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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