Sports Nutrition – Eat to Compete

1. Sports Nutrition – Eat to Compete Mark Mirabelli, M.D.Assistant Professor Depts. of Orthopaedics and Family Medicine University of Rochester

2. Goals • Understand basics of general nutrition • Recommendations for pregame and postgame meals • Brief words on sports supplements

3. 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

4. NutrientFunction • CarbohydratesENERGY • ProteinGrowth, Repair • FatEnergy stores • WaterFluid balance • VitaminsBody Processes • MineralsBody Processes

5. Carbohydrates • 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

6. 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

7. 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.

8. 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 banana Comparison of Diets

9. 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

10. Critical Re-Fueling Interval Re-FuelingInterval Re-FuelingInterval Recovery Recovery Exercise Exercise Phases of Timing Nutrient Intake

11. Summary • 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.

12. Protein • 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

13. 150 LBS 10% body fat 90% lean body 150 LBS 35% body fat 65% lean body Who needs more protein?

14. 9 calories for each gram (more than double carbs and protein) • Padding, protection, hormonal response • 25%-30% of our diet • TWO TYPES: • 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

15. Good Fat = Plant based Oils Nuts are healthy Nutrient dense Olive Oils

16. Hydration Status and Guidelines

17. 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

18. Dehydration and Performance

19. Dehydration and Performance 8 6 4 Weight Loss (% Body Weight) 2 2% 3% 4 - 6% > 6% Impaired temperature regulation Reduced muscular endurance Reduced strengthReduced endurance capacityHeat cramps Severe heat cramps Heat strokeComaDeath

20. 12 3 4 5 6 7 8 9 Monitoring HydrationStatus Urine color test for dehydration Lemonade—The good Apple juice—The bad Tea—The ugly

21. 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.

22. Minerals • 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

23. Vitamins • 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

24. USDA My Plate

25. 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.

26. Balancing calories Enjoy your food, but eat less Avoid oversized portions

27. Nutrient Dense and Non-Nutrient Dense Forms of Sample Foods

28. 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!

29. 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 ARE THOSE 500 CALORIES GETTING THE JOB DONE?

30. 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 !

31. Pre-Event Meal • Goals • “Top off” glycogen stores • Optimize hydration • Empty upper GI tract

32. Pre-Event Meal • Meal Composition • High in carbohydrates • mixed complex and simple • Reasonably low in fats and protein • Low in dietary fiber

33. Pre-Event Meal • Composition (cont.) • High in fluids • Individualize • Use familiar foods

34. Pre-Event Meal • Timing of meal • Complete > 2 hours before event • Individualize (3-4 hours better for some)

35. 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

36. 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

37. 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

38. For More Information • Web resources: • www.usada.org • www.wada-ama.org • www.drugfreesport.com • www.choosemyplate.gov