The Paleo diet, vegetarian or vegan diet, “eating clean,” the Banta Diet, the Atkins diet, low-carbohydrate diets – the list of popular, “best for you,” and “do-it-all” diets is endless! Athletes often struggle with the constant barrage of information available via the Internet, media, and their peers. Simply stated: “Food is fuel” for the athletic body and what you put into your “machine” (your body) affects how it runs! Food cannot be categorized as “good” or “bad”; food is not inherently “clean” or “dirty” (unless of course it physically has dirt on it), and eating is not an exercise in self-protection or the way to the fountain of youth.
Many athletes have questions about nutrition as it relates to performance, injury and recovery, and overall health. As physical therapists and athletic trainers, we should be knowledgeable and ready to answer basic questions and perform basic nutritional assessments to identify areas of concern or dysfunction. We must also acknowledge that we ARE NOT registered dietitians or certified nutritionists (unless you have received those credentials) and avoid passing along personal beliefs or strategies in the guise of nutritional counseling. It is within the scope of our practice to identify misconceptions, make basic recommendations, and discuss general wellness concerns.
So, what should every physical therapist and athletic trainer know about sports nutrition?
- The body extracts energy from ALL macronutrients and builds important end products: proteins, lipids, and glycogen.
- The body uses a variety of energy sources depending on exercise duration and intensity as well as the use of aerobic or anaerobic energy systems. These energy sources include ATP, creatine phosphate, glycogen, glucose, lipids, and amino acids.
Know the three macronutrient categories and their typical recommended percentages.*
- Carbohydrates: 45-65% of daily intake
- Fats: 25-35% of daily intake
- Proteins: 10-25% of daily intake
*Note: these percentages may vary among athletes, with special attention paid to protein in strength and power athletes.
Know the major micronutrients, their typical recommended intakes and how they affect athletic performance.
- Vitamins – Organic, essential for human survival, exist in water- (B and C) and fat-soluble (A, D, E, K) forms.
- Minerals – Inorganic, essential for human survival, no caloric value, not degraded by cooking or digestion. There are major and minor minerals based on the amounts the human body needs.
- Phytochemicals – Chemical substances from plants, commonly found in fruits, vegetables, and grains.
Articulate the role of hydration in performance and know guidelines for adequate hydration, including timing and sources of hydration.
Hydration is critical for human survival! You should monitor hydration with regard to sweat losses in athletes. Fluid replacement is essential for optimal performance. Read more about hydration in Danny Smith’s article.
Have a readily identified referral source for sports nutrition needs that exceed your knowledge!
- Seek out a sports dietitian in your area and have a conversation about referring athletes who need in-depth analysis and assistance with dietary planning.
- Acknowledge that your expertise is best when paired with a nutritional professional, and don’t go beyond your scope of practice.
To sum it up, athletes are at risk for making poor nutritional choices based on fads and media hype. They commonly have questions about nutrition, and you should explore the athletes’ eating history and fueling choices. This will help you address their performance issues and understand their responses to therapeutic interventions (healing), including muscle regeneration and strengthening, wound and tissue healing, and overall good health during rehab. Caloric demands of sports must be addressed to prevent energy deficits.
- Burke L, Loucks A, Broad N. Energy and carbohydrate for training and recovery. J Sports Sci. 2006;24(7):675-685.
- Casa DJ, Armstrong LE, Hillman SK, Montain SJ, Reiff RV, Rich BSE, Roberts WO, Stone JA. National Athletic Trainers Association Position Stand: Fluid replacement for athletes. J Athl Train. 2000;35(2):212-224.
- Clark N. Nancy Clark’s Sports Nutrition Handbook, 5th Human Kinetics, 2014.
- Rosenbloom C. Sports nutrition: Applying the Science. Nutrition Today. 2007;42(6):248-254