Aimee Ellen O’Keeffe is a Performance Nutritionist at Manchester United Women’s team and owner of Committed Nutrition Ltd, her own private nutrition coaching company. Aimee is passionate about the female athlete, particularly breaking down barriers to fuelling and changing attitudes towards carbohydrates. Aimee has carried out a lot of research since starting in her role at Manchester United, analysing areas such as MD-1 carbohydrate intake, injury nutrition, half time carbohydrate intake to name a few.
In this episode Aimee discusses:
- How working with a young female footballer with a stress fracture lead to her doing a Masters in Nutrition.
- Relative Energy Deficit Syndrome or “REDS”.
- How underfuelling nutritionally can result in compromised bone health and stress fractures.
- What a day in the life of a full-time nutritionist in a pro football club looks like.
- The difference between disorder eating and an eating disorder.
- How nutrition can affect the menstrual cycle and why this matters.
- How social media can influence young female athletes to underfuel.
You can listen to the episode in full here.
You can keep up to date with Aimee’s work via Instagram: @committednutrition2020 and Twitter: @Aimeellen1 .
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Rob Anderson
Amy, welcome to the podcast. Thanks so much for sparing your time with us today.
Aimee O’Keefe
No worries. That was good, too good to be on.
Rob Anderson
So before we dig into the ins and outs of nutrition, give us a bit of an insight into the young Amy growing up what were the sports that you got stuck into? What were the ones you were good at? Not so good at? How did that kind of unravelled for you sporting wise?
Aimee O’Keefe
Yeah so my, my background is football. So from the age of four. I was playing football at a local like club called Western juniors, based in Liverpool, and yeah, that was me just live for it. Loved it grab that took me along one Saturday morning. And yeah, that was my sort of upbringing and come from like, really strong evidence, backgrounds, family wise. So yeah, it just, I loved it. And then I guess as I got older, I sort of dipped out of football. Now again, like, I think I remember when I got to maybe 16. And it’s that age where you want to be going out with your friends on the weekend. So I stopped playing for a bit, then went back for a bit. And then yeah, I think it got to maybe like 18. And I was just, I was losing a lot of love for it. So I think I did remember I completely stopped for about a year. But then I went back again. And then did a big chunk really of football. And it wasn’t until I went back to university to do my masters in 2019. I sort of had to stop playing football and because something had to give, I just didn’t have a whole day in a Sunday to be travelling to Northwest. But I guess like within within those years. I found like a love for the sport of CrossFit. And so the more sort of passionate and into CrossFit, I got the less interested in football, and that couldn’t balance the two. So yeah, I got I got well into CrossFit and went all in with that for a little while too.
Rob Anderson
Nice. So when was it that sports science and nutrition specifically kind of piqued your interest? And what made you kind of go down that route? Rather than maybe going into football coaching specifically? Or, you know, some other avenue?
Aimee O’Keefe
Yeah I think any, any sport and kid in school, just wants to be a PE teacher think that’s the only thing you can think of unless you want to be a footballer. And that was assuming realised that I didn’t want to be a PE teacher. And then went to university and I’m sorry, a degree and I think it was called sport, exercise and nutrition loss to remember that it was that long ago. Sport fitness and exercise or exercise nutrition, I can’t remember anyway. Even during that time, I wasn’t very, like passionate about any of the subjects or new wants to be involved in sport in some capacity, but I just didn’t know why. So I graduated and then I got a job in public health. So went into the NHS worker child weight management programme. Working with the general public, absolutely, absolutely loved it to be honest. So I went down that route for a few years and then decided to go solo go self employed. And at that time, I was coaching CrossFit. And I was a PT, so I’ve literally done that for seven, eight years. And during that time of coaching and PT and I came across a was a young female football at the time. I think she was about 13 Maybe. And she played a Liverpool, and we worked together for years. And it wasn’t until we worked as maybe three years. She was that kind of kid that just in every sport so she was involved in a cross country. She played football she played for the school football team. She did everything. And she was really tall really skinny. And, and she got this injury where she essentially was out for a whole season, more or less and it was a poor stretch fracture to her back. I just started late I was off by this point well into nutrition. And I was thinking something’s got to be linked here. Like I don’t know what it is, but I want to dig deeper. So I have a mutual friend and my massage therapist Steve he and he he his best friend is Graham close Professor Graham close. So it was that networking and link up that I got the opportunity to ask him face to face. Like is this length is it to do with energy intake and expenditure. And lo behold it was. And I was like, You know what? That’s really interesting. Like I found it. Like, super interesting. So that’s when I went back to Liverpool John Moores to do my master’s in sport nutrition. And so it was literally it was more nutrition was always there. But it was definitely sparked when when I was sort of thinking about how that fracture and the fact that it was really common in teenage boys, and yeah, I was alright, I’m going back to uni.
Rob Anderson
Brilliant. So, how did you end up meehanite women from doing your masters in nutrition? And what did that look like in terms of placements and work experience and roles, etc?
Aimee O’Keefe
Yeah, so the course John was amazing and hardest years of my life, and especially someone going in after being away from education for eight years, it was a bit of a shock to the system. I’m not gonna lie, but during the placement, everyone gets the opportunity to share it during the course everyone gets the opportunity to take part in a placement so you apply for go got these like 20 Odd different placement opportunities. And funny story, really, so I put my name in the hat for Man United women. But I also put my name in for the actual scholars placements are working with the University scholars. And at the time, I was thinking, I can’t do two placements. I’m working part time, like, yeah, I got overwhelmed. So I cancelled the interview for my united. But then green clothes. And then I’ve said this before moving on previously to other people, but he he mails and just said three words, and it was impossible. Nothing is impossible. And I couldn’t get out we had so I emails, who was then the performance coach at Alterna and said is any chance I can come down for an interview again? And she was like, yeah, and then what happened was because the the club was, it was new. I think it was a year old when I got there just been promoted from the championship to the USL. And myself and a guy called Mitch had to go on a, like a trial day to gather at the club. And then you were there all day. And then the players at a vote at the end of the day, which is pretty intense. You have to present in front of them like a bit about your life. And yeah, and obviously, well, not obviously what the pick me so I was sick, chuffed. And so yeah, I started like in November of 2019, and then finished in the May, just as COVID was hitting a bit of a crazy time. And then I loved it like absolutely loved and treated it like a full time job. And like, give everything to it. And I had a really good relationship with the performance coach LTN at the time. So then that sort of broke down a barrier because I always got older S&C coach and nutritionist just don’t get on. And I was like, Oh, this must be a myth. Because we got on really well. And then wasn’t involved with them over the summer I was touching base with some of the players but I wasn’t involved rarely. And then the manager at the time, Casey Stoney, she pushed the board to find budget for one day a week, which was amazing at the time fresh out of uni. So went back in the November time, one day a week and I found it really hard to make an impact. Because you just weren’t there all time. I just didn’t think I was doing a great job. And then Professor James Morton, who is at John Moores. I was still in the contact with him. And obviously, he oversees like science and sport and he had a an idea that he could provide like a full time contract for six months. So from like January to the end of the season, funded by science and sport, who are the club sponsor. So obviously jumped at that. And I was in there full time. And that could literally within the first month, I was like, I can see changes or edits. You just need to be on the ground. And then once that ended, I was in limbo, but I was like, I don’t really know what I’m gonna do now. And again, like hats off to Casey Stoney. She saw the value in nutrition and the job I was doing and she, like, fought and fought and fought behind closed doors for me to be full time. And yeah, signed a contract last July and the rest is history kind of thing. So super, super grateful. I’ve stepped out to uni and from a placement into the same job, but it’s on head off, but it’s a massive thanks to that case, he was the previous manager and for seeing value in it so early on.
Rob Anderson
It’s a pretty intense kind of interview process. It sounds like a reality TV show. The players gonna vote for the one they want. Yeah, it sounds
Aimee O’Keefe
like you’re gonna do it in front in front of us and put the hands up. And then I was like, oh, no, this is not this is not okay. But we went out the room and then ended on the show of hands, thank God.
Rob Anderson
So it’s really interesting, cuz he touched on something that’s been my experience a lot of organisations is, is having, you know, either one nutritionist that covers a million teams, or a nutritionist that’s only coming in for one day a week. So people might say, you know, what, what’s the nutritionist doing the rest of the time outside of that. So give us a bit of an overview. What’s a day in the life look like for a full time nutritionist, a professional football club?
Aimee O’Keefe
Yeah. So typical day is medical meeting at 8pm. Every day. Once that soldier or not, you know, you report on any players and you would the performance staff and medical team. And then from there before players get in, it’s basically just making sure they’ve got everything they need. So whether that whether that be me stocking up, like my nutrition supplies for that day, or jumping on my laptop, and trying to get a bit of work done before the players come in, and then yeah, I guess it’s breakfast. And then making sure drinks outside water bottles. So when the training starts, what I usually do is, I’m not always out for training, and I try to but when you’ve got a lot of weight, so it’s hard to just be out on the pitch. But I’ll always make sure like I’m in and around the gym, before training when I do on like the pre activations like having like conversations sometimes not even about nutrition just just about life, which you think is important. And and then yet, while the training on days where they’ve got Jim on make sure like the shakes at dawn, like we have like a snack trolley for them to have snacks like after the pitch session and then before the gym session. And then I’m on my laptop like liaising with hotels, or that like food logistics for like the way much travel menu planning. Or like kinda like nitty gritty stuff that no one really sees. And then yeah, please finish. And then they have lunch, make sure I’m around for lunch. Like check in with any, anyone that I need to like, other, I wouldn’t say one to one, I like to keep it really like light hearted. And I can just catch them at the dinner table. If they want to jump in, you know, a quick meeting room in the can. And then yeah, once a player is gone, you can get a bit more work done. And yeah, that’s, that’s the day in the life, I really, it’s just a lot of just making sure things are there and in sight and stop, couldn’t ID and then once they’re gone, you can get on your laptop. And you know, so without the menus and meal plans and like data collection, if you’ve got any research going on at that time.
Rob Anderson
So I know there’s probably a whole a whole load of things you haven’t touched on yet. So around the sort of education side of things, you know, I know from having been in programmes we haven’t been nutritionists, as often, you know, might be one on one education with players or group workshops or those kinds of things. So when did those kinds of take place? Do you? Do you organise them specifically kind of in preseason periods to get them out the way? Or is it an ongoing thing throughout the season? Whether that’s group or one on one? What does that look like?
Aimee O’Keefe
The question and so I’ve only had one full preseason with the team. And that was last summer. And I got we went away to Scotland. And I’ve got quite a lot of education done there. I think it was like two or three presentations. But in terms of throughout the, throughout the season, I’ve got the opportunity present to present three times, which doesn’t sound like a lot, but I sort of split it into quarters. So like beginning the season, mid and then towards the end. And and the way I do it is I’ll just jump in for 510 minutes before the analysis of a morning. And obviously the know about it’ll be on the schedule. But a lot of it is sort of last minute, I can’t get anything as you can imagine. But yeah, I try. There’s never time in football, which I’m sure you’re aware of. So you really have just got to make time and if that’s five minutes before analysis, and then you just got to take it. So yeah, I’ll do that quite a lot. And then from those presentations, and usually it’s like some data collection that we’re going to do on the team whether it be Like this weekend against Birmingham, we’re going to monitor carbohydrate intake at halftime, and then it’s on me then to set that up and make sure everything’s in place, monitor it. And then they do a bit more education. And we’ll do it again, to get pre and post data. That’s the way I like I’ve been lucky to do it the past couple of years. So yeah, the divides quite quite a bit of education. But there’s still so much that you want to do, but time and time is an issue. So you just got to think of what what is the most important? And what are the priorities right now to impact performance.
Rob Anderson
So let’s dig into a few of their kind of, I guess, more specific things. So one of the things you’ve already touched on, which is a great a great topic for us to dig into a bit more is around stress factors and you know, calorie intake and expenditure and under under fueling, so talk us through what’s the link there, because stress factor is one of those things that a lot of people think it just happens. But actually, as you pointed out, there are underpinning things that could be influencing that from a nutritional perspective. So what are those things? How does that play out? Why why the terminated? Yeah,
Aimee O’Keefe
so it’s, it’s a common common injury, low stress fracture is a sign of something called red, which is a diagnosis that female males and females get when they are in often got low energy availability. So they’re expending way more energy than they’re taking in. So the calories aren’t enough, what the what the reason, compared to, you know, the training, load and, and volume. So, a lot of the time, what happens is there’s whether it be a stress, stress fracture to the ankle, like the back, which is common in teenagers. And that is one of the sorts of red flags. And then obviously, from there, if that does happen, that’s where I come in. And we, I guess, the first thing I’ll do is speak to the player, but then we will ask for a food diary, like assessment. So I like to do the food photography method. So get them to take pictures of the food with a little bit of a description. And then I’ll be able to see what the training was training volume was pre injury, and then we’ll try to piece it together to doctor will be LinkedIn, he’ll be taking Bloods, you know, to see what the iron levels are and everything else. So yeah, it’s quite a sort of multidisciplinary. Like hands on strategy that we do, but yeah, I guess, in females, specifically, reds is an issue as a nutritionist, and I guess, as a medical team, we don’t want any female dropping into reds because of risk of injury. And, and you know that they are low in energy. So they’re not going to be able to, you know, pull out that intensity, like day after day in training sessions and in matches. So yeah, I guess nutrition plays a huge, huge part. In that insurance, you’ve got enough calories and mentally, like, the comfortable with with food and carbohydrates. So there’s a there’s a bigger picture with females, I think, in terms of fueling and that risk of under fueling and maybe why why they do it. Some females, they don’t know they’re doing it. It’s just an education thing. Where I guess some, some females may still have that may carb phobic phobia, so they’re not getting in the calories that they should be. And then that impacts performance. And, you know, worst case scenario was to get injured.
Rob Anderson
Yeah, it’s kind of one of the things I wanted to dig into around that kind of, I guess, I don’t know if it’s social media or its, you know, some of the body image things. But you know, that kind of carb phobic is things that kind of pops up now and again, with female athletes, as you say, can lead to reds and you know, more serious issues like stress factors, etc. So, presumably, the link there is, you know, not having sufficient calories to have good bone health and sustained training volume at the same time. So something has to give, and it ends up being, you know, the health of your bones. Yeah.
Aimee O’Keefe
And it’s that like low bone mineral density is so so the term and what you look out for and I think this isn’t like we haven’t had any players this season. That had been diagnosed reds, I think there may have been a couple it’s quite complicated because you can’t you can’t it’s not black and white if your players are on the contraceptive pill or any, any other type of contraceptive. So it’s quite hard that in that sense to identify unless you’re looking at someone and thinking, you know, they’ve dramatically dropped weight maybe but Yeah, I think when you mentioned social media and body image, like personally, I think that definitely plays plays a part I’m quite passionate in, in this topic of body image and you know, without going into the the board and science and sports have recommended and takes the female recommended and take his, you know, six to eight grammes per kilo carbohydrates that the players to have the day before game day of a game. And that’s not happening for a lot of players. But what are the reasons? Like what are the barriers to that, like, why it’s not because the cheat a lot of them aren’t choosing not to, some of them just don’t know, the values of food, which can be easily fixed. But then obviously there there are some
Aimee O’Keefe
some athletes who I guess with Instagram and on social media, it’s it’s an extra pressure to maybe look good.
Aimee O’Keefe
So maybe that has an impact on them not wanting to eat, you know, that high carb meal that I want them to eat or, and I’m not just talking about my experience in Manulife, and I’m thinking of like, the bigger picture like why all of the teams are in, you know, females and other sports hit and, you know, the recommended carbon taken calorie intakes. And I think social media and the presence it has now and like the holder has over a lot of people is definitely a massive influence and barrier at the same time.
Rob Anderson
So obviously, you know, if someone is under fueling, unintentionally, then it’s, you know, maybe an education piece and you can change that behaviour. But if there is something that’s a bit more psychologically a barrier or a hurdle, that’s then I guess, a different kettle of fish and a different route to go down, isn’t it? Because if someone specifically making the choice No, I don’t want to hit that recommendation of six eight grammes, you know, I’m, I’m trying to do trying to keep it down because I want to look a certain way or I’m trying to aspire to this kind of body type, etc. How do you go down the kind of reeducation that and the kind of, I guess, mindset changed down that route to actually look, we look at the fuel performance? And if we’re not fueling, then the performance is going to suffer an injury risk goes up? How do you kind of switch tracks? Yeah.
Aimee O’Keefe
I think it’s a really complex, like nutritions, simple for one person, but really complex for someone else. And I think you’ve really got to be mindful of that with who you’re speaking to. And, you know, try to understand the players, history of nutrition, and maybe waist bodyweight and about any issues in the past, if, like, my one to one, so to speak, like, if we’re talking about energy intake, and, and trying to education educate them in that, in that sense, if if, if I’m sort of hitting a brick wall with that, I can link in the doctor and the physio team, especially if they are injured, it’s, it’s good to link in the physios because then you’ve got another voice. And they come back here to be like in your in your recovery process is potentially going to be longer because there’s no fuel to fuel rehab, or not enough fuel, I should say. And then if the doctor needs to be LinkedIn, then he can refer externally for like, maybe psych support if they need, you know, an external dietitian who’s specialised in, in this area, which is sort of something that I can’t, can’t really get to with, with my background and qualifications. I
Rob Anderson
think that’s important to highlight, isn’t it when something’s outside your scope of practice, you know, if if it’s an unintentional thing, and it’s all we need to improve, you know, carbohydrate intake, here’s a method for doing that versus, you know, diagnosed eating disorder that’s outside the scope of practice for a nutritionist requires refer out to it to a bigger side of things, doesn’t it? And then there’s a bit more at play. And I think it’s important for people to recognise where your scope of practice starts and ends and nutrition can be a bit of a grey area sometimes.
Aimee O’Keefe
Yeah, and you obviously want to help every single person but I’ve learned quickly that you can’t, and it’s, you know, it’s wise to just pass it on and, and make sure that you know, that person that is needing help, can can seek it. And maybe just rest assured that you’re, you have helped because you’ve, you’ve done sociogram work and hopefully the message can potentially hit home when you see someone more sort of superior and is an expert in in that field. So, yeah, luckily, we have not had to go down that route. Many, many times in the past, but there’s always a education piece when someone gets injured, say if they, you know, get on a hamstring and outfit, you know, six to eight weeks, there’s always a conversation with me, there’s always like an injury document that you’d be sent to be like, these are the priorities that we want to hit. Traditionally, whether it’d be creatine supplementation protein intake, and we’ll have a few priorities that the need to hit on a daily basis. So even for players who haven’t got a, an issue with food, it’s always important to educate them at any given opportunity. So if they get injured, let’s think of let’s think of the bigger pitch like why why they got injured, it might not be in nutrition. But if you start to drop in little messages around, like injury, nutrition, and how to get out quicker, kind of thing you’ll often buy in it, it’s just a good opportunity to build another relationship with it with a player.
Rob Anderson
Yeah, awesome. Often, when you fit and healthy, a lot of this stuff just washes over you. It’s not until you’re injured, and you’re thinking okay, now maybe I’ll pay a bit more attention in prehab, or pay a bit more attention to my diet, etc. So I guess good question probably is then where is the line between like disordered eating and an eating disorder in terms of, you know, fixing a few, maybe dietary habits versus someone who probably needs more of that psychological support around? Actually, there’s something a bit deeper going on here? It’s not, you know, adding a few more carbohydrates to your meals. It’s something we need a bit more support here. What would be some of the red flags that you would kind of think, okay, that’s kind of some scientific refer out?
Aimee O’Keefe
Yeah. Like disorders it is so common, like, I think I’ve got it like, sometimes I’ll, if I’ll like say I’m having a huge I normally and out and then me having a huge meal at dinner, Miss lunch, but have breakfast like, in the context of the meaning of disordered eating? That’s probably a but then when there’s a crossover to need the saw that it’s a good question that Reverend I’m like, fully, like, equipped to answer, but I’ll try my best. So I think I’ve had an experience in the past season. In another team, where there’s been a player who clearly has has an eating disorder, I guess the difference for me was, or how i i noticed it in comparison to like, your average player who, who hasn’t, I think, definitely how the and this is not meaning to be sort of stereotypical, like how they look. Like, in my experience, that person didn’t look like your average footballer, female footballer. And, like the will, obviously on the thinner sides. But not much muscle mass or body fat even to say. And then this is me just talking about my experience with someone who did have an eating disorder. So mine was the words that they’d say, and the way they’d say, around foods. Like it, they were like, he was scared, they were scared of it. And it was, it was really hard for me because I wouldn’t say I’m hugely experienced in in Well, I’m not experiencing this area. So I was like, okay, but I still had a job to do. Like, I needed to educate that person that, you know, carbohydrates or fuel, like they’re not gonna gain unnecessary weight and enhance performance. But yeah, I don’t know. I don’t know how to like, round that answer off. I’m trying to like think of that experience. And it obviously wasn’t that wasn’t a nice one. But I don’t know I just knew from the things he was saying. And then the amount of times I was saying the same message and it was just going in one ear and out the other and it was definitely more of a mental battle after we’re having rather than just don’t fancy that have enough for tea. There’s more towards food. Yeah, yeah, it was, it was definitely not like the attitude was was different and the perception of what food was or what carbohydrates were, was different to your, you know, your average Joe.
Rob Anderson
So one of the additional things I guess, you know, you mentioned reds, you know, can happen with both males and females, perhaps more so in females, but equally, it’s something to look out for, but I guess another element with female athletes is around menstrual health because, you know, with that, you know, drop in calories. Okay. Yeah, we’re getting there. helps, you know, compromised bone mineral density, but also menstrual health starts to suffer as well. So can you speak a little bit to that in terms of what are some of the, I guess, warning signs? And not not that it’s visible, but for athletes themselves? But also, in terms of maybe how you monitor that? Or how you have those discussions with athletes?
Aimee O’Keefe
Yeah, well, after the club, they have a wellness app, which you know, is being re re sort of amped for for the currencies. And so, all wellness data will be on an app, so players fill it in before breakfast. And they would maybe say if, you know, it was so as to get to the point where they know what site part of the cycle are in. And so you know, the medical team and performance team can visually see where players are are for the for the common dame, you know, they can report it to coaches. But I guess, if we specifically talk about menstrual cycle, and then and sort of that low energy and low calorie intake, I think one of the most common signs is when a player who isn’t on any contraceptive contraception loses the period or it becomes irregular. So I don’t mind talk about my experience with this. So I, when I was competing in CrossFit, I’m gonna go back to 2018, I went on a training like nutrition plan, and I was like training super hard. And I lost my period for six months. But at the time, I didn’t know what to do now. So I was just not really that bothered started last year, I was like, Okay, I’m going on holiday, I’m not too bothered about this. And when no one what I know, now, I was like, wow, that’s, that wasn’t a great six months was not like, Okay, that’s a long time to, for your reproductive system to not be working efficiently. And that was all down to lower calories going in, then, you know, well, low calorie intake, and then high training load. And I guess this, this is the thing with it with some females. So it could be that there’s it under 20 ones play that as came up to the first team. And they are now being exposed to a new environment, which can cause an N, like an extra stress, because we know stress can also cause irregular like irregularities and in your period. And I’ve actually got a good example of this. From my time at Man, United’s a player came off really 20 ones, they were in a new environment to train a programme change, the intensity was higher, the volume is higher. And that person was probably in the same and, you know, didn’t think anything of it. And she lost her period for two months. So that, obviously, like, she reported that and we were able to sort of jump in at the right time before it got any worse before it became you know, more of an injury concern. But that’s definitely one of the fears Porter call is the player on a pill. If not, it’s sort of an easy way to detect, but I guess it for those players that are on a contraceptive pill, they can sort of mask this area of reds. So I guess it’s sort of being a bit more vigilant in terms of like how they look and visually like, are they? Did they look like they dropped weight recently? And what are the portion sizes look like at lunch, dinner and breakfast? Like? Has there been any changes there? Are they naturally are they intentionally in less, and what they look like on the pitch so Lincoln with the cultures, that’s one of the coaches might just say Arjuna was such and such, like, didn’t look look like she’d have no energy today. Like she couldn’t cover what we wanted to call that. And usually, like simple conversations like that can just make you focus on that person a little bit more. It could be nothing, but or it could be something so I guess it’s just having gold columns, which I know is a big issue across any, you know, organisation, just communication, it can always be better.
Rob Anderson
Yeah, I think that’s one of the things and certainly this is something I’ve experienced as well comparison, we had females in the Scottish rugby Academy was a player, you know, I’ve kind of started building quite a good coach athlete relationship with kind of confronted me and said exactly that I haven’t had my period for six months. And to me that was flashing alarm bells. And, you know, when I spoke to the other, you know, coaching staff members who are male, they were like, Okay, what does that mean? Is that good? Is it bad? Like, you know, there’s there’s a bit of an education piece there to say actually No, as you said, That’s a sign your reproductive system isn’t functioning properly, which is should you know, should ring alarm bell that actually okay. And it was that exact scenario that you just mentioned, that player went from being part time to full time, nutrition wasn’t matching training volume. And I think that’s something people thought and certainly youth athletes maybe haven’t kind of wrap their head around is that, you know, when training volume goes up, the calorie intake has to go up. Exactly, and vice versa, you know, if you’re injured and you’re out for six months, you don’t need to eat like you’re playing and training every day of the week, like you were previously. You know, I think there’s a bit of education piece around there to, you know, say actually, we need to be matching this in accordance with what we’re doing. So, you know, if it’s preseason, we’re working really hard at points to go up. If it’s the offseason, then you’re aware on the beach. Mr. Baier, you don’t need as much, you know, like there’s, there’s an education piece there to say we need to make these inputs and outputs in the same sort of direction.
Aimee O’Keefe
Yeah, no, definitely. I guess, a lot like the example you said, it’s not the player doing it intentionally. It’s just, you know, it’s just a lack of awareness, like, not doing anything wrong, it’s just then you know, you stepping in and given them a gentle nudge to be like, Okay, you’re now covering, you know, an extra as an old 10k a day than you were, you know, two months ago. And we need to match that with, with what’s going in to give you the best chance of, you know, staying injury free and actually adapting to your training.
Rob Anderson
So one of the things we haven’t touched on yet is around that halftime feeling. So is it a case of your classic plough whip out the box of oranges at halftime? Or is there a bit more to it?
Aimee O’Keefe
Now, ographers you foresee for oranges? Yeah, I guess. I’m trying to think of how it’s evolved over the past season. So
Aimee O’Keefe
we actually done a new research piece at the beginning of the season, or maybe it was like, maybe November time, and we’re doing it across three games. So first game, was they had no education, it was just, they had their own. Like, it was like a Chinese takeaway box, like a clear box, it adds, you know, every type of carbohydrate snack that was available, so they could choose, you know, they could take as many as they want out of it. And I was the one that monitored it. So it was purely carbohydrates that we were focusing on. So obviously, inputted all the data, and it was a following week that I give some education on. So I was like, this is the recommended intakes, like for half time, and we’re gonna give you the opportunity to practice this again. So the art the opportunity, the next game to practice it, without me collecting any data just for them to get familiar with. We’re doing it and seeing what worked and what didn’t. And then it wasn’t until the game after that, we analysed it again. So from from the data that I collected, I set the target is 60 grammes of carbohydrates, which, for the listeners, and for context, that’s essentially two bananas, there’s too many Madonna’s to be say, your body can, you know, oxidise, their two grammes per hour. But I wanted to set it at 60. And because I think, you know, 90% of them have a gel, which is around 20 to 23. So I wanted to set it the target higher, because of the like the intensity of the game, like distance COVID and all that stuff. So in my experience, from my data collection, the made a positive improvement, and it became a competition as you can imagine, so something that I didn’t think would happen if I’m being honest. It was, it was a competition. So it was like a while many did you how many grammes did you get, and they wanted to know, like a leaderboard in the end, which, for me, I was happy with because it made them habitually more at halftime. And but I guess, I think the average went from that sort of thing. should really know this. It was in the 30s. And then in the 40s, there was like a maybe a 12 gramme increase. It’s really bad. I can’t remember that data, but I can’t think of off the top of my head. But like competition aside, the main, you know, improvement was the fact that it was on their mind at halftime, it was like getting, you know, instead of the mountain what they usually have, which may have been, you know, half a Gatorade and the gel. Now they will have an, like a full Gatorade and two gels or they would have been, you know, three different carb sources. So being able to have it in their mind was was really good and they got consistent with it. cross the season. So and then understanding why so like, they have to replace the energy that we’ve lost in the first half to be able to even try and hit levels of first half performance in the second half. So I guess me being picky I, what I want to evolve now and get better at is. Say for example, we had a player who hit 60 grammes of carbs. So she get, you know, two bananas and a few jellies can that person still hit the same amount, but in one source, so kind of be a high carb drink instead of three different types, which could cause you know, stomach distress and stomach issues, especially when it’s hot. So that’s how I like to evolve the the education piece fit for preseason into next season.
Rob Anderson
That’s great. And I think it’s always difficult when you’re doing nutritional research and in practice, because, you know, people will say, Oh, how did that affect the performance? It’s like, well, you’re playing a different team on a different day with a slightly different lineup. And it’s not all the controllables aren’t exactly the same. You know, they want to know how to kneel down at halftime, again, the second week, or whatever it was. So you can’t always extrapolate that out to the result of the pitch. But if those individuals are feeling that they’re putting out bits, or you’ve got some GPS metrics to say you’re still hitting some of those speeds, etc. That kind of backs it up. But it’s, it’s a bit like injury prevention, there’s so many factors, it’s hard to pin down and say, Oh, well, you now covered 10 condoms, because we did calf raises. Yeah, it’s obviously not true. But there’s a there’s an element there around, okay, we know you’re more likely to have those outputs if you’re fueled properly. And that says, yes, you’re fueling properly, because we’ve made this change. So it’s obvious to see that so what’s next for you in the next sort of 12 to 18 months? Obviously, it’s it’s offseason. Now. So preseason coming up, we’ve got any other research projects in the pipeline, or
Aimee O’Keefe
you know what I’ve not, I wouldn’t say research projects at the minute, I’m definitely gonna do some, you know, research with the team in preseason and next season, probably hydration, and monitoring, and testing and preseason. Because I think we’ll go and away to different country in August for preseason, potentially. And that’ll be the first time that I’ve experienced the preseason a different country in a different climate. So I’d like to monitor the sweat rates and the sodium losses, if possible, but I know that’s a big job and may cost quite a lot of money. And that’s a dream. And, and I guess, just nothing specific, but definitely just build on the carbohydrate. You know, fueling and recovery, just continue to break down the barriers. And I think like, on a personal level, I’d like to, like, I’ve been thinking about a PhD for a while. And it’s something that if you asked me last, you know, at the start of the masters are the enemy masters when, you know, I was a shallow me for myself, and I was just so stressed, I was like, No, never, ever, ever again, am I doing education, but to know, I’m just that type of person that I just feel like a little bit unfulfilled? And like, yeah, I don’t know, I’ve had a few conversations. And I’d like to do, you know, obviously do it at Manchester United in the women’s team, or whether it be in the younger age groups. But I’d also like some more nutrition support for the under 20 ones and Academy. So the RTC so we’ve had an amazing intern in the past few years, and he’s done a great job. But that’s the thing with an intern, like they’re for six months, and you know, someone else comes in, but I’d like to really put me energy into trying to get something more solid so that, you know, the nutrition service, and then the nutrition team, you know, on the women’s side can can evolve and get better.
Rob Anderson
I think that’s always the battle, isn’t it like you, especially at the senior level, you’re dealing with a group of players you have, but you’re actually also thinking actually, if I can improve what’s happening a squad or two below us age groups, then, you know, three, four or five years time getting players who are already on top of this stuff, they’re already on top of fuelling or on top of carbohydrate intake and you know, selfishly it makes your job easier. But it also means you’re kind of steering them clear a future issues or you can start to have deep conversations about other topics. But it’s always part of the battle is that when you’re in season, you are responsible for one squad thinking, Okay, I need to set up a programme for an internal Andre teens under 20 ones, but actually, we’ve got Liverpool this weekend. And so it’s always a sort of short term long term battle, isn’t it? But definitely, yeah, sounds like you’re headed the right way. Because I think those habits at a younger age is massive, isn’t it?
Aimee O’Keefe
Yeah, I agree. So where
Rob Anderson
can people find out more about what you’re doing? And I’m tracking down on social media? What’s the best place to find you?
Aimee O’Keefe
Yeah, so on Instagram, it’s committed nutrition 2020 And then on Twitter, it’s Amy Ellen one. Aim IE, either Lillian and then the number one. And then yeah, I think I think that’s that’s everywhere really? Want to drop me an email? I can. You can find me on committed nutrition email at nutrition@outlook.com. Awesome.
Rob Anderson
Well, thanks so much for your time today. Thanks for digging into some of that stuff around reds and around the importance of carbohydrates for female athletes in particular. I know that’s gonna be useful for a lot of people because it’s something that pops up time and again, so thanks for helping us out with that and digging into that it’s been a real pleasure chatting to you so thanks for time.
Aimee O’Keefe
No you very welcome. Thank you very much.