Parental concerns
Parental concerns about sports nutrition are age-
related in most cases. Parents of young children should
be aware of the ways in which children’s hydration
requirements during athletic activity differ from those
of adults. Parents of adolescents who are heavily
involved in sports should acquaint themselves with
the signs of unhealthy eating or dieting practices in
high school or college-age athletes.Hydration needs in young children
Young children are more susceptible to heat-
related illnesses than adults during exercise for several
reasons: they produce more heat relative to body mass
for the same intensity of exercise; they have a lower
cardiac output than adults at any exercise level; they
have a higher threshold for rise in body temperature
before beginning to sweat; and they have a lower
sweating capacity than adults, which makes it harder
for them to dissipate body heat through evaporation.
Children also have a less efficient thirst mechanism
than adults, which means that they are more likely to
become dehydrated during exercise because they do
not feel as intense a need to drink liquids. Orange- or
grape-flavored drinks are often a good way to rehy-
drate children because they will increase their fluid
intake when the beverage is flavored.Female athlete triad
Parents should watch for indications of the female
athlete triad, such as missing three or more menstrual
periods; an unusual number of stress fractures; an
excessive amount of time spent exercising or working
out; a tendency to wear baggy or concealing clothes
even in warm weather; and a restricted eating pattern.
Adopting a vegetarian or vegan diet may indicate the
onset of an eating disorder in a female athlete.Doping
Doping in sports refers to the practice of taking
anabolic steroids and other substances forbidden by
international sports organizations. The word is
derived from the Dutch word for an alcoholic drink
consumed by Zulu warriors to give them energy before
a battle. In the early twentieth century, doping
referred primarily to the illegal drugging of race
horses, but has been applied to human athletes since
the 1920s.
In the 1970s, testing of athletes’ blood samples
focused largely on steroid use, but in the 1980s and
1990s, new tests had to be devised to detect evidence of
blood doping. Blood doping refers to the use of bloodtransfusions or a hormone called erythropoetin (EPO)
in order to increase the level of hemoglobin in an
athlete’s blood, and therefore its oxygen-carrying
capacity. The use of EPO in such endurance sports as
marathon running or cycling increases the athlete’s
risk of heart disease if it is used to raise blood hemo-
globin levels above 13.0 g/dL.
Newer forms of doping include the use of modafinil
(Provigil), a drug ordinarily used to treat narcolepsy (a
sleep disorder), and gene doping. Gene doping is
defined by the World Anti-Doping Agency, an organ-
ization founded in 1999, as ‘‘the non-therapeutic use of
cells, genes, genetic elements, or of the modulation of
gene expression, having the capacity to improve athletic
performance.’’ One possible technique of gene doping
would be the use of a synthetic gene that could last for
years and produce high amounts of naturally occurring
muscle-building hormones.Vegetarian and vegan diets
It is possible for an athlete to maintain strength
and overall health on a vegetarian diet provided that a
variety of plant-based sources of protein are con-
sumed on a daily basis and energy intake is adequate.
Vegetarian and especially vegan athletes are at risk of
inadequate creatine andironintake, however, as well
as insufficient amounts ofzinc,vitamin B 12 ,vitamin
D,andcalcium. Iron deficiency will eventually affect
athletic performance, as will low levels of creatine.
Coaches and trainers should be aware that sudden
adoption of a vegetarian or vegan diet in an athlete
who was previously eating meat and fish may indicate
the onset of an eating disorder.Resources
BOOKS
American Psychiatric Association.Diagnostic and Statistical
Manual of Mental Disorders, fourth edition, text revi-
sion. Washington, DC: American Psychiatric Associa-
tion, 2000.
American Society of Health-System Pharmacists (ASHP).
AHFS Drug Handbook, 2nd ed. Philadelphia: Lippin-
cott Williams & Wilkins, 2003.
Larson-Meyer, D. Enette.Vegetarian Sports Nutrition.
Champaign, IL: Human Kinetics, 2007.
MacLaren, Don, ed.Sport and Exercise Nutrition. New
York: Elsevier, 2007.
McArdle, William D., Frank I. Katch, and Victor L. Katch.
Exercise Physiology: Energy, Nutrition, and Human
Performance, 6th ed. Philadelphia: Lippincott Williams
& Wilkins, 2007.
Pelletier, Kenneth R., MD.The Best Alternative Medicine,
Chapter 6, ‘‘Western Herbal Medicine.’’ New York:
Fireside Books, 2002.Sports nutrition