accompany severe dieting, usually result in diet
failure or relapse.
If energy intake decreases below 7.6–8 MJ ·
day–1 (1800–1900 kcal · day–1), nutrient intakes
can be severely compromised (Beals & Manore
1994, 1998; Manore 1996). This level of energy
intake is not adequate to replace muscle glyco-
gen and fuel the athlete during intense training
periods. Athletes have higher protein and car-
bohydrate requirements than their sedentary
counterparts (Coyle 1995; Lemon 1995). When
dieting, carbohydrate intake should remain as
high as possible (60–70% of energy) and protein
intake at 1.2–1.8 g · kg–1 body weight (Lemon
1995), while fat intake is reduced to 15–25% of
energy. Prolonged energy restriction also places
that athlete at risk for low dietary intakes of
calcium, iron, magnesium, zinc and B complex
vitamins (Manore 1996; Beals & Manore, 1998).
Thus, it may be necessary for athletes to use
vitamin and mineral supplements during long
periods of energy restriction (>3–4 weeks). This
may be especially true if the athlete makes poor
food choices, eats primarily processed or conve-
nience foods, or eliminates various food groups
from the diet.
Any weight loss plan for an athlete should
moderately reduce energy intake while teaching
good food choices. It is much easier to teach ath-
letes how to eliminate or reduce high fat and
energy dense foods from their diet than to count
kilocalories. They also need to become aware of
the situations and emotions that trigger overeat-
ing or binge eating. Athletes need to learn the
nutrient composition of the foods they eat and
why they eat them. This knowledge is useful in
developing a diet plan around better food
choices, training schedules, budgets and periods
when overeating is most likely to occur.
Role of exercise
Exercise is necessary for both weight loss and
weight maintenance. Unlike the general popula-
tion, most athletes participate in hard physical
activity. However, which activities are best for fat
loss? It is well documented that aerobic activity
480 practical issues
oxidizes fat; however, recent evidence indicates
that high-intensity anaerobic activity added to
an aerobic exercise programme may be better at
reducing body fat than aerobic-only exercise
(Trembly et al. 1994). Weight training can also
help preserve FFM and strength while dieting
if energy restriction is not too severe (Donnelly
et al. 1994). Thus, the type of exercise added to
a weight-loss programme will depend on the
current training practices of the athlete.Behaviour modification and
weight maintenance
In order for weight loss to be maintained,
changes in diet and exercise habits need to
become part of the athlete’s lifestyle. Foreyt and
Goodrick (1993) and Klem et al. (1996) found that
individuals who are successful at losing and
maintaining weight loss have the following
characteristics in common: they modify diet,
especially energy intake from fat; they exercise
regularly and monitor their weight; and they
have high levels of social support from family
and friends. These changes can be achieved by
first identifying the eating or exercise behaviour
that needs to be changed, then setting specific
and realistic goals for changing this behaviour.
Changes in behaviour should be made slowly
and modified as necessary. Finally, successful
behaviour is rewarded. This approach to weight
loss and maintenance will take time and may
require continuous social and professional
support (Foreyt & Goodrick 1991).Conclusion
Successfully guiding the overweight athlete
through the weight loss process is a challenge for
both the athlete and the sports medicine team.
Identifying the appropriate weight loss goal and
method is imperative for a successful outcome.
These basic considerations need to be re-
membered before beginning any weight loss
programme:- Both energy intake and expenditure are impor-
tant. If energy intake is less than energy expendi-