Elson M. Haas MD
This is a program that I am really excited about, partly because I like to think that I am an athlete. I believe that this program can really make a significant difference in the fine-tuning and longevity of the competitive athlete. The nutritional misconceptions among sports people are great, and the diets, protein concoctions, and vitamins they are taking may even be dangerous.
Although there may be some differences between the body builder and the marathon runner, they are both required to push their bodies to the limit. Increased activity levels, sweating, and tissue wear and tear mean a need for special support. Any intelligent athlete also should know how important it is to balance workouts with proper stretching exercises to maintain flexibility, and with toning exercises as well as some aerobic activity for cardiovascular health. Aerobic exercise—continuous, repetitive movement of large muscle groups (legs or whole body) for more than 10–15 minutes—uses oxygen more efficiently, plus it burns fat. Our maximum aerobic exercise heart rate (calculated simply) is 220 minus our age. Depending upon our physical state, we will usually exercise at a range from 70–85 percent of our maximum.
A concern I see in my practice is the “ex-athlete,” such as the college jock who was in training for years on a special high-protein, high-fat diet. Such people usually handle this type of diet well enough in their early years because of the high amount of exercise they did. However, when they entered the work world instead of professional sports and changed their lifestyle but not their diet, they gained weight and clogged their arteries. This is also true for retired sports professionals. Changes in activity levels require changes in diet, both total calories and types of food eaten. Such people need to keep exercising as well as change their diets to reduce the chances of early death from cardiovascular disease. No one should ever really become an ex-athlete anyway; exercise is for life. It represents a commitment to health.
One of the big problems with athletes is that regular training and vigorous workouts allow them to get along with the worst kind of diet. The body uses up everything and needs more. Exercise is as important as or more important than a good diet, but implementing both together is the optimum; this duo is the best plan for weight reduction and maintenance. Regular exercise improves metabolism and calorie/nutrient use, reduces cardiovascular disease risk, osteoporosis and diabetic risks, while it improves oxygenation and psychological attitude. Competitive or professional athletes also require a balanced exercise program supported by proper nutrition.
Athletics is affected by a lot of nutritional controversies, and it may be hard for athletes to know what is good for them. High-protein diets, lots of meat, protein powders, salt tablets, special vitamin pills, and now carbohydrate loading to prepare for endurance and competitive efforts—these are just a few of the topics. I do not support high-protein diets or protein powders, although in some cases these may be helpful. People in active training do have some increased protein needs, but too much animal protein and powders can stress the kidneys and contribute to toxic metabolic products in the colon and body.
Salt tablets are almost always unnecessary—water and high-nutrient foods and occasional salted snacks will replace what is needed. Potassium and magnesium are needed as much as or more than sodium chloride. High-fat diets are also contraindicated. Muscles need glycogen (a carbohydrate) for their fuel, and carbohydrates give us the sustained energy we need for athletic activity. Thus, a basic complex-carbohydrate diet is the healthiest focus, with some added special dimensions for training.
Regular vigorous exercise obviously increases our demands for most everything, particularly calories and nutrients. Exercise improves our elimination and our metabolism, which means we need to nourish ourselves regularly. Physical exercise is also a stressor that may increase free-radical formation, so that additional antioxidant nutrients may be required. The physical stresses of vigorous exercise may also cause tissue irritation and breakdown, which we can counteract with natural anti-inflammatories, such as vitamins E and C and bromelain enzyme, and with amino acids to build up the tissues again. Regular sweating also causes the loss of many nutrients, particularly water, Vitamin B1, and some minerals—sodium, potassium, chloride, and magnesium are probably the most significant.
If all of these processes and nutrients are not balanced, nutritional deficiencies may result. Then, injuries can occur more easily, bone or muscle loss or breakdown may result, and this can all interfere with athletic performance. We prevent injuries with proper care in nutrition, adequate stretching and warm-ups, proper cool-downs, and adequate liquid intake. In the competitive world, the slightest changes may make a great difference—sometimes the difference between losing and winning. For professional athletes, of course, this could affect their livelihood.
Diet for the athlete in training and/or for performance is centered on the complex carbohydrates—whole grains and their products, such as pasta, legumes, potatoes and other starchy vegetables—along with some good-quality vegetable and/or animal protein, fruits, and a low-to-moderate fat intake. Athletes, like everyone else, need a well-balanced diet with a high nutrient intake. The increased activity generates the need for a higher amount of calories, protein, and other nutrients than the less active person requires. For weight control or maintenance, we need to vary our calorie intake with our activity level. When the season is over or we take time off or just stop exercising for some reason, we need to change our diet and consume less calories, fats, and proteins.
A high-fat diet is definitely out for athletes. It slows them down and can increase the body fat percentage, something that is taboo for the active athlete. For many of us, the fatty flavor of foods is the more addictive aspect of the diet, and with any lessening of physical activity, the higher-fat foods will clog the blood vessels and increase cholesterol and heart disease risk. Athletes should definitely avoid fried foods, high-fat meals, lunch meats, bacon, ham, and any foods cooked in animal fats. The higher-protein, lower-fat foods such as fish and poultry are better than the red meats. Some nuts and seeds, high in essential oils and protein, can be used as well.
Protein is very important for athletes, but the subject of how much and which proteins are best needs a lot of clarification. Protein intake in general should be less of a focus in the diet. Excess protein intake can produce certain minor problems, including clogging of the colon and stress on the kidneys. More protein than is needed for tissue building and its other functions merely gets used for energy or must be eliminated. The complex carbohydrates, though, are used much more efficiently for energy needs or for storage for later use. So, for best efficiency and performance, I believe that a diet based on complex carbohydrates with adequate, but not excess, protein is ideal.
Athletes (and regular exercisers), however, do need some extra protein with increased activity, but it should be increased in proportion to calories. People who are trying to gain weight, those wanting to build muscle, or those in heavy training do need additional protein, sometimes up to 150–200 grams daily, to stay in positive protein balance, especially when the calorie intake goes up near 3,000 a day. Some protein powders and amino acid formulas can be used to augment the protein balance. Aerobic-type exercises may slightly increase protein needs but not as much as body-building activities. Some extra protein intake, still along with a high-complex-carbohydrate, low-fat diet, will support muscle bulk while maintaining body fat levels. Young athletes need even more good protein foods than adults but should still focus on the complex carbohydrates for proper development. Again, avoid high-protein diets that exclude other important foods, particularly the complex carbohydrates, fruits, and vegetables. For building muscle, it may be better in many cases (especially when extra calories are not needed) to use good-quality supplemental amino acids or protein hydrolysates containing peptides to provide the cells and tissues with what they need to build and repair, rather than eating an excess of heavier flesh food proteins.
Complex carbohydrates provide the sustaining long-term energy, proteins the tissue building, and fats the lubrication and tissue support. This type of diet is also high in fiber, which allows good elimination. It is wise for serious athletes and health-conscious people to avoid excessive use of alcohol, regular cigarette smoking, and stimulants such as caffeine in coffee, tea, and cola beverages. Some iron-rich foods are especially important for female athletes or active runners, as their red blood cells may be broken down more rapidly. High-iron foods include red meats and liver (organic only), shellfish such as oysters, leafy greens, prunes, and mushrooms. With anemia, higher doses of supplemental iron may be needed.
Carbohydrate loading is a fairly new concept in the athletic world. It is based on the fact that complex carbohydrates such as grains, pastas, pancakes, and whole grain breads increase available energy, improving the stamina and ability to work. Here is how carbohydrate loading works. Four or five days before an endurance-type event, we increase our exercise and reduce our complex carbohydrate intake to about 40–50 percent of our diet, and eat more protein, fats such as dairy products and eggs, and fruit. This depletes the glycogen in our muscles and liver. Then, two to three days before the event, we increase complex carbohydrates to 70–75 percent of our diet, eating at least three big meals of carbohydrates, plus some proteins and fats. This increases the stored glycogen in the liver and muscles. Glycogen, the storage form of glucose, is easily converted to the simple sugar that is used by all cells and tissues for energy. Glycogen is then burned first for energy; if more energy is needed, fat will be utilized, and that works well too. If there is very low body fat, proteins in tissues may also be converted to energy. All of these macronutrients will need to be replaced. Some athletes report that carbohydrate loading increases sexual energy too. For any athletes with fatigue, carbohydrates will often help. Adding more grains, pasta, cereals, breads, vegetables, and fruit may also add strength and endurance.
Carbohydrates—50–60 percent of total calories
10–20 percent simple—fruits, most vegetables, and any special “treats”
40–50 percent complex—whole grains, legumes, starchy vegetables
Proteins—15–20 percent (maximum 25 percent)
animal—fish, poultry, meats, eggs, dairy
vegetable—nuts, seeds, legumes
Fats—25–30 percent
saturated—meats, eggs, dairy products
unsaturated (more than half)—nuts, seeds, vegetable oils, avocado
One of the biggest nutrient concerns in athletes is water depletion. With heavy training, be it strenuous or extensive activity, large water losses can occur, and drinking water is the only way to remedy this. Long endurance events also increase the need for fluids. Any activity where sweating occurs sets up an even higher requirement for water than the usual one and a half or two quarts per day. Water, which should be our main liquid, has many essential functions. It supports the whole process of sweating and elimination of toxins, it nourishes the skin and other tissues, and it is the medium in which our blood cells circulate and everything in our body lives. Dehydration from low fluid intake leads to weakened tissue perfusion (circulation of blood with oxygen and nutrients), fatigue, and poor performance.
In addition to water, extra minerals must be replaced. These can be added to the water or replaced with food consumed following exercise. Prepared fluid-replacement drinks are good in concept, but many contain chemicals and are overly sweet. For fluid replacement, it is best to avoid sugary drinks or even lots of fruit juices. Diluted fruit juices with minerals would be helpful. I use a vitamin C powder with calcium, magnesium, and potassium designed by Allergy Research Company/Nutricology, sometimes adding some powdered amino acids.
For long events, a little sweet liquid, such as fruit juice, can be added to the water to provide some calories and energy. Water should be drunk in the couple of hours before an event to rehydrate the tissues and then, if there is extended competition or workout, sipped throughout the activity. No colas, caffeine, or alcohol should be consumed prior to or during a race or any exercise. Salt tablets are also best avoided.
Nutritional supplements are often helpful in improving athletic performance. A good-quality, high level multivitamin/mineral is crucial, one whose total daily dosage is contained in 3–6 capsules or tablets; this is best taken several times daily to ensure regular availability. Many B vitamins, such as thiamine, riboflavin, niacin, and pantothenic acid, are lost more rapidly with exercise and need more replacement.
Minerals are of major importance, as many are eliminated and need replacement to prevent muscle cramping, reduced cellular support, and other weakened physiological functions. Potassium chloride is lost during exercise through sweat. It is an important electrolyte for nerve conduction and muscle and heart function and is often useful in preventing spasms. Extra potassium, about 100–200 mg., is helpful after periods of exercise, along with potassium-rich foods eaten throughout the day. Calcium and magnesium are also important, a bit more so for women than for men. The calcium-magnesium cellular exchange supports muscle contraction and relaxation, nerve conductivity, cellular and bone strength, and delivery of oxygen to the muscles. From 600–1,000 mg. of calcium and 400-600 mg. of magnesium daily (above the diet) in two portions is suggested. Taking these supplements after exercise and before bed is the minimum. Iron is especially needed by women to maintain the red blood cells’ hemoglobin to carry oxygen; iron is also part of the muscle protein myoglobin. Without enough iron, energy and endurance are usually poor, which is not promising for athletic performance. Chromium is also lost in higher amounts during exercise; at least 200 mcg. are needed daily to help prevent or reduce any risk of sugar metabolism problems.
The antioxidant nutrients are important to reduce tissue irritations, inflammations, and loss of energy caused by free radicals. Vitamin A and beta-carotene, vitamin E, selenium, and vitamin C are all part of the athlete’s PEP. Loss of vitamin C, essential to connective tissue strength, is also increased with exercise. Joggers need extra C to prevent bone and ligament injuries, and ascorbic acid may be helpful in reducing all kinds of musculoskeletal irritation and injury. The vitamin C-mineral formula I mentioned previously is not only useful for assimilating the vitamin C, but is also an easily absorbable formula that replaces several important minerals. A complete mineral tablet can also be taken with it. Silicon or silica, usually derived from the horsetail herb Equisetum arvense, is important for maintaining elasticity and flexibility in the tissues.
B Vitamins
Minerals
Amino Acids (all L- forms)
Others
reduce inflammation
For adequate amino acids, a general formula of the L- forms (not D or DL) is best. Usually, two or three portions are taken daily, after exercise and/or after meals. An L-amino formula higher in L-tyrosine and L-phenylalanine may be more stimulating and physically energizing. L-proline will support the syntheses of collagen for membranes, ligaments, and tendons. Some extra magnesium and pyridoxal-5-phosphate, the active form of vitamin B6, may improve the metabolism of the amino acids in the liver and could be used as well after a workout.
Other amino acids useful for athletes could be used only in addition to the general formula. L-carnitine is an important one. It is peculiar in that it is not used in the formation of body tissues but can be made in the liver and kidneys from other amino acids, methionine and lysine, along with niacin, vitamins B6 and C, and iron. It is found in few foods other than animal meats. Carnitine is thought to be helpful in preventing cardiovascular disease, aiding weight loss, and improving athletic performance. It aids in fat metabolism and energy production in the cells’ mitochondria by improving utilization of fats. It is a good amino acid supplement for people who exercise.
The combination of L-arginine and L-lysine has also been shown to improve exercise endurance and strength, according to Rita Aero and Stephanie Rick in Vitamin Power (Harmony Books, New York, 1987). Two to three grams of arginine and one gram of lysine taken together stimulate growth hormone and protein building. (Other authors, such as Pearson and Shaw of Life Extension, have suggested an arginine-ornithine combination.) These combinations help put the body into a positive nitrogen balance, meaning that more protein is being made in the tissues than is being broken down and eliminated. These can be taken together in an amount of about 1,000 mg. each at night after days of heavy workouts, up to four or five times a week, when the other amino acids are taken as well during the day.
The branched-chain amino acids (BCAAs) are leucine, isoleucine, and valine, all of which are essential. In our bodies, these comprise about one-third of our muscle tissue. For people working on muscle building, supplementing the BCAAs can be helpful to this process. Having enough of these amino acids can prevent tissue wasting (protein loss) with exercise. Taking 1–3 grams of each of these amino acids has an anabolic (building) effect on muscle tissue similar to that experienced with steroid treatment, but without the risks and side effects (although they are also not as potent anabolically). When the BCAAs are used it is necessary to take them together, about half an hour to an hour before a workout. Taking 50 mg. of vitamin B6 or pyridoxal-5-phosphate, its active metabolite—will aid the utilization of the BCAAs. It is also wise to take additional amino acids, including extra L-tryptophan and L-tyrosine, because the BCAAs are so rapidly used that they can interfere with the absorption of these other amino acids.
A number of other supplements have been associated with increased athletic strength and endurance. None has been clearly shown to be effective by the little research done, but many an athlete has described feeling better when using these products. I will leave it up to you to try these “bioenergetic boosters” and see what they do for you.
Octacosanol is said to increase endurance, possibly by improving energy metabolism in the muscles. It is obtained mainly from wheat germ oil, where it is found in high concentration. Bee pollen and other bee products, such as royal jelly, definitely provide some simple carbohydrate energy, and many people feel uplifted and supercharged when using them. They also provide various minerals plus possibly some yet-to-be-discovered power agents. Pangamic acid (see Vitamin B15 in Chapter 5) is no longer available in the United States, but it is highly touted in Russia for its healing powers and endurance enhancement. Dimethylglycine, or DMG, is the form that people take now to get some of the pangamic acid precursors. Though it is not really clear how this product works, many people describe benefits from its use. Another precursor nutrient that I really like is inosine; used at a dosage of 300–500 mg. daily, inosine helps to release oxygen from hemoglobin. It is the precursor of adenosine, which is the building block for production of ATP, the energy molecule for cellular metabolism.
A formula that I use regularly and before exercise is Oxynutrients by Nutricology in San Leandro, California. It contains 150 mg. of inosine per capsule, plus dimethylglycine, L-carnitine, organo-germanium, coenzyme Q10, and more nutritional energizers. One capsule two or three times daily or two capsules 30 minutes before exercise really makes a difference. I also use it in patients with fatigue or viral problems, and have been receiving excellent reports.
Various body therapies, such as massage, acupressure, and chiropractic skeletal alignment, have helped many athletes perform better. Sexual activity also may add that extra charge for better performance, but this is controversial. Many athletes avoid sexual relations prior to competition. It may, however, be a very relaxing and energizing practice.
Herbs have been used in many ways for the various problems encountered by athletes as well as for increasing performance. Ginseng root has been known to increase stamina. It is a general tonic and also has some antistress properties. Cayenne pepper is a natural stimulant that may raise the metabolism and increase energy levels. Comfrey is a common herb for musculoskeletal injuries. It has some mild anti-inflammatory effects, and I have seen comfrey leaf work “magically” for healing sprains. To use it for this purpose, wrap lightly steamed leaves (or chew them and make a poultice) over the wound and then cover with a cloth. Leave on, if possible, for a few hours. Also, drinking an herbal tea containing comfrey root and the silica-containing spring horsetail will support the healing process. White willow bark contains natural salicylates and thus possesses anti-inflammatory properties. It is available in tablets or capsules and can be used like aspirin for sore joints or muscle aches. Bromelain is an enzyme from pineapple and is available as a supplement; it too has mild anti-inflammatory effects, and aids digestion of vegetable protein in the gastrointestinal tract.
Vigorous workouts cause muscle and tissue irritation and inflammation, which can lead to soreness after exercise. This is commonly due to lactic acid buildup and free-radical formation. Antioxidant nutrients, more water, and some anti-inflammatory nutrients and herbs may help reduce some of that soreness when it is bothersome. Also, warm baths, massage, and a long, slow walk will help restore the feeling of being loose and ready for more vigorous exercise.
The program shown in the following table is designed for the serious athlete as well as anyone who is seriously working out to achieve top physical condition by improving strength, flexibility, and endurance. When we work out this way, it affects every other aspect of our life. The amounts listed for each nutrient are the day’s total suggested intake, usually taken in several portions throughout the day. Good luck and keep exercising. It’s worth it!
| Calories* | 2,000–3,500 | |||
| Water* | 2–3 1/2 qt. | |||
| Protein* | 75–150 g. | |||
| Fats* | 60–100 g. | |||
| Vitamin A | 5,000–10,000 IUs | Molybdenum | 500 mcg. | |
| Beta-carotene | 15,000–25,000 IUs | Potassium | 2–3 g. | |
| Vitamin D | 400 IUs | Selenium | 250–400 mcg. | |
| Vitamin E | 400–1,000 IUs | Silicon | 100–200 mg. | |
| Vitamin K | 300 mcg. | Zinc | women—15–30 mg. | |
| Thiamine (B1) | 75 mg. | men—30–60 mg. | ||
| Riboflavin (B2) | 25–75 mg. | Optional: | ||
| Niacin (B3) | 50 mg. | L-amino acids | 1,500 mg. | |
| Niacinamide (B3) | 100 mg. | L-carnitine | 500–1,000 mg. | |
| Pantothenic acid (B5) | 1,000 mg. | L-arginine | 1,000–1,500 mg. | |
| Pyridoxine (B6) | 50 mg. | L-lysine | 1,000–1,500 mg. | |
| Pyridoxal-5-phosphate | 100 mg. | L-proline | 500 mg. | |
| Cobalamin (B12) | 100 mcg. | Branched-chain | 1,000 mg. each | |
| Folic acid | 800 mcg. | amino acids | (before workouts | |
| Biotin | 500 mcg. | (leucine, isoleucine, | with 50 mg. | |
| Choline | 500 mg. | valine) | vitamin B6) | |
| Inositol | 500 mg. | Bromelain | 100–200 mg. | |
| Vitamin C | 2–5 g. | (2,000 mcu/g.) | ||
| Bioflavonoids | 250–500 mg. | Pancreatic enzymes | 200–400 mg. | |
| (after meals) | (1–2) tablets | |||
| Lactobacillus | 1–2 billion organisms | |||
| Calcium | 600–1,000 mg. | Dimethylglycine | 25–50 mg. | |
| Chromium | 250–400 mcg. | (before exercise) | ||
| Copper | 2–3 mg. | Coenzyme Q10 | 30–60 mg. | |
| Iodine | 150–250 mcg. | Flaxseed oil | 2–3 t. | |
| Iron | women—20–25 mg. | Gamma-linolenic | ||
| men—10–15 mg. | acid (GLA) | 160–400 mg. | ||
| Magnesium | 400–650 mg. | Octacosanol | 2–4 capsules | |
| Manganese | 5–15 mg. | (250–500 mg.) | ||
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*Varies from women to men and with the extent of exercise.
Maryon Stewart
Jim Strohecker
Daniel Redwood DC