TrueSport: July 2021 - Hydration

Now that you know supplements are regulated post-market, you’re probably aware that all supplements are not created equal. Some are manufactured in safe environments with high quality control standards and then tested and certified by independent certification companies. But others are manufactured in ways that allow for both accidental and intentional contamination. Even worse, you can’t rely on that supplement label to know what’s in your product because no regulatory body is evaluating the contents of all supplements before they reach athletes and other consumers.

While it’s difficult to tell if a supplement is safe or potentially harmful, there are some red flags that you can always look out for when it comes to evaluating supplements and determining which ones to use and which ones to avoid.

Through this five-part series on supplements, you will find an overview of the dietary supplement industry so that you can decide if the potential benefits of dietary supplements outweigh the risks. And, if you find you do need to use supplements, how you can better choose a low-risk product.

What types of products should I avoid?

In general, it’s best to avoid supplements that are not certified by an independent certification company. The U.S. Anti-Doping Agency (USADA) provides guidance on reducing your risk from supplements by using NSF Certified for Sport supplements.

If you choose to use uncertified supplements despite the risks, avoid using products with red flags (see graphics below). However, you should always remember that even a thorough review for red flags is no guarantee.

USADA is aware of several dietary supplements that, on initial inspection, would not have exhibited any “red flags,” but testing revealed that they were contaminated with experimental drugs! Because a supplement’s label and contents are not checked by the Food and Drug Administration (FDA) or anyone else before a product is sold, it is completely up to the manufacturer to accurately list the ingredients and the amounts.

While there are many companies that make high-quality supplements and spend a lot of time ensuring the labeling on their products is accurate, there are also companies that are sloppy during manufacturing or deliberately spike their products with illegal ingredients that are not on the label. There have been many cases where seemingly safe or low-risk products ended up containing prohibited performance-enhancing drugs, even though there was nothing on the label that made the product appear unsafe.

How can you identify risky supplements?

Researching your supplements and recognizing red flags is one way to reduce your risk if you decide to use supplements. Before using any supplement, check to see if the product or manufacturer is on the USADA’s High Risk List or the FDA Tainted Supplements list. While these lists are not all inclusive, they do identify many supplements and manufacturers that are known to be risky for athletes and consumers.

You should also consider these red flags while evaluating and researching any supplement you might use.

HIGH RISK COMPANIES

• The manufacturer or company has received FDA warning letters or has been subject to other enforcement actions. Search for the company or product name on FDA.gov or FTC.gov.
• Products sold exclusively on the internet may raise a red flag. While there are some legitimate dietary supplement companies that only have an online presence, some companies deliberately avoid regulatory agencies by opening and closing websites quickly, or selling products online to the U.S. from other countries.

RISKY INGREDIENTS AND UNUSUAL USE INSTRUCTIONS

1. Product lists unrecognizable ingredients that seem out of place, or it lists ingredients by chemical names rather than common names.
2. The supplement label or advertising includes substances on the WADA Prohibited List, or in a general category of the WADA Prohibited List, such as anabolic agents or stimulants.
3. Any of the following phrase or characters on a body building product label should be considered a red flag because they might indicate the presence of steroids: andro, -ol, -diol, -dione, -stene or -stane, epi, epithio, gonado, or any ingredient that is listed as a chemical formula.
4. Any product that is taken or applied to the body in a way other than simply eating it or swallowing it, such as skin patches, creams, injections and drops. Also be wary of extra steps before swallowing, including placing the product under the tongue or swishing it around in your mouth.
5. Ingredients that have no clear, well-documented nutritional value. If you've never heard or an ingredient, then you should stop and do research first.

RED FLAG MARKETING

• Product claims to be "FDA approved," "WADA approved," or "USADA approved." These organizations do not approve dietary supplements.
• The supplement is advertised to be a thermogenic or stimulant-based weight loss or energy product, a sexual enhancement product, or as a hormonal or anabolic product. Companies often add stimulants, Viagra-like drugs or steroids to their products so they "work," but they might not list those ingredients on the label.
• Advertising contains phrases like "newest scientific breakthrough," "secret formula," "money-back guarantee," "quick fix," "used for thousands of years" or "what the experts don't want you to know."
• Product claims to treat or prevent a disease, such as hormone imbalances, the common cold, flu, diabetes or inflammation.
• Product claims to be an "alternative to prescription medication."

Coaching your child's team or coaching your child in an individual sport can be an extremely difficult task, albeit an incredibly rewarding one. It's not a position that should be taken lightly, and there are a few things to remember before you start.

Here's what a group of TrueSport experts and coaches want you to avoid.

Don't coach unless you actually want that responsibility

Too many parents casually sign up to coach without realizing what they're getting into. Before you offer to coach your child's team, get clear on why you want to do it -- and have a conversation with your child about if that's something they even want.

"To set yourself up for success, start by reflecting on why you are coaching this team in the first place," says TrueSport Expert and President of Now What Facilitation, Nadia Kyba, MS. A social worker and expert in conflict resolution, Kyba encourages parents to consider their motives: "Is it because volunteerism is one of your core values? Are you hoping to give your child their best shot at an athletic scholarship? Is it to become closer with your child by spending more time together? There are no right or wrong answers, but the key is to be aware of the reasons and to ensure they make sense in relation to your relationship with your child. Be careful not to get caught up in the ‘win at all cost’ mentality that can put a strain on your relationship.

Don't bring your bias to practice

"Be aware of your bias around your child when you are making decisions, such as starting line-ups, practice times and captaincy decisions," says Kyba. "If you haven’t checked your bias, parents, athletes, and your own child will be sure to pick on decision-making that is not sound." Bias can take shape in two ways: You may find you're tempted to favor your child and put them in the limelight, or you may notice that you actually shy away from putting your child in the starting lineup despite their skill. If you're not sure about where your bias lies, consult with an assistant coach, and above all, be open to feedback.

"To be a critical thinker, it can help to ask questions, gather information and reflect on the decisions and judgments you have made," Kyba adds. This means throughout the entire season, regularly reflect on the progress of all the athletes on the team, including your child. And make sure that your child isn't changing your impression of their teammates. "Are you viewing a player on the team through the lens of a story your daughter told at dinner last night, or putting together lineups that support friendship groups because that’s what your son wants?" Kyba asks. Those seemingly minor biases can impact your ability to coach a team well.

Don't bring coaching home, or bring parenting to the game

"After a game, in the car driving home, an average parent can talk about the game with their kid. But as a parent and a coach, I actually try to leave the coach persona on the ice and talk about other stuff on the way home," says hockey coach Greg Krahn, the latest TrueSport Coach Award winner. "If my kids bring up the game while we're in the car, great, we'll talk about it. But I won't bring it up. I try to view that as family time instead. I'm a dad in the car, not the coach trying to relive the game. Having that separation is important."

Krahn notes that the reverse is true as well: “Now, the other side of that is that when we are on the ice, I'm not Dad, I'm Coach. I tell my kids to refer to me as Coach at practice instead of Dad to create that boundary, and to help assure the other players that my kids don't get treated any differently."

Don't use criticism as a "learning tool"

"Remember that reinforcement is meant to increase behavior whereas punishment is designed to decrease behavior -- and reinforcement is always more powerful than punishment," says TrueSport Expert Kevin Chapman, PhD, clinical psychologist and founder of The Kentucky Center for Anxiety and Related Disorders. This is especially important for parent-coaches to understand, since it can impact your relationship with your child at home in addition to on the field. "The risk you run in criticizing your student-athlete -- punishing him or her -- is that they may increasingly equate their performance with their identity and presume your love is contingent upon their performance.” You can offer guidance and advice, but try to avoid criticism in favor of productive, proactive suggestions.

Don't forget your athlete's feelings

It can be easy to assume that your child enjoys having you coach his or her team. It's also easy to be so focused on treating everyone on the team fairly that you actually end up treating your child worse than the other kids on the team! "Check in regularly with your child. How do they feel about having you coach? Are they happy about it? Are there aspects that they like and others they don’t? Consider adjustments based on their feedback," Kyba advises.

Don’t expect to coach them forever

Kyba also reminds parents that coaching your kid shouldn't last forever. "Have a plan for how they will tell you if they no longer want you to coach. It may hard for them to tell you this, and they may worry about hurting your feelings," she notes. "But often as kids get older and are seeking independence -- which is developmentally natural -- they no longer want a parent-coach. They prefer to keep their family and sport lives separate. When they say it’s time for a change, accept this with grace and thank them for their honesty. Now it’s time to be their biggest fan from the sidelines."

If you're not the coach, don't coach

Right now, many parents have found themselves taking on a facilitator/coach role while school sports are put on hold due to the pandemic. If you're reading this article because that's the situation you're in, board-certified family physician and TrueSport Expert Deborah Gilboa, MD, urges you to remember that in this case, you're not the coach and shouldn't be "coaching" your athlete.

"During the pandemic, as parents, we have tried really hard to not become our children's teachers, but to support their learning. The same is true of their athletic goals." Rather, you should be helping them organize their practice sessions, helping where needed and relying on the team's coach to provide instruction for practice.

Takeaway

Coaching your own child is a serious responsibility and there are undoubtedly things NOT to do when taking on this role. Use these expert tips when determining if and how to become your athlete’s coach.

When it comes to proper hydration, calculating sweat rate is one of the easiest ways to ensure that your young athlete is drinking enough to stay hydrated during sport. And understanding sweat rate—how fast an athlete's body is sweating out fluids—is important for both performance and safety.

"People's hydration needs are really individual. If an athlete is even two percent dehydrated, that can decrease their performance by around 20 percent,” explains TrueSport Expert Kristen Ziesmer, a registered dietitian and board-certified specialist in sports dietetics. "Calculating your sweat rate is one of the best ways to tailor your hydration plan. It shows you how much fluid you're actually using, and how much you need to drink -- and it's one of the cheapest and simplest tests to do."

Here, Ziesmer explains how to help your athlete calculate sweat rate, and what you need to know to optimize their hydration plan.

Sweat rate is a moving target

The ounces of fluid an athlete loses per hour will change with different conditions. You may need to calculate it a few different times so your athlete knows how much to drink in different temperatures and weather situations. Of course, the hotter it gets, the more your athlete will sweat.

But is it a dry heat? Humidity is an important consideration in addition to general temperature. "The way that your body cools itself is by sweating and having that sweat evaporate," explains Ziesmer. "But when you are in a humid environment, sweat never has the chance to evaporate. So your body's just getting more hot, more sweaty, and more dehydrated."

How to calculate sweat rate

Before calculating sweat rate, have your athlete step on the scale before and after each practice session, and during practice, measure the amount of fluid they drink. Ziesmer suggests repeating this calculation several times to get an average, since there is plenty of room for error -- your athlete might forget that cup of sports drink that she chugged mid-practice. (Note: Make sure your athlete empties their bladder before getting on the scale to weigh in.)

Calculation:

1. Weight before exercise - Weight after exercise (in pounds)
2. Weight lost in pounds (A) x 16 ounces
3. Amount of fluids consumed during activity (in ounces)
4. Total fluids used during activity (B + C)
5. Duration of activity, in hours
6. Sweat Rate per hour = D / E

Example:

1. Weight before exercise (140 pounds) - Weight after exercise (138 pounds) = 2 pounds
2. Weight lost (in pounds) x 16 ounces = 32 ounces
3. Amount of fluids consumed during activity = 16 ounces
4. Total fluids used during activity (32 + 16) = 48 ounces
5. Duration of activity, in hours = 2 hours
6. Sweat Rate = 48 / 2 = 24 ounces per hour

Practice good judgement with scale usage

Some athletes shouldn't be looking at the scale, even if it is for the purpose of determining sweat rate. If your athlete has a history of disordered eating, eating disorders, body dysmorphia or any other kind of issue around his or her weight, Ziesmer recommends having your athlete stand on the scale facing away from the number while you record the information.

Keep the scale usage the same

When dealing with weights that are calculated down to the ounce, things like if your athlete is wearing his shoes on the scale or taking them off will matter. And for sweaty athletes in sports like cross-country running, another potential scale problem on hot days is that their clothes may be soaked with sweat after practice, so doing a pre- and post-workout weight check while they're wearing consistent attire is going to lead to a more stable calculation. An ounce or two doesn't make a major difference, but heavy shoes and extra gear can easily add a pound or two to the scale weight and throw off the calculations.

Use that sweat rate to determine hydration needs

The sweat rate -- ounces of fluid an athlete loses per hour -- is roughly what should be replaced per hour. In the above example, the athlete would need to drink around 24 ounces of water each hour in order to stay optimally hydrated. Ziesmer breaks it down even further for athletes by considering the number of times an athlete will drink per hour during practice, which will vary a lot depending on the type of sport and availability of drinks. If the athlete in the example above was playing soccer, for instance, she can only drink when she's over on the sidelines. If that happens four times each hour, and she needs to drink 24 ounces per hour, that means she'll need to drink six ounces of water or sports drink every time she's on the sideline.

Electrolytes are part of the equation as well

If your athlete tends to cramp during activity, low electrolytes might be to blame, and sodium in particular is a common culprit. "Cramping occurs due to one of four things: dehydration, low sodium, low carbohydrate, or as a result of being untrained," Ziesmer says. Focus on replenishing sodium with around 1 gram of sodium per hour of intense, prolonged activity. This can be done with a sports drink, electrolyte tab, or even simply a pinch of sea salt in your athlete's water bottle.

Have a recovery plan

Post-workout, for every pound lost, athletes should drink 24 ounces of fluid for recovery. (So, in the above example, an athlete should drink 48 ounces for recovery.) Athletes also need to eat carbohydrates for recovery: Chugging water alone isn't going to be enough to help them fully recover, Ziesmer notes. Her rule of thumb for how many grams of carbohydrate to eat post-workout is your athlete's weight in pounds multiplied by .7. That recovery snack should be eaten within 30 minutes of finishing the activity, and fluid recovery plus a full meal (including a protein source) should happen within two hours of finishing.

Watch for signs of dehydration

Even if you think you understand sweat rate and have calculated it correctly, tell your athlete to pay attention to signs of dehydration. Ziesmer explains that these signs include fatigue, headaches, nausea, chills, and sweating. Dehydration is a medical emergency, and the earlier it can be caught, the better your athlete's ability to recover will be.

Takeaway

Hydration is critical to both safety and performance. To truly understand your athlete’s hydration needs, it can be helpful to calculate their sweat rate and optimize their hydration plan using that information.

If your team has a hefty travel schedule and you regularly compete in cities that are more than 3,000 feet above sea level, you may be concerned about how to ensure your sea-level-dwelling athletes are prepared for the higher altitudes. The good news is that you can mitigate some of the potential negative effects of altitude for your athletes so that they can focus on the game and not the thinner air. TrueSport Expert Kristen Ziesmer, a registered dietitian and board-certified specialist in sports dietetics, explains what you can do to ensure your athletes are prepared for altitude.

Know your altitude

Most destinations for travel sport teams won't be at altitudes that will really affect your athletes' performance, says Ziesmer. But anything over 3,000 feet above sea level, such as Denver, Colorado, will start to shift their hydration and fueling needs, as well as their perceived exertion.

Pre-hydrate

"Make sure your athletes are well-fueled and well-hydrated before they go," says Ziesmer. "That really goes for any type of competition, but it's especially important at altitude. Have them up their drinking game the week before, aiming to drink between 25 and 50 percent more than they normally would."

... And keep hydrating

"The same thing applies once you're at altitude: Athletes should aim to drink about 25 to 50 percent more than they would drink normally,” says Ziesmer. “They should adjust their fluid intake based on the color of their urine -- it should ideally be a lemonade-like pale yellow -- and their weight. If they're gaining weight, they can cut back on water, but if they're losing weight, they should drink more."

Remember dehydration signs may change

At higher altitudes, it's easier to becoming dehydrated faster -- and research has found that thirst cues are less reliable. "Your body is cycling through oxygen faster as altitude increases," Ziesmer explains. "Higher altitudes also tend to be really dry, so athletes will sweat more, which makes them dehydrate faster. Typically, people also urinate more at higher altitude, which can add to dehydration."

Check in on sweat rate

Keeping an eye on the scale while at altitude is important, and if your athletes have done calculations on their sweat rates in the past, they may need to retest their sweat rates while at altitude. "Some athletes respond differently to altitude and to different weather situations," says Ziesmer. "If an athlete is losing a lot of weight during exercise at altitude, then they need to adjust how much they're taking in in terms of fluid during practice. They also need to appropriately rehydrate and refuel afterwards."

Drink regularly, don't chug

Throughout the day, athletes should be steadily drinking. Dehydration at altitude isn't just happening from a lack of hydration during practice, it's happening because athletes aren't drinking enough during the rest of their day. "The best thing for an athlete to do is try to drink a little bit every 15 to 20 minutes, rather than just chugging a bunch of water when they have a break," says Ziesmer.

Add electrolytes

"At altitude, because you're sweating more, the body requires a bit higher electrolyte intake," says Ziesmer. Not every drink needs to be a sports drink or electrolyte-infused, but Ziesmer favors splitting drinks between water and an electrolyte-based drink.

Fuel appropriately

While hydration is critical, proper fueling matters too. Traveling for training or competition can shake up an athlete's eating routines and mealtimes, but because of the high energy output they'll be expending during training or competition, it's important that their carbohydrate stores are topped up. In fact, research has found that most issues related to altitude training are actually related to the increased training stress rather than the altitude itself. "Training camps and travel competitions mean that athletes need to be eating more, not less," says Ziesmer. "But weird schedules and less access to food can make eating enough difficult." Make sure your athletes have access to regular meals and healthy snacks that they can grab between practice sessions.

Takeaway

Coaches are often responsible for athletes’ health and wellbeing while traveling, and when competing at altitude, hydration is especially important. These tips will help keep your team hydrated, feeling good and performing well.

For young teenagers, diet culture is hard to avoid. Whether they hear about a new fad from friends or read about a new diet trend in a health magazine, there's often pressure to have some kind of stance on food. And while some diet trends like intermittent fasting might be safe and healthy for most adults, that is not the case for children and teen athletes who are developing at a rapid pace. Any diet that puts restrictions on how an athlete eats should be looked at critically, and fasting in particular can be a gateway to destructive eating behaviors.

Here, TrueSport Expert Kristen Ziesmer, a registered dietitian and board-certified specialist in sports dietetics, explains what parents need to know about fasting and young athletes.

Kids don't need restrictions on diet

Eating when hungry is critical for development -- not just physical development, but also for athletes being able to understand their bodies and register their own hunger cues rather than relying on a clock to decide when they're "allowed" to eat. And fasting now can have consequences later: A study in 2013 found that any kind of dieting as a child or young adult increased the likelihood of developing an eating disorder in later years. Meal skipping has also been shown to lead to nutritional deficiencies in kids. Even if they're getting enough calories, it's often hard to make up all of the micronutrients that are critical to a young athlete's development. "Kids should be able to eat whenever they're hungry," Ziesmer says. "There's no good reason that a child should be fasting."

Remember that children model parent's behavior

"Often, kids get these ideas about following diets and food trends from their parents," says Ziesmer. "Remember that what works for you isn't necessarily going to be good or healthy for your growing athlete. And remember that your athlete is watching how you eat and hearing how you talk about food and your weight," says Ziesmer. "I see a lot of parents who are doing fasts or a restrictive diet like Whole30 and their children end up doing it as well."

Even if you're not suggesting that your child do a diet alongside of you, they may want to try it to lose weight, or you may be accidentally restricting their intake because you're no longer making breakfast for the whole family, or you're cooking only Whole30-approved options for dinner. If you're on a diet of any kind, ensure that your athletes still have access to the food that they need.

Fasting can be a gateway to an eating disorder or disordered eating patterns

Restricting hours where eating is "allowed" can be an athlete's way of maintaining strict control, says Ziesmer, and that can easily progress into an eating disorder or disordered eating. "Intermittent fasting is basically just a form of calorie restriction, which is not recommended for kids because they are still growing and developing,” Ziesmer explains. “Intermittent fasting can also lead to binge eating later on because your athlete is so hungry. In some cases, it can even lead to more severe disordered eating. It's better to focus on healthier eating practices overall and being active."

Fasting can cause attention issues in school and sport

For most student athletes, intermittent fasting is difficult because athletes can easily have an early morning practice, followed by a full day of school and possibly another practice, activity, or competition after school. That all requires fuel to function, but most intermittent fasting windows skip breakfast and focus on the middle part of the day—the time an athlete is typically in school and unable to eat an entire day's worth of food during a lunch period.

"There is research about kids who skip breakfast, and it shows that they wind up performing worse in school and on tests," Ziesmer says. "Skipping meals can lead to low glucose, which leads to low hormones, which can lead to agitation and irritability."

Adopt a "natural" eating schedule instead

Ideally, the body does get a break for a span of hours in order to rest and digest (this happens while we sleep). While intermittent fasting isn't a good idea or a necessary one for a young adult, if your teen wants to try it, a 12-hour window (i.e, not eating from 7 p.m. to 7 a.m.) won't be detrimental. It allows plenty of time for the body to reset and recover -- getting the potential benefits of intermittent fasting—without depriving your athlete of critical calories. But always make sure your athletes can eat before, during, and after practice.

Takeaway

Fad diets, including fasting, are often not appropriate for developing and active young athletes. Learn why not from our expert dietitian.