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Nutritional Considerations Mrs. Dobbins Sports Medicine I Objectives 1. 2. 3. 4. 5. 6. Describe the importance of a well balanced diet while in training and athletic competition. Explain what a well balanced diet should include for enhanced athletic performance. Discuss the basic principles of carbohydrate loading and its effects on athletic performance. Describe methods of weight gain and loss and their effects on athletic performance. Describe the difference between weight control and body composition. Explain the difference between Bulimia and Anorexia Nervosa. Objectives 7. 8. 9. 10. 11. 12. Identify the six classes of nutrients and describe their major functions. Describe the advantages and disadvantages of supplementing various nutrients in the athlete’s diet. Explain the advantages and disadvantages of pre-event meal. Explain the distinction between body weight and body composition. Explain the principle of caloric balance and how to assess it. Describe methods for losing and gaining weight. Nutrition Proper nutrition can positively contribute to: Strength Flexibility Cardiorespiratory Endurance Performance vs. Food consumption Myths and habits vs. physiological benefits Psychological vs. physiological considerations Nutrition Basics Nutrition is the science of substances found in food that are essential to life Six Classes of Nutrients 1. 2. 3. 4. 5. 6. Carbohydrates (CHO) Protein Fat Vitamins Minerals Water Nutritional Considerations Nutrients 1. 2. 3. 4. 5. 6. Carbohydrates Protein Fat Vitamins Minerals Water Roles Growth, repair & tissue maintenance Regulation of body processes Production of energy Carbohydrate Body’s most efficient energy source Major Dietary function recommendations Accounts intake Effects for 55-70% of total caloric on performance and injury prevention Carbohydrate Sugars Simple (sugars) and complex (starch and fiber) Monosaccharides single sugars (fruits, syrup and honey) Glucose Disaccharides 2 sugars combined (milk sugar, table sugar) Should account for <15% of caloric intake Carbohydrate Starches Complex CHO Long chain glucose units Rice, potatoes, breads Carbohydrate Starches Body cannot use starch directly Broken down in simple sugars Unused starches and sugars are stored as glycogen to be used by the body later Inadequate CHO intake results in protein utilization for energy Protein sparing action of glucose occurs if adequate CHO in the system Carbohydrate Body’s most efficient energy source Accounts for 55-70% of total caloric intake Carbohydrate Sugars Simple (sugars) and complex (starch and fiber) Monosaccharides single sugars (fruits, syrup and honey) Glucose Disaccharides 2 sugars combined (milk sugar, table sugar) Should account for <15% of caloric intake Carbohydrate Starches Complex CHO Long chain glucose units Rice, potatoes, breads Carbohydrate Starches Body cannot use starch directly Broken down in simple sugars Unused starches and sugars are stored as glycogen to be used by the body later Inadequate CHO intake results in protein utilization for energy Protein sparing action of glucose occurs if adequate CHO in the system Fiber Fiber Structural part of plants and is not digestible in humans Soluble Gums, pectin Oatmeal, legumes, and some fruits Insoluble Cellulose Grain breads and bran cereal Fiber Aids normal elimination of waste (bulk) Reduces risk of colon cancer and coronary artery disease Reduces incidents of obesity, constipation, colitis, appendicitis, and diabetes Fiber Intake should be approximately 25 grams per day Most only consume 10-15% Excessive consumption may lead to intestinal discomfort and increased loss of calcium and iron Fats Most concentrated source of energy Serves to make food flavorable and contain fat soluble vitamins Essential for normal growth and development Saturated vs. unsaturated Saturated (fatty acids derived from animal products) Unsaturated (plant derivatives - liquid at room temperature) Other Fats Phospholipids Lecithin Sterols Cholesterol (consume <300mg/day) Omega-3 fatty acids (unsaturated fat) aids in reduction of heart disease, stroke, hypertension) Found in cold-water fish Other Fats Fat Substitutes Simplese and Olean Contain 80% fewer calories than fat and no cholesterol May cause abdominal cramping and diarrhea Regulator Nutrients Vitamins (13) serve as regulators in many body processes Fat soluble Vitamins A, D, E , K Found in fatty portion of foods and oils Water soluble Vitamin C, B-complex vitamins (B6, B12,) Thiamin, Riboflavin, Niacin, Folate, Biotin, Pantohenic acid Help to regulate metabolism but cannot be stored Each serves a series of roles Antioxidants May prevent premature aging, cancers, heart disease and other health problems Help protect cells from free radicals Include vitamins A, C, E, and Beta Carotene Found in a number of dark green, deep yellow and orange fruits and vegetables Supplements Vitamin Deficiencies Illness can results from a deficit in a particular vitamin/mineral Are avoidable if an adequate diet is consumed Minerals 20 minerals have essential roles in the body Many are stored in liver and bones Minerals Major Minerals Phosphorus the second most abundant mineral in the body and 85% of it is found in the bones. The rest of the body's phosphorus is found in the blood, the fluid around and in cells, and in various organs like the heart, kidneys, brain, and muscles, where it is involved in many critical functions. It's main purpose is for building strong bones and teeth, but this mineral is used by practically every cell in the body. Minerals Copper essential mineral usually found in foods containing iron. The liver and brain contain the largest amounts of copper in the human body, however, other organs will contain smaller amounts. Copper is necessary for the growth, development, and maintenance of bone, connective tissue, brain, heart, and many other body organs. It is involved in the formation of red blood cells, the absorption and utilization of iron, and the synthesis and release of life-sustaining proteins and enzymes. Copper stimulates the immune system to fight infections, repair injured tissues, and promote healing. Copper also helps to neutralize "free-radicals" which can cause severe damage to cells. Deficiency: hemoglobin production is decreased and copper deficiency anemia can result. Insufficient amounts can lead to inefficient utilization of iron and protein, diarrhea and stunted growth. Various enzyme reactions require copper. Minerals Zinc It fuels everything from manufacturing DNA, wound healing, maintaining a strong immune system, to fighting colds, flu's, and other infections. Zinc is critical for proper functioning of the male reproductive system; The human body does not produce zinc on its own, so it must be obtained from outside sources. The mineral zinc can be found in both animal and plant food sources, but the richest source of zinc comes from animal food sources. Minerals Iodine two thirds of the body's iodine is in the thyroid gland. It plays a major role in thyroid health (thus controlling metabolism), Commonly derived from the diet in the form of iodized table salt (one teaspoon of salt = 300 mcg of iodine). Sea salt is not iodized and is not a good source of iodine, and most salty snacks do not contain iodized salt either. Iodine deficiency is most common in people living in undeveloped countries Severe iodine deficiency often occurs in people that are afflicted with thyroid disease or a hyperthyroid disorder, or those who have developed a goiter. Symptoms of iodine deficiency may manifest as extreme fatigue, weight gain, facial puffiness, constipation, slowing of both physical and mental processes, and lethargy. Minerals Fluorine Trace Mineral not technically an essential mineral because the body can live without it significant role in keeping teeth and bones healthy and strong been added to toothpaste and some drinking water supplies Minerals Iron (energy metabolism and oxygen transport) Iron is a mineral essential for life. It is present in every living cell and is necessary for the production of hemoglobin (primary component of red blood cells), myoglobin (major protein of muscle cells), and certain enzymes. Iron, along with calcium, are the two major deficiencies of American women (one of the reasons due to menstruation and bleeding) Can cause weakness, inability to concentrate, the susceptibility to infection, impaired performance, and in general, ill health. Other people at risk of iron deficiency include dieters, vegetarians and athletes. Calcium and copper must be present for iron to function properly, and ascorbic acid (vitamin c) enhances absorption. Iron is necessary for proper metabolizing of B vitamins. Minerals Magnesium (energy supplying reactions) Magnesium plays an important role in at least 300 fundamental enzymatic reactions and for that reason is of vital importance in our health. Magnesium is found in dairy products, fish, meat and seafood, as well as in legumes, apples, apricots, avocados, bananas, whole grain cereals, nuts, dark green vegetables, and cocoa, while hard water and mineral water may also supply it in fair quantities. Minerals Calcium (bone formation, clotting, muscle contractions) Calcium is the most abundant mineral in the body. primary function is to build and maintain skeletal tissue. Ninety-nine percent of the body's calcium supply resides in the bone and teeth. Osteoblasts are bone-forming cells in which calcium phosphate is deposited. Ameleoblasts are the tooth- forming cells that deposit calcium to form teeth maintaining the stability of fibrin, which allows blood to clot. required for the transmission of nerve impulses. controls the flow of fluid through cell membranes. also has a vital role in muscle contraction and relaxation. Minerals Sodium Sodium known as salt too much sodium increased risk of heart disease, stroke and high blood pressure, the development of kidney stones and other types of ailments the body needs more than 100 milligrams per day to function properly Sodium is an electrolyte and Potassium (nerve conduction) along with chloride and potassium, helps control the electrical charges that occur between cells. These electrical charges are used by cells to communicate with one another. The electrical charges are also what give our five senses the ability to see, smell, touch, hear and taste. Approximately 30% of the sodium mineral inside the body is stored in the bones and the balance is found in body fluids. Minerals Sodium is a main component of blood plasma and approximately 60% is contained in the fluids that surround cells. About 10% of the body's sodium is stored inside the cells. This division helps maintain a proper balance of water inside as well as outside these cells. Its presence in the circulatory system helps the body keep blood pressure and the overall volume of blood flow within normal ranges. Sodium helps keep the blood from clotting, which can be a very dangerous situation. In the blood, sodium together with potassium helps maintain the blood's delicate pH balance. Sodium also helps carry important nutrients to the cells. In the digestive system, sodium assists in the process of metabolizing foods into energy. It protects the stomach lining by preventing the acids inside the stomach from burning it Minerals Potassium (nerve conduction) Potassium is the third most abundant mineral in the body considered an electrolyte The human body has about a 4 1/2 ounce supply and most of it is located inside muscle cells. Studies have shown that potassium may help to prevent high blood pressure and may enhance the effect of antihypertensive medications. Both physical and mental stress can lead to a deficiency in potassium. Alcohol, coffee, and sugar deplete potassium levels in the body. Potassium assists in muscle contractions It is critical to maintaining a normal heartbeat or heart rhythm. Potassium also functions in the conduction of nerve impulses and enables the body to convert glucose into energy, which is then stored in reserve by the muscles and liver. Water Most essential nutrient and most abundant in body (60% of body weight) Essential for all chemical processes Lack of water (dehydration) can lead to illness and death Body has mechanisms to maintain homeostatic levels of hydration (kidneys and solute accumulation) Electrolyte Requirements Involve minerals of the body - must maintain adequate levels for optimal functioning Excess sweating can lead to depletion of these electrolytes Help to maintain levels of hydration Can generally maintain through proper diet, however, additional salts may need to be added periodically Recommendation for fluid replacement Athletes should begin all exercise sessions well hydrated. To ensure proper hydration the athlete should consume 17 to 20 ounces of water or sport drink 2 to 3 hours before exercise and then 7 to 10 ounces 20 minutes before exercise. Fluid replacement beverages should be easily accessible during activity and should be consumed at a minimal rate of 7 to 10 ounces every 10 to 20 minutes. Recommendation for fluid replacement During activity the athlete should consume the maximal amount of fluid that can be tolerated. A cool, flavored beverage at 50 to 59° F is recommended. Addition of proper amounts of carbohydrates and electrolytes to a fluid replacement solution is recommended for exercise events that last longer than 1 hour. A 6 percent carbohydrate solution appears to be optimal For exercise lasting longer than 1 hour the addition of carbohydrates and electrolytes does not seem to enhance physical performances. The Production of Energy from Foodstuffs How is energy produced from foodstuffs? How much energy is used during physical activity? Recommended Dietary Allowances (RDA) Nutrient Requirements and Recommendations Amount of nutrient required to prevent deficiency diseases Vary individuals and across populations Requirements vs. Recommendations RDA (Recommended Daily Allowance) vs. DRI (Dietary Reference Intake) Food Labels Aids consumers in determining levels of nutrients in foods Nutrition and Physical Activity Activity increases need for energy not necessarily all vitamins, minerals and nutrients Other Nutritional Considerations Protein Sugar Vitamin & Mineral Supplementation Creatine Caffeine Alcohol Organic, Natural, and Health Foods Herbs Vegetarianism Proteins Required for growth, maintenance, and repair of the body Aid with enzyme, hormone, and enzyme production Should encompass 12-15% of daily caloric intake Amino Acids (Proteins) Basic units that compose protein 20 amino acids compose the majority of body protein Most can be produced by the body while others (essential) must be consumed Animal products contain all essential amino acids Incomplete sources (i.e. plants sources) do not contain all essential amino acids Protein sources and needs Most diets are rich in protein and often athletes consume twice the amount that is recommended Excess protein is converted to fat and may result in dehydration and potential kidney damage Increased physical activity results in increased need for protein in the diet Supplements Protein Supplementation Approximately 1-1.5g/kg body weight of protein should be consumed for increasing muscle mass Often times exceeded with normal diet and supplementation is not necessary Sugar Sugar and Performance Ingesting large quantities of sugar prior to activity causes an increase glucose in the blood Release of insulin stimulated allowing cells to utilize free circulating glucose, sparing blood glucose Positive effect on performance However, some athletes are sensitive to high CHO feedings and have problems with increased levels of insulin Vitamin Supplementation Athletes believe large doses can lead to superior health and performance Common practices Vitamin C to prevent common cold and slow aging May cause kidney stones and diarrhea Vitamin Supplementation Vitamin E Protects cell membranes from damage Little evidence to support enhancing performance or life expectancy B-complex vitamins Aid in release of energy from CHO, fat, and protein If additional energy is required, increased caloric intake is necessary Mineral Supplementation A nutritious diet consists of eating a variety of foods in the amounts recommended on the food pyramid. An athlete whose diet meets those recommendations may not need nutrient supplements. Some people need extra iron and calcium. Calcium and iron tend to be low and diets may need to be modified Need to be certain additional minerals are necessary in diet prior to purchase (save money) Calcium Deficiency Most abundant mineral in body Over time additional levels of calcium are required for bone maintenance Without, bones become weak and brittle resulting in osteoporosis Young adult requires 1000mg/day Females tend not to get enough calcium in diet While exercise helps bones to retain calcium, extreme levels of exercise, causing hormonal imbalances, can disrupt calcium retention Supplementing with calcium carbonate or citrate is advisable Calcium Milk products are the most reliable source of calcium Some athletes complain it causes upset stomach due to a build up of intestinal gas May be lactose intolerant and lack the enzyme lactase (lactase deficient) Can supplement with lactase (scientifically produced) IRON Iron Deficiency Common in females Results iron-deficiency anemia, limiting oxygen carrying capacity of blood Athlete feels tired and weak due to muscles’ inability to generate energy Creatine Supplements Creatine Supplementation Naturally occurring substance in body produced by kidneys, pancreas and liver Found in meat and fish Role in metabolism Two types (free creatine and phosphocreatine) Creatine Phosphocreatine is stored in skeletal muscle and works to re-synthesize ATP during activity Positive effects increase intensity of workouts lactic acid buffer stimulates protein synthesis decreases total cholesterol and total triglycerides and improves HDL-LDL ratio increases fat free mass Creatine Negative effects weight gain muscle cramping gastrointestinal disturbances and renal dysfunction Not a banned substance, however, distribution by NCAA institutions is banned Caffeine Central nervous system stimulant found in carbonated beverages, coffee, tea (chocolate contains relate compounds related to caffeine) Increase alertness and decrease fatigue Too much causes nervousness, irritability, increased heart rate and headaches Headaches may result when ceasing caffeine use (withdrawal) Caffeine Not detrimental to performance Enhances fat utilization and endurance performance Makes calcium more available allowing muscles to work more effectively may cause slight headaches Alcohol Alcohol Provides energy for the body Little nutritional value Central nervous system depressant decreases coordination, slows reaction time, decreases mental alertness increases urine production (diuretic effect) Health Foods Organic, Natural, of Health Foods Claim to be safer and nutritionally superior due to absence of pesticides and fertilizers All foods are organic due to presence of carbon More expensive no increased benefit physiologically Processing (preservatives) helps to maintain nutritional value Herbs Herbs Trend - natural alternatives to drugs and medications Safe to ingest as natural medicines we few side effects (occasional allergic reaction) Offer nutrients that nourish brain, glands and hormones Don’t need to consume with food - contain own digestive enzymes Work with the body’s functions (whole body balancers) Caution must be exercised as there is no governmental control or regulation Vegetarianism Utilize plants to form foundation of diet - anima foods are either excluded or included in a variety of eating patterns Economic, philosophical, religious, cultural, or health reasons While practiced intelligently (not a fad) a vegetarian diet can result in deficiencies Diet must be carefully planned Vegetarianism Total vegetarian (vegan) all plant diet, no animal products must be certain to consume enough calories and vit B12, calcium, zinc, and iron Lactovegetarian Consume plant foods and milk products Must watch iron and zinc levels Vegetarianism Ovolactovegetarian Consume plant foods, milk products and eggs Iron is still a concern Semivegetarian Still primarily plants but all other products are consumed except red meat. More Nutritional Considerations Pre- Event Nutrition Fast Food Glycogen Supercompensation Fat Loading Weight Considerations Eating Disorders Pre-event Nutrition Importance and content pre-event meal vs. traditional rewarding that may hamper performance Traditional steak and eggs Long term food consumption is more important than immediate consumption Purpose should be to provide competitor with nutrients/energy and fluids for competitions (taking digestibility into consideration Pre-event Nutrition Encourage athletes to be conscious of diet Diets are also individual to each athlete Individual is the best judge of what should or should not be consumed Pre-event Nutrition What is the individual comfortable with Liquid Supplementation Extremely effective and successful 225-400 calories per serving Successful in reducing pregame symptoms of dry mouth, abdominal & leg cramps, nervous defecation and nausea Pre-event Nutrition Food generally takes 4 hours to clear stomach and upper GI tract Liquid supplements clear stomach and upper bowel before game time, settling the stomach and making available nutrients Pre-event Nutrition Sample Pre-event Meals Overview The pre-event meal should be (1) higher in carbohydrates (2) easily digested (3) eaten 2 to 4 hours before an event, and (4) acceptable to the athlete. Glycogen super compensation involves maximizing the stores of carbohydrate in muscle and liver before a competitive event. Glycogen Supercompensation Increase muscle and liver glycogen stores prior to major event by altering eating and training habits Decrease training at least 48 hours prior to event Increase CHO loading to increase glycogen stores and positively impact muscle glycogen and muscle endurance Glycogen Supercompensation Six-day Phase period I (Days 1-2): hard training with reduced CHO intake Phase II (Days 3-5): decrease training and increase CHO (potentially increasing glycogen stores 50-100%) Phase III (Days 6-7): resume normal diet Glycogen Supercompensation Not clearly demonstrated as being beneficial in endurance activities Do not perform more than 2-3 times per year Ideally for prolonged duration events Fat Loading Fat loading vs. carbohydrate loading Intent = better energy source Negative side effects cardiac protein and potassium depletion development of arrhythmias, increased serum and cholesterol Fast Foods Way of life in America --world of fast food junkies Often meal of choice during travel Big concern is the amount of fat (4050% of calories from fat) Size vs. supersize Increased menu size is a plus (variety) Nutritional information posting Weight Control and Body Composition Gains and loss of weight in athletes can be problematic Intelligent and conscientious approach involves some knowledge of what is involved on the part of the athlete and athletic trainer Results in athlete displaying discipline relative to types and quantities of food Overview Body composition analysis indicates the percentage of total body weight composed of fat tissue versus the percentage composed of lean tissue. Changes in body weight are caused almost entirely by a change in caloric balance, which is a function of the number of calories taken in and the number of calories expended. Weight can be lost by increasing caloric expenditure through exercise by decreasing caloric intake through reducing food intake or most effectively- by using a combination of moderate caloric restriction and a moderate increase in physical exercise during the course of each day. Body Composition Ideal body weight = age-related height/weight chart Inaccurate due to broad ranges and failure to take individual body types into consideration Health and performance may be best indicators Fat vs. nonfat components of body = body composition Body Composition Non-fat weight) bone, tissue Body or lean tissue (lean body muscle, tendon, connective comp is the relationship between fat tissue and lean body tissue Body Composition Averages Female 20-25% body weight = fat Male 12-15% body weight = fat Should not fall below 3% and 12 % for males and female respectively Results organs in loss of essential fat padding for Body Composition Overweight = excess body weight relative to size and stature Overfat = excessively high percentage of total body weight is fat Obesity = extreme amount of excessive fat Female >30% and male >20% percent body fat Body Composition Factors that determine amount of fat Number of cells Proliferation or hyperplagia of fat cells occurs from birth to puberty Size of cells Increase/decrease over time until adulthood relative to caloric balance Change of weight = change in size not number Body Composition Adipose cell stores triglycerides (liquid fat) Moves in and out of cells according to energy demands Moderate, long term activity uses greatest amount of fat One pound of fat = 3500 calories, stored as triglycerides Assessing Body Composition Several methods Hydrostatic, bioelectrical impedance, skinfold thickness measures Skinfolds based on the fact that 50% of body fat is subcutaneous Utilize skin fold calipers Relatively low accuracy but is easy to learn and utilize Error is + 3-5% Determining Body Mass Index Determine extent of overweight or obesity using height and body weight BMI (body mass index) is a ratio of height and weight Utilized to measure health risks associated with obesity BMI >25 indicate excess body fat BMI 25-30 indicates overweight BMI >30 indicates state of obesity Assessing Caloric Balance Caloric balance = Calories consumed - Calories expended Positive caloric balance results in weight gain and vice versa for negative caloric balance Assessing Caloric Balance Can be calculated through accurate record keeping of calories consumed and expended relative to metabolic and activity needs Calories are expended through: basal metabolism (calories expended at rest) work (activity that requires more energy than sleeping) excretion Assessing Caloric Balance Must calculate total time engaged in all 3 areas over a 24 hour period BMR is determined in laboratory setting through indirect calorimetry which measures oxygen uptake Assessing Caloric Balance Work (type, intensity, duration) must be determined Body size also factors in Energy expenditures can be consulted to determine average energy expenditures per activity (kcal/min/lb) Methods of Weight Loss Exercise or dieting alone is ineffective over the long run Dieting alone results in lean body tissue loss Should not drop below 1000-1200 calories for women and 1200-1400 for men Exercising, while resulting in loss of fat mass, will also enhance strength, cardiorespiratory endurance and flexibility Methods of Weight Loss The key is moderation A combination of dieting and exercise A negative energy balance must be achieved Loss of 1.5-2.0 pounds per week is adequate Weight loss of more than 4-5 pounds per week can be attributed to dehydration It takes time to put weight on and also takes time to take it off Methods of Weight Gain Aim should be to increase lean body mass Increased physical activity (muscle work) and dietary modifications Approximately 2500 calories is required per pound of lean body mass, an increase 5001000 calories per day A 1-2 pound per week gain is adequate Eating Disorders Epidemic in our society, especially in sports 1 out of 200 girls age 12-18 will develop some pattern of eating disorder (1-2% of population) Eating Disorders Bulimia Bulimia is an eating disorder that involves periodic binging and subsequent purging. Generally females ranging in age from adolescence to middle age Periods of starvation, bingeing (thousands of calories) and purging through vomiting, fasting and laxatives/diuretics Bulimia Characteristics Typically bulimic athletes are white, middle to upper-middle class Perfectionist, obedient, overcompliant, highly motivated, successful academically, well-liked, and a good athlete gymnastics, track, dance occasionally seen in male gymnasts and wrestlers Bulimia Bingeing and purging can result in stomach rupture heart rhythm liver damage tooth decay from acids chronically inflamed mucous lining of mouth and throat Anorexia Nervosa Anorexia nervosa is a form of mental illness in which a person reduces food intake and increases energy expenditure to the extent that the loss of body fat threatens health and life. 30-50% of anorexics also suffer from bulimia Characterized by distorted body image and constant concern about weight gain Impacts mostly females Starts often with adolescents and can be life threatening While the athlete tends to be too thin they continue to feel fat Deny hunger and are hyperactive Highly secretive Eating Disorders Early intervention is critical with eating disorders Empathy is a must Psychological counseling is key Must have athlete recognize the problem, accept the benefits of assistance and must voluntarily accept help for treatment to work Female Athlete Triad Potentially fatal problem Combination of eating disorder, amenorrhea and osteoporosis Some suggest eating disorders may exist in 62% of females in certain sports and amenorrhea found in 60% Major risk is the fact that bone lost may not be regained Chapter Overview The classes of nutrients are carbohydrates, fats, proteins, vitamins, minerals, and water. Carbohydrates, fats, and proteins provide the energy required for muscular work and also play a role in the function and maintenance of body tissues. Protein supplementation is not necessary. Vitamins are substances found in foods, which have no caloric value but are necessary to regulate body processes. Chapter Overview Antioxidants are nutrients that protect the body against various destructive agents. Minerals are also involved in regulation of bodily functions and are used to form important body structures. Water is the most essential nutrient and should be used with sports drinks in fluid replacement. Review Questions 1. What is the value of good nutrition in terms of an athlete's performance and injury prevention? 2. Have each member of the class prepare a week's food diary; then compare it with other class members' diaries. 3. What are the daily dietary requirements according to the food pyramid? Should the requirements of the typical athlete's diet differ from those on the food pyramid? If so, in what ways? 4. Describe the advantages and disadvantages of supplementing iron and calcium. 5. Is there some advantage to pre-event nutrition? 6. Are there advantages and/or disadvantages in the vegetarian diet for the athlete? 7. Discuss the importance of having an athlete monitor body composition. 8. Explain the most effective technique for losing weight. 9. Contrast the signs and symptoms of bulimia and anorexia nervosa. Questions?