Nutrition for Recovery

Athletes invest time, effort and money in their sport. They buy cloths, shoes and gear that is necessary for them to excel. But, how much do they invest in their recovery plan?! Yes, recovery is also stretching, foam rolling and ice baths but what about nutrition for recovery?

The main purpose of nutrition for recovery is replenishing glycogen stores, repairing and rebuilding muscle as well as re-hydrating in order to get to the next practice like new (the 3 Rs).
Fueling for recovery does change based on the intensity and duration of your workout as well as when your next workout will occur. For example: Someone that has football practice in the morning for 1.5 hours and then a 1.5 hour lifting session in the afternoon will need to put a little more effort in fueling for recovery versus someone that ran for 60 minutes and will play tennis in 2 days. Athletes that rest 24 hours or more between sessions, do not have to put emphasis on nutrient timing when it comes to glycogen, withstanding they consume enough carbohydrates throughout the day.

                

• Refuel (=replenish) - The main source of fuel utilized during exercise is carbohydrate. Carbohydrates are stored in the form of glycogen in the muscle and liver and these stores are drained the longer the activity is or the higher the intensity. Therefore, we need to replenish those glycogen stores, especially if there are multiple practices or tournaments in the same day. Refueling should start within 30-45 minutes after exercise. It is recommended to consume 1-1.5 gr/kg of carbohydrate every 2 hours up to 4-6 hours post activity (1 kg = 2.2 lbs. Example: 154 lbs=70 kg - Will need to consume 70-105 grams carbohydrates every 2 hours for up to 4-6 hours post exercise or until eating a meal).
• Rebuild - Exercise causes damage to the working muscle. Protein is the main nutrient that helps repair the damage and rebuild the muscle (muscle protein synthesis). Protein should be consumed within 2 hours of activity to promote a greater muscle growth. Combining protein with carbohydrate post workout has shown to enhance recovery. Recommendations for protein are 6-20 grams within 2 hours of activity.
• Rehydrate - During exercise we can lose quite a lot of fluids in the form of sweat. Sweat is not just contrived of water but also multiple electrolytes, mainly sodium, potassium and chloride. Therefore, to recover optimally we need to rehydrate with fluids and electrolytes. The best way to rehydrate properly is weighing yourself before and after practice. For each pound lost, drinking 16-24 oz is recommended. Hydrating throughout the day well, makes rehydrating for recovery much easier. Eating salty snacks and drinking a sports beverage could be a good way to help replenish some of the electrolytes lost.

Simple, right?! However, some people may have a hard time eating something post exercise. In that case, drinking could be an option. In fact, one of the best recovery drinks out there is chocolate milk. It has a combination of whey and casein (fast absorbed and slow absorbed high quality protein respectively), good amount of carbohydrates and its a liquid containing electrolytes. Win win! 

Research also suggests the best ratio of carbohydrate to protein for recovery should be 2:1-4:1, chocolate milk is 3:1. 

Other recovery options can be: 

• Yogurt with strawberries
• Milk and a banana
• Protein bar, water and a fruit
• Fruit smoothie
• Turkey and cheese sandwich with a sports beverage
• Cereal with milk and blueberries

It is also important to mention that part of a good recovery plan includes sleep. For more info on sleep refer to previous Sleep  blog.

Investing in recovery is as important as the time you invest in training so remember to refuel, rebuild and rehydrate to achieve optimal recovery 

Nutrition for the Injured Athlete

We talk all the time about nutrition for performance and nutrition for recovery but there is not much talk about nutrition for injury. Is there even a specific regimen for the injured athlete?!
Unfortunately, there is not much research out there on the injured athlete so we don't have a specific regimen, however, we do have some knowledge and recommendations to help heal faster and get back in the game sooner.

Injury has 3 healing phases:

1. Inflammation - occurs immediately up to 2-5 days post injury
2. Proliferation -  occurs 5 days - 3 weeks post. During this phase there is rebuilding and repairing 
3. Maturation - occurs 3 weeks - 2 years (depending on severity of injury). During this phase there is remodeling to a stronger structure

If the injury is serious we may not be able to immobilize which in turn will cause less muscle building, muscle loss, decrease in strength and of course decrease in performance.  

Nutritionally, we divide recommendations to 2 phases: 

1. Injury and immobilization - during this phase most of the muscle loss occurs
2. Rehabilitation - during this phase exercise is re-introduced in the form of therapy and advanced to full practice when able

Nutrition recommendations during Injury and immobilization (= inflammation and proliferation phase of healing):

• Energy (kcal) - demands of energy are slightly higher in order to assist with the healing processes. If injury is severe, energy expenditure can go up by 20%. If on crutches, energy expenditure can be 2-3 times higher than walking. Sometimes, a small weight gain is beneficial because with out enough calories we can prevent muscle protein synthesis (building muscle)
• Protein - During the immobilization phase we lose muscle which then causes us to lose strength. Protein helps us build and repair, therefore, are needs for protein are higher. Although we do not have an exact number of grams/lb we need per day, we assume its more than the DRI (dietary reference intake) which is 0.8 grams/kg (0.35 grams/lb). Some research suggests we need close to 1-1.2 grams/kg/day (0.45-0.55 grams/lb/day). Since the majority of us eat more protein than we need this should not be an issue
• Carbohydrates - When we exercise, carbohydrates are our main source of energy. However, when injured, we don't need as much, therefore, we may decrease carbohydrates slightly to prevent excessive weight gain. Sports beverages, gels, sodas and concentrated sweets are highly discouraged during this time
• Fats - very essential for healing. What type of fats is most important. Omega 3s (found in fatty fish as well as certain seeds/nuts) have been found to possibly help increase muscle protein synthesis (building muscle) as well as help with recovery and decreasing inflammation
• Vitamins and minerals:
             * Vitamin C - Helps with wound healing, tissue repair and increased immune function. Foods rich in vitamin C include: citrus fruit, strawberries, red bell peppers, watermelon, etc.
             * Vitamin A - Helps with cell growth and development as well as immune function. Foods high in vitamin A include: sweet potatoes, tomatoes, carrots, papaya (orange/red fruits and vegetables)
             * Zinc - Helps with wound healing, protein synthesis and immune function. Foods rich with zinc include: beef, almonds, seeds (sunflower, flax, pumpkin, etc.) and seafood
             * Vitamin D - Important for bone health and immune function. The sun vitamin - get 5-30 minutes of sun between 10 AM - 3 PM (time is based on skin color, the darker the skin the more time you need) or it can be found in dairy products, fatty fish or fortified foods

                      

• Fluids - fluids are needed in order to deliver the different nutrients to the different organs and tissues. Moreover, its needed to support joints and soft tissues. Roughly, you should be drinking half your weight in ounces, preferably water. 

Nutrition during rehabilitation phase

We treat this phase as we were to treat someone who does strength and conditioning. We put emphasis on enough energy and protein as well as healthy fats and plenty of vegetables and fruits. More on strength and conditioning nutrition in a future blog.

There are also foods/beverages that can prevent us from healing optimally, which we should avoid:

• Fried fatty foods (example: pizza, fried chicken, french fries, etc.)
• Added sugars and concentrated sweets (soda, candy, ice-cream, etc.)
• Being malnourished (more common in elderly but applies to people that restrict eating a lot)
• Less than optimal sleep (athletes should sleep 8-10 hours/day)
• Alcohol - it inhibits muscle protein synthesis and increases muscle loss 

So, if you or any of your friends get injured, remember to also focus on nutrition to help speed your healing and recovery! Food always comes first and if need be, consult a sports RD or a sports MD for supplement recommendations.

Soccer Nutrition

As you might have noticed, the world cup just started and it seems as though everyone is watching.
It took enormous amounts of training to get there and now it will take a lot to stay at the top. One of the more important ways to stay at the top, besides good players of course, is nutrition and rest. For those who don't know, only 2 teams brought their dietitian with them to Brazil. Team USA and the team from Italy (you can read more about what they are doing here). Therefore, I thought it would be appropriate to talk about sports nutrition strategies in soccer.

Soccer has a combination of endurance exercise and intense short burst sprints. Professional players that play most of the game, may cover up to 10-13 km (6-8 miles) with multiple sprints in between. Therefore, the main source of energy they utilize is carbohydrate. Athletes who do not consume enough carbohydrates and are insufficiently hydrated will not be able to train and/or compete at high intensities and will likely experience premature fatigue. 
Our nutrition strategy will focus on pre-during-post- activity:

Pre-activity/game nutrition depends on how soon my activity is:

Pre-activity meal (3-4 hours before):

-          High in carbohydrate

-          High in lean protein

-          Low in fiber and fat

-          12-20 fl. oz (e.g., milk, juice, sports drink)

Example:  Grilled chicken, brown rice, corn, green beans, salad and vanilla pudding.

Pre-activity snack (30-60 minutes before)

-          30-60 grams of easily digestible carbohydrate

-          Moderate in protein

-          Low in fiber and fat

-          5-16 fl. oz (e.g., water, sports drink)

Example: Banana & peanut butter, yogurt & small amount of granola, cereal & milk, granola bar, etc.

During activity depends on length of activity and whether you have one session or more per day:

 If activity is less than 60-90 minutes and that is the only session of the day:

-   hydrate with 5-10 oz of water every 15-20 minutes.

 If activity is more than 60-90 minutes and/or you have multiple sessions a day:

-          Drink 5-10 oz of fluid every 15-20 minutes (preferably a sports drink)

-          Consume 30-60 grams of carbohydrate every hour (by drinking or eating)

-          During half-time (or similar break), eat a simple carbohydrate snack with limited amount of protein, low in fiber and fat

-          Consume snacks that contain sodium (salt)  

Example: Banana, pretzels, crackers, beef jerky and/or a sports drink.

Post activity/Recovery

Recovery starts fairly close to when you finish your activity; therefore, within about 30-45 minute,
- focus on protein and carbohydrate foods and/or drinks. 

Example: Chocolate milk, Greek yogurt and a banana, recovery shake

Post-activity meal (1-2 hours after)

-          High in whole grain carbohydrates

-          High in lean protein

-          Good amount of fiber and fats

-          16-24 fl. oz (e.g. chocolate milk, smoothie, sports drink, water)

Example: 6”-12” sandwich with turkey, cheese & vegetables, trail mix, and oatmeal cookie.

Note - if you will have a meal within an hour post activity/game a recovery drink is not needed. However, if you are not hungry right after and there may be some time before your next meal, a recovery drink is important.

For hydration recommendations please refer to our previous post on that topic.

Remember, the right hydration and nutrition plan can really be a game changer, so make sure you fuel appropriately for your sport pre, during and after activity.

GO TEAM USA!

ole, ole, ole, ole, ole, ole .................... 

Gastrointestinal Issues in Runners and Strategies to Overcome Them

Bill Rogers, a famous American runner that won four times the Boston and NYC marathon's between 1975-1980 and a 2000 USA Track & Field Hall of Famer stated, "more marathons are won or lost in the portable toilets than at the dinner table". Obviously, he was well aware of the gastrointestinal (GI) issues runners face.
GI issues have a variety of symptoms including: diarrhea, nausea, vomiting, bloating, belching, cramps heartburn and bloody stools. Symptoms are more common in women, younger athletes, elite athletes and people with a history of GI issues. It is estimated to occur in 30-90% of distance runners during and/or after exercise. Complaints of GI issues differ in severity and they may cause a decline in performance and recovery.

                           

There are three main reasons for GI problems:

• Physiological - When we exercise, depending on the intensity, blood supply to the gut may decrease by up to 80% in order to transfer more blood to the working muscles, skin and heart. This in turn may cause diarrhea, nausea, vomiting and stomach pain.
• Mechanical -   Running is a high impact sport with continuous pounding. This pounding also influences the GI tract which in turn can cause GI symptoms. Therefore, runners have a tendency to have more problems than bikers. 
• Nutritional - The meal timing before exercise as well as beverage and food choices may cause GI symptoms. A meal shortly before running, rich with fiber, fat and protein will cause GI symptoms because these nutrients have a slow emptying rate in the stomach. Drinking a concentrated carbohydrate beverage during or slightly before a race will cause GI symptoms. Moreover, dehydration intensifies GI symptoms. As discussed in the previous blog on alcohol and performance, drinking the night before a run several drinks can cause GI symptoms probably due to its diuretic effect. 
• Note; Certain people may have a medical condition such as: celiac disease, lactose/fructose mal-absorption and irritable bowel syndrome to name a few, that makes them more susceptible to GI symptoms

Since this blog is a nutrition blog, lets talk about some nutrition strategies to prevent GI symptoms:

• Hydration, hydration, hydration - before a run, make sure you are hydrated. Focus on hydrating well throughout the day. 
• Avoid beverages during or slightly before a run rich with fructose such as juice. Prefer water or if running long distance, a sports beverage with 6-8% carbohydrates such as Gatorade or Powerade.
• Avoid high fiber foods 1-2 hours pre-exercise as well as the day before a big race. 
• Avoid high fat and high protein foods 1-2 hours pre-exercise
• "Train the gut" - the gut is very adaptable, therefore, train your gut by eating during your training as well as before (if activity is lower than 60-90 minutes there is no need to eat anything during and water should suffice). Experiment with foods before a training session to check what works and what doesn't.
• Avoid using non-selective, non steroidal anti-inflammatory drugs (NSAIDs) such as Aspirin and Ibuprofen as they tend to increase GI symptoms.
• Avoid lactose containing milk products if you think or know that you are lactose intolerant. 
• Avoid or limit alcohol drinking before a morning run or a big race

It is very important that if you have severe GI symptoms such as bloody stools, you consult with a medical professional.

For specific guidance and assistance if you suffer from the symptoms noted above, consider consulting with a sports dietitian to help you with strategies to prevent any GI symptoms.

Hydration, Hydration, Hydration

Summer is just around the corner and with it comes warm weather and training more outdoors. More time outdoors and training in the heat may cause dehydration and/or heat related issues.  Therefore, this summer, lets focus on hydrating for performance and preventing injuries related to dehydration.

To stay well hydrated we should rely mainly on fluids but we can also rely on foods.  Eating things like fruit, vegetables, soups, smoothies and yogurt can help replenish some of those fluids. Especially summer fruits and vegetables like: watermelon, peaches, nectarines, melons, grapes, cucumbers, sweet bell peppers, tomatoes, summer squash and berries. These fruits and vegetables not only have a good amount of fluids but they contain plenty of antioxidants to help us recover from our activity, stay healthy and maintain a strong immune system.

The most efficient way to stay hydrated is drinking water or a sports beverage. How much and what you need to drink depends on genetics, the length and intensity of the activity as well as if you are a heavy and/or salty sweater. Make sure you arrive to your training session/game well hydrated or else you may not even last half of it. Activities that are 60-90 minutes ideally should be replenished with water. If your activity is more than 60-90 minutes you should hydrate with a sports beverage. Try to reach for your beverage every 15-20 minutes and drink about 5-12 oz. The ideal sports beverage should have 110-170 mg of sodium, 20-50 mg of potassium and 12-24 grams (6-8%) of carbohydrates per 8 oz.

How much fluid should I drink after activity? Weigh yourself before and after activity (ideally with minimal amount of cloths), for each pound you lose hydrate with 16-24 oz. If you are a salty sweater (characterized by the following: your sweat stings in your eyes or burns when reaches an open cut, you tend to leave white lines on things like hats and shirts, your skin feels gritty after a run and it actually tastes salty) make sure you also add simple salty foods to the equation not just a sports beverage (pretzels, crackers, etc.). You can also have a sweat test done (a test that can tell you how much sodium and fluids you lose in an hour of exercise) in order to provide you with an exact regimen of how much you need to drink as well as how much sodium you need.

    

To make sure you are hydrated, it’s important to know what the signs and symptoms of dehydration are. Signs and symptoms of dehydration include:  elevated heart rate, headache, reduced sweating, muscle cramps, dark urine, small urine volume, chills, clammy skin, nausea, vomiting, may cause heat related illness – e.g heat exhaustion, heat stroke (For more info on heat exhaustion and heat stroke visit http://www.cdc.gov/nceh/extremeheat/warning.html).
A urine scale is commonly used to check level of hydration. The rule we try to stick to is that it needs to be more like lemonade versus apple juice   

Whether its for fun or practice, make sure you hydrate well this summer!
Here are some ways to help you stay hydrated:

1. Drink throughout the day
2. Carry a full water bottle with you at all times
3. Drink 1-2 cups of water before each meal
4. Drink 2-3 cups of fluids before each practice/activity
5. Drink 1-2 cups of water before you go to bed
6. Drink every 15-20 minutes during practice/exercise
7. Avoid hydrating with energy drinks or caffeinated beverages
8. Depending on activity level, consider eating salty snacks as they will cause you to drink

 Drink up!

Alcohol and Performance

Alcohol is the most abused recreational drug in society and is the one most used by athletes. It is well known to cause poor judgement, decreased reaction time and decreased fine motor skills which is why we don't drink and drive. In addition, it effects our heart function, our ability to regulate body temperature and it can cause hypoglycemia (low blood sugar).

Research states that 88% of intercollegiate American athletes use alcohol. Moreover, collegiate athletes are much more likely to binge drink compared with non-athlete students. It's speculated that maybe the competitive behavior of athletes is not just on the court or field but also in social activities, such as drinking.

So, what can alcohol do to performance? Lets go over some facts:

• Athletes that drink alcohol once per week have been shown to have twice the risk for injury. 
• Moderate alcohol consumption has been shown to lower force production.
• Chronic alcohol use can cause substantial weight gain. Which in turn can slow you down.
• Alcohol use can decrease aerobic ability as well as decrease sustained power output. In fact, one study showed that drinking 24 hours before an event caused 11% decrease in performance which could be the difference between being first and last.
• Alcohol hurts recovery by interfering with muscle protein synthesis (building and repairing muscle) as well as glycogen re-synthesis (restoring our glycogen stores so that we have stored fuel for exercise). One study showed that even if you consumed alcohol with protein after exercise you would still have lower rate of muscle protein synthesis.
• Alcohol can interfere with our ability to regulate core temperature, therefore, lowering our ability to tolerate training no matter what the temperature is (even in an air-conditioned facility).
• Alcohol influences our psycho-motor skills which means it can decrease balance, reaction time, visual search and recognition, memory as well as accuracy of fine motor skills. Now imagine a quarterback that has all these problems.
• Alcohol shortens our time in deep sleep (REM). Lack of deep sleep causes a decrease in performance as well as a decrease in human growth hormone (HGH) secretion. HGH helps us build and repair muscle. (Stay tuned for a blog on how sleep effects performance in the near future).
• Alcohol is a diuretic (promotes production of urine) which means it can cause dehydration. Dehydration in turn can cause a decrease in performance.
• Alcohol may continue to effect your performance 2-5 days after you drink, depending on how much you drank.

If you're an athlete that wants to improve PR, excel and/or win, you must think about what you are willing or not willing to do. Make sure you fuel right for performance and limit or avoid alcohol. Since social interaction with friends many times includes alcohol, be smart about it and consider following the American College of Sports Medicine (ACSM) guidelines:
"Pre-event - Avoid alcohol beyond low-amount social drinking for 48 hours.   

Post exercise - Re-hydrate first and consume food to retard any alcohol absorption"

Cheers! 

Homemade Sports Drink

Looking to save a little money? It's possible to make your own sports drink at home. Sports drinks are made to provide fluid, carbohydrate, and electrolytes during long duration, high-intensity exercise - but you don't have to buy it in the store! Here is a recipe for a sports drink that you can make at home. The recipe is from Nancy Clark, MS, RD, CSSD - a well respected sports dietitian in the Boston area. Enjoy!

1/4 cup sugar
1/4 teaspoon salt
1/4 cup hot water
1/4 cup orange juice (not concentrate) plus 2 tablespoons lemon juice
3 1/2 cups cold water

1. In the bottom of a pitcher, dissolve the sugar and salt in the hot water.
2. Add the juice and the remaining water; chill.

Nutrition information: (per 8 ounces) 50 calories; 12 g carbohydrate; 110 mg sodium

Reference:
Clark N. Sports Nutrition Guidebook. 4th ed. Champaign, IL; Human Kinetics; 2008.

Summer Sweat

It's been a hot week here in Sioux Falls. So in keeping with that theme, I thought I would mention a few quick notes about sweat and the factors that affect it. Some people are heavy sweaters and some are not. Why is that?

Genetics. That plays a huge part in how much you sweat and cannot be changed. But there are other factors that you need to consider. How hard are you working (intensity level) during your exercise? What is the weather like? Are you acclimatized to the conditions? 

Photo credit: Women's Health

Hot and humid environments (summer!) will cause an increase in sweat rate. If you are doing a lot of outdoor activities, be sure you are paying close attention to your hydration needs. The recommended water intake for men is 3 L per day and 2 L per day for women. However, that does not include any sweat loss from extra activity. If you are sweating a lot that day, you need to add to that amount. 

Go out there and enjoy summer activities while you can! Hiking, running, biking, or whatever you choose. Be sure to pack that water bottle with you!

Eat Right for Sports and Performance

From "Eat Right for Sports and Performance" - Academy of Nutrition and Dietetics

This is a nice article posted on the Academy of Nutrition and Dietetics website, eatright.org. It is another explanation of the important role nutrition plays in helping athletes prepare for and recover from training. 

"Eating right allows your body to adapt to training, helps you recover after exercise and attain peak performance." 

Eating well and staying properly hydrated will give you an edge in competition and is something that you have complete control over. After all of the hours spent training, why would you fall short here? Focus on a carbohydrate rich diet full of variety. Choose lean protein and foods low in fat.  

Nutrition Facts for Popular Sports Drinks

Replenishing fluid and electrolyte losses are an essential part of training and recovery. Your rehydration needs may be different depending on the duration and intensity of exercise you are doing. Luckily, not all sports drinks are created equal. There is a wide variety of drinks available that have different amounts of total calories, carbohydrates, and electrolytes. If you are exercising for long periods of time (more than 1 hour) and/or exercising at a high intensity that causes you to sweat a lot, you may want to choose a sports drink that contains carbohydrates and electrolytes to replenish what you lost. If you are a recreational athlete who works out for 45 minutes to an hour at the gym every day, a better choice for you might be one of the lower-calorie beverages or even plain water. Keep in mind that the reduced calorie sports drinks contain artificial sweeteners so they should be consumed in moderation. After reading this, hopefully you will be able to determine which formula of sports drink is right for you.

Nutrient breakdown of common sports drinks, per serving:

• Gatorade: 50 kcals, 14 g CHO, 110 mg Sodium, 30 mg Potassium, 0 g Prot
• Powerade: 50 kcals, 14 g CHO, 100 mg Sodium, 25 mg Potassium, 0 g Prot
• Vitamin Water: 120 kcals, 33 g CHO, 0 mg Sodium, 0 mg Potassium, 0 g Prot
• Gatorade Recover: 110 kcals, 20 g CHO, 105 mg Sodium, 0 mg Potassium, 0 g Prot
• Gatorade Fit: 10 kcals, 2 g CHO, 110 mg Sodium, 30 mg Potassium, 0 g Prot
• Gatorade Endurance: 50 kcals, 14 g CHO, 200 mg Sodium, 90 mg Potassium, 0 g Prot
• G2: 20 kcals, 5 g CHO, 110 mg Sodium, 30 mg Potassium, 0 g Prot
• Powerade Zero: 0 kcals, 0 g CHO, 100 mg Sodium, 25 mg Potassium, 0 mg Prot
• Propel Zero: 0 kcals, 0 g CHO, 100 mg Sodium, 25 mg Potassium, 0 mg Prot
• Vitamin Water Zero: 20 kcals, 5 g CHO, 0 mg Sodium, 0 mg Potassium, 0 mg Prot

Guest Blogger: Jocelyn Johnson, USD Dietetic Intern

Water In Your Body

I talk a lot about hydration on this blog. I thought it would be a good idea to talk about everything water does for us in our body, besides just cooling us off through sweat. Proper hydration is important to perform best at your sport, but it does so much more! Water helps control our internal body temperature through sweating. Athletes know all about that! 

It is the water in our blood that carries nutrients (glucose, oxygen, and fats) to the muscles and also removes the by-products from metabolism. The waste products are rid from our body through urine. Darker urine means that the waste is more concentrated. Being properly hydrated will reduce the stress on the kidneys and liver, whose job it is to remove waste from the body. Water also lubricates our joints and provides cushion to our organs. Drinking enough water will also help prevent constipation. 

So as you can see, water has many roles in our body. As an athlete, you are at a greater risk for dehydration due to the amount of sweat you lose. This post serves as another friendly reminder of the importance of drinking enough water throughout the day!

References:
Mayo Clinic
Clark N. Sports Nutrition Guidebook. 4th ed. Champaign, IL; Human Kinetics; 2008.

Knowing Your Sweat Rate

Answering the question, "what is my sweat rate?" can be tricky. Although it can be calculated easy enough, there are so many variables that can affect it that it will not always be the same. It will change depending on the type and intensity of activity, temperature outside, genetics, humidity, and the type of clothing/equipment you are wearing. Being mindful with your hydration plan will help prevent some of the effects of dehydration and possible muscle cramping. 

An example of how much sweat rates can vary can be seen by looking at two tennis players.

Male 1: He is in his summer competition with an average sweat rate of 1.6 L per hour.
Male 2: He is also in his summer competition and is prone to muscle cramps. His sweat rate is 2.6 L per hour.

As you can see, most everything between these two males is the same (temperature outside, humidity, clothing) with the exception of their genetics. So it goes to show that you really need to pay attention to your body and how much YOU are sweating to estimate how much water you should be drinking. Not only are you losing fluid in your sweat, but also electrolytes. Sodium, in particular, is lost in sweat and even the rate of that is highly dependent on genetic factors. Some people are "salty" sweaters while others not. It may require adding in some electrolytes to your water or drinking a sports drink.

Reference:
Sawka, M. N., Burke, L. M., Eichner, E. R., Maughan, R. J., Montain, S. J., & Stachenfeld, N. S. (2007). American College of Sports Medicine position stand. Exercise and fluid replacement. Medicine and science in sports and exercise, 39(2), 377-390.

Dehydration: A concern for basketball players?

Proper hydration is a key component for effective athletic performance. However, the impact and importance of hydration during basketball practice or, more importantly, a game is often unappreciated and underemphasized by the athletes and coaching staff. Many players don’t realize the effect dehydration may have on their on-court performance. As little as a 2% body weight deficit during practice or competition can diminish decision making and basketball-specific skills, slow response times, and cause fatigue to occur more rapidly.^1,2,4 Therefore, it is clearly advantageous for players to enter a game well-hydrated, and maintain their hydration throughout the game, as the outcome may depend on split-second decisions in the closing minutes of the contest.

Sweat rate and fluid intake in basketball

Studies show that a high percentage of basketball players (from middle school up to the NBA) are entering games dehydrated.⁵ Adult and older adolescent basketball players on average lose 2.0-4.5 L (67-152 fl. oz) of sweat over the course of a 2-hr practice and 1.0-4.6 L (33-155 fl. oz) during a game.⁴ While these sweat rates (at the upper end) may seem high, these extensive losses are very manageable if the players are deliberate in consuming the proper amount of fluid throughout their practices and games. However, studies also have shown that basketball players typically only consume about half of what they lose during practice and competition.^3,5 This is often times due to the fact that athletes underestimate the amount of fluid they are losing and because our thirst mechanism doesn’t provide the proper stimulus to fully maintain hydration during exercise. You may be fairly dehydrated and still not feel that thirsty during or after exercise.

Recommendations

Make sure to start each practice and game fully-hydrated. A simple way to determine proper hydration is to look at the color of your urine before you start. It should be a light color (lemonade color). If your urine is a darker color (apple juice color), more than likely you are dehydrated. But also make sure you are not overly hydrated, which can also hurt performance. If you are going to the bathroom often (e.g., every 45 minutes) you are probably drinking too much.

Drink regularly throughout the practice/game. A general recommendation for adults and older adolescents is to drink 6-8 oz. of fluid (water or sports drink) every 15 minutes. In addition, you also need to consider your sweat rate, the intensity of play, and the environmental conditions (in-season game vs. summer tournament) and adjust fluid consumption accordingly.

A more accurate way to determine sufficient hydration is to monitor your weight before and after practice or a game. A weight loss of 2% or greater indicates inadequate fluid consumption. For every pound of weight loss after play or practice, 16-20 oz. of fluid should be consumed over the course of the night to the next day.

If you are expending a lot of energy (playing at a high intensity and/or the duration of the game is greater than 90 minutes), a sports drink is recommended to replenish some carbohydrate and electrolytes. Stay away from energy drinks, soda, and caffeinated beverages, as they may cause you to become dehydrated and hurt your performance!

Coaches and training staffs also play key roles in keeping their athletes properly hydrated. Coaches need to schedule enough water breaks in practice and encourage their athletes to drink regularly throughout games, during time-outs, and when they are recovering on the bench. 

Following these recommendations can give you a performance advantage over your opponent the next time you step out onto the court.

Guest Blogger: Jason Dorman, MS, CSCS - Operations Manager at The National Institute for Athletic Health and Performance. Follow him on Twitter @SanfordJasonD

1. Baker, L.B., D.E. Conroy, and W.L. Kenney, Dehydration Impairs Vigilance-Related Attention in Male Basketball Players. Medicine & Science in Sports & Exercise, 2007. 39(6): p. 976-983.

2. Baker, L.B., et al., Progressive Dehydration Causes a Progressive Decline in Basketball Skill Performance. Medicine & Science in Sports & Exercise, 2007. 39(7): p. 1114-1123.

3. Broad, E.M., et al., Body Weight Changes and Voluntary Fluid Intakes During Training and Competition Sessions in Team Sports. International Journal of Sport Nutrition, 1996. 6: p. 307-320.

4. Dougherty, K.A., et al., Two Percent Dehydration Impairs and Six Percent Carbohydrate Drink Improves Boys Basketball Skills. Medicine & Science in Sports & Exercise, 2006. 38(9): p. 1650-1658.

5. Osterberg, K.L., C.A. Horswill, and L.B. Baker, Pregame Urine Specific Gravity and Fluid Intake by National Basketball Association Players. Journal of Athletic Training, 2009. 44(1): p. 53-57.

Don't forget about hydration during exercise!

How much fluid you should drink during physical activity is determined by several key factors. An appropriate rate of fluid intake depends on how much you sweat, which is primarily driving by how hard you are working and environmental conditions - temperature and humidity. It also depends on how long you exercise. Your body loses water throughout the day through breathing and going to the bathroom; but exercise- and heat-induced sweating prompt significant body water losses and hydration challenges. Just relying on your body to indicate that you "feel thirsty" is not always sufficient to stay well-hydrated during physical activity, especially when you sweat a lot. Being mindful of, and deliberate with, how much fluid you take in every day through beverages and food is crucial to prevent levels of dehyration that is severe enough to hurt your performance and increase your risk of heat illness, especially during situations when there is limited recovery time such as tournament events and two-a-day practices.

Sweat electrolyte losses, particulary sodium and chloride, vary by individual. Muscle cramping due to exertional heat stress can be attributed to an electrolyte deficit caused by sweating, as the sodium and chloride lost through sweat are not matched sufficiently by dietary salt intake. Replacing sodium is crucial to enhancing body water retention and distribution. Some athletes are referred to as "salty sweaters", because they have a relatively high concentration of sodium in their sweat and a high sweat rate. This combination puts these particular athletes at an elevated risk for developing muscle cramps. Knowing how much fluid and electrolytes your body loses through sweating helps you to properly rehyrated after training or competition.

Hydration - Before, During, and After

Before - Your body only needs to be dehydrated slightly to have a negative impact on performance, especially in the heat. Side effects of significant dehydration during sport include: decreased performance, strained cardiovascular system, premature fatigue, and increased risk for heat illness. This highlights why being properly hydrated before beginning a training session or competition is crucial for your body to perform safely and at its best. A simple way you can determine if you are drinking enough is by looking at the color and volume of your urine. Urine that is darker in color and low in volume can be a sign of significant dehyration. The goal is to have regular urinations that are light yellow in color. If you are making frequent stops at the bathroom with perfectly clear urine, it is probably a sign that you are drinking too much water.

During - Fluid and electrolyte (primarily sodium) losses during exercise can vary tremendously per individual and are also heavily influenced by environmental conditions, intensity of activity, age, and heat acclimatization state. Guidelines for fluid consumption during sport for adults is:

• Drink about 6-12 fluid ounces of water or sports drink every 15-20 minues to maintain optimal hydration during activity. Keep in mind that one medium mouthful of water is equal to about one ounce.

After - After exercise, your body's primary dietary needs are water, carbohydrate, electrolytes (primarily sodium and chloride - salt), and protein for complete rehydration and muscle recovery. Sufficiently replenishing water, electrolytes and other nutrients is crucial for recovery from exercise, as well as overall health. With a little planning, you can make sure you are drinking enough fluid to optimize recovery. Measure your weight before exercise and then again afterward (without wearing your sweaty clothes). This will let you know how much more fluid you lost during exercise than what you consumed. For every one pound lost through sweating that was not replaced during training or competition, drink 16-20 fluid ounces over the next several hours or more to make up for the remaining fluid deficit. Eating a salty snack or meal is also beneficial, because it will help you repalce some of the sodium lost through sweating and will enhance fluid retention and distribution throughout your body - examples of appropriate foods include soup, vegetable juice, or pretzels.