General Recommendations for Young Athletes

1. Energy intake level should be sufficient to support normal growth and development plus the added energy requirement of physical activity. As a general guide, young athletes should track normally on charts that measure height for age, weight for age, and weight for height (often used by pediatricians). A flattening of the growth percentile is a sign of inadequate energy intake.
2. The distribution of energy substrates is important, but parents and coaches should understand that total energy intake adequacy is more important than the amount of carbohydrate or fat in the diet. Slightly liberalizing the fat intake from 25 percent to 30 percent of total calories will make it easier for young athletes to obtain the calories they need. Protein intake is important but need not rise above 15 percent of total calories or 1.5 grams per kilogram of body weight provided total energy intake adequacy is satisfied.
3. Young athletes tend to underconsume fluids, predisposing them to dehydration and increasing the risk of heat illness. Athletes should be encouraged to take regular drinks by supervising adults, even when fluids are readily available. This may require fixed time-schedule drinking patterns that involve stoppage of play every 10 to 20 minutes, depending on the ambient heat and humidity.
4. Young female athletes are at risk for primary and secondary amenorrhea, both of which may be caused by excess physical activity, inadequate energy intake, and other factors. If a young female has a delayed menarche beyond age 14, she should be assessed by a pediatrician to make sure there is no underlying problem. In addition, the adequacy of nutrient and energy intake should be carefully assessed.
5. Young athletes should not diet because delayed eating and severe low-calorie intakes are counterproductive to achieving ideal body weight and body composition and negatively affect growth and development. The eating strategy should allow for frequent eating, with an opportunity to consume food approximately every 3 hours.
6. It is difficult for young female athletes to obtain sufficient iron, and surveys suggest that calcium intake is also marginal. Therefore, the parents of young athletes should consult with the family doctor to determine if iron or calcium supplements are warranted.

Young athletes have an extraordinary nutrition burden because they must satisfy the combined nutrition needs of growth plus the needs of physical activity. Young athletes should receive a minimum of six eating opportunities to ensure that nutrition needs can be met. Fluid consumption should be planned to lower dehydration risk. In addition, pediatricians should be satisfied that young athletes are maintaining normal and expected growth patterns at annual pre-participation physical examinations. Adolescent female athletes should be assessed for primary or secondary amenorrhea, with steps taken to resolve the amenorrhea as quickly as possible.