Energy production, hemoglobin synthesis, immune function, bone health and protection from oxidative damage are all affected by micronutrient intake. Intense exercise stresses metabolic pathways, thus higher intake of vitamins and minerals by the athlete may be needed. A lack of consensus as to the need for additional antioxidants leads the authors to note that supplementation of these nutrients is probably not necessary in most athletes if energy intake is adequate

Calcium, iron and zinc, however are often low in the diets of athletes, especially females. Women, especially distance runners and vegetarians, should be screened periodically to assess iron status. Iron deficiency anemia can take three to six months to reverse, so if interventions are indicated, they should begin before the condition develops.

Addressing hydration, the paper reiterates commonly known fluid balance information, recommending that athletes use beverages containing carbohydrates in concentration of four to eight percent when performing in intense exercise events. Plain water or sports drinks are appropriate for events lasting under one hour, however. Special environmental conditions such as excessive heat and humidity, cold and high altitudes require increased fluid intake to avoid dehydration. The degree of increased intake must take into account the athlete, the event, the duration and intensity of the event, and body composition, among other things.

Careful attention to the amount of fluid lost during exercise and the replacement of that fluid is essential to the athlete's health. Further, as energy requirement s increase, the athlete should first consume the maximum carbohydrate calories, then dairy and protein foods to make up for energy expenditure. In reference to timing, individual athletes vary.