Coaching Youth Middle Distance Runners: Nutrition

Proper nutritional practices alone cannot generate elite performances, but they can significantly affect young athletes' overall wellness. Maintaining a healthy energy balance, practicing effective hydration habits, and understanding the various aspects of supplementation practices can help athletes improve their performance and increase their enjoyment of the sport. Bingham, Borkan, and Quatromoni (2015) provide this practical advice for young athletes:

• Eat fresh, minimally processed foods.
• Ingest enough calories to remain healthy and competitive.
• Eat after exercising to recover.
• Consume enough fluids to maintain proper hydration levels.
• Plan meals ahead of time.
• Vary the content of meals to ensure they include a variety of nutrients.
• Seek help from a professional to address signs of disordered eating behavior.

Caloric Intake

Many elite runners maintain high carbohydrate, low-fat nutritional programs (Schröder et al., 2008). One study by Achten et al. (2004) indicated that significantly higher carbohydrate intake can improve running performance and mood. Couto et al. (2015) found that a diet high in carbohydrates correlated with a faster sprint speed in the final 400 m of a distance race. That said, children and adolescents have smaller glycogen stores, meaning that they are more likely to process fat during exercise than adults (Jeukendrup & Cronin, 2011), and a higher fat content diet does not inhibit endurance or anaerobic activities in runners (Hovarth et al., 2000). The quantity and type of calories ingested should depend on the individual athlete and the current training phase; higher volume and intensity should necessitate greater caloric intake (Stellingwerff et al., 2007). Obese children and adolescents often lower their caloric intake while participating in a structured physical activity (Schwartz et al., 2016).

Hydration

Athletes should understand that dehydration is unhealthy and detrimental to performance. There is little doubt that "(a) dehydration is a major and common problem within children exercising in the heat; and (b) children do not have the capacity to translate hydration awareness to successful hydration strategies" (Kavouras & Arnaoutis, 2012, p. S11). Stearns et al. (2009) found that improper hydration habits can even affect a runner's pacing ability. Education programs for athletes, such as a short group lecture on the importance of hydration, are an effective tool for improving young athletes' endurance performance (Kavouras, et al., 2012). Although adolescent runners can effectively gauge the amount of fluid they consume during exercise (Wilk et al., 2010), even experienced runners tend to underestimate the amount of fluids they lose through sweat (O'Neal et al., 2012), and they sometimes struggle to manage their hydration needs by ingesting fluids ad libitum—that is, "at one's pleasure" (Passe et al., 2007). Therefore, coaches should carefully monitor athletes' fluid intake during training and competitions to avoid dehydration:

The athlete should consume approximately 500 to 600 ml (17 to 20 US fl oz) of water or a sports drink 2 to 3 hours before exercise and 300 to 360 ml (10 to 12 US fl oz) of water or a sports drink 0 to 10 minutes before exercise. (Casa, 2004, p. 7)

Sports drinks

So long as the athlete has ingested an adequate meal approximately three hours before exercise, carbohydrate-based sports beverages such as Gatorade have not been found to provide physiological or psychological advantages over other drinks (Rollo & Williams, 2010). They can also lead to a higher rate of gastrointestinal complaints than water alone (van Nieuwenhoven et al., 2005). Medical groups, such as the American Academy of Pediatrics, caution against the overreliance on such drinks, and they strongly oppose the use of energy drinks containing stimulants (Schneider & Benjamin, 2011). A possible alternative—aside from water—is tart cherry juice, which has been shown to reduce runners' pain levels and aid recovery after a strenuous race (Howatson et al., 2010; Kuehl et al., 2010). In warmer temperatures, consuming a "slurry" of crushed ice prior to a workout can improve athletes' endurance capabilities (Siegel et al., 2010; Siegel et al., 2012). Ingested immediately post-exercise, low-fat chocolate milk has been shown to be a more effective recovery drink than water or carbohydrate-only drinks (Lunn et al., 2012; Pritchett & Pritchett, 2013).

Supplementation

Nutritional supplements are widely used among national-level youth track and field athletes (Nieper, 2005; Petróczi et al., 2008), but with very few exceptions, conventional supplements do not improve middle distance runners' performance (Burke et al., 2007; Schubert & Astorino, 2013). For some athletes, especially females, iron or calcium supplementation may be beneficial (Nickerson et al., 1989; Rowland et al., 1987; Winters-Stone & Snow, 2004). That said, even though many athletes report that their coach exerts the most influence on their supplementation practices (Nieper, 2005), this is not an appropriate role for a youth coach; rather, "an appropriate dietary intake rather than use of supplements (except when clinically indicated) is recommended to ensure young athletes participate fully and safely in athletics" (Meyer et al., 2007, p. S73).

Gender Differences

There are sex-specific factors that play a role in the bone health – which is closely tied to nutrition – of adolescent runners (Tenforde et al., 2015). Most notably, the female athlete triad of disordered eating, amenorrhea, and osteoporosis makes athletes more susceptible to long-term injuries, such as stress fractures. While it should be noted that Hulley et al. (2007) found that "participation in distance running at an elite level does not in itself predispose to an eating disorder" (p. 521), and mere participation in competitive athletics has no negative effect on bone mass levels in young females (Lucas et al., 2003), coaches should be well aware of the signs and symptoms of these conditions and be willing to address them.

One of the primary factors affecting these conditions is inadequate caloric intake (Gabel, 2006). Female runners are less likely than their male counterparts to meet the caloric intake requirements of an active young athlete (Barrack et al., 2014; Hawley et al., 1995). Female runners who exercise dietary restraint are more likely to have low bone mineral density (Barrack et al., 2008) and those who are "careful about their weight" are eight times more likely to sustain a stress fracture than those who are not (Bennell et al., 1995). Nieves et al. (2010) also found that "in young female runners, higher intakes of calcium, skim milk, and dairy products were associated with lower rates of stress fracture" (p. 146). Female runners often lack essential knowledge in this area (Zawila et al., 2003; Wiita & Stombaugh, 1996), so coaches must be prepared to educate others involved in the process:

Such efforts may include educating athletes, coaches, and parents about overtraining, the importance of rest and recovery, sports nutrition, and signs and symptoms of disordered eating as well as the female athlete triad. Education should also include discussion of the myths associated with endurance sports training, including the misperception that more training and lighter weight is always associated with performance improvements. (Voelker, 2013, p. 172)

One such education program for high school athletes improved students' nutritional knowledge by 32%. All of the participants claimed to have made changes to their food intake as a result of the program (Sarkisian, 2016).

References

Achten, J., Halson, S. L., Moseley, L., Rayson, M. P., Casey, A., & Jeukendrup, A. E. (2004). Higher dietary carbohydrate content during intensified running training results in better maintenance of performance and mood state. Journal of Applied Physiology, 96(4), 1331–1340. doi:10.​1152/​japplphysiol.​00973.​2003. http://jap.physiology.org/content/96/4/1331.short 

Schneider, M. B., & Benjamin, H. J. (2011). Sports drinks and energy drinks for children and adolescents: Are they appropriate?. Pediatrics, 127(6), 1182–1189. doi:10.1542/peds.2011-0965. http://pediatrics.aappublications.org/content/127/6/1182 

Barrack, M., Nichols, J., Rauh, M., & Van Loan, M. (2014). Evidence of energy deficiency, using doubly-labeled water, among adolescent endurance runners. The FASEB Journal, 28(1 supplement), LB316. doi:10.1096/fj.1530-6860. http://www.fasebj.org/content/28/1_Supplement/LB316 

Barrack, M., Rauh, M., Barkai, H., & Nichols, J. (2008). Dietary restraint and low bone mass in female adolescent endurance runners. The American Journal of Clinical Nutrition, 87(1), 36–43. http://ajcn.nutrition.org/content/87/1/36.short. 

Bennell, K., Malcolm, S., Thomas, S., Ebeling, P., McCrory, P., Wark, J., & Brukner, P. (1995). Risk factors for stress fractures in female track-and-field athletes: A retrospective analysis. Clinical Journal of Sports Medicine, 5(4), 229–235. doi:10.1097/00042752-199510000-00004. http://www.peterbrukner.com/wp-content/uploads/2012/07/13.-Bennell-CJSM-1996-Risk_Factors_for_Stress_Fractures_in_Female.4.pdf 

Bingham, M. E., Borkan, M. E., & Quatromoni, P. A. (2015). Sports nutrition advice for adolescent athletes: A time to focus on food. American Journal of Lifestyle Medicine, 20(10), 398–402. doi:10.1177/1559827615598530.. http://www.kingaquaticclub.com/king/UserFiles/File/Library/Docs/Sports%20Nutrition%20Advice%20for%20Adolescent%20Athletes%20A%20Time%20to%20Focus%20on%20Food.pdf 

Burke, L., Millet, G., & Tarnopolsky, M. (2007). Nutrition for distance events. Journal of Sports Sciences, 25(S1), S29–S38. doi:10.1080/02640410701607239. http://www.tandfonline.com/doi/abs/10.1080/02640410701607239 

Casa, D. (2004). Proper hydration for distance running: Identifying individual fluid needs. Track Coach, (167), 5321–5228. http://www.hartfordmarathon.com/Assets/Training+Program/ProperHydrationForDistanceRunning.pdf. 

Couto, P. G., Bertuzzi, R., de Souza, C. C., Lima, H. M., Kiss, M. A., de-Oliveira, F. R., & Lima-Silva, A. E. (2015). High carbohydrate diet induces faster final sprint and overall 10,000 m times of young runners. Pediatric Exercise Science, 27(3), 355–363. doi:10.1123/pes.2014-0211. https://www.researchgate.net/profile/Patricia_Couto/publication/275361486_High-CHO_Diet_Induces_Faster_Final_Sprint_and_Overall_10000_m_Times_of_Young_Runners/links/55faf84b08ae07629e07b6ed.pdf 

Gabel, K. (2006). Special nutritional concerns for the female athlete. Current Sports Medicine Reports, 5(4), 187–191. doi:10.1007/s11932-006-0045-9. http://www.personalclub.com.br/images/upload/Special_Nutritional_Concerns__for_the_Female_Athlete.pdf 

Hawley, J., Dennis, S., Lindsay, F., & Noakes, T. (1995). Nutritional practices of athletes: Are they sub‐optimal?. Journal of Sports Sciences, 13(S1), 75–81. doi:10.1080/02640419508732280. http://www.tandfonline.com/doi/abs/10.1080/02640419508732280 

Horvath, P. J., Eagen, C. K., Fisher, N. M., Leddy, J. J., & Pendergast, D. R. (2000). The effects of varying dietary fat on performance and metabolism in trained male and female runners. Journal of the American College of Nutrition, 19(1), 52–60. doi:10.1080/07315724.2000.10718914. http://www.tandfonline.com/doi/abs/10.1080/07315724.2000.10718914 

Howatson, G., McHugh, M. P., Hill, J. A., Brouner, J., Jewell, A. P., van Someren, K. A., . . . Howatson, S. A. (2010). Influence of tart cherry juice on indices of recovery following marathon running. Scandinavian Journal of Medicine & Science in Sports, 20(6), 843–852. doi:10.1111/j.1600-0838.2009.01005.x. http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0838.2009.01005.x/abstract 

Hulley, A., Currie, A., Njenga, F., & Hill, A. (2007). Eating disorders in elite female distance runners: Effects of nationality and running environment. Psychology of Sport and Exercise, 8(4), 521–533. doi:10.1016/j.psychsport.2006.07.001 

Jeukendrup, A., & Cronin, L. (2011). Nutrition and elite young athletes. In N. Armstrong, & A. M. McManus (Eds.). Medicine and Sport Science: Vol. 56. The elite young athlete (pp. 47–58). doi:10.1159/000320630. http://www.karger.com/Article/Abstract/320630 

Kavouras, S. A., & Arnaoutis, G. (2012). Hydration status in active youth. Nutrition Today, 47(S4), S11–S13. doi:10.1097/NT.0b013e3182626689. http://journals.lww.com/nutritiontodayonline/Abstract/2012/07001/Hydration_Status_in_Active_Youth.4.aspx 

Kavouras, S. A., Arnaoutis, G., Makrillos, M., Garagouni, C., Nikolaou, E., Chira, O., . . . Sidossis, L.S. (2012). Educational intervention on water intake improves hydration status and enhances exercise performance in athletic youth. Scandinavian Journal of Medicine & Science in Sports, 25(2), 684–689. doi:10.1111/j.1600-0838.2011.01296.x. http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0838.2011.01296.x/abstract 

Kuehl, K. S., Perrier, E. T., Elliot, D. L., & Chesnutt, J. C. (2010). Efficacy of tart cherry juice in reducing muscle pain during running: A randomized controlled trial. Journal of the International Society of Sports Nutrition, 7(1), 17–22. doi:10.1186/1550-2783-7-17. http://www.jissn.com/content/7/1/17 

Lucas, J. A., Lucas, P. R., Vogel, S., Gamble, G. D., Evans, M. C., & Reid, I. R. (2003). Effect of sub-elite competitive running on bone density, body composition and sexual maturity of adolescent females. Osteoporosis International, 14(10), 848–856. doi:10.1007/s00198-003-1455-7. http://link.springer.com/article/10.1007/s00198-003-1455-7 

Lunn, W. R., Pasiakos, S. M., Colletto, M. R., Karfonta, K. E., Carbone, J. W., Anderson, J. M., & Rodriguez, N. R. (2012). Chocolate milk and endurance exercise recovery: Protein balance, glycogen, and performance. Medicine & Science in Sports & Exercise, 44(4). doi:10.1249/MSS.0b013e3182364162. http://europepmc.org/abstract/MED/21904247 

Meyer, F., O'Connor, H., & Shirreffs, S. M. (2007). Nutrition for the young athlete. Journal of Sports Sciences, 25(S1), S73–S82. doi:10.1080/02640410701607338. http://www.tandfonline.com/doi/abs/10.1080/02640410701607338 

Nickerson, J., Holubets, M., Weiler, B., Haas, R., Schwartz, S., & Ellefson, M. (1989). Causes of iron deficiency in adolescent athletes. The Journal of Pediatrics, 114(4), 657–663. doi:10.1016/S0022-3476(89)80717-6 

Nieper, A. (2005). Nutritional supplement practices in UK junior national track and field athletes. British Journal of Sports Medicine, 39(9), 645–649. doi:10.1136/bjsm.2004.015842. http://bjsm.bmj.com/content/39/9/645.short 

Nieves, J. W., Melsop, K., Curtis, M., Cobb, K. L., Kelsey, J. L., Bachrach, L. K., . . . Sowers, M. (2010). Nutritional factors that influence change in bone density and stress fracture risk among young female cross-county runners. PM&R, 2(8), 740–750. doi:10.1016/j.pmrj.2010.04.020. http://www.pmrjournal.org/article/S1934-1482(10)00340-0/fulltext 

O'Neal, E., Davis, B. A., Thigpen, L. K., Caufield, C. R., Horton, A. D., & McIntosh, J. R. (2012). Runners greatly underestimate sweat losses before and after 1 h summer run. International Journal of Sport Nutrition and Exercise Metabolism, 22(5), 353–362. https://www.researchgate.net/profile/Eric_ONeal/publication/231211384_Runners_Greatly_Underestimate_Sweat_Losses_Before_and_After_a_1-hr_Summer_Run/links/54a6f3940cf256bf8bb6b7a4.pdf. 

Passe, D., Horn, M., Stofan, J., Horswill, C., & Murray, R. (2007). Voluntary dehydration in runners despite favorable conditions for fluid intake. International Journal of Sport Nutrition and Exercise Metabolism, 17(3), 284–295. http://www.cabdirect.org/abstracts/20073137783.html. 

Petrie, H. J., Stover, E. A., & Horswill, C. A. (2004). Nutritional concerns for the child and adolescent competitor. Nutrition, 20(7), 620–631. doi:10.1016/j.nut.2004.04.002 

Petróczi, A., Naughton, D. P., Pearce, G., Bailey, R., Bloodworth, A., & McNamee, M. (2008). Nutritional supplement use by elite young UK athletes: Fallacies of advice regarding efficacy. Journal of the International Society of Sports Nutrition, 5(1), 1–8. doi:10.1186/1550-2783-5-22 

Pritchett, K., & Pritchett, R. (2013). Chocolate milk: A post-exercise recovery beverage for endurance sports. In M. Lamprecht (Ed.). Medicine and Sport Science: Vol. 59. Acute topics in sport nutrition (pp. 127–134). doi:10.1159/000341954. http://www.karger.com/Article/Abstract/341954 

Rollo, I., & Williams, C. (2010). Influence of ingesting a carbohydrate-electrolyte solution before and during a 1-hour run in fed endurance-trained runners. Journal of Sports Sciences, 28(6), 593–601. doi:10.1080/02640410903582784. http://www.tandfonline.com/doi/abs/10.1080/02640410903582784 

Rowland, T., Black, S., & Kelleher, J. (1987). Iron deficiency in adolescent endurance athletes. Journal of Adolescent Health Care, 8(4), 322–326. doi:10.1016/0197-0070(87)90002-7 

Sarkisian, G. (2016). Development of a sports nutrition curriculum to increase nutrition knowledge among high school athletes in Los Angeles, CA (Unpublished master's thesis). http://scholarworks.csun.edu/bitstream/handle/10211.3/174064/Sarkisian-Gayane-thesis-2016.pdf. 

Schröder, S., Fischer, A., Vock, C., Böhme, M., Schmelzer, C., Döpner, M., . . . Döring, F. (2008). Nutrition concepts for elite distance runners based on macronutrient and energy expenditure. Journal of Athletic Training, 43(5), 489–504. doi:10.4085/1062-6050-43.5.489 

Schubert, M. M., & Astorino, T. A. (2013). A systematic review of the efficacy of ergogenic aids for improving running performance. Journal of Strength & Conditioning Research, 27(6). doi:10.1519/JSC.0b013e31826cad24. http://journals.lww.com/nsca-jscr/Abstract/2013/06000/A_Systematic_Review_of_the_Efficacy_of_Ergogenic.30.aspxx 

Schwartz, C., King, N. A., Perreira, B., Blundell, J. E., & Thivel, D. (2016). A systematic review and meta‐analysis of energy and macronutrient intake responses to physical activity interventions in children and adolescents with obesity. Pediatric Obesity. Advance online publication,. doi:10.1111/ijpo.12124. http://onlinelibrary.wiley.com/doi/10.1111/ijpo.12124/abstract 

Siegel, R., Maté, J., Brearley, M. B., Watson, G., Nosaka, K., & Laursen, P. B. (2010). Ice slurry ingestion increases core temperature capacity and running time in the heat. Medicine & Science in Sports & Exercise, 42(4), 717–725. doi:10.1249/MSS.0b013e3181bf257a. https://www.researchgate.net/profile/Rodney_Siegel2/publication/40045840_Ice_slurry_ingestion_increases_core_temperature_capacity_and_running_time_in_the_heat/links/00b7d52cda107dbad9000000.pdf 

Siegel, R., Maté, J., Watson, G., Nosaka, K., & Laursen, P. B. (2012). Pre-cooling with ice slurry ingestion leads to similar run times to exhaustion in the heat as cold water immersion. Journal of Sports Sciences, 30(2), 155–165. doi:10.1080/02640414.2011.625968. http://www.tandfonline.com/doi/abs/10.1080/02640414.2011.625968 

Stearns, R. L., Casa, D. J., Lopez, R. M., McDermott, B. P., Ganio, M. S., Decher, N. R., . . . Maresh, C. M. (2009). Influence of hydration status on pacing during trail running in the heat. The Journal of Strength & Conditioning Research, 23(9), 2533–2541. doi:10.1519/JSC.0b013e3181b73c3f. http://journals.lww.com/nsca-jscr/Abstract/2009/12000/Influence_of_Hydration_Status_on_Pacing_During.15.aspx 

Stellingwerff, T., Boit, M., & Res, P. (2007). Nutritional strategies to optimize training and racing in middle-distance athletes. Journal of Sports Sciences, 25(S1), S17–S28. doi:10.1080/02640410701607213. http://www.tandfonline.com/doi/abs/10.1080/02640410701607213 

Tenforde, A. S., Fredericson, M., Sayres, L. C., Cutti, Phil, & Sainani, K. L. (2015). Identifying sex-specific risk factors for low bone mineral density in adolescent runners. American Journal of Sports Medicine, 43(6), 1494–1504. doi:10.1177/0363546515572142. http://ajs.sagepub.com/content/43/6/1494.abstract 

van Nieuwenhoven, M. A., Brouns, F., & Kovacs, E. M. R. (2005). The effect of two sports drinks and water on GI complaints and performance during an 18-km run. International Journal of Sports Medicine, 26(4), 281–285. doi:10.1055/s-2004-820931. https://www.thieme-connect.com/ejournals/abstract/10.1055/s-2004-820931 

Voelker, D. K. (2013). Endurance sports. In J. J. Reel (Ed.). Eating disorders: An encyclopedia of causes, treatment, and preventionABC-CLIO (pp. 169–172). http://books.google.com/books?id=0IJ7VWTAfqcC&lr&pg=PA169. 

Wiita, B. G., & Stombaugh, I. A. (1996). Nutrition knowledge, eating practices, and health of adolescent female runners: A 3-year longitudinal study. International Journal of Sport Nutrition, 6(4), 414–425. http://europepmc.org/abstract/MED/8953343. 

Wilk, B., Timmons, B. W., & Bar-Or, O. (2010). Voluntary fluid intake, hydration status, and aerobic performance of adolescent athletes in the heat. Applied Physiology, Nutrition, and Metabolism, 35(6), 834–841. doi:10.1139/H10-084. http://www.nrcresearchpress.com/doi/abs/10.1139/H10-084#.UUDzzsXI0fA 

Winters-Stone, K. M., & Snow, C. M. (2004). One year of oral calcium supplementation maintains cortical bone density in young adult female distance runners. International Journal of Sport Nutrition and Exercise Metabolism, 14(1), 7–17. https://www.ncbi.nlm.nih.gov/pubmed/15129926. 

Zawila, L. G., Steib, C.-S. M., & Hoogenboom, Barbara (2003). The female collegiate cross-country runner: Nutritional knowledge and attitudes. Journal of Athletic Training, 38(1), 67–74.