Clinical Nutrition- Exam 1- Sports Nutrition

What nutritional assessment should be conducted on active patients/athletes

Nutrient focused physical exam, mainly on protein and iron

Daily carb needs for low intensity (

3-5 g/kg of body weight

Daily carb needs for moderate intensity (~1 hr/day)

General training needs

5-7 g/kg of body weight

Daily carb for moderate to high endurance (1-3 hr/day)

6-10 g/kg

Daily carb for moderate to high intensity (>4-5 hr/day)

Ultra endurance athletes

8-13 g/kg

With carbs, closer to an event you should

Limit fiber, choose liquid or easily digestible carbs

After a workout it is important to consume carbs with? Why?

Protein to enhance glycogen storage

Sedentary protein requirement

0.8

Active adults protein requirement

1.0

Endurance athletes, runners, cyclists protein requirement

1.2-1.4

Ultra endurance athletes protein requirement

1.2-2.0

Strength athletes (maintenance) protein requirement

1.2-1.4

Strength athletes (gain muscle mass) baseball, football protein requirement

1.6-1.7

Intermittent, high intensity training, basketball, hockey, soccer, tennis, swimming, track protein requirements

1.4-1.7

Vegetarian athlete protein requirements

1.1-2.2

What type of carbs should they eat

Carbs with a 50/50 fructose to glucose ratio

What type of carbs should they avoid

Carbs that have either a high fructose to glucose or high glucose to fructose ratio

Who needs to carb load

Endurance athletes

How should carb loading be accomplished

Rest for 48 hr prior to an event plus car intake of 10-12 g/kg/day

What are good quality proteins

Proteins high on the DIAAS scale (digestible indispensable amino acid score)

-its the one done in the pig ileum

-casein, why, cows milk, egg, fish, beef, soy protein isolate

What dose of protein is generally recommended at a time

About 20 grams

What is the crossover effect

As you go higher percentage in the exercise intensity than the more cabs provide energy and Vice versa for lipids

What are micronutrients of concern in athletes training in altitude

Increase need for iron and vitamin C

What are micronutrients of concern for female athletes

More iron, calcium, vitamin D and K

What are micronutrients of concern for vegetarians and vegan athletes

Higher requirements of iron and zinc, supplant with B12 as needed

What are micronutrients of concern with athletes with high and low carb diets

High carbs means more thiamin and zinc

Low carbs requires a variety of supplements to meet recommendations

What are some conditions that may increase fluid requirements

Training in heat

Cold

Altitude

Training in heat increases sweat rate by

10-20%

Important to monitor what when training in heat

Urine cooor

May need to do what for fluid replacement for training in heat

Increase sodium intake >3g/day

Increase fluid intake by what amount when training at altitude

1-1.5 L/day

Recovery drinks for endurance sports

4 g crabs 1 G protein

Low fat chocolate milk

1 cup low fat milk plus 1 small banana

Recorder drinks for strength sports

2-3 g carbs, 1 g of protein

1 cup of low fat milk plus Greek yogurt with granola

Smoothie with milk, fruit, ice and whey protein

Water soluble vitamin that has higher requirements with increasing carb intake

Thiamin

Water soluble vitamin that has higher requirements with increasing protein intake

B6

Fat soluble vitamin that is importance to not consume more than tolerable upper intake level

Vitamin A

Energy for acute phase of injury

2750-3250 Cal (mostly from carbs and protein)

Carb ratio (carb to proteins ratio) is dependent on_____ using acute phase of injury

Level of immobilization

-if immobilized then decrease percentage of carbs slightly

Protein amount for acute phase of injury

2.3 g/kg

30-40 g casein prior to bed

Important supplements for acute phase of injury

5 g fish oils (3 g EPA adn 2 g DHA)

Creatine loading 20g/day for 5 days

2000 IU vitamin D

Protein for functional phase of injury

Collagen or getlatin (not gummies) consumed wtih some vitamin C

20 g collagen plus Vit C 30-69 min prior to training

Avoid what during functional pas of injury? Why?

Bone broths-limited in some amino acids

Alcohol- inhibits muscle protein synthesis

Cabs during functional phase of injury

3-5 g/kd

Max 60%

Lipids during functional phase of lipids

0.8-2 g/kg

20-25% of energy

2 g/dah of fish oils

Protein during functional phase of injury

20-4 g/kg

Adequate leucine

What type of protein are recommended for bone

High animal protein plus low calcium intake (

Higher acid load is associated with

Lower bone mineral density

What calculations do you do to do dietary acid load

Net Endogenous Acid Production (NEAP)

Potential Renal Acid Load (PRAL)

What nutrients/dietary components have a negative influence on bone mineral density and WHY?

-

What nutrients/dietary components have a positive influence on bone mineral density and why?

-heavy alcohol

-high caffeine intake

-excessive fiber

What is the ratio for calcium to phosphorus is recommend

Calcium to phosphorus >1

What re the dietary recommendations for TBI (traumatic brain injury)

Intervention within 24-48 hrs

Energy greater then 25-30 kcal if

Protein 1-1.5 g/kg

Increase dietary vitamin E

How should food be staggered around post surgery

Soon after, 12 g EAAA plus 50 g glucose

How should food be staggered around post surgery

Soon after then 12 g of EAA plus 50 g glucose

How should food be acting as an appetite recovers

30 G protein shake

24 hrs post surgery

30 G protein

Days after surgery then open leg field area

Protein loading heavy again

How should food be staggered around leading up to a surgical procedure

7-10 days before normal food

12 hrs before 30 grams of protein

6 hrs before than is 12 g EAA plus 50 g glucose

Energy from protein/carbs

4 cal/g

Energy from fats

9 cal/g

Energy from alcohol

7 cal/g