Diploma proposal #2

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Diploma proposal #2

  1. 1. Sodium Bicarbonate: A Role in Collegiate SwimmingAllison KliewerUniversity of the Incarnate WordDecember 5, 2012
  2. 2. Sodium Bicarbonate: A Role in Collegiate SwimmingCompetitive athletes compete and train to the best of their abilities. They have to beable to perform in any condition and at their best in order to excel in a sport. Athletes trying toachieve at the highest level of competition often use ergogenic aids such as creatine, caffeine,and ephedrine to enhance sport performance. An ergogenic aid is defined as “any means ofenhancing energy utilization, including energy production, control, and efficiency” (Silver,2001). Albeit limited, the use of ergogenic aids has been increasing in the collegiate athletepopulation (Dascombe et al, 2010).Sodium bicarbonate (SB), more commonly known as baking soda, has been used foryears. As an ergogenic aid SB is reported to reduce the negative effects of acid build up in thecirculation. The claims made about SB are that it increases endurance, shortens recovery time,and helps increase intensity during exercise. In addition, claims by supplement shops includethat taking SB will increase endurance, intensity with resistance training, help with musclerecovery, and maximize physique and performance impact. Claims for enhanced performancecan be made, whether valid or not, without demonstrated safety and efficacy of a product(ADA, 2009). There are no regulations against the use of SB and is not banned by theInternational Olympic Committee (IOC) or the National Collegiate Athletic Association (NCAA).However, there is conflicting evidence in the literature that the supplement enhancesperformance, as the ergogenic effects of SB have been demonstrated in some types of exerciseand not others. According to the Australian Institute of Sport, sodium bicarbonate is considereda grade A supplement and has been shown to benefit performance in specific situations in sportfollowing a specific protocol (2010).
  3. 3. There is limited research on competitive swimmers even though many swimmers use itand many coaches recommend using it (personal experience). Limitations also lie in researchregarding the motives behind the collegiate swimmers choice to take SB. Conclusive evidenceis needed to determine the role of SB on competitive swimmers (Edge, J., Bishop, D., andGoodman, C. 2006).Extensive research has not been conducted on NCAA swimmers in regards to the use ofSB. The purpose of this study is to assess basic nutrition and supplementation knowledge, andthe use of SB including frequency, perceived benefits, and reasons for use in NCAA swimmers.Literature ReviewA study of use and perceptions of nutrition and supplements was conducted byKarabudak and Ercumen on elite water sport athletes who competed at national, internationaland Olympic levels within Europe (2011). Results show that 72% of athletes take supplements,and believe they are necessary to be successful in sport. The primary purpose for takingsupplements was to provide energy, maintain strength, maintain health, and restore nutrients.The most commonly used supplements by swimmers were multivitamins, multivitamin withminerals, and creatine. The lack of congruence between the reasons and supplements used,shows poor understanding of why the athletes take supplements. Forty-one percent of theathletes claimed an explanation for not seeking further information regarding a specificsupplement was that “the product must be safe since it is a commonly advice.” Results alsoindicate that the belief of supplements as an unavoidable part of competition, and the pressureto take dietary supplements is reflected in the high prevalence of use (Karabudak and Ercumen,
  4. 4. 2011). Fifty-four percent of those who do not take supplements and 78% of those who do takesupplements felt well informed about nutrition and nutrition supplements, however, otherresults showed that 53% of athletes had minimal or no knowledge about the supplements theytook, and only 36% of those who used supplements were aware of the possible contamination.The authors conclude that athletes appear to take supplements with poor understanding ofwhy they take them (Karabudak and Ercumen, 2011).Froiland et al, 2004, conducted a survey on 207 male and female division I athletes. Thesurvey was developed to determine an athlete’s definition of supplement, use and regularity ofsupplements, source of information and recommendations regarding use and reasons forchoosing to use, supplemental frequency of use, personal explanation for use and how itenhances performance or improve health, and demographics. Only 11% reported having neverused supplements and 34% accurately defined supplements by including a positive effect onsport performance, strength, muscle, and recovery in their definition. Of those who used, 86%took supplements for energy. Most information on supplements was obtained from either,family, teammates, strength coach, athletic trainer, registered dietitian (RD), friend or coach.The reasons for use were for health, strength and power, increased energy, and weight andmuscle gain. Thirty-three percent did not consider fluid and calorie replacement products as adietary supplement, and only 37% correctly identified the appropriate function of vitaminswhile 30% thought vitamins provided energy. Therefore, it is evident that athletes do not havea clear or complete understanding of what qualifies as a dietary supplement. It should be notedthe athletic department provided a RD specializing in sports nutrition at no charge to the
  5. 5. athletes. In this study advice given by staff clearly affected the choices of the athletes regardingsupplementation.Lewis, M. surveyed 152 male and female division I athletes of various sports with a 14item questionnaire (2012). Results showed that 51% of those that used nutritional ergogenicaids, and 33% of those who did not, believed supplements are the most effective way to buildmuscle and increase energy (2012). Of the 80% who used nutritional ergogenic supplements,90% reported an experienced benefit.Mechanism of Sodium BicarbonateDuring high-intensity exercise the body is supplied energy via anaerobic glycolysis. Theby-product of anaerobic glycolysis is lactic acid which builds up within the muscle cell, inhibitingenergy production, and resulting in fatigue (Ghaphery, N. A. 1995). The buildup of lactic acideventually will leak out of the muscle cell into the blood (Ghaphery, N. A. 1995). Sodiumbicarbonate is used as a buffering agent in the extracellular environment to improveperformance during continuous short-term high intensity work. Increased extracellularbuffering capacity efficiently buffers diffused hydrogen ions and lactate. This helps to indirectlymaintain intracellular pH because SB cannot diffuse directly into the muscle cells and affectintracellular pH (Ghaphery, N. A. 1995).Preventing a decrease in blood pH via increased buffering capacity has beenhypothesized to provide a delay in fatigue and enhance performance. Fatigue is attributed tolower pH values which inhibit muscular contraction by: inhibiting enzyme activity in keymetabolic pathways (glycolysis, citric acid cycle and electron transport oxidative
  6. 6. phosphorylation), inhibiting the release of calcium ions from the sarcoplasmic reticulum andthe binding of calcium ions to the protein troponin reducing the rate of cross bridge cycling. Italso impairs the rate of depolarization of the muscle membrane and propagation of the neuralimpulse initiated at the motor end plate (Requena et al, 2005).Intra and extracellular buffer systems act to reduce buildup of hydrogen ions bypreventing a large drop in pH during intense muscle contractions (Edge, J., Bishop, D., andGoodman, C. 2006). Sodium bicarbonate ingestion acts as a buffering agent and is thought toimprove performance in short term anaerobic exercise by reducing the accumulation ofhydrogen ions in skeletal muscle, interstitium, and blood (Edge, J., Bishop, D., and Goodman, C.2006). Sodium bicarbonate facilitates efflux of hydrogen ions and lactic acid from cells andreportedly increases the rate of ATP production. (Raymer, G., Marsh, G., Kowalchuk, T., andThompson, R. 2004). Edge et al. found SB ingestion leads to a greater lactate threshold, meanpower, and short term endurance (2006).ProblemOnly two studies have been conducted on swimmers as seen in Tabe 1. Of the studieson sodium bicarbonate, and the limited research with collegiate swimmers, no quantitativestudy has been conducted researching the relationship between attitudes, beliefs, nutritionknowledge and the usage of SB. Little published data specifically describes the dietary andpsychological profiles of NCAA swimmers. Scientific studies have thoroughly explored theergogenic mechanism of SB and the performance results in various sports other thanswimming, but less is known concerning swimmers’ attitudes toward integrating nutritional
  7. 7. practices, or SB, into his or her training/competition regimen and whether or not the athletebelieves this area to be beneficial to training/competing.
  8. 8. Table 1: Studies that use swimmers as subjects and explore relationship of sodium bicarbonate with swim performance, which lacksubjective data.Article Subject Age Anthropometrics Training Regimen NaHCO Dose Method VariablesMeasuredGI TolerabilityZajac, et al. 8 maletrainedcompetitiveyouthswimmerspostpuberty15.1 ±0.4yearsbody mass 56.1 ±1.2 kg, height1.66 ± 0.03 m,trainingexperience 6.6 ±0.6 yearsSwimmers trainedapproximately 25h per week,including 2.5 h ofstrength trainingon landAverage volumeof swim trainingequaled 69.5 kmper week300 mg. kg BMNaHCOdissolved in 500mlsolutionFluid was ingestedover 15 in period, 90min before start ofthe test trialEach subjectcompleted twotest trials of4x50m freestyleswims with 1min passive restbetween eachsprintBlood PhSBBELactateNot ReportedLindh, et al. 9 male elite-standardswimmers3- worldranked top 52- worldranked top 304- top 8nationally20.4 ±1.7180.5 ± 5.1 cm76.1 ± 4.0 kgRegular trainingregimenaverage 10 x 2.5hours pool-basedsessions per weekaverage 3 x 1.5hours land-basedsessions per week300 mg. kg BMNaHCOsupplementationwas consumed overa 30 min periodcommencing 90 minprior to the start ofthe performancewith water taken adlibitumMaximal effort200 m freestyleswim on 3separateoccasionsstandardizedwarm up(2000m -30 minduration)10 min postwarm upswimmerscompeted in200 m trialpH valuesBloodbicarbonateBase excessLactateNot Reported
  9. 9. MethodologyA group interview method will be used to administer the survey as a questionnaire. Thequestionnaire will be developed by the researcher to evaluate the swimmers preexistingnutrition and supplementation knowledge level, perceptions, beliefs, attitudes and utilizationpractices of SB. The swimmers taking part in the study are elite swimmers trainingapproximately 20 hours a week and have been cleared to participate in intense physical activityvia institutional sports physicals. They have a routine practice six days a week in which allswimmers participate. The swimmers cover approximately 55km to 60 km per week. Thesubjects are a sub-population of NCAA swimmers.Subjects must be at least 18 years or older. Subjects will not be identified and datacollection will be kept confidential. Documentation will be stored in a file cabinet in the closetof room 316 in the Bonilla Science Hall, in a locked room that only faculty have access to. Takingpart of the survey will in no way hinder the swimmers athletic or academic relationship with theUniversity of the Incarnate Word. No action will be taken if there are reports of illegal orbanned supplementation use. Subjects are at limited risk due to the nature of the study.Data CollectionThe head swim coach will be contacted prior to recruitment to obtain permission toconduct the survey with the swimmers. Subjects will be recruited via email and by word ofmouth by the head swim coach. A date will be set with the swim team at earliest convenienceand the downstairs classroom will be reserved for the date of the questionnaire administration.At the beginning of the swimmers normal practice time, the questionnaire will be administered
  10. 10. in the presence of the researcher. Swimmers will agree to participate by signing the IRBapproved consent form. Coaches will be asked to leave the room, in avoidance of any possiblebias from their presence. The researcher will give an introduction, explanation, and benefits ofthe survey followed by instructions and distribution of questionnaire. While in the classroomthe swimmers will be asked not to share answers, answer honestly, and remain silent unlessthey have questions in which they will raise their hand, and personal attention will be given.QuestionnaireThe questionnaire used was developed based on the research question and objectives.Important information required was decided with a target population defined. A groupinterview was determined to be the best method for data collection with this population.Content of questions were divided into three domains: nutrition and supplementationknowledge, SB knowledge and usage, and attitudes, beliefs, and influences of nutrition andsupplementation. Wording of questions and answer choices were articulated so that thesubject would be able to offer accurate answers. Multiple choice, numeric open-ended, textopen-ended, and agreement scale are included as answer choices. To reduce possiblehabituation, same answer choices are limited and changes in positive answers choices weremade (Appendix A). Questions pertaining specifically to swimmers were used to maintaininterest. The order and format of questions provide easy and less personal questions early andthe more difficult and open ended questions later. Related questions were randomized andseparated in order to reduce the possibility of associations made by the subject through otherquestions. Qualities of the questionnaire followed that of M. Crawford’s Marketing Research
  11. 11. and Information Systems (1997). Concepts associated with misconceptions or attitudestowards supplements and SB were identified through review of peer reviewed research articlesand based on personal experience as and with college athletes.Field StudyA field study was given to nutrition graduate students, registered dietitians, andprevious NCAA swimmers. The purpose of the field study is to determine if the questionsachieved desired results, are placed in the best order, easily understood, and is not misleadingto the subject, allowing for additional or elimination of specific questions or instruction. Thefield study included eight, what will be referred to as experts in the field. Of the eight, threeBA’s were held, one registered dietitian, two BS’s in dietetics, BS in business, BS in nutrition, BSin nutritional sciences, and a M Ed in Kinesiology. Combined they had 16 years experience as aNCAA swimmer, 14 years experience in nutrition, and 2 years in another NCAA sport field.Feedback from study was encouraged and changes were made accordingly. The expertsvalidated the questionnaire. It took an average time of 13 minutes to complete the survey.ResultsStatistical Package for the Social Sciences (SPSS) will be used for data analysis in theform of descriptive statistics for all variables, including demographic information to determineuse of SB and knowledge base scores. Univariate analysis and central tendencies will bedetermined and presented as frequency distribution on a univariate frequency table.
  12. 12. It is of interest of the researcher to identify: basic sport nutrition knowledge, basicknowledge of supplements, knowledge of SB as an ergogenic aid, perceived mechanism ofaction for SB, ethics pertaining to supplemental use, perceived demand of sport, sources ofnutritional and supplement knowledge, and a detailed usage of SB in NCAA swimmers.HypothesisA relationship between perceived demand of sport, sex, ethics pertaining to supplementuse, and the use of SB is expected. Basic nutrition and supplementation knowledge is expectedto be average.SignificanceThis study may benefit the expansion of current literature on the application ofnutrition-related practices in collegiate swimmers.
  13. 13. ReferencesAustralian Sports Commission. (2010). Supplements and sports foods. In Burke & Deakin (Eds.),Clinical Sports Nutrition (5thed.). Sydney: McGraw Hill.Crawford, M. (1997). Questionnaire design. Marketing Research and Information Systems.Rome: Food and Agriculture Organization of the United Nations.Dascombe, B., Karunaratna, M., Cartoon, J., Fergie, B., & Goodman, C. (2010) Nutritionalsupplementation habits and perceptions of elite athletes within a state-based sportinginstitute. Journal of Science and Medicine in Sport. 13(2): 274-280.Edge, J., Bishop, D., & Goodman, C. (2006). Effects of chronic NaHCO ingestion during intervaltraining on changes to muscle buffer capacity, metabolism, and short-term enduranceperformance. Journal of Applied Physiology. 101: 918-925.dio:10.1152/japplphysiol.01534.2005.Froiland, K., Koszewski, W., Hingst. J. & Kopecky, L. (2004). Nutritional supplement use amongcollege athletes and their sources of information. International Journal of SportNutrition and Exercise Metabolism. 14: 104-120.Ghaphery, N. A. (1995) Performance enhancing drugs. Orthopedic Clinics of North America. 26(3): 438-439.Karabudak, E. & Ercumen, S. (2011). Water sports athletes and nutritional supplements: A studyof use and perceptions. Scientific Research and Essays. 6(2): 4839-4847.
  14. 14. Lewis, M., (2012). Evaluation of knowledge beliefs and use of nutritional ergogenic aids amongcollegiate athletes. Master’s Theses. paper 835.Lindh, A., Peyrebrune, M., Ingham, S., Bailey, D., & Folland, J. (2008). Sodium bicarbonateimproves swimming performance. International Journal of Sports Medicine. 29: 519-523.Raymer, G., Marsh, G., Kowalchuk, T., & Thompson, R. (2004). Etabolic effects of inducedalkalosis during progressive forearm exercise to fatigue. Journal of Applied Physiology.96: 2050-2056. doi:10.1152/japplphysoiol.01261.2003.Requena, B., Zabala, M., Padial, P. & Feriche, B. (2005). Sodium bicarbonate and sodium citrate:Ergogenic aids? Journal of Strength and Conditioning Research. 19(1): 213-224.Zajac, A., Cholewa, J., Poprzecki, S Waskiewicz,Z., & Langfort, J. (2009). Effects of sodiumbicarbonate ingestion on swim Performance in youth athletes. Journal of Sports Scienceand Medicine. 8:45-50.(2009). Position of the American Dietetic Association, Dietitians of Canada, and the AmericanCollege of Sports Medicine: Nutrition and athletic performance. Journal of the AmericanDietetic Association. Doi:10.1016/j.jada.2009.01.005.
  15. 15. Appendix AQuestionnaire

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