Nutrition and Nutritional Supplements in Sports

1
Nutrition and Nutritional Supplements in Sports
2
Objectives

• Increase awareness that nutrition can affect an
  athletes 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

3
Performance Influencing Factors

• Genetics
• Training and Conditioning
• Nutrition

4
Determinants of the Athletes Energy Requirements

• 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

5
Formula for Estimating the Bodys 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

6
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
7
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

8
Carbohydrates

• 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

9
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

10
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

11
Carbohydrate Loading

• Increases the bodys 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

12
Carbohydrate LoadingOne 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

13
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

14
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

15
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

16
Nutritional Supplements

• 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

17
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

18
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)

19
Ephedra or MaHuang

• Following 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

20
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 (TE ratio)

21
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 bodys 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

22
Anabolic Steroid Precursors

• Potential adverse effects
• May cause liver damage
• 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

23
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

24
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)

25
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

26
Conclusions

• Nutrition plays an important role in an endurance
  athletes 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

27
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

28
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