Position of the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and Athletic Performance

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Abstract

It is the position of the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine that physical activity, athletic performance, and recovery from exercise are enhanced by optimal nutrition. These organizations recommend appropriate selection of food and fluids, timing of intake, and supplement choices for optimal health and exercise performance. This position paper reviews the current scientific data related to the energy needs of athletes, assessment of body composition, strategies for weight change, the nutrient and fluid needs of athletes, special nutrient needs during training, the use of supplements and nutritional ergogenic aids, and the nutrition recommendations for vegetarian athletes. During times of high physical activity, energy and macronutrient needs—especially carbohydrate and protein intake—must be met in order to maintain body weight, replenish glycogen stores, and provide adequate protein for building and repair of tissue. Fat intake should be adequate to provide the essential fatty acids and fat-soluble vitamins, as well as to help provide adequate energy for weight maintenance. Overall, diets should provide moderate amounts of energy from fat (20% to 25% of energy); however, there appears to be no health or performance benefit to consuming a diet containing less than 15% of energy from fat. Body weight and composition can affect exercise performance, but should not be used as the sole criterion for sports performance; daily weigh-ins are discouraged. Consuming adequate food and fluid before, during, and after exercise can help maintain blood glucose during exercise, maximize exercise performance, and improve recovery time. Athletes should be well-hydrated before beginning to exercise; athletes should also drink enough fluid during and after exercise to balance fluid losses. Consumption of sport drinks containing carbohydrates and electrolytes during exercise will provide fuel for the muscles, help maintain blood glucose and the thirst mechanism, and decrease the risk of dehydration or hyponatremia. Athletes will not need vitamin and mineral supplements if adequate energy to maintain body weight is consumed from a variety of foods. However, supplements may be required by athletes who restrict energy intake, use severe weight-loss practices, eliminate one or more food groups from their diet, or consume high-carbohydrate diets with low micronutrient density. Nutritional ergogenic aids should be used with caution, and only after careful evaluation of the product for safety, efficacy, potency, and whether or not it is a banned or illegal substance. Nutrition advice, by a qualified nutrition expert, should only be provided after carefully reviewing the athlete's health, diet, supplement and drug use, and energy requirements. J Am Diet Assoc. 2000;100:1543-1556.

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Position Statement

It is the position of the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine that physical activity, athletic performance, and recovery from exercise are enhanced by optimal nutrition. These organizations recommend appropriate selection of food and fluids, timing of intake, and supplement choices for optimal health and exercise performance.

Key Points

The following key points summarize the current energy, nutrient, and fluid recommendations for active adults and competitive athletes noted in this position paper. Sport nutrition experts can further adjust these general recommendations to accommodate the unique concerns of individual athletes regarding health, sports, nutrient needs, food preferences, and body weight and body composition goals.

■ During times of high-intensity training, adequate energy needs to be consumed to maintain body

Energy Requirements

Meeting energy needs is the first nutrition priority for athletes. Achieving energy balance is essential for the maintenance of lean tissue mass, immune and reproductive function, and optimum athletic performance. Energy balance is defined as a state when energy intake (the sum of energy from food, fluids, and supplement products) equals energy expenditure (the sum of energy expended as basal metabolism, the thermic effect of food, and any voluntary physical activity) (1). Inadequate energy

Body Composition

Body composition and weight are 2 of the many factors that contribute to optimal exercise performance. Taken together, these 2 factors may affect an athlete's potential for success within a given sport. Body weight can influence an athlete's speed, endurance, and power, whereas body composition can affect an athlete's strength, agility, and appearance. Most athletes require a high strength-to-weight ratio to achieve optimal athletic performance, and because body fat adds to weight without

Macronutrient Requirements for Exercise

The fuel burned during exercise depends on the intensity and duration of the exercise performed, the sex of the athlete, and prior nutritional status. All other conditions being equal, an increase in the intensity of an exercise will increase the contribution of carbohydrate to the energy pool (43), 44.. As the length of the exercise continues, the source of this carbohydrate may shift from the muscle glycogen pool to circulating blood glucose, but in all circumstances, if blood glucose cannot

Vitamins and Minerals

Micronutrients play an important role in energy production, hemoglobin synthesis, maintenance of bone health, adequate immune function, and the protection of body tissues from oxidative damage. They are also required to help build and repair muscle tissue following exercise. Theoretically, exercise may increase or alter the need for vitamins and minerals in a number of ways. Exercise stresses many of the metabolic pathways in which these micronutrients are required, thus exercise training may

Hydration

Exercise performance is optimal when athletes maintain fluid balance during exercise; conversely, exercise performance is impaired with progressive; dehydration (87), (88), (89), (90), (91). Moreover, dehydration increases the risk of potentially life-threatening heat injury such as heat stroke (92). Accordingly, athletes should attempt to remain well-hydrated before and during exercise.

The American College of Sports Medicine Position Stand on Exercise and Fluid Replacement (93) and the

The Training Diet

Recommendations for athletes’ intakes of energy, macronutrients, vitamins, and minerals are described elsewhere in this document. These recommendations are often presented in terms of milligram or gram amounts of nutrients (eg, 6 to 10 g carbohydrate/kg body weight) and must be translated into food choices consistent with food preferences and training schedules of athletes (109). The foundations (proportion of energy from protein, fat, and carbohydrate) for the training diets of athletes,

Supplements and Ergogenic Aids

The marketing of ergogenic aids (items claiming to increase work output or performance) is an international, multimillion dollar business that preys on the desires of athletes to be the best, and when one item does not work or is discredited by research, another comes along to take its place. Nutrition-related ergogenic aids are particularly problematic. In the United States, the Dietary Supplement Health and Education Act of 1994 (141) allows supplement manufacturers to make claims regarding

The Vegetarian Athlete

Some athletes choose to follow vegetarian diets. Nutrition recommendations for these athletes should be formulated with consideration of the effects of both vegetarianism and exercise. The position of the American Dietetic Association on vegetarian diets (147) provides appropriate dietary guidance that should be considered in conjunction with the information provided herein.

Vegetarianism does not necessarily affect energy needs, though energy availability could be reduced slightly if a

Roles and Responsibilities of Health Care Professionals

Every competitive and recreational athlete needs adequate fuel, fluids, and nutrients to perform at their best. It is the role of the sports nutrition expert to advise athletes regarding appropriate nutrition needs before, during, and after exercise, and for the maintenance of good health and optimal body weight and composition. Qualified health and nutrition professionals can help athletes and active people in the following ways:

■ Educate athletes about energy requirements for their sport and

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