Staying safe on the courts: 11 helpful tips

 

There are many things you can do to make sure you have a safe, optimal sports experience.

Sports help keep our bodies fit and allow us to feel good about ourselves.

However, all sports have a risk of injury. In general, the more contact in a sport, the greater the risk of injury. But there are many things you can do to make sure you have a safe, optimal sports experience.

Here’s a list of tips to help avoid sports injuries.

• Avoid playing with a pre-existing illness or injury. If in doubt, consult a medical practitioner.

• Remove sharp or dangerous objects from the playing area.

• The training room, first aid area and changing rooms should be: clean, adequate size for the number of athletes using them, stocked adequately with soap, paper towels, garbage bins, brooms, disinfectants, and a first aid kit at all times.

• Wear the right gear. Players should wear appropriate and properly fitted protective equipment such as pads (neck, shoulder, elbow, chest, knee, and shin), helmets, mouthpieces, face guards, ankle guards, protective cups, and eyewear if necessary.

• Strengthen muscles. Conditioning exercises before games and during practice helps prepare the mind and body for exercise. It also increases body and muscle temperature as well as increases the blood and oxygen supply to the working muscles.

• Increase flexibility. Stretching exercises before and after games or practice will keep you limber.

• Take breaks. Rest periods during practice and games can reduce injuries and prevent heat illness.

• Play safe. Rules should be enforced.

• Stop the activity if you feel pain.

• Avoid heat injury. Drink plenty of fluids before, during and after exercise or play; decrease or stop practices or competitions during especially hot or humid periods; wear light, sun-protective clothing, a hat, sunglasses and sunscreen.

• Maintain an adequate fitness level. Undertake conditioning and training exercises specific to physical demands of your sport.

This is the first in a series of informative articles relating to sports in general and specific sport-related injuries.

 

How to treat sports-related injuries quickly, effectively

  Sports Medicine: If you suffer a sprain, strain or muscle tear, immediate first aid can prevent complications and help you heal faster.

If you suffer an injury such as a sprain, strain or muscle tear, immediate first aid can prevent complications and help you heal faster.

When an injury occurs, the damaged area may bruise, swell or bleed – externally or internally – and become inflamed. Healing occurs as the damaged tissue is replaced by collagen, better known as scar tissue. In most cases, the tissue must be completely repaired before you can return to sports.

One of the most important acronyms to remember if you suffer a sports injury is PRICE-M: Protect, rest, ice, compression, elevation and medication.

Using these six immediate first-aid measures can relieve pain, limit swelling and protect the injured tissue, all of which speed up the healing process.

P – Protect the area from further injury. Leave the field using an appropriate method of transport to prevent further damage. Seek medical assistance.

If you move the injured body part, it will increase blood flow to the injury site, which may cause the blood clot to dislodge, and too much bleeding may cause even more tissue damage.

R – Rest only from activities that aggravate the condition. The first 24- 48 hours after the injury is considered a critical treatment period, and activities must to be curtailed. Resting is important immediately after injury for two reasons. First, it is vital to protect the injured muscle, tendon, ligament or other tissue from further injury. Second, your body needs to rest so it has the energy to heal most effectively.

But total rest is poor treatment! Rest means continuing physical activity that does not aggravate the pathological condition, but at the same time ensures that you maintain general physiological conditioning while your injury heals.

I – Ice packs to limit pain and swelling. Cold packs, a plastic bag filled with crushed ice in a towel or even a bag of frozen peas should be applied to the injured area for 20 minutes at a time, four to eight times per day. An ice massage is another extremely effective way to direct cold to the injured tissue.

Cold provides short-term pain relief.

It also limits swelling by reducing blood flow to the injured area. Keep in mind, though, that you should never leave ice on an injury for more than 20 minutes at a time. Longer exposure can damage your skin.

C – Compression of the injured body part. Compression helps limit and reduce swelling, which speeds up the healing process. Some people also experience pain relief from compression.

An easy way to compress the area of the injury is to wrap an ACE bandage, air cast or splint around the swollen part. The wrap should be snug, but should not cut offcirculation to the extremity. If the wrap feels too tight, remove the bandage and re-wrap the area so the bandage is a little looser.

E – Elevation at or above your heart. For lower extremity injuries – such as a knee or ankle – elevating the injured body part reduces swelling. This is most effective when elevated at or above the level of your heart. For example, if you injure an ankle, try lying on your bed with your foot propped on one or two pillows.

M – Medication and anti-inflammatory drugs. Medication should be administered by an expert due to possible contraindications or side effects.

In the first 48-72 hours following an injury, the following should be avoided: 

H – Heat: Saunas, spas, hot water bottles, hot showers and baths can increase bleeding.

A – Alcohol: Alcoholic drinks can increase swelling.

R – Running: Running or exercising too soon can make the injury worse.

M – Massage: Massages or heat rubs increase swelling and bleeding, if they’re given within two to three days after the injury was sustained.

After a day or two of PRICE-M, many sprains, strains or other injuries will begin to heal. If your pain or swelling does not decrease after 48 hours, make an appointment to see your primary care physician or local sports physical therapist, depending upon the severity of your symptoms.

Once the healing process has begun, very light massage may improve the function of forming scar tissue, cut healing time and reduce the possibility of injury recurrence.

Gentle stretching can begin once all swelling has subsided. Try to work the entire range of motion of the injured joint or muscle, but be extremely careful not to force a stretch, or you may re-injure the area. Remember that a stretch should never cause pain.

Heat may be helpful once the injury moves out of the acute phase and swelling and bleeding has stopped.

Moist heat will increase blood supply to the damaged area and promote healing.

Finally, after the injury has healed, strengthening exercises can begin. Start with easy weights and use good form.

"The big four" of sports injuries – what are they?

In this article, I wish to address the four most common types of sports injuries: Sprains, Strains, Tears and Fractures (SSTF). The most frequent sports injuries are sprains and strains, caused when an abnormal stress is placed on ligaments, and muscles. Only about 5 percent of sports injuries involve broken bones (fractures). Let's delve into each of these in slightly more detail:

•      SPRAINS: These are injuries that occur regarding ligaments. Ligaments are fibrous structures that connect bones to other bones. They serve mainly as passive stabilizers of the joints. They may simply be graded as follows:

Grade I Sprain: Grade I sprains cause stretching of the ligament. The symptoms tend to be limited to pain and swelling. In lower limb sprains, most patients can walk without crutches, but may not be able to jog or jump.

Grade II Sprain: This is a more severe partial tear of the ligament. There is usually more significant swelling and bruising caused by bleeding under the skin. Patients often have pain with walking, but can take a few steps.

Grade III Sprain: These are a complete tear of the ligament. The joint is usually quite painful, and walking can be difficult. Patients may complain of instability, or a giving-way sensation in the joint. Depending on the anatomical area concerned, surgery may be a consideration.

The most common ligaments that are injured in the body are those around the ankle.

In general, the degree of symptoms tends to correlate well with the extent of the damage to these ligaments.

•    STRAINS: These are injuries that occur regarding muscles. Muscles are fibrous tissue that connect tendons to bones and produce force that causes voluntary motion in all the joints in the body.  Muscle injury is graded in a similar way as ligament injury is. There are about 650 muscles in the human body and they make up about one half of your body's weight.

The most common muscle group that is injured is the hamstring. These three muscles connect the pelvis to the knee, behind the upper leg.

    •   TEARS: These are injuries that occur relating to Tendons. A tendon is a tough band of fibrous connective tissue that connects muscle to bone and is capable of withstanding. The primary function of a tendon is to transmit the contraction force of its associated muscle to the bone. Consequently, the tendon needs to have sufficient tensile strength. They are constructed with parallel collagen fibers running the length of the tendon. The longitudinal arrangement of the collagen fibers gives the tendon its tensile strength. Tendon injuries are usually graded as partial or complete.  More often, tendons are damaged with internal structural pathologies, termed tendonopathy or tendonosis. These conditions generally result from repetitive overuse as opposed to an acute injury. Tendons usually take between 6- 8 weeks to heal.

The most common tendons that are injured in the body are those around the ankle, shoulder and knee.

•      FRACTURES: These are injuries that occur relating to Bones:  Bones are formed by calcified connective tissues that help human beings in movements and provide protection to the inner organs. They further provide support to the body against constant gravitational pull. They also assist with production of blood cells. There are approximately two hundred fifty six bones in the human body. A break in the bone is known as a fracture. A fracture is caused due to inability of bone to withstand the force exerted on it. Most people get at least one fracture during their lifetime. Age factor plays a great role in fractures. The elderly are more prone to fractures, as the bones get more brittle with age. Children suffer less from fractures as their bones are more flexible, putting them at a lower risk of breaking bones. Fractures usually take between 6-8 weeks to heal in adults and 3-4 weeks in children.

The most common bones that are injured in the body are those around the ankle and the collar bone.

 

Exploring common sports injuries

 

Common areas of injury: Head, back and spinal cord.

Over the past weeks, I discussed the four most common types of sports injuries: Sprains, strains, tears and fractures.

In today’s article, I wish to discuss the most common areas of injury. This will be a two-part piece spread out over two weeks.

At the outset, I would like to reiterate that this is by no means a comprehensive review, but merely serves as a guide to the more common injuries per body part.

Head 

• Concussion – The term concussion describes an injury to the brain resulting from an impact to the head.

By definition, a concussion is not a life-threatening injury, but it can cause short-term headaches, confusion, nausea and vomiting, blurred vision and/or loss of short-term memory.

In more serious injuries, there may be long-term problems. A concussion results from a closed-head type of injury and does not include injuries in which there is bleeding.

Shoulder

• Clavicle Fracture (Collar bone) – This is generally caused from an impact injury, such as a fall or blow to the shoulder. Most are treated conservatively and healing is most satisfactory, even though a marked irregularity may be seen at the fracture sight.

• Shoulder Tendinopathy, Bursitis, and Impingement Syndrome – These conditions may produce similar symptoms and often occur together. If the rotator cuff (the four tendon group around the shoulder) and bursa (encapsulated sac of fluid) are irritated, inflamed, and swollen, they may become squeezed between the head of the humerus and theacromion.

• Torn Rotator Cuff (the fourtendon group around the shoulder) – This tends to happen as a result of a sudden, powerful movement. This might include falling over onto an outstretched hand at speed, making a sudden thrust with the paddle in kayaking, or following a powerful pitch/throw.

A common symptom of a rotator cuff injury is aching and weakness in the shoulder when the arm is lifted overhead.

Elbow 

Anyone can develop elbow pain, although tennis players and golfers have more elbow injuries than most. The most common is: 

• Tennis Elbow (Lateral epicondylalgia) – This is considered a cumulative trauma injury that occurs over time from repeated use of the muscles of the arm and forearm that lead to small tears of the tendons.

Although lack of or improper conditioning is a major cause, proper technique is essential to preventing problems. Take a class or get professional instruction.

Also, make sure your equipment fits well in whatever sports it is that you are participating in.

Back 

• The lower back is the most common site of back injuries and back pain. Common back injuries include sprains and strains.

Falling, twisting or getting hit can all cause a sprain. Twisting or pulling muscle tissues can cause a strain.

A very common cause of pain and disability is a herniated disk.

A human backbone, or spine, is made up of 26 bones called vertebrae. In between them are soft disks filled with a jelly-like substance. These disks cushion the vertebrae and keep them in place.

A herniated disk occurs when the liquid-like central material “slips out” of place or ruptures. If it presses on a nerve, it can cause back pain that spreads to the buttocks and legs.

Tingling or numbness, muscle spasms or weakness are all common symptoms. With treatment, most people recover. It can take a long time.

Treatments include rest, pain and anti-inflammatory medicines, physical therapy and sometimes surgery.

Losing weight can help, too.

You might be able to prevent some back injuries by maintaining good posture, a healthy weight, lifting objects with your legs and using lower-back support when you sit.

Exploring some more common sports injuries

Knee pain is extremely common in athletes and is often caused by improper technique.

Last week, I briefly covered head, shoulder, elbow and back injuries.

In today’s article, I’ll discuss the knee, leg and foot.

I would like to reiterate that this is by no means a comprehensive review, but merely serves as a guide to the more common injuries per body part.

Knee Knee pain is extremely common in athletes and is often caused by improper technique, lack of conditioning and poor flexibility.

To treat the cause of the pain, it is important to have an evaluation and proper diagnosis Common reasons for knee pain in athletes include the following: 

• Anterior cruciate ligament (ACL) injuries: Partial or complete ACL tears can occur when an athlete changes direction rapidly, twists without moving the feet, slows down abruptly, or misses a landing from a jump.

• Iliotibial (IT) Band Friction Syndrome: Knee pain that is generally felt on the outside (lateral) aspect of the knee or lower thigh often indicates IT Band Friction Syndrome.

• Medial and lateral collateral ligament tears: MCL and LCL injuries of the knee are common. In fact, injury to the MCL is the most common ligamentous knee injury. The MCL and LCL provide restraint to lateral and medial strains to the knee joint.

• Meniscal and cartilage injuries: The two most common causes of a meniscus tear are due to traumatic injury (often seen in athletes) and degenerative processes (seen in older patients who have more brittle cartilage). The most common mechanism of a traumatic meniscus tear occurs when the knee joint is bent and the knee is then twisted.

It is not uncommon for the meniscus tear to occur along with injuries to the ACL and MCL.

These three problems occurring together are known as the “unhappy triad,” which is seen in sports such as football when the player is hit on the outside of the knee.

• Articular cartilage: Cartilage is the white shiny covering over the ends of the bone. It has a very unique feature as it is smooth yet tough, and serves well as the bearing surfaces of the joint.

Over time, however, cartilage degeneration can lead to osteoarthritis, pain and disability of the joint. While it’s important to build up training gradually to avoid overuse,biomechanics can also come into play.

If you have flat feet or high arches, pronate or supinate, you may have more knee pain.

Appropriate footwear, insoles or orthotics can improve alignment and reduce injury risk. If you are a cyclist, proper bike fit can also make a huge difference.

Leg • Stress fracture: Stress fractures in the leg are often the result of overuse or repeated impacts on a hard surface.

• Achilles tendon rupture: The exact cause of a rupture of the Achilles tendon is unknown. As with Achilles tendonopathy, tight or weak calf muscles may contribute to the potential for a rupture.

• Hamstring strain: Hamstring injuries are common among runners.

The hamstring muscles run down the back of the leg from the pelvis to the lower leg bones, and an injury can range from minor strains to total rupture of the muscle.

• Shin splints: Shin splints describe a variety of generalized pain that occurs in the front of the lower leg along the tibia (shin bone). Shin splints are considered a cumulative stress injury.

Foot • Plantar fasciitis, or heel spur: Local pain in the heel, especially on weight-bearing after a period of rest, which may radiate into the arch of the foot.

Warming up to the notion of exercising your body properly

 

There is a common misconception that stretching is a type of warm-up, when in reality, they are two completely different activities.

It is commonly assumed that warming up is mandatory for a good workout and that without it, one will be at an increased risk for injury. Athletes believe that warming up is important and that it will lead to a significant reduction of injuries.

Before I let you in on the secrets of why warming up is essential prior to engaging in physical activity, it is important to know what is considered warming up and what is not.

There is a common misconception that stretching is a type of warm-up, when in reality, they are two completely different activities that should not be confused with each other. My second piece in this series will address the controversial issue of whether or not stretching leads to reduction in the incidence of injuries, or whether in fact, it does more harm than good.

Warm-ups are postulated to be beneficial for our bodies for a number of reasons.

The primary purpose of warming up is to increase body and muscle temperature, by slowing increasing your heart rate and breathing rate. This increases the flow of blood, oxygen and nutrients to your muscles, preparing them for hard, physical work. This is something that should be done BEFORE stretching.

An additional reason for warming up is that when your muscles and tendons are cold, they are more likely to be injured. Warming up muscles reduces their stiffness, which is essential for injury prevention.

Yet another benefit is that warming up speeds up nerve impulses, which means that coordination will improve, leading to better performance.

When you warm-up your body, you are slowly preparing your body for physical activity. This gradual adjustment to activity is much healthier for your body than rapid and instant change in activity.

Your body greatly appreciates the slow and steady rise in activity that gives your cardiovascular system (your heart and blood vessels) sufficient time to adapt to its new physical demands for oxygen and blood.

Your body is now prepared to start physical activity! Now that you know how warming up works, let’s elaborate on its different types.

As I wrote earlier, warming up is meant to increase your body temperature and there are different types of warm-ups that one can do.

There’s warming up using equipment (for instance, an elliptical machine), warming up without equipment that focuses on a specific body part (for instance, the knee), and warming up that focuses on the entire body (for instance, jumping jacks).

Research shows that a warm-up that focuses on a specific body part is most beneficial, because essentially you are practicing the activity that you will be doing.

The activity you are warming up for and one’s physical capabilities is definitely something that should be taken into account, as this will affect the type of warm-up that is required.

There is a lot of research that supports the claim that a warm-up is an essential part of physical activity and lowers the chances of injuries that can occur during physical activity.

When you warm up consistently before physical activity, you are ensuring that your muscle contractions will be smoother (as they are more used to the activity), due to greater muscle elasticity.

Many studies found that when participants warmed-up prior to engaging in physical activity, they were less susceptible to injury.

Warming up was found to reduce the occurrence of sports-related injuries to the musculoskeletal system (also called the locomotor system).

The musculoskeletal system can be injured by sprains, tears, strains and injuries between connecting tissues.

Musculoskeletal injuries can affect ligaments, muscles, bones, tendons, nerves, cartilage, spinal discs and joints.

Flexibility helps reduce injuries to these areas.

There are two different types of flexibility, static and dynamic.

Static flexibility – a passive movement where something or someone else is moving the joint and not the person themselves.

Dynamic flexibility – a movement that results from a muscle contraction from the person themselves.

As with any type of exercise, double-check with your sports physician, physiotherapist or personal trainer before attempting any of these stretches. The above examples are given only so that you will have some background information on the issue.

The next time you get ready to jog, swim, play basketball, or take part in your preferred physical activity, remember to warm up! Your body will feel better for having warmed itself up and your range of motion will be easier and smoother.

To stretch or not to stretch? (Part 1)

Stretching is thought to reduce the likelihood of injuries and many assume that stretching is necessary component of a workout.

Everyone knows that you are supposed to stretch before you work out.

Stretching is thought to reduce the likelihood of injuries and many assume that stretching is a necessary component of a workout.

People are always told that they mustn’t forget to stretch, lest they suffer from muscle strain and a great deal of pain, before engaging in physical activity.

The question is, is stretching really helping our bodies or is this just a myth that desperately needs revision? Many assume that stretching leads to a reduction of injuries, but before we can answer this question, we need to discuss what stretching is.

A common mistake people make is assuming that stretching is a type of warming up or even that stretching itself is warming up! Stretching and warming up are two different physical activities, with different purposes, goals and outcomes.

As mentioned in the previous article on warming up, its purpose is to increase your body and muscle temperature by slowing increasing your heart rate and breathing rate.

This increases the flow of oxygen and nutrients to your muscles, preparing them for hard, physical work.

This is something that should be done before stretching. Warming up will in fact increase the range of motion possible while stretching.

Stretching is a physical activity where a muscle is lengthened in order to increase its flexibility.

This leads to greater control of one’s muscles, which allows for a greater range of motion.

Stretching and warming up are therefore two different physical activities, with two different purposes and two different goals.

There are several forms of stretching.

Ballistic stretching – This involves repeating certain bouncing movements over and over again to force the muscle beyond its normal range of motion.

An example of this would be bouncing down and then trying to touch your toes.

Static stretching – This involves stretching the muscle and holding it in place for a certain period of time.

An example of this would be extending out your arms and holding them in position.

Proprioceptive neuromuscular facilitation (PNF) stretching This alternates between muscle contracting and muscle stretching.

An example would be stretching your leg and then contracting it for a few seconds.

As with any other type of exercise, double-check with your doctor, physiotherapist, or personal trainer before attempting any of these stretches.

The examples are given only so that you will have some background on the issue.

There is research that supports the claim that stretching is effective at reducing injuries. It is maintained that stretching prevents injuries because it increases the flexibility of muscles, which makes muscle contractions smoother.

Others found that stretching was also effective when it was combined with a warm-up (obviously, warming up before stretching and not vice versa).

It was also noted that stretching was found to reduce the number of groin or buttock problems in women.

One scientist recommended that stretching is most effective when done within 15 minutes before engaging in physical activity.

Another study found that there is support that stretching helps to lower the risk of musculotendinous injuries.

Next week, I will continue with part two.

Sports Medicine: Quite a stretch of a theory

There are several studies that reported that stretching does not help prevent injuries.

There is some research that supports the claim that stretching is effective at reducing injuries.

Such an opinion maintains that stretching prevents injuries because it increases the flexibility of muscles, which makes muscle contractions smoother, thereby reducing injuries.

Others have found that stretching was also effective when it was when it was combined with a warm-up.

Some scientists recommend that stretching is most effective when done within 15 minutes of engaging in physical activity.

Another study has found that stretching helps to lower the risk of musculotendinous injuries.

Conversely, there are several studies that reported that stretching does not help prevent injuries. One study found that general fitness was more important in injury prevention than stretching.

When it comes to stretching itself, some studies have found that stretching can actually hurt muscle strength and reduce power.

Other scientists discovered that when stretching was added after warming up, it did not lower the incidence of injuries that resulted from overuse.

The extra flexibility in range-of-motion was reported to not be as beneficial as initially thought, and was found to lead to injury as well as to impede performance.

Six different investigations found that static stretching did not reduce the prevalence of injuries caused by exercise and only one found that it helped reduce them.

Another researcher testified that when stretching is done either before or after physical activity, it does not aid in the prevention of muscle soreness and did not reduce the risk of injury.

Among the postulated reasons that stretching before exercise would not prevent injuries are the following: 1. In animal studies, it was found that when muscles were heated up (for instance, by a hot pack), this resulted in tissues rupturing more easily.

2. Certain activities (such as jogging) do not require extremely long muscles so stretching is unnecessary.

3. Most often, muscle strain occurs during activities that put pressure on the muscles, forcing them to elongate, such as slowly stepping down off of a step.

4. Stretching has been found to bring about damage at the cytoskeleton level.

One of the biggest problems with the literature on stretching is that many studies contain fatal design flaws.

Many of them did not distinguish between the types of physical activity performed when they examined the effect of stretching on injury reduction.

This is an important factor that should not be overlooked.

One researcher found that when studies differentiated between different types of physical activity, the effect of stretching depended on the type of activity performed.

For instance, certain activities such as gymnastics or dancing require stretching beforehand and therefore, stretching led to an increase in performance capabilities.

However, for activities such as jogging or cycling, which require less flexibility, there was found to be no positive effect of stretching. (It should be noted that there wasn’t a negative effect found either.) While some studies did not distinguish between the type of physical activity performed, others found that several studies did not differentiate between type of injury incurred.

This factor is also extremely important. Many studies did not differentiate between sprain, strain, overuse injury.

All of this makes information from studies rather confusing and therefore it is problematic to draw conclusions from faulty data.

A general conclusion reached by nearly all researchers was that there needs to be more research done in this area to clarify as to whether or not stretching reduces, increases or is ineffective when it comes to injury reduction.

This is one of the most heavily debated issues in sports medicine and while I would wish to give a definitive answer, it appears that it would be more realistic to conclude that more research really needs to be conducted.

Only once there is research that distinguishes between different types of injuries, as well as different types of athletic activities, with proper definitions and carefully constructed investigations can proper and most importantly, accurate conclusions be drawn.

For the time being it appears that there is more evidence supporting that stretching is not as effective as it commonly thought.

 

 We are what we eat – Nutrition (Part 1)

 

This article is the first of a nine part series that will focus on nutrition, and will hopefully provide athletes with the necessary tools they need to achieve their goals. The topics I hope to cover include nutrition goals and eating strategies, proteins and carbohydrates, hydration and finally the controversial issue surrounding supplement intake.

Every athlete knows that in a competition, even a split second can make that difference between winning or losing, scoring a goal, making that save or preventing the other team from victory.  Every moment counts and therefore several factors can have a huge impact on player performance.  An important factor that will make that difference between victory and failure is what athletes put into their bodies, in short, nutrition.

What we drink and eat will have a significant impact on our physical performance.  Diet influences how well an athlete is able to train for a competition and is what transforms a performance from good to great.  Once an athlete is already training hard to transform his or her body from minimal to maximal performance, it makes no sense to ignore diet, when this can also heavily impact performance.  Since there are several different types of athletic activities, it is difficult to prescribe a general diet that meets the needs of all athletes due to the different demands required by these activities. Some activities require greater speed, endurance, power, technique or strength and therefore no diet can meet these different requirements at once.  Additionally, body size, physique, physiological and biochemical characteristics also differ between individuals and make it difficult to list specific guidelines for diet that will apply to people with such diverse physical makeups.

Healthy food choices make all the difference and there are several benefits that arise from making smart choices of what to put into one's body.  The amount of food one needs to eat is something that is very much dependent on the energy needs of the athlete.  Calculating how much energy an athlete needs is dependent upon the activity performed during training and competition, as well as energy that is expended outside of these activities.  If an athlete trains regularly, he or she will need much more energy, especially when training sessions are lengthy and tough.  On the other hand, when an athlete trains irregularly or if an athlete's training sessions are much less demanding, or shorter, significantly less energy will be needed.  Another important factor to take into consideration is that many athletes will have an on-season and an off-season, periods of time of more and less physical activity (also including periods of time where athletes may be recuperating from injuries) and as a result, energy demands are lower and diet must be adjusted accordingly to these new demands.

Many people are under the impression that body weight is a good predictor of energy, however, this is not the case.  Keeping track of body weight is a complicated process and often the information collected can be misconstrued.

Now that I have provided basic background information to understand why nutrition is not simple hocus-pocus, we are ready to delve more in depth into the issue in Part 2.

 

Sports Medicine: What to keep in mind about protein

 

Today’s athletes are more likely to eat large quantities of meat, in addition to a diet that includes various protein supplements.

This is the second article in a series of articles on nutrition in sports. This piece will focus on nutritional goals for athletes, with a specific focus on proteins.

Every athlete will attest to the notion that protein is an important part of their diet.

Whereas in the past, Olympians would gorge large amounts of proteins in order to achieve maximal physical results, today’s athletes are more likely to eat large quantities of meat (probably not cyclist Alberto Contador any longer after almost being banned for eating steroid-tainted meat during the Tour de France), in addition to a diet that includes various protein supplements.

Scientists will often debate how much protein or meat athletes should be eating on a regular basis.

Many scientists are concerned about whether our athletes are meeting their protein goals, working out precise calculations in order to determine that exact amount that will lead our athletes to the finish line. The question is, are athletes even meeting these protein goals in the first place, and if so, how much protein should be a part of their daily diets? When we exercise, the amino acids from the protein already stored in our bodies are used to create new tissue (for instance, muscle) and repair existing tissues.

These amino acids also partake in the manufacturing of enzymes and hormones that are involved in several body functions, such as the regulation of the body’s metabolism. Protein is one of the body’s fuel sources for muscles during exercise.

Studies have shown that most athletes consume far more than the recommended daily protein intake and therefore do not need to worry that they are not receiving enough protein in their diets.

This above-average level of protein does not include the use of protein supplements.

What this seems to indicate is that athletes are aware of the need to incorporate protein in their diets and that scientists do not need to spend time worrying that the average athlete is suffering from a lack of protein.

Scientists recommend for the average inactive person to consume 0.8 grams per kilogram of body weight (BW) a day. For an average athlete focusing on endurance and resistance-training, the daily recommendation is augmented to 1.2-1.7 grams per kilogram of BW per day.

Some suggest that this need for additional protein results from increased physical activity, while others say that this theory is erroneous and not all athletes need to be consuming more protein.

Such a theory posits that protein requirements in athletes are not being measured properly, which is why many obtain results demonstrating this increased protein need.

The question remains as to whether or not this additional protein is actually helping athletes reach their physical goals, or if this extra protein is doing nothing at all.

Scientists discovered that some athletes who body-build or do resistance-training, eat more than 2-3 grams per kilograms BW of protein a day.

Certainly this extra protein is costing these athletes a lot of money and there is no evidence to date that this additional protein leads to any increase in muscle mass, muscle strength or enhances the body response to training.

Any athlete who is consuming extra amounts of protein must be careful to make sure that it does not come at the expense of meeting other nutritional goals that can severely affect performance.

I should also mention that protein-only powers and amino acid supplements are very costly and there isn’t much evidence to support their effectiveness.

Many everyday foods can meet the body’s needs and are often drastically cheaper.

Athletes who lack sufficient levels of protein in their diets are usually either consciously restricting their energy intake or are intentionally limiting their diet (for instance, eating only hamburgers).

Restricting levels of energy intake is a noteworthy problem as energy deficiency can constrain the amount of protein absorbed and hurt the protein balance in the body.

What scientists have found is that the intake of a small quantity of a high-quality protein together with a carbohydrate can improve the body’s protein synthesis.

For those whose workout centers on endurance, consumption is recommended to take place soon after the completion of exercise.

For one whose workout concentrates on resistance training, consumption is recommended before training.

It should be noted that much research is still being conducted in this area all the time and that more specific guidelines should be available in the future.

Based on the above recommendations, it seems more logical to spend time focusing on what high-quality proteins, combined with carbohydrates, athletes should be eating, as opposed to focusing on just gorging on large amounts of proteins.

The subject of carbohydrates will be expanded upon in the next article in this series.

 You Can't Go Wrong with Carbohydrates

 

This is the third article in a series of articles on the subject of nutrition.  In the past two articles I introduced the topic of nutrition and expanded upon the subject of proteins.  I discussed how small amounts of high-quality protein combined with carbohydrates have been found to have a significant impact on the body's protein synthesis, much more so than just eating large amounts of proteins.  It is with this information in mind that will start our discussion on carbohydrates, a poorly understood subject that has a bad reputation. 

Carbohydrates are the bread and butter of all foods. They are sugars and starches that are part of most everyday foods such as breads, fruits, vegetables, milk, honey, pasta, cereals, syrups, popcorn and of course, sugar. Carbohydrates are what our brain functions on and supplies energy for our entire body. Our bodies favour this energy source that is broken down into glucose, which the blood brings to all the cells in our body.  Glucose is used for energy; it powers the cells in our body. 

Glucose is an important energy source that helps power our muscles when we are involved in physical activity.  Our muscles use up our store of glycogen (a chain of glucose) when we work out. If athletes do not consume enough carbohydrates, this means that they might not have enough glycogen stored in their body and will likely experience symptoms of fatigue.  Eating the right amount of carbohydrates is a smart choice to prevent glycogen deficiency.

An athlete's performance relies greatly on the types of foods that are eaten several weeks before a competition.  If athletes are smart and monitor their diet to make sure they are receiving the right amount of nutrients, such as carbohydrates, in their diets, then they should have enough glycogen stored in order to engage in physical activity.

Scientists are constantly coming up with new ways to classify and make sense of the many properties of carbohydrates.  In the past, carbohydrates were classified as complex or simple carbohydrates, which referred to the complexity of the sugars.  Complex carbohydrates correspond to food made of 3 of more sugars, and these were once thought to be healthier than simple carbohydrates.  However, this is an oversimplification and the classification only makes sense from a chemical perspective.   For instance, white bread and white potatoes are considered to be complex carbohydrates, however, most people would argue that these are not healthy carbohydrates at all. 

A newer classification system called the glycemic index classifies carbohydrates based on how quickly they raise blood sugars levels in the body, in comparison to pure glucose.  In theory, foods with a low glycemic index, like chick peas, should be digested slower, causing a smaller and softer change in blood sugar.  Foods that receive a score of 70 and above are considered to be high in glycemic index (for instance, French fries), foods that receive a score of 55 of lower are considered to have a low glycemic index (like whole oats).   

Besides needing more research to validate its credibility, the glycemic index does not take into account digestible carbohydrates, which is the amount of carbohydrates that are digested in the upper gastro-intestinal tract, that then enter the blood stream.  Therefore scientists developed another classification system that considers the amount of carbohydrates in food, as well as their effect on blood sugar levels.  This system is called the glycemic load.  The glycemic load can be calculated by multiplying the glycemic index by the amount of carbohydrate contained in the food in question.  This is important, because, for instance, a snickers bar would fall into the category of low glycemic index and it is clearly not a healthy food choice. A healthy food, such as watermelon, is considered to have a high glycemic index. 

Now that we have an adequate background to understand some of the classification systems that scientists are using to evaluate the quality of carbohydrates, it is time to turn to the original question at state, which is the value of carbohydrates.  Many popular diets for the past several years have been treating carbohydrates like they are the plague and the root of all evils.  Studies have found that the Atkins diet which severely restricts carbohydrates, is very effective.  However, when examined more closely, it appears that in some of these studies, the participants did not follow the diets as prescribed and ingested sometimes triple the number of carbohydrates recommended.  A lot of these studies found that what was a better predictor of continued and maintained weight loss, was whether or not participants stuck with their diet, as opposed to what diet they went on.

Currently, health and nutrition experts recommend that between 55-60% of the calories in our daily diet should come from carbohydrates.  Only 30% should come from fats and only 10-15% from protein.  This is all contrary to what the average person believes they should be eating, a diet high in protein with little to no carbohydrates.  It should be noted that these numbers can vary depending on the type of activity an athlete is engaging in and should only be taken as general guidelines.

So what are some good carbohydrates? I recommend eating products that list as one of their first ingredients whole grains or whole oats.  Whole wheat bread is very healthy.  When it comes to rice, it's a good idea to eat brown rice.  For pasta lovers, whole wheat pasta is a good option, or at least pasta that is a combination of half whole wheat and half white flour. Beans are an extremely good source of carbohydrates as well.  What is important is that you are receiving carbohydrates in your diet (between 55-60%) and not restricting it so that you are receiving no or little carbohydrates.  Remember, you can not go wrong with carbohydrates.  Next week I will delve into the subject of hydration, emphasizing fluid intake and output during sport activity.

  

 

 Hydrate your life – Part 1

 

This article is the fifth article in a series of articles on nutrition and will focus on hydration.

All of our lives we are constantly told to stay hydrated.  Living in  Israel, especially, people are very aware of the need to stay hydrated, to constantly be drinking enough water, lest their bodies suffer from dehydration. If the general public is cognizant about this issue, then how much more so do athletes need to be aware of the importance of staying hydrated. 

The human body is composed of 55-70% water (depending on how muscular one is) and when one sweats, fluid is lost, which can lead to dehydration.  Essentially, staying hydrated means maintaining the levels of fluid in the body. Dehydration occurs when one does not drink enough fluids to replenish those lost.  Fluids are crucial for the body to function properly, and while one's body can function for several days without food, it can only last a few days without water.  The body's cells and organs use water to carry out basic operations such as the transport of oxygen and nutrients, removal of toxins and waste materials, controlling heart rate and blood pressure, regulation of body temperature, creation of saliva, lubrication of joints, and other key functions.

Before we can learn about how to stay hydrated, we need to understand how our body becomes dehydrated.  Every day the typical adult will lose approximately 10 cups of water (those who are very active will lose more) through natural processes such as going to the bathroom, sweating or breathing. People eat and drink to replenish these fluids lost, when feeling thirst or hunger.  Many assume that if one does not feel thirsty then he or she must not be dehydrated, this is in fact, a false assumption. Many people who are dehydrated do not experience symptoms of thirst; therefore thirst is not the best indicator of water levels in the body.

When people exercise they lose fluids through sweat.  Interestingly enough, however, we are not always aware that we are sweating, which means that we should be drinking, even if we do not feel that we are sweating.  It is suggested that one weigh oneself before and after physical activity in order to calculate how much fluid was lost. You must of course also make a note of how many litres of fluid you consumed during exercising.

Age also affects how much fluid is lost.  Infants, children, older adults, anyone overweight or obese and women are at a greater risk for dehydration.  The body's ability to store water as a person ages decreases.

Some symptoms of dehydration are irritability, fatigue or weakness, nausea, headaches, dizziness, lightheadedness, dry or sticky mouth, swollen tongue, constipation, dry skin, weight loss, decrease in urination and dark yellow urine.

It is a good idea to always be conscious of how much water one is drinking as to avoid a situation of dehydration. Obviously one needs to drink more than usual when ill, engaging in physical activity or when the weather is extremely hot, this will greatly reduce one's risk of dehydration.

Often one suffering from dehydration (whether mild, moderate or severe) will find it difficult to eat or drink, which means that the fluids lost will not be replenished.  When in this situation there are some tips that can help to rehydrate your body.  It is a good idea to suck on ice cubes, or popsicles, especially when one cannot eat or drink.  Keep a water bottle with you at all times so that you will not have to waste your energy getting up to get more to drink, until you have regained your strength. Instead of drinking large gulps of water at once, it is advised to drink small amounts of water at regular intervals.  It is a good practice to drink a large glass of water before going to bed and before waking up each morning.  One who suffers from diarrhea should choose beverages that contain sodium and potassium in order to aid in the replacements of nutrients lost. With severe dehydration is it strongly recommended to go see your doctor or to go to the hospital.

Next week I will continue the subject of hydration and discuss just how much water we should be drinking.

   

Beyond 8 cups of Water…Part 2

Last week I introduced the subject of hydration.  I discussed how one gets dehydrated and how to prevent this unfortunate situation.  This week I will continue this topic, but focus on staying hydrated.

How much fluid one should be consuming on a daily basis depends on one's lifestyle, in addition to how active one is and the type of physical activity.  It is best to speak with one's doctor as to the specific amount of water one should be consuming.  As always, what is written here is meant to be taken as general guidelines.

The American Dietetic Association recommends that women should be drinking 9 cups of water a day and men should be drinking 13 cups of water a day. People at risk for dehydration should be consuming more cups of water a day than the above recommendations.  For those who do not enjoy the taste of water, it is recommended to drink flavoured water or to add a slice of lemon.  Juices and tea can also help.  There are also several foods that contain high contents of water such as watermelon (92%), lettuce (95%) and broccoli (91%).  Soups are also recommended, as are yoghurt and popsicles.

Sports drinks can also be helpful and there are several different types on the market.  If one has an athletic event that lasts for over 90 minutes, the carbohydrates that are part of sports drinks could be of benefit to the athlete. A sports drink with between 15-18 grams of carbohydrate in every 0.2 litres, is recommended. Higher carbohydrate content can delay the absorption of water, which could lead the athlete down a path of cramps, dehydration, nausea or diarrhea.  It is advised that one experiment with sports drinks before practices and not before an actual competition.

It is never a bad idea to arrive fully hydrated to a competition.  Keep in mind where you are performing the competition and adjust your drinking habits accordingly.  If the athletic event is particularly long, it is a good idea to not just drink before the event, but also during to minimize water loss. It is advisable not to drink more than you will lose during sweating, if you do not want to gain weight during the athletic event. For those interested in measuring their sweating rate, I have included a simple formula to calculate it. 

Step 1:  Measure body weight before and after one hour of exercise.  It is advisable to do this under conditions that will be as identical as possible to those you will be competing under. While weighing yourself, make sure that you are wearing as little clothing as possible and also remove your shoes to avoid adding extra weight and to improve accuracy of measurement. After you finish exercising, towel dry and measure your weight.  It is also good to make a note of how many litres of fluid you consumed during exercising.

Step 2: Plug in your numbers to the following formula:

Sweat loss (litres) = Body weight before exercise (kg) – Body weight after exercise (kg) + fluid consumed during exercise (litres)

If you want to view your sweat rate per hour, all you have to do is divide the exercise time (in minutes) and multiply that number by 60. When you finish exercising, it is very important to rehydrate your body. When you sweat, your body loses not just water, but also salt, and therefore both levels need to be replenished. It is advisable to drink between 1.2-1.5 litres of fluid for each kg of weight that you have lost during exercise.  Make sure that your beverage or food choice after exercise contains sodium. If you lost a lot of sweat during physical activity, you can always add a little extra salt to your meal.  I would not recommend taking salt tablets to replenish the levels of salt in your body.

This concludes the two articles on hydration.  Next week, I will continue our series on nutrition, with a focus on supplements.

 

 

Supplements: Fad or Fiction?

 

This article as well as the next two articles, will discuss the topic of supplements. 

Recently, supplements have taken their place as the newest fad.  People think that they can obtain the exactly same nutrients from supplements that they can by eating the real thing.  As with any new "fad", the question always remains as to whether or not the topic of the day is real, and works, or if it's just a fad that will fade with time.

Obtaining the right amounts of copper, energy, iron, manganese, magnesium, protein, selenium, sodium, vitamins A, B6, B12, C, E, and zinc, is very important for everyday, general health.  One can attain the above nutrients from a rich and balanced diet.  Investing in a diet that is full of vegetables, fruits, beans, legumes, grains, lean meats, fish, dairy products and unsaturated oils will enable one to meet daily nutritional goals.  Most studies have shown that the average athlete is able to meet his or her nutritional goals solely by eating everyday foods.

Supplements (also called ergogenic aids) are products intended to enhance performance and are generally available without a prescription. Vitamins, minerals, amino acids, herbs and botanicals are all examples of types of supplements.

The usage of supplements has become extremely prevalent in sports.  Whether they help athletes on the other hand, is much less clear; separate from how athletes might feel about the "positive" effects of these supplements that could be boiled down to nothing more than placebo effects.  Many of these products are not backed by valid research, and therefore athletes should not expect gains from their usage.  It is even probable that these supplements could be harmful to the athlete and it is therefore advisable for athletes, (and non-athletes) to carefully research supplements, their risks and advantages, before introducing them into one's body.

Often supplements will be marketed as "natural", however, this does not mean that they are safe at all.  For instance, peppermint leaves can be safely used to make tea, but its oil (due to its higher concentration) could end up being toxic if one uses it improperly.  It is important to realize that supplements, like any product, are being marketed to sell, and therefore, advertisers wants to make the product as appealing as possible, which includes making false promises, such as claiming that their product is all natural, has no side effects, will cure all and is completely safe.

Supplements are not meant to be a solution for a poor diet, and athletes must remember that the best source of nutrients comes from the actual foods themselves.  Even when one suffers from a deficiency of a certain vitamin or mineral, it is always better to increase one's intake of foods that are rich in that nutrient.  Supplements might appear helpful, but they are best thought of as a short-term solution, if at all.  Dietary choices are crucial and athletes must be careful not to start popping supplements like candy. Taking supplements when they are not necessary can turn out to be quite harmful for the body, as is taking the wrong dosage.  There is also the issue of possible interactions between medications and supplements, such as the effect  St. John's wort has on depression medication.  One could also end up wasting a lot of money on purchasing supplements that essentially do not help at all.

The next article in this series will continue our discussion on supplements, with a focus on different types of supplements.

 

Just the real thing...

This article will continue our discussion on supplements that was begun in the previous article.

PROTEIN

One of the most popular types of supplements, are protein supplements, high protein bars and amino acids preparations.  As discussed in the second article in this series, protein is one of the body's fuel sources for muscles, during exercise. The amino acids that are found in the protein in our bodies create new tissue, repair existing tissue, and aid in the manufacturing of enzymes and hormones, which are involved in numerous bodily functions, such as metabolism.  Studies have shown that most athletes consume a far greater amount than the recommended daily dose of protein, which completely negates the need for supplementation.  Additionally, whole proteins found in foods are generally more advantageous than taking individual amino acids.

ANTI-OXIDANTS

Anti-oxidants play an important role in defending the body's tissues against the effects of strenuous exercise. The body naturally develops this defensive system, without the use of supplements, as long as one is consuming a balanced diet.  Taking the aforementioned into account, scientists are presently at a loss as to whether or not adding hard training exercises leads to a greater need for dietary antioxidants.  The use of supplements however, is not to be recommended at present time, as the research does not seem to indicate that anti-oxidant supplements provide any benefit for the body.  Some research even suggests that supplementation of this kind, can lead to a reduction in efficiency of the body's natural defense system.

IRON

The most prevalent nutrient deficiency in the world is iron deficiency, and is extremely widespread among athletes. When it occurs in athletes, it can cause impairments in training.  Some symptoms of iron deficiency are: Decreased endurance ability, chronic fatigue and recurring illness, for instance, minor infections.

Iron's importance, stems from the fact that it plays a fundamental role on the delivery and usage of oxygen to muscles during exercise.  Unfortunately, the human body does not generate its own iron; therefore, it must come from an outside source.  The average recommended daily dose of iron, according to a recent paper published in the British Journal of Sports Medicine, is 8mg/day for men and 18 mg/day for women.

Females need to carefully monitor their iron intake, as their menstrual cycle augments their requirements for iron, due to loss of blood and a lower food intake.  It is advised that females eat foods rich in iron, especially during this time of the month, and in general, since women on average, consume less food than men.

It is strongly recommended that anyone who has unexplained fatigue (which as the aforementioned stated, may be a direct result of iron deficiency), especially if he or she is a vegetarian, or vegan, to consult with a sports nutrition expert and a sports physician.  It is not a good idea to start going on supplements before properly investigating the matter.

When it comes to taking iron supplements, it is not advisable to take them.  Often, too much iron can be just as harmful to the body as is too little.  Additionally, giving the body too much iron without properly consulting with a doctor can lead to ignoring the real problem at hand – fatigue.  It is always better to consult with a doctor in order to discover what caused the poor iron status, than to just treat the symptoms.

CALCIUM

Another important nutrient and popular supplement is calcium.  Calcium promotes healthy bones and this fact has led to many countries adding calcium to many everyday foods.  Even so, calcium is obtained usually through dairy foods, including those that are low in fat, which prove to be better sources of calcium.  The average adult needs three servings a day of calcium.  Children and youth need more calcium due to all the growth spurts they experience.   As mentioned above for iron, women also need more calcium during their monthly cycle as well as pregnancy.  Women need to ingest more calcium in general, due to their lower food intake.

 

 

 How to catch the energizer bunny...

 

The market of energy supplements is large and can be quite confusing.  The various types of supplements can be categorized as stimulants (speed up metabolism), calories (the body's fuel) and substances that impact metabolism (how cells obtain energy from nutrients).

While the above categories are all energy supplements, they work in different ways.  Additionally, many supplements will combine and utilize ingredients that correspond to two or all three categories.

STIMULANTS

Caffeine

The most popular and sought after stimulant is caffeine.  There is some evidence that caffeine aids in concentration in the short term. Scientists have discovered that a small dose of caffeine (between 103 mg/kg) can actually be helpful in exercises of a short and long duration.  Since this dose is readily available in coffee, cola, and some sports products (one can obtain 100mg of caffeine by a small cup of brewed coffee, or in a 750ml can of cola), it is absolutely unnecessary to take caffeine supplements.  Contrary to popular belief, larger doses of caffeine have not been found to be more successful in terms of performance.  These doses can even cause one to experience negative side effects such as arousal and difficulty in one's sleeping patterns after a competition.

 

CALORIES

Calories are usually carbohydrates (similar to sugars) that our bodies convert into energy.  They are found in enhanced waters, energy drinks, bars and gels.  Taking these products can lead to adverse outcomes, such as pain and inflammation.  Furthermore, the benefits of spikes in blood sugar diminish very quickly, leaving one feeling tired. People who do not exercise often are especially not advised to consume these products, as they can lead to weight gain, since calories that are not burned are converted into fat.

SUBSTANCES THAT IMPACT METABOLISM

Coenzyme Q10 (CoQ10), vitamins B6, B12, folic acid, thiamine, taurine, creatine, and others, are all examples of nutrients that influence how one's body utilizes the nutrients it receives and how they are converted into energy.  Studies have shown that most people who eat a balanced diet, and receive enough of the aforementioned vitamins and minerals, do not need supplements.  Researchers have noted that no benefit is derived by taking these nutrient supplements, when one is not deficient.  Additionally, no evidence has been found that states an increase in energy.

One who is deficient on the other hand, in CoQ10, carnitine, and vitamin B, might actually benefit from the supplements.  Athletes who push themselves too hard, have a poor diet, or take medications regularly, such as, antibiotics, anti-inflammatory painkillers, or acid-blockers, are likely to be deficient.  In spite of this, one should not self-diagnose oneself with a suspected deficiency and start taking these supplements on one's own.  Always consult with a doctor. 

Creatine

Creatine is manufactured by our bodies and is also naturally found in meat and fish.  It boosts one's amount of energy and can therefore aid in the performance of sprints (single or multiple).  The usage of this supplement can result in gains in muscle mass, which could be advantageous for certain athletes, but unhealthy for others.  The problem with this supplement is that the doses given are more than what is found in normal foods.  Additional benefits are very task-specific and creatine can interfere with natural bodily processes such as sweating (which can lead to the unwanted consequences of cramps, muscle strain and dehydration).  Furthermore, scientists suspect that creatine can reduce athlete performance in long-term physical activity.

Some common side-effects from the usage of creatine supplements include: Weight gain, diarrhea, abdominal pain and muscle cramps.  Those who suffer from kidney problems are cautioned from using these supplements, as there could be possible repercussions in kidney function.

Taking the aforementioned into consideration, it is still unadvisable for people to introduce into their system extra nutrients that can be easily obtained from regular healthy eating, especially if one day scientists do discover adverse effects from build-up of too much creatine.

 

NATURAL ENERGY SOURCES

When one is suffering from fatigue, there are several natural remedies that are very successful in boosting one's energy and should be tried before turning to supplements. 

Sleeping enough is always a good start when one feels that he or she is lacking energy.  The average person needs about 7 to 8 hours a night of sleep.  Taking quick speed naps for about 20-30 minutes can also provide more energy.  It is also important to relax every so often, even if only for a few minutes.  Meditation or slow-breathing exercises can be very helpful.

As stated many times in this series on nutrition, eating right is one of the best sources for energy.  It is good to consume a diet that is rich in fruits, vegetables, whole grains and lean proteins.   It is advisable to eat good fats, such as olive oil (a monounsaturated fat).

Finally, exercise!  Many studies have demonstrated that when once sedentary individuals added exercise to their lifestyles, they more often than not, felt that they have much more energy and generally suffer from much less fatigue. Not everything is as it seems, and exerting yourself more will actually improve your energy level.  I like always, recommend consulting with your doctor about appropriate exercise programmes.

All of the above seems to point to the conclusion that at the present time, there is not enough evidence to recommend taking supplements.  It seems that supplements tend to harm more than they help, and most nutrients can be easily obtained from their natural food sources.