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Sport Nutrition for Health and Performance
by Melinda M. Manore, Nanna L. Meyer and Janice Thompson
560 Pages, 8.5
Sport Nutrition for Health and Performance, Second Edition, will help students and practitioners understand the function of the nutrients in the body and how these nutrients affect health and athletic performance. The authors present clear, comprehensive, and accurate nutrition information that may be applied to a variety of careers. The text provides students with practical knowledge in exercise and nutrition science, and it keeps practitioners on the cutting edge of current research and practices in the field.
Using the authors' extensive backgrounds in nutrition, exercise physiology, and fitness, the text combines micronutrients into functional groupings to provide an easy framework for understanding how these nutrients can influence exercise performance and good health for both athletes and active individuals. This unique presentation allows readers to fully understand why proper nutrition helps athletes prevent injury, enhance recovery, improve daily workouts, and maintain optimal health and body weight.
This second edition has been thoroughly revised and updated to reflect the latest issues, guidelines, and recommendations for active individuals. Chapters dealing with macronutrients and micronutrients have been entirely rewritten, and all chapters have been revised to reflect the latest Dietary Reference Intakes, USDA Food Guide Pyramid, Food Pyramid for Athletes, Dietary Guidelines for Americans, and physical activity recommendations from various organizations, including the 2008 Physical Activity Guidelines by DHHS. Following are some of the current topics discussed in the text:
-Carbohydrate recommendations for athletes before, during, and after exercise
-Protein requirements of athletes based on the latest research
-Updated evaluation of the fat needs of athletes and the role of fat loading
-An evidence-based reexamination of various diets and techniques used for weight loss
-New research on body composition assessments and standards
-The latest on controversial nutrition issues such as the role of protein, vitamin D, and energy in bone health and new criteria for assessing bone health in young adults
-New nutrition and fitness assessments, questionnaires, and methods for measuring energy expenditure
-Updated information on various topics such as the issues of the active female, ergogenic aids, energy balance, and fluid balance
Sport Nutrition for Health and Performance, Second Edition, has also been improved with an attractive two-color format, new artwork, and a slimmer design that allows the text to maintain the content while reducing “backpack bulge.” The text also includes an online image bank that instructors may use to create customized PowerPoint presentations using artwork, tables, and figures from each chapter. In addition, a variety of features help readers comprehend the material presented, including chapter objectives, key concepts and key terms, additional information to learn more about a topic, and references. Chapter highlights provide in-depth information on topics and critically evaluate issues regarding myths and controversies in sport nutrition.
This book provides readers with clear, authoritative content that will help them understand the scientific basis of nutrition and make sound recommendations in their careers. With up-to-date content based on current guidelines, Sport Nutrition for Health and Performance, Second Edition, is an outstanding text for both students and practitioners concerned with achieving good health and maximizing performance.
Chapter 1. Introduction to Nutrition for Exercise and Health
Role of Nutrition in Exercise and Sport
Essential Nutrients and Dietary Recommendations
Role of Eating a Balanced Diet
Role of Nutrition and Exercise in Disease Prevention
Chapter in Review
Learning Aides
Chapter 2. Carbohydrate as a Fuel for Exercise
Function, Classification, and Dietary Sources of Carbohydrate
Carbohydrate Metabolism During Exercise
Carbohydrate Reserves and Dietary Intake
Carbohydrate Feeding Before Exercise
Carbohydrate Feeding During Exercise
Carbohydrate Feeding Postexercise and During Training Periods
Muscle Glycogen Supercompensation
Chapter in Review
Learning Aides
Chapter 3. Fat As a Fuel for Exercise
Function, Classification, and Dietary Sources of Fat
Body Fat Reserves and Dietary Fat Intake
Fat Metabolism During Exercise
Enhancement of Fat Oxidation
Dietary Fat Recommendations for Optimal Performance and Health
Chapter in Review
Learning Aides
Chapter 4. Protein and Exercise
Functions and Classifications
Methods of Assessing Protein Status
Dietary Sources of Protein
Metabolism of Protein During and After Exercise
Dietary Protein Recommendations for Active Individuals
Chapter in Review
Learning Aides
Chapter 5. Energy and Nutrient Balance
Energy and Macronutrient Balance Equations
Macronutrient Balance
Energy Expenditure
Energy Intake
Chapter in Review
Learning Aides
Chapter 6. Achieving Healthy Body Weight
Role of Diet and Exercise in Achieving a Healthy Body Weight
Weight Loss Interventions
Adding Exercise to Weight Loss Programs
Recommendations for Maintaining or Gaining Weight
Weight Concerns of Athletes
Chapter in Review
Learning Aides
Chapter 7. Body Composition
Body Composition and Health
Body Composition and Sport Performance
Body Composition Assessment Models and Methods
Accuracy of Body Composition Assessment Methods
Selection Criteria for Field Methods
Body Composition of Athletes
Body Composition Standards and Health
Chapter in Review
Learning Aides
Chapter 8. Fluid and Electrolyte Balance
Water and Electrolyte Balance
Fluid and Electrolyte Recommendations for Exercise
Sport Drinks and Fluid Replacement Beverages
Fluid Needs in Hot Environments
Fluid Needs in Cold Environments
Fluid and Electrolyte Needs for Children and Adolescents
Chapter in Review
Learning Aides
Chapter 9. B Vitamins Important in Energy Metabolism
Exercise-Related Functions and Dietary Requirements
Rationale for Increased Need for Active Individuals
Assessment of Vitamin Status
Exercise and Vitamin Requirements
Vitamins and Exercise Performance
Chapter in Review
Learning Aides
Chapter 10. Antioxidant Nutrients
Actions of Antioxidants
Enzymes Involved in Antioxidant Activities
Nutrients Involved in Antioxidant Activities
Assessment of Oxidative Damage
Rationale for Increased Antioxidant Need Among Active Individuals
Antioxidants and Chronic Diseases
Antioxidants and Performance
Chapter in Review
Learning Aides
Chapter 11. Minerals and Exercise
Exercise-Related Functions, Dietary Requirements, and Food Sources
Assessment of Mineral Status
Rationale for Increased Need for Active Individuals
Nutritional Status of Active People
Chapter in Review
Learning Aides
Chapter 12. Micronutrients Important in Blood Formation
Exercise-Related Functions, Dietary Requirements, and Food Sources
Rationale for Increased Need for Active People
Assessment of Vitamin and Mineral Status
Nutritional Status of Active Individuals
Chapter in Review
Learning Aides
Chapter 13. Nutrients for Bone Health
Review of Bone Metabolism
Calcium
Phosphorus
Magnesium
Vitamin D
Other Nutrients Involved in Bone Metabolism
Exercise and Bone Health
Chapter in Review
Learning Aides
Chapter 14. Nutrition and Fitness Assessment
Medical and Health History Questionnaires
Assessing Energy and Nutrient Intake
Assessing Daily Energy Expenditure
Fitness Assessment
Chapter in Review
Learning Aides
Chapter 15. Nutrition and the Active Female
Energy and Nutrient Requirements
Female Athlete Triad
Chapter in Review
Learning Aides
Chapter 16. Ergogenic Substances
Ergogenic Substances in Sport and Exercise
Evaluating Ergogenic Substances
Choosing Quality Ergogenic Substances
Review of Two Ergogenic Substances
Chapter in Review
Learning Aides
Appendix A. Nutritional Recommendations
Appendix B. Artificial Sweeteners and Fat Replacers
Appendix C. Energy Balance
Appendix D. Body Fat Percentages for Athletes
Appendix E. Nutrition and Fitness Assessment
Index
About the Authors
Melinda M. Manore, PhD, RD, CSSD, FACSM, is a professor in the department of nutrition and exercise sciences and a nutrition specialist in extension at Oregon State University. She has taught and conducted research in nutrition and exercise for more than 25 years. She is a highly regarded researcher, particularly in the nutrition needs of active women, and has written more than 60 research articles, 6 books, 20 book chapters, and numerous nutrition articles for health and nutrition professionals.
Dr. Manore is a member of several editorial boards of nutrition and exercise journals. She is a member of the American Dietetic Association (ADA) and several organizations within the ADA, including Sports Dietetics USA, Weight Control, the research practice groups, and Sports, Cardiovascular, and Wellness Nutritionists (SCAN). She is a member of the American Society of Nutrition, the American College of Sports Medicine (where she is a fellow), and the Obesity Society. She is also a founding member of Professionals in Nutrition for Exercise and Sport (PINES) and on the academic advisory board for the International Olympic Committee (IOC) diploma in sports nutrition. Dr. Manore is a certified specialist in sport dietetics (CSSD) from ADA. In 2001, she received an Excellence in Practice Award from the ADA.
In her leisure time, Dr. Manore enjoys hiking, walking, gardening, birding, and cooking.
Nanna Meyer, PhD, RD, CSSD, is an assistant professor in health sciences at the University of Colorado. She has been working in sport nutrition as a scientist, clinician, and educator since 1997. She developed the sport dietetics emphasis degree at the University of Utah and is working on a new graduate program (to be launched in fall 2009) at the University of Colorado at Colorado Springs. Her primary research areas are the female athlete triad and nutritional issues in Olympic athletes. She also leads Professionals in Nutrition for Exercise and Sport (PINES), an international group that advances the field of study.
Dr. Meyer has been a member of the American College of Sports Medicine since 1992 and is a member of various other professional organization, including Sports Dietetics USA and Sports, Cardiovascular, and Wellness Nutritionists (SCAN). In 2000, she received a scientific prize for a presentation on nutrition for winter sports at the International Congress on Skiing and Science.
In her spare time, Dr. Meyer, who was a member of the Swiss ski team, likes to cross-country ski, alpine ski, run, cycle, and hike. She also enjoys modern art, reading, and writing.
Janice L. Thompson, PhD, FACSM, is a professor of public health nutrition and head of the department of exercise, nutrition and health at the University of Bristol in the United Kingdom. She has spent more than 20 years conducting research and teaching at universities in areas related to nutrition, public health, exercise, and sport nutrition. In addition to coauthoring the first edition of Sport Nutrition for Health and Performance, she has authored three other textbooks on nutrition with Dr. Manore.
Dr. Thompson serves as the vice president of the American College of Sports Medicine and is a fellow of that organization. In 1997 she received an Excellence in Undergraduate Teaching Award from the University of North Carolina at Charlotte. In her leisure time, Dr. Thompson enjoys hiking, yoga, and cooking.
“This informative book provides excellent explanations, especially of the metabolism of carbohydrate, fat, and protein in exercise.”
--Doody’s Book Review, 5-star review
Evolution of Dietary Guidelines for Americans
See how dietary guidelines have developed to help promote health, decrease the risk of chronic disease, meet nutrient requirements, and support active lives.
This is an excerpt from Sport Nutrition for Health and Performance, Second Edition.
Learning from the National Weight Control Registry
A look at the weight loss and maintenance strategies of successful individuals.
The National Weight Control Registry
In 1994, Drs. Rena Wing, PhD, of Brown Medical School and James Hill, PhD, of the University of Colorado Health Sciences Center founded the National Weight Control Registry (NWCR) (www.nwcr.ws). To date, this project is the largest prospective investigation of long-term successful weight loss maintenance. The goal of the project was to find individuals who had been successful at weight loss and describe the strategies that they used to achieve and maintain weight loss long-term. Currently, the NWCR is tracking over 5000 individuals who have lost significant amounts of weight and kept it off for long periods of time. In order to be part of the registry, people need to be 18 years or older, who have lost at least 30 lb (6.6 kg), and to have maintained this weight loss for at least one year. Once enrolled in the program, individuals are periodically asked to fill out detailed questionnaires about their successful weight loss, current weight maintenance strategies, and other health-related behaviors for the purpose of determining the behavioral and psychological characteristics of weight maintainers, as well as the strategies they use to maintain weight loss. Participants also fill out annual follow-up surveys so that their weight maintenance can be continually tracked. Thus the NWCR is not a randomized controlled study, but rather looks at who has been successful at weight loss and at weight loss maintenance. On average, 80% of the participants are women and 20% are men who have lost 66 lb (30 kg) and kept the weight off for 5.5 years. The average woman is 45 years of age and weighs 145 lb (66 kg), and the average man is 49 years of age and weighs 190 lb (86 kg). Of course, these averages hide the huge diversity of the individuals involved in the study, as well as facts such as the following:
- Weight loss has ranged from 30 to 300 lb (13.6-136 kg).
- Duration of successful weight loss has ranged from 1 to 66 years.
- Some participants have lost the weight rapidly, while others have lost it very slowly-over as many as 14 years.
The following are strategies used by these individuals to lose weight and keep it off. Some of the information has been adapted from a review of the NWCR by Manore (2004).
Methods of weight loss. Almost everyone in the registry has used a combination of diet and exercise to lose the weight, with 45% reporting that they lost the weight on their own and 55% reporting using some type of program. Nearly all of the participants (98%) reported that they modified their food intake in some way to lose weight, while 94% said that they increased their physical activity. The most common form of physical activity reported is walking. Nearly all of the participants have reported that their weight loss has led to significant improvements in energy levels, physical mobility, general mood, self-confidence, and physical health (Klem et al. 1997). Participants (~42%) state that keeping the weight off has not been as difficult as losing it initially (Klem et al. 1997). This is especially true in individuals who have kept the weight off for more than two years (Klem et al. 2000).
Strategies for weight maintenance. Since the initiation of the NWCR, investigators have been analyzing the data to determine successful weight maintenance strategies (Gorin et al. 2004; Hill and Wing 2003; Klem et al. 1997; McGuire et al. 1998; Phelan et al. 2007; Raynor et al. 2006; Shick et al. 1998; Wyatt et al. 2002). In general, most participants report continuing to maintain a low-calorie, low-fat diet and doing high levels of physical activity. The following are some of the specific and most frequently mentioned strategies used by participants who have been successful at maintaining weight loss:
- Eating breakfast. Nearly 80% of participants report eating breakfast every day, with only 4% reporting never eating breakfast. How might eating breakfast contribute to successful weight maintenance? Although there were no differences in total energy intake between frequent breakfast eaters and less frequent breakfast eaters (three times a week or less), breakfast eaters reported being more physically active (Wyatt et al. 2002).
- Monitoring energy and fat intake. A common characteristic of registry participants is that they continue to monitor their energy and fat intake even after the weight loss period is over. On average, participants consume diets with ~24% of energy from fat and have energy intakes lower than average (Shick et al. 1998). As a group, 80% consume diets with <30% of energy from fat, while 35% consume diets with less than 20% of energy from fat. The strategies employed to control food intake include limiting intake of certain high-fat foods, eating less food per meal, counting grams of fat or calories, eating regular meals, and adhering to the same diet regimen throughout the week (Klem et al. 1997; Gorin et al. 2004). Diet consistency across the week appears to help people prevent weight gain (Gorin et al. 2004).
- Exercising daily. Being physical active is an important characteristic of registry participants, with 90% reporting that they exercise, on average, about 1 h or more per day. Weekly energy expenditures from physical activity average ~2800 kcal: ~2500 kcal/week for women and 3300 kcal/week for men (Hill and Wing 2003; Klem et al. 1997). The most common forms of physical activity reported are cycling, aerobics, walking, and running (Klem et al. 1997). Comparison of the levels of physical activity between successful weight loss maintainers and people who had always maintained a normal weight showed that the weight loss maintainers spent significantly more time in high-intensity forms of physical activity and spent more minutes per week doing physical activity (Phelan et al. 2007).
- Engaging in less sedentary activity. It has long been recognized that sedentary behaviors, especially TV viewing, may contribute to weight gain. Raynor and colleagues (2006) examined the TV viewing of registry participants and found that 62% watched <10 h of TV per week, with 36% reporting that they watched <5 h/week. This level of TV viewing is much lower than the national average of 28 h/week.
- Monitoring weight. Nearly 75% of the registry participants weigh themselves at least once a week (Klem et al. 1997). Thus, regularly monitoring weight appears to be a behavior that is important for ensuring that weight regain does not occur.
What we have learned from the participants in the NWCR is that good nutrition, physical activity, and self-monitoring are important for keeping the weight off once it has been lost. Individuals who are successful at weight loss and the maintenance of weight loss appear to employ similar strategies. They eat breakfast, exercise regularly, monitor their diet for both energy and fat intake, participate in less TV watching, and weigh themselves regularly.
Choosing quality ergogenic substances
Because of the many potential risks associated with supplements, it is important to critically evaluate ergogenic substances prior to using or recommending them.
Because of the many potential risks associated with supplements, it is important to critically evaluate ergogenic substances prior to using or recommending them. However, evaluating the marketing, research, and safety of products can be a daunting task in the current regulatory environment. How do you decide what is safe and effective?
Third-Party Evaluations
Several organizations now offer third-party evaluations of dietary supplements. Independent testing of individual products is conducted (usually for a fee) to evaluate such quality control issues as labeling accuracy, purity, strength, and ability to dissolve. For companies that use these services, you will find certifications or seals of approval on their products. A recent certification useful for athletes is the Certified in Sport by NSF International. This program also tests for banned substances. Keep in mind that third-party testing is expensive; the fact that a product is not on the list of certified products does not mean it is unsafe. However, if it is on the list, it meets the criteria set forth by the evaluator.
Australian Institute of Sport (AIS) Sports Supplement Program
In recent years, the Australian Institute of Sport has implemented a sport supplement program to ensure that athletes are using sport foods and supplements safely. A panel of experts evaluates current research on various supplements and categorizes them based on how safe and effective they are.
- Group A supplements: Sport foods and supplements that provide a useful and timely source of energy and nutrients or for which there is scientific evidence supporting improved performance
- Group B supplements: Newer supplements on which not enough scientific studies have been conducted, but that may provide a performance benefit as suggested by preliminary evidence
- Group C supplements: Supplements that have not been shown to improve sport performance or that may impair sport performance-most ergogenic substances fall under this category
- Group D supplements: Supplements that are banned or are at high risk of being contaminated with substances (e.g., steroids) that could cause a positive drug test
Evaluating popular diets
Learn how to recognize a potential fad diet or nutrition program.
Popular or Fad Diets
Fad diets are those that enjoy short-lived success and popularity and are based on a marketing gimmick. Athletes can be particularly vulnerable to fad dieting because of their intense desire to optimize body composition and performance. Celebrities and other well-known persons endorse these diets in an attempt to give them credibility. Justification for these diets is typically based on a scientific or biochemical claim that may be speculative and unproven. Consumers must remember that if the claims associated with the diets were true, there would be no need for people to continue dieting and no need for the next fad diet! For example, if the Dr. Atkins diet, popular in the 1970s, had worked, there would be no need for the "new and improved" Dr. Atkins' New Diet Revolution in the 1990s and 2000s. As mentioned earlier, more modified versions of the Dr. Atkins diet are here to stay but are characterized by less carbohydrate restriction. Because LCDs bring about quick weight loss, they may be used to help people begin or "jump-start" a weight loss regimen.
There will always be a new fad diet in the marketplace, so it is important to understand how to evaluate each new diet and give good dietary advice to your clients. The criteria listed next will help you recognize a potential fad diet or nutrition program. If the diet either you or your clients are considering is associated with one of the following, it is probably just another fad diet:
- The claim that the diet is new, modern, improved, or recently discovered, with no scientific data available to back up the claim
- The claim that weight or fat loss will be rapid, usually more than 2 lb (0.9 kg) per week
- The claim of successful weight loss with no or little physical exercise
- Inclusion of special foods that are expensive and difficult to find; suggestion that foods should be consumed in a particular order or "combination"; suggestion that consumption of certain "bad" foods should be avoided; or inclusion of "magic" or "miracle" foods that will burn fat
- Inclusion of a rigid menu that must be followed daily; restriction to a limited list of foods (these diets frequently require adherents to eat the same foods day after day)
- Inclusion of supplemental meals, foods, or nutrient supplements with the claim that they will cure disease or a variety of ailments
Until we figure out how to solve the obesity problem, the consumer will be bombarded with new weight loss products and programs promising fast weight loss. It is important for nutrition and fitness professionals to educate consumers about the limitations of these products and programs. While some may be physically harmless (albeit expensive), others can cause illness or even death. It is always important to consider the safety and efficacy of any fad diet, including the associated supplements, before recommending it to a client.
Evolution of Dietary Guidelines for Americans
See how dietary guidelines have developed to help promote health, decrease the risk of chronic disease, meet nutrient requirements, and support active lives.
This is an excerpt from Sport Nutrition for Health and Performance, Second Edition.
Learning from the National Weight Control Registry
A look at the weight loss and maintenance strategies of successful individuals.
The National Weight Control Registry
In 1994, Drs. Rena Wing, PhD, of Brown Medical School and James Hill, PhD, of the University of Colorado Health Sciences Center founded the National Weight Control Registry (NWCR) (www.nwcr.ws). To date, this project is the largest prospective investigation of long-term successful weight loss maintenance. The goal of the project was to find individuals who had been successful at weight loss and describe the strategies that they used to achieve and maintain weight loss long-term. Currently, the NWCR is tracking over 5000 individuals who have lost significant amounts of weight and kept it off for long periods of time. In order to be part of the registry, people need to be 18 years or older, who have lost at least 30 lb (6.6 kg), and to have maintained this weight loss for at least one year. Once enrolled in the program, individuals are periodically asked to fill out detailed questionnaires about their successful weight loss, current weight maintenance strategies, and other health-related behaviors for the purpose of determining the behavioral and psychological characteristics of weight maintainers, as well as the strategies they use to maintain weight loss. Participants also fill out annual follow-up surveys so that their weight maintenance can be continually tracked. Thus the NWCR is not a randomized controlled study, but rather looks at who has been successful at weight loss and at weight loss maintenance. On average, 80% of the participants are women and 20% are men who have lost 66 lb (30 kg) and kept the weight off for 5.5 years. The average woman is 45 years of age and weighs 145 lb (66 kg), and the average man is 49 years of age and weighs 190 lb (86 kg). Of course, these averages hide the huge diversity of the individuals involved in the study, as well as facts such as the following:
- Weight loss has ranged from 30 to 300 lb (13.6-136 kg).
- Duration of successful weight loss has ranged from 1 to 66 years.
- Some participants have lost the weight rapidly, while others have lost it very slowly-over as many as 14 years.
The following are strategies used by these individuals to lose weight and keep it off. Some of the information has been adapted from a review of the NWCR by Manore (2004).
Methods of weight loss. Almost everyone in the registry has used a combination of diet and exercise to lose the weight, with 45% reporting that they lost the weight on their own and 55% reporting using some type of program. Nearly all of the participants (98%) reported that they modified their food intake in some way to lose weight, while 94% said that they increased their physical activity. The most common form of physical activity reported is walking. Nearly all of the participants have reported that their weight loss has led to significant improvements in energy levels, physical mobility, general mood, self-confidence, and physical health (Klem et al. 1997). Participants (~42%) state that keeping the weight off has not been as difficult as losing it initially (Klem et al. 1997). This is especially true in individuals who have kept the weight off for more than two years (Klem et al. 2000).
Strategies for weight maintenance. Since the initiation of the NWCR, investigators have been analyzing the data to determine successful weight maintenance strategies (Gorin et al. 2004; Hill and Wing 2003; Klem et al. 1997; McGuire et al. 1998; Phelan et al. 2007; Raynor et al. 2006; Shick et al. 1998; Wyatt et al. 2002). In general, most participants report continuing to maintain a low-calorie, low-fat diet and doing high levels of physical activity. The following are some of the specific and most frequently mentioned strategies used by participants who have been successful at maintaining weight loss:
- Eating breakfast. Nearly 80% of participants report eating breakfast every day, with only 4% reporting never eating breakfast. How might eating breakfast contribute to successful weight maintenance? Although there were no differences in total energy intake between frequent breakfast eaters and less frequent breakfast eaters (three times a week or less), breakfast eaters reported being more physically active (Wyatt et al. 2002).
- Monitoring energy and fat intake. A common characteristic of registry participants is that they continue to monitor their energy and fat intake even after the weight loss period is over. On average, participants consume diets with ~24% of energy from fat and have energy intakes lower than average (Shick et al. 1998). As a group, 80% consume diets with <30% of energy from fat, while 35% consume diets with less than 20% of energy from fat. The strategies employed to control food intake include limiting intake of certain high-fat foods, eating less food per meal, counting grams of fat or calories, eating regular meals, and adhering to the same diet regimen throughout the week (Klem et al. 1997; Gorin et al. 2004). Diet consistency across the week appears to help people prevent weight gain (Gorin et al. 2004).
- Exercising daily. Being physical active is an important characteristic of registry participants, with 90% reporting that they exercise, on average, about 1 h or more per day. Weekly energy expenditures from physical activity average ~2800 kcal: ~2500 kcal/week for women and 3300 kcal/week for men (Hill and Wing 2003; Klem et al. 1997). The most common forms of physical activity reported are cycling, aerobics, walking, and running (Klem et al. 1997). Comparison of the levels of physical activity between successful weight loss maintainers and people who had always maintained a normal weight showed that the weight loss maintainers spent significantly more time in high-intensity forms of physical activity and spent more minutes per week doing physical activity (Phelan et al. 2007).
- Engaging in less sedentary activity. It has long been recognized that sedentary behaviors, especially TV viewing, may contribute to weight gain. Raynor and colleagues (2006) examined the TV viewing of registry participants and found that 62% watched <10 h of TV per week, with 36% reporting that they watched <5 h/week. This level of TV viewing is much lower than the national average of 28 h/week.
- Monitoring weight. Nearly 75% of the registry participants weigh themselves at least once a week (Klem et al. 1997). Thus, regularly monitoring weight appears to be a behavior that is important for ensuring that weight regain does not occur.
What we have learned from the participants in the NWCR is that good nutrition, physical activity, and self-monitoring are important for keeping the weight off once it has been lost. Individuals who are successful at weight loss and the maintenance of weight loss appear to employ similar strategies. They eat breakfast, exercise regularly, monitor their diet for both energy and fat intake, participate in less TV watching, and weigh themselves regularly.
Choosing quality ergogenic substances
Because of the many potential risks associated with supplements, it is important to critically evaluate ergogenic substances prior to using or recommending them.
Because of the many potential risks associated with supplements, it is important to critically evaluate ergogenic substances prior to using or recommending them. However, evaluating the marketing, research, and safety of products can be a daunting task in the current regulatory environment. How do you decide what is safe and effective?
Third-Party Evaluations
Several organizations now offer third-party evaluations of dietary supplements. Independent testing of individual products is conducted (usually for a fee) to evaluate such quality control issues as labeling accuracy, purity, strength, and ability to dissolve. For companies that use these services, you will find certifications or seals of approval on their products. A recent certification useful for athletes is the Certified in Sport by NSF International. This program also tests for banned substances. Keep in mind that third-party testing is expensive; the fact that a product is not on the list of certified products does not mean it is unsafe. However, if it is on the list, it meets the criteria set forth by the evaluator.
Australian Institute of Sport (AIS) Sports Supplement Program
In recent years, the Australian Institute of Sport has implemented a sport supplement program to ensure that athletes are using sport foods and supplements safely. A panel of experts evaluates current research on various supplements and categorizes them based on how safe and effective they are.
- Group A supplements: Sport foods and supplements that provide a useful and timely source of energy and nutrients or for which there is scientific evidence supporting improved performance
- Group B supplements: Newer supplements on which not enough scientific studies have been conducted, but that may provide a performance benefit as suggested by preliminary evidence
- Group C supplements: Supplements that have not been shown to improve sport performance or that may impair sport performance-most ergogenic substances fall under this category
- Group D supplements: Supplements that are banned or are at high risk of being contaminated with substances (e.g., steroids) that could cause a positive drug test
Evaluating popular diets
Learn how to recognize a potential fad diet or nutrition program.
Popular or Fad Diets
Fad diets are those that enjoy short-lived success and popularity and are based on a marketing gimmick. Athletes can be particularly vulnerable to fad dieting because of their intense desire to optimize body composition and performance. Celebrities and other well-known persons endorse these diets in an attempt to give them credibility. Justification for these diets is typically based on a scientific or biochemical claim that may be speculative and unproven. Consumers must remember that if the claims associated with the diets were true, there would be no need for people to continue dieting and no need for the next fad diet! For example, if the Dr. Atkins diet, popular in the 1970s, had worked, there would be no need for the "new and improved" Dr. Atkins' New Diet Revolution in the 1990s and 2000s. As mentioned earlier, more modified versions of the Dr. Atkins diet are here to stay but are characterized by less carbohydrate restriction. Because LCDs bring about quick weight loss, they may be used to help people begin or "jump-start" a weight loss regimen.
There will always be a new fad diet in the marketplace, so it is important to understand how to evaluate each new diet and give good dietary advice to your clients. The criteria listed next will help you recognize a potential fad diet or nutrition program. If the diet either you or your clients are considering is associated with one of the following, it is probably just another fad diet:
- The claim that the diet is new, modern, improved, or recently discovered, with no scientific data available to back up the claim
- The claim that weight or fat loss will be rapid, usually more than 2 lb (0.9 kg) per week
- The claim of successful weight loss with no or little physical exercise
- Inclusion of special foods that are expensive and difficult to find; suggestion that foods should be consumed in a particular order or "combination"; suggestion that consumption of certain "bad" foods should be avoided; or inclusion of "magic" or "miracle" foods that will burn fat
- Inclusion of a rigid menu that must be followed daily; restriction to a limited list of foods (these diets frequently require adherents to eat the same foods day after day)
- Inclusion of supplemental meals, foods, or nutrient supplements with the claim that they will cure disease or a variety of ailments
Until we figure out how to solve the obesity problem, the consumer will be bombarded with new weight loss products and programs promising fast weight loss. It is important for nutrition and fitness professionals to educate consumers about the limitations of these products and programs. While some may be physically harmless (albeit expensive), others can cause illness or even death. It is always important to consider the safety and efficacy of any fad diet, including the associated supplements, before recommending it to a client.
Evolution of Dietary Guidelines for Americans
See how dietary guidelines have developed to help promote health, decrease the risk of chronic disease, meet nutrient requirements, and support active lives.
This is an excerpt from Sport Nutrition for Health and Performance, Second Edition.
Learning from the National Weight Control Registry
A look at the weight loss and maintenance strategies of successful individuals.
The National Weight Control Registry
In 1994, Drs. Rena Wing, PhD, of Brown Medical School and James Hill, PhD, of the University of Colorado Health Sciences Center founded the National Weight Control Registry (NWCR) (www.nwcr.ws). To date, this project is the largest prospective investigation of long-term successful weight loss maintenance. The goal of the project was to find individuals who had been successful at weight loss and describe the strategies that they used to achieve and maintain weight loss long-term. Currently, the NWCR is tracking over 5000 individuals who have lost significant amounts of weight and kept it off for long periods of time. In order to be part of the registry, people need to be 18 years or older, who have lost at least 30 lb (6.6 kg), and to have maintained this weight loss for at least one year. Once enrolled in the program, individuals are periodically asked to fill out detailed questionnaires about their successful weight loss, current weight maintenance strategies, and other health-related behaviors for the purpose of determining the behavioral and psychological characteristics of weight maintainers, as well as the strategies they use to maintain weight loss. Participants also fill out annual follow-up surveys so that their weight maintenance can be continually tracked. Thus the NWCR is not a randomized controlled study, but rather looks at who has been successful at weight loss and at weight loss maintenance. On average, 80% of the participants are women and 20% are men who have lost 66 lb (30 kg) and kept the weight off for 5.5 years. The average woman is 45 years of age and weighs 145 lb (66 kg), and the average man is 49 years of age and weighs 190 lb (86 kg). Of course, these averages hide the huge diversity of the individuals involved in the study, as well as facts such as the following:
- Weight loss has ranged from 30 to 300 lb (13.6-136 kg).
- Duration of successful weight loss has ranged from 1 to 66 years.
- Some participants have lost the weight rapidly, while others have lost it very slowly-over as many as 14 years.
The following are strategies used by these individuals to lose weight and keep it off. Some of the information has been adapted from a review of the NWCR by Manore (2004).
Methods of weight loss. Almost everyone in the registry has used a combination of diet and exercise to lose the weight, with 45% reporting that they lost the weight on their own and 55% reporting using some type of program. Nearly all of the participants (98%) reported that they modified their food intake in some way to lose weight, while 94% said that they increased their physical activity. The most common form of physical activity reported is walking. Nearly all of the participants have reported that their weight loss has led to significant improvements in energy levels, physical mobility, general mood, self-confidence, and physical health (Klem et al. 1997). Participants (~42%) state that keeping the weight off has not been as difficult as losing it initially (Klem et al. 1997). This is especially true in individuals who have kept the weight off for more than two years (Klem et al. 2000).
Strategies for weight maintenance. Since the initiation of the NWCR, investigators have been analyzing the data to determine successful weight maintenance strategies (Gorin et al. 2004; Hill and Wing 2003; Klem et al. 1997; McGuire et al. 1998; Phelan et al. 2007; Raynor et al. 2006; Shick et al. 1998; Wyatt et al. 2002). In general, most participants report continuing to maintain a low-calorie, low-fat diet and doing high levels of physical activity. The following are some of the specific and most frequently mentioned strategies used by participants who have been successful at maintaining weight loss:
- Eating breakfast. Nearly 80% of participants report eating breakfast every day, with only 4% reporting never eating breakfast. How might eating breakfast contribute to successful weight maintenance? Although there were no differences in total energy intake between frequent breakfast eaters and less frequent breakfast eaters (three times a week or less), breakfast eaters reported being more physically active (Wyatt et al. 2002).
- Monitoring energy and fat intake. A common characteristic of registry participants is that they continue to monitor their energy and fat intake even after the weight loss period is over. On average, participants consume diets with ~24% of energy from fat and have energy intakes lower than average (Shick et al. 1998). As a group, 80% consume diets with <30% of energy from fat, while 35% consume diets with less than 20% of energy from fat. The strategies employed to control food intake include limiting intake of certain high-fat foods, eating less food per meal, counting grams of fat or calories, eating regular meals, and adhering to the same diet regimen throughout the week (Klem et al. 1997; Gorin et al. 2004). Diet consistency across the week appears to help people prevent weight gain (Gorin et al. 2004).
- Exercising daily. Being physical active is an important characteristic of registry participants, with 90% reporting that they exercise, on average, about 1 h or more per day. Weekly energy expenditures from physical activity average ~2800 kcal: ~2500 kcal/week for women and 3300 kcal/week for men (Hill and Wing 2003; Klem et al. 1997). The most common forms of physical activity reported are cycling, aerobics, walking, and running (Klem et al. 1997). Comparison of the levels of physical activity between successful weight loss maintainers and people who had always maintained a normal weight showed that the weight loss maintainers spent significantly more time in high-intensity forms of physical activity and spent more minutes per week doing physical activity (Phelan et al. 2007).
- Engaging in less sedentary activity. It has long been recognized that sedentary behaviors, especially TV viewing, may contribute to weight gain. Raynor and colleagues (2006) examined the TV viewing of registry participants and found that 62% watched <10 h of TV per week, with 36% reporting that they watched <5 h/week. This level of TV viewing is much lower than the national average of 28 h/week.
- Monitoring weight. Nearly 75% of the registry participants weigh themselves at least once a week (Klem et al. 1997). Thus, regularly monitoring weight appears to be a behavior that is important for ensuring that weight regain does not occur.
What we have learned from the participants in the NWCR is that good nutrition, physical activity, and self-monitoring are important for keeping the weight off once it has been lost. Individuals who are successful at weight loss and the maintenance of weight loss appear to employ similar strategies. They eat breakfast, exercise regularly, monitor their diet for both energy and fat intake, participate in less TV watching, and weigh themselves regularly.
Choosing quality ergogenic substances
Because of the many potential risks associated with supplements, it is important to critically evaluate ergogenic substances prior to using or recommending them.
Because of the many potential risks associated with supplements, it is important to critically evaluate ergogenic substances prior to using or recommending them. However, evaluating the marketing, research, and safety of products can be a daunting task in the current regulatory environment. How do you decide what is safe and effective?
Third-Party Evaluations
Several organizations now offer third-party evaluations of dietary supplements. Independent testing of individual products is conducted (usually for a fee) to evaluate such quality control issues as labeling accuracy, purity, strength, and ability to dissolve. For companies that use these services, you will find certifications or seals of approval on their products. A recent certification useful for athletes is the Certified in Sport by NSF International. This program also tests for banned substances. Keep in mind that third-party testing is expensive; the fact that a product is not on the list of certified products does not mean it is unsafe. However, if it is on the list, it meets the criteria set forth by the evaluator.
Australian Institute of Sport (AIS) Sports Supplement Program
In recent years, the Australian Institute of Sport has implemented a sport supplement program to ensure that athletes are using sport foods and supplements safely. A panel of experts evaluates current research on various supplements and categorizes them based on how safe and effective they are.
- Group A supplements: Sport foods and supplements that provide a useful and timely source of energy and nutrients or for which there is scientific evidence supporting improved performance
- Group B supplements: Newer supplements on which not enough scientific studies have been conducted, but that may provide a performance benefit as suggested by preliminary evidence
- Group C supplements: Supplements that have not been shown to improve sport performance or that may impair sport performance-most ergogenic substances fall under this category
- Group D supplements: Supplements that are banned or are at high risk of being contaminated with substances (e.g., steroids) that could cause a positive drug test
Evaluating popular diets
Learn how to recognize a potential fad diet or nutrition program.
Popular or Fad Diets
Fad diets are those that enjoy short-lived success and popularity and are based on a marketing gimmick. Athletes can be particularly vulnerable to fad dieting because of their intense desire to optimize body composition and performance. Celebrities and other well-known persons endorse these diets in an attempt to give them credibility. Justification for these diets is typically based on a scientific or biochemical claim that may be speculative and unproven. Consumers must remember that if the claims associated with the diets were true, there would be no need for people to continue dieting and no need for the next fad diet! For example, if the Dr. Atkins diet, popular in the 1970s, had worked, there would be no need for the "new and improved" Dr. Atkins' New Diet Revolution in the 1990s and 2000s. As mentioned earlier, more modified versions of the Dr. Atkins diet are here to stay but are characterized by less carbohydrate restriction. Because LCDs bring about quick weight loss, they may be used to help people begin or "jump-start" a weight loss regimen.
There will always be a new fad diet in the marketplace, so it is important to understand how to evaluate each new diet and give good dietary advice to your clients. The criteria listed next will help you recognize a potential fad diet or nutrition program. If the diet either you or your clients are considering is associated with one of the following, it is probably just another fad diet:
- The claim that the diet is new, modern, improved, or recently discovered, with no scientific data available to back up the claim
- The claim that weight or fat loss will be rapid, usually more than 2 lb (0.9 kg) per week
- The claim of successful weight loss with no or little physical exercise
- Inclusion of special foods that are expensive and difficult to find; suggestion that foods should be consumed in a particular order or "combination"; suggestion that consumption of certain "bad" foods should be avoided; or inclusion of "magic" or "miracle" foods that will burn fat
- Inclusion of a rigid menu that must be followed daily; restriction to a limited list of foods (these diets frequently require adherents to eat the same foods day after day)
- Inclusion of supplemental meals, foods, or nutrient supplements with the claim that they will cure disease or a variety of ailments
Until we figure out how to solve the obesity problem, the consumer will be bombarded with new weight loss products and programs promising fast weight loss. It is important for nutrition and fitness professionals to educate consumers about the limitations of these products and programs. While some may be physically harmless (albeit expensive), others can cause illness or even death. It is always important to consider the safety and efficacy of any fad diet, including the associated supplements, before recommending it to a client.
Evolution of Dietary Guidelines for Americans
See how dietary guidelines have developed to help promote health, decrease the risk of chronic disease, meet nutrient requirements, and support active lives.
This is an excerpt from Sport Nutrition for Health and Performance, Second Edition.
Learning from the National Weight Control Registry
A look at the weight loss and maintenance strategies of successful individuals.
The National Weight Control Registry
In 1994, Drs. Rena Wing, PhD, of Brown Medical School and James Hill, PhD, of the University of Colorado Health Sciences Center founded the National Weight Control Registry (NWCR) (www.nwcr.ws). To date, this project is the largest prospective investigation of long-term successful weight loss maintenance. The goal of the project was to find individuals who had been successful at weight loss and describe the strategies that they used to achieve and maintain weight loss long-term. Currently, the NWCR is tracking over 5000 individuals who have lost significant amounts of weight and kept it off for long periods of time. In order to be part of the registry, people need to be 18 years or older, who have lost at least 30 lb (6.6 kg), and to have maintained this weight loss for at least one year. Once enrolled in the program, individuals are periodically asked to fill out detailed questionnaires about their successful weight loss, current weight maintenance strategies, and other health-related behaviors for the purpose of determining the behavioral and psychological characteristics of weight maintainers, as well as the strategies they use to maintain weight loss. Participants also fill out annual follow-up surveys so that their weight maintenance can be continually tracked. Thus the NWCR is not a randomized controlled study, but rather looks at who has been successful at weight loss and at weight loss maintenance. On average, 80% of the participants are women and 20% are men who have lost 66 lb (30 kg) and kept the weight off for 5.5 years. The average woman is 45 years of age and weighs 145 lb (66 kg), and the average man is 49 years of age and weighs 190 lb (86 kg). Of course, these averages hide the huge diversity of the individuals involved in the study, as well as facts such as the following:
- Weight loss has ranged from 30 to 300 lb (13.6-136 kg).
- Duration of successful weight loss has ranged from 1 to 66 years.
- Some participants have lost the weight rapidly, while others have lost it very slowly-over as many as 14 years.
The following are strategies used by these individuals to lose weight and keep it off. Some of the information has been adapted from a review of the NWCR by Manore (2004).
Methods of weight loss. Almost everyone in the registry has used a combination of diet and exercise to lose the weight, with 45% reporting that they lost the weight on their own and 55% reporting using some type of program. Nearly all of the participants (98%) reported that they modified their food intake in some way to lose weight, while 94% said that they increased their physical activity. The most common form of physical activity reported is walking. Nearly all of the participants have reported that their weight loss has led to significant improvements in energy levels, physical mobility, general mood, self-confidence, and physical health (Klem et al. 1997). Participants (~42%) state that keeping the weight off has not been as difficult as losing it initially (Klem et al. 1997). This is especially true in individuals who have kept the weight off for more than two years (Klem et al. 2000).
Strategies for weight maintenance. Since the initiation of the NWCR, investigators have been analyzing the data to determine successful weight maintenance strategies (Gorin et al. 2004; Hill and Wing 2003; Klem et al. 1997; McGuire et al. 1998; Phelan et al. 2007; Raynor et al. 2006; Shick et al. 1998; Wyatt et al. 2002). In general, most participants report continuing to maintain a low-calorie, low-fat diet and doing high levels of physical activity. The following are some of the specific and most frequently mentioned strategies used by participants who have been successful at maintaining weight loss:
- Eating breakfast. Nearly 80% of participants report eating breakfast every day, with only 4% reporting never eating breakfast. How might eating breakfast contribute to successful weight maintenance? Although there were no differences in total energy intake between frequent breakfast eaters and less frequent breakfast eaters (three times a week or less), breakfast eaters reported being more physically active (Wyatt et al. 2002).
- Monitoring energy and fat intake. A common characteristic of registry participants is that they continue to monitor their energy and fat intake even after the weight loss period is over. On average, participants consume diets with ~24% of energy from fat and have energy intakes lower than average (Shick et al. 1998). As a group, 80% consume diets with <30% of energy from fat, while 35% consume diets with less than 20% of energy from fat. The strategies employed to control food intake include limiting intake of certain high-fat foods, eating less food per meal, counting grams of fat or calories, eating regular meals, and adhering to the same diet regimen throughout the week (Klem et al. 1997; Gorin et al. 2004). Diet consistency across the week appears to help people prevent weight gain (Gorin et al. 2004).
- Exercising daily. Being physical active is an important characteristic of registry participants, with 90% reporting that they exercise, on average, about 1 h or more per day. Weekly energy expenditures from physical activity average ~2800 kcal: ~2500 kcal/week for women and 3300 kcal/week for men (Hill and Wing 2003; Klem et al. 1997). The most common forms of physical activity reported are cycling, aerobics, walking, and running (Klem et al. 1997). Comparison of the levels of physical activity between successful weight loss maintainers and people who had always maintained a normal weight showed that the weight loss maintainers spent significantly more time in high-intensity forms of physical activity and spent more minutes per week doing physical activity (Phelan et al. 2007).
- Engaging in less sedentary activity. It has long been recognized that sedentary behaviors, especially TV viewing, may contribute to weight gain. Raynor and colleagues (2006) examined the TV viewing of registry participants and found that 62% watched <10 h of TV per week, with 36% reporting that they watched <5 h/week. This level of TV viewing is much lower than the national average of 28 h/week.
- Monitoring weight. Nearly 75% of the registry participants weigh themselves at least once a week (Klem et al. 1997). Thus, regularly monitoring weight appears to be a behavior that is important for ensuring that weight regain does not occur.
What we have learned from the participants in the NWCR is that good nutrition, physical activity, and self-monitoring are important for keeping the weight off once it has been lost. Individuals who are successful at weight loss and the maintenance of weight loss appear to employ similar strategies. They eat breakfast, exercise regularly, monitor their diet for both energy and fat intake, participate in less TV watching, and weigh themselves regularly.
Choosing quality ergogenic substances
Because of the many potential risks associated with supplements, it is important to critically evaluate ergogenic substances prior to using or recommending them.
Because of the many potential risks associated with supplements, it is important to critically evaluate ergogenic substances prior to using or recommending them. However, evaluating the marketing, research, and safety of products can be a daunting task in the current regulatory environment. How do you decide what is safe and effective?
Third-Party Evaluations
Several organizations now offer third-party evaluations of dietary supplements. Independent testing of individual products is conducted (usually for a fee) to evaluate such quality control issues as labeling accuracy, purity, strength, and ability to dissolve. For companies that use these services, you will find certifications or seals of approval on their products. A recent certification useful for athletes is the Certified in Sport by NSF International. This program also tests for banned substances. Keep in mind that third-party testing is expensive; the fact that a product is not on the list of certified products does not mean it is unsafe. However, if it is on the list, it meets the criteria set forth by the evaluator.
Australian Institute of Sport (AIS) Sports Supplement Program
In recent years, the Australian Institute of Sport has implemented a sport supplement program to ensure that athletes are using sport foods and supplements safely. A panel of experts evaluates current research on various supplements and categorizes them based on how safe and effective they are.
- Group A supplements: Sport foods and supplements that provide a useful and timely source of energy and nutrients or for which there is scientific evidence supporting improved performance
- Group B supplements: Newer supplements on which not enough scientific studies have been conducted, but that may provide a performance benefit as suggested by preliminary evidence
- Group C supplements: Supplements that have not been shown to improve sport performance or that may impair sport performance-most ergogenic substances fall under this category
- Group D supplements: Supplements that are banned or are at high risk of being contaminated with substances (e.g., steroids) that could cause a positive drug test
Evaluating popular diets
Learn how to recognize a potential fad diet or nutrition program.
Popular or Fad Diets
Fad diets are those that enjoy short-lived success and popularity and are based on a marketing gimmick. Athletes can be particularly vulnerable to fad dieting because of their intense desire to optimize body composition and performance. Celebrities and other well-known persons endorse these diets in an attempt to give them credibility. Justification for these diets is typically based on a scientific or biochemical claim that may be speculative and unproven. Consumers must remember that if the claims associated with the diets were true, there would be no need for people to continue dieting and no need for the next fad diet! For example, if the Dr. Atkins diet, popular in the 1970s, had worked, there would be no need for the "new and improved" Dr. Atkins' New Diet Revolution in the 1990s and 2000s. As mentioned earlier, more modified versions of the Dr. Atkins diet are here to stay but are characterized by less carbohydrate restriction. Because LCDs bring about quick weight loss, they may be used to help people begin or "jump-start" a weight loss regimen.
There will always be a new fad diet in the marketplace, so it is important to understand how to evaluate each new diet and give good dietary advice to your clients. The criteria listed next will help you recognize a potential fad diet or nutrition program. If the diet either you or your clients are considering is associated with one of the following, it is probably just another fad diet:
- The claim that the diet is new, modern, improved, or recently discovered, with no scientific data available to back up the claim
- The claim that weight or fat loss will be rapid, usually more than 2 lb (0.9 kg) per week
- The claim of successful weight loss with no or little physical exercise
- Inclusion of special foods that are expensive and difficult to find; suggestion that foods should be consumed in a particular order or "combination"; suggestion that consumption of certain "bad" foods should be avoided; or inclusion of "magic" or "miracle" foods that will burn fat
- Inclusion of a rigid menu that must be followed daily; restriction to a limited list of foods (these diets frequently require adherents to eat the same foods day after day)
- Inclusion of supplemental meals, foods, or nutrient supplements with the claim that they will cure disease or a variety of ailments
Until we figure out how to solve the obesity problem, the consumer will be bombarded with new weight loss products and programs promising fast weight loss. It is important for nutrition and fitness professionals to educate consumers about the limitations of these products and programs. While some may be physically harmless (albeit expensive), others can cause illness or even death. It is always important to consider the safety and efficacy of any fad diet, including the associated supplements, before recommending it to a client.
Evolution of Dietary Guidelines for Americans
See how dietary guidelines have developed to help promote health, decrease the risk of chronic disease, meet nutrient requirements, and support active lives.
This is an excerpt from Sport Nutrition for Health and Performance, Second Edition.
Learning from the National Weight Control Registry
A look at the weight loss and maintenance strategies of successful individuals.
The National Weight Control Registry
In 1994, Drs. Rena Wing, PhD, of Brown Medical School and James Hill, PhD, of the University of Colorado Health Sciences Center founded the National Weight Control Registry (NWCR) (www.nwcr.ws). To date, this project is the largest prospective investigation of long-term successful weight loss maintenance. The goal of the project was to find individuals who had been successful at weight loss and describe the strategies that they used to achieve and maintain weight loss long-term. Currently, the NWCR is tracking over 5000 individuals who have lost significant amounts of weight and kept it off for long periods of time. In order to be part of the registry, people need to be 18 years or older, who have lost at least 30 lb (6.6 kg), and to have maintained this weight loss for at least one year. Once enrolled in the program, individuals are periodically asked to fill out detailed questionnaires about their successful weight loss, current weight maintenance strategies, and other health-related behaviors for the purpose of determining the behavioral and psychological characteristics of weight maintainers, as well as the strategies they use to maintain weight loss. Participants also fill out annual follow-up surveys so that their weight maintenance can be continually tracked. Thus the NWCR is not a randomized controlled study, but rather looks at who has been successful at weight loss and at weight loss maintenance. On average, 80% of the participants are women and 20% are men who have lost 66 lb (30 kg) and kept the weight off for 5.5 years. The average woman is 45 years of age and weighs 145 lb (66 kg), and the average man is 49 years of age and weighs 190 lb (86 kg). Of course, these averages hide the huge diversity of the individuals involved in the study, as well as facts such as the following:
- Weight loss has ranged from 30 to 300 lb (13.6-136 kg).
- Duration of successful weight loss has ranged from 1 to 66 years.
- Some participants have lost the weight rapidly, while others have lost it very slowly-over as many as 14 years.
The following are strategies used by these individuals to lose weight and keep it off. Some of the information has been adapted from a review of the NWCR by Manore (2004).
Methods of weight loss. Almost everyone in the registry has used a combination of diet and exercise to lose the weight, with 45% reporting that they lost the weight on their own and 55% reporting using some type of program. Nearly all of the participants (98%) reported that they modified their food intake in some way to lose weight, while 94% said that they increased their physical activity. The most common form of physical activity reported is walking. Nearly all of the participants have reported that their weight loss has led to significant improvements in energy levels, physical mobility, general mood, self-confidence, and physical health (Klem et al. 1997). Participants (~42%) state that keeping the weight off has not been as difficult as losing it initially (Klem et al. 1997). This is especially true in individuals who have kept the weight off for more than two years (Klem et al. 2000).
Strategies for weight maintenance. Since the initiation of the NWCR, investigators have been analyzing the data to determine successful weight maintenance strategies (Gorin et al. 2004; Hill and Wing 2003; Klem et al. 1997; McGuire et al. 1998; Phelan et al. 2007; Raynor et al. 2006; Shick et al. 1998; Wyatt et al. 2002). In general, most participants report continuing to maintain a low-calorie, low-fat diet and doing high levels of physical activity. The following are some of the specific and most frequently mentioned strategies used by participants who have been successful at maintaining weight loss:
- Eating breakfast. Nearly 80% of participants report eating breakfast every day, with only 4% reporting never eating breakfast. How might eating breakfast contribute to successful weight maintenance? Although there were no differences in total energy intake between frequent breakfast eaters and less frequent breakfast eaters (three times a week or less), breakfast eaters reported being more physically active (Wyatt et al. 2002).
- Monitoring energy and fat intake. A common characteristic of registry participants is that they continue to monitor their energy and fat intake even after the weight loss period is over. On average, participants consume diets with ~24% of energy from fat and have energy intakes lower than average (Shick et al. 1998). As a group, 80% consume diets with <30% of energy from fat, while 35% consume diets with less than 20% of energy from fat. The strategies employed to control food intake include limiting intake of certain high-fat foods, eating less food per meal, counting grams of fat or calories, eating regular meals, and adhering to the same diet regimen throughout the week (Klem et al. 1997; Gorin et al. 2004). Diet consistency across the week appears to help people prevent weight gain (Gorin et al. 2004).
- Exercising daily. Being physical active is an important characteristic of registry participants, with 90% reporting that they exercise, on average, about 1 h or more per day. Weekly energy expenditures from physical activity average ~2800 kcal: ~2500 kcal/week for women and 3300 kcal/week for men (Hill and Wing 2003; Klem et al. 1997). The most common forms of physical activity reported are cycling, aerobics, walking, and running (Klem et al. 1997). Comparison of the levels of physical activity between successful weight loss maintainers and people who had always maintained a normal weight showed that the weight loss maintainers spent significantly more time in high-intensity forms of physical activity and spent more minutes per week doing physical activity (Phelan et al. 2007).
- Engaging in less sedentary activity. It has long been recognized that sedentary behaviors, especially TV viewing, may contribute to weight gain. Raynor and colleagues (2006) examined the TV viewing of registry participants and found that 62% watched <10 h of TV per week, with 36% reporting that they watched <5 h/week. This level of TV viewing is much lower than the national average of 28 h/week.
- Monitoring weight. Nearly 75% of the registry participants weigh themselves at least once a week (Klem et al. 1997). Thus, regularly monitoring weight appears to be a behavior that is important for ensuring that weight regain does not occur.
What we have learned from the participants in the NWCR is that good nutrition, physical activity, and self-monitoring are important for keeping the weight off once it has been lost. Individuals who are successful at weight loss and the maintenance of weight loss appear to employ similar strategies. They eat breakfast, exercise regularly, monitor their diet for both energy and fat intake, participate in less TV watching, and weigh themselves regularly.
Choosing quality ergogenic substances
Because of the many potential risks associated with supplements, it is important to critically evaluate ergogenic substances prior to using or recommending them.
Because of the many potential risks associated with supplements, it is important to critically evaluate ergogenic substances prior to using or recommending them. However, evaluating the marketing, research, and safety of products can be a daunting task in the current regulatory environment. How do you decide what is safe and effective?
Third-Party Evaluations
Several organizations now offer third-party evaluations of dietary supplements. Independent testing of individual products is conducted (usually for a fee) to evaluate such quality control issues as labeling accuracy, purity, strength, and ability to dissolve. For companies that use these services, you will find certifications or seals of approval on their products. A recent certification useful for athletes is the Certified in Sport by NSF International. This program also tests for banned substances. Keep in mind that third-party testing is expensive; the fact that a product is not on the list of certified products does not mean it is unsafe. However, if it is on the list, it meets the criteria set forth by the evaluator.
Australian Institute of Sport (AIS) Sports Supplement Program
In recent years, the Australian Institute of Sport has implemented a sport supplement program to ensure that athletes are using sport foods and supplements safely. A panel of experts evaluates current research on various supplements and categorizes them based on how safe and effective they are.
- Group A supplements: Sport foods and supplements that provide a useful and timely source of energy and nutrients or for which there is scientific evidence supporting improved performance
- Group B supplements: Newer supplements on which not enough scientific studies have been conducted, but that may provide a performance benefit as suggested by preliminary evidence
- Group C supplements: Supplements that have not been shown to improve sport performance or that may impair sport performance-most ergogenic substances fall under this category
- Group D supplements: Supplements that are banned or are at high risk of being contaminated with substances (e.g., steroids) that could cause a positive drug test
Evaluating popular diets
Learn how to recognize a potential fad diet or nutrition program.
Popular or Fad Diets
Fad diets are those that enjoy short-lived success and popularity and are based on a marketing gimmick. Athletes can be particularly vulnerable to fad dieting because of their intense desire to optimize body composition and performance. Celebrities and other well-known persons endorse these diets in an attempt to give them credibility. Justification for these diets is typically based on a scientific or biochemical claim that may be speculative and unproven. Consumers must remember that if the claims associated with the diets were true, there would be no need for people to continue dieting and no need for the next fad diet! For example, if the Dr. Atkins diet, popular in the 1970s, had worked, there would be no need for the "new and improved" Dr. Atkins' New Diet Revolution in the 1990s and 2000s. As mentioned earlier, more modified versions of the Dr. Atkins diet are here to stay but are characterized by less carbohydrate restriction. Because LCDs bring about quick weight loss, they may be used to help people begin or "jump-start" a weight loss regimen.
There will always be a new fad diet in the marketplace, so it is important to understand how to evaluate each new diet and give good dietary advice to your clients. The criteria listed next will help you recognize a potential fad diet or nutrition program. If the diet either you or your clients are considering is associated with one of the following, it is probably just another fad diet:
- The claim that the diet is new, modern, improved, or recently discovered, with no scientific data available to back up the claim
- The claim that weight or fat loss will be rapid, usually more than 2 lb (0.9 kg) per week
- The claim of successful weight loss with no or little physical exercise
- Inclusion of special foods that are expensive and difficult to find; suggestion that foods should be consumed in a particular order or "combination"; suggestion that consumption of certain "bad" foods should be avoided; or inclusion of "magic" or "miracle" foods that will burn fat
- Inclusion of a rigid menu that must be followed daily; restriction to a limited list of foods (these diets frequently require adherents to eat the same foods day after day)
- Inclusion of supplemental meals, foods, or nutrient supplements with the claim that they will cure disease or a variety of ailments
Until we figure out how to solve the obesity problem, the consumer will be bombarded with new weight loss products and programs promising fast weight loss. It is important for nutrition and fitness professionals to educate consumers about the limitations of these products and programs. While some may be physically harmless (albeit expensive), others can cause illness or even death. It is always important to consider the safety and efficacy of any fad diet, including the associated supplements, before recommending it to a client.
Evolution of Dietary Guidelines for Americans
See how dietary guidelines have developed to help promote health, decrease the risk of chronic disease, meet nutrient requirements, and support active lives.
This is an excerpt from Sport Nutrition for Health and Performance, Second Edition.
Learning from the National Weight Control Registry
A look at the weight loss and maintenance strategies of successful individuals.
The National Weight Control Registry
In 1994, Drs. Rena Wing, PhD, of Brown Medical School and James Hill, PhD, of the University of Colorado Health Sciences Center founded the National Weight Control Registry (NWCR) (www.nwcr.ws). To date, this project is the largest prospective investigation of long-term successful weight loss maintenance. The goal of the project was to find individuals who had been successful at weight loss and describe the strategies that they used to achieve and maintain weight loss long-term. Currently, the NWCR is tracking over 5000 individuals who have lost significant amounts of weight and kept it off for long periods of time. In order to be part of the registry, people need to be 18 years or older, who have lost at least 30 lb (6.6 kg), and to have maintained this weight loss for at least one year. Once enrolled in the program, individuals are periodically asked to fill out detailed questionnaires about their successful weight loss, current weight maintenance strategies, and other health-related behaviors for the purpose of determining the behavioral and psychological characteristics of weight maintainers, as well as the strategies they use to maintain weight loss. Participants also fill out annual follow-up surveys so that their weight maintenance can be continually tracked. Thus the NWCR is not a randomized controlled study, but rather looks at who has been successful at weight loss and at weight loss maintenance. On average, 80% of the participants are women and 20% are men who have lost 66 lb (30 kg) and kept the weight off for 5.5 years. The average woman is 45 years of age and weighs 145 lb (66 kg), and the average man is 49 years of age and weighs 190 lb (86 kg). Of course, these averages hide the huge diversity of the individuals involved in the study, as well as facts such as the following:
- Weight loss has ranged from 30 to 300 lb (13.6-136 kg).
- Duration of successful weight loss has ranged from 1 to 66 years.
- Some participants have lost the weight rapidly, while others have lost it very slowly-over as many as 14 years.
The following are strategies used by these individuals to lose weight and keep it off. Some of the information has been adapted from a review of the NWCR by Manore (2004).
Methods of weight loss. Almost everyone in the registry has used a combination of diet and exercise to lose the weight, with 45% reporting that they lost the weight on their own and 55% reporting using some type of program. Nearly all of the participants (98%) reported that they modified their food intake in some way to lose weight, while 94% said that they increased their physical activity. The most common form of physical activity reported is walking. Nearly all of the participants have reported that their weight loss has led to significant improvements in energy levels, physical mobility, general mood, self-confidence, and physical health (Klem et al. 1997). Participants (~42%) state that keeping the weight off has not been as difficult as losing it initially (Klem et al. 1997). This is especially true in individuals who have kept the weight off for more than two years (Klem et al. 2000).
Strategies for weight maintenance. Since the initiation of the NWCR, investigators have been analyzing the data to determine successful weight maintenance strategies (Gorin et al. 2004; Hill and Wing 2003; Klem et al. 1997; McGuire et al. 1998; Phelan et al. 2007; Raynor et al. 2006; Shick et al. 1998; Wyatt et al. 2002). In general, most participants report continuing to maintain a low-calorie, low-fat diet and doing high levels of physical activity. The following are some of the specific and most frequently mentioned strategies used by participants who have been successful at maintaining weight loss:
- Eating breakfast. Nearly 80% of participants report eating breakfast every day, with only 4% reporting never eating breakfast. How might eating breakfast contribute to successful weight maintenance? Although there were no differences in total energy intake between frequent breakfast eaters and less frequent breakfast eaters (three times a week or less), breakfast eaters reported being more physically active (Wyatt et al. 2002).
- Monitoring energy and fat intake. A common characteristic of registry participants is that they continue to monitor their energy and fat intake even after the weight loss period is over. On average, participants consume diets with ~24% of energy from fat and have energy intakes lower than average (Shick et al. 1998). As a group, 80% consume diets with <30% of energy from fat, while 35% consume diets with less than 20% of energy from fat. The strategies employed to control food intake include limiting intake of certain high-fat foods, eating less food per meal, counting grams of fat or calories, eating regular meals, and adhering to the same diet regimen throughout the week (Klem et al. 1997; Gorin et al. 2004). Diet consistency across the week appears to help people prevent weight gain (Gorin et al. 2004).
- Exercising daily. Being physical active is an important characteristic of registry participants, with 90% reporting that they exercise, on average, about 1 h or more per day. Weekly energy expenditures from physical activity average ~2800 kcal: ~2500 kcal/week for women and 3300 kcal/week for men (Hill and Wing 2003; Klem et al. 1997). The most common forms of physical activity reported are cycling, aerobics, walking, and running (Klem et al. 1997). Comparison of the levels of physical activity between successful weight loss maintainers and people who had always maintained a normal weight showed that the weight loss maintainers spent significantly more time in high-intensity forms of physical activity and spent more minutes per week doing physical activity (Phelan et al. 2007).
- Engaging in less sedentary activity. It has long been recognized that sedentary behaviors, especially TV viewing, may contribute to weight gain. Raynor and colleagues (2006) examined the TV viewing of registry participants and found that 62% watched <10 h of TV per week, with 36% reporting that they watched <5 h/week. This level of TV viewing is much lower than the national average of 28 h/week.
- Monitoring weight. Nearly 75% of the registry participants weigh themselves at least once a week (Klem et al. 1997). Thus, regularly monitoring weight appears to be a behavior that is important for ensuring that weight regain does not occur.
What we have learned from the participants in the NWCR is that good nutrition, physical activity, and self-monitoring are important for keeping the weight off once it has been lost. Individuals who are successful at weight loss and the maintenance of weight loss appear to employ similar strategies. They eat breakfast, exercise regularly, monitor their diet for both energy and fat intake, participate in less TV watching, and weigh themselves regularly.
Choosing quality ergogenic substances
Because of the many potential risks associated with supplements, it is important to critically evaluate ergogenic substances prior to using or recommending them.
Because of the many potential risks associated with supplements, it is important to critically evaluate ergogenic substances prior to using or recommending them. However, evaluating the marketing, research, and safety of products can be a daunting task in the current regulatory environment. How do you decide what is safe and effective?
Third-Party Evaluations
Several organizations now offer third-party evaluations of dietary supplements. Independent testing of individual products is conducted (usually for a fee) to evaluate such quality control issues as labeling accuracy, purity, strength, and ability to dissolve. For companies that use these services, you will find certifications or seals of approval on their products. A recent certification useful for athletes is the Certified in Sport by NSF International. This program also tests for banned substances. Keep in mind that third-party testing is expensive; the fact that a product is not on the list of certified products does not mean it is unsafe. However, if it is on the list, it meets the criteria set forth by the evaluator.
Australian Institute of Sport (AIS) Sports Supplement Program
In recent years, the Australian Institute of Sport has implemented a sport supplement program to ensure that athletes are using sport foods and supplements safely. A panel of experts evaluates current research on various supplements and categorizes them based on how safe and effective they are.
- Group A supplements: Sport foods and supplements that provide a useful and timely source of energy and nutrients or for which there is scientific evidence supporting improved performance
- Group B supplements: Newer supplements on which not enough scientific studies have been conducted, but that may provide a performance benefit as suggested by preliminary evidence
- Group C supplements: Supplements that have not been shown to improve sport performance or that may impair sport performance-most ergogenic substances fall under this category
- Group D supplements: Supplements that are banned or are at high risk of being contaminated with substances (e.g., steroids) that could cause a positive drug test
Evaluating popular diets
Learn how to recognize a potential fad diet or nutrition program.
Popular or Fad Diets
Fad diets are those that enjoy short-lived success and popularity and are based on a marketing gimmick. Athletes can be particularly vulnerable to fad dieting because of their intense desire to optimize body composition and performance. Celebrities and other well-known persons endorse these diets in an attempt to give them credibility. Justification for these diets is typically based on a scientific or biochemical claim that may be speculative and unproven. Consumers must remember that if the claims associated with the diets were true, there would be no need for people to continue dieting and no need for the next fad diet! For example, if the Dr. Atkins diet, popular in the 1970s, had worked, there would be no need for the "new and improved" Dr. Atkins' New Diet Revolution in the 1990s and 2000s. As mentioned earlier, more modified versions of the Dr. Atkins diet are here to stay but are characterized by less carbohydrate restriction. Because LCDs bring about quick weight loss, they may be used to help people begin or "jump-start" a weight loss regimen.
There will always be a new fad diet in the marketplace, so it is important to understand how to evaluate each new diet and give good dietary advice to your clients. The criteria listed next will help you recognize a potential fad diet or nutrition program. If the diet either you or your clients are considering is associated with one of the following, it is probably just another fad diet:
- The claim that the diet is new, modern, improved, or recently discovered, with no scientific data available to back up the claim
- The claim that weight or fat loss will be rapid, usually more than 2 lb (0.9 kg) per week
- The claim of successful weight loss with no or little physical exercise
- Inclusion of special foods that are expensive and difficult to find; suggestion that foods should be consumed in a particular order or "combination"; suggestion that consumption of certain "bad" foods should be avoided; or inclusion of "magic" or "miracle" foods that will burn fat
- Inclusion of a rigid menu that must be followed daily; restriction to a limited list of foods (these diets frequently require adherents to eat the same foods day after day)
- Inclusion of supplemental meals, foods, or nutrient supplements with the claim that they will cure disease or a variety of ailments
Until we figure out how to solve the obesity problem, the consumer will be bombarded with new weight loss products and programs promising fast weight loss. It is important for nutrition and fitness professionals to educate consumers about the limitations of these products and programs. While some may be physically harmless (albeit expensive), others can cause illness or even death. It is always important to consider the safety and efficacy of any fad diet, including the associated supplements, before recommending it to a client.
Evolution of Dietary Guidelines for Americans
See how dietary guidelines have developed to help promote health, decrease the risk of chronic disease, meet nutrient requirements, and support active lives.
This is an excerpt from Sport Nutrition for Health and Performance, Second Edition.
Learning from the National Weight Control Registry
A look at the weight loss and maintenance strategies of successful individuals.
The National Weight Control Registry
In 1994, Drs. Rena Wing, PhD, of Brown Medical School and James Hill, PhD, of the University of Colorado Health Sciences Center founded the National Weight Control Registry (NWCR) (www.nwcr.ws). To date, this project is the largest prospective investigation of long-term successful weight loss maintenance. The goal of the project was to find individuals who had been successful at weight loss and describe the strategies that they used to achieve and maintain weight loss long-term. Currently, the NWCR is tracking over 5000 individuals who have lost significant amounts of weight and kept it off for long periods of time. In order to be part of the registry, people need to be 18 years or older, who have lost at least 30 lb (6.6 kg), and to have maintained this weight loss for at least one year. Once enrolled in the program, individuals are periodically asked to fill out detailed questionnaires about their successful weight loss, current weight maintenance strategies, and other health-related behaviors for the purpose of determining the behavioral and psychological characteristics of weight maintainers, as well as the strategies they use to maintain weight loss. Participants also fill out annual follow-up surveys so that their weight maintenance can be continually tracked. Thus the NWCR is not a randomized controlled study, but rather looks at who has been successful at weight loss and at weight loss maintenance. On average, 80% of the participants are women and 20% are men who have lost 66 lb (30 kg) and kept the weight off for 5.5 years. The average woman is 45 years of age and weighs 145 lb (66 kg), and the average man is 49 years of age and weighs 190 lb (86 kg). Of course, these averages hide the huge diversity of the individuals involved in the study, as well as facts such as the following:
- Weight loss has ranged from 30 to 300 lb (13.6-136 kg).
- Duration of successful weight loss has ranged from 1 to 66 years.
- Some participants have lost the weight rapidly, while others have lost it very slowly-over as many as 14 years.
The following are strategies used by these individuals to lose weight and keep it off. Some of the information has been adapted from a review of the NWCR by Manore (2004).
Methods of weight loss. Almost everyone in the registry has used a combination of diet and exercise to lose the weight, with 45% reporting that they lost the weight on their own and 55% reporting using some type of program. Nearly all of the participants (98%) reported that they modified their food intake in some way to lose weight, while 94% said that they increased their physical activity. The most common form of physical activity reported is walking. Nearly all of the participants have reported that their weight loss has led to significant improvements in energy levels, physical mobility, general mood, self-confidence, and physical health (Klem et al. 1997). Participants (~42%) state that keeping the weight off has not been as difficult as losing it initially (Klem et al. 1997). This is especially true in individuals who have kept the weight off for more than two years (Klem et al. 2000).
Strategies for weight maintenance. Since the initiation of the NWCR, investigators have been analyzing the data to determine successful weight maintenance strategies (Gorin et al. 2004; Hill and Wing 2003; Klem et al. 1997; McGuire et al. 1998; Phelan et al. 2007; Raynor et al. 2006; Shick et al. 1998; Wyatt et al. 2002). In general, most participants report continuing to maintain a low-calorie, low-fat diet and doing high levels of physical activity. The following are some of the specific and most frequently mentioned strategies used by participants who have been successful at maintaining weight loss:
- Eating breakfast. Nearly 80% of participants report eating breakfast every day, with only 4% reporting never eating breakfast. How might eating breakfast contribute to successful weight maintenance? Although there were no differences in total energy intake between frequent breakfast eaters and less frequent breakfast eaters (three times a week or less), breakfast eaters reported being more physically active (Wyatt et al. 2002).
- Monitoring energy and fat intake. A common characteristic of registry participants is that they continue to monitor their energy and fat intake even after the weight loss period is over. On average, participants consume diets with ~24% of energy from fat and have energy intakes lower than average (Shick et al. 1998). As a group, 80% consume diets with <30% of energy from fat, while 35% consume diets with less than 20% of energy from fat. The strategies employed to control food intake include limiting intake of certain high-fat foods, eating less food per meal, counting grams of fat or calories, eating regular meals, and adhering to the same diet regimen throughout the week (Klem et al. 1997; Gorin et al. 2004). Diet consistency across the week appears to help people prevent weight gain (Gorin et al. 2004).
- Exercising daily. Being physical active is an important characteristic of registry participants, with 90% reporting that they exercise, on average, about 1 h or more per day. Weekly energy expenditures from physical activity average ~2800 kcal: ~2500 kcal/week for women and 3300 kcal/week for men (Hill and Wing 2003; Klem et al. 1997). The most common forms of physical activity reported are cycling, aerobics, walking, and running (Klem et al. 1997). Comparison of the levels of physical activity between successful weight loss maintainers and people who had always maintained a normal weight showed that the weight loss maintainers spent significantly more time in high-intensity forms of physical activity and spent more minutes per week doing physical activity (Phelan et al. 2007).
- Engaging in less sedentary activity. It has long been recognized that sedentary behaviors, especially TV viewing, may contribute to weight gain. Raynor and colleagues (2006) examined the TV viewing of registry participants and found that 62% watched <10 h of TV per week, with 36% reporting that they watched <5 h/week. This level of TV viewing is much lower than the national average of 28 h/week.
- Monitoring weight. Nearly 75% of the registry participants weigh themselves at least once a week (Klem et al. 1997). Thus, regularly monitoring weight appears to be a behavior that is important for ensuring that weight regain does not occur.
What we have learned from the participants in the NWCR is that good nutrition, physical activity, and self-monitoring are important for keeping the weight off once it has been lost. Individuals who are successful at weight loss and the maintenance of weight loss appear to employ similar strategies. They eat breakfast, exercise regularly, monitor their diet for both energy and fat intake, participate in less TV watching, and weigh themselves regularly.
Choosing quality ergogenic substances
Because of the many potential risks associated with supplements, it is important to critically evaluate ergogenic substances prior to using or recommending them.
Because of the many potential risks associated with supplements, it is important to critically evaluate ergogenic substances prior to using or recommending them. However, evaluating the marketing, research, and safety of products can be a daunting task in the current regulatory environment. How do you decide what is safe and effective?
Third-Party Evaluations
Several organizations now offer third-party evaluations of dietary supplements. Independent testing of individual products is conducted (usually for a fee) to evaluate such quality control issues as labeling accuracy, purity, strength, and ability to dissolve. For companies that use these services, you will find certifications or seals of approval on their products. A recent certification useful for athletes is the Certified in Sport by NSF International. This program also tests for banned substances. Keep in mind that third-party testing is expensive; the fact that a product is not on the list of certified products does not mean it is unsafe. However, if it is on the list, it meets the criteria set forth by the evaluator.
Australian Institute of Sport (AIS) Sports Supplement Program
In recent years, the Australian Institute of Sport has implemented a sport supplement program to ensure that athletes are using sport foods and supplements safely. A panel of experts evaluates current research on various supplements and categorizes them based on how safe and effective they are.
- Group A supplements: Sport foods and supplements that provide a useful and timely source of energy and nutrients or for which there is scientific evidence supporting improved performance
- Group B supplements: Newer supplements on which not enough scientific studies have been conducted, but that may provide a performance benefit as suggested by preliminary evidence
- Group C supplements: Supplements that have not been shown to improve sport performance or that may impair sport performance-most ergogenic substances fall under this category
- Group D supplements: Supplements that are banned or are at high risk of being contaminated with substances (e.g., steroids) that could cause a positive drug test
Evaluating popular diets
Learn how to recognize a potential fad diet or nutrition program.
Popular or Fad Diets
Fad diets are those that enjoy short-lived success and popularity and are based on a marketing gimmick. Athletes can be particularly vulnerable to fad dieting because of their intense desire to optimize body composition and performance. Celebrities and other well-known persons endorse these diets in an attempt to give them credibility. Justification for these diets is typically based on a scientific or biochemical claim that may be speculative and unproven. Consumers must remember that if the claims associated with the diets were true, there would be no need for people to continue dieting and no need for the next fad diet! For example, if the Dr. Atkins diet, popular in the 1970s, had worked, there would be no need for the "new and improved" Dr. Atkins' New Diet Revolution in the 1990s and 2000s. As mentioned earlier, more modified versions of the Dr. Atkins diet are here to stay but are characterized by less carbohydrate restriction. Because LCDs bring about quick weight loss, they may be used to help people begin or "jump-start" a weight loss regimen.
There will always be a new fad diet in the marketplace, so it is important to understand how to evaluate each new diet and give good dietary advice to your clients. The criteria listed next will help you recognize a potential fad diet or nutrition program. If the diet either you or your clients are considering is associated with one of the following, it is probably just another fad diet:
- The claim that the diet is new, modern, improved, or recently discovered, with no scientific data available to back up the claim
- The claim that weight or fat loss will be rapid, usually more than 2 lb (0.9 kg) per week
- The claim of successful weight loss with no or little physical exercise
- Inclusion of special foods that are expensive and difficult to find; suggestion that foods should be consumed in a particular order or "combination"; suggestion that consumption of certain "bad" foods should be avoided; or inclusion of "magic" or "miracle" foods that will burn fat
- Inclusion of a rigid menu that must be followed daily; restriction to a limited list of foods (these diets frequently require adherents to eat the same foods day after day)
- Inclusion of supplemental meals, foods, or nutrient supplements with the claim that they will cure disease or a variety of ailments
Until we figure out how to solve the obesity problem, the consumer will be bombarded with new weight loss products and programs promising fast weight loss. It is important for nutrition and fitness professionals to educate consumers about the limitations of these products and programs. While some may be physically harmless (albeit expensive), others can cause illness or even death. It is always important to consider the safety and efficacy of any fad diet, including the associated supplements, before recommending it to a client.
Evolution of Dietary Guidelines for Americans
See how dietary guidelines have developed to help promote health, decrease the risk of chronic disease, meet nutrient requirements, and support active lives.
This is an excerpt from Sport Nutrition for Health and Performance, Second Edition.
Learning from the National Weight Control Registry
A look at the weight loss and maintenance strategies of successful individuals.
The National Weight Control Registry
In 1994, Drs. Rena Wing, PhD, of Brown Medical School and James Hill, PhD, of the University of Colorado Health Sciences Center founded the National Weight Control Registry (NWCR) (www.nwcr.ws). To date, this project is the largest prospective investigation of long-term successful weight loss maintenance. The goal of the project was to find individuals who had been successful at weight loss and describe the strategies that they used to achieve and maintain weight loss long-term. Currently, the NWCR is tracking over 5000 individuals who have lost significant amounts of weight and kept it off for long periods of time. In order to be part of the registry, people need to be 18 years or older, who have lost at least 30 lb (6.6 kg), and to have maintained this weight loss for at least one year. Once enrolled in the program, individuals are periodically asked to fill out detailed questionnaires about their successful weight loss, current weight maintenance strategies, and other health-related behaviors for the purpose of determining the behavioral and psychological characteristics of weight maintainers, as well as the strategies they use to maintain weight loss. Participants also fill out annual follow-up surveys so that their weight maintenance can be continually tracked. Thus the NWCR is not a randomized controlled study, but rather looks at who has been successful at weight loss and at weight loss maintenance. On average, 80% of the participants are women and 20% are men who have lost 66 lb (30 kg) and kept the weight off for 5.5 years. The average woman is 45 years of age and weighs 145 lb (66 kg), and the average man is 49 years of age and weighs 190 lb (86 kg). Of course, these averages hide the huge diversity of the individuals involved in the study, as well as facts such as the following:
- Weight loss has ranged from 30 to 300 lb (13.6-136 kg).
- Duration of successful weight loss has ranged from 1 to 66 years.
- Some participants have lost the weight rapidly, while others have lost it very slowly-over as many as 14 years.
The following are strategies used by these individuals to lose weight and keep it off. Some of the information has been adapted from a review of the NWCR by Manore (2004).
Methods of weight loss. Almost everyone in the registry has used a combination of diet and exercise to lose the weight, with 45% reporting that they lost the weight on their own and 55% reporting using some type of program. Nearly all of the participants (98%) reported that they modified their food intake in some way to lose weight, while 94% said that they increased their physical activity. The most common form of physical activity reported is walking. Nearly all of the participants have reported that their weight loss has led to significant improvements in energy levels, physical mobility, general mood, self-confidence, and physical health (Klem et al. 1997). Participants (~42%) state that keeping the weight off has not been as difficult as losing it initially (Klem et al. 1997). This is especially true in individuals who have kept the weight off for more than two years (Klem et al. 2000).
Strategies for weight maintenance. Since the initiation of the NWCR, investigators have been analyzing the data to determine successful weight maintenance strategies (Gorin et al. 2004; Hill and Wing 2003; Klem et al. 1997; McGuire et al. 1998; Phelan et al. 2007; Raynor et al. 2006; Shick et al. 1998; Wyatt et al. 2002). In general, most participants report continuing to maintain a low-calorie, low-fat diet and doing high levels of physical activity. The following are some of the specific and most frequently mentioned strategies used by participants who have been successful at maintaining weight loss:
- Eating breakfast. Nearly 80% of participants report eating breakfast every day, with only 4% reporting never eating breakfast. How might eating breakfast contribute to successful weight maintenance? Although there were no differences in total energy intake between frequent breakfast eaters and less frequent breakfast eaters (three times a week or less), breakfast eaters reported being more physically active (Wyatt et al. 2002).
- Monitoring energy and fat intake. A common characteristic of registry participants is that they continue to monitor their energy and fat intake even after the weight loss period is over. On average, participants consume diets with ~24% of energy from fat and have energy intakes lower than average (Shick et al. 1998). As a group, 80% consume diets with <30% of energy from fat, while 35% consume diets with less than 20% of energy from fat. The strategies employed to control food intake include limiting intake of certain high-fat foods, eating less food per meal, counting grams of fat or calories, eating regular meals, and adhering to the same diet regimen throughout the week (Klem et al. 1997; Gorin et al. 2004). Diet consistency across the week appears to help people prevent weight gain (Gorin et al. 2004).
- Exercising daily. Being physical active is an important characteristic of registry participants, with 90% reporting that they exercise, on average, about 1 h or more per day. Weekly energy expenditures from physical activity average ~2800 kcal: ~2500 kcal/week for women and 3300 kcal/week for men (Hill and Wing 2003; Klem et al. 1997). The most common forms of physical activity reported are cycling, aerobics, walking, and running (Klem et al. 1997). Comparison of the levels of physical activity between successful weight loss maintainers and people who had always maintained a normal weight showed that the weight loss maintainers spent significantly more time in high-intensity forms of physical activity and spent more minutes per week doing physical activity (Phelan et al. 2007).
- Engaging in less sedentary activity. It has long been recognized that sedentary behaviors, especially TV viewing, may contribute to weight gain. Raynor and colleagues (2006) examined the TV viewing of registry participants and found that 62% watched <10 h of TV per week, with 36% reporting that they watched <5 h/week. This level of TV viewing is much lower than the national average of 28 h/week.
- Monitoring weight. Nearly 75% of the registry participants weigh themselves at least once a week (Klem et al. 1997). Thus, regularly monitoring weight appears to be a behavior that is important for ensuring that weight regain does not occur.
What we have learned from the participants in the NWCR is that good nutrition, physical activity, and self-monitoring are important for keeping the weight off once it has been lost. Individuals who are successful at weight loss and the maintenance of weight loss appear to employ similar strategies. They eat breakfast, exercise regularly, monitor their diet for both energy and fat intake, participate in less TV watching, and weigh themselves regularly.
Choosing quality ergogenic substances
Because of the many potential risks associated with supplements, it is important to critically evaluate ergogenic substances prior to using or recommending them.
Because of the many potential risks associated with supplements, it is important to critically evaluate ergogenic substances prior to using or recommending them. However, evaluating the marketing, research, and safety of products can be a daunting task in the current regulatory environment. How do you decide what is safe and effective?
Third-Party Evaluations
Several organizations now offer third-party evaluations of dietary supplements. Independent testing of individual products is conducted (usually for a fee) to evaluate such quality control issues as labeling accuracy, purity, strength, and ability to dissolve. For companies that use these services, you will find certifications or seals of approval on their products. A recent certification useful for athletes is the Certified in Sport by NSF International. This program also tests for banned substances. Keep in mind that third-party testing is expensive; the fact that a product is not on the list of certified products does not mean it is unsafe. However, if it is on the list, it meets the criteria set forth by the evaluator.
Australian Institute of Sport (AIS) Sports Supplement Program
In recent years, the Australian Institute of Sport has implemented a sport supplement program to ensure that athletes are using sport foods and supplements safely. A panel of experts evaluates current research on various supplements and categorizes them based on how safe and effective they are.
- Group A supplements: Sport foods and supplements that provide a useful and timely source of energy and nutrients or for which there is scientific evidence supporting improved performance
- Group B supplements: Newer supplements on which not enough scientific studies have been conducted, but that may provide a performance benefit as suggested by preliminary evidence
- Group C supplements: Supplements that have not been shown to improve sport performance or that may impair sport performance-most ergogenic substances fall under this category
- Group D supplements: Supplements that are banned or are at high risk of being contaminated with substances (e.g., steroids) that could cause a positive drug test
Evaluating popular diets
Learn how to recognize a potential fad diet or nutrition program.
Popular or Fad Diets
Fad diets are those that enjoy short-lived success and popularity and are based on a marketing gimmick. Athletes can be particularly vulnerable to fad dieting because of their intense desire to optimize body composition and performance. Celebrities and other well-known persons endorse these diets in an attempt to give them credibility. Justification for these diets is typically based on a scientific or biochemical claim that may be speculative and unproven. Consumers must remember that if the claims associated with the diets were true, there would be no need for people to continue dieting and no need for the next fad diet! For example, if the Dr. Atkins diet, popular in the 1970s, had worked, there would be no need for the "new and improved" Dr. Atkins' New Diet Revolution in the 1990s and 2000s. As mentioned earlier, more modified versions of the Dr. Atkins diet are here to stay but are characterized by less carbohydrate restriction. Because LCDs bring about quick weight loss, they may be used to help people begin or "jump-start" a weight loss regimen.
There will always be a new fad diet in the marketplace, so it is important to understand how to evaluate each new diet and give good dietary advice to your clients. The criteria listed next will help you recognize a potential fad diet or nutrition program. If the diet either you or your clients are considering is associated with one of the following, it is probably just another fad diet:
- The claim that the diet is new, modern, improved, or recently discovered, with no scientific data available to back up the claim
- The claim that weight or fat loss will be rapid, usually more than 2 lb (0.9 kg) per week
- The claim of successful weight loss with no or little physical exercise
- Inclusion of special foods that are expensive and difficult to find; suggestion that foods should be consumed in a particular order or "combination"; suggestion that consumption of certain "bad" foods should be avoided; or inclusion of "magic" or "miracle" foods that will burn fat
- Inclusion of a rigid menu that must be followed daily; restriction to a limited list of foods (these diets frequently require adherents to eat the same foods day after day)
- Inclusion of supplemental meals, foods, or nutrient supplements with the claim that they will cure disease or a variety of ailments
Until we figure out how to solve the obesity problem, the consumer will be bombarded with new weight loss products and programs promising fast weight loss. It is important for nutrition and fitness professionals to educate consumers about the limitations of these products and programs. While some may be physically harmless (albeit expensive), others can cause illness or even death. It is always important to consider the safety and efficacy of any fad diet, including the associated supplements, before recommending it to a client.
Evolution of Dietary Guidelines for Americans
See how dietary guidelines have developed to help promote health, decrease the risk of chronic disease, meet nutrient requirements, and support active lives.
This is an excerpt from Sport Nutrition for Health and Performance, Second Edition.
Learning from the National Weight Control Registry
A look at the weight loss and maintenance strategies of successful individuals.
The National Weight Control Registry
In 1994, Drs. Rena Wing, PhD, of Brown Medical School and James Hill, PhD, of the University of Colorado Health Sciences Center founded the National Weight Control Registry (NWCR) (www.nwcr.ws). To date, this project is the largest prospective investigation of long-term successful weight loss maintenance. The goal of the project was to find individuals who had been successful at weight loss and describe the strategies that they used to achieve and maintain weight loss long-term. Currently, the NWCR is tracking over 5000 individuals who have lost significant amounts of weight and kept it off for long periods of time. In order to be part of the registry, people need to be 18 years or older, who have lost at least 30 lb (6.6 kg), and to have maintained this weight loss for at least one year. Once enrolled in the program, individuals are periodically asked to fill out detailed questionnaires about their successful weight loss, current weight maintenance strategies, and other health-related behaviors for the purpose of determining the behavioral and psychological characteristics of weight maintainers, as well as the strategies they use to maintain weight loss. Participants also fill out annual follow-up surveys so that their weight maintenance can be continually tracked. Thus the NWCR is not a randomized controlled study, but rather looks at who has been successful at weight loss and at weight loss maintenance. On average, 80% of the participants are women and 20% are men who have lost 66 lb (30 kg) and kept the weight off for 5.5 years. The average woman is 45 years of age and weighs 145 lb (66 kg), and the average man is 49 years of age and weighs 190 lb (86 kg). Of course, these averages hide the huge diversity of the individuals involved in the study, as well as facts such as the following:
- Weight loss has ranged from 30 to 300 lb (13.6-136 kg).
- Duration of successful weight loss has ranged from 1 to 66 years.
- Some participants have lost the weight rapidly, while others have lost it very slowly-over as many as 14 years.
The following are strategies used by these individuals to lose weight and keep it off. Some of the information has been adapted from a review of the NWCR by Manore (2004).
Methods of weight loss. Almost everyone in the registry has used a combination of diet and exercise to lose the weight, with 45% reporting that they lost the weight on their own and 55% reporting using some type of program. Nearly all of the participants (98%) reported that they modified their food intake in some way to lose weight, while 94% said that they increased their physical activity. The most common form of physical activity reported is walking. Nearly all of the participants have reported that their weight loss has led to significant improvements in energy levels, physical mobility, general mood, self-confidence, and physical health (Klem et al. 1997). Participants (~42%) state that keeping the weight off has not been as difficult as losing it initially (Klem et al. 1997). This is especially true in individuals who have kept the weight off for more than two years (Klem et al. 2000).
Strategies for weight maintenance. Since the initiation of the NWCR, investigators have been analyzing the data to determine successful weight maintenance strategies (Gorin et al. 2004; Hill and Wing 2003; Klem et al. 1997; McGuire et al. 1998; Phelan et al. 2007; Raynor et al. 2006; Shick et al. 1998; Wyatt et al. 2002). In general, most participants report continuing to maintain a low-calorie, low-fat diet and doing high levels of physical activity. The following are some of the specific and most frequently mentioned strategies used by participants who have been successful at maintaining weight loss:
- Eating breakfast. Nearly 80% of participants report eating breakfast every day, with only 4% reporting never eating breakfast. How might eating breakfast contribute to successful weight maintenance? Although there were no differences in total energy intake between frequent breakfast eaters and less frequent breakfast eaters (three times a week or less), breakfast eaters reported being more physically active (Wyatt et al. 2002).
- Monitoring energy and fat intake. A common characteristic of registry participants is that they continue to monitor their energy and fat intake even after the weight loss period is over. On average, participants consume diets with ~24% of energy from fat and have energy intakes lower than average (Shick et al. 1998). As a group, 80% consume diets with <30% of energy from fat, while 35% consume diets with less than 20% of energy from fat. The strategies employed to control food intake include limiting intake of certain high-fat foods, eating less food per meal, counting grams of fat or calories, eating regular meals, and adhering to the same diet regimen throughout the week (Klem et al. 1997; Gorin et al. 2004). Diet consistency across the week appears to help people prevent weight gain (Gorin et al. 2004).
- Exercising daily. Being physical active is an important characteristic of registry participants, with 90% reporting that they exercise, on average, about 1 h or more per day. Weekly energy expenditures from physical activity average ~2800 kcal: ~2500 kcal/week for women and 3300 kcal/week for men (Hill and Wing 2003; Klem et al. 1997). The most common forms of physical activity reported are cycling, aerobics, walking, and running (Klem et al. 1997). Comparison of the levels of physical activity between successful weight loss maintainers and people who had always maintained a normal weight showed that the weight loss maintainers spent significantly more time in high-intensity forms of physical activity and spent more minutes per week doing physical activity (Phelan et al. 2007).
- Engaging in less sedentary activity. It has long been recognized that sedentary behaviors, especially TV viewing, may contribute to weight gain. Raynor and colleagues (2006) examined the TV viewing of registry participants and found that 62% watched <10 h of TV per week, with 36% reporting that they watched <5 h/week. This level of TV viewing is much lower than the national average of 28 h/week.
- Monitoring weight. Nearly 75% of the registry participants weigh themselves at least once a week (Klem et al. 1997). Thus, regularly monitoring weight appears to be a behavior that is important for ensuring that weight regain does not occur.
What we have learned from the participants in the NWCR is that good nutrition, physical activity, and self-monitoring are important for keeping the weight off once it has been lost. Individuals who are successful at weight loss and the maintenance of weight loss appear to employ similar strategies. They eat breakfast, exercise regularly, monitor their diet for both energy and fat intake, participate in less TV watching, and weigh themselves regularly.
Choosing quality ergogenic substances
Because of the many potential risks associated with supplements, it is important to critically evaluate ergogenic substances prior to using or recommending them.
Because of the many potential risks associated with supplements, it is important to critically evaluate ergogenic substances prior to using or recommending them. However, evaluating the marketing, research, and safety of products can be a daunting task in the current regulatory environment. How do you decide what is safe and effective?
Third-Party Evaluations
Several organizations now offer third-party evaluations of dietary supplements. Independent testing of individual products is conducted (usually for a fee) to evaluate such quality control issues as labeling accuracy, purity, strength, and ability to dissolve. For companies that use these services, you will find certifications or seals of approval on their products. A recent certification useful for athletes is the Certified in Sport by NSF International. This program also tests for banned substances. Keep in mind that third-party testing is expensive; the fact that a product is not on the list of certified products does not mean it is unsafe. However, if it is on the list, it meets the criteria set forth by the evaluator.
Australian Institute of Sport (AIS) Sports Supplement Program
In recent years, the Australian Institute of Sport has implemented a sport supplement program to ensure that athletes are using sport foods and supplements safely. A panel of experts evaluates current research on various supplements and categorizes them based on how safe and effective they are.
- Group A supplements: Sport foods and supplements that provide a useful and timely source of energy and nutrients or for which there is scientific evidence supporting improved performance
- Group B supplements: Newer supplements on which not enough scientific studies have been conducted, but that may provide a performance benefit as suggested by preliminary evidence
- Group C supplements: Supplements that have not been shown to improve sport performance or that may impair sport performance-most ergogenic substances fall under this category
- Group D supplements: Supplements that are banned or are at high risk of being contaminated with substances (e.g., steroids) that could cause a positive drug test
Evaluating popular diets
Learn how to recognize a potential fad diet or nutrition program.
Popular or Fad Diets
Fad diets are those that enjoy short-lived success and popularity and are based on a marketing gimmick. Athletes can be particularly vulnerable to fad dieting because of their intense desire to optimize body composition and performance. Celebrities and other well-known persons endorse these diets in an attempt to give them credibility. Justification for these diets is typically based on a scientific or biochemical claim that may be speculative and unproven. Consumers must remember that if the claims associated with the diets were true, there would be no need for people to continue dieting and no need for the next fad diet! For example, if the Dr. Atkins diet, popular in the 1970s, had worked, there would be no need for the "new and improved" Dr. Atkins' New Diet Revolution in the 1990s and 2000s. As mentioned earlier, more modified versions of the Dr. Atkins diet are here to stay but are characterized by less carbohydrate restriction. Because LCDs bring about quick weight loss, they may be used to help people begin or "jump-start" a weight loss regimen.
There will always be a new fad diet in the marketplace, so it is important to understand how to evaluate each new diet and give good dietary advice to your clients. The criteria listed next will help you recognize a potential fad diet or nutrition program. If the diet either you or your clients are considering is associated with one of the following, it is probably just another fad diet:
- The claim that the diet is new, modern, improved, or recently discovered, with no scientific data available to back up the claim
- The claim that weight or fat loss will be rapid, usually more than 2 lb (0.9 kg) per week
- The claim of successful weight loss with no or little physical exercise
- Inclusion of special foods that are expensive and difficult to find; suggestion that foods should be consumed in a particular order or "combination"; suggestion that consumption of certain "bad" foods should be avoided; or inclusion of "magic" or "miracle" foods that will burn fat
- Inclusion of a rigid menu that must be followed daily; restriction to a limited list of foods (these diets frequently require adherents to eat the same foods day after day)
- Inclusion of supplemental meals, foods, or nutrient supplements with the claim that they will cure disease or a variety of ailments
Until we figure out how to solve the obesity problem, the consumer will be bombarded with new weight loss products and programs promising fast weight loss. It is important for nutrition and fitness professionals to educate consumers about the limitations of these products and programs. While some may be physically harmless (albeit expensive), others can cause illness or even death. It is always important to consider the safety and efficacy of any fad diet, including the associated supplements, before recommending it to a client.
Evolution of Dietary Guidelines for Americans
See how dietary guidelines have developed to help promote health, decrease the risk of chronic disease, meet nutrient requirements, and support active lives.
This is an excerpt from Sport Nutrition for Health and Performance, Second Edition.
Learning from the National Weight Control Registry
A look at the weight loss and maintenance strategies of successful individuals.
The National Weight Control Registry
In 1994, Drs. Rena Wing, PhD, of Brown Medical School and James Hill, PhD, of the University of Colorado Health Sciences Center founded the National Weight Control Registry (NWCR) (www.nwcr.ws). To date, this project is the largest prospective investigation of long-term successful weight loss maintenance. The goal of the project was to find individuals who had been successful at weight loss and describe the strategies that they used to achieve and maintain weight loss long-term. Currently, the NWCR is tracking over 5000 individuals who have lost significant amounts of weight and kept it off for long periods of time. In order to be part of the registry, people need to be 18 years or older, who have lost at least 30 lb (6.6 kg), and to have maintained this weight loss for at least one year. Once enrolled in the program, individuals are periodically asked to fill out detailed questionnaires about their successful weight loss, current weight maintenance strategies, and other health-related behaviors for the purpose of determining the behavioral and psychological characteristics of weight maintainers, as well as the strategies they use to maintain weight loss. Participants also fill out annual follow-up surveys so that their weight maintenance can be continually tracked. Thus the NWCR is not a randomized controlled study, but rather looks at who has been successful at weight loss and at weight loss maintenance. On average, 80% of the participants are women and 20% are men who have lost 66 lb (30 kg) and kept the weight off for 5.5 years. The average woman is 45 years of age and weighs 145 lb (66 kg), and the average man is 49 years of age and weighs 190 lb (86 kg). Of course, these averages hide the huge diversity of the individuals involved in the study, as well as facts such as the following:
- Weight loss has ranged from 30 to 300 lb (13.6-136 kg).
- Duration of successful weight loss has ranged from 1 to 66 years.
- Some participants have lost the weight rapidly, while others have lost it very slowly-over as many as 14 years.
The following are strategies used by these individuals to lose weight and keep it off. Some of the information has been adapted from a review of the NWCR by Manore (2004).
Methods of weight loss. Almost everyone in the registry has used a combination of diet and exercise to lose the weight, with 45% reporting that they lost the weight on their own and 55% reporting using some type of program. Nearly all of the participants (98%) reported that they modified their food intake in some way to lose weight, while 94% said that they increased their physical activity. The most common form of physical activity reported is walking. Nearly all of the participants have reported that their weight loss has led to significant improvements in energy levels, physical mobility, general mood, self-confidence, and physical health (Klem et al. 1997). Participants (~42%) state that keeping the weight off has not been as difficult as losing it initially (Klem et al. 1997). This is especially true in individuals who have kept the weight off for more than two years (Klem et al. 2000).
Strategies for weight maintenance. Since the initiation of the NWCR, investigators have been analyzing the data to determine successful weight maintenance strategies (Gorin et al. 2004; Hill and Wing 2003; Klem et al. 1997; McGuire et al. 1998; Phelan et al. 2007; Raynor et al. 2006; Shick et al. 1998; Wyatt et al. 2002). In general, most participants report continuing to maintain a low-calorie, low-fat diet and doing high levels of physical activity. The following are some of the specific and most frequently mentioned strategies used by participants who have been successful at maintaining weight loss:
- Eating breakfast. Nearly 80% of participants report eating breakfast every day, with only 4% reporting never eating breakfast. How might eating breakfast contribute to successful weight maintenance? Although there were no differences in total energy intake between frequent breakfast eaters and less frequent breakfast eaters (three times a week or less), breakfast eaters reported being more physically active (Wyatt et al. 2002).
- Monitoring energy and fat intake. A common characteristic of registry participants is that they continue to monitor their energy and fat intake even after the weight loss period is over. On average, participants consume diets with ~24% of energy from fat and have energy intakes lower than average (Shick et al. 1998). As a group, 80% consume diets with <30% of energy from fat, while 35% consume diets with less than 20% of energy from fat. The strategies employed to control food intake include limiting intake of certain high-fat foods, eating less food per meal, counting grams of fat or calories, eating regular meals, and adhering to the same diet regimen throughout the week (Klem et al. 1997; Gorin et al. 2004). Diet consistency across the week appears to help people prevent weight gain (Gorin et al. 2004).
- Exercising daily. Being physical active is an important characteristic of registry participants, with 90% reporting that they exercise, on average, about 1 h or more per day. Weekly energy expenditures from physical activity average ~2800 kcal: ~2500 kcal/week for women and 3300 kcal/week for men (Hill and Wing 2003; Klem et al. 1997). The most common forms of physical activity reported are cycling, aerobics, walking, and running (Klem et al. 1997). Comparison of the levels of physical activity between successful weight loss maintainers and people who had always maintained a normal weight showed that the weight loss maintainers spent significantly more time in high-intensity forms of physical activity and spent more minutes per week doing physical activity (Phelan et al. 2007).
- Engaging in less sedentary activity. It has long been recognized that sedentary behaviors, especially TV viewing, may contribute to weight gain. Raynor and colleagues (2006) examined the TV viewing of registry participants and found that 62% watched <10 h of TV per week, with 36% reporting that they watched <5 h/week. This level of TV viewing is much lower than the national average of 28 h/week.
- Monitoring weight. Nearly 75% of the registry participants weigh themselves at least once a week (Klem et al. 1997). Thus, regularly monitoring weight appears to be a behavior that is important for ensuring that weight regain does not occur.
What we have learned from the participants in the NWCR is that good nutrition, physical activity, and self-monitoring are important for keeping the weight off once it has been lost. Individuals who are successful at weight loss and the maintenance of weight loss appear to employ similar strategies. They eat breakfast, exercise regularly, monitor their diet for both energy and fat intake, participate in less TV watching, and weigh themselves regularly.
Choosing quality ergogenic substances
Because of the many potential risks associated with supplements, it is important to critically evaluate ergogenic substances prior to using or recommending them.
Because of the many potential risks associated with supplements, it is important to critically evaluate ergogenic substances prior to using or recommending them. However, evaluating the marketing, research, and safety of products can be a daunting task in the current regulatory environment. How do you decide what is safe and effective?
Third-Party Evaluations
Several organizations now offer third-party evaluations of dietary supplements. Independent testing of individual products is conducted (usually for a fee) to evaluate such quality control issues as labeling accuracy, purity, strength, and ability to dissolve. For companies that use these services, you will find certifications or seals of approval on their products. A recent certification useful for athletes is the Certified in Sport by NSF International. This program also tests for banned substances. Keep in mind that third-party testing is expensive; the fact that a product is not on the list of certified products does not mean it is unsafe. However, if it is on the list, it meets the criteria set forth by the evaluator.
Australian Institute of Sport (AIS) Sports Supplement Program
In recent years, the Australian Institute of Sport has implemented a sport supplement program to ensure that athletes are using sport foods and supplements safely. A panel of experts evaluates current research on various supplements and categorizes them based on how safe and effective they are.
- Group A supplements: Sport foods and supplements that provide a useful and timely source of energy and nutrients or for which there is scientific evidence supporting improved performance
- Group B supplements: Newer supplements on which not enough scientific studies have been conducted, but that may provide a performance benefit as suggested by preliminary evidence
- Group C supplements: Supplements that have not been shown to improve sport performance or that may impair sport performance-most ergogenic substances fall under this category
- Group D supplements: Supplements that are banned or are at high risk of being contaminated with substances (e.g., steroids) that could cause a positive drug test
Evaluating popular diets
Learn how to recognize a potential fad diet or nutrition program.
Popular or Fad Diets
Fad diets are those that enjoy short-lived success and popularity and are based on a marketing gimmick. Athletes can be particularly vulnerable to fad dieting because of their intense desire to optimize body composition and performance. Celebrities and other well-known persons endorse these diets in an attempt to give them credibility. Justification for these diets is typically based on a scientific or biochemical claim that may be speculative and unproven. Consumers must remember that if the claims associated with the diets were true, there would be no need for people to continue dieting and no need for the next fad diet! For example, if the Dr. Atkins diet, popular in the 1970s, had worked, there would be no need for the "new and improved" Dr. Atkins' New Diet Revolution in the 1990s and 2000s. As mentioned earlier, more modified versions of the Dr. Atkins diet are here to stay but are characterized by less carbohydrate restriction. Because LCDs bring about quick weight loss, they may be used to help people begin or "jump-start" a weight loss regimen.
There will always be a new fad diet in the marketplace, so it is important to understand how to evaluate each new diet and give good dietary advice to your clients. The criteria listed next will help you recognize a potential fad diet or nutrition program. If the diet either you or your clients are considering is associated with one of the following, it is probably just another fad diet:
- The claim that the diet is new, modern, improved, or recently discovered, with no scientific data available to back up the claim
- The claim that weight or fat loss will be rapid, usually more than 2 lb (0.9 kg) per week
- The claim of successful weight loss with no or little physical exercise
- Inclusion of special foods that are expensive and difficult to find; suggestion that foods should be consumed in a particular order or "combination"; suggestion that consumption of certain "bad" foods should be avoided; or inclusion of "magic" or "miracle" foods that will burn fat
- Inclusion of a rigid menu that must be followed daily; restriction to a limited list of foods (these diets frequently require adherents to eat the same foods day after day)
- Inclusion of supplemental meals, foods, or nutrient supplements with the claim that they will cure disease or a variety of ailments
Until we figure out how to solve the obesity problem, the consumer will be bombarded with new weight loss products and programs promising fast weight loss. It is important for nutrition and fitness professionals to educate consumers about the limitations of these products and programs. While some may be physically harmless (albeit expensive), others can cause illness or even death. It is always important to consider the safety and efficacy of any fad diet, including the associated supplements, before recommending it to a client.
Evolution of Dietary Guidelines for Americans
See how dietary guidelines have developed to help promote health, decrease the risk of chronic disease, meet nutrient requirements, and support active lives.
This is an excerpt from Sport Nutrition for Health and Performance, Second Edition.
Learning from the National Weight Control Registry
A look at the weight loss and maintenance strategies of successful individuals.
The National Weight Control Registry
In 1994, Drs. Rena Wing, PhD, of Brown Medical School and James Hill, PhD, of the University of Colorado Health Sciences Center founded the National Weight Control Registry (NWCR) (www.nwcr.ws). To date, this project is the largest prospective investigation of long-term successful weight loss maintenance. The goal of the project was to find individuals who had been successful at weight loss and describe the strategies that they used to achieve and maintain weight loss long-term. Currently, the NWCR is tracking over 5000 individuals who have lost significant amounts of weight and kept it off for long periods of time. In order to be part of the registry, people need to be 18 years or older, who have lost at least 30 lb (6.6 kg), and to have maintained this weight loss for at least one year. Once enrolled in the program, individuals are periodically asked to fill out detailed questionnaires about their successful weight loss, current weight maintenance strategies, and other health-related behaviors for the purpose of determining the behavioral and psychological characteristics of weight maintainers, as well as the strategies they use to maintain weight loss. Participants also fill out annual follow-up surveys so that their weight maintenance can be continually tracked. Thus the NWCR is not a randomized controlled study, but rather looks at who has been successful at weight loss and at weight loss maintenance. On average, 80% of the participants are women and 20% are men who have lost 66 lb (30 kg) and kept the weight off for 5.5 years. The average woman is 45 years of age and weighs 145 lb (66 kg), and the average man is 49 years of age and weighs 190 lb (86 kg). Of course, these averages hide the huge diversity of the individuals involved in the study, as well as facts such as the following:
- Weight loss has ranged from 30 to 300 lb (13.6-136 kg).
- Duration of successful weight loss has ranged from 1 to 66 years.
- Some participants have lost the weight rapidly, while others have lost it very slowly-over as many as 14 years.
The following are strategies used by these individuals to lose weight and keep it off. Some of the information has been adapted from a review of the NWCR by Manore (2004).
Methods of weight loss. Almost everyone in the registry has used a combination of diet and exercise to lose the weight, with 45% reporting that they lost the weight on their own and 55% reporting using some type of program. Nearly all of the participants (98%) reported that they modified their food intake in some way to lose weight, while 94% said that they increased their physical activity. The most common form of physical activity reported is walking. Nearly all of the participants have reported that their weight loss has led to significant improvements in energy levels, physical mobility, general mood, self-confidence, and physical health (Klem et al. 1997). Participants (~42%) state that keeping the weight off has not been as difficult as losing it initially (Klem et al. 1997). This is especially true in individuals who have kept the weight off for more than two years (Klem et al. 2000).
Strategies for weight maintenance. Since the initiation of the NWCR, investigators have been analyzing the data to determine successful weight maintenance strategies (Gorin et al. 2004; Hill and Wing 2003; Klem et al. 1997; McGuire et al. 1998; Phelan et al. 2007; Raynor et al. 2006; Shick et al. 1998; Wyatt et al. 2002). In general, most participants report continuing to maintain a low-calorie, low-fat diet and doing high levels of physical activity. The following are some of the specific and most frequently mentioned strategies used by participants who have been successful at maintaining weight loss:
- Eating breakfast. Nearly 80% of participants report eating breakfast every day, with only 4% reporting never eating breakfast. How might eating breakfast contribute to successful weight maintenance? Although there were no differences in total energy intake between frequent breakfast eaters and less frequent breakfast eaters (three times a week or less), breakfast eaters reported being more physically active (Wyatt et al. 2002).
- Monitoring energy and fat intake. A common characteristic of registry participants is that they continue to monitor their energy and fat intake even after the weight loss period is over. On average, participants consume diets with ~24% of energy from fat and have energy intakes lower than average (Shick et al. 1998). As a group, 80% consume diets with <30% of energy from fat, while 35% consume diets with less than 20% of energy from fat. The strategies employed to control food intake include limiting intake of certain high-fat foods, eating less food per meal, counting grams of fat or calories, eating regular meals, and adhering to the same diet regimen throughout the week (Klem et al. 1997; Gorin et al. 2004). Diet consistency across the week appears to help people prevent weight gain (Gorin et al. 2004).
- Exercising daily. Being physical active is an important characteristic of registry participants, with 90% reporting that they exercise, on average, about 1 h or more per day. Weekly energy expenditures from physical activity average ~2800 kcal: ~2500 kcal/week for women and 3300 kcal/week for men (Hill and Wing 2003; Klem et al. 1997). The most common forms of physical activity reported are cycling, aerobics, walking, and running (Klem et al. 1997). Comparison of the levels of physical activity between successful weight loss maintainers and people who had always maintained a normal weight showed that the weight loss maintainers spent significantly more time in high-intensity forms of physical activity and spent more minutes per week doing physical activity (Phelan et al. 2007).
- Engaging in less sedentary activity. It has long been recognized that sedentary behaviors, especially TV viewing, may contribute to weight gain. Raynor and colleagues (2006) examined the TV viewing of registry participants and found that 62% watched <10 h of TV per week, with 36% reporting that they watched <5 h/week. This level of TV viewing is much lower than the national average of 28 h/week.
- Monitoring weight. Nearly 75% of the registry participants weigh themselves at least once a week (Klem et al. 1997). Thus, regularly monitoring weight appears to be a behavior that is important for ensuring that weight regain does not occur.
What we have learned from the participants in the NWCR is that good nutrition, physical activity, and self-monitoring are important for keeping the weight off once it has been lost. Individuals who are successful at weight loss and the maintenance of weight loss appear to employ similar strategies. They eat breakfast, exercise regularly, monitor their diet for both energy and fat intake, participate in less TV watching, and weigh themselves regularly.
Choosing quality ergogenic substances
Because of the many potential risks associated with supplements, it is important to critically evaluate ergogenic substances prior to using or recommending them.
Because of the many potential risks associated with supplements, it is important to critically evaluate ergogenic substances prior to using or recommending them. However, evaluating the marketing, research, and safety of products can be a daunting task in the current regulatory environment. How do you decide what is safe and effective?
Third-Party Evaluations
Several organizations now offer third-party evaluations of dietary supplements. Independent testing of individual products is conducted (usually for a fee) to evaluate such quality control issues as labeling accuracy, purity, strength, and ability to dissolve. For companies that use these services, you will find certifications or seals of approval on their products. A recent certification useful for athletes is the Certified in Sport by NSF International. This program also tests for banned substances. Keep in mind that third-party testing is expensive; the fact that a product is not on the list of certified products does not mean it is unsafe. However, if it is on the list, it meets the criteria set forth by the evaluator.
Australian Institute of Sport (AIS) Sports Supplement Program
In recent years, the Australian Institute of Sport has implemented a sport supplement program to ensure that athletes are using sport foods and supplements safely. A panel of experts evaluates current research on various supplements and categorizes them based on how safe and effective they are.
- Group A supplements: Sport foods and supplements that provide a useful and timely source of energy and nutrients or for which there is scientific evidence supporting improved performance
- Group B supplements: Newer supplements on which not enough scientific studies have been conducted, but that may provide a performance benefit as suggested by preliminary evidence
- Group C supplements: Supplements that have not been shown to improve sport performance or that may impair sport performance-most ergogenic substances fall under this category
- Group D supplements: Supplements that are banned or are at high risk of being contaminated with substances (e.g., steroids) that could cause a positive drug test
Evaluating popular diets
Learn how to recognize a potential fad diet or nutrition program.
Popular or Fad Diets
Fad diets are those that enjoy short-lived success and popularity and are based on a marketing gimmick. Athletes can be particularly vulnerable to fad dieting because of their intense desire to optimize body composition and performance. Celebrities and other well-known persons endorse these diets in an attempt to give them credibility. Justification for these diets is typically based on a scientific or biochemical claim that may be speculative and unproven. Consumers must remember that if the claims associated with the diets were true, there would be no need for people to continue dieting and no need for the next fad diet! For example, if the Dr. Atkins diet, popular in the 1970s, had worked, there would be no need for the "new and improved" Dr. Atkins' New Diet Revolution in the 1990s and 2000s. As mentioned earlier, more modified versions of the Dr. Atkins diet are here to stay but are characterized by less carbohydrate restriction. Because LCDs bring about quick weight loss, they may be used to help people begin or "jump-start" a weight loss regimen.
There will always be a new fad diet in the marketplace, so it is important to understand how to evaluate each new diet and give good dietary advice to your clients. The criteria listed next will help you recognize a potential fad diet or nutrition program. If the diet either you or your clients are considering is associated with one of the following, it is probably just another fad diet:
- The claim that the diet is new, modern, improved, or recently discovered, with no scientific data available to back up the claim
- The claim that weight or fat loss will be rapid, usually more than 2 lb (0.9 kg) per week
- The claim of successful weight loss with no or little physical exercise
- Inclusion of special foods that are expensive and difficult to find; suggestion that foods should be consumed in a particular order or "combination"; suggestion that consumption of certain "bad" foods should be avoided; or inclusion of "magic" or "miracle" foods that will burn fat
- Inclusion of a rigid menu that must be followed daily; restriction to a limited list of foods (these diets frequently require adherents to eat the same foods day after day)
- Inclusion of supplemental meals, foods, or nutrient supplements with the claim that they will cure disease or a variety of ailments
Until we figure out how to solve the obesity problem, the consumer will be bombarded with new weight loss products and programs promising fast weight loss. It is important for nutrition and fitness professionals to educate consumers about the limitations of these products and programs. While some may be physically harmless (albeit expensive), others can cause illness or even death. It is always important to consider the safety and efficacy of any fad diet, including the associated supplements, before recommending it to a client.
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