Nutrition for Athletes and Diabetes

Special Considerations in Sports Nutrition

• Athletes with specific needs require more dietary adjustments than typical athletes
• Populations with special dietary needs include those with diabetes, pregnant athletes, children and teenagers, collegiate athletes, masters-level athletes, and vegetarians

Diabetes

• Affects approximately 29.1 million people in the United States
• Three-quarters are diagnosed; the remainder are unaware
• A metabolic disease, affecting carbohydrate metabolism
• Causes hyperglycemia, ketosis/ketoacidosis
• Increases risk of heart and kidney disease and causes peripheral nerve damage
• Involves the hormone insulin: a decreased release, or decreased sensitivity to insulin

Diabetes (Types)

• Type 1: Primarily diagnosed in children and young adults, constitutes ~5% of diabetes cases, is insulin-dependent, and requires insulin injections
• Type 2: Most prevalent in middle-aged and older adults, constitutes ~95% of diabetes cases, is non-insulin-dependent. Medicine, diet, and exercise can treat it; insulin may not be required

Common Symptoms of Diabetes

• Excessive thirst
• Excessive urination
• Dehydration
• Unexplained weight loss
• Excessive hunger
• Poor wound healing
• Dizziness
• Headache
• Blurred vision

Diabetes and Exercise

• Type 1: Requires careful self-monitoring of insulin timing, dosage, meal timing, and meal composition
• Type 2: Relatively easier to manage, requires some self-monitoring; insulin may not be required

Pre-Exercise Glucose Guidelines

• Pre-exercise glucose level < 100 mg/dL: Ingest additional carbohydrates (15-40g) prior to exercise.
• 100-250 mg/dL: Safe to exercise.

• 250 mg/dL with ketones: Do not exercise; adjust insulin/medication and retest glucose and ketones. Exercise can be resumed after satisfactory blood glucose and ketones testing.

• 250 mg/dL without ketones: Exercise can be initiated

• 300 mg/dL without ketones: Start exercise with caution.

Signs & Symptoms of Hypo- and Hyperglycemia

• Hypoglycemia: Sweating, pounding heart, hunger, shakiness, confusion, lethargy, incoordination, slurred speech, irritability, headache, nausea
• Hyperglycemia: Nervousness, restlessness, thirst, fatigue, blurred vision, muscle cramps, nausea, abdominal pain

General Nutritional Recommendations for Athletes with Diabetes

• Follow MyPlate food recommendations
• Establish a consistent daily eating schedule
• Consume similar amounts and types of carbohydrates at meals and snacks daily
• Learn best combinations of meal timing, carbohydrate intake, and dosage for optimal blood sugar levels before exercise

Diabetic Athletes and Long-Duration Exercise

• Consume carbohydrates during and after exercise
• Type 1 diabetes: Consume 15-30 grams of carbohydrates every 30-60 minutes during exercise (choices include 8oz of 6-8% sports drink, single serving of sports gel, a fig bar, or 8oz of 1:1 juice to water mix)

Avoiding Diabetic Emergencies

• Closely monitor for hypo- and hyperglycemia
• Keep insulin and syringes available
• Have glucose tablets, juice, or regular soda available
• Educate coaches, parents, and teammates to recognize signs and symptoms

Considerations for Pregnant Athletes

• Competition
• Intensity and volume of exercise
• Physician recommendations
• Dietary recommendations

Special Dietary Concerns for Pregnant Athletes

• Daily caloric intake
• Protein consumption
• B vitamins
• Vitamin C
• Vitamin A
• Magnesium
• Iron

Daily Caloric Intake for Pregnant Athletes

• Additional calories are needed (average 300 kcals/day)
• Range 25 - 800 kcals/day depending on the athlete type and energy expended in training
• Important in the second and third trimesters
• Weight gain (25-35 lbs) can monitor caloric intake

Protein Requirements for Pregnant Athletes

• Protein needs are slightly increased
• Extra 20-25 grams of protein needed daily
• Includes protein-rich foods (skim milk, beef, chicken, fish, beans, lentils, other legumes, nuts)

B Vitamin Requirements for Pregnant Athletes

• Critical for energy production and tissue development, particularly folate
  • Needed for DNA synthesis, red blood cell production, and nervous system development
• Recommended intake: 600 µg/day

Vitamin C Requirements for Pregnant Athletes

• Critical for collagen formation, hormone synthesis, and immune function
• Improves absorption of iron
• Increase intake to 80-85 mg/day

Vitamin A Requirements for Pregnant Athletes

• Needed for cell differentiation and immune function
• Increase intake to 750-770 µg (RAE)/day
• Obtain extra from foods: spinach, broccoli, tomato juice, and carrots

Magnesium Requirements for Pregnant Athletes

• Required for muscle contraction and energy production
• Increase by 40 mg to 350-360 mg/day
• Sources overlap with other foods: whole wheat, tofu, yogurt, beans, nuts, fish, spinach

Iron Requirements for Pregnant Athletes

• Required for red blood cell production, oxygen delivery, and energy level
• Increase intake to 27 mg/day
• Sources include beef, poultry, fish, legumes, and iron-fortified grains
• Supplementation might be needed

Nutritional Considerations for Child and Teen Athletes

• Caloric intake must support growth and meet sport needs
• Adequate nutrient intake for "growth channel"

Fluid Requirements for Child and Teen Athletes

• Children are less tolerant of heat
• Reminders to drink fluids are needed
• Improve intake through fluid availability and flavor

Vitamin/Mineral Requirements for Child and Teen Athletes

• Calcium: 1,300 mg/day (ages 9-18)
• Iron:
  • 8 mg/day (ages 9-13)
  • 11 mg/day (males ages 14-18)
  • 15 mg/day (females ages 14-18)

Nutritional Considerations for College Athletes

• First exposure to meal planning required
• Caloric needs may increase
• Create a meal plan; avoid skipped meals
• Avoid alcohol
• Future life after graduation considerations

Why Athletes Should Avoid Alcohol

• Use is banned in some circumstances, can be illegal (by age).
• Safety issues (driving).
• Nutritionally "empty" (poor carbohydrate source).
• Can increase body fat.
• Stimulates appetite.

Preparing College Athletes Nutritionally for Life After Graduation

• Calorie needs will likely decline.
• Maintain nutritional self-care skills, including meal planning, cooking, grocery shopping, and alcohol intake management.
• Manage business/social life, including dining out and travel nutrition.

Special Considerations for Masters Athletes

• Altered caloric needs
• Altered vitamin and mineral needs (decrease in chromium and iron, increase in vitamin D, calcium, magnesium)
• Chronic diseases
• Food–drug interactions

Special Considerations for Vegetarian Athletes

• Plant-based diet
• Types of vegetarians (semi, pesco, lacto-ovo, lacto, ovo, vegan)
• Protein intake (complementing)
• Vitamin D and B12 intake
• Zinc, calcium, and iron intake
• Eating out on the road

Complementing Proteins for Vegetarians

• Combining certain foods to ensure a balanced intake of essential amino acids (e.g., grains and legumes, legumes and nuts/seeds)

Vegetarian Dining Resources

• Online resources to locate vegetarian restaurants (e.g., Vegetarian Journal, etc.)

Test your knowledge on nutritional considerations for athletes, especially focusing on masters athletes and those with diabetes. Learn about dietary adjustments, types of vegetarian diets, and the nutritional needs of pregnant athletes. This quiz covers essential facts about managing nutrition for various athlete populations.