PROPER NUTRITION FOR ATHLETES: THE MISSING LINK

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1 Keynote Presentation at the 7 th SCSEPF Annual Conference PROPER NUTRITION FOR ATHLETES: THE MISSING LINK Nancy Clark Sports Nutrition Services, Healthworks Fitness Center, Chestnut Hill, Massachusetts, USA Nutrition should be an integral part of an athlete s training program. Yet, in the United States, American athletes and fitness exercisers alike commonly report that they do not eat as well as they should; they admit that nutrition is their missing link. Consequently, they may fail to attain the most benefits from their training programs and their competitive efforts. The purpose of this paper is to highlight the sports nutrition errors commonly made by American athletes who live in a culture where food is considered fattening, eatingon-the-run is the norm, and fast foods are a common alternative to home-cooked meals. Given the rapidly changing food culture in China, this information may help Chinese athletes avoid making the same nutritional mistakes. Common missing links in the sports diet of American athletes include: (1) respect for the power of a proper sports diet; (2) sufficient calories during the active part of the day; (3) equal-sized and regularly scheduled meals; (4) beneficial amount of dietary fat; (5) pre-exercise fuel; (6) optimal protein intake; (7) iron to prevent anemia; (8) post-exercise recovery food; (9) carbohydrates combined with protein for recovery food; (10) rest days for muscles to refuel; (11) adequate fluids; (12) sodium before exercise in the heat; and (13) the sports dietitian. [ J Exerc Sci Fit Vol 6 No ] Keywords: athletes, exercise, nutrition, performance, sports This article is a summary of sports dietitian Nancy Clark s presentation at the 7 th Annual Conference of The Society of Chinese Scholars on Exercise Physiology and Fitness, October 17 19, 2008, in Chengdu, China. Introduction Nutrition should be an integral part of an athlete s training program. Yet, in the United States, American athletes and fitness exercisers alike commonly report that they do not eat as well as they should; they admit that nutrition is their missing link. Consequently, they may fail to attain the most benefits from their training programs and their competitive efforts. Corresponding Author Nancy Clark, Healthworks Fitness Center, 1300 Boylston Street, Chestnut Hill, MA 02467, USA. Tel: (1) Fax: (1) nclarkrd@rcn.com The purpose of this paper is to highlight the sports nutrition errors commonly made by American athletes who live in a culture where food is considered fattening, eating-on-the-run is the norm, and fast foods are a common alternative to home-cooked meals. Given the rapidly changing food culture in China, this information may help Chinese athletes avoid making the same nutritional mistakes. Missing Link #1: Respect for the Power of a Proper Sports Diet Too many athletes show up for training but they don t show up for meals. They might as well not show up for training. These words, spoken by a successful collegiate ice hockey coach, are true indeed. Instead of rushing 130 J Exerc Sci Fit Vol 6 No

2 N. Clark to training sessions and competitions only to show up poorly fueled, busy athletes would be better off taking a few minutes from their training time to fuel properly and be able to perform better. Solution: Educate and repeatedly remind athletes about the benefits associated with optimal fueling patterns, so they understand that eating a proper sports diet will help them reach their performance goals. Missing Link #2: Sufficient Calories During the Active Part of the Day The same athletes who show up underfueled for training are generally the ones who undereat nourishing meals during the daytime, only to overeat sweets and treats with little nutritional value in the evening. This pattern fails to support an optimal sports diet and long-term health. Two reasons why athletes undereat during the active part of their day include: (1) They are too busy to eat. Wrong. If they can find time to train, they can also find time to fuel for training. (2) They want to lose undesired body fat. To do so, they restrict their calorie intake at breakfast and lunch. Given that the vast majority of female athletes wants to lose about 2.5 kg (5 lb), calorie restriction is common. In a survey of 425 female collegiate athletes, 43% of the women reported feeling terrified of becoming overweight, and 22% were extremely preoccupied with food and weight (Beals & Manore 2000). This fear that food is fattening certainly deters many weight-conscious athletes from eating optimally. Solution: Weight-conscious athletes should pay attention to when they eat. The best time to eat is during the active part of the day, so they will have the energy needed to exercise hard. Increased daytime calories reduces the evening appetite, and this can help weightconscious athletes consume 10 20% fewer calories at the end of the day. They end up losing weight when they are sleeping, instead of when they are trying to train hard. Missing Link #3: Equal-sized and Regularly Scheduled Meals Too many American athletes eat in a crescendo, with the biggest meal in the evening. The better plan is to divide their calories evenly throughout the day, eating every 4 hours, so the athletes are always in the process of fueling-up or refueling. Solution: A sports dietitian can help athletes create a food plan for a balanced sports diet with the appropriate amount of calories at each meal. For example, a 2400-calorie fueling plan for an active woman (or a dieting man) who trains after work might look like this: Meal Time Calories Breakfast 7 8:00 AM 600 Lunch noon 600 Second lunch 3 4:00 PM 500 Workout 5 6:30 PM Dinner 7 8:00 PM ± 700 The first three meals provide the energy needed for a strong workout. The last meal provides the nutrients needed to recover from the workout. Missing Link #4: Beneficial Amount of Dietary Fat Some athletes eat too much (> 35%) of calories from fat, such as butter, oil, salad dressing and fried foods. The fat displaces the carbohydrates needed to optimally fuel muscles and replenish depleted glycogen stores. The athlete who eats a plate filled with fried chicken for dinner is not carbohydrate-loading on rice, potato or pasta! His performance can suffer due to glycogen-depleted muscles. Other athletes eat too little fat (< 20% of calories from fat). They may fail to replenish the intramuscular fat stores that support endurance performance. A study with runners who ate a very low (16%) fat diet for a month reports that they had 14% less endurance compared to when they ate a moderate (31%) fat diet. Their self-selected diets were supposed to offer equal calories, but the runners with the moderate-fat diet actually ate not only more fat but also more calories. The extra calories did not increase their body fat stores, which suggests that the runners had been undereating on the low fat diet and conserving energy (Horvath et al. 2000). Solution: Athletes need to be taught how to balance the appropriate amount (about 25% of total calories) of primarily healthful fats into their sports diet (American College of Sports Medicine, American Dietetic Association, and Dietitians of Canada 2000). For example, an American athlete might enjoy a little peanut butter on J Exerc Sci Fit Vol 6 No

3 a bagel, olive oil in a salad, a few nuts for a snack, and salmon for dinner. Missing Link #5: Pre-exercise Fuel Athletes who believe they have no time to eat before their workout need to think again. Eating calories of a pre-exercise snack even 5 minutes prior to exercise enhances performance, assuming that: (1) the athletes will be exercising at a pace they can maintain for more than 30 minutes and (2) they can tolerate pre-exercise food. In one study, the subjects ate dinner and then the next morning exercised to exhaustion. They were able to exercise for only 109 minutes with no breakfast, but for 136 minutes with 400 calories of breakfast. That s a 20% improvement (Schabort et al 1999)! In another study, athletes biked hard for 45 minutes, and then sprinted as hard as they could for 15 minutes. When they ate a 180- or 270-calorie snack just 5 minutes before they exercised, they improved 10% in the last 15 minutes. They improved 20% when they had first eaten a meal 4 hours prior to the exercise, and then enjoyed the snack 5 minutes pre-exercise (Neufer et al. 1987). That is a significant improvement! Another study looked at the importance of preexercise water and carbohydrates for exercise that lasted less than an hour. The athletes ate no breakfast, biked hard for 50 minutes and then sprinted for 10 minutes to the finish. They were able to: sprint 6%harder when they consumed adequate water versus minimal water; sprint 6%harder with adequate carbohydrates versus no carbohydrates and minimal water; and sprint 12% harder with a sports drink (adequate carbohydrates plus water) (Below et al. 1995). Fueling appropriately certainly enhances performance! Solution: Athletes need to train their intestinal tracts to be able to tolerate pre-exercise food. They also need to plan their sports diet to accommodate their training. For example: athletes who exercise in the morning can plan to eat part of their breakfast (such as a banana) before the workout, and then afterwards refuel with the rest of their breakfast (such as a bagel and a yogurt); athletes who exercise at lunch could eat part of their lunch (half a sandwich) before the workout and then enjoy the rest of the lunch afterwards; for afternoon or after work sessions, athletes could eat a granola bar or some pretzels pre-exercise, and then refuel with chocolate milk. Missing Link #6: Optimal Protein Intake Some athletes eat too much protein (> 2 g/kg); others eat too little (< 0.8 g/kg). For example, a 70-kg athlete may need g/kg. This translates into about g/day. An athlete who overconsumes protein might consume these portions in a day: Breakfast 4 eggs 20 g protein Lunch 1 6-oz can tuna 35 g Snack 1 protein bar 20 g Dinner 2 chicken breasts 90 g 16 oz milk 16 g Total 181 g This amount of protein equates to more than 2.5 g protein per kilogram, and is excessive to the point some of the protein could be wisely traded for more carbohydrates to better fuel the workouts. In comparison, a vegetarian athlete on a reducing diet could easily consume too little protein as a consequence of restricting food intake. A typical reducing diet might include these protein portions: Breakfast 2 egg whites 7 g protein Lunch Salad with 60 g 3 g chickpeas Dinner 120 g tofu 10 g Total 20 g Too little protein contributes to poor recovery, muscle wasting, and suboptimal results from hard training. Solution: Athletes who have high or low protein intakes, or who are vegetarian, should consult with a sports dietitian. That nutrition professional can both assess the athlete s personal protein requirements and teach the athlete how to translate grams of protein into an effective sports diet. Missing Link #7: Iron to Prevent Fatigue from Anemia Iron-deficiency anemia is common, particularly in females. Anemia causes needless fatigue and reduced performance. A survey of collegiate athletes found that 20% of female volleyball and basketball players were anemic, as were 50% of the soccer team. Anemia is particularly common among women who have heavy menstrual blood losses, but eat neither red meat nor iron-enriched breakfast cereal (Eichner 2001). Solution: The athlete who feels needlessly tired should get a blood test (including serum ferritin) to 132 J Exerc Sci Fit Vol 6 No

4 N. Clark diagnose iron deficiency anemia. To help prevent anemia, all athletes should strive to eat an iron-rich diet that includes red meat or iron-rich alternatives (darkmeat chicken or turkey, salmon, tuna), and iron-fortified cereals (such as Wheaties, Raisin Bran, Total). Including a source of vitamin C (orange juice, strawberries, broccoli, tomatoes) with each meal enhances iron absorption. Missing Link #8: Post-exercise Recovery Food At the end of a hard workout, athletes haven t finished training until they have refueled! They should not simply rush off to work or school, with no time to eat as the excuse. Muscle glycogen synthesis is twice as rapid if carbohydrate is consumed immediately after exercise, as opposed to waiting several hours (Ivy 2001). Solution: Athletes need to plan ahead so they have recovery foods readily available. Even if time is limited, they should be able to refuel their muscles properly. No time is no excuse. Missing Link #9: Carbohydrates Combined with Protein for Recovery Food Recovery foods should offer a foundation of carbohydrates with protein as the accompaniment, or approximately g carbohydrate/kg body weight/hour and 0.4 g protein/kg body weight/hour within the first hour after exhaustive exercise, and repeated doses every hour for 4 5 hours (Berardi et al. 2006; Ivy et al. 2002). Some popular choices for American athletes include yogurt, chocolate milk, cereal with milk, and pasta with meat sauce. Athletes need not buy engineered recovery foods unless they are preferred for convenience. In a 10-week study of recreational body builders, those who consumed a protein-carbohydrate supplement both immediately before and right after the midafternoon strength training session gained about 1 kg more muscle and about 3 kg more in strength (as measured by bench press), compared to the group who did not eat right before and after strength training (Cribb & Hayes 2006). Eating for recovery can be initiated before exercise. That is, a pre-exercise yogurt gets digested into amino acids and glucose; those macronutrients are available to be put into use when the athlete stops exercising (Zachwieja 2002). Athletes who train twice a day definitely need to rapidly refuel with a proper recovery diet. A 6-week study with collegiate swimmers reports that those who did two workouts (morning and afternoon) sprinted slower than those who swam only in the afternoon (Costill et al. 1991). Although no mention was made of diet, the decline in performance may have been related to the inadequate dietary patterns that are common among college students. Solution: Exhausted athletes may not feel hungry for solid foods after a hard bout of exercise, but they might welcome a fruit smoothie (blenderized fruit with yogurt) or chocolate milk. Both contain carbohydrates to refuel, and protein to build/repair muscles and reduce muscle soreness. Missing Link #10: Rest Days for Muscles to Refuel Rest is an important part of a training program; muscles need time to refuel and heal. In one recovery study, subjects ran hard for about 16 kilometers on 3 consecutive days while eating a typical American diet that provided inadequate (50%) carbohydrates. By the third day, the athletes glycogen stores were low and the muscles felt tired (Costill et al. 1971). This study points out the importance of eating a carbohydrate-rich diet on a daily basis during periods of hard training, as well as the importance of days with little or no exercise. Depleted muscles may need more than 24 hours to replace glycogen stores. Although rest days with little or no exercise enhance a training program, athletes who want to lose weight commonly hesitate to take a rest day; they fear they will get fat. These athletes need to understand: (1) On a rest day, they may feel just as hungry because the muscles need food to refuel. (2) They will gain (water) weight. For each 1 g of glycogen, the muscles store about 3 g of water. This water gets released during exercise; it is beneficial. Solution: Athletes should schedule into their training program 1 2 rest days a week, and observe the benefits: better performance the day after a rest day. Missing Link #11: Adequate Fluids Athletes who maintain optimal hydration can train harder and perform better. For each 1%of body weight lost via sweat, the heart has to beat 3 5 more times J Exerc Sci Fit Vol 6 No

5 per minute (Casa et al. 2000); this creates needless fatigue. Solution: Athletes should be taught to monitor their urine to determine if they are adequately hydrated. Athletes who are well hydrated will need to urinate every 2 4 hours, and their urine will be a light color. Athletes who sweat heavily should learn how much sweat they lose (and thereby need to replace) during strenuous exercise. To learn their sweat rate, they simply need to weigh themselves without clothing before and after exercise. For each kilogram of sweat lost, they should drink at least liters of fluid (American College of Sports Medicine 2007). Missing Link #12: Sodium Before Exercise in the Heat Research with trained cyclists reports that they rode 20 minutes longer to exhaustion (99 vs. 79 minutes) in 32 C heat when they drank a pre-ride beverage with 1000 mg versus 150 mg sodium. They consumed no fluids while riding (Sims et al. 2007). Solution: Athletes who train and compete in the heat should consume salty foods pre-exercise. Sodium holds water in the body and reduces the risk of becoming dehydrated. Missing Link #13: The Sports Dietitian Serious athletes generally have a support crew that includes a coach, sports psychologist, medical doctor, physical therapist and massage therapist. But to their detriment, some fail to have a sports dietitian on their team. Solution: Serious athletes who want to get the most from their training programs should meet with a nutrition professional to get a nutrition check-up. In the USA, athletes can use the referral network at to find a local registered dietitian who is a Board Certified Specialist in Sports Dietetics (RD CSSD). This professional can help athletes to resolve struggles with no time to eat properly, find solutions to intestinal distress related to pre-exercise food, attain the desired weight and percent body fat, and transform disordered eating into effective fueling. Conclusion All athletes can benefit from sports nutrition education that focuses on the benefits associated with consuming a proper sports diet. These benefits include better performance, desired body weight/percent fat, and faster recovery. With nutrition education, athletes can learn to make responsible food choices that support the rigors of their training programs and competitive events. Every athlete will always win with good nutrition. References American College of Sports Medicine (2007). ACSM position stand on exercise and fluid replacement. Med Sci Sports Exerc 39: American College of Sports Medicine, American Dietetic Association, and Dietitians of Canada (2000). Joint position statement: nutrition and athletic performance. Med Sci Sports Exerc 32: Beals K, Manore M (2000). Behavioral, psychological, and physical characteristics of female athletes with subclinical eating disorders. Int J Sports Nutr Exerc Metab 10: Below P, Mora-Rodriquez R, Gonzalez-Alonso J, Coyle E (1995). Fluid and carbohydrate ingestion independently improve performance during 1 hour of intense exercise. Med Sci Sports Exerc 27: Berardi JM, Price TB, Noreen EE, Lemon PW (2006). Postexercise muscle glycogen recovery enhanced with a carbohydrate-protein supplement. Med Sci Sports Exerc 38: Casa D, Armstrong L, Hillman S, Montain S, Reiff R, Rich B, Roberts W, Stone J (2000). National Athletic Trainers Association position statement: fluid replacement for athletes. J Athletic Training 35: Costill D, Bowers R, Branam G, Sporks K (1971). Muscle glycogen utilization during prolonged exercise on successive days. J Appl Physiol 31:836. Costill D, Thomas R, Robergs R, Pascoe D, Lambert C, Barr S, Fink W (1991). Adaptations to swimming training: influence of training volume. Med Sci Sports Exerc 23: Cribb P, Hayes A (2006). Effects of supplement timing and resistance exercise on skeletal muscle hypertrophy. Med Sci Sports Exerc 38: Eichner R (2001). Anemia and blood boosting. Sports Science Exchange #81, Vol 14. Horvath P, Eagen C, Fisher N, Leddy J, Pendergast D (2000). The effects of varying dietary fat on performance and metabolism in trained male and female runners. J Am Coll Nutr 19: Ivy J, Goforth H, Damon B, McCauley T, Parsons E, Price T (2002). Early postexercise muscle glycogen recovery is enhanced with a carbohydrateprotein supplement. J Appl Physiol 93: Ivy J (2001). Dietary strategies to promote glycogen synthesis after exercise. Can J Appl Physiol 26(Suppl): Neufer P, Costill D, Flynn M, Kirwan J, Mitchell J, Houmard J (1987). Improvements in exercise performance: effects of carbohydrate feedings and diet. J Appl Physiol 62: Schabort E, Bosch A, Welton S, Noakes T (1999). The effect of a preexercise meal on time to fatigue during prolonged cycling exercise. Med Sci Sports Exerc 31: Sims S, van Vliet L, Cotter J, Rehrer N (2007). Sodium loading aids fluid balance and reduces physiological strain of trained men exercising in the heat. Med Sci Sports Exerc 39: Zachwieja JJ (2002). Protein: Power or Puffery? Gatorade Sports Science Institute. Available: articleid = 338 [Date accessed: September 30, 2008] 134 J Exerc Sci Fit Vol 6 No

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