Nutritional Guidelines for Sportspersons Geetanjali Bhide, Subhadra Mandalika
Page numbers followed by f refer to figure and t refer to table.
Acid base balance 91, 153
Adenosine triphosphate 21, 24, 132
cells 80
tissue 79
Aesthetic sport 254
athletes 255
Alanine 89
glucose cycle 28, 29, 29f
Aldosterone 159
Amenorrhea 256
American College of Sports Medicine 12
American College of Sports Nutrition 103
Amino acids 89, 89t, 168, 270
biosynthesis of 91
combination of 107
limiting 90
nonessential 89t
oxidation of 35f
score 90
synthesis of nonessential 92
Amylopectin 57
Amylose 57
Anaerobic system 24
Annual plan, divisions of 179f
athletica 255
nervosa 255
Anthocyanins 137
Anthropometrical methods 43
defense system 135
nutrients 134, 136
supplementation 141
Arginine 89, 107
Ascorbic acid 111, 112, 138
Ashwagandha 303
Asmita's usual diet on typical training day 244
Asparagine 89
Aspartic acid 89
Atherosclerosis 107
Athletes 163
body composition of 250
calcium requirement of 131
endurance 199
health and performance of 159
ketogenic diet for 85
performance of 258
physical performance of 254
physique and body composition of 48
strength and power 212t, 219
Athletic population, body fat percentage of 47t
Australian Institute of Sport 268
Badminton 234
two-month competition calendar for 240t
Baking soda 296
Balanced diet 16
Basketball 221
Batting field sports 219
Beta-alanine 200, 230, 261, 290, 291
Beta-carotene 144
Bicarbonate 154, 229
buffer system 297f
loading 297
Bioelectrical impedance analysis 43, 44, 163, 164
Biotin 17, 111, 112, 121
formation 123
indices 163
volume, maintenance of 153
carbohydrate store 58
composition 40, 253, 259
assessment of 42
fat 47
percentage 42t
composition 41
index 43
physique 41
muscle 46
protein turnover 91
temperature, regulation of 153
weight 8, 160, 163, 164, 180, 187, 272
calcium stores 129
formation 129f
health 8, 128
loss 108, 257
mass 48
peak 131
metabolism 129
mineral density 129
Borg's scale of perceived exertion modified 12t
Boron 145
Bovine colostrum, composition of 298t
Boxers and wrestlers, body composition of 251t
Boxing 248
Boyle's law 46
Brain-derived neurotropic factor 9
Branched chain amino acids 89, 118, 243, 275
metabolism of 96f
Bulimia nervosa 255
Buoyancy 48
Caffeine 168, 200, 229, 243, 261, 281283
Calcium 17, 115, 129, 145, 154
citrate 132
homeostasis 129, 129f
supplementation 131
Calorie intake, low 106
Camelia sinensis 283
Cancer 3, 9
Carbohydrate 32t, 36, 54, 55, 58t, 60, 68f, 110, 168, 190, 198, 201, 209, 224, 237, 244, 251, 251
aerobic breakdown of 29
availability 99
classification of 55
complete oxidation of 32
complex 56
contribution of 61f
feedings after exercise 67
flame of 34
high 68f
intake 195
during exercise 63
recommendations for 196t, 197f
loading 66, 192
protocol, modified 193t
low 68f
metabolism of 118
multiple transportable 195
recommendations 65, 66t
requirements 225t
role of 59
simple 55
stores 58
disease 3
health 8
acyl-CoA transferase 33
palmitoyltransferase 85
Carotenoid 137, 139
Casein 273
dosage of 273
Catalase 135, 138f
Catecholamines 81
integrity of 152
membranes, structural component of 78
Central fatigue hypothesis 276f
Central nervous system 59, 168
Chain triglycerides, medium 287
Chloride 115, 154, 155
Cholecalciferol 133
Cholesterol 77, 78
Choline 111
Chromium 116, 121, 287
picolinate 286
Chronic degenerative diseases 3
Chylomicron 76
Citrate 229
Citrulline malate 243
Cobalamin 17, 128
Coenzyme q10 293, 294
Colorectal cancer 126
Colostrum 230, 298, 299
Combat sport 50
athletes 251
aerobic capacity of 250
Compound lipids 73, 76
Copper 116, 127, 137
Cori cycle 28, 29f
Cortisol 38
Court games 218
Court sports 218, 219
Creatine 243, 289, 290
kinase 26
loading 289
monohydrate 215, 229, 261
types of 289
Creatinine excretion 98
Cricket 221
Cyanocobalamin 111, 120, 123, 144
Daily energy intake, estimated range of 224t
Dehydration 107, 158, 199, 214, 228
consequences of 159
hypertonic 160
hypotonic 161
types of 160
Densitometry 45
Deoxyribonucleic acid 56
Depression 3
Derived lipids 73, 77
Diabetes 9
mellitus 3
Diet 84, 126
allowance, recommended 111, 123
fiber 56, 57
proteins 91
slow and fast 101
supplement 266
Health and Education Act 306
Diglycerides 73
Dihydroxyacetone phosphate 27
Disaccharides 56, 58
Docosahexaenoic acid 75
Doping 283, 307
inadvertent 307
Dual energy X-ray absorptiometry 45
Eating disorder 255, 255t
warning signs of 256t
Ectomorphy 42
Egg protein 275
Eicosapentaenoic acid 75
Electrolytes 168, 226, 238
role of 153
Electron transport chain 31, 31f, 36
Elite endurance athletes, body fat levels of 188t
Endomorphy 42
Endurance athletes, nutrition for 186, 190
Energy 91, 201, 259, 262
deficit 256
drinks 170, 171
in racket sports 236
in team sports 221
intake 99
metabolism 24, 118, 121
regulation of 36
needs 190, 209, 224
estimation of 181
pathways 118f
production 92, 122
source 77
systems 207
contribution of 37t
transfer 20
utilization 188
yield 32
Enzyme 91
antioxidants 136, 136t
superoxide dismutase 135
Epinephrine 81
Ergocalciferol 133
Ergogenic aid 266
types of 266t
Erythropoietic system 127
Exercise 4, 60, 129, 134, 158
aerobic 10, 95
anaerobic 10
bioenergetics of 19, 20
duration of 61, 82
endurance 272
intensity 10, 61, 82, 99
classification of 11t
nutrition for 16
performance 291, 297
quantification of intensity of 11
training 83
types of 10
Extracellular fluid 151
Eye 242
Face 242
Fast twitch muscle fibers 22
Fat 36, 72, 110, 201, 210, 226, 228, 244, 252, 284, 286
body stores of 79
burners 279f, 280f, 288
classification of 73, 73t
free mass 41
loss 259
supplements 215, 261
mass 41
mobilization of 79
normal body stores of 58t
oxidation of 32
peaks 84f
role of 77
soluble vitamins 111
carrier of 78
functions of 113t
storage of 79
use of 82
Fatigue 276
Fatty acid 73, 80
beta oxidation of 33
binding protein 83, 85
cycle, triglyceride 80f
essential 75, 78
forms of 75f
free 33, 61f, 80
omega 3 75
omega 6 76
types of 74t
unsaturated 74, 75f
Female athlete triad 257f, 258f
Fermentable oligosaccharides 58
Ferritin 123
Field games 218
Fitness, nutrition for 16
Flavonoids 137
Fluid 226, 238
and electrolyte balance 91
balance 158
recommendations for endurance athletes 198
Fluorine 116
Fluoroquinolone 132
Folate 112, 127
Folic acid 17, 120, 144
Food 16, 156
and Drug Toxicology Research Centre 307
choices 194
guide pyramid for athletes 176
intake 260
pyramid for athletes 176f
Safety and Standards Authority of India 307
type of 117
Football 219
Fructose 55
1,6-bisphosphate 26
Fumarate 31
Galactose 56
Garcinia 286
cambogia 286
Genetics 50
Ginseng 300, 301
products 301
Glossitis 126
Glucagon 38
Gluconeogenesis 36, 80
Glucose 55
6 phosphate 26
anaerobic breakdown of 27f
breakdown of 24
transporter 56
protein 59
Glutamic acid 89
Glutamine 89, 278
dosage 278
Glutathione 137, 138f
peroxidase 135, 138f, 141
Glycemic index 63, 64t
low 64
medium 64
moderate 64
use of 64
Glycemic load 64
Glyceraldehyde 3-phosphate 27
Glyceride 73
Glycerol 33, 73, 80, 295
Glycine 89
Glycogen 58
levels and exercise 60
storage 62
synthase 59
utilization 61
Glycogenolysis 35
Glycolipids 77
Glycolysis 24, 35
anaerobic 26
Green tea 283, 284
Growth hormone 38
consequences 257, 258f
Foods and Dietary Supplements Association 307
related fitness 7f
components 6t
status 7f
Heart rate 11
Heat cramps 161
Heat exhaustion 161
Heat exposure 241
Heat related disorders 161
Heat stroke 161
Hemoglobin 91, 122
Hemosiderin 123
Herbal supplements 300
High density lipoprotein 8, 76, 77
High glycemic index 64
Hips 243
Histidine 89
Hockey 220
Hormonal control 158
Hormone 38, 91
antidiuretic 158, 159
sensitive lipase 80, 81
synthesis of 78
Hydration 252, 260
assessment techniques 164t
status, assessment of 163
Hydrogen peroxide 135
Hydrogenation 74
Hydroperoxyl 135
Hydroxyl 135
Hyperhydration 157
Hyperinsulinemia 63
Hypertension 3
Hypertrophy 92
Hypoglycemia 63
Hypohydration 158
Hyponatremia 162, 199
symptoms of 162t
Immunity 242
Indoor games 218
Infection 242
Ingestion, timing of 104
Injuries 253
Insulin 38
factors 37
fluid 151
phosphates 236
triglycerides 79, 81
Iodine 116
Iron 116, 122, 123, 137, 145
absorption of 124
bioavailability of 124
anemia 124
anemia, treatment of 126
chronic 126
stages of 125f
requirements 123
supplementation 126
Isocitrate 31
Isoflavones 137
Isoleucine 89
Isotonic dehydration 160
Isotope dilution 46
Jet lag 241
Jumping events 205
Kabaddi 221
Ketoglutarate 31
Ketone 81
Kidney 127
Kinetic energy 20
Lactic acid cycle 28
Lactose 56
Lawn tennis 235
L-carnitine 279, 280
Lean body mass 41
Leucine 89, 107, 243, 277
Linoleic acid 76, 76t, 285
classification of 73
simple 73
type of 73
Lipoprotein 77, 81
in blood 77t
low density 76, 77
very low density 76
Liver 127
toxicity 288
Lower body 243
Lysine 89
Macrocycle 180
Macronutrient 16
guidelines 237, 239t
Magnesium 17, 115, 122, 145, 154
Major electrolytes, concentration of 154t
Malate 31
Malondialdhyde 301
Maltose 56
Manganese 137, 141
Matrix GLA protein 134
Maximal oxygen consumption 222t
Meal planning 194
guidelines for 212
Meal, timing of 104, 105
Menstrual disturbances 256
Mesocycle 180
tracers 97, 98
water 156
Methionine 89
Microcycle 180
Microcytic hypochromic anemia 125
Micronutrients 16, 17, 110, 117, 128, 238, 252
Middle-distance running 205, 213
Mineral 17, 110, 113, 121, 190, 210, 226
bioavailability of 114
functions of 115t
interaction 117
supplements 142, 145t
Mineral-mineral interaction 117
Mitochondria 21
Mitochondrial protein synthesis 92
Mixed muscle protein fractional synthetic rate 102f
Monoglycerides 73
Monosaccharides 58
Monounsaturated fatty acid 74
Multimineral supplements 215
Multivitamin supplements 215
building 93
supplements 270
contraction 22
long 178
medium 178
short 177
characteristics of 23t
types of 22
gain 260
glycogen 58
depletion 228
storage 68f
breakdown 93
synthesis 93, 94f, 95f
turnover 95
Musculoskeletal fitness 8
Myoglobin 21
Myosin 21
National Collegiate Athletic Association 283
National Institute of Health-Office of Dietary Supplements 132
National Institute of Nutrition 307
National Nutrition Monitoring Bureau 307
Net protein balance 93
Niacin 17, 111, 112, 119, 143
Nicotinamide adenine dinucleotide 119
phosphate 118
Nitrate 200, 292, 293
absorption 292f
Nitric oxide 135, 292
Nitrogen balance 97
Nonessential amino acids 36, 89
Nonprotein containing nitrogen compounds, synthesis of 92
Nor-epinephrine 81
Nuclei 21
Nutrient 16
antioxidants 137t
content 104, 105, 201, 231, 262
deficiencies 214
requirements 201, 230
Nutrition 16, 238
and travel 241
concerns 214
exercise strategy 69, 70
focus 237
periodization 182
spotlight 9, 8, 57, 106, 134, 146, 198, 215, 242, 256, 283, 284, 288
challenges 199, 228
concerns 255
ergogenic aids 266
requirements 224, 237, 251
supplements beneficial 243
Obesity 3
Oligosaccharides 56
Olympic weightlifting 206
Osmosis 152
Osmotic pressure 152
Osteoblasts 128, 130, 131
Osteopenia 131
Osteoporosis 3, 131, 257
Oxaloacetate 31
Oxidation 24
phosphorylation 24, 32
stress 134, 135
system 24, 29
Oxidizing agent 24
Panax ginseng 300
Pantothenic acid 17, 111, 112, 144
Parathyroid hormone 129
Phenylalanine 89, 107
Phosphagen system 35
Phosphocreatine 26f
system 24, 26
Phosphofructokinase 26, 28
Phospholipids 76
Phosphorus 17, 115, 132, 145, 155
Phosphorylase 28
Phosphorylation 24
substrate level 24
Physical activity 4, 7f
and exercise, elements of 4t
pyramid 13f
guidelines 10, 12, 14t
Physical environment 8
Physical exercise 61f
Physical fitness 5
components of 176, 178f
performance-related components of 7t
Physical inactivity 4
Plain water and liquids 156
Plasma 164
fatty acid 79
lipoproteins 81
sodium levels 162t
triglycerides 79
Polysaccharide 56
forms of 57f
Polyunsaturated fatty acid 74
Potassium 17, 115, 145, 154
Potential energy 20
Power 177, 203
and strength sports 207
endurance 177
sport athletes 205t, 207, 214
training 208t
Pre-game meal options 227t
Premature death 3
Proline 89
Protein 36, 68f, 88, 90, 110, 168, 190, 201, 210, 225, 238, 244, 251, 270
classification of 89
consumption, guidelines for 103
digestibility 90
efficiency ratio 90
incomplete 90
ingestion 93
intake 102
kinetics 92f
metabolism 91, 92, 93t
oxidation of 34
powders 243
quality of 90, 100, 106
requirements 98, 104
role of 90
sources 104, 105
sparing action 59
status 97t
supplement 105, 106, 215, 270
selection of 107
types of 270
Pyridoxine 111, 112, 120, 144
Pyruvate dehydrogenase 30
Racket sport 234
athletes 237, 243
accidents in 242
aerobic capacity of 236
body composition of 236
injuries in 242
maximal oxygen consumption of 236t
characteristics of 234t
nutrition for 233
Range of motion 236
Reactive nitrogen species 134
Reactive oxygen species 134
lower 301
Red blood cells 59
Redox reactions 24
Regulatory Authorities for Dietary Supplements 306, 307
Relative energy deficiency syndrome 228, 257
Resistance exercise 93
Resistant starch 57
Rhabdomyolysis 162
Riboflavin 17, 111, 112, 119, 143
Ribonucleic acid 56
Ribose 56
Rotator cuff 242
Rowing, characteristics of 204t
Running, characteristics of 204t
Salt depletion 229
Sample meal plan 216, 230, 244
Sarcoplasm 21
Sarcoplasmic reticulum 21
Saturated fatty acids 74, 75f
Sedentary death syndrome 3
Selenium 110, 116, 137, 141, 145
Serine 89
Serotonin 276
Serum osmolality 164
Shock absorption 48
Singlet oxygen 135
Skeletal muscle
hypertrophy 272
myocyte 138f
structure of 21, 21f
Skin fold measurement 43
Sleep disorders 9
Slow twitch fibers 22
Sodium 17, 115, 146, 154
bicarbonate 200, 215, 261, 296
phosphate 295, 296
Source of energy 28, 59
Soy flour 274
Soy protein 273
concentrate 274
isolates 274
types of 274
Speed 178, 203
Spirulina 304, 305
percent nutrient composition of 304t
Spoon nails 126
Sport 5
endurance 188
types of 5t
bars 229
drinks 166, 169, 199, 229
components of 166
endurance 199
events, nutrition for 203
foods 267, 305, 306t
and supplements, classification of 268, 269t
need for 267
gels 169
nutrition for 16
performance 46, 47
persons 50, 177f
physiology of 250
supplements 267
training for 236, 207, 222, 251
body composition of 46
diet planning for 175
nutrition strategy formulation for 176
Sprint exercise 10
Squash 235
Stomatitis, angular 126
aerobic capacity of 207
body fat content of 205t
exercise 10
sport athletes 48
Succinate 30, 31
Sucrose 56
Sulfur 115
Superoxide 135
Supplement intake 180
need for 267, 270, 294
nutritional 265, 268
Sweat 157
Swimming 48, 206, 213
characteristics of 204t
Sympathetic nervous system 37
Table tennis 235
Taste and temperature 168
Team sport 219, 220t, 223t
athletes 224, 226, 228, 229
aerobic capacity of 222
body fat of 222t
nutrition for 218
persons 49
Thermal insulation 48
first law of 20
second law of 20
Thiamine 111, 112, 118, 143
pyrophosphate 118
Third party supplement certifications 309t
Threonine 89
Total body water 42
Total energy requirement, calculation of 182
Toxicity 108
Training regimen 200, 262
Training status 100
Training unit 180
Transferrin 91, 123
Transport proteins 91
Travel 241
Traveling athlete 107, 242
Tribulus terristris 302
Tricarboxylic acid 19
cycle 30, 30f, 35
Triglycerides 73, 81
Tryptophan 89
Tyrosine 107
Urea production 96, 97
color 164
indices 163
osmolality 164
specific gravity 164
water loss in 156
Valine 89
Vitamin 17, 110, 111, 113, 117, 190, 210
A 110, 113, 139, 143
B complex 118
B1 118
B12 17, 112, 123, 128
B6 120
B9 120
D 113, 133, 134, 143
deficiency 133
deficiency 138
K 113, 134, 143
supplements 143t
Volleyball 221
Waist to hip ratio 44
Water 17
and electrolyte 150
balance 152
distribution of 151
balance 156
intake 156, 158
output 156, 158
role of 152
soluble vitamin 111, 112
functions of 112t
Weight class
combat sports 248
sports, nutrition for 247
Weight control practices 181
Weight gain 99
Weight loss 99, 254, 284286
gradual 259
Weight management 214
concentrates 271
hydrolysate 271
isolates 271
protein 271, 272
chemical constituents of 271t
dose 272
powders 271t
World Anti-doping Agency's 252, 307
Wrestling 248
Wrists 243
Zinc 110, 116, 137, 140, 146
magnesium aspartate 297, 298
supplementation 141
Chapter Notes

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1Concepts of Sports Nutrition2

Introduction to Exercise, Nutrition and FitnessCHAPTER 1


The concepts of physical activity, exercise, sport, health, wellness and fitness are introduced in this Chapter. Physical activity, exercise or participation in a sport helps an individual to attain or maintain physical fitness. Physical fitness is the ability of the body to tolerate physical stress. Physical fitness is of two types: health-related and performance-related. The factors that can influence physical fitness are heredity, lifestyle, physical, social and psychological environment, and also personal attributes. The health benefits of physical activity/exercise are immense and regular exercise or being active is the key to health. The benefits of exercise or physical activity depend on the type, duration and intensity of exercise. Every individual should try to be active daily and must do at least 30 minutes of exercise/activity for five times in a week to attain health and fitness. Optimal nutrition is the base of achieving health, physical fitness and excellence in sports.
Human body is designed for activity and can adapt to a wide range of metabolic demands imposed by physical activity or exercise. Evolution teaches us that early humans could not have survived without the ability to perform very demanding physical work. Yet, in the current times the physical activity levels of humans have declined greatly due to increased automation, changed working patterns and lifestyle.
“Lack of activity destroys the good condition of every human being, while movement and methodical physical exercise save it and preserve it”—Plato (427–347 BCE)
Physical inactivity is also termed as “sedentary death syndrome” and is associated with chronic degenerative diseases (cardiovascular disease, diabetes mellitus, cancer, obesity, hypertension, osteoporosis and depression) and premature death. Physical inactivity is a modifiable risk factor. 4Individuals can adopt an active lifestyle; play a sport or exercise regularly to improve health and fitness.
“Positive health requires knowledge of man's primary constitution and of the powers of various foods, both those natural to them and those resulting from human skill”—Hippocrates (480 BC)
Similarly, good nutrition is inevitable to attain health, fitness, and excellence in sport. Appropriate diet helps to prevent illness, lowers the risk of chronic degenerative diseases and also helps athletes to excel in sports.
This chapter introduces you to the basics of physical activity, exercise, health, fitness and sports, while explaining the importance of being active and perform regular exercise to attain lifetime health and fitness. The precise role of nutrition in active lifestyle is also discussed.
Physical activity is defined as any body movement produced by skeletal muscle that results in energy expenditure and produces progressive health benefits (e.g. occupation, household chores, leisure time activities and sport).
Physical inactivity is an extremely inactive lifestyle characterized by excessive sitting all throughout the day, a level of activity lower than that is required to maintain good health.
Exercise is a subset of physical activity that is planned, structured, and repetitive and has the objective of improving or maintaining physical fitness, health performance and appearance. Table 1.1 explains the various elements of physical activity and exercise.
It is necessary to understand the difference between physical activity and exercise in order to decide the life style modifications required to attain health.
Table 1.1   Elements of physical activity and exercise.1
Physical activity
Bodily movement via skeletal muscles
Bodily movement via skeletal muscles
Results in energy expenditure
Results in energy expenditure
Energy expenditure varies continuously from low to high
Energy expenditure varies continuously from low to high
Positively correlated with physical fitness
Very positively correlated with physical fitness
Planned structured, and repetitive bodily movements
An objective is to improve or maintain physical fitness components
Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.2 Health has both positive and negative dimensions. Positive health is associated with a capacity to enjoy life and to withstand challenges; it is not merely absence of disease. Negative health is associated with morbidity and in the extreme with premature mortality.3 Many a time's health is synonymously used to wellness. But, Wellness is an active process of becoming aware of and making choices towards a healthy and fulfilling life.
The concept of physical fitness: When physical activity becomes more organized and goal oriented, it may be referred to as sport. Physical activity, exercise and sport help to attain or maintain physical fitness. Sport is defined as any organized activity that involves exercise, follows rules and has an element of competition. Sports can be broadly classified as power/strength, endurance, skilled, esthetic and team sports (Table 1.2). Every sport is unique, uses different energy systems, and requires varied training, fitness and nutritional needs.
Physical fitness is a state of bodily function that is characterized by the ability to tolerate physical stress. The stress could be as simple as climbing the stairs or a strenuous workout at the gym. Fitness for an individual is the ability to perform a given physical task with ease in a specified physical, social and psychological environment. WHO (1968)8 defines physical fitness as the ability to perform muscular work satisfactorily. It is the capacity to carry out tasks with vigor and alertness, without undue fatigue and with ample energy to enjoy pursuits and meet unexpected emergencies.
Physical fitness appears to be similar to physical activity in its relation to morbidity and mortality, but is more strong predictive of health outcomes than physical activity.9 Hence, fitness can be described as health related and performance related fitness.
Table 1.2   Types of sports activities.47
Racket sports
Long jump
High jump
Throwing events
Distance running
Distance swimming
Tour de France
Table 1.3   Health-related fitness components.9,11
Aerobic fitness/ Cardiorespiratory fitness
Relates to the ability of the circulatory and respiratory systems to supply oxygen during sustained physical activity
Aerobic fitness reflects the ability of the heart and lungs to deliver oxygen and nutrients to muscles and the muscles ability to produce energy
Enables an individual to sustain high levels of continuous exercise
Muscle strength
Muscle endurance
Ability of muscles to exert force
Ability to move muscles through full range of motion without discomfort, pain or fatigue
Muscle strength and endurance prevent injury, and exercise to improve muscle strength and endurance improves blood sugar regulation and body composition
Range of motion at a joint
Basic level of flexibility is necessary to maintain posture and ease of motion or movement
Body composition
Relative proportion of muscle fat water and bone in the body
Higher muscle mass is associated with strength, lower incidence of degenerative diseases
Excess abdominal fat increase incidence of cardiovascular diseases
Relates to the maintenance of equilibrium while stationary or moving
Good balance is necessary to prevent falls especially in older adults
Balance is important in sports-gymnastics, long and high jump, tennis etc.
Health-related fitness is defined as a state characterized by the ability to perform daily activities with vigor; and by traits and capacities that are associated with a low risk of developing chronic diseases and premature death.10 The fitness components are classified as cardiorespiratory, metabolic, muscle strength and endurance, motor and morphological fitness (Table 1.3).
Performance-related fitness refers to those components of fitness that are essential for optimal work and sports performance. It is defined in terms of individual's ability in athletic competition. Performance-related fitness depends on motor skills, cardiorespiratory power and capacity, muscular strength and power or endurance, body size and composition, motivation and nutritional status11 (Table 1.4).7
Table 1.4   Performance-related components of physical fitness.9,11
Motor skills
  • Specific movement pattern such as throwing a shot put, kicking a ball, hitting a ball with bat
  • Fine motor skills which require small movements such as accurately firing a gun, or large movements such as pole vault, long jumps and track events
Motor skills help individuals to participate and enjoy sports activities.
Related to the ability to use senses such as sight, hearing together with body parts performing motor tasks smoothly and accurately
A high level of coordination is necessary in bowling, gymnastics, hockey, skating, team sports
Reaction time
Time between stimulation and reaction or speed of response to stimulus
A fast reaction to stimulus is desirable in many sports that demand quick response
Is the ability to perform a movement within a short period of time
  • Time is crucial in many sports, faster athletes win
  • Short sprints, swims, and team sports success is governed by speed
The benefits of exercise and physical activity on health and fitness are well recognized. There exists a graded linear relation between the volume of physical activity and health status as seen in Flowchart 1.1.
zoom view
Flowchart 1.1: Relationship between physical activity, health-related fitness and health status.11
However, there are various other confounding variables that influence health and fitness as genetics, lifestyle, physical and social environmental conditions and personal attributes (Nutrition spotlight).
Health benefits of physical activity and exercise:
Exercise plays a major role in primary as well as secondary prevention of various chronic degenerative diseases. Here we discuss in detail the indisputable benefits of physical activity and exercise:
  1. Body weight and composition: Physical activity or exercise promotes weight loss in overweight and obese persons; and also helps to maintain ideal body weight and composition in both athletes and non-athletes.
  2. Musculoskeletal fitness: Exercise improves musculoskeletal fitness, muscle tone, strength, endurance and flexibility, body posture and physical appearance. Improved musculoskeletal fitness with exercise is particularly important for aging population. It is positively associated with functional independence, mobility, glucose homeostasis, bone health, psychological well-being and overall quality of life.
  3. Bone health: High impact/weight-bearing/resistance exercise increases bone mineral density and reduces the risk of osteoporosis and fractures. Intervention of regular exercise training prevents or reverses bone loss in postmenopausal women.
  4. Cardiovascular health: Exercise improves and strengthens the cardiovascular and respiratory systems. Exercise can attenuate or reverse the disease process in symptomatic as well as asymptomatic patients with cardiovascular disease. It reduces serum triglycerides and increases high density lipoprotein (HDL) cholesterol levels. Exercise also prevents rise in blood pressure, reduces systemic inflammatory markers such as C reactive protein, decreases blood coagulation, improves coronary blood flow and reduces plaque formation in heart patients.9
  5. Diabetes: Both resistance and aerobic exercise can prevent or delay the incidence of type 2 diabetes mellitus especially in those with increased risk. Exercise intervention is also effective in the management of diabetes. It improves cellular glucose sensitivity by increasing the activity of glycogen synthase and hexokinase; improving muscle capillary density and glucose delivery to the muscles.
  6. Cancer: Exercise reduces the incidence of breast and colon cancer in women. Exercise, increases energy expenditure, regulates sex hormone levels, improves immunity, and reduces free radical generation and consequently tumor formation. Exercise can also improve the overall quality of life and health status of patients with cancer. Further research is necessary to examine its role in prevention of cancer.
  7. Cognition and psychological well-being: Exercise increases serotonin in the brain which helps maintain mental health. Exercise increases circulating neurotrophin such as brain-derived neurotrophic factor (BDNF) that helps to alleviate depression. Furthermore increase in the levels of endorphins, epinephrine, serotonin and dopamine with exercise relieve pain, elevate mood and reduce anxiety. Exercise also improves the cognitive function and delays incidence of dementia.
    Exercise plays an important role in psychological well-being of individuals. Research suggests that exercise can be effectively used to treat anxiety, stress, mood swings, and premenstrual depression. It also helps to improve individuals’ self-esteem and body image.
  8. Sleep disorders: Exercise training helps individuals sleep better, improves sleep quality in individuals with obstructive sleep apnea.
  9. Immunity: Regular exercise or physical activity improves resistance to infections.
  10. Quality of life: Physical activity improves quality of life and physically fit individuals feel healthy and lead a happy life.
Benefits of exercise depend on the type and intensity of the activity. The types of exercise are classified on the basis of extent of muscle contraction and predominance of energy system.
Types of Exercise
  1. Exercise based on resistance or extent of contractile activity
    • Endurance means prolonged continuous or intermittent periods of contractile activity against low resistance. It increases breathing and heart rate for an extended period of time, e.g. walking, jogging, swimming, sweeping, dancing and playing tennis.
    • Resistance or strength exercise involves short periods of contractile activity against high resistance. These exercises build muscle, and even small changes in muscle strength can make a real difference in the ability to perform daily activities, e.g. weightlifting.
    • Sprint exercise consists of short periods of maximal contractile activity against low resistance, e.g. competitive 50 meter swim.
  2. Exercise based on predominance of energy system
    • Aerobic exercise derives energy mainly from biochemical processes that require oxygen directly or indirectly.
    • Anaerobic exercise derives energy from processes that do not require oxygen.
Endurance exercise is aerobic and also termed as cardiorespiratory exercise, while resistance and sprint exercises are anaerobic.
Intensity of Exercise
Intensity of activity/exercise is the ability to perform physical work and is dependent on the ability of the muscle to transform chemical energy into mechanical energy. The intensity of exercise determines the amount of energy expended and energy substrate required. The relative intensity of exercise is quantified in terms of oxygen consumption (VO2 max), heart rate (HR), rate of perceived exertion (RPE) and metabolic equivalents (METs). Each of these methods has strengths and limitations. A person is rarely able to describe his/her intensity of exercise or activity.11
Table 1.5   Classification of exercise intensity.1315
%VO2 max
% HR max
MET's (Absolute intensity)
Perceived exertion (Rating on 1-10 RPE scale) Modified
Very light
<Very light (RPE 1)
Very light-fairly light (RPE 2-3)
Moderate activity hard (RPE 4-6)
Somewhat hard to very hard (RPE 7-8)
Near maximal to maximal
≥ Very hard (RPE 9.10)
(HR max: Maximal heart rate; %VO2 max: Percent of maximal oxygen uptake; RPE: Ratings of perceived exertion; MET: Metabolic equivalent).
However, a sports/exercise nutritionist needs to be aware of these concepts to understand the extent of individuals’ exercise to determine nutritional requirements. In depth details of these methods are beyond the scope of this book. But brief details on the quantification and levels of intensity of exercise are explained below (Table 1.5).
Quantification of intensity of exercise:
  • VO2 max: VO2 max is the maximum capacity of an individual's body to transport and use oxygen during exercise and reflects individual's physical fitness. The relative rate of oxygen consumption is expressed as mL/kg/min.
  • Heart rate (HR): The increase in heart rate is proportional to intensity. Maximal HR is estimated by subtracting age from 220 (220-Age). For example, the maximal heart rate for a 20y individual equals to 200, i.e. 220-20. It can be easily monitored using a monitor or recording the pulse for a minute.
  • Rate of perceived exertion (RPE): RPE is measured by asking the person to rate how they feel while performing an activity. It is a psychological parameter linked to many physiological events that occur during exercise. The scale is valid and it generally evidences a linear relation with both heart rate and oxygen uptake during aerobic exercise. It is simple and user friendly. The Borgs Rating of Perceived Exertion (RPE) is widely used to determine the exertion.13 It is a 1–20-point scale but is now modified to 1–10-point scale (Table 1.6).
  • Metabolic equivalent (METs): MET is an index of energy expenditure. A MET is the ratio of the rate of energy expenditure during activity to the rate of energy expenditure at rest. One MET is equivalent to an oxygen uptake of 3.5 mL/kg/min.12
Table 1.6   Borg's scale of perceived exertion modified.13
Max effort activity—100% Max
Feels almost impossible to keep going. Completely out of breath, unable to talk
Very hard activity—90% of Max
Very difficult to maintain exercise intensity
Vigorous activity—70–80% of Max
On the verge of becoming uncomfortable. Short of breath, can speak a sentence
Moderate activity—40–60% of Max
Feels like you can exercise for hours. Breathing heavily and can carry on a conversation
Light activity—20–30% of Max
Feels like you can maintain for hours
Easy to breath and carry a conversation
Very light activity—10% of Max
Anything other than sleeping, Watching TV, riding in a car, etc.
Physical Activity Guidelines for Indians
Research on exercise, physical activity, sports and physical fitness on Indians is limited. The American College of Sports Medicine (ACSM), American Heart Institute and US Department of Health and Human Services (2008)12 recommends at least 150 minutes (2 hours and 30 minutes) of moderately intense physical activity per week for healthy adults. The Consensus Physical Activity Guidelines for Asian Indians recommends a total of 60 minutes of physical activity including 30 minutes of moderate-intensity aerobic activity, 15 minutes of work-related activity, and 15 minutes of muscle strengthening activity in view of the high proneness to Type 2 diabetes and coronary heart disease. The exercise guidelines for athletes are different and aim at enhancing performance related fitness components with the help of sports specific training.
The guidelines aim at reducing the risk of chronic degenerative diseases and promote health-related fitness (see Table 1.2) particularly cardiovascular and muscular fitness which is possible due to the various exercise induced metabolic alterations in working muscles as well as other organs and tissues such as liver and adipose tissues. The rate of metabolism is increased during physical activity and may remain elevated for hours or days. The alterations depend on many factors, viz. types of exercise, intensity and duration of exercise.15
Physical Activity Guidelines for Indians of Varied Age Groups
Healthy adults must adopt and follow these activity guidelines to prevent illness and attain good health and fitness. Children and adolescents need to 13be active to ensure proper growth and development. Along with increase in physical activity children must restrict their leisure time television/computer viewing to less than 2 hour per day. Schools should give more time for active participation in sports and help inculcate active lifestyle among children. Pregnant women with uncomplicated pregnancy can exercise throughout and also begin to exercise as soon as practicable following the birth of the baby. Senior citizens should initiate exercise in consultation with a physician if they have not exercised before. The activity recommendations for them are similar to healthy adults. Resistance training is particularly beneficial to improve strength and physical functioning (Fig. 1.1).
Table 1.7 elaborates the physical activity guidelines for varied age groups and pregnant women. The activity guidelines are compiled by the authors on the basis of FITT principle. FITT stands for frequency, intensity, type and time or duration of exercise; and guides individuals to exercise for achieving health and fitness.
Safety Concerns in Exercise and Physical Activity
Any individual who wants to start with an exercise regimen or routine must take into consideration the following aspects.
  1. Physical activity should be in accordance to individuals fitness level and health goals.
    zoom view
    Fig. 1.1: Physical activity pyramid.Source: ACSM guidelines for physical activity for illustration purpose.15
    Table 1.7   Physical activity guidelines for Indians.9,14,16
    Age group
    Children and adolescents
    (5–17 years)
    Preferably daily
    Moderate or vigorous
    Hopping, jumping, skipping, swimming, cycling, dancing
    60+ min/d
    Sports oriented activities are most suitable children
    At least 3 days/week
    Muscle strengthening
    Climbing trees, weights, playing on playground equipment
    20–30 min/d
    Active transport over and above habitual physical activity
    At least 3 days/week
    Bone strengthening
    Running, jumping rope, basketball, tennis, etc.
    20–30 min/d
    Television viewing and computer restricted to less than 2 hr/d
    Healthy adults
    Moderately intense aerobic activity
    Brisk walking, jogging, hiking, gardening, bicycling
    30 min/d
    Brisk walking preferred initial mode of exercise
    Work-related activity
    Climbing stairs, walking during breaks
    15 min/d
    For health benefits—
    moderately intense aerobic activity
    < 300 min/week
    Vigorous intensity <150 min/week
    Muscle strengthening activity
    Warm up, stretching of upper and lower body limbs, and weight training using lightweights
    15 min/d
    Intensive yoga is recommended15
    Moderate intensity
    Walking, cycling, swimming
    30 min/d
    Consult the doctor
    In absence of contraindications, exercise is recommended and safe throughout pregnancy
    Senior citizens
    (age above 60 years)
    (a) Moderately intense aerobic activity
    (b) Muscle strengthening exercise
    Same as healthy adults
    Weight training using light weights
    30 min/d
    15 min
    Aerobic activity has an inverse dose response relationship with major chronic diseases (cardiac disease, type 2 diabetes, depression, cancer, dementia, disabilities)
    Resistance exercise is recommended to improve strength and physical functioning
  2. Exercise or physical activity should be gradually increased to meet health goals
  3. Use appropriate clothing and sports equipment and exercise in safe environment, make sensible choices as to when, where and how to be active.
  4. Exercise under close supervision of a healthcare provider if an individual has severe chronic conditions or symptoms.
  5. Ensure adequate hydration prior to physical activity. During physical activity/exercise, fluids should be consumed frequently in an amount sufficient to compensate losses in sweat. The maximal amount of fluid should be comfortably tolerated without causing any gastrointestinal discomfort.
Nutrition, the science of food goes hand in hand with exercise and fitness. If an individual is physically active or on an exercise regimen he/she should consume the right blend of foods to support exercise and remain fit. It appears prudent for all to understand the basics of food, nutrition and diet to support activity, exercise, sports and health. A brief description on certain relevant terms is given below. But in depth scientific information on energy and nutrient requirements is given in the subsequent chapters.
Food is that which nourishes the body. It is also defined as anything that is eaten or drunk which meets the need for energy, building, regulation and protection of the body. Food is the raw material of our body. Intake of the right amounts and type of nutrients ensures good nutrition and health.
Nutrition is defined as food at work in the body. Nutrition is the intake of food, considered in relation to the body's dietary needs. It is everything that happens to food from the time it is eaten until it is used for various functions in the body.
Nutrients are components of food that are needed by the body in order to grow, reproduce and lead a normal healthy life. Nutrients include water, carbohydrates, fats, proteins, vitamins and minerals.
Balanced diet is the one which contains different types of foods in quantities and proportions that the need for energy, protein, carbohydrates, fats, vitamins and minerals is adequately met and a small provision is made for extra nutrients to withstand short duration of leanness.
Adequate, optimum and/or good nutrition indicates adequate supply of essential nutrients in correct proportion. It also implies that the nutrients are utilized in the body to the highest level in order to achieve and maintain physical and mental health throughout life.
Nutrients are of two types: macronutrients and micronutrients.
Macronutrients are defined as those macromolecules present in plant and animal structures that can be digested, absorbed, and utilized by another 17organism as energy sources and as substrate for the synthesis of the carbohydrates, fats and proteins required to maintain cell and system integrity.
Micronutrients are nutrients required in small quantities and essential for effective regulation of metabolic processes in the body. Micronutrients include vitamins and minerals.
Vitamins are organic substances that have crucial role in almost all bodily processes and must be obtained from food or dietary supplements.
Vitamins are classified as water soluble and fat soluble. Water soluble vitamins are thiamin, riboflavin, niacin, folic acid, pantothenic acid, biotin and vitamin B12 (cobalamin). Fat soluble vitamins are A, D, E and K. The functions of vitamins are listed here and the recommended dietary allowance (RDA) for vitamins is discussed elsewhere. The requirement of vitamins and minerals could be increased in physically active individuals.
Minerals are constituents of enzymes, hormones, and vitamins. Minerals are either bound to other chemicals such as calcium phosphate or available ionic form in body fluids. Minerals required in amounts higher than 100 mg/d are macrominerals (calcium, phosphorus, potassium, sodium and magnesium) and those required less than 100 mg/d are microminerals (iron, fluorine, zinc, copper, selenium, iodine and chromium).
Water is vital to life. Body cannot carry out most of its activities without water. It is abundant in the body and amounts to 40–70% of body weight. The water content in the body varies with age, gender and body composition. It constitutes 65–75% of muscle mass and about 50% of adipose tissues. Water, does not provide energy but must be consumed in sufficient amounts to replace the amounts lost—a balance between intake and output should be maintained. Water is a universal solvent, transports biomolecules, facilitates cellular reactions, acts as a lubricant, regulates body temperature and maintains acid base balance.
The precise functions, recommended dietary allowances (RDA) and sources of macro and micronutrients is explained in detail in upcoming chapters.
  1. Explain the difference between physical activity, exercise and sport.
  2. Classify the different sports.
  3. Discuss in detail the health related components of fitness.
  4. Explain in detail the benefits of exercise.
  5. Differentiate between resistance and endurance exercise.
  6. Practical assignment: review different gadgets/monitors used to assess exercise intensity/training. Get information on the parameters assessed, cost, merits and demerits.18
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  1. Physical Activity Guidelines Advisory Committee. Physical Activity Guidelines for Americans. Washington, DC: US Department of Health and Human Services;  2008. pp. 15–34.
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  1. Garber CE, Blissmer B, Deschenes MR, et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011;43(7):1334–59.
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