Multilevel Evaluation of Rapid Weight Loss in Wrestling and Taekwondo

The Practice of Weight Loss in Combat Sports Athletes: A Systematic Review

The aim of this systematic review is to comprehensively assess the weight loss (WL) practices in different combat sports (CS). The review protocol was preregistered with PROSPERO [CRD42023487196]. Three databases were searched (Web of Science, EBSCOhost, and PubMed) until 8 December 2023. Eligible studies had to meet five criteria: they must have been (a) written in English, (b) published in a peer-reviewed journal, (c) used a survey design to investigate the WL practices of CS athletes, and (d) reported the WL methods used by athletes using a five-point scale. Twenty-six studies (3994 participants from 14 CS) were included. This review found that (1) WL is highly prevalent in CS athletes; (2) many CS athletes started losing weight for competition as teenagers two to three times a year; (3) CS athletes usually lose <5% body weight in 7-14 days before competition; (4) increasing exercise and gradually dieting are the most commonly used WL methods; and (5) the influence of scientific practitioners on athletes is negligible. The habitual practices of CS athletes may be relatively harmless, but in some special cases, CS athletes also perform extreme WL practices. Scientific practitioners have little influence on their WL practices, which may form a vicious cycle of non-qualified influence.

Nutrient Intake, Performance, and Body Composition of Preseason Wrestlers

College athletes, especially in weight class sports, often experience energy deficits. Athletes competing in weight class sports such as wrestling are at greatest risk for deficiencies and little is known about the relationships between body composition, nutrient intake, and performance in these athletes. The purposes of this study were to (1) quantify macronutrient and micronutrient intake of pre-season male collegiate wrestlers and compare to estimated needs, and (2) examine relationships among nutritional intakes, body composition, and performance measurements of strength and anaerobic capacity. Male Division I wrestlers (n = 11, age: 21.3 ± 1.7 years, wrestling experience: 14.9 ± 2.5 years) were recruited during pre-season. Nutrient intake was collected from a 3-day food diary. A 7-site skinfold assessment determined fat-free mass (FFM) to estimate total daily energy expenditure (eTEE). Isokinetic and isometric strength were evaluated by a Biodex dynamometer. Anaerobic capacity was tested on a stationary cycle ergometer. Eight of eleven wrestlers were energy deficient based on estimated needs. Mean intake of four micronutrients fell below the Recommended Dietary Allowances (RDA). Significant correlations were found between dietary intake, strength and anaerobic performance variables (r = 0.603 - 0.902, p = 0.0001 - 0.05). However, after accounting for FFM, these relationships were no longer significant. Nutrient intake in tandem with body composition affects performance for weight class athletes. Achieving high FFM during the preseason may be advantageous for wrestling performance. Nutrient intake and body composition should be monitored so coaches and health professionals can create individualized recommendations to help athletes optimize performance.

Weight regain, body composition, and metabolic responses to weight loss in weight cycling athletes: A systematic review and meta-analyses

Depending on the nature of their sports, athletes may be engaged in successive weight loss (WL) and regain, conducing to "weight cycling." The aims of this paper were to systematically (and meta-analytically when possible) analyze the post-WL recovery of (i) body weight and (ii) fat mass; fat-free mass; and performance and metabolic responses in weight cycling athletes (18-55 years old, body mass index < 30 kg.m-2 ). MEDLINE, Embase, and SPORTDiscus databases were explored. The quality and risk of bias of the 74 included studies were assessed using the quality assessment tool for quantitative studies. Thirty-two studies were eligible for meta-analyses. Whatever the type of sports or methods used to lose weight, post-WL body weight does not seem affected compared with pre-WL. While similar results are observed for fat-free mass, strength sports athletes (also having longer WL and regain periods) do not seem to fully recover their initial fat mass (ES: -0.39, 95% CI: [-0.77; -0.00], p = 0.048, I2  = 0.0%). Although the methods used by athletes to achieve WL might prevent them from a potential post-WL fat overshooting, further studies are needed to better understand WL episodes consequences on athletes' performance as well as short- and long-term physical, metabolic, and mental health.

Weight cutting in female UFC fighters

BACKGROUND

It is common practice for fight sport athletes to use a variety of weight manipulation strategies to compete in desired weight classes. Although numerous studies have highlighted rapid weight loss (RWL) strategies and the magnitude of weight loss, few have focused specifically on weight loss in female fighters. The purpose of this study was to provide descriptive information on professional UFC female fighters engaging in RWL in all women's UFC weight divisions: strawweight (52.2 kg): flyweight (56.7 kg); bantamweight (61.2 kg); featherweight (65.8 kg).

METHODS

All fighter's weights were obtained at five separate time points: 72 hrs. pre-weigh-in, 48 hrs. pre-weigh-in, 24hrs. pre-weigh-in, official weigh-in, and 24 hrs. post-weigh-in (competition weight). Mixed effects models and random effects analysis were used to assess changes in weight and differences between weight divisions. All statistics were analyzed, and significance was set at p ≤0.05. Significant changes in weight between all time points were reported.

RESULTS

No statistical differences between weight divisions were observed. Female fighters lost 4.5-6.6% of their weight prior to the official weigh-in.

CONCLUSION

Females engaged in RWL practices lose weight in a similar fashion irrespective of weight class.

Low- or moderate-carbohydrate calorie-restricted diets have similar effects on body composition and taekwondo performance after high-carbohydrate recovery meals

Low-carbohydrate (LC) diets are popular among general and athletic populations attempting to lose body mass. This study investigated the effect of a 7-day LC or moderate-carbohydrate (MC) calorie-restricted diet followed by 18-h recovery on body composition and taekwondo-specific performance. In this randomised cross-over study, 12 male taekwondo athletes consumed an LC (10% of carbohydrate, 41% of protein, 49% of fat, and 15.8 ± 0.4 kcal/kg/day) or an isocaloric MC diet (60% of carbohydrate, 30% of protein, and 10% of fat) for 7 days. The participants then consumed a carbohydrate-rich recovery dinner (39.2 ± 3.1 kcal/kg) followed by breakfast (6.2 ± 0.4 kcal/kg) in both the trials. Three repeated sprint ability (RSA) tests were conducted after breakfast. The taekwondo-specific reaction battery was administered before the first RSA test and after each RSA test. The participants experienced similar magnitudes of significant loss of body mass in the LC (-2.4 ± 1.7%) and MC (-2.3 ± 1.7%) trials. Fat mass and fat percentage significantly decreased in the MC trial but remained unchanged in the LC trial after body mass loss. Fat free mass was maintained in both the trials. The average and peak power in the RSA tests and the premotor reaction time were similar between the trials. The participants experienced significantly higher fatigue in the LC trial. In conclusion, both the diets can help athletes rapidly lose body mass while maintaining performance as long as an adequate amount of carbohydrate is consumed during the recovery period.

Disrupting arrhythmia in a professional male wrestler athlete after rapid weight loss and high-intensity training-Case report

Introduction

Physiological heart adaptations may lead to increased susceptibility to arrhythmia in athletes. Furthermore, vigorous training and method like rapid weight loss (RWL) in combat sports could pose additional risks. This case represents how routine cardiovascular screening during high-risk methods like RWL and high-intensity training (HIT) reveal abrupt ventricular arrhythmias in a young athlete.

Case report

We report a case of a 20-year-old male wrestler athlete who developed disrupting arrhythmia during RWL and HIT. The study included: a medical exam, 12 lead electrocardiograms (ECG), transthoracic echocardiogram (ECHO), and 24 h of continuous ECG monitoring in baseline, phase one (P1), (in which the athlete had to simulate RWL through vigorous training and dietary intervention and HIT) and phase two (P2), (with the same HIT protocol performed without the RWL procedure). Baseline laboratory analyses were without abnormalities, ECG showed sinus rhythm with one premature atrial contraction (PAC) and ECHO showed signs of concentric remodeling with preserved systolic, diastolic function, and global longitudinal strain. After P1 RWL simulation, he lost 5.15% of body weight in 3 days, which resulted in lower blood glucose levels, higher urea, creatinine, creatine kinase (CK), CK-MB levels, and slightly increased levels of NT pro-BNP, ECG revealed sinus rhythm with one ventricular premature beat (VPB), 24-h continuous electrocardiogram (ECG) revealed frequent ventricular premature beats (PVB) 2,150/ 24 h, with two couplets, and 8 PAC. After an advised 4-week period of de-training continuous 24 h, ECG monitoring was improved with only occasional PVB. The 24 h continuous ECG monitoring was repeated after HIT and revealed even more frequent PVB, 5% of all beats for 24 h, 4,205 in total, and almost all VPB were in bigeminy and trigeminy. The athlete was advised against RWL and extremely vigorous exercise and for regular, frequent checkups with occasional ECG monitoring during and after exercise.

Conclusion

The short and long-term implication of abrupt ventricular arrhythmias provoked by intensive training and methods like RWL is unknown. We postulate that cardiovascular screening is necessitated, especially during high-risk methods like RWL and HIT, in helping us prevent adverse outcomes and come to individual-based clinical making decisions for each athlete.

The Preventable Effect of Taekwondo Sport among Cadets and Junior' Bone Mineral Density: DEXA Assessment

Athletes competing in Taekwondo (TKD), the weight-category sport, tend to rapidly lose weight to achieve the desired body weight for better competitive results. Little is known about the effect of rapid weight reduction on bone mass density (BMD), especially during childhood and adolescence. The current study aimed to investigate the impact of rapid weight loss on BMD among cadets and juniors TKD athletes. A descriptive case series study design was conducted and collected from 28 males and females aged 12-17 years old, with mean age 14.4 ± 1.7. Dual-energy X-ray absorptiometry (DEXA) was used for both BMD and body composition assessment, and laboratory tests were also performed for the total calcium (Ca), TSH, free T4 (FT4), and 25-OH-vitamin D. Results showed normal levels of Ca (82.1%), TSH (96.4%), and FT4 (96.4%), whilst 85.7% had vitamin D deficiency. DEXA results showed that within male athletes, juniors had a wider range of BMD than cadets, while within females, results did not vary, with no statistical difference between both males and females. Our results suggested that children and adolescents' BMD was positively related to TKD sport regardless of the abnormal weight loss strategies used, as evidenced by laboratory results. Children and adolescents should be conscious and practice TKD sport adopting healthy weight loss behaviors.

A Survey of Combat Athletes' Rapid Weight Loss Practices and Evaluation of the Relationship With Concussion Symptom Recall

OBJECTIVE

There is a high incidence of concussion and frequent utilization of rapid weight loss (RWL) methods among combat sport athletes, yet the apparent similarity in symptoms experienced as a result of a concussion or RWL has not been investigated. This study surveyed combat sports athletes to investigate the differences in symptom onset and recovery between combat sports and evaluated the relationships between concussion and RWL symptoms.

DESIGN

Cross-sectional study.

SETTING

Data were collected through an online survey.

PARTICIPANTS

One hundred thirty-two (115 male athletes and 17 female athletes) combat sport athletes.

INTERVENTIONS

Modified Sport Concussion Assessment Tool (SCAT) symptom checklist and weight-cutting questionnaire.

MAIN OUTCOME MEASURES

Survey items included combat sport discipline, weight loss, medical history, weight-cutting questionnaire, and concussion and weight-cutting symptom checklists.

RESULTS

Strong associations ( rs = 0.6-0.7, P < 0.05) were observed between concussion and RWL symptoms. The most frequently reported symptom resolution times were 24 to 48 hours for a weight cut (WC; 59%) and 3 to 5 days for a concussion (43%), with 60% to 70% of athletes reporting a deterioration and lengthening of concussion symptoms when undergoing a WC. Most of the athletes (65%) also reported at least one WC in their career to " not go according to plan ," resulting in a lack of energy (83%) and strength/power (70%).

CONCLUSIONS

Rapid weight loss and concussion symptoms are strongly associated, with most of the athletes reporting a deterioration of concussion symptoms during a WC. The results indicate that concussion symptoms should be monitored alongside hydration status to avoid any compound effects of prior RWL on the interpretation of concussion assessments and to avoid potential misdiagnoses among combat athletes.

Rapid Weight Loss of Up to Five Percent of the Body Mass in Less Than 7 Days Does Not Affect Physical Performance in Official Olympic Combat Athletes With Weight Classes: A Systematic Review With Meta-Analysis

Given the relevance of the effects that weight loss can generate on the physical performance in athletes, this study performed a systematic review with meta-analysis of the published literature on rapid weight loss (RWL) and examined its impact on the physical performance in Official Olympic combat sports athletes. The “Preferred Reporting Items for Systematic Reviews and Meta-Analysis” (PRISMA) guidelines were followed to ensure an ethical and complete reporting of the findings. PubMed, SPORT Discus, and EBSCO were the electronic databases explored for article retrieval and selection. The following string was applied: “RWL” OR “weight loss” OR “weight reduction” AND “judo” OR “wrestling” or “taekwondo” or “boxing” AND “performance.” Based on the quality analysis, conducted according to the “Tool for the assessment of study quality and reporting in exercise training studies” (TESTEX), ten articles achieved a score >6 points. The meta-analysis showed a significant difference in pre- vs. post-weight loss (p = 0.003) and no effects in pre- vs. post-power and strength performance analysis (p > 0.05 for both results). Based on our systematic review and meta-analysis of the literature, RWL up to ≤5% of the body mass in less than 7 days does not influence performance outcomes in Official Olympic combat athletes with weight classes, considering the strength and power measures.

The effect of rapid weight loss on sports injury in elite taekwondo athletes

OBJECTIVES

The purpose of this study was to reveal the relationship of injury patterns between normal training period and weight loss period in Korea elite taekwondo athletes.

METHODS

Since 2021, data for elite taekwondo athletes have been collected prospectively by the Korean Training Institute, there were 102 male and 95 female. The data were classified by sex, weight class, injury location, injuries during the normal training and weight loss periods. The χ2 test was used to compare groups. The injury incidence rates were calculated as the number of injuries per 1,000 hours of training.

RESULTS

A total of 703 injuries were recorded during normal training, and total of 149 injuries were recorded during the weight loss period. Taekwondo athletes showed a higher incidence of during the weight loss period than during the normal training period (3.66 VS 6.88; p < 0.001). The body parts affected by injury differed significantly between the normal training period and weight loss period (p = 0.033). Injury to the lower extremities or to the head and neck was relatively higher during the normal training period, while injury to the trunk and upper extremities was relatively higher during the weight loss period. Muscle, ligament, and bone injuries were common during both the normal training and weight loss periods. Level I injuries were relatively more frequent during normal training, while level II and III injuries were relatively more frequent during weight loss (p < 0.001).

CONCLUSION

Rapid weight loss is related to the injury patterns in taekwondo athletes. Injury incidence rate increases during rapid weight loss periods. Moreover, the injury site and injury severity depend on during normal training and during the weight loss period.

The Role of Psychological Factors in Judo: A Systematic Review

(1) Background: Psychological parameters are relevant in the practice of judo. Previous studies have shown that parameters such as anxiety or motivation can have a negative or positive impact on the athlete’s performance and general well-being, depending on the athlete’s perception. This systematic review aimed to summarize the studies examining the influence of various psychological parameters on well-being and performance in judo athletes; (2) Methods: We followed preferred reporting elements for systematic reviews and meta-analyses. We searched the Web of Science database for studies that explained the role of these parameters in elite athletes. Of the 286 articles initially identified, 17 met our eligibility criteria and were included in the review. In total, we analyzed data from 721 judo athletes; (3) Results: The studies found have demonstrated the impact of various psychological parameters during high-level performance and how these parameters can influence and lead an athlete to win or lose a competition. The feelings of tension, anger, anxiety, and nervousness were significantly increased in athletes who were facing defeat, while a decrease in the same segments and an increase in motivation among athletes who were experiencing better performance was observed. Further research under standardized conditions is needed to better understand the effects of these parameters on judo athletes; (4) Conclusions: Considering the athlete’s psychological state can affect performance, and it is therefore important to monitor and train these factors.