Eating to win: activity, diet and weight control E112_3 Eating to win: activity, diet and weight control Page 2 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control About this free course This free course is an adapted extract from the Open University course E112 Introduction to sport, fitness and management: www.open.ac.uk/courses/modules/e112. This version of the content may include video, images and interactive content that may not be optimised for your device. You can experience this free course as it was originally designed on OpenLearn, the home of free learning from The Open University - www.open.edu/openlearn/health-sportspsychology/health/sport-and-fitness/eating-win-activity-diet-and-weightcontrol/content-section-0. There you’ll also be able to track your progress via your activity record, which you can use to demonstrate your learning. Copyright © 2016 The Open University Intellectual property Unless otherwise stated, this resource is released under the terms of the Creative Commons Licence v4.0 http://creativecommons.org/licenses/by-nc-sa/4.0/deed.en_GB. Within that The Open University interprets this licence in the following way: www.open.edu/openlearn/about-openlearn/frequently-askedPage 3 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control questions-on-openlearn. Copyright and rights falling outside the terms of the Creative Commons Licence are retained or controlled by The Open University. Please read the full text before using any of the content. 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These are OU logos, trading names and may extend to certain photographic and video images and sound recordings and any other material as may be brought to your attention. Unauthorised use of any of the content may constitute a breach of the terms and conditions and/or intellectual property laws. We reserve the right to alter, amend or bring to an end any terms and conditions provided here without notice. All rights falling outside the terms of the Creative Commons licence are retained or controlled by The Open University. Head of Intellectual Property, The Open University Page 5 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control 978 1 47300 135 0 (.epub) 978 1 47300 040 7 (.kdl) Page 6 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control Contents Introduction Learning outcomes 1 Activity, diet and weight control 2 Activity versus dieting 2.1 Activity and appetite 2.2 Post-meal lipidaemia 2.3 How much food and how often? 3 Fitness and fat metabolism 3.1 Eating and drinking for performance; before, during and after exercise 3.2 Role of high GI foods for athletes 4 Diet, exercise and cholesterol 5 Hydration: Water and sports drinks 6 Eating disorders and the female athlete triad Conclusion Keep on learning References Acknowledgements Page 7 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control Introduction In this free course, Eating to win: Activity, diet and weight control, we will examine the links between physical activity and weight management as well as considering the importance of adequate pre-and post-exercise nutrition and hydration. In examining the role of physical activity in weight management, we will compare physical activity and dieting as weight loss methods and discuss the relative benefits of physical activity, such as an improved blood lipid profile and increased lean tissue. What we eat before and after exercise can have a significant effect on sport and exercise performance, therefore the course will also consider pre and post exercise nutrition and hydration for optimal performance. Finally, the course will consider disordered eating and what is known as the ‘female athlete triad'. This OpenLearn course is an adapted extract from the Open University course E112 Introduction to sport, fitness and management. This OpenLearn course provides a sample of level 1 study in Sport [http://www.open.ac.uk/courses/find/sport]. Page 8 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control Learning outcomes After studying this course, you should be able to: recognise the importance of physical activity in weight management compare and contrast physical activity and dieting as methods of weight loss understand the importance of pre and post exercise nutrition and hydration describe the ‘female athlete triad'. Page 9 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control 1 Activity, diet and weight control This course will focus on why dieting alone is not a successful strategy for weight control. There is a clear relationship between physical activity and measures of body composition such as waist to hip ratio, waist circumference and body fat. Yet data from the Health Survey for England shows that in 2004 only one-third of men and one-quarter of women were taking thirty minutes of exercise at least five times a week (NHS, 2006). Low levels of physical activity are associated with poor diet and obesity, which may in turn be a barrier to being active (Skidmore, 2007). According to NHS statistics (NHS, 2006) the main reasons given by adults for not participating in active sports during the last year were: their health wasn’t good enough (50 per cent), followed by difficulty in finding time (18 per cent) and not being interested (15 per cent). In this course we will consider why this inactivity is of concern in relation to healthy weight and why physical activity is a key component for weight loss and weight maintenance. Physical activity influences appetite and leads to improved overall fitness levels. In turn, higher fitness levels mean you gain advantages that benefit your weight control, because of the increased use of body fat as an energy source, without losing lean muscle mass. One of the major physiological advantages of Page 10 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control exercise is that levels of fat in the blood are reduced. We will consider how exercise can influence cholesterol in the blood, and therefore reduce the risk of coronary heart disease (CHD). Reading 1 Activity and weight control Allow about 1 hour 10 minutes Now read the extract linked below from ‘Fitness and Health’, by Sharkey and Gaskill. In this reading you will learn more about the influence of exercise on weight control compared with dieting. Right-click on the following link to open the PDF in a new tab or window. View document View discussion - Reading 1 Activity and weight control Page 11 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control How much energy is used during activity is related to several factors including the duration and intensity of the exercise. For effective weight control, Sharkey and Gaskill recommend moderate rather than high intensity exercise, because more calories are used before exhaustion is reached. Others emphasise that intensity alone is not so important, and it is the total energy expenditure (duration and intensity) that is more relevant. Sharkey and Gaskill also emphasise that greater fitness allows more activity and therefore more weight control, hence frequency may be more important than intensity. Exercise may be more effective than dieting because of the excess post-exercise oxygen consumption (EPOC), where calorie expenditure remains high for a short while after the period of exercise (the recovery period). Page 12 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control 2 Activity versus dieting In Reading 1, Sharkey and Gaskill refer to several studies that point towards the need to include physical activity in weight-control programmes for successful longer-term outcomes. This is because restricting calorie intake alone, by dieting, leads to a loss of lean tissue (muscle mass) and body water in addition to fat. They emphasise that when the body loses lean tissue it becomes less able to burn calories due to the decreased metabolic rate, and so when energy intake increases again, fat is regained more easily than prior to the calorie-restricted diet. Weight loss with exercise allows the decline in body fat levels without the accompanying loss of lean tissue. Indeed, exercise will increase lean tissue and thus increase basal metabolic rate (BMR). Sharkey and Gaskill conclude that exercise and dieting combined is more effective than dieting alone. 2.1 Activity and appetite As physical activity and food intake are the two key components in energy balance, exercise may have an influence on food intake. Effects on intake are likely to be influenced by the duration, intensity and frequency of exercise. Appetite is a complex phenomenon and is influenced by several factors. In the brain, within a region called the hypothalamus, is the control centre for Page 13 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control food intake, the appestat. Many psychological factors influence the desire to eat. Physiological factors, such as blood sugar levels and hormones, also influence the appestat. It is argued that regular exercise helps the appestat to adjust calorie intake to energy expenditure. It is likely that the types of nutrients in post-exercise food can influence the effectiveness of weight control. In a study on the effects of exercise on energy balance, Tremblay et al. (1994) provided free access to diets of varying fat content to individuals after a 60-minute running session which induced a 500 calorie energy deficit. They found that when exercise was combined with free access to a high-fat diet, individuals were in positive energy balance (750 calories) whereas when exercise was combined with medium- or low-fat diets, individuals were in negative energy balance (-500 and -1000 calories respectively). This suggests that for the exercise to be of benefit in weight loss then high-fat foods must be avoided. Exercise does not provide us with permission to eat high-fat foods; there is a trade-off between the calorie loss from the physical activity and the calorie intake from the foods consumed. 2.2 Post-meal lipidaemia Page 14 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control Lipidaemia (or lipaemia, the presence of fat in the blood) is associated with atherosclerosis. Studies have shown that exercise either just before or after a meal is effective in reducing lipidaemia, by increasing fat utilisation. Sharkey and Gaskill state that exercise before eating may inhibit the appetite and increase fat metabolism, since the metabolic rate remains high immediately after exercise, and that a post-meal walk or other physical activity is also able to reduce lipidaemia. Because metabolism remains high after exercise, this may be the best time to eat a meal if weight loss is the goal. 2.3 How much food and how often? Sharkey and Gaskill point out that by eating food over several periods in the day (three to six), that is, little and often instead of eating a couple of larger meals, the blood lipid and cholesterol levels will be lowered, since the metabolism of the fat eaten will occur over a longer period. In contrast, avoiding meals will lower the metabolic rate and so blood lipid and cholesterol levels will increase. Page 15 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control 3 Fitness and fat metabolism Reading 2 Fitness and fat Allow about 30 minutes Read the extract from ‘Fitness and Health’ by Sharkey and Gaskill linked below. In this reading you will discover the benefits of physical activity on fat mobilisation and utilisation. Right-click on the following link to open the PDF in a new tab or window. View document View discussion - Reading 2 Fitness and fat Fitness contributes to energy expenditure and weight control. As fitness improves it is possible to do more work at the same heart Page 16 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control rate and level of perceived exertion; you are able to burn more energy for the same perceived effort. The term metabolism means the breakdown of foods to release energy. We can metabolise fat, carbohydrate or protein to release energy. 3.1 Eating and drinking for performance; before, during and after exercise During exercise, fatigue may be caused by depletion of muscle glycogen stores and low blood sugar levels. In overall terms, a low-fat diet with plentiful, low GI (glycaemic index) carbohydrates and a suitable amount of protein and plenty of vitamins and minerals is most suitable for athletes. Hydration is also very important and it is considered later in this course. To prepare for exercise, high-carbohydrate meals and snacks are needed to maximise stores. The pre-exercise meal should be taken around two hours before exercise and should consist of low to moderate GI carbohydrates with small amounts of protein and some vitamins and minerals, for example, a chicken salad sandwich made with wholemeal bread. Both immediately before and during exercise which lasts for more than one hour, carbohydrate foods with a high Page 17 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control GI value will delay the time before muscle glycogen stores become depleted. The important aspect of post-exercise recovery is the replacement of carbohydrate. Depending on the intensity of exercise, 7 to 12 grams per kilogram of body weight per day of carbohydrate are required. Evidence suggests that higher GI snack foods may also be more appropriate immediately after exercise since they promote glycogen storage. Glycogen storage occurs faster in the first two hours after exercise but does not begin until after 1 gram per kilogram of body weight has been consumed (Burke, 2007). Therefore it is very important to refuel quickly, using a suitable snack, when there is limited time between training sessions. One example of a high GI snack providing 75 grams of carbohydrate would be a plain bagel (90 grams) with two heaped teaspoons of jam (Bean, 2006) and this snack would begin the refuelling process. This should be followed by a carbohydrate-based main meal. It is important to begin training sessions in a fully hydrated state and it is crucial to re-hydrate during and after exercise to aid a speedy recovery. It may take several hours to fully hydrate even after a loss of only 2 per cent of body weight due to physical exertion. Since alcohol is a diuretic agent and will interfere with rapid hydration, as well as interfering with recovery, the choice of Page 18 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control post-exercise drinks should be carefully considered. Alcohol should be avoided for at least three hours. 3.2 Role of high GI foods for athletes Foods with a high GI value have a useful role in the diet of athletes since they can be helpful in the speedy replacement of muscle glycogen stores. Table 1 shows examples of some high, moderate and low GI foods. Table 1 Examples of high, moderate and low glycaemic index foods High GI Moderate GI Low GI Glucose 100 Cornflakes 81 Potato (boiled) 56 Parsnips 97 Chips 75 Sweet potato 54 French baguette 95 Bagel 72 Bananas 52 Lucozade Original 95 Watermelon 72 White pasta 50 Honey 87 Wholemeal bread 71 Muesli 49 Potato (baked) 85 White bread 70 Porridge oats 49 Sports drinks 70 Baked beans 48 Weetabix 66 Apples 38 White rice 64 Yogurt 36 Shredded Wheat 64 Chickpeas 28 Raisins 64 Whole milk 27 Cherries 22 Fructose 20 Page 19 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control (Source: Adapted from Bean, 2006) A summary of the key information about the use of the glycaemic index for physically active people is presented below: High GI foods are useful two to three hours before and during exercise and in recovery (within two hours of exercise) to speed up glucose entry into muscle cells and to replenish the glycogen stores quickly. Glycogen is replaced at its fastest rate within two hours of exercise. After exercising, glycogen stores need to be topped up quickly to be ready for the next training session. A high-carbohydrate diet with high GI foods immediately after training will result in greater glycogen storage. The term ‘bonking’ is used to describe the experience when cyclists become fatigued as blood glucose levels fall too low, although you may perhaps be more familiar with the term ‘hitting the wall’, often used to describe the same experience in long-distance running. Food or drinks containing high amounts of carbohydrate are the best choices for initial postexercise snacks to replenish muscle glycogen stores Page 20 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control in order to meet the demands of the next training session. Assessing the effectiveness of your eating strategy Allow about 50 minutes Keep a record of everything you eat and drink and all of the physical activity you undertake over a period of 2 or 3 days. Examine the times and frequency of your meals and drinks, and comment on their size. Also note the times and frequency of your bouts of exercise. How does your pattern of eating and drinking compare with the timings that would be most appropriate for exercise performance? Did you eat a high-carbohydrate snack within two hours of exercising? Judging the food record ‘by eye’, was your overall diet high in complex carbohydrate and low in fat? View discussion - Assessing the effectiveness of your eating strategy Page 21 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control 4 Diet, exercise and cholesterol Cholesterol is another type of lipid that is often given bad press due to its role in developing CHD. However, it is produced and used by the body for a range of functions. In fact, cholesterol is so important that it is produced by the liver to meet our daily needs. However, if we consume foods containing cholesterol our liver will make less to compensate for this. The problem comes when we consume more than is needed to meet the requirements of the body. Cholesterol performs the following functions: helps to form the structure of the cell membranes produces bile, which aids fat digestion produces steroid hormones such as oestrogen and testosterone produces vitamin D from sunlight. Cholesterol is found in the same places as saturated fats. Meat, poultry, egg yolks, seafood and dairy products are all sources of cholesterol. Reading 3 Blood lipids Page 22 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control Allow about 30 minutes Read the extract from Fitness and Health by Sharkey and Gaskill linked below. There are quite complex issues about the biochemistry of blood lipids (triglycerides) and cholesterol mentioned here. The important thing to remember is that cholesterol in blood is not all of the same type and so health professionals use measurements of HDL and LDL in addition to overall cholesterol concentration for a more accurate indication of the risk of heart disease. Right-click on the following link to open the PDF in a new tab or window. View document View discussion - Reading 3 Blood lipids Page 23 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control Figure 1 The function of the liver in processing cholesterol Table 2. Risk of coronary heart disease with increasing blood cholesterol levels Blood cholesterol level (mmol/l) <5.2 5.2–6.5 Risk of CHD 6.5–7.5 >7.5 Low Increased Moderate High Blood cholesterol level is measured in millimoles per litre (mmol/l), and this can be measured through a simple blood test. There is cause for concern if the measure of blood cholesterol is over 5.2 millimoles per litre. However, it is important to know the ratio of LDLs to HDLs as well: it should be 75 per cent LDL to 25 per cent HDL. If the amount of LDL is more than 75 per cent, then there is Page 24 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control also an increased risk of CHD. It is possible to have a low blood cholesterol level but still be in danger if the HDL count is less than 25 per cent. HDL count is increased by taking regular exercise and is lowered by smoking and increasing exposure to pollution. LDL count is raised through excess alcohol intake and high consumption of foods rich in saturated fat. The key points about blood triglyceride and cholesterol are: Elevated blood levels of cholesterol and triglyceride are associated with increased risk of CHD. Dieting and exercise can both reduce blood plasma triglyceride levels. Exercise enhances the removal of triglyceride from the circulation, and its utilisation in the muscle cells. The major cholesterol-carrying proteins are LDL and HDL. LDL particles in the blood contain a high concentration of cholesterol. LDL is a major factor in the development of CHD since these LDL particles contribute to the narrowing and hardening of the coronary arteries. Page 25 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control When considering blood cholesterol level measurements, the lipid profile is very important. There is a direct relationship between LDL and CHD whereas there is an inverse relationship between HDL and CHD, so that as HDL levels increase the risk of CHD is reduced. Exercise helps to shift the balance between these, raising HDL and lowering LDL. Thus regular physical activity provides a very substantial health benefit. Page 26 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control 5 Hydration: Water and sports drinks It is essential for health that good levels of hydration are maintained. Water is the most important aspect of our diet because we can’t manage without daily supplies, and fluid losses must be replaced quickly to avoid long-term damage, for example, to the brain and vital organs. The body only has a small reserve of water, and dehydration of tissues results in weakness, headaches, tiredness and loss of concentration, followed by collapse and eventually death. Water losses through urine, from the skin, from breath and in faeces average about two litres per day, and they must be replaced. During physical activity dehydration results from sweating, and so rehydration is necessary to maintain physical and mental performance levels. It is important not to rely on your thirst as an indicator of dehydration, because by then it is already too late as the effects of dehydration are already impacting on performance. Even a loss of water representing 1 to 2 per cent of your body weight can result in a lack of concentration and loss of performance. Video content is not available in this format. Video 1 Hydration Page 27 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control Source: The Open University, 2008 Figure 2 It is important to maintain hydration levels during exercise. View description - Figure 2 It is important to maintain hydration levels during exercise. Figure 3 illustrates the damage caused by increasing levels of dehydration on the body. It is necessary to drink plenty of fluids before, during and after exercise, especially in warm weather. As a general rule, you are advised to drink about 0.5 litres (500 millilitres) about two hours before exercise and 150 millilitres every ten to fifteen minutes during exercise. For events of a long duration, hypotonic or isotonic sports drinks, which supply some Page 28 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control carbohydrate, may be preferred to water. These sports drinks also contain the electrolytes, sodium and potassium, which control the flow of water in and out of cells and are vital to ensure absorption. Figure 3 Adverse effects of dehydration on work capacity (Greenleaf, 1992). View description - Figure 3 Adverse effects of dehydration on work capacity (Greenleaf, 1992). Page 29 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control Water is an excellent sports drink and may well be the preferred drink for activities of less than one hour, but isotonic sports drinks are considered beneficial for use by athletes for events of one hour or more duration. Isotonic drinks are so-called because they have the same number of particles per 100 millilitres as plasma and therefore are quickly absorbed. They contain 4 to 8 grams of carbohydrate per 100 millilitres and some electrolytes (including sodium) that aid absorption. Isotonic drinks are absorbed as fast, or faster, than water alone. These drinks are beneficial for endurance sports because they provide a source of fuel (usually glucose sucrose, glucose polymer or maltodextrin) in addition to water to reduce dehydration. Colouring and flavouring are usually added. You may have come across other sports drinks that are described as hypotonic or hypertonic. The decision to use these drinks will depend upon whether the goal is promoting hydration or promoting carbohydrate uptake from the gut. Hypertonic drinks contain more than 8 grams of carbohydrate per 100 millilitres. They increase the amount of carbohydrate fuel that can be supplied to the muscles, but that will also decrease the rate at which water is available because it slows the rate at which the contents of the stomach empty into the small intestine. When the provision of water for fluid replacement is the first priority, then hypotonic drinks (less than 4 grams of carbohydrate per 100 Page 30 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control millilitres) or isotonic drinks should be used, not hypertonic drinks (Figure 4). Figure 4 The energy concentration of different types of sports drink. View description - Figure 4 The energy concentration of different types of sports drink. Page 31 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control 6 Eating disorders and the female athlete triad Disordered eating describes a range of abnormal eating practices, but the most common among women who engage in physical activity are anorexia nervosa and anorexia bulimia. Disordered eating is more common among female athletes than in the general population and it is more common in sports such as gymnastics where a low body weight is desirable. Male athletes with eating disorders are less common, but cases are observed among jockeys, boxers and wrestlers. Sources of support include b-eat (formerly the Eating Disorders Association). For guidelines in dealing with eating disorders you can visit the b-eat website.The organisation offers advice and information sheets that can be downloaded from its website, for athletes, coaches, and family and friends who may be concerned about the problem. Female athletes who have inappropriate low-energy diets and demanding exercise regimes are at risk of developing the female athlete triad syndrome. The triad is associated with increased morbidity and mortality and is a syndrome of three interrelated conditions: Page 32 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control disordered eating amenorrhoea (absence of periods) osteoporosis (loss of bone density). These three conditions have a synergistic effect (i.e. the overall effect is greater than the sum of the three individual conditions). Disordered eating increases the risk of muscle and tendon injury and decreases concentration. In addition, low body-fat levels may result in menstrual dysfunction including amenorrhoea, which is also more prevalent among female athletes than other women. Amenorrhoea athletica may be a consequence of a combination of factors such as an intense training regime with a strict weightcontrol diet that is too low in fat. Amenorrhoea is associated with low body fat and an associated lack of oestrogen that influences bone density. When hormone levels drop, the breakdown of old bone exceeds the formation of new bone and the result is a loss of bone minerals and bone density. This is a problem that affects young women (less than twenty years old), because at this time they should in fact be accumulating bone to achieve a healthy peak bone mass. Young adults with low bone density do not catch up bone density over time, and if a high peak bone mass is not achieved by the time they reach their mid-twenties it is not likely to be achieved at all. Bone density falls below the fracture threshold at a younger age in people with a low peak bone mass. Therefore Page 33 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control amenorrhoea leads to poor bone health and the increased risk of stress fractures, and early osteoporosis as bone density declines. Bone loss can occur quickly in young female athletes who have stopped having periods and treatment should not be delayed. Teenage girls who recover from anorexia nervosa and amenorrhoea continue to show thin spinal bone years after oestrogen levels have returned to normal (Goulding, 2007). Page 34 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control Conclusion In this course the discussion centred on why it is particularly important to use physical activity in combination with dieting as a means of achieving and maintaining a healthy weight, since activity ensures that fat loss is achieved without the loss of lean tissue. You learned the following: Physical activity should be included in weight loss programmes as it minimises losses of lean body mass (muscle, etc.). Physical activity leads to a decrease in blood levels of triglycerides and LDL and an increase in HDL. It is important to maintain hydration levels during exercise. Maintenance of physical activity is a good predictor of long-term weight loss. An energy deficit of 500 to 1000 kilocalories per day is recommended for weight loss, with a reduction in fat intake to less than 30 per cent of total calories. A drastic reduction in calorie intake, as sometimes occurs in athletes ‘making weight’ or in the female triad syndrome (featuring disordered eating, amenorrhoea and osteoporosis), leads to long-term adverse health consequences. Page 35 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control Page 36 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control Keep on learning Study another free course There are more than 800 courses on OpenLearn for you to choose from on a range of subjects. Find out more about all our free courses. Take your studies further Find out more about studying with The Open University by visiting our online prospectus. If you are new to university study, you may be interested in our Access Courses or Certificates. Page 37 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control What’s new from OpenLearn? Sign up to our newsletter or view a sample. For reference, full URLs to pages listed above: OpenLearn – www.open.edu/openlearn/free-courses Visiting our online prospectus – www.open.ac.uk/courses Access Courses – www.open.ac.uk/courses/do-it/access Certificates – www.open.ac.uk/courses/certificates-he Newsletter – www.open.edu/openlearn/about-openlearn/subscribe-theopenlearn-newsletter Page 38 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control References Bean, A. (2006) The Complete Guide to Sports Nutrition, London, A & C Black. Burke, L.M. (2007) ‘Sports nutrition’ in Mann, J. and Truswell, A.S. (eds) Essentials of Human Nutrition (3rd edn), Oxford, Oxford University Press. Goulding, A. (2007) ‘Major minerals: calcium and magnesium’ in Mann, J. and Truswell, A.S. (eds) Essentials of Human Nutrition (3rd edn), Oxford, Oxford University Press. NHS (2006) Statistics on obesity, physical activity and diet: England, 2006, London, The Information Centre. Sharkey, B.J. and Gaskill, S.E. (2007) Fitness & Health (6th edn), Leeds, Human Kinetics. Skidmore, P. (2007) ‘Macronutrient intakes and their role in obesity’, British Nutrition Bulletin, vol. 32 (supplement, pp. 4-13. Tremblay, A., Almeras, N., Boer, J., Kranenberg, E.K. and Despres, J.P. (1994) ‘Diet composition and post-exercise energy balance’, American Journal of Clinical Nutrition, vol. 59, pp. 975-9. Page 39 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control Acknowledgements Except for third party materials and otherwise stated (see terms and conditions), this content is made available under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 Licence. The material acknowledged below is Proprietary and used under licence (not subject to Creative Commons Licence). Grateful acknowledgement is made to the following sources for permission to reproduce material in this free course: Course image: Ryosuke Yagi in Flickr made available under Creative Commons Attribution 2.0 Licence. Every effort has been made to contact copyright owners. If any have been inadvertently overlooked, the publishers will be pleased to make the necessary arrangements at the first opportunity. Don't miss out If reading this text has inspired you to learn more, you may be interested in joining the millions of people who discover our free learning resources and qualifications by visiting The Open University – www.open.edu/openlearn/free-courses. This free course is adapted from a former Open University course called 'Introduction to sport, fitness and management (E112)'. Page 40 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control Page 41 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control Reading 1 Activity and weight control Discussion The key message of this chapter is that, in weight control, neither exercise nor diet alone result in the same level of longer-term success as exercise with diet. Back to Session 1 Activity 1 Page 42 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control Reading 2 Fitness and fat Discussion The section on cholesterol underlines the fact that with improved fitness you receive additional benefits including a healthier blood lipid profile, with lower LDL (low-density lipoprotein) and higher HDL (high-density lipoprotein) levels. There is a direct relationship between LDL levels and CHD, whereas as HDL rises, the incidence of heart disease declines. Back to Session 3 Activity 1 Page 43 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control Assessing the effectiveness of your eating strategy Discussion Overall, a low-fat diet with plentiful low GI carbohydrates is desirable. Did you achieve this? To prepare for exercise, highcarbohydrate meals and snacks are needed to maximise stores. Both immediately before and during exercise that lasts more than one hour, carbohydrate foods with a high GI value will promote the storage of glucose as glycogen in the muscles. A high GI value post-exercise snack within two hours of exercise should be followed later by a low to moderate GI carbohydrate-based main meal. Were your snacks appropriate? Rehydration, both during and after exercise, is also important for recovery. Did you drink plenty of fluid at the appropriate times? If you are fully hydrated your urine will be a pale straw colour, no darker. Back to Session 3 Activity 2 Page 44 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control Reading 3 Blood lipids Discussion The function of the LDLs is to carry cholesterol from the liver to the tissues where it is needed. The HDLs are responsible for the removal of surplus LDLs from the tissues to be taken back to the liver for disposal (see Figure 1). Therefore, HDLs are regarded as good cholesterol and LDLs as bad cholesterol. (To help remind you: LDL cholesterol is Less healthy, HDL cholesterol is Healthy.) There are clear guidelines as to what are acceptable cholesterol levels and levels associated with an increased risk of CHD. These levels are shown in Table 2. Excess amounts of cholesterol in the blood can increase the risk of cholesterol being deposited onto the artery walls. As the cholesterol is laid down in the artery walls, the artery space will start to narrow and it will cause a hardening of the artery wall. The resulting loss of elasticity to the artery wall and smaller space to transport blood is the start of CHD and can cause angina. Back to Session 4 Activity 1 Page 45 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control Figure 2 It is important to maintain hydration levels during exercise. Description Figure 2 It is important to maintain hydration levels during exercise. Back to Session 5 Figure 1 Page 46 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control Figure 3 Adverse effects of dehydration on work capacity (Greenleaf, 1992). Description Figure 3 Adverse effects of dehydration on work capacity (Greenleaf, 1992). Back to Session 5 Figure 2 Page 47 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0 Eating to win: activity, diet and weight control Figure 4 The energy concentration of different types of sports drink. Description Figure 4 The energy concentration of different types of sports drink. Back to Session 5 Figure 3 Page 48 of 48 27th February 2017 http://www.open.edu/openlearn/health-sports-psychology/health/sport-and-fitness/eating-winactivity-diet-and-weight-control/content-section-0
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