Integrative Body Systems in Sports Nutrition

• We begin the module with an introduction to integrative thinking within the setting of sports nutrition.

  Lecture content
  After a historical review of functional and integrative medicine practices within the context of health, we progress to the application of functional matrix and timeline approaches within the context of sport and exercise. Justification is then given to the phrase health feeds performance: an athlete’s physiological body systems must be operating in a healthy way before optimal athletic performance can be expected. The lecture is completed with a discussion of research contextualisation; how do we apply generalised research observations into the life of our individual sporting client(s)?

  Tutorial case study
  In the group tutorial, we discuss a case study of an aspiring English Channel swimmer with problems of fatigue and hormonal imbalance. This is an opportunity for the class to apply their collective knowledge and come up with some intervening nutrition and lifestyle strategies for our client.

Week 2 views individuality through the now popular lens of ’n = 1’, encompassing the modern scientific application of genetics and genomics.

Lecture content
This lecture begins with a historic view of Biochemical Individuality, as introduced by Dr Roger Williams in the 1950s. The limited application of a one-size-fits-all approach is then discussed, acknowledging, for instance, large inter-individual metabolic differences between athletes. The scientific topics of nutrigenetics and nutrigenomics are then introduced, considering how our unique differences can affect health, nutrition and performance needs. In particular, the following subjects are explored within the concept of genetic expression (gene-nutrient interaction): fuel metabolism, methylation, iron absorption, oxidative stress, caffeine sensitivity, cortisol dynamics, circadian rhythms, injury susceptibility, and athletic power and endurance attributes.

Tutorial case study
The individuality tutorial considers the unique health and performance challenges of an elite long course triathlete with single nucleotide polymorphisms (SNPs) on some of her methylation and antioxidant genes, plus issues with recovery. Your class will be asked to collectively discuss nutrition and lifestyle intervention strategies for the athlete.

Week 3 deep dives into arguably the most important body system of an athlete – their gut.

Lecture content
This lecture begins with a tour of our gastrointestinal (GI) system and a view of the phases of digestion, like a cascade system. It then progresses to scientific observations of specific GI issues experienced by athletes, and a review of the microbiome and microbiota in a sports context. The second half of the lecture focusses on integrative and functional medicine strategies for gastrointestinal health, including polyphenol antioxidant support of an athlete’s gut. The lecture finishes with some specific pre-exercise strategies that can be employed to reduce the likelihood of GI complaints during exercise.

Tutorial case study
In the tutorial, we discuss a case study of a talented trail runner who experiences no GI symptoms in a non-competitive environment, but the moment he exceeds 50 kilometres duration in a race, his performance comes under jeopardy. Your class will collectively suggest intervening gastrointestinal strategies for our endurance athlete.

Week 4 explores liver (and related organ) detoxification and biotransformation systems, and their huge relevance to an athlete.

Lecture content
We start our lecture with a review of the main detoxification processes within our body, including physiological sites of detoxification, what constitutes a ‘toxin’, and Phase I, Phase II, and Phase III pathways. The genetics of detox and antioxidant systems are then explored within a sporting context, also recognising the additional detoxification challenges of an athlete compared to a lay person. The second part of the presentation is devoted to nutritional support of the detoxification systems, including the important cross linking with Nrf2 pathways and oxidative stress. Detoxification and biotransformation processes are highly energy consuming, but yet many athletes burden them heavily with processed foods and drinks – this habitual practice is therefore questioned!

Tutorial case study
Our detox tutorial considers the health challenges of a recreational weight lifter who has felt mildly hungover for the past 10 years. Your class will be asked to collectively discuss detoxification supporting nutrition and lifestyle intervention strategies for him.

Week 5 views our musculoskeletal system (related to recovery from training and injury) from a biological perspective, including how we nourish it.

Lecture content
We begin our lecture by breaking the musculoskeletal (MS) system down into the building blocks of the connective tissue network, considering how we can nourish this system via well chosen foods and food supplements. We then deeply examine our musculoskeletal inflammatory and oxidative stress responses during exercise training. In the second half of the presentation we view inflammation and oxidative stress from a nutritional biochemical perspective, thereby suggesting nutrition and lifestyle strategies for recovery from hard training and injury. These include foods and supplements rich in antioxidants, and which are anti-inflammatory in nature, plus building block nutrients, including collagen.

Tutorial case study
In our tutorial we work through the case of a CrossFit participant who is struggling with tendonitis in his shoulder after over-rotating on a Snatch lift. Your class will be asked to collectively discuss musculoskeletal-supporting nutrition and lifestyle intervention strategies for him to accompany his rehabilitation programme.

Week 6 views immunity through a lens of exercise participation: balanced exercise can be very supportive to our immune system, while excessive loads may be depleting.

Lecture content
We begin this lecture with an overview of our innate and adaptive immune systems, and consider what can go wrong when our physiology is under prolonged pressure. Specific exercise immunology literature is then shared within a context of an athlete’s training demands, psychological stress, nutritional support, and other ‘life load’ factors. The second part of this presentation is dedicated to nutrition and lifestyle strategies to support immune resistance and tolerance. This includes macronutrient and micronutrient provision, antioxidant support, distinct nutraceutical immune strategies, plus acknowledgement of the role of gut-based immunity.

Tutorial case study
Our tutorial considers the immunological challenges of a recreational triathlete who becomes ill after almost every competitive experience. Your class will be asked to collectively discuss immune-supporting nutrition and lifestyle intervention strategies for her.

Week 7 explores our ‘communication systems’ within a sports setting: the endocrine and nervous systems.

Lecture content
The endocrine and nervous systems work hand-in-hand with one another to maintain body balance, but disruption of their function can result from heavy training and life loads, resulting in fatigue plus many other symptoms. In this lecture, we begin by exploring relevant neuroendocrine physiological functioning in a sporting context, including consideration of the hypothalamus-pituitary-adrenal (HPA) axis. Like other lectures, the second half is dedicated to nutrition, lifestyle, and exercise strategies to support these vital communication systems. We also discuss testing modalities, including laboratory hormone screens plus the use of heart rate variability to assess tone of the nervous system.

Tutorial case study
The case study discussed in our tutorial is a young marathon runner suffering from symptoms of adrenal fatigue and HPA axis disruption. Your class will be asked to collectively discuss neuroendocrine-supporting nutrition and lifestyle intervention strategies for him.

Week 8 considers the energy of an athlete, including health of their cardiovascular system and nourishment of their mitochondria.

Lecture content
In order for macronutrient food energy to become ATP chemical energy, our cardiovascular system (CV) needs to be performing well, plus we rely on strongly vibrating mitochondria in every active cell. Within this lecture, we consider the CV health outcomes of long term endurance training: how much is too much, and how do we nutritionally support our CV system and mitochondrial function? We also discuss antioxidant needs for an athlete, including consideration of the ‘antioxidant debate’ in sport: should we or shouldn’t we recommend antioxidant supplementation to an athlete engaged in heavy exercise training? The ultimate purpose of this lecture is to arm an athlete with sufficient energy for his or her training demands.

Tutorial case study
Our tutorial considers the cardiovascular concerns of a masters endurance athlete who has recently experienced spontaneous heart arrhythmias, along with declining energy for training. Your class will be asked to collectively discuss cardiovascular-supporting nutrition and lifestyle intervention strategies for him.

Formative assignment

As a student of this module you will be asked to fill in a questionnaire and create a health timeline and functional matrix for yourself. Additionally, you’ll reflect on what you have learned as a practitioner (or prospective practitioner) from the process of filling in the forms that you may give to your clients. 

Summative assignment

You will be asked to write an essay on a fictitious athlete, or an individual regularly involved in exercise training, who needs your help. This will be a 1000 word essay if you’re enrolled on the Certificate course, and 2500 words if you’re enrolled on the Diploma programme.

You’ll pick one of the following topics to focus your integrative body systems discussion: genetics, gastrointestinal, detoxification, endocrinology, musculoskeletal physiology, immunology, and mitochondrial function.

The first half of your essay will be committed to a description of your client, including their sport or exercise goal(s), and a cross-linking of body systems, showing that you understand how their sporting endeavours may be affecting the health and functioning of the particular body system you have chosen. The second part of your essay will focus on intervening strategies (nutrition, exercise and lifestyle) to support that particular body system within the context of their desired exercise performance.