Carbohydrates Part III
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Transcript of Carbohydrates Part III
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Carbohydrates Part III
Fueling the Athlete
Diabetes
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• Recall: – When intensity of exercise goes up, use of
what fuel goes up? Why?– Over time (duration), use of what fuel goes
up? (assuming there’s plenty of oxygen available) Why?
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CHO and the Athlete
– Why the concern over Why the concern over CHO?CHO?
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• CHO is the prime E source for –
–
–
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• What types of athletes risk glycogen depletion?– – –
• What happens when an athlete starts to run out of glycogen?
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THE TIME TO FATIGUE IS DIRECTLY RELATED TO
INITIAL GLYCOGEN STORES
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• So the goals of feeding CHO to these athletes are to – Maximize glycogen stores before the event– Minimize losses during the event– Re-synthesize glycogen after the event
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Daily CHO Needs for Athletes:
60% CHO recommended (up to 70% during heavy training)
OR If exercise < 60 minutes per day
5 g/kg (typical Am. Diet = 4 g/kg)
If exercise 60 - 90 minutes/day 6-7 g/kg
If training >90 - 120 minutes/day8 - 10 g/kg
If extreme program (6-8 hours/day - cycling)
10-12 g or more/kg
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Pre-Endurance Event:Glycogen Supercompensation
• AKA CHO-loading• For events 90 min. OR intermittent • NOT recommended for those w/ diabetes
or known heart disease• Can nearly double muscle glycogen stores
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: day 6 90 min (70-75% VO2max) 60% CHO (nl)
5 40 normal
4 40 normal
3 20 70%
2 20 8-10g/kg males,
6-8g/kg females
1 rest same
race day
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• Can be done in 2-3 days, as long as –
–
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PRE EVENT MEAL
• Best: Consume 4 hours prior to event
– 4-5 g/kg body weight
Example: 60kg athlete:
• If 4 hrs before event isn’t feasible, consume less 1-
2 hours before the event (1-2g/kg).
– Foods that are easily digested and low in fat/fiber
– Glycemic index?
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During Event: Minimizing losses, Maintaining blood glucose levels
• 15 to 20g CHO every 15-20 min. – (or 30-60g CHO per hour of exercise)– – at optimal concentration
• Glycemic index?
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Post-Event:Glycogen Repletion: Biphasic
• Rapid initial response – to baseline
• Slower 2° phase: to above normal levels
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• Proportional to CHO intake–
–
–
– protein-CHO combination may increase glycogen re-synthesis
• Important for athletes who have events or training sessions within 24-48 hours of activity
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• (Repletion usually takes ~ 48h for events lasting >90 minutes. – Can take up to 5 days
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Sports Drinks
• 6-8% CHO solution is best (most sports drinks)–
–
• Glucose polymers in sports drinks are quickly absorbed
•
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– Optimal post exercise fluids should be high glycemic index fluids (low fructose)
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Diabetes Mellitus
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Diabetes Mellitus: • A group of metabolic diseases
characterized by hyperglycemia
• Resulting from defects in insulin secretion, insulin action, or both. (ADA Website)
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Approximately half the people with diabetes are undiagnosed
Major cause of:–
–
–
–
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Definitions• FPG: Fasting Plasma Glucose• CPG: Casual Plasma Glucose (non-
fasting)• OGTT: Oral Glucose Tolerance Test
(75g)• Hemoglobin A1c (glycated
hemoglobin, glycosylated hemoglobin) – Indicates average BG levels over approx.
3 months. % of total Hgb attached to glucose
– Normal: 4-6% (DM: >8%)
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Diagnosis(don’t memorize - just remember that
having hyperglycemia once is not diagnostic, and can happen for reasons
other than diabetes)
• Pre-Diabetes (new diagnosis) – FPG 100-125mg/dl– OGTT 2h 140-199 mg/dl
• Diabetes– Confirmed FPG 126 mg/dL – CPG 200 mg/dl + symptoms – OGTT (75g glu) 2hPG 200 mg/dl
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Type 1 Diabetes
• AKA “juvenile onset diabetes,” or “insulin-dependent diabetes”
•
• Most diagnosed < age 20
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• Damage to beta cells of pancreas
• Dependent on exogenous ___________
• Meals timed w/ insulin doses to regulate blood glucose– CHO control
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Type 2 Diabetes AKA “adult onset diabetes” or non-
insulin dependent diabetes.
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Pancreas produces some insulin, but
Most diagnosed > age 40…
Risk:
gestational diabetes
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Consequences of Diabetes
• Hyperglycemia
– Dehydration
– Excessive thirst and urination
– Excessive hunger
• Glycosuria (glu spills into urine:
>180mg/dl)
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• Ketosis (Type 1) – Cells aren’t receiving glucose/amino
acids due to inadequate or no insulin
– Fat is mobilized for E
– Liver responds (to fat mobilization) by producing ketone bodies
– Accumulate in blood ketoacidosis
– Severe ketoacidosis _________
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• Nonketotic Coma (Type2) – coma due to extremely high blood glucose
• Hypoglycemia – too much insulin/mediacations, strenuous activity, inadequate food intake, alcohol intake, etc. Can be life-threatening. – (note: hypoglycemia resembles
intoxication—Type 1 pts should wear ID bracelets)
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Symptoms Of Hypoglycemia – Shakiness, dizziness, sweating– Hunger– Headache– Pale skin color – Sudden moodiness or behavior
changes, such as crying for no apparent reason
– Clumsy or jerky movements – Difficulty paying attention, or
confusion – Tingling sensations around the
mouth
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Chronic Complications of Diabetes
• Cardiovascular Disease• Microangiopathies (disorders
of capillaries)– Kidneys– Retina
• Neuropathy– loss of sensation in extremities– gangrene amputations
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Treatment• Type 1: Diet, exercise, insulin
• Type 2:– Treatment includes weight loss – Meal planning:consistent CHO intake
throughout the day – Medications: Oral hypoglycemic
agents (OHA)– 40% will require exogenous insulin
• Both types:
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Effects of Exercise•
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