nutrient needs for active adults
DESCRIPTION
Nutrient Needs for very Active People: An Update by Johanna Dwyer, Tufts University School of Medicine and Tufts Medical Center, Boston, USATRANSCRIPT
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Nutrient Needs for Very Active
People:
An UpdateJohanna Dwyer, D.Sc,RD
Tufts University School of Medicine and
Tufts Medical Center, Boston USA
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Agenda
• History lesson
• Nutrient needs of
– not so active
– very active people
• Dietary advice- needed by all on
– Food
– Supplements 2
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Most of Human History
•Everyone active, nobody
sedentary
•Food short for most
people
•Obesity rarely a problem
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Changing times:Evolution or Devolution???
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Today
•Many very sedentary
few active
•Lots of food available
•Both intakes and
activity need attention
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Not this
But this
Few people are very active physicallythey confuse being busy with active
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Who is active?
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What is usual?In USA, most are sedentary or low/light activity
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Regardless of physical activity level
• We need certain nutrients, not certain foods
• We all need same kinds of nutrients
• Amounts of nutrients we need vary
• Timing may be important in some situations
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Nutrient Needs: Sedentary/Light activity
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Most people in highly
industrialized countries are
sedentary
• So, reference person is sedentary/light
activity
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US Reference People
• Male
– 5’’’’10 inches, 154 lb BMI 22
• Female
– 5’’’’4”””” , 126 lb BMI 22
characteristic height, weight, sex, physical
activity etc. of people in country. 14
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Recommended energy Intakes vary by
reference person and activity
Age & Sex Singapore
(sedentary
to light
activity)
USA
Sedent
ary
USA
Light
activity
Male
18-29 2550 2498 2726
30-59 2550 2309 2535
60+ 2100 2164 2393
Women
18-29 2000 1901 2102
30-59 2000 1762 1969
60+ 1800 1659 1865
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Nutrient Needs of Sedentary and
Low Active People
• Very large part of the population
• Few adjustments in nutrient requirements
necessary but need dietary advice
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Good Advice
• Sit less
• Move more
• Play sports
• Eat well
But a little less
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U.S. Department of Health and Human Services
2008 Physical Activity Guidelines for Americans
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Need for our dogs, too!!!
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Amounts of nutrients needed vary by
Physiology
Environment
Genetics
\
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Those with Sedentary and Light
Activity Levels Need Dietary Advice
• Easy to eat too much since energy needs are
so low
• Difficult to meet all nutrient needs with very
low energy intakes, esp below 1600 Kcal
• US recommendations geared to them, but
assume they are weight stable and PAL may
be higher than actual21
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Energy:
Estimated Energy Requirement (EER)
Average intake to maintain energy balance in a healthy
adult of defined age, sex, height, weight and physical
activity level (PAL)
-
EER for sedentary people may be too highpossibly reference person is even more sedentary
than assumed
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EER is recommendation for individuals
ENERGY INTAKE
EER= RDA
High
Low
RISK of deficiency or excess
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Even small reductions in energy intake coupled
with physical activity help speed weight loss
0
500
1000
1500
2000
2500
3000
Light ac vity Light ac vity
+500 Kcall less
food
Light ac vity +
250 Kcal less
food
126 lb BMI 22 150 lb BMI 26 180 lb BMI 31
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Weight loss
• Old rule of 3500 KCal
(15,000KJ) to lose 1 pound of
fat overestimates losses
• Losses slower and smaller
� Why: errors in
estimating E intake and
output
• Kevin Hall has better
estimates of time and
amount fat lost http://bwsimulator.niddk.ni
h.gov
Permanent 10 Kcal/d less
causes weight loss of 1 lb at
new body steady state
(but may take 1-3 yr to show
up)
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•Unhealthy reducing diets common
•Energy intakes must decrease
�During weight loss phase
�After weight loss
oto cope with decreased weight and
cost of physical activity
Overweight need dietary advice
to lose and maintain loss
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Other than food energy, needs change little Exception:When intakes <500 Kcal, protein, water,
electrolytes, and calcium needs increase
Macronutrient composition
short term shifts in water balance
but very small effects long term
Nutrient needs in weight loss
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Nutrient Needs of Very Active
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•Nutrient amount
•Optimal diet composition
• Intake timing & quality CHO, Protein
•Nutrition pre, during and post extreme exertion
Much still to learn in
developing requirements for
for very active individuals
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•Younger 17-50 yr olds
�Different height, weight, body fat, lean mass
�Different, often much higher, levels of physical
activityBased on standard US reference person adjusted for very active
people, used to develop menus
Reference individual for very
active deployed military different
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•Resting energy expenditure (REE) higher
� More muscle mass (actively metabolizing tissue)
•Physical activity higher
• Cost of moving body
So estimated Energy Expenditure (EER)
higher
Very active individuals’ energy
needs higher
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Energy:
Estimated Energy Requirement (EER)
EER for “active” young adults :
3067 Males, 2403 Calories Females
- May be too low for very active
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� Ideal Criterion: Functional outcomes most relevant
� (muscle strength, immune function)
� Problem : Difficult or impossible to measure functional
outcomes ,so little data available
� Solution: Use measure along causal pathway to function
such as
o Protein (N) balance (measure of adequacy)
o tracers
o Research with better measures and outcomes
Requirement for protein
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Recommended Dietary Allowance
-covers requirement for nearly all healthy people
INTAKE
RDA ULAI??
High
Low
RISK of deficiency or excess
Adequate for ‘healthy’individual
Adapted from the IOM/FNB: Dietary reference intakes applications in dietary assessment, 2000.
EAR
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RDA protein 0.8 gm/kg/d
• Recommendation covers requirement for virtually
all individuals (RDA)
• Best single estimate of safe requirement for an individual
is RDA – a single value (or AI if impossible to determine
EAR)
• Range of healthy intakes above RDA
(individual requirement) also reasonable
– Intakes between “RDA” and “UL” safe &“optimal”
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Protein
0.8 gm/kg/day RDA
Is more protein needed for active individuals?
� Maximize repair & replacement damaged protein?
� Remodel protein in muscle?
� Increase LBM?
� Increase immune response, plasma proteins?
� Maintain metabolic pathways for aa?
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Protein Recommendations, gm/kg/d,
US Military for very active individuals
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Protein recommendations for active
individuals vary from 1.2-2.0 gm/kg/d
•Vary by criteria used, body composition,
type of exercise, purpose (normal or rehab)
•Research needed on
- Requirements and effects of individual amino acids
in actual exercise conditions & requirements
-Amount, composition
-Timing and recovery
Timing
Amount
PROTEIN
Composition
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Do certain amino acids enhance performance or
recovery from exhaustion in very active adults?
No, for
Beta alanine
Ko et al Nutrition Reviews (Feb 2014)
Arginine (in press)
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Composition of gain varies
� Energy 3500 Kcal/lb gain fat
� Less if more water, muscle
� Fluid shifts and gains in glycogen due to diet
changes may obscure actual lean tissue gains
• Do protein intakes need to increase?
• Still debated; if yes, only a little
Protein for Weight Gain?
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Chicken soup doesn’t work either
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Water needs increase for very active
individuals
Very active individuals need more fluids
� Avoid dehydration, replace fluid loss
� Compensate for environment, weight, training
� Compensate for work intensity, sweat rates of 0.5-2.0 L /hr
depending on temperature, humidity, exercise, individual
factors
Disagreement is on how much
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Upper safe level for sodium is likely
higher for very active individuals
because of losses
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Acceptable macronutrient ranges differ for very
active people, at least pre, during and post
exercise
More carbs??
More Protein ?
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Acceptable macronutrient distribution
ranges to decrease chronic disease risk
may be wrong for very active• Energy providing nutrients (not experimentally determined)
– Carbohydrate 45-65% Calories, Fat 20-35% Calories
– Protein 10-35% Calories ( calculated as residual after CHO
and Fat criteria set)
– Lower limit at RDA
– Upper based on complementing ranges for protein, CHO
• Very active individuals may need more carbohydrate than
sedentary people (and possibly more protein)
• Pre, during and post exercise recommendations provided by
sports nutritior expert groups
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Most vitamin & mineral needs do not
change in very active individuals
Exception: Electrolyte needs increased
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•Food first:� Varied, balance, nutrient dense foods and beverages
•Efficacy dietary supplements unproven� Evidence weak for efficacy of most non-nutrient ergogenic
and performance aids, antioxidants and other nutrient
supplements
Do dietary supplements
improve performance?
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Optimal Range
“Optimal Range” easy to exceed with
high doses nutrient supplements
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Optimal range of intakes is at or above
RDA and below upper safe Level
• Adapted from the IOM/FNB: Dietary reference intakes applications in dietary assessment, 2000 and R Bailey.
INTAKE
RDA UL
UL easy to exceed with supplementsHigh
Low
RISK of deficiency or excess
Adequate and safe intakes for
usual ‘‘‘‘healthy ’’’’population
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Mega-T Green Tea Dietary Supplement/Fat Burning Sup plement• Green tea is the primary ingredient (600mg)• Does not include breakdowns of polyphenols, EGCG, or catechin•Gotu Kola contains catechins
Green tea fat burners
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• Weight loss
• Energy
• Antioxidant
• Thermogenesis/increased metabolism/Fat
burning
• Immune system
Proof lacking for green tea extract
claims and harms possible
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Weak evidence health benefits of green tea /extracts
Epidemiological observational studies
In some studies, green tea consumption associated with reduced risk for decreasng excess weight, diabetes,heart disease:
Interventional studies : randomized controlled trials
Limited poor quality clinical trials claim potential preventive effects for weightloss and weight maintenance
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Reviewed in Schonthal, Mol. Nutr. Food Res. 2011, 55, 874–885
Harms?? Hepatotoxicity caused by highly concentrated green tea extracts: conflicting report s
. Major pharmacokinetic and safety studies of Green Tea extracts
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Sound advice on nutrition and dietary
supplements for performance
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Energy shots and drinks
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Possible effects attention
Little evidence positive effects on physicalperformance
Concerns about safety of very high total doses, esp with alcohol
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. Label Statement 5-hour ENERGY Grape:““““Contains caffeine comparable to a cup of the leadin g premium coffee ””””.
Cartoon from 5-hour ENERGY website
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•Be realistic about how active they really are
•Adjust for clearly altered calorie and nutrients
needs
• Focus on total nutrient intake
Food, beverages, nutrient containing supplements & over the
counter medications containing nutrients
•Use reliable sources for guidance
How can people make sure
their intakes are appropriate?
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Remember diet alone is not nutritional status:
consider body composition, biochemical indices,
clinical signs and symptoms as well
Consult reliable sources
How can very active people make
sure their intakes are adequate?
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Good web-based nutrition advice
for very active people
• Human Performance Resource Center:
– http:hprc-online.org/nutrition
• Australian Government Sports Commission
http://www.ausport.gov.au/als/nutrition
• Singapore:
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http://www.humanperformanceresourcecenter.org/
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• Nutrition Module
•Nutrient timing
exercise
refueling
recovery
maintanence
•Fatigue and glycogen
depletion
•Carbohydrates and
glycemic index
•Protein
•Water
•Dietary supplements
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Take Homes
• Address dietary intake and physical
activity together
• Food and drink, not supplements,
best to maximize health and
performance
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Take Homes
• Sedentary /light physically active
need to watch dietary intakes to
–maintain and avoid gaining weight
– lose weight
–stay healthy
Sit less, move more , play sports, and
eat well but a bit less68
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Take Homes
• Very physically active have altered
needs for a few nutrients, and no
proven needs for dietary
supplements to enhance
performance
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