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Spring 2016 Elevate Health Elevate A quarterly research digest of the President’s Council on Fitness, Sports & Nutrition Series 17, Number 1 Spring 2016 ENT’S CO ID UN ES C R IL HEP ALTH O N N O F I I T IT N R fitness. sports. nutrition. E T S U S, N SPORTS & Healthy Foods and Beverages for Youth in Sports In partnership with ENT’S CO ID UN ES C R IL P O N N Opening Commentary O F I I T IT N R E T S U S, N SPORTS & Misty Copeland, Member President’s Council on President’s Council on Fitness, Sports & Nutrition Fitness, Sports & Nutrition Guest Authors As a ballerina, I have the opportunity Michelle Draxten, MPH, RD to spend long days doing what I love to Lifestyle Medicine Program for Weight Management do—dance. It requires a great deal of University of Minnesota Physicians discipline in order to push my body Toben F. Nelson, ScD further to reach my goals. Along with Division of Epidemiology and Community Health the countless hours of practice and School of Public Health outside physical activity pursuits, fueling University of Minnesota my body with the proper nutrients is Editor-in-Chief an important component of being an Rachel K. Johnson, PhD, MPH, RD, FAHA athlete and ballerina. Robert L. Bickford, Jr. Green and Gold Professor of Nutrition When I was younger, I spent time Professor of Pediatrics participating in various activities as a part University of Vermont of my local Boys & Girls Club. It gave me the Editorial Board chance to be active through play and learn Alexandra Evans, PhD, MPH about healthy food options that would help University of Texas at Austin me as I started to focus more on dance. My time as a young athlete and learning Diane L. Gill, PhD about how to properly fuel my body to ensure I could become the best dancer University of North Carolina at Greensboro I could be has shaped my life to this day. Jeffrey I. Mechanick, MD, FACP, FACE, FACN Icahan School of Medicine at Mount Sinai On a typical day, I try to eat foods high in protein accompanied by fruits, Leah E. Robinson, PhD vegetables, and whole grains. For snacks, frozen grapes and pistachios are some University of Michigan of my favorite treats. Hydration is also an important part of my training schedule. Diane Wiese-Bjornstal, PhD I drink a lot of water to make sure my muscles have enough stamina to dance University of Minnesota the title role in The Firebird and other demanding performances. In this issue of Elevate Health, Michelle Draxton, M.P.H., R.D., and Toben F. INDIANA UNIVERSITY Nelson, Sc.D., explore the need for parents, doctors, school officials, public BLOOMINGTON health leaders, and youth themselves to create opportunities to make healthy foods and beverages more readily available for young athletes. The authors This publication is made possible by a co-sponsorship agreement with Indiana provide examples of why healthy eating is a challenge for many young athletes, University School of Public Health- explain what young athletes should eat and drink, and offer some suggested Bloomington, Department of Kinesiology. solutions for making healthy foods available for young athletes. The findings and conclusions in this paper are those of the authors and do not necessarily represent My time as a young athlete and learning the official position of the President’s Council on Fitness, Sports & Nutrition or the U.S. Department about how to properly fuel my body to ensure of Health and Human Services. I could become the best dancer I could be has shaped my life to this day. ’’ —Misty Copeland 2 ELEVATE HEALTH Healthy Foods and Beverages for Youth in Sports Nutritious eating habits promote healthy Unhealthy Eating is development and allow young people to perform their best in school and other an Accepted Part of activities. Parents, doctors, school officials, Youth Sports public health leaders, and youth themselves have recognized the importance of adopting Unfortunately, youth sport activities are not better eating habits and creating opportuni- currently living up to their potential as a ties to make healthy foods and beverages setting for promoting healthy eating. more easily available. Working together, these According to the Dietary Guidelines for groups have made significant efforts to Americans, healthy eating emphasizes foods improve the foods and beverages available in such as fruits, vegetables, whole grains, lean many schools. Although much more can be meats, and low-fat milk products. Healthy accomplished in school settings, overall, eating provides a balance of protein, carbohy- these changes have led to better diets and drates, fat, water, vitamins, and minerals and healthier students.1,2 a limited amount of calories. Unhealthy eating includes foods and beverages that are One setting that has received comparatively high in fat, sugar, sodium, and calories. It is less attention for encouraging healthy eating possible for youth to find unhealthy food 3 is youth sports. Youth sports are terrific and beverage options most anywhere they go, venues for promoting health because sports including from vending machines, conces- touch the lives of many youth. Today, youth sions, convenience stores, and fast food sports are more popular than they have ever restaurants. This is especially true in youth Each year, more 4 been. More than 44 million youth in the sport settings. than 44 million youth United States participate in sports each year, and two in three students in high school play in the United States on at least one sports team at their school or participate in sports, and in their community.5,6 Sports, including soccer, basketball, tennis, and dance, among two out of three high others, offer youth an opportunity to engage in vigorous physical activity while they learn schoolers play on at least how to work together, have fun, and compete one sports team. toward a common goal. For these reasons and many more, participation in sport can promote healthy development for youth and adolescents.7,8 3 ELEVATE HEALTH Physical Activity and activity.17,18 While most sports involve vigorous physical activity, they also involve Eating Habits in Sport considerable time in light activity or no Are Out of Balance activity, such as waiting on the sidelines to enter the game and standing around between The widespread availability of unhealthy plays or while receiving instruction from foods and beverages in sport settings helps coaches. The amount of energy expended in contribute to a cultural norm of accepting, sport can vary by type of sport, age of the and even expecting, unhealthy eating as a participant, coaching practices, and other part of youth sport. Parents and coaches view factors, but the data suggest the amount of post-game snacks, concession stand items, energy expended in sports is relatively and fast food meals in youth sport as an modest.17,18 If youth consume the types of occasional indulgence that is permitted, even foods that are widely available in youth sport if it is inconsistent with the foods prepared at settings, they may be overcompensating for home.12,16 We have heard anecdotally, and the amount of energy they expended in the when conducting systematic focus group sport’s activity by taking in extra calories. They research, that part of the reason that coaches are also consuming foods and beverages that and parents may relax their usual standards may fail to provide the appropriate balance for healthy eating is that they see youth of nutrients that comprise a healthy diet. engaging in vigorous exercise during sport.12,16 Parents and coaches report that Youth who participate in sports consume they believe this activity offsets the potential more fast food, more sugary drinks, and downside of any unhealthy foods or bever- more calories overall than youth who are not ages they may have consumed.12,16 A involved in sport.3,9,10 The foods and common view of post-game treats is beverages that are convenient and widely exemplified by the following statement from available to youth in sport settings are the parent of a child participating in sport: generally unhealthy.11–13 For example, “These kids have been running around for an concession stands are common in youth hour. They can have ice cream.” sport settings. Typical choices at concession Despite this belief, research suggests that stands include items such as chocolate and parents, coaches, and young athletes may other candy, ice cream, salty snacks, sugary overestimate the amount of physical activity beverages, and high-fat, calorie-dense entrees sports provide. Studies that objectively such as hot dogs and pizza. Healthier measure the amount of physical activity alternatives are rare. Additionally, parents youth gain during sports have found that often organize schedules for providing treats only about one in four achieve recommended Physical activity studies after each game for their child’s team. These levels of daily activity.17,18 The U.S. Depart- treats often include candy, doughnuts, chips, suggest only about one ment of Health and Human Services (HHS) and sugary drinks. Parents report that team Physical Activity Guidelines for Americans, in four students who engage members and other parents can have a 2008 recommend that children and adoles- negative reaction when offering healthy in sports achieve cents accumulate 60 minutes of moderate to choices for post-event treats, such as fruit. vigorous physical activity each day.19 Youth sport schedules often overlap with recommended levels Examples of moderate intensity physical regular family meal times and encourage activity for adolescents include
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