“Food First but Not Always Food Only”: Recommendations for Using Dietary Supplements in Sport

Abstract

The term “food first” has been widely accepted as the preferred strategy within sport nutrition, although there is no agreed definition of this and often limited consideration of the implications. We propose that food first should mean “where practically possible, nutrient provision should come from whole foods and drinks rather than from isolated food components or dietary supplements.” There are many reasons to commend a food first strategy, including the risk of supplement contamination resulting in anti-doping violations. However, a few supplements can enhance health and/or performance, and therefore a food only approach could be inappropriate. We propose six reasons why a food only approach may not always be optimal for athletes: (a) some nutrients are difficult to obtain in sufficient quantities in the diet, or may require excessive energy intake and/or consumption of other nutrients; (b) some nutrients are abundant only in foods athletes do not eat/like; (c) the nutrient content of some foods with established ergogenic benefits is highly variable; (d) concentrated doses of some nutrients are required to correct deficiencies and/or promote immune tolerance; (e) some foods may be difficult to consume immediately before, during or immediately after exercise; and (f) tested supplements could help where there are concerns about food hygiene or contamination. In these situations, it is acceptable for the athlete to consider sports supplements providing that a comprehensive risk minimization strategy is implemented. As a consequence, it is important to stress that the correct terminology should be “food first but not always food only.”

How Do Male Football Players Meet Dietary Recommendations? A Systematic Literature Review

“…To achieve the recommended amounts of nutrients in the diet of an athlete, and due to the difficulty in consuming large meals immediately after exercise, periodic supplementation with supplements, especially from group A according to the Australian Institute of Sport (AIS), may be considered. According to recent reports, food-first but not always food-only [ 58 ] football players in special cases should develop a personalized nutrition and supplementation plan via collaboration with their dietitian to optimize their performance.…”

“…Athletes with low 25-(OH)D levels (<30 ng/mL or <75 nmol/L) have also been shown to be at a higher risk of injury, including musculoskeletal injuries [ 64 ]. Close et al [ 58 ] proposed recommendations for using dietary supplements in sport food-first but not always food-only. Authors have suggested several reasons why a food-only approach may not always be optimal for athletes, one of which concerns vitamin D [ 65 ].…”

“…Therefore, its serum concentration should be monitored, and dietary supply should be controlled. Proper doses of iron may be required to improve health through supplementation to correct any deficiency [ 58 ].…”

“…To achieve the recommended dietary amount, football players should follow a mixed diet that includes calcium-rich foods (mainly dairy products, with smaller amounts from bony fish, legumes, certain nuts, plus fortified soy beverages and breakfast cereals). Consideration of the need for calcium supplementation may be required in cases of RED-S or in situations of increased calcium requirements (vegetarian/vegan diets) [ 58 ].…”

Managing Female Athlete Health: Auditing the Representation of Female versus Male Participants among Research in Supplements to Manage Diagnosed Micronutrient Issues

“…Although micronutrient deficiencies are common in the community [5], athletes may have elevated risks due to increased nutrient turnover [3] and/or sub-optimal vitamin/mineral consumption [6]. Since micronutrients play central roles in numerous bodily functions, including energy production, gene transcription, bone health, immunity, and inflammatory responses [3,[7][8][9][10], deficiencies can…”