ESPEN Congress Geneva 2014DIETETIC SESSION: SPORT AND NUTRITION
Mens sana in corpore sano: optimal nutrition for fitnessF. Wardenaar (NL)
Mens sana incorpore sano
FlorisWardenaar,MSc HANUniversityofAppliedSciencesHeadTeamNutritionDutchOlympicCommitteePhDcandidateDietaryExposureAssessmentinAthletes,Wageningen University
OptimalNutritionforFitness
Ethical dilemmas Bioethical principles Application of bioethical principles to Nutrition at the end-of-life The decision-making process
Fitnessinrelationto
Nutrition inrelation tofitnessandperformance
Fuel
RecoveryBrainfunction
Protection
Fitness and performance
Introduction
Doathletes meetnutritionrecommendations?
Areguidelines feasibleinpractice?
Preliminary dataofDSSS
DifferentrecommendationsEstimatedAverageRequirement(EAR)CHO2.9g/kg.bwPRO0.6g/kg.bw
RecommendedDailyIntake(RDI)CHO2.9*1.4g/kg.bwPRO0.8g/kg.bw
SportsnutritionRecommendationsCHO610g/kg.bwPRO1.21.7g/kg.bw
SportsnutritionRecommendationsCHO312g/kg.bwPRO1.31.7g/kg.bw
RoadmapWhatdoathletes
need?
Doathletesmeetrecommendations
Timingproteinintake
(averageathlete)
Duringcompetition
(ultramarathon)
Habitualdiet(ultramarathon)
Doathletesneeddietary
supplements?
Timingaroundtraining(rowing)
Doathletesusedietary
supplements?(generalpopulation)
EstimatedAverage
RequirementRecommendDailyIntake
Individualneed
P
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2*SD
AssessmenthabitualdietPreferredmethod:Probabilty ofInadequacy(POI)Percentageofpopulationbelowacertainvalueofanestimatednormaldistribution(basedonZscore)Precondition:EARavailable
Aditional method:MedianbasedqualitativeanalysesIncaseofmedianhigherthenRDI/AIlowriskforlownutritionintake,otherwisenostatementcanbemade(ns)
Nutrient intakeofultramarathonrunnersHabitual diet andnutrition on acompetion day
S
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v
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y Mean intake:3x24hR+3xdailyquestionnairesrunnerspreparingfor 60or120km
Energy(MJ),CHO(g/kg),PRO(g/kg)
Q
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Adjusted GSSIquestionnaireabout nutritionintakeduring60km
CHO/PRO/Fluidg/kgor ml/kg,CHO/Fluidintakeperhour
O
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Continousobservation ofnutrition andfluid intakeduring 120km
CHO/Fluidintakeperhour
Groupcharacteristics
Survey:Habitualnutrientintake
Accuracyofmethod:limitedinformation
Validationstudy:comparingmultiple24hourrecallanddailyquestionnaireswithgoldenstandard:24hournitrogeninurine
EstimatedproteinbasedonRecalls:10736g/dVSNitrogenexcretions:14239g/d
24hourrecallunderestimatedaveragemeanproteinintakewith35.539g/dor30%.
Crudecorrelationbetweenintakeestimateswasr=0.61(95%CI:0.420.74)
Multiple24hrecallswithdailyquestionnairesunderestimateproteinintakeequallyforindividuals(basedonBlandAltmanplot)
Proteinneedsforathletesaresuggestedtobe1.21.8g/kg/bw
Dailyratesofproteinsynthesisarehighestwithregular(i.e.every3hours)intakeofmoderate(20g)quantitiesofrapidlydigestedwheyprotein1
1.Areta,J.L.,etal.,Timinganddistributionofproteiningestionduringprolongedrecoveryfromresistanceexercisealtersmyofibrillar proteinsynthesis. JPhysiol,2013.591(Pt9):p.231931
Timingofprotein intake20gprotein/3hours
n=82
MeanSD Dt PRO(g)recommendation
POI
Breakfast 20.77.2 7.5 20 39.5
Morning 5.86.4 12.4 20 100
Lunch 28.713.3 4.1 20 9.4
Afternoon 7.27.8 10.5 20 100
Dinner 39.118.8 10.4 20 0.5
Before sleep 9.29.8 10.2 20 100
Protein intakeinclusive sports nutrition productsn=82,maleathletes
Dt:precisionofthemeanestimate,POI:probabilityofInadequacy
Rowing,males andfemales n=22Eating moments persubjectaround training
Nutrition intakeduring ultramarathon60kmofTexeloveradistanceof60or 120km
Meantemperature 2C Road,trail,beach 4beveragestations
Recommendations before race: CHO: Kerksick et al. (2008), PRO: Tarnapolsky et al. (2005) and Fluid: combined guidelines proposed by Sawka et al. (2007). Both recommendations of Sawka et al (2007) based on 3-4 hour 5-7ml/kg.bw before exercise and 2 hours before 3-5 ml/kg.bw were combined into one range of 8-10 ml before competition . Recommendations during race: CHO Burke et al. (2011): and Fluid: Kreider et al. (2010).
Nutrientintakebeforeandduringtheracebasedonaquestionnaireby60kmrunners
Observation:Nutrientintakeduring120kmofTexel
Observation:Individualtimelineoffoodandfluidintake
*DutchNationalSportInvestigation(NSO)2013
SupplementintakeofgeneralDutchpopulation
Selfreportedconsumptionfrequency*
RepresentativesampleoftheDutchpopulation:
N=1544 51%(n=791)men,49%(n=753)women 74%(n=1143)didparticipateinsports
33%(n=512)memberofaclub 43%(n=287)competition ~2%(n=26)highlevelcompetition
*engagedinsportsN=1143,notengagedinsportsN=401
Useofsportnutritionproductsanddietarysupplements
26%7%
14%
8%
26%
35%
34%51%
0102030405060708090
100
engagedinsports* notengagedinsports*
%
o
f
r
e
s
p
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d
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s
none
onlynutritionalsupplements
onlysportnutritionproducts
both
*generalpopulationN=1544;womenN=753,menN=791
Genderdifferences
36%
20%
7%
17%
05
101520253035404550
women* men*
%
o
f
r
e
s
p
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d
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s
onlysportnutritionproducts
onlynutritionalsupplements
Conclusion
Largevariationinrecommendationsandwaystoassessthediet HabitualdietofDutchultramarathon runnersdidnotmeetthe
recommendationsforCHOandpartlyforPRO Timingofproteinintakeoverthedayisfocusedonbreakfast,lunch
anddinner:classicalsportnutritionfocus Mostathletes,butnotall,managetoeatbetweenonehouraftera
morningtrainingsessionwhenquickrecoveryisnecessary Duringcompetitionmostultramarathon runnersdidnotmeet
carbohydraterecommendations,butalargevariationwasfoundintheintakeofmacronutrientsandfluid
Sportsnutritionproductsanddietarysupplementsareusedbyathletesandnonathletes
Take homemessages
Athletesdonotmeetrecommendations,butisthisalwaysneededforoptimalfitness?
Distributeproteinbetterovertheday Focusoncompletedietandmealtimeplanningtooptimizerecovery
Traincarbohydrateandfluidintakeduringregulartrainingsessions
Makesuretogiveattentiontodietarysupplementsandsportnutritionproductsinallcases
DutchSportsNutritionandSupplementStudy(#DSSS)
Staffandresearchteam
Students WURonaldHangelbroekApostolos MangouJoraSteennisMarkRothuisIngeSpronkChristophKappCindyvanderAvoort
Students HHRianneDijkhuizenVictorMoorenSjoerdPriveeAstridvanderLaanFleurineMenijnTimoty HilderingBovanRooijEmmaJonkLeanderDoornekampNaomiBrinkmans
Students HvAMarleenvanHaastrecht
Students HANNenaKrolIngeNottenBasMommersIngevanderLindenShiannahDanenMerijnvandenBroekErikSusebeekNaomiDerksLisannevanKampMarkMullerCoenMandersPimHutingWiljanFloorsJessevanSchijndelJoeriPieterseTimJansenHylkeReitsmaGijsCampbellGijsHoeveTeresaBreidenbachNinaVeeken
Students UGENTBenDemontyBartJacobsArnoBoonants
www.hansportnutrition.nl [email protected]
Staff HANSportandExercise NutritionNickIedema |GertVriendKristinJonvik |IngridCeelenTjieuMaas |SaraiPannekoekPimKnuiman |HeleenvanderWiltCindyvanderAvoort
SupervisorsWUProf.Dr.RWitkamp|Dr.MMensinkDr.JdeVries
SupervisorsHANDr.Ir.MdevanderSchuerenProf.Dr.Ir.GSchaafsma
ConsortiumpartnersWU|HAN|VSNNOC*NSF|Dedopingautoriteit
SupportersInnosportlabPapendalTopsportrestaurantArnhemhalUgent |Mulier Instituut