Human Growth and Development Discussions
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562 Chapter 15 | Weight Management
NUTRITION in PRACTICE: Sports Medicine Specialist and PT
A dam is a 40-year-old Fine Arts
professor who has gained
20 pounds over the last year. He
blames his weight gain on the nagging
pain in his shoulder, which has caused
him to drop out of the faculty tennis
league. Adam used to play league tennis
games three to four times a week and
practice drills on the weekend. Unhappy
with his excess weight, Adam decided to
visit the campus health center. While he
was at the center, he saw a flyer advertis-
ing the new Sports Medicine Clinic on
campus, adjacent to the Health Center.
Adam made an appointment with the
sports medicine specialist, a physician
who specializes in sports medicine, for the
next day. The doctor diagnosed his shoul-
der soreness as impingement syndrome,
which is pain sometimes experienced by
tennis players when they lift and rotate
their arm. The doctor referred Adam to
the physical therapist (PT) at the clinic for
guidance for an exercise program that
would strengthen his shoulder muscles to
ease the pain. To help him lose his excess
weight, the doctor recommended that
Adam visit with the registered dietitian
nutritionist (RDN) at the clinic.
Adam’s Stats
❏ Age: 40
❏ Height: 6 feet
❏ Weight: 210 pounds
❏ BMI: 28.5
Critical Thinking Questions
1. Based on Adam’s food log, which
waist-friendly food groups are missing
from his diet?
2. Why do you think Adam is snacking
between meals, even when he isn’t
very hungry?
3. What beverage recommendations
would you make based on Adam’s
food log?
PT’s Observation and Plan for Adam
❏ Explain that impingement syndrome
occurs when the tissues in the shoul-
der are pitched or compressed due to
poor mechanics.
❏ Provide Adam with a strengthening pro-
gram for shoulder stabilizing muscles.
RDN’s Observation and Plan
for Adam
❏ Discuss the lack of adequate amounts
of whole fruits and vegetables in his
diet and the role these high-fiber, high-
volume, lower-energy-dense foods
play in weight reduction. Explain the
concept that these foods displace
other higher-kilocalorie foods in the diet
and “fill you up before they fill you out.”
❏ Discuss the issue of routinely snack-
ing when not hungry. Consider alter-
natives to eating when bored.
❏ Replace the bowl of energy-dense
granola cereal with lower-kilocalorie
shredded wheat cereal with a sprin-
kling of granola as a topping.
❏ Substitute skim milk for whole milk on
his cereal and the cream in his coffee.
❏ Decrease the size of the sandwich at
lunch. Instead of a large sub, order a small
sub and a side salad with light dressing.
Two weeks later, Adam returns for
a follow-up visit with the RDN and PT.
While he has only lost a pound, he is
feeling better about this diet and the
strengthening program that the PT
designed for him, although his overhead
tennis serve is still somewhat painful. He
has added more fruits and vegetables
to his diet and, surprisingly, doesn’t feel
hungry. The RDN works with Adam to
choose leaner sources of protein at lunch
and dinner. Adam agrees to try a smaller
turkey sandwich at lunch and grilled
salmon or chicken for dinner more often.
He made another appointment to see the
RDN in a month. The PT tweaks Adam’s
strengthening program and continues to
work with him through the month.
Adam
ADAM’S FOOD LOG
Food/Beverage Time
Consumed
Hunger
Rating* Location Granola with whole milk, orange juice, coffee with cream
7:00 A.M. 3 Kitchen
Coffee with cream, donut 10:30 A.M. 2 Campus coffee shop Ham and cheese sub 1:30 P.M. 5 Sub shop on campus Cookies
4:00 P.M. 1 Vending machine in faculty lounge
Steak, rice, and corn 6:30 P.M. 3 Kitchen Peanuts
9:00 P.M. 1 Watching TV *Hunger Rating (1–5): 1 = not hungry; 5 = super hungry.
600 Chapter 16 | Nutrition and Fitness
D alton was recruited with a full
scholarship to be a guard on the
college basketball team. He was
the star basketball player in high school
and played with a travelling team. While he
was used to heavy schedule of games and
practices in high school, his college routine
of games, practices, and weight train-
ing six days a week is taking a toll on this
energy level. He finds he is getting tired
before the end of practices and doesn’t
have the stamina to play all four quarters
of the game. Dalton understands how
important his performance is to retaining
his athletic scholarship, so he met with
the team Athletic Trainer (AT) to see if he
should change his training routine. The
AT asked Dalton if he is getting adequate
sleep and how he is doing in school. Dal-
ton told the AT that he sleeps soundly at
night and that his school work was man-
ageable. The AT then asked about his diet.
When Dalton told him what he typically
eats daily, the AT recommended that Dal-
ton make an appointment with the team’s
Registered Dietitian Nutritionist (RDN), who
has a specialty in sports nutrition.
Dalton’s Stats
❏ Age: 18
❏ Height: 6 feet 4 inches
❏ Weight: 205 pounds
❏ BMI: 25
❏ Percent Body Fat: 9%
Critical Thinking Questions
1. What nutrient is missing from Dalton’s
diet, possibly contributing to his fatigue?
2. Is Dalton’s food timing appropriate for
his exercise performance? What recom-
mendations would you make to improve
the timing of his meals and snacks?
3. What changes should Dalton make in
his diet in the evening and why?
RDN’s Observation and Plan
for Dalton:
❏ Discuss the importance of consuming
adequate amounts of carbohydrates
at his meals to achieve optimal energy
storage as liver and muscle glycogen.
If there is not adequate carbohydrate
intake before a practice and game,
NUTRITION in PRACTICE: Athletic Trainer
the body’s fuel storage will be quickly
depleted.
❏ Recommend Dalton add vegetables
to his omelet and add a salad, fresh
fruit, or vegetables to his lunch. The
RDN also recommends Dalton change
his dinner choices to include grilled or
sautéed chicken, rice, and more veg-
etables to increase his carbohydrates.
The increased fat content of fried
chicken may slow the absorption of
carbohydrate and protein.
❏ Discuss the need for Dalton to have
more snacks during the day to allow
increased accessibility to kilocalories
and to better balance intake and
output of energy. The large gap
between breakfast and lunch should
be reduced to help sustain his energy
over the course of the day. The RDN
recommends that Dalton eat cereal
and milk as a midmorning snack.
❏ Recommend Dalton continue drink-
ing a carbohydrate-containing sports
drink during games to maintain blood
glucose levels, slow glycogen deple-
tion, and provide fluid for hydration.
Also recommend he eat a protein bar
before and after the event, rather than
during, to help with protein sparing
and muscle recovery.
Two weeks later, Dalton returns for a
follow-up visit with the RDN. He is feel-
ing less fatigued and the increased food
opportunities during the day are enabling
him to have more stamina during his
games and practices. However, he is
getting bored with the evening snacking
and wants more food choices. The RDN
recommends that he try baked beans on
toast, beef jerky and crackers, potatoes
and eggs, granola and cottage cheese,
or chicken and rice as an evening snack.
Dalton
DALTON’S FOOD LOG
Food/Beverage Time
Consumed
Hunger
Rating* Location 3-egg omelet with ham and cheese, hash browns, and sports drink
8 AM 5 Dining hall
3 oz. cheeseburger, fries, sports drink
1:00 PM 4 Dining hall
16 ounces sports drink; 3 protein bars
3:00 PM (before and dur- ing his 3 hour practice)
3 Basketball court
10 oz. fried chicken, mashed potatoes, corn
7 PM (after practice) 5 Fast-food eatery with teammates* Hunger Rating (1–5): 1 = not hungry; 5 = super hungry.
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