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McGuire A, Warrington G, Walsh A, Byrne T, Doyle L. Measurement of energy availability in highly trained male endurance athletes and examination of its associations with bone health and endocrine function. Eur J Nutr 2024:10.1007/s00394-024-03433-8. [PMID: 38953963 DOI: 10.1007/s00394-024-03433-8] [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: 08/23/2023] [Accepted: 05/17/2024] [Indexed: 07/04/2024]
Abstract
PURPOSE Despite the introduction of Relative Energy Deficiency in Sport (RED-s) in 2014, there is evidence to suggest that male endurance athletes still present with a high prevalence of low energy availability (LEA). Previous findings suggest that energy availability (EA) status is strongly correlated with impairments in endocrine function such as reduced leptin, triiodothyronine (T3), and insulin, and elevated bone loss. This study aimed to report the current EA status, endocrine function and bone health of highly trained Irish male endurance athletes. METHODS In this cross-sectional study, participants (n = 3 triathletes; n = 10 runners) completed a 7-day testing period during the competition season using lab-based measures, to ascertain EA status, hormone level and rates of bone metabolism. Serum blood samples were obtained to assess hormone levels and markers of bone metabolism. RESULTS Mean EA was < 30 kcal/kg lean body mass (LBM)/day in 76.9% of athletes. There was a strong association between LEA and low carbohydrate intake, and lower LBM. Mean levels of insulin, IGF-1 and leptin were significantly lower than their reference ranges. Elevated mean concentrations of β-CTX and a mean P1NP: β-CTX ratio < 100, indicated a state of bone resorption. CONCLUSION The EA level, carbohydrate intake, hormone status and bone metabolism status of highly trained male endurance athletes are a concern. Based on the findings of this study, more frequent assessment of EA across a season is recommended to monitor the status of male endurance athletes, in conjunction with nutritional education specific to EA and the associated risks.
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Affiliation(s)
- Amy McGuire
- Department of Sport and Early Childhood Studies, Technological University of the Shannon, Limerick, Ireland.
- ACTIVE Research Group, Technological University of the Shannon, Limerick, Ireland.
| | - Giles Warrington
- Department of Physical Education and Social Sciences, University of Limerick, Limerick, Ireland
- Sport and Human Performance Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Adam Walsh
- Department of Sport and Exercise Science, South East Technological University, Cork Road, Waterford, Ireland
| | - Thomas Byrne
- Department of Sport and Exercise Science, South East Technological University, Cork Road, Waterford, Ireland
| | - Lorna Doyle
- Department of Sport and Exercise Science, South East Technological University, Cork Road, Waterford, Ireland
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2
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Vardardottir B, Olafsdottir AS, Gudmundsdottir SL. A real-life snapshot: Evaluating exposures to low energy availability in male athletes from various sports. Physiol Rep 2024; 12:e16112. [PMID: 38923409 PMCID: PMC11194298 DOI: 10.14814/phy2.16112] [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: 04/30/2024] [Revised: 06/06/2024] [Accepted: 06/06/2024] [Indexed: 06/28/2024] Open
Abstract
Problematic low energy availability (LEA) is the underlying cause of relative energy deficiency in sport (REDs). Male specific etiology, as well as the duration and degree of LEA exposures resulting in REDs remain to be adequately described. The present study aimed to assess occurrences of LEA (energy availability [EA] <25 kcal/kg fat-free mass/day) in male athletes from various sports over 7 days. Associations between number of LEA days, physiological measures, and body image concerns were subsequently evaluated. The athletes recorded their weighed food intakes and training via photo-assisted mobile application. Body composition and resting metabolic rates were measured, and venous blood samples collected for assessments of hormonal and nutrition status. Participants also answered the Low Energy Availability in Males Questionnaire (LEAM-Q), Eating Disorder Examination-Questionnaire Short (EDE-QS), Exercise Addiction Inventory (EAI), and Muscle Dysmorphic Disorder Inventory (MDDI). Of 19 participants, 13 had 0-2, 6 had 3-5, and none had 6-7 LEA days. No associations were found between the number of LEA days with the physiological and body image outcomes, although those with greatest number of LEA days had highest EEE but relatively low dietary intakes. In conclusion, this group displayed considerable day-to-day EA fluctuations but no indication of problematic LEA.
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Affiliation(s)
- Birna Vardardottir
- Faculty of Health Promotion, Sport & Leisure StudiesUniversity of IcelandReykjavikIceland
| | - Anna S. Olafsdottir
- Faculty of Health Promotion, Sport & Leisure StudiesUniversity of IcelandReykjavikIceland
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3
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Amawi A, AlKasasbeh W, Jaradat M, Almasri A, Alobaidi S, Hammad AA, Bishtawi T, Fataftah B, Turk N, Saoud HA, Jarrar A, Ghazzawi H. Athletes' nutritional demands: a narrative review of nutritional requirements. Front Nutr 2024; 10:1331854. [PMID: 38328685 PMCID: PMC10848936 DOI: 10.3389/fnut.2023.1331854] [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: 11/01/2023] [Accepted: 12/21/2023] [Indexed: 02/09/2024] Open
Abstract
Nutrition serves as the cornerstone of an athlete's life, exerting a profound impact on their performance and overall well-being. To unlock their full potential, athletes must adhere to a well-balanced diet tailored to their specific nutritional needs. This approach not only enables them to achieve optimal performance levels but also facilitates efficient recovery and reduces the risk of injuries. In addition to maintaining a balanced diet, many athletes also embrace the use of nutritional supplements to complement their dietary intake and support their training goals. These supplements cover a wide range of options, addressing nutrient deficiencies, enhancing recovery, promoting muscle synthesis, boosting energy levels, and optimizing performance in their respective sports or activities. The primary objective of this narrative review is to comprehensively explore the diverse nutritional requirements that athletes face to optimize their performance, recovery, and overall well-being. Through a thorough literature search across databases such as PubMed, Google Scholar, and Scopus, we aim to provide evidence-based recommendations and shed light on the optimal daily intakes of carbohydrates, protein, fats, micronutrients, hydration strategies, ergogenic aids, nutritional supplements, and nutrient timing. Furthermore, our aim is to dispel common misconceptions regarding sports nutrition, providing athletes with accurate information and empowering them in their nutritional choices.
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Affiliation(s)
- Adam Amawi
- Department of Exercise Science and Kinesiology, School of Sport Science, The University of Jordan, Amman, Jordan
| | - Walaa AlKasasbeh
- Department of Physical and Health Education, Faculty of Educational Sciences, Al-Ahliyya Amman University, Amman, Jordan
| | - Manar Jaradat
- Department of Nutrition and Food Technology, School of Agriculture, The University of Jordan, Amman, Jordan
| | - Amani Almasri
- Department of Nutrition and Food Technology, School of Agriculture, The University of Jordan, Amman, Jordan
| | - Sondos Alobaidi
- Department of Nutrition and Food Technology, School of Agriculture, The University of Jordan, Amman, Jordan
| | - Aya Abu Hammad
- Department of Nutrition and Food Technology, School of Agriculture, The University of Jordan, Amman, Jordan
| | - Taqwa Bishtawi
- Department of Nutrition and Food Technology, School of Agriculture, The University of Jordan, Amman, Jordan
| | - Batoul Fataftah
- Department of Nutrition and Food Technology, School of Agriculture, The University of Jordan, Amman, Jordan
| | - Nataly Turk
- Department of Family and Community Medicine, Faculty of Medicine, The University of Jordan, Amman, Jordan
| | - Hassan Al Saoud
- Department of Exercise Science and Kinesiology, School of Sport Science, The University of Jordan, Amman, Jordan
| | - Amjad Jarrar
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Oxford Brookes Center for Nutrition and Health, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, United Kingdom
| | - Hadeel Ghazzawi
- Department of Nutrition and Food Technology, School of Agriculture, The University of Jordan, Amman, Jordan
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4
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Melin AK, Areta JL, Heikura IA, Stellingwerff T, Torstveit MK, Hackney AC. Direct and indirect impact of low energy availability on sports performance. Scand J Med Sci Sports 2024; 34:e14327. [PMID: 36894187 DOI: 10.1111/sms.14327] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/27/2023] [Accepted: 02/01/2023] [Indexed: 03/11/2023]
Abstract
Low energy availability (LEA) occurs inadvertently and purposefully in many athletes across numerous sports; and well planned, supervised periods with moderate LEA can improve body composition and power to weight ratio possibly enhancing performance in some sports. LEA however has the potential to have negative effects on a multitude of physiological and psychological systems in female and male athletes. Systems such as the endocrine, cardiovascular, metabolism, reproductive, immune, mental perception, and motivation as well as behaviors can all be impacted by severe (serious and/or prolonged or chronic) LEA. Such widely diverse effects can influence the health status, training adaptation, and performance outcomes of athletes leading to both direct changes (e.g., decreased strength and endurance) as well as indirect changes (e.g., reduced training response, increased risk of injury) in performance. To date, performance implications have not been well examined relative to LEA. Therefore, the intent of this narrative review is to characterize the effects of short-, medium-, and long-term exposure to LEA on direct and indirect sports performance outcomes. In doing so we have focused both on laboratory settings as well as descriptive athletic case-study-type experiential evidence.
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Affiliation(s)
- Anna K Melin
- Department of Sport Science, Faculty of Social Sciences, Swedish Olympic Committee Research Fellow, Linnaeus University, Växjö/Kalmar, Sweden
| | - José L Areta
- School of Sport and Exercise Sciences, Faculty of Science, Liverpool John Moores University, Liverpool, UK
| | - Ida A Heikura
- Canadian Sport Institute - Pacific, Victoria, British Columbia, Canada
- Exercise Science, Physical & Health Education, University of Victoria, Victoria, British Columbia, Canada
| | - Trent Stellingwerff
- Canadian Sport Institute - Pacific, Victoria, British Columbia, Canada
- Exercise Science, Physical & Health Education, University of Victoria, Victoria, British Columbia, Canada
| | - Monica Klungland Torstveit
- Department of Sport Science and Physical Education, Faculty of Health and Sport Science, University of Agder, Kristiansand, Norway
| | - Anthony C Hackney
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA
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Sesbreno E, Blondin DP, Dziedzic C, Sygo J, Haman F, Leclerc S, Brazeau AS, Mountjoy M. Signs of low energy availability in elite male volleyball athletes but no association with risk of bone stress injury and patellar tendinopathy. Eur J Sport Sci 2023; 23:2067-2075. [PMID: 36480965 DOI: 10.1080/17461391.2022.2157336] [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] [Indexed: 12/13/2022]
Abstract
Relative Energy Deficiency in Sport (RED-S) syndrome is associated with undesirable health and performance outcomes. The aetiology of RED-S syndrome is low energy availability (LEA). LEA has been reported in male athletes in various sports, but there is little information in team sports. Therefore, the aims of this study were to assess the point-prevalence of surrogate markers of LEA in elite male volleyball players and examine the association between low and normal total-testosterone (TES) on endocrine markers, resting metabolic rate, bone mineral density (BMD), and history of injury/illness. Using a cross-sectional design, 22 elite male volleyball players underwent anthropometric, dual-energy X-ray absorptiometry (DEXA or DXA) and resting metabolic rate testing, bloodwork, dietary analysis, the three-factor eating questionnaire-R18, injury/illness questionnaire and Victorian Institute of Sport Assessment - patellar tendon questionnaire. The primary finding of this investigation was that 36% of athletes had ≥2 surrogate markers of LEA. Although fasted insulin was lower and cortisol was higher in players with low-total TES, low BMD, low RMR and various other endocrine markers linked to LEA were not observed. More research is required to define surrogate markers of LEA in male athletes.HIGHLIGHTS Thirty-six percent of volleyball players had ≥2 surrogate markers of LEA.The Cunningham, 1991 predictive RMR equation and/or the cut-off point (<0.9) may be unsuitable for detecting energy conservation associated with LEA in large male athletes.There was no association between total-TES and risk of bone stress injury, illness and patellar tendinopathy.
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Affiliation(s)
- Erik Sesbreno
- l'Institut National du Sport du Québec, Montréal, Canada
- French-speaking Olympic Sports Medicine Research Network (ReFORM), Montréal, Canada
- School of Human Nutrition, McGill University, Montréal, Canada
| | - Denis P Blondin
- Division of Neurology, Department of Medicine, Faculty of Medicine and Health Sciences, Centre de Recherche du CHUS, Université de Sherbrooke, Sherbrooke, Canada
| | | | | | - François Haman
- School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Suzanne Leclerc
- l'Institut National du Sport du Québec, Montréal, Canada
- French-speaking Olympic Sports Medicine Research Network (ReFORM), Montréal, Canada
| | | | - Margo Mountjoy
- Association for Summer Olympic International Federations (ASOIF), Lausanne, Switzerland
- Department of Family Medicine. Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Canada
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6
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Stellingwerff T, Mountjoy M, McCluskey WT, Ackerman KE, Verhagen E, Heikura IA. Review of the scientific rationale, development and validation of the International Olympic Committee Relative Energy Deficiency in Sport Clinical Assessment Tool: V.2 (IOC REDs CAT2)-by a subgroup of the IOC consensus on REDs. Br J Sports Med 2023; 57:1109-1118. [PMID: 37752002 DOI: 10.1136/bjsports-2023-106914] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2023] [Indexed: 09/28/2023]
Abstract
Relative Energy Deficiency in Sport (REDs) has various different risk factors, numerous signs and symptoms and is heavily influenced by one's environment. Accordingly, there is no singular validated diagnostic test. This 2023 International Olympic Committee's REDs Clinical Assessment Tool-V.2 (IOC REDs CAT2) implements a three-step process of: (1) initial screening; (2) severity/risk stratification based on any identified REDs signs/symptoms (primary and secondary indicators) and (3) a physician-led final diagnosis and treatment plan developed with the athlete, coach and their entire health and performance team. The CAT2 also introduces a more clinically nuanced four-level traffic-light (green, yellow, orange and red) severity/risk stratification with associated sport participation guidelines. Various REDs primary and secondary indicators have been identified and 'weighted' in terms of scientific support, clinical severity/risk and methodological validity and usability, allowing for objective scoring of athletes based on the presence or absence of each indicator. Early draft versions of the CAT2 were developed with associated athlete-testing, feedback and refinement, followed by REDs expert validation via voting statements (ie, online questionnaire to assess agreement on each indicator). Physician and practitioner validity and usability assessments were also implemented. The aim of the IOC REDs CAT2 is to assist qualified clinical professionals in the early and accurate diagnosis of REDs, with an appropriate clinical severity and risk assessment, in order to protect athlete health and prevent prolonged and irreversible outcomes of REDs.
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Affiliation(s)
- Trent Stellingwerff
- Canadian Sport Institute Pacific, Victoria, British Columbia, Canada
- Exercise Science, Physical & Health Education, University of Victoria, Victoria, British Columbia, Canada
| | - Margo Mountjoy
- Association for Summer Olympic International Federations (ASOIF), Lausanne, Switzerland
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | | | - Kathryn E Ackerman
- Wu Tsai Female Athlete Program, Division of Sports Medicine, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Evert Verhagen
- Amsterdam Collaboration on Health and Safety in Sports and Department of Public and Occupational Health, VU University Medical Centre Amsterdam, Amsterdam, The Netherlands
| | - Ida A Heikura
- Canadian Sport Institute Pacific, Victoria, British Columbia, Canada
- Exercise Science, Physical & Health Education, University of Victoria, Victoria, British Columbia, Canada
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7
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Pensgaard AM, Sundgot-Borgen J, Edwards C, Jacobsen AU, Mountjoy M. Intersection of mental health issues and Relative Energy Deficiency in Sport (REDs): a narrative review by a subgroup of the IOC consensus on REDs. Br J Sports Med 2023; 57:1127-1135. [PMID: 37752005 DOI: 10.1136/bjsports-2023-106867] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2023] [Indexed: 09/28/2023]
Abstract
Overall athlete health is a stated priority by the International Olympic Committee (IOC), yet it can be difficult for athletes to safely balance nutritional needs, training load, recovery, social interactions, expectations and other demands. The effect of energy intake and, especially, low energy availability (LEA) on athlete mental health, is understudied. In this narrative review, we examine research that has included psychological factors and mental health variables when investigating the effect of LEA, dieting/restrictive eating and Relative Energy Deficiency in Sport (REDs), since the 2018 IOC consensus statement on REDs. Based on currently available data, early psychological indicators associated with problematic LEA are mood changes, fatigue and psychological conflict. More severe mental health outcomes associated with REDs are reduced well-being, elevated anxiety, depressive symptoms and eating disorders. We propose a psychological model that helps structure how possible risk factors (eg, body dissatisfaction, environmental demands or increased training load) and moderating (eg, gender, sport) and/or potential mediating (eg, social climate, self-esteem) factors are associated with LEA and ultimately REDs. The current scientific literature underscores the importance of including mental health factors when screening for REDs and for developing a clinical approach to address the psychological sequelae of REDs once diagnosed. An interdisciplinary perspective is recommended. Lastly, and importantly, the athlete perspective urges clinicians to not underestimate the drive for success and denial of health consequences that athletes demonstrate when pursuing their sport goals.
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Affiliation(s)
| | | | - Carla Edwards
- McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | | | - Margo Mountjoy
- Association for Summer Olympic International Federations (ASOIF), Lausanne, Switzerland
- Department of Family Medicine, Hamilton, Hamilton, Ontario, Canada
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8
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Siedler MR, De Souza MJ, Albracht-Schulte K, Sekiguchi Y, Tinsley GM. The Influence of Energy Balance and Availability on Resting Metabolic Rate: Implications for Assessment and Future Research Directions. Sports Med 2023; 53:1507-1526. [PMID: 37213050 DOI: 10.1007/s40279-023-01856-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2023] [Indexed: 05/23/2023]
Abstract
Resting metabolic rate (RMR) is a significant contributor to an individual's total energy expenditure. As such, RMR plays an important role in body weight regulation across populations ranging from inactive individuals to athletes. In addition, RMR may also be used to screen for low energy availability and energy deficiency in athletes, and thus may be useful in identifying individuals at risk for the deleterious consequences of chronic energy deficiency. Given its importance in both clinical and research settings within the fields of exercise physiology, dietetics, and sports medicine, the valid assessment of RMR is critical. However, factors including varying states of energy balance (both short- and long-term energy deficit or surplus), energy availability, and prior food intake or exercise may influence resulting RMR measures, potentially introducing error into observed values. The purpose of this review is to summarize the relationships between short- and long-term changes in energetic status and resulting RMR measures, consider these findings in the context of relevant recommendations for RMR assessment, and provide suggestions for future research.
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Affiliation(s)
- Madelin R Siedler
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Mary Jane De Souza
- Departments of Kinesiology and Physiology, Pennsylvania State University, University Park, PA, USA
| | | | - Yasuki Sekiguchi
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Grant M Tinsley
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA.
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9
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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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10
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Prevalence of low energy availability and associations with seasonal changes in salivary hormones and IgA in elite male Gaelic footballers. Eur J Nutr 2023; 62:1809-1820. [PMID: 36841899 PMCID: PMC9968222 DOI: 10.1007/s00394-023-03112-0] [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: 05/24/2022] [Accepted: 02/07/2023] [Indexed: 02/27/2023]
Abstract
PURPOSE Evidence suggests low energy availability (LEA) is prevalent in elite male Gaelic football (GF) players. Previous research in male and female team sports found LEA may negatively impact endocrine function. The aim of this study was to examine the seasonal variations in energy availability (EA) and its associations with salivary measures in elite male GF players across the competitive season. METHODS Energy availability was assessed using field-based methods in conjunction with salivary testosterone (s-T), cortisol (s-C) and immunoglobin A (s-IgA) concentrations at pre-season (PRE), in-season (IN) and post-season (POST). RESULTS 38% reported LEA at PRE, 33% at IN, and 28.5% at POST. s-C, s-T and s-IgA levels were within normal ranges at PRE, IN and POST. Salivary cortisol declined significantly from PRE to IN, remaining reduced at POST. Salivary testosterone decreased significantly from PRE to IN but was significantly elevated at POST compared to IN. Salivary IgA was significantly greater at POST than IN. No significant associations were found between s-C or s-T and EA at any time point. Pre-season s-IgA exhibited a significant inverse association with PRE EA. Decreased s-IgA flow rate and s-IgA secretion rate were significantly associated with decreased EA at PRE. Reduced carbohydrate (CHO) intake was also associated with decreased s-IgA secretion rate at PRE. CONCLUSION This study suggests that LEA is prevalent in elite male GF players, but is not associated with s-C or s-T. However, EA is associated with s-IgA which may impact the immune system. Therefore, education and interventions surrounding the prevalence and associations of EA should be implemented in this population.
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11
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Jurov I, Keay N, Rauter S. Reducing energy availability in male endurance athletes: a randomized trial with a three-step energy reduction. J Int Soc Sports Nutr 2022; 19:179-195. [PMID: 35813848 PMCID: PMC9261741 DOI: 10.1080/15502783.2022.2065111] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Low energy availability (EA) can be detrimental for athlete health. Currently, it is not known what the threshold for low EA in men is, and what effects it may have on performance. Methods This study was set to determine potential effects of low EA by modulating male participants’ exercise energy expenditure and controlling energy intake and consequently manipulating EA in three progressive stages (reducing EA by 25%%, and 75 %). Performance was measured with three specific tests for explosive power, endurance, and agility. Blood was drawn, resting energy expenditure was monitored and two questionnaires were repetitively used to address any changes in eating behaviors and well-being. Results Repeated measured design showed poorer performance (power output 391.82 ± 29.60 vs. 402.5 ± 40.03 W, p = 0.001; relative power output 5.53 ± 0.47 vs. 5.60 ± 0.47 W/kg, p = 0.018; explosive power 0.28 ± 0.04 vs. 0.32 ± 0.05 m, p = 0.0001, lactate concentration 7.59 ± 2.29 vs 10.80 ± 2.46 mmol/L, p = 0.001). the quartile range for testosterone was lower (2.33 ± 1.08 vs. 2.67 ± 0.78, p = 0.026) and there was a tendency for lower triiodothyronine (4.15 ± 0.61 vs. 4.46 ± 0.54 pmol/L, p = 0.072). Eating behaviors and well-being were worse (46.64 ± 7.55 vs. 24.58 ± 7.13, p = 0.011 and 15.18 ± 2.44 vs. 17.83 ± 3.54, p = 0.002). The intervention also resulted in lower body fat (8.44 ± 3.15 vs. 10.2 ± 2.5%, p = 0.013). Conclusions Analysis showed that most of the negative effects occurred in the range of 9–25 kCal·kg∙FFM·d−1. This is the range where we suggest a threshold for LEA in men could be. Reducing EA impaired explosive power first, then endurance. It was associated with a reduction in testosterone, triiodothyronine and there was a tendency for reduced IGF-1, but hormones were more resilient to changes in EA. Psychological assessment of eating behaviors and well-being proved to be very useful, whereas monitoring resting energy expenditure did not.
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Affiliation(s)
- Iva Jurov
- Faculty of Sport, University of Ljubljana, Slovenia
| | - Nicola Keay
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
| | - Samo Rauter
- Faculty of Sport, University of Ljubljana, Slovenia
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12
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Jurov I, Keay N, Spudić D, Rauter S. Inducing low energy availability in trained endurance male athletes results in poorer explosive power. Eur J Appl Physiol 2021; 122:503-513. [PMID: 34825937 PMCID: PMC8617370 DOI: 10.1007/s00421-021-04857-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 11/12/2021] [Indexed: 12/15/2022]
Abstract
Purpose Low energy availability in males needs more original research to understand its health and performance consequences. The aim of the study was to induce low energy availability in previously healthy male endurance athletes by reducing energy availability by 25% for 14 consecutive days and measure any potential changes in performance, health, mental state or energy markers. Methods Energy availability was reduced in 12 trained, well-trained and elite endurance athletes by increasing energy expenditure and controlling energy intake. After intervention, health was assessed by blood draw, body composition was measured, energy markers by measuring resting energy expenditure, performance with three specific tests (measuring endurance, agility and explosive power) and two questionnaires were used for psychological assessment (the Three Factor Eating Questionnaire and Well-being questionnaire). Results Reduced energy availability (22.4 ± 6.3 kcal/kg FFM/day) caused significantly lower haemoglobin values (t(12) = 2.652, p = 0.022), there was a tendency for lower iron and IGF-1 (p = 0.066 and p = 0.077, respectively). Explosive power was reduced (t(12) = 4.570, p = 0.001), lactate metabolism was altered and athletes reported poorer well-being (t(12) = 2.385, p = 0.036). Cognitive restriction was correlated with energy availability (r = 0.528, p = 0.039). Conclusion This is the first research providing direct evidence that suboptimal energy availability negatively impacts explosive power before hormonal changes occur in male endurance athletes. It is also the first to show direct association of low energy availability and higher cognitive restriction. We also observed worse well-being and lower haemoglobin values. 25% of energy availability reduction as not enough to elicit changes in resting energy expenditure. Supplementary Information The online version contains supplementary material available at 10.1007/s00421-021-04857-4.
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Affiliation(s)
- Iva Jurov
- Faculty of Sport, University of Ljubljana, Gortanova 22, 1000, Ljubljana, Slovenia.
| | - Nicola Keay
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
| | - Darjan Spudić
- Faculty of Sport, University of Ljubljana, Gortanova 22, 1000, Ljubljana, Slovenia
| | - Samo Rauter
- Faculty of Sport, University of Ljubljana, Gortanova 22, 1000, Ljubljana, Slovenia
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Severe Reduction of Energy Availability in Controlled Conditions Causes Poor Endurance Performance, Impairs Explosive Power and Affects Hormonal Status in Trained Male Endurance Athletes. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11188618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study was to severely reduce energy availability (EA) in controlled conditions in trained male endurance athletes to observe any effects on health, performance, and psychological and energy markers. EA was reduced by 50% over 14 days in athletes by maintaining identical energy intake and increasing exercise energy expenditure. Blood was drawn, performance was measured by three specific tests (endurance, explosive power and agility) and two psychological questionnaires were used. Reduced EA (17.3 ± 5.0 kcal/kg FFM/day) resulted in lower body fat% (t(12) = 3.36, p = 0.006), lower power output and relative power output (t(12) = 2.69, p = 0.021 t(12) = 2.34, p = 0.036), explosive power was reduced (t(12) = 6.41, p = 0.000), lactate metabolism was altered (p = 0.001). EA was negatively correlated with haemoglobin and testosterone (r = −0.557, p = 0.30 and r = −0.532, p = 0.037), anaerobic threshold (r = −0.597, p = 0.02) and respiratory compensation point (r = −0.575, p = 0.025). There were significant differences in Well-being (t(12) = 4.11, p = 0.002) and the Three Factor Eating Questionnaire (t(12) = −2.71, p = 0.020). This is the first study to demonstrate that endurance performance and explosive power can be affected before detrimental health effects occur in male athletes. Drastic reductions of EA could lead to poor eating behaviours. The two psychological questionnaires seem to be more sensitive to EA changes than blood markers.
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Risk Factors, Diagnosis and Management of Bone Stress Injuries in Adolescent Athletes: A Narrative Review. Sports (Basel) 2021; 9:sports9040052. [PMID: 33923520 PMCID: PMC8073721 DOI: 10.3390/sports9040052] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/03/2021] [Accepted: 04/13/2021] [Indexed: 12/14/2022] Open
Abstract
Physical activity is known to be beneficial for bone; however, some athletes who train intensely are at risk of bone stress injury (BSI). Incidence in adolescent athlete populations is between 3.9 and 19% with recurrence rates as high as 21%. Participation in physical training can be highly skeletally demanding, particularly during periods of rapid growth in adolescence, and when competition and training demands are heaviest. Sports involving running and jumping are associated with a higher incidence of BSI and some athletes appear to be more susceptible than others. Maintaining a very lean physique in aesthetic sports (gymnastics, figure skating and ballet) or a prolonged negative energy balance in extreme endurance events (long distance running and triathlon) may compound the risk of BSI with repetitive mechanical loading of bone, due to the additional negative effects of hormonal disturbances. The following review presents a summary of the epidemiology of BSI in the adolescent athlete, risk factors for BSI (physical and behavioural characteristics, energy balance and hormone disruption, growth velocity, sport-specific risk, training load, etc.), prevention and management strategies.
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