March 2008

Big League RDs: Refereeing Players’ Diets in the NFL
By David Yeager
Today’s Dietitian
Vol. 10 No. 3 P. 32

Whether they’re behind the scenes calling nutrition plays for a full roster of athletes or calculating caloric needs for individual players, dietitians are proving to be some of teams’ most valuable members.

If you’re one of the millions of people who gather in front of TV screens and fill stadiums each fall rooting for your favorite NFL team, you may occasionally marvel at the players’ size. But while their size and athleticism generate excitement on the field, a lot of preparation goes into getting them ready to play. From the first day of training camp to the last day of the season, as well as throughout the off-season, there is a great deal of work needed from every member of the team.

And in the NFL, a team is more than the players on the field. Like a movie or film crew, the people who work behind the scenes help the players prepare for their moment in the spotlight. A share of any team’s success can be attributed to front office personnel, coaches, trainers—and dietitians. What was once a part-time job has become a year-round pursuit of size, strength, and speed. And even though physical training is still the mainstay of football camps and NFL workweeks, what the players eat can have a big effect on how well they play.

Nutrition 101
Most NFL teams now have a dietitian on staff. From recommending foods to serve at a team’s training facility to developing meal plans for individual players, the team dietitians try to make sure the players eat healthy diets—a large undertaking, to say the least. “When you have a team of 53 active players and eight people on the practice squad, monitoring the diets of 61 people individually is a struggle,” says Roberta Anding, MS, RD, LD, CDE, CSSD, of the Houston Texans. “But setting up a system where the system supports the needs of players is, in my opinion, probably a better strategy.”

To that end, the Texans include two foodservice lines in the team cafeteria, one of which is based on American Heart Association (AHA) guidelines minus the sodium restrictions, since NFL players sweat a lot. Anding finds the AHA line to be an excellent teaching tool, especially for players who need to watch their weight. “I can help them to set up their plate in the cafeteria, and then it’s one-stop shopping,” says Anding. “The great thing about that is, when you teach those basic principles, they may or may not do it when they go home, but at least they know how to organize a plate and a little bit about why this is a better choice for them.”

One method of teaching that Jeanie Subach, MA, RD, CSSD, LDN, of the Philadelphia Eagles has used is color coding the items on the team’s menu. Red dots for penalty foods—high fat, high calorie, high sodium; yellow dots for field goal foods—nutritious but not the best choices; and green dots for touchdown foods—low fat, lean proteins, and fruits and vegetables. “You want to go for the touchdown. If you can’t go for the touchdown, you go for the field goal. Sometimes, you go offsides,” she explains.

“A perfect example would be a turkey sandwich on whole grain bread with lettuce, tomato, and olive oil. That would be a touchdown food. You have your lean protein, you have your vegetables, you have your whole grains, you have your good fats,” says Subach. “Then you might want to go to the turkey sub, which would have some cheese on it; you have white bread. It’s the same components but just a little more fat and calories. And then, of course, a penalty food would be a cheesesteak. The penalty foods are mostly the fats and the sweets—the big chocolate chip cookies, the alcohol. And basically there’s no restrictions, but they know that if you eat a penalty food, eat it, it’s done, walk away.”

Getting Player Buy-In
Anding has found that the players’ perception of certain foods can affect their willingness to eat them. “I tried one time to bring in—and this was a flat-out disaster—quiche,” she says. “It was like, ‘Are you kidding me? I’m not eating quiche.’ And it’s not that they don’t eat eggs because they eat eggs. It’s not that they don’t eat egg whites because we have egg whites on our breakfast menu every single day. But it was the form that it was in. It looked more like a brunch menu than it did a meal for a football player. So it’s the perception of what the food needs to be. Those types of things change slowly.”

To head off the debate about what real men will or won’t eat, Anding took a suggestion from Dan Riley, the Texans’ strength and conditioning coach. She started a food committee and asked two veterans to let her know what the players in the locker room were saying about their food preferences. The arrangement has worked well for Anding and the players.

All the dietitians interviewed for this article agree that strength and conditioning coaches are valuable assets for connecting with players, and the importance of proper nutrition for athletic performance is not lost on Riley. He devoted 14 of the 67 pages in the Texans’ training manual to the subject. Riley says the physical demands of games and practices exact a heavy toll on the players once the season begins, leaving them “on the edge of being able to recover.” Eating a healthy diet can influence how well a player meets those demands, but ultimately, the decision to work with the dietitian rests with the individual.

“Generally, a player realizes that there’s something that might be nutritionally related that may be keeping him from performing at his peak,” says Michele Macedonio, MS, RD, CSSD, LD, of the Cincinnati Bengals. “For instance, I’ve had players come to me with cramping issues. I’ve had players come because they need to bulk up, they’ve tried different supplements, different routes, it’s not working, and the strength coach will say, ‘You need to talk to Michele because your training program has to be coupled with your nutrition program in order to get the best results.’”

The players who come to the dietitians are often highly motivated. “The most amazing thing about these guys is that you give them a plan to gain a pound a week or 2 pounds a week, and they come back a week later and they’re exactly, scientifically where they should be,” says Wendy Meyer Sterling, MS, RD, CDN, of the New York Jets.

Once a player makes up his mind to follow a nutrition program, the dietitian’s job is to help him figure out what his needs are. Everyone’s metabolism is different. “Usually what I do is I come up with my best professional guess of what the calorie levels are, and then we adjust it on a week-to-week basis,” Sterling says. “So should my guess be off or should it not be working, then we adjust it as needed.”

Fueling Performance
The premise is simple: Food fuels the body, so the better the fuel, the better the performance. But putting that premise into action can be complicated by the type of work the body does and the amount of energy it expends. Is the player a lineman who’s trying to keep his weight down or a defensive back who’s struggling to maintain the hard-earned muscle he added in the off-season? When you consider that players typically practice for a couple of hours per day during the season and follow a regular weight lifting schedule, it’s clear that they need not only plentiful sources of good fuel but also a healthy dose of nutritional advice.

“Every player has their unique set of goals that they’re working towards, be it weight gain or lean muscle mass or body fat reduction or improved performance,” says Sterling. “Everybody’s got a different set of goals.”

Calorie consumption varies depending on the size of the player, how much he runs during the week, and whether he’s trying to lose weight or add muscle. It can range anywhere from 2,500 to 5,000 calories per day. Macedonio says that, generally speaking, players need to consume approximately 37 to 41 calories per kilogram of body weight to maintain athletic performance.

While most people know how difficult losing weight can be, gaining it can be equally challenging. Players don’t want to get heavier for the sake of being heavier; they want lean muscle mass. But getting enough calories to fuel performance and maintain muscle isn’t easy, especially because most players don’t like to eat before going through a strenuous practice. This is an area where the team dietitian can help.

“My focus is going to be four things: It’s going to be fluid, fiber, getting in the appropriate types of fat, and lean protein. I want them getting in adequate calories, but we’re not going to do that by junking up their eating,” says Leslie Bonci, RD, MPH, LDN, CSSD, of the Pittsburgh Steelers. “I’m going to push them to have a little bit more, but volumewise, I can add a little bit more if I add some pesto to a pasta rather than just making them eat another whole plate of pasta. Or I can throw those nuts and seeds into a salad to give them a little bit more or throw some cheese into that salad, not a huge hunk of cheese, but there are ways that I can take that same volume of food and up the calories without making it blatantly obvious to that player that he has to be consuming more.”

A common stumbling block to adding muscle is protein overconsumption. Muscle magazines and football coaches across the land drill the “more protein” mantra into young men’s heads. In one sports nutrition class that she teaches, Anding asked her football players to track the amount of protein that they ate, and she found most of them were eating roughly 4 grams per kilogram of body weight—more than twice the amount they need. Lean protein is important for muscle synthesis but so are carbohydrates. Frequently, the carbs are shortchanged.

“What is happening is they are eating this high-protein diet and limiting the carbs, but that protein is actually being used as an energy source because the carbohydrate’s not there,” says Subach. “And then when it comes time for muscle synthesis, there’s not enough protein to develop the muscle.” To derive maximum benefit, players need to consume approximately 1.7 grams of protein per kilogram of body weight and 5 to 7 grams of carbohydrate per kilogram of body weight per day.

Meal timing is another important consideration. In addition to eating within two hours before a workout or game, eating after a workout is critical for maintaining and adding muscle. Bonci recommends that players eat within 15 minutes of a workout. “Otherwise, we’re delaying the recovery that much more, and that doesn’t help somebody to perform at the optimum,” she says. The players don’t need to eat large quantities; they just need to consume enough nutrients to aid muscle recovery. Macedonio says peanut butter and jelly sandwiches, yogurt and fruit smoothies, dried cereal, nuts, milk, and kefir all make good after-workout snacks. While whole grains and other low-glycemic carbohydrates are generally a preferred source of calories, high-glycemic carbohydrates such as white bread are useful for postworkout recovery.

Proper hydration is also necessary to maintain performance and prevent dehydration or cramping. Players often mistakenly assume they’re getting enough water, says Bonci. “They may not be drinking enough, and they need to realize that there are other ways for them to get their fluids in and optimize the amount of fluid that goes in.” Thirst is not always an accurate indicator of whether a player needs fluid, she adds. And cramping isn’t strictly a warm weather problem either. Anyone who watched January’s playoff game between the Green Bay Packers and the New York Giants—the temperature during the game dipped to a balmy -4°F—may remember that cornerback Al Harris had cramping problems that caused him to miss some playing time.

Off-the-Field Benefits
Whatever a player’s reason for changing his diet, the sooner he talks to the dietitian, the more he’s likely to benefit. “Most of the players—and I give this talk to the rookies—who come to me are the players at the end of their careers, and they’re saying, ‘What can I do to improve my performance to extend my playing time a little bit?’” says Subach. “And I tell the rookies, ‘If you can just take the advice that I give these guys and start it early in your career, you’re not going to be looking for the magic answers in the last few years.’”

And working with a dietitian early in a player’s career can have benefits beyond football. “I had a young rookie this year who, for the first time when he looked at his blood work, he was just shocked,” says Macedonio. “He said, ‘You know, at home my mother was really good about nutrition, and she was real careful. I’ve never had high cholesterol before.’ And he said, ‘I looked at my lipid profile, and my cholesterol’s up there.’ So we worked on that. I gave him some guidance on how he might select better so that he can control his cholesterol better.”

As Anding points out, “Say you have a retired player who has a heart attack at 45. Cardiovascular disease didn’t start for him when he retired. Cardiovascular disease is a lifelong process, and who was monitoring the store prior to that?” For this reason, she has lobbied the NFL Players Association to implement dietary counseling for retired players.

“I think across the league, a lot of us as sports dietitians are really trying to push this issue, given the fact that life expectancy is not wonderful for NFL players,” says Bonci. “[We need] to really start to talk with them as they are approaching their last year of play and say, ‘How can we start to do this? How can you make that transition?’”

Considering all the ways dietitians can contribute to a player’s—and team’s—success, it’s not surprising that so many teams employ them. “[Former Steelers head coach] Bill Cowher said to me after we won the Super Bowl, ‘You know, you’re one of the reasons that we’re here. You’re one of the reasons that these players did what they needed to do.’ It was just so neat to hear,” says Bonci. “And that’s true. There isn’t one discipline that’s going to do it all, and everybody together makes those players better. So if somebody’s following those nutrition recommendations, they’re going to put out more in the weight room, and they’re going to put out more on the field, and they may be injured less. So all of these little building pieces together are what helps us to construct a great athlete, no matter what sport it is that an athlete plays.”

— David Yeager is an editorial assistant at Today’s Dietitian and an avid Eagles fan, but he wishes the Bengals, Jets, Steelers, and Texans good luck in the 2008 season.

Audibles
Pro Tips for Working With Everyday Athletes
Professional football players are highly trained athletes with highly specialized dietary needs, so much so that most NFL teams now have a dietitian on staff. But the skills that these dietitians apply to professional athletes can be adapted to athletes at any level of competition, be it recreational, scholastic, or collegiate. So how do these pros go about teaching sports nutrition?

The first thing to consider is whether the athlete has any medical conditions that need to be addressed. It’s important to integrate medical nutrition issues that the athlete has into the overall nutrition program, says Roberta Anding, MS, RD, LD, CDE, CSSD, of the Houston Texans. “If I have a marathoner who has high cholesterol, I just can’t have them pound back food that’s high in saturated fat,” she says.

“When you’re working with an everyday athlete, it’s all about ‘Can I help them meet their performance goals?’” adds Anding. She recommends documenting outcomes to build a portfolio of success stories.

It’s also important to clearly explain basic nutrition principles. “Don’t assume that people know basic nutrition,” says Jeanie Subach, MA, RD, CSSD, LDN, of the Philadelphia Eagles. “That’s an assumption we make all the time. We assume that they know, and they don’t.” Start with the basics and build from there, Subach says. “Sports nutrition is basic nutrition fine-tuned.”

When designing a nutrition program, remember that athletes need more—more rest, more water, and more food. “One of the things I think is really important is to get out of our heads just MyPyramid.gov,” says Leslie Bonci, RD, MPH, LDN, CSSD, of the Pittsburgh Steelers. “As wonderful as that is, it’s just not geared toward somebody who is going to be very physically active.” Bonci says, for the most part, athletes will need at least 1.5 times the amount of food recommended by MyPyramid.

“No. 2 to me, even beyond the food, is the timing,” says Bonci. “That’s the thing that I harp on with my athletes. Even more so than what they eat is when it is that they’re eating. … So in that hour before practice or workout, you are starting at that point to hydrate and fuel. And within that 15-minute post [practice], you’re closing the deal. You are helping your body to rehydrate and expedite recovery,” she says. “So if we phrase things that way, then it gets an athlete to say, ‘OK, when I’m preparing for practice, this is what I need to do.’ And that’s a selling point. And I’ve never had an athlete come back and say, ‘That didn’t work.’ It works 100% of the time, which is really a nice thing to be able to say.”

An athlete’s schedule can be hectic, so consider when they’ll have time for meals. “I think that sometimes an athlete’s schedule can be the most daunting, in that an athlete is usually so busy that they only have short moments of free time throughout the day. I find that I spend a lot of time talking about logistics,” says Wendy Meyer Sterling, MS, RD, CDN, of the New York Jets. “Where are they going to get the food? How are they going to get the food? How are they going to get lunch? Where is it going to come from? And so I certainly think paying individualized attention to an athlete’s schedule is going to be key.”

Finally, strive for changes that can be maintained in the long run. “What I try to do is give the client enough information so that when they are not working with me, they can go ahead and continue on their program, that it’s not a diet that they go on and off, that it’s something that becomes a way of life,” says Michele Macedonio, MS, RD, LD, of the Cincinnati Bengals. “And with the recreational athlete, I stress small changes over time. They don’t necessarily have a hard and fast time frame where something has to [happen]. And what I have found is that when people make reasonable adjustments over time, they’re more likely to keep them.”

— DY