Youth Exercise & Sport –
Relevance of “Sports” Nutrition?
Jennifer Sacheck, PhD
Tufts University
Friedman School of Nutrition Science & Policy
John Hancock Center on Physical Activity, Nutrition, and
Obesity Prevention
1
The National Crisis
~32% Kids 2-19 yrs
~69% Adults
APOP, IOM, 2012
2
Energy In vs. Energy Out
Dietary Intake
Physical Activity
Plethora of
Low Cost/Energy
Dense Foods
Development of
Childhood
Obesity
Multi Media
Saturation
Increased
Portion Sizes
Energy OUT
Food Advertising/
Marketing Aimed
at Children
Less Sleep
Physical Education
and Recess
Cuts
Energy IN
Declines in
Physical Activity
Sugar Sweetened
Beverage Consumption
Frequent Eating Away
from Home
Changing
Built
Environment
We Eat Too Much….
SPAGHETTI & MEATBALLS
20 Years Ago
500 calories
1 cup pasta w/ sauce
3 small meatballs
Today
1,025 calories
2 cups of pasta w/ sauce
3 large meatballs
Caloric Difference: 525 calories
Estimated Calorie Requirements by Age and
Activity Level
Gender
Young child
Female
Male
Age
Sedentary
Activity
Moderate
Activity
Active
2-3
1,000
1,000-1,400
1,000-1,400
4-8
9-13
14-18
1,200
1,600
2,000
1,400-1,600
1,600-2,000
2,000
1,400-1,800
1,800-2,200
2,400
4-8
9-13
14-18
1,400
1,800
2,200
1,400-1,600
1,800-2,200
2,400-2,800
1,600-2,000
2,000-2,600
2,800-3,200
(Institute of Medicine Dietary Reference Intakes, 2002)
WE EAT “DEAD FOOD”
AND MORE “DEAD FOOD”
Contribution of Solid Fats and Added
Sugars to Energy Intake Among Children
and Adolescents in the United States
Objective: Identify top dietary sources of energy, solid fats,
added sugars among 2-18 year olds in the U.S
Methods: Data from NHANES (energy-2005-2006; SOFAS
2003-2004)
Results: Nearly 40% of total energy consumed was from solid
fats and added sugars
Results: Top sources of energy for 2-18 year olds were:
• Grain Desserts (138 kcal/day)
• Pizza (136 kcal/day)
• Soda (118 kcal/day); Soda + Fruit Drinks (173 kcal/day)
Reedy J, et al. J Am Diet Assoc; 2010; Volume 110 (Oct).
Food Sources and Mean Intake of Empty Calories for Male Children and
Adolescents, Relative to Discretionary Calorie Allowance
Discretionary calorie
Soda
allowance
Soda
Soda
Whole
milk
290
165
195
171
Males (by age)
Reedy J, et al. J Am Diet Assoc; 2010; Volume 110 (Oct).
Data Source:
NHANES
2003-04
AND WHAT ABOUT
SUGAR?.....
WHITE, CANE, BEET, FRUIT, TABLE, BROWN, & HFCS….&
HONEY, MAPLE SYRUP, & AGAVE
Sources of Dietary Added Sugars:
Americans Ages 2+, NHANES 2005-2006
Total Television Food Advertising
Exposure, by Age
Teens see 14 ads/day
Rudd Report TRENDS IN TELEVISION FOOD ADVERTISING. Data Used from Nielsen Report (2008)
Lack of Physical Activity
Can Johnny Come Out and Eat?
16
Physical Activity Guidelines for
Children
Children and adolescents should do 60 minutes or more
of physical activity daily.
Aerobic: Most of the 60 or more minutes a day should be either
moderate- or vigorous-intensity aerobic physical activity, and
should include vigorous-intensity physical activity at least 3 days a
week.
Muscle-strengthening: As part of their 60 or more minutes of daily
physical activity, children and adolescents should include musclestrengthening physical activity on at least 3 days of the week.
Bone-strengthening: As part of their 60 or more minutes of daily
physical activity, children and adolescents should include bonestrengthening physical activity on at least 3 days of the week.
Youth Meeting Physical Activity
Guidelines
Troiano R, et al. Medicine & Science in Sports & Exercise, 2008.
Massachusetts Youth Risk Behavior Survey, 2011
Youth Cardiorespiratory Fitness
12-19 yrs (NHANES 1999-2002)
• ~65% of males and females met the standard
Males
Females
Pate et al 2006 19
Built Environment & Free Play
20
Physical Education
150 min/week for elementary and 225 min/week
of PE for middle and high school students
APOP, IOM, 2012
21
Media Blitz
APOP, IOM, 2012
22
Contribution of Organized Sports to
Physical Activity Recommendations
Physical Activity During Youth Sports Practices
Design: Cross-sectional study
Setting: Community sports leagues in San Diego
County (middle income areas)
Participants: 200 youth, ages 7-14 from 29
teams total of youth soccer and baseball/softball
Measurement: Minutes of PA at intensity levels
using accelerometers and established cut-points
Leek, D. et al. Arch Pediatr Adolesc Med 2010;0:archpediatrics.2010.252v1-6.
Moderate to Vigorous Physical Activity (MVPA) during
Practice and Participants Meeting PA Guidelines by Sex
Leek, D. et al. Arch Pediatr Adolesc Med 2010;0:archpediatrics.2010.252v1-6.
Contribution of Organized Sports to
Physical Activity Recommendations:
Physical Activity During Youth Indoor Soccer
Games
Design: Cross-sectional study
Setting: Indoor soccer leagues in suburban
Massachusetts
Participants: 113 boys and girls
Measurement: Minutes of PA at intensity levels
using accelerometers and established cut-points
Sacheck, et al. Pediatric Exercise Science, 2010
Out of School Time – Organized Sports
Time spent at various intensities of physical activity during
a 50-min soccer match
Males
Females
Time
Time
Intensity
Min
%
Min
%
Sedentary
25.9 (4.5)
50.0 (8.6)
25.1 (6.2)
48.4 (11.1)
Light
10.2 (3.7)
19.7 (6.6)
9.2 (2.6)
17.8 (5.1)
Moderate
11.9 (3.0)*
23.0 (5.6)**
13.7 (3.7)
26.6 (7.4)
Vigorous
3.9 (2.7)
7.4 (5.0)
3.7 (2.3)
7.2 (4.5)
MVPA
15.8 (4.4)
30.4 (8.0)
17.5 (4.7)
33.8 (9.5)
Values are means (SD). Moderate-to-vigorous activity (MVPA).
* P < 0.05, ** P < 0.01, vs. females
Sacheck et al, Ped Exer Sci, 2010
% Time spent in different intensities of physical
activity during a 50-min soccer match by BMI
category
N
N N
Normal
Weight
NNormal
Weight
Overweight/Obese
Overweight/Obese
Values are means  SE. Different than normal weight individuals
**P<0.01
Estimated kcals for BMR, AEE, and TEE during a
50-min soccer match by BMI category
N
N
N
N
Normal Weight
Normal Weight
Overweight/Obese
Overweight/Obese
BMR = basal metabolic rate; AEE = activity energy expenditure; TEE = total energy
expenditure (BMR + AEE). Values are means  SE. Different than normal weight
individuals *P<0.05, **P<0.01
Consequences
29
Poor Health Outcomes
WHO estimates that 1.9 million deaths
worldwide are attributable to physical inactivity
APOP, IOM, 2012
30
The Somerville FIT Study
BMI
<85th %tile >85th %tile
(n=236)
(n=194)
Fitness
Fit
(n=192)
Unfit
(n=206)
Cholesterol
(mg/dL)
155.1 (24.4) 158.8 (26.1) 157.1 (26.0) 156.2 (24.7)
Triglycerides
(mg/dL)
73.3 (26.1) 106.8 (61.4)** 76.0 (25.9) 100.5 (62.2)**
HDL (mg/dL)
56.1 (11.4)
49.6 (10.6)**
55.7 (10.7)
50.9 (11.6)**
LDL (mg/dL)
84.4 (20.1)
87.8 (22.7)
86.3 (22.3)
85.3 (20.6)
**P<0.001
Combined Impact of
Fitness & Fatness on
Metabolic Risk Factors
in Children
Black Bars = unfit
32
Mean Number of
Fitness Tests
Passed by BMI
Percentile
End run, ab strength, flexibility, upper body strength and agility
Kim et al Obes Res 2005
33
What is happening?
• Obese children may:
– have a more difficult time moving their body
against gravity
– Be more likely to have physical
complications/pain during PA
– perform less PA so that they also have less
opportunity to practice and develop
proficiency
– have fewer opportunities for and have less
enjoyment in PA
34
Adult Fitness, BMI and CVD
Mortality in Men
• Fitness trumps “fatness” (Aerobics Center
Longitudinal Study)
35
Lee et al Circulation 2011
Student Academic
Achievement
36
Likelihood of Passing Academic Tests For
Each Fitness Test Passed by Massachusetts
Students in Grades 4 to 8
Odds of passing
increased by
24% per test
passed
Odds of passing
increased by 38%
per test passed
Chomitz V, et al. Journal of School Health, 2009.
Kids: Sports Nutrition Issues
• Consuming adequate calories
• Eating consistent meals
• Getting a good balance of foods/nutrients
(carbohydrate, protein, & fat)
• Refueling after exercise
• Drinking enough fluids
– Most appropriate fluids
• Inappropriate use of sports drinks, bars and
supplements
Estimated Calorie Requirements by Age and
Activity Level
Gender
Young child
Female
Male
Age
Sedentary
Activity
Moderate
Activity
Active
2-3
1,000
1,000-1,400
1,000-1,400
4-8
9-13
14-18
1,200
1,600
2,000
1,400-1,600
1,600-2,000
2,000
1,400-1,800
1,800-2,200
2,400
4-8
9-13
14-18
1,400
1,800
2,200
1,400-1,600
1,800-2,200
2,400-2,800
1,600-2,000
2,000-2,600
2,800-3,200
(Institute of Medicine Dietary Reference Intakes, 2002)
Macronutrient Needs
• Protein: 10-30% calories
• Carbohydrate: 45 to 65%
calories
• Fat: 25-35% calories
– 5 to 10% as linoleic acid
– 0.6 to 1.2% as linolenic acid
RDA
Males
Females
9-13 yr
34
34
14-18 yr
52
46
Protein (g/day)
Carbohydrate (g/day)
9-13 yr
130
130
14-18 yr
130
130
Protein Needs: 0.8-1.2 g/kg/day
Recommended Dietary Allowance for Protein
Grams of protein
needed each day
Children ages 1 – 3
13
Children ages 4 – 8
19
Children ages 9 – 13
34
Girls ages 14 – 18
46
Boys ages 14 – 18
52
Women ages 19 – 70+
46
Men ages 19 – 70+
56
Here are examples of amounts of protein in food:
•1 cup of milk has 8 grams of protein
•A 3-ounce piece of meat has about 21 grams of protein
•1 cup of dry beans has about 16 grams of protein
•An 8-ounce container of yogurt has about 11 grams of protein
WHAT TO EAT?
– 2/3 carbohydrates:
• 1/3 bread, bagels, cereal, rice, pasta, crackers,
pretzels
• 1/3 vegetables, beverages
– 1/3 protein OR LESS:
• Meat, poultry, fish, dairy foods, nuts, seeds, soy
foods, dried beans, eggs
Nutrient Needs: Critical Minerals
Males
Females
Calcium (mg/day), AI
Calcium
– Most important for obtaining
peak bone mass at this age
9-18
Iron
1300
1300
(700-1150
actual
intake)
(550-800
actual intake)
Iron (mg/day), RDA
– Increased need related to
rapid rate of linear growth,
increase in blood volume,
and in females, onset of
menarche
9-13
8
8
14-18
11
15
Zinc (mg/day), RDA
Zinc
– Required for sexual
maturation, important cofactor in enzymes
9-13
8
8
14-18
11
9
Thermal Stress and Children
• Children rely more on convection and radiation, which
are enhanced through greater peripheral vasodilation
• Evaporative heat loss is lower because of reduced
sweat rates
• Children have greater ratios of surface area to mass
• Acclimatization to heat is slower in boys than in adult
men (no data available for girls)
Water is critical
for endurance
performance!
And What About All Those
Drinks???
Sport Drinks
• Uniquely designed to meet both energy and fluid needs
of athletes
• Composition influences gastric emptying
• Carbohydrate solutions empty more slowly
• Most sports drinks contain:
– 6-8% CHO in the form of glucose and glucose
polymers
– 20-60 mmol/L sodium
• Adding glucose stimulates sodium and water
absorption
• Sodium increases thirst
Who Really Needs Sports
Drinks?
• American Academy of Pediatrics:
– “If children are participating in prolonged
vigorous physical activity in hot, humid
conditions for more than one hour, small
amounts of sports drinks may be
appropriate”
• 2010 National Youth PA & Nutrition
Study
– 16% drank at least one serving/day
– 9% drank at least two servings/day
• Participation in varsity sports: 33%
(girls) 37% (boys)
Johnston LD, et al. Am J Prev Med 2007; Volume 33 (Oct).
Hydration
BEFORE – Water!
• 1-2 hours before: 2-1/2 cups (20 oz.)
• 15-30 min before: 1-1/2 cups (12 oz.)
DURING – Water!
8 oz every 15-20 min
• diluted fruit juice, sports drinks (6-8%) IF exercise is >60 min
AFTER – Water!
Drink 2 cups for each pound lost
• Weigh yourself before and after exercise
• Don’t trust thirst
• Avoid caffeine
Caffeine
Benefits
Increases:
• Mental alertness
• Concentration
• Catecholamine release
• Use of fats by muscles
• Decreases fatigue &
lowers perception of
effort
• Improves endurance
performance
– May improve
sprint/strength
performance
Potential
side-effects
• Increased urination
• Gastrointestinal
distress
• Tremors
• Decreased sleep
• Nervousness/Anxiety
symptoms
• Irregular heart
rate/rhythm
Ergogenic Aids
•
•
•
Ergogenic = “work-producing”
Performance enhancers
Many product claims
–
•
Energy, enhance performance, change body composition
This includes ergogenic aids that are:
–
–
–
–
–
–
Pharmacological – amphetamines, caffeine, diuretics
Hormonal – anabolic steroids, oral contraceptives
Physiological
Nutritional
Psychological
Biomechanical
Four Important Questions
• Effective?
–
–
–
–
–
Advertisements
Popular press
Anecdotal evidence
Personal experience
Research and science
• Safe?
– Toxicity and knowledge
• Legal?
– Determined by governing body of the sport
• Ethical?
– Moral, guiding principles
Sports Supplements
•
•
•
•
Natural and safe are NOT the same
Supplements can interfere with medications
More is NOT BETTER
Tell someone what you take, or are planning
to take
• Be informed, and be cautious with
supplements, as what you don’t know may
hurt you!
And What About Those
Bars???
Nutrition Facts
• We eat FOOD, NOT nutrients
• Athletes need carbohydrate, protein and fatcontaining foods daily
• We can be selective about the types of foods
we choose to eat:
• Fish instead of a hot dog
• Kashi instead of Fruit Loops
• Peanut butter instead of bacon
Bottom Line!!
• Food, fluid, and rest are essential for
peak mind and body performance
• Food choices, timing, and amounts
matter
• Foster POSITIVE environments
Healthy Kids Out of School
Unite out-of-school organizations around
nutrition and physical activity principles
and providing the resources to help
them become effective venues for
childhood obesity prevention.
Three Guiding Principles
Drink Right: Choose water instead of
sugar-sweetened beverages.
Move More: Boost movement and
physical activity in all programs.
Snack Smart: Fuel up on fruits
and vegetables.
Healthy Kids Hub website