PARIS - Like many other athletes, Justin Phongsavanh has his own take on the chocolate muffins in the Paralympic Village.
"It doesn't get much better than that," said Phongsavanh, a U.S. Paralympian and bronze medalist in the seated javelin. Phongsavanh and other Paralympians can't survive on muffins alone, though. They and their diet teams face complex challenges, but scientists and sports personnel are working on their own solutions, even as research lags.
The biggest challenge with paranutrition strategies is that athletes' needs vary greatly, not only based on their sport, but also on their limitations and other underlying conditions, says applied sports nutrition scientist Joëlle Leonie Flück.
"Disabled people are so different in terms of needs and requirements from a nutritional perspective, but also from a medical perspective," said Flück, who is also president of the Swiss Sports Nutrition Society. "There are a lot of things to consider, like energy expenditure, which can be totally different from person to person, or from disability to disability."
For example, a wheelchair basketball player with full arm mobility requires very different fueling strategies than a quadriplegic wheelchair rugby player, Flück says.
Specific needs
All athletes have specific nutritional needs, but the limitations and underlying conditions of para athletes complicate the strategy. Gastrointestinal issues are especially common in para athletes due to fiber deficiencies, high sodium levels, and even sensitivity to spices.
At the Team USA High Performance Center in Eaubonne, just north of Paris, nutrition director Brian Knutson and dietitian Hilary Kave said many of the meals come "straight from Colorado Springs," the location of the U.S. Olympic & Paralympic Committee training center and home to many Paralympic athletes. Supplements and American-made snacks are shipped in, while fresh ingredients are sourced domestically.
"We know there are certain athletes that like to see things a certain way," Knutson said. "For us, that gives us a little bit of an advantage. That little bit of familiarity, home and comfort, it just makes their lives easier."
Paratriathlete Allysa Seely said she and her teammates eat most of their meals at the HPC in Eaubonne for that exact reason.
"We know the chefs, we know the food, the recipes, the menu, we know all that," said Seely, who won a bronze medal in the women's PTS2 classification, which is designed for athletes with coordination issues. "It's something we feel comfortable and confident with."
But gastrointestinal issues are just one dimension of para-athletic nutrition strategy. Andrew Shepherd offers workshops, consultations and other services to athletes and para-athletes at Loughborough University in the UK.
Shepherd said para athletes sometimes have specific challenges staying hydrated. People with spinal cord injuries, for example, may have trouble regulating their body temperature. Shepherd said nutrition staff implements more cooling strategies for Paralympians than for Olympians, including an increase in "ice vests, ice packs, cold slushies."
Bringing accessibility to the dining room
Accessibility isn't just about elevators and ramps. Certain methods of food delivery can pose challenges for para-athletes. Self-service buffets often make food inaccessible to wheelchair users and people of short stature.
According to Shepherd, small changes, such as placing boxes and bowls at an angle forward, can make a big difference.
"They're simple things, but it's about consistently spotting them and doing them, making sure we're making it fair rather than making it equal," Shepherd said. "It's really, really important that they're able to take full advantage of that space."
At the USOPC center, Kave said, the nutrition team takes a wide range of disabilities into account. Self-serve food is placed at a lower height so that everyone can reach it. Registered dietitians can make plates for athletes with visual impairments.
Delivery isn't always a matter of physical space. Neurodivergent athletes can be sensitive to textures and food mixing, so Shepherd said the Loughborough team is also taking those concerns into account.
Learning is missing
Kave, Shepherd and others say their work helping Paralympic athletes get the most out of their meals takes place in the context of a larger societal problem: Most people, with and without disabilities, don't know enough about healthy eating.
This means that the biggest challenge for dietitians working with para-athletes is not only to become familiar with the individual athlete and their needs, but also to teach athletes to view nutrition as a life skill.
"The more you absorb, the better it's going to be for when you're completely on your own," Kave said. "When you stop being that athlete, maybe you're not in the competitive field anymore, I want you to have that knowledge so you can keep going."
Paratriathlete Seely said her current nutrition team is relatively new, but she worked with the same nutritionist for seven years.
"I still go back to our notes, our references, and I use all of that information pretty much every day to advocate for myself with my newer team," Seely said. "Without that dietitian, nothing I accomplished and everything I know to this day would not be possible."
A Paralympic army marches on its stomach
The United States brought an army of dining staff and registered dietitians from its training center in Colorado Springs to the Paralympics. Some countries, such as Japan, brought none. The difference in approaches reflects the fact that scientists do not know enough about the physiology and health needs of Paralympians to develop best practices that serve all athletes and all classifications. Currently, most Paralympians' nutritional challenges are addressed on a case-by-case basis.
"We don't have any idea about fueling strategies in relation to types of disability; we just use the general guidelines of able-bodied people and try to adapt them a little bit," said Flück, the Swiss nutrition scientist. "There really is a lot of research needed."
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Julianna Russ is a student in the bachelor's certificate program at the University of Georgia's Carmical Sports Media Institute.
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