NUTRIZIONE NELLO SPORTIVO

VEGETARIANO E VEGANO

DOTT . L. VALERIANIU.O. Dietologia e Nutrizione Clinica (SC)

ASL Bologna

Roman army troopers, the “legionnaires”, had daily expenditure of energy that can be estimated at around 5000 kcal for the legionnaire performing engineer work and at 6000 kcal for the legionnaire in war action

At present, only workmen and sportsmen reach such levels of energy expenditure

«È un mito che muscoli, forza e resistenza

richiedano il consumo di grandi quantità di alimenti di origine animale […] Il mio

anno migliore nelle competizioni è stato

quello in cui sono passato ad una dieta vegan […]

Il tuo corpo è il tuo tempio. Se lo nutri correttamente starà bene ed aumenterà

la longevità»CARL LEWIS.

IL FIGLIO DEL VENTO

l’atleta vegano russo diventato medaglia d’oro nel bob ai Giochi Olimpici invernali 2014, ha dichiarato di essere vegano da tre anni e mezzo.

“Nella mia professione, flessibilità ed elasticità sono estremamente importanti. Il mio corpo si è alleggerito, o meglio, ripulito. Infatti non soffro più di raffreddore e influenza. [...] Inoltre, il mio ruolo come ambasciatore dei giochi è quello di promuovere lo sport, incoraggiando le persone ad

adottare uno stile di vita sano”.

Alexey Voyevoda

A 48-year-old male finished Triple-Ironman distance in 41 hours and 18 minutes (11.4 km swimming, 540 km cycling, and 126 km running).

This case demonstrates that even top-class sporting performance, like that of a three-time Ironman, is possible on a vegan diet.

60,310 persons living in the United

Kingdom, 18,431 regular meat

eaters (who ate meat5 times/wk on

average), 13,039 low (less-

frequent) meat eaters,8516 fish eaters (who ate fish but not meat),

and 20,324 vegetarians

(including 2228 vegans who did not

eat any animal foods).

Conclusions: United Kingdom–based vegetarians and comparable nonvegetarians have similar all-cause mortality. Differences found for specific causes of death merit further investigation. Am J Clin Nutr2016;103:218–30.

No distinguished differences between vegetarian-based diets and omnivorous mixed diets were

identified when physical performance was compared.

Consuming a predominately vegetarian-based diet did not improve nor hinder performance in athletes.

However, with only 8 studies identified, with substantial variability among the studies'

experimental designs, aims and outcomes, further research is warranted.

Int J Sport Nutr Exerc Metab. 2016 Jun;26(3):212-20.

Vegetarian and Omnivorous Nutrition Comparing Physical Performance.

In conclusion, 6 wk ona lacto-ovo vegetariandiet caused a minordecrease in totaltestosterone and nosignificant changes inphysical performancein male enduranceathletes comparedwith 6 wk on a mixed,meatrich diet.

Williams studied the effect of a vegetarian diet on running performance (5–8-km test runs).

The subjects completed the runs before and after the 2-wk test diet, and then again 2 wk after

resuming a nonvegetarian diet.

No significant differences in performance were found between the trials, suggesting that the vegetarian diet had neither a beneficial nor a

detrimental effect on aerobic endurance.

Williams MH. Nutritional aspects of human physical and

athletic performance. Springfield, IL: Charles C Thomas Publisher, 1985:415–6.

After consuming a lactoovovegetarian (LOV) diet for 2 wk, 21 men aged 65 ± 5 y were randomly assigned to either consume a beef-containing (BC) diet (n = 10) or to continue the LOV diet (n = 11) throughout resistive training

Conclusions—These data suggest that increases in muscle strength and size were

not influenced by the predominant source of protein consumed by older men with

adequate total protein intake.

Hanne, N., Dlin, R. and Rotstein, A. (1986) Physical fitness, anthropometric and metabolic parameters in vegetarian athletes.Journal ofSports Medicine and Physical Fitness 26, 180-185

Uno dei pochi studi osservazionali su 49 atleti vegetariani e 49 non vegetariani da tempo non ha comunque trovato alcuna differenza in termini di prestazioni associati con la quantità di proteine

animali consumate.

“No significant differences were found between groups in pulmonary function, aerobic and anaerobic capacities, arm and leg circumferences, hand grip and back strength, hemoglobin, or total

serum protein”

N. 27 Veg vs 43 OMNIn the vegetarian group, 24 of the 27 participants (89%) had adhered to a vegetarian diet for >2 years.

Of the remaining three participants, the diet had been followed for three, six, or eleven months.

Fifteen of the vegetarians were vegans (nine men and six women), and twelve were lacto-ovovegetarians (five men and seven women).

Nutrients 2016, 8, 726; doi:10.3390/nu8110726

Nutrients 2016, 8, 726; doi:10.3390/nu8110726

Results from this study indicate that vegetarianendurance athletes’ cardiorespiratory fitnesswas greater than that for their omnivorouscounterparts..Peak torque did not differ between diet groups.

These data suggest that vegetarian diets do not compromise performance outcomes and may facilitate aerobic capacity in athletes

It is the position of the American Dietetic Association that appropriately planned vegetarian diets, including total vegetarian or vegan diets, are healthful, nutritionally adequate, and may provide health benefits in the prevention and treatment of certain diseases. Well-planned vegetarian diets are appropriate for individuals during all stages of the life cycle, including pregnancy, lactation, infancy, childhood, and adolescence, and for athletes

J Am Diet Assoc..Position of the American Dietetic Association: vegetarian diets

2009 Jul;109(7):1266-82

“Le diete vegetariane sono pure in grado di soddisfareil fabbisogno degli atleti agonisti.

[….] Le diete vegetariane che soddisfinoi fabbisogni energetici e che contengano

una varietà di cibi ricchi di proteine vegetali, quali i derivati della soia, i legumi, i cereali, la frutta secca e i semi oleaginosi, possono fornire una quantità adeguata

di proteine senza richiedere l’uso di cibi speciali o di integratori”.

J Am Diet Assoc..Position of the American Dietetic Association: vegetarian diets

2009 Jul;109(7):1266-82

“Le diete vegetariane sono pure in grado di soddisfareil fabbisogno degli atleti agonisti.

[….] Le diete vegetariane che soddisfinoi fabbisogni energetici e che contengano

una varietà di cibi ricchi di proteine vegetali, quali i derivati della soia, i legumi, i cereali, la frutta secca e i semi oleaginosi, possono fornire una quantità adeguata

di proteine senza richiedere l’uso di cibi speciali o di integratori”.

J Am Diet Assoc..Position of the American Dietetic Association: vegetarian diets

2009 Jul;109(7):1266-82

“La ricerca indica che un assortimento di cibi vegetali assunti nel corso della giornata è in grado di fornire tutti gli aminoacidi essenziali e assicurare in modo adeguato assunzione e utilizzo di azoto negli adulti

sani; ciò significa che le proteine complementari non debbono necessariamente essere consumate

all’interno dello stesso pasto”.

J Am Diet Assoc..Position of the American Dietetic Association: vegetarian diets

2009 Jul;109(7):1266-82

V.R. Young and P.L. Pellett, Plant proteins in relation to human protein and amino acid nutrition, Am J Clin Nutr 59

(suppl) (1994), pp. 1203S–1212S.

L’ ADA raccomanda di aumentare l’introito del 10% rispetto ai fabbisogni indicati per gli atleti

non vegani.Questa raccomandazione si traduce in un

fabbisogno raccomandato che varia tra 1,3 g/kg/die e 1,8 g/kg/die

di proteine (contro 1 g/kg/die valido per chi non pratica attività sportiva).

Per un’attività amatoriale, anche esercitata tutti i giorni, e per sport di resistenza, si consiglia di rimanere nel limite inferiore (1,3 g/kg/die).Si consiglia di aumentare l’introito proteico

(mantenendosi intorno a 1,7-1,8 g/kg/die) solo se gli allenamenti sono svolti tutti i giorni per diverse

ore, come succede agli atleti professionisti e soprattutto per atleti impegnati in sport di forza

(pesistica, lotta, football, lanciatori);

American Dietetic Association. Position of the AmericanDietetic Association and Dietitians of Canada: vegetarian diets. J Am Diet Assoc. 2003;103:748–65.

Vegetarian athletes may be at risk for low intakes of energy, fat, vitamins B12, riboflavin, and D, calcium, iron, and zinc, which are readily available from animal proteins.

Sport dietitians should educate novice vegetarian athletes on resources for menu planning, cooking, and shopping—especially high-quality plant protein combinations and acceptable animal sources (i.e., dairy and eggs) as well as foods rich in or fortified with key nutrients (calcium, vitamins D, B12, and riboflavin, iron, and zinc)

FERROL'anemia da carenza di ferro è frequente in moltisportivi, e non è raro che determini uno scadimentodelle prestazioni.

Lo sportivo ha una maggiore eliminazione di ferro conurine, feci e in particolare con il sudore e perde,mediamente, una quantità di ferro doppia rispetto alsoggetto sedentario.

Il rischio di carenza di ferro risulta elevato nelleattività di endurance di intensità medio-elevata, dovesia la componente dovuta ai microtraumi che quelladovuta alla sudorazione sono massime.

In un atleta femminile quindi le perdite giornaliere diferro possono raggiungere livelli importanti, rendendopiù difficile il bilancio del ferro tramite la solaalimentazione.

La maggior parte del ferro in una dieta vegetariana èin forma non-eme con assorbimento più basso dellaforma eme

Crit Rev Food Sci Nutr. 2016 Nov 23:0. [Epub ahead of print]The effect of vegetarian diets on iron status in adults: A systematic review and meta-analysis.Haider LM1, Schwingshackl L2, Hoffmann G3, Ekmekcioglu C1.

In conclusion our results showed that vegetarians are more likely to have lower iron stores compared with non-vegetarians. However, since high iron stores are also a risk factor for certain non-communicable diseases, such as type II diabetes, it is recommended that not only vegetarians but also non-vegetarians should regularly control their iron status and improve their diet regarding the content and bioavailability of iron by consuming more plants and less meat.

Am J Clin Nutr 2003

Seiler et al also reported lower ferritin concentrations in vegetarian than in

nonvegetarian runners, both male and female.

However, no impairment in ability to compete in a 20-d, 1000-km race was measured in the

vegetarian runners.

During the 1000-km race, dietary iron intake was higher in the vegetarian group, but the iron was of the nonheme variety from legumes, dried

fruit, nuts, vegetables, and grain products.

Int J Sports Med. 1989 Oct;10(5):357-62.Effects of long-distance running on iron metabolism and hematological parameters

Vegan athletes should include iron-rich plant foods in their diets,but iron supplementation is notessential except in cases of ironinsufficiency marked by a very lowferritin or anemia, or in women withheavy menstrual bleeding

Fifty-two percent of vegans, 7% of vegetarians and one omnivore were classified as vitamin B12 deficient (defined as serum vitamin B12 < 118 pmol/l).

Half of the vegans were categorised as vitamin B12 deficient and would be expected to have a higher risk of developing clinical symptoms related to vitamin B12 deficiency.

Am J Prev Med. 2015 Jun;48(6):e11-26. doi: 10.1016/j.amepre.2015.02.009.Is vitamin B12 deficiency a risk factor for cardiovascular disease in vegetarians?Pawlak R1.

Vitamin B12 deficiency may negate the cardiovascular disease prevention benefits of vegetarian diets.

In order to further reduce the risk of cardiovascular disease, vegetarians should be advised to use vitamin B12 supplements

Vitamina B12

La presenza nei cibi vegetali è praticamente nulla

I latto-ovo-vegetariani sono in grado di ricavare adeguatequantità di vitamina B12 a partire da latticini, uova o altrefonti affidabili di vitamina B12 (come cibi fortificati eintegratori), se questi cibi vengono consumati regolarmente.

Per i vegani, la vitamina B12 deve essere ottenutadall’utilizzo regolare di cibi fortificati con vitamina B12,come le bevande fortificate di soia e di riso e alcuni cerealiper colazione.

Diversamente, è necessaria l’assunzione giornaliera di unintegratore di vitamina B12

Ann Nutr Metab 44 (2000), pp. 229–234. Clin Chem 47 (2001), pp. 1094–1101.)

Low-oxalate vegetables such as bok choy (rapa) and kale (cavolo) have higher levels of calcium bioavailability than milk (approximately 50% vs 30%)

Nuts and seeds also are rich in several minerals includingcalcium.

Exercise decreases urinary calcium excretion

Calcium deficiency is an invalid concern for vegan athletes

Creatine supplementation has been suggested as an ergogenic aid for athletes who engage in repeated bouts of short-term, high-intensity exercise

The estimated daily requirement of creatine is <2 g. Nonvegetarians typically get <1 g creatine/d from the various meats they ingest and the body synthesizes 1 g in the liver, kidney, and pancreas, using the amino acids arginine and glycine as precursors.

Vegetarians generally have low body creatine pools, suggesting that inadequate dietary creatine from meat sources is not compensated for by increased endogenous creatine production

Various studies have shown that consuming <20–25 g creatine/d for 5–6 consecutive days significantly increases muscle creatine in most people, especially those with low amounts to begin with, ie, vegetarians

Creatine supplementation has no effect on aerobic exercise metabolism and performance

CREATINA

Am J Clin Nutr 1999

These findings confirm an ergogenic effect of Cr during resistance training and suggest that subjects with initially low levels of intramuscular Cr (vegetarians) are more responsive to supplementation.

MEDICINE & SCIENCE IN SPORTS & EXERCISE®Copyright © 2003 by the American College of Sports Medicine

Taurine

Taurine is a supplement that may offer a performance benefit to athletes, andfrequently is low or deficient in vegan athletes.

Taurine is an amino acid that is concentrated in skeletal muscle tissue.

Urinary excretion of taurine correlates with markers of muscle damage.

Taurine presupplementation has been shown to increase athleticperformance in human and animal studies.

A nonvegetarian diet supplies approximately 100 to 400 mg/die of taurine.

Supplementation with 500 mg taurine twice daily is appropriate for seriousvegan athletes.

Added B12, vitamin D, zinc, DHA, and possibly taurine are more likely to be helpful.

Current Sports Medicine ReportsCopyright * 2010 by the American College of Sports Medicine

It has now become common knowledge that vegans need to supplement with B12Supplementation of a minimum of 6 µg vitamin B12 is essential for vegans.

Zinc supplementation or a multivitamin/multimineral containing zinc is a wise choice for vegan athletes

Supplementation with 500 mg taurine twice daily is appropriate for serious vegan athletes.

SISTEMA IMMUNTARIOL’ allenamento, specialmente seintensivo, può portare a svilupparealcune problematiche.Atleti di alto livello spess mostranouna ridotta efficienza del sistemaimmunitario ed un’aumentataincidenza di infezioni nel trattosuperiore del sistema respiratorio.L’eccesso di grassi ed i cibiraffinati poveri di nutrienti possonopeggiorare questa situazione.

Gleeson M. Can nutrition limit exercise-induced immunodepression?Nutr. Rev. 2006

Viceversa, il ricorso a cibi vegetaliricchi di vitamine e di antiossidantipuò migliorare la risposta immunitaria.In particolare i carotenoidi e gli acidigrassi omega 3 (contenuti in semi di lino e noci in elevate quantità) hanno mostrato un’attività positiva sul sistema immunitario

Subjects consumed two different diets for 2 x 6 wk, separated by 4 wk on an ad libitum diet, in a cross-over design

It is concluded that, in male athletes, the concentration, composition, and in vitro function

of human blood mononuclear cells are unaffected by whether the diet in the preceding 6

wk has been a meat-rich mixed diet or a lacto-ovo vegetarian diet.

OXIDATIVE STRESS There is increasing evidence that heavy exertion produces an oxidative stress

that leads to the generation of oxygen free radicals and lipid peroxidation

Chronic physical training augments the physiologic antioxidant defenses in several tissues

People who exercise regularly and intensely should eat foods rich in antioxidants

Vegetarian athletes with high intakes of fruit, vegetables, and whole grains have a special advantage.

The role of antioxidant supplements is still controversial

Clarkson PM. Antioxidants and physical performance. Crit Rev Food Sci Nutr 1995;35:131–41.Sen CK. Oxidants and antioxidants in exercise. J Appl Physiol 1995;79:675–86.Ji LL. Exercise and oxidative stress: role of the cellular antioxidant systems. Exerc Sport Sci Rev 1995;23:135–66.Kanter M. Free radicals and exercise: effects of nutritional antioxidant supplementation. Exerc Sport Sci Rev 1995;23:375–97.

J Sports Sci. 2010 Oct;28(12):1261-8. doi: 10.1080/02640414.2010.507676.Could a vegetarian diet reduce exercise-induced oxidative stress? A review of the literature.Trapp D1, Knez W, Sinclair W.

As a typical vegetarian diet comprises a wide range of antioxidant-rich foods, it is plausible that the consumption of these foods will result in an enhanced antioxidant system capable of reducing exercise-induced oxidative stress.

Two reports (published as letters) suggested that a significant proportion of female athletes with amenorrhea were vegetarians.

However, these were descriptive studies that could not determine whether the cause was the vegetarian diet, heavy exercise training, lower energy intake, or other factors.

There is increasing evidence that low energy intake, not diet quality, is a major cause of oligoamenorrhea in female athletes, and that when brought into positive energy balance, hormonal profiles return to normal and menstruation resumes

Hanne et al observed that when vegetarian female athletes are properly nourished, their menstrual cycle function is normal compared with that of matched nonvegetarian control subjects.

Diet in athletic amenorrhea. Lancet 1984;1:559–60 (letter).Amenorrhea in vegetarian athletes. Lancet 1984;1:1474–5 (letter).Treatment of athletic amenorrhea with a diet and training intervention program. Int J Sport Nutr 1996;6:24–40.

HORMONAL ALTERATIONS

Some individuals, especially women, may switch to vegetarianism as a means of avoiding red meat and/or restricting energy intake to attain a lean body composition favored in some sports.

Occasionally, this may be a red flag for disordered eating and increase the risk for the female athlete triad

Because of this association, coaches, trainers, and other health professionals should be alert when an athlete becomes a vegetarian and should ensure that appropriate weight is maintained.

International Olympic Committee Medical Commission Working Group on Women in Sport. Position stand on the female athlete triad. Available from:

http://multimedia.olympic.org/pdf/en_report_917.pdf.

American College of Sports Medicine position stand. The female athlete triad. Med Sci Sports Exerc. 2007;39:1867–82.

Athletes at greatest risk for low energy availability are those who restrict dietary

energy intake, who exercise for prolonged periods,

who are vegetarian, and who limit the types of food

they will eat

2007 by the American College of Sports Medicine

CONCLUSIONI1) ben pianificate e opportunamente integrate le diete vegetariane sembranosupportare in modo efficace le prestazioni atletiche;

2) la assunzione di proteine è sufficiente per soddisfare le esigenze di azoto totale e lefonti aminoacidiche, vegetali e animali sembrano fornire un sostegno equivalente allapreparazione atletica e alle prestazioni;3) i vegetariani (in particolare donne) sono ad aumentato rischio di carenza di ferro,che può limitare le prestazioni di resistenza;4) come gruppo, i vegetariani hanno concentrazioni di creatina muscolare inferioreagli onnivori, e questo può influire sulle prestazioni di esercizio sovramassimale.5) allenatori e preparatori devono essere consapevoli che alcuni atleti possonoadottare una dieta vegetariana come una strategia per il controllo del peso. Pertanto,la possibilità di un DCA dovrebbe essere esaminato se una dieta vegetariana èaccompagnata da perdita di peso ingiustificata.

•Barr SI, Rideout CA Nutritional considerations for vegetarian athletes. Nutrition. 2004 Jul‐Aug;20(7‐8):696‐703.

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