The German Young Olympic Athletes' Lifestyle and Health Management Study (GOAL Study): design of a mixed-method study

Global hotspots and trends of nutritional supplements in sport and exercise from 2000 to 2024: a bibliometric analysis

BACKGROUND

Nutritional supplements for sports and exercise (NSSE) can facilitate the exogenous replenishment of the body. This study provides the first extensive overview of NSSE research through bibliometric and visual analyses.

METHODS

We searched the Web of Science Core Collection database for literature related to "NSSE" from 1st January 2000 to 8th March 2024. A total of 1744 articles were included. CiteSpace, VOSviewer, and Bibliometrix R package software were used to analyze the data.

RESULTS

Research in the NSSE can be divided into steady growth, exponential growth, fluctuating stage, and surge stages. The United States is the most active country in this field. In recent years, the leading countries have been Croatia, Colombia, Slovenia, Chile, Egypt, China, and Thailand. The Australian Institute of Sports is the top research institution in terms of number of publications. Burke, LM from Australia published the most articles. Research in this area has primarily been published in Nutrients in Switzerland. The study population mainly consisted of men, and postmenopausal women were the main focus of the female group. Coronary heart and cardiovascular diseases continue to dominate research.

CONCLUSION

Research on the NSSE is developing rapidly, with an annual growth trend. Insulin resistance, sports nutrition, inflammation, alpha-linolenic acid, limb strength performance, female sex, and gut microbiota are the focus of the current research and trends for future research. Future research should focus on improving the scientific training system for athletes and quality of training and life for the general public.

Coping strategies for handling stress and providing mental health in elite athletes: a systematic review

Background

The combination of stressors unique to the athletic context plus the sensitive developmental phase that elite athletes go through during their peak performance may increase the athletes' vulnerability to mental health decrements. To emphasize the necessity to raise elite athletes' awareness of health risks, it seems to be essential to teach them coping skills to handle stress and to make affected athletes aware of how to recognize, evaluate, and articulate potential risks to their health.

Objective

This systematic review analyzes coping strategies used by elite athletes to deal with stress and the effect of these strategies on mental health to identify gaps that future research could prioritize.

Methods

The current review analyzes studies containing quantitative, qualitative, and mixed data and results, all of them focusing on coping strategies to deal with stress and the effect of coping strategies on elite athletes' mental health. Literature search for this systematic review took place between August and October 2023 and included the use of 3 electronic databases: PubMed, PsychINFO, SPORTdiscus.

Results

There were initially 5,705 hits from 3 electronic databases, hand search and from a complementary search in Google Scholar. After the screening process and quality appraisal 30 studies were included. The analyzed study results point to a broad spectrum of coping categories, elite athletes make use of to deal with stressful situations. The results of this review underpin the necessity that especially young athletes being confronted with a wide range of stressors, need to be taught mental skills to cope with these stressors. In addition, teaching coaches and teammates about social support seemed to decrease elite athletes' stress reactions, such as anxiety or depressive symptoms.

Conclusion

Coping in elite sporting settings is very complex and dynamic. There is evidence of coping being effective to buffer stress, but the interrelationships between stressor, appraisal of the stressor, application of a corresponding coping strategy and its effect especially in terms of mental health outcomes is still unclear because of lacking intervention-based study designs.

Elite athletes’ lifestyles: Consumerism to professionalism

Today, elite athletes form an important social group, and the non-sport facets of their lives matter as much as their sports performances. However, there has been little empirical research on the lifestyles of elite athletes. Therefore, this study aimed to develop knowledge about the Iranian elite athletes’ lifestyle. The study was conducted with a qualitative approach in two phases. Glaserian grounded theory was used in the first phase, and thematic analysis was used in the second phase. Participants of the first phase included 19 sports experts, such as sports sociologists, sports psychologists, and sports coaches, who were selected by purposive and snowball sampling methods for holding unstructured in-depth interviews. The data were simultaneously analyzed using a set of open, theoretical, selective coding and memos. The codes were grouped into three different categories with different natures. The emerged theory advanced our understanding of the lifestyle shaping structures of elite athletes, lifestyle indicators, and even professionalization of their lifestyles. According to the results, the Iranian elite athletes’ lifestyles include indicators, such as professional mindset, competencies, life vision, financial literacy, responsibility, consumption, leisure, personal issues, and religious behavior. Subjects of the second phase were 44 Iranian athletes in the national levels who participated voluntarily in the study. The data were analyzed by thematic analysis method, and lifestyles typologies were identified. Based on results, five dominant lifestyles among the Iranian elite athletes were identified: consumerist, easy going, socially useful, profit-oriented, and professional. Finally, the features of each lifestyle were discussed.

Learning Football for Good: The Development and Evaluation of the Football3 MOOC

Over the last two decades, sport has become a recognised tool to achieve sustainable development outcomes. Known as sport for development (SFD), this approach can broadly be defined as the intentional use of sport to achieve development objectives. Many SFD organisations implement methods that seek to achieve developmental goals by reorienting sport away from its competitive aspects and encouraging participation, fair play and communication. Of these methods, football3 is arguably the most widespread. Despite its popularity, there remain challenges in its implementation. As a result, there have been numerous calls to develop educational materials and opportunities around football3. In response, the football3 for all project led to the development and launch of a freely accessible, Massive Open Online Course (MOOC). However, there is still little knowledge about how online learning approaches are used in SFD, how they accommodate the practical and social nature of SFD, and whether they optimise student learning. Using findings from feedback surveys and focus group discussions, we present results from the development and evaluation of the football3 MOOC. The findings suggest a high level of satisfaction with the course, but also a need for practical tools and exchange to improve delivery on the pitch.

Level of Adherence to the Mediterranean Diet and Weight Status among Adolescent Female Gymnasts: A Cross-Sectional Study

Adolescent female gymnasts are a vulnerable population in terms of their diet, as their nutritional needs are higher due to their growth and high daily training demands. The Mediterranean diet (MD) is a well-known dietary pattern that is associated with a greater nutritional adequacy and a lower prevalence of overweight. The aim of this cross-sectional study was to evaluate the degree of adherence to the MD among adolescent female athletes who participated in all disciplines of gymnastics in Greece, as well as to explore the potential correlations between MD adherence, body weight, and body mass index (BMI). A total of 269 female gymnasts (between 11-18 years old) completed the Mediterranean Diet Quality Index (KIDMED) and reported their weight and height. Approximately 10% of the participants were underweight and a mere 5.6% were classified as overweight. A high adherence to the MD was reported by 34.9% of the sample and this was correlated with a healthier BMI. Moreover, specific eating habits, such as eating nuts 2-3 times per week and eating fast-food less than once-weekly, were also associated with BMI. Athletes, parents, and coaches of gymnastics should be informed and educated regarding balanced nutrition habits. Future studies could evaluate adherence to MD, as well as the factors that influence the eating behaviors of adolescent female and male athletes in various sports.

Trajectories of Health Status during the Transition from School to University: Piloting the Method of Biographical Mapping in German Medical Students

Health status and health behavior change during the transition from school to university. However, it is still unclear whether these changes occur at specific points in time, and whether these changes are stable. Therefore, our aim was to conduct a pilot test on biographical mapping (BM) for the first time in this research area in order to map the trajectories of the health status of university students over time. This enabled us to also test the practicability of BM, and to assess the agreement of the findings of BM with those of a standardized questionnaire. We included 30 fourth-year university students. First, they filled in a standardized questionnaire on their sociodemographic information, current health status, and health status compared with that for their final year of school. Second, they filled in a BM grid that allows for drawing the changes in health status that have taken place over the transition period. The health status changed during the transition (e.g., slight decline in general subjective health), and was related to specific events before and after the transition (e.g., examinations), showing that all health variables were not stable over time. The findings of BM were also reflected in the standardized questionnaire. Using BM revealed the changes in health during a six-year-period, including the school-university transition. The identified changes in health during transition and at specific time points underline that not only assistance before the transition, but also psychological support during studies, seems to be important for the health promotion of students. Besides this, BM seems to be a useful, although time-consuming, instrument for which the results were similar to those in the questionnaire.

Weight Stigma Experiences and Physical (In)activity: A Biographical Analysis

INTRODUCTION

People with obesity often report experiences of weight-related discrimination. In order to find out how such experiences throughout the life course are related to physical activity behavior, we exploratively studied activity-related biographies of people with obesity from a social constructivist perspective.

METHODS

We collected biographical data of 30 adults (mean age 37.66 years; 14 males and 16 females) with obesity (average BMI 40.64, including a range from 33 to 58) using a biography visualization tool that allows participants to map developmental courses and critical life experiences over their life course.

RESULTS

Participants remembered a continuous decrease of physical activity from childhood to mid-adulthood. Weight-related discrimination, both in sport and non-sport settings, was especially experienced in adolescence and mid-adulthood. Against the background of our findings, we assume that the degree of felt stigma rather than the stigmatizing behavior itself influences physical activity behavior over the life course.

CONCLUSION

The results of our exploratory study reiterate the detrimental effect weight stigma can have on health behaviors. Initiatives are needed to reduce weight stigma in exercise contexts; additionally, initiatives to promote physical activity should focus on helping individuals with obesity to establish coping strategies to reduce the experienced burden from weight stigma.

No Pain, No Gain? Prevalence, Location, Context, and Coping Strategies with Regard to Pain Among Young German Elite Basketball Players

Pain among young athletes requires special attention given that symptoms occur during the ongoing development of the conditional, and in particular, the motor capacities, and while the musculoskeletal system is in a continuous process of growth. The purpose of this study was to evaluate prevalence, location, context, and coping strategies regarding pain among young athletes. We chose survey data of young elite athletes from the highest level national basketball leagues in Germany, as this meant that health implications may be observed earlier and in a more pronounced manner. The German 'Adolescents' and Children's Health in Elite Basketball study' (ACHE study), a quantitative survey, was conducted between April and June 2016. Analyses were based on elite basketball players between 13 and 19 years of age from 46 German teams (n = 182). Constant, and to some extent severe pain, was part of daily life of young elite basketball players: eight out of ten players in the highest German leagues suffered from pain at the time of the survey. Knee, leg, and back pain occurred most frequently. For most players, occasional or frequent consumption of analgesics was the norm, in some cases these were also taken "prophylactically". The consumption of multiple pharmaceutical substances, especially of cyclooxygenase inhibitors such as ibuprofen and diclofenac, is widespread among adolescent elite basketball players. Physicians involved in treating these athletes should address pain and its management preemptively. Coaches, sporting organizations and parents should be involved in this process from an early stage.

[Joint pain and consumption of analgesics among young elite athletes : Nationwide data from youth basketball]

BACKGROUND

Joint pain may be an early indicator of biomechanical stress. During adolescence the physical development, including the development of the musculoskeletal system, is still ongoing and joint pain requires special attention, especially among young athletes.

OBJECTIVE

Young athletes from the highest national basketball leagues in Germany were questioned about prevalence, location, context and coping strategies concerning joint pain.

MATERIAL AND METHODS

Data were derived from the German "Adolescents' and Childrens' Health in Elite Basketball study" (ACHE study). Analyses were based on an online survey of 182 elite basketball players between 13 and 19 years of age from 46 German teams, conducted between April 2016 and June 2016.

RESULTS

In the highest German leagues 2 out of 3 players suffered from joint pain at the time of the survey (7-day prevalence 64.6%). Pain in the lower extremities occurred most frequently. The 7‑day prevalence for knee and leg pain reached up to 40% and foot pain up to 21%. For 84% of all players, occasional consumption of analgesics was the norm and 40% took them frequently. The consumption of several medicinal substances, especially of cyclooxygenase inhibitors, such as ibuprofen and diclofenac, is widespread among adolescent elite basketball players as 1 out of 7 athletes (13%) used medicinal substances despite being pain-free and 5% used it prophylactically with the purpose of preventing pain.

CONCLUSION

From the point of view of pain medicine, it is not only the high prevalence of pain that is remarkable but also the widespread use of analgesics without a prescription and the misguided conception of adolescent competitive athletes that such medications have preventive effects.

Eating disorder pathology in elite adolescent athletes

OBJECTIVE

We aimed to investigate eating disorder pathology in German elite adolescent athletes. Evidence suggests that eating disorder pathology is more common in adult elite sports, especially in female athletes and in sports emphasizing leanness. There is a scarcity of studies in elite adolescent athletes who are in a vulnerable developmental stage and are affected by general as well as sport-specific risk factors.

METHOD

Our data was derived from the German Young Olympic Athletes' Lifestyle and Health Management Study (GOAL) which conducted a survey in 1138 elite adolescent athletes. In this sample, we assessed body weight, weight control behavior, body acceptance and screened overall for core symptoms of eating disorders, depression and anxiety. We performed a tree analysis to identify high risk groups for eating disorder pathology.

RESULTS

High risk groups comprised (a) athletes competing in weight dependent sports, and among athletes competing in disciplines other than weight dependent sports (b) athletes who are high on negative affectivity, (c) female athletes and (d) male athletes competing in endurance, technical or power sports. Athletes competing in weight dependent disciplines reported wide spread use of compensatory behaviors to influence body weight. Athletes reporting eating disorder pathology showed higher levels of depression and anxiety than athletes without eating disorder pathology.

DISCUSSION

Increased psychosocial burden in athletes with eating disorder pathology suggests that eating disorder symptoms should not be accepted as an unproblematic and functional part of elite sports. The prevention and management of eating disorder pathology is especially important in weight dependent sports. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:553-562).

Weight-control behaviour and weight-concerns in young elite athletes - a systematic review

Weight-control behaviour is commonly observed in a wide range of elite sports, especially leanness sports, where control over body weight is crucial for high peak performance. Nonetheless, there is only a fine line between purely functional behaviour and clinically relevant eating disorders. Especially the rapid form of weight manipulation seems to foster later eating disorders. So far, most studies have focussed on adult athletes and concentrated on manifest eating disorders. In contrast, our review concentrates on young athletes and weight-control behaviour as a risk factor for eating disorders. An electronic search according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) Statement was performed using Pubmed, PsychInfo and Spolit. The following search terms were used: weight-control, weight-control behaviour, weight gain, weight loss, pathogenic weight-control behaviour and weight-concerns, each of them combined with elite athlete, young elite athlete, adolescent elite athlete and elite sports. Overall, data are inconsistent. In general, athletes do not seem to be at a higher risk for pathogenic weight concerns and weight-control behaviour. It does seem to be more prevalent in leanness sports, though. There is evidence for pathogenic weight-control behaviour in both genders; male athletes mostly trying to gain weight whereas females emphasise weight reduction. There is not enough data to make predictions about connections with age of onset. Young elite athletes do show weight-control behaviour with varying degrees of frequency and severity. In particular, leanness sports seem to be a risk factor for weight manipulation. Further research is needed for more details and possible connections.

Body dissatisfaction in female adolescents: extent and correlates

This study aimed to assess the extent, patterns, and predictors of feelings of body dissatisfaction experienced by female German adolescents. Using 3D-avatar software, a sample population of 144 girls between 14 and 17 years of age was asked to estimate their actual body image, their desired body image (individual ideal), and the body image they believed their parents and their best female friend considered to be the ideal body image for them. The participants estimated their actual body mass index (BMI) to be 18.82 ± 3.01. The individual ideal body shape reported was significantly thinner, with a BMI score of 16.84 ± 2.51. Given a girl who stands 1.65 m and weighs 55 kg, this corresponds to a difference in weight of about 5.5 kg. After adjustment for the participant's self-reported BMI, participating in an esthetic sport was correlated with a significantly lower body dissatisfaction. Conversely, low socio-economic status and the amount of time spent watching TV was correlated with a significantly higher body dissatisfaction. Negative body image-related comments made by parents were significantly associated with body dissatisfaction. The girls who participated in this study would like to be an average of 1.97 BMI units thinner. The findings presented here suggest that future intervention measures should focus on the risk groups of physically inactive girls, those who smoke, and those with a lower social status and high rates of TV consumption. Intervention measures would be especially effective in German schools which offer lower education levels and should include the pupils' parents, who should be informed about the negative effects weight- and diet-related comments have on their children's body images.