Performance Nutrition

Transcription

1 Performance Nutrition Nikos Jakubiak MSc SENr RD HCPC registered Performance

2 Don t treat us any differently! Yes, in the long run some athletes with an impairment may have to do something different than our able-bodied counterparts, but don t start out thinking we are any different. It is important to listen, be supportive, and sometimes you may have to think outside the square! Carol Cooke, Paralympic Cyclist From Sports Nutrition for Paralympic Athletes edited by Elizabeth Broad, CRC Press

3 Control the controllables There is only one way to happiness and that is to cease worrying about things which are beyond the power or our will Epictetus, AD

4 Controllable factors impacting on performance Technical skills Physical attributes (e.g. strength, fitness) Mental skills & Motivation Physique Optimum Optimum nutrition in Performance elite athletes Equipment Nutrition & Hydration Performance driven lifestyle Support (staff, management etc.)

5 What Essential nutrients nutritional do we need? needs Base all main meals on starchy carbohydrates. Carbohydrates Proteins Fats Vitamins Minerals Water

6 From Nutrition to Performance Nutrition

7 Performance added motive in food choice Fuel training (Vol & Q) & competition Support physique adaptations e.g. MM Achieve/maintain Optimal/required BM Resist fatigue Optimum nutrition for in elite performance athletes Maintain focus Recovery during & post training & competition Reduce training attrition due to illness e.g. colds Support good current & long-term health Maintain motivation Maintain +ve mood Prevent injury

8 But, we seek the pleasure of food Kringelbach 2015, Flavour

9 Evaluate & Reassess Needs analysis Monitor compliance Identify potential barriers Agree & implement intervention Plan intervention

10 Needs analysis: Physical & metabolic demands of events

11 Different events different demands (in calories, macronutrients, body mass, hydration & education)

12 Different condition different demands Impaired muscle power e.g. spinal cord injuries or spina bifida Impaired passive range of movement e.g. hypermobility of joints or joint instability Limb deficiency e.g. amputation or congenital limb deficiency Leg length difference e.g. trauma or congenital deficiency Short stature e.g. growth hormone dysfunction Hypertonia e.g. cerebral palsy or multiple sclerosis Ataxia e.g. cerebral palsy or multiple sclerosis Athetosis e.g. cerebral palsy or multiple sclerosis Visual impairment Intellectual Impairment

13 Identifying potential barriers to implementing PN plan

14 Potential challenges for wheelchair athletes Inability to reach food from counters (at accommodation or camp) support team need to be proactive e.g. check wheelchair access, height and depth of tables used to lay out food, availability of appropriate trays and cutlery Inability to access snacks or fluids during competition (racket strapped on hand) better preparation e.g. remove unnecessary wrapping Journeys can take longer affecting meal times some appropriate back up snacks & fluids should be available in kit bags Risk of UTIs from deliberate restriction of fluid intake in order to manage urine output better planning for journey conditions & types of fluids needed (consider use of hypotonic or isotonic drinks) Pressure sores higher requirement for protein

15 Disability athletes have to deal regularly with the prevailing able-bodied bias

16 Disability can also influence food choice as it may impact on: getting access to food deciding on preferred option (e.g. visually impaired) getting hold of food ingestion & digestion of food enjoyment of food comprehension of PN strategies (athletes with learning disabilities)

17 Barriers to athletes physical & metabolic capacity

18 From a metabolic/nutrition standpoint, disability athletes range from people with no impairment in their biomechanical and physiological abilities to athletes with severe impairments

19 What is the % of functional muscle mass?

20 Variability potential in daily use of calories Non disability athlete Disability (with no muscle impairments) Disability (with partial muscle impairments) Disability (with whole body muscle impairments) Basal Metabolic Rate (BMR) Daily activities (not training) Limited variability Limited variability Limited variability Limited variability Some variability Some variability Some variability Limited variability Training High variability High variability High variability Limited variability

21 Hydration

22 Thermoregulation compromised by dehydration In some athletes with spinal cord injury thermoregulation can be compromised even when they are not dehydrated

23 DIY sports drinks Hypotonic drinks (best used as fluid replacement) For every1000ml of cold water add: A small amount of no added sugar squash for flavouring 20-30g table sugar (approx. 2 tablespoons) A pinch of table salt (the tip of a teaspoon) Isotonic drinks ( as above & for short supply of energy in long sessions) For every 1000ml of cold water add: Some no added sugar squash for flavouring 50-70g of table sugar (approx. 4 tablespoons) A pinch of salt (the tip of a teaspoon) How much of the sports drink you should have each day depends on: how often, how hard, and for how long you exercise for. It also depends on the weather conditions (heat & humidity), how much you sweat, and of course your body size. Seek advice from a dietitian or a qualified sports nutritionist.

24 Plan & Implement PN strategies Various areas to address, not all relevant to every case but worth considering: Proteins PN education to empower athletes Green Vegetables Other Vegetables Starchy Carbohydrates Fruits Finding practical solutions Prioritise the changes needed Meal pattern, food choices, portion sizes & rehydration Meal planning and meal preparation skills Nutrition periodisation The nutritional value of meals and snacks

25 Monitoring Various options but not all relevant to every case: Body mass Urine specific gravity or colour (some medication can influence colour) Food diary Wellness diary Direct feedback from athlete Feedback from coach and support staff

26 Evaluation Various options but not all relevant to every case: Change in performance behaviours Improvement in habitual food choices Appropriate change in body mass Appropriate change in skin folds Improvement in blood test results R Impact on performance outcomes e.g. agility test.

27 Motive for change: Improve performance to secure top rank Aim: Improve agility Example: wheelchair athlete Objective: Reduce skin folds and body mass (adjusted skin folds test) Assessment Lower limbs limited function but high training volume with upper body Skin folds total high Portion sizes similar to non-disabled peers Actions Adjusted meal pattern, meal balance, portion sizes Outcome Body mass reduced by 4Kg, SFs by ~20% and agility scores improved

28 Example: Learning disability Motive for change: Secure qualification for Paralympics Aim: Maintain strong performances throughout multi day events Objective: Minimise weight loss rate on week leading up, and during, events Assessment Previously bad diet and following advice attitude change 180 Obsessed with low SFs (belief that lower SFs = faster times) Often self catering accommodation but no culinary skills Actions Prioritise & repeat standalone messages, supervised safe-cooking methods to promote more autonomy, smoothies Outcome Body mass stable during competitions & qualification achieved

29 Vitamin D

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31 Sunshine in Athens, Glasgow and Stirling 100% 75% 50% 25% %

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33 Benefits from adequate sunshine Increase or maintenance of high vitamin D Increase of NO Improve mood Improve sleep quality Support healthy immune function Increase MSH ( melanin, appetite)

34 Risks of too much sunshine Skin damage (sunburn, premature aging of skin, risk of skin cancer) Eye damage (always wear good sunglasses) Sun stroke

35 How much sunshine for vitamin D? UV index Shadow rule Smartphone applications e.g. Dminder

36 Performance Nutrition Questions? Comments? Nikos Jakubiak MSc SENr RD HCPC registered Performance