Azimah Ahmad - Role of a dietitian for paralympic athletes
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Azimah Ahmad - Role of a dietitian for paralympic athletes

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    Azimah Ahmad - Role of a dietitian for paralympic athletes Azimah Ahmad - Role of a dietitian for paralympic athletes Presentation Transcript

    • ROLE OF A DIETITIAN FOR PARALYMPIC ATHLETES Azimah Ahmad National Sports Institute of Malaysia MDA2013
    • INTRODUCTION • The sports involved persons with physical disability has increased dramatically and become more competitive. • Those who excel in Paralympics Games like Olympic Para Games, Asian Para Games had brought up the same glory for the country • Physical differences in disabled athletes may lead to serious health problems and increase the risk of injuries. • Therefore, suggested proper nutrition may be a key component in preventing many healthy problems specific to athletes with disability
    • HISTORY IN MALAYSIA • Paralympic sport was started in 1970’s in Malaysia. • The early sports were basketball, table tennis, badminton, darts and carom • Now days, Malaysia paralympians are competing in more than 20 sports
    • • Able-bodied sports in Malaysia have gained certain recognition with current achievement in international competition such as badminton , cycling , diving etc • However, paralympic situation in Malaysia still remains unclear to most even their achievement is comparable to able-bodied sports
    • ACHIEVEMENT • Hasihin Sanawi- Wheelchaire archery W1/W2 – Silver: Palympic London 2012 • Mohd Ziyad Zolkefli- Shortput F20 – Bronze: Paralympic London 2012
    • • Siow Lee Chan – Silver Paralympic 2008, Beijing
    • ACHIEVEMENT Medal Name Games Sport Event Bronze Perumal Mariappan 1988 Seoul Weightlifting Men's 57 kg Silver Cheok Kon Fatt 1992 Barcelona Weightlifting Men's 52 kg Bronze Mohamad Khasseri Othman 1992 Barcelona Athletic Men's High Jump B2 Bronze Perumal Mariappan 1992 Barcelona Weightlifting Men's 60 kg
    • CHALLENGES? • Type of disabilities – Blind, wheelchair, amputate, CP etc • Illness/diseases • Background of family – Stay with family or • Education background – Ability to received information given • Years of disabilities
    • SERVICES EDUCATION TRAINING PROGRAM & ADAPTATION WEIGHT MANAGEMENT THERAPEUTIC DIET
    • IMPORTANCE OF EDUCATION • Nutrition Knowledge & Attitude in Athletes with Physical Disabilities Ratmanesh et al; 2007J Athl Train. 2007 Jan- Mar; 42(1): 99–105
    • • To compare the nutritional knowledge and attitudes of Iranian athletes with physical disabilities (APDs) after nutrition education Objective • Seventy-two APDs (42 APDs in the intervention group and 30 age-matched and sex-matched control APDs) and 10 coaches completed the study) Subject • IG;3hrs education with education tools • CG received nothingIntervention • 2 times qualitative and quantitative questionnaire; 30 days apart before and after • 88 Likert scale and true-false questions • 18 open-ended questions • 13 of which were specifically designed for APDs. • Each APD completed two 3-day food records. Method
    • RESULTS & CONCLUSION RESULTS: • The APDs in the intervention group scored significantly higher after nutrition education and higher than the control group on the knowledge subscales and interest in nutrition. • Although the nutrition knowledge score in this study was moderate, several specific areas of deficient nutritional knowledge were identified that are critical for the health of APDs Conclusions: • Findings suggest that Iranian APDs lack nutritional knowledge in areas critical to preventing nutrition related health problems, especially components related to nutrition
    • Nutrition Knowledge & Practice Of Malaysian Paralympic Elite Athletes (Poster presentation) Objective • To understand the nutrition knowledge and practice among paralympic athletes Subjects • 44 elite paralympic athletes Instrumentation • Demographic • 25 questions knowledge of nutrition and sports nutrition • 12 questions to assess the nutrition practices (Cupisti et al, 2002)
    • Male •The highest among powerlifters (mean 52.2 ± 21.4mm) •The lowest was wheelchair fencing (mean = 19.3 ± 6.7mm) Female •The highest among powerlifters (mean = 56.8 ± 25.5mm) • The lowest among wheelchair tennis Wheelchair Male •The highest among sailing (mean = 99.4 ± 65.8mm) •The lowest among swimming athletes (mean = 48.7 ± 19.2mm Female •Not much different; the highest (mean = 119.3 ± 56.4mm) and the lowest (mean = 115.6 ± 22.9mm) Non- wheelchair
    • RASIONAL • Body composition profiling can help sports scientists to monitor their training program and performance accordingly and manage their weight to optimize the power to weight ratio for their respective sports.
    • CASE STUDY 1 • Male wheelchair athletes • Athletic :throwers • Kidney failure due to motorcycle accident • 2008 : haemodialysis with one kidney dysfunction • 2010 : haemodialysis with both kidney dysfunction
    • ANTHROPOMETRIC & BIOCHEMICAL DATA Parameters May 2012 June 2012 Body weight (kg) 58 60.1 Triceps (mm) 5.2 (10-15th) 4.8 (10-15th) Subscapula (mm) 6.3 6.6 Biceps (mm) 3.9 4.4 Abdominal (mm) 7.7 7.9 Arm relax (cm) 34 (>95th) 33.7 (>95th) Arm flex (cm) 36.9 36.7 Sodium (135-145 mmol/L) 133 130 Potassium (3.5-5.0 mmol/L) 5.6 5.2 Urea (1.7 – 8.3mmo/L) 12.8 10.8 Creatinine (64-122umol/l) 531 453 Uric acid (M= 202-417umol/l) 323 320
    • WHAT BEEN PRESCRIBE? • Eat inside athletes café • Energy requirement ~1995 kcal • Protein requirement – Dialysis 1.3 g/kg/bw/day – Strength athlete 1.0-1.2 g/kg bw/day – Therefore : 1.2 g/kg bw/day • CHO= 6g/kg bw/day • Glucose polymer module • Sports drink : carbohydrate beverages • Protein supplementation: whey protein after training
    • CASE STUDY 2 • Wheelchair power lifting female athletes • Body weight management due to weight category (below 56 kg) • Very motivated • Able to control her diet • Cook by herself at home
    • BODY COMPOSITION ASSESSMENT Parameter May 2008 Aug 2008 Body weight 58.5 56.5 % body fat (Bodpod) 54.6 44.4 Fat mass (kg) 31.9 25.1 Muscle mass (kg) 29.6 31.4
    • WHAT BEEN PRESCRIBE? • Menu plan hand over to café staff • Low fat diet • CHO -5g/kg bw/day • Protein – 1.2g/kg bw/day • No sports drink during training • Food choices e.g: wholemeal bun vs croissant • Increase fiber intake • Cooking method; protein sources
    • CASE STUDY 3 • Wheelchair archery (compound) male athletes • Chronic pressure sore – Went for surgery once. – New pressure sore at different place • Pressure sore was infected before world ranking paralympic archery competition (Bangkok) and recovered • Due to hot weather, dehydrate and long hour of sitting, his sore re-infected • Fever till 39 ⁰C. Sent to hospital, IV antibiotic. no fever after 2 days. Back to Malaysia • Was advised to go for surgery and referred to HUKM
    • WHAT BEEN PRESCRIBE? • High protein- 1.0-1.5 g/kg bw • Adequate water- 1000 ml vs 2000 ml • Vitamin C food sources • Zink food sources
    • ACKNOWLEDGEMENT • Mr Goh Kok Wei • Miss Noorfadzlina Abd Rashad • Miss Ivy Loke Wai Theng • Mr Qusyairi Ajmain