Module 8 - Sport Nutrition Assessment and Nutrition Care Plan for Athletes Flashcards
What are the parts of the nutrition care process model?
- Nutrition assessment and reassessment
- Nutrition diagnosis
- Nutrition intervention
- Nutrition monitoring and evaluation
All influenced by social systems, economics, practice setting, and health care system as well as the skills of the practitioner
What is the purpose of a nutrition assessment and what should be identified?
Purpose is to collect and interpret relevant client information to identify:
- If the athlete is at risk for malnutrition and if so, why
- The potential to positively influence sport performance through dietary changes
- Nutrition assessment gives you the evidence you need to know how to care for the athlete you are working with
- Assessment data, not the athlete’s preferences or wishes, determine the nutrition care plan
Define malnutrition
The condition that occurs when the body’s requirements for one or more essential nutrients is not met
What are some of the causes of malnutrition?
- Inadequate or unbalanced diet
- Problems with digestion or absorption
- Certain medical conditions
Explain how starvation and malnutrition are related
- Starvation = just one form of malnutrition! A subset of malnutrition
- A person can appear healthy and still be malnourished
What should you never assume when working with athletes?
Don’t assume all athletes are healthy
- There is a tendency to assume that all athletes are healthy by virtue of their participation in sport
- This is inaccurate and potentially dangerous
- There are many cases where athletes appear healthy but are subsequently diagnosed with very significant health issues, including malnutrition
- If we assume people are healthy, there is a risk that preventable or treatable illness will be missed or discounted
What occurred in the Capati versus crunch fitness case?
- Given a herbal supplement with epheddrine that cause capati to have a stroke, excessive and uncontrollable bleeding in the brain
- lack of health assessment skills (assumed she was healthy with no medications)
- Lack of understanding of health history: hypertension (high blood pressure)
- Lack of awareness of risk: assumption that the herbal supplements were “natural” and “safe”. Ephedrine increases blood pressure
- Focus on appearance versus health
What happened with Sergei Grinkov?
- Figure skater with olympic, worlds gold medals. Won majority of the competitions he was in
- Not obese, obviously active, appeared to be very healthy
- Died on the ice while training from a heart attack at age 28
- Clogged coronary arteries and genetic risk factors linked with premature heart attack that had gone undetected (family history)
Nutrition Assessment involves _________________
Critical thinking
What critical thinking/steps need to be done during a nutrition assessment?
- determine appropriate data to collect and selecting valid and reliable tools
- Distinguish relevant from irrelevant data
- Select appropriate norms and standards for comparing data
- Organizing and categorizing the data in a meaningful way that relates to the nutrition concerns of the client
- Identifying the absolute base nutrition issue (versus issues that are symptoms more than the base issue)
→ Low body weight in an adult with anorexia nervosa. Weight is a symptom; mental health issues are the base case
By the end of the nutrition assessment process what should you be able to say with confidence?
- What the athlete’s specific nutrition-related concerns are
- Why you know these are the concerns (e.g. you can cite your evidence) AKA back your diagnosis
- What you need to do to correct or optimize the athlete’s nutritional health
→ If you can’t say with confidence why you are offering the care or advice you’re offering you should not give care
What are the four main elements of the nutrition care process?
- Nutrition Assessment
- Nutrition Diagnosis
- Nutrition Intervention
- Monitoring an evaluation
What are the 5 key elements of a nutrition assessment?
- Personal health, sport, and social history
- Dietary assessment
- Body weight and composition assessment (anthropometric assessment)
- Assessment of energy expenditure
- Fitness assessment
What is the purpose of taking the personal health, sport, and social history of an athlete?
- Determine any current or potential health problems so you can determine their health risk level
- Provide contextual info about the athlete’s life, their training habits (type, frequency, duration, and intensity)
What are the key elements of personal health, sport, and social history?
- Demographic info: name, age, height, weight, gender
- Family and personal history of disease or health concerns (including allergies, menstruation)
- History of illness and injuries
- Surgical history
- Menstrual history (for females)
- Medication and supplement use
- Detailed info on their level of sport participation: type, frequency, duration, intensity, goals of sport participation
What is an example of how you could take an athlete’s history?
- Health History Questionnaire
What is the purpose of a dietary assessment?
- Used to assess energy (Kcal) and nutrient intakes
- Quantity supplement use
- Assess eating pattern (e.g. timing of meals and snacks, consistency of eating pattern)
What does the fitness assessment do? Who does it?
- Flexibility
- Muscular strength
- Muscular endurance
- Aerobic/cardiorespiratory fitness
- Anaerobic fitness
- Generally completed by the athlete’s trainer, coach or other qualified fitness appraiser and shared with the sport dietitian
When taking a social and personal history what should you find out?
- Socioeconomic status, social and medical support, cultural and religious beliefs, housing situation, and social isolation/connection
- Others involved in their Circle of Care: may include obtaining formal consent to communicate with others in the Circle
- Age, occupation, role in family, and education level
- ## Who is responsible for shopping for food, cooking, etc.
What is the purpose of finding out social/personal history?
Helps you understand how the athlete lives and the support they have. If parents are doing the cooking, may want to talk to them for example.
What are potential lab values of interest for athletes?
The following are good to check, if good then can move on:
- Blood lipid levels: Tchol, LDL, HDL, VLDL, LDL/HDL ratio, TG
- HbAic% (higher in diabetes)
- Blood glucose
- Urine protein
- Urine glucose
- BUN
- Serum creatinine
- Albumin
What should be done when doing a body weight and composition assessment?
- Current (Usual) Weight - is this weight normal for them? If rapid weight loss and unintended = red flag
- Ideal/optimal weight for sport - room for variation
- Weight history - has it changed? What direction and over how long? The larger the magnitude of weight change over the shorter duration of time = increased risk for malnutrition
- Body composition measures - if accessible
How do you calculate percent usual body weight?
% usual body weight = (Actual Body Weight/Usual Body Weight) x 100%
What are the percent usual body weights that indicate degree of malnourishment?
- Weight indicator of malnourishment
- Does not tell you how long it took to change
How do you calculate percent weight change? What is needed to show if this is a concern or not?
(Usual weight - Actual Weight)/Usual weight
E.g. Mary Jane was 150lb last time you saw her 3 weeks ago, today is is 135 lbs. = (150-135)/150 = 10%
- The importance of this change will depend on the time over which it occurred. 10% weight loss over 1 year is less of a concern, 10% weight loss over 1 month is a greater concern
What percent weight changes are considered significant versus severe?
Significant weight loss:
- 5% loss over 1 month
- 7.5% loss over 3 months
- 10% loss over 6 months
Severe weight loss:
- >5% loss over 1 month
- >7.5% over 3 months
- >10% loss over 6 months
These standards are widely used to assess significant weight changes in
Look into why these changes have occurred!!
What are the ideal weights for sport performance?
- Dependent on the sport and sometimes the gender
- In some sports it is advantageous to be heavy: heavy wresters can be harder to topple because of the low centre of gravity
- In some sports it is advantagoues to be light: being ligher makes it easier for female gymnasts to keep their balance and control their momentum
What is an NFPE?
- Nutrition focused physical findings - clinical exam. Not used on its own
- Includes a review of key physical areas related to nutrition
- At minimum all athlete’s should have a visual examination but looking at an athlete’s physical condition!
What will you look at when doing an NFPE?
- Hair
- Skin (colour, texture, integrity)
- Nails
- Muscle and fat mass
- Dentition/mouth teeth
- Eyes
- Emaciated
What are common diet assessment methods and their advantages and disadvantages?
What is meant by “respondent burden”?
- Get them to do all the work
- 24 hour recalls or food frequency questionnaires have lower burden (AKA less work)
What are the components of a 24 hour recall/dietary history/food record review?
- Includes all foods and quantities eaten, eating habits, accessibility of food, and cultural and socioeconomic factors that effect selection of food
- Details matter: portion sizes, brand names, eating times (pattern)
- Use the 3 pass method: Pass 1 - when and what (general), Pass 2 - portion sizes, Pass 3 - things often forgotten (condiments, items in or on things)
What process is followed to make a nutrition diagnosis?
- Sport dietitians develop a nutrition diagnosis for each athlete they work with
- A nutrition care process is followed!
- A diagnostic/PES statement is created for each problem