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la Torre ME, Monda A, Messina A, de Stefano MI, Monda V, Moscatelli F, Tafuri F, Saraiello E, Latino F, Monda M, Messina G, Polito R, Tafuri D. The Potential Role of Nutrition in Overtraining Syndrome: A Narrative Review. Nutrients 2023; 15:4916. [PMID: 38068774 PMCID: PMC10708264 DOI: 10.3390/nu15234916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/13/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
Competition between athletes and an increase in sporting knowledge have greatly influenced training methods while increasing the number of them more and more. As a result, the number of athletes who have increased the number and intensity of their workouts while decreasing recovery times is rising. Positive overtraining could be considered a natural and fundamental process when the result is adaptation and improved performance; however, in the absence of adequate recovery, negative overtraining could occur, causing fatigue, maladaptation, and inertia. One of the earliest forms of fatigue is overreaching. It is considered to be an accumulation of training that leads to reduced sports performance, requiring days or weeks to recover. Overreaching, if followed by adequate recovery, can lead to an increase in athletic performance. Nonetheless, if overreaching becomes extreme, combined with additional stressors, it could lead to overtraining syndrome (OTS). OTS, caused by systemic inflammation, leads to central nervous system (CNS) effects, including depressed mood, further inflammation, central fatigue, and ultimately neurohormonal changes. There are therefore not only physiological, biochemical, and immunological but also psychological symptoms or markers that must be considered, independently or together, being intrinsically linked with overtraining, to fully understand OTS. However, to date, there are very few published studies that have analyzed how nutrition in its specific food aspects, if compromised during OTS, can be both etiology and consequence of the syndrome. To date, OTS has not yet been fully studied, and the topic needs further research. The purpose of this narrative review is therefore to study how a correct diet and nutrition can influence OTS in all its aspects, from prevention to treatment.
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Affiliation(s)
- Maria Ester la Torre
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy; (M.E.l.T.); (M.I.d.S.); (G.M.)
| | - Antonietta Monda
- Department of Experimental Medicine, Section of Human Physiology, Unit of Dietetics and Sports Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.M.); (M.M.)
| | - Antonietta Messina
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Maria Ida de Stefano
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy; (M.E.l.T.); (M.I.d.S.); (G.M.)
| | - Vincenzo Monda
- Department of Economics, Law, Cybersecurity, and Sports Sciences, University of Naples “Parthenope”, 80131 Naples, Italy; (V.M.); (E.S.); (D.T.)
| | - Fiorenzo Moscatelli
- Department of Human Sciences, Telematic University Pegaso, 80100 Naples, Italy; (F.M.); (F.L.)
| | - Francesco Tafuri
- Heracle Lab Research in Educational Neuroscience, Niccolò Cusano University, 00166 Roma, Italy;
| | - Emma Saraiello
- Department of Economics, Law, Cybersecurity, and Sports Sciences, University of Naples “Parthenope”, 80131 Naples, Italy; (V.M.); (E.S.); (D.T.)
| | - Francesca Latino
- Department of Human Sciences, Telematic University Pegaso, 80100 Naples, Italy; (F.M.); (F.L.)
| | - Marcellino Monda
- Department of Experimental Medicine, Section of Human Physiology, Unit of Dietetics and Sports Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.M.); (M.M.)
| | - Giovanni Messina
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy; (M.E.l.T.); (M.I.d.S.); (G.M.)
| | - Rita Polito
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy; (M.E.l.T.); (M.I.d.S.); (G.M.)
| | - Domenico Tafuri
- Department of Economics, Law, Cybersecurity, and Sports Sciences, University of Naples “Parthenope”, 80131 Naples, Italy; (V.M.); (E.S.); (D.T.)
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Overtraining Syndrome Symptoms and Diagnosis in Athletes: Where Is the Research? A Systematic Review. Int J Sports Physiol Perform 2022; 17:675-681. [PMID: 35320774 DOI: 10.1123/ijspp.2021-0448] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 02/13/2022] [Accepted: 02/13/2022] [Indexed: 11/18/2022]
Abstract
CONTEXT To understand overtraining syndrome (OTS), it is important to detail the physiological and psychological changes that occur in athletes. OBJECTIVES To systematically establish and detail the physiological and psychological changes that occur as a result of OTS in athletes. METHODS Databases were searched for studies that were (1) original investigations; (2) English, full-text articles; (3) published in peer-reviewed journals; (4) investigations into adult humans and provided (5) objective evidence that detailed changes in performance from prior to the onset of OTS diagnosis and that performance was suppressed for more than 4 weeks and (6) objective evidence of psychological symptoms. RESULTS Zero studies provided objective evidence of detailed changes in performance from prior to the onset of OTS diagnosis and demonstrated suppressed performance for more than 4 weeks accompanied by changes in psychological symptoms. CONCLUSIONS All studies failed to provide evidence of changes in performance and mood from "healthy" to an overtrained state with evidence of prolonged suppression of performance. While OTS may be observed in the field, little data is available describing how physiological and psychological symptoms manifest. This stems from vague terminology, difficulties in monitoring for prolonged periods of time, and the need for prospective testing. Real-world settings may facilitate the collection of such data, but the ideal testing battery that can easily be conducted on a regular basis does not yet exist. Consequently, it must be concluded that an evidence base of sufficient scientific quality for understanding OTS in athletes is lacking.
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Armstrong LE, Bergeron MF, Lee EC, Mershon JE, Armstrong EM. Overtraining Syndrome as a Complex Systems Phenomenon. FRONTIERS IN NETWORK PHYSIOLOGY 2021; 1:794392. [PMID: 36925581 PMCID: PMC10013019 DOI: 10.3389/fnetp.2021.794392] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 12/13/2021] [Indexed: 12/29/2022]
Abstract
The phenomenon of reduced athletic performance following sustained, intense training (Overtraining Syndrome, and OTS) was first recognized more than 90 years ago. Although hundreds of scientific publications have focused on OTS, a definitive diagnosis, reliable biomarkers, and effective treatments remain unknown. The present review considers existing models of OTS, acknowledges the individualized and sport-specific nature of signs/symptoms, describes potential interacting predisposing factors, and proposes that OTS will be most effectively characterized and evaluated via the underlying complex biological systems. Complex systems in nature are not aptly characterized or successfully analyzed using the classic scientific method (i.e., simplifying complex problems into single variables in a search for cause-and-effect) because they result from myriad (often non-linear) concomitant interactions of multiple determinants. Thus, this review 1) proposes that OTS be viewed from the perspectives of complex systems and network physiology, 2) advocates for and recommends that techniques such as trans-omic analyses and machine learning be widely employed, and 3) proposes evidence-based areas for future OTS investigations, including concomitant multi-domain analyses incorporating brain neural networks, dysfunction of hypothalamic-pituitary-adrenal responses to training stress, the intestinal microbiota, immune factors, and low energy availability. Such an inclusive and modern approach will measurably help in prevention and management of OTS.
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Affiliation(s)
- Lawrence E Armstrong
- Human Performance Laboratory, University of Connecticut, Storrs, CT, United States
| | - Michael F Bergeron
- Sport Sciences and Medicine and Performance Health, WTA Women's Tennis Association, St. Petersburg, FL, United States
| | - Elaine C Lee
- Human Performance Laboratory, University of Connecticut, Storrs, CT, United States
| | - James E Mershon
- Department of Energy and Renewables, Heriot-Watt University, Stromness, United Kingdom
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