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ESPEN Congress Geneva 2014DIETETIC SESSION: SPORT AND
NUTRITION
Mens sana in corpore sano: optimal nutrition for fitnessF.
Wardenaar (NL)
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Mens sana incorpore sano
FlorisWardenaar,MSc
HANUniversityofAppliedSciencesHeadTeamNutritionDutchOlympicCommitteePhDcandidateDietaryExposureAssessmentinAthletes,Wageningen
University
OptimalNutritionforFitness
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Ethical dilemmas Bioethical principles Application of bioethical
principles to Nutrition at the end-of-life The decision-making
process
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Fitnessinrelationto
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Nutrition inrelation tofitnessandperformance
Fuel
RecoveryBrainfunction
Protection
Fitness and performance
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Introduction
Doathletes meetnutritionrecommendations?
Areguidelines feasibleinpractice?
Preliminary dataofDSSS
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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
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RoadmapWhatdoathletes
need?
Doathletesmeetrecommendations
Timingproteinintake
(averageathlete)
Duringcompetition
(ultramarathon)
Habitualdiet(ultramarathon)
Doathletesneeddietary
supplements?
Timingaroundtraining(rowing)
Doathletesusedietary
supplements?(generalpopulation)
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EstimatedAverage
RequirementRecommendDailyIntake
Individualneed
P
e
r
c
e
n
t
a
g
e
o
f
p
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p
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l
a
t
i
o
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2*SD
AssessmenthabitualdietPreferredmethod:Probabilty
ofInadequacy(POI)Percentageofpopulationbelowacertainvalueofanestimatednormaldistribution(basedonZscore)Precondition:EARavailable
Aditional
method:MedianbasedqualitativeanalysesIncaseofmedianhigherthenRDI/AIlowriskforlownutritionintake,otherwisenostatementcanbemade(ns)
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Nutrient intakeofultramarathonrunnersHabitual diet andnutrition
on acompetion day
S
u
r
v
e
y Mean intake:3x24hR+3xdailyquestionnairesrunnerspreparingfor
60or120km
Energy(MJ),CHO(g/kg),PRO(g/kg)
Q
u
e
s
t
i
o
n
n
a
i
r
e
Adjusted GSSIquestionnaireabout nutritionintakeduring60km
CHO/PRO/Fluidg/kgor ml/kg,CHO/Fluidintakeperhour
O
b
s
e
r
v
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t
i
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Continousobservation ofnutrition andfluid intakeduring 120km
CHO/Fluidintakeperhour
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Groupcharacteristics
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Survey:Habitualnutrientintake
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Accuracyofmethod:limitedinformation
Validationstudy:comparingmultiple24hourrecallanddailyquestionnaireswithgoldenstandard:24hournitrogeninurine
EstimatedproteinbasedonRecalls:10736g/dVSNitrogenexcretions:14239g/d
24hourrecallunderestimatedaveragemeanproteinintakewith35.539g/dor30%.
Crudecorrelationbetweenintakeestimateswasr=0.61(95%CI:0.420.74)
Multiple24hrecallswithdailyquestionnairesunderestimateproteinintakeequallyforindividuals(basedonBlandAltmanplot)
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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
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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
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Rowing,males andfemales n=22Eating moments persubjectaround
training
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Nutrition intakeduring
ultramarathon60kmofTexeloveradistanceof60or 120km
Meantemperature 2C Road,trail,beach 4beveragestations
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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
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Observation:Nutrientintakeduring120kmofTexel
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Observation:Individualtimelineoffoodandfluidintake
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*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
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*engagedinsportsN=1143,notengagedinsportsN=401
Useofsportnutritionproductsanddietarysupplements
26%7%
14%
8%
26%
35%
34%51%
0102030405060708090
100
engagedinsports* notengagedinsports*
%
o
f
r
e
s
p
o
n
d
e
n
t
s
none
onlynutritionalsupplements
onlysportnutritionproducts
both
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*generalpopulationN=1544;womenN=753,menN=791
Genderdifferences
36%
20%
7%
17%
05
101520253035404550
women* men*
%
o
f
r
e
s
p
o
n
d
e
n
t
s
onlysportnutritionproducts
onlynutritionalsupplements
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Conclusion
Largevariationinrecommendationsandwaystoassessthediet
HabitualdietofDutchultramarathon runnersdidnotmeetthe
recommendationsforCHOandpartlyforPRO
Timingofproteinintakeoverthedayisfocusedonbreakfast,lunch
anddinner:classicalsportnutritionfocus
Mostathletes,butnotall,managetoeatbetweenonehouraftera
morningtrainingsessionwhenquickrecoveryisnecessary
Duringcompetitionmostultramarathon runnersdidnotmeet
carbohydraterecommendations,butalargevariationwasfoundintheintakeofmacronutrientsandfluid
Sportsnutritionproductsanddietarysupplementsareusedbyathletesandnonathletes
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Take homemessages
Athletesdonotmeetrecommendations,butisthisalwaysneededforoptimalfitness?
Distributeproteinbetterovertheday
Focusoncompletedietandmealtimeplanningtooptimizerecovery
Traincarbohydrateandfluidintakeduringregulartrainingsessions
Makesuretogiveattentiontodietarysupplementsandsportnutritionproductsinallcases
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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
