Measuring dietary intake in athletes

1. Measuring dietary intake in athletes Dr Kristen MacKenzie-Shalders Bond Institute of Health & Sport, Bond University, Robina, AUSTRALIA. CRICOS CODE 00017B

2. HIERARCHY OF SPORTS NUTRITION INTERVENTIONS

3. Dietary measurement and prescription It’s a tricky business Difficulties effectively measuring Difficulties effectively prescribing

4. Today • Dietary methodology: observations and experiences • Research & developments • Limitations and future directions

5. Dietary assessment in athletes Body composition Energy requirements Nutrient requirements Diet quality Image Source

6. Dietary energy Can’t forget growth in some athletes. Accurate measurement/ prediction and thus prescription

7. The measurement of energy expenditure (and thus requirements) RMR PA DIT • DLW technique – potentially increased sources of error. • ~moderate agreement between EI/EE in athlete populations – tend towards underestimation of energy intake.

8. The measurement of energy expenditure (and thus requirements) RMR PA DIT • Systematic review of methodology • Minimum restriction of physical activity for 14 hours suggested for heavy exercise (Grade III) • Fasting period Compher, C., Frankenfield, D., Keim, N., & Roth-Yousey, L. (2006). Best Practice Methods to Apply to Measurement of Resting Metabolic Rate in Adults: A Systematic Review. Journal of the American Dietetic Association, 106, 881-903.

9. Considerations for testing RMR in athlete populations • The stress associated with the measurement and the ventilated hood • Intake of stimulants before the measurement, some common items as caffeine, nicotine and alcohol and some supplement ingredients • Recent food intake, acute changes in DIT will artificially inflate the RMR measurement and chronic energy deprivation will depress RMR (Bullough et al., 1995) • A change in physiological state including illness, certain medications or exposure to high altitudes or high altitude simulated environments (Manore & Thompson, 2006) • Physical activity including on the day preceding the measure and the method used to travel to the site of measurement. • Menstrual cycle phase

10. The measurement of energy expenditure (and thus requirements) RMR PA DIT • Spontaneous physical activity & thermic effect of activity • Algorithms based on movement monitors or physical activity diaries • Complex movements performed by many athletes in different conditions.

11. Changes in RMR with training • Aminimum change of 6 – 8% is required to discount the effect of usual daily variations in RMR (Roffey et al., 2006). Source. Thesis: Kristen MacKenzie

12. The measurement of energy expenditure (and thus requirements) RMR PA DIT • Protein/energy intake may be higher or lower, applications for DIT

13. The prediction of energy expenditure (and thus requirements) RMR PA DIT

14. Challenges for the effective prediction of RMR in athletes • Few studies in athletes eg. Thompson & Manore 1996; Carsholnet al (2011) • Total body mass (TBM) and lean mass (LM) highly predictive

15. Common prediction equations used with athletes Source. Thesis: Kristen MacKenzie

16. Under-predicted due to body composition? Metabolic increase? What about energy-efficiency?

17. Challenges for the effective prediction of RMR in athletes • LM derived equations more representative? Kinney J. M & Elia M. (1992) in Organ and tissue contribution to metabolic rate. in Energy Metabolism: Tissue Determinants and Cellular Corollaries, ed Kinney J. M. (Raven, New York), pp 61–77.

18. Can we improve predictability? • B = C + BoMb b = 1 for a linear model b = ¾ for exponential model b = ? for our model..? • Lean mass compartmental prediction: has been shown to be more predictive in general population (Kistorp et al, 2000) RMR = …. x Trunk LM + …. x Head LM + …. x Limbs LM

19. But what is ‘lean mass’?Body composition assessment methods • Lean-mass index? • Fat-free mass? • What method & procedure?

20. Variability of energy expenditure 424 average TEE measurements in military personnel which ranged from 13.0 to 29.8 MJ per day (Tharion et al., 2005).

21. Dietary assessment: macronutrients Image Source

22. Case study: Can you see any difference?

23. Case study: Dietary intake assessment 7 day food diary 7 x 24-hr recalls

24. The best dietary assessment method to use with athletes Image Source

25. Nutrition BulletinVolume 26, Issue 1, pages 29-42, 7 JUL 2008 DOI: 10.1046/j.1467-3010.2001.00096.xhttp://onlinelibrary.wiley.com/doi/10.1046/j.1467-3010.2001.00096.x/full#f2

26. Dietary distribution/patterns Defined ‘eating occasions’ Breakfast: 0500–0959 Morning tea: 1000–1159 Lunch: 1200–1459 Afternoon tea: 1500–1759 Dinner: 1800–2059 Evening snack: 2100–0459 Training: all energy-containing foods and fluid consumed during a workout Burke, L. M., Slater, G. J., Broad, E. M., Haukka, J., Modulon, S., & & Hopkins, W. G. (2003). Eating patterns & meal frequency of elite Australian athletes. International Journal of Sport Nutrition and Exercise Metabolism, 13, 521-538.

27. Dietary distribution/patterns

28. Methodological definitions and abbreviations

29. Do we systematically under-report specific nutrients?

30. Practicalities & challenges • Emerging technologies all prospective • No current validated FFQ’s (for macronutrients) • Heterogeneity of athlete groups and dietary intake practices • Importance of publication of data – adds to dialogue

31. Acknowledgements Professor Neil King1 Professor Nuala Byrne2 Dr Gary Slater2 School of Exercise & Nutrition Sciences, Queensland University of Technology, Brisbane, AUSTRALIA. Bond Institute of Health & Sport, Bond University, Robina, AUSTRALIA. School of Health and Sport Sciences, University of the Sunshine Coast, Sippy downs, AUSTRALIA. Energy Metabolism Group (QUT IHBI) Bond University/Bond Institute of Health & Sport NHMRC/APA

32. Thank you – questions?

33. References • Kinney J. M & Elia M. (1992) in Organ and tissue contribution to metabolic rate. in Energy Metabolism: Tissue Determinants and Cellular Corollaries, ed Kinney J. M. (Raven, New York), pp 61–77. • Manore, M.M. and J.L. Thompson, Energy requirements of the athlete: assessment and evidence of energy efficiency. Clinical Sports Nutrition, ed. L.M. Burke and V. Deakin. Vol. 3rd Edition. 2006, Sydney: McGraw-Hill. • Levine, J.A., Measurement of energy expenditure. Public Health Nutrition, 2007. 8(7a). • Nutrient Reference Values for Australia and New Zealand, D.o.H.a. Aging, Editor. 2005, Commonwealth of Australia. • Thompson, J.L., Energy balance in young athletes. International Journal of Sport Nutrition, 1998. 8(2): p. 160-174 • Thompson, J., & Manore, M. M. (1996). Predicted and Measured Resting Metabolic Rate of Male and Female Endurance Athletes. Journal of the American Dietetic Association, 96(1), 30-34. doi: 10.1016/s0002-8223(96)00010-7 • Carlsohn, A., Scharhag-rosenberger, F., Cassel, M., & Mayer, F. (2011). Resting Metabolic Rate in Elite Rowers and Canoeists: Difference between Indirect Calorimetry and Prediction. Annals of Nutrition & Metabolism, 58(3), 239-244. • Burke, L. M., Slater, G. J., Broad, E. M., Haukka, J., Modulon, S., & & Hopkins, W. G. (2003). Eating patterns & meal frequency of elite Australian athletes. International Journal of Sport Nutrition and Exercise Metabolism, 13, 521-538. • Compher, C., Frankenfield, D., Keim, N., & Roth-Yousey, L. (2006). Best Practice Methods to Apply to Measurement of Resting Metabolic Rate in Adults: A Systematic Review. Journal of the American Dietetic Association, 106, 881-903.