Nutrition and Nutritional Supplements in Sports

Objectives

 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 Factors

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Genetics

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Training and Conditioning

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Nutrition

Determinants of the Athlete’s Energy Requirements

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During intense exercise

 Carbohydrate stored in muscles and liver (glycogen) is predominant fuel source 

During prolonged exercise

 Fat stores are predominant fuel source 

Fitness level of the athlete

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

Formula for Estimating the Body’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) Backpacking 131 180 Basketball (game) Bicycling, 10 mph (6 minutes/mile) 198 112 Hiking, no load Jogging, 5 mph (12 minutes/mile) 140 167 Raquetball Running, 08 mph (7.5 minutes/mile) 185 274 Soccer Swimming (25 yards/minute) Walking, 3 mph (20 minutes/mile) Weight training (40 sec. between sets) 176 108 72 230 305 195 120 80 255 145 200 220 125 155 185 205 336 215 132 88 280 160 220 242 138 171 203 225 366 234 144 96 306 174 240 264 150 186 222 246 396 253 156 104 332 189 260 286 162 202 240 266 427 273 168 112 357 203 280 308 175 217 259 287 458 292 180 120 382 218 300 330 188 232 278 308 488 312 192 128 408 232 320 352 200 248 296 328 518 332 204 136 433 247 340 374 213 263 315 349 549 351 216 144 459 261 360 396 225 279 333 369 579 371 228 152 484 276 380 418 237 294 352 389 610 390 240 160 510 290 400 440 250 310 370 410

Carbohydrates

 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

Carbohydrates

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After 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?

 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 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 Loading

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

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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: One 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

Protein

 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

Fat

 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 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 Supplements

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1994 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 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 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 MaHuang

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Following the death of two professional athletes, FDA banned sale of Ephedra as a nutritional supplement

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Since this time, manufacturers have started substituting other stimulants

 Citrus Aurantium  Orange extract  Chemical structure very similar to ephedrine

Anabolic 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 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 Precursors

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Potential adverse effects

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May cause liver damage

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In females

 Can cause male features in women  May increase risk of uterus cancer 

In males

 Can cause female features in men  May increase risk of prostate cancer

Anabolic Steroids and Anabolic 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!

 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 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

Conclusions

 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

Conclusions

 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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