A professional vegan footballer (Part 1) – Ian Craig

This case study by Ian Craig showcases how many dietary cases represent more of a psychological than a nutritional intervention.

I revisited his genetics tests, reaffirming his need for detoxification, inflammation and oxidative stress support, plus a little magnesium since he was heterozygous for the COMT 472 gene, which is involved in the inactivation of the catecholamine neurotransmitters.”

As a practitioner, I don’t often work with vegan clients, let alone professional athletes who are vegan. My whole philosophy around human nutrition and nourishment is more all-encompassing than I feel that any singular dietary approach can achieve. That said, I do recognise that certain individuals thrive on ways of eating and living that would make another person ill – “one man’s meat is another man’s poison”.

I also strongly respect the ethics and values of my clients. If an individual has chosen the vegan path for health reasons but I feel they would rather benefit from a small inclusion of animal-sourced food in their diet, I enter negotiation mode. If, on the other hand, their choice is purely ethical and around animal cruelty and not environmental issues, I help them to be the most educated vegan that they can possibly be regarding nutrition.

Introducing Sello

Sello, a 24-year-old South African professional male footballer, played for one of the South African premier division teams. Sello was a left-back explosive player whose football training schedule had been 2h30 of conditioning and pitch time 4/per week, plus an average of 1 game per week. He also added some cycling, running, gym and ball work.

My clinical psychologist colleague, Gerard Finnemore, referred Sello to me. Gerard had worked with him after a hospital visit due to a bout of mental overwhelm six weeks prior to our first appointment. He had been contracted to a new team in another part of the country a year before; he lived in temporary accommodation, didn’t cook sufficiently, and did not resonate with the coach, the dynamics or the interrelationships of the team.

Gerard ran a genetics test, which revealed a mild to moderate tendency towards addictive behaviour (dopaminergic) and stress reactivity (serotonergic), along with some inflammatory potential, which could delay recovery from training.

After meeting him for the first time and hearing his story, I could tell that Sello was one of the most intelligent and driven players I have worked with, adding in complementary training and with a strong awareness of healthy eating behaviours. Standard dietary behaviour in South African clubs is to buy fast food for the players after training and games, whereas Sello had a strong ethical concern for animals and the environment, plus an unusual priority placed on his health. No wonder he struggled to connect with an old-school coach and football system.

A vegan outlier

Sello had been mostly vegetarian for a number of years but had switched to full veganism six months previously. Also acknowledging the other psychological factors in his life at the time, Gerard rightly questioned whether there was a connection between lack of neurotransmitter provision (from amino acids in food) and Sello’s time in the hospital. In terms of gastrointestinal function, his bowels moved 2-3 times per day but were on the loose side, and he became very bloated with a lot of plant-based foods, which was his default diet.

He had grown up with asthma but hadn’t needed his pump for several years. However, he was allergic to dust and experienced some hay fever. More immune significant, though, he’d had a bout of shingles a few months previously, showing clear immune compromise. He also experienced a lot of tendonitis pain and joint stiffness when in full training, not ideal for a professional athlete. His energy was generally good, but he experienced evening fatigue and morning sluggishness, possibly suggesting some adrenal insufficiency.

His genetic tests picked up a deletion on the GSTT1 gene, and he was heterogenous for the GPX1 gene, meaning he had a greater than normal need for glutathione substrate, which happens to be three amino acids: cysteine, glutamic acid and glycine. What’s more, glutathione is a vital systemic antioxidant, which, if in short supply, could compromise the protection of cells with neurological function. He also showed a significant genetic inflammatory tendency, which could bolster oxidative stress and further compromise neurological health. In theory, a vegan diet could be helpful in this regard, but it would depend on the sufficient provision of essential fatty acids and the avoidance of refined grains.

Sello’s diet was not, unfortunately, a great example of veganism – he relied too much on refined oats, bread and cheap peanut butter (high in refined oil and sugar). His dinner typically consisted of brown rice, lentils and vegetables, or a four-bean salad with vegetables and squash. However, I had to remember that for a long time, he had not eaten this way due to temporary accommodation; plus, if I were to count his daily macronutrient contributions, he would likely have fallen short of his professional sporting needs, especially when it came to protein.

My vegan revisions

Turning towards my first intervention with Sello, he set the goal to eat in a way that supported health, energy, mood and performance. I, in turn, focussed on amino acid sufficiency for neurotransmitter, collagen and glutathione provision, plus the inclusion of anti-inflammatory foods. My first job was to upgrade his food sourcing – he had the money to buy quality produce, but he’d been cultured into sourcing cheap, poor-quality foods. I gave him the details of an organic box scheme near where he lived and then taught him the concepts of protein combining e.g. combining legumes and wholegrain in a meal for a complete protein. Revisions shown in Table 1.

Table 1 – First consultation vegan revisions for Sello.

Six months later…

As is sometimes the case with clients, I didn’t see or hear from Sello for six months, but suddenly he was back in my clinic room updating his story. His personal conflicts within his football club had come to a head, essentially forcing him into a transfer to a club in his home city. The plus side was that he was back in his more stable home environment, but the downside was that he had to deal with family dynamics again, including dietary patterns. Having stuck strongly to his vegan ideals away from home (it is often a self-control pattern to isolate one controllable aspect of a person’s life when other things are outside their control), once back home, he had slowly slipped back into his family’s standard eating patterns, which were also far from ideal for a professional athlete.

His breakfast of rolled oats that we’d previously agreed on had largely remained unless he was running late for practice (practice was now at 8.30 am), at which time he would simply consume a piece of fruit with peanut butter. For lunch and dinner, he tended to default to the daily family patterns of poor-quality chicken, white rice or maize meal, boiled vegetables, or a peanut butter sandwich if there wasn’t a prepared meal. With this regime, he was feeling a sense of failure because he had not demonstrated the willpower needed to continue his vegan ideals, along with a certain degree of guilt due to animal consumption. He was, however, in a good psychological place to pursue the moderation principle – bringing back some of his previous vegan patterns while maintaining little animal consumption.

Taking my original dietary recommendations as a nutritional base, I then revised my suggestions to him with some inclusion of animal protein – this is shown in Table 2. 

Table 2 – Second consultation dietary revisions for Sello.

Neurotransmitters and genetics

A few weeks later, now the third consultation, I could delve a little deeper into Sello’s health. I revisited his genetics tests, reaffirming his need for detoxification, inflammation and oxidative stress support, plus a little magnesium since he was heterozygous for the COMT 472 gene, which is involved in the inactivation of the catecholamine neurotransmitters (NTs). I also asked him to complete the Braverman neurotransmitter questionnaire (1), which showed that all NTs assessed (dopamine, acetylcholine, GABA and serotonin) were potentially compromised. GABA was particularly far out of optimal range. Just like depleted serotonin levels are synonymous with depression, depleted GABA levels are strongly linked to anxiety, which was clearly the case for Sello.

The supplement recommendations that I made to him at the time were as follows:

• • High-strength fish oil (along with hemp oil on his food) – anti-inflammation

• • Magnesium malate – COMT enzyme support and muscular recovery

• • Sprouted broccoli seed extract – glutathione support

• • GABA/inositol/l-threonine product – GABA support and anti-anxiety

Conclusions

I haven’t seen Sello for a while, but catching up with him on a recent phone call, he is doing well. Nutritionally, he is eating in a balanced way by bringing some vegan principles into his diet while including selective fish, chicken and dairy products. He continued his psychology work with Gerard (which you’ll hear about in Part 2), and he is currently seeking a transfer to a North American or European club, where his high values of quality physical and mental athletic preparation will more likely be met.

If you want to read Part 2 of this case study, click here.

To continue learning about Integrative Sports Nutrition, where health feeds performance, click here to access CISN’s library of articles.

Click to listen to Ian Craig’s ‘The Science and Strategy of Personalizing Nutrition‘ interview on the Nutra-preneur podcast.