Strategies for training and racing in the heat

I’ve published an old version of this article in another website. The following is an updated version with additional references and information. Let me know if you would like to have access to any of the full paper in the references. 

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It is a known fact that heat stress impairs aerobic performance and high temperature and humidity affects endurance performance negatively.  

Some athletes may be affected more than others. Possible factors contributing to individual athlete response to heat response and acclimation are listed below (Casadio et al 2016):

Factors Influence on heat response Influence on heat acclimation
Sex females have a higher threshold for start of sweating and reduced sweating output females may require moderate-term (longer) heat acclimation
Ethnicity individuals from hot climates may have greater heat shock proteins faster heat acclimation for those from hot climates
Athlete Type Endurance athletes have enhanced evaporative cooling vs sprint athletes not related to specific athlete type, but more to VO2Max
Training Status Higher VO2 max relates to higher heat shock proteins content and exercise heat tolerance higher VO2max relates to faster heat acclimation and greater heat tolerance following heat acclimation
Body Size Larger body size = lower body surface area to body mass ratio and higher heat strain in body mass dependent exercise not available in literature
Body Composition higher body fat results in faster increase in body core temperature higher body fat is directly related to VO2max
Heat Acclimation History Reduced heat strain in subsequent heat response test (2-4weeks prior heat acclimation) heat acclimation occurs faster with 2-4 sessions
Menstrual Cycle Reduced body core temperature (0.1-0.2C) prior to ovulation and increased (0.2-0.5C) following ovulation females can heat acclimatize regardless of menstrual cycle phase, following a moderate-term period vs short term
Oral Contraceptives Combined pill use causes higher body core temperature (0.5C) and cyclical fluctuations may be dampened.
Progesterone-only pills reduce body core temperature (0.6-0.7C)
similar acclimation between users and non-users
Immune Status Fever or Upper Respiratory Tract Infections increase Exertional Heat Injury heat acclimation may change immune markers but protect against EHI

 

What are the strategies that can be implemented to minimize the negative impacts of racing in the heat?

In this article I am providing you a summary of the latest research on strategies to improve endurance performance in the heat.

Not only have all these strategies been tested in the labs, many are currently used by elite athletes and sports teams around the world. Some of these strategies may seem to only accessible to the elites, but there are still some take-aways that we can use.

In the recent “Heat stress and sport performance” conference, Mujika (2015) divided the heat management strategies into the following categories:

    • pre-cooling interventions during race
    • optimal hydration practices – before, during and after exercise/race
    • heat acclimatization/adaptation
    • before race, to prepare athletes coping with heat stress

Each strategy works differently with the same out come which is “to enhance well trained athletes’ endurance performance in hot environments”.

Pre-cooling Strategies

Pre-cooling strategies include any strategy that can help to lower body core temperature BEFORE exercise. It can be further divided into skin-cooling (which will reduce cardiovascular strain during exercise) and whole-body cooling (to reduce organ and skeletal muscle temperatures).

Pre-cooling has been proven to improve endurance performance and prolong endurance capacity in hot condition.

Some of the applications include:

    • whole body cold water immersion : 30 mins at a water temperature 22-30C or lower body cold water immersion: at lower temperature 10-18C.
      This will definitely help to lower body core temperature but at the same time cooling the muscles which may not desirable before exercise.
      It is currently the most effective method of precooling to improve endurance performance in hot conditions, if muscle cooling is not an issue.
    • using cooling garments : iced towel or special cooling packs or vests. Fanning and staying in a cold room will also help.
      This is ideal for skin-cooling strategy which reduces skin temperature without reducing muscle temperature.
    • drinking cold water. Interestingly, cold water could improve performance if ingested before but not during exercise.
    • drinking ice-slushy. This method is proven to be more efficient in cooling prior or during exercise than drinking cold water. It is also the second most effective method after whole-body cold water immersion.
    • mixed methods of any of the above.

Hydration Strategies

Hydration strategies are something that we often associate with race day hydration. Maintaining and practising hydration strategies during training is essential to maintain fluid balance before the race.

The latest recommendation to maintain adequate hydration status is for athletes to consume 6mL of fluid per kg of body mass every 23 hr before training or racing in the heat.

Another interesting note: If you ever consider losing some (water) weight before your cycling race in order to gain a higher power-to-weight ratio, don’t. Mijuko pointed out that such “benefit” is more detrimental than “dehydration induced hyperthermia” or having an increased body core temperature due to dehydration.

The notion of slight dehydration leads to reduced performance has not been conclusively proven. The latest finding by Cheung, et al (2015) states that 3% body mass loss due to dehydration induced hyperthermia does not lower hydration status nor perception of thirst in the “sustained submaximal exercise performance in the heat for a healthy and fit population”. Current recommendation still stands that up to 2% of body mass loss due to dehydration does not hinder any aerobic performance.

Drinking to thirst is highly recommended for most endurance events, unless you are taking part in a very hot long distance event or multi-days events. Daily morning body mass and urine colors may be used to monitor dehydration status.

Athletes training in the heat have higher sodium requirements than the general population. Heavy sweaters may increase sodium (salt) intake prior to and after hot weather training and racing.

(Racinais et al 2015)
(Heavy sweaters can add 3.0g of salt to 0.5L of a carbohydrateelectrolyte drink , prior to and post training/competition to maintain sodium balance).

For exercise longer than 1 hr, you should aim to consume a solution containing 0.5-0.7g/L of sodium. If you are prone to muscle cramping, you can try to increase sodium supplementation to 1.5g/L of fluid if it is sodium-related.

Note: 1g salt ~ 400mg sodium, 1 tsp salt ~ 5g salt ~ 2000mg sodium

When calculating your sodium intake on race day, you should consider ALL intakes (from gels/drinks/tablets/bars). Below is the sodium composition of some popular electrolyte tablets (taken from respective websites)

Product   Sodium
High 5 Zero Electrolyte Tablets 1 effervescent tablet added to 750ml fluid. 0.2g/tablet
High 5 Zero Electrolyte Extreme Tablets 1 effervescent tablet added to 750ml fluid.
Contains 65mg caffeine.
0.2g/rablet
Nuun 1 effervescent tablet added to 500ml fluid. 0.36g/tablet
Shotz Electrolytes 1 effervescent tablet added to 500ml fluid 0.43g/tablet
Salt Stick Caps 1 capsule 0.215g/capsule
Precision Hydration Sweat Salt 1 capsule 0.25g/capsule
Precision Hydration Electrolytes varies 0.125-0.75g/sachet or tablet
PURE Electrolyte Replacement Capsule 1 capsule 0.176g/capsule

 

Some studies have shown that hyperhydration (or overhydration) “prior to prolonged exercise in the heat” might be beneficial. It is something you can consider in training and see if it works out for you.

Over-hydration should be avoided in races as it may result in “water intoxication” or hyponatraemia that has very serious consequences.

One interesting hydration strategies mentioned is glycerol hyperhydration.
It involves adding glycerol to the water consumed (before and during race) whose purpose is to increase water content in the body. This method does not seem to decrease the body core temperature but some studies showed that it decreases the water loss that often leads to dehydration.

Glycerol is chemically an alcohol, technically a sugar alcohol. It is a component of stored fat (triglycerides), is present naturally in blood plasma as free glycerol and is obtained from oil or fats.

Analysis of some studies in this area indicates that “endurance athletes intending to hyperhydrate with glycerol should ingest glycerol 1.2 g/kg BW in 26 mL/kg BW of fluid over a period of 60 minutes, 30 minutes prior to exercise”.

 

General guideline for proper hydration post-training is to replace 150% of body mass losses within 1 hr of exercise, 100-120% more realistic, through consumption of fluids with foods (salty foods)carbs, proteins, sodium

 

Heat acclimatization/adaptation strategies

Heat acclimatization/adaptation strategies include passive and active acclimatization strategies that can raise body core temperature, skin temperature and sweat rate. Note that this has to be done repeatedly before the race and is considered essential for athletes participating in any event in a hot condition.

Passive acclimatization strategies involve any “passive environmental heat exposure” such as taking a sauna.

Active heat adaptation ideally would involve training in the similar hot and humid condition you will be racing in (“acclimatization”). If that is not possible, training indoor in a simulated hot condition will also work (“acclimation”).

Ideally, each acclimatization session would last at least 60mins/day (90mins is ideal or 2h broken into two, 1 hr exposures) for at least 2 weeks to induce the physiological adaptation required. It would take at least 1 week for the body to obtain the main physiological adaptations, but early adaptation will start as early as the first few days. 

Of course individual adaptations will vary, with adaptations developing more quickly in highly trained athletes. The more aerobically fit athletes can induce heat acclimatization faster (as much as 50%) and retain its benefit longer.

During the heat acclimatization period, the body will continually adapt. Increasing the duration and/or intensity should be considered in the heat-training strategy. 

For those living in temperate climate or do not have the opportunity/time to train in the heat for acclimation purposes, taking a hot bath (40C) for at least 15mins immediately after training has been shown to elicit heat adaptation response in endurance runners. (Zurawlew et al, 2016)  The duration of hot bath should be increased by 5mins daily up to 40mins for at least 6 consecutive days.

Interestingly, heat acclimatization strategies have also been proven to increase racing performance in neutral conditions. It is possible to use heat acclimatization training as another training stimulus for experienced athletes to improve performance. Note that for beginners, training quality should not be compromised and be substituted with heat training. 

A mixed high intensity sessions with a duration of 60 minutes each (at least 5 sessions) may improve aerobic-based performance in hot and temperate conditions.  Peak anaerobic performance does not seem to be enhanced by this. (Charlmers et al 2014)

Both pre-cooling strategy (cold water immersion 20mins prior) and cooling strategy during event (cold water spray, 3x every 1km) have been shown to improve performance in a 5km running time trials performed on 9 trained runners, racing in 33C. (Stevens et al 2017)

 

Humid vs dry heat

Cooling takes place via evaporation of sweat. Another strategy that has not been proven to be successful but has a potential to be tested in a long distance event is “wearing sweatbands soaked in alcohol or menthol based liquid solution”. The increased rate of evaporation may contribute to a cooling effect on the skin.

 

References

 

Chalmers S, et al, 2014, “Short-term heat acclimation training improves physical performance: a systematic review, and exploration of physiological adaptations and application for team sports” Sports Med, Jul, vol 44 no 7, pg971-88

Cheung SS, et al, 2015, “Separate and combined effects of dehydration and thirst sensation on exercise performance in the heat” Scandinavian Journal of Medicine & Science in Sports, May, vol.25, Suppl, pp 104-111

Jones P, et al, 2012, “Pre-cooling for endurance exercise performance in the heat:: a systematic review” BMC Medicine, vol 10 no 166

 
Marathon athlete pouring water over his head to cool down during an intense run.

All About Iron

Dietary iron is available in two forms: haeme iron mainly found in meat, poultry and fish and non-haeme mainly from plants and dairy products. Iron forms and individual’s iron nutritional status influences iron absorption in the body. Haeme iron is more readily absorbed while non-haeme iron’s absorption is strongly influenced by dietary factors.

Phytates (antioxidant compound found in legumes) and tannins (polyphenols in tea, coffee, read and white wine) are known inhibitors while vitamin C and acids are enhancers (Higdon et al 2009; Killip et al 2008). Efficiency of absorption in human’s varies between 5-15%

Most of our daily requirement of iron comes from the recycling of red blood cells, however at least 1-2mg of iron needs to be absorbed from diet to compensate for losses through bleeding, perspiration, epithelial (surface cell) sloughing.

Some of functions of Iron:

  • Transport of oxygen from the lungs to the rest of the body and within muscle cells, as part of haeme in haemoglobin and myoglobin.
  • Production of energy (ATP) in the electron transport chain, as cofactor in cytochrome
  • Detoxification process in liver, as cofactor in cytochrome
  • Antioxidant function, contained in catalase and peroxidase, antioxidant enzymes
  • Pro-oxidant function
  • DNA synthesis, as iron-dependent enzyme required in DNA synthesis
  • Regulation of intracellular iron, as part of proteins used in cells to adjust iron levels
  • As a cofactor in a critical enzyme for dopamine synthesis
  • Immune resistance
  • Regulating cell growth including skin and nail formation

Recommended Daily Intake:

  • 0-5yrs: 6mg/day
  • 5-13yrs: 8-10mg/day
  • 14-18yrs: 11-15mg/day – girls on higher end
  • Men: 8mg/day
  • Women: 18mg/day
  • Prenatal: 10-20mg/day
  • Pregnancy and lactation: 30mg/day
  • Iron requirement can be up to 30% higher in athletes
Increased Intakes
Decreased Intakes
Growing infants and children
Menstruating women
Pregnancy
Lactation
Training in high altitude
Low socioeconomic status
Vegetarian diets
Poor intake/lack of balanced diet
Alcoholism
lderly
Disadvantaged populations (refugees, indigenous Australians)
Excessive loss Decreased absorption
Menorrhagia
GI bleeding
Regular blood donors
Post-operative patients with significant blood loss
hematuria
Extreme physical exercise (endurance athletes)
Dietary factors (tannins, phytates, calcium in milk, tea, coffee, carbonated drinks)
Upper GI Pathology: chronic gastritis, gastric lymphoma, celiac disease,

crohn’s diseaseGastrectomy or intestinal bypass
Duodenal pathology
Chronic renal failure patients
Medications (regular aspirin or other NSAID usage – leading to GI bleeding)

Table 2. Causes for Iron Deficiency and Iron Deficiency Anemia (The Clinical Practice Guidelines 2010; GESA 2008)

Some Iron Sources:

Food Serving Iron Content
Beef 85gr, cooked 2.32 mg
Chicken, dark meat 85gr, cooked 1.13 mg
Tuna, light 85gr, canned 1.30 mg
Oysters 6 medium
5.04 mg
Tofu, firm
1/3 cup 2.15 mg
Spinach
1 cup
6.43 mg
Bok Choy 1 cup 1.77 mg
Asparagus
1 cup 1.64 mg
Romaine Lettuce 2 cups
0.91 mg
Swiss Chard 1 cup 3.96 mg
Kale 1 cup 1.17 mg
Broccoli 1 cup 1.05 mg
Green Beans 1 cup 0.81 mg
Green Peas 1 cup 2.12 mg
Brussels Sprouts 1 cup 1,87 mg
Cabbage 1 cup 0.99 mg
Garbanzo beans 1 cup 4.74 mg
Lima beans 1 cup 4.49 mg
Lentils 1/2 cup, cooked
3.30 mg
Kidney beans 1/2 cup, cooked 1.97 mg
Black beans 1 cup 3.61 mg
Pumpkin seeds 1/4 cup 2.84 mg
Raisins
30gr 0.5 mg
Dried apricot 30gr 0.9 mg
Cashew nuts 30gr 1.9 mg

Some important nutrient interactions:

  • Copper is required for normal iron metabolism and red blood cell formation. Copper deficiency is often found in anemia.
  • High doses of zinc supplementation together with high doses of iron supplement may inhibit zinc absorption when taken on an empty stomach. It does not seem to have similar effect when taken with food.
  • Calcium and iron supplements should not be taken together. Calcium has been shown to decrease absorption of haeme and non-haeme iron in a single meal.

Do I need Iron supplement as an athlete?

Unless you have been diagnosed with iron deficiency by your doctor, taking iron supplement is not recommended. A full Iron Panel Blood Testing is necessary before iron deficiency can be diagnosed.

Recommendations for athletes:

  • Monitor fatigue level. If you experience chronic fatigue and are showing the symptoms of iron deficiency, consult your doctor to do a full Iron Panel Blood Test.
  • Be conscious of consuming iron-rich foods.
  • If you frequently consume coffee/tea with your meals, note that absorption of iron may be reduced even if you are consuming an iron-rich meal.
  • Consume vitamin C sources with your iron-rich foods.
  • If you are a vegetarian/vegan, you will need to consume more than the daily recommended amount – as non-haeme iron absorption is less than haeme iron.
  • If you are training at high altitude, your iron requirement will be higher.
  • Female athletes should monitor their iron level regularly. Consume more iron-rich foods during your menstrual cycle.

Iron Deficiency vs Iron-deficiency Anemia (IDA)

Iron deficiency begins when iron needs are inadequately met as more iron is being lost than absorbed. It develops gradually with minimal symptoms until inadequate iron is available to support erythrocytes formation, leading to iron-deficiency anemia (IDA). Fewer erythrocytes are formed, they become smaller in size (microcytic) with decreased haemoglobin content (hypochromic) reducing their oxygen-carrying capacity. Diagnosis of IDA requires evidence that total body iron is reduced to the point where iron stores are fully depleted and tissue iron deficiency exists (Cook 2005). Vitamin A deficiency may exacerbate Iron deficiency anemia.

The most common symptom of any anemia is chronic fatigue. Pallor, rapid heart rate, palpitations are symptoms compensating for decreased tissue oxygen delivery. Development of pica is unique to IDA while other clinical features: koilonychia, glossitis and dysphagia are seldom seen in modern clinical practice (Killip et al 2008). The only definitive test for IDA is by showing laboratory evidence of iron deficiency including “a complete blood cell count, peripheral smear, reticulocyte count and serum iron indices” (Johnson-Wimbley & Graham 2011).

Cook (2005) classified causes of IDA into two major categories: physiological and pathological. Physiological causes include nutritional iron deficiency due increased requirements (rapid growth, menstrual blood loss, extreme exercise) and/or decreased intake (low diet bioavailability). Pathological causes are due to malabsorption syndromes or pathological excessive blood loss as in gastrointestinal bleeding.

Common Others Severe IDA
fatigue,feeling weak, tired
pallor
rapid heart rate
palpitation
rapid breathing on exertion
difficulty maintaining body temperature/cold hands and feet
decreased concentration capacity
brittle, spoon-shaped nails (koilonychia)
sores at corners of mouth
sore tongue (glossitis)
taste bud atrophypica: consumption of non-food item (ice, dirt, paint)
susceptibility to infection
difficulty in swallowing (dysphagia)

Table 1. Symptoms for Iron Deficiency and Iron Deficiency Anemia (GESA 2008; Higdon et al 2009)

References
Cook JD, 2005, ‘Diagnosis and management of iron-deficiency anaemia’ Best Practice & Research Clinical Haemotology vol 18 no 2, pp319-32.

Gastroenterological Society of Australia (GESA), 2008, ‘Iron Deficiency’, Australia, viewed on 10 November 2010, < http://www.gesa.org.au/files/editor_upload/File/Professional/Iron_def.pdf>.

Higdon J, Drake VJ, Wessling-Resnick M, 2009, ‘Micronutrient Information Center – Iron’, Linus Pauling Institute, Oregon, USA, viewed 10 November 2014, <http://lpi.oregonstate.edu/infocenter/minerals/iron/>.

Johnson-Wimbley TD, Graham DY, 2011, ‘Diagnosis and management of iron deficiency anemia in the 21st century’ Therapeutic Advances in Gastroenterology, vol 4 no 3, May, pp.177-84, doi:10.1177/1756283X11398736.

Killip S, Bennett JM, Chambers MD, 2008, ‘Iron deficiency anemia’ American Family Physician, vol 75 no 5, March, pp.671-8.

The Clinical Practice Guidelines, 2010, ‘Iron Deficiency – Investigation and Management’, Ministry of Health British Columbia, viewed on 10 November 2014, <http://www.bcguidelines.ca/pdf/iron_deficiency.pdf>

Nutrition for Youth Athletes

What foods to eat to provide energy, when to eat certain food, how to fuel before and during training/events, when and what to eat for recovery / to replenish after activity

Nutrition plays an essential role in sports performance of any athlete.
Macronutrients, micronutrients, fluid/electrolytes intake, recovery process, meal planning, nutrient supplements, weight management are all important aspects to consider to optimize sports performance.

In this article I will touch only the energy and macronutrients requirements for youth athletes.

ENERGY REQUIREMENTS (Caloric Needs)

Adequate energy is required to support growth and development needs and the demands of sports activities. The main goal of basic nutrition is to balance energy intake and expenditure to properly fuel training and recovery.

While energy excess results in overweight and obesity, health consequences of energy deficits include:

  • Delayed puberty
  • Short stature
  • Menstrual dysfunction
  • Loss of muscle mass
  • Increased susceptibility for injury and illness
  • Constant fatigue

Minimum energy requirements for boys and girls are similar BEFORE puberty.
For adolescents, they depend on:

  • Age
  • Activity level
  • Growth rate
  • Stage of physical maturity

ENERGY EXPENDITURE

  • Children use more energy per kg of body weight than adults in sports (less metabolically efficient)
  • General rule of thumb:
    • 8-10 yrs – add 20-25% to adult values for estimated ENERGY EXPENDITURE
    • 11-14 yrs – add 10-15% to adult values of estimated ENERGY EXPENDITURE

Estimated Minimum Energy Requirement (Kcal/day) to make sure proper growth and bodily function

Age (yrs) Male Female
4-6 1800 1800
7-10 2000 2000
11-14 2500 2200
15-18 3000 2200

Additional Energy Requirements needed:

  • During growth spurts
  • To support sports/activities

 

meal, snacks, kids eat, children's snack, peel, table, cover, multicoloured, food, nourishment, yummy, vegetables

MACRONUTRIENTS (carbohydrate, protein, fats)

CARBOHYDRATE

Children (boys and girls ) generally rely more on fat as fuel (due to smaller glycogen storage and possibly conservation of carbohydrates for energy requirements of growth) hence they are well-equipped for aerobic activities.  Their anaerobic capacity is highly dependent on maturation status.

The difference in substrate utilisation during exercise may exist till mid to late puberty and tends to diminish in adolescents, especially in boys.

Children tend to oxidize relatively more exogenous carbohydrate during exercise compared to adults  despite their lower whole body rate of carbohydrate oxidation and higher rate of fat oxidation. Reliance on exogenous CHO oxidation during exercise (as percentage of total energy expenditure)  is sensitive to pubertal status (not just chronological age). (It was reported that more total energy expenditure is contributed by exogenous CHO oxidation in pre-pubertal and early pubertal boys compared to mid-to-late pubertal boys).

Efficiency of CHO absorption is lower in children under 5 – gradually increases with age. Similar to adults, rate of absorption of CHO varies depending on ratio of glucose to fructose in drinks. Intestinal absorption of CHO shows no difference between children and adults at rest or during exercise.  The higher % of exogenous CHO oxidation during exercise in children may be due to higher intensity and greater energy expenditure during exercise in adults.

In boys (but not found in girls), the ability of exercising muscles to oxidise endogenous glycogen as an energy substrate may contribute to reliance on exogenous CHO.

Pre-pubescent children may have a reduced dietary carbohydrate requirement.

Once they get to adolescence, puberty hormones (growth hormone, insulin-like growth factor, sex hormones, catecholamines – adrenaline/noradrenaline) play an important role in energy metabolism.
(Jeukendrup, Cronin, 2011)

Recommended intake for adolescent athletes: very similar to adults is very dependent on type, duration and intensity of exercise sessions.

Before events: Although carbohydrate loading is generally recommended for adults, it is not advised for children mostly due to shorter events and limited glycolytic capacity mentioned above.

During events:

  • Carbohydrate ingestion (6%) has been shown to increase performance in intermittent, high intensity exercise and increase explosive strength and speed, and shooting skill performance in a basketball test (in adolescent boys)
  • Carbohydrate ingestion enhances endurance exercise performance (cycling time)
  • Reduced perceived exertion by 1-2 points in RPE scale (boys 13-19yrs in a cycle test 60% VO2 max)

Carbohydrate ingestion during exercise may alter substrate used by sparing endogenous glucose utilization in boys and decreased fat utilization of total energy expenditure.

It is important to note that both insulin sensitivity and substrate utilisation during exercise are affected by training. No studies have been done on elite youth athletes which may have different metabolic behaviours.

Good sources of carbohydrates: whole grains, vegetables, fruits, milk, yogurt

Activity CHO intake (g/kg/day)
Immediate recovery after exercise 1-1.2g/kg
Minimal physical activity 2-3
Light exercise (3-5hrs/week) 4-5
Moderate duration and intensity (10hrs/week) with daily recovery 5-7
Moderate to heavy endurance training (20+hrs/week) with daily recovery 7-12
Extreme program (4-6+hr/day) 10-12

(Jeukendrup A. 2010)

PROTEIN

Protein is essential to support development and growth. Children and adolescents have a relatively higher protein requirements compared to adults. The Recommended Daily Allowance (RDA) for the general population are generally too low for athletes.

Recommended intake for adolescent athletes: 1.3-1.8g/kg/day, to be spread throughout the day.

Good sources of carbohydrates: lean meat, poultry, fish, dairy products, legumes, nuts.

RDA for protein

Gender and age RDA USA/Canada g/kg/day
Male/Female 1-3yrs 1.05
4-8yrs 0.95
9-13yrs 0.95
14-18yrs 0.85
19-30yrs 0.8

(Jeukendrup, Cronin, 2011)

FATS

Role of fats:

  • Provide essential fatty acids (DHA/EPA) – important for growth and development
  • Absorb fat-soluble vitamins (A,D,E,K)
  • Protect vital organs
  • Provide insulation
  • Provides satiety

Total fat intake recommendation is highly dependent on energy expenditure. General recommendation: 25-30% of energy intake should come from dietary fat.

Link of fat to performance is still not clear.

Good sources of fats: lean meats, poultry, fatty fish, dairy products, nuts, olive oils, avocado.