Post-Hockey Nutrition Tips for Type 1 Diabetes
Post-Hockey Nutrition Tips for Type 1 Diabetes
by Lisa Miadovnik, MSc.
Refueling after exercise is a hot topic in the health & fitness industry. From chocolate milk to protein bars and supplements, billions of dollars go into creating and marketing these products for post-workout nutrition. A widely-accepted recommendation is to consume a snack rich in simple carbohydrates and protein within 30 minutes of finishing a hockey game, practice, or workout, followed by a nutritious, slow-digesting protein- and carbohydrate-rich meal between 1-2 hours after1. When you factor in the time that hockey games are played at, that could mean eating a meal at 11:00 pm or later! In this article, we will discuss post exercise nutrition and late-night eating for athletes with type 1 diabetes.
Parents and athletes wonder about eating late at night, because it sounds so counterintuitive based on advice for the general population. What needs to be considered is that nutrition for athletes and nutrition for the general population are two very different things. Very little research has been conducted on post-workout nutrition for athletes with type 1 diabetes, in specific. However, the same basic principles should apply for all athletes, whether they have diabetes or not.
Let’s look into this a little further;
In the average 60-minute game (3 periods of 20 minutes), a hockey player will only play for a total of about 20 minutes. Each shift lasts about 30-80 seconds, with heart rates reaching or exceeding 90% of their maximum each time2. Just to give some perspective, a 15 year-old would have a maximum heart rate of roughly 205 beats per minute (formula: 220 – age). Their heart rate would likely reach or exceed 185 beats per minute during each shift – that is some hard work being done on the ice!
Working at such high intensity is exhausting and burns up a lot of calories – calories that mostly come from glucose stored inside the muscle (called “muscle glycogen”). In a typical game, a hockey player will use up 60% of the muscle glycogen in their legs3, and burn about 950 calories depending on their size (950-calorie-estimate is based on a 60kg boy playing three 20-minute periods). Whether an athlete eats at 6pm or 11pm after training, and whether their body uses those nutrients to recover while they are awake or while they are sleeping – the most important factor is that the refueling happens. After such physically demanding work, the body needs to be refueled. Eating late at night can pose a bit of a problem for those with type 1 diabetes since it may mean going to bed with a fair amount of nutrients to be absorbed and a lot of insulin on board, which can sometimes cause large changes in blood glucose level unless these two things are balanced perfectly.
For type 1 diabetes, this concept is especially important with the risk of nocturnal hypoglycemia following exercise. As muscles replenish their glycogen stores by taking up glucose from the blood, blood sugar can drop if carbohydrates have not been eaten. If you are hypoglycemic or within a normal blood glucose range, a simple carbohydrate snack should be consumed immediately after games, and a balanced meal of slow-digesting carbohydrate, protein, and fat should be eaten 1-2 hours later. Experts advise to consume in excess of 1 gram of carbohydrate per kg of body weight to optimize glycogen store replenishment5. Usually, some amount of bolus insulin is needed to cover this amount of carbohydrate snack after a game or practice, but typically not the full amount. This should be discussed with your diabetes care team. This strategy should supply the fuel needed for recovery, while preventing hypoglycemia which can persist for up to 48 hours if sufficient carbohydrates are not consumed1.
There are additional factors to keep in mind when it comes to post-hockey eating for type 1 diabetes, such as blood glucose levels and trends. If blood sugars are high after hockey, you may wish to skip the high-carbohydrate snack immediately following exercise (within the 30-minute window) in favor of water, as there is already enough glucose in the blood that is available for your muscles to take up. In this case, the blood sugar will likely drop on its own within an hour or two following hockey (without the need for insulin), but the individual should be monitored to ensure blood glucose levels do not rise further.
Alternatively, the individual experiencing hyperglycemia may wish to take some insulin to help bring their blood glucose down. Some athletes with diabetes have found that a 50% correction bolus post-exercise helps to restore blood glucose levels without promoting hypoglycemia later in the night3 (i.e. taking only half the amount of insulin normally taken to correct a high blood sugar on a typical day). In either case, it is still advisable to eat a slow-digesting meal afterwards to prevent delayed hypoglycemia. In addition, setting a 20% temporary basal reduction at bedtime for about 6 hours helps protect against night time hypoglycemia after vigorous exercise6.
Ultimately, many experts agree that the timing of meals doesn’t matter as much as ensuring the total amount of daily calories and nutrients consumed are within range. So the next time you get home late at night after playing a tough game, don’t be afraid to eat. You may wish to have a meal of leftovers in the fridge for when you get home (or in the car for the ride home), so that the post-game meal is convenient and preparation time is minimal. By giving yourself the nutrients needed after intense physical activity, your legs will probably feel more refreshed the next day, and you’ll have less risk of going hypoglycemic at night as well.
Sign up for the Medtronic of Canada e-newsletter to receive additional educational tips, product information and more at www.medtronicdiabetes.ca/getconnected
Lisa Miadovnik, MSc Exercise Physiologist, CSEP-CEP, Team Canada Senior National Synchronized Skating Team Member and Power Skating Coach for Dskate
1) Purcell, L.K. "Sport Nutrition for Young Athletes: Position Statements and Practice Points." Canadian Paediatric Society, 2 April 2013. Web. 1 December 2014.
2) Montgomery, D.L. 1988. “Physiology of ice hockey.” Sports Medicine, 5(2), 99-126. doi: 10.2165/00007256-198805020-00003.
3) Houston, M.E. 1979. “Nutrition and ice hockey performance.” Canadian Journal of Applied Sport Science, 4(1), 98-99. Retrieved from < http://www.ncbi.nlm.nih.gov/pubmed/498411>.
4) Litt, A. (2004). Fuel for young athletes: essential foods and fluids for future champions. Windsor: Human Kinetics.
5) Ivy, J.L. 1998. “Glycogen resynthesis after exercise: effect of carbohydrate intake.” International Journal of Sports Medicine, 19 (S3), 142-145. doi: 10.1055/s-2007-971981.
6) Taplin, C.E., Cobry, E., Messer, L., McFann, K., Chase, H.P., Fiallo-Scharer, R. 2010. Preventing post-exercise nocturnal hypoglycemia in children with type 1 diabetes. The Journal of Pediatrics, 157(5), 784-788. doi: http://dx.doi.org/10.1016/j.jpeds.2010.06.