final

Question 1

Identify key acute nutrition concerns for endurance athletes including fueling pre, during and post training / events

Answer 1

Pre: 24 hrs pre event: moderate fibre intake - may avoid altogether. Avoid dehydration, aspirin and NSAIDs, foods and drinks high in fructose. Awareness of GI distress. Dietary CHO intake increases to 10-12 g/kg/d. Mix of high and low fibre foods.
During: during endurance exercise indl stop and start sports 1-2.5 h, 30-60 g/h. During ultra endurance exercise <2.5-3 hrs - up to 90 g/h. Dehydration and sport: try to keep BW losses to no more than 2-3%. Calculate BW loss during exercise; (body weight loss / starting BW) * 100. Drink that contains some sodium, drink 100-200mls every 15 mins (unless individual sweat rate overrides this). Cool drinks recommended. Flavored, multiple carbs eg glucose/maltodextrin, fructose mix. Choose a drink of appropriate tonicity.
Post: Replace fluids and fuels lost after exercise. Restore body temp and regular CV function. Repair damaged tissue. To allow for timely optimal performance in the next training session or competitive event.

Question 2

Functions of iron:

Answer 2

Essential component of hemoglobin and myoglobin
Cytochromes in the EEC contain hemeproteins
Essential cofactor in many enzymatic reactions
Required for a healthy immune system

Question 3

1. Know the ABCDE approach to nutrition assessment

Answer 3

Anthropometry: height, weight (incl history in last 12mo), age, gender, BMI
Biochemistry: bloodwork eg iron, B12, Vit D. Hydration testing
Clinical: medical eg diabetes, GI illness, frequent colds, asthma, allergies, stress fracture history, ED, menstrual cycle history and BC use, sleep
Dietary: nutrition intake around training, rest days, comp day, offseason and alcohol. Avoid any major food groups? supplements/health
Food environment: living with? Who does shopping and cooking? Nutrition skills and awareness

Question 4

2. Identify key acute and chronic nutrition concerns for strength - power and intermittent sport athletes

Answer 4

Chronic: carb modification, protein requirements, optimal body composition including off season, supplement edu and periodization
Acute: treatment nutrition

Question 5

3. Discuss strategies for weight loss and weight gain

Answer 5

Goal setting
Give athlete the nutrition parameters; let them set the action
Limit changes: 3-5 requests, manage expectations: what is realistic change/good progress given timeframe
Timely review + next steps
Protein reqs
1.2 - 2 g/kg/ day advised
Space out throughout day (0.3-0.4 g/kg every 3 hours)
Consume protein in close proximity to exercise
Protein rich snack at night (preferably casein rich)
Carb considerations
S/P exercise can deplete muscle glycogen but not to the same degree as endurance exercise
Resistance exercise: multiple set resistance exercise to fatigue = 25-40% decor in total muscle glycogen
Single sprint exercise : since 6 sec bout of all out cycle : 14% decor, 30 s cycling sprint: 27% decr
Repeated sprints: two 30 s sprints: 47% in total muscle glycogen
Muscle glycogen is depleted more rapidly from type II than from tupe I fibers during high intensity exercise
Moderate intakes (5-7g/kg) suggested in most cases to support training
Gaining lean tissue - recommendations: track intake for 3 days. Have a recovery food or bevg after every workout. Add one extra meal or two extra snacks every day, eat until full and every 2-3 hrs. Avoid or limit alcohol. Supplementation may support goals eg creatine. Set realistic goals. Get enough sleep
Losing BF: track intake for 3 days. Eat high protein breakfast. Reduce portions sizes of energy dense carbs and fats. Incl protein (energy deficit: as high as 2.4 g/kg) and veggies every meal. Snack smarter. Choose drinks wisely.

Question 6

4. Discuss team sport game day considerations

Answer 6

Glycogen stores quadriceps femoris - pre; 96 mmol/kg ww, halftime; 32 mmol, end: 9 mmol
Players w greater starting high muscle glycogen covered a greater distance and spent more of the total time completing high intensity runs (27% vs 15%) v those players who began the match with low muscle glycogen.

Question 7

5. Discuss the effects of alcohol on athletic performance

Answer 7

High in energy - implications for higher BF. affect appetite. In recovery - affect muscle protein synthesis. Association with dehydration (decr anti diuretic hormone) and cramp. Less REM sleep.

Question 8

1. Be aware of the different sports where “making weight” is a focus

Answer 8

Boxing, rowing, horse racing, wrestling, martial arts

Question 9

2. List and explain the consequences of acute weight loss

Answer 9

ACUTE:
Decor aerobic exercise capacity
Plasma volume loss - susceptibility to heat illness
Impaired cognitive function
Increased RPE
Reduced bone remodeling (>3 days restriction)
Electrolyte imbalances (hospitalization)
Decr glycogen = reduction in anaerobic performance lasting 5 min
CHRONIC:
Loss in muscle mass
Slowing of metabolic rate
Poor nutritional status
Poor bone health
ED development

Question 10

3. List the strategies commonly undertaken by athletes for acute weight loss

Answer 10

Sauna, suit, decr fluid/food, fasting, laxatives, excessive exercise.

Question 11

4. Provide examples of strategies that could support athletes in these sports engage in safer acute weight loss strategies and subsequent recovery

Answer 11

Develop and implement chronic BM management plan
Plan, practice and record responses to acute WL/recovery plans at mock weigh ins/ less important comps
Develop and refine pre-bout nutrition routines around key training sessions/less important comps
Including caffeine, carb mouth rinse and beta alanine
Debrief all the strategies employed to make weight and recover between the weigh in and the event

Question 12

Short and long term WL strategies

Answer 12

LT: body tissue - how much weight can they lose? Energy restriction - dieting to manipulate BF:lean tissue
ST: glycogen, extracellular water, gut reside

Question 13

WL strategy - low fiber

Answer 13

Purpose: slow gut transit times and draw water into intestinal space to bulk up stools
Reduction will reduce undigested plant matter in the gut and reduce water drawn into this space
48 hrs before competition reduce fiber intake to <10 g/day
Expected loss of 1.5% body mass
Food swaps; low - high fiber
Grains: white - brown rice
Cereals: rice krispies - oatmeal
Dairy: eggs - some smoothies
Meat and alts: poached chicken - lentils and beans
Fruit: canned - with skin, avocado
Veggies: peeled and cooked veg - sweet corn
Spreads: honey - jam w seeds, PB

Question 14

WL strategy - low carb

Answer 14

1 molecule of glycogen + 3 molecules of water
Reduction in training for comp allows for reduction in carb intake
Suggestion of <50g./d for 3-7 days prior to comp
Very individual - depends on training load and glycogen status

Question 15

WL strategy - water

Answer 15

A. consume less, B. excrete more
2-3% dehydration is unlikely to affect performance
Passive sweating (sauna) decreases plasma volume, sweat rate and SV, contributing to incr seum osmolality, HR and body heat storage
This happens to a lesser extent following active sweating (exercise)
Water loading practices rampant in sport

Question 16

WL strategy - salt

Answer 16

Kidney will attempt to maintain osmotic pressure
1-2% body water loss seen in hypertensive subjects
No data in normotensive or athletes

Question 17

How much WL is common?

Answer 17

Very common to see losses of >10% when athletes are acting alone
5-8% loss from waking weight w a combo of strategies
Upper end for athletes who have 12-24 hrs between weigh in an competition
Lower end for athletes who weigh in morning of competition with less recovery time

Question 18

Recovery strategies post weight in:

Answer 18

Rehydrate
Fluid: restore fluid losses to within 2% of pre-hypohydration BM. difficult to calculate fluid lost. Advice; consume 600-900 mls immediately post weigh in and regular bolus doses
Electrolytes: oral rehydration solution (>2 x the sodium of sports drinks). Sport drinks + salted snacks
Glycogen replenishment
Provide adequate fuel for comp - 5-10 g/kg BM carb post weigh in if time allows, or 1 g/kg 2-3 hrs before comp.
High GI or carb rich fluids will help, avoid fluids >10% carb eg many energy drinks
First hour: prioritize rehydration and/or glycogen replenishment via fluids . second hour: begin with solid food
GI discomfort
Priority is fluid and glycogen. Limit fiber and fat - esp with short recovery period. If severe, some athletes consider: caffeine - but may worsen GI upset, carb mouth rinse 10 sec

Question 19

1. Understand the components of the female athlete triad and how they related to RED-S

Answer 19

Low energy availability
= energy remaining for bodily functions and physiological processes after energy for exercise has been removed.
EA = energy intake - exercise energy expenditure / fat free mass
Why may athletes present with LEA?
Unintentional: not aware of incr caloric needs, busy schedule and poor prep, eating very healthy foods which lack calorie density
Intentional: EDs, restricting cals to lose weight
Menstrual health
Irregularities: primary amenorrhea - no menses by 15 years. Secondary amenorrhea - no menstruation for >3 consecutive months, no ovulation and no hormonal fluctuations in estrogen and progesterone. Oligomenorrhea - no prolonged absence of menses but menstrual cycles >35 days. Anovulatory - period but no ovu, no mid cycle peak in estrogen or LH, blunted hormonal changes in latter luteal phase.
Bone mineral density (BMD)
(between resorption and formation)
98% of skeletal mass is acquired by age 20 - goal to optimize peak bone mass in young adulthood, reduces risk of osteoporosis later in life. Low BMD is a z score between -1.0 and -2.0 SD

Question 20

2. List the areas of concern for athlete health within RED-S and these might be assessed

Answer 20

Nutrition observation, BW self report or monitoring ,menstruation, recovery (acute and chronic), illness/injury rates, training intensity, performance indicators, bloodwork, bone density scan.

Question 21

3. Define and know how to calculate energy availability

Answer 21

(Energy intake - Exercise energy expenditure) / fat free mass = EA

Question 22

4. Describe how to support athletes losing weight in a more healthy weight and how to monitor athletes health

Answer 22

Self monitoring - BW, satiety and mood state, sleep and training quality, performance outcomes, illness/injury occurrence, menstrual cycle regularity.

Question 23

1. Describe the main components of the immune system and how it functions

Answer 23

Innate immune system (T cells, B cells) vs acquired immune system (physical barriers and bloodborne).

Question 24

2. Describe common illness challenges faced by athletes and the reasons for increased risk

Answer 24

Athlete risks: increased exposure to pathogens (lung ventilation, sin abrasions, frequent travel, crowds), increased stress (physio, psycho stress, altitude, inadequate diet or poor sleep), inflammation of airways.

Question 25

Effects of exercise on the immune system:

Answer 25

acute - temporary depressive effect on immune function => risk of infection; suppression of AIS, decr salivary iGA, incr stress hormone prod, expression of genes that code for anti inflammatory components, incr anti inflammatory mediators, plasma glutamate concentration decreases.