Optimizing Performance Nutrition for Adolescent Athletes: A Review of Dietary Needs, Risks, and Practical Strategies

TL;DR

This narrative review synthesizes evidence on energy, macronutrient, hydration, micronutrient, and supplement needs for adolescent athletes, emphasizing individualized, food-first care. It highlights frequent under-fueling and risks of low energy availability, while noting that many guidelines and safety data remain extrapolated from adults.

Key findings

• Many adolescent athletes fail to meet energy needs: Portuguese male soccer players had mean energy intake of 1929 kcal/day vs predicted expenditure of 3568 kcal/day (deficit 1639 kcal/day); volleyball players met 60% of estimated requirements vs 74% in non-athletes; tennis players averaged 2027–2275 kcal/day across age groups. LEA risk threshold <30 kcal/kg FFM/day and ≥45 kcal/kg FFM/day optimal are cited from female athletes, but adolescent-specific cutoffs are not established; a proposed PAL range for adolescents is 1.75–2.05.
• Carbohydrate recommendations are 6–10 g/kg/day; during exercise >60 min, 30–60 g/hour; post-exercise 1.0–1.2 g/kg every 2 h for 4–6 h. Protein guidance for athletes is 1.4–2.0 g/kg/day vs 0.75–1.05 g/kg/day for children/adolescents 8–19 years; 20–40 g high-quality protein per meal every 3–4 h is advised, with post-exercise 0.25–0.30 g/kg; whole-body net protein balance plateaued at ~0.30 g/kg in adolescents 14–18 years (n = 13).
• Iron deficiency affects approximately 20% of athletes overall, more than 35% of female athletes, and up to 52% of female adolescent athletes; ferritin <15 µg/L indicates depleted stores, 15–30 µg/L low reserves, and a clinical cutoff of 30 µg/L is proposed for athletes >15 years. Calcium recommendation is 1300 mg/day for ages 14–18; vitamin D RDA is 600–800 IU/day; NHANES data indicate 22.7% of U.S. adolescents 12–19 are at risk of inadequacy and 4.8% at risk of deficiency. Hydration: young adolescents should consume ~3–8 oz every 20 min, older adolescents up to 1.0 L/hour; 1–2% body-mass fluid loss can impair aerobic performance and cognition.
• Creatine use was reported by 8.8% of boys and 1.8% of girls in grades 6–12, and 21% of boys/3% of girls aged 13–18; low-dose creatine (0.03 g/kg/day) over seven days improved power output in elite youth soccer players. Energy drinks had been tried by 68% of European adolescents 10–18 vs 30% of adults; health organizations recommend a maximum caffeine intake of 100 mg/day for adolescents. Protein supplements are usually unnecessary, and a food-first approach with third-party testing is recommended; nutrition knowledge gaps include only 16% of youth athletes reporting dietitian input, and 65% of New Zealand athletes using social media for nutrition information, with 84% concerned about reliability.

Methods

• Narrative review synthesizing published research on sports nutrition for young athletes; no systematic review protocol, search strategy, or meta-analysis is described.
• Population definition: adolescent athletes are girls aged 12–18 years and boys aged 14–18 years (Tanner stages 3–4) engaged in structured physical training for more than 60 min/day, 5–6 days/week, typically in school, club, or community sports.
• Main analysis is a narrative synthesis of energy requirements, macronutrients, hydration, key micronutrients, ergogenic aids/supplements, and practical nutrition-education strategies, with summary tables.

Limitations

• Stated: most existing guidelines are based on adult populations; ethical and logistical challenges limit research in adolescents; there is no universally accepted gold standard for estimating energy needs; direct measurement methods are impractical; adolescent-specific LEA cutoffs are not established; research on creatine and vitamin D in adolescent athletes is limited; evidence for omega-3 and artificial food colors in this population is limited or mixed.
• Evident: as a narrative review, it does not describe systematic search, inclusion criteria, or quality appraisal, and many findings are extrapolated from adults or non-adolescent athletic groups (e.g., vitamin D, omega-3, iron timing), limiting adolescent-specific certainty.
• Stated: a male adolescent RED-S study noted periodic energy-availability measurements may have been insufficient, and more research is needed to determine LEA thresholds in male adolescents.