1
|
Ghazzawi HA, Nimer LS, Haddad AJ, Alhaj OA, Amawi AT, Pandi-Perumal SR, Trabelsi K, Seeman MV, Jahrami H. A systematic review, meta-analysis, and meta-regression of the prevalence of self-reported disordered eating and associated factors among athletes worldwide. J Eat Disord 2024; 12:24. [PMID: 38326925 PMCID: PMC10851573 DOI: 10.1186/s40337-024-00982-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 01/31/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND The purpose of this meta-analysis was to provide a pooled prevalence estimate of self-reported disordered eating (SRDE) in athletes based on the available literature, and to identify risk factors for their occurrence. METHODS Across ten academic databases, an electronic search was conducted from inception to 7th January 2024. The proportion of athletes scoring at or above predetermined cutoffs on validated self-reporting screening measures was used to identify disordered eating (DE). Subgroup analysis per country, per culture, and per research measure were also conducted. Age, body mass index (BMI), and sex were considered as associated/correlated factors. RESULTS The mean prevalence of SRDE among 70,957 athletes in 177 studies (132 publications) was 19.23% (17.04%; 21.62%), I2 = 97.4%, τ2 = 0.8990, Cochran's Q p value = 0. Australia had the highest percentage of SRDE athletes with a mean of 57.1% (36.0%-75.8%), while Iceland had the lowest, with a mean of 4.9% (1.2%-17.7%). The SRDE prevalence in Eastern countries was higher than in Western countries with 29.1% versus 18.5%. Anaerobic sports had almost double the prevalence of SRDE 37.9% (27.0%-50.2%) compared to aerobic sports 19.6% (15.2%-25%). Gymnastics sports had the highest SRDE prevalence rate, with 41.5% (30.4%-53.6%) while outdoor sports showed the lowest at 15.4% (11.6%-20.2%). Among various tools used to assess SRDE, the three-factor eating questionnaire yielded the highest SRDE rate 73.0% (60.1%-82.8%). Meta-regression analyses showed that female sex, older age, and higher BMI (all p < 0.01) are associated with higher prevalence rates of SRDE. CONCLUSION The outcome of this review suggests that factors specific to the sport affect eating behaviors throughout an athlete's life. As a result, one in five athletes run the risk of developing an eating disorder. Culture-specific and sport-specific diagnostic tools need to be developed and increased attention paid to nutritional deficiencies in athletes.
Collapse
Affiliation(s)
- Hadeel A Ghazzawi
- Department of Nutrition and Food Technology, School of Agriculture, The University of Jordan, Amman, Jordan
| | - Lana S Nimer
- Department of Nutrition and Food Technology, School of Agriculture, The University of Jordan, Amman, Jordan
| | - Areen Jamal Haddad
- Department of Nutrition and Food Technology, School of Agriculture, The University of Jordan, Amman, Jordan
| | - Omar A Alhaj
- Department of Nutrition, Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan
| | - Adam T Amawi
- Department of Exercise Science and Kinesiology, School of Sport Science, The University of Jordan, Amman, Jordan
| | - Seithikurippu R Pandi-Perumal
- Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
- Division of Research and Development, Lovely Professional University, Phagwara, Punjab, 144411, India
| | - Khaled Trabelsi
- High Institute of Sport and Physical Education of Sfax, University of Sfax, 3000, Sfax, Tunisia
- Research Laboratory: Education, Motricity, Sport and Health, University of Sfax, EM2S, LR19JS013000, Sfax, Tunisia
| | - Mary V Seeman
- Department of Psychiatry, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - Haitham Jahrami
- Ministry of Health, Manama, Bahrain.
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain.
| |
Collapse
|
2
|
Best R, Williams JM, Pearce J. The Physiological Requirements of and Nutritional Recommendations for Equestrian Riders. Nutrients 2023; 15:4977. [PMID: 38068833 PMCID: PMC10708571 DOI: 10.3390/nu15234977] [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: 11/26/2023] [Accepted: 11/28/2023] [Indexed: 12/18/2023] Open
Abstract
Equestrian sport is under-researched within the sport science literature, creating a possible knowledge vacuum for athletes and support personnel wishing to train and perform in an evidence-based manner. This review aims to synthesise available evidence from equitation, sport, and veterinary sciences to describe the pertinent rider physiology of equestrian disciplines. Estimates of energy expenditure and the contribution of underpinning energy systems to equestrian performance are used to provide nutrition and hydration recommendations for competition and training in equestrian disciplines. Relative energy deficiency and disordered eating are also considered. The practical challenges of the equestrian environment, including competitive, personal, and professional factors, injury and concussion, and female participation, are discussed to better highlight novelty within equestrian disciplines compared to more commonly studied sports. The evidence and recommendations are supported by example scenarios, and future research directions are outlined.
Collapse
Affiliation(s)
- Russ Best
- Centre for Sport Science & Human Performance, Waikato Institute of Technology, Te Pūkenga, Hamilton 3200, New Zealand
| | - Jane M. Williams
- Department of Animal Science, Hartpury University, Hartpury Gl19 3BE, UK;
| | - Jeni Pearce
- High Performance Sport New Zealand, Auckland 0632, New Zealand;
| |
Collapse
|
3
|
Torres-McGehee TM, Uriegas NA, Hauge M, Monsma EV, Emerson DM, Smith AB. Eating Disorder Risk and Pathogenic Behaviors Among Collegiate Student-Athletes. J Athl Train 2023; 58:803-812. [PMID: 37459386 DOI: 10.4085/1062-6050-0539.22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
CONTEXT Eating disorders (EDs) are a cluster of behavioral conditions characterized by uneasy thoughts and behaviors that grow into severe or persistent eating disturbances. The demands on student-athletes may create mental and physical stressors that increase the likelihood of EDs and disordered eating. OBJECTIVE To examine the ED risk through eating attitudes and behaviors in male and female student-athletes and across various sport types (endurance, aesthetic, power, ball or team, or technical sports). DESIGN Cross-sectional study. SETTING Collegiate athletics. PATIENTS OR OTHER PARTICIPANTS National Collegiate Athletic Association Division I and II student-athletes (n = 2054; males = 631; females = 1423) from 40 institutions. MAIN OUTCOME MEASURE(S) Participants completed a web-based demographic survey and the Eating Attitudes Test-26 (EAT-26). Multiple χ2 analyses examined participants classified as at risk for EDs. Independent-samples t tests and a 1-way analyses of variance compared sex and sport type across EAT-26 totals and subscale (Dieting, Bulimia, and Oral Control) scores. RESULTS Overall, 25.3% (n = 520/2054) of student-athletes were classified as at risk for EDs. Differences were found between sex and ED risk (χ21,2054 = 32.9, P ≤ .01; 17.3% [n = 109/631] males, 28.9% [n = 411/1423] females) and across ED risk and sport type (χ24,2054 = 13.4, P = .01). When examining females only, we observed differences across ED risk and sport type (χ24,1423 = 13.4, P ≤ .01). No differences were evident across ED risk and sport type for males. Differences were seen between sex and binge eating (χ21,2054 = 6.8, P = .009), sex and diet pill use (χ21,2054 = 19.6, P ≤ .01), and sport type and diet pill use (χ24,2054= 12.2, P = .016), excessive exercise (χ24,2054 = 32.1, P ≤ .01), and losing more than 20 lb (9 kg) in the last 6 months (χ24,2054 = 10.2, P ≤ .037). CONCLUSIONS Student-athletes in the collegiate setting are at risk for EDs. Medical professionals, such as athletic trainers, need to be educated on the potential risk factors that may lead to EDs. Protocols for prevention, screening and recognition, and referral should be developed for student-athletes at risk for EDs.
Collapse
|
4
|
Forino S, Cameron L, Stones N, Freeman M. Horse-Rider Pairing Perception by Dressage Judges and Equestrian Coaches. J Equine Vet Sci 2023; 128:104864. [PMID: 37343691 DOI: 10.1016/j.jevs.2023.104864] [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: 01/13/2023] [Revised: 05/09/2023] [Accepted: 06/12/2023] [Indexed: 06/23/2023]
Abstract
The ideal equestrian body image (BI) is a smaller physique and riders feel body shape (BS) influences subjective judge scoring within dressage competitions. The aims were to identify perceptions of equestrian coaches and dressage judges of rider body shape (BS), identify perceptions of appropriate horse-rider matching and establish the impact of BS on perceived rider ability. An online survey (GoogleFormsTM) was shared, respondents (n = 265, coaches = 174 judges = 91) viewed images of twelve riders of different BS (Ectomorph, Mesomorph, and Endomorph) mounted on three horses of different breeds/types and asked to indicate the best horse-rider match. Judges were asked if body shape or inappropriate horse-rider matching influenced scores given, this was used to identify any bias from judges. A significant perception for horse rider matching identified the cob as the most appropriate for the Endomorph physique (P < .001). Ectomorph was the most chosen as the ideal BS on all horses. Both coaches and judges identified the ideal physique as a smaller image from the BI scale. Both coaches and judges individually perceive that BS impacts rider ability (P < .001). These findings of BS perceived as linked to rider skill potentially identifies an issue and may correspond to the smaller physique being idealistic. Future research into physique related bias from judges is required to further identify the impact of BS on subjective judging within equestrian sport.
Collapse
Affiliation(s)
- Sofia Forino
- University Centre Sparsholt, Westley Lane, Winchester, SO21 2NF, UK.
| | - Lorna Cameron
- Hartpury University, Hartpury House, Gloucester GL19 3BE, UK
| | - Natalie Stones
- University Centre Sparsholt, Westley Lane, Winchester, SO21 2NF, UK
| | - Marianne Freeman
- University Centre Sparsholt, Westley Lane, Winchester, SO21 2NF, UK
| |
Collapse
|
5
|
Eck KM, Byrd-Bredbenner C. Development and Psychometric Validation of the Athletes' Perceived Body Pressures from Coaches Questionnaire (APBPCQ). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192416416. [PMID: 36554296 PMCID: PMC9778746 DOI: 10.3390/ijerph192416416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/30/2022] [Accepted: 12/05/2022] [Indexed: 06/01/2023]
Abstract
This study aimed to develop a questionnaire to assess male and female athletes' perceived weight and shape pressure from coaches and establish its psychometric properties. Exploratory factor analysis (N = 412 in each female sample 1 and 2) provided evidence for 4 scales for female athletes and 3 scales for male athletes which were confirmed in confirmatory factor analysis (N = 260 in each male sample 1 and 2). For both females and males, KMO testing and Bartlett's test of sphericity indicated that the sampling was adequate and survey items were appropriate for factor analysis. Additionally, all scales for both sexes had strong factor loadings (≥0.65), good Cronbach alpha coefficients (>0.70), and made contextual sense. The magnitude of difference results were indicative of a stable factor structure. Goodness-of-fit indicators were all in the expected direction. Good convergent validity was demonstrated. The questionnaire's excellent psychometric properties and novelty make it a valuable tool for researchers and practitioners. This questionnaire has the potential to identify training needs in coaching staff, as well as to identify athletes who may benefit from support and guidance for effectively coping with pressure from coaches.
Collapse
Affiliation(s)
- Kaitlyn M. Eck
- Department of Nutrition and Dietetics, Marywood University, Scranton, PA 18509, USA
| | - Carol Byrd-Bredbenner
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ 08901, USA
| |
Collapse
|
6
|
Jagim AR, Fields J, Magee MK, Kerksick CM, Jones MT. Contributing Factors to Low Energy Availability in Female Athletes: A Narrative Review of Energy Availability, Training Demands, Nutrition Barriers, Body Image, and Disordered Eating. Nutrients 2022; 14:nu14050986. [PMID: 35267961 PMCID: PMC8912784 DOI: 10.3390/nu14050986] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 12/28/2022] Open
Abstract
Relative Energy Deficiency in sport is experiencing remarkable popularity of late, particularly among female athletes. This condition is underpinned by low energy availability, which is a byproduct of high energy expenditure, inadequate energy intake, or a combination of the two. Several contributing factors exist that may predispose an athlete to low energy availability, and therefore a holistic and comprehensive assessment may be required to identify the root causes. The focus of the current narrative review is to discuss the primary contributing factors as well as known risk factors for low energy availability among female athletes to help practitioners increase awareness on the topic and identify future areas of focus.
Collapse
Affiliation(s)
- Andrew R. Jagim
- Sports Medicine, Mayo Clinic Health System, La Crosse, WI 54601, USA
- Exercise & Sport Science Department, University of Wisconsin-La Crosse, La Crosse, WI 54601, USA
- Patriot Performance Laboratory, Frank Pettrone Center for Sports Performance, Intercollegiate Athletics, George Mason University, Fairfax, VA 22030, USA; (J.F.); (M.K.M.); (M.T.J.)
- Correspondence: ; Tel.: +1-608-392-5280
| | - Jennifer Fields
- Patriot Performance Laboratory, Frank Pettrone Center for Sports Performance, Intercollegiate Athletics, George Mason University, Fairfax, VA 22030, USA; (J.F.); (M.K.M.); (M.T.J.)
- Exercise Science and Athletic Training, Springfield College, Springfield, MA 01109, USA
| | - Meghan K. Magee
- Patriot Performance Laboratory, Frank Pettrone Center for Sports Performance, Intercollegiate Athletics, George Mason University, Fairfax, VA 22030, USA; (J.F.); (M.K.M.); (M.T.J.)
- Sport, Recreation, and Tourism Management, George Mason University, Manassas, VA 22030, USA
| | - Chad M. Kerksick
- Exercise & Performance Nutrition Laboratory, Lindenwood University, St. Charles, MO 63301, USA;
| | - Margaret T. Jones
- Patriot Performance Laboratory, Frank Pettrone Center for Sports Performance, Intercollegiate Athletics, George Mason University, Fairfax, VA 22030, USA; (J.F.); (M.K.M.); (M.T.J.)
- Sport, Recreation, and Tourism Management, George Mason University, Manassas, VA 22030, USA
| |
Collapse
|
7
|
Smith AB, Gay JL, Monsma EV, Arent SM, Sarzynski MA, Emerson DM, Torres-McGehee TM. Investigation of Eating Disorder Risk and Body Image Dissatisfaction among Female Competitive Cheerleaders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042196. [PMID: 35206381 PMCID: PMC8872421 DOI: 10.3390/ijerph19042196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/07/2022] [Accepted: 02/11/2022] [Indexed: 12/04/2022]
Abstract
Social agents associated with cheerleading environments are increasingly linked to body image dissatisfaction (BID) and eating disorders (ED). This study examined ED risk across team type, squad type, and position. An additional purpose determined BID in clothing type (daily clothing, midriff uniform, and full uniform), and meta-perceptions from the perspective of peers (MP peers), parents (MP parents), and coaches (MP coaches). Female cheerleaders (n = 268) completed an online survey which included demographics, the Eating Attitudes Test-26, and pathogenic behavior questions. Body image perceptions were assessed by using the Sex-Specific Figural Stimuli Silhouettes. Overall, 34.4% of cheerleaders (n = 268; mean age: 17.9 ± 2.7 years) exhibited an ED risk. Compared to All-Star cheerleaders, college cheerleaders demonstrated significant higher ED risk (p = 0.021), dieting subscale scores (p = 0.045), and laxative, diet pill, and diuretic use (p = 0.008). Co-ed teams compared to all-girl teams revealed higher means for the total EAT-26 (p = 0.018) and oral control subscale (p = 0.002). The BID in clothing type revealed that cheerleaders wanted to be the smallest in the midriff option (p < 0.0001, η2 = 0.332). The BID from meta-perception revealed that cheerleaders felt that their coaches wanted them to be the smallest (p < 0.001, η2 = 0.106). Cheerleaders are at risk for EDs and BID at any level. Regarding the midriff uniform, MP from the perspective of coaches showed the greatest difference between perceived and desired body image.
Collapse
Affiliation(s)
- Allison B. Smith
- School of Kinesiology, University of Louisiana at Lafayette, Lafayette, LA 70507, USA
- Correspondence:
| | - Jennifer L. Gay
- Department of Health Promotion & Behavior, University of Georgia, Athens, GA 30602, USA;
| | - Eva V. Monsma
- Department of Physical Education, University of South Carolina, Columbia, SC 29208, USA;
| | - Shawn M. Arent
- Department of Exercise Science, University of South Carolina, Columbia, SC 29208, USA; (S.M.A.); (M.A.S.); (T.M.T.-M.)
| | - Mark A. Sarzynski
- Department of Exercise Science, University of South Carolina, Columbia, SC 29208, USA; (S.M.A.); (M.A.S.); (T.M.T.-M.)
| | - Dawn M. Emerson
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS 66160, USA;
| | - Toni M. Torres-McGehee
- Department of Exercise Science, University of South Carolina, Columbia, SC 29208, USA; (S.M.A.); (M.A.S.); (T.M.T.-M.)
| |
Collapse
|
8
|
Examination of the Prevalence of Female Athlete Triad Components among Competitive Cheerleaders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031375. [PMID: 35162393 PMCID: PMC8835590 DOI: 10.3390/ijerph19031375] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/19/2022] [Accepted: 01/22/2022] [Indexed: 12/10/2022]
Abstract
The purpose of this study was to examine individual and combined Female Athlete Triad components within collegiate cheerleaders, an at-risk group. Cheerleaders (n = 19; age: 20.3 ± 1.2 years) completed anthropometric measurements, health history questionnaires, resting metabolic rate, the eating disorder inventory-3 and symptom checklist, blood sample, and DXA scan. Participants completed dietary and exercise logs for 7 days and used heart rate monitors to track daily and exercise energy expenditure. Proportions were calculated for low energy availability (LEA) risk, disordered eating risk, and pathogenic behaviors. Chi-square analysis was used to determine the difference between cheerleaders who experience low EA with or without disordered eating risk. All cheerleaders demonstrated LEA for the days they participated in cheerleading practice, 52.6% demonstrated LEA with eating disorder risk and 47.4% demonstrated LEA without eating disorder risk, 52.6% self-reported menstrual dysfunction, 14% experienced menstrual dysfunction via hormonal assessment, and 0% demonstrated low bone mineral density. Overall, 47.7% presented with one Triad component, 52.6% demonstrated two Triad components using self-reported menstrual data, and 10.5% demonstrated two Triad components using hormonal assessments. All cheerleaders displayed LEA. These findings support the need for increased education on the individual components of the Triad and their potential consequences by qualified personal.
Collapse
|
9
|
Forino S, Cameron L, Stones N, Freeman M. Potential Impacts of Body Image Perception in Female Equestrians. J Equine Vet Sci 2021; 107:103776. [PMID: 34802624 DOI: 10.1016/j.jevs.2021.103776] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 01/12/2023]
Abstract
Female body image (BI) has been investigated in many sports yet, in female-dominated equestrianism, there is a paucity of BI research. This study aimed to identify self-perceptions of BI, rider perceptions of judge and coach bias, relationships between BI and self-consciousness and effect of breast size. A four-part, 27 question survey (GoogleForms) was completed by female equestrians (n = 493). The second smallest BI was considered ideal for equestrianism (χ2 = 352.751, P < .001) regardless of age, own BI or level of riding commitment. There was a perception judges favor riders with smaller frames (χ2 = 54.2111, P < .001) and an association between riders with a larger BI feeling self-conscious when riding (χ2 = 87.514, P < .001). More respondents perceived the ideal equestrian BI to be smaller than theirs (Median = -1.5, W = 7777.00, P < .001) and an association between those dissatisfied with their BI and self-consciousness when riding was seen (χ2 = 83.649, P < .001). Perception of the ideal equestrian frame is smaller than many riders' own BI, and a larger BI perception negatively impacts self-confidence, potentially hindering performance and participation. Female riders with a larger frame feel they are perceived negatively by judges and further study is indicated to investigate the extent of this potential bias on subjective judging in equestrian disciplines.
Collapse
Affiliation(s)
| | - Lorna Cameron
- University Centre Sparsholt, Winchester, UK; Hartpury University, Gloucester, UK.
| | | | | |
Collapse
|
10
|
Stoyel H, Stride C, Shanmuganathan-Felton V, Serpell L. Understanding risk factors for disordered eating symptomatology in athletes: A prospective study. PLoS One 2021; 16:e0257577. [PMID: 34559831 PMCID: PMC8462695 DOI: 10.1371/journal.pone.0257577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 09/06/2021] [Indexed: 12/01/2022] Open
Abstract
Disordered eating and eating disorders have huge impact on athletic health and performance. Understanding risk factors for disordered eating development is paramount to protecting the health and performance of these athletes. This project tested a model longitudinally to test whether body dissatisfaction (mediated by negative affect) and societal pressures (mediated by internalisation) predicted bulimic symptomatology at 1 year. The study recruited 1017 male and female athletes in a range of sports at three time points over a year. Cross-lag meditation modelling in MPLUS was utilised to test the hypothesised model. Results indicated that societal pressures mediated by general internalisation led to bulimic symptomatology and that gender and sport type do moderate the relationships. However, measurement issues indicate that scales not originally created for athletes may not reliably measure athletes' experience. This research highlights how understanding how to better assess risk factors and disordered eating related concepts in athletes is a key next step. The study is unique in its longitudinal design and in its sampling of a wide range of sports in both male and female athletes.
Collapse
Affiliation(s)
- Hannah Stoyel
- University College London, London, England, United Kingdom
| | - Chris Stride
- University of Sheffield, Sheffield, England, United Kingdom
| | | | - Lucy Serpell
- University College London, London, England, United Kingdom
| |
Collapse
|
11
|
Riviere AJ, Leach R, Mann H, Robinson S, Burnett DO, Babu JR, Frugé AD. Nutrition Knowledge of Collegiate Athletes in the United States and the Impact of Sports Dietitians on Related Outcomes: A Narrative Review. Nutrients 2021; 13:nu13061772. [PMID: 34067402 PMCID: PMC8224733 DOI: 10.3390/nu13061772] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/11/2021] [Accepted: 05/19/2021] [Indexed: 12/15/2022] Open
Abstract
In the last decade, the number of full-time registered dietitians (RDs) serving intercollegiate athletes in the United States has more than quadrupled. However, many student athletes may be at increased risk of nutrition-related problems that impact physical and academic performance, which include inadequate macronutrients, inadequate micronutrients, and excessive macronutrients. This narrative review reports the current literature to date on nutrition-related knowledge in collegiate athletes and the impact of sports RDs on student athletes’ nutrition knowledge and behaviors. To date, only observational and quasi-experimental studies have been published with regard to changes in nutrition knowledge and behaviors in NCAA athletes. While these studies report benefits of the RD as a member of the interdisciplinary student athlete support team, more well-designed randomized control trials are warranted to determine benefits related to health outcomes and sport-specific performance outcomes.
Collapse
Affiliation(s)
- Aaron J. Riviere
- Department of Education and Human Development, Texas A&M University, College Station, TX 77843, USA
- Correspondence:
| | - Rae Leach
- Department of Nutrition, Dietetics, and Hospitality Management, Auburn University, Auburn, AL 36849, USA; (R.L.); (H.M.); (D.O.B.); (J.R.B.); (A.D.F.)
| | - Haleigh Mann
- Department of Nutrition, Dietetics, and Hospitality Management, Auburn University, Auburn, AL 36849, USA; (R.L.); (H.M.); (D.O.B.); (J.R.B.); (A.D.F.)
| | | | - Donna O. Burnett
- Department of Nutrition, Dietetics, and Hospitality Management, Auburn University, Auburn, AL 36849, USA; (R.L.); (H.M.); (D.O.B.); (J.R.B.); (A.D.F.)
| | - Jeganathan R. Babu
- Department of Nutrition, Dietetics, and Hospitality Management, Auburn University, Auburn, AL 36849, USA; (R.L.); (H.M.); (D.O.B.); (J.R.B.); (A.D.F.)
| | - Andrew Dandridge Frugé
- Department of Nutrition, Dietetics, and Hospitality Management, Auburn University, Auburn, AL 36849, USA; (R.L.); (H.M.); (D.O.B.); (J.R.B.); (A.D.F.)
| |
Collapse
|
12
|
Torres-McGehee TM, Emerson DM, Pritchett K, Moore EM, Smith AB, Uriegas NA. Energy Availability with or without Eating Disorder Risk in Collegiate Female Athletes and Performing Artists. J Athl Train 2020; 56:993-1002. [PMID: 33351913 PMCID: PMC8448477 DOI: 10.4085/jat0502-20] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Female athletes/performing artists can present with low energy availability (LEA) either through unintentional (e.g., inadvertent undereating) or intentional methods (e.g., eating disorder [ED]). While LEA and ED risk have been examined independently, little research has examined these simultaneously. Awareness of LEA with or without ED risk may provide clinicians with innovative prevention and intervention strategies. OBJECTIVE To examine LEA with or without ED risk (e.g., eating attitudes, pathogenic behaviors) in female collegiate athletes/performing artists. DESIGN Cross-sectional and descriptive. SETTING Free-living in sport-specific settings. PARTICIPANTS Collegiate female athletes/performing artist (n=121; age: 19.8±2.0 years; height: 168.9±7.7 cm; weight: 63.6±9.26 kg) in equestrian (n=28), volleyball (n=12), softball (n=17), beach volleyball (n=18), ballet (n=26) and soccer (n=20) participated in this study. MAIN OUTCOME MEASURES Anthropometric measurements (height, weight, body composition), resting metabolic rate, energy intake, total daily energy expenditure, exercise energy expenditure, Eating Disorder Inventory-3 (EDI-3), and EDI-3 Symptom Checklist were assessed. Chi-square analysis examined differences between LEA and sport type, LEA and ED risk, ED risk and sport type, and pathogenic behaviors and sport type. RESULTS Female athletes/performing artists (81%; n=98) displayed LEA and significant differences were found between LEA and sport type (χ25=43.8, P<.01). Female athletes/performing artists (76.0%; n=92) presented with ED risk with no significant difference between ED risk and sport. EDI-3 Symptom Checklist revealed 61.2% (n=74) engaged in pathogenic behaviors, with dieting the most common (51.2%; n=62). Athletes/performing artist displayed LEA with ED risk (76.0%; n=92). No significant differences were found between LEA with ED risk and sport. Softball was the highest with 82.4% (n=14) reporting LEA with ED risk followed by ballet (76%; n=19). CONCLUSION Our results suggest a large proportion of collegiate female athletes/performing artists are at risk for LEA with ED risk, thus warranting education, identification, prevention, and intervention strategies relative to fueling for performance.
Collapse
Affiliation(s)
| | | | - Kelly Pritchett
- Central Washington University, , Twitter Handle: @KPritchettRD
| | - Erin M Moore
- University of South Florida, , Twitter Handle: @ErinMMoore2
| | - Allison B Smith
- University of South Carolina, , Twitter Handle: @ally_smith6
| | - Nancy A Uriegas
- University of South Carolina, , Twitter Handle: @Nancy_Uriegas
| |
Collapse
|
13
|
Stoyel H, Slee A, Meyer C, Serpell L. Systematic review of risk factors for eating psychopathology in athletes: A critique of an etiological model. EUROPEAN EATING DISORDERS REVIEW 2019; 28:3-25. [PMID: 31793151 DOI: 10.1002/erv.2711] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Revised: 10/08/2019] [Accepted: 10/29/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The theoretical model by Petrie and Greenleaf (2007, 2012) is an admirable attempt to collate the causal factors of disordered eating in athletes. The aims of this systematic review are (a) to provide an overview of the findings from the relevant literature, (b) to assess whether the model is supported by the existing research, (c) to evaluate the different designs, methods, and measures used to test the mediators in the model, and (d) to highlight areas for improvements and future research. METHOD A systematic review of four major online databases identified 37 relevant papers on risk factors of disordered eating in athletes, which were reviewed and critically compared with the theoretical model. RESULTS There is a lack of longitudinal research with the relevant mediators in athlete populations, which makes it difficult to determine whether the potential mediators described by Petrie and Greenleaf are causal risk factors rather than simply correlates of disordered eating for athletes. Findings for all the potential mediators are inconsistent, and the range of measures used makes it problematic to draw conclusions. CONCLUSIONS Future research needs to use gold standard measures and longitudinal designs in order to fully test and possibly update the model.
Collapse
Affiliation(s)
- Hannah Stoyel
- Department of Clinical, Educational and Health Psychology, UCL, London, UK
| | - Adrian Slee
- Division of Medicine, Faculty of Medical Sciences, UCL, London, UK
| | - Caroline Meyer
- WMG and Warwick Medical School, University of Warwick, Coventry and Warwickshire NHS Partnership Trust, Coventry, UK
| | - Lucy Serpell
- Department of Clinical, Educational and Health Psychology, UCL/NEFLT, London, UK
| |
Collapse
|
14
|
Abstract
Equestrian media is showing an increasing interest in the impact of mental health on performance and general wellbeing of equestrian athletes. This study explores the awareness of mental health difficulties and psychological wellbeing within equestrian sport from the perspectives of equestrian athletes, instructors/coaches and parents. The exploratory nature of the research offered opportunity to use a dual approach including e-surveys and semi-structured interviews. Analysis of the qualitative data identified five key themes (Emotional WellbeinginBalance; Emotional WellbeingImbalance; WellbeingImbalance—Impact on Equestrian Sportspeople; Impact of Equestrian Sport on Wellbeing; Regaining Balance) and 22 sub-themes. The findings determine a compelling need for education, promotion of sharing experiences, facilitation of specialist (clinical and sport) professional training and intervention as well as a review of regulations from equestrian Governing Bodies.
Collapse
|
15
|
Body Dissatisfaction in Collegiate Athletes: Differences Between Sex, Sport Type, and Division Level. JOURNAL OF CLINICAL SPORT PSYCHOLOGY 2018. [DOI: 10.1123/jcsp.2018-0018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Body dissatisfaction is associated with marked distress and often precipitates disordered eating symptomology. Literature on body dissatisfaction in athletes appears to be mixed, perhaps because athletes vary along several key characteristics related to how they experience their bodies. This study sought to investigate group differences in body dissatisfaction between sex (men vs. women), sport type (lean-promoting vs. non-lean-promoting), and division level (Division I vs. Division III). Collegiate athletes (N = 191) completed a self-report measure of body dissatisfaction, demographics, and sport characteristics. A factorial ANOVA revealed that women reported greater body dissatisfaction compared to men regardless of division level and sport type. There was an interaction between sex and sport type such that men in lean-promoting sports reported greater body dissatisfaction than men in non-lean-promoting sports. Findings suggest that some athletes participating in lean-promoting sports may be at risk of developing significant body dissatisfaction. Research on body dissatisfaction in collegiate athletes can be used to develop clinical interventions that aim to reduce body dissatisfaction and the potential of developing disordered eating and related psychopathology.
Collapse
|
16
|
Abstract
After the passage of Title IX in 1972, female sports participation skyrocketed. In 1992, the female athlete triad was first defined; diagnosis required the presence of an eating disorder, amenorrhea, and osteoporosis. However, many athletes remained undiagnosed because they did not meet all three of these criteria. In 2007, the definition was modified to a spectrum disorder involving low energy availability (with or without disordered eating), menstrual dysfunction, and low bone mineral density. With the new definition, all three components need not be present for a diagnosis of female athlete triad. Studies using the 1992 definition of the disorder demonstrated a prevalence of 1% to 4% in athletes. However, in certain sports, many female athletes may meet at least one of these criteria. The actual prevalence of athletes who fall under the "umbrella" diagnosis of the female athlete triad remains unknown.
Collapse
|
17
|
Goltz FR, Stenzel LM, Schneider CD. Disordered eating behaviors and body image in male athletes. BRAZILIAN JOURNAL OF PSYCHIATRY 2014; 35:237-42. [PMID: 24142083 DOI: 10.1590/1516-4446-2012-0840] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Accepted: 06/17/2012] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To identify disordered eating behaviors and body image dissatisfaction, as well as their relationship to body fat (BF), among male athletes in high risk sports for eating disorders. METHODS One hundred and fifty-six male athletes were divided into the following categories: weight-class sports, sports where leanness improves performance, and sports with aesthetic ideals. BF was assessed and three questionnaires were used: the Eating Attitudes Test; the Bulimic Investigatory Test, Edinburgh; the Body Shape Questionnaire. RESULTS Disordered eating behaviors and body image dissatisfaction were found in 43 (27.6%) and 23 athletes (14.7%), respectively, and an association was detected between the two variables (p < 0.001). Athletes with and without disordered eating behaviors did not differ in %BF (11.0 ± 5.2% and 9.8 ± 4.0%, respectively; p = 0.106). However, athletes with body image dissatisfaction had higher %BF than those who were satisfied (12.6 ± 5.9% and 9.7 ± 3.9%, respectively; p = 0.034). There were no differences in BF, frequency of disordered eating behaviors, and body image dissatisfaction between sports categories. CONCLUSION Nearly one-quarter of athletes showed disordered eating behaviors, which was associated with body image dissatisfaction. Athletes with higher %BF were more likely to be dissatisfied with body image. There was no difference in eating behavior and body image between athletes from different sports categories.
Collapse
Affiliation(s)
- Fernanda Reistenbach Goltz
- Universidade Federal de Ciências da Saúde de Porto Alegre, Department of Nutrition, Porto AlegreRS, Brazil
| | | | | |
Collapse
|
18
|
McLester CN, Hardin R, Hoppe S. Susceptibility to eating disorders among collegiate female student-athletes. J Athl Train 2014; 49:406-10. [PMID: 24762233 DOI: 10.4085/1062-6050-49.2.16] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
CONTEXT Research has suggested that the prevalence of young women with eating disorders (EDs) is increasing, but determining the exact prevalence of EDs within the female student-athlete (FS-A) population is difficult. Looking at certain traits may help us to identify their level of susceptibility to developing an ED. OBJECTIVE To determine the susceptibility of FS-As to EDs in relation to self-concept, including self-esteem and body image. DESIGN Cross-sectional study. SETTING Athletic training and health centers at National Collegiate Athletic Association Division I, II, and III institutions via e-mail questionnaire correspondence. PATIENTS OR OTHER PARTICIPANTS A total of 439 FS-As from 17 participating institutions completed the questionnaires. The sample was primarily white (83.1%) and underclass (61.8%). MAIN OUTCOME MEASURE(S) The questionnaire consisted of 4 parts: 3 subscales of the Eating Disorder Inventory-2, the Rosenberg Self-Esteem Scale, the Body Cathexis Scale, and demographic items. RESULTS A total of 6.8% of FS-As were susceptible to anorexia and 1.8% were susceptible to bulimia. The majority of FS-As (61%) reported normal self-esteem levels, whereas 29.4% had high self-esteem. Overall, 64.5% were satisfied and 23% were very satisfied with their body image. CONCLUSIONS These results are generally positive in that they suggest FS-As have high levels of self-concept and are at low risk to develop EDs. However, these findings do not mean that all concerns should be dismissed. Although more than 90% of the respondents were not susceptible to an ED, there are still FS-As who may be. Athletic departments should evaluate their FS-As' levels of self-concept so that their susceptibility to EDs can be addressed. The emotional aspect of health care should be included in providing holistic care for student-athletes. Athletic trainers often are the primary health care providers for FS-As, so they should be made aware of this concern.
Collapse
Affiliation(s)
- Cherilyn N McLester
- Department of Exercise Science and Sport Management, Kennesaw State University, GA
| | | | | |
Collapse
|
19
|
Exploring Indices of Disordered Eating Literacy in Male and Female Athletes: Knowledge Gaps and Lay Beliefs as Predictors of Attitudes Toward Help-Seeking. JOURNAL OF CLINICAL SPORT PSYCHOLOGY 2013. [DOI: 10.1123/jcsp.7.4.275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The aim of this pilot study was to explore disordered eating (DE) literacy in male and female athletes and to examine whether any gender differences were present. A related aim was to examine the moderating effect of gender on the relationship between indices of DE literacy and attitudes toward help-seeking for DE. A nonclinical sample of 133 (37% male) athletes from a variety of sports and competitive levels were recruited to complete an online questionnaire addressing a range of topics linked to DE literacy. Chi-square analysis indicated no significant gender differences on indicators of DE literacy. Findings from the survey revealed a number of beliefs conducive to low or inappropriate help-seeking for DE. The results highlight the importance of exploring DE literacy in athletes to develop more targeted interventions for this specific population.
Collapse
|
20
|
Torres-McGehee TM, Monsma EV, Dompier TP, Washburn SA. Eating disorder risk and the role of clothing in collegiate cheerleaders' body images. J Athl Train 2013; 47:541-8. [PMID: 23068592 DOI: 10.4085/1062-6050-47.5.03] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
CONTEXT With increased media coverage and competitive opportunities, cheerleaders may be facing an increase in eating disorder (ED) prevalence linked to clothing-related body image (BI). OBJECTIVE To examine ED risk prevalence, pathogenic weight control behaviors, and variation in clothing-specific BI across position and academic status among collegiate cheerleaders. DESIGN Cross-sectional study. SETTING National Collegiate Athletic Association Division I and II institutions. PATIENTS OR OTHER PARTICIPANTS Female collegiate cheerleaders (n = 136, age = 20.4 ± 1.3 years, height = 160.2 ± 8.1 cm, weight = 57.2 ± 8.3 kg). MAIN OUTCOME MEASURE(S) Participants self-reported height, weight, and desired weight and completed the Eating Attitudes Test. Body image perceptions in 3 clothing types (daily clothing, midriff uniform, full uniform) were assessed using sexbased silhouettes (body mass index = 18.3 kg/m(2) for silhouette 1, 23.1 kg/m(2) for silhouette 4). RESULTS The ED risk for cheerleaders was estimated at 33.1%. However, when body mass index was controlled using backward stepwise logistic regression, flyers had greater odds (odds ratio = 4.4, 95% confidence interval = 1.5, 13.2, P = .008) of being at risk compared with bases, but no difference was noted between the base and back-spot positions (odds ratio = 1.9, 95% confidence interval= 0.5, 6.6, P = .333). A main effect of BI perceptions was seen (P < .001), with a significant interaction by clothing type (F(2,133) = 22.5, P < .001, η(2) = 0.14). Cheerleaders desired to be smaller than their perceived BIs for each clothing type, with the largest difference for midriff uniform (2.6 ± 0.8 versus 3.7 ± 0.9), followed by full uniform (2.7 ± 0.8 versus 3.5 ± 0.9) and daily clothing (2.8 ± 0.8 versus 3.5 ± 0.9). CONCLUSIONS Cheerleaders, especially flyers, appear to be at risk for EDs, with greatest BI dissatisfaction when wearing their most revealing uniforms (ie, midriffs). Universities, colleges, and the national governing bodies of these squads need to focus on preventing eating disorders and BI dissatisfaction and promoting self-esteem.
Collapse
Affiliation(s)
- Toni M Torres-McGehee
- Department of Physical Education and Athletic Training, University of South Carolina, 1300 Wheat Street, Blatt PE Center 218, Columbia, SC 29208, USA.
| | | | | | | |
Collapse
|
21
|
Reel JJ, Petrie TA, SooHoo S, Anderson CM. Weight pressures in sport: examining the factor structure and incremental validity of the weight pressures in sport - females. Eat Behav 2013; 14:137-44. [PMID: 23557809 DOI: 10.1016/j.eatbeh.2013.01.003] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Revised: 11/12/2012] [Accepted: 01/15/2013] [Indexed: 11/26/2022]
Abstract
Due to pressures within the sport environment, such as from coaches, teammates, uniforms and judges, female athletes may develop unhealthy eating practices to lose weight or change their body size/shape to become more competitive and meet societal and sport-related physique ideals. However, up until the development of the Weight Pressures in Sport for Females (WPS-F; Reel, SooHoo, Petrie, Greenleaf, & Carter, 2010) there was no way to quantify sport-specific weight pressures with female athletes. In this study, the psychometric properties of the scale were further examined using a sample of 414 female collegiate athletes. Sample 1 [n=207; M=19.27 years; SD=1.16] and Sample 2 [n=207; M=19.19 years; SD=1.66] participants were of a similar age and were used for exploratory and confirmatory analyses respectively. A two factor structure was confirmed and it was established that the scale was unique from general sociocultural pressures that all women experience, predicting female athletes' internalization, body dissatisfaction, dietary intent, and bulimic symptomatology. Specifically, the following factors, Coach and Sport Pressures about Weight (Factor 1) and Pressures Regarding Appearance and Performance (Factor 2), were found to have strong internal consistency and the emerging reliable and valid WPS-F has practical implications for screening and identifying weight-related sport pressures within female athletes. WPS-F can also serve to educate sport professionals about environmental pressures so that disordered eating and body image disturbances can be prevented.
Collapse
Affiliation(s)
- Justine J Reel
- Department of Health Promotion and Education, University of Utah, Salt Lake City, UT 84112, USA.
| | | | | | | |
Collapse
|