Assessment of Nutritional & Hydration Habits of

Ultra-Marathon Runners During a Semi Self-Sufficient Ultra-Marathon Competition in a hot

Ambient Environment: 2011 Al Andalus Ultra-trail (230km)

11-15th July 2011

General Sports Nutrition & Dietary Guidelines & Recommendations

The information provided in this booklet is based on a summary of current scientific literature. With continuous research advancements, nutritional recommendations may alter. American College of Sports Medicine (2009). Joint position statement: Nutrition and athletic performance. Medicine and Science in Sports and Exercise; 41(3): 709-731. Broad, E.M., & Cox, G.R. (2008). What is the optimal composition of an athlete’s diet. European Journal of Sports Science; 8: 57-65. International Society of Sports Nutrition Position, (2008). Position Stand: Nutrient Timing. Journal of the International Society of Sports Nutrition. 5:17. Noakes, T.D., (2007). Drinking guidelines for exercise. J Sports Science; 25(7):781-796. ACSM (2007). Exercise and fluid replacement. Medicine & Science in Sports & Exercise; 337-390. Hew-Butler, T., Verbalis, J.G., Noakes, T.D., (2006). Position statement from the International Medical Directors Association. Clinical Journal of Sports Medicine; 16:283-292.

Dr. Ricardo Costa Research supervisor

Samantha Gill Research coordinator Emily Freeth Dietetic Researcher

Edel Barrett Dietetic Researcher Jessica Waterman Nutritional Researcher Slawomir Marczak Nutritional Researcher

Coventry University Sport & Exercise

Science Applied Research

Group

General Dietary Advice

Energy

You can derive energy for muscle contraction from carbohydrates, fats, proteins, & phosphocreatine. Carbohydrate is the body’s main energy source during exercise, while fat is considered a reserve energy source, only significantly used when the body’s carbohydrate energy stores become depleted. During endurance/aerobic type training, the body’s metabolism can slowly adapt to use more fat energy stores at the same exercise intensity & preserve carbohydrate energy stores for later use during exercise. However, it is important to note that at high aerobic exercise intensities, carbohydrates will always be the primary source of energy, even though a lot of fat energy sources are available. The body’s protein energy stores are only significantly used in exercise during extremely prolonged exercise bouts (e.g. >6hr of continuous exercise), when the body’s carbohydrate energy stores become substantially depleted. Phosphocreatine energy is mainly used at extremely high explosive muscle contractions (e.g. sprinting or explosive weight bearing).

Daily Energy Expenditure

- Volume & Intensity of

training

+ Daily Energy Expenditure

The greater the intensity & volume of exercise the greater the body’s energy expenditure. Therefore, it is important to supply the body with sufficient good quality energy to cope with competition demands. A simple, effective way to check that you are supplying your body with appropriate energy is to monitor your weight on a weekly basis and observe any changes. Weight gains suggests increased energy intake, whereas weight losses represents energy deficit. Energy intake should be regulated dependant on sporting objectives, with fluctuations in weight being monitored. The amount & type of dietary energy that should be consumed is dependent on sporting objective & seasonal variations in training intensity & volume. However, most of your dietary energy should come from carbohydrate sources, with other energy sources being consumed mainly to supply other important nutrients (amino acids, essential fatty acids, vitamins, minerals, fluids) to the body.

Macronutrient Energy Distribution for Sport & Exercise Protein: ~10%

Carbohydrate: ~60-70% Fat: 15-20%

Carbohydrate

Carbohydrate (CHO) is the body’s main rapid energy source. Research has shown that the total amount of carbohydrate in an athlete’s diet will determine how that athlete will cope with training loads & ultimately the final outcome of sporting performance. CHO food sources: Simple CHO: fruit, dairy products, sugars. Complex CHO: pasta, rice, potatoes, noodles, pulses, breads, oats, cereals, vegetables, seeds, nuts, grains, flours. Fibre rich foods: pulses, oats, wholemeal cereals, vegetables, fruit, wholemeal flours, seeds, nuts, wholegrains.

Athletes Carbohydrate Necessities Training workload

CHO/day

Type of food to be eaten

2-3hr/day 4-6gCHO/kgbw/day

Fruit, pulses, vegetables, wholemeal grains & cereals,

3-4hr/day 6-8gCHO/kgbw/day

Fruit, pulses, vegetables, wholemeal grains & cereals, simple CHO foods and CHO supplements (eg. Isotonic drinks, energy bars, CHO powders, gels).

>4hr/day >8gCHO/kgbw/day (dependant on total training load)

Fruit, pulses, vegetables, grains & cereals, simple CHO foods, and CHO supplements (eg. Isotonic drinks, energy bars, CHO powders, gels).

kgbw: kilogram body weight- lean body mass. Ideally, carbohydrate intake should be determined by grams of carbohydrate per kilogram body weight. This will cater specifically for athletes rapid energy demands during training & competition. Fibre is an important part of dietary intake in relation to general health, but has no real significance in sporting performance. However, research has shown that large intakes of fibre; especially, insoluble fibre (cellulose- wholegrains, wholemeal products) may promote gastrointestinal complications during periods of intense training & competition and should therefore be limited at these times.

Athletes Dietary Fibre necessities Training workload Dietary fibre/day

Type of food to be eaten

General training 18g

Pulses, oats, wholemeal cereals, vegetables, fruit, wholemeal flours, seeds, nuts, wholegrains.

Intense training Pre-competition During competition

Limit insoluble fibre intake*

White rice, pasta, white breads, pulses, fruit, vegetables, plain cereals, white flours, simple carbohydrates.

*If constipation is a consistent feature, consult a clinical dietitian for appropriate individual advice.

Protein

Protein is used by the body for growth, maintenance, & repair. Protein is considered as the body’s building blocks, since the various body tissues, cells, & other chemical components are made from proteins. The more intense & prolonged training or competition is, the more your body’s tissues are destroyed & consequently repair required. As you adapt to the stresses of your training and competition, your body will be modified & grow in accordance with these training induced stresses. Therefore, protein acts as a base for training recovery & adaptation. Protein food sources: Plant proteins*: Oats, wholemeal cereals, wholegrains, pasta, pulses, nuts, seeds, soya products, quorn, TVP, broccoli, peas, dried fruit, dried vegetables, rice. Animal proteins*: Poultry, red meats, white meats, white fish, oily fish, dairy products, eggs, seafood. * Protein from animal sources tends to be of high biological value (contains all the indispensable amino acids), while protein from plant sources tends to be of low biological value. However, soya, TVP, & quorn have been reported as being of high biological value.

Athletes Dietary Protein necessities

(*example only, dependant on athletes body weight)

Training workload Protein g/day

Type of food to be eaten

1-2hr training/day ~ 70-80g* Wholegrain cereals, grains, pulses, nuts, seed, certain vegetables, quorn, soya, TVP, poultry, fish, dairy, eggs.

Moderate portions.

2-3hr training/day ~ 84-96g*

Wholegrain cereals, grains, pulses, nuts, seed, certain vegetables, quorn, soya, TVP, poultry, fish, dairy, eggs.

Favourable portions

3-4hr training/day ~ 98-112g* Cereals, grains, pulses, nuts, seed, certain vegetables, quorn, soya, TVP, poultry, fish, dairy, eggs.

Large portions

>4hr training/day

~ >120g* (dependant on training load)

Cereals, grains, pulses, nuts, seed, certain vegetables, quorn, soya, TVP, poultry, fish, dairy, eggs.

Increasingly larger portions

Any excess protein ingested that the body does not use for tissue maintenance, repair, &/or growth will be used as an energy source. If the amount ingested is still in excess it will be removed via urine production. Therefore, hydration is also another important issue in an athlete’s energy metabolism & dietary regime. “Protein or amino acid supplements are not required. The use of these supplements incorporated into an athlete’s daily dietary habits will only promote excess protein intake, which will negatively affect sports performance due to metabolic disturbances”.

“Endurance athletes, must be aware that their daily protein requirements can easily be

met from normal daily dietary habits, if energy requirements for training & competition are being met”

Recommendation for athletes’ protein requirements.

Group Protein kgbw/day

Example: 70kg male

Example: 65kg female

Sedentary 0.7 49g protein/day 46 protein/day

Active 1.0 70g protein/day 65 protein/day

Strength athlete 1.2-1.8* 84-126g protein/day 78-117 protein/day

Endurance athlete 1.2-1.6* 84-112g protein/day 78-104 protein/day *Dependant on the intensity & volume of training. kgbw: kilogram body weight- lean body mass Consuming protein up to 2.0g protein/kgbw/day is acceptable. However, athletes should avoid consuming protein greater than 3.0g protein/kgbw/day.

Fats

Fats are the body’s main reserve energy. They are an important component of cell & tissue membrane structures, are used in the production of hormones, & are also required for the functioning of the body’s internal transport system. The amount of dietary fat that an athlete requires is dependent on the athlete’s body composition, type of sport, & sporting objective. Therefore, dietary recommendations on fat intake are based on an individual basis. However, it is important to incorporate “healthy fats” into daily dietary habits. Healthy Fats: Limit the intake of saturated & trans fats: butter, lard, take away/fast foods/ready meals, cakes, biscuits, chocolate, pastries, meat & meat products, full fat dairy products (milk, creams, yoghurts, cheese), coconut oil/cream, palm oils. Limit the intake of polyunsaturated fats which contain a high amount of omega 6 essential fatty acids (Sunflower oil, grape seed oil, sesame seed oil, safflower oil, corn oil, certain seeds & nuts, primrose oil, meat products). These types of fats are known to have pro-inflammatory properties. Choose olive or rapeseed oil for daily cooking activities (predominantly monounsaturated fats). Choose monounsaturated-based nuts: macadamia nut, hazelnut, and almonds. Choose an olive based spread to use on breads instead of butter or polyunsaturated spreads. Introduce food that are rich in polyunsaturated omega 3 essential fatty acids: - Oily fish: salmon, fresh tuna, kippers, mackerel, herring, trout, sardines, and fresh cod with skin (Because of progressive increases in PCB’s, dioxins, & mercury in marine life, it is advised that female athletes of childbearing age should see a dietitian for appropriate advice on oily fish.) - Include oats, pulses, rapeseed oil, flaxseeds/linseeds, walnuts, wheat germ, soya products, and/or omega 3 enriched eggs into your dietary habits (Omega 3 enriched milk, yoghurts, spreads not sufficient per portion; therefore, not recommended). Fish oil supplements may also be considered.

Vitamins & Minerals

Vitamins & minerals are required by the body in minimal amounts, mainly for metabolic, structural & transport functions. There is currently no research to indicate that athletes are at risk of vitamin or mineral deficiencies if they are consuming a varied diet & meet their training & competition energy requirements. Therefore, vitamin & mineral supplementation is not required or recommended. However, if an athlete feels more secure taking a vitamin/mineral supplement to ensure requirements are being met, a multi-vitamin/mineral supplementation (x1/day that provides no more than 100% RNI) is a safe dosage to use. Athletes are advised not to exceed recommended dose. Research has reported that large doses of vitamins & minerals do not enhance performance in the healthy athlete, & will promote excess toxic side effects; especially in regards to lipid soluble vitamins & mineral. This will actually inhibit optimal sporting performance. Athletes are also advised to not take excess doses of single vitamin or mineral, unless advised by clinical dietitian or GP, for health reasons.

“Consume a wide range of wholesome foods, with quantities to meet your energy requirements”

If you are at risk of not meeting energy requirements, & present a limited variation in food intake, you should consult a sport & exercise dietitian/nutritionist for individualised advice.

Applied Sports Nutrition (General Recommendations)

Pre-competition

As training load decreases prior to competition, increase the volume of carbohydrates in your diet. This will increase your quick carbohydrate energy stores in your muscles for competition. Have a large carbohydrate rich breakfast or meal 3hr prior to competition. A lighter snack >1hr prior to competition. This will avoid any gastrointestinal complication during exercise & at the same time providing your body with carbohydrate to maintain your rapid energy stores prior to competition. Avoid excess amounts of protein, fats, & fibre (especially insoluble fibre- wholemeal products) in the days leading up to competition. This will avoid gastrointestinal complication during competition, & metabolic fatigue at increased exercise intensities. Ensure urine is clear prior to competition, by drinking moderate amounts of fluids with electrolytes (can be carbohydrate rich fluids) more frequently in the days leading up to competition.

During competition

Competitions <1hr, no feeding required, providing that carbohydrate loading has been done. Competitions >1hr- 20g of carbohydrates in the first hour if desired, then 30-60g of carbohydrate every hour after. Ensure carbohydrates are taken in an ~isotonic form (e.g. ~6% carbohydrate solution) The body has a maximum rate of how much carbohydrate it can absorb & utilise as energy during exercise. Therefore, it is important to fill up the tank prior to competition & provide the maximum quantity of carbohydrates during competition & avoid excess gastrointestinal transit &/or complications. Each athlete has different preferences in regards to the type of carbohydrates given. It is important to trial different sports drinks, bars, gels, or even high carbohydrate foods during training at the recommended quantities identified, & assess which is the best tolerated for competition use.

Post competition

Immediately post competition, provide the body with a large portion of carbohydrate (1.2gCHO/kgbw, ~80gCHO) rich food/drink, with a small amount of protein (0.4gprotein/kgbw, ~30g protein) to aid the recovery process (energy & tissue repair). Drink caffeine & alcohol free fluid with electrolytes, until urine becomes clear (small & frequent drinking). Nutrient rich fluids in the recovery period will help provide the body with carbohydrates, proteins as well as fluids.

Hydration

Providing sufficient fluids to your exercising body is extremely important in regards to achieving optimal performance during training & competition. The hotter & more humid the exercising environment, the higher the water & electrolyte losses your body will experience. Therefore, it is important to replace these losses & avoid dehydration, fatigue, & total decreases in training & competition performance.

The main functions of water in our body are: Acts as the main transport background for gases & nutrients. Act as a main background medium for chemical reactions. Acts as a main background medium for cell communications. Helps in the maintenance of body structure. Helps gases diffuse across membranes. Very important in thermoregulation (controlling body temperature).

EXERCISE ↑ Intensity & ↑ duration=  ↑ Fluid & electrolyte losses  

ENVIRONMENT ↑ Temperature & ↑ humidity=  ↑ Fluid & electrolyte losses  

TOTAL BODY FLUID & ELECTROLYTE LOSSES

Total fluid & electrolyte losses  GREATER THAN 

Total fluid & electrolyte intake 

Total fluid & electrolyte losses  EQUAL 

Total fluid & electrolyte intake 

DEHYDRATION, FATIGUE, DECREASES IN SPORTS 

PERFORMANCE 

OPTIMAL FLUID BALANCE 

How do you gain & lose body water:

Water gains Food

Drinks Metabolic activity (muscle

glycogen breakdown)

Water losses Urine Faeces Sweat

Respiratory activity

Sport & exercise dramatically increase water losses through sweat & respiration: The more intense & prolonged the exercise bout, & the more hotter/humid the environment is, the more sweat your body produces to try & keep cool. As exercise intensity increases your breath rate increases. If you do a long duration exercise session the total number of breath taken during that particular session will be very high. You loss water through your normal respiratory activity (breathing); therefore, the more you breathe the more water you lose; especially in cooler/dry environments. If your fluid & electrolyte losses are greater than your intake, you will become dehydrated. Dehydration is associated with: ↑ heart rate at rest & during exercise. ↑ cardiac volume. ↑ blood thickness (viscosity). ↑ blood pressure at rest & during exercise. ↑ stress hormones. ↑ body temperature at rest & during exercise. ↓ gastrointestinal activity. Production of darkish urine. Central fatigue (dizziness, nausea, confusion, disorientation). ↓ in the body’s enzyme activity. ↑ in the body’s carbohydrate metabolism.

“TOTAL DECREASE IN EXERCISE PERFORMANCE”

How can you identify & replace fluid losses to avoid dehydration: 1. Electrolyte balance. 2. Weight control. 3. Urine colour guide. 4. Fluid solutions.

Electrolyte balance:

Electrolytes are minerals (sodium, chloride, potassium, calcium, magnesium, phosphate) that posses different electron charges, which are extremely important in regulating body water around the different compartments of your body. The body’s two main water compartments which are affected by your fluid balance are: 1. Extracellular fluids (the water in our blood). 2. Intracellular fluids (the water in our body cells, e.g. muscle cells). The concentration of electrolytes in these compartments depends on the type of electrolyte & its main function in regards to hydration (pushing water into cells or pushing water into the blood). A summary of your body’s electrolyte activities is show below:

EElleeccttrroollyytteess CCoonncceennttrraattiioonn iinn sswweeaatt ((mmmmooll//ll))

CCoonncceennttrraattiioonn iinn eexxttrraacceelllluullaarr fflluuiiddss ((mmmmooll//ll))

CCoonncceennttrraattiioonn iinn iinnttrraacceelllluullaarr fflluuiiddss ((mmmmooll//ll))

SSooddiiuumm ((NNaa++)) 2200--880011 113300--115500 1100 PPoottaassssiiuumm ((KK++)) 44--88 33..22--55..55 115500 CCaallcciiuumm ((CCaa22++)) 00--11 22..11--22..99 00 MMaaggnneessiiuumm ((MMgg22++)) <<22..00 00..77--11..55 1155 CChhlloorriiddee ((CCll--)) 2200--6600 9966--111100 88 PPhhoosspphhaattee ((HHPPOO44

22--)) 00..11--00..22 00..77--11..66 6655 -- MMaaiinn iinnttrraacceelllluullaarr eelleeccttrroollyyttee == PPoottaassssiiuumm ((KK++)),, -- MMaaiinn eexxttrraacceelllluullaarr eelleeccttrroollyyttee == SSooddiiuumm ((NNaa++)),, 11 AA llaarrggee aammoouunntt ooff ssooddiiuumm ((ssaalltt)) iiss lloosstt iinn sswweeaatt.. TThhee ggrreeaatteerr tthhee sswweeaatt pprroodduuccttiioonn,, tthhee ggrreeaatteerr tthhee ssooddiiuumm lloosssseess..

Electrolytes are important in optimising hydration prior to training & competition, & are essential in assisting rehydration after training & competition. Therefore, it is important that you take sufficient electrolytes via a balanced diet. Since there are large sodium losses in sweat, it is recommended to add a pinch of salt in all your training/competition & post training/competition drinks. Otherwise, rehydration and euhydration will not be optimal & a state of mild dehydration may persist despite sufficient quantities of plain water being taken.

Weight control:

Most acute changes in your body weight that occur during exercise are reported to be due to losses of body water & muscle stored carbohydrates. If you weigh yourself before training/competition & then again after training/competition, noting the difference between the two weights, this can give you an estimated measure of fluid and carbohydrate changes during a particular training session/competition. From this weight loss, you can program you fluid and carbohydrate intake volumes and timing to prevent >2% weight loss during exercise bouts. It is important to note that total urine production during exercise is reduced because of hormone activity stimulated by the exercise itself. Therefore, there is a total decrease in water lost through urine during exercise.

Urine colour guide:

The colour of your urine can give a good indication of how much fluid you are giving your body. Clear or light coloured urine generally indicate that your body has sufficient water for hydration. Whereas, a darkish, bland colour urine indicates dehydration. A urine colour chart (Hydration Guide) has been provided with this hydration information booklet.

How to use your Hydration Guide: Optimal hydration can only be achieved at urine colour 1,2, or 3. Colours 4 & 5 represents initial stages of mild dehydration. Colours 6, 7, & 8 represents severe dehydration

Important factors to take into consideration when interpreting your urine colour, include: Large intakes of plain water will produce clear urine & provide a water source for the body. Be aware that optimal hydration can only be achieved with the help of electrolytes. Therefore, a clear urine colour only signifies water availability. The body’s electrolyte and nutritional status will determine whether the available water will enter into the body’s cells & optimise hydration. Caffeinated & alcoholic beverages will promote excess clear urine, but will not help with optimising hydration. You should avoid excess intakes of caffeinated or alcoholic beverages & select non-caffeinated/non-alcoholic drink to optimise hydration. Large consumptions of fruit, certain vegetables, medications, & nutritional supplements may produce excessive colour in the urine. However, this colour is generally bright & vivid.

Important note: The previously suggested methods to monitor hydration status are only tools to be used in catering for individual hydration needs.

It is also important to drink to thirst and not over-hydrate, which may also cause serious complications.

Fluid solutions: Fluid solutions can be used to provide your body with water & rapid carbohydrate energy during training & competition. There appropriate applications are listed below:

Hypotonic solution (<4%)

Isotonic Solution (4-8%)

Hypertonic Solution (>10%)

Electrolyte solution

Carbohydrate Concentration

(g CHO/100ml)

<4 4-8 >10 0-2

Objective

Water replacement with a small amount of quick energy.

Water & rapid energy replacement.

Mainly general energy replacement with accompanying water.

Water replacement.

Application

During aerobic exercise in hot/humid (>30°C) environments,

Pre training, During aerobic exercise, Recovery post training/competition.

Recovery post training/competition, Carbo-loading feeding regime pre competition.

Rehydration, During training in hot/ humid environments (>30°C).

Carbohydrate sources that can be used to make up these solutions includes: - Sports drink powders - Dextrose powders - Maltodextrin powders - Sugar - Honey - Normal squash can also be used to make up the appropriate solution - Fruit juice - Sodas Avoid the use of pure fructose powders, sweeteners- saccharin, acesulfameK, aspartame, sucralose, sorbitol, & beverages containing sweeteners- no added sugar/diet drinks, during the making-up of these solutions. Adding a pinch of salt to your solution mix will aid in the delivery of the water & carbohydrates to the body. The salt will also provide a sodium source, which compensates for the losses through sweat & acts as an electrolyte. The application of appropriate dental hygiene is important to avoid dental complications if consuming large amount of carbohydrate solutions in order to meet training & competition energy & fluid requirements.