Sports Nutrition Final

Vitamins and minerals are required for

muscle contractions and energy expenditure

What are vitamins?

Organic molecules

Water- and fat-soluble forms

Water soluble

B, C, and Choline

Dissolve in water

Fat soluble

A, D, E, and K

Dietary fat for transport in blood

Excess stored in fat tissues

Thiamin

B1

Functions: Energy production, Nervous system

RDA/AI: Men - 1.2mg, Women - 1.1 mg, or 0.5 mg/1,000kcal expended

Signs of deficiency: Headaches, Confusion, Muscle pain and weakness, Fatigue, Beriberi when severe

Symptoms of toxicity: Rare, No UL established

Are supplements needed? : Maybe if trying to lose weight

Riboflavin

B2

Functions: Electron Transport in aerobic energy production

RDA/AI: Men - 1.3 mg, Women - 1.1 mg

Signs of deficiency: Red, cracked lips, Sore throat, Inflamed tongue

Symptoms of toxicity: Rare, No UL established

Are supplements needed? : Needs typically met through balanced diet

Niacin

B3

Functions: Electron transport in aerobic and anaerobic energy production

RDA/AI: Men - 16 mg, Women - 14 mg

Signs of deficiency: Skin rashes, Mental confusion, Muscle weakness, Fatigue, Pellagra in severe cases

Symptoms of toxicity: Itchy rashes, Headaches and nausea, Liver complications, UL - 35 mg

Are supplements needed? : Not reccomended 

B6

Functions: Glycogen metabolism, Transamination, Neutral function

RDA/AI: 1.3 mg

Signs of deficiency: Nausea, Convulsions, Skin disorders, Fatigue, Weakness, Anemia

Symptoms of toxicity: Irreversible nerve damage, Impaired gait, UL - 100 mg

Are supplements needed? : Inconclusive

Cobalamin

B12

Functions: Energy production, Tissue growth and development, Nervous and cardiovascular health

RDA/AI: 2.4 μg

Signs of deficiency: High homocysteine, Neurological problems, Pernicious anemia, Deficiencies develop slowly

Symptoms of toxicity: Rare, No UL established

Are supplements needed? : May be beneficial for vegetarians, vegans, and masters athletes

Folate

Folic Acid

Functions: DNA synthesis, Cell division, Tissue repair, RBC maturation

RDA/AI: 400 μg

Signs of deficiency: Neural tube defects, Macrocytic anemia, Chronic diarrhea, Impaired immune function

Symptoms of toxicity: Rare, UL - 1,000 μg

Are supplements needed? : No evidence of performance benefit, maybe during pregnancy

Biotin

Functions: DNA synthesis, Aerobic energy production from big 3

RDA/AI: No RDA, AI - 30 μg

Signs of deficiency: Depression, Dermatitis, Fatigue, Nausea, Deficiencies are rare

Symptoms of toxicity: None documented, No UL established

Are supplements needed? : No evidence of benefits

Pantothenic Acid

Functions: /aerobic energy production from big 3

RDA/AI: No RDA, AI - 5 mg

Signs of deficiency: Sleep disturbances, Impaired coordination, Muscle cramping, Fatigue, NAusea

Symptoms of toxicity: None documented, No upper UL established

Are supplements needed? : No

Choline

Functions: Muscle activation, Structural integrity of cell membranes

RDA/AI: No RDA, AI - 550 mg (men), 425 mg (women)

Signs of deficiency: Rare

Symptoms of toxicity: Low blood pressure, Diarrhea, Fishy body odor, UL - 3,500 mg

Are supplements needed? : Inclonclusive, more research needed

Vitamin C

Ascorbic acid or ascorbate

Functions: Collagen synthesis, Immune function, Antioxidant

RDA/AI: Men - 90 mg, Women - 75 mg, Smokers, +35 mg

Signs of deficiency: Swollen gums, Fatigue, Scurvy

Symptoms of toxicity: Reletivley nontoxic, Kidney stones, Nausea and diarrhea, UL - 2,000 mg

Are supplements needed? : Not if deficient, may address low iron

Vitamin A

Retinoids

Functions: Vision, Cekk differentiation, Immune function

RDA/AI: Men - 900 μg RAE, Women - 700 μg RAE

Signs of deficiency: Rare, Night blindness, Hyperkeratosis

Symptoms of toxicity: Vomiting, Fatigue, Blurred vision, Liver damage, UL - 3,000 μg RAE

Are supplements needed? : No

Carotenoids

Not a vitamin

Can be converted to Vitamin A

Functions: Antioxidant, Immune function

RDA/AI: None established

Intake increased by more fruit and vegetables

Are supplements needed? : Not recommended

Vitamin D

Functions: Controls blood calcium levels, Bone growth/development

RDA/AI: 19-70 - 600 IU, 70+ - 800 IU

Signs of deficiency: Rickets, Osteoporosis

Symptoms of toxicity: Hypercalcemia, Muscle weakness, Heart arrhythmias, Kidney stones, UL - 50 μg

Are supplements needed? : Maybe

Vitamin E

Alpha-tocopherol

Functions: Antioxidant

RDA/AI: 15 mg

Signs of deficiency: Rare, Muscle weakness, Loss of motor coordination, Hemolytic anemia

Symptoms of toxicity: Decreased blood clotting, Easy bruising, UL - 1,000 mg

Are supplements needed? :

Vitamin K

Quinone family of compounds

Functions: Blood clotting, Bone mineralization

RDA/AI: Men - 120 μg Women 90 μg

Signs of deficiency: Impaired blood clotting, Excessive bleeding

Symptoms of toxicity: None documented, No UL established

Are supplements needed? :

Vitamin D Activity

Affects over 1,000 genes

Helps regulate inflammation and immune system

Heart, Lungs. Adrenal medulla, Neurons, Muscle, Pituitary, Bone, and Brain

Factors Affecting Vitamin D Production

Latitude

Season of year

Time of day

Amount of time spent indoors

Melanin content

Sunblock

Age

Extent of clothing covering skin

Free radical

Highly reactive molecules, usually containing oxygen, that possess unpaired electrons in their structure

Produced in the body as byproducts of normal
metabolism or introduced from outside sources
(polluted air). Increased during exercise

Oxidation

Process by which free radicals cause molecules to give up electrons

Free radical damage

can contribute to cancer, cardiovascular disease, and possibly nerve degeneration

Phytochemicals

Chemical substance from plants

Consumption associated with decreased risk for cardiovascular disease and cancers

Common source are fruit, vegetables, and grains

Phenolic Compound

Group of varied phytochemicals

Flavonoids, Phenolic acids

Teas, Grapes

Organosulfides

Group of phytochemicals

Glucosinolates, Indoles, Isothicyanates

Cruciferous vegetables, Garlic, Onions

Lycopene

Carotenoid

Tomatoes, Tomato products

Minerals are

Inorganic molecules

Essential for human survival

Have no caloric value

Not degraded by cooking or digestion

Major Minerals

Needed in amounts more than 100 mg

E.g. Sodium, Potassium, Calcium

Trace minerals

Needed in amounts less than 100 mg

E.g. Iron, Zinc, Chromium

Calcium

Most abundant

Functions: Blood clotting, Muscle contraction, Nerve transmission, Bone formation.

RDA/AI: 19-50 - 1,000 mg, Women 50+ and Men 70+ 1,200mg

Signs of deficiency: Hypocalcemia (rare), Muscle spasms, Convulsions, Low bone density

Symptoms of toxicity: Hypercalcemia, Calcium deposits, Kidney stones, Fatigue, UL - 2,500mg (age 19-50), 2,000 (age 50+)

Are supplements needed? : If calories are restricted

Phosphorus

Functions: Bone formation, Cell membrane formation, Enzyme activity

AI: 700 mg

Signs of deficiency: Bone malformation, Bone pain, Muscle weakness

Symptoms of toxicity: Alter calcium metabolism, Osteoporosis, UL - 4,000 mg

Are supplements needed? : Evidence is ambigous

Magnesium

Functions: Bone formation, Blood clotting, Regulation of blood pressure, Enzyme activity

RDA/AI: Men - 400 mg (19-30) to 420 mg (31-70), Women - 310 (19-30) to 320 mg (31-70)

Signs of deficiency: Irritability, Muscle cramps, Heart arrhythmias, Hypertension

Symptoms of toxicity: Nausea, Diarrhea, Vomiting, Muscle weakness, UL - 350 mg from supplements

Are supplements needed? : if deficient

Sodium

Functions: Major electrolyte, Nerve impulse transmission, Muscle contraction, Regulation of blood pressure

AI: 1,500 mg

Signs of deficiency: Hyponatremia, Nausea, Vomiting, Seizures, Coma

Symptoms of toxicity: Swelling, Increased blood pressure, UL not determined but reduce if above 2,300mg

Are supplements needed? : 4+ hour endurance athletes

Chloride

Functions: Major electrolyte, Nerve impluse transmission, Aids digestion (HCI), Fluid balance

AI: 2,300 mg

Signs of deficiency: Increased blood pH, Abnormal heart rhythm, Poor blood flow

Symptoms of toxicity: Increased blood pressure, UL - 3,600 mg

Are supplements needed? : No

Potassium

Functions: Major electrolyte, Nerve impulse transmission, Muscle contraction, Blood pressure regulation

AI: Men - 3,400 mg (19+), Women - 2,600 mg (19+)

Signs of deficiency: Muscle cramping, Muscle weakness, Loss of appetite, Heart arrhythmias

Symptoms of toxicity: Rare, No UL established

Are supplements needed? : No

Sulfur

Functions: Part of hundreds of sulfur-containing compounds in the body

RDA/AI: None

Signs of deficiency: Rare

Symptoms of toxicity: Rare, Diarrhea, Colitis, No UL established

Are supplements needed? : No

Iron

Functions: Oxygen transport and utilization, Component of hemoglobin and myglobinmyoglobin

RDA/AI: Women 19-50 - 18 mg, Men and Menopausal women - 8 mg, Vegetarians - 32 mg, 14 mg 

Signs of deficiency: Anemia, Fatigue

Symptoms of toxicity: Nausea, Diarrhea, Hemochromatosis, UL - 45 mg

Are supplements needed? : If deficient

Zinc

Functions: Cofactor in over 200 enzymatic systems, Wound healing, Growth and maintenance, CNS, GI, and reproductive systems

RDA: Men - 11 mg, Women - 8 mg

Signs of deficiency: Rare, Poor immunity, Dermatitis, Diarrhea, Loss of appetite

Symptoms of toxicity: Rare, Nausea, Vomiting, Increased LDL, Anemia

Are supplements needed? : No

Chromium

Functions: Enhances function of insulin, Decreases cellular insulin resistance

AI: Men - 35 μg, Women - 25 μg

Signs of deficiency: High blood sugar, Decreased muscle endurance

Symptoms of toxicity: Rare, High levels may decrease Zn and Fe absorption

Are supplements needed? : No

Fluoride

Functions: Bone and tooth mineralization, Prevents dental caries, Ligament and tendon strength

AI: Men - 4mg, Women - 3 mg

Signs of deficiency: Dental caries, Increased bone fractures

Symptoms of toxicity: Rare, Flurosis, Gastritis, Stiff joints, UL - 10 mg

Are supplements needed? : No

Copper

Functions: Iron metabolism, Antioxidant cofactor, Enzyme cofactor in tissue growth and energy metabolism

RDA: 900 μg

Signs of deficiency: Rare, Bone and conncective tissue abnormalities, MEnkes syndrome

Symptoms of toxicity: Gi distress, Liver disease, Wilson’s disease, UL - 10,000 μg

Are supplements needed? : No

Manganese

Functions: Enzyme cofactor (Metabolism, Antioxidant, Tissue growth)

RDA/AI: Men 2.3 mg, Women - 1.8 mg

Signs of deficiency: Poor growth, Bone and tissue connective abnormalities, Altered carbohydrate and fat metabolism

Symptoms of toxicity: Fatigue, Weakness, Neurological problems, UL - 11 mg

Are supplements needed? : No

Iodine

Functions: Assists in synthesis of thyroid hormones

RDA: 150 μg

Signs of deficiency: Weight gain, Cold intolerance, Goiter

Symptoms of toxicity: Goiter, UL - 1,100 μg

Are supplements needed? : No

Molybdenum

Functions: Antioxidant cofactor, Enzyme cofactor is metabolism of amino acids containing sulfur

RDA: 45 μg

Signs of deficiency: Rare, Unknown

Symptoms of toxicity: Rare, Unknown, Can decrease absorption, UL - 2000 μg

Are supplements needed: No

Selenium

Function: Component of many proteins in body, Enzyme cofactor (immune function, Thyroid function, Antioxidant)

RDA: 55μg

Signs of deficiency: Rare, Cardiomyopathy, Increased risk of cancer

Symptoms of toxicity: Brittle hair and nails, Hair and nail loss, UL - 400 μg 

Are supplements needed? : No

Iron absorption depends on

Gastrointestinal function

Need for Iron

Amount and kind of iron consumed

Dietary factors that inhibit or enhance iron absorption

Why are athletes at increased risk for iron deficiencies?

Low dietary intake

Increased demand for hemoglobin and myoglobin

Loss through sweat

Mechanical hemolysis

Types of Erogenic Aids

Nutritional

Physiological

Psychological

Biomechanical

Pharmacological

Nutrional Erogenic Aids

Supplement, foo product or dietary manipulation

Carbohydrate loading, creatine phosphate, amino acid supplementation

Physiological Erogenic Aids

Practice or substance that enhances functioning of bosily systems

Training, blood doping via tranfusions, warming up

Pyschological Erogenic Aids

Practice or treatment that changes the mental state

Relaxation techniques, visualization, pep talks

Biomechanical Erogenic Aids

Device, piece of equipment, or external product

Weight belts, knee wraps, spikes

Pharmalogical Erogenic Aids

Drug or hormonal agent

Caffeine, beta-blockers

What are dietary supplements?

Not food

Contains on of the following:

Vitamin

Mineral

Herb or botanical

Amino acid

Dietary substance to supplement diet

A concentrate or combination of the above

Why do athletes use dietary supplements?

Health maintenance

Faster recovery

Increased energy

Increased muscle mass

Increased strenght

2004 Ephedra Ban

Stimulant, appetite suppressant

Reports of heart attacks, strokes, seizures, deaths

Steve Bechler, Orioles

First time FDA had taken formal action to halt sale of a dietary supplement ingredient since DSHEA

Where can information on nutritional ergogenic aids be found?

NSF International

USADA

WADA

NCAA

Tools for Researching Nutritional Ergogenic Aids

PUBMED/Medline

CINAHL

SPORTSDiscus

CARDS

What is doping?

Practice of enhancing performance using foreign substances or other artificial means

Inadvertent Doping

Ingestion of substances that unbeknownst to the athlete can cause a positive test for doping

Types of Commonly Encountered Doping Agents

Anabolic agents

Fat reducers

Anticatabolics

Endurance enhancers/fatigue reducers

Anabolic Agents

Enhance the body’s ability to build tissue, particularly muscle

Includes substances touted to be converted to or increase production of anabolic hormones in the body

Pro-hormones

Examples

Androstenedione: “Andro”

Beta-hydroxy-beta-methyl butyrate (HMB)

Ornithine and arginine

Clonidine

Anabolic Steroids

Typically used in a stacking Regimen, where they are administered with several different drugs simultaneously.

One anabolic agent’s potency may be enhanced when consumed with another.

Evidence-Based Supplements

Protein supplements

Creatine

Caffeine

Beta-Alanine

BetB-Hydroxy-B-Methylbutyrate

Grey Area Supplements

Branched-Chain Amino Acids (BCAAs)

Pre-Workout

Fat Burners/Weight Loss Supplements

Which Populations Require Special Considerations?

Athletes with diabetes

Athletes who are pregnant

Child and teen athletes

Collegiate athletes

Masters-level athletes

Athletes who are vegetarians

Diabetes

Affects approximately 30 million people in the United States

Three quarters are diagnosed; remainder are unaware.

Metabolic disease

Affects carbohydrate metabolism

Causes hyperglycemia

Ketosis/ketoacidosis

Increases risk for heart and kidney disease

Causes peripheral nerve damage

Type 1 Diabetes

Diagnosed most often in children and young adults

Constitutes ~5% of diabetes cases

Also known as insulin-dependent diabetes

Pancreas fails to produce enough insulin.

Treatment requires insulin injections.

Type 2 Diabetes

Most prevalent in middle-aged and older adults

Constitutes ~95% of _____ cases

Known as non-insulin-dependent ______

Pancreas produces enough or too much insulin.

Cells are insulin insensitive/insulin resistant.

Medicine, diet, and exercise can be treatments.

Common Symptoms of Diabetes

Excessive thirst

Excessive urination

Dehydration

Dizziness

Headache

Blurred vision

Unexplained weight loss

Excessive hunger

Poor wound healing

Hypoglycemia

Sweating

Pounding heart

Hunger

Shakiness

Confusion

Lethargy

Incoordination

Slurrred or difficult speech

Irritability

Headache 

Nausea

Hyperglycemia

Nervousness

Restlessness

Thirst

Fatigue

Blurred vision

Muscle cramps

Nausea

Abdominal pain

Considerations for Pregnant Athletes

Competition

Intensity and volume of exercise

Physician recommendations

Dietary recommendations

Special Dietary Concerns for Pregnant Athletes

Daily caloric intake

Protein consumption

B vitamins

Vitamin C

Vitamin A

Magnesium

Iron

Why Athletes Should Avoid Alcohol

Use is banned

Can be illegal (age)

Safety issues (driving)

Nutritionally “empty”

Poor carbohydrate source

Can increase body fat

Stimulates appetite

Special Considerations for Masters Athletes

Altered caloric needs?

Altered vitamin and mineral needs

Decrease chromium

Decrease iron

Increase vitamin D

Increase calcium

Increase magnesium

Chronic diseases

Food‒drug interactions

Special Considerations for Vegetarian Athletes

Plant-based diet

Types of vegetarians

Semi, pesco, lacto-ovo, lacto, ovo, vegan

Protein intake

Complementing

Vitamin D and B₁₂

Zn, Ca, and Fe intake

Eating out on the road

Special Considerations for Athletes with Disabilities

Types of physical disabilities

Paraplegic

Quadriplegic

Amputees

Energy needs in athletes with disabilities

BMR anywhere from 5-30% lower

Energy needs for any given sport depend on

Injury level

Energy demands of specific sport

Common Weight Management Concerns for Athletes

Impact on performance

Aesthetics/body image

Weight classifications for competition

Changing body composition

Increase muscle mass

Decrease fat mass

Disordered Eating’s Prevalence in Sports

Female: 6-45%

Male: 0-19%

up to 84% of college athletes

~42% of high school athletes

~9.3% of female elite athletes

~6.9% of male elite athletes

RED-S

Relative Energy Deficiency in Sports

Inadequacy of energy to support the range of body functions involved in optimal health and performance

More comprehensive than Female Athlete Triad

Males also affected

Impaired physiological function

Metabolic rate

Menstrual function

Bone health

Immune system

Protein synthesis

Cardiovascular health

Causes of Disordered Eating

Athletes at risk

“Appearance” sports

Sports requiring weigh-ins

Pressure to attain the “ideal” in their sport

Social physique anxiety

Pressure from others

Coaches, parents, trainers

Eating Disorders

Clinically defined in DSM-5

Anorexia nervosa

Bulimia nervosa

Binge eating disorder

Not clinically defined in DSM-5

Anorexia athletica

Muscle dysmorphia

Anorexia Nervosa

Severe calorie restriction; energy drain

Significant weight loss

Refusal to maintain normal, healthy weight

Intense fear of weight gain

Distorted body image

Bulimia Nervosa

Binge episodes

Out of control

Inability to stop despite being overly full

Inappropriate compensatory methods

Vomiting, laxative abuse, overexercise, fasting

Distorted body image; influences self-esteem

Binge Eating Disorder

Frequent overeating

Overeating combined with feelings of lack of control and depression or guilt afterwards

Eating food very rapidly, eating until uncomfortably full

Eating alone

Muscle Dysmorphia

Not in DSM—5

Highly muscular individuals (usually men) who have a pathological belief that they are of very small musculature

Intense and excessive preoccupation or dissatisfaction with body size and muscularity (Pope, et al.)

Signs of Muscle Dysmorphia

Preoccupation with body shape/size

Preoccupation with muscularity impairs other aspects of life.

Excessive exercise

Obsesses about food

May abuse steroids

Anorexia Athletica

Not in DSM-5

Similarities with bulimia and anorexia nervosa

Behaviors and symptoms may be different from those in non-athletes

Signs of Anorexia Athletica

Decreased energy intake

Decreased weight in the absence of medical illness or affective disorder explaining the weight reduction

Maintenance of high physical performance

Desire to lose weight not based in appearance

Desire to lose weight based on performance or perceived performance improvement

Intense fear of weight gain

Weight cycling based on training levels

Dietary restraint

Bingeing and purging

Gastrointestinal complaints

Menstrual dysfunction

Compulsive exercise despite illness or injury

View of self-worth by athletic ability or performance

Individual does not meet DSM-5 criteria for eating disorder but possesses many eating-disorder characteristics

Physical Effects of Eating Disorders in Athletes

Decreased fat-free mass (i.e., muscle)

Dehydration

Glycogen depletion

Negative hormonal disturbances

Gastrointestinal problems due to laxative use

Anxiety

Inability to sleep

Decreased concentration

Poor exercise performance

Increased risk for overuse injuries

The Female Athlete Triad

Typically observed in young female athletes

Three definable components

Low energy availability

Can result from eating disorders or disordered eating

May not meet criteria for eating disorder

Menstrual dysfunction

Amenorrhea or oligomenorrhea

Occurs because of insufficient energy availability

Cause changes in sex hormone secretion

Irregular menstruation and ultimately amenorrhea

Low bone mineral density

Reduction in body fat to unhealthy levels can alter hormone levels that affect BMD

Low energy intake can also restrict calcium, vitamin D, and magnesium, all important for bone health

Treatment Options for Eating Disorders

Based on emotional and psychological issues that manifest themselves in disordered eating and exercise behaviors

Team approach - multidisciplinary team

Medical exam

Regular counseling

Disordered Eating Prevention Practices

Reduce emphasis on body weight and/or body composition.

Emphasize skills and performance.

Discourage diets and quick weight loss.

Model healthy eating (coaches, trainers, etc.).

Develop a healthy gym environment.

Help set achievable goals.