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Sport and exercise have long been recognised as important components in the therapy and rehabilitation of people with physical or intellectual impairments. However, since the inception of the Summer Paralympic Games in 1960 and the Winter Paralympic Games in 1992, there has been a dramatic increase in the number of individuals with impairments training and competing at high levels. Performance standards continue to improve and Paralympic athletes therefore need to train to the same intensity and with the same structure and planning as non-disabled athletes. Even in non-Paralympic sports, athletes with impairments are accomplishing challenging feats, such as individuals with paraplegia swimming the English Channel and completing the Hawaii Ironman Triathlon.

Despite the growth of Paralympic sports internationally, scientific research about these athletes has failed to match that of their non-disabled counterparts. Applying sports nutrition principles to some of these athletes is straightforward as their events and nature of their impairment mean that there is little to no physiological difference to non-disabled athletes. Others require the sports dietitian to adapt sports nutrition principles and/or their practical application on an individual basis. This chapter outlines some common areas where such adaptations may be required and provides simple strategies to help optimise training capacity, health and ultimately the performance of Paralympic athletes.


The large range of sports on offer to Paralympic athletes presents opportunities for many types of impairment. At the Summer Paralympic Games, athletes compete in 22 sports, and at the Winter Paralympic Games in six sports, although this can change from one Games to the next (see Within each sport, there are specific classification rules that govern the type of impairment that an athlete must have to participate. For example, wheelchair rugby is limited to athletes who mobilise in a wheelchair and have an impairment involving all four limbs (usually quadriplegia), whereas goalball, judo and five-a-side football are only for vision-impaired athletes.

The rules governing each sport are outlined on the International Paralympic Committee (IPC) website ( At times, rules may differ from those of non-disabled sports to ensure the safety of competitors.


Paralympic athletes must be classified within 1 of 10 eligible impairment types (refer to IPC 2016). For the purposes of this chapter, impairment types are grouped into five primary descriptors; their associated sports nutrition considerations are outlined in this chapter. In addition to the Paralympic Games, there are several large-scale international competitions for individuals with impairments, such as the Special Olympics (intellectual impairments), Deaflympics (hearing impairments), Invictus/Warrior Games (injured or sick defence force veterans) and Transplant Games (organ transplants); the scope of this chapter does not allow for a full discussion of all forms of impairment.

Each Paralympic sport has its own system or approach to classification that categorises athletes according to ...

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