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LIFESTYLE

Tip of the “Day”
Changes in Body Composition

In general, individuals who have restricted eating patterns
during the day are more likely to binge eat compared to

those who eat moderately throughout the day. This type of
Jacqueline R. Berning, PhD, RD, low calorie eating during the day leaves a surgeon feeling so
CSSD (CSSD= Board Certified
hungry; they over consume and eat more than they ordinarily
Specialist in Sports Dietetics) would at the end of a long surgical day. Additionally, the
Professor, Department of Biology
weight loss and long periods of fasting reduce the rate of
University of Colorado-Colorado metabolism. This Yo-Yo type of metabolism, using protein to
Springs
fuel the body during the day and overloading on calories at
the end of the day along with a slowing metabolic rate, will,

over-time, change body composition by increasing body fat
and decreasing lean muscle mass.
Member of the Sports Science and Safety Committee US Lacrosse
Food Plan to Maintain Lean Body Mass and Energy
25 years as the Sport Dietitian for the Denver Broncos
18 years as the Sport Dietitian for the Cleveland Indians
Realizing that orthopedic surgeons have long days in surgery
and not much time in between cases stress the importance
8 years as the Sport Dietitian for the Colorado Rockies
17 years as the Sport Dietitian for the University of Colorado- to eat throughout the day. The nutrient composition of these
Boulder Athletics Department
meals and snacks should focus on whole-grain carbohydrate

17 years as the Sport Dietitian for USA Swimming along with lean protein and healthy fats.
*CSSD=Board Certified Specialist in Sports Dietetics
Try these suggestions to maintain energy and lean body mass
during long surgical days:
How do I maintain high energy level

and not loose weight
TIME
EXAMPLE OF FOODS

during a full surgery day 6am–7am Oatmeal with almonds Or 2 hard-boiled eggs

10am
Greek Yogurt with fruit Or P-nut butter or
without having time to eat?
Almond butter sandwich on whole grain bread

1pm
Recovery shake such as Gatorade Protein
Nutritional Advice
shake or recovery shake

4pm
Cottage cheese with vegetables like celery,
Whether you are an orthopedic surgeon or an elite athlete, carrots sticks, cut up peppers

working or training for long periods of time without consuming Evening meal
Grilled Salmon with wild rice, asparagus, and
food affects energy metabolism and results in a lack of fuel for salad with low fat dressing Or Lean Roast beef
performance and changes in body composition.
with medium baked potato, spinach salad with

low fat dressing
Energy Metabolism
The preferred fuel source for the body is carbohydrates in the
Of course the success of any diet plan is to PLAN and PACK
form of glucose. Carbohydrates are stored in the liver and before you need the snack or meal. Try packing foods the
muscles. Muscle glycogen is only used for muscular work night before having foods close by that you can grab and go.

while liver glycogen is released into the circulatory system and
used systemically throughout the body. When the liver is fully

loaded with carbohydrates, it can store about 16–18 hours
worth of glucose.

If a surgeon is scheduled for 12 hours of surgery starting
at 7am after an overnight fast and without eating breakfast,

surgery starts with decreasing blood glucose. If the fast
continues throughout the morning, liver glycogen becomes

exhausted and ketone levels start to rise. Although most cells
can use fatty acids for energy, the central nervous system and

red blood cells only use glucose for energy. As blood glucose
decreases, there is a corresponding decrease in the insulin to

glucagon ratio which signals the release of Amino Acids (AA),
particularly from muscles, to be oxidized and converted into

glucose (gluconeogenesis) to maintain vital bodily functions.
The use of AA to maintain energy results in rapid weight loss
impacting body mass and body composition.

44 ISAKOS NEWSLETTER 2013: Volume II