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Practical Adolescent Sports Nutrition for Pediatricians Elisabeth Hastings,MPH,RD,CSSD,LD Pediatrics Disclosure I do not intend to discuss an unapproved/ investigative use of a commercial product/device in my presentation I have no relevant financial relationships with the manufacturers of any commercial products and/or provider of commercial services discussed in this CME activity Page 1 Pediatrics xxx00.#####.ppt 9/10/2013 11:50:54 AM Introduction Pediatrics Objectives 1. To discuss the increased requirements and barriers to optimal nutrition in competitive adolescent athletes 2. To describe key sports nutrition concepts and sound resources for competitive adolescent athletes 3. To provide appropriate baseline sports nutrition education and referrals for individual nutritional assessment for competitive adolescent athletes Page 3 Pediatrics xxx00.#####.ppt 9/10/2013 11:50:56 AM Stats on Teen Athletes •Current estimates indicate that 55.5% of high school students compete in sports1 •Texas has the greatest number of high school athletes1 •Most coaches and athletes have inadequate knowledge of sport specific nutrition2 •Parents want more positive messages about nutrition from health care professionals that are specific to youth3 Page 4 Pediatrics xxx00.#####.ppt 9/10/2013 11:50:56 AM Who Plays What? •Boys1 ‐Football, track, basketball, baseball, soccer, wrestling •Girls1 ‐Track, basketball, softball, soccer, cross country © Lucky Dragon USA –Fotolia.com •6% of high school football players will play in college4 •Early specialization can cause burn out; overuse injuries Page 5 Pediatrics xxx00.#####.ppt 9/10/2013 11:50:57 AM Sports Nutrition •Sports nutrition can help promote optimal training, body composition, performance, growth, healing and immunity in teen athletes5 •Without proper nutrition, athletes are at risk for suboptimal growth6 •A dietitian specialized and credentialed in sports nutrition is a CSSD5 ‐Certified Specialist in Sports Dietetics Page 6 Pediatrics xxx00.#####.ppt 9/10/2013 11:50:57 AM Barriers to Optimal Nutrition in Teen Athletes •Poor knowledge base •Concrete thinkers •Poor organization of food and meal times •Lack of financial resources •Pubertal body changes •Obesogenic society •Body dissatisfaction •Interest in supplements •Lack of parental support & fad diets •School challenges Page 7 Pediatrics xxx00.#####.ppt 9/10/2013 11:50:58 AM Calories - New School Lunch Program7 GRADES LUNCH (kcal) BREAKFAST (kcal) K-5 6-8 9-12 550-650 600-700 750-850 350-500 400-550 450-600 Is it enough? © Michael Flippo – Fotolio.com Page 8 Pediatrics xxx00.#####.ppt 9/10/2013 11:50:58 AM Sports Nutrition Basics Subtitle Pediatrics What Type of Athlete? Anaerobic Aerobic •Max effort-short duration •Distance running •Lineman © Shariff Che'Lah – Fotolia.com •Sprinters •Triathlons •Stop and go sports •Cycling Page 10 Pediatrics xxx00.#####.ppt 9/10/2013 11:50:59 AM Hydration •Never underestimate the value of hydration •Differences in thermoregulation exist between children and adult athletes •Teen athletes are particularly poor at hydration ‐Thirst is not a good indicator of dehydration in sports •AAP policy statement for children & adolescents8 ‐Adolescents may consume up to 1-1.5 liters of fluids every hour of exercise ‐Who is at highest risk? Page 11 Pediatrics xxx00.#####.ppt 9/10/2013 11:50:59 AM Hydration •ACSM exercise and fluid replacement position stand9 ‐Pre-pubescent children have lower sweat rates than adults ‐Performance is impaired with a >2% loss in body weight •How to monitor hydration status ‐Urine color/Chart10 •http://www.csbsju.edu/Documents/CSB%20Campus%20 Rec/Scan_Doc0011.pdf ‐Sweat rate9 ‐Urine specific gravity9 Page 12 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:00 AM Fluid Intake Recommendations •Before Exercise: ‐2-3 cups fluid 4 hours before ‐1½ -2 cups 15-30 minutes before •During Exercise: ‐½ - 1 cup every 15-20 minutes •After exercise: ‐2½ - 3 cups for every pound lost © Geoffrey Whiteway – freerangestock.com Page 13 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:00 AM Comparison of Popular Fluids Beverage 8oz CHO % CHO (gm) Calories Sodium (mg) Potassium (mg) Water 0 0 0 0 0 Propel Sport Water 1 3 10 35 0 2.5 6 24 407 183 G2 3 7 20 110 30 Coconut Water 4 11 42 28 484 Vitamin Water 5.5 13 50 0 0 Gatorade 6 14 50 110 30 Powerade 8 19 72 53 33 Coke 11 27 100 30 1 Pedialyte Page 14 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:01 AM Food Is Fuel •High school athletes tend to ‐Skip breakfast ‐Eat at least one meal at school ‐Come to practice 4+ hours after eating •Consequences of under-fueling5 ‐Loss of lean body mass ‐Earlier fatigue/suboptimal performance ‐Increase risk for injury & illness ‐Prolonged recovery & healing ‐Menstrual dysfunction © Ogerepus – Fotolia.com Page 15 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:02 AM Daily Calorie Requirements11 AVE TEEN FEMALE AVE TEEN MALE 1700-1800 calories 2200-2400 calories FEMALE ATHLETE MALE ATHLETE 2200-3000 calories 3000-4000 calories Page 16 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:02 AM Calories - New School Lunch Program7 GRADES LUNCH (kcal) BREAKFAST (kcal) K-5 6-8 9-12 550-650 600-700 750-850 Is it enough? Often not for competitive athletes © Michael Flippo – Fotolio.com Page 17 Pediatrics 350-500 400-550 450-600 xxx00.#####.ppt 9/10/2013 11:51:03 AM Timing is Key – The Training Diet 2 TRAININGS/DAY 1 TRAINING/DAY •Wake up •Wake up •Pre-training meal (breakfast) •Breakfast meal •Training (fluids) •Lunch meal/fluids •Recovery meal/fluids •Pre-training snack •Between training meal (lunch) •Training (fluids) •Training (fluids) •Recovery meal/fluids •Recovery meal/fluids •Post training meal (dinner) •Post training meal (dinner) •Bedtime (snack) •Bedtime (snack) Page 18 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:03 AM Optimal Training Diet •Abundant in Fluids Water, milk, 100% juice, sports drinks ‐Drink all day •Ample in nutrient dense carbohydrates Whole grains breads/pasta/cereals, fruits, vegetables, low fat milk/yogurt, beans , energy bars ‐50-70% of total calories •Adequate in protein Lean meats and fish, low fat dairy, nuts, beans ‐15-20% of total calories Dairy products, nuts, heart healthy oils and butters , avocado •Balance of fat ‐20-35% of total calories Page 19 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:04 AM Carbs are King! •Main source of energy for working muscles & academic brain •Inadequate carbohydrate consumption can lead to glycogen depletion •Younger athletes have smaller gylcogen stores and more limited glycolytic capacity than adults12 © Katie Park – freerangestock.com Page 20 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:04 AM Carbohydrates •Low intensity, skill based athletes with large body mass or energy restriction ‐3-5g/kg/d •Moderate Exercise Program ~1 hour per day ‐5-7g/kg/d •Endurance Program 1-3 hour moderate to high intensity ‐7-10g/kg/d •Extreme Commitment >4-5h per day moderate to high intensity ‐8-12g/kg/d Page 21 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:05 AM Pre-workout Fuel •Ideally 3-4 hours before event/practice, maybe again 1 hour before •High in carbohydrate, low or moderate in protein, low in fat, low in fiber •High individual tolerance •Race day NOT a good time to try a new food! Page 22 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:05 AM © Chance Agrella – freerangestock.com During Exercise •Prepubertal athletes may rely more on exogenous carbohydrate intake during exercise than post12 •30 grams (120 calories) of carbohydrate per hour during 1 to 2 hours of exercise •60-90 gram (240-360 calories) of carbohydrate per hour for exercise lasting more than 2.5 hours •Easily absorbed carbohydrates ‐Sports drinks, banana, gummy candy, gels, dried fruit ‐Swish and spit? Page 23 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:06 AM Protein5 •Post Pubertal Non exercising: ‐0.8 gm/kg/day •Maintenance/Endurance athletes ‐1.2-1.4 gm/kg/day •Strength/resistance athletes ‐1.4-1.8 gm/kg/day •Teens © Liddy Hansdottir - Fotolia.com ‐1.4-1.5 gm/kg/day (can be higher if actively growing) •Most teens exceed this intake12 Page 24 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:06 AM Fat12 •Few studies have investigated fat intake for active teens •Recommendations are the same as general for age ‐20-35% daily calories •Younger athletes rely more on fat as fuel than adults •Especially important for endurance athletes •Restriction of fat intake in non-obese children may result in impaired growth and development Page 25 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:07 AM Post-workout Fuel: Recovery5 •Muscles replenish energy stores most efficiently within 30 minutes after exercise •Type of carbohydrate ‐Fructose alone less affective that glucose and sucrose •Addition of protein promotes maximal repair and anabolism ‐Carbohydrate to protein ratio of 3:1 or 4:1 •Goal: 1.5 grams of carbohydrate per kg with 0.30.5 grams/protein/kg per 2 hour interval Page 26 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:08 AM Key Nutrients of Interest5 •Calcium & Vitamin D •Iron, Zinc, Magnesium •B Vitamins •Vitamin C, E, Beta carotene, selenium •Sodium, chloride, potassium •Omega 3 Fatty Acids Use of a multivitamin supplement does not improve performance in athletes consuming nutritionally adequate diets Page 27 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:08 AM Vegetarian Athletes5 •Variety & monitoring body weight/body composition is important to ensuring adequacy of diet •Protein recs increase to 1.3-1.8gm/kg/day •Protein quality may be of concern if athlete is a vegan •May be at risk for low intakes of energy, fat, vitamin B12, riboflavin, vitamin D, calcium, iron, zinc •Females may be at greater risk for developing iron deficiency anemia Page 28 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:09 AM Female Athlete Triad Spectrum13,14 Reduced or Low Energy Availability Low Bone Mineral Density or Osteoporosis Subclinical Menstrual Disorders or Amenorrhea Page 29 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:09 AM Disordered Eating in Teen Athletes15 •Increased incidence at the onset of adulthood (1825 years) supports prevention strategies in adolescence •Female athletes and those with >16 hours/week of activity have an increased tendency toward disordered eating •“Anorexia Athletica” •“Lean-build sports” ‐cross country & track runners, swimming, gymnastics, cheerleading, yoga, wrestling, dancing •Can result in suboptimal bone mass in adulthood Page 30 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:10 AM Alcohol and Teens21 •Drinking alcohol after exercise negates training effect, hinders recovery, increases likelihood for injury, decreases immunity •Alcohol can increase appetite and promote weight gain •Males athletes are more likely than females to drink heavily •Team sports in adolescence increases likelihood of alcohol intoxication Page 31 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:11 AM Practical Tools & Meal Ideas Pediatrics Athlete’s Meal Plate #1 Wt loss or low intensity/no workout day Fruits and Veggies Page 33 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:12 AM Lean Protein Grains Athlete’s Meal Plate #2 Moderate/usual intensity workout day Fruits and Veggies Page 34 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:13 AM Lean Protein Grains Athlete’s Meal Plate #3 Veggies High intensity or double workout day Grains Fruit Pediatrics Lean Protein USOC ATHLETE PLATES: http://www.teamusa.org/About-theUSOC/Athlete-Development/Sport-Page 35 Performance/Nutrition/Resources-and-Fact-Sheets xxx00.#####.ppt 9/10/2013 11:51:13 AM Pre-Exercise Meals (2-4 hours) Breakfast Cold or hot cereal, fruit, and low-fat or nonfat milk Pancakes or waffles with maple syrup, fruit English muffin with peanut butter, banana, and fruit juice 2 eggs, potatoes or wheat toast, fruit, milk or yogurt Bagel with low fat cream cheese, oatmeal, fruit Granola bar, cereal with milk & almonds, fruit Liquid meal replacement or smoothie Page 36 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:14 AM Pre-Exercise Meals (2-4 hours) Lunch or Dinner Pasta with tomato sauce, grilled chicken, steamed vegetables, low-fat milk, canned fruit Baked or grilled fish or lean beef; steamed rice, roll, green beans, yogurt, and fruit juice Grilled chicken sandwich, baked potato with low-fat sour cream or salsa, and low-fat frozen yogurt Turkey or tuna sandwich, baby carrots, trailmix with nuts, low fat milk Tacos, rice, salad with dressing, fruit, milk Page 37 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:16 AM Pre-Exercise Meals (<1hour) •Simple/Refined: ‐Banana, gummy candy, dried fruit, pretzels, applesauce, honey, fig bars, sports drinks, gels •More complex: ‐oatmeal, bagel, banana, dried fruit, energy bar, yogurt, liquid nutrition supplement •Some choose to refrain from food and fluids just before and during exercise Page 38 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:16 AM The Athlete’s Pantry •Trailmix •Canned tuna •Mini-wheats •Canned beans •Dry cereal •Canned fruits/veggies •100% juice •Whole wheat pasta/bread •Instant brown rice •Tomato sauce •Sports drinks •Low fat sandwiches •Nuts •Sports bars •Granola bars •Dried fruits •Graham crackers •Peanut butter •Pretzels •Canned tuna •Oatmeal •Light popcorn •Beef jerkey Page 39 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:17 AM The Athlete’s Cooler •Fresh fruit •Meal replacement drinks •Cottage cheese •Peanut butter & crackers •Fresh vegetables © Adamophoto – freerangestock.com •Yogurt •Hummus •Turkey sandwich •Food bar •Low-fat choc milk Page 40 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:18 AM What Makes a Good Post Exercise/Recovery Food? Snack Food Carbohydrate Protein 15-30gm Post Exercise Food 30-100gm <6gm 6-25gm Page 41 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:18 AM Recovery Snack Ideas Fluids Food Bars •Low-fat choc milk •Lean meat or PBJ sandwich •PowerBar Recovery •Carnation Instant Breakfast •Yogurt & granola •Clif bar •Banana & PB •Luna Sunrise Bar •Boost/Ensure •Tuna w/ crackers •Gatorade Recovery •Trailmix & juice •Gatorade Energy Bar •Cheese & fruit •Kashi Go lean •Muscle Milk •Pita & hummus •Balance Bar •Smoothie Page 42 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:19 AM Recovery •Fruit smoothie made with yogurt or milk •Turkey sandwich with a piece of fruit •Yogurt with berries and granola •Bowl of minestrone soup with whole grain crackers and low fat cheese •Oatmeal with milk, raisins, and slivered almonds •Peanut butter and banana sandwich •Vegetable omelet with toast Page 43 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:19 AM Travel & Eating Out (night before) •2 cheese pizza slices with added grilled chicken, green salad, 100% juice •Turkey & cheese sub sandwich, baked chips, fruit, low-fat milk •Grilled chicken soft tacos, rice, beans, tomatoes, corn •Spaghetti with meat sauce, bread, green salad with dressing, low fat milk •Baked potato with chili and broccoli •2 burgers, extra veggies, no fries, water Page 44 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:20 AM Grocery Store Tips for Athletes •Perimeter of store = good •Middle aisles = not as good •Fruits & veggies = fluids & vitamins •Round or Loin = leaner cuts •Olive & canola oil = heart healthy •100% whole wheat = Magnesium •Blue/red/purple foods = helps delay muscle soreness Page 45 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:20 AM To Gain Lean Body Mass •Weight (muscle) gain is as hard to do for some as weight loss •Needs more than just protein but also, strength training stimulus and extra calories •Increasing calorie intake 300-500 calories per day equates to ½-1 pound of body weight per week •Late-maturing adolescents usually most concerned about gaining muscle and size Page 46 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:21 AM To Gain Lean Body Mass •Always eat breakfast •Eat every 3-4 hours •Pack high calorie snacks •Add fluids that contain calories to meals •Increase portion sizes Page 47 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:21 AM To Lose Body Fat •A combination of proper training, calorie deficit, plenty of protein, & enough, but not too many, carbohydrates •Cutting back on about 300-500 calories equates to ½ -1 pound of body weight per week •Body composition assessment techniques •Lowest reference body fat for adolescents16 ‐7% males, 14% females – adolescents Page 48 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:22 AM To Lose Body Fat •Don’t skip or restrict meals •Fill up on fruits and vegetables © Geoffrey Whiteway – freerangestock.com •Avoid foods with added fats and sugars •Decrease carbohydrates in meals that are not before workouts •Increase aerobic exercise as needed Page 49 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:22 AM Supplements Subtitle Pediatrics NOTHING BEATS REAL FOOD THE KITCHEN SHOULD BE AS CRUCIAL AS THE VITAMIN STORE SUPPLEMENTS CAN HARM AN ATHLETE AS MUCH OR MORE THAN THEY CAN HELP Page 51 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:23 AM Athletes & Supplements •An athlete is fully responsible for all prohibited substances found in his/her body •Athletes generally don’t ask their doctors for advice on taking supplements - you need to ask them! •Scientifically testing products is becoming more common, but the industry is still highly unregulated Page 52 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:24 AM Teen Athletes and Supplements12,17 •Supplements for adolescents are generally not recommended ‐Very few studies in children and adolescents •Nonetheless, supplements are very popular among adolescents ‐Most commonly used are sports drinks, multivitamins, vitamin C, iron, whey protein, caffeine, & creatine •Younger elite athletes tend to be more performance focused and less health conscious than adults with regards to supplements Page 53 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:25 AM Look at Your Label VS Page 54 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:25 AM Whey Protein Powders •Helps in conjunction with CHO •Increases muscle mass more aggressively than other proteins •Enhances immune function •Effective for those who don’t eat enough •Isolate vs concentrate •No more or less effective than food! Page 55 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:26 AM Creatine •Amino acid that provides energy to muscles, usually as phosphocreatine •Delays fatigue during explosive exercise •May benefit those who are naturally deficient •Dose: ‐20 gm total/day (divided) for five days, followed by 3-5 gm per day to maintain. •Sources: red meat, poultry, fish •Water retention Page 56 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:27 AM Creatine Guidelines for Teen Athletes18 •Only recommended when the athlete is a serious competitor and is post-puberty. •The athlete is eating a well-balanced sports diet that optimizes performance. •Both athlete and parents understand the effects of creatine supplementation and approve of taking the supplement. No one can guarantee safety. •Qualified professionals supervise the supplementation of only reputable brands of creatine supplements. •The athlete does not take more than the recommended dose. Page 57 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:28 AM Caffeine •Both a CNS and muscular stimulant •Increases alertness and decreases perception of fatigue •May increase fat utilization & decrease CHO •Sources: Energy drinks, coffee, tea •Optimal Dose: 3-6mg/kg taken ~1 hr prior •Doping threshold in urine •Symptoms of caffeinism •Adolescents may be more sensitive to effects Page 58 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:29 AM Common Caffeine Sources Beverage/ Food Coffee, brewed Coffee, instant Tea Caffeine (mg) 110-150 Beverage/ Food Caffeine (mg) Red Bull 80 40-108 5-Hour Energy 208 20-58 200 Chocolate, 1 oz 6-13 NoDoz or Vivarin 10-50 Soda 30-5 Coffee Ice cream Page 59 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:29 AM Branched Chain Amino Acids •Leucine, isoleucine, valine – essential amino acids known to fuel skeletal muscle •Assists in synthesis of other amino acids •Helps muscles absorb BG for energy •Slows water absorption •Food Sources: Dairy, eggs, red meat, fish, legumes •Dose: 1-5gm/day Page 60 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:30 AM Beet Root Juice19 •Modulation of nitric acid •Reduces oxygen demand •Optimal for events lasting 5-30 minutes •Poor taste •Dose: 300-500mg •Food sources: ‐beets, Chinese cabbage, leeks, spinach, arugula, endive, fennel, parsley, celery, kohlrabi Page 61 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:31 AM © Witold Krasowski – Fotolia.com Sodium Bicarbonate •Base that buffers lactic acid in the blood •Delays onset of intracellular acidosis •Enhances anaerobic exercise performance •Ideal for 400-800 meter runs •Dose: 0.3+gm/kg 1-2 hrs prior •Diarrhea side effect Page 62 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:32 AM Beta-Alanine20 •An amino acid building block for carnosine, a compound naturally found in muscle ‐Leads to a gradual increase in muscle carnosine. which buffers muscle acids produced during high-intensity physical activity ‐Reduces muscle burn and fatigue •Dose: 3-6 g/day •Relatively new, promising, but only a few well designed studies have shown beneficial as well as no improvements Page 63 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:33 AM Resources Pediatrics Sports Nutrition Links & Resources •www.scandpg.org •www.eatright.org •http://www.teamusa.org/About-the-USOC/Athlete-Development/SportPerformance/Nutrition/Resources-and-Fact-Sheets •http://www.usada.org/files/active/athletes/NutritionBookletFinal.pdf •http://acsm.org/access-public-information/acsm's-sports-performancecenter •www.sportsnutritionresource.com •www.healthydiningfinder.com •http://www.teamusa.org/About-the-USOC/Athlete-Development/SportPerformance/Nutrition Page 65 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:34 AM Sports Nutrition Links & Resources •http://kidshealth.org/teen/food_fitness/sports/eatnrun.html# •www.americanathleticinstitute.org •http://vegetariannutrition.net/vegetarian-teens/vegan-teen-athlete/ •www.femaleathletetriad.org •www.gssiweb.com •http://www.powerbar.com/nutrition-in-training/eat-to-compete-highschool •www.supertracker.usda.gov •www.nal.usda.gov/fnic •www.ounceofprevention.org Page 66 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:35 AM Be Supplement Savvy •www.drugfreesport.com •www.usada.org •www.informed-choice.org •www.supplementwatch.com •www.nsfsport.com •www.supplementsafetynow.com •www.consumerlab.com •www.naturaldatabase.com •www.supplement411.org •www.wada-ama.org •www.ods.od.nih.gov •FDA MedWatch Hotline 800-332-1088 Page 67 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:35 AM How to Find a Sports RD •Commission on Dietetic Registration Specialist Locator Directory ‐ www.cdrnet.org/applications/directory •Find a SCAN RD ‐www.scandpg.org © Geoffrey Whiteway – freerangestock.com Page 68 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:36 AM RD’s Who See Teen Athletes in Texas •Houston ‐Roberta Anding, RD, CSSD & Lisa Hastings, RD, CSSD ‐Texas Children’s Hospital Sports Medicine Clinic ‐832-822-4887 ‐http://www.texaschildrens.org/sportsmed/ •Dallas-Fort Worth-Keller ‐Eve Pearson, RD, CSSD ‐214-793-2223 ‐www.nutritionworkscnc.com Page 69 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:37 AM RD’s Who See Teen Athletes in Texas •San Antonio ‐Mandy Taylor, RD ‐Power at Play, LLC ‐210-286-7346 ‐[email protected] •El Paso ‐Marilyn Rotwein, RD ‐915-255-0487 ‐[email protected] Page 70 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:37 AM Summary •Nutrition can play an essential role in the health and performance of competitive adolescent athletes •Adolescent athletes require more fluid, calories, carbohydrates, proteins, and many key vitamins than their non-athletic peers •Meal time constraints, poor nutrition knowledge, and pubertal body changes are among the many barriers to optimal sports nutrition for adolescents Page 71 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:38 AM Summary •Timing and composition of meals before, during, and after exercise are crucial for optimal sports performance and recovery •Adolescent athletes at highest risk for suboptimal nutrition are those who under-fuel, are vegetarian, have disordered eating, or abuse alcohol •Although supplements are popular and commonly used among adolescents, they are not generally recommended •Individual assessment by a CSSD is recommended to best meet an elite athlete’s nutritional needs Page 72 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:39 AM Bibliography 1. National Federation of State High School Association 2011-2012 2. Torres-McGee et al, J of Athletic Training, 2012 3. Thomas et al, J of Nutr Edu & Behav, 2012 4. http://www.collegesportsscholarships.com/percentage-high-school-athletesncaa-college.htm 5. American College of Sports Medicine Position Statement: Nutrition and Athletic Performance, 2009 6. Stang & Story, Guidelines for Adolescent Nutrition Services, 2005 7. Nutrition Standards in the National School Lunch Program and Breakfast Program; Final Rule. Federal Register, Dept of Agriculture, Vol. 77, No. 17, January 26, 2012 8. American Academy of Pediatrics. Council on Sports Medicine and Fitness & Council on School Health. Policy Statement-Climatic heat stress and exercising children & adolescents. Pediatrics, Vol 128, No. 3, 2011 Page 73 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:39 AM Bibliography 9. American College of Sports Medicine Position Stand. Exercise and Fluid Replacement. Med & Science in Sports & Exercise 2007 10. Urine Color Chart: Armstrong. L.E. (2000). Performing in Extreme Environments.Human Kinetics. Champaign. IL. 11. Institute of Medicine Dietary Reference Intakes. Estimated Energy Requirements, 2005 12. Jeukendrup A, Cronin L. The Elite Young Athlete; Med Sport Sci. Basel, Karger, 2011, vol 56, pp 47-58: Chapter 3: Nutrition and the Elite Young Athlete 13. American College of Sports Medicine Position Stand: The Female Athlete Triad. Medicine & Science in Sports & Exercise, 2007. 14. Thein-Nissenbaum J, Carr, KE. Female athlete triad syndrome in the high school athlete. Phys Therapy in Sport 12; 108-116. 2011 15. Anton, LG. Disordered Eating in Adolescent Athletes: Prevalence and Risk Factors. SCAN’s Pulse Winter 2010, Vol 29, No. 1: 9-12 Page 74 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:40 AM Bibliography 15. Turocy, et al. National Athletic Trainer’s Association Position Statement: Safe Weight Loss and Maintenance Practices in Sport and Exercise. J Athletic Training. 2011;46(3): 322-366 16. Holway FE, Spriet LL. Sport Specific Nutrition: Practical strategies for team sports. J Sports Sciences, 2011; 29(S1):S115-S125 17. http://www.menshealth.com/supplements/articles/The_Facts_About_Creatin e.php 18. Coleman E. Reap the benefits of beetroot juice – evidence suggests it improves heart health and athletic performance. Today’s Dietitian. 2012, 14(2): 48 19. http://www.humankinetics.com/excerpts/excerpts/beta-alanine-as-a-sportsupplement 20. http://www.goeata.org/protected/EATACD10/downloads/pdf/presentationosullivan.pdf Page 75 Pediatrics xxx00.#####.ppt 9/10/2013 11:51:41 AM Questions? [email protected] 832-822-4154 Pediatrics