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Sports Nutrition

by: Dr. Arlie Durgan
Dr. Arlie Durgan
GPA 3.8

Robert McMurray

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Robert McMurray
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This 86 page Class Notes was uploaded by Dr. Arlie Durgan on Sunday October 25, 2015. The Class Notes belongs to EXSS 360 at University of North Carolina - Chapel Hill taught by Robert McMurray in Fall. Since its upload, it has received 26 views. For similar materials see /class/228712/exss-360-university-of-north-carolina-chapel-hill in EXERCISE AND SPORT SCIENCE at University of North Carolina - Chapel Hill.



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Date Created: 10/25/15
V NUTRITION AND THE FEMALE ATHLETE 39 W Overview Introduction to Female Athlete physiological and performance comparisons to males Dietary Issues anemia and low Caloric intake Menstrual dysfunction Bone health Eating disOrders anoreXia and bulemia Female Athlete Triad i PERFORMANCE COMPARISONS FEMALE VERSUS MALE Comparison Between Male and Female Performance Times World Records Sport Event Males Females A 1 Track 100 984 1049 62 6 1500 7 32600 35046 106 6 5000 39 123936 142809 125 6 Marathon 12650 141 06 103 6 Swim 50 Freestyle 2181 2451 110 6 200 Free 14669 15678 85 6 1500 Free 144166 155210 74 6 Cycle Flying 500 26649 34017 217 6 39 1 Hr 39 5638km 4820km 145 6 A PHYSIOLOGICAL COMPARISONS FEMALE VS MALE Men gt Women ini I Women gt Men in Height Fat Mass Body Mass Fat Metabolism Muscle Mass 39 Muscle Strength Muscle Power Androgen Levels Muscle Glycogen Muscle XSec Area Heart Size M Stroke Volume Hemoglobin amp RBC Arterial 02 Content Female Body Composition Fat content normally 2025 younger Essential fat bone organs CNS 3 Sex specific fat necessary for normal physiologic functioning breast genitals 39 lower body 3 Storage fat subcutaneous 9 Nonessential fat 510 Mirkin top marathon runners males 540 women 1220 Prdblems Related to Diet That Affect Performance ANEMIA PROBLEMS TYPES 0F ANEMIA Pernicious Anemia Vegans B12 necessary in RBC formation Found in animal foods lron Deficiency Anemia Dietary iron isheme and nonheme 39 Heme is more bioaVailable and absorbed better Animal food iron is about 4060 39 Plant is39nonheme Megaloblastic Anemia y Folate necessary in RBC formation Found particularly in leafy green vegetables Iron 40 iron on RBC endurance performance can be reduced i Low lron lt oxidative phosphorylation increases lactate amp reduces lactate clearance Haymes Nutr Exerc Sport 1998 934 female athletes deficient amp 17 True Anemia 39 r 1 Average intake lt 12 mgd need 15 mgd Low bioavailability 10 absorbed Supplementation 3060 mgd improves performance Taken with vitamin C improves uptake Avoid taking with fiber alkaline products 39 FactOrs Affecting Iron Absorption DeCreased 39 i Increased Absorptloni 7 Absorption Tea39COffee Vitamin C non Fiber heme Soy High altitude chi 7 A exposure CalCIUm Exercise training Manganese V Lopr in stomach ngh antaCId use High pH in stomach MineralNitamin concerns Riboflavin B2 may be of some concern due to low calorie diet B396 reduces symptoms of PMS Folate 4 RDA may be too IOW for women during childbearing years 400 vs 180 pgd Vitamin C help with iron uptake Zinc may be low due to lbw energy intake or low meat intake MENSTRUAL DYSFUNCTION AmenOrrhea Can be associatedwith Infertility Osteoporosis Cholesterol abnormalities Etiology 7 gt 7 disrupted release of GnRH leading to lower LH levels Low Body Fat Low body fat related to delayed onset or irregular menstrual functioning Frisch Hum Biol 1971 Sci 1974 suggests 1 minimum 17 fat necessary for onset of menses 2 22 fat necessary for normal functioning Schweiger et al Fertil Steril 1988 Women at lt17 normal Amenorrheic runners with 2128 fat Katch et al Ann Hum Biol 1984 30 athletes 30 nonathletes all lt20 fat 2 14A amp 21 NA lt20 fat had regular cycles 4A amp 3NA with 1115 had regular cycles 7A amp 2NA with 1115 were amenorrheic Trainingrelated menstrual dysfunction Luteal phase deficiency short luteal phase decreased progesterone levels normal cycle length and menses 39 39 39 Anovulatory cycles estrogen level is normal but no progesterone cycles are long and irregular g 7 l Exerciseassociated amenorrhea can be reversed by an increase in calorie intake or a reduction in training intensity Training Related Factor That May Influence the menstrual Cycle Weight loss Low weight Low body fat Dietary alterations Nutritional inadequacies Physical stress Emotional stress Acute hOrmonal alterations Chronic hormonal alterations Betaen dorphin Theory of Amenorrhea Stress gt betaendorphin gt block GnRH gt no FSH or LH gt no Cycle 39 39 Effects reversed by administering Naloxone Cortisol Theory of Amenorrhea Stress gtTCRH TACTH gt T Cortisol gt iGnRH gt FSH 39 LH gt no cycle Estrogen PhysiOIOQY Estrogen reproduction functions Ovulation Uterine growth 39 Secondary Sex charaCteristics 39 Estrogen nonreproductive functions Tissue membrane Metabolic 39 Bone OSTEOPOROSIS Osteoporosis Risk Factors Female sex Asian or Caucasian race Age Menstrual irregularities Sedentary lifestyle Thinness Tobacco use Decreased bone mineral density 7 Prolonged corticosteroid use Decreased calcium intake Lack of Vitamin D Estrogen deficiency Bone Concerns Gain bone39mass until about age 35 Matko vic Am J Clin Nutr 1979 two groups of Yugoslavian women calcium intakes of 974 amp 424 mgday greater bone mass in the high calcium group Calcium supplementation may be necessary UNC study college women intake 600 mgd What to supplement 400500 mgday l hypoestrogenic women 10001500 mgd Several small doses per day with food Check for available not total calcium Bone concerns Smith Calcif Tissue Int 1984 4050 min of aerobic 39 weight bearing exercise 34 times a week will maintain skeleton in middle V aged women a Drinkwater J Am Med Women Assoc 1990 y swimmers notshowing the effect of gymnasts runners or tennis players a nonweightbearing activity D rinkwater N Engl J Med 1984 am enorrheic 39 runners haveless bone mass than 39 eumenorrehic runners AND39 65 yr old women EATING DISORDERS Anorexia Athletica Controlling weight on a shortterm basis for athletes can become a long term practice I 39 r r V Yates N EndJMed 1983 same personalities seen in male long distance runners Disordered Eating Exists on a continuum from skipping meals to using diet pills diuretics or laxatives to purging to Anorexia Nervosa 39 The hallmark is distorted body image Up to 62 of college athletes practice some form of pathologic weight control behavior True disorders estimated to occur in 20 university pOpulation 39 39 Anorexia Nervosa Fear of fatness leads to selfimposed starvation Failure to maintain adequate body weight Classically 1418 yrs old normal quotperfectquot But has low self esteem c0mpulsive over achiever has a sweet tooth Self imposed dietary restriction e no CHOs Substantial weigh loss y I Morbid concern with losing control over eating behavior Anorexia Nervosa Preoccupation withfood will cook or watch Distorted body image High level of physical activity Am enorrhea a 95100 Insomnia poor cold tolerance Like to watch others eat Drug abuse diuretics emetics amphetamines I Sig39ns emaciation dry Skin loss cf hair cold skin hypotension BULIMIA Binge amp purge at least 2wk for 3 months Once weight low done to keep weight low Sometimes related to anorexia After purging enormous shame amp guilt which triggers a greater resolve to diet 20 college students 2 3 normal population seen in long distance runners and gymnasts General Predisposing Risks Chronic dieting Low selfesteem 7 Family dysfunction Physical or sexual abuse Biological factors currently unknown PerfeCtionism Lack of nutrition knowledge Shared Features Athletes ampAnorectics39 Fad diets Controlled caloric consumption Specific carbohydrate avoidance Low body weight Resting bradycardia and hypotension Increased physical activity Amenorrhea or oligomenorrhea Anemia Distinct Features Athletes vs Purposeful training Increased Exercise Tolerance 7 Good Muscular Development Accurate Body Image Body Fat Level in Normal Range Anorectics Aimless PA Poor or decreasing performance Poor muscular deveIOpment Flawed Body Image Low Body Fat Distinct Features Athletes vs Increased Plasma Vdume Efficient Energy MyetabOIism Increased VO2 Increased HDL2 Anorectics Electrolyte Abnormalities Cold Intolerance Dry Skin Cardiac Arrhythmias Lanug o hair Leukocyte Dysfunction If disorder is suspected Q Contact a person coach that has best rapport private meeting 39 Be supportive 39 9 Observation that has aroused concern Affirm that role on team notjeopardized Can they correct on own 9 Outside confidential help Sport may have played a role 1 Talk or question other teammates 7 2 Attempt to discipline straighten up t Failure may not bedue to lack of effort or weakness of athlete 39 oto Keep it in the family if necessary THE FEMALE TRIAD Osteoporosis Amenorrhea Disordered Eating The Female Athlete Triad 1 Amenorrhea Menstrual dysfunction has long been known to b associated with exercise 39 r 2 Disordered Eating 7 Eating disorders are a cause of lower bone mineral density and premature osteoporosis 3 Premature Osteoporosis Amenorrhea secondary to hypoestrogenism is associated with osteoporosis Female Athlete Triad Identified by American College of Sport Medicine in 1992 Since then medical personnel and others have attempted to intervene through screeningreducation and treatment Sportspecific Risks Emphasis on weight for performance or appearance Pressure to lose weight from parents coaches judges or peers Drive to win at any cost Selfidentity tied tosport Exercises through injury Overtrained and undernourished Caloric Requirements for Sport 22002500 Kcalday for 1020 hours of exercise per week Up to 4000 Kcalday for endurance 7 exerCIses Endurance athletes requireincreased protein 1215 gkg 5 8 gkg of carbohydrate Symptoms of Inadequate Calories Fa gue V 39 Irritability hunger difficulty concentrating Frequent injuries Poor athletic performance Growth failure in adolescence Weight loss Amenorrhea Female Athletic39Triad39 Athletic Performance Societal Stress Pressure I Eating Disorders OIigoAmm enorrhea a a Low Decreases Ca7ntake A Ca retention Osteopenioa Stress Fractures 7 Prevention Education to dispel myths regarding body weight and body fat and their relationship to performance athletes often mistakenly feel that the lower their body fat the better their performance Nutrition education regarding a healthy diet morecalories are often required to improve performance and health Female Athlete and NUtritional Needs Resource Tutorial by Dr Douglas McKeag Indiana University Center for Sports Medicine at httpwww sportsmed iu edupresentations femaleathlete f0rwebpdf Sports Nutrition Guidebook by N Clarke V Nutrition and the Female Athlete by JS Ruud Carbohydrates Made of carbon hydrogen amp oxygen Categories Monosaooharides Disaooharides Polysaooharides I 0 o I O O IO IO I0 I u I I I0 OI O O o T 0 IONIO NIOOI I I O O N100 mMOFUDMm MmOUDAG wmctmcoomwocoz Other Monosaccharides Galactose Mannose Ribose Xylose Deoxyribose Arabinose Disaccharide Sucrose HOCH2 HOCH2 H H CH HO COH HC39 O4H OHC H H OH OH H Disaccharides Sucrose glucose fructose Most Common Lactose glucose glactose Milk Sugar Maltose glucose glucose Plants Theoretical Starch Molecule Amylopectin Theoretical Glycogen Molecule 0 0390 0390 U 000 U Q 00quot 0 000000000 03 0 0 039 35 o o 9 aquot Glycemic Index The effect carbohydrate has on blood glucose levels Related to the rate of catabolism amp absorption into the blood Scale uses glucose as the anchor GI 100 Give 50 g of food and monitor rate of rise in glucose GI 75 is absorbed at 75 the rate of glucose GI 20 is adsorbed at 20 the rate of glucose Only maltose has a GI above 100 GI 110 Factors Influencing GI Amount of protein present slows GI Amount of fats present slows GI Fiber pectin slows GI Whole milk 27 while pure lactose is 46 Not all starches have a lower GI than simple sugars Mashed potatoes 80 while fructose 20 WHY IS GI IMPORTANT Important when planning the precompetition meal High GI foods 34 hr before exercise improves glycogen stores High GI food close to competition not advisable Can cause insulin to rise gt hypoglycemia during exercise Elevated insulin during exercise blocks 3 oxidation Reduces fat use for energy Important when trying to replenish after exercise 50 g glucose l 2 hr post glycogen storage rate of 56 mmollkghr Fructose at the same rate glycogen storage rate of 3 mmollkghr Contribution of Substrates to Energy Expenditure 300 l Muscle Glycogen l Muscle Trig W Plasma FFA l Plasma Glucose l Protein 250 N O O A O O I 01 O I EE callkglmin Q O 25 65 85 Percent Maximal Aerobic Power Coyle Am J Clin Nutr 1995 Effects 0f uratim of Exercise at 70 0f Maxima ntens fcy on Substrate U n zat on 100 90 80 70 60 50 40 30 20 10 0 Rest 1 2 3 Time hr I Glycogen I Glucose I Plasma FFA I Muscle Trig I Protein Energy J Coyle Am J Clin Nutr 1995 FATIGUE Lightlow intensity exercise Predominently FFA No direct metabolic cause Fatigue may be CNS in origin Asmussen amp Mazin 73 Moderate intensities 5085 Uses 70 CHO 25 FFA Highly correlated to availability of CHO stores Muscle amp liver stores Wahren 77 High intensities gt85 Uses up to 95 CHO Related to depletion of muscle glycogen stores Possible lactate accumulation Bergstrom s7 Gollnick as Hepatic glycogen amp blood glucose unchange Hultman 67 FATIGUE Prolonged exercise May lead to hypoglycemia decrease CNS function amp fatigue some literature in opposition Reduces glycogen stores amp increases utilization of blood glucose Fatigue more normally due to muscle glycogen depletion Glycogen depletion can reduce sprint performance at the end of an event increased injuries because muscle cannot contract rapidly to avoid injury High Carbohydrate Diet on Supramaximal Exercise at 110 VOZmax Low Normal High Dietary CHO Content Blood glucose responses during exercise to exhaustion 75 VOZmax in relation to Glucose mmolL N I O I 01 A D I O dietary carbohydrate 1W Low Mixed I High I I Exhaustion Rest 30 6O 90 120 150 180 210 240 270 300 360 Exercise Duration Muscle glycogen content during 3 days of heavy training with high and Muscle Glycogen mMkg wet wt 8039 low carbohydrate diets High GHQ 70 Low GHQ 40 I I I o 6 12 18 24 30 36 42 48 54 60 66 72 Timeh 2 h Training Costill 1985 Timing Sequence 36 days before event carbohydrate loading With or without depletion 35 hour before an event precompetition meal High CHO low Fats some protein lt hour of an event Questionable practice Not recommended maybe 68 solution Immediately before an event Liquid sources 68 solution Ingestion during endurance events liquidsolid 1030 min intervals at 150250 gmlhr during prolonged exercise Carbohydrate Loading 250 Glycogen mMkg wet wt Techniques High CHO 55 Sherman 1986 Dietary Composition during Loading 35 I Pre Diet l Post Diet Glycogen 9100 muscle 0 4 N 11 01 l 01 O DS DC NDS NDC D depletion ND no depletion Roberts EJAP 1988 S Simple sugars C complex carbohydrates Effect of Timing of Ingestion of Glucose on Plasma Glucose Levels at Rest and during Exercise 65 VOZmax to Exhaustion 160 39 150 39 140 39 Glu 90 GIU60 A 130 39 Glu 30 g 120 39 Pia60 g 110 8 2 quot D 90 39 80 39 70 60 90 75 60 45 30 1 5 0 1 5 30 45 60 EXh Exercise Tokmakidis Int J Sports Med 2000 Blood Glucose at Rest and during Exercise 70V02max after the Ingestion of Glucose Fructose or Saccharin P n Glucose Fructose Saccharin Blood Glucose mML A A A 01 I I l I lt 39o o 2 lt o D 3 m N 01 l 6O 30 0 3O 6O ReSt Exercise McMurray 1979 Total Work Produced during 30 min Performance Ride 90 min after the Ingestion of Glucose Waxy Starch Resistant Starch or Placebo Work kJ Glucose Amylose Amylopectin Placebo Goodpaster Int J Sports Med 1995 Effects of ingesting 4OO mL of a 20 glucose lelectrolyte Solution one hour before exercise on a Time Trial Performance1 after 90 min of cycling 70 V02max 0 I I E E6 UJ 26 o Effects of Ingesting Liquid CH0 1 h Before Exercise on Performance Times Exercise 90 min 70V02max Time Trial Time mi n Placebo 75 9 CH0 150 9 CH0 Sherman Am J Clin Nutr 1991 Peak Power Output during 6 min of HighIntensity Exercise after Ingestion of 500 mL of a 5 Glucose Polymer 15 Minutes before Exercise Power Output W Control Glucose Wouassi Eur J ApplPhysio1997 Time to Exhaustion after Ingesting 100 g of Solid or Liquid Carbohydrate 5 min before Intermittent High Intensity Exercise TIME Min Solid Liquid Placebo Walton Biol Sport 1997 Total Number of Sets and Repetitions 80 10RM a39fter Ingesting Glucose Polymer 1 g lkg 160 140 120 100 8D 602 4390 20 SETS REPETITIONS Lambert J Appl Spon Sci Res 1991 Carbohydrate Feeding during E 39 5 A45 lt1 2 E 4 3 Fatigue O 235 D I U E 3 CHo E IPacebo 1 Fatigue 25 2 0 3O 60 90 120 150 180 Exercise Time Min CHO1 k m39n 2025 k 6090120 9 g I g g CoyleJAppPhysiol1983 Glycogen Replenishment Glycogen resynthesis 78 mmolkgh first 2 h post Normal Resynthesis 56 mmolkgh Some marathon runners still 60 depleted gt 48 hours Even on a high carbohydrate diet Low CHO diet five days to fully replenish Exercise Light exercise increases glycogen synthesis Timing First 2 hours most critical Sugar containing solutions high glycemic index Need to ingest within 6 hours post exercise Forms Liquid first 2 hr post Solid or liquid next 22 hr Sports Drinks l Sports Bars 600 g24 h or gt8 g CHOkgl24 h Moderatehigh GI Low GI foods for 2448 hours post Glycogen replenishment Glucose 50 92 hr glycogen storage rate of 56 mmollkgh Higher ingestion amounts no better uptake Fructose same rate glycogen storage rate of 3 mmollkgh Higher ingestion amounts no better uptake Glucose Polymer same rate glycogen storage rate of 56 mmollkgh Glucose glucose polymer and sucrose appear best even thought Sucrose has a GI 59 Rate of glycogen resynthesis during 35 h recovery from prolonged exercise Carbohydrate vs carbohydrate protein A NNwwF O OU IOCDOU IOU I IIIIIII Glycogen Resynthesis m MngWh O I I i u I O O OCHO I CHOPRO 06 08 1 12 14 16 Dose gkg h I 18 Muscle glycogen comparing the post exercise consumption of a liquid or solid source 400 350 300 250 200 150 100 50 I Liquid I Solid Glycogen mMkgDW Pre Post 5 h 22 h Liquid 714 CHO Solid 775 CHO KeizerntJ Sports Med 1987 SPORTS DRINKS Sports Drinks For the average athlete fluid to reduce the chances of dehydration is more important than CHOs Best way to replace fluids is what they will drink with low amounts of sugar Prolonged exerciser benefits from sport drinks Osmolality of Various Glucose and Glucose Polymer Solutions 1200 1000 IGlucose l Glucose Polymer E 800 E w 0 LE 5 600 E Osmolality of 2 Blood 1 O 400 1 200 0 Percent Carbohydrate Foster et al Res Quan Exerc Sport 1980 Gastric emptying 30 minutes post ingestion of 400 ml of various glucose and glucose polymer solutions 250 a 200 7 I Glucose I Glucose Polymer Gastric Emptying 5 10 15 20 Percent Carbohydrate Foster et al Res Quart Exerc Sport 1980 Total carbohydrate delivered in 30 minutes related to solutions containing glucose and glucose polymer Carbohydrate g O 5 10 15 20 Percent Carbohydrate in Solution Foster et al Res Quan Exerc Sport 1980 Name CHO Source Sodium Potassium Osmolarity m2 m2 mosmL Gatorade 6 SGF 110 30 347351 All Sport 86 Fructose 55 50 526529 Powerade 82 PF 55 30 397410 Endura 65 GFP 46 190 367 Torq 21 GFP 200 85 gt700 Endurox 18 GFP 230 140 gt650 Pedialyte lt1 GF 236 179 293 Orange juice 117 GF 3 I 690


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