Eating Disorders in Female Athletes

Eating disorders in female athletes are often higher then the general population.  This is especially true for female athletes in aesthetic based sports such as dance, gymnastics, swim, volleyball as well as track and field.  Where in the general population the prevalence of eating disorders is ~2%, in female athletes it can be as high as ~40%, dependent on sport and level of play.  Female athletes are often driven with discipline, strength, and determination, pushing their physical limits to achieve success in their sport. While the pressure and drive to excel can be an asset, it can also take a toll on their health and relationship with their body image.  Having an eating disorder as a female athlete can hinder performance, disrupt hormones and damage health.  This blog post will discuss the types of eating disorders , risk factors, warning signs and how to help an athlete with a suspected eating disorders.

Types of Eating Disorders

Eating disorders in female athletes can present as one of the many type of eating disorders.  An eating disorder is a diagnosable mental health condition defined by the Diagnostic Statistical Manual V (DSM-V).  If you have heard of the term disordered eating, it is defined as engaging in restrictive eating such as skipping meals or food groups, compulsive eating or exercise, and restriction of calories without meeting the DSM-V criteria for an eating disorder.

Below are three of the highlighted eating disorders defined by the DSM-V:

1) Anorexia Nervosa: A brain-based eating disorder characterized by severe calorie restriction and an intense fear of weight gain, anorexia can lead to malnutrition, fatigue, and a decline in athletic performance. Female athletes with anorexia may go to extreme lengths to maintain a low weight, even at the expense of their overall well-being.  AN is treatable and reversible. 

2) Bulimia Nervosa: Bulimia involves recurrent episodes of binge eating followed by compensatory behaviors such as forced vomiting, excessive exercise, or the use of laxatives. This cycle of binging and purging can have detrimental effects on both physical and mental health, impacting performance and overall quality of life.

3) Binge Eating Disorder: While not as commonly discussed in athletic circles, binge eating disorder can also affect female athletes. This disorder is characterized by consuming large amounts of food in a short period and experiencing a lack of control over eating. Binge eating disorders can result in weight gain, poor nutrition, and negative psychological effects.

Risk Factors for Eating Disorders in Female Athletes

Female athletes face unique expectations when it comes to body image and performance. Societal pressures often dictate that successful athletes must possess certain body types to excel in their chosen sport. For instance, gymnastics and figure skating tend to emphasize a lean physique, while sports like weightlifting or shot put require more muscular build. These unrealistic body ideals often drive female athletes to resort to extreme measures.

Several factors contribute to the development of eating disorders in female athletes:

Performance Pressure: The focus on achieving specific body ideals to meet competitive standards can lead to a decreased sense of self-worth and body dissatisfaction.  While there is some evidence that an athletes body fat percentage can impact performance, there has been no standard set for each sports.  Female athletes and their coaching staff should focus on performance and adequately fueling their training.  

Coaches and Peers: The attitudes, comments, and behaviors of coaches and teammates can significantly impact an athlete's relationship with their body. Coaches are at times are providing athletes with misinformation and guidance around nutrition, body composition and weight.  In many aesthetic based sports, weight and body shape is tightly monitored by staff who does not have the education and credentials to provide guidance or information.  Pressure from these sources can exacerbate disordered eating behaviors.

Social Media Influence: Constant exposure to social media, showcasing images of "ideal" athletic bodies, can distort perceptions of reality and contribute to the development of eating disorders.  Social media for female athletes is often providing misguided information on nutrition plans and food choices.  Exposure to social media, specifically body and weight loss focused content, showcasing bodies, can be harmful to a female athletes self-esteem and body image.  

Warning Signs and an Eating Disorder in Female Athletes 

1) Restriction of Intake: This can look innocently as an attempt to lose weight.  Unfortunately, many weight loss tactics are riddled with eating disorder behaviors such as obsessive tracking, excessive exercise, and reducing calorie intake purposefully.  Restriction can look like restriction of calories but also specific foods and food groups.  This can include cutting carbohydrate rich foods, sugars, foods higher in fat, cutting out dairy and/or gluten containing foods.  

Following specific fad diets to “improve health” can also fall under restriction.  This can include:

• Intermittent Fasting: A diet with an intention for weight loss where an individual restricts the hours of the day in which they eat. Many claim they are engaging for health benefits, but no proven benefits for athletes have been shown. For female athletes, their nutrition timing is very specific and crucial to their performance. Intermittent fasting is not a way to fuel to perform and engaging in it can be a sign of disordered eating.

• Ketogenic: A ketogenic diet is a low-carb, high-fat diet that involves reducing carbohydrate intake and replacing it with fat. For athletes, carbohydrates are critical to health and performance. Carbohydrates are often one of the most restricted food groups in eating disorders. Yet, restricting carbohydrates is the most harmful.

• Paleo: Very popular in the weight lifting and crossfit community. The diet focuses on unprocessed meats, fish, eggs, vegetables, fruits, nuts, seeds, and healthy fats, while avoiding processed foods, sugar, grains, and dairy products. While it is a seemingly healthful diet, a key hallmark of some eating disorders is restriction, and this is important to pay attention to.

2) Absence of or Irregular Periods: Female athletes menstrual cycle can be impacted by low calorie intake and well as binge eating disorder. Altered nutrition intake can disrupt the normal fluctuations of sex hormones such as estrogen and luteinizing hormone. These key hormones in regulating a normal menstrual cycle, when disrupted, can result in irregular cycles (oligomenorrea) and loss of period for 2 or more months (amenorrhea).

A normal menstrual cycle is not just important for fertility, but many aspects of womens health, including:

• Bone mineral density

• Cardiac Health

• Healthy body composition

• Iron status

3) Increased injuries and illnesses: Suppression of nutrient intake and imbalance of nutrient intake can impair the immune system. Nutrients, particularly proteins and micronutrients, compose a large part of your immune system. Low intake of nutrients, inflammation in the body from binge-purge and damage to the body tissues from eating disorders can distrupt immune function. As for injuries, athletes with low calorie intake and high energy output are at high risk for injuries, including stress fractures and regular fractures. Stress fractures can be contributed to impaired bone mineral density caused by lower estrogen levels. A missing or irregular period is also connected to this. This is part of a condition known as the Female Athlete Triad and part of Relative Energy Deficiency in Sport (RED-S).

4) Weight loss and fluctuations: Changes in weight can be a result of a variety of factors. When someone has an eating disorder, weight changes are often drastic and over a shorter period of time. Weight changes can be loss, gain or fluctuate between both. Weigh fluctuations are a cause for concern, and have health risks. It is important to note that any eating disorder can exist at all body shapes and sizes. Those of normal or higher weights often go missed since they do not “look like they have an eating disorder”. This is untrue and can continue to harm the individual.

5) Decrease in performance markers: With inadequate nutrition, both calories and nutrients, athletes performance can suffer. This includes skills in their respective sport, decrease in speed, power and strength. You may also notice their cognitive performance can suffer, as well as mood swings and change of character.

Getting Your Athlete Help

Eating disorders are a treatable disorder. If you suspect your athlete may have an eating disorder, book a discovery call. Here we can discuss how a Registered Dietitian specializing in female athletes with eating disorders can help with recovery. Most treatments do best with a team. This team is comprised of a Registered Dietitian, Therapist and Physician. The team works together to collaborate on a treatment plan to get the athlete recovered, healed and back to training. The goal is to ensure adequate nutrition intake and reduce eating disorder symptoms. The team will discuss when and if training is appropriate as multiple factors contribute to back to play.

The Best Pre and Post Workout Foods to Feel Results

Getting the most out of your training starts with fueling your session with proper nutrition. During your workout, your heart, muscles, nervous system, adrenals and brain are working hard to sustain the reps and sets you have planned. And we know all these systems function best when they have adequate energy and carbohydrates to do so. What and when we eat before and after a workout will influence our training, energy and whether or not we get all the benefits from it. In this article we will go over the best foods to have before and after your next pump session.

Let’s talk pre-workout fueling…

In the world of sports nutrition, before a workout we suggest primarily carbohydrates, maybe some protein and little fat. Here is why:

1. Carbohydrates are the primary source of fuel for the brain and muscles during all forms of physical activity. During endurance type exercise, you will start to utilize more fat than during a weight lifting session, but carbohydrates still remain the #1 fuel source.

2. While protein is not completely necessary, it won’t hurt before a training session. It actually can help with satiety, fullness during training and making your pre-exercise snack more satisfying.

3. We recommend lower fat options since fat can slow down the digestion of carbohydrates. That’s not something we want to do when our muscles are going to be using them pretty soon after we eat.

Speaking of pretty soon, let’s talk about when you want to be eating pre-exercise and how much. The general recommendation is 45-60 minutes prior to the start of your session. It is important to note that how much carbohydrates you consume prior to training may be dependent on your overall carbohydrate needs. This can be assessed better during a personalized nutrition plan. Generally, for weightlifting and gym workouts, 15-45 grams of carbohydrates is sufficient for a 60 minute workout session. For endurance athletes or training hard for over an hour, it may be necessary to consume upwards of 45-60 grams of carbs. It is important to listen to your body during training and determining if what you are consuming before is enough. Feeling like your dragging or hungry by the end? A little more fuel before, but also throughout the day, may be necessary.

So what types of carbs and fuel should you be consuming? We have two main type of carbs we discuss when he comes to exercise nutrition: complex carbohydrates, or starches, and simple carbohydrates, or sugars. When it comes to fueling within the hour prior to exercise, we want to focus on primarily simple carbohydrates like fruits and sugars. Having some complex carbs along with simple carbohydrates can be useful strategy. This will allow us to have quick energy for the start of training plus sustained energy as our bodies breakdown the starches during our workout.

So what specfic foods can give us a mix of complex + simple carbs, plus feel satiated and filling to last the hour? Here’s a list of the best food combos to have before training, and why:

1) Fruit + handful of nuts: Fruit will provide us with simple carbohydrates and nuts will provide a little fat and fiber to help us feel fuller and more sustained with our fueling. Fruit like bananas, melon, pinneapple, oranges and grapes are all a great choice.

2) Toast + nut butter + sliced banana: A classic simple snack, the toast and nut butter give use complex carbs, fat and fiber for sustained energy and fullness plus simple carbs from some sliced banana.

3) Dates: Dates are one of our favorite pre-workout carbs as this dried fruit is packs in 20 grams of carbs per date. These are a perfect choice for the person who doesn’t like to eat before a workout. It’s low in volume and higher in carbs, so it won’t make you feel too full.

4) Smoothie: Fruit blended with milk, coconut water or regular water is a great way to get in simple carbs with faster digestion and absorption.

5) Granola bar: Great for on the go and thrown into a gym bag or purse, granola bars have a mix of simple and complex carbohydrates, perfect to fuel a tough workout ahead.

You may be asking, well what about pre-workout? The best pre-workout supplement is…caffeine! Other ingredients in a pre-workout you will want to look for are nitric oxide activators like a pre-workout with beet root extract. Klean Athlete’s pre-workout is the perfect combo of caffeine and beet root extract, you can find it here.

Now let’s talk about what you do after a workout…

Post workout nutrition is just as important. You may have heard that protein immediately after is essential, but why? During a workout your whole body is working to get more blood, nutrients and oxygen to your muscles in order to create energy and do work. After a workout your body and muscles are more sensitive and accepting of nutrients, allowing more to be absorbed at a fast rate. Additionally, exercise itself turns on and increases the muscle building process called muscle protein synthesis. With this process triggered, we want to make sure muscles have the building blocks (like proteins) to rebuild and recovery.

While protein has a main character moment post training, carbohydrates are also of importance. During exercise you are depleting some of your carbohydrate stores that you want to replenish before the next session. With muscles more sensitive to nutrients, carbohydrate repletion is more favorable during this time.

When it comes to how much protein you need in the hour after training, a minimum of 25 grams of animal based protein is suggested. This is the amount that will provide us with at least 2.5 grams of leucine, an amino acid that stimulates the process of muscle building. Reaching that leucine threshold to ignite muscle protein synthesis is key to your recovery and progress. What if you are plant-based? If you are relying on plant-based protein sources, consuming 35 grams may be more appropriate. This is because plant-based sources of protein have lower leucine amounts and you need more protein to hit your leucine needs. If you are using a plant-based powdered protein supplement, always read the amino acid profile to ensure you are getting 2.5 grams per serving. Most “sport” based supplements will have enough, but always check.

Whether it is a food or a supplement, hitting your 25 grams minimum post workout to reach your leucine needs is key here. Just a side note: while we are stressing leucine here, it is important to note that all amino acids are needed to build muscle an the leucine is important to stimulate (or start) the process. With that said, here’s some ideas for your post workout protein + carb needs:

1) Whey protein isolate protein shake: A classic and commonly recommended for a good reason. Whey protein isolate is rapidly absorbed into the bloodstream, having a better effect on muscle protein synthesis. Interested in a plant-protein? Garden of Life Sport plant-based protein is a great option.

2) Greek Yogurt: We love that 1 cup of Greek yogurt contains 2.5 g leucine plus 25 grams of protein. Adding fruit will help you get in more carbohydrates, add flavor and fiber.

3) Cottage cheese: Similarly to yogurt, a 1 cup serving of cottage cheese has over 2.5 g leucine and 25 grams of protein.

4) Grilled chicken or turkey: When it comes to poultry, about 4.5 oz will contain 2.5 g of leucine.

Here’s a little key tip we have: If you can get to a meal immediately after training, or within the hour, that is preferable. A meal will have a mix of nutrients, amino acids and carbs that are most beneficial. But many of us aren’t going straight to a meal or may not be in the mood for one right after. This is where protein supplements play a huge role. For powders, we recommend Garden of Life Sport Whey protein and for bottles drinks we like Core Power and Owyn Pro Elite as a plant-based option.

Outside of the pre and post workout nutrition, what you are doing day to day is also very important for you to feel good during training and see progress. Ensuring you have energy throughout the day, including adequate protein, carbohydrates and fats, is the foundation you need to train your best. Including adequately timed nutrition around your workouts will add to this solid foundation. Unsure if you’re foundation is solid? Book a discovery call today to see how we can work together.

Banana Bread Cookies

Ingredients

• 2 tbsp chia seed soaked in 1/4 cup water overnight (or several hours until thick)

• 2 overripe bananas, mashed

• 2 tbsp agave or maple syrup

• 1/2 tsp pure vanilla extract

• 1 cup almond flour

• 2 tbsp coconut flour

• 1/4 tsp baking soda

• 1/8 tsp salt

• 1/3 cup chocolate chips

Instructions

1. Set oven to 325F and line a cookie sheet with parchment paper.

2. Mash banana in a large mixing bowl until smooth and no large chunks remaining. To the bananas add chia seed mixture, agave or maple syrup, and vanilla extract. Mix thoroughly.

3. To the wet mixture add almond flour, coconut flour, baking soda, and salt. Mix thoroughly and then fold into chocolate chips.

4. Scoop batter into 9 even cookies on the baking sheet and shape. Place in oven for 20-25 minute until lightly golden on top. Allow the cookies to cool slightly before digging in.

Chocolate Date and Protein Energy Balls with Pumpkin and Almond

Chocolate Date and Protein Energy Balls with Pumpkin and Almond

Yield: ~10 balls 

Ingredients:

• 15 pitted medjool dates

• 1/2 cup whole almonds

• 1/4 cup chocolate protein powder

• 2 tbsp cacao powder

• 2 tbsp almond butter

• 1/4 cup pumpkin puree

Instructions

1. In a food processor, pulse 1/4 cup almonds until finely chopped and remove from food processor into a small bowl. This will be used to roll the balls in.

2. Add in the dates and pulse until finely chopped. Next, add in the rest of the whole almonds and place on high until the dates and nuts are combined into a sticky paste.

3. Next add in the protein powder, cacao, almond butter, and pumpkin puree until thoroughly mixed.

4. Using a small cookie scoop, or a heaping tablespoon worth, scoop mixture into your hands and roll into a ball. Place in the ground almonds and mix around until evenly coated.

5. Place balls on a baking tray and place in the fridge to chill for an hour. Transfer to an airtight container and keep them in the fridge for ~7 days. These can be frozen too for up to 1 month.

Peanut Butter Brownies

Ingredients

• 1 can black beans, thoroughly rinsed and drained

• 2/3 cup cacao powder

• 1/3 cup peanut butter

• 1/4 cup coconut sugar

• 1/4 cup maple syrup

• 1 tsp vanilla extract

• 1/4 tsp salt

• 1 tsp baking soda

• 2 tbsp soy/almond/coconut milk

• 1/2 cup chocolate chips + extra to sprinkle on top (dairy-free if needed)

• 2 tbsp flaxseed

• 6 tbsp water

Instructions

1. Set oven to 350 degrees and oil or line a 9×9 baking dish.

2. Grind flax seeds and combine into 6 tbsp of water and allow to sit for 5-10 minutes. This acts as the egg, adding fiber and healthy fats.

3. In a food processor or high powered blender, add black beans, peanut butter, cacao powder, coconut sugar, maple syrup, vanilla extract, salt, baking soda, milk, and flax egg. Mix until the batter is completely smooth.

4. Remove the blade and stir in the chocolate chips. (If you need to transfer to a bowl and mix in, do not mix with the blade.

5. Transfer to the baking dish, sprinkle some extra chocolate chips on top and bake in the oven for ~35 minutes. Allow the brownies to cool completely before digging in. They will be yummy and gooey.

Blog Post Title Four

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Be clear, be confident and don’t overthink it. The beauty of your story is that it’s going to continue to evolve and your site can evolve with it. Your goal should be to make it feel right for right now. Later will take care of itself. It always does.