Diet Quality Profile of Track-and-Field Paralympic Athletes. Int J Sport Nutr Exerc Metab. 2019;1-7. [PMID: 31034250 DOI: 10.1123/ijsnem.2018-0361]

Dietary Quality and Nutrient Intakes of Elite Paracyclists

Nutrient requirements for para-athletes will be influenced by a variety of factors secondary to their impairment and, therefore, recommendations for para-athletes cannot be drawn directly from that of able-bodied athletes. Information on the dietary intakes of para-athletes is lacking and therefore needs to be examined. This study assessed the nutrient intakes and diet quality of 31 paracyclists via food frequency questionnaires. Based on the dietary reference intakes, most paracyclists consumed intakes above the recommended dietary allowance (RDA) or adequate intake (AI). Recommendations were not met for iodine (males = 87% RDA; females = 62% RDA) or fibre in males (84% AI). A 26% risk of inadequacy was noted for vitamins D and E in females. A total of 42% of females and 75% of males did not meet fibre recommendations (14 g/1000 kcal), and only three athletes (all females) consumed fatty acids in the recommended omega-6 to omega-3 ratio of 4:1 or less. Athletes consumed grains, fruits, and vegetables frequently, though whole grains, pulses, and oily fish were generally consumed less often. Paracyclists appear to be consuming intakes at or above recommendations for most nutrients, though several nutrients were consumed below the recommended amounts; therefore, increasing the variety of foods consumed is suggested.

Nutritional intake in high-performance para athletes

OBJECTIVE

This study aimed to describe the eating habits of para-athletes who attended a specialized training center in Brazil.

METHODS

Participants were recruited from the Sports Training Center at the Universidade Federal de Minas Gerais, Brazil. Energy, macronutrient (expressed in absolute terms and relative to body weight), fiber, cholesterol, and micronutrient intakes were assessed via a food frequency questionnaire, based on intakes over the preceding 12 mo. Sociodemographic factors were assessed using a purpose-designed survey, which included self-reported weight and height. Differences in nutrient intake based on sex, age, body mass index, and sporting factors were evaluated.

RESULTS

A total of 30 para-athletes (in para athletics, para-powerlifting, para-swimming, and para-taekwondo) were included in the study. The median total energy intake was 4089 (2855-5829) kcal. The median consumption of carbohydrates, proteins, and fats was 512.3 (358.7-853.5), 184.5 (118.5-246.4), and 137.1 (96.8-189.5) g/d, respectively. Adolescent athletes had higher protein intakes than adult athletes (P = 0.02). Para-athletes with a longer sports career had lower consumption of fiber (P = 0.01) and thiamine (P = 0.02). Participants with a higher body mass index had higher intake of alcohol (P = 0.04) and monounsaturated fats (P = 0.01). Higher consumption of alcohol was also reported by older para-athletes (P = 0.02).

CONCLUSIONS

We identified a higher saturated fat intake in male than in female para-athletes as well as higher protein intake (g/kg) in younger compared with older athletes. In addition, sociodemographic characteristics influenced the dietary intake of some para-athletes, such as length of sports career, age, and income.

Diet quality, diet-related factors and disability status among male adults of reproductive age in the USA

OBJECTIVE

To examine diet quality and diet-related factors among male adults of reproductive age with and without disabilities.

DESIGN

Cross-sectional data from the National Health and Nutrition Examination Surveys, 2013-2018.

SETTING

Disability was reported as serious difficulty hearing, seeing, concentrating, walking, dressing and/or running errands due to physical, mental or emotional conditions. Diet quality was assessed by the Healthy Eating Index (HEI)-2015 and diet-related factors included self-rated diet healthfulness, food security and food assistance programmes. Multivariable linear regression estimated differences in HEI-2015 scores. Multivariable Poisson regression estimated adjusted prevalence ratios (aPR) and 95 % CI for diet-related factors.

PARTICIPANTS

In total, 3249 males, 18-44 years; of whom, 441 (13·4 %) reported having disabilities.

RESULTS

Compared with males without disabilities, those with disabilities had a 2·69-point (95 % CI: -4·18, -1·20) lower mean total HEI-2015 score and approximately one-third to half of a point lower HEI-2015 component scores for greens and beans, total protein foods, seafood and plant proteins, fatty acids and added sugars. Males with any disabilities were more likely to have low food security (aPR = 1·57; 95 % CI: 1·28, 2·92); household participation in food assistance programmes (aPR = 1·61; 95 % CI: 1·34, 1·93) and consume fast food meals during the previous week (1-3 meals: aPR = 1·11; 95 % CI: 1·01-1·21 and 4 or more meals: aPR = 1·18; 95 % CI: 1·01-1·38) compared with males with no disabilities.

CONCLUSIONS

Factors affecting diet and other modifiable health behaviours among male adults of reproductive age with disabilities require further investigation. Health promotion strategies that are adaptive to diverse populations within the disability community are needed.

Intermediate-Level Diet Quality of Brazilian Paralympic Athletes Based on National and International Indexes

Diet quality indexes are used to characterize the dietary patterns of individuals and populations. The objective of this study was to compare two specific diet quality indexes, namely the Brazilian Healthy Eating Index Revised (BHEI-R) and the Global Diet Quality Score (GDQS), among Brazilian parathletes. This comparison was performed using either the initial 24 h recall (Rec1) or an assessment of usual dietary intake. Additionally, our study aimed to explore the association of these indexes with sociodemographic and behavioral sport variables. This cross-sectional, observational study evaluated 101 disabled athletes, including 23 international-level and 78 regional-/national-level participants, with a distribution of 82 males and 19 females across 13 Paralympic modalities. The Multiple Source Method (MSM) was employed, utilizing data from two or four non-consecutive 24 h food recalls. The comparison between the Rec1 and the assessment of usual dietary intake revealed the following median (IQR) values: for the BHEI-R, they were 60.3 ± 11.1 and 80.7 ± 6.2, respectively; for the GDQS, they were 19.5 ± 6.5 and 18.3 ± 2.6, respectively. Most athletes had diets classified as either "in need of modification" (according to BHEI-R) or of "moderate risk" (according to GDQS). The comparison between type of sport (team/individual), age, sex, income, education, sport scholarship, and nutritional support between the diet quality indexes is presented. Athletes involved in individual sports exhibited higher scores than team sports for BHEI-R (p < 0.02), and athletes receiving nutritional support achieved higher scores on both indexes (p < 0.03). The analysis of diet quality using the initial Rec1 with the BHEI-R was deemed sufficient to evaluate the diet quality of these athletes. However, when evaluating sporadically consumed food groups, the adoption of GDQS is necessary to assess usual dietary intake. We found that both BHEI-R and GDQS can be utilized to evaluate the diet quality of athletes with disabilities, and the diet quality of parathletes reached an intermediate score level.

Dietary assessment of 101 para-athletes from team and individual sports

Assessing the usual food intake of para-athletes enables knowledge and description of nutrient intakes, providing insight into the potential nutritional status of para-athletes and may help tailor dietary intake to their specific training needs. This study aimed to evaluate the usual intake of macronutrients and food groups and meal food patterns of athletes with a disability. We also compared dietary intake data between team and individual sport para-athletes. One hundred and one athletes with a disability from 13 Paralympic disciplines living in Brasília, Federal District, Brazil were included. Food intake was estimated from two or four non-consecutive 24-h food recalls in which para-athletes reported all food, beverages, and supplements consumed in the previous 24-h. Dietary intake analysis was performed by implementing the National Cancer Institute (NCI) method to calculate the macronutrient and food group usual intake. Macronutrient intakes were compared to Acceptable Macronutrient Distribution Ranges for the general population and food group intakes were compared to the 2008 Brazilian National Dietary Guidelines. Para-athletes consumed a low-carbohydrate, adequate protein, high-fat diet. There was no significant difference in macronutrient intake distribution between team sport and individual sport para-athletes. Most para-athletes had three main meals during the day. The prevalence of inadequate fruit servings in the middle and highest energy intake tertiles was significantly higher in team sport para-athletes (92.5% and 98.4%) than in individual sport para-athletes (90.8% and 65.5%), respectively. The prevalence of inadequate vegetable servings was significantly higher between team and individual para-athletes for the middle energy intake tertiles. Para-athletes generally consumed an imbalanced diet, which is a cause for concern given their additional physiological demands and specific training needs.

Dietary Patterns of Competitive Swimmers with Moderate-to-Severe Cerebral Palsy: A 3-Year Longitudinal Evaluation

AIM

To evaluate the longitudinal dietary patterns of three adolescents with moderate-to-severe cerebral palsy (CP) participating in a performance-focused swimming training intervention.

METHOD

Participants were three previously inactive adolescents with CP (15-16 years, GMFCS IV) who had recently (<6 months) enrolled in a swimming training program. Diet quality from diet histories was calculated at 10-time points over 3.25 years using the Dietary Guidelines Index for Children and Adolescents (DGI-CA) and the Healthy Eating Index for Australian Adults (HEIFA-2013). A food group analysis was compared to the Australian Guide to Healthy Eating recommendations. Trends were considered in the context of dietary advice given and the training load.

RESULTS

Longitudinal diet quality scores were consistent and ranged from 40 to 76 (DGI-CA) and 33 to 79 (HEIFA-2013). Food group intake remained stable; participants rarely met the recommendations for fruit, vegetables, dairy, grain, and meat but frequently achieved discretionary serves.

CONCLUSIONS

Participants with moderate-to-severe CP who were enrolled in a performance-focused swimming training intervention and were monitored frequently maintained diet quality throughout a period where it conventionally declined. Scores were higher than the general population and were maintained irrespective of the training load. Participants frequently met food group recommendations for discretionary foods and were comparable to the general population for other food groups.

INFLUENCE OF PHYSICAL TRAINING ON THE PHYSICAL FITNESS OF YOUNG THROWING ATHLETES

ABSTRACT Introduction The improvement of physical training is a prerequisite to achieving excellent athletic performance in throwing. Following these requirements, it is also necessary to improve the scientificity, effectiveness, and flexibility of the physical training of adolescent athletes. Objective To study the influence of physical training on the physical fitness of young throwing athletes. Methods This article uses mathematical statistics to study the physical fitness of young throwing athletes. We divided the young volunteers included in the experimental study into training and control groups. A comparative analysis of their physical fitness indicators before and after sports practice. Results After physical training, the physical fitness indicators of adolescents showed a more significant impact. The athletics competitions of the young athletes’ results also improved significantly (P<0.05). Conclusion The throwing sport can improve the physical fitness of young athletes. In adolescence, the intervention of physical training can be increased to improve indicators of physical fitness in young practitioners. Evidence level II; Therapeutic Studies - Investigating the results.

Nutritional Considerations for Para-Cycling Athletes: A Narrative Review

Para-cycling is a sport including athletes with different disabilities competing on the track and on the roads using bicycles, tandems, tricycles, and handbikes. Scientific literature in this special population is scarce, especially in the field of sports nutrition. This review summarizes the physiological aspects and demands of para-cycling. This information together with the existing literature on nutritional interventions in this population, helps to discuss the nutritional considerations. To date, only a limited amount of recommendations are available for this population. In most para-cycling athletes, a reduction in active muscle mass and consequently a reduction in resting energy expenditure occurs, except for visually impaired athletes. Furthermore, carbohydrate and protein intake and hydration, supplementation, heat, and weight loss need to be tailored to the disability-specific adaptations such as the reduced active muscle mass, neurogenic bladder, and bowel, a reduced metabolic cost during exercise, and a higher risk of micronutrient deficiency.

Eating Perception, Nutrition Knowledge and Body Image among Para-Athletes: Practical Challenges in Nutritional Support

Limited information exists on dietary practices in para-athletes. The aim of this study was to clarify the actual situation of para-athletes' dietary practice and to sort out the factors (i.e., eating perception, nutrition knowledge, and body image), that may hinder their dietary practices, and explored the practical challenges in nutritional support and improving nutrition knowledge for para-athletes. Thirty-two Japanese para-athletes (22 men) and 45 collegiate student athletes without disabilities (27 men) participated in the online survey. The questionnaire included demographic characteristics, eating perception, dietary practices, and nutrition knowledge. The Japanese version of the body appreciation scale was used to determine their body image. Para-athletes who answered that they knew their ideal amount and way of eating showed significantly higher body image scores (r = 0.604, p < 0.001). However, mean score for nutrition knowledge of para-athletes were significantly lower than collegiate student athletes (19.4 ± 6.8 vs. 24.2 ± 6.1 points, p = 0.001). Both groups did not identify a dietitian as the source of nutrition information or receiving their nutrition advice. The results indicate para-athletes have unique eating perceptions and inadequate nutrition knowledge. Future interventions are needed to examine nutritional supports and education in relation to the role of dietitians.

Pro-Healthy Diet Properties and Its Determinants among Aging Masters Athletes

Qualitative dietary assessments are not common in aging athletes. Therefore, this study aimed to evaluate diet quality and its determinants among aging masters athletes. Eighty-six participants of the 8th World Masters Indoor Athletics Championships were enrolled in the study (age range 36-65 years). Three subgroups were distinguished to represent countries with different eating habits. Body composition was measured by bioelectrical impedance. Eating habits and diet quality were assessed using the Dietary Habits and Nutrition Beliefs Questionnaire (KomPAN®, Warszawa, Poland), and the Pro-healthy Diet Index (pHDI-10). Dietary quality determinants were identified by a multiple regression model conducted for each subgroup separately (Great Britain, France, and Poland). The results showed that none of the subgroups adhered to the reference intake of products with beneficial health outcomes. This was particularly noticeable in the insufficient consumption of whole grain products, dairy, and fish. The fish and vegetables consumption frequency significantly differentiated the eating habits of the studied groups. Diet quality determinants varied depending on the group. However, in each of them, fruit consumption was one of the components of a good-quality diet. The obtained results can be used by institutions providing health education among the elderly to develop an appropriate strategy aimed at changing inappropriate eating habits.

Diet in neurogenic bowel management: A viewpoint on spinal cord injury

The aim of this review is to offer dietary advice for individuals with spinal cord injury (SCI) and neurogenic bowel dysfunction. With this in mind, we consider health conditions that are dependent on the level of lesion including skeletal muscle atrophy, autonomic dysreflexia and neurogenic bladder. In addition, SCI is often associated with a sedentary lifestyle, which increases risk for osteoporosis and diseases associated with chronic low-grade inflammation, including cardiovascular and chronic kidney diseases. The Mediterranean diet, along with exercise and dietary supplements, has been suggested as an anti-inflammatory intervention in individuals with SCI. However, individuals with chronic SCI have a daily intake of whole fruit, vegetables and whole grains lower than the recommended dietary allowance for the general population. Some studies have reported an increase in neurogenic bowel dysfunction symptoms after high fiber intake; therefore, this finding could explain the low consumption of plant foods. Low consumption of fibre induces dysbiosis, which is associated with both endotoxemia and inflammation. Dysbiosis can be reduced by exercise and diet in individuals with SCI. Therefore, to summarize our viewpoint, we developed a Mediterranean diet-based diet and exercise pyramid to integrate nutritional recommendations and exercise guidelines. Nutritional guidelines come from previously suggested recommendations for military veterans with disabilities and individuals with SCI, chronic kidney diseases, chronic pain and irritable bowel syndrome. We also considered the recent exercise guidelines and position stands for adults with SCI to improve muscle strength, flexibility and cardiorespiratory fitness and to obtain cardiometabolic benefits. Finally, dietary advice for Paralympic athletes is suggested.