Nutrition Final

PubMed

A free service of the US National Library of Medicine that enables searches on life science topics

True

According to the ISSN position statement on probiotics, certain probiotics strains can increase the absorption of amino acids.

False

According to the ISSN's exercise and sports nutrition review, over the last 20 years supplement companies have increasingly marketed and produced unsafe and ineffective nutrition products. True

True

According to the article "Nutrition Periodization: Applications for the Strength Athlete", the concept of nutrition periodization has been understudied.

Nitrogen input > nitrogen output Protein intake = 1.4 to 2.0 g/kg body weight Excessive amounts (> 2 g/kg) not recommended Supplements not required, but can offer some advantages

Achieving a Positive Nitrogen Balance

Measures body volume like underwater weighing Air, rather than water, is displaced BOD POD Accuracy similar to underwater weighing Smaller, lighter, more portable than underwater weighing Expensive

Air Displacement Plethysmography

NSF International

An independent, nonprofit commited to making the world safer, provides consumers with info on foods and supplements

type 1 diabetes

An individual unable to regulate their blood glucose level because the pancreas does not secrete insulin is diagnosed with which of the following?

eggs

An ovo-vegetarian would eat which of the following animal products?

Andro Arginine/ornithine Adenosine Tri-Phosphate (THP) Beta-Hydroxy-Beta=methyl-butyrate (HMB) Boron Chromium picolinate Clonidine Conjugated linoleic acid (CLA) Creatine monohydrate Dehydroepiandrosterone (DHEA) Essential Amino Acids (EAA) Gamma oryzanol (ferulic acid) Myostatin inhibitors Phosphatidic acid Protein powder Tribulus terrestis Vanadyl sulfate (vanadium)

Anabolic Agents

Severe calorie restriction; energy drain Significant weight loss Refusal to maintain normal, healthy weight Intense fear of weight gain Distorted body image

Anorexia Nervosa

False

Anorexia nervosa is characterized by an individual who binges on large amounts of food and purges several times per week.

Alpha-ketoglutarate Branched chain amino acids (BCAAs) Casein protein Leucine Tart Cherry Juice Taurine Whey protein

Antocatabolic Nutritional Ergogenic Aids

Biomechanical ergogenic aid

Any device, piece of equipment, or external product that can be used to improve athletic performance during practice or competition Examples: weight belts, knee wraps, corked bats

Physiological ergogenic aid

Any practice or substance that enhances the functioning of the body's various systems and this improves athletic performance. Examples: Bicarbonate buffering, physical training, blood doping, warming up

Psychological ergogenic aid

Any practice or treatment that changes mental state and thereby enhances sport performance Examples: visualization, hypnosis, pep talks

Pharmacological ergogenic aids

Any substance or compound classified as a drug or hormonal agent that is used to improve work output and/or sport performance. Examples: hormones, caffeine, ephedrine

Nutritional ergogenic aid

Any supplement, food product, or dietary manipulation that enhances work capacity or athletic performance. Examples: liquid meals, sports, gels, vitamin supplementation, carbohydrate loading

70%

Approximately what percentage of Americans are overweight or obese?

Protein is not a major provider of energy; however, high energy expenditures can increase utilization. May delay fatigue during prolonged exercise. Needed primarily for tissue repair and muscle adaptation. 1.2 to 2.0 g of protein per kilogram body weight per day is current recommendation based on training intensity and duration.

Are protein needs different for endurance athletes?

Closely monitor athlete for signs and symptoms of hypo- and hyperglycemia. Keep insulin and syringes available. Have glucose tablets, juice, or regular soda available. Educate coaches, parents, and teammates to recognize signs and symptoms of hypo- and hyperglycemia.

Avoiding Diabetic Emergencies

Measures resistance to flow of electrical current through body Fat is an insulator and thus creates a greater resistance Quick, easy, portable Less accurate that underwater weighing

BIA

If feasible, increase exercise/activity. Set short- and long-term goals. Encourage self-monitoring: Food diaries Exercise/training logs Sport performance

Behavioral Modificiations that Help in Weight Loss

Plan ahead for day-long events. Pack gear bags rather than rely on concessions. Practice with different snacks to ensure no gastrointestinal upset Nonperishable items are best. Whole fruit and juices in drink boxes Water or sports drinks Granola or energy bars Fig bars or bagels with jelly

Between Event Snacking: Strength/Power

Frequent overeating Overeating combined with feelings of lack of control and depression or guilt afterwards Eating food very rapidly, eating until uncomfortably full Eating alone

Binge Eating Disorder

•A discriminating indicator of body fatness •Expressed as % body fat •Two-compartment model •Fat mass •Essential fat •Nonessential (storage) fat •Fat-free mass •Muscle, bone, connective tissue, organ tissue, water

Body composition

Binge episodes Out of control Inability to stop despite being overly full Inappropriate compensatory methods Vomiting, laxative abuse, overexercise, fasting Distorted body image; influences self-esteem

Bulimia Nervosa

Energy needs are based on: Age Gender Body mass Sport-specific training demands Main goal: •Consume adequate calories to meet total daily calories or to achieve individual body weight goals •Can be estimated using Table 13.1 •Majority of calories should be consumed before or after training sessions •Total daily calorie needs should be adjusted based on body weight goals

Caloric Needs of Strength/Power Athletes

CHOs are the master fuel for these athletes. Heavy training can tax glycogen stores. Daily intake of 6-10 g/kg of body weight recommended for most strength/power athletes (i.e., 55-65% of total calories). CHO consumption immediately prior to or during training not necessary, but may help. Athletes should experiment to assess effect. CHO consumption during recovery is ~1.0-1.2 g/kg every hour for 4 hours postexercise.

Carbohydrate Needs for Strength/Power

Many team sports involve intense bouts interspersed with low levels of activity. Anaerobic metabolism is important. Carbohydrate intake is very important. Carbohydrate requirements range from 6 to 10 grams per kilogram body weight per day (i.e., 55-65% of total calories).

Carbohydrate Needs: Team Athletes

Liquid meals are excellent options: Provide energy Can be consumed with jittery stomach Quickly digested and absorbed Help in hydration

Carbs Between Games: Team Athletes

Rarely are glycogen stores depleted. If game < 1 hour, carbohydrate feedings are not necessary. If > 1 hour, 30 to 60 grams of carbohydrate per hour or 1 cup of 6-8% sports drink every 15 minutes.

Carbs During Competition: Team Athletes

Begin consumption of carbohydrates ASAP. 1 to 1.2 grams of carbohydrate per kilogram of body weight every hour for first 4 hours postexercise. Keep high-carbohydrate snacks and drinks readily available to help start process.

Carbs During Recovery: Team Athletes

Genetic predisposition Behavioral practices Poor diet Lack of exercise Social/cultural influences Psychological factors Environmental factors Physiological factors Hormonal imbalances Chronic disease

Causes of Obesity

Caloric intake must provide for growth. Caloric intake must meet sport needs. Nutrient intake must be adequate to maintain "growth channel" of child.

Children/Adolescent Athletes

Sodium bicarbonate

Claims: Buffers acidity in muscle, thereby delaying the onset of fatigue Concerns: may cause nausea, diarrhea, irritability and or muscle spasms

Quercetin

Claims: Flavonoid that increases mitochondrial function Concerns: more research needed, no apparent effect in highly trained athletes

Adenosine Tri-Phosphate (ATP)

Claims: Helps increase training volume thus increasing stimulus for hypertrophy Concerns: Only a few human studies have been published

Creatine monohydrate

Claims: Increased anaerobic output (strength/power) in events lasting 6 seconds to 4 minutes Concerns: Long term effects (>5 years) still unknown

Clonidine

Claims: Increases growth hormone production Concerns: No research supporting claims

Conjugated Linoleic acid (CLA)

Claims: Increases response to tissue growth factors, hormones and cell messengers, increases muscle mass Concerns: Animals studies suggest it is safe, long-term effects unknown

Andro

Claims: Increases testosterone Concerns: May decrease muscle mass and increase estradiol levels

Beta-hydroxy-beta-methyl-butyrate (HMB)

Claims: Prevents protein breakdown and enhances synthesis, increases strength, improves body composition concerns: Long term effects unknown, benefits appear to decline with continued use

Pyruvate

Claims: accelerates Krebs cycles, enhances use of glucose, greater fat loss, increases glycogen storage Concerns: limited research available on ergogenic effects and side effects of long term use

L-carnitine

Claims: assists in transfer of fats into the mitochondria, thereby increasing fat oxidation Concerns: appears to be safe but lack of research support raises questions about use, avoid D-carnitine supplements because they may be toxic

Yohimbe

Claims: blocks receptors that inhibit lipolysis, thereby increasing fat loss Concerns: side effects include anxiety, nausea and tremors, purity of supplements is a concern

Chitosan

Claims: decreases amount of dietary fat absorbed across intestinal lining during digestion Concerns: can cause diarrhea, decreases absorption of fat-soluble vitamins

Branched chain amino acids (BCAAs)

Claims: decreases exercise-induced protein degradation and muscle damage Concerns: research results are still mixed

Tart Cherry Juice

Claims: decreases postexercise muscle damage Concerns: research is still in infancy

Glycerol

Claims: energy source during exercise, promotes hyperhydration status before endurance exercise Concerns: USOC/OIC bans use, may cause gastrointestinal upset and cramping

Chromium picolinate

Claims: enhances action of insulin, increases muscle mass Concerns: Sufficient amounts can be consumed in the daily diet

Sports Beverages

Claims: enhances endurance performance and delays fatigue by supplying fluid, carbohydrates, and electrolytes Concerns: Practice during training to avoid gastrointestinal distress during competitions

Coenzyme Q-10

Claims: enhances function of electron transport chain. increases endurance performance Concerns: potential for cell damage when consumed in large amounts and exercising intensely

Caffeine (kola nut, guarana)

Claims: enhances performance by increasing serum FFA/use of muscle triglycerides, sparing muscle glycogen, decreases perception of fatigue Concerns: elevates heart rate and blood pressure, can cause irritability, nervousness and gastrointestinal distress

Chromium

Claims: enhances the actions of insulin, increases muscle mass, thus increasing metabolic rate Concerns: kidney failure and muscle wasting have been reported at high doses

Vanadyl sulfate (vanadium)

Claims: enhances/mimics effects of growth factors in muscle Concerns: animals studies demonstrate severe side effects; human effects are less clear

Branched chain amino acids (BCAAs)

Claims: essential amino acids that are touted to enhance endurance performance Concerns: BCAAs are supplied by whole foods, which also provide other nutrients

L-carnitine

Claims: fat transporter within cells, increases endurance performance Concerns: acoid D-carnitine supplements, because they may be toxic and can deplet L-carnitine

Carbohydrates

Claims: increased dietary intake increases muscle glycogen levels Concerns: research on carbohydrate loading is extensive

Taurine

Claims: increases ability to tolerate exercise stress, lessens post-exercise muscle damage Concerns: research results still mixed

Sodium Phosphate

Claims: increases aerobic capacity and anaerobic threshold Concerns: ergogenic effects seem to be muted in females

Nitrates (Sodium Nitrate)

Claims: increases blood supply to working muscles Concerns: dosing amounts seem to be well tolerated, research is still mixed

Tribulus terrestris

Claims: increases body's production of testosterone Concerns: promoted as safe alternative to steroids, can be toxic

Carnitine

Claims: increases fat availability and metabolism thus improving endurance Concerns: bioavailability of supplemented carnitine questionable

Arginine/ornithine

Claims: increases growth hormone production Concerns: No research supports increase in growth hormone levels

Ephedrine

Claims: increases lipolysis and resting metabolic rate, suppresses hunger Concerns: no longer sold over the counter because of reported adverse side effects

Essential Amino Acids (EAA)

Claims: increases muscle protein synthesis Concerns: still unclear whether benefits are greater than complete protein source

Boron

Claims: increases plasma testosterone Concerns: No research support for effectiveness, can be toxic

Citruline

Claims: increases production of nitric oxide and thus increases vasodialation Concerns: role played in aerobic and anaerobic benefits unclear, its isolated effects questionable

Ginseng

Claims: increases stamina, ability to adapt to training stressors, enhances immune function Concerns: Ginseng contents in supplements can vary greatly, may increase blood pressure

Beta-alanine

Claims: increases strength endurance and decreases neuromuscular fatigue Concerns: high doses can cause unpleasant tingling of the skin

Protein powder

Claims: increases strength, aids in muscle growth and development Concerns: watch for other added ingredients

Gamma oryzanol (ferulic acid)

Claims: increases testosterone and human growth hormone Concerns: limited research mixed outcome

Dehydroepiandrosterone (DHEA)

Claims: increases testosterone levels and this muscle mass, which increases metabolic rate Concerns: in women, can increase testosterone level and increase risk of heart disease

Dehydroepiandrosterone (DHEA)

Claims: increases testosterone levels, decreases fat, builds muscle Concerns: research does not support claims, may decreas HDL levels and insulin sensitivity, female athletes may experience increases in androgen levels

Myostatin inhibition

Claims: inhibits actions of myostatin, a negative regulator of muscle hypertrophy, thereby increasing muscle mass Concerns: currently no data supporting claims

Sodium/electrolyte tablets

Claims: prevents hyponatremia by supplying sodium during exercise and other electrolytes as buffers Concerns: avoid supplements containing mainly sodium bicarbonate can cause diarrhea/cramping

Beet root

Claims: provides nitrates that increase blood flow to working muscles thus enhancing endurance Concerns: limited research, less effect in elite athletes, side effects of long term use unknown

Energy gels

Claims: quick supply of carbs during endurance exercise Concerns: consume with 8-12oz of fluid, may be better tolerated taken in smaller amounts

Energy bars

Claims: quick supply of carbs during endurance exercise Concerns: should not be used as a meal replacement

Medium-chain triglycerides (MCTs)

Claims: quickly metabolize fatty acids that spare glycogen and thus delay fatigue Concerns: may cause gastrointestinal upset and cramping

Casein protein

Claims: source of essential amino acids, which decreases muscle protein degradation and stimulates protein synthesis Concerns: Potential for allergic reactions but rare, can increase cholesterol levels

Whey Protein

Claims: source of essential amino acids, which decreases muscle protein degradation and stimulates protein synthesis Concerns: potential for allergic reactions, but rare, no serious side effects reported, even with high doses

Alpha-ketoglutarate

Claims: spares glutamine, thus sparing muscle tissue, which is biggest source of glutamine Concerns: long term safety is unknown, but limited evidence indicates it is well tolerated

Leucine

Claims: spares muscle by increasing availability of leucine, which is used by various tissues for energy Concerns: appears to be safe

Caffeine

Claims: stimulates central nervous system, increases lipolysis Concerns: elevates blood pressure and heart rate, can cause loose bowel and gastric upset

Phosphatidic acide

Claims: stimulates muscle protein synthesis signaling Concerns: research is limited, optimal dosing and long term risks unknown

Glutamine

Claims: stimulates protein and glycogen synthesis, increases cell volume Concerns: although research is limited, no evidence supports claims

First exposure to meal planning Caloric needs may increase Make a meal plan No skipped meals Avoid alcohol Life after graduation

College Athletes

Impact on performance Aesthetics/body image Weight classifications for competition Changing body composition Increase muscle mass Decrease fat mass

Common Weight Management Concerns for Athletes

75g of carbohydrate every hour for 4 hours with the first dose within 15-30min of finishing the race

Consider a 24 year old, 165lbs male who just completed a marathon. Which of the following demonstrates an appropriate post-event carbohydrate consumption strategy for this athlete?

2500kcal

Consider a 25 year old, 60kg, regular exerciser who becomes pregnant but wishes to maintain her exercise habits of 4 x 1 hour training sessions each week. Which of the following is the most appropriate recommendation for total caloric intake for this person on exercise days? REE = (14.7 * BW in kg) + 496 PAF = 1.6 on exercise days

55g of carbohydrate at 8am

Consider a 35 year old, 120lbs female competing in a triathlon today that begins at 9am. Which of the following recommendations for carbohydrate consumption before the event is MOST appropriate for this athlete?

~2,800 calories

Consider a 45 year old, 115lbs female half-marathon competitor. Today she is completing an 8-mile training run. Which of the following is the best estimate for her total daily caloric need for today? REE = (8.7 * BW in kg) + 829 PAF = 1.6 - 2.4

Competition Intensity and volume of exercise Physician recommendations Dietary recommendations

Considerations for Pregnant Athletes

Like underwater weighing, also considered a standard Relies on X-ray technology Also measures bone mineral density Provides regional composition measures Technical and expensive

DEXA

Additional calories are needed Average 300 kcals/day Range 25 to 800 kcals/day Varies with type of athlete and energy expended in training Particularly important during second and third trimesters Weight gain can help monitor caloric intake 25 to 35 lbs over the course of the pregnancy

Daily Caloric Intake for Pregnant Athletes

Old height/weight tables not used anymore Body mass index (BMI) Most widely used height for weight index Wt(kg)/Ht(m)2 Correlates fairly strongly with body fatness

Determining Weight Status

Type I Requires careful self-monitoring Timing of insulin Dosage of insulin Timing of meals Meal composition Type 2 Comparatively easier to manage Requires some self-monitoring Insulin not usually required because exercise enhances glucose uptake

Diabetes and Exercise

Involves the hormone insulin Decreased insulin release Decreased sensitivity to insulin Type 1 diabetes Diagnosed most often in children and young adults Constitutes ~5% of diabetes cases Also known as insulin-dependent diabetes Pancreas fails to produce enough insulin Treatment requires insulin injections Type 2 diabetes Most prevalent in middle-aged and older adults Constitutes ~95% of diabetes cases Known as non-insulin-dependent diabetes Pancreas produces enough or too much insulin Cells are insulin insensitive/insulin resistant Medicine, diet, and exercise can be treatments Common Symptoms of Diabetes Excessive thirst Excessive urination Dehydration Dizziness Headache Blurred vision Unexplained weight loss Excessive hunger Poor wound healing

Diabetic Athletes

Carbohydrates should be consumed during and after exercise. Athletes with Type 1 diabetes should consume 15 to 30 grams of carbohydrate every 30 to 60 minutes during exercise: 8 oz of 6-8% sports drink 1 single serving of sport gel 1 fig bar 8 oz of 1:1 juice to water mix

Diabetic Athletes and Long-Duration Exercise

Carbohydrate and protein rich food sources should predominate during recovery. Experiment ahead of time to determine best postevent food preferences If possible, pack a gear bag to encourage immediate postevent consumption. Plan ahead to establish which food choices are best at restaurants, if on the road

Diet Ideas for After Competition: Strength/Power

Physiological Environmental Social/Cultural Emotional

Dietary Intake Influences

NSF International PubMed Supplements Watch United States Anti-Doping Agency United State Pharmacopeia WebMD World Anti-Doping Agency

Dietary Supplements Resources

Becoming a more prevalent problem Athletes at risk "Appearance" sports Sports requiring weigh-ins Pressure to attain the "ideal" in their sport Social physique anxiety Pressure from others Coaches, parents, trainers

Disordered Eating

meeting carbohydrate, fluid, and sodium recommendations

Doug is completing a marathon and averaging a 7min 30sec per mile pace. Which of the following is his top nutrition priority within the race (not before or after)?

Bone mineral density Lean body mass All of these are correct Body fat percentage

Dual-energy X-ray absorptiometry (DEXA) assesses which of the following?

Clinically defined in DSM-5 Anorexia nervosa Bulimia nervosa Binge eating disorder Not clinically defined in DSM-5 Anorexia athletica Muscle dysmorphia

Eating Disorders

Decreased fat-free mass

Eating disorders in athletes can result in which of the following?

Beet root Beta-alanine Branched chain amino acids (BCAAs) Caffeine (kola nut, guarana) Carbohydrates Carnitine Citrulline Coenzyme Q Energy bars Energy gels Ginseng Glycerol L-carnitine Medium chain triglycerides (MCTs) Nitrates (Sodium Nitrate) Pyruvate Quercetin Sodium bicarbonate Sodium/electrolyte tablets Sodium Phosphate Sports beverages

Endurance Enhacers/Fatigue Reducers

10-12g/kg/day

Endurance athletes completing a taper prior to an event are recommended to consume which of the following relative daily intakes of carbohydrate during the taper in order to maximize glycogen stores for the event?

Ability of the heart and blood vessels to deliver oxygen and nutrients to working muscles Usually measured by a maximal treadmill test

Endurance: Cardiovascular

Ability to repeatedly contract without fatigue Usually measured by having an athlete perform a maximal number of repetitions in 1 minute

Endurance: Muscular

200- to 300-calorie snack immediately after exercise 1/2 sandwich Milk 100% juice Larger meal within 1 to 2 hours postexercise

Endurance: Caloric Intake After Exercise

Matching caloric intake with expenditure is difficult and many times not feasible. Focus on meeting carbohydrate (30 to 60 grams/hour) and fluid requirements. Sports drinks (6-8% CHO) are appropriate.

Endurance: Caloric Intake During Exercise

The goal is to provide for rapid recovery of glycogen stores. Consume 1.0 to 1.2 g carbohydrate per kilogram body weight every hour for 4 hours after exercise. Whole foods, juices, and low-fat dairy products are good options.

Endurance: Carbohydrate Ingestion After Competition

The goal is to provide athlete with some energy and maintain blood glucose levels. 30 to 60 g carbohydrates per hour is recommended rate of intake (individual tolerance/preference can range from 30 to 90 g per hour). Can be easily supplied by 6-8% carbohydrate sports drink (1 to 2 cups/15 minutes) and/or energy bars, energy gels, and food.

Endurance: Carbohydrate Ingestion During Competition

The goal is to provide athlete with energy. Must leave time for digestion and absorption. The larger the carbohydrate intake, the longer time between ingestion and competition. Athletes should experiment with times, amounts of carbohydrates, and food sources. Current recommendation: 1 to 4 g carbohydrates per kilogram body weight in the 1 to 4 hours prior to exercise.

Endurance: Carbohydrate Ingestion Prior to Competition

Taper training 6 to 7 days prior to event. Gradually increase carbohydrate intake to 65-70% of total calories. Juices, smoothies, etc. are excellent sources. As carbohydrate intake increases, total calorie, fiber, and fat consumption should decrease.

Endurance: Carbohydrate Loading

6 to 10 g/kg body weight per day for endurance athletes exercising 1 to 3 hours per day 8 to 12 g/kg body weight per day for ultra-endurance athletes exercising < 4 to 5 hours per day Should amount to 50-65% of total daily calories Macronutrient balance should be maintained

Endurance: Carbohydrate Requirements

Main dietary concerns should be on carbohydrate and protein needs of athlete. Fat stores are unlikely to have been depleted. Fats also slow digestion, which can delay delivery of nutrients for recovery. Small amounts of fat can provide flavor and a sense of satiety after exercise.

Endurance: Fat consumption after exercise

Consider the following factors: Length of event Feasibility of eating Refrigeration/heating Space for storage and transport of supplies Athlete should practice the nutrition plan in training many times before the day of competition

Endurance: Meal Planning/Event Logistics

Most important macronutrient is carbohydrate. Combination of carbohydrate with protein may enhance insulin activity, thus accelerating recovery. Recommendation is approximately 15 to 25 grams of protein (0.25 to 0.30 gram per kilogram body weight) immediately following endurance exercise.

Endurance: Protein Intake After Competition

Research in this area is in its infancy. Protein intake 2 to 4 hours prior may offer benefits. Appetite satiation Provision of branched chain amino acids (BCAA) Excessive protein intake should be avoided.

Endurance: Protein Intake Before Competition

Research in this area is also in its infancy. May help boost BCAA and prevent central fatigue (especially applicable during ultra-endurance events). May also diminish flavor fatigue. Example food sources: Meat jerky, trail mix, mixed nuts, peanut butter

Endurance: Protein Intake During Competition

Primary systems •Phosphagen system •Anaerobic system The aerobic energy system is important for recovery.

Energy Systems Important to Strength/Power Athletes

3-5%

Essential body fat for men is approximately:

Very little fat is used during performance of strength/power activity. Fat intake can vary based on athlete's goals. Recommended intake is 2 g/kg of body weight (i.e., 20-35% total calories) Majority should be in form of unsaturated fats Minimize fat intake before, during, and immediately after exercise.

Fat Needs for Strength/Power

Fat utilization for energy varies depending on the team sport and length of competition. Dietary composition should not differ from other athletes (i.e., ~20-35% of total calories). May be best to calculate carbohydrate and protein needs first, then fill remaining needed calories with fats (not to exceed ~35%).

Fat Needs: Team Athletes

Caffeine Chitosan Chromium Dehydroepiandrosterone (DHEA) Ephedrine L-carnitine Yohimbe

Fat Reducers

Slow digestion/absorption is an issue. Potential for gastrointestinal upset. Research on medium-chain triglycerides (MCT) has not been convincing. Fat consumption at these times is not recommended.

Fat consumption immediately prior to and during endurance exercise

Hydration is critical to all athletes. Muscle is ~ 70% water. Intentional restriction is discouraged. The longer the duration of activity, the greater the impact of dehydration. Perform sweat trials to assess fluid needs. Plan hydration schedule accordingly Water (activities < 60 minutes long) Sports drinks (activities > 60 minutes long)

Fluid Needs for Strength/Power

Fluid loss is a concern in endurance athletes. Maintenance of hydration is critical to safety and performance. Determine individual fluid needs: Perform sweat trials under different conditions. Monitor training-induced weight changes. Athletes should practice their hydration strategies before, during, and after training.

Fluid Needs of Endurance Athletes

Team sports are played outdoors in heat and humidity or in poorly ventilated gyms. Fluid intake recommendations: ~ 2 cups fluid 2 to 3 hours prior to game ~ 1 cup 10 to 20 minutes prior to game ~ 1 cup every 10 to 20 minutes during game After competition, begin rehydration ASAP Monitor body weight (~ 2 to 3 cups/pound lost)

Fluid Needs: Team Athletes

Children are less tolerant of heat Reminders to drink fluids are needed Improve intake through fluid availability and flavor

Fluid Requirements: Children

Arginine and lysine Correct Answer None of these is correct Leucine Glutamine

For which amino acid(s) is there adequate evidence to make firm conclusions and subsequent supplement recommendations to strength/power athletes?

Follow MyPlate food recommendations. Establish a consistent daily eating schedule. Quantity and type of carbohydrate eaten at meals/snacks should be similar each day. Athletes requiring insulin need to learn best combination of meal timing, carbohydrate intake, and dosage for achieving optimal blood sugar levels before exercise.

General Nutritional Recommendations for Athletes with Diabetes

Increased mortality Increased morbidity Heart disease Hypertension Stroke Type II diabetes Osteoarthritis

Health Consequences of Obesity

Large variability in energy requirements Physical demands of the sport Different positions Different body sizes Games lasting 1 to 2 hours usually do not need calories during event Energy expenditure calculations same as for other athletes

How are energy needs of team athletes different?

they are the same

How do the recommended intakes of carbohydrate following a training session (i.e. post-exercise carbohydrate recommendations) compare between endurance athletes and strength/power athletes?

diabetic athletes should consume carbohydrates during exercise if the length of the session is greater than 30min

How does the recommendation for consuming carbohydrate during exercise differ between a diabetic athlete and a non-diabetic athlete?

Assess her risk factors

If a patient's BMI is 29 and she does not want to lose weight, what is the next step in assessing and treating her?

Required for red blood cell production, oxygen delivery, energy level. Increase to 27 mg/day. Sources include beef, poultry, fish, legumes, and iron-fortified grains. Supplementation may be needed.

Iron Requirements for Pregnant Athletes

World Ant-Doping Agency

Lists of banned ergogenic aids and other infor for athletes and public

United States Anti-Doping Agency

Lists of banned ergogenic aids and supplement info for athletes and the public

United State Pharmacopeia

Lists of dietary supplements that have USP-verified seal

Required for muscle contraction and energy production. Increase by 40 mg to 350 to 360 mg/day. Sources overlap with others: Whole wheat, tofu, yogurt, beans, nuts, some fish, spinach

Magnesium Requirements for Pregnant Athletes

Calorie needs will likely decline Continue to acquire nutritional self-care skills Meal planning, cooking, and grocery shopping Manage business/social life Alcohol intake Dining out Travel nutrition

Masters Athletes

Nutritional Beta Alanine Physiological Resistance Training Psychological Visualization Biomechanical Larger golf club head Pharmacological Anabolic Steroids

Match the ergogenic aid category in the left column with its representative example in the right column

Packing food for road trips is best: Storage and refrigeration can be a problem. Check with hotel or schools ahead of time. Pack plenty of water and sports drinks. Plan food stops before leaving home. Check menus of restaurants that are on route. Food intake during competition is not critical because most events last only 1 to 3 hours. Between games, snacking is important: Provide low-fat, high-carbohydrate, moderate-protein snacks. Pack snacks ahead of time rather than depending on concessions. If concessions are only option, make a list of healthier food options.

Meal Planning Logistics for Team Sport Athletes

Not well studied Needs probably similar to other active athletes or individuals Supplementation not currently warranted: Antioxidant vitamins Minerals (B, Ca, Cr, Fe, Mg, Zn) A regular multivitamin may be used as nutritional insurance.

Micronutrient Needs for Strength/Power

In general, needs are no different from those of active nonathletes. Most team sport athletes who meet their energy needs meet their vitamin/mineral needs. Intake of vitamins A, E, and folate and the mineral iron have been noted to be low in some team sport athletes. Dietary adjustment rather than supplementation is recommended.

Micronutrient Needs: Team Athletes

Preoccupation with body shape/size Preoccupation with muscularity impairs other aspects of life Excessive exercise Obsesses about food May abuse steroids

Muscle Dysmorphia

Approximately 70% of general population is overweight or obese. In athletes, obesity is relatively rare. Athletes at risk: Football Wrestling (heavyweight division) Boxing (heavyweight division) Field events (e.g., throwers)

Obesity in Athletics

Decreased fat-free mass (i.e., muscle) Dehydration Glycogen depletion Negative hormonal disturbances Gastrointestinal problems due to laxative use •Anxiety •Inability to sleep •Decreased concentration •Poor exercise performance •Increased risk for overuse injuries

Physical Effects of Eating Disorders in Athletes

•Ability to generate force at high speed •Known as speed strength •Arguably more important to most sports than strength

Power

Top off glycogen stores and provide adequate blood glucose levels 1 to 4 grams carbohydrate per kilogram body weight 1 to 4 hours prior to competition Liquid meals okay

Pre-Event Carb Recommendations: Team Athletes

Calorie needs will likely decline Continue to acquire nutritional self-care skills Meal planning, cooking, and grocery shopping Manage business/social life Alcohol intake Dining out Travel nutrition

Preparing College Athletes Nutritionally for Life After Graduation

Reduce emphasis on body weight and/or body composition. Emphasize skills and performance. Discourage diets and quick weight loss. Model healthy eating (coaches, trainers, etc.). Develop a healthy gym environment. Help set achievable goals.

Prevention Practices

Proteins are critical for tissue repair and adaptation to training. Recommended intake is 1.4-2.0 g/kg body weight per day. Excessive amounts (> 2.0 g/kg body weight per day) not recommended (unless athlete is injured). Meals and snacks should include complete or complementary protein sources. Consume protein supplements in moderation, if at all. Anabolic effects of consuming individual amino acid supplements have met with mixed review, thus they are not warranted. Consumption of essential amino acids before and immediately after training shows promise. Foods or supplements containing combinations of CHO (~ 35 grams) and protein (15-25 grams or 0.25-0.20 g/kg) immediately after training are recommended.

Protein Needs for Strenght/Power

Protein is rarely used as an energy source. Protein's main role is tissue repair and muscle adaptation to training. Needs vary: Training, position played, body size Recommended intake is 1.2 to 2.0 grams per kilogram body weight per day (~15-20% total calories). Consuming as little as 10 grams of essential amino acids stimulates protein synthesis. 15 to 25 grams of complete protein will provide ~10 grams of essential amino acids. Combining protein intake with carbohydrate intake within 1 to 2 hours after exercise is recommended.

Protein Needs: Team Athletes

Protein needs are slightly increased. Extra 20 to 25 grams of protein are needed each day 3 cups of skim milk 3 oz of beef, chicken, or fish 1.5 cups of beans, lentils, or other legumes 3 oz of nuts Protein needs usually are easily met if caloric intake is appropriate. B Vitamin Requirements for Pregnant Athletes B vitamins are critical for energy production and tissue development. Of particular concern is folate: DNA synthesis Red blood cell production Development of nervous system Recommended intake is 600 µg/day.

Protein Requirements for Pregnant Athletes

WebMD

Provides info on the uses, side effects, interactions and dosing for supplements

Regular participation in a resistance training program Achieving a positive energy balance Achieving a positive nitrogen balance

Requirements for Weight Gain

Caloric intake > caloric expenditure Optimal rate of weight gain is ~ 1/2 to 1 pound per week Additional 300 to 500 calories per day Carbohydrates should predominate What are the pros and cons of weight gain supplements?

Resistance Training

Supplements Watch

Scientific reviews of research related to supplements, provides a ratings system for any supplements it has reviewed

Measures thickness of skin and underlying subcutaneous fat Not as accurate as underwater weighing Considered a field measure Requires some skill Inexpensive, very portable

Skinfold Assessment

True

Slower, more gradual weight loss is more likely to produce fat weight loss than muscle weight loss.

Daily caloric intake Protein consumption B vitamins Vitamin C Vitamin A Magnesium Iron

Special Dietary Concerns for Pregnant Athletes

Ability to generate maximal force Usually measured by having an athlete perform a 1RM test Speed of movement is irrelevant

Strength

American football

Strength/power athletes primarily utilize either the phosphagen energy system or glycolysis to provide the ATP needed to carry out the athletic task. However, aerobic metabolism can also play a role in strength/power sports. Which of the following strength/power sports relies MOST on aerobic metabolism in addition to the phosphagen system and glycolysis?

False

Sufficient evidence is available to support a recommendation to endurance athletes to consume Medium Chain Triglycerides during an event due to a glycogen sparing effect.

Skinfold thickness use of handheld calipers to estimate amount of sub-cutaneous fat Bioelectrical impedence measures speed of electrical current through body to estimate fat-free mass Underwater weighing measures density of body in water to estimate fat free mass Bod Pod (Air displacement plethsmyography) measures density of body in air to estimate fat free mass Dual energy X-ray absorptiometry (DXA) imaging technique that leads to a small amount of radiation exposure; the gold standard for measuring bone density ultrasound assessment of thickness of sub-cutaneous fat using high frequency sound waves

The article you read this week described 8 techniques that can be used to assess body composition. Match the assessment in the left column with its description in the right column.

DEXA

The body composition measurement technique that uses a three-component model for measuring fat mass, bone mineral mass, and lean mass through low-energy radiography technology is called:

True

The combination of at least 35 grams of carbohydrates and 15 grams of high-quality protein both before and after high-intensity training is beneficial for protein synthesis.

Consume fluids after meals. Avoid carbonated beverages. Have small frequent meals/snacks. Consume a variety of nutrient/energy dense foods. Use sports drinks instead of water. Include bedtime snacks.

Tips for weight gain

Nutritional Physiological Psychological Biomechanical Pharmacological

Types of Ergogenic Aids

•A discriminating indicator of body fatness •Expressed as % body fat •Two-compartment model •Fat mass •Essential fat •Nonessential (storage) fat •Fat-free mass •Muscle, bone, connective tissue, organ tissue, water

Underwater weighing

Plant-based diet Types of vegetarians Semi, pesco, lacto-ovo, lacto, ovo, vegan Protein intake Complementing Vitamin D and B12 Zn, Ca, and Fe intake Eating out on the road

Vegetarian Athletes

Needed for cell differentiation and immune function. Increase intake to 750 to 770 µg (RAE)/day. Obtain extra from foods, not supplements: Spinach Broccoli Tomato juice Carrots

Vitamin A Requirements for Pregnant Athletes

Critical for collagen formation, hormone synthesis, and immune function. Improves absorption of iron. Increase intake to 80 to 85 mg/day.

Vitamin C Requirements for Pregnant Athletes

Increased energy demands and sweating require increased focus on certain nutrients. Athletes should focus on ensuring adequate intake rather than megadosing with supplements. Vitamins of concern: B complex, C, and E Minerals of concern: Fe, Ca, Na, and K

Vitamin and Mineral Needs of Endurance Athletes

•Calcium recommendations: 1,300 mg/day for children and teens (9 to 18 years) •Iron recommendations: 8 mg/day for teens 9 to 13 years 11 mg/day for males, 14 to 18 years 15 mg/day for females, 14 to 18 years

Vitamin/Mineral Requirements: Children

Macronutrients 4 kcals/gram (proteins and carbohydrates) 9 kcals/gram (fats) 7 kcals/gram (alcohol) Energy (dietary) intake assessment Food records 24-hour dietary recall Food frequency questionnaires

Weight Management: Energy Intake

Large caloric expenditures required for training Ensuring that caloric intake is sufficient to meet total daily energy expenditure

What are the main nutritional concerns of endurance athletes?

consumption of the same relative protein intake either before or after exercise will stimulate MPS similarly

What does the available evidence indicate regarding the consumption of protein either before or after a training session and its effect on supporting muscle protein synthesis?

500-1,000 calories

What is the recommended total calorie deficit per day for weight loss?

multiple studies out of different laboratories finding the same effect are better than a single study demonstrating effectiveness of a supplement

When evaluating the available evidence for a nutritional ergogenic aid, which of the following statements is true?

FDA

Which government agency regulates the production of the dietary supplement industry, specifically when a new product is brought to market that was not available before 1994?

Anabolic agent

Which of the following categories of nutrition ergogenic aids is an American Football athlete most likely to consume?

Creatine may increase muscular strength

Which of the following is a legal claim that a supplement manufacturer could place on its product?

All of these are potential mechanisms of inadvertent doping: Consuming a product that contains a banned substance that is not included on the label Consuming a product with a banned substance listed under an unrecognized name on the label Consuming a product with a banned substance listed on the label, but not knowing it is a banned substance

Which of the following is a possible mechanism for inadvertent doping?

SportDiscus

Which of the following is a research database specifically created to include published research in the areas of sports medicine, exercise physiology, biomechanics, psychology, training techniques, coaching, physical education, physical fitness, active living, recreation, history, facilities, and equipment?

Following a famous runner's marathon training program

Which of the following is an example of a physiological ergogenic aid?

Carbohydrates play an indirect role in helping to build muscle mass.

Which of the following is true of carbohydrate intake?

iron

Which of the following micronutrients is most likely to require supplementation in the diet during pregnancy due to increased needs and difficulty meeting these needs through food alone?

chocolate milk

Which of the following post-resistance training snacks is likely to yield the largest increase in muscle protein synthesis based on the available evidence? (Assume an equal number of total grams of protein consumed with each answer choice)

Use is banned Can be illegal (age) Safety issues (driving) Nutritionally "empty" Poor carbohydrate source Can increase body fat Stimulates appetite

Why Athletes Should Avoid Alcohol

~3500 kcals

You are working with a 22 year old male who weighs 85kg. He resistance trains daily for 30-45min at a moderate intensity, but sufficient to stimulate muscle protein synthesis. He states that he would like to gain 8lbs of lean tissue over the next 8 weeks. How many calories will you recommend he consume each day? REE = (15.3 * BW in kg) + 679 PAF = 1.6 (low volume, moderate intensity daily activity)

maintain current daily carbohydrate intake

You are working with a 22 year old, 62kg female swimmer who specializes in sprint distance events. A 3-day food record reveals she consumes an average of 540g of carbohydrate each day. She trains 3 hours per day (2 hours in the morning, 1 in the evening) 5 days per week. She wishes to maintain her current weight. Which of the following recommendations will you make to this athlete regarding her carbohydrate intake? REE = (14.7 * BW in kg) + 496 PAF = 2.4

no exercise today, make adjustments to insulin or medications

You work with a type 2 diabetic who takes insulin. At your request, he measures his blood glucose levels 10min before beginning his exercise training session with you. The results indicate a blood glucose level of 260mg/dL and a follow up urine test reveals ketones are present. What is your recommendation to this person?