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1. Gymnast isn't eating enough

I’ve talked about this one a lot on the blog, but it’s one of the most important, yet overlooked reasons as to why your gymnast is always fatigued. Click here and here to read more about the energy needs of high level gymnasts. Growing teens need a lot of energy to support normal development, add on top of that 20 + hours a week in the gym and these needs are difficult to meet at times.

A high-level gymnast cannot perform optimally without adequate nutrition. The starving brain does everything it can to conserve energy, including slowing down metabolic rate (adaptive thermogenesis), decreasing production of certain hormones like leptin which signals satiety (fullness), and decreasing core body temperature. Symptoms of inadequate energy availability include fatigue, poor recovery, poor injury healing/excessive stress reaction or overuse injuries, menstrual cycle abnormalities (amenorrhea, oligomenorrhea), and are collectively known as “Relative Energy Deficiency in Sport” or RED-S.

Inadequate nutrition will also disrupt sleep (it’s not normal to wake up hungry in the middle of the night), which then effects recovery, growth/development, etc.

If your gymnast follows a plant-based diet (vegan, vegetarian), eats “clean”, is struggling with food and her body, or has food allergies/intolerances, you need to ensure that A) she’s getting enough nutrition (energy aka calories) which come from macronutrients (carbs, protein, fat) and adequate micronutrients (vitamins, minerals). Or, if you’re just wanting to make sure you’ve done everything to ensure optimal fueling, growth, and development, it’s time for a nutrition check-in!

If you have any concerns, meet with a registered dietitian nutritionist who can evaluate your gymnast’s growth, nutritional needs, trainings needs, etc. It’s incredible to see how much improvement happens in the gym when athletes are fueling properly (and in other areas of life like schooling!).

If you need ideas of easy, delicious meals that the entire family will love, check out my weekly meal plan post.

2. Inadequate Iron and Vitamin D

I’ll have a separate post on these two soon, but in a nutshell, both are major players for the high-level gymnast.

Both are micronutrients that need to be tested via blood lab work and not just arbitrarily supplemented. These tests are low-cost and almost always covered by insurance.  

Studies have shown that 60% of female athletes are iron deficient, so this isn’t something to overlook. Inadequate dietary intake, menstruation, high intensity training, sweat losses, and iron malabsorption are among some of the most common causes.

Symptoms of iron deficiency or iron deficiency anemia include fatigue, feeling “heavy” (especially the legs), pallor (pale looking appearance, abnormal), and shortness of breath. Other symptoms include nausea and frequent infections. These symptoms are related to inadequate iron which impairs the red blood cell’s ability to carry oxygen throughout the body. This is something you need to check with the pediatrician or sports medicine physician; you do not want to just start supplementing iron. Iron can be toxic in excessive amounts and can also be hard on the GI tract, so let’s “test, don’t guess”.

When you ask the pediatrician or sports medicine physician to check your gymnast’s iron, you want to ask for a complete blood count (CBC) and then additional labs like serum iron, serum ferritin, transferrin saturation, and total iron binding capacity—often called an “iron panel”. This is easily overlooked, so working with a physician who is familiar with athletes (or then bringing your results to the sports dietitian as well) will ensure your gymnast gets the appropriate recommendations. 

Vitamin D helps calcium be absorbed from the intestines which is then essential for bone mineralization. It is also has an important role in muscle tissue function and inflammation. Fatigue and lethargy are symptoms that can also be related to vitamin D deficiency.

Vitamin D is especially important for athletes due to the role it plays in bone mineralization, especially in sports where the athletes are more at risk for inadequate energy availability. Less known for, vitamin D also plays an important role in protein synthesis, hormone synthesis, immune response, and cell turnover and regeneration which are all involved in maximizing adaptation to training and recovery. 

Many individuals are deficient in vitamin D, and in short it’s something that needs to be tested and supplemented if warranted (especially if the athlete is complaining of fatigue, has limited dairy products in the diet, has suspected inadequate energy availability, or is an aesthetic sport athletes). The recommended amounts for children and adolescents is 600 IU but it’s unknown as to whether this is sufficient, especially for the athlete. Vitamin D deficiency is a blood level less than 20 ng/dL, insufficiency is less than 30 ng/dL.

Because vitamin D is a fat-soluble vitamin, it’s not something the body will “pee out” if you consume too much. It takes a lot of vitamin D over time to develop a toxicity, but it’s a supplement that you don’t want to blindly take without the guidance of a physician who can order and monitor laboratory tests.

The form of Vitamin D you want your physician to order (blood work) is called “25-hydroxyvitamin D) or 25-OHD. This is different than 1, 25 di-hydroxyvitamin D, and that lab test won’t tell you if your gymnast is deficient or not. The goal of 25-OHD is to be above 30 ng/dL, ideally closer to 40 ng/dL for athletes.

Vitamin B12 deficiency can also cause symptoms of fatigue, lethargy and are not uncommon in individuals who follow a vegan or vegetarian diet since the major sources of B12 come from animal proteins. This is a bit more nuanced, starting with a complete blood count and then the physician may need to order additional labs to tease out whether there is a B12 deficiency or folate as one can mask the other.

3. Gymnast isn’t eating enough carbohydrate

Carbohydrate is the gymnast’s fuel, so inadequate amounts throughout the day to support nutrition and performance needs can result in feelings of fatigue and lethargy. The recommendation for high level gymnasts is a minimum of 5 g/kg/day if not up to 6-7 g/kg based on training intensity, frequency, and duration.

As I’ve written about here, carbohydrates are probably one of the most demonized food groups in the sport of gymnastics.  They’re incorrectly associated with “weight gain” and other health issues that are taken totally out of context.

Inadequate carbohydrate can also lead to sleep disturbances as well, as carbohydrates plays an important role in melatonin and serotonin synthesis, two hormones involved in sleep and mood regulation.  Though this area certainly needs or more research for adolescent athletes, if your gymnast is not consuming enough carbohydrate and isn’t sleeping well, it would be something to look into from both the sleep and optimal performance angels.

4. Inadequate Sleep

The recommendation for 12-18 year old’s is 9 hours of sleep per night, even though we know the average amount is 7.5-8.5 hours per night.

The role of sleep in appetite regulation, body composition, recovery, and mental health is undeniably important. Research also shows a strong correlation between inadequate sleep and increased risk of injury. Research also shows that adolescents who are restricted on sleep have an increased desire for sweets/desserts. There is nothing wrong with enjoying the “fun foods”, but if your gymnast is always craving sugar, she’s could either be A) not eating enough, or B) not getting enough sleep, or C) all of the above.

What are essential to good “sleep hygiene”?

  • No caffeine close to bed (caffeine has a half-life of 6 hours, so cut of caffeinated drinks by 2-3PM at the latest). As a side note, children and adolescents under 17 years should not have more than
  • Dark, cool room- this is an easy fix, get blackout curtains and a fan if you need to cool a specific room down
  • Consistency- be consistent with the schedule, aim to not sleep in for hours on the weekend or take long, disruptive naps that make it difficult to stay on a schedule
  • Remove electronics from the room (TVs, phones, computers, etc)

I’d say the gymnast’s two biggest barriers are A) Schedules and B) social media/cell phones. Let me explain…

We all know that gymnastics requires a lot of time in the gym. While the necessitation of 20-30+ hours a week is currently being challenged, it’s still the norm for high level gymnasts. This kind of schedule makes it difficult to get all school requirements completed AND all the other commitments, activities that our gymnasts are involved in.

In my opinion, if your gymnast has workout form 4-8PM or 5-9PM, most all homework needs to be completed before practice, if possible. A lot of gymnasts are able to get an “athletic leave” or some sort of study-hall the last hour of the school day where homework can be finished before they leave for practice. Sometimes the answer may be homeschooling or virtual school, especially if your gymnast is doing everything she can to maximize her time and still can’t get more than 7 hours of sleep a night.

Getting all homework finished before practice isn’t always possible, so pre-planning meals and packing food can be helpful to save time and get a head-start on recovery nutrition. Perhaps a parent can bring dinner in the car for the gymnast to eat on the way home, or at least a recovery snack to get a head start on nutrition. This would also save from running through the drive through, and while you can make nutritious choices at fast food restaurants, it’s going to be easier to build the gymnast’s plate appropriately (and more economically) from home.

The other issue with nutrition and late practices is a lot of gymnasts are not fueling adequately during the day, and thus they are STARVING when they get home and eat a huge dinner which can impair sleep. I’d aim for consistency with meals and ensure adequate fueling pre-and-intra workout.  

Ok, on to the bigger issue…social media and cell phones. I get it, we’ve all been there. It’s really difficult to part with the phone at times, but this is crucial for your gymnast to get in bed and actually get to sleep instead of lying there scrolling the phone for another 30 min or more.

As a parent, you can decide what is best here. Perhaps your gymnast needs to put her phone on the charger across the room. Perhaps she needs to place it away from the bedroom (downstairs, the kitchen, another room, etc) and use a conventional alarm clock. These are all small habits that contribute to that 1% difference that will separate your gymnast from the rest. And, these are good habits to form for adult life where it could be busier and more complicated than school and gym (and all the other activities associated).

In Summary

If your gymnast is always tired, complaining of fatigue, asleep in the car to and from workouts or school, the first step is to be sure a physician has evaluated for the obvious causes of fatigue (iron deficiency, B12 if history of vegan or vegetarian diet or eating disorder, vitamin D, other issues like mononucleosis) and the other issues like inadequate sleep.

The second, and equally important, area to evaluation would be overall nutrition and proper fueling which a registered dietitian sports nutritionist is equipped to do (with training in pediatric/adolescent nutrition if the gymnast is <18 years).

If you’re looking for more specific help or advice, feel free to contact me and we can set up a free 20-minute consultation call to chat.