Running On Empty:Fad Diets and Athletic

Performance

National Athletic Trainers AssociationJune 13, 2005

Gale Welter, MS, RD, CSCSUniversity of Arizona

Campus Health Service

You Are the First Line of Information

• Athletic Trainers (plus Strength Coaches and Personal Trainers)

– Often have the closest relationship with athletes– Are trusted with personal information– Are trusted sources of information– Athletes will ask your opinion when they want to

lose weight for enhanced performance

When Is Weight Loss Desirable?

• This could be a whole session in itself

When Is Weight Loss Desirable?

Things to Consider…• Optimal weight for performance? Many

factors involved– Body weight vs body fat– Sensitivity to amount of body fat and

disordered eating

• Advisability of weight loss for performance needs careful evaluation

Weight Loss Is Confusing to Athletes

• Non-athlete friends’ and family members’ weight loss experiences don’t apply to athletes

• Media hype everywhere; quick fix promises are very appealing

• Healthy weight yardsticks for general public are not relevant to athletes (like BMI)

For the Purposes of This Discussion:

• Assume weight/body fat loss is appropriate and advisable

• The athlete asks your advice about “diets”

Objectives of This Presentation

• Review energy systems• Review fuels used by energy systems• Learn the amounts of fuels provided by the “Fad

Diets” and compare them to weight loss needs• Review basic performance-oriented weight loss

strategies• Learn suggested talking points to use with an

athlete who desires to lose weight – For effective weight/fat loss with a minimal impact on

ability to train

Energy Systems of Athletic Performance

• Phosphagen system (a.k.a. creatine phosphate

system) – very limited ATP* supply

• Anaerobic system – Some ATP*

• Aerobic system – Lots of ATP*

*basic energy currency in cells.

Phosphagen System• Short burst, all-out effort

• 5-6 seconds duration

• Quick, but limited energy source– Creatine-phosphate stored in muscles– small amounts – Oxygen not necessary– By-products of ATP breakdown in this system

initiates the anaerobic glycolysis system

Anaerobic System

• Bursts of activity lasting 60-180 seconds

• Relatively quick energy transfer

• Lactic acid build-up decreases pH of cell, limiting continuation

• Fuel is Carbohydrate (glucose)

• Oxygen is not needed

Aerobic System• Moderate or low intensity activity over

extended periods of time• Slower energy transfer• Greatest capacity because of fuel availability

– Carbohydrate, limited storage (~ 1900 calories)

– Fat, unlimited storage capacity

– Protein only as a reserve fuel, conversion to glucose takes energy to do

• Oxygen required

FATTY ACIDS

AMINO ACIDS GLUCOSE

Aerobic(with oxygen)

Anaerobic(without oxygen)

Cell Membrane

Lots of ATP

Some ATP

Inside Cell

University of Arizona, Winning Sports Nutrition, 2004

Glucose

Fatty Acids

Amino Acids

High Intensity Activity Low Intensity Activity

University of Arizona, Winning Sports Nutrition, 2004

Diet and Training

• Can influence the capacity of the energy transfer system

• Can optimize the storage and utilization of carbohydrate and fat

Primary Fuel Source - Carbohydrate

• Direct fuel, as glucose

• Glucose is also necessary– For fat oxidation to produce energy– To fuel protein’s functions of repair,

maintenance, and growth – To convert protein to glucose for energy, when

needed

• Stored form of glucose is called glycogen

Carbs Currently Have a Bad Rep

Athletes are Bombarded by

Low-Carb Messages

Tough Sell #1

• Convincing athletes that these messages do not apply to them, because their primary fuel source for performance energy is carbohydrate foods.

Athletes Need a Regular Supply of Carbohydrate

• Starches

• Grains

• Fruits

• Vegetables

Inadequate Carbohydrate Intake

Inadequate Carbohydrate Intake

Athletes Need More Protein Than the General Public, to meet their higher needs for:

• All structural tissue growth and tissue repair• Oxygen-carrying hemoglobin• Enzymes, hormones, immune function, etc.

General Public Athlete

0.8g / kg body wt 1.2 – 2.0g / kg body wt

(0.4g / lb. body wt) (.5 - .9g / lb. body wt)

Rosenbloom, CA. Sports Nutrition, A Guide for the Professional Working with Active People. 3 rd Ed., American Dietetic Association, 2000

Tough Sell #2 Athletes Do Not Need an Extraordinary Amount of

Protein• 130 lb female athlete needs 65 – 117 g/d

(Non-athlete needs = 52 g/d)

• 200 lb male athlete needs 100 – 180 g/d(Non-athlete needs = 80 g/d)

What does 100g Protein look like ?

1C cereal, 1C milk

½ C blueberries

Sports bar (40-30-30 type)

Sandwich, 2oz turkey,1oz cheese

½ C baby carrots

1 C milk

8 oz yogurt

¼ C nuts

4 oz chicken breast

1 C brown rice

1 C cooked veggies

1 C salad with 2T low fat dressing

11

0

10+

28

1

8

8

6

28

6

2

1

Total grams Protein (calories) 109 (1925)Source: exchange system estimates

What does 180g Protein look like ?

2 C cereal, 1½ C milk

2 large bananas

Sports bar (40-30-30 type)

2 Sandwiches, each with 2oz turkey,1oz cheese

1 C baby carrots

2 C milk

8 oz yogurt

½ C nuts

6 oz chicken breast

2 C brown rice

2 C cooked veggies

2 slices of bread

18

2

10+

56

2

16

8

12

42

12

4

4

Total grams Protein (calories) 186 (3400)Source: exchange system estimates

Dietary Fat Is Essential:• As a structural component of all cells• For brain and nervous system growth and

maintenance• For sex hormone production• For immune response• To keep skin and other soft tissue pliable• For blood clotting, blood pressure regulation,

heart rate

Fat Deficiency Is Marked By:

• Low sperm counts

• Loss of menstral function

• Increased susceptibility to infections

• Food cravings

• Irritability

• Anxiousness

• Mild depression

Tough Sell #3Quality Fats/Oils

Contribute to Optimal Performance

• Especially to female athletes, smaller athletes and some coaches who believe that dietary fat = body fat

• It is difficult for many to understand that additional body fat is a result of eating more calories from the total of all food ( and beverage) sources than are being used up… and doing so consistently over time

Different Sports, Different PositionsSlightly Different Needs

• Power/Strength sports– Weight lifting, wrestling, gymnastics, ice skating,

track/swim/bike sprints, throwing, diving, football

• Intermittent (stop and go) sports– Team sports: baseball, softball, basketball,

volleyball, soccer, lacrosse, hockey, football etc.– Individual sports: tennis, golf, etc

• Endurance sports– All long distance run/swim/bike, or combination;

some positions in soccer, lacrosse, etc.

Current Best Science

Energy Needs of AthletesAthlete General Public

Carbohydrate 55%-65% calories

Strength Athlete 5-7 g/kg body wt

Endurance Athlete 7-10 g/kg body wt

Protein 0.8 g/kg body wt

Strength Athlete 1.6-1.7 g/kg body wt

Endurance Athlete

Restricting calories

1.2-1.4 g/kg body wt

1.4- 2.0g/kg body wt

Fat 20%-30% of calories ≤ 30% calories

Rosenbloom, CA. Sports Nutrition, A Guide for the Professional Working with Active People. 3 rd Ed., American Dietetic Association, 2000

Many Factors Effect Weight/Fat Loss

• Timing of meals and snacks• Sleep• Stress levels• Psychology: drive to win• Personal / Emotional

– Relationships– Finances– Expectations of others, need for acceptance

Every Athlete Is Different

• Different genetics– Body type, enzyme and hormone makeup– Athletic potential

• Different body size• Different food preferences and cooking skills• Different emotional relationships with food• Different ages and stages in sport• Different athletic ambitions • Different emphasis on social life • Different money available

Different Sports, Different PositionsSlightly Different Needs

• Power/Strength sports– Weight lifting, wrestling, gymnastics, ice skating,

track/swim/bike sprints, throwing, diving, football

• Intermittent (stop and go) sports– Team sports: baseball, softball, basketball,

volleyball, soccer, lacrosse, hockey, football etc.– Individual sports: tennis, golf, etc

• Endurance sports– All long distance run/swim/bike, or combination;

some positions in soccer, lacrosse, etc.

For Comparison to Fad Diets Use Nutrition Needs of

an Endurance and a Power Athlete

Power / Strength Endurance

Weight Maintenance - Female

5’3” 125 lb (57kg)

Power/StrengthCalories (grams)

EnduranceCalories (grams)

Carb @5g/kg 1140 (285) @7g/kg 1600 (400)

Protein @1.6g/kg 360 (90) @1.2g/kg 275 (68)

Fat @ 25% cal 500 (56) @ 25% cal 625 (70)

Total Calories

2000 2500

Using low end of estimated needs with some rounding.

Weight Maintenance - Male Power: 6’3” 230 lb (105kg)

Endurance: 6’3” 200 lb (91kg)

Power/StrengthCalories (grams)

EnduranceCalories (grams)

Carb @5g/kg 2100 (525) @7g/kg 2560 (640)

Protein @1.6g/kg 675 (168) @1.2g/kg 450 (110)

Fat @ 25% cal 925 (103) @ 25% cal 990 (110)

Total Calories

3700 4000

Using low end of estimated needs with some rounding.

Endurance Female – “Fine Tuning” Weight/Fat Loss Advisable

5’3” 125 lb (57kg)

MaintenanceCalories (grams)

5’3” 135lb (61kg)

Weight LossCalories (grams)

Carb @7g/kg 1600 (400) @ 5g/kg 1259 (315)

Protein @1.2g/kg 275 (68) @ 1.4g/kg 341 (85)

Fat @ 25% cal 625 (70) @ 20% cal 400 (44)

Total Calories

2500 <500> = 2000

Power Male – “Basic Performance”Weight/Fat Loss Advisable

6’3” 230 lb (105kg)

MaintenanceCalories (grams)

6’3” 280 lb (127kg)

Weight LossCalories (grams)

Carb @5g/kg 2100 (525) @ 2.6g/kg 1315 (328)

Protein @1.6g/kg 672 (168) @ 1.4g/kg 710 (178)

Fat @ 25% cal 924 (103) @ 25% cal 675 (75)

Total Calories

3700 <1000> = 2700

The Appeal of Fad Diets

• Promise quick weight loss

• Provide a “plan”

• Have a certain sociability to them

Categories of Fad Diets

1. High Protein, High Fat, Low Carb

2. Lower Carb, Higher Protein, Moderate Fat

3. Low Fat and Very Low Fat

4. Moderate Fat, Nutrient Balanced

High Protein, High-Fat, Low Carb Fad Diets

• Atkins

• Protein Power

• Carbohydrate Addict’s Diet

Endurance Female5’3” 135 lb ≤ 10 lb Wt/Fat Loss Goal

Calories

(grams)

Est. Wt Loss

Needs

Atkins Phase 2a

Protein Power

Carb Addict’sa

Carb 1259(315) 140 (35) 224 (<56) 348 (87)

Protein 341 (85) 536 (134) 413(103)b 335 (84)

Fat 400 (44) 945 (105) 855 (95c) 801 (89)

Calories 2000 1621 1492 1484

Footnotes a, b and c – see separate slides following

Power Male6’3” 280lb ≥ 30 lb Wt/Fat Loss Goal

Calories

(grams)

Est. Wt Loss

Needs

Atkins Phase 2a

Protein Power

Carb Addict’sa

Carb 1315(328) 140 (35) 224 (<56) 348 (87)

Protein 710 (178) 536 (134) 756(189)b 335 (84)

Fat 675 (75) 945 (105) 855+ (95c) 801 (89)

Calories 2700 1621 1835+ 1484

Footnotes a, b and c – see separate slides following

High Protein, High-Fat, Low Carb Fad Diets

PRO

• Can adjust quantity by nutrient (fat or protein) to meet greater calorie needs

CON• Carbs provided are too

low to fuel athletic performance, even in off season

• Fatigue, irritability, constipation reported

• Atkin’s and Carb Addict’s have unisex diet levels where no calculations are based on current wt or activity level

Lower Carb, Higher Protein, Moderate Fat Fad Diets

• The Zone

• South Beach

• Sugar Busters

Endurance Female5’3” 135 lb ≤ 10 lb Wt/Fat Loss Goal

Calories (grams)

Est. Wt Loss

Needs

The

Zoned

South Beache

Sugar Bustersa

Carb 1259(315) 550 (138) 652 (163) 704 (176)

Protein 341 (85) 413(103)d 340 (85) 356 (89)

Fat 400 (44) 413 (46) 738 (82) 522f (58)

Calories 2000 1376 1730 1582

Footnotes a, d, e, and f – see separate slides following

Power Male6’3” 280lb ≥ 30 lb Wt/Fat Loss Goal

Calories (grams)

Est. Wt Loss

Needs

The

Zoneg

South Beache

Sugar Bustersa

Carb 1315(328) 1008(252) 652 (163) 704 (176)

Protein 710 (178) 756(189)d 340 (85) 356 (89)

Fat 675 (75) 756 (84) 738 (82) 522f (58)

Calories 2700 2520 1730 1582

Footnotes a, d, e, and f – see separate slides following

Lower Carb, Higher Protein, Moderate Fat Fad Diets

PRO• Zone could meet needs of power

athlete

• S. Beach close to meeting calorie needs of endurance athlete, if adj’d to swap calories from fat to carbs

CON• Zone compliance low due to

– Learning about and eating in“blocks” of carb/protein/fat takes effort

– Repetitious

• S. Beach and Sugar Busters – don’t use calculations based on

nutrient needs and wt, rather, they rely on athlete to make adjs without specific directions

– have too few carbs– fat too high for endurance/smaller

athlete– protein too low for power athlete

Low-Fat and Very-Low-Fat Fad Diets

• Ornish Diet

Endurance Female5’3” 135 lb ≤ 10 lb Wt/Fat Loss Goal

Calories (grams)

Est. Wt Loss

Needs

Ornisha

Carb 1259(315) 1032(258)

Protein 341 (85) 192 (48)

Fat 400 (44) 117 (13)

Calories 2000 1341

Footnote a – see separate slide following

Power Male6’3” 280lb ≥ 30 lb Wt/Fat Loss Goal

Calories (grams)

Est. Wt Loss

Needs

Ornisha

Carb 1315(328) 1032(258)

Protein 710 (178) 192 (48)

Fat 675 (75) 117 (13)

Calories 2700 1341

Footnote a – see separate slide following

Low-Fat and Very-Low-Fat Fad Diets

PRO• May be a good

framework for vegetarians if modified for increased calories (from plant protein and fat) to more closely meet needs

CON• Protein too low to

maintain lean mass• Very low fat level could

contribute to cravings• Very low calories• People on this diet often

belong to support groups to help them sustain the lifestyle changes it requires

Moderate-Fat, Balanced-Nutrient Diets

• 2005 MyPyramid

• Weight Watchers• Jenny Craig

• Nutri-Systems

Endurance Female5’3” 135 lb ≤ 10 lb Wt/Fat Loss Goal

Calories (grams)

Est. Wt Loss

Needs

Weight Watchersa

My

Pyramidh

Carb 1259(315) 826 (207) 1056(264)

Protein 341 (85) 292 (73) 392 (98)

Fat 400 (44) 378 (42) 558 (62)

Calories 2000 1496 2006

Footnotes a and h – see separate slides following

Power Male6’3” 280lb ≥ 30 lb Wt/Fat Loss Goal

Calories (grams)

Est. Wt Loss

Needs

Weight

Watchersa

My Pyramidh

Carb 1315(328) 1100(275) 1325(331)

Protein 710 (178) 400 (100) 500 (125)

Fat 675 (75) 500 (56) 700 (78)

Calories 2700 2000 2525

Footnotes a and h – see separate slides following

Moderate-Fat, Balanced-Nutrient Diets

PRO• Wt Watchers can be adjusted

(carbs) to generally meet the needs of endurance athlete.

• MyPyramid is generally in line with needs of – endurance may need to adjust

between carb and fat cals– Power athlete may need to adjust

between protein and carb cals

CON• A Wt Watchers plan may

be a way to organize an athlete, but their participation in the weekly program isn’t likely.

• Athlete may be reluctant to take the time to plan out the MyPyramid food group info into a meal plan.

• Both WW and MyPyramid need some adjustment between nutrients

SummaryDiet Meets Endurance

NeedsMeets Power Needs

Atkins No No

Protein Power No No

Carb Addict’s No No

Zone No Yes

South Beach Maybe, with adj No

Sugar Busters No No

Ornish No (vegetarian,yes?) No

Weight Watchers Maybe, with adj No

MyPyramid Maybe, with adj Maybe, with adj

Footnotes for Sources and Calculations of Nutrition

Values of the Diets

• a- Nutrient values from “Popular Diets, A Scientific Review,” MR Freedman, J King, E Kennedy, Obesity Research, Vol 9, Suppl 1, March 2001, pp 11S, 12S.

• b- Calculated at 0.9g protein per pound lean body mass (assumption 85% for endurance female, 75% for power male) recommended by diet, p 94, in Protein Power, MR Eades and MD Eades. 1996. All other values claculated per instructions based on protein.

Footnotes for Sources and Calculations of Nutrition

Values of the Diets• c- The diet does not limit or specify an amount for fats

and oils, but does specify the types: olives, nuts, seeds, avocados, and their oils, butter. An average of the Atkins and Carb Addict’s fat grams was used.

• d- “Very active” activity factor of 0.9 times lean body mass (assumption of 85% for endurance female, 75% for power male) per diet, p 80, The Zone, B Sears, 1995. All other values calculated per the diet’s instructions based on protein.

Footnotes for Sources and Calculations of Nutrition

Values of the Diets

• e- All nutrient values from analysis of Day 1 menu of Phase 2 plans, p 184, The South Beach Diet, A Agnatson, 2003.

• f- Includes 98 calories (14g) from alcohol allowed in the diet per footnote “a”.

Footnotes for Sources and Calculations of Nutrition

Values of the Diets

• g- Weight Watchers uses a point system that translates into calories. Power male values were calculated based on distributions of the female athlete (see “a”) at the same <500> calorie difference from “wt loss needs” calories.

• h- 2000 calorie values from www.mypyramid.gov for endurance female were adjusted at same distribution of carbs, protein and fat for 2500 calories for power male

What Works Best for Weight/Fat Loss…

…When it is Advisable and Appropriate?

When Weight Loss IS Advisable- General Guidelines

1. Weight loss is best done in the OFF-SEASON– Avoid weight gain in the off-season

2. Have reasonable EXPECTATIONS– Athletes are often already fairly lean– Smaller weekly wt loss retains more lean mass,

promotes fat loss• 0.5 – 1.0 lbs per wk for smaller or leaner athletes• 1.0 to 3.0 for larger or fatter (by % body wt) athletes

When Weight Loss IS Advisable- General Guidelines

3. Get regular, adequate, restful SLEEP• Important because

– Repair and maintenance occur– Growth hormone peaks lean mass growth/retention– All systems reset, regulatory hormones rebalance and restore

• Possible problem areas– Environment– Neurochemical imbalances – Emotional problems/stress

• Know referral sources

When Weight Loss IS Advisable- General Guidelines

4. Adjust TIMING of meals and snacks to provide fuel throughout the day– Breakfast most days– Keep it light at night

• Eat every 3-4 hours during the day

• More sophistication is possible on this issue…a topic for another session

When Weight Loss IS Advisable

- General Guidelines5. Based on “whatever you eat now,” identify

ways to cut out needless calories– <300-500> calories per day for smaller

athletes– <500-1000> calories per day for large

athletes– Chose one or more ways to easily

cut out calories depending on the athlete’s usual habits

Reducing Calories…Four Easy Ways

1. Cut down on (saturated) fat2. Don’t drink useless calories3. Eat out less4. Eliminate a high-calorie or large

quantity snack (when it’s not needed for energy or recovery)

Reducing Calories

Cut Down on (Saturated) Fat• Use Less:

– Fried foods, cream sauces, gravy– High fat meats: sausage, bacon, hot dogs, salami, etc.– Salad dressing and mayo (the regular-fat versions)– Whole fat versions of milk, yogurt, cheese, ice cream

• Use More:– lean protein sources like chicken, turkey, fish/tuna, deli meats, beans,

lentils, egg whites or egg substitutes, low fat cottage cheese– 1% or fat free dairy products, low-fat cheese (≤5g fat/oz)– Olive and canola oil (look for them in dressings), nuts and nut butters,

seeds, avocado, olives

• Read labels:– < 3 grams total fat per 100 calories – Cheese: 5 g or less fat / 1 oz.

Reducing Calories

Don’t Drink Useless Calories

Avoid• 12 oz juice, lemonade,

punch ~ 180 calories (cal)• 20 oz bottle of fruit juice ~

300 cal• 12 oz whole milk = 225 cal• 12 oz soda = 150 cal• Grande carmel macchiato =

310 cal• Red Bull (8 oz) = 120 cal• 12 oz beer = 150 cal• 5 oz wine = 110 cal

Use• 12 oz V-8 = 70 calories

(cal)• 12 oz flavored water = 0 cal• 12 oz crystal light = 0 cal• 12 oz fat free milk = 135 cal• 12 oz diet soda = 0 cal• Tall non-fat latte = 120 cal

Reducing Calories

Eat Out Less

• When eating out– Hold the cheese, sauces, mayo– Order salad dressing on the side, use less– Order grilled, baked, broiled, roasted– Marinara is a lot less calories than alfredo– Avoid bread before your meal– At fast food places, get the smallest sizes of

anything, and avoid fried items and regular sodas

Reducing Calories

Eliminate High-Calorie or Large Quantity Snacks…

when they’re not needed for energy or recovery

High Calorie• 3 small/large cookies =

180/400 calories (cal)

• Snickers = 240 cal

• 8 Twizzlers = 280 cal

• 2.2 oz bag Skittles = 240 cal

• 20 oz smoothie ~ 450 cal

• 1C Goldfish crackers = 325

• Coffee drinks = 250-600 cal

Large Quantity• 2 bowls cereal and milk =

400 cal (low sugar, low fat)

• ½ medium cheese pizza = 1000 cal

• 5 oz bag chips ~ 750cal

• 4 beers = 600 cal

• 1 cup (baseball-sized) regular ice cream, frozen yogurt = 300 cal

Make “clean fuel” choices most of the time for less calories and more

“quality” fuel for performance

• More frozen low fat entrees – ≤3g fat for every 100 calories

• More soups and low fat stews and chili– ≤3g fat for every 100 calories

• More fruit, vegetables (fresh, frozen, canned )• Look for “whole or 100% grain” as first ingredient

in breads, crackers, and cereals• More low fat milk, yogurt, cottage cheese• More lean protein: meats, chicken, fish, beans, nuts

(fresh, frozen, canned)

So… they ask you:

“How should I lose weight?”

(and they mean “fat weight”)

Athletic Trainer’s Checklist

1. Why do you want to lose weight/fat?– Based on what information?

(This is a topic for an additional session)

Athletic Trainer’s Checklist

2. Check on non-food aspects of their training and life that may have an impact on performance or get in the way of weight/fat loss.

• Does your training plan need updating?• Are you working hard?• Are you getting plenty of fluids?• Is sleep adequate and restful?• Are you timing food throughout the day?• How is your “mental game?”

• Stress/worry/anxiety: personal, financial, overload, etc?

Athletic Trainer’s Checklist

3. Where could you cut out 300-1000 calories a day (depending on the athlete’s size and circumstances)?

• Cut down on (saturated) fats• Don’t drink useless calories

– Eliminate alcohol

• Eat out less• Eliminate high-calorie or large quantity

snacks where they are not needed

Resources and References

For a copy of this presentation, go to the University of Arizona’s

Campus Health Service website at www.health.arizona.edu

– Click on “On-line library,” go to “Nutrition,” then to “Sports Nutrition”

Resources and References

• Burke L and Deakin V. Clinical Sports Nutrition – 2nd Edition. 2000. McGraw Hill Book Company, Roseville, Australia.

• Clark, N. Nancy Clark’s Sports Nutrition Guidebook, 3rd Edition. 2003. Human Kinetics, Champaign, IL.

• Freedman, M, King, J, and Kennedy, E. Popular Diets: A Scientific Review. Obesity Research. March 2001; Vol 9, Suppl 1: pp 1S – 40S.

• Liebman, B. Weighing the Diet Books. Nutrition Action Healthletter. Jan/Feb 2004; pp 3-8.

Resources and References

• Manore,M and Thompson J. Sport Nutrition for Health and Perofrmance. 2000. Human Kinetics, Champaign, IL.

• Rosenbloom, CA (Editor). Sports Nutrition – A Guide for the Professional Working with Active People. 2000. The American Dietetic Association, Chicago, IL.

• www.gssiweb.com (Gatorade Sports Science Institute). Search for your topic of interest.

• www.mypyramid.gov for 2005 MyPyramid info and resources.

Thank you!to the

University of Arizona Athletic Training Staff

for their valued input and support

in preparing this presentation

The End