Weight cycling in combat sports: revisiting 25 years of scientific evidence

Sport-Related Cutaneous Infections: A Narrative Review

ABSTRACT

Bacterial and viral cutaneous infections pose a great risk of serious complications in combat athletes and contribute to a significant amount of time lost in practice and competition. Although these infections can be treated with standard antimicrobials, the rise in resistance of Staphylococcus aureus and dermatophytes calls for updated treatment recommendations. Methicillin-resistant S. aureus (MRSA) is becoming a highly prevalent culprit of impetigo, folliculitis, and cellulitis and must be managed correctly to eradicate infection effectively. In addition, the increased prevalence of tinea incognito and terbinafine-resistant Trichophyton tonsurans makes dermatophyte infections difficult to handle. Limited studies provide evidence for a nuanced approach when treating athletes who engage in weight cycling or rapid weight loss, but adjusted dosing and treatment guidelines remain important.

Rapid Weight Changes and Competitive Outcomes in Muay Thai and Mixed Martial Arts: A 14-Month Study of 24 Combat Sports Events

This study investigates the rapid weight loss (RWL) and rapid weight gain (RWG) of contest winners and losers from Muay Thai (MT) and mixed martial arts (MMA) events. The relationship between rapid weight change variables of males and females, and competitive success is also examined. Data from a weight management questionnaire was collected one day post-competition from 185 participants across 24 fight events, resulting in 263 responses (MMA: n = 78, MT: n = 185). Official and secondary weigh-in data were provided by the Combat Sports Commission. The results show that in MT, contest winners compared to losers had significantly greater RWL-7 days (5.9 ± 2.6% vs. 4.6 ± 2.7%, p = 0.01), RWG (6.2 ± 2.9% vs. 4.7 ± 2.8%, p = 0.003), and RWG/RWL ratio (108% [86-132%] vs. 86% [60-119%], p = 0.038), while no significant differences were observed for MMA. Mixed logistic regression models that controlled for age showed that a 1% increase in female RWL-24 h ([OR = 1.57, R2 = 0.105, p = 0.001]) was associated with a 1.6 times higher likelihood of winning compared to female athletes without this increase. We emphasise that associations do not imply causation, and it is possible that other factors which align with rapid weight change practices may impact the observed relationship. Nonetheless, MT contest winners show greater RWL, RWG, and RWG/RWL ratio than losers, and female rapid weight changes appear to be associated with competitive success in this cohort.

Yoyo Dieting, Post-Obesity Weight Loss, and Their Relationship with Gut Health

Excessive body weight is associated with many chronic metabolic diseases and weight loss, so far, remains the gold standard treatment. However, despite tremendous efforts exploring optimal treatments for obesity, many individuals find losing weight and maintaining a healthy body weight difficult. Weight loss is often not sustainable resulting in weight regain and subsequent efforts to lose weight. This cyclic pattern of weight loss and regain is termed "yoyo dieting" and predisposes individuals to obesity and metabolic comorbidities. How yoyo dieting might worsen obesity complications during the weight recurrence phase remains unclear. In particular, there is limited data on the role of the gut microbiome in yoyo dieting. Gut health distress, especially gut inflammation and microbiome perturbation, is strongly associated with metabolic dysfunction and disturbance of energy homeostasis in obesity. In this review, we summarise current evidence of the crosstalk between the gastrointestinal system and energy balance, and the effects of yoyo dieting on gut inflammation and gut microbiota reshaping. Finally, we focus on the potential effects of post-dieting weight loss in improving gut health and identify current knowledge gaps within the field, including gut-derived peptide hormones and their potential suitability as targets to combat weight regain, and how yoyo dieting and associated changes in the microbiome affect the gut barrier and the enteric nervous system, which largely remain to be determined.

A scoping review of rapid weight loss in judo athletes: prevalence, magnitude, effects on performance, risks, and recommendations

PURPOSE

Combat sports, such as judo, are weight categorized. Weight control was established to promote fair disputes among individuals. However, combat sports athletes adopt rapid weight loss (RWL) to obtain an advantage over smaller and lighter opponents. This scoping review article presents the prevalence, magnitude, and methods of RWL and its effects on physical and competitive performance, health risks, and psychological effects. Specific recommendations for attenuating the effects of RWL are also presented.

METHODS

Studies were retrieved from Web of Science, PubMed, and Scopus databases. Four hundred and forty-six articles were identified, of which fifty-three were considered eligible for this review.

RESULTS

The results showed that the prevalence of RWL was between 40% and 92.9% and that athletes reduced their body mass by approximately 5%. Although the literature suggests that RWL impairs the performance and psychological well-being of athletes, these results were obtained when recovery time was not provided.

CONCLUSION

No negative effects on performance were observed when the recovery time was >4 h. However, health risks due to RWL practices should be considered, and RWL should be avoided.

Physiological Perturbations in Combat Sports: Weight Cycling and Metabolic Function-A Narrative Review

Combat sports athletes seeking a competitive edge often engage in weight management practices to become larger than their opponents, which ultimately includes periods of gradual weight loss, rapid weight loss, and weight regain. This pattern of weight loss and regain is known as weight cycling and often includes periods of low energy availability, making combat sports athletes susceptible to metabolic dysfunction. This narrative review represents an effort to explore the metabolic perturbations associated with weight cycling and outline the short-, medium-, and long-term effects on metabolic flexibility, function, and health. The short-term effects of rapid weight loss, such as a reduced metabolic rate and alterations to insulin and leptin levels, may prelude the more pronounced metabolic disturbances that occur during weight regain, such as insulin resistance. Although definitive support is not currently available, this cycle of weight loss and regain and associated metabolic changes may contribute to metabolic syndrome or other metabolic dysfunctions over time.

Is dieting a risk for higher weight gain in normal-weight individual? A systematic review and meta-analysis

While there is an increasing prevalence of dieting in the overall population, weight loss (WL) practices could be a risk factor for weight gain (WG) in normal-weight (NW) individuals. The aim of the present work was to systematically review all the studies implicating diet restriction and body weight (BW) evolution in NW people. The literature search was registered in PROSPERO (CRD42021281442) and was performed in three databases from April 2021 to June 2022 for articles involving healthy NW adults. From a total of 1487 records initially identified, eighteen were selected in the systematic review. Of the eight dieting interventional studies, only one found a higher BW after weight recovery, but 75 % of them highlighted metabolic adaptations in response to WL favouring weight regain and persisting during/after BW recovery. Eight of the ten observational studies showed a relationship between dieting and major later WG, while the meta-analysis of observational studies results indicated that 'dieters' have a higher BW than 'non-dieters'. However, considering the high methodological heterogeneity and the publication bias of the studies, this result should be taken with caution. Moreover, the term 'diet' was poorly described, and we observed a large heterogeneity of the methods used to assess dieting status. Present results suggest that dieting could be a major risk factor for WG in the long term in NW individuals. There is, however, a real need for prospective randomised controlled studies, specifically assessing the relationship between WL induced by diet and subsequent weight in this population.

Effects of Different Rapid Weight Loss Strategies and Percentages on Performance-Related Parameters in Combat Sports: An Updated Systematic Review

Most combat sports (CS) are structured in weight categories, and it is very common to carry out body weight adjustment strategies in order to compete in lower weight categories. For this reason, different rapid weight loss (RWL) strategies are usually performed to pass the pre-competition weigh-in test, and then a replenishment of fluids and carbohydrate-rich foods is conducted in an attempt to recover the weight and avoid a performance loss. In this context, no clear references have been found on whether these types of strategies have negative effects, impairing the athlete's combat and/or physical performance. For this reason, the aim of this study was to review the scientific literature on the effect of rapid weight reduction strategies on the performance of CS athletes. A literature search was performed through four different databases (PubMed, SPORTDiscus, Web of Science and ScienceDirect). Four inclusion criteria were established as follows: (1) the subjects had to be competitors in the CS and carry out RWL strategies; (2) at least two measurement points, that is, normal conditions and dehydration condition; (3) measurements in a real competition or simulating the same conditions; (4) original research articles written in English or Spanish and available in full text. Finally, a total of 16 articles were finally included in this research. All subjects (n = 184) were athletes from combat disciplines, with a minimum of 3-4 years of practice, as well as with certain experience in RWL. Six of the studies reported that an RWL strategy of around 5% of body weight loss did not affect performance parameters. However, the other ten studies with RWL between 3 and 6% or even higher reported negative effects or impairments on different parameters related to performance and/or athlete's psychophysiology, such as perceived fatigue, mood states, strength and power production, as well as changes in hormonal, blood and urine parameters, body composition, or the kinematics of the technical gesture. Although there is still no clear answer to the issue approached in this research, in general terms, it seems that in order to guarantee an acceptable athletic performance of the competitor, the weight loss should not exceed 3% to ≤5% of body weight together with ≥24 h for adequate (or at least partial) recovery and rehydration processes. In addition, it is highly recommended to lose weight progressively over several weeks, especially focusing on competitions lasting several days, as well as multiple rounds or qualifying stages.

Premature Death in Bodybuilders: What Do We Know?

Premature deaths in bodybuilders regularly make headlines and are cited as evidence that bodybuilding is a dangerous activity. A wealth of research has revealed elite athletes typically enjoy lower mortality rates than non-athletes, but research on bodybuilder lifespan is surprisingly limited. Anabolic androgenic steroid (AAS) use is commonly cited as a key contributor to morbidity and premature mortality in bodybuilders, but this area of research is highly nuanced and influenced by numerous confounders unique to bodybuilding. It is quite possible that bodybuilders are at elevated risk and that AAS use is the primary reason for this, but there remains much unknown in this realm. As global participation in bodybuilding increases, and healthcare providers play a more active role in monitoring bodybuilder health, there is a need to identify how numerous factors associated with bodybuilding ultimately influence short- and long-term health and mortality rate. In this Current Opinion, we discuss what is currently known about the bodybuilder lifespan, identify the nuances of the literature regarding bodybuilder health and AAS use, and provide recommendations for future research on this topic.

Patterns of weight cycling in youth Olympic combat sports: a systematic review

BACKGROUND

Patterns of weight cycling in adult combat sports have been extensively studied, yet data on this matter in youth combat athletes is rather scarce.

METHODS

PubMed, EBSCOhost and Web of Science were used to retrieve relevant data. Eligible studies had to record the methods used to elicit rapid weight loss (RWL) and/or record the oscillations in bodyweight during the RWL phase. Only studies conducted in the context of an official competition were considered for inclusion in the present review.

RESULTS

RWL is highly prevalent in children and adolescent combat athletes, ranging from 25 to 94% depending on the type of combat sport, age and level of competition. These athletes regularly prompt RWL by increasing exercise frequency and intensity, decreasing fluid and food intake, training in impermeable suits and using sauna frequently. Overall, the magnitude of RWL was ranging from ~ 1% to 6.3 ± 3.7% with significant RWL variations within individual studies and individuals within those studies.

CONCLUSION

Acquired data indicated that RWL patterns in young combat athletes are similar to those found in their adult counterparts. Knowing that childhood and adolescence are critical periods for growth and development, RWL needs to be stringently regulated and ideally banned in this population.

Psychological Distress in Elite Sambo and Recreational Athletes

Background

Previous studies suggest that engagement in any type of physical activity can be protective against mental health issues, whereas elite-level athletes can endure various mental health challenges. The aim of this study was to determine variations in the prevalence of psychological distress among elite sambo athletes and their recreational counterparts.

Methods

A sample consisting of 245 athletes (127 males and 118 females) was chosen. Out of the total sample, 105 were elite-level athletes while 140 were recreational athletes. Participants were accessed via the Depression Anxiety Stress Scales-21 to determine their stress in various domains at a given time.

Results

Data indicated that all tested differences between elite sambo athletes and recreational athletes were statistically significant; recreational athletes had a higher score on the depression scale, anxiety and stress, and a general distress score than sambo athletes. Although there are no gender differences in psychological distress in the total sample of athletes, elite sambo athletes achieve significantly lower scores in all tested variants than recreational ones. Women who engage in recreational activities have stood out as a vulnerable subsample in psychological stress.

Conclusion

Future epidemiological and interventional studies should explore optimal strategies to identify mental health needs based on specific sport activity, especially in terms of gender. There is a need to place special emphasis on psychological distress in the context of combat sports.

Rapid Weight Loss Practices in Grapplers Competing in Combat Sports

Background

Grappling is a wrestling style that combines different techniques such as freestyle wrestling, jiu-jitsu, judo, sambo, and others. As with other combat sports, it requires categorizing the athletes in weight classes, which leads to the use of certain methods to lose body weight in a short amount of time which poses a serious threat to athletes’ health and wellbeing. Therefore, the objective of this study was to investigate the most widespread rapid weight loss (RWL) methods and sources of influence used by grappling athletes.

Methods

A total of 145 athletes took part in the study by voluntarily filling out a questionnaire regarding their weight loss techniques and methods. They were divided into two groups, male (27.7 ± 5.2 years, 1.76 ± 0.13 m, and 82.1 ± 20 kg) and female (27.33 ± 6.3 years, 1.65 ± 0.08 m, and 64.3 ± 10.4 kg), for further statistical analysis. After calculating descriptive statistics for all the variables, a t-test was conducted for gender differences in weight loss and weight regain, and a chi-square test measured the diversity in techniques and source of influence.

Results

Out of 145 participants, 120 athletes (85.2%) reported engaging in rapid weight loss prior to weigh-in. Coaches (52.4 and 59%) and teammates (42.6 and 22.1%) seemed to be the most influential on their rapid weight-loss strategies, whereas physicians (17.1 and 17.9%) and parents (23.2 and 23.1%) were the least influential. A statistical difference between men and women (p = 0.05) was found when teammates were a source of influence (42.6 and 21.1%, respectively). Regarding the methods used, both groups practiced gradual dieting (85.4 and 79.5%) as the most prevalent, followed by increased exercise (79 and 66.6%) and sauna (78.7 and 66.6%). Moreover, men trained in plastic suits significantly more often than women (67.1 vs. 41%, p = 0.01).

Conclusion

Rapid weight loss is detrimental to athletes’ health and wellbeing. Hence, it is crucial to find and implement methods that will control and ultimately limit its use in combat sports. Physicians and nutritionists need to be closely linked with the staff, collaborate and supervise the weight cutting.