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Dietitian’s Corner – PKU and Sports Nutrition
Melissa Edwards, RD, CD
Metabolic Dietitian | Clinical Nutrition, Seattle Children’s Hospital
 Competitive and recreational athletes are often looking for ways to improve their performance. Customizing a sports nutrition plan of fuel, fluids and nutrients can be a challenging task for any athlete, and even more challenging for young athletes with PKU.
The greatest risk to athletic performance is dehydration. The young athlete is at increased risk for dehydration and heat illness, especially in hot, humid weather or during long and intense activities or multi-day tournaments. Thirst is not a reliable indicator of fluid loss. Young athletes should have a hydration plan, and practice scheduled drinking to avoid dehydration. General guidelines are:
- One hour before exercise drink approximately 16-20 ounces
- Drink 4-8 ounces of water every 15 to 20 minutes during activity
- Typically 2 kid “gulps” = 1 ounces. 1 teen gulp = 1 ounce.
- Plain water is the best drink for most athletes, unless prolonged competition/ training over 90 minutes.
- Carbonated drinks should not be used for fluid replacement.
- Body weight should be the same before and after exercise and urine should be pale yellow, almost clear.
Some general principles for optimal nutrition for an athlete with PKU are first ensuring adequate intake of protein from medical formula. PKU athletes (and non-athletes alike!) should consume 100% of their prescribed medical formula each day. Depending on an individual’s PHE tolerance the balance of the diet should be primarily low protein “grains” with a wide variety of fruits and vegetables. Choosing dark and bright colored fruits and vegetables, such as blueberries, raspberries and oranges, can provide an excellent source of vitamins, minerals and antioxidants. Also include healthy fats, such as formulas fortified with essential fats or inclusion of flax, olive and canola oils. Timing of meals and snacks is also important for athletic performance. Eating regular meals and snacks and consuming medical formula in three or more separate servings keeps energy levels high. Also, consuming medical formula after exercise and competition may help with recovery and future performance. Athletes with PKU should work closely with their dietitian to develop individual nutrition strategies to optimize performance.
There are a lot of supplements and sports nutrition products that claim to be performance enhancing that are popular among young athletes. Typically, an athlete with PKU should be getting adequate vitamin and minerals with their medical formula or nutrition plan. Some endurance female adolescent athletes may require additional iron supplements. However, in general individual supplements are generally not recommended, especially in the young athlete as research on potential and real side-effects is very inadequate. Be especially cautious of “proprietary blends” and “ergogenic” aids as the supplement market is not a well regulated industry and many products can contain banned substances.
The bottom line is a little strategy in the diet of an athlete with PKU can help with performance. So plan out the diet, then get out there, play hard and have fun!
References:
American Dietetic Association, Dietitians of Canada and the American College of Sports Medicine. Nutrition and athletic performance. JADA 2009; 109: 509-527.
Nemet D, Eliakim A. Pediatric sports nutrition: an update. Curr Opin Clin Nutr Metab Care 2009; 12: 304-309.
http://www.aap.org/sections/sportsmedicine/SportsShorts.cfm
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