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Nutrition (Midterm)pm me in facebook if dili ninyo madownload or ma'use.God bless. :)
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ENERGYENERGY
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Calorie - used as standard unit for measuring the energy value of food- amount of heat necessary to raise 1 gram of water by 1�C ◦measures human energy expenditures
1 Kcal = 4.184 kilojoules (KJ)1000 KJ = 1 megajoule (MJ)1000 Kcal = 4.184 MJ1 MJ = 239 Kcal
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Methods of Energy Methods of Energy MeasurementMeasurement
Direct calorimetryMeasures amount of energy expended by
monitoring heat productiona. Bomb calorimeter – heat of combustion =
gross energy value of foodb. Respiration chamber – heat released from
a person’s body determine how much energy each activity has burned for that person
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Indirect calorimetry◦Measured by determining with a respirometer
the oxygen consumption and carbon dioxide production of the body in a given period of time
Volume of CO2 Eliminated
RQ = ————————————Volume of O2 Consumed
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Indirect Calorimeter- Atwater (physiologic fuel value of food)
Energy PathwaysEnergy PathwaysGlycolysis – major pathway of CHO
metabolism; 1 glucose 2 pyruvate anaerobic
Pyruvate acetyl CoA
TCA cycle additional ATP and Carbon dioxide
Electron transport chain Water
WMSU BSND Review 2007
GlucoseGlucoseThe fate of pyruvate
◦Anaerobic vs. aerobic pathways
Occurs in the cytoplasmPyruvic acid & ATP
Sprint activity
Occurs in the mitochondria CoA (Pyruvic acid +Coenzyme)Aerobic exercise
GlucoseGlucose
The fate of pyruvate ◦AnaerobicPyruvate-to-lactic acid◦Cori cycle
GlucoseGlucoseThe fate of pyruvate
◦AerobicPyruvate-to-acetyl CoA
Glycerol & Fatty Glycerol & Fatty AcidsAcids
Fatty acids-to-acetyl CoA◦Beta-oxidation (mitochondria)
WMSU BSND Review 2007
Amino AcidsAmino AcidsAmino acids-to-acetyl CoA
WMSU BSND Review 2007
Amino AcidsAmino AcidsDeamination
◦Keto acid◦Ammonia
Amino AcidsAmino AcidsTransamination
Amino AcidsAmino Acids Ammonia- to-urea
Urea excretion via the kidneys
Economics of FeastingEconomics of Feasting
Excess protein
Excess carbohydrate
Excess fat
Economics of FeastingEconomics of Feasting
WMSU BSND Review 2007
Economics of FastingEconomics of Fasting
Economics of FastingEconomics of FastingGlucose needed for the brain
Protein meets glucose needs
Economics of FastingEconomics of FastingShift to ketosis
Economics of FastingEconomics of FastingSuppression of appetite
Slowing of metabolism
Symptoms of starvation
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Energy BalanceEnergy Balance
Weight Stability:Energy intake balances with energy out
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Energy BalanceEnergy Balance Overweight and obesity result from
an energy imbalance
Body weight is the result of genes, metabolism, behavior, environment, culture and socio-economic status
Behavior and environment play a large role causing people to be overweight and obese (greatest areas for prevention and treatment actions)
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Positive & Negative Positive & Negative Energy BalanceEnergy Balance
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Energy IntakeEnergy IntakeWhat regulates our food intake?
◦ Hunger Prompts eating; physiological desire
Hypothalamus: center that control activities such as maintenance of water balance, temperature regulation, appetite control
◦ Appetite The integrated response to the sight, smell,
thought or taste of food that initiates or delays eating
◦ Satiation Feeling of satisfaction and fullness that occurs
during a meal signals to stop eating◦ Satiety
Feeling of satisfaction that occurs after a meal; inhibits eating until the next meal
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A Cascade of Regulation: HungerAppetiteSatiation and Satiety
WMSU BSND Review 2007 31
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Satiety hormone?Satiety hormone?Leptin
▪ An appetite-suppressing hormone
▪ Produced by adipose tissue▪ Travels to the brain▪ Directly linked to appetite and
body fatness▪ Gain of body fatness stimulates
leptin production (reduces food consumption resulting in fat loss)
▪ Loss of body fat reduces leptin secretion (increasing appetite)
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HYPOTHALAMUSHYPOTHALAMUSThe main function is homeostasisReceives inputs about the state of the
bodyDozens of chemical participate in
appetite control and energy balance▪ Neuropeptide Y ▪ causes CHO cravings ▪ initiates eating ▪ decreases energy expenditure ▪ increases fat storage
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COMPOSITION OF FOODS/MEALS COMPOSITION OF FOODS/MEALS IMPACTS SATIATION AND SATIETYIMPACTS SATIATION AND SATIETY
Protein – most satiating; may account for the popularity of high-protein weight loss diet
Complex CHO/Fibers – fill stomach, delay absorption of nutrients
Fat – weaker impact on satiation, however, in the intestine secretes CCK which signals satiety
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Energy ExpenditureEnergy ExpenditureEnergy Out: Components of Energy
Expenditure◦Basal Metabolism (BMR)◦Physical Activity (PA)◦Thermic Effect of Food (TEF)
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Basal Metabolic RateBasal Metabolic Rate
Basal metabolism – is the basic essential metabolic processes by the body at rest also defined as the minimum amount of energy required to carry out vital processes.
Basal metabolic rate – the amount of energy required for basal metabolic processes per unit of body weight per unit of time.
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BMR
Male = 1 kcal/kg IBW/hrFemale = .95 kcal/kg IBW/hr
Example: IBW 56 kg, FemaleBMR = .95 kcal x 56 x 24 hrs.
= 1276.8 kcal/day
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Energy ExpenditureEnergy Expenditure
BMR: 60 to 65%
PA: varies from individual
TEF: 10%
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Energy Balance: Energy Balance: Energy ExpenditureEnergy Expenditure
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Increase BMRIncrease BMR Decrease BMRDecrease BMR
Fever * StressTotal body weightSmoking * CaffeineHigh Lean Body Mass Rapid growthHot & cold ambient
tempPregnancy, lactationHyperthyroidismLarge body surface
area
AgingFemaleFasting/StarvationSleepHypothyroidism
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Physical activityPhysical activity
-Voluntary movement of the muscles and the support system
Types of activity % kcal/kg
Bedridden 25Sedentary (light) 30Moderate (active) 35Very active (heavy) 40Strenuous 45
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Example: Female, IBW = 56 kgs. BMR = 1276.8 kcal/day Activity = Light activity (30%)
PA = BMR x Activity = 1276.8 kcal/day x 30%= 383.04 kcal/day
Thermic Effect of Food (TEF or DIT)- estimate energy requirements of processing of food.
- on usual mixed diet- 6 to 10 % total energy expenditure for basal and physical activity- high protein diet – 15%- high fat and carbohydrate diet – 5%
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Energy Balance: Body Energy Balance: Body WeightWeight
Body Mass IndexBMI = weight (kg)
height (m)2
or
BMI = weight (lb) x 703 height (in)2
Healthy weight is 18.5 to 24.9 (WHO, 1979)
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Table 6. Proposed BMI Classification by Table 6. Proposed BMI Classification by
FAO/WHO (RENI, 2002)FAO/WHO (RENI, 2002)
ClassificationClassification BMI (kg/mBMI (kg/m22)) Risk of co-morbidities Risk of co-morbidities
UnderweightUnderweight < 18.5 Low
Normal Normal RangeRange
18.5 – 24.9 Average
OverweightOverweight 25.0-29.9 Increased
Obese Obese 30-39.9 Moderate
Extreme Extreme obeseobese
> 40 Severe
Estimating Energy RequirementEstimating Energy Requirement
Calculate the IBW using the tannhauser’s formula
Calculate the BMRCalculate the Physical ActivityCalculate the TEFCalculate the TER
1. IBW (Ideal BodyWeight)1. IBW (Ideal BodyWeight)
Steps:a. take height into cmb. Subtract the factor 100 and the result is the ideal body weight in kilograms (large frame)c. subtract 10% for medium frame (Filipinos)d. subtract another 10% for small frame
Note: do not round off the answer.
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Limitations of BMILimitations of BMI
BMI does not reflect body fatMay misclassify people (muscular)Used to reflect disease risksReflects height and weight – not body
composition
BMI = 31 Is this obese???
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BODY FAT/BODY COMPOSITIONBODY FAT/BODY COMPOSITION
Men and women vary in body composition
. Men typically have greater lean mass
. Women have greater body fat
. Normal Body Fat. Men – 12-20%. Women – 20-30%
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Energy MetabolismEnergy Metabolism
Glycogenesis (glucose to glycogen)Glycogenolysis (glycogen to glucose)Gluconeogenesis (amino acids to
glucose)Lipogenesis (glucose or FAAs to fats)Lipolysis (fats to FAAs & glycerol)
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Metabolic Energy Production: Metabolic Energy Production: Review & OverviewReview & OverviewReactants: glucose
◦Glycogen, FAAs◦Amino acids
PhosphorylationGlycolysis–cytoplasm
◦2 ATPs, anaerobicCitric Acid Cycle-2 ATPs, mitochondria,
aerobicElectron Transport systemHigh energy e-, 32 ATPs
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WMSU BSND Review 2007 53
Fat MetabolismFat Metabolism
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Pancreatic Hormones, Insulin & Pancreatic Hormones, Insulin & Glucagon Regulate MetabolismGlucagon Regulate Metabolism
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NUTRITION AND ALCOHOLNUTRITION AND ALCOHOL
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AlcoholAlcohol Class of organic compounds with hydroxyl groups (OH) Examples of alcohol:
H
H – C – OH
H – C – OH
H – C – OH
H
Glycerol: component of triglycerides
H
H – C – H
H – C – H
OH
Ethanol or Ethyl Alcohol: alcohol found in beer, wine, distilled spirits
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Facts About EthanolFacts About Ethanol
1 g ethanol = 7 kcal without additional nutrients
Medically defined as a depressant drug when taken in low levels euphoric effect
could dissolve lipids in cell membranes rapidly enter cells
Production of ethanol: anaerobic metabolism of CHO by microorganisms
“ proof” : amount of ethanol stated in distilled liquors
100 proof = 50% ethanol 80 proof = 40% ethanol
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Facts About AlcoholFacts About Alcohol
1 alcoholic drink contains ½ oz of pure ethanol
4-5 oz wine10 oz wine cooler12 oz beer
1 ¼ oz distilled liquor (80 proof- whiskey, scotch, rum,
vodka)
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Digestion, Metabolism and Digestion, Metabolism and UtilizationUtilization
A. In the Stomach- no digestion needed, quickly absorbed
- if stomach is empty, then 20% directly absorbed through gastric lining
- Alcohol absorption is minimized in the presence of food
- Alcohol in stomach breakdown by alcohol dehydrogenase
* Women produce less alcohol dehydrogenase
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B. In the Duodenum- Alcohol readily absorbed and metabolized compared to other nutrients transported through intestinal veins and capillaries to the liver
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C. In the Liver - Liver produces alcohol
dehydrogenase that oxidizes alcohol- Normally: liver breaks and uses fatty acids as its energy source- in the presence of alcohol, liver metabolize alcohol first instead of fat- Liver can process ½ oz of ethanol per our
alcohol consumed > available enzymes, extra alcohol circulates throughout the body
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Table 1. Effects of Alcohol on the BrainTable 1. Effects of Alcohol on the Brain
Blood R-OH Conc. Effect on Brain
0.05 Impaired judgment, relaxed inhibitions, altered mood, increased heart rate
0.10 Impaired coordination, delayed reaction time, exaggerated emotions, impaired peripheral vision, impaired ability to operate a vehicle
0.15 Slurred speech, blurred vision, staggered walk, seriously impaired coordination and judgment
0.20 Double vision, inability to walk
0.30 Uninhibited behavior, stupor, confusion, inability to comprehend
0.40-0.60 Unconsciousness, shock, coma, death due to cardiac or respiratory failure
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Table 2. Alcohol Doses and Blood LevelsTable 2. Alcohol Doses and Blood Levels
No. of Drinks
Percentage of blood alcohol
by body weight
100 lbs 120 lbs 150 lbs 180 lbs 200 lbs
2 0.08 0.06 0.05 0.04 0.04
4 0.15 0.13 0.10 0.08 0.08
6 0.23 0.19 0.15 0.13 0.11
8 0.30 0.25 0.20 0.17 0.15
12 0.45 0.36 0.30 0.25 0.23
14 0.52 0.42 0.35 0.34 0.27
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Table 3. Health Effects of Alcohol Table 3. Health Effects of Alcohol ConsumptionConsumption
What is the health problem?
What is the effect of alcohol?
Arthritis Increased risk of having gout
Cancer Increased risk of cancer of the liver, rectum, breast, pancreas, mouth, throat: very harmful when combined with tobacco or nicotine
Fetal alcohol syndrome Causes permanent physical, behavior, mental abnormalities in the fetus
Heart Disease Raises blood pressure, blood lipids, and increased risk for stroke
Diabetes May increase or decrease blood glucose levels
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Table 3. Health Effects of Alcohol Table 3. Health Effects of Alcohol ConsumptionConsumption
What is the health problem?
What is the effect of alcohol?
Kidney problems Enlarges the kidneys
Liver disease Fatty liver, cancer of the liver
Malnutrition Increased risk of having PEM and other vitamin/mineral deficiencies
Nervous disorders Causes dementia, impairs balance and memory
Obesity Increased energy intake
Psychological disturbances Causes depression, anxiety and insomnia
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Table 4. Myths and Truths about Table 4. Myths and Truths about AlcoholAlcohol
Myths Fact
Alcohol warms the body. Blood is momentarily diverted to skin overall effect is a cooling one
Wine and beer do not lead to addiction.
Substance abuse is directly related to amounts consumes and is not dependent on the kind of alcoholic beverage consumed
Mixing drinks gives a hangover.
Excessive alcohol intake of any kind results in a hangover
Walking will “sober up” a person.
Alcohol metabolism is time-dependent. Only liver cells not muscle cells can metabolize alcohol
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Table 4. Myths and Truths about Table 4. Myths and Truths about AlcoholAlcohol
Myths Fact
Caffeine offsets the effects of alcohol.
Caffeine is a stimulant but will not speed up alcohol metabolism
Driving coordination is still impaired after a night of drinking. Allow at least 24 hours for alcohol to be metabolized completely
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NUTRITION NUTRITION AND AND
PHYSICAL FITNESSPHYSICAL FITNESS
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Physical FitnessPhysical Fitness
A set of abilities individuals possess to perform specific types of physical activity
Physically fit individuals have energy for both planned and unplanned activities at home or the workspace
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Physical FitnessPhysical Fitness
Physical Activity can be classified as:◦Unstructured physical activityUsual activities of daily life
◦Structured physical activityPlanned program designed to improve physical fitness
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Physical FitnessPhysical Fitness
Benefits of physical fitness:◦Restful sleep◦Nutritional health◦Optimal body composition◦Optimal bone density◦Lower incidence of anxiety and depression◦Improves self image◦Improves circulation and lung function
"Those who do not find time for exercise will have to find time for illness." ~ Earl of Derby
Excessive Exercise Risks
ChildrenEnergy needs not achieved and limited growth and development
TeensInadequate energy intakeDietary protein used for energyAmenorrheaNegative calcium balance and reduced bone massSports anemia
AdultsPossible increased need for riboflavin and vitamin B6Exercise-related injuries
Pregnant WomenLow weight gainLow-birth-weight infant
Nursing mothersExcessive rate of weight loss, reducing milk production and limiting the infant growth
Older adultsExercise-related injuries leading to disability
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Components of FitnessComponents of Fitness
Flexibility – ability to bend and recover without injury
Muscle strength – ability of ,muscles to work against resistance
Muscle endurance – ability of muscle to contact repeatedly without being exhausted
Cardio-respiratory endurance – ability to perform large muscle dynamic exercise of moderate to high intensity for prolonged periods.
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Basic Elements of the Exercise Basic Elements of the Exercise PrescriptionPrescription
FrequencyIntensityTimeModeRate of Progression
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FrequencyFrequencyNumber of days per week
Hard/Easy principle
Active rest
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IntensityIntensity
Initial levels of fitness determine at what intensity a client should begin with.
Methods of determining intensity:◦% of Maximum heart rate◦heart rate reserve◦Perceived Exertion
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TimeTime
ACSM recommendation: “ every individual should accumulate 30 minutes or more of moderate physical activity on most , but preferably all days of the week”.
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ModeModeWhat the client likes or will do!Health and weight loss should involve
using large muscle groups.Weight bearing exercise for
strengthening bones.Specific exercise for performance.Swimming is not great for weight loss.
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Rate of ProgressionRate of Progression3 stages:
◦initial conditioning stage-4 weeks.◦improvement stage- 4 to 5 months.◦maintenance stage- begins 6 months after
start, can last a lifetime!
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Exercise PrescriptionExercise Prescription
Simultaneous increase in any 3 elements may overload the individual's physiological system increasing risk to exercise-related injuries and exercise burn out
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Stages of Progression in Stages of Progression in Exercise ProgramExercise Program
Stages:◦Initial Conditioning
◦Improvement
◦Maintenance
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Factors Related to Exercise Factors Related to Exercise Program AdherenceProgram Adherence
Biological Factors
Relative body fat
Overweight
Psychological Factors
Self motivation
Self efficacy
Attainment of exercise goals
Depression/anxiety/introversion
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Factors Related to Exercise Factors Related to Exercise Program AdherenceProgram Adherence
Social Factors
Family Support
Family Problems
Exercise/job Conflicts
Income and education levels
Behavioral Factors
Smoking
Leisure time
Credit training
Type A behavior prone
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Factors Related to Exercise Factors Related to Exercise Program AdherenceProgram Adherence
Program Factors
Social support
Location and convenience of exercise facility
Exercise leadership and supervision
Initial exercise intensity
Variety of exercise modes
Program costs
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Strategies to Increase Exercise Strategies to Increase Exercise Program AdherenceProgram AdherenceProgram Strategies
◦Offer both group and individual activities
◦Select time and locations that are convenient
for program participants
◦Offer variety of exercise and fitness activities
◦Monitor the progress of program participants
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Strategies to Increase Exercise Strategies to Increase Exercise Program AdherenceProgram AdherenceProgram Strategies
◦Set realistic short-term and long-term goals for
each participants
◦Educate participants about exercise, physical
fitness and health benefits
◦Provide incentive for exercise
◦Encourage social support
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Strategies to Increase Exercise Strategies to Increase Exercise Program AdherenceProgram Adherence
Behavioral Strategies for Exercise Leaders◦Be a positive role model
◦Show interest in participants
◦Exhibit enthusiasm
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Strategies to Increase Exercise Strategies to Increase Exercise Program AdherenceProgram Adherence
Behavioral Strategies for Exercise Leaders◦Develop good rapport with each participant
◦Motivate and encourage
◦Attend to orthopedic and musculoskeletal
problems of participants
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Importance of Importance of Nutrition in PerformanceNutrition in PerformanceInadequate intake of essential nutrients
impair performance due to:◦Inadequate energy supply◦Inability to regulate exercise metabolism at
an optimal level◦Decreased synthesis of key body tissues or
enzymes
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Importance of Importance of Nutrition in PerformanceNutrition in Performance
Excessive intake of essential nutrients impair performance results to:◦Increased proportions of body fat◦Poor athletic performance◦Increased risk of developing diseases◦Toxicity symptoms
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Energy Requirements Energy Requirements During PerformanceDuring Performance
Thermic Effect of
Food
Basal Metabolism
Physical Activity
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How the Body Stores EnergyHow the Body Stores Energy
Glycogen in liver
Fat in adipose Tissues
Glycogen is used to top-up the blood
glucose level
Majority of glycogen is stored
in muscles
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How the Body Stores EnergyHow the Body Stores Energy
Exercise converts stored energy to kinetic energy and heat
Muscles use energy at a rate directly proportional to the rate and intensity of the activity or exercise
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Factors that Influence Factors that Influence Fuel ChoicesFuel Choices
1. Fuel availability from the diet
2. Intensity and duration
3. Degree to which the body is conditioned to perform the activity
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Intensity and DurationIntensity and Duration
Activity Intensity
Activity Duration
Preferred Source
Fuel Oxygen Needed
Activity Example
Extreme < 30s ATP NO Shot put
Very High 30s – 3m Carb NO ¼ mile run
High3 - 20m
Carb and some fats
YEScycling,
swimming
Moderate> 20m
Fat and some carbs
YES hiking
FLUID INTAKE
The following are the guidelines to ensure adequate fluid replacement, leading to optimal performance
a. Eat a nutritionally balanced diet and drink adequate fluids during the 24-hour period before an event
b. Consume 2 cups of fluid 2 hours before exercise followed by another 2 cups 15 to 20 minutes before exercise and 4 to 6 oz fluid every 10 to 15 minutes during exercise.
c. Drink cool beverages to reduce body core temperature.
d. Consume sports drink to enhance fluid intake and absorption and help delay fatigue in endurance events lasting longer than 1 hour.
e. After exercise, consume sports drink to enhance palatability and further promote fluid replacement.