COACHES CHECKLIST- A FUELING COACHES CHECKLIST- A FUELING AND HYDRATION GAME PLANAND HYDRATION GAME PLAN

Leslie Bonci, M.P.H., R.D.,LDN,CSSDLeslie Bonci, M.P.H., R.D.,LDN,CSSD

Director Sports Nutrition ProgramDirector Sports Nutrition ProgramUniversity of Pittsburgh Medical CenterUniversity of Pittsburgh Medical Center

WHAT DO YOU WANT?WHAT DO YOU WANT?

– Players with• Improved performance• Reduced fatigue• More energy• Fewer injuries• Faster recovery• Appropriate Body composition changes

PERFORMANCE DISABLERSPERFORMANCE DISABLERS

• Inadequate sleep

• Not eating/drinking BEFORE Exercise

• Waiting too long to eat/drink AFTER exercise

• Rapid weight loss

• Alcohol/Caffeine/supplements misuse/abuse

INAPPROPRIATE TIMING OF INAPPROPRIATE TIMING OF FUELING AND HYDRATIONFUELING AND HYDRATION

muscle mass performance perceived effort of exertion

• Delayed recovery risk of injury

• Harder to achieve weight goals

SO HOW DO WE ADDRESS SO HOW DO WE ADDRESS PERFORMANCE ISSUES?PERFORMANCE ISSUES?

Low energy? More even calorie distribution over the day

rather than uploadOptimal hydrationAppropriate macronutrient distribution as part

of every mealFood availability over the day, not just snacks

DECREASED ENERGY OVER THE DECREASED ENERGY OVER THE SEASONSEASON

• Focus on post exercise recovery:– Carbohydrate + protein post workout- amount

and timing matter– Less is more– Consistency with eating amounts / frequency– ATHLETES NEED IT THE MOST WHEN

THEY WANT IT THE LEAST– Take advantage of the anabolic “window” post

strength training

PracticePracticeWorkoutsWorkouts

GamesGames

TIME ITTIME IT

• More even food intake during the day

• Breakfast before bed for early morning workouts

• Eat/drink BEFORE practice

• Eat/drink AFTER practice

• Fueling/hydrating pre and post exercise as part of warm-up and cool down

PRE- EXERCISEPRE- EXERCISE

• In the hour before exercise:– 20 ounces of fluid and – 35-50 grams carbohydrate +– 12-15 grams of protein

• Yogurt- light is fine• Chocolate milk-low-fat- 10-12 ounces• ½ of peanut butter sandwich or peanut butter and

crackers• Sports bar-not no carb, but not > 400 calories

PRE WORKOUT HYDRATIONPRE WORKOUT HYDRATION

• 2-3 hr before: 16 ounces of fluid– Optimizes hydration and allows time to

eliminate excess fluid

• Just before: 8-16 ounces fluid if thirsty

• Monitor urine color

Measuring Hydration StatusMeasuring Hydration Status

• USE URINE COLOR AS A GUIDE

1 If your urine matches the colors 1, 2, or 3, you are properly

hydrated. Continue to consume fluids at the recommended

amounts.

2

3

4 If your urine color is below the BLUE line, you are DEHYDRATED and at

risk for cramping / a heat illness!

YOU NEED TO DRINK MORE WATER / SPORTS DRINK!

5

6

7

8

POST-EXERCISEPOST-EXERCISE

• Within 15 minutes:– Fluid to replace what the body has lost– 35-50 grams of carbohydrate– 12-15 grams of protein to expedite recovery

• 12 ounces low-fat chocolate milk• ½ of a bar or ½ of a shake• 3-4 strips beef jerky and ½ cup pretzels• ¼ cup nuts and a piece of fruit

HYDRATION AFTER HYDRATION AFTER EXERCISEEXERCISE

• At least 20 ounces per pound lost• Carbohydrate + fluid + electrolytes• Mix of carbohydrate sources: sucrose, glucose,

fructose, maltodextrins• Metered rehydration vs large volumes may help

to conserve fluid volumes and is preferred unless regular access to fluid is limited

BREAKFAST SPECIFICSBREAKFAST SPECIFICS

– At least 3-400 calories• Protein ( eggs, yogurt, milk, ham, turkey

sausage)• Fat ( nuts, nut butters)• Fiber ( whole grain cereals, bread, fruit)• Fluid ( milk, water, coffee, tea, diluted

juices)

EATING BEFORE BEDEATING BEFORE BED

• What TO eat:– Cereal- hot or cold with milk and juice– A smoothie– Egg sandwich with milk or juice

• What NOT to eat– Fried foods– Pizza– Wings/ribs

SIZE ITSIZE IT

• In general- with food, LESS is more

• Baseball size pre/post practice or games

• Plate- picnic size at meals

• Snack size plate- salad or dessert size or small bowl size for evening snack

• With beverages, at least 8 up to 20 ounces per meal/snack

CALORIESCALORIES

• 9-13 year old boys: 1800-2200/day

• 9-13 year old girls: 1600-2000

• 14-18 year old boys- 2200-2600

• 14-18 year old girls- 2000

• MORE CALORIES REQUIRED FOR ATHLETES!

CARBOHYDRATESCARBOHYDRATES

• Essential for fluid balance• Primary fuel substrate for exercise• Requirements may range from 200-500

grams/day• Important for muscle glycogen resynthesis

and muscle growth• Type of carbohydrate: Fruits, vegetables,

grains, sweets

TIMING OF TIMING OF CARBOHYDRATESCARBOHYDRATES

• Before exercise 1-2 hours before exercise: cereal, bread, pasta, rice, granola or cereal bar

< 1 hour before exercise ( sports drink, honey, gelatin)

• During for activities> 1 hr duration– During exercise: sports drink, honey, gels,

sugar cubes

PROTEINPROTEIN

• NOT an efficient fuel substrate for exercise• MINIMUM of 0.5 grams protein per pound body weight to

ensure bone health and a stronger immune system• MAXIMUM OF 1 gram/pound body weight

• EXAMPLES– 3 ounces of chicken, beef, tuna- 21 grams of protein– A veggie burger- 18 grams of protein– 12 ounce glass of milk- 12 grams protein– 2 eggs- 14 grams of protein– 8 ounce yogurt- 11 grams of protein– 2 TBSP peanut butter- 10 grams of protein

• (TBSP = TaBle Spoon)

PROTEIN TIMINGPROTEIN TIMING

• Timing of protein intake is important – BEFORE lifting and AFTER!

• 12-20 grams of protein with 35 grams of carbohydrate BEFORE lifting

• Only 12-20 grams of protein needed AFTER lifting- With 35 grams of carbohydrate

FAT AND EXERCISEFAT AND EXERCISE

• Diet too low in fat MAY limit performance by inhibiting intramuscular triglyceride stores

• Dual duty foods: cheese, nuts, peanut butter

• Healthier fats: fish, fish oils, olive, soybean, safflower, corn, sunflower and canola oils

AAP GUIDELINES FOR AAP GUIDELINES FOR WEIGHT CONTROLWEIGHT CONTROL

• Maximum weight loss-1-2 lb/week• 53-63% carbohydrate, 15-20% protein,

20-30% fat• Smaller, more frequent meals• Calories in food, not fluid• Add liquid foods, protein, fiber• Keep a food log• Portion

WANEWANE

AAP GUIDELINES FOR AAP GUIDELINES FOR WEIGHT GAINWEIGHT GAIN

• Maximum 1 pound increase/week

• Need to strength train

• 0.7-0.9 grams protein/lb body weight

• Eat ¼ more at every meal and snack

• Add calories in food and beverages

• Eat more 7 days/week

GAINGAIN

FACTORS THAT INFLUENCE FACTORS THAT INFLUENCE FLUID CONSUMPTIONFLUID CONSUMPTION

• Frequency/regularity of eating episodes• Level of dehydration/Stomach

fullness/distention• Dryness or unpleasant taste in the mouth• Accessibility• Intensity of training• Weight lost during training, practice, or game

is fluid loss, not fat loss

WHAT ELSE INFLUENCES WHAT ELSE INFLUENCES HYDRATION?HYDRATION?

• Fad diets

• Rapid weight loss

• Glycogen depletion

• Supplements

• Illness

• Temperature/altitude

POINTS TO CONSIDERPOINTS TO CONSIDER

• Dehydration affects cognitive functioning• Liter of sweat loss = to 8 beats/minute in heart rate

• Chronic dehydration that often accompanies weight class sports impairs training/ performance

• Body water loss of> 2% impairs performance• 185 pound cornerback will see a decrease in performance with 3.7 pound

BM loss during training/competition

• Dehydration impairs mental functioning:• Decrease in sustained attention• Increase in error rate• Decrease in response time and task accuracy

FLUID GOALS DURING FLUID GOALS DURING EXERCISEEXERCISE

• Most athletes consume 8 oz/hour

• Larger fluid intake during exercise leads to:– Greater cardiac output– Greater skin blood flow– Lower core temperature– Reduced perceived effort of exertion

FLUID GUIDELINES FOR FLUID GUIDELINES FOR EXERCISEEXERCISE

• 20 oz 1 hour before exercise

• At least 14-20+ ounces/hr of practice/conditioning

• 20 oz per pound lost DURING exercise

• Gulps over sips

• Swallow instead of spit

• IN, NOT ON

TYPES OF FLUIDTYPES OF FLUID

• Water

• Carbonated beverages/seltzer

• Coffee or tea or herbal teas

• Milk

• Juices

• Sports drinks

• Energy drinks

CAFFEINECAFFEINE

• Not a diuretic

• Muscle glycogen sparing effect in endurance exercise

• Varying doses in energy drinks

• Caffeine + fluid, i.e. coffee, tea, energy drink or caffeine alone- 5 hour energy

CAFFEINECAFFEINE

• Caffeine- IS a central nervous system stimulant

• >200 mg may cause:– Jitteriness, increased anxiety, restlessness– Insomnia– Upset stomach– May be addicting

CAFFEINE CONTENTCAFFEINE CONTENT

• 5 hr energy drink- 150

• Starbucks: 260-550

• Espresso shot- 75-150

• Mountain Dew, 20 ounces: 118

• Red Bull- 80

• FRS- 38

HOW TO CONSUME FLUIDHOW TO CONSUME FLUID

• Large volume of fluid empties more rapidly than small amounts

• 1 liter of fluid empties from the stomach and is absorbed by the intestine within 1 hour

• Maximum 2 liters/hour• Large bolus of fluid followed by repeated

ingesting of additional fluids

TEMPERATURE OF FLUIDTEMPERATURE OF FLUID

• Cold fluid may attenuate increased core temperature rise and improve exercise performance in the heat

• May be more palatable than room temperature beverages and increase the drive to drink

• In cold weather activities, warm fluids may be better tolerated

WATER VS SPORTS DRINK?WATER VS SPORTS DRINK?

• Source of additional fuel• Glucose stimulates sodium and water absorption• More fluid is absorbed from

carbohydrate/electrolyte beverages than plain water

• Higher the carbohydrate content, the slower the rate of gastric emptying

ALCOHOLALCOHOL

• May dehydrate in susceptible individuals• May delay muscle glycogen resynthesis• Can cause liver disorders• May delay recovery from injury• Can be significant source of calories• What is a drink?

– 12 oz beer– 8 oz malt liquor– 4-5 oz glass of wine– Shot of liquor

HOW MUCH FLUIDHOW MUCH FLUID

• BASELINE– Ages 4-8: 5 cups (1.2L)– Age 9-13- boys- 8 cups (1.8L)– Age 9-13 –girls- 7 cups (1.6L)– Age 14-18- boys- 11 cups (2.6 L)– Age 14-18- girls- 8 cups (1.8L)

FLUID GUIDELINES FOR FLUID GUIDELINES FOR CHILDRENCHILDREN

<10 >10

1-2- HRS BEFORE: 4 OZ 8 OZ

15 MINUTES BEFORE: 4 OZ

6 OZ

EVERY 20 MINUTES DURING ACTIVITY: 4

8 OZ

AFTER: 16 OZ/LB LOST 16 OZ /LB LOST

HYPONATREMIAHYPONATREMIA

• Blood sodium < 136 mEq/L

• CAUSES:– Increased total body water– Reduced urine output– Inadequate sodium intake– Large sodium loss

Who is at risk?Who is at risk?

• Heavy, salty sweaters “ cake sweat” • Females• Slower runners• Athletes on low sodium diets• Water-only drinkers• Drinking more fluids than needed• Exercise duration > 4 hours• Low body weight ( BMI < 20)• Exercising in Extreme environmental conditions

SODIUM NEEDS OF SODIUM NEEDS OF ATHLETESATHLETES

• Sweat loss: 1-4 liters

• Sodium loss: 1150-3220 mg

• Football- may be as high as 8000 mg sodium loss during 2 a days

• Tennis- losses can exceed 10,000 milligrams in a match

MUSCLE CRAMPINGMUSCLE CRAMPING

• May be many causal factors in the development of muscle cramps

• A strategy that works for many athletes is an increase in fluid and sodium

• Bananas or other high potassium foods will NOT help in the prevention/treatment of cramps

MEETING SODIUM NEEDSMEETING SODIUM NEEDS

• Salt added to foods• Salty condiments: Soy sauce, marinades• Salty beverages• Salty foods: pickles, pretzels, crackers, snack mixes• Cooking with saltier items, ie. Bouillon or broth• Adding salt to every meal• Adding ¼ tsp salt to 20 ounces of sports drink or ½

tsp added to 32 oz sports drink

WATER INTOXICATION AND WATER INTOXICATION AND HYPONATREMIAHYPONATREMIA

• Need to know sweat rates of athletes

• Formulate a hydration plan

• Don’t worry about caffeinated beverages

• Palatability of fluids is key

• NOT just water alone

• Extra salt for the salty sweaters

• Recommend that athletes weigh in/out

SWEAT RATE EQUATIONSWEAT RATE EQUATION

Pre-weight – Post Weight+

Fluid Intake During Activity÷

Number of hours of activity=

Your Individual Sweat Rate

CALL TO ACTIONCALL TO ACTION

• Help athletes become fluid savvy• Individualize requirements• Have athletes bring water/sports bottle to

practice and have cups available• Encourage athletes to hydrate during the day• Work with the ADs/parents/schools to enforce a

hydration policy

BOTTOM LINEBOTTOM LINE

• If you RESIST - your athletes won’t change

• If You INSIST - Your athletes are more likely to try

• If you PERSIST - You will have athletes who perform at their maximum in the classroom and on the field of play

CONTACT INFORMATIONCONTACT INFORMATION

• Leslie Bonci, MPH,RD,CSSD,LDN

• Phone: 412-432-3674

• Email: boncilj@upmc.edu