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International Association of Athletics Federations Consensus
Statement 2019: Nutrition for Athletics
Louise M. Burke
Australian Institute of Sport and
Australian Catholic University
Linda M. Castell
University of Oxford
Douglas J. Casa
University of
Connecticut
Graeme L. Close
Liverpool John
Moores University
Ricardo J. S. Costa
Monash University
Ben Desbrow
Griffith University
Shona L. Halson
Australian Catholic University
Dana M. Lis
University of California Davis
Anna K. Melin
Linnaeus University
Peter Peeling
The University of
Western Australia
Philo U. Saunders
Australian Institute of Sport and
University of Canberra
Gary J. Slater
Australian Institute of Sport and
University of the
Sunshine Coast
Jennifer Sygo
Athletics Canada
Oliver C. Witard
University of Stirling
Stéphane Bermon
International Association
of Athletics Federations and
Université Côte d’Azur
Trent Stellingwerff
Canadian Sport Institute –Pacific,
Athletics Canada, and
University of Victoria
The International Association of Athletics Federations recognizes the importance of nutritional practices in optimizing an Athlete’s
well-being and performance. Although Athletics encompasses a diverse range of track-and-field events with different performance
determinants, there are common goals around nutritional support for adaptation to training, optimal performance for key events, and
reducing the risk of injury and illness. Periodized guidelines can be provided for the appropriate type, amount, and timing of intake
of food and fluids to promote optimal health and performance across different scenarios of training and competition. Some Athletes
are at risk of relative energy deficiency in sport arising from a mismatch between energy intake and exercise energy expenditure.
Competition nutrition strategies may involve pre-event, within-event, and between-event eating to address requirements for
carbohydrate and fluid replacement. Although a “food first”policy should underpin an Athlete’s nutrition plan, there may be
occasions for the judicious use of medical supplements to address nutrient deficiencies or sports foods that help the athlete to meet
nutritional goals when it is impractical to eat food. Evidence-based supplements include caffeine, bicarbonate, beta-alanine, nitrate,
and creatine; however, their value is specific to the characteristics of the event. Special considerations are needed for travel,
challenging environments (e.g., heat and altitude); special populations (e.g., females, young and masters athletes); and restricted
dietary choice (e.g., vegetarian). Ideally, each Athlete should develop a personalized, periodized, and practical nutrition plan via
collaboration with their coach and accredited sports nutrition experts, to optimize their performance.
Keywords:performance supplements, RED-S, track and field
Burke and Slater are with the Australian Institute of Sport, Canberra, ACT, Australia. Burke is also with the Mary MacKillop Institute for Health Research, Australian
Catholic University, Melbourne, Victoria, Australia. Castell is with Green Templeton College, University of Oxford, United Kingdom. Casa is with the Korey Stringer
Institute, Department of Kinesiology, University of Connecticut, Storrs, CT, USA. Close is with the Research Institute for Sport and Exercise Sciences, Liverpool John
Moores University, Liverpool, United Kingdom. Costa is with the Department of Nutrition Dietetics & Food, Monash University, Melbourne, Victoria, Australia. Desbrow is
with the School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia. Halson is with the School of Behavioural and Health Sciences, Australian
Catholic University, Melbourne, Victoria, Australia. Lis is with the Neurobiology, Physiology and Behavior Department, University of California Davis, Davis, CA, USA.
Melin is with the Department of Sport Science, Linnaeus University, Växjö, Sweden. Peeling is with the School of Human Sciences (Exercise and Sport Science), The
University of Western Australia, Crawley, Western Australia, Australia. Saunders is with Performance Services, Australian Institute of Sport, Canberra, ACT, Australia; and
with the University of Canberra Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia. Slater is also with the School of Health and Sport
Sciences, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia. Sygo and Stellingwerff are with Athletics Canada, Ottawa, Ontario, Canada. Witard is
with the Physiology, Exercise and Nutrition Research Group, Faculty of Health Sciences and Sport, University of Stirling, United Kingdom. Bermon is with the Health and
Science Department, International Association of Athletics Federations, Monaco, Principality of Monaco; and LAMHESS, Université Côte d’Azur, Nice, France.
Stellingwerff is also with the Canadian Sport Institute—Pacific, Victoria, British Columbia, Canada; and the Department of Exercise Science, Physical & Health Education,
University of Victoria, British Columbia, Canada. Burke (Louise.burke@ausport.gov.au) is corresponding author.
1
International Journal of Sport Nutrition and Exercise Metabolism, (Ahead of Print)
https://doi.org/10.1123/ijsnem.2019-0065
© 2019 Human Kinetics, Inc. CONSENSUS STATEMENT
The sport of athletics (track and field) encompasses a wide
range of events involving running, walking, jumping, and
throwing, in which success is underpinned by a diversity of
physiological, psychological, and biomechanical attributes. Its
governing body, the International Association of Athletics Fed-
erations (IAAF), recognizes a number of distinct disciplines:
sprints, middle/long distance, hurdles, and relays on the track;
throws and jumps on the field; the combined events of heptathlon
and decathlon; road running; race walks; cross-country; and
mountain running and ultrarunning (www.iaaf.org). The term
“athlete”can be used as a generic description for any type of
sports person, whereas athletics is known as “track and field”in
North America: to avoid confusion, this statement will use the
terms Athletics and Athletes (with a capital “A”) to denote the
disciplines within the IAAF umbrella and their participants.
Despite the extreme range in the characteristics between and
within these disciplines, high-performance Athletes share some
common goals: to train as hard as possible with optimal adapta-
tion and recovery, to remain healthy and injury free, to achieve a
physique that is suited to their event, and to perform at their best
on the day(s) of peak competitions.
The IAAF has long recognized the role of diet and nutrition
strategies in helping the athlete to achieve these goals. In 1995, it
hosted the first meeting on nutrition for Athletics in Monaco,
followedbyanupdatein2007.Bothmeetingsledtoaconsensus
statement on the importance of nutrition in the preparation
for, and performance of, events in the track-and-field program
(International Association of Athletics Federations, 2007;
Maughan & Horton, 1995). These statements were underpinned
by review papers, published in special issues of the Journal of
Sports Science (13: [Suppl. 1] 1995 and 25: [Suppl. 1] 2007,
respectively). Other outputs from these meetings have included
booklets for Athletes and coaches, provided at major Athletics’
competitions and accessible via the IAAF communications link
(Maughan & Burke, 2012).
Knowledge and practice of nutrition evolve over time and
must be constantly updated and integrated into the Athlete’s
preparation. Indeed, in the decade since the last IAAF consensus
meeting, a range of new developments in sports nutrition has been
recognized globally by expert bodies such as the American
College of Sports Medicine, Academy of Nutrition and Dietetics,
and Dietitians of Canada (Thomas et al., 2016). In the light of
some profound changes, the IAAF has recently commissioned a
review of the current status of knowledge, attitudes/cultures,
practices, and opportunities for sports nutrition to be specifically
applied to events in Athletics. This consensus statement provides
a summary of the contemporary principles of sports nutrition,
identifying strategies that may be used by competitors in Athletics
to enjoy a long, healthy, and successful career in their chosen
event. The focus targets high-performance Athletes, while
acknowledging the needs of some special elite populations
(e.g., adolescents, females, masters) as well as the opportunity
for the many nonelite competitors who enjoy Athletics
(e.g., recreational marathon runners) to benefitfromanappropri-
ate translation of these principles into their own pursuits.
Recognizing the Special Issues of Event
Groups in Athletes
For the purposes of this summary, the IAAF disciplines in track and
field were divided into five event groups for individual review
(sprints, jumps/throws/combined events, middle distance, long
distance, and ultradistance/mountain running; Table 1). The con-
siderable heterogeneity of events present within each group is
acknowledged; nevertheless, this strategy achieves a pragmatic
balance between the need for efficiency and the challenge of
addressing unique and specific needs of each event. These reviews
were charged with summarizing key nutrition goals and concerns
within each event group, discussing novel aspects such as contem-
porary beliefs and dietary practices, identifying the scenarios in
which the rules or conditions of events assist or hinder the optimal
intake of nutrients, especially in the competition scenario, and
reviewing event-specific research on nutritional issues. The key
findings of these reviews are presented in Table 1.
Issues identified in the event group summaries are expanded in
this consensus statement below, and the special issue of the
International Journal of Sport Nutrition and Exercise Metabolism,
via the examination of 12 themes that provide a framework of
nutrition for Athletics and allow a more global understanding of the
recent changes in sports nutrition knowledge and practice. Con-
temporary sports nutrition should be underpinned by a recognition
that Athletes often share common goals (e.g., to meet the energy
and specific fuel requirements needed to support training and
competition); common challenges (to balance such intake against
the desire to manipulate body composition, while remaining free of
illness and injury); and common scenarios (e.g., periods of travel
away from their home base and its familiar food environment).
However, the specific features of each event, including optimal
physique, typical training protocols, competition characteristics,
and the parameters that limit performance, create differences in
nutritional requirements as well as the opportunities to address
them. The principles of sports nutrition for each event must be
further individualized and periodized for each Athlete, then im-
plemented via translation into practical eating practices and food
choices, and, sometimes, the judicious use of special sports pro-
ducts and supplements. Thus, Athletes and coaches are advised to
work collaboratively with sports science, medicine and nutrition
experts to develop a model that identifies where nutrition can
enhance event- and individual-specific performance, to refine this
model through experimentation and experience, and to achieve it in
real-life practice.
Theme 1. Periodization of Nutrition Strategies in the
Yearly Training Plan (Stellingwerff et al., 2019b)
Periodization is a cornerstone concept in training for Athletics
whereby the exercise load (mode, frequency, intensity, and
duration) is strategically manipulated within a sequence of
cycles to gradually achieve the physical, biomechanical, physi-
ological, neuromuscular, and psychological attributes needed for
success at chosen competition(s). It is self-evident therefore that
the Athlete’s dietary intake and nutrition strategies should be
continually changing to optimize the adaptive effects from
the ever changing training program. Although a repositioning
of the Athlete’s diet from static and universal, to changing and
individualized, was specifically targeted in the 2007 consensus
statement, there have been further developments in the principles
and practices around periodized nutrition since then. The over-
arching philosophy of periodized nutrition is that each training
session, micro-, meso-, and macro-cycle of training should be
analyzed in terms of how it addresses an individual Athlete’s
gaps to achieving the event specific attributes of success, with
nutrient intakes and dietary strategies being arranged around
(Ahead of Print)
2Burke et al.
International Journal of Sport Nutrition and Exercise Metabolism
Table 1 Common Characteristics of Different Event Groups in Athletics
Event group/key events Special features Key nutritional challenges Key nutritional strategies
Sprints
(Slater et al., 2019)
100 m, 100/110 m hurdles
200, 400, 400 m hurdles
4×100, 4 ×400 relays
•Performance determined pri-
marily by reaction time,
acceleration, maximum run-
ning velocity, and the ability
to sustain this in the presence
of increasing fatigue
•Large dependence on anaer-
obic energy generation
•Training typically involves
brief maximum intensity re-
petitions of varying length,
with either long or short
recovery periods, while com-
petition involves single efforts
through heats and finals
•Much greater metabolic de-
mands in training (via multi-
ple daily sessions) compared
with competition
•Power to weight needs to be
optimized rather than maxi-
mized. Currently, there are
insufficient morphological
data to provide detailed
guidance
•When contrasted against other
Athletes, relative energy and
macronutrient intake is lower
than in middle-distance and
long-distance Athletes.
•Nutrition strategies to amplify
training-induced adaptive
signals outside of protein
metabolism remain to be
explored
•Greater focus on training
nutrition given the metabolic
demands of training far
exceed those of competition
•Emphasis placed on the stra-
tegic timing of nutrient intake
before, during, and after
exercise to assist in optimiz-
ing training capacity, recov-
ery, and body composition
•Some evidence to support the
use of a small number of
supplements (e.g., caffeine
and creatine, plus beta-alanine
and bicarbonate for longer
sprints) to assist in the training
and/or competition
environment
Jumps/throws/combined
events
(Sygo et al., 2019)
Long, triple, high, pole
vault, shot put, hammer,
javelin, discus
Heptathlon and decathlon
•An emphasis on speed and
explosive movements along
with technical proficiency to
convert forward or rotational
movement into the highest
jump or longest jump or throw
•Wide ranging somatotypes
that share the commonality of
optimal strength–weight
ratios and Type II muscle fiber
typing
•Competition consists of short
repeated explosive bouts but
often includes prolonged time
in the field of play.
•The additional challenge of
counterbalancing speed/
power with middle-distance
aerobic/anaerobic bioenerget-
ics demands for combined
event Athletes
•Optimization of athlete body
mass, which varies widely by
event, with emphasis on
optimal power–weight ratio in
some events
•Recovery from training that
may result in substantial
muscle damage and neuro-
muscular fatigue
•Energy requirements that can
vary considerably between
peak training vs. competition
phase
•“Trade-offs”for combined
event Athletes of maintaining
a more powerful physique
suitable for shorter sprints and
throws vs. a lower body mass
for jumps and middle-distance
events
•Periodization of energy and
macronutrient intake to meet
training demands across the
yearly training plan and
competition cycle
•Appropriate use of ergogenic
aides, such as creatine, beta-
alanine, and/or caffeine, de-
pending on event, stage of
season, and performance
goals
•Periodized body composition
over the season, reaching peak
power–weight ratio for key
competitions
•Planning of nutrition and
hydration strategies to support
extended competition days,
often occurring in peak sun
and/or heat
Middle distance
(Stellingwerff et al., 2019a)
800/1,500 m
3,000 m steeplechase,
5,000 m
•Exceptional aerobic and
anaerobic bioenergetic devel-
opment, with emphasis on
sprint biomechanical/struc-
ture performance components
•Large dependence on exoge-
nous and endogenous buffer-
ing systems for performance
•Large individual and seasonal
diversity of training programs,
with large volumes during
general preparation phase, and
sprint-based workouts in the
competition phase
•2–3 races in major cham-
pionships with minimal days
for recovery between races
•Huge variability of training
throughout the season (large
differences in volume and
intensity) dictates very dif-
ferent caloric and macronu-
trient demands
•High-metabolic acidosis limits
performance
•Important of exceptional
power to weight ratios for
optimal competition perfor-
mance while staying healthy
in a structurally demanding
sport (risk of stress fractures)
•2–3 training bouts/day and 2–
3 races over several days in
major competitions require
optimized nutritional recovery
•Periodization of nutrition to
meet the demands of training
and competition volumes and
intensity to dictate caloric and
macronutrient requirements
•Potential use of exogenous
(sodium bicarbonate) and
endogenous (beta-alanine
leading to carnosine) buffer-
ing approaches
•Periodized approach to body
composition throughout the
yearly training plan to opti-
mize power–weight ratio for
targeted competition season.
•Optimized nutrition and fluid-
based recovery routines dur-
ing intensive training days and
competition periods
(continued)
(Ahead of Print)
Nutrition for Athletics 3
International Journal of Sport Nutrition and Exercise Metabolism
each period, from individual session to overall season, to con-
tribute to the changes that will address the Athlete’s long-term
goals. The diversity and complexity of the needs for success
across different Athletic events means that many models of
periodized nutrition are possible.
An illustration of periodized nutrition is provided in Figure 1
in relation to four different concepts: carbohydrate (CHO) fuel for
support and adaptation of “aerobic”events, protein for adaptation
and physique manipulation, special needs around micronutrient
support, and understanding the different roles of supplements for
training support and performance optimization. The first of these
concepts provides an example of an evolving subtheme in nutri-
tional periodization: Nutritional strategies employed to achieve one
goal might be contradictory for another. More specifically,
although proactive nutrient support directed at the specific factors
that limit performance is an important goal for competition and
performance-focused training sessions, in some cases, the deliber-
ate or accidental exposure to the absence of nutrient support can
accentuate adaptive responses to an exercise stimulus. This is
illustrated by robust evidence demonstrating that strategies which
provide high CHO availability enhance the performance of sus-
tained exercise conducted at intensities below the so-called anaer-
obic threshold. Yet, when such exercise is undertaken with low
CHO availability (particularly low muscle glycogen stores), there
is a further upregulation of the signaling pathways underpinning
various adaptive responses. The deliberate integration and
sequencing of adaptation-focused and performance-focused
nutrition strategies into an Athlete’s training program is a highly
individualized and specialized task that should involve the input
of Athlete, coach, and scientists specializing in nutrition, while
featuring continual modifications according to feedback and
experience.
Table 1 (continued)
Event group/key events Special features Key nutritional challenges Key nutritional strategies
Distance
(Burke et al., 2019)
10,000 m
Half marathon/marathon
20/50 km race walks
Cross-country
•Race times for elite performers
span ∼26 min–>4hr
•Elite performers typically
peak for two races/year
•Key factors for success are
high aerobic power, the ability
to exercise at a large fraction
of this power, and high
economy of movement
•High-volume training typi-
cally maintained
•High training volume requires
dietary energy and CHO sup-
port, especially for high
quality and race practice
workouts
•High power to weight ratio
(i.e., low body mass/fat con-
tent) associated with success
but poses another risk for low
energy availability.
•Race success requires high
availability of economical
CHO fuels
•Longer races permit within-
event intake of CHO and
fluid, but must be balanced
against time lost in obtaining/
consuming supplies from feed
zones and risk of gut upset
•Periodization of energy and
CHO intake according to
training volume and goals to
balance performance and
adaptation goals of each ses-
sion and cycle
•Periodization of body com-
position to balance health and
performance
•Race nutrition strategies to
meet event-specific CHO re-
quirements including appro-
priate pre-race glycogen
storage, within-event CHO
intake according to opportu-
nity to achieve muscle and
central nervous system bene-
fits
•Event-specific hydration plan
before and during race to find
individual balance between
rates of sweat loss and op-
portunities to drink
•Well practiced use of evi-
dence-based performance
supplements (e.g., caffeine)
Ultradistance and mountain
running
(Costa et al., 2019)
>Marathon distance:
self-sufficient, semisup-
ported, and full support
•Much longer race distances
(∼50–250 km than other
Athletics events; however,
conducted at much lower
intensities, across varied ter-
rain and surfaces (i.e., desert,
mountain, forest, jungle, arc-
tic)
•Large dependency of endog-
enous fat energy substrate but
requires a constant supply of
exogenous CHO energy sub-
strate for synergistic energy
provisions and prevention of
metabolic fatigue
•May include additional burden
of carrying day or self-suffi-
ciency pack
•Establishing the ideal power–
weight ratio for specific race
characteristics
•High training volumes and
quality running require suffi-
cient carbohydrates before,
during, and posttraining.
•High-risk events for promot-
ing fluid overload and exer-
cise-associated hyponatremia
•High prevalence of gastroin-
testinal symptoms, including
gradual development of food
and fluid intolerance as dis-
tance progresses
•Periodization of nutrition to
meet specific (i.e., terrain,
surface and environmental
conditions) training and
competition demands
•Ad libitum fluid intake for
protection against dehydra-
tion and overhydration.
Assess gastrointestinal toler-
ance to race food and fluid,
and adjust accordingly
•Practice race nutrition prior to
competition (i.e., train the gut)
Note. CHO = carbohydrate.
(Ahead of Print)
4Burke et al.
International Journal of Sport Nutrition and Exercise Metabolism
Theme 2. Energy Availability in Athletics: Managing
Health, Performance, and Physique (Melin et al.,
2019)
Dietary energy must meet the energy cost of an Athlete’straining
load and competition program as well as support the body’s
nonsport function/activities related to health and well-being.
The conventional interest in energy targets the concept of energy
balance where differences between dietary energy intake and total
daily energy expenditure create opportunities for changes in body
composition to store or utilize body fat and protein. This is
recognized as an important concept in Athletics since, at different
times in their sporting career or each annual training plan, many
Athletes deliberately manipulate both sides of the energy balance
equation to achieve physique changes that optimize performance
in their event (e.g., gain in body mass [BM]/muscle mass, loss of
BM/body fat). However, the contemporary concept of energy
availability examines energy intake in relation to the energy
that is left to address the body’s myriad nonexercise needs once
the energy expenditure committed to training and competition is
removed. Here it should be noted that, as the energy expenditure
associated with the Athlete’s prescribed training load is already
committed, an energy mismatch (i.e., initial energy deficit) leads
to an adjustment in expenditure on the nonexercise body functions
to conserve energy, with potential impact on health and perfor-
mance. Low energy availability (LEA) underpins the Female
Athlete Triad syndrome, but new insights over the last decade
have identified its occurrence in male Athletes and its impact on a
range of body systems and performance factors, beyond bone and
menstrual health. Thus, the concept of relative energy deficiency
in sport was developed to address this expanded range of con-
cerns, together with the sequelae of functional hypothalamic
amenorrhea (females), reduced testosterone levels and libido
(males), poor bone health, increased risk of illness and injuries,
gastrointestinal disturbances, cardiovascular disease, impaired
hematological, training capacity and performance. LEA is known
to occur in Athletics, and, although the highest prevalence appears
to be in the weight-sensitive endurance and jump events, all
Athletes may be at risk of its development via disordered eating,
misguided weight loss programs, and inadvertent failure to rec-
ognize or address increased energy expenditure associated with
training/competition. Preventive educational programs and
screening to identify Athletes with LEA/relative energy defi-
ciency in sport are important for early intervention to prevent
long-term secondary health consequences. Treatment for these
Athletes is primarily to increase energy availability and often
requires a team approach including a sports physician, sports
dietitian, physiologist, and psychologist.
Figure 1 —A theoretical model highlighting periodization considerations for three common nutrition interventions of CHO, PRO, and iron in relation
to the Athletics event performance determinants. CHO = carbohydrate; PRO = protein.
(Ahead of Print)
Nutrition for Athletics 5
International Journal of Sport Nutrition and Exercise Metabolism
Theme 3. Protein Needs for Adaptation and
Physique Manipulation (Witard et al., 2019)
Whether the recommended daily allowances for protein for the
general population, set at 0.8–1g/kginmostcountries,are
suitable for high-level Athletes has been a point of controversy
for many decades. It is only recently that there has been agree-
ment that allowances, which target the absence of protein insuf-
ficiency in largely sedentary populations, are not relevant to
competitive Athletes who need to optimize the adaptive response
to training and to achieve the physique attributes of lean mass to
body fat ratio needed for successful performance in their events.
There is now clear evidence of the benefits of consuming high-
quality proteins (those providing relevant amounts of all essential
amino acids) in a well-timed distribution over the 24-hr
period following key workouts or events; this promotes the
manufacture of new body proteins in response to the specific
training stimulus as well as replacing damaged ones. High-
quality protein-rich foods (high in leucine), when consumed in
amounts equivalent to ∼0.3–0.4 g/kg of rapidly digested protein
at four to five eating occasions per day, can optimize the training
response in Athletes with optimal energy availability. This target
probably should be increased to 0.4–0.5g/kginthecaseofmixed
meals that slow the protein digestion/absorption kinetics and
scenarios of energy deficit/weight loss in which rates of muscle
protein synthesis are suppressed. Overall, dietary protein intakes
of 1.3–1.7 g·kg
−1
·day
−1
represent optimal targets for the physique
and adaptation goals of weight-stable Athletes. Meanwhile,
Athletes who wish to achieve effective weight loss, which
promotes the retention or even an increase in lean mass, are
advisedtoengageinresistanceexercise and to consume dietary
protein in quantities of 1.6–2.4 g/kg. Protein-rich whole food
sources are the preferred source of protein due to cost, safety and
nutrient content. However, protein supplements may sometimes
provide a valuable option when it is impractical to transport,
prepare, or consume food sources of protein (e.g., immediately
postexercise). Table 2summarizes the current recommendations
for protein intakes for high-performance Athletes according to
their major goals.
Theme 4. Fluid Needs for Training, Competition,
and Recovery (Casa et al., 2019)
The past decade has seen controversy over guidelines for fluid
intake during sport. The best advice to enable adequate replacement
of sweat losses has been debated, as have the benefits/impairment
to performance associated with proactive or passive hydration
strategies. What is irrefutable is that the fluid needs of most
Athletes are determined by their reliance on the evaporation of
sweat to dissipate the heat produced during exercise or absorbed
from a hot environment. Athletics, probably more than any sport,
illustrates the futility of trying to apply a single set of guidelines for
behavior regarding fluid and electrolyte replacement around sport.
Not only is there great diversity in terms of sweat loss during
different Athletic events, but there are also differences in oppor-
tunities for fluid intake and the penalty for incurring a fluid
mismatch. At one end of the spectrum are events such as jumps
in which the risk of becoming dehydrated during an event is low
and where there may even be benefits to performance if a mild level
of hypohydration on competition day creates an increase in power–
weight ratios. Conversely, distance and ultradistance events are
associated with large rates and absolute volumes of sweat loss due
to sustained high-intensity exercise, prolonged duration, hot/humid
weather, or combinations of these three. However, opportunities
for fluid intake from aid stations or the Athletes’own supplies
range from minimal to excessive in comparison with sweat losses.
In the case of high-level competitors, at least, fluid intake during
continuous events needs to be balanced against the time lost in
drinking and the risk of gut upsets. Fluid losses equivalent to >2–
3% BM are typically associated with increases in perceived exer-
tion and reductions in plasma volume, cardiac, and thermoregula-
tory function and performance in warm–hot conditions. However,
the difficulty in drinking during some races means that the winners
(i.e., those who are most successful at maintaining an absolute
speed despite hypohydration) may incur fluid losses >5% of BM.
Advice for fluid intake for training and events in track and field
should encourage Athletes to understand the characteristics of their
event in terms of the likelihood of large sweat losses, the oppor-
tunities to replace these by drinking during the event, and the
Table 2 Guidelines for Protein Intake for Athletes
Current recommendations based on available evidence
1 The optimum daily protein intake for weight stable Athletes exceeds the protein RDA (0.8–1.0 g/kg BM/day) set for the general adult population.
2 The optimum daily protein intake for Athletes who have a goal of weight maintenance or weight gain ranges from 1.3 to 1.7 g/kg BM/day.
3 The optimum per meal/serving of protein for Athletes who have a goal of weight maintenance or weight gain ranges from 0.3 to 0.4 g/kg BM/
meal.
4 Very high protein intakes of >2.5 g/kg BM/day offer no adaptive advantage.
5 The optimum daily protein intake for Athletes who are undertaking high-quality weight loss exceeds 1.6 g/kg BM/day and may be as high as
2.4 g/kg BM/day.
6 Athletes who consume a high-protein diet (e.g., 2.4 g/kg BM/day) during weight loss are not at increased risk of kidney problems or poor bone
health.
Areas for future research
1 Event-specific protein needs in Athletics related to body composition manipulation.
2 Dose response of muscle protein synthesis to different protein-rich food sources and meals rather than isolated proteins (e.g., whey, soy)
3 Long-term benefits and/or protein needs of Athletes undertaken high-quality weight loss.
4 Individual variability in body composition responses to manipulation of dietary protein during weight loss in Athletes.
Note. RDA = recommended daily allowance; BM = body mass. High-quality weight loss is defined as the loss of fat mass while preserving, or even increasing, lean BM
(Witard et al., 2019).
(Ahead of Print)
6Burke et al.
International Journal of Sport Nutrition and Exercise Metabolism
consequences of being hypohydrated. It may be possible and useful
to drink to the dictates of thirst when sweat losses are low and the
opportunities to drink are plentiful. However, other circumstances
require a proactive plan, that is, when performance is affected by
hypohydration and the likelihood of large losses is matched with
fewer opportunities for hydration. In very hot and/or humid en-
vironments, such as may be encountered in high-level competition
(e.g., 2019 IAAF World Championships in Doha or 2020 Tokyo
Olympic Games), strategies for hyperhydration and precooling
prior to events may provide an additional advantage. Table 3
summarizes some of the events in Athletics in which within-
race fluid plans may be beneficial. All strategies should be well
practiced in training and fine tuned for the specific event. In the case
of Athletes who undertake distance and ultradistance events at
slower paces with lower sweat rates, specific advice against over-
consuming fluids may be necessary to avoid the problems
associated with hyponatremia (low blood sodium levels, usually
due to excessive fluid intake). In some scenarios where large sweat-
associated electrolyte losses occur, replacement of electrolytes,
particularly sodium, may be beneficial in within and postexercise
plans; this may be achieved via the use of whole foods or sports
food/supplement choices.
Theme 5. Competition Fuel Needs for Longer
Events (Burke et al., 2019;Costa et al., 2019)
Most of the power used in long and ultradistance events is provided
by oxidative fuel-generating pathways. As CHO is a more eco-
nomical fuel source than fat (i.e., it produces great amounts of
adenosine triphosphate for a given amount of oxygen) and can
produce adenosine triphosphate via oxygen-independent path-
ways, it becomes the dominant fuel source at higher intensities.
Table 3 Nutritional Strategies for CHO and Fluid Intake Before and During Distance and Ultrarunning Events in
Athletics
Issue and general
guidelines 21.1-km half marathon 20-km race walk 42.2-km marathon 50-km race walk Ultramarathon
Pre-race refueling:
•Normalization of
glycogen =
7–12 g/kg/day for 24 h
•CHO loading =
10–12 g/kg/day for
36–48 h
Glycogen normalization Accentuated glycogen
normalization
CHO loading, especially
with low-residue diet
CHO loading,
especially with
low-residue diet
CHO loading especially
with low-residue diet
and removal of foods
known to cause gut
issues
Pre-race meal:
•1–4 g/kg CHO in
1–4 h pre-race
•Reduced fat, fiber, and
protein according to
risk of gut issues
Familiar pre-race meal +
CHO after warm-up
Familiar pre-race meal
+ CHO after warm-up
Familiar pre-race meal +
CHO after warm-up
Familiar pre-race
meal + CHO after
warm-up
Familiar pre-race meal
+ CHO after warm-up
Opportunities for
in-race nutrition:
(availability of drink
stations)
Typically every 5 km in
elite races
Frequency differs in large
city races
Every lap of 2 km loop
course (sometimes
course = 1 km loop)
Typically every 5 km in
elite races. Frequency dif-
fers in large city marathons:
may be every 1–2 miles
Every lap of 2 km
loop course
Ranges from fully or
semisupported to
requiring runner to
carry own supplies
In-race fueling goals:
•45–75 min: mouth
rinse/small CHO
amount
•1–2.5 h: 30–60 g/h
•>2.5 h: up to 90 g/h
Trial CHO mouth rinse up
to intake of 30–60 g from
CHO drinks or gels/
confectionery
Trial CHO mouth rinse
up to intake of 30–60 g
from CHO drinks or
gels/confectionery
30–60 g/hr CHO; Consider
trialing intakes up to 90 g/hr
from mix of CHO drinks
and more concentrated
gels/confectionery
Target 60–90 g/hr
from mix of CHO
drinks or concen-
trated gels/
confectionery
Target 30–90 g/hr ac-
cording to needs (rate of
CHO use decreases
with slower pace of
longer races) and what
is tolerated/practical
In-race hydration goals:
•Aim to keep net fluid
deficit <2–3% BM,
especially in hot
weather
Cost–benefit analysis may
show that time cost of
drinking may negate
benefits in elite runners
Drink stations allow
plentiful opportunities
for frequent small in-
takes of CHO contain-
ing fluid toward a race
plan
Fast runners will find it
difficult to drink large
volumes
Drink stations
allow plentiful
opportunities for
frequent small
intakes of CHO
containing fluids
within the race plan
BM changes less likely
to reflect true fluid def-
icit. Lower sweat rates
with slower pace in
longer races might
mean drinking to thirst
may underpin race plan
Special issues for hot
weather events
Consider pre-cooling with ice slurry in addition to external cooling strategies if significant thermal challenge is anticipated
Consider pre-race hyperhydration if large fluid deficit is anticipated
Adjust fluid intake during event where possible in view of increased sweat losses. Be aware of sweat rates for an array of
environmental conditions so that rehydration plans can be individualized and rehearsed prior to the event
Special comments for
nonelite or slower
competitors
Do not overdrink by consuming fluid in excess of sweat losses. A good tip is to avoid drinking beyond thirst cessation if not
aware of individual fluid needs
Note. BM = body mass; CHO = carbohydrate (Burke et al., 2019;Casa et al., 2019;Costa et al., 2019).
All strategies should involve a personalized and well-practiced plan that is suited to the specific needs of the events. General guidelines can be found in more detail in
the guidelines by Thomas et al. (2016).
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International Journal of Sport Nutrition and Exercise Metabolism
The depletion of the body’sfinite CHO stores can be a limiting
factor in the performance of distance and ultradistance events, and
strategies that increase CHO availability to meet their fuel demands
are associated with performance enhancement. Such strategies
including CHO intake during the days prior to the event to
normalize or supercompensate muscle glycogen stores, CHO
intake in the pre-race meal to restore liver glycogen after overnight
fasting, and the intake of CHO during the event. Table 3sum-
marizes guidelines for strategies that are commensurate with the
demands of different events on the Athletics program, as well as the
opportunities to achieve feeding during a race. Contemporary
evidence regarding events of over 90 min in duration indicates
that within-race CHO becomes more important in supplying
substrate to the muscle and brain as endogenous supplies dwindle;
indeed, with races of >2 hr, higher CHO intakes (e.g., up to 90 g/hr
from mixed CHO sources) are often associated with larger perfor-
mance benefits. However, with the longest ultraendurance events,
realistic/optimal rates of intake may start to scale down due to
reduced fuel needs at lower exercise intensities, the logistics of
gaining access to such supplies, and the increasing importance of
managing gastrointestinal comfort and function during the race.
Although the role of within-race CHO intake as additional
substrate for the muscle and brain has been understood for nearly a
century, there is now evidence that CHO consumed during exercise
can provide an additional performance benefit via central (brain/
nervous system) effects. More specifically, CHO intake can stim-
ulate areas of the brain that control pacing and reward systems via
communication with receptors in the mouth and gut. This “mouth
sensing”of CHO provides another reason for frequent intake of
CHO during longer events (Table 3) as well as some of the shorter
events in which it may not be necessary to provide muscle fuel
(e.g., half marathon, 20-km race walk). All strategies used during
races should be personalized to the event and the individual: they
should be well practiced and able to be achieved within the event
logistics which include considerations of supply, consumption
while running/walking, and gut comfort.
Meanwhile, there is interest in nutritional strategies including
chronic or periodized exposure to high-fat, low-CHO diets that
may allow Athletes in ultraendurance (>4 hr) events to increase
their ability to oxidize fat as a muscle fuel in view of its relatively
unlimited pool size and capacity to support exercise at intensities
up to ∼75–80% VO
2
peak. However, it should also be noted that
most ultramarathon runners already have a high capacity for fat
oxidation, regardless of dietary background. Furthermore, although
targeted adaptation to a high-fat diet with CHO restriction is
associated with very high rates of fat utilization across a range
of exercise intensities, this comes at a cost of a greater oxygen
demand during exercise (lower speed for a given oxygen supply or
greater oxygen requirement for the same speed) as well as a
downregulation of the capacity of CHO oxidation pathways.
Such adaptations have been shown to impair performance of races,
or selected segments within a longer race conducted at higher
exercise intensities (>80–85% VO
2
peak), probably limiting the
utility of high-fat, low-CHO diets to selected individuals, events, or
scenarios.
Theme 6. Staying Healthy (Castell et al., 2019)
The physiological, metabolic, and psychological stresses involved
in training and competition may be linked to immune dysfunction,
inflammation, oxidative stress, and muscle damage. Physically
demanding bouts of exercise reduce the metabolic capacity of
immune cells, with this transient immunodepression lowering the
resistance to pathogens and increasing the risk of subclinical and
clinical infection and illness. Indeed, early studies reported a high
incidence of postexercise upper respiratory tract illness among
marathon and ultramarathon runners, especially among the faster
runners and those with greatest training volumes. Illness surveys
conducted at major competitions have reported high levels of upper
respiratory tract illness among Athletes within mixed sport events
(e.g., the London Olympic Games), while among Athletics groups
at IAAF World Championships females and endurance Athletes
reported the highest incidence of illness.
Optimizing training load management (e.g., excessively large
training volumes and/or sudden changes in training) plays a major
role in reducing the incidence of illness. Illness interferes with
training consistency and can directly affect performance for several
days if it occurs during competition. Athletes who start an endur-
ance event with systemic acute illness symptoms are two to three
times less likely to finish the race. Other factors to be considered
include high levels of depression/anxiety, long-haul flights, winter
competitions, lack of sleep, and LEA.
Immunonutrition may help to combat exercise-induced im-
munodepression, with important considerations including energy
availability and adequate intakes of protein, CHO, fatty acids, and
micronutrients (iron, zinc, magnesium, and Vitamins A and D).
Traveler’s diarrhea is a frequently reported illness among
Athletes who travel across multiple time zones and continents to
train or compete in remote countries. Pathogens vary from country
to country but contamination of food and water by Escherichia coli
is a frequent cause, while Norovirus and Rotavirus are the most
frequently reported, and highly contagious, viruses. Although
recovery may occur within a couple of days, an infectious episode
may seriously impair the Athletes’ability to train or compete. The
effectiveness of precautions around food and water management in
high-risk areas is unclear; nevertheless, it makes sense to avoid
unsafe drinking supplies or foods (see Table 4). An illness preven-
tion program should be implemented, requiring coordinated
involvement of medical staff, coaches, and Athletes, focusing
on preventative precautions for high-risk individuals, with isolation
and appropriate treatment of team members who are ill.
Athletes may experience various gastrointestinal problems
during exercise, with the main complaint being diarrhea known
as “runner’s diarrhea.”During running or racewalking, reduced
splanchnic blood flow is sometimes associated with reperfusion,
creating intestinal barrier function loss, increased permeability and
bacterial translocation. Aggravating factors include a hot environ-
ment, consumption of nonsteroidal anti-inflammatory medicines,
long duration or high-intensity exercise and, potentially, the jarring
action of running. Nutritional factors include high dietary intakes of
fiber, intakes of fructose, and other fermentable CHO sources
(known as FODMAPS [fermentable oligosaccharides, disacchar-
ides, monosaccharides, and polyols]) in susceptible individuals, the
use of bicarbonate or caffeine as performance supplements, and
within race intake of drinks of high CHO content and osmolality.
The stomach and gut can possibly be trained to improve tolerance,
gastric emptying, and absorption during exercise. Other strategies
to reduce gut problems include the removal of problem foods in
susceptible people.
Iron status is an important factor in health and performance,
but compromised iron status is a common occurrence among
endurance Athletes, particularly females. This occurs due to factors
from both exercise (e.g., hemolysis and alterations to the iron
regulatory hormone hepcidin) and nonexercise origin (e.g.,
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8Burke et al.
International Journal of Sport Nutrition and Exercise Metabolism
inadequate iron intake, heavy menstrual blood losses). Routine
screening of iron status according to standardized protocols and
treatment of suboptimal iron stores is recommended. Options
include dietary counseling to improve iron intake, oral iron supple-
ments and, in the case where the athlete is unresponsive or where
faster approaches are needed, an intramuscular or intravenous
supplement. These latter options must only be undertaken in a
medical setting under the supervision of a physician. Strategies to
address issues of illness in athletes are summarized in Table 4.
Theme 7. Preventing and Treating Injuries (Close
et al., 2019)
Injuries are an inevitable consequence of participation in high-level
Athletics with most competitors sustaining one or more during their
athletic careers. This can directly affect performance if it occurs
during a major competition, as well as have indirect effects on
performance due to interrupted training. Injuries to skeletal muscle
account for over 40% of all injuries with the lower leg being the
predominant injury site. Other common injuries include fractures,
especially stress fractures in Athletes with LEA, and injuries to
tendons and ligaments, especially those involved in high-impact
sports such as jumping. Given the high prevalence of injury in
Athletes, it is not surprising that there has been a great deal of
interest in factors that may reduce the injury risk or that decrease
the recovery time should an injury occur.
Low energy availability is known to be a major risk factor in the
development of bone stress fractures and should be corrected in both
the prevention and treatment of such problems. Attention to Vitamin
D status and intake of protein and calcium may also be of value.
Nutrition goals during the rehabilitation of muscular injuries include
adjustment to new energy requirements and distribution of daily
Table 4 Strategies to Promote Athlete Health
Training and competition load management
•Develop detailed and personalized training and competition
plans, which promote adequate recovery using sleep,
nutrition, hydration, and psychological strategies
•Use small increments when changing training loads (typi-
cally <10% weekly)
•Develop competition calendar based on the Athletes’health
•Monitor for early signs and symptoms of overreaching,
overtraining, and illness
•Avoid intensive training when experiencing illness or early
signs and symptoms
Hygienic, lifestyle, and behavioral strategies
•Maintain appropriate vaccination schedule for home (e.g., annual flu
vaccine) and travel (recommended protocols for foreign countries)
•Minimize general exposure to pathogens by avoiding close contact with
infected individuals in crowded spaces and avoiding the sharing of drinking/
eating implements and personal items
•Establish good hygiene practices that limit hand to face contact, including
regular and effective hand washing and capturing sneeze/cough expectorant
in the crook of the elbow
•In group situations (e.g., travel, communal living) encourage Athletes/
entourage to report illness symptoms at an early stage to allow expedited
isolation of persons with potentially infectious illnesses
•Implement practices that limit all infection types including safe sex/condom
use, insect repellant and skin coverage strategies, and protection against skin
infections in public places
•Facilitate regular, high quality sleep
•Avoid excessive alcohol intake
Psychological load management
•Follow stress management techniques to reduce the extra-
neous load of life hassles and stresses
•Develop coping strategies to minimize internalized impact
of negative life events and emotions
•Periodically monitor psychological stresses using available
instruments
Nutritional strategies
To promote general immune health:
•consume well-chosen diet with adequate energy availability and nutrient
provision
To minimize traveler’s diarrhea:
•drink only safe fluids: hot drinks made from boiled water, cold drinks from
sealed bottles
•avoid high-risk foods, for example, unpeeled fresh fruit and vegetables,
buffet meals that have been standing without precise temperature and
hygiene control, undercooked meat, street vendors’foods
To minimize runner’s diarrhea in susceptible individuals:
•avoid poorly tolerated nutrients/ingredients in pre-exercise meals; these may
include fiber, fat, protein, fructose, and caffeine or bicarbonate supple-
mentation
•experiment with the type and amount of drinks/sports foods/foods consumed
during longer sessions or races to develop a protocol that can be tolerated
with practice
•with Irritable Bowel Syndrome, trial the avoidance of fermentable oligo-
saccharide, disaccharide, monosaccharide, polyol carbohydrates in some
foods
To maintain adequate iron status:
•include iron-rich foods in the diet (e.g., red meats, nuts, seeds and fortified
cereals, leafy green vegetables, legumes, etc) and use strategies to enhance
bioavailability (mixing plant iron sources with Vitamin C or animal iron
sources)
•check iron status regularly if in high-risk group for suboptimal iron status
(females, endurance Athletes, and vegetarians)
•To treat deficiency or suboptimal status, use intravenous or intramuscular
iron supplements but only under medical supervision
Note. Adapted from Castell et al. (2019).
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Nutrition for Athletics 9
International Journal of Sport Nutrition and Exercise Metabolism
protein intake to minimize loss of lean mass and increase muscle
repair. The prevention and treatment of injuries to tendons and
ligaments are an area of recent active research with initial data on the
role of nutritional support from collagenous proteins and micronu-
trients (e.g., Vitamin C, copper) showing potential benefits.
Theme 8. Supplements and Sports Foods (Peeling
et al., 2019)
Athletes represent an enthusiastic audience for the numerous supple-
ments and sports foods that are marketed with often questionable
claims of optimizing health, function, and performance. Although a
“food first”philosophy is promoted in relation to nutritional needs,
medical supplements may be used under supervision to treat or
prevent nutrient deficiencies (e.g., iron deficiency, see Theme 6),
while sports foods may assist the Athlete to meet their nutritional
goals or nutrient targets in scenarios where it is impractical to eat
whole foods. The majority of performance products lack evidence to
support their efficacy. However, five evidence-based performance
supplements (caffeine, creatine, nitrate/beetroot juice, beta-alanine,
and bicarbonate) may contribute to performance gains, according to
the event, the specific scenario of use and the individual Athlete’s
goals and responsiveness (Table 5). Specific challenges include
developing protocols to manage repeated use of performance supple-
ments in multi-event or heat final competitions or the interaction
between several products that are used concurrently. Potential dis-
advantages of supplement use include expense, false expectancy, and
the risk of ingesting substances banned under the World Anti-Doping
Agency’s List, which are sometimes present as contaminants or
undeclared ingredients. However, major organizations and expert
bodies now recognize that a pragmatic approach to supplements and
sports foods is needed in the face of the evidence that some products
(previously mentioned) can usefully contribute to a sports nutrition
plan and/or directly enhance performance. We conclude that it is
pertinent for sports foods and nutritional supplements to be consid-
ered only where a strong evidence base supports their use as safe,
legal, and effective, and, moreover, that such supplements are
trialed thoroughly by the individual before committing to using
them in a competition setting. Table 5provides a summary of
performance supplements that might be of value in different events
in Athletics, as well as evidence-based uses of medical supplements
and sports foods.
Theme 9: Special Environments: Altitude and Heat
(Saunders et al., 2019)
High-level Athletes are often required to compete in environments
(e.g., hot weather, altitude) that reduce performance. Furthermore,
in the continual search for ways to optimize competition perfor-
mance in normal conditions, it has become popular to train in such
challenging/altered environments to increase the adaptive stress.
Indeed, this may be further potentiated by associated nutrition and
hydration interventions. Although altitude training was first used
to prepare for competition in a similar environment (e.g., 1968
Mexico City Olympic Games), it is now more routine for elite
Athletes to undertake a series of altitude training camps to improve
their sea-level performance. Similarly, the use of heat acclimation/
acclimatization to optimize performance in hot/humid environ-
mental conditions (e.g., 2019 IAAF Doha World Championships)
is a common and well-supported practice. However, the use of heat
training to improve exercise capacity in temperate environments is
a more recent theme that may produce positive outcomes. When
Athletes expose themselves to blocks of training with either or
both environmental challenges, it is important to provide ample
dietary support to optimize training quality and the resultant
adaptive responses. For example, LEA, poor iron status, and
illness are known to attenuate the response to altitude training
and should be addressed prior to the training block. In addition, the
special or additional nutrition needs of the training block
(e.g., increased energy and CHO utilization or fluid losses) due
to the environment or changed training load should be recognized
and addressed.
Table 5 Performance Supplements and Sports Foods That May Achieve a Marginal Performance Gain in Athletics
Events as Part of a Customized and Periodized Training and Nutrition Plan
Event Caffeine Creatine Nitrate Beta-alanine Bicarbonate Sports foods
100/200 m + 100/110 m
hurdles, 4 ×100 m relay
✓✓ Sports drinks
•Can be used to achieve hydration and fuel
strategies around longer/high-quality training
sessions and longer races
Electrolyte supplements
•Can be used to achieve (re)hydration goals by
replacing electrolytes lost in sweat
Sports gels/confectionery
•Can be used to achieve fueling strategies
during longer training sessions/races
Protein supplements
•Can provide a convenient source of quickly
digested, high-quality protein when it is
impractical to eat food
Liquid meals
•Can provide a convenient source of carbo-
hydrate, protein, and nutrients when it is
impractical to eat food
400 m + 400 m hurdles
4×400 m relay
✓✓ ✓ ✓
800 m ✓✓✓ ✓ ✓
1,500 m + 3,000 m steeplechase ✓✓✓✓
3,000 m steeplechase ✓✓✓✓
5,000/10,000 m, cross-country ✓✓
20/50 km race walk
Half marathon/marathon
✓✓
Mountain/ultrarunning ✓✓
Jumps (long, high, triple, and
pole vault)
✓✓
Throws (discus, hammer, jave-
lin, and shot put)
✓✓
Heptathlon and decathlon ✓✓✓ ✓ ✓
Note. Readers are referred to Burke et al. (2019), Costa et al. (2019), Slater et al. (2019), Stellingwerff et al. (2019a), Sygo et al. (2019).
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10 Burke et al.
International Journal of Sport Nutrition and Exercise Metabolism
Theme 10. Special Populations: Young, Female and
Masters Athletes (Desbrow et al., 2019)
Adolescent, female, and masters Athletes have unique nutritional
requirements as a consequence of undertaking daily training and
competition in addition to the specific demands of age and sex-
related physiological characteristics. Dietary education and recom-
mendations for these special populations require a focus on eating
for long-term health, with particular consideration given to “at risk”
dietary patterns and nutrients (e.g., sustained periods of restricted
eating, low calcium, Vitamin D and/or iron intakes relative to
increased requirements). Recent research highlighting strategies to
address age-related changes in protein metabolism and the devel-
opment of tools to assist in the management of relative energy
deficiency in sport are of particular relevance to Athletes in these
special populations. Whenever possible, young Athletes should be
encouraged to meet their nutrient needs by the consumption of
whole foods rather than supplements, as the recommendation of
dietary supplements to this population overemphasizes their ability
to manipulate performance in comparison with other training/
dietary strategies.
Theme 11. Special Needs for Travel (Halson et al.,
2019)
Domestic and international travel represents a regular challenge to
high-performance Athletes, particularly when associated with the
pressure of competition or the need to support specialized training
(e.g., altitude or heat adaptation). Jetlag is a challenge for trans-
meridian travelers while fatigue and alterations to gastrointestinal
comfort are associated with many types of long haul travel.
Planning food and fluid intake that are appropriate to the travel
itinerary may help to reduce problems. Resynchronization of the
body clock is achieved principally through manipulation of zeit-
gebers such as light exposure and the typical timing of meals. More
investigation of the effects of melatonin, caffeine, and the timing/
composition of meals will allow clearer guidelines for their contri-
bution to be prepared. At the destination, the Athlete, the team
management, and catering providers each play a role in achieving
eating practices that support optimal performance and success in
achieving the goals of the trip. Best practice includes pretrip
consideration of risks around the quality, quantity, availability,
and hygiene standards of the local food supply and the organization
of strategies to deal with general travel nutrition challenges as well
as issues that are specific to the area or the special needs of the
group. Management of buffet style eating, destination-appropriate
protocols around food/water and personal hygiene, and arrange-
ment of special food needs including access to appropriate nutri-
tional support between the traditional “3 meals a day”catering
schedule should be part of the checklist.
Theme 12. Special Diets: Vegetarians, Food
Intolerances, and Fasting (Lis et al., 2019)
Some Athletes implement special diets in accordance with their
culture or beliefs or with a specific aim to improve health and/or
performance. Four diets of contemporary interest are: vegetarianism;
diets with low fermentable oligosaccharides, disaccharides, mono-
saccharides, and polyols; gluten-free eating; and fasting. An
evidence-based approach to any diet is recommended to minimize
the risks associated with unnecessary dietary restriction, which may
potentially do more harm than good. Gluten-free diets and low
fermentable oligosaccharides, disaccharides, monosaccharides, and
polyols diets have emerged as novel regimens thought to improve
gastrointestinal health and reduce the risk of exercise-associated
gastrointestinal symptoms. No direct benefits have been associated
with the avoidance of gluten by clinically healthy athletes. However,
a gluten-free diet is associated with other dietary changes, particu-
larly a reduction in fermentable oligosaccharides, disaccharides,
monosaccharides, and polyols, for which emerging evidence sug-
gests a potential improvement in adverse gastrointestinal symptoms.
Vegetarian diets can theoretically support athletic demands, but
special attention and good planning are required to ensure adequate
intake of energy and specific nutrients that are less abundant or less
well absorbed from plant sources (e.g., iron). Finally, intermittent
fasting is a long-standing concept, undertaken on an obligatory basis
(e.g., Ramadan fasting), or a voluntary pattern (e.g., time-restricted
feeding, intermittent energy-restricted days) in search of putative
health or body composition benefits. Strict obligatory fasting is
likely to require the implementation of tailored nutrition strategies to
help Athletes cope with their sports-related demands. Overall, a
multitude of factors influence adherence to special diets. Even when
adherence to a special diet is a necessity, education and advice from
an accredited dietitian/nutritionist are recommended to allow the
Athlete to integrate nutrition strategies for optimal health and
performance.
Conclusions
The IAAF recognizes that the Athlete’s well-being, performance, and
recovery from sporting activities are enhanced by well-chosen nutri-
tion strategies. Although Athletics encompasses a diverse range of
events with different requirements for success, there are common
goals around nutritional support for adaptation to training, optimal
training performance, and remaining at low risk of injury and illness.
This includes guidelines for the appropriate type; amount; and timing
of intake of food, fluids, and occasionally, some supplements and
sports foods, to promote optimal health and performance across
different scenarios of training and competition. Ideally, Athletes
should develop a personalized, periodized, and practical nutrition
plan via collaboration with their coach and sports science/medicine
team, including accredited sports nutrition experts.
Acknowledgments
All authors contributed material to the preparation of this manuscript.
The authors declare no conflicts of interest in the preparation of this
review. We wish to acknowledge the contribution of our colleagues to the
preparation of the material in this consensus statement. We thank Keith
Baar, Ingvill Bovim, Nicholas Burd, Robert Chapman, Sam Cheuvront,
Olivier De Hon, Wim Derave, Kirsty Elliott-Sale, Stuart Galloway, Ina
Garthe, Laura Garvican-Lewis, Ida Heikura, Martin Hoffman, Asker
Jeukendrup, Andrew Jones, Majke Jorgensen, Alice Kendig Glass, Sophie
Killer, Daniel King. Beat Knechtle, Enette Larsen-Meyer, Daniel Moore,
Martin Mooses, James Morton, Margo Mountjoy, David Nieman, Jeni
Pearce, Julien Periard, Stuart Phillips, Craig Sale, Susan Shirreffs, Mark
Tarnopolsky, Adam Tenforde and Jamie Whitfield for their expertise and
assistance in undertaking this project.
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