Lisa Dorfman, MS, RD, CSSD, LMHC, FANDThe Running Nutritionist®

Working With Competitive AthletesAn Integrative, Evidence-Based

Approach for Assessing & Formulating Performance Nutrition© Programs

Thank You

Kory DeAngelo, MS RDN CD

&

Amy Jarck

Executive Board & Fellow Members

Dietitians in Integrative & Functional Medicine

Professional Disclosure

No paid Company Affiliations

No Conflicts of Interest

Objectives

This webinar will:

1. Describe priorities for the Integrative Sports & Performance

Dietitian.

2. Perform step-by-step integrative dietary assessment &

evaluation.

3. Identify challenges, road blocks & potential consequential

dietary deficiencies.

4. Address performance eating opportunities & options for

gluten free, lactose free, vegetarian & FODMAP free athletes.

5. Select biochemical tests for evaluating nutritional status.

6. Decide if, when & safety of supplements to correct

deficiencies, reach optimal health & performance.

7. Tools & Resources

Who Am ILisa Dorfman, MS, RD, CSSD, LMHC, FAND

Integrative Sports & Performance Nutritionist—30 years+

Licensed/Registered Dietitian (LD/N, RD)

Board Certified Specialist in Sports Dietetics (CSSD)

Licensed Mental Health Counselor (LMHC)

Certified UST&F & USA Triathlon Performance Coach

Academia:

Former Director Graduate Degree Program Nutrition for Health & Human Performance, Department of Kinesiology & Sports Sciences, University of Miami

Education:

4 years, U Miami Miller School of Medicine—Integrative & Functional Medicine Program

Academy of Nutrition & Dietetics:

AODA Country Representatives Chair—’16-’18 ( Media Rep ‘15/’16)

Academy Media Spokesperson, SCAN PR;

3 x DPG Chair: CN, VN, BHN

DIFM Certification Task Force Committee Co-Chair;

CSSD Certification Task Force Committee Co-Chair; CDR Certification Committee; DIFM—Nominating Committee ‘15-’16

My Integrative Professional “Climb”

Lifelong athlete, aspiring Musician, carnivore to vegetarian @ 15 y/o

Unexpected Life events-18 y/o Hit by Drunk Driver

Changed Majors, Moved to Miami ’80

BS, MS Dietetics and Nutrition-FIU

Post Grad PhD-Miami Institute of Psychology

4th year UM Medical School Integrative & Complimentary Medical

Program (ICAMP)

Credentials:

Licensed/Registered Dietitian (LD/N)

Licensed Mental Health Counselor (LMHC)

Board Certified Specialist in Sports Dietetics (CSSD)

Certified Level I -ISAK (Int’l Society for Advancement of Kinanthropometry)

Certified FNGLA Horticulture Professional

Certified Reiki Therapist

Certified USAT&F, USAT, & USA Swimming Coach

Personal Performance Nutritionist & Coach20+ individual & team sports

US Olympic/ Paralympic Sailing Team Nutritionist, Beijing ‘08—Gold/Silver medals

RIO—Nutritionist for Gold Medalist Tennis Player

ZUMBA® Plate Nutrition Expert

USAT&F world champion, gold medalist in 4x100

World Middle Weight Boxing Champion—Jermain Taylor

US Swimming—Olympic Gold Medalist

‘16 World champion figure skaters

Umiami Sports Nutritionist ’03-’10, 13 teams

NFL, NBA, MLB, USTA

Tae Kwan Do Junior US champions/ Pan American Game Competitors

Rowers-National Junior Gold Medalists

Gymnasts-junior champion gymnasts

Olympic Divers

Junior Olympic (JO) Development Coach—USA Triathlon

Award Winning Actors -Avengers, Gone Girl, Book Thief, Ironman 3, 13 Hours,

Glades

Sports & Performance Nutritionist

NFL, NBA, MLB, USTA, US Boxing

US Olympic Paralympic Sailing Team Nutritionist Beijing ‘08

World Middle Weight Boxing Champion—Jermain Taylor, Michael

Oliviera …

Miami City Ballet Dancers; Julliard School of Performing Arts, NYC

Award Winning Actors -Avengers, Gone Girl, Book Thief, Ironman 3,

Glades

Nutrition Expert for Zumba Plate™ Program w/ Drs Hyman & Barnard

Author: 8 books

Book Chapters: Krause's Food & The Nutrition Care Process, 14th Edition,

23, Nutrition for Exercise and Sports Performance. (2016)

TV/Print CNN,ESPN,MSMBC,E, Good Morning America, 20/20, Dateline

NYT, WSJ, USAToday, Runners World, Men’s Health, Food & Wine, Shape, O

Co-Founder—cTHRU Nutrition App

Sony Entertainment Latin America, Miami Nutritionist

Culinary, Coaching, Counseling, Communications

Professional Background: Education & Communications

Author Sports & Performance Nutrition Books

Faculty, My SportsDUniversity https://mysportsduniversity.com/aboutus/

Sports Nutrition Handouts (Momentum Media)

Co-Founder/Chief Nutritionist- CTHRUNutrition Global Mobile App

www.cthru.in

Personal Disclosure

Lifelong Athlete! Professional Triathlete’92-98

Racing 30+ years, Vegetarian, Injury & Anemia FREE 25-40 events/year

High School—T&F, X-Country, Basketball, Softball

Adult:

35 marathons (PR 2:52)

TEAM USA Member, World Championship Frederica, Denmark, ‘04, (qualified

‘10 Budapest, Hungary)

Biased:

I believe Nutrition is 99% of sports performance success!* Photo credit Damian Stephens

Lets Get Started

What Are Top Priorities

of Sports Dietitian?

THE ATHLETES!

Fresh off ’16/’17 The Year of the Athlete!

Summer & Winter Olympic Games

Summer

≥ 200 nations, International Olympic Committee (IOC)

compete

42 sports.

306 events

19 days competition

28 sports, 41 disciplines

≥ 10,500 athletes

“Live your passion”Rio Olympics THEME

As Sports Dietitians we do the same!

We Help Athletes Attain Their DreamsMaintain Optimal Health & Performance

with Dietary Fuel

We can ALL assist our athletes

with food strategies

to attain OPTIMAL HEALTH

& Performance

We Can & Need to Personalize Performance

Nutrition for Athletes

To help them to achieve their Gold Medal in

Optimal Health, Sport & Life!

Sports Performance is a JourneyTime & Dedication = Success

Training + Diet

Integrative Sports Nutrition

Food-Centric

Food + Fluids

= performance success

energy, power,

endurance

Thomas DT1, Erdman KA2, Burke LM3.Position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and

the American College of Sports Medicine: Nutrition and Athletic Performance. J Acad Nutr Diet. 2016 Mar;116(3):501-

28.

Integrative Sports & Performance Nutrition

Considers ALL factors for

Assessing

Assisting

Guiding clients in selecting foods, fluids

& supplements when warranted

Match Diet to Training

Called:

“Nutritional Periodization”

Type/quantity

Quality & TIMING of fluid/foods

as it relates to specific workout regimens, season & competitive schedule

Also Deal & strategize w/ athletes on specific Issues:

Supplements, weight management, injury/illness , eating disorders prevention, nutrient deficiencies

BUT

Eating Well is Complicated for Athletes

Reality: More Than Nutrition Science

Integrative:

Physical

psychological

Emotional

Social

Spiritual

Cultural

Impacted by:

Self, family, friends, sports, health, preferences, economics, availability,

peer pressure, drugs/alcohol, self esteem/image, medications, mood,

food trajectories

Not Always Easy to Make Healthy Food Choices

Athletes Needs Lots of Calories

But Often Don’t Eat Enough

Eating Well Subject to InterpretationInfluenced By Athlete, Coach, Family, Friends & Internet

Need a lot of protein

Carbs good? Bad?

Fats good or bad?

Fast food bad?

Milk & Gluten Not good?

Calorie control?

Paleo or Vegetarian?

Supplements or not?

Good taste

Sometimes Look for Quick Fix

Often, Nutrition NOT a Priority Until….

Athlete Faced With Challenge Lack of Energy

Dehydration/Cramping

Illness

Injury/stress fractures

Eating disorder

Amenorrhea

Steroid/drug use

Weight loss/gain

Overtraining/poor recovery

Drop in performance

Role of Integrative Sports Dietitian

Guide & Motivate Athletes

to Make THEIR Best Dietary Decisions

to Attain & Maintain Optimal Health in Sport & Life

Priority

Help Athletes Achieve Dietary Balance

Attain

“Ideal Performance State” (IPS)

How do we Help them to Achieve IPS?

w/ Integrative Sports Nutrition Assessment

IFMNT RadialNutrition Intervention Influenced by 5 key areas

Lifestyle

Systems Signs/Symptoms

Core imbalances

Metabolic pathways

Biomarkers

Ford D et al. J Am Diet Assoc. 2011 Jun;111(6):902-913.e1-23

Integrative Nutrition Assessment

“Whole” Systems Approach

KEYs:

1. Understand lifestyle, cultural, social, familial & spiritual factors

2. Perform Dietary & Body Composition Assessment

3. Order -Conventional & functional labs as needed

4. Provide Personalized Nutrition Intervention

Can Include: Medical Nutrition Therapy, Psychotherapy mind-body

modalities, culinary coaching, & supplements as needed

Priority Equip Yourself With Skills & Tools for

Complete Assessment

Nutrition Focused Physical Assessment

Tools Used in Practice

Step by Step Assessment

1. Nutrition Activity Assessment©

Prior to appointment –to determine game plan for initial consultation

2. Meet with Client-Interview LISTEN, WHAT ARE THEIR GOALS

3. Measure-Weight/Body Mass Index—(BMI), Body Comp assessment, circumference, Body fat %, FFM

4. Assess Diet—3 to 7 day to determine DIETARY deficiencies & excesses

5. Biochemical analysis –

As needed & affordable to rule out and/or consider dietary opportunities—i.e., deficiencies, food sensitivities, dysbiosis, malabsorption, gluten or lactose intolerance, nutrigenomic support for dietary Rx

(IFM) Integrative Documentation

Institute of Functional Medicine-Timeline & Matrix

Membership, Education, Certification, Practitioner Tools

Tools for Your BoxEarn your CSSD Credential

Get ISAK Certification for Accurate Body Comp

Measurement testing

Take Integrative Courses, Get DIFM Certified!

Become Lab Savvy—do your homework—

Vitamin/Mineral, Nutrigenomic

Develop and/or Find simple tools/handouts

Consider IFM Membership—tools/menus

Determining Dietary Needs

Fuel from Food

Not Static, Changes with Training Calendar

Recovery & Overall Health

How Much Energy (Calories)?Food & Nutrition Board of Institute of Medicine’s (IOM)

Estimated Energy Requirements (EER)

~45 calories/kg FFM/Day =Energy Balance & Optimal Health

≤30 calories/kg FFM/day

associated with EA Issues-low EI, High TEE

Female Athletic Triad (FAT)

Thomas DT Position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and Athletic Performance. J Acad Nutr Diet. 2016 Mar;116(3):501-28

Calculating Calorie Needs

Components of formula Influences on Expenditure of calories

1. BMR (Basal Metabolic Rate) Genetics (40 percent), weight, size,

age, health, body comp, exercise level,

diet.

2. EEPA (Energy Expended for PA) Weight, body composition, muscle

(planned, spontaneous fiber, training intensity/duration, diet.

non exercise)

3. TEF Weight, size, diet composition, health.

(Thermic Effect of Food)

Calculating Athlete Needs

1. BMR -Cunningham Equation:

BMR (calories/day) = 500 + (22 x Lean Body Mass in kg)

60-80% TEE-Sedentary, 38%- 50% for elite endurance athletes

2. EEPA by weight x min in activity and/or factor

1.200 sedentary – 1.9 very hard training

3. TEF

(BMR + EEPA) x 10% = SDA

TEE requirements = BMR + EEPA + TEF

Diet Composition

Approximately—(TBD):

55 - 60% total calories-carbs

12- 15% total calories -protein

25 - 30% total calories -fat

Must be personalized

Timing critical

Training Vs Competition

CHO & Protein (g/kg) to accommodate body

sizes & training volume/intensity

What Does Athlete want to eat????

Thomas DT1, Erdman KA2, Burke LM3.Position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and Athletic Performance. J Acad Nutr Diet. 2016 Mar;116(3):501-28. doi: 10.1016/j.jand.2015.12.006.

Carbohydrates are Key!

Primary energy source-anaerobic/aerobic sports

Physical & mental performance

Spare muscle/recovery

Immunity

Prevent overtraining syndrome

Mood

Carbohydrate GuidelinesLight •Low intensity or

skill-based activities

3-5 g/kg of athlete’s

body weight/d

(68kg)

204-340g

Timing of intake of

carbohydrate over the day may

be manipulated to promote

high carbohydrate availability

for a specific session by

consuming carbohydrate

before or during the session,

or during recovery from a

previous session

•

Otherwise, as long as total fuel

needs are provided, the

pattern of intake may simply

be guided by convenience and

individual choice

•

Athletes should choose

nutrient-rich carbohydrate

sources to allow overall

nutrient needs to be met

Moderate •Moderate exercise

program (e.g., ∼1 h/d)

5-7 g/kg/d

(68kg)

340-476g

High •Endurance program

(e.g., 1-3 h/d

moderate to high-

intensity exercise)

6-10 g/kg/d

(68kg)

408-680g

Very high •Extreme

commitment (e.g., >4-

5 h/d moderate to

high-intensity

exercise)

8-12 g/kg/d

(68kg)

544-816g

Thomas DT1, Erdman KA2, Burke LM3.Position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and Athletic

Performance. J Acad Nutr Diet. 2016 Mar;116(3):501-28. doi: 10.1016/j.jand.2015.12.006.

Carbohydrates

Emphasize

Nutrient dense

Low glycemic

Whole grains—3 oz. or 48 grams

Phytonutrients

Fiber: 25-40 g/d

Watch added fats, fried & additives

such as sauces, dressings, butter, &

oils

Watch Sugar: Target 10% total Cal

~25-50 grams /day-

4 grams for every tsp

Protein

Daily:

1.2 – 2.0 g/kg/d

2-2.3g/kg for making wt./low cal

≥ 2.4 gm/kg/d- no added value

Example:

Wt. = 150 pounds/68kg

81 – 136g/day

Post training: 0.25- 0.3g/kg

(about 15-25 Gms)

Over 40g, no added value

Go for:

Pre workout EAA w/ Carbs to

stimulate MPS

Blend proteins (w/carbs) best for

MPS post w/o

Evenly divided meals w/ 30-45 g

p/meal = greatest association

with leg lean mass/strength

Animal or plant based

Strategies for Improving Protein Quality

ProteinLimit PRO-Inflammatory!

Fried

Processed

Trans fats

Most Fast foods

High Sat fat

Whole milk dairy, eggs

Vegetarian also adequate—tofu,

tempeh, beans, nuts, vegetables

Emphasize Healthy Fast Food!

Fats

Long term energy

Absorbs fat soluble vitamins A,D,E,K

Fat Type more important:

omega 3s & mono fats-fish, nuts, olives/oil

How much?

Individualized-weight gain? Loss?

Train Low, compete high? Keto?

30-35% total Calories, 2000 cal.—66-77grams

Saturated fats ≤10% total

Trans Fat ≤ 1% total

Fluids Daily:

2.7 liters –women (95 oz./d, 12c)

3.7 liters –men (130 oz./d, 16 c)

Pre Workout

~14-22 oz water/sports drink

400 to 600 mL

During Workout

6-12 oz. /15-20 minutes—cool

150 to 350 mL

AFTER WORKOUT

25% to 50 % more than existing

weight loss

16-24 oz. water/sports fuel

450 to 675 mL

0.5 -0.7 g/Na/L if ≥ 1 hour w/o

When & What to Eat?

1- Food Timing

Balanced meals

2-3 snacks

Pre & Post Training Fuel

Training Vs. Competition Fuel

Eat & drink foods & fluids

support performance

not hinder it

Training Vs Competition Diet

Eliminate Alcohol/Energy Drinks

Ensure Safe Supplements

Training Carbs

ALWAYS INDIVIDUALIZED

Before:

1 -4 g/carbs/ kg/BW

1-4 hours before:

Avoid spices, fibers, fats

During:

Less than 1 hour: NONE

During 45-75 min- small amounts,

1-2.5 hours: 30-60 g/hr.

2.5-3 hrs. +: up to 90g/hr.

After for Quick Recovery:

1-1.2g/kg carbs/hr., 1st 1-4 hours

then normal amts after

High in carbs/moderate in high

quality protein

High-glycemic index carbs

(SUGAR!) for immediate

recovery

Thomas DT1, Erdman KA2, Burke LM3.Position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and Athletic Performance. J Acad Nutr Diet. 2016

Mar;116(3):501-28.

CHO—Acute Refueling Strategies

Acute fueling strategies – These guidelines promote high carbohydrate availability to promote optimal performance during competition or

key training sessions

General fueling

up

•Prep events

<90 min

7-12 g/kg/24 h•

Athletes may choose

carbohydrate-rich sources

that are low in fiber/residue

and easily consumed to

ensure that fuel targets are

met, and to meet goals for

gut comfort or lighter

“racing weight”Carbohydrate

loading

•Prep events

>90 min of

36-48 h of 10-12

g/kg bw/24 h

Speedy

refueling

<8 h recovery

between 2/day

workouts

1-1.2 g/kg/h 1st

4 h then resume

daily fuel needs

•

There may be benefits in

consuming small, regular

snacks

•

Carbohydrate-rich foods

and drink may help to

ensure that fuel targets are

met

FODMAP, Gluten Free, Lactose Free?

Sensitive Gut, FODMAP and/or Natural Gluten Free

Fuel Options

Recovery Fuel— Protein + Carbs

150 lb. (68kg) athlete needs:

68-81 gms carbs

17-20 gms pro

Protein 0.25-0.3 g/kg Carbs 1-1.2 g/kg

Quick & easy:

Chocolate “Milk” Options-Organic, Almond

Single Portion Shakes

Sports drinks/bars

Nut Butter & Jelly Sandwich

Do Athletes Need Supplements?

Do Athletes Need Supplements?

Dietary deficiencies ID-blood or diet analysis

Imbalanced diets—fast- and processed-food dependent, alcoholic drinkers, travelers

Clinical issues: anemia, GI Bypass, IBS, Celiac, Lactose

Taking prescription medications or recreational drugs

Vegetarians, vegans, or those on restrictive diets which eliminate whole food groups such as dairy or grains.

Allergies, food sensitivities or personal aversions where whole food groups are eliminated or avoided (like dairy, whole grains, or meat).

Eating disorders or who are undernourished due to low-calorie dieting

Functional Blood test indicates need

Evidence Suggests

Deficiency Impacts

Overall Health & Performance

WITHOUT adequate amounts, calories, carbs

= dietary deficiencies = compromised training,

performance & overall health

i.e. immune, bone, hormones, mental wellness….ENERGY!

McClung JP, et al. J Trace Elem Med Biol. 2014 Lukaski HC. Nutrition. 2004

Evidence Suggests Athletes Deficient

Do not meet the Estimated Average Requirement

(EAR) & RDI/A.

48% + females

Do not meet - folate, calcium, magnesium, iron

44% + men

Do not meet -vitamin A, vitamin C, Vitamin D,

folate, calcium, magnesium

McClung JP, et al. J Trace Elem Med Biol. 2014 Lukaski HC. Nutrition. 2004

Assess!

3-7 day food and fluid diary

Vitamin/mineral testing

Metabolic testing

Nutrigenomic testing

Why Food First?

Why Food First?

1-Food/Eating Drives Energy Levels

2-Food compounds work synergistically

3-Nutrition young -new compounds discovered

4-Supplement Safety— poorly regulated, tested.

Might Be Getting Enough!

Nutritionally savvy athletes

How much is enough?

Wholesome nutritious foods- high level

nutrients

+ Additional Fortification

Extras consumed?

= Potentially exceeding dietary needs

Increases risk for adverse reactions

Supplements for Insurance?

MVI –no performance benefits except in deficiency states

May contain much higher or lower doses then recommended

Athletes at risk- above UL -if consuming fortified foods, sports

drinks, bars, beverages.

Risk of GI distress, headaches, nausea, cramps—NOT

PERFORMANCE ENHANCING

Daly RM et al. Curr Osteoporos Rep 2014; McClung JP, et al. J Trace Elem Med Biol. 2014http://www.ausport.gov.au/ais/nutrition/supplements/groupa.

Food First, Create & Educate

Performance Supplements ?

IOC & AND Position Statement

“Dietary supplements or ergogenic aids

never substitutes for genetics, training & optimal

nutrition”

“It’s a personal Choice; remains controversial.”

AISAustralian Institute of Sport

“Supplement use involves balance”

Between

“potential benefits contribution to evidence-based

sports nutrition program

&

potential risks waste of resources, distraction, poor role

modelling, anti-doping rule violations”

AIS Nutrition & Supplementshttp://www.ausport.gov.au/ais/nutrition/supplements

Performance SupplementsGreen = strong evidence Amber = moderate/emerging Red =lacks evidence/banned

Close GL1, Hamilton DL2, Philp A3, Burke LM4, Morton JP5. New strategies in sport nutrition to increase exercise performance. Free Radic Biol Med. 2016 Feb 5. pii: S0891-5849(16)00030-7.

Safety Issues

Global Issue

Validity, Safety, Quality & Identity

www.ConsumerLab.com , 4,500+ products tested (11/99-)

Failures-

#1 too little/none main ingredient

Wrong ingredient; potentially dangerous/illegal

ingredients; contamination w/heavy metals

"spiking" w/unexpected ingredients;

Poor disintegration (affects absorption)

Misleading/incomplete product information

• 20% vitamins/minerals

• 43 % herbals

• 21% Other supplements

• 24% powders/drinks

McClung JP, et al. J Trace Elem Med Biol. 2014

Amphetamine cmpd sold as botanical

extracts- Acacia rigidula & BMPEA

Found in :weight loss, cognitive function, enhanced athletic performance

Contains plant extract called Acacia rigidula

beta-methylphenylethylamine (BMPEA).

BMPEA -synthetic compound closely related to amphetamine.

Safety not tested in humans,

Animals-Increase blood pressure & heart rate

“Since the FDA discovered BMPEA in supplements, supplements containing

Acacia rigidula & BMPEA has increased, 42.9% (2012 )to 52.4% (2014)

Cohen PA et al.An amphetamine isomer whose efficacy and safety in humans has never been studied, β-methylphenylethylamine (BMPEA), is found in multiple dietary supplements. Drug Test Anal. 2015 Apr 7.

NY Attorney General

Targets Supplements 2/15

GNC, Target, Walgreens, Walmart

4/5 products did not contain any herbs on labels.

Cheap fillers:

• powdered rice, asparagus & houseplants, some w/

substances dangerous for allergies.

Walgreens- Ginseng pills: powdered garlic & rice.

Walmart- Ginkgo biloba: powdered radish, houseplants & wheat — despite label wheat/gluten-

free.

Target — ginkgo biloba, St. John’s wort and valerian root —0 herbs, powdered rice, beans, peas

& wild carrots.

GNC: unlisted ingredients, fillers, powdered legumes, includes peanuts, soybeans

http://well.blogs.nytimes.com/2015/02/03/new-york-attorney-general-targets-supplements-at-major-retailers/

Better Safe than Sorry

GMP/NSF-plant-manufacturing

• USP-purity

• ConsumerLab-off shelf testing

For Pro Sports:

• NSF for Sport

• Informed Choice

• BSCG

Next Steps

Do Athletes Need To Change Diet?

1. How do they look?

2. How do they feel? Energetic?

3. Do they have headaches? Brain fog?

4. Does their body’s ache, cramp?

5. Do they go to the bathroom-regularly?

6. Are they moody?

7. Do they get frequent colds?

8. Do they sleep 6-8 hours night soundly?

9. Are they getting in better shape? Healthier?

Take a Closer Look

Write down:

Everything they eat in 24 hour period

Always ask yesterday –Morning to night (and beyond)

Time, Food & amount

Food Condiments & candies

Alcohol, soda, juice, drink

Add:

Exercise/activity

Hunger level

Sleep

Stress

Look for Weak Link:

Carbohydrates-4 cal/gm.

Protein-4 cal/gm.

Fat-9 cal/gm.

Vitamins

Minerals

Water/fluids

Also

Peri Training Fuel

Snack habits

Hydration

Electrolyte replacement

Alcohol & recreational drug use

Sleep & Stress!

1.Timing of meals— How many meals/times each day are they

eating?

2.Portion size- How big is their Biggie? Whopper? Grande Latte?

3.Variety- Colors, “food jags”—eating same foods day after day,

i.e. cereal, granola bars, etc.

4.Fluid intake- Do they drink enough? What are they drinking?

5.Hunger vs. appetite? Why do they eat when they eat?

Diet Balanced? Nutritious?

Resources

Integrative Nutrition

DIFM DPG

SOP/SOPP

DIFM TOOL KIT: https://integrativerd.org/resources-2/

Learn More:

Integrative & Functional Nutrition (DIFM)

SOP/SOPP

DIFM Certificate of Training

https://cpd.webauthor.com/modules/edu

Institute of Functional Medicine-Timeline & Matrix

Membership, Education, Certification, Practitioner Tools

https://www.functionalmedicine.org

Integrative & Functional Nutrition Training/Certification

Fellow DIFM Members, IFN Pioneers

http://nextlevelfunctionalnutrition.com/

https://www.ifnacademy.com/

Sports Nutrition Resources

SCAN Sports, physical activity, cardiovascular health,

wellness, and the prevention & treatment of disordered eating

& eating disorders.

CSSD –Board Specialty Certification

http://www.scandpg.org/

Sports Nutrition Resources

SCAN www.scandpg.org

Sports, physical activity, cardiovascular health, wellness, and

the prevention & treatment of disordered eating & eating

disorders.

CDR

CSSD –Board Specialty Certification

Sports Nutrition Resources

Collegiate and Professional Sports Dietitian Association

http://www.sportsrd.org/

Advocates for sports dietetic positions

to operate in nutrition related functions

for athletic & military programs

Sports Nutrition Resourceswww.EatRight.org

The 6th edition of Sports Nutrition: A Handbook for Professionals, will be

available June 2017

Sports Nutrition Care Manual® (SNCM)

AIS Nutrition & Supplementshttp://www.ausport.gov.au/ais/nutrition/supplements

American Academy of Sports Dietitians & Nutritionists

501 (c) 6 non-profit organization with the mission to provide health

professionals with sound, scientific nutrition programs, under the

guidance of licensed dietetic professionals, to help increase access to

nutritional services.

RDs on Team

FREE Handouts

http://www.aasdn.org/programs/nutrition-handouts/

Supplement Resources

Natural Products Association

Vitamin/Mineral/Herb/Supplement Guide

FREE

http://www.naturalproductsinfo.org/index.php?submenu=About&src

=gendocs&ref=DietarySupplements&category=About

http://ods.od.nih.gov/

Supplement Safety Resources

WADA

https://www.wada-ama.org/

Consumer Lab www.Consumerlab.com

publishes reports on dozens of supplement categories &

hundreds of name brand products at their website.

FREE Newsletter:https://www.consumerlab.com/list.asp

Subscriptions ($): www.consumerlab.com.

Supplement Resources

Examine.com

Founded 2011• Independent & unbiased encyclopedia on supplementation

& nutrition.

• Newsletter ($)

Supplement Safety

FREE

USADA, Supplement 411

http://www.supplement411.org/supplement411/

National Center for Drug Free Sport

www.drugfreesport.com

Determining Deficiency & Supplement Needs-Traditional/Functional

Biochemical Assessment options

1. Spectracell

www.spectracell.com

2. Genova Labs

www.GDX.net

https://www.gdx.net/learngdx

3. Direct LABS: https://directlabs.com/Home/tabid/36/language/en-US/Default.aspx

4. Nutrigenomic/: GenoVive & Nutrigenomix

5. Food Allergy, Food Sensitivity

Further Reading

Thomas DT1, Erdman KA2, Burke LM3.Position of the Academy of Nutrition and Dietetics,

Dietitians of Canada, and the American College of Sports Medicine: Nutrition and Athletic

Performance. J Acad Nutr Diet. 2016 Mar;116(3):501-28.

Close GL1, Hamilton DL2, Philp A3, Burke LM4, Morton JP5. New strategies in sport

nutrition to increase exercise performance. Free Radic Biol Med. 2016 Feb 5. pii: S0891-

5849(16)00030-7.

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