Vitamins
What does Vit D. help with (roles)? what other vitamins/ minerals does it help absorb?
Key regulator of bone metabolism, transcription of proteins (VD Receptor, RXR), gene expression, control of cell growth/ differentiations, calcium and phosphorous homeostasis, muscle structure and function - through a negative feedback with the parathyroid hormone
-Enhances calcium uptake and myogenesis
How can you maintain calcium homeostasis? What factors help with this?
●↑[Ca] → bone mineralization
●Calcitonin inhibits bone resorption
●↓[Ca] → PTH
●Renal Ca reabsorption
●Bone resorption
●Activates 1,25-(OH)2D for intestinal Ca absorption
What is chronic low energy availability? And how can you maneuver this with an athlete?
Chronic low energy availability (LEA) occurs when an athlete consistently consumes too few calories to support both their training demands and essential physiological functions, leading to hormonal disruptions, impaired bone health, and decreased performance.
It can result from intentional restriction or unintentional under-fueling.
To address LEA, assess the athlete’s total energy expenditure and gradually increase caloric intake, prioritizing nutrient-dense foods and consistent fueling around training.
Explain what intracellular and extracellular water is and how much water it contains.
Intracellular: water in-closed within cell membranes
Medium through which chemical reactions of cellular metabolism occur
2/3 of water
Extracellular: water outside the cell
Intravascular: in the plasma
Fluid transportation
Role in thermoregulation
Interstitial fluid: around the cell
1/3 of water
Why are menstrual cycles appropriate to consider for nutritional recommendations?
What can you recommend during these phases?
the follicular phase can last ~14 days – low estrogen/progesterone – When estrogen is low, it is easier to break down carbohydrates.
since carbohydrates are primarily used for high-intensity bouts, women can capitalize during follicular phase phase by lifting heavier weights and performing higher-intensity activities with the ingestion of CHOs.
Focus on: focus should be on vitamin B1, calcium, vitamin C, zinc, iron, and omega-3 fatty acids to lower inflammation and oxidative stress, improve recovery
Ovulation (bleeding) starts day ~11-13, and this is when the luteinizing hormone spikes. The nutritional focus during this time should be hydration, fiber, gut support, folic acid, vitamin E, vitamin D, omega-3 and omega-6, and selenium to aid in the removal of estrogen.
Luteal phase - starts (day ~14). During this phase, luteinizing hormone and follicular stimulating hormone return to close to baseline levels. However, progesterone and estrogen rise around day 20-24 (mid-luteal phase) and then fall - estrogen and progesterone reduce the ability to break down carbohydrates; marked by an increase in protein breakdown
Focus on: increase carbohydrate consumption to support higher glycogen levels, female athletes should consume ~1.6g/kg/day, emphasizing essential amino acids (EAA), branched-chain amino acids
Explain the vitamin interactions with Vitamin K
excess Vitamin A interferes with Vitamin K
Excess vitamin E interferes with phylloquinone metabolism
What are the factors affecting calcium absorption?
•Estrogen status
●Activation of vitamin D
●Increased urinary Ca excretion
•Powerful influence on osteoclast number and activity
•Generally associated with menopause
•Present in some young female athletes
●Amenorrhea
●
●Caffeine status
●Oxalic Acid
●Phytic Acid
●Other nutrients: excessive Mg2+ and zinc
How would one decrease fat mass and increase muscle mass?
Decrease fat mass:
•Exercise
Increase caloric expenditure
Maintain LBM
•Nutrition
Reduced kcals
Maintain or increase PRO
; increase MM:
•Muscle hypertrophy
Overload stimulus
Individual muscle fibers increase in size
Periodization
•Nutrition, typically +~500 kcal per day
Protein
•Heat Cramps
Painful cramping of large muscles
Na+ loss, dehydration
Prevent by proper hydration, Na+ intake
Common in individuals who sweat a lot
•Heat exhaustion
Fatigue, dizziness, nausea, vomiting, fainting, rapid pulse
Cardiovascular system cannot meet demands of the body
Mostly due to Dehydration à treated as such
•Heatstroke
Requires immediate medical attention à death
Failure of thermoregulatory mechanism
Core temp >104 ◦F
Explain the RAAS system.
1.Renin released from kidney
2.Converts ANG1 to ANG II by ACE in the lungs
3.ANGII powerful vasoconstrictor
4.Hypertension?? Prescribed ACE inhibitors to. Lower BP
5.ANGII stimulates aldosterone, which increases Na2+ reabsorption, increases thirst mechanism
1. Explain all the roles of Vit. E
2. Explain Vit E's interactions.
•Antioxidant on cellular membrane
•Maintains integrity of cellular membrane to avoid cellular leakage and death
•Regenerated by vitamin C
--
Need vitamin C to help with absorption
Increased dietary PUFAs increases requirement for Vit. E
Excess vitamin E inhibits B-carotene absorption
Vitamin E impairs Vit. K absorption
What are the functions of copper? Deficiency of copper?
•Functions
●Involved in antioxidant enzymes
●Involved in iron transport
●Involved in collagen synthesis and hormone activation
•Can interfere with zinc absorption;
Deficiency can lead to anemia
Explain what REDS and the female athlete triad are:
Disordered eating can lead to energy imbalances and can result in amenorrhea, the absence of a menstrual cycle.
Lack of proper nutrition may lead to two possible conditions: Relative Energy Deficiency in Sport (RED-S) and the Female Athlete Triad (Triad).
Female athlete triad - menstrual dysfunction, low energy availability (with or without an eating disorder), and decreased bone mineral density (BMD)
Relative Energy Deficiency in Sport (RED-S) - ) RED-S includes psychological aspects, covers the broader consequences of chronic low energy availability ; Included in that is the female athlete triad
What is the electrolyte composition in the interstitial and intracellular fluid compartments?
Interstitial - Sodium*, potassium, bicarbonate, chloride*
Intracellular - Potassium*, sodium, phosphate, protein anions
Explain the two hypotheses of muscle cramps.
When you’re dehydrated or imbalanced, it should affect ALL your SKM not just the ones you’re using that would cramp
Research looking at electrolyte levels who are cramping vs non cramping, electrolyte levels were the same
Hypothesis 2 – more support/ plausible
- over stimulus and blunted inhibition of alpha motor neurons as exercise intensity and duration increase (MORE FIRING)
- even if we’re hydrated, we can still cramp…
Explain how B12 is absorbed.
What are common deficiencies of these vitamins?
Functions of B12: conversions of homocysteine to methionine to help form tetrahydrofolate (THF) – methionine synthase
Folate: synthesis of new cells, RBC formation, gene expression;
--
B12 is absorbed by:
HCl and pepsin release B12 from proteins in food
B12 binds to an R protein found in saliva and gastric juice
B12 binds to intrinsic factor in duodenum
Then travels to ileum and enterocyle (where B12 Is released from IF)
--
Deficiencies can lead to megaloblastic macrocytic anemia
Explain what can cause Iron deficiency and anemia.
Calcium:
•Inhibits Iron Absorption: Calcium can significantly reduce the absorption of non-heme iron (found in supplements and plant-based foods). This occurs when calcium and iron are consumed simultaneously, whether in foods or as supplements.
--
Zinc:
•Competitive Inhibition: Iron and zinc compete for absorption because they share similar pathways. High doses of iron can inhibit the absorption of zinc, which may lead to deficiencies, especially in people already at risk for low zinc levels.
What are the strengths and weaknesses of 24 hr recall, FFQ, and 3-7 day food diary?
24 hr-
Strength
Little effort required by respondent
Suitable for large studies
Can be conducted remotely
Weakness
Estimations of portion size only
24hr will not provide and accurate representation of diet
Respondent bias toward ‘good’ foods
Requires respondent to remember accurately; FFQ -
Strength
Little effort required by respondent
Gives a measure of usual diet
Illustrations can be used to increase accuracy of respondent
Weakness
Food lists may not be extensive enough
Portion sizes may be difficult to interpret;
3-78 DIET diary -
Strength
Little or no recall bias as it is completed ‘live’
Portion sizes are accurately measured and recorded
Can be conducted remotely
Weakness
Respondents must accurately record food and portion sizes
Foods may not be included in the analysis software
Explain the fluid replacement goals for pre- during and post exercise
•Before
Euhydration
Normal plasma electrolytes
5-10 ml/kg body weight 2-4 hrs before exercise
Add sodium to foods or take tablets with caution
•During
Prevent dehydration >2% BW
<1 hours, water is generally adequate
>1 hour, consume 30-60 g/hour of carbohydrates
Add sodium if salty sweater and dependent on environmental conditions
•After
Replace fluid and electrolyte deficits
1-1.5 L for every 1 kg body weight loss (16-24 oz. per pound)
Consume over time, not just bolus
Add sodium if needed
How can you maneuver lactose intolerance?
Explain the causes and treatment:
Causes of lactate intolerance:
1.recessive genetic mutations in the intestinal lactase enzyme
2.In premature neonates intestinal lactase may not be fully developed
3.***The most common form of lactose maldigestion is adult onset hypolactasia – lactose maldigestion, diminishing activity of lactase
4. lactose maldigestion relates to diseases causing loss or injury to the small bowel. In this situation intestinal villi are lost and with it there is a reduction in intestinal lactase leading to lactose spill into the lower intestine
--
Treatment:
Dairy foods provide more calcium, protein, magnesium, potassium, zinc, and phosphorous per calorie than any other typical food found in the adult diet
The avoidance of all dairy products in patients with lactose intolerance is no longer recommended. Most people with lactose intolerance can tolerate up to 12–15 grams of lactose per day.
Strategies to increase tolerance of lactose containing foods to improve nutrition adequacy, avoid deficiencies and improving symptoms
1. Explain all the roles of Vit. A
2. Explain Vit A's interactions.
3. Explain the roles of antioxidants and its function in exercise.
Functions: reproduction, bone development/ maintenance, immune system function
Cellular differentiation – skin, respiratory, GI
Deficiency – keratin producing cells replace mucus secreting cells in eyes, skin, GI tract
Carotenoids – antioxidant
---
Increase Vit. A, decreases Vit K
Increases B-carotene, decreases Vit. E
Inadequate protein – decreases B-carotene
Fiber and vitamin E can diminish absorption
--
We need ROS for adaptations
•Exercise increases antioxidant enzyme activity, DNA repair, and production of new mitochondria, reduction in inflammation and cell death
Explain all the minerals associated with bone metabolism and remodeling and their interactions.
Calcium -
Calcitonin – released from thyroid gland to lower [Ca2+]
PTH released in response to LOW Ca2+
Calcitriol – active form of vitamin D, in response to PTH
--
phosphorus -
●PTH stimulates the resorption of phosphate from bone to increase serum phosphorus levels
●PTH also stimulates the excretion of phosphorus in urine to override bone resorption of phosphorus so as to effect a net decrease in plasma phosphate
●Vitamin D stimulates phosphate absorption in the intestine
●Calcitonin decreases serum phosphorus concentrations by promoting the use of phosphorus in bone mineralization;
--
magnesium -
PTH increases intestinal mg absorption, decreases renal excretion, and enhances bone mg resorption to raise mg
Intracellular mg rigidly maintained
*fructose and oligosaccharides increase Mg absorption
*High phosphorus intake, unabsorbed Faa, phytic acid/ insoluble fiber, high doses of vitamin D decrease Mg2+ absorption
;
-- Vit D: Calcium, Mg2+, phophorus, PTH
Calculate the TDEE for a male who resistance trains (at least one hour per day) and plays soccer several hours per day, at least 5 days a week. He is 19 weighs 185 lbs and 6'1.
BMR = 839 + 1158.75 – 95 + 5 = 1907.75 kcal/day
TDEE = 1907.75 × 1.48 = ~2825 kcal/day
An athlete weighs 190 pounds. He exercises for 1.5 hours and consumes 15 oz of fluid. His end weight is 188.7. Calculate his fluid replacement.
16.7 ÷ 8 = ~2.1 cups/hr
24.7 ÷ 8 = ~3.1 cups/hr
Provide the following for the below individual:
1.Dietary recommendations.
2.Exercise and training adjustments.
3.Supplementation if applicable.
4.Monitoring and evaluation methods.
Tactical Athlete (Firefighter Competitor)
Sport: Firefighter Combat Challenge / Tactical Conditioning
Gender: Male
Current Body Composition Metrics:
Weight: 205 lbs (93.0 kg)
Height: 6'0" (182.9 cm)
Body Fat Percentage: 24%
Muscle Mass: Moderate-to-High (functional strength focus)
Overview of Performance Goals:
Reduce body fat percentage to 15% to improve agility, heat tolerance, and endurance during high-intensity drills.
Increase anaerobic capacity and power output for short bursts of high-effort tasks (e.g., stair climbs, hose drags, dummy carries).
Implement a nutrition and hydration plan that supports body composition changes, maintains lean mass, and enhances recovery in high-heat environments.
Dietary Recommendations:
This tactical athlete should follow a moderate-calorie deficit nutrition plan focused on high-protein intake (1.6–2.2 g/kg/day) to preserve lean muscle mass while promoting fat loss. Meals should include complex carbohydrates (e.g., oats, quinoa, sweet potatoes) for sustained energy and healthy fats (avocados, olive oil, nuts) for hormonal support and recovery. Hydration is essential due to high-heat exposure, so electrolyte balance must be maintained, especially post-training.
Exercise and Training Adjustments:
Incorporate a combination of functional strength training, HIIT, and agility drills 4–5 days per week. Include circuit-style metabolic conditioning and loaded carries to mimic real-life firefighting movements while increasing caloric burn.
Supplementation (if applicable):
Creatine monohydrate (3–5 g/day) can enhance strength and recovery. A whey protein supplement may be useful post-workout to meet protein targets. Consider a vitamin D supplement if training mostly occurs indoors or in winter months.
Monitoring and Evaluation Methods:
Track progress via monthly body composition assessments (e.g., skinfolds, BIA, or DEXA) and performance metrics (timed drills, VO₂peak estimates, recovery time). Daily food logs and hydration tracking will help ensure dietary compliance. Adjust macros based on changes in lean mass and fat loss trends.