Position of the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and Athletic Performance

Impact of Equation Choice on Resting Metabolic Rate Ratio in High-Level Men and Women Athletes

OBJECTIVE

To examine the impact of the RMR ratio cutoff point selected on the categorization of prevalence/absence of low energy availability among predictive equations in high-level athletes (n = 241 [99 women]; 52% competed at the World Championship and Olympic Games), and whether this categorization is influenced by sex and the predictive equation used.

METHODS

We assessed RMR using indirect calorimetry, predicted the RMR using the equations proposed by Harris-Benedict, FAO/WHO/UNU, de Lorenzo, ten Haaf and Wejis, Wong, Jagim, Cunningham, and Freire, and computed the RMR ratio for each equation.

RESULTS

We observed that the cumulative percentage of RMR ratio values increased at a faster rate using Jagim, ten Haaf and Wejis, and Cunningham equations compared to the other equations. At the 0.90 value (the most used cutoff point in literature), the Jagim equation categorized ≥ 50% of the athletes into "low energy availability". No Sex × Equation × Sport interaction effect was observed (F = 0.10, p = 1.0). There was a significant main effect to Sex (F = 11.7, p < 0.001, ES = 0.05), Sport (F = 16.4, p < 0.001, ES = 0.01), and Equation (F = 64.1, p < 0.001, ES = 0.19). Wong and FAO/WHO/UNU equations yielded the largest errors (assessed vs. predicted RMR) in men and women, respectively.

CONCLUSION

The selected RMR ratio cutoff point influences the prevalence/absence of low energy availability characterization in high-level athletes and suggests that certain equations could bias its assessment.

Dietary Habits and Race Day Strategies among Flexitarian, Vegetarian, and Vegan Recreational Endurance Runners: A Cross-Sectional Investigation from The NURMI Study (Step 2)

Many of today's recreational runners have changed their diet from omnivorous to vegetarian or vegan for reasons like better sport performance, animal ethics, positive health, eco-aspects, or male infertility. Others have constructed the flexitarian diet due to current trends in sustainable eating. The aim of this investigation was to analyze the dietary habits and race day strategies of recreational endurance runners following current sustainable dietary trends. Recreational endurance runners (18+ years) were invited to complete the standardized online survey on socio-demography/anthropometry, motivations, running/racing history, food frequency, and race day dietary strategy. Chi-squared tests and Wilcoxon tests were used for the statistical analysis. In total, 289 participants submitted the survey; 146 subjects following flexitarian (n = 34), vegetarian (n = 50), or vegan (n = 62) diets were included in the final sample. Significant differences were found across the diet types: BMI (p = 0.018), fruit/vegetable consumption (p < 0.001), and the dietary motive of performance (p = 0.045). The findings suggest that the flexitarian diet may be appropriate for health- and environmentally conscious populations living in a meat-centered society and lacking social support to eat completely vegetarian/vegan. Following a plant-based diet is perceived as easy for health-conscious, athletic populations, and the vegan diet does not require a particularly effortful/complex race day strategy for endurance runners.

Investigating the interrelationships among food habits, sports nutrition knowledge, and perceived barriers to healthy eating: a study of adolescent swimmers

This cross-sectional study aims to explore the relationships between food habits, perceived barriers to healthy eating, and sports nutrition knowledge among adolescent swimmers. The study focuses on understanding how these factors interact and influence dietary choices in young athletes. A cohort of 52 adolescent swimmers aged 12-18 from Al Hussein Youth Club in Al-Hussein Sport City participated in the study. Data were collected through surveys assessing food habits, perceived barriers to healthy eating, and sports nutrition knowledge. Pearson Correlation analysis was employed to examine associations between variables, and stepwise regression analysis was used to identify predictors of food habits. The analysis revealed a significant positive association between food habits and sports nutrition knowledge (r = 0.393, p = 0.004). Knowledge emerged as a significant positive predictor of food habits (β = 0.393, p = 0.004), highlighting the influential role of sports nutrition knowledge in shaping the dietary choices of adolescent swimmers. However, the introduction of Barriers lacked significance, and individual predictors did not reach statistical significance. These findings underscore the importance of targeted interventions aimed at enhancing nutritional education among adolescent swimmers. Understanding the interplay between knowledge, barriers, and food habits provides valuable insights into the complex dynamics that influence the dietary choices of young athletes. Addressing these factors through tailored educational programs can promote healthier eating habits and optimize performance among adolescent swimmers. This study highlights the critical role of sports nutrition knowledge in shaping the dietary behaviors of adolescent swimmers. By addressing knowledge gaps and overcoming perceived barriers, targeted interventions can help improve food habits and enhance the overall health and performance of young athletes.

Integrative metabolomics highlights gut microbiota metabolites as novel NAFLD-related candidate biomarkers in children

Altered gut microbiota and metabolites are important for non-alcoholic fatty liver disease (NAFLD) in children. We aimed to comprehensively examine the effects of gut metabolites on NAFLD progression. We performed integrative metabolomics (untargeted discovery and targeted validation) analysis of non-alcoholic fatty liver (NAFL), non-alcoholic steatohepatitis (NASH), and obesity in children. Fecal samples were collected from 75 subjects in the discovery cohort (25 NAFL, 25 NASH, and 25 obese control children) and 145 subjects in an independent validation cohort (53 NAFL, 39 NASH, and 53 obese control children). Among 2,491 metabolites, untargeted metabolomics revealed a complete NAFLD metabolic map containing 318 increased and 123 decreased metabolites. Then, machine learning selected 65 important metabolites that can distinguish the severity of the NAFLD. Furthermore, precision-targeted metabolomics selected 5 novel gut metabolites from 20 typical metabolites. The functionality of candidate metabolites was validated in hepatocyte cell lines. In the end, this study annotated two novel elevated pathogenic metabolites (dodecanoic acid and creatinine) and a relationship between depleted protective gut microbiota (Butyricicoccus and Alistipes), increased inflammation (IL-1β), lipid metabolism (TG), and liver function (ALT and AST). This study demonstrates the role of novel gut metabolites (dodecanoic acid and creatinine), as the fatty acid metabolism regulator contributing to NAFLD development through its influence on inflammation and liver function.

IMPORTANCE

Altered gut microbiota and metabolites are a major cause of non-alcoholic fatty liver disease (NAFLD) in children. This study demonstrated a complete gut metabolic map of children with NAFLD, containing 318 increased and 123 decreased metabolites by untargeted metabolomic. Multiple validation approaches (machine learning and targeted metabolomic) selected five novel gut metabolites for targeted metabolomics, which can distinguish NAFLD status and severity. The gut microbiota (Butyricicoccus and Alistipes) and metabolites (creatinine and dodecanoic acid) were novel biomarkers associated with impaired liver function and inflammation and validated by experiments of hepatocyte cell lines. The data provide a better understanding of the importance of gut microbiota and metabolite alterations in NAFLD, which implies that the altered gut microbiota and metabolites may represent a potential target to prevent NAFLD development.

Genotypic and Allelic Distribution of the CD36 rs1761667 Polymorphism in High-Level Moroccan Athletes: A Pilot Study

Previous studies have shown that variations in the CD36 gene may affect phenotypes associated with fat metabolism as the CD36 protein facilitates the transport of fatty acids to the mitochondria for oxidation. However, no previous study has tested whether variations in the CD36 gene are associated with sports performance. We investigated the genotypic and allelic distribution of the single-nucleotide polymorphism (SNP) rs1761667 in the CD36 gene in elite Moroccan athletes (cyclists and hockey players) in comparison with healthy non-athletes of the same ethnic origin. Forty-three Moroccan elite male athletes (nineteen cyclists and twenty-four field hockey players) belonging to the national teams of their respective sports (athlete group) were compared to twenty-eight healthy, active, male university students (control group). Genotyping of the CD36 rs1761667 (G>A) SNP was performed via polymerase chain reaction (PCR) and Sanger sequencing. A chi-square (χ2) test was used to assess the Hardy-Weinberg equilibrium (HWE) and to compare allele and genotype frequencies in the "athlete" and "control" groups. The genotypic distribution of the CD36 rs1761667 polymorphism was similar in elite athletes (AA: 23.81, AG: 59.52, and GG: 16.67%) and controls (AA: 19.23, AG: 69.23, and GG: 11.54%; χ2 = 0.67, p = 0.71). However, the genotypic distribution of the CD36 rs1761667 polymorphism was different between cyclists (AA: 0.00, AG: 72.22, and GG: 27.78%) and hockey players (AA: 41.67, AG: 50.00, and GG: 8.33%; χ2 = 10.69, p = 0.004). Specifically, the frequency of the AA genotype was significantly lower in cyclists than in hockey players (p = 0.02). In terms of allele frequency, a significant difference was found between cyclists versus field hockey players (χ2 = 7.72, p = 0.005). Additionally, there was a predominance of the recessive model in cyclists over field hockey players (OR: 0.00, 95% CI: 0.00-0.35, p = 0.002). Our study shows a significant difference between cyclists and field hockey players in terms of the genotypic and allelic frequency of the SNP rs1761667 of the CD36 gene. This divergence suggests a probable association between genetic variations in the CD36 gene and the type of sport in elite Moroccan athletes.

Advances in Understanding the Interplay between Dietary Practices, Body Composition, and Sports Performance in Athletes

The dietary practices of athletes play a crucial role in shaping their body composition, influencing sports performance, training adaptations, and overall health. However, despite the widely acknowledged significance of dietary intake in athletic success, there exists a gap in our understanding of the intricate relationships between nutrition, body composition, and performance. Furthermore, emerging evidence suggests that many athletes fail to adopt optimal nutritional practices, which can impede their potential achievements. In response, this Special Issue seeks to gather research papers that delve into athletes' dietary practices and their potential impacts on body composition and sports performance. Additionally, studies focusing on interventions aimed at optimizing dietary habits are encouraged. This paper outlines the key aspects and points that will be developed in the ensuing articles of this Special Issue.

Sports Diet and Oral Health in Athletes: A Comprehensive Review

Food and fluid supply is fundamental for optimal athletic performance but can also be a risk factor for caries, dental erosion, and periodontal diseases, which in turn can impair athletic performance. Many studies have reported a high prevalence of oral diseases in elite athletes, notably dental caries 20-84%, dental erosion 42-59%, gingivitis 58-77%, and periodontal disease 15-41%, caused by frequent consumption of sugars/carbohydrates, polyunsaturated fats, or deficient protein intake. There are three possible major reasons for poor oral health in athletes which are addressed in this review: oxidative stress, sports diet, and oral hygiene. This update particularly summarizes potential sports nutritional effects on athletes' dental health. Overall, sports diet appropriately applied to deliver benefits for performance associated with oral hygiene requirements is necessary to ensure athletes' health. The overall aim is to help athletes, dentists, and nutritionists understand the tangled connections between sports diet, oral health, and oral healthcare to develop mitigation strategies to reduce the risk of dental diseases due to nutrition.

Female Athlete Triad and Relative Energy Deficiency in Sport (REDs): Nutritional Management

The female athlete triad (TRIAD) is a spectrum of disorders involving low energy availability (LEA), low bone mineral density, and menstrual disorders. It is increasingly common to use the term 'relative energy deficiency in sport' (RED), emphasising the extensive impact of LEA on the body. The aim of this narrative review was to gather original research encompassing female athletes across various sports as well as to collect findings on the potential of a nutrition-focused approach to prevent or treat the aforementioned disorders. A comprehensive search was conducted in PubMed and Scopus. Several challenges were identified regarding the adequacy of the energy availability, protein, and carbohydrate requirements in the diets of female athletes. Moreover, insufficient intake of vitamin D has been observed across all athlete groups studied. This insufficiency also extends to the average requirement for Ca, Mg, the Ca/P ratio, Zn, and Fe. To address those concerns, a nutritional approach is proposed in the latter part of this review. The factors that can improve the absorption of micronutrients have also been discussed. The TRIAD/REDs affect an ever-growing number of women and require appropriate therapeutic management, particularly through nutritional care. Therefore, cooperation within an interdisciplinary team comprising a physician, nutritionist, physiotherapist, and psychologist is crucial.

Optimizing the Gut Microbiota for Individualized Performance Development in Elite Athletes

The human gut microbiota can be compared to a fingerprint due to its uniqueness, hosting trillions of living organisms. Taking a sport-centric perspective, the gut microbiota might represent a physiological system that relates to health aspects as well as individualized performance in athletes. The athletes' physiology has adapted to their exceptional lifestyle over the years, including the diversity and taxonomy of the microbiota. The gut microbiota is influenced by several physiological parameters and requires a highly individual and complex approach to unravel the linkage between performance and the microbial community. This approach has been taken in this review, highlighting the functions that the microbial community performs in sports, naming gut-centered targets, and aiming for both a healthy and sustainable athlete and performance development. With this article, we try to consider whether initiating a microbiota analysis is practicable and could add value in elite sport, and what possibilities it holds when influenced through a variety of interventions. The aim is to support enabling a well-rounded and sustainable athlete and establish a new methodology in elite sport.

Assessment of sports nutrition knowledge, dietary intake, and nutrition information source in female collegiate athletes: A descriptive feasibility study

Objective: This descriptive feasibility study aimed to assess dietary intake, sports nutrition knowledge, and nutrition information source in collegiate athletes. Participants: Fourteen indoor volleyball female collegiate athletes from a National Collegiate Athletic Association Division I university. Methods: Participants completed a Nutrition for Sports Knowledge Questionnaire (NSKQ) once and dietary and body composition assessments over four time points. Results: Pre-season mean energy and carbohydrate intake were lower than the American College of Sports Medicine Recommendations (25 ± 6.4 vs 37-41 kcal/kg BW/day and 3 ± 0.9 vs 6-10 g/kg BW/day; respectively). Off-season carbohydrate intake followed similar trends. The average score on the NSKQ was 45 ± 9.6% out of 100. Athletic trainers were identified as a top nutrition source followed by strength and conditioning coaches and nutritionists. Conclusion: Female volleyball athletes have inadequate dietary intake and sports nutrition knowledge and may benefit from nutrition education and counseling by trained sports nutrition experts.Supplemental data for this article can be accessed online at https://doi.org/10.1080/07448481.2021.1987919.

Diet, Supplementation and Nutritional Habits of Climbers in High Mountain Conditions

Appropriate nutritional preparation for a high-mountain expedition can contribute to the prevention of nutritional deficiencies affecting the deterioration of health and performance. The aim of the study was to analyze the dietary habits, supplementation and nutritional value of diets of high mountain climbers. The study group consisted of 28 men (average age 33.12 ± 5.96 years), taking part in summer mountaineering expeditions at an altitude above 3000 m above sea level, lasting at least 3 weeks. Food groups consumed with low frequency during the expedition include vegetables, fruits, eggs, milk and milk products, butter and cream, fish and meat. The energy demand of the study participants was 4559.5 ± 425 kcal, and the energy supply was 2776.8 ± 878 kcal. The participants provided 79.6 ± 18.5 g of protein (1.1 ± 0.3 g protein/kg bw), 374.0 ± 164.5 g of carbohydrates (5.3 ± 2.5 g/kg bw) and 110.7 ± 31.7 g of fat (1.6 ± 0.5 g/kg bw) in the diet. The climbers' diet was low in calories, the protein supply was too low, and the fat supply was too high. There is a need to develop nutritional and supplementation recommendations that would serve as guidelines for climbers, improving their well-being and exercise capacity in severe high-mountain conditions, which would take their individual taste preferences into account.

Questionable advisability of vitamin and mineral dietary supplement use in adolescents

OBJECTIVE

Present study aimed to assess potential health risk in Slovenian adolescents due to inadequate diet and/or dietary supplement (DS) use.

METHODS

Data on DS use, micronutrient intake (24-h recall), eating habits (FFQ), body height and mass were collected within ACDSi (Analysis of Children's Development in Slovenia) cross-sectional study conducted in 2014. Adolescents enrolled in first year of 15 secondary schools (average (SD) age: 15.4 (0.7) years, N = 342) were included in the sample.

RESULTS

Adolescents' use of DS (especially multivitamins ingested as a popular drink (60%), magnesium (16%), and vitamin C (10%)) significantly contributed to their absolute intake of vitamins/minerals, resulting in higher percentage of DS users meeting reference values proposed by the nutrition societies of Germany, Austria, and Switzerland (D-A-CH recommendation). Simultaneously, DS users did not exceed the upper tolerable level proposed by the European Food Safety Authority for daily intake. With diet alone, adolescents consumed less than recommended amounts of the following vitamins/minerals: the intake was lowest for fat-soluble vitamins A, D, and E; water-soluble vitamins folate, biotin, and pantothenic acid; and minerals fluoride, iodine, chromium, and molybdenum. Suboptimal intake was due to the fact that around ¾ of adolescents consumed less than 54% of the recommended amounts (according to Optimized Mixed Diet (OMD) recommendations) for fruits, vegetables, milk/dairy products, fish, and cereals/cereal products. In contrast, the diet contributed to the consumption of 200-300% of D-A-CH minimum value for sodium. Furthermore, almost ¾ of adolescents exceeded the recommended amount for meat/meat products (320% of OMD) and sweet/salty snacks (453% of OMD).

CONCLUSIONS

Although DS use improved micronutrient intake in adolescents (especially vitamin C and magnesium), activities on public-health interventions should be focus to improve their diets, especially to achieve increased intakes of fruits, vegetables, cereals/cereal products and milk/dairy products, and to reduce consumption of sweet/salty snacks and meat products.

Dietary Intake of Protein and Essential Amino Acids for Sustainable Muscle Development in Elite Male Athletes

Athletes need to develop a relatively high muscle mass and low body adipose tissue for the sake of better athletic performance. A full range of nine essential amino acids and eleven non-essential amino acids have to attend in appropriate amounts for protein biosynthesis. The aim of the observational comparative cross-sectional study was to assess the association between the diet quality profile and training-induced muscle mass estimated by bioelectrical impedance among elite male athletes. The research sample comprised 18.1 ± 3.1 year-old Lithuanian professional male athletes (n = 234). The study participants were enrolled to complete 24-h dietary recalls of three non-consecutive days. The body composition was assessed using the bioelectrical impedance analysis (BIA) method. The present study showed a significant insufficiency of the mean carbohydrate intake of 5.7 g/kg/day in a group of aerobic male athletes. The lower muscle mass of aerobic male athletes was related to the lower-carbohydrate diet (adjusted odd ratio (ORadj) 0.3; 95% confidence interval (CI): 0.1-0.7). The mean protein intake of 1.8 g/kg/day was optimal for anabolism in the samples of both anaerobic and aerobic male athletes. The protein intake in appropriate doses was potentially associated with an increase in muscle mass only in anaerobic male athletes (ORadj 2.2; 95% CI: 1.3-3.7). The positive relationship was revealed between the possible muscle mass gain and the increased intakes of amino acids such as isoleucine and histidine among anaerobic athletes (ORadj 2.9; 95% CI: 1.1-4.7 and ORadj 2.9; 95% CI: 1.0-4.3, respectively). An inverse feasible association was indicated between a higher intake of valine and lower muscle mass quantities among anaerobic male athletes (ORadj 0.1; 95% CI: 0.1-0.5). The recommendations for sports nutritionists should emphasize the necessity of advising professional athletes on dietary strategies on how to manipulate dietary amino acid composition with respect to achieving long-term body composition goals.

Cooking and food skills confidence of team sport athletes in Ireland

Nutritional support often focuses on cooking and food skills such as food selection, recipe planning and meal preparation. Individuals with greater cooking and food skills confidence have previously displayed higher diet quality scores and lower intakes of overall calories, saturated fat and sugar. Despite this, the cooking and food skills of team sport athletes have yet to be investigated. This study aimed to evaluate the relationship between cooking and food skills confidence and athletes' demographic characteristics. A validated measure for the assessment of cooking and food skills confidence was distributed via an online survey. Participants were required to rate their confidence on a Likert scale (1 "very poor" - 7 "very good") for 14 items related to cooking skills and 19 items for food skills. Food engagement, general health interest and self-reported fruit and vegetable consumption as a measure of diet quality were also measured. The survey was completed by 266 team sport athletes (male: 150, female: 116, age: 24.8 ± 6.1 years). Group differences were explored using t-tests and ANOVA and associations were evaluated using Spearman's correlation and hierarchical multiple regressions. Athletes' total cooking and food skills confidence was 62.7 ± 17.4 (64.0 ± 17.8%) and 83.8 ± 20.1 (63.0 ± 15.1%), respectively. Females reported greater confidence in both cooking (+20.3%, p < 0.01) and food skills (+9.2%, p < 0.01). Hierarchical multiple regressions explained 48.8% of the variance in cooking skills confidence and 44% of the variance in food skills confidence with gender, previous culinary training, cooking learning stage, general health interest and food engagement all remaining significant in the cooking skills confidence model and cooking frequency, previous culinary training, general health interest and food engagement remaining significant in the food skills confidence model. Male team sport athletes may benefit the most from educational interventions designed to increase cooking and food skills confidence.

The associations between anthropometric characteristics and nutritional parameters in male elite rugby union players

The objective was to analyse the associations between anthropometric characteristics and diet in male rugby players according to the playing position. A cross-sectional study was developed. The forwards had higher body weight (107 kg) and fat mass (FM; 12%) than the backs (87.8 kg and 8.47%, respectively) (p < 0.05). The quality of diet needs to improve (KIDMED value of 5.87 and 6.36 for forwards and backs, respectively). Nutritional imbalances, such as deficits in carbohydrates, fibre, calcium, magnesium and vitamin D, and excess of fats, saturated fatty acid, cholesterol and sugars were found. Carbohydrates and proteins intake were significant associated (p < 0.05) with a minor FM. Forwards with a KIDMED index of less than 8 had a significantly higher FM than those who maintained an optimal diet (p < 0.05). The diet of rugby players should be more in line with dietary recommendations and take into account the player position to optimise sports performance.

Impact of the COVID-19 Lockdown on the Body Composition and Physical Performance of Athletes: A Systematic Review with Meta-Analysis and Meta-Regression

Sporting events were cancelled, and sports training was banned to prevent the spread of COVID-19. These changes during the COVID-19 pandemic decreased the physical activity levels, increased sedentary time, and also impaired the mental health of elite and sub-elite athletes. The impact on body composition and physical performance is not clear, however, especially considering a systematic review with meta-analysis. Thus, our objective was to conduct a review in accordance with the PRISMA Statement studies published in scientific journals (PubMed, Web of Science, or Scopus databases) that investigated the effect that social distancing during the COVID-19 pandemic had on the physical performance (muscle power, cardiorespiratory capacity, and sprint) or body composition (body weight, percentage of fat, fat mass, and fat-free mass) of athletes. Data from 24 studies indicate that, throughout the global lockdown, the athletes maintained muscle power, cardiorespiratory capacity, and sprint, and prevented significant changes in fat mass and fat-free mass. However, the total body weight (meta-analysis with 18 studies), showed a significant increase (p = 0.006), with a small ES = 0.12; 95% CI = 0.04 to 0.21. Furthermore, the time of follow-up, level of training, and the age of the athletes were possible moderators of these effects. The data reinforce the importance of general strength and endurance exercises sessions to maintain physical fitness during non-competitive periods or due to the mandatory lockdown.

Sport activities for children and adolescents: the Position of the European Academy of Paediatrics and the European Confederation of Primary Care Paediatricians 2023-Part 1. Pre-participation physical evaluation in young athletes

The European Academy of Paediatrics (EAP) and the European Confederation of Primary Care Paediatricians (ECPCP) emphasize the importance of promoting healthy lifestyles within the pediatric population. Many health professionals have questions concerning adequate levels of physical activity for both the healthy pediatric population and for those who may have specific complications. Unfortunately, the academic literature that provides recommendations for participation in sport activities within the pediatric population that have been published during the last decade in Europe is limited and is mainly dedicated to specific illnesses or advanced athletes and not toward the general population. The aim of part 1 of the EAP and ECPCP position statement is to assist healthcare professionals in implementing the best management strategies for a pre-participation evaluation (PPE) for participation in sports for individual children and adolescents. In the absence of a uniform protocol, it is necessary to respect physician autonomy for choosing and implementing the most appropriate and familiar PPE screening strategy and to discuss the decisions made with young athletes and their families. This first part of the Position Statement concerning Sport Activities for Children and Adolescents is dedicated to healthy young athletes.

Effects of Nutrition Interventions on Athletic Performance in Soccer Players: A Systematic Review

BACKGROUND

More than 270 million participants and 128,893 professional players play soccer. Although UEFA recommendations for nutrition in elite football exist, implementing these guidelines among professional and semiprofessional soccer players remains suboptimal, emphasizing the need for targeted and individualized nutritional strategies to improve adherence to established recommendations.

METHODS

We conducted a comprehensive search in PubMed, Scopus, Web of Science, and clinical trial registers. Inclusion criteria focused on professional or semiprofessional soccer players, nutrition or diet interventions, performance improvement outcomes, and randomized clinical trial study types. We assessed quality using the Risk of Bias 2 (RoB 2) tool. We identified 16 eligible articles involving 310 participants. No nutritional interventions during the recovery period effectively improved recovery. However, several performance-based interventions showed positive effects, such as tart cherry supplementation, raw pistachio nut kernels, bicarbonate and mineral ingestion, creatine supplementation, betaine consumption, symbiotic supplements, and a high-carbohydrate diet. These interventions influenced various aspects of soccer performance, including endurance, speed, agility, strength, power, explosiveness, and anaerobic capacity.

CONCLUSIONS

Specific strategies, such as solutions with bicarbonate and minerals, high carbohydrate diets, and supplements like creatine, betaine, and tart cherry, can enhance the performance of professional soccer players. These targeted nutritional interventions may help optimize performance and provide the competitive edge required in professional soccer. We did not find any dietary interventions that could enhance recovery.

An Intense Bout of Acute Aerobic Exercise, but Not a Carbohydrate Supplement, Improves Cognitive Task Performance in a Sample of Black, Indigenous, and People of Color (BIPOC) Student Athletes

BACKGROUND

There are contradictory findings in the literature on whether an acute bout of aerobic exercise leads to a post-exercise improvement in cognitive function (CF). Moreover, participants used in the published literature are not representative of the racial make-up of sport or tactical populations.

METHODS

A randomized crossover design was incorporated, with participants randomly consuming water or a carbohydrate sports drink within the first 3 min of a graded maximal exercise test (GMET) conducted in a laboratory. Twelve self-identified African American participants, (seven males, five females, age = 21.42 ± 2.38 years, height = 174.94 ± 12.55 cm, mass = 82.45 ± 33.09 kg) completed both testing days. Participants completed the CF tests immediately pre- and post-GMET. CF was assessed with the Stroop color and word task (SCWT) and concentration task grid (CTG). Participants completed the GMET when they reported a score of 20 on the Borg ratings of perceived exertion scale.

RESULTS

Time to complete the SCWT incongruent task (p < 0.001) and CTG performance (p < 0.001) significantly improved post-GMET in both conditions. VO_2max was positively correlated with pre- and post-GMET SCWT performance.

CONCLUSIONS

The findings of our study suggest that an acute bout of maximal exercise significantly improves CF. Additionally, cardiorespiratory fitness is positively associated with CF in our sample of student athletes from a historically Black college and university.

Nutrient Adequacy in Endurance Athletes

Proper nutrition is critical for optimal performance in endurance athletes. However, it is unclear if endurance athletes are meeting all their energy and nutrient needs. We examined if endurance athletes are meeting their nutritional requirements and if this differed by sex. Ninety-five endurance athletes (n = 95; 50.5% men; 34.9 ± 12.9 y) participated in the study. Dietary intake was evaluated using the 24 h dietary recall method. Energy and nutrient intakes were calculated using the ESHA Food Processor Diet Analysis Software and compared against reference nutrient intakes. Endurance athletes did not consume the recommended amount of energy (76.8% of athletes), carbohydrates (95.8%), linoleic acid (75.8%), α-linolenic acid (ALA) (77.9%), eicosatetraenoic and docosahexaenoic acid (96.8%), dietary fiber (49.5%), vitamins D (93.7%), E (71.6%), and K (54.7%), folate (54.7%), pantothenic acid (70.5%), biotin (83.2%), manganese (58.9%), magnesium (56.8%), chromium (91.6%), molybdenum (93.7%), choline (85.3%), and potassium (56.8%), and consumed too much saturated fat (50.5%) and sodium (94.7%) than recommended. Fisher's Exact test showed that the requirements for dietary fiber (70.8% vs. 27.7%), ALA (87.5% vs. 68.1%), and total water (70.8% vs. 44.7%) were not met by more men versus women (p < 0.05). The needs for protein (70.2% vs. 25%) and vitamin B12 (46.8% vs. 22.9%) were not met by more women compared to men (p < 0.05). These findings need to be confirmed by a larger study.

The VegPlate for Sports: A Plant-Based Food Guide for Athletes

Background: Nutrition strategies improve physiological and biochemical adaptation to training, facilitate more intense workouts, promote faster recoveries after a workout in anticipation of the next, and help to prepare for a race and maintain the body’s hydration status. Although vegetarianism (i.e., lacto-ovo and veganism) has become increasingly popular in recent years, the number of vegetarian athletes is not known, and no specific recommendations have been made for vegetarian dietary planning in sports. Well-planned diets are mandatory to obtain the best performance, and the available literature reports that those excluding all types of flesh foods (meat, poultry, game, and seafood) neither find advantages nor suffer from disadvantages, compared to omnivorous diets, for strength, anaerobic, or aerobic exercise performance; additionally, some benefits can be derived for general health. Methods: We conceived the VegPlate for Sports, a vegetarian food guide (VFG) based on the already-validated VegPlate facilitating method, designed according to the Italian dietary reference intakes (DRIs). Results: The VegPlate for Sports is suitable for men and women who are active in sports and adhere to a vegetarian (i.e., lacto-ovo and vegan) diet, and provides weight-based, adequate dietary planning. Conclusions: The VegPlate for Sports represents a practical tool for nutrition professionals and gives the possibility to plan diets based on energy, carbohydrate (CHO), and protein (PRO) necessities, from 50 to 90 Kg body weight (BW).

Body Composition, Nutritional Intake Assessment, and Perceptions about Diet for Health and Performance: An Exploratory Study for Senior Futsal Players

This study aims to assess the body composition and nutritional intake of senior male futsal players from the II Futsal Division—Azores Series and explore their individual viewpoints regarding the benefits and barriers of healthy eating and performance. Two groups were identified: those who only completed the sociodemographic questionnaire and the anthropometric data (Group 1, n = 48), and those who additionally had their food intake assessed using three 24-h dietary recalls and were interviewed (Group 2, n = 20). Although most of the players have a healthy body composition, those from Group 2 had a significantly higher Body Mass Index, showing that they are under “pre-obesity”, and have a higher percentage of body fat compared to the players from Group 1. Findings from the nutritional intake assessment revealed that players from Group 2 met dietary recommendations for protein, but not for energy and carbohydrate, and they slightly exceeded recommendations for fat. Findings from the interviews revealed that most of these players reported low levels of satisfaction with their sport performance, explained by their deviation from a healthy eating practice in their daily lives. They recognized the need to alter their diets, identifying food items that should be taken and avoided.

No changes in the abundance of selected fecal bacteria during increased carbohydrates consumption period associated with the racing season in amateur road cyclists

Background

Cyclists often use high-carbohydrate, low-fiber diets to optimize the glycogen stores and to avoid the gastrointestinal distress during both, the trainings and the competitions. The impact of such dietary changes on gut microbiota is not fully known.

Methods

We assessed the abundances of Faecalibacterium prausnitzii, Akkermansia muciniphila, Bifidobacterium spp., and Bacteroides spp. and the fecal pH in 14 amateur cyclists during the racing season. Eleven healthy men formed the control group.

Results

Despite significant differences in the diet composition and physical endurance levels of amateur cyclists before the competition season (1st term) and control group (carbohydrates: 52.2% ± 4.9% vs 41.9% ± 6.6%; VO₂max: 56.1 ± 6.0 vs 39.7 ± 7.7; p < 0.01; respectively), we did not observe any significant differences in studied gut bacteria abundances or fecal pH between the groups. Although the cyclists' carbohydrates consumption (2nd term) have increased throughout the season (4.48 g/kg b.w. ± 1.56 vs 5.18 g/kg b.w. ± 1.99; p < 0.05), the studied gut bacteria counts and fecal pH remained unchanged. It seems that the amateur cyclists' diet with increased carbohydrates intake does not alter the gut microbiota, but further research is needed to assess the potential impact of even higher carbohydrates consumption (over 6 g/kg b.w.).

Protein Ingestion in Reducing the Risk of Late-Onset Post-Exercise Hypoglycemia: A Pilot Study in Adolescents and Youth with Type 1 Diabetes

Dietary protein causes dose-dependent hyperglycemia in individuals with type 1 diabetes (T1D). This study investigated the effect of consuming 50 g of protein on overnight blood glucose levels (BGLs) following late-afternoon moderate-intensity exercise. Six participants (3M:3F) with T1D, HbA1c 7.5 ± 0.8% (58.0 ± 8.7 mmol/mol) and aged 20.2 ± 3.1 years exercised for 45 min at 1600 h and consumed a protein drink or water alone at 2000 h, on two separate days. A basal insulin euglycemic clamp was employed to measure the mean glucose infusion rates (m-GIR) required to maintain euglycemia on both nights. The m-GIR on the protein and water nights during the hypoglycemia risk period and overnight were 0.27 ± 043 vs. 1.60 ± 0.66 mg/kg/min (p = 0.028, r = 0.63) and 0.51 ± 0.16 vs. 1.34 ± 0.71 mg/kg/min (p = 0.028, r = 0.63), respectively. Despite ceasing intravenous glucose infusion on the protein night, the BGLs peaked at 9.6 ± 1.6 mmol/L, with a hypoglycemia risk period mean of 7.8 ± 1.5 mmol/L compared to 5.9 ± 0.4 mmol/L (p = 0.028) on the water night. The mean plasma glucagon levels were 51.5 ± 14.1 and 27.2 ± 10.1 ng/L (p = 0.028) on the protein and water night, respectively. This suggests that an intake of protein is effective at reducing the post-exercise hypoglycemia risk, potentially via a glucagon-mediated stimulation of glucose production. However, 50 g of protein may be excessive for maintaining euglycemia.

Dietary intakes and daily distribution patterns of macronutrients in youth soccer players

Introduction

There has been an abundance of dietary analysis research conducted on adult male soccer players, while studies on youth players are lacking. Furthermore, the daily distribution of energy and macronutrient intake throughout the day has been reported to influence training adaptations, but this is often not considered in the literature. This study aims to quantify daily energy and macronutrient intake and assess their distribution over 5 days, and compare daily energy intakes and predicted daily energy expenditure in under-16 male soccer players.

Methods

The sample included 25 soccer participants aged 14.8-15.7 years. Five-day self-reported food diaries were used to record the food/drink consumption. Intake was analyzed for total daily energy, macronutrient intakes, and distribution among meals (breakfast, lunch, dinner, and snacks). Daily energy expenditure was predicted by resting energy expenditure and physical activity levels developed for youth sports participants.

Results

The mean total energy intake was 1,928 ± 388 kcal∙day^-1, whereas the estimated daily energy expenditure was 3,568 kcal∙day^-1. Relative daily protein intakes were lower at breakfast, morning snack, afternoon snack, and night snack compared to lunch and dinner.

Discussion

Youth soccer players do not appear to meet energy requirements and daily CHO guidelines. Fluctuations in protein intake throughout the day were noted and may influence training adaptations (i.e., muscle protein synthesis and recovery).

Cardiorespiratory, Metabolic, and Performance Changes from the Effects of Creatine and Caffeine Supplementations in Glucose-Electrolyte-Based Sports Drinks: A Double-Blind, Placebo-Controlled Study

The purpose of this study is to investigate the additive effects of creatine and caffeine on changes in the cardiorespiratory system, metabolism, and performance of soccer players. Seventeen male soccer players randomly ingested three sports drinks comprising the following: glucose−electrolyte-based (Drink 1, control; D1), glucose−electrolyte-based drink + 5 g creatine (Drink 2; D2), and glucose−electrolyte-based drink + 5 g creatine + 35 mg caffeine (Drink 3; D3) during a 15 min recovery period after the modified Loughborough Intermittent Shuttle Test (LIST) on a standard outdoor soccer field. Then, a 20-m repeated intermittent sprinting activity was performed. The results showed no significant differences in cardiorespiratory and gas exchange variables. The non-significant levels of blood glucose concentrations among drinks with higher blood lactate concentrations were detected in parallel with increased heart rate during intermittent sprinting as a result of exercise intensities. Significantly longer sprinting time was found in D3 than D1 (p < 0.05), with no significant differences between D2 and D3. From this study, we conclude that the additive effect of caffeine−creatine supplements in a glucose−electrolyte drink during the 15 min recovery period enhances repeated 20-m high-intensity running in soccer players with no negative effect on cardiorespiratory functions.

The Evaluation of Videos about Branched-Chain Amino Acids Supplements on YouTube™: A Multi-Approach Study

Branched-chain amino acids (BCAAs) are one of the most controversial ergogenic aids in terms of effectiveness and safety. This study aimed to evaluate the quality and reliability of BCAA supplements related to English videos on YouTube^™ and to synthesize with the sentiment-emotion analysis of comments on videos. The content analysis of the information on videos was evaluated with the use of DISCERN, Journal of American Medical Association (JAMA) benchmark criteria, and Global Quality Score (GQS). In addition, word cloud and sentiment and emotional analysis of comments in videos were performed with the R package. As a result, the mean ± standard error values of DISCERN, JAMA, and GQS scores of all videos were 29.27 ± 1.97, 1.95 ± 0.12, and 2.13 ± 0.17, respectively. It was found that advertisement-free videos have a significantly higher DISCERN and GQS score than advertisement-included videos (p < 0.05). A moderately significant positive correlation was determined between DISCERN score of video content and the positive sentiment of video comments (rs: 0.400, p = 0.002). In conclusion, it was determined that BCAA-related YouTube^™ videos have mostly very poor quality in terms of content and that videos with higher quality may receive positive comments from viewers according to the DISCERN instrument.

Influence of Upper-Extremity and Lower-Extremity Resistance Exercise on Segmental Body Composition and Body Fluid Estimates

ABSTRACT

Rodriguez, C, Florez, CM, Prather, J, Zaragoza, J, Tinnin, M, Brennan, KL, Taylor, L, and Tinsley, GM. Influence of upper-extremity and lower-extremity resistance exercise on segmental body composition and body fluid estimates. J Strength Cond Res XX(X): 000-000, 2022-The purpose of this analysis was to determine if acute, localized resistance exercise (RE) artificially influences total and regional estimates of body composition from dual-energy X-ray absorptiometry (DXA) and bioelectrical impedance analysis (BIA). Recreationally active male (n = 14) and female (n = 18) subjects completed 3 testing visits: rest (R), upper-extremity RE (U), and lower-extremity RE (L). Dual-energy X-ray absorptiometry scans were completed before exercise and 60 minutes after exercise. Bioelectrical impedance analysis was completed immediately before and after exercise and at 15, 30, and 60 minutes after exercise. Subjects were not allowed to intake fluid during the exercise session or during the postexercise assessment period. The effects of the acute RE session on DXA and BIA estimates were analyzed using linear mixed-effects models with a random intercept for subject. Condition by time interactions were observed for most BIA outcomes. Relative to the reference model (i.e., R condition at baseline), total body water and fat-free mass estimates were, on average, approximately 1 and approximately 1.2 kg higher, in the U condition. In contrast, lower-extremity RE exerted little or no impact on most BIA variables. Some DXA estimates exhibited time main effects, but the magnitude of changes was negligible. An acute bout of localized RE, particularly upper-extremity RE, can artificially influence BIA body fluid and composition estimates, whereas DXA may be robust to the acute biological error introduced by RE. Although body composition assessments should ideally be conducted under standardized conditions, DXA may be suitable in less standardized situations. In addition, BIA is differentially influenced by upper-extremity and lower-extremity resistance exercise.

Professional Male Beach Handball Players Performance Profile

Beach handball is a sport that has seen an increase in the number of players in the last decade. The aim of the study was to evaluate the basic measures of body composition, maturation, performance outcomes and the adherence to the Mediterranean diet of professional beach handball players, as a function of category (junior vs. senior) and playing positions. Thirty-six professional beach handball players participated in the study: 18 seniors (age: 25.0 ± 5.19) and 18 juniors (age: 16.7 ± 0.46); Each player’s body composition and different sports performance variables were analysed using the CMJ test, the Abalakov test, the Yo-Yo Test IR1 and the handgrip test. The Mediterranean diet Adherence was analysed using the KIDMED questionnaire. Significant differences are observed for all performance variables, with the values of senior players being higher in all cases (p < 0.005). Moreover, the adherence to the Mediterranean diet is moderate. Positive correlations were observed between the CMJ and weight (p = 0.012) and the CMJ and the BMI (p = 0.003). The same was observed for the Abalakov test, with p = 0.004 for weight and p = 0.001 for the BMI. Regarding the dynamometry, it positively correlates with the height (p = 0.002), the sitting height (p = 0.008), wingspan (p < 0.001) and weight (p = 0.011). The opposite occurred with the Yo-Yo Test and the KIDMED variables. Conclusions: One aspect to improve, as a key performance factor, would be the adherence to the Mediterranean diet for both categories. Players with a better adherence, achieved better results in the performance tests.

Association of nutrition knowledge, practice, supplement use, and nutrient intake with strength performance among Taekwondo players in Nepal

BACKGROUND

Optimum dietary intake and adequate nutritional knowledge have been recognized as the key factors that play a critical role in improving the athlete's health and nutrition status. This study aimed to measure the association of nutritional knowledge, practice, supplement use, and nutrient intake with strength performance among Nepalese Taekwondo players.

METHODS

Between August 2019 and January 2020, a cross-sectional study was conducted among 293 Taekwondo players in Kathmandu Metropolitan City (mean age, 18 years; 63.1% male, 36.9% female). Face-to-face interviews were conducted using semi-structured questionnaires. Anthropometric measures, nutritional intake, nutrition knowledge, and practice were all recorded. The handgrip strength was measured using a handgrip dynamometer as a proxy for strength performance. Univariate and bivariate analyses were used to find out the association between predictor and outcome variables.

RESULTS

More than half of the participants had poor nutrition knowledge [54.3% (159/293)], and poor nutrition practice [55.3% (162/293)] scores. Daily mean energy, carbohydrate, protein and fat intake were 48.0 kcal.kg-1.d-1, 8.6, 1.6, and 1.5 g.kg-1.d-1, respectively among Taekwondo players. Daily total energy and carbohydrate intake were 48.2 kcal.kg-1.d-1 and 8.7 g.kg-1.d-1, respectively among male players which is higher than female players. However, daily protein and fat intake were higher in female players (1.7 and 1.6 g.kg-1.d-1, respectively). Both calcium (375.3 mg) and iron (9 mg) intake among Taekwondo players were significantly lower than current sports nutrition guidelines. Nutritional knowledge score (r = 0.117), height (r = 0.538), weight (r = 0.651), body mass index (r = 0.347), fat (r = 0.075), and energy (r = 0.127) intake showed significant positive correlation with strength performance of athletes. The strength performance was positively associated with training hours per day (β = 0.41, 95% CI: 0.09-0.91), body mass index (β = 0.35, 95% CI: 0.09-0.61), nutrition knowledge score (β = 0.13, 95% CI: 0.01-0.25), and energy intake (β = 0.13, 95% CI: 0.12-0.14).

CONCLUSIONS

The nutritional knowledge and practice both were suboptimal among Taekwondo athletes. Height, weight, body mass index, nutritional knowledge, energy, and fat intake showed a positive correlation with strength performance. Future studies can build on the premise of this study to identify the robust relationship between nutritional knowledge, practice, different supplement use, and nutrient intake among other athletes too.

Combined Physical Exercise and Diet: Regulation of Gut Microbiota to Prevent and Treat of Metabolic Disease: A Review

BACKGROUND

Unhealthy diet and sedentary lifestyle have contributed to the rising incidence of metabolic diseases, which is also accompanied by the shifts of gut microbiota architecture. The gut microbiota is a complicated and volatile ecosystem and can be regulated by diet and physical exercise. Extensive research suggests that diet alongside physical exercise interventions exert beneficial effects on metabolic diseases by regulating gut microbiota, involving in the changes of the energy metabolism, immune regulation, and the microbial-derived metabolites.

OBJECTIVE

In this review, we present the latest evidence in the modulating role of diet and physical exercise in the gut microbiota and its relevance to metabolic diseases. We also summarize the research from animal and human studies on improving metabolic diseases through diet-plus-exercise interventions, and new targeted therapies that might provide a better understanding of the potential mechanisms.

METHODS

A systematic and comprehensive literature search was performed in PubMed/Medline and Web of Science in October 2022. The key terms used in the searches included "combined physical exercise and diet", "physical exercise, diet and gut microbiota", "physical exercise, diet and metabolic diseases" and "physical exercise, diet, gut microbiota and metabolic diseases".

CONCLUSIONS

Combined physical exercise and diet offer a more efficient approach for preventing metabolic diseases via the modification of gut microbiota, abating the burden related to longevity.

Energy and Macronutrients Intake in Indoor Sport Team Athletes: Systematic Review

Indoor team sports are characterized by matches that are shorter in duration and with frequent substitution (high-intensity intermittent). The main goal of teams is to best cover athletes' physiological demands, while meeting their dietary intake needs is critical. The aim of this study is to conduct a systematic review of the dietary intake of indoor team sports athletes and to analyze whether they comply with nutritional recommendations. A search of PubMed-MEDLINE, Web of Science, and Scopus databases from 2008 to July 2022 was conducted and 2727 documents were identified. The studies focused on adult professional or semi-professional volleyball, basketball, handball, or futsal athletes. Two independent researchers screened and extracted the data, with 20 documents included after they met the inclusion criteria. Most of the athletes, both men and women, did not meet the official recommendations based on under-consumption (energy and carbohydrates) or over-consumption (fats). In relation to protein, 28.6% of studies met the recommendations, with 50% of those who did not meet it being due to under-consumption. Although there are references on athletes' dietary intakes, there are no references considering sexes or types of sport. More adapted recommendations are needed in order to more precisely evaluate athletes' intake to know if they meet their real nutritional requirements.

Nutritional Status and Habits among People on Vegan, Lacto/Ovo-Vegetarian, Pescatarian and Traditional Diets

Background: This study assessed the possible dependencies between nutritional habits and body composition among subjects with different dietary habits. Materials: A total of 196 healthy (aged 18−50 yrs) participants were enrolled in the study and divided into 4 groups according to their diet: vegans-VEGAN (n = 53), lacto/ovo-vegetarians—VEGE (n = 52), pescatarians-PESCA (n = 28), and omnivores-OMN (n = 43). Methods: The Food Frequency Questionnaire (FFQ) was used, and body composition was assessed on the In-Body120 analyzer. Results: Our result revealed in OMN + PESCA groups a higher average consumption frequency of sweets (p = 0.024), cheese/plant cheese (p < 0.001), eggs and egg dishes/egg substitutes (p < 0.001), butter, margarine/plant margarine (p < 0.001), cream /plant cream (p = 0.018), wine and cocktails (p = 0.028), vodka (p = 0.039) and lower of natural cottage cheese/tofu/tempeh (p < 0.001), vegetable oils (p = 0.036), legumes (p < 0.001) and nuts and seeds(p < 0.001) compared to the VEGAN + VEGE groups. The body composition analysis showed significant differences in skeletal muscle mass (SMM) (p = 0.019) and the content of minerals (p = 0.048) between groups. VEGAN disclosed the lowest average values of body fat mass (BFM), percentage body fat (PBF), and visceral adipose tissue (VAT) than other studied groups. Conclusions: The body composition analysis showed mean values within normal ranges in all of the groups, but some average results of OMN, PESCA, and VEGE compared to VEGAN were not highly satisfactory (in addition to eating behavior outcomes).

A questionnaire study on the knowledge, attitudes, and practices of fluid replacement and urination among Chinese elite athletes

OBJECTIVE

To evaluate the knowledge, attitudes and practices (KAP) of Chinese elite athletes about fluid replacement and urination.

METHODS

A cross-section study was carried out among Chinese national and national youth teams from March to April 2020, using a pretested questionnaire. The 42-questions questionnaire was designed to assess the KAP regarding fluid replacement and urination. The questionnaire included knowledge of fluid replacement (KFR), attitudes of fluid replacement (AFR), knowledge of urination (KU), and attitudes of urination (AU), which were awarded 20 scoring points. Descriptive statistics, independent samples t-tests, one-way ANOVA, Pearson's correlation analysis, Multiple linear stepwise regression and Chi-square test were performed.

RESULTS

A total of 779 valid questionnaires were collected and the effective rate is 98.4%. We finally conducted an assessment of 646 questionnaires of elite athletes. The mean score for KFR, AFR, KU, and AU was 2.8±1.3, 2.3±0.6, 3.0±1.5, and 2.1±0.8, respectively, with higher scores indicating positive hydration knowledge and attitudes. KFR and AFR scores of winter sports athletes were higher than those of summer sports athletes(P<0.05). Athletes who had lower athletic grades and training years had a worse KFR(P<0.05). Only 31.0% athletes knew that rehydration should be carried out before, during, and after training, which was scarcer among women, lower-athletic grades athletes, or athletes with lower training years (P<0.05). Male athletes had a worse KU but a better AU than female athletes(P<0.05). And athletes who were international-class athletic grades had the highest KU scores(P<0.05). The athletic grades and sport events were the main factors influencing the total scores of knowledge and attitudes (P<0.05, 95% CI -0.789--0.168,95% CI 0.025-1.040). Most of athletes tend to get hydration knowledge from internet. In practices, thirst is the main reason for rehydration (77.9%). The percentages of athletes with normal urine color (42.0%), frequency (75.0%,) and volume (20.0%) were low.

CONCLUSIONS

These findings indicate that Chinese elite athletes did not have sufficient KAP on fluid replacement and urination, more marked in the individuals who were summer sport events, the lower athletic grades and in lower training years. It is recommended that education should be provided in the early stages of professional training for athletes.

Fitness Soccer Athletes Training at the University of Limpopo, South Africa: Are the Macronutrients Intake and Anthropometric Status of These Athletes Optimal?

BACKGROUND

Dietary practices of the University of Limpopo soccer team athletes have been reported. However, the practices of those engaging in soccer for general fitness from different non-competitive teams remain unknown. To respond to this gap, the researchers investigated the energy, macronutrient intake, and BMI status and further correlated the two variables of the fitness non-competitive soccer athletes registered at the University of Limpopo in South Africa.

METHOD

A quantitative study design was undertaken to conveniently sample 60 out of 90 fitness soccer athletes from the four non-competitive soccer teams at the University of Limpopo sports grounds. Ethics approval was obtained from the University of Limpopo Research and Ethics Committee, and permission was given by the university sports management and team coaches. Athletes signed the informed consent form before participating in the study. Data were collected at the soccer fields during the afternoons before the start of training. Macronutrient intake data were collected using multiple (two) 24-h recall questionnaires on different days, which were validated by the food frequency questionnaire. Weight and height were measured using a digital scale (Seca 813 electronic flat scale) and stadiometer (Seca 213 portable stadiometer) for BMI calculations, respectively. The average energy and macronutrient intakes were calculated through the SAMRC FoodFinder software (3.0). The nutrient averages, together with the BMI results, were loaded into SPSS (26.0) for further analysis. Descriptive statistics were used to report the energy, macronutrient intake, and BMI statuses of athletes using percentages, means, and standard deviations (±SD). A one-way ANOVA test was used to determine the association between the latter variables. A p-value of ≤ 0.05 was the criterion used to correlate the variables.

RESULTS

All (100%) athletes were males, most of whom played soccer for 2-3 years while at the university. Almost half (48%) of athletes consumed energy (39.6 kcal/kg) below the recommendations. About 92% and 53% of athletes consumed carbohydrates (5.0 g/kg) and fat (1.2 g/kg) below the recommended values; while 43% consumed protein (1.4 g/kg) optimally. The majority (>80%) had a normal BMI (21.6 ± 2.6 kg/m²) status. However, there were no relationships between the energy (p = 0.383), CHO (p = 0.261), protein (p = 0.543), and fat (p = 0179) intake and the BMI status of athletes.

CONCLUSION

The macronutrient intake of fitness soccer athletes at the University of Limpopo is, on the whole, suboptimal. However, the athletes had normal body weights. There was no association between both the energy and macronutrient intake and the anthropometric (BMI) status of soccer athletes.

Nutritional Habits of Professional Cyclists during Pre-Season

The first aim of the present study was to assess the dietary intake of professional cyclists during pre-season. The second aim was to assess the dietary habits of this population during a complete season. Fifteen elite male (age: 23.2 ± 5.4 years) and twenty-three elite female (age: 20.1 ± 7.0 years) cyclists volunteered to participate in the study. Dietary nutrient intake during pre-season was assessed using a 72 h dietary recall interview, and a 136-item food frequency questionnaire was used to assess dietary habits during the year. Protein intake exceeded the PRI’s recommendation of 0.83 g/kg/day for all cycling groups. Fat exceeded RI recommendations in females in both road (43.3%) and CXO (39.8%) cycling groups, whilst males were found to follow recommendations for fat intake. CHO intake was below recommendations in all groups. Intake of all vitamins exceeded recommendations, with the exception of B9 in female road cyclists (77.8% RDA) and vitamin D in all groups. With regards to mineral intake, consumption exceeded RDA/AI recommendations in all groups except for iodine in male XCO cyclists (61.6%), female road cyclists (61.6%), and female XCO cyclists (58%) and potassium in female road cyclists (74.6%). Males consumed greater amounts of eggs and non-processed foods than females. Road cyclists consumed greater amounts of fish and seafood and had a lower intake of coffee and tea than XCO cyclists. Better knowledge of food guidelines in terms of serving and food variety is important for professional cyclists at may impact health and performance.

The health effects of soy: A reference guide for health professionals

Soy is a hotly debated and widely discussed topic in the field of nutrition. However, health practitioners may be ill-equipped to counsel clients and patients about the use of soyfoods because of the enormous, and often contradictory, amount of research that has been published over the past 30 years. As interest in plant-based diets increases, there will be increased pressure for practitioners to gain a working knowledge of this area. The purpose of this review is to provide concise literature summaries (400-500 words) along with a short perspective on the current state of knowledge of a wide range of topics related to soy, from the cholesterol-lowering effects of soy protein to the impact of isoflavones on breast cancer risk. In addition to the literature summaries, general background information on soyfoods, soy protein, and isoflavones is provided. This analysis can serve as a tool for health professionals to be used when discussing soyfoods with their clients and patients.

New Predictive Resting Metabolic Rate Equations for High-Level Athletes: A Cross-Validation Study

PURPOSE

The present study aims a) to assess the agreement between the measured resting metabolic rate (RMR) using indirect calorimetry and different predictive equations (predicted RMR), and b) to propose and cross-validate two new predictive equations for estimating the RMR in high-level athletes.

METHODS

The RMR of 102 athletes (44 women) was assessed using indirect calorimetry, whereas the body composition was assessed using skinfolds. Comparisons between measured and predicted RMR values were performed using one-way ANOVA. Mean difference, root mean square error (RMSE), simple linear regression, and Bland-Altman plots were used to evaluate the agreement between measured and predicted RMR. The accuracy of predictive equations was analyzed using narrower and wider accuracy limits (±5% and ±10%, respectively) of measured RMR. Multiple linear regression models were employed to develop the new predictive equations based on traditional predictors (equation 1) and the stepwise method (equation 2).

RESULTS

The new equations 1 and 2 presented good agreement based on the mean difference (3 and -15 kcal·d -1 ), RMSE (200 and 192 kcal·d -1 ), and R2 (0.71 and 0.74), respectively, and accuracy (61% of subjects between the limit of ±10% of measured RMR). Cunningham's equation provided the best performance for males and females among the existing equations, whereas Jagim's equation showed the worst performance for males (mean difference = -335 kcal·d -1 ; RMSE = 386 kcal·d -1 ). Compared with measured RMR, most predictive equations showed heteroscedastic distribution (linear regression's intercept and slope significantly different from zero; P ≤ 0.05), mainly in males.

CONCLUSIONS

The new proposed equations can estimate the RMR in high-level athletes accurately. Cunningham's equation is a good option from existing equations, and Jagim's equation should not be used in high-level male athletes.

Effect of a Multi-Strain Probiotic Supplement on Gastrointestinal Symptoms and Serum Biochemical Parameters of Long-Distance Runners: A Randomized Controlled Trial

As many as 70% of athletes who practice endurance sports report experiencing gastrointestinal (GI) symptoms, such as abdominal pain, intestinal gurgling or splashing (borborygmus), diarrhea or the presence of blood in the stool, that occur during or after intense physical exercise. The aim of the study was to evaluate the effect of a multi-strain probiotic on the incidence of gastrointestinal symptoms and selected biochemical parameters in the serum of long-distance runners. After a 3-month intervention with a multi-strain probiotic, a high percentage of runners reported subjective improvement in their general health. Moreover, a lower incidence of constipation was observed. In the group of women using the probiotic, a statistically significant (p = 0.035) increase in serum HDL cholesterol concentration and a favorable lower concentration of LDL cholesterol and triglycerides were observed. These changes were not observed in the group of men using the probiotic. Probiotic therapy may reduce the incidence and severity of selected gastrointestinal symptoms in long-distance runners and improve subjectively assessed health condition.

Microbiota in sports

The influence of microbiota on the human body is currently the subject of many studies. The composition of bacteria colonizing the gastrointestinal tract varies depending on genetic make-up, lifestyle, use of antibiotics or the presence of diseases. The diet is also important in the species diversity of the microbiota. This study is an analysis of the relationships between physical activity, diet, and the microbiota of the gastrointestinal tract in athletes. This review shows the differences in the microbial composition in various sports disciplines, the influence of probiotics on the microbiome, the consequence of which may be achieved even better sports results. Physical activity increases the number of bacteria, mainly of the Clostridiales order and the genus: Lactobacillus, Prevotella, Bacteroides, and Veillonella, and their number varies depending on the sports discipline. These bacteria are present in athletes in sports that require a high VO₂ max. The players’ diet also influences the composition of the microbiota. A diet rich in dietary fiber increases the amount of Lactobacillus or Bifidobacterium bacteria, probiotic microorganisms, which indicates the need to supplement the diet with probiotic preparations. It is impossible to suggest an unambiguous answer to how the microbiota of the gastrointestinal tract changes in athletes and requires further analyzes.

Effects of Breakfast Omission on Resting, Exercise, and Postexercise Autonomic and Hemodynamic Profile in Men

Purpose: The acute effects of fasting interventions on metabolic dynamics have been widely investigated. However, knowledge about the acute effect of overnight fasting on hemodynamic and cardiac autonomic modulation is limited, especially during and after exercise. Our objective was to investigate the effects of breakfast omission on hemodynamic and cardiac autonomic modulation during different stress conditions. Method: Twenty-one young men [age: 20.3 (20.1, 26.5 years); body mass index: 22.7 (21.4, 24.4 kg/m²)] underwent resting and postexercise blood pressure assessments and heart rate variability (HRV) analysis, using the SD1 and SD2 indices of Poincaré plots, at rest in supine and standing positions, every 10 minutes during moderate cardiorespiratory training and every 10 minutes throughout the postexercise recovery phase, for a total of 30 minutes for each phase (exercise and recovery). All measurements were performed in a randomized order after overnight fasting or 60 minutes after a breakfast containing ~20% of the total recommended daily calories. The normality hypothesis was rejected, and the Wilcoxon test was conducted to compare the interventions (p < .05). Results: No differences between interventions were observed for resting and postexercise blood pressures (p = .21 to 0.87) or for resting, exercise, and postexercise SD1 (p = .10 to 0.82) and SD2 indices (p = .14 to 0.71). Conclusions: We concluded that overnight fasting does not promote significant changes in resting and postexercise blood pressures or cardiac autonomic modulation in young men at rest (in supine and standing positions), during 30 minutes of moderate cardiorespiratory training and throughout a 30-minute postexercise recovery phase.

Systematic training in master swimmer athletes increases serum insulin growth factor-1 and decreases myostatin and irisin levels

During ageing, anabolic status is essential to prevent the decrease in quantity and quality of skeletal muscle mass (SMM). Exercise modulates endocrine markers of muscle status. We studied the differences of endocrine markers for muscle status in 62 non-sarcopenic Mexican swimmer adults aged 30-70 y/o, allocated into two groups: the systematic training (ST) group including master athletes with a physical activity level (PAL) >1.6, and the non-systematic training group (NST) composed by subjects with a PAL <1.5. Body composition, diet, biochemical and endocrine markers were analyzed. The ST group showed lower myostatin (MSTN) and irisin (IRI) levels, two strong regulators of SMM. The insulin growth factor-1 (IGF-1) was higher in the ST. This is consistent with most of the evidence in young athletes and resistance training programs, where IGF-1 and IRI seem to play a crucial role in maintaining anabolic status in master athletes.

The Salzburg 10/7 HIIT shock cycle study: the effects of a 7-day high-intensity interval training shock microcycle with or without additional low-intensity training on endurance performance, well-being, stress and recovery in endurance trained athletes-study protocol of a randomized controlled trial

BACKGROUND

Performing multiple high-intensity interval training (HIIT) sessions in a compressed period of time (approximately 7-14 days) is called a HIIT shock microcycle (SM) and promises a rapid increase in endurance performance. However, the efficacy of HIIT-SM, as well as knowledge about optimal training volumes during a SM in the endurance-trained population have not been adequately investigated. This study aims to examine the effects of two different types of HIIT-SM (with or without additional low-intensity training (LIT)) compared to a control group (CG) on key endurance performance variables. Moreover, participants are closely monitored for stress, fatigue, recovery, and sleep before, during and after the intervention using innovative biomarkers, questionnaires, and wearable devices.

METHODS

This is a study protocol of a randomized controlled trial that includes the results of a pilot participant. Thirty-six endurance trained athletes will be recruited and randomly assigned to either a HIIT-SM (HSM) group, HIIT-SM with additional LIT (HSM + LIT) group or a CG. All participants will be monitored before (9 days), during (7 days), and after (14 days) a 7-day intervention, for a total of 30 days. Participants in both intervention groups will complete 10 HIIT sessions over 7 consecutive days, with an additional 30 min of LIT in the HSM + LIT group. HIIT sessions consist of aerobic HIIT, i.e., 5 × 4 min at 90-95% of maximal heart rate interspersed by recovery periods of 2.5 min. To determine the effects of the intervention, physiological exercise testing, and a 5 km time trial will be conducted before and after the intervention.

RESULTS

The feasibility study indicates good adherence and performance improvement of the pilot participant. Load monitoring tools, i.e., biomarkers and questionnaires showed increased values during the intervention period, indicating sensitive variables.

CONCLUSION

This study will be the first to examine the effects of different total training volumes of HIIT-SM, especially the combination of LIT and HIIT in the HSM + LIT group. In addition, different assessments to monitor the athletes' load during such an exhaustive training period will allow the identification of load monitoring tools such as innovative biomarkers, questionnaires, and wearable technology.

TRIAL REGISTRATION

clinicaltrials.gov, NCT05067426. Registered 05 October 2021-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT05067426 . Protocol Version Issue date: 1 Dec 2021. Original protocol. Authors: TLS, NH.

Evidence‐Based Recovery in Soccer – Low‐Effort Approaches for Practitioners

Strategies to improve recovery are widely used among soccer players at both amateur and professional levels. Sometimes, however, recovery strategies are ineffective, improperly timed or even harmful to players. This highlights the need to educate practitioners and athletes about the scientific evidence of recovery strategies as well as to provide practical approaches to address this issue. Therefore, recent surveys among soccer athletes and practitioners were reviewed to identify the recovery modalities currently in use. Each strategy was then outlined with its rationale, its physiological mechanisms and the scientific evidence followed by practical approaches to implement the modality. For each intervention, practical and particularly low-effort strategies are provided to ensure that practitioners at all levels are able to implement them. We identified numerous interventions regularly used in soccer, i.e., sleep, rehydration, nutrition, psychological recovery, active recovery, foam-rolling/massage, stretching, cold-water immersion, and compression garments. Nutrition and rehydration were classified with the best evidence, while cold-water immersion, compression garments, foam-rolling/massage and sleep were rated with moderate evidence to enhance recovery. The remaining strategies (active recovery, psychological recovery, stretching) should be applied on an individual basis due to weak evidence observed. Finally, a guide is provided, helping practitioners to decide which intervention to implement. Here, practitioners should rely on the evidence, but also on their own experience and preference of the players.

Bioavailability, Efficacy, Safety, and Regulatory Status of Creatine and Related Compounds: A Critical Review

In 2011, we published a paper providing an overview about the bioavailability, efficacy, and regulatory status of creatine monohydrate (CrM), as well as other “novel forms” of creatine that were being marketed at the time. This paper concluded that no other purported form of creatine had been shown to be a more effective source of creatine than CrM, and that CrM was recognized by international regulatory authorities as safe for use in dietary supplements. Moreover, that most purported “forms” of creatine that were being marketed at the time were either less bioavailable, less effective, more expensive, and/or not sufficiently studied in terms of safety and/or efficacy. We also provided examples of several “forms” of creatine that were being marketed that were not bioavailable sources of creatine or less effective than CrM in comparative effectiveness trials. We had hoped that this paper would encourage supplement manufacturers to use CrM in dietary supplements given the overwhelming efficacy and safety profile. Alternatively, encourage them to conduct research to show their purported “form” of creatine was a bioavailable, effective, and safe source of creatine before making unsubstantiated claims of greater efficacy and/or safety than CrM. Unfortunately, unsupported misrepresentations about the effectiveness and safety of various “forms” of creatine have continued. The purpose of this critical review is to: (1) provide an overview of the physiochemical properties, bioavailability, and safety of CrM; (2) describe the data needed to substantiate claims that a “novel form” of creatine is a bioavailable, effective, and safe source of creatine; (3) examine whether other marketed sources of creatine are more effective sources of creatine than CrM; (4) provide an update about the regulatory status of CrM and other purported sources of creatine sold as dietary supplements; and (5) provide guidance regarding the type of research needed to validate that a purported “new form” of creatine is a bioavailable, effective and safe source of creatine for dietary supplements. Based on this analysis, we categorized forms of creatine that are being sold as dietary supplements as either having strong, some, or no evidence of bioavailability and safety. As will be seen, CrM continues to be the only source of creatine that has substantial evidence to support bioavailability, efficacy, and safety. Additionally, CrM is the source of creatine recommended explicitly by professional societies and organizations and approved for use in global markets as a dietary ingredient or food additive.

In-Season Nutrition Strategies and Recovery Modalities to Enhance Recovery for Basketball Players: A Narrative Review

Basketball players face multiple challenges to in-season recovery. The purpose of this article is to review the literature on recovery modalities and nutritional strategies for basketball players and practical applications that can be incorporated throughout the season at various levels of competition. Sleep, protein, carbohydrate, and fluids should be the foundational components emphasized throughout the season for home and away games to promote recovery. Travel, whether by air or bus, poses nutritional and sleep challenges, therefore teams should be strategic about packing snacks and fluid options while on the road. Practitioners should also plan for meals at hotels and during air travel for their players. Basketball players should aim for a minimum of 8 h of sleep per night and be encouraged to get extra sleep during congested schedules since back-to back games, high workloads, and travel may negatively influence night-time sleep. Regular sleep monitoring, education, and feedback may aid in optimizing sleep in basketball players. In addition, incorporating consistent training times may be beneficial to reduce bed and wake time variability. Hydrotherapy, compression garments, and massage may also provide an effective recovery modality to incorporate post-competition. Future research, however, is warranted to understand the influence these modalities have on enhancing recovery in basketball players. Overall, a strategic well-rounded approach, encompassing both nutrition and recovery modality strategies, should be carefully considered and implemented with teams to support basketball players' recovery for training and competition throughout the season.

Resting energy expenditure in elite athletes: development of new predictive equations based on anthropometric variables and bioelectrical impedance analysis derived phase angle

Background

An accurate estimation of athletes’ energy needs is crucial in diet planning to improve sport performance and to maintain an appropriate body composition. This study aimed to develop and validate in elite athletes new equations for estimating resting energy expenditure (REE) based on anthropometric parameters as well as bioimpedance analysis (BIA)-derived raw variables and to validate the accuracy of selected predictive equations.

Methods

Adult elite athletes aged 18–40 yrs were studied. Anthropometry, indirect calorimetry and BIA were performed in all subjects. The new predictive equations were generated using different regression models. The accuracy of the new equations was assessed at the group level (bias) and at the individual level (precision accuracy), and then compared with the one of five equations used in the general population or three athletes-specific formulas.

Results

One-hundred and twenty-six male athletes (age 26.9 ± 9.1 yrs; weight 71.3 ± 10.9 kg; BMI 22.8 ± 2.7 kg/m²) from different sport specialties were randomly assigned to the calibration (n = 75) or validation group (n = 51). REE was directly correlated with individual characteristics, except for age, and raw BIA variables. Most of the equations from the literature were reasonably accurate at the population level (bias within ±5%). The new equations showed a mean bias −0.3% (Eq. A based on anthropometric parameters) and −0.6% (Eq. B based on BIA-derived raw variables). Precision accuracy (individual predicted-measured differences within ±5%) was ~75% in six out of eight of the selected equations and even higher for Eq. A (82.4%) and Eq. B (92.2%).

Conclusion

In elite athletes, BIA-derived phase angle is a significant predictor of REE. The new equations have a very good prediction accuracy at both group and individual levels. The use of phase angle as predictor of REE requires further research with respect to different sport specialties, training programs and training level.

The Personal Food Systems of Pre-Season NCAA Division 1 High-Contact, Low-Contact, and Non-Contact College Athletes

Previous research indicates that dietary habits may differ between athletes of different sports. In this cross-sectional study, we hypothesize meal frequency, food choices, and food preferences will significantly differ between contact types. The participants were athletes (n = 92; men: n = 57, body fat percent (BF%): 14.8 ± 8.4%, body mass index (BMI): 25.5 ± 5.5 kg·m^-2; women: n = 36, BF%: 26.7 ± 7.3%, BMI: 22.3 ± 2.7 kg·m^-2) from high-contact (HCS), low-contact (LCS), and non-contact (NCS) sports. Meal frequency, food preference, and food choice questionnaires assessed factors influencing dietary habits. Dual-energy X-ray absorptiometry (DXA) measured lean body mass, fat mass, and body fat. A GLM multivariate analysis was used with significance accepted at p < 0.05. Significant body composition differences were observed between genders (p < 0.001) and among sports (p < 0.001). Dinner (83.7%), lunch (67.4%), and breakfast (55.4%) were the most frequently eaten meals, followed by evening snack (17.8%), afternoon snack (15.2%), and morning snack (8.7%). Greater preferences for starches were observed for HCS (p = 0.04; η² = 0.07) and for a greater preference for vegetables was found for NCS (p = 0.02; η² = 0.09). Significant differences also existed in the importance of health (p = 0.04; η² = 0.07), weight control (p = 0.05; η² = 0.11), natural content (p = 0.04; η² = 0.07), and price (p = 0.04; η² = 0.07). These results support our hypothesis that food choices and food preferences differ between contact types. This may help sports dieticians create more individualized nutrition programs.

Sensory Perception of an Oral Rehydration Solution during Exercise in the Heat

Prolonged exercise in the heat elicits a number of physiological changes as glycogen stores are low and water and electrolytes are lost through sweat. However, it is unclear whether these changes provoke an increase in liking of saltiness and, therefore, palatability of an oral rehydration solution (ORS). Twenty-seven recreationally active participants (n = 13 males; n = 14 females) completed sensory analysis of an ORS, a traditional sports drink (TS), and a flavored water placebo (PL) at rest and during 60 min (3 × 20-min bouts) of cycling exercise at 70% age-predicted maximum heart rate (HR_max) at 35.3 ± 1.4 °C and 41 ± 6% relative humidity. Before and after every 20 min of exercise, drinks were rated (using 20-mL beverage samples) based on liking of sweetness, liking of saltiness, thirst-quenching ability, and overall liking on a nine-point hedonic scale. Hydration status was assessed by changes in semi-nude body mass, saliva osmolality (S_Osm), and saliva total protein concentration (S_PC). After 60 min of exercise, participants lost 1.36 ± 0.39% (mean ± SD) of body mass and there were increases in S_Osm and S_PC. At all time points, liking of sweetness, saltiness, thirst-quenching ability, and overall liking was higher for the TS and PL compared to the ORS (p < 0.05). However, the saltiness liking and thirst-quenching ability of the ORS increased after 60 min of exercise compared to before exercise (p < 0.05). There was also a change in predictors of overall liking with pre-exercise ratings mostly determined by liking of sweetness, saltiness, and thirst-quenching ability (p < 0.001), whereas only liking of saltiness predicted overall liking post-exercise (R² = 0.751; p < 0.001). There appears to be a hedonic shift during exercise in which the perception of saltiness becomes the most important predictor of overall liking. This finding supports the potential use of an ORS as a valuable means of hydration during the latter stages of prolonged and/or intense exercise in the heat.