When an athlete protein intake is too high, the athlete either burns it for energy, or stores it as fat. Consuming too much protein increases the body's water requirement and may contribute to dehydration. The kidneys require more water to eliminate the excess nitrogen load of a high protein intake. A high protein, high fat diet after heavy training will cause incomplete replacement of muscle glycogen and impair performance.
Marathon Guide.
Tuesday, March 31, 2009
Monday, March 30, 2009
Fluid and Electrolyte Balance
What is fluid and electrolyte balance?
Electrolytes are chemicals such as salts and minerals needed for various functions in the body.
Dehydration is a state of imbalance and it is loss of water and important blood salts like potassium (K+) and sodium (Na+).
Over hydration is also called water excess or water intoxication, is a condition in which the body contains too much water.
Hyponatremia or Low blood sodium. -- what is it?
Hyponatremia means a low concentration of sodium in the blood. When it occurs in triathletes, it usually happens during long or ultra-distance races in the heat but may occur anytime. It is estimated that approximately 30% of the finishers of the Hawaii Ironman are both hyponatremic and dehydrated. The longer the race, the greater the risk of hyponatremia.
What causes it?
The exact mechanisms are not fully understood. The simplest answer is that lost sweat (salt and water) is replaced by ingested water (no salt). This dilutes the sodium in the bloodstream, and hyponatremia results. Longer races carry a greater risk of hyponatremia because of the total amount of sweat lost. During exercise in the heat, more salt is lost in sweat per hour than is usually replaced by food and fluids, including sports drinks. Your body can tolerate a degree of imbalance for a short period of time, but it may decompensate if this continues for too long.
Sweat contains between 2.25 - 3.4 grams of salt per liter, and the rate of perspiration in a long, hot race can easily average 1 liter per hour. So, for a 12 hour race, one could lose approximately 27 to 41 grams of salt. If the athlete replaces only the lost water and has minimal salt intake, hyponatremia can result.
Treatment: eat salt.by SportsMed Web
Why are athletes susceptible to fluid and electrolye imbalances? Exercise causes sweating and the rapid loss of fluids. The simple answer is to drink plenty of fluids to avoid dehydration and to include salt and sugar in the drinks to avoid hyponatremia. The following web site contains a more detailed explanations in an article: Advanced Sports Nutrition by Dan Benardot, PhD, RD, FACSM Sports Nutrition
A short burst of intensive exercise (100-m swim lasting one minute and resulting in a 12-fold rise in the level of blood lactate) resulted in frank hypernatremia (serum sodium level, greater than 150 mEq/L) in 30% to 40% of well-trained athletes. In contrast, less intensive exercise (800-m swim lasting ten minutes and resulting in a sevenfold rise in the level of blood lactate) failed to cause a rise in serum sodium level despite comparable elevations in hematocrit reading and serum protein levels. Hypernatremia induced by intensive exercise cannot be explained by losses in body fluid or solute ingestion, but is probably a consequence of a shift of hypotonic fluid from the extracellular to the intracellular compartment. Thus, the mechanism of exercise-induced hypernatremia may be unique, as compared with other clinically recognized forms of hypernatremia. P. Felig, C. Johnson, M. Levitt, J. Cunningham, F. Keefe and B. Boglioli
That there will be a certain number of individuals that will need medical intervention due to hypernatremia or hyponatremia during or after a race was the conclusion a study by these people:Allenpress:Alexander Kratz, MD, PhD, MPH; Arthur J. Siegel, MD; Joseph G. Verbalis, MD; Marvin M. Adner. The reasons for their distress are not fully understood. It is presumed that the individuals that have the problems are the weekend warriors; not the trained athletes. In other words a very important preventative measure is to train. A doctor once explained to me that a body that was accustomed to fluxuations in electrolytes was more apt to suffer less severe consequences from the fluxuations.
A nutritionally sound individual who has adequately trained and that drinks plenty of fluids in the form of water and includes the occasional sports drink, should not have any problems with electrolyte imbalance. I might also be prudent to avoid running in 100 degree weather and to dress properly for conditions. Many people can have health issues that they may or may not be aware of so it is important that everyone listen to their body.
Additional links of interest:
by Lane Parks, MS, ATC
Dietary Report on body requirements for water and electrolytes.
Guidelines
Lab values
Electrolytes are chemicals such as salts and minerals needed for various functions in the body.
Dehydration is a state of imbalance and it is loss of water and important blood salts like potassium (K+) and sodium (Na+).
Over hydration is also called water excess or water intoxication, is a condition in which the body contains too much water.
Two major imbalances in electrolytes are hyponatremia and hypernatremia
Hyponatremia or Low blood sodium. -- what is it?
Hyponatremia means a low concentration of sodium in the blood. When it occurs in triathletes, it usually happens during long or ultra-distance races in the heat but may occur anytime. It is estimated that approximately 30% of the finishers of the Hawaii Ironman are both hyponatremic and dehydrated. The longer the race, the greater the risk of hyponatremia.
What causes it?
The exact mechanisms are not fully understood. The simplest answer is that lost sweat (salt and water) is replaced by ingested water (no salt). This dilutes the sodium in the bloodstream, and hyponatremia results. Longer races carry a greater risk of hyponatremia because of the total amount of sweat lost. During exercise in the heat, more salt is lost in sweat per hour than is usually replaced by food and fluids, including sports drinks. Your body can tolerate a degree of imbalance for a short period of time, but it may decompensate if this continues for too long.
Sweat contains between 2.25 - 3.4 grams of salt per liter, and the rate of perspiration in a long, hot race can easily average 1 liter per hour. So, for a 12 hour race, one could lose approximately 27 to 41 grams of salt. If the athlete replaces only the lost water and has minimal salt intake, hyponatremia can result.
Treatment: eat salt.by SportsMed Web
Why are athletes susceptible to fluid and electrolye imbalances? Exercise causes sweating and the rapid loss of fluids. The simple answer is to drink plenty of fluids to avoid dehydration and to include salt and sugar in the drinks to avoid hyponatremia. The following web site contains a more detailed explanations in an article: Advanced Sports Nutrition by Dan Benardot, PhD, RD, FACSM Sports Nutrition
What causes hypernatremia or high blood sodium?
A short burst of intensive exercise (100-m swim lasting one minute and resulting in a 12-fold rise in the level of blood lactate) resulted in frank hypernatremia (serum sodium level, greater than 150 mEq/L) in 30% to 40% of well-trained athletes. In contrast, less intensive exercise (800-m swim lasting ten minutes and resulting in a sevenfold rise in the level of blood lactate) failed to cause a rise in serum sodium level despite comparable elevations in hematocrit reading and serum protein levels. Hypernatremia induced by intensive exercise cannot be explained by losses in body fluid or solute ingestion, but is probably a consequence of a shift of hypotonic fluid from the extracellular to the intracellular compartment. Thus, the mechanism of exercise-induced hypernatremia may be unique, as compared with other clinically recognized forms of hypernatremia. P. Felig, C. Johnson, M. Levitt, J. Cunningham, F. Keefe and B. Boglioli
That there will be a certain number of individuals that will need medical intervention due to hypernatremia or hyponatremia during or after a race was the conclusion a study by these people:Allenpress:Alexander Kratz, MD, PhD, MPH; Arthur J. Siegel, MD; Joseph G. Verbalis, MD; Marvin M. Adner. The reasons for their distress are not fully understood. It is presumed that the individuals that have the problems are the weekend warriors; not the trained athletes. In other words a very important preventative measure is to train. A doctor once explained to me that a body that was accustomed to fluxuations in electrolytes was more apt to suffer less severe consequences from the fluxuations.
A nutritionally sound individual who has adequately trained and that drinks plenty of fluids in the form of water and includes the occasional sports drink, should not have any problems with electrolyte imbalance. I might also be prudent to avoid running in 100 degree weather and to dress properly for conditions. Many people can have health issues that they may or may not be aware of so it is important that everyone listen to their body.
Additional links of interest:
by Lane Parks, MS, ATC
Dietary Report on body requirements for water and electrolytes.
Guidelines
Lab values
Friday, March 27, 2009
More on Blood Pressure Readings
I'm spending a lot of time on the subject of blood pressure because of a personal interest. I am afraid to run or participate in an exercise program because I get an occasional single high blood pressure reading, for example 184/98. My blood pressure reading are usually within what I consider the "normal", blood pressure range. I'm a trained nurse and I know that my fear is unreasonable, but I can't help to feel a twinge of anxiety when I see those high figures. I do not want an unrealistic fear to be a stubbling block for me as I train to run. Too, despite the information that streams out to educate individuals about the importance of taking a daily blood pressure pill, I think there is a lot of misunderstanding about what "high" blood pressure actually is. Too often a persons blood pressure reading will be elevated, during activities or because of stress, but that is no reason to punch the panic button. Too often expensive and potentially health damaging medications are prescribed for individuals to take, medications they may not even need! On the other hand if you have hypertension please take that BP medication every day. Exercise, lose weight and cut out some of that salt!
These are some random facts to establish figures that indicate "true" hypertension or "true" hypotension readings are and at what levels of increase or decrease we should consider it an emergency situation.:
Franklin D. Roosevelt died of a stroke
on April 12, 1945. One month before, his
blood pressure was a systolic of 240 and
a diastlic of 180 mm Hg (240/180).
Bis For Bloodpressure
Blood pressure increases in response to the extra requirement of the muscles and organs for oxygen-rich blood during exercise. However, some otherwise healthy individuals may find that their blood pressure reaches excessively high levels during exercise – for example, instead of reaching a systolic blood pressure of around 200 mmHg at maximal exercise rates, they may spike at around 250mmHg or higher.Exercise Hypertension
We had a 260/180 in the ED by machine confirmed by manual. History of uncontrolled high blood pressure. Presented because of two days of nosebleeds. He stated he gets them when his systolic gets over 250 so he came for treatment.
Student Doctor
My mom just had a blood pressure reading of 200/112. We were unnable to get an immediate doctor's apoitment and the next available date is 10 days from now. Would you consider this an emergency and should she go to the emergency room or can we wait until the 16th? The test was done at a free mobile clinic. She has no health insurance hence she will be going to a public clinic.
General Nursing Discussions
If my blood pressure is 172 over 135, should I just go to the doctor or to the hospital?
Just Answer
I went to the doctor today and I had a very high blood pressure reading. I have always been normal. I went to a new doctor for a tetnaus shot and blood test....something that sends me into fits of anxiety. Would the anxiety over the blood test affect the reading? I have never had high blood pressure before...I'm not exactly in the best shape of my life but I do exercise and try to eat healthy. I'm going back on Friday for another reading. But now I'm worried.
Heart Disease
my husband's bp has been high 179 over 110 for months. He feels fine. Should we go to the er?
Health Central
Postural (orthostatic) hypotension has many causes but is probably the most common and potentially most troublesome psychotropic side-effect (Box 4). Usually defined as a 20 mmHg reduction in systolic blood pressure after 1–3 minutes of standing upright, it may cause symptomatic underperfusion of vital organs, leading to dizziness, blurred vision, fainting, falls, fractures, seizures, strokes and cardiac ischaemia, especially in elderly people. Fainting usually occurs when mean arterial pressure (diastolic plus 1/3 pulse pressure) drops to 70 mmHg or below, corresponding to an upper-arm blood pressure of 90/60 or less.
Psych Org
.
These are some random facts to establish figures that indicate "true" hypertension or "true" hypotension readings are and at what levels of increase or decrease we should consider it an emergency situation.:
What are HIGH systolic and diastolic reading?
Franklin D. Roosevelt died of a stroke
on April 12, 1945. One month before, his
blood pressure was a systolic of 240 and
a diastlic of 180 mm Hg (240/180).
Bis For Bloodpressure
Blood pressure increases in response to the extra requirement of the muscles and organs for oxygen-rich blood during exercise. However, some otherwise healthy individuals may find that their blood pressure reaches excessively high levels during exercise – for example, instead of reaching a systolic blood pressure of around 200 mmHg at maximal exercise rates, they may spike at around 250mmHg or higher.Exercise Hypertension
We had a 260/180 in the ED by machine confirmed by manual. History of uncontrolled high blood pressure. Presented because of two days of nosebleeds. He stated he gets them when his systolic gets over 250 so he came for treatment.
Student Doctor
My mom just had a blood pressure reading of 200/112. We were unnable to get an immediate doctor's apoitment and the next available date is 10 days from now. Would you consider this an emergency and should she go to the emergency room or can we wait until the 16th? The test was done at a free mobile clinic. She has no health insurance hence she will be going to a public clinic.
General Nursing Discussions
If my blood pressure is 172 over 135, should I just go to the doctor or to the hospital?
Just Answer
I went to the doctor today and I had a very high blood pressure reading. I have always been normal. I went to a new doctor for a tetnaus shot and blood test....something that sends me into fits of anxiety. Would the anxiety over the blood test affect the reading? I have never had high blood pressure before...I'm not exactly in the best shape of my life but I do exercise and try to eat healthy. I'm going back on Friday for another reading. But now I'm worried.
Heart Disease
my husband's bp has been high 179 over 110 for months. He feels fine. Should we go to the er?
Health Central
What are Low systolic and diastolic readings?
Postural (orthostatic) hypotension has many causes but is probably the most common and potentially most troublesome psychotropic side-effect (Box 4). Usually defined as a 20 mmHg reduction in systolic blood pressure after 1–3 minutes of standing upright, it may cause symptomatic underperfusion of vital organs, leading to dizziness, blurred vision, fainting, falls, fractures, seizures, strokes and cardiac ischaemia, especially in elderly people. Fainting usually occurs when mean arterial pressure (diastolic plus 1/3 pulse pressure) drops to 70 mmHg or below, corresponding to an upper-arm blood pressure of 90/60 or less.
Psych Org
.
Thursday, March 26, 2009
The importance of blood pressure accessment for athletes.
Why are blood pressure readings important? Just what is "blood pressure"? Blood pressure is the force of the blood pushing against the side of it's container, the blood vessel wall. The higher number or the systolic pressure as it is called, is the maximum pressure on the artery, the diastolic pressure is the elastic recoil or resting pressure that the blood exerts constantly in between each heart contraction. Blood pressure readings are determined by the use of a piece of equipment called a sphygmomanometer which is used with a stethoscope. There are many different kinds available for people to use at home.
Measurement of blood pressure provides important information about circulatory function. It is an invaluable tool to use when making assessments related to cardiovascular health or when making determinations in fluid balance management.
How high is too high? What is a hypertensive emergency? To determine an individuals accurate blood pressure reading the blood pressure needs to be taken three different times on three different occasions.
Dr. Nathan J. Smith, M.D., agrees that limitation of sports participation is not warranted for individuals with mild hypertension. At the present time the level of systolic blood pressure that constitues a contraindication to strenuous competion is not known, but it is probably in the range of a systolic reading of 230 to 250 mm Hg.(Sports Medicine: Health Care for Young Athletes; 1983)
When are a series of high blood pressure readings an emergency? A hypertensive emergency is defined as increases in arterial pressure that if sustained for a few hours could cause irreversible organ damange. (some causes of a hypertensive emergency are: left ventricle failure, unstable angina/myocardial infarction, arortic dissection or cerebral hemorrhage.) Maglignant hypertension is defined as severe hypertension with a diastolic blood pressure usually greater than 130 mm Hg with retinal hemorrahages. A treatment which resulted in too rapid a decrease in the blood pressure would have negative effects on the patient.(The Handbook of Dialysis; Todd s. Ing; Lippincott 2001.)
A regular exercise program may lower blood pressure in individuals who already have elevated blood pressure of a systolic reading of over 165 and a diastolic reading of over 100.(Fitness Theory and practice by Peggy Jordan, RN. Aerobics Fittness of America; 1995)
Taking blood pressure readings as well as monitoring pulse rates are excellant methods of guaging the level and speed at which the vessels and heart are returning to acceptible levels. Increasing exercise activities yield a proportionate increase in blood pressure. Within 5 minutes of terminating the exercise, the blood pressure readings normally returns to the baseline figures.(Burch and DePasquale, 1962.)
Notes on aging: The aorta and major arteries begin to harden with age as the heart pumps against a stiffer aorta, the sytolic pressure increases. With many older people both the systolic and diastolic pressures increase so much so that it may be difficult to distinquish normal aging values from abnormal hypertension.(Physical Examination and Health Assessment; Carol Javis; W. B. Saunders Co. ;1992)
Cardiac output and strength of contraction decrease, thus lessen the older persons activity tolerance. The heart rate returns to its resting rate more slowly after exertion than it did when the individual was younger. Sudden emotional and physical stresses may result in cardiac arrhythmias and heart failure. (Fundamentals of Nursing; 1994)
Measurement of blood pressure provides important information about circulatory function. It is an invaluable tool to use when making assessments related to cardiovascular health or when making determinations in fluid balance management.
How high is too high? What is a hypertensive emergency? To determine an individuals accurate blood pressure reading the blood pressure needs to be taken three different times on three different occasions.
Dr. Nathan J. Smith, M.D., agrees that limitation of sports participation is not warranted for individuals with mild hypertension. At the present time the level of systolic blood pressure that constitues a contraindication to strenuous competion is not known, but it is probably in the range of a systolic reading of 230 to 250 mm Hg.(Sports Medicine: Health Care for Young Athletes; 1983)
When are a series of high blood pressure readings an emergency? A hypertensive emergency is defined as increases in arterial pressure that if sustained for a few hours could cause irreversible organ damange. (some causes of a hypertensive emergency are: left ventricle failure, unstable angina/myocardial infarction, arortic dissection or cerebral hemorrhage.) Maglignant hypertension is defined as severe hypertension with a diastolic blood pressure usually greater than 130 mm Hg with retinal hemorrahages. A treatment which resulted in too rapid a decrease in the blood pressure would have negative effects on the patient.(The Handbook of Dialysis; Todd s. Ing; Lippincott 2001.)
A regular exercise program may lower blood pressure in individuals who already have elevated blood pressure of a systolic reading of over 165 and a diastolic reading of over 100.(Fitness Theory and practice by Peggy Jordan, RN. Aerobics Fittness of America; 1995)
Taking blood pressure readings as well as monitoring pulse rates are excellant methods of guaging the level and speed at which the vessels and heart are returning to acceptible levels. Increasing exercise activities yield a proportionate increase in blood pressure. Within 5 minutes of terminating the exercise, the blood pressure readings normally returns to the baseline figures.(Burch and DePasquale, 1962.)
Notes on aging: The aorta and major arteries begin to harden with age as the heart pumps against a stiffer aorta, the sytolic pressure increases. With many older people both the systolic and diastolic pressures increase so much so that it may be difficult to distinquish normal aging values from abnormal hypertension.(Physical Examination and Health Assessment; Carol Javis; W. B. Saunders Co. ;1992)
Cardiac output and strength of contraction decrease, thus lessen the older persons activity tolerance. The heart rate returns to its resting rate more slowly after exertion than it did when the individual was younger. Sudden emotional and physical stresses may result in cardiac arrhythmias and heart failure. (Fundamentals of Nursing; 1994)
Monitoring Heart Recovery Rates
A good method of gauging exercise intensity and recovery times is by taking the pulse. There are several important numbers. The resting heart rate which can be established by taking the pulse first thing in the morning for three consecutive days. The average will determine the resting pulse. The maximum heart rate and the recommended training rates are important to know. Those numbers can be determined by taking the number 220 subtracting age; then multiply 55% for the lower number and 85% for the upper number. In my case a good training zone is a pulse rate of between 90 and 134. My pulse seems to be between 120 and 126 after a hard run. Besides good training pulse rate ranges we can also determine the heart recovery rate. Take your pulse immediately after you have cooled down for 5 minutes. It should only take 5 minutes for a runners pulse to return to 60% of the maximum heart rate. In my case a recovery pulse rate five minutes after I've stopped running should be 94.8. If my pulse has not come down to 94 then I haven't spent enough time cooling down. In the Fitness: Theory and Practice book I learned that "A recovery heart rate can indicate an individuals fitness level by the speed at which heart rate returns to a pre-exercise level. It is also an indicator of whether the cool down period was sufficient, and if exercise intensity was appropriate. After five minutes, the heart rate should by 60% or less of the estimated maximum HR(220-age, multiplied by .6)."Warning Signs 1. Check to see if your pulse rate returns to normal within 5 minutes of finishing your activity.2. Be careful of overheating or dehydrating during exercise.3. Proper rest is essential.4. Do not overdo it - watch for recurring or persisting pain.What Is Recovery Heart Rate? --by eHow.com
Getting started
This blog is going to consist of articles about exercise and health. There will be links to websites that provide information about sports health. My first subject is blood pressure readings and exercise.
Vaughns Pages Blood Pressure Chart
Vaughns Pages Blood Pressure Chart
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