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Fahrenholtz IL, Melin AK, Garthe I, Wasserfurth P, Ivarsson A, Hollekim-Strand SM, Koehler K, Logue D, Madigan S, Gräfnings M, Torstveit MK. Short-term effects and long-term changes of FUEL-a digital sports nutrition intervention on REDs related symptoms in female athletes. Front Sports Act Living 2023; 5:1254210. [PMID: 38164441 PMCID: PMC10757931 DOI: 10.3389/fspor.2023.1254210] [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: 07/06/2023] [Accepted: 11/24/2023] [Indexed: 01/03/2024] Open
Abstract
Female endurance athletes are at high risk for developing Relative Energy Deficiency in Sport (REDs), resulting in symptoms such as menstrual dysfunction and gastrointestinal (GI) problems. The primary aim of this study was to investigate effects of the FUEL (Food and nUtrition for Endurance athletes-a Learning program) intervention consisting of weekly online lectures combined with individual athlete-centered nutrition counseling every other week for sixteen weeks on REDs related symptoms in female endurance athletes at risk of low energy availability [Low Energy Availability in Females Questionnaire (LEAF-Q) score ≥8]. Female endurance athletes from Norway (n = 60), Sweden (n = 84), Ireland (n = 17), and Germany (n = 47) were recruited. Fifty athletes with risk of REDs (LEAF-Q score ≥8) and with low risk of eating disorders [Eating Disorder Examination Questionnaire (EDE-Q) global score <2.5], with no use of hormonal contraceptives and no chronic diseases, were allocated to either the FUEL intervention (n = 32) (FUEL) or a sixteen-week control period (n = 18) (CON). All but one completed FUEL and n = 15 completed CON. While no evidence for difference in change in LEAF-Q total or subscale scores between groups was detected post-intervention (BFincl < 1), the 6- and 12-months follow-up revealed strong evidence for improved LEAF-Q total (BFincl = 123) and menstrual score (BFincl = 840) and weak evidence for improved GI-score (BFincl = 2.3) among FUEL athletes. In addition, differences in change between groups was found for EDE-Q global score post-intervention (BFincl = 1.9). The reduction in EDE-Q score remained at 6- and 12- months follow-up among FUEL athletes. Therefore, the FUEL intervention may improve REDs related symptoms in female endurance athletes. Clinical Trial Registration www.clinicaltrials.gov (NCT04959565).
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Affiliation(s)
- Ida Lysdahl Fahrenholtz
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
| | | | - Ina Garthe
- The Norwegian Olympic and Paralympic Committee and Confederation of Sport, Oslo, Norway
| | - Paulina Wasserfurth
- Department Health and Sport Sciences, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Andreas Ivarsson
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Siri Marte Hollekim-Strand
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Karsten Koehler
- Department Health and Sport Sciences, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Danielle Logue
- Sport Ireland Institute, National Sports Campus, Dublin, Ireland
| | - Sharon Madigan
- Sport Ireland Institute, National Sports Campus, Dublin, Ireland
| | - Maria Gräfnings
- Department of Medical Science, Dalarna University, Falun, Sweden
| | - Monica K. Torstveit
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
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Vento KA, Delgado F, Skinner J, Wardenaar FC. Funding and college-provided nutritional resources on diet quality among female athletes. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:1732-1739. [PMID: 34379567 DOI: 10.1080/07448481.2021.1947301] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 06/04/2021] [Accepted: 06/20/2021] [Indexed: 06/13/2023]
Abstract
ObjectiveTo examine funding and college-provided nutritional resources and to assess whether these are associated with diet quality and subsequent dietitian referral among female collegiate athletes of different sports levels. Participants: Female athletes (N = 120) from NCAA, NJCAA, and Club sports. Methods: Differences in questionnaire-based demographics, diet quality, and dietitian referrals were analyzed using Kruskal-Wallis and Chi-Square tests, with p < 0.05. Factors associated with diet quality and dietitian referral were examined using regression. Results: NCAA reported more funding than Club and NJCAA (p < 0.05). NJCAA expressed insufficient funds for purchasing food and reported fewer college-provided nutritional resources (p < 0.05) while showing lower diet quality scores and higher subsequent dietitian referrals than NCAA and Club. No significant associations for dietary quality and dietitian referrals were found. Conclusions: Athletes across all sports levels reported insufficient funds for purchasing food and low diet quality, with NJCAA, showing the least funding and fewest nutritional resources.
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Affiliation(s)
- Kaila A Vento
- College of Health Solutions, Arizona State University, Phoenix, Arizona, USA
| | - Ferdinand Delgado
- College of Health Solutions, Arizona State University, Phoenix, Arizona, USA
| | - Jensen Skinner
- College of Health Solutions, Arizona State University, Phoenix, Arizona, USA
| | - Floris C Wardenaar
- College of Health Solutions, Arizona State University, Phoenix, Arizona, USA
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Effects of a 16-Week Digital Intervention on Sports Nutrition Knowledge and Behavior in Female Endurance Athletes with Risk of Relative Energy Deficiency in Sport (REDs). Nutrients 2023; 15:nu15051082. [PMID: 36904082 PMCID: PMC10005555 DOI: 10.3390/nu15051082] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/13/2023] [Accepted: 02/16/2023] [Indexed: 02/24/2023] Open
Abstract
Female endurance athletes are considered a high-risk group for developing Relative Energy Deficiency in Sport (REDs). Due to the lack of educational and behavioral intervention studies, targeting and evaluating the effects of the practical daily management of REDs, we developed the Food and nUtrition for Endurance athletes-a Learning (FUEL) program, consisting of 16 weekly online lectures and individual athlete-centered nutrition counseling every other week. We recruited female endurance athletes from Norway (n = 60), Sweden (n = 84), Ireland (n = 17), and Germany (n = 47). Fifty athletes with symptoms of REDs and with low risk of eating disorders, with no use of hormonal contraceptives and no chronic diseases, were allocated to either the FUEL intervention (n = 32) (FUEL) or a 16-week control period (n = 18) (CON). All but one completed FUEL, while 15 completed CON. We found strong evidence for improvements in sports nutrition knowledge, assessed via interviews, and moderate to strong evidence in the ratings concerning self-perceived sports nutrition knowledge in FUEL versus CON. Analyses of the seven-day prospective weighed food record and questions related to sports nutrition habits, suggested weak evidence for improvements in FUEL versus CON. The FUEL intervention improved sports nutrition knowledge and suggested weak evidence for improved sports nutrition behavior in female endurance athletes with symptoms of REDs.
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Miralles-Amorós L, Asencio-Mas N, Martínez-Olcina M, Vicente-Martínez M, Frutos JMGD, Peñaranda-Moraga M, Gonzálvez-Alvarado L, Yáñez-Sepúlveda R, Cortés-Roco G, Martínez-Rodríguez A. Study the Effect of Relative Energy Deficiency on Physiological and Physical Variables in Professional Women Athletes: A Randomized Controlled Trial. Metabolites 2023; 13:metabo13020168. [PMID: 36837787 PMCID: PMC9962361 DOI: 10.3390/metabo13020168] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 01/26/2023] Open
Abstract
Energy deficits are often observed in athletes, especially in female athletes, due to the high expenditure of sport and strict diets. Low energy availability can cause serious health problems and affect sport performance. The aim of this study was to evaluate the effects of different personalized dietary plans on physiological and physical factors related to energy deficit syndrome in female professional handball players. Twenty-one professional female handball players, aged 22 ± 4 years, 172.0 ± 5.4 cm and 68.4 ± 6.7 kg, divided into three groups (FD: free diet; MD: Mediterranean diet; and AD: high antioxidant diet), participated in this 12-week randomized controlled trial. Energy expenditure through indirect calorimetry, energy availability, 7 day dietary intake analysis, blood pressure, cholesterol, menstrual function, body composition by both anthropometry and bioelectrical impedance, and strength performance were assessed. All participants showed low energy availability (<30 kcal/lean mass per day); despite this, all had eumenorrhea. Significant improvements were found after the intervention in all components of body composition (p < 0.05). In the remaining variables, despite slight improvements, none were significant neither over time nor between the different groups. Low energy availability has been observed in all professional female handball players, which may lead to serious consequences. A longer period of intervention is required to assess the differences between diets and improvements in other parameters.
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Affiliation(s)
- Laura Miralles-Amorós
- Department of Analytical Chemistry, Nutrition and Food Science, University of Alicante, 03690 Alicante, Spain
| | - Nuria Asencio-Mas
- Department of Analytical Chemistry, Nutrition and Food Science, University of Alicante, 03690 Alicante, Spain
| | - María Martínez-Olcina
- Department of Analytical Chemistry, Nutrition and Food Science, University of Alicante, 03690 Alicante, Spain
| | | | - José Manuel García-De Frutos
- Physical Activity and Sport Sciences Department, Faculty of Sport, Catholic University San Antonio of Murcia, 30107 Murcia, Spain
| | - Marcelo Peñaranda-Moraga
- Department of Analytical Chemistry, Nutrition and Food Science, University of Alicante, 03690 Alicante, Spain
| | - Lucía Gonzálvez-Alvarado
- Department of Analytical Chemistry, Nutrition and Food Science, University of Alicante, 03690 Alicante, Spain
| | - Rodrigo Yáñez-Sepúlveda
- Faculty of Education and Social Sciences, Universidad Andres Bello, Viña del Mar 2520000, Chile
| | - Guillermo Cortés-Roco
- Escuela de Educación, Pedagogía en Educación Física, Entrenador Deportivo, Universidad Viña del Mar, Viña del Mar 2520000, Chile
| | - Alejandro Martínez-Rodríguez
- Department of Analytical Chemistry, Nutrition and Food Science, University of Alicante, 03690 Alicante, Spain
- Alicante Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain
- Correspondence:
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Marí-Sanchis A, Burgos-Balmaseda J, Hidalgo-Borrajo R. Eating disorders in sport. Update and proposal for an integrated approach. ENDOCRINOL DIAB NUTR 2022; 69:131-143. [PMID: 35256056 DOI: 10.1016/j.endien.2022.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 04/24/2021] [Indexed: 06/14/2023]
Abstract
Eating disorders are a group of conditions which have a huge impact on the health and performance of athletes. The aetiology of eating disorders is multifactorial, being influenced by genetic and environmental factors, but also involving psychological factors and factors specific to the practising of sport. Eating disorders are highly prevalent in sport, particularly in disciplines involving endurance, those that have weight-categories or those where low weight is a competitive advantage and aesthetics are important. Athletes with eating disorders need to be assessed and receive early, comprehensive treatment. Close monitoring of nutritional status is vital, especially with female athletes. Prevention is crucial and plays an invaluable role in this type of disorder, but represents a significant challenge for all professionals who look after athletes. Priority needs to be given to implementing structured nutrition training programmes for the athlete and their entourage to help prevent eating disorders.
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Affiliation(s)
- Amelia Marí-Sanchis
- Servicio de Endocrinología y Nutrición, Unidad de Nutrición Clínica y Dietética, Complejo Hospitalario de Navarra (CHN), Navarra, Spain; Instituto de Investigación Sanitaria de Navarra (IdisNa), Navarra, Spain.
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Validation and Implementation of General and Sport Nutrition Knowledge Questionnaire for University Students and Athletes. CENTRAL EUROPEAN JOURNAL OF SPORT SCIENCES AND MEDICINE 2022. [DOI: 10.18276/cej.2022.4-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
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Godoy-Izquierdo D, Díaz I. Inhabiting the Body(ies) in Female Soccer Players: The Protective Role of Positive Body Image. Front Psychol 2021; 12:718836. [PMID: 34630229 PMCID: PMC8497972 DOI: 10.3389/fpsyg.2021.718836] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/24/2021] [Indexed: 11/13/2022] Open
Abstract
In a social and sports world dominated by weight-centred beliefs and highly exigent and gendered athletic and beauty body standards, the vulnerability for eating pathology, i.e., disordered eating and eating disorders (EDs), is elevated among women athletes. The aim of this study was to explore body image facets and ED risk among female athletes in masculinised sports such as soccer. Forty-five federated amateur female soccer players from Spain participated in this study, voluntarily complying with an extensive evaluation protocol on attitudes towards body and appearance and eating practises. The participants overall reported self-representations of their bodies that corresponded to their reality as athletes, but their body ideals were also more demanding in terms of low fat and muscularity, in association with the functionality of their body and the physical demands of their athletic activity. Despite having a fairly high positive body image and body satisfaction, they also expressed negative attitudes towards their bodies. Around 2 out of 10 players were at risk of suffering from an ED. Players with negative attitudes towards their bodies had an odd 12 times likely to develop an ED compared to those with lower self-devaluation, after adjusting for BMI and body perceptions (OR = 12.3, p < 0.01). On the contrary, players who appreciate their bodies and hold a positive body image had an odd 83% lower to suffer from eating pathology, after adjusting for BMI and body satisfaction (OR = 0.17, p < 0.05). Our findings support the healthy and protective role of positive body image in sports contexts. Body attitudes should be addressed in preventive and therapeutic efforts for reducing the prevalence of EDs in women's sports, within both a "negative" and a "positive" paradigm of body image.
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Affiliation(s)
- Débora Godoy-Izquierdo
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Granada, Granada, Spain.,Women's and Gender Studies Research Institute, University of Granada, Granada, Spain
| | - Isabel Díaz
- Gimbernat-Cantabria Research Unit (Servicio Universitario de Investigación Gimbernat-Cantabria), University School Gimbernat-Cantabria, University of Cantabria, Torrelavega, Spain
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8
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Bartholomew J, Gilligan C, Spence A. Contemporary Variables that Impact Sleep and Development in Female Adolescent Swimmers and Gymnasts. SPORTS MEDICINE - OPEN 2021; 7:57. [PMID: 34373962 PMCID: PMC8353044 DOI: 10.1186/s40798-021-00331-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 05/24/2021] [Indexed: 11/10/2022]
Abstract
The effects of sleep on elite athletes in late adolescence and early adulthood have been well documented in a myriad of sports. However, there is underrepresentation of pre-pubertal and young female adolescent athlete research between the ages of 11-17, and specifically female gymnast and swimmers. Neglecting to understand how high energy demand at a young age relates to sleep and restoration may lead to developmental ramifications for this group, as they display physiological dysfunctions like delayed puberty, amenorrhea and are at risk for the female athlete triad or components of the triad. This review aims to summarize the contemporary variables of blue light emitting screens, social media, and caffeine on quality and quantity of sleep in young athletes while identifying gaps in the literature on how these factors impact the target group of young female swimmers and gymnasts. The implications of this work include sleep hygiene recommendations for increasing duration and quality of sleep, as well as future research with respect to electronic device usage, social media participation, caffeine consumption, and sport engagement in female early adolescent athletes.
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Affiliation(s)
- Janine Bartholomew
- Department of Biology, Portage Learning, 2521 Darlington Road, Beaver Falls, PA, 15010, USA
| | - Carrie Gilligan
- Carlow University, 3333 Fifth Ave, Pittsburgh, PA, 15237, USA
| | - Ann Spence
- Department of Nursing, Carlow University, 3333 Fifth Ave, Pittsburgh, PA, 15237, USA.
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Marí-Sanchis A, Burgos-Balmaseda J, Hidalgo-Borrajo R. Eating disorders in sport. Update and proposal for an integrated approach. ENDOCRINOL DIAB NUTR 2021; 69:S2530-0164(21)00125-7. [PMID: 34148864 DOI: 10.1016/j.endinu.2021.04.004] [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: 12/28/2020] [Revised: 04/19/2021] [Accepted: 04/24/2021] [Indexed: 11/15/2022]
Abstract
Eating disorders are a group of conditions which have a huge impact on the health and performance of athletes. The aetiology of eating disorders is multifactorial, being influenced by genetic and environmental factors, but also involving psychological factors and factors specific to the practising of sport. Eating disorders are highly prevalent in sport, particularly in disciplines involving endurance, those that have weight-categories or those where low weight is a competitive advantage and aesthetics are important. Athletes with eating disorders need to be assessed and receive early, comprehensive treatment. Close monitoring of nutritional status is vital, especially with female athletes. Prevention is crucial and plays an invaluable role in this type of disorder, but represents a significant challenge for all professionals who look after athletes. Priority needs to be given to implementing structured nutrition training programmes for the athlete and their entourage to help prevent eating disorders.
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Affiliation(s)
- Amelia Marí-Sanchis
- Servicio de Endocrinología y Nutrición, Unidad de Nutrición Clínica y Dietética, Complejo Hospitalario de Navarra (CHN), Navarra, España; Instituto de Investigación Sanitaria de Navarra (IdisNa), Navarra, España.
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Body Composition, Training Volume/Pattern and Injury Status of Slovenian Adolescent Female High-Performance Gymnasts. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042019. [PMID: 33669675 PMCID: PMC7923138 DOI: 10.3390/ijerph18042019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/15/2021] [Accepted: 02/18/2021] [Indexed: 12/25/2022]
Abstract
Body composition (BC), training volume/pattern, and injury status are a few important factors affecting training quality and sport performance in female artistic gymnastics. We aimed to examine BC status, training volume/pattern, and injury status during the first competition period. Our cross-sectional study included 17 female gymnasts (age: 17.4 ± 4.1 years, body height: 159.8 ± 6.2 cm, and body weight: 54.8 ± 5.3 kg) who were high performance at the international and national level. The BC (measured by dual-energy X-ray absorptiometry) parameters included body height and mass, body fat percentage (BF %), lean body mass (LBM), body mass index (BMI), total bone mineral density (BMD total), and total bone mineral content (BMC total). Training volume and pattern were assessed via an author-developed questionnaire, while injury status (i.e., anatomical location, symmetry and rate of injuries) was assessed via a modified questionnaire on overuse injuries used in sports injury epidemiology studies with elite-level athletes. Body composition parameters were as follows: the BMI was 21.5 ± 1.4 kg/m2, BF % was 21.9 ± 4.7%, LBM was 41.2 ± 3.4 kg, BMD total was 1.22 ± 0.08 g/cm2, and BMC total was 2486 ± 344 g. Furthermore, the average weekly volume of training was 23.5 ± 1.4 h, with the highest training volume occurring on Monday and Tuesday and high variability within gymnasts. Our study also revealed that the most frequently injured joints that had the most negative impact on training volume, sport performance and pain status were the ankles and low back, followed by the knees and shoulders. This kind of yearly screening method is warranted to allow more definitive conclusions to be made on adjusted training and preventive strategies.
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