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NUTR 380 > Introductory Module - Role of the Sport Dietitian > Flashcards

Introductory Module - Role of the Sport Dietitian Flashcards

1
Q

Define Physical Activity

A

Any bodily movement produced by SMs that result in EE. The EE can be measured in kcals.

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2
Q

Define Exercise

A

A subset of physical activity that is planned, structured, and repetitive and has a final or an intermediate objective for improvement or maintenance of physical fitness. `

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3
Q

How is physical activity different than exercise?

A

Physical activity is an umbrella term and may not result in quantifiable gains whereas exercise is part of physical activity and is specifically planned and meant for improvement. Exercise can also be called training.

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4
Q

Define physical fitness

A

A set of attributes that are either health- or skill-related. The degree to which people have these attributes can be measured with specific tests

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5
Q

Provide ways you would test physical fitness.

A
  • Health related: VO2 max for cardio-respiratory fitness, strength tests, flexibility tests.
  • Skill related: improved time, skating, etc.
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6
Q

Define leisure activity

A
  • Activities that we engage in for reasons as varied as relaxation, competition, or growth and may include reading for pleasure, meditating, and participating in sports.
  • Leisure activities EXCLUDE activities that are work oriented or that involve life maintenance tasks such as housecleaning or sleeping.
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7
Q

Define athlete

A
  • Athletes are individuals that train in a sport and aim to improve their performance or results.
  • They are actively participating in sport competitions and can be formally registered in a local, regional, or national sport federations.
  • Training and competition is a major activity/focus (way of living) and they devote several hours on all or most days for these activities exceeding time allocated to other types of professional or leisure activities.
  • E.g. Irish dancers.
  • Training may be their principle form of employment or a daily activity
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8
Q

Do all people benefit from sport nutrition?

A

Active people and athletes can both benefit from sports nutrition. Elements such as fluids and hydration can benefit for active people and pre-event eating. Athletes often need additional and unique support. Sports dietitians can work with both active people and athletes but teaching will vary depending on focus and goals

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9
Q

What is sport medicine?

A

Sports medicine refers to a broad field of medical practices related to physical activity and sport. Focus on areas of performance enhancement, injury care, and prevention. Defined by American College of Sports Medicine (ACSM) as multidisciplinary

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10
Q

What are the goals of sports medicine?

A
  • Help active individuals (recreationally active or athletes) achieve optimal health AND meet their specific performance goals
  • HEALTH IS THE OVER-ARCHING GOAL. It supersedes performance goals if there is a conflict (e.g. eating disorder in competition athletes, injured athlete who wants to compete against medical advice)
  • Ethically sport medicine professionals cannot recommend strategies that would enhance performance to the detriment of health (e.g. cutting via dehydration)
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11
Q

How is sports medicine tailored?

A

Sport medicine professionals tailor the advice they offer to active individuals and athletes based on their: age, stage of athlete development (LTAD), goals, health status, and existing knowledge or experience

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12
Q

What does LTAD stand for?

A

Long term athlete development

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13
Q

What is LTAD?

A
  • Sport-specific frameworks for systematically training and developing physical, mental, and emotional capacities in athletes according to scientifically-recognized principles and stages of human development.
  • A training, competition, and recovery model, it respects the natural stages of physical, mental, and emotional development in athletes
  • Provide recommendations for rations of training-to-competition hours, points of emphasis in skills training, formats for competition, nutrition education and more (based on science)
  • varies across stages of life/ages
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14
Q

What are the two different parts of a sports med team and who does what?

A

1) Sports performance and health promotion (physician, exercise physiologist, biomechanist, sport psychologist, sport dietitian strength and conditioning coach, sport coach)
2) Injury treatment and management (athletic therapist, sport physical therapist, massage therapist. dentist, chiropractor) - These are primary roles
- providers can and do function in both realms of care

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15
Q

Describe the athlete’s circle of care

A
  • professionals around the athlete that are trying to keep them healthy and enhance performance
  • Those individuals involved in the care of the athlete: mental, physical performance and/or health-related
  • Athletes, vs active individuals, often have a circle of care that involves a wide range of health and physical activity professionals
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16
Q

Describe the athlete’s circle of care model

A
  • Few athletes achieve their potential without support
  • Multiple individuals may be part of an athlete’s circle of care
  • Model isn’t really a good representation of how RDs work with athletes, in this case athlete would have to go through everyone before they could meet with an RD
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17
Q

What is the role of health care providers in the circle of care?

A
  • The primary obligation of the health care providers involved in the care of athletes is to promote lifelong fitness and wellness, and to prevent illness or injuries
  • athlete health and well-being always supersedes performance goals if there is a conflict
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18
Q

What is the role of parents for child/youth athletes in circle of care?

A
  • Parents play an integral role in the sport development of child/youth athletes.
  • The child/youth athlete is the focus of the care provider’s services BUT care providers who work with child/youth athletes need to consider both the child/youth athlete and the parents when offering recommendations
  • Parents help kids implement recommendations
  • Parents should maintain open communication with the athletic training staff regarding injury risk, athletic development, proper nutrition, and treatment of injuries
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19
Q

What are the two models of athlete care?

A
  1. Athlete management approach
  2. Athlete centred care model
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20
Q

Explain the athlete management approach

A
  • The athlete has a performance manager which may be a coach, agent, sponsor, doctor, trainer, parent and they then converse with those on the sports med team including the physiotherapist, doctor, soft tissue therapist, psychologist, etc.
  • This is a better approach than the athlete centred approach but sometimes the athlete does not want to tell the performance manager what is wrong (e.g. fear of being benched bc of injury)
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21
Q

Explain athlete centred care

A
  • Considered the best model and most sports are moving toward it though some are still behind
  • The athlete is in the centre and have the ability to interact with those they need without going through anyone
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22
Q

What are integrated support teams (IST)?

A
  • Another name for sports medicine team
  • Interdisciplinary (team) approach to promoting sport performance and athlete health
  • Team members work together collaboratively to identify goals for the athletes
  • Supports:
    –Rational goal setting and prioritization (do not set conflicting goals)
    –reduction of confusion on the part of both the athlete and care providers
    –evidence-based care
    –intelligent use of resources (time, money, facilities, expertise)
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23
Q

What is scope of practice?

A
  • the procedures, actions, and processes that a healthcare practitioner is knowledgeable, competent, and permitted to undertake in keeping with the terms of their professional license or registration
  • Scopes of practice may over-lap to some degree
  • To avoid conflict and confusion, each IST needs to proactively define who will manage what (and to what degree) when overlapping scopes of practice exist
24
Q

What is a team physician and what are the roles associated?

A
  • A physician contracted by the team. The team is the employer:
  • Focus is on screening and assessment
  • May also diagnose and treat using resources available through the team only
  • Shares athlete’s health information with team officials
  • Must explain role and obtain consent from the athlete
  • Makes decisions about ready to play
25
Q

What is a personal physician and how do they differ from a team physician?

A
  • A personal physician is selected by the athlete instead of by the team
  • They provide comprehensive, ongoing health care to the athlete
  • Sport related health concerns and non-sport related health concerns
  • Not affiliated with the team or the couch
  • Bound by patient-doctor confidentiality expectations
26
Q

What are the roles and responsibilities of a head coach?

A
  • may or may not hold any formal coaching education (most high-performance coaches are certified and well educated)
  • Coaches act as motivators, demonstrators, strategists, and supports for the athletes they work with
  • Coach must be aware of the abilities, needs, and responsibilities of each athlete (even in team situations)
  • Coach must understand limits of their ability to function as a health care provider: should refer care decisions to other team members
  • Directly responsible for injury prevention and setting requirements for injury prevention: E.g. helmet and mouth guard requirements, non-participation, etc.
27
Q

What are the responsibilities and education required for strength and conditioning coaches?

A
  • Responsible for:
  • Training program design
  • Exercise technique - education/demonstration
  • Program organization and administration
  • Fitness testing and evaluation
  • Minimum education: Typically - an undergraduate degree, NSCA membership, and CSCS certification (course work + qualifying examination).
  • Need to work closely with them to understand the energy requirements/what athletes are doing
28
Q

What are the roles of athletic therapists and the education required?

A
  • Experts in sport injury assessment and rehabilitation:
  • First responders who provide on-field emergency care of professionals and elite athletes
  • Provide athlete education on risks and corrective actions associated with participation in fitness and sport programs
  • Engage in rehab therapy (including electrical, thermal, mechanical modalities) using standard techniques and procedures
  • Administer therapeutic and conditioning exercise(s) to facilitate recovery, function and/or performance
  • Must have completed a minimum Bachelor’s degree from CATA accredited program + practicum
29
Q

What are the responsibilities of physical therapists and the education required?

A
  • Physical therapists help athletes:
  • Improve and maintain their physical performance and ability to function independently;
  • Prevent and manage pain, physical impairments, disabilities and limits to participation; and
  • promote fitness, health and wellness
  • May perform restricted/invasive procedures to support patient care (e.g. intra-muscular stimulation, ultrasound, etc.)
  • Minimum education: Master’s degree + accredited practicum
30
Q

What are the roles and minimum education required for chiropractors?

A
  • Chiropractors diagnose, treat and help prevent musculoskeletal (bones, muscles, cartilage, tendons, joints, and connective tissues) conditions and disorders and the effect they have on the nervous system
  • Chiropractors deliver non-invasive procedures to help relieve pain and discomfort, and restore range of motion
  • Minimum education: at least 3 years of undergraduate university level study plus a 4 year degree at the accredited chiropractic program + practicum
  • Sometimes give nutrition information and it is often incorrect
31
Q

What are the responsibilities and minimum education for sport psychologists?

A
  • Psychologists assess, diagnose, and treat psychological, emotional, and behavioral disorders. They also research and apply theories relating to behavior and mental processes
  • Psychologists work with athletes to provide emotional support
  • E.g. performance anxiety, goal-setting, motivation
  • Minimum education: Master’s degree plus accredited practicum
  • May help with eating disorders but often refer
32
Q

What are the roles of massage therapists and their minimum education required?

A
  • Work with athletes to:
  • Assess the soft tissue and joints of the body
  • Treat and prevent physical dysfunction and pain of the soft tissues and joints by mobilization and other manual methods to develop, maintain, rehab or augment physical function or relieve pain
  • Minimum education: diploma in massage therapy plus approved practicum
33
Q

What are the roles of sport dietitians?

A
  • Sport dietitians work with individual athletes, teams, and sport organization to provide nutrition advice and strategies that support the:
  • Achievement of basic nutrient recommendations and promote health,
  • Peak sport performance,
  • Prevention of sport-related injuries (e.g. dehydration)
34
Q

What must sport dietitians demonstrate competence in?

A
  • Nutrition and metabolism foundational knowledge (e.g. biochemistry, nutrient requirements, nutrition across the lifespan)
  • Dietetic practice skills (nutrition assessment, care plan development, nutrition education, monitoring, evaluation)
  • Foods and culinary arts
  • Athletes eat foods NOT nutrients
  • You have to know food!
  • Sport science (exercise physiology, psychology, anatomy)
  • Sport knowledge
35
Q

What are the minimum educational requirements of a sports dietitian?

A
  • Bachelor’s degree from a PDEP-accredited program
  • Minimum - 1250 hours approved practicum
  • Successful completion - Canadian Dietetic Registration Examination (CDRE)
  • Note: sport nutrition is not considered an entry-to-practice activity. Dietitians are encouraged to gain experience in general client/patient care before treating athletes
  • Encouraged to do further education
  • Need to be proficient at counselling
36
Q

What are the career opportunities of sport nutrition?

A
  • Most sport dietitians have advanced training beyond those for dietitians at entry-to-practice
  • IOC Sport Nutrition Diploma
  • MSc/PhD Work
  • Ongoing CE related to exercise physiology, nutrition assessment, motivational counselling/interviewing
  • Job opportunities are generally self-generated (e.g. private practice - few dietitians that work solely in sport nutrition)
  • Very few RDs work exclusively in sport nutrition
37
Q

What does a high LTAD usually indicate?

A

That they are working with more people (e.g. everyone on sports medicine team)

38
Q

Does misinformation occur in sport nutrition? Why is it bad?

A
  • Misinformation about sport nutrition requirements, products, and eating pattern is rampant
  • Misinformation has the potential to harm both sport performance and health
  • Misinformation about sport nutrition supplements (nutritional ergogenic aids) has also led to athlete disqualification from competition owing to doping violations
  • As professionals with a background in nutrition generally, and (by the end of this course) sport nutrition, specifically we have an obligation to share reliable, evidence-based information
39
Q

What are ergogenic aids?

A

Aids that improve movement. Can lead to disqualification because they contain banned substances which improve performance.

40
Q

Give an example of nutrition misinformation you see with pro sports?

A
  • Mustard on the bench because it contained antioxidatns
  • Players dying of heatstroke from not hydrating
  • Hydroxycut recall due to liver injuries
41
Q

Is sport nutrition opinion-based?

A
  • Sport nutrition practice is not opinion-based
  • There is an unfortunate environment in sport nutrition where people (professionals and non- professionals) feel free to share personal opinions about what works and what doesn’t work in terms of nutrition to enhance performance
  • This climate often confuses which nutrition strategies are likely to offer a performance benefit and which likely won’t and create risk for the athlete:
  • Lack of results
  • Health concerns
  • Doping violations
  • Sport dietitians are continually called upon to combat opinion-based misinformation:
  • Building trust
  • Re-teaching information
  • Can create conflict within a sport medicine team
42
Q

What are the characteristics of statements of personal opinion?

A
  • Are influenced by the writer’s or speaker’s personal experiences, training, interests, and context, rather than scientific evidence
  • Often use language that is impassioned and packs an emotional punch
  • Frequently make value judgements, e.g. “Supplements are a better way to get your nutrition than food”
  • Often predict future events with no evidence base to support a prediction, e.g. “If you eat more protein now in 6 months your body will be unbelievable”
  • Are likely to provide interpretations of events that are well-founded or logical e.g. “The chia seeds in this smoothie were what helped Bob lose the body fat”
    Cannot be checked for accuracy
43
Q

What did the FTC analysis show?

A
  • Analyzed 300 advertisements for weight loss products
  • Nearly 40% of the 300 ads made at least one representation that almost certainly was false
  • An additional 15% of the ads made at least one representation that was very likely to be false or, at the very least, to lack adequate substantiation
44
Q

Why is marketing so effective?

A
  • Athletes are a vulnerable audience so they are particularly susceptible to marketing of quick fixes and unbelievable products. They want to be the best
45
Q

What are the characteristics of statement of fact?

A
  • Are evidence-based and can be verified, or checked, for accuracy
  • Often include dates, numbers, and statistics
  • Are not subject to broad interpretation. Do not vary from person to person or place to place
  • Describe events using neutral language that has little or no emotional effect on the listener or reader
  • Don’t make predictions, assumptions, express value judgements, or offer interpretations
  • Aren’t subject to change, except in cases where previously unavailable information or new technology arrives on the scene
46
Q

Why are some athletes/people not interested in evidence-based nutrition and what can you do?

A
  • Following recommended sports nutrition guidelines based on published research is not always “cool” or exciting to an athlete.
  • Athletes are often more interested in unusual, unproven supplements or diet patterns followed by their peers or pro athletes.
  • Practitioner jobs in professional sports are few and sought after. In pro sport in particular, there is often pressure to find something new and different.
  • Waiting until something is “proven” by science is often seen as too slow and won’t be “cutting edge” or provide a competitive advantage.
  • Some athletes are going to do what they want regardless of what you say. Keep in mind that you can’t control everything and that education and reiteration of your foundational nutrition principles will keep your message consistent.
47
Q

What does jurisprudence and liability mean? How does that apply to sport dietitians

A
  • Individuals who provide nutrition counselling, guidance, advice, coaching, training, or instruction to a client (s) are legally responsible for the advice that is offered.
  • Both dietitians and non-dietitians
  • Sport dietitians/nutritionists have both an ethical and a legal obligation to provide advice and care that is defensible and based on sound scientific evidence.
48
Q

How can a practitioner balance evidence-based practice with the desire to be “cutting edge”?

A
  • Look for a meta-analysis on a topic.
  • If you are evaluating an individual study, utilize paper to podium: evaluation of the translational potential of performance nutrition related research
49
Q

What are the issues with translating sports nutrition research?

A
  • Research in the lab may not translate to the field of play, and field research can be difficult to control.
  • New ingredients may be studied in isolation, but in the real world consumed as part of a food matrix.
  • To feel confident in the effectiveness of a nutritional intervention, a body of research must be developed. Definitive answers do not come from one research study alone.
  • It takes time to build a body of literature, and athletes or practitioners looking for an “edge” don’t want to wait
  • The subject population of a research study varies, so evaluating if an intervention will translate to elite athlete performance is often difficult
  • Elite athletes may not want to experiment on their bodies
  • Coaches may not allow research using their teams
  • “Recreationally active” individuals are more available on a college campus
  • Funding may be for target populations, such as older adults, women, or children (lots of research done on varsity athletes because it is convenient for researchers)
  • Sample sizes, especially if elite athletes are tested, are often too small.
  • Many interventions begin with endurance-type activity (running or biking) because it’s easier to control in the lab and has clear performance outcomes. The definition of “performance” varies among studies on team sports.
50
Q

What is the paper-to-podium matrix?

A
  • The first step in translating research to practice should be a critique of the translational potential of the existing scientific evidence
  • The matrix includes an evaluation and scoring of:
  • Context
  • Participants
  • Research Design
  • Control
  • Validity & Reliability
  • Data Analytics
  • Application
  • Risk/Reward
  • Timing
  • Scores the literature on a range in these different areas to see if the study is appropriate to guide practice (positive = good, negative = bad)
51
Q

Why is the paper to podium matrix good to use?

A
  • The matrix is not exhaustive
  • But use of the matrix may help practitioners evaluate a research paper, increasing their confidence in an intervention which may lead to a more enthusiastic athlete and increase the chance of effectiveness
  • Note: You need to find and read the entire research paper when evaluating evidence! Relying on an abstract or information found on social media is not an effective way to truly evaluate a research study.
  • Published recommendations are not absolute but guides to help you customize your strategy
52
Q

Scenario: You are a new sports dietitian for a soccer team. After attending a conference, you’ve become interested in a new strategy and think it can help your team. The theory is strong, but there have only been a few published research studies. You’ve evaluated the available research using the Paper to Podium matrix and feel confident in implementing this strategy. What’s next?

A
  • Consider your athletes. Do any of your athletes have food sensitivities, specific beliefs, or any other issues that could hinder implementing this strategy? Can the athlete, team and/or club afford to implement the strategy consistently?
  • Check the regulations of your league to ensure all parts of the new strategy are permissible.
  • Develop a plan to implement the strategy. Be sure to consider:
  • Individual needs of each athlete. Is the strategy right for everyone?
  • Timing –begin to implement slowly and stepwise. Also plan plenty of time to adjust during practices well in advance of competition. - How to evaluate effectiveness
  • Cost and logistics
  • Develop a communication plan to the sport coaches, performance and sports medicine staff, and then the athletes. Be prepared for the staff or athletes to push back on the new ideas.
53
Q

If you are working with an athlete who is interested in changing their nutrition habits what process should you use and steps you should take?

A
  • When working with an athlete who is interested in making a change to their nutrition habits, you’ll use a process of trial and error, starting with the published guidelines, to find the best plan to meet their needs. Set the ultimate goal but start small and work up to that goal in small achievable steps.
  • Sometimes you may think an athlete should make a change to their nutrition habits, but it’s difficult to convince them to follow the current guidelines.
  • Don’t get frustrated. Plant the seed in their head and tell them what they need to hear. If they are still not interested, tell them that you will be available when they do want to commit to make the change.
  • Sometimes your athletes will want to use new supplements or foods/ingredients, some making grandiose claims. If you don’t have published guidelines, a meta-analysis, or information in the Evidence Analysis Library, you will need to evaluate the current state of the science.
  • Need to have clear communication to your peers and staff in order to implement evidence-based nutrition strategies
54
Q

What would you do?
- Client: Kelly
- Age: 19 years old
- Sport: Figure Skating
- Height: 5’3”
- Weight:100 lbs.
- Client’s Goal: Weight loss

A

May not be able to communicate what she actually wants. Need to consider her other goals, maybe she wants fat loss or composition changes

55
Q

Assume you are a sport dietitian. You have a client: 37 years old; Female; Complains of having “low energy levels” and wants to lose weight. What would you do?

A
  • Need to look at her diet, sleep, activity levels, bloodwork
  • Other health issues, stress
56
Q

Explain the Capati vs crunch lawsuit

A
  • Trainer gave his client a over-the-counter herbal product to help with her low energy levels
  • It makes you feel more alert and productive, he had no side-effects, and it was low cost.
  • However, she had hypertension and the product had ephedrine which increases bp. She ended up collapsing during a session and had a stroke and died.

NUTR 380 (12 decks)

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