Sports Nutrition -Role of Diet

Sports Nutrition Unit 8 Role of Diet if Athletics Maximize their performance Provide the necessary raw material to allow a good training program to build and run the human machine Nutritional status, age, genetic background affect nutrient needs Diets must be individualized Many myths and fads among athletes Purpose of Nutrition Good Nutrition promotes a healthier mind and body Aids in resistance to illnesses Energy and vitality are increased Help athlete feel better and sleep better Functions of Food The right combination of nutrients work together in the body to: Provide heat Promote growth Repair tissue Regulate body processes The United States Department of Agriculture (USDA) Developed The Food Guide Pyramid Provides the following basic dietary guidelines: Eat a variety of foods Avoid too much fat, especially unsaturated fat and cholesterol Eat food with adequate starch and fiber Maintain a desirable body weight Avoid too much sodium and sugar The Food Guide Pyramid The categories in the pyramid are not considered to be equals Idea is to get people to eat more of the foods at the base of the pyramid and fewer foods in the groups toward the top Benefits are many Lower fat Increase Fiber Get more vitamins and minerals in diet Protect yourself from illness Breads,Cereals, Rice and Pasta Group 6-11 servings per day Foundation of a healthy diet Good source of complex carbohydrates, which are rich in vitamins, minerals and other nutrients Ideally 50-60% of the daily calories in a typical American diet should come from complex carbohydrates Vegetable Group 3-5 servings per day Naturally low in fat and high in fiber Provide crucial vitamins and minerals One serving consists of: one cup of leafy vegetables one-half cup of other vegetables one potato or ear of corn Best to eat a variety Many vegetables help lower a person’s risk of cancer Fruit Group 2-4 servings per day Excellent source of vitamins, minerals, and fiber Fruits may protect against cancer Serving of fruit consist: Medium apple, banana or orange half cup of chopped, cooked, or canned fruit three-quarters of a cup of fruit juice Meat, Poultry, Fish, Dry Bean, Egg and Nut Group 2-3 servings per day Excellent source of proteins Build framework for our muscles, bones, blood, hair, and fingernails and essential for growth and repair Supply various vitamins and minerals Serving consists of: 2-3 oz of lean, cooked mean, fish, or poultry or about the size of your palm One egg or 1/2 cup dry beans Milk, Yogurt and Cheese Group 2-3 servings per day Milk and yogurt are best sources Choose products that are low fat or non-fat One Serving consists: 8 oz cup of milk One cup of plain yogurt 11/2 oz of hard cheese 1 tablespoon of cheese spread Fat, Oil, and Sweet Group Use sparingly These are placed at the very top of the pyramid so that all Americans will realize they should use them only in very small amounts Supply little or no vitamins or minerals Added sugars are often hidden in favorite foods (sweeteners in jam, jellies or syrup) Basic Nutrients Chemical substances in food that: provide energy act as a building block in forming new body components Assist in the functioning of various body processes 6 classes Carbohydrates, Proteins, Fats, Vitamins, Minerals, and Water Carbohydrates Basic source of energy for body heat and body activities Sugars, starches, and fiber found in fruits, vegetables and grains Body converts sugars and starches to glucose for energy or to glycogen for energy storage in the liver and muscles When glycogen stores are full, excess carbohydrates are stored to fat Fiber is not absorbed but is essential for gastrointestinal functioning 50-60% of caloric to keep glycogen stores filled Carbohydrate loading requires 70-80% carbohydrate intake Proteins Derived from animal foods-meat, milk, eggs, fish, cheese and poultry Derived also from soybeans, dry beans, some nuts and whole grain products Broken down into 20 amino acids 8 are essential to build and repair tissue Bodies least efficient source of energy Body can not store protein, therefore extra is converted into fat Intake 10-12% of caloric intake Fats (Lipids) Fried foods, butter, margarine, salad dressings, oils, mayonnaise are all high sources Meats, eggs, milk and cheese contain fat too Provide energy, carry vitamin A and D to cells, and are necessary for normal growth and development Insulate the body from temperature extremes Protect and shield body organ’s from impact Add flavor to our food Fats cont... Are necessary, in fact important in diet Often eat far more than the daily recommended values 30% of caloric intake is recommended Most Americans consume 50% or more of their caloric intake from fat High fat diets are associated with heart disease, hypertension and cancers Saturated or Unsaturated Fats Saturated fats tend to raise the cholesterol level of blood Unsaturated fats are subdivided Monounsaturated Are neutral effect on cholesterol Polyunsaturated Lower the cholesterol level in blood Fats are not digested as quickly as other nutrients Considered basic source of muscular energy, since they are used when carbohydrates are depleted Vitamins Essential for maintaining good health Lack of vitamins lead to deficiency conditions Most cannot be synthesized by body and must be ingested via foods or pills No single food or food group will supply all vitamins needed by the body Eat a variety of foods Fat Soluble or Water Soluble Vitamins Fat Soluble Vitamins A, D, E, and K Emulsified and absorbed in the small intestines Stored in body cells, especially the liver Water Soluble B complex and Vitamin C Absorbed along with water through the digestive track and dissolve in body fluids Body does not store well, excess excreted in urine Minerals Inorganic substances Have functions essential to life Calcium Necessary for bone strength and muscle contractions Potassium Regulates cardiac rhythm Iron Assists hemoglobin in the delivery of oxygen to body tissues Sodium Essential in maintaining fluid balance Phosphorus Needed for strong bones and teeth Water Necessities of life Most of water intake is ingested in the daily diet as fluid or as the fluid contained in solid food Metabolism Chemical reactions occurring in the body Two phases Catabolism Reactions which break down complex organic compounds into simple compounds Provides Energy Anabolism Series of reactions whereby small molecules are built into more complex molecules Form body’s structural and functional components Requires energy Sports Nutritional Myths Calories are calories False- a variety of nutrients are very important to maintaining a healthy diet Athlete’s bodies require supplements during training False-Supplements are only required when the diet is not able to meet the body’s demands Protein build strong bodies False-Exercise builds strong bodies. Protein is required to repair tissue but does not build muscle by itself Sports Nutritional Myths When we need fluids, we feel thirsty False- We need water long before we feel thirsty. Constant fluid replacement is required. Body weight matters most; light athletes are faster False- Body composition is more important than body weight. Muscle is heavy. Sports Nutritional Myths The only food intake that really matters is the food ingested immediately before an important event False-Nutrition is a long-term pursuit and what you eat weeks before an event can effect your performance What you eat between and after events doesn’t matter False-What you eat before, during, and after an event can affect your performance. Post event is very important for rapid recovery Pre Game Meals What you eat before you train or compete has four main functions To help prevent hypoglycemia To help settle your stomach, absorb some of the gastric juices and decrease hunger To fuel your muscles with food eaten in advance that is stored as glycogen and food eaten within an hour To pacify your mind with knowledge that your body is well fueled Nutrition Benefits for Sport Performance Eat adequate high carbohydrate meals To fuel and refuel your muscles Food eaten an hour before exercise keeps you from getting hungry and maintains your blood sugar, they don’t replenish muscle glycogen stores If exercising for longer than 60-90 minutes intake carbohydrates that enter bloodstream slowly as they are digested Rice, pasta, yogurt, oatmeal, bean soup, apples, banana If exercising for less than an hour snack on foods that digest easily and will settle Bread, English muffins, bagels, crackers, pasta Nutrition Benefits for Sports Limit high-fat proteins like cheese, steak, hamburgers and peanut butter These proteins take longer to empty from the stomach Fat delays gastric emptying and cause sluggishness and nausea Be cautious with sugary foods Soft drinks, jelly beans, sport drinks etc… Quickly enter the bloodstream as they are digested If eat within 15-20 minutes before hard exercise can drop the blood sugar , leaving one tired, light-headed, and fatigue Nutrition Benefits for Sports Allow adequate time for food to digest High calorie meals take longer to leave the stomach than do lighter snacks Allow 3-4 hours for a large meal to digest, 2-3 hours for a smaller meal and 1-2 hours for a liquid meal and less than an hours for a small snack If you get jittery and are unable to tolerate any food before an event Have an extra-large bedtime snack instead of breakfast Learn how to best fuel your body Nutrition Benefits Cont… Always eat familiar foods before competition Don’t try anything new New foods always carry the risk of settling poorly, causing intestinal discomfort, acid stomach, heartburn or camps Drink plenty of fluids You are unlikely to starve to death during an event, but you might dehydrate Drink an extra 4-8 glasses of fluid the day before Drink at least 2-3 glasses of water up to 2 hours before Dink another 1-3 glasses 5-10 min before start Pre-Event Training Tapering It is wise to gradually decrease the training program about 48 hours before competition This enables the body to replenish essential stores Reduces or allows body to eliminate various metabolites that might reduce performance Alternate Eating Patterns Food fads are rampant among athletes NO food, vitamin, hormone or supplement will substitute for sound nutrition and hard work Vegetarian diet Primary concern is whether enough protein is consumed Proteins have essential amino acids and are balanced better in animal products than plant foods Must carefully plan diet to include all amino acids Carbohydrate Loading Endurance athletes whose events last for more than 90 continuous minutes benefit best from carbohydrate loading Long distance runners, swimmers, bicyclists and cross country skiers May also benefit athletes involved in sports that require prolonged movements of varying intensities Soccer, lacrosse, ice hockey, as well as tournament sports Carbohydrate Loading Defined as saturating the muscle with carbohydrates- the body’s most efficient source of fuel 1-3 pounds of water weight is usually gained during carbo-loading, since water is stored with glycogen 70-80% of calories should come from carbs, 1015% from fat and 10-15% from protein Carbohydrate Loading Load every day, not just before a big event Daily intake of 60-80% of carbohydrates prevents chronic glycogen depletion Allows one not only to compete at best, but train at best Be careful, too many carbohydrates can cause intestinal distress When you taper training, you do not need to intake additional calories, simply maintain standard intake Carbohydrate Loading Include adequate protein Especially endurance athletes who use some protein for energy Do not fat overload Choose wholesome, fiber-rich carbs Keeps your system running smoothly Bran muffins, whole wheat bread, bran cereals, fruit Plan meals carefully Day before event, eat biggest meal at lunchtime so that the food has more time to digest Drink extra fluids to hydrate your body Avoid alcoholic and caffeine beverages- dehydrating Post Game Meals What you eat after a hard workout or competition affects recovery Often athletes do not feel hungry or don’t have time to eat after exercise Recreational exerciser who works out 3-4 times a week, need not worry about recovery diet Competitive athletes need to make careful selections of foods eaten after exercise Football two a days An athlete with multiple event per meet Triathlete who trains twice a day An aerobic instructor who teaches several classes daily Recovery Fluids Loose fluids by sweat during exercise Best replacements are by water, juices and watery foods like watermelons Determining how much you need to replace Weigh yourself before and after The goal is to lose no more that 2% of bw Any more than 2% are you are dehydrated Recovery Carbohydrates Ideally you should consume carbohydrate rich food/beverages within 15 minutes after your workout Enzymes responsible for making glycogen are most active at this time and will most rapidly replace the depleted glycogen stores Liquids and solids are equal Recovery Carbohydrates Popular carbohydrate rich foods are: 8 oz or orange juice and medium bagel 16 oz of cranberry juice 8 oz fruit yogurt One bowl of corn flakes with milk and banana Sport drinks Be aware that they lack most vitamins and minerals that natural foods have More expensive Recovery Protein Protein can enhance glycogen replacement in the initial hours after hard exercise Protein Eaten along with carbohydrates is a winning combination Recovery Electrolytes When you sweat you lose water as well as minerals such as potassium and sodium Electrolytes are primarily responsible for muscle cramping and intolerance to heat You do not need supplements to replenish electrolytes after exercise- standard diet has more than enough to replenish any lost Rest Time is necessary for the recovery process of healing and refueling To completely replace depleted glycogen stores, the muscles may need up to 2 days of rest with no exercise and a high carb diet Expect to experience soreness on the second day after strenuous exercise that damages your muscle Quality training is better than quantity training- do not underestimate the power of rest Fluid Replacement Water is one of the most important nutrients You can survive only a few days without it Drinking too little water or losing too much through sweating inhibits ability to exercise at maximum potential Free access to water before, during and after activity should be encouraged Purpose of Water Water in the blood transports glucose, oxygen and fats to working muscles In blood, water carries away metabolic waste products In urine, water eliminates metabolic waste In sweat, water dissipates heat through the skin, regulating body temperature In saliva and gastric secretions, water helps digest food Water helps to lubricate joints and cushion organs and tissues Fluid Replacement Plain water is most effective and inexpensive means Drink small volumes (8 oz) of water frequently (every 15 min) rather than large volumes infrequently Thirst mechanism is unreliable Brain does not signal the thirst until you are becoming dehydrated This significantly hurts your performance Drink a cold fluid, help hydrate and cool you off Body Composition Estimation of a person’s body fat versus body mass Women have approximately 10% more adipose tissue than do men Fat is stored in various locations and severs as a protection and insulation to the body Average Female 22-25% fat Average Male 12-18% fat Fat is a must, a goal of 0% is not possible Less than 6% is unsafe for males Less than 10% for women leads to amenorrhea Measuring Body Fat There are four common methods Underwater weighing, Skin calipers, BIA and NIR There is no simple, inexpensive method to date that is 100% accurate Standard error of most measurement is plus or minus 3% Body Fat and Ideal Body Weight should be discussed together Body Fat changes as one Lose fat, gain muscle, shape up or slim down Underwater Weighing Traditionally considered to be most accurate Subject exhales all the air in their lungs and is then weighed while submerged in a tank of water Measures body density and is translated mathematically into percent body fat Errors Not completely exhaling all air out of lungs Equipment may not have precise weighing systems Skin fold Calipers Convenient and relatively accurate Calipers are large “pinchers” that measure the thickness of the fat layer of specific body sites Errors Poorly calibrated calipers Imprecise location of the specific body sites Bioelectrical Impedance Analysis Computerized method with increasing accuracy Current current is sent through the body via electrodes attached to wrists and ankles Flow of the current is affected by the amounts of water in the body Because water is the only fat free tissue, current flow can be translated into percent body fat Errors If you are dehydrated, premenstrual, have undigested food in your stomach or are improperly positioned during the test Near Infrared Reaction Measures the thickness of the skin at only one site May poorly represent overall body fat Based on the principles of light absorption and reflection An instrument that emits an infrared light beam is placed over the biceps The light that is absorbed by the muscle and fat and is reflected off the bone The measurement at only one site limits the accuracy Weight Gain Proper exercise and diet must be combined in right ways In order to gain 1 pound of body weight per week you need to consume an additional 500 calories per day- above normal intake Extra calories should primarily come from extra carbohydrates rather than extra proteins Protein Powders and amino acid supplements are fruitless expenses Weight Gain Challenges Finding time to eat can be hard, here are some tips to help boost caloric intake Pack portable snacks Eat frequently Eat an extra snack Eat larger than normal portions at mealtime Eat higher calorie foods You most likely to gain weight if you consistently eat larger than normal meals Weight Gain Summary Consume 500-1000 additional calories per day Include muscle-building exercise- weight workouts to promote muscle growth rather than fat deposits Have your body fat measured, to be sure that your weight gain is mostly muscle not fat Weight Loss High energy, low calorie reduce programs are the best possible method for weight loss Wisely choose what and when you eat Before attempting a weight loss program have your body fat measured Weight Loss Facts To lose weight and successfully keep it off you should do the following: Pay attention to how much you eat Calories do count! The amount of calories is important, not just the amount of fat grams Pay attention to when you eat Eat big breakfasts rather than big dinners Pay attention to why you eat Are you bored, stressed, lonely, or actually hungry Weight Loss Summary Eat 500 fewer calories per day than you normally do You should only lose 1-2 pounds per week for a safety reasons Eat slowly- the brain needs 20 minutes to receive the signal that you are full Exercise regularly, but do not over exercise Eating Disorder Statistics One out of every 150 American girls ages12-30 develop patterns of an eating disorder (among athletes much higher) At least 1/3 of all Americans are obese and 60% are overweight 77% of individuals with eating disorders report that the illness can last 1-15 years The mortality rate for eating disorder is 20% Only 50% of all people with an eating disorders report being “cured” 10% of all eating disorders are males Eating Disorder Facts All people with an eating disorder can die at any time and at any weight- not just extreme cases Most often death is due to a “side effect” such as cardiac arrest or kidney failure Eating disorders are on the rise among active people Sports that emphasize weight such as running, gymnastics, dancing, wrestling, and figure skating 4 types of eating disorders: Anorexia Nervosa, Bulimia Nervosa Compulsive Eating and “Bigger-exia” Eating Disorder Thinking Process Food is not fuel, it is the “Enemy” Desire to be perfectly thin Goal is thinness at any price Distorted body image Feeling loss of control over their lives Eating disorder sometimes is not about the food, but rather a way to exert some control over something in their lives Signs to an Eating Disorder Social isolation Lack of confidence Ritualistic eating behaviors Obsession with calories and weight Distorted body image Wearing layers of baggy clothes Nervous at mealtime Patterns of leaving table after mealtime Hyperactivity/compulsive exercise Decrease in performance Recurrent overuse injuries Running water in the bathroom after meals Significant weight loss Obsession with grades Obsession with organization and personal space High emotions Signs of Malnutrition Menstrual irregularities Loss of hair Light headedness Blood shot eyes Inability to concentrate Chronic fatigue Depression Typical Victim Perfectionist Obedient Over compliant Highly motivated Successful academically Well liked Good athlete Anorexia Nervosa Restriction of caloric intake for long period of time and deliberately starve themselves Loss of body weight of at least 15% Achieved by avoiding food, frenzied exercise Intense fear of becoming obese Distorted body image American Psychiatric Association Defines anorexia Nervosa as Intense fear of gaining weight or becoming fat even though they are already under weight Disturbance in body weight perception- claiming they “feel fat” Weight loss to less than 85% of normal weight Refusal to maintain body weight over a minimal normal weight for age and height Denial of the seriousness of the current weight loss Absence of at least three consecutive menstrual cycles Anorexia is a life threatening condition if left untreated Bulimia Nervosa A cycle pattern of binge-eating associated with some type of purging Purging takes on different forms Fasting Self-induced vomiting Excessive exercising Use of enemas or diuretics American Psychiatric Association Defines Bulimia as Recurrent episodes of binge eating, characterized by both of the following: Eating an unusually large amount of food in a discrete period of time Feeling out of control during the eating episodes and unable to stop eating or control what and how much is eaten Compensating for the binge to prevent weight gain such as induced vomiting, misusing laxatives, enemas, or other medications, fating or exercising excessively Binge eating and purging, on the average at least twice a week for three months Evaluation of self worth according to body shape and weight Side Effects of Anorexia/Bulimia Up to 50% of individuals who have been diagnosed with anorexia will also develop Bulimia Eating disorders are extremely dangerous! Some serious medical complications are commonly seen in Anorexic and Bulimic individuals are: Stomach rupture Tooth decay Inflammation of the mucous lining of mouth and throat Eventually cause heart, kidney and liver damage Urinary infections Osteoporosis Menstrual irregularities Compulsive Eating Largest percentage of individuals with eating disorders are compulsive eaters A compulsive eater keeps eating beyond the time when hunger has been satisfied Eating is driven by anxiety, feat, frustration, or anger rather than by hunger or pleasure Feel great amount of guilt and shame after eating Feel envious and inferior toward others who handle food better than they do May be a compulsive dieter as well More about Compulsive Eating You can be any weight and be a compulsive eater A person can be heavy and obese and not be a compulsive eater It is the relationship to the food that determines whether or not a person is a compulsive eater A person who values food for its instant gratification and its ability to comfort, defuse anger, or help calm down is probably a compulsive eater “Bigger-exia” New term to described individuals who use steroids and other ergogenic aids to build muscle mass They are both compulsive and excessive about body building workouts See extreme size not as an exaggeration but as something to aspire to Feels the need to be big and powerful in order to feel good about themselves Reverse of people who desire to be thin A lot of health problems associated with use of some ergogenic aids Treatment Any victim must be approached and handled extremely carefully! Referral for medical treatment is essential True anorexic and bulimic commonly deny the problem, insisting that they are perfectly fine Eating Myths Many athletes believe that by restricting food intake to lose weight that they will exercise better, look better and enhance performance Restricting food actually; depletes fuel stores, cause ammenorrhea, stress fractures, fainting, weakness, fatigue and impaired performance Can maintain for a while, but lack of energy and injuries will catch up with them Prevention of Eating Disorders People need to learn to love their bodies As a society we must: Dispel the myth that thinness equals happiness and success Discourage the notion that the thinnest or most muscular athlete is the best athlete Love our bodies for what they are, rather hate them for what they are not Emphasize fit and healthy as more appropriate goals than slender and skinny Ergogenic Aids Any substance (or food) that is believed to enhance one’s performance above normal standards IOC definition: (summarized) The administration or use of substances in any form alien to the body with the exclusion aim of attaining an artificial and unfair increase in performance in sports Use of these substances and practices is controversial Drug testing has been instituted in many sports in order to help curtail the use of these substances Because of the inequities that result in competition and health problems can result, the use of these substances cannot be condoned Examples of Ergogenic Aid Vitamins and minerals Amino Acids Nutritional supplements Anabolic steroids Caffeine Creatine Diuretics Human Growth Hormone Other illegal “recreational” drugs Class 1 IOC Ergogenic Aids Stimulants Narcotics Anabolic Steroids Beta Blockers Diuretics Types of Stimulants Amphetamines Cocaine Ephedra Caffeine Stimulants Effects Increase alertness Reduce fatigue Increase competitiveness Produce hostility Increase blood pressure Vomiting Headaches Irregular heart beat Anxiety Tremors Caffeine Effects Energy-enhancing effect May reduce the fatigue associated with long bouts of exercise Has a diuretic effect In large quantities has been listed as a banned substance by the IOC Narcotics Morphine and codeine Used for management of moderate to severe pain Banned by the IOC High risk for physical and psychological dependency Beta Blocker Produce a relaxation of blood vessels Slows the heart rate Decreases cardiac output Used in sports where physical activity is of little to no importance, but a steady hand is necessary Heart rate and signs of nervousness are kept to a minimum Diuretics Increase kidney excretion and urine output Can be misused in two ways: To reduce body weight quickly To decrease a drug’s concentration in the urine to try to avoid the detection of drug misuse through urinalysis Anabolic Steroid Most commonly abused ergogenic aid in sports It is illegal to possess or distribute for non-medical uses Steroids are obtained on the black market Banned by all sports governing boards including the IOC, NCAA and professional sport leagues Anabolic Steroids Synthetic forms of male sex hormones Increase muscle size and body weight Gives athlete advantage over their opponents No studies that show steroids improve agility, skill, cardiovascular capacity or overall performance Major problem in sports that involve strength Side Effects to using Steroids Increase muscle mass Permanent side effects, including death Other side effects to name a few Aggression, mania and depression Heart, liver and kidney disease/cancer Risk of HIV/ Hepatitis Acne, Baldness, bad breath, decrease sex drive Increase muscle, tendon injuries Infertility Male- increase risk to prostate cancer, growth of breasts Female-deep voice, facial and body hair, cervical cancer Human Growth Hormone Is naturally produced by pituitary gland Can be made synthetically and is readily available Increases muscle mass, skin thickness, body length and weight and decreases body fat More difficult to detect in urine than steroids Permanent side effects Premature closure of growth sites Acromegaly Erythropoeitin / EPO EPO is naturally produced by the kidneys as a response to a low oxygen level Can be synthetically created and used as a supplement Used generally by endurance athletes Increases the number of red blood cells Side effects Stroke Class II IOC Ergogenic Aid Blood re-injection or “blood doping” Used by endurance athletes or events at high altitude Purpose is to increase blood volume and red blood cells to meet the increased aerobic demands Banned my many sport governing bodies Blood Doping Blood is removed form the athlete and stored After at least 6 weeks the blood is re-infused into the athlete During the 6 weeks the body has reestablished a normal red blood cell count The added blood raises the cell count to greater than normal levels This increases the oxygen carrying capacity and improves aerobic endurance Risks to Blood Doping Allergic reactions Clotting Kidney damage Fever Jaundice Transmission of infectious disease Shock Heart failure Class III IOC Ergogenic Aid Alcohol Local anesthetics Corticosteroids Alcohol Number one abused substance in US Acts as a depressant Produces sedation and tranquility Does not improve athletic performance Not currently banned by IOC, however they can request a blood alcohol level and can take actions if the level is too high Local Anesthetics and Corticosteroids Inhibit or deaden the pain Serious concerns: The athlete will not feel the pain that could indicate a serious injury Continued use of these drugs can lead to weakness and degeneration of tendons and ligaments Prevention of Drug Use Goal of sporting organizations Protect the health of athletes Help ensure that competition is fair and equitable Sports programs should have full-service programs that provide substance abuse education, counseling and drug-detection Drug testing should be done periodically in a random manner Prevention of Drug Use Athletes, parents, coaches, athletic trainers physicians and administrators must be educated about the dangers of drug abuse “Winning at all cost” is wrong Promote athletes to do their best and adhere to the rules The End Any Questions???