III.

HUMAN ENERGY AND PERFORMANCE

1. Importance of nutrition in performance

Good nutrition can enhance sporting performance. A well-planned, nutritious diet should meet
most of an athlete's vitamin and mineral needs, and provide enough protein to promote muscle
growth and repair. Foods rich in unrefined carbohydrates, like wholegrain breads and cereals,
should form the basis of the diet.

2. Energy requirement during performance and how the body stores and uses energy

Nutrition and exercise

The link between good health and good nutrition is well established. Interest in nutrition and
its impact on sporting performance is now a science in itself.

Whether you are a competing athlete, a weekend sports player or a dedicated daily exerciser,
the foundation to improved performance is a nutritionally adequate diet.

Daily training diet requirements

The basic training diet should be sufficient to:

 provide enough energy and nutrients to meet the demands of training and exercise
 enhance adaptation and recovery between training sessions
 include a wide variety of foods like wholegrain breads and
cereals, vegetables (particularly leafy green varieties), fruit, lean meat and low-fat dairy
products to enhance long term nutrition habits and behaviours
 enable the athlete to achieve optimal body weight and body fat levels for performance
 provide adequate fluids to ensure maximum hydration before, during and after exercise
 promote the short and long-term health of athletes.

The athlete’s diet

An athlete’s diet should be similar to that recommended for the general public, with energy
intake divided into:

 45 to 65% from carbohydrates

 15 to 25% from protein
 20 to 35% from fat.

Athletes who exercise strenuously for more than 60 to 90 minutes every day may need to
increase the amount of energy they consume, particularly from carbohydrate sources.
Guidelines for carbohydrate and protein based on grams intake per kilogram (g/kg) of body
weight are also available.

The current recommendations for fat intake are for most athletes to follow similar
recommendations to those given for the general community, with the preference for fats
coming from olive oils, avocado, nuts and seeds.

Athletes should also aim to minimise intake of high-fat foods such as biscuits, cakes, pastries,
chips and fried foods.

Carbohydrates and exercise

During digestion, all carbohydrates are broken down into sugars (primarily glucose), which are
the body’s primary energy source.

After absorption, glucose can be converted into glycogen and stored in the liver and muscle
tissue. It can then be used as a key energy source during exercise to fuel exercising muscle
tissue and other body systems.

Athletes can increase their stores of glycogen by regularly eating high-carbohydrate foods.

If carbohydrate in the diet is restricted, a person’s ability to exercise may be compromised

because there is not enough glycogen kept in storage to fuel the body.

If dietary protein intake is insufficient, this can result in a loss of protein (muscle) tissue,
because the body will start to break down muscle tissue to meet its energy needs, and may
increase the risk of infections and illness.

Carbohydrates are essential for fuel and recovery

Current recommendations for carbohydrate requirements vary depending on the duration,

frequency and intensity of exercise.

Foods rich in unrefined carbohydrates, like wholegrain breads and cereals, should form the
basis of the athlete’s diet. More refined carbohydrate foods (such as white bread, jams and
lollies) are useful to boost the total intake of carbohydrate, particularly for very active people.

Athletes are advised to adjust the amount of carbohydrate they consume for fuelling and
recovery to suit their exercise level. For example:

 light intensity exercise (30 mins/day): 3 to 5 g/kg/day

 moderate intensity exercise (60 mins/day): 5 to 7 g/kg/day
 endurance exercise (1 to 3 hrs/day): 6 to 10 g/kg/day
 extreme endurance exercise (more than 4 hrs/day): 8 to 12 g/kg/day.
Training with low carbohydrate availability

There may be some situations in an athlete’s training program that warrants a period of
restricted carbohydrate intake. A more recent strategy adopted by some athletes is to train
with low body carbohydrate levels and intakes (train low).

There is accumulating evidence that carefully planned periods of training with low
carbohydrate availability may enhance some of the adaptations in muscle to the training
program. However, currently the benefits of this approach to athletic performance are unclear.

Sporting performance and glycaemic index

The glycaemic index (GI) ranks food and fluids by how ‘carbohydrate-rich’ they are and how
quickly they affect the body’s blood sugar levels. The GI has become of increasing interest to
athletes in the area of sports nutrition.

Evidence does not generally support a significant impact of manipulation of GI in the diet on
exercise performance, assuming total carbohydrate and energy intake are sufficient in an
athlete’s diet. However, the particular timing of ingestion of carbohydrate foods with different
GIs around exercise might be important.

There is a suggestion that low GI foods may be useful before exercise to provide a more
sustained energy release, although evidence is not convincing in terms of any resulting
performance benefit.

Moderate to high GI foods and fluids may be the most beneficial during exercise and in the
early recovery period. However, it is important to remember the type and timing of food eaten
should be tailored to personal preferences and to maximise the performance of the particular
sport in which the person is involved.

Pre-event meal

The pre-event meal is an important part of the athlete’s pre-exercise preparation.

A high-carbohydrate meal 3 to 4 hours before exercise is thought to have a positive effect on

performance. A small snack one to 2 hours before exercise may also benefit performance.

It is important to ensure good hydration prior to an event. Consuming approximately 500 ml of

fluid in the 2 to 4 hours prior to an event may be a good general strategy to take.

Some people may experience a negative response to eating close to exercise. A meal high in fat,
protein or fibre is likely to increase the risk of digestive discomfort. It is recommended that
meals just before exercise should be high in carbohydrates as they do not cause gastrointestinal
upset.
Examples of appropriate pre-exercise meals and snacks include cereal and low-fat milk,
toast/muffins/crumpets, fruit salad and yoghurt, pasta with tomato-based sauce, a low-fat
breakfast or muesli bar, or low-fat creamed rice. Liquid meal supplements may also be
appropriate, particularly for athletes who suffer from pre-event nerves.

For athletes involved in events lasting less than 60 minutes in duration, a mouth rinse with a
carbohydrate beverage may be sufficient to help improve performance. Benefits of this strategy
appear to relate to effects on the brain and central nervous system.

Eating during exercise

During exercise lasting more than 60 minutes, an intake of carbohydrate is required to top up
blood glucose levels and delay fatigue.

Current recommendations suggest 30 to 60 g of carbohydrate is sufficient, and can be in the

form of lollies, sports gels, sports drinks, low-fat muesli and sports bars or sandwiches with
white bread.

It is important to start your intake early in exercise and to consume regular amounts
throughout the exercise period.

It is also important to consume regular fluid during prolonged exercise to avoid dehydration.
Sports drinks, diluted fruit juice and water are suitable choices. For people exercising for more
than 4 hours, up to 90 grams of carbohydrate per hour is recommended.

Eating after exercise

Rapid replacement of glycogen is important following exercise.

Carbohydrate foods and fluids should be consumed after exercise, particularly in the first one to
2 hours after exercise.

While consuming sufficient total carbohydrate post-exercise is important, the type of

carbohydrate source might also be important, particularly if a second training session or event
will occur less than 8 hours later. In these situations, athletes should choose carbohydrate
sources with a high GI (for example white bread, white rice, white potatoes) in the first half
hour or so after exercise. This should be continued until the normal meal pattern resumes.

Suitable choices to start refuelling include sports drinks, juices, cereal and low-fat milk, low-fat
flavoured milk, sandwiches, pasta, muffins/crumpets, fruit and yoghurt.

Since most athletes develop a fluid deficit during exercise, replenishment of fluids post-exercise
is also a very important consideration for optimal recovery. It is recommended that athletes
consume 1.25 to 1.5 L of (non-alcoholic) fluid for every kilogram of body weight lost during
exercise.

Protein and sporting performance

Protein is an important part of a training diet and plays a key role in post-exercise recovery and
repair. Protein needs are generally met (and often exceeded) by most athletes who consume
sufficient energy in their diet.

The amount of protein recommended for sporting people is only slightly higher than that
recommended for the general public. For example:

 General public and active people – the daily recommended amount of protein is 0.8 to
1.0 g/kg of body weight (a 60 kg person should eat around 45 to 60 g of protein daily).
 Sports people involved in non-endurance events – people who exercise daily for 45 to
60 minutes should consume between 1.0 to 1.2 g/kg of body weight per day.
 Sports people involved in endurance events and strength events – people who exercise
for longer periods (more than one hour) or who are involved in strength exercise, such
as weight lifting, should consume between 1.2 to 2.0 g protein/kg of body weight per
day.
 Athletes trying to lose weight on a reduced energy diet – increased protein intakes up to
2.0 g/kg of body weight per day can be beneficial in reducing loss of muscle mass.

For athletes interested in increasing lean mass or muscle protein synthesis, consumption of a
high-quality protein source such as whey protein or milk containing around 20 to 25 g protein in
close proximity to exercise (for example, within the period immediately to 2 hours after
exercise) may be beneficial.

As a general approach to achieving optimal protein intakes, it is suggested to space out protein
intake fairly evenly over the course of a day, for instance around 25 to 30 g protein every 3 to 5
hours, including as part of regular meals.

There is currently a lack of evidence to show that protein supplements directly improve athletic
performance. Therefore, for most athletes, additional protein supplements are unlikely to
improve sport performance.

While more research is required, other concerns associated with very high-protein diets
include:

 increased cost
 potential negative impacts on bones and kidney function
 increased body weight if protein choices are also high in fat
 increased cancer risk (particularly with high red or processed meat intakes)
  displacement of other nutritious foods in the diet, such as bread, cereal, fruit and
vegetables.

Using nutritional supplements to improve sporting performance

A well-planned diet will meet your vitamin and mineral needs. Supplements will only be of any
benefit if your diet is inadequate or you have a diagnosed deficiency, such as
an iron or calcium deficiency. There is no evidence that extra doses of vitamins improve
sporting performance.

Nutritional supplements can be found in pill, tablet, capsule, powder or liquid form, and cover a
broad range of products including:

 vitamins
 minerals
 herbs
 meal supplements
 sports nutrition products
 natural food supplements.

Before using supplements, you should consider what else you can do to improve your sporting
performance – diet, training and lifestyle changes are all more proven and cost effective ways
to improve your performance.

Relatively few supplements that claim performance benefits are supported by sound scientific
evidence. Use of vitamin and mineral supplements is also potentially dangerous. Supplements
should not be taken without the advice of a qualified health professional.

It’s best if dietary imbalances are adjusted after analysing and altering your diet, instead of by
using a supplement or pill.

The ethical use of sports supplements is a personal choice by athletes, and it remains
controversial. It’s important to remember that if you take supplements, you are responsible for
the ingestion of these and any subsequent health, legal or safety consequences that may occur.
If taking supplements, you are also at risk of committing an anti-doping rule violation no matter
what level of sport you play.

Water and sporting performance

Dehydration can impair athletic performance and, in extreme cases, may lead to collapse and
even death.

Drinking plenty of fluids before, during and after exercise is very important. Don’t wait until you
are thirsty. Fluid intake is particularly important for events lasting more than 60 minutes, of
high intensity or in warm conditions.

Water is a suitable drink, but sports drinks may be required, especially in endurance events or
warm climates. Sports drinks contain some sodium, which helps absorption. A sodium content
of 30 mmol/L (millimoles per litre) appears suitable in sports nutrition.

While insufficient hydration is a problem for many athletes, excess hydration may also be
potentially dangerous. In rare cases, athletes might consume excessive amounts of fluids that
dilute the blood too much, causing a low blood concentration of sodium. This condition is called
hyponatraemia, which can potentially lead to seizures, collapse, coma or even death if not
treated appropriately.

Consuming fluids at a level of 400 to 800 ml per hour of exercise might be a suitable starting
point to avoid dehydration and hyponatraemia, although intake should ideally be customised to
individual athletes, considering variable factors such as climate, sweat rates and tolerance.

IV. ISSUES AND CONTROVERSIES

1. Ergogenic Aids and Performance

For years people have routinely searched for ways to optimize physical performance, increase
the amount of work that can be accomplished under various environmental extremes, and
enhance recovery from a physically exhausting task. Aids that are used to increase physical
performance or enhance recovery from physical exertion are referred to as ergogenic aids. The
word ergogenic is derived from the Greek word ergon meaning “work” and the suffix -
genic meaning “producing.” Therefore, the word ergogenic literally means “work producing” or
“tending to increase work.”
Ergogenic aids are mechanical, nutritional, pharmacological, physiological and psychological
tools that athletes use to increase energy, performance and recovery. Commonly used
ergogenic aids include dried adrenal glands, amino acids, bee pollen, caffeine, carnitine,
chromium, creatine, ginseng, glucosamine and protein powders. Side effects from high doses
may include allergic reactions, central nervous system and gastrointestinal disorders, and
kidney damage.
Anabolic steroids, androstenedione (andro) and DHEA, beta-hydroxy-beta-methylbutyrate
(HMB), gamma hydroxybutyric acid (GHB) and human growth hormone (HGH) may cause
significant side effects, and, in some cases, death. The International Olympic Committee has
banned androstenedione and human growth hormone, and the National Collegiate Athletic
Association (NCAA) has banned caffeine at the 600-milligram level (six to eight 8-ounce cups
of brewed coffee daily) [43–46].
Consistent sport-specific training; well-designed sport-specific diets supported by adequate
fluids, vitamin and mineral supplements; and rest are still the safest strategies for sports
performance. The field of sports nutrition is growing to address these and other strategies.
Ergogenic aids are generally classified into five categories: (1) mechanical, (2) psychological, (3)
physiological, (4) pharmacological, and (5) nutritional. An example of a mechanical ergogenic
aid is the fiberglass pole for pole vaulting or the lightweight frame on a racing bike. A
psychological ergogenic aid might be hypnosis or mental rehearsal. Blood doping or
erythropoietin injections are considered powerful physiological ergogenic aids by virtue of their
ability to increase red blood cell mass and increase maximum aerobic capacity. Pharmacological
ergogenic aids might be the xanthines such as caffeine or the amphetamines. Carbohydrate and
protein supplements are examples of nutritional ergogenic aids. It should be noted that many
ergogenic aids can be classified into more than one category. For example, caffeine can be
classified as a nutritional or a pharmacological ergogenic aid. Likewise, bicarbonate could be
classified as a physiological or pharmacological ergogenic aid.
Of the various aids known to have ergogenic effects, many are natural foods or derivatives of
food products. This chapter identifies some of the more effective food components that have
been found to enhance physical performance and describes their methods of action. Some
potential yet unproved ergogenic aids are also discussed.
Food components or food derivatives that might have ergogenic effects are generally classified
as either a nutritional or a pharmacological ergogenic aid. Such aids enhance performance by:
1.acting as a central or peripheral nervous system stimulant,
2.increasing the stored amount or availability of a limiting substrate,
3.acting as a supplemental fuel source or reducing reliance on a limiting substrate during
prolonged physical exertion,
4.reducing or neutralizing metabolic by-products that interfere with energy-producing
reactions or muscle contraction, and
5.enhancing recovery.

2. Nutritional ergogenics

Athletes use a variety of nutritional ergogenic aids to enhance performance. Most nutritional
aids can be categorized as a potential energy source, an anabolic enhancer, a cellular
component, or a recovery aid. Studies have consistently shown that carbohydrates consumed
immediately before or after exercise enhance performance by increasing glycogen stores and
delaying fatigue. Protein and amino acid supplementation may serve an anabolic role by
optimizing body composition crucial in strength-related sports. Dietary antioxidants, such as
vitamins C and E and carotenes, may prevent oxidative stress that occurs with intense exercise.
Performance during high-intensity exercise, such as sprinting, may be improved with short-
term-creatine loading, and high effort exercise lasting 1-7 min may be improved through
bicarbonate loading immediately prior to activity. Caffeine dosing before exercise delays fatigue
and may enhance performance of high-intensity exercise.

CONCLUSIONS

Many natural foods or derivatives of food products have ergogenic effects. Their mechanisms of
action as well as the types of physical performance they enhance are quite varied. Some have
been found to be beneficial during prolonged moderate-intensity exercise, whereas others
enhance anaerobic performance. For maximum effectiveness, it is important to understand
their limitations and the proper way in which they should be used.
 Carbohydrates may be beneficial in extending the time to fatigue when taken before
and during prolonged moderate-intensity aerobic exercise. In combination with protein,
they stimulate the rapid recovery of muscle glycogen stores following exercise. In
combination with electrolytes and water, they are effective in rehydration postexercise.
 Caffeine appears to be a strong enhancer of aerobic endurance. This may be due to its
ability to spare muscle glycogen and facilitate neural processes.
 The chronic feeding of pyruvate-dihydroxyacetone may increase aerobic endurance, but
a major disadvantage of this supplement is that the concentrations shown to be
effective may result in a mineral overload.
 Although it has been suggested that medium-chain triglycerides may enhance aerobic
endurance, this has not been substantiated, nor have there been any definitive results
demonstrating a positive effect of choline supplementation on physical performance.
 Branched-chain amino acids may enhance aerobic endurance by reducing the rate of
brain serotonin accumulation during prolonged exercise. However, more research is
needed to substantiate this hypothesis.
 For maximum performance during prolonged physical exertion in a hot and humid
environment, water or fluid supplementation is essential.
 For high-intensity aerobic and anaerobic performance, phosphate loading may be
beneficial because of the ability of phosphate to increase the blood 2,3-
diphosphoglycerate concentration and reduce the affinity of oxygen for hemoglobin.
 Anaerobic capacity may be enhanced by preexercise ingestion of sodium bicarbonate or
dichloroacetate. Sodium bicarbonate increases blood pH, which helps with the buffering
of lactate and its efflux from the exercising muscle. Dichloroacetate increases the
activity of pyruvate dehydrogenase and thus reduces the rate of lactate accumulation.