2. + Role of Nutrition In Injury Prevention and Treatment Dana Angelo White, MS RD ATC - Quinnipiac University CATA Symposium May 2014

3. + Today’s Session The injured athlete Calorie and protein guidelines Target nutrients Resources

4. + The Injured Athlete Nutrition for performance still needs to be a priority. Eat to promote optimal healing and recovery. Emotions are high! Change of schedule, immobilization, medications and various other factors can easily affect eating habits. Similar guidelines for preventative measures.

5. + Energy Balance Nutrient needs will vary depending on injury. Central themes: Don’t stop eating for fear of weight gain. Injury creates a hyper-metabolic state where calorie and protein needs will increase. Too few calories may risk a delay in healing. Balanced diet - nutrient dense foods… Lean protein, F&V, whole grains, low fat dairy, healthy fats. Avoid highly processed, high sugar and/or high fat options.

6. + Energy Balance Stay hydrated! Eat every 2-4 hours throughout the day to help keep energy levels stable. Have a recovery meal or snack after rehab sessions with an emphasis on healthy carbs and high quality protein.

7. + Guidelines for Intake Start with calories and protein 1) Calories Increase needs by: 5 to 10 kcal/kg/day for moderate injuries - soft tissue strains/sprains 10 to 15 kcal/kg/day for significant trauma such as skeletal fractures 25 to 30 kcal/kg/day for severe trauma such as major surgery and head trauma 2) Protein Needs may approach 1.5 to 1.7 grams/kg 127 grams (175# @ 1.6) 3) Make appropriate allotment for carbohydrates and fat

8. + Promote Healing Keep calories coming in. Choose nutrient dense foods. Stay hydrated. Use a food log or website/app (MyFitnessPal)to assess intake. Increase intake of nutrients that promote tissue repair, immune function, and bone health: Protein, Omega-3 fats, Vitamins C, A & D, Calcium Conservatively consider dietary supplements where appropriate.

9. + Target Nutrients Protein Promotes tissue growth, healing Greek yogurt, lean meat/poultry, tofu, beans Omega-3 Reduce inflammation Salmon, tuna, flax, walnuts, soy EPA and DHA Vitamin A Cell growth and development Sweet potatoes, bell peppers, carrots, fortified milk and cereals

10. + Target Nutrients Vitamin C Wound healing & tissue repair Fruits and vegetables Zinc Wound healing & immunity Fish, meat, poultry, legumes, eggs, whole grains Calcium & Vitamin D Bone development & repair Milk, fortified foods, tofu, leafy greens, pork, eggs

11. + Supplements Treatment of injury (Malinauskas 2007) College athletes 71% rely on ATCs for info about supplements 34% express interest in supplement use for treatment of injury Contamination (Maughan 2005) As many as 1 in 4 supplements may be contaminated 18.8% of 240 US products tested contained steroids IOC research (2004) 15% of 634 products tested contained illegal or banned substances not listed on labels HFL Sport Science (2007) - Now LGC Group 25% of 52 products tested with small amounts of steroids and other banned substances

12. + Resources Sports Nutrition SCAN Fact Sheets AND (eatright.org) My Sports Dietitian @BobcatNutrition @nclarkrd Supplements NSF Certified for Sport Drug Free Sport Informed Choice USP

13. + Questions?