These conditions include, but are not limited to:

1. Relative Energy Deficiency in Sport (RED-S)

RED-S is a condition resulting from not taking in enough energy to meet the demands of sport. Think of this mismatch of energy intake to energy output as being similar to a cell phone running on 5% battery – some apps might start shutting down. In the case of an athlete, these “apps” include metabolic rate, hormone function (reduced oestrogen in males leading to amenorrhea or a lost period, and reduced testosterone in males), immune function, cardiovascular function, psychological function, and performance/response to training.

2. Inflammatory Bowel Disease (IBD)

IBD is an umbrella term for Chron’s disease and ulcerative colitis, both of which can adversely affect an athlete’s health and performance. Chron’s disease and ulcerative conditions have overlapping symptoms such as diarrhoea, weight loss, fever, anaemia, and intolerances. Crohn’s disease could affect any part of the gut but occurs mainly in the distal (end of the) small intestine and the colon, whereas ulcerative colitis occurs mainly in the colon and the rectum. In Chron's disease, areas of inflammation can be separated from healthy areas, whereas in ulcerative colitis, inflammation is continuous across the whole area.

Nutritional support for these conditions can help to improve nutritional status, manage intolerances, assess deficiencies and reduce flare-ups. Specific supplements can also be provided if necessary. Medications used to treat IBD can also have nutritional implications, which our dietitian can assess and provide guidance on how to adjust the meal plan accordingly.

3. Diabetes

Diabetes is one of the most common chronic diseases in South Africa and around the globe. In individuals with diabetes, blood glucose levels increase. This happens when the body can’t produce enough insulin (type 1 diabetes) or the body is insulin resistant (type 2 diabetes). Because of the important role of glucose metabolism in exercise, athletes with diabetes need a carefully planned diet to prevent both hypo- and hyperglycaemia, especially during workouts.

4. Hypertension

Alongside diabetes, hypertension is one of the most common chronic diseases and can lead to cardiovascular problems, renal problems and stroke. Hypertension is defined as a blood pressure of ≥140 mmHg over ≥90 mmHg.

A common misconception about high blood pressure is that athletes are not at risk. However, certain genetic biomarkers can make even fit athletes at risk of hypertension. According to the World Health Organization, it is estimated that about 46% of people with hypertension do not know they have the condition, less than 42% have received a diagnosis and subsequent treatment, and only 21% of adults with the disease are able to control their hypertension.

A carefully planned program can help to decrease the risk of complications and help to enhance the quality of life.

5. Reflux, gastro-oesophageal reflux disease and ulcers

Reflux and gastro-oesophageal reflux disease is commonly referred to as “heartburn”. Ulcers are internal sores that affect the oesophagus, stomach, or small intestine. Both of these conditions can affect an athlete’s quality of life, sleep and absorption of nutrients like iron and vitamin B12.

A food and symptom diary as part of a clinical evaluation can help to identify how symptoms and food patterns are linked and highlight where adaptions in the diet can lead to a better quality of life. Our dietitian can also assess if any deficiencies have occurred and give guidance on the relevant supplements.

6. Nutrition for optimized immunity

Improving immunity has become a big focus over the last two years during the COVID-19 pandemic. It is well known that a well-balanced and well-planned diet can improve immunity and prevent illness.

A food-first approach to optimizing immunity is recommended because whole foods do not only contain micronutrients (vitamins and minerals) but also come packaged with fibre, antioxidants and phytochemicals, which can help to improve gut health and recovery from training. However, if a deficiency is found during our nutritional assessment, guidance on relevant supplements can also be given.

7. Anaemias and iron deficiency

Athletes are at higher risk of anaemia and iron deficiency due to losses during exercise, low intake, or growth in young athletes. Symptoms of iron deficiency include extreme fatigue, reduced performance, paleness, shortness of breath, dizziness and headaches, a red/inflamed tongue, and brittle nails.

During the nutritional assessment, athletes will be screened for iron deficiency, iron intake will be assessed, and a personalized plan to improve iron levels will be given.

8. Osteopenia and osteoporosis

Bone health plays a crucial role in health and performance. Bone injuries such as stress fractures can side-line an athlete for prolonged periods of time. A window of opportunity exists up until the age of 30 years to optimize bone health, otherwise known as peak bone mineral density (Mahan & Raymond, 2016).

A lesser-known fact is that the bone is a dynamic organ, which means that the density of the bone changes according to factors such as nutritional intake and exercise. The process of bone resorption (breaking down of bone tissue) and bone reformation (building of the bone) is called “bone remodelling”.

Factors such as hormonal imbalances (for example, low oestrogen levels due to RED-S or menopause), low calcium intake, or age can affect bone density. Tailoring your nutrition plan to optimize bone health is key to overall health and performance both in the long- and short term.

9. Eating disorders

Eating disorders are complex in cause and treatment. It is also a lot more common than people and athletes realize, occurring in up to 19% of male athletes and 6 – 45% of female athletes (Bratland-Sanda & Sundgot-Borgen, 2013).

At Health Elevation Nutrition, our goal is to work with a multidisciplinary team of psychologists, doctors and coaches to provide our athletes with the support they need.

References

Bratland-Sanda, S., & Sundgot-Borgen, J. (2013). Eating disorders in athletes: overview of prevalence, risk factors and recommendations for prevention and treatment. Eur J Sport Sci, 13(5), 499-508. doi:10.1080/17461391.2012.740504 Mahan, L. K., & Raymond, J. L. (2016). Krause's food & the nutrition care process-e-book: Elsevier Health Sciences.