WEIGHTGAIN.Athletesinsportsrequiringstrength
or weight lifting (football, rugby, basketball, body-
building) may try to gain weight in order to build the
body’s muscle mass. Inappropriate methods, however,
will lead to gaining fat rather than muscle, putting the
athlete at risk in midlife for high blood pressure, cardi-
ovascular disease, and type 2 diabetes. It is important
for athletes to recognize the genetic limitations related
to their body build, as persons who are naturally slender
cannot add as much muscle tissue to their bodies as
those who are built more solidly.
The safest way to gain weight and build muscle tissue
is to consume 1.5 to 1.75 grams of protein per kilogram of
body weight per day and participate in strength training.
The most effective form of strength training is thought to
be multiple sets of weight lifting with a relatively high
number of repetitions (8–15) per set. Athletes should
avoid the use of dietary supplements in building muscle,
particularly steroids, which have been shown to be harm-
fultohealthinbothmalesandfemales.
Use of ergogenic aids
Ergogenic aidsare drugs or dietary supplements
taken to improve athletic performance or endurance
by providing energy or adding muscle tissue. The most
common ergogenic aids used are anabolic or andro-
genic steroids (male sex hormones), steroid precursors,
growth hormone, creatine (an organic acid stored in
the body that supplies energy to muscle cells), and
ephedra, an herb sometimes called by its Chinese
name, ma huang. Some ergogenic aids are illegal to
use in competition.
Medical and nutritional professionals are con-
cerned about the use of ergogenic aids among young
athletes for two major reasons. The first is that these
drugs and supplements, first used by adult athletes in
the 1980s, are now being used by children as young as
10 or 12. The second is that creatine and anabolic
steroids may produce long-term adverse effects on
the body even though they do produce gains in
body mass and strength, while steroid precursors,
ephedra, and growth hormone pose a good many
risks to health without any proof that they enhance
athletic performance.
The ADA’s position statement says, ‘‘Nutritional
ergogenic aids should be used with caution, and only
after careful evaluation of the product for safety, effi-
cacy, potency, and whether or not it is a banned or
illegal substance.’’
Precautions
Consultation with a qualified sports nutritionist is
a sound practice for anyone in any age group who is
heavily involved in any sport, whether amateur or
professional. Specific precautions:
Consultation should be individualized, as people
vary in their energy needs, sweating rates, body com-
position, etc.
Any female athlete who stops having menstrual peri-
ods (amenorrhea) or has only scanty periods (oligo-
menorrhea) should be evaluated for disordered
eating.
Nutritional advice should be given by a registered
dietitian or physician, not by a coach. The American
Academy of Pediatrics notes that ‘‘most coaches do
not have an adequate nutritional background to
counsel an athlete about weight loss.’’
Coaches should avoid discussing weight loss with
young athletes (with the exception of sports requiring
weigh-ins before competition), as such discussions
often lead to the athlete’s use of harmful weight-
loss practices.
Athletes should not take any dietary supplement
without consulting their physician and a nutritionist.
Athletes following a vegetarian or vegan diet require
special attention to protein and iron intake.Interactions
Some herbal dietary supplements used by athletes
are known to interact with prescription medications,
such asSt. John’s wort(Hypericum perforatum) and
ephedra (Ephedra sinica), often used to promote
weight loss; valerian (Valeriana officinalis), often
taken for insomnia; cayenne (Capsicum frutescens),
ginseng(Panax ginseng), and cordyceps (Cordyceps
sinensis), taken internally to increase carbohydrate
metabolismor increase endurance; and Siberian gin-
seng (Eleutherococcus senticosus)andechinacea
(Echinacea angustifolia), taken to boost the immune
system. Some of these drug interactions are potentially
serious. Athletes should not take any herbal remedies,
including those marketed specifically to athletes, with-
out consulting their physician and a nutritionist.Complications
There are no complications associated with nutri-
tional monitoring of athletes by qualified professio-
nals. The AAP, however, recommends seeking
nutritional information and assessment from dietetics
professionals, not from team coaches or personal
trainers.Sports nutrition