Nutrition: Keeping the Coach Healthy by Lisa Dorfman, MS, RD, CSSC, LMHC (2009)


I am excited to be here. I have worked with thousands of athletes in my 25 year career, but who I like to work with most are really the coaches because you really impact those athletes on a daily basis. I had passed around my card so feel free, if you want to email me after the presentation if you have any questions about an athlete that you are working with. I would be happy to share some information and direct you to an RD in your area.

I am here to talk about keeping the coach healthy and I do want to say thank-you to ASCA for inviting me, to Judith Woolger, who is a physician down at the University of Miami, John Leonard, the Executive Director and to all the sponsors because sponsors are really the driving force behind these meetings. I want to give you some nuggets that you could leave with and start to get you thinking about nutrition. I know when you are on vacation or at a business meeting it is probably the hardest time to eat well, but at least you could start. Nutrition is a process and so if you could at least start thinking about it now when you get back home – you know – perhaps you could incorporate some of these strategies so that you could feel better and guaranteed, you will be a little bit tired when you get home by the scope of these meetings. Why should you make change if you are not internally inspired to make change? We know that there is a diet and chronic disease connection. We know that diet is related, certainly, to obesity Heart disease, Type II diabetes, cancer, arthritis, we all have family members and friends – if not ourselves – who suffer with these diseases and nutrition can make a difference so even if you are not here for yourselves today, you could take some information to help those that you do love.

So, I am the nutritionist for US Sailing. I did travel to Beijing, Ching Dau actually, which was a really interesting food experience and challenge for our athletes as anybody who traveled over there knows. Anybody that stands on a pool deck for 9 or 10 hours a day knows what a challenge it is.
I have been an athlete for a long time, but I have also been on the coaching end with USA Triathlon. In addition, I am a mom of three pretty active kids and I do not know what is harder, being the athlete or being the coach because it is almost a performance. You almost go through the same experiences and then some, because for some reason we carry a lot of responsibility being on the other side. The athlete needs to swim and do what they need to do but we carry the burden in a way and that impacts our nutritional needs.

My presentation today is really the strategies of how to assess if you need to make changes in your diet. Do you know how to do that? Maybe you are just fine and you are just here to see if there is some information you could pass down to your athletes. You certainly can pass down some of this information to your athletes. Where do you start with all this nutrition stuff? I always say just take a look in the mirror. Do you like what you see?

And I always qualify this for my swimmers. I did this actually yesterday in class because I have one of our swim team members in my class this semester and I said well, look at your hair. Hair is a great place to start to see if you’re really nutritionally adequate. If your hair falls out, if you find yourself with a pillow full of hair in the morning or shower full of hair, you have no sheen to it, this is outside of being in a chlorinated pool every day. Look at your eyes. If you pull your eyelids down, they should be pink. If there are cracks in the sides of the eyes there are risks such as liver problems with young kids who have imbalanced diets or older kids who may drink too much alcohol, or drink too much caffeine, or have really imbalanced diets because of the stress and travel of our careers. You may be suffering from some vitamin deficiencies and major nutrient deficiencies.

When I say major nutrient I mean protein, carbohydrates and fats. They are the only energy yielding nutrients. Alcohol gives us energy in the form of calories, actually lots of calories. I do my whole alcohol routine because alcohol is metabolized to fat and is metabolized to a compound that limits your body’s ability to use fat by about 70%. So alcohol is not wonderful for our athletes. Alcohol is not wonderful for us, but it does give you calories.

Protein is the nutrient that really keeps your system together. It is not a nutrient that you typically use for energy unless you force your body to on those long travel days or those long days on the deck when you are not eating enough food and you don’t have enough carbohydrates. Some of the signs that you will see are for these cracks and the signs of vitamin deficiencies that can cause that. You will see flaccid muscles, very poor muscle tone, both in yourselves and in your athletes.

Age related macular degeneration is something that is going to affect all of us. If we eat this good food and live long enough we are going to start to lose our eyesight. But you can get a head start by eating foods that are lower in fat and high in anti-oxidants, lower glycemic index foods. These are the kinds of sugars that keep your blood sugars really nice and steady. There are Omega 3’s, essential fatty acids and I guarantee nobody in this room gets enough.

I am particularly interested, both as a licensed nutritionist and a licensed psychotherapist about this relationship between diet and stress. My last book was on diet and stress. Not only does our stress level sort of start to dictate the food choices and drink choices that we make, but the food choices that we make can impact our mood so there might be better foods that you could choose to eat during the day when you have to stand and coach and better foods that you could eat at night

We know, I can only testify that, as a parent and a coach when I am sitting on the sidelines and I am watching my athletes compete, I get revved up. I don’t know about you, but that adrenaline starts going (called the fight, flight, or freeze mode). Freeze is when your athlete doesn’t do as well as you had anticipated. You want to get mad or upset, you want to guide them and coach them. We experience all that stress and that has major metabolic effects on the body.

We know that nutrition certainly improves sport performance, but I think it also improves coaching performance because we infuse that energy that we have into our athletes and that is very powerful. With athletes, you can see the impact that their coach is making in their lives.

I call this the wellness trilogy: the food, the fitness, the emotional/spiritual. There are a whole bunch of services that you can locate in your hometowns to reduce stress and enhance your energy levels. For instance, acupuncture and massage have all been researched. You are allowed to be selfish coaches. You are allowed to take an hour out for yourselves. I know it is hard. You feel guilty. You are taking time away from charting progress or notes or being available to parents, but it is really critical for the longevity of you and your career.

You can look at yourself and look for signs that let you know you need to do something different. For 15 years, I didn’t have a scale because I thought the scale was the most ridiculous tool that I could have in my office. I really rely on other tools, like body fat analysis. I also take circumference measurements because we want to educate our athletes and ourselves especially as we get older, about the importance of maintaining muscle mass to support our bones. Another tool that is often used in the doctor’s office to assess disease risk is the waist circumference or the waist-hip ratio.

To take the waist-hip ratio, you measure your waist where the belly button is and then around the biggest part of your hip area and then do the math. A risk factor for men is above .90, and for women a ratio greater than.80 identifies risk for disease.

When I examined my diet based on that adage “you are what you eat,” I realized I was nuts. Sometimes as we are eating, the food looks very different going in our mouths than it does on paper. We eat for all sorts of reasons. Hunger would be a nice reason, but often our appetite drives our eating. The hormones behind appetite control drive our eating. Stress drives our eating. As we go through the next several slides I just want you to think about your diet yesterday.

There are actually three numbers that you use or three factors that impact the calories that you need a day. The BMR (basal metabolic rate) is how many calories you need to sustain your system, just lying in bed staring straight up at the ceiling. So that is absolutely doing nothing. There are a thousand ways and a thousand formulas to calculate this, but the easiest one is your weight X 10 calories per pound. If you need to lose weight and you are shooting for a target, I like to work with the formulas more because let’s say you have like 20, 30, 40 pounds to lose and you are eating very little calories your metabolism could take an impact over time, we call that the plateau.

The second one is the EPA, which is the energy expended per physical activity. Light activity, a couple of hundred calories per day walking around the deck, going doing your chores around the house doing what you do 2-300 calories a day in addition to that BMR. Finally, the SDA which you don’t really hear much about – covers specific dynamic action.

So, what kinds of strategy can you use? Where do you start with this whole nutrition ball of wax? We want to look well, feel well for a very, very long time. Starting with protein, if you are very active 1.5 grams per pound is what you should be consuming from protein. Each ounce of protein has about 7 grams. Eating a chicken breast puts you are at 42 grams right there. It is not hard to meet your protein needs. Excess protein, certainly when it comes from the high fat sources, is stored as fat. Remember I had explained much earlier that protein is not generally used as an energy source so there is no advantage to consuming extra protein. But most of us in this room are really just trying to get by and be healthy, so we should aim for ¾ of a gram per pound.

Nutritionists have made carbohydrates so complicated, and I could spend two semesters talking about it. But, it is so simple. Simple carbohydrates give us simple quick energy, it hits the blood stream, gives us that energy and we are doing great. We have to be really careful, especially as we get older. We don’t really use, or metabolize, carbohydrates as well as when we were 20. So we want to make sure that those carbohydrates are complex, meaning that they have fiber. Research suggests that at least if you get 20 grams of fiber a day it really helps with that weight management issue of feeling full. Fibers come from fruits and vegetables and whole grains. You should be chewing away when you eat that bread on your sandwich. Whole grain not whole wheat, you want things in your whole grains. You want brown rice and whole grain pasta and you will feel a lot better. Now, for women that are mildly active in this room, probably no more than 1-2 tennis balls of whole grains a day and for men probably 3 to 4 tennis ball-sized servings. I always use tennis balls because it’s about a cup and easy to visualize.

Most people over-eat this food group in particular: sugar should be less than 10% or about 25-50 grams a day. There are 4 grams of sugar for every teaspoon of sugar. I always use the “naked drink” as an example because they look so healthy. Check the label and you will see there are about 27 grams of sugar per serving, which means it has about 7 teaspoons of sugar and there are 2 ½ servings in that little bottle. Remember, we are supposed to drink 3 liters of water a day for men and 2 liters women. Adding sugar to that volume of liquid makes the calories start to add up. On salads: so many people just douse them with oils and fats. We have to be really careful. Take away the oils and you strip it down to the natural grain and you have a good shot at getting what you can from the carbohydrate group.

With that we are still watching that intake, don’t really want to take all the fats out of our diets nor our athlete’s diets. Fat helps to use the fat soluble vitamins A, D, E and K. They are critical for just about everything. The Omega 3, the essential fats, have some anti-inflammatory effect, they impact blood pressure. We must get through our diet every single day. You could find it in soy and you could find it in particularly almonds and pistachios, but you have to eat a lot of this stuff and probably be a lot more than 44-66 grams of fat a day so most people have to take a supplement these days. There are many fortified products. There is Omega 3 fortified milk, egg beaters, cereals and the cereals you have to be careful because in the flax, the conversion from the plant based to the actual active Omega 3 compound is very low. If you have vegetarians they are probably going to need a supplement.

When you look at nutrition focusing on protein, carbohydrates, fat, vitamins and minerals, the next level of improving it is cleaning up, kind of detoxing from your vices and then building on that strong healthy foundation. Most of my clients’ and athletes’ diets are brown and white and full of very, very bland colors. I want to make sure as you leave this room today that you are getting at least 5 colors in your diet. You are bound to get vital nutrients in your foods and these vital compounds have a number of health benefits, both for your heart and the cells of your system.

So Probiotics are healthy bacteria. They build up your gut. Your gut is your first line of detoxification system. It helps to absorb some nutrients. You do find it in some yogurts and tea, but a lot of people like to take lactobacillus. There are several on the market that you could find. If you want to find a brand that is safe and good to use go to they rate the Probiotics and other supplements.

Phytosterols are a cousin to cholesterol, but they are like the good cousin. We find phytosterols in plant based foods. But not in the amounts that would be required to reduce cholesterol and bad cholesterol levels in the blood. They cause the incomplete absorption of cholesterol and so they might help if you are having issues with your cholesterol levels. Fortification is great. I think it really helps us along, but do your research. Don’t spend money on very expensive drinks or formulas. Assess your diet first. I definitely believe in supplements. It is almost like a religion, but I believe in them and there is a reason to take supplements. That will enhance your well-being, but just to take them to take them is not really recommended.

Fresh and organic foods have been a really controversial issue lately. It is not as expensive as we once thought it was so it is not out of reach for any of us. You can find it at Wal-Mart. These are the dirty dozen that the Environmental Protection Agency rates as the worst offenders so if you do want to splurge I would encourage you to get these fruits and vegetables organic: Apples, Pears
Peaches, Bell peppers, Celery, Cherries, Imported grapes, Nectarines, Potatoes, Raspberries, Strawberries, Spinach, Meat, poultry, eggs and dairy limits your exposure to antibiotics

Choosing better on the road is key. We eat out 70% of the time. That is double what it was in the 1980’s and restaurant food is filled with fat. There are some great websites “Eat this, not that.” You could go to Good Food near If you are on the road you punch in the zip code and you could find all the fast food healthiest choices in that area but it’s also lots of the foods contain lots of extra fat and sugar They are tasty. They smell good. Fat carries the aroma and so we tend to go for these foods, but really – they are fat and sugar. The CSPI has a really wonderful Newsletter called “Nutrition Action Newsletter” where they explore health issues and they provide recommendations for different food choices. They will give you lists of foods rich in fibers and I find it very easy to read. Checking the label is also key to improving our diet and eating on the road. What I typically recommend is look at fat contents so if there are 9 calories per gram of fat but 99% of the calories in this product come from fat, you want to look at food labels anf you want to look at some of the vitamins and minerals you to see if you are getting anything.

Dieting healthy is really important but I believe in the 80/20% role. If you eat well 80% of the time – 20% you have off. We all need that mental space, just like our athletes. I work with athletes who always ask what to do on Sundays? And I said – eat whatever you want. I want you to relax do nothing. Because, they could burn out, we could burn out if we were on this diet all the time.

It is tough to stay #1. You could see some of the challenges Michael Phelps has had in the last year. The University of Miami has had its share of challenges. When you are the best and when you want to be the best at what you do, it is hard to stay there. We cannot always be the best. Our athletes cannot always be the best in the world in their schoolor in the state and so that brings pressure. That really distorts our perception of our potential and so it is not just the fact that we cannot be #1 all the time, it is important to consider what it does to our bodies in the process. Ongoing stress changes metabolism. You know that adrenaline rush increases your heart rate, your blood pressure. It throws fats in the blood and sugars in the blood. You are just ready to go and scream at your swimmer. Cortisol is the hormone produced to combat stress, but it also produces the fatty gut. And over time it is just really hard shed to that gut fat and that leads to potential obesity and leads to all those health problems.

What is your Motivation? You have got to find something. Do not wait for your cholesterol level to be high to make change. Walk out of here and tell yourself I do want to be #1. I do want to be #1 to myself and make change. You have got to find that reason, whether it is losing weight or losing body fat or just being healthy. Clear up the mixed messages for yourself. Before I came in here today, I think you knew exactly what you needed to do with your diets. Everybody has a hunch. Sometimes it is a little bit more. If you weigh 220 now, and weighed 160 in high school, it is unrealistic to expect yourself to get back to that when you are 40 years old. That was a long time ago, so be more realistic. Focus on one or two goals and then sort out those messages. Refer to experts like Registered Dietitians in the field and be realistic. Take a look at yourself. We know that underweight people really distort their body image, but we know that close to 30% of overweight people thing they are just slightly overweight and 74% of obese just think they are overweight

When you read those labels, you’re developing good habits but a lot of that is very, very confusing so go on line. They have plenty of great websites. The International Food and Information Council has a lot of information on label reading. Make sure your food tastes good. If you are going to start eating healthier again, season it. You don’t have to throw in fat and oils but season it in a way that is going to taste for you so you continue.

Start with lifestyle changes. Be realistic. Set realistic goals. Do it slowly. It takes 8-12 weeks to make a change. Take some kind of action. Practice portion control and eat organic foods. Look for the colors in your foods. Eat little by little throughout the day, not these big meals at the end of the day after you have starved all day. Look at the whole pattern. It is the overall picture. It is not that one meal that is going to set you back. Be active. I know this is just so far-fetched that I am telling coaches to get some activity in their lives, but you spend so much time with athletes. Even for just the stress factor, whether it is strength training or cardiovascular training, just sweat. Anything that makes you sweat will help you be healthier. As Mark Twain said “part of the secret of success in life is to eat what you like and let the food fight it out inside.”

I don’t think there is any easy answer. This is a big topic. You obviously came here today because you wanted to learn something, certainly something that you could share with your athletes. Look at the colors of their diet, start there. Tuna, chicken, pasta, white bread, and bagel is very boring most of the time. There are so many websites you could go on to analyze your athletes’ diets, to analyze your own diet. There are so many resources and free resources so you do not have to pay a lot of money to get this information. Google online and you will get some of these links on line. I am the Nutrition Editor of SoBeFit magazine. It is going national so be on the lookout for the Magazine. It’s great magazine with great information that is evidence based. Thank you.

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