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Dr. Stewart Champions the Whole Person Approach for Female Athletes

Pennington Professor and psychologist Dr. Tiffany Stewart is leading two new studies that will  reveal more connections between physical resilience and psychological health in female  athletes.

“Female athletes face a unique mix of stresses to their mental, physical, hormonal and immune  health during training and competition,” said Dr. Stewart to Pennington news. Stewart is the Director of the Behavior Technology Laboratory at Pennington Biomedical Research Center.  “For too long, sports have focused solely on the results – wins, losses, faster times, and higher  scores – while ignoring athletes’ mental health. But mental resilience and emotional well-being  are every bit as important to succeeding in athletic endeavors or life overall.”

Dr. Stewart’s Behavior Technology Laboratory at LSU’s Pennington Biomedical Research Center  is dedicated to Translational Science. She and her team take health behavior change programs  and the accompanying technologies from laboratory settings and transform them into  programs that everyone can use. The Lab has pioneered the development and testing of e- health technologies in order to bring health behavior tools to those who need it most wherever  they are in the world, reported 225 Magazine.

The new research is supported by two awards from the Wu Tsai Human Performance Alliance,  whose founding members are Stanford University, Boston Children’s Hospital, UC San Diego,  the University of Kansas, the University of Oregon, and the Salk Institute.

According to Stewart, one project will recruit 500 female athletes and assess overall mental  health and resilience. Included will be measures of mood, anxiety, body image, social support,
excessive training, sleep, and injury at four points during a 12-month period.

The second study, will focus on 50 of LSU’s female athletes. Scientists will measure mental,  physical, hormonal and immune resilience factors during periods of normal, moderate and high stress.

“It’s time we looked at our athletes from a person-centered focus, not solely a performance- centered focus,” Dr. Stewart said. “We need a core paradigm shift that includes health and well-being for the long-term. We need to hand our athletes mental health and resilience skills, and  we also need to look at a shift in athletics’ culture and environment,” she said.

Why is it important that the paradigm shift include mental health? “We are still very much a  performance based sport environment,” Dr. Stewart said. “I think mental health as a key piece  of the whole athlete has been missing from not only helping our athletes be the best they can  be on the playing field but in life- thriving in and out of sport,” she said.

“Our model all along has been a ‘push through no matter what’ model–with expectations that  in athlete will persevere physical and mental ailments to get the job done. But in seeing what  has happened through Covid and what happened in the Olympics–world class athletes leaving  the floor due to mental health struggle, for example, Simone Biles–we have come to an impasse on the push through model,” she said.

“It’s an organic moment to address the health and well-being of the whole athlete for the good  of performance but also for the good of the life of the athlete outside of sport. Some of our  work to come is also focusing on athlete transition out of sport–into life,” Dr. Stewart said.

Why are these research projects so exciting? “These projects are so exciting and important  because while research has steadily increased and improved to investigate how to help athletes perform better, there has been little research on psychological performance, mental health,  and resilience in athletes and even Dr. Stewart Champions the Whole Person Approach for Female Athletes, continued further- women are underrepresented in these studies,” said Dr.  Stewart.

These two studies were funded specifically to study female athletes. Little research has been  done on resilience-based strategies for athletes, especially for female athletes. These projects  are the first step towards developing skills training for athletes to better cope with stress,  especially chronic stress. And- the ability to bounce back from tough things, e.g. injury, tough  life events, etc.,” Dr. Stewart said.

225 Magazine noted that for the past 20 years, Dr. Stewart’s team has worked with high  performance populations such as U.S. Army Soldiers and NCAA female athletes, in an effort to optimize their health and performance.

“Athletes are not immune to struggles with mental health,” Dr. Stewart said. “The pressure to  perform at all costs is more intense than ever. This leaves athletes at risk for consequences  such as less than optimal eating habits, exercise, sleep, as well as more serious mental health outcomes, including depression, anxiety, and even suicidality. These difficulties can last a  lifetime if not addressed. Proactive, mental health skills training specific to athletes is needed in  order to build positive mental coping and resilience skills.”

Dr. Stewart’s team has worked with female collegiate athletes over the years in an NIH-funded  trial with a program called the Female Athlete Body Project, according to the report in 225  Magazine. The next phase of work will include the final development and testing of the  S.C.O.R.E. (Sport Carried Forward for Resilience and Enrichment) Program- a digital platform  and smartphone application to assist athletes in mental and physical thriving.

“The aim is to provide tools and evidence-based coaching to help athletes at all stages of their  career to bounce back from difficult challenges and optimize their lives, mentally and physically, moving forward.”

Dr. Stewart has explained that research suggests that disordered eating among female athletes  is prevalent, and is especially dangerous in female athletes because it increases risk for the  Female Athlete Triad––low energy availability/disordered eating, menstrual disorders, and decreased bone mineral density/ osteoporosis and subsequent injury.

Dr. Stewart’s work has also attracted multimillion dollar funding from the National Institutes of  Health and the Department of Defense to understand and help soldiers. She develops programs and technologies to improve nutrition, fitness, and sleep of U.S. Army Soldiers and  their family members.

In 2018, the Pennington Biomedical Research Foundation honored their 30-year relationship  with the U.S. Defense Department, by hosting a special Scientific Dinner. Dr. Stewart joined with leaders of the Louisiana National Guard to celebrate the 140 studies and 100 papers that have  come as a result of joint projects and efforts to improve the health of military warfighters.

“Every day, soldiers and their families make sacrifices for our freedoms,” Dr. Stewart said. “At  Pennington Biomedical, we are looking at the health of the whole soldier. We want our men and
women in uniform to be ready for whatever they may face during their service, and that means  optimization of physical and mental health and resilience, as well as the families that support  them.”

According to Pennington, they are one of the Defense Department’s top nutrition research  contributors. “With 30 years of collaboration and $80 million in DOD funding to date, Pennington Biomedical has improved and continues to advance warfighter nutrition, fitness,  sleep, technology, body weight, body fat and metabolism.”

Stewart’s Healthy Eating, Activity, and Lifestyle Training Headquarters or H.E.A.L.T.H., is part of the  Weight Measurements and Standards for Soldiers Project.

The work is an ongoing, collaborative effort between Pennington and the Department of Defense, designed to aid Soldiers in  maintaining healthy weight status, fitness status, combat readiness, and Warfighter  performance.

H.E.A.L.T.H. includes programs to aid soldiers’ family members in reaching overall health and  fitness goals and incorporates cutting edge interactive technology such as with the Internet and  Smartphones, so soldiers and their family members can use it wherever they are in the world.  The project is considered a population health program, used and tested in two projects, at Ft.  Bragg, NC, and New England Reserves, and is being tested in the Louisiana Army National  Guard, according to Pennington.

The program is disseminated Army-wide as part of the U.S. Army Surgeon General’s  Performance Triad Initiative to improve nutrition, fitness, sleep, overall health, and resilience for our technologically advanced fighting force and their families.

Dr. Stewart and her team work to distribute information in the broader community. In 2019 she applied her innovations for a community health program at the Knock Knock Children’s Museum, in Baton Rouge. The program was a collaborative effort between the Baton Rouge  Mayor’s Healthy BR Initiative, the Museum, Pennington, and other community organizations, noted officials.

Dr. Stewart and her team provided the program called “Sisu & You: Healthy Kids and Healthy  Family Workshop.” Sisu is the Finnish word for resilience. “How we view our bodies is a key component of successful health behaviors and significantly affects our quality of life,” said the  developers.

Dr. Stewart is also an inventor and entrepreneur, and named 2015 Woman of Excellence by the  Louisiana Legislative Women’s Caucus Foundation. She was also commended by the Louisiana  Legislature in a House Concurrent Resolution for her work and research, and for “spearheading  unique, large, multi-site prevention studies that have included the development and  deployment of novel approaches for health behavior change, …”.

In the private sector, Stewart was a Founder and Chief Scientific Officer of Body Evolution Technologies Inc., a venture capital-funded entrepreneurial project dedicated to taking e-health  assessment, prevention, and treatment programs and technologies from the lab to those who  would benefit most, “… especially among young women as they face enormous pressures  concerning body-image, weight, eating behavior, and self-esteem.”

In an interview with Huffington Post Healthy Living in 2012, Dr. Stewart said, “I’m a scientist first  and foremost, as well as a clinical psychologist, Now I find myself an entrepreneur. My mission  is to bring scientific tools to the people who need them most. So many things are developed in  science that get great results but stay in the academic realm, like programs for the prevention  of eating disorders,” she said. “The work I do is dedicated to translating scientific tools into  popular formats that can engage young people to change their health behaviors — their eating,  exercise, body image and self-worth.”

Stewart said that the majority of the general population struggles with body image and it is  critical to health.

“Even in the scientific literature, body image is thought about as an appearance-based thing,”  Stewart explained. “No one has ever talked about body image in the context of health. But it  certainly affects our health, influencing our eating, our fitness and social habits. With everything we’re doing, we’re looking for a place where appearance and health can meet and basically be happy together.”