1
Q
what are the parts the female athlete triad
A
eating disorder
amenorrhea
osteoporosis
2
Q
when does REDs start to occur
A
negative energy balance for weeks to months
3
Q
what effect does REDs have on sport performance
A
can have small boost in short term in some sports but long term performance is always suppressed
4
Q
what does “disordered eating is a continuum” mean
A
ranges from “healthy dieting” which is not healthy for athletes to extreme weight loss
5
Q
disordered eating affects what percent of female and male athletes
A
62% females
33% males
6
Q
what is the criteria for anorexia nervosa
A
refusal to maintain body weight for age and height or failure to gain weight during growth
intense fear of gaining weight or fat
disturbed body image or denial of seriousness of current low body weight
amenorrhea
7
Q
what are the criteria for bulimia nervosa
A
recurrent episodes of binge eating
recurrent compensatory behaviour to prevent weight gain
binge eating and inappropriate compensatory behaviours occur twice a week for 3 months
self evaluation influenced by body image
may occur with/without anorexia nervosa
8
Q
what is menarche
A
first menstrual cycle
12.5 years average
9
Q
what is eumenorrhea
A
normal menstrual cycle
28 days average
21-35
10
Q
what is oligomenorrhea
A
menstrual cycles at intervals longer than 35 days
11
Q
what is amenorrhea
A
absent menstrual cycle greater than 3 months
primary = delayed menarche (15yr)
secondary = after menarche
12
Q
what is luteal suppression
A
menstrual cycle with a luteal phase shorter than 11 d in length or with low progesterone
13
Q
what is anovulation
A
menstral cycle without ovulation
14
Q
how common is primary amenorrhea
A
7%
as high as 22% in cheerleading, diving and gymnastics
15
Q
how common is secondary amenorrhea
A
2-5%
high as 69% in dancers and 65% in long distance runners
16
Q
how quickly can LEA cause amenorrhea
A
just 1 month of LEA can but usually 2-3 months. takes 3-6 months to recover
17
Q
why does LEA cause menstrual dysfunction
A
LEA alters LH pulsality not exercise.
18
Q
what is the criteria for osteopenia or low bone mineral density
A
bone mineral density z-score between -1 and -2
19
Q
what is the criteria for osteoporosis
A
bone mineral density z-score less than and including -2
20
Q
why might athletes have low BMD
A
LEA
-low IGF-1
-high cortisol
- perhaps low intake of calcium
menstrual dysfunction
21
Q
how does undernutrition effect bone
A
decrease rate of bone formation
leads to increase risk of osteoporosis and fractures
22
Q
how does hypoestrogen effect bone
A
increased bone resorption rate
leads to increase risk of osteoporosis and fractures
23
Q
how to treat low BMD?
A
make EA >30kcal/kg of FFM
increase Ca2+ to 1000-1300 mg/d
increase VitD to 400-800IU/D
protein 1.2-1.6 g/kg/day
resistance train
reduce overall training
increase BW by 2-3%
24
Q
A
25
why might pregnancy actually benefit the CV system
ventricular blood volume, CO and systemic resistance benefits do not return to baseline by 1 year postpartum
26
what are the statistics for postpartum MH issues and why do they occur
-1/5 will experience perinatal mental illness
-low mood to psychosis
-1/4 of all maternal deaths between 6weeks to a year after childbirth are related to mental health problems
rapid changes in sex hormones
27
what is stress urinary incontinence and how common for postpartum
a type of pelvic floor dysfunction
leaking when coughing sneezing or during impact activity
1/3 postpartum women
risk of it when not pregnant increases by more than 2 if previously given birth
28
long long does WHO recommend exclusive breastfeeding
first 6 moths of life
29
does exercise adversely impact breastmilk quality or quantity
no but LEA can
30
what are one of the maternal health concerns of breastfeeding
calcium losses are significant and double that of pregnancy
decline in BMD 3-10% during pregnancy and lactation.
31
what type of exercise is recommended in postpartum
150mvpa
pelvic floor muscle trianing
light abdominal muscle training.
32
how does exercise help in postpartum
reduced complications
40% reduction in MH issues
37% reduction in stress urinary incontinence
high BMD
better sleep efficiency and quality
33
how does pregnancy and birth effect exercise performance
depends on if maternity occurs before estimated peak performance age. if before performance can return and surpass previous. if after then performance will likely decrease
34
how does intention predict exercise performance post pregnancy
those who intended to return to equivalent performance levels postpregnancy would return in the 1-3 years postpregnancy. over half would improve
35
what is the bipsychosocial model of rehabilitation
-emphasizes individualized athlete centred care.
-risk balance between being fully ready and needing to return
-less on deadlines and more functional milestones
36
how does exercise effect breastmilk
no effect on quantity and quality
however exercise during lactation decreases childhood obesity risk
37
what to note about total energy intake for athletes
can vary because of body size and energy expenditure from activity
also can vary due to weight gain and weight loss
38
what are the macro nutrient ranges for athletes
45-65 carb
10-35 protein
20-35 fat
39
what is the acute effect of endurance exercise on CHO stores
high intensity exercise (75%Vo2max 1 hr) depletes 50% liver glycogen
repeat supramax also depletes
time to exhaustion directly related to resting glycogen stores
40
how does endurance training effect CHO use and storage
glycogen sparing
improved mitochondrial metabolism enhances lipid oxidation
larger glycogen stores in skeletal muscle
41
how much carbohydrate can be stored in muscle
12-16g CHO per kg of muscle
42
what is glycemic index
compares food in blood glucose response compared to pure glucose (100)
43
what 4 factors influence the glycemic index of the food
biochemical structure of carbohydrate
absorption process
size of food particle
coingestion of fat fibre or protein
44
how to calculate glycemic index
area under curve (AUC) of 50g of the CHO/AUC 50g glucose x 100 = GI
45
how to calculate glycemic load
(GI x g CHO) /100
46
draw the comparison in plasma glucose response of high GI food and low GI food
47
what are high GI foods
fruit, veg, whole grain, basmati rice, pasta
<55 GI
48
what are medium GI foods
sucrose, croissant, brown rices
GI 56-70
49
what are high GI food
corn flakes, bake potato, jasmine rice, white bread
GI >70
50
what is the general ACSM intake of CHO recommendation and why isn't this perfect
6-10g/kg of body weight
intake should match demands
-mod duration, low intensity = 5-7g/kg
-mod to heavy endurance: 7-12g/kg
-extreme (4-6hr): 10-12g/kg
51
what benefits do CHO supercompensation give an athlete and when is it appropriate
useful for activities longer than 60-90min
increases time to fatigue by 20%
decreases time to complete task by 2-3%
52
how many grams of water are stored with each gram of glycogen
2-3g of water / g glycogen
53
describe classical vs modern CHO loading
training decreases while carbohydrate in diet increases
54
what are the potential issues with classical CHO supercompensation
-hypoglycemia when CHO low
-not practical b/c big differences
-GI problems
-Mood
-tenseness without training
55
do men and women get same benefits from CHO loading and why
no. high CHO diet seems not to effect CHO storage for women
women have greater reliance on fat oxidation
possibly issues with compliance
maybe liver storage
56
when CHO loading which storage locations typically get filled first
muscle fills first before full recovery of liver glycogen
57
what's different with carb loading with fructose (fruit/honey) vs glucose
fructose is slower to fill muscle glycogen but similar liver replenishment
58
can CHO hours before exercise replenish stores?
3-4 hours before exercise muscle glycogen can be restored
1 hour before exercise, liver can be restored but not muscle
1-1.2g/kg snack 30-60 min before exercise
-reactive hypoglycaemia risk can be mitigated by eating sooner to exercise or using a warmup
59
what is the timing goal of CHO right before exercise
not feeling hungry or undigested food in stomach
60
when comparing high GI and low GI meal 3 hour before moderate intensity endurance exercise what is the result
low GI group performed better, maybe due to increased fat oxidation during exercise
61
what to know about CHO during competition
30-60g/hr or .7g/kg/hr
usually good for high intensity long duration exercise
training state doesnt improve ability to unitize oral CHO
every 15-20min than just after 2 hour
no high fructose
-slow to absorb
-more GI issue
may not be useful for under 1 hour
62
why might adding some fructose into CHO in competition work better
fructose is oxidized separately and is not limited by max glucose oxidation rate.
63
what is the point of CHO intake after exercise
replenish stores by creating a positive glycogen repletion environment
-greater insulin response and sensitivity
-eat high glycemic index
-the sooner you eat the greater rate of glycogen synthesis
-->b/c exercise up regulates glycogen synthase (rate limiter)
-->for long duration this doesnt matter
stores are directly related to performance
64
what dosage does ACSM recommend for post comp CHO
1-1.5g/kg moderate to high GI CHO within 30min and every 2h for up to 6hr until 500g (7-10g/kg)
65
what effects rate of glycogen synthesis
availability of glucose
insulin
prior exercise which increases insulin sensitivity
66
what is the optimal rate of glycogen ingestion AFTER exercise
1.2g/min of higher GI food.
->synthesis of glycogen is 50% lower with fructose or low GI meal
67
why might adding protein to after exercise meal increase muscle glycogen synthesis
AA can increase insulin release
-important to note that CHO is still the limiting factor so this is only useful for when CHO intake is lower than optimal.
68
how long does it typically take to replenish glycogen stores
2-6days
depends on expenditure and remaining stores
69
summarize the ACSM guidelines for CHO intake around exercise
70
how does fat metabolism change with exercise
improved ability to oxidize FFA
-enhanced capitalization
improved FFA transport
increase oxidative enzyme
more mitochondria and bigger
71
when can a high fat diet be beneficial?
eating a high fat diet then CHO
-results in same glycogen stores as high CHO but increased fat metabolism
-long term performance on high fat diet is reduced
-not recommended by ACSM
72
why might protein be important for atheltes
muscles synthesis, tissue maintenance, transporters, enzymes, NT, hormones
73
can you have too much protein?
yes. if insufficient carbohydrate, decreased glycogen stores. this can result in fatigue
74
which are the BCAA
isoleucine
leucine
valine
75
what must happen to AA before it can be used as energy
remove amino group (transamination or deamination)
-ammonia converted to urea
76
how much of AA pool is from protein intake
25%
75% is from protein in the gut kidney and liver which synthesize and resynthesizes
77
what is the most common way of estimating protein metabolism
nitrogen balance,
nitrogen intake - excretion
ignores sweat losses so usually overestimates nitrogen retention
78
what is the average requirement and safe intake of protein in healthy young adults
.66g/kg/day average
.83g/kg/d safe (average + 2SD)
79
what does the acsm recommend for protein intake for general pop, endurance and strength
gen pop
-.8g/kg
-10-35% of TDEI
endurance
-1.2-1.4g/kg
-more for ultra endurance
-->high intake not a problem because of high total calories
strength
-1.2-1.7g/kg
-important for early phases of training
80
how much protein do athletes eat on average
2.05g/kg
81
what factors minus training can be used to maximize protein synthesis
co ingestion with CHO
amount of protein
timing of protein
type of protein
82
mix CHO, AA or just AA after resistance training leads higher essential AA uptake? why?
mix leads to higher uptake
insulin elevations
83
why do studies typically recommend higher protein for trained than untrained
training stimulus so big that protein doesnt really matter for beginners
for advanced that have less stimulus then protein matters more
84
how effective is protein supplementation for older populations
less than younger people. possibly because almost all of them are untrained.
85
what is the recommendation for protein intake for weight gain
1.6g/kg/day
86
for FFM gain which is more important, protein or training
resistance training is the more important stimulus
87
what are the protein recommendations for "high quality weight loss"
1.6-2.4 g/kg
88
what is the relationship between energy deficit and protein intake for "high quality weight loss"
greater the energy restriction the greater the protein intake. everything is a range. type of training matters in this calculation. if resistance training then less protein needed because of training stimulus
89
how does splanchnic AA extraction effect the availability of AA for synthesis
extraction reduces AA availability for protein synthesis
90
what is the RDA for iron
women 18mg/day
men 8mg/day
91
what does ACSM say about vitD
indoor and northern athletes could benefit from vita supplementation
92
