Sports Nutrition and Diabetes Management

Special Considerations in Sports Nutrition

• Individuals with specific dietary needs require adjustments beyond standard recommendations
• This includes athletes with diabetes, pregnant athletes, children and teenagers, collegiate athletes, masters-level athletes, and vegetarians

Athletes with Diabetes

• Affects approximately 29.1 million people in the US
• Three-quarters are diagnosed; the remainder are undiagnosed
• Metabolic disease affecting carbohydrate metabolism
• Causes hyperglycemia, ketosis/ketoacidosis
• Increases risk for heart and kidney disease, peripheral nerve damage
• Involves the hormone insulin: decreased insulin release and decreased sensitivity to insulin

Types of Diabetes

• Type 1:
• Diagnosed mostly in children and young adults
• ~5% of diabetes cases
• Insulin-dependent
• Pancreas fails to produce enough insulin
• Treatment requires insulin injections
• Type 2:
• Most prevalent in middle-aged and older adults
• ~95% of diabetes cases
• Non-insulin-dependent
• Pancreas produces enough or too much insulin, but cells are insensitive/resistant
• Treatments include medicine, diet, and exercise

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 (timing of insulin, dosage, timing of meals, and meal composition)
• Type 2: Comparatively easier to manage, requiring some self-monitoring. Insulin may not be needed because exercise enhances glucose uptake

Pre-Exercise Glucose Guidelines

• <100 mg/dL: Ingest 15-40g carbohydrates before exercise.
• 100-250 mg/dL: Safe to exercise.
• >250 mg/dL with ketones: Do not exercise. Adjust insulin or medication and retest; exercise possible upon retesting.
• >300 mg/dL without ketones: Exercise with caution.

Signs and Symptoms: 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.
• Similar carbohydrate amounts should be consumed at meals/snacks.
• Athletes needing insulin must learn the best combination of meal timing, carbohydrate intake, and insulin dosage for controlling blood sugar before exercise

Diabetics and Long Duration Exercise

• Consume 15-30g carbohydrates every 30-60 minutes
• 8oz 6-8% sports drink
• 1 single serving sports gel
• 1 fig bar
• 8oz juice-water mix

Avoiding Diabetic Emergencies

• Closely monitor athletes for signs and symptoms of hypo- and hyperglycemia.
• Keep insulin and syringes on hand.
• Have glucose tablets, juice, or regular soda available.
• Educate coaches, parents, and teammates on recognizing signs and symptoms of hypo- and hyperglycemia

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

• Average 300 kcals/day extra; Range 25 to 800 kcals/day.
• Especially important during the second and third trimesters
• Weight gain (25-35 lbs) can help track caloric intake over time.

Protein Requirements for Pregnant Athletes

• Protein needs are slightly increased; extra 20-25 grams daily.
• 3 cups skim milk, 3oz beef/chicken/fish, or 1.5 cups beans/lentils/legumes, or 3oz nuts

B Vitamin Requirements for Pregnant Athletes

• Critical for energy production and tissue development.
• Folate is especially important for DNA synthesis, red blood cell production, and nervous system development
• Recommended intake is 600 µg/day

Vitamin C Requirements for Pregnant Athletes

• Collagen formation, hormone synthesis, & immune function
• Improves iron absorption
• 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) daily
• Obtain extra from foods (spinach, broccoli, tomato juice, carrots), not supplements

Magnesium Requirements for Pregnant Athletes

• Needed for muscle contraction and energy production
• Increased by 40 mg to 350-360 mg/day
• Sources: whole wheat, tofu, yogurt, beans, nuts, some fish, spinach

Iron Requirements for Pregnant Athletes

• Needed for red blood cell production, oxygen delivery, and energy level.
• Increase intake to 27 mg/day
• Sources: Beef, poultry, fish, legumes, iron-fortified grains; supplementation may be needed

Nutritional Considerations for Child and Teen Athletes

• Caloric Intake: Must support growth and meet sport needs.
• Nutrient Intake: Adequate to maintain growth.
• Fluid Requirements: Less heat tolerance; drink reminders are needed; improve intake through accessibility and flavor.

Vitamin/Mineral Requirements for Child and Teen Athletes

• Calcium (9-18 years): 1,300mg/day
• Iron (9-13 years): 8mg/day
• Iron (14-18 male): 11mg/day
• Iron (14-18 female): 15mg/day

Nutritional Considerations for College Athletes

• First exposure to meal planning.
• Caloric needs may increase.
• Make a meal plan (- No skipped meals).
• Avoid alcohol.
• Life after graduation.

Why Athletes Should Avoid Alcohol

• Use is often banned.
• Can be illegal (age).
• Safety concerns (driving).
• Nutritionally "empty" - poor carbohydrate source.
• Can increase body fat.
• Stimulates appetite

Preparing College Athletes for Life After Graduation

• Calorie needs may decline.
• Continue to acquire nutritional self-care skills (meal planning, cooking, grocery shopping, managing business/social life, alcohol intake, dining out, travel nutrition.)

Special Considerations for Masters Athletes

• Altered caloric needs
• Altered vitamin and mineral needs
• Decrease chromium
• Decrease iron
• Increase vitamin D
• Increase calcium
• Increase magnesium
• Chronic diseases
• Food-drug interactions

Famous Vegetarian Athletes

• List of athletes and coaches following/followed a vegetarian diet (Hank Aaron, Danny Garcia, Venus Williams, Tony LaRussa, etc)

Special Considerations for Vegetarian Athletes

• Plant-based diet
• Types of vegetarians (semi, pesco, lacto-ovo, lacto, ovo, vegan)
• Protein intake (complementation)
• Vitamin D and B12
• Zinc (Zn), Calcium (Ca), and Iron (Fe) intake
• Eating out on the road

Complementing Proteins for Vegetarians

• Animal products, soy products, grains, legumes, and nuts/seeds are complimentary sources of protein
• Grains complement legumes, and legumes complement nuts/seeds

Vegetarian Dining Resources

• Websites for locating vegetarian restaurants.

This quiz focuses on the intersection of sports nutrition and diabetes management, addressing special dietary considerations for athletes with diabetes. Participants will test their knowledge on diabetes types, symptoms, and recommended dietary guidelines specific to these athletes.