Do Sports Drinks and Foods Improve Athletic Performance for Kids?

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If you’re the parent of a child who is serious about sports, you know these young athletes are looking for anything to give them an edge over the competition. Building skills, strength and endurance are all part of the picture. So is eating right. But is there a place in an athlete’s toolkit for special food and beverages specifically aimed at enhancing athletic performance and recovery? We talked with UH pediatric sports medicine specialist Laura Goldberg, MD, to find out.

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Transcript

Macie Jepson

So, Pete, all your kids play sports. I know that. My kids play sports. Between the two of us, we have three kids playing in college. Heck, you even played in college. You know, I think you'd agree. The pressure to compete at the top level is more intense than when we were kids.

Pete Kenworthy

No, for sure. Yeah. So many teams, but so few opportunities to make it into that top tier that just about every kid dreams about, right? So, how do we help them get there? And is it as simple as just fueling them there?

Macie Jepson

Hi, everybody. I'm Macie Jepson.

Pete Kenworthy

And I'm Pete Kenworthy. And this is Healthy@UH. As a parent, sure, I'm interested in giving my kids that competitive edge, but within reason, right? I don't think we're as over the top as some parents are about it. Well, I hope we aren't, right? So, we try to make sure they eat right before a game, stay hydrated, that kind of thing.

Macie Jepson

You know, my dad used to throw a Snickers bar at me before a basketball game or a track meet. My kids would give me the stink eye if I pulled out a Snickers bar for myself at one of their matches. I mean, now team moms provide special meals for before and after and during. They spent a lot of money, too, on sports drinks and recovery meals, pre-fuel chews. And a lot of them are filled with sugar.

Pete Kenworthy

Yeah. Which brings us to our topic today. The focus is on our kids, actually. Do all those products work? And in some cases, can they actually be bad for our kids? So, we're joined today by Dr. Laura Goldberg, who's the medical director for West Side Sports Medicine for University Hospitals. Thanks for being with us.

Laura Goldberg, MD

Thanks for having me.

Macie Jepson

Doctor, let's start with sports drinks because it is a $10 billion industry in this country. And if you don't think it's targeting kids by the way, folks, Google Teal Edible Glitter. I’m not kidding. It's on the wholesale market to add to sports drinks for a wow factor. That's got to be for kids. What are sports drinks meant to do exactly?

Laura Goldberg, MD

Well, there's a couple of things that the companies have aimed for. Primarily, they were designed to replace hydration, so fluid, water, as well as electrolytes and some carbohydrates for while you're exercising. Unfortunately, they also taste great. And so kids love them, and they end up drinking them all day long when they don't need to. Around sports themselves, whether you have it before, during or after really makes a difference in what you're drinking.

Pete Kenworthy

Go a little more into that. What does that mean? But before, during or after and, and how it impacts. So, it impacts how they work?

Laura Goldberg, MD

Well, it impacts how your body uses it. So, an electrolyte drink is really designed to replace electrolytes, to replace carbohydrates, or just prior to helping give you some. But really before any sort of athletic event most important is that you're, what we call euhydrated, meaning that your body just has just enough water. And how can you tell? Well, the simplest thing is the urine check. So, looking, when you go to the bathroom, you want to see pale yellow urine. That means you're really ready to participate in any event and that you're euhydrated. If you see dark urine, that means you need to drink more. And ideally before any exercise, you're just drinking water. That's all you need. Your body, if you're eating healthy foods and regular foods, you don't need any electrolyte drink beforehand.

Pete Kenworthy

OK. So, let's go a little bit deeper than even the drinks really. So how does nutrition affect your sports performance? My guess is, I mean, you talked about water before a sporting event, but there's food involved here, too, or bars or all sorts of things that we’re eating and drinking beforehand.

Laura Goldberg, MD

So, I'm just going to get it out here right now. I am all about whole food, natural food, homemade products. In general, if you eat a healthy diet of whole foods, including fruits and vegetables, that is the best way to provide nutrition for your body. And most athletes really at the highest level, you'll see it, and it's advertised left and right about different, you know, LeBron James and Tom Brady, how important their diet is to how they are fit and how well they can prevent injury and last through their events. And so really what you want to do is make sure that you're providing a well-rounded diet. And then depending on what exercise you're going to do will dictate, do you need to have more of a carbohydrate load or more of a sort of endurance mode? Now I just mentioned a couple of people and some people really are big on keto diet, which is low-carbohydrate, and definitely athletes can survive on that. But again, if you're going to do a specialized diet, you need to know what nutrients you need to get to the energy levels that you need for your event. So, it's not something to just say, oh, I'm going to follow what LeBron James does and do this without significant knowledge about the diet and your own body.

Macie Jepson

Not so easy with kids sometimes, though, when they're on the go. Let's talk about some of those products: Gatorade, Honey Stinger, Body Armour. They market pre-, during, post-activity products. And let's face it. Parents are not only talking about hydration; they're talking about endurance and peak performance here, and they're hoping to give their kids an edge with some of these products. Can you do that with food alone?

Laura Goldberg, MD

Well, you can. But I think when we look at our kids, especially at school sporting events, we really promote having some form of electrolyte drink. So, let's take example football. Football is, you know, a couple hours in a game, depending on the weather, you may or may not need electrolyte replacement. In the hotter months or in hotter locations, these kids are sweating a lot. And when you sweat, you lose sodium and potassium, and so if you're a big, heavy sweater, you need to replace those electrolytes lost with electrolyte fluids. And in general, the most easy and accurate way to do that is with an electrolyte drink. Studies have been done and they create these drinks to be palatable so that your body can tolerate them without getting an upset stomach and can replace not only the fluid, but the electrolytes to prevent the changes in your mental status that caused decreased performance, which is really what we're talking about here. These kids want performance. If you're dehydrated, your cognition goes down, your reaction time, your ability to, your stamina actually doesn't go down as quickly. It takes more of a hydration, a dehydration to lose your muscle effects and all that. But your mental capacity goes down much more quickly, which obviously affects your performance.

Pete Kenworthy

You mentioned electrolytes a few times already during this. Why is that so important? So, we lose electrolytes when we exercise. Why is it so important to replace electrolytes?

Laura Goldberg, MD

So, depending on how long you exercise, for example, we talk about this a lot in endurance sports, such as marathons or any sort of activity over three or four hours. If you just replace the fluids that you lose with water, your body is going to become, it's going to have a lower level of sodium, which can cause hyponatremia, which can cause significant effects on your brain. It is unique to sporting events that are long that, you know, traditionally we think of marathons. But if you think of a kid that is playing soccer all day or volleyball or a basketball tournament, and they're playing all day, and all they're doing is drinking water, but they're sweating out tons of electrolytes, they have that capability of becoming hyponatremic, which can really cause effects on your brain.

Macie Jepson

You mentioned tournaments, which brings me to a question about one game. Is a huge thing of Gatorade really necessary when your kid is going out and playing a match on a Saturday?

Laura Goldberg, MD

So, it comes back to what you said about the Snickers. You know, a large load of sugar is not healthy for anybody's body, especially if you don't, if your body doesn't need it. So, one game, really any sport, unless it's really hot out and it's over an hour long or an hour and a half long, and you're playing that whole game, you probably do not need anything other than water. More than an hour and a half, then we start saying you need to replace it with an electrolyte drink of sugar, but really otherwise the sugar load is not necessary.

Pete Kenworthy

So, is it that simple? Because really the next question I was going to ask you is, when is these products helpful, right? And at what point can they be bad for our kids? Too much sugar, for example. Is it as simple as under an hour, hour and a half, use water? Over that amount of time, use things like Gatorade or, or other kinds of drinks to replace electrolytes?

Laura Goldberg, MD

So interestingly, it's a little different based on what activity you're doing, what the temperature is outside and what age you are. Adults can tolerate about a 2 percent loss of fluid, their body weight. So, if you're exercising a long period of time, you're much more at risk of losing that percentage, and so we want you to drink fluids at regular intervals. A kid can't really tolerate more than about 1 percent body weight. So, the younger, the kid, the hotter, the environment, the more they're sweating, the longer they're doing that, they're going to need that more quickly than an adult. And it comes down to really making sure that your body is euhydrated or that you are keeping up for the amount of sweat that you're losing. So, if you drink three bottles of Gatorade or three bottles of water, whatever it is before your event, that is not going to make up for your sweat loss afterwards. It's better to do it at regular intervals so that you're maintaining rather than… you can't prevent it, is what I'm trying to point out. It's better to maintain it than it is to try and front-load.

Macie Jepson

So, we see a lot of products out there: post-fuel recovery products. Is there any place for that in a kid's life as well? And what about quick energy?

Laura Goldberg, MD

Quick energy is a hot topic. When you said it, it kind of caught me cause I didn't, think of it the same way. So, energy drinks: there is research out there that shows caffeine to a certain level can promote increased focus and concentration and can help performance in some sports. In fact, the NCAA has rules about how much caffeine you can have, which is about four cups of Starbucks. If you think about those energy drinks, Red Bull…just being a common one, or at least one of the oldest or original ones…that is, does not have as much caffeine as a full cup of Starbucks, which is surprising. You’d think it would have more. But these kids that are doing that, you might see some enhancement, but after a certain point, it becomes A) illegal and B) it loses its efficacy because if you're all jittery and you can't focus, you've gone too far. So, the energy drinks, I wouldn't promote them, but on the flip side, they're not as bad for you as you'd think.

Pete Kenworthy

It seems like there's a lot of vaguery, right? It's like a lot of, OK, I can have a little bit of this or up to four cups of this. Like, how do I know what's right for my kids, right? I mean, and especially if I'm one of those parents looking to really get peak performance out of my kid. Maybe they're competing at a high level in high school, and we're looking to, you know, have college coaches look at them or something, right? So, I'm looking for any edge I can get over the kid on that other team. Is it really kid-dependent? Weight of the kid? Environment that you're playing in, in terms of how much of X, Y, or Z you should eat or drink pre-, during and post-contest?

Laura Goldberg, MD

So, in the most controlled ideal world, let's look at a cyclist, because that is something that is so easily monitored in terms of the amount of effort they're putting out. I think of Lance Armstrong and all the studies that go into the cycling world and their nutrition. What you eat makes a huge difference in how you perform. Again, natural whole foods are the best source for our body to get nutrition. Supplements and vitamins are not absorbed the same way as natural whole foods. So, a real, unprocessed, whole food diet absolutely is the best. And that includes fluids. So, I'm a big fan of homemade electrolyte fluids, and, you know, there's different recipes out there and whatnot, but there is a science behind that. And one of the companies that started out with the whole electrolyte fluid was Gatorade, and they did do a lot of studies looking at how much carbohydrates could you put into the fluids so that your body absorbs it without getting sick? Cause that's really what we're looking at is how can we get nutrients in our body in a quick way that will not upset our stomach while we're performing? So, what you eat during the time when you're not exercising is important, but what you eat during exercise affects everyone differently. Some people can't tolerate high sugar loads. In fact, most people can't tolerate really high sugar loads. About 6 percent carbohydrate is acceptable for our gut during exercise. So, coming back to Macie’s point about the recovery drinks, those have a different percentage because you're not exercising currently and so your stomach can tolerate a higher load. During exercise your stomach isn’t… we don't want our stomach to be where the focus is. We want all the blood and energy to go to our muscles, not to our stomach. So, the drinks and the gels and the replacement carbohydrates that you can get during exercise have a different percentage makeup. So, back to your question of, is there one answer for everyone? No. And really that comes down to different sports, whether you're in a burst energy sport, whether you're in a sustained energy sport, whether you're playing a game for, you know, volleyball has shorter games. You might be at a tournament all day long, but you don't need the same amount of replacement as someone who's playing five basketball games, because those games are so much longer in endurance. It's more of an endurance activity in basketball whereas volleyball is more short effort. You have a little bit more time if you're subbing and doing rotations of getting your fluids in and all that.

Macie Jepson

One more question about hydration. Is there a secret formula to how often we should be providing this for our kids?

Laura Goldberg, MD

So, ideally, we want to maintain hydration and a little bit different based on age. And younger kids, we want to do it more in like a 20-minute interval. And three to five ounces every 20 minutes is fine. As you get older, you need a little bit more. And so you're thinking more nine to 13 ounces every 15 to 20 minutes. Again, it has to be so that you're not upsetting your stomach. And it's more of a constant rehydration. You don't want to stop at every single water station on a marathon race and every single break in a game, you don't need to take water. Unfortunately, your body will not tell you when you need water. You can't listen to say, oh, I'm thirsty and now I drink. Cause then generally that's too late. You can't wait until you feel like you're kind of woozy or not thinking straight because that's too late. So, maintaining some sort of regular interval is important. One way to know whether or not you're getting enough hydration is to weigh yourself before and after you exercise. And that weight loss between tells you how much weight you lose. So, football players … we do this a lot during two-a-days ... it's really important to know. Some kids sweat a lot, and they're going to need to replace more than someone who doesn't. We see that a lot in kids that cramp. You tend to start to follow them more closely. But in ideal world, everybody would weigh pre and post so that you would know what you're losing and know what you need to replace. So, when you weigh yourself, pre and post, you measure how much weight you've lost. And for every pound, you lose in water weight, you want to replace that times three. So, it's really important to be cognizant about whether or not you're a heavy sweater or not. If you're a heavy sweater, you need to replace more than someone who doesn't sweat a lot.

Pete Kenworthy

Are you saying literally, like say you lose four pounds while you're exercising … you're saying literally 64 ounces of water? Like there's 16 ounces in a pound, right? So, you're saying 64 ounces of water after you work out?

Laura Goldberg, MD

Yes. So, that would be a lot to do in one sitting. So, really in the there's you want to replace upfront a portion of that, and then slowly over the next 24 hours. So, it's not all sit down and drink that 64 ounces at once. It's before you go to your next exercise so that you get your body back to your euhydrated state, your equal hydrated state.

Macie Jepson

And is that replacing with water or a replacement drink?

Laura Goldberg, MD

Well, ideally, it would be mostly water, but if you are a heavy sweater, you have to have some electrolytes in there. So, that is where the post-recovery drinks come in. They have a high concentration of electrolytes that you can get upfront. But then, so let's say you have to replace 64 ounces of water. You might do 12 ounces of the post recovery drink. And then over the next 24 hours, it could just be water, assuming you're also eating.

Pete Kenworthy

OK. So, we probably should have brought this up at the beginning of the podcast. But aside from being a sports medicine doctor, you're also an accomplished sailor, a marathon runner, a cyclist, what else? What else do you do?

Laura Goldberg, MD

A ski racer until a couple of years ago.

Pete Kenworthy

A ski racer. So, a very accomplished athlete as well. So, you know this from a physician side and from the athlete’s side. I guess my next question really is instead of eating a gel or a power bar or chugging some Gatorade, are there other foods or natural things that you're suggesting we replace those things with?

Laura Goldberg, MD

Yes. And I, there are so many options out there in terms of recipes on Pinterest and other places where you can look up and look up energy bars and granola bars. And I think most of us just say, all right, we're running around, we're driving our kids left and right. Or we are working and we're trying to fit in our exercise. How can we just get it simply done? And there are really good pre-packaged sports and exercise bars out there. So, there are some great books out there that I myself looked into for me that include, for example, one is called The Feed Zone, and it talks about making your own supplements and for during race, before and after. And it uses a lot of rice base cause that’s a quick, easy carbohydrate. It's great for people that are gluten intolerant, and it has a wide variety for taste. You know, so there's some rice cakes in there that have peanut butter and jelly, and then there's some that are curry. And so, it's fun. And also you can do burritos, some simple foods. If you're vegan, people concerned that you can't supplement enough with vegan diet, you can. If you read Born to Run, Scott Jurek is a great example of someone who's an ultra marathoner and has proven that he can compete not only as well as he was, but better based on a vegan diet. So, a lot, there are a lot of alternatives out there if you're interested, and it takes a little bit of research and making sure that you are replacing things you need. In most people's homes, you know, simple things like a banana and peanut butter or oatmeal, banana, peanut butter before you exercise, generally over an hour before, because you want to make sure you're absorbing in your body and that your stomach isn't still working on it when you start. That's a really simple one at the beginning.

Pete Kenworthy

Should we be replacing these things? That's the real question, right? Because what you're talking about is extra work, right? We're going to have to make things or create things at home or buy the right things, instead of buying those quick and easy sports bars.

Macie Jepson

Can I add to that question, too? That at the end of the day, if your kid isn't going to be putting out the energy, even those homemade products can be too many calories.

Laura Goldberg, MD

Right. Absolutely. So, I struggle with this in my home because I have two young girls, one of which has become a vegetarian, and our whole family has therefore become vegetarian to support her, partly personal preference as well. But I watch the lack of regular meals. The kids prefer to snack. And so when you go to a volleyball tournament, and you play your game, and when you're done, they put out all these snacks for everyone to replenish. Well, if your kid was the one sitting on the sideline, how do you tell them that they don't need that? They didn't expend that energy. They don't need that, you know, homemade peanut butter, chocolate chip, oatmeal, hardy cookie that is supposed to be almost a meal replacement, but they don't need it. So, the question is, do we want to replace the supplements or … supplement isn't the right word … do you want to replace the bars? No, you don't have to, but your body's going to absorb a granola bar that is pre-packaged the same as one that's homemade. But in the end, it's what you want to do. So, some people they'd rather go out and buy a box of granola bars at $2 a granola bar, when you could make an entire plate for $2. So, it's just a matter of balancing between your time, your effort, your expenses. And if you buy the right product, it doesn't matter whether it's homemade or a company has made it.

Pete Kenworthy

All right. So, let's wrap it up here. So, parents have two goals in mind when they're buying products for their kids and even if they're making products for their kids. But let's talk about buying those products: performance and endurance, right? The bottom line question is, are they a waste of money?

Laura Goldberg, MD

I don't think so. I think that if you, in our world, we're running so many different directions, that if you make sure and research to make sure that what you are buying fulfills your own personal values. For example, I don't want any corn syrup in my products. I'm going to make sure that whatever I buy is that. And at home, I'll spend more time and energy making a good meal, but maybe it's a lot easier on the weekend to grab that bar. So, it's really a balance. And I think that the companies out there that have made these bars, in general, are really, most of them are really well-designed and are good, useful products.

Pete Kenworthy

So, I said we were wrapping it up, but you brought up a great point about the corn syrup. Are there things specifically we should be looking for to avoid like corn syrup?

Laura Goldberg, MD

Well, I think that there's been a lot of research done out there, the negative effects of corn syrup and dyes and just artificial ingredients that don't need to be in there. It comes back to my whole premise of natural whole foods is better for you. You know, putting honey or agave into something, they’re still sweeteners. They’re certainly, you want to limit them. You don't want to have a high spike of sugar, but at times we need that. And so if you're going to put a sweetener in, let's make it a natural one.

Macie Jepson

Dr. Laura Goldberg, who is medical director for West Side Sports Medicine for University Hospitals, thank you so much for your answers and your insight.

Laura Goldberg, MD

Thank you for having me today.

Macie Jepson

Remember you can find and subscribe to this podcast at Apple, Google, Stitcher, or wherever you get your podcasts. Search University Hospitals or Healthy@UH, depending on where you subscribe.

Pete Kenworthy

For more health news, advice for medical experts and Healthy@UH podcasts, go to UHHospitals.org/blog.