Nutritional strategies to promote postexercise recovery. JND has no conflicts of interest to report. ASR has received grants to evaluate the efficacy of dietary supplements, serves as a scientific advisor for sports nutrition companies, and received remuneration from companies for presenting evidenced-based nutritional supplement and exercise research at professional conferences. RBK has received externally-funded grants from industry to conduct research on dietary supplements and has served as a scientific and legal consultant. Burke LM. Since credentialing practices vary internationally, the term “sports dietitian” will be used throughout this paper to encompass all terms of accreditation, including RDN, RD, CSSD, or PDt. It is beyond the scope of this paper to address the multitude of sports supplements used by athletes and caveats surrounding sport-specific rules allowing their use. Loucks AB. The presence of flavor in a beverage may increase palatability and voluntary fluid intake. Mountjoy M, Sundgot-Borgen J, Burke L, et al. Sequential extracts of human bone show differing collagen synthetic rates. Would you like email updates of new search results? Some experts suggest daily fluid needs as high as 4–5 L with altitude training and competition, while others encourage individual monitoring of hydration status to determine fluid requirements at altitude.112, Extreme environmental challenges (heat, cold, humidity, altitude) require physiological, behavioral, and technological adaptations to ensure athletes are capable of performing at their best. Carbohydrates for training and competition. Adequate energy is needed to optimize protein metabolism, and when energy availability is reduced (eg, to reduce body weight/fat), higher protein intakes are needed to support MPS and retention of fat-free mass. In: Burke L, Deakin V, eds. The Academy of Nutrition and Dietetics157 describes the competencies of the sports dietitian to “provide medical nutrition therapy in direct care and design, implement, and manage safe and effective nutrition strategies that enhance lifelong health, fitness, and optimal physical performance.” Roles and responsibilities of sports dietitians working with athletes are outlined in Table 4. When conducting such monitoring programs, it is important that the communication of results with coaches, training staff, and athletes is undertaken with sensitivity, that limitations in measurement technique are recognized, and that care is taken to avoid promoting an unhealthy obsession with body composition.17,18 Sports dietitians have important opportunities to work with these athletes to help promote a healthy body composition, and to minimize their reliance on rapid-weight loss techniques and other hazardous practices that may result in performance decrements, loss of fat-free mass, and chronic health risks. Individual name recognition is reflected in the acknowledgments at the end of the statement. 1 Exercise and Performance Nutrition Laboratory, School of Health Sciences, Lindenwood University, St. Charles, MO, USA. You may choose to go into health promotion, the food and There is ample evidence in weight sensitive and weight-making sports that athletes frequently undertake rapid weight loss strategies to gain a competitive advantage.20,23,24 However, the resultant hypohydration (body water deficit), loss of glycogen stores and lean mass, and other outcomes of pathological behaviors (eg, purging, excessive training, starving) can impair health and performance.18 Nevertheless, responsible use of short-term, rapid weight loss techniques, when indicated, is preferred over extreme and extended energy restriction and suboptimal nutrition support.17 When actual loss of body weight is required, it should be programmed to occur in the base phase of training or well out from competition to minimize loss of performance,25 and should be achieved with techniques that maximize loss of body fat while preserving muscle mass and other health goals. Factors that increase energy needs above normal baseline levels include exposure to cold or heat, fear, stress, high altitude exposure, some physical injuries, specific drugs or medications (eg, caffeine, nicotine), increases in fat-free mass and, possibly, the luteal phase of the menstrual cycle.2 Aside from reductions in training, energy requirements are lowered by aging, decreases in fat free mass (FFM), and, possibly, the follicular phase of the menstrual cycle.3. We thank the reviewers for their many constructive comments and suggestions. The genetic variability between individuals can affect physical properties (muscle strength, skeletal structure, heart and lung size, tendon elasticity) but also nutrients absorption, distribution, metabolism, and excretion. Dietary supplements and sports foods with evidence-based uses in sports nutrition. Goulet ED. Is there a need for protein ingestion during exercise? Binge drinking is also associated with high-risk behaviors leading to accidents and anti-social behaviors that can be detrimental to the athlete. 24. Stimulation of net muscle protein synthesis by whey protein ingestion before and after exercise. Cannell JJ, Hollis BW, Sorenson MB, Taft TN, Anderson JJ. J Am Diet Assoc. This protocol of achieving supercompensation of muscle glycogen evolved from the original studies of glycogen storage in the 1960s and, at least in the case of trained athletes, can be achieved by extending the period of a carbohydrate-rich diet and tapering training over 48 h36 (Table 2). Nattiv A, Loucks AB, Manore MM, et al. 92. Hoffman JR, Ratamess NA, Tranchina CP, Rashti SL, Kang J, Faigenbaum AD. 153. Sundgot-Borgen J, Meyer NL, Lohman TG, et al. Cox GR, Clark SA, Cox AJ, et al. American College of Sports M, Sawka MN, Burke LM, et al. Because exercise can increase oxygen consumption by 10- to 15-fold, it has been hypothesized that chronic training contributes a constant “oxidative stress” on cells.101 Acute exercise is known to increase levels of lipid peroxide by-products,101 but also results in a net increase in native antioxidant system functions and reduced lipid peroxidation.102 Thus, a well-trained athlete may have a more developed endogenous antioxidant system than a less-active individual and may not benefit from antioxidant supplementation, especially if consuming a diet high in antioxidant rich foods. Low energy availability can result in unwanted loss of muscle mass; menstrual dysfunction and hormonal disturbances; sub-optimal bone density; an increased risk of fatigue, injury, and illness; impaired adaptation and a prolonged recovery process. Carbohydrate-loading and exercise performance. Empirical data are still needed to elucidate the direct role of vitamin D in musculoskeletal health and function to help refine recommendations for athletes. The fluid plan that suits most athletes and athletic events will typically achieve an intake of 0.4 to 0.8 L/h,104 although this needs to be customized to the athlete’s tolerance and experience, their opportunities for drinking fluids and the benefits of consuming other nutrients (eg, carbohydrate) in drink form. 114. Sports nutrition is a constantly evolving field with hundreds of research papers published annually. The Australian Institute of Sport has developed a classification system that ranks sports foods and supplement ingredients based on significance of scientific evidence and whether a product is safe, legal, and effective in improving sports performance.142Table 3 serves as a general guide to describe the ergogenic and physiological effects of potentially beneficial supplements and sport foods.141,143–148 This guide is not meant to advocate specific supplement use by athletes and should only be considered in well-defined situations. Body composition and strength changes in women with milk and resistance exercise. Foster C, Costill DL, Fink WJ. Pennings B, Boirie Y, Senden JM, Gijsen AP, Kuipers H, van Loon LJ. Effect of alcohol intake on muscle glycogen storage after prolonged exercise. 32 The amount and localization of glycogen within the muscle cell alters the physical, metabolic, and hormonal environment in which the signaling responses to exercise are exerted. Calcium supplementation should be determined after a thorough assessment of usual dietary intake. or M.Sc. Requirements can fluctuate based on “trained” status (experienced athletes requiring less), training (sessions involving higher frequency and intensity, or a new training stimulus at higher end of protein range), carbohydrate availability, and most importantly, energy availability.46,48 The consumption of adequate energy, particularly from carbohydrates, to match energy expenditure, is important so that amino acids are spared for protein synthesis and not oxidized.49 In cases of energy restriction or sudden inactivity as occurs as a result of injury, elevated protein intakes as high as 2.0 g/kg/day or higher26,50 when spread over the day may be advantageous in preventing fat-free mass loss.39 More detailed reviews of factors that influence changing protein needs and their relationship to changes in protein metabolism and body composition goals can be found elsewhere.51,52, Laboratory based studies show that MPS is optimized in response to exercise by the consumption of high biological value protein, providing ∼10 g essential amino acids in the early recovery phase (0–2 h after exercise).40,53 This translates to a recommended protein intake of 0.25–0.3 g/kg body weight or 15–25 g protein across the typical range of athlete body sizes, although the guidelines may need to be fine-tuned for athletes at extreme ends of the weight spectrum.54 Higher doses (ie, >40 g dietary protein) have not yet been shown to further augment MPS and may only be prudent for the largest athletes, or during weight loss.54 The exercise-enhancement of MPS, determined by the timing and pattern of protein intake, responds to further intake of protein within the 24-hour period after exercise,55 and may ultimately translate into chronic muscle protein accretion and functional change. 70. In sports involving strength and power, athletes strive to gain fat-free mass via a program of muscle hypertrophy at specified times of the annual macro-cycle. In: Burke LM, Deakin V, eds. 129. 30 mins. Reduced resting skeletal muscle protein synthesis is rescued by resistance exercise and protein ingestion following short-term energy deficit. MDR has received academic and industry funding related to dietary supplements, served as a non-paid consultant for industry and received honoraria for speaking about topics discussed in this paper. Dietary protein for athletes: from requirements to optimum adaptation. Body mass management of lightweight rowers: nutritional strategies and performance implications. Over-drinking fluids in excess of sweat and urinary losses is the primary cause of hyponatremia (blood sodium <135 mmol/L), also known as water intoxication, although this can be exacerbated in cases where there are excessive losses of sodium in sweat and fluid replacement involving low-sodium beverages.113,114 It can also be compounded by excessive fluid intake in the hours or days leading up to the event. Adaptations that enhance metabolic flexibility include increases in transport molecules that carry nutrients across membranes or to the site of their utilization within the muscle cell, increases in enzymes that activate or regulate metabolic pathways, enhancement of the ability to tolerate the side-products of metabolism and an increase in the size of muscle fuel stores.3 While some muscle substrates (eg, body fat) are present in relatively large quantities, others may need to be manipulated according to specific needs (eg, carbohydrate supplementation to replace muscle glycogen stores). 103. [email protected]. Barnes MJ. In addition to the usual daily water losses from respiration, gastrointestinal, renal, and sweat sources, athletes need to replace sweat losses. Potential performance effects of RED-S may include decreased endurance, increased injury risk, decreased training response, impaired judgment, decreased coordination, decreased concentration, irritability, depression, decreased glycogen stores, and decreased muscle strength.12 It is now also recognized that impairments of health and function occur across the continuum of reductions in EA, rather than occurring uniformly at an EA threshold, and require further research.12 It should be appreciated that low EA is not synonymous with negative EB or weight loss; indeed, if a reduction in EA is associated with a reduction in RMR, it may produce a new steady-state of EB or weight stability at a lowered energy intake that is insufficient to provide for healthy body function. However, the previous warnings about caffeine as a diuretic appear to be overstated when it is habitually consumed in moderate (e.g. For example, it has been established that recovery of performance129 and glycogen repletion rates53 were similar in athletes consuming 0.8 g carbohydrate/kg/BW + 0.4 g protein/kg/BW compared to athletes consuming only carbohydrate (1.2 g/kg/BW). 143. 80. Depending on the extent of dietary limitations, nutrient concerns for vegetarianism may include energy, protein, fat, iron, zinc, vitamin B-12,, calcium, n-3 fatty acids,149 and low intakes of creatine and carnosine.151 Vegetarian athletes may have an increased risk of lower bone mineral density and stress fractures.152 Additional practical challenges include gaining access to suitable foods during travel, restaurant dining, and at training camps and competition venues. More work is needed to elucidate the relevance and practicality of protein consumption on subsequent exercise performance and if mechanisms in this context are exclusive to accelerating muscle glycogen synthesis. Etheridge T, Philp A, Watt PW. American College of Sports Medicine position stand. A critical examination of dietary protein requirements, benefits, and excesses in athletes. 71. For a detailed description of the methods used in the evidence analysis process, access the Academy’s Evidence Analysis Process at https://www.andevidencelibrary.com/eaprocess. The item(s) has been successfully added to ", This article has been saved into your User Account, in the Favorites area, under the new folder. In the United States and in Canada, the Certified Specialist in Sports Dietetics (CSSD) is a registered dietitian/nutritionist and a credentialed sports nutrition expert. Targets should be individualized to the athlete and his or her event, and also periodized over the week, and training cycles of the seasonal calendar according to changes in exercise volume and the importance of high carbohydrate availability for different exercise sessions. Motivations for use include enhancement of performance or recovery, improvement or maintenance of health, an increase in energy, compensation for poor nutrition, immune support, and manipulation of body composition,138,139 yet few athletes undertake professional assessment of their baseline nutritional habits. Techniques used to measure or estimate components of TEE in sedentary and moderately active populations can also be applied to athletes, but there are some limitations to this approach, particularly in highly competitive athletes. 65. Recovery from a cycling time trial is enhanced with carbohydrate-protein supplementation vs. isoenergetic carbohydrate supplementation. Ivy JL, Res PT, Sprague RC, Widzer MO. Reference values for body composition and anthropometric measurements in athletes. 135. However, this must be carefully balanced against risks, and the expense and potential for ergolytic effects.139,141 Factors to consider in the analysis include a theoretical analysis of the nutritional goal or performance benefit that the product is to address within the athlete’s specific training or competition program, the quality of the evidence that the product can address these goals, previous experience regarding individual responsiveness, and the health and legal consequences. Bergeron MF, Bahr R, Bartsch P, et al. The ethical use of sports supplements is a personal choice and remains controversial. 20. Current data suggest that dietary protein intake necessary to support metabolic adaptation, repair, remodeling, and for protein turnover generally ranges from 1.2 to 2.0 g/kg/d. 68. Several factors can increase the risk of hypohydration when exercising in the cold, such as: cold-induced diuresis, impaired thirst sensation, reduced desire to drink, limited access to fluids, self-restricted fluid intake to minimize urination, sweat losses from over-dressing and increased respiration with high altitude exposure. This paper outlines the current energy, nutrient, and fluid recommendations for active adults and competitive athletes. 122. 32. A single and rigid “optimal” body composition should not be recommended for any event or group of athletes.15 Nevertheless, there are relationships between body composition and sports performance that are important to consider within an athlete’s preparation. Mettler S, Mitchell N, Tipton KD. your express consent. Training and nutrition have a strong interaction in acclimating the body to develop functional and metabolic adaptations. Woolf K, Manore MM. The effects of season-long vitamin d supplementation on collegiate swimmers and divers.
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