With the growing participation of athletes with disabilities in competitive sports, there is an increased need for specialized nutritional support tailored to their unique physiological differences. These athletes often exhibit distinct body compositions, metabolic rates, training loads and activity patterns compared to their peers without disabilities. Sports nutritionists, especially those working with Paralympic athletes, have underscored the urgent need for a more profound understanding of these athletes’ nutritional demands. A critical first step is elucidating the daily energy requirements of Paralympic athletes, as this knowledge is essential for setting initial targets for their daily energy intake. In our study, we employed the doubly labeled water method, which is widely recognized as the gold standard for measuring total daily energy expenditure under free-living conditions. This technique involves consuming water enriched with the stable isotopes deuterium (2H) and oxygen-18 (18O). After allowing the isotopes time to equilibrate within the body, their elimination is measured through urine samples. Deuterium is exclusively lost through water (H2O), whereas oxygen-18 is lost through both water and carbon dioxide (CO2). The differing rates of elimination for these isotopes provide a measure of carbon dioxide production and, consequently, reflect the energy expended by the individual.
Our study, published in the May 2024 issue of Medicine & Science in Sports & Exercise®, involved 48 Dutch and Norwegian Paralympic athletes from diverse sports, including Para cycling, wheelchair tennis, wheelchair basketball, Para Nordic skiing and alpine skiing. Over a 14-day period, the mean total daily energy expenditure across all participants was assessed at 2,908 ± 797 kcal per day. However, we observed a considerable variation among sports: wheelchair basketball players had an energy expenditure of 2,322 ± 340 kcal per day, whereas Para cyclists expended 3,607 ± 1,001 kcal per day. Notably, the energy expenditure for some athletes neared 5,000 kcal per day. Given that these measurements span a 14-day period, it is possible that energy expenditure could even surpass 6,000 kcal on days of intense training or competition.
Our analyses revealed that fat-free mass, exercise duration and the presence of a spinal cord disorder are primary factors influencing energy expenditure. Consequently, athletes with greater fat-free mass or longer training durations generally display higher energy expenditures. Conversely, those with spinal cord disorders typically exhibit lower energy expenditures.
Although the doubly labeled water method is the gold standard for assessing total daily energy expenditure, its high costs and logistical challenges make it impractical for routine use. To address these issues, we developed prediction equations based on readily obtainable factors. These equations enable accurate estimates of daily energy expenditure for Paralympic athletes, assisting nutritionists in establishing initial targets for their athletes’ daily energy intake.
Altogether, our study provides advanced insights into the daily energy requirements of Paralympic athletes and introduces practical tools for accurately estimating these needs. These developments aid sports nutritionists in aligning nutritional strategies with individual energy demands, ultimately enhancing both health and performance of Paralympic athletes. Furthermore, our research enhances the understanding of nutrition for athletes with disabilities and lays the groundwork for future studies and the development of targeted nutritional guidelines in this area.
Jan-Willem van Dijk, Ph.D., leads the Sport & Nutrition Expertise Team at HAN University of Applied Sciences in the Netherlands. In addition to research and educational tasks, his team offers specialized nutritional counselling to elite athletes, including those competing at the Olympic and Paralympic levels. The combination of daily practice and academic research not only generates relevant research questions but also aids in translating research findings into innovative nutritional strategies.
