Nutritional Preparation of Athletes: What Makes Sense?

Abstract

With the increased public awareness of fitness and participation in athletics, the primary care physician needs a basic understanding of nutrition's role in athletics. Energy metabolism shifts from anaerobic glycogen metabolism to aerobic free fatty acid and then glycogen metabolism as intensity and duration of exercise increases. Body glycogen stores are, therefore, important to maximum performance and can be manipulated to some degree with appropriate diet. Protein, vitamin, and other dietary supplements have not been demonstrated to effect performance.

Good day-to-day nutrition has greater impact on athletic performance than the pregame meal, but, four hours precompetition, a moderate meal high in complex carbohydrates should be eaten. High carbohydrate meals should be continued after competition to replace glycogen stores. Fluid intake, particularly water and juices, should be increased for the hours before the competition and, in endurance events, at 20-minute intervals during the competition, since absorption is rate-limited. Postcompetitive fluid replacement should be enough to replenish body weight.

“Value of Lymph Node Biopsy in Unexplained Lymphadenopathy in Homosexual Men,” RUSSELL K. BYRNES, et al. The acquired immune deficiency syndrome (AIDS) manifested by severe opportunistic infections, Kaposi's sarcoma, or lymphoma often has a prodrome of lymphadenopathy accompanied by constitutional symptoms. We studied the histopathologic findings of lymph node biopsy specimens and peripheral blood immunologic parameters of 24 clinically indistinguishable homosexual men with chronic generalized lymphadenopathy. Two different morphological patterns were observed: (1) lymph nodes with follicular and paracortical hyperplasia in 21 patients who had had no clinical deterioration and (2) an atypical pattern of lymphoid proliferation in three patients who experienced rapid development of non-Hodgkin's lymphoma and/or opportunistic infections. Several immunologic laboratory results paralleled these changes. Lymph node morphological findings seem to be a useful predictor of outcome in homosexual men with generalized lymphadenopathy. (Journal of the American Medical Association 1983;250:1313–1317.)

“Long-term Diazepam Therapy and Clinical Outcome,” KARL RICKELS, et al. This double-blind study involved the continuous (six to 22 weeks) treatment of 180 chronically anxious outpatients with diazepam, 15 to 40 mg/day. Our findings indicate that a significant number of patients benefit from prolonged diazepam treatment and that tolerance to the anxiolytic effect of diazepam does not develop during a 22-week study period. The duration of continual treatment with sedative-benzodiazepines was clearly the most important determinant of withdrawal reactions. Patients treated continuously for less than eight months with sedative-benzodiazepines had an incidence of withdrawal of 5%, whereas 43% of patients treated for eight months or more demonstrated clear withdrawal reactions. While these withdrawal reactions produced considerable distress, they were neither life threatening nor incapacitating and did not include convulsions or psychotic reactions. In all cases, withdrawal reactions could be readily managed by gradually tapering the dose of the benzodiazepine. (Journal of the American Medical Association 1983;250:767–771.)