Blood, sweat and fears... Part V

Storms make us stronger, Bear Grylls

To supplement, or not...

Given my recovery is taking far longer than I'd ever anticipated I thought I would continue the theme of sharing tips and nuggets of information that either I've come across, found useful, researched or where I've at last started to implement my professional skills on myself. Yep, you know that well known phrase 'do as I say, not as I do'? Well, I'm as guilty as the next person of looking after everyone else and dishing out helpful advice when actually I should be taking my own advice! Did I hear some of you say at long last?!

I'd like to have a brief delve into nutrition and supplementation... A contentious subject at the best of times but also a really interesting and important one. Not least because we all eat food so therefore we are all experts, uh hm! I came across this nice little infographic, below, a while ago and although I would add 'Performance Nutritionist' alongside 'Dietician' (if not substitute where sports nutrition is concerned) it sums up the issue really nicely. If you wanted professional advice or assistance on almost another other issue you would seek out the appropriately qualified 'expert', however it comes to nutrition and it seems that we mostly take leave of our senses. 'My friend says', 'that magazine article', 'the Sunday supplement reported' and so on. Unsurprisingly, along the way the right information gets lost or diluted. Don't get me wrong there's a place for anecdotal reporting and supporting others through shared experiences but it's always best to check with the right sources first. Anyway, the purpose of this post isn't to have a bit of a grumble about all of the poor information out there, it's to share some useful information to consider in times of illness or injury.

The convoluted path that people take for nutrition advice

As athletes and in particular cyclists, weight is never far from our minds - the better our power to weight ratio the faster we will be... However in times of injury or illness weight is often pushed even more to the forefront of our minds given the main device for weight maintenance - exercise - might be limited or totally off limits. You might feel that there is a need to restrict what you are eating, particularly carbohydrates*, count calories, change your food habits etc in a bid not to lose the athletic physique that you've worked so hard for. However, whilst it's important to be mindful of your diet overall, you probably don't need the added stress of something else to worry about. The most important thing is to ensure that you are giving your body as many nutrients as it requires to heal, so at its simplest don't underestimate the 'eat a rainbow' a day message.

*It's really important not to completely relegate carbohydrates from your diet. Carbs are often seen as the enemy and are the first nutrient to be reduced or removed from the diet during a period of injury or reduced training in fear of gaining body fat. However, this is actually counterintuitive as chronic energy restriction and/or energy deficit can inhibit the bone remodelling process - potentially increasing the period of injury time. This isn't to say that tracking diet and weight isn't important, especially in long term injuries when training might be disrupted for many weeks or months, just that it should be carefully managed. The body needs the right fuel for the work required, so perhaps eating good quality carbohydrate sources would be better than a surplus of lower quality foods (yep sadly that's the biscuits, cakes etc).

A rainbow a day will provide a diverse range of nutrients

I am very much an advocate of a food first approach and by that I mean if you can fill your diet with as many different sources of energy and nutrients before you consider supplementing then you are likely to be better off. A simple rule that I like to use is that if there is an ingredient on the packet that you've never heard of or can't pronounce then the likelihood is that your body won't be able to process it. If you just can't be bothered to eat fruit or vegetables on a regular basis then supplementing  Multi-vitamins isn't going to help you! Equally if you are supplementing with x, y and z because your teammate does then this isn't really an appropriate rationale either. Half of the reason that nutrition is so complicated is that we are all different, have different needs and respond in different ways.

There is an excellent quote from Professor Ron Maughan on supplements:

"If it works it is probably banned and if it isn't banned it probably doesn't work!"

This is a pretty good place in which to start considering supplements, so it's always best to err on the side of caution/cynicism in this area. However, there are occasions where there is evidence for efficacy and supplements can be a useful addition - both to athletes in our diet and nutritionists in our toolkit. 

For me this mainly falls in to two areas - 

• To correct a deficiency (Vitamin D or Iron status)
• To prevent illness (pre/pro biotics)

However, before I go any further, there is one logo that you always need to be mindful of if you are competing at any level:

Things to consider when you are injured

Vitamin D3
Living in the UK we are unlikely to see adequate sunshine through the bulk of the Winter months and as cyclists most likely do not do a huge amount of weight bearing exercise. The absolute way of qualifying this on an individual level is to have frequent blood tests (baseline - supplementation - follow up). Or, you could consider a good quality Vit D3 supplement (1,000 iu or 4,000 iu depending on your starting levels) as a precaution. The recommended dose for athletes is at the higher end of the scale.

Calcium
This can be consumed in the diet from dairy products and dark green leafy vegetables. However, if your injury involves a broken bone for example, the body is trying to remodel this in addition to normal bone turnover. It might be wise to consider a calcium supplement in this instance - depending on how rich your diet already is in calcium.

Collagen
Research shows that collagen can support bone, tendon and ligament remodelling by increasing the availability of collagens within the body. There are no known negative side effects if you wanted to consider this. Recommended dose: 15mg per day (ideally 1 hour before high intensity exercise, but if your athlete is injured and not taking part in high intensity exercise then any time of day will be fine).

Vitamin C
This can support collagen formation. Consuming foods such as dark green leafy vegetables, kiwi fruit, melon, pineapple, bell peppers, sprouts etc is likely to be beneficial. If the diet is lacking in Vitamin C then a fallback could be to supplement at 1 - 2 grams per day. Remember, food first though!

I have no allegiance or declaration of sponsorship from Healthspan but their elite range of supplements are reasonably priced, contain what you need (rather than a load of baking agents) and importantly are batch tested and Informed Sport trusted. As time has gone on, even with a mostly well balanced diet, I have been supplementing Vit D3 and collagen alongside a balanced diet to try and support my body to heal.

If you are unsure please consult an appropriately qualified professional (not your mates, unless they are suitably qualified!) Sadly, many GPs may not be able to give appropriate advice to highly trained athletes in this area, you are likely better consulting an experienced Performance Nutritionist working in your field.