From the Academy Position Paper| Volume 116, ISSUE 3, P501-528, March 2016

Download started.


Position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and Athletic Performance

Published:February 23, 2016DOI:


      It is the position of the Academy of Nutrition and Dietetics (Academy), Dietitians of Canada (DC), and the American College of Sports Medicine (ACSM) that the performance of, and recovery from, sporting activities are enhanced by well-chosen nutrition strategies. These organizations provide guidelines for the appropriate type, amount, and timing of intake of food, fluids, and supplements to promote optimal health and performance across different scenarios of training and competitive sport. This position paper was prepared for members of the Academy, DC, and ACSM, other professional associations, government agencies, industry, and the public. It outlines the Academy’s, DC’s, and ACSM’s stance on nutrition factors that have been determined to influence athletic performance and emerging trends in the field of sports nutrition. Athletes should be referred to a registered dietitian nutritionist for a personalized nutrition plan. In the United States and in Canada, the Certified Specialist in Sports Dietetics is a registered dietitian nutritionist and a credentialed sports nutrition expert.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of the Academy of Nutrition and Dietetics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Deakin V.
        • Kerr D.
        • Boushey C.
        Measuring nutritional status of athletes: Clinical and research perspectives.
        in: Burke L. Deakin V. Clinical Sports Nutrition. 5th ed. McGraw-Hill, North Ryde, Australia2015: 27-53
        • Manore M.
        • Thompson J.
        Energy requirements of the athlete: Assessment and evidence of energy efficiency.
        in: Burke L. Deakin V. Clinical Sports Nutrition. 5th ed. McGraw-Hill, Sydney, Australia2015: 114-139
        • Spriet L.L.
        New insights into the interaction of carbohydrate and fat metabolism during exercise.
        Sports Med. 2014; 44: S87-S96
        • Cunningham J.J.
        A reanalysis of the factors influencing basal metabolic rate in normal adults.
        Am J Clin Nutr. 1980; 33: 2372-2374
        • Roza A.M.
        • Shizgal H.M.
        The Harris Benedict equation reevaluated: Resting energy requirements and the body cell mass.
        Am J Clin Nutr. 1984; 40: 168-182
        • Guebels C.P.
        • Kam L.C.
        • Maddalozzo G.F.
        • Manore M.M.
        Active women before/after an intervention designed to restore menstrual function: Resting metabolic rate and comparison of four methods to quantify energy expenditure and energy availability.
        Int J Sport Nutr Exerc Metab. 2014; 24: 37-46
        • Ainsworth B.E.
        • Haskell W.L.
        • Whitt M.C.
        • et al.
        Compendium of physical activities: An update of activity codes and MET intensities.
        Med Sci Sports Exerc. 2000; 32: S498-S504
      1. US Department of Health and Human Services and US Department of Agriculture. 2015 – 2020 Dietary Guidelines for Americans. 8th Edition. December 2015. Accessed February 5, 2016.

        • Institute of Medicine, Food and Nutrition Board
        Dietary Reference intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids.
        The National Academies Press, Washington, DC2005
        • Loucks A.B.
        Energy balance and energy availability.
        in: Maughan R.J. Sports Nutrition, The Encyclopaedia of Sports Medicine, an IOC Medical Commission Publication. John Wiley & Sons, Ltd, West Sussex, UK2013: 72-87
        • De Souza M.J.
        • Nattiv A.
        • Joy E.
        • et al.
        2014 Female Athlete Triad Coalition consensus statement on treatment and return to play of the female athlete triad: 1st International Conference held in San Francisco, California, May 2012 and 2nd International Conference held in Indianapolis, Indiana, May 2013.
        Br J Sports Med. 2014; 48: 289
        • Mountjoy M.
        • Sundgot-Borgen J.
        • Burke L.
        • et al.
        The IOC consensus statement: Beyond the female athlete triad—Relative Energy Deficiency in Sport (RED-S).
        Br J Sports Med. 2014; 48: 491-497
      2. Garner DM. Eating Disorder Inventory-3: Professional Manual. Lutz, FL: Psychological Assessment Resources, Inc; 2004.

      3. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5. Arlington, VA: American Psychiatric Association; 2013.

        • Sundgot-Borgen J.
        • Meyer N.L.
        • Lohman T.G.
        • et al.
        How to minimise the health risks to athletes who compete in weight-sensitive sports review and position statement on behalf of the Ad Hoc Research Working Group on Body Composition, Health and Performance, under the auspices of the IOC Medical Commission.
        Br J Sports Med. 2013; 47: 1012-1022
        • Stellingwerff T.
        • Maughan R.J.
        • Burke L.M.
        Nutrition for power sports: Middle-distance running, track cycling, rowing, canoeing/kayaking, and swimming.
        J Sport Sci. 2011; 29: S79-S89
        • O'Connor H.
        • Slater G.
        Losing, gaining and making weight for athletes.
        in: Lanham-New S. Stear S. Sherriffs M. Collins A. Sport and Exercise Nutrition. Wiley-Blackwell, West Sussex, UK2011: 210-232
        • Sundgot-Borgen J.
        • Garthe I.
        Elite athletes in aesthetic and Olympic weight-class sports and the challenge of body weight and body compositions.
        J Sport Sci. 2011; 29: S101-S114
        • Steffes G.D.
        • Megura A.E.
        • Adams J.
        • et al.
        Prevalence of metabolic syndrome risk factors in high school and NCAA division I football players.
        J Strength Conditiong Res. 2013; 27: 1749-1757
        • Ackland T.R.
        • Lohman T.G.
        • Sundgot-Borgen J.
        • et al.
        Current status of body composition assessment in sport: Review and position statement on behalf of the ad hoc research working group on body composition health and performance, under the auspices of the I.O.C. Medical Commission.
        Sports Med. 2012; 42: 227-249
        • Santos D.A.
        • Dawson J.A.
        • Matias C.N.
        • et al.
        Reference values for body composition and anthropometric measurements in athletes.
        PloS ONE. 2014; 9: e97846
        • Turocy P.S.
        • DePalma B.F.
        • Horswill C.A.
        • et al.
        National Athletic Trainers' Association position statement: Safe weight loss and maintenance practices in sport and exercise.
        J Athletic Train. 2011; 46: 322-336
        • Slater G.
        • Rice A.
        • Jenkins D.
        • Hahn A.
        Body mass management of lightweight rowers: Nutritional strategies and performance implications.
        Br J Sports Med. 2014; 48: 1529-1533
        • Wilson G.
        • Drust B.
        • Morton J.P.
        • Close G.L.
        Weight-making strategies in professional jockeys: Implications for physical and mental health and well-being.
        Sports Med. 2014; 44: 785-796
        • Garthe I.
        • Raastad T.
        • Refsnes P.E.
        • Koivisto A.
        • Sundgot-Borgen J.
        Effect of two different weight-loss rates on body composition and strength and power-related performance in elite athletes.
        Int J Sport Nutr Exerc Metab. 2011; 21: 97-104
        • Mettler S.
        • Mitchell N.
        • Tipton K.D.
        Increased protein intake reduces lean body mass loss during weight loss in athletes.
        Med Sci Sports Exerc. 2010; 42: 326-337
        • Thomas D.M.
        • Martin C.K.
        • Lettieri S.
        • et al.
        Can a weight loss of one pound a week be achieved with a 3500-kcal deficit? Commentary on a commonly accepted rule.
        Int J Obes (Lond). 2013; 37: 1611-1613
        • Hopkins W.G.
        • Hawley J.A.
        • Burke L.M.
        Design and analysis of research on sport performance enhancement.
        Med Sci Sports Exerc. 1999; 31: 472-485
        • Maughan R.J.
        • Gleeson M.
        The Biochemical Basis of Sports Performance.
        Oxford University Press, Oxford, United Kindom2010
        • Hawley J.A.
        • Burke L.M.
        • Phillips S.M.
        • Spriet L.L.
        Nutritional modulation of training-induced skeletal muscle adaptations.
        J Appl Physiol. 2011; 110: 834-845
        • Cole M.
        • Coleman D.
        • Hopker J.
        • Wiles J.
        Improved gross efficiency during long duration submaximal cycling following a short-term high carbohydrate diet.
        Int J Sports Med. 2014; 35: 265-269
        • Philp A.
        • Hargreaves M.
        • Baar K.
        More than a store: Regulatory roles for glycogen in skeletal muscle adaptation to exercise.
        Am J Physiol Endocrinol Metab. 2012; 302: E1343-E1351
        • Bartlett J.D.
        • Hawley J.A.
        • Morton J.P.
        Carbohydrate availability and exercise training adaptation: Too much of a good thing?.
        Eur J Sport Sci. 2014; : 1-10
        • Stellingwerff T.
        Contemporary nutrition approaches to optimize elite marathon performance.
        Int J Sports Physiol Perform. 2013; 8: 573-578
        • Lee J.M.
        • Kim Y.
        • Welk G.J.
        Validity of consumer-based physical activity monitors.
        Med Sci Sports Exerc. 2014; 46: 1840-1848
        • Burke L.M.
        • Hawley J.A.
        • Wong S.H.
        • Jeukendrup A.E.
        Carbohydrates for training and competition.
        J Sports Scis. 2011; 29: S17-S27
        • Cox G.R.
        • Clark S.A.
        • Cox A.J.
        • et al.
        Daily training with high carbohydrate availability increases exogenous carbohydrate oxidation during endurance cycling.
        J Appl Physiol. 2010; 109: 126-134
        • Burke L.M.
        Fueling strategies to optimize performance: Training high or training low?.
        Scan J Med Sci Sports. 2010; 20: 48-58
        • Phillips S.M.
        • Van Loon L.J.
        Dietary protein for athletes: From requirements to optimum adaptation.
        J Sports Sci. 2011; 29: S29-S38
        • Phillips S.M.
        Dietary protein requirements and adaptive advantages in athletes.
        Br J Nutr. 2012; 108: S158-S167
        • Miller B.F.
        • Olesen J.L.
        • Hansen M.
        • et al.
        Coordinated collagen and muscle protein synthesis in human patella tendon and quadriceps muscle after exercise.
        J Physiol. 2005; 567: 1021-1033
        • Babraj J.
        • Cuthbertson D.J.
        • Rickhuss P.
        • et al.
        Sequential extracts of human bone show differing collagen synthetic rates.
        Biochem Soc Transact. 2002; 30: 61-65
        • Churchward-Venne T.A.
        • Burd N.A.
        • Mitchell C.J.
        • et al.
        Supplementation of a suboptimal protein dose with leucine or essential amino acids: Effects on myofibrillar protein synthesis at rest and following resistance exercise in men.
        J Physiol. 2012; 590: 2751-2765
        • Burd N.A.
        • West D.W.
        • Moore D.R.
        • et al.
        Enhanced amino acid sensitivity of myofibrillar protein synthesis persists for up to 24 h after resistance exercise in young men.
        J Nutr. 2011; 141: 568-573
      4. World Health Organization and Food and Agriculture Organization of the United Nations, United Nations University. Joint WHOFAOUNUEC. Protein and amino acid requirements in human nutrition. World Health Organization Technical Report Series. Geneva, Switzerland: World Health Organization; 2007(935):1-265, back cover.

        • Rosenbloom C.A.
        • Coleman E.J.
        Sports Nutrition: A Practice Manual for Professionals.
        Academy of Nutrition & Dietetics, Chicago, IL2012
        • Moore D.R.
        • Phillips S.M.
        • Slater G.
        in: Deakin V. Burke L. Clinical Sports Nutrition. 5th ed. McGraw-Hill Education, Sydney, Australia2015: 94-113
        • Areta J.L.
        • Burke L.M.
        • Camera D.M.
        • et al.
        Reduced resting skeletal muscle protein synthesis is rescued by resistance exercise and protein ingestion following short-term energy deficit.
        Am J Physiol Endocrinol Metab. 2014; 306: E989-E997
        • Rodriguez N.R.
        • Vislocky L.M.
        • Gaine P.C.
        Dietary protein, endurance exercise, and human skeletal-muscle protein turnover.
        Curr Opin Clin Nutr Metab Care. 2007; 10: 40-45
        • Wall B.T.
        • Morton J.P.
        • van Loon L.J.
        Strategies to maintain skeletal muscle mass in the injured athlete: Nutritional considerations and exercise mimetics.
        Eur J Sport Sci. 2015; 15: 53-62
        • Phillips S.M.
        • Moore D.R.
        • Tang J.E.
        A critical examination of dietary protein requirements, benefits, and excesses in athletes.
        Int J Sport Nutr Exerc Metab. 2007; 17: S58-S76
        • Tipton K.D.
        • Witard O.C.
        Protein requirements and recommendations for athletes: Relevance of ivory tower arguments for practical recommendations.
        Clin Sports Medicine. 2007; 26: 17-36
        • Beelen M.
        • Burke L.M.
        • Gibala M.J.
        • van Loon L.J.
        Nutritional strategies to promote postexercise recovery.
        Int Sport Nutr Exerc Metab. 2010; 20: 515-532
        • Moore D.R.
        • Robinson M.J.
        • Fry J.L.
        • et al.
        Ingested protein dose response of muscle and albumin protein synthesis after resistance exercise in young men.
        Am J Clin Nutr. 2009; 89: 161-168
        • Areta J.L.
        • Burke L.M.
        • Ross M.L.
        • et al.
        Timing and distribution of protein ingestion during prolonged recovery from resistance exercise alters myofibrillar protein synthesis.
        J Physiol. 2013; 591: 2319-2331
        • Schoenfeld B.J.
        • Ratamess N.A.
        • Peterson M.D.
        • Contreras B.
        • Sonmez G.T.
        • Alvar B.A.
        Effects of different volume-equated resistance training loading strategies on muscular adaptations in well-trained men.
        J Strength Condition Res. 2014; 28: 2909-2918
        • Josse A.R.
        • Tang J.E.
        • Tarnopolsky M.A.
        • Phillips S.M.
        Body composition and strength changes in women with milk and resistance exercise.
        Med Sci Sports Exerc. 2010; 42: 1122-1130
        • Phillips S.M.
        A brief review of critical processes in exercise-induced muscular hypertrophy.
        Sports Med. 2014; 44: S71-S77
        • Tipton K.D.
        • Elliott T.A.
        • Cree M.G.
        • Aarsland A.A.
        • Sanford A.P.
        • Wolfe R.R.
        Stimulation of net muscle protein synthesis by whey protein ingestion before and after exercise.
        Am J Physiol Endocrinol Metab. 2007; 292: E71-E76
        • Hartman J.W.
        • Tang J.E.
        • Wilkinson S.B.
        • et al.
        Consumption of fat-free fluid milk after resistance exercise promotes greater lean mass accretion than does consumption of soy or carbohydrate in young, novice, male weightlifters.
        Am J Clin Nutr. 2007; 86: 373-381
        • Josse A.R.
        • Atkinson S.A.
        • Tarnopolsky M.A.
        • Phillips S.M.
        Increased consumption of dairy foods and protein during diet- and exercise-induced weight loss promotes fat mass loss and lean mass gain in overweight and obese premenopausal women.
        J Nutr. 2011; 141: 1626-1634
        • Pennings B.
        • Boirie Y.
        • Senden J.M.
        • Gijsen A.P.
        • Kuipers H.
        • van Loon L.J.
        Whey protein stimulates postprandial muscle protein accretion more effectively than do casein and casein hydrolysate in older men.
        Am J Clin Nutr. 2011; 93: 997-1005
      5. Health Canada. Eating Well with Canada's Food Guide. Accessed July 7, 2015.

        • Phinney S.D.
        • Bistrian B.R.
        • Evans W.J.
        • Gervino E.
        • Blackburn G.L.
        The human metabolic response to chronic ketosis without caloric restriction: Preservation of submaximal exercise capability with reduced carbohydrate oxidation.
        Metab Clin Experiment. 1983; 32: 769-776
        • Volek J.S.
        • Noakes T.
        • Phinney S.D.
        Rethinking fat as a fuel for endurance exercise.
        Eur J Sport Sci. 2014; : 1-8
        • Havemann L.
        • West S.J.
        • Goedecke J.H.
        • et al.
        Fat adaptation followed by carbohydrate loading compromises high-intensity sprint performance.
        J Appl Physiol. 2006; 100: 194-202
        • Stellingwerff T.
        • Spriet L.L.
        • Watt M.J.
        • et al.
        Decreased PDH activation and glycogenolysis during exercise following fat adaptation with carbohydrate restoration.
        Am J Physiol Endocrinol Metab. 2006; 290: E380-E388
        • Burke L.M.
        Re-examining high-fat diets for sports performance: Did we call the “nail in the coffin” too soon?.
        Sports Med. 2015; 45: 33-49
        • Barnes M.J.
        Alcohol: Impact on sports performance and recovery in male athletes.
        Sports Med. 2014; 44: 909-919
        • Lourenco S.
        • Oliveira A.
        • Lopes C.
        The effect of current and lifetime alcohol consumption on overall and central obesity.
        Eur J Clin Nutr. 2012; 66: 813-818
        • Burke L.M.
        • Collier G.R.
        • Broad E.M.
        • et al.
        Effect of alcohol intake on muscle glycogen storage after prolonged exercise.
        J Appl Physiol. 2003; 95: 983-990
        • Hobson R.M.
        • Maughan R.J.
        Hydration status and the diuretic action of a small dose of alcohol.
        Alcohol Alcoholism. 2010; 45: 366-373
        • Parr E.B.
        • Camera D.M.
        • Areta J.L.
        • et al.
        Alcohol ingestion impairs maximal post-exercise rates of myofibrillar protein synthesis following a single bout of concurrent training.
        PloS ONE. 2014; 9: e88384
        • Burke L.M.
        • Read R.S.
        A study of dietary patterns of elite Australian football players.
        Can J Sport Sci. 1988; 13: 15-19
        • Graham T.
        Alcohol ingestion and man's ability to adapt to exercise in a cold environment.
        Can J Appl Sport Sci. 1981; 6: 27-31
        • Verster J.C.
        The alcohol hangover—A puzzling phenomenon.
        Alcohol Alcoholism. 2008; 43: 124-126
        • Farajian P.
        • Kavouras S.A.
        • Yannakoulia M.
        • Sidossis L.S.
        Dietary intake and nutritional practices of elite Greek aquatic athletes.
        Int J Sport Nutr Exerc Metab. 2004; 14: 574-585
        • Lukaski H.C.
        Vitamin and mineral status: Effects on physical performance.
        Nutrition. 2004; 20: 632-644
        • Volpe S.L.
        • Bland E.
        Vitamins, minerals, and exercise.
        in: Rosenbloom C.A. Coleman E.J. Sports Nutrition: A Practice Manual for Professionals. 5th ed. Academy of Nutrition and Dietetics, Chicago, IL2012: 75-105
        • Woolf K.
        • Manore M.M.
        B-vitamins and exercise: Does exercise alter requirements?.
        Int J Sport Nutr Exerc Metab. 2006; 16: 453-484
        • Haymes E.
        in: Driskell J. Wolinsky I. Sports Nutrition: Vitamins and Trace Elements. CRC/Taylor & Francis, New York, NY2006: 203-216
        • Beard J.
        • Tobin B.
        Iron status and exercise.
        Am J Clin Nutr. 2000; 72: 594S-597S
        • McClung J.P.
        • Karl J.P.
        • Cable S.J.
        • et al.
        Randomized, double-blind, placebo-controlled trial of iron supplementation in female soldiers during military training: Effects on iron status, physical performance, and mood.
        Am J Clin Nutr. 2009; 90: 124-131
        • DellaValle D.M.
        Iron supplementation for female athletes: Effects on iron status and performance outcomes.
        Curr Sports Med Rep. 2013; 12: 234-239
        • Cowell B.S.
        • Rosenbloom C.A.
        • Skinner R.
        • Summers S.H.
        Policies on screening female athletes for iron deficiency in NCAA division I-A institutions.
        Int J Sport Nutr Exerc Metab. 2003; 13: 277-285
        • Peeling P.
        • Dawson B.
        • Goodman C.
        • Landers G.
        • Trinder D.
        Athletic induced iron deficiency: New insights into the role of inflammation, cytokines and hormones.
        Eur J Appl Physiol. 2008; 103: 381-391
        • Sim M.
        • Dawson B.
        • Landers G.
        • Trinder D.
        • Peeling P.
        Iron regulation in athletes: Exploring the menstrual cycle and effects of different exercise modalities on hepcidin production.
        Int J Sport Nutr Exerc Metab. 2014; 24: 177-187
        • Peeling P.
        • Sim M.
        • Badenhorst C.E.
        • et al.
        Iron status and the acute post-exercise hepcidin response in athletes.
        PloS ONE. 2014; 9: e93002
        • Burden R.J.
        • Morton K.
        • Richards T.
        • Whyte G.P.
        • Pedlar C.R.
        Is iron treatment beneficial in, iron-deficient but non-anaemic (IDNA) endurance athletes? A meta-analysis.
        Br J Sports Med. 2015; 49: 1389-1397
        • Pojednic R.M.
        • Ceglia L.
        The emerging biomolecular role of vitamin D in skeletal muscle.
        Exerc Sport Sci Rev. 2014; 42: 76-81
        • Sinha A.
        • Hollingsworth K.G.
        • Ball S.
        • Cheetham T.
        Improving the vitamin D status of vitamin D deficient adults is associated with improved mitochondrial oxidative function in skeletal muscle.
        J Clin Endocrinol Metab. 2013; 98: E509-E513
        • Ruohola J.P.
        • Laaksi I.
        • Ylikomi T.
        • et al.
        Association between serum 25(OH)D concentrations and bone stress fractures in Finnish young men.
        J Bone Mineral Res. 2006; 21: 1483-1488
        • Larson-Meyer D.E.
        • Willis K.S.
        Vitamin D and athletes.
        Curr Sports Med Rep. 2010; 9: 220-226
        • Cannell J.J.
        • Hollis B.W.
        • Sorenson M.B.
        • Taft T.N.
        • Anderson J.J.
        Athletic performance and vitamin D.
        Med Sci Sports Exerc. 2009; 41: 1102-1110
        • Halliday T.M.
        • Peterson N.J.
        • Thomas J.J.
        • Kleppinger K.
        • Hollis B.W.
        • Larson-Meyer D.E.
        Vitamin D status relative to diet, lifestyle, injury, and illness in college athletes.
        Med Sci Sports Exerc. 2011; 43: 335-343
        • Lagowska K.
        • Kapczuk K.
        • Friebe Z.
        • Bajerska J.
        Effects of dietary intervention in young female athletes with menstrual disorders.
        J Int Soc Sports Nutr. 2014; 11: 21
        • Lewis R.M.
        • Redzic M.
        • Thomas D.T.
        The effects of season-long vitamin D supplementation on collegiate swimmers and divers.
        Int J Sports Nutr Exerc Metab. 2013; 23: 431-440
        • Moran D.S.
        • McClung J.P.
        • Kohen T.
        • Lieberman H.R.
        Vitamin D and physical performance.
        Sports Med. 2013; 43: 601-611
        • Nickols-Richardson S.M.
        • Beiseigel J.M.
        • Gwazdauskas F.C.
        Eating restraint is negatively associated with biomarkers of bone turnover but not measurements of bone mineral density in young women.
        J Am Diet Assoc. 2006; 106: 1095-1101
        • Nattiv A.
        • Loucks A.B.
        • Manore M.M.
        • et al.
        American College of Sports Medicine position stand. The female athlete triad.
        Med Sci Sports Exerc. 2007; 39: 1867-1882
        • Peternelj T.T.
        • Coombes J.S.
        Antioxidant supplementation during exercise training: Beneficial or detrimental?.
        Sports Med. 2011; 41: 1043-1069
        • Watson T.A.
        • MacDonald-Wicks L.K.
        • Garg M.L.
        Oxidative stress and antioxidants in athletes undertaking regular exercise training.
        Int J Sports Nutr Exerc Metab. 2005; 15: 131-146
        • Draeger C.L.
        • Naves A.
        • Marques N.
        • et al.
        Controversies of antioxidant vitamins supplementation in exercise: Ergogenic or ergolytic effects in humans?.
        J Int Soc Sports Nutr. 2014; 11: 4
        • Sawka M.N.
        • Burke L.M.
        • Eichner E.R.
        • et al.
        • American College of Sports Medicine
        American College of Sports Medicine position stand. Exercise and fluid replacement.
        Med Sci Sports Exerc. 2007; 39: 377-390
        • Shirreffs S.M.
        • Sawka M.N.
        Fluid and electrolyte needs for training, competition, and recovery.
        J Sports Sci. 2011; 29: S39-S46
        • Kenefick R.W.
        • Cheuvront S.N.
        Hydration for recreational sport and physical activity.
        Nutr Rev. 2012; 70: S137-S142
        • Armstrong L.E.
        • Casa D.J.
        • Millard-Stafford M.
        • et al.
        • American College of Sports Medicine
        American College of Sports Medicine position stand. Exertional heat illness during training and competition.
        Med Sci Sports Exerc. 2007; 39: 556-572
        • Goulet E.D.
        Dehydration and endurance performance in competitive athletes.
        Nutr Rev. 2012; 70: S132-S136
        • Jeukendrup A.
        • Carter J.
        • Maughan R.J.
        Competition fluid and fuel.
        in: Burke L. Deakin V. Clinical Sports Nutrition. 5th ed. McGraw-Hill Australia Pty Ltd, North Ryde NSW, Australia2015: 377-419
        • Garth A.K.
        • Burke L.M.
        What do athletes drink during competitive sporting activities?.
        Sports Med. 2013; 43: 539-564
        • Mountjoy M.
        • Alonso J.M.
        • Bergeron M.F.
        • et al.
        Hyperthermic-related challenges in aquatics, athletics, football, tennis and triathlon.
        Br J Sports Med. 2012; 46: 800-804
        • Koehle M.S.
        • Cheng I.
        • Sporer B.
        Canadian Academy of Sport and Exercise Medicine position statement: Athletes at high altitude.
        Clin J Sports Med. 2014; 24: 120-127
        • Jeukendrup A.E.
        Nutrition for endurance sports: Marathon, triathlon, and road cycling.
        J Sports Sci. 2011; 29: S91-S99
        • Hew-Butler T.
        • Rosner M.H.
        • Fowkes-Godek S.
        • et al.
        Statement of the Third International Exercise-Associated Hyponatremia Consensus Development Conference, Carlsbad, California, 2015.
        Clin J Sports Med. 2015; 25: 303-320
        • Bergeron M.F.
        Exertional heat cramps: Recovery and return to play.
        J Sport Rehab. 2007; 16: 190-196
        • Cermak N.M.
        • van Loon L.J.
        The use of carbohydrates during exercise as an ergogenic aid.
        Sports Med. 2013; 43: 1139-1155
        • Burke L.M.
        • Kiens B.
        • Ivy J.L.
        Carbohydrates and fat for training and recovery.
        J Sports Sci. 2004; 22: 15-30
        • Hawley J.A.
        • Schabort E.J.
        • Noakes T.D.
        • Dennis S.C.
        Carbohydrate-loading and exercise performance. An update.
        Sports Med. 1997; 24: 73-81
        • Ormsbee M.J.
        • Bach C.W.
        • Baur D.A.
        Pre-exercise nutrition: The role of macronutrients, modified starches and supplements on metabolism and endurance performance.
        Nutrients. 2014; 6: 1782-1808
        • Rehrer N.J.
        • van Kemenade M.
        • Meester W.
        • Brouns F.
        • Saris W.H.
        Gastrointestinal complaints in relation to dietary intake in triathletes.
        Int J Sports Nutr. 1992; 2: 48-59
        • Foster C.
        • Costill D.L.
        • Fink W.J.
        Effects of preexercise feedings on endurance performance.
        Med Sci Sports. 1979; 11: 1-5
        • Coyle E.F.
        Timing and method of increased carbohydrate intake to cope with heavy training, competition and recovery.
        J Sports Sci. 1991; 9 (discussion 51-22): 29-51
        • Thomas D.E.
        • Brotherhood J.R.
        • Brand J.C.
        Carbohydrate feeding before exercise: Effect of glycemic index.
        Int J Sports Med. 1991; 12: 180-186
        • Burke L.M.
        • Claassen A.
        • Hawley J.A.
        • Noakes T.D.
        Carbohydrate intake during prolonged cycling minimizes effect of glycemic index of preexercise meal.
        J Appl Physiol. 1998; 85: 2220-2226
        • Stellingwerff T.
        • Cox G.R.
        Systematic review: Carbohydrate supplementation on exercise performance or capacity of varying durations.
        Appl Physiol Nutr Metab. 2014; 39: 998-1011
        • Burke L.M.
        • Maughan R.J.
        The Governor has a sweet tooth—Mouth sensing of nutrients to enhance sports performance.
        Eur J Sport Sci. 2014; : 1-12
        • Jeukendrup A.E.
        Carbohydrate and exercise performance: The role of multiple transportable carbohydrates.
        Curr Opin Clin Nutr Metab Care. 2010; 13: 452-457
        • Betts J.A.
        • Williams C.
        Short-term recovery from prolonged exercise: exploring the potential for protein ingestion to accentuate the benefits of carbohydrate supplements.
        Sports Med. 2010; 40: 941-959
        • Berardi J.M.
        • Noreen E.E.
        • Lemon P.W.
        Recovery from a cycling time trial is enhanced with carbohydrate-protein supplementation vs. isoenergetic carbohydrate supplementation.
        J Int Soc Sports Nutr. 2008; 5: 24
        • Tipton K.D.
        • Rasmussen B.B.
        • Miller S.L.
        • et al.
        Timing of amino acid-carbohydrate ingestion alters anabolic response of muscle to resistance exercise.
        Am J Physiol Endocrinol Metab. 2001; 281: E197-E206
        • van Essen M.
        • Gibala M.J.
        Failure of protein to improve time trial performance when added to a sports drink.
        Med Sci Sports Exerc. 2006; 38: 1476-1483
        • Ivy J.L.
        • Res P.T.
        • Sprague R.C.
        • Widzer M.O.
        Effect of a carbohydrate-protein supplement on endurance performance during exercise of varying intensity.
        Int J Sports Nutr Exerc Metab. 2003; 13: 382-395
        • Etheridge T.
        • Philp A.
        • Watt P.W.
        A single protein meal increases recovery of muscle function following an acute eccentric exercise bout.
        Appl Physiol Nutr Metab. 2008; 33: 483-488
        • Hoffman J.R.
        • Ratamess N.A.
        • Tranchina C.P.
        • Rashti S.L.
        • Kang J.
        • Faigenbaum A.D.
        Effect of a proprietary protein supplement on recovery indices following resistance exercise in strength/power athletes.
        Amino Acids. 2010; 38: 771-778
        • Beelen M.
        • Koopman R.
        • Gijsen A.P.
        • et al.
        Protein coingestion stimulates muscle protein synthesis during resistance-type exercise.
        Am J Physiol Endocrinol Metab. 2008; 295: E70-E77
        • van Loon L.J.
        Is there a need for protein ingestion during exercise?.
        Sports Med. 2014; 44: S105-S111
      6. Health Canada. Pathway for licensing natural health products making modern health claims. Accessed August 19, 2015.

        • Braun H.
        • Koehler K.
        • Geyer H.
        • Kleiner J.
        • Mester J.
        • Schanzer W.
        Dietary supplement use among elite young German athletes.
        Int J Sport Nutr Exerc Metab. 2009; 19: 97-109
        • Maughan R.J.
        Risks and rewards of dietary supplement use by athletes.
        in: Maughan R.J. Sports Nutrition, The Encyclopaedia of Sports Medicine, an IOC Medical Commission Publication. 1st ed. John Wiley & Sons Ltd, West Sussex, UK2014
      7. International Organization for Standardization and International Electrotechnical Commission. General requirements for the competence of testing and calibration laboratories, Switzerland. ISO/IEC 17025:2005 (E). ISO; 2005.

        • Burke L.M.
        • Cato L.
        Supplements and sports foods.
        in: Burke L.M. Deakin V. Clinical Sports Nutrition. 5th ed. McGraw-Hill Pty Ltd., North Ryde NSW, Australia2015: 493-591
      8. Australian Institute of Sport. Supplements. Accessed July 7, 2015.

        • Tarnopolsky M.A.
        Caffeine and creatine use in sport.
        Ann Nutr Metab. 2010; 57: 1-8
        • Astorino T.A.
        • Roberson D.W.
        Efficacy of acute caffeine ingestion for short-term high-intensity exercise performance: A systematic review.
        J Strength Conditioning Res. 2010; 24: 257-265
        • Burke L.
        • Desbrow B.
        • Spriet L.
        Caffeine for Sports Performance.
        Human Kinetics, Champagne, IL2013
        • Carr A.J.
        • Hopkins W.G.
        • Gore C.J.
        Effects of acute alkalosis and acidosis on performance: A meta-analysis.
        Sports Med. 2011; 41: 801-814
        • Quesnele J.J.
        • Laframboise M.A.
        • Wong J.J.
        • Kim P.
        • Wells G.D.
        The effects of beta-alanine supplementation on performance: A systematic review of the literature.
        Int J Sport Nutr Exerc Metab. 2014; 24: 14-27
        • Jones A.M.
        Influence of dietary nitrate on the physiological determinants of exercise performance: A critical review.
        Appl Physiol Nutr Metab. 2014; 39: 1019-1028
        • Craig W.J.
        • Mangels A.R.
        • American Dietetic Association
        Position of the American Dietetic Association: Vegetarian diets.
        J Am Diet Assoc. 2009; 109: 1266-1282
        • Berning J.R.
        The vegetarian athlete.
        in: Maughan R.J. The Encyclopaedia of Sports Medicine: An IOC Medical Commission Publications, Sports Nutrition. Wiley, West Sussux, United Kingdom2014: 382-391
        • Burke D.G.
        • Chilibeck P.D.
        • Parise G.
        • Candow D.G.
        • Mahoney D.
        • Tarnopolsky M.
        Effect of creatine and weight training on muscle creatine and performance in vegetarians.
        Med Sci Sports Exerc. 2003; 35: 1946-1955
        • Wentz L.
        • Liu P.Y.
        • Ilich J.Z.
        • Haymes E.M.
        Dietary and training predictors of stress fractures in female runners.
        Int J Sport Nutr Exerc Metab. 2012; 22: 374-382
        • Ross M.L.
        • Martin D.S.
        Heat and altitude.
        in: Deakin V. Burke L. Clinical Sports Nutrition. 5th ed. McGraw-Hill Education, Sydney, Australia2015: 767-791
        • Bergeron M.F.
        • Bahr R.
        • Bartsch P.
        • et al.
        International Olympic Committee consensus statement on thermoregulatory and altitude challenges for high-level athletes.
        Br J Sports Med. 2012; 46: 770-779
        • Meyer N.L.
        • Manore M.M.
        • Helle C.
        Nutrition for winter sports.
        J Sports Sci. 2011; 29: S127-S136
        • Cheuvront S.N.
        • Ely B.R.
        • Wilber R.L.
        Environment and exercise.
        in: Maughan R.J. Sports Nutrition, The Encyclopaedia of Sports Medicine, an IOC Medical Commission Publication. 1st ed. John Wiley & Sons Ltd, West Sussex, United Kingdom2014: 425-438
        • Steinmuller P.L.
        • Kruskall L.J.
        • Karpinski C.A.
        • Manore M.M.
        • Macedonio M.A.
        • Meyer N.L.
        Academy of Nutrition and Dietetics: Revised 2014 Standards of Practice and Standards of Professional Performance for registered dietitian nutritionists (competent, proficient, and expert) in sports nutrition and dietetics.
        J Acad Nutr Diet. 2014; 114 (e643): 631-641

      Linked Article

      • Errata
        Journal of the Academy of Nutrition and DieteticsVol. 117Issue 1
        • Preview
          Due to an undisclosed potential conflict of interest with author Louise L. Burke and the potential endorsement of Sports Oracle, the statement on pp 521 in the March 2016 article “Position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and Athletic Performance” published in the Journal of the Academy of Nutrition and Dietetics that reads, “Enhancement of sports nutrition knowledge and continuing education can also be achieved by completing recognized postgraduate qualifications such as the 2-year distance learning diploma in sports nutrition offered by the International Olympic Committee.
        • Full-Text
        • PDF