Optimizing Post-Game Nutrition Helping Your Athletes Refuel and Recover

Ruth Carey, RD, CSSD, LD Ruth is a nutrition consultant specializing in sports nutrition, general fitness, weight control and disordered eating. She works with kids and adults in her private practice. She is the sports nutritionist for the Portland Trail Blazers NBA basketball team, and consults for Portland State athletics and Lewis and Clark track and field teams. Ruth has two grown children, now ages 24 and 26. She enjoys golf, skiing and exercise in general.

What We’ll Cover Today An overview of good “post-game” nutrition Chocolate milk and post-exercise recovery research Tips to create a post-game nutrition action plan

Post-Game Nutrition Can affect performance at the next game/practice Can help reduce the chances of injury Boost the health, well-being of your athletes It’s Just As Important As Pre-Game Nutrition!

The Workout’s Finished… But The Body Isn’t 2-Hour Recovery Window Replenish and Recover Immediately After Exercise and Throughout the 2-Hour Window

Who Needs To Recover? Football players after two-a-days Cheerleaders after the big competition Basketball players after a game ALL athletes – professional or high school

? Do Your Athletes Already Know About Recovery? ?

Before The GameAfter The Game ?

Endurance Athletes Recognize The Importance, But Know Little According To A Recent Study… 88% of endurance athletes say that RECOVERY is an important part of their training Yet, only one out of three recognized the importance of the 2-hour RECOVERY window Yet, only one out of three recognized the importance of the 2-hour RECOVERY window Laymon AS, et al. Medicine & Science in Sports & Exercise. 2008;40:S399.

How Do Athletes Recover? Water A Recovery Beverage Rest Only 1 in 4 athletes opted for a recovery beverage Laymon AS, et al. Medicine & Science in Sports & Exercise. 2008;40:S399.

In Addition To Water, Athletes Need… CARBOHYDRATES to refuel muscle glycogen PROTEIN to reduce muscle breakdown, stimulate growth FLUID and ELECTROLYTES to replenish what is lost in sweat and to rehydrate the body VITAMINS and MINERALS to contribute to overall health and nutrition

Post-Exercise Nutrition Guidelines What The Experts Say Carbohydrate 1.5g of carbs/kg body weight during first 30 min and again every 2 hours for 4 to 6 hours Carbohydrate 1.5g of carbs/kg body weight during first 30 min and again every 2 hours for 4 to 6 hours Fluids fl. oz. for each pound of body weight lost during exercise helps restore fluid balance Fluids fl. oz. for each pound of body weight lost during exercise helps restore fluid balance Electrolytes Based on extent of sweat loss (If sweat water and electrolytes are not replaced, then the person will dehydrate) Electrolytes Based on extent of sweat loss (If sweat water and electrolytes are not replaced, then the person will dehydrate) Protein Ratio of about 3:1 or 4:1 carbohydrate to protein Protein Ratio of about 3:1 or 4:1 carbohydrate to protein Position of the American Dietetic Association, Dietitians of Canada, American College of Sports Medicine. Journal of the American Dietetic Association. 2009;109: International Society of Sports Nutrition. Journal of the International Society of Sports Nutrition. 2008; American College of Sports Medicine. Medicine & Science in Sports & Exercise. 2007;39:

Carbohydrate 82 grams (amount in about 24 ounces of chocolate milk) Carbohydrate 82 grams (amount in about 24 ounces of chocolate milk) Fluids 24 ounces (depending on exercise intensity, weight lost) Fluids 24 ounces (depending on exercise intensity, weight lost) Electrolytes Sodium to aid hydration, others minerals (depending on sweat losses) Electrolytes Sodium to aid hydration, others minerals (depending on sweat losses) Protein 20 to 27 grams Protein 20 to 27 grams 120 Pound Athlete May Need… For Example, Within 2 Hours After Exercise

Carbohydrate 130 grams (amount in about 40 ounces of chocolate milk) Carbohydrate 130 grams (amount in about 40 ounces of chocolate milk) Fluids 24 ounces (depending on exercise intensity, weight lost) Fluids 24 ounces (depending on exercise intensity, weight lost) Electrolytes Sodium to aid hydration, others minerals (depending on sweat losses) Electrolytes Sodium to aid hydration, others minerals (depending on sweat losses) Protein 32 to 43 grams Protein 32 to 43 grams And a 190 Pound Athlete May Need…

Choosing An Effective Post-Exercise Drink What The Research Says About Chocolate Milk

Why Milk? Protein Carbohydrates Electrolytes Fluids Calcium and vitamin D B vitamins 9 essential nutrients To help rehydrate the body To help convert food to energy Offers additional nutrients not typically found in traditional sports drinks To strengthen bones and help reduce the risk of stress fractures To help replenish what’s lost in sweat (sodium, calcium, potassium and magnesium) To refuel muscles (restore muscle glycogen) To help build muscle, reduce muscle breakdown and work with carbohydrates to restore muscle glycogen

The Nutrition Facts Lowfat Chocolate Milk Good Source of 9 Essential Nutrients Potassium Niacin Calcium Vitamin D PhosphorusProtein Vitamin A Riboflavin Vitamin- B12 U.S. Department of Agriculture, Agricultural Research Service USDA National Nutrient Database for Standard Reference, Release 21.

Why Chocolate Milk? The Right Mix of Carbohydrates and Protein 3.25/1 There’s research on the benefits of BOTH chocolate and white milk for athletes… But chocolate milk has the added benefits of extra CHO needed after exercise! There’s research on the benefits of BOTH chocolate and white milk for athletes… But chocolate milk has the added benefits of extra CHO needed after exercise!

The Research Refuel muscles Build muscle and help reduce exercise-induced damage Hydrate and replenish electrolytes 1 2 3

Chocolate milk may be just as effective as certain commercial sports drinks in helping athletes refuel muscles after a workout 1

Karp JR, et al. Journal of Sport Nutrition and Exercise Metabolism. 2006;16: Thomas K, et al. Applied Physiology, Nutrition and Metabolism. 2009;34: After Recovery, Researchers Compared Lowfat Chocolate Milk To: Carbohydrate Replacement Drink (with CHO and protein) Fluid Replacement Drink (with CHO) Indiana University (9 trained cyclists) When drinking chocolate milk they exercised longer and with more power during a second workout When drinking chocolate milk they exercised just as long Northumbria University, UK (9 trained cyclists) After chocolate milk they were able to cycle 51% longer After chocolate milk they cycled 43% longer Chocolate Milk Has The Right Combination Of CHO And Protein To Refuel Tired Muscles

Milk’s high-quality protein helps build and repair muscles 2

A Muscle Building Advantage Compared to a soy beverage: Canadian researchers found that active adults who drank milk after resistance exercise experienced greater support for muscle gain A second study found that untrained participants who drank fat free milk after exercise gained more muscle and lost more body fat at the end of a 12-week training program Researchers suggest milk’s advantage may be due to unique properties of milk proteins that may cause differences in speed of digestion and absorption. Wilkinson SB, at al. American Journal of Clinical Nutrition 2007;85: Hartman JW, et al. American Journal of Clinical Nutrition, 2007;86:

Aids Protein Metaboli sm Athletic men and women who drank milk one hour after a leg resistance exercise routine experienced a significant increase in two measured amino acids Net Muscle Synthesis Net Muscle Synthesis Elliot TA, et al. Medical Science in Sports and Exercise. 2006;38:

Reduced Exercise-Induced Muscle Damage Research subjects who drank reduced-fat regular or flavored milk after a strenuous muscle workout had less exercise-induced muscle damage than those who drank water or typical sports drinks Exercise-induced muscle damage can lead to future impairments in muscle performance, which could affect future exercise bouts. Cockburn E, et al. Applied Physiology, Nutrition and Metabolism. 2008;33:

Recovery Aid For Soccer Players Chocolate milk drinkers had significantly lower levels of creatine kinase – an indicator of muscle damage – compared to when they drank the carbohydrate beverage. Chocolate milk’s “natural” muscle recovery benefits match or may even surpass a specially- designed carbohydrate sports drink with the same amount of calories Chocolate milk’s “natural” muscle recovery benefits match or may even surpass a specially- designed carbohydrate sports drink with the same amount of calories Gilson SF, et al. Medicine & Science in Sports & Exercise. 2009;41:S577.

Milk may be an equivalent or better choice for hydration after exercise compared to certain beverages, replenishing needed electrolytes and fluids Milk may be an equivalent or better choice for hydration after exercise compared to certain beverages, replenishing needed electrolytes and fluids 3

Milk Helped Restore Hydration Better Than Other Popular Post-Exercise Beverages 4 hours Significantly more urine excretion after drinking water or sports drink compared to milk Researchers believe milk’s electrolyte content and energy density may help restore and maintain hydration after exercise. Researchers believe milk’s electrolyte content and energy density may help restore and maintain hydration after exercise. Shirreffs SM, et al. British Journal of Nutrition. 2007;98:

Milk Helps Replace Essential Electrolytes Lost in Sweat PotassiumMagnesiumCalcium Helps regulate the balance of fluids in your body. Plays a role in maintaining normal blood pressure. Milk Provides: 12% of the Daily Value Milk Provides: 12% of the Daily Value Milk Provides: 8% of the Daily Value Milk Provides: 8% of the Daily Value Milk Provides: 30% of the Daily Value Milk Provides: 30% of the Daily Value Helps maintain nerves, muscles and bones. Plays a role in maintaining normal blood pressure. Helps build and maintain strong bones and teeth. Plays a role in maintaining normal blood pressure.

Milk Is An Excellent Source of Calcium For Strong Bones One study found that basketball players had significant bone mineral content losses throughout the season (6% loss overall) – likely related to sweat losses. – Adding calcium to the diet helped offset the losses. Martin BR, et al. Medicine and Science in Sports and Exercise. 2007; 39: Klesges RC, et al. Journal of the American Medical Association. 1996;276: Lappe J, et al. Journal of Bone and Mineral Research. 2008;23: Rigorous exercise could cause substantial losses of calcium, which if not replenished, could increase the risk for bone fractures

Teens Need Calcium During Peak Bone Building Years Nearly 90 percent of teenage girls and 70 percent of teenage boys don’t get the calcium they need. Teens ages 14-18; What We Eat in America, NHANES : Usual Nutrient Intakes from Food Compared to Dietary Reference Intakes;

Scientific Support For Milk Karp JR, et al. Chocolate milk as a post-exercise recovery aid. International Journal of Sport Nutrition and Exercise Metabolism. 2006;16: Thomas K, et al. Improved endurance capacity following chocolate milk consumption compared with 2 commercially available sport drinks. Applied Physiology, Nutrition and Metabolism. 2009;34: Karp JR, et al. Chocolate milk as a post-exercise recovery aid. International Journal of Sport Nutrition and Exercise Metabolism. 2006;16: Thomas K, et al. Improved endurance capacity following chocolate milk consumption compared with 2 commercially available sport drinks. Applied Physiology, Nutrition and Metabolism. 2009;34: Refuel Muscles Wilkinson SB, et al. Consumption of fluid skim milk promotes greater muscle protein accretion after resistance exercise than does consumption of an isonitrogenous and isoenergetic soy- protein beverage. American Journal of Clinical Nutrition 2007;85: Hartman JW, et al. Consumption of fat-free fluid milk following resistance exercise promotes greater lean mass accretion than soy or carbohydrate consumption in young novice male weightlifters. American Journal of Clinical Nutrition, 2007;86: Elliot TA, et al. Milk ingestion stimulates net muscle protein synthesis following resistance exercise. Medical Science in Sports and Exercise. 2006;38: Cockburn E, et al. Acute milk-based protein-CHO supplementation attenuates exercise-induced muscle damage. Applied Physiology, Nutrition and Metabolism. 2008;33: Gilson SF, et al. Effects of chocolate milk consumption on markers of muscle recovery during intensified soccer training. Medicine & Science in Sports & Exercise. 2009;41:S577. Wilkinson SB, et al. Consumption of fluid skim milk promotes greater muscle protein accretion after resistance exercise than does consumption of an isonitrogenous and isoenergetic soy- protein beverage. American Journal of Clinical Nutrition 2007;85: Hartman JW, et al. Consumption of fat-free fluid milk following resistance exercise promotes greater lean mass accretion than soy or carbohydrate consumption in young novice male weightlifters. American Journal of Clinical Nutrition, 2007;86: Elliot TA, et al. Milk ingestion stimulates net muscle protein synthesis following resistance exercise. Medical Science in Sports and Exercise. 2006;38: Cockburn E, et al. Acute milk-based protein-CHO supplementation attenuates exercise-induced muscle damage. Applied Physiology, Nutrition and Metabolism. 2008;33: Gilson SF, et al. Effects of chocolate milk consumption on markers of muscle recovery during intensified soccer training. Medicine & Science in Sports & Exercise. 2009;41:S577. Build and Repair Muscles Shirreffs SM, et al. Milk as an effective post-exercise rehydration drink. British Journal of Nutrition. 2007;98: Watson P, et al. A comparison of the effects of milk and a carbohydrate- electrolyte drink on the restoration of fluid balance and exercise capacity in a hot, humid environment. European Journal of Applied Physiology; 2008;104: Shirreffs SM, et al. Milk as an effective post-exercise rehydration drink. British Journal of Nutrition. 2007;98: Watson P, et al. A comparison of the effects of milk and a carbohydrate- electrolyte drink on the restoration of fluid balance and exercise capacity in a hot, humid environment. European Journal of Applied Physiology; 2008;104: Rehydrate and Replenish

Putting It All Together Creating A Recovery Plan For Your Athletes

Our Recovery Must-Do’s Pay attention to the 2-hour recovery window 1 1 Emphasize fluids, protein and carbohydrates 2 2 Make recovery easy and convenient 3 3

Post-Workout Snack Ideas Chocolate Milk – Nature’s fitness drink. Chocolate milk has the added bonus of bone-building nutrients (not found in traditional sports drink) to help maintain strong bones. Turkey and Cheese with Apple Slices and Pretzels –If you're not in the mood for a sandwich, skip the bread and eat the fillings on their own! Tuna on Whole Wheat – Tuna over a slice of whole wheat bread is a great protein/carb mini-meal. Banana and Peanut Butter – Provides a good source of protein and vitamin E, while the banana provides the carbohydrates you need to get re-energized.

How Coaches Are Getting In The Game Lori Baldwin: Cross Country Coach Brings Chocolate Milk Coolers To Practice “My athletes noticed a difference the next day in their muscle recovery. Now it’s a routine the entire team looks forward to and enjoys together.” Lori Baldwin: Cross Country Coach Brings Chocolate Milk Coolers To Practice “My athletes noticed a difference the next day in their muscle recovery. Now it’s a routine the entire team looks forward to and enjoys together.” Denny Marsh: Strength and Conditioning Consultant Makes Chocolate Milk Mandatory “Right now, I have 120 clients doing this and I’ve seen results with every single one.” Denny Marsh: Strength and Conditioning Consultant Makes Chocolate Milk Mandatory “Right now, I have 120 clients doing this and I’ve seen results with every single one.” Anjanette Arabian Whitman: Track Coach Gives Her Athletes Chocolate Milk 3-4 Times Per Week “It’s not fancy or complicated – just a gallon of chocolate milk and cups. I know serving chocolate milk plays a large role in the success of my teams.” Anjanette Arabian Whitman: Track Coach Gives Her Athletes Chocolate Milk 3-4 Times Per Week “It’s not fancy or complicated – just a gallon of chocolate milk and cups. I know serving chocolate milk plays a large role in the success of my teams.”

How YOU Can Get In The Game Log onto MilkDelivers.org for tips and tools to share with your student athletes Talk to your local processor how you can get milk into your locker room/onto the sidelines Ask you School Food Service Director how to move milk vending machine outside the locker room Copy and distribute the flyers to your students and fellow coaches After a team practice, show your athletes the NBA vignette

How Do You Help Your Athletes Recover? Questions?

Thank You