Much emphasis is placed on recovery post exercise, one marker of recovery status that sports scientists use is salivary testosterone to cortisol ratio. Cortisol is a catabolic hormone secreted from the adrenal glands in response to physical and psychological stress. Cortisol is released during exercise, breaking down skeletal muscle and adipose tissue to help maintain blood glucose levels and acts as an anti-inflammatory. On the other hand testosterone is an anabolic hormone secreted from the testes (in males) and adrenal glands and is important in the growth and maintenance of skeletal muscle. Measuring the ratio between these hormones gives an indication of whether an athlete is recovering well from exercise or is overtraining.
During an acute bout of intense exercise (rugby, long distance running, wrestling) cortisol levels have been reported to rise sharply (up to 2.5-fold compared to resting values) after which they returned to basal values within 1.5 to 4 hours. Conversely testosterone was shown to decrease during exercise and remained low for a short period of time, followed by a rise in levels that corresponded to the fall in cortisol. These studies indicated a high testosterone to cortisol ratio (T/C) for between 3 and 5 days post competition that suggested an anabolic recovery period (Lac and Berthon 2000, Passelergue and Lac 1999, Elloumi et al 2003). Unfortunately these studies only looked at a single event and not what could happen to T/C ratio over a longer period of games / events. In a state of overtraining it might be expected to see elevated cortisol, reduced testosterone and a lower T/C ratio corresponding to a catabolic recovery state. The chronic response to exercise of testosterone and cortisol depends on interplay of exercise variables including intensity, duration, volume and rest periods as well as recovery interventions.
The aim of the sports scientist and / or sports nutritionist is how to best manipulate the recovery of these hormones between games / events, so that cortisol levels return to their lower resting levels allowing testosterone levels to return to their higher normal levels quickly after exercise and how to manipulate the highest T/C ratio between events for optimum recovery. There are many methods that are used to foster recovery of these hormones included active recovery, massage, compression, contrast bathing etc… A more recent recovery strategy to manipulate these hormones is to use optimum nutrition.
Hormone response to dietary intervention has been rarely documented (Hayes et al 2010). Goldin, et al (1994) reported a diet containing roughly 20% fat lead to significantly lower levels of testosterone compared to a diet containing roughly 40% fat. Volek et al (1997) report that monounsaturated (MUFA) and saturated fat (SFA) were the strongest positive predictors of testosterone concentrations. This is quite important to take note of as many athletes are still advised to eat a lower fat diet to aid body composition. The myth that fat makes you fat, unfortunately still persists. Many athletes may also avoid saturated fat through fear of it affecting cholesterol levels – the debate about whether this is true is beyond the scope of this article – however it appears that athletes should not avoid consuming some saturated fat in the diet.
Anderson et al (1987) reported consistently higher testosterone levels after ten days on a low protein diet (10% of total energy) than during a high protein diet (44% of total energy). By contrast, cortisol concentrations were consistently lower during the low protein diet. Volek et al (1997) also found that lower levels of protein in the diet lead to higher testosterone concentrations, however as mentioned testosterone was positively correlated to MUFA and SFA content in the diet. It is unclear whether a lower protein diet leads to increased testosterone synthesis or lower production of sex hormone binding globulin (SHBG). Bio-available free testosterone levels have been inversely related to SHBG levels, i.e. higher SHBG binds up more testosterone possibly leaving less active unbound testosterone.
Raben et al (1992) demonstrated that a vegetarian diet consisting of 58% carbohydrate, 27% fat and 15% protein resulted in a lower total fasting serum testosterone level compared to an omnivore diet containing meat consisting of 58% carbohydrate, 28% fat and 14% protein. Serum free testosterone and SHBG, however, did not differ significantly during this 6 wk trial. This would indicate that a vegetarian diet may lead to lower total testosterone levels, but not free testosterone and SHBG, and that the type of protein and fat consumed plays a role in steroid hormone synthesis.
Calorie restriction seems to lead to lower testosterone levels, Mäestu et al (2010) reported that severe energy restriction significantly decreased the concentrations of 3 anabolic hormones, including testosterone, despite a high protein intake in fourteen male bodybuilders. Similarly Mero et al (2010) demonstrated that a calorie deficit of 1100 calories a day whilst maintaining a high protein intake lead to a decrease (30%) in total testosterone and an increase in SHBG that lead to a decrease in free testosterone in women. This would indicate that lack of calories reduces testosterone levels perhaps via increased SHBG.
However, some criticisms of these studies are that they measured serum testosterone, whereas measuring salivary testosterone may be a more sensitive measure.
There is paucity in the literature looking at whether different foods or diets raise cortisol levels. There is anecdotal evidence that not controlling blood sugar levels and eating food that may cause intolerances may raise cortisol via a compromised intestinal mucosa, therefore maintaining blood sugar and testing for food intolerances may be warranted in some individuals.
Various nutrients are required and have been found to improve testosterone and cortisol status. All the steroid hormones are made from cholesterol and go through various metabolic steps to be turned into the various individual hormones. These enzymatic steps require vitamin and mineral co-factors such as B vitamins, zinc, magnesium and vitamin C. Deficiencies of these co-factors could affect the production of the hormones and the recovery status of an athlete.
Prasad et al (1996) found that inducing a specific marginal zinc deficiency in normal young men lead to a decrease in serum testosterone. They also found that zinc supplementation to marginally zinc-deficient elderly men increased serum testosterone levels. This suggests that zinc plays a role in regulating testosterone secretion. Meat and fish are rich sources of zinc as are nuts and seeds, these foods also contain SFA and MUFA and nutrition professionals should encouraged athletes to consume them. Zinc supplements may also be useful if an athlete is zinc deficient, however, zinc supplementation (ZMA supplements for example) to people who eat a zinc sufficient diet has been shown to have no effect on serum testosterone levels (Koehler et al 2009). Judicious use of zinc such as in a multivitamin and mineral is probably still wise to administer to athletes as mineral levels (including zinc) in our soil and our food are declining.
Cinar et al (2010) demonstrated that magnesium supplementation increases free and total testosterone in sedentary individuals and in athletes, with increases being higher in individuals who exercised. Subjects in this study were given 10mg of magnesium per kg of bodyweight and this dose seems appropriate for athletes to take divided pre, during and after exercise to naturally boost testosterone. Magnesium is also used by nutritional practitioners to aid sleep and a bolus dose of magnesium may be indicated after exertion, particularly at night to aid sleep. Many athletes after a night match, who may not get home or get to sleep until the early hours of the morning report poor sleep and tiredness the following day. Andersen and Tufik (2008) report that testosterone levels rise during sleep and fall during the day. Sleep deprivation induces reduced circulating testosterone in men thus poor sleep is detrimental to the recovery status of an athlete post exercise (Andersen and Tufik 2008). Encouraging the consumption of magnesium containing foods such as beans, nuts, seeds and green leafy vegetables should be encouraged. Magnesium supplementation is also indicated, particularly after night games / events.
Vitamin C is concentrated in the adrenal glands and acts as an antioxidant in the production of cortisol. Peake (2003) cites several research studies whereby 500-1500mg of vitamin C attenuated post exercise cortisol production. Although it is still unclear how and why this happens, one mechanism how vitamin C is used is to counter the oxidative stress created during exercise from cortisol release. Eating foods rich in vitamin C pre-event should be encouraged. Oranges and orange juice are often assumed to be rich sources of vitamin C; however this is not the case. Foods such as broccoli, cauliflower, peppers, tomatoes and kiwi fruit are much richer sources of vitamin C. Orange juice consumption should be decreased as it is generally loaded with sugar and the aforementioned fruits and vegetables should be consumed. Adding 500-1500mg of vitamin C post exercise would not be detrimental to and would probably be beneficial to shift the testosterone cortisol ratio back to a more anabolic environment.
Short term supplementation with the phospholipid phosphatidyl serine has been shown to reduce post exercise cortisol production and muscle soreness (Jager et al 2007) and may be an effective supplement to reduce exercise induced stress and improve testosterone to cortisol ratios (Starks et al 2008). The exact dose of supplementation is still to be identified however 750mg per day for 10 days has been shown to be effective (Jager et al 2007). Although long term supplementation may not be indicated, it could be an effective strategy to use during an intense run of games or events during a season.
- Eat a diet rich in healthy fats including some saturated fats from animal tissue.
- Eat moderate but not excessive amounts of protein.
- Eat plenty of low to moderate glycemic load carbohydrates such as fruits, green leafy vegetables, beans, legumes as well as nuts and seeds for vitamin C, magnesium, fibre and antioxidants.
- Do not restrict calories to improve body composition (it may be wiser to alter macronutrients levels rather than calorie intake)
- Consume a daily multivitamin and mineral for co-factors and baseline nutrients such as zinc, B vitamins, vitamin C and magnesium.
- Consider supplementing with 10mg of magnesium per kg BW in divided doses through the day, with the majority being in the evening to aid sleep, particularly around evening games / events.
- Consider 500-1500mg of vitamin C post games / event.
- Consider 750mg of PS for short periods during and intense run of games / events.
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