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Gregorace JI, Bellenger CR, Edwards AM, Greenham GE, Nelson MJ. Contextual factors associated with running demands in elite Australian football: a scoping review. SCI MED FOOTBALL 2024; 8:278-286. [PMID: 36940253 DOI: 10.1080/24733938.2023.2192042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/11/2023] [Indexed: 03/22/2023]
Abstract
OBJECTIVES To identify and summarise the contextual factors associated with running demands in elite male Australian football (AF) gameplay that have been reported in the literature. DESIGN Scoping review. METHODS A contextual factor in sporting gameplay is a variable associated with the interpretation of results, yet is not the primary objective of gameplay. Systematic literature searches were performed in four databases to identify what contextual factors associated with running demands in elite male AF have been reported: Scopus, SPORTDiscus, Ovid Medline and CINAHL, for terms constructed around Australian football AND running demands AND contextual factors. The present scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and narrative synthesis was conducted. RESULTS AND CONCLUSION A total of 36 unique articles were identified by the systematic literature search, which included 20 unique contextual factors. The most studied contextual factors were position (n = 13), time in game (n = 9), phases of play (n = 8), rotations (n = 7) and player rank (n = 6). Multiple contextual factors, such as playing position, aerobic fitness, rotations, time within a game, stoppages, and season phase appear to correlate with running demands in elite male AF. Many identified contextual factors have very limited published evidence and thus additional studies would help draw stronger conclusions.
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Affiliation(s)
- Josh I Gregorace
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), UniSA Allied Health and Human Performance, University of South Australia, Adelaide, Australia
- High Performance Department, Adelaide Football Club, Adelaide, South Australia Australia
| | - Clint R Bellenger
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), UniSA Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Ashleigh M Edwards
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), UniSA Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Grace E Greenham
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), UniSA Allied Health and Human Performance, University of South Australia, Adelaide, Australia
- High Performance Department, Adelaide Football Club, Adelaide, South Australia Australia
| | - Maximillian J Nelson
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), UniSA Allied Health and Human Performance, University of South Australia, Adelaide, Australia
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Otte CJ, Mantzioris E, Salagaras BS, Hill AM. Seasonal health tracking of Australian Football League Women's athletes. SCI MED FOOTBALL 2024; 8:103-111. [PMID: 36744433 DOI: 10.1080/24733938.2023.2175901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/29/2023] [Indexed: 02/07/2023]
Abstract
BACKGROUND Studies evaluating the dietary intake of Australian Football League Women's (AFLW) athletes are few and limited to the preseason. This prospective observational study aims to evaluate seasonal changes in dietary intake and health parameters of professional AFLW athletes. METHODOLOGY Dietary intake (3-day weighed food records), body composition (bioelectrical impedance analysis, skinfolds), physical performance (global positioning system, GPS), and iron status (fasted blood sample) were assessed in 19 athletes (24 ± 5 years, 170 ± 6 cm, 22.8 ± 2.1 kg/m2) at three timepoints: start of preseason, end of preseason, and end of competition season. Sociodemographic information, sports nutrition knowledge (SNK), and risk of low energy availability (LEA) questionnaires were completed at the start of preseason. RESULTS Mean daily energy and carbohydrate (CHO) intakes were lower than recommendations across all seasons (p < 0.05). Mean daily CHO intake was highest at start of preseason (3.6 g/kg/day), decreased during preseason (3.1 g/day) and remained low during competition (3.2 g/day); >80% of players did not meet minimum recommendations at each timepoint (all, p < 0.05). The sum of seven skinfolds and fat mass (%) decreased during preseason (both, p < 0.05). Serum iron fell within recommended ranges for 95% of athletes at all timepoints. The total distance (m) and number of Very High Intensity (>21 km/h) efforts significantly increased across preseason and decreased during competition (all, p < 0.05). Nutrition knowledge was 'poor', and 42% of athletes were at risk of LEA. CONCLUSIONS AFLW athletes do not meet energy and carbohydrate requirements across the preseason and competition seasons, which may impact health and performance if deficits are sustained.
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Affiliation(s)
- Chloe J Otte
- Clinical and Health Sciences, University of South Australia, Adelaide, Australia
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, Australia
| | - Evangeline Mantzioris
- Clinical and Health Sciences, University of South Australia, Adelaide, Australia
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, Australia
| | - Brianna S Salagaras
- Football Department, Adelaide Football Club, West Lakes, Australia
- Performance Health, Queensland Sport and Athletics Centre, Nathan, Australia
| | - Alison M Hill
- Clinical and Health Sciences, University of South Australia, Adelaide, Australia
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, Australia
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Janiczak A, Alcock R, Forsyth A, Trakman GL. A systematic review of interventions targeting modifiable factors that impact dietary intake in athletes. Br J Nutr 2024; 131:229-247. [PMID: 37559383 PMCID: PMC10751945 DOI: 10.1017/s0007114523001769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 07/18/2023] [Accepted: 08/02/2023] [Indexed: 08/11/2023]
Abstract
Appropriate dietary intake has been found to positively impact athletes' performance, body composition and recovery from exercise. Strategies to optimise dietary intake often involve targeting one or more of the many factors that are known to influence dietary intake. This review aims to investigate the types and effectiveness of interventions used to impact modifiable factors of dietary intake in athletes. MEDLINE, CINAHL, SPORTDiscus and Web of Science were searched from inception to May 2022 for intervention studies that measured dietary intake with a quantitative tool and explored at least one factor thought to influence the dietary intake of adult athletes. Study quality was assessed using the ADA Quality Criteria Checklist: Primary Research. Twenty-four studies were included. The most common interventions focused on nutrition education (n 10), macronutrient adjustment (n 7) and physical activity (n 5). The three most common factors thought to influence dietary intake addressed were nutrition knowledge (n 12), hunger and appetite (n 8), and body composition (n 4). Significant changes in dietary intake were found in sixteen studies, with nutrition education interventions returning significant results in the largest proportion of studies (n 8). Study quality within this review was mostly average (n 4 < 50 %, n 19 50-80 %, n 1 > 80 %). As studies included were published between 1992 and 2021, interventions and factors explored in older studies may require up-to-date research to investigate possible differences in results due to time-related confounders.
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Affiliation(s)
- Amy Janiczak
- Sport, Performance and Nutrition Research Group, Department of Sport, Exercise and Nutrition Sciences, La Trobe University, Melbourne, VIC, Australia
| | - Rebekah Alcock
- Sport, Performance and Nutrition Research Group, Department of Sport, Exercise and Nutrition Sciences, La Trobe University, Melbourne, VIC, Australia
- Essendon Football Club, Melbourne, VIC, Australia
| | - Adrienne Forsyth
- Sport, Performance and Nutrition Research Group, Department of Sport, Exercise and Nutrition Sciences, La Trobe University, Melbourne, VIC, Australia
- School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, VIC, Australia
| | - Gina Louise Trakman
- Sport, Performance and Nutrition Research Group, Department of Sport, Exercise and Nutrition Sciences, La Trobe University, Melbourne, VIC, Australia
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Chou Z. FITNESS TRAINING FOR COLLEGE SOCCER PLAYERS. REV BRAS MED ESPORTE 2023. [DOI: 10.1590/1517-8692202329012022_0347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Introduction: Physical fitness is an essential factor affecting soccer in China, and its high-level results from the overlapping training effects of various factors on the soccer athlete. Objective: This study aims to analyze the relationship between practical fitness training and performance in college soccer players. Methods: College soccer players volunteered for a fitness training session. Mathematical statistics were used to analyze volunteers’ fitness and competition performance before and after training. The impact of soccer fitness training on the athletes’ physical quality was also considered. Results: After eight weeks of fitness training, improvement in the performance of college soccer players was noticed. There was a statistical difference in performance and physical quality after physical training (P<0.01). Conclusion: College soccer players improved performance after fitness training. Such training can improve the physical fitness of college soccer players. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.
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Affiliation(s)
- Zhen Chou
- Changchun University of Science and Technology, China
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Posthumus L, Driller M, Darry K, Winwood P, Rollo I, Gill N. Dietary Intakes of Elite Male Professional Rugby Union Players in Catered and Non-Catered Environments. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16242. [PMID: 36498314 PMCID: PMC9737971 DOI: 10.3390/ijerph192316242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/25/2022] [Accepted: 12/01/2022] [Indexed: 06/17/2023]
Abstract
In professional rugby union, it is common for players to switch between catered and non-catered dietary environments throughout a season. However, little is known about the difference in dietary intake between these two settings. Twelve elite male professional rugby union players (28.3 ± 2.9 y, 188.9 ± 9.5 cm, 104.1 ± 13.3 kg) from the New Zealand Super Rugby Championship completed seven-day photographic food diaries with two-way communication during two seven-day competition weeks in both catered and non-catered environments. While no significant differences were observed in relative carbohydrate intake, mean seven-day absolute energy intakes (5210 ± 674 vs. 4341 ± 654 kcal·day-1), relative protein (2.8 ± 0.3 vs. 2.3 ± 0.3 g·kgBM·day-1) and relative fat (2.1 ± 0.3 vs. 1.5 ± 0.3 g·kgBM·day-1) intakes were significantly higher in the catered compared to the non-catered environment (respectively) among forwards (n = 6). Backs (n = 6) presented non-significantly higher energy and macronutrient intakes within a catered compared to a non-catered environment. More similar dietary intakes were observed among backs regardless of the catering environment. Forwards may require more support and/or attention when transitioning between catered and non-catered environments to ensure that recommended dietary intakes are being achieved.
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Affiliation(s)
- Logan Posthumus
- Faculty of Health, Education and Environment, Toi Ohomai Institute of Technology, Tauranga 3112, New Zealand
- Te Huataki Waiora School of Health, The University of Waikato, Hamilton 3216, New Zealand
- New Zealand Rugby, Wellington 6011, New Zealand
| | - Matthew Driller
- School of Allied Health, Human Services and Sport, Sport and Exercise Science, La Trobe University, Melbourne 3086, Australia
| | | | - Paul Winwood
- Faculty of Health, Education and Environment, Toi Ohomai Institute of Technology, Tauranga 3112, New Zealand
- Department of Sport and Recreation, Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland 0627, New Zealand
| | - Ian Rollo
- Gatorade Sports Science Institute, PepsiCo Life Sciences, Global R&D, Leicestershire LE4 1ET, UK
| | - Nicholas Gill
- Te Huataki Waiora School of Health, The University of Waikato, Hamilton 3216, New Zealand
- New Zealand Rugby, Wellington 6011, New Zealand
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Nutritional Intake and Training Load of Professional Female Football Players during a Mid-Season Microcycle. Nutrients 2022; 14:nu14102149. [PMID: 35631290 PMCID: PMC9146243 DOI: 10.3390/nu14102149] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/17/2022] [Accepted: 05/18/2022] [Indexed: 01/28/2023] Open
Abstract
Football (soccer) is a high-intensity intermittent sport with large energy demands. In a repeated-measures design, we analysed the nutritional intake and training load of fourteen female football players (22.50 ± 4.38 y; 57.23 ± 8.61 kg; 164 ± 6.00 cm; 18.33 ± 2.48% of fat mass and 23.71 ± 2.51 kg of muscle mass) competing in the highest female Football Portuguese League across a typical mid-season microcycle. The microcycle had one match day (MD), one recovery session (two days after the MD, MD+2), three training sessions (MD-3, MD-2, MD-1) and two rest days (MD+1). Energy intake and CHO (g.kg.BW−1) intake were lower on the days before the competition (MD+2, MD-3, MD-2 and MD-1 vs. MD; p < 0.05; ES: 0.60−1.30). Total distance, distance covered at high-speed running (HSRD) and the high metabolic distance load (HMLD) were lower on MD+2, MD-3 and MD-1 compared with MD (p < 0.05; ES: <0.2−5.70). The internal training load was lower in all training sessions before the competition (MD+2, MD-3, MD-2 and MD-1 vs. MD; p ≤ 0.01; ES: 1.28−5.47). Despite the small sample size and a single assessment in time, the results suggest that caloric and CHO intake were below the recommendations and were not structured based on the physical requirements for training sessions or match days.
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Wing C, Hart NH, McCaskie C, Djanis P, Ma'ayah F, Nosaka K. Running Performance of Male Versus Female Players in Australian Football Matches: A Systematic Review. SPORTS MEDICINE - OPEN 2021; 7:96. [PMID: 34923616 PMCID: PMC8685186 DOI: 10.1186/s40798-021-00391-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 11/27/2021] [Indexed: 01/05/2023]
Abstract
Background Australian Football is a fast paced, intermittent sport, played by both male and female populations. The aim of this systematic review was to compare male and female Australian Football players, competing at elite and sub-elite levels, for running performance during Australian Football matches based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Methods Medline, SPORTDiscus, and Web of Science searches, using search terms inclusive of Australian Football, movement demands and microsensor technology, returned 2535 potential manuscripts, of which 33 were included in the final analyses. Results Results indicated that male athletes performed approximately twice the total running distances of their female counterparts, which was likely due to the differences in quarter length (male elite = 20 min, female elite = 15 min (plus time-on). When expressed relative to playing time, the differences between males and females somewhat diminished. However, high-speed running distances covered at velocities > 14.4 km·h−1 (> 4 m·s−1) were substantially greater (≥ 50%) for male than female players. Male and female players recorded similar running intensities during peak periods of play of shorter duration (e.g., around 1 min), but when the analysis window was lengthened, females showed a greater decrement in running performance. Conclusion These results suggest that male players should be exposed to greater training volumes, whereas training intensities should be reasonably comparable across male and female athletes.
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Affiliation(s)
- Christopher Wing
- School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, , Perth, WA, 6027, Australia.
| | - Nicolas H Hart
- School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, , Perth, WA, 6027, Australia.,Institute for Health Research, University of Notre Dame Australia, Fremantle, WA, Australia.,Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Callum McCaskie
- School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, , Perth, WA, 6027, Australia
| | - Petar Djanis
- South Fremantle Football Club, Parry Street, Fremantle, WA, Australia.,Murdoch Applied Sport Science Laboratory, Murdoch University, Perth, WA, Australia
| | - Fadi Ma'ayah
- School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, , Perth, WA, 6027, Australia.,School of Education, Curtin University, Bentley, WA, Australia
| | - Kazunori Nosaka
- School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, , Perth, WA, 6027, Australia
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Salagaras BS, Mackenzie-Shalders KL, Slater GJ, McLellan C, Coffey VG. Increased carbohydrate availability effects energy and nutrient periodisation of professional male athletes from the Australian Football League. Appl Physiol Nutr Metab 2021; 46:1510-1516. [PMID: 34314619 DOI: 10.1139/apnm-2021-0316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This research aimed to explore the effect of increased carbohydrate availability intervention on energy intake and distribution in professional Australian Football athletes. Six 24-h energy and macronutrient intakes were quantified (n = 19 males; age 24 ± 4 y, stature 187 ± 8 cm, mass 87 ± 9 kg) using photographic food diaries and Foodworks analyses. Energy expenditure was estimated for the same period using GeneActiv accelerometers. During 3 control days, athletes had ad libitum access to food, while the 3 intervention days increased carbohydrate availability, through greater prompting and access to carbohydrate foods. Daily energy intake was higher during intervention (185 ± 40 kJ/kg/d) compared with control (172 ± 31 kJ/kg/d; p < 0.05) but remained below estimated expenditure, and carbohydrate intake was also greater with intervention (5.0 ± 0.2 g/kg/d) than control (4.0 ± 0.2 g/kg/d; p < 0.05). Expenditure was highest during the morning, which coincided with lowest intake on all days, while the intervention was associated with greater carbohydrate intake in the morning (0.6 g/kg, p < 0.05) compared with control. Increasing availability of carbohydrate during high-load training generated a modest increase in carbohydrate and energy intake, and the intervention was most effective in improving carbohydrate intake during mornings. Novelty: Increased access and provision of carbohydrate foods increased carbohydrate consumption and energy intake on high training load days. Daily distribution of energy intake can be modified through actively promoting carbohydrate consumption.
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Affiliation(s)
- Brie S Salagaras
- Bond Institute of Health and Sport, Faculty of Health Sciences and Medicine, Bond University, QLD, Australia
| | | | - Gary J Slater
- School of Health and Sport Sciences, Faculty of Science, Health Education and Engineering, University of the Sunshine Coast, QLD, Australia
| | - Chris McLellan
- School of Health and Wellbeing, University of Southern Queensland, QLD, Australia
| | - Vernon G Coffey
- Bond Institute of Health and Sport, Faculty of Health Sciences and Medicine, Bond University, QLD, Australia
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Competition Nutrition Practices of Elite Male Professional Rugby Union Players. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105398. [PMID: 34070155 PMCID: PMC8158491 DOI: 10.3390/ijerph18105398] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 05/14/2021] [Accepted: 05/16/2021] [Indexed: 11/17/2022]
Abstract
Thirty-four elite male professional rugby union players from the New Zealand Super Rugby championship completed dietary intakes via the Snap-N-Send method during a seven-day competition week. Mean seven-day absolute energy intake was significantly higher for forwards (4606 ± 719 kcal·day−1) compared to backs (3761 ± 618 kcal·day−1; p < 0.01; d = 1.26). Forwards demonstrated significantly higher mean seven-day absolute macronutrient intakes compared to backs (p < 0.03; d = 0.86–1.58), but no significant differences were observed for mean seven-day relative carbohydrate (3.5 ± 0.8 vs. 3.7 ± 0.7 g·kg·day−1), protein (2.5 ± 0.4 vs. 2.4 ± 0.5 g·kg·day−1), and fat (1.8 ± 0.4 vs. 1.8 ± 0.5 g·kg·day−1) intakes. Both forwards and backs reported their highest energy (5223 ± 864 vs. 4694 ± 784 kcal·day−1) and carbohydrate (4.4 ± 1.2 vs. 5.1 ± 1.0 g·kg·day−1) intakes on game day, with ≈62% of total calories being consumed prior to kick-off. Mean pre-game meal composition for all players was 1.4 ± 0.5 g·kg−1 carbohydrate, 0.8 ± 0.2 g·kg−1 protein, and 0.5 ± 0.2 g·kg−1 fat. Players fell short of daily sports nutrition guidelines for carbohydrate and appeared to “eat to intensity” by increasing or decreasing energy and carbohydrate intake based on the training load. Despite recommendations and continued education, many rugby players select what would be considered a “lower” carbohydrate intake. Although these intakes appear adequate to be a professional RU player, further research is required to determine optimal dietary intakes.
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Fernandes HS. Carbohydrate Consumption and Periodization Strategies Applied to Elite Soccer Players. Curr Nutr Rep 2020; 9:414-419. [PMID: 33098050 DOI: 10.1007/s13668-020-00338-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2020] [Indexed: 12/26/2022]
Abstract
PURPOSE OF REVIEW During a soccer season, athletes tend to play intense and light matches such as decisive and qualifying games. The amount of muscle glycogen stores is a determining factor of performance during exercise, and manipulation of carbohydrate intake during the soccer season to enhance muscle glycogen stores can improve the performance of elite soccer players. The purpose of this review is to provide a holistic view of the periodization of carbohydrates and their effects on sports performance, based on what the literature recommends for the periodization of carbohydrates for endurance athletes, and of muscle glycogen recovery and compensation among professional soccer players. RECENT FINDINGS The ingestion of large amounts of carbohydrates (CHO;10 g/kg of body weight (BW)/day) is important 36 h before a match for the elite soccer player to ensure muscle glycogen supercompensation. In addition, elite soccer players should intake 1 to 1.5 g/kg BW/h within the first 4 h after a soccer game to maximize glycogen resynthesis. However, the season is comprised of away and home games that require different intensities; thus, soccer players need to periodize CHO intake based on evidence-based recommendations such as "train low," "train low, compete high," and/or "sleep low." The goal is to induce training adaptations by alternating with high or low CHO availability based on seasons, matches, and training intensities. The strategy can result in improved performance during games. Periodizing the consumption of carbohydrates, based on the intensity of training and matches, should include more carbohydrates when the matches require higher intensity and fewer carbohydrates when they require lower intensity; this is a strategy that will improve the performance of elite soccer athletes.
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Affiliation(s)
- Haniel Soares Fernandes
- Nutrition Departament, Estácio de Sá College, Fortaleza, Ceará, Brazil.
- Nutrition, Metabolism e Physiology in Sport, São Gabriel da Palha College, São Gabriel da Palha, Espírito Santo, Brazil.
- Clinical and Functional Nutrition, São Gabriel da Palha College, São Gabriel da Palha, Espírito Santo, Brazil.
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