Sports Nutrition Flashcards

1
Q

carbohydrates

A

Carbohydrates are categorized as either simple or complex, based on their structure.

To understand the composition of carbohydrates in foods, imagine them as links of chains of varying length.

  1. The basic unit of a carbohydrate is the monosaccharide molecule. Examples of monosaccharides are

glucose (also called dextrose),
fructose (fruit sugar) and
galactose (found in milk sugar).

  1. When two monosaccharides are combined, it is called a disaccharide.

Examples of disaccharides in food include

sucrose (found as table sugar, cane sugar, brown sugar, maple syrup and honey, sports drinks, gels and blocks),
lactose (naturally found in milk) and
maltose (found in cereals and germinating seeds).

3.Simple Sugars
Monosaccharides and disaccharides are known as simple sugars.

  1. Polysaccharides (Complex Carbohydrates)

Complex carbohydrates are long chains of monosaccharides linked together.

Common sources of polysaccharides in food are grains such as

wheat,
rice,
oats,
cornmeal,
barley,
grain products and
potatoes.
Maltodextrin, is also made up of multiple glucose molecules, and is found in many sports nutrition products.
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2
Q

Carbohydrate Sources

A
Carbohydrates are the most important fuel for endurance athletes. Endurance athletes should select those foods that are high in nutrients and fiber whenever possible. However, if meals and snacks are consumed close to or before training, more processed forms may be better tolerated, as well as more readily available and portable for quick fueling and refueling.
Breads, Cereals and Grains
Fruit
Vegetables
Milk and Yogurt
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3
Q

Carbohydrates as Energy

A

Each gram of carbohydrate provides four calories of energy.

For example, a medium banana has 27 grams, which provides approximately 108 calories, or enough energy for an average male athlete to run one-half mile at a fast pace.

The recommended number of grams of carbohydrate varies based on the phase of the training plan, and range from 2.3 to 5.5 grams per pound, or 5 to 12 grams per kilogram.

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4
Q

Dietary Fats

A

Dietary fats play key roles in an athlete’s diet because they transport and absorb the fat-soluble vitamins A, D, E and K. Essential fatty acids are required for biological processes such as maintaining cell membranes, and are known to have anti-inflammatory effects. Dietary fats also enhance the taste of many foods. Each type of fat has a different fatty acid structure, but they all supply the same number of calories.

Keep in mind: The sources of fats and oils in our diet can provide several types of fats, though one may predominate. For example, olive oil contains monounsaturated, polyunsaturated and saturated fat, but is over 70% monounsaturated fat, so it is classified as such.

  1. Saturated Fats
    Sources of saturated fat include animal foods such as high-fat cuts of beef, lamb, pork, and poultry; butter; cream; full-fat and 2% milk; cheese; and full fat yogurt.

Saturated fat in a more liquid form is found in coconut and palm oil.

  1. Polyunsaturated Fats
    Polyunsaturated fats supply omega-3 and omega-6 fats.

The omega-3 fats provide the essential fatty acid alpha-linolenic acid and are found in many varieties of fish and plant foods such as flaxseed, walnut and canola oil.

Omega-6 fats provide the essential fatty acid linoleic acid. They are found in safflower, sunflower, corn, soybean, cottonseed and sesame seed oils.

These fats are required to make substances called eicosanoids, which affect blood pressure, immunity, inflammation and contraction of smooth muscle tissue.

  1. Monounsaturated Fats
    Monounsaturated fats are omega-9 fats and are integral to keeping the heart healthy. Because of this, monounsaturated fat is often referred to as a “good fat.”

These fats are found in foods such as olive oil, canola oil, peanuts and peanut oil, most nuts and avocado.

  1. Trans Fat
    Trans fat is harmful to the heart and increases inflammation in the body.

Trans fat naturally occurs in small amounts in meat and dairy. However, there is also man-made trans fat, which is processed differently by the body and is very harmful. Common sources are packaged cookies, crackers, snack chips and commercial fried foods such as french fries.

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5
Q

Fat as Energy

A

Each gram of fat provides nine calories—over twice the amount of energy as carbohydrates and protein. This makes stored fats a valuable source of energy for endurance athletes.

For example, one tablespoon of oil has 14 grams of fat, which provides approximately 120 calories.

Compared to carbohydrates, fats are calorically dense.

The recommended number of grams of fat varies slightly based on the phase of the training plan, and ranges from less than .5 to .8 grams per pound, or one to two grams per kilogram.

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6
Q

Protein: Structure

A

Dietary proteins are made up of a combination of 20 different amino acids. The body is able to manufacture 11 of these non-essential amino acids.

The remaining amino acids are considered essential because they cannot be synthesized in the body at a sufficient rate.

Three important essential amino acids associated with endurance training are leucine, isoleucine and valine, which are known as Branch Chain Amino Acids (BCAA). (Some sports nutrition products contain these BCAAs and they are found in unprocessed foods as well.)

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7
Q

Protein Sources

A

Protein is required for recovery from high-intensity and endurance workouts, repair of muscle tissue, and the maintenance of a strong immune system.

Endurance athletes can easily obtain enough protein by incorporating protein-rich products into meals and snacks.

Protein can be found in both animal and plant foods.

  1. Animal Sources
    Animal products are more concentrated sources of protein than plant sources. Some animal protein sources can also contain substantial amounts of fat and saturated fat.

Endurance athletes who consume animal products should choose lean cuts of poultry, beef, pork, fish, and lamb; lower-fat cheese, milk, and yogurt; and egg whites.

Although higher in fat content, athletes should also choose cold-water fatty fish such as tuna and salmon, as a source of healthy omega-3 fatty acids.

Higher-fat source of protein should be consumed in planned portions.

  1. Plant Sources
    Vegetarian athletes should take care to eat ample amounts of plant protein sources to ensure adequate total protein intake.

Some of these plant sources include dried beans (such as black beans and pinto beans), soy products (such as tofu), tempeh and edamame. Lentils, split peas and nut spreads also provide protein.

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8
Q

Protein: Recommendations

A

Similar to carbohydrates, each gram of protein provides four calories of energy.

For most endurance triathletes, the recommended number of grams of protein varies based on the volume of training, and the phase of the training plan.

The recommendations range from .5–1 gram per pound, or 1–2.2 grams per kilogram. (There are additional recommendations for triathletes who are on a calorie-restricted diet.)

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9
Q

Nutrition Periodization

A

The macronutrient intake for endurance athletes should vary throughout the year due to the changes in duration and intensity of training.
Nutrition periodization: Fluctuating macronutrient intake to meet the energy demands based on the phase of training.

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10
Q

The Components of Total Daily Energy Expenditure

A
  1. Resting Metabolic Rate
    Resting Metabolic Rate (RMR) is the amount of energy that is needed to keep the body functioning during rest. It includes energy needed to breathe, as well as the energy needed for the heart and brain to function. RMR generally accounts for 60–75% of the total daily energy expenditure (depending on the daily level of physical activity).

There are many factors that determine a person’s RMR, including (but not limited to) age, gender, body composition, height and weight.

  1. Non-Exercise Activity Thermogenesis
    Non-exercise activity thermogenesis (NEAT) is the amount of energy that is expended for normal activities of daily living, excluding sleeping, eating and exercising.

In fact, as you take this course, you are expending non-exercise activity thermogenesis calories!

  1. Thermic Effect of Food
    The thermic effect of food (TEF) is the amount of energy that is needed to digest and absorb food.

TEF contributes to less than 10% of Total Daily Energy Expenditure.

4. Exercise Energy Expenditure
Energy expenditure (ExEE) is any energy that is expelled during exercise. ExEE will vary greatly based on the duration, intensity and type of exercise.

This component generally makes up about 30% of the Total Daily Energy Expenditure, but for endurance athletes it can account up to 80%, depending on the duration and intensity of exercise.

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11
Q

Factors Affecting Energy Needs
There are many factors that affect an athlete’s resting metabolic rate and his or her total daily energy expenditure.

To learn more about these factors, let’s assess the energy needs of Jane. Jane is a female in her mid-thirties living in Houston, Texas. She is currently training for her first IRONMAN.

A
  1. Body Weight and Height
    Body weight and height are both factors contributing to Jane’s RMR. The more body mass, the greater the RMR.

Additionally, energy expended during weight-bearing activities increases proportional to body mass. (Body mass takes into consideration the athlete’s weight and height.)

  1. Body Composition
    Body mass composition comprises fat-free mass and fat mass.

Fat-free mass (or lean body mass) includes muscle, bones, organs, tissue and water. Fat mass includes adipose tissue, intramuscular fat and plasma fats. By nature, males have a higher percentage fat-free mass than females.

Fat mass includes adipose tissue, intramuscular fat and plasma fats. On average, males have a higher RMR due to the larger percent of fat-free mass.

Qualified health professionals can assess body composition by using indirect measures such as skin fold testing and bioelectrical impedance analysis (BIA).

  1. Gender
    Jane’s gender will affect her RMR.

Males tend to have a higher RMR (up to 10%) than females of similar age and level of fitness. This is primarily due to the body composition differences between males and females. On average, females have a lower RMR due to a larger percent body fat and smaller muscle mass.

  1. Age
    This will also affect Jane’s RMR, because a triathlete’s caloric needs decline with age. This is due to a loss in fat-free body mass that occurs naturally over time.

It has been estimated that RMR decreases approximately 2% per decade in healthy adult women and approximately 3% per decade in healthy men.

  1. Daily Caloric Consumption
    To maintain her present body weight, Jane’s calorie intake must be equal to the calories she expends.

To gain weight, Jane’s caloric intake must exceed her caloric expenditure. To lose weight, her caloric intake must be less than the energy she expends.

Metabolic adaptations occur when athletes are calorie deficient or when they restrict calorie intake. The body compensates by using the available energy sources more efficiently. This effect can lower the RMR.

  1. Climate and Altitude
    Environmental factors can also influence an athlete’s RMR.

Warm Weather: Individuals living in tropical climates average 5–20% higher RMR than counterparts in more temperate regions. Exercise performed in hot weather also causes about a 5% elevation in oxygen intake (and correlated energy expenditure), compared to the same work performed in a thermoneutral climate. This increased energy expenditure is due to an elevated core temperature and additional energy required for sweat gland activity.

Cold Weather: Depending upon an athlete’s body fat content and type of protective clothing, cold environments can increase energy expenditure required to regulate body temperature. Extreme cold causes shivering, a response meant to generate enough heat to maintain a stable core body temperature. This response can triple the athlete’s RMR.

Altitude: During the first few days at altitude, resting metabolic rate can increase by as much as 40%. However, it gradually drops to approximately 15% above sea-level values. The increase in RMR may increase the athlete’s overall energy needs by 200–300 calories per day.

  1. Economy of Movement
    As you may recall from the Exercise Science module, because oxygen utilization is directly tied to ATP and heat production, the measurement of oxygen consumption is used to quantify energy expenditure.

As movement economy increases, the amount of oxygen required to perform the exercise, and therefore the amount of energy expended, decreases. Although this does not directly affect the RMR, it does play a factor in the overall daily energy expenditure.

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12
Q

Estimating Total Daily Energy Expenditure using Equipment

A

The RMR test, using portal equipment available at research labs and fitness centers, is non-invasive, time-efficient, well validated and widely available.

It is the most accurate method because it measures oxygen uptake which directly correlates to energy expenditure.

This direct method is recommended for endurance athletes who struggle with weight management issues.

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13
Q

Estimating Total Daily Energy Expenditure using Body Weight

A

The simplest method of estimating daily calorie needs is to calculate the calories per pound (or kilogram).
This method is based on weight and training level, and takes into account the RMR, daily energy needs and additional energy needed for exercise.
To use this formula, you must know the athlete’s weight, the level of exercise intensity and/or the duration of exercise.

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14
Q

The Mifflin St. Jeor Equation

A

The Mifflin St. Jeor Equation predicts TDEE by estimating an athlete’s RMR and multiplying the RMR by a specified physical activity level factor (PAL).

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15
Q

Calorie Burning Data

A

The calorie burning data collected from a heart rate monitor or power meter can also be used to determine that day’s TDEE.
The Mifflin St Jeor equation estimates RMR. You can then multiply this by a factor of 1.2 to 1.3 for a sedentary job, or 1.4 to 1.5 if you have an active job.
Then add in the calories burned during training.

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16
Q

Role of Water

A

Water plays many vital roles that directly affect the athlete’s health and performance.
Water is also the main component of blood, which is responsible for transporting nutrients (such as glucose), gases (such as oxygen) and waste.
When the body is fully hydrated, 90% of blood is water!
Water dissipates heat through the evaporation of sweat from the skin, cooling the body and maintaining its core temperature.
Water removes lactic acid from exercising muscles, and muscle glycogen holds water, which can be an advantage to well-hydrated athletes.
Water is also responsible for lubricating joints, moistening tissue and protecting body organs.

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17
Q

Balancing Water Gain and Loss

A

The athlete must regain fluid balance by replacing water and electrolytes lost during the sweating process.
Water balance depends on the net difference between water gained and water lost.
Because endurance athletes are particularly at risk for excessive loss of water during exercise, coaches should encourage athletes to carefully monitor their hydration status and replenish fluids to meet physiological needs.

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18
Q

Fluid Loss

A

Daily water balance depends on the net difference between water gained and water lost. Athletes gain water from the consumption of foods and fluids.

Fluids are lost through sweat, oxidation of carbohydrates, proteins and fats, respiration (breathing), and the output of body waste (urine and feces).

One study found that during an IRONMAN, the average athlete’s sweat rate for the bike leg is .81 liters per hour, with ranges from .47–1.08 liters. The average sweat rate for the run is 1.02 liters per hour with ranges from .4–1.8.

Even small changes in temperature can increase the amount of sweat produced. Therefore, the athlete’s goal is to take in adequate amounts of fluid and electrolytes to compensate for the fluid and electrolyte losses.

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19
Q

Sodium

A

99% of sweat is water; the other 1% is electrolytes. Sodium is an especially critical electrolyte, particularly for endurance athletes with a high sweat rate, because compared to the other electrolytes, it has the highest concentration in sweat.

Athletes can lose between 115–2,300 milligrams of sodium per liter of sweat, and athletes with higher sweat rates or sweat sodium concentrations may exceed this range. To put this in perspective, one teaspoon of table salt has approximately 2,000 milligrams (mg) of sodium.

Note: Sodium and salt are not interchangeable. Dietary salt, or table salt, is only made up of 40% sodium. The other 60% of salt is chloride.

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20
Q

Other Important Electrolytes

A

Potassium controls fluid and electrolyte balance, assists in the conduction of nerve transmission and helps move glucose into the cell.

Magnesium regulates muscle relaxation and aids electrolytes through the cell membranes.

Calcium plays a role in skeletal muscle contraction, nerve impulse transmission and the synthesis and breakdown of muscle and liver glycogen.

To perform optimally, athletes must find ways to replenish these valuable electrolytes.

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21
Q

Factors that Affect Fluid Needs

A
  1. Sport
    Even during swimming the body loses water through sweat and respiration. This water loss is increased when swimming in warm bodies of water, and in a wetsuit. Generally, sweat rates while cycling tend to be less than sweat rates while running due to the cooling effect of wind.

Running usually elicits a higher sweat rate than swimming or biking, because of heat production and/or exercise intensity.

  1. Skin and Clothing
    Both wet skin and dehydration reduce sweat rates.

Because different materials absorb water at different rates, athletes should be encouraged to wear clothing that allows for heat dissipation and sweat evaporation. Coaches should also encourage athletes to wear light-colored clothing when training and racing in warm climates to reflect heat rays away from the body.

Heavy impermeable clothing, such as wetsuits, also increases sweat rate and inhibits the dissipation of heat. Athletes who wear wetsuits and swim in warmer water should allow for an increase in fluid and electrolyte consumption. Moisture-wicking materials worn close to the skin transfer heat and moisture from the skin to the environment, particularly in hot weather.

Wicking material is also beneficial during cold weather because dry clothing reduces the risk of hypothermia.

  1. Environment
    Athletes exercising in warm to hot and humid climates, as well as indoors on treadmills or trainers may have a higher sweat production. Coaches should encourage athletes to monitor hydration to ensure adequate fluid intake and slightly increase sodium intake to replenish lost electrolytes.

In temperate and cooler environments, there is a reduced need for evaporative cooling. Sweat losses are relatively small but there are still respiratory fluid losses. Athletes should monitor their sweat rates at various temperatures to prepare for various race conditions and adjust their race plan.

  1. Heat Acclimatization and Altitude
    Heat acclimatization improves the athlete’s ability to reabsorb sodium and chloride and reduces the sodium concentration in sweat.

Complete heat acclimatization requires up to 14 days. Therefore, athletes planning to race in hot environments (but living in cool climates) should be encouraged to allow extra time to acclimatize prior to the race.

Athletes living, training and racing at altitude greater than 2,500 m (8,200 ft) have increased fluid losses not associated with exercise.

According to the American College of Sports Medicine, respiratory losses may be as high as 1.9 Liters (2 quarts) in males and .85 Liters (28 ounces) in females per day. This means, to promote optimal kidney function, athletes should consume three to four liters of fluid per day, at high altitude.

Maintaining hydration by matching fluid intake with water lost through sweat is one of the most critical factors in preventing heat illness. Choosing clothing and equipment that is light-colored, loose-fitting, and moisture-wicking will help keep an athlete cool.

Athletes should progressively increase the intensity and duration of their training sessions to become fully acclimated to their environment.

  1. Level of Fitness and Diet
    One effect of training is an increase in efficiency at regulating core temperature.

Although sweat rate is variable, training can increase the density of sweat glands producing a greater amount of sweat. Trained athletes also begin sweating sooner than untrained athletes. This is beneficial since evaporation of sweat cools the skin.

Athletes who consume more dietary sodium tend to lose more sodium in their sweat than those with a lower sodium intake.

  1. Body Weight, Gender, and Age
    Women have more heat-activated sweat glands than men, but sweat less profusely. Women also begin sweating at a higher skin and core temperature.

Older athletes may have age-related blunting, which is a reduced sensitivity to thirst. These athletes should be encouraged to monitor fluid intake and create plans for drinking fluids while exercising based on set time intervals. Age does not have an effect on sweat electrolyte concentrations.

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22
Q

Guidelines for Fluid and Sodium Needs

A
  1. Fluid Replacement Before Exercise
    Athletes should consume fluids several hours before exercise. At least four hours before exercise, athletes should drink about five to seven milliliters per kilogram body weight of water or a sport beverage. (This is equivalent to approximately one fluid ounce per each 10 pounds of body weight.)

If profuse sweating is expected, or if there is still a deficit in fluid balance, athletes should drink an additional three to five milliliters per kilogram body weight within two hours before exercise. (This is equivalent to approximately 0.6 fluid ounces per each 10 pounds of body weight.)

It is important to consume the fluids slowly, rather than all at once.

Consuming beverages with sodium will help

  1. Fluid Replacement During Exercise
    During exercise, the goal of drinking fluids is to avoid dehydration. This is accomplished by replacing fluids based on the athlete’s sweat rate and according to his or her level of thirst. Consuming fluids in excess of sweat rate should be discouraged.

To increase gastric emptying, athletes should consume an average of four to eight ounces of fluid every 15–20 minutes of exercise. For example, if the athlete’s sweat rate was 16 ounces (480 ml) per hour, he or she would try to drink four ounces (120 ml) every 15 minutes.

The amount of fluid intake, as well as the rate of intake, will depend on the individual’s tolerance, the type of activity and the intensity of the activity.

  1. Fluid Replacement After Exercise
    After exercise, the athlete should drink adequate fluids to replace sweat loss.

Coaches should encourage athletes to consume approximately 16 to 24 ounces (450 to 675 milliliter) fluid for every pound (0.5 kg) of body weight lost during exercise.

To promote rehydration, fluids should be consumed within three hours of exercise. Consuming beverages and snacks with sodium will also help restore hydration levels by stimulating thirst and retaining fluids.

Athletes needing rapid and complete recovery from excessive dehydration can drink approximately 1.5 L of fluid for each kilogram of body weight lost. (This is equivalent to 23 fluid ounces per pound of body weight lost.)

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23
Q

Optimal Intake

A

Before exercise: consume beverages with sodium (460–1150mg/liter) and/or sports nutrition products and sodium-containing foods to help to stimulate thirst and retain the consumed fluids.

During exercise: consume 500–700 mg sodium per liter or 32 fl. oz.

After exercise: consume foods and fluids that contain sodium to facilitate rehydration. This results in less urine production and improved hydration.

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24
Q

Sports Drinks and Nutrition Products

A

During exercise, coaches should encourage athletes to obtain the necessary sodium using sports drinks, and products with sodium and salty foods.

For example, sports drinks typically contain 500mg–700mg sodium per liter (33 fluid ounces).

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25
Q

Factors Affecting Fluid Absorption

A

Fluids must be absorbed through the intestines to be moved into the cells.
Factors that reduce gastric emptying time and intestinal absorption will negatively affect the athlete’s performance.

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26
Q

Calculating Sweat Loss

A

Sweat rate calculations determine how much fluid an athlete should consume during a training session by calculating the amount of fluid that is expelled through sweat during exercise.

Sweat rate is specific to the discipline being tested, so athletes should conduct this test for swimming, biking and running.

The following screens will explore how coaches and athletes can determine sweat rate. This resource covers how to calculate sweat loss. Use this as a companion resource as you continue through the next few screens of the course. You may also use this to determine the sweat rates of your athletes.

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27
Q

Rehydrating after Exercise

A

It’s just as important to hydrate after exercise as it is before and during exercise.

To adequately rehydrate, athletes should consume approximately 16 to 24 fluid ounces for every pound or 1.5 liters per kg body weight lost during exercise.

These fluids should be consumed within three hours of exercise. Beverages and snacks with sodium will also help restore hydration levels by stimulating thirst and retaining fluids.

Athletes needing rapid and complete recovery from excessive dehydration can drink approximately 1.5 liters of fluid for each kilogram of body weight lost. This is equivalent to 23 fluid ounces per pound of body weight lost.

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28
Q

Causes of Dehydration

A

Dehydration can be mild, moderate or severe, with health and performance risks increasing with progressive dehydration.

Dehydration can also be cumulative and add up over the training session or event. This is especially true when the interval between training sessions is inadequate to fully hydrate.

Engaging in vigorous exercise (especially in hot climates) with inadequate hydration is the most common cause of dehydration.

Other common causes include

intense diarrhea,
vomiting,
fever and
excessive sweating.

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29
Q

Signs of Dehydration

A

Signs of dehydration include

thirst,
flushed skin,
premature fatigue,
increased body temperature,
faster breathing and pulse rate,
an increased perception of effort and
a decreased exercise capacity.
Other sign (that may occur later) include
dizziness,
dark colored urine,
chills,
muscle cramping,
increased weakness and
labored breathing during exercise.
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30
Q

Physiologic Responses to Dehydration

A

The following are physiologic responses to dehydration.

A decrease in blood volume, reducing the amount of oxygen-rich blood delivered to the brain and the muscle (This negatively impacts muscle function, energy production and mental/cognitive performance.)
An increase in heart rate (Due to lower blood volume, the heart compensates by beating faster to circulate more blood.)
An increase in perceived exertion of exercise
An increased risk of gastrointestinal distress (This is due to a delayed stomach emptying.)
An increase in the body’s core temperature, risk for heat illness, heat stroke and injury (This is due to the increased loss of sodium in sweat and reduction in sweat production.)

31
Q

How to Treat/Prevent it

A

Mild to moderate dehydration can be reversed or at least halted by taking in more fluid and electrolytes.

Severe dehydration needs immediate medical treatment. Therefore, athletes should do everything possible to prevent it from happening.

To prevent dehydration, athletes should

monitor and replenish fluid loss,
create and follow customized hydration plans, and
adjust fluid intake when the athlete’s health, training location or training duration changes.

32
Q

Hyponatremia

A

Hyponatremia is a medical condition in which the concentration of sodium in the blood is lower than normal.
Severe hyponatremia is a medical emergency.
Athletes and coaches should become familiar with the signs and symptoms of hyponatremia as well as know how to prevent it from occurring.

33
Q

Causes of Hyponatremia

A

The following are contributing factors to exercise-associated hyponatremia.

Overdrinking of hypotonic fluids, such as plain water
Excessive fluid intake* compared to sweat rate
Excessive loss of total body sodium (due to sweat)
Inadequate sodium intake during exercise
* It is important to note, this occurs with the intake of water or fluid replacement beverages.

34
Q

Who is at Risk?

A

Individuals with small body mass, and a large sweat rate are most at risk for hyponatremia. Because women tend to have smaller body mass, they are at greater risk than men to develop exercise-associated symptomatic hyponatremia.

Endurance triathletes are also at risk due to the length of time exercising.

Novice triathletes who are not lean, run slowly, sweat less or consume excess water before, during or after an event are at risk.

Older adults may have slower renal responses to water due to their age and may be at greater risk for hyponatremia.

Nonsteroidal anti-inflammatory drug (NSAID) use may increase the risk of development of hyponatremia during strenuous exercise by inhibiting prostaglandin formation.

According to the ACSM, in longer endurance events, sodium losses can induce hyponatremia regardless if the individual is overdrinking or under drinking, so replacing lost sodium is warranted.

35
Q

Signs and Symptoms

A

The following characteristics are signs of acute exercise-associated hyponatremia.

Weight gain
Nausea and vomiting
Headache
Confusion
Loss of energy and fatigue
Restlessness and irritability
Muscle weakness, spasms or cramps
Seizures
Coma
36
Q

How to Treat/Prevent it

A

To prevent hyponatremia, athletes should make sure to adhere to the following practices.

Calculating and monitoring fluid needs
Using thirst as a guide
Adhering to the prescribed hydration plan
Consuming sports drinks and salty snacks
Avoiding consuming an excess amount of sodium-free water
If an athlete is suffering from hyponatremia, they should immediately stop exercising and seek medical attention.

37
Q

Dehydration and Hyponatremia

A

The combination of dehydration and hyponatremia is called hyponatremic dehydration.

In this condition athletes are dehydrated (fluid loss is greater than fluid replenishment) and have a low serum blood concentration.

Any athlete who experiences symptoms related to dehydration or hyponatremia should immediately stop exercising and seek medical attention.

38
Q

Carbohydrates: Digestion and Absorption

A

The muscles and liver store a limited supply of this energy source. Therefore, during longer training sessions and racing, the athlete must supplement these stores with carbohydrates found in sports nutrition products and food. The goal for the athlete is to consume carbohydrates to maintain energy expenditure (without causing gastrointestinal distress).

39
Q

Digestion

A

Carbohydrate digestion begins in the mouth and continues in the stomach and small intestine. During digestion, complex carbohydrates are broken down into glucose, fructose and galactose molecules that are absorbed in the upper small intestines.

40
Q

Glucose Absorption

A

Each of these monosaccharides uses a different type of molecule to transport it from the intestines to the blood. Glucose uses a sodium dependent transporter (SGLT1) for absorption. Glucose moves through the intestinal wall, and is followed by water through the process of osmosis.

41
Q

Carbs: Absorption to Storage

A

Once absorbed, a small amount of glucose that is not used immediately for energy circulates in the blood. This is referred to as “blood glucose” or “blood sugar.”
Glucose is also stored as glycogen.
There is a limited amount of glycogen in the muscles, which is the largest reserve, and the liver, which is a smaller reserve.
The body can only use glucose as an immediate source of energy.
Both fructose and galactose are transported to the liver and converted to glucose.
The liver’s glycogen provides the glucose needed to maintain the body’s blood glucose level.
When energy is needed, blood glucose is transported into the muscle cell.
During prolonged exercise, muscle glycogen directly provides the energy to the working muscle cells, breaking into single glucose links that enter the mitochondria of a cell. Liver glycogen is reconverted to glucose to maintain the supply of blood glucose.
When glycogen stores are depleted, the body is forced to slow down.

42
Q

Fats: Conversion to Energy

A

When energy is needed, stored fats are catabolized into a glycerol and three fatty acids. From there, they enter the aerobic pathway where they are used to produce energy.

Fats provide significantly more energy than carbohydrates.

However, fats can also only be converted to energy during low-to-medium-intensity exercise. They also take longer to convert into energy than carbohydrates.

43
Q

The First 20 Minutes of Exercise

A

During exercise, blood glucose, liver glycogen and muscle glycogen produce energy through the aerobic and glycolytic pathways. Because of this, carbohydrates are the primary source of energy during the first 20 minutes of exercise, and during higher intensity exercise.

44
Q

The Contribution of Fats

A

As exercise continues, and carbohydrate stores are depleted, fats contribute to the total energy for muscular activity. Fats are not as efficient as carbohydrates in releasing energy, because they take longer to catabolize and require the presence of oxygen. This means that fats can only be converted to energy during lower intensity exercise.

45
Q

Pre-Event Choices

A

Pre-event meals should consist primarily of food that can be easily digested such as carbohydrates and fluids.

Protein should be consumed only in small amounts, and fat intake should be very low to minimize the risk of gastrointestinal upset.

Keep in mind: Carbohydrates high in fiber and gas forming foods such as legumes, onions, cabbage and bran products, are NOT recommended on the day before a big event as they may cause intestinal discomfort.

46
Q

Pre-Event Timing

A

On race day, the athlete should wake up early and consume breakfast. This will refill liver glycogen stores, which become up to 80% depleted overnight.

The guidelines for fueling before exercise are based on the athlete’s body weight and the amount of time food will be consumed prior to exercise.

This pre-event fueling window starts four hours before an event and slowly closes 30 to 60 minutes before the start.

The largest amount of carbohydrate can be consumed three to four hours before the event, with smaller amounts consumed (as tolerated) up to the race start. However, the exact timing and amount of carbohydrate consumed should meet the individual preferences and tolerances of the athlete.

For example, if eating three hours prior to exercising, the 80-kilogram (176 lb.) athlete will consume 240 grams of carbohydrate. The 55-kilogram (121 lb.) athlete should strive to consume 165 grams of carbohydrate.

47
Q

Morning Training Sessions

A

If the athlete trains early in the morning it can be difficult to consume the recommended amount of carbohydrate in the suggested window of one to three hours prior to exercise.

In this situation, athletes should be encouraged to eat a small snack or sports nutrition product (containing approximately 30 grams of carbohydrate) immediately before exercising.

48
Q

Afternoon Training Sessions

A

To prepare for an afternoon event or training, coaches should encourage athletes to eat a carbohydrate-based meal both the night before training and for breakfast.

Athletes should plan meals accordingly.

If the meal is small (400–500 calories), it can be consumed approximately two to three hours prior to exercise. This will allow the body enough time for digestion and absorption.
Meals high in fat, protein or fiber will need five to six hours to digest.

49
Q

Evening Training Sessions

A

To accommodate the typical daytime work schedule, many athletes choose to complete training sessions in the evening.

To fuel for an evening training session, athletes should consume a high-carbohydrate breakfast and lunch. They should also make sure to eat a light meal or snack one to four hours prior to exercising.

50
Q

Exercise from 0 to 60 minutes

A

If the athlete has properly fueled prior to exercising, hydrating the body with water and/or sports drinks is sufficient for most athletes exercising less than one hour.

However, for endurance athletes who have multiple training sessions in a day, carbohydrate consumption in amounts typically provided in sport drinks (6% to 8%), especially in athletes who exercise in the morning after an overnight fast, will help maintain blood glucose levels and improve performance. Blood glucose also supplies the brain with fuel helping the athlete to focus and complete the workout.

51
Q

Exercise from 1 hour to 3 hours

A

For training sessions lasting up to 3 hours, athletes should consume up to 60 grams of carbohydrate per hour.

Select products with multiple carbohydrate sources including glucose, glucose polymers (such as maltodextrin and dextrose) and some fructose. (For example, sucrose breaks down to fructose and glucose.)

The athlete may choose to refuel with sports nutrition products such as carbohydrate gels, chews, and energy bars, or easily digestible carbohydrate foods low in fat, protein and fiber.

Foods and fluids should be consumed in regular short intervals, such as every 15 to 20 minutes. This allows time for gastric emptying and absorption.

Training is an ideal time for an athlete to experiment with foods and nutrition products to determine which they prefer. This should all be determined well ahead of an actual IRONMAN competition.

52
Q

Exercise that lasts beyond 3 hours

A

For exercise sessions lasting more than three hours athletes should consume approximately 60-70 grams per hour of carbohydrate.

Based on the athlete’s TDEE and preferences, or when completing multiple training long sessions in a day, some athletes may be able to tolerate up to 90 grams of carbohydrates per hour, as long as the athlete consumes products with multiple sources of carbohydrate including glucose and glucose polymers. This recommendation is the upper limit, and may not be well tolerated when exercising at high intensity or while running.

In a recent study, it was shown that athletes who are not accustomed to fluid and food ingestion during exercise had a two-fold risk of developing gastrointestinal symptoms compared with athletes who were accustomed to taking fluid and food during exercise. Therefore, coaches should encourage the athletes to use these longer training sessions as an opportunity to practice the quantity and timing of nutrient intake for race day nutrition.

53
Q

Factors that Decrease the Rate of Stomach Emptying

A

Factors that decrease rate of stomach emptying and intestinal absorption should be avoided or limited before and during exercise.

These include consuming the following.

Large amounts of calories
A high concentration of fluids
Dietary fiber
High fructose beverages
Fats and proteins
Dehydration is known to decrease the rate of stomach emptying.

Stomach emptying also decreases when exercise intensity reaches 75% of the maximum exertion.

54
Q

Factors that Increase the Rate of Stomach Emptying

A

Factors that increase the rate of stomach emptying and intestinal absorption include consuming the following.

Low to medium levels of glucose
Low to moderate levels of sodium
Liquids and semi-solids (as compared to solids)
Hypotonic and isotonic liquids (< 8% carbohydrate concentration)

55
Q

Fueling After Exercise: Carbohydrates

A

The goal of the post-exercise meal is to replace the muscle and liver glycogen stores depleted during exercise (especially important when an additional session is planned within an eight-hour time frame).

Successive days of inadequate calories and glycogen replacement may ultimately result in LOW energy levels and POOR performance.

There is a very rapid phase of recovery that lasts for the 30 to 60 minutes after exercise when muscle glycogen stores are very low.
The general rule of thumb for post-training carbohydrate intake is one to 1.2 grams per kilogram of body weight.
This amount of carbohydrate can be divided over the 30 minutes to two hours following the training session.
The rate of muscle glycogen resynthesis then remains somewhat elevated for the first six hours after training, and then slows down.

56
Q

Fueling After Exercise: Protein

A

Protein provides the amino acid building blocks needed to repair damaged muscle tissue that generally occurs with high-volume, high-intensity training.
Consume 15-25 g of protein within 30 min to 2 hours following the exercise.
Athletes do not benefit from larger protein quantities and their needs could be met with 12 ounces (or 354 milliliters) of chocolate milk, or 2 to 3 ounces (or 56 to 85 grams) of low fat meat such as turkey or chicken.

57
Q

Sodium and Fluids

A

If the fluid intake was inadequate, coaches should encourage athletes to consume approximately 16 to 24 ounces (450 to 675 milliliters) fluid for every pound (0.5 kg) of body weight lost during exercise.
To promote rehydration, fluids should be consumed within three hours of exercise.
Athletes needing rapid and complete recovery from excessive dehydration can drink approximately 1.5 L of fluid for each kilogram of body weight lost. (This is equivalent to 23 fluid ounces per pound of body weight lost.)

58
Q

Pre-Race: Three to Four Hours Before

A

On race day, it is very important to encourage athletes to wake up and eat early. This will allow the body adequate time for the pre-event meal to digest. Preferably, athletes should consume a meal three to four hours before the start. This gives the body plenty of time to absorb and digest the calories prior to race start time and to help prevent gastrointestinal upset. Food selection should be planned well in advance. Everything available should be familiar to the athlete as well as easy to digest. If the athlete is unable to eat due to anxiety, consuming calories in two smaller meals rather than one large meal is recommended.

59
Q

Pre-Race: Two Hours Before

A

If the athlete has consumed a meal three to four hours before, this meal is not necessary.

If this is the first meal, it is recommended that athletes consume no more than two grams of carbohydrate per kilogram of body weight.

60
Q

Pre-Race: 90–60 Minutes Before

A

Within 90 minutes of the race start, athletes should consume only liquid or semi-solid fuel sources, such as sports drinks, carbohydrate gels or chews. This is because there is not sufficient time for solid foods to digest. Taking in anything solid at this point may put the athlete at risk for gastrointestinal upset.

Within one hour of the race, athletes should avoid taking in more than 30 grams of carbohydrates, even in liquid form.

61
Q

Pre-Race: 20–15 Minutes Before

A

If the athlete can tolerate it, he or she may choose to take in a final carbohydrate gel, which provides approximately 100 calories and 25 grams of carbohydrates. Athletes may choose to bring a carbohydrate gel with them by tucking it into their wetsuit sleeve.

Otherwise, at this point, it is best to only take in liquids, such as sports drinks and water. Athletes may want to time their last liquid intake and amount to leave enough time to empty their bladder before the race start.

Many athletes will choose to bring a disposable bottle for water or a sports drink to the swim start.

62
Q

Fueling During the IRONMAN Race

A

Bike

Athletes can typically consume more calories and fluids during the bike leg.

Some athletes choose to wait a short period of time after they start cycling before eating or drinking.

Athletes should follow the plan that has been tested during training. This plan should be based on the estimated sweat rates during cycling.

In hot and humid races, athletes may be prescribed a sodium intake of 500–1,000 milligrams per hour. Again, this should be evaluated during training sessions and tested during lower priority races.

Run

To improve the rate of gastric emptying, it is recommended that athletes consume small amounts of liquids or semi-solid foods in frequent intervals of 15–20 minutes.

Coaches should encourage athletes to follow the fueling plan as much as possible, and to stop at the aid station for sports nutrition products if planned, even if they are feeling good.

Heart rates are generally highest during the run leg, and dehydration is more likely to occur. Both of these factors may impair the athlete’s ability to absorb carbohydrates and liquids.

63
Q

GI Distress

A

GI distress is a common occurrence that affects many athletes during an IRONMAN.
The symptoms of GI vary among athletes, and can be classified as upper-GI and lower-GI tract problems.
Generally lower-GI tract problems are more severe, but all symptoms have the potential to negatively impact performance.

64
Q

What are the symptoms of GI distress?

A

There are three main causes of GI symptoms.

The most common cause is physiological (a reduced blood flow to the gut).

Other causes are mechanical. For example, the bouncing effect of running may cause GI distress.

Other causes are nutritional. Nutritional problems may be causes by issues with the athlete’s intake of

fructose,
fiber,
fat,
protein and
concentrated carbohydrate solutions.
GI issues may also occur to an athlete’s lack of sodium and/or dehydration.
65
Q

How to respond to GI distress

A

Often, the triathlete may have no other choice than to slow his or her pace and provide the stomach and intestinal symptom an opportunity to empty.

When symptoms improve, he or she should restart the fueling and hydration process by consuming a sports drink.

Remember: To prevent GI problems, have the athlete prepare the gut for the stress of a long race during the entire training season. A tested race day nutrition plan will eliminate many unnecessary GI issues on race day.

66
Q

Sports Drinks

A

Sports drinks are a combination of water, carbohydrates and selected minerals.
These drinks are designed to replenish the electrolytes and fluids lost to sweat and respiration, improve carbohydrate absorption and promote thirst.
Most sports drinks offer a blend of carbohydrate sources, which may include sucrose, glucose, fructose, and glucose polymers (such as dextrose and maltodextrin).
The athlete should consume sports drinks before, during and after exercise.
Coaches should teach athletes how to evaluate and effectively use their preferred product when training and racing.

67
Q

Optimal Fluid Absorption

A

Sports drinks are absorbed at higher rates when the following are true.

The carbohydrate concentration is less than 8%.
The drink contains a small amount of sodium.
The drink contains multiple sources of carbohydrates.
Fluid absorption is impeded when the following are true.

Concentration of carbohydrates in the drink is greater than 8%.
The drink’s fluid is too calorie-dense.
The athlete is dehydrated.

68
Q

Optimal Carbohydrate Concentration

A

The optimal range is 4–8% percent carbohydrate.

Concentrations lower than 4% do not provide adequate amounts of carbohydrate to maintain glucose metabolism.

Concentrations higher than 8% may impede gastrointestinal (GI) emptying and cause gastrointestinal distress. If the concentration of carbohydrate is higher than 8%, water can be added to dilute it.

69
Q

Calculating a Carb Percentage

A

To calculate the carbohydrate percentage of a sports drink divide the carbohydrate content (in grams) by the fluid volume (in milliliters) and then multiply this result by 100.

Carbohydrate content (in grams) ÷ the fluid volume (in milliliters) × 100 = carbohydrate percentage

For example, if a sports drink has 21 grams of carbohydrate in 366 milliliters, then 21 divided by 366 multiplied by 100 = 5.74% carbohydrate.

70
Q

Sodium and Transportable Carbohydrates in Sports Drinks

A

A moderate amount of sodium helps maintain plasma sodium concentration and promotes fluid retention and glucose absorption in the small intestine.

How much sodium does a sports drink contain?
The amount of sodium in sports drinks varies. However, the American College of Sports Medicine recommends that sports drinks contain .5 to .7 grams of sodium per liter for exercise lasting longer than one hour. Some products specifically made for endurance athletes will have a higher amount of sodium.

For example, this product has 300 mg per 366 ml (or 12 fluid ounces), which calculates to 800 milligrams sodium per liter.

How much sodium does the athlete need to consume?
Athletes should calculate the contribution of sodium from sports drinks when creating their training and racing hydration plan.

For example, if the athlete needs to replace 650 mg sodium and 24 fluid ounces (732 milliliters) per hour, the sports drink alone could supply 600 mg of sodium.

71
Q

Transportable Carbohydrate Sources

A

Most sports drinks have multiple transportable sources of carbohydrate to promote greater absorption.

72
Q

Electrolyte Supplements

A

The amount of sodium contributed by sports drinks and other nutrition products may not be adequate for some endurance athletes with high sodium concentrations in sweat or “salty sweaters.”

Salty sweaters may need to supplement sodium intake during long training sessions and races to offset excess sodium losses in sweat.

Small amounts of sodium can be replaced by adding measured amounts of table salt into the athlete’s drink.

73
Q

Carbohydrates Supplements

A

Carbohydrate Bars
Athletes should select bars with about 25–40 grams of carbohydrates.
Bars with high amounts of protein, fat and fiber should be avoided during and before races.
Bars should be consumed in small amounts over a period of time; larger quantities may impede gastric emptying.

Gels and Chews
Gels and chews come in many varieties and flavors.
One serving provides approximately 100 calories (25 grams of carbohydrate).
Due to the concentration of carbohydrates, they should be consumed with water (four to eight ounces). Some athletes may choose to take smaller amounts over a 10–15 minute interval to reduce the potential of gastric distress.
Gels and chews with small amounts of sodium will increase absorption.
Some of these products may contain caffeine.

Powders
Carbohydrate powders are used to aid in recovery or during training.
They are generally composed of glucose polymers such as maltodextrin and dextrose.
They are very concentrated and may be used with fluids as a part of the recovery plan if food is not available.