6/12/15

The dehydrated athlete - hydration tips


Many factors contribute to the total volume of fluid lost from the body on a daily basis - environmental conditions, size/surface area of an individual, metabolic rate, physical activity load (ex. frequency, duration, intensity), sweat loss, diet composition and volume of excreted fluids. 

The daily fluid loss in cool weather (less than 70 degrees F) can be around 2300 mL (with much of that as fluid lost in urine) whereas in warm/hot weather (above 85 degree F weather) it can total 6600+ mL (with most of that lost as sweat). 

Once again, as mentioned in my previous post, relying on thirst to initiate daily water (or sport drink consumption during workouts) is a false recommendation to ensure adequate fluid consumption. I hear it over and over again that athletes feel that they don't need to drink because they aren't thirsty but then when they do feel thirsty, they do not provide themselves with opportunities for frequent drinking and it becomes uncomfortable to fully replace what was lost earlier in the workout/race. When the body is already dehydrated, performance is not only already declining but there is already considerable strain on the body to digest and absorb adequate electrolytes and fluids and carbohydrates. 

There are many physical benefits of training. But because almost all athletes in the Northern Hemisphere train throughout the summer in hot temperatures, minimizing dehydration is critical to receiving the adaptations to following a training plan. 

By developing a fluid replacement program that prevents excessive dehydration, you provide your body with the following benefits:

-Lower heart rate
-Higher stroke volume
-Higher cardiac output
-Higher skin blood flow
-Lower core temperature
-Decreased RPE
-Improved performance

Every time you start, continue on or finish a workout dehydrated, you put yourself at a competitive disadvantage to other athletes who are maintaining hydration status OR you are limiting your full athletic potential as an athlete (and risking serious health consequences). 

Without going into estimating sweat loss/rates, here are a few very simple tips to ensure that you are not sabotaging workouts with improper hydration. 

HYDRATION TIPS BEFORE, DURING and AFTER workouts

PRE:
-Understand the warning signals of dehydration 

-Plan your hydration strategy before a workout (rather than waiting until the last minute)

-Drink ~5-7 mL per kg body weight 4hours before exercise (appropriate for afternoon workouts or races) OR 17-20 ounces of water 2-3 hours before workouts/races. 

-Drink 7-10 ounce water 10-20 min before workouts/races (in addition to above recommendations if you have 3 hours before your workout/race) 

-Add additional electrolytes (in a well formulated pill/powder) like sodium, chloride and potassium to pre workout/race fluids when exercising in warm environments (or for long durations).
NOTE: Glycerol has been promoted to help with hyperhydration. Glycerol is a WADA banned substance and should not be used by athletes (it also comes with dangerous side effects).
-Avoid drinking large volumes (more than 30 ounces in the 3 hours prior to a workout/race) before a workout/race which can cause GI discomfort, low blood sodium levels or excessive urine production.
-Plan to bring fluids/electrolytes/sport drinks with you for the start of your workout (generally at least 1 hour of running and 2-3 hours of cycling and 1 hour of swimming) so that you do not have to ration your fluid supply. Plan to stop as needed so you can voluntarily drink as needed. 

-According to the Institute of Medicine (2005), daily fluid needs are ~3.7L (or 130 ounces, 16 cups) for men and ~2.7L (95 ounces, 12 cups) for females. Around 20% of daily water intake is from water in food (so long as you consume a wholesome diet) so around 80% of your fluid intake should be directly from  fluid ingested. 

-In warm environments when you anticipate sweating (indoors or outdoors), start your workout with a comfortable full stomach full of fluid. 

DURING/POST
-Be consistent in training with fueling/hydration during workouts.
-Always have fluids/sport drink with you and plan to refill bottles along your route/course. 

-Practice consuming liquids while you are working out - specifically running while drinking and grabbing bottles from cages while cycling. 

-1 mouthful of fluid is around 1 ounce. I suggest to take 2-3 swallows every time you drink from a bottle while cycling and 1-2 sips every time you drink from a cup/flask while running. 

-Bring money in the case you need to stop for fluids while cycling. Always have enough fluid on your bike to last 1 hour of cycling and enough fluid to last 30 minutes of running.
-Record body weight before and after workouts. You want to avoid losing more than 2% body weight and you do not want to weigh more after your workout. Any weight lost during a workout is not fat, it's fluid! You do not want to be proud of your weight loss during workouts as it can affect your health and performance. Some weight loss is fine but be mindful of signs of dehydration. You can estimate sweat loss/fluids needs with basic calculators or get yourself tested in professional lab. 

-Better hydration = better performance = better health. Aim to consume frequent intakes of fluid (sport drinks) starting around 15 minutes into your workout/race and be consistent throughout your entire workout/race. Prioritize liquid calories and vary your flavors so you prevent taste bud fatigue (ex. choose a different flavor drink for running versus cycling and if riding more than 4 hours, opt for 1-2 bottles of a different flavor than your other 2-3 bottles).
Drink no more than 10 ounce fluid every 15-20 minutes (best as 4-5 ounces every 10 minutes).

-Put more fluid in your stomach than on your head. Use cold water to cool yourself but don't go long periods without drinking. 

-In the case of GI upset or a sloshy stomach, slow down for 5-15 minutes and consume additional sodium with a little water to help empty contents from gut. Diarrhea will increase electrolyte loss so be sure to stay up with sport drink consumption during and post workout/race in the case that you experience loose stools while working out/racing. 

-Drink on a schedule, don't wait until you are thirsty. You are better off drinking earlier in a workout/race when your body temperature and heart rate are more controlled. 

-Hydrating with a sport drink that contains carbohydrate, electrolyte and water before and during workouts/races will help replaces losses and provide your body with sustainable energy. 

-Post workout, consume around 16-24 ounces for every lb of body weight lost during the workout. DO NOT consume all fluids at once. Start with an electrolyte rich beverage of around 16 ounces and aim to replace weight loss (in ounces) within 4-6 hours post workout.
For example, if you lost 5 lbs in a workout, aim to consume 80 ounces of fluid in a 4-6 hour time period in the form of an electrolyte beverage, recovery drink, food and water. 

If you find that you struggle with hydration or consuming adequate fuel during workouts or races, consult with a sport RD to help you fuel smarter in your athletic development. 

Information in this blog collected from Sport Nutrition: A practice manual for professionals. By Christine A Rosenbloom, PhD, RD, CSSD and Ellen J Coleman MA, MPH, RD, CSSD. 

6/11/15

The dehydrated athlete


It surprises me how many athletes assume they are just fine just "getting by" in workouts by not fueling or hydrating during the workout.
Could you be underfueling and more importantly, underhydrating during your workout?

Maintaining adequate hydration during workouts and especially in races is one of the most important nutrition strategies for optimizing performance and for keeping the body in good health. 

Every athlete knows that even losing a small percentage of body weight can affect health and can impair performance so why even think twice about going for a swim, bike or run without adequate fluids?

I find myself spending a lot of my time educating athletes on what they are not doing well (or consistently) which could be sabotaging workouts and one area is speaking to triathletes and runners to try to get them to consume adequate fluids during workouts.
With so many athletes coming to me looking to boost performance, improve health or to reach body composition goals, you wouldn't believe how many of these athletes (runners or triathletes) struggle to remember (or make an effort) to put on a fuel belt when they run or bring a bottle to a swim workout or stay on top of fluids during a long bike. They will easily put in the work training but taking a few minutes to fill a bottle and drink from it during a workout can be quite difficult (or it's an afterthought).

With so many hydration belts, packs and handhelds on the market, it really saddens me that athletes don't think more about the physical and health consequences of dehydration. 

Let's talk first about sweating and thirst. 
When we sweat, we experience a decrease in plasma volume and an increase in plasma osmolality. 
As vascular pressure receptors and hypothalamic osmoreceptors respond to the increase in sodium and chloride concentrations in blood plasma, ADH (antidiuretic hormone) is released from the pituitary gland, renin releases from the kidneys and aldosterone and angiotensin II increase water and sodium retention by kidneys and ultimately, we feel thirsty. Yes, all that happens before we "feel" thirsty. 

There has been a lot of talk lately about athletes not needing to drink during workouts or that athletes should simply rely on natural thirst mechanism to let us know when to drink when we workout or race. Because of this advice, athletes will many times train and race underhydrated and express afterward "but I didn't feel thirsty" or "but I didn't feel like I needed it."

Relying on thirst may work for the average fitness enthusiast but when it comes to athletes, it can be quite difficult to offset the large volume of sweat that we lose AND meet carbohydrate and electrolyte needs without risking GI issues by "just waiting" until we are thirsty.
More so, many athletes go into workouts in a dehydrated state which doesn't make it any easier to train consistently in a training cycle.

Before I give some basic hydration tips for athletes to help ensure that you are making an effort to meet hydration needs, consider the following: 

-To assure rapid gastric emptying of fluids/electrolytes/carbohydrates, you need a comfortable volume of fluid in the stomach (pre and during workouts/races)

-It's very easy to get distracted, feel you don't need it or to consider carrying fluids as a nuisance so thirst signals may be ignored or overlooked. 

-If fluids are not available, it won't be convenient to act on your thirst. Whereas on race day, with ample aid stations, you may find yourself acting too often, in too large of amounts. 

-Based on plasma osmolality, there is a specific amount of fluid that needs to be lost from the body before thirst is stimulated so it is true that by the time thirst is perceived, the body may already be dehydrated.

-Carbohydrate stimulates rapid water absorption in the small intestines with sodium, chloride and potassium replacing electrolytes.

-Sodium plays a critical role in maintaining the osmotic drive to drink and provides an osmotic stimulus to retain fluid in extraceullar space (plasma and interstitial fluid compartments).

-Drinking plain water dilutes sodium concentration in blood and removes the osmotic drive to drink.
 Drinking plain water as a means to stay hydrated during long duration or intense activities causes premature satiation of thirst which results in a decrease in fluid intake before adequate fluid has been ingested. OR the opposite happens. Excessive water intake (or consuming low sodium/low carb sport drinks) can quickly dilute plasma sodium concentrations. This can lead to hyponatremia or more serious, water entering the brain as the osmotic balance across the blood-brain barrier becomes disrupted. 

-Drinking plain water during long distance or intense exercise will cause plasma osmolality to decrease which suppresses thirst and increase urine output. When sodium is added to drinks, the osmotic drive to drink is maintained and urine production is decreased. 

-Plain water can quench thirst but is not adequate to serve as a rehydration beverage during or post workout. 

-A properly formulated sport drink (one that contains carbohydrates, sodium, chloride and potassium) not only improves palatability but also helps maintain an osmotic drive for drinking, reduces the amount of sodium that the blood has to supply to the intestine prior to fluid absorption, helps maintain plasma volume during exercise and serves as a primary osmotic impetus for restoring extracellular fluid volume after exercise. Carbohydrates will provide sweetness in a drink to improve palatability, will help fuel muscles and will stimulate fluid absorption from intestines. 

In my next post I will give some tips to help with hydration before, during and post workout. 

Information in this blog collected from Sport Nutrition: A practice manual for professionals. By Christine A Rosenbloom, PhD, RD, CSSD and Ellen J Coleman MA, MPH, RD, CSSD. 

6/9/15

A nutrient-rich diet fuels performance


Most sport nutrition experts try to make nutrition and fueling a body in motion as simple as possible because aside from a few of us who love biochemistry, explaining metabolism in the picture above is likely not the most practical way to understand and apply information as it relates to turning food into energy (aka metabolism). 

These days we often hear about ways to eat less. Over and over again, nutrition "experts" proclaim that to be healthier, stronger, leaner, fitter and sexier you need to fast, cleanse, detox or find a way to restrict food.
And these suggestions are not just for the sedentary, clinical unhealthy or lightly active. They often trickle down to age group, elite and professional athletes too! 

Athletes who restrict food, undereat, overeat, skip meals, underfuel around/during workouts (either intentionally or unintentionally), frequently diet or overtrain may find that the diet is negatively affecting physical and mental health just like overeating can effect physical and mental health. 

Sport nutrition is not simple but we must not forget that general sport nutrition recommendations that apply to the masses, generally work to help you stay healthy and to help take your training to the next level. And they are not super complicated. 

Far too often I find athletes struggling with their training load, feeling run-down, sick, injured or feeling "off". These athletes often feel like they don't have enough energy or the energy they use to have in training and seek dietary changes to boost energy (or to help with weight loss). 


If you consider the many metabolic processes that your body needs fuel for (through carbohydrates, fats and protein) in order to function properly at rest and during activity, if you don't consume enough energy (calories) for your activity regime, you can't consume adequate macronutrients (carbs, protein, fat). If you don't consume the appropriate amount of macronutrients, you may become deficient in key micronutrients. If your body doesn't receive the energy and nutrients that it needs, performance and health will suffer.

The problem is that athletes struggle to enjoy "healthy" eating. There is little passion to fueling a body in motion. Rather than respecting the body with sport nutrition and good nutrition practices, athletes bash, criticize and overwork the body.
Athletes often want a quick fix, hoping to make a few changes or lots of changes to get results fast. It's often the "easy" approach that athletes want when it comes to nutrition for every other approach looks hard (or appears to fail at first attempt). There is little consistency in the diet or fueling regime yet extreme dedication and 
commitment to training.
Sadly, you can't out-train a poorly designed diet. 

The human body works rather hard to keep you in good health. But let's get real here. 
Through in a 10-20+ hour training load on top of your daily life stresses, you can only imagine how much harder the body has to work on a daily basis to not only keep you well but also to help you get faster, stronger and fitter. Health doesn't improve overnight just like performance gains aren't achieved in 1 week of training. 

The scary part about an athlete's body is that many times, an athlete does not recognize that he/she is underfueling, underhydrating or undernourishing until it's too late. In other words, an athlete feels as if "all of a sudden" something isn't working whereas in reality, the athlete was likely never fueling, hydrating or nourishing properly and the body finally caught up (or more likely couldn't keep up). 


Did you know that because vitamin B12 is secreted daily into the bile and then reabsorbed, it can take around 20 years for a otherwise healthy person to show signs of a deficiency? 

Vitamin B12 is just one of many micronutrients that is necessary for metabolism. Riboflavin (B2) is involved in glycolsis, the ETC and citric acid cycle (all important during exercise), Thiamin (B1) is needed to convert pyruvate to acetyl-CoA during carbohydrate metabolism which is essential for the aerobic metabolism of glucose, vitamin C protects against oxidative stress and iron is utilized for many functions related to exercise. 
And don't forget about calcium, phosphorus, magnesium, potassium, sodium, chloride, vitamin A, D, E and K, pantothenic acid, biotic and choline....all necessary to keep your body healthy and to support your body during training and racing.  

If you are an athlete who intentionally or unintentionally does not consume enough energy through meals and snacks, does not use (enough) sport nutrition or hydration before/during/after workout, has a low appetite (or overeats) or chooses a limited/food restricted diet, there is a great change that you could be consuming an inadequate consumption of micro AND macronutrients which ultimately will affect your exercise performance and health. 

And who wants to put in all that hard work in training but not receive favorable fitness gains as an outcome? 

Do not overwhelm, scare yourself or stress over food. 
Just eat. Food is your fuel and your medicine.

If you make the effort to fuel/hydrate your body before, during and after workouts, consume a whole food diet throughout the day and indulge responsibly, on occasion, you will likely consume adequate vitamins and minerals to meet your needs and will likely keep your body in optimal health.

 In return, you will gain the competitive edge as you can push your body harder as you can stronger, faster and more powerful all through consuming a nutrient-rich diet. 

Happy fueling! 


6/7/15

3 sport nutrition tips to fueling your body in motion











-At the beginning of exercise, your body uses carbs at a very high rate since fat metabolism can not keep up up with producing ATP (energy) fast enough, so early in a workout. Carbs are quick energy makers but we know that utilizing fat for fuel can be a sustainable energy source so long as the intensity and duration are reasonable.
(This is why a warm-up is very important before you begin your actual workout to help lower your HR and taking short walk breaks frequently in the first 2-3 miles of a long run or race. To help your body metabolize the right fuels for your workout, wait around 10-15 minutes into your workout/race to start fueling (ex. on the bike and on the run but do not wait any longer than 20 minutes to ensure that your body receives the fuel it needs to help last the duration of your race/workout).


But did you know that carbs are a rate limiting fuel? In order to continue to burn fat for fuel, you need carbohydrates during your workouts even when you are working out at a low intensity but for more than 1 hour. Consuming carbs (30-60g per hour, in 10-15 min intervals with fluids) during workouts can help keep blood sugar elevated and favors carbohydrate use when you need it. 
Bottom line: Exercising for fat burning purposes is different than exercising for optimal performance.

Do not sabotage a workout by underfueling/underhydrating. You can still burn and use fat even when you consume carbohydrates (ex. sport drinks/gels) during a workout.
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-As an endurance athlete, you place a tremendous amount of intentional stress on your body in order to meet your fitness goals by race day. Therefore, it is important to have an appropriately planned diet to support your athletic development.
 Any diet that is restrictive (e.g. paleo, vegan, gluten-free, dairy-free) or lacking in variety (e.g. you rely on fast food, you don’t like to cook, etc.) may demonstrate potential nutritional deficiencies. Thus, all endurance athletes should consider working with a dietitian who specializes in sports nutrition, especially if desiring to make dietary modifications/swaps. 
For any athlete who is seeking a change in the diet, be mindful that if there are underlying dietary clinical issues (e.g. IBS, food allergies, gluten intolerance/sensitivity, Hashimoto’s, PCOS, etc.) those should be considered first in an effort to create the most balanced, varied diet possible.
As a guideline or starting point, a balanced diet for your endurance body should include around 25-30% daily calories from fat, around 3-10g/kg body weight from carbohydrates, and around 1.2-1.8 g/kg body weight of protein per day.
There are many apprehensions by athletes, coaches, and outsiders who question the athletic potential (or lack thereof) of vegetarian endurance athletes. Within a restrictive diet, there will always be concerns for nutritional deficiencies so it would appear that vegetarians are undoubtedly lacking key nutrients by not eating animal protein.
There are often concerns of anemia or iron deficiency, inadequate consumption of quality dietary protein, zinc, calcium, vitamin D, and B12 and an alleged inability to eat “enough” calories/energy from plants. But, let’s not pick too hard on vegetarians. Remember that an under-fueled and undernourished athlete will always under-perform. 
So, if you have recently made an extreme change in your diet or adhere to a restrictive style of eating, it doesn’t matter if you call yourself a vegetarian or where you get your protein (animal or from the earth), because ALL endurance athletes must provide the body with a variety of vitamins and minerals in order to meet the demands of your training regime.
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-If you are an endurance athlete, be mindful that nutrition plays a key role in promoting the necessary adaptations that take place in response to intentional training stress and can help us maintain the energy we need, with a healthy body, throughout a given season.
Unlike high-intensity training, where fatigue is associated with a rapid decrease in the intracellular concentrations of creatine phosphate (CP) or marked acidosis within the muscle cells, there is a strong metabolic component to fatigue in endurance sports.

Although appropriate pacing, a well designed training plan, exceptional mental strength and ability to train/race in the heat contribute to great race day performances, keep in mind that any intentional change in your daily or sport nutrition fueling regime should allow for better performances. An underfueled athlete will always underperform.
The human body is an amazing machine - but every body is different. Do not assume that the nutrition intervention for one athlete is going to be the necessary nutrition intervention for you.
If you have a clear nutrition-related limiter as to why you are not improving your performance, you should be addressing that area as top priority. Never let anyone convince you that there is only one "best" way to eat, fuel and re-fuel as an endurance athlete, especially if that someone is not a trained/qualified professional in the area of sport nutrition/exercise physiology.



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