University of Montana ScholarWorks at University of Montana
Graduate Student Theses, Dissertations, & Professional Papers Graduate School
1979
The effects of high and low carbohydrate diets on perceived energy levels of ski instructors at high altitude
Cheryl DiCarlo The University of Montana
Follow this and additional works at: https://scholarworks.umt.edu/etd Let us know how access to this document benefits ou.y
Recommended Citation DiCarlo, Cheryl, "The effects of high and low carbohydrate diets on perceived energy levels of ski instructors at high altitude" (1979). Graduate Student Theses, Dissertations, & Professional Papers. 7228. https://scholarworks.umt.edu/etd/7228
This Thesis is brought to you for free and open access by the Graduate School at ScholarWorks at University of Montana. It has been accepted for inclusion in Graduate Student Theses, Dissertations, & Professional Papers by an authorized administrator of ScholarWorks at University of Montana. For more information, please contact [email protected]. COPYRIGHT ACT OF 1976
Th is is an unpublished m anuscr ipt in w hich c o py r ig h t sub
s i s t s . Any further r e p r in t in g of it s contents must be approved BY THE AUTHOR,
Ma n s f ie l d L ibrary
Un iv e r s it y of Montana D a t e : 19 7 9
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. THE EFFECTS OF HIGH AND LOW CART’OHYDRATE DIETS
ON PERCEIVED ENERGY LEVELS CP SKI INSTRUd’CRS
AT HIGH ALTITUDE
Cheryl DlCarlo
B.S., University of Montana, 1973
Presented In partial fulfillment of the requirements for
the devree of
Master of Science
UNIVERISTY OF MONTANA
1979
Approved hyi
*^~-^C^alrman,/B^rd of Examiners
De^n, Graduate Schoo
/ - / S' ' S ’ à rv. ♦-e
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. UMI Number: EP38029
All rights reserved
INFORMATION TO ALL USERS The quality of this reproduction Is dependent upon the quality of the copy submitted.
In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, If material had to be removed, a note will Indicate the deletion. UMT DisMrUUion Pitblishing
UMI EP38029 Published by ProQuest LLC (2013). Copyright In the Dissertation held by the Author. Microform Edition © ProQuest LLC. All rights reserved. This work is protected against unauthorized copying under Title 17, United States Code
uesf
ProQuest LLC. 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, Ml 48106-1346
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. ABSTRACT
DiCarlo, Cheryl A., M.S., AuP-ust, 1979 Health and PhyRleal Education
The Effect of HIp-h and Low Carbohydrate Diets on Perceived Enerp-y Levf^l.i of Ski Instructors at^H^yh Altitude (53PP*)
Director: Dr. Brian J. Sharkey U' _ It was the ruroose of this study to survey the effect of h'ph and low carbohydrate diets on perceived energy levels of ski Instructors at high altitude, Soeclfleally, the study Investigated the difference between the 'nean existing diet of Instructors In comparison to the norms of the adult American diet, and the differences In perceived energy levels of Instructors on a high carbohydrate diet, a low carbohydrate diet, or a normal mixed diet. A su 'vey packet was Issued to thirty full time Instructors of the Copper Mountain Ski Education Center. Nineteen completed rackets met all criteria and were used for fl’^al analysis. The su vey packet Included five percei '/ed ener-^y questlonnalres, four daily dietary Intake forms, and suggestions for diets and alternatives. The data was analyzed using a chi square test to establish a significant difference between three Indepen dent samnles and a Z score to establish a difference between two Independent pronortIons. The followlng conclusions were sunported by the study: (1) no difference occurred between the control group and the average diet of the adult American and (?) significant difference occurred in perceived energy levels am.onr Instruc'^ors on a h^gh carbohydrate diet, a low carbohydrate diet, and a n( rmal mixed diet.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. ACKNOWLEDGEMENTS
The author wishes to express her gratitude and appreciation to the instructors of the Copper Mountain Ski Education Center and to Copper Mountain for their help and support. The author is indebted to her husband, Michael, for his support in allowing her to continue her education, which made this thesis possible. C.M.D.
1X1
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. TABLE OF CONTENTS Page
ABSTRACT 11
ACKNOWLEDGED ENTS 111
LIST OF TABLES vl
LIST OF FIGURES vll
Chapter
I. INTRODUCTION 1
The Problem 2
The Hypotheses 3
The Limitations 3
The Definition of Terms 3
II. REVIEW OF LITERATURE 4
Diet and Exercise 5
Sources of Enerp;y 5
Glyccfren Resynthesls 7
Glycofren and Flher Type 10
Diet and Altitude 11
CHO Metabolism and Hypoxia 12
Diet and Alpine Skllnfr 13
Glyccff-en Utilization and Skiing * 13
Perceived Exertion 15
Summary 16
III. METHODS AND PROCEDURES 18
The Subjects 18
1V
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. V
Chapter Pag-e
Survey Procedures 18
Survey Groups 19
Statistical Procedures 20
IV, ANALYSIS OF D/TA 22
Testing of Mull Hypothesis I 24
Testing of Null Hypothesis II 24
V. SVÎŒARY, CONCLUSTONS, AMD RECOMMENDATIONS 32
SuTr.irary 32
Conclusions 3^+
Recomrrendat ions 35
SELECTED BIRLIOGRA.FHY 37
APPENDICES 4 2
A. VOLUNTEER FORM 42
B. DIETARY IN^^AKE FORM 44
C. PERCEIVED ENERGY QUES^'ICKNAIHE 46
D. HIGH CARBOHYDRATE SAMPLE DIET ANDALTERNATIVES 4B
E. LOW CARPCHYDRATE SAMPLE DIET AMD ALTERNATIVES 50
P. FORMULAS FCR COMPUTATION 52
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. LIST OF TAPLES
Table Pap-e
1. Content Analysis of Mean Dietary Intake 23
2. Difference Between Group One and Averapre American Diet 2 5
3. Perceived Hnerpry Questionnaire Tabulation For Control Group 2?
4. Perceived Energy Questionnaire Tabulation For Hiprh Cari oh yd ra t e Group 28
5. Perceived Energy Questionnaire Tabulation For Low Carbohydrate Group 29
6. Comparison of Differences Between Groups 31
vi
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. LIST OF FIGURES
Flp-ure Pape
1, Perceived Enerpy Tabulation Between GrouDs 26
vll
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Chapter 1
INTRODUCTION
A vast amount of research has been done on the effects of diet on physical performance. Scientists have known for several decades that the energy necessary for muscular contraction was derived from chemical reactions within the body» and that an inadequate diet or undernutrition may impair physical performance. Unfortunately the relationship of diet to skier performance has been little known in American society. The majority of the skiing public is not aware that diet does have an effect on physical performance, especially when the skier is abruptly exposed to high altitude. Many skiers do not realize that diet can be a major factor in adapting to acute high altitude exposure or that diet has a direct effect upon endurance and
fatigue. Skier injury statistics conclude that a majority of ski related accidents occur toward the end of the skiing day. Perhaps the knowledge that a diet has the potential
to enhance skier energy levels could lead to an increase in endurance and a decrease in fatigue. Ideally diet, alone,
1
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 2
could decrease the incidence of skier injuries, reduce the effects of high altitude exposure, and enhance learning
and enjoyment of the sport.
THE PROBLEM
The main purpose of this study was to evaluate the
effects of high carbohydrate and low carbohydrate diets in relationship to a normal mixed diet on perceived energy
levels of ski instructors at high altitude.
The Subproblems
The first subproblem was to determine the average existing diet of full-time instructors at the Copper Mountain Ski Education Center. The second subproblem was to compare the mean of the existing diet of Copper Mountain instructors with the established averages for the adult American diet. The third subproblem was to measure the perceived energy levels of the Copper Mountain instructors using an adapted General High Altitude Questionnaire (GHAQ), as cited by Evans (22).
The fourth subproblem was to establish high and low carbohydrate guidelines to be used by the experimental
groups to determine dietary effects on perceived energy levels.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. The Hypotheses
Hypothesis I. There will be no significant difference between the mean dietary intake of the full-time ski instructors and the established mean dietary intake of
the average adult American over a five day survey period. Hypothesis IT. A change in diet will result in no
significant difference in perceived energy levels of instructors at high altitude.
The Limitations
This study will be limited to full-time instructors of the Copper Mountain Ski Education Center. The study will not examine the skier population in general. High and low carbohydrate diets will not be standardized with respect to fat and protein content. Inability to control variations in portion size and food preparation will result in approxiamation of dietary food intake. The inability to control the amount of sleep, alcohol, and drug intake will result in individual variations within this study.
The Definition of Terms
Full-time Ski Instructor. This is an employee of Copper Mountain, Inc., who teaches at least six days per
week with staggered days off throughout the week. Teaching time is based on an average of four and one-half hours of
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. group lessons per day and one hour of private lesson time per day. Catrbohydrate. This is either a simple sugar or more complex compound such as starch which is formed by the union of many sugar groups. High Carbohydrate Diet. This is a diet in which
60jS or more of the total daily caloric intake is composed
of some form of carbohydrates. Low carbohydrate Diet. This is a diet in which
30^ or less of the total daily caloric intake is composed of some form of carbohydrates. High Altitude. This represents the elevation of Copper Mountain, Colorado which is 9*630 feet base elevation and extends to 12,481 feet at the summit.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Chapter II
REVIEW OF RELATED LITERATURE
Diet and Exercise
The search for a relationship between physical
performance and diet is not a recent issue. The practice of consuming large quanities of meat during heavy muscular work was first recorded in Greece during the fifth century B.C. as cited by Astrand and Rodahl (5)* Protein traditionally had been the mainstay of athletes, but according to Astrand (4), protein in excess of normal daily caloric requirements was more for psychological value and taste rather than sound physiological value. Protein was found to be the least efficient energy source and was used as fuel for muscular energy only when an individual was undernourished or fasting (5* 44),
Sources of Energy
The twentieth century marked the beginning of the application of the scientific approach to the field of nutrition and physical performance. Christensen and Hansen (13) conducted one of the earliest scientific
studies providing evidence that subjects placed on a high 5
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. fat diet had a marked decrease in performance capacity. Subjects became exhausted after one and one-half hours at work loads that could normally be tolerated for twice
that long. Several Swedish physiologists became involved in studies of diet and performance. Hultman (28) further demonstrated that fat and carbohydrate were mainly used for energy during exercise. Fat is the more concentrated energy source, but the conversion process of fat to energy is complicated. The conversion requires an adequate supply of oxygen in order to be utilized. Smith stated that carbohydrates are the most
efficient and readily available energy source. All carbohydrates are either simple sugars or more complex compounds, such as starch, which are formed by the union
of many sugar groups (9, 33)» Carbohydrate is either broken down into glucose for transport via the bloodstream to the brain, muscles, and vital organs, or is converted into glycogen for storage in the muscles or liver (45). According to Keul, et al. (33)» the maximum energy yield from muscle and liver glycogen is about ?00 grams. Hultman (28) found an average of seventy kilogram body weight
stored about 390 grams of glycogen in the muscles and 66 grams in the liver for a total of 456 grams.
Saltin's studies (40) reiterated that aerobic
processes were responsible for playing the dominate role in energy production during prolonged muscular work.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 7 Bergstrom (?) established the use of muscle biopsy to measure glycogen levels in human muscle which contributed to the progress in analyzing dietary effects upon performance. Hermansen, Hultman, and Saltin (28) determined glycogen stores in the muscle were the limiting factor in
performing prolonged strenuous work at relative high work loads. A significant decrease in muscle glycogen was noted following prolonged exercise.
The effects of a high fat and a high protein diet were compared to a normal mixed diet and to a high carbohydrate diet. Bergstrom, et al. (8) found a close correlation between the capacity for prolonged heavy exercise and the amount of glycogen stored in the muscles. Bergstrom (8) also found that muscle glycogen stores were the limiting factor in performing prolonged heavy exercise. The conclusion that glycogen content and subsequent work capacity varied appreciably was made by instituting different diets after glycogen depletion. The energy needed for muscular work was taken directly from fat and carbohydrate depots. Ahlborg, et al. (1) also
concluded that a higher muscle glycogen content resulted in a longer performance time.
Glycogen Resynthesis
Hultman and Bergstrom (27) noted a marked difference between a high carbohydrate diet and a low carbohydrate
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 8
diet with respect to their ability to maintain glycogen stores in skeletal muscle. The resynthesis of glycogen is exceedingly slow on a low carbohydrate diet. Resynthesis on a high carbohydrate diet is much more rapid. Glycogen stores were also found to rise far above the normal range with the ingestion of a high carbohydrate diet. Ratliff
and Lamb (39) indicate that glycogen depletion enhances resynthesis of more glycogen. Conflicting reports have been filed regarding the resynthesis time of muscle glycogen following depletion. According to Hultman and Bergstrom (2?), glycogen stores could be restored within twelve to twenty-four hours. Piehl’s studies indicated muscle glycogen stores could take up to forty-six hours to be fully replenished (37)*
Piehl (3 8 ) later indicated that sixty percent of the total glycogen increase occurred approximately ten hours after ingestion of carbohydrates. Hultman (28) established that the only physiological way to empty glycogen stores within the muscle was by hard exercise. Glycogen stores can decrease slowly by fasting, but one week of total starvation resulted in
only a 3O to 40^ decrease. Bergstrom, et al. (8) concluded that the enhancement of glycogen synthesis is localized to muscle that has been
worked and does not affect other muscle groups. Glycogen
levels were depleted in an experiment involving one leg
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 9 being exercised to exhaustion on a bicycle ergometer. Glycogen content was found to be normal in the unexercised
leg. Muscle glycogen content and work performance time was found to be dependent upon the type of diet before exercise. One experiment conducted by Bergstrom et al. (8), allowed participants to work at a fixed load for 210 minutes after a three to seven day diet of predominately carbohydrate
intake. Later only 80 minutes could be tolerated at the same work load following a diet predominately of fat. At a symposia on nutrition and fitness conducted in
Sweden in 196?* Saltin and Hermansen (41) reported that the relationship between the amount of fat and carbohydrate used as fuel depended upon diet, work intensity, duration of exercise, and the fitness of the individual. Astrand (3) stated that during rest or mild exercise the proportion of fat and carbohydrate used as fuel are relatively the same. Fat contributes in increasing amounts to energy yield as work progresses. Carbohydrate becomes more important at high intensities. Carbohydrate was not only an important oxidative substrate, as shown by Chapler and Stainsky (12), but also was the contributing
energy source under anaerobic conditions. Carbohydrate
also plays an increasing role in situations where the oxygen supply is limited or inadequate.
Asmussen, et al. (2) reiterated that the body's
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 10
ability to liberate energy by anaerobic processes and lactate formation was based upon the body's storage of glycogen.
Muscle Glycogen and Fiber Type
Costill, Sparks, Gregor, and Turner (16) established
that a difference in glycogen depletion by muscle fiber type occurred. As research methods becEime more specific, slow twitch muscle fibers and fast twitch muscle fibers were found to differ with respect to glycogen concentrations. Glycogen depletion was found to be less in fast twitch fibers than in slow twitch fibers after a mixed or
carbohydrate diet. Slow twitch fibers were depleted of glycogen at work intensities of sixty to eighty percent of maximum oxygen uptake. Fast twitch fibers were not
depleted until an individual exercised to exhaustion (1 7 » 18) Costill, et al. (1?) found that subjects who exercised to near exhaustion on successive days needed dietary allowances including a carbohydrate rich diet to continue to function at that level.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 11
DIET AND ALTITUDE
The energy cost of muscular work must be defrayed
primarily through oxidative processes. According to Keul» Doll, and Keppler (33), the individual experiences a reduced ability to extract oxygen during hypoxic conditions. The result of hypoxia is a reduction of man’s ability to perform work.
Frisancho (2 3 ) studied subjects exposed rapidly to high altitude and found newcomers to altitude experienced a reduction in aerobic capacity of thirteen to twenty-two percent. Oxygen has about thirty-five percent less
pressure at 3OOOM (11,840 feet) than at sea level. Horvath (26) reported that maximum oxygen uptake is decreased by 3 . 2 ^ for every 1000 feet in elevation. An acclimatized man will experience only a 2% decrease. The blood is less saturated with oxygen at high altitude ; therefore, not as much oxygen is transported to the tissues. Hurtado (29) found the greater the intensity of exercise, the less the oxygen saturation of arterial blood occurred.
Muscle glycogen is severly exhausted as an immediate source for energy yield under hypoxic conditions. Consalazio, Matoush, Johnson, Krzywicki, Davis, and Issac (14) studied mountain climbers and orienteers during high altitude exposure. A marked craving for
sweets and sugar was noted. Prior to World War II a
physiological advantage was noted in feeding a carbohydrate
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 12
rich diet to crews and passengers in unpressurized
aircraft.
Carbohydrate Metabolism and Hypoxia
Carbohydrate metabolism is of particular importance under conditions of hypoxia. Hansen, Hartley, and Hogan
(24) concluded that feeding of a carbohydrate rich diet is a feasible way to increase ventilation and improve oxygenation when ambient air is decreased. A3 carbohydrate rich diet increased carbon dioxide production which in turn stimulated the respiratory system and raised the oxygen content in the lungs during conditions of low oxygen atmosphere ( as cited in Science News, 42). Hansen and associates also noted the feeding of a high carbohydrate diet was desirable in early acclimitization or in anorexia. fhis loss of appetite, therefore, led to a caloric deficit as found by Consolazio, et al. (15). A high carbohydrate diet was beneficial in increasing work capacity, decreasing acute mountain sickness symptoms and its severity, and increasing mental efficiency. Johnson, Consolazio, Krzywicki, and Daws (31) found that
men on high carbohydrate diets fared better when exposed to acute altitude than those on a normal diet or a diet high in protein. Hansen, et al. (24) determined that
natives residing in extreme high altitude areas naturally
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 13 tend to incorporate large amounts of carbohydrates in their diet. Andean natives consume a diet of 79% to &9% carbohydrates.
DIET AND ALPINE SKIING
The aerobic demands in recreational and competitive downhill skiing are great. A linear relationship has been established by Karlsson» Eriksson, Forsberg, Kallberg, and Tesch (32) between heart rate,and oxygen uptake during downhill skiing. As oxygen demand increases, the heart beats faster. EGG recordings during two hours of recreational alpine skiing on rather easy slopes
yielded heart rate of 160 - 1 7 O beats per minute. Eriksson, et al. (20) found that this was only five to
twenty beats per minute below maximum heart rates. Karlsson, et al. (32) also monitored the aerobic demands of competitive alpine skiers and recorded heart rates approaching maximum.
Glycogen Utilization and Skiing
Quanitative measurements of glycogen content, done by Eriksson, et al. (20) in the thigh muscles of skiers, showed after an entire day of skiing, muscle glycogen
in experienced skiers declined by 35 - 40 mmoles/kg of wet muscle tissue. This was true for skiing both short
and long slopes. Beginning skiers showed a reduction
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 14
of 25 - 30 mmoles/kg of wet muscle tissue. During a week of skiing, total glycogen consumption was calculated by determining the glycogen content in tissues before and after exercise. Morning glycogen levels
showed a decline from 70 - 80 mmoles/kg wet muscle tissue
on the first day to around 50 mmoles/kg on the fifth
day. 70 -80 mmoles/kg represent values similar to what
is normally found in the thigh muscle after a normal
mixed diet; whereas, 50 mmoles/kg is below normal level of muscle glycogen storage. Afternoon levels following exercise also declined far below normal. When subjects were advised to consume a high carbohydrate diet on the third day of testing, those participants involved had glycogen levels far above normal when measured the following day. When testing competitive skiers at a training camp,
Karlsson, et al (3 2 ) found glycogen stores gradually declined day by day. They concluded that a relatively high concentration of muscle glycogen was essential to
the maintenance of good musclular function. Karlsson also concluded that there is every reason to believe that the injuries which often occurred at the end of a day of training were frequently linked to muscle fatigue caused by a glycogen deficiency. This was also applicable to the active recreational skier. Thus according to
Karlsson, the high incidence of injury at the close of
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 15 the skiing day could be related to glycogen deficiency.
PERCEIVED EXERTION
Man can perceive small differences in work intensities. A healthy adult is capable of discerning differences between work loads (Skinner, Hustler, and Buskirk, 43). Morgan (35) agreed with this capacity of man, but added that the capacity to perceive small differences in work intensity did not apply to depressed, neurotic, or anxious people, as they had difficulty in assessing the work situation appropriately.
Research by Noble, Metz, and Cafarelli (3 6 ) concluded that responses to exertion or perceived energy levels are made from sensations which result from physiological processes. Man does not directly attend to changes in the physiological processes, per se, but to the externalization of these processes, such as increased ventilation, other respiratory responses, and skin temperature. Ekblom and Goldberg (21) evaluated individual's perceived exertion on two levels. The first is a local level in which the individual actually feels strain in the muscles. The second level is a central factor such as tachycardia, tachypnea, or even dyspnea. A mood symptom questionnaire, as cited by Carson, et al. (11), was developed to record subject symptomology
for persons subjected to acute high altitude exposure.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 16 The questionnaire allowed subjects to rate the severity of their reactions on a scale from one to five. Later
testing, by Evans (2 2 ), found the questionnaire to be reliable and valid based upon perceived symptomology as opposed to actual physiological changes.
SUMP4ARY OF REVIEW
The majority of researchers conclude that carbohydrates are the most efficient and readily available energy source
for vigorous work. Kost studies are in agreement that glycogen sotres in the muscles are one of the biggest limiting factors in performing prolonged strenuous work at relative high work loads. A marked difference was found between a high carbohydrate diet and a low carbohydrate diet with respect to the ability to maintain glycogen stores in skeletal muscle. Resynthesis of glycogen was proven to be exceedingly slow on a low carbohydrate diet ; whereas, resynthesis was extremely rapid on a high carbohydrate diet. Researchers found carbohydrate metabolism to be of particular importance under conditions of hypoxia. Feeding of a high carbohydrate diet was desirable in early acclimitization to altitude to increase work capacity,
(decrease acute mountain sickness symptoms and its severity, and increase mental efficiency. Data also revealed that glycogen stores gradually
decline with successive days of skiing. There was some
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 17 indication that the incidence of skier injury levels and glycogen deficiency could be related. Finally, research indicates that subjects are capable of perceiving differences in symptomology and work loads based upon external and internal changes.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Chapter III
PŒTHOD AND PROCEDURE
This research was designed to study the effects of high carbohydrate and low carbohydrate diets, in relationship
to a normal mixed diet, on perceived energy levels of ski instructors at high altitude.
THE SUBJECTS
Thirty full-time instructors of the Copper Mountain Ski Education Center volunteereed to participate in the study* Participants included nineteen men and eleven women ranging in age from twenty-three to fifty-five.
The mean age was 30 .1 years.
SURVEY PROCEDURES
The thirty participants were assigned to one of three
groups by a random draw. Each subject received a survey packet and oral instruction as to procedures, depending upon group assignment. Each survey packet contained a liability release form (Appendix A), five perceived energy questionnaires (Appendix C), four daily dietary intake forms (Appendix B),
and sample diets depending upon group assignment. 18
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 19 All thirty subjects were allowed to choose when to begin the experiment to avoid overlapping with days off
or days not skied. Subjects were instructed to fill out the first perceived energy questionnaire on the same day the first dietary intake form was completed. Participants were expected to either be skiing or teaching on the days in which the survey forms were completed. Instructors were to fill out the perceived energy questionnaire immediately after ski school check-out time in the afternoon. The subjects were to record their immediate reaction as to how they perceived themselves
at that very moment and not try to analyze the questionnaire too closely.
SURVEY GROUPS
Group One - Control
Group one was made up of ten subjects chosen by a random draw from the initial group of thirty volunteers. They were designated to be the control group and were to
consume their normal diet (NMD). All subjects were issued the basic survey packet with instructions to
record everything consumed, including beverages, for four
consecutive days. They were to simultaneously fill out the five consecutive perceived energy questionnaires.
All subjects in the control group were advised to eat and
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 2 0 drink in as normal a pattern as possible.
Group Two - High Carbohydrate Intake
Ten subjects were assigned by a random draw to group two, known as the high carbohydrate diet group (HOD).
Group two subjects received the basic survey packet plus a sample high carbohydrate diet with suggestions for
alternatives (Appendix D). The HOD group was instructed to consume at least sixty percent of their total dietary intake in the form of carbohydrates.
Group Three - Low Carbohydrate Intake
The final ten subjects were assigned to the low carbohydrate intake group (LCD). They received the same basic survey packet plus sample low carbohydrate diets with suggestions for alternatives (Appendix E). This group was instructed to consume no more than thirty percent of their daily caloric intake in the form of carbohydrates.
STATISTICAL PROCEDURES
After all the data was collected, the daily dietary intake forms were analyzed regarding content based upon
computations as set forth by Deutsch (19)* Data to test the Null Hypothesis I stating that no
difference would occur between the control group's diet
and the established averages for the adult American's diet.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 21 was analyzed using Z Scores to establish the significant
differences between two independent proportions. Those subjects meeting the established criteria for carbohydrate intake were used for further analysis of
Hypothesis II which states no difference would occur in perceived energy levels of ski instructors ingesting a high carbohydrate diet, a low carbohydrate diet, or a normal mixed diet over a five day survey period. Data to test the Null Hypothesis II was analyzed using Chi Square tests to determine significant differences
between samples. Formulas for computation are found in Appendix F.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Chapter IV
ANALYSIS OF DATA
Survey packets were administered to thirty instructors of the Copper Mountain Ski Education Center. Data was
collected and analysis was done based upon information obtained from the dietary intake forms and the perceived energy questionnaires. Twenty-four completed survey packets were returned. Dietary intake forms for actual diet consumed by all
subjects were analyzed to establish whether the criteria (ie. 60^ or greater CHO intake for group two or or less CHO intake for group three) for group assignment
had been followed and met. Two subjects, assigned to group two and group three respectively, had switched diets with each other due to individual dietary preferences.
Neither individual met the criteria and were not used in final analysis. Nineteen subjects met all established criteria and
were used for further analysis. The results of the content analysis of the daily dietary intake forms are
shown in Table I.
Eight control group survey packets were returned and
all met established criteria. Only four of the eight
high carbohydrate survey packets returned met the sixty
22
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 23
TABLE I
CONTENT ANALYSIS OF
IVIEAN DIETARY INTAKE *
Group One Group Two Group Three (Control) (High CHO) (Low CHO)
% CHO Fat Protein % CHO % CHO
JC 35 48 1 7 RA 5 2 RK 3 0
TD 29 38 33 SC 65 CM 3 1
EJ 5 6 37 7 SG 62 MM 20
DM 41 4 5 14 JJ 60 DS 24
GM 4 5 35 20 JJ 5 4 MS 28
MP 2 9 60 11 GS 60 MS 2 3
KS 35 33 3 0 TS 5 0 ST 24
BS 37 39 2 4 PS 55 FY 19
* % representations are aproximate as exact caloric intake as to portion and serving size and individual food preparation were not measured in this study.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 24 percent carbohydrate intake level. Seven of the eight low carbohydrate intake survey packets could be used for final statistical analysis.
Testing of Null Hypothesis I
The control group was compared with the adult American
norms as set forth by a U.S. Senate Select Committee on Nutrition and Human Needs. According to Brody (10), the average adult American consumes a daily average of 42^ fat, 12^ protein, and 46^ carbohydrates. The daily dietary intake mean of the control group was 42j5 fat, 19% protein, and 38% carbohydrates. A Z score to establish the significant differences between two independent proportions was used to determine whether to accept or reject the Null Hypothesis I that no difference would occur between the control group and the average American diet. The results are shown in Table II. According to the 2 scores no significant difference
does exist between the norms for the American population and the dietary intake of the control group. The Null Hypothesis I was then retained on the basis of no
significant difference.
Testing of Null Hypothesis II
All answers on the perceived energy level questionnaire were assigned a corresponding numerical value from one to five. These answers were based upon the subject’s reaction
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 25
TABLE II
DIFFERENCES BETWEEN GROUP ONE AND AVERAGE AMERICAN ADULT DIET
% CHO Protein Fat Average American Diet 46 % 12^ hZfo 20^ 42^ Group One Mean 38^
Z Score .4653 .5357 .0075
P - .05
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 2 6 to his present energy level at the time of testing.
Each score was tabulated to find a daily median and a five day cumulative median for each subject, as well as for each group respectively. The results are shown in Table III for the control group. Table IV for the high carbohydrate intake group, and Table V for the low carbohydrate intake group. Figure I graphically represents the daily medians for the control group, the high carbohydrate group, and the low carbohydrate intake group.
FIGURE I
PERCEIVED ENERGY TABULATION BETWEEN GROUPS
high
Perceived 5 Energy 4 3 2 low 1
Days
C = control H - high carbohydrate diet L = low carbohydrate diet
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 27
TABLE III
PERCEIVED EMEPCY QUESTIONNAIRE TABULATION FOR THE CONTROL GROUP
day 1 day 2 day 3 day 4 day 5 cumulât ive
JC 3.4 2.9 2.8 2.6 2,2 2.78
TD 4.2 3.8 4.2 3.9 4.2 4.06 EJ 2.9 2.8 4.1 3.0 2.9 3.14 DM 3.2 3.0 2.5 3.2 3.3 3.04
GM 3.7 4,2 3.9 4.1 3.6 3.90 MP 3.0 2.0 3.0 4.0 3.9 3.18
KS 3.4 2.6 2.9 3.3 3.6 3.16
BS 3.6 3.4 3.1 2.9 3.0 3.20
Med Ian 3.^5 2-95 3.05 3.25 3.45 3.17
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 28
TA^LE IV
PERCEIVED ENERGY QUESTIONNAIRE TABULATION FOR THE HIGH CARBOHYDRATE GROUP
Day 1 Day 2 Day 3 Day 4 Day 5 Cumulative
RA
SC 3.2 4.0 3.9 4.6 4.4 4,02
SG 3.4 2.9 3.8 4.0 4.1 3.64
JJ 3.4 3.8 4.4 4.4 4.4 4.08
JJ ------
GS 3.4 3.4 3.6 3.8 3.9 3.62 TS —- - -
PS - - - —
Median 3.4 3.55 3.85 4.20 4.25 3.83
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 29
TABLE V
PERCEIVED ENERGY QUESTIONNAIRE TABULATION
LOW CARBOHYDRATE GROUP
Day 1 Day 2 Day 3 Day 4 Day 5 Cumulative
RK 2.5 3.7 3.6 2.0 2.2 2.80
CM - - - - -
MM 2.5 4.0 3.^ 4.5 4.5 3.78
DS 3.3 3.7 2.8 3.0 3.0 3.16
MS 4.0 2.8 3.2 4.3 3.6 3.58
MS 3.3 3.3 3.6 2.8 3.1 3.22
ST 3.9 2.7 2.6 3.5 2.9 3.12
FY 3.1 3.5 3.6 3.9 3.2 3.46
Med Ian 3.3 3.5 3.4 3.5 3.1 3.22
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 30 The Null Hypothesis II, which states that no difference between perceived energy levels will occur when subjects are measured on a HCD, a LCD, or a NMD over a five day survey period, was analyzed using a chi square test to establish significant differences between independent samples. Chi square test results are shown in Table VI, No significant difference was found between any of the three groups on the first and second day of the survey. A significant difference (p = .0 5 ) did occur on day three between the HCD group and the LCD group. Significant difference also occurred between these groups on the fifth day. No significant difference was found between the NMD and the HCD groups. Nor were any significant differences found on any of the days between the NMD group and the LCD group. The cumulative scores showed no significant differences between the three groups. The Null Hypothesis II was rejected on the basis that significant difference did occur between perceived energy levels of the HCD group and the LCD group on the third and fifth days.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 31
TABLE VI
COMPARISONS OF DIFFERENCES
BET WEEN GROUPS
(p = .0 5 )
CHI SINARE COMPARISONS RETVJ 'EN ALL GROUPS
day 1 1.9525
day 2 1.7132
day 3 6.8560 *
day 4 3.2349
day 5 8.8969 *
INDIVIDUAL CHI SQUARE COMPARISONS ON DAYS OF SIGNIFICANT DIFFERENCES WITH YATES CORRECTION
DAY THREE DAY FIVE
HCD/LCD 5.2288 * H C D / L C D 5.2288 *
HCD/NMD .2812 H CD/NMD 2.6667
LCD/NMD . 6 3 2 6 L C D / N M D ,8010
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Chapter V
SUMMARY, CONCLUSIONS. AND RECOMMENDATIONS
SUMMARY
This study was conducted to survey the difference between perceived enerry levels of ski Instructors at high altitude in relationship to a high carbohydrate diet, a low carbohydrate diet, and a normal mixed diet. The difference between the control group, on a normal mixed diet and the established norms for the adult American diet were also surveyed. Thirty full-time ski instructors participated in the survey. Ten instructors were assigned to each of three groups. Group one was designated the control group. Group two was the high carbohydrate intake group, and group three was designated the low carbohydrate intake group. Twenty-four completed survey packets were returned. Nineteen of the tvrerty-four packets met all criteria and were used for final analysis of data. There were two main objectives in this study. The first objective was to establish whether the existing diet of ski instructors at the Copper Mountain Ski Education Center, as measured by the control group, were 32
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 33 consistent vrlth the estobllshed dietary averapres of the adult American, The second objective was to determine if differences in hiprh and low carbohydrate intake over a
five day survey period could result in changes in perceived enerp-y levels.
Data was analyzed using Z scores to determine differences between the control group and the adult American population, Chi square tests were used to establish differences in perceived energy levels between instructors on a high carbohydrate diet, a. low carbohydrate diet, or a normal
mixed diet. The level of significance was accepted
at p = ,0 5 . The analysis of data yielded the following findingsi
1, No significant difference was found between
the daily dietary intake of the control group
on a NMD when compared to the norms for the
American population, 2, No difference was found in perceived energy levels
between diets on either the first or second day
of the survey,
3 , Significant difference did occur on the third day
between perceived energy levels of instructors
on a HCD when compared to those on the LCD,
Difference was also found on the fifth day between
these two groups, with the high carbohydrate intake
group presenting higher perceived energy levels.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 34 4# No slp-niricant differences were found between instructors on a HCD and those on a NMD. No
d 1 fferences were found between the control proup on a NMD and the LCD c?roup,
CONCLUSIONS
This study was undertaken to determine whether differences in perceived enerpry levels of ski instructors
could be distinguished between subjects on a HCD, a LCD, or a NMD and whether the diet of the average ski instructor at the Copper Mountain Ski Education Center was consistent with the average American Adult’s diet. The results supnort the conclusions that the diet of the Copper Mountain
instructor is consistent with that of the American population. Secondly, differences in perceived energy
levels can occur within a five day period when subjects
are subjected to different amounts of carbohydrate
ingestion. The results of this study show that no significant
difference occurred among diets on the first or second
day. Significant differences did occur on the third and
fifth days between the HCD group and the LCD group. These
results are consistent with the earlier findings of Hultman,
Costill, Eriksson, and Karlsson (^8 ,17,20,32), The HCD group had higher perceived enervy scores on the third and
fifth days than either the low carbohydrate Intake group
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 35 or the control p;roup. No sig:nifleant differences occurred between the control proup and the LCD subjects
or between the HCD subjects and the control gcroup on a NMD. The Null Hypothesis I was retained on the basis that no differences were found between the protein, fat, and carbohydrate Intake of the control prroup when compared to the averag'e American adult's diet. The Null Hypothesis II was rejected when significant differences were found between the HCD group and the LCD group.
RECOMMENDATIONS
This investigation has compiled data that suggest
the diet of the full-time ski instructor at Copper Mountain
was consistent with the average American diet. The
investigation also suggests that a dietary change high in carbohydrates was beneficial in increasing perceived energy
levels on a five day testing period. Despite significant results, obvious limitations
occurred in this study. Inability to control precise
serving size and individual food preparation resulted in
approximations regarding caloric intake. Extraneous
variables including amount of sleep, alcohol, and drug
intake were not measured.
Recommendations for Future Research
The present study has compiled data which may aid
in understanding the role of diet on skier energy levels.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 36 Further research is recommended in order for this information to be applicable to the skier population in general. Further research should include the followingi 1. Conduct the survey over a longer period of
time to eliminate the possibility of a placebo effect.
2. Use the same subjects on both a HCD and a LCD to eliminate the effects of individual variations including sleep, alcohol, and drug intake, 3. Maintain a log of vertical feet of skiing per day and whether skiing was done in a teaching situation or a free skiing situation. 4. Survey the skier population, in general, to establish whether diet can result in decreased
fatigue and increased enjoyment of the sport,
5. Study the skier population in relationship to
diet to measure whether a change in dlet can
decrease the incidence of skier injury.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. SELECTED BIBLIOGRAPHY
37
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. BIBLIOGRAPHY
1. Ahlborg, B., J. Bergstrom, L. Ekelund, and E. Hultman, "Muscle Glycogen and Muscle Electrolytes During Prolonged Physical Exercise," Acta Physioloeica Scandinavica. 70%129-142, 196?,
2. Asmussen, E . , K. Klausen, L. Nielsen, and P. Ponder, "Lactate Production and Anaerobic Work Capacity After Prolonged Exercise," Acta Physiologica Scandinavica. 90%731-734, 1974. ------
3 . Astrand, P., "Interrelationship Between Physical Activity and Metabolism of CHO, Pat, and Protein," in G. Blix (ed.)i Nutrition and Fitness, Almquist and Wiksells, Sweden, 19 6 7 .
4. Astrand, P. "Diet and Athletic Performance," Federation Proceedings, 26:1772, I9 6 7 ,
5 . Astrand, P., and K. Rodahli Textbook of Work Physiology, New York: McGraw-Hill, 19771 p.483.
6 . Bailey, C.% Fit or Fat, Pleasant Hill, California: Covert Bailey Publications, 1977.
7 . Bergstrom, J., "Muscle Electrolytes in Man," Scandinavean Journal of Clinical Lab. Invest., 14 (Supplement 6Ô )V 1962. 8 . Bergstrom, J., L. Hermansen, E. Hultman, and B. Saltin, "Diet and Muscle Glycogen on Physical Performance," Physiologica Scandinavica, 71»l40-150, I9 6 7 .
9 . Bogert, L., G. Briggs, and D. Calloway: Nutrition and Physical Fitness, Philadelphia: W.B. Saunders, Co., 1966, p.2 0 . 10. Brody, J., "Guide to Good Nutrition," Woman* s Day: November 20, 197 8, pp.113-1 1 6 . 11. Carson, R ., W. Evans, J. Shields, and J. Hannon, "Symptomology, Paraphysiology and Treatment of Acute Mountain Sickness." Psychological Reports, 19*1085- 1091, 1966. ------
12. Chapler, C., and W. Stainsby, "CHO Metabolism in Contracting Dog Skeletal Muscle, in situ," Journal of American Physiology, 215:995-1004, 1968.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 39 13. Christensen» E. and 0. Hansen, "Exercise and Nutrition," Scandinavean Archives of Physiology. 8l* 160, 1939. 14. Consolazio, C., L. Matoush, H. Johnson, H. Krzywicki, T. Davis, and G. Isaac, "Effects of High CHO Diet on Performance and Clinical Symptomatology after Rapid Ascent to High Altitude," Federation Proceedings, 28*937-943, 1 9 6 9 .
1 5 . Consolazio, C ., H. Johnson, and H. Krzywicki, "Body Fluids, Body Composition and Metabolic Aspects of High Altitude Adaptation, in M. Yousef (ed.)1 Physiological Adaptations. p p .227-241, Academic Press, New York, 1 9 7 2 .
1 6 . Costill, D . , K. Sparks, R. Gregor, and C. Turner, "Muscle Glycogen During Exhaustive Running," Journal of Applied Physiology. 31*353-356, 1971.
1 7 . Costill, D., R . Bowers, G . Bronam, and K. Sparks, "Muscle Glycogen Utilization During Prolonged Exercise on Successive Days," Journal of Applied Physiology, 31* 834-8 3 7 » 1 9 7 3 . 1 8 . Costill, D . , P. Gollnick, E. Jonsson, and B, Saltin, "Glycogen Depletion Pattern in Human Muscle Fibers During Distance Running, Acta Physiologica Scandinavica. 8 9 *374-3 8 3 , 1 9 7 3 . 1 9 . Deutsch, R .: Pocket Fat Counter. Palo Alto, California Bull Publishing Company, 197^. 20. Eriksson, E., E. Nygaard, and B. Saltin, "Physiological Demands in Downhill Skiing," The Physician and Sportsmedicine, December, pp.29-37* 1977 * 21. Ekolom, B. and A. Goldbarg, "The Influence of Physical Training and Other Factors on the Subjective Rating of Perceived Exertion," Acta Physiologica Scandinavica, 83*399-406. 1971 * 22. Evans, W., "Measurement of Subjective Symptomatology of Acute High Altitude Sickness," Psychologic^ Reports, 19*815-8 2 0 , 1 9 6 6 .
2 3 . Frisancho, A., "Functional Adaptation to High Altitude Hypoxia," Science, 187*313-319. 1975 24. Hansen, J., Hartley, and R. Hogan, "Arterial Oxygen Increased by High CHO Diet at Altitude, Journal of Applied Physiology. 33*441-445. 1972.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 40 25. Hermansen, L., E. Hultman, and B. Saltin, "Muscle Glycogen During Prolonged Severe Exercise," Physiologica Scandinavica. 71:129-139, 196?. 26. Horvath, S., "Physiology of Work at Altitude," in M. Yousef and S. Horvath (eds.): Physiological Adaptations, pp.183-190. New York: Academic Press, Inc., 1972,
2 7 . Hultman, E, and J. Bergstrom, "Muscle Glycogen Synthesis in Relation to Diet Studied in Normal Subjects," Acta Medica Scandinavica. 182:109-117, I967.
2 8 . Hultman, E .: "Muscle Glycogen Stores and Prolonged Exercise, in R. Shephard (ed.): Frontiers of Fitness, p.37, Charles C. Thomas, Springfield, 1971.
2 9 . Hurtado, A., "The Influence of High Altitude on Physiology," in R. Porter and J. Knight (eds): High Altitude Physiology, pp.3-8, Churchill and Livingstone, London, 1971•
3 0 . Isaac, S. and W. Michael,: Handbook in Research and Evaluation, pp.124-134, Edits PubTîshers, San” Dîego 1 9 7 7 .
3 1 . Johnson, H., C . Consolazio, J, Krzywicki, and T. Daws, "The Effect of Diet Upon Men Exposed to Altitude," Federation Proceedings, 28:593» 1969.
3 2 . Karlsson, J., A. Eriksson, A. Forsberg, L. Kallberg, and P. Tesch: The Physiology of Alpine Skiing. Published by U.S. Coaches Association, Park City, Utah, 1977*
3 3 . Keul, Doll, and D. Keppler: Energy Metabolism of Human Muscle, Baltimore: Uniyersity Park Press, 1972, pp.19, 1 0 0 , 2 0 3 . 204.
3 4 . Marrack, D., "Regulation of Glycogen Metabolism in Man," American Journal of Clinical Pathology. 50:12-20, 1 9 6 8 .
3 5 . Morgan, W.,"Psychological Factors Influencing Perceived Exertion," Medicine and Science in Sports, 5*97-103» 1973. 3 6 . Noble, B., K. Metz, K. Pandolf, and E, Cafarelli. "Perceptual Responses to Exercise* A Multiple Regression Study, Medicine and Science in Sports, 5*104-109, 1973»
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 41 37. Piehl, K., "Time Course for Refilling of Glycogen Stores in Human Muscle Fibers Following Exercise Induced Glycogen Depletion,” Acta Physiologica Scandinavica. 90*297-302, 1974.
3 8 . Piehl, K., "Glycogen Storage and Depletion in Human Skeletal Muscle Fiber," Acta Physiologica Scandinavica, Supplement 402*1-33, 1 9 7 W. 3 9 . Ratliff, R . and D . Lamb, "Glycogen Replenishment Following Exercise," Journal of Applied Physiology. 38:961- 964, 1 9 7 5 . ------40. Saltin, B ., "Aerobic Work Capacity and Circulation in Man," Acta Physiologica Scandinavica 62* (supplement 2 3 0 ) 2 5 , 1 9 ‘64T
41. Saltin, B ., and L. Hermansen, "Glycogen Stores and Prolonged Severe Exercise," in G . Blix (ed.): Nutrition and Fitness, pp.32-46, Almquist and Wiksells, Sweden, 1967. 42. Science News, IBP* "Setting the Stage," 92*512, 196?,
4 3 . Skinner, J., R . Hutsler, and E. Buskirk, "Validity and Reliability of a Rating Scale of Perceived Exertion," Medicine and Science in Sport, 5*94-94, 1973* 44. Smith, N.: Food for Sport, Palo Alto, California* Bull Publishing, p.13, 1973. 4 5 . Wilmore, J.* Athletic Training and Physical Fitness, Boston* Allyn and Bacon, Inc., p.20, 1977.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. a p p e n d i x a
VOLUNTEER FORM
42
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 43
VOLUNTEER FORM THE EFFECTS OF HIGH AND LOW CARBOHYDRATE DIETS ON PERCEIVED ENERGY LEVELS OF SKI INSTRUCTORS AT HIGH ALTITUDE
I hereby freely volunteer to act as a subject in a scientific investigation as an authorized part of the educational and research program of the University of Montana and the Copper Mountain Ski Education Center. I acknowledge that I have read and concur in the procedures and objectives of this investigation as summarized on this sheer,
I certify that to the best of my knowledge and belief» I have no physical or mental illness or weakness that would increase the risk to me of participation in this investigation. The investigation involves the analysis of different diets on the perceived energy level of full-time ski instructors. Volunteers will be randomly divided into three groups. One group will remain on their normal diet and will fill out a five day series of questionnaires. One group will be asked to consume a carbohydrate rich diet for four consecutive days and the last group will consume a carbohydrate low diet for the four day period. Changes in diet were not designed to affect weight loss or gain. If you decide to volunteer please sign this sheet indicating your willingness to comply with the provisions of the investigation and your willingness to assume personal risks of participation.
Date
Age
Signature of Subject
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. APPENDIX B
DIETARY INTAKE FORM
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. ^5
DIETARY INTAKE RECORD
Name Please list everything consumed daily including beverages. List quanity or serving size ------if known. Date
BREAKFAST
LUNCH
SNACKS
DINNER
SNACKS
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 46
APPENDIX C
PERCEIVED ENERGY QUESTIONNAIRE
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. ■DCD PERCEIVED ENERGY QUESTIONNAIRE O Q. C g Q. Fill out as soon as possible after ski school check-out or skiing. Put a ■D CD circle around the phrase which best describes how you feel right at this moment. Put down what first comes to mind. Do not try to analyze too closely. C/) C/) o 3 1. very lively a little lively about average less lively not lively 3 liveliness than usual at all ~o8 2 . not tired less tired than about average a little tired very tired at all usual tiredness CQ i not irritable less irritable about average a little very 3 3. CD at all than usual irritability irritable irritable c"n 3. 4. no headache a little some headache bad headache severe 3" CD at all headache headache ■DCD O 5. very active a little active about usual less active not active C a activity than usual at all
3 ■o 6. not lazy less lazy than about usual less active not active O 3" usual laziness CT 1—H CD Q. 7. very a little about usual less energy not energetic 1—H than usual at all 3" energetic energetic energy O
■O 8 . very refreshed a little about usual less refreshed not refreshed 1 refreshed refreshed than usual at all C/) C/) o' 3 9. very a little about usual less comfort not comfortable comfortable comfortable comfort than usual at all
10. not hungry less hungry about usual a little very hungry than usual hungriness hungry APPENDIX D
HIGH CARBOHYDRATE SAMPLE DIET
AND ALTERNATIVES
48
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 49
HIGH CARBOHYDRAfE SAMPLE DIET AND ALTERNATIVES
You will be on a high carbohydrate diet for four consecutive days. Listed below are sample high carbohydrate diets. These are only for reference and need not be followed explicitly. You are free to choose from the alternative list that follows. Try to stay within your normal caloric intake but substitute carbohydrate rich foods for as much of your caloric intake as possible.
BREAKFAST LUNCH DINNER SNACKS CEREAL jelly sandwich Spaghetti raisins or SKIM OR Z% milk fruit (apple) Salad fruit or toast and jam soda or fruit cake or pie dessert juice drink chocolate bar
french toast or hamburger chicken same as above pancakes fruit mached potatoes juice soda or fruit vegetables drink fruit salad
♦coffee, tea, or water may be consumed with any meal or anytime.
SUGGESTED ALTERNATIVES: whole grain breads and cereals, spaghetti, lasagna, pasta, Mexican food, Italian food, pie, cake, waffles, pancakes, cookies, popcorn, potatoes, rolls, jelly, all vegetables, fresh and dried fruit, wheat, rice, corn, fruit juices, soft drinks, skim or 2% milk, beer instead of mixed drinks, lettuce, cabbage, and if meat desired - poultry and fish (preferably only once).
FOODS TO AVOID: red meat (beef and pork), whole milk cheese, ice cream, bacon, eggs, excess butter, margarine, salad oil, peanut butter, potato chips, and french fries. Avoid most fried foods.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. APPENDIX E
LOW CARBOHYDRATE SAMPLE DIET
AND ALTERNATIVES
50
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 51
LOW CARBOHYDRATE SAMPLE DIET AND ALTERNATIVES
You will be on a low carbohydrate diet for four consecutive days. Listed below are sample low carbohydrate diets. These are only for reference and need not be followed explicitly. You are free to choose from the alternative list that follows. Try to stay within your normal caloric intake but substitute foods that are low in carbohydrate for as much of your caloric intake as possible.
BREAKFAST LUNCH DINNER SNACKS two eggs hard boiled steak yogurt or bacon eggs salad ice cream milk yogurt french fries milk ice cream
yogurt grilled cheese beef or pork cheese or "Al*s doughnut' french fries salad above milk milk fried potatoes
♦coffee, tea, or water may be consumed with any meal or anytime.
SUGGESTED ALTERNATIVES: bacon, eggs, salad, salad dressing, cheese, dairy products, whole milk, peanuts, potato chips, ice cream, as much beef and pork as desired. Mixed drinks that do not include pop should be substituted for beer.
FOODS TO AVOID: breads, cereals, pancakes, waffles, wheat, rice, corn, excess fruits and vegetables, beer pasta, spaghetti, lasagna, and most desserts in excess such as pie, cake, and cookies.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. APPENDIX F
FORMULAS FOR COMPUTATION
52
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 53
FORMULAS FOR COMPUTATION
Chi Square test to measure a significant difference between Independent samplest
X2 = N(AD - BC) ^______(a + B) (C + D) (A + C) (B + D)
degree of freedom = (Rows - l) (Columns - 1)
Z score to measure a significant difference between two Independent proport Ions :
2 = PI - P2 SPl - P2
P = proportion S = standard error of proportion
SPl - P2 = y p q X (i X l) K N
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.