MEDICAL NUTRITION

SPORTS NUTRITION

Dr. maria Lourdes Corazon-fernandez-tapang

15 october 2014

CONTENT
1. Energy metabolism
2. Dietary requirements
3. Nutrition: before, during, and after exercise
4. Weight management
5. Dietary supplements and ergogenic aids

THE PHOSPHAGEN SYSTEM (ATP-CP SYSTEM)

Anaerobic
Adenosine Triphosphate and Creatine Phosphate provide
readily available energy present within the muscle
The amount of ATP in skeletal muscles is approximately
5 mmol/kg wet weight and is not sufficient to provide
continuous supply of energy
Creatine-phosphate is an ATP reserve in the muscle that can
be readily converted to sustain activity for 3-5 min.
Creatine-phosphate in skeletal muscle is approximately 4x
greater than ATP and is therefore the primary fuel for high
intensity, short-duration activities
Used for events lasting no longer than a few seconds and of
high intensity
Diving
100 m dash
Weight lifting
Fast break in basketball
Jumping

INTRODUCTION
Proper nutrition is a vital consideration for athletes who seek
to maximize their performance
A proper diet will provide proper nutrients and energy for
athletic performance, training and healing
Many factors affect nutrient needs and nutrient availability
including the athletes
Physical condition
Nutrient status
Age
Genetic background
These factors make it essential that the diet be individualized
SPORTS NUTRITION GOALS ARE TO ENSURE:
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 to maintain a healthy immune system
Adequate hydration
Consumption of food and beverages to delay fatigue during
training and competition
Minimization of dehydration during exercise
ENERGY METABOLISM
ENERGY
STORAGE

TRANSFER

CHO, fat, protein supply energy, with fats and CHO

being primary source
energy is stored in the body in the of CP, CHO
(blood glucose, liver, muscle, glycogen), fat (serum
FFA and TG, muscle triglyceride, adipose tissue),
protein (muscle)
two metabolic systems to transfer stored energy to
form ATP

ENERGY SYSTEMS
ANAEROBIC SYSTEM
These system are
capable of producing
ATP energy at a high
rate.
The main limitation of
this system is the
relatively small amount
of ATP that can be made
before fatigue ensues.

AEROBIC SYSTEM
It supplies all of the
energy for low to
moderate intensity
exercise.
It supplies energy for
sleeping, resting, sitting,
walking and other forms
of low intensity physical
activity.

THE ANAEROBIC GLYCOLYTIC PATHWAY (EMDEN-MEYERHOFPARNAS OR GLYCOGEN-LACTIC ACID SYSTEM)

Uses muscle glycogen and
glucose that are rapidly
metabolized anaerobically
through the glycolytic
cascade
This pathway supports
events lasting 60 to 180
seconds
Approximately 25% to 35%
of total muscle glycogen
stores are used during a
single 30-second sprint or
resistance exercise bout.
200-m dash

Anaerobic Metabolism
Phosphagen system
Glycolytic pathway
Aerobic Metabolism
Oxidative pathway

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Neither the phosphagen nor the glycolytic pathway can sustain the
rapid provision of energy to allow muscles to contract at a very
high rate for events lasting greater than 2 to 3 minutes.

ENERGY INTAKE
Food
Fluids
Supplements

THE OXIDATIVE PATHWAY

The major substrates include muscle and liver glycogen,
intramuscular, blood, and adipose tissue triglycerides, and
negligible amounts of amino acids from muscle, blood, liver,
and the gut.
Can produce large amounts of ATP over time via the Krebs
cycle and the electron transport system.
Fuels events lasting longer than 2-3 min.
Examples include
1,500-meter run
Marathons
Half-marathon
endurance cycling or 500 meter swimming events.

ENERGY EXPENDITURE
Basal Metabolic Rate
Thermic Effect of Food
Thermic Effect of Activity

Athletes need to consume adequate energy during periods of highintensity and/or long-duration training to:
MAINTAIN

Body weight and health

MAXIMIZE

Training effect

LOW ENERGY INTAKES

Can result in:
Loss of muscle mass
Menstrual dysfunction
Loss of or failure to gain bone density
Increased risk of fatigue, injury, and illness
Prolonged recovery process
DIETARY REQUIREMENTS

Athletes do not need a diet substantially different from that

recommended in the Dietary Guidelines for Americans and
Eating Well with Canadas Food Guide
Cautions is recommended in using specific proportions as a
base for meal plans for athletes

Uses only
glucose,
anaerobic, high
intensity activity
1-3 min,
produces 2
ATP/glucose

Oxidative pathway

ATP-CP provides
rapid energy,
anaerobic,
seconds,
produces 0.7
ATP/PC

EMP pathway

Phosphagen system

BASIC NUTRIENTS
Nutrients are chemical substances in food that provide
energy, act as building blocks in forming new body
components, or assist in the functioning of various body
processes
CARBOHYDRATES
Carbohydrates is the optimal fuel for exercise
Yields approximately 4 kcals/gram
Carbohydrates are the basic source of energy for the body
In general, carbohydrates (CHO) should always provide at
least 55% of total daily calorie (TDC) intake ideally 60-70% of
TDC
At meals, carbohydrates should take up 2/3 of your plate
Foods containing carbohydrates: bread, rice, pasta, cereals,
crackers, fruits, juices, vegetables, dried beans/peas, and
grains
The body converts sugars and starches to glucose for energy
or to glycogen for energy storage in the liver and muscles
When glycogen stores are full, excess carbohydrates are
converted to fat
While a high-carbohydrate diet is essential to good health in
all individuals, it is especially important to the athlete
50-60% of the athletes caloric intake should be from
carbohydrates to keep the glycogen stores filled
Carbohydrate loading (during pre-competition meals) is used
to generate extra glycogen and requires a carbohydrate
intake of 70-80%
Athlete recommendation is 5-10 g/kg/day or
2.7 to 4.5 g/lb/day
Endurance 5-10 g/kg/day
Strength 5-7 g/kg/day

uses CHO, fat,

protein, aerobic,
longer periods,
produces 38
ATP/glucose

PROTEIN
Protein is critical to growth and development especially
muscle and bones
General functions of protein
Function as enzymes to catalyse chemical reactions in the
body
Many hormones are proteins
Can be a source of energy
Yields approximately 4 kcals/gram
When carbohydrates and fats are not available (such
as in starvation) and during prolonged endurance
exercise
Used for building and repairing muscles, red blood cells, hair,
and other tissues

The use of energy system over the other depends on:

duration of physical activity
intensity of physical activity
frequency of exercise
type of physical activity
fitness level of the individual
nutrient intake and energy stores
ENERGY BALANCE
The objective of sports nutrition is to achieve energy balance,
which is achieved when energy expenditure equals energy
intake

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FAT

Used for energy when carbohydrates are not available

Proteins are derived from animal foods meat, milk, eggs,
fish, cheese, and poultry. Also, from soybeans, dry beans,
some nuts, and whole-grain products.
As stated earlier, proteins may be used by the body for
cellular energy, but proteins are the bodys least efficient
source of energy.
Recommended protein intakes can generally be met through
diet alone, without the use of protein or amino acid
supplements
Extra protein not needed by the body, is burned for energy or
stored as fat
The body cannot store protein
Protein intake should be approximately 10-12% of caloric
intake
The Dietary Reference Intake (DRI) for adults is 0.8 g/kg body
weight
Athlete recommendation is 1.2-1.7 g/kg or
0.5 to 0.8 g/lb/day
Endurance athletes
1.2 1.4 g/kg (1.2-1.5 g/kg)
Strength athletes
1.6 1.7 g/kg (1.5-1.7 g/kg)

Source of energy, fat-soluble vitamins, and essential fatty

acids
Yields 9 kcals/g (over twice carbohydrates and proteins)
General functions of fat
They carry vitamins A and D to cells, and are necessary for
normal growth and development
Fats insulate the body
They protect the body from the impact of injuries, and
shield the bodys organs
Add flavor to our food
Helps sustain prolonged exercise
Source of stored energy, burned mostly during low-level
activity, and when other sources are not available
Main sources include meats, eggs, milk, cheese, fried foods,
butter, margarine, salad dressings, oils, and mayonnaise
Healthier fat choices: nuts, seeds, olive oil, canola oil, fish,
avocados, and olives
Fats are necessary and important in our diet. Yet many
people consider fats to be a harmful nutrient
The problem is the fact that we often eat far more than
the daily recommended amount of fats (30% of our
caloric intake)
High-fat diets are associated with heart disease,
hypertension, and cancers
Fats are not digested as quickly as other nutrients
Fats are used when carbohydrate sources are depleted
High-fat diets are not recommended for athletes
Athele recommendation is 1.0-2.0 g/kg/day
CHO
CHON
FAT

B Vitamins
Two major functions related to exercise:
Involved in energy production
Thiamine, riboflavin, niacin, pyridoxine, pantothenic
acid, and biotin
Required for production of red blood cells, protein
synthesis, and in tissue repair and maintenance including
the CNS
Vitamin B12 and folate
Vitamin D
For adequate calcium absorption and bone health
Regulates development and homeostasis of the nervous
system and skeletal muscle
Athletes who train indoors
Recommended daily intake:
5 g/day or 200 IU (19-49 y/o)
Antioxidants: Vitamin C and E, -carotene, and Selenium
Because exercise can increase oxygen consumption, it has
been hypothesized that long-term exercise produces a
constant oxidative stress on muscles and other cells
Habitual exercise however has been shown to result in an
augmented antioxidant system
Should not exceed tolerable upper intake levels
Vitamin C is also needed for absorption of iron
MINERALS: Calcium, Iron, and Phosphorus
Minerals do not provide energy!
Minerals are inorganic substances and are known to have
functions essential to life
Calcium
Bone health, bone strength, muscle contraction, nerve
conduction, and normal blood clotting
Athletes need 1200-1500 mg of calcium per day
One serving from the dairy group has about 300 mg
calcium
Iron one of the most prevalent nutrient deficiencies
observed among athletes
Oxygen carrying proteins, haemoglobin and myoglobin
Enzymes involve in energy production
Women need 15 mg and men need 10 mg of iron each
day
Phosphorus
For bone health
Needed for strong bones and teeth
Sodium, Potassium, and Chloride
Particularly for athletes who sweat profusely

5-10 g/kg/day or 2.7 to 4.5 g/lb/day

1.2-1.7 g/kg or 0.5 to 0.8 g/lb/day
1.0-2.0 g/kg/day

VITAMINS AND MINERALS

Vitamins do not provide energy!
Vitamins are essential for maintaining good health
Needed to regulate processes in the body
Used to utilize energy from carbohydrates, protein, and
fat
A lack of vitamins in the diet leads to deficiency conditions,
which express themselves in a variety of ways
Most vitamins cannot be synthesized by the body and must
be ingested via foods or pills
No single food or food group will supply all the vitamins
needed by the body
A good reason to eat a variety of different foods
Vitamins are usually identified as either fat soluble or water
soluble

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Fat soluble vitamins (vitamins A, D, E, and K) are

emulsified and absorbed in the small intestines
These vitamins are stored in body cells. Especially
liver cells
Water soluble vitamins (B complex and vitamin C) are
absorbed along with water through the digestive tract
and dissolved in body fluids
The body doesnt store these vitamins well and
excess quantities are excreted in urine
Vitamin requirements do not increase during exercise
Available evidence does not justify supplementing the
diet of the athlete with vitamins to improve physical
performance unless a pre-existing vitamin deficiency
exists
Likewise, in athletes who do not choose nutrient dense
foods, supplementation may be suggested
Vitamins and minerals found to be of concern in athletes
diets:
Calcium
Vitamin D
B Vitamins
Iron
Zinc
Magnesium
Antioxidants such as Vitamin C, E, beta-carotene, and
selenium

Sodium, potassium, and chloride are important for

maintaining normal fluid balance in the body as well as in
generation of muscle impulses
Potassium regulates cardiac rhythm
Sodium loss in sweat outweighs potassium and chloride
loss
Loss of this electrolytes will cause cramping
Exercise does not seem to affect dietary needs of most
minerals with the exception of the effects of sweating
Heavy sweating may lead to excess losses of sodium,
chloride, and potassium
Losses of these minerals may affect performance
It is recommended that athletes involved in prolonged
activity, especially those who are considered salty
sweaters consume more salt in their meals before and
after activity
Generally, this added salt can easily be gained
through the salt added to foods and not through salt
pills

WATER
Water is often considered the most important nutrient
Failure to consume other nutrients will show harmful
effects on the body after several weeks or months but
humans can only survive without water for a few days!
General function of water
Provides an aqueous medium for chemical reactions to
occur and for transportation of its products
Provides a medium for transportation of oxygen,
hormones, nutrients, etc. throughout the body (i.e. the
blood)
Facilitates thermoregulation for the body (i.e. sweat)
Lubricates joints and cushions organs and tissues
In saliva and gastric secretions, water helps digest food
Note that a loss of fluid through exercise may have an effect
on these functions; many of which will affect performance
Dehydration loss of >2% body weight
Compromise aerobic performance and may impair
mental/cognitive performance heat stress
We dont rely on thirst mechanism but depends on a timely
basis in rehydration (we hydrate even not thirsty)

FLUID REPLACEMENT
Exercise increases water loss
During normal breathing, water is added to inspired air to
protect delicate respiratory cells from drying out
Increased breathing during exercise increase this loss
Heat production is a byproduct of muscle contraction
Increased muscle contraction during exercise
increases overall body heat forcing the body to
compensate through sweating
Athletes may lose up to 1 liter per hour
Water loss affects performance
Diminished water content in the blood causes:
Diminished capacity to transport oxygen and
nutrients to body cells
Diminished capacity to get rid of excess heat from
working muscles causing increased body temperature
o Body cells must have a consistent temperature
to function properly (homeostasis)
Loss of fluid causes cells to shrink (crenation) which
affects their normal function
Hydration Protocol
2 hours
before

2-3 cups

15 min
before

1-2 cups

Every 15 min
during

After activity

- 1 cup

At least 2
cups for each
pound of
body weight
lose

Monitoring hydration status

The bodys thirst mechanism lags behind dehydration
By the time you are thirsty, you are already dehydrated
Therefore, thirst is not a good indicator of hydration
There are a number of very expensive and time consuming
test to monitor hydration but this process can be
accomplished with relative ease
Urine color is a good indicator of hydration
Diet, supplementation, or medications, may affect
urine color
Weight loss that occurs during a single bout of exercise is
likely due to fluid loss
Changes in body weight can be used as a marker for
short term fluid loss
One liter of water weighs approximately 1 kg (2.2 lbs)
o If an athlete completes a hard workout lasting
approximately one hour and loses 2 kg of body
weight it can be assumed that approximately 2
liters of fluid have been lost
o Or just simply drink until the pre-workout weight
is reached

SPORTS DRINK
Help replenish lost sodium and glycogen stores
During heavy sweating, water is not the only element lost

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Electrolytes such as sodium, potassium, chloride, and

traces of some others are also lost
Of these, sodium is lost in the greatest abundance
During exercise of 2 hours or less the body is able to reabsorb
sodium loss
During exercise lasting less than two hours, the athlete
would need to pay more attention to fluid replacement to
address water loss through sweating than to sodium
replacement
Water works well as a fluid replacement beverage under
these conditions
During exercise lasting over 2 hours and in hot environments,
sodium loss in sweat occurs too rapidly for reabsorption to
occur and may also significantly decrease glycogen stores
(stored glucose)
Sports drinks may be a good option for fluid replacement
during exercise lasting over 2 hours and for exercising in
the heat
Sports drinks may help to replenish lost sodium and
glycogen stores
Sodium replacement and maintaining hydration
during exercise may help to reduce muscle cramping
during exercise especially in salty and heavy sweaters
o One cause of muscle cramping is an electrolyte
imbalance caused from fluid and sodium loss
from sweating
o It should be noted that another cause of muscle
cramping is muscle fatigue
There are many types of sports drinks to choose from and
choosing one over another is up to each individual
However, there is a proper proportion of the chemicals in
the drink in order to optimize performance and limit any
detrimental effects
Guidelines in choosing sports drink
6-8% carbohydrates is recommended
Less likely to induce gastric distress
o Due to slowed gastric emptying in most
individuals
Water absorption is maximized
Sodium content of 460-690 mg/L
Replace loss
Encourage drinking
o Since sodium tends to induce thirst
Cold drink is preferable because it attenuates changes in core
temperature and peripheral blood flow, decreases sweat
rate, and speeds up gastric emptying time
Example of a sports drink recipe
1 quart or 1 liter water
1/3 cup sugar
teaspoon table salt
Flavor to taste use orange juice, lemon juice, etc.
Keep refrigerated

Fluid replacement strategies

Pre-hydration should begin at least 4 hours before
competition
Recommended is 5-7 mL/kg (5-10 mL/kg or 2-3 mL/lb)
Ex: a 50 kg (110 lb) female would drink 250-350 mL
(8-12 oz or 1-1 cups)
This recommendation assumes the athlete is in a
hydrated state at the time
It should be noted that water is sufficient, however,
sodium stimulates thirst and retention of body water so a
beverage that contains sodium may be beneficial
Pre-hydration should be determined on an individual
basis and by trial and error to determine the appropriate
amount for each individual
Too little may lead to dehydration during competition
and therefore, decreased performance
Too much may leave the athlete feeling bloated and
cause too frequent urine brakes that may interfere
with pregame activities
Hydration during activity
it is generally recommended that an athlete drink 6-12 oz
of fluid every 15-20 minutes
Small amounts taken frequently are tolerated best by
most athletes and leads to more effective gastric
emptying
Hydration needs during activity is highly individual
and routines should be established well before
competition to avoid introducing a new routine
during competition
Cool beverages are tolerated best although studies do not
show that temperature influences gastric emptying
Free access to water before, during, and after activity should
be encouraged

Before Exercise
At least 4 hours
before
5-7 ml/kg body
weight (2-3
ml/lb)

During Exercise
To avert
dehydration
Dependent on
sweat rate,
exercise
duration, and
opportunities to
drink
6-12 oz every
15-20 min. (not
more than 1
cup)

Athletes should be encouraged to consume enough

fluid to match fluid loss and prevent dehydration
while not exceeding the amount of fluid lost
Replacing sodium loss 0.5 to 0.7 g/L
NUTRITION BEFORE, DURING, AND AFTER EXERCISE
PRE-EXERCISE OR PRE-GAME MEAL
Purpose:
To help prevent hypoglycaemia
Symptoms: light-headedness, needless fatigue,
blurred vision, and indecisiveness all of which can
interfere with performance
To help settle the stomach absorb some of the gastric
juices, and decrease hunger
To fuel muscles, both with food eaten in advance that is
stored as glycogen, and with food eaten within an hour
To pacify the mind with the knowledge that the body is
well fuelled
Characteristics of a Pre-game Meal
Meal or snack should provide sufficient fluid to maintain
hydration
fat and fiber to facilitate gastric emptying and minimize
gastrointestinal distress
carbohydrate to maximize maintenance of blood glucose
Moderate in protein
Composed of familiar foods
Well tolerated by the athlete
Sports nutrition for performance benefits must begin day in
advance
Every day, eat adequate high-carbohydrate meals to fuel
and refuel your muscles so they will be ready for action
Food eaten within an hour before exercise primarily
decreases hunger and maintains blood sugar
o It doesnt significantly replenish muscle glycogen
stores
When exercising for more than 1 hour (60-90 mins.),
carbohydrates which slowly enter the bloodstream as they
are digested (low glycemic index) such as rice, pasta, yoghut,
oatmeal, bean soup, lentils, apples, or bananas are ideal
When eaten an hour before exercise, these slow
carbohydrates will be digested enough to be burned for
fuel, and then will continue to provide sustained energy
during long workout
When exercising for less than an hour, snacking on any triedand-tested foods that digest easily and settle comfortably is
satisfactory.
Bread, English muffins, bagels, crackers, and pasta are a
few of the most popular high-carb, low-fat choices
Limit high-fat proteins like cheese, streak, hamburgers, and
peanut butter
they take longer to empty from the stomach because the
fat delays gastric emptying
may cause sluggishness and nausea
Be cautious with sugary foods (such as soft drinks, jelly beans,
and even lots of maple syrup or sports drinks) or
carbohydrates that quickly enter the bloodstream as they are
digested (potato, honey, or corn flakes) postprandial
hypoglycaemia
Many athletes who eat these foods within 15-120
minutes before hard exercise can experience a drop in
blood sugar that leaves them feeling tired, light-headed,
and needlessly fatigued
Experiment and learn how your body responds
Allow adequate time for food to digest
Remember that high calorie meals take longer to leave
the stomach than do lighter snacks
The general rule of thumb is to allow at least 3-4 hours
for a large meal to digest, 2-3 hours for a smaller meal, 12 hours for a blended or liquid meal, and less than an
hour for a small snack, according to your own tolerance
Some athletes can comfortable eat before they exercise,
but others prefer to abstain. Both sports perform well,
and both have simply learned how to best fuel their
bodies

After Exercise
Recovery from
dehydration
16-24 oz (450675 ml) of fluid
for every pound
of body weight
lost

HYPONATREMIA
A potentially serious medical complication that may occur in
endurance athletes during prolonged exercise such as
ultramarathons or triathlons
Events lasting 4 hours or more and is more common in
heat and high humidity
Occurs when plasma sodium concentration falls below
normal (130 mEq/L)
Sodium plays a vital role in maintaining normal fluid balance
throughout the body
Low sodium level in the extracellular compartment
causes fluid to move into cells causing them to swell
This is particularly important in nerve cells which require
sodium in proper proportions in order for nerve
conduction to occur
Causes:
Excessive sodium loss due to heavy sweating
Overconsumption of hypotonic fluids (water)
Signs and symptoms:
Dizziness, confusion, lethargy, seizure, loss of
consciousness or coma, and death
Prevention: for events lasting over 3 hours replace sodium
loss through use of fluids containing sodium or eating salty
foods
Matching amount of sweat lost

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 It should be noted that exercise increases blood flow to

working muscles and away from digestive organs
This can cause stomach irritation if a large meal is
eaten just prior to exercise
Always eat familiar foods before a completion
Dont try anything new!
New foods always carry the risk of settling poorly; causing
intestinal discomfort, acid stomach, heartburn, or cramps
Drink plenty of fluids

Carbohydrate Loading
The purpose of carbohydrates loading is to supercompensate for glycogen depletion in an effort to store the
maximum amount of glycogen possible prior to an event
Athletes who may benefit from the strategy:
Endurance athletes whose events last for more than 90
minutes
Examples: long-distance runners, swimmers,
bicyclists, and cross-country skiers
Athletes involved in sports that require prolonged
movement of varying intensities
Examples: soccer, lacrosse, and ice hockey
Athletes who participate in tournament sports such as
tennis
The most accepted protocol is a 6 day cycle
Phase 1 depletion phase
The athlete participates in 3 days of high intensity
training to deplete glycogen stores
o The first day should be 90 minutes of intense
training
o Followed by 2 days of 40 minutes of intense
training
Carbohydrate intake during this phase should be
5 g/kg/day the minimum amount recommended to
athletes in training
Phase 2 repletion phase
Intensity of training is tapered over the next 3 days
Carbohydrate intake increases to 10 g/kg/day
This is followed by 1 day of rest
Some side effects may occur
During, carbo-loading, the athletes weight should
increase by 1-3 pounds, since water is stored with
glycogen
This may not be tolerated well by some athletes who
may feel sluggish and heavy
Eating too many carbohydrates can lead to intestinal
distress
Choose wholesome, fiber-rich carbohydrates
to keep your system running smoothly
pasta, rice, bran muffins, whole wheat bread, cran
cereals, fruits, and vegetables are good choices

DURING EXERCISE
Important for endurance events lasting longer than an hour
when an athlete has not consumed adequate food or fluid
before exercise, or if an athlete is exercising in an extreme
environment (e.g. heat, cold, or high altitude)
Rationale:
replace fluid losses
provide carbohydrates for maintenance of blood glucose
levels
provide needed sodium lost during heavy sweating
Recommended intake:
Events lasting more than one hour or less: 6-8% CHO in
sports drink
Events longer than one hour: 0.7g CHO/kg body
weight/hr or 30 to 60 g per hour
Sodium: 0.5 0.7 g/L of fluid lost
Fluid as much as sweat rate or approximately 1 cup every
15-20 min.

POST-EXERCISE/RECOVERY MEAL
What you eat after a hard workout or competition does affect
your recovery
Foods eaten after exercise or competition require the same
careful selections as the meal before exercise
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Competitive athletes who are engaged in2 or more workouts

per day must be especially concerned about recovery diet
such as:
Football player at training camp
Competitive swimmers who compete in multiple events
per meet
Triathletes who train twice per day
Aerobics instructors who teaches several classes daily
Basketball players who needs to endure the entire season
of intense training and competing
Athletes commonly have reasons to eat inadequately after
exercise, including that they dont feel hungry and dont have
time
Provide adequate fluids, electrolytes, energy, and
carbohydrates
Replace muscle glycogen and ensure rapid recovery
RECOVERY CARBOHYDRATE:
1.0 to 1.5 g/kg (0.5-0.7 g/lb) body weight
(0.75-1.5 g/kg body weight in the handout)
Ex: a 176 lb athletes should consume approximately
120 g of carbohydrates
o This could easily be achieved with a banana, 10
oz of sports drink, and a bagel
o Consumption of carbohydrates in smaller, more
frequent meals appears to further aid the rate at
which muscle glycogen is replaced in the hours
after exercise
- With larger meals, blood glucose and insulin
rise rapidly and then return to baseline
relatively quickly
- Blood glucose levels can be sustained for a
longer period of time with smaller meals
Ideally, carbohydrate-rich foods and beverages should be
consumed within 1st 30 minutes (15-30 minutes in the
handout) after a workout and again every 2 hours for 4
to 6 hours
This is when the enzymes responsible for making
glycogen are most active and will mostly rapidly
replace the depleted glycogen stores
Liquids and solid foods will refuel muscles equally well
Glucose rather than fructose is the preferred substrate
Studies show fructose does not result in glycogen
synthesis rates that are as high as those with glucose
Solid foods should have a high glycemic index (causes a
rapid rise in blood glucose levels)
These are most effective in enhancing the resynthesis
of glycogen
Ex: white bread, corn flakes, baked potatoes, white
rice, pancakes, bagels
Many energy bards have a high glycemic index
RECOVERY PROTEIN:
Protein intake after exercise is important for muscle
anabolism
Provide amino acids for building and repair of muscle
tissue
6 g immediately after exercise (0.1 g/kg body weight)
Good examples of proteins are:
Yogurt with fruit in the bottom
Chocolate milk
Turkey sandwich
Some protein can actually enhance glycogen replacement
in the initial hours after hard exercise
Protein eaten along with carbohydrates is recommended
RECOVERY ELECTROLYTES
Sweating not only causes water loss but also some
minerals (electrolytes) such as potassium and sodium that
help the body function normally
Electrolytes losses are primarily responsible for muscle
cramping and intolerance to heat
Most athletes should be able to consume more than
enough electrolytes from standard post-exercise foods
Salt tablets or special supplements are rarely needed

WEIGHT MANAGEMENT

o May underestimate body fat by 2-3%

Dual X-ray Absorptiometry (DXA)
o Originally developed to assess bone mineral
o Fairly accurate, quick and non-invasive
o Cost and accessibility limits its use in practice
LEVEL III DOUBLY INDIRECT ASSESSMENT
Skinfold Calipers
o Makes use of large pinchers that measure
thickness of the fat layer on specific body sites
abdomen, biceps, triceps, subscapula,
supraspinale, medial calf, and front thigh
o Method of choice because of its convenience
and because its relatively inexpensive
Bioelectrical impedance analysis (BIA)
o An imperceptible electrical current is sent
through the body which flows up one leg and
down the other
o Based on the principle that an electrical signal is
more easily conducted through lean tissue than
fat or bone
o Fat mass is estimated by subtracting the BIAdetermined estimate of FFM from total body
mass
o Hydration status affects result
All methods for body fat measurement have potential errors

BODY COMPOSITION
Refers to all of the components that make up the body
Divided into 2 main categories:
Fat mass
Fat-free or lean body mass
Includes muscle, bone, fluids, and organs
Most athletes are interested in the ratio of fat mass to
total body mass which is commonly expressed as percent
body fat
Essential fat is the minimum amount of fat necessary for
proper physiological function

Description
Essential fat
Athletes
Fitness
Average
Obese

Women
10-13 %
14-18 %
19-23 %
24-29 %
36 %

Men
2-5 %
6-11 %
12-16%
17-23 %
29+ %

Essential fat for males = 3% of body weight

Essential fat for females = 12% of body weight
Of this 12% approximately 9% is considered sexspecific fat
o this is fat needed for proper hormonal and
reproductive functions
Body composition that drops below these levels
interferes with normal body function
Body Fat norms are as follows
Females
Males
<13
caution
<5
14-18
excellent
6-11
19-23
good
12-16
24-29
average
17-23
30-36
overfat
24-29
>36
obese
>29

WEIGHT GAIN STRATEGIES

Weight gain should be achieved through a gradual increase in
energy intake
Theoretically, in order to gain 1 pound of body weight per
week, the consumption of an additional 500 calories per day
is needed
The extra calories should primarily come from extra
carbohydrates
Carbohydrates fuel muscle so the muscles can
perform intense muscle-building exercise
Energy coming from fat should not exceed more than
30%
Increased protein intake is likewise recommended
Daily increase of 14 grams per day
To provide necessary amino acids for muscle growth
To date, research indicates that protein powders and amino
acid supplements are a fruitless expense when it comes to
gaining muscle weight
The only reason some athletes may see results from
these is likely due to the additional calories
Weight is most likely gained if larger-than-normal meals are
consumed
Finding the time to eat can be the biggest challenge to
boosting caloric intake
Pack portable snacks
Eat frequently throughout the day
Eat larger than normal portions at mealtime
Eat higher calorie foods
Taking the prescribed 500-1000 additional calories per day
should cause some weight gain
It is vital to include muscle-building resistance exercise
(weight workouts) to promote muscular growth rather
than just fat deposits

Three levels of assessment techniques are used to assess

body composition:
LEVEL I DIRECT ASSESSMENT
Based on analysis of cadavers
Not used in clinical practice
LEVEL II INDIRECT ASSESSMENTS
Hydrostatic (underwater: weighing)
o Traditionally considered as the most accurate
method
o The subject exhales and is weighed while
submerged in a tank of water
o Measures body density which is then translated
mathematically into percent body fat
Plethysmography (Bod Pod)
o Measures displacement of air to determine body
volume
o Once body volume is determined, body density
can be calculated and body fat estimated
o The subject sits in an air-tight enclosure while
amount of air displaced is sensed by a special
diaphragm and pressure transducer

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It is recommended to have body fat routinely measured,

to be sure that weight gain is mostly muscle, not fat

WEIGHT LOSS STRATEGIES

Understanding body composition is an important component
of weight loss
Muscle weighs more than fat
When an individual begins an exercise program in an
effort to lose weight he or she may find that the scale
is not showing significant weight loss however, it is
likely that body composition is changing (fat may be
decreasing while muscle is increasing)
For this reason some form of body composition analysis
should be utilized rather that body weight itself
Body fat is stored energy
In order to decrease body fat, one must burn more
calories that he or she eats which forces the body to use
these energy stores (fat) eat less and exercise more
It should be noted that every human body is different and
fat is stored at different rates for each person
Storing fat can be affected by genetics, health, etc
Theoretically, 1 lb per week should be lost if 500 fewer
calories per day is eaten
It is recommended that only 1-2 pounds per week be lost
for safety reasons
To lost weight healthfully, and successfully keep it off pay
attention to dietary habits
Pay attention to the quantity of food eaten
Pay attention to when food is eaten (eat big breakfasts,
rather than big dinners)
Pay attention to why food is eaten
i.e. boredom, stress loneliness, or actually hungry
Studies show that eating 5-6 small meals per day is an
effective method to loose body fat
Eat slowly the brain needs about 20 minutes to receive the
signal that food has been eaten
No matter how much food is consumed during those 20
minutes, the satiety signal doesnt move any faster
Exercise regularly but not overdo it
Moderate intensity can be sustained longer and to
ensure fats are mobilized and not carbohydrates
Too much exercise may lead to injury, fatigue, and
irritability
Exercise will be more satisfying when it is for fun and
fitness, not for simply burning off calories
Crash diets never work
Weight loss fads are common in todays world
These technique usually focus on restriction of calorie
intake and usually have an individual eating foods that
vary from their usual choices
Such diets are unsuccessful because losing body fat and
keeping it off requires a behaviour change that can
continue throughout the persons life!
These diets can actually cause long term weight gain
because caloric restriction causes the body to slow its
metabolism in an effort to save the calories that are
available
This means that the body will burn less calories day to
day than normal
These fads are dangerous and can cause problems such
as hair loss, weakened immune system, pH imbalances,
and sudden death
Weight loss should be done only during off season

ERGOGENIC AIDS

Any substance (or food) that is believed to enhance ones

performance above normal standards.
The IOC definition: The administration or use of substances
in any form alien to the body or of physiological substances in
abnormal amounts and with abnormal methods by health
persons with the exclusive aim of attaining an artificial and
unfair increase in performance in sports.
The use of these substances and practices is controversial.
There is great concern about the number of athletes engaging
in the use of ergogenic aids.
Drug testing has been instituted in many sporting
programs in order to help curtail the use of these
substances
Because of ethical violations associated that can result, use of
these substances cannot be condoned!

COMMON ERGOGENIC AIDS

Ergogenic aids that perform as claimed
Ergogenic aid
Creatine

Caffeine

RAPID WEIGHT LOSS IN SPORTS

Some sports dictate that athletes make changes in body
weight and composition that may not be best for the
individual athlete
Sports that have weight categories because differences in
body size make it impossible for all athletes to fairly
compete among one another
Examples include wrestling, boxing, martial arts, and
lightweight rowing
Body-conscious sports where physical appearance may be
judged

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Examples include gymnastics, figure skating, horse

racing, and cheerleading
With extreme energy restrictions, losses of both muscle and
fat mass may adversely influence an athletes performance
Weight loss tactics include calorie restrictions, excessive
exercise, fluid restriction, or a combination (exercising in
rubber suits, spitting in a cup, etc)
These tactics have serious risks and should never be
condoned
Most health risks are associated with prolonged energy
deprivation or dehydration
There are several documented cases of deaths due to
these tactics
Other side effects include frequent nose bleeds,
headache, dizziness, nausea, etc
Studies are also showing that the weight cycling of
these athletes is leading to lowered metabolic rate as
aging occurs and an increase likelihood of being
overweight later on in life
Many states are implementing rules to limit such tactics
in order to create a safer environment for the athletes
In 2006 the National Federation of State High School
Associations instituted rule changes that include:
o A body fat assessment no lower than 7% in
males and 12% in females
o A monitored weight-loss program that does not
exceed 1.5% loss of body weight per week
o A specific gravity of urine not to exceed 1.025

Sodium
Bicarbonate

Protein and
Amino Acid
Supplements

Pros*
Widely used.
Build muscle
and enhance
recovery.
Effective in high
intensity activity
in sports.
Not for
endurance
sports such as
distance
running.
Central nervous
system
stimulant.

Cons
The effects of longterm use of creatine
remain unknown.

Remarks
Screening of liver
or kidney
dysfunction.

Diuretic.
Anxiety.
Rapid heartbeat.
Gastrointestinal
distress
Diarrhea.

Athlete should
drink a lot of
fluid.

Effective as a
blood buffer
(role in acidbase balance
and prevention
of fatigue).
Protein and amino acid supplements are no more or no less
effective than food when energy is adequate for gaining lean
body mass.

Creatinine
The most widely used ergogenic aid among athletes wanting
to build muscle and enhance recovery
Shown to be effective in repeated short bursts of highintensity activity in sports that derive energy primarily from
the ATP-CP energy system
Adverse effects: cramping, weight gain, nausea, and diarrhea
Caffeine
Ergogenic effects may be closely related to its role as a CNS
stimulant and the decreased perception of effort
Still a restrictive substance by the NCAA
Positive doping test would be caffeine level >15 g/mL of
urine
Adverse effects: anxiety, jitteriness, rapid heartbeat, GI
distress, and insomnia
Sports drinks, gels, and bars
Used as convenient dietary supplements or ergogenic aids for
busy athletes and active people
Sodium bicarbonate
May be an effective ergogenic aid as a blood buffer (acid-base
balance and prevention of fatigue)
Side effect: diarrhea
Protein and amino acid supplements
Current evidence indicates that protein and amino acid
supplements are no more or no less effective than food when
energy is adequate for gaining lean body mass
Potential source of illegal substances such as nandrolone
Ergogenic aids that may perform as claimed but for which there is
insufficient evidence
Glutamine
Boosts immunity and for muscle building
-hydroxymethylbutyrate
Anticatabolic enhances recovery by stimulating protein
and glycogen synthesis
Colostrum
Ribose
Ergogenic aids that do not perform as claimed
Majority of ergogenic aids currently in the market fall in this
category
Examples:
amino acids
bee pollen
branched chain amino acids
carnitine
chromium picolinate
cordyceps
coenzyme Q10
conjugated linoleic acid
cytochrome C
dihydroxyacetone
-oryzanol
ginseng
inosine
medium-chain triglycerides
pyruvate
oxygenated water
vanadium

Source:
Dra. Tapangs PPT, lecture and handout

Ergogenic aid that are dangerous, banned, or illegal

Banned by WADA
Examples:
androstenedione
dehydroepiandrostrone
19-norandrostenedione
19-norandrostenediol
androgenic steroids
Tribulus terrestris
ephedra
strychnine
human growth hormone
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HELLO milove. ;)