and Symptoms that Can Lead to Severe Health Complications:

  • Osteomalacia
  • Osteoporosis
  • Risk of stress fractures
  • Muscle aches and weakness
  • Muscle twitching
  • Periodontitis
  • Light-headedness

In the Body, Vitamin D is Linked with:

  • Immune function
  • Blood pressure regulation
  • Muscle strength and mass
  • Absorption of calcium
  • Healthy weight management
  • Overall bone and teeth health

Vitamin D and Athletes

Numerous studies reviewed in the Journal of the International Society of Sports Nutrition has assessed the possibility for vitamin D’s impact on performance and recovery. In fact a study published in the Journal of Strength and Conditioning Research examining soccer players who supplemented with 5,000 IU of vitamin D per day for a total of eight weeks had interesting results. Those that supplemented jumped higher and were linked to faster sprints.

A vitamin D deficiency in athletes increases the risk for stress fractures, anemia and a weaker immune system which and blunt athletic performance. A 2008 study examining Vitamin D status in a group of distance runners found that forty percent of the runners, who trained indoors in sunny Baton Rouge, Louisiana had insufficient vitamin D.   deficiency is common among athletes and enough levels are needed to maintain bone health and aid in injury repair. A review carried out in 2015 identified about 56% of athletes had inadequate levels of vitamin D. Another study evaluating vitamin D levels in athletes participating at the NFL combine found that players with a history of lower extremity muscle strain an core muscle injury had a greater prevalence of inadequate vitamin . Furthermore, another study assessing association of vitamin  levels with race and found a higher rate of vitamin D deficiency among black football players than white football players.

As stated above musculoskeletal pain and weakness are often unrecognized symptoms of vitamin D deficiency. A study conducted in Minnesota identified 93% of individuals with persistent non-specific musculoskeletal pain had 25(OH)D concentration <20 ng mL and 28% had a concentration <8 ng mL. Animal studies have also reported that vitamin D deficiency leads to the atrophy of fast-twitch muscle fibers, which are critical in power movements like sprints. Fast-twitch fibers also fatigue faster which can explain the physiological why vitamin D can influence based on its function.

As you have learned, vitamin D deficiency is overlooked and should be a focus of concern for any professionals working with athletes. The strong association in muscle fatigue and low vitamin D levels in elite and collegiate athletes may lead to long-term injuries with life and career altering effects. An article published in the American College of Sports Medicine provides charts and illustrations representing the vitamin D status in athletes living in various geographic locations.

To Supplement or Not Supplement?

Upon reading this article you can see how challenging it is to achieve daily vitamin D needs from foods and limited sun exposure. Provided the critical role vitamin D plays in our mood, digestion, cognition, recovery, athletic performance and overall health it would be wise to supplement with 1,000 to 2,000 IU of vitamin D3 per day during the winter solstice months and likely even more if you fall into any of the high-risk categories for vitamin D deficiency. Justifying a greater need for vitamin D for athletes who train often and participate in multiple sports. Disclaimer, I am not a physician and I would encourage you to discuss vitamin D testing with your doctor to ensure you’re not reaching toxicity, which can occur with high-dose vitamin D intakes of 60,000 IU per day. Blood levels should be monitored by anyone who chooses to take higher dose of vitamin D. As always, talk with your doctor and sports medicine staff before taking any vitamin and mineral supplements. Interested in learning more about your vitamin D status? Check out the website of the Vitamin D Society for more information. Other great resources to learn more about vitamin D include ,the Linus Pauling Institute and the National Institute of Health fact sheet for health professionals.

 

Check out my previous blog highlighting the six risk factors for vitamin D deficiency.

In good health,

Wendi Irlbeck, MS, RD, Sports Nutritionist

 

Carbohydrate and Protein Needs for Young Athletes Desiring to Make the Jump from Good to Great!

Bowls filled with granola and berries

There’s No “One-Size-Fits-All” Nutrition Approach

An athlete’s energy and nutrient needs depend individually on his or her age, body composition, goals, and training volume, and depends globally on the demands and intensity of the sport. Put simply, the greater the intensity, duration and frequency of the activity combined with the athlete’s weight or body composition, the higher the demand of protein, carbohydrate and calorie intake.

If you’re a coach, parent or athlete reading this, don’t become overwhelmed. This article intends to introduce to you some general guidelines on optimizing energy needs (i.e. calories, protein, and carbohydrates) to sufficiently support overall health and advance athletic performance.

First rule of thumb, ALL adolescent athletes should consume breakfast, lunch and dinner with 2-3 snacks in between meals to fully optimize energy levels. You must build a plate that includes a source of lean protein, a fruit, a vegetable, a healthy fat and a serving of dairy if you wish to get real and progress with your nutrition. A visual of the plate and practical nutrition strategies can be found in my previous blog here.

Fuel Up to Avoid Stalling Out

Youth athletes have significantly higher nutritional needs than their less-active classmates because athletes need more calories to support performance demands, normal growth, general development and maturation. According to the Academy of Nutrition and Dietetics, female teen athletes need roughly 2,200-3,000 calories and male teen athletes need roughly 3,000-4,000 calories per day (depending upon the individual and sport). Additionally, adolescent athletes training in multiple sports may need upwards of 5,000 calories per day to maintain weight and support growth needs. It’s paramount to encourage adequate calorie consumption during times of heavy training. For perspective, low-energy availability in female adolescent athletes can lead to short stature, increased injury, delayed puberty, poor bone health, metabolic and cardiovascular issues, menstrual irregularities, disordered eating behaviors – this according to a review published in the International Journal of Sport Nutrition and Exercise Metabolism published by Desbrow et al., 2019.

Relative Energy Deficiency Syndrome (RED-S) is a more comprehensive label that builds on the condition of low-energy availability, also known as “female athlete triad,” to describe an energy deficiency gap that results when energy intake is insufficient to support daily activities, living, growth and function. RED-S affects primarily females, but also young males.

Premium Fuel for the Young Athlete – Carbohydrates!

Carbohydrates are an athlete’s most important source of energy for optimal athletic performance. Several studies carried out during the last 50-60 years have consistently highlighted carbohydrates as the primary macronutrient to sustain and enhance physical performance. The Institute of Medicine (IOM) has established that 45-65 percent of calories in one’s diet should come from carbohydrates or between 3 and 8 grams per kilogram of body mass, depending upon the exercise intensity. For example, a 14-year-old female athlete should consume 2,000-2,400 Granola and yogurt with fruit, juice, and eggscalories per day, with 225 – 270 g (45% of total calories) to 325 – 390 g (65% of total calories) from carbohydrates. Keep in mind the dietary reference intake (DRI) remains at 100 g per day and recommended daily allowance (RDA) at 130 g day for all age and sex categories (children ≥ 1 year), both measures not related to physical activity. High-quality carbohydrates for athletes to consume include, but are not limited to, 1. whole grains like pasta, rice, tortillas, bread, oatmeal, low-fat dairy, and energy bars, 2. fruits like berries & bananas, and apples, 3. starchy vegetables like squash, potatoes and eggplant. To experience a boost in energy, consider adding items from this longer list of quality carbohydrate-rich foods to achieve enhanced athletic performance.

Performance tip: Make half your plate carbohydrates if you’re an endurance athlete, especially on heavy training days. The average athlete should be eating around 360-500 grams of carbohydrates per day. Failing to consume enough carbohydrates will cause a decline in performance, cognition, focus, and athletic performance. Time-to-fatigue and injury risk will also increase without enough dietary carbohydrates. To keep it simple, carbohydrates are not “optional”; they are essential. You can take it from an RDN whom stands for science or examine the science for yourself by checking out Nutritional Considerations for Performance in Young Athletes published in the Journal of Sports Medicine.

Power Up with Protein!

Protein is critical for building, maintaining and repairing many cellular structures, like skeletal tissues. Consuming enough protein supports synthesis of hormones, neurotransmitters, energy production, gene activity and transportation of biological molecules. The Institute of Medicine (IOM) has established that 15 to 20 percent of total calories, or about 70-160 grams should derive from high-quality protein sources.

To breakdown the science, consuming adequate protein is critical for proper growth, development and normal physiological function during adolescence leading into adulthood. Distinctive demands during adolescence, especially those that engage in high-intensity sport, call for a greater daily protein intake than that of adults. Currently the RDA for protein is 0.95 g/kg/day for children ages 4-13 years and 0.8 g/kg/day for adolescents between the ages of 14-18. Those that engage in regular training and endurance sports like swimming, rowing, distance running, and soccer may need 1.2-1.4 g/kg/day while power sports like weightlifting, gymnastics, football, wrestling shall require 1.0 – 1.5 g/kg/day .

High-quality protein sources include beef, poultry, bison, pea protein, pork, tuna, turkey, seafood, fish, and dairy products, such as milk, yogurt, whey, cheese and cottage cheese. To find out how much protein some of your favorite sources provide, check out this list from the Academy of Nutrition and Dietetics. Keep in mind that not all proteins are created equal. To deter you from going down the rabbit hole of plant proteins vs. animal proteins, I will simply link an article for you to review here. It’s important to just remember that foods rich in leucine, a branched chain amino acid found in animal proteins, will have the greatest positive affect on driving muscle protein synthesis. We could get really complex on this topic but it’s enough to simply emphasize the importance of consumption of high-quality proteins that are listed above due to their rich leucine content, especially since we are addressing protein intake for adolescent athletes. Most young athletes barely consume enough calories and protein as it is. To keep it simple, make sure your adolescent athlete consumes ¼ of their plate or a 4 oz. serving of a high-quality protein three-five times per day. As I always say, success starts with the basics and carrying them out on a consistent basis.

Failure by your adolescent athlete to consume adequate protein intake will cause declines in energy, weight, muscle growth, and strength, while increasing the likelihood of onset fatigue. Does this mean your adolescent athlete should be slamming protein shakes? Of course not, but they should be consistently consuming whole foods at regular mealtimes. Consuming good old fashioned chocolate milk on-the-go can even be a great way to increase calories while meeting additional protein intake demands. This is especially a great addition to refuel and re-hydrate post-practice or game! Make no mistake, a protein shake or chocolate milk will not make up for missed nutrients from consuming regular meals. Furthermore, supplements like protein powders are not regulated by the FDA and so it is important to select a protein powder that has been third-party tested with a NSF stamp of approval, which deems it certified for sport. This is paramount to ensure there are no banned substances on the label, that the product is manufactured in a facility that follows acceptable manufacturing standards, and that the contents of the supplement match what is printed on the label, ultimately being safe for consumption. To search supplements that are third-party tested and free of any banned substances, check out Informed-Sport.

Stirring it Altogether:

Knowing your carbohydrate and protein intake recommendations is great, but I encourage using the plate as a method of hitting your intake requirements. If you consume a balanced plate with all the components 3-5 times per day with high-quality snacks in between, you’re likely going to meet the energy demands of your sport. Again, it’s important to remember that carbohydrates are the body’s preferred source of energy.

Keeping with the basics such as eating breakfast, lunch and dinner with small snacks in between meals will help improve your health and sport performance. Don’t skip meals and make sure your plate is full of colorful fruits and vegetables. Always choose water or milk over sugary beverage to support hydration and better overall health. It’s time we get back to the basics, which I discuss in detail in the last article I published, available for reference here. As always, nutrition is a secret weapon that can help you perform optimally in the classroom and in sport.

Your sports nutritionist,

Wendi Irlbeck, MS, RDN

Practical Nutrition Strategies for Youth Athletes

Most parents and families understand how critical a nutrient-rich, balanced diet is for optimal health and athletic performance. If you’re raising an adolescent or teen athlete performing at a high-level, you must focus greater attention to their fueling needs to ward off fatigue, prevent nutrient deficiencies, and decrease risk of injury.

Support your youth athlete using these strategies:

There is no “special diet plan” to assist in achieving optimal athletic performance. Consumption of the fundamentals (three high-quality balanced meals with 2-3 snacks between) on a consistent basis leads to better sports performance, games won, strength increases, and fewer injuries. A great resource to build a plate for optimal performance can be viewed here .

The greater intensity the sport, duration and training volume, the greater requirement of carbohydrates and calories to sufficiently support energy levels. This pertains to sports like ice hockey, field hockey, basketball, swimming, soccer and long-distance running.

You must also make a conscious effort to consume snacks containing protein and carbohydrates between meals. Fruit with string cheese is a great snack to support energy levels and maintain fueling between meals! For snack ideas to fuel your teen athlete, be sure to check out this article from the Academy of Nutrition and Dietetics.

Hydrate, hydrate, hydrate! Water is vital to maintain peak performance during exercise. A good rule of thumb is to encourage consumption of 1 oz. of water per pound of body weight. It is worthwhile to invest in a good water bottle for your teen athlete to carry and keep on hand to foster good habits and prevent dehydration. Check out this article from USA Triathlon for fluid needs before, during and after exercise.

Eating breakfast is non-negotiable. Teens need adequate nutrition to support proper growth and development. Research has indicated nutrients and calories missed at breakfast by teens is unlikely made up for later in the day. This can result in insufficient intake which can hinder sports performance and prevent proper maturation. Great grab-and-go meals include a hard boiled-egg and fruit, string cheese and banana, yogurt parfait and whole-grain granola, berries and oatmeal.

A bedtime snack containing 15-20 grams of protein and approximately 30 grams of carbohydrates will support restful sleep and help build lean muscle tissue during the night. Athletes training intensely especially need bedtime protein to improve recovery and training adaptations (Trommelen & VanLoon, 2016). Cottage cheese, milk, and yogurt are rich in casein, a slow digesting protein. Pair an 8 oz. serving of cottage cheese with sliced bananas, which are a rich source of magnesium helping to relax the muscles in your body as well as lower brain temperature to regulate hormones.

Caffeine has no place in an adolescent’s diet. A 2018 report stated that greater than 40% of American teens surveyed had consumed an energy drink within the past three months. Several emergency visits have occurred due to energy drink consumption among teens between the ages of 12-17. The American Academy of Pediatrics has concluded that energy drinks are “not appropriate for children and adolescents, and should never be consumed.” Monster and Gatorade do not provide the same hydration benefits so be weary of advertisements that contribute to this confusion. Caffeine can negatively impact sleep, anxiety levels and also impair appetite.

Load up on fruits and vegetables between meals! The more colorful your athlete’s plate, the better their gut health and immune function will be. Fruits and vegetables are rich in antioxidants and contain quality nutrients needed for optimal growth and development.

Calcium is critical for proper bone growth, development and overall health. However, calcium can only reach its full bone-growth potential in the presence of adequate vitamin D. Calcium and vitamin D work together. How? Vitamin D helps absorb calcium. Research has proven that American girls do not get adequate calcium in their diet after age 11. This deficiency increases risk of injuries like stress fractures. Recommendations for calcium and vitamin D vary. A great way to attain adequate calcium and vitamin D is to consume dairy productsOatmeal bowl topped with fruit and nut butter such as cheese, yogurt, milk and fortified beverages. A yogurt parfait with mixed berries is a great pre-exercise snack to fuel performance and also serves as a great breakfast to start the day!

Ramp up the color game! No, I am not talking about your outfit; I am talking about your plate. Be sure to fill your plate with many colorful fruits and vegetables that are rich in antioxidants, vitamins and minerals that are essential for health and injury prevention. Citrus fruits, red and yellow bell peppers, dark leafy greens, broccoli, berries and tomatoes offer vitamin C. Vitamin C offers anti-inflammatory properties that speed up recovery and decrease risk of injuries.

Due to their zinc content, meat, fish, nuts, seeds and whole grains should be staple foods to help your youth athlete recover from a tough practice, while supporting growth and even provide wound-healing properties. Zinc is a component of proteins and enzymes and research has shown that insufficient zinc can delay recovery and wound-healing.

I hope you find useful these basic strategies to support your adolescent in their sport. It is important to make sure your adolescent is consuming balanced meals consistently with snacks in between before implementing supplements, as supplements are meant to satisfy the gaps in nutrition. Good nutritional habits must be established first. Click here for information on building a performance plate.

Nutrition is a secret weapon! It can make a good athlete great or a great athlete good, the choice is up to you!

In good health,

Wendi Irlbeck, MS, RDN