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Edlund K, Forsberg N, Källberg H, Melin A. Assessment of eating disorder symptoms, compulsive exercise, body dissatisfaction and depression in Swedish national team gymnasts, with a one-year follow-up. Eat Weight Disord 2024; 29:46. [PMID: 38997566 PMCID: PMC11245422 DOI: 10.1007/s40519-024-01667-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 05/21/2024] [Indexed: 07/14/2024] Open
Abstract
PURPOSE The purpose of this study was to explore changes in symptoms of eating disorders, compulsive exercise, and depression, between two assessments 12 months apart, among elite gymnasts. METHOD Factors related to the development of mental health symptoms in male and female Swedish national team gymnasts were investigated using baseline and 1-year follow-up scores in two subscales of the Eating Disorders Inventory 3; drive for thinness and body dissatisfaction, two subscales of the Compulsive Exercise Test; avoidance and rule-driven behavior and exercise for weight control, and the Montgomery-Åsberg Depression Rating Scale-Self report (MADRS-S). Linear mixed models were used to investigate the influence of drive for thinness, exercise for weight control, avoidance and rule-driven behavior, and MADRS-S on body dissatisfaction. RESULTS Body dissatisfaction increased from baseline to the follow-up assessment, while drive for thinness and depression remained stable. Symptoms of eating disorders and depression were generally low in this group of elite gymnasts at both assessments. Drive for thinness, exercise for weight control, and symptoms of depression were associated with body dissatisfaction. DISCUSSION Our findings indicate that there were no significant changes over time in eating disorders and depression symptoms but significant associations with body dissatisfaction. Furthermore, we found independent effects of drive for thinness, exercise for weight control and symptoms of depression for body dissatisfaction.
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Affiliation(s)
- Klara Edlund
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, 17177, Stockholm, Sweden.
- Musculoskeletal and Sports Injury Epidemiology Center, Department of Health Promotion Sciences, Sophiahemmet University, Stockholm, Sweden.
| | | | - Henrik Källberg
- Musculoskeletal and Sports Injury Epidemiology Center, Department of Health Promotion Sciences, Sophiahemmet University, Stockholm, Sweden
| | - Anna Melin
- Department of Sports Science, Linnaeus University, Växjö/Kalmar, Sweden
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Sun Q, Liu C, Li S, Ren J, Wang Z. The different association between fat mass distribution and intake of three major nutrients in pre- and postmenopausal women. PLoS One 2024; 19:e0304098. [PMID: 38809895 PMCID: PMC11135700 DOI: 10.1371/journal.pone.0304098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 05/06/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Obesity, characterized by excessive body fat accumulation, is associated with various chronic health conditions. Body fat plays a crucial role in health outcomes, and nutrient intake is a contributing factor. Menopause further influences body fat, but the precise relationships between nutrients and fat mass distribution in pre- and post-menopausal women are unclear. METHODS Data from 4751 adult women aged ≥18 years old (3855 pre-menopausal, 896 post-menopausal) with completed information were obtained from the National Health and Examination Survey (NHANES) from 2011 to 2018. Multivariate linear regression models were used to examine the associations between protein, carbohydrate, fat intake and total percent fat (TPF), android percent fat (APF), gynoid percent fat (GPF), android to gynoid ratio (A/G), subcutaneous adipose tissue mass (SAT), visceral adipose tissue mass (VAT). Subgroup analyses, stratified by menopausal status, were also conducted. Additionally, we employed smoothing curve fitting techniques to investigate potential non-linear relationships between fat mass distribution and nutrient intake. RESULTS Compared with pre-menopausal women, post-menopausal women had higher body fat, BMI, and metabolic indicators but lower nutrient intake (All p<0.05). In the overall analysis, we found significant correlations between nutrient intake and fat mass. Specifically, protein intake was negatively correlated with TPF (β = -0.017, 95% CI: -0.030, -0.005), APF (β = -0.028, 95% CI: -0.044, -0.012), GPF (β = -0.019, 95% CI: -0.030, -0.008), while fat intake showed positive correlations with these measures (SAT: β = 2.769, 95% CI: 0.860, 4.678). Carbohydrate intake exhibited mixed associations. Notably, body fat mass-nutrient intake correlations differed by menopausal status. Generally speaking, protein intake showed negative correlations with body fat distribution in pre-menopausal women but positive correlations in post-menopausal women. Carbohydrate intake revealed significant negative associations with abdominal and visceral fat in post-menopausal women, while fat intake was consistently positive across all fat distribution indices, especially impacting visceral fat in post-menopausal women. CONCLUSION Dietary intake plays a crucial role in body fat distribution, with menopausal status significantly influencing the impact of nutrients on specific fat distribution metrics. The study emphasizes the need for dietary guidelines to consider the nutritional needs and health challenges unique to women at different life stages, particularly concerning menopausal status, to effectively manage obesity.
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Affiliation(s)
- Qin Sun
- Department of Obstetrics and Gynecology, Yulin Hospital, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Congrong Liu
- Department of Obstetrics and Gynecology, Yulin Hospital, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Shuxin Li
- Department of Obstetrics and Gynecology, Yulin Hospital, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Juanjuan Ren
- Department of Obstetrics and Gynecology, Yulin Hospital, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Zhaoxia Wang
- Department of Obstetrics and Gynecology, Yulin Hospital, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
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de Souza LC, Moris JM, Lee KM, Fant KH, Gallucci A, Funderburk LK. Dietary Intake and Menstrual Health among Acrobatics and Tumbling NCAA Division I Student-Athletes. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2024; 43:101-109. [PMID: 37307023 DOI: 10.1080/27697061.2023.2218458] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 05/22/2023] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Acrobatics & Tumbling (A&T) is an emerging sport in the National Collegiate Athletic Association that lacks research regarding the dietary intake and health of A&T student-athletes (A&Tsa). This study assessed the dietary intake adequacy, estimated energy availability (EA), self-reported menstrual health, and body composition of A&Tsa. METHODS Twenty-four female A&Tsa participated during week 8 of the preseason (11 top: Age= 20.1 ± 0.9 years; BMI= 22.1 ± 1.7 kg/m2; 13 base: Age= 19.5 ± 1.3 years; BMI= 26.2 ± 2.7 kg/m2). Total energy intake (TEI) and macronutrient intakes were assessed via a paper-based 3-day dietary recall. Resting Metabolic Rate [RMR = 500 + 22 * fat-free mass (FFM)] and energy availability [EA = (TEI - exercise energy expenditure)/FFM)] were estimated; and LEAF-Q assessed menstrual health. Body composition was measured using Dual-Energy X-Ray Absorptiometry. Macronutrient intakes and EA were compared to sports nutrition recommendations (carbohydrate: 6-10 g/kg; protein: 1.2-2.0 g/kg) and the Acceptable Macronutrient Distribution Range (carbohydrate: 45-65%; protein: 10-35%; fat: 20-35%). RESULTS TEI was 1753 ± 467 kcal (top) and 1980 ± 473.8 kcal (base). A total of 20.8% of A&Tsa failed to meet RMR with TEI, with a higher prevalence in the top (-266 ± 219.2 kcal, n = 3) vs. base (-414.3 ± 534.4 kcal, n = 2) A&Tsa. Top and base A&Tsa had both low EA (28.8 ± 13.4 kcals·FFM-1; 23.8 ± 9.5 kcals·FFM-1) and inadequate carbohydrate intake averages (4.2 ± 1.3 g/kg; 3.5 ± 1.1 g/kg, p < 0.001), respectively. A total of 17% of A&Tsa reported secondary amenorrhea, with a higher prevalence in the top (27.3%, n = 3) vs. the base (7.7%, n = 1). CONCLUSION TEI and carbohydrate intake of the majority of A&Tsa were below recommendations. Sports dietitians should encourage and educate A&Tsa about following an adequate diet that meets energy and sports-specific macronutrient needs.
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Affiliation(s)
- Leticia C de Souza
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, Texas, USA
| | - Jose M Moris
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, Texas, USA
| | - Katherine M Lee
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, Texas, USA
| | - Kristin H Fant
- Performance Nutrition (Baylor Athletics), Baylor University, Waco, Texas, USA
| | - Andrew Gallucci
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, Texas, USA
| | - LesLee K Funderburk
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, Texas, USA
- Department of Human Sciences and Design, Baylor University, Waco, Texas, USA
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Vicente F, Holanda M, Ramalho R, Mendes J, Marques-Vidal P, Pereira P. Lower calcium and iron intake in adolescent gymnasts: A case of concern for youth sports nutrition. Nutrition 2023; 110:112020. [PMID: 36963267 DOI: 10.1016/j.nut.2023.112020] [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: 11/09/2022] [Revised: 02/06/2023] [Accepted: 02/21/2023] [Indexed: 03/06/2023]
Abstract
OBJECTIVES Diet is important for the appropriate development and maturation of young amateur athletes. The aim of this study was to determine whether young gymnasts were consuming adequate amounts of nutrients, particularly calcium and iron. METHODS This cross-sectional survey was conducted in Portugal's Almada and Lisbon regions in 2020. To determine if participants' diet was adequate, weight, height, and skinfold measurements were taken. Dietary consumption was examined using two 24-h recalls. We collected data from 66 participants (60% females, 12-18 y of age), of whom 82% had normal weight and 39% had ideal body fat. RESULTS The daily total energy intake (TEI) was1605 ± 601 kcal. Of the TEI, 19%, 31%, and 50% were comprised of protein, fat, and carbohydrates, respectively. The most often consumed protein sources were poultry and ultra-processed meat products (52% and 45%, respectively). The average daily consumption of calcium and iron was 626 ± 293 and 9 ± 3 mg, respectively. Only 2 of the 66 participants had calcium intake within recommended levels, and 1of 5 had iron intake within recommended levels, the percentage of which was lower in girls than boys (7.5% versus 38.5%, P < 0.05). CONCLUSIONS Despite having a sufficient macronutrient distribution, Portuguese gymnasts consume a high amount of ultra-processed items and a low amount of calcium and iron. The low proportion of female gymnasts with adequate iron consumption is cause for worry in sports nutrition.
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Affiliation(s)
- Filipa Vicente
- Instituto Universitário Egas Moniz (IUEM), Campus Universitário Quinta da Granja, Monte de Caparica, Caparica, Portugal; Centro de Investigação Interdisciplinar Egas Moniz (CIIEM), Campus Universitário Quinta da Granja, Monte de Caparica, Caparica, Portugal; Grupo de Estudos em Nutrição Aplicada (GENA), Campus Universitário Quinta da Granja, Monte de Caparica, Caparica, Portugal.
| | - Marcela Holanda
- Instituto Universitário Egas Moniz (IUEM), Campus Universitário Quinta da Granja, Monte de Caparica, Caparica, Portugal; Grupo de Estudos em Nutrição Aplicada (GENA), Campus Universitário Quinta da Granja, Monte de Caparica, Caparica, Portugal
| | - Renata Ramalho
- Instituto Universitário Egas Moniz (IUEM), Campus Universitário Quinta da Granja, Monte de Caparica, Caparica, Portugal; Centro de Investigação Interdisciplinar Egas Moniz (CIIEM), Campus Universitário Quinta da Granja, Monte de Caparica, Caparica, Portugal; Grupo de Estudos em Nutrição Aplicada (GENA), Campus Universitário Quinta da Granja, Monte de Caparica, Caparica, Portugal
| | - João Mendes
- Instituto Universitário Egas Moniz (IUEM), Campus Universitário Quinta da Granja, Monte de Caparica, Caparica, Portugal; Centro de Investigação Interdisciplinar Egas Moniz (CIIEM), Campus Universitário Quinta da Granja, Monte de Caparica, Caparica, Portugal
| | - Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Paula Pereira
- Instituto Universitário Egas Moniz (IUEM), Campus Universitário Quinta da Granja, Monte de Caparica, Caparica, Portugal; Centro de Investigação Interdisciplinar Egas Moniz (CIIEM), Campus Universitário Quinta da Granja, Monte de Caparica, Caparica, Portugal; Grupo de Estudos em Nutrição Aplicada (GENA), Campus Universitário Quinta da Granja, Monte de Caparica, Caparica, Portugal
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Rutkowska M, Czajkowska M, Nowakowska I, Kowalczyk A, Król T, Dąbrowska-Galas M, Skrzypulec-Plinta V. Eating Behaviours in Sportswomen from the Silesian Training in Different Sports Disciplines. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16843. [PMID: 36554721 PMCID: PMC9779681 DOI: 10.3390/ijerph192416843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/05/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
UNLABELLED Eating disorders are characterized by abnormal, unhealthy eating habits, and disordered body image. In severe cases, it can cause serious health consequences, including cardiac problems, osteoporosis, infertility, or missing menstrual periods. In women competitively training sports, the main cause for disordered eating behaviours are factors associated with dissatisfaction with their appearance and body image and a need to reduce body weight. Factors related to dissatisfaction with one's own appearance and body image, a need to reduce body weight, a negative perception of themselves and their bodies, the pressure in sports circles, and stress are predictors for eating disorders. The aim of the study was to compare eating behaviours, body satisfaction, and taking various actions related to body mass reduction among women training competitively in volleyball, athletics, gymnastics, and young women not participating in sports. MATERIAL AND METHODS The study covered a group of girls and young women from the Silesian, Poland, who represented three sports disciplines (volleyball, athletics, and gymnastics), of which 30 girls were used as a control group (B). The study was conducted using a study questionnaire. RESULTS The study participants ate regularly and consumed all food groups during a week. The majority of girls from A1 (83.33%), A3 (53.33%), and B (80%) groups expressed their dissatisfaction with their body weight. In the group of gymnasts, a positive correlation was noted between the need to reduce body weight and regular eating (r = 0.449; p = 0.013). In the group of volleyball players, it was demonstrated that the higher the competitive experience and the greater the training load, the more regular their eating was (r = 0.475; p = 0.009). CONCLUSIONS The importance of a diagnosis of early signs of eating disorders in girls and women as a basic component contributing to FAT development implies that further studies in this area, as well as education of the entire sports circle are necessary.
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Affiliation(s)
- Magdalena Rutkowska
- Department of Kinesitherapy and Special Methods, Department of Physiotherapy, Faculty of Health Sciences in Katowice, Medical University of Silesia in Katowice, Medyków 12 Street, 40-752 Katowice, Poland
| | - Mariola Czajkowska
- Department of Propaedeutics of Obstetrics, Department of Women’s Health, Faculty of Health Sciences in Katowice, Medical University of Silesia in Katowice, Medyków 12 Street, 40-752 Katowice, Poland
| | - Iwona Nowakowska
- Department of Balneoclimatology and Biological Regeneration, Department of Physiotherapy, Faculty of Health Sciences in Katowice, Medical University of Silesia in Katowice, Medyków 12 Street, 40-752 Katowice, Poland
| | - Anna Kowalczyk
- Department of Physiotherapy, Faculty of Health Sciences in Katowice, Medical University of Silesia in Katowice, Medyków 12 Street, 40-752 Katowice, Poland
| | - Tomasz Król
- Department of Kinesitherapy and Special Methods, Department of Physiotherapy, Faculty of Health Sciences in Katowice, Medical University of Silesia in Katowice, Medyków 12 Street, 40-752 Katowice, Poland
| | - Magdalena Dąbrowska-Galas
- Department of Kinesitherapy and Special Methods, Department of Physiotherapy, Faculty of Health Sciences in Katowice, Medical University of Silesia in Katowice, Medyków 12 Street, 40-752 Katowice, Poland
| | - Violetta Skrzypulec-Plinta
- Department of Reproductive Health and Sexuology, Department of Women’s Health, Faculty of Health Sciences in Katowice, Medical University of Silesia in Katowice, Medyków 12 Street, 40-752 Katowice, Poland
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Dietary Iron and the Elite Dancer. Nutrients 2022; 14:nu14091936. [PMID: 35565904 PMCID: PMC9105128 DOI: 10.3390/nu14091936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 04/28/2022] [Accepted: 05/03/2022] [Indexed: 12/10/2022] Open
Abstract
Dancers are an athlete population at high risk of developing iron deficiency (ID). The aesthetic nature of the discipline means dancers potentially utilise dietary restriction to meet physique goals. In combination with high training demands, this means dancers are susceptible to problems related to low energy availability (LEA), which impacts nutrient intake. In the presence of LEA, ID is common because of a reduced mineral content within the low energy diet. Left untreated, ID becomes an issue that results in fatigue, reduced aerobic work capacity, and ultimately, iron deficient anaemia (IDA). Such progression can be detrimental to a dancer’s capacity given the physically demanding nature of training, rehearsal, and performances. Previous literature has focused on the manifestation and treatment of ID primarily in the context of endurance athletes; however, a dance-specific context addressing the interplay between dance training and performance, LEA and ID is essential for practitioners working in this space. By consolidating findings from identified studies of dancers and other relevant athlete groups, this review explores causal factors of ID and potential treatment strategies for dancers to optimise absorption from an oral iron supplementation regime to adequately support health and performance.
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Weight Pressures and Eating Disorder Symptoms among Adolescent Female Gymnasts of Different Performance Levels in Greece. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9020254. [PMID: 35204974 PMCID: PMC8870309 DOI: 10.3390/children9020254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 01/24/2022] [Accepted: 02/11/2022] [Indexed: 01/12/2023]
Abstract
This study examined the weight pressures within the gymnastics environment and explored associations between these pressures and eating disorder (ED) symptoms in adolescent female gymnasts. One hundred and forty-seven competitive gymnasts and 122 recreational-level gymnasts (11–17 years old) completed the Eating Attitudes Test (EAT-26), the Weight-Pressures in Sport-Females (WPS-F), the Social Desirability Scale (SDS) and provided information on their training. It was found that 16.3% of competitive gymnasts and 7.4% of non-competitive gymnasts scored ≥20 in EAT-26, indicating disordered eating behavior. Competitive gymnasts scored higher than non-competitive in the total score of EAT-26 (p = 0.027), as well as in the total score of WPS-F, the sport and coaches weight pressures sub-scale and the appearance and performance weight pressures sub-scale (p < 0.001). Multiple regression analyses indicated that sport and coaches weight pressures, appearance and performance weight pressures and body mass index accounted for 30.3% of the variance of EAT-26 in competitive gymnasts, while the appearance and performance weight pressures sub-scale accounted for 16.3% of the variance of EAT-26 in non-competitive gymnasts. Sport and coaches weight pressures are associated with ED in competitive gymnasts, while body appearance and performance demands correlate with ED in female gymnasts irrespective of competitive level.
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Kontele I, Grammatikopoulou MG, Vassilakou T. Level of Adherence to the Mediterranean Diet and Weight Status among Adolescent Female Gymnasts: A Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8121135. [PMID: 34943331 PMCID: PMC8700392 DOI: 10.3390/children8121135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 11/24/2021] [Accepted: 11/29/2021] [Indexed: 02/07/2023]
Abstract
Adolescent female gymnasts are a vulnerable population in terms of their diet, as their nutritional needs are higher due to their growth and high daily training demands. The Mediterranean diet (MD) is a well-known dietary pattern that is associated with a greater nutritional adequacy and a lower prevalence of overweight. The aim of this cross-sectional study was to evaluate the degree of adherence to the MD among adolescent female athletes who participated in all disciplines of gymnastics in Greece, as well as to explore the potential correlations between MD adherence, body weight, and body mass index (BMI). A total of 269 female gymnasts (between 11-18 years old) completed the Mediterranean Diet Quality Index (KIDMED) and reported their weight and height. Approximately 10% of the participants were underweight and a mere 5.6% were classified as overweight. A high adherence to the MD was reported by 34.9% of the sample and this was correlated with a healthier BMI. Moreover, specific eating habits, such as eating nuts 2-3 times per week and eating fast-food less than once-weekly, were also associated with BMI. Athletes, parents, and coaches of gymnastics should be informed and educated regarding balanced nutrition habits. Future studies could evaluate adherence to MD, as well as the factors that influence the eating behaviors of adolescent female and male athletes in various sports.
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Affiliation(s)
- Ioanna Kontele
- Department of Public Health Policy, School of Public Health, University of West Attica, 196 Alexandras Avenue, GR-11521 Athens, Greece
- Correspondence: (I.K.); (T.V.)
| | - Maria G. Grammatikopoulou
- Department of Nutritional Sciences & Dietetics, Faculty of Health Sciences, International Hellenic University, Alexander Campus, GR-57001 Thessaloniki, Greece;
| | - Tonia Vassilakou
- Department of Public Health Policy, School of Public Health, University of West Attica, 196 Alexandras Avenue, GR-11521 Athens, Greece
- Correspondence: (I.K.); (T.V.)
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