2. Objectives 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 Definition of a supplement Impact of this legislation Discuss specific nutritional supplements commonly used by athletes Do they work? Are they safe?

3. Performance Influencing Factors Genetics Training and Conditioning Nutrition

4. Basics of Nutrition 6 Classes of Nutrients Macronutrients Carbohydrates (CHO) Fats Proteins (PRO) Micronutrients Vitamins Minerals Water

5. Determinants of the Athlete’s Energy Requirements During intense exercise Carbohydrate stored in muscles and liver (glycogen) is predominant fuel source During prolonged exercise Fat stores are predominant fuel source Fitness level of the athlete Well trained endurance athletes burn fat more efficiently, sparing limited glycogen stores

6. Formula for Rough Estimation of the Body’s Calorie Requirements Sedentary person Weight (kg) x 25 Moderately active person Weight (kg) x 30 Active person (endurance athlete) Weight (kg) x 40 Underweight person Weight (kg) x 45 kg = lbs / 2.2

7. Carbohydrates Simple (sugars) and Complex (starches) Major & most efficient fuel source for exercising muscle 4 kcal/gm Athletes should ingest 6 to10 gm/kg/day 55 to 60 % of total calories should come from carbohydrates Complex carbohydrates (starches) are preferable During exercise 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

8. Carbohydrates After exercise Athletes should consume 1.0 to 1.5 gm/kg immediately post exercise and again one hour later Decrease in storage efficiency the greater duration of time 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 Chocolate Milk?

9. Why Complex Carbohydrates? Compared to ingesting simple carbohydrates (sugar), ingesting complex carbohydrates (starch and fiber): 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

10. Protein Athletes require more protein than non-athletes 15 to 20% of total calories should come from protein 4 kcal/gm Protein intake should be tailored to type of training 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

11. Fat Major source of energy 9 kcal/gm 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

12. Pre-exercise Meal Importance Less hunger before and during exercise Maintains optimum glycogen stores Recommendations Emphasize complex carbohydrates (starches) 1 to 4 gm/kg about 1 to 4 hours prior to event Consume less closer to event Avoid high fat and high protein foods Slower gastric emptying can cause stomach upset Avoid high fiber or gas forming foods Can lead to crampy abdominal pain

13. Carbohydrate Loading Athlete should have overall high carbohydrate diet Body is more efficient at storing CHO 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%

14. Carbohydrate Loading: One Example of How Days prior to eventExercise durationCarbohydrate intake 6 90 minutes 5 gm/kg/day 5 40 minutes 5 gm/kg/day 4 40 minutes 5 gm/kg/day 3 20 minutes 8 gm/kg/day 2 20 minutes 8 gm/kg/day 1 rest 8 gm/kg/day

15. Body Composition Measures Hydrostatic Electrical impedance Skinfold thickness Endurance Athletes Men: 8-12% Women: 10-18% NOT BELOW Men: 3% Women: 12%

16. Weight Control Body Composition Refers to fat and non fat components Percentage of body fat Lean body weight Two Factors Number of adipose (fat) cells Size of adipose cells 1 lb. of fat = ~3500 kcal

17. Weight Loss & Gain Weight Loss Safe weight loss is 1-2 lbs. per week Exercise utilizes fat stores 80-90% with almost no loss of lean mass Dieting alone may decrease lean mass 35-40% Weight Gain Approproiately gain 1-2 lbs. per week Aim to increase lean body mass Add 500-1000 kcal a week MUST include weight training

18. Nutritional Supplements 1994 Dietary Supplement Health and Education Act 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

19. 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

20. Vitamins and Minerals Essential nutrients Human body needs these to produce energy No evidence in U.S. studies that taking vitamin and mineral supplements improves athletic performance 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 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

21. 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

22. 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 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 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)

23. Conclusions 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

24. Conclusions 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 Physicians Physician assistants Nurse practitioners Athletic trainers School nurses Dieticians