Sports Medicine: Just the Facts

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a. About 55–70% (6–10 g/kg body weight or 8–10
kcal/kg body weight) of the diet should be in the
form of carbohydrates.
b.About 25–30% of the diet should be from fats.
c. About 12–15% (1–1.5 g/kg body weight) of the
diet should be high quality protein (American
College of Sports Medicine, 2000).
•Athletes are always looking for something that will
give them an advantage over their competitors. There
are many ergogenic aids that are available, both
legally and illegally, to athletes in an attempt to
improve their performance. Carbohydrate loading has
been proven to improve performance during
endurance events. Caffeine ingestion of 3–5 g/kg also
improves endurance performance for many athletes.
This dose typically has an ergogenic effect without
exceeding those serum levels banned by sport govern-
ing bodies (Paluska, 2002).



  1. Carbohydrate loading has been a proven method to
    increase endurance event performance since the
    late 1960s. This technique has been shown to
    increase the glycogen stores in the muscles being
    exercised in events that last longer than 90 min.

  2. The older method of depleting glycogen stores, 1
    week of exhaustive exercise in conjunction with 3
    days of a low carbohydrate (less than 100 g/day)
    diet prior to 3 days of carbohydrate loading with
    minimal exercise, is no longer recommended due
    to significant undesired side effects (irritability,
    hypoglycemia, stiffness and heaviness of muscles,
    diarrhea, dehydration, and chest pain in older ath-
    letes) (DiMarco and Samuels, 2001).

  3. The current recommendations for carbohydrate
    loading are a diet composed of 60–70% carbohy-
    drates and a decrease in the training regiment
    during the 3 days prior to competition.



  • Athletes need to experiment with an individualized
    preevent and intraevent fuel source that will help to
    minimize the risk of glycogen depletion, dehydration
    and poor performance. Triathletes should never utilize
    a new hydration–nutrition regimen on race day.



  1. High fat and protein containing foods should be
    avoided in the 3 h prior to competition. About
    150–300 g of carbohydrate in any form is recom-
    mended. Some competitors recommended 1g/kg of
    body weight of carbohydrate 1 h before competi-
    tion. There is no evidence that this will improve
    performance and is more of an anecdotal recom-
    mendation that athletes need to decide for them-
    selves about.

  2. About 30–60 g/h of carbohydrate during events that
    last longer than 1 h has been proven to be beneficial
    to performance. Glucose and sucrose should be the
    primary carbohydrates ingested as they provide


more energy and have fewer side effects than fruc-
tose. Newer studies suggest that a small amount of
protein along with carbohydrates may have an even
better effect on endurance performance (Convertino
et al, 1996).
3.Following postevent rehydration, ingestion of
foods high in carbohydrates along with a moderate
amount of protein should be consumed to help
with the repair and maintenance of muscle tissue.


  • Hydration

    1. Hydration is the most important factor affecting
      performance. As little as 2–4% dehydration has
      been shown to negatively affect performance.
      2.Water loss occurs primarily through sweat.
      Ambient temperature, humidity, exercise intensity,
      and rate of fluid intake all play a role in the overall
      hydration status of a competitor. Competitors can
      lose 2 to 6% of their body weight during a race as
      a result of sweating. Trained athletes can lose
      1–3 L of sweat per hour.
      a. Average competitors do not consume enough
      fluid to negate the fluid lost. Consuming bever-
      ages while biking is a little easier and more pro-
      ductive than drinking while running. Elite
      runners may consume as little as 200 mL of
      fluid during distance events that last over 2 h.
      b.Minimal dehydration leads to impaired heat dis-
      sipation due to decreased skin blood flow,
      decreased plasma volume and can lead to severe
      hydration that can lead to decreased stroke
      volume, increased heart rate, and possibly heat
      stroke.

    2. Starting an event hydrated or slightly overhydrated
      will be beneficial to the competitor, as we know
      that by the end they will be dehydrated.
      Competitors need to force hydrate themselves the
      day prior to the competition and consume 400 to
      600 mL up to 2 h prior (Convertino et al, 1996).

    3. Ideally an athlete will replace fluids at a rate that
      equals their loss. A loss of 500 mL of fluid equates
      to a 1-lb decrease in body weight. This can be an
      excellent guide to post competition fluid replace-
      ment needs (Fieseler, 2001).

    4. The frequency and amount of fluid consumed by
      an endurance athlete is a topic of great interest
      with recommendations changing as more research
      on the topic is published. About 150 to 300 mL of
      water every 15 to 20 min of exercise depending on
      sweat rate is recommended.
      a. Too little or too much hydration each lead to
      their own set of problems—dehydration and
      hyponatremia respectively, so consuming the
      proper amount is paramount to maximizing per-
      formance.




542 SECTION 6 • SPORTS-SPECIFIC CONSIDERATIONS

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