nutrition for cycling fueling 3/21/13 heather schwartz,...

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Nutrition for Cycling Fueling Your Human Powered Vehicle 3/21/13 Heather Schwartz, M.S., R.D. BIOGRAPHY: Heather Schwartz, Registered Dietitian, is a Medical Nutrition Therapist at Stanford University Medical Center. After completing her undergraduate degree in Nutrition at Cal Poly St University in San Luis Obispo, she received her Masters degree in Nutrition at San Jose State University. After a clinical internship at UCSF, Heather went to work with the Heart and Lung Transplant teams at Stanford. Having worked in the hospital on an internationally recognized medical team for several years, Heather turned her focus towards counselingintensive practice. She has been the lead dietitian at Stanford’s Nutrition Clinic since 2009 and coaches patients and their families towards optimal health by cultivating sustainable behavior change. Heather also works in Stanford’s Executive Health Program where she works with top executives from across the globe. Heather works daily with athletes of all calibers, from those interested in getting back into cycling after an injury, to professional, multisport athletes. BIBLIOGRAPHY: Ainsworth BE, Haskell WL, Herrmann SD, Meckes N, Bassett DR Jr, TudorLocke C, Greer JL, Vezina J, WhittGlover MC, Leon AS. 2011 Compendium of Physical Activities: a second update of codes and MET values. Med Sci Sports Exerc. 2011 Aug; 43(8):157581. American College of Sports Medicine, Sawka MN, Burke LM, Eichner ER, Maughan RJ, Montain SJ, Stachenfeld NS. American College of Sports Medicine position stand. Exercise and fluid replacement. Med Sci Sports Exerc. 2007 Feb;39(2):37790. American Dietetic Association; Dietitians of Canada; Rodriguez NR, Di Marco NM, Langley S. American College of Sports Medicine position stand. Nutrition and athletic performance. Med Sci Sports Exerc. 2009 Mar;41(3):70931. Armstrong LE, Soto JA, Hacker FT Jr, Casa DJ, Kavouras SA, Maresh CM. Urinary indices during dehydration, exercise, and rehydration. Int J Sport Nutr. 1998 Dec; 8(4):34555. Casa DJ, Clarkson PM, Roberts WO. American College of Sports Medicine roundtable on hydration and physical activity: consensus statements. Curr Sports Med Rep. 2005 Jun;4(3):11527. Ivy JL, Goforth HW Jr, Damon BM, McCauley TR, Parsons EC, Price TB. Early postexercise muscle glycogen recovery is enhanced with a carbohydrateprotein supplement. J Appl Physiol. 2002 Oct;93(4):133744. LoganSprenger HM, Heigenhauser GJF, Jones GL, Spriet LL. Progressive Dehydration during Cycling Increases Skeletal Muscle Glycogenolysis and Perceived Exertion in Hydrated Males. Int J Sport Nutr Exerc Metab. 2012 Oct 30. Williams M, Raven PB, Fogt DL, Ivy JL. Effects of recovery beverages on glycogen restoration and endurance exercise performance. J Strength Cond Res. 2003 Feb;17(1):129.

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Nutrition for Cycling Fueling Your Human Powered Vehicle 

3/21/13  

Heather Schwartz, M.S., R.D.  BIOGRAPHY:  Heather Schwartz, Registered Dietitian, is a Medical Nutrition Therapist at Stanford University Medical Center.  After completing her undergraduate degree in Nutrition at Cal Poly St University in San Luis Obispo, she received her Masters degree in Nutrition at San Jose State University.  After a clinical internship at UCSF, Heather went to work with the Heart and Lung Transplant teams at Stanford.  Having worked in the hospital on an internationally recognized medical team for several years, Heather turned her focus towards counseling‐intensive practice.  She has been the lead dietitian at Stanford’s Nutrition Clinic since 2009 and coaches patients and their families towards optimal health by cultivating sustainable behavior change.  Heather also works in Stanford’s Executive Health Program where she works with top executives from across the globe.  Heather works daily with athletes of all calibers, from those interested in getting back into cycling after an injury, to professional, multisport athletes.   

 BIBLIOGRAPHY:  Ainsworth BE, Haskell WL, Herrmann SD, Meckes N, Bassett DR Jr, Tudor‐Locke C, Greer JL, Vezina J, Whitt‐Glover MC, Leon AS. 2011 Compendium of Physical Activities: a second update of codes and MET values. Med Sci Sports Exerc. 2011 Aug; 43(8):1575‐81.  American College of Sports Medicine, Sawka MN, Burke LM, Eichner ER, Maughan RJ, Montain SJ, Stachenfeld NS. American College of Sports Medicine position stand. Exercise and fluid replacement. Med Sci Sports Exerc. 2007 Feb;39(2):377‐90.  American Dietetic Association; Dietitians of Canada; Rodriguez NR, Di Marco NM, Langley S. American College of Sports Medicine position stand. Nutrition and athletic performance. Med Sci Sports Exerc. 2009 Mar;41(3):709‐31.  Armstrong LE, Soto JA, Hacker FT Jr, Casa DJ, Kavouras SA, Maresh CM. Urinary indices during dehydration, exercise, and rehydration. Int J Sport Nutr. 1998 Dec; 8(4):345‐55.  Casa DJ, Clarkson PM, Roberts WO. American College of Sports Medicine roundtable on hydration and physical activity: consensus statements. Curr Sports Med Rep. 2005 Jun;4(3):115‐27.  Ivy JL, Goforth HW Jr, Damon BM, McCauley TR, Parsons EC, Price TB. Early post‐exercise muscle glycogen recovery is enhanced with a carbohydrate‐protein supplement. J Appl Physiol. 2002 Oct;93(4):1337‐44.  Logan‐Sprenger HM, Heigenhauser GJF, Jones GL, Spriet LL. Progressive Dehydration during Cycling Increases Skeletal Muscle Glycogenolysis and Perceived Exertion in Hydrated Males. Int J Sport Nutr Exerc Metab. 2012 Oct 30.   Williams M, Raven PB, Fogt DL, Ivy JL. Effects of recovery beverages on glycogen restoration and endurance exercise performance. J Strength Cond Res. 2003 Feb;17(1):12‐9.  

3/22/2013

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Nutrition for Cycling Fueling Your Human Powered Vehicle

Heather Schwartz, M.S., R.D.UCSF Osher Center for Integrative Medicine 

Medicine of CyclingMarch 2013

Objectives

1. Learn how much, when, and what kinds of fluid your body needs before/during/after your ride

2. Calculate your energy needs to fuel your cycling goals on and off the bike

a. what kinds of fuels are best and when 

b. everyday energy needs

c.  pre‐ride

d.  in the saddle

e.  post‐ride recovery

Optimal Nutrition On and Off the Saddle

• Everyday nutrition vs ride‐day nutrition

– 60% carb, 20% pro, 20% fat vs race day needs

– Energy and fluid distribution throughout the day

– Honor your hunger and thirst

• Is it worth your time and energy? 

– Quantitative: go faster, go harder, go longer

– Qualitative: improve energy, improve overall health, better mood

Hydration

• Raise your glass to…– Everyday function: tissue perfusion, blood pressure, mental abilities, appetite regulation, etc…

– Performance: speed, duration, recovery, injury prevention– 2% loss in body mass = 5% loss of performance

• 75kg cyclists who loses 1.5kg/2 hours = 6 minutes

• Fluid needs: kg x 30‐35ml/kg= ____ml per day– Ex: 165#/2.2=75kg

• 75 x 30‐35=2250‐2625ml per day

Int J Sport Nutr. 1994 Sep;4(3):265‐79.  Int J Sport Nutr Exerc Metab. 2012 Oct 30 (Epub ahead of print)

30ml=1oz8oz=1cup

Hydration Schedule

• General Guidelines for optimal performance

*Heat, intensity, altitude, acclimatization, sweat rate may alter these values

Current Sports Med Reports 2005, 4:115‐127.

Int J Sports Nutr 8:354‐355.

Time Amount of fluid

1‐2 hours before 16‐20oz

30 mins before 8‐16oz 

Every 15min on ride 4‐8oz 

Within 1 hr after ride 16‐24oz/# body wt lost

Individualized Hydration Needs 

• Sweat Rate

A. Weight: pre ride ‐ weight post ride = _____kg x 16 oz

B. Fluid consumed during ride= _____oz

C. Total oz/hours of ride= _____oz/hr

Example: 75kg‐73.5kg=1.5x16oz=16oz

24oz+40oz=64oz

64oz/2 hours=32oz per hour

So…1 1/3 bottles per hour

• Hydration needs change depending on temperature/elevation acclimatization, pre‐ride hydration status and exertion

Med Sci Sports Excer. 2007 Feb:39(2):377‐90.

1oz = 30mlMost bottles = 24oz

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How to Hydrate

• General rule of thumb: drink 4‐6x per hour– Ex: 32oz/4x=8oz every 15 minutes

• Sports drinks vs water on the ride– >60 min ride, sports drinks provide benefit

• Replace electrolyte losses• Enhance fluid absorption and utilization• Efficient delivery method of carbohydrates• Flavor burnout

• Practice hydration proficiency• Drinking while pedaling, climbing, alone vs peloton, switching 

hands, swapping cages, use of jersey pockets• Timing‐drink before you’re thirsty

Med Sci Sports Excer 39(2):377‐90., 2007.Med Sci Sports Excer 41(3):709‐731, 2009.

Which sports drinks are best?

• Every 8oz should provide the following…

Current Sports Med Reports 2005, 4:115‐127.

Timing Ingredients Characteristics Examples

0‐3 hours Mixed carbs (glucose, fructose, sucrose,  maltodextrin, polymers)

6‐8% carb solution, ~75mg sodium and 25mg potassium, other ‘lytes

Gatorade, Cytomax, Fluid, Skratch Labs, Powerade, Gu Brew, First Endurance‐EFS

>3 hours Mixed carbs, sodium, protein

~150mg sodium and 50mg potassium, ‘lytes, BCAA

Gatorade Endurance, Accelerade, Endurox, Roctane

Fueling Up• How big is my everyday fuel tank?

– Weight maintenance: 30‐35kcal/kg vs Harris Benedict Equation

• Example: 45yr old male, 5’10, 165# (75kg), active

2225‐2625 vs 2400kcals

• What kind of fuel do I need? • Dependent on level of riding….

• 60‐70% carbohydrate, 15‐20% fat, 15‐20% protein

• Example: If 2400kcals, 360gcarb, 55g fat, 120g pro

• Spread evenly throughout the day

Med Sci Sports Exer 41(3):709‐731, 2009.

1g carb=4kcal1g fat=9kcal1g pro=4kcal

Pre‐ride Fueling

• Goal: top off muscle and liver glycogen, hydrate– 3‐4 hours before: 2g carb/kg, ~800kcals

– 1 hour before: 1g carb/kg, ~300kcals

– High carb, moderate protein, low fat, low fiber

Example: 75kg cyclist, 40K ride starts at 9am

Med Sci Sports Exer 2009; 41:709‐731. 

Time Carb (g) H20 (oz) Examples

6am 150 20 Bagel with lowfat cream cheese and jam, 12oz OJ, banana with PB

8am 75 20 Accelerade (2 scoops, 20oz H20),  1 pkg Sports Beans

Fuel choices: 89 vs 91

Fuel Source 89 91

Carbs refined grains‐sweet cereals, cookies, candy, pastries, chips, sodas and sweetened drinks

whole grains‐barley, brown rice, quinoa, whole grain products‐oatmeal, breads, pasta, cereals, crackers, grits, granolawhole fruits‐anystarchy veggies‐potatoes, corn, peas

Protein high fat meats, cheeses and dairy‐salami, hot dogs, rib eye, >20% fat ground beef, ice cream

lentils, beans, nuts and seedslean meats‐poultry, beef, pork, seafood, eggslowfat dairy or soy‐milk, yogurt, cheese

Fat butter, lard, creamy sauces, gravies

olive oil, canola, avocado, nuts, seeds,  sardines, salmon, mackerel

Example 1 sausage, egg, cheese breakfast sandwich with 16oz mocha

Whole wheat bagel with lox and lowfat cream cheese, 16oz coffee with lowfat milk

How much fuel for my ride?

• How big is my ride‐day fuel tank?

– Daily needs + energy expenditure on ride 

– (___METs x 3.5 ___kg) / 200 = ___kcal/min

• Example: (12 METs (15‐19mph) x3.5 x75kg)/200=  15.75kcal/min945kcals/hr

• Total kcal needs for day with 1 hr ride=2400+945 = 3345

“ 2 hr ride=4290

• Honor your hunger 1st, calories 2nd

Med Sci Sports Exerc 32 (suppl):S498‐S516, 2000.

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Fueling In the SaddleGeneral carbohydrate guidelines

*heat, body mass, intensity, and acclimatization may change estimates

Med Sci Sports Excer 41(3):709‐731, 2009.

Time Carbs/ hr kcal/hr Sample fuel plan (+water)

<60 mins 0‐15 g/hr 0‐60 1/2c OJ mixed with water

1‐2 hours 30 g/hr 120 16oz Gatorade (30g) 

2‐3 hours 60 g/hr 240 32oz Gatorade (60g)‐OR‐

16oz Gatorade (30gm) + 1 gel (25g)

>3 hours 90 g/hr 360 6 scoops Roctane + 3 Roctane Gels‐OR‐

8oz OJ (30g) + 2 fig bars (30g) + Bonk Breaker (32g)

Fueling In the Saddle

• Tolerance is king of the mountain

– GI distress 

• Dehydration, under/over fueling, fuel type, genetics

• In theory, smaller the particle size the better

– Drinkable carbs vs edible carbs (liquid>solids)

• Practice your pit stop

– Timing, packaging, bento box vs jersey pocket, fluid vs solid, engineered food vs whole food

Fueling for Recovery Your workout is not over until you have refueled.

• Goal: rebuild, refuel, rehydrate – 1‐1.5g carb/kg within 30 mins

– .2‐.4g protein/kg within 30 mins

– ~500mg sodium, other ‘lytes

Example: 75kg cyclist, 75‐112g carb, 15‐30g pro

J Strength Cond Res. 2003 Feb, 17(1)12‐9.

J Appl Physiol. 2002 Oct;93(4) 1337‐44.

Sample recovery fuel plans + H20 (oz) Carb (g) Pro (g)

Bagel, 2 Tbsp PB, string cheese, banana 48 86 22

16oz choc soy milk, Cliff Bar 32 98 28

1 scoop Ultragen w/20oz H20,  Bonk Breaker Bar 22 96 27

Sample Fuel and Hydration Plan

45yr old male cyclist, 75kg, 2 hr ride, avg 12 METs • Breakfast, 6am: 12oz OJ, 1.5c oatmeal with 1 Tbsp almonds, 2 Tbsp honey, 1 

banana, 12oz coffee with lowfat milk and sugar, 12oz water

• Snack, 8am: 1.5c Cheerios with 1c soy milk, 12oz water with 1 scoop Gu Brew 

• Ride: 1st hour‐24oz G’ade, 8oz H20, rice ball

2nd hour‐Cliff Bloks, 16oz H20, 1 med yam (baked)

• Snack, 10:30am: 8oz lowfat yogurt w/berries, 1 scoop Ultragen/24oz H20, 12oz H20

• Lunch, 1pm: 2 PB&J on 100% whole wheat bread, 1c carrots with 1/2c hummus, 16oz soy milk, 8oz H20

• Snack, 3pm: 1c grapes, 2oz nuts, 8oz H20

• Dinner, 7pm: 2.5c pasta, 1c tomato sauce, 4oz 85% lean ground beef, 1c broccoli, 4oz wine, 16oz H20

• Snack, 9pm: 1 cup Ben and Jerry’s ice cream, 16oz H20

Nutrition Resources

• Websites: • www.acsm.org• www.gssiweb.com• www,ausport.gov.au• www.sportsoracle.com

• To find a sports dietitian near you• www.scandpg.org

• Columns, newsletters: • VeloNews‐Monique Ryan• ACSM’s Fit Society• CSPI’s Nutrition Action Newsletter

• Books:– The Cyclist’s Food Guide, Nancy Clark and Jenny Hegmann– Endurance Sports Nutrition, Suzanne Eberle– Sports Nutrition For Endurance Athletes, Monique Ryan

• Cookbooks:– The Feed Zone Cookbook by Dr. Allen Lim and Chef Bijou Thomas– The Athlete's Plate, Adam Kelvinson 

Thank you!

Heather Schwartz, M.S., [email protected]

3/22/2013

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Self Tracking and Gadgets

for Training and Health

Paul Abramson MDMy Doctor Medical GroupUCSF Clinical Instructor

Why Gather Data?

• Engineers: Tight feedback is important to get a system to converge

• Psychologists: Seeing your progress will motivate behavior

• Coaches: I want to know what’s going on so I can help

Self Tracking is Hot

• The Quantified Self movement has taken off since 2010

• Wearable sensors and gadgets have proliferated into the popular consciousness

Non-Cycling Sensors

Cyclists Already Do This

• The cycling computer is not a new concept

• Then: Cadence, heart rate, speed, distance

• Now: Power output and heart rate variability (HRV)

• Helps to quantify workouts and guide training.

Cycling Computers

Wahoo RFLKTLeikr

Garmin Edge510

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Power Tracking

• Power combines cadence and torque

• Reflects muscle activity, not just cardiovascular effort

• Not affected by the environment and other confounding variables(temperature, excitement, altitude, stimulants, hangover status)

Measuring Power Output

PowerTap hub

Cyclops PowerBeam Pro: Indoor trainer

Measuring Power Output

iBike Newton

SRAM REDQuarq

CycleOps Virtual Trainingwith Powerbeam Pro

Wahoo KICKRwith KinoMap

Indoor Trainers+ Power

+ Virtual Ride

Relative Perceived Exertion (RPE)

• Subjective self rating of exertional effort

• 1 = Easy

• 10 = Eyes are bleeding

• Some prefer this instead of objective measures

Heart Rate Variability

• CardioSport Smart HR

• Wahoo BLUEHR

• Polar H7

• Zephyr HxM SMART

• iThlete app

Helps guide recovery

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Zephyr BioHarness

Commercial Data Platforms & Sharing

• Strava

• Endomondo

• MapMyRide

• TrainingPeaks

• Runkeeper

Exercise Metabolic Testing

Body Composition

LifeBeamSmart Bike Helmet

Withings Wireless Scale

3/22/2013

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Withings BP CuffSleep Tracking - Zeo

(R.I.P.)

Lumoback

Putting it all together..

The Quant CoachMedically-Supervised

Quant Coaching

Patient

Doctor

Quant Coach

Dietitian

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Trainer-SupervisedQuant Coaching

Cyclist

Team Trainer

Quant Coach

Dietitian

The Quant Coach• Designs self-tracking program

with participant, trainer, dietitian

• Implements monitoring tech

• Reviews data with participant

• Gives concise feedback to participant, trainer, dietitian

• Team adjusts training program dynamically

Quant Coach

Define variablesto track

Gather baselinedata

Adjust variables

Do experiment

Adjust experimentAdjust variables

Active Tracking

Data Review

Why Quant Coaching?(medical)

• Figure out odd symptoms

• Identify environmental, dietary, emotional triggers

• Conduct controlled personal experiments of potential treatments

• Achieve goals, enhance motivation

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• Enhance and speed up training feedback loop using standard metrics

• Identify other factors affecting training

• Experiments with food, environment, hydration, sleep, mental training

• Identify overtraining, stress, burnout

• Help implement changes, enhance motivation

Why Quant Coaching?(cycling)

It’s not just the data..

• Data serves to trigger memory

• Dynamic narrative builds motivation

• Iterate - iterate - iterate

Contact

Paul Abramson MDMy Doctor Medical Group

San Francisco

[email protected]

Twitter: @paulabramsonmd