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7439191 
Journal Article 
Nutritional Optimization for Athletes with Stress Fractures 
Minagawa, S; Buell, J; , 
2020 
Springer International Publishing 
Cham 
Stress Fractures in Athletes 
129-139 
The occurrence of stress fractures is likely multifactorial and can include inadequate nutrition over an extended period of time. Assessing the dietary needs of an athlete and correcting inadequate energy intake may help prevent negative consequences of relative energy deficiency in sport (RED-S) including future recurrences or new stress fractures. In addition to consuming adequate energy, athletes need to consider the macronutrient and micronutrient composition of their diet and the recommendations set specific to athletes by the American College of Sports Medicine in collaboration with the Academy of Nutrition and Dietetics and Dietitians of Canada. Although current evidence suggests calcium, vitamin D, and iron play a significant role in general health, other micronutrients such as vitamins K and A, phosphorus, potassium, and magnesium are also known to be involved in bone metabolism. However, most studies on the latter micronutrients have been carried out in postmenopausal women and have not been considered in stress fracture athletes. It is crucial that athletes follow the recommended adequate intake of energy, macronutrients, and micronutrients for their specific activity level without exceeding the tolerable upper intake levels. Maintaining this balance optimizes nutrition for athletes with stress fractures as well as helps to limit stress fracture recurrence.