Nutrition Module 5: Fitness

Isolated Individuals

Alcoholics, mentally ill, or drug addicts who lack access to food resources.

Natural Disasters

Droughts, mudslides, and hurricanes have a negative impact as homes, resources, and infrastructures are destroyed.

Elderly

Due to economic difficulties, physical limitations and social isolation

Working Poor

Individuals who may or may not qualify for food assistance.

homeless

Limited income and lack of consistent cooking facilities

Night Eating Syndrome

Recently, psychologists have petitioned to have night eating syndrome also recognized as a formal psychiatric diagnosis.

Resistance Training

resistance exercises to build muscle and stretches for flexibility should also be done several times per week.

Aerobic Workout

should be performed for 20-60 minutes five days per week. The goal is to increase your heart rate to the target zone. -

There are three components to any fitness program

(1) aerobic workout, (2) resistance training, and (3) stretching and flexibility.

Three primary types of eating disorders

(1) anorexia nervosa, (2) bulimia nervosa, and (3) binge-eating disorder.

Erogenic

(meaning "work producing") aids are defined as a mechanical, nutritional, psychological, or physiological substance or treatment intended to improve performance. Such aids may also be used by athletes to enhance performance. However, such aids may be harmful. Examples of allowed ergogenic aids that athletes can use include vitamin and minerals, energy bars, sports drinks, and products that are meal replacements, such as Ensure or Boost. Examples of harmful and dangerous ergogenic aids (and as such are banned in competition) include anabolic steroids, growth hormones, GHB, and blood doping. The FDA has little control over these supplements, and their safety and effectiveness are questionable. Despite the risks associated with these products, many athletes are unfortunately willing to take the chance with the hopes of gaining a competitive edge.

steps can be taken to establish a fitness routine that can be maintained long term

1) Find enjoyable activities and vary the routines, (2) have an exercise partner to increase accountability, (3) start slowly, (4) set specific goals, and (5) reward yourself (but not with food) once goals are achieved. Importantly, the focus should be on disease prevention and the maintenance of flexibility and balance as we age.

Shared characteristics

1) There is no simple cause or simple treatment of the disorders. 2) It is usually not a food issue but rather related to the lack of coping mechanisms and/or dysfunctional family relationships. Food becomes simply something that can be controlled. 3)There is a genetic component. 4)Often there are other issues such as depression, an anxiety disorder, and substance abuse. 5) Eating disorders can result in serious health risks, including death.

what supplies energy to the muscles

Adenosine triphosphate (ATP) is the first source of energy for cells. Following digestion, energy is released from food and used to convert adenosine diphosphate (ADP) to adenosine triphosphate (ATP) through the addition of a phosphate group. In terms of ATP usage, the resting muscle can store enough ATP to do work for approximately two to four seconds. This amount of activity can be accomplished without oxygen, and, as such, it is a form of anaerobic activity. As soon as the ATP in the cells begins to be used, a compound called phosphocreatine (PCr) is broken down into creatine and phosphate, the latter of which is then used to convert ADP into more ATP. PCr can maintain muscle contractions for approximately 10 seconds. Thus, most activities that utilize PCr involve quick bursts of energy, such as jumping, throwing, sprinting, and performing a bench press. For events lasting 30 seconds to 3 minutes, such as sprinting 400 meters, the body uses carbohydrates as a quick source of energy under anaerobic conditions. However, the body cannot rely on anaerobic glucose breakdown for long periods of time due to the release of lactic acid. Lactic acid is a byproduct of glucose breakdown and can lead to muscle fatigue.

Depletion of farmland and water

Agriculture production is at its peak in many countries. However, excess demands, poor farming practices, and shrinking resources will have a negative effect on food production.

Intuitive Eating and Role Models

As a society, the preoccupation with food and diets in the hopes of achieving the perfect body needs to be re-examined. All body shapes and sizes should be accepted with an emphasis on having a healthy and fit body that promotes the prevention of ailments and diseases related to the aging process. Parents and other adults who work with children and teens should model healthy eating habits and teach children about normal body changes that occur during puberty. Misconceptions about nutrition, body weight, and dieting should be discussed and strategies to handle stress and emotional issues should be a part of the discussion. Intuitive eating, which involves learning to listen to the internal cues on hunger and satiety, should be honored by adults and other care givers of young children and teens. Open discussions about diversity in body shape and weight as well as being respectful and supportive of others can play a key role in the prevention and development of an eating disorder. Parents, coaches, teachers, and health professionals can all play important roles in the prevention of eating disorders.

Healthy Tip for Athletes

Calorie needs will vary depending on the athletic fitness of the individual and the type of training being done to prepare for an event. Regardless of whether the training is for a 5K or simply walking to stay fit, maintaining an appropriate weight for your age and height is important. As a rule, moderate physical activity requires 5-8 kilocalories per minute. There are several ways to monitor your calorie intake to ensure that you are eating enough, but not overindulging. For instance, food diaries are a great monitoring tool. Begin by recording anything you eat and drink, including the amount and how it was prepared. This info can then be entered in a nutrient analysis program such as MyPlate (Links to an external site.). It is easy to compare your intake with current recommendations for someone your age, gender, weight, and physical status. Combining variety, proportionality, and moderation, as illustrated MyPlate, will help you make wise choices that include a mix of carbohydrates, fats, and proteins. In addition, measuring your fat percentage is a good way to compare your body fat composition with standards. For the average male, body fat percentage should be between 8%-24%. A male athlete may have fat percentages between 5%- 18%. The same is true with females. The average female should have a body fat percentage between 20%-35%, while an athlete would have between 17%-28%. If it is determined that you are consuming excess calories or have a high body fat percentage, decreasing intake by 200-500 calories per day will allow you to lose some weight without harming your performance.

Anorexia Nervosa Warning Signs

Common warning signs of anorexia include a distorted body image, which leads to low self-esteem, and abnormal eating habits. Wearing baggy clothes and weighing one's self frequently are also common. Anorexics will go to extremes to avoid eating and spend a great deal of time thinking about food, preparing food, and watching others eat. They are often critical of themselves (and others) and frequently withdraw from family and friends. There is an intense fear of becoming fat, and even a small weight gain can lead to panic. Very low-calorie diets and nutrient deficiencies can lead to physical and psychological problems. As shown Figure 5.2, the physical effects of anorexia nervosa are numerous.

Stats

Currently more than 5 million people in North America have one of these disorders, and females outnumber males 5:1.

Population Growth

Expansion often leads to food shortages. Much of the growth is occurring in the poorest nations such as Asia, Sub-Saharan Africa, and the Pacific Rim. Economists estimate that we currently have adequate food to feed the world's population, but disparities exist between the developed and under developed countries, among the rich and poor in a country, and also food distribution in families. In some countries the males eat first, and the women and children eat whatever is left. Currently, there is not a food shortage as much as an inequality in food distribution. However, if population growth continues at the current pace, food production will fall below need.

Children

Family circumstances that may hinder or prevent proper oversight

Maximum and target zone

For example, A 40-year-old person would want a maximum heart rate of 180 (220 - 40=180). The target zone is then set at 60-90% of the maximum heart rate. This means that a 40-year-old should aim to get their heart rate between 108 (180 x 0.6 = 108) and 162 (180 x 0.9 = 162) beats per minute.

Disorder Eating

For some people the combination of individual eating patterns, the media's influence, as well as body perception can contribute to abnormal eating patterns. Disordered eating is a short-term change in normal eating patterns related to a stressful event, illness, or desire to change physical appearance. If this pattern continues long term, it may cause physiological or psychological issues, such as excessive food restriction, binging, purging, and weight fluctuations. If it interferes with daily activities, professional help for an eating disorder may be required.

inadequate shelter and sanitation

In developing countries, it is common for the impoverished to reside in ghettos and shantytowns. The result is a lack of a safe and convenient water supply, lack of facilities to keep food safe from spoilage, rotting garbage, infestation of insects/rodents, and poor health care. -Note: Children, the elderly, and those with compromised immune systems are likely to succumb to illness, such as AIDS or diarrhoeal disease. The World Health Organization (WHO) estimates that 1.1 billion people have an unsafe and inadequate water supply while 2 billion people lack proper sanitation facilities.

Sports Drinks

In summary, athletes are often looking for something that will boost their performance above their competitor. Hydration is important, and when attending any sporting event, it is not uncommon to see many athletes walking around with a sports beverage such as Gatorade, Powerade, and All Sport in their hands. However, the necessity of consuming a sports beverage actually depends on the type and duration of the activity. For athletes participating in endurance events lasting longer than 60 minutes, sport drink beverages may be helpful. Although water allows for cooling, transport of waste products, and increased blood volume, it does not replace electrolytes that are lost through sweat. As sports drinks contain carbohydrates, sodium, and potassium, the carbohydrates (often in in the form of glucose) provide a source of energy for the muscle and are readily absorbed, while sodium and potassium help replace electrolytes lost. For events lasting less than 60 minutes and are of light to moderate levels of activity, water is still the best choice as the introduction of excess glucose and electrolytes is unnecessary and may actually cause dehydration.

World Food Bank's three approaches

It is a difficult task to reduce undernutrition in developing countries, and there is no easy solution. While more affluent countries often provide food and aid, it may not always in the best interest of the people of that nation—the lasting goal of affected countries should be to become independent and learn to use their natural resources. To this end, the World Food Bank is currently working to implement three approaches to counter undernutrition (1) increasing diversity of the food supply, (2) fortifying food with nutrients, and (3) providing nutrient supplementation. To achieve success, the Peace Corp is working with people in developing nations by providing education, distributing food and supplies, and building structures to improve the country's independence. Education on family planning, technology for the production and processing of food, supplementation of food crops, land ownership, and water purification can together lead to an independent and productive society.

war and political unrest

Many areas with the regions of Africa, the Republic of Congo, and Ethiopia have been involved in military conflicts over the years. War leads to an increase in poverty, a disruption in health care, and lack of safe water, shelter, and food. Even when food is available, it may not be distributed to the needy due to lack of infrastructure or politics.

Optimal nutrition for athletic performance

Optimal nutrition for athletic performance entails consumption of adequate energy and nutrient needs, maintaining appropriate body composition, promoting optimal recovery following exercise, and maintaining proper hydration. To ensure adequate calories are being taken in to support energy needs, a mix of carbohydrates, fats, and proteins should be consumed daily.

anaerobic activity

Physical activity done in short, fast bursts in which the heart cannot supply oxygen as fast as muscles use it. -For events lasting < 30 minutes, muscles utilize glycogen stores found directly in the muscle as its source for fuel

Resistance and Stretching

Resistance training along with stretching exercises are important because, as we age, we lose muscle, and it is often replaced with fat. Adding weight training, Pilates, push-ups, or yoga two to three days per week will tone the body, increase muscle density and strength, and improve balance and flexibility. In addition, the increase in muscle tissue will increase your basal metabolic rate and calories will be burned more efficiently.

Where do we begin

Studies suggest incorporating 30 minutes of activity into your daily routine is a good place to start. Those 30 minutes can be broken into shorter segments throughout the day. For example, instead of emailing a colleague at work, walk to their office to relay the message, take the stairs in place of the elevator, or add a short brisk walk during the lunch hour. Once comfortable with this level of activity, add another 30 minutes to the day (now 60 total minute) and also increase the intensity of the work out. However, a note of caution: if you have not been physically active, are a male over the age of 40 or a female over the age of 50, and have a history of hypertension, diabetes, or cardiovascular disease, it is wise to check with your physician prior to initiating any activity. Current recommendations for physical activity for adults and children can also be found on the MyPlate (Links to an external site.) website. MyPlate provides a general recommendation. Specific guidelines for all ages can be located on the Physical Activity Guidelines for Americans, 2 nd Edition website. Click the resource tab on MyPlate to find the Activity Guidelines and review the recommendations for adults and children.

Anorexia Nervosa Continued

The anorexic person views themselves as fat even when they are wasting away. Body weight less than 85% of the normal weight relative to the person's age, height, and gender and a BMI of less than or equal to 17 are clinical guidelines for a diagnosis. It is a serious disease that produces hormonal changes, lower body temperature, a slow heart rate, decreased immune system, and loss of menstrual periods. If left untreated, death may result. Treatment usually begins with outpatient therapy involving the patient and a team of medical professionals, including a physician, dietitian, and a psychologist. Involvement of other family members is also important to the outcome. If an individual's weight falls below 75% of their standard body weight, suffers other health issues, or has suicidal tendencies or severe psychological problems, hospitalization may be necessary. In both cases, the first goal is to gain the confidence and trust of the patient. Helping the patient recognize they have an illness is necessary to achieve the goal of increasing oral intake and ultimately achieve a healthy weight. Promotion of a healthy attitude towards food and learning to eat in response to natural hunger/satiety cues is important. A BMI of 20 or greater is usually the long-term goal. Once normal feeding has been established, the psychological issues can then be treated. Cognitive behavior therapy can be used to help the patient begin to accept a healthy body weight and address the underlying issues. Family therapy and self-help groups are useful in helping the patient develop coping skills and strategies. The current recovery time is 7 years, and success is not always guaranteed.

why do we eat?

We eat in order to provide nourishment is the simple answer, but the reality is that the true reasons are much more complex. Numerous psychological, social, genetic, environmental influences, and cultural patterns determine daily food choices. As an infant, we begin to associate food with pleasure as endorphins, the body's natural tranquilizers, are released as part of the feeding response. As we age, different memories are often associated with food: thoughts of safety and warmth may come to mind when you smell certain foods cooking (i.e. mom's chicken), and the memories linger for years to come. For many, food is a symbol of love and comfort. As such, individuals will often turn to food as a means of handling stress. Additionally, there are many cultural influences that affect our choices as well as social events. In many European countries, meal time is a celebration of good food and family time. Families look forward to spending time around the table eating and conversing. Compare and contrast the latter with the typical pace of the United States where meal time is limited and the option of a drive-through for fast food is readily available.

Undernutrition and Food Insecurity

While over-nutrition is more of a concern in the United States and developed nations, it is important to note that undernutrition is a global concern. Undernutrition results from the lack of adequate food required to meet one's nutrient needs over a period of time. Notably, undernutrition is the most common form of malnutrition among the poor in both developed and underdeveloped countries. Undernutrition can lead to numerous deficiency diseases and has a negative impact on the physical and cognitive development of young children. Interestingly, although adequate food is grown and harvested to meet the needs of people throughout the world, malnutrition may still occur. Millions are simply either unable to acquire enough food for everyone in their family or the quality and variety of the foods are inadequate to meet their nutrient needs. When such conditions occur, it is known as food insecurity. In the developing world, food insecurity and undernutrition may be the result of many factors:

Bulimia Nervosa

an eating disorder in which large quantities of food are consumed over a short time period, referred to as a binge. Bulimia translates to "ox hunger." Following a binge pattern of eating there is a great desire to get rid of the excess calories, usually through purging (vomiting) or the use of laxatives. Most bulimics tend to be at a normal weight (or slightly above) for their height. They tend to have a low self-esteem, suffer from depression, and gain comfort by turning to food in times of crisis. While anorexics are very controlled and usually come from families where the parents are overly involved, bulimics tend to be impulsive and have difficulty controlling their impulses. They often come from families where the parents are disinterested and the rules of the household are lax. Due to the nature of their impulsive behaviors, they are also more likely to be sexually active than their peers and practice illegal acts such as stealing or drug and alcohol abuse. As much of binge eating is done in secret, it is often difficult to diagnosis a case of bulimia. The criteria are based on a binge-purge cycle occurring at least twice a week for 3 months and a loss of control over behavior, fluctuating between consumption of inordinately large quantities of food in a short time period and attempts to restrict food (Figure 5.3). It is not uncommon for an individual to consume 3,000 calories in a single binge. Shame and guilt also tend to accompany the binge cycle. Triggers for a binge include stress, boredom, loneliness, and depression. Unlike anorexics, bulimics are aware they have an eating disorder and often end up battling a vicious cycle of binging-purging-restriction that may also include excessive exercise.

Proteins

are a minor fuel source for the muscles compared to carbohydrates and fats. Protein is primarily utilized during endurance events as glycogen stores in the muscle are depleted. Contrary to popular belief, protein itself does not build muscle. Instead, resistance through strength training exercises increases muscle mass. While ads promoting high protein bars and drinks may be aimed at weightlifters, the primary fuels during this exercise are actually PCr and carbohydrates. When recovering from exercise, studies have shown that simply drinking an eight-ounce glass of milk after strength training can be very beneficial to the muscles. In fact, protein supplements are usually not necessary as the typical North American diet provides adequate amounts of protein. Consuming foods high in carbohydrates and moderate in protein enhances the muscle building effect of a weight training activity.

carbohydrates

are needed to prevent fatigue, and you need to consume enough to store in the liver and muscles. Approximately 60% of the total calorie intake should come from carbohydrates. Translated into grams of carbohydrates (CHO), a minimum of 5 grams per kg of body weight should be ingested daily. For endurance athletes, activities > 60 minutes, 7-10 grams of CHO per kg weight should be ingested.

Heat Exhaustion

can occur when temperatures and humidity levels are high. As humidity rises, sweat becomes an inefficient way to keep the body cool. Symptoms of heat exhaustion include profuse sweating, dizziness, nausea/vomiting, muscle weakness, fatigue, and skin flushing. If someone appears to be suffering from heat exhaustion, they should be moved to a cool place, encouraged to drink fluids, and sponged with cool water.

Mass Media

comprised of television, billboards, magazines and the Internet, also influences our food choices as well as our body perception. Mass media is saturated with food advertisements, and companies spend billions of dollars to market their products to target audiences. At no other point in history has the availability of sugar and fat-laden foods been more abundant. However, mixed messages are being sent as the media also advertises pictures of "acceptable" or "attractive" body types (often thin and/or toned), and yet these body types fail to align with the types of foods being advertised. The result is the unrealistic desire to achieve the "ideal" figure through flawed methods. In truth, eating unhealthy foods will not result in a healthy body. The contradictions in the media can thus lead to unhealthy perceptions. Studies have proven that a negative perception of being overweight or obese begins early in life. In fact, many feel that this is the last acceptable form of social discrimination: Fat equals lazy, ugly, weak, and lacking will power, while thin is equated with hard working, beautiful, strong, and self-disciplined.

Heart rate

defined as the number of beats per minute. To calculate, count the number of heart beats (pulse) for 10 seconds and multiply by six. To find the target zone, the maximum heart rate must first be determined. The maximum heart rate is established by subtracting your current age from 220.

Night Eating Syndrome

diagnosed when at least one-third of a person's calories are consumed after the evening meal. The eating disorder occurs in a much smaller proportion of the population, with approximately 9% of treated people in obesity programs having been officially diagnosed. The individual awakens at least once during the night and needs to eat prior to falling back to sleep. Often there is a lack of hunger in the morning, and the circadian rhythm (your body's 24-hour clock) is out of sync. A person suffering from night eating syndrome frequently suffers from depression, and the use of antidepressants has been found to beneficial in treating the disorder.

For activities lasting more than 20 minutes that are performed at a low or moderate rate such as weight lifting, hiking, or a fast walk-

fat becomes an important energy source. Fat is stored throughout the body in a concentrated form and is broken down into 3 fatty acids and a glycerol molecule for energy. As fitness levels improve, the utilization of fat as a source of fuel increases. However, fat is only useful in slow, steady, aerobic activities, while carbohydrates are the major fuel source for higher intensity or fast-paced events.

Recommended daily Allowance for protein

for adults is 0.8 grams per kg of body weight. Athletes have a slightly higher need, 1.0-1.6 grams per kg of body weight. During strength training, the extra protein is used for repair of muscle fibers. Once a desired muscle mass is achieved, the athlete will require approximately 1.2 grams of protein per kg of body weight. Excess protein intake can actually have a negative effect on your work out by increasing urine production, which leads to dehydration and fatigue.

SNAP

formerly known as the food stamp program, provides access cards to individuals who qualify to extend their food purchasing power.

Bulimia Nervosa Continued

in addition to the numerous psychological issues that a bulimic must deal with, there are also physical health problems that occur from the disorder. Demineralization of the teeth related to erosion from the stomach acids, burns on the knuckles related to the vomiting, and swollen salivary glands are common in the bulimic population. As in the treatment of anorexics, a team approach is required to successfully treat this disease. The first goal is to address the binging and decrease the amount of food consumed in a sitting. By addressing the quantity consumed, the frequency of purging will decline and allow healing of the esophagus and decrease damage to the teeth. Cognitive behavior therapy is used to help the patient improve their self-esteem and decrease the concern with body weight. Learning to cope with stressful situations, controlling their impulsive behaviors, and relearning normal patterns of eating will help an individual overcome this disorder. In certain cases, medication may be prescribed to help the patient achieve success.

Primary causes of malnutrition

insufficient food, inadequate health care (especially for children and females), and unhealthy living conditions. Together these lead to poor dietary intake and disease. To conquer malnutrition, countries must work together to solve these issues and improve their independence and ability to use their own natural resources.

Female Athlete Triad

involves disordered eating, lack of menstrual periods, and osteoporosis related to inadequate calcium and vitamin D intake. The triad often affects females who are participating in appearance-based or endurance sports, such as gymnastics, ballet, or cross-country running. Treatment goals are to gradually increase caloric intake to achieve a normal weight and reduce the preoccupation with food. At the same time, training intensity should be decreased, and a normal menstrual cycle should be established.

Iron

is a mineral that is of concern for athletes, especially female athletes. Iron is important in the production of red blood cells and the transport of oxygen throughout the body as well as for energy production. A deficiency can lead to anemia, which would negatively affect performance. Vegetarians and those who are restricting their calorie intake to < 1400 calories are at risk for low iron levels. Females also have a higher risk due to monthly menstrual losses. A blood test to check hemoglobin levels is the only way to determine if someone is deficient in iron. To prevent low iron levels, a diet rich in lean red meat and enriched grains should be advised. In some cases, a physician may recommend an iron supplement.

Hunger

is a painful sensation caused by lack of food. For those who readily have access to food, true hunger is rarely experienced. For those who are less fortunate, hunger can have devastating physical consequences. Lack of energy is an initial symptom of inadequate food intake due to the fall of blood sugar levels. As the brain uses glucose as its primary energy source, without it there is an impaired ability to learn and concentrate. Additionally, there is increased susceptibility to disease and delayed healing when ill. Eventually, the basal metabolic rate will decline, extreme lethargy sets in, and the body begins to break down muscle for fuel. In the United States, as well as other countries, the primary cause of hunger is poverty. In the United States, there are certain subpopulations that are at increased risk for malnutrition.

Calcium

is another mineral needed for strong bones and normal muscle function. A good illustration of the importance of calcium for bone health is to think about a bank. You can make regular deposits and withdrawals of funds at your local branch. The same is true of your bones, as they are in constant turnover. Bones are always being broken down and rebuilt. From birth until your mid-twenties, calcium deposits are being made to your bones, and bone mass is being accumulated. Just like the bank, daily withdrawals and deposits are being made. However, after your mid-twenties, the deposits slow and eventually stop. Although bone turnover is still occurring, bone mass is no longer being built. As such, bone maintenance now relies on adequate daily calcium intake. Unfortunately, many young women restrict their daily intake of dairy products in favor of diet sodas to help with weight maintenance. This can lead to a loss of bone mass. Additionally, female athletes may have minimal fat stores, which lead to cessation of menstruation. The result is thinning bones and an increased risk for stress fractures. Unfortunately, the bone loss appears to be irreversible and can lead to issues with osteoporosis later in life. The combination of disordered eating leading to a low body mass index, osteoporosis, and loss of menstruation combined with excessive physical training is known as the Female Athlete Triad. It is important that coaches are aware of this risk and encourage their female athletes to make wise and healthy nutrition choices while maintaining an appropriate weight.

Water

is needed to regulate your body temperature and to stay cool. The average adult needs 9-11 cups of fluid per day. Athletes will require more to prevent dehydration and maintain performance. Overall, fluid requirements are based on body size, ability to sweat, level of activity, and duration of the exercise. It is also important to establish how much fluid is lost through sweat per each hour of activity. Weighing one's self before, during, and after the activity can be used to determine fluid loss. Water loss > 3% of your body weight can not only affect your performance, but it also leads to several potentially fatal conditions: heat exhaustion, heat cramps, and heat stroke. If weight change cannot be monitored, a good indicator of dehydration can be simply urine color. For instance, a well hydrated individual has clear to pale yellow urine. However, dark yellow urine indicates a risk of dehydration. To prevent dehydration, 2.5 to 3 cups of water should be consumed for each pound lost during or after the event. It is also beneficial to drink 1.5 to 2.5 cups of fluid 2-3 hours before the event. Water, juice, coffee, tea, and sports drinks can all be used to stay hydrated. Although coffee and tea contain caffeine, which can have a diuretic effect, the effects are minimal if limited to less than 3 cups in 24 hours. However, there are some beverages that are being marketed for athletes to improve performance using caffeine. Caffeine-containing energy drinks are not recommended to maintain hydration status in athletes. While caffeine can improve performance, it can also have negative side effects, such as shakiness, nervousness, and anxiety. Taken together, should dehydration occur, the following conditions may be observed:

Binge Eating Disorder

is similar to bulimia and characterized by binge-eating episodes that are not accompanied by purging. Other characteristics include a lack of control over how much food is consumed and what is eaten, eating rapidly until feeling uncomfortable, eating alone due to embarrassment and feeling disgusted, and feeling depressed or guilty after over eating. Compulsive overeating at least two times per week for at least 6 months can lead to a diagnosis. Binge-eating was first diagnosed in 1994 and is recognized today as a growing problem. In fact, a much greater percentage of the population suffers from this disease than anorexia or bulimia. Individuals normally start out with weight issues and numerous attempts at dieting early in life. They next progress into trying commercial weight loss programs, usually without success, and then turn to binging in their late teens or twenties. Although approximately 4 million people in the United States have been diagnosed with this disorder, there are likely many more that suffer the symptoms but are not yet diagnosed. Similar to the other eating disorders, food is used as a coping mechanism. Many individuals come from dysfunctional families, and they never learned to deal with their emotions. As such, binge-eating empowers them to feel in control of their emotions and their situation. After the euphoria subsides following the binge, the individual must deal with feelings of guilt, embarrassment, and shame. Body image and weight are not necessarily linked to the disorder. Obesity may occur with excess intake, but not all binge eaters are overweight. As with the other disorders discussed above, professional help is recommended for treatment. The key is to help the individual identify personal needs and express emotions. Using behavior modification techniques, an individual with a binge-eating disorder must relearn hunger cues and normalized eating patterns. Self-help groups and medication may also be part of the treatment plan.

Churches and social organizations

lso run food pantries and soup kitchens for the homeless or anyone else who might be in need.

Vitamins and Minerals

needs can be met through the diet without supplements. It should be noted that there are certain individuals who could be at risk for a vitamin or mineral deficiency. For instance, wrestlers, ballerinas, and gymnasts may not eat enough calories to meet all their vitamin and mineral needs. Daily intake of less than 1,400 calories can make it difficult to meet your nutrient needs—the B complex vitamins and rich sources of antioxidants can be especially limited. Choosing low-fat, nutrient-dense foods, fortified options such as breakfast cereals and whole grains, and a variety of fruits and vegetables can help to prevent a deficiency.

Heat Cramps

occur when fluids are replaced but sodium levels in the body are low. Exercising over long periods in high temperatures can lead to painful contractions of the skeletal muscle. Prevention includes moderation of activity and adequate salt and fluid intake.

WIC

program was established for pregnant and lactating women as well as children under the age of 5. WIC is available to those who meet the income guidelines and have one or more nutrition-related health concerns. Food and nutrition services are provided for program participants.

Nervosa

refers to an attitude of disgust with one's body. This typically begins in the teenage or early adult years. The Diagnostic and Statistical Manual of Mental Disorders outlines the criteria used to diagnosis eating disorders. Although anorexia nervosa and bulimia nervosa are separate diseases, they do share several characteristics, and often an individual may suffer from both. Below are characteristics shared by the two disorders.

Eating disorders not otherwise specified

s a term used to classify eating disorders of abnormal eating patterns that do not meeting the criteria for either anorexia nervosa or bulimia nervosa. Three main disorders fall under this system of classification: (1) binge-eating disorder, (2) night eating syndrome, and (3) the female athlete triad.

Fats

should make up approximately 35% of the total calorie intake. The main fat source should be mainly from monounsaturated fatty acids. Rich fatty foods, which slow absorption, should be avoided the day before the event to allow for optimum performance.

aerobic activity

steady activity in which the heart can supply all the oxygen the muscles need -For events lasting between 2 minutes and 3 hours, such as cross country running or long-distance swimming, glucose breakdown occurs under aerobic (with oxygen) conditions—the energy is released more slowly and is thus the fuel for endurance-type activities. In fact, the aerobic breakdown of carbohydrates produces 95% of the body's ATP needs -For events lasting more than 1 hour, the glucose in the blood comes from glycogen stores found in the liver. As these stores are depleted, fatigue and a decline in mental function occurs (in cycling, this is called bonking; and in marathons, it is called hitting the wall). By consuming 30-60 grams of carbohydrates per hour in events lasting longer than 1 hour, this depletion and subsequent fatigue can be adverted.

Why is physical fitness important

the ability to perform moderate to vigorous activity without excess fatigue. Moderate levels of fitness can reduce the risk for many diseases, and yet a malnourished athlete cannot perform to maximum capacity. A healthy diet that supplies all the needed nutrients allows the body to perform at its peak ability. As the level of fitness increases, the type of fuel used by the muscle changes. In other words, improved fitness translates into increased utilization of fat for muscle fuel. Beyond burning fat for fuel, there are many other benefits that occur from regular physical activity, including increased cardiovascular function, reduced stress, lower blood pressure, weight loss/control, reduced risk of certain cancers, improved sleep, improved immune function, improved blood glucose control, slowing of the aging process, and an improved self-image. With all these benefits, one would assume that everyone is exercising; however, many of us lead very sedentary lives. Desk jobs are the norm, and with modern technology, we hardly need to exert any energy in a day's time. To perform physical activity daily, we need to attempt to schedule it into our day. Healthy People (Links to an external site.) was a 10-year government sponsored program started in 2000 designed to improve the nation's health. The program set specific objectives for adults in order to get them moving and physically active. Objectives included reducing the number of adults who failed to engage in leisure-time physical activity, double the number of adults who engaged in at least 30 minutes of activity daily, and increase the number of adults who participated in some type of resistance exercise to build muscle and endurance.

Excersize for beginners

the goal is to reach the lower number of beats per minute. As fitness levels improve the heart rate should be more towards the upper level of the target zone.

Heat Stroke

the most serious condition related to dehydration, occurs when the body's internal temperature reaches 104 degrees Fahrenheit. The body's cooling capacity fails and sweating stops. Symptoms include hot and dry skin, fainting, confusion, poor coordination, and seizures. Without immediate treatment, coma or death will result. During hot humid weather, athletes should carefully monitor weight loss, replace lost fluids, and limit training activities during the hottest part of the day. Unfortunately, several athletes die each year from heatstroke, most often occurring at the high school, college, or professional levels.

Carb loading

the process of consuming CHO prior to an event, is often used by endurance athletes and found to be effective in maximizing their muscle glycogen load. However, for events lasting longer than 60 minutes, an athlete should start to practice carbohydrate loading a week prior to the event. Each day the percentage of calories from carbs should be increased until 70% of your calories are coming from carbs. At the same time, the exercise intensity should be declining daily, with no activity the day prior to the event. An untrained muscle can hold 13 grams of glycogen per 100 grams of muscle, while a trained muscle can hold 32 grams per 100 grams of muscle. After the practice of carbohydrate loading, that same muscle can hold 35-40 grams / 100 grams of muscle. However, if an athlete is interested in carb loading, experts recommend trying this practice several times prior to the actual event. The practice of carbohydrate loading may result in muscle stiffness and heaviness because of excess water storage in the muscle.

Anorexia Nervosa

translates to "a denial of appetite." Extreme weight loss through starvation, a fear of becoming obese, and a distorted body image are all characteristics of anorexia. Most individuals suffering from anorexia are adolescent females who are not happy with the normal body changes that come with puberty. However, children as young as 7 years of age have been hospitalized with a diagnosis of anorexia. Once thought to be prevalent among middle and upper-class Caucasian females, it is now being diagnosed among all ethnic groups. An individual with anorexia tends to be competitive and obsessive. The desire to lose weight stems from their feelings of hopelessness in human relations, conflict in the family, evaluation of self-worth in terms of self-control, social stress, and life changes. Through strict discipline and self-denial of food, they feel empowered and in control. Dieting or control over food becomes their focus. Rituals involving food and excessive exercise and calorie counting are common.

Child and Adult Care Feeding Program and the National school Lunch Program

were established by Congress to help ensure adequate nutritional intake for seniors and children. Both provide nutritious meals in congregate settings to help meet 33-50% of an individual's daily nutrient needs.