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Sidelined with an Injury: How do I prevent weight gain?

Written by Heather Nakamura, MPE, MS, RD.

Scott Kuehnertore his hamstring cross-country skiing a couple of years ago and has experienced ongoing problems with it since then. He has been working with a physical therapist for the past year or so, and has finally been cleared to start running again. I talked with Scott at a sports nutrition presentation I gave at REI, and he expressed frustration that his limited activity had resulted in weight gain. He was used to running 3-4 times per week and hiking, climbing or skiing on the weekends, but had been unable to do these activities for the past two years. Since his activity level would still be limited for the next few months, we decided to review his diet to make sure it was supporting his weight loss efforts.

Male. Age: 47. Height: 6’0”. Weight: 181. Goal Weight: 170. Occupation: Geologist

Training Program: Yoga – 90 minutes: Other activities presently limited due to hamstring injury.                             

First visit: 4/18/02:

During our first meeting, Scott and I talked about some of the “nutrition pitfalls” that had likely promoted weight gain. As is the case with many active people who become injured, his eating habits had changed as he became more sedentary. He started to increase his intake of sweets and alcohol, and wasn’t as motivated to make healthy choices. His exercise program wasn’t optimal for weight loss either, so we discussed some ways he could make it more effective.

Body Composition Test

Current weight: 181 pounds        Percent Body fat: 20.5%
Lean Weight: 144 pounds           Fat weight: 37 pounds

Goal weight at 16% body fat: 171

Goals:

1.       Increase your aerobic activity to three times per week for at least 30 minutes. Since your running is still limited to short bouts, try to include other activities that don’t affect your injuries and that you can do for an extended period of time. Do an interval workout of brisk walking and jogging for 30 minutes once per week, then add another two days of low-impact cross-training activities like stationary cycling or swimming.

2.       Add a weight-training program to replace lost muscle mass:Once of the biggest challenges facing any injured athlete is preventing the loss of muscle mass. Most people who decrease their level of activity tend to lose significant amounts of muscle, which can decrease their resting metabolism. This decreases their calorie needs, though many people don’t adjust their calorie intake accordingly. Adding a total body weight training program, 2-3 times per week, will help to replace the lean body mass you’ve lost and give your metabolism the boost that it needs.

3.       Add a protein-containing snack mid-morning and mid-afternoon:Many people experience cravings for sugar and alcohol when their blood sugar drops below a certain level. Eating a balanced meal or snack (containing both protein and carbohydrate) every 3-4 hours, can help to prevent these drops in blood sugar. Try adding some fruit and yogurt mid-morning, and snacking on string cheese and veggies in the afternoon.

4.       Limit your caloric fluids: A common problem I see with clients struggling to lose weight is the fact that they consume too many caloric fluids. Studies have shown that people who consume caloric fluids before a meal don’t reduce their calorie intake accordingly. In other words, if you consume 250 calories of beer before dinner, you won’t eat 250 calories less during mealtime. This becomes a problem when you drink lots of caloric fluids during the day, such as soda (16 oz = 120 calories), beer (16 ounces = 150 calories), and juice (16 ounces = 225 calories).

SECOND VISIT: 5/2/02

Scott returned for his second visit, having lost three pounds and feeling much better than before. He was eating more balanced meals and snacking regularly, which had improved his energy and decreased his hunger in the evening. He also found that this new pattern of eating had made it easier to decrease his intake of high-fat snacks and alcohol. He had begun to incorporate weight training into his exercise program and said that the workouts were challenging, but felt good. He mentioned feeling fatigued the morning after his yoga classes, and wondered what he could do to prevent that. We discussed the following goals for his next visit:

Goals:

1.       Hydrate before yoga - rehydrate after class: Bikram’s is a form of yoga that involves exercising in up to 100-degree temperatures. Though the heat can be helpful in promoting flexibility, many people underestimate the toll that the elevated temperature can take on their body. It sounds like you may be suffering from dehydration the morning after your class. One way to makes sure you are fully rehydrating after each session is to weigh yourself before and after each session. You should drink 2 cups of water for every pound you lose on the scale (Unfortunately, any weight change will be due to loss of water – not fat!)

2.       Measure your starch servings at dinner. Overeating carbohydrates is common with active people, especially if they were used to being able to eat more in the past. It’s helpful to measure your starch servings for a few days, until you get a feel for “eyeballing” the appropriate portions. This can be particularly helpful when dining out, since restaurants tend to serve you 2-3 times what you should be eating.

THIRD VISIT: 6/18/02

Scott reported that he had been performing about three short bouts of running per week, along with some balanced weight training, but his activity was still limited due to recurrent hamstring pain. He had continued to make some positive changes in his diet, substituting diet coke for regular, increasing his water intake, and snacking on fruit and veggies regularly. His weight had decreased another five pounds since his last visit, and he was anxious to see the results of his body fat test.

Body Composition Test

Current weight: 175 pounds        Percent Body fat: 18.2%
Lean Weight: 143 pounds           Fat weight: 32 pounds

Changes since last test:

Total weight: - 6 pounds       Body Fat: - 2%

Fat weight: - 5 pounds          Lean weight: - 1 pound

Ongoing Goals:

1.       First, congratulations on your successful efforts! Losing 2% body fat over two months is a great accomplishment, especially when your activity level has been limited. Your weight loss was a direct result of the healthy changes that you made in your diet, since you were unable to increase your activity level significantly.

2.       Focus on cross-training and extended cardiovascular activity: In order to promote continued weight loss, focus on adding more activities that don’t aggravate your current injuries. It sounds like you can tolerate cycling and hiking on relatively flat terrain. Try to incorporate longer bouts of those activities on the weekends, increasing the time slowly and backing off if pain occurs. (Don’t forget to use ice and ibuprofen as necessary!) Continuing to increase the intensity of your weight training workouts will also help to minimize further losses of muscle mass. Keep up the great work!!

 


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