bariatric athlete nutrition

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© BariAthletes Bariatric Athlete Nutrition Lea Crosetti, RD, CSSD www.BariAthletes.com September 22 nd 2012

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Bariatric Athlete Nutrition. Lea Crosetti, RD, CSSD www.BariAthletes.com September 22 nd 2012. Objectives. Review bariatric and sports nutrition guidelines Identifying the variables when combining bariatric and sports nutrition guidelines - PowerPoint PPT Presentation

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Page 1: Bariatric Athlete Nutrition

© BariAthletes

Bariatric Athlete Nutrition

Lea Crosetti, RD, CSSDwww.BariAthletes.comSeptember 22nd 2012

Page 2: Bariatric Athlete Nutrition

© BariAthletes

Objectives

• Review bariatric and sports nutrition guidelines

• Identifying the variables when combining bariatric and sports nutrition guidelines

• Learn how to address and motivate the athlete through their transformational barriers

Page 3: Bariatric Athlete Nutrition

© BariAthletes

Bariatric Surgery

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© BariAthletes

Nutritional Changes Post Bariatric

• Minimal caloric intake– Restrictive and

malabsorption

• Minimal carbohydrate intake– Dumping syndrome– Expansion– Reduces protein

intake

• Minimal fluid intake– 1-3oz fluid at a time– Hold fluids 30

minutes pre and post meals

• Vitamin and mineral deficiencies– Malabsorption and

reduced intake– Noncompliance with

supplements

EVERYTHING IS REDUCED! VERY CATABOLIC!

Allis, Blankenship, Buffington, Furtado, Parrott. Surgery for Obesity and Related Diseases. ASMBS Allied Health Nutritional Guidelines for the Surgical Weight Loss Patient. 4 (2008) S73-S108

Page 5: Bariatric Athlete Nutrition

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Athletes

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Page 7: Bariatric Athlete Nutrition

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Sports Nutrition Guidelines• Maintain neutral or positive calorie balance

– +500-1000kcal for muscle building

• Increase carbohydrates to meet the energy demands of workouts– 5-13g CHO / kg

• Increase fluids to meet sweat losses– ~1L/hr

• Adequate vitamin and minerals– Fe, Ca, Zn, K, Vitamin D, E, C, B12, Folic acid

Rosenbloom CA, Coleman, E. Sports Nutrition: A Practice Manual for Professionals, 5th ed. SCAN dietetic practice group, American Dietetic Association (in press).

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Disconnect Between Bariatrics and Sports Nutrition Goals

• Bariatric Nutrition Goals– Low carb, high protein– Low calorie diet– Small volume meals

• Sport Nutrition Goals– High carbohydrate

diet– High calorie diet– Large volume meals

There are NO set guidelines for bariatric athletes!

Page 9: Bariatric Athlete Nutrition

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Common Complaints When Trying To Follow One Or The

Other• Follow Bariatric

Guidelines– No energy!– ‘Hit the wall’ or

‘bonk’

• Follow Sports Nutrition Guidelines– GI distress or

dumping syndrome– Vomiting or

stomach pain

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What Are Their Goals?

• To finish?• To PR?• Achieve healthy

weight?• Develop new

lifestyle to avoid weight regain?

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Things to consider when working with this population

• Sports Nutrition:– What type of event do they plan on doing?– Individual preferences

• Bariatric Nutrition:– No 2 patients are the same

• Different surgeries• Different surgeons• Different time post op

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© BariAthletes

Considering the Spectrum

5k

1 month post op

3 years post op

Ironman

Page 13: Bariatric Athlete Nutrition

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Leave the Numbers Out

• There are no standards!

• Everyone’s anatomy is different

• Great opportunity to reconnect with hunger / fullness levels

Page 14: Bariatric Athlete Nutrition

© BariAthletes

Tapping Into the Right Energy Source

• Training the body to rely more on its own energy stores (fat tissue), which reduces calorie intake during training

• Goal is to reduce calorie consumed per hour during training and race

• This is ideal for bariatric athletes who can’t consume large amounts of simple sugars during events

Seebohar. Metabolic Efficiency Training.; Teaching the Body to Burn More Fat. 2009

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Periodized Workouts

• Training philosophy that is done in cycles, with each cycle having its own goal.

• Cycles vary in volume and intensity, allowing you to build and prevent injury.

• Each cycle is broken up into weekly cycles that will have gradual builds and then a recovery week.

• Periodized training allow for an aerobic base to be built early in the season while more sport specific and higher intensity workouts the closer the event becomes.

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Periodized Nutrition

• If volume and intensity changes so should nutritional intake

• The composition of meals change because of the different energy systems being used

• Fat can be a primary fuel source for lower intensity workouts

• Carbohydrates are primary fuel source for higher intensity workouts

Seebohar. Nutrition Periodization for Endurance Athletes: Taking Traditional Sports Nutrition to the Next Level. 2005

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Basic Everyday Guidelines

• Eat balanced meals throughout the day• Plan to have a meal, snack or shake

every 2-4 hours • Should be a mix of carbohydrates and

protein• Volume of meals and snacks depend on

type of surgery, how far out from surgery, and type of activity

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Pre Workout Nutrition

• Something easy to digest and best tolerated

• Make sure there is both protein and carbohydrates in it, preferably low in fat

Page 19: Bariatric Athlete Nutrition

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During Workouts

• May not be needed – depends on workout intensity and duration as

well as the conditioning of the athlete– 1 hr or more will likely need carbohydrate and

electrolyte repletion• Smaller more frequent dosing to prevent

high sugar load• Usually whey protein

– Protein mixed with carbohydrate tends to have better results during and helps with recovery

– Try to avoid fructose as it is less tolerable among most athletes

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Sports Nutrition Products

• Drinks, Bars, Gels, GUs, Shot Blocks– Infinite drinks, Cliff bars, Shot Blocks

• Hydration and Electrolytes– NUUN, Salt Sticks

• Find one the one that is best tolerated

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Post Workout Nutrition

• 45 minute to 2 hour window for best repletion

• Post workout nutrition is key for recovery, strength building, and improved performance during next workout

• Carbohydrates and protein mix – Typical sports nutrition: 4:1 ratio– Bariathlete appropriate: 2:1 ratio

Page 22: Bariatric Athlete Nutrition

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Who are you working with?

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New perceptions

• Weight loss driven– Vs performance driven

• Food is now fuel– Breaking emotional ties to

food– No “good”/”bad”

• Exercise is no longer punishment

• Establish rapport– Not the food police!

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How they see themselves

• They still see themselves as overweight – Body dysmorphia and poor body image

• Really hard for them to acknowledge themselves as athletes– Athlete as an image vs trait/behavior– Definition: a person trained or gifted in

exercises; a participant in a sport, exercise, or game requiring physical skill.

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© BariAthletes

Page 27: Bariatric Athlete Nutrition

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Triggers and Barriers

• Taking injuries personally and motivating them to stay on track

• Mentality to do it all right now• Knowing past triggers and saboteurs • Identifying new coping strategies• Remember their journey

– Remind them how far they have come

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Page 29: Bariatric Athlete Nutrition

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Key Points To Remember

• You are working with people with very individualized needs – Assess surgical and athletic status

• Focus on balancing daily meals and snacks• Help them find what products may be right

for them• Adjust for individualized tolerances• Always be a major contributor to their

support system

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© BariAthletes

[email protected]

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