Chapter 6

1. Chapter 6 Nutritional Considerations

2. Nutrition • Diet influences virtually every aspect of sports participation. • Performance • Recovery from training and competition • And to some extent, likelihood of injury

3. Knowledge of Nutrition • Coaches and athletes may be familiar with the food groups but often lack adequate nutrition information and incorporate unfounded nutritional practices into training programs. • Athletes may be receiving nutritional education from other sources. • Parents, TV commercials, magazines • Certified athletic trainers and strength & conditioning coaches are most knowledgeable about nutrition.

4. Eating for Sport Performance • Academy of Nutrition and Dietetics indicates that eating properly will: • help you train longer and at a higher intensity • delay the onset of fatigue • promote recovery • help your body adapt to workouts • improve body composition and strength • enhance concentration • help maintain healthy immune function • reduce the chance of injury • reduce the risk of heat cramps and stomach aches.

5. Overview of Nutrients Macronutrients • Carbohydrates • Fats (Lipids) • Protein Micronutrients • Vitamins • Minerals Water

6. Caloric Intake (Rest + Activity) • Caloric intake should be based the body weight goal. • Total caloric intake should be determined by calculating the basal metabolic rate (BMR) and the energy needs for activity. • The metabolic qualities of the activity should be considered when calculating the need for each energy-producing nutrient (carbohydrates, fats, proteins).

7. Calculating Goal Weight • Based on ideal body fat percentages • 10-22% Males • 20-32% Females • To calculate goal weight: • Current % body fat – Desired % body fat = Nonessential body fat % • Current body weight X Nonessential body fat % (decimal form) = Nonessential fat (lbs) • Current body weight – Nonessential fat (lbs) = Ideal body weight (lbs)

8. Basal Metabolic Rate (BMR) • The amount of energy needed to sustain functioning at rest. • Female BMR = 655.1 + (9.6 X weight [kg]) + (1.9 X height [cm]) – (4.7 X age [yrs]) • Male BMR = 66.5 + (13.8 X weight [kg]) + (5 X height [cm]) – (6.8 X age [yrs]) • Add daily activity to find amount of energy expended daily • Sedentary - 20-40% of BMR • Light Activity - 55-65% • Moderate Activity – 70-75% • Heavy Activity – 80-100% • Sport participation > 200%

9. Carbohydrates • Carbohydrates (CHO) provide energy for high-intensity exercise • Experts recommend 60% to 70% of daily calories be supplied by CHO. • Each gram of CHO provides 4 kilocalories. • Average person stores approximately 1500 to 2000 kcals of CHO, the majority of which is in the form of muscle and liver glycogen. Small portion available as blood glucose. • CHO are now classified on how fast they are oxidized. Known as the Glycemic Index.

10. Carbohydrates • CHO derived from plant sources, primarily grains, seeds, fruits, and vegetables. • Simple CHO – monosaccharides • Sugars such as fructose, glucose, galactose • Typically stimulate insulin release and blood glucose fluctuations. • Foods containing are high caloric and often referred to as empty calories. • Complex CHO – polysaccharides • Whole-grain cereals & breads, vegetables, and fruits. • Dietary fiber (indigestible CHO) essential for digestion.

11. Carbohydrates • Simple and complex CHO are suitable to describe foods, but these do not represent the way they are hydrolyzed and absorbed by the body. (Table 6.1) • Low Glycemic Index CHO • Cause a steadier rise and decline in blood glucose and insulin. Best for weight management and overall diet. • High Glycemic Index CHO • Typically result in a large and rapid rise in blood glucose and insulin, followed by a rapid decrease in blood glucose. Best for refueling after event.

12. Carbohydrate Loading • Carbohydrate loading can benefit athletes involved in aerobic sports, especially activities lasting 60 minutes or more. • Properly executed regimen of CHO loading can boost the level of stored glycogen. • 1 week prior to the competition and includes a gradual tapering of physical activity accompanied with a slight increase in CHO ingestion.

13. Fats (Lipids) • Fats are needed for energy, insulation, and protection of organs. • Fatty acids and glycerol make up fats. • Fatty acids: Saturated and Unsaturated • Experts recommend that fats compose 30% or less of total calories. 10% saturated • Each gram of fat supplies 9 kilocalories.

14. Fats • Saturated - all of the available bonding sites on the fatty acid molecule are occupied by a hydrogen atom. Derived from animal sources (i.e., beef, pork, poultry, and dairy products). Generally solid at room temperature. • Unsaturated fats are structured in such a way as to prevent all of the available bonding sites from being occupied by a hydrogen atom. Plant based. Generally liquid at room temperature.

15. Proteins • Proteins are needed for tissue construction, enzyme reactions, and energy during prolonged exercise. • Experts recommend that proteins compose 10-15%. • Each gram of protein supplies 4 kilocalories. • Proteins are composed of amino acids • 20 different amino acids are used to make thousands of proteins. • 8 are essential amino acids, which cannot be synthesized by the body and must be ingested in the diet.

16. Proteins • Sources include eggs, meats, dairy products, legumes, or grains. • Athletes who are on vegetarian diets must take care to eat foods in the correct combination to provide all of the essential amino acids. • A solution to the problem is for such athletes to include either eggs (ovolactovegetarian), milk products (lactovegetarian), or both to ensure adequate supplies of essential amino acids.

17. Protein Supplementation • Protein supplementation is not recommended because: • Increase saturated fat in the diet • Overstress the liver and kidneys. • NO scientific evidence that protein supplements enhance muscles. • During intense training, 1.2-1.8 grams protein/kg body weight are recommended. • 0.83-1.2 g/kg for sedentary or light exerciser • Normal diet provides adequate protein consumption for intense training.

18. Vitamins • Vitamins have various functions • Regulate biochemical reactions (energy metabolism and cell and tissue generation) • Serving as antioxidants that protect cell structure. • Vitamins contain no caloric value and a balanced diet supplies the Recommended Daily Allowance (RDA). • There are water- and fat-soluble types of vitamins. • Water soluble: Vitamins C, B1, B2, B6, B12, niacin, folic acid, biotin, and pantothenic acid. • Fat soluble: vitamins A, D, E, and K.

19. Minerals • Minerals are elements needed for various body functions. • Provide structure, help maintain normal heart rhythm, assist muscle contractility, promote neural conductivity, and regulate metabolism. • There is no scientific evidence to support taking minerals in excess of RDA for performance. • But endurance athletes may be at an increased risk of iron or calcium deficiency • Iron and Calcium RDAs • Iron:10 mg for males and 18-20 mg for females • Calcium: 1500 mg

20. Vitamins and Minerals Athletes who do not eat a balanced diet should be advised to include a vitamin and mineral supplement. • A convenient method of supplementation is a daily multivitamin • Megadoses of vitamins/minerals should be avoided and could result in severe consequences

21. Water (H2O) • Water is necessary for human performance, as well as survival. • Adult water requirement at rest is approx. 2.5 liters daily, but it can increase to 5–10 liters during heavy exercise, especially in high temperature and humidity. • Water lost during exercise needs to be replaced to maintain body’s fluid balance. • A reduction of body weight of 2-5% can impair function. • Current recommendations are for every 1 lb lost due to sweating, 20-24 oz. of water be consumed.

22. Nutritional Knowledge: The Research • Athletes are largely uneducated regarding proper nutrition, even though they understand the importance of adhering to a quality diet. (Torres-McGehee et al., 2012) • Sources information come from family members (32%), fellow athletes (32%), athletic trainers (30%), dietitians (30%), coaches (28%), and TV, radio, or the Internet (10%) to obtain their information. (Froiland et al., 2004) • Hilton (2005) reported that 70% of university athletes (n = 345) are falling short of their daily caloric needs.

23. Female Athletes • As more women become involved in organized sports, concerns have been raised regarding their special nutritional considerations. • Especially those involved in aesthetic sports that place an emphasis on being lean, such as gymnastics, diving, and dancing. • Greenleaf and colleagues (2009) determined that 54% of college athletes were dissatisfied with their current weight. • Clinical disordered eating: 47% in lean sports; 20% in “non-lean” sports

24. Endurance Sports Athletic energy deficit - athletes not consuming enough calories to match their output. A new concern emerging in athletics. • Athletes with athletic energy deficit will be unable to support vital body functions including bone growth. • With insufficient energy post exercise repair is inhibited, hormones affected, amenorrhea and slower/poor bone growth. • Other adverse health-related consequences include: depression, lethargy, attention deficits, sleep disorders, and increases in body fat.

25. Wrestling • Wrestling is one of only a few sports that match participants on the basis of weight. • Wrestlers often follow unhealthy weight loss procedures to compete in lighter weight categories. • Rapid weight loss occurs via dehydration. • Dehydration occurs through the use of laxatives and diuretics, fluid restriction, artificially induced sweating, and starvation. • No definitive proof that such tactics actually present an advantage.

26. Wrestling • Short-term effects of repeated bouts of extreme weight loss include: (Nelson, 1989; Williams, 1992) • Increased blood viscosity • Blood clots • Kidney, liver and pancreas problems • Ulcers • Speculative long-term effects may include interference with normal growth and development.

27. Wrestling Minimum Weight Project (WMWP) • Wisconsin instituted WMWP in 1989. (Oppliger et al., 1995) • Weight loss must be no more than 3 lbs. of weight loss/week. • A minimum 7% body fat level was established. • Testing of athletes along with nutrition education for coaches was implemented. • Feedback has been positive from 95% of coaches. • Participation has increased.

28. Wrestling Rules • The NFSH has developed a national wrestling rule #1-3-1 that states: • “An ideal program would be one where a medical professional would assist in establishing a minimum weight through the use of checking body fat and hydration. The recommended minimum body fat should not be lower than 7%” (NFHS, 2011) • Weight cutting can have physiological effects on performance. (ACSM; Oppliger et al., 1996, updated in 2010)

29. ACSM Recommendations for Wrestling • Education should be provided to coaches and wrestlers. • Rubber suits, steam rooms, hot boxes, saunas, laxatives, and diuretics should not be used for making weight. • Weigh-ins immediately prior to competition. • Daily weigh-ins need to be scheduled before and after practice. • The body composition assessed prior to the season. • Caloric intake needs to support the normal developmental needs.

30. Conclusions (ACSM, 2009; McArdle et al., 2009) • Athletes do not consume the proper proportions of nutrients • CHO amount depends on the athletes daily expenditure, sport, gender, and conditions • Protein needs can be met through diet alone • Athletes eat too much “junk food” • Athletes in sports that require lean bodies tend to eat diets with insufficient calories • Most athletes’ diets are deficient in important minerals, i.e., calcium, iron, & zinc.

31. What Can the Coach Do? • Coaches are an important source of nutrition information. • People planning to enter the coaching profession should take at least one basic college nutrition course. • Attend in-service meetings, professional conferences, or community education programs in sports nutrition. • Subscribe to professional journals that include nutrition articles.

32. What Can the Coach Do? • Locate nutrition experts, including dietitians, university nutrition faculty, or sports medicine staff. • Implement peer-led programs like Athletes Targeting Healthy Exercise & Nutrition Alternatives (ATHENA). (Eliot et al., 2008) • Have athletes keep a record of their diet that is reviewed periodically by a person knowledgeable in nutrition. • When working with children, discuss nutritional needs of the athlete with parents.

33. General Dietary Guidelines for Athletes • Tailored to meet individual needs • Nutrition should prepare athletes for: practice, competition and recovery • Educated to make proper food selection and informed supplement using interactive resources Sports, Cardiovascular, and Wellness Nutrition practice group (http://www.scandpg.org)

34. Precompetition Diets • Foods eaten just before a contest will contribute virtually nothing to performance. • Experts recommend that the typical pregame meal should be eaten no later than 1 to 4 hours prior to the contest. (ACSM, 2009) • Eat low-fat, easy-to-digest foods. • Liquid meals increase hydration and are less likely to cause bloating or “heavy” feeling. • Foods should provide 150 to 300 grams of CHO or 3 to 5 grams/kg of body weight. (McArdle et al., 2009)

35. Nutrition During Competition • One hour of highly intense exercise can reduce liver glycogen by 55% and 2 hours can almost completely deplete both liver and muscle glycogen. • CHO consumption during long-duration exercise (1 to 3 hours at 70% to 80% VO2max ) allows muscle cells to rely on blood glucose for energy. • Recommended fluid source of CHO is 8 oz. of a 5% CHO solution consumed every 15-20 min. Especially for morning workouts.

36. Nutrition After Competition • Dietary goals are to replace muscle glycogen and ensure quick recovery. • A carbohydrate intake of approximately 1.0–1.5 g/kg body mass (0.5–0.7 g/lb) during the first 30 min and again every 2 h for 4–6 h will be adequate to replace glycogen stores. • Timing of CHO ingestion is important as glycogen levels will replenish faster if the food is consumed within 30 minutes – 1 hour. • Protein consumed after exercise will provide amino acids for building and repair of muscle tissue.

37. Nutrition and Injury Recovery • Weight gain is a concern with forced inactivity due to injury. • Athletes who are ill/injured should not reduce total caloric intake as metabolism may increase as the body repairs itself. • Recommend cross training during recovery. • Runners can ride stationary bikes or run in swimming pools. • Those with infectious illnesses and unable to exercise should establish a caloric intake based on their BMR until they are healthy.

38. Nutrition and Recovery • CHO stimulates insulin/insulin growth factor which helps tissue building. • Proteins (amino acids) contain the building blocks for connective tissue and muscle. • Anti-inflammatory foods encouraged: garlic, cocoa, tea, blueberries, pineapple • Proteolytic enzymes are known to inactivate bradykinins, reduce viscosity of extracellular fluid(swelling), and help molecular debridement: cheese, rye, papaya • Free fatty acids contain eicosanoids, which can reduce pain, cause vasodilation and enhance the immune system: omega 3 & omega 6 fatty acids

39. Managing Body Weight • Body weight consists of water, fat, and lean tissue. • Muscle is denser than fat. • In order to maintain weight an athlete’s caloric intake must equal caloric expenditure. • Consume too many calories per day the excess calories are converted to fat. Too few, stored fat will be metabolized to form energy. • Severe caloric restrictions (fasting) result in protein breakdown. • Athletes should only weigh themselves once/week at the same time of day and after going to the bathroom.

40. Managing Body Weight • Percentage of body fat = the ratio of fat to lean body weight • Better measurement for weight management and is commonly referred to as body composition. • Ranges for most active young females are 14-24% and active young males are 7-17%. • Lowest reference body fat for males is 5% and in females it is 12% (Sammarone Turocy et al., 2011) • NATA position statement “Safe weight loss and maintenance practices in sport and exercise” (Sammarone Turocy et al., 2011) is an excellent resource

41. Minimal Competitive Weight (MCW) % body fat can be used to accurately calculate an athlete’s minimal competitive weight so they can excel during the season. • Sample Equation: [MCW = LBW / % fat desired] • Determine % fat desired (5%); (1 - % fat desired = 0.95) • A 135 lb athlete with 14% body fat = 135 x 0.14 = 18.9 lb fat • 135 lb – 18.9 (fat weight) = 116.10 lb (LBW) • MCW = 116.10 / 0.95 = 122 lbs

42. Supplements and Ergogenic Aids • Supplements have become very popular with athletes of all calibers. • Ergogenic Aid: Food/drink that has potential to increase work output of the person using them • Marketed to make athletes think they will improve their personal performance and reach their goals faster. • It is important for the consumer to evaluate the marketing claims, research studies, and safety issues associated with ergogenic aids. (Manore, Meyer, and Thompson, 2009) • Many pose adverse health risks or are illegal and their use will result in disqualification or other penalties.

43. Nutritional Supplements • NATA released two comprehensive position stands evaluating dietary supplements (Buell et al., 2013) and anabolic-androgenic steroids (Kersey et al., 2012) • Food first philosophy • Dietary Supplement Health and Education Act (DSHEA) of 1994 • Supplements can be divided into two categories: Legal and Illegal

44. Nutritional Supplements Write how it can increase performance, its adverse effects, how it is regulated (banned, illegal, legal, dosage, etc.) and how to get it. • Caffeine • Ephedra • Androstenedione (andro) • Dehydroepiandrosterone (DHEA) • Creatine • Amino acids • Nitric Oxide • Herbals

45. Anabolic-Androgenic Products • Illegal supplements include the following but are mostly legal products when used in therapeutic doses under physician or veterinarian's care. • Anabolic steroids – high doses build muscle but have many adverse effects • Erythropoietin (EPO) - stimulates RBC proliferation, increased viscosity makes the heart work harder • Amphetamines – stimulants that block fatigue messages to the brain, associated cardiac problems • Gammahydroxybutyrate (GHB) – deep sleep aid, suggested HGH is released in this sleep cycle