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Optimal Nutrition for Active People with Pre-Existing Health Conditions

Do you have a pre-existing health condition that negatively impacts your ability to take part in physical activity? Have you felt like you are repeatedly battling against yourself and considered throwing in the towel, ending your fitness or athletic journey because of it? If you answered yes to either of these questions, you are not alone.

People of all ages can be born with or develop diabetes, Crohn's disease, celiac disease, irritable bowel syndrome, and asthma which limit their ability to be active without discomfort. It is up to these individuals to learn how to best prepare for physical activity in a way that keeps them safe. Luckily, proper nutrition is one of the simplest, most accessible and important ways to achieve safe exercise practices and outcomes. This goes for anyone, but is even more important for those with the aforementioned conditions.[8]

By the end of this article, you will know exactly what to consume before, during, and after physical activity. Proper nutrition is vital to achieving the best physical outcome with the least amount of discomfort, or worse, lasting damage.

Optimal nutrition for diabetes

In 2018, 10.5% of the US population was living with diabetes.[14] One of the most common concerns for those with diabetes when engaging in moderate to vigorous exercise is the possibility of experiencing hypoglycemia, a state where one's blood sugar drops below safe levels.[13] It is vital to beware of the signs that may indicate hypoglycemia, including feeling light-headed and dizzy, as well as headaches and sudden hunger. If all who engage in exercise are aware of these waring signs, the incidences of dangerous hypoglycemia could be diminished dramatically.

Carbohydrates are the main macronutrient to consider when trying to keep blood sugar levels safe. Within 3 hours prior to exercise, a high carbohydrate meal should be eaten to assure adequate blood sugar supply by the time of exertion. A piece of fruit or granola bar are great options to take with you and consume about halfway through your long run or strength training workout, as well as your sports game or practice, especially if these activities last from 45 minutes to an hour (or more).[13] This will assure your body is able to replenish blood sugar levels before the end of working out and reach the recovery phase comfortably.

The best recovery includes ways to safely refuel before the physical activity has even been completed. For those taking part in all day sporting events or tournaments, it is recommended that 5-6 meals consisting of adequate amounts of carbohydrates be consumed throughout the day. Any moderate to rigorous activity should be closely followed by a balanced meal containing carbs (to limit the chances of hypoglycemia 4-48 hours after completing exercise), as well as protein (to aid muscle recovery). Whole wheat/grain products serve as great carbohydrate sources, including brown rice, whole wheat bread, quinoa, whole wheat pasta, and oats.[13] Following these simple guidelines and turning them into steady habits will help set you up for safe outcomes.

Optimal nutrition for Crohn's disease

Crohn's disease is a condition that inhibits proper digestion, resulting in diminished absorption of essential nutrients, vitamins, and minerals.[5] Slightly less than 1% of the US population has been previously diagnosed with Crohn's disease.[11] Inflammation of the digestive tract causing abdominal pain and severe diarrhea are some of the most common symptoms of Crohn's disease. When food cannot be properly digested, it cannot be broken down to the point that makes its components absorbable. This clearly is a major issue that causes concerns during many daily activities, and must be considered and properly handled before, during, and after physical activity. Lack of consideration for your diet prior to exercise can result in malnourishment and a high level of danger, especially if you're physically active for longer periods of time or engage in very rigorous activities. It is as vital to know which foods or beverages may worsen Crohn's symptoms, as it is to practice food habits that assure safe nutrient intake.

Every person is different - foods that work for you may cause high levels of pain for somebody else. Thus, it is up to each individual with Crohn's to test foods and beverages in small amounts in order to find out what specifically affects them. It has been shown that eating small, frequent meals throughout the day results in less frequent flare ups and milder symptoms.[5] Other things that may help include drinking ample amounts of water, as well as taking a common once-per-day multivitamin to stay on top of the body's nutrient needs. Diarrhea causes dehydration, so it is extremely important to regularly hydrate before, during, and after activity to stay safe. Exercise is important and highly recommended for those with Crohn's, who shouldn’t feel like they need to avoid it.[5] As always, exercise is necessary to maintain other aspects of one's health and helps keep body weight in check. It is safe for people with Crohn's to engage in physical activity, as long as they consistently follow nutrition guidelines and know not to push their body's physical limits when experiencing symptoms.

Optimal nutrition for celiac disease

Celiac disease is a condition in which the consumption of gluten-containing foods leads to negative reactions within the small intestine.[3] Only about 1% of the current US population has been found to have celiac disease.[2] It can be extremely dangerous, if not handled carefully, as the intestinal lining can become damaged resulting in severe malabsorption of nutrients. Overall fatigue, as well as symptoms like diarrhea and weight loss can occur as a result of these reactions. It is pivotal for those with celiac disease to learn which foods contain gluten and what substitutes to use in order to not miss on key beneficial nutrients.

For athletes or those engaging in rigorous physical activity, it is even more important to avoid gluten-containing products, so that they don't suffer any of the potentially dangerous symptoms of celiac disease.[12] Trying to push on while experiencing symptoms can cause extensive internal harm and it is up to the individual to identify when it may be time to take a break or be done for the day. Athletes who are always on-the-go and may not have time to prepare food for themselves, need to plan in advance to find restaurants in their area that can provide safe, gluten-free options. Those with celiac disease should not live in fear and avoid physical activity due to the chance that they may have a flare up of symptoms in the middle of training. As long as they consistently avoid gluten-containing products and consume alternative sources of carbohydrates, they can perform well and remain safe and pain-free.

Optimal nutrition for irritable bowel syndrome

In the United States about 10-15% of the population experiences symptoms of irritable bowel syndrome (IBS), but just 5-7% has been officially diagnosed.[9] IBS is another gastro-intestinal disorder that affects the body's bowel functionality, resulting in severe abdominal pain and discomfort.[8] The ability to defecate may be sped up or delayed, having an effect on the form of the stool and resulting in frequent diarrhea and/or constipation. It is recommended that fiber intake be increased if constipation occurs frequently. However, it is important to boost fiber intake gradually, as swift and dramatic increases can also cause undesirable symptoms.[6] Soluble fiber has been found more effective than insoluble fiber in helping alleviate the symptoms of IBS.

A low FODMAP diet should be followed daily in order to best prevent symptoms of IBS.[3] The acronym FODMAP stands for fermentable oligo-, di-, mono-saccharides and polyols. FODMAPs come from various food sources, including certain meats, grains, dairy products, and a wide variety of fruits and vegetables. This does not mean that all products from said food groups will have a negative impact on those with IBS. But it is important to know which exact foods from each food group have been shown to worsen symptoms. It is clear that the symptoms of IBS can have a dramatic effect on the ability to engage in physical activity and athletic events. Abdominal pain and bowel issues, including diarrhea and constipation, can most definitely inhibit your ability to participate in physical activity or affect the level at which you can perform. This is why it is vital to work with skilled medical and nutrition professionals to come up with a nutrition plan that provides consistency and ensures sustained well-being. Once you determine which foods and beverages cause symptom flare ups, a custom nutrition plan can be put into place and followed consistently to best control the effects of IBS, especially during exercise. The below table shows a list of low or high FODMAPs sources broken by food group.

Optimal nutrition for asthma

Over 25 million Americans deal with asthma on a daily basis.[1] Difficulty breathing is an asthma symptom that nobody wants to experience, yet there's an increased chance for it to occur while exercising. There are no foods that have the ability to completely eliminate the symptoms of asthma. Nevertheless, growing evidence shows that certain foods and eating habits can lessen the severity of symptoms.[10] First off, it is most important to eat a well-balanced diet that supports healthy body weight. Being overweight or obese may worsen symptoms of asthma and make the condition more difficult to control. Consuming high amounts of fruits and vegetables has been found to reduce chances of lung inflammation and swelling. It is the nutrients beta carotene, vitamin C, and vitamin E, that are likely responsible for the benefits coming from fruits and vegetables.[10] The reduced chance for inflammation promotes better breathing outcomes during sports games or workouts. Additionally, Vitamin D levels tend to be lower in those with moderate to severe asthma, so it is crucial for these individuals to consume sufficient amounts of vitamin D on a regular basis. It is advised that 10 mcg of vitamin D per day be taken during colder months with less sunlight exposure.[15] Conversely, sulfites (commonly used as food preservatives) have been found to worsen symptoms for some people with asthma and should therefore be avoided.

Asthma affects many people and can be a burden during exercise, but the right nutrition plan can promote healthy lung function and proper breathing. An overall healthy diet that includes the vitamins discussed previously can provide safer, more comfortable outcomes during and after physical activity.

The main narrative

There is one main theme that I want you to take with you after reading this article. It is that each of these health conditions can be made much more tolerable with the incorporation of a nutrition plan that fits your body's unique needs. Foods and beverages give your body the components it needs to prepare for and endure athletic or other activities. This is one aspect of your health and well-being that you have complete control over, being able to consume the foods that promote your best self. If you follow the steps and tips laid out in this article, you will at the very least know that you are doing everything in your power to fuel your body optimally. There is no magic diet or nutrition plan that can wipe away all symptoms of chronic, pre-existing conditions, but consistency in following sound recommendations can help keep you more comfortable and safer during your workouts.


About the author

Brandon Hoeflinger is a senior undergraduate student at the University of Delaware with a major in Nutrition and Dietetics, and a minor in Professional Selling and Sales Management. He will be pursuing a sales position with a healthcare or nutrition related company after receiving his bachelor's degree. Brandon has been extremely passionate about proper nutrition and how it benefits people in numerous facets of life. He emphasizes the fact that food and beverage choice are factors that people most often have complete control over, and that these simple daily choices can greatly impact the quality and length of one's life.



4. Chang L. Eating, Diet, & Nutrition for Irritable Bowel Syndrome. National Institute of Diabetes and Digestive and Kidney Diseases.

5. Crohn's Disease Nutrition And Exercise Tips. Crohn's and Colitis.

6. Eating, Diet, & Nutrition for Irritable Bowel Syndrome. National Institute of Diabetes and Digestive and Kidney Diseases.

7. Gunnars K. FODMAP 101: A Detailed Beginner's Guide. Healthline.

8. Heiman DL, Hishnak TS, Trojian TH. Irritable Bowel Syndrome in Athletes and Exercise. Current Sports Medicine Reports. 2008.

10. Li JTC. Asthma diet: Does what you eat make a difference? Mayo Clinic.

11. Loftus EV. Update on the Incidence and Prevalence of Inflammatory Bowel Disease in the United States. Gastroenterology & hepatology.

12. Mancini LA, Trojian T, Mancini AC. Celiac Disease and the Athlete. Current Sports Medicine Reports. March-April 2011;10(2).

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