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by ADMIN on NOVEMBER 9, 2011

So you just finished your workout and you're starving… what should you eat?!

If you’re an avid daily (or bi-daily!) exerciser, providing your body with nutrients to recover is very important. This will help your body replenish glycogen stores (carbohydrates your body stores to use during exercise), repair and rebuild muscle, and help rehydrate.

Your body is working its hardest and fastest to replenish glycogen stores within 30 to 45 minutes after you finish a workout. During this time, it’s best to have a carbohydrate-rich snack with a smidge of protein. Protein actually helps your body store glycogen more efficiently.

For endurance athletes, this 3:1 or 4:1 carb-to-protein ratio is ideal. (source)

Good Carbohydrate-Protein Combo Snacks:

  • Low fat or fat free chocolate milk

  • A bowl of corn flakes with fat free or low fat milk

  • 8 oz orange juice and half a bagel

  • Low fat or fat free yogurt with a piece of fruit

  • A couple slices of turkey with a slice of whole grain bread

  • Low fat cottage cheese and fruit

  • Cheese and crackers

  • Pretzels and a bit of peanut butter

  • Commercial Recovery drink with a 3:1 or 4:1 ratio of carbs:protein

We don't care as much about nutrition quality during the immediate post-workout refueling snack because we're looking for speed of glycogen recovery. Simple carbs will be digested quicker and get into the muscle faster during that important post-workout window.

Once you're out of that window, revert to whole grains and less processed foods.

How much recovery fuel do you need?

This ultimately depends on how long you worked out and the intensity of the session. Your body needs about 1 - 1.2 grams of carbs per kg of weight per hour of exercise performed (g/kg/hr).

For an hour-long workout, that might look like these amounts:

  • Women: 150 – 200 calories

  • Men: 300 – 400 calories

What about after strength training?

If you’re trying to build muscle, recovery fuel is also an important aspect of your diet. Keeping you in the anabolic - or muscle-building) zone means taking in more calories than your body needs for maintenance. For this reason, you certainly do not want to skip this ideal opportunity to refuel!

Recovery needs differ slightly after strength. Your goal is to consume mostly, if not purely, protein. This will help maximize your muscle adaptations.(Source)

Do you always have to have a post-workout snack?

Refueling right away speeds recovery and helps prepare your body for your next workout or competition. This is especially important when you're working out again on the same day or within 24 hours.

However, if your next exercise or training session is more than 24 hours away, you don’t necessarily need to worry about eating within 30 minutes. Your body will be able to slowly and naturally build back up your glycogen stores over the next 24+ hours so that you’re ready to go!

One last benefit of a post-workout snack:

If your next full meal is more than an hour away but you aren't working out until the next day (ie: no immediate need for a recovery snack), think about grabbing a piece of fruit, yogurt, or cheese after your workout.

This will help prevent you from getting too hungry before your next meal, which in turn helps to prevent overeating. Score!

by ADMIN on JUNE 21, 2012

Sports Drinks – they’re all the rage now. But are they worth it?

The short answer: Depending on when, why, and how you’re using them – Yes

When would sports drinks have NO benefit? If sports drinks are drunk during the day (not while exercising), they only add extra sugar and calories that your body simply doesn’t need. It’s best to stick with water during these times.

Also, if you’re working out less than 45 minutes, water is sufficient for good hydration. In fact, studies show that when exercising less than 30 minutes, fluid (water or otherwise) has no benefits to performance.

During exercise the body generates over 20 times more heat (energy) than at rest – and the only way to release the heat is through sweating. If you don’t have enough fluid in your system to help get rid of this excess energy, your body can over-heat quickly, resulting in poor performance, weakness, and dizziness.

So when it’s hot out, or you’re a heavy sweater, then you may lose a lot of your hydration. Even just 2% dehydration can decrease your performance.

The History

Sports drinks have been around since the 1960s when a Florida college football team, the Gators, went looking for a better way to hydrate their athletes in the hot, humid weather of the south. The coach approached a group of physicians at the college and explained his quest: To prevent the negative effects of heat-related illnesses he saw his athlete’s suffering from – and to help increase performance during games if possible.

The physicians came up with two primary reasons the athletes were declining in performance:

  1. Loss of electrolytes from excessive sweating,

  2. Depletion of muscle glycogen (stored form of carbohydrates), which leads to muscle fatigue and failure during long practices.

The result? A specially formulated drink with a mix of carbohydrates, sodium, and potassium – with a squeeze of lemon for flavor. After using this drink during practice and games, the Gators began winning almost all of their games in hot, humid conditions – and then went on to win the Orange Bowl in 1966 for the first year ever.

And what did they name the drink? Gatorade. After the team.

As you may have guessed, this drink went on to be the first sports drinks on the market and became the official sports drink of the National Football League in 1968.

The Science


In most sports, particularly cycling (Hermansen et al. 1967) and running (Williams 1998), the point of fatigue is closely linked to glycogen depletion in the exercising muscle. By both increasing muscle glycogen stores before exercise, as well as consuming carbohydrates during exercise enhances performance significantly – particularly in terms of maintaining a faster running and cycling speed and extending exercise time.

Studies have also found that carbohydrate sports drinks improve sprinting and delay fatigue of basketball players. Surprisingly, the players also sunk more baskets due to improved cognitive function and focus.

The amount of carbohydrate taken in is key. Too much and the gastrointestinal (GI) tract is overwhelmed, resulting in gas, bloating, or diarrhea. Ideally, men can take in about 50-90 grams of carbs per hour while women can take in about 35-60 grams per hour (total).

When to ingest carbohydrates is also important. Many studies also show that carbohydrate fueling should be started well before fatigue sets in – or it may be too late to gain benefits.

The type of carbohydrates consumed makes a big difference as well. Each type of sugar (glucose, sucrose, oligosaccharides, fructose) is absorbed via a different pathway in the intestines. If you take in too much of one type, the pathway gets overwhelmed and the rest of the sugar will just… come out (diarrhea!). So taking in a mixture of sugars is best since more will be absorbed (each via a different pathway). Interestingly, Fructose takes much longer to digest and absorb, so drinking juice or other pure fructose-sweetened beverages may lead to stomach upset and other GI issues.

Another benefit: Ingestion of carbohydrates will actually help your body absorb more water.


Along with water, sodium is also lost in sweat. This is the most important electrolyte when it comes to exercise.

Sodium, the most abundant cation, and chloride, the most abundant anion help with muscle contractions and nerve signaling (Salt is made up of NaCl, or Sodium Chloride). Without enough sodium, hyponatremia (the fancy work for low sodium) sets in, which can be very dangerous. Symptoms include nausea, disorientation, slurred speech, and confusion. Hydrating with water alone in a hot environment simply dilutes your sodium even further – causing more problems and potential heath issues. Not good for performance!

Sodium actually stimulates sugar and water absorption in the intestines and helps to maintain blood volume. It maintains blood volume by helping the body retain the fluids you drink – which in turn helps keep you hydrated for longer. While drinking only water can actually dehydrate you during extreme heat or long competitions/training. Without sodium, water is simply expelled by the body via urine and sweat.

Soft drinks contain virtually no sodium (1-2mmol/L) while sports drinks have about 30-90 mmol/L – an optimal amount to replenish normal sodium loss. If you’re a salty sweater (you can tell by how much salt is dried on your skin and cloths after a workout), you may even need salt tablets in a long distance race in addition to a sports drink. Talk to your coach to see if this is an appropriate option for you.

What about Coconut water? As you may have read in this article, coconut water is not the best sports drink for intense workouts lasting longer than 75 minutes. It simply doesn’t not have enough sodium to keep you well hydrated and performing your best.

Fluid Needs

The goal of hydration is to maintain body weight. On average, an athlete needs about 8-12 ounces of fluid every 15 minutes of exercise to maintain top performance and hydration.

Make sure you are well hydrated going into a competition or race. Check your pee! It should be a light yellow or clear. Drinking 8 ounce of fluids about 20 minutes before the race can also prime the intestines to be able to absorb more fluids during the race.

A Good Guide to your Fluid Needs:

Daily Fluid Needs: 30ml/kg

  1. (Your weight in pounds) / 2.2 = Kg body weight

  2. Kg x 30 = Total ml fluid needed per day

  3. (Total ml) / 240 = Number of cups you need to drink per day

Exercise Needs: (Added to your daily needs)

  1. Drink 2 cups 2 hours before exercise

  2. Drink 1 cup (8oz) 10 minutes before exercise

  3. Drink 1 cup every 15-20 minutes during exercise

* Weigh yourself before and after training/competition and for every pound you lost, drink 16 ounces (2 cups) of fluids.

Make Your Own

Don’t want to spend money on commercial drinks? You can make your own sports drinks with the right amount of sodium, potassium, and carbohydrates to fuel your workout.

Dawn Jackson Blatner, RD

3.5 cups water

1/2 cup orange juice

2.5 Tbsp honey

1/4 tsp salt

8oz: 50 calories, 14g cho, 160mg sodium

Nancy Clark, RD

1/4 cup sugar

1/4 tsp salt

1/4 cup hot water

1/4 cup orange juice (not concentrate)

2 Tbsp lemon juice

1.5 cups cold water

8oz: 50 calories, 12g CHO, 110mg sodium

Exercise in general is very beneficial. It helps improve cardiovascular health, reduces stress, and enhances our overall quality of life.

And yet if we aren't fueling our body appropriately for the amount of work we are asking it to perform, it can result in RED-S: Relative Energy Deficiency in Sport.

RED-S is when an athlete is not getting enough calories to support the extra energy needs required for their training and daily living, resulting in impaired physiological functioning, poor health, and declining athletic performance. This syndrome has been linked to impairments in bone health, metabolic rate, menstrual cycle, cardiovascular health, protein synthesis, immunity, and endocrine functioning, just to name a few.

RED-S can affect athletes of any gender and ability level.

Energy Deficiency

With enough fueling, rest, and recovery meals, most athletes will overcome the energy deficit created during training. However, if the body is not being restored appropriately, the deficit grows over time and eventually begins to affect physiological function and performance.

Low energy availability, or not getting enough calories, may often be accidental. This may occur because a newer athlete may not know how to fuel their workouts appropriately and understand how many calories they need to support good health and optimal performance.

On the other hand, the pressure of having a certain physique may cause the athlete to control their intake, often restricting specific food groups and total calories. This controlled eating may be anywhere on the disturbed eating spectrum, from disordered eating to a full-blown eating disorder.

Some sports – such as gymnastics, ice skating, diving, weight category sports, and endurance running or cycling – emphasize a smaller, or more controlled, physique, putting remarkable pressure on an athlete to restrict their food intake. RED-S can be more common among these groups of athletes.

The Female Athlete Triad

The Female Athlete Triad is a subset of RED-S.

This syndrome, which includes disordered eating, menstrual dysfunction, and reduced bone mineral density, can be present in female athletes of all levels; from high school girls just joining the gym or a team, to elite adult athletes. As with RED-S, the crux of the triad is low energy intake. This is particularly dangerous in adolescents when the body has a heightened need for growth and maturation, and when bone development and mineralization is at its peak.

Menstrual dysfunction is when menstruation does not happen on a consistent cycle. It may be too short, too long, or may stop altogether. Some athletes think missing their period means they are training well, but in reality, this should not be happening at all. Both training and weight fluctuations affect the hypothalamus, which in turn affects estrogen. Reduced estrogen then impacts the menstrual cycle.

Reduced bone mineral density is when the bone is not as strong as it should be, and is a stepping stone to osteoporosis. Causes include low estrogen (if the female has irregular or nonexistent periods), low body weight, or insufficient nutrient intake; particularly of protein, calcium, and vitamin D. Bone mineral density reaches its peak during adolescence and young adulthood, and if there are problems accruing enough bone during this time, a girl may never reach her full bone mineral density, leaving her more prone to fractures, breaks, and osteoporosis as an adult.

Symptoms of RED-S

Symptoms of RED-S include:

  • Rapid weight loss

  • Fatigue

  • Low libido (male athletes)

  • Delayed puberty or missed menstrual cycles (female athletes)

  • Hair loss

  • Frequent illness

  • Trouble staying warm

  • Difficulty focusing

  • Irritability or depression

Performance indicators of RED-S:

  • Impaired endurance

  • Decreased muscle strength

  • Decreased training response

  • Increased risk for injury

  • Decreased coordination

  • Decrease judgment and concentration

Prevention, Screening, and Treatment

Prevention of RED-S and Female Athlete Triad is key. Athletes, coaches, and parents should be educated on healthy eating habits and caloric needs for their sports, as well as appropriate fueling and recovery techniques for before, during, and after training.

Athlete Risk Categories

High Risk: Athletes with eating disorders, medical conditions related to low energy availability, or who have lost a significant amount of weight in a short period using extreme methods are at the highest risk for RED-S.

Moderate Risk: Athletes who have lost a significant amount of weight within the past month (5-10% of their body weight) or who have had a prolonged abnormally low body fat percentage, have irregular menstrual cycles, or a history of stress fractures or low bone mineral density are considered at moderate risk for RED-S.

Low Risk: Athletes who have an appropriate body composition that is maintained without stress or an unhealthy diet or exercise strategies; who have a healthy functioning endocrine system, and who have healthy bone mineral density for their age and sport are considered low risk for RED-S.


Athletes categorized in the Red or Yellow risk zones should receive a medical and nutrition evaluation and ensuing treatment. Treatment should include a team approach that may include a sports medicine physician, sports dietitian, exercise physiologist, athletic trainer, and sports psychologist. Of course, coaches and parents should be involved in management as well.

Treatment should focus on correcting energy balance by either increasing calories or decreasing output (training volume). Some athletes may need a focus on specific nutrients to help correct deficiencies.

Ongoing treatment and check-ins should be conducted by the team to ensure the athlete continues to improve, and eligibility to participate in athletic activities should be determined on an individual basis. If improvements are not made, the athlete may need to be taken out of training completely.

Physical activity is an important part of health and wellness, but as more people engage in training, it’s important to be aware of the potential health risks that are present and to screen for them.


Mountjoy M. Sundgot-Borgen J, Burke L, et al. RED-S CAT. Br J Sports Med 2015;49:421–423. doi:10.1136/bjsports-2014-094559.

Cabre HE, Moore SR, Smith-Ryan AE, Hackney AC. Relative Energy Deficiency in Sport (RED-S): Scientific, Clinical, and Practical Implications for the Female Athlete. Dtsch Z Sportmed. 2022;73(7):225-234. doi:10.5960/dzsm.2022.546.

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