Sport and nutrition is a golden combination! Getting the right balance results in more strength, greater endurance, better recovery and improved sporting performance. This is relevant for both top athletes and (enthusiastic) recreational athletes. On Friday 13 October 2017, over 850 sports and nutrition professionals attended the 2nd Conference on “Sports & Nutrition” organised by the FrieslandCampina Institute in the Netherlands. They heard about the most recent insights in the world of sports supplements, nutritional recommendations for recreational athletes and how the optimum timing of nutrition can contribute to muscle protein synthesis.
Whether you are an top athlete or an (enthusiastic) recreational athlete, according to sports dietitian Sita Veenstra from AVS Nutrition and Sport Advisory Service, it is important to start with a good basic diet: “Focus on the big picture first, before zooming in on the details. The “Sports Nutrition Pyramid” designed by the Dutch Dairy Organisation and Dutch Sport Dietetics Association demonstrates what good basic nutrition is for an athlete. A varied diet, the bottom layer of the Sports Nutrition Pyramid, is the starting point for each athlete, regardless of their level. Fruit, vegetables, pulses, whole grains, fish, meat, eggs and dairy are part of a varied diet. Milk, yoghurt, quark and cheese are natural sources of protein and calcium. The second layer of the pyramid contains sport-specific foods and fluids, which are important before, during and after training or competition. It gives the athlete just that little bit extra.
The timing of the food is also important. The top of the pyramid contains the sports supplements. Examples are creatine and beta-alanine.” Each individual will have their own specific requirements to which the diet needs to be adapted. Veenstra: “You have a unique athlete in front of you, with taste preferences, a body with its own responses and the athlete’s personalised training schedule. The athlete also needs to practice the dietary intervention. For example: how do they like eating extra protein soon after strength training? And the athlete will need to practice drinking from a cup whilst running.” According to Veenstra, a dietary intervention is always a practical translation from theory to practice. She advises professional athletes to seek advice from a sports dietitian or registered sports nutritionist, to work together to achieve the athlete’s goals.
Muscle gain? Diet and exercise!
Our muscles renew themselves every day. Protein in the diet is broken down to amino acids, which are released to muscles via the blood. In addition to muscle protein synthesis, muscle protein is also broken down, for example, in the case of muscle damage. It is beneficial that the damaged tissue is rebuilt and is an essential process in muscle. The combination of high-protein food and exercise is essential to achieving a positive protein balance and stimulating muscle growth. As far as exercise is concerned, it is important to perform at least 2 training sessions per muscle group per week and to perform at least 3 sets of exercises per training session. Complete (large) movements are also important and it is recommended to train in the region of “muscle failure”. Muscle failure is the point at which you feel that you almost cannot continue and this is a trigger for muscle growth. Heavier training loads will allow you to reach the point of muscle failure quickly, whilst more repetitions are required for lighter training loads.
According to Jorn Trommelen, MSc – Department of Movement Sciences, Maastricht University, protein intake is also important: “The recommendation is to consume a minimum of 20 grams of protein per meal, with at least 4 meals per day: breakfast, lunch, dinner and just prior to sleep. Animal protein sources are preferable. Carbohydrates and fat do not have any direct added benefit, but they do have indirect effects. After all, a negative energy balance reduces muscle protein synthesis.”
Naomi Brinkmans, researcher at HAN Sport and Exercise and sports dietitian for PSV (Dutch football club) and KNVB (Dutch football organisation) reports: “Dutch (top) athletes are already failing to achieve the recommended 20 grams of protein per meal. Research from 2016 demonstrates that athletes fall just short of this quantity of protein at breakfast and their snacks are also not optimal. In terms of protein the focus is primarily on the evening meal and on eating sufficient amounts of carbohydrate.” Brinkmans notes that it increasing the athlete’s knowledge and providing practical dietary tools can be helpful for achieving the protein recommendations. Research into the timing of protein intake between two football teams within the same club revealed that protein intake and distribution was better in the older team that had already received more individual nutritional coaching than the younger team that had received little to no individual nutritional coaching. “I recommend eating a main meal or high-protein snack within 2 hours after exercising, for example quark or an omelette made with 2 eggs and 80 grams of cottage cheese. I focus on spreading the daily protein intake to 20-25 grams every 2-3 hours and recommend 20-40 grams of a casein based protein before going to sleep, so that protein synthesis during the night is higher than the protein breakdown and therefore optimise muscle building overnight.”
According to Nick Iedema, MSc – lecturer HAN Sport and Exercise, and sports dietitian for team nutrition at NOC*NSF, many athletes use the Sports Nutrition Pyramid the wrong way around. They start with sports supplements instead of basic food groups. “One study revealed that 57% of people in the Netherlands who are actively engaged in fitness use at least 1 supplement.” This is not as innocent as it may seem, because the use of supplements is associated with risks. For example, 10-15% of the supplements can be contaminated and indiscriminate use of supplements can cause damage to the body. It is recommended not to take just any supplement and also not to believe everything on the packaging. In Europe, we have the EFSA (European Food Safety Authority), which checks whether health claims are used correctly. Iedema: “At the moment, only claims for carbohydrate electrolyte solutions and creatine are permitted by the EFSA.
In addition, the AIS system (Australian Institute of Sports) indicates whether there is sufficient evidence to prove the efficacy of a supplement (see table). A panel of experts from the AIS has divided supplements into 4 categories (A, B, C and D). A new supplement in category A is nitrate. Nitrate causes blood vessels to dilate and the muscles to receive more oxygen which results in a brief improvement of the aerobic capacity. This allows muscles to work more efficiently. However “the exact mechanism of action of nitrate for short high intensity training is not yet known. A recent, as yet unpublished study among athletes reveals that the use of nitrate does not improve the total capacity and peak capacity over 3 repeated maximum exertions of 30 seconds, but does improve the speed at which the peak capacity is reached. These small differences are not relevant in most situations, but the use of nitrate could be relevant for a top athlete who needs to make an explosive start. Think, for example, of a BMX race in which it is important to have a top 1 or 2 head position on the first corner if you want to win the race. More research is still required here”.
TABLE of Evidence: ABCD Classification System according to the AIS
|Group A||Suitable in sport for specific situations using evidence-based protocols.|
|Group B||Eligible for further investigation and can be considered for use in specific situations with good monitoring.|
|Group C||There is little meaningful proof of beneficial effects.|
|Group D||Banned or carries a high risk of contamination that could result in a positive doping test.|
Copied from presentation by Nick Iedema
According to Evelien Backx, PhD – lecturer at Fontys Sporthogeschool – a vitamin D supplement could also have an influence on performance. Research involving top athletes shows an effect of high vitamin D levels (above 75 nmol/L) on muscle strength and the prevention of stress fractures. This allows athletes to train more and perform better. Not enough is known yet about the effects of vitamin D across the different sporting disciplines. Research involving 128 Dutch top athletes has shown that almost three quarters of these athletes have a vitamin D concentration that is considered low. Therefore, Backx advocates regular monitoring of the 25(OH)-D levels. Backx: “For a target value of 75 nmol/L, you should recommend a daily dose of 10-55 mcg/day. I would not recommend higher doses.”
Start them young…
Tommy Visscher is an epidemiologist and health scientist and Associate lecturer “De Gezonde Stad”. He emphasise that children who are overweight will become the obese adults of the future. “Healthy eating and exercise habits that you develop as a toddler will stay with you for the rest of your life. We therefore need to focus on guiding our children.”
Not much is known about the nutritional intake and eating habits of adolescent (top) athletes and this needed to be investigated, according to Vera Wisse, MSc sports dietitian. She studied the nutritional intake of adolescents aged 12-16 years who participated in sports for at least 6 hours per week. Wisse: “We noted that the protein intake was concentrated around the lunch and evening meals, that there was no difference in energy intake between rest days and training days and that there were no food and drink strategies during training and no recovery strategy. Striking results included the low intake of fruit, vegetables and dairy and the high intake of soft drinks: 500-700 mL per day!” According to Wisse, this all boils down to knowledge, education and habits. “Evidently the target group is not really focused on this yet.”
Jutta Hulshof, sports psychologist, discussed the motivational techniques: “Try to match the developmental level and ask yourself what you can expect of a child at which age and what would interest a child. For example, teenagers want to have a say and enjoy contact with peers, whilst for children up to the age of 12 years having fun is most important. Ensure a good relationship between adults and children: talk with the child and not to the child. In addition, many children benefit from precise and brief instructions and be sure to offer positive feedback. Children must feel successful in order to want to repeat things.”
Healthy sports canteen and healthy restaurant
Fewer than 1 in 5 canteens sell fruit and 1 in 7 children are overweight. Enough reason for sports dietitian Esther van Etten to engage in Team:Fit. Team:Fit is helping Dutch sports canteens to become healthier step-by-step! Drastic changes are difficult, but it is possible to make gradual changes to make the products on offer in every sports canteen healthier. Clubs who enrol in the Team:Fit project receive free advice from the advisors, after which a team within the club sets to work on improving the healthy range on offer in the sports canteen.
Sports canteens aren’t the only facilities with room for improvement, various restaurants of hotels that provide accommodation for the Tour de France cyclists also leave a lot to be desired. A challenge for sports dietitian, chef and sports instructor Janneke Pieterson. From 2012 through to 2015 she cooked for the cyclists of team Giant-Alpecin, on location, in the kitchens of the hotels. Pieterson: “Chefs in hotels often think that cyclists only eat pasta. I made different meals, offered variety and also provided a different experience. You have to bear in mind that cyclists eat at long tables in large halls during the Tour. On rest days I had free reign. For example, I let the athletes eat outside and sometimes provided a cold meal for lunch instead of the hot meal that they usually get.” Pieterson often eats with the athletes: “I really recommend doing that as you see what they choose and can respond to this. Athletes tell you more when you sit at the table with them and they are more likely to listen to you.”
The technology is moving forward
In addition to consulting passionate sports and nutrition professionals, increasing numbers of people are also using new technologies to become healthier and more active. Frederieke Jacobs, entrepreneur and co-founder of SmartHealth knows all about it. According to Jacobs, this important trend is due to the 24/7 economy. “Long-distance coaching is also possible. Conversations can take place via digital media instead of in person. In addition, apps and videos can provide exercise instructions. This allows the physiotherapist to coach and suggest adjustments from a distance too.” Another trend is the tracking of your diet. “A new domain within this is the concept of nutrigenomics. This consists of a blood and saliva test. A personal eating plan is prescribed based on the results of these tests. There is a trend towards people starting to eat more based on personal advice that matches their DNA.”
The foundation as starting point
Olympic top athlete Dafne Schippers mainly uses common sense when it comes to sports nutrition. “It is important to me that I use the correct fuels and that they are as natural as possible. I have developed a diet for myself that fits who I am and that makes me feel good. I am an explosive athlete and consume few carbohydrates and a lot of protein. Meat and dairy are an easy way for me to consume a lot of protein. I always try to eat a high-protein meal or snack within 2 hours after training, such as a bowl of quark with fruit or a high-protein recipe from my own cookbook! My most important advice to athletes: train your eating habits too. Plan your meals around your training schedules, so that you can see what you do and don’t like.”
Nutrition and sports: a golden combination!
Sports and nutrition are a golden duo. However, which food is best for each individual athlete, what their preferences are and how this fits into their busy lifestyle of competitions and training and possibly also a family and work is personal and can be discovered by putting the theory into practice. Not surprisingly, dietitian Anja van Geel said: “You cannot win a competition with nutrition, but you can lose a competition as a result of nutrition”!