Translating Sports Nutrition Essentials

into Clinical Practice

Sarah Dobkins, MS, RD, CSSD

Board Certified Specialist in Sports Dietetics

Texas Children’s Hospital The Woodlands

Nothing to disclose

Disclosures

Objectives

• Identify obstacles that prevent athletes from putting a sports nutrition plan into practice

• Discuss practical tips to help athletes overcome nutrition obstacles

Outline

• Current Challenges

• Best Practices

– Fueling• Energy availability

• Energy and Protein needs

• Hydration

– Supplements

– Body composition

– Recovery

1904 Summer Olympics –

Men’s Marathon

Author: unknown

Source: "The Olympic Games 1904", report by Charles J.P. Lucas

Author: photographer of the IOC

Challenges Young Athletes

Face• Energy & Hydration-

– Limited time to eat and drink during school hours

– Busy schedules

– Most high school athletes go into practice on <1,000 calories

– Athletes are dehydrated before even starting practice

– Sleep is prioritized over eating

– 30% of HS athletes do not eat breakfast

• Lack of education on how to safely alter body composition

• Interested in supplements

Low Energy Availability• Energy Availability (EA) = the amount of energy

available to the body to perform all other functions

after the cost of exercise is subtracted

– Sets the foundation for health

and success in sport

• Screen For:

– Low bone density

– Menstrual dysfunction

– Decreased performance

– Stress fractures

– Weight loss

– Mood changes,

low self esteem

De Souza, Bri J Sports Med 2014

Energy Requirements• Determined by?

• Calories are the body guard!

• Should be periodized and individualized

Protein: Sports and Exercise• Misconceptions:

– A survey of male collegiate athletes indicated

67% did not know the protein recommendations

– 33% estimated the need at 8.7 g protein/kg

• Athletes may benefit from protein intakes greater than the

RDA of 0.8g/kg/day

– Suggested Daily Intake for Athletes: 1.2 - 2.0 g/kg body weight/day

– Suggested meal intake: Aim for 15-30 g of high quality protein after workouts

and at main meals

J Acad Nutr Diet. 2016: 116:501-528

Fox et al. JISSN. 2011

Protein: Timing and Quality Matter

Source: National Dairy Council

TIMING

• Teens tend to eat most of their protein

in the evening

• Even distribution of protein throughout

the day and immediately after training

can maximize the anabolic response

QUALITY

• Leucine is a key essential Amino Acid

for muscle hypertrophy

• Pop-tarts ≠ Leucine

Have a Recovery Plan!

• Carbohydrate – Replenish glycogen

• Protein – Rebuild muscle

• Fluids – Rehydrate

• Window of Recovery – aim to consume a snack/meal within 30-45 minutes of

stopping exercise

• Encourage athletes to pack a recovery snack and leave in locker

• Encourage players to bring sports drink to practice and weigh-in before/after

3 R’s to Recovery

Hydration• Develop a drinking plan based on body weight changes to

minimize weight loss ≤2% body weight

• Monitor sweat rate and urine color

• Drink 20 oz. for every 1 pound lost

• Sports drinks recommended >1 hour of exercise or hot/humid

conditions

• Don’t forget high water volume foods

Drink up! Fluid needs are higher during:

Heat Travel

Humidity Altitude

Hard training Illness

Body Composition Management• Body composition matters to all athletes…

body fat loss/lean mass gains

• Body Mass Index (BMI) – use with caution in athletes

• Do not overemphasize weight as a measure of success

• Focus on:– How they feel

– Athletic performance

– Power to Weight (PWR) ratio – the amount of power that can be generated per kilogram of body weight

Understanding Supplements• Not regulated by the Food and Drug Administration

– Manufacturers are not required to prove their

products’ safety, purity or effectiveness

• Look for the NSF stamp

• No amount of supplements can make up for poor fueling

• Just because it’s certified doesn’t mean it works

• 2016 Sports Position Paper – Dietary supplements and sports foods with evidence-based uses in sports nutrition

Food is 100% legal

What Can a Sports Dietitian Address?

• Body Composition

• Chronic Fatigue

• GI upset with exercise

• Disordered eating in athletes

• Irregular menstrual cycles

• Stress fractures

• Race day fueling plans

• Iron Deficiency Anemia

• Low Bone Mineral Density

• Poor eating habits

• Sports supplement use

• Diabetic athlete

Referral Process

Refer to TCH Sports/Ortho MD

Sports/Ortho MD will place referral

for sports RD

Community Pediatrician

Summary• Body composition versus scale weight

• Energy availability sets the foundation for health and success in sport

• Nutritional needs: should be periodized and individualized

• Consume 15-30 g high-quality protein

within 30 min of workout

• Dehydration is the most common performance-

sapping mistake and the most preventable

• Athletes want a competitive edge– Supplements are typically prioritized over food

Resources• www.nsfsport.com

• www.scandpg.org

• Consider referring patients to a sports dietitian to further discuss nutrition status and goals.

Thank you!

Sarah Dobkins, MS, RD, CSSD

sldobkin@texaschildrens.org