The Mediterranean Athlete's Nutrition: Are Protein Supplements Necessary?

Changing food choices: the option for high-protein foods and the move away from the Mediterranean diet

PURPOSE

 The growing importance placed on health and physical well-being by consumers continues to influence food industry choices. The food market therefore, pandering to the desires for a lean and athletic body, offers new products deemed more healthy and able to impact body image. It is evidenced, thus, a change in food choices and habits, with more attention to the quality and nutrient content of the products consumed, in which protein is assuming increasing importance. The purpose of the study is to highlight important changes in eating habits and in particular the increase in the consumption of high-protein foods, attributable to the focus on physical fitness and thinness, resulting in a decreasing adherence to the Mediterranean diet and the progressive loss of its positive impact on health.

METHODS AND RESULTS

This analysis is based on CIRCANA srl data on food consumption trends (change percentage of quantity and value sales) in recent years. Specifically, between January and September 2022 vs. 2021, there was a 21.6% increase in the sale of high-protein products, significantly higher than all the previous ones.

CONCLUSIONS

The past few years have seen the gradual discovery of new products, at first little-known and niche, which are becoming major players on the national food consumption scene. The trend is toward a growing preference for high-protein foods and diets with the gradual abandonment of the Mediterranean and an increased risk of nutritional deficiencies, obesity, and cardiovascular disease.

LEVEL OF EVIDENCE

Level IV, evidence obtained from multiple time series with or without the intervention.

Dietary intake and adherence to the Mediterranean diet in semi-professional female soccer players: a cross-sectional study

Background

Adequate energy and nutrient intakes in athletes contribute to optimal performance and recovery, decrease the risk of injury, and help preserve athletes' health. The Mediterranean diet (MD) is considered suitable for covering the nutritional needs of athletes, while contributing to improve eating habits. The aim of the present study was to investigate the energy and nutrient intakes of semi-professional female soccer players and their adherence to the MD, during the competitive season.

Methods

A cross-sectional observational study was conducted on twenty-three female soccer players, who were invited to fill in a 3-day food diary twice, one month apart, to assess their energy and nutrient intakes and a validated questionnaire (MEDI-LITE) to evaluate their adherence to MD. Exercise energy expenditure during three training and match-play days was monitored by GPS.

Results

On average, the participants consumed 1,981 kcal/day, with 44% of their energy deriving from carbohydrates, 21% from protein, and 34% from fat; the mean MD adherence score was 10.1 ± 1.8, corresponding to a good MD adherence. A substantial percentage of athletes were at risk of insufficient nutrient intakes for vitamin D (100%), iodine (87%), potassium (87%), vitamin E (39%), iron and zinc (17 and 30%, respectively).

Conclusion

The evaluation of the dietary intake in female soccer players showed energy deficiency in relation to training level, mainly due to the insufficient intake of carbohydrates, and micronutrient deficiencies. The technical staff should promote adequate consumption of starchy foods in female athletes and emphasize the importance of a proper distribution of energy intake among different eating occasions, including snacks. Periodic monitoring of the nutritional status of micronutrients (vitamin D and some minerals) could help reduce deficiency risk. Over all, nutrition education to improve eating habits of athletes seems worthy of attention, in order to preserve athletes' health and performance.

Effectiveness of current protein recommendations in adolescent athletes on a low-carbon diet

Adolescent athletes require adequate energy and nutrient supply to support growth, development, and the demands associated with exercise and training. However, they are susceptible to nutritional inadequacies affecting their health and physical performance. Food choices with nutrient adequacy and environmental protection is crucial for a sustainable diet. Therefore, we aimed to assess the adequacy of low-carbon diets to meet the protein requirements of adolescent athletes. Therefore, a cross-sectional observational study was conducted with 91 adolescent athletes from sports clubs in Rio de Janeiro who underwent anthropometric and food consumption assessments. To estimate the environmental impact of anthropogenic activities, the sustainability indicators carbon footprint (CF) and water footprint (WF) were used. The CF of the athlete's diet was compared with the benchmark of 1,571 g CO2eq/cap/d estimated by the World Wildlife Fund (WWF). Protein recommendations according to the American Dietetic Association (ADA) for athletes and protein food groups according to the low-carbon EAT-Lancet reference diet were used as references. The results were stratified by sport modality, age, sex, and income range. The Mann-Whitney test was performed, followed by the Kruskal-Wallis test with Dunn's post-hoc test to assess the differences between groups using the statistical program GraphPad PRISM® version 8.0. CF and WF were directly associated with total energy intake, total protein intake, animal-origin protein intake, and the food groups of meat and eggs. Significant differences were observed in the environmental impact of diet based on sports groups and gender. The athletes' profile with higher environmental impact was male, middle-income class, and of any age group. The quartiles of CF of the overall diets were above the 1,571 g CO2eq/cap/d benchmark. Additionally, ADA's recommended range of daily protein consumption was met by most athletes, even in the lowest quartile of CF. Thus, a diet with a lower environmental impact can meet protein recommendations in adolescent athletes. The results found are of interest to the sports and food industries. It could help in designing a balanced diet for athletes as well as ensure less negative environmental impacts of food production and consumption.

Protein Supplement Perceptions, Use, and Associated Performance in Young Lebanese Resistance-Training Athletes

The aims of this study were first to evaluate the nutritional knowledge, perception, and source of nutrition information among resistance-trained individuals consuming protein supplements (PS), to determine whether a correlation exists between nutrition-related knowledge and the use of PS, and finally to compare the impact of PS use among participants classified as nonprotein supplement users (NPSUs) and protein supplement users (PSUs). A cross-sectional study was conducted among a highly selected group of resistance-specialized trainees (RSTs). Among the 100 RST participants recruited, the Internet and coaches were the most common source of nutritional information. About one-third of participants believed that there were no health risks after consuming PS. Both NPSU and PSU exhibit performance improvement that was significantly lessened in PSU compared to NPSU. This study demonstrated that RST may have misconceptions regarding the benefits of PS usage to increase strength. Our data also suggest a shortage of knowledge about PS and confirm that PSUs lack proper professional guidance. These findings highlight the need for proper monitoring to ensure adequate perception, awareness, and safety in the Lebanese sports sector.

Adherence to Mediterranean Diet and Tendency to Orthorexia Nervosa in Professional Athletes

Among many lifestyle components that professional athletes have to follow, nutrition is gradually growing to be one of the key factors for achieving and maintaining optimal sport performance. The Mediterranean diet (MD) is recognized as one of the healthiest dietary patterns worldwide; however, data regarding adherence to the MD among professional athletes are still scarce. Moreover, with the imposed need for a healthy diet among professional athletes, orthorexia nervosa (ON) could become a rising issue. This cross-sectional study included 150 professional athletes and 150 matched recreational athletes from Croatia. Four questionnaires were used for the assessment: general information, a test for the diagnosis of ON (ORTO-15), the International Physical Activity Questionnaire (IPAQ) and the Mediterranean Diet Serving Score (MDSS). Significantly more professional athletes were adherent to the MD (p < 0.001) and had a tendency to ON (p < 0.001). Moreover, there was a significant negative correlation between the ORTO-15 score and the total MET min/week score (r = −0.524, p < 0.001) and a significant positive correlation between the MDSS score and the total MET min/week score in the professional athlete group (r = 0.478, p < 0.001). All of these results imply that professional athletes are more concentrated on their dietary patterns than recreational athletes, and that due to this dedication, they possibly have a higher adherence to the MD but also possibly a higher risk for developing ON. However, the association between ON and the MD should be further addressed in the future.

Adherence to the Mediterranean Diet and Its Association with the Level of Physical Activity in Fitness Center Users: Croatian-Based Study

The Mediterranean diet (MD) is based on the traditional cuisine of south European countries, and it is considered one of the healthiest dietary patterns worldwide. The promotion of combined MD and physical activity has shown major benefits. However, the association between physical activity and the MD in regular fitness center users is still insufficiently investigated. This cross-sectional survey-based study was conducted on 1220 fitness center users in Croatia. The survey consisted of three parts: general information, the Mediterranean Diet Serving Score (MDSS) and the International Physical Activity Questionnaire Short Form (IPAQ-SF). The results showed that 18.6% of fitness center users were adherent to the MD, and there was a significant positive correlation between the level of physical activity and the MDSS score (r = 0.302, p < 0.001). Moreover, after dividing the sample into tertiles based on the IPAQ-SF score, the third tertile (MET > 3150 min/wk) had the most fitness center users (34.4%) adherent to the MD, while the first tertile (MET < 1750 min/wk) had the least (6.1%). These outcomes emphasize the importance of physical activity as they imply that, with higher levels of physical activity, people are also possibly more aware of the importance that a healthy and balanced diet has on their well-being.

The Mediterranean dietary pattern for optimising health and performance in competitive athletes: a narrative review

Nutrition plays a key role in training for, and competing in, competitive sport, and is essential for reducing risk of injury and illness, recovering and adapting between bouts of activity, and enhancing performance. Consumption of a Mediterranean diet (MedDiet) has been demonstrated to reduce risk of various non-communicable diseases and increase longevity. Following the key principles of a MedDiet could also represent a useful framework for good nutrition in competitive athletes under most circumstances, with potential benefits for health and performance parameters. In this review, we discuss the potential effects of a MedDiet, or individual foods and compounds readily available in this dietary pattern, on oxidative stress and inflammation, injury and illness risk, vascular and cognitive function, and exercise performance in competitive athletes. We also highlight potential modifications which could be made to the MedDiet (whilst otherwise adhering to the key principles of this dietary pattern) in accordance with contemporary sports nutrition practices, to maximise health and performance effects. In addition, we discuss potential directions for future research.