Gymnastics culture has generally not supported adequate fueling and hydration due to a variety of issues, but right now we’re facing additional challenges re: COVID-19. Gyms are not allowing gymnasts use the locker rooms for health and safety, so they are forced to be creative and find liquid carbohydrate sources that can cleanly be kept in a bottle for intra-workout fueling and hydration.

It’s not that they aren’t allowing adequate hydration and nutrition during workouts, but most gyms (or parents) think liquid sugars like fruit juice or a sports drink are “toxic” and only want to support the use of fruit intra-workout. This comes from a fundamental misunderstanding of carbohydrate utilization during sport and metabolism. Start here for a primer before we dive in to the role of carbohydrates in hydration.

What is Hydration?

Hydration is the addition of adequate liquid to bodily tissues. Liquids or fluid moistens the body’s tissues (eyes, nose, mouth) and the muscles are composed of 75% water, which means the under-hydrated muscle will not have the pliability needed for optimal functioning and increases risk of injury. Hydration is also the medium through which nutrients, waste products, and oxygen travel through the blood and into the cells of the body. If your athlete is not drinking enough, there won’t be adequate fluid to transport these nutrients.

Hydration also provide lubrication to the joints. In a sport that demands supple muscles and flexible joints, we want to make sure dehydration is not the cause of decreased range of motion, flexibility, etc. which is to some degree a modifiable factor in their performance and execution of skills.

We also can’t ignore post-workout refueling and hydration, and I’ll touch on the re-hydration piece later in this post (see here for last week’s blog on recovery nutrition).  

Myths and misconceptions surrounding hydration for the gymnast

There are a lot of myths around hydration. Gymnastics has been a sport where the thought is that “water is sufficient”. Lots of gyms still have policies allowing water-only for gymnasts w/ 4+ hour workouts. I’m not saying this is a practice of all gyms, but for any gym to hold this policy represents a fundamental misunderstanding of hydration, energy metabolism, etc.

All fluids count

Water, juice, milk, tea, coffee, soda, etc. all contain what we call “free water”. Most of these beverages are 98-100% “free water” which is what the body absorbs for hydration. Fruit and veggies also contain a high proportion of free water, about 70-74%, so they “count” towards fluid goals to be technical.

Adding high water fruits and vegetables can be helpful, especially for the athlete who doesn’t love to drink plain water but aren’t sufficient in and of themselves for adequate hydration.

A common misconception surrounding caffeine is that it is dehydrating as it has some diuretic effects. One study looked at hydrated males and gave them 1 liter of water with 0, 50, 200, and or 400 mg of caffeine. The researchers measured urine output for the next 4 hours and found no significant differences, thus no diuretic effect from the caffeine.

Obviously this study was conducted in adult males and cannot be extrapolated entirely to children/adolescent athletes, but something to think about the next time you hear “caffeine is dehydrating”.

Should a high-level gymnast have caffeine?

For children/adolescents from 12 to 17 years of age, the American Academy of Pediatrics recommends less than 80-100 mg of caffeine per day which is the equivalent to X cups of coffee or shots of espresso (Unless it’s 8 oz of Starbuck’s brewed coffee which has 180 mg caffeine).

While I don’t love my athletes consuming coffee drinks, especially the sugar laden Frappuccino’s which provide more sugar than one is typically aware of (and thus potentially unneeded excess calories), etc…if my older athletes enjoy their morning cup of coffee or latte (an excellent way to fit in some calcium and vitamin D), this is acceptable within the appropriate parameters and no issues related to the caffeine (anxiety, heart palpitations, etc).

Soda has around 40 mg caffeine per 12 oz, tea has about 48 mg per 8 oz, and energy drinks have 150 mg or more per 12 oz and is the biggest culprit of caffeine intake in youth. I prefer my athlete to not consume soda or energy drinks as these are non-nutritious sources of energy; coffee and tea is something debatable and highly dependent on age.

Why the gymnastics world thinks sports drinks are “toxic” and unnecessary

There is a big misconception around carbohydrate sports drinks like Gatorade or Powerade (and other products like Skratch, etc.).

These products are typically a 6-8% carbohydrate solution with added sodium and potassium (and sometimes magnesium and calcium) that are meant to serve in situations where water will not adequately hydrate—typically over 1.5 hrs. of moderate to intense exercise.

The gymnastics world thinks the carbohydrate, which is simple sugar like dextrose, glucose, fructose, or maltodextrin is “bad” or “toxic” as this is a pervasive myth not only in the gymnastics world but as a culture.

Carbohydrates are what fuel the brain, heart, lungs, and every cell of the body. They are the preferred fuel source of the body and the primary fuel source during anaerobic high intensity sports like gymnastics. And before you argue about low-carbohydrate and keto, just know that I’m a certified diabetes educator who has a lower carbohydrate bias for diseases like diabetes. But I also learned from years of working with clients that it doesn’t matter how great a diet is in theory, if the client can’t stick to it the benefits don’t matter. And, for a high level metabolically healthy athlete who is engaging in anaerobic training, a low carbohydrate or ketogenic diet is not optimal in terms of energy metabolism and fueling. Send me a message if you want to learn more.

Regardless of your stance on or fear of carbohydrates, during a workout the gymnast needs carbohydrate that will digest quickly and get out of the stomach, into the small intestines, and into the bloodstream the glucose/fructose can be carried to the cells of the body, muscles, and brain for fuel.

To be technical, the fructose has to first go to the liver before it can enter the cells which is why agave syrup is “lower glycemic” than some other sugars (because it’s mostly fructose) but there’s no advantage to this during high intensity exercise.

Yes, you can use fruit or fruit juice intra-workout as a more “natural” source of carbohydrate (aka sugar) versus a sports drink, but the only difference is vitamin/mineral/antioxidant content. Yes, micronutrients and antioxidants are important, and most individuals do not get enough from regular meals and snacks. But, I tell my athletes to “maximize nutrition when able”. I’d rather your gymnast drink a sports drink halfway through practice than nothing if she refuses solid food, and I’d rather her have use a sports drink than just plain fruit juice or coconut water which are inadequate in and of themselves in terms of electrolytes when needed for rehydration purposes when it’s hot/humid.

Yes, you could add electrolytes like Nuun to a carbohydrate beverage like juice or coconut water for a more “natural” approach, but at the end of the day sugar is sugar and the body doesn’t are where it comes from.

“Natural” doesn’t mean healthy or adequate for performance, and on most food products it’s all just “health washing” as a marketing tactic.

Nutrition is all about “context” in terms of what is best for your gymnast in specific situations.  

But won’t the sugar in a sports drink “make you fat” or “cause diabetes”?

Another misconception about sports drinks or using carbohydrates (solid or liquid) during a workout is they will cause weight gain or detract from weight/fat loss efforts.

Even if an athlete is trying to improve their body composition, we don’t want to sacrifice performance nutrition. In short, I will cut calories (energy) from other areas of the diet if needed for an athlete but I won’t cut down their performance nutrition. This means I’m never going to tell a high-level gymnast just to “drink water” during a 4+ hour workout just because they’re trying to lean out.

From a metabolic perspective, using carbohydrates 1-2 hours into an intense workout will not give someone diabetes. We would simply be replacing what the body is using, not chronically overproviding carbohydrates like in the context of someone eating too much overtime.

As a simple aside, type 2 diabetes comes from excessive bodyfat that blunts insulin sensitivity and causes the pancreas to “work too hard” which overtime can cause loss of function and thus the need for injected insulin to regulate blood glucose. This is very different than type 1 diabetes which is an autoimmune disease where the body is genetically programed to destroy the insulin-producing cells of the pancreas leading to a total insulin deficiency and the need for injected insulin to sustain life (yes, even on a ketogenic diet small amounts of insulin are always needed for someone with type 1 diabetes).

The societal problems with obesity right now, especially in children, are in part related to an excess of sugary beverages (flavored milk, sugary soda/sports drinks, and juice), but again this is all relative to context. It is not the sugary beverages in and of themselves that are causing the issue, but the likelihood of them contributing to an energy surplus that children are not reconciling through adequate physical activity.

A glass of chocolate milk as a post-workout snack for the gymnast is not necessarily “excessive” nor will it cause detriment to their body composition or health if used in the appropriate context and within their energy needs. An eight-ounce glass of chocolate milk has about 30g of carbohydrate, of which 18 g are added sugar which is 1.5 tbsp. It also has 8g of protein which provides a 3:1 carbohydrate to protein ratio which is ideal for post-workout recovery. The carbohydrate (natural milk sugar lactose and added sugar) start the process of refilling muscle and liver glycogen stores (essential for two-a-day workouts) and the protein beings the process of muscle repair/recovery (muscle protein synthesis).

Using a glass of chocolate milk for a high-level gymnast’s post-workout snack is very different than sedentary children drinking 2-3 cups of juice and flavored milk at school every day and then coming home to more juice, soda, and flavored milk. Several cups of juice, flavored milk, and soda per day would be an excessive amount of added sugar, in turn calories, and would likely put them over their energy needs which would eventually cause weight gain if continued long enough. And, these are “empty” sources of calories for the most part (soda, sugary Gatorade) which displace other important nutrients. I will add that though the chocolate milk still has some protein and calcium and thus provides some valuable nutrition, I’d prefer children to drink white milk.

We’ll may talk more about these public health issues in another blog post, but I just want to point out that the nutrition needs of a high-level gymnast training 20+ hours a week is very different than a sedentary child or recreational athlete of her age.

So why would the high-level gymnast need something more than water?

At first glance you may think “oh, just drink water and you’ll be fine”. That was certainly my mentality as a young gymnast and that of my coaches.

Well, let’s talk a little about the science of hydration.

When we think about hydration, we think water. It’s so much more than this. Hydration involves the balance of fluid and electrolytes in the body, which at the clinical level is a very intricate process. When I worked in the hospital as a pediatric clinical dietitian, I helped the medical team make decisions for the patients on which kinds of IV fluids they needed and what balance of electrolytes and glucose were put into those fluids, which was all highly dependent on why they were hospitalized and what the current issues were.

There are different kinds of IV fluids—sometimes it’s normal saline which is sodium chloride (similar to blood composition). Other fluids have more glucose, potassium, some magnesium, etc. and we can add additional electrolytes to these fluids based on the source of the fluid loss. The electrolytes, sodium, potassium chloride, magnesium, and calcium are in differing proportions based on the source.

What is in sweat?

Sweat losses are primarily composed of sodium and chloride with some potassium which is different than the fluid lost from copious amounts of diarrhea like in the case of a gastrointestinal illness. Sweat also contains smaller amounts of magnesium and calcium which help with nerve and muscular contractions.

One liter (about 33 oz or what we consider 2 pounds) contains about 460 mg sodium (about ¼ tsp salt), 710 mg chloride, 160 mg potassium, 0-36 mg magnesium, and 0-120 mg calcium. When you look at the composition of an electrolyte beverage, these are designed to provide a fluid that replaces what the body has lost. This is why some beverages like coconut water are not great choices by themselves as 16 oz of coconut water only contains about 50 mg of sodium and 940 mg potassium which does not match the sweat losses. Yes, you could add additional supplemental sodium and chloride, this is just something to be aware of and not assume every product advertised as “rehydrating” is equal. Pedialyte has more electrolytes, but less glucose, than Gatorade but isn’t advertised as a sports drink; it’s what we call an “oral rehydration solution” and is closer to what an IV fluid would provide for someone who is ill.

The whole goal of fluid and electrolyte management is to replace what the body has used or lost.

Fluid Replacement is not just about the water

When talking about hydration for the athlete, it’s not just about rehydrating with adequate fluid aka water. If a gymnast is practicing over 1.5-2 hours, they’re likely losing some electrolytes which need to be replaced so all of the cellular processes can continue. We know that dehydration causes significant ramifications with performance and work output, so this needs to be avoided.

We also know the gymnast will start needing additional carbohydrate about 1.5-2 hours into a sport like gymnastics due to the anaerobic nature (carbohydrate dependent for fuel). Some sports need carbohydrates as early as 1 hour, but this is dependent on the timing of conditioning, etc for the gymnast and how much of the first hour is spent “working”.

Not only does carbohydrate help replace the glycogen used from the muscles and liver, but also helps to facilitate absorption of fluids from the intestines which is the first part of hydration.

To keep it simple, salt and sugar (glucose aka a simple carbohydrate) are used in what are called “sodium glucose intestinal transport proteins” which are like little bridges in the walls of the small intestines which allow water to cross into the bloodstream.

When an athlete is dehydrated, water will only do so much, and we need the additional help of sugar and sodium to optimally absorb the hydration that is needed for the body. This is why Gatorade was developed. The Florida “Gators” developed this rehydration beverage for the hot, humid climate of Florida to help the football players optimally hydrate during 4+ hour football practices in the heat of the summer. Gatorade or most sports drinks are 6-8% carb solutions with sodium and potassium. The 6-8% carbohydrate won’t provide too much sugar that could lead to diarrhea or gastrointestinal discomfort and this is the highest we’d want to go without additional gastrointestinal training. The whole goal of hydration is to replace what is lost in the fluid, and we know that sweat contains electrolytes and the body is using carbohydrate (especially for an intense activity like an anaerobic sport).

To be continued...

Part 2 to come later this week, so stay tuned. 

If this article was helpful but you still have questions about your gymnast, please send me a message or apply for 1:1 nutrition coaching if you think your gymnast has a problem and needs help. Together we’ll develop a specific fueling and hydration strategy for your gymnast, ensure they’re optimally meeting their nutrition needs for performance and growth, and ensure they’re doing everything they can to prevent injuries.