Nutrition Issues in Underperforming Athletes, Part II

author : Nancy Clark
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Learn more about protein intake, iron, post exercise food, recovering with carbs and protein, rest days, fluids and sodium.

The Athlete’s Kitchen
Copyright: Nancy Clark MS RD CSSD October 2008

In Part I of this article, I discussed five common missing nutrition links that hurt athletic performance:

  1. Respect for the power of food.

  2. Sufficient calories during the active part of the day.

  3. Equal sized, evenly scheduled meals.

  4. A beneficial intake of dietary fat.

  5. Pre-exercise fuel.

Here are six more missing links, with solutions to help you eat to win.

MISSING LINK #6: Beneficial protein intake
Some athletes eat too little protein; others eat too much. For example, a 150 lb (68 kg) athlete may need 0.5-0.75 g pro/lb (1-1.5 g pro/kg); this translates into about 75-105 g pro/day. This athlete can easily consume too much protein if the foundation of the menu is:

Breakfast:          6 egg whites 18 g protein
Lunch:                   1 can tuna 35 g
Snack:               1 protein bar 20 g
Dinner:       2 chicken breasts 90 g
                              16 oz milk 16 g
                                   Total: 179 grams

One hundred seventy nine grams of protein is excessive, to the point some of the protein could be wisely traded for more carbs to better fuel the workouts. In contrast, a vegetarian athlete on a reducing diet could easily underconsume protein if foundation of the menu is:

Breakfast:               2 egg whites 7 g protein
Lunch:  salad w/ 1/4 c. chickpeas 3 g
Dinner:              1 garden burger 11g
                                           Total: 21grams
Too little protein contributes to poor recovery, muscle wasting, and suboptimal results from hard training.

Solution: By meeting with a sports dietitian, you can learn your protein requirement and how to translate that into food.

MISSING LINK #7: Iron to prevent fatigue from anemia
Iron-deficiency anemia is common, particularly in females. Anemia causes needless fatigue and reduced performance. A survey of collegiate athletes indicates 20% of the female volleyball and basketball players were anemic, as were 50% of the soccer team. Yikes! (1) Anemia is particularly common among women who have heavy menstrual blood losses, but eat neither red meat nor iron-enriched breakfast cereal.

Solution: If you feel needlessly tired, get your blood tested by your MD, and be sure to get your serum ferritin measured. To help prevent anemia, strive to eat an iron-rich diet:

  • red meat, or iron-rich alternatives (dark-meat chicken or turkey, salmon, tuna)

  • iron-fortified cereals (Wheaties, Raisin Bran, Total)

To enhance iron absorption, include with each meal a source of vitamin C, such as orange juice, berries, broccoli, tomato, and other fruits and vegetables.

MISSING LINK #8: Post-exercise food.
At the end of a hard workout, you haven’t finished your training until you have refueled! Don’t rush off to work or school, with “no time to eat” as the excuse.

Solution: Plan ahead, so you have recovery foods readily available. Even in a time-crunch, you should be able refuel your muscles properly. “No time” is no excuse.

MISSING LINK #9: Recovering with both carbs + protein
Recovery foods should offer a foundation of carbs with protein as the accompaniment. A reasonable target is about 240 calories of carbs (60 g carb) and about 80 calories (20 g) of protein. Some popular choices include Greek yogurt with honey, chocolate milk, cereal with milk, and pasta with meat sauce. You need not buy engineered recovery foods; standard fare works fine!

Note that recovery foods can be eaten pre-exercise. That is, a pre-exercise yogurt gets digested into amino acids and glucose; those food components will be ready and waiting to be put into use when you stop exercising. In a 10-week study with recreational body builders, those who consumed a protein-carb supplement both immediately before and right after the mid-afternoon strength training session gained 2.3 pounds more muscle and 7 pounds more in strength (as measured by bench press), compared to the group without the pre- and post-exercise fuel. (2)

Athletes who do two workouts a day really need to rapidly refuel with a proper recovery diet. A six-week study with swimmers reports those who did two workouts (morning and afternoon) sprinted slower than those who swam only in the afternoon (3). If nutrition is your missing link, don’t even think about double workouts!

Solution: You may not feel hungry for solid foods after a hard bout of exercise, but you are likely thirsty. A fruit smoothie (made with yogurt) is excellent for recovery, as is a chug of chocolate milk. Both contain carbs to refuel, and protein to build/repair muscles and reduce muscle soreness.

MISSING LINK #10: Rest days for muscles to refuel
Rest is an important part of a training program; muscles need time to refuel and heal. Depleted muscles may need more than 24 hours to replace glycogen stores. Hence, rest days with little or no exercise enhance a training program.
Athletes who want to lose weight commonly hesitate to take a rest day; they fear they will “get fat.” These athletes need to understand:

  1. On a rest day, they will feel just as hungry because the muscles need food to refuel.

  2. They will gain (water) weight. For each 1 ounce of glycogen, the muscles store about 3 ounces water. This water gets released during exercise; it is beneficial.

Solution: Plan one to two rest days a week. Notice how much better you are able to perform the day after a rest day.


MISSING LINK #11: Adequate Fluids
Athletes who stay well hydrated can train harder and perform better. For each one percent of body weight lost via sweat, your heart has to beat 3 to 5 more times per minute (4); this creates needless fatigue!

Solution: If you are well hydrated, you will need to urinate every 2 to 4 hours, and your urine will be a light color. If you are sweat heavily, you really should learn how much sweat you lose (and thereby need to replace) during a workout. Do this by weighing yourself naked before and after exercise. For each pound (16 oz) of sweat, you should drink at least 16 to 24 oz. fluid.

MISSING LINK #12: Sodium before exercise in the heat.
Research with trained cyclists reports they rode 20 minutes longer to exhaustion (99 vs. 79 minutes) in 90°F (32° C) heat when they drank a pre-ride beverage with about 1,000 vs. 150 mg sodium. They drank no fluids while riding. (5)

Solution: If you train and compete in the heat, you should consume salty foods beforehand. This holds water in your body and reduces your risk of becoming dehydrated.

MISSING LINK #13: The Sports Dietitian (RD, CSSD)
Serious athletes generally have a support crew that includes a coach, sports psychologist, medical doctor, physical therapist and massage therapist. But to their detriment, some fail to have a sports dietitian on their team. Don’t let that be your case!

Solution: To get the most from your workouts, use the referral network at to find a local registered dietitian who is a Board Certified Specialist in Sports Dietetics (RD CSSD). This professional can help you to do the following:

  • resolve your struggles with “no time” to eat properly.

  • find pre-exercise fuel that reduces stomach problems and “transit trouble.”

  • attain your desired weight and percent body fat.

  • transform disordered eating into effective fueling.

The bottom line: Don’t let nutrition be your missing link! You will always win with good nutrition!


Nancy Clark, MS, RD, CSSD (Board Certified Specialist in Sports Dietetics) offers consultations to casual and competitive athletes in her practice at Healthworks, the premier fitness center in Chestnut Hill MA (617-383-6100). Her Sports Nutrition Guidebook (2008), Food Guide for Marathoners, and Cyclist’s Food Guide are available via See also


1. Eichner, R. Anemia and Blood Boosting. Sports Science Exchange #81, Vol 14(2), 2001

2. Cribb, P., and A. Hayes. 2006. Effects of supplement timing and resistance exercise on skeletal muscle hypertrophy. Med Sci Sports Exerc 38(1):1918-1925.

3. Costill, D.L., R. Thomas, R.A. Robergs, et al. 1991. Adaptations to swimming training: Influence of training volume. Med Sci Sports Exerc 23(3):371-377.

4. Casa D., L. Armstrong, S. Montain, et al. 2000. National Athletic Trainers’ Association position statement: Fluid replacement for athletes. J Athletic Training 35(2):212-224.

5. Sims, S.T., L. van Vliet, J. Cotter, and N. Rehrer. 2007. Sodium loading aids fluid balance and reduces physiological strain of trained men exercising in the heat. Med Sci Sports Exerc 39(1):123-130.


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date: November 16, 2008

Nancy Clark

Nancy Clark, MS, RD, an internationally known sports nutritionist and nutrition author, is a registered dietitian (RD) who specializes in nutrition for exercise, health and the nutritional management of eating disorders.

avatarNancy Clark

Nancy Clark, MS, RD, an internationally known sports nutritionist and nutrition author, is a registered dietitian (RD) who specializes in nutrition for exercise, health and the nutritional management of eating disorders.

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