Official websites use. gov A. gov website belongs to an official government organization in the United States.

gov website. Share sensitive information only on official, secure websites. Nutrition plays a key role in exercise and athletic performance. Explore pre- and post-workout nutrition guidance for recreational and competitive athletes.

Fueling Your Adolescent Athlete [hprc-online. Nutritional Needs Among High School Athletes [extension. The Female Athlete Triad in Adolescent Athletes [digitalcommons. Eat to Compete: Sports Nutrition for Young Adults - Publication Series [aces.

A Guide to Eating for Sports: For Teens [kidshealth. Nutrition Resources - NCAA Sports Science Institute [ncaa. Combat Rations Database ComRaD [hprc-online.

Go for Green: DoD Dining Facility Initiative [hprc-online. Perhaps more alarming is a report by the Centers for Disease Control suggesting 2,, emergency room visits were due to prescription drug-related events which dwarfs the emergency room visits due to dietary supplements adjusted from 23, visits after excluding cases of older adults choking on pills, allergic reactions, unsupervised children consuming too many vitamins, and persons consuming ingredients not defined by DSHEA as a dietary supplement [ 5 ].

Furthermore, a recent Healthcare Cost and Utilization Project Statistical Brief by Lucado et al. Notwithstanding, there have been case reports of liver and kidney toxicity potentially caused by supplements containing herbal extracts [ 7 ] as well as overdoses associated with pure caffeine anhydrous ingestion [ 8 ].

Collectively, the aforementioned statistics and case reports demonstrate that while generally safe, as with food or prescription drug consumption, dietary supplement consumption can lead to adverse events in spite of DSHEA and current FDA regulations described below. Recognizing that new and untested dietary supplement products may pose unknown health issues, DSHEA distinguishes between products containing dietary ingredients that were already on the market and products containing new dietary ingredients that were not marketed prior to the enactment of the law.

DSHEA grants the FDA greater control over supplements containing NDIs. The first criterion is silent as to how and by whom presence in the food supply as food articles without chemical alteration is to be established. The second criterion—applicable only to new dietary ingredients that have not been present in the food supply—requires manufacturers and distributors of the product to take certain actions.

The guidance prompted great controversy, and FDA agreed to issue a revised draft guidance to address some of the issues raised by industry. In August , FDA released a revised Draft Guidance that replaced the Draft Guidance.

The purpose of the Draft Guidance was to help manufacturers and distributors decide whether to submit a premarket safety notification to FDA, help prepare NDI notifications in a manner that allows FDA to review and respond more efficiently and quickly, and to improve the quality of NDI notifications.

The Draft Guidance has been criticized by industry and trade associations for its lack of clarity and other problems. Some of these issues include the lack of clarity regarding Pre-DSHEA, Grandfathered , ingredients and FDA requiring an NDI notification even if another manufacturer has submitted a notification.

Self-Affirmed GRAS is when a company has a team of scientific experts evaluate the safety of their ingredient. There is no requirement that the safety dossier be submitted to FDA but is used by the company as an internal document that may be relied upon if the ingredient is challenged by the FDA.

FDA has expressed its concern with this practice and does not encourage dietary supplement manufacturers to use Self-Affirmed GRAS to avoid submitting NDI notifications. In any event, the likelihood of another revised Draft Guidance from FDA becoming available in the future is high, and possibly more enforcement actions taken against companies that market an NDI without submitting a notification.

In response to growing criticism of the dietary supplement industry, the th Congress passed the first mandatory Adverse Event Reporting AER legislation for the dietary supplement industry.

In December , President Bush signed into law the Dietary Supplement and Nonprescription Drug Consumer Protection Act, which took effect on December 22, After much debate in Congress and input from the FDA, the American Medical Association AMA , many of the major supplement trade associations, and a host of others all agreed that the legislation was necessary and the final version was approved by all.

The law strengthens the regulatory structure for dietary supplements and builds greater consumer confidence, as consumers have a right to expect that if they report a serious adverse event to a dietary supplement marketer the FDA will be advised about it.

An adverse event is any health-related event associated with the use of a dietary supplement that is adverse. A serious adverse event is an adverse event that A results in i death, ii a life-threatening experience, iii inpatient hospitalization, iv a persistent or significant disability or incapacity, or v a congenital anomaly or birth defect; or B requires, based on reasonable medical judgment, a medical or surgical intervention to prevent an outcome described under subparagraph A.

Once it is determined that a serious adverse event has occurred, the manufacturer, packer, or distributor responsible person of a dietary supplement whose name appears on the label of the supplement shall submit to the Secretary of Health and Human Services any report received of the serious adverse event accompanied by a copy of the label on or within the retail packaging of the dietary supplement.

The responsible person has 15 business days to submit the report to FDA after being notified of the serious adverse event. Following the initial report, the responsible person must submit follow-up reports of new medical information that they receive for one-year. The FDA has various options to protect consumers from unsafe supplements.

The FDA also has the authority to protect consumers from dietary supplements that do not present an imminent hazard to the public but do present certain risks of illness or injury to consumers.

The law prohibits introducing adulterated products into interstate commerce. The standard does not require proof that consumers have actually been harmed or even that a product will harm anyone.

It was under this provision that the FDA concluded that dietary supplements containing ephedra, androstenedione, and DMAA presented an unreasonable risk. Most recently, FDA imposed an importation ban on the botanical Mitragyna speciose, better known as Kratom.

In , FDA issued Import Alert 54—15, which allows for detention without physical examination of dietary supplements and bulk dietary ingredients that are, or contain, Kratom. Criminal penalties are present for a conviction of introducing adulterated supplement products into interstate commerce.

While the harms associated with dietary supplements may pale in comparison to those linked to prescription drugs, recent pronouncements from the U. Department of Justice confirm that the supplement industry is being watched vigilantly to protect the health and safety of the American public.

When DSHEA was passed in , it contained a provision requiring that the FDA establish and enforce current Good Manufacturing Practices cGMPs for dietary supplements. However, it was not until that the cGMPs were finally approved, and not until that the cGMPs applied across the industry, to large and small companies alike.

The adherence to cGMPs has helped protect against contamination issues and should serve to improve consumer confidence in dietary supplements.

The market improved as companies became compliant with cGMPs, as these regulations imposed more stringent requirements such as Vendor Certification, Document Control Procedures, and Identity Testing. These compliance criteria addressed the problems that had damaged the reputation of the industry with a focus on quality control, record keeping, and documentation.

However, it does appear that some within the industry continue to struggle with compliance. In Fiscal Year , it was reported that approximately Further, Undoubtedly, relying on certificates of analysis from the raw materials supplier without further testing, or failing to conduct identity testing of a finished product, can result in the creation of a product that contains something it should not contain such as synthetic chemicals or even pharmaceutical drugs.

All members of the industry need to ensure compliance with cGMPs. According to the Nutrition Labeling and Education Act NLEA , the FDA can review and approve health claims claims describing the relationship between a food substance and a reduced risk of a disease or health-related condition for dietary ingredients and foods.

However, since the law was passed it has only approved a few claims. The delay in reviewing health claims of dietary supplement ingredients resulted in a lawsuit, Pearson v.

Shalala , filed in After years of litigation, in the U. Court of Appeals for the District of Columbia Circuit ruled that qualified health claims may be made about dietary supplements with approval by FDA, as long as the statements are truthful and based on adequate science.

Supplement or food companies wishing to make health claims or qualified health claims about supplements can submit research evidence to the FDA for review. The FTC also regulates the supplement industry. Further, before marketing products, they must have evidence that their supplements are generally safe to meet all the requirements of DSHEA and FDA regulations.

This has increased job opportunities for sports nutrition specialists as well as enhanced external funding opportunities for research groups interested in exercise and nutrition research.

While the push for more research is due in part to greater scrutiny from the FDA and FTC, it is also in response to an increasingly competitive marketplace where established safety and efficacy attracts more consumer loyalty and helps ensure a longer lifespan for the product in commerce.

Companies that adhere to these ethical standards tend to prosper while those that do not will typically struggle to comply with FDA and FTC guidelines resulting in a loss of consumer confidence and an early demise for the product.

A common question posed by athletes, parents, and professionals surrounding dietary supplements relates to how they are manufactured and perceived supplement quality.

In several cases, established companies who develop dietary supplements have research teams who scour the medical and scientific literature looking for potentially effective nutrients.

These research teams often attend scientific meetings and review the latest patents, research abstracts presented at scientific meetings, and research publications. Leading companies invest in basic research on nutrients before developing their supplement formulations and often consult with leading researchers to discuss ideas about dietary supplements and their potential for commercialization.

Other companies wait until research has been presented in patents, research abstracts, or publications before developing nutritional formulations featuring the nutrient. Upon identification of new nutrients or potential formulations, the next step is to contact raw ingredient suppliers to see if the nutrient is available, if it is affordable, how much of it can be sourced and what is the available purity.

Sometimes, companies develop and pursue patents involving new processing and purification processes because the nutrient has not yet been extracted in a pure form or is not available in large quantities.

Reputable raw material manufacturers conduct extensive tests to examine purity of their raw ingredients. When working on a new ingredient, companies often conduct series of toxicity studies on the new nutrient once a purified source has been identified.

The company would then compile a safety dossier and communicate it to the FDA as a New Dietary Ingredient submission, with the hopes of it being allowed for lawful sale. When a powdered formulation is designed, the list of ingredients and raw materials are typically sent to a flavoring house and packaging company to identify the best way to flavor and package the supplement.

In the nutrition industry, several main flavoring houses and packaging companies exist who make many dietary supplements for supplement companies.

Most reputable dietary supplement manufacturers submit their production facilities to inspection from the FDA and adhere to GMP, which represent industry standards for good manufacturing of dietary supplements. Some companies also submit their products for independent testing by third-party companies to certify that their products meet label claims and that the product is free of various banned ingredients.

For example, the certification service offered by NSF International includes product testing, GMP inspections, ongoing monitoring and use of the NSF Mark indicating products comply with inspection standards, and screening for contaminants.

More recently, companies have subjected their products for testing by third party companies to inspect for banned or unwanted substances. These types of tests help ensure that the dietary supplement made available to athletes do not contained substances banned by the International Olympic Committee or other athletic governing bodies e.

While third-party testing does not guarantee that a supplement is void of banned substances, the likelihood is reduced e. Moreover, consumers can request copies of results of these tests and each product that has gone through testing and earned certification can be researched online to help athletes, coaches and support staff understand which products should be considered.

In many situations, companies who are not willing to provide copies of test results or certificates of analysis should be viewed with caution, particularly for individuals whose eligibility to participate might be compromised if a tainted product is consumed.

The ISSN recommends that potential consumers undertake a systematic process of evaluating the validity and scientific merit of claims made when assessing the ergogenic value of a dietary supplement [ 1 , 4 ]. This can be accomplished by examining the theoretical rationale behind the supplement and determining whether there is any well-controlled data showing the supplement is effective.

Supplements based on sound scientific rationale with direct, supportive research showing effectiveness may be worth trying or recommending. Sports nutrition specialists should be a resource to help their clients interpret the scientific and medical research that may impact their welfare and help them train more effectively.

The following are recommended questions to ask when evaluating the potential ergogenic value of a supplement.

Most supplements that have been marketed to improve health or exercise performance are based on theoretical applications derived from basic science or clinical research studies.

Based on these preliminary studies, a dietary approach or supplement is often marketed to people proclaiming the benefits observed in these basic research studies. Although the theory may appear relevant, critical analysis of this process often reveals flaws in the scientific logic or that the claims made do not quite match up with the cited literature.

By evaluating the literature one can discern whether or not a dietary approach or supplement has been based on sound scientific evidence. To do so, one is recommended to first read reviews about the training method, nutrient, or supplement from researchers who have been intimately involved in the available research and consult reliable references about nutritional and herbal supplements [ 1 , 9 ].

To aid in this endeavour, the ISSN has published position statement on topics related to creatine [ 10 ], protein [ 11 ], beta-alanine [ 12 ], nutrient timing [ 13 ], caffeine [ 14 ], HMB [ 15 ], meal frequency [ 16 ], energy drinks [ 17 ], and diets and body composition [ 18 ].

Each of these documents would be excellent resources for any of these topics. In addition, other review articles and consensus statements have been published by other researchers and research groups that evaluate dietary supplements, offer recommendations on interpreting the literature, and discuss the available findings for several ingredients that are discussed in this document [ 19 , 20 , 21 ].

A quick look at these references will often help determine if the theoretical impetus for supplementing with an ingredient is plausible or not. Proponents of ergogenic aids often overstate claims made about training devices and dietary supplements while opponents of ergogenic aids and dietary supplements are often either unaware or are ignorant of research supporting their use.

Sports nutrition specialists have the responsibility to know the literature and search available databases to evaluate the level of merit surrounding a proposed ergogenic aid.

Some athletic associations have banned the use of various nutritional supplements e. and many professional sports organization have now written language into their collective bargaining agreements that products made available by the team must be NSF certified as safe for sport.

Obviously, if the supplement is banned, the sports nutrition specialist should discourage its use. In addition, many supplements lack appropriate long-term safety data. People who consider taking nutritional supplements should be well aware of the potential side effects so they can make an informed decision whether to use a supplement.

Additionally, they should consult with a knowledgeable physician to see if any underlying medical problems exist that may contraindicate its use. When evaluating the safety of a supplement, it is suggested to determine if any side effects have been reported in the scientific or medical literature.

In particular, we suggest determining how long a particular supplement has been studied, the dosages evaluated, and whether any side effects were observed.

Unfortunately, many available supplements have not had basic safety studies completed that replicate the length of time and dosages being used. The next question to ask is whether any well-controlled data are available showing effectiveness of the proposed ergogenic aid in athletic populations or people regularly involved in exercise training.

The first place to look is the list of references cited in marketing material supporting their claims. Are the abstracts or articles cited just general references or specific studies that have evaluated the efficacy of the nutrients included in the formulation or of the actual supplement?

From there, one can critically evaluate the cited abstracts and articles by asking a series of questions:. For perspective, studies reporting improved performance in rats or an individual diagnosed with type 2 diabetes may be insightful, but research conducted on non-diabetic athletes is much more practical and relevant.

Were the studies well controlled? For ergogenic aid research, the gold standard study design is a randomized, double-blind, placebo controlled clinical trial. This means that neither the researcher nor the subject is aware which group received the supplement or the placebo during the study and that the subjects were randomly assigned into the placebo or supplement group.

At times, supplement claims have been based on poorly designed studies i. or testimonials which make interpretation more difficult. Well-controlled clinical trials provide stronger evidence as to the potential ergogenic value and importantly how the findings can best be used.

Do the studies report statistically significant results or are claims being made on non-significant means or trends? Appropriate statistical analysis of research results allows for an unbiased interpretation of data.

Although studies reporting statistical trends may be of interest and lead researchers to conduct additional research, studies reporting statistically significant results are obviously more convincing. With this said, it is important for people to understand that oftentimes the potential effect a dietary supplement or diet regimen may have above and beyond the effect seen from the exercise bout or an accepted dietary approach is quite small.

In addition, many studies examining a biochemical or molecular biology mechanism can require invasive sampling techniques or the study population being recruited is unique very highly trained resulting in a small number of study participants. When viewed together, the combination of these two considerations can result in statistical outcomes that do not reach statistical significance even though large mean changes were observed.

In all such cases, additional research is warranted to further examine the potential ergogenic aid before conclusions can be made. Do the results of the cited studies match the claims made about the supplement or do they accurately portray the response of the supplement against an appropriate placebo or control group?

It is not unusual for marketing claims to greatly exaggerate the results found in the actual studies and do so by focusing upon just the outcomes within the supplement treatment group as opposed to how the supplement group changed in comparison to how a placebo group changed.

Similarly, it is not uncommon for ostensibly compelling results, that may indeed be statistically significant, to be amplified while other relevant findings of significant consumer interest are obscured or omitted e.

a dietary supplement showing statistically significant increases in circulating testosterone yet changes in body composition or muscular performance were not superior to a placebo. Reputable companies accurately and completely report results of studies so that consumers can make informed decisions about using a product.

At times, claims are based on research that has either never been published or only published in an obscure journal. If you see only a few other journals this is a suggestion that the journal is not a reputable journal.

Additionally, one can also look up how many articles have been published by the journal in the last 6—12 months and how many of these articles are well-conducted studies.

Impact factors are determined and published by Thomson Reuters under Journal Citation Reports® a subscription service available at most university libraries.

Most journals list their impact factor on the journal home page. Historically, those articles that are read and cited the most are the most impactful scientifically.

Have the research findings been replicated? If so, have the results only been replicated at the same laboratory? The best way to know an ergogenic aid works is to see that results have been replicated in several studies preferably by several separate, distinct research groups.

The most reliable ergogenic aids are those in which multiple studies, conducted at different labs, have reported similar results of safety and efficacy. Additionally, replication of results by different, unaffiliated labs with completely different authors also removes or reduces the potentially confounding element of publication bias publication of studies showing only positive results and conflicts of interest.

A notable number of studies on ergogenic aids are conducted in collaboration with one or more research scientists or co-authors that have a real or perceived economic interest in the outcome of the study. This could range from being a co-inventor on a patent application that is the subject of the ergogenic aid, being paid or receiving royalties from the creation of a dietary supplement formulation, providing consulting services for the company or having stock options or shares in a company that owns or markets the ergogenic aid described in the study.

An increasing number of journals require disclosures by all authors of scientific articles, and including such disclosures in published articles.

This is driven by the aim of providing greater transparency and research integrity. It is important to emphasize that disclosure of a conflict of interest does not alone discredit or dilute the merits of a research study.

The primary thrust behind public disclosures of potential conflicts of interest is first and foremost transparency to the reader and second to prevent a later revelation of some form of confounding interest that has the potential of discrediting the study in question, the findings of the study, the authors, and even the research center or institution where the study was conducted.

Dietary supplements may contain carbohydrate, protein, fat, minerals, vitamins, herbs, enzymes, metabolic intermediates i.

Supplements can generally be classified as convenience supplements e. As discussed previously, evaluating the available scientific literature is an important step in determining the efficacy of any diet, diet program or dietary supplement.

In considering this, nutritional supplements can be categorized in the following manner:. Strong Evidence to Support Efficacy and Apparently Safe: Supplements that have a sound theoretical rationale with the majority of available research in relevant populations using appropriate dosing regimens demonstrating both its efficacy and safety.

Limited or Mixed Evidence to Support Efficacy: Supplements within this category are characterized as having a sound scientific rationale for its use, but the available research has failed to produce consistent outcomes supporting its efficacy.

Routinely, these supplements require more research to be completed before researchers can begin to understand their impact. Importantly, these supplements have no available evidence to suggest they lack safety or should be viewed as harmful.

Several factors are evaluated when beginning to counsel individuals who regularly complete exercise training. To accomplish this, one should make sure the athlete is eating an energy balanced, nutrient dense diet that meets their estimated daily energy needs and that they are training intelligently.

Far too many athletes or coaches focus too heavily upon supplementation or applications of supplementation and neglect these key fundamental aspects. Following this, we suggest that they generally only recommend supplements in category I i. If an athlete is interested in trying supplements in category II i.

Obviously, the ISSN does not support athletes taking supplements in category III i. We believe this approach is scientifically substantiated and offers a balanced view as opposed to simply dismissing the use of all dietary supplements.

A well-designed diet that meets energy intake needs and incorporates proper timing of nutrients is the foundation upon which a good training program can be developed [ 22 , 23 ]. Incorporating good dietary practices as part of a training program is one way to help optimize training adaptations and prevent overtraining.

The following is an overview of energy intake recommendations and major nutrient needs for active individuals. The primary component to optimize training and performance through nutrition is to ensure the athlete is consuming enough calories to offset energy expenditure [ 22 , 23 , 24 , 25 , 26 ].

People who participate in a general fitness program e. However, athletes involved in moderate levels of intense training e. For elite athletes, energy expenditure during heavy training or competition will further exceed these levels [ 27 , 28 ].

Additionally, caloric needs for large athletes i. This point was clearly highlighted in a review by Burke who demonstrated that carbohydrate needs are largely unmet by high-level athletes [ 22 ].

Additionally it is difficult to consume enough food and maintain gastrointestinal comfort to train or race at peak levels [ 35 ]. Maintaining an energy deficient diet during training often leads to a number of physical i. and psychological i.

It is still a question whether there may be specific individualized occasions when negative energy balance may enhance performance in the days prior to running performance [ 36 ]. Populations susceptible to negative energy balance include runners, cyclists, swimmers, triathletes, gymnasts, skaters, dancers, wrestlers, boxers, and athletes attempting to lose weight too quickly [ 37 ].

Additionally, female athletes are at particular risk of under fueling due to both competitive and aesthetic demands of their sport and their surrounding culture. Female athletes have been reported to have a high incidence of eating disorders [ 38 ]. This makes LEA a major nutritional concern for female athletes [ 39 ].

Consequently, it is important for the sports nutrition specialist working with athletes to assess athletes individually to ensure that athletes are well fed according to the goals of their sport and their health, and consume enough calories to offset the increased energy demands of training, and maintain body weight.

Further, travel and training schedules may limit food availability or the types of food athletes are accustomed to eating. This means that care should be taken to plan meal times in concert with training, as well as to make sure athletes have sufficient availability of nutrient dense foods throughout the day for snacking between meals e.

Beyond optimal energy intake, consuming adequate amounts of carbohydrate, protein, and fat is important for athletes to optimize their training and performance. In particular and as it relates to exercise performance, the need for optimal carbohydrates before, during and after intense and high-volume bouts of training and competition is evident [ 41 ].

Excellent reviews [ 42 , 43 ] and original investigations [ 44 , 45 , 46 , 47 , 48 , 49 ] continue to highlight the known dependence on carbohydrates that exists for athletes competing to win various endurance and team sport activities. A complete discussion of the needs of carbohydrates and strategies to deliver optimal carbohydrate and replenish lost muscle and liver glycogen extend beyond the scope of this paper, but the reader is referred to several informative reviews on the topic [ 23 , 41 , 50 , 51 , 52 , 53 ].

As such, individuals engaged in a general fitness program and are not necessarily training to meet any type of performance goal can typically meet daily carbohydrate needs by consuming a normal diet i. However, athletes involved in moderate and high-volume training need greater amounts of carbohydrate and protein discussed later in their diet to meet macronutrient needs [ 50 ].

In terms of carbohydrate needs, athletes involved in moderate amounts of intense training e. Research has also shown that athletes involved in high volume intense training e. Preferably, the majority of dietary carbohydrate should come from whole grains, vegetables, fruits, etc.

while foods that empty quickly from the stomach such as refined sugars, starches and engineered sports nutrition products should be reserved for situations in which glycogen resynthesis needs to occur at accelerated rates [ 53 ].

When considering the carbohydrate needs throughout an exercise session, several key factors should be considered. Previous research has indicated athletes undergoing prolonged bouts 2—3 h of exercise training can oxidize carbohydrates at a rate of 1—1.

Several reviews advocate the ingestion of 0. It is now well established that different types of carbohydrates can be oxidized at different rates in skeletal muscle due to the involvement of different transporter proteins that result in carbohydrate uptake [ 55 , 56 , 57 , 58 , 59 ].

Interestingly, combinations of glucose and sucrose or maltodextrin and fructose have been reported to promote greater exogenous rates of carbohydrate oxidation when compared to situations when single sources of carbohydrate are ingested [ 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 ].

These studies generally indicate a ratio of 1—1. In addition to oxidation rates and carbohydrate types, the fasting status and duration of the exercise bout also function as key variables for athletes and coaches to consider.

When considering duration, associated reviews have documented that bouts of moderate to intense exercise need to reach exercise durations that extend well into 90th minute of exercise before carbohydrate is shown to consistently yield an ergogenic outcome [ 41 , 68 , 69 ].

Of interest, however, not all studies indicate that shorter 60—75 min bouts of higher intensity work may benefit from carbohydrate delivery. Currently the mechanisms surrounding these findings are, respectively, thought to be replacement of depleted carbohydrate stores during longer duration of moderate intensity while benefits seen during shorter, more intense exercise bouts are thought to operate in a central fashion.

Moreover, these reviews have also pointed to the impact of fasting status on documentation of ergogenic outcomes [ 41 , 68 , 69 ]. In this respect, when studies require study participants to commence exercise in a fasted state, ergogenic outcomes are more consistently reported, yet other authors have questioned the ecological validity of this approach for competing athletes [ 43 ].

As it stands, the need for optimal carbohydrates in the diet for those athletes seeking maximal physical performance is unquestioned. Daily consumption of appropriate amounts of carbohydrate is the first and most important step for any competing athlete. As durations extend into 2 h, the need to deliver carbohydrate goes up, particularly when commencing exercise in a state of fasting or incomplete recovery.

Once exercise ceases, several dietary strategies can be considered to maximally replace lost muscle and liver glycogen, particularly if a limited window of recovery exists. In these situations, the first priority should lie with achieving aggressive intakes of carbohydrate while strategies such as ingesting protein with lower carbohydrate amounts, carbohydrate and caffeine co-ingestion or certain forms of carbohydrate may also help to facilitate rapid assimilation of lost glycogen.

Initially, it was recommended that athletes do not need to ingest more than the RDA for protein i. However, research spanning the past 30 years has indicated that athletes engaged in intense training may benefit from ingesting about two times the RDA of protein in their diet 1.

If an insufficient amount of protein is consumed, an athlete will develop and maintain a negative nitrogen balance, indicating protein catabolism and slow recovery. Over time, this may lead to muscle wasting, injuries, illness, and training intolerance [ 76 , 77 , 81 ]. For people involved in a general fitness program or simply interested in optimizing their health, recent research suggests protein needs may also be above the RDA.

Phillips and colleagues [ 76 ], Witard et al. In this respect, Morton and investigators [ 83 ] performed a meta-review and meta-regression involving 49 studies and participants and concluded that a daily protein intake of 1.

In addition and in comparison to the RDA, non-exercising, older individuals 53—71 years may also benefit from a higher daily protein intake e.

Recent reports suggest that older muscle may be slower to respond and less sensitive to protein ingestion, typically requiring 40 g doses to robustly stimulate muscle protein synthesis [ 84 , 85 , 86 ]. Studies in younger individuals, however, have indicated that in the absence of exercise, a 20 g dose can maximize muscle protein synthesis [ 87 , 88 ] and if consumed after a multiple set workout consisting of several exercises that target large muscle groups a 40 g dose might be needed [ 89 ].

Consequently, it is recommended that athletes involved in moderate amounts of intense training consume 1. This protein need would be equivalent to ingesting 3—15 three-ounce servings of chicken or fish per day for a 50— kg athlete [ 78 ]. Although smaller athletes typically can ingest this amount of protein, on a daily basis, in their normal diet, larger athletes often have difficulty consuming this much dietary protein.

Additionally, a number of athletic populations are known to be susceptible to protein malnutrition e. After exercise, a snack that provides a good dose of protein and carbs is especially important for replenishing glycogen stores and supporting muscle protein synthesis.

They help provide an appropriate balance of energy, nutrients, and other bioactive compounds in food that are not often found in supplement form. That said, considering that athletes often have greater nutritional needs than the general population, supplementation can be used to fill in any gaps in the diet.

Protein powders are isolated forms of various proteins, such as whey, egg white, pea, brown rice, and soy. Protein powders typically contain 10—25 g of protein per scoop, making it easy and convenient to consume a solid dose of protein. Research suggests that consuming a protein supplement around training can help promote recovery and aid in increases in lean body mass.

For example, some people choose to add protein powder to their oats to boost their protein content a bit. Carb supplements may help sustain your energy levels, particularly if you engage in endurance sports lasting longer than 1 hour.

These concentrated forms of carbs usually provide about 25 g of simple carbs per serving, and some include add-ins such as caffeine or vitamins. They come in gel or powder form.

Many long-distance endurance athletes will aim to consume 1 carb energy gel containing 25 g of carbs every 30—45 minutes during an exercise session longer than 1 hour. Sports drinks also often contain enough carbs to maintain energy levels, but some athletes prefer gels to prevent excessive fluid intake during training or events, as this may result in digestive distress.

Many athletes choose to take a high quality multivitamin that contains all the basic vitamins and minerals to make up for any potential gaps in their diet. This is likely a good idea for most people, as the potential benefits of supplementing with a multivitamin outweigh the risks.

One vitamin in particular that athletes often supplement is vitamin D, especially during winter in areas with less sun exposure. Low vitamin D levels have been shown to potentially affect sports performance, so supplementing is often recommended.

Research shows that caffeine can improve strength and endurance in a wide range of sporting activities , such as running, jumping, throwing, and weightlifting. Many athletes choose to drink a strong cup of coffee before training to get a boost, while others turn to supplements that contain synthetic forms of caffeine, such as pre-workouts.

Whichever form you decide to use, be sure to start out with a small amount. You can gradually increase your dose as long as your body tolerates it. Supplementing with omega-3 fats such as fish oil may improve sports performance and recovery from intense exercise.

You can certainly get omega-3s from your diet by eating foods such as fatty fish, flax and chia seeds, nuts, and soybeans. Plant-based omega-3 supplements are also available for those who follow a vegetarian or vegan diet.

Creatine is a compound your body produces from amino acids. It aids in energy production during short, high intensity activities. Supplementing daily with 5 g of creatine monohydrate — the most common form — has been shown to improve power and strength output during resistance training, which can carry over to sports performance.

Most sporting federations do not classify creatine as a banned substance, as its effects are modest compared with those of other compounds. Considering their low cost and wide availability and the extensive research behind them, creatine supplements may be worthwhile for some athletes.

Beta-alanine is another amino acid-based compound found in animal products such as beef and chicken. In your body, beta-alanine serves as a building block for carnosine, a compound responsible for helping to reduce the acidic environment within working muscles during high intensity exercise.

The most notable benefit of supplementing with beta-alanine is improvement in performance in high intensity exercises lasting 1—10 minutes. The commonly recommended research -based dosages range from 3.

Some people prefer to stick to the lower end of the range to avoid a potential side effect called paraesthesia , a tingling sensation in the extremities.

Sports nutritionists are responsible for implementing science-based nutrition protocols for athletes and staying on top of the latest research. At the highest level, sports nutrition programs are traditionally overseen and administered by registered dietitians specializing in this area.

These professionals serve to educate athletes on all aspects of nutrition related to sports performance, including taking in the right amount of food, nutrients, hydration, and supplementation when needed.

Lastly, sports nutritionists often work with athletes to address food allergies , intolerances , nutrition-related medical concerns, and — in collaboration with psychotherapists — any eating disorders or disordered eating that athletes may be experiencing.

One of the roles of sports nutritionists is to help debunk these myths and provide athletes with accurate information. Here are three of the top sports nutrition myths — and what the facts really say. While protein intake is an important factor in gaining muscle, simply supplementing with protein will not cause any significant muscle gains.

To promote notable changes in muscle size, you need to regularly perform resistance training for an extended period of time while making sure your diet is on point. Even then, depending on a number of factors, including genetics, sex, and body size, you will likely not look bulky.

Another common myth in sports nutrition is that eating close to bedtime will cause additional fat gain. Many metabolic processes take place during sleep. For example, eating two slices of pizza before bed is much more likely to result in fat gain than eating a cup of cottage cheese or Greek yogurt.

Coffee gets a bad rap for being dehydrating. While sports nutrition is quite individualized, some general areas are important for most athletes.

Choosing the right foods, zeroing in your macros, optimizing meal timing, ensuring good hydration, and selecting appropriate snacks can help you perform at your best.

However, it does appear that some within the industry continue to struggle with compliance. In Fiscal Year , it was reported that approximately Further, Undoubtedly, relying on certificates of analysis from the raw materials supplier without further testing, or failing to conduct identity testing of a finished product, can result in the creation of a product that contains something it should not contain such as synthetic chemicals or even pharmaceutical drugs.

All members of the industry need to ensure compliance with cGMPs. According to the Nutrition Labeling and Education Act NLEA , the FDA can review and approve health claims claims describing the relationship between a food substance and a reduced risk of a disease or health-related condition for dietary ingredients and foods.

However, since the law was passed it has only approved a few claims. The delay in reviewing health claims of dietary supplement ingredients resulted in a lawsuit, Pearson v. Shalala , filed in After years of litigation, in the U. Court of Appeals for the District of Columbia Circuit ruled that qualified health claims may be made about dietary supplements with approval by FDA, as long as the statements are truthful and based on adequate science.

Supplement or food companies wishing to make health claims or qualified health claims about supplements can submit research evidence to the FDA for review.

The FTC also regulates the supplement industry. Further, before marketing products, they must have evidence that their supplements are generally safe to meet all the requirements of DSHEA and FDA regulations.

This has increased job opportunities for sports nutrition specialists as well as enhanced external funding opportunities for research groups interested in exercise and nutrition research.

While the push for more research is due in part to greater scrutiny from the FDA and FTC, it is also in response to an increasingly competitive marketplace where established safety and efficacy attracts more consumer loyalty and helps ensure a longer lifespan for the product in commerce.

Companies that adhere to these ethical standards tend to prosper while those that do not will typically struggle to comply with FDA and FTC guidelines resulting in a loss of consumer confidence and an early demise for the product. A common question posed by athletes, parents, and professionals surrounding dietary supplements relates to how they are manufactured and perceived supplement quality.

In several cases, established companies who develop dietary supplements have research teams who scour the medical and scientific literature looking for potentially effective nutrients.

These research teams often attend scientific meetings and review the latest patents, research abstracts presented at scientific meetings, and research publications.

Leading companies invest in basic research on nutrients before developing their supplement formulations and often consult with leading researchers to discuss ideas about dietary supplements and their potential for commercialization.

Other companies wait until research has been presented in patents, research abstracts, or publications before developing nutritional formulations featuring the nutrient. Upon identification of new nutrients or potential formulations, the next step is to contact raw ingredient suppliers to see if the nutrient is available, if it is affordable, how much of it can be sourced and what is the available purity.

Sometimes, companies develop and pursue patents involving new processing and purification processes because the nutrient has not yet been extracted in a pure form or is not available in large quantities.

Reputable raw material manufacturers conduct extensive tests to examine purity of their raw ingredients. When working on a new ingredient, companies often conduct series of toxicity studies on the new nutrient once a purified source has been identified.

The company would then compile a safety dossier and communicate it to the FDA as a New Dietary Ingredient submission, with the hopes of it being allowed for lawful sale.

When a powdered formulation is designed, the list of ingredients and raw materials are typically sent to a flavoring house and packaging company to identify the best way to flavor and package the supplement. In the nutrition industry, several main flavoring houses and packaging companies exist who make many dietary supplements for supplement companies.

Most reputable dietary supplement manufacturers submit their production facilities to inspection from the FDA and adhere to GMP, which represent industry standards for good manufacturing of dietary supplements.

Some companies also submit their products for independent testing by third-party companies to certify that their products meet label claims and that the product is free of various banned ingredients.

For example, the certification service offered by NSF International includes product testing, GMP inspections, ongoing monitoring and use of the NSF Mark indicating products comply with inspection standards, and screening for contaminants. More recently, companies have subjected their products for testing by third party companies to inspect for banned or unwanted substances.

These types of tests help ensure that the dietary supplement made available to athletes do not contained substances banned by the International Olympic Committee or other athletic governing bodies e.

While third-party testing does not guarantee that a supplement is void of banned substances, the likelihood is reduced e. Moreover, consumers can request copies of results of these tests and each product that has gone through testing and earned certification can be researched online to help athletes, coaches and support staff understand which products should be considered.

In many situations, companies who are not willing to provide copies of test results or certificates of analysis should be viewed with caution, particularly for individuals whose eligibility to participate might be compromised if a tainted product is consumed.

The ISSN recommends that potential consumers undertake a systematic process of evaluating the validity and scientific merit of claims made when assessing the ergogenic value of a dietary supplement [ 1 , 4 ]. This can be accomplished by examining the theoretical rationale behind the supplement and determining whether there is any well-controlled data showing the supplement is effective.

Supplements based on sound scientific rationale with direct, supportive research showing effectiveness may be worth trying or recommending. Sports nutrition specialists should be a resource to help their clients interpret the scientific and medical research that may impact their welfare and help them train more effectively.

The following are recommended questions to ask when evaluating the potential ergogenic value of a supplement. Most supplements that have been marketed to improve health or exercise performance are based on theoretical applications derived from basic science or clinical research studies.

Based on these preliminary studies, a dietary approach or supplement is often marketed to people proclaiming the benefits observed in these basic research studies. Although the theory may appear relevant, critical analysis of this process often reveals flaws in the scientific logic or that the claims made do not quite match up with the cited literature.

By evaluating the literature one can discern whether or not a dietary approach or supplement has been based on sound scientific evidence. To do so, one is recommended to first read reviews about the training method, nutrient, or supplement from researchers who have been intimately involved in the available research and consult reliable references about nutritional and herbal supplements [ 1 , 9 ].

To aid in this endeavour, the ISSN has published position statement on topics related to creatine [ 10 ], protein [ 11 ], beta-alanine [ 12 ], nutrient timing [ 13 ], caffeine [ 14 ], HMB [ 15 ], meal frequency [ 16 ], energy drinks [ 17 ], and diets and body composition [ 18 ].

Each of these documents would be excellent resources for any of these topics. In addition, other review articles and consensus statements have been published by other researchers and research groups that evaluate dietary supplements, offer recommendations on interpreting the literature, and discuss the available findings for several ingredients that are discussed in this document [ 19 , 20 , 21 ].

A quick look at these references will often help determine if the theoretical impetus for supplementing with an ingredient is plausible or not. Proponents of ergogenic aids often overstate claims made about training devices and dietary supplements while opponents of ergogenic aids and dietary supplements are often either unaware or are ignorant of research supporting their use.

Sports nutrition specialists have the responsibility to know the literature and search available databases to evaluate the level of merit surrounding a proposed ergogenic aid.

Some athletic associations have banned the use of various nutritional supplements e. and many professional sports organization have now written language into their collective bargaining agreements that products made available by the team must be NSF certified as safe for sport.

Obviously, if the supplement is banned, the sports nutrition specialist should discourage its use. In addition, many supplements lack appropriate long-term safety data. People who consider taking nutritional supplements should be well aware of the potential side effects so they can make an informed decision whether to use a supplement.

Additionally, they should consult with a knowledgeable physician to see if any underlying medical problems exist that may contraindicate its use. When evaluating the safety of a supplement, it is suggested to determine if any side effects have been reported in the scientific or medical literature.

In particular, we suggest determining how long a particular supplement has been studied, the dosages evaluated, and whether any side effects were observed. Unfortunately, many available supplements have not had basic safety studies completed that replicate the length of time and dosages being used.

The next question to ask is whether any well-controlled data are available showing effectiveness of the proposed ergogenic aid in athletic populations or people regularly involved in exercise training. The first place to look is the list of references cited in marketing material supporting their claims.

Are the abstracts or articles cited just general references or specific studies that have evaluated the efficacy of the nutrients included in the formulation or of the actual supplement? From there, one can critically evaluate the cited abstracts and articles by asking a series of questions:.

For perspective, studies reporting improved performance in rats or an individual diagnosed with type 2 diabetes may be insightful, but research conducted on non-diabetic athletes is much more practical and relevant.

Were the studies well controlled? For ergogenic aid research, the gold standard study design is a randomized, double-blind, placebo controlled clinical trial.

This means that neither the researcher nor the subject is aware which group received the supplement or the placebo during the study and that the subjects were randomly assigned into the placebo or supplement group. At times, supplement claims have been based on poorly designed studies i.

or testimonials which make interpretation more difficult. Well-controlled clinical trials provide stronger evidence as to the potential ergogenic value and importantly how the findings can best be used.

Do the studies report statistically significant results or are claims being made on non-significant means or trends? Appropriate statistical analysis of research results allows for an unbiased interpretation of data.

Although studies reporting statistical trends may be of interest and lead researchers to conduct additional research, studies reporting statistically significant results are obviously more convincing.

With this said, it is important for people to understand that oftentimes the potential effect a dietary supplement or diet regimen may have above and beyond the effect seen from the exercise bout or an accepted dietary approach is quite small.

In addition, many studies examining a biochemical or molecular biology mechanism can require invasive sampling techniques or the study population being recruited is unique very highly trained resulting in a small number of study participants.

When viewed together, the combination of these two considerations can result in statistical outcomes that do not reach statistical significance even though large mean changes were observed. In all such cases, additional research is warranted to further examine the potential ergogenic aid before conclusions can be made.

Do the results of the cited studies match the claims made about the supplement or do they accurately portray the response of the supplement against an appropriate placebo or control group? It is not unusual for marketing claims to greatly exaggerate the results found in the actual studies and do so by focusing upon just the outcomes within the supplement treatment group as opposed to how the supplement group changed in comparison to how a placebo group changed.

Similarly, it is not uncommon for ostensibly compelling results, that may indeed be statistically significant, to be amplified while other relevant findings of significant consumer interest are obscured or omitted e. a dietary supplement showing statistically significant increases in circulating testosterone yet changes in body composition or muscular performance were not superior to a placebo.

Reputable companies accurately and completely report results of studies so that consumers can make informed decisions about using a product.

At times, claims are based on research that has either never been published or only published in an obscure journal. If you see only a few other journals this is a suggestion that the journal is not a reputable journal. Additionally, one can also look up how many articles have been published by the journal in the last 6—12 months and how many of these articles are well-conducted studies.

Impact factors are determined and published by Thomson Reuters under Journal Citation Reports® a subscription service available at most university libraries. Most journals list their impact factor on the journal home page. Historically, those articles that are read and cited the most are the most impactful scientifically.

Have the research findings been replicated? If so, have the results only been replicated at the same laboratory? The best way to know an ergogenic aid works is to see that results have been replicated in several studies preferably by several separate, distinct research groups.

The most reliable ergogenic aids are those in which multiple studies, conducted at different labs, have reported similar results of safety and efficacy. Additionally, replication of results by different, unaffiliated labs with completely different authors also removes or reduces the potentially confounding element of publication bias publication of studies showing only positive results and conflicts of interest.

A notable number of studies on ergogenic aids are conducted in collaboration with one or more research scientists or co-authors that have a real or perceived economic interest in the outcome of the study. This could range from being a co-inventor on a patent application that is the subject of the ergogenic aid, being paid or receiving royalties from the creation of a dietary supplement formulation, providing consulting services for the company or having stock options or shares in a company that owns or markets the ergogenic aid described in the study.

An increasing number of journals require disclosures by all authors of scientific articles, and including such disclosures in published articles. This is driven by the aim of providing greater transparency and research integrity. It is important to emphasize that disclosure of a conflict of interest does not alone discredit or dilute the merits of a research study.

The primary thrust behind public disclosures of potential conflicts of interest is first and foremost transparency to the reader and second to prevent a later revelation of some form of confounding interest that has the potential of discrediting the study in question, the findings of the study, the authors, and even the research center or institution where the study was conducted.

Dietary supplements may contain carbohydrate, protein, fat, minerals, vitamins, herbs, enzymes, metabolic intermediates i. Supplements can generally be classified as convenience supplements e. As discussed previously, evaluating the available scientific literature is an important step in determining the efficacy of any diet, diet program or dietary supplement.

In considering this, nutritional supplements can be categorized in the following manner:. Strong Evidence to Support Efficacy and Apparently Safe: Supplements that have a sound theoretical rationale with the majority of available research in relevant populations using appropriate dosing regimens demonstrating both its efficacy and safety.

Limited or Mixed Evidence to Support Efficacy: Supplements within this category are characterized as having a sound scientific rationale for its use, but the available research has failed to produce consistent outcomes supporting its efficacy.

Routinely, these supplements require more research to be completed before researchers can begin to understand their impact. Importantly, these supplements have no available evidence to suggest they lack safety or should be viewed as harmful. Several factors are evaluated when beginning to counsel individuals who regularly complete exercise training.

To accomplish this, one should make sure the athlete is eating an energy balanced, nutrient dense diet that meets their estimated daily energy needs and that they are training intelligently. Far too many athletes or coaches focus too heavily upon supplementation or applications of supplementation and neglect these key fundamental aspects.

Following this, we suggest that they generally only recommend supplements in category I i. If an athlete is interested in trying supplements in category II i. Obviously, the ISSN does not support athletes taking supplements in category III i. We believe this approach is scientifically substantiated and offers a balanced view as opposed to simply dismissing the use of all dietary supplements.

A well-designed diet that meets energy intake needs and incorporates proper timing of nutrients is the foundation upon which a good training program can be developed [ 22 , 23 ].

Incorporating good dietary practices as part of a training program is one way to help optimize training adaptations and prevent overtraining. The following is an overview of energy intake recommendations and major nutrient needs for active individuals.

The primary component to optimize training and performance through nutrition is to ensure the athlete is consuming enough calories to offset energy expenditure [ 22 , 23 , 24 , 25 , 26 ].

People who participate in a general fitness program e. However, athletes involved in moderate levels of intense training e. For elite athletes, energy expenditure during heavy training or competition will further exceed these levels [ 27 , 28 ]. Additionally, caloric needs for large athletes i.

This point was clearly highlighted in a review by Burke who demonstrated that carbohydrate needs are largely unmet by high-level athletes [ 22 ]. Additionally it is difficult to consume enough food and maintain gastrointestinal comfort to train or race at peak levels [ 35 ].

Maintaining an energy deficient diet during training often leads to a number of physical i. and psychological i. It is still a question whether there may be specific individualized occasions when negative energy balance may enhance performance in the days prior to running performance [ 36 ].

Populations susceptible to negative energy balance include runners, cyclists, swimmers, triathletes, gymnasts, skaters, dancers, wrestlers, boxers, and athletes attempting to lose weight too quickly [ 37 ]. Additionally, female athletes are at particular risk of under fueling due to both competitive and aesthetic demands of their sport and their surrounding culture.

Female athletes have been reported to have a high incidence of eating disorders [ 38 ]. This makes LEA a major nutritional concern for female athletes [ 39 ]. Consequently, it is important for the sports nutrition specialist working with athletes to assess athletes individually to ensure that athletes are well fed according to the goals of their sport and their health, and consume enough calories to offset the increased energy demands of training, and maintain body weight.

Further, travel and training schedules may limit food availability or the types of food athletes are accustomed to eating. This means that care should be taken to plan meal times in concert with training, as well as to make sure athletes have sufficient availability of nutrient dense foods throughout the day for snacking between meals e.

Beyond optimal energy intake, consuming adequate amounts of carbohydrate, protein, and fat is important for athletes to optimize their training and performance. In particular and as it relates to exercise performance, the need for optimal carbohydrates before, during and after intense and high-volume bouts of training and competition is evident [ 41 ].

Excellent reviews [ 42 , 43 ] and original investigations [ 44 , 45 , 46 , 47 , 48 , 49 ] continue to highlight the known dependence on carbohydrates that exists for athletes competing to win various endurance and team sport activities.

A complete discussion of the needs of carbohydrates and strategies to deliver optimal carbohydrate and replenish lost muscle and liver glycogen extend beyond the scope of this paper, but the reader is referred to several informative reviews on the topic [ 23 , 41 , 50 , 51 , 52 , 53 ].

As such, individuals engaged in a general fitness program and are not necessarily training to meet any type of performance goal can typically meet daily carbohydrate needs by consuming a normal diet i. However, athletes involved in moderate and high-volume training need greater amounts of carbohydrate and protein discussed later in their diet to meet macronutrient needs [ 50 ].

In terms of carbohydrate needs, athletes involved in moderate amounts of intense training e. Research has also shown that athletes involved in high volume intense training e.

Preferably, the majority of dietary carbohydrate should come from whole grains, vegetables, fruits, etc. while foods that empty quickly from the stomach such as refined sugars, starches and engineered sports nutrition products should be reserved for situations in which glycogen resynthesis needs to occur at accelerated rates [ 53 ].

When considering the carbohydrate needs throughout an exercise session, several key factors should be considered. Previous research has indicated athletes undergoing prolonged bouts 2—3 h of exercise training can oxidize carbohydrates at a rate of 1—1.

Several reviews advocate the ingestion of 0. It is now well established that different types of carbohydrates can be oxidized at different rates in skeletal muscle due to the involvement of different transporter proteins that result in carbohydrate uptake [ 55 , 56 , 57 , 58 , 59 ].

Interestingly, combinations of glucose and sucrose or maltodextrin and fructose have been reported to promote greater exogenous rates of carbohydrate oxidation when compared to situations when single sources of carbohydrate are ingested [ 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 ].

These studies generally indicate a ratio of 1—1. In addition to oxidation rates and carbohydrate types, the fasting status and duration of the exercise bout also function as key variables for athletes and coaches to consider. When considering duration, associated reviews have documented that bouts of moderate to intense exercise need to reach exercise durations that extend well into 90th minute of exercise before carbohydrate is shown to consistently yield an ergogenic outcome [ 41 , 68 , 69 ].

Of interest, however, not all studies indicate that shorter 60—75 min bouts of higher intensity work may benefit from carbohydrate delivery.

Currently the mechanisms surrounding these findings are, respectively, thought to be replacement of depleted carbohydrate stores during longer duration of moderate intensity while benefits seen during shorter, more intense exercise bouts are thought to operate in a central fashion. Moreover, these reviews have also pointed to the impact of fasting status on documentation of ergogenic outcomes [ 41 , 68 , 69 ].

In this respect, when studies require study participants to commence exercise in a fasted state, ergogenic outcomes are more consistently reported, yet other authors have questioned the ecological validity of this approach for competing athletes [ 43 ].

As it stands, the need for optimal carbohydrates in the diet for those athletes seeking maximal physical performance is unquestioned.

Daily consumption of appropriate amounts of carbohydrate is the first and most important step for any competing athlete. As durations extend into 2 h, the need to deliver carbohydrate goes up, particularly when commencing exercise in a state of fasting or incomplete recovery.

Once exercise ceases, several dietary strategies can be considered to maximally replace lost muscle and liver glycogen, particularly if a limited window of recovery exists. In these situations, the first priority should lie with achieving aggressive intakes of carbohydrate while strategies such as ingesting protein with lower carbohydrate amounts, carbohydrate and caffeine co-ingestion or certain forms of carbohydrate may also help to facilitate rapid assimilation of lost glycogen.

Initially, it was recommended that athletes do not need to ingest more than the RDA for protein i. However, research spanning the past 30 years has indicated that athletes engaged in intense training may benefit from ingesting about two times the RDA of protein in their diet 1.

If an insufficient amount of protein is consumed, an athlete will develop and maintain a negative nitrogen balance, indicating protein catabolism and slow recovery. Over time, this may lead to muscle wasting, injuries, illness, and training intolerance [ 76 , 77 , 81 ].

For people involved in a general fitness program or simply interested in optimizing their health, recent research suggests protein needs may also be above the RDA.

Phillips and colleagues [ 76 ], Witard et al. In this respect, Morton and investigators [ 83 ] performed a meta-review and meta-regression involving 49 studies and participants and concluded that a daily protein intake of 1.

In addition and in comparison to the RDA, non-exercising, older individuals 53—71 years may also benefit from a higher daily protein intake e. Recent reports suggest that older muscle may be slower to respond and less sensitive to protein ingestion, typically requiring 40 g doses to robustly stimulate muscle protein synthesis [ 84 , 85 , 86 ].

Studies in younger individuals, however, have indicated that in the absence of exercise, a 20 g dose can maximize muscle protein synthesis [ 87 , 88 ] and if consumed after a multiple set workout consisting of several exercises that target large muscle groups a 40 g dose might be needed [ 89 ].

Consequently, it is recommended that athletes involved in moderate amounts of intense training consume 1. This protein need would be equivalent to ingesting 3—15 three-ounce servings of chicken or fish per day for a 50— kg athlete [ 78 ].

Although smaller athletes typically can ingest this amount of protein, on a daily basis, in their normal diet, larger athletes often have difficulty consuming this much dietary protein.

Additionally, a number of athletic populations are known to be susceptible to protein malnutrition e. and consequently, additional counseling and education may be needed to help these athletes meet their daily protein needs.

Overall, it goes without saying that care should be taken to ensure that athletes consume a sufficient amount of quality protein in their diet to maintain nitrogen balance. Proteins differ based on their source, amino acid profile, and the methods of processing or isolating the protein undergoes [ 11 ].

These differences influence the availability of amino acids and peptides, which may possess biological activity e. For example, different types of proteins e. Therefore, care should be taken not only to make sure the athlete consumes enough protein in their diet but also that the protein is high quality.

The best dietary sources of low fat, high quality protein are light skinless chicken, fish, egg whites, very lean cuts of beef and skim milk casein and whey while protein supplements routinely contain whey, casein, milk and egg protein.

In what is still an emerging area of research, various plant sources of protein have been examined for their ability to stimulate increases in muscle protein synthesis [ 77 , 97 ] and promote exercise training adaptations [ 98 ].

While amino acid absorption from plant proteins is generally slower, leucine from rice protein has been found to be absorbed even faster than from whey [ 99 ], while digestive enzymes [ ], probiotics [ ] and HMB [ ] can be used to overcome differences in protein quality.

Preliminary findings suggest that rice [ 98 ] and pea protein [ ] may be able to stimulate similar changes in fat-free mass and strength as whey protein, although the reader should understand that many other factors dose provided, training status of participants, duration of training and supplementation, etc.

will ultimately impact these outcomes and consequently more research is needed. While many reasons and scenarios exist for why an athlete may choose to supplement their diet with protein powders or other forms of protein supplements, this practice is not considered to be an absolute requirement for increased performance and adaptations.

Due to nutritional, societal, emotional and psychological reasons, it is preferable for the majority of daily protein consumed by athletes to occur as part of a food or meal. However, we recognize and embrace the reality that situations commonly arise where efficiently delivering a high-quality source of protein takes precedence.

Jager and colleagues [ 11 ] published an updated position statement of the International Society of Sports Nutrition that is summarized by the following points:. An acute exercise stimulus, particularly resistance exercise and protein ingestion both stimulate muscle protein synthesis MPS and are synergistic when protein consumption occurs before or after resistance exercise.

For building and maintaining muscle mass, an overall daily protein intake of 1. Higher protein intakes 2. Optimal doses for athletes to maximize MPS are mixed and are dependent upon age and recent resistance exercise stimuli.

General recommendations are 0. The optimal time period during which to ingest protein is likely a matter of individual tolerance; however, the anabolic effect of exercise is long-lasting at least 24 h , but likely diminishes with increasing time post-exercise.

Rapidly digested proteins that contain high proportions of EAAs and adequate leucine, are most effective in stimulating MPS. Different types and quality of protein can affect amino acid bioavailability following protein supplementation; complete protein sources deliver all required EAAs.

The dietary recommendations of fat intake for athletes are similar to or slightly greater than dietary recommendations made to non-athletes to promote health. Maintenance of energy balance, replenishment of intramuscular triacylglycerol stores and adequate consumption of essential fatty acids are important for athletes, and all serve as reasons for an increased intake of dietary fat [ ].

For example, higher-fat diets appear to maintain circulating testosterone concentrations better than low-fat diets [ , , ]. Additionally, higher fat intakes may provide valuable translational evidence to the documented testosterone suppression which can occur during volume-type overtraining [ ].

In situations where an athlete may be interested in reducing their body fat, dietary fat intakes ranging from 0. This recommendation stems largely from available evidence in weight loss studies involving non-athletic individuals that people who are most successful in losing weight and maintaining the weight loss are those who ingest reduced amounts of fat in their diet [ , ] although this is not always the case [ ].

Strategies to help athletes manage dietary fat intake include teaching them which foods contain various types of fat so that they can make better food choices and how to count fat grams [ 2 , 33 ]. For years, high-fat diets have been used by athletes with the majority of evidence showing no ergogenic benefit and consistent gastrointestinal challenges [ ].

In recent years, significant debate has swirled regarding the impact of increasing dietary fat. While intramuscular adaptations result that may theoretically impact performance [ , ], no consistent, favorable impact on performance has been documented [ , ].

A variant of high-fat diets, ketogenic diets, have increased in popularity. This diet prescription leads to a greater reliance on ketones as a fuel source. Currently, limited and mixed evidence remains regarding the overall efficacy of a ketogenic diet for athletes.

In favor, Cox et al. Additionally, Jabekk and colleagues [ ] reported decreases in body fat with no change in lean mass in overweight women who resistance trained for 10 weeks and followed a ketogenic diet. In light of the available evidence being limited and mixed, more human research needs to be completed before appropriate recommendations can be made towards the use of high fat diets for athletic performance.

In addition to the general nutritional guidelines described above, research has also demonstrated that timing and composition of meals consumed may play a role in optimizing performance, training adaptations, and preventing overtraining [ 2 , 25 , 40 ].

In this regard, it takes about 4 h for carbohydrate to be digested and assimilated into muscle and liver tissues as glycogen.

Consequently, pre-exercise meals should be consumed about four to 6 h before exercise [ 40 ]. This means that if an athlete trains in the afternoon, breakfast can be viewed to have great importance to top off muscle and liver glycogen levels.

Research has also indicated that ingesting a light carbohydrate and protein snack 30 to 60 min prior to exercise e. This also serves to increase availability of amino acids, decrease exercise-induced catabolism of protein, and minimize muscle damage [ , , ].

Additionally, athletes who are going through periods of energy restriction to meet weight or aesthetic demands of sports should understand that protein intake, quality and timing as well as combination with carbohydrate is particularly important to maintain lean body mass, training effects, and performance [ 25 ].

Notably, this strategy becomes even more important if the athlete is under-fueled prior to the exercise task or is fasted vs. unfasted at the start of exercise [ 68 , 69 , ]. Following intense exercise, athletes should consume carbohydrate and protein e.

This eating strategy has been shown to supersaturate carbohydrate stores prior to competition and improve endurance exercise capacity [ 2 , 40 ]. Thus, the type of meal, amount of carbohydrate consumed, and timing of eating are important factors to maximize glycogen storage and in maintaining carbohydrate availability during training while also potentially decreasing the incidence of overtraining.

The ISSN has adopted a position stand on nutrient timing in [ ] that has been subsequently revised [ 13 ] and can be summarized with the following points:.

The importance of this strategy is increased when poor feeding or recovery strategies were employed prior to exercise commencement. Consequently, when carbohydrate delivery is inadequate, adding protein may help increase performance, mitigate muscle damage, promote euglycemia, and facilitate glycogen re-synthesis.

Ingesting efficacious doses 10—12 g of essential amino acids EAAs either in free form or as a protein bolus in 20—40 g doses 0. However, the size 0. Post-exercise ingestion immediately-post to 2 h post of high-quality protein sources stimulates robust increases in MPS.

Similar increases in MPS have been found when high-quality proteins are ingested immediately before exercise. Vitamins are essential organic compounds that serve to regulate metabolic and neurological processes, energy synthesis, and prevent destruction of cells.

Water-soluble vitamins consist of the entire complex of B-vitamins and vitamin C. Since these vitamins are water-soluble, excessive intake of these vitamins are eliminated in urine, with few exceptions e.

vitamin B6, which can cause peripheral nerve damage when consumed in excessive amounts. Table 1 describes the RDA, proposed ergogenic benefit, and summary of research findings for fat and water-soluble vitamins. Research has demonstrated that specific vitamins possess various health benefits e.

Alternatively, if an athlete is deficient in a vitamin, supplementation or diet modifications to improve vitamin status can consistently improve health and performance [ ].

For example, Paschalis and colleagues [ ] supplemented individuals who were low in vitamin C for 30 days and reported these individuals had significantly lower VO 2 Max levels than a group of males who were high in vitamin C. Further, after 30 days of supplementation, VO 2 Max significantly improved in the low vitamin C cohort as did baseline levels of oxidative stress of oxidative stress.

Furthermore, while optimal levels of vitamin D have been linked to improved muscle health [ ] and strength [ ] in general populations, research studies conducted in athletes generally fail to report on the ergogenic impact of vitamin D in athletes [ , ].

However, equivocal evidence from Wyon et al. The remaining vitamins reviewed appear to have little ergogenic value for athletes who consume a normal, nutrient dense diet. Finally, athletes may desire to consume a vitamin or mineral for various health non-performance related reasons including niacin to elevate high density lipoprotein HDL cholesterol levels and decrease risk of heart disease niacin , vitamin E for its antioxidant potential, vitamin D for its ability to preserve musculoskeletal function, or vitamin C to promote and maintain a healthy immune system.

Minerals are essential inorganic elements necessary for a host of metabolic processes. Minerals serve as structure for tissue, important components of enzymes and hormones, and regulators of metabolic and neural control. Notably, acute changes in sodium, potassium and magnesium throughout a continued bout of moderate to high intensity exercise are considerable.

In these situations, athletes must work to ingest foods and fluids to replace these losses, while physiological adaptations to sweat composition and fluid retention will also occur to promote a necessary balance.

Like vitamins, when mineral status is inadequate, exercise capacity may be reduced and when minerals are supplemented in deficient athletes, exercise capacity has been shown to improve [ ].

However, scientific reports consistently fail to document a performance improvement due to mineral supplementation when vitamin and mineral status is adequate [ , , ]. Table 2 describes minerals that have been purported to affect exercise capacity in athletes. For example, calcium supplementation in athletes susceptible to premature osteoporosis may help maintain bone mass [ ].

Increasing dietary availability of salt sodium chloride during the initial days of exercise training in the heat helps to maintain fluid balance and prevent dehydration.

Finally, zinc supplementation during training can support changes in immune status in response to exercise training. However, there is little evidence that boron, chromium, magnesium, or vanadium affect exercise capacity or training adaptations in healthy individuals eating a normal diet.

The most important nutritional ergogenic aid for athletes is water and limiting dehydration during exercise is one of the most effective ways to maintain exercise capacity. Before starting exercise, it is highly recommended that individuals are adequately hydrated [ ].

When one considers that average sweat rates are reported to be 0. For this reason, it is critical that athletes adopt a mind set to prevent dehydration first by promoting optimal levels of pre-exercise hydration. Throughout the day and without any consideration of when exercise is occurring, a key goal is for an athlete to drink enough fluids to maintain their body weight.

Next, athletes can promote optimal pre-exercise hydration by ingesting mL of water or sports drinks the night before a competition, another mL upon waking and then another — mL of cool water or sports drink 20—30 min before the onset of exercise.

Consequently, to maintain fluid balance and prevent dehydration, athletes need to plan on ingesting 0. This requires frequent every 5—15 min ingestion of 12—16 fluid ounces of cold water or a sports drink during exercise [ , , , , ]. Athletes should not depend on thirst to prompt them to drink because people do not typically get thirsty until they have lost a significant amount of fluid through sweat.

Additionally, athletes should weigh themselves prior to and following exercise training to monitor changes in fluid balance and then can work to replace their lost fluid [ , , , , ].

During and after exercise, athletes should consume three cups of water for every pound lost during exercise to promote adequate rehydration [ ]. A primary goal soon after exercise should be to completely replace lost fluid and electrolytes during a training session or competition. Additionally, sodium intake in the form of glucose-electrolyte solutions vs.

only drinking water and making food choices and modifications added salt to foods should be considered during the rehydration process to further promote euhydration [ ].

Finally, inappropriate and excessive weight loss techniques e. are considered dangerous and should be prohibited. Sport nutritionists, dietitians, and athletic trainers can play an important role in educating athletes and coaches about proper hydration methods and supervising fluid intake during training and competition.

Educating athletes and coaches about nutrition and how to structure their diet to optimize performance and recovery are key areas of involvement for sport dietitians and nutritionists. Currently, use of dietary supplements by athletes and athletic populations is widespread while their overall need and efficacy of certain ingredients remain up for debate.

Dietary supplements can play a meaningful role in helping athletes consume the proper amount of calories, macro- and micronutrients. Dietary supplements are not intended to replace a healthy diet. Supplementation with these nutrients in clinically validated amounts and at opportune times can help augment the normal diet to help optimize performance or support adaptations towards a training outcome.

Sport dietitians and nutritionists must be aware of the current data regarding nutrition, exercise, and performance and be honest about educating their clients about results of various studies whether pro or con.

Currently, misleading information is available to the public and this position stand is intended to objectively rate many of the available ingredients. Additionally, athletes, coaches and trainers need to also heed the recommendations of scientists when recommendations are made according to the available literature and what will hopefully be free of bias.

We recognize that some ingredients may exhibit little potential to stimulate training adaptations or operate in an ergogenic fashion, but may favorably impact muscle recovery or exhibit health benefits that may be helpful for some populations.

These outcomes are not the primary focus of this review and consequently, will not be discussed with the same level of detail. Consequently, meal replacements should be used in place of a meal during unique situations and are not intended to replace all meals.

Care should also be taken to make sure they do not contain any banned or prohibited nutrients. The following section provides an analysis of the scientific literature regarding nutritional supplements purported to promote skeletal muscle accretion in conjunction with the completion of a well-designed exercise-training program.

An overview of each supplement and a general interpretation of how they should be categorized is provided throughout the text.

Table 3 summarizes how every supplement discussed in this article is categorized. However, within each category all supplements are ordered alphabetically. For example, increases in body mass and lean mass are desired adaptations for many American football or rugby players and may improve performance in these activities.

In contrast, decreases in body mass or fat mass may promote increases in performance such as cyclists and gymnasts whereby athletes such as wrestlers, weightlifters and boxers may need to rapidly reduce weight while maintaining muscle mass, strength and power.

HMB is a metabolite of the amino acid leucine. It is well-documented that supplementing with 1. The currently established minimal effective dose of HMB is 1. To optimize HMB retention, its recommend to split the daily dose of 3 g into three equal doses of 1 g each with breakfast, lunch or pre-exercise, bedtime [ ].

From a safety perspective, dosages of 1. The effects of HMB supplementation in trained athletes are less clear with selected studies reporting non-significant gains in muscle mass [ , , ].

In this respect, it has been suggested by Wilson and colleagues [ 15 ] that program design periodized resistance training models and duration of supplementation minimum of 6 weeks likely operate as key factors.

Before and after each supplementation period, body composition and performance parameters were assessed. When HMB was provided, fat mass was significantly reduced while changes in lean mass were not significant between groups.

The same research group published data of 58 highly trained males athletes who supplemented with either 3 g of calcium-HMB or placebo for 12 weeks in a randomized, double-blind, crossover fashion [ ]. In this report, fat mass was found to be significantly reduced while fat-free mass was significantly increased.

Finally, Durkalec-Michalski and investigators [ ] supplemented 42 highly-trained combat sport athletes for 12 weeks with either a placebo or 3 g of calcium-HMB in a randomized, double-blind, crossover fashion. In conclusion, a growing body of literature continues to offer support that HMB supplementation at dosages of 1.

In our view, the most effective nutritional supplement available to athletes to increase high intensity exercise capacity and muscle mass during training is creatine monohydrate. Body mass increases are typically one to two kilograms greater than controls during 4—12 weeks of training [ ].

The gains in muscle mass appear to be a result of an improved ability to perform high intensity exercise enabling an athlete to train harder and thereby promote greater training adaptations and muscle hypertrophy [ , , , ].

The only clinically significant side effect occasionally reported from creatine monohydrate supplementation has been the potential for weight gain [ , , , ]. The ISSN position stand on creatine monohydrate [ 10 ] summarizes their findings as this:.

Creatine monohydrate is the most effective ergogenic nutritional supplement currently available to athletes in terms of increasing high-intensity exercise capacity and lean body mass during training.

Creatine monohydrate supplementation is not only safe, but has been reported to have a number of therapeutic benefits in healthy and diseased populations ranging from infants to the elderly.

If proper precautions and supervision are provided, creatine monohydrate supplementation in children and adolescent athletes is acceptable and may provide a nutritional alternative with a favorable safety profile to potentially dangerous anabolic androgenic drugs. At present, creatine monohydrate is the most extensively studied and clinically effective form of creatine for use in nutritional supplements in terms of muscle uptake and ability to increase high-intensity exercise capacity.

The addition of carbohydrate or carbohydrate and protein to a creatine supplement appears to increase muscular uptake of creatine, although the effect on performance measures may not be greater than using creatine monohydrate alone. Initially, ingesting smaller amounts of creatine monohydrate e. Clinical populations have been supplemented with high levels of creatine monohydrate 0.

Further research is warranted to examine the potential medical benefits of creatine monohydrate and precursors like guanidinoacetic acid on sport, health and medicine. Research examining the impact of the essential amino acids on stimulating muscle protein synthesis is an extremely popular area.

Theoretically, this may enhance increases in fat-free mass, but to date limited evidence exists to demonstrate that supplementation with non-intact sources of EAAs e.

Moreover, other research has indicated that changes in muscle protein synthesis may not correlate with phenotypic adaptations to exercise training [ ]. An abundance of evidence is available, however, to indicate that ingestion of high-quality protein sources can heighten adaptations to resistance training [ ].

While various methods of protein quality assessment exist, most of these approaches center upon the amount of EAAs that are found within the protein source, and in nearly all situations, the highest quality protein sources are those containing the highest amounts of EAAs. To this point, a number of published studies are available that state the EAAs operate as a prerequisite to stimulate peak rates of muscle protein synthesis [ , , , ].

To better understand the impact of ingesting free-form amino acids versus an intact protein source, Katsanos et al. Protein accrual was greater when the amino acid dose was provided in an intact source. Teen athletes need extra fuel, so it's usually a bad idea to diet.

Athletes in sports where there's a focus on weight — such as wrestling , swimming , dance, or gymnastics — might feel pressure to lose weight. But drastically cutting back on calories can lead to growth problems and a higher risk of fractures and other injuries.

If a coach, gym teacher, or teammate says that you need to go on a diet, talk to your doctor first or visit a dietitian who specializes in teen athletes. If a health professional you trust agrees that it's safe to diet, they can work with you to create a healthy eating plan.

When it comes to powering your game for the long haul, it's important to eat healthy, balanced meals and snacks to get the nutrients your body needs.

The MyPlate food guide can guide you on what kinds of foods and drinks to include in your diet. Besides getting the right amount of calories, teen athletes need a variety of nutrients from the foods they eat to keep performing at their best.

These include vitamins and minerals. Calcium and iron are two important minerals for athletes:. Athletes may need more protein than less-active teens, but most get plenty through a healthy diet.

It's a myth that athletes need a huge daily intake of protein to build large, strong muscles. Muscle growth comes from regular training and hard work. Good sources of protein are fish, lean meats and poultry, eggs, dairy, nuts, soy, and peanut butter.

Carbohydrates are an excellent source of fuel. Cutting back on carbs or following low-carb diets isn't a good idea for athletes. That's because restricting carbs can make you feel tired and worn out, which can hurt your performance. Good sources of carbs include fruits, vegetables, and grains.

Choose whole grains such as brown rice, oatmeal, whole-wheat bread more often than processed options like white rice and white bread. Whole grains provide the energy athletes need and the fiber and other nutrients to keep them healthy.

Sugary carbs such as candy bars or sodas don't contain any of the other nutrients you need. And eating candy bars or other sugary snacks just before practice or competition can give athletes a quick burst of energy, but then leave them to "crash" or run out of energy before they've finished working out.

Everyone needs some fat each day, and this is extra true for athletes. That's because active muscles quickly burn through carbs and need fats for long-lasting energy.

Like carbs, not all fats are created equal. Choose healthier fats, such as the unsaturated fat found in most vegetable oils, fish, and nuts and seeds. Limit trans fat like partially hydrogenated oils and saturated fat, found in fatty meat and dairy products like whole milk, cheese, and butter.

Choosing when to eat fats is also important for athletes. Fatty foods can slow digestion, so it's a good idea to avoid eating them for a few hours before exercising. Sports supplements promise to improve sports performance. But few have proved to help, and some may do harm.

Anabolic steroids can seriously mess with a person's hormones , causing unwanted side effects like testicular shrinkage and baldness in guys and facial hair growth in girls. Steroids can cause mental health problems, including depression and serious mood swings.

Some supplements contain hormones related to testosterone, such as DHEA dehydroepiandrosterone. These can have similar side effects to anabolic steroids. Other sports supplements like creatine have not been tested in people younger than So the risks of taking them are not yet known.

Salt tablets are another supplement to watch out for. People take them to avoid dehydration, but salt tablets can actually lead to dehydration and must be taken with plenty of water. Too much salt can cause nausea, vomiting, cramps, and diarrhea and may damage the stomach lining.

In general, you are better off drinking fluids to stay hydrated. Usually, you can make up for any salt lost in sweat with sports drinks or foods you eat before, during, and after exercise.

Speaking of dehydration , water is as important to unlocking your game power as food. When you sweat during exercise, it's easy to become overheated, headachy, and worn out — especially in hot or humid weather.

Even mild dehydration can affect an athlete's physical and mental performance. There's no one set guide for how much water to drink. How much fluid each person needs depends on their age, size, level of physical activity, and environmental temperature. Athletes should drink before, during, and after exercise.

Don't wait until you feel thirsty, because thirst is a sign that your body has needed liquids for a while.

More plant-based diets can provide a wide variety of nutrients and natural phytochemicals, plenty of fibre and tend to be low in saturated fat, salt and sugar. Fat is essential for the body in small amounts, but it is also high in calories.

The type of fat consumed is also important. Studies have shown that replacing saturated fat with unsaturated fat in the diet can reduce blood cholesterol, which can lower the risk of heart disease and stroke. Fat-rich foods usually contain a mixture of saturated and unsaturated fatty acids but choosing foods that contain higher amounts of unsaturated fat and less saturated fat, is preferable as most of us eat too much saturated fat.

Find more information on fat on our pages on this nutrient. If I am doing endurance training, should I be following low carbohydrate, high fat diets? Carbohydrate is important as an energy source during exercise.

Having very low intakes of carbohydrate when exercising can cause low energy levels, loss of concentration, dizziness or irritability.

Because carbohydrate is important for providing energy during exercise, there is a benefit in ensuring enough is consumed. This is especially for high-intensity exercise where some studies have shown that performance is reduced when carbohydrate intakes are low.

Some studies in specific exercise scenarios such as lower intensity training in endurance runners, have found beneficial effects of low carbohydrate diets on performance. However, these results have not been consistent and so at the moment we do not have enough evidence to show that low-carbohydrate diets can benefit athletic performance.

Water is essential for life and hydration is important for health, especially in athletes and those who are physically active, who will likely have higher requirements.

Drinking enough fluid is essential for maximising exercise performance and ensuring optimum recovery. Exercising raises body temperature and so the body tries to cool down by sweating. This causes the loss of water and salts through the skin. Generally, the more a person sweats, the more they will need to drink.

Average sweat rates are estimated to be between 0. Dehydration can cause tiredness and affect performance by reducing strength and aerobic capacity especially when exercising for longer periods. So, especially when exercising at higher levels or in warmer conditions, it is important to try and stay hydrated before, during and after exercise to prevent dehydration.

In most cases, unless training at a high intensity for over an hour, water is the best choice as it hydrates without providing excess calories or the sugars and acids found in some soft drinks that can damage teeth. For more information on healthy hydration see our pages on this topic.

For those who are recreationally active to a high level, or for athletes, managing hydration around training or competition is more important. The higher intensity and longer duration of activity means that sweat rates tend to be higher.

Again, the advice for this group would be to ensure they drinks fluids before, during and after exercise. Rehydration would usually involve trying to drink around 1. Below are some examples of other drinks, other than water that may be used by athletes, both recreational and elite.

Sports drinks can be expensive compared to other drinks; however it is easy to make them yourself! To make your own isotonic sports drink, mix ml fruit squash containing sugar rather than sweeteners , ml water and a pinch of salt.

Supplements are one of the most discussed aspects of nutrition for those who are physically active. However, whilst many athletes do supplement their diet, supplements are only a small part of a nutrition programme for training.

For most people who are active, a balanced diet can provide all the energy and nutrients the body needs without the need for supplements. Sports supplements can include micronutrients, macronutrients or other substances that may have been associated with a performance benefit, such as creatine, sodium bicarbonate or nitrate.

The main reasons people take supplements are to correct or prevent nutrient deficiencies that may impair health or performance; for convenient energy and nutrient intake around an exercise session; or to achieve a direct performance benefit.

Whilst adequate amounts of protein and carbohydrate are both essential in maximising performance and promoting recovery, most people should be able to get all the nutrients they need by eating a healthy, varied diet and, therefore, supplements are generally unnecessary.

For athletes, supplementing the diet may be beneficial, possibly on performance, on general health or for reducing injury and illness risk. However, there is not much research on many of the commonly used supplements, and there are only a small number of supplements where there is good evidence for a direct benefit on performance, including caffeine, creatine in the form of creatine monohydrate , nitrate and sodium bicarbonate.

Even in these cases, the benefits on performance vary greatly depending on the individual and there is only evidence for a benefit in specific scenarios. This means that any athletes considering supplementation will need to weigh the potential benefits with the possible negative impacts, such as negative effects on general health or performance, risk of accidental doping or risks of consuming toxic levels of substances such as caffeine.

The advice to consider supplementation for a performance benefit is for high performance athletes and should be carried out alongside expert advice from qualified sports nutritionists or dietitians.

It is a common myth that consuming lots of excess protein gives people bigger muscles. Quite often, people taking part in exercise focus on eating lots of protein, and consequently may not get enough carbohydrate, which is the most important source of energy for exercise.

The main role of protein in the body is for growth, repair and maintenance of body cells and tissues, such as muscle. Fifteen to 25g of high-quality protein has been shown to be enough for optimum muscle protein synthesis following any exercise or training session, for most people, and any excess protein that is ingested will be used for energy.

The recommendations for daily protein intake are set equally for both endurance training and resistance training athletes, so higher intakes are not recommended even for those exclusively trying to build muscle.

Any more protein than this will not be used for muscle building and just used as energy. Therefore, whilst among recreational gym-goers protein supplementation has become increasingly popular for muscle building, it is generally unnecessary.

However, after competition or an intense training session, high quality protein powders can be a more convenient and transportable recovery method when there is limited access to food or if an individual does not feel hungry around exercise, and may be effective for maintenance, growth and repair of muscle.

If you have a more general query, please contact us. Please note that advice provided on our website about nutrition and health is general in nature. We do not provide any personal advice on prevention, treatment and management for patients or their family members.

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Eating well for physical activity and sport can have many benefits including: allowing you to perform well in your chosen sport or activity reducing the risk of injury and illness ensuring the best recovery after exercise or a training programme However, the dietary patterns that will best suit an individual will depend on the amount and intensity of activity.

Physical activity when losing weight Doing physical activity will increase your energy expenditure the calories you use , as energy is required during exercise to fuel the contracting muscles, increased breathing and heart rate and metabolism.

Foods for fuel and exercise Carbohydrates Protein Vegetarian and vegan diets for athletes Fat Carbohydrates The main role of carbohydrates in physical activity is to provide energy.

The table below shows the carbohydrate content of some common foods: Food source Serving size Carbohydrate content g per serving size Wholewheat pasta boiled g Protein Protein is important in sports performance as it can boost glycogen storage, reduce muscle soreness and promote muscle repair.

The table below shows the protein content of some common foods: Food source Serving size Protein content g per serving size Chicken breast grilled g Fat Fat is essential for the body in small amounts, but it is also high in calories.

How to stay well hydrated Water is essential for life and hydration is important for health, especially in athletes and those who are physically active, who will likely have higher requirements. The amount an individual sweats varies from person to person and depends on: intensity and duration of exercise — longer and higher intensity exercise can cause greater sweat loss.

environmental temperature — in hot, humid conditions sweat loss can increase. clothing — the more clothing that is worn, the quicker you are likely to heat up which may cause greater sweat loss. genetics — some people sweat more than others.

Sports drinks: sports drinks contain carbohydrates in the form of glucose, as well as electrolytes such as sodium. Sodium will replace any lost from sweating and enhance rehydration, and glucose will replenish carbohydrate stores. Sports drinks have been shown to help endurance performance and recovery for active individuals performing endurance exercise over a longer duration 60 minutes or more e.

When seeking personalized nutritional information and guidance, ACSM recommends consulting with a licensed nutrition or dietary professional such as an LD, RDN, or CSSD. Featured Resource: ACSM's Nutrition for Exercise Science This clear and highly applied overview of exercise nutrition illustrates difficult concepts using real-world examples and case studies that allow students to put learning into practice.

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Contemporary Issues Statement Energy Drinks A Contemporary Issues Paper Position Stands Nutrition and Athletic Performance The Female Athlete Triad Team Physician Consensus Statement Selected Issues for Nutrition and the Athlete: A Team Physician Consensus Statement Featured Partner Resource: GSSI Sports Nutrition Toolkit This comprehensive toolkit provides sports nutritionists with introductory materials covering fundamental sports nutrition topics, including athlete consultations and dietary analysis, nutrition monitoring, nutrition interventions and individualized meal planning.

Nutrition Strategies for Creating a Champion - Evolved Historical nutrition strategies were based on beliefs and sport-specific traditions that had little to do with any consideration of human biology and physiology.

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