5 th Edu Sport International Summer School Vegetarian

5 th Edu. Sport International Summer School Vegetarian Diet and Sport Cristina Angeloni, Ph. D University of Bologna Department of Biochemistry G. Moruzzi Nutrition Research Center September 17 th 2008, Rimini

Vegetarian diet: a growing phenomenon 2. 5% of American adults and 4% of Canadian report following a vegetarian diet. Motivations: • • religious or cultural customs, perceived health benefits, ethical or philosophical beliefs, concern for the environment and animal welfare factors, • world hunger.

Characteristics of vegetarianism Advantages Disadvantages Lower levels of: • Satured fat Iron • • Cholesterol • Vitamin B 12 • Vitamin Higher levels of: D Calcium • • Carbohydrates Zinc • • Fiber Riboflavin • • Magnesium • Folate • Antioxidants: • Vitamins C and E • Carotenoids • Phytochemicals American Dietetic Association, Dietitians of Canada. Vegetarian diets. J Am Diet Assoc 2003; 103: 748

Health implications of vegetarianism Reduced risks for: obesity, type 2 diabetes, hypertension, cardiovascular disease, some cancers. Key TJ, et al. Am J Clin Nutr 1999; 70(suppl): 516 S Key TJ, et al. Proc Nutr Soc 1999; 58: 271 Fraser GE. Am J Clin Nutr 1999; 70(suppl): 532 S

Macronutrients • Proteins • Carbohydrates

Typical protein recommendations for athletes 1. 2 to 1. 4 g/kg/d for endurance athletes up to 1. 7 g/kg/d for resistance and strengthtrained athletes Do vegetarian athletes require more proteins than non-vegetarian athletes? American Dietetic Association, Dietitians of Canada, American College of Sports Medicine. J Am Diet Assoc 2000; 100: 1543

Vegetarian athletes and protein Observational studies of vegetarian and non vegetarian athletes have not found differences in performance associated with the amount of animal protein consumed. • • Hanne N et al. J Sports Med Phys Fitness 1986; 26: 180 Cotes JE et al. J Physiol 1970; 209(suppl): 30 P Nieman DC. Am J Clin Nutr 1988; 48(suppl): 754 Richter EA et al. Med Sci Sports Exerc 1991; 23: 517

Effect of exercise and vegetarianism on protein requirements Separate recommendations for protein consumption are not required for vegetarians who consume dairy products or eggs and complementary mixtures of high-quality plant proteins.

Effect of exercise and vegetarianism on protein requirements Plant proteins may be limiting in: • lysine • threonine, • tryptophan, • sulfur-containing amino acids. The issue of protein quality is recognized as a potential concern for individuals who avoid all animal protein sources

Food And Nutrition Board/Institute Of Medicine Scoring Pattern It represents mg of an essential amino acid that must be present per g of dietary protein to meet the recommended daily allowance for the essential amino acid when total protein intake is equal to the recommended daily allowance.

Lysine intake of vegetarians 50 kg adult RDA for protein: 40 g/d (0. 8 g/kg/d x 50 kg) RDA for lysine: ~2 g/d (38 mg/kg/d x 50 kg) If that individual consumes a diet containing 40 g of protein, 25% of which provided from wheat, rice, almonds, this would provide only 1. 6 g of lysine. However, if total protein intake is increased to 50 g or more, this would provide at least 2 g of lysine.

Protein intakes of vegetarians Vegetarians’ protein intakes are lower than those of omnivores. • • • American Dietetic Association, J Am Diet Assoc 2003; 103: 748 Barr SI et al. J Am Coll Nutr 2000; 19: 781 Larsson CL et al. Am J Clin Nutr 2002; 6: 100 But vegetarians’ protein intakes are generally well above the RDA

Protein intakes Vegans • 10 -12% Lacto-ovo-vegetarians • 12 -14% Omivores • 14 -18%

Protein intakes of active vegetarians 50 kg vegetarian young woman If she was a vegetarian with a relatively low protein intake (e. g. , 11% of energy): • her diet would provide 55 g/d of protein If she was an athlete expending 3000 kcal/d with 11% from protein, • her protein intake would further increase to 82 g/d. The possible exception could be athletes following low-protein vegan diets who are also attempting to limit their energy intake.

Carbohydrate Recommendations for athletes: 6 -10 g/kg body weight Diets of omnivores and vegetarians can readily provide from 7 to 8 g of carbohydrate per kg of body weight per day 60 kg endurance athlete expending 3600 kcal/d would receive more than 8 g of carbohydrate per kg of body weight per day even if the diet provided only 55% of energy from carbohydrate. American Dietetic Association, Dietitians of Canada, American College of Sports Medicine. J Am Diet Assoc 2000; 100: 1543

Micronutrients • • • Iron Vitamin B 12 Antioxidants

Iron occurs in the food supply in two chemical forms: • Heme • 40% of the iron in meat, fish, and poultry. • about 15% to 40% absorption • Non-heme • the remaining iron in meat, fish, and poultry and all iron in other foods • about 1% to 15% absorption, Vegetarian diets contain no heme iron

Iron balance Total iron intake of vegetarians ≥ than that of omnivores. Total iron intake provides almost no indication of the amount of absorbed iron, which varies inversely with body iron stores and is influenced by different factors.

Iron absorption Inhibitors • phytate • calcium and phosphate salts • polyphenols in tea • coffee • cocoa • some spices • fibers Enhancers • vitamin C • alcohol • retinol • carotenoids

Recommended iron intake for vegetarians Recommended iron intakes for vegetarians are increased by 80% to compensate for the reduced bioavailability of iron from vegetarian diets. RDAs for omnivorous adult men and premenopausal women are 8 mg/d and 18 mg/d respectively; RDAs for vegetarians 14 mg/d and 32 mg/d

Vitamin B 12 Inadequate intakes of vitamin B 12 will lead to macrocytic anemia that is associated with reduced oxygen transport. Vegetarians who exclude all foods from animal sources do not have a reliable source of vitamin B 12 in their diet

Vitamin B 12 An additional concern about vitamin B 12 deficiency in vegetarians is that macrocytic anemia may be masked by high folate intakes, which would be expected higher in vegetarians. Vegan athletes need to include synthetic vitamin B 12 in their diets to prevent macrocytic anemia.

O 2 ROS DNA genetic mutation LIPIDS membrane function Protein enzyme inactivation

Antioxidant status of vegetarians Plasma vitamin C , E and β-carotene concentrations are consistently higher in vegetarians than in omnivores. • Rauma AL, Mykkanen H. Antioxidant status in vegetarians versus omnivores. Nutrition 2000; 16: 111 Fruit and vegetable are rich source of phytochemicals that are antioxidants: • Polyphenols • Glucosinolates

Creatine is found in meat, fish, and poultry. Typical omnivorous diets provide ~ 1 g/d. Creatine is also synthesized endogenously at a rate of about 1 g/d. A large majority of the body creatine pool is found in muscle, primarily in the form of phosphocreatine, and serves as a temporary storage site for ATP.

Creatine in vegetarians Adopting a vegetarian diet lead to a reduction in muscle creatine concentration. • Lukaszuk JM et al. Int J Sport Nutr Exerc Metab 2002; 12: 336 It could be hypothesized that vegetarians’ performances could be impaired in athletic events that rely on the high-energy phosphate system Burke et al. suggested that vegetarians experience a greater benefit from creatine supplementation than do omnivores. • Burke DG et al. Med Sci Sports Exerc 2003; 35: 1946

The Female Athlete Triad The female athlete triad denotes a combination of three conditions that can affect female athletes: • disordered eating, • amenorrhea, • osteoporosis. The consequences of the female athlete triad are serious with respect to athletic performance in the short term and to reproductive and bone health in the long term.

Vegetarianism and the female athlete triad A vegetarian diet could be associated with disordered eating habits Menstrual cycle disturbances may be more common among vegetarians A LOV diet does not appear to predispose one to osteoporosis; however, vegan diets are typically low in calcium and may be associated with lower bone mineral density

Young vegetarian athletes A well-planned vegetarian diet can support normal growth and development. Adolescents following a restrictive diet have lower intakes of vitamin B 12 and calcium, and their serum ferritin levels are lower. Tests of cognitive functioning found reductions in performance among those who were deficient in vitamin B 12. Because of the potential bulk of a vegetarian diet it may be challenging for young athletes to meet their energy needs

Does vegetarianism have any implication on athlets performances?

Assessing the effects of a vegetarian diet on performance Vegan diet does not impair the physiological response to submaximal exercise. No significant differences in fitness parameters were found between vegetarian and nonvegetarian athletes in a variety of physical fitness, anthropometric and metabolic measures Lacto-ovo-vegetarian diet does not affect endurance performances Venderley AM and Campbell WW, Sport Med 2006; 36; 293 -305

Conclusions A well-planned vegetarian diets appear to effectively support athletic performance Vegetarian diets provide protein intakes adequated to meet needs for total nitrogen and the essential amino acids Vegetarians are at increased risk for nonanemic iron deficiency, which may limit endurance performance Vegetarians have lower mean muscle creatine concentrations than do omnivores, and this may affect supramaximal exercise performance

Who is this man? 1983 1984 1987 1988 1991 1992 1996 World championship: 3 gold medals Olympic games: 4 gold medals World championship: 3 gold medals Olympic games: 2 gold medals World championship: 2 gold medals Olympic games: 1 gold medals

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