Nutrition and Nutritional
Supplements in Sports
Objectives
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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
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Discuss specific nutritional supplements commonly used
by athletes
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Definition of a supplement
Impact of this legislation
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
Genetics
Training
Nutrition
and Conditioning
Determinants of the Athlete’s
Energy Requirements
 During
intense exercise
 Carbohydrate
stored in muscles and liver
(glycogen) is predominant fuel source
 During
 Fat
prolonged exercise
stores are predominant fuel source
 Fitness
 Well
level of the athlete
trained endurance athletes burn fat more
efficiently, sparing limited glycogen stores
Formula for Estimating the
Body’s Calorie Requirements

Sedentary person


Moderately active person

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Weight (kg) x 40
Underweight person
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Weight (kg) x 30
Active person (endurance athlete)
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Weight (kg) x 25
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)
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
Carbohydrates

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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

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60 to 70% of total calories should come from carbohydrates
Complex carbohydrates (starches) are preferable
During exercise

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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
 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:

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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
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Less hunger before and during exercise
Maintains optimum glycogen stores
Recommendations
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Emphasize complex carbohydrates (starches)

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Avoid high fat and high protein foods
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1 to 4 gm/kg about 1 to 4 hours prior to event
Consume less closer to event
Slower gastric emptying can cause stomach upset
Avoid high fiber or gas forming foods

Can lead to crampy abdominal pain
Carbohydrate Loading
 Increases
the body’s 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%
Carbohydrate Loading:
One Example of How
Days prior to event Exercise duration
6
90 minutes
5
40 minutes
4
40 minutes
3
20 minutes
2
20 minutes
1
rest
Carbohydrate intake
5 gm/kg/day
5 gm/kg/day
5 gm/kg/day
10 gm/kg/day
10 gm/kg/day
10 gm/kg/day
Protein

Athletes require more protein than non-athletes
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12 to 18% of total calories should come from protein
Protein intake should be tailored to type of training

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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

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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
 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

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No evidence in U.S. studies that taking vitamin and
mineral supplements improves athletic performance
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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

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Human body needs these to produce energy
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
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Herbal forms of the stimulant ephedrine
80 confirmed deaths related to ephedra use

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Experts suspect many more unconfirmed deaths
Adverse effects
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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
 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

Anabolic Steroid Precursors

Dehydroepiandrosterone (DHEA) and
Androstenedione (“Andro”)
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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
 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

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
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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
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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
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Signed into federal law on October 22, 2004
Amends the Anabolic Steroid Control Act of 1990
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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
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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
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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
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Physicians
Physician assistants
Nurse practitioners
Athletic trainers
School nurses
Dieticians
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http://www.usdoj.gov/ndic/pubs11/12620/steroids.htm