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Translating Sports Nutrition Essentials into Clinical Practice Sarah Dobkins, MS, RD, CSSD Board Certified Specialist in Sports Dietetics Texas Children’s Hospital The Woodlands
Translating Sports Nutrition Essentials
into Clinical Practice
Sarah Dobkins, MS, RD, CSSD
Board Certified Specialist in Sports Dietetics
Texas Children’s Hospital The Woodlands
Nothing to disclose
Disclosures
Objectives
• Identify obstacles that prevent athletes from putting a sports nutrition plan into practice
• Discuss practical tips to help athletes overcome nutrition obstacles
Outline
• Current Challenges
• Best Practices
– Fueling• Energy availability
• Energy and Protein needs
• Hydration
– Supplements
– Body composition
– Recovery
1904 Summer Olympics –
Men’s Marathon
Author: unknown
Source: "The Olympic Games 1904", report by Charles J.P. Lucas
Author: photographer of the IOC
Challenges Young Athletes
Face• Energy & Hydration-
– Limited time to eat and drink during school hours
– Busy schedules
– Most high school athletes go into practice on <1,000 calories
– Athletes are dehydrated before even starting practice
– Sleep is prioritized over eating
– 30% of HS athletes do not eat breakfast
• Lack of education on how to safely alter body composition
• Interested in supplements
Low Energy Availability• Energy Availability (EA) = the amount of energy
available to the body to perform all other functions
after the cost of exercise is subtracted
– Sets the foundation for health
and success in sport
• Screen For:
– Low bone density
– Menstrual dysfunction
– Decreased performance
– Stress fractures
– Weight loss
– Mood changes,
low self esteem
De Souza, Bri J Sports Med 2014
Energy Requirements• Determined by?
• Calories are the body guard!
• Should be periodized and individualized
Protein: Sports and Exercise• Misconceptions:
– A survey of male collegiate athletes indicated
67% did not know the protein recommendations
– 33% estimated the need at 8.7 g protein/kg
• Athletes may benefit from protein intakes greater than the
RDA of 0.8g/kg/day
– Suggested Daily Intake for Athletes: 1.2 - 2.0 g/kg body weight/day
– Suggested meal intake: Aim for 15-30 g of high quality protein after workouts
and at main meals
J Acad Nutr Diet. 2016: 116:501-528
Fox et al. JISSN. 2011
Protein: Timing and Quality Matter
Source: National Dairy Council
TIMING
• Teens tend to eat most of their protein
in the evening
• Even distribution of protein throughout
the day and immediately after training
can maximize the anabolic response
QUALITY
• Leucine is a key essential Amino Acid
for muscle hypertrophy
• Pop-tarts ≠ Leucine
Have a Recovery Plan!
• Carbohydrate – Replenish glycogen
• Protein – Rebuild muscle
• Fluids – Rehydrate
• Window of Recovery – aim to consume a snack/meal within 30-45 minutes of
stopping exercise
• Encourage athletes to pack a recovery snack and leave in locker
• Encourage players to bring sports drink to practice and weigh-in before/after
3 R’s to Recovery
Hydration• Develop a drinking plan based on body weight changes to
minimize weight loss ≤2% body weight
• Monitor sweat rate and urine color
• Drink 20 oz. for every 1 pound lost
• Sports drinks recommended >1 hour of exercise or hot/humid
conditions
• Don’t forget high water volume foods
Drink up! Fluid needs are higher during:
Heat Travel
Humidity Altitude
Hard training Illness
Body Composition Management• Body composition matters to all athletes…
body fat loss/lean mass gains
• Body Mass Index (BMI) – use with caution in athletes
• Do not overemphasize weight as a measure of success
• Focus on:– How they feel
– Athletic performance
– Power to Weight (PWR) ratio – the amount of power that can be generated per kilogram of body weight
Understanding Supplements• Not regulated by the Food and Drug Administration
– Manufacturers are not required to prove their
products’ safety, purity or effectiveness
• Look for the NSF stamp
• No amount of supplements can make up for poor fueling
• Just because it’s certified doesn’t mean it works
• 2016 Sports Position Paper – Dietary supplements and sports foods with evidence-based uses in sports nutrition
Food is 100% legal
What Can a Sports Dietitian Address?
• Body Composition
• Chronic Fatigue
• GI upset with exercise
• Disordered eating in athletes
• Irregular menstrual cycles
• Stress fractures
• Race day fueling plans
• Iron Deficiency Anemia
• Low Bone Mineral Density
• Poor eating habits
• Sports supplement use
• Diabetic athlete
Referral Process
Refer to TCH Sports/Ortho MD
Sports/Ortho MD will place referral
for sports RD
Community Pediatrician
Summary• Body composition versus scale weight
• Energy availability sets the foundation for health and success in sport
• Nutritional needs: should be periodized and individualized
• Consume 15-30 g high-quality protein
within 30 min of workout
• Dehydration is the most common performance-
sapping mistake and the most preventable
• Athletes want a competitive edge– Supplements are typically prioritized over food
Resources• www.nsfsport.com
• www.scandpg.org
• Consider referring patients to a sports dietitian to further discuss nutrition status and goals.
Thank you!
Sarah Dobkins, MS, RD, CSSD
