Final Flashcards
Total Energy Intake (individual considerations and sport considerations)
- needs can be quite variable in athletes, so consider recommendations relative to body size and expenditure, i.e. in some sports like the Tour de France, high energy expenditure is hard to fuel, leading to challenges for weight gain and loss
Macro intake CHO - general other shit
- staying below anaerobic threshold is better to spare glycogen
- there is not different between liver and muscle stores of glycogen except for the fact that liver is more accesible quicker
-we need about 12-16 grams of CHO per KG of muscle when its wet when its dry multiple it by 4.5 so if someone has 25 kg of muscle they need 300-400 grams of CHO - liver glycogen has a higher concentration than muscle but a lower total amount of about 100 g, which can be depleted to below 20 after an overnight fast, so try to spare liver glycogen as much as possible cuz its so easy to use… if you running a marathon the next day want to make sure you have as high of liver glycogen as possible fore but actually you can regen liv it so eat a lot the night beforer glycogen stores fairly quickly. Therefore, it is important to get glycogen which is important for everything
Macronutrient. intake (CHO) - Acute effect of endurance exercise
- High intensity exercise depletes liver glycogen by 50 percent
- supramax repetitive work also depletes it
- time to exhaustion is directly related to restiing glycogen stores
-High glycogen store in liver fast quick source of energy
Other effects of endurance exercise - glycogen sparing
improved mitochondrial metabolism enhances lipid oxidation
larger glycogen stores in skeletal muscle
Macro - blood glucose levels with training
- you want to maintain glucose levels as much as possible with proper refuelling
- if doing suer high intesnity activity glycogen gets quickly depleted even more important as intensity goes up liver puts more glycogen into blood stream
High vs low CHo diets in marathoon runners study
- marathon runners for those eatinig high CHO diet their glycogen stores recovered stayed relatively constant compared to those on a low CHO diet
Glycemic index What can influence the GI of a food
-Pure glucose is that standard reference (100)
- biochemical structure of the CHO
- the absorption process
- size of the food particle
- congestion of fat fibre or protein
Glycemic index and load
- Gi = area under curce (AUC) times 50g other CHO (like fructose) / AUC times 50 glucose times 100
Gi 0-100 50 g is standard - less interested in GI and more in glycemic load
Glycemic load = GI times gCHO/100 - how much is available in the system for energy
Foods with high glycemic index fast response to blood glucose values
-average plasma is 6 if you injest lots of cho like gummy bears there is a sharp spike in blood glucose cause body releases insulin to reduce those levels to normal but sometimes the insulin being released cause a rapid drop in glucose which can result in glucose levels below where you started and this mainly occurs when you eat up to an hour before exercise, neveer want to start with low glucose
- can monitor it by eating a little less maintain reponse rather than sharp drop off
- ideally, start the race with the highest blood glucose possible. Eat gummy bears 30 minutes before as soon as you start to exercise, epinephrine release stops from being released; then you get to maintain blood glucose for longer periods of time
Glycemic index - values
- Low GI - less than 55 - most fruits veg expet potatoes, whole grains, basmati rice and pasta
- medium - 56-70 - sucrose, croissant, brown rice
- high - over 70, corn flakes baked potato, soe white rice like jasmine, and white bread
General CHO intake guidelines
- ACSM says 6-10 g/kg of body weight but depends on type of sport playing doo like
daily moderate duration low intensity 5-7
daily mod to heavy endurance 7-12
daily extreme 4-6 hours 10-12 plus
CHO days before competition
- goal - replenish and maximize muscle glycogen
- Supercompensation - CHO loading - increse time to fatiuge by 20 percent, decrese time to completed task by 2-3 percent, mostly for activities longer than 60-90 mins
- other considerations
5-7 days of supercompensation is not always feasbile
if each g of CHO is stores with 2-3 grames of water there is a balence between whats the most advanagoues thing like for a sprinter the glycogen or the weight
Carb loading
- some studies suggest muscle glycogen doubled compared to normal resting levels
- slowly increase the amount of CHO in your diet while reducing the amount of training you are doing as well as best results for comp
Potential issues with classical supercompensation
- hypoglycemia when CHO is low
- may not be practical (meal prep)
- GI problems
-Mood
-tenseness without training
-randomized to 5 days of high 75% vs lowe session 75% for 1 hr then. did muscle biopsy also, did time to fatigu 55% CHO exercise at 85% max
Men vs Women
- showed that for men that a low vs high CHO intake incresed the time to fatiuge greatly
- for women increse in glycogen in the muscle that same change was not prevalent did not increse time for fatiuge
why might glycogen stores be different in men vs women
- women tend to have a greater reliance on fat oxidation
- CHO loading may increse weight - issues with complicance ( prolly not)
- if CHO loading does not increse muscle glycogen then where tf does it go
CHO loading - muscle vs liver glycogen
-Muscle glycogen is often super compensated before full recovery of liver glycogen ie if boh are depleted than muscle will fill faster
fructorse fruits and honey vs glucose like pasta
- fructose can lead to slower muscle glycogen but similar liver glycogen replenishment so if you want CHO fast then get glucose
CHO hours before comp
- goal - replenish maximise liver glycogen and increse glucose delivery to muscle
- 0-4 hrs before exercise
- meal 3-4 hrs before exercise can increse muscle glycogen - however s run is early am might not be possible most important thing is risk benefit sleep or replenisment - if you are doing a more cognitive sport like team sports sleep may be more importat then vs a run
- 200-300g 3-4 hrs before exercise
- some controversy due to glucose induced insulin release w high GI hypoglycemia excessive skeletal muscle uptake and blunted lipolysis
- low GI vs high Gi to minimise hypoglycemia
- timing goal is to not feel hungry or have undigested food in stomach - more benefits if CHO cannot be consumed during exercise
individuals who ate a high GI index meal 3 hrs before running fatiuge meaning they tired out faster than those who ate a low GI index food
CHO during comp
- 30-60 g/hr or .7g/kg/hr liquid or solid benefits high intensity long duration and extends time to exhaustion
- trianing state does not imporve ability to utilize CHO - metabolism cannot be trained
- better to provide CHO every 15-20 mins than after 2 hrs
- Dont consume things with high fructose - as its slower to absorb
- controversial for events lasting less than an house there have been shown evidence of beenfits with just rinsing mouth with CHO bevy
- glycemic index - remember exercised induced epinephrine inhibits insulin release
Cho during comp - what is the exception to fructose
- Evidence has shown that adding some fructose in can actually help in peak oxidation the max glucose you can oxidise is 1.2 g/min no matter how much more you eat this number never changes - BUT if you intake some fructose alongside it it can actuallly increse the CHO oxidation slightly because of different transporters of glucose and fructose and different receptos allowing for slightly higher oxodation
CHO during comp - what is the maximal amoutn of intake
70g/hr - the max you would ever want to digest intake during comp like a 1-litre sports drink, 600ml of cola etc. ACSM recommends .7g/kg/hr
CHO intake after exercise
- Goal - replensish muscle and liver glycogen -
create positive glycogen repletion enviroment (increse insulin icnrese tissue sensitivity to insulin reduce catecholamine and increse glycogen synthase - greater insulin respnse means a greater glycogen storgae however not supported by research
- easiest way to increse insulin is to EAT
- ACSM says to consume 1-1.5g/kg moderate to high GI CHO within 30 mins and then every 2 hrs for up 2 6 hours until 500g or 701-g/kg has been ingested
- this is very dependent on the activity performed and the next activity to be performed
WHy CHO load after comp?
- Replenish depelted liver and muscle glycogen
- glycogen stores is directly related to performance
What affects the rate of glycogen syntheiss
- availibility of glucose
-insulin - prior exercise - increse insulin sensitivity
CHO intake after exercise - timing
- Rapid phase of glycogen syntheisis is 1-2 hours glycogen synthase (exercise upregulates this rate limiting enzyme and glucose availibility)
- Slow phase of glycogen synthesis - insulin availibility
- eat immediately after you get the greatest rate of glycogen synthesis
- wait 2 hours, and it’s much slower
CHo intake after exercise - timing - takeaways and why is there variability
- essentially just know that eating right after exercise you get a lot more glycogen replenishment quickler but there is lots of variation between indiviudals as a result of:
- Timing - when they are eating after 15-30mins
- Type of CHO they are eating - higher glycemic index easier to absorb and digest so better
- type of training - high intensity - more liekly to get glycogen syntheiss occuring vs a walk
- how much glycogen stores were depleted - the more depleted they are the quicker they would replenish
- As long as you get sufficient CHO in recovery glycogen stores will recovery at 24 hours again no matter what type of foods were ate so if you eat sufficient CHO within 6 hours of comp glycogen stores will recover similarly at 8 hrs and 24 hrs post exercise
CHo intake after exercise - rate of ingestion - what if you need to recovery quicker
Optimal rate if 1.2g/min
CHO intake after exercsie - what if you need to recover quicker - type of CHO
- muscle glycogen synthesis may be up to 50 % slower with fructose or low GI meals as initially fructose may be stored in liver as glycogen or is converted to glucose
CHO intake after exercise - WHat if you nee dto recover quicker - Protein
- adding protei may help if CHO intake is lower
- AA can increse insulin release but CHO is the limiting factor
- Solid vs liquid- liquid food passes through quickly solid would be slower - so if needed quickly liquid would be beter
- Solid may also delay gastric emptying, but no major effect usually comes from this
CHO - recovery
- total energy intake must match expentidture or glycogen stores will deplete
time to replenish glycogen stores varies 2-6 days
some studies have been able to show good super-compensation (attain supranormal muscle glycogen values) following a very short bout of very intense exercise (less than 24 hrs before)
Summary table for CHO intake - values
- Pre comp (Days) - intake enough for supercompensation 6-10g/kg more than 60 percent of daily EI with a low to mod GI
- precomp (3-4 hrs) - 200-300grams with a low to mod GI
-precomp 5-60 mins - 1-1.2g/kg can be high GI especially if closer to event or in warm up
-During comp- 30-60g/hr or .7g/kg/hr at 4-8 percent in drinks and a high GI
-after comp - 1-1.5g/kg during the first 30 mins then every 2 hours for 4-6 hours at more than 65 percent of daily EI and a high GI if rapid replenishment is required
Intake of fats - good bad ugly
- Monosaturated and polysaturated like fatty fish salmon planbased very important for essential fat and muscle brain health
- saturated fat always going to be there but avoid overconsumption
- avoid trans
Macronutrient intake fats
- know that fats has the longest amoung of energy reserve - glycogen has low while fats is almost unlimited - if there is a way to adpat training to increse fat metabolims you will be at a great advantage as save glycogen stores till the end for last sprint
- never at any point would you ever want to use muscle protein stores - in extreme situations it will occur but try to avoid as it is very hard to get back
Fat metabolism changes with training
- opposite of CHO
- imporved ability to oxidise FFA
- increse FFA faster
- enhanced capillarisation number and density to access fats
- FFA transport through plasma membrane and mitochondria
- incresed number of oxidative enzymes
-mitochondrial adaptations (increased density and size)
When can a high fat diet be beneficial
Essentially just says that In short term can spare glycogen as it increses fat metabolism and can increse performance on a one off but over the long term it impairs beformance
Bottom line of high fat diets
- In theory high fat diets coul dincrese ability to oxidize fat and spare muscle glycogen particularly if muscle glycogen is replenished before exercise
- however - high-fat diets are not recommended by ACSM, and there are supplements to increase fat oxidation, like caffeine pyruvate and carnitine
Macronurtient intake (fats) new approaches
- periodization of macronutrient intake during training
-recommendations are the same as Gen Pop- individualize based on training level and body comp goals
Macronutrient intake - protein - why are they important
- for everything
- strutcural and regulatroy functions
- fuel source - dont want it to be however it cna in certain situations
can also be converted to glucose via gluconeogensis - also have very high energetic meaning you wont get as much energy from 1 gram of protein vs 1 gram of CHO as it is not as efficient
Why might protein be important for strength trained athletes
- muscle but also tissue maintenance, transporter enzymes and also important for endurance athletes
Can you have too much protein
- YES, if there is insufficient CHO decrese glycogen stores and fatiuge cant train as hard
Protein - amino acids
- protein synthesis - all 20 AA
- certain AA must be in the diet
- Essential (must eat cannot make otehrwise vs non esential ones
- The key ones are isoleucine leucine and valine - if you dont have these muscle building wont be at full capacity
-20% of muscle protein is BCAA - muscle synthesis
Protein - why do we need it - protein breakdown -
- to replace damaged proteins
- synthesize neurotransmitters (serotonin or hormones like adrenaline)
- to provide energy (converted to glucose ketones or fatty acids
- must remove amino group - transamination or deamination
- ammonia NH2 converted to urea
- protein synthesis
Protein turnover synthesis
- Example -
- the amoutn of protein you intake wil lbe excreted in a day IF you are in energy balance
- Protein turnover is several times greater than protein intake , protein intake accounts for 25 percent of the AA that enters the AA pool every day
- the remaining 75 percent comes from proetin in the gut kidney liver which syntheisse and resynthesise
- turnover of muscle much slower than other tissues
Estimating protein metabolism
- Nitrogen balance - nitrogen intake minus nitrogen excretion in sweat and urine
- advantage - accurate method when used over relatively long periods of time
-disadvantages and limitations - difficult and time consuming tends to overestimate nitrogen retention usually ignored nitrogen loss in sweat - highly dependent on subject complicance give sno insight into metabolic pathways - eat specific fods known nitrogen content and measure excretion
- during exercise, nitrogen excretion is substantial and must be included in the measurement
Nitrogen balance methods
- About 16 percnet of protein is nitrogen - nitrogen intake - nitrogen loss
- loss is via fecal urine sweat and some with breath
- average dialy requirement in healthy young adults is about .66g/kg/day
- the safe intake of protein is .83g/kg/day
- lots of athelets and other use a lot more reuslts in expensive ass piss
- this method provides an estimate
- often can only measure in urine because of feasbility issues
- overall underestimates nitrogen excrestion and therefore overestimated retention
when eating high protein diet can reuslt in overestimation
ie example weightlifter eating 2.5g/kg/day leads to a positive nitrogen balance of 17 g/day equivalent to 110kg of lean tissue in one year which is not possible
Macronurtient intake (protein for athelets
- Those that belive in it state that
AA may be oxidized during exercise - increased protein synthesis is necessary to repair damage and training adaptations
Macronurtient intake protein study for body builder low vs high intakes
- incresed nitrogen balance showed that there was a limit for positive nitrogen balance meaning that there was a noticed difference between no protein vs adequete protein but no differnce in muscle area, strength or total lean mass in high vs even higher group
Protein guidelines
gen pop
- .8g/kg/day or 10-35% of TDEI
Endurance athletes
- 1.2-.1.4 - and even higher for ultralong endurance but this is not usually an issue due to higher intakes anyways
Strength trained athletes
- 1.2-1.7 especially during early phases of training
Going above these values showed no advantages - for gen pop 1.3 was shown as upper limit but average for athletes is like 2 and there is no actual benefits to this
- Co- ingestion PRO with CHO why does it work
- This is due to insulin response you want insulin to rise and rget release as it helps muscle synthesis and build it
- study showed that for essential AA the highest uptake of protein ito muscle is when you have a combonation of CHO and protein post exercise as incresed insulin helps too
- Timing of intake - WEIGHT GAIN PROTEIN
- protein should be taken in immediately after exercise for best effect results in bigger cross-sectional size strength and larger mean fibre area in muscle vs. waiting 2 hrs after exercise to intake
Study - 1RM trained vs untrained
- early days training jst doing resistence trianing enough for growth however as you get more trained added more protein in is helpful leads to better growth line of no effect
How can we favour protein synthesis
- Co-ingetsion with CHo for insulin release
- amount of protein consued at one time 20-25 g
timing of protein
type of protein
ergonenic AA
Recommendations of protein for weight gain - How doe sit affect old populations
- proetin supplements less effecteive in older population as they have less muscle mass and they are untriaend dont move around as much
recommendations of protein for weight gain - general recommendations
- 1.6 g/kg/day for weigth gain but above that no further improvement s in FFM
- more effective in younger and trained individuals vs older and unrtained
- Resistence training is the most important stimulus for this and account for most of the variability we see the more resistence training the higher the stimulus the more it will beenfit you
Recommendations for weight loss PRO
- The most important thing it to save as much muscle as possible
- high quality weight loss meaning retention of skeletal muscle and promotion of fat loss
- especially important for athletes as muscle loss can adversely impact performance
recommendations for weight loss - guidelines (PRO)
- current recommendations are 1.6-2.4. g kg during weight loss to prevent muscle loss
the greater the energy restriction the greater the intake should be
what effects it?
= rate of weight loss - the faster it is lost the more protein is needed
type of training - if RT, then you need to lower the amount because you are maintaining muscle
What type of protein is best
- EEA - Essential AA
BCAA - branced chain AA - PDCAAs - protein digestibility corrected AA
- Whatever you choose you want to make sure it has a low splanchic AA extraction which is how much is extracted in the gut, having a high splanich AA extraction means reduced AA availability for prtein synthesis in muscle so low as possible is good
Micronutrient intake
Plays an important role in
- energy production - b complex vitamins
- bone health - vitamin d calcium which is critical for females
- Hemoglobin ie iron
- Others - immune function antioxidants, building and repair red meats
BCAA
- not as beneficial if you already have a chronic disease like heart disease especially if you are not doing resistance training as there could be adverse effects
Micronutrient intake _ athletes
- athletes with low energy intake or who exclude 1 or more food groups may be at particular risk for micronutrient deficiences as a general rule use a multivitamin if unsure
Micronutrient intake - according to ACSM
- indoor and northern athletes could beenfit from vit d supplementation
- potential role for vit E to reduce oxidative stress, inflammation and muscle soreness
- sodium and potassium as if you are exercising in heat or at high intensity lots of micronutrient los due to swear
- minerals that are often low in athletes include calcium zinc magnesium and iron
Micronutrient intake - according to ACSM - IRON
- Iron needs may increse by about 70 percent in disance runners and is also low in a lot of females
- this is due to foot strike hemolysis - and does not occur the same in biking but it is de to th eimpact of your foot hitting teh ground over and over again which breaks down RBCs and decreses hemoglobin
- this leads to sports anemia or delusional anmemia
- Women tend to have lower iron intake and are more likely to become deficient due to less intake of red meats and bleeding through menstruation
Supplement use for micronutrients
- prevent micronutrient deficiences
- convienent form of energ yand macronurtients
- directly impact performance
- support higher intensity training
supplement use
- protein bars shakes pills powders
What to ask before taking supplements
- is it availible affordable and compatible with performance goals
- does coach doctor know and support it
- is it produced by a reliable source to prevent cross contamination
the take home is that supplements can play a role in athletes but it takes effort and expert knowledge to identify which ones are appropriate and if benefits outweight the negative effects
Water intake - what is dehydration
- dehydration classifies as losing more than 2% of baseline body weight
Water recommendations
Before exercise
- 5-7 ml of water /kg at least 4 hrs before exercise so about 2 cups
During exercise
- Develop fluid replacement plans to prevent exessive (more than 2 percent) loss of baseline body weight from dehydration as performance is directly related to amount of water lost
- Sweat rates can vary from .2-2.4l an hour and the max rate of gastric emptying is 1-1.5 l hr so you lose .9 l hr
- concersn over hypoatremia or low soidum
After exercise
- If time permits consumption of normal meals and beverage will restore hydration
- if need more rapid recovery from it can drink 1.5 L of fluid per kg of weight lost
fluid and foods with high sodium will help expedite rapid recovery by stimulating thirst and fluid retention
Sweat rate is related to running time but it is also impacted by ambient temp
Recommendation for weight loss (General) - determining body weight fat goals or standards
- Be careful with tools used to assess body comp ie BIA errors
- be careful assigning specific weight or percent fat goals for a group as you nee dto take into accound individual needs
- provide appropriate support and expertisue when suggesting weight loss or gain
- more significant weight (fat) loss should preferably take place in the off-season
Recommendations for weight loss general (nutrition)
- moderal energy restruction
- gradual loss of .5-1 kg per week meaning approx a 500-1000kcal deficit
- or increse teh expenditure with less restirtcion which is difficult for already active athlets
- appropriate CHO for training needs as lower CHO impairs performance
- maintain or increse aboslute protein intake espeically during teh first week AA used to make glucose instead of synthesis
- decrease absolute fat intake
Recommendations for weight loss general - Adequete energy intake
- protein syntheiss is a costly activity
Effect of pregnancy
- Not a career-ending event, but many physical and emotional symptoms occur postpartum
3 stages of post partum
- acute - 6-12 hrs eclampsia and hemmorage
- subacute - 24 hrs -2-6 weeks body still change less likely to expierince a medical emergency
- delayed - about 6 weeks to 6 months. changes are gradual and consist of muscles and tissues returning to pre-preg state
Biopsycosocial considerations after childbirth
- long term beneficial impacts in that ventricular blood vol cardiac output and systemic resistence do not return to pre preg levels by one year post partum
Hormones preg
- rapid change low mood anxiety
- 1 in 5 experience perinatal mental illness
- ## maternal mental health considerations can range from low mood to psycosis
Stress urinary incontinance - preg
- pelvic floor dysfunction - involunatary leakage of urin when coughing sneezing or during impact activities affects 1/3 of post partum women
- risk doubles if the person has previously given birth
Breastfeeding
- Who recommends it for the first 6 months of life
- common issues
- discomfort with exercise, LEA - Coordinating schedules
Calcium loss - preg
- significnat during lactation with estimates that losses through 9 months of lactation are double than 9 months of preg as its used for bone urine and feeding now
Bone mineral denisty - preg
- if BMD has a significant decrese breastfeeding should stop - decline in BMD between 3-10 percent during preg recovers after cessation of lactation
Sleep - preg
- short ooor quality sleep consitently associated with an incresed risk of diabetes hypertension CVD and depression in gen pop exercise improves sleep quality
Exercise in post partum -
- Kegels as a core exercise for pelvic floor training - research early mobilization and incorporation of light PA can facilitate postpartum recovery the ability to return and surpass previous performance levels influences by the age at which preg coorus relative to the age or peak performance of preganancy
Mental health preg
- Returning to mod to vig intensty PA within the first 12 weeks post partum has a net positive influence on mental wellbeing including a 40 percent reducion in odds of developing depression
Exercise performance and intention - preg
- participants who intended to retun to equialent performance levels post preg no stat decrese in performance in the 1-3 yr post preg compared with prepreg and 56 percent imporved post preg
COntraindications to post partum exercis
- Severe ab pain
vag bleeding
high bp
malnutrition
fatiuge
breathing difficulty
renal kidney disease
Biopsycosocial abrriers to post partum exercise
- mental health
pelvic floor dysfunction
ab wall dysfunction
lactation status
LEA
poor sleep
fear of movement
lack of social or emotional support
Type of delivery - preg
- palys an important role recovery and healing are relatively quick following an uncomplicated vag delivery in conrtast from healing from c section takes longer as its major ab surgery
what is an ergogenic aid
- work producing - anything that ui sused to improve athelteic performance
How do you determine if an aid is effective
- does the amount in the bottle equal the amount done in research studies
- does the claim made by bottle match the science
- does the claim make sense for the sport in which claim is made
- is it safe
- is it illegal or banend by any athletic organizations
How to evaluate nutrition studies
- hypothesis, who was the study done on, was the population similar to real life, were external variables controlled, was, were good techniques used, was it randomized, was there a crossover design, do other studies confirm the studies, was it peer- there a placeboreviewed, who was it funded by
Types of ergogenics -
weight strength gain growth promoting protein synthesis - a lot of them including anabolic steroids DHEAs, growth hormones, HBM creatine
Weigth loss aerobic performance - like ephedrine caffine aspring cocktails nicotine dieuretics
Thermogenic drugs - Caffiene and ephedrine
- SNS major regulator of thermogenesis - these drugs stimulate it
a receptors including a1 heart vascular smooth muscle and a2 presynaptic terminals vascualr and other smooth muscle cells
b receptors including b1 b2 b3 heart-lung blood vessels many functions including increasing lipolysis
Thermogenic drugs - Ephedrine and pseudoephedrine also called ephedra - Benefits
- Weight loss
incresed reaction time acceleration speed
incresed strength power muscle endurance - better aerobic endurance
- higher max HR and peak lactate at exhaustion
- better focus
- fine motor coordination
Thermogenic drugs - ephedrine and pseudoephedrine - risks
- death
cardiac arrhythmias
delay densation of fatiuge
extreme nervousness
aggressive behavior
insomnia
Thermogenic drugs - ephedrine - what was it originally used for
- low blood pressure
- pseudoephedrine still availible oer counter but ephedrien is more effective
- herb ma huang contains ephedrine
Proposed effects of it appetite suppresion weight loss and prevents loss of FFM during resirtction form protein sparing and protein syntheiss
Syngergistic effect of ephedrine and caffiene
- tendenday for dose effect for ephedrine
low dose considered .09 kg/month or 10-20 mg a day
medium dose considered 0.9 kg/month or 40-90 mg day
high dose is 1.4 kg/month of 100-150 mg a day
Side effects of ephedrine
- tremors nervousness increse bp and HR
MI stroke seiziure - ephedra contraining products account for 64 percent of all adverse reactiosn to herbs in US
- banned in diet drugs since 2004
some sports drinks used to include it in the mix
Thermogenic drugs - caffience
- found mostly in coffee beans teas peak in blood about 60 mins after consumption and the half life is 2-10 hrs
incresed mental awarenedd reduce perception of fatiuge incresed fibre recruitment - adosine - when it binds to receptors it slows neural activity dont get sleepy as easy
- reduced the negative feedback that inhibits the secretion of noradrenalin
- relax smooth muscle
- increse intestinal CHO absorption and helps stim adrenal medulla
- increased lipolysis increased FFA and increased fat oxidation
Thermogenic drugs - caffience - wieght loss study
- short term 100 mg was shown to increse resting oxyegn consumtpion by 3-4 percent in lean and postobese subjects
- long term fewer studies but shown that caffeine alone does not seem to result in much more weight loss than a placebo
Thermogenic drugs - caffiene - performance study
-more and moer energy drinks contain it
in general no benefits on VO2max and max strength
benefits on submax aerobic and anaerobic endurance
- often time to fatiuge at a certain intensity increses
- greater impact if. If you aren’t a caffeine user then if you are
Thermogenic drugs - caffience - side fx
- increse HR
- dieuretic
- reaction different in regular users vs non users
- interferes with absorption of vitamin c and iron
- bone mineral desity and osteoporosis
- insulin resistence and type 2 diabetes
- important to consider the difference between coffee and caffeine
- also associeted with death caffience induced arrhythmias
- removed from WADA list in 2004 but is on the monitoring list to see if there is abuse
- can also be beneficial at altitude
Weight strength and gain - creatine
- dont need a loading phase unless quick performance increse is wanted
- does not lead to water retention not for everyone tho
- not a steroid
- no kidney damage or renal dysfunction at recommended dosages
- does not cause hair loss
does not lead to dehyration - not increse fat mass
- monohydrate best
weight strength and gain - creatine - evidence and older adult use
- increse muscle mass strength impored performance high intensity exercise reduction in muscle fatige
- very effective in older adults for incresing n muscle mass and strength in older adults as well
Weght strength and gain - anabolic steroids
- similar to test
- used clinically to treat delayed puberty in osteoporosis increse bone strength and anaemia incresed RBC count and percent Hb
- intramuscular injection orally or by using gels or creams
- increse muscle size and strength
reduce recovery time between periods of strenuous activity
no effect on endurance or stamina
stimulated brain to stim feelins of euphoria
Anabolic steroids side fx
incresed aggressive behavior acne and body hair
- prolonged use interfereres with the ability to naturlaly produce test
- hypertension atherosclerosis blood clotting and reduced fertlity
- heart attack and liver cancer
- banned substance since 1975 small effect size on strength but medium on lean mass
Doping in sport
- presence of prohibited substances or methods to unfairly improve their sporting performances and gain an advantae over their competitors WADA created in 1999
- BEN jhonson - silken laumen rower for pseudoephedrine
Why do athletes dope
- competitors take drugs
- have to use them to be compeitive
- dissastisfaction with size and weight
- peer and team pressure
- community attitudes and expectations
- financial rewards and media influence
Doping deaths
- cyclists OD on it
need to understand what is prohibited at all times vs only at time of copetition - all teh time
- non approed substances
- anabolic agents
etc…
methods used for it are like - manipulation of blood and blood compoentns like enhancement of oxygen transfer
- chemical or phsycial manipulation
- gene doping
WHats prohibited in competition
- stimulatnts
cannabinoids
glucocorticosteroids - alcohol in some sports
Alcohol
- lots of performance deficits hangovers reduction in hand eye reaction time strength etc but benned because it kills fear ie any extreme sport earier to do things
Cannabis
- impars performance - incresed HR and decresed SV reduced max performance
- respiratroy tract infection less oxugen for performance
BUT
Improved perforance because - euphoric effects and anxiety reduction during performance like ROSS reality -
Beta blockers
- prohibite din specific sports as it decresed HR reduced anxiety and stabilises motor performance side fx of it tho are things like
- laxiness drowsiness
sleep problems - breathing probnlems
slow HR
depresison
Pregnacy - 6 R framework
- Ready
review
restore
recondition
return to sport
refine performance
reframe how we think about preg and condition for the entire rehab journey
Female athlete triad
- Eating disorders - not usually included now but if you have it there is an incresed risk for LEA
- amenorrea.- loss of menstral cycle
- osteoporosis - loss of bone - penia is the predisposition to it and seen in older women cause is LEA
REDS
- now callled REDS to include men
- based on energy baalnce EI and EE
- can be a sign of disordered eating - which is a continuum - ranging from healthy dieting to extreme weight loss
Outcomes of LEA and REDS syndrome
decrese in energy reproductive function MSK helath immunity glycogen synethsis cardio health etc which can lead to impaired well being incresed injury risk and decresed sport performance
- LEA is the underlying factor in this syndrome
- NO performance enhancements at all with LEA mayeb short term but it is never a good thing long term
Disordered eating
- affects up to 62 percent of females and 33 percent of makes but that is still severe amount
LEAK - eating disorders
- international classification of disease
- diagnostic and statistical denial of mental disorders
- both are 2 institutions that are internationally used to classify and disgnose LEA REDS and disoredered eating
Anorexia nervosa
- refusal to maitain body weight for age and height - BMI of less than 17.5 or less than 85 percent of expected weight,
- failue to gain weight durnig growth and its also a personal refusal mental health disorder
- intense fear of gaining weight or fat
- distrubed body image or denial of seriousness of current low body weight
- amenorrhea
Bulimia nervosa
- recurrent episodes of binge eating
- eating a larger amoung of food in a discrete time you will never know about it
- more common but more difficult to identify
- sense of lack of control over eating during the episode
- recurrent inappropriate copensatory behaviro in order to prevent weight gain
- binge eating and inappropriate compensatory behaviors occur twoice a week for 3 months
- self evaluation influced by body image
- may occur with or without an AN
Menstrual dysfunction
- Menarch - first cycle around 12.5 years
- Eumenorrhea - how many days the cycle is avergae - 28 and the range is 21-35
- Oligomenorrhea - cycles longer than 35 days also called infrequent cycles and occurs more than 3-6 times per year
- amenorrhea - absense of cycle more than 3 months (primary is delayed menarch 15 years or older) (secondary) occurs after menarch)
- luteal suppresion - cycle with a luteal phase shorter than 11 days in length or with a low concentration of progesterone
- Anovulation - cycle without oulation
- Primary amenorrhea - has been estimaeted at 7 percnet overall with 22 percent in cheer diving and gymmnastics
- secondary amenorrhea - 2-5 percent in women and most in dancers and long distance runners
- can occur in as little as 1 month of LEA but more likely 2-3 months and it takes 3-6 months to recover after improvement in energy availability
- Menstrual cycle
- estrogen goes up then LH spikes then ovulation occurs all happens in the first 7 days of the follicular phase
What is the cause of menstral dysfunction - study
- is ie LEA or EE -
found that its due to a disruption in LH pulsatility - exercise itself did not supress but in LEA reduced pulsatility by 60 percent - theroretically can resume menses by eating more while exercises even at high levels
Misconceptions of LEA
- some athletes coach trainers consider amenorrhea as a benign consequence of training and an indicatior of good training body fat levels at optimal level for performance this is a misconception
- there is actaully multifactorial causes - pysiologcal and psychologicll
- some people work better with lower body weight and some with more everyone is different
Low bone mineral density
- osteopenia z score between -1 and -2 porosis z score more than -2
with secondary risk factors for fracture ie undernutrition hypoestogenism and prior factors that can also affect this - undernutrition - decreses rate of bone formation
- hypoestorgen - increse bone reabsorption rate
- consequences are incresed risk of stress fractures and incresed risk of osteoprosis -
Causes of BMD in athelets
- LEA
- Low IGF1 - which promotes bone health
- high cortisol
- low calcium
- menstral dysfunction./ estrogen is a major determinant of BMD late menarch irregularities or amenorrhea lead to reduced peak BMD premature bone loss or incresed fracture risk
How to treat BMD
- seek proper health especially if its a eating disorder
- Make EA more than 30kcal/kg of FFM but preferably 45 kcal/kg of FFM
- nutrition conselling incresing calcium intake to 1000-1300mg.day vitamin d to 400-800 uu a day and protein intake to 1.2 -1.6 g /kg /day
- resistence trianing to boost muscle and bone
- decrese overall trainign by 10 -20 percent
- aim to increse body weight by 2-3 percent too
