Alcohol and football

Harmful alcohol consumption in elite sports players in Ireland

BACKGROUND

Sportspeople are more prone to binge drink than their peers.

AIMS

We aimed to assess alcohol consumption, harms and behaviours in an elite Irish sporting population (Gaelic footballers and hurlers).

METHODS

An anonymous web-based questionnaire (demographics, alcohol consumption, culture and related harms) was administered to all elite players. The AUDIT-C questionnaire (frequency, quantity of alcohol consumption and frequency of binge drinking) was used to assess for adverse alcohol use. Univariate and multivariate analyses assessed for predictors of adverse alcohol use.

RESULTS

717 players (mean age 24 years) were analysed. The majority of patients were male (75%), unmarried (93%) and had completed university (67%). 96% were current drinkers. Players consumed more alcohol during the off-season (median 20 versus 8 standard drinks in 28 days) compared to the elite season. Amongst current drinkers, 73% exhibit adverse alcohol use, 93% reported binge drinking and 65% an alcohol related harm in the past year. Most players would turn to family (36%) or friends (21%) for help. There were significant associations between monthly bingeing (OR 18.4), smoking (OR 3.3), generally drinking in public (OR 3.2), current gambling (OR 2.3), male gender (OR 2.1), an alcohol harm in the past year (OR 1.9) and adverse alcohol use. In contrast, co-habiting with a partner (OR 0.5) was protective.

CONCLUSIONS

Excess alcohol consumption, alcohol related harms and binge drinking are prevalent in an elite sporting population, particularly during the off-season. Specific strategies are required to reduce alcohol related harms, particularly amongst high-risk groups during the off-season.

Cultural differences in hydration practices among physically active individuals: a narrative review

It is well-established that appropriate hydration practices are essential in promoting health and optimizing performance and recovery. However, evidence-based hydration guidelines may not be adopted due to cultural differences across countries, such as religious beliefs, traditions, preferences, and beverage availability. Examples of hydration practices influenced by culture include beer consumption after sports in Western countries, consumption of sugarcane juice in India and Ramadan fasting among Muslims. For most cultural hydration practices, there is limited scientific evidence on their effects on rehydration, exercise performance, and recovery. Despite possible benefits of various hydration practices on exercise performance and recovery, they are inconsistent with current evidence-based hydration recommendations. More research on the impacts of cultural hydration differences on physiology, performance, and recovery is warranted to allow evidence-based guidelines and advisories.

Abbreviations: ABV: alcohol by volume, ACSM: American College of Sports Medicine, NATA: National Athletic Trainers’ Association, ROS: reactive oxygen species, TCM: Traditional Chinese Medicine

Nutritional Considerations for Injury Prevention and Recovery in Combat Sports

Sports participation is not without risk, and most athletes incur at least one injury throughout their careers. Combat sports are popular all around the world, and about one-third of their injuries result in more than 7 days of absence from competition or training. The most frequently injured body regions are the head and neck, followed by the upper and lower limbs, while the most common tissue types injured are superficial tissues and skin, followed by ligaments and joint capsules. Nutrition has significant implications for injury prevention and enhancement of the recovery process due to its effect on the overall physical and psychological well-being of the athlete and improving tissue healing. In particular, amino acid and protein intake, antioxidants, creatine, and omega-3 are given special attention due to their therapeutic roles in preventing muscle loss and anabolic resistance as well as promoting injury healing. The purpose of this review is to present the roles of various nutritional strategies in reducing the risk of injury and improving the treatment and rehabilitation process in combat sports. In this respect, nutritional considerations for muscle, joint, and bone injuries as well as sports-related concussions are presented. The injury risk associated with rapid weight loss is also discussed. Finally, preoperative nutrition and nutritional considerations for returning to a sport after rehabilitation are addressed.

Harmful alcohol consumption in elite sports players in Ireland

BACKGROUND

Sportspeople are more prone to binge drink than their peers.

AIMS

We aimed to assess alcohol consumption, harms and behaviours in an elite Irish sporting population (Gaelic footballers and hurlers).

METHODS

An anonymous web-based questionnaire (demographics, alcohol consumption, culture and related harms) was administered to all elite players. The AUDIT-C questionnaire (frequency, quantity of alcohol consumption and frequency of binge drinking) was used to assess for adverse alcohol use. Univariate and multivariate analyses assessed for predictors of adverse alcohol use.

RESULTS

717 players (mean age 24 years) were analysed. The majority of patients were male (75%), unmarried (93%) and had completed university (67%). 96% were current drinkers. Players consumed more alcohol during the off-season (median 20 versus 8 standard drinks in 28 days) compared to the elite season. Amongst current drinkers, 73% exhibit adverse alcohol use, 93% reported binge drinking and 65% an alcohol related harm in the past year. Most players would turn to family (36%) or friends (21%) for help. There were significant associations between monthly bingeing (OR 18.4), smoking (OR 3.3), generally drinking in public (OR 3.2), current gambling (OR 2.3), male gender (OR 2.1), an alcohol harm in the past year (OR 1.9) and adverse alcohol use. In contrast, co-habiting with a partner (OR 0.5) was protective.

CONCLUSIONS

Excess alcohol consumption, alcohol related harms and binge drinking are prevalent in an elite sporting population, particularly during the off-season. Specific strategies are required to reduce alcohol related harms, particularly amongst high-risk groups during the off-season.

The prevalence of non-contact muscle injuries of the lower limb in professional soccer players who perform Salah regularly: a retrospective cohort study

Background

The present study assessed the prevalence of non-contact muscle injuries of the lower limbs, including hamstring injuries, in professional Russian soccer players who regularly perform Salah, an obligatory Muslim prayer performed 5 times a day.

Methods

Using a retrospective cohort study design, 68 professional male soccer players (excluding goalkeepers), 34 of whom were Muslims regularly performing Salah (exposure group) and 34 were randomly chosen non-Muslim players (control group), were included in the study. The groups were similar in their playing leagues, field positions, age (27 ± 3.1 vs 28 ± 4.2 years), and body mass index (22 ± 1.2 vs 23 ± 0.92 kg/m²).

Results

The incidence of hamstring injury was significantly lower in the exposure group (2 vs 14, p = 0.0085). A declining trend for the number of muscle injuries (either hamstring or not) was observed in the exposure group (11 vs 27, p = 0.0562). Two players in the exposure group and 11 in the control group (p = 0.0115, OR 0.1307, 95% CI 0.0276 to 0.5698) suffered a hamstring injury, with no statistically significant difference in the occurrence of other injuries. The total amount of the training and play days missed because of hamstring and other muscle injuries was significantly lower in the exposure group (24 vs 213 days, p = 0.0043, and 200 vs 344 days, p = 0.0066, respectively).

Conclusion

The prevalence of non-contact muscle injuries, including hamstring injuries, was lower in professional Russian soccer players who regularly performed Salah.

Post-Exercise Rehydration: Effect of Consumption of Beer with Varying Alcohol Content on Fluid Balance after Mild Dehydration

Purpose

The effects of moderate beer consumption after physical activity on rehydration and fluid balance are not completely clear. Therefore, in this study, we investigated the effect of beer consumption, with varying alcohol content, on fluid balance after exercise-induced dehydration.

Methods

Eleven healthy males were included in this cross over study (age 24.5 ± 4.7 years, body weight 75.4 ± 3.3 kg, VO_2max 58.3 ± 6.4 mL kg min⁻¹). Subjects exercised on a cycle ergometer for 45 min at 60% of their maximal power output (W_max) until mild dehydration (1% body mass loss). Thereafter, in random order, one of five experimental beverages was consumed, in an amount equal to 100% of their sweat loss: non-alcoholic beer (0.0%), low-alcohol beer (2.0%), full-strength beer (5.0%), an isotonic sports drink, and water. Fluid balance was assessed up till 5 h after rehydration.

Results

After 1 h, urine production was significantly higher for 5% beer compared to the isotonic sports drink (299 ± 143 vs. 105 ± 67 mL; p < 0.01). At the end of the 5-h observation period, net fluid balance (NFB) was negative for all conditions (p = 0.681), with the poorest fluid retention percentage for 5% beer (21% fluid retention) and the best percentage for the isotonic sports drink (42%). Non-alcoholic beer, low-alcoholic beer, and water resulted in fluid retention of 36, 36, and 34%, respectively (p = 0.460).

Conclusion

There was no difference in NFB between the different beverages. Only a short-lived difference between full-strength beer and the isotonic sports drink in urine output and NFB was observed after mild exercise-induced dehydration. Fluid replacement – either in the form of non-alcoholic beer, low-alcoholic beer, full-strength beer, water, or an isotonic sports drink of 100% of body mass loss was not sufficient to achieve full rehydration. The combination of a moderate amount of beer, with varying alcohol content, enough water or electrolyte- and carbohydrate beverages, and salty foods might improve rehydration, but more research is needed.

Effects of Beer, Non-Alcoholic Beer and Water Consumption before Exercise on Fluid and Electrolyte Homeostasis in Athletes

Fluid and electrolyte status have a significant impact on physical performance and health. Pre-exercise recommendations cite the possibility of consuming beverages with high amounts of sodium. In this sense, non-alcoholic beer can be considered an effective pre-exercise hydration beverage. This double-blind, randomized study aimed to compare the effect of beer, non-alcoholic beer and water consumption before exercise on fluid and electrolyte homeostasis. Seven male soccer players performed 45 min of treadmill running at 65% of the maximal heart rate, 45 min after ingesting 0.7 L of water (W), beer (AB) or non-alcoholic beer (NAB). Body mass, plasma Na⁺ and K⁺ concentrations and urine specific gravity (USG) were assessed before fluid consumption and after exercise. After exercise, body mass decreased (p < 0.05) in W (−1.1%), AB (−1.0%) and NAB (−1.0%). In the last minutes of exercise, plasma Na⁺ was reduced (p < 0.05) in W (−3.9%) and AB (−3.7%), plasma K⁺ was increased (p < 0.05) in AB (8.5%), and USG was reduced in W (−0.9%) and NAB (−1.0%). Collectively, these results suggest that non-alcoholic beer before exercise could help maintain electrolyte homeostasis during exercise. Alcoholic beer intake reduced plasma Na⁺ and increased plasma K⁺ during exercise, which may negatively affect health and physical performance, and finally, the consumption of water before exercise could induce decreases of Na⁺ in plasma during exercise.

Ethanol does not delay muscle recovery but decreases testosterone/cortisol ratio

PURPOSE

This study investigated the effects of ethanol consumption on recovery from traditional resistance exercise in recreationally trained individuals.

METHODS

Nine recreationally trained volunteers (eight males and one female, 26 ± 4 yr, 81 ± 4 kg) conducted four resistance exercise sessions and consumed a low (0.6 (females) and 0.7 (males) g · kg(-1) body mass) or a high dose (1.2 or 1.4 g · kg(-1) body mass) of ethanol 1-2.5 h after exercise on two occasions. The first session was for familiarization with the tests and exercises and was performed without ethanol consumption. As a control trial, alcohol-free drinks were consumed after the exercise session. The sequence of trials, with low and high ethanol doses and alcohol-free drinks (control), was randomized. Maximal voluntary contractions (MVC) (knee extension), electrically stimulated contractions (knee extension), squat jumps, and hand grip strength were assessed 10-15 min and 12 and 24 h after the ethanol/placebo drinks. In addition to a baseline sample, blood was collected 1, 12, and 24 h after the ethanol/placebo drinks. The exercise session comprised 4 × 8 repetition maximum of squats, leg presses, and knee extensions.

RESULTS

MVC were reduced by 13%-15% immediately after the exercise sessions (P < 0.01). MVC, electrically stimulated force, and squat jump performance were recovered 24 h after ethanol drinks. MVC was not fully recovered at 24 h in the control trial. Compared with those in the control, cortisol increased and the free testosterone/cortisol ratio were reduced after the high ethanol dose (P < 0.01).

CONCLUSIONS

Neither a low nor a high dose of ethanol adversely affected recovery of muscle function after resistance exercise in recreationally strength-trained individuals. However, the increased cortisol levels and reduced testosterone/cortisol ratio after the high ethanol dose could translate into long-term negative effects.

Experiences and attitudes of collegiate athletic trainers regarding alcohol-related unintentional injury in athletes

CONTEXT

Alcohol-related unintentional injury (ARUI) has been an unexamined consequence of alcohol consumption by collegiate athletes. It has a potentially devastating effect on their athletic performances and careers. Awareness of this problem in athletes could have a huge effect on what athletic trainers (ATs) do to recognize, treat, and prevent it in a collegiate athlete population.

OBJECTIVE

To examine the experiences and attitudes among collegiate and university ATs about ARUI in the athletes in their care.

DESIGN

Cross-sectional study.

SETTING

Web-based survey.

PATIENTS OR OTHER PARTICIPANTS

A total of 1767 e-mail addresses for collegiate and university ATs within National Athletic Trainers' Association Districts 1, 2, 3, and 9.

MAIN OUTCOME MEASURE(S)

We calculated frequencies, percentages, and attitudes of ATs regarding ARUI in collegiate athletes during the 2010-2011 academic year.

RESULTS

The resulting sample size for the analysis was 459 (26.0%) participants of the initial total sample. More than 56% (n = 260) of the ATs reported that they had evaluated, treated, or referred if needed at least 1 ARUI in a collegiate athlete. On average, these ATs had evaluated, treated, or referred if needed 3 alcohol-related unintentional injuries within the 2010-2011 academic year. About 73% (n = 331) of ATs agreed that ARUI is a serious problem. Nearly 80% (n = 358) indicated they believe ATs should receive more training to identify student-athletes with alcohol-related problems.

CONCLUSIONS

Alcohol-related unintentional injury is a common and serious consequence of alcohol use among collegiate athletes. Many ATs also view it as a serious problem yet would like more training in how to address it. Alcohol-related unintentional injury may have important negative effects on the careers and athletic performances of athletes. Researchers need to determine how prevalent ARUI is in the collegiate athlete population and what ATs can do to address it.

Sport-related achievement motivation and alcohol outcomes: an athlete-specific risk factor among intercollegiate athletes

Intercollegiate athletes report greater alcohol consumption and more alcohol-related problems than their non-athlete peers. Although college athletes share many of the same problems faced by non-athletes, there are some consequences that are unique to athletes. Studies have demonstrated that alcohol negatively affects athletic performance including increased dehydration, impeded muscle recovery, and increased risk for injury. Beyond risk factors for alcohol misuse that may affect college students in general, research has begun to examine risk factors that are unique to collegiate athletes. For example, research has found that off-season status, the leadership role, and athlete-specific drinking motives are associated with increased alcohol use. Given these findings, it is possible that other athlete-specific variables influence alcohol misuse. One such variable may be sport achievement orientation. The purpose of the current study was to examine the relationship between sport achievement orientation and alcohol outcomes. Given previous research regarding seasonal status and gender, these variables were examined as moderators. Varsity athletes (n=263) completed the Sport Orientation Questionnaire, which assesses sport-related achievement orientation on three scales (Competitiveness, Win Orientation, and Goal Orientation). In addition, participants completed measures of alcohol use and alcohol-related problems. Results indicated that Competitiveness, Win Orientation, and Goal Orientation were all significantly associated with alcohol use, but not alcohol-related problems. Moreover, these relationships were moderated by seasonal status and gender. These interactions, clinical implications, and limitations are discussed.

Heavy episodic drinking and soccer practice among high school students in Brazil: the contextual aspects of this relationship

Background

Heavy episodic drinking (HED) (consumption of five or more drinks on the same occasion) among adolescents is related to several problems and partaking in sport or physical activities has been suggested as an option to prevent or reduce alcohol consumption among this population. The aim of this study was to investigate the relationship between soccer practice and heavy episodic drinking among high school students from Brazil.

Methods

Data were obtained from a cross-sectional study among a representative sample of public and private high school students from all Brazilian state capitals (N=19,132). Only students aged from 14 to 18 who reported having taken part in soccer practice, other team sports or non-practicing sports in the last month were included. Characteristics of sport practice (frequency and motivation) and HED in the last month (type of drink; where and with whom they drank; frequency of HED) were also considered. Regression models were controlled for sociodemographic variables.

Results

For all groups studied most of the students reported drinking beer, with friends and at nightclubs or bars. Soccer practice was associated to HED when compared to non-practicing sports and to other team sports. Compared to other team sports, playing soccer for pleasure or profession, but not for keep fit or health reasons, were more associated to HED. Frequency of soccer practice from 1 to 5 days per month and 20 or more days per month, but not from 6 to 19 days per month, were also more associated to HED.

Conclusions

The relationship between soccer and HED appears to be particularly stronger than in other team sports among adolescents in Brazil. Induced sociability of team sports practice cannot be assumed as the main reason for HED among soccer players. Possibly these results reflect the importance of a strong cultural association between soccer and beer in Brazil and these findings should be integrated to future prevention or intervention programs.

A qualitative study of the perceived impact of a community mobilisation intervention to reduce alcohol consumption among amateur sportsmen

Aim The aim of this study was to examine the perceived impact of a community mobilisation intervention programme to reduce alcohol consumption among amateur sportsmen aged 16-34 years.

METHOD

A qualitative focus group format was used to identify potentially important themes or concepts relating to players' and coaches' experiences of the intervention. Six focus groups were conducted (five with four to seven players per focus group and one with six coaches) to elicit participants' experiences of the intervention.

RESULTS

Three major themes emerged from the analyses: patterns of alcohol consumption and associated factors; perceived impact of the intervention; and suggested changes to the community mobilisation intervention. Excessive binge drinking (i.e. the consumption of six or more standard drinks on any one occasion) was common among players. The perceived impact of the intervention programme among players was low; players and coaches believed that if future programmes were to succeed, a 'bottom-up' rather than a 'top-down' approach should be adopted.

CONCLUSIONS

The findings suggest that players perceived the community mobilisation programme to have had only limited success in changing attitudes or behaviour towards alcohol consumption in this amateur sports setting.

The effects of acute alcohol consumption and eccentric muscle damage on neuromuscular function

Voluntary and electrically stimulated muscular performance was examined to identify the effects of acute alcohol consumption on neuromuscular function in the presence and absence of exercise-induced muscle damage (EIMD). After initial neuromuscular performance measures were made, 12 subjects completed a bout of eccentric exercise (EX) using the quadriceps muscles of 1 leg while the remaining 11 subjects did not exercise (NX). Subjects then consumed either an alcoholic beverage containing 1 g·kg–1body weight (ALC) or a nonalcoholic beverage (OJ). On another occasion the contralateral leg of both groups was tested and those in the EX group performed an equivalent bout of eccentric exercise after which the other beverage was consumed. Measurements of neuromuscular function were made pre-exercise and 36 and 60 h post-beverage consumption. Creatine kinase (CK) was measured pre-exercise and at 12, 36, and 60 h. Significantly greater (p < 0.01) decrements in maximal voluntary isometric contraction were observed with EX ALC at 36 and 60 h compared with EX OJ, and no change was seen in the NX group. Significant decreases in voluntary activation were observed at 36 h (p = 0.003) and 60 h (p = 0.01) with EX ALC only. Elevations in CK were observed at all posteccentric exercise time points (all p < 0.05) under both EX OJ and ALC. No change in electromyography or low-frequency fatigue was observed under either treatment in either group. These results suggest that decreased neural drive appears to contribute to alcohol’s effect on the magnitude of EIMD-related decrements in voluntary force generation.

A low dose of alcohol does not impact skeletal muscle performance after exercise-induced muscle damage

Moderate, acute alcohol consumption after eccentric exercise has been shown to magnify the muscular weakness that is typically associated with exercise-induced muscle damage (EIMD). As it is not known whether this effect is dose-dependent, the aim of this study was to investigate the effect of a low dose of alcohol on EIMD-related losses in muscular performance. Ten healthy males performed 300 maximal eccentric contractions of the quadriceps muscles of one leg on an isokinetic dynamometer. They then consumed either a beverage containing 0.5 g of alcohol per kg bodyweight (as vodka and orange juice) or an isocaloric, isovolumetric non-alcoholic beverage. At least 2 weeks later, they performed an equivalent bout of eccentric exercise on the contralateral leg after which they consumed the other beverage. Measurement of peak and average peak isokinetic (concentric and eccentric) and isometric torque produced by the quadriceps was made before and 36 and 60 h post-exercise. Significant decreases in all measures of muscular performance were observed over time under both conditions (all P < 0.05); however, no difference between treatments was evident at any of the measured time points (all P > 0.05). Therefore, consumption of a low dose of alcohol after damaging exercise appears to have no effect on the loss of force associated with strenuous eccentric exercise.

Drinking by professional Australian Football League (AFL) players: prevalence and correlates of risk

OBJECTIVES

To examine self-reported patterns of alcohol consumption and experience of alcohol-related harms among professional Australian Football League (AFL) players.

DESIGN, SETTING AND PARTICIPANTS

Cross-sectional survey of player alcohol consumption and self-reported alcohol-related harms among members of all 16 professional AFL clubs. Data relating to the 2006 football year were collected between 25 July and 30 August 2006 at regular football training sessions using a self-administered structured questionnaire.

MAIN OUTCOME MEASURES

Risky/high-risk drinking for long- and short-term harm at different times of the year; Alcohol Use Disorders Identification Test (AUDIT) score.

RESULTS

582 AFL players completed the questionnaire (an 83% response rate). Alcohol consumption varied at different times of the year. During the playing season (approximately 22 weeks), the level of risky/high-risk consumption for long-term harm in AFL players (11/564 [2%]) was typically lower than in age-matched Australian men in the general population (15%). However, risky/high-risk consumption for long-term harm was higher in AFL players during the end-of-season period (approximately 2 weeks) (303/561 [54%]) and vacation period (6-8 weeks) (231/559 [41%]) than in age-matched Australian men. Risky/high-risk drinking for short-term harm on a monthly basis was frequent at all times of the year (eg, 395/560 [71%] in the pre-season period). The mean AUDIT score was 8.8 (95% CI, 8.4 to 9.1; range, 0 to 36). Reports of harmful effects of drinking and negative consequences, such as getting involved in a fight (physical or verbal) while drinking (146/556 [26%]), were common. Risky/high-risk consumption for short-term harm on a monthly basis was associated with a variety of player characteristics, such as usually drinking in public locations (odds ratio, 1.55 [95% CI, 1.02 to 2.35]). AUDIT score was associated with variables such as marital status, with married players scoring more than two points lower (95% CI, - 3.58 to - 0.58) than single players. Formal club rules on alcohol consumption had little effect on outcome measures.

CONCLUSIONS

Drinking among AFL players is intricately related to time of year. This seasonal drinking pattern requires the development of specific club and league strategies to minimise drinking-related harms to players.

Alcohol consumption: the good, the bad, and the indifferent

Dietary ethanol (alcohol) is the most widely consumed drug worldwide. High levels of mortality, morbidity, and social malaise are associated with abuse of alcohol, and increasing numbers of women and youth are abusing alcohol. However, strong epidemiological data demonstrate a U- or J-shaped relationship between volume of alcohol consumed and all-cause mortality or disease burden. Moderate alcohol consumption is associated with a lower risk of all-cause mortality and disease burden than are abstinence and immoderate drinking. A brief review of the absorption, distribution, metabolism, and excretion of ethanol is provided with a discussion of the impact of gender differences. Potential mechanisms by which ethanol, ethanol metabolites, and (or) phytochemicals, as associated with different types of ethanol-containing beverages, are discussed in regards to the beneficial and detrimental impacts they may have on physiological system functioning and mortality or disease burden. Per capita consumption of ethanol-containing beverages varies across geo-political regions worldwide. A more recent research focus is the impact of consumption patterns on consumption volumes as they relate to disease and mortality. Certain drinking patterns moderate overall volume of ethanol consumption. Thus, an emerging approach to the study of alcohol consumption in populations is to consider both the volume and pattern of consumption as they relate to mortality and disease burden. Alcohol consumption patterns among athletes are discussed; physiological implications of alcohol abuse in this population are outlined. Current guidelines for the consumption of alcohol are reviewed. Alcohol consumption guidelines reflect the current scientific understanding of both the benefits of moderate alcohol consumption and the detriments of immoderate alcohol consumption.

The effect of alcohol on athletic performance

The use of alcohol is often intimately associated with sport. As well as providing a source of energy, alcohol (ethanol) has metabolic, cardiovascular, thermoregulatory, and neuromuscular actions that may affect exercise performance. Strength is minimally affected, and performance impairments depend on the dose of alcohol and subject habituation to alcohol intake, exercise duration, environmental conditions, and other factors. Central nervous system function is impaired at high doses, resulting in decrements in cognitive function and motor skill, as well as behavioral changes that may have adverse effects on performance. Effects may persist for hours after intoxication.

Energy and carbohydrate for training and recovery

Soccer players should achieve an energy intake that provides sufficient carbohydrate to fuel the training and competition programme, supplies all nutrient requirements, and allows manipulation of energy or nutrient balance to achieve changes in lean body mass, body fat or growth. Although the traditional culture of soccer has focused on carbohydrate intake for immediate match preparation, top players should adapt their carbohydrate intake on a daily basis to ensure adequate fuel for training and recovery between matches. For players with a mobile playing style, there is sound evidence that dietary programmes that restore and even super-compensate muscle glycogen levels can enhance activity patterns during matches. This will presumably also benefit intensive training, such as twice daily practices. As well as achieving a total intake of carbohydrate commensurate with fuel needs, the everyday diet should promote strategic intake of carbohydrate and protein before and after key training sessions to optimize the adaptations and enhance recovery. The achievement of the ideal physique for soccer is a long-term goal that should be undertaken over successive years, and particularly during the off-season and pre-season. An increase in lean body mass or a decrease in body fat is the product of a targeted training and eating programme. Consultation with a sports nutrition expert can assist soccer players to manipulate energy and nutrient intake to meet such goals. Players should be warned against the accidental or deliberate mismatch of energy intake and energy expenditure, such that energy availability (intake minus the cost of exercise) falls below 125 kJ (30 kcal) per kilogram of fat-free mass per day. Such low energy availability causes disturbances to hormonal, metabolic, and immune function.