FAQ: Hydration for Young Athletes

By Shonda Brown, RD, CNSC, CSP, clinical dietitian at CHOC

Water is the most essential nutrient for athletes, yet it’s often forgotten when discussing adequate nutrition for physical activity and improving sports performance.

Adequate fluid intake provides multiple advantages to an athlete, including decreased perceived effort, decreased heart rate, decreased core temperature and increased performance.

Check out some answers to frequently asked questions about sports hydration:

Q: What should athletes drink to optimize hydration?

A: Water is an appropriate beverage choice for children and adolescents who participate in recreational activities or low intensity sports.  However, for young athletes who engage in prolonged and/or vigorous physical activity, a sports electrolyte drink is recommended.

Carbohydrate-containing beverages aid the absorption of water, and provide a fuel source for intense activity. The sodium content in these beverages helps replace what is lost in sweat. This becomes very important for those athletes exercising for more than two hours or for those who are heavy, salty sweaters.

Q: What’s the difference between energy drinks and sports drinks?

A: Varying widely in their nutrient content, energy drinks may contain zero grams of carbohydrates or up to 160 percent of the recommended concentration of carbohydrates for proper rehydration. High concentration of carbohydrates can lead to slow gastric emptying and therefore impede hydration during exercise.

Energy drinks are not regulated by the Food and Drug Administration. Also, the content and purity of energy drinks have no guarantee and the American Academy of Pediatrics, as well as the National Federation of State High School Association, discourage their use in youth.

Sport drinks are formulated to replace fluid and electrolytes lost through sweat during exercise. They often contain carbohydrate, sodium and other electrolytes. Sports electrolyte drinks should contain 14 to 19 grams of carbohydrates and 110 to 165 milligrams of sodium per 8 fluid ounces.

Q: How much fluid is recommended for young athletes?

A: Athletes have varying sweat rates and therefore require different fluid and electrolyte intakes to optimize hydration and sports performance. Environmental factors, clothing and equipment, training adaptations and age all affect an athlete’s sweat rate.

Athletes should not rely on thirst as an indicator of when to drink fluids, as thirst is not stimulated until dehydration has already occurred.

Some general recommendations are to consume

  • 16 to 20 fluid ounces of fluid two to three hours before exercise
  • An additional 5 to 10 fluid ounces of water or a sports drink 10 to 20 minutes prior to exercise
  • 5 to 10 fluid ounces of water or sports drink every 15 to 20 minutes during exercise
  • 16 to 24 fluid ounces of a sports drink or water (with a salty snack) for each pound of weight lost during exercise

Q: How does an athlete know if they are appropriately hydrated?

A: Check the color of urine during an athlete’s first morning void. If the color looks like lemonade, then the athlete is appropriately hydrated. If it appears more like apple juice, the athlete is not consuming adequate amounts of fluid during the day. Also, try weighing the athlete right before and after exercise. The change in weight is due to fluid loss. More than 1 percent weight loss can negatively affect sports performance.

Q: Can an athlete consume too much fluid?

A: An athlete can over-hydrate or consume high amounts of water without proper sodium replacement, which puts the body at risk for hyponatremia. If an athlete weighs more after exercise than before, then the athlete is consuming too much fluid.

Hydration Tips

  •  Pack a water bottle to school
  • Consume fluids throughout the day to produce a light-colored (lemonade color) urine prior to exercise
  • One gulp equals approximately 1 ounce of fluid. Train children to take five gulps during a water break
  • Consume a salty snack after a workout. This not only helps retain fluid consumed but also promotes thirst and drives athletes to drink more fluid
  • Infuse water with lemon, herbs or fruit to make drinking water throughout the day fun and enjoyable
  • Weigh a child before and after exercise to see if she is consuming adequate fluid
  • Parents should provide sports electrolyte drinks for young children who are exercising outside on a very hot day or are engaged in prolonged activity

Learn more about CHOC’s Clinical Nutrition and Lactation Services.

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When Illness Sidelines a Young Athlete

baseball_athlete_illnessBeing sidelined by illness can be difficult for dedicated young athletes, as well as their parents who question when to keep their child off the field and when to send them back.

Depending on symptoms and energy levels, children can often still participate in sports when under the weather, says Dr. Jacqueline Winkelmann, a CHOC Children’s at Mission Hospital pediatrician who works to provide health tips and guidance for young athletes.

If a child’s symptoms are “above the neck,” he or she can usually participate in athletic activities so long as energy levels are appropriate. “Above the neck” symptoms include a runny nose, nasal congestion, sneezing and minor sore throat, she says.

“If you have a mild cold and no fever, and have enough energy, you can still play,” Dr. Winkelmann says.

But even if a young athlete feels well enough to exercise while in the final throes of a cold, he or she must plan on scaling back the intensity of play, she cautions.

“You need to understand that you won’t be able to practice at the same level,” Dr. Winkelmann says. “You need to speak up and tell your coach that you’re not 100 percent.”

However, a child with symptoms “below the neck” – chest congestion, respiratory ailments, gastrointestinal concerns, fatigue, fever or muscle aches – should stay off the field until well, Dr. Winkelmann says.

And though being sidelined by illness might be frustrating for committed athletes, taking a few days – even weeks – off from practice will not result in a significant setback in performance.

“It may take you a while to get back to where you were, but it’s much more prudent to take the time to rest your body when you’re sick,” Dr, Winkelmann says.

Young athletes can do some things to help speed the recovery process and get back on the field faster: Focus on rest by going to bed 30 minutes earlier than usual, Dr. Winkelmann advises. Also, limit dairy, sugar and processed foods, and increase fruits and vegetable intake.

When comes to returning to play, a child, especially one who suffered a respiratory illness, should first feel normal for one to two days after recovery, she says.

And above all, a child needs to trust her body, and mom and dad should listen to their parental instincts.

“I tell kids to listen to your body, not your coach or trainer or parents,” Dr. Winkelmann says. “Parents should trust their gut. They know their kid and their personality.”

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Athlete Nutrition Fit for a Champ

The new spring sports season means reasoccer_athlete_nutritionrranging schedules and picking up extra equipment, but parents of young athletes should also examine their meal plans to ensure young athletes are eating enough.

“They absolutely need to eat more,” says Dr. Jacqueline Winkelmann, a CHOC Children’s at Mission Hospital pediatrician who works to provide nutrition tips and guidance in youth sports.

“Young athletes are still growing, and their metabolic demands are so high,” she says. “They need to take in the necessary amount of calories for growth and whatever the sport demands.”

How much, when to eat

Parents can estimate the amount of calories a child’s activity burns by using this tool. That number can help guide the week’s menu and ensure a consistent healthy diet – a key factor for top athletic performance, Dr. Winkelmann says.

“It isn’t true that if you eat badly all week and have one good meal before you play, you’ll be fine,” she said.

Here’s why: Glycogen is an energy source that fuels exercise in humans, but it’s built days before use, Dr. Winkelmann explains. That’s why eating well in the days preceding a game is crucial to optimal performance.

Pre-game eating particulars

Nonetheless, both the timing and type of food an athlete eats right before a game is also important. Whether a snack or a meal, she advises that pre-game fuel should be about 70 percent carbohydrates, 25 percent protein and 5 percent healthy fats. Carbohydrates are a key source of energy for children, adolescents and teens, Dr. Winkelmann advises.

“A meal can be anything from a whole wheat sandwich, a wrap, or chicken noodsoccer_athlete_nutrition_2le soup with bread,” she says. “But if you have less than two hours before competition, focus on a snack that will fill up your tank, and then wait until after the game to eat a full meal.”

Post-game eats matter too

Indeed, what’s eaten after the game is also important. After vigorous activity, the body’s muscles can absorb more nutrients and can produce glycogen two times faster than normal. Dr. Winkelmann calls this time the “golden window.”

“We want to take advantage of it,” she explains. “That’s what your body will soak up. It’s important to have the right kind of fuel at that time.”

To that end, Dr. Winkelmann recommends food with a carbohydrate-to-protein ratio of three-to-one:

  • Chocolate milk
  • Fruit with cheese cubes
  • Yogurt and granola
  • Pretzels and nut butter

Tips for tournament eating

An athlete’s road tournaments also present new challenges for healthy eating, but a little preparation can go a long way, Dr. Winkelmann says.

Try traveling with a cooler so that healthy foods like yogurt, cheese, fruit and nut butters are always nearby. Technology can also help track down healthy fast food and restaurant options. For example, www.healthydiningfinder.com finds eateries nearby that offer healthy choices, Dr. Winkelmann says.

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Allowing Your Child to Play Sports with Asthma

girl_soccerballYour 7-year-old son loves baseball and can’t wait to join the local Little League team. Your daughter is a big soccer fan and all her fourth-grade friends play soccer after school, so she wants to play soccer also. Both kids have asthma. What to do?

Just because your children have asthma does not mean they can’t participate in any sports or physical activities, says Dr. Stanley Galant, an asthma specialist and medical director of CHOC Breathmobile.

“I encourage every child to exercise. If you control the asthma you have less of a chance of a problem,” he says. “It’s very important for asthmatic kids to stay competitive. It’s important for the families and their providers to create a situation that allows them to participate.”

“First of all, exercise is very important for lung development. It’s important to take a deep breath, and exercise makes you take a deep breath. On the other hand, asthma is a known trigger for having a shortness of breath, or coughing or wheezing. The symptoms frequently occur after you stop exercising.”

Young athletes participating in sports can take some steps to minimize or avoid asthma trouble, according to Dr. Galant. He said children should warm up first with some “energy bursts” like sprints and other short exercises. They could also use their albuterol inhaler about 15 minutes before exercising to help prevent an attack caused by exercise if necessary.

If it’s a cold day, athletes with asthma should wear a mask to prevent the cold, dry air from getting into their lungs, Dr. Galant advised. “Swimming is the best exercise for asthmatic kids. Running is the hardest, particular in dry cold air,” he notes.

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Dr. Sharief Taraman Talks with AM830’s Travis Rodgers about Sports and Concussions

Travis Rodgers, host of the Angels AM830 morning radio show “The Travis Rodgers Show” broadcast live from Seacrest Studios at CHOC Children’s during “CHOC Week”. In this interview, Travis speaks with CHOC Children’s Pediatric Neurologist Dr. Sharief Taraman about concussions in sports, their long term effects, and how children are particularly vulnerable to serious injury. Dr. Taraman explains how concussions can happen in any sport, not just football, and how kids (and their parents) need to weigh the risks and benefits before playing contact sports.

Enjoy the show.

Learn more about the concussion program at CHOC Children’s.

Click here for more CHOC Radio episodes.