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    Nutritional Recommendations for Breath-Hold Divers

    Greenberg     February 23, 2025 in News - 24 Minutes


    1. Introduction

    Presently, breath-hold diving (BHD) is practiced in recreational, hunting, military, and competitive manners. At the elite level, freedivers can hold their breath for an impressive time of ~10 min, can reach depths > 200 m, or dive into pools longer than 300 m depending on the specific diving discipline [1]. The two main disciplines are static apnea and dynamic apnea. The periods of prolonged apnea that these athletes endure make the BHD environment extreme. Such extremity is pronounced especially in a competitive context, where the ultimate limits of the body’s ability to withstand intense hypoxic and hypercapnic states are tested in hyperbaric conditions [1,2,3,4,5,6]. Frequent exposure to such physiological and physical limitations increases the risk of potential dangers to the health of freedivers [7,8]. Furthermore, it can be speculated that the specific requirements of long-term diving apnea make inadequate nutrition a greater obstacle in this sport. This speculation can be observed from nutritional recommendations in other aquatic sports [9,10]. Also, performance in synchronized swimming, defined with shorter periods of apnea, could be improved with proper diet [11]. Hence, the nutritional recommendations for these athletes may present a potentially important factor in performance.

    General Recommendations for a Healthy Daily Diet for Freedivers: Mediterranean and Alkaline Diet

    Diving is a specific sport that requires exceptional physical and mental fitness [12]. Proper nutrition not only provides the energy needed for training and competitions but also supports complex biochemical mechanisms such as the regulation of acid–base balance and the management of oxidative stress, which are especially endangered during the practice of apnea diving. This is why it is necessary to develop a permanent habit of daily healthy and balanced eating. It is not only a matter of personal discipline, but also of understanding the importance of nutrition in improving physical and mental characteristics. A balanced, varied, unprocessed, and high-quality diet could be a prerequisite for achieving maximum diving abilities, safer diving, and long-term health. The combination of the Mediterranean and alkaline diet offers an optimal nutritional basis for achieving and maintaining these goals. The Mediterranean and alkaline diets share many common features, such as an emphasis on the intake of large amounts of fruits, vegetables, and minimally processed foods, but they are not completely identical [13,14]. The Mediterranean diet (MD) also includes acid-forming foods such as fish and dairy products, while the alkaline diet tends to eliminate such foods [14]. A combination of the principles of both diets can provide a balanced and healthy approach to nutrition, especially for the specific needs of freedivers.

    Due to the high demands of this sport and the significant energy expenditure, freedivers are forced to carefully balance between these two nutritional approaches, depending on the training periodization. In the phase of the predominantly physical conditioning phase, when a higher protein intake is needed for recovery and muscle mass building, the Mediterranean diet provides optimal nutritional support. On the other hand, in specific apnea and/or competition phases, when it is crucial to reduce oxidative stress and optimize the body’s acid–base balance, an alkaline diet can play an important role.

    By combining these nutritional principles on a daily basis in accordance with the phase of the planned training process, while respecting the characteristics and intensity of operational loads and the necessary recovery during microcycles and individual training sessions, divers can ensure optimal intake of nutrients. This allows them to support endurance and performance, as well as improve diving safety and efficiency.

    The literature review showed a lack of studies that examined the diet of BHD and gave full recommendations for different disciplines. Previous studies have demonstrated similar work aimed at scuba divers [15]. The authors concluded that the recommendations for recreational divers are to consume ~170–210 kJ·kg−1 (40–50 kcal·kg−1) body mass, depending on their workload underwater. Also, all divers should take special care to hydrate themselves properly. However, there are no recommendations for apnea divers. Hence, the main aim of this study is to examine and propose recommendations for this specific population. Also, the aim is to divide nutrition according to three main BHD disciplines (static, dynamic, and spearfishing). As mentioned above, an MD and alkaline diet could represent a good BHD diet.

    2. Mediterranean and Alkaline Diet

    The aim of this study was to examine the previous literature and propose proper nutritional recommendations for BHD. Another aim was to examine adherence to the Mediterranean diet for those engaging in BHD. As already mentioned, the current literature focused on different diving populations, than those our research focuses on [15]. Hence, this is the first study to give full recommendations for static, dynamic, and spearfishing athletes. In addition, the results of the MDSS questionnaire showed adherence to an MD. The results showed that only 20% of examined divers adhere to MD. Therefore, these recommendations should be considered and followed thoroughly.

    2.1. Mediterranean Diet: The Foundation for Health and Diving Performance

    The Mediterranean diet is rich in olive oil, fresh vegetables and fruits, legumes, nuts, and whole grains, with moderate consumption of fish, eggs, and dairy products and minimal intake of meat and animal fats [16]. This diet supports cardiovascular health, regulates body weight and reduces inflammatory processes, making it the perfect choice for maintaining health and physical performance [17]. Therefore, it could provide an optimal framework for the freediver’s diet. Furthermore, the combination of omega-3 fatty acids from oily fish and nuts and omega-9 from olive oil contributes to improving circulation and lipid profile, lowering bad LDL cholesterol and raising HDL cholesterol [18]. Reduced intake of omega-6 fatty acids prevents imbalances that can cause inflammatory processes, while the anti-inflammatory effect of omega-3 and the protective role of antioxidants from vegetables and fruits, such as vitamins C and E, help to maintain health at the cellular level [19,20]. This diet not only provides optimal nutritional support but also promotes a lifestyle that combines balanced food intake with physical activity and longevity, and can be specifically tailored to the needs of freedivers or anyone who strives for health and peak aquatic performance.

    2.2. Alkaline Diet: Acid–Base Balance

    During an apnea, hydrogen ions accumulate, which acidify the body, and hence shorten breath-holding duration [21]. For this reason, freedivers are advised to avoid excessive intake of meat, especially processed meat, simple sugars, alcohol, caffeine, and carbonated drinks, or any foods that further create an acidic environment in the body. In contrast, the alkaline diet is based on the theory that certain foods can affect the body’s pH balance, promoting alkalinity. An alkaline diet is very rich in important micronutrients and, due to this very fact, is very healthy. In general, vegetables, fruits, nuts, and seeds are considered alkaline foods that help to maintain a favorable acid–base status, which increases endurance, especially regarding the capacity of the anaerobic glycolytic metabolic system, and reduces the risk of fatigue [21]. Accordingly, recommended alkaline foods are as follows: various naturally grown vegetables such as zucchini, broccoli, and green leafy vegetables in particular (kale, spinach…), seasonal fruits (citrus fruits, berries, watermelon…), nuts and seeds (almonds, chia seeds…), legumes, and some whole grains (quinoa, lentils, millet…).

    2.3. Different Nutrition Concepts Concerning the Specifics of Diving Disciplines

    Freediving encompasses a wide range of disciplines that differ significantly in performance, as well as in functional–metabolic energy demands. Static apnea (maximum breath-holding on the surface at rest) is based exclusively on aerobic capacity, while dynamic disciplines such as long-distance and deep diving include pronounced anaerobic requirements [22]. On the other hand, spearfishing is characterized by the alternation of frequent shallow dives with short surface rest intervals, breath-holding at rest on the bottom (dive hold), and deep dives with longer recoveries, which requires a flexible and durable energy system with aerobic and anaerobic components [23]. Nutritional approaches to practicing these different diving disciplines must be adapted to the specifics of training and competition. While apnea training in freediving usually lasts up to an hour, spearfishing can last more than six hours, which creates different nutritional needs. Optimal nutrition for divers is based on a balanced and planned intake of calories and macro- and micronutrients, as well as adaptation of nutrition to the training and competition demands.

    The three main nutrition concepts include preparation for statics, for dynamic and deep-sea disciplines, and for the specifics of spearfishing, with a common emphasis on healthy eating habits and avoiding undesirable foods before diving.

    3. Static Apnea

    In static apnea, divers need to maintain a lean body mass, high aerobic capacity, and lower basal metabolism [2]. Hence, the recommended diets consist of Mediterranean and alkaline diets, depending on the training periodization. All phases are characterized by eating multiple, but not large, meals, and a diet rich in vegetables, fruits, whole grains, legumes, mushrooms, cold-pressed vegetable oils, and a moderate intake of protein. Moreover, proteins should be mostly plant-based to support the optimal functioning of the body, improve the capacity to store and utilize oxygen at the cellular level, and contribute to the health of the circulatory system. In the preparatory phases, when generic physical conditioning predominates, the Mediterranean diet can provide the necessary nutrients and energy to increase aerobic capacity.

    3.1. Before Competition

    To achieve optimal sports results, precise nutrition for competitors is an important parameter. It is advised that 20 days before important competition nutrition should be based on an energetic, restrictive, alkaline, almost-vegetarian diet. The basis is the intake of cooked and raw vegetables which contain a small share of carbohydrates and root vegetables, to maintain an acid–base balance. Following that, various whole cereals should be consumed. In this period, the body should be exposed to fat and omega fatty acids.

    About 10 days before competitions, it is recommended to gradually induce a calorie deficit. Also, good hydration is a crucial factor with mild vitamin and mineral supplementation. Carbohydrate reduction should not be to the point of inducing ketosis. Precisely, ketosis is not optimal for static apnea discipline, both due to the increase in basal metabolic rate and increased carbon dioxide production. Increased CO2 production can lead to a faster accumulation of this gas in the body during breath-holding, which can shorten apnea time and negatively affect performance.

    In the 2 days preceding a competition, moderate fasting is recommended (calorie deficit of about 40–50%), with continuation of nutrition based mainly on vegetables and olive oil, with whole cereals, mushrooms, vegetables, and fruit which is not rich in simple sugars.

    3.2. Supplementation

    Supplementation supports the optimal function of the organism and helps in the regulation of acid–base balance, hydration, and reduction in oxidative stress in static apneists. The recommended supplements should be introduced, including the following: Magnesium—especially in the form of magnesium citrate or magnesium malate to relax muscles, reduce stress, and support normal nervous system function [24]. Potassium—can help to maintain electrolyte balance, especially with reduced food intake and hydration [25]. Zinc and selenium—key to strengthening immunity and reducing oxidative stress [26]. Vitamin C—as an antioxidant, this helps to reduce oxidative stress and supports the immune system [27]. L-arginine or L-Citrulline—to support better circulation and better oxygen supply by increasing the production of nitric oxide which dilates blood vessels [28]. Spirulina and chlorella—rich in chlorophyll and micronutrients and can help to detoxify and maintain the body’s alkaline pH [29,30]. Ashwagandha or Rhodiola rosea—adaptogens that help to regulate stress and support cortisol reduction, which can contribute to calmness, which is especially important before static apnea competition.

    4. Dynamic and Depth Disciplines in Freediving

    In contrast to static apnea, dynamic apnea requires a high level of anaerobic functional capacity. This is partly due to a specific physiological mechanism known as the “diving reflex”. It is activated by immersion in water during apnea, causing intense sympathetic activity and consequent peripheral vasoconstriction. As a result, blood flow to the large muscle groups of the legs and arms is significantly reduced, which causes increased reliance on anaerobic metabolism. The dominant energy metabolic background under these conditions becomes anaerobic glycolysis, with blood glucose and glycogen stored in the muscles and liver, serving as the key energy sources. Although the aerobic energy system contributes to overall endurance, anaerobic capacities dominate during high-intensity diving performances. Because of these specifics, nutrition must therefore ensure an efficient energy supply and support regeneration.

    The Mediterranean diet, as a basic dietary framework for freedivers, is ideally suited to these needs. This diet is rich in complex carbohydrates, which are essential for replenishing muscle glycogen stores which is beneficial for dynamic apneists. In addition to carbohydrates, increased protein intake is essential for muscle tissue regeneration after intense exercise. More easily digestible sources of protein, such as eggs, lean meat, fish, and plant-based proteins (tofu, tempeh, legumes), are optimal for supporting muscle fiber recovery and growth. At the same time, a balanced intake of healthy fats is important, with an emphasis on omega-3 fatty acids. Following all of this, calorie intake must be aligned with the diver’s needs, especially during intense training sessions when physical conditioning is dominant, to avoid energy imbalance.

    Recommendations for nutrient intake include the implementation of a Mediterranean diet with the following food groups: Carbohydrates (40–60% of total intake): focus on complex carbohydrates like quinoa, sweet potatoes, oats, and brown rice to maintain steady energy levels. Protein (20–30%): focus on muscle regeneration with high-quality protein sources (lean meat, fish, eggs, and legumes). Healthy fats (20–30%): omega-3 (flax and chia seeds, fish, avocado) and omega-9 fatty acids (olive oil). Additional focus: supplementation with creatine, beta-alanine, and magnesium to support strength and endurance. The last meal before training (3–4 h) should incorporate complex carbohydrates and easily digestible proteins (whole-grain oatmeal with almonds and banana). After training, hydration comes first and then a small meal of a combination of fast-absorbing carbohydrates (rice and fruit, especially dates and bananas) and protein (Greek yogurt, protein shake) is recommended.

    Supplementation

    Given the dynamic nature of these disciplines, different supplementation should be considered. The following supplements may be useful for performance enhancement: BCAA—prevents muscle catabolism and accelerates recovery [31]. Beta-alanine—increases muscular anaerobic endurance and tolerance to lactate accumulation [32]. Creatine—supports explosive power and regeneration [33]. Magnesium and electrolytes—help in muscle relaxation, maintaining fluid balance, and preventing cramps [24]. At the time of extensive conditioning and specific diving apnea training with a high volume of load (comprehensive development programs after basic preparatory phase), which significantly physically exhausts the athlete’s body and contributes to mental stress, additional supplementation is suggested with the following: B complex and L-glutamine—play an important role in maintaining optimal energy levels, reducing fatigue, and supporting recovery. B vitamins—essential for normal energy-yielding metabolism and a reduction in tiredness and fatigue [34]. L-glutamine—a non-essential amino acid involved in gluconeogenesis, the process through which glucose is produced from sources other than carbohydrates, such as lactate or glycerol [35].

    5. Spearfishing

    Spearfishing requires exceptional psychophysical endurance, as the exhausting activity can last from a minimum of two to more than six hours [23]. The metabolic energy background of spearfishing includes both aerobic and anaerobic ergogenesis, and situational performance includes a combination of fin swimming, dynamic diving for distance and depth, and static diving at rest (fish searching and ambushing). All of these activities require extremely complex physical fitness preparation conditioning, as well as specific apnea training. During intensive spearfishing with prolonged surface swimming, divers expend a significant amount of energy. This energy expenditure is estimated at around 800 kcal per hour, which can reach up to 4800 kcal after six hours [36]. Given that the average daily energy requirement is around 2500 kcal, the total daily intake for spearfishermen can reach up to 7300 kcal. Repeated exposure to hyperbaric conditions during about a six-hour diving session stimulates the secretion of atrial natriuretic peptide (ANP), a hormone that increases diuresis and lipolysis. As a result, in addition to glycogen depletion, there is a significant loss of water and fat stores [37]. It is estimated that approximately 50% of the energy required for spearfishing diving comes from fat. Spearfishermen require supplementation that covers their specific needs for long-term, exhausting activity that combines elements of static and dynamic diving, with a large calorie deficit after fishing. Their supplementation should support the optimal function of the organism, reduce oxidative stress, speed up recovery, and enable the replacement of the key nutrients lost during activity. Similar as it is in dynamics, meal before training (3–4 h) should incorporate complex carbohydrates and easily digestible proteins, whereas, after training, hydration and then a small meal of a combination of fast-absorbing carbohydrates.

    Supplementation

    Supplementation for spearfisherman is supposed to be similar to that of dynamic apnea. Hence, it is good to take BCAA to prevent muscle catabolism and maintain energy levels during activity, beta-alanine, which helps in the tolerance of lactate accumulation and increases anaerobic endurance, and L-citrulline or L-arginine, which increase the production of nitric oxide, improve circulation, and thus supply muscles with oxygen [28]. Furthermore, due to the frequent horizontal body position, water temperature, hydrostatic pressure, and the resulting diuresis caused by ANP sweating in the diving suit and increased breathing, increased water loss occurs [38]. Dehydration of 2% of body weight can reduce aerobic capacity by 10%. Therefore, it is important to maintain hydration during diving with the possible addition of essential electrolytes. A good choice for this is isotonic drinks that contain the following: Sodium—maintains fluid balance and prevents dehydration. Potassium—key for healthy muscle function and the prevention of cramps [39]. Magnesium—supports the work of muscles and the nervous system [40]. Calcium—important for muscle contraction [41]. Optionally, isotonic drinks can also contain carbohydrates, usually in the form of glucose, fructose, maltodextrin, or sucrose, which provide a quick source of energy and help replenish depleted glycogen reserves, as well as vitamin C as an antioxidant and B-group vitamins to support energy metabolism [42].
    After spearfishing, it is necessary to replace lost fluids rich in minerals as soon as possible, for example with isotonic drinks. For rapid regeneration, it is important to first consume a carbohydrate complex, such as maltodextrin or isomaltose, or, as a healthier and more natural option, a few dates and a ripe banana to quickly restore depleted glycogen reserves. In addition, a protein shake, such as whey protein, enriched with L-glutamine is recommended for accelerated muscle regeneration, protein replacement, and reduced fatigue [35]. The post-spearfishing meal can be supplemented with Omega-3 fatty acids from fish or flaxseed oil to reduce inflammatory processes, while vitamins C and E act as powerful antioxidants that neutralize oxidative stress caused by apnea and exhausting physical activity. B vitamins additionally support energy metabolism and reduce the feeling of fatigue, while minerals such as zinc and selenium strengthen the immune system and contribute to recovery [27].

    Such supplementation enables spearfishermen to maintain a high energy capacity during spearfishing, quickly replenish glycogen reserves, protect muscles, and reduce the negative effects of oxidative stress, thereby ensuring optimal preparation for spearfishing activity and accelerated recovery.

    6. Conclusions

    Proper nutrition for freedivers is based on a variety of natural foods that support an acid–base balance, provide a stable source of energy, and facilitate quality recovery. By adopting healthy eating habits based on the Mediterranean and alkaline diet, along with regular hydration and adapting the diet to the specific demands of diving, divers can improve their performance and ensure long-term health. The recommendations presented in this paper can be useful for freedivers in better planning their nutrition and training, as well as in creating pre-competition and training routines.

    Future studies should include an examination of BHD eating habits. Also, they should be directed towards the examination of the influences of different diets on performance parameters. However, this is the first study proposing and recommending a diet for the three main BHD disciplines.

    Author Contributions

    Conceptualization, I.D. and Ž.D.; methodology, N.F.; software, D.V.; validation, D.V., I.D., and N.F.; formal analysis, D.V.; investigation, D.V.; resources, Ž.D.; data curation, D.V.; writing—original draft preparation, I.D. and D.V.; writing—review and editing, D.V. and Ž.D.; visualization, D.V.; supervision, N.F.; project administration, N.F.; funding acquisition, Ž.D. All authors have read and agreed to the published version of the manuscript.

    Funding

    This research received no external funding.

    Institutional Review Board Statement

    Ethical review and approval were waived for this study due to the fact that this study included only review of current literature, hence no human or animal participants were included.

    Data Availability Statement

    All data are included in the manuscript.

    Conflicts of Interest

    The authors declare no conflicts of interest.

    Abbreviations

    The following abbreviations are used in this manuscript:

    BHDBreath-hold diving
    MDSSMediterranean diet service score
    ANPAtrial natriuretic peptide
    MDMediterranean diet
    BCAAsBranch-chain amino acids

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