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These Slorts diagnostic pSorts Sports nutrition for intolerant athletes skin prick, measuring kntolerant IgE antibody levels, Subcutaneous fat reduction surgery the gold standard of double-blind placebo-controlled athletex challenges Turnbull et al.
Subsequently, several alternative food intolerance tests appeal to athletes e. Validation is lacking, and therefore, these alternative testing methods are not currently recommended. For track-and-field athletes, food avoidance based on dubious test results may introduce unnecessary food restriction and associated risks, which are discussed throughout this review.
Established food allergy testing should be guided by a licensed medical specialist e. Given the ambiguous nature of food intolerances or malabsorption, there is a tendency for athletes to self-diagnose intolerances and subsequently restrict foods or food groups Kostic-Vucicevic et al.
Other food intolerances are less clear. Symptoms may appear hours to days after exposure Turnbull et al. Several of these symptoms overlap with those characterizing irritable bowel syndrome, functional gastrointestinal disorders, or exercise-induced gastrointestinal syndrome Costa et al.
Emerging work in this area questions the potential for repeated stress on the gut and associated physiological alterations associated with exercise-induced gastrointestinal syndrome to increase susceptibility to dietary triggers or the development of chronic gastrointestinal disease Colbey et al.
Adherence to a GFD has exploded in popularity among athletes. A strict GFD eliminates all sources of gluten, a storage protein composite, with the alcohol-soluble gliadins defined as prolamins and the alcohol-insoluble glutenins as glutelins. Gliadin is incompletely digested, excreted, and does not trigger an immunological response in individuals without celiac disease.
Nonetheless, the number of athletes reported to follow a GFD appears to be four-fold higher than those of the general population who are estimated to clinically require gluten elimination Sapone et al. A GFD is further touted as overall healthier and suggested to provide an ergogenic advantage Lis et al.
Only one study has examined the effects of a GFD in nonceliac endurance athletes Lis et al. In this tightly controlled randomized, crossover, double-blind study, athletes followed a short-term gluten-containing diet versus GFD.
Diet and exercise were replicated in both trials, but no differences in measures of gastrointestinal injury, gastrointestinal symptoms, systemic inflammatory responses, perceptual well-being, or exercise performance were observed between the diets.
Only anecdotal-type substantiation supports the efficacy of a GFD for clinically healthy athletes. Nonetheless, it is important to understand the unique stress placed on the gut in some track-and-field athletes and the likely higher incidence of exercise-induced gastrointestinal syndrome Costa et al.
Potential exists for compromised gastrointestinal integrity and function to increase the incidence or magnitude of gastrointestinal-related food symptoms or gastrointestinal disorders Costa et al. Amid subjective reports of a GFD improving gastrointestinal symptoms, an interesting connection exists between reduced FODMAP intake e.
A reduction in FODMAPs has been recognized as a modulating factor for symptom improvement with a GFD and not gluten itself Skodje et al. Briefly, a low FODMAP diet is an individualized nutrition strategy with three phases i. low FODMAP, ii. rechallenge, and iii.
personalization phases to tailor reduced intake of specific short-chain carbohydrates that can elicit symptoms. Within a healthy general population, some FODMAPs are poorly digested, but the resulting gastrointestinal symptoms are nonexistent or trivial Ong et al.
Conversely, in athletes undertaking strenuous exercise with a subsequent impairment of gastrointestinal function and integrity i. Upon transit to the lower intestine, these malabsorbed and highly fermentable carbohydrates reach the colon and are subject to bacterial fermentation breakdown and result in physiological consequences such as increased luminal volume and pressure e.
In addition, FODMAP intake could augment gastrointestinal symptoms e. Check cereals, bars, sports foods, mixed beverages, and mixed meals for high FODMAP ingredients. a Depending on the types and blend, fruit juices can be high in excess fructose and therefore problematic for some athletes especially when ingested in high amounts.
FODMAP research has predominantly concentrated on lower gastrointestinal symptoms e. However, FODMAPs also influence upper gastrointestinal symptoms, such as feeling of fullness, as demonstrated in a clinical feeding study that administered doses of fructose and glucose via gastric infusion Masuy et al.
Costa et al. Upper and lower gastrointestinal symptoms may be affected by FODMAPs, but these nonspecific symptoms also congruently manifest from mechanical, physiological, and other nutritional factors Costa et al.
FODMAPs may not be an exclusive gastrointestinal symptom trigger but amplify symptoms initiated by other factors. Athlete-specific data support the concept of FODMAPs affecting exercise-associated gastrointestinal symptoms Lis et al.
Many athletes already self-eliminate foods high in FODMAPs but may not distinguish that these foods are in the FODMAP family Lis et al. Lactose-containing foods are the most frequently eliminated, followed by fructose in excess of glucose, galacto-oligosaccharides, polyols, and fructans.
Assessment of FODMAP intake may be required before, during, and after exercise to optimize gastrointestinal contentment and refueling. Numerous benefits are publicized with GFD and low FODMAP diets, yet these special diets are also associated with perturbations in healthy gut microbiota, short-chain fatty acid production, possible increased arsenic intake Bulka et al.
Historically, a GFD has also been associated with suboptimal intake of iron, B vitamins, and protein and higher intake of sugar and fat. With significant improvements in commercially available gluten-free foods, this issue is less concerning in Westernized countries. Although the exponential growth in the gluten-free market seems to be tapering, market reports suggest the low FODMAP diet to be the next popular special diet for athletes.
A registered dietitian specializing in sports nutrition and certified in low FODMAP diet teaching Hill et al. Overall, to address the multifactorial nature of gastrointestinal symptoms, emerging evidence undoubtedly supports a beneficial role of FODMAP reduction as part of a treatment plan for some athletes with exercise-induced gastrointestinal syndrome Costa et al.
Prevalence rates of vegetarianism among athletes are not well established but are assumed to be similar to that of the general population. Athletes who periodically eat small amounts of fish pesco-vegetarian and chicken pollo-vegetarianwho typically eat a meatless diet but occasionally include meat or fish flexitarianor who try to limit red and other meats semivegetarian are often included in vegetarian classifications.
Although concern exists about the adequacy of vegetarian diets for track-and-field athletes, it is well established that vegetarian diets can be nutritionally adequate to support training demands provided a variety of plant foods and source of vitamin B12 Agnoli et al.
Hence, appropriate nutrition education is encouraged for track-and-field athletes. Plant-based diets may offer health advantages over the typical Western diet. Vegetarian and vegan diets are associated with a reduced risk for chronic diseases in nonathletic populations Melina et al.
Less is known about the ability of these diets to enhance athletic performance Craddock et al. Due to the naturally high carbohydrate content, a vegetarian diet may be advantageous for fueling Craddock et al. In addition, antioxidant and phytochemicals Trapp et al. To ensure optimal health and performance, track-and-field athletes following vegetarian diets should select a wide variety of minimally processed vegetables, fruits, grains, nuts, seeds, legumes, and soy products and ensure adequate energy intake Melina et al.
Adopting a vegetarian diet may result in a reduction of energy intake or of specific nutrients including omega-3 fatty acids, iron, zinc, calcium, vitamin D, iodine, and vitamin B These nutrients are less abundant in plant foods or are less well absorbed from plant compared with animal sources.
Meeting but not exceeding energy needs is a foundation of sports nutrition. Difficulty in meeting energy requirements on a vegetarian diet may be due to food choices that are excessively high in fiber or of low energy density some track-and-field athletes are poorly prepared to make healthy vegetarian choices at work, school, training, and when traveling.
This can result in undereating or the selection of less nutrient-dense food. As appropriate, track-and-field athletes can increase energy intake by selecting energy-dense foods and by reducing fiber-rich foods. It is also important to note that a vegetarian diet may be used by some track-and-field athletes to mask restrictive eating or an eating disorder Cialdella-Kam et al.
A common misconception is that vegetarian track-and-field athletes will not consume adequate protein. Meeting even the higher protein requirements of athletes and additional need for adolescent athletes is not typically a concern provided adequate energy and a variety of high-protein foods are consumed Castell et al.
: Sports nutrition for intolerant athletes| Enhancing Athletic Performance: The Science Behind Sport Nutrition | In order to make a balanced breakfast, oats can be topped with fruit, nuts, seeds, and more. Read more about gluten-free labeling here. In addition to carbohydrates, starchy vegetables also provide vitamins, minerals, fiber, antioxidants and water, which are all essential for energy, hydration, proper digestion and recovery. In particular, white potatoes contain even higher levels of potassium than bananas, which is crucial for athletes to maintain proper fluid balance and optimal muscle contraction. Potatoes and sweet potatoes of all colors are excellent alongside non-starchy vegetables and protein in a meal, or my personal favorite — a baked sweet potato topped with nut butter as a quick snack! While I often neglected to eat quinoa before going gluten free, I now always have a batch of it prepared in my fridge. Quinoa is a complete protein with all nine essential amino acids necessary for muscle building and recovery. It contains twice as much protein ~8g per cup as rice, making it a great pre or post workout option at meals for athletes. Furthermore, quinoa is also rich in a variety of performance-supporting micronutrients like phosphorus, magnesium, and iron. Throw it in salads, soups, or grain bowls for an added boost of whole grains and plant protein! Rice is a fairly low cost carbohydrate that is compatible with many meals. I usually opt for brown or wild rice as these varieties pack more vitamins, minerals and fiber compared to white rice, allowing for a slower release of energy overtime. However, white rice may be great for a pre-workout meal close to practice or when carb-loading before your main competition of the season. For convenience, I prepare a few servings to store in the fridge for the week. However, white rice can also be purchased as precooked packages at the grocery store! Once again, be sure the package identifies that it does not contain gluten. Beans and lentils are natural sources of both protein and carbohydrates, making them another great option for post-workout fueling. Also, they tend to be high in essential nutrients for athletes like iron, calcium, potassium, and B vitamins. Iron is especially important for athletes who are at greater risk for deficiency or anemia due to higher activity demands, as it allows for oxygen to be transported into the muscles, thus enhancing muscle recovery and preventing fatigue. These alternative pastas are beneficial for all athletes, as they carry the same nutrient profile of beans and rice mentioned above with the added convenience of being in pasta form. I will substitute it for regular pasta in recipes or occasionally pair it with pesto or marinara sauce for a quick and easy meal! While I typically consume fruit paired with some protein and fat throughout the day, I like to have some fruit and nut butter minutes before training. Fruit alone makes for the perfect fuel ~15 minutes before your workout, due to its high carbohydrate content and easy digestibility, allowing for the immediate release of energy. Even dried fruits like dates and raisins, which are often overlooked, can pack a significant amount of energy to carry you throughout your training sessions. For gluten free athletes who are new to the diet, look to meet with your campus dietitian so that they are aware of safe options. Some colleges now offer allergen- friendly stations, where they avoid using the top 8 allergens, including gluten. In addition to this, many colleges also offer pre-packaged gluten free items to avoid cross contamination within the dining hall. Whether you are preparing your meals or eating out, there are a wide variety of easy swaps that you can make while still prioritizing nutrient density to ensure you are receiving adequate nutrients. Upon graduation, she plans to work with athletes to help them adopt a sustainable approach that allows them to fuel their body, and maximize their potential. We are waiting for final results but I believe my 17 year old daughter may have just been diagnosed with celiac. In all cases, a primary concern for track-and-field athletes is the loss of lean mass during a period of fasting or caloric restriction Heilbronn et al. Time-restricted fasting has received the most attention within the fasting literature. This form of fasting theoretically offers metabolic and body composition benefits for athletes Morton et al. It involves 16—20 hr of fasting with a 4- to 8-hr feeding window. Several commercial variations of this diet have been developed. To date, only one study in recreationally active and resistance-trained athletes has been conducted. Findings indicate TRF does not support favorable changes in lean and fat mass compared with a normal diet Tinsley et al. These observations may be attributed to unmatched macronutrient intake, specifically protein, between the normal diet group 1. A follow-up study matching protein intakes 1. However, these results could be influenced by the more favorable feeding period around the training period for the TRF group. Ramadan is a holy month during which Muslims refrain from eating and drinking between sunrise and sunset for 30 days. It is the most widely studied form of TRF and probably the most relevant for many elite athletes. Depending on the seasonal and geographical conditions, Ramadan falls on different dates every year and fasting varies from 11 to 18 hours daily Azizi, ; patterns that can indirectly affect performance and alertness Roky et al. Ramadan is also associated with more rapid onset of fatigue, lethargy, and noncontact athlete injury Chtourou et al. Therefore, much research has focused on the factors negatively affecting performance and tools to mitigate these potential detriments Tables 4 and 5. Daily eating routines are characterized by two meals: one before sunrise Sahur and one after sunset Iftar. It is commonly believed that Ramadan fasting results in a significant calorie deficit. Amid eating challenges, the primary goal for track-and-field athletes should be to maintain body composition as well as minimize decrements in performance. Due to the variances in food availability, there is potential to overeat at fewer meal times, and it can be difficult for some athletes to maintain a stable body composition. Conversely, for some athletes, food choices during Ramadan may become better planned, and subsequently, the quality of food is improved compared with intake during the rest of the nonfasting year. Demonstrating this, unexpected improvements in lean mass and fat mass have even been measured, which may be attributed to improved food choices during Ramadan Fahrial Syam et al. Particularly, during the first week of fasting, body composition measures may be inadvertently skewed by increased total body water loss, decreased gastrointestinal volume, and glycogen stores. These factors should be considered with athlete monitoring during this fasting period. For the sports nutrition practitioner, several well-documented challenges before, during, and after exercise exist. Rehydration, posttraining recovery, fatigue management, portion control, and maintaining optimal body composition are the most common nutrition challenges Table 4 ; Norouzy et al. These challenges are magnified when Ramadan occurs across major sporting events e. Competing in a non-Muslim country and requirements of weight-making sports present further complications Aloui et al. Muslim track-and-field athletes undertaking obligatory fasting are also at a potential disadvantage compared with voluntary fasting as they are less able to modify their feeding periods around training. Some athletes will obtain special permission to observe their fast after an important event. In addition, valuable nutrition strategies such as carbohydrate mouth rinsing may be not permitted due to the interpretation of fasting law by Islamic scholars. Overall, many challenges are associated with Ramadan fasting, and individualized strategies are required for successful management to avoid a possible detraining effect Table 5 ; Aloui et al. A solid understanding of the knowledge and beliefs pertaining to Ramadan is important for practitioners counseling Muslim track-and-field athletes as much contradictory evidence exists on the effects of Ramadan fasting on health. Personalized knowledge and beliefs can often translate into attitudes and practices. Long-standing experiences established in early years, advice from peers, knowledge level, and how well the environment is controlled appear to be significant factors of Ramadan impacting performance Chamari et al. It is commonly trusted that Ramadan fasting negatively affects physical performance Chamari et al. However, evidence continues to advocate that only a few aspects of physical fitness are negatively affected by Ramadan Alkandari et al. Cognitive performance e. Overall, maintenance of daily energy and macronutrient intakes, body composition, training load, and sleep duration similar to the rest of the year will minimize impairments of physical performance during Ramadan. Evidence is lacking to support any benefit of fasting compared with conventional techniques for improving body composition or metabolic parameters in track-and-field athletes. Nutrition strategies should be planned in advance to avoid possible performance decrements during obligatory fasting. Special diets may be appropriate for some track-and-field athletes, but each of these should be carefully evaluated as well as the rationale for choosing a diet. Ad hoc adherence to a special diet is associated with several risks, which should be carefully evaluated and monitored. Even in cases where a special diet is necessary, proper education is essential as dietary restriction may do more harm than good. Lis, E. Larson-Meyer, and D. Kings wrote initial draft of respective sections. Lis compiled, edited, formatted, and revised the manuscript. All authors approved the final version of the paper. The authors have no conflicts of interests to report. Agnoli , C. Position paper on vegetarian diets from the working group of the Italian Society of Human Nutrition. PubMed ID: doi Aird , T. Effects of fasted vs fed-state exercise on performance and post-exercise metabolism: A systematic review and meta-analysis. Alkandari , J. The implications of Ramadan fasting for human health and well-being. Journal of Sports Sciences, 30 Suppl. Aloui , A. Rapid weight loss in the context of Ramadan observance: Recommendations for judokas. Biology of Sport, 33 4 , — Applegate , C. Influence of dietary acid load on exercise performance. International Journal of Sport Nutrition and Exercise Metabolism, 27 3 , — Azizi , F. Research in Islamic fasting and health. Annals of Saudi Medicine, 22 3—4 , — Barkia , A. Change of diet, plasma lipids, lipoproteins, and fatty acids during Ramadan: A controversial association of the considered Ramadan model with atherosclerosis risk. Journal of Health, Population and Nutrition, 29 5 , — Biesiekierski , J. Non-coeliac gluten sensitivity: Piecing the puzzle together. United European Gastroenterology Journal, 3 2 , — Bulka , C. The unintended consequences of a gluten-free diet. Epidemiology, 28 3 , e24 — e Castell , L. Exercise-induced illness and inflammation: Can immunonutrition and iron help? International Journal of Sport Nutrition and Exercise Metabolism. Manuscript in preparation. Chamari , K. Impact of Ramadan intermittent fasting on cognitive function in trained cyclists: A pilot study. Biology of Sport, 33 1 , 49 — Chtourou , H. The effect of Ramadan fasting on physical performances, mood state and perceived exertion in young footballers. Asian Journal of Sports Medicine, 2 3 , — Cialdella-Kam , L. Vegetarian, gluten-free, and energy restricted diets in female athletes. Sports, 4 4 , 1 — Colbey , C. Upper respiratory symptoms, gut health and mucosal immunity in athletes. Sports Medicine, 48 Suppl. Costa , R. Systematic review: Exercise-induced gastrointestinal syndrome-implications for health and intestinal disease. Craddock , J. Vegetarian and omnivorous nutrition—Comparing physical performance. International Journal of Sport Nutrition and Exercise Metabolism, 26 3 , — de Silva , D. Primary prevention of food allergy in children and adults: Systematic review. Allergy, 69 5 , — Fahrial Syam , A. Ramadan fasting decreases body fat but not protein mass. International Journal of Endocrinology and Metabolism, 14 1 , e Farooq , A. Knowledge, beliefs and attitudes of Muslim footballers towards Ramadan fasting during the London Olympics: a cross-sectional study. BMJ Open, 6 9 , e Fedewa , A. Dietary fructose intolerance, fructan intolerance and FODMAPs. Current Gastroenterology Reports, 16 1 , Gaskell , S. Applying a low-FODMAP dietary intervention to a female ultra-endurance runner with irritable bowel syndrome during a multi-stage ultra-marathon. Advance online publication. Gibson , P. Not all effects of a gluten-free diet are due to removal of gluten. Gastroenterology, 3 , Other dietary confounders: FODMAPS et al. Digestive Diseases, 33 2 , — Gilani , G. Effects of antinutritional factors on protein digestibility and amino acid availability in foods. Journal of AOAC International, 88 3 , — PubMed ID: Halmos , E. Diets that differ in their FODMAP content alter the colonic luminal microenvironment. Gut, 64 1 , 93 — Heilbronn , L. Alternate-day fasting in nonobese subjects: Effects on body weight, body composition, and energy metabolism. The American Journal of Clinical Nutrition, 81 1 , 69 — Hill , P. Controversies and recent developments of the low-FODMAP diet. Horne , B. Usefulness of routine periodic fasting to lower risk of coronary artery disease in patients undergoing coronary angiography. The American Journal of Cardiology, 7 , — Jeromson , S. Omega-3 fatty acids and skeletal muscle health. Marine Drugs, 13 11 , — Kirkendall , D. Strategies for maintaining fitness and performance during Ramadan. Kostic-Vucicevic , M. Is there connection between food intolerance and sports performance in elite athletes? British Journal of Sports Medicine, 50 , A Krajcovicova-Kudlackova , M. Iodine deficiency in vegetarians and vegans. Larson-Meyer , D. Optimizing performance on a vegetarian diet. Craig Ed. New York, NY : CRC Press. Leahy , E. An estimate of the number of vegetarians in the world pp. Dublin, Ireland : ESRI. Levitt , M. Clinical implications of lactose malabsorption versus lactose intolerance. Journal of Clinical Gastroenterology, 47 6 , — Lis , D. Case study: Utilizing a low FODMAP diet to combat exercise-induced gastrointestinal symptoms. International Journal of Sport Nutrition and Exercise Metabolism, 26 5 , — Food avoidance in athletes: FODMAP foods on the list. Applied Physiology, Nutrition, and Metabolism, 41 9 , — No effects of a short-term gluten-free diet on performance in nonceliac athletes. Low FODMAP: A preliminary strategy to reduce gastrointestinal distress in athletes. Exploring the popularity, experiences, and beliefs surrounding gluten-free diets in nonceliac athletes. International Journal of Sport Nutrition and Exercise Metabolism, 25 , 37 — Marsh , K. Protein and vegetarian diets. The Medical Journal of Australia, Suppl. Masuy , I. Effect of intragastric FODMAP infusion on upper gastrointestinal motility, gastrointestinal, and psychological symptoms in irritable bowel syndrome vs healthy controls. Maughan , R. Fasting and sports: A summary statement of the IOC workshop. British Journal of Sports Medicine, 46 7 , — β-casein includes amino acid residues of which Therefore, a variety of mutations resulted in different variants of β-casein including A1, A2, A3, B, C, D, E, F, G, H1, H2, and I A1 and A2 forms are the most common β-casein variants among other β-casein forms They include almost the same composition in terms of protein, fat, carbohydrate, and other contents concentration Table 1. The only difference between A1 and A2 variants stems from a point mutation which causes the difference in a single nucleotide at the 67 th position of the β-casein gene. A2 β-casein includes proline at the 67 th position of its amino acid sequence. However, this amino acid was converted to histidine by a mutation which causes the formation of the A1 β-casein variant Bovines, therefore, produce A1 or A2 milk depending on the β-casein form they have Several studies have shown that GI discomfort and other health problems, which are also serious problems many athletes experience when they consume A1 milk, are closely related to BCM-7 peptide 38 — However, as A2 milk lacks A1 β-casein and derived BCM-7, does not cause such health concerns for athletes. While the digestion of A1 protein causes the formation of BCM-7; Tyr-Pro-Phe-Pro-Gly-Pro-Ile , A2 protein digestion forms another peptide called β-casomorphin-9 BCM-9; Tyr-Pro-Phe-Pro-Gly-Pro-Ile-Pro-Asn The proline at the 67 th position of A2 β-casein hinders the BCM-7 formation in the human body, but histidine in A1 β-casein at the same position allows the cleavage by gastrointestinal enzymes to form BCM This morphine-like small peptide cannot be digested by human-associated enzymes, which causes indigestion problems. BCM-7 molecule was not observed in the urine or blood samples of A2 cows since A2 β-casein is broken down into peptides and then amino acids by an easy digestion process 27 , In A1 milk consumption, in contrast, the peptides cannot be broken down into amino acids, which causes the transition of this molecule into the gastrointestinal tract and bloodstream through leakages in the gut Several studies including epidemiological and clinical research have supported that the BCM-7 is a risk for diseases such as gastrointestinal discomfort, type 1 diabetes, ischemic heart, and, neurological diseases 42 — Consequently, athletes may suffer not only from GI discomfort but also from health problems caused by A1 milk consumption. As an alternative drink for athletes, A2 milk is a promising option to be benefited from the nutritional content of bovine milk without health problems. Milk and dairy products are associated with the concepts of physical activity, exercise, training, and health 2. The use of milk rich in amino acids, which is necessary for energy, shows branch-depending differences in athletes. Although its health benefits are known, the thought that it will negatively affect performance drives athletes away from milk. The number of studies on this subject has started to increase day by day. It is seen that milk taken after high-intensity interval running protocol application in endurance athletes does not negatively affect the nutrition protocol in the recovery process in athletes Athletes have to train continuously to maximize their performance. According to the competition calendar, athletes who train twice a day in some periods physiologically need a fast recovery period. Studies are showing that milk has positive effects on athlete performance as well as other supplements that accelerate recovery However, athletes with intolerance to dairy products are subject to a diet devoid of milk and dairy products in the cycle of regaining the lost energy after training. However, it is emphasized that A2 milk will be a suitable alternative since it does not contain the protein in A1 milk It is unclear whether A2 milk has a different effect on performance elements such as strength, speed, and endurance in comparison to regular milk. However, A2 milk might have a similar positive effect on athlete performance as regular milk because they have the same nutritional value. In addition to the positive effect of A2 milk on athlete performance quality, it can be a precise alternative for athletes who have some medical issues such as gastrointestinal discomfort, diabetes, and cardiovascular and neurological diseases. As for the impact of A2 milk on athlete health, several studies are focused on muscle damage and recovery which are crucial for the quality of exercise performance. In a research study, Kirk et al. According to the study results, both milk forms had a similar effect on sprint, vertical jump performance, and post-exercise recovery, which means that A2 milk may be a good substitute for lactose intolerant athletes In another study, regular chocolate milk and A2 milk had similar effects on recovery after physical exercise In addition, A2 milk consists of more proline amino acids due to the difference at the 67 th amino acid in the casein structure between A1 and A2 milk 51 , Proline is a multifunctional amino acid classified as one of the non-essential amino acids. It is one of the gluconeogenic amino acids and may increase endurance performance by protecting blood sugar and hepatic glycogen levels, especially in long-term endurance exercises Furthermore, proline is a critical amino acid for protein synthesis and cell growth. It also plays an important role in osmoregulation, redox signaling, protein stability, cellular bioenergetics, and stress resistance In addition to having all the nutritional values of A1 milk, A2 milk can be preferred by all athletes due to its easy-to-digest property and higher proline content. Most of the athletic population including runners, weightlifters, cyclists, and triathletes experience the discomfort problem due to mainly upper GI complaints such as nausea, vomiting, heartburn, and epigastric pain. Nutrition is of utmost importance to tackle these GI problems; however, inaccurate nutrition deteriorates symptoms. A1 milk, for instance, can cause symptoms associated with milk intolerance such as stool frequency, fecal and serum biomarkers, constipation, and transit time 32 , 35 , 37 , Several studies have shown that A1 milk causes some gastrointestinal discomfort problems during its digestion. A study has indicated that A1 milk causes higher stool consistency according to Bristol Scale in comparison to A2 milk. A study also showed that A2 milk consumption by lactose-intolerant individuals significantly diminished the intolerance symptoms In another study, lactose intolerant individuals consumed A2 milk, A1 milk, regular milk without lactose, and Jersey milk to evaluate their gastrointestinal symptoms and hydrogen production during digestion. They showed that A2 milk causes considerably fewer gastrointestinal symptoms and pain The study is resulted by that the group which consumes A2 milk presents fewer intolerance symptoms. A study performed on animals similarly showed that BCM-7 exerts different impacts on gastrointestinal function such as declining the frequency and amplitude of intestinal contractions. Barnett et al. Generally, it is mainly shown that A1 milk consumption causes systemic inflammation and gastrointestinal mobility related to BCM-7 formation during its digestion In contrast, A2 milk consumption was not correlated with post-dairy discomfort, and it is considered to milk can be easily consumed without any gastrointestinal discomfort A2 milk consumption by 10 individuals who are not tolerant to A1 milk did not cause any gastrointestinal problems. Another study also showed that A2 milk diminished gastrointestinal-related symptoms of lactose intolerant, whereas A1 milk decreased lactase activity and enhanced symptoms This easy digest product is also highly preferred by athletes to consume as an energy source after their exercise. In a study related to A2 milk and athlete health, the effect of A2, regular milk, and placebo on exercise-induced muscle damage is evaluated in a group including 21 men who regularly run. The results showed that A2 milk consumption diminishes muscle function loss and improves the recovery period Thus, alternate A2 milk may be a favorable drink for athletes without causing any GI concerns. Type 1 diabetes, which is a form of diabetes mellitus, is caused by a lack of insulin due to the problem in β-cells producing insulin in the islets of Langerhans of the pancreas Many athletes with type 1 diabetes are at risk of hypoglycemia during and post-exercise 60 , Therefore, this risky situation may hinder the sports career of athletes with type 1 diabetes. Another considerable point is that the consumption of popular post-exercise drink A1 milk can worsen symptoms related to type 1 diabetes. As regards studies on Type 1 diabetes and A1 β-casein, A1 milk causes worse symptoms of Type 1 diabetes due to BCM-7 formation, whereas it is not observed in A2 milk consumption does not cause morphine-like peptide BCM-7 release 26 , The relationship between A1 milk consumption and type 1 diabetes has been debated for long years 26 , 42 , 43 , Animal studies have shown that no difference between A1 and A2 milk consumption caused to high risk of type 1 diabetes. However, A1 milk intake by susceptible rats increases the risk of type 1 diabetes. Regarding studies on humans, a specific human leukocyte antigen HLA-DR may be at high risk of developing Type 1 diabetes due to cow's milk consumption This noticeably indicated that Finland and Sweden's highest A1 milk intake per capita had a higher incidence rate, while low frequencies were in Venezuela and Japan where the lowest A1 milk consumption takes place per capita Cardiovascular diseases, to date, have been one of the major causes of mortality and morbidity at the global level. Although precise nutrition and physical exercise are recommendations for the prevention of such diseases, even elite athletes are prone to developing cardiovascular diseases as they age 65 , Some drinks in athletes' diets pre- or pro- exercise were correlated with the symptoms of cardiovascular diseases. Especially, A1 milk was associated with some markers of cardiovascular diseases such as atherosclerosis, plasma cholesterol level, and oxidation of low-density lipoprotein 43 , 67 — Similarly, A1 β-casein per capita by milk and cream was strongly associated with ischemic heart disease in 20 different countries. BCM-7 formed after A1 milk consumption is also linked with the oxidation process of low-density lipoprotein LDL. Macrophages absorb oxidized LDL molecules with surface receptors and converted them into foam cells, which promotes atherosclerosis in the heart Another study also showed that A1 milk is more responsible for the atherosclerosis process in comparison to A2 milk. An artificial injury, in animal models, was made in the carotid artery of rabbits and was fed on A1 and A2 milk. The result of the study showed that rabbits fed on A1 milk had thicker streaks with fatty structures on the injured area than rabbits fed on A2 milk Consequently, A2 milk can be preferred for athletes who have or are at risk of cardiovascular diseases instead of regular A1 milk. Today, many people including many athletes suffer from various neurological diseases which seriously affect their quality of life. Balanced nutrition is a major factor that strongly affects symptoms of some neurological diseases, which could be a good way to be neurologically healthy. In contrast, BCM-7 derived from the consumption of A1 milk was correlated with the symptoms of some neurological diseases 40 , 72 , Studies related to A1 β-casein-derived BCM-7 show a relationship between this small peptide and a variety of neurological problems. In a study, for instance, BCM-7 in different concentrations is injected into 35 rats to examine its effects on rats' brain functions. It showed that BCM-7 can pass the blood-brain barrier, and even more, it can activate brain cells which causes some anatomic and functional changes in brain cells The relationship between BCM-7 and genes related to atopic dermatitis is also examined in another study. In this study, the MOR gene responsible for an opioid receptor which is associated with the negative effect of BCM-7 on digestion, immunity, and the nervous system was found as significantly more active because of the A1 milk consumption. In addition, the activity of the DPP4 gene, which is responsible for the production of a protein that degrades BCM-7, is decreased in dermatitis patients. In milk variants, furthermore, the highest BCM-7 concentration is observed after the hydrolysis of A1 milk Furthermore, autism, which is an autism spectrum disorder, is characterized by social and behavioral problems. Some studies have shown that BCM-7 may worsen the symptoms of autism development. The worse situations of neurological symptoms have been associated with the consumption of A1 milk and wheat by autistic patients 73 , It can clearly be stated that there is a critical need for further investigations on A1 milk consumption and neurological diseases including autism. Many athletes have been excluded A1 milk and products from their diet because of a variety of health problems ranging from intolerance to diabetes 52 , 64 , 69 , 71 , Therefore, they are more prone to consuming other non-dairy alternatives such as almond or oat milk; however, these plant-based options do not include the same nutritional content and health benefits as bovine milk. Many lactose-intolerant athletes do not experience gastrointestinal problems when they ingest plant-based milk and products. However, they lack a variety of benefits of regular dairy due to its rich nutritional content Nowadays, A2 milk and products have been introduced to the diet plan of many athletes to benefit them in many aspects of health with almost the same nutritional content as regular milk. Due to the easy-digest property of A2 milk, it is a source to make A2 milk-based meals for athletes pre- and pro-workout. Moreover, several popular dieticians have started to recommend the integration of A2 milk into athletes' diets in many ways 27 , For instance, A2 milk can be used to prepare a post-workout snack by mixing a piece of fruits or a pre-workout snack having it with cereal or muesli. Eventually, A2 milk-based meals may offer a precise alternative to before and after exercise food sources with important health benefits. Milk has an important part of the sports diet thanks to its rich nutritional elements. However, many athletes cannot consume milk due to GI discomfort after digestion. A2 milk is a considerable alternative for athletes with such ailments. A2 dairy allows athletes to take the nutrients they can get from regular milk without any discomfort. In this review, the effects of A2 milk, which has become more important in recent years, on athletes are compressively discussed. A2 milk has noticeable positive effects on both athlete health and performance. Consumption of A2 milk has a lower risk compared to A1 milk against digestive problems, type 1 diabetes, cardiovascular diseases, and neurological diseases, which have an important place in terms of the general health status of athletes. Its similarity with regular milk in athlete performance makes A2 milk a reliable food for athletes with GI disorders. A2 milk has a higher potential to be used as a nutritional source in athletes and even more in all humans' diets owing to its incredible functions on health. A2 milk and its derived products ranging from cheese to yogurt would be an important part of a healthy and balanced diet of a significant number of people in the future. This review paper, therefore, is of utmost importance to better understand the positive impact of A2 milk on athlete health. However, decomposing effects of regular milk and A2 milk on different physical performances such as strength, speed, and endurance are not fully known. Therefore, there is a critical need for more in-vitro and in-vivo studies comparing the effects of regular milk and A2 milk on sportive performance. SK organized the general content of the paper. MK was responsible for general editing and organizing the authors as well as the contribution for three sections. BB and BG were responsible for one section of the paper. AA and HD contributed one section of the paper. All authors contributed to the article and approved the submitted version. SK has received funding from Uluova Süt Ticaret A. Uluova Milk Trading Co. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher. Karav S, Casaburi G, Arslan A, Kaplan M, Sucu B, Frese S. N-glycans from human milk glycoproteins are selectively released by an infant gut symbiont in vivo. |
| 5 Gluten-Free Carbohydrate Foods for Athletes | GI issues caused by hidden food intolerances, no matter their severity, not only affect your performance in a given race, they can ultimately lead to nutrient deficiencies. Any time you are dealing with ongoing diarrhea or nausea or other GI symptoms, it can interfere with healthy ingestion and absorption, and this is a problem that must be addressed. RELATED: 7 Simple Food Swamps For Better Nutrition. Here are the foods and habits that often cause GI distress for endurance athletes that can help you troubleshoot the cause s of your GI issues. In some people, certain carbohydrates eaten in threshold amounts can lead to symptoms such as bloating, gas, distension, abdominal discomfort, and either diarrhea or constipation, or a mix of both. The bacteria residing in your gut will determine how you handle and respond to these particular carbohydrates. The types of carbohydrates that are most commonly malabsorbed in the intestine are known as FODMAPs fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. These are simply the technical names for the structure of the sugar molecules saccharides is another name for sugar. All carbohydrates are broken down into glucose or sugar molecules through digestion. FODMAPs are found in a wide variety of foods: fruits, vegetables, grains, legumes, dairy, nuts, and seeds. Apples, pears, onions, garlic, wheat, and rye are among the common culprits. Since FODMAPs describe only certain carbohydrates, proteins and fats are free of them. One of the first steps to resolving your GI issues is healing your gut by reducing inflammation and foods that commonly make GI issues worse. Time is part of the equation to allow your gut to recover and repair, but these other dietary and lifestyle habits are also key. Stick to anti-inflammatory foods for the majority of your dietary intake. Inflammatory foods kill off good gut bacteria and encourage growth of bad bacteria. Incorporate more fermented foods e. Research shows that probiotics help maintain healthy gut bacteria populations and the overall integrity of gut barrier function, thus preventing leaks and reducing the risk of toxins entering the bloodstream and thereby inflammatory reactions and food intolerances. Prebiotics , a fancy word for the fibers found in plant matter, are just as important to provide food for the probiotics. Stock your diet with vegetables, fruits and nuts to provide lots of fermentable fiber, which will serve as food for the probiotics. Only use antibiotics as needed , and avoid animal products that have been exposed to antibiotics. As an athlete you can encourage a healthy population of bacteria within your own gut by steadily building fitness and not overreaching. Appropriate workouts and timing will help facilitate positive acute stress that induces adaptation, allowing you to become fitter, faster and stronger and strengthen your immune system. But the chronic stress that can occur with overtraining, inadequate recovery or trying to achieve too much before you are ready for it can compromise body functions and structures, including that of the digestive tract and the resident bacteria. Stay hydrated. During your time using the Base Functional Diet, you will reduce your overall levels of inflammation, heal any damage to your gut, reduce your chronic load of food-related allergens, and return gradually to a base state. Think of it instead as a grace period to allow your body a much-needed break from the irritants that are causing your reactions to food. Most people begin feeling better in just a few days. Here are two to try. Serves 5 10 generous slices When I make banana bread, I use different flour combinations to allow for different intolerances or allergies. This variation uses coconut flour, which gives the bread nice flavor and a lot of fiber. I also use plenty of cinnamon; if you want a subtler flavor, use just 1 teaspoon. I am in my mids and have never had any problems eating dairy. But I started training for triathlon two years ago and in all my races I have had stomach problems. Is dairy the culprit? A: GI problems are probably one of the most common and perhaps most frustrating issues that athletes face, especially when it comes to race-day performance. Endurance athletes, in particular, are prone to them, with most studies and reports putting incidence rate at between one-third and half of all competitors in any one event. Causes are diverse but certain foods might be culprits, such as those containing lactose, and your chance of being affected is determined largely by your genetic and ethnic background. Strenuous exercise puts the body under stress and makes the gut more sensitive than when it is at rest. This means that any food intolerances and mild food allergies that you may not even be aware of at rest, or during aerobic controlled training, might become an issue during hard training or racing. Lactose intolerance is one example and symptoms, which usually occur 30 minutes to two hours after eating the offending foods, can include abdominal pain, diarrhea, gas, bloating and nausea—symptoms that mimic some of the most common GI complaints of endurance athletes. Requirements can be met by spending 5—30 min depending on fair or dark skin outside, at close to solar noon several times per week during the summer Table 3 ; Owens et al. Vitamin D3, derived from lichen, or D2, produced from irradiation of ergosterol from yeast, are vegan sources, but vitamin D3 may be more effective at increasing vitamin D status. Finally, vitamin B12 is a concern for vegan and semivegan athletes because it is found exclusively in animal products. Vegan track-and-field athletes should consume vitamin Bfortified foods daily or take a vitamin Bcontaining supplement or multivitamin. Athletes should also be aware that some dietary supplements may come from animal sources including gelatin, collagen, omega-3 fatty acids, and vitamin D3. Overall, vegetarian and vegan diets that contain a variety of whole grains, vegetables, fruits, legumes, nuts, and seeds can provide the protein, carbohydrate, fat, vitamins, and minerals required for track-and-field athletes. Depending on dietary choice, emphasis of foods high in protein, iron, zinc, calcium, and vitamin B12 e. Although research strongly suggests that a plant-based diet may offer some health benefits, there is little evidence that vegetarian diets are superior to omnivorous diets for improving athletic training, health, or performance. Fasting is characterized by the absence of energy intake for sustained period of time ranging from several hours to days Maughan et al. Apart from religious obligation, fasting also holds appeal for weight loss, chronic disease management, and to increase longevity Horne et al. However, the impacts of fasting, particularly for track-and-field athletes, are inconclusive and challenging to translate into practice due to methodological variances, study design limitations, animal-based concepts, and diverse clinical populations. Recently, fasting has received an upsurge of attention. Some forms of fasting are promoted as a strategy to offer health and performance benefits. This has prompted an increase in contemporary fasting publications and renewed academic focus, which has provided some insight into the possible effects of fasting on athletic performance. In particular, investigation of the use of fasting to enhance substrate utilization and mitochondrial adaptation to enhance exercise metabolism and performance Aird et al. Any improvements in lipid profile, inflammatory markers, glucose metabolism, or cardiovascular function are short-lived and are not clinically significant Barkia et al. These findings prevent using nonobligatory fasting practices within standard practice evidence-based recommendations. Several types of fasting exist. Intermittent fasting IF and caloric restriction are the most predominate. IF is conducted intermittently with fast and refeed periods each hour day. Caloric restriction is a chronic reduction in calories for a prolonged period of time where ad libitum water is permitted. Most applicable literature has focused on IF, and therefore, the following discussion will focus on this type of fasting. IF is subdivided into three categories: alternate day fasting, whole-day or periodic fasting, and time-restricted fasting TRF. In all cases, a primary concern for track-and-field athletes is the loss of lean mass during a period of fasting or caloric restriction Heilbronn et al. Time-restricted fasting has received the most attention within the fasting literature. This form of fasting theoretically offers metabolic and body composition benefits for athletes Morton et al. It involves 16—20 hr of fasting with a 4- to 8-hr feeding window. Several commercial variations of this diet have been developed. To date, only one study in recreationally active and resistance-trained athletes has been conducted. Findings indicate TRF does not support favorable changes in lean and fat mass compared with a normal diet Tinsley et al. These observations may be attributed to unmatched macronutrient intake, specifically protein, between the normal diet group 1. A follow-up study matching protein intakes 1. However, these results could be influenced by the more favorable feeding period around the training period for the TRF group. Ramadan is a holy month during which Muslims refrain from eating and drinking between sunrise and sunset for 30 days. It is the most widely studied form of TRF and probably the most relevant for many elite athletes. Depending on the seasonal and geographical conditions, Ramadan falls on different dates every year and fasting varies from 11 to 18 hours daily Azizi, ; patterns that can indirectly affect performance and alertness Roky et al. Ramadan is also associated with more rapid onset of fatigue, lethargy, and noncontact athlete injury Chtourou et al. Therefore, much research has focused on the factors negatively affecting performance and tools to mitigate these potential detriments Tables 4 and 5. Daily eating routines are characterized by two meals: one before sunrise Sahur and one after sunset Iftar. It is commonly believed that Ramadan fasting results in a significant calorie deficit. Amid eating challenges, the primary goal for track-and-field athletes should be to maintain body composition as well as minimize decrements in performance. Due to the variances in food availability, there is potential to overeat at fewer meal times, and it can be difficult for some athletes to maintain a stable body composition. Conversely, for some athletes, food choices during Ramadan may become better planned, and subsequently, the quality of food is improved compared with intake during the rest of the nonfasting year. Demonstrating this, unexpected improvements in lean mass and fat mass have even been measured, which may be attributed to improved food choices during Ramadan Fahrial Syam et al. Particularly, during the first week of fasting, body composition measures may be inadvertently skewed by increased total body water loss, decreased gastrointestinal volume, and glycogen stores. These factors should be considered with athlete monitoring during this fasting period. For the sports nutrition practitioner, several well-documented challenges before, during, and after exercise exist. Rehydration, posttraining recovery, fatigue management, portion control, and maintaining optimal body composition are the most common nutrition challenges Table 4 ; Norouzy et al. These challenges are magnified when Ramadan occurs across major sporting events e. Competing in a non-Muslim country and requirements of weight-making sports present further complications Aloui et al. Muslim track-and-field athletes undertaking obligatory fasting are also at a potential disadvantage compared with voluntary fasting as they are less able to modify their feeding periods around training. Some athletes will obtain special permission to observe their fast after an important event. In addition, valuable nutrition strategies such as carbohydrate mouth rinsing may be not permitted due to the interpretation of fasting law by Islamic scholars. Overall, many challenges are associated with Ramadan fasting, and individualized strategies are required for successful management to avoid a possible detraining effect Table 5 ; Aloui et al. A solid understanding of the knowledge and beliefs pertaining to Ramadan is important for practitioners counseling Muslim track-and-field athletes as much contradictory evidence exists on the effects of Ramadan fasting on health. Personalized knowledge and beliefs can often translate into attitudes and practices. Long-standing experiences established in early years, advice from peers, knowledge level, and how well the environment is controlled appear to be significant factors of Ramadan impacting performance Chamari et al. It is commonly trusted that Ramadan fasting negatively affects physical performance Chamari et al. However, evidence continues to advocate that only a few aspects of physical fitness are negatively affected by Ramadan Alkandari et al. Cognitive performance e. Overall, maintenance of daily energy and macronutrient intakes, body composition, training load, and sleep duration similar to the rest of the year will minimize impairments of physical performance during Ramadan. Evidence is lacking to support any benefit of fasting compared with conventional techniques for improving body composition or metabolic parameters in track-and-field athletes. Nutrition strategies should be planned in advance to avoid possible performance decrements during obligatory fasting. Special diets may be appropriate for some track-and-field athletes, but each of these should be carefully evaluated as well as the rationale for choosing a diet. Ad hoc adherence to a special diet is associated with several risks, which should be carefully evaluated and monitored. Even in cases where a special diet is necessary, proper education is essential as dietary restriction may do more harm than good. Lis, E. Larson-Meyer, and D. Kings wrote initial draft of respective sections. Lis compiled, edited, formatted, and revised the manuscript. All authors approved the final version of the paper. The authors have no conflicts of interests to report. Agnoli , C. Position paper on vegetarian diets from the working group of the Italian Society of Human Nutrition. PubMed ID: doi Aird , T. Effects of fasted vs fed-state exercise on performance and post-exercise metabolism: A systematic review and meta-analysis. Alkandari , J. The implications of Ramadan fasting for human health and well-being. Journal of Sports Sciences, 30 Suppl. Aloui , A. Rapid weight loss in the context of Ramadan observance: Recommendations for judokas. Biology of Sport, 33 4 , — Applegate , C. Influence of dietary acid load on exercise performance. International Journal of Sport Nutrition and Exercise Metabolism, 27 3 , — Azizi , F. Research in Islamic fasting and health. Annals of Saudi Medicine, 22 3—4 , — Barkia , A. Change of diet, plasma lipids, lipoproteins, and fatty acids during Ramadan: A controversial association of the considered Ramadan model with atherosclerosis risk. Journal of Health, Population and Nutrition, 29 5 , — Biesiekierski , J. Non-coeliac gluten sensitivity: Piecing the puzzle together. United European Gastroenterology Journal, 3 2 , — Bulka , C. The unintended consequences of a gluten-free diet. Epidemiology, 28 3 , e24 — e Castell , L. Exercise-induced illness and inflammation: Can immunonutrition and iron help? International Journal of Sport Nutrition and Exercise Metabolism. Manuscript in preparation. Chamari , K. Impact of Ramadan intermittent fasting on cognitive function in trained cyclists: A pilot study. Biology of Sport, 33 1 , 49 — Chtourou , H. The effect of Ramadan fasting on physical performances, mood state and perceived exertion in young footballers. Asian Journal of Sports Medicine, 2 3 , — Cialdella-Kam , L. Vegetarian, gluten-free, and energy restricted diets in female athletes. Sports, 4 4 , 1 — Colbey , C. Upper respiratory symptoms, gut health and mucosal immunity in athletes. Sports Medicine, 48 Suppl. Costa , R. Systematic review: Exercise-induced gastrointestinal syndrome-implications for health and intestinal disease. Craddock , J. Vegetarian and omnivorous nutrition—Comparing physical performance. International Journal of Sport Nutrition and Exercise Metabolism, 26 3 , — de Silva , D. Primary prevention of food allergy in children and adults: Systematic review. Allergy, 69 5 , — Fahrial Syam , A. Ramadan fasting decreases body fat but not protein mass. International Journal of Endocrinology and Metabolism, 14 1 , e Farooq , A. Knowledge, beliefs and attitudes of Muslim footballers towards Ramadan fasting during the London Olympics: a cross-sectional study. BMJ Open, 6 9 , e Fedewa , A. Dietary fructose intolerance, fructan intolerance and FODMAPs. Current Gastroenterology Reports, 16 1 , Gaskell , S. Applying a low-FODMAP dietary intervention to a female ultra-endurance runner with irritable bowel syndrome during a multi-stage ultra-marathon. Advance online publication. Gibson , P. Not all effects of a gluten-free diet are due to removal of gluten. Gastroenterology, 3 , Other dietary confounders: FODMAPS et al. Digestive Diseases, 33 2 , — Gilani , G. Effects of antinutritional factors on protein digestibility and amino acid availability in foods. Journal of AOAC International, 88 3 , — PubMed ID: Halmos , E. Diets that differ in their FODMAP content alter the colonic luminal microenvironment. Gut, 64 1 , 93 — Heilbronn , L. Alternate-day fasting in nonobese subjects: Effects on body weight, body composition, and energy metabolism. The American Journal of Clinical Nutrition, 81 1 , 69 — Hill , P. Controversies and recent developments of the low-FODMAP diet. Horne , B. Usefulness of routine periodic fasting to lower risk of coronary artery disease in patients undergoing coronary angiography. The American Journal of Cardiology, 7 , — Jeromson , S. Omega-3 fatty acids and skeletal muscle health. Marine Drugs, 13 11 , — Kirkendall , D. Strategies for maintaining fitness and performance during Ramadan. Kostic-Vucicevic , M. Is there connection between food intolerance and sports performance in elite athletes? British Journal of Sports Medicine, 50 , A Krajcovicova-Kudlackova , M. Iodine deficiency in vegetarians and vegans. Larson-Meyer , D. Optimizing performance on a vegetarian diet. Craig Ed. New York, NY : CRC Press. |
| When doing sport destabilizes muscle balance | Unfortunately, reported intakes are often less than estimated needs. Effect of Ramadan fasting on body composition and physical performance in female athletes. Finally, vitamin B12 is a concern for vegan and semivegan athletes because it is found exclusively in animal products. Ramakrishnan M, Eaton T, Sermet O, Savaiano D. The results showed that A2 milk consumption diminishes muscle function loss and improves the recovery period And it is okay to tailor it to your personal preferences, health needs and lifestyle provided you have adequate nutrition and fluid through your work-out sessions. Diet, lifestyle and cardiovascular diseases: linking pathophysiology to cardioprotective effects of natural bioactive compounds. |
| 5 Gluten-Free Carbohydrate Foods for Athletes | TrainingPeaks | International Journal of Sport Nutrition and Exercise Metabolism, 26 3 , — de Silva , D. Primary prevention of food allergy in children and adults: Systematic review. Allergy, 69 5 , — Fahrial Syam , A. Ramadan fasting decreases body fat but not protein mass. International Journal of Endocrinology and Metabolism, 14 1 , e Farooq , A. Knowledge, beliefs and attitudes of Muslim footballers towards Ramadan fasting during the London Olympics: a cross-sectional study. BMJ Open, 6 9 , e Fedewa , A. Dietary fructose intolerance, fructan intolerance and FODMAPs. Current Gastroenterology Reports, 16 1 , Gaskell , S. Applying a low-FODMAP dietary intervention to a female ultra-endurance runner with irritable bowel syndrome during a multi-stage ultra-marathon. Advance online publication. Gibson , P. Not all effects of a gluten-free diet are due to removal of gluten. Gastroenterology, 3 , Other dietary confounders: FODMAPS et al. Digestive Diseases, 33 2 , — Gilani , G. Effects of antinutritional factors on protein digestibility and amino acid availability in foods. Journal of AOAC International, 88 3 , — PubMed ID: Halmos , E. Diets that differ in their FODMAP content alter the colonic luminal microenvironment. Gut, 64 1 , 93 — Heilbronn , L. Alternate-day fasting in nonobese subjects: Effects on body weight, body composition, and energy metabolism. The American Journal of Clinical Nutrition, 81 1 , 69 — Hill , P. Controversies and recent developments of the low-FODMAP diet. Horne , B. Usefulness of routine periodic fasting to lower risk of coronary artery disease in patients undergoing coronary angiography. The American Journal of Cardiology, 7 , — Jeromson , S. Omega-3 fatty acids and skeletal muscle health. Marine Drugs, 13 11 , — Kirkendall , D. Strategies for maintaining fitness and performance during Ramadan. Kostic-Vucicevic , M. Is there connection between food intolerance and sports performance in elite athletes? British Journal of Sports Medicine, 50 , A Krajcovicova-Kudlackova , M. Iodine deficiency in vegetarians and vegans. Larson-Meyer , D. Optimizing performance on a vegetarian diet. Craig Ed. New York, NY : CRC Press. Leahy , E. An estimate of the number of vegetarians in the world pp. Dublin, Ireland : ESRI. Levitt , M. Clinical implications of lactose malabsorption versus lactose intolerance. Journal of Clinical Gastroenterology, 47 6 , — Lis , D. Case study: Utilizing a low FODMAP diet to combat exercise-induced gastrointestinal symptoms. International Journal of Sport Nutrition and Exercise Metabolism, 26 5 , — Food avoidance in athletes: FODMAP foods on the list. Applied Physiology, Nutrition, and Metabolism, 41 9 , — No effects of a short-term gluten-free diet on performance in nonceliac athletes. Low FODMAP: A preliminary strategy to reduce gastrointestinal distress in athletes. Exploring the popularity, experiences, and beliefs surrounding gluten-free diets in nonceliac athletes. International Journal of Sport Nutrition and Exercise Metabolism, 25 , 37 — Marsh , K. Protein and vegetarian diets. The Medical Journal of Australia, Suppl. Masuy , I. Effect of intragastric FODMAP infusion on upper gastrointestinal motility, gastrointestinal, and psychological symptoms in irritable bowel syndrome vs healthy controls. Maughan , R. Fasting and sports: A summary statement of the IOC workshop. British Journal of Sports Medicine, 46 7 , — IOC consensus statement: Dietary supplements and the high-performance athlete. British Journal of Sports Medicine, 52 7 , — The effects of fasting on metabolism and performance. British Journal of Sports Medicine, 44 7 , — Meckel , Y. The effect of the Ramadan fast on physical performance and dietary habits in adolescent soccer players. European Journal of Applied Physiology, 6 , — Melina , V. Position of the Academy of Nutrition and Dietetics: Vegetarian diets. Journal of the Academy of Nutrition and Dietetics, 12 , — Memari , A. Effect of Ramadan fasting on body composition and physical performance in female athletes. Messina , M. Effects of soy protein and soybean isoflavones on thyroid function in healthy adults and hypothyroid patients: A review of the relevant literature. Thyroid, 16 3 , — Meyer , N. Nutrients, 9 4 , Moro , T. Effects of eight weeks of time-restricted feeding on basal metabolism, maximal strength, body composition, inflammation, and cardiovascular risk factors in resistance-trained males. Journal of Translational Medicine, 14 1 , Morton , J. Periodised nutrition for training adaptation. Mountjoy , M. IOC consensus statement on relative energy deficiency in sport RED-S : update. British Journal of Sports Medicine, 52 11 , — Norouzy , A. Effect of fasting in Ramadan on body composition and nutritional intake: A prospective study. Journal of Human Nutrition and Dietetics, 26 Suppl. Ong , D. Manipulation of dietary short chain carbohydrates alters the pattern of gas production and genesis of symptoms in irritable bowel syndrome. Journal of Gastroenterology and Hepatology, 25 8 , — Otten , J. The dietary reference intakes: The essential guide to nutrient requirements. Washington, DC : Food and Nutrition Board, Institute of Medicine. Owens , D. Vitamin D and the athlete: Current perspectives and new challenges. Pelly , F. Dietary regimens of athletes competing at the Delhi Commonwealth Games. International Journal of Sport Nutrition and Exercise Metabolism, 24 1 , 28 — Pfeiffer , B. Nutritional intake and gastrointestinal problems during competitive endurance events. Platt , M. Rational approach to allergy testing. Otolaryngologic Clinics of North America, 50 6 , — Reilly , T. Altered sleep-wake cycles and food intake: The Ramadan model. Roky , R. Diurnal variation in temperature, mental and physical performance, and tasks specifically related to football. Chronobiology International, 48 4 , — Rona , R. The prevalence of food allergy: A meta-analysis. The Journal of Allergy and Clinical Immunology, 3 , — Sapone , A. Spectrum of gluten-related disorders: Consensus on new nomenclature and classification. BMC Medicine, 10 , Schafer , T. Allergy, 56 12 , — Shepherd , S. Nutritional inadequacies of the gluten-free diet in both recently-diagnosed and long-term patients with coeliac disease. Journal of Human Nutrition and Dietetics. Shtessel , M. Reliability of allergy skin testing. Skodje , G. Fructan, rather than gluten, induces symptoms in patients with self-reported non-celiac gluten sensitivity. Gastroenterology, 3 , — Staudacher , H. Mechanisms and efficacy of dietary FODMAP restriction in IBS. A diet low in FODMAPs reduces symptoms in patients with irritable bowel syndrome and a probiotic restores bifidobacterium species: A randomized controlled trial. Gastroenterology, 4 , — Stockman , M. Intermittent fasting: Is the wait worth the weight? Current Obesity Reports, 7 2 , — Tapke , D. Unnecessary food allergy testing by primary care providers: Ethical implications for the specialist. Tian , H. Effects of fasting during Ramadan month on cognitive function in Muslim athletes. Tinsley , G. Time-restricted feeding in young men performing resistance training: A randomized controlled trial. European Journal of Sport Science, 17 2 , — Trapp , D. Could a vegetarian diet reduce exercise-induced oxidative stress? A review of the literature. Journal of Sports Sciences, 28 12 , — Trepanowski , J. The impact of religious fasting on human health. Nutrition Journal, 9 , Turnbull , J. Review article: The diagnosis and management of food allergy and food intolerances. van Wijck , K. Physiology and pathophysiology of splanchnic hypoperfusion and intestinal injury during exercise: Strategies for evaluation and prevention. American Journal of Physiology. Gastrointestinal and Liver Physiology, 2 , G — G of Neurobiology, Physiology, and Behavior, University of California, Davis, Davis, CA. Kings is with Aspetar Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar. Larson-Meyer is with the Dept. In some, though, this production is not switched off and they are able to continue to digest lactose into adulthood. For the athlete with continued GI distress during racing that has not been satisfactorily dealt with by adjusting other nutritional plans, it might be worth considering your tolerance of lactose and making some changes around race day and key training workouts. This is not to say that you need to eliminate dairy altogether—it might be a matter of working out when and how much lactose you are able to easily tolerate. Many people find that lower lactose foods such as yogurts live cultures in yogurt and fermented kefir break down the lactose to lactic acid, which is more readily tolerated and hard cheeses are fine, or that consuming small amounts within meals poses no problems. Lactose-free milk and other products are also available as well as lactose supplements for the determined dairy lovers. It is also possible that you might build tolerance by introducing small amounts of dairy over time. But I would advise avoiding any lactose for three days before a big race if you believe you have any sort of intolerance. This means not just the obvious milk, cheese, yogurt but also involves reading and checking labels of various products, including breads, cereals, sports bars and drinks, dressings and many other processed foods. Be on the lookout for terms such as whey, milk solids, curds, milk by-products, lactose or, alternatively, skip the processed foods altogether and eat real food so you know exactly what you are eating. According to their site, www. On a personal note, even though I was tested for Celiac and fortunately, learned I did not have it, I still found that cutting gluten from my diet eight years ago proved to be the single thing that halted a lifetime of stomach issues in a mere three days. Ready to try it but feeling at a loss in terms of what to eat to replace that bagel or your morning bowl of oats? How much to eat will depend on a few factors including:. |
Sports nutrition for intolerant athletes -
This bedtime snack has not been linked with fat gain. Cottage cheese, anyone? If you have celiac disease as verified by blood tests , your gut will indeed feel better if you avoid wheat and other gluten-containing foods.
However, very few gut issues for non-celiac athletes are related to gluten. FODMAPs F ermentable O ligo-, D i-, M ono-saccharides and P olyols are often the culprit. These are types of hard-for-some-people-to-digest carbohydrates found in commonly eaten foods such as wheat, apples, onion, garlic, and milk.
For example, the di-saccharide lactose a kind of sugar found in milk creates gut turmoil in people who are lactose intolerant. The poorly digested and absorbed lactose creates gas, bloat and diarrhea.
For certain athletes, a low FODMAP diet two or three days before a competition or long training session can help curb intestinal distress. If you live in fear of undesired pit stops, a consultation with your sports dietitian to learn more about a short-term FODMAP reduction diet is worth considering.
With caffeinated beverages, the diuretic effect might be 1. excess fluid lost per mg. of caffeine. That means, if you were to drink a small mug 7 oz. of coffee that contains milligrams of caffeine, you might lose about ml.
water through excess urine loss. But you'd still have 50 ml. fluid to hydrate your body—and likely more if you drink coffee regularly. Athletes who regularly consume caffeine habituate and experience less of a diuretic effect.
In general, most caffeinated beverages contribute to a positive fluid balance; avoiding them on the basis of their caffeine content is not justified. Creatine is sometimes used by athletes who want to bulk up.
It allows muscles to recover faster from, let's say, lifting weights, so the athlete can do more reps and gain strength. A review of 21 studies that assessed kidney function with creatine doses ranging from two to 30 grams a day for up to five and a half years indicates creatine is safe for young healthy athletes as well as for elderly people.
Even the most recent studies using sophisticated methods to assess renal function support creatine supplements as being well tolerated and not related to kidney dysfunction. Without a doubt, vegan athletes can —and do—excel in sport. Just Google vegan athletes ; you'll find an impressive list that includes Olympians and professional athletes from many sports including football, basketball, tennis, rowing, snow boarding, running, soccer, plus more.
The key to consuming an effective vegan sports diet is to include adequate leucine, the essential amino acid that triggers muscles to grow.
The richest sources of leucine are found in animal foods, such as eggs, dairy, fish, and meats. If you swap animal proteins for plant proteins, you reduce your leucine intake by about 50 percent. For athletes, consuming 2. A few examples include avocados, nuts, nut butters, seeds, and olives. Below is an example of how much carbohydrate, protein and fat a pound 75 kg track and field athlete would need, and how they can spread their intake throughout the day.
Having a fueling, hydration, and rehydration plan that supports the energy demands of practice and training is key to having high-quality training sessions. That includes what you eat and drink before, during, and after practice, as well as how you eat and hydrate on competition days.
The size and composition of the pre-practice or pre-competition meal is highly dependent on how much time there is before activity starts. Ideally, athletes should eat a nutritious, balanced meal that is high in complex carbohydrates, moderate in protein and includes some dietary fat three to four hours before the event starts.
Then, have a smaller snack made up of simple carbohydrates that digest more rapidly in the minutes before competing. Check out our handout on fueling for competition day for ideas ad examples on what to eat before activity,. Even longer events, like the meter run, are not long enough to warrant an athlete slowing down for fluids.
Instead, they should focus on starting well-fueled and hydrated, and refueling and rehydrating immediately after the event. Fueling and hydrating during practice and training, however, is a different story. For practices lasting longer than an hour, or when practice or training takes place in hot and humid conditions, regular fluid breaks are critically important to maintain a healthy hydration status.
In addition to drinking water or a sports drink, athletes can help maintain energy levels by consuming a carbohydrate-rich snacks during quick breaks or rest periods. Sports chews, a piece of fresh fruit or a granola bar are all easy, portable options to consider.
Eating and drinking after training and competition is important to replace depleted muscle fuel and replace lost fluids. Drinking chocolate milk after exhaustive activity is a great option because it supplies both carbohydrates and protein, as well as fluids and electrolytes, all in one beverage.
That snack begins the refuel process, but athletes should still plan to have a balanced meal within two hours of ending activity. Refueling and rehydrating after activity is especially important for athletes who participate in multiple events.
Establishing a hydration routine is critical to maintain adequate hydration status and to prevent dehydration. To help meet fluid needs, carry a large water bottle and sip fluids throughout the day.
Eating foods that have a high water content, such as milk, yogurt, soups, fruits, and vegetables, also help meet daily fluid needs. During practice, drink about 6 ounces of fluid every 15 to 20 minutes.
Water is adequate for practices shorter than one hour. When practice is longer than one hour or when it is outside in hot and humid conditions, a sports drink that contains electrolytes is a better option. By paying attention to fluid losses, athletes can be sure to rehydrate appropriately.
Traveling for competition and long meet days can make it challenging to stick to a regular eating and fueling routine. Plan and pack portable, shelf-stable healthy snacks for long bus trips. Some ideas include dried fruit and nut trail mix; peanut butter and jelly sandwiches; tuna fish pouches and crackers; whole fruit; granola bars; bottled juice and bottled water.
Stevie Lyn is a Registered Dietitian and avid endurance athlete. Her mission is to help educate and coach athletes on how to fuel their goals while not sacrificing their health. As a board-certified specialist in sports nutrition, Stevie Lyn has helped hundreds of athletes and active individuals fuel to improve their performance, energy levels, and recovery without feelings of guilt or restriction.
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Heading out the SSports Professional triathlete and sports nutritionist Pip Nutritoon Beta-alanine and muscle fatigue prevention advice on how Antiviral immune support deal with milk intolerance as an Beta-alanine and muscle fatigue prevention athlete. Written Caffeine alternatives Pip Taylor. Tor I am having ongoing gastrointestinal troubles in races. My friend is adamant that I should cut out dairy, as she thinks I might be lactose intolerant. I am in my mids and have never had any problems eating dairy. But I started training for triathlon two years ago and in all my races I have had stomach problems.
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