1. Athlete Presentation: Sandy Touchton Meredith Murphy, Violeta Nieves, Mujan Noroozian

2. Outline ●Anthropometrics ●Medical History ●Physical Activity Related Questions ●Nutrition Assessment ●Specialty Products ●Exercise and work Schedules ●Nutrition and Fitness Goals ●Supplements ●3-Day Food Record ●Vitamins & Minerals ●6-Day Pre-week Race ●Race Event ●Lessons Learned

3. Anthropometrics ●Date of Birth: 02/06/1959 ●Age: 55 ●Marital Status: Married ●Gender: Female ●Height: 5’3” ●Weight: 120 lbs, 54.4 kg ●BMI: 21.3 (Normal) Occupation: Massage therapist

4. Medical History ●Arthritis (neck & hip) ●Medications: Hormones ●Surgical History: 2 c-sections, hysterectomy ●Family History: Heart Attacks (both parents) ●Not a smoker & drinks 2-3 glasses of wine per week

5. Physical Activity Related Questions ●Does not think she consumes enough water/ water alternatives ●Has experienced symptoms of dehydration ●Other physical or recreational activities: lifting weights, swimming, biking, running ●Work environment: not strenuous

6. Nutrition Assessment ●No cultural/religious dietary practices ●No known allergies ●No food intolerances ●Eats at sit-down restaurants 3-4 times weekly ●Does her own grocery shopping and cooking

7. Food Preferences ●Protein: chicken, muscle milk, turkey, eggs, limited beef ●Dairy: cheese, milk, yogurt- (all very limited) but prefers almond milk ●Grains: little to no wheat ●Fruit: all ●Vegetables: mostly all (no brussel sprouts) ●Beverages: water, tea, gatorade ●Snacks: Cheese-its, fruits/vegetables, almonds ●Food dislikes: salad dressing, onion, peppers, liver, rice, beans ●Limits: fatty and fried foods

8. Nutrition Assessment Cont’d MealTime to Prepare MealsTime to Consume Meals Breakfast2 minutes30 min (sometimes in the car) Lunch10-15 minutes30 min Dinner30-45 minutes30 min ●Usually consumes 2 snacks (one in the morning & one in evening)

9. Specialty Products ●Salt tabs (ThermoTabs) ●Nuun Energy -Tri-Berry Drink Tabs ●Hammer Gels

10. Work Schedule Day of the weekWork Schedule SundayMassage ½ day (2 X a month) MondayOffice work 8am-5pm TuesdayOffice work 8am-5pm WednesdayOffice work 8am-5pm ThursdayOffice work 8am-5pm FridayMassage ½ day (2-3 X a month) SaturdayOFF (Massages on occasion)

11. Exercise Schedule vs 6 Pre-week Race Day of the week Exercise Schedule6 Day Pre-week Race SundayLong bike ride 40-60 miles30 min run Monday30 min runOFF TuesdayOFF40 min run (5.2 mph at 11.5 min/mile) & 45 min vigorous boot camp Wednesday40 min run & vigorous boot camp if shorten OFF Thursday55 min run30 min run FridayOFF SaturdayLong run or 40 min intervals15 mile run (RACE DAY)

12. Nutrition and Fitness Goals 1.Complete a half marathon in less than 2 hours 25 minutes 1.Eat well 80% of the time

13. Supplements Morning ●Fish oil ●Methylsulfonylmethane (MSM) ●CoQ-10 ●Magnesium ●Potassium ●Glucosamine ●Chondroitin ●Ginkgo Biloba ●Grape seed extract ●Alpha-lipoic acid Evening ●Fish oil ●Bromelain ●Biotin ●Glucosamine ●Chondroitin ●Ginkgo Biloba ●Grape seed extract ●Alpha-lipoic acid

14. Fish Oil ●Source of omega-3’s ●Research shows intake provides cardioprotective effect Blood TG levels ●Anti-inflammatory agent, supports healthy joints Total daily intake of 1 gram Fish oil/ day, approximately 10 calories

15. Ginkgo Biloba ●Alzheimer’s disease and other forms of dementia ●Improving thinking problems caused by old age ●Improving thinking in young people 120 mg morning, 120 mg night

16. Alpha-lipoic acid ●Antioxidant ●Helps maintain optimal blood sugar levels ●Works with Co-Q10 to fight against aging and disease 100 mg morning, 100 mg night

17. Caloric Needs Assessment Activity FactorTotal Daily Calories (Kcals) Mifflin St. Jeor1.61,780.8 Cunningham1.62,336 (FFM of 20) Simplified RMR1.61,883.5 Rule of ThumbN/A2,016.5 54.5 kg 160.02 cm

18. 3-Day Food Record Assessment - Total Calories Sandy’s Average Caloric Intake 1,626.3 Kcals - 29.8 Kcals/kg/d Recommendation: Female athlete with a moderate activity level; (activities of daily living + moderate activity 3-5 days a week) 37 Kcal/kg/d Sandy met 81 % of her caloric needs from the average 3-day food record

19. 3-day Averages of Macro’s On g/kg Basis Sandy’s 3-day Average (g/kg) Recommended CHO3.35-7 g/kg when training is reduced to 1 hr/day 6-10 g/kg, moderate-rigorous training (1-3 hr/day) 8-12 g/kg, moderate-rigorous training (4-5 hr/day) Fat1.131-1.5 g/kg to meet energy needs Pro1.231.0 g/kg (+/- 10% for the range)

20. 3-Day Food Record Assessment Day 1Day 2Day 3Average% SourceAMDR Total kcal1,4182,0101,4511,626.3---------- CHO (g)14224914617944 %45-65% Fat (g)65626062.335 %20-35% Pro g)49767566.616 %10-35%

21. 3-Day Food Record Assessment - CHO 5-7 g/kg when training is reduced to 1 hr/day Average 3-day Intake is 3.3 g/kg or 179 g Met her minimum CHO needs (5 g/kg) by 66 % Met AMDR recommendation with 44 % of her calories from CHO

22. 3-Day Food Record Assessment - FAT 1.0-1.5 g/kg to meet energy needs Average 3-day intake is 1.13 g/kg or 62.3 g Met her minimum FAT needs (1.0 g/kg) by 113 % Met AMDR recommendation at 35 % of her calories from FAT

23. 3-Day Food Record Assessment - PRO 1.0 g/kg (+/- 10% for the range) Average 3-day intake is 1.23 g/kg or 66.6 g Met her protein needs (1.0 g/kg) by 123% Met AMDR recommendation at 16% of her calories from PRO

24. Vitamins VitaminFood IntakeDRI% of DRI Vitamin A956 ug700 ug137 % Vitamin B61.1 mg1.5 mg73 % Vitamin B122.1 ug2.4 ug88 % Vitamin C61 mg75 mg81 % Vitamin D1 ug10 ug*10 % Vitamin E6 mg15 mg40 % Vitamin K148 ug90 ug164 % Folate395 ug400 ug99 % Thiamin1.0 mg1.1 mg91 % Riboflavin1.5 mg1.1 mg136 % Niacin15 mg14 mg107 %

25. Vitamin Deficiencies Vitamin + DRI or AISuggested Food Source Vitamin B6 (1.5 mg)1 c. Sweet Potato (0.541 mg) 3 oz. Salmon (0.695 mg) Vitamin B12 (2.4 ug)3 oz. King crab (9.78 ug) 3 oz. Salmon (2.70 ug) Vitamin C (75 mg)1 c. Sweet Potato (42 mg) 1 c. cantaloupe (58.7 mg) VItamin D (10 ug)6 oz. Low-fat Yogurt (2 ug) 1 Lg. Egg (1 ug) 14 oz. Muscle Milk (3 ug) Vitamin E (15 mg) 1 c. Sweet Potato (3 mg) 22 Almonds (7 mg) 1 c. Spinach (4 mg)

26. Minerals

27. Average 3-Day Mineral Intake Including Magnesium Supplement Compared to DRI Magnesium is necessary for the formation of bone, protein, DNA, and is an important mineral that regulates blood pressure, blood sugar, and muscle/nerve functions. Good sources include whole grains, legumes, nuts, seeds, fortified foods such as breakfast cereals, and green leafy vegetables. MineralFood IntakeDaily Supplement DRI% of DRI Magnesium256 mg300 mg320 mg174%

28. 6 Day Pre-Race Week GOALS Total kcal/kg 1. “Rule of Thumb” 2. Mifflin St. Jeor *With a deviation for the range 37kcal/kg x 54.5 = 2,017 kcal/day Women: RMR (kcal/day)= (9.99 X wt) + (6.25 X ht) - (4.92 X age) - 161 X activity factor of 1.6 RMR (kcal/d) =1,781 kcal/day Total CHO/kg CHO depletion 4g/kg CHO loading 8g/kg Total PRO/kg1.2-1.5 g/kg Total FAT/kg1.0 g/kg (+/- 10% for the range)

29. 6 Day Pre-Race Week

30. Avoiding Repetition

31. What Was Prescribed & What Was Practiced... For the most part our athlete stuck to what we prescribed... Exceptions: ●Some fruits were substituted/changed ●Ate out with friends a few days during the week

32. Race Event Originally ½ marathon (13.1 miles) → 15 mile run Date: November 15, 2014 Location: Clear Lake, TX Weather: Little windy, 48-50°F during the run Ran with a group of ladies (MOTIVATION)

33. Race Event Menu *Actual Intake *Recommended FoodCHO (grams) PRO (grams) FAT (grams) Fluid (fl. oz) Pre-Race Meal ●1.5-2 hours before run Poptart (unfrosted), 14 oz Muscle Milk ●15-20 min before run Gu and 2-4 fl oz water 70271516-18 During Race ●Every ~1.5 miles 2-4 fl oz water ●Mile 3 and 9 Nuuns and Hammer Gels 95 (90)0030 (16-32) Post Race●2 scoops Hammer Recoverite, 8 oz skim milk, 2 Hammer Bar, 24 fl oz water 95 (82)26 (20-25)1432 (16-24 fl. oz for every lb of body weight lost) Totals g/kg4.70.980.6

34. Race Event Results “The nutrition you planned for my 15 mile run was spot on!! I followed your plan and with the exception of a couple of ½ mile differences in consumption due to our intervals and I felt great and had the energy I needed to go the distance. I was very excited! That is the longest run I’ve done to date and was very happy to feel good the entire distance.“ ●Meal plan was mostly followed → positive results ●What we prescribed met her energy needs ●Fluid amounts were perfect ●States she will use prescribed menu on long runs and race day

35. Lessons Learned - Violeta ●Its more than just numbers and equations to individualize a meal plan ●Disadvantages of using emails to communicate ●This assignment helped me learn meal frequency, macronutrient/ratios and micronutrient specific to an athlete ●RDs (students in nutrition) can make a difference and help improve athletic sports performance

36. Lessons Learned - Meredith Individualizing a meal plan for someone with specific preferences and goals is time consuming (for even 1 day) Meal planning is hard to do in a group, unless you design the meals together A drafted meal plan will go through many revisions May be better to meet with client in person, rather than relying on a questionnaire to get all the little details about their food preferences

37. Lessons Learned - Mujan ●Difficult and time consuming to communicate with a client via email. ●Advantages/Disadvantages to working with a group. ●There are a lot of alterations and adaptations when you’re planning a meal for more than one day (you have to be willing to modify). ●I’ve learned about many products that are available for athletes. ●This assignment has taught me what amounts of macro/micronutrients are needed for athletes.