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 'Diet For Sports Person With Diabetes!'
  By Kavitha Reddy
BSc Home science, MSc Food & Nutrition
Executive - Diabetes Infoline

D
iabetes
is a metabolic disorder caused by deficiency or malfunctioning of insulin, one of the hormones produced by the pancreas. With proper control and reasonable precautions, diabetes should not keep one away from participating in sports. All levels of exercise including leisure activities, recreational sports, and competitive performance can be managed by people with diabetes. Athletes with diabetes routinely compete in athletic events from Iron Man triathlons to professional football. New insulin devices and blood glucose monitoring devices make it much easier for athletes to monitor the body’s response to exercise and act according to the physical needs. In addition regular or more intense sporting activity improves quality of life, self-esteem, and sense of well being in adolescents and adults with diabetes.

Dietary guidelines for pre-exercise or competition mainly involves the 

  • Provision of an adequate carbohydrate to support exercise.
  • Food choices should be low in fat and protein and should provide mainly complex carbohydrates
  • Athletes should choose foods that are familiar and comforting, have been consumed before training sessions, and are known not to cause gastric distress. 
  • Small carbohydrate feedings during endurance events maintain normoglycaemia. It may be required to supplement with 10-30 Gms of carbohydrate per hour of exercise, depending on the blood sugar response to each sport or activity and starting blood sugar levels. 
  • Fluids should be consumed during the activity regardless of thirst.
During exercise athletes mainly rely on pre-existing glycogen stores and fat stores. If the pre-event meal is eaten at proper time glycogen stores are plenty full and this will optimise performance. Liquid meals can be more advantageous as they are digested rapidly than solid foods and as well provide hydration. Pre event snacks with in 1 hr of competition can be more beneficial to athletes that exercise longer than 60 min. 


Nutrient Intake distribution in athletes and sports person with Diabetes


Energy:

To maintain sufficient energy while performing a sport, an athlete needs to consume adequate energy prior to engaging in the activity. Fuelling the body with sufficient calories at frequent, regular intervals during the day promotes strength, speed and stamina. Approximately 50 kcal/kg of body weight per day for males and 45-50 kcal/kg of body weight for female athletes is required. Both whole foods and liquid meals aid in maintaining muscle glycogen stores and maintain blood glucose levels during extended exercise besides keeping hydrated.

Carbohydrates:

Carbohydrates are essential for the best athletic performance. Maximizing glycogen stores is the primary goal of sports nutrition. It is recommended that 60-70 % of calories should come from carbohydrate. ASCM, ADA, and Dietitians of Canada (2000) recommended that athletes should consume 6-10 gms of carbohydrate/kg of body wt/day. After prolonged or intensive activity or exercise, extra carbohydrate food is needed for up to 24 hrs to refill muscle stretch reserves and to prevent delayed hypoglycaemia. Complex carbohydrates like green leafy vegetables, whole grains-rice, wheat, bajra, maize, pasta increases glycogen stores more efficiently than sugars or simple carbohydrates

Protein:

Protein is an essential component of any diet. Because, this macronutrient builds, maintains and repairs cells and produces enzymes, hormones and antibodies. Athletes may require more protein than the recommended dietary allowance (RDA) of 0.8gms/kg body weight. About 1-1.5 gm /kg is needed per day. 

Fat:

Fat intake should be adequate to provide the essential fatty acids and fat-soluble vitamins, as well as to provide adequate energy for weight maintenance. Diet should provide moderate amounts of energy from fat that is 20-25 % of calories should come from fats. Foods like cheese desserts, snacks, whole milk, oil in the food, should provide required amount of calories from fats.

Fluids:

Water is an amazing but yet often forgotten nutrient that helps improve the energy, stamina, performance and cramping tolerance of every athlete. Athletes should be well hydrated before during and after exercise to balance fluid loss. 

  • 2 hrs before exercise: 2 cups of fluid.
  • During exercise: 0.5 to 1 cup every 15 min.
  • After exercise: 2 cups of fluid. 

Minerals:

Vitamins and minerals are vital to bodily process, from fighting infection to repairing muscle tissue to boosting the immune system. Athletes will not need vitamin and mineral supplements if adequate energy to maintain body weight is consumed from a variety of foods. However, supplements may be required by athletes who restrict energy intake, eliminate one or more food groups from their diets, or consume high carbohydrate diets with low micronutrients density.


Guidelines for Vegetarian athletes and sports person:

All the athletes require approximately 40 different nutrients. A vegetarian athlete must make up for the nutrients that normally get from meat. Most of the nutrients are obtained easily but one has to keep track of protein and minerals. 

The vegetable sources of protein do not contain all the essential amino acids so a combination of grains such as wheat, barley or rice with legumes such as chick peas, black beans, lentils at each meal or soy bean alone will meet the protein requirement. 

Minerals like iron, zinc, calcium, and vitamin B12 are hard to get in vegetable diets. 

By including lentils, kale, greens, dried fruits, fortified breakfast cereals iron needs can be met.

Wheat germ, beans, nuts, and fortified cereals are rich in zinc.

By including milk or low fat yoghurt daily the calcium needs can be met. Broccoli and leafy greens also have calcium. Athletes, who do not eat eggs or milk may not get enough vitamin B12. Eating fortified breakfast cereals or taking a vitamin supplement will meet the RDA for vitamin B12.

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