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Sports Nutrition – Eat to Compete. Mark Mirabelli, M.D. Assistant Professor Depts. of Orthopaedics and Family Medicine University of Rochester. Goals. Understand basics of general nutrition Recommendations for pregame and postgame meals Brief words on sports supplements.

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sports nutrition eat to compete

Sports Nutrition – Eat to Compete

Mark Mirabelli, M.D.Assistant Professor

Depts. of Orthopaedics and Family Medicine

University of Rochester

  • Understand basics of general nutrition
  • Recommendations for pregame and postgame meals
  • Brief words on sports supplements
key nutrition and performance goals
Key Nutrition and Performance Goals
  • Optimize/maintain hydration/ electrolyte status
  • Maximize/maintain fuel supplies
  • Maximize protein synthesis to increase lean body mass
  • Accelerate recovery from a strenuous bout of activity


  • CarbohydratesENERGY
  • ProteinGrowth, Repair
  • FatEnergy stores
  • WaterFluid balance
  • VitaminsBody Processes
  • MineralsBody Processes
  • 4 calories for each gram
  • Provides ENERGY for athletes!
  • 50%-60% of our total diet
  • Simple carbs for fast energy
    • Candy, Soda, Fruit, Sugary foods

- Complex for sustained energy

    • Pasta, Rice, Breads, Grains, Starchy foods
maximize glycogen synthesis
Maximize Glycogen Synthesis
  • Glycogen - primary fuel source during moderate to high intensity exercise
  • Muscle glycogen repletion is slow, and can take 24 hrs.
  • Exponential relation between rate of glycogen resynthesis and recovery time
  • Restoration of muscle glycogen most critical factor for recovery/ subsequent performance
glycogen and resistance training
Glycogen and Resistance Training:
  • Resistance exercise reduces glycogen by approximately 30-40%;
  • Resynthesis is slow unless energy substrates are provided;
  • Provision of CHO after exercise enhances resynthesis of glycogen;
  • Provision of protein and fat with CHO after exercise does not impair resynthesis.
comparison of diets
Low CHO diet (40% kcal from CHO)

Double cheeseburger

Medium fries

Chocolate milkshake

High CHO diet (70% kcal from CHO)

12 inch sub sandwich (lots of vegetables & no mayo)

500 ml apple juice

250 ml chocolate milk


Comparison of Diets
carbohydrate snacks
Carbohydrate Snacks
  • Foods supplying 50g CHO
    • 500 ml Juice
    • 3 Medium pieces of fruit
    • 1 honey sandwich
    • 2 breakfast bars
    • 1 sports bar (check label)
    • 1.3 bagels
    • 1/2 cup dried fruit
    • 1 cup white rice
    • 1 baked potato
critical re fueling interval
Critical Re-Fueling Interval







Phases of Timing Nutrient Intake

  • To replete glycogen stores after exercise, carbohydrates should be eaten within 15 min and repeated every 2 hr for 4 to 6 hr.
  • Ingesting protein following resistance exercise should enhance protein synthesis and may inhibit protein catabolism.
  • For recovery from exercise, food with a CHO to protein ratio of about 4 to 1 should be ingested within 30 minutes after exercise.
  • 4 calories for each gram
  • Growth and Repair of all tissue (muscle etc)
  • 10%-15% of our total diet
  • Red meat, chicken, pork, Fish, Eggs
who needs more protein
150 LBS

10% body fat

90% lean body

150 LBS

35% body fat

65% lean body

Who needs more protein?
9 calories for each gram (more than double carbs and protein)
  • Padding, protection, hormonal response
  • 25%-30% of our diet
    • Unsaturated (15%-20%) GOOD fat (plant)
      • -Liquid at room temperature
      • Oils, Nuts, Seeds, Avocados etc.
    • Saturated (10%) BAD fat (animal)
      • -Solid at room temperature
      • Red meats, fried foods, butter
good fat plant based oils
Good Fat = Plant based Oils

Nuts are healthy

Nutrient dense

Olive Oils

regulation of water balance
Regulation of Water Balance
  • Thirst
    • Daily water balance varies between 0.2 and 0.5% each day, independent of climate
  • Metabolism
    • Daily turnover between 3.3 and 4.5 L/day (6 L for very active populations) for sedentary and active populations
  • Requirements
    • Low activity: 4.5 - 8 L/day
    • High Activity: 6 to 12 L/day
  • Losses
    • 1 - 2 L/h for athletes
dehydration and performance1
Dehydration and Performance




Weight Loss (% Body Weight)




4 - 6%

> 6%

Impaired temperature regulation

Reduced muscular endurance

Reduced strengthReduced endurance capacityHeat cramps

Severe heat cramps

Heat strokeComaDeath

monitoring hydration status









Monitoring HydrationStatus

Urine color test for dehydration

Lemonade—The good

Apple juice—The bad

Tea—The ugly

fluid recommendations
Fluid recommendations

Clear liquids up to 1 hour before event

Drink 3-8 fl oz of water every 15-20 min when exercising for < 60 min

Drink 3-8 fl oz of a beverage with CHO (5% to 8%) and electrolytes every 15-20 min when exercising> 60 min.

Simple liquid carbs after event

DO NOT DRINK MORE THAN 1 L or 1 Qt/hr during exercise.



  • Necessary for food metabolism, energy production, and protection of body tissues
  • Iron and Zinc supplementation beneficial in those with deficiency
  • Sparse evidence
    • Magnesium, Copper, Selenium, Chromium


  • Required nutrients in the diet (A,B,C,D,E,K)
  • Traditionally no need to supplement dietary intake
  • No advantage to ingesting “mega” doses
  • Can be necessary in restrictive type diets to replace lost intake
selected messages for consumers
Selected Messages for Consumers

Balancing Calories

  • Enjoy your food, but eat less.
  • Avoid oversized portions.

Foods to Increase

  • Make half your plate fruits and vegetables.
  • Switch to fat-free or low-fat (1%) milk
  • Make half your grains whole grains.

Foods to Reduce

  • Compare sodium in foods like soup, bread and frozen meals and choose the foods with lower numbers.
  • Drink water instead of sugary drinks.
Balancing calories

Enjoy your food, but eat less

Avoid oversized portions

what a typical m s h s athlete eats prior to activity
What A Typical M.S./H.S. Athlete Eats Prior to Activity:
  • Breakfast: 0 calories
  • Lunch: 450-550 calories
    • Chips = 100 calories
    • 1 slice of Pizza = 200-250 calories
    • Gatorade or other drink = 150-200 calories

Total: 450-550 Calories Prior to Activity!

caloric need for practice or game
Caloric Need For Practice or Game
  • Football: 900-2700
  • Basketball: 600-1800
  • Running: up to 1500
  • Wrestling: up to 1800
  • Baseball: 450-1200
  • Dance/Cheerleading: 450-1000
  • TV or Reading: up to 270



The Pregame Meal

  • It takes 1- 4 hours for food to leave your stomach
  • High Carb foods are digested quickly
  • High Protein foods can increase water requirements
  • Foods high in Fat can stay in your stomach for more than 4 hours

Best choice for pre-game meals is something high in Carbs - easy to digest and becomes quick energy !

pre event meal
Pre-Event Meal
  • Goals
  • “Top off” glycogen stores
  • Optimize hydration
  • Empty upper GI tract
pre event meal1
Pre-Event Meal
  • Meal Composition
  • High in carbohydrates
    • mixed complex and simple
  • Reasonably low in fats and protein
  • Low in dietary fiber
pre event meal2
Pre-Event Meal
  • Composition (cont.)
  • High in fluids
  • Individualize
    • Use familiar foods
pre event meal3
Pre-Event Meal
  • Timing of meal
    • Complete > 2 hours before event
  • Individualize (3-4 hours better for some)

1994 Dietary Supplement Health and Education Act (DSHEA)

  • Intent: allow consumers access to nutrition based supplement
  • FDA no longer responsible for the purity or safety of dietary supplements
    • responsible for taking action against UNSAFE dietary supplements after market
  • Supplement manufacturer is responsible safety, efficacy but do not have to provide EVIDENCE
    • No approval or product registration required
  • FTC responsible for regulating advertising claims/labeling
    • Can make health, nutrient, or structure/function claim NOT disease claim

Lack of Regulation and Evidence

  • Few well designed studies exist
  • Most studies showing benefits of supplements are biased (funded by manufacturer)
  • Few patients actually studied
  • Placebo effect (sugar pill) may account for up to 30-50% of the benefit of supplements
supplements conclusions
Supplements Conclusions
  • Some supplements improve performance somewhat in some athletes some of the time
  • Supplement use is ubiquitous
  • Theory is better than reality - many claims of supplements to improve sports performance are untrue, overstated or taken out of context
  • There are few or no studies of most supplements in athletes
for more information
For More Information
  • Web resources: