Sports Nutrition for Student Athletes – PediaCast 555

Show Notes


  • This week we consider sports nutrition for student athletes as guest host, Alycia Kingcade, chats with Sakiko Minagawa and Dr Tom Pommering. Discover the importance of food as fuel and energy availability. We also explore dietary supplements, sports drinks, and picky eaters. We hope you can join us!


  • Sports Nutrition
  • Student Athletes
  • Food as Fuel
  • Low Energy Availability
  • Dietary Supplements
  • Sports Drinks
  • Picky Eaters

Guest Host




Episode Transcript

Announcer:     This is Pediacast. ♪♪♪ Welcome to Pediacast, a pediatric podcast for parents. And now, direct from the campus of Nationwide Children's, here is your host, Dr. Mike.

Dr Mike Patrick:     Hello everyone, and welcome once again to Pediacast. It is a pediatric podcast for moms and dads This is dr. Mike coming to you from the campus of Nationwide Children's Hospital. We're in Columbus, Ohio It's episode 555 We're calling this 1 sports nutrition for student athletes. I want to welcome all of you to the program.

Dr Mike Patrick:     So I hope you all have had a good week here in central Ohio. And I would imagine in many parts of the United States, a viral season has really ramped up as it usually does this time of year, except, you know, in pandemic years and when social distancing makes everything go haywire. But in your typical year, which thankfully this is becoming a typical year, viral illnesses are really, really in high prevalence this time of year and a part of that is wintertime but why in the winter? Like why do we see all of these viruses? And we don't exactly understand all of the reasons why, but 1 big thing is school.

Dr Mike Patrick:     So you get, you know, 20 kids in a classroom and they share their viruses with each other. And then they take those home, share them with their parents and their siblings who then take them to their class or their work. And so because all of these kids are in close contact in a classroom, these things get spread so easily. And so if you find yourself with a runny nose, congestion, cough, maybe a fever with it, you are in good company. There is a lot of that going around right now.

Dr Mike Patrick:     We do worry, you know, for the young kids, if you have a baby at home who has a high fever, you definitely want to have them seen and checked out. For older kids, you know, it's okay to let your body have a fever for a couple of days, especially if you're drinking well and going to the bathroom, you know, several times during the day so you're well hydrated, you know, and then just taking ibuprofen and acetaminophen for the fever. If there's other symptoms that you're worried about, by all means, give your child's doctor a phone call. Let them know what symptoms they're having, and then they'll be able to tell you, hey, this is something you can treat at home. Maybe you need to come to the office, for instance, if you have a sore throat and not a lot of congestion, you know, you may need a strep test.

Dr Mike Patrick:     Or if it's after hours, they may say, find a pediatric urgent care or find an emergency room. So, you know, sometimes parents are like, where do we go? What do we do? And always the first thing is just give your doctor a phone call. There's someone's going to be on a call for them and you should be able to get a hold of someone at the office really 24-7.

Dr Mike Patrick:     It may be an answering service and they may say, hey, if it's not an emergency, doctor will call you back in the morning. That's appropriate. But it really is important to reach out to your regular physician. And then I also want to mention, you know, each of these viruses typically last a week to 2 weeks sometimes. Now usually the first week is worse and then symptoms just kind of linger for another week after that.

Dr Mike Patrick:     So, you know, you get 2 viruses back to back and you've got a kid who is sick for a month. And that is really not all that unusual. But again, if the fever's lasting more than a couple of days or the fever goes away and then comes back, that's going to be something that you want to have your child seen because as we have talked about on this program before, viruses can then lead to bacterial infections as a complication. So what starts as a cold may turn into an ear infection or a pneumonia in older kids or maybe a sinus infection. And so you really do want to pay attention to how long the fever is lasting and if it goes away and comes back.

Dr Mike Patrick:     And of course anytime your child's having difficulty breathing or you're worried they're getting dehydrated, it's definitely time to see someone. So as I said you're in good company if you are dealing with all of this, this time of the year, because this is when we see it. And this is when the offices and the emergency rooms and the urgent cares are particularly busy. So you'll probably have a longer wait. And that's just because, you know, it's hard to predict exactly when these illnesses are gonna spike.

Dr Mike Patrick:     We know it's during the winter, but you know, sometimes it's earlier, sometimes it's later, and it can be hard to staff appropriately when things change so quickly. So please do have patience with your medical staff. They are working hard, I guarantee you, and really trying to get everybody as soon as and as fast as they can, but also providing really good quality care for each person and not rushing through and perhaps missing something. So that's all important things to keep in mind. So today is kind of a special day on Pediacast.

Dr Mike Patrick:     As I mentioned, we are talking about sports nutrition for student athletes. Lots of topics to cover. You know, we're going to discuss food as fuel, low energy availability, sports drinks, supplements, hormones, you know, anabolic steroids. Why are those dangerous? Also, picky eaters.

Dr Mike Patrick:     How do you keep them well fueled for sports? And injuries that can arise from poor nutrition. But what makes this episode super special is we have a co-host this week, Alicia Kincaid. She is a certified athletic trainer at Nationwide Children's Hospital and a podcast fanatic. No, she loves podcasts and we are really excited to have her as a co-host and she's gonna join us for a few more episodes that we have lined up a little bit later in the year.

Dr Mike Patrick:     Our guests today to talk about sports nutrition is Dr. Tom Pomering. He is chief of sports medicine at Nationwide Children's Hospital and Sakiko Minagawa. She is a sports dietitian at Nationwide Children's. Don't forget you can find us wherever podcasts are found and wherever you find us, please consider leaving a review about the program.

Dr Mike Patrick:     We really do value those and want to certainly be the best podcast that we can be. And so the other thing that's nice with the reviews is that others who come along and are looking for a good program with evidence-based child health and parenting information, we want, you know, them to know that other people have enjoyed the podcast. So that's a really super helpful. Also, we're on social media. We love connecting with you there or on all the platforms.

Dr Mike Patrick:     Just search for Pediacast and you should find us. And then over at, we do have that contact page if you would like to suggest a future topic for the program. Also want to remind you the information presented in every episode of our podcast is for general educational purposes only We do not diagnose medical conditions or formulate treatment plans for specific individuals If you have a concern about your child's health always call your health care provider Also your use of this audio program is subject to the PDA Cast Terms of Use Agreement, which you can find at So let's take a quick break. We'll get all the players settled into the studio, and then we will be back to talk about sports nutrition for student-athletes.

Dr Mike Patrick:     It's coming up right after this. Dr. Tom Palmering is chief of sports medicine at Nationwide Children's Hospital and a professor of pediatrics at The Ohio State University College of Medicine. Sikiko Minagawa is a registered dietitian and nutrition expert with Sports Medicine at Nationwide Children's. They both have a passion for keeping student athletes healthy and performing at the top of their game, which includes the fuel that drives the body, otherwise known as food.

Dr Mike Patrick:     That's what they're here to talk about today, sports nutrition. And we have a co-host joining us this week. Alicia Kincaid is a certified athletic trainer with sports medicine at Nationwide Children's. So first let's give a warm PDA cast. Welcome to our guests, Dr.

Dr Mike Patrick:     Tom Pomering and Sakiko Minagawa. Thank you both

Dr Tom Pommering:     so much for being here today. Always great to be here, Dr. Mike.

Sakiko Minagawa:     Thank you for having us here today.

Dr Mike Patrick:     Yeah, absolutely. We really appreciate you guys taking time out of your busy schedule and joining us. And then I also want to give a special welcome to our co-host this week, Alicia Kincaid. Again, She is an athletic trainer here at the hospital and you are going to hear from her moving forward in the future. We plan on doing several of these episodes here in 2024.

Dr Mike Patrick:     And so Alicia, I just want to thank you for all of your hard work and getting us ready for this episode.

Alycia Kingcade:     Yeah, Thanks for allowing me to be a co-host and be able to share about our sports medicine department and get to record future episodes as well.

Dr Mike Patrick:     Yeah, absolutely. So I will go ahead and hand the reins over to you, Alicia, as we really get into it and talk about sports nutrition for student athletes.

Alycia Kingcade:     Yeah, thank you. Thanks everyone listening. Today we are going to be talking about sports nutrition like Dr. Mike had mentioned and today we'll discuss a few things that fall within sports nutrition such as proper fueling, low energy availability, injuries caused by inadequate fueling, and even when to use appropriate sports supplements. So things come along with sports nutrition and sports and so we just want to make sure that we give out the resources that we have and the information to educate to make sure that athletes are returning to sport well and are feeling well.

Alycia Kingcade:     So I wanted to start with asking Sekiko, you are a registered sports dietitian. I wanted to ask you, can you tell us what a registered sports dietitian is and can you tell us what a registered sports dietitian is? And can you tell us what a typical day looks like for you?

Sakiko Minagawa:     Absolutely. So first, a registered dietitian, or we can also go by registered dietitian nutritionist. We are food and nutrition expert and we have to meet certain criteria and earn the RDN credential. And I can kind of go through the steps. First, we have to earn an accredited bachelor's or master's degree.

Sakiko Minagawa:     However, starting January 1st of 2024, all registered dietitian nutritionists requires their master's degree. We have to complete a dietetic internship and then pass the Commission on Dietetic Registration exam. And then some states require state licensure and the state of Ohio does. And then last we have to maintain our state licensure and registration. In terms of a typical day, every day is a little bit different but typically I do a one-on-one consult or one-on-two.

Sakiko Minagawa:     Typically I see the athlete and a parent or both of their parents and kind of talk through their typical food and nutrition and hydration intake and try to find areas where we can improve. I usually say, hey, let's make progress, not perfection and find areas that we can improve our nutrition.

Alycia Kingcade:     Awesome, yes, Sokeko is a fantastic key factor of our sports medicine department and she's a huge asset and comes out to the high schools and talks with our sports teams as well. So it's she's an incredible resource that we have and I love learning from her as well. Sakiko, can you tell us when working with athletes with restrictive diets and or picky eaters, how do you work around their specific needs to get their proper daily intake?

Sakiko Minagawa:     Yeah, so 1 thing I love about my job is I get to work with athletes. So I try to find areas where they might have motivation. And so for athletes, typically, right, they want to be a better athlete. So I kind of use that as a motivation to help them understand that, hey, food and hydration, that's the input you put into your body and performance is the output. So we got to make sure we have the right food and nutrition and hydration, the input so that we can get the most out of your body.

Alycia Kingcade:     Thank you. Do you have any problems with these athletes feeling properly throughout the school day?

Sakiko Minagawa:     Yeah, absolutely. Well, school can also be helpful because it does create some structure in their day But some schools start very early and some kids have a hard time eating so early So breakfast tends to be 1 of the most challenging part of proper feeling. We try to find some ways to overcome that. For example, we try to, I try to encourage athletes, hey let's start somewhere. Maybe it's just a granola bar.

Sakiko Minagawa:     Maybe it's, hey if your parents drive you, maybe can you eat on the way to school? Or hey when you're at school, maybe can you eat something during your first period class. So breakfast tends to be challenging, school lunch can be challenging. Some kids love their school lunch, some kids struggle with the school lunch. Sometimes I encourage athletes to pack their lunch.

Sakiko Minagawa:     So yeah that school lunch can be challenging and depending on their school schedule. Some kids have lunch at 9.30 a.m. Some kids have lunch at 1.30 p.m. So that trying to individualize, provide individualized nutrition recommendation based on their food likes, dislikes, as well as schedule is something that I love to do.

Alycia Kingcade:     Dr. Palmering, when you're in clinic, when do you see nutrition come up in your exam?

Dr Tom Pommering:     Yeah, I think it comes up in different scenarios. Sometimes it comes up as part of a treatment for a condition such as a stress fracture. Sometimes parents will bring up the questions to us about their child was a picky eater or questions about supplements or sometimes they might be in there for a joint injury, but I notice that they may have weight control issues and then we'll talk about it then. And I think, kind of to pick up on what Sakiko said, a good nutrition plan is like the secret sauce of kids performing well on the playground or in their sport or even in school because you know healthy bodies and healthy brains perform the best so it really is an important part of just really good healthy active lifestyle.

Alycia Kingcade:     What are signs of low energy availability and what problems can this condition cause?

Dr Tom Pommering:     Yeah so the most obvious sign of low energy availability will be in our female athletes who are having light or mist periods. So that's always a red flag for us and that conversation usually comes up when we're treating someone for a stress fracture. And so other sort of more indirect signs would be, you know, burnout, physical burnout or emotional burnout with their sport where they just don't have the energy or motivation to continue to train or be active. And so a lot of times, you know, those will lead to wider conversations about their diet and their eating patterns and then how it kind of affects their injury or the condition that we're taking care of.

Dr Mike Patrick:     If I can just jump in real quickly, Tom, I think that a lot of student-athletes sort of look at missed periods as like a badge of honor. Like, I'm fit enough that my body doesn't need to have periods. And so I think there may be this misconception that not having periods while you're training or while you're performing is a good thing, but I think it's really important that folks understand, no, that just means that your body doesn't have enough extra energy to make periods, correct?

Dr Tom Pommering:     Yeah, great point, Mike. It's even a very convenient thing to have if you're training all the time, especially if you might be a swimmer. So I think that what athletes need to understand in their parents is that when you're missing periods for extended amounts of time, it's almost like it's the same as being in menopause. And that's very unhealthy for your bones. The bones, you have until you're about 25 to generate all the bone density that you're gonna use for the rest of your life.

Dr Tom Pommering:     And if you interrupt that precious time of bone building, and if you do it long enough, you will lose bone density, and sometimes it's very hard, if not impossible, to get it all back.

Sakiko Minagawa:     To add to that, I do get a lot of, hey, a lot of my friends, for female athletes, a lot of my friends lose their period during times of high activity, and so it's normal. And I often have to remind them, hey, just because it happens often doesn't mean it's okay and that it is normal. It is not normal.

Dr Mike Patrick:     Yeah. So I think if listeners out there, this is something that's happening in your family, don't sweep it under the rug. Ask your regular doctor that you see, hey, we need to see, I think we need to see a sports nutrition expert because my daughter's not having her periods and we want to fuel her body in the best way possible. So parents out there who are listening, this is an area where you really can be an advocate for your kid because they're unlikely to mention this and to bring it up because it may be embarrassing for them. And so I think it's really important as a parent to really address that issue head-on and talk to somebody about it.

Sakiko Minagawa:     1 more thing I do want to add, another pretty clear sign of low energy availability is weight loss, right? Especially for our young kids, they should still be growing and not just growth in height but also weight. And so especially if kids go to their wild child visit from year to year, if we see a big drop in weight, weight loss is a pretty clear sign that they're not fueled properly.

Dr Tom Pommering:     Yeah, I would just add 1 last thing, just to kind of combat some of the folklore out there, you can have a normal menstrual status and still achieve good results in your training and competition. So I think sometimes people think it's 1 or the other and it doesn't have to be that way and shouldn't.

Alycia Kingcade:     I have 1 question for you both is how do you see that sleep is in conjunction with low energy availability and just not fueling properly? Like how do you think, how do you see sleep come up with that?

Dr Tom Pommering:     So I think you know the way I kind of my discussion with the athletes who are training seriously or have high aspirations to be able to perform at a high level is you need 3 really good things. You need a really good, thoughtful training plan, you need a really good, thoughtful recovery plan, and you need a good nutrition plan. So I would put sleep into the realm of recovery. And again, there are a lot of reasons kids don't get great sleep these days. A lot of it's because they're over-scheduled, but obviously if there are other things that can be affecting their sleep, it's sort of an onion.

Dr Tom Pommering:     You're gonna peel back those layers, but it's really important. All 3 of those are, to me, is equally as important.

Sakiko Minagawa:     Within my sports nutrition consultation, I see a lot of athletes who are under fueled and struggle falling asleep because they're hungry, or they fall asleep and they wake up in the middle of the night because they're hungry or thirsty and have to eat during the middle of the night and then they wake up and then they have poor sleep so then they're not hungry and so it's a pretty bad cycle of under feeling and poor sleep.

Alycia Kingcade:     I feel like as a high school athletic trainer I see a lot of sleep becoming or I see that sleep is working in conjunction with low fuel and not feeling properly. So from my perspective in in the high school setting specifically I just see that there's a lot of kids that come in and they're really tired, and I ask them, what did you eat today? And then they said a granola bar or a cup of yogurt. And there's just that, there's some sort of disconnect and then they are not sleeping very well, kind of like you guys just said. So, there's, I see that from my perspective as being they work together and bank off of each other.

Alycia Kingcade:     So, Sakiko, when you're in clinic and you're working with an athlete, how do you address low energy availability with students and their families?

Sakiko Minagawa:     Yeah, so first I like to make sure the athlete and the parents understand what it is, right? So I try to make it as easy to understand as possible. So I describe low energy availability as an imbalance, right? Of how much you're putting into your body in terms of fuel and how much your body needs. And when we have this imbalance, I kind of describe fueling like a cell phone, right?

Sakiko Minagawa:     When we charge our cell phone, the battery charges and same thing with our body. When we fuel our body, our body battery charges and throughout the day if we're not fueling or eating enough, our body battery goes down and down and down. And just like our cell phone gives us a notification right when it's low battery, our body also starts to give us a notification, like our stomach starts to growl, we feel lightheaded, we feel dizzy, we can't focus, we get hangry, right? All those are signs that we're not eating enough. And so my way of using this analogy is to help athletes understand, hey, we need to charge our body by eating and fueling and hydrating throughout the day.

Sakiko Minagawa:     And I do like to, I like to focus on how when we don't eat enough, right, it affects not just how we feel today, but also our performance in terms of sports. And if we continue to do that for a long period of time, and it increases your risk for injuries and illnesses, and, and it can affect your sports performance. As well as the longevity of your sport, right? We wanna make sure our athletes are healthy and strong, not just for this season of sport, but for next season as well, as well as in the future. A good, healthy life involves physical activity.

Sakiko Minagawa:     And if we're constantly hurt, or if we're hurt doing any forms of physical activity, right? That's not enjoyable And so I like to talk about how I want athletes to feel strong and confident and that requires us to make sure that You're feeling properly

Alycia Kingcade:     Sekiko, Can you tell the listeners a little bit more about what sports drink is and how it's efficient, when to drink it or when to take it? Because I see a lot of kids drinking Celsius and even caffeine. And I think that on top of it's just a snowball effect on top of not fueling properly or not enough. And then on top of not sleeping very much and just explaining how sports drink works and how to get proper fuel.

Sakiko Minagawa:     Yeah, so I guess in general, like hydration, right? Hydration is extremely important No matter how well we eat if we're dehydrated not and if we're dehydrated, right? That's gonna affect our health and sports performance in terms of hydration I think there is a time and place for sports drink and usually I like to focus on sports drink as a hydration beverage when we're active, when we're sweating, when it's hot humid condition or during games or tournament when we're active for a long period of time. Usually we say greater than 60 minutes. In terms of hydration from energy drinks, I'm not a big fan of, right?

Sakiko Minagawa:     We want to use food as our fuel, not energy drink or caffeine or whatever other ingredients that are in energy drinks that's supposedly supposed to give you energy. In terms of hydration from other methods, for example, fruits, soups, smoothies can be a great way to hydrate our body but also give us a lot of great nutrients and calories, right? Especially for our athletes that are a higher risk for under fueling or low energy availability. We, I like to encourage hydrating through other methods that gives you calories as well so that these athletes can get nutrition and hydration and energy through that way.

Alycia Kingcade:     Yeah, I really like what you said about how food is first and then you can have other things. But I think that's the key part is that we need to get our intake from food as the first part of fuel and then things come later if okay, you know, but hydration is also another key aspect as well that I don't hydrate enough as much as I can, so, but it's 1 of those things that I think that needs to be put out more education-wise.

Dr Tom Pommering:     So Alicia, I might just add something about supplements that we get that question a lot from parents, you know, asking if it's, is it okay for their child to take supplements, probably creatine is the most common. But, and the way I sort of frame this up is that navigating the supplement world is like living in the Wild West because the supplements are regulated by the FDA, so there's nothing to prove what you're getting is what they say you're getting. And so when that happens, the most benign problem is, which you're paying a lot of money for and putting in your body isn't giving you what it says it's gonna give you. And the more dangerous potential is that it's giving you things you don't want to have in your supplements. Cross-contamination with steroids or amphetamines, things like that.

Dr Tom Pommering:     And so it is buyer beware, I think, when you're using supplements. There are a few independent bodies that will manufacturers of supplements can voluntarily submit their product and they can be approved or evaluated for pureness. The 1 that comes to mind for me is USP. I think Sakiko has several others that she mentions to us when she's educating our physician group. So if kids are going to enter into the supplement world, I at least ask them to consider getting products with those types of stamps of approval so that you know that there's been some regulation and evaluation.

Dr Tom Pommering:     But really, what Sakiko said is so true. Natural food is where you want to go. It's less expensive, it's more predictable, and it's really the safest way also to enhance your diet. And just the 1 last thing I would say about this, some of our athletes are competing at the elite level or international level, and what parents and athletes need to know is that you fall under the regulation, the anti-doping regulations for that organization. And so if you unintentionally use a supplement that's been tainted and you test positive, in most circumstances, it's on the athlete.

Dr Tom Pommering:     You're responsible for it goes into your body. So the last thing you want to do is train for years and years of your life and get to an ultimate contest and find out your results are going to be negated or you'll have penalties because of something you thought was okay to put your body. So the very, you know, for those listeners whose kids are competing at that level, you just need to be aware of that as well.

Dr Mike Patrick:     Tom, can you just comment on the dangers of anabolic steroids and testosterone and the things that we are worried about cross-contamination, especially folks who think, well, I'm not in a sport where they're gonna test me. There may be some student athletes out there who think, oh, I'm gonna do better if I use these. Can you just comment on the dangers of those products?

Dr Tom Pommering:     Yeah, sure, Mike. We see all types of different complications from using anabolic steroids. Things like you can have breast enhancement. For men, you can have testicular atrophy. You can have mood changes, which includes aggression.

Dr Tom Pommering:     It raises your blood pressure. It can raise your cholesterol as well. And it can enhance acne. And then as far as injuries go, we'll see athletes tearing muscles that they shouldn't tear because they're lifting weights or doing things that their skeleton isn't really meant to support. So we'll see like pectoralis tears and things like that.

Dr Tom Pommering:     So there's a lot of dangers with using steroids both in the short term and the long term.

Alycia Kingcade:     Yeah, I had reached out to some of our high school strength and conditioning coaches just to see what they had been hearing in the weight rooms about what kids are asking them is appropriate to take as far as protein, creatine, and those are some of the things that they had mentioned that they get asked about. And so I'm glad that you guys touched on that because I know that that's a common thing that kids are wondering about and wondering when to take it, how much to take it, what types to take. And so I think that's a huge piece that parents could definitely benefit from knowing about just because knowing what their kids should be taking. But the natural food is definitely the best route as we've all said so far.

Dr Tom Pommering:     Yeah, Alicia, I know the other thing to know is that if student-athletes in high school are training with these types of substances and then they are lucky enough to get a scholarship or be able to play at the college level, the NCAA at Division I, II, III does test for this. So if you think that you're kind of getting away with it, no one's looking, and now you're playing in college, you need to realize that you could be tested and test positive. That won't be very good for your career or for your team either.

Alycia Kingcade:     Yeah I think there's a lot that goes into it and then there's also that that mental dependence on it and thinking that that's going to be the key to your muscle growth or whatnot but it's really just just an added thing to to your routine. So Natural food is the best route to go just for fueling and recovering. But Dr. Pomering, can you touch, we're going to circle back to the injury aspect of inadequate nutrition. I wanted to ask what other types of injuries, I know you mentioned stress factors that you see and then obviously there's menstrual issues.

Alycia Kingcade:     Can you touch how inadequate nutrition causes injuries and then kind of how that hinders recovery with injuries?

Dr Tom Pommering:     So I think you know if you're poorly fueled and poorly rested, I think the injuries are more indirect. In other words, of course, you know, we see bone stress injuries as a more direct result of, you know, having it being amenorrheic or not having a menstrual period or being under fueled. But think about this, a lot of the injuries we see in sports occur late in the contest. So in that last half or last quarter, you're tired, you're fatigued, and if you, on top of the demands of your sport, if you're not, you haven't been feeling properly to lead up to that or on the day of the contest, then you're more likely to have slower reaction time. You know, you can't make your body do the things that it's used to doing.

Dr Tom Pommering:     And we'll see just more injuries in the fourth quarter. Again, I think just being poorly fueled plays a role in that indirectly.

Alycia Kingcade:     I think that especially with sports like track, we see especially towards the beginning of the season, those athletes are training a lot or they are if they did, especially if they hadn't been active in the offseason, they start to come in and you start to see things like shin splints and those can develop into stress fractures. And it's due to now they're increasing their activity load and their intensity and they are not feeling properly, not getting enough sleep. So it's the whole trifecta of things happening. So how do you recommend them moving forward, obviously based off of person to person, but how do you kind of have that conversation if an athlete with shin splints comes into your clinic, how do you kind of go about discussing forward movements with them?

Dr Tom Pommering:     Well, I think, you know, any injury where, so obviously, you know, you're going to get shin splints are a common injury, it's sort of painful anterior shin when you're doing a lot of running, especially at the beginning of your training of your season or if you're training long and hard. So I think what happens is we talk about how to treat your injury, but we also spend a fair amount of time how to prevent it from happening again. And so part of that discussion in a lot of patients will be like, well, tell me what your training regimen is like. Tell me what your eating and sleeping regimen is like. And so it sort of opens up a larger conversation.

Dr Tom Pommering:     And then when you do find something that's pretty obviously out of sync and it could be improved, I mean, we're just really lucky to have someone like Sakiko to kind of really pick up the ball there and help the athletes and the families too because the families are a big part of the plan. So she meets with the athlete and the family and I think that's really helpful.

Sakiko Minagawa:     I do want to add a little bit to that. In terms of nutrition, right, nutrition can help with injury prevention, but it also can be helpful for injury healing too. Injuries can happen for so many reasons, whether it's nutrition related or not, but when we're injured, right, our muscles, our bones, something is hurting and in turn to heal that injury, nutrition can be very, very helpful to help with that healing process.

Alycia Kingcade:     Yes, thank you guys for touching on that. I think that it's you guys have given a lot of great information for listeners to hear and absorb. You guys touched on a lot

Sakiko Minagawa:     of things that I think that there is some sort of disconnect and it's just because of lack of not knowing or being told. So I wanted to know what are some key take-homes that parents can be aware of to make sure that their kids are being fueled efficiently? A tip I like to give to my athletes is making to make sure you're eating enough, right? Make sure you eat a balanced and variety of food, a balanced diet, making sure you have all kinds of different food groups and a variety of food and making sure that we eat consistently throughout the day. And a tip that I like to give is the rule of 3 is something I created making sure we have a breakfast we have breakfast lunch and dinner so those 3 good balanced meals but also snacking in between meals.

Sakiko Minagawa:     For example mid-morning between breakfast and lunch or mid-afternoon between lunch and dinner, trying to fuel our body about every 2 to 4 hours. So the rule of 3, making sure you have 3 balanced meals, snack maybe once, 2, twice, 3, or maybe even 4 times a day by fueling our body about every 2 to 4 hours.

Dr Mike Patrick:     Does it make a difference the size of each of those meals? So, you know, traditionally here in the United States, dinner's like your big meal, but does it make sense for the big meal of the day to be in the evening like that? Or I mean, or is that okay?

Sakiko Minagawa:     Yeah. Portion size, it depends on the individual's nutritional needs, right? Typically I like to encourage athletes to keep make, make their breakfast or the early mid morning breakfast, lunch, and that mid morning snack to be a bigger portion of their daily nutritional needs. Most athletes are exercising, moving their bodies mid-afternoon or in the evening. And so it makes sense to make sure our body is extra fueled in the morning and make sure that they have that energy for their activity.

Dr Mike Patrick:     And I also wanted to ask you, Sekiko, this is great advice, and obviously there are a lot of student athletes who can benefit from the services of sports nutrition, especially if we're worried about low energy availability. Is this something that is typically covered with insurance? So, you know, or do folks need a referral or do you need to like prove to the insurance company that I need to see sports dietitian?

Sakiko Minagawa:     For my nutrition services, you do not need a referral. They can just schedule sports, they can call our nationwide children's number and ask for sports nutrition. In terms of insurance, every insurance is a little bit different, so I do encourage parents to contact their insurance and see if a nutrition consultation is covered.

Alycia Kingcade:     And then if parents do not decide to go to an appointment quite yet or they're just curious for more knowledge, where can they go to get more information about how to make sure that their child's plate is covered adequately, when to fuel all the things?

Sakiko Minagawa:     If they feel that they don't need a one-on-one consultation. There's a lot of great nutrition information out there. For example, the Academy of Nutrition and Dietetics or CPSDA is another great website that they can get general nutrition information there. In terms of like my tip, right? Making sure your child is getting those balanced meals and snacks throughout the day.

Sakiko Minagawa:     If they see signs of under feeling like their child is constantly tired, exhausted, if they're frequently sick or injured those could be a sign that hey maybe we need to talk to our physician, our doctor, and then consider talking to a dietitian one-on-one.

Alycia Kingcade:     Thank you. Yes. And obviously, this podcast episode is going to be an awesome resource as well for these families to listen to as well. So like I said before, thank you both for being on here and sharing all the knowledge you have about these specific topics under sports nutrition. Dr.

Alycia Kingcade:     Palmering, I kind of wanted to finish up and wanted to ask you if you could tell us a little bit more or tell the listeners a little bit more about the sports medicine program at Nationwide Children's Hospital.

Dr Tom Pommering:     Yeah, so we operate out of 8 different clinical sites located around the inner and outer belt. Kind of what's coming up new for us that we're excited about is this summer we will open up a brand new center downtown that will house or our colleagues from orthopedics, there'll be a surgery center, an MRI, and there'll be a state-of-the-art rehab, a training facility, a really nice place for our adaptive patients to rehab as well. So that'll be in July. And so we hope that people will come visit us. I'm sure there'll be an open house.

Dr Tom Pommering:     You don't have to be injured to see us then, but we'll be there if you do get injured.

Sakiko Minagawa:     I do want to add to that in terms of sports nutrition services, I have an office in the Dublin and Westerville office, but I also do telehealth consultation as well for those that are live a little far from those locations.

Dr Mike Patrick:     Yeah. And we'll put a link to CORE Sports Medicine at Nationwide Children's Hospital in the show notes over at And then there's also a schedule an appointment page that's specific for sports medicine and it includes a link for sports nutrition right there on that page. And I'll put a link in the show notes for that too so folks can find it for this episode of 555.

Alycia Kingcade:     Well, thank you Dr. Pomering and Sakiko for being our guests on this episode today and thank you Dr. Mike for letting me be a co-host. It was a great time and I'm excited that parents and families get to hear this information about sports nutrition.

Dr Mike Patrick:     Yeah, I think You did a fantastic job and we are looking forward to you joining us again in some episodes coming up a little bit later on in the year. And once again, I just want to say thanks to Dr. Tom Pomering and Sakiko Minagawa. Thank you so much, both of

Dr Tom Pommering:     you for stopping by. Great to be here. Thank you.

Sakiko Minagawa:     Thank you Alicia and Dr. Mike for having us.

Dr Mike Patrick:     We are back with just enough time to say thanks once again to all of you for taking time out of your day and making PDACAST a part of it. Really do appreciate that. Thank you to our guests this week. Again, Dr. Tom Palmer, Chief of Sports Medicine and Sakiko Minagawa, Sports Dietitian at Nationwide Children's Hospital.

Dr Mike Patrick:     Also thank you to our guest host this week, our guest co-host, Alicia Kincaid, Certified Athletic Trainer at Nationwide Children's. Don't forget you can find PDA Cast wherever podcasts are found. We're in the Apple and Google podcast apps, iHeartRadio, Spotify, SoundCloud, Amazon Music, YouTube, and most other podcast apps for iOS and Android. Our landing site is You'll find our entire archive of past programs there, along with show notes for each of the episodes, our terms of use agreement, and a handy contact page if you would like to suggest a future topic for the show.

Dr Mike Patrick:     Reviews are helpful wherever you get your podcasts. We always appreciate when you share your thoughts about the show. And we love connecting with you on social media. We are on Facebook, Instagram, threads, LinkedIn, Twitter, X, simply search for Pediacast. Also, don't forget we have a podcast for pediatric providers similar to this program.

Dr Mike Patrick:     We turn the science up a couple notches and offer free continuing medical education credit for those who listen. And it's category 1 credit, so it will most likely count toward your state's CME requirements. And that includes physicians, nurse practitioners, physician assistants, nurses, pharmacists, psychologists, social workers, and dentists. And it's because Nationwide Children's is jointly accredited by all of those professional organizations. That's how we can give that Category 1 Continuing Education, CE or CME, to you for listening.

Dr Mike Patrick:     And it's easy to do. Just head over to You'll find all the shows there and all the directions for claiming that category 1 credit. You do want to keep in mind though that you'll want the content of the episode to match your scope of practice. Shows and details are available at the landing site for that program,

Dr Mike Patrick:     You can also listen wherever podcasts are found. Simply search for PDACastCME. Thanks again for stopping by. And until next time, this is Dr. Mike saying stay safe, stay healthy, and stay involved with your kids.

Dr Mike Patrick:     So long everybody!

Announcer:     This program is a production of Nationwide Children's. Thanks for listening. We'll see you next time on PediaCast.

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