Nutrition Timing Planning and Gastrointestinal Maladies

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Expert insights on athlete nutrition timing: GI issues, RED-S, PCOS, and fueling strategies. Learn about tailored snack recommendations.

Q: What recommendations do you have for athletes experiencing amenorrhea or relative energy deficiency in sport (RED-S)?

A (Dr. Curtis): While not a typical GI condition, amenorrhea and RED-S require a multidisciplinary approach. Often, medication is prescribed to induce a period, but this does not resolve underlying hormone imbalances or decreased bone density. These conditions frequently arise from an athlete's energy deficiency, such as a marathon runner not increasing fuel intake to match activity, leading the body to prioritize survival over non-essential functions like menstruation.

Q: How can athletes add more fuel to help resolve amenorrhea?

A (Poole): It's a myth that athletes should not get their period; it is not normal. Addressing overall energy intake is crucial. In severe cases, decreasing activity while increasing fuel might be necessary. We often work with athletes who are injured or returning to sport, which provides an opportune time to address their fueling needs.

Q: How do you address athletes dealing with PCOS and stress fractures?

A (Dr. Curtis): The culture of sports often pressures athletes toward specific body images or weight classes, which is unhealthy. We must educate athletes that a balanced diet is acceptable and that restrictive diets are not always necessary. Coaches also play a role in fostering a healthier environment.

Q: How do you approach discussing sensitive topics like nutrition and body image with athletes?

A (Dr. Curtis): As a former pediatric sports medicine doctor, I learned the importance of creating a trusting and safe environment. While it's harder to have parents leave the room now in full sports medicine, fostering trust is key.

A (Poole): We focus on the athlete's performance goals, as health often isn't the primary motivator for adolescents. We seek out what truly motivates them to achieve their best performance through proper nutrition.

Q: What are the best snack recommendations for athletes?

A (Bri Poole): Snack recommendations are highly individualized based on what works and what an athlete enjoys. Simple, easily digestible options like GoGo Squeez are generally safe choices.

Q: Are there specific snacks you recommend for gastrointestinal (GI) comfort during exercise?

A (Dr. Curtis): I don't have specific go-to snacks; the focus is on what an individual athlete likes and what doesn't cause GI distress. Suggesting foods they are unwilling to eat can lead to non-compliance.

A (Poole): Simple carbohydrates are typically easy on the GI system around exercise. It's best to stick with foods the athlete has consumed before. Liquid carbohydrates can be a good option as they may sit better for some. While many believe “sugar is bad,” simple sugars are the body's preferred fuel source during exercise.

Q: Should athletes track their food intake?

A (Poole): Some athletes have higher or different energy needs, even if they aren't playing intensely. Athletes generally have elevated caloric demands. It's perfectly fine for them to eat snacks, especially when readily available, such as on the sidelines.

Q: How do you approach nutrition planning for athletes from diverse cultural backgrounds or those who observe religious practices like Ramadan?

A (Poole): Always approach with an open and curious mindset. Ask questions to understand cultural practices better, especially regarding fuel timing within non-fasting windows. Work closely with the athlete to create a tailored plan.

A (Dr. Curtis): Meet athletes where they are; you cannot simply forbid them from fasting. I am willing to write letters to coaches if training times need to be adjusted to accommodate an athlete's practices, ensuring they can continue to play safely.

Q: How does pre-exercise nutrition differ for a morning lift versus a morning run?

A (Poole): Many runners prefer not to eat before a run. For shorter runs (e.g., 5 miles or 3k), it can be acceptable if the athlete had sufficient fuel the day prior and will refuel adequately post-run. However, for exercise lasting 50-90 minutes or longer, pre-exercise fuel is essential, particularly for running due to its impact on bone resorption. The specific goals of the runner (e.g., marathon training) also influence recommendations.