Iron Deficiency: Fast Facts You Need to Know

Iron Deficiency: Fast Facts You Need to Know

Iron is a mineral that the body needs to grow and develop. Iron helps make healthy red blood cells that transport oxygen throughout the body. Iron is critical for normal immune function. Iron is the structural component of hundreds of essential molecules. Iron assists antioxidant enzymes.

  • Iron deficiency is the number one nutritional deficiency in the United States. According to the National Health and Nutrition Examination Survey (NHANES) II. iron deficiency occurs in approximately 11% of women,1-2% of all adults, and in approximately 12.5% of athletes.

 

  • It is the No. 1 cause of anemia in athletes. Iron deficiency rates (with or without anemia) in athletes range from 20-50% in women and 4-50% in men.

 

  • Iron deficiency anemia occurs when the body does not have enough healthy red blood cells due to a lack of iron in the body.

Two forms of dietary iron

  • Heme iron is better absorbed than nonheme iron; the absorption of nonheme iron is enhanced by vitamin C. 


  • National dietary surveys indicate that iron is under-consumed by adolescent and premenopausal females.

 

 

 

 


Iron recommendations vary between adults and teens

 


What causes iron deficiency

  • Iron losses occur from blood loss in the gastrointestinal (GI) tract, microscopic losses in urine, hemolysis of red blood cells (RBC) breakdown, menstrual cycle, sweat loss, and intense exercise. 

  • Non-steroidal anti-inflammatories (NSAIDs) like ibuprofen, Advil, and naproxen deplete iron and folate. Frequent use of medications with GI side effects such as aspirin and non-steroidal anti-inflammatories like ibuprofen or naproxen can cause or worsen iron deficiency.

 

  • Physical activity particularly high intensity and endurance types increase iron losses by as much as 70% when compared to sedentary populations. Athletes lose more iron due to heavy sweating as well as increased blood loss in the urine and GI tract.

 

Causes range from a variety of health issues to simply overtraining or even lack sleep.  Any athlete that experiences a decrease in training or performance coupled with symptoms should seek out their primary care doctor for further testing and analysis.


Signs and symptoms of low iron

Weakness, fatigue, decreased physical endurance, feeling hot or cold, diminished immune response, alterations in energy levels, cognitive performance, and overall behavior.  Iron deficiency is not the only cause of these common symptoms.  

 

 

 

 


Food sources

Iron in meat, fish, and eggs is easily absorbed by the body but the iron in plant sources is attached to phytates that bind iron in foods.

Following a plant-based diet and limiting animal iron sources can be a challenge. As a practitioner, I meet the client where they are at but do share that consuming animal protein will offer greater iron to support their health and performance goals.

 


Guidance on increasing iron as a plant-based athlete

  • Pair leafy greens (bok choy, kale, spinach) with a source of vitamin c (broccoli, strawberries, bell peppers, and kiwi) –This can increase the absorption by up to 67%! (3)

 

  • Cooking food in cast iron or stainless steel cookware also aids in iron absorption (cook all veggies and protein in the cast iron skillet)

 

  • Eat more beans, lentils, edamame, baked potatoes, and Iron-fortified oatmeal (higher sources of iron).
    • Lima beans
    • Red beans
    • Kidney beans
  • Drink tea or coffee separately from an iron-containing meal or snacks. Caffeine inhibits iron absorption.
  • Additional ways to combine vitamin C-rich foods with beans
    • Drain a can of pineapple cubes and add them to canned baked beans
    • Toss cooked black beans with shredded cabbage in your favorite coleslaw recipe
    • Sauté red peppers and onions in olive oil and stir into the white navy or Great Northern beans (cast iron pan)
    • Add any type of cooked beans to a spinach or kale salad with pineapple or fruit

Add fatty fish into your diet 1x/week (3 oz of salmon) or oysters (also a rich source of iron)!!

    • Blend up leafy greens and fruits rich in vitamin C with your smoothies (you can even add beans – I promise it is a neutral taste)
    • Eat more lean red meat, chicken, seafood, beans, lentils, edamame, baked potatoes, and Iron-fortified oatmeal (higher sources of iron).
  • Sauté red peppers and onions in olive oil and stir into the white navy or Great Northern beans (cast iron pan)
  • In a skillet prepare steak, spinach, or collard greens paired with berries (best way to increase iron)

 

 

 

 


When young athletes or adults we start with simple guidance to help increase iron

  • Set meal goals: 4 oz of flank steak 2-3 x/week paired with leafy greens
  • Snack idea: A side of roasted chickpeas paired with pineapple
  • Snack idea 2: A 1/2 cup of mixed berries paired with fortified oatmeal

Before taking an iron supplement to correct an iron deficiency you should contact your physician and work with a dietitian to raise iron levels properly. It is best to work closely with a dietitian to ensure you or your young athlete is getting the proper amount if iron to avoid health and performance consequences. We have worked with hundreds of teen athletes and plant-based adults that have struggled with low iron. We can help you too! Contact us for student-athlete coaching or for a virtual presentation for your sports team.

 

In good faith, health, and athletic performance,

 

Wendi Irlbeck, MS,RDN,LD,CISSN

 

 

 

 

 

 

 

 


Citations and resources to learn more:

National Health and Nutrition Examination Survey (NHANES) II.

 

Hurrell, R., & Egli, I. (2010). Iron bioavailability and dietary reference values. The American journal of clinical nutrition91(5), 1461S–1467S. https://doi.org/10.3945/ajcn.2010.28674F

 

Goldstein, J. L., Chan, F. K., Lanas, A., Wilcox, C. M., Peura, D., Sands, G. H., Berger, M. F., Nguyen, H., & Scheiman, J. M. (2011). Hemoglobin decreases in NSAID users over time: an analysis of two large outcome trials. Alimentary pharmacology & therapeutics, 34(7), 808–816. https://doi.org/10.1111/j.1365-2036.2011.04790.x

 

Hallberg, L., & Hulthén, L. (2000). Prediction of dietary iron absorption: an algorithm for calculating absorption and bioavailability of dietary iron. The American journal of clinical nutrition, 71(5), 1147–1160. https://doi.org/10.1093/ajcn/71.5.1147

 

Koehler, et al.  Iron status in elite young athletes: gender-dependent influences of diet and exercise.  Eur J. Appl Physiology, 2011.

Simple and Practical Weight Gain Tips for Athletes

“How can I/my kid gain weight? We have tried everything and can’t seem to get anywhere.” I get this question and concern daily from coaches and parents. Weight gain is really hard when athletes are young calorie-burning machines!

“BUT COACH I CAN’T GAIN WEIGHT? WATCH TO LEARN MORE”

 

As always my objective is to provide people with simple and practical tips to achieve their goals!

 “How to Gain Weight Tip List”

Test don’t guess! Start tracking what you’re eating to know how many calories you’re actually eating each day. Too often teen and college athletes are under-eating without knowing it. What is measured is well-managed. Download a free app to help with tracking calories, protein, fats, and carbs. You can’t gain weight if you’re not eating enough calories consistently to attain a calorie surplus. If you’re unwilling to track calories I recommend the plate method for weight gain. See our weight-gain performance plate here.

The mistake many make when trying to gain weight is not understanding fundamental portion sizes. Weight gain means half your plate comes from CHO and during weight loss, it would be 1/4 the plate (smaller portion = less kcal).

 

Too many teen athletes fail to consistently eat regular meals so this is a super easy place to start. (CLICK TO SEE THE FULL INSTAGRAM POST ON WEIGHT GAIN).

 

Eat breakfast consistently. Nutrients missed at breakfast are often not made up later in the day. Toast, eggs, and peanut butter paired with whole-fat chocolate milk are a low-cost, high-calorie, and quality option.  Try Greek yogurt parfaits with oats, nut butter, and fruit. Avocado egg toast is also super easy and high-calorie. For more ideas check out my Grab and Go Breakfast Ideas 

Eat snacks every 2 hours that are high in calories. Set alarms on phones or create email reminders to snack every few hours. (Weight gain requires eating in a calorie surplus so EAT UP!)

Pack high-calorie snacks. Peanut butter banana bagel sandwiches, trail mix, grab-n-go core power protein drinks, smoothies to store in a Yeti at school, peanut butter oat energy bites, mason jar  protein oats 

Planning ahead by meal prepping on the weekend

    • Grill up a dozen chicken breasts and steaks for the week to cut and portion out
    • Prepare PB energy bites
    • Hard-boiled eggs
    • Grab n Go Whole-fat chocolate milk
    • Oatmeal mason jars
    • Loaded baked potato + cheese + broccoli with butter
    • Greek yogurt parfaits (whole-fat dairy)
    • See my weight gain snacks here!

Special considerations for eating more:

  • Sample Weight gain breakdown
  • Double up on protein servings when dining out (double meat)
  • Add beef jerky, string cheese,  nuts, seeds, nut butters,  avocado, butter, olive oil, cheese, and whole-fat sour cream/Greek yogurt when you’re able for more calories!
  • Sometimes eating a lot of calories can be challenging especially around training. I recommend smoothies. You can consume half in the morning and a half in the evening or afternoon as tolerated. Smoothies are a great liquid vehicle for calories!  (oatmeal, peanut butter, whole-fat Greek yogurt, and whole-fat cow’s milk). See my Chunky Monkey Smoothie Recipe here
  • Recovery nutrition is key for muscle repair and growth. Prioritize a recovery snack or meal immediately post-training. Be sure to include both complex carbohydrates and protein.
  • Vary your protein throughout the day and be sure to power up with protein as part of your recovery snack to achieve a positive protein balance, promoting muscle growth and recovery. See my backpack portable options here! 

“But Wendi, what about nutrient timing?” Great point, please see my 4-2-1 guidance here. Too much fat or too much solid food in the stomach around training can blunt performance.

I emphasize a food-first approach but supplements help supplement the gaps in our nutrition. Supplements like creatine, whey protein, vitamin D, and casein can be helpful for athletes’ muscle recovery, lean mass maintenance, and muscle gain when properly used. Should youth athletes use creatine? Find out what the research says in my blog.

Include a bedtime snack !! Research has effectively demonstrated that consuming casein protein (found in milk and
dairy products) prior to sleep can increase muscle
protein synthesis and facilitate better recovery.

See my recommendations here.

 

SLEEP DEPRIVATION WILL BLUNT YOUR GAINS. SLEEP BETTER WITH THESE TIPS


How to simply start gaining weight:

  • Identify how much you’re eating. (track in an app or journal)
  • Add 300-500 kcal per day to your baseline intake. If you consume an added 500 kcal per day x 7 days a week you’re consuming 3,500 kcal equivilant to one pound.
  • Focus on doubing up on portions, adding in liquid kcal and staying consistent.
  • It won’t happen overnight. If you want to gain you’ve gotta eat!

SEE MY TWITTER ACCOUNT FOR PRACTICAL GUIDANCE! 500 KCAL EXAMPLE MEALS + SNACKS!

Aim for consuming 4,000-6,000 kcal per day if you’re an HS athlete and likely 6,000 + kcal for collegiate athletes. For individual recommendations contact me and let’s create a custom fueling plan that supports weight gain goals.

I have worked with both HS and college athletes for > 5 years now. I spent time at the University of Florida as a sports nutrition intern in 2015 working with football, men’s and women’s track, swim, soccer, baseball, lacrosse, and tennis. I also worked as a performance nutrition assistant at the University of Wisconsin-Stout during my graduate studies. I educated football, gymnastics, hockey, soccer, men’s and women’s basketball, and baseball on proper fueling from 2014 to 2016.  Both of these experiences were volunteer and I sought them out because I knew I wanted to help athletes as a future dietitian. These opportunities helped me understand what it takes to fuel an elite athlete with a small budget! Sleep for more gains..yes sleep impacts our ability to recover and synthesize muscle! Aim for 7-9 hours of sleep per night.

Many young athletes also skip breakfast and snacks so it’s more of a willingness than an ability problem with weight gain. If your young athlete won’t listen to you don’t worry you’re not alone! But they tend to listen to me, a former college athlete and total stranger :). I provide meal plans and performance nutrition guidance for picky eaters and those with food allergies/intolerances. (see my student-athlete nutrition coaching package)

 

 

In good faith, health, and wellness,

-Wendi A. Irlbeck, MS, RDN, LD, CISSN

Should Youth Athletes Use Creatine Monohydrate?

17-year-old, Jenkins comes strutting out of the weight room after he just crushed a workout living his strongest, healthiest, and injury-free life. While walking out of the weight room Jenkins is using Nutrition with Wendi’s recommended “25-50-30 rule” and is downing a shaker bottle with chocolate milk and creatine paired with a banana. Jenkins is a smart kid and has focused on proper sleep, hydration, eating well, and managing his stress while training hard. But of course, many make comments like, “You know that powder he is mixing in there is steroids right? One of my parent’s friends said his coach has been encouraging the use of anabolic steroids for years!” YIKES RIGHT??

Ever heard this crazy misinformation before? Yes, me too. It has spread like wildfire.  It is even more gut-wrenching when it’s spread by doctors, trainers, health care professionals, influencers, or random people on the internet that know very little about science, sports performance, or even what creatine is. Insert facepalm. Good news! I am here to dispel those myths and provide the science to help combat the misinformation that is so toxic.

Creatine is one of the most effective ergogenic aids for adult athletes and is safe. Creatine effectively increases lean mass, strength, power, speed, and exercise capacity (1).  But what about youth athletes? I have had several high school coaches and concerned parents of youth athletes ask me questions like, “Is creatine safe for my kids? Should my female athletes be using creatine?” In almost every conversation, my first response is, “It depends.” Just like any other question I get, nutrition-, health-, fitness- or performance-related, it should be individualized. Creatine, however, is beneficial to all populations according to the science outlined in this article. As a registered dietitian, I strongly promote a “food first” and back-to-basics philosophy. For more information on healthy eating and performance nutrition, see a previous blog here. I empower anyone working with youth athletes to use the guidance in this article when considering “to supplement with creatine or not.”

Creatine Monohydrate 101:

  • 95% of creatine is found in skeletal muscle
  • The human body needs 1-3 g per day
  • Most creatine in the diet comes from animal products like meat, fish, & poultry
  • Enhances post-exercise recovery, injury prevention, and/or spinal cord neuroprotection and muscle growth

What is it?

Creatine is a naturally occurring compound formed by three amino acids, making it a tripeptide (tri- meaning three) of the amino acids L-glycine, L-arginine, and L-methionine. Creatine is assembled in a two-step process that occurs in the kidneys and liver. 

Creatine can be consumed via dietary sources, which include foods like eggs, milk, tuna, salmon, herring, cod, shrimp, beef, and pork. Consuming enough creatine from the diet is challenging given the total creatine pool available according to an article published in Frontiers in Nutrition Sport and Exercise Nutrition by Candow et al., 2019. This literature, along with the International Society of Sports Nutrition Position Stand on Creatine Supplementation and Exercise, suggests the body needs to replenish about 1–3 g of creatine per day to maintain normal (un-supplemented) creatine stores depending on muscle mass.  Creatine monohydrate is the most well-studied form of creatine in the literature. For a more detailed breakdown of other forms please check out Will Brink’s fantastic breakdown on Creatine HCL vs Monohydrate for a deep dive.

Creatine improves numerous factors including strength, power, sprint ability, muscular endurance, resistance to fatigue, muscle mass, recovery, cognition, and rate of muscle growth. Creatine is one of the most widely studied, proven performance enhancers available that also offers clinical benefits (4).

How does creatine work?

Creatine deposits high-energy phosphate groups in the form of phosphocreatine. This is given to adenosine diphosphate (ADP), regenerating it to adenosine triphosphate (ATP), the sole energy carrier in the human body, which can be called “energy currency” for cells to carry out their functions. For example, during conditions of short-term, high-energy demand activities (<30 seconds) with limited recovery time, ATP runs out quickly, which illustrates the importance of creatine stored in muscles in the form of creatine phosphate. This is explained here

Since creatine phosphate restores ATP, it gives muscle cells the ability to produce greater energy. The greater creatine stores you have, the greater energy your muscle cells can yield during high-intensity exercise, thus leading to increased exercise performance. Even though the most well-documented and primary benefit is higher energy production, this mechanism also supports muscle gain and strength increases, as explained here.

Despite creatine being widely tested since the early 1900s with significant data supporting its effectiveness, it is widely misunderstood by many trainers, coaches, athletes, and concerned parents of high school athletes. Yes, it is 2021 and people still think creatine monohydrate is a steroid due to misinformation generated across social media and the general population (4).

Disregard the false, outlandish, disproven claims. I am referencing the silly fallacies like, “creatine will make you fat,” “creatine will cause liver, kidney, or bone injury,” “creatine will dehydrate you,” or my personal favorite, “creatine is a steroid that will also lead to baldness.” I know. What a bunch of nonsense. I addressed these fallacies in a previous blog, Creatine Not Just for Men or Muscle. Please go check it out if you are a female because creatine can help you improve your lean mass and lose that fat.

Antonio et al. published a phenomenal paper outlining the common questions and misconceptions regarding creatine use available for open access here (1). I highly recommend you read it and share it with anyone who may have creatine confusion disorder. I made that up, but you get my point. Creatine monohydrate is beneficial for many things beyond performance, which is not my opinion but sc!

Potential ergogenic benefits of creatine supplementation in adults (4):

  • Greater training tolerance
  • Increased sprint performance
  • Increased work performed during sets of maximal effort
  • Increased lean mass & strength adaptations during physical training
  • Enhanced glycogen synthesis
  • Increased work capacity
  • Enhanced recovery
  • Increased anaerobic threshold

If you’re interested in my opinion as a dietitian and performance practitioner working with several athletes I highly recommend creatine. Creatine is like the Swiss Army knife of supplements! It can do so many things!

In November 2020 I had the fortunate opportunity to be a guest on Dr. Bradford Cooper’s podcast, Catalyst Coaching, where I discussed the role creatine plays according to science. Please check out the video or podcast here.

What about side effects?

There is robust evidence to support the effectiveness of creatine in the adult population. Among children and adolescents, there is mounting evidence to support the therapeutic benefits of creatine supplementation as well as clinical and exercise performance. Available studies in the adolescent population involving high-intensity exercise training indicate performance benefits as well as no reported side effects (1,2).

In relation to performance, the International Society of Sports Nutrition (ISSN) has concluded that creatine monohydrate is the most effective ergogenic supplement available to athletes in terms of increasing high-intensity exercise and supporting lean body mass during training. The ISSN has also concluded CM is safe. (4).

Does creatine work in young athletes?

Regardless of the limited data on the teen population, creatine is likely safe, beneficial, and well-tolerated among youth athletes as evidenced by the available data (2). 

  • Creatine supplementation improved time performance and strength in highly competitive swimmers (2,3).
  • Youth soccer players experienced improved sprinting, vertical jump, dribbling, and shooting (6).
  • Creatine can support brain health, offering neuroprotective effects following a concussive injury in athletes < 16 years old (4).

Check out a Creatine Supplementation in Children and Adolescents review carried out by Jagim and Kerksick, 2021, outlining the available studies involving youth athletes for more information.

Another podcast to check out is Gerry DeFilippo. Gerry kindly invited me on his podcast to discuss the different forms of creatine. To learn more download and listen to Episode #143 Everything You Need to Know About Creatine with Wendi Irlbeck.

Should my teen athletes be supplementing with creatine?

As always, food first, but creatine can be a safe and effective regimen for young athletes who meet the following criteria (1,5):

  • Consuming a well-balanced diet
  • Consuming a diet with a greater emphasis on plant proteins like soy and pea which do not provide creatine like animal proteins
  • Involved in high-intensity training, and competitive sports which include:
    • Track
    • Swimming
    • Lacrosse
    • Ice Hockey
    • American Football
    • Volleyball
    • Field Hockey
    • Basketball
    • Soccer
    • Tennis
    • Olympic Weightlifting
    • Rugby
    • Combat Sports (MMA, wrestling, boxing, etc.)

It is always best practice that athletes of any age fully educate themselves by consulting with a registered dietitian nutritionist, certified sports nutritionist, exercise physiologist, or sports-focused physician before the use of any supplement. Similarly, any products used should be NSF International Certified for Sport to reduce the risk of consuming any harmful or contaminated products. Supplements are regulated but not as heavily regulated as pharmaceuticals. Please see the reasons to use NSF Certified for Sport products in a previous blog.

“The USADA recommends that athletes use only dietary supplements that have been certified by a third-party program that tests for substances prohibited in sport. The USADA is responsible for anti-doping education and testing for athletes in the U.S. Olympic and Paralympic Movements as well as the UFC.”

Therefore, all supplements used should be third-party tested for safety, purity, and compliance. For the sake of convenience and safety, you and your athlete can download the NSF Certified Sport app. 

I preach food first, nutrient periodization, quality rest, good sleep hygiene, hydration, and appropriate training, all of which can be better enhanced using creatine monohydrate (CM). Based on the strongest science and studies, CM is the recommended form. CM is used in the studies. Therefore, it should be used in practice as well. I discussed the other forms in my guest appearance on Muscles and Management.

When to use creatine?

The science suggests creatine is most effective immediately post-workout when paired with protein and carbohydrate (7). Creatine consumed immediately post-resistance training is superior to pre-workout in terms of body composition and strength (7). The recommended dose is 3-5 g of creatine per day. Creatine can be used at any time of day. Creatine is safe and effective on rest days from exercise as well as training days. (Click here to follow on Instagram)

While CM is best paired with a carbohydrate-rich source (like oatmeal, whole-grain bread, rice, fruit, smoothies, or yogurt) to draw it into muscle cells, it can also be added to water or other beverages. A saturated cell is a happy cell! This supports recovery and muscle repair following resistance training. 

Most creatine supplements are in powder form and must be used in warm water to support the dissolving process. CM will dissolve slowly in cold water and often ends up in the bottom of a shaker bottle, which won’t do any good if it doesn’t make it into your mouth! Creapure is a great brand to use and offers more explanation on dosing. Check it out here! No, I do not have a partnership or any affiliation with Creapure. I just want to share that they make a great product.

My female youth soccer players have integrated CM post-training with their tart cherry juice and chocolate milk. I have taken time to discuss the safety, use, and benefits with my youth athlete’s parents, coaches, and even their PE teachers. I have 50% of my youth athletes supplementing with CM. CM is always a conversation we have after we wrap up their 6-week Nutrition with Wendi Coaching Program.

Do I need to load?

No, you do not need to “creatine load”. In fact, many studies use a typical creatine dose of 5-10 g daily or smaller doses like the standard 2-3 g. However, if you desire to do a loading phase, it would look something like 20-25 g for 5-7 days followed by a maintenance phase of 5 g daily for 4 weeks, 2 weeks off, and then repeat. I do not have any of my athletes do this cycling as it is unnecessary. See the ISSN’s Position Stand for more on this (4).

Studies support the benefits of CM supplementation regardless of the dose. However, that does not mean more is better. If you are a vegetarian and new to using CM, you would benefit from saturating the muscles with CM, leading to an acute increase in strength and body weight via water retention. However, please refer to the experts and those I respect most in the field like Dr. Darren Candow, Dr. Tim N. Ziegenfuss, Dr. Scott Forbes, Dr. Jose Anotonio, Dr. Rich Krider, Dr. Eric Rawson, and others who can further provide the research they have been doing for the last few decades.

Please see another podcast in which I had the opportunity to speak about creatine in the youth population via the Big Time Strength podcast.

Closing thoughts

There is robust literature to support the beneficial effects creatine has on body composition, physical performance, injury prevention, recovery, brain health, and clinical use. Currently, there have not been any negative effects associated with the use of CM in both the adolescent and adult populations. Adolescent athletes under the age of 18, and even children as young as infants, can safely consume CM. There is zero evidence to suggest CM supplementation would cause harm, dehydration, cramping, or any other outlandish claims that have been disproven by Antonio et al., 2021, and others. Not incorporating a CM supplement would be a disservice to your athletes or even yourself!

Key takeaways:

  • Anyone looking to improve their health of any age or activity level can safely consume 3-5 g of creatine monohydrate immediately post-workout paired with a carbohydrate. 
  • By supplementing with creatine monohydrate immediately following training, you’re able to support muscle growth and recovery, injury prevention, and overall health. 
  • Yes, creatine is safe to consume if you are a teen athlete. Yes, you should use creatine monohydrate.
  • No, creatine is not a steroid. No, creatine will not cause baldness. No, creatine will not dehydrate you. No, creatine will not cause cramps. No, creatine will not decrease your bone mineral density.
  • If you have a beating pulse, then creatine monohydrate is for you!

Sports physicians, athletic trainers, coaches, performance nutritionists, and others working with youth athletes should provide the best guidance to teen athletes based on the available science to support their principal interests. Kids are going to be using supplements like energy drinks and pre-workouts, which contain dangerous amounts of caffeine. I would rather we provide education on the safety and use of creatine, which is not dangerous but beneficial. I would like to see more people using creatine given the ergogenic benefits and no reported adverse effects. Creatine monohydrate is a safe, effective, and inexpensive way to support health and physical performance! Please don’t let, “Joe Public” from accounting or “Susie Quinn,” on Instagram tell you any different. 

In good health health, and physical performance,

Wendi Irlbeck, MS, RDN, LD CISSN

Wendi Irlbeck, MS, RDN, CISSN  is a registered dietitian nutritionist, and performance coach. Wendi utilizes evidence-based science to tailor nutrition programs for athletes to optimize performance, minimize health risks, and enhance recovery from training while focusing on injury prevention. She partners with parents, sports performance staff, and special needs and recreational athletes to offer nutritional guidance and optimal athletic performance and lifestyle plans. Wendi provides virtual services including telehealth but is based in Nashville, TN.  Wendi works with clients of all levels internationally.

What can hiring a sports nutritionist offer your program? Learn more here.  Interested in signing up for the NEW and upcoming NWW newsletter? Click here to sign up!

References

  1. Antonio, J., Candow, D.G., Forbes, S.C. et al. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show?. Journal of the International Society of Sports Nutrition 18, 13 (2021). https://doi.org/10.1186/s12970-021-00412-w
  2. Grindstaff PD, Kreider R, Bishop R, Wilson M, Wood L, Alexander C, et al. Effects of creatine supplementation on repetitive sprint performance and body composition in competitive swimmers. Int J Sport Nutr. (1997) 7:330–46.
  3. Ostojic SM. Creatine supplementation in young soccer players. Int J Sport Nutr Exerc Metab. 2004 Feb;14(1):95-103. doi: 10.1123/ijsnem.14.1.95. PMID: 15129933.
  4. Kreider, R.B., Kalman, D.S., Antonio, J. et al. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr 14, 18 (2017). https://doi.org/10.1186/s12970-017-0173-z
  5. Jagim AR, Stecker RA, Harty PS, Erickson JL, Kerksick CM. Safety of creatine supplementation in active adolescents and youth: A Brief Review. Front Nutr. 2018;5:115. Published 2018 Nov 28. doi:10.3389/fnut.2018.00115
  6. Ostojic SM. Creatine supplementation in young soccer players. Int J Sport Nutr Exerc Metab. 2004 Feb;14(1):95-103. doi: 10.1123/ijsnem.14.1.95. PMID: 15129933
  7. Antonio J, Ciccone V. The effects of pre versus post workout supplementation of creatine monohydrate on body composition and strength. J Int Soc Sports Nutr. 2013 Aug 6;10:36. doi: 10.1186/1550-2783-10-36. PMID: 23919405; PMCID: PMC3750511.

 

6 Necessary Tips to Maintain Health and Conditioning During Quarantine

Baseball and softball diamonds are empty. Soccer fields and tracks lay desolate. High school sports’ championships are cancelled. Indefinite halt in practices, games, and tournaments have left many coaches, parents and young athletes devastated. A whole new pain has developed around the world when the term “cancelled” is used due to the novel Coronavirus (COVID-19). For many, their outlet for stress, health, social time and joy has been halted with short notice. The all-around impact when sports and organized recreation resumes, remains uncertain. The big question remains: “When will this end, and when can we return to our normal lives again?” The reality is, we will not return to how things were. How do we adapt, overcome, and conquer the many challenges of unknowns and uncontrollable modalities? This article will aim to provide clarity, support and motivation, and simple tips to stay healthy and conditioned during the COVID-19 pandemic.

There are many things sport athletes cannot control, such as weather conditions, their opponent, playing fields and, now, a pandemic! Ultimately one thing that athletes of all ages (adults too) can control is themselves. Being involved in a sport creates routine through practice and preparation. Routines were carried out and executed pre-pandemic and they should now be established during the coronavirus to prevent further declines in health, wellness, and overall athletic performance. Creating structure in life is more important than ever. Many young athletes may find themselves feeling “abnormal” or “off” and it is important for coaches and parents to check in with them. During these first few weeks of the “Stay at Home Order” here in Michigan many of my young athletes and clients have been faced with a different way of life and schedule. Schedule and routine should be the second most important priority after the shelter in place. Health hack: You can still maintain your fitness at home with regular walking, body weight exercises, light weights with greater volume and of course proper nutrition. -Please Schedule a consultation with me if you’re desiring further assistance in any area of your health, I am here to help.

5-6 Simple Suggestions to Keep You Healthy & Conditioned During the Pandemic:

  • PLAN Your Day. Set your alarm to wake up to the same time each day, eat regular meals & snacks, hydration goals, when you will train, complete school-work, watch your favorite show, read, walk the dog, study, and complete chores. Without a routine, your energy, nutrition, water or fueling goals will be affected. Structuring your day will benefit your mental health and athletic success post-virus. Utilize this time to focus on taking care of your body, schoolwork, mental health, and maintaining overall optimism. It is okay to live by the “one-day-at-a-time” mantra. Do not undo all the hard work put into your training. Take a breath, stay motivated, and conditioned.
  • PLAN Your Bedtime. Establish a bed-time routine to carve out time to brush teeth, wash your face, and prepare for rest. Research supports more restful sleep when we limit phone use prior to bed. For example, establish a bedtime of 10 pm. Begin getting ready for bed at 9:15 pm. Put your phone away, meditate, limit time around books and activities that would decrease your ability to relax. Be in bed by 9:45 with time to quiet your mind and fall asleep by 10 pm.
  • PLAN Your Intent. What does this mean? When you wake up, write down what you want to accomplish for the day. This simple act is powerful, it creates structure and meaning to our day. If we start our day being mindful of what we want to accomplish and the intent of our actions, it will facilitate the motivation and drive to tackle them.
  • Body Composition. Many are concerned about gaining weight due to less activity. This applies to not only young impressionable athletes but adults as well. Do not overdo it with exercise trying to “earn calories” or “burn off what you ate”. For some young and older athletes, this time at home may mean more activity because of “extra time”. It may be wise to limit intensive training to what your coach or trainer has prioritized. Be sure to enjoy light, mindful movement with your family such as going on walks together. It is key to remember that supporting proper growth, development and maturation needs, are all priorities for young athletes. To learn more, please read one of my previous blogs here. Reminder: young athletes eat first and fuel second. This concept is also illustrated in a blog I recently wrote for strength coaches at the high school level.
  • PLAN Your Meals. By no means should young athletes be cutting out food groups, meals or critical calories because schedule changes. Meal planning and usual eating habits are likely to be affected if they are less active and not training as intensely. Pandemic or not, young athletes still need the fundamental three to four high-quality meals that contain the basics (lean protein, fruit, vegetable, whole-grain and dairy). The snacks consumed in-between meals may decrease due to less activity, training and events. I have always encouraged my athletes to consume a protein and carbohydrate source as snack. However, with less activity than usual, a lower carbohydrate snack may be a better option (such as string cheese with cucumber slices). For many, eating nowadays may be similar to “off-season” eating or rest days. However, the athletes training more intensely or adding in addition cardio sessions, may need to increase their protein and carbohydrate snacks following training. This a very important concept for people to understand. Ultimately, an athlete’s plate needs to support the training and work that is being done. See the performance plate guidelines which provide clear illustrations of building a plate to reflect the type of training day.
  • PLAN to be Creative. Food access, security, safety, and overall availability impacts how we eat. Now is not the time to try out a rigid diet, dirty dozen, 21-day fix in the house. Foods may be available in limited amounts and many families are going shopping for one to two week’s worth of groceries. Meeting nutrition needs perfectly is not necessarily the reality, but it is a good goal to keep front and center. When shopping, pick up canned veggies, canned beans, frozen fruits, frozen vegetables, and consider buying meats in bulk that can be placed in the freezer. Keep in mind you can freeze many food items! Please navigate to my social media platforms such as twitter and Instagram for more instructions and ideas. A quick online search will also show you some creative ideas. It is critical to continue avoiding overly processed foods that are high in sugar and low in nutrition, such as chips, pastries, sweets, etc. All foods fit, but keep in mind good nutrition is the foundation for good health. Focus on consuming a variety of foods that are nutrient dense to support a healthy immune system to fight off disease, decrease exercise induced inflammation, promote healing of tissues and overall health. Eating an abundance of nutritious foods will provide stable energy levels, cognition, athletic performance, injury reduction, self-confidence, healthy body composition, and heart health. I encourage my athletes to continue to pursue a healthy relationship with food despite the challenges we currently face.

If you’re interested on some specifics check out what the Food and Drug Administration has to say regarding food availability during the novel Covid-19 virus in a recent article.

This unexpected challenge is our opportunity to define our new normal. Stay at home, wash your hands, create a routine, limit discretionary calories, keep training, prioritize your hydration, eat well and fuel accordingly. This is the ultimate chance to learn from professionals, peers, and family, to move forward with different and healthier habits. And, this is exactly what we will do. Opportunity favors the prepared. Don’t miss this opportunity to optimize your health and training. What controllable behaviors are you willing to work on daily to set yourself up for your next power play?

 

**The Academy of Nutrition and Dietetics has helpful tips on keeping your family healthy and safe at home. They can be found here. Avoid misinformation online regarding COVID-19. Rely on credible, accurate sources such as the CDC, FDA ,and the NIH .

**I recently delivered a presentation on “The Importance of a Routine During Uncertainty” on a recent webinar with the West Virginia Soccer Association. The webinar will be available on demand on the WVSA Beyond the Pitch Podcast in the next week.

“Nutrition is your athlete’s secret weapon to out compete their competition. Nutrition can make a good athlete great or a great athlete good.” (SM)

 

– Wendi Irlbeck, MS, RDN

Wendi Irlbeck, MS, RDN is a registered dietitian, nutritionist, and fitness coach. Wendi utilizes evidence-based science to tailor nutrition programs for athletes to optimize performance, minimize health risks, and enhance recovery from training while focusing on injury prevention. Wendi partners with parents, sports performance staff, special needs and recreational athletes to offer nutritional guidance and optimal athletic performance & lifestyle plans. Wendi is based in East Lansing, Michigan and is the founder of Nutrition with Wendi, LLC. Wendi is active on Twitter and other social media platforms as Nutrition_with_Wendi.

 

Carbohydrate and Protein Needs for Young Athletes Desiring to Make the Jump from Good to Great!

Bowls filled with granola and berries

There’s No “One-Size-Fits-All” Nutrition Approach

An athlete’s energy and nutrient needs depend individually on his or her age, body composition, goals, and training volume, and depends globally on the demands and intensity of the sport. Put simply, the greater the intensity, duration and frequency of the activity combined with the athlete’s weight or body composition, the higher the demand of protein, carbohydrate and calorie intake.

If you’re a coach, parent or athlete reading this, don’t become overwhelmed. This article intends to introduce to you some general guidelines on optimizing energy needs (i.e. calories, protein, and carbohydrates) to sufficiently support overall health and advance athletic performance.

First rule of thumb, ALL adolescent athletes should consume breakfast, lunch and dinner with 2-3 snacks in between meals to fully optimize energy levels. You must build a plate that includes a source of lean protein, a fruit, a vegetable, a healthy fat and a serving of dairy if you wish to get real and progress with your nutrition. A visual of the plate and practical nutrition strategies can be found in my previous blog here.

Fuel Up to Avoid Stalling Out

Youth athletes have significantly higher nutritional needs than their less-active classmates because athletes need more calories to support performance demands, normal growth, general development and maturation. According to the Academy of Nutrition and Dietetics, female teen athletes need roughly 2,200-3,000 calories and male teen athletes need roughly 3,000-4,000 calories per day (depending upon the individual and sport). Additionally, adolescent athletes training in multiple sports may need upwards of 5,000 calories per day to maintain weight and support growth needs. It’s paramount to encourage adequate calorie consumption during times of heavy training. For perspective, low-energy availability in female adolescent athletes can lead to short stature, increased injury, delayed puberty, poor bone health, metabolic and cardiovascular issues, menstrual irregularities, disordered eating behaviors – this according to a review published in the International Journal of Sport Nutrition and Exercise Metabolism published by Desbrow et al., 2019.

Relative Energy Deficiency Syndrome (RED-S) is a more comprehensive label that builds on the condition of low-energy availability, also known as “female athlete triad,” to describe an energy deficiency gap that results when energy intake is insufficient to support daily activities, living, growth and function. RED-S affects primarily females, but also young males.

Premium Fuel for the Young Athlete – Carbohydrates!

Carbohydrates are an athlete’s most important source of energy for optimal athletic performance. Several studies carried out during the last 50-60 years have consistently highlighted carbohydrates as the primary macronutrient to sustain and enhance physical performance. The Institute of Medicine (IOM) has established that 45-65 percent of calories in one’s diet should come from carbohydrates or between 3 and 8 grams per kilogram of body mass, depending upon the exercise intensity. For example, a 14-year-old female athlete should consume 2,000-2,400 Granola and yogurt with fruit, juice, and eggscalories per day, with 225 – 270 g (45% of total calories) to 325 – 390 g (65% of total calories) from carbohydrates. Keep in mind the dietary reference intake (DRI) remains at 100 g per day and recommended daily allowance (RDA) at 130 g day for all age and sex categories (children ≥ 1 year), both measures not related to physical activity. High-quality carbohydrates for athletes to consume include, but are not limited to, 1. whole grains like pasta, rice, tortillas, bread, oatmeal, low-fat dairy, and energy bars, 2. fruits like berries & bananas, and apples, 3. starchy vegetables like squash, potatoes and eggplant. To experience a boost in energy, consider adding items from this longer list of quality carbohydrate-rich foods to achieve enhanced athletic performance.

Performance tip: Make half your plate carbohydrates if you’re an endurance athlete, especially on heavy training days. The average athlete should be eating around 360-500 grams of carbohydrates per day. Failing to consume enough carbohydrates will cause a decline in performance, cognition, focus, and athletic performance. Time-to-fatigue and injury risk will also increase without enough dietary carbohydrates. To keep it simple, carbohydrates are not “optional”; they are essential. You can take it from an RDN whom stands for science or examine the science for yourself by checking out Nutritional Considerations for Performance in Young Athletes published in the Journal of Sports Medicine.

Power Up with Protein!

Protein is critical for building, maintaining and repairing many cellular structures, like skeletal tissues. Consuming enough protein supports synthesis of hormones, neurotransmitters, energy production, gene activity and transportation of biological molecules. The Institute of Medicine (IOM) has established that 15 to 20 percent of total calories, or about 70-160 grams should derive from high-quality protein sources.

To breakdown the science, consuming adequate protein is critical for proper growth, development and normal physiological function during adolescence leading into adulthood. Distinctive demands during adolescence, especially those that engage in high-intensity sport, call for a greater daily protein intake than that of adults. Currently the RDA for protein is 0.95 g/kg/day for children ages 4-13 years and 0.8 g/kg/day for adolescents between the ages of 14-18. Those that engage in regular training and endurance sports like swimming, rowing, distance running, and soccer may need 1.2-1.4 g/kg/day while power sports like weightlifting, gymnastics, football, wrestling shall require 1.0 – 1.5 g/kg/day .

High-quality protein sources include beef, poultry, bison, pea protein, pork, tuna, turkey, seafood, fish, and dairy products, such as milk, yogurt, whey, cheese and cottage cheese. To find out how much protein some of your favorite sources provide, check out this list from the Academy of Nutrition and Dietetics. Keep in mind that not all proteins are created equal. To deter you from going down the rabbit hole of plant proteins vs. animal proteins, I will simply link an article for you to review here. It’s important to just remember that foods rich in leucine, a branched chain amino acid found in animal proteins, will have the greatest positive affect on driving muscle protein synthesis. We could get really complex on this topic but it’s enough to simply emphasize the importance of consumption of high-quality proteins that are listed above due to their rich leucine content, especially since we are addressing protein intake for adolescent athletes. Most young athletes barely consume enough calories and protein as it is. To keep it simple, make sure your adolescent athlete consumes ¼ of their plate or a 4 oz. serving of a high-quality protein three-five times per day. As I always say, success starts with the basics and carrying them out on a consistent basis.

Failure by your adolescent athlete to consume adequate protein intake will cause declines in energy, weight, muscle growth, and strength, while increasing the likelihood of onset fatigue. Does this mean your adolescent athlete should be slamming protein shakes? Of course not, but they should be consistently consuming whole foods at regular mealtimes. Consuming good old fashioned chocolate milk on-the-go can even be a great way to increase calories while meeting additional protein intake demands. This is especially a great addition to refuel and re-hydrate post-practice or game! Make no mistake, a protein shake or chocolate milk will not make up for missed nutrients from consuming regular meals. Furthermore, supplements like protein powders are not regulated by the FDA and so it is important to select a protein powder that has been third-party tested with a NSF stamp of approval, which deems it certified for sport. This is paramount to ensure there are no banned substances on the label, that the product is manufactured in a facility that follows acceptable manufacturing standards, and that the contents of the supplement match what is printed on the label, ultimately being safe for consumption. To search supplements that are third-party tested and free of any banned substances, check out Informed-Sport.

Stirring it Altogether:

Knowing your carbohydrate and protein intake recommendations is great, but I encourage using the plate as a method of hitting your intake requirements. If you consume a balanced plate with all the components 3-5 times per day with high-quality snacks in between, you’re likely going to meet the energy demands of your sport. Again, it’s important to remember that carbohydrates are the body’s preferred source of energy.

Keeping with the basics such as eating breakfast, lunch and dinner with small snacks in between meals will help improve your health and sport performance. Don’t skip meals and make sure your plate is full of colorful fruits and vegetables. Always choose water or milk over sugary beverage to support hydration and better overall health. It’s time we get back to the basics, which I discuss in detail in the last article I published, available for reference here. As always, nutrition is a secret weapon that can help you perform optimally in the classroom and in sport.

Your sports nutritionist,

Wendi Irlbeck, MS, RDN

Practical Nutrition Strategies for Youth Athletes

Most parents and families understand how critical a nutrient-rich, balanced diet is for optimal health and athletic performance. If you’re raising an adolescent or teen athlete performing at a high level, you must focus greater attention on their fueling needs to ward off fatigue, prevent nutrient deficiencies, and decrease the risk of injury.

Support your youth athlete using these strategies:

There is no “special diet plan” to assist in achieving optimal athletic performance. Consumption of the fundamentals (three high-quality balanced meals with 2-3 snacks between) on a consistent basis leads to better sports performance, games won, strength increases, and fewer injuries. A great resource to build a plate for optimal performance can be viewed here .

The greater intensity of the sport, duration and training volume, the greater requirement of carbohydrates and calories to sufficiently support energy levels. This pertains to sports like ice hockey, field hockey, basketball, swimming, soccer, and long-distance running.

You must also make a conscious effort to consume snacks containing protein and carbohydrates between meals. Fruit with string cheese is a great snack to support energy levels and maintain fueling between meals! For snack ideas to fuel your teen athlete, be sure to check out this article from the Academy of Nutrition and Dietetics.

Hydrate, hydrate, hydrate! Water is vital to maintain peak performance during exercise. A good rule of thumb is to encourage consumption of 1 oz. of water per pound of body weight. It is worthwhile to invest in a good water bottle for your teen athlete to carry and keep on hand to foster good habits and prevent dehydration. Check out this article from USA Triathlon for fluid needs before, during, and after exercise.

Eating breakfast is non-negotiable. Teens need adequate nutrition to support proper growth and development. Research has indicated nutrients and calories missed at breakfast by teens are unlikely made up for later in the day. This can result in insufficient intake which can hinder sports performance and prevent proper maturation. Great grab-and-go meals include a hard-boiled egg and fruit, string cheese and banana, yogurt parfait, and whole-grain granola, berries, and oatmeal.

A bedtime snack containing 15-20 grams of protein and approximately 30 grams of carbohydrates will support restful sleep and help build lean muscle tissue during the night. Athletes training intensely especially need bedtime protein to improve recovery and training adaptations (Trommelen & VanLoon, 2016). Cottage cheese, milk, and yogurt are rich in casein, a slow-digesting protein. Pair an 8 oz. serving of cottage cheese with sliced bananas, which are a rich source of magnesium helping to relax the muscles in your body as well as lower brain temperature to regulate hormones.

Caffeine has no place in an adolescent’s diet. A 2018 report stated that greater than 40% of American teens surveyed had consumed an energy drink within the past three months. Several emergency visits have occurred due to energy drink consumption among teens between the ages of 12-17. The American Academy of Pediatrics has concluded that energy drinks are “not appropriate for children and adolescents, and should never be consumed.” Monster and Gatorade do not provide the same hydration benefits so be wary of advertisements that contribute to this confusion. Caffeine can negatively impact sleep, anxiety levels and also impair appetite.

Load up on fruits and vegetables between meals! The more colorful your athlete’s plate, the better their gut health and immune function will be. Fruits and vegetables are rich in antioxidants and contain quality nutrients needed for optimal growth and development.

Calcium is critical for proper bone growth, development, and overall health. However, calcium can only reach its full bone-growth potential in the presence of adequate vitamin D. Calcium and vitamin D work together. How? Vitamin D helps absorb calcium. Research has proven that American girls do not get adequate calcium in their diet after age 11. This deficiency increases the risk of injuries like stress fractures. Recommendations for calcium and vitamin D vary. A great way to attain adequate calcium and vitamin D is to consume dairy productsOatmeal bowl topped with fruit and nut butter such as cheese, yogurt, milk, and fortified beverages. A yogurt parfait with mixed berries is a great pre-exercise snack to fuel performance and also serves as a great breakfast to start the day!

Ramp up the color game! No, I am not talking about your outfit; I am talking about your plate. Be sure to fill your plate with many colorful fruits and vegetables that are rich in antioxidants, vitamins, and minerals that are essential for health and injury prevention. Citrus fruits, red and yellow bell peppers, dark leafy greens, broccoli, berries, and tomatoes offer vitamin C. Vitamin C offers anti-inflammatory properties that speed up recovery and decrease the risk of injuries.

Due to their zinc content, meat, fish, nuts, seeds, and whole grains should be included to help athletes recover from tough practices while supporting growth. Zinc is a component of proteins and enzymes and research has shown that insufficient zinc can delay recovery and wound healing.

I hope you find useful these basic strategies to support your adolescent in their sport. It is important to make sure your adolescent is consuming balanced meals consistently with snacks in between before implementing supplements, as supplements are meant to satisfy the gaps in nutrition. Good nutritional habits must be established first. Click here for information on building a performance plate.

Nutrition is a secret weapon! It can make a good athlete great or a great athlete good, the choice is up to you!

In good health,

Wendi Irlbeck, MS, RDN, CISSN