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Aiming for Healthy Weight in Wrestlers and Other Athletes by Vito A

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Aiming for Healthy Weight in Wrestlers and Other Athletes by Vito A Aiming for healthy weight in wrestlers and other athletes By Vito A. Perriello, Jr., MD Wrestlers and athletes in other “weight-sensitive” sports are at high risk of engaging in unhealthy weight-loss practices. Learning how to intervene effectively will help you deal better with weight issues in all your patients. nhealthy weight loss and sports, unhealthy weight loss Ⅲ Pediatricians are more likely to suboptimal nutrition, along practices are prominent in both encounter patients experiencing Uwith disordered eating habits sexes, with reported prevalences weight loss problems in wrestling and eating disorders, are significant of 10% to 15% in boys and 25% to than in most other sports. problems among adolescents. Seventy- 30% in girls.3,4 Ⅲ Other health issues associated five percent of patients with dis- Weight-sensitive sports involve with wrestling, such as injury and ordered eating develop the problem either a requirement to reach a spread of infection, put wrestling during adolescence.1 specific weight or a perception in the fish bowl of public scrutiny. Because 90% of eating disorders that an advantage exists if the This year, the National Fed- occur in girls and women, most athlete performs at a lower eration of State High School Asso- discussion in the literature focuses weight. Sports often cited for ciations, the governing body for on this as a female problem. A having a high incidence of ath- high school athletics, recom- 1995 study of middle schools in letes engaging in unhealthy nu- mended to the wrestling rules North Carolina, however, found trition and weight loss prac- committee that all states have that, in addition to the 10% of tices include rowing, gymnastics, weight management programs in girls in the sixth to eighth grades cross country, cheerleading, place for wrestling no later than who reported using vomiting and dancing, and wrestling. Although 2004. Physicians across the coun- laxatives to lose weight, 4% of many of the same concerns apply try may therefore be called upon boys reported similar practices.2 to all of these sports, this review to certify the minimum appropri- Among athletes, especially those focuses on unhealthy weight loss ate weight for participation in participating in “weight-sensitive” practices in wrestling for several wrestling, especially if a youngster’s reasons: natural weight is below the recom- Ⅲ THE AUTHOR is a general pediatrician in private The magnitude of the weight loss mended minimum. Physicians practice in Charlottesville, Va. He serves on the problem in wrestling is great and making these decisions for patients Medical Advisory Committees of the Virginia High has been well-documented, with involved in wrestling and other School League and the National Federation of studies reporting as many as 45% weight-sensitive sports need to be State High School Associations. He is clinical assistant professor of pediatrics, University of wrestlers at risk for a major familiar with techniques for deter- 5,6 of Virginia School of Medicine. eating disorder. mining body fat and appropriate Wrestlers photographer: Jill Sabella/FPG International September 2001 CONTEMPORARY PEDIATRICS 55 WEIGHT AND WRESTLING TABLE 1 weight management pro- Medical concerns more likely to try diuretics, grams. This information also chromium, pyruvate, or can provide a valuable tool associated with wrestling ephedrine (ma huang) to lose for educating youngsters weight. [Editor’s note: For Injuries about nutrition, fitness, and more on supplements, see healthy weight loss or gain, Wrestling ranks fourth in nonfatal catastrophic sports injury “Nutritional supplements whether or not the youngster Wrestling ranks first or second in overall sports injury rate and the young athlete: What participates in sports. you need to know” in the Three wrestlers died from wrestling-related causes in 1998 July issue, also accessible Health concerns Use of supplements at www.contpeds.com.] in wrestling Alleged fat-burning supplements (more common These substances have not Wrestling has a long and in wrestling than in other sports) been shown to be effective, storied history. Drawings of Ephedrine (ma huang) and their use presents sig- wrestling holds have been nificant risks to young found in Egyptian tombs Chromium athletes. from 2,500 BC, and wrestling Pyruvate The greatest medical was one of the five sports in Androgenic supplements (less common in wrestling concern associated with the first Quadern Olympiad than in other sports) wrestling is the dangerous in 776 BC. Participation in weight loss methods used by Creatine wrestling has been shown to many wrestlers. In 1998, contribute positively to self- Androstenedione these behaviors led to the esteem, mental and physical Spread of contagious disease deaths of three collegiate toughness, self-discipline, wrestlers that were directly Viral illnesses (rhinovirus, influenza) and character. Despite these attributed to excessive weight positive attributes, wrestling HIV infection/hepatitis (theoretical but not reported) loss.10 has suffered from the general Skin disease (herpes gladiatorum, impetigo, perception that it is an un- tinea gladiatorum) What is fighting weight? healthy sport. The medical Inappropriate weight loss literature substantiates this For most young athletes in all perception to some extent. Excessive weight loss sports, the best weight at Table 1 lists some of the Too rapid weight loss which to compete is the ath- medical concerns associated Cycling of weight (repeated rapid loss and gain) lete’s natural weight, which is with wrestling.7 In addition defined as out-of-season to a high injury rate, the weight when eating and exer- spread of infectious diseases, hepatitis B is not zero, it is extremely cising in a healthy manner. Studies highlighted by documented epi- low, and no documented trans- suggest that a body fat percentage demics of herpes gladiatorum, mission in the course of sports of 7% to 9% is efficient meta- has long concerned the wrestling participation has been reported. bolically for most males. For most community, and much work has The use of supplements in all females the most efficient and been done on developing guide- sports is of concern to the sports healthy percentage is 12% to lines for wrestlers’ return to medicine community. In contrast 15% body fat.4,11 Attempts to participation after developing skin to athletes in many other sports, achieve body fat compositions be- diseases.8,9 Although the risk for who take supplements such as cre- low these percentages usually re- spread of systemic contagious dis- atine or androstenedione to gain quire unhealthy eating practices. eases such as HIV infection and weight and strength, wrestlers are No evidence exists to suggest any 56 CONTEMPORARY PEDIATRICS Vol. 18, No. 9 WEIGHT AND WRESTLING additional benefit in metabolic effi- myth that wrestling at a lower Losing weight too rapidly, losing ciency or performance at lower weight for the same height improves an excessive amount of weight, and levels. These percentages are con- leverage and provides an advantage frequent “cycling” of weight (rapid, sidered the minimum for most per- over one’s opponent. Because it is repeated loss and gain), on the sons and therefore are not neces- difficult to demonstrate how an ath- other hand, can undermine health sarily the natural or ideal for a lete would have performed at differ- and well-being. Such unhealthy given youngster. ent weights, no convincing data are patterns generally occur only if Because of ethnicity or genetics, available to show whether perfor- water is lost—which can lead to some youngsters’ natural weight mance is better or worse at lower dehydration—or “fat-free” tissue may place them below the 7% weight classes. Wrestling at a lower (such as muscle) is lost because of minimum body fat for males and weight class may also be motivated inadequate caloric intake. Neither 12% minimum for females. A by the desire to avoid competing type of weight loss benefits athletic physician familiar with the youth against a wrestler in the athlete’s performance and, when carried may be asked to verify that he or more natural weight class who is to extremes, can impair growth, she is healthy and fit and can safely significantly better or to help the strength, and endurance. participate at his or her present team fill an empty weight class slot. In female athletes, the triad of weight even though body fat is be- Last, many in the wrestling commu- osteoporosis, amenorrhea, and low the established minimum. The nity have developed a mentality of eating disorders, along with de- physician should feel comfortable commitment, sacrifice, and self- layed physical maturation, have certifying such a youngster for discipline that traditionally sees been linked to excessive weight participation if medical records weight loss as a critical component loss and sports participation at document a consistent pattern of of the “no pain, no gain” philosophy. weights below minimum natural weight and no evidence of mal- weight. nutrition or pathologic eating or When is losing weight Weight loss in prepubertal chil- exercise behaviors. harmful? dren is an even greater concern if Obviously, not all weight loss is not undertaken cautiously. Ex- Why do wrestlers harmful. Anyone, including an cessive restriction of caloric in- want to lose weight? athlete, can benefit from losing take and inadequate nutrition Most athletes who want to lose body fat in certain circumstances. during growth can have an ad- weight are motivated by a desire Excessive fat does not enhance an verse effect on adult height and for improved appearance, better athlete’s performance, even in foot- health. performance, or perceived compet- ball where coaches often seek out Two kinds of weight-loss prac- itive advantage. Sports such as heavy players. It can hamper heat tices in wrestlers are cause for con- wrestling, crew, and youth football acclimatization, speed, endurance, cern. One is loss of weight to a require that teams or individuals and work efficiency.
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