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Nancy Clark

Surveys suggest that 8 to 41% of athletes may struggle with binge/purge and bulimic eating behaviors. Many of these athletes with bulimia struggle alone, receiving no professional help for recovery. This article offers effective counseling strategies for nutrition professionals who want to help bulimic athletes. Through a case study of a triathlete who binges, and then purges through compulsive exercise, a nutrition care plan is discussed that addresses the food and weight concerns commonly expressed by athletes with bulimia. The priorities of the care plan are to reduce preoccupation with weight, establish a pattern of regular eating, and address the underlying causes of the binges. The case demonstrates that nutrition counseling is only one part of the treatment program, and emphasizes the importance of developing a team of health professionals to assist athletes with bulimia.

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Debra M. Vinci

This paper presents an overview of the Husky Sport Nutrition Program at the University of Washington. This program is a component of the Department of Intercollegiate Athletics Total Student–Athlete Program, an NCAA-sponsored CHAMPS/Life Skills Program that provides life skills assistance to student–athletes. Successful integration of a sport nutrition program requires an understanding of the athletic culture, physiological milestones, and life stressors faced by college athletes. The sport nutritionist functions as an educator, counselor, and administrator. Team presentations and individual nutrition counseling provide athletes with accurate information on healthy eating behaviors for optimal performance. For women's sports, a multidisciplinary team including the sport nutritionist, team physician, clinical psychologist, and athletic trainer work to prevent and treat eating disorders. Case studies are presented illustrating the breadth of nutrition-related issues faced by a sport nutritionist working with college athletes.

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Giovanna Ghiani, Sara Magnani, Azzurra Doneddu, Gianmarco Sainas, Virginia Pinna, Marco Caboi, Girolamo Palazzolo, Filippo Tocco and Antonio Crisafulli

and nutritional status of an athlete attempting a Solo yacht race around the globe. We were interested in discovering whether planned nutritional counseling with established meals could help in maintaining the balance between energy intake and expenditure. Moreover, we also investigated the effect

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Janne Sallinen, Arto Pakarinen, Mikael Fogelholm, Elina Sillanpää, Markku Alen, Jeff S. Volek, William J. Kraemer and Keijo Häkkinen

This study examined the effects of strength training and diet on serum basal hormone concentrations and muscle mass in aging women. Fifty-one women age 49 to 74 y were divided into two groups: strength training and nutritional counseling (n = 25), and strength training (n = 26). Both groups performed strength training twice a week for 21 wk. Nutritional counseling was given to attain sufficient energy and protein intake and recommended intake of fat and fiber. We found that the cross-sectional area of the quadriceps femoris increased by 9.5 ± 4.1% in the nutritional counseling group versus 6.8 ± 3.5% in the strength training only group after training (P < 0.052). Nutritional counseling evoked dietary changes such as increases in the proportion of energy from protein and the ratio of poly-unsaturated and saturated fatty acids. Strength training increased testosterone and testosterone/sex hormone-binding globulin ratio after the first half of training, but these returned to baseline values at the end of the entire training period. Changes in serum basal hormone concentrations did not differ between the groups. Our results support the conclusion that nutritional counseling can contribute to the increase in the muscle cross-sectional area during prolonged strength training in aging women.

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Alice K. Lindeman

Self-esteem, a hierarchical and multifactorial perception, can be described as the extent to which a person feels positive about himself or herself. Social factors such as life satisfaction, sex, age, and strongly held values can affect self-esteem. Low self-esteem Is a well-recognized trait of those with eating disorders and may be associated with a heightened self-awareness. Body dissatisfaction, common among women in Western society, may enhance this awareness. Athletes, especially those with eating disorders, are perfectionists and have acute body awareness and a sense of loss of control Control is a crucial issue with these athletes. Before any nutrition counseling starts, readiness to listen should be assessed in conjunction with a mental health professional. Various tools are available to assess the eating disordered athlete's self-esteem, body image, and eating behavior. Nutrition counseling can help the athlete overcome an eating disorder by clarifying misconceptions and focusing on the role of nutrition in promoting health and athletic performance.

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Katsumi Sugiura, Izumi Suzuki and Kando Kobayashi

Mean daily intakes of energy and nutrients were surveyed from 3-day food records for 62 elite Japanese track-and-field athletes (28 males and 34 females) selected to participate in the 1994 Asian Championship games held in Hiroshima, Japan. Mean energy intakes of male and female athletes were 3,141 kcal (±592) and 2,508 kcal (±537), respectively. Based on the Japanese Recommended Dietary Allowances (JRDAs), long-distance and middle-distance runners had significantly higher energy and macronutrient intakes than did sprinters, jumpers, and throwers. There was no significant difference in micronutrient intake among the different types of athletes. However, of the sprinters, jumpers, and throwers. 15 males (54%) and 22 females (65%) consumed less than the JRDA for at least one micronutrient (i.e., vitamin or mineral). For some athletes, nutritional counseling that provides strategies for increasing food intake is recommended to optimize nutrient intake.

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Suzanne Nelson Steen, Kirsten Mayer, Kelly D. Brownell and Thomas A. Wadden

The purpose of this study was to evaluate the adequacy of dietary intake in 16 female heavyweight rowers during the sprint racing phase of the season. Caloric intake for the rowers was 2,633 kcal/day, lower than expected given the training regimen of these athletes. On average, rowers consumed below-optimal levels of carbohydrate. Protein intake was satisfactory but fat intake was higher than recommended. For the majority of rowers, micronutrient intake met the RDA. However, calcium, zinc, B6, and B12 fell short of meeting two-thirds of the RDA for a significant percentage of rowers. The preevent meal consumed both 15 hr and 2 hr before the event provided less carbohydrate and fluid but more fat than desirable. Female heavyweight rowers would benefit from nutritional counseling that provides strategies for increasing complex carbohydrates, calcium, zinc, B6, and Bl2 while reducing dietary fat. Adequate fluid intake is also essential.

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Jean Storlie

Athletes, like all people, have special nutritional needs based on their age, lifestyle, health status, level of physical activity, physical conditioning, and type of sport. The diets of many athletes are inadequate due to overly restrictive eating habits, nutrition misinformation, dietary fads, and/or obsession with weight and food. There is a growing need for sports nutrition counseling and education to help athletes improve their eating habits. However, before attempting to develop intervention strategies, sports nutritionists should assess the metabolic changes that take place during exercise and how these changes affect nutrition status. In addition, it is important to consider how psychosocial factors may influence an athlete's eating habits and his/her ability to make positive changes. A two-pronged model is introduced that can be used as a guide for the practitioner in interpreting relevant data and integrating physiological and psychological considerations for the design of individualized nutrition care plans for athletes.

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Sue Reeves and Kieran Collins

The aim of this study was to investigate the dietary intakes and anthropometric profiles of county and club Gaelic football players and compare them to soccer players and control subjects. Seven-day dietary records were analyzed and anthropometric measurements were taken midway through the Gaelic football competitive season. The county group with a mean height of 1.82 ± 0.04 m were significantly taller (p < .05) and had less body fat than any other group. The county and club teams consumed 151 ± 11 and 150 ± 16 kJ · kg−1 · day−1, respectively, with 52.2 ± 5% and 49.5 ± 9% of their energy intakes as carbohydrate. This compares to 173 ± 11 kJ · kg−1 · day−1 for the soccer players and 159 ± 8 kJ · kg−1 · day−1 for the controls, with 57 ± 4% and 44.9 ± 5% of their energy from carbohydrate. The nature of Gaelic football demands a balanced diet, rich in energy and carbohydrate and with adequate calcium is consumed; the subjects needed to increase these dietary components in order to meet the energetic demands of competition and training. Additional nutritional counseling was provided on an individual basis.

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Mark R. McKean, Gary Slater, Florin Oprescu and Brendan J. Burkett

Australia has approximately 26,000 registered exercise professionals (REP), in comparison with 3,379 accredited practicing dietitians (APD). The REP workforce has the potential to reach more than 10% of the Australian population but there is limited data on their educational background and professional behaviors with regards to nutritional counseling of clients. The purpose of this research was to determine if REPs are working within their scope of practice and if their qualifications align with their practice, specifically as it relates to nutrition advice. Using a cross sectional descriptive study design, a self-administered online survey of REPs was conducted over 5 months. REPs were recruited through electronic and social media using a snowballing technique. The study focused on education, nutrition advice, and sources of information. A total of 286 respondents completed the survey, including 13 with tertiary dietetic qualifications i.e., APDs. The nationally recognized industry Certificate III/IV in Fitness was the most common qualification. The majority of REPs responding (88%) were working outside of their professional scope of practice, offering individual nutrition advice to clients across fitness and medical issues. This was despite 40% of REPs undertaking no further training in nutrition since graduating, and primarily basing advice on use of readily accessible sources of nutrition information. It is recommended the nutrition advice provided to REPs during training be limited to general nonmedical nutrition information in accordance with nationally endorsed evidence based guidelines and that issues pertaining to scope of practice be addressed with onward referral to other health professionals be advocated.