Fluid replacement requirements in soccer

Nutrition and Supplementation in Soccer

Contemporary elite soccer features increased physical demands during match-play, as well as a larger number of matches per season. Now more than ever, aspects related to performance optimization are highly regarded by both players and soccer coaches. Here, nutrition takes a special role as most elite teams try to provide an adequate diet to guarantee maximum performance while ensuring a faster recovery from matches and training exertions. It is currently known that manipulation and periodization of macronutrients, as well as sound hydration practices, have the potential to interfere with training adaptation and recovery. A careful monitoring of micronutrient status is also relevant to prevent undue fatigue and immune impairment secondary to a deficiency status. Furthermore, the sensible use of evidence-based dietary supplements may also play a role in soccer performance optimization. In this sense, several nutritional recommendations have been issued. This detailed and comprehensive review addresses the most relevant and up-to-date nutritional recommendations for elite soccer players, covering from macro and micronutrients to hydration and selected supplements in different contexts (daily requirements, pre, peri and post training/match and competition).

Prevalence of Dehydration Before Training Sessions, Friendly and Official Matches in Elite Female Soccer Players

This study aimed to evaluate and compare the hydration states prior to different sporting events (training sessions, friendly and official matches) in elite female soccer players and relate that to the importance that the player attached to the hydration state as a determinant of sports performance. The hydration state of 17 female elite soccer players (age: 21.5 ± 3 years; body mass: 62 ± 6 kg; body height: 165 ± 9 cm) was determined by measuring their urine specific gravity (USG) prior to three different sports events: training sessions (PT), friendly (PF) and official (PO) matches. The importance that each player attached to the hydration state as a determinant of sports performance was evaluated through a simple questionnaire. An average of 47.05% of the soccer players were severely dehydrated (USG > 1.030), 33.33% were significantly dehydrated (USG > 1.020), 17.64% were mildly dehydrated (USG > 1.010) and 1.96% were euhydrated (USG < 1.010). The average USG was 1.027 ± 0.007 (PT = 1.029 ± 0.009; PF = 1.023 ± 0.010 and PO = 1.030 ± 0.006). Differences were found between urine specific gravity prior to a friendly and an official match (p = 0.03). No relationship was found between urine specific gravity and the importance each player attached to the hydration state as a determinant of sports performance. The results show that dehydration is the most prevalent hydration state of elite soccer players before training sessions, friendly and official matches. Players were most dehydrated prior to official matches, which was unlinked to the players’ perceived importance of hydration for sports performance.

Impact of clothing on exercise in the heat

Clothing targeting the exercise enthusiast has been advertised to keep individuals drier, cooler, and more comfortable during exercise in the heat. The marketing of such clothing has increased dramatically within the last decade. In hot environments, clothing acts as a barrier to thermal balance by inhibiting evaporative and convective cooling. Clothing construction, fit, and fabric are all critical influences on the amount of sweat absorbed from the skin and transported throughout the clothing. The majority of the research analyzing advertised synthetic fabrics has shown no difference in thermoregulation or clothing comfort while exercising in those fabrics in the heat compared to natural fabrics. The influence of clothing construction on thermal balance has received minimal research in regards to exercise. Further research is needed in this area, since it is poorly understood from ecologically valid human testing. Future research should also consider examining the effects of clothing characteristics on comfort during exercise and recovery. The incorporation of protocols that more closely mirror sporting and recreational activity lasting >60 min as well as simulated work-related protocols lasting >120 min is warranted.

Living, training and playing in the heat: challenges to the football player and strategies for coping with environmental extremes

Dehydration and hyperthermia both, if sufficiently severe, will impair exercise performance. Dehydration can also impair performance of tasks requiring cognition and skill. Body temperature may exceed 40 °C in competitive games played in hot weather, but limited data are available. Football played in the heat, therefore, poses a challenge, and effects on some aspects of performance become apparent as environmental temperature increases above about 12-15 °C. Prior acclimatization will reduce the impact of high environmental temperatures but provides limited protection when humidity is also high. Ingestion of fluids is effective in limiting the detrimental effects on performance: drinks with added carbohydrate and electrolytes are generally more effective than plain water and drinks may be more effective if taken cold than if taken at ambient temperature. Pre-exercise lowering of body temperature may aid some aspects of performance, but the efficacy has not been demonstrated in football.

Desidratação e recomendações para a reposição hídrica em crianças fisicamente ativas

OBJETIVO: A prática de exercícios físicos, devido à produção inerente de calor, pode conduzir à desidratação. A maioria dos estudos que abordam os riscos da desidratação e fornecem recomendações de reposição hídrica é direcionada a indivíduos adultos residentes em regiões de clima temperado, porém, em regiões tropicais, pouco é conhecido sobre as necessidades de reposição hídrica em crianças fisicamente ativas. Esta revisão discute as recomendações para esta população e estabelece os riscos da prática esportiva em ambiente de clima tropical. FONTES DE DADOS: Análise sistemática com levantamento da literatura nacional (SciELO) e internacional (Medline) de artigos publicados entre 1972 e 2009, com os seguintes descritores isolados ou em combinação: hidratação, crianças, desidratação e reposição hídrica. Foram selecionados artigos publicados nas línguas portuguesa e inglesa. SÍNTESES DE DADOS: Observou-se que há riscos de desidratação e possível desenvolvimento de um quadro de hipertermia principalmente se as crianças são submetidas a condições climáticas desfavoráveis sem reposição hídrica adequada. O principal fator desencadeante da hipertermia é a menor adaptação das crianças aos extremos de temperatura, em comparação aos adultos, por possuírem área maior de superfície corporal e capacidade menor de termorregulação por evaporação. CONCLUSÕES: Conhecidos os fatores intervenientes da desidratação, a melhor recomendação, perante uma condição climática sabidamente desfavorável, é estabelecer um plano impositivo de hidratação com bebida com sabor e acréscimo de carboidratos e sódio, evitando-se uma perda hídrica significativa, diminuição da performance e, principalmente, com o objetivo de reduzir os riscos à saúde impostos pela hipertermia e desidratação a crianças fisicamente ativas.

Dehydration: cause of fatigue or sign of pacing in elite soccer?

Numerous studies have suggested that dehydration is a causal factor to fatigue across a range of sports such as soccer; however, empirical evidence is equivocal on this point. It is also possible that exercise-induced moderate dehydration is purely an outcome of significant metabolic activity during a game. The diverse yet sustained physical activities in soccer undoubtedly threaten homeostasis, but research suggests that under most environmental conditions, match-play fluid loss is minimal ( approximately 1-2% loss of body mass), metabolite accumulation remains fairly constant, and core temperatures do not reach levels considered sufficiently critical to require the immediate cessation of exercise. A complex (central) metabolic control system which ensures that no one (peripheral) physiological system is maximally utilized may explain the diversity of research findings concerning the impact of individual factors such as dehydration on elite soccer performance. In consideration of the existing literature, we propose a new interpretative pacing model to explain the self-regulation of elite soccer performance and, in which, players behaviourally modulate efforts according to a subconscious strategy. This strategy is based on both pre-match (intrinsic and extrinsic factors) and dynamic considerations during the game (such as skin temperature, thirst, accumulation of metabolites in the muscles, plasma osmolality and substrate availability), which enables players to avoid total failure of any single peripheral physiological system either prematurely or at the conclusion of a match. In summary, we suggest that dehydration is only an outcome of complex physiological control (operating a pacing plan) and no single metabolic factor is causal of fatigue in elite soccer.

Fluid and fuel intake during exercise

The amounts of water, carbohydrate and salt that athletes are advised to ingest during exercise are based upon their effectiveness in attenuating both fatigue as well as illness due to hyperthermia, dehydration or hyperhydration. When possible, fluid should be ingested at rates that most closely match sweating rate. When that is not possible or practical or sufficiently ergogenic, some athletes might tolerate body water losses amounting to 2% of body weight without significant risk to physical well-being or performance when the environment is cold (e.g. 5-10 degrees C) or temperate (e.g. 21-22 degrees C). However, when exercising in a hot environment ( > 30 degrees C), dehydration by 2% of body weight impairs absolute power production and predisposes individuals to heat injury. Fluid should not be ingested at rates in excess of sweating rate and thus body water and weight should not increase during exercise. Fatigue can be reduced by adding carbohydrate to the fluids consumed so that 30-60 g of rapidly absorbed carbohydrate are ingested throughout each hour of an athletic event. Furthermore, sodium should be included in fluids consumed during exercise lasting longer than 2 h or by individuals during any event that stimulates heavy sodium loss (more than 3-4 g of sodium). Athletes do not benefit by ingesting glycerol, amino acids or alleged precursors of neurotransmitter. Ingestion of other substances during exercise, with the possible exception of caffeine, is discouraged. Athletes will benefit the most by tailoring their individual needs for water, carbohydrate and salt to the specific challenges of their sport, especially considering the environment's impact on sweating and heat stress.

Physiological Aspects of Soccer Refereeing Performance and Training

The role of the referee is far from minimal in the economy of soccer, as very often, particularly in professional soccer, a wrong judgment may have profound implications on the outcome of the game. In this regard, a better knowledge of soccer refereeing can obviously benefit the game. Recent studies have shown that during a competitive match, an elite soccer referee may cover 9-13 km attaining approximately 85-90% and approximately 70-80% of maximal heart rate and maximal oxygen uptake (VO2max), respectively. Of the total distance covered about 4-18% is covered at high intensity. Blood lactate concentration has been reported to be in the range of 4-5 mmol/L; however, during competitive matches, blood lactate concentrations as high as 14 mmol/L have been observed. This figure is similar to that extensively reported for soccer players, specifically paralleling that observed in midfield players. However, compared with players, referees are 15-20 years older, often have a non-professional status and cannot be substituted during the game. Furthermore, this important physical stress superimposes onto a high perceptual-cognitive workload throughout the entire game. In relation to fitness status, referees possess VO2max values somewhat lower than the players they officiate, with mean values in the range of 44-50 mL/kg/min. However, the methods used by the Federation Internationale de Football Association and the Union of European Football Associations to test referee fitness need to be changed as the current fitness tests do not relate to match performance. More task-specific tests such as the Yo-Yo Intermittent Recovery Test (YYIRT) have been devised and validated for use with referees. Given that aerobic performance is positively correlated with match performance, it is important that referees are trained to improve their ability to cover large distances during a match and also to repeat high-intensity efforts. A number of studies have shown large improvements in YYIRT performance following both short-term (12 weeks) and long-term (16 months) high-intensity interval training. Future research needs to focus on a number of important areas including the decision-making ability of referees when officiating under different conditions, such as high thermal strain, and the impact of age on both physical and mental performance.

Special populations: the female player and the youth player

Females and youth are frequently described as "special" populations in football literature, but together these two populations outnumber male players. What makes females "special" is that they tend to eat less when training and competing than their male counterparts, leading to lower intakes of energy, carbohydrate, and some nutrients. Youth football players are special in regard to energy and nutrient requirements to promote growth and development, as well as to fuel sport. There is limited research on the dietary habits of these two populations, but the available literature suggests that many female and youth players need to increase carbohydrate intake, increase fluid intake, and develop dietary habits to sustain the demands of training and competition.

The effect of intermittent high-intensity running on gastric emptying of fluids in man

PURPOSE

This study examined the effect of variable-intensity shuttle running on gastric emptying of a carbohydrate-free placebo (Plac) drink and of a 6.4% carbohydrate-electrolyte (CHO) sports drink.

METHOD

We compared the volume of test drink emptied during two 15-min periods of walking exercise (WE) with that during two 15-min periods of the Loughborough Intermittent Shuttle Test (LIST). Gastric emptying was measured on the four trials using a double-sampling aspiration technique in eight healthy males after ingestion of a 420 +/- 49 mL and a 168 +/- 20 mL bolus of the appropriate test drink at the start of the first and second exercise period, respectively.

RESULTS

During the initial 15 min of exercise, the mean (+/-SD) volume of Plac (124 +/- 95 mL) and CHO (71 +/- 43 mL) drink emptied was similar between the two LIST trials, but the volume of Plac (227 +/- 85 mL) and CHO (159 +/- 63 mL) drinks emptied on the WE trials was greater than for the respective test drinks on the LIST trials. Similar volumes of test drinks were emptied on all trials (P = 0.20) during the second 15 min of exercise. Over the 30 min of each trial, the exercise intensity of the LIST reduced the volume of the Plac (211 +/- 108 mL) and CHO (208 +/- 83 mL) drink emptied compared with that on the WE trial for the Plac (396 +/- 74 mL) and CHO (293 +/- 73 mL) drink, respectively.

CONCLUSIONS

The exercise intensity of the LIST is sufficient to slow gastric emptying of carbohydrate and noncarbohydrate containing drinks compared with walking. Dilute carbohydrate-electrolyte drinks empty at about the same rate as carbohydrate-free beverages during variable-intensity running.

Nutritional strategies for football: Counteracting heat, cold, high altitude, and jet lag

Environmental factors often influence the physical and mental performance of football players. Heat, cold, high altitude, and travel across time zones (i.e. leading to jet lag) act as stressors that alter normal physiological function, homeostasis, metabolism, and whole-body nutrient balance. Rather than accepting performance decrements as inevitable, well-informed coaches and players should plan strategies for training and competition that offset environmental challenges. Considering the strength of scientific evidence, this paper reviews recommendations regarding nutritional interventions that purportedly counterbalance dehydration, hyperthermia, hypothermia, hypoxia, acute or chronic substrate deficiencies, sleep loss, and desynchronization of internal biological clocks.

Water and electrolyte needs for football training and match-play

The high metabolic rates sustained by soccer players during training and match-play cause sweat to be produced in both warm and temperate environments. There is limited published information available on the effects of this sweat loss on performance in soccer. However, this limited information, together with knowledge of the effects of sweat loss in other sports with skill components as well as endurance and sprint components, suggests that the effects of sweating will be similar to the effects in these other activities. Therefore, the generalization that a body mass reduction equivalent to 2% should be the acceptable limit of sweat losses seems reasonable. This amount, or more, of sweat loss reflected in body mass loss is a common experience for some players. Sodium is the main electrolyte lost in sweat and the available data indicate considerable variability in sodium losses between players due to differences in sweating rate and sweat electrolyte concentration. Additionally, the extent of sodium loss is such that its replacement will be warranted for some of these players during training sessions and matches. Although soccer is a team sport, the great individual variability in sweat and electrolyte losses of players in the same training session or match dictates that individual monitoring to determine individual water and electrolyte requirements should be an essential part of a player's nutritional strategy.

Effects of sock type on foot skin temperature and thermal demand during exercise

Many fabrics and clothing 'systems' have been designed to enhance heat balance and provide greater thermal comfort for the wearer. However, studies on the effects of socks have largely been ignored in clothing research. It has been suggested that the thermal state of the extremities may alter core temperature and mental stress may be a major determinant of skin blood perfusion on the foot. However, no definite conclusions have been drawn. The aim of this study was to examine the effects of two different sock types on foot skin temperature and to investigate any impact on whole body thermoregulation and energy expenditure. Sixteen subjects carried out two sessions of treadmill running exercise, one session wearing a standard running sock and one session wearing an ergonomic asymmetric fitted sock. The overall mean heart rate, core (aural) temperature, foot skin temperature, weighted mean skin temperature and sweat rate during exercise were not statistically significant between the sock conditions (p > 0.05). There was a consistent trend in all participants for the ergonomic sock to induce a higher core temperature and higher skin temperatures compared to the standard sock. Overall mean ratings of perceived exertion and ratings of thermal perception were similar for both sock conditions. Participant questionnaires highlighted a general perception that the ergonomic socks had superior cushioning but that the standard socks were comfortable to wear. Despite there being no significant physiological or thermal differences between socks, the ergonomic sock was perceived to be cooler and was the preferred sock which suggests that subjective perceptions may be more important than objective measurements when selecting a sock for wear during prolonged exercise.

Aspectos nutricionais do futebol de competição

O futebol envolve exercícios intermitentes e a intensidade do esforço físico depende do posicionamento do atleta, qualidade do adversário e importância do jogo. Pretende-se rever as principais alterações metabólicas desses atletas com prováveis implicações nutricionais e/ou na conduta dietética para melhor desempenho. O gasto energético de um jogador de futebol é estimado em 1.360kcal/jogo. As atividades do segundo tempo são 5% menores que as do primeiro, com variações diretamente relacionadas com os níveis do glicogênio muscular pré-jogo. Em jogadores de elite o consumo das reservas de glicogênio muscular, durante o jogo, varia de 20% a 90%, dependendo de fatores como: condicionamento físico, intensidade do esforço, temperatura ambiente e composição dietética pré-competição. Desidratação e hipertermia são aceleradores do consumo de glicogênio e, assim, da fadiga muscular, perceptível, particularmente, no segundo tempo, quando o atleta evita sprints, caminha mais do que corre e reduz a distância percorrida. A hidratação e suprimento glicídico constituem, então, os principais ergogênicos nutricionais para os futebolistas. Por ser uma modalidade esportiva sem intervalos regulares, o futebol não permite a reposição hidroeletrolítica periódica. Por isso, recomenda-se que o atleta inicie o jogo bem hidratado, ingerindo meia hora antes 500ml de líquido contendo polímeros de glicose (5%-8%). O aumento do desempenho físico é verificado com a ingestão de dietas contendo 312g de carboidrato quatro horas antes do jogo e, para a normalização do glicogênio muscular, após o jogo, recomenda-se oferta de dieta contendo 7-10g/kg/24h com maior consumo nas duas primeiras horas. Os futebolistas encontram-se sob risco constante de deficiências latentes de micronutrientes pelo desgaste muscular, perdas intestinais, sudorese intensa, viagens constantes, mudanças de fuso horário e cardápios. Para o caso específico dos futebolistas, os maiores desbalanceamentos parecem ocorrer pelo elevado consumo de proteínas, gorduras e álcool e baixa ingestão de carboidratos.

Gastric emptying of a carbohydrate-electrolyte drink during a soccer match

PURPOSE

To investigate the effect on gastric emptying of intermittent exercise at varying intensities such as occurs during a soccer match.

METHODS

We compared the emptying rate of a carbohydrate-electrolyte (CE) drink during two 15-min periods of a competitive 5-a-side indoor soccer match separated by 10 min and during two 15-min periods of low-intensity walking exercise. Seven healthy male subjects, all of whom regularly played soccer, completed the study. Exercise intensity on each trial was calculated from heart rate recordings. Subjects ingested 500 mL of the CE drink immediately before starting each exercise period. Before and after completing each 15-min exercise period, the gastric contents were aspirated and the volume recorded. Ambient room temperature ranged from 16-22 degrees C and humidity ranged from 57-72% on both trials.

RESULTS

Mean +/- SD heart rate was higher during the Soccer trial than during the Walking trial at all time points. Exercise intensity was calculated to be 54 +/- 23% and 63 +/- 20% VO2max, respectively, for the first and second periods of exercise on the Soccer trial and 13 +/- 9% and 12 +/- 11% VO2max, respectively, for the first and second periods of exercise on the Walking trial. During the first 15-min period of exercise, a greater (median (range)) volume of the CE drink was emptied from the stomach on the Walking trial (247 mL (102-361 mL)) than on the Soccer trial (84 mL (17-230 mL); P = 0.022). In the second exercise period, however, gastric emptying rates were not different (P = 0.16) between the Walking trial (247 mL (104-363 mL)) and Soccer trial (148 mL (17-293 mL)).

CONCLUSION

As indicated by heart rate, the overall exercise intensity of an indoor soccer match appears to be moderate. The pattern of activity during a match is intermittent with periods of low level activity punctuated by short bursts of high-intensity sprinting. The present study demonstrates that the intensity of activity during this type of exercise is sufficient to slow gastric emptying.

Medical issues associated with international competition. Guidelines for the traveling physician

This article describes the concerns and duties of the team physician while traveling for international competition. The medical preparedness and social interaction required of the team physician are addressed.

Energetics of high-intensity exercise (soccer) with particular reference to fatigue

Soccer entails intermittent exercise with bouts of short, intense activity punctuating longer periods of low-level, moderate-intensity exercise. High levels of blood lactate may sometimes be observed during a match but the active recovery periods at submaximal exercise levels allow for its removal on a continual basis. While anaerobic efforts are evident in activity with the ball and shadowing fast-moving opponents, the largest strain is placed on aerobic metabolism. On average, competitive soccer corresponds to an energy expenditure of about 75% maximal aerobic power. The energy expenditure varies with playing position, being highest among midfield players. Muscle glycogen levels can be reduced towards the end of a game, the level of reduction being reflected in a decrease in work rate. Blood glucose levels are generally well-maintained, although body temperature may rise by 2 degrees C even in temperate conditions. The distance covered by players tends to under-reflect the energy expended. Unorthodox modes of motion-running backwards and sideways, accelerating, decelerating and changing direction-accentuate the metabolic loading. These are compounded by the extra requirements for energy associated with dribbling the ball and contesting possession. The overall energy expended is extreme when players are required to play extra-time in tournaments. Training, nutritional and tactical strategies may be used to reduce the effects of fatigue that may occur late in the game.

Body weight changes and voluntary fluid intakes during training and competition sessions in team sports

Fluid losses (measured by body weight changes) and voluntary fluid intakes were measured in elite basketball, netball, and soccer teams during typical summer and winter exercise sessions to determine fluid requirements and the degree of fluid replacement. Each subject was weighed in minimal clothing before and immediately after training, weights, and competition sessions; fluid intake, duration of exercise, temperature and humidity, and opportunity to drink were recorded. Sweat rates were greatest during competition sessions and significantly lower during weights sessions for all sports. Seasonal variation in dehydration (%DH) was not as great as may have been expected, particularly in sports played indoors. Factors influencing fluid replacement during exercise included provision of an individual water bottle, proximity to water bottles during sessions, encouragement to drink, rules of the game, duration and number of breaks or substitutions, and awareness of personal sweat rates. Guidelines for optimizing fluid intakes in these three sports are provided.

Epidemiology and traumatology of injuries in elite soccer: a prospective study in Finland

A prospective study of male soccer injuries among 12 teams playing at the highest competition level was carried out in Finland in 1993. Overall, two out of three players were injured during the whole season. The injury incidence per 1000 playing hours among injured players and all players during games was higher than during practice, 14.2 vs. 11.3 and 2.3 vs. 1.8, respectively. The lower extremity was involved in 76% of the injuries. Thigh injuries were most frequent (22%), whereas overuse injuries were scarce (6%). Eighteen per cent of the injured players needed surgery and in most cases (58%) the reason for surgery was a knee injury. Sixteen per cent of all injured players were absent from soccer for more than 1 month after the injury. The mean absence time was 17 days for all and 84 days for operatively treated players.

Preparing for and competing in the heat: the human perspective

This review provides an overview of the challenges that face man and horses when exercising in the heat. Some of the strategies that are used and are being developed for human athletes exercising in the heat are reviewed. There are many similarities between human and equine physiological responses to exercise in the heat; and equine exercise science may gain some useful insights from the training, fluid replacement and heat acclimatisation strategies used by human athletes. There are, however, some important differences that impact on the ability of horses to thermoregulate and to regulate fluid and electrolyte balance. The major differences are the low surface area to body mass ratio in horses compared to man; and the high metabolic capacity of equine skeletal muscle. These 2 factors may limit the ability of horses to dissipate heat when exercise is performed under hot conditions. Some of the more important equine differences are highlighted within the context of the "human perspective'.