Iron Intake, Anemia & Dancers

Proper nutrition is always a concern for dancers. Dance is an activity that requires high levels of energy fueled by food, but it is also an activity that requires an aesthetically pleasing body. Since dancers are often concerned about their appearances, they tend to limit the amount of food they eat. Eating a limited amount of food means dancers are not likely to get enough required vitamins and minerals in their daily diets.

Not consuming adequate amounts of iron can be detrimental to dancers and other athletes. It becomes an even bigger concern when you understand that iron is a mineral that can be lost through sweat. On extremely warm days, during an intense class or rehearsal, dancers can lose between 1 and 2 mg of iron.

A study of 47 female teen dancers in New Zealand found that 28% of them had iron levels that were less than ideal, and 5 dancers were found to have an iron deficiency. Another study conducted in the United States found that only 12% of 28 teen female ballet dancers ingested the recommended daily intake of iron.

Iron deficiency is a problem because results in anemia. Our bodies use iron to make hemoglobin. Hemoglobin is the main part of our red blood cells and the part of our blood that binds with oxygen. Hemoglobin’s main job is to attach itself to oxygen in the lungs and deliver that oxygen to all of the other parts of the body. Our muscles and organs need oxygen to function, and our brains need oxygen to think clearly and operate well.

When there is not enough iron in the body, hemoglobin cannot be created, and oxygen delivery cannot occur. When a dancer is anemic, he or she may feel tired or weak, may have cold hands or feet, look pale, be moody, get injured easily and may have difficulty with concentration and memory.

It is very important that dancers consume enough iron so their bodies can function at their highest levels, and they can focus in class and remember combinations and choreography. 

Although everyone needs iron, it is especially important for teens. The body needs higher amounts of iron when going through a growth spurt. The average adolescent should try to ingest 6-8 mg of iron each day. Dancers and athletes need to have 9-12 mg per day to help distribute extra oxygen to their active bodies and make up for any iron that is lost through sweat.

Although iron can be gained from a supplement, the majority of iron we ingest should come from the food we eat. There are two kinds of iron that can be found in food. Iron that is found in meat is called heme iron. The body can absorb 15-18% of this kind of iron. Some sources of heme iron are beef, lamb, liver, seafood, pork, and chicken.  The other kind of iron can be found in plants and is called non heme iron. The body can only absorb about 5% of the iron found in these foods. Some sources for non heme iron are grains, dried fruits, and nuts.

It is very important for dancers to think about how much iron they are getting when they plan their meals and snacks. Being sure to ingest enough iron will keep them dancing at peak levels and help lower chances of injury.

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Beck K.L., Mitchell S., Foskett A., Conlon C.A. & Von Hurst, P.R. (2015). Dietary intake, anthropometric characteristics, and iron and vitamin D status of female adolescent ballet dancers living in New Zealand. International Journal of  Sports Nutrition and  Exercise  Metabolism, 25 (4), 335-43.

Bonbright, J. (1989). The nutritional status of female ballet dancers 15-18 years of age. Dance Research Journal, 21(2), 9-14.

Lee, H., Kim, D. & Kim, S. (2015). An analysis of nutrients intake, related factors of anemia and bone density in ballet dancers. Indian Journal of Science and Technology, 8(25), 1-6.

Pacy, P.J., Khalouha, M., & Koutedakis, Y. (1996) Body composition, weight control and nutrition in dancers. Dance Research,  14(2), 93-105.

The Female Athlete Triad and What It Means for Dancers

"To keep the body in good health is a duty..." - Buddha

The female athlete triad is a medical term that refers to three separate health conditions occurring at the same time in female athletes. The three conditions are:

Caloric Energy Deficit – Typically dancers are conscious of the food they eat.  They worry about ingesting too many calories and gaining weight. The problem with this logic is that calories also supply dancers with the energy they need to perform in class, rehearsals and on stage.  By reducing their caloric intake, dancers often end up burning more calories than they eat and create an energy deficit.

Irregular Menstrual Cycles – Many dancers experience irregular cycles or may find that their periods stop completely. The purpose of periods is to support the life of a developing baby. If the body does not have enough fat or is not at a healthy weight that could sustain both the body and a developing fetus, periods will stop. Dancers who are below a healthy body weight and/or lack body fat may experience irregular cycles or an absence of a cycle.

Osteoporosis – Irregular or absent menstrual cycles cause low levels of estrogen in the body. Our bodies need estrogen to be able to properly absorb and use calcium, which is necessary for bone growth. If our estrogen levels are low, calcium is not absorbed and bone growth in hindered. The lack of bone growth leads to osteoporosis. Osteoporosis is a decrease in bone density which results in weakened bones that can break easily and may result in stress fractures in dancers.

When all three of these factors combine, they create a weakened state and a very unhealthy dancer.  

http://www.femaleathletetriad.org/for-professionals/what-is-the-triad/

Knowing how to eat healthy is a key element in avoiding the female athlete triad. Dancers need to remember that they expend a lot of energy on a daily basis and that the food we eat is the fuel that powers our bodies. According to USDA Dietary Guidelines for Americans, active teen females should consume between 2200-2400 calories per day. It is extremely important that these calories be healthy calories that will provide dancers with enough energy to get through their long days of classes and rehearsals and enough protein to keep their muscles healthy. 

Learning about nutrition and what to eat before and after class and rehearsals is extremely important. It is also important that dancers who experience irregular or an absence of menstrual cycles speak with their health professionals to avoid sliding down the slippery slope of injury.

What happens to our muscles when we don't drink enough water?

         

“Water is the driving force in nature.” - Leonardo da Vinci


Summer is here, and dancers will constantly be encouraged to stay hydrated. Past blog posts have discussed which beverages are best to drink while exercising.

But why do we need to stay hydrated? 

And what happens inside our bodies when we become dehydrated?

          

Our bodies are 60% water and water can be found:

• in the tears that keep our eyes moist and flush out dirt
• in our saliva and our digestive system to help break down foods and absorb nutrients
• in our blood to help transport nutrients and oxygen
• in the synovial fluid in our joints to keep our bones from grinding against each other
• around our brains and spinal cords where it provides cushioning
• in our sweat which helps keep us cool and maintains our body temperature
• in our urine where it eliminates toxins from our bodies
• in our muscle cells which rely upon it to function properly     

        We lose water through our tears, our sweat and everyone time we use the bathroom but through other less obvious ways as well. We lose 250 milliliters a day by simply breathing. People can survive several weeks without food but only one week without water.

        People often use thirst as a signal that they are becoming dehydrated. Thirst in an unreliable indicator - when you grow thirsty, you are probably already dehydrated. Other symptoms of dehydration are chills, clammy skin, an increased heart rate, nausea, headache, dizziness and shortness of breath.

        Since dancers rely upon their muscles, it is important to know exactly what happens in the muscle cells when the body is lacking water. During any type of physical exercise or training, muscles experience minor tears, or microtraumas. When muscles contract, water flows from the blood into the muscles. This water is used when the body begins to repair the microtraumas that have occurred during exercise. Through muscular protein synthesis (MPS) damaged protein is moved out of the muscles, and stronger, denser, new versions of the damaged proteins are created.

        When the body is dehydrated, instead of the water traveling into the muscles from the blood, the blood begins to steal water from the muscle cells. Since MPS uses water, the creation of new protein slows down, muscle cells begin to shrivel, and the dancer will experience muscular fatigue.

        According to the American College of Sports Medicine, muscular fatigue increases the strain upon the body and the dancer or athlete needs to exert more effort to perform exercises which leads to an increased stress load upon the already often overworked body.

          It is for these reasons that dancers need to stay a step ahead of their bodies, drink proactively, and never allow themselves to grow dehydrated.     

Why Having Multiple Teachers Can Be a Good Thing

            “No one’s education is every complete.” 
                                                                  – John Marks Templeton

            When dance students first begin taking dance classes, they are, more than likely, introduced to one dance teacher who will begin to expose them to the world of dance. This teacher can provide the disciplined routine upon which to build a strong dance education. Having one teacher helps foster a student’s basic understanding of dance and establishes a strong foundation from which the student can begin to branch out and grow.     

            As dancers grow serious about their training, they will begin to realize that different dance educators have different ways of teaching. While the format for a dance class is standard, the material that is presented and how it is presented can differ greatly, depending upon the dance educator’s background. Some dance educators have been performers, some have earned degrees in dance, some have experience in many techniques, and others may have focused in depth on one technique. Some may approach dance from a traditional perspective while others may combine dance science with dance technique to formulate their classes. All of these dance educators have something valuable to offer their students.

            Everyone learns differently. Some of us are visual learners and will have great success with a dance educator who demonstrates every combination, some are auditory learners and will excel with teachers who emphasize dance terminology and counts, and others are kinesthetic learners and will perform best with teachers who use a hands on approach and encourage them to boldly try new movement.

            While all dance educators must incorporate dance technique, presentational and performing skills, musicality, and proper anatomical instruction in their classes, each individual educator may focus upon one of these categories more than the others. Those with extensive performing experience may emphasize the presentational and performing skills. Educators with a dance science background may spend a good deal of time speaking about how the body works. Teachers who also have a background in music may insist on paying careful attention to musicality throughout the entire class.

            Additionally, some dance educators may focus more upon alignment, some may focus more upon turns, some may focus more on jumps, some may focus more upon the technique of the upper body, and some may focus more upon lower body technique. Some teachers may use imagery in class to explain how to perform a step while others may use technical terminology or movement quality descriptions.

            It is for these reasons that students who are pursuing advanced dance training should have the opportunity to study with more than one teacher.  In doing so, students may develop a more well-rounded approach to dancing. A particular exercise that may have always been a struggle can become clearer when it is approached or described in a new way. Becoming the strongest dancer possible is dependent upon the students’ opportunity to seek out other dance educators and glean as much from each of them as possible.

            Dance educators should not feel threatened when their students seek supplementary training but should instead encourage it. When students begin to explore the bigger world of dance, they do so because they are passionate about the artform. The original dance educators get to claim credit for instilling this passion and providing these students with a lifelong gift that is more important than any technical training could ever be.

The Psychology of the Injured Dancer

"A setback is a setup for a comeback" - T.D. Jakes

          Dancers spend so much time taking class, rehearsing and performing that experiencing an injury at some point in their training or their careers is almost inevitable.

          Injury rates among dancers have been reported to be as high as 97%, yet less than 50% of those injuries are treated by medical professionals.  Dancers tend to dance through any pain they feel because they worry about missing class and losing technique, losing their roles to other dancers and losing pay due to missed rehearsals and performances.

          However, injuries do occur, and there are times when dancers may be forced to stop dancing for a period of time. It is important for everyone in the dance field to know and understand that there are some psychological effects a dancer may likely experience when injured.


          A dancer may feel shocked and frustrated to discover that this body that he/she has spent year's training has betrayed him/her. If the injury forces the dancer to take time off, the frustration may soon turn to depression as the dancer begins to miss classes and/or rehearsals. It is important to note that this depression may not only be psychological but may have some of its roots in the fact that when we dance our bodies naturally release endorphins which promote a sense of euphoria. When dancers are forced to stop, the endorphins are not released, and they will not experience the sense of euphoria which is a normal state for them.

          Standard practice within the dance community is that injured dancers should attend classes and rehearsal when injured and observe. Although dancers can certainly learn by observing (see my post, about mental rehearsal), a 1996 study determined that watching class was related to an increase in  the injured dancer's feelings of guilt, anger and distress over being injured.

          As the injury begins to heal, the dancer will grow optimistic but may soon become pessimistic as he/she grows impatient with the amount of time necessary for the body to heal.

          Dance directors, educators and parents can help dancers cope with injuries in several ways. Very few dancers have enough anatomical knowledge to understand the nature of an injury and the body's recovery process. By educating dancers before injuries occur, we can eliminate the fear that often accompanies an injury.

          Dancers need to be reassured by everyone around them that injuries are temporary and that they will eventually be able to return to the technical level at which they were performing prior to the injury.

          It is equally important for an injured dancer to see a medical professional who understands the mentality of dancers. The doctor or physical therapist should understand that the primary goal is to get the dancer back in the studio as soon as possible and provide realistic rehabilitation exercises. Quite often, the rehabilitation exercises that are prescribed are less challenging than the exercises dancers do on a daily basis.

          Lastly, it is important that injured dancers who sit through class or rehearsals feel they have a purpose. A dancer with a leg injury can sit in a chair and perform all of the upper body movements, or the dancer may be asked to take notes for the teacher or rehearsal director so that he/she feels valued.

          While it is inevitable that injuries will occur in dance, psychological feelings of depression, fear, and anxiety may be avoidable or alleviated by the approaches of those surrounding the dancer. Their reassurances and kind gestures can help keep the injured dancer in a healthy psychological state while the body is given the chance to heal.

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Bowling, A.  (1989) Injuries to dancers:  prevalence, treatment and perceptions of causes. BMJ. 298:731-34.

Kerr, G., Krasnow, D., Mainwaring, L.  (1992) The nature of dance injuries. Medical Problems of Performing Artists. 7:25-9.

Macchi R, Crossman J. (1996). After the Fall: Reflections of injured classical ballet dancers, Journal of Sport Behavior. 19(3): 221-234. 

The Perfectionist Adolescent Dancer and a Happy New Year Giveaway!

            "Understanding the difference between healthy striving and perfectionism is critical..." - Brené Brown

          Adolescent dancers experience a growth spurt between the ages of 11 and 14 that can last from 1-2 years. As was discussed in the post Dancing Through the AdolescentGrowth Spurt, major physical changes affect how the body moves and can make dancing difficult. The body seems foreign to the dancer, and movements that were once performed easily may now seem impossible. It is also important for dancers, dance parents, and dance educators to understand and acknowledge the psychology of the adolescent dancer.

            Studies on dancers indicate that they tend to be perfectionists. Perfectionists are individuals who are overly critical of themselves, strive to achieve because they have an intense fear of failure, and look at most opportunities as risks for failure rather than chances for success.

            Perfectionism can be divided into three different categories:

                        self-oriented – An individual who wants to be perfect, 
                                    sets unrealistic/unattainable goals, focuses on flaws, is his/her worst 
                                    critic, and believes he/she is only as good as his/her performance.

                        other-oriented – An individual who judges others harshly, sets 
                                  unrealistic expectations for family, friends or peers, and has trouble 
                                  trusting others to follow-through with plans.

                                 socially-prescribed – An individual who becomes obsessed with
                                 trying to live up to others' standards or expectations.

          
          A 2014 study found that university age dancers showed significantly higher levels of self-oriented perfectionism than their peers. This tendency to be overly critical of themselves led them to feel negatively about themselves in general, made them feel they could not live up to the expectations of others, and resulted in high levels of socially prescribed perfectionism.

                       

            If dancers are normally hard on themselves and display perfectionist tendencies, it seems logical that these feelings would be amplified during adolescence.

            As dancers experience changes in body mass and shape which lead to decreased flexibility and difficulties with coordination and balance, they begin to feel defeated. It is not uncommon for adolescent dancers to feel that they should quit studying dance because they cannot perform as well as they once did. Although the physical effects are temporary, the adolescent will still struggle with a decrease in self-confidence.

            It is important for dance educators and parents to provide emotional stability and support during this time. While corrections should still be given, the educator should acknowledge that there are some areas, like flexibility and coordination, over which the adolescent dancer may have little or no control.

            Letting the dancer know that people understand what is happening validates everything the dancer is experiencing and can help relieve some of the psychological pressure. Encouraging adolescent dancers to be patient with themselves will help them realize that once the growth spurt is over, they will soon feel in control of their bodies once again and will no longer feel frustrated with their dancing.

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Eusanio, J., Thomson, P., & Jaque, S.V. (2014) Perfectionism, Shame and Self-Concept in Dancers as a Mediation Analysis. Journal of Dance Medicine and Science, 18:3.

Krasnow, D., Mainwaring, L., & Kerr, G. (1999) Injury, Stress & Perfectionism in Young Dancers and Gymnasts. Journal of Dance Medicine and Science, 3:2.

OUR GIVEAWAY!!

A new novel written by former ballerina and Pushcart Prize nominee Sari Wilson is a coming of age story that follows a young dancer on her quest for perfection in the cutthroat world of New York City Ballet.

It has been described as a cross between Black Swan and Lolita, and Harper Collins is offering one of our lucky readers a chance to win a copy of this book which will go on sale January 26 through the author’s website, www.sariwilson.com. To be entered for a chance to win between now and midnight on January 31, comment on this post letting us know what topics you'd like The Healthy Dancer to cover this year. You can also increase your chances of winning by tweeting about this blogpost.  Just follow the directions below!

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