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Sergi TE, Roberts BM, Heileson JL. What About Water? Implications for Body Composition Assessment in Military Personnel. J Strength Cond Res 2024; 38:e534-e540. [PMID: 39074192 DOI: 10.1519/jsc.0000000000004840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/31/2024]
Abstract
ABSTRACT Sergi, TE, Roberts, BM, and Heileson, JL. What About Water? Implications for Body Composition Assessment in Military Personnel. J Strength Cond Res 38(9): e534-e540, 2024-Body composition standards ensure service members maintain physical fitness, wellness, and support mission readiness. Anthropometric techniques (i.e., height/mass, circumference-based "tape test") have been the primary screening and percent body fat (%BF) assessment method in military personnel for about 4 decades. Recently, the Army and Marine Corps have implemented more advanced body composition assessment methods, such as air displacement plethysmography (ADP), multifrequency bioelectrical impedance analysis (MF-BIA), and dual-energy x-ray absorptiometry (DXA), to serve as supplemental %BF assessment after failing the tape test. Although supplemental assessments are intended to improve on the accuracy and precision of the tape test, preassessment standardization, specifically regarding acute water ingestion (AWI), is lacking. Thus, the purpose of this narrative review was to (a) summarize the available literature regarding the influence of AWI on body composition estimates derived from ADP, MF-BIA, and DXA and (b) provide evidence-based recommendations for researchers and practitioners. Studies indicate that AWI increases %BF estimates with ADP (4 of 6 [4/6] observations) and MF-BIA (6/7), whereas AWI increases muscle mass (6/6) and likely decreases %BF (2/3) when obtained by DXA. In conclusion, ADP, MF-BIA, and DXA are susceptible to confounding from AWI, leading to inaccurate body composition estimates that may negatively affect the careers of military personnel. Based on the findings from this narrative review, military practitioners and researchers should (a) follow manufacturer guidelines for calorie intake [food and fluid] and exercise avoidance, (b) conduct urine-specific gravity testing [if possible], and (c) limit AWI to <250 ml before assessment.
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Affiliation(s)
- Tina E Sergi
- Nutrition Services Department, Walter Reed National Military Medical Center, Bethesda, Maryland; and
| | - Brandon M Roberts
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Jeffery L Heileson
- Nutrition Services Department, Walter Reed National Military Medical Center, Bethesda, Maryland; and
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Bennett JP, Cataldi D, Liu YE, Kelly NN, Quon BK, Schoeller DA, Kelly T, Heymsfield SB, Shepherd JA. Development and validation of a rapid multicompartment body composition model using 3-dimensional optical imaging and bioelectrical impedance analysis. Clin Nutr 2024; 43:346-356. [PMID: 38142479 DOI: 10.1016/j.clnu.2023.12.009] [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] [Received: 05/08/2023] [Revised: 11/21/2023] [Accepted: 12/11/2023] [Indexed: 12/26/2023]
Abstract
BACKGROUND & AIMS The multicompartment approach to body composition modeling provides a more precise quantification of body compartments in healthy and clinical populations. We sought to develop and validate a simplified and accessible multicompartment body composition model using 3-dimensional optical (3DO) imaging and bioelectrical impedance analysis (BIA). METHODS Samples of adults and collegiate-aged student-athletes were recruited for model calibration. For the criterion multicompartment model (Wang-5C), participants received measures of scale weight, body volume (BV) via air displacement, total body water (TBW) via deuterium dilution, and bone mineral content (BMC) via dual energy x-ray absorptiometry. The candidate model (3DO-5C) used stepwise linear regression to derive surrogate measures of BV using 3DO, TBW using BIA, and BMC using demographics. Test-retest precision of the candidate model was assessed via root mean square error (RMSE). The 3DO-5C model was compared to criterion via mean difference, concordance correlation coefficient (CCC), and Bland-Altman analysis. This model was then validated using a separate dataset of 20 adults. RESULTS 67 (31 female) participants were used to build the 3DO-5C model. Fat-free mass (FFM) estimates from Wang-5C (60.1 ± 13.4 kg) and 3DO-5C (60.3 ± 13.4 kg) showed no significant mean difference (-0.2 ± 2.0 kg; 95 % limits of agreement [LOA] -4.3 to +3.8) and the CCC was 0.99 with a similar effect in fat mass that reflected the difference in FFM measures. In the validation dataset, the 3DO-5C model showed no significant mean difference (0.0 ± 2.5 kg; 95 % LOA -3.6 to +3.7) for FFM with almost perfect equivalence (CCC = 0.99) compared to the criterion Wang-5C. Test-retest precision (RMSE = 0.73 kg FFM) supports the use of this model for more frequent testing in order to monitor body composition change over time. CONCLUSIONS Body composition estimates provided by the 3DO-5C model are precise and accurate to criterion methods when correcting for field calibrations. The 3DO-5C approach offers a rapid, cost-effective, and accessible method of body composition assessment that can be used broadly to guide nutrition and exercise recommendations in athletic settings and clinical practice.
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Affiliation(s)
- Jonathan P Bennett
- Graduate Program in Human Nutrition, University of Hawai'i at Manoa, Agricultural Science Building, 1955 East-West Rd, Honolulu, HI, 96822, USA; Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, HI, 96813, USA
| | - Devon Cataldi
- Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, HI, 96813, USA
| | - Yong En Liu
- Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, HI, 96813, USA
| | - Nisa N Kelly
- Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, HI, 96813, USA
| | - Brandon K Quon
- Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, HI, 96813, USA
| | - Dale A Schoeller
- Department of Nutritional Sciences, University of Wisconsin-Madison, 1415 Linden Drive, Madison, WI, 53706, USA
| | - Thomas Kelly
- Hologic Inc, 250 Campus Drive, Marlborough, MA, 01752, USA
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University, 6400 Perkins Rd, Baton Rouge, LA, 70808, USA
| | - John A Shepherd
- Graduate Program in Human Nutrition, University of Hawai'i at Manoa, Agricultural Science Building, 1955 East-West Rd, Honolulu, HI, 96822, USA; Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, HI, 96813, USA.
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Ayar M, Kucuk Yetgin M, Agopyan A, Elmacioglu F. The effect of a nutrition program for weight loss during the pre-competition period on the body composition, hydration, and mood profile of elite Greco–Roman wrestlers. SPORT SCIENCES FOR HEALTH 2023. [DOI: 10.1007/s11332-023-01059-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
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Cutrufello PT, Landram MJ, Venezia AC, Dixon CB. A Comparison of Methods Used to Determine Percent Body Fat, Minimum Wrestling Weight, and Lowest Allowable Weight Class. J Strength Cond Res 2021; 35:633-637. [PMID: 33395183 DOI: 10.1519/jsc.0000000000003929] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Cutrufello, PT, Landram, MJ, Venezia, AC, and Dixon, CB. A comparison of methods used to determine percent body fat, minimum wrestling weight, and lowest allowable weight class. J Strength Cond Res 35(3): 633-637, 2021-The National Collegiate Athletic Association's weight management program allows for the use of skinfold measurements (SF), air displacement plethysmography (ADP), and hydrostatic weighing in the assessment of percent body fat (%BF) and determination of a wrestler's minimum wrestling weight (MWW). Dual energy x-ray absorptiometry (DXA) and ultrasound (US) may offer alternative assessment methods. The purpose of this study was to examine %BF, MWW, and the lowest allowable weight class as determined by SF, ADP, DXA, and US. Thirty-three college-aged men (20.8 ± 1.1 years) participated. Urine specific gravity (Usg) was assessed to ensure proper hydration (1.006 ± 0.006). Percent body fat and MWW were then determined using the 4 assessment methods. Each method was significantly different from one another (p < 0.05) with the exception of ADP compared with SF (17.6 ± 7.1% vs. 17.4 ± 6.3%, p = 1.000) and DXA compared with US (20.5 ± 6.2% vs. 19.2 ± 7.5%, p = 0.124). DXA (68.6 ± 7.1 kg) and US (69.3 ± 6.0 kg) determined the lowest MWW, whereas those determined by SF (70.8 ± 6.8 kg) and ADP (70.9 ± 6.6 kg) were significantly greater (p< 0.05). The SEEs for MWW when compared with SF were 3.2, 3.4, and 2.4 kg for ADP, DXA, and US, respectively. Compared with SF, DXA and US would allow wrestlers to certify at a lower weight class 64 and 33% of the time, respectively. When comparing the approved methods (SF and ADP), approximately 50% of subjects would certify at a different weight class depending on the method used. The use of different methods in assessing %BF offer a wide variability in the determination of MWW.
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Affiliation(s)
- Paul T Cutrufello
- Department of Health and Human Performance, The University of Scranton, Scranton, Pennsylvania; and
| | - Michael J Landram
- Department of Health and Human Performance, The University of Scranton, Scranton, Pennsylvania; and
| | - Andrew C Venezia
- Department of Health and Human Performance, The University of Scranton, Scranton, Pennsylvania; and
| | - Curt B Dixon
- Department of Health Science, Lock Haven University, Lock Haven, Pennsylvania
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Changes of Hydration Measures in Elite National Collegiate Athletic Association Division I Wrestlers. Int J Sports Physiol Perform 2019; 14:1378-1381. [PMID: 30958064 DOI: 10.1123/ijspp.2019-0059] [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: 01/20/2019] [Revised: 03/11/2019] [Accepted: 03/18/2019] [Indexed: 11/18/2022]
Abstract
PURPOSE To evaluate the changes in the state of hydration in elite National Collegiate Athletic Association (NCAA) Division I college wrestlers during and after a season. METHODS Ohio State University wrestling team members (N = 6; mean [SD] age = 19.6 [1.1] y; height = 171.6 [2.9] cm; body mass = 69.5 [8.1] kg) gave informed consent to participate in the investigation with measurements (ie, body mass, urine-specific gravity [USG; 2 methods], Visual Analog Scale thirst scale, plasma osmolality) obtained during and after the season. RESULTS Measurements for USG, regardless of methods, were not significantly different between visits, but plasma osmolality was significantly (P = .001) higher at the beginning of the season-295.5 (4.9) mOsm·kg-1 compared with 279.6 (6.1) mOsm·kg-1 after the season. No changes in thirst ratings were observed, and the 2 measures of USG were highly correlated (r > .9, P = .000) at each time point, but USG and plasma osmolality were not related. CONCLUSIONS A paradox in the clinical interpretation of euhydration in the beginning of the season was observed with the USG, indicating that the wrestlers were properly hydrated, while the plasma osmolality showed they were not. Thus, the tracking of hydration status during the season is a concern when using only NCAA policies and procedures. The wrestlers did return to normal euhydration levels after the season on both biomarkers, which is remarkable, as previous studies have indicated that this may not happen because of the reregulation of the osmol-regulatory center in the brain.
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Zubac D, Paravlic A, Reale R, Jelaska I, Morrison SA, Ivancev V. Fluid balance and hydration status in combat sport Olympic athletes: a systematic review with meta-analysis of controlled and uncontrolled studies. Eur J Nutr 2019; 58:497-514. [DOI: 10.1007/s00394-019-01937-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 02/22/2019] [Indexed: 11/28/2022]
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Gadomski SJ, Ratamess NA, Cutrufello PT. Range of Motion Adaptations in Powerlifters. J Strength Cond Res 2019; 32:3020-3028. [PMID: 30204657 DOI: 10.1519/jsc.0000000000002824] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Gadomski, SJ, Ratamess, NA, and Cutrufello, PT. Range of motion adaptations in powerlifters. J Strength Cond Res 32(11): 3020-3028, 2018-The aim of this study was to investigate range of motion (ROM) and training patterns in powerlifters. Upper- and lower-extremity passive ROMs were assessed through goniometry in 15 male powerlifters (35.3 ± 13.7 years) and 15 age-matched controls (34.9 ± 14.6 years). The Apley scratch test and modified Thomas test were used to assess ROM across multiple joints. Training frequency, stretching frequency, and exercise selection were recorded using questionnaires. Passive glenohumeral (GH) extension, internal rotation, and external rotation ROM were significantly decreased in powerlifters (p < 0.050). Powerlifters displayed decreased ROM in the Apley scratch test in both dominant (p = 0.015) and nondominant (p = 0.025) arms. However, knee extension angle was markedly improved in powerlifters (20.3 ± 7.3°) compared with controls (29.9 ± 6.2°; p < 0.001). Bench press and bench press variations accounted for 74.8% of all upper-body exercises, whereas back squat and deadlift accounted for 79.7% of all lower-body exercises in powerlifters' training programs. To determine whether existing ROM adaptations were seen in elite powerlifters, the powerlifting cohort was split into 3 groups based on Wilks score: <400 (low), 400-500 (intermediate), and >500 (high). GH ROM limitations were more pronounced in elite powerlifters (Wilks >500), who had more powerlifting experience (p = 0.048) and greater lean body mass (p = 0.040). Overall, powerlifters displayed decreased GH ROM, but increased hamstring ROM, after training programs that were heavily focused on the bench press, back squat, and deadlift.
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Affiliation(s)
- Stephen J Gadomski
- Medical Scientist Training Program, Medical University of South Carolina, Charleston, South Carolina
| | - Nicholas A Ratamess
- Department of Health and Exercise Science, The College of New Jersey, Ewing, New Jersey
| | - Paul T Cutrufello
- Department of Exercise Science and Sport, The University of Scranton, Scranton, Pennsylvania
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Zubac D, Reale R, Karnincic H, Sivric A, Jelaska I. Urine specific gravity as an indicator of dehydration in Olympic combat sport athletes; considerations for research and practice. Eur J Sport Sci 2018; 18:920-929. [PMID: 29746803 DOI: 10.1080/17461391.2018.1468483] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Urine specific gravity (USG) is the most commonly reported biochemical marker used in research and applied settings to detect fluid deficits in athletes, including those participating in combat sports. Despite the popularity of its use, there has been a growing debate regarding the diagnostic accuracy and the applicability of USG in characterizing whole-body fluid status and fluctuations. Moreover, recent investigations report universally high prevalence of hypohydration (∼90%) via USG assessment in combat sport athletes, often in spite of stable body-mass. Given the widespread use in both research and practice, and its use in a regulatory sense as a 'hydration test' in combat sports as a means to detect dehydration at the time of weigh-in; understanding the limitations and applicability of USG assessment is of paramount importance. Inconsistencies in findings of USG readings, possibly as a consequence of diverse methodological research approaches and/or overlooked confounding factors, preclude a conclusive position stand within current combat sports research and practice. Thus the primary aim of this paper is to critically review the literature regarding USG assessment of hydration status in combat sports research and practice. When taken on balance, the existing literature suggests: the use of laboratory derived benchmarks in applied settings, inconsistent sampling methodologies, the incomplete picture of how various confounding factors affect end-point readings, and the still poorly understood potential of renal adaptation to dehydration in combat athletes; make the utility of hydration assessment via USG measurement quite problematic, particularly when diet and training is not controlled.
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Affiliation(s)
- Damir Zubac
- a Science and Research Center Koper , Institute for Kinesiology Research , Koper , Slovenia.,c Faculty of Kinesiology , University of Split , Split , Croatia
| | - Reid Reale
- b Gatorade Sports Science Institute , Bradenton , FL , USA
| | - Hrvoje Karnincic
- c Faculty of Kinesiology , University of Split , Split , Croatia
| | | | - Igor Jelaska
- c Faculty of Kinesiology , University of Split , Split , Croatia
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McDermott BP, Anderson SA, Armstrong LE, Casa DJ, Cheuvront SN, Cooper L, Kenney WL, O'Connor FG, Roberts WO. National Athletic Trainers' Association Position Statement: Fluid Replacement for the Physically Active. J Athl Train 2017; 52:877-895. [PMID: 28985128 PMCID: PMC5634236 DOI: 10.4085/1062-6050-52.9.02] [Citation(s) in RCA: 202] [Impact Index Per Article: 28.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To present evidence-based recommendations that promote optimized fluid-maintenance practices for physically active individuals. BACKGROUND Both a lack of adequate fluid replacement (hypohydration) and excessive intake (hyperhydration) can compromise athletic performance and increase health risks. Athletes need access to water to prevent hypohydration during physical activity but must be aware of the risks of overdrinking and hyponatremia. Drinking behavior can be modified by education, accessibility, experience, and palatability. This statement updates practical recommendations regarding fluid-replacement strategies for physically active individuals. RECOMMENDATIONS Educate physically active people regarding the benefits of fluid replacement to promote performance and safety and the potential risks of both hypohydration and hyperhydration on health and physical performance. Quantify sweat rates for physically active individuals during exercise in various environments. Work with individuals to develop fluid-replacement practices that promote sufficient but not excessive hydration before, during, and after physical activity.
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