Nutrition and Nutritional Nutrition and Nutritional Supplements in SportsSupplements in Sports

ObjectivesObjectives Increase awareness that nutrition can affect an athlete’s

performance Discuss current nutritional recommendations for athletes Review the 1994 Dietary Supplement Health and

Education Act Definition of a supplement Impact of this legislation

Discuss specific nutritional supplements commonly used by athletes Do they work? Are they safe?

Review the Anabolic Steroid Control Act of 2004 Help providers answer questions and address concerns

of athletes, parents and coaches

Performance Influencing FactorsPerformance Influencing Factors

Genetics

Training and Conditioning

Nutrition

Determinants of the Athlete’s Determinants of the Athlete’s Energy RequirementsEnergy Requirements

During intense exercise Carbohydrate stored in muscles and liver

(glycogen) is predominant fuel sourceDuring prolonged exercise

Fat stores are predominant fuel sourceFitness level of the athlete

Well trained endurance athletes burn fat more efficiently, sparing limited glycogen stores

Formula for Estimating the Formula for Estimating the Body’s Calorie RequirementsBody’s Calorie Requirements

Sedentary person Weight (kg) x 25

Moderately active person Weight (kg) x 30

Active person (endurance athlete) Weight (kg) x 40

Underweight person Weight (kg) x 45

kg = lbs / 2.2

Activity for 30 min. 90 lbs. 100 lbs. 110 lbs. 120 lbs. 130 lbs. 140 lbs. 150 lbs. 160 lbs. 170 lbs. 180 lbs. 190 lbs. 200 lbs.

Aerobics step training, 4" step (beginner) 131 145 160 174 189 203 218 232 247 261 276 290

Backpacking 180 200 220 240 260 280 300 320 340 360 380 400

Basketball (game) 198 220 242 264 286 308 330 352 374 396 418 440

Bicycling, 10 mph (6 minutes/mile) 112 125 138 150 162 175 188 200 213 225 237 250

Hiking, no load 140 155 171 186 202 217 232 248 263 279 294 310

Jogging, 5 mph (12 minutes/mile) 167 185 203 222 240 259 278 296 315 333 352 370

Raquetball 185 205 225 246 266 287 308 328 349 369 389 410

Running, 08 mph (7.5 minutes/mile) 274 305 336 366 396 427 458 488 518 549 579 610

Soccer 176 195 215 234 253 273 292 312 332 351 371 390

Swimming (25 yards/minute) 108 120 132 144 156 168 180 192 204 216 228 240

Walking, 3 mph (20 minutes/mile) 72 80 88 96 104 112 120 128 136 144 152 160

Weight training (40 sec. between sets) 230 255 280 306 332 357 382 408 433 459 484 510

CarbohydratesCarbohydrates

Non-essential nutrient (human body can make sugar) Simple (sugars) and Complex (starches) Major fuel source for exercising muscle Athletes should ingest 6 to10 gm/kg/day

60 to 70% of total calories should come from carbohydrates Complex carbohydrates (starches) are preferable

During exercise Athletes should consume 25 to 30 gm of carbohydrate for

every 30 minutes of exercise Athletes should drink 6 to 8 ounces of water or sports drink for

every 10 to 15 minutes of exercise

CarbohydratesCarbohydratesAfter exercise

Athletes should consume 1.0 to 1.5 gm/kg immediately post exercise and again one hour later

To replace muscle glycogen stores To prevent gradual depletion of muscle

glycogen stores over time caused by repetitive daily bouts of heavy exercise

To decrease muscle breakdown

Why Complex Carbohydrates?Why Complex Carbohydrates?

Compared to ingesting simple carbohydrates, ingesting complex carbohydrates: Increases muscle glycogen stores better Improves performance and delays fatigue Promotes faster stomach emptying Causes less stomach upset and indigestion Leads to lower blood sugar and insulin levels Provides other beneficial nutrients

Fiber, vitamins and minerals

Pre-exercise MealPre-exercise Meal

Importance Less hunger before and during exercise Maintains optimum glycogen stores

Recommendations Emphasize complex carbohydrates (starches)

1 to 4 gm/kg about 1 to 4 hours prior to event Consume less closer to event

Avoid high fat and high protein foods Slower gastric emptying can cause stomach upset

Avoid high fiber or gas forming foods Can lead to crampy abdominal pain

Carbohydrate LoadingCarbohydrate Loading

Increases the body’s pre-exercise glycogen stores by 50 to 100%

Benefits endurance athletes who compete for longer than 90 minutes Can increase endurance up to 20% Can increase performance by 2 to 3%

Carbohydrate Loading:Carbohydrate Loading:One Example of HowOne Example of How

Days prior to event Exercise duration Carbohydrate intake

6 90 minutes 5 gm/kg/day

5 40 minutes 5 gm/kg/day

4 40 minutes 5 gm/kg/day

3 20 minutes 10 gm/kg/day

2 20 minutes 10 gm/kg/day

1 rest 10 gm/kg/day

ProteinProtein Athletes require more protein than non-athletes

12 to 18% of total calories should come from protein Protein intake should be tailored to type of training

1.2 to 1.4 gm/kg/day recommended for endurance athletes 1.7 to 1.8 gm/kg/day recommended for strength athletes

Average American diet provides 1.4 gm/kg/day Adequate calorie intake is just as important as

adequate protein intake for building muscles Too much protein intake can be bad

Excess protein calories are stored as fat Excess protein intake can lead to dehydration and may

contribute to kidney problems

FatFat

Major source of energy 25 to 30% of total calories should come from fat

Less than 10% of total calories should come from saturated fats

Cholesterol intake should be less than 300 mg/day Average American diet provides 37% of total

calories from fat

Nutritional SupplementsNutritional Supplements 1994 Dietary Supplement Health and

Education Act Definition of a supplement

Any product that contains vitamins, minerals, amino acids, herbs, botanicals or a concentrate, metabolite, constituent, extract or combination of any of these ingredients

Removed dietary supplements from FDA regulation on the front end

FDA must prove a supplement is dangerous before its sale can be prohibited

Nutritional SupplementsNutritional Supplements1994 Dietary Supplement Health and

Education Act Manufacturers do not have to provide

scientific proof of claims Manufacturers cannot state product is

meant to diagnose, treat, prevent or cure a disease but can make indirect suggestions

Created a multi-billion dollar industry that continues to grow rapidly

Vitamins and MineralsVitamins and Minerals Essential nutrients

Human body needs these to produce energy No evidence in U.S. studies that taking vitamin and

mineral supplements improves athletic performance Being deficient in vitamins or minerals is rare in the U.S.

compared to the rest of the world A few studies outside U.S. showed an effect

Did population studied have some baseline deficiency treated with these supplements?

Vegetarian athletes are at risk for being deficient in vitamins B12, D, riboflavin, iron, zinc and calcium Athletes who are strict vegetarians should take a

multivitamin to prevent deficiencies and a calcium supplement (1000 mg/day) to help prevent bone loss

Ephedra or MaHuangEphedra or MaHuang Herbal forms of the stimulant ephedrine 80 confirmed deaths related to ephedra use

Experts suspect many more unconfirmed deaths Adverse effects

High blood pressure (most common) Palpitations and increased heart rate Seizure Thermoregulatory dysfunction Stroke Heart attack Sudden death Vasculitis Allergic myocarditis (one case reported) Acute hepatitis (one case report)

Ephedra or MaHuangEphedra or MaHuangFollowing the death of two professional

athletes, FDA banned sale of Ephedra as a nutritional supplement

Since this time, manufacturers have started substituting other stimulants Citrus Aurantium

Orange extract Chemical structure very similar to ephedrine

Anabolic Steroid PrecursorsAnabolic Steroid Precursors Dehydroepiandrosterone (DHEA) and

Androstenedione (“Andro”) Chemicals that can be converted into testosterone

in human biochemical pathways Naturally available in wild yams An early study done by a manufacturer of these

products showed no significant increase in blood levels of testosterone

Study looked at lower doses of these supplements than are usually taken and did not measure ratio of testosterone to epitestosterone (T:E ratio)

Anabolic Steroid PrecursorsAnabolic Steroid Precursors Subsequent independent scientific studies

DHEA Does not seem to have much if any effect on fat-free

body mass and strength Androstenedione

Causes a temporary increase in testosterone levels Has no effect on body’s ability to make protein Does not seem to have any effect on strength No long term effect on blood testosterone levels Chronic use causes increase in estrogen levels

Anabolic Steroid PrecursorsAnabolic Steroid PrecursorsPotential adverse effects

May cause liver damageIn females

Can cause male features in womenMay increase risk of uterus cancer

In malesCan cause female features in menMay increase risk of prostate cancer

Anabolic Steroids and Anabolic Steroids and Anabolic Steroid PrecursorsAnabolic Steroid Precursors

Are banned and tested for by the USOC, IOC, NCAA, NFL, NBA and MLB

NHL has no official policy and does not perform testing

You can be disqualified from participating in college sports if you test positive for a substance banned by the NCAA Whether or not you knew it was banned Whether or not the product was mislabeled

Buyer Beware!Buyer Beware! IOC funded study by Shanzer (Germany) from 10/00 to 11/01

Analyzed 634 products labeled as non-hormonal nutritional supplements from 13 countries and 215 different suppliers

94 products (14.8%) were found to be “positive supplements” (contained anabolic steroid precursors not declared on the label)

Anabolic androgenic steroid concentrations ranged from 0.01 to 190 micrograms per gram of supplement

23 products contained steroid precursors of nandrolone and testosterone 64 products contained steroid precursors of testosterone only 7 products contained steroid precursors of nandrolone only Percentage of positive supplements per country

25.8% of products bought in Netherlands 22.7% of products bought in Austria 18.8% of products bought in UK 18.8% of products bought in US (45 positive out of 240 tested)

Anabolic Steroid Control Act of 2004Anabolic Steroid Control Act of 2004 Signed into federal law on October 22, 2004 Amends the Anabolic Steroid Control Act of 1990

Modifies the definition of anabolic steroids to include tetrahydrogestrinone (THG), androstenedione, and specified related chemicals

Directs the U.S. Sentencing Commission (USSC) to review federal sentencing guidelines with respect to anabolic steroid-related offenses

Amends guidelines to provide for increased penalties Authorizes the Attorney General to exempt from regulation any

compound, mixture, or preparation containing an anabolic steroid that does not present a significant abuse potential

Directs the Secretary of Health and Human Services to award grants for science-based education programs in elementary and secondary schools to highlight the harmful effects of anabolic steroids and to ensure that the NSDUH includes questions concerning the use of these drugs.

Source: Library of Congress

ConclusionsConclusions

Nutrition plays an important role in an endurance athlete’s ability to perform

Proper nutrition in combination with sound and proven training techniques can help endurance athletes to maximize their genetic abilities

Certain nutritional supplements have not demonstrated any performance benefit in studies

ConclusionsConclusions Certain nutritional supplements can have

potentially dangerous side effects Further legislation is needed to address the

dangers of some nutritional supplements Professionals in the community need to be

resources of good information for athletes, parents and coaches Physicians Physician assistants Nurse practitioners Athletic trainers School nurses Dieticians

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