Healthy Hydration for Young Athletes

18 | N ATA news | JULY 2018

s a sports dietitian that special-

izes in fueling young athletes,

I’m asked the same questions

over and over again. Parents and coaches

want suggestions for what to feed ath-

letes before, during and after activity.

While game-day fueling is important,

adequate hydration sits at the top of the

priority list for young athletes.

There is no easier, effective or more

economical way to help performance and

protect health than staying hydrated during

exercise. Water is the most vital nutri-

ent and plays a key role in how well ath-

letes perform. In adults, a loss of 2 percent

body weight in ﬂuids has been shown to

have adverse effects on performance.

children, those same negative effects are

thought to occur sooner, with just 1 percent

decrease in body weight.

This is especially

true when exercising in hot and humid

conditions. The negative side effects asso-

ciated with dehydration in children leads

to decreased endurance and performance

by negatively affecting the cardiovascu-

lar system, thermoregulation and central

fatigue or perceived exhaustion.

Poor

hydration increases a young athlete's risk

for exertional heat illness.

How Much Water is Enough?

As with nutrients, the Dietary Reference

Intakes’ (DRI) recommend

how much

water is needed daily:

AGE MALES FEMALES

9-13 2.4 liters =

10 cups

2.1 liters =

9 cups

14-18 3.3 liters =

14 cups

2.3 liters =

10 cups

Healthy adolescents can generally regu-

late their ﬂuid intake and avoid dehydration,

but active young athletes need to pay closer

attention. As with nutrient recommenda-

tions, adequate water intakes for athletes

are much more researched in adults than

in children and adolescents. DRI is a great

place to start, but young athletes need

more. How much more depends on a lot of

things. Intensity and duration of training,

environmental conditions (heat/humid-

ity) and equipment (uniform/pads) all

play a role in how much ﬂuid is lost during

activity. Sweat loss varies from one athlete to

another and should also be considered.

Ideally, athletes would be able to drink

enough fluid during activity to keep pace

with their sweat rate, but unfortunately,

that’s not always possible. Not all ath-

letes know their sweat rate and may not

realize how much fluid they lose when

exercising. Maintaining fluid equilibrium

during activity is especially difficult for

athletes who are heavy sweaters.

One way for athletes to learn how much

ﬂuid they lose during activity is to weigh

themselves before and after training ses-

sions. Knowing how much ﬂuid is lost

during activity will help to individualize

a hydration plan. To determine ﬂuid loss,

athletic trainers can help young athletes

complete this simple formula (Figure 1).

Not only will completing the chart help

identify youth athletes who may be at

increased risk of dehydration, it also shows

them how much you prioritize ﬂuid status.

In addition to calculating the ﬂuid

losses during activity, athletic trainers can

help youth athletes become familiar with

evaluating their urine. When possible,

Ways to Prevent Fluid Loss From Becoming Detrimental

BY HEATHER MANGIERI, RDN, CSSD

HEALTHY HYDRATION

FOR YOUNG ATHLETES

Photo © iStock/krystiannawrocki

nata.org | 19

hang a urine chart in workout areas that

is visible for athletes. Also, make sure that

young athletes know the general rule of

thumb: pale yellow urine (like lemonade)

indicates being fairly well-hydrated, while

darker yellow (like apple juice) indicates

potential dehydration. The more emphasis

athletic trainers put on hydration status, the

more likely young athletes are to prioritize it.

Knowing the Signs of Dehydration

Symptoms of dehydration can be vague,

but the earlier we educate young athletes

on what to look for, the easier it will be for

them to identify the signs. Some warning

signs include: headache and lightheaded-

ness, noticeable thirst, irritability, nausea,

muscle cramping, dark yellow urine, difﬁ-

culty paying attention, weakness and fatigue

resulting in decreased performance.

The most recent hydration recom-

mendations, released in 2011 from the

American Academy of Pediatrics,

can be

found in Figure 2.

Talking to Teens about Hydration

Notice the recommendation from the

American Academy of Pediatrics to educate

children and adolescents on the importance

of getting adequate hydration. As the face

of the sports medicine team, athletic train-

ers play a key role in helping youth athletes

understand why hydration is important. But

telling them they need to drink is not enough.

A study by Cleary and colleagues assessed

the hydration status and behaviors of ado-

lescent athletes both before and after a one-

time education intervention, then compared

it to a prescribed hydration intervention.

The outcome showed that a one-time educa-

tion session alone was not enough to change

hydration behaviors of the young athletes, but

prescribing individualized hydration protocols

for adolescents improved their ﬂuid intake.

This study supports the need to go above and

beyond simply telling teenagers they should

drink more ﬂuid. They need to be shown how

to do it.

In addition to encouraging athletes to

drink during activity, helping adolescent

athletes develop their own hydration sched-

ule is also useful. Scheduling ﬂuid intake

will help athletes get in the habit of drink-

ing at regular times throughout the day.

The following is an example of a basic ﬂuid

hydration schedule. Use this as a guide to

help athletes understand the purpose, but

have them tailor the times to their school,

work and training schedule changes:

TIME OF DAY FLUID INTAKE

6:30 AM (wake up) Drink 8 ounces

of water

8:30 a.m. (or

between classes)

4 ounces

10:30 a.m. (or

between classes)

4 ounces

Noon (with lunch) 4 ounces

1:30 p.m. (or

between classes)

4 ounces

2:30 p.m. (after

school)

8 ounces

3:30 p.m. (or before

practice)

8 ounces

During practice Drink breaks—

about 4-12 ounces

every 15 minutes

After practice Drink 8-16 ounces

of fluid

7:30 p.m. 8 ounces of fluid

9:30 p.m. 8 ounces of fluid

Tip: 4 big gulps from the drinking

fountain is about 4 ounces of fluid

Special Considerations

Certain situations and conditions may

require additional ﬂuids. Athletes compet-

ing in extreme weather conditions, wearing

heavy equipment or competing at altitude

will need to pay extra attention to ﬂuid

intake. Recent illness, especially if it involved

gastrointestinal distress or fever, athletes

taking medications or an athlete with a

known medical condition also may require

additional ﬂuids. For the safety of all youth

athletes, athletic trainers should have water

or other appropriate ﬂuids readily available,

and athletes should be given regular oppor-

tunities throughout practice and events to

hydrate and offset sweat losses.

Sports Drink vs. Water

Another common question is whether

water is enough or should sports drinks

be considered. The answer depends on

the individual athlete, the intensity and

duration of activity and the conditions

in which the activity is occurring. When

used properly, sports drinks can be bene-

ﬁcial for youth athletes.

As athletes perspire, they lose electro-

lytes, especially sodium and chloride. In

addition to water, those electrolytes need

to be replaced to prevent ﬂuid imbalance.

In addition to its role in maintaining ﬂuid

balance, adequate sodium may help pre-

vent muscle cramping and help maintain

hydration status.

Although water is often sufﬁcient to main-

tain adequate hydration, a sports beverage

can help replace electrolytes. Activity of

longer duration (more than one hour), higher

intensity and/or repeated same-day exercise

sessions that result in a greater sweat loss can

be supported by electrolyte supplementation.

This is especially true for athletes who have

high sweat rates or are salty sweaters.

The purpose of a sports drink is to

provide ﬂuid, fuel (as carbohydrates) and

electrolytes to offset the losses that occur

during and after activity. For other times

of the day, water is the beverage to drink.

The goal of hydration is the same for

all youth athletes: prevent dehydration

and optimize performance. Maintaining a

healthy hydration status is the ﬁrst priority

when putting a performance plan in place.

About the Author: Heather Mangieri, RDN,

CSSD, is a nationally recognized expert in nutri-

tion, wellness & human performance, a registered

FIGURE 1. FLUID LOSS FORMULA

STEP 1 Weigh nude* immediately before

starting exercise

Record Weight=

STEP 2 Keep track of exactly how much fluid is

consumed during the exercise session

Record Fluid Consumed=

STEP 3 Weigh nude* immediately after exercise Record Weight=

STEP 4 Subtract post-exercise weight from pre-

exercise weight to determine pounds lost.

Pounds Lost=

STEP 5 Multiply pounds lost X 3 to determine how

much fluid to replace after exercise

Cups of fluid to replace

losses=

* While best practice would be a nude weight, it is understandable that this is not always feasible or

ethically prudent. In practicality, at least have your athlete weigh themselves in the exact same

clothes as to try to account for any potential variable which may cause an error in accuracy. Also,

please note, that dry clothes at the start of practice may be “heavier” sweat soaked clothes at the

completion of a practice and can also account for an error in measurements.

20 | N ATA news | JULY 2018

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dietitian-nutritionist, a board-certiﬁed specialist

in sports dietetics and the author of Fueling Young

Athletes (Human Kinetics, 2017). She has more

than 18 years of professional experience in well-

ness, sports nutrition/adolescent sports nutrition,

weight management and disordered eating.Her

company, Heather Mangieri Nutrition, provides

food, ﬁtness and nutrition consulting services for

organizations, companies and clients.

References:

Rosenbloom, Christine, et al. 2012. Sports nutrition: A

practical manual for professionals, 5th ed. Academy

of Nutrition and Dietetics. Chicago, Illinois.

Council on Sports Medicine and Fitness and

Council on School Health, Bergeron MF, Devore

C, Rice SG; American Academy of Pediatrics.

Policy Statement- climatic heat stress and exer-

cising children and adolescents. Pediatrics. 2011;

128(3): e741-e747.

Dietary Reference Intakes for Water, Potassium,

Sodium, Chloride, and Sulfate. This report may

be accessed via www.nap.edu.

Arnaoutis, G., Kavouras, S.A., Angelopoulou, A., et

al. 2015. Fluid balance during training inelite young

athletes of different sports. Journal of Strength and

Conditioning Research 29 (12): 3447-3452.

Cleary, M.A., Hetzler, R.K., Wasson, D., et al.

2012. Hydration behaviors before and after an

educational and prescribed hydration interven-

tion in adolescent athletes. Journal of Athletic

Training 47 (3): 273-281.

FIGURE 2. AMERICAN ACADEMY OF PEDIATRICS HYDRATION RECOMMENDATIONS

Provide and promote consumption of readily accessible fluids at regular intervals before,

during and after activity to oset sweat loss and maintain adequate hydration while

avoiding overdrinking.

Encourage children to drink during activity to minimize sweat induced body-water

deficits during exercise as long as pre-activity hydration status is good.

-9 to 12 years: 3-5 ounces every 20 minutes

-Older athletes: Up to 34-50 ounces per hour (9-13 ounces every 15 minutes)

Pre- and post-activity body weight measurements can provide more information for

individual rehydration needs.

Electrolyte-supplemented beverages that emphasize sodium may be warranted during

long duration (≥1 hour), repeated same-day sessions of strenuous exercise, sports

participation and hot weather.

Educate children and adolescents of the merits of ample hydration.

Youth sports governing bodies, tournament directors and other event administrators

should provide adequate rest and recovery periods of two or more hours between same

day contests in warm to hot weather to allow sucient recovery and rehydration.

REFERENCE: Council on Sports Medicine and Fitness and Council on School Health, Bergeron MF,

Devore C, Rice SG; American Academy of Pediatrics. Policy Statement- climatic heat stress and

exercising children and adolescents. Pediatrics. 2011; 128(3): e741-e747.