Conan Gasque (Host): We're talking about proper nutrition for young athletes. I'm Conan Gasque, joined by Dr. Darby McElderry of Greenvale Brook Highland Pediatrics, part of Children's of Alabama. Thanks so much for your time today.

Dr. Darby McElderry: Thank you.

Host: So, a big part of succeeding in sports is the things you put into your body. We're going to break it down in terms of what you do before, during, and after the game. But first, I want to get a little bit of advice about general hydration and nutrition. What are some general tips for sports-playing kids?

Dr. Darby McElderry: So, nutrition and fluid intake is so important overall, not only for just healthy growth in general, but also during exercise to replace those fluids and electrolytes and energy that you're using. So in general, you want to make sure your child is very well hydrated all the time. And water should be our drink of choice, not necessarily sports drinks. And then, with food, just good general nutrition with some carbohydrates, protein, fat content for most meals. And then, we can talk specifically about some things that you want to add in to help them be at their best during their game.

Host: Good general advice. And also, there's some things you need to consider, like we said, before the game, during the game, after the game, and it all kind of starts the night before, right?

Dr. Darby McElderry: Yes, certainly. The day before you really want to make sure that they are drinking plenty of fluids that day. And then, for an evening meal before the next day begins, you want to have a protein, a carbohydrate, and a fat source in that meal.

And a good general guideline is about half of the plate should be carbohydrates, about a quarter of your plate should be protein, and about a quarter of the plate should be your fruit or a vegetable. And so, a good example might be a lean piece of meat like chicken, some healthy like whole wheat pasta or some rice and potatoes, some broccoli, and lots of water.

Host: Okay. So, that's the night before. Let's move on to the day of. What should they be doing in that sort of short window before the game?

Dr. Darby McElderry: About four hours before, whenever that falls in the day, any sporting event, you want to start kind of water loading. And so, somewhere between about 400 and 600 milliliters of fluid leading up to the event. And you might want to eat a lighter breakfast if they've got an early morning event. So, you know, again, a smaller, like, oatmeal with some fruit might be something good. Not a big heavy breakfast,. because something too heavy in the fat content, Fats are a little harder to break down for energy. And they can tend to make your athlete feel sluggish because they can delay gastric emptying.

Host: That's not good during the game, to feel sluggish.

Dr. Darby McElderry: Not good. It does not optimize their performance.

Host: Yes, and that's what we're talking about here.

Dr. Darby McElderry: And that's kind of the goals of nutrition, is not only helping them grow and, and thrive and be healthy, but it's optimizing that sports performance.

Host: And we've talked about what to do to optimize that performance leading up to the game. So now, they're in the middle of the game, what should they do now?

Dr. Darby McElderry: They definitely need to pay attention continuing to drink water. So for shorter events, then they should be good kind of with that loading we talked about earlier. But if you have a longer event, you really want to pay attention to about every 15 to 20 minutes getting an extra 150 to 300 milliliters of water on board during the event. Again, for a longer event, they may need a snack in between, like mid-game. So, a small something, an applesauce pouch or, you know, a small piece of fruit or peanut butter and crackers with a small piece of fruit. But not too much on their stomach, because, you know, you don't want them having digestive issues during the game.

So for any event lasting longer than an hour or if you're playing in a really hot, humid weather, weather you're going to have increased loss of sweat, so you do want to have something that has some sodium chloride in it and maybe a little carbohydrate repletion. So, that's the circumstance where sports drinks can be useful. If it's a very long, prolonged event. So, you know, a track meet where they're very active all day or a long cross country run.

Host: Very important to understand what to have and when to have it, and of course how much of it. So at this point in our conversation, they have made it through the end of the game, and now they've used all that energy, all that sweat, everything. What do they do now?

Dr. Darby McElderry: So, fluid replacement after a game, the goal is to replace those electrolyte losses as well as those energy sources. So, they have used a lot of glycogen for their muscles, so you want to replace those glycogen stores, and that's where the carbohydrates come in after the game.

And then, you also want to replace, kind of protein helps repair those muscles. And so, you want a carbohydrate and a protein source with your post-game meal. So generally, within about 30 minutes to an hour of finishing your exercise or your sporting event, you want to provide a meal. And again, that can be proportioned similarly to your pre-game meal the night before with some protein, carbohydrate, and fat content. As far as fluids, you want to make sure that you're replacing the fluid loss there. And so, drinking 16 to 24 ounces of water is important within those few hours after an event as well to replace those fluids. And don't ignore some other sources of fluids. Chocolate milk can be a good post-recovery drink because it contains almost the ideal portion of carbohydrate to protein ratio.

Host: That sounds like good news. Yeah, I could stand to drink more chocolate milk.

Dr. Darby McElderry: Only after a sporting event.

Host: Only after a sporting event.

Dr. Darby McElderry: Not on a regular basis.

Host: Yeah, got to do it the right way. Okay. So, that's a look at a lot of the different things that we need to know about nutrition. Just to kind of wrap things up here. What's kind of some general advice about nutrition, hydration, how important they are overall in a person's life?

Dr. Darby McElderry: Overall exceedingly important. Again, you want to make sure that you're drinking the amount of water for your body weight every day on a regular basis, and then adding on more in accordance with your activity level. And the same with food. You know, make sure you're eating enough calories for just basic maintenance every day, and you add on or subtract a little bit depending on how active you are at various times of the year, because of course we all know that children participate and rotate in different sports. And so, those needs may change a little bit. You know, you can't just eat 3,000 calories a day like you might when you're running cross-country and eat that all the time. That may end up having a negative effect at some point, so you have to adjust.

Host: Gotcha. All right. Once again, Dr. Darby McElderry of Greenvale Brook Highland Pediatrics at Children's of Alabama. Thanks so much for your time.

Dr. Darby McElderry: Thank you.

Host: Thanks for listening to Inside Pediatrics. For more podcasts like this one, go to childrensal.org.