1.

Management of body
composition in athletes

1.1 Body fat loss

Advantageous of low levels of body fat

Improve power-to-mass ratio

Locomotive efficiency

Aesthetic appearance

More effective thermoregulation

Reduced energy cost


Does fat loss improve performance?

5-15% 16-28%

Sports Nutrition, 2006







More young female athletes report improvement of appearance than

improvement of performance as a reason for dieting

 Nick Broad



 GI Joe


 2014-2015

n = 926

Obesidade 19,8%
Excesso de peso 35,6%
Baixo Peso 1,7%

Prevalncia EPO futebol, luta livre e Obesidade 5x futebol americano vs.

remo > que NHANES (1999-2002) outros desportos

Menor velocidade Mais msculo

Menor agilidadade Mais fora

 Which energy deficit?


 Deficit 500 kcal/d
~ 0.5 kg/wk (only for obese > 30kg of fat)

Larger deficit per kg required with greater body fat

Reason why men lose more weight than women for a given energy deficit

Energy balance is dynamic

75-kg extra 100 kcal/d for 40y
190 kg. Real weight gain 2.7kg (Swinburn 1993)

TEI (and % macro) influence TEE

High-intensity Ex can blunt appetite-regulating hormones ( EI)

 SR: 0.7% BW/w; 470kcal (19%); 8wk

FR: 1.4% BW/w; 791kcal (30%); 5wk

21%

31%

Strength trained women ; 4w; HWR -1100 kcal/d or LWR -550 kcal/d

HWR
greater BM and FM loss

30% testosterone and SHBG

5% bench press strength but endurance squat in squat and CMJ

 4w; HWR -750 kcal/d or LWR -300 kcal/d

BM (2.2kg) and FM (1.7kg) only in HWR

= FFM, testosterone, cortisol, SHBG

CMJ and 20-m sprint time improved consistently only in HWR

Negative consequences of severe ER

Decreased ability to train at higher intensities

Increased risk of injury due to fatigue and loss of lean tissue

Increased risk of disordered eating behaviors

Increased risk of dehydration, especially if the diet is ketogenic

Increased risk of poor nutrient intakes

Increased emotional distress due to hunger, fatigue and stress

 Metabolic adaptation

 EE beyond weight loss

50% ER 24w
25% BM, 40% BMR (25% WL + 15% metabolic adaptation)

79 kcal/d (Camps 2013) to 504 kcal/d (Johannsen 2012)

Make further weight loss increasingly difficult and predispose to weight regain

Metabolic adaptation

1. Adaptive thermogenesis ( BMR, NEAT, TEF, EAT)

2. Increased mitochondrial (metabolic) efficiency ( UCP-3 and UCP-1)

3. Hormonal changes

Persist even 1y after cessation of weight loss

Endocrine response

leptin
satiety and EE

insulin
MPB and satiety

testosterone
MPS, Htc and adipogenesis

thyroid hormones
thermogenesis and metabolic rate

ghrelin
appetite

cortisol
MPB and inhibit leptin

 Preparation Competition Recovery
5d/w 2d/w
Prot 36% 30% 46% 28%
CHO 36% 48% 29% 37%
FAT 28% 22% 25% 34%

 Preparation Competition Recovery

TBW (L) 62,6 62,1 60,3

Cardiovascular and blood parameters
recovered quickly
HR (bpm) 53 27 47

BP (mmHg) 132/69 104/56 116/64 Mood improved 1 month after

HDL (mg/dL) 49 79 53

Weight (kg) 102,9 88,9 99,0 Strength and anaerobic performance

Body fat (%) 14,8% 4,5% 14,6% began to recover 2 months after
FFM (kg) 87,65 84,84 84,59

Mood (units) 6 43 4 Hormonal profile returned to baseline

Bench press levels within 3 months
161 147 150
1RM (kg)



Athletes should follow diet and exercise regimens that provide energy
availabilities of 3045 kcal/kg FFM/d while training to reduce body fat

Periodic refeeding (cheat meals)

Overfeeding period, 1-2d/ w, in which EI is raised slightly above maintenance levels

Aim
temporarily increase leptin and metabolic rate

Only studies of 3 days (Chin-Chance 2000, Dirlewanger 2000)

 3d CHO (not fat) overfeeding 28% leptin, 7% TDEE, = BMR and EAT

7% TDEE
138 kcal (36 kcal due to the thermic effect of CHO intake)

More research is needed to determine if is an efficacious strategy

Post-starvation obesity

Metabolic adaptations + dramatic increase in EI
rapid accumulation of fat mass

Repeated cycles of weight loss associated with long-term weight gain

Reverse dieting

Slowly increasing EI to restore hormone levels and metabolic rate to baseline

Despite popularity, research is needed to evaluate its efficacy

 High-quality weight loss

25% of the BM lost is FFM (almost exclusively muscle) and 75% FM

Consequences of muscle mass loss

Glycaemia deregulation

Increased postprandial lipidemia

Decreased BMR

Tendency to plateau in weight loss and risk for weight regain

Adverses effects on long-term metabolic health

How to attenuate losses in LBM?

Structured resistance training program

Sufficient protein intake

High-protein diets + resistance exercise work synergistically

 EB followed by 5d ED (30 kcal/kg FFM/d) 27% MPS

Resistance exercise (REX) restored MPS to values at rest in EB

15 and 30 g of whey after REX in ED MPS 16 and 34% above resting EB

 Which diet for athletes?

1.000.000 question

What balance of macronutrients promote a greater fat loss, relative retention

of lean mass, and still allow athletic performance to remain uncompromised?

[28d-12m]

> 12 months; HP ( 25%) vs. LP ( 20%), both low fat ( 30%)

2w 40%ER; 1g/kg (15%) vs 2.3g/kg (35%); both 51% CHO (3.3g/kg)

= Performance

1.6 0.3

 Hypoenergetic (- 500kcal/d)

% Prot 16(< 2) 18 (7.5) 28 (15)

(dairy)
% Fat 28 24 31

% CHO 56 58 41

Frame around Protein

Higher protein intakes during ER enhance the retention of FFM (Helms13,

Krieger 06, Wycherley 12), particularly when combined with exercise (Mettler 10)

1.8 - 2.7 g/kg (Helms 2013, Phillips 2011)

requirements: training, lean conditions, habitual high-Pro diet

Mechanisms?

Satiety ( insulin, ketosis)

Thermic effect of food
Protein synthesis
gluconeogenesis
fat oxidation
cortisol-induced muscle loss
More monotonous diet
Protein seeking behavior
Tryptophan
serotonine anorexigenic ?
Leucine sparing effect on muscle mass ?

High-protein diets (30% vs 15%) associated with increased satiety

and reductions in energy intake ( 441kcal/d) over 12-week

ER isocaloric diets
Fat intake 30% TEI

Reduce Fat and/or CHO?




 Marker Cut off points*

Triglyceride/HDL cholesterol 1.8 SI (3.0 traditional units)

Triglyceride 1.47 mmol/L (130 mg/dL)

Fasting Insulin Level 108 pmol/L (U/mL)



 1. Larger energy deficit (1%)
0,5%/w
21% Rossow 2013
0,7%w
32% Kistler 2014
2. Lower CHO intake (20%)
36% Rossow 2013
37% Kistler 2014
3. More endurance exercise

 What science on athletes says about low CHO-diets?

1w 2.3g/kg vs 3.2 g/kg CHO
muscular endurance (Walberg 1988)

Low CHO high-intensity sprint (Havemann 2006)

2d 25% vs 70% CHO 32% time to exhaustion cycling 115% VO2max (Lima-Silva 2013)

3.5d 4 vs 8g/kg CHO distance soccer (8077m vs 93280m) (Souglis 2013)

48h 2.1 vs 11.1g/kg CHO oxidation
performance squash (Raman 2013)

What science on athletes also says about low CHO-diets??

1-2w 2.5g/kg no impairment in endurance performance (Yeo 2011)

1w 5.4% CHO = strength and power (Sawyer 2013)

4w low-CHO diet (246g, 40%) on running TT, cortisol (Piacentini 2012)

30d ketogenic diet (22g) no differences on strength (Paoli 2012)

CHO threshold?

While low CHO is effective for weight loss, a threshold appears to exist
where further reductions negatively impact performance and LBM

That threshold need to be determined individually

 Decide case-by-case

High intensity training Fat; Low intensity and volume training CHO

Insulin sensitive
Fat; Insulin resistant
CHO (Cornier 2005)

Once reached the desired level of leanness, reduce deficit by CHO

Potential risks of Low-CHO Diets

Fib, Ca, K, Mg, Fe, folates, thiamine
multivitamin supplement

Halitosis, constipation, headache, muscle cramps, diarrhea, asthenia,

<concentration, dehydration, and difficulty in maintaining weight loss

Fat in diet

High-fat diets facilitate passive overconsumption

Low-fat diets more effective for weight maintenance and prevention of weight gain

ER required
gradual 10-20% to prevent feeeling to hungry

Other approaches?

 Spread food intake throughout the day

Increase dairy consumption

Low-energy- dense diet

Eating breakfast

Low IG

Meal frequecy studies

1 vs 3 meals/d
weight loss and FM loss, gain FFM (Stote 07)

3 vs 14 meals/d
RMR, satiety and glycemia, hunger (Munster 12)

3 vs 6 meals/d
glucose (Holmstrup 10)

3 vs 6 meals/d
fullness ratings , 9% PYY (Leidy 10)

3 vs 6 meals/d
worst for improving body composition (Arciero 13)

 So?

Very lows or highs meal frequencies threaten FFM preservation and hunger control

Impact of meal frequency at moderate ranges (36 meals/d) likely negligible

Calcium

High-dairy diet lipolysis and fat oxidation (30g/d) (Melanson05), 5.4% BF

(Zemel05)

ER 1250 mg vs 450mg/d 70% weight loss and 64% FM loss (Zemel 04)

Effect greater wih dairy rather than supplements (Zemel 04)

Benefits more pronounced if regular intake is low (<600md/d) (Major 2009)

Mechanisms of calcium action

Calcitriol adipocytary Ca lipogenesis and lipolysis

Calcitriol UCP2 expression

Calcitriol upregulates 11-HSD 1 and cortisol release
visceral adiposity

Calcium FA absorption ( 2.5x fecal excretion)

BCAAs/Leucine

Depletion of calcium from milk reduces its anti-obesity efficacy 40-50%

Leucine mitochondrial biogenesis and fat oxidation

33.4 g/d (300 kcal) fat oxidation (Zemel 2009)

Whey supplement on ER
fat loss and FFM (Frestedt 2008)


 32%

Low-Energy Dense Diets

Effective at reducing energy intake, facilitating weight loss and prevention of

weight regain, and maintaining satiety

whole fruits and vegetables, whole grains, low-fat dairy, legumes/beans, and
lean meats, sweetened, alcoholic beverages and high-fat foods

During ER diet, sport foods, that are energy-dense, less satiating, should be
strategically placed around exercise



Low-GI diets

Promote satiety and maintain insulin sensitivity (Brand-Miller 2008)

Favorable affects weight loss, better management of glucose and insulin, and

reductions in triglyceride levels and blood pressure (Radulian 2009)

Long-term studies for WL produced inconclusive results

Low-GI diets may be a problem for endurance athletes

Eating breakfast

Associated with a energy intake and bodyweight (Timlin 2007)

Breakfast eaters consumed 17% fewer kcals at lunch (Astbury 2011)

Skipping breakfast may lead to an upregulation of appetite (Pereira 2011)

Include low-fat high-quality protein (e.g. low-fat dairy, egg whites, lean meats) and
fiber- and nutrient-rich foods (e.g. whole grains and fruits)





1.2 Making weight

 The majority of wrestlers cut weight by reducing calories and
restricting fluids starting 2 days before the competition

To achieve necessary weight loss, wrestlers approach a 5% dehydration

No loss of FFM because of weight cycling was evident to achieve

competitive weight



 Dehydration and electrolyte manipulation in the final days and hours prior to

competition can be dangerous and may not improve appearance.

Increasing carbohydrate intake at the end of preparation has a theoretical

rationale to improve appearance, however it is understudied.