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Helping Athletes with Eating Disorders

An estimated 30% to 60% of female athletes struggle with food, as do 10% to 33% of male athletes. Many of these athletes believe they are not “sick enough” to seek treatment. Others are too ashamed to ask for help. And some believe getting treatment will hinder them from reaching athletic goals. They fear:

1) they will gain weight, and any added weight will impair their performance.
2) they will not be able to participate in training or competitions during treatment, hence will lose status with their team; and
3) they might displease their coaches and teammates.

But the questions they want to ponder are:

What do you think your future will look like with the eating disorder?
Are you satisfied with your current quality of life?

At the October 2022 Food and Nutrition Expo and Conference of the Academy of Nutrition and Dietetics (the nation’s largest group of nutrition professionals), sports nutritionist Page Love MS RD CSSD (nutrifitga.com) of Atlanta and psychologist Ron Thompson PhD of Bloomington IN (rthomps2@att.net) addressed the topic of Athletes with Eating Disorders. They shared insights from their years of professional experience. This article passes along some of their words of wisdom and offers insights into why some athletes struggle with food, body image, and weight issues. and hopefully will nudge athletes’ friends, family, and loved ones to encourage these athletes to seek help.

• When dieting goes awry and eating disorders take hold, relationships and quality of life suffer, to say nothing of longevity as an athlete. Athletes with eating disorders (ED) can easily believe they have more reasons to keep the eating disorder than they do to give it up. Eating disorders can distract from difficult emotions; offer a source of power and control; give a sense of security; provide an excuse for anything and everything; sustain an identity; offer a way to be angry, self-abusive, special, rebellious, and competitive inside and outside of sport.

• Given many athletes with EDs are in denial of the seriousness of this mental health disease, Dr. Thompson has asked his clients, “Do you realize that people with your disorder sometimes die?” Indeed, athletes can—and have—died from eating disorders, often via suicide. Looking from the inside out, an athlete’s life can feel very stress-filled, despite the athlete appearing happy, bubbly, and “just fine” on the outside.

• Ideally, food should be one of life’s pleasures, as well as an enjoyable source of energizing fuel that enhances performance. If you stop eating at mealtimes just because you think you should, or because your allotted portion of food is all gone (but you are still hungry), you might want to ask yourself a few probing questions:

–What are your food rules and nutrition beliefs that restrict your food choices and portions?

For example, do you forbid yourself to eat second helpings?

–What percent of your time do you spend thinking about food and weight?

Thinking about food includes shopping for food, preparing food for yourself and others, reading cookbooks or other food- and diet-related publications, binge-eating, purging, and thinking about how much you ate at your last meal. When the answer is “I spend way too much time thinking about food; it dominates my thoughts”, you likely have a problematic relationship with food and are living in a state of hunger. That’s no fun, and also limits your ability to fully recover after a hard workout, heal the micro-injuries that occur during hard workouts, and perform optimally. “Normal eaters” think about food as they appropriately get hungry before a meal or snack.

–Do you enjoy eating socially with friends and teammates?

Or do you avoid such situations?

–Are your food allergies and intolerances real?

Or are they convenient excuses to avoid certain foods?

–Ladies, do you currently have regular menstrual periods?

Amenorrhea—loss of menses—can be a sign of under-eating, to the point of disrupting normal body functions.

–Gentlemen, are you experiencing reduced sex drive?

Loss of morning erections can be a sign of under-eating, to the point of disrupting normal body functions.

–Does your family have a history of eating issues, dieting practices, and/or mental health concerns?

If yes, how have those issues influenced your food habits?

• Chronically underfed bodies can end up “hibernating,” with slowed metabolic processes. Symptoms related to inadequate fueling include fatigue, lack of energy, dehydration, anemia, frequent injuries, amenorrhea, stress fractures, and “weird” eating habits. These are all good reasons to seek help from a registered dietitian who specializes in sports nutrition (RD CSSD). The referral network at eatright.org can help you find a local RD CSSD).

• Most of my clients report, “I know what I should eat. I just don’t do it.” Given today’s confusing food environment, any athlete with nutrition questions and weight concerns would be wise to meet with a sports RD to learn how to overcome barriers that limit optimal fueling. Don’t let (self-imposed) shame or embarrassment stop you. Eating “right” is not as simple as it once used to be.

• All food can fit into a balanced sports diet—even fatty foods. Athletes should consume at least half of their calories from (preferably nutrient-rich) carbohydrate, and at least 20% of calories from (preferably health-promoting) fat. A fat intake less than that increases the risk of inadequate energy intake.

• If you live in Food Jail and consume a very repetitive but “safe” diet, a sports RD can help you expand your menu so you can consume a wider variety of nutrients. If you want to try to do this on your own, start by making a list of your fear-foods (foods you are afraid to eat because they lack nutrient-density or because you deem them to be “fattening”). Challenge yourself to include at least one food each day into your meals and snacks, starting with the easiest and ending with the hardest foods. With time, you’ll be able to enjoy social eating with your friends and teammates.

• Notice that other athletes look forward to, let’s say, a special holiday gathering like a New Year’s Brunch—but you don’t because the foods will be way too fattening or you’re afraid you’ll end up eating way too much. Other athletes can eat holiday treats; why can’t you? Your body is not different from everyone else’s and will not “get fat on you.” The problem isn’t the food or your body, but more likely your self-imposed food rules.

• Few athletes will ever achieve a perfect body. Please don’t measure your self-worth as an athlete by your body weight or size. You may be an athletic person, but you are also a human, like the rest of us, and are excellent the way you are.

Nancy Clark MS RD CSSD counsels both fitness exercisers and competitive athletes in the Boston-area (Newton; 617-795-1875). Her best-selling Nancy Clark’s Sports Nutrition Guidebook is a popular resource, as is her online workshop. Visit NancyClarkRD.com for info.


Chocolate and Athletes

During a long bike ride, I snack on chocolate to boost my energy.

After a hard workout, chocolate milk is my go-to recovery food!

How bad—or good—is chocolate for me?

Most athletes love chocolate in any form: candy bars, chocolate chip cookies, squares of dark chocolate. Over 60% of all US candy sales are chocolate-based. But how good—or bad—is chocolate for our health? Is it as health-promoting as we want it to be? What about all the sugar and caffeine that comes with the chocolate? Is dark chocolate a far better choice than milk chocolate? Below are answers regarding chocolate and your sports diet.

Is dark chocolate really a “health food”?

Chocolate is made from the fruit of cacao trees. Like all fruit, the cacao bean is a rich source of health-protective phytochemicals (flavonoids) that are antioxidants and fight inflammation. Roasted beans are used to create cocoa. Two tablespoons of natural cocoa powder (the amount in one cup of homemade hot cocoa) offer the antioxidant power of 3/4 cup blueberries. Impressive!

The darker the chocolate, the better in terms of health-protective flavonoid content. Unfortunately, dark chocolate has a bitter taste, and many athletes prefer milk chocolate; it’s sweeter. That said, epidemiological surveys of large groups of people indicate those who regularly enjoy chocolate of any kind consume more flavonoids than non-chocolate eaters. This reduces their risk of heart disease. For example, in the Netherlands, elderly men who routinely ate chocolate-containing products had a 50% reduced risk of dying from heart disease (1).

Shouldn’t we stay away from sugary foods, like chocolate?

The US Dietary Guidelines recommend a limit of 10% of calories from refined sugar per day. For most athletes, that’s about 200 to 300 calories of carbohydrate (sugar) to fuel muscles. The better question is: What nutrients accompany the sugar? For example, “sugary” chocolate milk comes with high quality protein, calcium, vitamin D, riboflavin, and other life-sustaining nutrients. When used as a recovery fluid, it is far healthier than a sports drink, which is just sugar, water, and a dash of salt.

What about sugar spikes…?

Chocolate has a high fat content. Fat slows the rate sugar enters the blood stream and thus reduces the risk of sugar spikes. The Glycemic Index ranks from 0 to 100 the blood glucose response after consumption of 200 calories (50 grams) of carbohydrate (sugar, starch). Gatorade ranks high on the Glycemic Index (78), M&Ms rank lower (33), and dark chocolate ranks even lower (23). Given most of us—well, some of us—don’t eat 200 calories of sugar from just one food at one time, a preferable ranking is the Glycemic Load, based on a standard serving of the food. For example, the Glycemic Load of a standard serving (8-ounces) of Gatorade is 12, chocolate milk is 3.5, and an ounce of M&Ms is 3.

What about chocolate milk for post-exercise recovery?

Chocolate milk can be an enjoyable and nourishing treat that boosts intake of nutrients important for athletes. It has a low glycemic effect and is unlikely to contribute to sugar spikes Drinking chocolate milk after a hard workout effectively refuels and repairs your muscles, boosts your blood sugar, and replaces electrolytes lost in sweat. It’s a nutritionally preferable choice to a carb-only, sugar-based sports drink (2). And it is yummy chocolate—with purpose and meaning, and no guilt!!!

How much caffeine is in chocolate?

The amount of caffeine in chocolate depends on how much cocoa powder is in it. Milk chocolate is only 10 to 20% cocoa, regular dark chocolate is 50-69% cocoa, and strong dark chocolate has more than 70% cocoa. The higher the percentage of cocoa, the higher the caffeine. That said, the 20 milligrams of caffeine in an ounce of dark chocolate pales in comparison to the 200 mg. in a mug of coffee. Chocolate’s energy boost comes from sugar, more so than caffeine.

Is chocolate fattening?

Like any food that is eaten in excess, chocolate can be fattening. That said, data from 13,626 adults (>20 years old, nondiabetic) suggests chocolate consumption was not associated with obesity.

Is there a best time of the day to eat chocolate?

If you are destined to eat a treat, such as chocolate cake, enjoy it earlier in the day, as opposed to indulging at 8:00 p.m. when you are tired and lack the mental energy needed to stop yourself from over-indulging. You are going to eat the chocolate eventually, so why not enjoy it sooner than later?

Believe it or not, eating chocolate cake with breakfast might actually help dieters reach their weight loss goal. Research (3) with 193 adults on a reducing diet suggests those who had cake with breakfast had fewer cravings for carbohydrates and sweets later in the day. By front-loading their calories, they were less hungry and less likely to stray from their diet plan. They ate either a 300-calorie protein-based breakfast or a 600-calorie breakfast that included protein plus chocolate cake (or another dessert).

In the first 16 weeks, both groups lost an average of 33 pounds per person. But in the second half of the study, the no-cake group had poor compliance and regained an average of 22 pounds per person while the cake-eaters continued to lose another 15 pounds each. By 32-weeks, the cake eaters had lost about 40 pounds more than their peers. Does chocolate make for a more sustainable diet?

The bottom line

By no means is chocolate the key to a healthy sports diet, nor is eating lots of dark chocolate preferable to snacking on apples and bananas. It’s no secret: chocolate contains primarily nutrient-poor calories from sugar and fat. A Hershey’s Bar (43 g) has 220 calories—of which about 40% are from 21 grams of added sugar and about 55% of calories from fat. Hence, you want to enjoy chocolate in moderation, so it does not crowd-out other nutrient-dense foods. But even if you are a weight-conscious, health-conscious athlete, you can balance chocolate into your overall wholesome sports diet—and add a taste of pleasure to your day.

Nancy Clark MS RD CSSD counsels both fitness exercisers and competitive athletes in the Boston-area (Newton; 617-795-1875). Her best-selling Sports Nutrition Guidebook is a popular resource, as is her online workshop. Visit NancyClarkRD.com for info.


1. Buijsse B, Feskens EJ, Kok FJ, Kromhout D. Cocoa intake, blood pressure, and cardiovascular mortality: the Zutphen Elderly Study. Arch Intern Med. 27;166(4):411-7, 2006.

2. Lunn WR, Pasiakos SM, Colletto MR, Karfonta KE, Carbone JW, Anderson JM, Rodriguez NR. Chocolate milk & endurance exercise recovery: protein balance, glycogen and performance. Med Sci Sports Exerc. 44(4):682-91,2012.

3. Jakubowicz D, O Froy, J Wainstein, M Boaz. Meal timing and composition influence ghrelin levels, appetite scores and weight loss maintenance in overweight and obese adults. Steroids 77(4): 323-331, 2012.

athlete riding indoor cycle

Fretting about Food & Physique?

Many athletes feel pressure to have a perfect body, perfect diet, and ideally, perfect performances. The stress-inducing trait of perfectionism often pushes athletes to not only become stronger and faster, but also leaner and food-phobic. We have seen perfection play out with football phenom Tom Brady. While he is a poster child for the benefits of eating ”perfectly,” he also has great mental strength that keeps him focused on his goals without getting side-tracked by comparisons.

Most of us are a bit more insecure than Tom and end up comparing ourselves to others. Take note: To compare is to despair! Please stop comparing your physique and your food choices to those of your teammates, friends, and family! Here are strategies to help you fret less and instead gain confidence with your food choices and your physique.

Body Comparisons

She’s leaner than I am…   
He’s got bigger muscles than I do…  
She’s prettier than I am…
He’s got a better 6-pack ab than I do

How often do you find yourself comparing your body to that of your teammates, friends, and social media influencers? If the answer is too often, just STOP IT! Your body is yours; it is good enough the way it is. You want to stop criticizing your body for being too fat, too slow, too short, too freckled—and instead be grateful for all the good things it does for you, like run marathons, row in regattas, win soccer games, and/or compete in triathlons. Those “thunder thighs” contribute to your ability to be a strong, powerful, and successful athlete. Thank them!

Few athletes have the “perfect body”; even the leanest athletes complain about undesired bumps and bulges. Athletes who whine about feeling fat are more likely feeling imperfect, inadequate, anxious, and/or out of control.

Recommendations: To achieve body acceptance, practice living on a fantasy island where you and your body are good enough—if not excellent—the way you are. If you wander off your island and start comparing yourself to others, you’ll undoubtedly end up despairing. Stay on your island!

When you look in the mirror, greet yourself with a welcoming smile and grateful words. With time, you will start to internalize that your body is indeed good enough the way it is. While you may never attain the perfect physique, you can still be grateful for all your body does for you. 

Portion Comparisons

Do you eat like a bird compared to your teammates? Or maybe you feel self-conscious because you need to eat twice as much as your peers just to maintain your desired weight?  At team meals/social gatherings, many athletes monitor the quantity of food others are eating. Salads and small portions tend to get praised more than lumberjack servings. (I wish I had your discipline vs. You sure do eat a lot….) For athletes recovering from restrictive, dysfunctional eating, eating a sandwich, fruit, yogurt &pretzels for lunch seems embarrassing—way too much food—when it’s really what is needed to properly fuel up for an after-school practice or after-work trip to the gym.

When I educate my clients how many calories they “deserve” to eat, most are flabbergasted to learn athletic females commonly require 2,400+ calories to maintain weight; athletic males may require 2,800+ calories. That’s 600-700 calories four times a day: breakfast, early lunch, second lunch/afternoon snack, and dinner.

Recommendation: Please don’t start counting calories; your body is your best calorie counter. Rather, listen to your innate hunger and fullness cues. Eat when hungry; stop when content. Pay attention to why you stop eating: Do you think you should?  Is the food all gone? Or are you actually feeling content and comfortably fed?

Food Comparisons

I eat only healthy foods… 
I avoid sugar like the plague…
I won’t touch the pies at Thanksgiving.  

In the world of “clean eating”, athletes feel pressure to choose the “right” foods. That translates into no sugar, salt, red meat, white flour, packaged foods, fat, and no fun foods. The E in Eating stands for Enjoyment; you want to be able to enjoy (in appropriate portions) the foods you truly want to eat!

Believe it or not, it’s OK to balance fun foods into an overall good diet. The goal is 85-90% nutrient-rich whole grains, fruits, veggies, lean proteins and 10-15% fun food. You need not eat the perfect diet to have an excellent diet.

You want to eat a foundation of about 1,500 calories from a variety of nutrient-dense foods to consume the vitamins, minerals, and protein required for an effective sports diet. Because your body needs at least 2,400-2,800 calories a day, you have space in your diet for both health-promoting food and fun food. While you want to enjoy more of the best foods and less of the rest, you can balance fun foods into your sports diet. That is, an apple is a healthy food; a diet of all apples is a very unhealthy, unbalanced diet.

Recommendation: If you find yourself being judgmental about food, the problem is unlikely the food, but rather your relationship with the food—and fears it will make you get fat or ruin your health. Eating out of the same pot as your pals is a very healthy thing to do! A few fun meals will not ruin your health forever.

Nutrition Supplement Comparisons

I often counsel athletes who wonder if they can nourish their bodies with real food instead of taking supplements. As one athlete sheepishly asked, “I don’t take any vitamin pills. Should I? My teammates takes a handful of them..” Let me reassure you that opting out of supplements is okay (and can save you bundles of money). If you eat wisely 85-90% of the time, you are likely getting the vitamins and minerals and protein you need, with a few possible exceptions (iron, vitamin D).

Recommendation: If you question the adequacy of your diet, consult with a registered dietitian (RD) who is board certified as a specialist in sports dietetics (CSSD). Make an appointment today to learn how to choose food based on facts, not fears, and can fret less and enjoy better quality of life.

Nancy Clark MS RD CSSD  counsels both fitness exercisers and competitive athletes in the Boston-area (Newton; 617-795-1875). Her best-selling Sports Nutrition Guidebook is a popular resource, as is her online workshop. Visit NancyClarkRD.com for info.

athletes gym

News from ACSM: Tools to Enhance Performance

The American College of Sports Medicine (ACSM)  is the nation’s largest group of exercise physiologists, sports nutritionists, and a multitude of other sports medicine professionals. 

Each year, at ACSM’s Annual Meeting, members gather to share their latest research. Here are highlights of two talks (June 2022 meeting in San Diego) that might be of interest to serious athletes intent on improving their performance.

Coffee, Caffeine and Caffeinated foods: What Do Athletes Need to Know?

Speakers: Louise Burke PhD. Australian Catholic University and Ben Desbrow PhD, Griffith University, Australia

Guidelines regarding caffeine used to enhance athletic performance have changed significantly. Caffeine was once believed to be a diuretic, beneficial in high doses primarily for marathoners, and most effective when consumed an hour pre-event. Almost every aspect of those ideas has been replaced with newer knowledge

• Caffeine is not just for endurance athletes; it offers a three-percent improvement in performance in many real-life sporting events including shorter races and team sports. In addition, caffeine may help athletes such as body builders train harder.

• Caffeine offers similar benefits whether you take it one hour pre-exercise or only during exercise. Even low doses of caffeine are effective when consumed just prior to the onset of fatigue.

• Caffeine helps athletes train better when they are jetlagged or when their circadian rhythms are out of line.

• Caffeine comes in many forms, including caffeinated water, potato chips, gums, gels, sprays, pouches, strips, medications, pre-workout supplements, and pills. The caffeine content of commercial pre-workout supplements can vary from batch to batch (~40 mg difference per serving) Of the top 15 most popular pre-workout supplements, caffeine content ranged from about 90 to 390 mg/serving —and often contained more—or less—of what was listed on the nutrition facts panel.

• Each individual needs to learn from their own personal experiences the right caffeine source and dose for their bodies. Genetics influences the enzymes that break down caffeine.

• If you consume 1 cup of coffee in the morning, most of the caffeine will have dissipated by lunchtime. In general, caffeine stays in the body for about 7 hours. Its half-life (time taken for caffeine in the body to drop by half) ) might be five hours (or less) for some people, but ten hours (or more) for others.

• Female athletes should know that birth control pills almost double the half-life of caffeine, making it more effective for longer.

• If you happen to be a slow metabolizer and then take a pre-workout caffeine boost before your afternoon workout, you might have some caffeine “overlap” from your morning cup of brew. Even if you abstain from caffeine for 12 hours, circulating caffeine might still be detected in your blood due to caffeine accumulation with repeated caffeine consumption.

• Habitual caffeine intake does not seem to influence its ergogenic effect across a range of different sports. That means, if you regularly consume coffee every day, there’s no need for you to stop consuming caffeine for a few days prior to a competitive event. Caffeine withdrawal feels horrible and you’re unlikely to gain any benefits!

Biomarkers That Impact Training and Performance

Speaker: Shawn Arent, PhD, CSCS, FACSM, University of South Carolina

While caffeine is a drug that can be consumed to influence performance, biomarkers are substances in your body that are indicators of physiological processes. Endocrine biomarkers measure stress and adaptations to training.  Biochemical biomarkers measure muscle damage and inflammation. Nutritional biomarkers measure the impact of diet, such as on blood glucose and iron levels.  

Biomarkers are best used to document changes over time (as opposed to taking one measurement, such as serum ferritin, to see if the measurement simply falls within normal limits). Biomarker data can help assess changes in performance, recovery, and training optimization. Biomarkers might be able to predict and prevent illness. In an 8-week basic training study, a third of the soldiers whose biomarkers classified them as being over-reached experienced illness.

Biomarker research

The military and some professional athletes and teams are very interested in measuring biomarkers. Connecting biomarkers to measurables like performance, training, sleep, and diet provides context and meaning to the measurements. By keeping athletes healthy and in the game, the likelihood of a winning season improves.

• With biomarker research, we now know that food deprivation can be more detrimental to performance than sleep deprivation. Many markers can take a full month post-dietary restriction to get back to normal. With Army ranger training, a 1,000 calorie per day deficit reduced testosterone and increased cortisol.

• Biomarkers can document the physiological impact of restrictive food intake and show how much better athletes can recover when they are adequately fueled.

• Both physical and psychological stress impact biomarkers, as does travel through time zones. Seeing sleep data can help athletes learn the value of prioritizing sleep.

Wave of the future?

Athletes interested in getting their biomarkers measured should know this is an emerging field with yet unanswered questions, including:

What is the best time to measure biomarkers? (Should recovery markers be measured right after exercise or a day later?) 

How often should measurements be taken? (Might depend on who is paying the bill!)

Should athletes not exercise the day before blood draws/data collection?

Do biomarkers differ when measured under research conditions? (That is, does lab data compare to data collected at real-life competitive events?)

What is the minimal performance-enhancing level of a biomarker? Is higher better?  When is a level too low?

 Can biomarkers predict and prevent illness? And very importantly,

Will coaches (and athletes) be willing to alter their training schedules based on biomarkers? Coaches’ buy-in is essential, as is the athlete’s willingness to alter training plans.

With time and well-established protocols for measuring biomarkers, this evolving field will have a significant impact on improving the health and performance of members of the military, professional athletes, as well as curious consumers who can afford this luxury. 

Sports nutritionist Nancy Clark MS RD CSSD has a private practice in the Boston area. She is author of the best-selling Nancy Clark’s Sports Nutrition Guidebook and co-leader of an online sports nutrition workshop. Visit www.NancyClarkRD.com for more information.

athlete riding indoor cycle

ADHD and (Adult) Athletes: Can diet help with management?

As a sports nutritionist, I commonly counsel athletes who have Attention Deficit Hyperactivity Disorder—generally referred to as ADHD (or ADD). ADHD is characterized by hyperactivity, impulsivity, and/or inattention. It affects 4-10% of all American children and an estimated 4.4% of adults (ages 18-44 years). ADHD usually peaks when kids are 7 or 8 years old. Some of the ADHD symptoms diminish with maturation but 65-85% of the kids with AHDH go on to become adults with ADHD.

Ideally, athletes with ADHD have gotten the help they need to learn how to manage their time and impulsiveness. Unfortunately, many youth athletes with ADHD just receive a lot of negative feedback because they have difficulty learning rules and strategies. This frustrates teammates and coaches. Older athletes with ADHD often use exercise to reduce their excess energy, calm their anxiety, and help them focus on the task at hand.

This article offers nutrition suggestions that might help coaches, friends, and parents, as well as athletes with ADHD, learn how to calm the annoying ADHD behaviors.

  • To date, no clear scientific evidence indicates ADHD is caused by diet, and no specific dietary regime has been identified that resolves ADHD. High quality ADHD research is hard to do because the added attention given to research subjects with ADHD (as opposed to the special diet) can encourage positive behavior changes. But we do know that when & what a person eats plays a significant role in ADHD management and is an important complimentary treatment in combination with medication.
  • ADHD treatment commonly includes medications such as Concerta, Ritalin & Adderall. These medications may enhance sports performance by improving concentration, creating a sense of euphoria, and decreasing pain. These meds are banned by the World Anti-Doping Agency (WADA) and the International Olympic Committee (IOC). Hence, athletes who hope to compete at a high level are discouraged from taking ADHD medications.
  • To the detriment of ADHD athletes, their meds quickly blunt the appetite. Hence, they (like all athletes) should eat a good breakfast before taking the medication.
  • The medication-induced lack of appetite can thwart the (teen) athlete who wants to gain weight and add muscle. Teens taking ADHD meds should be followed by their pediatricians, to be sure they stay on their expected growth path. If they fall behind, they could meet with a registered dietitian (RD) with knowledge of sports nutritionist (CSSD) to help them reach their weight goals.
  • An easy way for “too thin” athletes to boost calories is to swap water for milk (except during exercise). The ADHD athlete who does not feel hungry might find it easier to drink a beverage with calories than eat solid food. Milk (or milk-based protein shake or fruit smoothie) provides fluid the athlete needs for hydration and simultaneously offers protein to help build muscles and stabilize blood glucose.
  • A well-balanced diet is important for all athletes, including those with ADHD. Everyone’s brain and body need nutrients to function well. No amount of vitamin pills can compensate for a lousy diet. Minimizing excess sugar, food additives, and artificial food dyes is good for everyone.
  • Eating on a regular schedule is very important. All too often, high school athletes with ADHD fall into the trap of eating too little at breakfast and lunch (due to meds), and then try to perform well during afterschool sports. An underfed brain gets restless, inattentive, and is less able to make good decisions. This can really undermine an athlete’s sports career
  • Adults with ADHD can also fall into the same pattern of under-fueling by day, “forgetting” to eat lunch, then by late afternoon are hangry and in starvation mode. We all know what happens when any athlete gets too hungry – impulsiveness, sugar cravings, too many treats, and fewer quality calories. This is a bad cycle for anyone and everyone.
  • All athletes should eat at least every four hours. The body needs fuel, even if the ADHD meds curb the desire to eat. ADHD athletes can set a timer: breakfast at 7:00, first lunch at 11:00, second lunch at 3:00 (renaming snack as second lunch leads to higher-quality food), dinner at 7.
  • For high school athletes with ADHD, the second lunch can be split into fueling up pre-practice and refueling afterwards. This reduces the risk of arriving home starving and looking for (ultra-processed) foods that are crunchy, salty, and/or sweet.
  • Athletes with ADHD are often picky eaters and tend to prefer unhealthy snacks. For guidance on how to manage picky eating, click here for adults and here for kids.
  • Fiber-rich fruits, vegetables, and whole grains can be low on an ADHD athlete’s food list. Their low fiber diet can lead to constipation. Fiber also feeds the zillions of microbes in their digestive tract that produce chemicals that can positively impact brain function and behavior. Everyone with ADHD should eat more fiber-rich foods like beans (hummus, refried beans in a burrito), seeds (chia, pumpkin, sunflower, sesame), and whole grains (oatmeal, brown rice, popcorn). They offer not only fiber but also magnesium, known to calm nerves.
  • With more research, we’ll learn if omega-3 fish oil supplements help manage the symptoms of ADHD. No harm in taking them. At least eat salmon, tuna, and oily fish as often as possible, preferably twice a week, if not more.
  • Picky eaters who do not eat red meats, beans, or dark leafy greens can easily become iron deficient. Iron deficiency symptoms include interrupted sleep, fatigue, inattention, and poor learning and can aggravate ADHD. Iron deficiency is common among athletes, especially females, and needs to be corrected with iron supplements.
  • While sugar has the reputation of “ramping kids up”, the research is not conclusive about whether sugar itself triggers hyperactivity. The current thinking is the excitement of a party ramps kids up, more so than the sugary frosted cake. Yes, some athletes are sugar-sensitive and know that sugar causes highs and crashes in their bodies. They should choose to limit their sugar intake and at least enjoy protein along with sweets, such as a glass of milk with the cookie, or eggs with a glazed donut. Moderation of sugar intake is likely more sustainable than elimination of all sugar-containing foods.

For more information about ADHD in kids, teens, and adults, please use these resources:

  • Feeding the Child with ADHD—a podcast with Jill Castle RD
  • Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) – a national resource center

Nancy Clark MS RD CSSD counsels both fitness exercisers and competitive athletes in the Boston-area (Newton; 617-795-1875). Her best-selling Sports Nutrition Guidebook is a popular resource, as is her online workshop. Visit NancyClarkRD.com for info.

preworkout supplement

Commercial Sports Foods: A Matter of Preference

“I thought I was supposed to use gels during long runs. Can candy work just as well..?”

 “Are electrolyte tablets the best way to replace sodium loses from sweaty workouts?”

 “I get diarrhea when I use some commercial sports foods…help!”

If you are among the many athletes who have no idea which commercial sports foods are best to support your workouts, welcome to the club! Advertisements have led many active people—from serious competitors to anyone who breaks a sweat—to believe that pre-workout drinks, energy gels, and electrolyte replacers (among the many other commercial sports foods) are a necessary part of a sports diet. Guess what? Real foods can often work just as well.

While there is a time and a place for commercial sports foods, many athletes needlessly spend lots of money on them. The purpose of this article is to help you become an informed consumer, so you know what these products are (convenient, expensive)—and what they are not (essential for all exercisers). Whatever you do, test them during training, so you can learn if they settle well in your gut. You don’t want surprises during competitions!

Pre-Workout Supplements

When you feel low on energy and are dreading your afternoon training session, pre-workout products that promise explosive energy, sharp focus, and incredible results can be very tempting to buy. While simply eating a heartier breakfast, lunch, and pre-exercise snack can help prevent an afternoon droop, many athletes fail to appreciate the power of food. Instead, they look for “magic.”

  • The “magic” ingredient in most pre-workout products is caffeine. You could just as easily get stimulated with coffee or NoDoz. True energy comes with eating a pre-exercise banana, granola bar, or carb-based snack.
  • The best pre-workout snacks digest easily and don’t talk back to you. Standard supermarket foods (e.g., toast, oatmeal, animal crackers, dried pineapple, dates, banana, even a swig of maple syrup) are likely more familiar to your gut (less likely to cause intestinal upset) than unfamiliar commercial sport fuels.
  • Some pre-workout products tout they are sugar free, as if sugar is evil for athletes. Sugar (carbohydrate) is a true energizer in comparison to caffeine, which is just a stimulant. Carbs + caffeine will offer a better workout (for those who tolerate caffeine, that is)!
  • Some pre-workout products contain creatine, vitamins, beta-alanine, and/or other stuff that looks good on the label. The dose may be inadequate to make a significant difference in your performance. Do your homework to learn what is an effective dose.
  • Buyer beware, pre-workout products are poorly regulated. Who knows what the products contain. Claims that sound too good to be true should raise an eyebrow. Be sure your choice says NSF Certified for Sport or Informed Sport on the label.


During hard exercise lasting 1 to 2.5 hours, you’ll perform better if you consume ~30 to 60 grams (120-240 calories) carbohydrate per hour. Take your choice of gel, sport drink, or gummi bears!

  • During extended exercise lasting more than 2.5 hours (ultra-marathon, long bike ride), you want to target 60 to 90 g carb/h (240-360 calories), depending on the intensity of your exercise, your body size, sport, and intestinal tolerance.
  • Most gels offer 100 calories (25 g carb) in the form of some type of sugar, such as maltodextrin, sucrose, fructose, or glucose. The Nutrition Facts on the gel’s label can you help determine the right amount to consume.
  • Many athletes love the convenience of gels because they come in a good portion-size and are easy to carry. Others dislike them due to their consistency. For some athletes, gels digest poorly because they contain a type of sugar that can trigger bloat, diarrhea, and undesired pit stops. Always experiment with new gels during training!!!
  • Some popular alternatives to the 100 calories of carb (sugar) in a gel include gummy bears, Twizzlers, Swedish fish, gum drops, peppermint patties, maple sugar candy, even chocolate (though it melts in hot weather). The trick with choosing “real food” is to figure out how to carry it. Pockets help.

Electrolyte tablets

Electrolytes (electrically charged particles, most often known as sodium, calcium, magnesium, and potassium), are minerals abundant in food.

  • For sweaty athletes, sodium (a part of salt) is the main electrolyte of concern. Salty foods enhance fluid retention and help keep you better hydrated than plain water, which goes in one end and out the other.
  • Many electrolyte replacers are lower in sodium than you may think. By reading food labels, you’ll discover a slice of bread can have more sodium than 8-ounces of Gatorade.
  • Athletes who sweat heavily might lose about 500 to 1,000 mg sodium in an hour of vigorous exercise. Some options for replacing these sodium losses include:
Commercial Sports Food Sodium (mg) Salty food Sodium (mg)
Propel Electrolyte water, 8 oz


105 String cheese, 1 stick   220
Gatorade, 8 oz


110 Beef Jerky, 1 oz   600
Gu Salted Caramel, 1 gel 125 Salt sprinkled on food, ¼ tsp   600
Nuun, 8 oz


175 Broth, from 1 cube Herb-ox 1,100
  • Replacing sodium is most important for athletes who sweat heavily for extended periods in the heat. Yet, these athletes generally consume foods that contain sodium before, during and after exercise. For example, football players who refuel from morning practice with a high-sodium ham and cheese sandwich with mustard and dill pickles can bypass the Gatorade at lunch.
  • Consuming 500 mg. sodium before you exercise helps retain fluid, delay dehydration, and enhance endurance. Sprinkle salt on that pre-exercise omelet, pasta, or sweet potato before you exercise in the heat!

The Bottom Line

While commercial sports foods have their time and place for intense exercisers, not every athlete needs to pay the price for pre-wrapped convenience.

Nancy Clark MS RD CSSD counsels both fitness exercisers and competitive athletes in the Boston-area (Newton; 617-795-1875). Her best-selling Sports Nutrition Guidebook is a popular resource, as is her online workshop. Visit NancyClarkRD.com for more info.


Once You Lose Weight, Can You Keep It Off?

“I lost 10 pounds and vowed to keep them off, but no such luck. I’m so discouraged.”

“I reached my goal weight, then BOOM, I regained it once I stopped dieting.

“This is my 3rd time losing 40 pounds…”

If any of those stories sound familiar, you are not alone. Research suggests dieters tend to regain lost weight within five years, if not sooner. This includes many fitness exercisers and athletes who struggle to stay at a goal weight.

If you are fearful of regaining your hard-lost weight, this article will help you understand why maintaining lost weight takes effort. Paul MacLean, PhD, Professor of Medicine & Pathology at the University of Colorado School of Medicine, has carefully studied weight regain. He notes three reasons why dieters regain weight: biology, behavior, and environment.

Biology: The body has a strong biological drive to regain lost weight, as noted with increased appetite and a slowed metabolic rate. As backlash from dieting, the body learns to store fuel very efficiently as fat.

Behavior: After three to nine months, dieters tend to be less strict with their low-calorie diets; they often report they have hit a weight plateau. Despite self-reported claims they are diligently dieting (yet only maintaining weight), these dieters can become discouraged and less adherent. (Note: Diligently dieting anecdotes are hard to verify.)

Environment: We live in an obesogenic environment with easy access to ultra-processed foods, a sedentary lifestyle, and chemicals that contribute to weight gain including those found in upholstered furniture, pesticides, cosmetics, and who knows where else. Weight is far more complex than self-induced over-eating and under-exercising!

When adding on exercise, some people lose weight and some gain weight. Exercise alone does not guarantee fat loss. Exercisers who lose weight tend to keep the weight off if they stick with their exercise program. High levels of exercise are linked with greater success. That’s good news for athletes who train regularly! That said, a fine line exists between compulsive exercisers (who exercise to burn off calories) and athletes (who train to improve their performance). Fear of weight gain can impact both groups.

Questions arise:

  1. Is weight maintenance more about being compliant to a restrictive eating plan than to exercise?
  2. Do those who comply with a strict diet escape weight-regain?
  3. Are exercisers more likely to stay on their diet?
  4. Does exercise create metabolic adaptations that favor maintaining lost weight?

Research with rodents

Finding answers to these questions is hard to do in humans because of biology, behaviors, and environment. So MacLean turned to studying formerly obese rodents who had lost weight by being put “on a diet” and then were allowed to eat as desired for 8 weeks. Some weight-reduced rodents stayed sedentary while others got exercised.

  • Fancy cages accurately measured the rodents’ energy intake and energy expenditure. MacLean was able to see how many calories the rodents burned and if they preferentially burned carbohydrate, protein, or fat for fuel.
  • The exercise reduced-obese rodents ate less than the sedentary rodents and they regained less weight. Exercise seemed to curb their drive to overeat, meaning they felt less biological pressure to go off the diet. With exercise, their appetites more closely matched their energy needs.
  • Exercise promoted the burning of dietary fat for fuel. Hence, the exercised rodents converted less dietary fat into body fat. They used carbohydrate to replenish depleted glycogen stores. Note: Carbohydrate inefficiently converts into body fat. That is, converting carb (and also protein) into body fat uses ~25% of ingested calories to pay for that energy deposition. To convert dietary fat into body fat requires only ~2% of ingested calories. Given the calorie-burn of exercise plus the metabolic cost of converting carbs into body fat, the exercised rodents regained less weight.
  • The sedentary rodents ate heartily and were content to be inactive. Their bodies efficiently converted dietary fat into body fat; they used carb & protein to support their limited energy needs. They easily regained weight.

The Depressing News

When followed over time, the longer the rodents were weight-reduced, the stronger their appetites and drive to eat got. When allowed to eat as desired, they quickly regained the weight. “At least people, as compared to rodents, can be taught to change their eating behaviors to help counter those biological pressures,” noted MacLean. For example, people who have lost weight can stop buying fried foods, store snacks out of sight, limit restaurant eating, etc.

More depressing news. Most of MacLean’s data is from reduced-obese male rodents. Exercised males showed less weight regain than did exercised females. The female rodents seemed to know they needed extra energy to exercise, so they ate more and regained weight. MacLean states we need more research to understand the clear differences in the biological drive to regain weight.

A glimmer of hope

The best way to maintain weight is to not gain it in the first place. Yes, easier said than done (as stated upfront), but at least athletic people who maintain a consistent exercise program can curb weight regain. We can also change our behaviors to minimize weight regain by prioritizing sleep, curbing mindless eating, and choosing minimally processed foods.

Ideally, the sports culture will change so that athletes can focus less on weight and more on performance. It’s time to acknowledge that athletes, like dogs, come in many sizes and shapes. Some athletes are like St. Bernards, others are like Greyhounds. A starved St. Bernard does not become a Greyhound, but rather a miserable St. Bernard.

By fueling your genetic body type and focusing on how well you can perform, you can enjoy being stronger, more powerful—and likely can still meet your sports goals. When being leaner comes with a life-long sentence to Food & Exercise Jail, you might want to think again?

Nancy Clark MS RD CSSD counsels both fitness exercisers and competitive athletes in the Boston-area (Newton; 617-795-1875). Her best-selling Sports Nutrition Guidebook is a popular resource, as is her online workshop. Visit NancyClarkRD.com for more info.

Beer Glass Alcohol

Alcohol & Athletes: The good, the bad and the ugly

When asked, Is beer good for runners? Running legend Jim Fixx’s answer was, “Sure, if it’s the other guy drinking it!” By abstaining from alcohol, you can indeed gain an advantage over your competitor’s poor judgment. Just how bad is alcohol for athletes? Does it have any health benefits, too? Let’s look at some of the good, the bad, and the ugly regarding alcohol and athletes.

The Good

Socializing with a glass of wine, a beer, or a cocktail can add a nice touch to the end of the day for those who like to relax with an alcoholic beverage. Raising a glass to celebrate a victory is a fond tradition. But we know surprisingly little about possible health benefits of drinking in moderation because almost all studies are based on self-reported information that gets tangled up with lifestyle. Do adults who do moderate social drinking enjoy a healthier lifestyle than non- or heavy-drinkers? Does alcohol make them healthier—or do social connections make the difference? While moderate alcohol intake has been linked to reduced risk of heart disease, so has eating a healthy diet and being physically active.

The Bad

Alcohol has a negative reputation regarding athletics, be it heavy beer consumption after a hard work-out, or teams enmeshed in a culture of binge drinking. Student-athletes binge-drink more than non-athletes. Male athletes binge-drink more than female athletes. And all athletes drink more than non-athletes. The higher alcohol intake of athletes can be attributed to stress and anxiety associated with being a competitive athlete, increased muscle pain and soreness, socializing or bonding with teammates, and the belief the athlete “earned” the drink—a reward for having completed the hard effort.

The Ugly

Alcohol is the 3rd leading preventable cause of death in the US. (Tobacco is Number One. A poor diet with inactive lifestyle is Number Two.) Any level of alcohol intake can contribute to several types of cancer

How do you know if you have a drinking problem?

Moderate drinkers typically sip (not gulp) their drinks, stop drinking before they get drunk, and do not drive after drinking. Problem drinkers commonly drink to get drunk and to solve their problems. They drink at inappropriate times (such as before going to work) and may become loud/angry or silent/reclusive. People addicted to alcohol start drinking with no plan, deny drinking, hide bottles, and miss work or school because of hangovers.

Alcohol management

Despite the bad and the ugly, alcohol is an undeniable part of our sports culture. The following tips offer suggestions for helping athletes manage alcohol.

• Don’t drink excessive alcohol before an event—especially in the summer heat! Drinking too much the night before an event will hurt your performance the next day. You’ll notice a slower reaction time and reduced eye-hand coordination and balance. Research with Australian rugby players who consumed on average 9 beers post-game (with a range of <1 to 22 beers) indicates—no surprise— their high alcohol intake impaired their performance. Other studies report athletes are less able to do repeated sprints (think soccer, hockey) and jumps (volleyball, basketball). Among heat-stricken summer runners, a common denominator was booze the night before the race.

• If you are going to drink the night before or after an event, plan to also consume a proper sports meal with extra water. While excessive drinking is obviously problematic, a modest amount of alcohol consumed along with a balanced meal will unlikely have a negative impact. Yes, alcohol impairs glycogen resynthesis a bit. But in the real world of sports drinking, athletes who are heavy drinkers tend to make high fat food choices (nachos, burgers, etc.). The lack of healthful grains, fruits and veggies (carbohydrates) more significantly hinders glycogen replacement!

• First quench your post-exercise thirst with water, then enjoy alcohol, if desired. Alcohol is a diuretic; it stimulates the formation of excess urine. Whiskey and other spirits with a high alcohol content will dehydrate (not rehydrate) you. If you “must” drink spirits, ask for extra ice with the cocktail. Beer would be the better choice, given the alcohol content of beer is lower and the water content is higher. Yes, dehydrated adult athletes can rehydrate with a beer or two. Low-alcohol beer is the wiser choice, and no-alcohol beer the wisest beer choice.

• Heavy alcohol intake is not on the list of Best Recovery Practices for athletes to follow! Remember: bad things happen during exercise and good things happen during recovery. Wisely chosen recovery fluids and foods help you rehydrate, refuel, and repair your muscles. Adding alcohol to the mix slows down muscle repair, protein synthesis and adaptation processes. Yet a glass or two of wine or beer, along with plenty of water and food, is permissible.

• Alcohol is a source of calories that can quickly add up. Add in the calories in the pizza, nachos or munchies that you can easily overeat when alcohol lowers your inhibitions, and you can easily succeed in gaining body fat. Just five Heineken Light Beers add 500 calories. A goblet of wine can easily add 200 calories. Be wary of drinks that come with umbrellas! (400-800 calories/10-ounces)!

• Beware of drinks in a can, such as White Claw Surge with 8% Alcohol By Volume. (ABV). You can end up drinking more alcohol than you intended. You might want to stick with the original White Claw—hard seltzer with 5% ABV—similar to most canned beers, though some craft beers have a higher alcohol content.

• Don’t drink alcohol if you want a good night’s sleep. Alcohol might help you fall asleep faster, but it disrupts your sleep cycle. You’ll get less restorative sleep. Alcohol alters body temperature, which can affect how well you sleep. It also aggravates snoring (due to relaxed muscles and a lower breathing rate), so your bed partner becomes sleep deprived and grumpy. Plus, you’ll need to go to the bathroom more often in the middle of the night. None of this enhances athletic performance.

• If you don’t want to drink, be prepared to quickly say “No thanks” in a polite but convincing voice. If the person keeps insisting, respond again: “Î don’t want to drink today. I’d appreciate if you’d help me out.” Instead, be pleased that you will enjoy the natural high of exercise.

Nancy Clark MS RD CSSD counsels both fitness exercisers and competitive athletes in the Boston-area (Newton; 617-795-1875). Her best-selling Sports Nutrition Guidebook is a popular resource, as is her online workshop. Visit NancyClarkRD.com for more info.

ahtlete running

RED-S: What’s That?

RED-S stands for Relative Energy Deficiency in Sport. It happens when athletes eat insufficient food relative to the number of calories they burn. Athletes who enjoy the See Food Diet (they see food and they eat it) are less likely to experience RED-S compared to those who eat restrictively because they are fearful of weight gain. Athletes who eat only “healthy” foods can also slide into RED-S when they unknowingly consume too few calories to support optimal physiological functions.

Athletes most at risk for RED-S tend to be in sports that 1) emphasize appearance (figure skating, dancing), 2) have weight categories (wrestling, rowing), and 3) require endurance (running, cycling). But any athlete can suffer from RED-S—even those who have not lost weight. Take note: under-eating is not always accompanied by weight loss! When the body perceives a “famine” (too little fuel), it does an amazing job of preserving itself from wasting away. 

I get concerned about RED-S when I hear athletes say things like: 

“My friends tell me I eat like a bird…”

“I’m not losing weight, despite all my exercise. Am I eating too much—or too little?”

“I stopped getting my period last year. My doctor said that’s normal for female athletes.”

As mentioned above, RED-S is common in weight-class sports. Case in point: A survey of male and female competitive lightweight rowers (≥18 years old) indicates that many of the rowers had RED-S. They ate an inadequate amount of food relative to what their bodies deserved to be fed. They prioritized weight over health to qualify to row. As a result, the under-eaters experienced excessive fatigue, muscle loss, poor recovery between training sessions, stress fractures, and reoccurring injuries. 

Interviews with the rowers indicates they knew very little about RED-S. Most of the rowers—as well as their health care providersthought RED-S affected only women who had stopped having regular menstrual periods. Wrong. RED-S applies to both male and female athletes!!! 

Because lack of RED-S education can easily contribute to long-term health issues, this article educates all athletes, males and females alike, about the adverse effects of being under-fueled. Please share this with your partners, teammates and others whom you may notice “eating like a bird.” 

  • A tell-tale sign of RED-S in males is loss of libido/sex drive, and in females, irregular or no monthly menstrual period. Other health issues related to RED-S include weight loss (bot not always), reduced bone health that shows up as stress fractures today and osteoporosis in the future, chronic fatigue due to poorly fueled muscles, nagging injuries, moodiness, and depression. Performance issues include inability to gain or build muscle or strength, reduced agility and coordination, poor recovery from hard workouts, impaired judgement, loss of mental sharpness, and reduced ability to focus. An athlete’s plan to lose weight to enhance performance commonly backfires in the long run, if not the short term.
  • As mentioned above, RED-S appears in not only athletes who consciously restrict their food intake, but also in those who unknowingly consume inadequate fuel to support their bodies’ energy needs. This can happen with athletes who juggle school, work, family, friends, and training demands—and have “no time” to eat. RED-S can also happen with others whose “healthy diet” includes a lot of high fiber foods such as beans, nuts, and whole grains that can curb one’s appetite. Or maybe the athletes think they are eating enough because they eat large portions—but the foods are what I call “fluff” (rice cakes, popcorn, lettuce). Regardless of the cause, having low energy availability affects all systems of the body.
  • While restricting food and prioritizing weight over health has become normalized among athletes, you need to know that under-eating is not harmless. Living with an energy deficit affects every system in the body, including the gastro-intestinal system (reduced GI motility, constipation), cardiovascular system (dangerously low heart rate, unusual fatigue), slowed metabolism (energy conservation, cold hands, cold feet). An athlete should never try to maintain a “competitive weight” all year round. 
  • Poor knowledge of RED-S can lead to under-diagnosis, poor management, and poor health outcomes. For example, some health care providers still tell female athletes that amenorrhea is normal in women who train hard. The recommendation to “Just take a birth control pill to get your period” is outdated and does not resolve the underlying problem: an inadequate amount of fuel to support normal functioning of the whole body.

Do you have RED-S? 

Here are a few questions that could help identify if you are under-eating. Do you:

  • Constantly think about your food, weight, or body image? 
  • Severely limit your food intake?        
  • Experience guilt or shame around eating “unhealthy foods”? 
  • Count calories or fat grams whenever you eat or drink? 
  • Feel fat even though others tell you that you are thin?

What’s the solution? 

If you are training hard and eating very little, you could easily be experiencing RED-S. While the obvious answer is— Just eat more and exercise less — doing so can be difficult. Fear of weight gain is a huge barrier. As I repeatedly hear from my doubting clients, “What makes you think I could eat more, exercise less, and not get fat? That just doesn’t make sense.” 

Well, it does make sense because the body does an amazing job of conserving energy (cold hands and feet, low heart rate, loss of menses/libido). When you eat more, your metabolism perks up and you burn off the added calories, as opposed to store them as excess flab. You’ll then be able to train better, recover better, and perform better. If you are under-eating, start by adding 100 to 300 calories to breakfast, then lunch, and then afternoon snack. Notice the benefits: feeling perkier and well-fueled!

The time is right to revolutionize the culture of sport, so that athletes can focus more on performance and health, and less on weight. To initiate this change, you might want to participate in your sport at a weight that fits your genetic physique and allows you to prioritize health over weight. Excelling as a strong and powerful athlete could easily lead to a more satisfying sports career than starving yourself to be an injury-prone athlete who spends too much time sitting on the sidelines. The thinnest athlete is unlikely the best athlete. The best fueled athlete who is genetically gifted will win the prize!

The bottom line: If you think you have RED-S, talk with a trusted sport dietitian (RD). Poorly managed RED-S can too easily end up as malnutrition, disordered eating, osteoporosis—and a disappointing future for your athletic aspirations.

Nancy Clark MS RD CSSD counsels both fitness exercisers and competitive athletes in the Boston-area (Newton; 617-795-1875). Her best-selling Sports Nutrition Guidebook is a popular resource, as is her online workshop. Visit NancyClarkRD.com for info.