@mariespano

Fueling Athletes for Peak Performance

Tennessee School Nurses Association

Marie Spano, MS, RD, CSSD, CSCS

Today’s Topics

• Challenges for young athletes

• Muscle strength, size, building and repair

• Carbohydrate, your energy nutrient

• Micronutrient needs

• Hydration

• Supplements

• Weight Loss/Weight Gain

Challenges

• Kids rely on parents, coaches, school to shop for and prepare their food

• Parental pressures, influence – not always positive

• Kids are challenged to meet nutrition needs for growth and development plus their sport

• Hydration is a major issue

No two athletes are

alike

Lifestyle Current

Diet

Medical History

Hx cramping injuries

Lab results

Body fat

Goals

Challenges

• Athletes are confused about food

• They are more confused about dietary supplements

• Tons of misinformation

• Who do I listen to?

Every Athlete is different but....

• Proper nutrition combats the damaging effects of intense strength & power training and leads to greater training adaptations

• Athletes that do not consume enough calories, carbohydrate, protein & nutrients will likely:

– Lose body mass

– Lose muscle mass!

– Increase illness, injury

– Under perform

* Impair growth, development, hormone production and attainment of peak bone mineral density

Nutritional Needs of Kids

• “From childhood to adolescence marks a period of rapid growth and development and may also be a sensitive period where there is the potential for irreversible effects on the body in adulthood.”

• Nutrition is a major component of training due to:

– growth and development

– fueling optimal performance

– preventing injuries and other problems that may arise due to nutrient deficiencies

Brustaert et al. 2006; Petrie et al. 2004

Jeff Stout, PhD

Food, an overlooked

performance-enhancing aid

• Kids need 20-30% more energy than adults for the same exercise activity

• Kids need more energy per pound of body weight than adults

• Energy needs depend on:

– Growth rate

– Age

– Gender

– Size

– Activity levels

– Weight changes

Daniels et al. 1978

Berning and Steen 1991

Energy Needs

Meeting Nutrient Needs

• Chronic nutrient deficiencies are most prevalent in: – Weight restricted sports

– Physique sports

– Young girls

• Nutrient deficiencies may result in: – menstrual irregularities

– poor bone health

– delayed puberty

– increased risk of injuries

Jeff Stout, PhD

Bass 2006

Protein – a MUST for Muscle

Muscle Strength, Size, Repair

1. Post resistance training:

– Catabolic hormones & Anabolic hormones

– Increase in muscle protein synthesis and degradation

– Significant changes in Muscle Protein Balance persist for 3 hours after resistance exercise

Am J Physiol 1995;268:E514-20.

Am J Physiol 1997;273:122-9.

Stimulation of muscle protein synthesis enhanced with protein or amino acid intake consumed in temporal proximity to exercise

Protein Timing

• Purpose: Examine the effects of supplement timing

• Single-blind, randomized protocol

• Resistance trained males matched for strength and placed in 1 of two groups

• 10 week resistance training program

• Protein, creatine and carbohydrate (1 g/kg bodyweight) either:

– Immediately before & after resistance training

– Morning and evening

Med Sports Sci Exerc 2006;38:1918-

25.

*

*

* *

Muscle Strength, Size, Repair

After weight training with elevated levels of amino acids in the blood – muscle protein synthesis increases 250% compared to normal blood levels of amino acids

Muscle Anabolic Potential

Minutes Post Exercise

How Much Protein?

• 6 healthy young men, after a bout of resistance training given:

• 0, 5, 10, 20 or 40 grams whole egg protein

• Results:

– Leucine oxidation not different between fasted, 0 and 10 grams protein

– Leucine oxidation stimulated at 20 & 40 grams protein, trend toward greater oxidation at 40 grams

Am J Clin Nutr 2009;89:161-168.

Mean (±SEM) mixed-muscle fractional protein synthesis (FSR) after resistance exercise in

response to increasing amounts of dietary protein.

Moore D R et al. Am J Clin Nutr 2008;89:161-168

©2009 by American Society for Nutrition

Increasing protein intake stimulates mixed-muscle and plasma albumin protein synthesis

in a dose-dependent manner up to 20 g dietary protein, after which there is a marked stimulation of whole-body leucine oxidation and no further increase in protein synthesis.

Type of Protein?

• Examined protein type and MPS at rest and after exercise

• 6 men

• Resistance training protocol followed by protein containing equivalent EAAs (10 grams):

– Whey hydrolysate

– Soy protein isolate

– Miscellar asein

Am J Appl Physiol 2009;107:987-

992.

MPS at rest: Whey 93% greater than casein & 18% greater than soy MPS - exercise: Whey 122% greater than casein & 31% greater than soy

Protein Speed Matters

Food Leucine

Egg whites, 4 large 2.4

Beef, 3 oz, cooked 2.15

Chicken, 3 oz, cooked 2.00

Pork Chop, 3 oz, cooked 1.75

Tuna, 3 oz 1.75

Salami, 3 oz 1.45

Almond, 1/3 cups 0.40

Edamame, ½ cup 0.40

Asparagus, ½ cup 0.10

Leucine signals mTOR -

Muscle building amino acid

Protein Needs Without Exercise

Age (yrs) Protein (gm/kg)

4 – 6 1.2

7 – 10 1.0

11 - 14 (m) 1.0

11 – 14 (f) 1.0

15 – 18 (m) 0.9

15 – 18 (f) 0.8

These are values are close to the RDA

*Based on National Academy of Science, 1989

Protein Requirements for Male Adolescent Soccer Players

• Determine the protein requirements in adolescent

soccer players using nitrogen balance measurements.

• Subjects – 14 year old boys

• One of 3 different diets:

– Diet 1 = 1.6 g/kg/day

– Diet 2 = 1.5 g/kg/day

– Diet 3 = 1.25g/kg/day

* RDA is 0.8 to 1.0g/kg/day

26

-15

-10

-5

0

5

10

15

20

25

30

1 2 3

Nit

roge

n B

alan

ce

Diet 1 = 1.6 g/kg/day Diet 2 = 1.5 g/kg/day Diet 3 = 1.25g/kg/day

Negative

Nitrogen

balance with

1.25 grams

protein/kg

bodyweight/day

For Kids Only

• Relative to body weight, kids need more protein and essential amino acids than adults due to growth and development.

• Young athletes need more protein and may benefit from up to 1.5g per kg each day.

Steen, S. Nutrition for Young Athletes. Nutrition Dimension, Eureka, CA. 2001.

Post Exercise – From breakdown to Growth

What Why

Carbohydrate Fills fuel tank in muscle (30-40% drop from resistance training)

Decreases muscle breakdown

May stimulate muscle growth if not enough CHO

Protein Muscle growth

Decreases muscle breakdown

Carbohydrate + Protein = greater results from your training

• Exercise sensitizes muscle to protein for up to 24 hours after exercise

– Type 2 muscle fiber recruitment is essential

– Maximal fiber activation may

be essential

>> exercise until failure

J Nutr 2001;141:568-573.

Adult Protein Distribution

Best for Building & Maintaining

Muscle Mass Curr Opin Clin Nutr Metab Care 2009;12:86-90

Am J Clin Nutr 2008;87:1562S-1566S).

Strength Gains: Summary

• When & How Much:

• 30 minute “window of opportunity post exercise”

– Resistance training:

• Kids? We don’t know

• 20-25 grams for adults 18 – 40

– Endurance:

• > 10 grams

•In regular intervals throughout the day

– Maximum strength gains – every 3 hours

Am J Clin Nutr. 1994;60:501-9; Clin Nutr 2008;27(5):675-84; Curr Opin Clin Nutr Metab Care

2009;12(1):86-90.

J Gerontol A Biol Sci Med Sci. 2001;56:M373-80; Curr Opinions Clin Nutr Metab Care 2009;12:617-22; Med

Sci Sports Exerc 2010;42:326-337

Dietary Recommendations for Protein

• Relative to body weight, kids need more protein and essential amino acids than adults due to growth and development.

• Young athletes need more protein and may benefit from up to 1.5g per kg each day.

• Suggested Foods:

– Two to three servings of meat, poultry, fish, eggs, beans and peas, nuts;

– Three servings of low-fat milk, yogurt, cheese

Steen, S. Nutrition for Young Athletes. Nutrition Dimension, Eureka, CA. 2001.

Consuming Protein + Carbohydrate post workout will stimulate muscle growth,

restore energy levels and your reserve tank of fuel and improve body composition.

Carbohydrate = Energy

• Carbohydrate

– Energy

– Low levels result in fatigue, decreased exercise intensity & decreased motivation

– Performance is directly related to initial carbohydrate stores

Athletic performance is directly related to initial carbohydrate stores

Factors Affecting CHO Needs

• Age

• Training – competitive or recreational?

– Duration of activity

– Intensity of activity

– Time until next workout

– Body composition goals

Fuel in an Athlete’s “Gas” Tank

• Start with maximum carbohydrate stores

Partially Empty Fuel Tank

Exercise intensity Immune system functioning

Full Tank of Fuel 60-90 minutes 40 minutes

of intense

exercise

Carbohydrates • Energy comes from stored carbohydrate (glycogen)

• Your carbohydrate stores decrease during training

• Carbohydrate stores impact performance

Stored Carbohydrate

Pre exercise

Stored Carbohydrate

Stored Carbohydrate

During exercise Post exercise

Carbohydrates

• Start with maximum carbohydrate stores

Stored Carbohydrate

Stored Carbohydrate

Full Tank of Fuel lasts 60-90 minutes

Partially Empty Fuel Tank

Exercise intensity Immune system functioning

Carbohydrates

• If you do not replenish your carbohydrate stores, over time you will start with less in your fuel tank

Stored Carbohydrate

Pre-season

Stored Carbohydrate

Stored Carbohydrate

Mid-season Playoffs

Fatigue, Decreased Performance

⏎

Staying Fueled – Adult Recommendations

• Stay fueled during activity – improve performance

– Sugar is best! Quickly used to fuel active muscles.

– 30-60 grams/hour

– More if multiple types of carbohydrates consumed

• Re-fuel immediately after exercise – asap, within 30 minutes.

Are Kids Different then Adults?

Carbohydrates/Glycogen

• Glycogen stores are lower in children compared to adults

• Glycolytic capacity (breakdown of glucose to form ATP) isn’t fully developed which may explain their limited anaerobic capacity compared to adults

• Pre-pubertal and Adolescent athletes oxidize more fat and less Carbohydrate than adults

Boisseau 2000; Kaczor et al. 2007;

Burke et al. 2007

Timmons et al. 2007

• Pre-pubertal and adolescent athletes metabolize more

exogenous CHO than adults.

– Possibly to preserve glycogen stores since they have less

glycogen than adults.

45 Timmons et al. 2003, 2007

Carbohydrates/Glycogen

• Adolescent athletes in a simulated soccer match resulted

in 35% depletion in glycogen stores. (up to 90% in

adults)

• Zehnder et al. also demonstrated that a CHO intake of

4.8g per kg of body weight was sufficient to restore the

glycogen to pre-simulated soccer match levels.

Zehnder et al. 2001

Carbohydrates for Kids

• Current Recommendation: 6 – 9 gm / kg body weight (Steen, 2001)

• Based on the available science: 5 – 6 grams per kg of body weight

– depending on volume and intensity of training

– 14 yr girl, 40kg -200 to 240 grams

• After puberty, then go to adult recommendations

• Suggested Foods:

– Four servings from the bread, cereal, rice and pasta group

– Three servings from the vegetable group

– Two servings from the fruit group

Carbohydrate Recommendations

• Immediately post-training

– Milk, yogurt

– Fruit

– Granola bars, kids bars

• Daily

– 5 – 6 grams per kg of body weight

– depending on volume and intensity of training

– 14 yr girl, 40kg -200 to 240 grams

– After puberty, then go to adult recommendations

Fat

• Secondary source of energy

• Absorption of fat soluble vitamins, some antioxidants

• Hormone production

• Low fat diet = low testosterone

• Growth and development

Micronutrients

Calcium

• Strong bones = less risk of fracture

• Muscle contraction

• Blood vessel expansion and contraction

• Nervous system functioning

• Secretion of hormones

If your blood calcium levels drop, your body leaches it out of your bones (storage site) to maintain blood levels of calcium

Young Athletes and Bone Health

Peak growth velocity in the skeleton

Age ~14 yrs for males

Age ~12.5 yrs for females

About half of adult bone structure is developed during teen years!

Teen years – prime for building bone mineral density

Calcium & Vitamin D:

–Most important nutrients to maximize the development of peak bone mass

• Milk: – #1 source of calcium, magnesium

& vitamin D in all people over the age of 2

– Contains other bone building nutrients – phosphorus, zinc, potassium

– Recent study - children (boys and girls 3 to 13 years) who avoid drinking cows milk were at greater risk for bone fractures

Young Athletes and Bone Health

Pediatrics 2006;117:578–85.

Steen, S. Nutrition for Young Athletes. Nutrition Dimension, Eureka, CA. 2001

NIH Consensus Development Panel on Osteoporosis Prevention. JAMA 285:785, 2001

Weaver, C.M. Nutrition 16:514, 2000

Bailey et al. J Bone Res 2000;15:2245.

Goulding et al. J Am Diet 2004; 104:250-253.

Meeting daily calcium needs with leafy greens

Not as bioavailable as calcium from dairy

4 cups of cooked spinach /day

8 + cups raw greens

• Other vegetarian sources

– Soy, rice, almond milk

– Shake the container

– Vitamin D2 not D3

Calcium Crisis!

Age % Meeting RDA for Calcium

Females 2 – 8 years 79%

Females 9 – 19 years 19%

Males 2 – 8 years 89%

Males 9 – 19 years 52%

• USDA – 60 – 90% of kids don’t consume enough calcium per day

• 92% of female teens know that milk is a good source of calcium, but only 12% of these young women’s diet meet the RDA for Calcium

NHANES, CDC, 1988-1994

Science Daily 2007

J Am Diet Assoc 1985

Is Protein Bad for Bone??

• Protein makes up about 50% of bone volume and 33% of mass

• Truth or myth: High protein diets and calcium loss

– Not observed with food sources of protein

– 30% calories from protein – no increase in calciuria

– 2.1 g/kg bodyweight protein, urinary calcium increased but, intestinal absorption increased.

• No truth that animal based proteins are bad for bone or vegetable based proteins are better for bone

Am J Clin Nutr 2008;87: 1567S-70S.

Vitamin D

• Calcium absorption

• Greater bone density = less risk of fracture

• Neuromuscular functioning

• Immune function

• Low levels –

– Fat infiltration in muscle tissue (impairs muscle functioning)

– Rise in inflammation

– Illness

Vitamin D

• Mass vitamin D insufficiency and deficiency!!

• Deficiency/Insufficiency = less than 30ng/ml

• Dietary intake is leading cause of insufficiency

– Only 50% of young girls 9-13 yrs and 32% adolescent girls 14-18yrs consume the RDA

– Winter sports – at risk

Foo et al. Osteoporos Int. 20:417-425, 2009; 2. Gilsanz. J. Clin. Endocrin. Metab.

2010; 3. Rajakumar et al. Obesity J. :1690-95, 2008; 4. Ward et al. J. Clin. Endocrin

Metab. 2008; 5. Ceglia, Lisa. Molecular Aspects of Medicine 29:407-414, 2008; 6.

Kremer et al. J. Clin Endocrinol Metab, 94:67-73, 2009; 7. Hannan et al. J. Clin

Endocrinol Metab. 93:40-46, 2008.

Vitamin D

• Positive relationship between Vitamin D status compared to muscle mass, physical function, and bone mineral density.

• Vitamin D insufficiency is associated with increased body fat and decreased final height in young women.

• Vitamin D is associated with muscle power and strength in adolescent girls 12-14yrs.

Magnesium

• > 300 biochemical reactions in the body

• Nerve functioning

• Muscle functioning

• Bone health

• Immune health

Hydration

Hydration

• Heat stroke (is/was) the second reported cause of death in high school athletes!

Steen, (2001), Nutrition For Young Athletes. Nutrition Dimension Inc. 2001

Impaired

temperature

regulation

Reduced

muscular

endurance

Reduced

strength

Reduced

endurance

capacity

Heat cramps

Severe heat

cramps

Heat stroke

Coma

Death

We

igh

t Lo

ss (

% B

od

y W

eig

ht)

8

6

4

2

2% 3% 4-6% 6%

Hydration

• Kids may have a greater risk for heat related illness

– Lower sweating rates than adults – overheat

– Greater surface area relative to their body mass - gain more heat from the environment

– Equipment can make it more difficult to dissipate heat

– Athletes adjust poorly to hot environments

– Girls may be at greater risk than boys

Recommendations to Avoid Dehydration

• Increase level of intensity slowly (over a period of 5-10 days)

• Schedule frequent rest and water breaks.

• Cancel or reschedule practice to avoid the hottest times of the day.

• Adjust the duration of exercise and rest periods should be adjusted according to the humidity, air temperature, and degree of sun exposure experienced by the players.

• Drink liquids periodically during activities even if they do not feel thirsty.

• Clothing should be light-colored, lightweight, and limited to one layer of absorbent fabric to facilitate the evaporation of sweat. If clothes become wet, they should be changed for dry ones.

Avoiding Dehydration

• Modify drills and clothing to prevent overheating.

• Weigh athletes before and after practice to estimate their water loss (unless ED)

– Post-Exercise:

• Young athletes should ingest two cups of water for every pound of weight loss.

• Young athletes trying to lose weight often engage in dangerous dehydration techniques that should never be encouraged (wrestlers, gymnasts, judo, and dancers).

hydrated

dehydrated

Extremely dehydrated!!

consult a doctor

How Do You Know if You Are Dehydrated?

• Impairs our judgment

• Contributes to body fat

– Junk food

– Body will store fat and burn off alcohol first

• Impairs recovery from training

– Impairs muscle growth!!!

– Impairs absorption of some vitamins & minerals

Nutrient Timing

69

Pre Exercise Nutrition

• 1 hour or less before competition, lighter foods such as sports drinks, breads, bagels, and fruit work well.

• 2-4 hours before competition:

• Low fiber, low fat

• Pastas, breads, bagels, crackers, baked potatoes and cereal (low sugar) and all fruits are good choices.

• Remember one thing, if the young athlete has poor dietary habits most of the time then good pre-exercise nutrition won’t make up for it.

Post-Exercise

• Chocolate or strawberry milk

• Sports drink with protein

• Flavored Yogurt

• String cheese and fruit

Nutrition Strategies for Gaining Weight

• Kids will grow into their weight

• Encourage intake of calorie dense foods

• Stay away from high-saturated fat foods

• Eat healthy foods with high carbohydrate contents (fruit, pizza, milk shakes, peanut butter sandwiches)

Strategies for Losing Weight

** Promoting a healthy lifestyle is more important than how fast he or she drops the pounds!!!!

• Weight loss should not exceed 1 to 2 pounds for girls and 2 to 3 pounds for boys per week.

• Encourage intake of healthy foods that promote performance vs. focusing on weight

Vegetarian Diets-Appropriate for Kids?

• A well-planned vegetarian diet can meet caloric and macro and micronutrient needs, however, the serious youth athlete must be committed to putting more thought and planning into their daily food choices

• Do you think a 13, 14, 15 yr old elite youth athlete can follow this type of plan?

Vegetarianism

• Disordered eating/body image ? – Excuse to cut out foods

• Potential for unbalanced eating:

– animal foods eliminated

– little regard given to appropriate substitutes

– Low in protein, iron, zinc, Vitamin B12 and D, calcium and creatine

– Potential increased risk of iron-deficiency anemia, a weak immune system, nagging injuries, rhabdomyolysis

– Females – ammenorrhea or oligomenorrhea, low bone mineral density, potential increase stress fractures

Neiman 1999, Gibson 1994, Maughan 1996

Semi-vegetarians

• Semi-vegetarians who eat poultry and/or fish can obtain the same range of nutrients as red meat eaters

• Those who avoid animal flesh but eat dairy foods and eggs typically meet protein, calcium, and vitamin B12 needs but may have trouble getting enough zinc and iron

• IRON deficiency “manifests itself as alterations in immune function, cognitive performance, energy metabolism, and/or exercise or work performance” Dr. Stella Volpe, PhD, RD

• Zinc deficiency in children can causes growth retardation, delayed sexual maturation, infection susceptibility, and diarrhea

76

Good Food Sources: Iron and Zinc

• Good dietary sources of iron and Zinc include: shellfish, red meat, poultry, fish and dairy foods

• OK, not the best sources (absorption) but… Iron and Zinc-fortified breakfast cereal, lentils, spinach, fortified soy foods, peanut butter, nuts and seeds, whole grains, Baked potato with skin and wheat germ, green leafy vegetables

• IRON and Zinc Recommendations -

• Boys and Girls 9 to 13 yrs = 8mg/day Iron + 23mg Zinc

• Boys 14 to 18 yrs = 11mg/day Iron + 34mg Zinc

• Girls 14 to 18 yrs = 18mg/day Iron + 34mg Zinc

77

Vegetarian Diet

• Must pay attention to: – High Quality COMPLETE Protein

– Vitamin D and Calcium

– Iron, Zinc, Vitamin B12 and Creatine

1 Do No Harm

2 Do What is Safe, Convenient and Works

Food vs. Supplement?

Banned Substance?

Yes or maybe No

Quit taking it Is it Harmful in the context

it is being used & given the

person’s health history?

Yes or

maybe No

Quit taking it Ergogenic?

No Yes or

maybe

Quit taking it Continue

Most Athletes • Incorrect use of ergogenic aids

– Not certified safe

– Not the right ingredients

– Not the right amount of effective ingredients

– Wrong supplement completely

– Unnecessary for their use

– Taking it at the wrong time or in the wrong amount

• Supplement “kitchen sink” – take anything and everything recommended.

Correct Use of Supplements

• What does it do?

• Why do you need it?

• How much (dose)?

• When should you take it?

• Certified Safe

– NSF

– Informed Choice

Whey

• What:

– Highly digestible

– Amino acid profile most closely related to muscle

• Why?

– Protein is essential for recovery and repair – resistance training damages muscle

– Protein quality is important for determining responses to training

– Dairy proteins are the highest quality proteins

Whey

• Why:

– If you want to gain weight/get bigger, you need more protein and more total calories

• How much? – 20 - 30 grams post exercise

– 1.2 – 2.0 grams per kilogram bodyweight per day

Whey

• When? – Timing is everything!

– Post workout

– For weight gain – pre and post weight training

Delaying consumption of

protein after lifting weights

slows strength gains

Glutamine

• What: – non-essential amino acid (body makes it)

– * possibly essential during illness, injury or times of stress

– # of physiological functions in the body

– Stimulates protein synthesis

• Why: – Strenuous exercise decreases the concentration of

glutamine in the blood.

– Supplemental glutamine can decrease the likelihood of illness in endurance athletes.

Glutamine

• How much?

– 0.1 – 0.3 grams per kg body weight

– 1 – 3 grams for a 200 lb (90 kg) athlete

• When:

– Post-exercise

• Safety profile:

– Safe, but shouldn’t be taken if you have kidney disease, liver disease, Reye syndrome or you are taking drugs for chemotherapy

Creatine

• What: – A nitrogen containing compound found naturally in meat

and fish

– Stored in the body as phosphocreatine

• Why: – Helps re-fuel the body for short duration, intense

exercise (< 10 seconds)

– Improves: • Maximum power

• Strength

• Sprint performance

• Boosts weight gain

Creatine

• How much?

– 20 grams or 0.3 grams/kg bodyweight for 5-7 days

• 10 grams at a time 2x a day (otherwise stomach upset)

– 3-5 grams per day or 0.03 grams/kg bodyweight

• When?

– Before or after working out

– Add it to a shake or juice

Creatine

• Safety profile

– Over 1,000 studies published on creatine

(creatine monohydrate)

– Only side effect: weight gain

– Does not cause cramping or dehydration

• Increases total body water and intracellular water

DMAA

Methylhexaneamine

1,3-Dimethylamylamine

1,3-Dimethylpentylamine

4-methylhexan 2-amine

Forthane, Floradrene

Geranium extract, plant, oil, parts, stem, leaf.

DMAA

• Non-prescription drug added under the guise it was geranium

• Stimulant effects

• 2010 WADA banned substance list

• # of positive drug tests

• Debate over “natural”

• Questions about safety

after the deaths of 2 military

It all started with.....

Headlines:

Hydroxycut

Recalled Due to

Reports of

Death, Liver

Failure, and

Other Risks

Headlines: Teens down energy

drinks, with some risk

At issue are the

drinks’ heavy

caffeine and sugar

content, the

common practice

of mixing them with

alcohol, and

advertising that

seems to target

minors for drinks

with names like

Cocaine.

Headlines

• A 16-year-old student in Palm Beach

County, Fla., died last month after

consuming alcohol and energy drinks,

according to her family. Investigators

were awaiting the results of a toxicology

report.

In the U.S. there is no requirement to state the amount of caffeine in a

product. But, the word caffeine must be added to the ingredients list.

“Proprietary Blends” do not need to list the actual individual ingredients

Are Energy Drinks Harmful?

• Caffeine?

– Red Bull Energy drink – 60 mg caffeine

– Starbucks Tall Coffee – 279 mg caffeine

• Consider other substances athletes take

– Rx (Cox 2 inhibitors like Vioxx), pain medications

– Alcohol

– Herbs, diuretics, laxatives

Energy Drinks tested for Caffeine

Energy Drink Caffeine (in mg)

BF 108

FT 91

RS 126

SB 108

Anal Bioanal Chem

2008;391:2811-2818

USDA study - 53 Supplements tested

0 - <200 mg caffeine

27 products

200 - <400 mg caffeine 11 products

400 - <600 mg caffeine

3 products

>800 mg caffeine

1 product

Beverage Caffeine (in mg)

Snapple Iced tea, 16 oz. 42

Diet Coke, 12 oz. 47

StarbucksTall Café Mocha, 12 oz. 58

Excedrin (1 tablet) 65

Red Bull energy drink w/ added caffeine 75

Steaz Energy Drink, 12 oz. 80

Instant coffee, 8 oz. 90

Tab Energy 95

Beverage Caffeine (in mg)

Espresso, 2 oz. 100

Brewed coffee, 8 oz. 135

Full Throttle, 16 oz. 144

Rockstar Energy Cola, 12 oz. 150

NoDoz maximum strength (1 tablet) 200

Vamp, 16 oz. 240

Starbucks Tall Coffee, 12 oz. 279

VPX Redline 250

1 oz pack Shock-A-Lots (candy coated

coffee beans)

300

• Adenosine inhibits neural activity

• Caffeine stimulates neural activity

• Caffeine binds to adenosine receptors

Caffeine

• GRAS

• Tolerance differs

• 250 - >300 mg/day

– Tachyarrhythmia (rapid, irregular heartbeat)

– Difficulty sleeping

• 10-14 grams (150-200 mg/kg bodyweight)

– Death

– 170 Red Bulls in one day for a 150 lb person

Caffeine in Sports • Enhances:

– aerobic performance

– anaerobic performance

– mental performance

• Temporarily increases thermogenesis

• May enhance weight loss in certain products

• May attenuate DOMS after eccentric exercise

• May decrease leg pain associated with cycling

Mitigating Fatigue, Pain & Inflammation

Beta-Alanine

• Your muscles feel like lead, fatigue

– Accumulation of Hydrogen ions & drop in muscle pH

• 2 ways to boost body’s production of carnosine

– Train hard - intensity (speed work, intervals)

– Take beta-alanine

– Attenuates fatigue

– Less fatigue

• Train harder

• Better performance

Beta-Alanine

• Non-essential amino acid

– Synthesized in the liver

– In # foods as part of a histidine-containing dipeptide: chicken, turkey

• Histidine + beta alanine = carnosine

• Carnosine (skeletal muscle)

– Mainly in Type 2 muscle fibers

– Contributes up to 40% of skeletal muscle buffering capacity of H+

– Enhances buffering capacity within muscle

Beta-Alanine

• Acute: – Increases muscle carnosine synthesis

– Decreases fatigue

– Increases power

– Increases muscular endurance

– Decreased RPE

– Promotes recovery

• Over time

– Improves endurance and strength

– Increased lean body mass

• Trained athletes > untrained

• Men > women

• Meat eaters > Vegetarians

• Sprint-trained athletes may have higher initial muscle carnosine levels (type II)

• Time Release – 2 x 800mg twice/day for 4 weeks

– 60% increase in carnosine

– No paresthesia (tingly feeling)

• Washout: (Harris et al)

– 2-4% per week

– 9-14 weeks full washout (7 weeks for low-responders)

Slide modified from Abbie Smith, PhD, UNC- CH

Beta-Alanine

• Type:

– Controlled Release

• How much & When?

– Take no more than 1 gram post workout (the rest is eliminated and wasted)

– Take 800 mg twice/day

Every lot of CSN CarnoSyn® is tested by an

ISO17025 Certified and WADA (World Anti-Doping

Agency) accredited laboratory.

Inflammation

• Some – normal

• Unresolved/chronic inflammation may contribute to prolonged muscle soreness and impaired sports performance

• Saturated fat • Glucose • Advanced glycation end products

British Journal of Nutrition 2011;106:S5-7

Journal of the American Dietetic Association

2010;110:911-16.

• Lower cooking temperatures • Moist heat • Lemon juice, vinegar, acidic

ingredients

• EPA, DHA – rheumatoid arthritis 1.7 – 9.6; 2 gm

• Vitamin D – low D => Chronic, nonspecific skeletal muscle pain

• Zinc

• Ginger – 2 grams heat treated or raw

• Resveratrol

• Curcumin

• ASU

British Journal of Nutrition 2012;107:S171-84).

The Journal of Pain 2010;11:894-903).

Omega 6: Omega 3?

It’s Complicated…..

LA (linoleic acid) Omega 6

ALA, alpha linolenic acid

Omega 3 Vegetable oils, seeds, nuts

flaxseed oil, walnuts, flaxseed, canola oil

Delta 6 desaturase

EPA (fish)

DHA (fish)

Omega 3 Eicosanoids

Gamma –linoleic acid (GLA: borage & primrose oil)

Arachidonic Acid (meat, eggs, dairy)

Pro-inflammatory Omega 6 Eicosanoids Curr Opin Clin Nutr Metab Care.

2004;7(2):137-144.

NSAIDs

> 1-9%

Omega 3

• Decreased pro-inflammatory markers – IL-6, IL-1ra, TNFalpha, C-reactive protein

• Increased anti-inflammatory markers – IL-10, TGFbeta

J Clin Endocrinol Metab 2006;91(2):439-46.

Concussions

• DHA?

• Preliminary evidence, 10 – 40 mg/kg bw

• Potentially preventative

• Traumatic brain injury – ketogenic diet

2. Bailes J.E. and Mills J.D. 2010. A pre-clinical study, conducted in adult male Sprague-Dawley rats

found that DHA, when given after a traumatic brain injury, reduced the injury response, as measured

by markers of axonal injury and cell death. Journal of Neurotrauma. 2010;27:1617-24

This preclinical study determined the benefits supplementation with DHA post-head injury. Three

groups of 10 adult male rats were subjected to a head injury. Two of the three groups were then

supplemented with DHA for 30 days. Group 1 received 10 mg/kg/day, while group 2 received 40

mg/kg/day. Group 3 served as an un-supplemented control group and received no DHA. In

addition, a forth group of 10 adult male rats underwent a sham surgery and received no

supplementation.

After 30 days of supplementation, brains were isolated and a histological analysis of the brain

was performed to measure markers of brain injury, including β-amyloid precursor protein (β-APP),

a marker of axonal injury, and caspase-3, a marker of cell death.

Results of the study found that DHA, when given after a traumatic brain injury, reduced the injury

response; markers of axonal injury and cell death were significantly reduced.

Post-Head Injury Study Design - Rats were subjected to a head injury. Injured rats were

then supplemented with DHA for 30 days. After 30 days of supplementation with DHA, brains

were isolated and a histological analysis of the brain was performed to measure markers of

brain injury, including  β-amyloid  precursor  protein   (β-APP), a marker of axonal injury, and

caspase-3, a marker of cell death.

B. Cardiovascular

1. Buckley J. et al. 2008. A randomized, controlled trial conducted in elite football players showed

a significant reduction in exercising heart rate and resting blood pressure after supplementation

with DHA-rich omega-3 fatty acids. Journal of Science and Medicine in Sports. 2009;12(4):503-7.

This randomized, controlled trial examined the benefits of omega-3 fatty acid

supplementation on cardiovascular parameters during exercise. Elite football players (n = 25)

were supplemented with DHA-rich omega-3 fatty acids, at a dose of 360 mg EPA and 1560

mg DHA/day, or placebo for 5 weeks. Heart rate was measured during an exercise test

(treadmill running) which was performed at baseline and after 5 weeks of supplementation.

Resting blood pressure was also measured at baseline and after 5 weeks of

supplementation. Results of the study found that supplementation with omega-3 fatty acids

significantly improved cardiovascular function (heart rate and blood pressure) in elite athletes.

Case Studies

College >> NFL?

• 6/26/12: 176.8 lbs, 3.4% body

• Goal, 7/30/12: 190

• Program: – Followed an exact meal plan; 5,500 – 6,000

– Drink whole milk, high calorie juice vs. water during the day

– Add oil, butter, cheese

– Supplements • Protein powder – high calorie

• Creatine

• Carbohydrates

Adolescent Athlete

• 10 years old

• Plays lacrosse, swims, karate

• Runs at recess or plays basketball

Performance Nutrition Plan

• Key Points:

– Includes a variety of foods to promote training adaptations, speed recovery and promote overall health

– Individualize your plan as much as possible

* If an athlete is under fueled, inadequately

fueled or under hydrated their training and

performance will suffer

Breakfast

Lunch Dinner

Conclusions:

• Kids are NOT little adults

– Have Different Nutritional Needs

– Staying hydrated is a problem

– Must support growth and development 1st

• Ensure your athletes are meeting their calorie needs

– CHO – 5-6g per kg body weight

– Fat – 25-35% of total calories

• Less than 10% saturated fat

– Protein (complete) – 1.5g/kg BW

Questions? Comments?

Marie Spano, MS, RD, CSCS, CSSD

Spano Sports Nutrition Consulting

Competitive Edge Sports

Atlanta Braves, Minor Leagues

www.mariespano.com

marie@mariespano.com

@mariespano