Kids and Sports Drinks

Dr. Kevin Mercado, DC, CSCS, NSCA-CPT www.drkevinmercado.com

QUESTION
Water vs Sports Drinks Why?

Types of Sports Drinks

Gatorade Powerade Accelerade Propel Vitamin Water

Gatorade
G- Series
Prime: Pre-Game
15 minutes before exercise

Perform: During
Sodium; Potassium; Carbohydrates to sustain

Recover: Post Game

Protein; Carbohydrates; Electrolytes

The Bottle

THE LABEL: Perform

G Series G2 Series

Reading a Sports Drink Label

Electrolytes
Sodium: 110 mg
Half of it is found outside of cells; 15% inside cells Electrolyte for the function of muscle and nerve Glucose Absorption Regulate blood volume and is related to blood pressure
Food sources: meats; most processed or preserved foods; table salt

Sodium Gatorade Statement

A sodium

level of about 100-110 mg per 8 oz enhances the taste, optimizes absorption, and maintains body fluids. Diluted juices are severely lacking in this area. Generally speaking, the lower sodium levels in water and some sports drinks (e.g., Powerade and AllSport) may not stimulate voluntary drinking or help maintain fluid balance as does the higher sodium content in other sports drinks.

Potassium K+
30 mg Found primarily inside cells especially that of nerve and muscle Electrolyte for function of nerve and muscle Required for protein synthesis

Potassium contd
Other Health Benefits: 4.7 g to lower blood pressure, blunt the effects of Na, and reduce the risk of kidney stones. Most American women 31-50 years consume no more than half of the recommended amount of K+ and Mens intake is only moderately higher. Food Sources: Veggies, Fruits, Dairy Products, Meats & Broth Chloride -Table Salt; Drinking water -Food digestion

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Adult Recommendations
Daily
1.5 g of Na 4.7 g K+ 2.3 g of Cl 3.8 g of Na to replace amount lost thru sweat UL (upper level) for Na is 5.8 90% of American Men and 75% of American Women regularly consume salt in excess of the UL.

Carbohydrates
MONOSACCHARIDES
CARBOHYDRATES: Word derives from biochemistry make up:

Compounds of Carbon and Water.

SIMPLE SUGARS
---Simplest form that cannot be broken down to smaller

sugars by digestion ---Can absorb directly 6-Carbon Carbohydrates H --D-Glucose : O=C-C-C-C-C-C-CH2O2 --Galactose H --Mannose --Fructose

Disaccharides
Disaccharides: 2 monosaccharides linked together. Polysaccharides: COMPLEX SUGARS ---At least 3 monosaccharides ---Starch: Grains ; Cereals; Flours; breads, pastas, pastries ---Glycogen: aka Animal Starch; Stored glucose primarily in muscle and liver

Glucose-Sugars

FOODS

GRAPES ORANGES FRUIT JUICES BERRIES PEARS CORN CARROTS HONEY CORNSYRUP MAPLE SYRUP SPORTS DRINKS Products of di and polysaccharides

CALORIES= ENERGY
#2 Providing Energy
1 Gram of CHO generates 4 calories 14 G x 4 kcals= 56 units of Energy

ENERGY SYSTEMS
ATP-Adenosine TriPhosphate PC-Phospahte Creatine LA-Lactic Acid Aerobic ATP derives from
Blood glucose Muscle Glycogen

Energy Systems
Anaerobic (ATP-CP)
ATP Stores in muscle last for 2 seconds ATP resynthesized of ATP from CP will continue for 4-5 seconds (until CP stores are depleted) Gives us around 5-7 seconds of ATP production Athletes demand a rapid available supply of ATP Activity Examples: Power Lift High Jump Javelin Throw Golf Swing

Glycolytic System
CP stores depleted > body resorts to stored glucose for ATP Glucose utilization leads to lactate production and hydrogen ions production. Increase of hydrogen ions is what causes fatigue in runs of 300m-800m or < 2 minutes.

Energy Pathways vs Time

DURATION 1-4 Seconds 4-20 seconds 20-45 seconds 45-120 seconds 2-4 minutes 4-6 minutes Classification Anaerobic Anaerobic Anaerobic Anaerobic Anaerobic Anaerobic Energy Supplied By ATP ( in muscles) ATP + PC ATP + PC + Muscle Glycogen Muscle Glycogen Muscle Glycogen+Lactic Acid Muscle Glycogen+Fatty Acid

What is G afraid of?

A decreasing amount of energy

Are we concerned?
Why Not? Adequate Meals Not enough sodium in a sports drink to optimize post exercise fluid replacement: Athletes can rehydrate with a sodium containing meal.

The electrolytes provided in a sports drink usually isnt enough to provide complete replenishment. An adequate post recovery meal should be sufficient. The body is provided with enough sugars from a pregame meal as long as the diet is sufficient to provide them.

 There is little physiological need to replace electrolytes during a single exercise session of moderate duration (eg, less than 3-4 hours) particularly if sodium was present in the previous meal. However including sodium in amounts between .5g-.7g is recommended during exercise lasting longer than 1 hour because it may enhance palatability and the drive to drink. It should be noted that this amount of sodium exceeds the typically available in commercial beverages.

ACSM, ADA and Dieticians of Canada Position Stand: Nutrition & Athletic Performance (2000). Medicine and Science in Sports & Exercise (32(12)2130-2145

 Pediatric athletes can benefit from using sports drinks that contain carbohydrates, protein, or electrolytes2; however, for the average child engaged in routine physical activity, the use of sports drinks in place of water on the sports field or in the school lunchroom is generally unnecessary.
Committee on Nutrition and the Council on Sports Medicine and Fitness American Academy of Pediatrics PEDIATRICS Vol. 127 No. 6 June 2011, pp. 1182-1189 (doi:10.1542/peds.20110965)

Eat Your Water for Health, Sports, and Weight Control: Physical Activity and Hydration
For every pound lost, 16 to 24 additional ounces of water should be consumed routinely during exercise of similar duration and intensity as the test period.[11] Because of the electrolyte losses that occur with sweat loss, the IOM recommends that individuals performing prolonged activity (ie, >1 hour in duration) and/or in hot weather consume sports beverages, which contain a combination of sodium, potassium, and carbohydrates.[11] Sodium and potassium replace sweat electrolyte losses, and the sodium has an added benefit of stimulating the thirst response; carbohydrate provides energy for sustained physical activity.[11] Such beverages should not contain more than 15 to 18 g of carbohydrate per cup since consuming more carbohydrate during exercise may cause cramping, nausea, and diarrhea because concentrated beverage can delay gastric emptying.

Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts

Victoria J. Vieira Potter, PhD, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, 711 Washington St, Boston, MA 02111;

Exercise

Meal Products/Goal of Exercise Low in Fat Low in Fiber High in Cho Mod PRO Well Tolerated Maintain energy

Pre Game

In Game

Post Game

CHO PRO Fat

Sports Drinks
Benefits: recommended during exercise lasting longer than 1 hour. Why?
A sports drink with Na may help to increase palatability and the drive to drink, therefore increasing the amount of fluid consumed. Maintains proper fluid balance increasing desire to drink. Na may decrease urine production. Body has enough stored sugar for performance.

Gastric Emptying
Fluids must be emptied from stomach before absorption into small intestine. Factors:
()Fluid Temp ( Cold Water) ()Fluid Volume(8.5 oz /15 min.) () Fluid Osmolarity

Functions of Water
Food Digestion Transports Nutrients, O2, metabolic wastes, and hormones Storage of Nutrients Medium for Enzyme Reactions Body Temperature Regulations Lubricant for joints Bowel Movement Appearance and Skin Health Source of Minerals

Daily Requirement
Factors Men
3.7 Liters

Women
2.7Liters **80 % should come from Fluids; 20% from foods Age Level of Activity Hormones Environment

Deficiency
Food Ingestion, Digestion, and Absorption Body Fluid Circulation Body Temperature Regulation Constipation Metabolism Reduction

Dehydration: Symptoms
Dry Sticky Mouth Continued thirst Headache Dizziness Cramps Excessive Fatigue

Risk Factors
Wears clothing or protective gear Rarely Exercises Overweight or Obese Is sick or had a recent illness (vomiting, diarrhea, fever) Certain medicines or supplements Previous heat related illness Medical condition (diabetes) Isnt well rested

Consequences of Dehydration
Heat Disorders
Heat Cramps Heat Exhaustion Heat Stroke

Cause
Prolonged exertion in heat; Negative Na

Symptom
Tightening Cramps

Prevention
Salt Acclimatization Hydration before & during exercise Water Minerals acclimatization

Cumulative Negative Extreme Fatigue Water Loss Flushed Skin Extreme Hyperthermia; Circulation failure Extreme high fever Lack of sweat Neurological Failure

Fluid Replacement
To maintain plasma volume so that circulation and sweating progress at optimal levels.
Fluid Requirement During Prolonged Exercise and Competition Timing /Event Length 2-3 hours before event Fluid Requirement 400-600ml (14-22 oz) Type of Fluid Water

Immediately Before Event

During Event up to 60 mins Event lasting>60 mins

500ml (16 oz)

6-12 oz every 15-20 mins 6-12 oz every 15 mins

Water
Water Fluid with <8% CHO concentration. Fluid with 500-700mg Na/L for event> 3 hours (or consume salt with food.)

**Commercial Sports Drinks contain 55-110mg Na/L

ACSM, ADA and Dieticians of Canada Position Stand: Nutrition & Athletic Performance (2000). Medicine and Science in Sports & Exercise (32(12)2130-2145

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Drink Water the Night before Drink water 2-3 hours before event Encourage your child to drink Even if they are not thirsty To ensure they are adequately hydrated check Urine Color: no color tinge (clear urine) adequately hydrated Especially important for days that are hot/humid and for long endurance events

References
1. Biochemical Nutrition: David C. Lin;Ph.D, FACN, CN; 2004 2. Katz, David L; Nutrition in Clinical Practice 2001: Lippencott, Williams and Wilkins Clinical Nutrition; Debra Kettler; 2005 http://aappolicy.aappublications.org/cgi/content/full/pediatrics;127/6/11 82 http://www.mayoclinic.com/health/dehydration/SM00037 http://www.medscape.com/viewarticle/747332_3