Roberta Anding, MS,RD, CSSD, CDE, LD
Director of Sports Nutrition
Texas Children’s Hospital
Sports Dietitian, Houston Texans
Sports Dietitian, Houston Astros
Rice University Owls
2012 Houston Texans Playoffs
 Never
underestimate the value of
hydration
 Body composition matters to all athletes
which translates into body fat loss and
lean mass gain
 Athletes want a performance edge and
turn to supplements first, food second
 Age matters!
CHILDREN AND TEENS
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Hydration needs
School challenges
Concrete thinkers
Teens are interested in
supplements
Puberty allows for
muscular hypertrophy
Without androgen, muscles
can get stronger just not
bigger
COLLEGE & PROFESSIONAL
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More flexibility in meeting
fluid needs
Development of abstract
thinking
Supplements are norm
Bodies fully developed with
the ability to increase
strength and hypertrophy
 ACSM
exercise and fluid replacement
position paper
 The scale can help determine fluid lostmeasure of acute/chronic dehydration
 Urine color is a reflection of blood 2
hours ago- an easy measure; easily
confounded-only use first morning
 Urine specific gravity is a tool <1.020
 Don’t forget high water volume foods
 Genetic
predisposition-body size
 Level of acclimatization
 Heavy gear and multiple training session
 AAP position stand for children
• Adults may place them at risk
• 9- to 12-year-old children should drink 100 to
250 mL of fluids every 20 minutes, and
adolescents may consume 1.0 to 1.5 L of fluids
every hour.
Policy statement-Climatic heat stress and exercising
children and adolescents. Pediatrics 2011

ACSM position on hydration
• Greater than 60 minutes in the heat
• Drink on a schedule
• Electrolyte replacement
• Not a lunch time beverage
• No need for athletes that don’t play
 Aerobic
• Distance running
• Triathlons
• Cycling
 Anaerobic
• Stop and go sports
• Lineman
• Sprinters
• Max effort-short duration
 Carbohydrates-
focus on glycemic index
with increased need
 Protein needs 1.2- 1.4 g/kg/day
 Protein can help control postprandial rise
in blood glucose and prevent
hypoglycemia in very lean runners
 Low
intensity, skill based athletes with large
body mass or energy restriction: 3-5g/kg/d
 Moderate Exercise Program~1 hour per day: 57g/kg/d
 Endurance Program1-3 h moderate to high
intensity: 7-10g/kg/d
 Extreme Commitment>4-5h per day moderate
to high intensity: 8-12g/kg/d
 Strength/resistance
athletes may require
over 200% of RDA
• 1.4-1.8 g/kg body weight per day
• Maintaining muscle mass takes less protein
 0.5-1 g/kg per day
• Energy (total caloric intake) must meet or
slightly exceed needs-this becomes the
limiting factor in teens
Sports Nutrition—A guide for the professional Working with Active People,
Fifth edition From the Academy, Christine A. Rosenbloom PhD, RD and Ellen
Coleman, editors.
 Athletes
want to get bigger and stronger
 In teens, Tanner staging makes a
difference
 Women don’t want to look like guys
 Eccentric exercise appears to generate
the best gains
 “Time under load” or “slow rep trigger
an increase in muscle protein synthesis
even when the weight lifted is the same
Burd, et al.J Physiology 2012 590:2-351
Eccentrically
emphasized
15
 Matt
Schaub-QB
Houston Texans
 230pounds
 105 kg
 1.4 – 1.8 g/kg/day
 Needs 145-190
grams per day
 Stefano
Baldini—
2004 Olympic
Marathon
Winner
 132 lbs. = 60 kg
 1.2-1.4 g/kg/day
 Needs 70-85
g/day
16
 Protein
requirements for strength
athletes are no greater than 2 grams/kg.
Few studies demonstrate greater needs
in body builders
 A survey of collegiate athletes indicated
67% did not know the protein
recommendations
 33% estimated need at 8.7 g/kg
Fox, et al. JISSN 2011, 8:9
 Tradition, coaches, religious
and cultural
beliefs influence nutrition choices
 Parents provide nutrition information to
youth in sports- consider Paleo, Atkins
and other strategies
 Supplements may prove useful but the
NCAA, NFL and MLB regulate what can
be provided
 What happened to real food?
 Teaching
point-remember your nursery
rhymes!
 Question to athletes- where does whey
protein come from?
• Health food store
• Supplements
• Supplements but only get NSF certified
 Studies
indicate improved muscle protein
synthesis with fat free fluid milk and
whey protein
 Both mitochondrial (aerobic) and
myofibrillar proteins( force production)
improve
 Driving factor may be the rich content of
BCAA particularly leucine
 High
biological value- 91
 PDCAAS score of 1.00
 80% casein BV of 77
 20% whey BV of 104
 Protein
 Soy
fortified milks
has a biological value of 74
 Isoleucine, leucine
and valine
 Leucine alone is as effective as total
BCCA
 Muscle protein’s “light switch” via mTOR
 3-4 grams of leucine per serving is
needed
 500 ml of milk has 1.35 grams of leucine
 Consider adding additional whey
 Protein
distribution is important
 Physiological need dictates protein at
each meal
 Busy student athletes often miss
breakfast
 Can
women accrue the same benefits
with strength training as men?
 Majority of studies done with men
 A study by Josse and Phillips
demonstrated a favorable impact on
overall body composition with the use of
high quality milk/dairy protein in women
not calorie restricted
Josse, A & Phillips S. Acute Topics in Sports Nutrition
2013 59:94
Siri, Brozek for adults and
Lohman
equation for pediatrics.
Protocol is important.
 Calipers-
do you have the skill
 Bioelectrical impedance
 Hydrostatic weighing
 Body fat scales
 DEXA
 Height
6’4”
 Weight 305
 BMI 37 obese
 Percent body
 Fat ~19%
BW
% Fat
LBW
FW
= 196
= 5.2
= 186
= 10
 Research
often focuses on the endurance
athlete
 How do you operationalize any nutrition
principle into a team sport?
 Barriers include education, culture,
health beliefs religion, coaches and
schedules
 John Ivy’s research has provided great
insight
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31
32
 Although
science suggests that creatine,
beta alanine and others have clinical
utility, industry is still unregulated
 NCAA, NFL, MLB have policies in place
 NFL allows only Gatorade products
 Just because it is certified doesn’t mean it
works
Modulation of nitric oxide
 Reduces oxygen demand
 Challenge is the taste
 Smoothies
 Other nitrate rich vegetables
• Chinese cabbage
• Leeks, parsley
• Celery, spinach, beets
• Food based supplement-Garden Veggies/Nature
Way
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TAKE THIS – FISH OIL
Fish oil contains EPA & DHA
EPA is anti-inflammatory
Used for arthritis, brain
health
Fatty liver
High triglycerides-heart
failure
Blood levels of EPA/DHA
important before
concussive event
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NOT THIS- FLAXSEED OIL
Although it is an omega 3
fatty acid it has to be
converted to EPA & DHA
Conversion is 8-15%
The current American diet
contains about 10 X the
omega 6 as omega 3
This imbalance prevents
the conversion
Flax is a great source of
fiber
We are dietitians- we promote
food first !
Thank you!
Roberta Anding MS, RD,
LD, CDE, CSSD
randing@bcm.edu