Nutrition for Sports, Physical Activity and obesity prevention

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Nutrition for Sports, Physical Activity and
obesity prevention

• Bonnie A. Spear, Ph.D., RD
• Associate Professor of Pediatrics
• University of Alabama at Birmingham

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Fluids and Hydration
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Younger Teens are at higher risk for heat illness
because.

• lower sweating rate
• higher body surface area
• produce more heat with exercise

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Dehydration Affects Performance

• 1 Increased body temperature
• 3 Impaired performance
• 5 GI problems, heat exhaustion
• 7 Hallucinations
• 10 Circulatory collapse

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Responses to Dehydration

• INCREASE IN
• GI distress
• Plasma osmolality
• Blood viscosity
• Heart rate
• Muscle glycogen use
• Temperature at which sweating begins and blood
  flow increases

• DECREASE IN
• Plasma volume
• Renal blood flow
• Central blood volume
• Cardiac output
• Sweat rate
• Performance
• Endurance capacity

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Fluid losses increased with

• Caffeine ingestions
• medications
• temperature
• Humidity
• Acclimatizing
• Some supplements
• Fitness level

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Rehydration Guidelines
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Water vs. Sports Drinks

• Research on active kids showed they'll drink 90
  more of Flavored Fluids than water.

Wilk B. and O. Bar-Or. Journal of Applied
Physiology 801112-1117, 1996
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Target Sports Diet for Adolescents

• 55-60 Carbohydrate
• 25-30 fat
• 15 protein

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Determinants of Exercise Fuel Usage

• Carbohydrates are the preferred fuel for
  high-intensity work
• High-intensity/short duration- glycolytic (lactic
  acid) pathway for the production of ATP
• Only glucose, derived primarily from the
  breakdown of muscle glycogen can be used.
• Very rapid breakdown of muscle glycogen
• More rapid during the early stages of exercise

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CHO Utilization

• Mixed anaerobic-aerobic exercise such as in
  soccer, football, basketball, swimming and
  football drills results in a greater breakdown of
  muscle glycogen
• During endurance exercise, glycogen provides 50
  of the energy for moderate workout (60 VO2max),
  but almost 100 for intense workout ( 80 VO2
  max)

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Carbohydrates in the Diet

• Building up and maintaining glycogen stores
  during training require a CHO rich diet.
• Glycogen depletion can occur gradually over
  repeated days of heavy training when muscle
  breakdown exceeds its replacement

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Carbohydrate Recommendations
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Classification of Carbohydrates by Glycemic Index
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When to use GI

• To increase muscle glycogen especially after
  intense exercise
• Provide 50-100 g of high GI CHO immediately after
  intense activity
• Encourage athletes to continue to eat high CHO to
  improve glycogen replacement

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When to use GI

• Low GI foods may play a role
• Athletes who want to minimize changes in blood
  glucose should select moderate to low GI foods
• Athletes who are doing endurance may want to
  consume moderate to low GI meal before exercise
  to sustain CHO availability

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Post-event Carbohydrate

• 2 hour opportunity that muscles are receptive to
  carbohydrate
• Carbohydrates can be in the form of fluids or
  food
• 1.7 gm/kg (during first 2-3 hours post exercise)

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Pre-exercising Food Guidelines

• High carbohydrate
• Low fat
• Moderate Protein
• Extra Fluids
• Appropriate Portions

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Meal/Snack Pattern
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EAR and RDA for Protein
RDA or g/d based on average weight/age
(reference individual)
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How Much Protein is needed?

• Average Teen consumes 1.3g/kg/d
• Athletes beginning training
• 1.2-1.8 g/kg/d
• Endurance athletes
• May need 1.2-1.4 g/kg/d
• Resistance/Strength Training
• May need 1.4-1.8 g/kg
• Athletes who chronically restrict Kcal
• May need 1.5-1.7 g/kg/d

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Sports Supplements
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How Many Teens Are Actually Taking Supplements?

• A 2003 nationally representative survey conducted
  by Blue Cross and Blue Shield revealed that as
  many as 1.1 million people ages 12-17 have taken
  potentially dangerous performance enhancing
  supplements and drugs.
• 76 could not identify any negative side-effects
  that might result from using steroids, ephedra
  and other similar substances.

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BCBS Survey

• Among all youth surveyed, who knew someone using
  performance-enhancing substances, 38 used
  creatine and 34 used steroids
• 27 of the teens were taking the substance to
  look better, a 19 increase from 2001.
• Football players were thought to use substances
  the most but baseball players usage was thought
  to have increased from 22 to 27 since 2001.

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BCBS Survey

• Parents viewed the use of performance-enhancing
  supplements and drugs as their number one concern
  in youth sports at 39.
• More than aggressive behavior, competitiveness
  and injury.
• Yet, 81 of teens said they had never had a
  conversation about it with their parents.

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Supplement Regulation

• If marketed prior to 1994, no FDA review required
  on their safety.
• For a new dietary ingredient, FDA must be
  notified of how the product had reasonable
  evidence determined for safe human use.
• However, manufacturers do not have to provide the
  FDA with evidence of safety or effectiveness.

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Supplement Standardization

• Quality control depends on the producer no
  strict quality control regulation by the FDA.
• No standardization required in the United States.

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Nutrient Supplements(from Bright Futures in
Practice Physical Activity)
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Nutrient Supplements(from Bright Futures in
Practice Physical Activity)
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Do Extra Amino Acids Help?

• Consumption of large amounts of single AA
• Metabolic imbalances and absorption problems
• Most high protein foods associated with high fat
  which has the possibility of be atherogenic

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Dangers of excessive Protein

• The breakdown of protein requires more fluids-
  this is critical in hot humid weather
• The breakdown of protein requires almost 2x as
  much fluid as the breakdown of CHO or fat.
• Excessive protein has also been shown to increase
  calcium loss- this is especially important in
  female athletes

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Creatine

• Introduced in 1992
• Most widely used ergogenic supplement
• 41-48 of male college athletes reported use
• Annual sale of greater than 200 million

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Creatine- What is it?

• Naturally occurring compound
• Found in fresh fish and meat
• Excreted by kidney, where it is broken down to
  creatinine
• Proposed Effect
• Increases work capacity over brief, repetitive
  exertion by increasing resting phosphocreatine
  levels in muscle.

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Creatine Results

• May delay fatigue of workouts for athletes in
  power sports (football, weight lifters)
• May be effective for simple, short-duration,
  maximal effort anaerobic events
• Does not improve endurance

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Creatine Adverse Effects

• Generally regarded as safe, but risks more likely
  to occur at doses of 20 g/d or higher
• Early weight gain from water retention
• Muscle cramping, stomach cramping, hydration
  issues
• Case reports of reversible renal problems
• No long term data- do not know if endogenous
  creatine production is reduced
• Not tested in those younger than 18 years

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Creatine Legal Issues

• Not banned by IOC.
• 33 professional athletic teams have banned use
• The NCAA prohibits distribution within training
  facilities.

BUT NOT BANNED BY HIGH SCHOOLS
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Caffeine What is it?

• Xanthine derivative
• Other names
• Methylzanthine, guarana
• Sources
• Coffee (100 to 150 mg/cup)
• Tea (30-70 mg/cup)
• Cola (30-45 mg/can)
• Chocolate bar (30 mg/serving)
• NoDoz (200 mg/pill)
• Found in some analgesic pills.

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Caffeine

• Results
• Appears to reduce the perception of fatigue, thus
  allowing for further performance.
• Adverse Effects
• Restlessness, nervousness, insomnia, and diuresis
• Excessive doses can interfere with performance.

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Caffeine Legal issues

• Excessive levels banned by certain sports
  governing agencies (IOC, NCAA).
• Recommend
• 4 12oz. Mountain Dews (2.5-20oz. Svg.)
• 2 Red Bull Energy Drinks
• 2 NoDoz Energy Pills
• 1 ½ Tall Coffee Frappuccino
• BUT NOT BANNED IN HIGH SCHOOLS

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Ephedrine What is it?

• Alkaloid found naturally in ephedra herb plants,
  such as ma huang
• Often found combined with guarana, an herbal
  form of caffeine

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Ephedrine Adverse Effects

• Serious cardiovascular and central nervous system
  events, including
• Anxiety
• Ventricular dysrhythmias
• Hypertension
• Hallucinations
• Seizures
• Stroke
• Effects are potentiated by caffeine- combination
  can be deadly

www.mayoclinic.com
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Ephedrine Legal Issues

• FDA banned sales of Ephedra (Feb. 2004)
• Herbal forms of ephedrine available
  over-the-counter.
• Reformulated in lower doses

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Further Information

• International Olympic Committee
• www.olympic.org
• National Collegiate Athletic Association
• www.ncaa.org
• National Center for Drug-Free Sport
• www.drugfreesport.com
• World Anti-Doping Agency
• www.wada-ama.org
• AAP Sports Shorts Online
• http//www.aap.org/family/sportsshort.htm

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Many Youth Are Physically Inactive
- CDC, 2004.
Association of State and Territorial Health
Officers-ASTO
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Obesity Increased Medical Expenses

• An average increase of 395/yr in inpatient and
  ambulatory care
• 36 higher health costs overall
• A 77 increase in medication costs
• An estimated 117 billion in Medicaid (2000)

- Strum, 2002.
Association of State and Territorial Health
Officers-ASTO
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State health agencies can

• shape the community of tomorrow by supporting
  healthy behaviors in youth today.

Association of State and Territorial Health
Officers-ASTO
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Why focus on physical activity?

• Regular physical activity controls weight
• Contributes to healthy bones and muscles
• Reduces anxiety and depression
• Reduces risk for leading causes of morbidity and
  mortality

- Surgeon General Report, 1996.
Association of State and Territorial Health
Officers-ASTO
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State health agencies can

• Provide information to individuals and
  communities
• Design policies and environments that promote
  healthy living
• Ensure effective program implementation and
  strategic use of scarce resources.

Association of State and Territorial Health
Officers-ASTO
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Promote statewide interagency
collaboration to improve health outcomes Lead
planning efforts focused on health promotion and
disease prevention Coordinate efforts among
key stakeholders
Develop a plan that coordinates existing resources
Association of State and Territorial Health
Officers-ASTO
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Consider the following actions

• Conduct an environmental scan
• Coordinate internal agency efforts
• Convene strategic partners
• Develop targeted health messages
• Manage knowledge
• Provide technical assistance

- Fierro, 2002.
Association of State and Territorial Health
Officers-ASTO
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State health agencies cant do it alone!
Association of State and Territorial Health
Officers-ASTO
53
Involving the education community is essential.

• State and local health agencies can work
  together with partners to develop and expand
  physical activity programs in communities and
  schools.

Association of State and Territorial Health
Officers-ASTO
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Promote innovative policy-based approaches

• Engage new partners
• Change the environment
• Legitimize use of staff time and resources
  to promote activity among youth

Association of State and Territorial Health
Officers-ASTO
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Partnering with Schools
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Vending Machines

• Accounts for 3 of all teen-eating occasions
• Typical Purchase 0.75
• 736 million in vending machine sales
• 78 of this occurs at school

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Frequency of Competitive Foods

• Vending machine or a school store, canteen, or
  snack bar where students could purchase food or
  beverages (School Health Policies and Programs
  Study)
• 43 of elementary,
• 73.9 of middle/junior high, and
• 98.2 of senior high schools

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Influence of Income

• Income from competitive food sales, including
  vending machines, primarily from carbonated
  beverages but also bottled water, to support
  discretionary spending not related to school
  foodservice.

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Examples

• Best
• Nutragrain bars
• Nuts
• Chex mix
• Yogurt bars
• Fruit and oatmeal bars
• Fruit

• Next Best
• Baked chips
• Animal crackers
• Rice Krispie treats
• Fig Newtons
• Teddy grahams
• Pretzels
• Breakfast bars

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Student Health Task Force SBOE-Alabama

• Fundraising Activities
• All fundraising activities that involve the
  selling of food should reinforce food choices
  that promote good health.

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Fund Raising Ideas

• Things to Do
• Gift wrapping Fun runs
• Magic shows Family glamour portraits
• Walk-a-thons Treasure hunt/scavenger
  hunt
• Bike-a-thons Tennis/horseshoe
  competition
• Jump-rope-a-thons Raffle (movie passes,
  theme bags)
• Rent-a-teen helper (rake leaves,
  Workshops/classes
• mow lawns, walk dogs) Festivals
• Carnivals (Halloween, Easter) Recycling
  cans/bottles/paper
• Dances (kids, father, daughter, family)
  Golf Tournament
• Skate night/skate-a-thon Bowling/
  bowl-a- thon

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Pouring Rights Contracts

• Exclusive distribution
• Increase the percentage of profits when sales
  volume increases, and this is a substantial
  incentive for schools to
• promote soft drink consumption by adding vending
  machines,
• increasing the times they are available,
• marketing the products to students

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• Does food advertising and marketing influence
  childrens food preferences, eating behavior, and
  weight status?

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Growth in New Food Products Targeted to U.S.
Children and Youth 1994 to 2004
New products targeted to total market
New products targeted to children youth
Source Williams J. 2005b. Product
Proliferation Analysis for New Food and Beverage
Products Targeted to
Children, 19942004. University of Texas at
Austin Working Paper.
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Effects of Food Promotion on Childrens Food
Preferences and Behavior

• Strength of Evidence
• Preferences Strong
• Purchase-related behavior Strong
• Consumption Modest

G. Hastings et al., 2003 Review The Extent and
Nature of Food Promotion to Children
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• State Health Agencies have a vital role in
  helping schools and communities
• increase the levels of
• physical activity in youth
• thereby
• reducing the number of youth who are overweight
  and at risk
• for other health problems

Association of State and Territorial Health
Officers-ASTO