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Jeukendrup AE, Areta JL, Van Genechten L, Langan-Evans C, Pedlar CR, Rodas G, Sale C, Walsh NP. Does Relative Energy Deficiency in Sport (REDs) Syndrome Exist? Sports Med 2024:10.1007/s40279-024-02108-y. [PMID: 39287777 DOI: 10.1007/s40279-024-02108-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2024] [Indexed: 09/19/2024]
Abstract
Relative energy deficiency in sport (REDs) is a widely adopted model, originally proposed by an International Olympic Committee (IOC) expert panel in 2014 and recently updated in an IOC 2023 consensus statement. The model describes how low energy availability (LEA) causes a wide range of deleterious health and performance outcomes in athletes. With increasing frequency, sports practitioners are diagnosing athletes with "REDs," or "REDs syndrome," based largely upon symptom presentation. The purpose of this review is not to "debunk" REDs but to challenge dogmas and encourage rigorous scientific processes. We critically discuss the REDs concept and existing empirical evidence available to support the model. The consensus (IOC 2023) is that energy availability, which is at the core of REDs syndrome, is impossible to measure accurately enough in the field, and therefore, the only way to diagnose an athlete with REDs appears to be by studying symptom presentation and risk factors. However, the symptoms are rather generic, and the causes likely multifactorial. Here we discuss that (1) it is very difficult to isolate the effects of LEA from other potential causes of the same symptoms (in the laboratory but even more so in the field); (2) the model is grounded in the idea that one factor causes symptoms rather than a combination of factors adding up to the etiology. For example, the model does not allow for high allostatic load (psychophysiological "wear and tear") to explain the symptoms; (3) the REDs diagnosis is by definition biased because one is trying to prove that the correct diagnosis is REDs, by excluding other potential causes (referred to as differential diagnosis, although a differential diagnosis is supposed to find the cause, not demonstrate that it is a pre-determined cause); (4) observational/cross-sectional studies have typically been short duration (< 7 days) and do not address the long term "problematic LEA," as described in the IOC 2023 consensus statement; and (5) the evidence is not as convincing as it is sometimes believed to be (i.e., many practitioners believe REDs is well established). Very few studies can demonstrate causality between LEA and symptoms, most studies demonstrate associations and there is a worrying number of (narrative) reviews on the topic, relative to original research. Here we suggest that the athlete is best served by an unbiased approach that places health at the center, leaving open all possible explanations for the presented symptoms. Practitioners could use a checklist that addresses eight categories of potential causes and involve the relevant experts if and when needed. The Athlete Health and Readiness Checklist (AHaRC) we introduce here simply consists of tools that have already been developed by various expert/consensus statements to monitor and troubleshoot aspects of athlete health and performance issues. Isolating the purported effects of LEA from the myriad of other potential causes of REDs symptoms is experimentally challenging. This renders the REDs model somewhat immune to falsification and we may never definitively answer the question, "does REDs syndrome exist?" From a practical point of view, it is not necessary to isolate LEA as a cause because all potential areas of health and performance improvement should be identified and tackled.
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Affiliation(s)
- Asker E Jeukendrup
- Loughborough University, Loughborough, UK
- Netherlands Olympic Committee, Arnhem, The Netherlands
| | | | | | | | | | - Gil Rodas
- Medical Department, Futbol Club Barcelona, Barça Innovation Hub, Barcelona, Spain
| | - Craig Sale
- Manchester Metropolitan University, Manchester, UK
| | - Neil P Walsh
- Liverpool John Moores University, Liverpool, UK.
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Wang M, Chee J, Tanaka MJ, Lee YHD. Relative Energy Deficiency in Sport (REDs) and knee injuries: current concepts for female athletes. J ISAKOS 2024; 9:781-787. [PMID: 38795863 DOI: 10.1016/j.jisako.2024.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 05/19/2024] [Accepted: 05/19/2024] [Indexed: 05/28/2024]
Abstract
In athletes, a mismatch between caloric intake and energy expended in exercise can eventually lead to Relative Energy Deficiency in Sport (REDs), where the athlete suffers from physiological derangements and decreased sport performance. The prevalence of REDs is higher in females than males. Females are already at a higher risk of knee injuries, which has been attributed to a multitude of factors such as hormonal influences, differences in musculoskeletal anatomy and neuromuscular control compared to males. The literature demonstrates an even higher risk of knee injuries in female athletes with symptoms of REDs. We propose the various factors that influence this risk. A reduction in anabolic hormones can affect muscle development and tendon repair. A relationship between poor neuromuscular control and knee injury has been established, and this can be further worsened in patients with menstrual dysfunction. Chronic deficiency in nutrients such as collagen and vitamin D can result in poorer recovery from microtrauma in tendons and ligaments. All these factors may contribute to increasing the risk of knee injuries, which may include anterior cruciate ligament tears, patella tendinopathy and patellofemoral pain syndrome. This review aims to educate sports clinicians to have a high index of suspicion when treating knee injuries in females; to screen and then manage for REDs if present, for holistic patient care.
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Affiliation(s)
- Mingchang Wang
- Division of Sports, Shoulder and Elbow Surgery, Department of Orthopaedic Surgery, National University Hospital, NUHS Tower Block, Level 11, 1E Kent Ridge Road, 119288, Singapore.
| | - Jade Chee
- Division of Sports, Shoulder and Elbow Surgery, Department of Orthopaedic Surgery, National University Hospital, NUHS Tower Block, Level 11, 1E Kent Ridge Road, 119288, Singapore
| | - Miho J Tanaka
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, 175 Cambridge Street, Suite 400, Boston, MA, 02114, USA
| | - Yee Han Dave Lee
- Division of Sports, Shoulder and Elbow Surgery, Department of Orthopaedic Surgery, National University Hospital, NUHS Tower Block, Level 11, 1E Kent Ridge Road, 119288, Singapore
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Hiromatsu C, Goto K. Energy Availability and Interstitial Fluid Glucose Changes in Elite Male Japanese Triathletes during Training Camp: A Case Study. Nutrients 2024; 16:2048. [PMID: 38999796 PMCID: PMC11243290 DOI: 10.3390/nu16132048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 06/21/2024] [Accepted: 06/25/2024] [Indexed: 07/14/2024] Open
Abstract
This study explored the impact of varying energy availability (EA) on the 24-h interstitial fluid glucose concentration (IGC) in five elite male Japanese triathletes at a training camp. Measurements of IGC, energy and macronutrient intake, and exercise energy expenditure (EEE) through metabolic equivalents (METs) from training logs were conducted. Three subjects were evaluated over two 4-day periods, and two subjects over one 4-day period. Findings revealed significant correlations of daily mean nocturnal IGC with daily EA (r = 0.553, p = 0.001) and energy intake (EI) (r = 0.595, p < 0.001). However, no significant correlation was found between mean daily nocturnal IGC and EEE (r = -0.278, p = 0.124). Daytime IGC was ≥110 mg/dL for >50% of the time in all subjects, except on 1 day in one subject, and never fell <70 mg/dL. Therefore, daily EA may influence nocturnal IGC in elite male triathletes, although high daytime IGC levels were maintained without hypoglycemia.
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Affiliation(s)
- Chiyori Hiromatsu
- Graduate School of Sports and Health Science, Ritsumeikan University, Shiga 525-8577, Japan
| | - Kazushige Goto
- Graduate School of Sports and Health Science, Ritsumeikan University, Shiga 525-8577, Japan
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Alves Vas FJ, Grijota Pérez FJ, Toro-Román V, Sánchez IB, Maynar Mariño M, Barrientos Vicho G. Changes in the Fatty Acid Profile in Erythrocytes in High-Level Endurance Runners during a Sports Season. Nutrients 2024; 16:1895. [PMID: 38931250 PMCID: PMC11206387 DOI: 10.3390/nu16121895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 06/13/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024] Open
Abstract
Fatty acids (FAs) are an essential component of the erythrocyte membrane, and nutrition and physical exercise are two variables that affect their structure and function. The aim of this study was to evaluate the erythrocyte profile in a group of high-level endurance runners, as well as the changes in different FAs, throughout a sports season in relation to the training performed. A total of 21 high-level male endurance runners (23 ± 4 years; height: 1.76 ± 0.05) were evaluated at four different times throughout a sports season. The athletes had at least 5 years of previous experience and participated in national and international competitions. The determination of the different FAs was carried out by gas chromatography. The runners exhibited low concentrations of docosahexaenoic acid (DHA) and omega-3 index (IND ω-3), as well as high values of stearic acid (SA), palmitic acid (PA), and arachidonic acid (AA), compared to the values of reference throughout the study. In conclusion, training modifies the erythrocyte FA profile in high-level endurance runners, reducing the concentrations of polyunsaturated fatty acids (PUFAs) such as DHA and AA and increasing the concentrations of saturated fatty acids (SFAs) such as SA and the PA. High-level endurance runners should pay special attention to the intake of PUFAs ω-3 in their diet or consider supplementation during training periods to avoid deficiency.
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Affiliation(s)
- Francisco Javier Alves Vas
- Faculty of Education, University Pontificia of Salamanca, 37007 Salamanca, Spain; (F.J.A.V.); (I.B.S.); (G.B.V.)
| | - Fco. Javier Grijota Pérez
- Sport Science Faculty, Department of Physiology, University of Extremadura, 10003 Caceres, Spain;
- Faculty of Health Sciences, Isabel I University, 09003 Burgos, Spain
| | - Víctor Toro-Román
- Research Group in Technology Applied to High Performance and Health, Department of Health Sciences, Universitat Pompeu Fabra, TecnoCampus, 08302 Mataró, Spain
| | - Ignacio Bartolomé Sánchez
- Faculty of Education, University Pontificia of Salamanca, 37007 Salamanca, Spain; (F.J.A.V.); (I.B.S.); (G.B.V.)
| | - Marcos Maynar Mariño
- Sport Science Faculty, Department of Physiology, University of Extremadura, 10003 Caceres, Spain;
| | - Gema Barrientos Vicho
- Faculty of Education, University Pontificia of Salamanca, 37007 Salamanca, Spain; (F.J.A.V.); (I.B.S.); (G.B.V.)
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Zamboni F, Ferrari P, Cazzoletti L, Setti A, Bertoldo F, Dalle Carbonare LG, Danese E, Tardivo S, Crisafulli E, Ferrari M. Bone Mineral Density in Mountain, Road Cyclists and Untrained Controls: Exercise, Diet and Hormones. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2024; 95:423-430. [PMID: 37540285 DOI: 10.1080/02701367.2023.2242417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 06/12/2023] [Indexed: 08/05/2023]
Abstract
Purpose: The aim of the study was to compare bone mineral density (BMD) in the lumbar spine (LSBMD) and the femoral neck (FBMD) in male road cyclists (RC n = 39), mountain cyclists (MC n = 30) and controls (C n = 27) and to determine the factors associated with BMD in the same group of participants. Methods: BMD, fat mass (FM) and fat-free mass (FFM) were measured using DXA. Calcium intake (Cal), exercise energy expenditure (EEE) and energy availability (EA) were assessed using self-reported questionnaires. Samples for circulating hormones were also obtained. VO2max was estimated by a cycloergometric test. Results: After adjustment for body mass, in cyclists LSBMD (RC 0.98 ± 0.12; MC 0.98 ± 0.10 g/cm2) was significantly lower than in C (1.11 ± 0.10; p < .001), while FBMD resulted in no significant difference in cyclists compared to C (p = 0.213). EA (kcal/FFM/day) was different in cyclists and in C (p < .05). In C, EEE and EA were positively associated with LSBMD (R = 0.561, R = 0.656, respectively, p < .01), whereas only EA was associated with FBMD (R = 0.554, p < .05); a positive association between EA and FBMD was found in MC (R = 0.464, p < .05). A negative relationship between VO2max and LSBMD in RC (R = -0.418, p < .05) and a positive one between EEE and LSBMD in MC were found (R = 0.605, p < .001). CaI, free testosterone and cortisol were unrelated to BMD. Conclusion: Both the RC and MC had lower LSBMD than C, whereas no difference was found between the two groups of cyclists. The factors associated with BMD are manifold, vary in relation to the measurement site and are likely different in RC, MC and C.
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Pai NN, Brown RC, Black KE. Risk of low energy availability and nutrition knowledge among female team sport athletes. J Sports Med Phys Fitness 2024; 64:446-454. [PMID: 38305006 DOI: 10.23736/s0022-4707.23.15273-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
BACKGROUND Nutrition knowledge influences adequate dietary intake in athletes. Inadequate dietary intakes can result in low energy availability (LEA) which can lead to relative energy deficiency in sport (RED-S). To date, there is little information on the relationship between nutrition knowledge and the risk of LEA in female team sport athletes. This study investigates if general and sports nutrition knowledge are associated with the risk of LEA in female team athletes. METHODS A cross-sectional design was used. Female athletes (>16 years) who participate in team sports in New Zealand were asked to complete an online questionnaire. The LEA in Females Questionnaire and the Abridged Sport Nutrition Knowledge Questionnaire were included. LEA risk and general/sports nutrition knowledge were assessed. The relationship between LEA risk and knowledge was analyzed using the Kruskal-Wallis Test of independent variables and χ2 tests. RESULTS Among 100 female athletes, 53% were at-risk for LEA, and 70% (N.=67) had poor nutrition knowledge. Athletes who were "at-risk" for LEA and those who were "not at-risk" for LEA did not differ statistically in terms of age (P=0.350) or BMI (P=0.576). Of those "not at risk" 54% had an A-NSK score between 50 and 60% (i.e., average knowledge), whereas 54% of the athletes who were "at risk" for LEA had poor nutrition knowledge. There was no statistical difference between the groups (P=0.273). CONCLUSIONS The poor nutrition knowledge and the high rates of those "at risk" of LEA among team sports athletes indicates the need for more nutrition education in this population.
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Affiliation(s)
- Namratha N Pai
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
- Department of Dietetics and Applied Nutrition, Welcomgroup Graduate School of Hotel Administration, Manipal Academy of Higher Education, Manipal, India
| | - Rachel C Brown
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - Katherine E Black
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand -
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de Souza LC, Moris JM, Lee KM, Fant KH, Gallucci A, Funderburk LK. Dietary Intake and Menstrual Health among Acrobatics and Tumbling NCAA Division I Student-Athletes. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2024; 43:101-109. [PMID: 37307023 DOI: 10.1080/27697061.2023.2218458] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 05/22/2023] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Acrobatics & Tumbling (A&T) is an emerging sport in the National Collegiate Athletic Association that lacks research regarding the dietary intake and health of A&T student-athletes (A&Tsa). This study assessed the dietary intake adequacy, estimated energy availability (EA), self-reported menstrual health, and body composition of A&Tsa. METHODS Twenty-four female A&Tsa participated during week 8 of the preseason (11 top: Age= 20.1 ± 0.9 years; BMI= 22.1 ± 1.7 kg/m2; 13 base: Age= 19.5 ± 1.3 years; BMI= 26.2 ± 2.7 kg/m2). Total energy intake (TEI) and macronutrient intakes were assessed via a paper-based 3-day dietary recall. Resting Metabolic Rate [RMR = 500 + 22 * fat-free mass (FFM)] and energy availability [EA = (TEI - exercise energy expenditure)/FFM)] were estimated; and LEAF-Q assessed menstrual health. Body composition was measured using Dual-Energy X-Ray Absorptiometry. Macronutrient intakes and EA were compared to sports nutrition recommendations (carbohydrate: 6-10 g/kg; protein: 1.2-2.0 g/kg) and the Acceptable Macronutrient Distribution Range (carbohydrate: 45-65%; protein: 10-35%; fat: 20-35%). RESULTS TEI was 1753 ± 467 kcal (top) and 1980 ± 473.8 kcal (base). A total of 20.8% of A&Tsa failed to meet RMR with TEI, with a higher prevalence in the top (-266 ± 219.2 kcal, n = 3) vs. base (-414.3 ± 534.4 kcal, n = 2) A&Tsa. Top and base A&Tsa had both low EA (28.8 ± 13.4 kcals·FFM-1; 23.8 ± 9.5 kcals·FFM-1) and inadequate carbohydrate intake averages (4.2 ± 1.3 g/kg; 3.5 ± 1.1 g/kg, p < 0.001), respectively. A total of 17% of A&Tsa reported secondary amenorrhea, with a higher prevalence in the top (27.3%, n = 3) vs. the base (7.7%, n = 1). CONCLUSION TEI and carbohydrate intake of the majority of A&Tsa were below recommendations. Sports dietitians should encourage and educate A&Tsa about following an adequate diet that meets energy and sports-specific macronutrient needs.
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Affiliation(s)
- Leticia C de Souza
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, Texas, USA
| | - Jose M Moris
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, Texas, USA
| | - Katherine M Lee
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, Texas, USA
| | - Kristin H Fant
- Performance Nutrition (Baylor Athletics), Baylor University, Waco, Texas, USA
| | - Andrew Gallucci
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, Texas, USA
| | - LesLee K Funderburk
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, Texas, USA
- Department of Human Sciences and Design, Baylor University, Waco, Texas, USA
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Lodge MT, Ward-Ritacco CL, Melanson KJ. Considerations of Low Carbohydrate Availability (LCA) to Relative Energy Deficiency in Sport (RED-S) in Female Endurance Athletes: A Narrative Review. Nutrients 2023; 15:4457. [PMID: 37892531 PMCID: PMC10609849 DOI: 10.3390/nu15204457] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/11/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023] Open
Abstract
The purpose of this narrative review is to identify health and performance consequences associated with LCA in female endurance athletes. The intake of carbohydrates (CHO) before, during, and after exercise has been demonstrated to support sport performance, especially endurance activities which rely extensively on CHO as a fuel source. However, low energy availability (LEA) and low carbohydrate availability (LCA) are common in female athletes. LEA occurs when energy intake is insufficient compared to exercise energy expenditure, and LEA-related conditions (e.g., Female Athlete Triad (Triad) and Relative Energy Deficiency in Sport (RED-S)) are associated with a myriad of health and performance consequences. The RED-S model highlights 10 health consequences and 10 performance consequences related to LEA. The independent effect of LCA on health and performance has been under-researched, despite current CHO intake being commonly insufficient in athletes. It is proposed that LCA may not only contribute to LEA but also have independent health and performance consequences in athletes. Furthermore, this review highlights current recommendations for CHO intake, as well as recent data on LCA prevalence and menstrual cycle considerations. A literature review was conducted on PubMed, Science Direct, and ResearchGate using relevant search terms (i.e., "low carbohydrate/energy availability", "female distance runners"). Twenty-one articles were identified and twelve met the inclusion criteria. The total number of articles included in this review is 12, with 7 studies illustrating that LCA was associated with direct negative health and/or performance implications for endurance-based athletes. Several studies included assessed male athletes only, and no studies included a female-only study design. Overall, the cumulative data show that female athletes remain underrepresented in sports science research and that current CHO intake recommendations and strategies may fail to consider female-specific adaptations and hormone responses, such as monthly fluctuations in estrogen and progesterone throughout the menstrual cycle. Current CHO guidelines for female athletes and exercising women need to be audited and explored further in the literature to support female athlete health and performance.
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Affiliation(s)
- Melissa T. Lodge
- Department of Kinesiology, College of Health Sciences, University of Rhode Island, Kingston, RI 02881, USA;
| | - Christie L. Ward-Ritacco
- Department of Kinesiology, College of Health Sciences, University of Rhode Island, Kingston, RI 02881, USA;
| | - Kathleen J. Melanson
- Department of Nutrition, College of Health Sciences, University of Rhode Island, Kingston, RI 02881, USA;
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Haines MS, Kaur S, Scarff G, Lauze M, Gerweck A, Slattery M, Oreskovic NM, Ackerman KE, Tenforde AS, Popp KL, Bouxsein ML, Miller KK, Misra M. Male Runners With Lower Energy Availability Have Impaired Skeletal Integrity Compared to Nonathletes. J Clin Endocrinol Metab 2023; 108:e1063-e1073. [PMID: 37079740 PMCID: PMC10505543 DOI: 10.1210/clinem/dgad215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/19/2022] [Accepted: 04/18/2023] [Indexed: 04/22/2023]
Abstract
CONTEXT Female athletes, particularly runners, with insufficient caloric intake for their energy expenditure [low energy availability (EA) or relative energy deficiency] are at risk for impaired skeletal integrity. Data are lacking in male runners. OBJECTIVE To determine whether male runners at risk for energy deficit have impaired bone mineral density (BMD), microarchitecture, and estimated strength. DESIGN Cross-sectional. SETTING Clinical research center. PARTICIPANTS 39 men (20 runners, 19 controls), ages 16-30 years. MAIN OUTCOME MEASURES Areal BMD (dual-energy x-ray absorptiometry); tibia and radius volumetric BMD and microarchitecture (high-resolution peripheral quantitative computed tomography); failure load (microfinite element analysis); serum testosterone, estradiol, leptin; energy availability. RESULTS Mean age (24.5 ± 3.8 y), lean mass, testosterone, and estradiol levels were similar; body mass index, percent fat mass, leptin, and lumbar spine BMD Z-score (-1.4 ± 0.8 vs -0.8 ± 0.8) lower (P < .05); and calcium intake and running mileage higher (P ≤ .01) in runners vs controls. Runners with EA CONCLUSIONS Despite weight-bearing activity, skeletal integrity is impaired in male runners with lower caloric intake relative to exercise energy expenditure, which may increase bone stress injury risk. Lower estradiol and lean mass are associated with lower tibial strength in runners.
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Affiliation(s)
- Melanie S Haines
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - Snimarjot Kaur
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - Geetanjali Scarff
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Meghan Lauze
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Anu Gerweck
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Meghan Slattery
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Nicolas M Oreskovic
- Harvard Medical School, Boston, MA 02115, USA
- Department of Internal Medicine and Pediatrics, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Kathryn E Ackerman
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02115, USA
- Female Athlete Program, Division of Sports Medicine, Boston Children's Hospital, Boston, MA 02115, USA
| | - Adam S Tenforde
- Harvard Medical School, Boston, MA 02115, USA
- Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Cambridge, MA 02129, USA
| | - Kristin L Popp
- Harvard Medical School, Boston, MA 02115, USA
- Endocrine Unit, Massachusetts General Hospital, Boston, MA 02114, USA
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, USA
- Department of Energy, Oak Ridge Institute for Science and Education, Oak Ridge, TN 37830, USA
| | - Mary L Bouxsein
- Harvard Medical School, Boston, MA 02115, USA
- Endocrine Unit, Massachusetts General Hospital, Boston, MA 02114, USA
- Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
| | - Karen K Miller
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - Madhusmita Misra
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02115, USA
- Division of Pediatric Endocrinology, Massachusetts General Hospital, Boston, MA 02114, USA
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Baranauskas M, Kupčiūnaitė I, Stukas R. Dietary Intake of Protein and Essential Amino Acids for Sustainable Muscle Development in Elite Male Athletes. Nutrients 2023; 15:4003. [PMID: 37764784 PMCID: PMC10535035 DOI: 10.3390/nu15184003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/08/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
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.
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Affiliation(s)
- Marius Baranauskas
- Faculty of Biomedical Sciences, Panevėžys University of Applied Sciences, 35200 Panevėžys, Lithuania;
| | - Ingrida Kupčiūnaitė
- Faculty of Biomedical Sciences, Panevėžys University of Applied Sciences, 35200 Panevėžys, Lithuania;
| | - Rimantas Stukas
- Institute of Health Sciences, Faculty of Medicine, Department of Public Health, Vilnius University, 01513 Vilnius, Lithuania;
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Redinger AL, Allen SMF, Buchanan SR, Black CD, Baker BS. Non-traditional HIIT-style ROTC training elicits positive bone quality and performance adaptations. J Sports Sci 2023; 41:1587-1595. [PMID: 38126323 DOI: 10.1080/02640414.2023.2283998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 11/09/2023] [Indexed: 12/23/2023]
Abstract
Military personnel experience elevated bone injury incidence, partly due to arduous and repetitive training. Non-traditional High-Intensity Interval Training-style (HIIT) may benefit pre-enlisted Reserve Officer Training Corps (ROTC) cadet's musculoskeletal health and performance prior to military service. This study investigated 16 ROTC (n = 12 males; n = 4 females) and 15 physically active sex-, age-, and body mass-matched Controls' musculoskeletal health and performance from November to April. Total body, lumbar spine, and dual- hip dual-energy X-ray absorptiometry scans and 4%, 38%, 66% tibial peripheral quantitative computed tomography scans, blood draws (serum sclerostin and parathyroid hormone), and maximal muscle strength and aerobic capacity testing were completed. From November to April, ROTC improved bone density (DXA) of the dominant total hip and greater trochanter and non-dominant greater trochanter and 38% and 66% tibial total volumetric and cortical bone density (pQCT) similarly or more than Controls (all p ≤ 0.049). From November to April, ROTC also improved bench and leg press, and peak aerobic capacity (all p ≤ 0.013). From November to January, serum sclerostin increased (p ≤ 0.007) and remained elevated through April, while parathyroid hormone was unchanged. HIIT-style training induced positive musculoskeletal adaptations, suggesting it may be an excellent pre-service training modality for this injury prone group.
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Affiliation(s)
- Allen L Redinger
- Musculoskeletal Adaptations to Aging and eXercise (MAAX) Lab, Oklahoma State University, Stillwater, OK, USA
| | - Shawn M F Allen
- Musculoskeletal Adaptations to Aging and eXercise (MAAX) Lab, Oklahoma State University, Stillwater, OK, USA
| | - Samuel R Buchanan
- Department of Health and Human Performance, University of Texas Rio Grande Valley, Edinburg, TX, USA
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, USA
| | - Christopher D Black
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, USA
| | - Breanne S Baker
- Musculoskeletal Adaptations to Aging and eXercise (MAAX) Lab, Oklahoma State University, Stillwater, OK, USA
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, USA
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Toro-Román V, Muñoz A, Zoido A, Sánchez-Alcaraz BJ, Grijota F, Muñoz D. Type of Diet and Sports Supplements in Padel Players According to Level of Competition and Sex. Nutrients 2023; 15:3633. [PMID: 37630822 PMCID: PMC10459596 DOI: 10.3390/nu15163633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023] Open
Abstract
Padel is the world's fastest growing racket sport. However, the analysis of the intake of sports supplements in padel players is scarce. The aim of this research was to analyse and compare the type of diet and the use of sports supplements in padel players according to their competition level and sex. A total of 123 players (94 men and 29 women) participated in the study. Subjects were divided according to their sex and competition level. All participants completed an anonymous questionnaire on diet type and nutritional supplement intake. There were differences found in diet type between competition levels. Regarding players' sex, differences in the number of supplements consumed were reported (p < 0.01). Relationships were found between the number of supplements ingested and the perceived effectiveness of supplements with frequency and time of training (p < 0.05). Creatine in men (≈15%) and vitamin complexes (≈10%) in women were the most used supplements. Lower level padel players do not adapt their diet to the physical demands of padel. Male padel players use a greater number of supplements than female padel players. It is important that nutrition specialists advise players to control diets and supplement.
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Affiliation(s)
- Víctor Toro-Román
- Faculty of Sports Sciences, University of Extremadura, 10003 Caceres, Spain; (V.T.-R.); (D.M.)
| | - Alejandro Muñoz
- Exercise Physiology Group, Exercise and Sport Sciences, Faculty of Health Sciences, Universidad Francisco de Vitoria, 28223 Madrid, Spain;
| | | | | | - Francisco Grijota
- Faculty of Sports Sciences, University of Extremadura, 10003 Caceres, Spain; (V.T.-R.); (D.M.)
| | - Diego Muñoz
- Faculty of Sports Sciences, University of Extremadura, 10003 Caceres, Spain; (V.T.-R.); (D.M.)
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Garron T, Klein DJ. Male Army ROTC Cadets Fail to Meet Military Dietary Reference Intakes and Exhibit a High Prevalence of Low Energy Availability and Poor Sleep Quality. J Funct Morphol Kinesiol 2023; 8:95. [PMID: 37489308 PMCID: PMC10366743 DOI: 10.3390/jfmk8030095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 06/30/2023] [Accepted: 07/04/2023] [Indexed: 07/26/2023] Open
Abstract
The purpose of this study was to assess the dietary habits, prevalence of low energy availability (EA), and sleep quality in a cohort of male army Reserve Officer Training Corps (ROTC) cadets, and to investigate the relationship between EA and sleep quality as well as EA and various body composition variables that are important for tactical readiness. Thirteen male army ROTC cadets (22.2 ± 4.1 yrs; BMI: 26.1 ± 2.3) had their EA and body composition assessed using diet and exercise records alongside bioelectrical impedance analysis. Cadets also completed a validated sleep questionnaire. Sixty-two percent of participants presented with clinically low EA (<30 kcal/kg fat-free mass [FFM]) and none met the optimum EA threshold (≥45 kcal/kg FFM). Dietary analysis indicated that 15%, 23%, 46%, 23%, and 7% of cadets met the Military Dietary Reference Intakes (MDRI) for calories, carbohydrates, protein, fat, and fiber, respectively. Additionally, 85% of cadets exhibited poor sleep quality. Significant associations between EA and fat mass/percent body fat were shown (p < 0.05). There was, however, no statistically significant correlation between EA and sleep quality. The present study found a high prevalence of low EA and sleep disturbance among male army ROTC cadets and that many were unable to meet the MDRIs for energy and macronutrient intake. Further, low EA was associated with higher percent body fat and fat mass but not sleep quality.
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Affiliation(s)
- Taylor Garron
- Department of Health and Exercise Science, Rowan University, Glassboro, NJ 08028, USA
| | - Dylan J Klein
- Department of Health and Exercise Science, Rowan University, Glassboro, NJ 08028, USA
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14
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Klein DJ, McClain P, Montemorano V, Santacroce A. Pre-Season Nutritional Intake and Prevalence of Low Energy Availability in NCAA Division III Collegiate Swimmers. Nutrients 2023; 15:2827. [PMID: 37447154 DOI: 10.3390/nu15132827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/03/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
There is limited information regarding the dietary habits and energy availability (EA) of collegiate athletes. Therefore, the purpose of the present study is to assess the nutrient intakes, dietary habits, and prevalence of low EA (<30 kcals/kg FFM) in a group of National Collegiate Athletic Association (NCAA) Division III male and female swimmers. Energy and nutrient intake, body composition, and exercise energy expenditure was assessed in 30 (n = 15 males, n = 15 females) NCAA Division III swimmers during pre-season using three-day diet and seven-day activity records alongside multi-frequency, bioelectric impedance analysis. A validated screening tool was used to assess for low EA in the female swimmers. Mean EA in male and female athletes was 32.7 ± 12 and 34.9 ± 13.7 kcals/kg FFM, respectively, and was not significantly different between the sexes (p = 0.65). Twenty percent of swimmers (n = 3 males, n = 3 females) presented with optimal EA, 37% (n = 5 males, n = 6 females) presented with sub-optimal EA, and 43% (n = 7 males, n = 6 females) presented with low EA. Swimmers who presented with a low EA consumed significantly less calories, carbohydrates, and proteins than non-low EA swimmers (p < 0.02). The validated screening tool failed to classify 50% of female swimmers who presented with low EA. Only eight athletes achieved the USDA MyPlate recommendation for fruits, whereas three athletes achieved the recommendation for vegetables, with no differences between the sexes (p > 0.05). The present findings show that there was a high prevalence of low EA during the pre-season among male and female collegiate swimmers that was not fully captured using a validated screening tool for females. Low EA occurred alongside lower intakes of calories, carbohydrates, and proteins, and the majority of swimmers did not meet the United States Department of Agriculture recommendations for fruit and vegetable intake. These data stress the need for improved dietary intakes in NCAA Division III collegiate swimmers.
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Affiliation(s)
- Dylan J Klein
- Department of Health and Exercise Science, Rowan University, Glassboro, NJ 08028, USA
| | - Patrick McClain
- Department of Health and Exercise Science, Rowan University, Glassboro, NJ 08028, USA
| | - Victoria Montemorano
- Department of Health and Exercise Science, Rowan University, Glassboro, NJ 08028, USA
| | - Alaina Santacroce
- Department of Health and Exercise Science, Rowan University, Glassboro, NJ 08028, USA
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Fredericson M, Roche M, Barrack MT, Tenforde A, Sainani K, Kraus E, Kussman A, Miller Olson E, Kim BY, Fahy K, Miller E, Diamond E, Meraz S, Singh S, Nattiv A. Healthy Runner Project: a 7-year, multisite nutrition education intervention to reduce bone stress injury incidence in collegiate distance runners. BMJ Open Sport Exerc Med 2023; 9:e001545. [PMID: 37180969 PMCID: PMC10174024 DOI: 10.1136/bmjsem-2023-001545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2023] [Indexed: 05/16/2023] Open
Abstract
Objectives We evaluated the effect of a nutrition education intervention on bone stress injury (BSI) incidence among female distance runners at two NCAA Division I institutions. Methods Historical BSI rates were measured retrospectively (2010-2013); runners were then followed prospectively in pilot (2013-2016) and intervention (2016-2020) phases. The primary aim was to compare BSI rates in the historical and intervention phases. Pilot phase data are included only for descriptive purposes. The intervention comprised team nutrition presentations focused on optimising energy availability plus individualised nutrition sessions for runners with elevated Female Athlete Triad risk. Annual BSI rates were calculated using a generalised estimating equation Poisson regression model adjusted for age and institution. Post hoc analyses were stratified by institution and BSI type (trabecular-rich or cortical-rich). Results The historical phase included 56 runners and 90.2 person-years; the intervention phase included 78 runners and 137.3 person-years. Overall BSI rates were not reduced from the historical (0.52 events per person-year) to the intervention (0.43 events per person-year) phase. Post hoc analyses demonstrated trabecular-rich BSI rates dropped significantly from 0.18 to 0.10 events per person-year from the historical to intervention phase (p=0.047). There was a significant interaction between phase and institution (p=0.009). At Institution 1, the overall BSI rate dropped from 0.63 to 0.27 events per person-year from the historical to intervention phase (p=0.041), whereas no decline was observed at Institution 2. Conclusion Our findings suggest that a nutrition intervention emphasising energy availability may preferentially impact trabecular-rich BSI and depend on team environment, culture and resources.
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Affiliation(s)
- Michael Fredericson
- Department of Orthopaedic Surgery, Division of Physical Medicine & Rehabilitation, Stanford University, Stanford, California, USA
| | - Megan Roche
- Department of Epidemiology, Stanford Hospital and Clinics, Stanford, California, USA
| | - Michelle T Barrack
- Department of Family and Consumer Sciences, California State University Long Beach, Long Beach, California, USA
| | - Adam Tenforde
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA
| | - Kristin Sainani
- Department of Epidemiology and Population Health, Stanford University, Stanford, California, USA
| | - Emily Kraus
- Department of Orthopaedic Surgery, Stanford Hospital and Clinics, Stanford, California, USA
| | - Andrea Kussman
- Department of Orthopaedic Surgery, Stanford Hospital and Clinics, Stanford, California, USA
| | | | - Brian Young Kim
- Family Medicine, University of California, Los Angeles, Santa Monica, California, USA
| | - Katherine Fahy
- Department of Family Medicine, University of Washington Medical Center, Seattle, Washington, USA
| | - Emily Miller
- Family Medicine, University of California, Los Angeles, Santa Monica, California, USA
| | - Ellie Diamond
- Department of Orthopaedic Surgery, Stanford University, Stanford, California, USA
| | - Sonya Meraz
- School of Nursing, University of Massachusetts System, Boston, Massachusetts, USA
| | - Sonal Singh
- School of Medicine, St George’s University, St George’s, Grenada
| | - Aurelia Nattiv
- Division of Sports Medicine, Departments of Family Medicine and Orthopaedic Surgery, University of California, Los Angeles, Los Angeles, California, USA
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Marzuki MIH, Mohamad MI, Chai WJ, Farah NMF, Safii NS, Jasme JK, Jamil NA. Prevalence of Relative Energy Deficiency in Sport (RED-S) among National Athletes in Malaysia. Nutrients 2023; 15:nu15071697. [PMID: 37049534 PMCID: PMC10096906 DOI: 10.3390/nu15071697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/14/2023] [Accepted: 03/29/2023] [Indexed: 04/03/2023] Open
Abstract
Relative energy deficiency in sport (RED-S), which underpins the concept of low energy availability (LEA), can negatively affect athletes’ health and performance. This study aims to investigate the prevalence of RED-S among national athletes in Malaysia. A total of 192 national athletes (97 males, 18–39 years old) responded to an online survey regarding the RED-S risk. Most athletes (67.2%) were classified as having a medium/high RED-S risk. Female (41.2%), weight-class (23.9%), and intermittent sports (20.3%) had the highest prevalence of medium/high RED-S risk. Overall, most athletes spent 2–5 h daily (55.2%) and 6–7 days weekly (53.6%) practicing or playing their sport, and 47.9% reported feeling tired recently. The athletes were also terrified of being overweight (61.5%), worried about what they eat (64.7%), concerned about having fat on their bodies (62.6%), and thinking about burning calories while exercising (69.3%). Only 16.7% of the athletes had a prior history of stress fractures, and 40.6% continued to participate in activities 6–7 days per week while injured. The majority of female athletes (88.3%) had regular menstrual cycles. These findings support the notion that RED-S screening should be addressed in the athletic community. Future research is needed to clinically assess these athletes and investigate the impacts of RED-S on their health and sports performance.
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Affiliation(s)
- Muhammad Irfan Haiqal Marzuki
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
| | - Mohd Izham Mohamad
- Sports Nutrition Centre, National Sports Institute of Malaysia, Bukit Jalil, Kuala Lumpur 57000, Malaysia
| | - Wen Jin Chai
- Sports Nutrition Centre, National Sports Institute of Malaysia, Bukit Jalil, Kuala Lumpur 57000, Malaysia
| | - Nor M. F. Farah
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
| | - Nik Shanita Safii
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
| | - Jasmiza Khuzairi Jasme
- Sports Medicine Centre, National Sports Institute of Malaysia, Bukit Jalil, Kuala Lumpur 57000, Malaysia
| | - Nor Aini Jamil
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
- Correspondence:
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Kapoor MP, Sugita M, Kawaguchi M, Timm D, Kawamura A, Abe A, Okubo T. Influence of iron supplementation on fatigue, mood states and sweating profiles of healthy non-anemic athletes during a training exercise: A double-blind, randomized, placebo-controlled, parallel-group study. Contemp Clin Trials Commun 2023; 32:101084. [PMID: 36817736 PMCID: PMC9932653 DOI: 10.1016/j.conctc.2023.101084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 01/24/2023] [Accepted: 01/29/2023] [Indexed: 02/05/2023] Open
Abstract
Iron is specifically important to athletes, and attention has grown to the association between sports performance and iron regulation in the daily diets of athletes. The study presents new insights into stress, mood states, fatigue, and sweating behavior among the non-anemic athletes with sweating exercise habits who consumed a routine low dose (3.6 mg/day) of iron supplementation. In this double-blind, randomized, placebo-controlled, parallel-group study, both non-anemic male (N = 51) and female (N = 42) athletes were supplemented either with a known highly bioavailable iron formulation (SunActive® Fe) or placebo during the follow-up training exercise period over four weeks at their respective designated clinical sites. The effect of oral iron consumption was examined on fatigue, stress profiles, as well as the quality of life using the profile of mood state (POMS) test or a visual analog scale (VAS) questionnaire, followed by an exercise and well-being related fatigue-sweat. Also, their monotonic association with stress biomarkers (salivary α-amylase, salivary cortisol, and salivary immunoglobulin A) were determined using spearman's rank correlation coefficient test. Repeated measure multivariate analysis of variance (group by time) revealed that the total mood disturbance (TMD) score was significantly lower (P = 0.016; F = 6.26) between placebo and iron supplementation groups over the four weeks study period among female athletes. Also, a significant reduction in tired feeling/exhaustion after the exercise (P = 0.05; F = 4.07) between the placebo and iron intake groups was noticed. A significant within-group reduction (P ≤ 0.05) was noticed in the degree of sweat among both male and female athletes after 2 and 4 weeks of iron supplementation, while athletes of the placebo intake group experienced a non-significant within-group reduction in the degree of sweat. Overall, the result indicates routine use of low dose (3.6 mg/day) iron supplementation is beneficial for non-anemic endurance athletes to improve stress, mood states, subjective fatigue, and sweating conditions.
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Affiliation(s)
- Mahendra P. Kapoor
- Taiyo Kagaku Co., Ltd., Research & Development, Nutrition Division, 1-3 Takaramachi, Yokkaichi, Mie, 510-0844, Japan,Corresponding author.
| | - Masaaki Sugita
- Nippon Sport Science University, Faculty of Sport Science, 7-1-1 Fukusawa, Setagaya-Ku, Tokyo, 158 8508, Japan
| | - Mikiko Kawaguchi
- Otsuma Women's University, Faculty of Home Economics, Department of Food Science, 12 Sanbancho, Chiyoda, Tokyo, 102-8357, Japan
| | - Derek Timm
- Taiyo International Inc, 5960 Golden Hills Dr., Minneapolis, MN, 55416, USA
| | - Aki Kawamura
- Nippon Sport Science University, Faculty of Sport Science, 7-1-1 Fukusawa, Setagaya-Ku, Tokyo, 158 8508, Japan
| | - Aya Abe
- Taiyo Kagaku Co., Ltd., Research & Development, Nutrition Division, 1-3 Takaramachi, Yokkaichi, Mie, 510-0844, Japan
| | - Tsutomu Okubo
- Taiyo Kagaku Co., Ltd., Research & Development, Nutrition Division, 1-3 Takaramachi, Yokkaichi, Mie, 510-0844, Japan
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18
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Coffey AB, Alai NL, Gray VB, Cotter JA, Barrack MT. Nutrition Education Curriculum Promotes Adolescent Runners' Self-Efficacy, Knowledge, and Intake of Nutrient-Rich Carbohydrate Foods. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2023; 42:178-186. [PMID: 35512779 DOI: 10.1080/07315724.2021.2019139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Endurance runners exhibit an elevated prevalence of low bone mass and characteristics consistent with undernourishment. OBJECTIVE This quasi-experimental, pretest-posttest design study evaluated the efficacy of a 4-week nutrition education curriculum to optimize nutrition knowledge, self-efficacy, and the intake of nutrient-rich carbohydrate foods. METHODS Forty-eight adolescent endurance runners, age 15.7 ± 1.2 y, from two high schools in Southern California were recruited to complete four, weekly lessons addressing the quantity, quality, and timing of carbohydrate intake. Differences in pre- compared to post-intervention nutrition knowledge and self-efficacy to consume nutrient-rich carbohydrate foods were evaluated using paired samples t-tests. Qualitative coding of open-response questions explored changes in food intake behaviors reported by runners during the intervention. RESULTS The percent of nutrition knowledge questions answered correctly increased after Lessons 1 and 2 (59.0% ± 20.0% pre- vs. 81.9% ± 22.8% post-Lesson 1; 44.7% ± 13.7% pre- vs. 74.5% ± 17.4% post-Lesson 2, P<.001) and the number of identified nutrient-rich carbohydrate foods (8.7 ± 2.7 vs. 12.4 ± 2.3, P < 0.001). Self-efficacy scores improved after all lessons (P<.001). After Lesson 2, 84% (n = 27/32) of runners increased the carbohydrate included in a snack or meal; after Lesson 4, 85% (n = 29/34) added a post-exercise snack. Frequent themes identified from questions addressing dietary changes included increasing quantity and quality of carbohydrates in snacks and meals and being more aware of food choices.Conclusions: Findings suggest that the curriculum enhanced nutrition knowledge, self-efficacy, and dietary behaviors related to intake of nutrient-dense carbohydrate foods in adolescent runners.
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Affiliation(s)
- Alaina B Coffey
- Department of Family and Consumer Sciences, California State University Long Beach, Long Beach, California, USA
| | - Nicole L Alai
- Department of Family and Consumer Sciences, California State University Long Beach, Long Beach, California, USA
| | - Virginia B Gray
- Department of Family and Consumer Sciences, California State University Long Beach, Long Beach, California, USA
| | - Joshua A Cotter
- Department of Kinesiology, California State University Long Beach, Long Beach, California, USA
| | - Michelle T Barrack
- Department of Family and Consumer Sciences, California State University Long Beach, Long Beach, California, USA
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Brimacomb OE, Martinez MP, McCormack WP, Almstedt HC. A 2-Year Longitudinal Study of Bone Mineral Density in Collegiate Distance Runners. J Strength Cond Res 2023:00124278-990000000-00204. [PMID: 36727720 DOI: 10.1519/jsc.0000000000004449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
ABSTRACT Brimacomb, OE, Martinez, MP, McCormack, WP, and Almstedt, HC. A 2-year longitudinal study of bone mineral density in collegiate distance runners. J Strength Cond Res XX(X): 000-000, 2022-The purpose of this investigation was to examine changes in bone mineral density (BMD) of male and female collegiate distance runners over 2 years. Bone mineral density of 29 collegiate distance runners (16 men and 13 women) were measured 5 times over 24 months using dual-energy x-ray absorptiometry (DXA) at the anterior-posterior (AP) and lateral (LAT) spine, femoral neck (FN), total hip (TH), whole body (WB), and ultradistal (UD) forearm. Repeated-measures multivariate analysis of covariance, with bone-free lean mass (BFLM) as covariate, was used to compare mean BMD values. Adjusted for BFLM, there were no significant differences (p > 0.05) in BMD at any site between sexes. There were no significant differences at the AP or LAT spine, FN, or WB between visit 1 and 5 for either sex. There was a significant increase in BMD (p = 0.044) at the UD forearm over 2 years in males. However, 56% of the men (n = 9) had a Z-score < -1.0 at the UD forearm. Seven of 11 women had Z-scores < -1.0 at the LAT spine and 4 of 13 had Z-scores < -1.0 at the AP spine. There were no significant changes in BMD at any site over the 2-year time frame, except a significant increase in BMD at the nondominant forearm in men. The spine appears to be an area of concern for women in this study when examining Z-score results. Coaches and medical staff need to continually educate collegiate endurance athletes about the importance of achieving and maintaining BMD through their college years.
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Affiliation(s)
- Olivia E Brimacomb
- Department of Health and Human Sciences, Loyola Marymount University, Frank R. Seaver College of Science and Engineering, Los Angeles, California
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20
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Kojima C, Ishibashi A, Ebi K, Goto K. Exogenous glucose oxidation during endurance exercise under low energy availability. PLoS One 2022; 17:e0276002. [PMID: 36223366 PMCID: PMC9555626 DOI: 10.1371/journal.pone.0276002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 09/27/2022] [Indexed: 11/07/2022] Open
Abstract
The present study was conducted to determine the effect of endurance exercise under low energy availability (EA) on exogenous glucose oxidation during endurance exercise. Ten active males (21.4 ± 0.6 years, 170.4 ± 1.4 cm, 62.4 ± 1.5 kg, 21.5 ± 0.4 kg/m2) completed two trials, consisting of two consecutive days (days 1 and 2) of endurance training under low EA (19.9 ± 0.2 kcal/kg fat free mass [FFM]/day, LEA trial) or normal EA (46.4 ± 0.1 kcal/kg FFM/day, NEA trial). The order of these two trials was randomized with at least a 1-week interval between trials. As an endurance training, participants performed 60 min of treadmill running at 70% of maximal oxygen uptake ( V˙O2max) during two consecutive days (on days 1 and 2). On day 1, the endurance training was performed with consumed individually manipulated meals. During the endurance exercise on day 2, exogenous glucose oxidation was evaluated using 13C-labeled glucose, and respiratory gas samples were collected. In addition, blood glucose and lactate concentrations were measured immediately after exercise on day 2. Body composition, blood parameters, and resting respiratory gas variables were evaluated under overnight fasting on days 1 and 2. Body weight was significantly reduced in the LEA trial on day2 (day1: 61.8 ± 1.4 kg, day 2: 61.3 ± 1.4 kg, P < 0.001). There were no significant differences between trials in 13C excretion (P = 0.33) and area under the curve during the 60 min of exercise (LEA trial: 40.4 ± 3.1 mmol•60min, NEA trial: 40.4 ± 3.1 mmol•60min, P = 0.99). However, the respiratory exchange ratio (RER, LEA trial: 0.88 ± 0.01, NEA trial: 0.90 ± 0.01) and carbohydrate oxidation (LEA trial: 120.1 ± 8.8 g, NEA trial: 136.8 ± 8.6 g) during endurance exercise showed significantly lower values in the LEA trial than in the NEA trial (P = 0.01 for RER and carbohydrate oxidation). Serum insulin and total ketone body concentrations were significantly changed after a day of endurance training under low EA (P = 0.04 for insulin, P < 0.01 for total ketone). In conclusion, low EA during endurance exercise reduced systemic carbohydrate oxidation; however, exogenous glucose oxidation (evaluated by 13C excretion) remained unchanged during exercise under low EA.
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Affiliation(s)
- Chihiro Kojima
- Japan Institute of Sports Sciences, Nishigaoka, Kitaku, Tokyo, Japan
| | - Aya Ishibashi
- Department of Life Science, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
| | - Kumiko Ebi
- Graduate School of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan
| | - Kazushige Goto
- Graduate School of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan
- * E-mail:
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21
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Energy Availability Over One Athletic Season: An Observational Study Among Athletes From Different Sports. Int J Sport Nutr Exerc Metab 2022; 32:479-490. [PMID: 35894910 DOI: 10.1123/ijsnem.2022-0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 05/09/2022] [Accepted: 05/18/2022] [Indexed: 11/18/2022]
Abstract
During the athletic season, changes in body composition occur due to fluctuations in energy expenditure and energy intake. Literature regarding changes of energy availability (EA) is still scarce. The aim was to estimate EA of athletes from nonweight and weight-sensitive sports during the athletic season (i.e., preparatory and competitive phase). Eighty-eight athletes (19.1 ± 4.2 years, 21.8 ± 2.0 kg/m2, 27% females, self-reported eumenorrheic) from five sports (basketball [n = 29]; handball [n = 7]; volleyball [n = 9]; swimming [n = 18]; and triathlon [n = 25]) were included in this observational study. Energy intake and exercise energy expenditure were measured through doubly labeled water (over 7 days and considering neutral energy balance) and metabolic equivalents of tasks, respectively. Fat-free mass (FFM) was assessed through a four-compartment model. EA was calculated as EA = (energy intake - exercise energy expenditure)/FFM. Linear mixed models, adjusted for sex, were performed to assess EA for the impact of time by sport interaction. Among all sports, EA increased over the season: basketball, estimated mean (SE): 7.2 (1.5) kcal/kg FFM, p < .001; handball, 14.8 (2.9) kcal/kg FFM, p < .001; volleyball, 7.9 (2.8) kcal/kg FFM, p = .006; swimming, 8.7 (2.0) kcal/kg FFM, p < .001; and triathlon, 9.6 (2.0) kcal/kg FFM, p < .001. Eleven athletes (12.5%) had clinical low EA at the preparatory phase and none during the competitive phase. During both assessments, triathletes' EA was below optimal, being lower than basketballers (p < .001), volleyballers (p < .05), and swimmers (p < .001). Although EA increased in all sports, triathlon's EA was below optimal during both assessments. Risk of low EA might be seasonal and resolved throughout the season, with higher risk during the preparatory phase. However, in weight-sensitive sports, namely triathlon, low EA is still present.
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22
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Fahrenholtz IL, Melin AK, Wasserfurth P, Stenling A, Logue D, Garthe I, Koehler K, Gräfnings M, Lichtenstein MB, Madigan S, Torstveit MK. Risk of Low Energy Availability, Disordered Eating, Exercise Addiction, and Food Intolerances in Female Endurance Athletes. Front Sports Act Living 2022; 4:869594. [PMID: 35592590 PMCID: PMC9110838 DOI: 10.3389/fspor.2022.869594] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/04/2022] [Indexed: 11/13/2022] Open
Abstract
Relative energy deficiency in sport (RED-S) is a complex syndrome describing health and performance consequences of low energy availability (LEA) and is common among female endurance athletes. Various underlying causes of LEA have been reported, including disordered eating behavior (DE), but studies investigating the association with exercise addiction and food intolerances are lacking. Therefore, the aim of this cross-sectional study was to investigate the association between DE, exercise addiction and food intolerances in athletes at risk of LEA compared to those with low risk. Female endurance athletes, 18-35 years, training ≥5 times/week were recruited in Norway, Sweden, Ireland, and Germany. Participants completed an online-survey comprising the LEA in Females Questionnaire (LEAF-Q), Exercise Addiction Inventory (EAI), Eating Disorder Examination Questionnaire (EDE-Q), and questions regarding food intolerances. Of the 202 participants who met the inclusion criteria and completed the online survey, 65% were at risk of LEA, 23% were at risk of exercise addiction, and 21% had DE. Athletes at risk of LEA had higher EDE-Q and EAI scores compared to athletes with low risk. EAI score remained higher in athletes with risk of LEA after excluding athletes with DE. Athletes at risk of LEA did not report more food intolerances (17 vs. 10%, P = 0.198), but were more frequently reported by athletes with DE (28 vs. 11%, P = 0.004). In conclusion, these athletes had a high risk of LEA, exercise addiction, and DE. Exercise addiction should be considered as an additional risk factor in the prevention, early detection, and targeted treatment of RED-S among female endurance athletes.
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Affiliation(s)
- Ida Lysdahl Fahrenholtz
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
| | | | - Paulina Wasserfurth
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Andreas Stenling
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
- Department of Psychology, Umeå University, Umeå, Sweden
| | - Danielle Logue
- Sport Ireland Institute, National Sports Campus, Dublin, Ireland
| | - Ina Garthe
- The Norwegian Olympic and Paralympic Committee and Confederation of Sport, Oslo, Norway
| | - Karsten Koehler
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Maria Gräfnings
- Department of Medical Science, Dalarna University, Falun, Sweden
| | - Mia Beck Lichtenstein
- Centre for Telepsychiatry, Mental Health Services in the Region of Southern Denmark, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Sharon Madigan
- Sport Ireland Institute, National Sports Campus, Dublin, Ireland
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Jagim AR, Fields J, Magee MK, Kerksick CM, Jones MT. Contributing Factors to Low Energy Availability in Female Athletes: A Narrative Review of Energy Availability, Training Demands, Nutrition Barriers, Body Image, and Disordered Eating. Nutrients 2022; 14:986. [PMID: 35267961 PMCID: PMC8912784 DOI: 10.3390/nu14050986] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 12/28/2022] Open
Abstract
Relative Energy Deficiency in sport is experiencing remarkable popularity of late, particularly among female athletes. This condition is underpinned by low energy availability, which is a byproduct of high energy expenditure, inadequate energy intake, or a combination of the two. Several contributing factors exist that may predispose an athlete to low energy availability, and therefore a holistic and comprehensive assessment may be required to identify the root causes. The focus of the current narrative review is to discuss the primary contributing factors as well as known risk factors for low energy availability among female athletes to help practitioners increase awareness on the topic and identify future areas of focus.
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Affiliation(s)
- Andrew R. Jagim
- Sports Medicine, Mayo Clinic Health System, La Crosse, WI 54601, USA
- Exercise & Sport Science Department, University of Wisconsin-La Crosse, La Crosse, WI 54601, USA
- Patriot Performance Laboratory, Frank Pettrone Center for Sports Performance, Intercollegiate Athletics, George Mason University, Fairfax, VA 22030, USA; (J.F.); (M.K.M.); (M.T.J.)
| | - Jennifer Fields
- Patriot Performance Laboratory, Frank Pettrone Center for Sports Performance, Intercollegiate Athletics, George Mason University, Fairfax, VA 22030, USA; (J.F.); (M.K.M.); (M.T.J.)
- Exercise Science and Athletic Training, Springfield College, Springfield, MA 01109, USA
| | - Meghan K. Magee
- Patriot Performance Laboratory, Frank Pettrone Center for Sports Performance, Intercollegiate Athletics, George Mason University, Fairfax, VA 22030, USA; (J.F.); (M.K.M.); (M.T.J.)
- Sport, Recreation, and Tourism Management, George Mason University, Manassas, VA 22030, USA
| | - Chad M. Kerksick
- Exercise & Performance Nutrition Laboratory, Lindenwood University, St. Charles, MO 63301, USA;
| | - Margaret T. Jones
- Patriot Performance Laboratory, Frank Pettrone Center for Sports Performance, Intercollegiate Athletics, George Mason University, Fairfax, VA 22030, USA; (J.F.); (M.K.M.); (M.T.J.)
- Sport, Recreation, and Tourism Management, George Mason University, Manassas, VA 22030, USA
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Carbuhn AF, Yu D, Magee LM, McCulloch PC, Lambert BS. Anthropometric Factors Associated With Bone Stress Injuries in Collegiate Distance Runners: New Risk Metrics and Screening Tools? Orthop J Sports Med 2022; 10:23259671211070308. [PMID: 35178462 PMCID: PMC8844446 DOI: 10.1177/23259671211070308] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 10/04/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Lower limb bone stress injury (BSI) of the pelvis, femur, and tibia is prevalent in collegiate track and field distance runners. Bone mineral density (BMD), body composition (BComp), and anthropometric parameters before initial collegiate injury have not been compared between runners with BSI and their noninjured counterparts. PURPOSE To characterize bone health in relation to BComp and anthropometric measurements from total-body dual x-ray absorptiometry (DXA) scans in collegiate male and female distance runners before BSI and develop BMD prediction models. STUDY DESIGN Case-control study; Level of evidence, 3. METHODS Distance runners (N = 79) from a single university track and field team were retrospectively enrolled into this study. The runners completed a DXA scan during the fall season (August-November) and participated in sport activities before the scan. Three months after scanning, electronic medical records were reviewed for the occurrence of BSI. An independent-sample t test was used to compare BMD (total and regional [spine, pelvis, and legs]), BComp (% body fat, fat mass, and lean mass), and anthropometric measurements (shoulder width and leg, arm, and trunk length) between runners with versus without BSI (included subgroup analysis by sex). Multiple linear regression with stepwise removal was used to determine variables most predictive of BMD. RESULTS Of the 79 enrolled participants (42 male, 37 female), 18 runners (22.8%; 11 female, 7 male) sustained a lower limb BSI. Compared with the noninjured group, injured runners had lower total and regional BMD (P < .001 for all) and shorter leg and arm lengths (P < .05 for both), whereas injured male runners had lower fat mass and injured female runners had lower lean mass in the legs (P < .05 for both). Injured runners' age-matched total BMD Z score (-0.1 ± 0.6) was considered clinically normal. BComp and anthropometric measures were predictive of total and regional BMD (P < .05; R 2 = 0.64-0.80; percentage error = 3.8%-4.8%). CONCLUSION The DXA scans of injured runners prior to incidence indicated lower BMD compared with noninjured runners. Shorter limb lengths, lower fat mass (male), and lower leg lean mass (female) may also be indicative of risk. Certain BComp and anthropometric measures were predictive of BMD.
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Affiliation(s)
- Aaron F. Carbuhn
- Department of Dietetics and Nutrition, University of Kansas Medical
Center, Kansas City, Kansas, USA
| | - Daniel Yu
- Department of Dietetics and Nutrition, University of Kansas Medical
Center, Kansas City, Kansas, USA
- Kansas Team Health, Kansas Athletics Inc, Lawrence, Kansas,
USA
| | | | - Patrick C. McCulloch
- Department of Orthopedics and Sports Medicine, Houston Methodist
Hospital, Houston, Texas, USA
| | - Bradley S. Lambert
- Department of Orthopedics and Sports Medicine, Houston Methodist
Hospital, Houston, Texas, USA
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Kinoshita N, Uchiyama E, Ishikawa-Takata K, Yamada Y, Okuyama K. Association of energy availability with resting metabolic rates in competitive female teenage runners: a cross-sectional study. J Int Soc Sports Nutr 2021; 18:70. [PMID: 34784926 PMCID: PMC8594218 DOI: 10.1186/s12970-021-00466-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 10/11/2021] [Indexed: 11/10/2022] Open
Abstract
Background Resting metabolic rate (RMR) has been examined as a proxy for low energy availability (EA). Previous studies have been limited to adult athletes, despite the serious health consequences of low EA, particularly during adolescence. This study aimed to explore the relationship between RMR and EA in competitive teenage girl runners. Methods Eighteen girl runners (mean ± standard-deviation; age, 16.8 ± 0.9 years; body mass, 45.6 ± 5.2 kg, %fat, 13.5 ± 4.2 %) in the same competitive high-school team were evaluated. Each runner was asked to report dietary records with photos and training logs for seven days. Energy intake (EI) was assessed by Registered Dietitian Nutritionists. The runners were evaluated on a treadmill with an indirect calorimeter to yield individual prediction equations for oxygen consumption using running velocity and heart rate (HR). Exercise energy expenditure (EEE) was calculated by the equations based on training logs and HR. Daily EA was calculated by subtracting EEE from EI. The daily means of these variables were calculated. RMR was measured early in the morning by whole-room calorimetry after overnight sleep on concluding the final day of the seven-day assessment. The ratio of measured RMR to predicted RMR (RMR ratio) was calculated by race, age, sex-specific formulae, and Cunningham’s equation. Body composition was measured using dual-energy X-ray absorptiometry. Bivariate correlation analyses were used to examine the relationship between variables. Results RMR, EI, EEE, and EA were 26.9 ± 2.4, 56.8 ± 15.2, 21.7 ± 5.9, and 35.0 ± 15.0 kcal⋅kg−1 FFM⋅d−1, respectively. RMR reduced linearly with statistical significance, while EA decreased to a threshold level (30 kcal⋅kg−1 FFM⋅d−1) (r= 0.58, p= 0.048). Further reduction in RMR was not observed when EA fell below the threshold. There was no significant correlation between RMR ratios and EA, irrespective of the prediction formulae used. Conclusions These results suggest that RMR does not reduce with a decrease in EA among highly competitive and lean teenage girl runners. RMR remains disproportionally higher than expected in low EA states. Free-living teenage girl runners with low EA should be cautiously identified using RMR as a proxy for EA change.
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Affiliation(s)
- Norimitsu Kinoshita
- Faculty of Sports and Health Studies, Hosei University, 4342 Aihara, Tokyo, 194-0298, Machida, Japan.
| | - Eriko Uchiyama
- Faculty of Sports and Health Studies, Hosei University, 4342 Aihara, Tokyo, 194-0298, Machida, Japan
| | - Kazuko Ishikawa-Takata
- Health and Nutrition, National Institutes of Biomedical Innovation, 1-23-1 Toyama, Tokyo, 162-8636, Shinjuku, Japan.,Faculty of Applied Bioscience, Tokyo University of Agriculture, 1-1-1 Sakuragaoka, Tokyo, 156-8502, Setagaya, Japan
| | - Yuka Yamada
- Health and Nutrition, National Institutes of Biomedical Innovation, 1-23-1 Toyama, Tokyo, 162-8636, Shinjuku, Japan
| | - Kenta Okuyama
- Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms Gata 35, 20502, Malmö, Sweden
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Assessment of Sport Nutrition Knowledge, Dietary Practices, and Sources of Nutrition Information in NCAA Division III Collegiate Athletes. Nutrients 2021; 13:nu13092962. [PMID: 34578840 PMCID: PMC8470142 DOI: 10.3390/nu13092962] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/23/2021] [Accepted: 08/24/2021] [Indexed: 02/05/2023] Open
Abstract
Nutrition knowledge is a critical component of meeting sport nutrition guidelines. The present study aimed to evaluate the sport nutrition knowledge of National Collegiate Athletic Association (NCAA) Division III (DIII) athletes using a validated questionnaire, and to assess the dietary practices and sources of nutrition information in this population. A total of 331 student-athletes (n = 149 males, n = 181 females, n = 1 no sex indicated) completed the questionnaire. The mean score for total sport nutrition knowledge was 6.49 ± 8.9 (range −49 to 49) with a mean percent (%) correct score of 36.9 ± 19.1%. Athletes who had a previous college-level nutrition course (n = 62) had significantly higher (p < 0.05) total sport nutrition, carbohydrate, and hydration knowledge compared to those who did not (n = 268). Individual sport athletes (n = 90) scored significantly higher (p < 0.05) on hydration and micronutrients knowledge than team sport athletes (n = 237), while females scored higher than males for hydration knowledge (p < 0.05). The majority of athletes reported sensible dietary habits, such as not frequently skipping meals and eating carbohydrate and protein foods peri-workout. Athletes also reported their primary sources of nutrition information, the top three sources being social media, coaches, and athletic trainers, despite most frequently rating registered dietitians/nutritionists as “extremely knowledgeable”. Despite low sport nutrition knowledge, NCAA DIII collegiate athletes practiced seemingly prudent dietary habits but lacked exposure to high-quality sources of nutrition information.
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Ishizu T, Torii S, Taguchi M. Habitual Dietary Status and Stress Fracture Risk Among Japanese Female Collegiate Athletes. J Am Coll Nutr 2021; 41:481-488. [PMID: 34125657 DOI: 10.1080/07315724.2021.1920068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The aim of the present study was to identify the habitual dietary intake and stress fractures history among sport types and to determine the factors related to the risk of stress fractures among Japanese female collegiate athletes. METHODS This study involved 589 Japanese female collegiate athletes. We investigated habitual dietary intake (food frequency questionnaire), eating attitude (EAT-26), demographics, training status, participation in sports events, history of injury in their career, and menstrual status using a self-reported questionnaire. A multivariate logistic regression analysis was conducted to determine the risk factors associated with stress fractures. RESULTS Thirty percent of the total participants had a history of stress fractures, although most participants had no risk of eating disorders. Most Japanese female collegiate athletes consumed less than the dietary reference intake levels for the general Japanese female population aged 18-29 years and the athletes' dietary guideline for key bone-health nutrients such as calcium and vitamin D. The multivariate logistic regression analysis revealed body mass index (BMI; OR, 0.91; 95% CI, 0.82-0.99) and energy intake (EI; OR, 0.99; 95% CI, 0.99-0.99) as significant and independent factors in the history of stress fractures among Japanese female collegiate athletes (p = 0.047 and p = 0.039, respectively). CONCLUSIONS Japanese female collegiate athletes failed to meet energy and nutrient recommendations; BMI and EI were significantly associated with stress fractures, a diet that includes an appropriate amount of energy is essential.
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Affiliation(s)
- Tatsuya Ishizu
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
| | - Suguru Torii
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Motoko Taguchi
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
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Infantino NA, McCormack WP, Almstedt HC. Bone mineral density and hip structure changes over one-year in collegiate distance runners and non-athlete controls. Bone Rep 2021; 14:101056. [PMID: 33850975 PMCID: PMC8022846 DOI: 10.1016/j.bonr.2021.101056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 03/01/2021] [Accepted: 03/19/2021] [Indexed: 11/28/2022] Open
Abstract
Modification of bone is continuous throughout life and influenced by many factors, including physical activity. This study investigated changes in areal bone mineral density (aBMD) and hip structure among male and female collegiate distance runners and non-athlete controls over 12 months. Using dual-energy x-ray absorptiometry (DXA) and hip structure analysis (HSA) software, aBMD at the posterior-anterior (PA) and lateral spine, femoral neck, total hip (TH), whole body (WB), and bone geometry at the narrow neck (NN) of the femur was measured three times over 12 months. HSA included cross-sectional area (CSA), cross-sectional moment of inertia (CSMI), and Z-section modulus (Z). Male runners had significantly higher aBMD at TH and WB and greater CSA, CSMI, and Z than male controls at the end of 12 months. Female controls had higher aBMD at the PA spine than female runners at the end of 12 months. Male runners had significant increases in aBMD at the PA (p = 0.003) and lateral spine (p = 0.002), and TH (p = 0.002), female runners had significant decreases in aBMD at TH (p = 0.015) and WB (p = 0.002), male controls had significant increases in aBMD at the PA spine (p < 0.001) and WB (p < 0.001), and female controls had significant decreases in aBMD at lateral spine and TH (p = 0.008) over the year. When applying covariates of bone-free lean mass and vitamin D, male distance runners demonstrated significant improvement in CSA (3.602 ± 0.139 vs. 3.675 ± 0.122 cm2, p = 0.05), CSMI (3.324 ± 0.200 to 3.467 ± 0.212 cm4, p < 0.05), and Z (1.81 ± 0.08 to 1.87 ± 0.08 cm3, p = 0.05) during the study. No other changes in hip structure occurred over the year. Distance running may be beneficial to aBMD and hip structure in college-age males but not females. Further research is needed on potential influences of weight-bearing activity, energy availability, and hormonal status on aBMD and hip structure in males and females.
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Key Words
- ANCOVA, analysis of covariance
- BFLM, bone-free lean mass
- BMI, body mass index
- CSA, cross-sectional area
- CSMI, cross-sectional moment of inertia
- DXA, dual-energy x-ray absorptiometry
- EA, energy availability
- FFQ, Food Frequency Questionnaire
- Femur bone geometry
- HSA, Hip Structure Analysis
- Hip structure analysis
- METs, metabolic equivalents
- NN, narrow neck
- Peak bone mass
- RDA, recommended dietary allowance
- Stress fracture
- Z, Z-section modulus
- aBMD, areal bone mineral density
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Affiliation(s)
| | - William P McCormack
- Human Performance Laboratory, Department of Health and Human Sciences, 1 LMU Drive, MS 8888, Los Angeles, CA 90045, USA
| | - Hawley C Almstedt
- Human Performance Laboratory, Department of Health and Human Sciences, 1 LMU Drive, MS 8888, Los Angeles, CA 90045, USA
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Alves J, Barrientos G, Toro V, Sánchez E, Muñoz D, Maynar M. Changes in Anthropometric and Performance Parameters in High-Level Endurance Athletes during a Sports Season. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052782. [PMID: 33803383 PMCID: PMC7967258 DOI: 10.3390/ijerph18052782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/04/2021] [Accepted: 03/07/2021] [Indexed: 12/01/2022]
Abstract
Several anthropometric and performance parameters related to aerobic metabolism are associated with performance in endurance runners and are modified according to the training performed. The objective of this study was to investigate the ergospirometric and body composition changes in endurance runners during a sports season in relation to their training. Twenty highly trained men endurance runners performed an incremental test until exhaustion (initial, and at 3, 6, and 9 months) on a treadmill to determine maximal oxygen consumption (VO2 max), second ventilatory threshold (VT2), and their associated running speeds. Skinfolds, perimeters, and weights were measured. No changes were obtained in VO2 max or VT2 during the study, although their associated running speeds increased (p < 0.05) after 3 months of the study. Decreases in fat mass (p < 0.05) and muscle mass (p < 0.05) were observed at the end of the season (9 months). Changes occurred in the different skinfolds according to the characteristics of the training performed during the season. In conclusion, vVO2 max and vVT2 increase with a greater volume of kilometres trained and can be adversely affected by loss of muscle mass.
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Affiliation(s)
- Javier Alves
- Department of Sport Science, Faculty of Education, Pontifical University of Salamanca, 37007 Salamanca, Spain; (J.A.); (E.S.)
| | - Gema Barrientos
- Department of Sport Science, Faculty of Education, Pontifical University of Salamanca, 37007 Salamanca, Spain; (J.A.); (E.S.)
- Correspondence: ; Tel.: +34-923-125-027
| | - Víctor Toro
- Department of Physiology, Faculty of Sports Science, University of Extremadura, 10003 Cáceres, Spain; (V.T.); (D.M.); (M.M.)
| | - Esther Sánchez
- Department of Sport Science, Faculty of Education, Pontifical University of Salamanca, 37007 Salamanca, Spain; (J.A.); (E.S.)
| | - Diego Muñoz
- Department of Physiology, Faculty of Sports Science, University of Extremadura, 10003 Cáceres, Spain; (V.T.); (D.M.); (M.M.)
| | - Marcos Maynar
- Department of Physiology, Faculty of Sports Science, University of Extremadura, 10003 Cáceres, Spain; (V.T.); (D.M.); (M.M.)
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Risk of Low Energy Availability among Female and Male Elite Runners Competing at the 26th European Cross-Country Championships. Nutrients 2021; 13:nu13030873. [PMID: 33800051 PMCID: PMC8000897 DOI: 10.3390/nu13030873] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/18/2021] [Accepted: 03/03/2021] [Indexed: 02/08/2023] Open
Abstract
Low energy availability (LEA) causes impaired physiological functioning. Cross-country running is a weight-sensitive sport, making athletes more prone to LEA. We aimed to estimate the prevalence of elite European cross-country athletes at risk of LEA using the LEA in Females Questionnaire (LEAF-Q) and to analyze demographic and physical characteristics that are associated with LEA. Athletes ≥ 18 years competing at the 26th European Cross-Country Championships (n = 602) were invited to complete a questionnaire (sociodemographic, training, anthropometric characteristics, and LEAF-Q). A total of 207 valid surveys were collected (83 females, 22.1 (4.0) years, and 124 males, 22.3 (4.1) years), and 16 surveys were excluded. A high prevalence of athletes at risk of LEA (64.3%) was observed, being higher in females than in males (79.5 and 54.0% respectively, p < 0.001). More than half of athletes (54.1%, n = 112) reported bowel movements once a week or more rarely, while 33 female athletes (41.3%) did not report normal menstruation. Overall, cross-country athletes are at high risk of LEA. Moreover, a high prevalence of gastrointestinal and menstrual impairments was reported. Hence, athletes should be followed by multidisciplinary teams to inform, prevent, and treat LEA and its effects.
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Prevalence of Low Energy Availability in Collegiate Women Soccer Athletes. J Funct Morphol Kinesiol 2020; 5:jfmk5040096. [PMID: 33467311 PMCID: PMC7804888 DOI: 10.3390/jfmk5040096] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/14/2020] [Accepted: 12/16/2020] [Indexed: 01/20/2023] Open
Abstract
(1) Background: Limited information exists on the prevalence of low energy availability (LEA) in collegiate team sports. The purpose of this study was to examine the prevalence of LEA in collegiate women soccer players. (2) Methods: Collegiate women soccer athletes (n = 18, height: 1.67 ± 0.05 m; body mass: 65.3 ± 7.9 kg; body fat %: 24.9 ± 5.6%) had their body composition and sport nutrition knowledge assessed in the pre-season. Energy availability was assessed mid-season using a 4-day dietary log and activity energy expenditure values from a team-based monitoring system. A validated screening tool was used to screen for LEA. (3) Results: The screening tool classified 56.3% of athletes as at risk of LEA (<30 kcal/kg of FFM); however, the actual dietary intake identified 67% as LEA. Athletes identified as non-LEA consumed significantly more absolute (p = 0.040) and relative (p = 0.004) energy than LEA athletes. (4) Conclusions: There was a high prevalence of LEA among collegiate women soccer athletes. Although previously validated in women endurance athletes, the LEA screening tool was not effective in identifying those at risk of LEA in this sample of athletes.
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Rothschild JA, Kilding AE, Plews DJ. Pre-Exercise Nutrition Habits and Beliefs of Endurance Athletes Vary by Sex, Competitive Level, and Diet. J Am Coll Nutr 2020; 40:517-528. [PMID: 32926647 DOI: 10.1080/07315724.2020.1795950] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The purpose of this study was to determine the self-reported beliefs and practices relating to pre-exercise nutrition intake among endurance athletes of varying ages and competitive levels and examine differences based on sex, competitive level, and habitual dietary pattern. METHOD An anonymous online survey was circulated internationally in English and completed by 1950 athletes of varying competitive levels (51.0% female, mean age 40.9 years [range 18:78]). Survey questions included training background, determinants of pre-exercise nutrition intake and composition, and timing relative to exercise. RESULTS Prior to morning exercise, 36.4%, 36.0%, and 27.6% of athletes consumed carbohydrate-containing food/drinks before almost every workout, some of the time, and never/rarely, respectively, with significant effects of sex (p < 0.001, Cramer's V (ϕc) = 0.15) and competitive level (p < 0.001, ϕc = 0.09). Nutritional intake before exercise varied based on workout duration for 47.6% of athletes, with significant effects of sex (ϕc = 0.15) and habitual diet (ϕc = 0.19), and based on workout intensity for 39.1% of athletes, with significant effects of sex (ϕc = 0.13) and habitual diet (ϕc = 0.17, all p < 0.001). Additionally, 89.0% of athletes reported using at least some type of dietary supplement (including caffeine from coffee/tea) within 1 hour before exercise. CONCLUSIONS Overall, nearly all factors measured relating to pre-exercise nutrition intake varied by sex, competitive level, habitual dietary pattern, and/or intensity/duration of the training session and suggest a large number of athletes may not be following current recommendations for optimizing endurance training adaptations.
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Affiliation(s)
- Jeffrey A Rothschild
- Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand
| | - Andrew E Kilding
- Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand
| | - Daniel J Plews
- Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand
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