How to Handle the Emotional Effects of a Young Athlete’s Concussion

Concussions are currently a hot topic in the media and within the sports medicine world. It is important to know about the dangers, signs, and symptoms of concussions as well as what measures can be taken to prevent or minimize concussion risk. Athletes must closely follow the recommendations of doctors and trainers before returning to play, school, or regular activities after a concussion.

What is less emphasized in concussion and/or other head injury discussions are the emotional and psychological experiences that athletes experience during or after a concussion. As with many sports injuries, concussions can place an athlete at an increased risk for depression, irritability, and isolation. The common psychological symptoms associated with injuries in general (i.e. knee injury) are often magnified when dealing with a concussion because of the sensitive nature of the brain.

An athlete that has suffered from a concussion may demonstrate dramatic or subtle changes in mood and behavior, which should be carefully monitored and attended to during and after recovery. Like many injuries, concussions can result in a number of emotional experiences. Here are some important areas to consider or be aware of in a concussed athlete:

  • It is important to observe mood and emotional well-being, social adjustment, sleep and eating habits, etc. during the concussion period and continue to follow such symptoms after medical clearance and other medical signs of injury appear to be resolved. Continued emotional symptoms may indicate post concussion syndrome (PCS) and should be evaluated.
  • The severity of the head injury does not correlate with the likelihood of PCS. For example, a mild concussion does not necessarily mean PCS symptoms will be mild and a severe head injury does not necessarily mean that PCS symptoms will be severe.
  • Ensure athlete is receiving adequate sleep and nutrition.
  • Limit stimulation and stress but allow for regular, healthy, and moderate social interactions, as isolation can lead to worsening of symptoms.
  • Ask for modifications at school so that the athlete may engage in academics (when cleared) but does not become overwhelmed.
  • Early identification and treatment of negative emotional responses to concussions and PCS is critical and can dramatically improve outcomes, decrease recovery time, and can be helpful in preventing the development of more severe psychological responses.
  • Trained sport psychologists can help to identify concerning emotional responses to a concussion or PCS symptoms and work with athletes to help them resume healthy emotional functioning.

Written by: Kendra Dunn, Psy. D., Certified Sport Psychologist Consultant. Some information in this blog post has been adapted from the Etiology of the post-concussion syndrome: Physiogenesis and psychogenesis revisited article. 

How to Pack a Healthy Lunch for a Day of Skiing or Snowboarding

When we moved to Colorado, we quickly found a ‘locals’ mountain that fit our lifestyle.  Since then, we pack our lunch in a backpack, bring it up the mountain on the first run and throw it under a tree with everyone else’s backpacks.  The snow keeps our lunch cold until we are ready to eat.

Depending on your weight and the terrain that you ski, you may burn between 400-750 calories per hour of downhill and cross-country skiing.

Here are some tips for making the most of your lunch on the slopes:

Types of food to eat

  • A good supply of carbohydrates that will keep your muscles fueled all day.
  • Some salty foods, fruits and nuts for electrolytes.
  • Protein, mostly from leaner sources, and a little fiber that will keep your body feeling well fed but not sleepy.

Examples of foods to pack for the day

  • Turkey and cheese, or peanut butter with jam or honey on whole grain bread-you may need two sandwiches.
  • Portable fruit or vegetables: Oranges or cuties, dried fruit such as raisins and apricots, ready-washed bag of snap peas
  • Crunchy/salty snack:  pretzels, pop chips, tortilla chips

Snacks? Think hearty and portable:

  • Cereal bars with protein
  • Trail mix with your favorite foods-nuts, seeds, cereal, dried fruit, chocolate bits, mini pretzels or any of these things by themselves.
  • You will be burning plenty of calories so hot chocolate or a cookie and low fat milk is a great treat on a cold, high-energy expenditure day.

Stay hydrated! 

  • To avoid dehydration and increased potential for altitude sickness, be sure to stop for fluid breaks.
  • Drink lots of water. Juice and milk are also good options.
  • An indicator of hydration is urine color and volume.  Aim for light yellow and decent volume when you go to bathroom.  Otherwise, it’s time to take a rest and tank up with some water, juice or a sports drink.

What do you eat for lunch while spending a day on the slopes?

Written by:  Lauren Furuta, RD, Clinical Nutrition, Children’s Hospital Colorado.

Gymnastic Safety Tips

Gymnastics is a vigorous sport that can lead to building some of the most dynamic young athletes in the world and, at the same time, results in more injuries than most people realize. In fact, statistically, it has similar injury rates to football and rugby. The U.S. Consumer Product Safety Commission reported 22,000 children under the age of 14 years were treated in hospital emergency rooms for gymnastics-related injuries in 2009 and this number is trending upward. Almost half of the injuries occur with hand springs and flips; as the learning of these skills is a process of repeated failures and falls.

To limit the risk of injury, four tips should be followed (I would use followed with ‘tips’ and taken with ‘steps’) with all levels of gymnastics participation.

1. Set appropriate environment boundaries for training

Gymnastics facilities spend tens of thousands of dollars on protective equipment to pad and decrease the strains of the sports frequent tumbles and falls. Your basement or backyard lacks this same protection and is not the location to demonstrate to friends your “special tricks,” or master new skills.  Parents need to set appropriate boundaries on where training occurs. Protective environment also includes the proper hand grips, wrist guards and event specific bracing that the coach may recommend.

2. Let your body take a break

Physical conditioning is a year round activity, but gymnastics at an early age should not be.  Everyone needs a physical and emotional break throughout the year and this allows small strains to recover and not turn into significant injuries. Playing on multiple teams is rarely healthy and is setting you up to be injured.

3. Warm up and cool down before performing

Dynamic warm ups, appropriate post practice, or a training cool down with stretching helps the body absorb more strain, delaying injury and increasing the body’s tolerance to the demands of the sport long term.

4. Take your time to master the sport

Finally, gymnastics should not be a trial and error sport. Learning a new skill requires coaching, spotting and appropriate feedback on each attempt, as the child learns and adapts to a new challenge. Children below the age of 12 struggle with complex commands and do better with visual feedback. Filming their attempts on an electronic device can be helpful and gives them the ability to self-assess.

When an injury does occur it is important to fully recover with full range of motion, pain free strength, and a gradual build up to the prior level to allow the body to re-adapt after a break.

Written by: Nathan Estrada, sports medicine therapist for Children’s Hospital Colorado’s Outpatient Specialty Care in Parker, Colorado. Did you like this blog post? Then consider subscribing to our blog to receive helpful advice, resources and information for young athletes. 

How To Be a Positive Parent of a Young Athlete

When I was playing sports as a kid, most parental involvement included things like  bringing orange slices for half time or picking your kids up from  practice on time . It was exciting to hear your parents’ voices in the crowd cheering for you and later giving accolades, regardless of the outcome or individual performance that day. It seems this role has taken a negative turn recently. Not all parents have participated in this transformation, but some parents have been spotlighted for exhibiting out of control behaviors – displaying anger towards referees and opposing teams.

  • It’s important to set a good example of sportsmanship for your kids and even other parents. Here are some tips for being a supportive and positive parent of an athlete:
  • Help your child understand winning isn’t everything. Make sure you help to emphasize the positive things they can gain from playing sports, such as camaraderie and self confidence.
  • Pay close attention to the influence your actions and words have on your child. Pressure and high expectations from parents can influence the satisfaction young athletes get out of their sport. Check in throughout the season and make sure you’re they are enjoying their sport.
  • Think before you act out in the stands or voice your opinion to a referee or member of the opposing team. Is this role model behavior?
  • If you do become upset over a referee’s call or a coaching decision, walk away from the event to cool down and collect your thoughts so your actions remain positive. Remember, you are not only a role model for your child, but you also represent his or her team as well.
  • From the start of the season, take the time to understand the coach’s philosophy about team rules, playtime, travel, practices, etc.
  • Respect the coach’s guidelines about boundaries, especially when it comes to communicating with him or her (email, texting, call limitations).
  • Follow the limits set by the coach in regards to coaching from the sidelines or sharing your opinion about a specific coaching decision.
  • Do not be afraid to ask appropriate questions at parent meetings or informational sessions. Chances are a couple other parents will benefit from your inquiry as well.

Written by: Melissa GollickSport Psychology Consultant, Children’s Hospital Colorado.

Families on the Go: The Importance of Eating Dinner with Your Family

I’m breathing a sigh of relief because my kids’ fall sports seasons officially ended last week. That means no more soccer practice during the dinner hour! Well, at least for the next three months.

If your family is anything like mine, it is not uncommon for the five of us to be going in three different directions on certain school nights. Also, our work schedules can interfere with time for meal preparation. So it takes determination to have homemade dinners prepared for us to eat together around our dining room table.

Why are family meals so important?

Researchers from the University of Minnesota have studied family meals through Project EAT (Eating Among Teens), where they found that about a third of families with teenagers have two or less family meals each week. Family meals are associated with healthier food choices; fewer disordered eating behaviors, less substance abuse, and better psychosocial well-being among adolescents.

Tips for preparing family meals

The most important part of preparing healthy dinners is to plan ahead. Here are some meal ideas for your busy seasons in life:

1. Buy frozen meals and customize them: 

  • Add your own veggie toppings and grilled chicken to a frozen cheese pizza.
  • Add green peppers, onions, and pineapple to frozen sesame or orange chicken, serve with brown rice.
  • Add marinara or cream sauce to frozen ravioli, serve with salad and garlic bread.

2. Make homemade breakfast for dinner – be sure to add fruits or vegetables

3. Have a few “go to” recipes that you are familiar with and you know are quick and easy. Keep your freezer full of staples like lean meats, vegetables, fruits, and breads. Keep your pantry stocked with staples like pasta and rice. Have milk ready to go in your refrigerator.

4. For those of you who are ambitious:

  • Prepare dinner in the morning and cook it in the crock pot while you are at work and the kids are at school.
  • Take a weekend day or day off from work and prepare meals ahead of time in big batches. Store them in the freezer. I like to have a stash of homemade chili and marinara sauce in our freezer.

More tips:

  • Don’t be too hard on yourself. Strive for improvement, not perfection. Project EAT found that some benefits of eating meals together can be seen with as little as three meals per week.
  • Eat an early dinner (right after school) or a late dinner (after practice) – whichever fits into your family’s schedule better. At least you’re eating it together.
  • Weeknight dinners don’t have to be the only family meal. If a tournament isn’t occupying your weekend, try a family brunch or Sunday afternoon meal.
  • Even if you’re having breakfast for dinner you can still set the table and light the candles.
  • Turn off the TV during mealtime! Project EAT found that families who eat with the TV off had teenagers who ate more fruits and vegetables and less fried foods and soda.

I’m thankful that life comes in seasons. If we we’re so inclined, our kids could play competitive soccer year round. But we choose to take time off in the winter and the summer to pursue other things.  Encouraging family meals is just one of many reasons why it is a good idea for young athletes to have one to two rest days per week and two to three months off from their sport per year. Learn more about overtraining and burnout in young athletes.

And you can look forward to that big milestone when your young athlete reaches high school, because practice is after school instead of during the dinner hour! Now that’s something to cheer about!

What has helped you keep family meals on the calendar?

Written by: Laura Watne, MS, RD, Clinical Nutrition, Children’s Hospital Colorado. To learn more, visit our Orthopedic Institute website, or schedule an appointment at 720-777-6600. We are happy to consult with parents or referring providers before a patient is seen at Children’s Colorado. Did you like this blog post? Then consider subscribing to our blog to receive helpful advice, resources and information for young athletes.

Common Volleyball Injuries in Young Athletes

Side out. 

Second to only soccer, volleyball has one of the highest participation rates worldwide, including both indoor and beach volleyball. It is one of the unique team sports that has evolved into two distinct Olympic events–indoor and beach. Although injury patterns differ between indoor and beach volleyball, there are similar injuries commonly seen between the two sports. Overall, overuse injuries are more common than acute injuries because of the amount of repetition, improper technique, and type of playing surface. Overuse conditions of the knee, shoulder and lower back are not unusual in volleyball.

Ankle injuries

Ankle sprains are the most common acute injuries seen in volleyball athletes, accounting for about 40% of all volleyball related injuries. They occur most commonly at the net when an opposing player lands onto another player’s foot.  When dealing with an ankle sprain it is important to adequately rehab the injury before returning to play, preferably under the supervision of an athletic trainer or physical therapist.

Recurrent ankle sprains are extremely common within 6 months of the initial injury, owing to inadequate rehabilitation. One study showed that balance board training to regain balance is an effective tool to help prevent recurrent ankle injuries in volleyball players.

Hand injuries

Trauma to fingers is extremely common, especially during setting and blocking. Most finger injuries in volleyball involve joint sprains, tendon tears, and dislocations. X-rays are indicated in most finger injuries in volleyball to evaluate for any fractures.

Knee injuries

The nature of volleyball requires repetitive explosive jumping, which places a lot of stress on the patellar tendon, resulting in pain in this area. At some point, approximately half of volleyball athletes develop patellar tendinitis, known to many as “jumper’s knee”.  The most common site of pain is where the patellar tendon attaches to the lower pole of the knee cap. Treatment consists of stretching and strengthening exercises, and use of a patellar tendon strap can sometimes improve the pain. For some athletes, a period of rest from jumping activities may be necessary.

Although not as common as patellar tendinitis, anterior cruciate ligament (ACL) tears can be a more serious injury and typically occurs in volleyball during a cutting maneuver or when an athlete comes down from a jump awkwardly. Most athletes who wish to return to high demand sports like volleyball generally opt for surgical repair to have the ligament reconstructed. Because many athletes have difficulties returning to high level sports and the potential long term complications after an ACL tear, there is a lot of emphasis placed on prevention programs.

Shoulder injuries

Volleyball players repetitively use their shoulders for overhead serving, spiking and blocking, which commonly leads to shoulder pain. Overuse of the rotator cuff muscles can lead to rotator cuff tendinitis or tears, which is more commonly seen in adults than in young athletes, although it can occur. More often, pain from shoulder instability and resulting impingement is what we typically see in our young athletes. In addition to the rotator cuff muscles, there are also ligaments that help to stabilize the shoulder joint during movement.

In volleyball, the player’s arm typically goes into extreme positions and rotations for hitting. When these muscles and ligaments are overworked and unable to restrain excessive movement of the shoulder, the player may sense as if the shoulder is unstable and typically will develop pain when the rotator cuff and labrum (cartilage) gets impinged against structures inside the shoulder joint because of excessive shoulder movement. Over time, this can also lead to a labral tear.

Lower back pain

Back pain in volleyball players is very common because of repetitive bending and rotating of the trunk. Strains of the lower back is the most common back injury although the repetitive hyperextension of the lower back during hitting and setting can also place a lot of stress on the lower back bones. This can lead to stress fractures of the vertebra in the spine, known as spondylolysis, which is a very common cause of low back pain in volleyball players. Adolescents, in particular, are very vulnerable to this injury because their vertebral bones are still weak in this area. Learn how we treat spondylolysis.

Although volleyball is a relatively safe sport compared to other high contact, collision sports, it does lend itself to unique injury patterns; particularly overuse injuries of the knee, shoulder and back. Like many young athletes who are training year round or are focusing on just one sport, regardless of which sport, overuse injuries in volleyball players are becoming problematic. To help prevent these overuse injuries, we highly encourage limiting the number of teams an athlete plays on in a given season, as well as discouraging participation in only one sport year round.

Written by: Quynh Hoang, MD, FAAP, CAQSM, Pediatric Primary Care Sports Medicine Assistant Professor, Department of Orthopedics, Children’s Hospital Colorado.

Winter Sports Safety Tips-Have Fun, Stay Injury-Free

Skiing, hockey and sledding, oh my! We are lucky to live in Colorado…the Rocky Mountain winters allow us to enjoy outdoor activities including

Winter recreational activities provide all of us – adults and children – with a ton of fun, but along ice skating, snowboarding, snow tubing, snowmobiling and many other snow sports.

Here are some quick  winter sports tips to help ensure keep everyone safe as you and your children head outdoors. *with that comes a lot of risk for injuries. It’s early in the season, but we are already starting to see a lot of winter sports-related injuries in our sports medicine clinics.

Sledding and Snow Tubing

  • Finding a good hill. Choose one that has a clear path without obstacles in the way. Make sure that the hill does not end on a street, road, parking lot or any bodies of water such as a pond or river.
  • Never slide down hill headfirst. Sit up facing forward to steer. Risks of head and back injuries are greater by lying down on the sled.
  • Clear the bottom of the hill. Make sure that no one is at the bottom of the hill before allowing another sled to go down the slope.
  • Do not use materials that can be pierced by objects in the ground as sleds. Examples include rubber or plastic sheets.
  • Use a sled with runners and a steering mechanism. Toboggans and snow disks are not as safe.

Snowmobiling

  • Any child under 6 years of age should not be allowed to ride on a snowmobile, regardless if an adult is present.
  • Children under 16 years of age should not be permitted to operate the snowmobile.
  • A bike helmet is not appropriate! Do wear certified helmets designed specifically for high speed motor sports.

Ice Skating / Pond Skating

Choose skating rinks over pond skating.

If you do choose pond skating, here are some recommendations:

  • Call local authorities to ask which areas have been approved and to ask permission to skate on a pond or lake.
  • Make sure that the weather has been cold enough for at least one week before skating on a pond or lake.
  • Skates need to be sharpened properly before skating on pond or lake ice.

Skiing and Snowboarding

  • If your child has never skied or snowboarded, enroll them in lessons.
  • Warm up the muscles that will be used in skiing and snowboarding with exercise activities to help prevent injuries. Take the time to stretch after the warm up as well.
  • Use proper ski and snowboard equipment such as well fitted boots and adjusted bindings. Ask a certified technician to help with the fittings.
  • Stick to trails within your child’s skill level.
  • Pay attention to signs on the trail. Obey trail closure and do not go off trail.

General safety for any winter activity

  • Always wear a helmet and make sure they are properly fitted!
  • Helmet safety is of utmost importance to help prevent head injuries.
  • Different activities require different types of helmet so choose appropriately and make sure they are certified to meet federal safety standards.
Activity Type of Helmet
Skiing and Snowboarding Ski helmet
Sledding, Snow Tubing Ski helmet or Bicycle helmet
Ice Skating Bicycle helmet, Multi-sport helmet
Snowmobiling Snowmobile helmet
  • An adult should always be present to supervise
  • Dress for the winter- wear warm fitting clothes, dress in layers and stay dry.
  • Stay hydrated. Have them drink fluid before, during and after their activities.
  • Don’t forget sunscreen!  Even on overcast days, especially up in the mountains, the sun rays can be harmful.

*Some of these guidelines are adapted from the American Academy of Orthopaedic Surgeons (AAOS) position statement on winter sports safety.

Written by: Quynh Hoang, MD, FAAP, CAQSM, Pediatric Primary Care Sports Medicine Assistant Professor, Department of Orthopedics, Children’s Hospital Colorado.

Mini Veggie Pizza Post-Game Snack Recipe

The game is over, and it’s not quite time for lunch or dinner. But you may want to consider making a fun alternative snack of mini veggie pizzas to refuel your young athlete after a long game.

Just follow the directions below.

Recipe time:

Allow for 15 minutes of preparation before you leave for the game.

What you will need:

  • 8 mini bagels (try choices with fiber)
  • 1 cup pizza sauce
  • 2 cups shredded cheese (Part skim mozzarella)
  • 1 cup chopped veggies (Note: bright colored veggies offer great nutrition) 

How to make:

Split each bagel and add 1 tablespoon of pizza sauce onto each half. Top with your favorite veggies (i.e. bell peppers, onions, mushrooms, etc.) and divide the cheese evenly over each mini pizza. When you get home from the game, broil your already prepared mini pizzas until cheese is bubbly.

You have made a healthy, vegetarian alternative to a traditional delivery pizza.

Nutritional information* per 1 bagel prepared or per serving
Calories

220

Fat

6g

Carbohydrates

28g

Protein

13g

Fiber

1-2g

Servings

8

*Source: Calorie King

Get more healthy recipes and resources from the Weight Management Program at Children’s Hospital Colorado.

Download our Calorie Card that can help your child make healthier food choices.

Do you have a favorite team recipe? Let us know in the comments section below. 

Is a Vegetarian Diet OK for Young Athletes?

Adolescence is a time of experimentation and growth and this often happens within the realm of eating.

Teenagers may decide to become vegetarians for various reasons including animal rights, religious reasons and/or perceived health benefits. Parents should engage their young athlete in a conversation regarding motivations for starting such a diet to ensure it is not being used as a means of weight control.

Types of vegetarian diets

Being a vegetarian is not ‘one size fits all’ or the same for every person. There are many types of vegetarians and it is important to recognize the differences among them. Below is a table that outlines the different types of vegetarian diets.

Vegetarian Type  Animal proteins allowed Animal proteins excluded
Semi-vegetarian May allow all or certain animal proteins in limited amounts Variable
Lacto-ovo vegetarian Dairy and eggs Meat, fish and fowl
Lacto-vegetarian Dairy Eggs, meat, fish, fowl
Vegan None All

 

 

 

Food choices to keep vegetarians healthy

Because the vegetarian diet excludes certain foods, protein and certain vitamin and mineral intake can be low. If the vegetarian is thoughtful about their food choices, however, the diet can also be made complete. The more restrictive the vegetarian is, the more thoughtful they will need to be about incorporating the following nutrients:

Protein

Protein intake is important for young athletes because it helps build and repair muscles. Good vegetarian sources of protein to keep your young athlete strong include:

  • Nuts and nut butters
  • Seeds
  • Beans and lentils
  • Whole grains
  • Tofu and soy milk
  • Protein analogs (i.e. veggie burgers)
  • Protein bars

Calcium and vitamin D*

Calcium and vitamin D build and maintain strong bones. Specifically, calcium is involved in many processes that send messages to the nerves and muscles so that the body can move. Learn more about calcium and vitamin D deficiency.

Vegetarian sources for calcium and vitamin D include:

  • *Dairy foods and eggs (depending on vegetarian type—see the table above)
  • *Fortified foods and beverages such as soy, rice and almond milks, orange juice, cereals and protein bars. Note: check the label for vitamin D and calcium.
  • Vegetables, like broccoli, kale and Bok Choy
  • Sesame seeds, almonds and dried beans

Vitamin B12

Vitamin B12 helps maintain healthy blood cells and the nervous system. B12 deficiency can lead to a certain type of anemia that can cause such symptoms as fatigue, which can affect a young athlete’s performance. Great vegetarian sources of vitamin B12 include:

  • Dairy and eggs (depending on vegetarian type—see the table above)
  • B12 fortified foods (be sure to check labels, as it is not in all brands)
  • Meat analogs (i.e. veggie burgers, soy burgers and soy chicken analogs)
  • Rice, soy and almond milk
  • Cereals and protein bars

Iron

Iron helps carry oxygen throughout the body, including muscles where it can be stored. Low iron in the body can mean a tired athlete. To avoid fatigue, vegetarian sources for iron intake for young athletes can include:

  • Legumes, enriched cereals and breads
  • Nuts, blackstrap molasses (thick syrup) and prunes
  • Dark green vegetables

Guidance for young vegetarian athletes

Athletes can be vegetarians, but they need to be mindful of their diet’s potential inadequacies. It’s always a possibility that the young vegetarian athlete may require a vitamin/mineral supplement to ensure the diet is complete. Also seeing a registered dietitian is a good step to help the athlete maintain the nutrition necessary for their sport while choosing a vegetarian lifestyle. For more information about a vegetarian diet, check out this list of helpful resources.

Do you have a favorite vegetarian recipe or favorite site for vegetarian recipes that you would like to share?                                    

Written by: Lauren Furuta, MOE, RD, Clinical Nutrition, Children’s Hospital Colorado. To find out more about nutrition tips, read our archived sports nutrition posts, or schedule an appointment at 720-777-6600. We are happy to consult with parents or referring providers before a patient is seen at Children’s Colorado.

How Much Iron Do Young Athletes Need in an Everyday Diet?

Young athletes hear a lot about the importance of eating enough calories and drinking the right amount of fluids for their performance and growth.

As a dietitian and mother of two young athletes, I believe it’s also important to think about the smaller nutrients, including vitamins and minerals, to get your kids through a long day of school and a demanding practice.

Below is an overview of the importance of iron intake and good food sources to help work this mineral into your young athlete’s diet.

Why is iron important for young athletes?

Iron deficiency anemia can occur when the body does not have enough iron.  In turn, it will make fewer red blood cells or red blood cells that are too small.  This results in the blood having a decreased ability to carry oxygen throughout the body.

Depending on how significant the iron deficiency is, it can reduce sports performance, especially endurance activities (such as distance running, swimming and triathlons), impair concentration and cause increased fatigue and risk of injury.

Many of the symptoms mentioned above, however, may not show up until the deficiency is more significant. So it is a good idea to be aware of who is at risk, the signs and symptoms and to know how to prevent iron deficiency in young athletes.

Common signs and symptoms of iron deficiency (anemia):

At risk iron deficient anemia populations among athletes include:

  • Female athletes (related to menstrual losses)
  • Vegetarian athletes or athletes who may restrict iron rich foods in their diet
  • Underweight/undernourished athletes
  • Endurance athletes

Iron rich foods (include daily choices to prevent iron deficiency):

  • Lean meats, dark meat from chicken or turkey (absorbed better than plant sources)
  • Beans, lentils, nuts and sunflower seeds
  • Iron fortified cereals: cold cereals and oatmeal
  • Green, leafy vegetables such as spinach and broccoli
  • Dried fruits such as raisins, apricots and prunes

For more food sources, check out Tables 1 and 2 in the Center for Diseases and Control website.

Animal sources of iron are better absorbed than plant sources. But you can improve absorption of iron in the following ways:

  • Include citrus fruit or drink orange juice with iron rich foods. Vitamin C  enhances absorption of iron.
  • Vitamin C rich foods include red pepper, grapefruit, broccoli and strawberries.
  • Avoid teas, coffees and cocoa with meals (nutrients in these beverages decreases absorption).

If you feel your athlete is at risk for iron deficiency, talk to your doctor. Professional guidance from your Pediatrician will help determine whether or not blood work to assess your athlete’s iron stores and/or risk of anemia is warranted.

Written by: Lauren Furuta, MOE, RD, Clinical Nutrition, Children’s Hospital Colorado. To find out more about nutrition tips, like calcium and vitamin D intake, read our archived sports nutrition posts, or schedule an appointment at 720-777-6600. We are happy to consult with parents or referring providers before a patient is seen at Children’s Colorado.