sports nutrition research update 2009 with exercise physiology, strength conditioning & topics...

Sports Nutrition Research Update 2009

with exercise physiology, strength conditioning & topics of interest

in sports medicine

G. DOUGLAS ANDERSEN DCDACBSP, CCN

www.andersEnchiro.com

Carb Loading Update

CHO loading was first studied in the early 1960’s Vigorous exercise of 1-3 days followed by 3 days of

rest accompanied simultaneous dietary manipulation of low and high carbohydrates.

Various protocols had mixed results with some responding while others did not.

The theory that super compensating glycogen stores would provide biochemical advantage

Performance was not always improved and sometimes (loading CHO) it was harmful.

Carb Loading UpdateEarly Problems

• Marked dietary changes prior to competition were hard to follow

• Major dietary changes often disrupt GI rhythm leading to gas, bloating and stool changes.

• Exercise increases (to deplete glycogen) so close to competition altered established tapers.

• Increased injuries from glycogen depleting exercise.

Carb Loading Improvements

In the 1980’s 3-4 days of exercise taper followed by 3

high CHO days made the process much more practical.

Research then showed depletion exercise was not

required to super-compensate contractile tissues and,

once elevated, would remain so for 3-5 days provided

calories were adequate & activity was low

In a 2002 study, 1 day of inactivity with a high (10g/kg/bw)

CHO intake of high glycemic index CHO’s elevated

glycogen 90% with no additional benefit with 2 more days.

Sedlock, D., The Latest Carbohydrate Loading: A Practical Approach. Cur. Sports Med. Reports 2008; 7(4) 209-13 4

Carb Loading 2009 - Summary

Glycogen super-compensation can remain elevated for up to 5 days.

For each gram of stored glycogen, 3-5 grams of water are stored.

The type of CHO is less important than the amount of CHO.

Events must be at least 90 minutes for any benefit.

Sedlock, D., The Latest Carbohydrate Loading: A Practical Approach. Cur. Sports Med.

Reports 2008; 7(4) 209-13

10 Subjects consumed a CHO-protein drink on 3 occasions under 2 conditions (rest or exercise) with 3 types of protein.

Protein types were Casein 100%, Whey 100% & Casein-Whey 85-15%

Drinks all had 19 gm protein, 76 gm CHO & 2 gm fat.

Measurements were taken at rest after 3 different drinks and after 60 minutes of exercise with 3 different drinks (6 weeks total)

Results Protein type had no impact on post prandial A.A. concentration after rest or exercise.

T.J. Smith, S.J.Montain, J.McClung, et. al Milk Protein Type Does Not Impact Plasma Amino Acid Concentration When Incorporated Into a High Carbohydrate Beverage. Med. Sci. Sports Excer. 2008; 40 (5) A-955 S101 6

Protein Uptake in High CHO Beverage

Sport Drinks & Protein- Is it the Protein or Calories?

Adding small amounts of protein to CHO-Electrolyte (E) drinks is superior to traditional CHO-E drinks for cyclists.

In most trials the added protein means the comparison is not isocaloric.

11 trained cyclists completed 4 rides to exhaustion in a double blind randomized fashion.

Every 15 minutes the subjects drank 250 ml. (8.45 oz.) of 1 of 4 drinks.

Placebo, 7.75% CHO-E 9.69% CHO-E 7.75% CHO 1.94% Protein.

Blood was drawn before, ~8 hours after and ~24 hours after each round of the trial.

Valentine, R.J., Saunders, M.J., Todd, M.K., St. Laurent, T.G. Influence of Carbohydrate – Protein Beverage on Cycling Endurance and Indices of Muscle Disruption. Int. J. Sport Nut. Excerc. Metab. 2008; 18 (4) 363-78

Valentine, R.J., Saunders, M.J., Todd, M.K., St. Laurent, T.G. Influence of Carbohydrate – Valentine, R.J., Saunders, M.J., Todd, M.K., St. Laurent, T.G. Influence of Carbohydrate – Protein Beverage on Cycling Endurance and Indices of Muscle Disruption. Int. J. Sport Protein Beverage on Cycling Endurance and Indices of Muscle Disruption. Int. J. Sport Nut. Excerc. Metab. 2008; 18 (4) 363-78Nut. Excerc. Metab. 2008; 18 (4) 363-78

INGREDIANT COMPARISON OF EXPERIMENTAL DRINKS


Time to Fatigue with each Beverage Treatment


Plasma Creatine Kinase


Serum Myoglobin Concentration

Cystine and Theanine 15 Subjects (mean age 23) with 4-5 years of

resistance training @ 3x/week enrolled in a 2 week experiment.

Divided into 2 groups and took either 700 mg Cystine + 280 mg theanine or placebo after dinner.

Week one subjects continued with normal workout. Week two subjects doubled their workout (6 days) Blood was drawn at beginning and end of each week. Results Natural killer cell activity decreased 30% in placebo

group following high intensity, high frequency resistance exercise with no decrease in C/T groups.

Kawada, S., Kobayashi, K., Ohtani, M., Fukusaki, C. Protective Effects of Cystineand Theanine SupplementatioOn Immune System In High-Intensity Resistance Training. Med. Sci. Sports Exerc. 2008; 40(5) A-2204 S402

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Beta Glucagon & URI’s

A Class of Soluble fibers found in plants especially oats and barley best known for modest cholesterol reduction.

Promoted to prevent upper respiratory infections following strenuous endurance exercise.

36 male cyclists were randomized into 2 groups under double blind conditions

Subjects took either 5.6 grams of Beta Glucagon (N=19) or placebo (N=17) for 17 days the last 3 of which were intense 3 hour rides.

Pre and Post blood tests were done on all subjects.

Beta Glucagon for URI’sRESULTS

Natural Killer Cell activity, lymphatic proliferation various interleukin and plasma cytokines did not differ pre-post between groups.

URI incidence was 9/19 for Beta Glucagon and 6/17 for placebo

The URI rate 47% in Beta Glucagon and 35% in placebo groups did not statistically differ according to the authors.

Neiman, DC, Hensen, DA, McMahon, M et al. Beta Glucagon Immune Function and Upper Respiratory Tract Infections in Athletes. Med. Sci. Sports Exerc. 2008;40(8) 1463-71

New study: B-G lowers total + low density cholesterol & tri’s but not HDL’s Bandayl, L. Dietary Soluble Fiber may be Beneficial for Adults w & w/out

Hypercholesterolemia. Ann. Int. Med. 2009 (7) 157-63

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Quercetin A flavonoid found in onions, kale, apples and broccoli Typical US diet contains ~107mg/d Estimated intake of persons with the highest intake of

fruits and vegetables (90th percentile) ~225 mg/d Quercetin is a powerful antioxidant (much stronger than

vitamin C) with high levels anti-carcinogenic activity and other properties including protection of proteins, DNA and regulation of gene expression

1000 mg/d 3 wks prior to exhaustive endurance exercise reduced URI’s post exercise challenge fm 9/20 to 1/20.

Quercetin Increases Power and Endurance

12 fit college age students tested in double blind fashion.

Baseline fitness on exercise bike was established. Took 500 mg Quercetin 2x/day for 7 days or placebo Measured lab test ride then protocol was repeated

so all subjects were tested with both treatments. Quercetin (1000mg/day) x 7 days increased

maximum aerobic power 3.9% and time to exhaustion by 13.2%.

S.C. Chen, J.M. Davis, C. Carlsted et.al Effects of Quercetin Feedings on Maximal Oxygen Consumption and Fatigue During Prolonged Exercise .Med. Sci. Sports Excer. 2008; 40 (5) A-1250 S165

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Beta-Alanine

Beta-alanine is the only natural occurring AA in beta form It is the rate limiting molecule for Carnosine synthesis Carnosine is a dipeptide which buffers hydrogen ions.

Muscles contain most of the bodies carnosine Ample carnosine allows muscles to buffer hydrogen ions

produced during contraction. The more hydrogen we buffer, the more work we can do

before the ‘burn’ stops us. Carnosine (also composed of histidine) is not absorbed well

and is best elevated by increasing Beta-alanine which is absorbed well and, because of the Beta group is not incorporated into other proteins.

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Beta Alanine with Resistance Exercise

Double Blind trial with resistance trained subjects 4 weeks of 4.8 grams of Beta Alanine or placebo. 6 sets of 12 reps of squats with blood draws at

baseline, after exercise and 30 minutes after exercise.

Protocol was repeated for 4 weeks with a second test.

Results: 4 weeks of B.A. increased reps by 22%. No changes in growth hormone, testosterone or cortisol levels.

J.R. Hoffman, N.A. Ratamess et. al Effects of B-Alanine Supplementation on the Acute Hormonal Response to Resistance Exercise. Med. Sci. Sports Exerc. 2008;40 (5) A-1253 S166

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Caffeine Regular use can build intolerance and dependency. Addicts will suffer from withdrawal headaches + brain

fog, fatigue.

Side effects may include insomnia, nervousness, elevated heartbeat, and headaches.

Caffeine is not a diuretic. (under 600mg)

Some report better results and improvement during an athletic event when they have abstained for 48 hours.

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CaffeineContinued

Increases time to exhaustion in both endurance exercise and in shorter, higher intensity activities

Studies are negative for events lasting under 1 minute Can improve concentration Can increase speed of reaction (i.e., a shorter time to

react) Increases strength of contraction Improves ventilation in asthmatics A vasoconstrictor, it can relieve headaches

Caffeine Mobilization of free fatty acids – it blocks enzymes that breakdown

C-AMP Higher C-AMP increases lipolysis allowing preservation of glycogen Reduction of potassium gradient run down Stimulation of CNS motor control Increase neurotransmitter release Increase motor unit firing rates Translocation of calcium to a more favorable membrane position for

excitation – contraction coupling in skeletal muscle Binds to adenosine receptors which prevents adenosine from

causing drowsiness thus improving alertness.

Stewart, G.R., Hopkins, W.G., Cook, C., Caims, S.P. Multiple Effects of Caffeine on Simulated High-Intensity Team-Sport Performance. Med Sci Sp Ex. 2005; 37 (12): 1998-2005

Kalmar, J.M. The Influence of Caffeine on Voluntary Muscle Activation Med Sci Exerc. 2005;37(12) : 2113-19

Caffeine Improves Sprint Times

21 males (age 18-21) participated in a double blind trial preceded by establishing a baseline.

Subjects took 5 mg/kg/bw caffeine or placebo 1 hour prior to sprint testing.

Test was 12 sprints of 30 meters with a 35 second break after each run and repeated 4-5 days later with the opposite treatment.

Caffeine Improves Sprint Times RESULTS

20/21 had their fastest sprint time with caffeine. 9/21 were able to ID which trial they took

caffeine. There was a placebo effect, with mean times

faster than baseline. (But slower than caffeine) Caffeine’s effect decreased in later stages (6-12)

Glaister, M., Howatson,G., Abraham, C.S., et al. Caffeine Supplementation and Multiple Sprint Running Preformance. Med.Sci. Sports Exerc. 2008;40(10) 1835-40

CAFFEINE IMPROVES SPRINT TIMES

Glaister, M., Howatson,G., Abraham, C.S., et al. Caffeine Supplementation and Multiple Sprint Running Preformance. Med.Sci. Sports Exerc. 2008;40(10) 1835-40

Caffeine and Glycogen Replenishment

7 males volunteered for a 2-trial double blind study. Interval cycling to exhaustion followed by low CHO

dinner. Next morning ride to fatigue then consume either 4 gm

CHO/kg bodyweight or 4gm/kg/bw of CHO + 8mg/kg/bw of caffeine.

Drinks were consumed over 4 hour period. For a 175 pound person, the treatment was 70 grams of

CHO per hour or 70gm/CHO/hr + 140 mg caffeine per hour.

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Hawley, J., Pedersen, D., Lessard, S. et al. High Rates of Muscle Glycogen Resynthesis After Exhaustive Exercise When Carbohydrate Is Co-Ingested With Caffeine. Med. Sci. Sports Exerc. 2008; 40(5) A-669 S36

Caffeine and Glycogen Replenishment

continued

GLYCOGEN LEVELS* *measured by muscle biopsy

Treatment Exhaustion 1 Hour Post 4 Hour Post

CHO 75 mmol 121 mmol 234 mmol

CHO + Caff 75 mmol 149 mmol 313 mmol

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Hawley, J., Pedersen, D., Lessard, S. et al. High Rates of Muscle Glycogen Resynthesis After Exhaustive Exercise When Carbohydrate Is Co-Ingested With Caffeine. Med. Sci. Sports Exerc. 2008; 40(5) A-669 S36

Exercise Frequency and Workload 30 Obese women 25-38 years old were divided into 2 groups:

8 weeks of 75 minute exercise 2x/week

8 weeks of 30 minute exercise 5x/week Both groups exercised at 90-95% lactate threshold (typical untrained

individuals reach LT@60% VO2 max) RESULTS No

difference between groups in fitness improvement, insulin resistance or reduction in waist circumference.

CONCLUSION Total time per week at a similar intensity yields similar benefit regardless of

frequency.

Manthou, E., Gill, J., Malkova, D. Impact of Exercise Programs With Different Frequency On Physical And Metabolic Characteristics In Overweight Women. Med. Sci. Sports Exerc. 2008; 40(5) A-875 S83

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Intense Resistance Exercise Can Lower Post-Prandial Blood Lipids

10 males (ages 21-30) performed 3 two day trials.

Day 1 was one of three routines; no exercise, moderate exercise, or intense exercise followed by a 50-35-15 (%CPF) meal @ 5 cal/kg bodyweight

Day 2 was identical in all 3 trials. 15.5 hours after exercise (or rest) subjects returned for morning meal 25-11-64 (%CPF) meal @ 20 cal/kg bodyweight.

Venous samples were taken before and 3 hours after the meal.

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Intense Resistance Exercise Can Lower Post-Prandial Blood Lipids

continued

Moderate resistance exercise was 3 sets of 16 reps of 10 exercises @ weight of 50% of 8 rep max.

Intense resistance exercise was 3 sets of 8 reps of 10 exercises @ a weight of 100% of 8 rep max.

Meals for 70 kg (154lb) subject averaged 350 calories post-exercise and 1400 calories the next morning.

RESULTS High intensity R.E. the day before lowered post-prandial lipids following high calorie, high fat breakfast. Moderate intensity of equal work had no effect on post-prandial lipids.

Singhal, A., Trilk, J., Jenkins, N., et al. Effect of Intensity of Resistance Exercise on Postprandial Lipemia. Med. Sci. Sports Exerc. 2008; 40(5) A-757 S56

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Exercise Dependence Exercise dependence is defined as 3 or more of

the following: -Tolerance -Symptoms of Withdrawal -More exercise than intended -Inability to reduce exercise -Excessive time spent exercising -Conflict with other activities -Exercising despite contraindications

Bartholomew, J., Hodgkinson, M., Exercise Motivation and Dependence: A Cluster Analysis of Endurance Athletes. Med. Sci. Sports Exerc. 2008; 40(5) A-1424 S209

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Korean Red Ginseng 8 male students were divided into 2 groups. Ginseng group took 7 grams of Korean Red

Ginseng extract 3x/day for 7 days in 6 oz. liquid. Placebo group followed same protocol. On the 8th day subjects did two 45 minute uphill

treadmill runs with 5 minute rest break. Blood was drawn immediately pre-post exercise

and @ 30 min, 1,2,3,24,48, 72 hours and 10 days following exercise.

Interleukin, creatine kinase and cortisol were determined (3 factors at 8 times = 24 data points.)

Korean Red Ginseng results

Interleukin-6 was reduced @2 hour test in Ginseng group .22 pg/ml vs .26 pg/ml in placebo.

Creatine kinase activity was lower in the ginseng group @ 72 hour test. 223 IU/L vs 263 IU/L in placebo.

Cortisol response @ 72 hours was lower in ginseng 13.6 vs 18.7 ug/dl in placebo

There were no significant differences in any other factors over the 8 measurements taken.

3/24 data points showed benefit.

Park, S., Jung, H.L., Hong, S. et al. Effects of Red Ginseng Intake on Interleukin-6 (IL-6) and Cortisol Responses after High-Intensity Exercise. Med. Sci. Sports Exerc. 2008; 40(5) A-2329 S432

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33

Energy Patch Science Claims

Organic nanoscale biomolecular antennas are imbedded in a matched pair of patches.

They are placed on the skin in two locations. The patches emit a frequency that resonates in

unison with intracellular biomolecules. These biorhythms are able to signal metabolic

pathways causing a shift of substrate to fat utilization by activation of Beta-oxidation.

This enables greater ability to use fat for fuel thus spares glycogen.

Smith, D., Jacobson,B., Fedick, J. et. Al. The Effect of Energy Patches on Graded Exercise Test Performance in College Male Cross-Country Runners. Med. Sci. Sports Exerc. 2008; 40(5) A-2269 S418

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Energy Patch Experiment - Males 14 collegiate cross country males were measured

in the laboratory. Oxygen consumption, respiratory exchange ratio,

rate of perceived exertion, heart rate and time to exhaustion were measured in a baseline test, with energy patches and with placebo patches.

Results

There were no differences between placebo and active patches in any of the measured variables. This included no change in fat utilization.

Smith, D., Jacobson,B., Fedick, J. et. Al. The Effect of Energy Patches on Graded Exercise Test Performance in College Male Cross-Country Runners. Med. Sci. Sports Exerc. 2008; 40(5) A-2269 S418

Energy Patch Experiments – Females 17 women (ages 18-43) were divided into 2 groups. Body mass, body fat %, oxygen consumption and

respiratory exchange ratio were determined. Every other day for 2 weeks energy patches or placebo

were worn in different areas (ankle, knee, shoulder, wrist).

Diet and exercise diaries were kept.

Results Energy patches had no effect on any of the monitored

factors. Witt, J., Wooten, N.D. Effect of LifewaveTM Patches on Fat Metabolism in

Moderately Active Women. Med. Sci. Sports Exerc. 2008; 40(5) A-1894 S326

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Passive Stretching and Golf Driver 15 Male Competitive golfers underwent 2 trials 1. Dynamic warm-up with golf clubs 2. Same warm-up plus 20 minute total-body passive

stretching After warm-up subjects hit 10 balls at full velocity

with their drivers. RESULTS – EFFECTS of STRETCHINGAccuracy decreased 31% Distance dropped 5.6%Ball Contact lost 16.3% Club speed slowed 4.2%

Gergley, J., Austin, S. Acute Effects of Passive Static Stretching During Warm-up on Driver Clubhead Speed, Distance, Accuracy, and Consistent Ball Contact in Young Male competitive Golfers. Med. Sci. Sports Exerc. 2008; 40(5) A-2263 S417

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Drink Temperature During Exercise 8 males (ages 18-29) completed 2 trials in a

random fashion separated by 1-2 weeks. Food and activity 48 hours prior to testing were

identical. Subjects rode exercise bike in a chamber with a

temperature of 95 degrees and relative humidity of 60%.

Every 10 minutes they drank 100 ml (~3.5 oz) of orange flavored water (sugar free).

The beverage temperature was either 4˚C or 37˚C (39˚F or 98.6˚F)

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Drink Temperature During Exercise Results

Average time to exhaustion with cold water 63:48

Average time to exhaustion with hot water 52:00

Cold drinks extended time to exhaustion during exercise in the heat by 23%.

Lee, J.K.W., Shirreffs,S.M., Maughan, R.J. Cold Drink Ingestion

Improves Exercise Endurance Capacity in the Heat. Med Sc Sport Exerc. 2008;40(8) 1637-44

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Athletic Cramping

Exercise associated muscle cramps (EAMC) is an umbrella term that describes any cramp sustained during a workout, practice, training or competition.

Ask a health professional ‘what causes EAMC?’ and most likely a debate will ensue.

Ask a grocer ‘What color is fruit?’ and he will reply ‘What kind of fruit?’

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Cramp Type Cause/Comment TreatmentMuscle Fatigue True EAMC from repetitive

contractureStretch

Soft Tissue Lengthening

Muscle Tearing Reflex guarding to fiber tearing Ischemic compression then ice then wrap

Heat Fluid and electrolyte loss from heavy sweating = ‘Sweat Cramps’

Fluid and electrolytes, esp. Na

Ischemic compression

Nocturnal 1.Following overload workout and or incomplete fluid replacement

2. Mineral Deficiency (Calcium is most common)

1. Stretch, fluid + electrolyte if bodyweight loss.

2. Cal-Mag with dinner

3. R/O medication side effects

Whole Body Precursor to life threatening heat illness

Cool body. Fluid and electrolytes, esp. Na. Call 911

Side Stitches 1. Organ bouncing in runners leads to swelling and spasm. Liver trauma is why pain often occurs on right side.

2. Diaphragm Ischemia

Stop Activity

Flex Forward

Relax

Pre-competition meal earlier

Types of Cramps and Treatment

Eichner E.R. Heat Cramps in Sports. Curr. Sports Med. Rep. Eichner E.R. Heat Cramps in Sports. Curr. Sports Med. Rep. 2008;7(4)178-9 2008;7(4)178-9

Eichner E.R. Stitch in the Side: Causes Workup Solutions. Eichner E.R. Stitch in the Side: Causes Workup Solutions.

Curr Sports Med. Rep. 2006; 5(5) 289-92 Curr Sports Med. Rep. 2006; 5(5) 289-92

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New England Journal of Medicine. March 19, 2009

Reisenauer, C. Solomayer, E. Pelvic-Organ Prolapse and Uterine Inversion NEJM. 2008; 360 (12) 1238

Fruits in Cure-All JuicesAcai

From a palm tree in the Amazon Purple/black berries the size of a grape 12-15 vit’s/min’s; 15-20 amino & fatty acids High anthocyanin content (class of flavonoids

known for red/purple/blue pigment & anti oxidant properties

Claims of highest ORAC score (but can’t quench hydroxyl radical)

Tastes like unsweetened dark chocolate

Fruits in Cure-All JuicesGoji

Berries from a vine-like bush in Tibet, western China and Mongolia.

AKA Wolfberry, it is the size of a raspberry; when dried looks like red/orange raisin

Has bitter/sour taste 17 vit’s/mins, 18 amino acids, 5 fatty acids Goji is a rich source of 5 carotenoids & vitamin

C (50 mg/oz) Some claim Goji has highest ORAC score

Fruits in Cure-All JuicesNoni

Fruit from a South Pacific evergreen tree Pale yellow, oval w/ bumpy skin ~ 2” long When ripe, has a foul smell Taste is bitter; juice is dark brown Grape & other juices are added to commercial

products ~ 20 vitamins & minerals Over 120 phytochemicals

Fruits in Cure-All JuicesMangosteen

A fruit from an Asian evergreen tree A thick dark purple skin with juicy white tangerine sized

wedges in the center Tastes like a grape/strawberry mix Low in vitamins & minerals Has 40 of the known 200 xanthones which are anti

oxidants in the polyphenol family Mangosteen marketers also claim it has the highest

ORAC score.

Fruits in Cure-All JuicesIndian Gooseberry

From a tree native to foothills of India AKA Amalaki Fruit is cherry sized, lime green, w/ 6 furrows Low in most vitamins and minerals - except Very high in vitamin C (125-475mg/oz) Does contain Quercetin Fibrous w/ bitter/sour taste (often dipped in salt

when consumed in India.) Some say ORAC score doubles Acai

Fruits in Cure-All juicesOranges

Grown on trees, named after it’s color 17 vitamins and minerals 18 amino acids 20 carotenoids Over 150 phytochemicals A medium orange has ~ 100mg vitamin C, 75 mg calcium, 325 mg potassium, 3 gm fiber and 12.5 mg omega 3 fatty acids Taste is delicious

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Sodium Levels and Exercise-Associated Muscle Cramps in 14 NFL Players (6 cramp hx. – 8 n/c)

SubstanceSubstance CrampCramp Non-crampNon-cramp

Fluid intakeFluid intake 3.0 L3.0 L 2.1 L2.1 L

Net dehydrationNet dehydration 2.9 L2.9 L 2.7 L2.7 L

Sweat lossSweat loss 5.9 L5.9 L 4.8 L4.8 L

% water% water% sports drink % sports drink

81%81% 19%19%

58%58% 42%42%

Sweat NaSweat Na 52.6 mmol/L52.6 mmol/L 38.3 mmol/L38.3 mmol/L

Acute Na balanceAcute Na balance -223 mmol-223 mmol -133 mmol-133 mmol

Players with a history of cramping lost more sweat, drank less sports drink, and lost more sodium compared to players without a cramping history.

Stofan J.R., Horswill, C.A., Lacambra, M., Torriscelli, T., Murray, R. Acute Change in Blood Sodium During a

Two-a-day Training in Professional Football Players. Med. Sci. Sports Exerc. 2007; 39(5): S15, A-572.

50

Sodium Loading 8 endurance trained males, (~36 yrs) double-

blind trial. High vs. Low sodium beverage prior to a run to

exhaustion @ 70% VO2 max in 90 degree heat with 50% relative humidity.

Repeated 2 weeks later with opposite treatment. 65 minutes prior to the run, subjects drank 25

oz. in equal portions (3.5 oz. every 9 minutes) High sodium 164mmol Na/L Low sodium 10mmol Na/L

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Sodium LoadingContinued

Time to exhaustion in minutesSubject Hi Na Low Na__1 49.1 47.02 82.2 47.03 85.2 59.84 136.3 125.95 59.0 48.86 59.3 38.37 70.0 53.28 37.4 38.4

High Na increased plasma volume, decreased perceived exertion andimproved exercise capacity in the heat in 7/8 subjects.

Sims, S.T, Vliet, L., et. al. Sodium Loading Aids Fluid Blance and Reduces Physiological Strain of Trained Men Exercising in the Heat. Med.Sci.Sports.Exerc. 2007; 39 (1) 123-130

Salt Reduction Could Reduce Incidence of Myocardial Infarction

Salt is 99% sodium chloride (NaCl) NaCl is ~40% sodium and 60% chloride US RDA is <2400 mg sodium 6000 mg NaCl contains 2400mg Na Average U.S. daily salt intake has doubled since

1970 and is now ~12 grams. 3 grams/day reduction in US could reduce M.I.

8% and death by 3%. Domingo,K.B., Fonarow,G.C. Slight Cut in Salt would reduce heart attacks.

American Heart Association Cardiovascular disease Epidemiology and Prevention Conference 3/11/2009

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U.S. Dietary Sodium

77% Restaurants, canned, frozen & processed foods

12% Naturally present in food

6% Added to table salt

5% Added by the cook

Salt - Conversion to Sodium ¼ level tsp = 1437.5 mg = 575 mg ¼ rounded tsp = 1500 mg = 600 mg ½ level tsp = 2875 mg = 1150 mg ½ rounded tsp = 3000 mg = 1200 mg

Mickleborough,T.P. A Nutritional Approach to Managing Exercise Induced Asthma. Exerc.Sport Sci.Rev. 2008;36(3)135-9

Effects of Salt at Rest 9 Normotensive male subjects volunteered and spent 2.5

hours at rest with temperature of 82 degrees. BP, Core Temperature, Skin Temperature, and Oxygen

consumption were monitored every 10 minutes Salt pills were ingested every 3 minutes for 2 hours or

until BP increased 20mmHG or 25 salt pills were ingested.

RESULTS BP increased mean arterial pressure 16mm/Hg Core Temp decreased .45 degrees F. CONCLUSION NaCl lowers core temperature and raises blood pressure

in males at rest in warm conditions.

Kim, C., Ryan, E., Blankfield, R. et al. Effects of Sodium Chloride Ingestion on Blood Pressure, Core Temperature, and Oxygen Consumption in Normotensive Men. Med. Sci. Sports Exerc. 2008; 40(5) A-1497 S227

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Exercise Induced Asthma

Exercise induced asthma (EIA) is defined by a 10% (or greater) reduction in post-exercise forced expiratory volume (FEV1) vs pre-exercise values.

Forced expiratory volume 1 is the amount of air that can be forcefully exhaled in 1 second after taking a deep breath.

Post-exercise FEV1 reduction greater than 7% indicated abnormal pulmonary function.

Rundell,KW, Wilber,R.L., Szmedra, L et al. Exercise-induced Asthma Screening of

Elite Athletes; Field versus Laboratory Exercise Challenge. Med. Sci. Sports Exerc. 2000;32(2) 309-16

Low Salt Helps EIA Patients

Epidemiological studies have identified an association between salt intake and asthma.

24 Subjects w/Exercise Induced Asthma (EIA) enrolled in a double blind randomized study.

On 3 occasions they did an exercise challenge test and ran on a treadmill that had a 1 Tgrade increase each 60 seconds until exhaustion.

For 2 weeks prior to each challenge, participants consumed a low, moderate and high sodium diet.

Mean dietary Na levels were: Low Sodium ~ 1450 mg from 3625 mg salt Medium Sodium ~ 3540 mg from 8850 mg salt High Sodium ~ 9870 mg from 24,675 mg salt

Low Salt Helps EIA PatientsCONTINUED

Dietary NADietary NA LowLow MediumMedium HighHigh

FEV 1FEV 1 -7.9%-7.9% -18.3%-18.3% -27.4%-27.4%

Puffs**Puffs** 1212 1818 2626

** # of Bronchodilator puffs required during the test.

Low Salt Helps EIA PatientsCONCLUSION

Salt increases airway sensitivity and causes a greater bronchoconstrictor response in EIA patients.

Salt impedes arterial oxygen saturation in EIA patients by augmenting capillary permeability (leakage)

Salt promotes mucus & edema formation, airway inflammation and raises leukotriene and interleukin production.

Salt reduction reverses the above reactions and therefore can reduce the degree of asthmatic response to vigorous activity.

Salt ingestion during training and/or competition in the form of sports drinks, gels or salt pills has not yet been studied in EIA patients.

Mickleborough, T.D., A Nutritional Approach to Managing Exercise –Induced Asthma. Exerc. Sports Sci. Rev. 2008 36(3) 135-44

Mickleborough, T.D., Lindley, M.R. , Ray, S. Dietary Salt Airway Inflammation, and Diffusion Capacity in Exercise Induced Asthma. Med.Sci.Sports Exerc. 2005; 37(6) 904-19

EIA and Caffeine #1

10 patients with EIA received 1 of 3 treatments 2 hours prior to exercise on 3 occasions.

Intervention was placebo, moderate caffeine (3.5 mg/kg/bw) or high caffeine (7mg/kg/bw).

RESULTS

FEV1 post exercise declined

25% placebo

14% moderate caffeine

10% high caffeine

Mickleborough, T.D., A Nutritional Approach to Managing Exercise –Induced Asthma.

Med.Sci.Sport. Exerc. 2008 36(3) 135-44

EIA and Caffeine # 2

11 patients with EIA received 1 of 3 treatments 90 minutes prior a dry gas challenge (which served as an exercise surrogate)

Intervention was placebo, moderate caffeine (5mg/kg/bw) or high caffeine (10mg/kg/bw)

RESULTS FEV1 post exercise declined 16.7% placebo 10.2% moderate caffeine 7.1% high caffeine

Mickleborough, T.D., A Nutritional Approach to Managing Exercise –Induced Asthma. Med.Sci.Sport. Exerc. 2008;36(3) 135-44

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Vitamin C and EIA

8 subjects with exercise-induced asthma (EIA) consented to this trial

1500 mg of vitamin C or placebo was taken for 2 weeks

Following a one-week washout, protocol was repeated with the opposite treatment

Procedure: pre and post-exercise pulmonary function was evaluated, pre and post-exercise urine samples were assayed for pro-inflammatory chemicals, and pre- and post-exercise exhaled breath nitric oxide was measured.

62

Vitamin C and EIARESULTS

Test Vitamin C PlaceboPost exercise nitric oxide (ppb) 23.7 34.1Post ex. leukotriene (ng/mmol/cr) 5.3 11.1Post ex. prostaglandin F2 (ng/mmol/cr) 8.5 13.0Post ex. hydrogen peroxide (mmol/L) 5.6 12.6

Conclusion: In this trial vitamin C reduced severity of exercise-induced asthma

Tecklenburg, S., Stager, J.M., et al. Ascorbic Acid Supplementation Reduces Severity of Exercise-Induced Asthma. Med Sci Sports Exerc. 2006;38(5) A-2158; S382

High Tech Swimsuits

14 Competitive Swimmers were studied in 3 types of swimsuits.

Subjects swam 25, 50, 100, 200, 400 and 800 meters in each of the 3 types of suits.

Appropriate control measures were implemented Suits were normal, fastskin lower-body, fastskin full-body There were 5 brands used (Speedo, Tyr, Nike, Arena and

ASCI) so this was not a brand vs. brand trial. 6 distances X 14 Swimmers=84 Swims (done for each

suit)

High Tech SwimsuitsResults

The 84 fastest times were with the Fastskin suits. 63 were in the Full Body and 21 were in the Lower Body. Full Body suits had 3.2% benefit. Lower Body suits had 1.8% benefit. Drag reduction was 6.2% Full Body and 4.7% Lower

Body. Average energy savings in Fastskin was 5%.

Chatard, JC., Wilson, B. Effects of Fastskin Suits on Performance, Drag and Energy Cost of Swimming. Med. Sc. Sports Exerc. 2008;40(6) 1149-54

Chatard, JC., Wilson, B. Effects of Fastskin Suits on Performance, Drag and Energy Cost of Swimming. Med. Sc. Sports Exerc. 2008;40(6) 1149-54

COMPARISON OF FULL BODY & LOWERBODY FASTSKIN SUITS

Creatine, Whey and CLA 69 Experienced weight lifter (Age 18-30) (52M, 17F)

were divided into 3 groups for a 5 week study. Before and after each workout and at bed the groups

consumed the supplements mixed with water. Workouts were free-weights, 3 on - 1 off (1.

Chest/Triceps 2.Back/Biceps 3. Legs/Shoulders 4.off) Supplements were:

Creatine 9 gm, CLA 6 gm, Whey 36 gm (3-2-12 x3) Creatine 9 gm, Safflower oil 6 gm, Whey 36 gm Whey 45 gm, Safflower oil 6 gm

Cornish, S.M., Candow, D.G., Jantz, N.T., et al Conjugated Linoleic Acid and Compound with Creatine Monohydrate and Whey Protein Supplementation During Strength Training. Int. J. Sport

Nutr. Exerc. Metab. 2009;19(1)79-96

Cornish, S.M., Candow, D.G., Jantz, N.T., et al Conjugated Linoleic Acid and Compound with Creatine Monohydrate and Whey Protein Supplementation During Strength Training. Int. J. Sport Nutr. Exerc. Metab. 2009;19(1)79-96

Bench Press

Leg Press

CREATINE, CLA & WHEY vs. CREATINE & WHEY vs. WHEY

Ginger Promoted to reduce pain and inflammation and increase

oxygen consumption. 25 college students were studied in a double blind,

crossover design to test ginger and its influence during and following 30 minutes of moderate intensity cycling.

Results 2000 mg of Ginger 30 min prior to exercise did not effect

muscle pain or muscle recovery. There was no difference between ginger and placebo in

heart rate, oxygen consumption or work output.

Black, CD., O’Connor PJ Acute Effects of Dietary Ginger on Quadriceps Muscle Pain During Moderate-Intensity Cycling Exercise. It. J. Sports. Nutr. Exerc. Metab. 2008;18(6) 653-64

69

Resolved Concussion? 66 subjects 19-22 years old were divided into groups

based on concussion history (none, 1+). All 66 were free of concussion residuals. Neurocognitive assessment, tasks and stimuli were

measured by event-related potentials.

Results There was suppression of neuroelectric activity in

subjects with concussion history even though they had normal cognitive function on standard clinical measures.

Broglio, S., Heo, S., O’Connor, P., et al. The Chronic Effect of Concussion on Clinical Neurocognition And Neuroelectric Indices of Attention. Med. Sci. Sports Exerc. 2008; 40(5) A-811 S69

Best Tuning Fork to Detect Fracture256 Hz was more accurate than 128 Hz or 512 Hz A1759 Vincent, K., Vincent, H., Stewart, J., Wilder, R. Clinical Use of Tuning Forks to Identify Running-Related Stress Fractures. Med. Sci. Sports Exerc. 2008; 40(5) A-1759 S293

Glycerol HyperhydratesGlycerol ½ gm/lb pre-event and ¼ gm/lb/per hour during event reduced urine out put 4oz/hr. Burns, S., Physiological Responses To Glycerol Ingestion and Hyperhydration. Med. Sci. Sports Exerc. 2008; 40(5) A-1339 S188

Black Tea Reduced Muscle Soreness9 Days of 1750 mg of Black Tea reduced DOM’s @24 and 48 hours post eccentric exerciseArent , S.M., Pellegrino, J., Senso, M. et al. Black Tea Reduces DOMS, Oxidative Stress, and Cortisol Responces to High-Intensity Interval Training. Med. Sci. Sports Exerc. 2008; 40(5) A1562, S244

11 Days for Altitude AdaptationTime for erythropoietic response to altitude training in elite cyclists was 11 days. Ten additional days had no additional hematological advantage.

Garvican, L.A., Martin, D.T., Clark, M.A., et al. The Time Course of the Erythropoietic Reponse to Natural Altitude Training In Elite Endurance Cyclists. Med. Sci. Sports Everc. 2008; 40(5) A738 S52

2 weeks of 200 mg Co Q10 in soft gel form showed a ‘trend’ for increased

endurance during an exercise challenge. Cooke, M., Iosia, M., Buford, T., et al. Effects of Coenzyme Q10 Supplementation On Exercise Performance in Trained and Untrained Individuals. Med. Sci. Sports Exerc. 2008; 40(5) A-2203 S402

L-Arginine increases ‘The Pump’6 grams of Arginine 1 hour before workout incerased muscle blood volume during recovery.

Alvares, T., Meirelles, C., Matsuura,C., et al. L-Arginine Supplementation Increases Muscle Blood Volume During Recovery After Sets Of Resistance Exercise. Med. Sci. Sports Exerc. 2008; 40(5) A-2201 S402

L-Carnitine & Ammonia2 grams/day L-Carnitine for 2 wks reduced exercise induced plasma ammonia accumulation by ~20% during 60 & 90 minutes exercise @70% VO2 max. L-Carnitine did not effect fat, protein or carbohydrate metabolism during exercise

Broad, E.M., Maughan, R.J. Gallowa, SDR. Carbohydrate, Proteinand Fat Metabolism During Exercise After Oral Carnitine Supplementation in Humans. Int.J. Sport Nutr. Exerc.Met. 208;18(6) 567-84

CoEnzyme Q10

72

Iron Major Functions

A component of both hemoglobin and myoglobin

Involved in oxygen transportation Required for collagen synthesis and

immune function A component of cytochrome enzymes,

which are involved in electron transport chain reactions

These enzymes also help in the detoxification of drugs, alcohol, and carcinogens

73

Iron Deficiency Signs and Symptoms

Fatigue Shortness of breath Pallor Drowsy following exercise Angular stomatitis Decreased cold tolerance (especially hands/feet) Itchy skin

74

Other Side Effects of Iron Deficiency

Hair Loss Women who complain of hair loss when compared to normal controls had much lower mean ferritin levels.Kantor, J., Cotsarelis, G. Decreased Serum Ferritin Is Associated With Alopecia in Women, J Invest Dermatol, November 2003; 121(5) :P985-988

Restless Legs Syndrome•21/22 patients with normal serum iron had resolution after Fe supplementation. • When serum ferritin is at or below 50 mcg/L, a high % respond to Fe. Earley, C.J. Restless Legs Syndrome. New England Journal of Medicine 348 (21) 2003; 2103-9

Cognition

Low ferritin is associated with reduced cognitive performance & low hemoglobin is associated with slower processing speed. Both symptoms were reversed with Fe.

Murray-Kolb, L.E., Beard, J.L., Iron Treatment Normalizes Cognitive functioning in Young Women. Am. J. Clin. Nutr. 2007; 85(3) 778-87

75

Iron Comments

Iron is the most common mineral deficiency in the U.S. 20% of women are deficient, which may be elevated in

pregnancy. Deficiencies are also seen in infants, children,

adolescents, and even males Heme iron from animal sources is absorbed 11 times

better than nonheme vegetable sources Oxalates in tea, chocolate, berries, and spinach along

with phytates in grains and the preservative EDTA all bind iron and reduce absorption, which is enhanced by taking vitamin C.

It can take 3-6 months to fully replenish reserves. It will only take 3-6 days to feel a marked benefit with

supplement use

Iron and Activity in Women Iron deficiency is typically diagnosed when serum ferritin

is under 12 mcg/L Endurance capacity loss can occur when iron is under

20 mcg/L 47 women (age 28-30) volunteered to be studied. Blood tests for iron status were performed. Low iron (SF<20 mcg/L) subjects were matched with

normal iron subjects (SF>20mcg/L) for age and self reported activity level.

Subjects wore accelerometers for 5 days (3 week days and 2 weekend) 16 hours/day.

Activity levels were divided into 4 categories for sedentary, low, moderate and vigorous.

Time In Minutes 16 Hours (960 minutes)

Results Sedentary Low Moderate Vigorous

Low Iron 650 153 126 31

Normal Iron 559 195 155 51

Crouter, S., DellaValle D., Haas, J. Relationship Between Iron Status and Physical Activity. Med. Sci. Sports Exerc. 2008; 40(5) A-1955 S341

Iron and Activity in WomenContinued

78

Iron Measured in College Cross-Country Runners

Distance runners tend to be prone to iron deficiency

Serum Ferritin (SF) and hemoglobin (Hb) were measured 4 times in collegiate cross country team (9-F;15-M) over a 5 month season

Iron deficiency was defined as SF <20mcg/L was

Anemia was defined as Hb<13.5g/dl

79

Iron Measured in College Cross Country Runners

Results

Iron Deficiency was present in at least 1 test for 33% of males and 89% of females.

Anemia was present in at least 1 test for 33% of males and 44% of females

This occurred despite a weekly team cookout with red meat.

Frye, A., Solberg, B., Eichinger, M., Pasche, S. Iron Status In Collegiate Cross Country Runners. Med. Sci. Sports Exerc. 2008; 40(5) A-1956 S342

2009 American College ofSports Medicine Joint

Position Stand on Nutrition and Athletic Performance

with The American Dietetic Association andDietitians of Canada

Medicine & Science in Sports & Exercise2009; 41(3) 709-731

ACSM 2009 Nutrition & PerformanceSelected Highlights

CHO Rx 6-10 gm/kg/bw (2.7-4.5 gm/lb) Protein Rx 1.2-1.7 gm/kg/bw (.5-.8 gm/lb) Fat Rx 20-35% calories

Pre-Ex Meal low fat & fiber, moderate Pro, high CHO During Ex 30-60 gm/CHO/hr (120-240 cal/hr) Post Ex w/in 30 min. 1-1.5gm/kg/bw/CHO

(.5-.7 gm/lb) & repeat every 2 hrs up to 6 hrs


In athletes w/ Iron deficiency, replacement - increases work capacity, oxygen uptake - reduces heart rate, lactate & muscle fatigue - improves enduranceSodium - many endurance athletes require much more than the daily upper limit (under 2400mg) - “Muscle cramps are more common in profuse sweaters who experience large sodium losses” - sports drinks should contain .5-.7 gm/Na/L


When air temperature approaches & exceeds body temp., heat dissipation via radiation ceases.

When humidity is high, ability to dissipate heat by evaporation of sweat is greatly inhibited.

Sweat rates can be as high as 2.4 L/hr Sweat Na averages ~50 mmol/L (~1000 mg/Na/L) Dehydration can also occur in cold temps due to low

fluid intake. Elevation from sea level increases fluid losses from

respiration & at ~8000 feet can be 1.9/L (64 oz) day


ERGOGENIC AIDS THAT PREFORM AS CLAIMED Creatine

Caffeine

Sports drinks, gels & bars ( For CHO & electrolytes)

They mentioned over 20 that do not perform as claimed & 4 (colostrum,

HMB, glutamine, ribose & Na bicarbonate) that may work but lack proof.

Three Dimensional Displacement, Velocity and Acceleration of the Breast During a

Running Gait Cycle

Regarding research on breast pain during running, the authors contend:

1. Kinematic research of the breast while running is limited.2. Most of the focus has been on displacement in the

coronal plane.3. Only two studies reported on breast acceleration and

they only analyzed motion in the vertical axis.4. There have been no studies on breast acceleration

during running in 3-D.

Three Dimensional Displacement, Velocity and Acceleration of the Breast During a

Running Gait Cycle Continued

15 Subjects (19-33) with D cups were recruited They were filmed on the treadmill with a 5 camera

infrared motion capture system in 3D.

Scurr, J., White, J., Hedger, W. Three Dimensional Displacement, Velocity and Acceleration of the Breast During a Running Gait Cycle. Med. Sci. Sport Exerc. 2008;40(5) A-1471, S221

Three Dimensional Displacement, Velocity and Acceleration of the Breast

During a Running Gait Cycle Continued

I know what you’re thinking…..

15 women…D Cups…5 camera’s….3D

Who are these guys, Scurr, White & Hedger?

Scurr, J., White, J. Hedger, W. Three Dimensional Displacement, Velocity and Acceleration of the Breast During a Running Gait Cycle. Med. Sci. Sport Exerc. 2008;40(5) A-1471, S221



Those ‘guys’ go by JoannaJenniferWendy

Scurr, J., White, J. Hedger, W. Three Dimensional Displacement, Velocity and Acceleration of the Breast During a Running Gait Cycle. Med. Sci. Sport Exerc. 2008;40(5) A-1471, S221



Results• Breast displacement and velocity significantly increased

during the deceleration phase of the gait cycle.• However, the peak acceleration values were greater

during the acceleration phase of the gait cycle.




The author’s concluded “…future research on breast pain and breast support should report breast acceleration in

3D…”

I concluded the authors must be using assumed names.


sports nutrition research update 2009 with exercise physiology, strength conditioning & topics...

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