Introduction to Sports Nutrition Chapter 1 Nutrition for Sport and Exercise Dunford & Doyle Learning Objectives Explain the need for an integrated training and nutrition plan. Explain basic nutrition principles and how they might be modified to meet the needs of athletes. List sports nutrition goals. Outline the basic issues related to dietary supplements and ergogenic aids, such as legality, ethics, purity, safety, and effectiveness. Learning Objectives (cont’d) Distinguish between types of research studies, weak and strong research designs, and correlation and causation. Compare and contrast the academic training and experience necessary to obtain various exercise and nutrition certifications. Proper nutrition supports training, performance, and recovery. p1 Sports Nutrition • Definition: A blend of nutrition and exercise physiology • Nutrition supports the body’s ability to respond and adapt to physical challenge • Sports nutrition is a young field; knowledge base is continually expanding as understanding evolves and research is done • Athlete must use genetics, training, and nutrition to their advantage in order to achieve success Definitions • Exercise Physiology – Science of the response and adaptation of bodily systems to the challenge imposed by movement • Nutrition – Science of ingestion, digestion, absorption, metabolism and biochemical functions of nutrients • Sports Nutrition – Integration and application of scientifically based nutrition and exercise physiology principles that support and enhance training, performance, and recovery What is an Athlete? • A person who participates in a sport o Elite o Well-trained o Recreational Differences in Types of Athletes • Elite – Exceptionally skilled – Dedicated to training • Well-trained – Collegiate athletes – Dedication to training is important to maintain and improve performance • Recreational – Some are former competitive athletes – Train very little, if at all – Primary focus is healthy lifestyle and enjoyment Defining Physical Activity, Exercise, & Sport • Physical Activity — bodily movement resulting in an increase in energy expenditure above resting levels – Exercise — physical activity that is planned, structured, and purposive – Sport — competitive physical activities Defining Physical Activity, Exercise, & Sport • Exercise – Aerobic — with oxygen • Uses oxygen-dependent energy system for energy (oxidative phosphorylation) • Endurance activities • “Endurance” or “ultraendurance” athletes • Examples: Triathlon, Marathon – Anaerobic — without oxygen • Uses energy system that is not dependent on oxygen (creatine phosphate replenishes ATP rapidly, or anaerobic glycolysis) • Short in duration and high in intensity • “Strength” or “power” athletes • Examples: Sprints, Shot Put, Heavy Weight-lifting Defining Intensity, Training, & CV Fitness • Intensity – the absolute or relative difficulty of physical activity or exercise • Training – a planned program of exercise with the goal of improving or maintaining athletic performance • Cardiovascular fitness – ability to perform endurance-type activities, determined by heart’s ability to provide O2rich blood to exercising muscles and ability of those muscles to take up and use O2 Importance of Training and Nutrition “Everyone is an athlete; only some of us are not in training” -George Sheehan, running philosopher (1980) Importance of Training and Nutrition • Sports performance is improved by skill development and training – Skill development – practice, instruction, coaching – Training – sport-specific • Physical conditioning – consistent physical training to improve specific components of fitness – Ex/ distance runners must have high level of cardiovascular fitness, which is developed through rigorous running training program – More widely used even for athletes such as golfers and race car drivers Importance of Training and Nutrition • Nutrition supports training and good health • Nutrition for recovery – Inadequate replenishment of fluid, energy, carbohydrate, protein and vitamins/minerals will lead to fatigue during next training session • Consistent inadequate replenishment will lead to chronic fatigue • Consistent daily proper nutrition plan important – or can lead to “crash dieting” or other quick fixes Training Goals for Athletes • • • • Improving performance (main goal!) Improving specific components of fitness Avoiding injury and overtraining Achieving top performance for selected events (i.e., peaking) Long-term Nutrition Goals for Athletes • Adequate energy intake to meet the energy demands of training • Adequate replenishment of muscle and liver glycogen with dietary carbohydrates • Adequate protein intake for growth and repair of tissue, particularly muscle • Adequate overall diet (ex/ proteins, antioxidant vitamins) to maintain a healthy immune system • Adequate hydration • Appropriate weight and body composition Short-term Nutrition Goals for Athletes • Consumption of food and beverages to delay fatigue during training and competition • Minimization of dehydration and hypohydration during exercise • Use of dietary strategies known to be beneficial for performance (such as precompetition meal, caffeine intake, or carbohydrate loading) • Intake of nutrients that support recovery • Appropriate timing of nutrients Basic Training and Nutrition Principles • • • • • Progressive overload Individuality Specificity Hard/Easy Periodization o Macrocycle o Mesocycle o Microcycle • Disuse 1. The principle of progressive overload • Overload – An exercise stimulus that is of sufficient magnitude to cause enough strength to warrant long-term changes by the body • The body will adapt to the overload stimulus • For further adaptation to occur, the overload stimulus must be progressively increased 2. The principle of individuality • Individuals may respond and adapt differently when exposed to the same training stimulus • Ex/ 2 similar athletes that follow the same strength training program will both improve their strength, but amount and rate of change in strength will be different • Must take this into account when designing an athlete’s training program 3. The principle of specificity • The type of physiological responses and eventual adaptations will be specific to the type of stimulus and stress imposed on the body • “Specificity” refers to a training program that stresses muscles in a manner similar to which they are to perform • Ex/ Aerobic exercise will result in cardiovascular adaptations 4. The principle of hard/easy • Hard physical efforts are followed by training sessions with less physical stress to allow for the rest necessary for optimal adaptation • Rest and recovery are required for adaptation to occur 5. The principle of periodization • Periodization refers to dividing a block of time into distinct periods – Macrocycle • Overall time period beginning at onset of training and goes up to specific athletic goal – Mesocycle • Macrocycles divided into mesocycles of varying lengths of time, each with specific training purpose – Microcycle • Repeated time intervals that make up mesocycle 6. The principle of disuse • Occurs if stress is insufficient or absent • Body can adapt negatively • Atrophy – Wasting or decrease in organ or tissue size • Intentional or unintentional • May occur when an athlete has forced inactivity due to an injury • “Use it, or lose it!” Training and Nutrition Periodization • Training periodization involves changing the intensity, volume, and specificity of training to achieve specific goals • Nutrition periodization refers to a nutrition plan developed to support the various training cycles – It should match the training plan – Each mesocycle and microcycle will have specific nutrition goals A Training and Nutrition Periodization Plan Plyometric Exercise • Definition: Specialized type of athletic training that involves powerful, explosive movements – These movements are preceded by rapid stretching of these muscles • Muscles exert maximum force in as short a time as possible, with the goal of increasing both speed and power • “jump training” • Commonly used in martial arts, high jumping “10 Best Plyometric Exercises for MMA, Martial Arts and Combat Fighters” – Barbell jump squats – Plyo Push-ups – Skipping/jumping rope – Tuck jumps – Box jumps – Explosive step-ups – Lateral hops – one-legged hops – Med ball wall throws – Bounding – long jumps – Depth jumps Video • https://www.youtube.com/watch?v=DEjGc g_I_Cw Basic Nutrition Standards and Guidelines • Sports nutrition principles are based on sound general nutrition principles o Dietary Reference Intakes (DRI) o Dietary Guidelines for Americans o MyPlate (previously MyPyramid) o Other meal planning systems • Can be modified to reflect demands of training and competition The Dietary Reference Intakes (DRIs) Reference Values Defined The DRIs • DRIs were developed for the general population, but also apply to athletes – Energy, fluid, Na may be higher for athletes than general population • DRI is the current standard – RDA is one of the reference values of DRIs • When an RDA cannot be determined, the AI becomes the reference value for the DRI • See DRI Tables – inside front cover of text Dietary Guidelines for Americans, 2010 • Encompass Two Over-Arching Goals: o Maintain calorie balance over time to achieve and sustain healthy weight o Focus on consuming nutrient-dense foods and beverages • Key Recommendations o Balancing Calories to Manage Weight o Foods and Food Components to Reduce o Foods and Nutrients to Increase o Building Healthy Eating Patterns MyPlate Is a Tool for Creating a Nutritious Diet Figure 1-9 p13 Food Pyramid for Athletes • Athletes 20-35 yrs old, • Weighing 50-85 kg, • Training 5-28 hrs/week Basic Nutrition Standards and Guidelines • Others o Food Exchange System (See Appendix D) Categorizes foods based on carbohydrate, protein, and fat content Based on exchange lists by ADA Foods can be exchanged with foods that have same macronutrient composition, but there may be substantial differences in micronutrient composition o Carbohydrate Counting 45-60 g CHO/ meal plus 15-20 g CHO/snack o Dietary Analysis software Nutrition Facts Label Basic Sports Nutrition Guidelines • Athletes need to understand general nutrition principles and then can “fine tune” nutritional intake to meet individual demands of training Key Sports Nutrition Recommendations for Athletes 1. Energy Adequate amount needed to support training and performance and overall health Avoid long-term energy deficits or excesses 2. Carbohydrates 3-12 g CHO / kg body weight per day Depends on sport, type of training, gender, CHO loading Timing is important – before, during, and after Key Sports Nutrition Recommendations for Athletes 3. Proteins 1.2-1.7 g/kg body weight Depends on sport, type of training, desire to increase or maintain skeletal muscle mass Timing important 4. Fats 20-35% of total calories 5. Vitamins & Minerals Meet DRI for all vitamins and minerals Consume “nutrient dense” foods Key Sports Nutrition Recommendations for Athletes 6. Fluid Balance fluid intake with fluid loss Consider athlete’s sweat rate, humidity, temperature, altitude Body water loss of 2-3% of body mass can decrease performance and negatively affect health Hyponatremia can occur if too much water is ingested and can be potentially fatal Key Sports Nutrition Recommendations for Athletes 7. Food and fluid before exercise Relieve hunger, help with hydration Volume depends on amount of time prior to exercise and GI tolerance In general, a meal or snack should be – high CHO, moderate protein, low fat Key Sports Nutrition Recommendations for Athletes 8. Food and fluid during exercise Replace fluid lost in sweat and provide CHO 9. Food and fluid after exercise Replenish nutrients lost during exercise and help to speed recovery CHO to replenish muscle glycogen Protein to repair muscle tissue Fluid to restore hydration Electrolytes if large amounts lost in sweat Some Critical Areas Involving Diet • Disordered Eating (DE) – Abnormal eating pattern, but not as severe as an eating disorder • Eating Disorder (ED) – A substantial deviation from normal eating, which meets established diagnostic criteria – Ex/ Anorexia Nervosa, Bulimia Nervosa, Anorexia Athletica Some Critical Areas Involving Diet • Adhering to rigid diet can lead to social isolation and lead to compulsive behavior • Goal is for flexible eating and to include a variety of foods • Flexibility may cause short-term over and undereating, but results in long-term weight stability, proper nutrition, and enjoyment of eating Dietary Supplements • Dietary Supplement Health and Education Act (DSHEA) – law passed in 1994 that governs dietary supplements in the U.S. • Supplement is defined as a “vitamin, mineral, herb, botanical, amino acid, metabolite, constituent, extract, or a combination of any of these ingredients” (FDA, 1994) • The law does NOT ensure or require safety or effectiveness • Supplements cannot claim to treat, prevent, diagnose, or cure a disease Dietary Supplements • The law includes standards to ensure that the supplements: 1. contain the intended ingredients 2. are free from contamination 3. are accurately labeled • Good Manufacturing Practices (GMP) – Quality control procedures for the manufacture of products ingested by humans to ensure quality and purity – Intended to bring dietary supplement manufacturing standards closer in line with pharmaceutical standards Supplement Use in Athletes • ~85% of all elite athletes use one or more dietary supplement (Lun et al, 2012) • ~70% of adolescent athletes use one or more dietary supplement • Collegiate and high school athletes frequently use supplements – Energy drinks and calorie replacement drinks – MVI, Vitamin C – Creatine – Protein powders and protein drinks Why do athletes take supplements? • Consumption of poor diet • Physical demand of training & competition • Teammates and competitors are taking supplements • Recommendation by physician, coach or parent • To avoid sickness • Lack of time to prepare meals • To overcome injury • To enhance overall health Legality of Supplements • Many athletes are governed by the International Olympic Committee (IOC) or the National Collegiate Athletic Association (NCAA) • Each athlete is responsible for knowing the current rules as they pertain to dietary supplements • Banned substances may be intentionally or unintentionally added to some supplements Safety of Dietary Supplements • Important to consider ingredients and dose • Be careful with: – Caffeine – Ephedrine (banned) – DHEA (banned) – Weight loss supplements and energy drinks (may contain banned substances) – Herbal supplements (contamination, lack of standardization, interactions w/ meds) Purity of Dietary Supplements • Purity refers to lack of contamination and accurate labeling • Lack of standardization common in herbal supplements • Dietary supplement certification programs – ConsumerLab.com – NSF – United States Pharmacopiea – Informed-Choice Figure 1-12 p20 Research – Gurley, Gardner, & Hubbard. (2000). Content vs. label claims in ephedra-containing dietary supplements. American Journal of Health Systems Pharmacy, 57(10), 963-969. • Compared amount of ephedra contained in supplement to amount listed on label • Results: – ½ of supplements varied by > 20% – One contained no ephedra – One contained 150% of the amount stated on label – 5 out of 20 supplements contained norpseudoephedrine (a controlled/banned drug) Effectiveness of Dietary Supplements • Most dietary supplements sold are NOT effective for improving performance, increasing muscle mass, or decreasing body fat – >30,000 supplements in U.S. – little or no scientific evidence of effectiveness for majority • Scientific research has shown safety and effectiveness at recommended doses for: – – – – Caffeine Creatine Vitamins & Minerals Protein Effectiveness of Dietary Supplements • Some supplements have shown promise and are still under investigation: – Beta-alanine for buffering muscle pH – Branched-chain amino acids for immune system support and reduction of post-exercise fatigue – Growth hormone releasers, such as arginine, to stimulate growth hormone release – Omega-3 fatty acids for asthma – Quercitin for antiinflammatory effects “Quackery” • The practice of making false claims about health-related products – This can include dietary supplements • Often marketed under Multi-Level Marketing (MLM) • Nonprofit websites devoted to combatting health misinformation, fraud, and quackery – National Council Against Health Fraud (NCAHF) – Quackwatch.org • Consumers need to do their research! Process for Evaluating Dietary Supplements = Critical Thinking Skills Understanding and Evaluating Scientific Evidence • Sports nutrition recommendations should be evidence-based o Based on scientific research and evidence to determine the most effective outcome o Quality of research is important o Also, use clinical judgment and evaluate the athlete’s personal preferences and values Understanding and Evaluating Scientific Evidence • Types of Research Studies: Case studies o Observational records o Weakest type of study Epidemiological studies o Studies health-related events in a population o Shows associations and correlations Experimental studies o Follow strict protocols and control most variables o Establishes cause and effect relationships o Strongest type of study Understanding and Evaluating Scientific Evidence • Correlation – a relationship between variables • Cause-and-effect – implies that one causes the other • Mortality – refers to the number of deaths in a population • Placebo – an inactive substance • Placebo effect – subjects taking placebo will have a perceived improvement Understanding and Evaluating Scientific Evidence • Research Design and Methods – Control (Placebo) & Experimental (Treatment) groups – Randomization of the sample – and randomly assigned to placebo or treatment groups – Placebo – inactive substance • Double-blind – Neither the subjects nor the researchers know who is receiving placebo and who is receiving treatment – Helps to reduce bias – Crossover design – subjects receive both treatments Research Design – Crossover Understanding and Evaluating Scientific Evidence • The strongest research protocol is a randomized, double-blind, placebo-controlled, crossover study performed on humans • Also, the larger the number of subjects (n) the stronger • Should be peer reviewed before publication – Scrutinized by trained professionals • Well-designed studies reduce bias and help ensure accurate results Figure 1-15 p26 Levels of Evidence and Grades of Recommendations • Grade I (Level A) – Supported by good evidence; consistent results of well-designed, large, randomized research studies; confidence high • Grade II (Level B) – Supported by fair evidence; less-convincing results due to inconsistent results or limited number of well-designed studies, or studies with weaker designs Levels of Evidence and Grades of Recommendations • Grade III (Level C) – Supported by limited evidence; confidence limited by study size and/or design or by size of body of literature • Grave IV (Level D) – Supported by expert opinion (panel consensus judgment) based upon review of body of experimental research • Anecdotal Evidence – Personal account or testimonial Levels of Evidence and Grades of Recommendations • Scientific research is graded to help indicate strength and quality • Ideally – Grade A evidence would be available to answer all questions regarding nutrition and training needs for athletes, however….. …..sports nutrition is a YOUNG field and there is not always a lot of good evidence! Drawing Appropriate Conclusions from Scientific Research • Distinguish between correlation and causation • Importance of replicating results • Extrapolate with caution, if at all • Interpret results correctly • Focus on cumulative results and consensus – general agreement among members of a group • Recognize slow evolution of knowledge Is the Research Study Similar to the Competitive Event? Consumer Exposure to Scientific Studies • Widely reported in the media – Television, magazines, newspaper • Preliminary data typically reported • Cause and effect inferred, when its actually correlation or association • Results used as marketing tool • Professional responsibilities include: – Providing science-based information – Recognize and correct misinformation – Address the effects of misinformation Use of the Internet for Nutrition, Exercise, and Health Related Information • Widely used for health information • Much of this information is inaccurate or poor quality – < 25% physical activity websites considered high quality (Bonnar-Kidd et al, 2009) • Look for HONcode – Code of conduct for medical and health websites – Backs up claims with research – Clearly distinguishes advertising from editorial content Use of the Internet for Finding Scientific Information about Sports Nutrition Many Types of Practitioners in Exercise Science • Background in… – Anatomy – Physiology – Principles of exercise and fitness • College degrees in… – Exercise science – Kinesiology – Physical education – Other related degrees Scope of Practice and Certifications for Exercise • Scope of practice helps to establish professional boundaries by outlining skills, responsibilities, and accepted activities • Scope of practice takes into account academic training and professional knowledge and experience • Scope of practice protects both consumers and practitioners • Practitioners must recognize the limitations of their training, skills, and knowledge Scope of Practice and Certifications for Exercise • American College of Sports Medicine (ACSM) – Registered Clinical Exercise Physiologist (RCEP) – Clinical Exercise Specialist (CES) • Bachelors degree in allied field – Health/Fitness Specialist (HFS) • Associates or bachelors in allied field – Certified Personal Trainer (CPT) • High school diploma Scope of Practice and Certifications for Exercise • National Strength and Conditioning Association – Certified Strength and Conditioning Specialist (CSCS) • Must have bachelors or chiropractic degree and CPR certification • National Athletic Trainers Association – Certified Athletic Trainer (ATC) • Must have degree from athletic training program and pass certification exam Figure 1-20 p31 Scope of Practice for Sports Nutrition • Nutrition scope of practice – Registered Dietitian (RD) or Registered Dietitian Nutritionist (RDN) • • • • • Bachelor’s degree Supervised practice or internship National certification State licensure RD/RDN can provide “Medical Nutrition Therapy” or MNT – Nutritionist • General term • Training can range from marginal to rigorous Scope of Practice for Sports Nutrition • Nutrition-related certifications – Board Certified Specialist in Sports Dietetics (CSSD) • RD for >2 years • 1500 hours in sports nutrition w/in past 5 years – Certified Sports Nutritionist from the International Society of Sports (CISSN) • 4 year degree in any field – Certified Lifestyle Eating and Performance Therapist (CLT) • BS in Nutrition Figure 1-21 p32 Summary • The ultimate goal of sports nutrition is improved performance, which involves both skill development and training • Proper nutrition helps to support training, performance, and recovery • Sports nutrition principles are based on sound general nutrition principles that have been modified to reflect the demands of training and competition for the athlete’s sport and position Summary • Dietary supplements are widely used by athletes, but are not well regulated • Sports nutrition recommendations should be evidence-based • Practitioners must understand and respect the limitations of their training, skills, and knowledge • Many people who work with athletes are certified or licensed