Download Full Nutrition PP

Bryan Kegans MS CSCS, PES, CES
Director of Strength and Conditioning
Kyle Keese
Strength and Conditioning
Guyer Nutrition
Macronutrients
Carbohydrates
Lipids
Protein
Roles of Macronutrients:
 Provide energy
 Maintain structure
 Provide functional integrity
Carbohydrates
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Primary energy Source (especially during
high intensity exercise or competition)
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Adequate carbohydrate intake preserves tissue
proteins.
Metabolic primer
Fuel for the central nervous system (CNS)
and red blood cells.
Importance of Fiber
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Retains considerable water and thus gives
“bulk” to the food residues in the intestines
Binds or dilutes harmful chemicals
Shortens transit time for food residues to
pass through the digestive tract
Most Americans only consume 12-15 g per
day compared to the recommended 38 g for
men & 25 g for women under 50 years
Carbohydrates Stored as Glycogen
 Glucose is stored as glycogen in mammalian
muscle and liver (glucogenesis)
 Glycogenolysis is the reconversion process of
glycogen to glucose; it provides a rapid extra
muscular glucose supply.
 A limited amount of glycogen can be stored
 Approx 15g per kg body weight
Lipids
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Provide energy
Protect vital organs
Provide insulation from the cold
Transport the fat-soluble vitamins A, D, E,
and K
Bad Fats
• Trans Fatty acids-found in magarine, commercial baked
goods, and deep-fried foods. Typically account for
30,000 deaths per year from heart disease(6).
• Trans Fatty acids may impair arterial wall flexibility and
function(6).
• Women with high tissue levels of trans fatty acids are
40% more likely to develop breast cancer(6).
• 0 trans fat on food label doesn’t necessarily indicate
the absence of trans fat because the government
allows 0.5g to still be considered zero.
Good Fats
• Nonhydrogenated Monounsaturated and Poly
Unsaturated Fatty Acids.
• Consuming these fats can lower coronary risk below
normal levels.
• OMEGA 3- Found in Shellfish, Salmon, Herring,
Sardines, bluefish, mackeral, dark green leafy
vegetables, flax, hemp, canola, soy, and walnut oils.
• One study stated that a reduction of 42% in heart
attacks among men who ate 7oz or more of fish a week
compared with men who did not eat fish(6).
Protein
 Supplies amino acids for a variety of metabolic
processes
 Proteins, especially those in nervous and
connective tissue, generally do not participate in
energy metabolism.
 Protein catabolism accounts for 2-5% of the body’s
total energy requirements
 However, the amino acid alanine plays a key role
in providing carbohydrate fuel via
gluconeogenesis during prolonged exercise.
Protein
• Protein catabolism accelerates during exercise as
carbohydrate reserves deplete.
• Athletes who train vigorously must maintain
optimal levels of muscle and liver glycogen to
minimize lean tissue loss and deterioration in
performance.
• Regular exercise training enhances the liver’s
capacity to synthesize glucose from the carbon
skeletons of non-carbohydrate compounds.
Bio-energenics
A “very” brief explanation
• Depending on type of Exercise or Competition
the body will use energy in three different
ways.
• Understanding the three pathways for ATP
creation is vital for proper sport preparation
and exercise.
Fuel and the Intensity
Continuum
 For all-out, short-duration efforts the
intramuscular stores of ATP and PCr provide the
required energy for exercise (anaerobic
metabolism).
 Examples: 100-m dash; Lifting heavy weights
 For intense exercise of 1 to 2 minutes duration,
glycolysis provides the energy.
 For top performance in all-out 2-minute exercise,
a person must possess a well-developed capacity
for both aerobic and anaerobic metabolism.
Fuel and the Intensity
Continuum
 When exercise progresses beyond several
minutes, the aerobic system predominates
with oxygen uptake capacity becoming the
important factor.
 **Energy systems do not act independently
of one another but rather overlap and work
together to supply the body with the energy
needed
Energy System Breakdown
Sources of Energy for
ATP Synthesis
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Liver and muscle glycogen
Triacylglycerols within adipose tissue and
active muscle
Amino acids within skeletal muscle donate
carbon skeletons
Athlete Nutrient Recommendations
An Optimal Diet
 Supplies required nutrients in adequate
amounts for tissue maintenance, repair, and
growth without excess energy intake
 Proper nutrition helps:
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Improve athletic performance
Optimize programs of physical conditioning
Improve recovery from fatigue
Avoid injury
Pounds to Kilograms
• 1lb = 0.45359237
• 200lb Athlete * 0.45359237 = 91kg
Recommendations
Carbohydrates
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The NSCA recommends for Aerobic Athletes
8-10g/kg of Body Weight
Anaerobic Athletes
5-6g/kg of Body Weight
Recommendations
Carbohydrates
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135lb Aerobic Athlete * .045359237 = 61kg
61 * 8 = 488g of Carbohydrate per day
180lb Anaerobic Athlete * .045359237 = 82kg
82 * 8 = 656g of Carbohydrate per day
Why So Many Carbs?
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Lima-Silva et al, 2011
Compared time to exhaustion in a high carbohydrate group (CHO) 80% of diet and
a low carbohydrate group (LCHO) 10% of diet.
Time to exhaustion in LCHO was significantly lower than the CHO.
Gleeson, Greenhaff, & Maughan, 1988
Showed that a 24 h fast is detrimental to cycling performance at an intensity of
100% Vo2max: the mean endurance time (212±27 s) was lower when exercise was
performed 24 h after the last meal than when the same meal was eaten 4 h before
exercise (243±17 s).
Maughan & Poole 1981
A similar loss of performance was seen when a low-carbohydrate diet was
substituted for the normal mixed diet: exercise time at 104% of Vo2max was
reduced from 4.87 min on a mixed diet to 3.32 min on a low-carbohydrate (3%
CHO) diet.
Greenhaff et al 1987
Reported that time to fatigue at 100% of Vo2max was reduced from 5.13 to 3.68
min after 3 days on a low-carbohydrate (10% CHO) diet.
Why So Many Carbs?
Glycemic Index
 Carbohydrates differ in their rate of digestion
and absorption.
 The glycemic index provides a measure of how
quickly these processes occur.
Use of Glycemic Index in Sports
 Ingesting low-glycemic food is recommended
in the immediate pre-exercise period provides
a steady supply of slow release glucose from
the intestinal tract during exercise.
 Post-exercise meals should include highglycemic foods in order to maximize glycogen
replenishment
Glycemic Index
Carbohydrate Absorption Rate
Protein Recommendations
 The RDA = 0.8 g per kilogram body mass
represents a liberal requirement believed to be
adequate for all people.
 Dependent on the athlete, increases in protein
may be require
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General Public: .8g/kg body weight
Endurance athletes: 1.2-1.4 g/kg body weight
Strength/power athletes: 1.6-1.8 g/kg body weight
Vegetarians & adolescents should increase these
values by 10%
Protein Research
• Kerksick et al, 2006
• Showed that after 10 weeks of 4 day split
resistance training program subjects that
ingested a combination of Whey Protein and
Casein protein had the greatest increases in
fat-free mass as compared with whey protein
coupled with BCAAs and L-Glutamine.
Protein Research
Is more protein really needed?
 Both resistance training & endurance training “break
down” protein (protein catabolism)
 However, recent research has found that exercise may
not necessitate increased protein consumption
because training enhances our ability to preserve
protein
 Protein catabolism is greatest when carbohydrate
stores are low
 Thus, eating a high-carbohydrate diet (with adequate
energy intake) conserves muscle protein in individuals
who engage in hard training.
General Recommendation on Protein
Supplementation
• Protein Supplementation can become
extremely complicated. Therefore
• A serving of whey protein before and after
training.
• A serving of Casein Protein at night before
going to bed.
Fat Intake
 The general recommendation is to not exceed
30% of daily calories from lipids.
 Of this amount, most should be unsaturated fatty acids.
 Research has shown a decrease in endurance
performance in individuals’ who consume 20%
or less calories from fat
 Low-diets (<20%) may not allow for an athlete
to ingest enough calories to maintain body
weight & muscle mass
Fat a Human’s Friend
• Fat makes the human body the ultimate
endurance machine.
• You can live up to 4 to 6 weeks without food.
• Why? Fat Stores!
The Energy Balance Equation
 3500 extra kCal = 1
pound
 If total food calories
exceed daily energy
expenditure, excess
calories accumulate as
fat in adipose tissue.
 Goal:
Energy intake = energy
output
Understanding Serving Size
When and How
• EAT 6-7 TIMES A DAY
• It will speed up your metabolism, helps you
become leaner.
• It will build muscle faster.
• It will increase your energy for workouts.
• It will help you get all the nutrients you need
for everyday.
COMMON MISTAKES
• Skipping breakfast- body will go into starvation responsestore food as fat for survival later.
• Lifting on an empty stomach.
• Drinking too many protein shakes- the body will take
whatever it needs, and the rest will be excreted or stored as
fat.
• Eating fried foods- saturated fats = a non lean body.
• Not eating until you feel hungry- eat every 3 hours.
• Not timing your meals out after workouts. (30 min, 2 hours,
etc..)
• Not staying properly hydrated. Carry around a gallon of
water.
HOW TO ADD QUALITY CALORIES
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Add 2 spoons peanut butter to things like toast, bagels, waffles, oatmeal, crackers,
shakes, etc.
Add granola to cereal, trail mix, yogurt, oatmeal, ice cream
Add avocado to salads, sandwiches, wraps, chips, crackers, dips
Eat sandwiches on wheat buns, subs, or bagels instead of on bread or a thin wrap
Choose high calorie cereals, energy bars, granola bars, yogurts, etc.
Cook vegetables and meat in Extra Virgin Olive Oil
Make shakes with high calorie shake powder & add things like peanut butter, honey,
chocolate syrup, some ice cream, etc to it
Add nuts to cereal, granola, trail mix, oatmeal, yogurt, parfaits, ice cream, salads & eat
plain
Drink 2% milk, low-fat chocolate milk and/or some juice with meals and snacks
Eat a snack (as mentioned above) right before you go to bed, 7 days a week
NUTRIENT TIMING
• The timing of your meals is very important to help
your body recovery and rebuild from workouts.
Following workouts your body needs nutrients that
will help it repair and recover. If you miss a meal, your
body will not properly complete this process.
• Never come to a workout on an empty stomach. Your
body needs energy to perform at its best level.
• A missed meal may not affect you tomorrow, but may
destroy your workout on Friday!
• 10, 2, 4 Rule: Dr. Pepper. Perfect time for a snack.
NUTRIENT TIMING WINDOWS
ACTIVITY
MEAL DESCRIPTION
EXAMPLES
PRE 7 AM LIFT
(1 Hr Before Lift)
Snack
POST 7 AM LIFT
(30 Min Post Lift
Quick Recovery
4:1 Carbs to Protein
Chocolate Milk, Whey Protein,
Gatorade
Well Balanced Breakfast
Whole Grain, Lean Meat, Fruit,
Milk
Breakfast
(2 Hr Post Lift)
Whole grains, H20,
Supplement, Fruit
SNACK
Additional Recovery
Hunger Prevention
H20, Calorie Replacement,
PB & J, Smoothie
LUNCH
Well Balanced Meal
Lean Meat, Veggies, Fruit,
Whole Grains.
PRE 4TH BLOCK
(1 Hr Before 4th Block)
POST 4TH BLOCK
(30 Min Post Lift)
DINNER
BEFORE BED
Snack
Granola Bar, PB & J, Fruit, H20
Quick Recovery
4:1 Carbs to Protein
Chocolate Milk, Whey Protein,
Gatorade
Most Nutritious Meal
More Protein than Carbs
Lean Meat, Veggies, Fruit,
Whole Grains.
Slow Recovery
Casein Protein Supplement
POST WORKOUT RECOVER
Chocolate Milk
The Perfect Post Workout Should Consist of:
40-60 g Carbohydrates
•Carbs replenish muscle glycogen levels
from glycogen depleting exercise.
10-20 g Protein
•Protein is main ingredient in muscle tissue
repair.
16 oz glass of 1% Low Fat Chocolate Milk
4:1 Ratio Carbs to Protein
340 Calories
56 g Carbs
16 g Protein
Nutrition Facts
Serving Size: 8 oz
Amount per Serving
•Calories 170
•Calories from Fat 25
% Daily Value *
•Total Fat 2.5g
•Saturated Fat 1.5g
•Trans Fat 0g
•Cholesterol 5mg
•Sodium 260mg
•Total Carbohydrate 28g
•Dietary Fiber 0g
•Sugars 27g
•Protein 8g
•Vitamin A
•Vitamin C
Est. Percent of Calories from:
Fat
Carbs
Protein
13.2%
65.9%
18.8%
4%
8%
2%
11%
9%
0%
16%
10%
0%
HEALTHY FAST FOOD CHOICES
Try to limit to one meal a week, 1 cheat weekend = 6 day set back
Good Choices
•Drink water over sodas- additional bad calories
•Make careful menu selections – pay attention to the descriptions on the menu.
•Order dressing on the side.
•Ask for fresh fruit instead of fries.
•Look for leaner meats.
•Don’t order “the works”.
•Ask for the restaurant for a nutritional data menu.
What to AVOID!!!
•Dishes labeled deep-fried, pan-fried, basted, batter-dipped, breaded, creamy, crispy, scalloped,
Alfredo, au gratin or in cream sauce are usually high in calories, unhealthy fats or sodium. Order items
with more vegetables and choose leaner meats.
•Fating dressings and condiments
•Filling up on appetizers- bread, chips, bread sticks, etc….all empty calories.
•Salt- high in sodium, which leads to high blood pressure.
•Bacon- try pickles, lettuce, jalapeños, tomatoes.
•Buffets- even salad buffets. You will likely over eat to get your moneys worth.
Special Considerations for Female
Athletes
• Osteoporosis-starts at early age 85% of
teenage females are consuming inadequate
amounts of calcium. 29 gallons of milk versus
49 gallons of soft drinks.
• Osteoporosis affects 28 million Americans of
whom 80 to 90% are women.
• Osteoporosis is a progressive disease. Nearly
90% of bone mass accumulates by age 17.
The Female Triad
• Women who train intensely and emphasize weight loss
often engage in disordered eating behaviors.
• This further decreases energy availability, reducing body fat
to a point at which significant alterations occur in secretion
of the pituitary gonadotropic hormones.
• Resulting in Amenorrhea-the cessation of monthly
menstrual cycles for at least three consecutive months
after establishing regular cycles.
• Cessation of menstrual cycle removes estrogen’s protective
effect on bone making calcium loss more prevalent.
• The combination of disordered eating and amenorrhea can
lead to osteoporosis which completes the female triad.
Risk Factors for Disordered Eating
1. Pressure to optimize and/or modify appearance.
2. Psychological factors-low self-esteem, poor
coping skills, perceived loss of control,
perfectionism, obsessive-compulsive traits,
depression, anxiety, and history of abuse.
3. Underlying chronic diseases related to caloric
use.
4. Preoccupation with appearance in revealing
uniforms.
Shopping For Lean Proteins
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Bass
Clams
Flounder
Halibut
Mackerel
Salmon
Snapper
Turkey
Catfish
Cod
Game Meats
Haddock
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Perch
Shrimp
Swordfish
Tuna (fresh or canned in
water)
Chicken
Egg Whites
Grouper
Lean Beef
Pike
Soy Beans
Trout
Fibrous Carbohydrates & Vegetables
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Alfalfa Sprouts
Bean, green, yellow, wax
Broccoli
Carrots
Collard Greens
Endive
Lettuce, romaine, red lead
Onions
Radishes
Tomatoes
Turnip Greens
Zucchini
Asparagus
Beet greens
Brussels Sprouts
Cauliflower
Cucumbers
Kale
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Mushrooms
Peppers
Spinach
Tomato Juice
Vegetable Juice
Bamboo Shoots
Broccoflower
Cabbage
Celery
Eggplant
Leeks
Mustard Greens
Pimentos
Summer Squash
Turnips
Watercress
Complex Carbs
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Apples
Berries
Bread-100% whole wheat
Buckwheat
Green beans
Nuts
Potatoes
Root vegetables
Spelt
Wheat
Beans
Barley
Black-eyed-peas
Cabbage
Leafy Greens
Oats
Pumpkin
Rye
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Squash
Wheat Germ
Beets
Bran
Broccoli
Corn
Lentils
Pears
Rice, brown, wild, puffed
Shredded Wheat
Sweet Potatoes
Yams
Low Sugar Fruits
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Blackberries
Cranberries
Green Pears
Strawberries
Blueberries
Granny Smith Apples
Kiwi Fruit
• Boysenberries
• Green Apples
• Raspberries black
Fat
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Canola Oil
Safflower oil
Sunflower seed oil
Evening primrose oil
• Salmon oil
• Flax seed oil
• Soybean oil
Tracking Nutrient Intake
• www.livestrong.com
Supplements
Creatine
• Creatine Monohydrate is an ergogenic aid most frequently used in our
society for muscle building. Creatine and creatine phosphate are natural
nutrients essential for muscle contraction that are found in the skeletal
muscles. Most of the creatine we require comes from foods such as
meat, poultry and fish, but when dietary consumption is not providing
adequate amounts, creatine can be synthesized from amino acids.
Creatine is necessary to maintain the ATP necessary for muscle
contraction and also minimizes lactic acid production which can allow one
to train harder and longer.
• Most studies observed increases in muscle mass and performance with
creatine supplementation. This hypertrophy could be due to the
supplements ability to increase performance and volume in training.
• Creatine may not be as recommended for more endurance type sports
due to the fact that increased muscle mass may hinder performance.
Creatine supplementation therefore, is more beneficial to bodybuilders,
wrestlers, football players and baskeball players who benefit from the
weight gain that corresponds with increased muscle mass.
Taking Creatine
• It is recommended to cycle creatine supplementation
by supplementing with it for 3 months and then
stopping for 3 weeks and repeating the process. One
teaspoon within 2 hours of a workout or anytime
during rest days taken with a glass of juice is the
recommended intake. One should not consume more
than 20-30 grams per day. The most observed side
effect from creatine is water retention. Creatine has
not been proven unsafe and can be a recommended
supplement if increases in muscular hypertrophy or
performance in anaerobic sport are the main goal.
Nitric Oxide
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The products available over the counter are amino acid combinations that boosts or enhances the production of
nitric oxide in the body (L-arginine hydrochloride, L-arginine alpha-ketogluterate and L-arginine ketoisocaproate).
Currently, there are no pure nitric oxide supplements in production. The closest molecule that is synthesized for
production is 2-[nitrooxy]ethyl 2-amino-3-methylbutanoate (Bloomer et al., 2010). This is marketed as the "real
nitric oxide" as opposed to a nitric oxide precursor.
Chiseled Look, Pumped up muscles, builds muscle, greater weightlifting capacities, better blood flow, improved
sports performance.
L-arginine hydrochloride, L-arginine alpha-ketogluterate and L-arginine ketoisocaproate. Also supplemented with
grade-seed extract, L-ornithine, L-carnitine. Cost can range from $24.99 - $69.99 per month.
No improvements in VO2max (Sutherland et al., 2010).
Improved 1RM bench press (Sutherland et al., 2010).
Improved power output. 1.5g and 3g of arginine with grape-seed supplement. (Camic et al., 2010)
Increased GH in blood with arginine and ornithine (6g, 4.4g) after heavy resistance training, which can lead to
better recovery and possible increased muscle mass (Zajac et al., 2010).
No increased nitrate/nitrite in blood after supplementing 2-[nitrooxy]ethyl 2-amino-3-methylbutanoate (Bloomer
et al., 2010).
L-arginine used to treat hypertension, renal failure, heart disease.
Side Effects- Abdominal pain, bloating, diarrhea, gout, blood abnormalities, allergies, airway inflammation,
worsening of asthma, and low blood pressure (MedlinePlus, 2010).
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BCAA
Amino acids are the building blocks of protein molecules. Of the twenty amino
acids required by the human body, eight are considered essential amino acids
because they cannot be synthesized in the body, and must be acquired from foods.
The remaining non-essential amino acids are so named because they are
manufactured in the body, and do not have to be ingested.
They play an important role in the promotion of protein synthesis and the
inhibition of protein degradation, with leucine being the most powerful stimulator
of these processes (1, 2, 5).
BCAAs account for 35-40% of the dietary essential amino acids in body protein and
14-18% of the total amino acids in muscle proteins (1).
Many supplement companies imply that branched chain amino acids are a vital
component to the nutritional strategy of all bodybuilders, serious athletes, or
anyone interested in increasing strength and muscle mass.
BCAA supplements are said to:
Help promote muscle recovery from sports activities.
Maintain optimal performance during exercise.
Support the liver under times of stressful function.
Support muscle tissue from breakdown and maintains lean muscle mass.
Exert an anti-catabolic hormonal effect, supporting healthy testosterone and
cortisol levels when used in conjunction with high-intensity resistance training.
Promote increases in muscle strength and size (11, 12).
Continued
• Oral BCAA supplementation has been shown to increase muscle protein
synthesis to an even greater extent when coupled with resistance training
(6, 4, 5).
• Sufficient BCAA availability increases testosterone levels and decreases
cortisol and lactate levels (6, 3).
• BCAA supplementation has been shown to reduce exercise induced
muscle damage, delayed onset muscle soreness (DOMS), and muscular
fatigue (1, 7, 8).
• BCAAs promote recovery for several hours or even days after exercise (1,
2, 4, 8).
• BCAAs play a similar role in increasing performance in and aiding in
recovery from endurance exercise as well (3, 9, 10).
• Research seems to confirm the efficacy of oral BCAA supplements. BCAA
products can be found in tablet, powder, and liquid form, and prices range
from $10 to $80 depending on the brand and the quantity (11, 12).
• BCAAs are quite safe amino acids when the three BCAAs are provided in a
ratio similar to that of animal protein (e.g., a 2:1:1
leucine:isoleucine:valine ratio) (2).
Caffeine
• Caffeine is the one of the most utilized ergogenic aids in the world.
• Caffeine is found in a naturally occurring plant alkaloid which is known as
methylxanthine (Keisler & Armsey, 2006)
• Classified as a stimulant because of its lack of nutritional value and its
potential ergogenic effects.
• Caffeine is found in many common drinks such as coffee, tea, chocolate,
sodas, energy drinks, candies, frozen dairy products, puddings, and over
the counter drugs.
• It is consumed on a daily basis by the majority of adults in the world and
“is currently the most wide spread and indiscriminately used drug
available to consumers of all ages” (Jacobson & Kulling, 1989).
• The effect of caffeine consumption is thought to help improve mental
readiness, alertness, and stimulate the central nervous system. (Sokmen
et al, 2008).
• Caffeine is thought to have potential effects on endurance athletes. The
claim is that caffeine is supposed to help athletes overcome fatigue and
therefore be able to perform and continue with their sport for longer
durations, it is also thought that caffeine is able to decrease perception of
exertion (Jacobson & Kulling, 1989 & Keisler & Armsey 2006).
• Caffeine appears to work best in situations where exercise lasts more than
an hour (Jacobson & Kulling, 1989).
Continued
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Research shows that caffeine can “increase heart rate and blood pressure, it can
elevate systolic blood pressure, produce bronchial dilation and relaxation of
pulmonary smooth muscles” (Rogers & Dinges, 2005 & Keisler & Armsey, 2006).
Caffeine can cause tachycardia, increased in anxiety, increased drowsiness,
decreased alertness, peptic ulcers, impaired hand steadiness, tremors,
nervousness, irritability, insomnia, seizures, chronic muscle tension, and
arrhythmias.
Caffeine appears to have negative effects on ones coordination, movement time,
as well as vision and ones tracking ability.
Some research suggests that the use of caffeine can cause diuresis as well as
dehydration; however there is conflicting research on this topic (Rogers & Dinges,
2005) Research conducted by Sokmen et al 2008 shows that caffeine leads to
dehydration is a myth, and their research showed “In chronic consumers acute
caffeine ingestion did not alter fluid-electrolyte and physiologic responses during
exercise in heat when compared to a placebo” (Sokmen et al 2008).
Caffeine reaches its peak at levels anywhere from 30-75 minutes after
consumption and it has a half-life ranging from 2-7 hours (Jacobson & Kulling, 1989
& Sokmen et al 2008)
It has been shown that as little as 70 mg and as large as 800 mg have an effect on
performance. *The NCAA and IOC have placed restrictions on the dosage of
caffeine. “The maximum allowable level with urinary testing is approximately 800
mg” (Keisler & Armsey, 2006). That is equivalent to 6-8 cups of coffee in a period
of 1-2 hours.
Erythropoietin
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Erythropoietin (EPO) is a glycoprotein hormone that is produced in the kidneys and functions to
promote red blood cell production and initiate production of hemoglobin.
• The avialability of oxygen plays a critical role in aerobic performance to manufacture ATP for
energy.
• Athletes had already been experimenting with blood doping to increase oxygen carrying capacity
before rEPO thus, as expected, experimentation of rEPO began early on after its’ development
(1985).
• Between 1997- 2000 18 professional European cyclists died from myocardial infarction, stroke
and pulmonary embolism which coincided with rEPO availability.
• Due to the increase in hematocrit there is increase in blood viscosity which increases the risks of
thrombotic events (stroke and myocardial infarction).
• EPO use has been banned by the International Olympic Committee, USA Olympic Committee,
International Cycling Union and the National Collegiate Athletic Association.
• Drug screening has proved challenging due to the nature of rEPO being so similar to the naturally
appearing EPO.
• Birkeland et al, 1999 showed 4 weeks of rEPO supplementation on healthy male athletes caused
an increase of hematocrit from 42.7%- 50.8% and an increase in VO2 max by 7%. The increase in
VO2 was sustained three weeks after the trial was stopped.
• Ekblom, B. & Berglund, B. 1991 showed that seven weeks of rEPO increased run time to
exhaustion in recreational runners by 17%. Heamtocrit levels increased by 6- 11%.
• rEPO use is effective, as effective as blood doping, with the advantage that it can be used during
training and competition and the positive effects are rapid.
Ephedra
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Ephedra has been sold as a fat loss supplement.
The product is marketed across a large range of consumer, from the overweight/obese patient needing to lose
weight to improve overall health, to the elite athlete trying to lean out to maximize performance.
Other forms of the supplement such as Pseudoephedrine are found in popular decongestant medications across
the globe. (Calfee., et al. 2006)
When combined with caffeine, ephedra has been shown to help reduce body fat, when combined with a low
caloric diet.
Previous FDA recommendations warned against taking Ephedra for longer than periods of 1 week, and exceeding
25mg daily. Legally banned in 2004. FDA statement on ban “presents an unreasonable risk of illness or injury
under the conditions of use recommended or suggested in labeling.” (Diepvens K., et al. 2006)
Ban overturned in 2006, doses must remain below 10mg/daily.
Only proven benefits of ephedra have been shown when taken in dosages of at least 20mg/daily. That dosage has
been shown to increase heart rate and blood pressure. (Vukovich, M., et al. 2005)
Negative reactions from past studies include hypertension, arrhythmias, anxiety, tremors, insomnia, seizures,
paranoid psychoses, cerebral vascular accident, myocardial infarction, and death. (Calfee., et al. 2006)
Two deaths directly attributed to ephedra: 2001, 22 year old healthy male sustained cardiac arrest while taking
ephedra product, and 15 year old female sustained fatal arrhythmia while taking same product.
Currently banned by The International Olympic Committee, NCAA, Major League Baseball, National Basketball
Association, and National Football League.( Calfee., et al. 2006)
While the benefits of combining ephedra and caffeine have been proven, the adverse health effects associated
with the combination outweigh any possible benefit, and have lead to the supplement being banned by most
overseeing athletic agencies.
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