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?
