Nutritional Challenges in Para-Athletes: A Scoping Review of Current Knowledge

Para-athletes face unique nutritional challenges arising from impairment-specific physiological and metabolic characteristics, along with environmental and economic barriers influencing food access and meal preparation. Despite the rapid growth of parasport, evidence guiding nutritional practice in this population remains limited. This scoping review systematically mapped the literature on dietary intake and supplement use among para-athletes, identifying key nutritional challenges and research gaps across impairment types, sports, and competition levels. Following the Joanna Briggs Institute and PRISMA-ScR frameworks, five databases were searched. Studies including para-athletes of any impairment, sport, or competitive level were eligible. Data were synthesized across seven domains: macronutrient and fiber intake, micronutrient intake, supplement use, hydration status, alcohol consumption, low energy availability, and dietary habits. Dietary intake was assessed against reference standards. Methodological quality assessment of the included studies was also performed with appropriate tools. Forty-seven studies were included. Across impairment groups, carbohydrate and fiber intakes were often below recommendations, while protein intake was generally adequate but insufficient in some female athletes. Vitamin D, calcium, magnesium, and iron inadequacies were common, alongside elevated sodium and B vitamin intakes. Supplement use ranged from 0% to 91%, dominated by vitamin/mineral, creatine, and omega-3 products. Evidence on hydration, alcohol use, low energy availability, and dietary habits was scarce but indicated potential health risks. Para-athletes face distinct and recurring nutritional challenges that impact sport performance and long-term health. Addressing these gaps through impairment-specific research and integrated nutrition care is essential to optimize performance and health in parasport.