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From the Gatorade Sport Science Institute

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INTRODUCTION

Sleep is extremely important for performance, learning, development and physical and mental health.3 Some of the consequences of inadequate sleep include: a reduction in academic performance, mood disturbance, increases in risk-taking behaviour and drowsy driving. ¹¹ From an athletic perspective, reductions in performance, decision- making ability, learning and cognition can occur alongside reductions in immune function and an increased susceptibility to weight gain. While this chapter will outline the importance of sleep for all athletes, additional focus will be placed on the adolescent athlete. It is becoming increasingly clear that adolescence (ages 12-18 yrs) is a period of development where sleep is particularly important. What is also becoming obvious is that many adolescents do not obtain the recommended amount of sleep. ¹¹ This chapter will discuss consequences of reduced sleep, how much sleep is required, reasons for poor sleep and strategies that can be utilized to enhance sleep quality, and quantity in athletes and adolescents.

KEY FINDINGS

CONSEQUENCES OF REDUCED SLEEP

ATHLETIC PERFORMANCE

While there is limited research on exercise performance and sleep, a small number of studies have examined the effect of partial sleep deprivation on athletic performance in adults. Reilly and Deykin ¹³ reported decrements in a range of psychomotor functions after only one night of restricted sleep; however, muscle strength, lung power and endurance running were unaffected. ¹³ Reilly and Hayles ¹⁴ reported similar effects in females following partial sleep deprivation, with gross motor functions being less affected by sleep loss than tasks requiring fast reaction times. ¹⁴ Reilly and Percy ¹⁵ found a significant effect of sleep loss on maximal bench press, leg press and dead lifts, but not maximal bicep curl. Submaximal performance, however, was significantly affected on all four tasks and to a greater degree than maximal efforts. The greatest impairments were found later in the protocol, suggesting an accumulative effect of fatigue from sleep loss. 15

From the available research it appears that submaximal prolonged tasks may be more affected than maximal efforts, particularly after the first two nights of partial sleep deprivation. ¹⁵

OTHER CONSEQUENCES

There are a number of other biological functions that can be altered following sleep deprivation. Changes in glucose metabolism and neuroendocrine function as a result of chronic, partial sleep deprivation may result in alterations in carbohydrate metabolism, appetite, food intake, and protein synthesis. Ultimately these factors can all negatively influence an athlete's nutritional, metabolic and endocrine status and hence potentially reduce athletic performance.

EFFECTS OF SLEEP EXTENSION

Another means of examining the effect of sleep on performance is to extend the amount of sleep an athlete receives and determine the effects on subsequent performance. Mah et al, ⁹ instructed six basketball players to obtain as much extra sleep as possible following two weeks of normal sleep habits. Faster sprint times and increased free-throw accuracy was observed at the end of the sleep extension period. Mood was also significantly improved, with increased vigour and decreased fatigue. 9 While limited, this data suggests that increasing the amount of sleep an athlete receives may significantly enhance performance.

EFFECTS OF NAPPING

Athletes suffering from some degree of sleep loss may benefit from a brief nap, particularly if a training session is to be completed in the afternoon or evening. Waterhouse et al ¹⁶ are one of the only groups to investigate the effects of a lunchtime nap on sprint performance following partial sleep deprivation (4 h of sleep). Following a 30-min nap, 20-m sprint performance was increased (compared to no nap), alertness was increased, and sleepiness was decreased. In terms of cognitive performance, sleep supplementation in the form of napping has been shown to have a positive influence on cognitive tasks following a night of sleep deprivation (2 h). ¹² Naps can markedly reduce sleepiness and can be beneficial when learning skills, strategy or tactics. 12 Napping may be beneficial for athletes who have to routinely wake early for training or competition and for athletes who are experiencing sleep deprivation. ¹⁶

HOW MUCH SLEEP ARE ATHLETES GETTING?

According to a 2005 Gallup Poll in the USA, the average self-reported sleep duration of healthy individuals is 6.8 h on weekdays and 7.4 h on weekends.7 However, the sleep habits of elite athletes have only recently been investigated. Leeder et al ⁸ compared the sleep habits of 26 elite athletes from Olympic Sports (Canoeing, n=11; Diving, n=14; Rowing, n=10; Short-track speed skating, n=11) using actigraphy over a four- day period to that of age-and sex-matched non-sporting controls. The athlete group had a total time in bed of 8:36 ± 0:53 hr:min, compared to 8:07 ± 0:20 in the control group. Despite the longer time in bed, the athlete group had a longer sleep latency (time taken to fall asleep) (18.2 ± 16.5 min vs. 5.0 ± 2.5 min), a lower sleep efficiency (estimate of sleep quality) than controls (80.6 ± 6.4% vs. 88.7 ± 3.6%), resulting in a similar time asleep (6:55 ± 0:43 vs. 7:11 ± 0:25 hr:min). The results demonstrated that while athletes had a comparable quantity of sleep to controls, significant differences were observed in quality of sleep between the two groups. 8

While the above data was obtained during a period of normal training without competition, athletes may experience disturbed sleep prior to important competition or games. Erlacher et al 4 administered a questionnaire to 632 German athletes to assess possible sleep disturbances prior to competition. Of these athletes, 66% (416) reported that they slept worse than normal at least once prior to an important competition. Of these 416 athletes, 70% reported problems falling asleep, 43 reported waking up early in the morning and 32% reported waking up at night. Factors such as thoughts about competition (77%), nervousness about competition (60%), unusual surroundings (29%) and noise in the room (17%) were identified as reasons for poor sleep. ⁴

In a study from the Australian Institute of Sport, athletes and coaches ranked sleep as the most prominent problem when they were asked about the causes of fatigue/tiredness. ⁵ Sleep characteristics ranked first when athletes were asked about the aspects of the clinical history that they thought were important.

Therefore, it appears that sleep disturbances in athletes can occur at two time points: 1) prior to important competitions and 2) during normal training. This sleep disruption during normal training may be due to poor routine as a consequence of early training sessions, poor sleep habits (i.e., watching television in bed), nocturnal waking to use the bathroom, caffeine use, and excessive thinking/worrying/ planning. While not documented in the literature, anecdotal evidence also suggests that athletes such as soccer players who compete at night also have significant difficulties falling asleep post competition.

HOW MUCH SLEEP DO ADOLESCENTS NEED?

Research suggests that the sleep needs of adolescents do not differ from that of younger children. ¹⁰ Evidence suggests that when adolescents are allowed to sleep as much as they want, they sleep for an average of 9.25 hrs per night. ² Further, during mid-puberty, there is an increased desire to sleep during the day even when sufficient sleep occurred at nighttime. ² From the literature available, it appears that adolescents require a minimum of 9 hrs per night of sleep.

HOW MUCH SLEEP ARE ADOLESCENTS GETTING?

Despite the recommendation that 12-18 year olds obtain a minimum of 9 hrs of sleep per night, research shows that adolescents sleep between 7.5 and 8.5 hrs per night. 11 While there is certainly going to be individual differences, it is clear that many adolescents are not meeting the minimum requirements for the recommended hours of sleep.

CAUSE OF POOR SLEEP IN ADOLESCENTS

There are a number of factors that may explain the poor sleep observed in adolescents, and these can be broken down to internal and external factors.

INTERNAL FACTORS

A shift in circadian rhythm occurs during puberty as a result of changes in the timing of melatonin release. ¹¹ Melatonin is a hormone that when released precipitates sleepiness. The delay in release of melatonin in adolescents results in the later feelings of sleepiness, the later subsequent bedtime, and the later wake-up time.

EXTERNAL FACTORS

As mentioned above, adolescents have a propensity to go to bed later and wake up later the following morning based on biological factors. However, due to school and extracurricular activities, most adolescents do not have the opportunity to wake later in the morning on school nights and potentially weekends, depending on their sporting schedule. This significantly reduces their sleep opportunity.

Adolescence is usually associated with increased social demands. This can include time spent "in person" or electronically. There is an increasing trend for adolescents to communicate via telephone, SMS, email, Facebook and Twitter into the late evening. As many adolescents experience sleep deprivation, they have increased levels of daytime sleepiness, which may result in caffeine and/or energy drink intake to feel alert and more awake. Caffeinated beverages can have a significant impact on the time taken to fall asleep.

WHEN DO ADOLESCENTS SLEEP?

The changes that occur with development result in adolescents feeling sleepy later in the evening when compared to children. ¹¹ Specifically, sleep onset time (time at which a person falls asleep) occurs later in the evening, and wake-up time is later in the morning. ⁶ The reasons for this delay will be discussed below; however, the result of the delay is most often reduced total sleep time due to the requirement to attend school or training the following morning.

One study found that in a group of 20 healthy adolescents, average sleep onset time was 12:44 a.m. with a rise time of 8:18 a.m., resulting in 7.7 hrs of sleep. ¹ In addition, adolescents tend to have more variable sleep patterns across the week when compared to children and adults. ⁶ This is evidenced by significant differences between school-night and weekend sleep onset time, wake-up time and total sleep times. Reports suggest that adolescents delay their bedtime by 1-2 hrs on weekends, and they may sleep in 3-4 hrs later on weekends compared to school nights. ¹⁰ This typically results in more sleep obtained on weekends, as the adolescent is able to fit his or her sleep pattern to their more favoured bedtime and wake-up time due to no influence of school schedules. However, this also results in significantly altered routines across a 7-day week.

HOW TO ASSESS SLEEP

A simple sleep diary in which information on bedtime, wake-up time, total sleep time, caffeine consumed prior to sleep, activities performed before going to bed, perceptions of sleep quality, and daytime functioning is recorded can be very useful. The National Sleep Foundation (https://www.thensf.org/) has excellent resources including diaries for adults and teens, which can be helpful to gain insight into sleep habits. A sleep clinician can conduct a detailed sleep history and assessment to determine if the athlete has a clinical sleep disorder. Psychiatric and medical conditions may need to be considered due to their interaction with sleep. A sleep clinician may conduct sleep assessments using actigraphy (wearing of a wristwatch to detect movement during sleep) or polysomnography (overnight stay in a sleep laboratory to measure brain activity and other physiological functions).

SOLUTIONS TO SLEEP PROBLEMS

Many of the strategies suggested for optimising sleep in adults also apply to the adolescent. However, there are some specific tips and tricks that may be useful for this age group. Table 1 includes some of the guidelines from The National Sleep Foundation (https://www.thensf.org/).

SUMMARY

Sleep is one of the body's most important biological functions with roles in performance, cognition, learning, development and mental and physical health. While there are numerous consequences as a result of inadequate sleep, identifying sleep problems and following the recommended sleep guidelines can help ensure sporting performance is maximized.

REFERENCES

1. Beebe, D.W., G. Fallone, N. Godiwala, M. Flanigan, D. Martin, L. Schaffner, and R. Amin (2008). Feasibility and behavioral effects of an at-home multi-night sleep restriction protocol for adolescents. J. Child Psychol. Psych. 49:915-923.

2. Carskadon, M.A. and C. Acebo (2002). Regulation of sleepiness in adolescents: update, insights, and speculation. Sleep. 25:606-614.

3. Dewald, J.F., A.M. Meijer, F.J. Oort, G.A. Kerkhof, S.M. Bogels (2010). The influence of sleep quality, sleep duration and sleepiness on school performance in children and adolescents: A meta-analytic review. Sleep Med. Rev. 14:179-89.

4. Erlacher, D., F. Ehrlenspiel, O.A. Adegbesan, and H.G. El-Din (2011). Sleep habits in German athletes before important competitions or games. J. Sports Sci. 29:859-66.

5. Fallon, K.E. (2007). Blood tests in tired elite athletes: expectations of athletes, coaches and sport science/sports medicine staff. Br. J. Sports Med. 41:41-4.

6. Gradisar, M., G. Gardner, and H. Dohnt (2011). Recent worldwide sleep patterns and problems during adolescence: a review and meta-analysis of age, region, and sleep. Sleep Med. 12:110-8.

7. Foundation NS (2006). Sleep in America- Poll. In: Foundation NS (ed). Washington, DC.

8. Leeder, J., M. Glaister, K. Pizzoferro, J. Dawson, and C. Pedlar (2012). Sleep duration and quality in elite athletes measured using wristwatch actigraphy. J Sports Sci. 30:541- 545.

9. Mah, C.D., K.E. Mah, E.J. Kezirian, and W.C. Dement (2011). The effects of sleep extension on the athletic performance of collegiate basketball players. Sleep. 34:943-950.

10. McLaughlin Crabtree, V., and N.A. Williams (2009). Normal sleep in children and adolescents. Child Adolesc. Psychiatr. Clin. N. Am. 18:799-811.

11. Moore, M., and L.J. Meltzer (2008). The sleepy adolescent: causes and consequences of sleepiness in teens. Paediatr. Respir. Rev. 9:114-20; quiz 20-1.

12. Postolache, T.T., and D.A. Oren (2005). Circadian phase shifting, alerting, and antidepressant effects of bright light treatment. Clin. Sports Med. 24:381-413.

13. Reilly, T., and T. Deykin (1983). Effects of partial sleep loss on subjective states, psychomotor and physical performance tests. J. Hum. Move. Stud. 9:157-170.

14. Reilly, T., and A. Hales (1988). Effects of partial sleep deprivation on performance measures in females. In: E.D. McGraw (ed). Contemporary Ergonomics. London: Taylor and Francis, pp. 509-513.

15. Reilly, T., and M. Piercy (1994). The effect of partial sleep deprivation on weight-lifting performance. Ergonomics. 37:107-15.

16. Waterhouse, J., G. Atkinson, B. Edwards, and T. Reilly (2007). The role of a short post- lunch nap in improving cognitive, motor, and sprint performance in participants with partial sleep deprivation. J. Sports Sci. 25:1557-66.

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Coach F 508 555 1234
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Every Day Captains will pick one of 4 of these to do...

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Warm up for indoor or if you have arrived late

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Are you eating enough of the right nutrients?
Try a free tracker like https://www.loseit.com/ and keep reading up on nutrition!

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Pertaining to the hard-to-get-out-of-bed, fast food-eating teenagers who spend their days learning calculus and American history and then tear up fields and courts after the final bell rings. These growing and developing creatures require nutrition above and beyond the offerings of most high school cafeterias, drive-through windows, or convenience store snack aisles, yet few are meeting their unique dietary needs.

High school athletes face similar fueling challenges as their collegiate counterparts, such as limited time, minimal motivation for meal prep, and frequent travel. However, they have a few more hurdles to consider. For instance, many inhabit bodies that are rapidly changing, and the population as a whole is generally less likely to take responsibility for food choices.

In addition, as high school athletes grow and change, they often struggle with their body image, self-esteem and self-acceptance. To address these concerns, some look to lose fat, while others try to gain muscle. Attempting to meet either of these goals without a corresponding nutrition plan can be detrimental to performance and health.

The available research on nutrition for high school athletes supports a meal plan that incorporates eating multiple times a day and balancing macronutrients to maintain performance. This often requires fueling and hydrating in a creative manner.

For the past 10 years, the Washington Interscholastic Nutrition Forum (WIN- Forum), a science-based sports nutrition resource geared toward high school athletes, coaches, athletic support staff, and parents, has supported high school athletes in creating fueling game plans to help them succeed in sport. In my experience, science-based education and a bit of planning up front can go a long way in meeting the fueling challenges for high school athletes.

Basic needs

When it comes to macronutrients like carbohydrates, protein, and fat, it's important that high school athletes are getting adequate intake. To start, they should get more than half of their daily calories from high-quality carbohydrates, such as grains, fruits, and dairy.

Unfortunately, this does not always happen because many high school athletes misunderstand carbohydrates. They are quick to adopt fad diets that restrict carbohydrates or cut out whole food groups, such as dairy or grains. Of course, athletes with medically diagnosed conditions, for example, Celiac disease, should follow their prescribed diet. But for all athletes, carbohydrates play a valuable role in their growth and performance.

Protein is also a crucial part of a high school athlete's diet to maximize muscle growth and repair. Generally, teenage athletes require between .7 and .9 grams of protein per pound of bodyweight each day. Because the body can only utilize approximately 25 grams of protein per feeding interval, athletes should focus on consuming small, high-quality doses throughout the day. Dairy, eggs, meat, chicken, fish, tofu, edamame, and soy milk are all high-quality sources.

Additionally, new research suggests that a pre-bed snack consisting of 20 to 25 grams of high-quality protein can help the body assimilate muscle tissue during sleep. Acquiring muscle while they sleep? This should be an easy sell to high school athletes.

It can be hard for teenagers to figure out how to consume protein throughout the day, so I find it helpful to provide them with ideas and examples. Here's a sample eating plan I drew up for Sara, a 16-year-old, 5-foot-11-inch, 150-pound basketball player. She needed 120 grams of protein per day to maintain stamina and gain muscle during her offseason training.

Breakfast: Two-egg scramble on two pieces of toast with avocado and tomato and eight ounces of milk = 24 grams of protein.

Snack: Six ounces of Greek yogurt and fruit = 12 grams.

Lunch: Three ounces of tuna on two slices of bread, granola bar, carrots and hummus, and fruit = 24 grams.

Pre-practice snack: Half of a peanut butter and jelly sandwich and a fruit leather = 7 grams.

Post-practice snack: 12 ounces of chocolate milk = 12 grams.

Dinner: Three-ounce portion of grilled pork tenderloin, baked sweet potato, steamed broccoli, and fruit salad with yogurt = 25 grams.

Pre-bed snack: Cottage cheese and fruit = 15 grams.

Finally, high school athletes need fat - the heart-healthy kind. Be sure to educate them on the importance of consuming fats from fish, nuts, vegetable oils (e.g., olive and canola) and avocados. These support energy, muscle growth, immune function and recovery.

Tailored to teens

In my years of working with high school athletes, I've learned to conquer the three main roadblocks of getting them to fuel properly. The first is convincing them to eat a quality breakfast.

I've yet to meet a teenager who willingly wakes up earlier than they absolutely have to, so it can be difficult to convince high school athletes that consuming a morning meal is more important than a few extra minutes of sleep. It helps to explain that those who skip breakfast won't have enough gas in the tank for a focused afternoon practice. This missing fuel can lead to muscle loss - not to mention the potential loss of a starting spot on a team.

Two other ways I've had success getting athlete buy-in are through visual aids and by organizing team breakfasts. I use Pinterest to create visual boards that I share with athletes, so they can see how easy it is to make a microwave egg sandwich or toaster waffle "Big Mac" (layer toaster waffles with peanut butter and banana). For team breakfasts, I suggest making oatmeal in a large slow cooker and assigning players to bring their favorite toppings, such as nuts, granola, milk, and fruit.

Just because breakfast is the most important meal of the day, doesn't mean it has to be the most complicated. There are tons of quick, high- carbohydrate, moderate-protein options that will keep athletes energized and their muscle tissue intact. Some I recommend are a bagel with eggs, banana, and milk; yogurt, oatmeal, and an orange; and whole grain waffles with peanut butter and strawberries.

You'll notice that none of my go-to options include a bowl of cereal. This common breakfast item for high schoolers is often loaded with sugar and rarely provides long-lasting energy. Advise athletes to ditch their corn flakes and honey-nut O's for some- thing more substantial. If they must have cereal in the mornings, remind them that it should serve as an appetizer to a heartier breakfast.

The second challenge is getting high school athletes to snack throughout the day. Approximately 25% to 30% of their total calories should come prior to lunch. For the athlete who needs 3,000 calories per day, this means 750 to 1,000 calories should come in the form of breakfast and a morning snack.

Snacks for the rest of the day should contain carbohydrates for energy and protein for repairing muscles and keeping athletes satisfied. Since time between classes is short and many schools limit eating and drinking, good snack options should be nonperishable and easy to store in lockers or book bags. (See "Snack Time" below.)

One of my clients, Luke, a freshman cross country runner, recently learned the benefits of all-day fueling. When we started working together, Luke complained of fatigue and felt his performance was lacking. His eating habits reflected, well, a typical high schooler's. His breakfast consisted of one bowl of cereal ("if there was time"). Lunch was finely crafted cafeteria pizza or chicken nuggets, chips, fruit snacks, and a carbonated drink, and he capped off the day with a home-cooked dinner after practice.

Together, Luke and I developed a performance nutrition game plan that better suited his dietary needs. Here's what it looked like:

Breakfast: Waffles with peanut butter and bananas, yogurt, and coffee

Snack: Trail mix

Lunch: Sandwich, veggies, fruit, goldfish crackers, and a granola bar

Pre-practice snack: Dried fruit and peanut butter pretzels

Post-practice snack: Chocolate milk and an energy bar

Dinner: Grilled fish, veggies, salad, bread, and milk

Pre-bed snack: Peanut butter and jelly sandwich with fruit.

After a short time practicing his new meal plan, Luke reported significant improvements in his performance. He broke two freshman school records, made first team all-freshman in his conference, competed in the state championship meet, and is now ranked nationally.

Finally, the third challenge of working with teenage athletes is accepting that they won't always make healthy choices. Remember, good nutrition doesn't have to be all or nothing. Creating rules like "no sweets" or "no fries" sets high school athletes up for failure and increases the likelihood of binge eating and secretive eating behavior.

Instead, try to balance high-performance fueling with realistic expectations. I recommend high school athletes follow the 80-20 rule. If they focus on high-performance foods 80% of the time, 20% is left for eating "cheat" foods.

I also tell athletes to use some of their favorite treats to fuel performance. For example, if an athlete loves his mom's chocolate chip cookies, I suggest including them as a pre- practice snack with milk. This way, his body can use the carbohydrates and protein for energy and muscle growth, and he feels guilt-free about his choice.

Losing & gaining

High school athletes do a lot of looking in the mirror, and they aren't always happy with what they see. Like most teenagers, high school athletes can struggle with self-esteem, and some may want to make their bodies look a certain way through fat loss or muscle gain. It's important that they pursue either option in a healthy manner.

Athletes' weight and body composition desires are influenced by coaches, athletic trainers, media, teammates, parents, and their own athletic and aesthetic goals. These influences and pressures can tempt young athletes to restrict calories and eliminate food groups in order to lose weight.

I recently worked with a high school swimmer, Ciera, who wanted to lose weight after she heard her coach say that dropping a "few pounds" can help athletes swim faster. She quickly put his blanket statement of, "Stop eating sweets to lose weight," into action.

Ciera removed all things with sugar in them from her diet, including her pre-practice snacks, which cut about 800 calories from her daily intake. The frequent praise she received on her appearance once she started losing weight encouraged her to continue with her calorie restriction. She created a new rule, "No White at Night," and cut out all carbohydrates that were white, such as bread, pasta, and rice.

For an athlete with extremely high carbohydrate needs like Ciera, restricting these foods can lead to low energy availability, amenorrhea, fear of eating with friends and teammates, and the potential for developing an eating disorder. With a starting body composition of 19% body fat (already low for a teen swimmer), Ciera did not need to lose a few pounds, and the calorie restriction was too great for her to maintain muscle and bone mass, as well as energy.

While I worked alongside Ciera's physician and therapist to adjust her eating habits, she took a break from training and competition. After six months, she was able to face her fears around eating, get back to a healthy, strong weight, and gradually return to the pool. Ciera also regained her menstrual cycle and is now swimming faster than ever.

To prevent a frustrating and potentially damaging battle against the scale, encourage athletes to ask themselves three important questions before they start a weight-loss plan:

→ Why do I want to lose weight? There are many reasons athletes think they need to lose weight, and improving their overall health is not typically one of them. Some think it will increase their athletic performance, but many are fueled by a desire to look "better." As Ciera's case shows, calorie restriction for the wrong reason can be dangerous.

→ Do I need to lose weight? Athletes frequently hear losing weight improves sports performance, but that is not al- ways the case. In many circumstances, cutting calories can lead to nutrient deficiencies, muscle loss, and performance declines if energy needs are not met.

Communicating best practices and choices for an athlete's health and performance should be a "team" effort that includes coaches, athletic trainers, parents, nutritionists, and family physicians. This will help ensure athletes reach their goals without compromising well-being.

→ Is this the right time to lose weight? Optimal timing for weight loss is in the offseason to ensure it has minimal effects on performance. In addition, periods of high stress (e.g., finals weeks, family conflicts) and times of growth (puberty) can make weight loss more difficult to attain.

If athletes want to lose weight for the healthy reasons and the timing is right, recommend they fuel every three to four hours, as research on nutrient timing says eating smaller meals more frequently minimizes excessive caloric over-feeding (fat storage) and excessive caloric deficit (muscle loss). Learning to be self-aware of hunger and satiety can help athletes stick to this fueling schedule. Remind them to listen to their bodies for true hunger cues, such as a growling stomach, rather than eating because they are bored, lonely, or sad. Some may benefit from keeping a hunger and full- ness chart (rating hunger and fullness on a scale of one to 10 throughout the day) or setting an alarm on their watches or phones to eat every few hours.

High school athletes looking to gain weight may think their road has to be paved with muscle-building supplements. Contrary to popular belief, simply consuming extra protein in the form of powders and pills and hitting the gym on occasion is not enough to gain muscle. To see results, high-quality protein must be consumed in multiple small portions (20 to 25 grams) throughout the day and combined with a well-planned strength program.

I advise a three-step "Ready, Set, Go" approach when working with athletes who are looking to increase muscle mass:

Ready: Have athletes start a strength-based, sport-specific lifting program designed to maximize muscle gain. Then, create an eating plan to support growth that includes a meal-snack-meal-snack pattern and caloric distribution spread around practices and games.

Set: Be realistic when helping athletes set goals for muscle gain. A good target is to add 400 to 500 calories per day, which will build half a pound to a pound of muscle per week when following their strength program.

Go: Provide consistent support for athletes to fuel and train. Remind them to fuel during training by consuming extra energy sources.

It is vital to remind high school athletes about the importance of recovery and repetition in a muscle-gaining program. Encourage a recovery snack after each training session that includes carbohydrate and protein. Stress that staying consistent with eating and training habits will ultimately help them reach their goals.

High school is the perfect time and place to engage athletes in sports nutrition. Building a solid nutrition game plan in their teens will help them continue to enhance performance as they move along in sport.

Since 2005, Emily Edison, MS, RD, CSSD, is the owner and founder of Momentum Nutrition in Seattle and spent seven years as the consulting Sports Dietitian for the University of Washington athletic department.

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On the Move: Meeting nutrition needs of teenage athletes | Training & Conditioning

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Pertaining to the hard-to-get-out-of-bed, fast food-eating teenagers who spend their days learning calculus and American history and then tear up fields and courts after the final bell rings. These growing and developing creatures require nutrition above and beyond the offerings of most high school cafeterias, drive-through windows, or convenience store snack aisles, yet few are meeting their unique dietary needs.

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Schedule (sample)