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Athletes with sickle cell trait deserve special attention to optimize performance and prevent a medical emergency due to the complex nature of the condition. Sickle cell trait is considered benign at rest yet dangerous during exercise. During exertional activities, athletes with sickle cell trait have a reduced oxygen carrying capacity, possibly leading to lactic acid buildup causing red blood cells to sickle. The practitioner should implement pre-calculated work-to-rest ratios or allow athletes to self-pace. Low atmospheric pressure at high altitudes lowers oxygen saturation levels, increasing the risk of red blood cells sickling. If travel to high-altitude areas is necessary for athletes with sickle cell trait, stakeholders (including coaching staff) will need to be educated on the risks, modify activities and set restrictions based on symptoms. Exercising in warm to hot environments raises core body temperature, potentially causing red blood cells to sickle as warmed blood moves from the core of the body to the working muscles. Practitioners should monitor environmental conditions using wet bulb globe temperature and modify activities based on established heat risk zones along with the utilization of heat acclimatization guidelines to promote beneficial adaptations.
Course Objectives
Course
Credits
Course Expiration
ACSM
1
02/28/2028
BOC
1
02/28/2028
Commission on Dietetic Registration
1
03/06/2028
CSCCa
1
02/28/2028
The management of fluctuating blood glucose levels in athletes with type 1 diabetes (T1D) is crucial for both safety and performance during training, sport and competition. Low blood glucose (hypoglycemia) is a major barrier to most forms of exercise, but activity-related high blood glucose levels (hyperglycemia) can also occur with some forms of intense exercise and when insulin dose adjustments are suboptimal for exercise. Continuous glucose monitors (CGM) offer real-time insights into interstitial glucose levels, as a proxy for circulating blood glucose concentrations, for these individuals and their coaching and support teams. Endurance and resistance training present unique challenges in glucose self-management for physically active individuals with T1D, as aerobic exercise generally decreases glucose levels while anaerobic exercise keeps glucose more stable or can increase it. With competition, glucose levels may rise because of stress hormones, but then glucose levels can drop into the hypoglycemic range (low blood glucose levels) in recovery. Proactive blood glucose measures guided by CGM are critical. CGM data helps to inform carbohydrate intake strategies for training and competition, and to help guide more appropriate insulin adjustments for different forms of activity (e.g., aerobic, anaerobic, mixed), with the primary goal of reducing the occurrence of both hypo- and hyperglycemia.
Course Objectives
Course
Credits
Course Expiration
ACSM
1
02/25/2028
BOC
1
02/25/2028
Commission on Dietetic Registration
1.25
03/03/2028
CSCCa
1
02/25/2028
Dietary protein ingestion to support skeletal muscle recovery, acute reconditioning and longer-term adaptations to exercise training represents a cornerstone within modern sports nutrition. However, most of our recommendations tacitly assume protein needs can be met by the (increased) consumption of animal-derived protein sources. There is interest for an evidence base for increasing alternative dietary protein choices within sports nutrition. While protein ‘source’ has traditionally been less studied within sports nutrition, data are now accumulating such that we can begin to incorporate this issue within modern sports nutrition recommendations. A clear practical challenge for the athlete wishing to become less reliant on animal-derived foods is obtaining sufficient dietary protein. However, it is clear the accelerating availability of alternative protein rich foods is making this achievable. It has traditionally been assumed that animal-derived proteins are the most anabolic (i.e. the most robust at stimulating muscle protein synthesis rates), attributable to a high bioavailability and leucine content. Our evolving understanding and expanded dataset now suggests anabolic parity between animal and carefully selected alternative proteins can be achieved. Promising alternative dietary protein sources that have been investigated include a variety of plant- (including blends), fungal-, algal- and insect-derived proteins. All these proteins provide differing challenges and opportunities, with each existing at various stages of maturity concerning the data supporting their application, and broader applied and commercial viability. Acute studies of muscle protein synthesis and translational studies of muscle adaptive responses to training now show equivalent magnitude responses can be achieved using traditional omnivorous diets and/or animal-derived protein supplementation compared with (more) alternative protein-based approaches, assuming sufficient protein is consumed. However, many limitations in our knowledge base still exist; including how alternative diets interact with different training regimens, populations and various adaptive responses.
Course Objectives
Course
Credits
Course Expiration
ACSM
1
02/21/2028
BOC
1
02/21/2028
Commission on Dietetic Registration
1.25
02/19/2028
CSCCa
1
02/21/2028
Sexual reproduction is one of the most notable sex differences. During puberty girls experience menarche, which signals the ‘official start’ of the menstrual cycle and persists until menopause. During the menstrual cycle, the ovarian hormones oestrogen and progesterone fluctuate in a predictable repeating pattern, although it should be noted that there is large inter- and intra-individual variability in cycle length and hormone levels. Aside from their paradigmatic roles, oestrogen and progesterone have been shown to have non-reproductive functions. As such, the menstrual cycle has developed - over the last century - into a topic of interest for female athletes from a health and performance perspective.
Course Objectives
Course
Credits
Course Expiration
ACSM
1
02/13/2028
BOC
1
02/13/2028
Commission on Dietetic Registration
1
02/10/2028
CSCCa
1
02/13/2028
While total energy needs of female athletes are lower than male athletes, macronutrient needs tend to be similar relative to body size (i.e. g per kg body mass). Macronutrient utilization may vary over the course of a menstrual cycle; however, the overall effect appears to be small and can be minimized with proper fueling. Micronutrient needs of female athletes differ from male athletes, and the risk of deficiency should be considered in the development of nutrition plans. Nutrition programs that encourage autonomy, build competence and enhance connection have the potential to improve athlete performance by increasing intrinsic (internal) motivation. Nutrition plans should consider the individual needs of female athletes and be adjusted throughout the training and competitive phase to help athletes achieve their goals.
Course Objectives
Course
Credits
Course Expiration
ACSM
1
01/27/2028
BOC
1
01/27/2028
Commission on Dietetic Registration
1
01/23/2028
CSCCa
1
01/27/2028
Interval training describes an intermittent style of exercise in which repeated bouts of relatively intense effort are interspersed with short recovery periods. The basic premise is simple, but responses depend on many variables, including the intensity, duration, and frequency of work bouts, and overall training volume. An ~80-to-20 ratio of low- to-moderate-intensity and high-intensity/interval training is commonly recommended to optimize performance in already well-trained athletes who compete in events that require a high rate of aerobic energy provision. The optimal interval training strategy to enhance performance in highly trained athletes is unknown and likely depends on individual characteristics and the demands of the sport or event. There is debate over the best method to structure the portion of training time spent at high intensity including whether a polarized, pyramidal, or threshold approach to intensity distribution is optimal to enhance endurance performance. A key focus of interval training for health has been on maximal oxygen uptake (VO2max), a direct measure of the clinical correlate cardiorespiratory fitness, which is a strong predictor of mortality and risk for many chronic diseases. Recent research has shown the potential for simple, practical, and relatively time-efficient applications of interval training to increase VO2max and other health-related markers. This includes include “exercise snacks” or short (≤1 min) bouts performed periodically throughout the day, and “vigorous intermittent lifestyle physical activity”, which refers to short bursts of vigorous effort embedded incidentally or secondary to regular activities of daily living.
Course Objectives
Course
Credits
Course Expiration
ACSM
1
01/16/2028
BOC
1
01/16/2028
Commission on Dietetic Registration
1
01/09/2028
CSCCa
1
01/16/2028
Athletes’ use of supplements is highly prevalent across sport and competitive levels. High prevalence is combined with indiscriminate use. This remains a concern in sport as it can lead to negative health effects and the risk of committing an anti-doping rule violation. Consequences of committing an anti-doping rule violation through supplement use are significant for competitive athletes due to the principle of strict liability. The principle of strict liability interacts with a growing and professionally marketed industry that is poorly regulated. Consequently, competitive athletes can find themselves in a vulnerable and risky position when it comes to consuming supplements. Dr Susan Backhouse discusses adopting a behavioral approach and adherence to RMSUG to help identify what needs to change to protect athletes from unintentionally doping through indiscriminate supplement use.
Course Objectives
Course
Credits
Course Expiration
ACSM
1
12/27/2027
BOC
1
12/27/2027
Commission on Dietetic Registration
0.75
01/03/2028
CSCCa
1
12/27/2027
Daily hydration management for a youth athlete extends beyond just sport performance to also facilitating academic achievement and overall health. Establishing sensible hydration behaviors as a youth athlete can be instrumental in underpinning healthy hydration habits as an adult that enable wellness and help to maintain long-term health. As youth develop and advance through sport, they need to develop personal initiative and autonomy to make healthy and ethical decisions about their involvement in sport, including managing their own hydration needs and strategies. Dr Michael Bergeron discusses contemporary approaches utilizing multi-domain, complex systems, and state-of-the-art tools and methods instrumental in fully recognizing the wide-ranging role and contribution of hydration to youth athletes’ health and sustainable sport participation and performance.
Course Objectives
Course
Credits
Course Expiration
ACSM
1
12/17/2027
BOC
1
12/17/2027
Commission on Dietetic Registration
0.75
12/12/2027
CSCCa
1
12/17/2027
Athlete monitoring can be used to gauge and elevate players’ responses to training to help the maintenance of maximal performance and minimize injury and/or illness risk. There are many tools for both internal and external load monitoring, however little research has been performed within the context of American football. Given that American football is a team sport made up of different positions requiring unique skillsets and game demands, the individualization of monitoring tools and/or techniques is critical. Data analysis and interpretation needs context, both in terms of training phase (e.g., preseason vs. in-season) and in determining meaningful changes in selected monitoring tools. The authors review different parameters associated with external and internal load assessments in football and tools on how to monitor the player’s recovery with the aim of optimizing both their health and performance.
Course Objectives
Course
Credits
Course Expiration
ACSM
1
11/27/2027
BOC
1
11/27/2027
Commission on Dietetic Registration
1.25
12/03/2027
CSCCa
1
11/27/2027
