Chris G. Koutures, MD, FAAP Pediatric and sports medicine specialist

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Proud physician:
USA Volleyball Mens/Womens National Teams
CS Fullerton Intercollegiate Athletics
Chapman University Dance Department
Orange Lutheran High School

Co-Author of Acclaimed Textbook

Pediatric Sports Medicine: Essentials for Office Evaluation

Orange County Physician Of Excellence, 2015 and 2016

 

Filtering by Tag: creatine

Top Nutrition Concerns Seen in Adolescent Sports Medicine

Trying to figure if your young athlete needs iron to boost performance?

Uncertain if water or sports drinks would be be the best choice for the next practice or game?

Looking for healthy post-game snacks that will assist in muscle recovery?

Hearing a lot about protein and creatine supplements but not sure if adolescent athletes should use them?

You've come to the right place for practical answers to these and many other nutrition questions that I regularly hear in my sports medicine practice.

In appreciation of CHOC Children's Hospital inviting me to speak on Top Sports Nutrition Concerns Seen in Adolescent Sports Medicine first at their RDs in Practice – Pediatric Sports Nutrition conference and following up with a Pediatric Grand Rounds on the same subject,  figured I would compile a list of past blog posts that will form the backbone of those presentations.

Click on the above links to view the relevant post.

Eager to hear of any additional nutrition or other sports medicine based questions- will offer initial responses via email but always available for office consultations and more in-depth recommendations

5 Sensible Tips Guiding Nutrition and Recovery After Exercise

For centuries, athletes have searched for any substance or technique that could enhance exercise and allow for more effective weight gain/loss or increases in strength and endurance. Many available performance enhancing products may report claims of potential amazing efficacy but use of them can be clouded by concerns over true scientific support, side effects, and financial cost.

Here are 5 sensible tips to guide you on nutrition and recovery with your exercise program:

1.       The Importance of Sleep

Can’t begin to tell you how sleep deprivation can derail even the best constructed exercise program, as skeletal muscle needs adequate recovery time to rebuild damaged fibers and to increase the working capabilities of contractile units. Multiple studies support the efficacy of a minimum of 8-9 hours of sleep a day to foster such recovery. Insufficient sleep can also reduce mental alertness on the job or at school and has also been associated with statistically higher risk of illness or injury.  Establish a regular bedtime and not allow deviation of more than ½ hour and also encourage daytime naps of under one hour per day which have been shown to be restorative, add to the cumulative daily sleep amount, and not adversely affect nighttime sleep patterns.

·         TIP TO ASSIST WITH SLEEP: Stop any type of screen device use no later than one hour before bedtime, and do not have screen devices in the sleep area, as use right before bedtime or alerts/temptation to check during sleep have been associated with reduced amount and quality of sleep.

2.       The Timing and Amount of Protein

Protein is the building block of skeletal muscle and is needed to assist in that reparative and rebuilding process after exercise. Good data suggests that the best time for workout-related protein intake is within 30 minutes after completing exercise. A post workout protein amount of 25-30 grams along with a total daily intake of 0.5-0.7 mg protein/pound of body weight are both solid recommendations. I have always favored dairy or meat/bean/egg sources of protein as readily available products that confer well-absorbed collateral benefits of calcium, Vitamin D, and iron. Amino Acids are the building blocks of proteins, and intake of specific individual amino acids has been touted for both weight loss and strength building. However, there is a lack of rigorous support for high amounts of individual amino acids, so stick with whole food protein sources.

·         TIP TO ASSIST WITH PROTEIN INTAKE: 8-12 ounces of chocolate milk within 30 minutes of exercise is a sensible recovery drink that has a ratio of carbohydrate to protein that allows enhanced transport of protein to recovering muscles. Other good post workout food-based protein sources include Greek yogurt and peanut butter.

3.       What About Creatine?

Creatine is a natural substance that assists with regeneration of short-acting energy sources that fuel contraction in working skeletal muscle. Increased amounts of creatine in working muscles can potentially contribute to more intense workouts and also assist in muscle recovery after workouts. Powdered and liquid creatine supplement products have been studied, with trials that include higher loading doses for the first few days, followed by lower daily maintenance doses and other regimens that include medium daily doses without any higher loading amount. Positive results have included increased speed and ability to complete multiple short-burst activities such as 80-100 yard sprints. Possible side-effects include water retention, bloating, muscle cramping, and potential kidney injury (currently only reported with individuals that had pre-existing kidney concerns).  Anecdotally, many athletes using creatine have reported enhanced recovery with increased ability to work harder in subsequent workouts, and documented strength increases support increased muscle size not being simply due to water retention, but to increased contractile abilities.  Take note that many United States-based sports medicine advisory organizations do not endorse creatine supplementation in children under 18 years of age.

·         TIPS ON CREATINE USE: Creatine monohydrate in either liquid or powder format has been the best studied form of creatine. If using any supplement, ensure that you are getting exactly what is on the container and not any additional substances (see below). Reductions in creatine dose have been shown to assist with bloating, cramping or extreme water retention. Good food sources of creatine include wild game meats or wild-caught fish which also have those collateral benefits of protein, calcium and iron. Domestic meats and fish (especially free-range meats) still have reasonable amounts of creatine.

4.       Are Pre-Workout Supplements Safe and Efficacious?

Advertised preworkout supplements or “energy drinks” report to enhance athletic performance and routinely contain multiple components such as caffeine and taurine. While a few small studies support the performance enhancement of stand-alone agents, published data on combination products is scant, inconclusive, or confusing.  Safety concerns exist with use of products that have cross reactivity of multiple agents or larger than studied amounts of a certain product.

·         TIPS ON PREWORKOUT SUPPLEMENTS: Read labels! If using any preworkout supplement in addition to usual daily caffeinated beverage of choice, you might be getting an enormous caffeine load with possible dangers that outweigh possible benefits to your workout.

5.       What’s the Lowdown on other Supplements?

Use of a vast array of pre and post-workout supplement products has been touted to enhance athletic performance and exercise capabilities. Many of these products will work- no doubt about it, - however the gross majority of products do not have any rigorous practical scientific result to support clams and there is a tangible risk of adverse consequences from both known and potentially unreported elements in supplement products.  What is on the label of many products is not the same as what is in the actual container. Personal experience along with results found by national sport organizations have found a significant number of supplements that have additional, unreported elements that are potentially dangerous and might be banned for sporting competition. While most of you are not subject to drug testing for performance-enhancing agents, suffering real and possibly long-term health consequences is not worth the short-term gains in strength and endurance.