TrueSport: March 2022 - Nutrition

You may have heard of inflammation in popular news media lately and wondered if it could impact your athlete. Or maybe your athlete has been feeling more sore than usual and you’re not sure if that’s a good thing or a bad thing.

Inflammation sounds scary, but for athletes, it’s a natural part of the training and competition process. Here, TrueSport expert Stephanie Miezin, MS, RD, CSSD, explains what inflammation really means for an athlete, why it’s not always a bad thing and how to naturally lower levels of chronic inflammation.

Inflammation isn’t a bad thing

Inflammation is the natural and necessary process of the body trying to deal with an issue. It can come from many things: exercise, muscle damage or trauma, and the immune system removing pathogens in the body. We all think that inflammation is inherently bad, but it’s happening for a reason.

You may not want to decrease inflammation

Everyone wants to decrease inflammation, but there is a purpose for it. For things to heal and get better, inflammation needs to occur. For athletes, muscle damage occurs naturally through physical activity and the body's repair process will generally include some sort of inflammatory process.

Your goals matter

If an athlete is training frequently and needs to recover quickly, decreasing some inflammation is useful. On the other hand, if somebody is prioritizing adaptation to exercise (lifting heavy at the gym, for example), that means letting that inflammatory process take its course, so it may be better to skip anti-inflammatory strategies.

Skip anti-inflammatory supplements

There are a lot of anti-inflammatory foods like tumeric, tart cherry juice and antioxidant-rich foods that have been shown to decrease different markers of inflammation. When it comes to antioxidants and anti-inflammatory foods, ‘food first’ is recommended. We’ve seen that with supplements, some research has found that increased inflammation or increased oxidation can occur, so the supplements are actually backfiring.

It’s also important to remember that foods that are high in anti-inflammatories and antioxidants are generally good to eat regardless. For instance, foods that naturally contain the antioxidant vitamin C, like oranges, berries or red peppers, contain so much more than just that one vitamin. They have beta carotene, which turns into vitamin A, and they have fiber and other phytonutrients.

Food can also cause inflammation

While some foods can help lower inflammation, other foods can exacerbate it. Refined sugar — that’s added sugar, not natural sugar from fruit or grains — can increase inflammation. More specifically, the high glucose load that comes in when an athlete eats a lot of refined sugar can lead to increased oxidation, which can harm cells and lead to inflammation. If blood glucose is going out of a healthy range frequently, that can lead to inflammation that builds up over time. Saturated fat is also associated with increased inflammation, as are fried foods, particularly those fried in oil that’s been heated and cooled multiple times.

…But athletes still need to eat

While refined sugars and fried foods might add to inflammation, it’s critical not to undereat in an attempt to avoid extra sugar. Instead, try to eat healthfully with whole foods — including plenty of unrefined or less refined carbohydrates — 80 percent of the time. For young athletes who are really active, it might be difficult to meet all their energy needs with ultra-healthy foods, so focus on nutrient-dense sources like vegetables, protein and whole grains in the appropriate quantities. If athletes are under-fueling, that’s going to lead to low energy availability and potentially poor immune system function and increased risk of infections.

Inflammation can’t be “cured” with food

Instead of looking to food to cure suspected inflammation issues, consider first where that inflammation may be coming from. For athletes, high training volume and intensity, especially for prolonged periods, could be the root of excessive inflammation. While dietary strategies may be able to help, they very likely won’t be as effective as focusing on adjusting training to better manage inflammation.

Inflammation is a moving target

Testing for inflammation, or even what the appropriate inflammation levels are, is difficult. There are some blood markers like C-Reactive Protein (CRP) and interleukin proteins 6, 8 and 10 that are used for research purposes, but even those are only part of the picture, and the ‘right’ level for people will vary. And even symptoms aren’t perfect indicators. Feeling sore is the obvious one for athletes, but even that might be related to delayed onset muscle soreness (DOMS) rather than systemic inflammation.

Inflammation shouldn’t be your focus

Ultimately, the best offense for inflammation is a good defense. Rather than stressing about testing certain blood markers, take control of your training and fueling before it becomes a concern. Avoid overtraining and build your diet from colorful fruits and vegetables that are rich in antioxidants and fiber. Overall, people don't need to be worrying about inflammation as much as they might think.

Takeaway

To prevent inflammation, athletes should avoid overtraining and eat a whole food-based diet that contains plenty of colorful fruits and vegetables, protein and whole grains. And remember: some inflammation is a good thing.

Creating strong boundaries is an important and often overlooked piece of the coaching dynamic. A lack of boundaries can not only impact a team’s success, but also lead a coach to experience burnout and negative mental health effects. Here, TrueSport expert Kevin Chapman, PhD, clinical psychologist and founder of The Kentucky Center for Anxiety and Related Disorders, is helping coaches understand how to set — and stick to — boundaries with athletes, parents, administrators and even with themselves.

Why does a coach need to think about their boundaries?

As a coach, a lot is expected of you. But of course, you aren’t only a coach...you likely have many other responsibilities in your life. “Ultimately, coaches have lives, they have families, they have spouses, they have their own spiritual lives and they often even have other full-time jobs outside of the sport,” says Chapman. “Like athletes need to be able to leave a bad practice or game on the field and move on, coaches need to be able to step away from the team as well. When coaches don't set healthy boundaries, that can create emotional dysregulation as well as strife within the team. And in many ways, it can create a negative relationship that affects performance.”

How to set boundaries with your team

A healthy coach-athlete relationship is one that is well-defined and has specific boundaries. Many student-athletes unfortunately put their coaches in an almost parent-like role in their lives, but that can be problematic for many reasons. “Oftentimes, we have unrealistic expectations for coaches, because in many ways, people expect coaches to parent their kids. But coaches aren't responsible for that,” Chapman says. “Coaches are responsible for enhancing the development of the student athlete by teaching them discipline, camaraderie, teamwork and communication, which are those skills that they won't learn necessarily in other settings. And that's why being an athlete is so incredibly rewarding: If you have the right coaches, you learn those things.”

However, that doesn’t mean responding to emails from athletes at 3 a.m. or talking to teachers about getting athletes extensions on papers they haven’t done. Make sure athletes know what they can expect from you, and keep those expectations the same for the entire team. No one athlete should get special treatment or extra allowances from you.

How to set boundaries with parents

This can be really hard to navigate, Chapman admits. Some parents want to be involved with a team for good reasons and with the best intentions, but it’s better to set a blanket boundary for parents rather than allowing some to participate and not others. “Draw a line in the sand about the boundaries that you will maintain throughout the season with parents as it relates to interacting with you as the coach on an individual level, as well as their interactions with players, parents, and officials,” says Chapman. Start each season by informing parents of your boundaries for them: Can they be at practice? What do you expect them to do on competition days? Should they email you about their athlete?

How to set boundaries with administration

“Coaches have a really delicate interplay with school administration, since the administration is responsible for their livelihood, but the coach might also be the mediator between the administration and a student, or administration and a parent,” says Chapman. To create boundaries and consistency, consider having all the coaches at your school or within your club get together to create a set of ideal boundaries between yourselves and the administration and present them as a united front.

For school coaches, this could include establishing your ability to bench or suspend any athlete for misconduct. This might help if, for example, you have to bench your star player for skipping too many practices, but he gets reinstated by the school administrator who wants the team to win the statewide championship. “Things like that undermine a coach’s authority and can lead to burnout or worse,” says Chapman.

How to set boundaries with your own goals

It might sound strange to set boundaries around yourself, but when it comes to goal-setting, you do need to set some healthy expectations around performance and outcomes. If you don’t create a boundary between how the team performs and your personal goals for coaching, you’ll often end up frustrated and/or putting too much pressure on yourself or the team.

“As a coach, your goals shouldn’t be focused on the team’s outcomes in competition,” Chapman says. “Instead, coaches need to set goals that show that their coaching is working and improving. This might include practical process goals like boosting percentages of shots made in a game, but it can also include things like communicating your emotions effectively as a coach and helping your players do the same. A process goal for that could be deciding that at least once in every single team meeting, you ask athletes, ‘What is an emotion you experienced today at practice? How did you respond?’” Make sure that your goals enhance team culture and help your athletes develop as both athletes and humans. It’s also beneficial to communicate these goals to others, especially administration, to ensure that your values are aligned.

Owning your mistakes

As a coach, ensuring that your athletes don’t view you as an infallible, always-perfect person is important for both their wellbeing and your own. It’s tempting to set up a boundary that blocks athletes from seeing any part of you that’s imperfect, but that kind of boundary isn’t healthy for anyone. “Know when you need to show your athletes that you’ve messed up, since that lets them see it’s okay to make mistakes and that it’s important to own those mistakes,” Chapman says. “It’s also important to know when to apologize, and when to let athletes know you’re struggling.”

Of course, this is context dependent: You likely don’t need to apologize to your kindergarten soccer team for a call you made that caused them to lose the game. But you could explain a mistake you made in designing a play to your high school football team.

The importance of sticking to your boundaries

Boundaries only work when they’re clearly defined and respected — most importantly, when they’re respected by you. It’s tempting to allow for exceptions, such as a late-night call with your star athlete who’s going through a tough time, but that doesn’t do you or your team any favors in the long run.

Takeaway

As a coach, it may feel like you struggle to find the right boundaries, and to maintain them. But by setting clear boundaries and expectations early, you’re not only helping yourself and your mental health, you’re helping your team members, parents and school administration.

You might think of bone and joint health as something older adults have to contend with as they age, but in reality, childhood and adolescence is the time to lay the foundation for bone and joint health. In fact, the National Institutes of Health points out that “up to 90 percent of peak bone mass is acquired by age 18 in girls and by age 20 in boys.”

Fortunately, bone and joint health can be supported by food choices. Here, TrueSport expert Kristen Ziesmer, a registered dietitian and the owner of Elite Nutrition and Performance, is sharing how to eat for bone and joint health.

Why does eating for bone health matter for young athletes in particular?

“Anytime that a young athlete is doing any type of exercise, that puts stress on their bones and joints. This is especially true of sports with a lot of repetitive movements,” says Ziesmer. “And that includes most sports young athletes are doing, since even sports that aren’t super repetitive often will have repetitive drills in practice. That repetition, especially when it’s high impact things like jumping, puts a lot more stress on their bones. Injury is obviously a concern, so we want to help our athletes proactively prevent that."

Calcium

You probably remember from high school health class that calcium is the mineral necessary for growing strong bones. Calcium provides structure and strength to your bones. “Making sure young athletes eat enough calcium now is so important for them later,” Ziesmer says. “As early as our 30s, we start slowly losing bone density. So, we want to make sure that athletes are stocking up on calcium when they're young.”

She recommends aiming for roughly 1500 to 2000 milligrams per day. Dairy is the obvious source of calcium: milk, Greek yogurt, regular yogurt and kiefer are all great sources. But you can look beyond dairy too, including leafy greens, broccoli, and fish with the little bones in them (sardines or canned salmon with bone in).

Vitamin D

What you may not remember from high school health class is that without enough vitamin D, calcium can’t be absorbed properly. And this is tricky, since vitamin D is almost impossible to get from food alone — it requires exposure to sunlight (or doctor-recommended supplementation).

Ziesmer suggests getting vitamin D levels checked regularly because many young athletes end up deficient in this vitamin since outdoor exposure is limited during school hours and many northern climates lack the opportunity for sun exposure. “Vitamin D is an important hormone that controls so many things in our body, including bone health,” she says. “The best source is from the sun, so try spending 30 minutes a day outside during prime sun hours.” You can also get small amounts from foods, including egg yolks, sockeye salmon and shiitake mushrooms, as well as dairy and other foods like orange juice that are fortified with vitamin D. Before you consider adding a vitamin D supplement, make sure you check with a doctor.

Vitamin K and Magnesium

Vitamin K and magnesium are also essential to help the body absorb calcium. “Both of these can also inhibit bone healing if people are not getting enough,” Ziesmer adds. The good news is that these two micronutrients are relatively easy to find in a whole food diet. “Leafy greens, nuts, seeds, beans, whole grains — all of these offer plenty of vitamin K and magnesium,” she says.

Glucosamine

Many older adults supplement with glucosamine or glucosamine chondroitin to improve joint health. But while glucosamine does have positive effects on bone health, young athletes can likely skip the supplement (unless directed by a doctor). Like collagen, your body is born with a certain amount of glucosamine and you don’t naturally reproduce it. It just goes away slowly as we age. But a healthy diet that includes the appropriate vitamins and minerals can go a long way to protecting your athletes’ bones and joints without resorting to supplements.

If you do want to add glucosamine to your athlete’s diet, consider buying or making a bone broth. Because bone broth is made by breaking down connective tissue and cartilage, it actually does contain glucosamine, as well as collagen, which can potentially help with joint and muscle protection, says Ziesmer.

Protein

While we’ve been focusing on micronutrients, a healthy diet that contains a good blend of carbohydrates, fats and proteins is also critical for bone health. Protein in particular is important, though not specifically for your bones. Rather, Ziesmer says, we need enough protein to protect and develop the muscle that attaches to your bones and serves as their primary protection from injury. The stronger and healthier your muscles, the more protective they are. She suggests aiming for one gram of protein per kilogram of body weight at least. If an athlete is injured, increase that number to 1.5 grams of protein per kilogram of body weight to promote healing.

Eating Enough

The last, and arguably most important thing to remember about eating for bone and joint health, is simply eating enough. A young athlete who isn’t getting enough calories overall is more prone to injury, bone loss, bone damage and other negative health repercussions like a loss of periods for young women or issues with illness and fatigue. Unfortunately, there are many young athletes who are chronically under-fueled, and that can have disastrous consequences. “Athletes should eat consistently throughout the day with a balanced meal or snack at least every three hours, and really focus on eating to a comfortable fullness,” says Ziesmer. (You can see what a balanced plate should look like right here.)

Takeaway

Strong bones and joints can lead to stronger performances and healthier bodies for young athletes who strive for optimal performance. Eating enough of the right foods, including calcium, vitamin K and vitamin D, can help improve bone density and strength: