Poor precompetitive sleep habits, nutrients’ deficiencies, inappropriate body composition and athletic performance in elite gymnasts

Dietary Intake and Menstrual Health among Acrobatics and Tumbling NCAA Division I Student-Athletes

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.

Sleep patterns before and after competition: A real-world examination of elite athletes

Good sleep before and after competitions is crucial to cognitive, physiological performance and recovery. Yet, elite athletes face a unique set of challenges when acquiring good sleep before and after competitions, and indeed commonly report sleep problems when it matters most. This study examined the sleep of elite athletes before and after competition compared to before and after free days. A total of 1808 unique nights of actigraphy (n = 1495) and sleep diary (n = 1335) data from elite Australian Football League and National Rugby League male athletes (N = 85, M-age = 24.4 ± 3.6) were collected and analysed using multi-level mixed models. On nights before competitions, athletes advanced sleep timings (p < .001, d = 0.63) and increased total sleep time (p < .001, d = 0.65) compared to nights before free days. On nights after competitions, athletes delayed sleep timings (p < .001, d = 1.64), reduced total sleep time (p < .001, d = 1.28), and had significantly worse quality sleep (p < .001, d = 0.71) compared to nights after free days. Sleep was especially worse following night competitions. While elite athletes and organisations may be implementing effective sleep strategies to optimise sleep the night before competitions, strategies to improve sleep after competitions may be lacking. We discuss potential factors contributing to this asymmetry and propose areas for research moving forward.

RELATIONSHIP BETWEEN NUTRITION KNOWLEDGE AND AEROBIC FITNESS IN YOUNG GYMNASTS

This study aimed to analyze the nutrition knowledge, nutritional status, body composition, nutrient intake and physical fitness of young gymnasts. The study used a cross-sectional design with 20 subjects comprising rhythmic and artistic gymnasts in Raden Inten, Jakarta. Nutritional status and body composition were measured using anthropometric measurements, macronutrient and micronutrient intakes were measured with 3x24-h food recall, physical fitness was measured using the bleep test (20m shuttle run), and nutrition knowledge was assessed using questionnaires consisting of 30 questions on macronutrients, micronutrients and water. The results indicated that the gymnasts (n=20, 13.7±2.1 y.o, 37.8±8.2 kg and 147.3±10 cm) generally had a fairly good nutrition knowledge score (73.2%); i.e. 10 people in the good nutrition-knowledge group and 10 people in the poor nutrition-knowledge group. The majority of the macronutrient and micronutrient intakes were below the nutritional requirements, in both the good and poor nutrition-knowledge groups. The nutrition knowledge scores were low for hydration-related knowledge (66%), while the scores for macronutrient and micronutrient knowledge were 73.8% and 84.2%, respectively. This study found that nutrition knowledge had a positive correlation with physical fitness (p<0.05). A sports nutrition-related education intervention is needed for those gymnasts that still have poor nutrition knowledge. Sports nutrition knowledge needs to be provided for athletes and coaches so that athletes’ intakes meet their nutritional requirements in order to maximise their performance.

Training-Load Management in Rhythmic Gymnastics: Practices and Perceptions of Coaches, Medical Staff, and Gymnasts

PURPOSE

This study described and analyzed practices and perceptions of rhythmic gymnastics coaches, medical staff, and athletes on training-load management.

METHODS

Online surveys were distributed among professionals and gymnasts involved in rhythmic gymnastics training across the world. One hundred (50 coaches, 12 medical staff, and 38 gymnasts) participants from 25 different countries completed the surveys.

RESULTS

Respondents stated using coaches' perception on a daily basis as a method of monitoring external (57%) and internal (58%) load, recovery/fatigue (52%), and performance (64%). Variables and methods (eg, wearable devices, athlete self-reported measures, session rating of perceived exertion), and metrics (eg, acute and chronic load) commonly reported in the training-load literature and other sports were not frequently used in rhythmic gymnastics. The majority of coaches (60.3% [17%]) perceived that maladaptation rarely or never occurred. Medical staff involvement in sharing and discussing training-load information was limited, and they perceived that the measurement of athletes' recovery/fatigue was poor. Gymnasts noted good quality in relation to the measurement of performance. Most participants (≥85%) believed that a specific training-load management model for rhythmic gymnastics could be very or extremely effective.

CONCLUSIONS

In conclusion, rhythmic gymnastics coaches' perception is the most commonly used strategy to monitor load, recovery/fatigue, and performance; although, this could be a limited method to guarantee effective training-load management in this sport.

Level of Adherence to the Mediterranean Diet and Weight Status among Adolescent Female Gymnasts: A Cross-Sectional Study

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.

Screening Tools as a Predictor of Injury in Gymnastics: Systematic Literature Review

Background

Gymnastics requires a high level of physical ability and technical skill which utilises short sets of athleticism and artistry to perform complex and intense movements which can overload musculoskeletal tissues and result in acute injuries which can develop into chronic injuries. The aim of this systematic literature review was to investigate which screening tools predict injury in gymnasts and encompasses all genres, levels and ages.

Methods

An electronic search of seven databases from their inception until March 2021 was conducted. The databases were the Allied and Complementary Medicine Database, CINAHL, eBook Collection (EBSCOhost), MEDLINE, Cochrane Database of Systematic Reviews, SPORTDiscus and PEDro (the Physiotherapy Evidence Base). A combination of the following search terms was used: (1) Gymnastics AND injury AND Screening, (2) Screening AND Gymnastics and (3) Musculoskeletal AND Screening AND Gymnastics. These terms were searched in all text, abstract, title and subject terms. Studies were assessed using a 20-point scoring tool.

Results

The mean methodological quality score was 13.1 points (range 10–17 points). Range of motion, anthropometric and postural measurements, hypermobility, clinical diagnostic tests, movement screening tools, muscle strength, power and endurance were reported in the included studies. Some evidence existed for screening measurement of height and mass as taller and heavier gymnasts might be more susceptible to injury; however, the different methodologies utilised and lack of acknowledgment of confounding variables limit the clinical relevance of these findings.

Conclusions

Height and mass should be recorded during the screening process. A lack of heterogeneity in study methodology prevented a meta-analysis. Studies were limited by a lack of prospective injury design, poor injury definition, self-reporting of injury and only 2 studies reported reliability of screening tools. Further research is required to determine the role of injury screening in gymnastics.

Registration: The review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) with the registration number CRD42020218339.

Contemporary Variables that Impact Sleep and Development in Female Adolescent Swimmers and Gymnasts

The effects of sleep on elite athletes in late adolescence and early adulthood have been well documented in a myriad of sports. However, there is underrepresentation of pre-pubertal and young female adolescent athlete research between the ages of 11-17, and specifically female gymnast and swimmers. Neglecting to understand how high energy demand at a young age relates to sleep and restoration may lead to developmental ramifications for this group, as they display physiological dysfunctions like delayed puberty, amenorrhea and are at risk for the female athlete triad or components of the triad. This review aims to summarize the contemporary variables of blue light emitting screens, social media, and caffeine on quality and quantity of sleep in young athletes while identifying gaps in the literature on how these factors impact the target group of young female swimmers and gymnasts.  The implications of this work include sleep hygiene recommendations for increasing duration and quality of sleep, as well as future research with respect to electronic device usage, social media participation, caffeine consumption, and sport engagement in female early adolescent athletes.

Overtraining Syndrome (OTS) and Relative Energy Deficiency in Sport (RED-S): Shared Pathways, Symptoms and Complexities

The symptom similarities between training-overload (with or without an Overtraining Syndrome (OTS) diagnosis) and Relative Energy Deficiency in Sport (RED-S) are significant, with both initiating from a hypothalamic-pituitary origin, that can be influenced by low carbohydrate (CHO) and energy availability (EA). In this narrative review we wish to showcase that many of the negative outcomes of training-overload (with, or without an OTS diagnosis) may be primarily due to misdiagnosed under-fueling, or RED-S, via low EA and/or low CHO availability. Accordingly, we undertook an analysis of training-overload/OTS type studies that have also collected and analyzed for energy intake (EI), CHO, exercise energy expenditure (EEE) and/or EA. Eighteen of the 21 studies (86%) that met our criteria showed indications of an EA decrease or difference between two cohorts within a given study (n = 14 studies) or CHO availability decrease (n = 4 studies) during the training-overload/OTS period, resulting in both training-overload/OTS and RED-S symptom outcomes compared to control conditions. Furthermore, we demonstrate significantly similar symptom overlaps across much of the OTS (n = 57 studies) and RED-S/Female Athlete Triad (n = 88 studies) literature. It is important to note that the prevention of under-recovery is multi-factorial, but many aspects are based around EA and CHO availability. Herein we have demonstrated that OTS and RED-S have many shared pathways, symptoms, and diagnostic complexities. Substantial attention is required to increase the knowledge and awareness of RED-S, and to enhance the diagnostic accuracy of both OTS and RED-S, to allow clinicians to more accurately exclude LEA/RED-S from OTS diagnoses.

Determinants of Sports Injury in Young Female Swedish Competitive Figure Skaters

Introduction: Although figure skating attracts several hundred thousand participants worldwide, there is little knowledge about physical health and sports injuries among young skaters. The present study aimed to describe the health status of a geographically defined Swedish population of licensed competitive figure skaters and to examine injury determinants.

Methods: All licensed competitive skaters in the southeastern region of Sweden were in April 2019 invited to participate in a cross-sectional study using an online questionnaire. Multiple binary logistic regression was used for the examination of injury determinants. The primary outcome measure was the 1-year prevalence of a severe sports injury episode (time loss >21 days). The secondary outcome measure was the point prevalence of an ongoing injury. The determinants analyzed were age, skating level, relative energy deficiency indicators, and training habits.

Results: In total, 142 (36%) skaters participated, 137 (96%) girls [mean (SD) age: 12.9 (SD 3.0) years]. Participating boys (n = 5) were excluded from further analysis. The 1-year prevalence of a severe sports injury episode was 31%. The most common injury locations for these injuries were the knee (25%), ankle (20%), and hip/groin (15%). In the multiple model, having sustained a severe injury episode was associated with older age (OR 1.2, 95% CI 1.1–1.4; p = 0.002) and an increased number of skipped meals per week (OR 1.1, 95% CI 1.0–1.3; p = 0.014). The point prevalence of an ongoing injury episode was 19%. The most common locations were the knee (24%), ankle (24%), and foot (24%). Having an ongoing injury episode was associated with older age (OR 1.4, 95% CI 1.2–1.7; p < 0.001) and an increased number of skipped meals per week (OR 1.1, 95% CI 1.0–1.3; p = 0.049).

Conclusion: One-third of young female Swedish competitive figure skaters had sustained a severe injury episode during the past year, and a fifth reported an ongoing episode. Older age and an increased number of skipped meals per week were associated with a sports injury episode. Long-term monotonous physical loads with increasing intensity and insufficient energy intake appear to predispose for injury in young female figure skaters. Further examination of injury determinants among competitive figure skaters is highly warranted.

Body Composition, Dietary Intake and the Risk of Low Energy Availability in Elite-Level Competitive Rhythmic Gymnasts

The aim of this study was to analyze dietary intake and body composition in a group of elite-level competitive rhythmic gymnasts from Spain. We undertook body composition and nutritional analysis of 30 elite gymnasts, divided into two groups by age: pre-teen (9-12 years) (n = 17) and teen (13-18 years) (n = 13). Measures of height, weight, and bioimpedance were used to calculate body mass index and percent body fat. Energy and nutrient intakes were assessed based on 7-day food records. The two groups had similar percentages of total body fat (pre-teen: 13.99 ± 3.83% vs. teen: 14.33 ± 5.57%; p > 0.05). The energy availability values for pre-teens were above the recommended values (>40 kcal/FFM/day) 69.38 ± 14.47 kcal/FFM/day, while those for the teens were much lower (34.7 ± 7.5 kcal/FFM/day). The distribution of the daily energy intake across the macronutrients indicates that both groups ingested less than the recommended level of carbohydrates and more than the recommended level of fat. Very low intakes of calcium and vitamin D among other micronutrients were also noted. The main finding is that teenage gymnasts do not consume as much energy as they need each day, which explains their weight and development. Moreover, they are at a high risk of developing low energy availability that could negatively impact their performance and future health.

Psychological correlates of insomnia in professional soccer players: An exploratory study

Sleep promotes health, well-being, recovery and athletic performance. As a consequence, sleep problems in athletes may have detrimental effects. Previous investigations showed that professional athletes often reported to suffer of poor sleep quality and insomnia (e.g. difficulties falling asleep and/or maintaining sleep). However, psychological variables exacerbating and maintaining insomnia in professional athletes as well as its mechanistic pathways are still largely unknown. Available literature mostly focused on effects of sport-related variables, such as evening training and stimulant consumption on athletes' sleep. Instead, the contribution of cognitive and emotional variables globally associated with insomnia in athletes in clinical models has been largely neglected. To address these limitations, this study explored the associations between emotional experience, pre-sleep arousal, pre-sleep worry and rumination and insomnia severity in a sample of 210 (25.93 ± 6.68 years) male professional soccer players. Bivariate correlations, multiple regression, and structural equation modelling with manifest variables (path analysis) were computed. Results showed that insomnia severity was associated with stimulants consumption, pre-sleep arousal, negative emotions, positive emotions, and pre-sleep worry/rumination (all p < .05). Path analysis showed that relationship between stimulant consumption, emotional experience, worry/rumination and insomnia was mediated by pre-sleep arousal (p < .05). Our results suggest that preventive and interventional studies in professional soccer players would benefit from considering global cognitive-emotional variables as targets of interventions.HighlightsInsomnia was associated with greater stimulants consumption, pre-sleep arousal, negative emotions, pre-sleep worry/rumination, and lower positive emotions.Path analysis showed that pre-sleep arousal mediated the relationship between stimulant consumption, emotional experience, worry/rumination and insomnia severity.Cognitive-emotional and behavioural factors as well as sport-related variables were important predictors of insomnia in professional soccer players.

Genomic profile in association with sport-type, sex, ethnicity, psychological traits and sport injuries of elite athletes: review and future perspectives

In the last few years, some inherited determinants have been associated with elite athletic performance, but its polygenic trait character has limited the correct definition of elite athlete's genomic profile. This qualitative descriptive study aims to summarise the current understanding about genetic and epigenetic factors in elite athletes, as well as their genomic profile in association with sport-type, sex, ethnicity, psychological traits and sport injuries. A narrative review of the literature across a broad cross-section of the elite athletes' genomic profile was undertaken. Elite performance relies on rare gene variants within a great interface between molecular, cellular and behavioural sport-related phenotypes and the environment, which is still poorly understood. ACTN3 rs1815739 and ACE I/D polymorphisms appear to be associated to specific sprint phenotypes and influence the athletic status, i.e., the rs1815739 variant is more influential to 200-m performance and the ACE ID polymorphism is more involved in the longer, 400-m sprint performance. Generally, athletes show endurance-based sports characteristics or power-based sports characteristics, but some studies have reported some genes associations to both sports-based characteristics. Furthermore, genetic studies with larger cohorts of single-sport athletes might be preferable than studies combining athletes of different sports, given the existence of distinct athlete profiles and sport demands. Athletic performance may be influenced by the serotonergic pathway and the potential injury risk (namely stress fracture) might be associated to a genetic predisposition associated to the mechanical loading from the intense physical exercise. The study of gene variants associated to sex and ethnicity-related to athletic performance needs further investigation. The combination of genome-wide association studies addressing the genetic architecture of athletes and the subsequent replication and validation studies might for additional genetic data is mandatory.

[Vitamin D Deficiency in Sports]

Vitamin D Deficiency in Sports Abstract. A deficiency in vitamin D is very common in the general population as well as in athletes. The aim of this overview is to assess the level of knowledge about the importance of vitamin D for athletes. A deficiency in vitamin D is present in up to 90 % of athletes. Risk groups are young athletes, female athletes, athletes with a limitation such as paraplegia, vegetarians, athletes with a resorption disorder such as celiac disease, athletes training and competing indoors (e.g. ice hockey, basketball, boxing, rhythmic gymnastics), and older athletes. Dark skin pigmentation, the use of sunscreen, the time of day of the training (early morning, late evening) and the geographical location influence the risk for a deficiency in vitamin D. Exposure to the sun and a balanced diet are often not enough to prevent a vitamin D deficiency.

The 4R's Framework of Nutritional Strategies for Post-Exercise Recovery: A Review with Emphasis on New Generation of Carbohydrates

Post-exercise recovery is a broad term that refers to the restoration of training capacity. After training or competition, there is fatigue accumulation and a reduction in sports performance. In the hours and days following training, the body recovers and performance is expected to return to normal or improve. ScienceDirect, PubMed/MEDLINE, and Google Scholar databases were reviewed to identify studies and position declarations examining the relationship between nutrition and sports recovery. As an evidence-based framework, a 4R’s approach to optimizing post-exercise recovery was identified: (i) Rehydration—a fundamental process that will depend on the athlete, environment and sports event; (ii) Refuel—the consumption of carbohydrates is not only important to replenish the glycogen reserves but also to contribute to the energy requirements for the immune system and tissue reparation. Several bioengineered carbohydrates were discussed but further research is needed; (iii) Repair—post-exercise ingestion of high-quality protein and creatine monohydrate benefit the tissue growth and repair; and (iv) Rest—pre-sleep nutrition has a restorative effect that facilitates the recovery of the musculoskeletal, endocrine, immune, and nervous systems. Nutritional consultancy based on the 4R’s is important for the wise stewardship of the hydration, feeding, and supplementation strategies to achieve a timely recovery.

Motivation, Self-Concept and Discipline in Young Adolescents Who Practice Rhythmic Gymnastics. An Intervention

This study aims to develop an intervention based on TARGET strategies in young people practicing rhythmic gymnastics, with the aim of observing whether motivation, discipline, self-concept and flexibility are improved. This research is a longitudinal study of a quasi-experimental nature. A total of 104 young adolescents between the ages of 11 and 12 years (11.66 ± 0.47) participated in the study, of which 60 belong to the control group and 44 to the experimental group. The intervention programme lasted two months (17 sessions). TARGET strategies were applied to the experimental group during training. While the experimental group continued with its routine training. To measure the psychological variables, the instrument used were the Youth Physical Self-Concept Scale (C-PSQ), Reason Scale for Discipline (RSD) and Success Perception Questionnaire (SPQ), and for flexibility, the tests were applied to the Sit and Reach and Deep trunk flexion test. The results showed that those teenagers who participated in the intervention, obtained an increased climate task, which entails an enjoyment by the practice of physical activity itself, more optimal levels of physical self-concept and discipline, subsequently, obtaining better results of flexibility. While in the control group gymnasts the ego climate and demotivation increased. TARGET strategies applied to young adolescents have positive effects, improve motivation towards physical activity, self-concept and discipline. This results in greater performance in flexibility. This will encourage young adolescents to continue to engage in physical activity in the future.

Training Load and Recovery During a Pre-Olympic Season in Professional Rhythmic Gymnasts

CONTEXT

Rhythmic gymnastics requires a high level of complexity and perfection of technical gestures, associated with well-developed physical and artistic capacities. The training-load and recovery profiles of rhythmic gymnasts across a season are unknown.

OBJECTIVE

To analyze the training load and recovery of professional rhythmic gymnasts during 1 season.

DESIGN

Cohort study.

SETTING

Brazilian National Training Center of Rhythmic Gymnastics and competition facilities.

PATIENTS OR OTHER PARTICIPANTS

Eight gymnasts from the Brazilian national senior rhythmic gymnastics group.

MAIN OUTCOME MEASURE(S)

Session rating of perceived exertion (session-RPE) and total quality recovery (TQR) scores were collected daily for 43 weeks. We obtained the session-RPE after each session and TQR score before the first session of the day. Performances during 5 competitions were also recorded. The season was divided into 8 periods. Total weekly internal training load (wITL), training intensity, frequency, duration, recovery, and acute : chronic workload ratio were calculated for analysis.

RESULTS

The season mean wITL was 10 381 ± 4894 arbitrary units, mean session-RPE score was 5.0 ± 1.6, and mean TQR score was 12.8 ± 1.3. The gymnasts trained an average of 8.7 ± 2.9 sessions per week, with a mean duration of 219 ± 36 minutes. Each competitive period showed increased wITL compared with the previous period. Training-load variables (wITL and session-RPE) and recovery were inversely correlated. Gymnasts were poorly recovered (TQR < 13) during 50.9% of the season (n = 167 times), especially during competitive weeks. Spikes in load (acute : chronic workload ratio ≥ 1.5) occurred across 18.1% of the season (n = 55 times).

CONCLUSIONS

The training-load variables and recovery changed throughout a professional rhythmic gymnastics group season, mainly during competitive periods. The correct distribution of training load is critical to ensure that gymnasts are entering competitions in a recovered state.

The Impact of Sleep Duration on Performance Among Competitive Athletes: A Systematic Literature Review

The athletic advantage of sleep, although commonly touted by coaches, trainers, and sports physicians, is still unclear and likely varies by sport, athletic performance metric, and length of sufficient or insufficient sleep. Although recent literature reviews have highlighted circadian and nutritional factors that influence different aspects of athletic performance, a systematic summary of the effects of sleep duration and sleep quality on performance among competitive athletes is lacking. Here we systematically review the relationship between sleep duration and sleep quality and objective athletic performance among competitive athletes across 19 studies representing 12 sports. Taken holistically, we find that the sports requiring speed, tactical strategy, and technical skill are most sensitive to sleep duration manipulations. Furthermore, longer-term sleep manipulations are more likely than acute sleep manipulations (whether deprivation or extension) to affect athletic performance. Thus, the importance of sleep for competitive athletes to achieve high performance is dependent on the demands of the sport as well as the length of sleep interventions. In light of the limited number of studies investigating sleep quality and performance, the potential relevance of subjective sleep quality remains an interesting question for future work.

Intermittent Pneumatic Compression and Cold Water Immersion Effects on Physiological and Perceptual Recovery during Multi-Sports International Championship

BACKGROUND

Congested-fixture championships are common during the selection of the athletes and teams participating in the Olympic Games. Throughout these tournaments, it is fundamental to perform optimally, rest well, and recover between competitions. This study aimed to (a) explore the effectiveness of the use of intermittent pneumatic compression (IPC) and cold water immersion (CWI) to recover muscle mechanical function (MuscleMechFx), hydration status (HydS), pain perception (PainPercep), rate of perceived exertion (RPE), sleep hours, and sleep quality (SleepQual) during a regional multi-sports international championship and (b) compare these results by sex.

METHODS

A total of 52 basketball and handball players were exposed to a recovery protocol after the competition as follows: IPC, sequential 20 min at 200 mmHg, and CWI, continuous 12 min at 12 °C.

RESULTS

MuscleMechFx presented differences by match and sex (p = 0.058) in time of contraction of biceps femoris; SleepQual and sleep hours were different between matches (<0.01).

CONCLUSIONS

IPC + CWI seems to be effective to maintain some MuscleMechFx, HydS, and recovery and pain perception during a congested multi-sport tournament.

ANTHROPOMETRIC PROFILE OF GYMNASTS PARTICIPATING IN THE EUROPEAN GAMES 2015 IN BAKU, AZERBAIJAN

Sports performance is strongly influenced by the athletes’ anthropometric profile. In the specific case of Gymnastics, body weight assumes particular relevance, given the aesthetic character of this sport. Anthropometric data were collected from 309 gymnasts (20.9 ± 4.1 years old) participating in the 2015 European Games: age, body weight and height, from a database of the organization of this competition available online in the 5 disciplines of the Gymnastics included in the competition, namely Men´s and Women´s Artistic Gymnastics, Rhythmic Gymnastics, Acrobatic Gymnastics and Aerobic. Body mass index was calculated. Female gymnasts were significantly younger and lighter than male gymnasts and had a lower body mass index than males (P = 0.000). Female athletes were in the 25th percentile for weight and BMI and in the 15th percentile for height, according to their age. Male gymnasts were in the 25th percentile for weight, height and BMI. Female acrobatic gymnasts were younger and lighter (25th percentile) than other gymnastics disciplines; rhythmic gymnasts presented the lowest BMI (5th percentile). Male artistic gymnasts were the lightest (15th percentile) and with the lowest BMI (25th percentile) within the male participants. BMI was dependent on weight, height and gender, with exception for exclusive-gender disciplines and, surprisingly, also in Aerobics. Gymnasts presented an anthropometric profile with results for body weight, height and body mass index below the normal for their age.  

Sleep, energy disturbances and pre-competitive stress in female traveller athletes

Background:

Gymnasts of high performance level are submitted to a demanding competitive schedule, which can negatively affect their circadian rhythm, sleep, appetite and pre-competitive stress. Therefore, the purpose of this study was to investigate sleep, body composition, pre-competitive stress and energy in elite female athletes just before a World Cup and potential sleep risks according to the travelled distance by athletes in order to compete.

Methods:

Sixty-seven rhythmic gymnasts of high performance level were evaluated in order to collect training and competition data, daytime sleepiness (DS) by the Epworth Sleepiness Scale, sleep quality (SQ) by the Pittsburgh Sleep Quality Index, precompetitive anxiety by the Sport Competition Anxiety Test-A and dietary intake prior to a World Cup.

Results:

Gymnasts suffering from severe DS had worse scores in the competition than those who reported normal DS (p=0.004). In addition, gymnasts with severe DS reported reduced SQ (p=0.014) and showed high levels of precompetitive stress (p<0.01). Gymnasts with reduced SQ demonstrated great DS (p=0.014) and high levels of precompetitive stress (p=0.010).

Conclusions:

Gymnasts demonstrated disordered sleep and precompetitive stress. Athletes who travelled long distances to compete presented high risk for short sleep duration, abnormal DS and reduced SQ.

Influence of organised sports practice during adolescence on health of adult women with special emphasis on participation in aesthetic sports

This study aimed to assess the differences in psychosocial health and cardiometabolic risk during adulthood in women based on previously organised sport (OS) participation during adolescence and current activity levels, with emphasis on participation in aesthetic sports. The study included 1947 women aged 18-55 years who were categorised into four groups: 355 aesthetic athletes during adolescence, 494 non- aesthetic athletes during adolescence, 791 non-athletes during adolescence with similar current levels of physical activity (PA) to OS groups and 307 currently inactive non-athletes during adolescence. Participants answered questionnaires regarding sport participation, psychosocial health and cardiometabolic risk. The results show that non-athletes during adolescence who are currently inactive reported significantly lower psychosocial health and higher cardiometabolic risk scores. Women with currently homogenous PA levels (χ² = 0.514) reported similar physical quality of life (QoL), exercise addiction, anxiety and depression symptoms regardless of participation in OS during adolescence (P > .05), except aesthetic athletes who reported the worst sleep and mental QoL. Very high training volumes in aesthetic athletes did not influence psychological outcomes and cardiometabolic risk in adulthood compared to lower training volumes. In conclusion, the effects of PA during adulthood appear to be powerful enough to induce beneficial adaptations in health outcomes that match those observed in women who participate in OS during adolescence, except for aesthetic sports participants, who show a high risk of lower quality of sleep in adulthood. PA should be promoted in adults and especially women who have not participated in OS during adolescence.

Anxiety and Performance in Sex, Sport, and Stage: Identifying Common Ground

Anxiety has long been associated with diminished performance within a number of domains involving evaluative interpersonal interactions, including Sex, Sport, and Stage. Here, we pose three questions: (1) how do these disparate fields approach and understand anxiety and performance; (2) how does the understanding of the issue within one field offer insight to another field; and (3) how could each field benefit from the ideas and strategies used by the others. We begin with a short review of models of anxiety/arousal and performance and then explore definitions, models, presumed underlying physiological processes, and characterizing and influencing factors within each domain separately in a narrative review. This discussion is followed by a synthesis that identifies elements specific to and common across the various domains, with the latter captured in a model of essential characteristics. Concluding remarks note the potential value of promoting increased cross-disciplinary conversation and research, with each domain likely benefiting from the conceptualizations and expert knowledge of the others.

Pelvic Floor Dysfunction in Female Athletes: Is Relative Energy Deficiency in Sport a Risk Factor?

Due to the unique demands of sport participation on the body, female athletes are at increased risk for pelvic floor dysfunction (PFD) and relative energy deficiency in sport (RED-S). A high number of female athletes suffer from PFD, especially urinary incontinence. Several biomechanical and physiological risk factors may play a role in the development of PFD in female athletes. RED-S has been shown to be associated with PFD. The goal of this commentary is to discuss RED-S as a risk factor for PFD and propose a mechanism for this relationship.

Magnesium and vitamin B2 supplementation is an important nutritional resource of sports medicine

The supply of the with magnesium and vitamin B2 is essential to maintain the energy metabolism of cells, hormonal balance, endurance, immunity, cardiovascular health of athletes. As a result, by increasing the availability of these micronutrients, it is possible to increase maximum aerobic power, achieve better sports results and stimulate adequate recovery after competition or after intensive training. A promising way to increase the supply of athletes with magnesium and vitamin B2 is the use of aqueous solutions of magnesium citrate in combination with riboflavin.

The elite athlete as a special risk traveler and the jet lag's effect: lessons learned from the past and how to be prepared for the next Olympic Games 2020 Tokyo

BACKGROUND

Elite athletes have to travel long-haul distances and cross multiple meridians; thus, a unique syndrome named as jet-lag is induced. Furthermore, traveler athletes are submitted to several factors negatively affecting their well-being and athletic performance. This qualitative descriptive study aims to promote safely and future promising participations of elite athletes in great events, such as the next Olympic Games 2020 Tokyo, based on the chronobiology of jet-lag, factors affecting the traveler athlete and previous experiences from the 2014 FIFA World Cup Brazil, the 2018 FIFA World Cup Russia and the Olympic Games Rio 2016.

METHODS

A narrative review of the literature across a broad cross-section of the chronobiology of jet-lag and factors affecting the traveler athlete was undertaken. In addition, a general analysis based on the past sport events aforementioned is also included.

RESULTS

The jet-lag disorder may occur after transmeridian travel over more than three time-zones and the resynchronization is dependent on the direction and number of the time-zones crossed and the availability and the intensity of local circadian time cues. Also the athlete's ability to sleep, eat, get hydrated and train, are essential, as well as, others individual tolerance differences, such as age, gender, chronotype and ethnic differences. Athletes should arrive a number of days before the competition according to the number of time-zone transitions experienced.

CONCLUSIONS

Jet-lag is usually benign and self-limited, but can occasionally have serious consequences for the athlete's mental and physical health and performance. A good plan concerning the athlete's traveling schedule, sleeping, eating and training before and after travelling is mandatory.

Sleep-Related Issues for Recovery and Performance in Athletes

The body of research that reports the relevance of sleep in high-performance sports is growing steadily. While the identification of sleep cycles and diagnosis of sleep disorders are limited to lab-based assessment via polysomnography, the development of activity-based devices estimating sleep patterns provides greater insight into the sleep behavior of athletes in ecological settings. Generally, small sleep quantity and/or poor quality appears to exist in many athletic populations, although this may be related to training and competition context. Typical sleep-affecting factors are the scheduling of training sessions and competitions, as well as impaired sleep onset as a result of increased arousal prior to competition or due to the use of electronic devices before bedtime. Further challenges are travel demands, which may be accompanied by jet-lag symptoms and disruption of sleep habits. Promotion of sleep may be approached via behavioral strategies such as sleep hygiene, extending nighttime sleep, or daytime napping. Pharmacological interventions should be limited to clinically induced treatments, as evidence among healthy and athletic populations is lacking. To optimize and manage sleep in athletes, it is recommended to implement routine sleep monitoring on an individual basis.

Risk factors for precompetitive sleep behavior in elite female athletes

BACKGROUND

Sleep is of major importance for the athletes' short and long-term health, performance and recovery; however, published studies on athletes' sleep and even fewer before competition are scarce. This study evaluated the risk factors of sleep in young female gymnasts before an international competition.

METHODS

Sixty-seven rhythmic gymnasts (M=18.7, SD=2.9 years) of high performance (M=36.6, SD=7.6 h/week) were evaluated regarding training and sport practice, body composition, sleep duration, daytime sleepiness by the Epworth Sleepiness Scale, sleep quality by the Pittsburgh Sleep Quality Index, precompetitive anxiety by the Sport Competition Anxiety Test form A, and detailed dietary intake just prior to a world competition.

RESULTS

The majority of the participants (83.6%) presented reduced body fat levels (M=9.1, SD=2.1%) and low energy availability (EA, M=31.5, SD=11.9 kcal/kgFFM/day). They slept 8h10±1h30/night on weekdays and 8h40±00h40/night on weekends, 67% suffered from mild daytime sleepiness and 78% had a reduced sleep quality. Precompetitive anxiety was on average moderate (M=22.7, SD=3.2). The risk factors for short sleep duration were: 1.92 for a training volume>30 hours/week (95% CI 0.84-4.39), 4.57 for menstruation (95% CI 1.17-17.77), 6.62 for bedtime ≥11:00 PM (95% CI 1.74-25.10), 1.40 for BF<12% (95% CI 1.03-1.92), 2.19 for FFM<30 kg (95% IC 0.94-4.94), 2.37 for BMR<1100 kcal/day (95% CI 1.06-5.32), 1.90 for EEE≥700 kcal (95% CI 0.92-3.93) and 3.17 for EA<45 kcal/kg FFM/day (95% CI 0.84-6.59). Age, performance, sleep duration on weekdays and precompetitive stress were also predictors for a reduced sleep quality and/or abnormal daytime sleepiness.

CONCLUSIONS

Age, training regime, menstruation, individual preferences for bedtime, body composition and energy were important predictors of gymnasts' precompetitive sleep with consequences upon their sleep duration, SQ and DS.

Sleep duration, body composition, dietary profile and eating behaviours among children and adolescents: a comparison between Portuguese acrobatic gymnasts

Sleep, body composition and dietary intake are crucial for athletes' health and performance but have never been investigated in acrobatic gymnasts. Thus, this study aimed to evaluate sleep, body composition, dietary intake and eating behaviours of acrobatic gymnasts. Using a cross-sectional study, 82 Portuguese acrobatic gymnasts (12.8 ± 3.1 years, 61 females and 21 males) were evaluated during the competitive period to collect training data, sleep duration, body composition, dietary intake and eating behaviours before, during and after practices. Most of the gymnasts (91.5%) slept less than 8 h/night. Female adolescents slept significantly less on weekdays than female children (P = 0.024). Female adolescents' mean body mass was below the normal and 60.0% showed menstrual irregularities; 4.9% of females bases were overweight and 2.4% obese. Male adolescents slept significantly less on weekdays than male children (P = 0.001); significant differences were shown for fat-free mass (P = 0.014); however, 3.7% were overweight. All daily energy and macronutrient intakes were significantly different according to age and gender, with exception for fibre and energy intake in females (P = 0.057 and P = 0.052, respectively), and for protein in males (P = 0.068). Female and male adolescents demonstrated significant lower energy availability (32.8 ± 9.4 kcal/kg FFM/day and 45.1 ± 14.7 kcal/kg FFM/day) than children (45.8 ± 8.7 kcal/kg FFM/day and 53.8 ± 9.1 kcal/kg FFM/day), respectively. Significant low intakes of important vitamins and minerals were reported. Most of the participants did not eat or drink during or immediately after training sessions.

CONCLUSION

Acrobatic gymnasts revealed low BF, short sleep duration and macro- and micronutrients inadequate intakes. The Female Athlete Triad was demonstrated by female adolescent gymnasts. What is Known: • Adequate dietary intake is an important resource for athletes' short and long-term health and performance. • There are no published studies in acrobatic gymnasts' sleep, body composition or dietary intake. What is New: • This study provides the first data on significant differences in energy intake and availability between acrobatic gymnasts; overweight and obesity were present in females. • Macro and micronutrients were inappropriate. Female Athlete Triad was observed in female adolescent acrobatic gymnasts.

Does Elite Sport Degrade Sleep Quality? A Systematic Review

BACKGROUND

Information on sleep quality and insomnia symptomatology among elite athletes remains poorly systematised in the sports science and medicine literature. The extent to which performance in elite sport represents a risk for chronic insomnia is unknown.

OBJECTIVES

The purpose of this systematic review was to profile the objective and experienced characteristics of sleep among elite athletes, and to consider relationships between elite sport and insomnia symptomatology.

METHODS

Studies relating to sleep involving participants described on a pre-defined continuum of 'eliteness' were located through a systematic search of four research databases: SPORTDiscus, PubMed, Science Direct and Google Scholar, up to April 2016. Once extracted, studies were categorised as (1) those mainly describing sleep structure/patterns, (2) those mainly describing sleep quality and insomnia symptomatology and (3) those exploring associations between aspects of elite sport and sleep outcomes.

RESULTS

The search returned 1676 records. Following screening against set criteria, a total of 37 studies were identified. The quality of evidence reviewed was generally low. Pooled sleep quality data revealed high levels of sleep complaints in elite athletes. Three risk factors for sleep disturbance were broadly identified: (1) training, (2) travel and (3) competition.

CONCLUSION

While acknowledging the limited number of high-quality evidence reviewed, athletes show a high overall prevalence of insomnia symptoms characterised by longer sleep latencies, greater sleep fragmentation, non-restorative sleep, and excessive daytime fatigue. These symptoms show marked inter-sport differences. Two underlying mechanisms are implicated in the mediation of sport-related insomnia symptoms: pre-sleep cognitive arousal and sleep restriction.

Cough in exercise and athletes

Cough is the most common respiratory symptom reported by athletes and can significantly impact on health status, ability to train and athletic performance. The presence of cough in an athlete is typically taken to indicate exercise-induced bronchoconstriction (EIB), yet in many athletes with chronic cough there is no objective evidence of airway hyper-responsiveness (AHR) or heightened airway inflammation. Moreover, cough in athletes often fails to respond to a therapeutic asthma strategy, thus further work is urgently needed to progress our understanding of the pathophysiology of exercise-associated cough in this unique population. This article provides an overview of the current state of knowledge of exercise-associated cough in athletes. The article summarises our understanding of pathophysiological basis of cough in this context and provides a pragmatic clinical approach to this problem.

Comparison of body composition and nutrients' deficiencies between Portuguese rink-hockey players

We evaluated dietary intake and body composition of child and adolescent rink-hockey players and controls. Seventy-two male rink-hockey players (38 children and 34 adolescents) and 79 male controls (43 children and 36 adolescents) were evaluated in order to collect training data, detailed dietary intake and body composition. Rink-hockey players presented significantly lower body fat (BF) and higher fat-free mass (FFM) than controls. Mean intakes of carbohydrate and protein were considered to be adequate, but mean intakes of fat were above the recommended levels in athletes. Significant differences were found for energy intake (EI) and exercise energy expenditure (EEE) between athletes and controls (P < 0.05), resulting in some cases of low energy availability in rink-hockey players. Significant group differences (P < 0.05) were also observed for vitamins and mineral intakes in child and adolescent rink-hockey players due to higher mean intakes in control groups. Low intakes of vitamins D, E and K, calcium, iron, boron and magnesium were reported in athletes, with exception for thiamine (P = 0.449), riboflavin (P = 0.246), pantothenic acid (P = 0.065), magnesium (P = 0.061) and phosphorus (P = 0.051) in children and for niacin (P = 0.652), vitamin D (P = 0.406) and zinc (P = 0.783) in adolescents.

CONCLUSION

Nutritional deficiencies in macronutrients and micronutrients observed in very young rink-hockey players can impair their growth and development with negative consequences upon athletic performance. What is Known: • Adequate dietary intake is an important resource for athletes' short- and long-term health, performance and recovery. • There are no published studies in rink-hockey players' energy availability. What is New: • This study provides the first data on significant differences in energy intake between very young athletes and controls, resulting in low energy availability in rink-hockey players. • Mean intakes of fat were above the recommended levels, and micronutrients intakes were inappropriate in athletes with consequences for their health and performance.