Performance Nutrition

Nikos Jakubiak MSc SENr RD HCPC registered

Performance Nutritionist

@Nikos_Jakubiak

“Don’t treat us any differently! Yes, in the long run some athletes with an

impairment may have to do something different than our able-bodied

counterparts, but don’t start out thinking we are any different. It is important

to listen, be supportive, and sometimes you may have to ‘think outside the

square’!”

Carol Cooke, Paralympic Cyclist From Sports Nutrition for Paralympic Athletes edited by Elizabeth Broad, CRC Press

“There is only one way to

happiness and that is to

cease worrying about things

which are beyond the power

or our will”

Epictetus, AD 55-135

Control the ‘controllables’

Optimum nutrition in elite athletes

Optimum Performance

Physical attributes (e.g. strength, fitness)

Mental skills & Motivation

Nutrition & Hydration

Technical skills

Support (staff, management etc.)

Performance driven lifestyle

Physique Equipment

Controllable factors impacting on performance

Base all main meals on starchy carbohydrates.

What nutrients do we need?

• Carbohydrates

• Proteins

• Fats

• Vitamins

• Minerals

• Water

Essential nutritional needs

From Nutrition

to Performance Nutrition

Optimum nutrition in elite athletes

Optimum nutrition for performance

Fuel training (Vol & Q) & competition

Achieve/maintain Optimal/required BM

Recovery during & post training & competition

Support physique adaptations e.g. MM

Support good current & long-term health

• Maintain motivation • Maintain +ve mood • Prevent injury

Reduce training attrition due to illness e.g. colds

Resist fatigue Maintain focus

‘Performance’ added motive in food choice

But, we seek the pleasure of food

Kringelbach 2015, Flavour

Needs analysis

Identify potential barriers

Plan intervention

Agree & implement

intervention

Monitor compliance

Evaluate & Reassess

Needs analysis:

Physical & metabolic

demands of events

Different events – different demands

(in calories, macronutrients, body mass, hydration & education)

• Impaired muscle power e.g. spinal cord injuries or spina bifida

• Impaired passive range of movement e.g. hypermobility of joints or joint

instability

• Limb deficiency e.g. amputation or congenital limb deficiency

• Leg length difference e.g. trauma or congenital deficiency

• Short stature e.g. growth hormone dysfunction

• Hypertonia e.g. cerebral palsy or multiple sclerosis

• Ataxia e.g. cerebral palsy or multiple sclerosis

• Athetosis e.g. cerebral palsy or multiple sclerosis

• Visual impairment

• Intellectual Impairment

Different condition – different demands

Identifying potential barriers

to implementing PN plan

• Inability to reach food from counters (at accommodation or camp) • support team need to be proactive e.g. check wheelchair access,

height and depth of tables used to lay out food, availability of appropriate trays and cutlery

• Inability to access snacks or fluids during competition (racket strapped on hand)

• better preparation e.g. remove unnecessary wrapping

• Journeys can take longer affecting meal times • some appropriate back up snacks & fluids should be available in

kit bags

• Risk of UTIs from deliberate restriction of fluid intake in order to manage urine output

• better planning for journey conditions & types of fluids needed (consider use of hypotonic or isotonic drinks)

• Pressure sores • higher requirement for protein

Potential challenges for wheelchair athletes

Disability athletes have to deal

regularly with the prevailing

able-bodied bias

Disability can also influence food choice as it may impact on:

• getting access to food

• deciding on preferred option (e.g. visually impaired)

• getting hold of food

• ingestion & digestion of food

• enjoyment of food

• comprehension of PN strategies (athletes with learning disabilities)

Barriers to athletes’ physical

& metabolic capacity

From a metabolic/nutrition standpoint, disability athletes

range from people with no impairment in their

biomechanical and physiological abilities to athletes with

severe impairments

What is the % of functional muscle mass?

Variability potential in daily use of calories

Non disability athlete

Disability (with no muscle impairments)

Disability (with partial muscle impairments)

Disability (with whole body muscle impairments)

Basal Metabolic Rate (BMR)

Limited variability Limited variability Limited variability Limited variability

Daily activities (not training)

Some variability Some variability Some variability Limited variability

Training High variability ↑↑ High variability ↑↑

High variability ↑

Limited variability

Hydration

Thermoregulation compromised by dehydration

• In some athletes with spinal cord injury thermoregulation can be compromised even when they are not dehydrated

• Hypotonic drinks (best used as fluid replacement)

For every1000ml of cold water add: A small amount of no added sugar squash for flavouring 20-30g table sugar (approx. 2 tablespoons) A pinch of table salt (the tip of a teaspoon) • Isotonic drinks ( as above & for short supply of energy in long sessions) For every 1000ml of cold water add: Some no added sugar squash for flavouring 50-70g of table sugar (approx. 4 tablespoons) A pinch of salt (the tip of a teaspoon) • How much of the sports drink you should have each day depends on: how

often, how hard, and for how long you exercise for. It also depends on the weather conditions (heat & humidity), how much you sweat, and of course your body size. Seek advice from a dietitian or a qualified sports nutritionist.

DIY sports drinks

Plan & Implement PN strategies

Various areas to address, not all relevant to every case but worth considering: • PN education to empower athletes

• Finding practical solutions

• Prioritise the changes needed

• Meal pattern, food choices, portion sizes &

rehydration • Meal planning and meal preparation skills

• Nutrition periodisation

• The nutritional value of meals and snacks

Proteins

Green

Vegetables

Starchy

Carbohydrates

Other Vegetables Fruits

Monitoring

Various options but not all relevant to every case: • Body mass

• Urine specific gravity or colour (some

medication can influence colour)

• Food diary

• Wellness diary

• Direct feedback from athlete

• Feedback from coach and support staff

©R

Evaluation

Various options but not all relevant to every case: • Change in performance behaviours

• Improvement in habitual food choices

• Appropriate change in body mass

• Appropriate change in skin folds

• Improvement in blood test results

• Impact on performance outcomes e.g.

agility test.

Motive for change: • Improve performance to secure top rank

Aim: • Improve agility

Objective: • Reduce skin folds and body mass (adjusted skin folds test)

Assessment • Lower limbs limited function but high training volume with upper body • Skin folds’ total high • Portion sizes similar to non-disabled peers Actions • Adjusted meal pattern, meal balance, portion sizes

Outcome • Body mass reduced by 4Kg, SFs by ~20% and agility scores improved

Example: wheelchair athlete

Motive for change: • Secure qualification for Paralympics

Aim: • Maintain strong performances throughout multi day events

Objective: • Minimise weight loss rate on week leading up, and during, events

Assessment • Previously bad diet and following advice attitude change 180° • Obsessed with low SFs (belief that lower SFs = faster times) • Often self catering accommodation but no culinary skills Actions • Prioritise & repeat standalone messages, supervised safe-cooking

methods to promote more autonomy, smoothies Outcome • Body mass stable during competitions & qualification achieved

Example: Learning disability

Vitamin D

0%

25%

50%

75%

100%

0 6 12 18 24

Sunshine in Athens, Glasgow and Stirling

Benefits from adequate sunshine

• Increase or maintenance of high vitamin D

• Increase of NO

• Improve mood

• Improve sleep quality

• Support healthy immune function

• Increase MSH (↑ melanin, ↓ appetite)

Risks of too much sunshine

• Skin damage (sunburn, premature aging of skin, ↑ risk of skin

cancer)

• Eye damage (always wear good sunglasses)

• Sun stroke

• UV index

• ‘Shadow’ rule

• Smartphone applications e.g. Dminder

How much sunshine for vitamin D?

Performance Nutrition

Nikos Jakubiak MSc SENr RD HCPC registered

Performance Nutritionist

Questions?

Comments?

@Nikos_Jakubiak