Athletes w/ Special Considerations

This page will include nutrition information for the following special considerations:

• Vegetarian athletes
• Athletes with physical disabilities
• Nutrition for female athletes
• Athletes who wish to gain or lose weight

Athletes who are Vegetarians

Plant-based diets are becoming increasingly popular in today’s society, so it is important to understand how this type of diet may impact your athletic performance. An athlete may choose to be a vegetarian for religious or cultural reasons, perceived health benefits, ethical or philosophical beliefs, and many other reasons¹. Individuals can identify as the following:

• Semivegetarian¹
  • This individual will avoid some, but not all, foods that are sourced from animals. Most often, these individuals will avoid red meats or consume them in limited amounts.
• Lacto-ovo-vegetarian¹
  • This individual will include milk and other dairy products and eggs, but they will avoid meat, poultry, fish, and other seafood
• Ovovegetarian/lactovegetarian¹
  • Ovovegetarians will include eggs but they will avoid milk and other dairy products, meat, poultry, fish/seafood
  • Lactovegetarians will include milk and other dairy products while avoiding eggs and other animal-sourced food products
• Vegan¹
  • This individual will avoid all animal-sourced food products
• Macrobiotic¹
  • This individual will avoid most animal-sourced foods and emphasizes unprocessed organic foods

Positive health effects reported with a vegetarian diet include reduced risks for obesity, type 2 diabetes, hypertension, cardiovascular disease, and some cancers¹. These benefits are only seen in individuals who are using a well-planned and varied vegetarian diet.

With that in mind, literature is beginning to provide the following conclusions regarding the nutritional needs of vegetarian athletes¹:

1. well-planned and appropriately supplemented vegetarian diets can support athletic performance
   1. Vegetarians who exclude all animal-sourced foods do not have a reliable source of vitamin B12 in their diets and must use fortified foods or a supplement to meet this need. Prolonged inadequate intake of this vitamin will lead to macrocytic anemia which leads to reduced oxygen transport in the body
2. Protein intakes must be adequate to meet the needs for total nitrogen and the essential amino acids, and it has been demonstrated that plant-based protein sources can adequately meet those needs
   1. The current recommendations for protein intake are 1.2 to 1.4 g/kg/d for endurance athletes and up to 1.7 g/kg/d for resistance and strength-trained athletes¹
3. vegetarian athletes may be at a higher risk for non-anemic iron deficiency and this can inhibit endurance performance
   1. Individuals with diets that include meat, fish, and poultry are regularly consuming the heme form of iron which is more efficiently absorbed by the body. Vegetarians are typically consuming the non-heme form of iron. It is recommended that vegetarians increase their iron intake by up to 80% to match the iron absorption of their omnivore counterparts
4. Vegetarians have lower mean muscle creatinine concentrations when compared to omnivores. This may impact submaximal exercise performance
5. A vegetarian diet accompanied with an unwarranted weight loss could indicate a disordered eating pattern and should be investigated

Athletes with Physical Disabilities

Due to the physiology of sport and the functional abilities of the individual, there is a wide range of energy requirements for athletes with physical disabilities². Typically, athletes with physical disabilities have lower energy requirements compared to athletes without physical disabilities². The energy requirement for athletes with physical disabilities has been determined to be between 1500 and 2300 kcal on average².

Athletes with physical disabilities and athletes without physical disabilities’ nutritional requirements are roughly the same, but it is important that athletes with physical disabilities are educated on their dietary needs for their specific sport and disability². It is also important to ensure that athletes with physical disabilities are ingesting adequate amounts of micronutrients either through their diet or with dietary supplements².

Female Athletes

Female athletes are being considered a special consideration because of their increased risk of eating disorders and disordered eating when compared to both male athletes and non-athlete females³. This increased risk in turn places them at risk for menstrual irregularities, bone injuries, cardiovascular issues, depression, decreased athletic performance, social isolation, and a lower quality of life. Disordered eating is defined as abnormal eating behaviors while an eating disorder is a clinically diagnosed disorder³.

Another condition specific to females is known as female athlete triad. This is defined by the American College of Sports Medicine as a syndrome that links low energy availability, with or without disordered eating, menstrual disturbances, and low bone mineral density³. This syndrome is a result of the failure to consume adequate energy to compensate for the energy lost through exercise³.

A lack of proper nutrition can lead to many health issues and negatively impact athletic performance. Oftentimes, health issues arising from poor nutrition are not independent issues but happen in conjunction with other health issues³. A lack of proper nutrition can also result in a vitamin and mineral deficiency as well.

Any type of body composition assessment should be done with the intent of monitoring unhealthy changes that may occur, and this intent should be appropriately communicated with athletes to prevent body image issues or the sense of pressure to lose weight³. Generally, protein intake should be around 1.5-1.7 g/kg of body weight and carbohydrates be 55% of the total caloric intake in a day³. The remaining calories should come from fats³. Females should ensure they are getting enough iron intake with their diets. This can be done by eating dark leafy vegetables, peppers, guavas, broccoli, berries, red meats, seafood, and legumes³.

Athletes Wishing to Gain or Lose weight

Females wishing to lose fat should consider the following recommendations³:

1. make any goals realistic. Goals of high-weight loss quickly may lead to failure. It is recommended to lose 1-2 pounds of body fat per week.
2. Any type of caloric restriction should be modest. To lose a pound of fat per week, a caloric restriction of only 500 cal/d from what the body burns in a day.
3. Another method to lose weight is to burn extra calories. Be careful though, excessive caloric expenditure can lead to health issues. An increase of 250-500 cal/d is enough to still induce weight loss without any health detriments.
4. Your diet should include 1.5-1.7 g/kg of body weight in protein, 55% of calories should come from carbohydrates, and the remaining should come from fats. You should also ensure proper intake of iron by eating red meats, seafoods, and legumes paired with dark leafy vegetables, peppers, guavas, broccoli, and berries.

Females who wish to gain weight or muscle mass should follow the same recommendations as above but omit the caloric restrictions and caloric expenditures and consume an additional 300-500 calories per day³.

The National Athletic Trainers’ Association issues a position statement on safe weight loss and maintenance for athletes. It can be found here.

General guidelines for athletes wishing to gain weight include⁴:

1. Consume an extra 400-500 cal/day in addition to your regular daily caloric requirements
2. Eat regular snacks and meals. Aim to eat every 2-3 hours
3. Increase portion sizes at mealtimes
4. Include a smoothie or meal replacement drink between meals for extra calories
5. Include nutrient and energy-dense foods into meal preparation such as vegetable oil, nuts and seeds, natural peanut butter, low-fat dairy, and dried fruit
6. Include an extra meal or two extra snacks a day

Easy ways to increase calories include⁴:

1. Choosing hearty bread
2. Drink juices such as cranberry blends, apple, grape, and pineapple
3. Eat fruits such as bananas, grapes, figs, dried cranberries and apricots, plantains
4. Add avocado, raisins, cheese, chickpeas, meat, olives, nuts, and/or seeds to salads
5. Add nut butter to toast
6. Consume high-calorie cereals such as granola, oatmeal, and muesli

It is important to note that any weight loss or weight gain should be discussed with a dietician or other professional to ensure that you are utilizing safe and effective practices and to maximize your performance.