When is nutrition counselling successful?

This intervention is successful. The success is clearly visible! In fact, we can measure or clearly recognize success in many areas of sport. Athletes are faster, exercises are performed with better technique, body weight is lower, the re are more victories than losses, many goals have been scored, medals are won and records are broken.

Being successful and measuring success by numbers is not uncommon in sports. When it comes to nutrition, many would also like to represent success in terms of specific variables and thus also measure success. But the question is, can successful nutritional support be measured or represented by any number? Does a low weight mean the diet is good? Does low body fat mean that the diet is right? Or do defeats mean that the the current dietary practices are wrong?

Journalists regularly ask me how you can say that support is successful. How do you recognize that? If you can measure success in some areas of sport through figures and results, that is not so easy in nutrition. There is no size that shows that the nutrition intervention is good. Let's take a quick look at the goals of nutrition in sport:

• support health,
• meet nutritional and energy requirements,
• support performance and reduce fatigue,
• become as metabolically efficient as possible
• accelerate regeneration,
• cover fluid requirements,
• well-coordinated energy supply,
• optimize body weight and composition,
• healthy eating habits,
• Food first and if supplements, only those that have been tested and also make sense.

These goals, when achieved, cannot be measured by a number and represented by a number.

In nutrition, there are no record levels and no indicators to achieve.

However, goals achieved can be recognized in different ways in everyday life, in season, in competition.

Achieving goals with nutrition

Health is not so easy to measure, but when athletes are ill less frequently because of better nutrient intake (and therefore lose fewer training days) or incidence of injury (and therefore frequency) decreases, a goal is achieved, which is to support and maintain athletes' health in the best possible way. If you meet your nutritional and energy requirements, you minimize the risk of a deficiency,  underfuelling, an increased risk of injury and thus the risk of health complications.

In competition, whoever has better energy reserves in the final part of a race and can outsprint competitors or is able to maintain a high level of performance until the finish is the winner. This can only be achieved through an adequate supply of energy during competition. Training is also about having good energy till the end. Not those athletes train best, who feel the most empty in the end (and have therefore given everything), but those who can get the best out of their training through optimal energy intake and therefore can set the best stimuli. Because one thing is also clear: being totally empty and finishing a workout really tired does not automatically mean that it was a good workout. Achieving training goals through adequate carbohydrate intake and getting the most out of training without finishing every session completely empty can also be success in nutritional support.

The hours after training are also important. Even though people always talk about training, the time after a workout is no less important. In the end that's the time where training adaptation happens. We talk a lot about energy intake during training. Endurance athletes are familiar with the 90-120 g/h, but what is necessary after exercise in order to support and accelerate regeneration is often less known. When athletes do know what is important after exercise and fill their recovery time with drinks and snacks, and support their bodies with a clear nutrition strategy, then this can also be seen as successful nutritional support.

Of course, high performance sport is also very often about timing. That is also the case with nutrition. When I eat makes a big difference. If I want to achieve something with my diet, I make sure that the intake is done at the right time. For athletes, this also means being equipped and supported in such a way that they can eat at the right time. It's probably the easiest way to do this at home, but athletes travel a lot. Fuelling the body while traveling and having meals available in hotels when they are needed are important. When they're in place, that is also a success because the body is supplied at the right time, which ultimately contributes to performance and health.

And then there is the extensive topic of supplements... a very important one in sports, because our athletes are constantly contacted by companies and their representatives. The latest product with the best effect. It is not easy for athletes to filter out what is relevant in all the huge abundance of supplements and commercials. Many also have no opportunity to contact experts. How do you then decide whether the product is good, important or makes sense? Hopefully, those who have experts in their area will reach out to them before they use a product. I've received a lot of questions from my athletes recently. Does that make sense? What do you think of that? Should I take that? Do I need that? This critical thinking and behavior is perhaps one of the most important goals in sports nutrition. That athletes also question whether they need products. That they try to optimize their diet first and only then consider whether any supplements make sense at all. Food first not only means minimizing the risk of a positive doping test, it also means that the body receives and can absorb the nutrients and chemicals from food in the quantities that work best. Foods with their food matrix are still (with a few exceptions) the best way for supply nutrients.

Finally, there is the topic of eating behavior and the healthy relationship with food. This aspect also has a place in nutritional care and plays an important role. As a result of the fact that body weight is playing an increasingly important role in many sports and the widespread opinion that a lower weight brings more performance, the role of eating has also changed. For some, food has become the enemy, out of fear or frustration because the weight seems too high. As a result, some of the healthy relationship with food has been lost in sports over the last 25 years. Eating is associated with many negative feelings, but eating is something wonderful that enables us to perform in the first place. What would our muscles do if they didn't get any energy? What would our brain do if it ran out of energy? We need energy to live and function, and in sport, the body needs even more of it. One goal in nutritional support is also to teach athletes this key role of nutrition and to show them what nutrition enables them to do. Nutrition is not the enemy in sport; it is the right nutrition that enables us to achieve maximum performance and thus achieve sporting goals. A healthy relationship with food also includes not categorizing food and meals as good and bad. No food is just good, no food is just bad. All foods have their place in the diet and even though some are healthier than others, the consumption of both of one and the other has no immediate consequences in terms of healthy eating habits. If you eat two large pieces of cake at a birthday dinner, that's fine. Two pieces of cake in this one occasion are no problem; it only becomes a problem if you eat two large pieces of cake at every breakfast. Healthy eating habits also allow us to eat something from time to time that is not in line with healthy cuisine - and that completely without consequences, feelings of guilt and stress. In sport, this healthy, relaxed eating pattern isn't everywhere, but it's important. When athletes rediscover this healthy eating pattern and relaxed mindset, this also falls under successful nutritional support.

Low weight doesn't automatically mean perfect nutrition

What has not yet been mentioned in the goals is the optimal weight. Of course, weight also plays an important role in sport and, of course, weight management is one of the areas of nutritional support. However, reaching a certain weight or reaching a lower target weight does not automatically mean that a nutritional intervention is successful and good. We know from many publications and reports that you can achieve a low weight even in an unhealthy way. Starving, fasting, eating disorders, skipping meals, etc. are all ways that can trigger weight loss. However, the weight achieved is never the only decisive factor for successful nutritional support, but also the path that led to the weight. Unhealthy, extreme methods can lead to a target weight, but health consequences often follow, and performance often suffers from incorrect methods of weight regulation too. That is why an achieved target weight is not automatically a success of a nutrition intervention. Only if the path to the target weight meets the experts' recommendations is it a successful nutritional intervention. This is because the intervention also has no negative health effects for athletes.

As you can see, successful nutritional support can manifest itself in many different ways. Each of these goals mentioned above is important. Achieving them, ultimately, contributes to better sporting performance and health. But no individual figures do not indicate successful nutritional support. Healthy eating habits, performance, health, meal timing, food first go beyond a simple number and ranking system including certain parameters.

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Further reading:

Pelly F et al. (2009) Catering for the Athletes Village at the Sydney 2000 Olympic Games: The Role of Sports Dietitians. IJSNEM, 19 (4) :340-54. doi: 10.1123/ijsnem.19.4.340.

Thomas DT et al. (2016) American College of Sports Medicine Joint Position Statement. Nutrition and Athletic Performance. Med Sci Sports Exerc, 48 (3): 543-568 | doi: 10.1249/MSS.0000000000000852

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