MAXIMIZING WRESTLING PERFORMANCE THROUGH HEALTHY EATING

Taken from the video of the same title produced by the National Wrestling Coaches Association.

The information provided here comes from the video produced by the NWCA. It is provided in print form so coaches can make copies to distribute to wrestlers & parents. The information is provided by Karen Wetherall, Ms, RD, LD, Sports Nutritionist at the University of Tennessee, Lisa McAnulty, PhD, RD, Sports Nutritionist with Appalachian State University, and Debra Vinci, Dr.PH, RD, LDN Sports Nutritionist with Appalachian State University.

Question #1: Why are high carbohydrate foods important to wrestlers and what are some high carbohydrate foods?

High carbohydrate foods provide the muscles with readily available energy needed for optimal performance. Carbohydrates are provided in foods such as breads, cereals, rice, corn, pretzels, pasta, potatoes, fruits, vegetables, and fruit and vegetable juices.

Question #2: How much protein does a wrestler need and what are some sources of high quality protein?

About 15-20% of a wrestler's calories should come from protein. Specifically, a wrestler should consume about .6 grams of protein daily for each pound of body weight. A 152-pound wrestler should consume about 91 grams of protein per day.

Good sources of protein include: 3 ounces of lean meat, poultry or fish = 21 grams; ½ cup of beans or peas = 7 grams; 1 egg = 7 grams; 1/4 cup cottage cheese = 7 grams; 1 ounce of cheese = 7 grams; 8 ounces of low fat milk or yogurt = 8 grams.

Question #3: Should wrestlers use any nutritional supplements?

If they are concerned about maintaining a healthy diet they may choose to take a multivitamin, but should not need any other supplements.

Question #4: What should wrestlers eat between the time they weigh in and compete?

Drinking fluids is the most important thing. Water, or a sports drink containing no more than 8% carbohydrate are both good choices. Eating fruit, turkey on bread, or a cereal bar are also good choices.

Question #5: What should wrestlers drink between weigh-in and competition?

About 1 hour before competition they should drink 2 cups of fluids that contain some carbohydrate and electrolytes, especially sodium and potassium. About 15 - 20 minutes before competition they should drink another 1 ½ - 2 cups of similar fluid or water. Any fluid consumed within 1 hour of competition or a workout should not contain more than 60 calories per 8-ounce serving. Drinking fluid with more calories than this delays the speed the fluid is absorbed by the body and may cause an upset stomach during exercise.

Question #6: What should wrestlers eat during an all-day tournament?

Fluids are the most important, followed by carbohydrates & a little protein. Low-fat chocolate milk, Carnation Instant Breakfast mix, or anything mentioned in question #5 are good choices.

Baby carrots, celery, fruit, low fat granola bars, cereal bars, and low fat yogurt are all good choices. When eating prepackaged snack foods, choose those that have 4 grams of carbohydrate for every 1 gram of fat.

Question #7: What should wrestlers drink during all-day tournaments?

About 2 hours before competition they should drink 2 cups of fluid. This fluid may contain about 180 calories per 8-ounce serving. About 1 hour before competition they should drink 2 cups of fluids that contain some carbohydrate and electrolytes, especially sodium and potassium. About 15 - 20 minutes before competition they should drink another 1 ½ - 2 cups of similar fluid or water. Any fluid consumed within 1 hour of competition or a workout should not contain more than 60 calories per 8-ounce serving. Drinking fluid with more calories than this delays the speed the fluid is absorbed by the body and may cause an upset stomach during exercise.

Question #8: What should a wrestler eat after a workout or a match to help boost recovery?

Fluids are a must. Fruit and vegetable juices are good. Anything that is good between the weigh-in and competition, and for an all-day tournament is also good after a workout or competition. Within one hour after exercise wrestlers can benefit from eating foods that contain protein. See questions #9 and #10 for healthy protein choices.

Question #9: What kind of food preparation should be considered when trying to lose weight?

Try to eat fewer processed foods. For example, eat more raw fruits and vegetables. Choose lean meats, tuna salad with lite mayonnaise, salad with turkey and low fat dressing, stir fry with only a little oil for cooking, lean meat sandwiches and pasta.

Question #10: Is it possible to eat healthy at a fast food restaurant?

Yes, especially if the coach and wrestlers plan ahead. Choosing a fast food restaurant such as Subway or discussing healthy, low fat options at other restaurants are important. Healthy choices would include such foods as turkey, lean roast beef, ham, bean burritos, rice, pasta, salads with turkey or ham & low fat dressings and baked chips. For breakfast, cold & hot cereals and pancakes, waffles, french toast, without extra butter are good choices. To substantially lower the fat, skip the bacon and sausage.

Other thoughts are to choose the foods designated on the menu as "heart healthy choices." Also, skip the butter, gravies, special sauces, etc. Super sizing an order can easily double the fat content compared to a regular serving size.

Question #11: What foods are good "lite," or heart healthy options?

Any foods that are steamed, broiled, char broiled, boiled, poached, grilled, baked, or in its own juice are good choices. Avoid foods that are fried, crispy, buttery, Au Gratin, or served with gravy on top.

Question #12: What are the signs of dehydration?

An athlete can lose about 1% of their body weight through fluid loss with no apparent signs of dehydration. So it's very important for the athlete to drink fluids when any signs of dehydration occur. Symptoms of dehydration are progressive. They include: thirst, dry mouth & throat, flushed skin, fatigue, headache, loss of performance, weakness, increased heart rate, decreased sweating, confusion, dizziness, and collapse into a coma.

Question #13: What are the best ways to prevent dehydration and its negative effects on performance?

First, always avoid voluntary dehydration. This can occur through excessive exercise, saunas, rubber suits, not drinking fluids, using diuretics, etc. Methods of quick weight, which cause dehydration, are unsafe and against the rules. Next, be sure to drink fluids on a regular basis and concentrate on fluid intake during the 24 hours before exercise or competition. Be sure to drink fluids during the 2 hours before exercise or competition using the guidelines already provided. Last, monitor weight loss and urine color. When adequately hydrated, one's urine should be pale or clear in color. Every pound of weight lost during exercise should be replaced by drinking 24 ounces of fluid within several hours after exercise.

Question #14: Is it better to drink water or a sports drink?

There is nothing wrong with drinking water. It does not contain electrolytes or carbohydrate which may improve performance in some cases, but it will not be detrimental to performance either. Sports drinks can improve performance in some situations, but can also be harmful to performance if used improperly. Discussion has already taken place, in questions #5 and #7, about how much carbohydrate a sports drink should contain to improve, or not be harmful to performance. It is also important to avoid fructose in a sports drink. Fructose is not absorbed well by the body and may cause stomach upset. Sports drinks should not contain caffeine as it will dehydrate the body further.

Here is the formula for a home made thirst quencher that is easy to make and much cheaper than commercial brands: ½ cup honey; ½ teaspoon lite salt; 1/4 cup lemon juice; and 7 ½ cups luke warm water. This drink is made with luke warm water so the honey will be dissolved. It can be cooled after making it. The drink contains about 60 calories, 72 milligrams of sodium and 85 milligrams of potassium per 8-ounce serving.

Should I Wear A Mouthguard?
This article explains the benefits of wearing a mouthguard while wrestling. Wearing a mouthguard is not mandatory in the IKWF or to wrestle with the Matmen. The older and stronger the wrestlers get the greater the contact so wearing a mouthguard at an early age will get wrestlers comfortable wearing it while they wrestle so when they are older there is less of a chance for injury.

Fluids and Hydration
How important are fluids?

When you are dehydrated, you have a smaller volume of blood circulating through your body. Consequently, the amount of blood your heart pumps with each beat decreases and your exercising muscles do not receive enough oxygen from your blood. Soon exhaustion sets in and your athletic performance suffers.

If you have lost as little as 2% of your body weight due to dehydration, it can adversely affect your athletic performance. For example, if you are a 150-pound athlete and you lose 3 pounds during a workout, your performance will start to suffer unless you replace the fluid you have lost. Proper fluid replacement is the key to preventing dehydration and reducing the risk of heat injury during training and competition.

How can I prevent dehydration?

The best way to prevent dehydration is to maintain body fluid levels by drinking plenty of fluids before, during, and after a workout or race. Often athletes are not aware that they are losing body fluid or that their performance is being impacted by dehydration.

If you are not sure how much fluid to drink, you can monitor your hydration using one of these methods.

Weight: Weigh yourself before practice and again after practice. For every pound you lose during the workout you will need to drink 2 cups of fluid to re-hydrate your body.

Urine color: Check the color of your urine. If it is a dark gold color like apple juice, you are dehydrated. If you are well hydrated, the color of your urine will look like pale lemonade.

Thirst is not an accurate indicator of how much fluid you have lost. If you wait until you are thirsty to replenish body fluids, then you are already dehydrated. Most people do not become thirsty until they have lost more than 2% of their body weight. And if you only drink enough to quench your thirst, you may still be dehydrated.

Keep a water bottle available when working out and drink as often as you want, ideally every 15 to 30 minutes. High school and junior high school athletes can bring a water bottle to school and drink between classes and during breaks so they show up at workouts hydrated.

What about sport drinks?

Researchers have found that sports drinks containing between 6% and 8% carbohydrate (sugars) are absorbed into the body as rapidly as water and can provide energy to working muscles that water cannot. This extra energy can delay fatigue and possibly improve performance, particularly if the sport lasts longer than 1 hour. If you drink a sports drink, you can maintain your blood sugar level even when the sugar stored in your muscles (glycogen) is running low. This allows your body to continue to produce energy at a high rate.

Drinks containing less than 5% carbohydrate do not provide enough energy to improve your performance. So, athletes who dilute sports drink are most likely not getting enough energy from their drink to maintain a good blood sugar level. Drinking beverages that exceed a 10% carbohydrate level (most soda pop and some fruit juices) often have negative side effects such as abdominal cramps, nausea, and diarrhea and can hurt your performance.

What does the sodium in sports drinks do?

Sodium is an electrolyte needed to help maintain proper fluid balance in your body. Sodium helps your body absorb and retain more water. Researchers have found that the fluid from an 8-ounce serving of a sports drink with 6% carbohydrates (sugars) and about 110 mg of sodium absorbs into your body faster than plain water.

Some parents, coaches, and athletes are concerned that sports drinks may contain too much sodium. However, most sports drinks are actually low in sodium. An 8-ounce serving of Gatorade has a sodium content similar to a cup of 2% milk. Most Americans do get too much sodium, but usually from eating convenience-type foods, not from sports drinks.

What are guidelines for fluid replacement?

Drink a sports drink containing 6% to 8% carbohydrates to help give you more energy during intense training and long workouts. To figure out the percentage of carbohydrate in your drink use the following formula:

grams of carbohydrate/serving

-------------------------------------------- X 100 = % of carbohydrate in drink

ml of drink/serving

For example, 240 ml (a 1-cup serving) of a drink with 24 grams of carbohydrate per serving would have a 10% carbohydrate concentration. Almost all drinks have the grams of carbohydrate per serving and the volume in ml somewhere on the container.

*Drink a beverage that contains a small amount of sodium and other electrolytes (like potassium and chloride).

*Find a beverage that tastes good; something cold and sweet is easier to drink.

*Drink 10 to 16 ounces of cold fluid about 15 to 30 minutes before workouts. Drinking a sports drink with a 6% to 8% carbohydrate level is useful to help build up energy stores in your muscles, particularly if the workout will last longer than 1 hour.

*Drink 4 to 8 ounces of cold fluid during exercise at 10 to 15 minute intervals.

*Start drinking early in your workout because you will not feel thirsty until you have already lost 2% of your body weight; by that time your performance may have begun to decline.

*Avoid carbonated drinks, which can cause gastrointestinal distress and may decrease the fluid volume.

*Avoid beverages containing caffeine and alcohol due to their diuretic effect.

*Practice drinking fluids while you train. If you have never used a sports drink don't start during a meet or on race day. Use a trial-and-error approach until you find the drink that works for you.

THE ATHLETE'S KITCHEN

Copyright: Nancy Clark, MS, RD 9/04

Peanut Butter: A Super Sports Food

In this day and age of energy bars, protein powders and weight gain shakes, many athletes forget about “real" foods, such as peanut butter. Peanut butter, in my opinion, is one of the best sports foods around. It’s tasty, inexpensive, satisfying, nourishing––and even good for our health. But all too often, I hear athletes say "I don't keep peanut butter in my house. It's too fatty, too fattening." or "I ration peanut butter to once per week––on my Sunday morning bagel." They try to stay away from peanut butter. That’s nuts!

Yes, peanut butter is calorie-dense. But it can beneficially fit into your sports diet. The following information explains why I vote peanut butter (and all nuts and nut butters, for that matter) to be a super sports food for athletes who want to eat well and invest in their health.

• Peanut butter is satiating and satisfying ... perfect for dieters.

Because you will never win the war against hunger, your best bet is to eat foods that keep you feeling fed. This means, foods with protein and fiber––like peanut butter (and nuts, in general). You'll feel fuller for longer if you have half a whole wheat bagel with peanut butter, as compared to the same amount of calories of a plain white bagel. The protein and fiber in peanut butter "sticks to your ribs" and is not fattening–unless you overeat total calories that day.

A Perdue University study reports subjects who ate peanuts every day did not overeat daily calories. (Kirkmeyer, Int'l J Obesity 24:1167, 2000) Peanut eaters tend to naturally eat less at other times of the day. (Alper, Int'l J Obesity 26:1129, 2002) Plus, if you enjoy what you are eating on your reducing diet, you'll stay with the food plan and be able to keep the weight off. This is far better than yo-yo dieting!

• Peanut butter is a quick and easy way to reduce your risk of heart disease.

Just slap together a peanut butter (and honey or jelly) sandwich on multi-grain bread, and you have the makings of a heart-healthy meal, if not a childhood memory. A quick and easy peanut butter sandwich is healthier, by far, than a fast food burger or fried chicken dinner and far better than, let's say, an equally easy "meal" of chips or ice cream. That's because peanut butter offers health-protective mono- and polyunsaturated oil. Trading burgers (saturated fat) for peanut butter sandwiches reduces your risk of developing heart disease. In fact, the more often you eat peanut butter (and nuts), the lower your risk of heart disease. (Hu, J Am College Nutr 20(1):5, 2001) Start spreading peanut butter (instead of butter) on toast. Enjoy PB & banana for a "decadent" snack in place of ice cream.

• Peanut butter is an affordable source of calories.

If you are a hungry athlete who needs 3,000 or more calories a day, you can spend a significant amount of money fueling yourself (especially if you routinely eat protein bars, weight gain shakes and other engineered sports foods). Peanut butter can fuel your body without breaking the bank. One hundred calories of peanut butter (about 1 tablespoon) costs about 7¢, far less than 100 calories of other protein sources, such as cottage cheese (55¢ per 100 calories), tuna (60¢) and deli turkey breast (75¢). The cost of 200 calories of peanut butter is about 15¢, far less than the $1.49 you'd spend on 200 calories of an energy bar... and generally, the peanut butter is far tastier!

• Peanut butter is a source of protein, needed to build and repair muscles.

But take note: peanut butter is not protein-dense. That is, two tablespoons of peanut butter, the amount in an average sandwich, provides about 7 grams of protein. In comparison, the calorie equivalent of turkey in a sandwich offers about 20 grams of protein. Athletes who weigh 140 pounds may need 70 to 100 grams protein per day; 200-pound athletes, 100 to 150 grams. For 100 grams of protein, you'd have to eat the whole jar of peanut butter! Unlikely!

To boost the protein value of peanut butter, simply accompany it with a tall glass of milk: a PB &J sandwich + 16 ounces lowfat milk = 28 grams of protein, a good chunk of your daily requirement. Milk simultaneously enhances the value of the protein in the peanut butter sandwich. That is, peanuts are low in some of the essential amino acids muscles need for growth and repair. The amino acids in milk (as well as those in the sandwich bread) nicely complement the limiting amino acids in peanuts.

• Peanut butter is a reasonable source of vitamins, minerals and other health-protective food compounds. For example, peanut butter contains folate, vitamin E, magnesium and resveratrol, all nutrients associated with reduced risk of heart disease. Magnesium is also associated with reduced risk of adult-onset diabetes. Peanut butter offers a small amount of zinc, a mineral important for healing and strengthening the immune system. As an athlete, you need all these nutrients to keep you off the bench and on the playing field.

• Peanut butter contains fiber--not a lot (1 gram per tablespoon) but some.

Fiber in food contributes to a feeling of fullness that can help dieters eat less without feeling hungry. Fiber also promotes regular bowel movements and helps reduce problems with constipation. By enjoying peanut butter on whole grain bread, you can contribute 6 to 8 grams of fiber towards the recommended target of 20 to 35 grams fiber per day.

• Peanuts contain mostly health-protective mono- and polyunsaturated fats.

When peanuts are made into commercial peanut butter (such as Skippy or Jif), some of the oil gets converted into a harder, saturated fat. This keeps the oil from separating to the top. The hardened oil, called trans-fat, is less healthful. But the good news is, commercial peanut butters contain only a tiny amount of trans fats and just a small amount of (naturally occurring) saturated fat. For example, only 3.5 of the 17 grams fat in two tablespoons of Skippy are "bad."

To minimize your intake of even this small amount of unhealthful fat, you can buy all-natural peanut butter. If you dislike the way the oil in this type of peanut butter separates to the top of the jar, simply store the jar upside down. That way, the oil rises to what becomes the bottom of the jar when you turn it over to open it. And if you eat peanut butter daily, you won't have to refrigerate it, thereby making the all-natural peanut butter easier to spread.

• Caution: Peanut butter is a poor source of the carbohydrates needed for muscle fuel.

Don't try to subsist on peanut butter by the spoonful! Luckily, peanut butter combines nicely with banana, bread, apples, oatmeal, crackers, raisins, and even pasta (as in Thai noodle dishes). These combinations will balance your sports diet.

Sports nutritionist Nancy Clark, MS, RD offers nutrition consultations to casual and competitive athletes at her private practice in Healthworks (617-383-6100) in Chestnut Hill MA. Her Sports Nutrition Guidebook ($23) and Food Guide for Marathoners ($20) offer abundant information on how to enhance your sports diet. Both books are available at www.nancyclarkrd.com or by sending a check to PO Box 650124, West Newton MA 02465.

Water or Sport Drinks

Fluid replacement is vital for athletes or anybody who is alive and breathing. This paper looks at fluid replacement to replenish the body.

Water. Water is most important for several reasons. For one, water is abound and around everywhere in the continental usa and in most cases is free. Experts believe water to be the most important nutrient to all bodies…second only to the air we breathe or oxygen. Some other important functions of water are that: it is needed to maintain homeostasis, it is the most abundant solvent or medium in the human body, it is important in regulating cell volume, nutrient transport, waste removal, and body temperature, & it is distributed both in intra- and intercellular compartments and accounts for up to 80% of our body weight at birth and up to 70% of our adult body weight.

People who work out and or lose water or sweat via workouts may need to replace more of this fluid. Researchers believe it depends on several factors such as climate, age, exercise level, and body weight to determine the appropriate amounts of water needed daily. For instance, if you sweat more profusely or more than someone older, younger, bigger, or smaller, you may need to drink more water. Two other examples are people exercising at high altitudes and people exercising at elevated or hot environments. These folks may lose more water via sweat thus requiring more water replacement. Every ones body is different, but all bodies need water.

Proper hydration should begin before you begin to exercise, while you are exercising, and after exercise is complete. Here are some suggestions:

· drink 17 to 20 oz of water 2 to 3 hours before exercise

· drink 7 to 10 oz of water 10 to 20 minutes before exercise

· drink 7 to 10 oz of water every 10 to 20 minutes during activity

· if you sweat heavily, you may need to drink more

Experts have not determined how much water everyone needs because everyone is different and several other factors. But, all of the experts suggest by the time you are thirsty due to exercising you may already be dehydrated.

Sport Drinks. There are several sport drinks that replenish the body with electrolytes. These drinks and others like them (read the labels to find what the drinks contain) are known to keep the body from overheating, much like water, and also supply the body with the electrolytes potassium, magnesium, calcium, and sodium to provide energy during intense workouts (water does not replace these energy sources). Sport drinks may be considered an enhancement over water as a body temperature regulator and fluid replacer for the aforementioned reasons.

It is interesting to note that most sport drinks, if not all, have flavors. This is done, perhaps, to make certain you drink the appropriate amounts of the drinks and or a marketing ploy. Sometimes, people drink till they are not thirsty which may or may not replace or hydrate the body fully. Most sport drinks with flavor tend to make folks drink more thus hydrating the body fully. Unlike most waters, sport drinks are not free.

Super Sport Drinks. Super sport drinks tend to add to what water and sport drinks already have. Some of the ingredients in super sport drinks may include: choline, creatine, protein, carbohydrates, & antioxidants (again, it is important to read the labels). Most of these drinks are designed for endurance athletes or sports they may perform for hours on end. The body tends to lose more energy and other nutrients when workouts are longer or of the endurance nature.

Super sport drinks are also known to help muscle recovery. Soreness that results from overuse of body or muscles may be relieved if super sports drinks are employed within half an hour after intense exercising.

Fruit Juices. Fruit juices are fine for dinners and or snacks. But, fruit juices are typically over concentrated with carbohydrates and sugars and thus may not be suited ideally as a fluid replacer before, during, or after exercising. The high levels of sugars and carbohydrates may trigger an upset stomach or a laxative effect in your body. This may work against your body and dehydrate you further or make your stomach have severe pains.

Caffeine Drinks. Drinks like coffee or colas may not replace fluids in the short or long run. In fact, these drinks are known to be diuretics and can even have a laxative effect too. Although most of these drinks are water like and water is the main source of fluid in them, they appear to do more damage as a fluid replacer. Caffeine drinks also do not replenish any of the electrolyte stores the body loses during sweating.

Understanding why & how fluid replacement may enhance your workouts is important. This paper briefly alluded to suggestions that may help you on your quest to effectively and efficiently replenish your body with fluids.

The Importance of a Clean Wrestling Room

by Yvette Ingram, Lock Haven University (PA)

Consequences of an Unclean Mat

If a wrestling mat is not cleaned properly athletes may catch skin diseases. Staphylococcal infections, ringworm, impetigo, and herpes simplex virus are the four most commonly seen in wrestling. One problem lies in the fact that not only can wrestlers catch skin disease from other teammates, they can also catch skin diseases from others who may use the wrestling room. For example at Lock Haven University physical education classes also use the wrestling facilities.

How can skin diseases be prevented?

Keeping The Mat Clean
·
All mats and walls should be cleaned on a daily basis with a disinfectant cleaner such as a solution of 1:100 household bleach and water. This solution should be made everyday (5).

Street shoes should not be worn on a wrestling mat and wrestling shoes should not be worn off of a wrestling matt (6). This is where the physical education classes hinder the wrestling room process, PE classes often just wear whatever shoes they wear outside.

What wrestlers and coaches can do to stop the spread of skin diseases:

General

• Do not use others combs, brushes, hair ornaments, hats, scarves, towels, washcloths, socks or shoes.
• Never walk barefoot in public places. If you must use a public shower area always wear shower shoes.
• After bathing or swimming dry your feet and in between your toes thoroughly.
• Do not involve yourself in any contact sports without wearing socks or shoes (3).
• Expose your feet to the air when you are at home. Change your socks and underwear frequently.
• Do not wear heavy clothing in warm weather that will cause you to sweat.
• Check your pets for areas of hair loss(4).
• Wrestlers should shower before and after workouts with disinfectant soap.
• Clothing should be washed daily including all towels (6).
• Wash hands frequently (5).

Wrestling

• Following each use of head gear the equipment should be wiped down with alcohol pads.
• Coaches should direct skin inspections on a daily basis.
• Wrestlers that have open wounds or any breaks in the skin should be dissuaded from participating until the skin is healed or the wrestler has been allowed to participate by a licensed physician. If a wrestler is cleared to play, they should have the affected area covered to avoid any cross contamination form happening (6).
• If a wrestler believes they may have a skin infection the athlete must notify a coach and athletic trainers as soon as possible.
• Ventilate the wrestling room with fans to lower the humidity and temperature.
• Neoprene sleeves and support braces must be wiped with a disinfectant after each use.
• All team members should keep their finger nails short in order to avoid scratching anyone (5).
• If a wrestler sees a skin lesion on his/her body, s/he needs to get it checked immediately. The wrestler should tell the coach about it, as well as seeing a physician at the first opportunity. The athletic trainer should also be made aware of the skin infection.

Ringworm

Ringworm is a contagious fungus infection that can affect the scalp, the body, the feet (athlete's foot), or the nails.

• People can get Ringworm from: 1) direct skin-to-skin contact with an infected person or pet, 2) indirect contact with an object or surface that an infected person or pet has touched, or 3) rarely, by contact with soil.
• Ringworm can be treated with fungus-killing medicine.
• To prevent Ringworm, 1) make sure all infected persons and pets get appropriate treatment, 2) avoid contact with infected persons and pets, 3) do not share personal items, and 4) keep common-use areas clean.

What is Ringworm?

Ringworm is a contagious fungus infection that can affect the scalp, the body (particularly the groin), the feet, and the nails. Despite its name, it has nothing to do with worms. The name comes from the characteristic red ring that can appear on an infected person's skin. Ringworm is also called Tinea.

What is the infectious agent that causes Ringworm?

Ringworm is caused by several different fungus organisms that all belong to a group called "Dermatophytes." Different Dermatophytes affect different parts of the body and cause the various types of Ringworm:

• Ringworm of the scalp
• Ringworm of the body
• Ringworm of the foot (athlete's foot)
• Ringworm of the nails

Where is Ringworm found?

Ringworm is widespread around the world and in the United States. The fungus that causes scalp Ringworm lives in humans and animals. The fungus that causes Ringworm of the body lives in humans, animals, and soil. The fungi that cause Ringworm of the foot and Ringworm of the nails live only in humans.

How do people get Ringworm?

Ringworm is spread by either direct or indirect contact. People can get Ringworm by direct skin-to-skin contact with an infected person or pet. People can also get Ringworm indirectly by contact with objects or surfaces that an infected person or pet has touched, such as hats, combs, brushes, bed linens, stuffed animals, telephones, gym mats, and shower stalls. In rare cases Ringworm can be spread by contact with soil.

What are the signs and symptoms of Ringworm?

Ringworm of the scalp usually begins as a small pimple that becomes larger, leaving scaly patches of temporary baldness. Infected hairs become brittle and break off easily. Yellowish crusty areas sometimes develop.

Ringworm of the body shows up as a flat, round patch anywhere on the skin except for the scalp and feet. The groin is a common area of infection (groin Ringworm). As the rash gradually expands, its center clears to produce a ring. More than one patch might appear, and the patches can overlap. The area is sometimes itchy.

Ringworm of the foot is also called athlete's foot. It appears as a scaling or cracking of the skin, especially between the toes.

Ringworm of the nails causes the affected nails to become thicker, discolored, and brittle, or to become chalky and disintegrate.

How soon after exposure do symptoms appear?

Scalp Ringworm usually appears 10 to 14 days after contact, and Ringworm of the skin 4 to 10 days after contact. The time between exposure and symptoms isnot known for the other types of Ringworm.

How is Ringworm diagnosed?

A health-care provider can diagnose Ringworm by examining the site of infection with special tests.

Who is at risk for Ringworm?

Anyone can get Ringworm. Scalp Ringworm often strikes young children; outbreaks have been recognized in schools, day-care centers, and infant nurseries. School athletes are at risk for scalp Ringworm, Ringworm of the body, and foot Ringworm; there have been outbreaks among high school wrestling teams. Children with young pets are at increased risk for Ringworm of the body.

What is the treatment for Ringworm?

Ringworm can be treated with fungus-killing medicine. The medicine can be in taken in tablet or liquid form by mouth or as a cream applied directly to the affected area.

What complications can result from Ringworm?

Lack of or inadequate treatment can result in an infection that will not clear up.

Is Ringworm an emerging infection?

Although Ringworm is not tracked by health authorities, infections appear to be increasing steadily, especially among pre-school and school-age children. Early recognition and treatment are needed to slow the spread of infection and to prevent re-infection.

How can Ringworm be prevented?

Ringworm is difficult to prevent. The fungus is very common, and it is contagious even before symptoms appear.

Steps to prevent infection include the following:

• Educate the public, especially parents, about the risk of Ringworm from infected persons and pets.
• Keep common-use areas clean, especially in schools, day-care centers, gyms, and locker rooms. Disinfect sleeping mats and gym mats after each use.
• Do not share clothing, towels, hair brushes, or other personal items.

Infected persons should follow these steps to keep the infection from spreading:

• Complete treatment as instructed, even after symptoms disappear.
• Do not share towels, hats, clothing, or other personal items with others.
• Minimize close contact with others until tr