Assessment of under-reporting of energy intake by elite female gymnast

A FOUR-YEAR CYCLE COMPARISON OF THE NUTRITIONAL AND CARDIOVASCULAR HEALTH STATUS OF AN ELITE-LEVEL FEMALE ARTISTIC GYMNAST: CASE STUDY REPORT FROM SLOVENIA

Regular monitoring of body composition, nutrition, health, and motor skills are crucial for further training process planning and performance progress. With the same protocol and methods, we evaluated a four-year change (2018 vs. 2022) in the nutritional and cardiovascular health status of the currently most successful elite-level adult female artistic gymnast in Slovenia. Detailed body composition and dietary intake were assessed using dual-energy X-ray absorptiometry and a standardized food questionnaire FFQ. The blood lipids and safety factors, blood pressure, and serum micronutrients (e.g., B12, 25-hydroxyvitamin D (25(OH)D), potassium, calcium, phosphorus, magnesium, and iron) status were measured. The four-year comparison showed an improved body composition status: decreased body fat mass/percentage, android fat percentage, and android/gynoid ratio, while other anthropometrical and body composition parameters remained essentially unchanged. We also measured an improvement of some and worsening of other cardiovascular health serum variables (i.e., decreased total cholesterol but increased low-density lipoprotein cholesterol and S-glucose), most likely due to the differences in assessed dietary intake (i.e., lower total fat, mono- and polyunsaturated fatty acid intake but higher cholesterol intake and still high free sugar and saturated fat intake, despite higher fiber). Notably, nutrient intakes that are generally of concern (fiber (borderline low intake), eicosapentaenoic omega-3 fatty acids and docosahexaenoic omega-3 fatty acids, vitamin B12 and D, calcium (borderline low intake), iron, and zinc) were within recommended ranges. However, the athlete’s vitamin E and potassium intakes were not adequate. Furthermore, in 2018, the athlete did not consume dietary supplements, while she now regularly uses several dietary supplements, including enriched plant-based protein powder, isolated vitamin B12, C, D, and iron. Moreover, the athlete had significantly lower than recommended serum levels of 25(OH)D, probably due to insufficient regular intake of vitamin D in the form of a dietary supplement (1000 IU/d). Moreover, from the micronutrient serum, phosphorus, and iron levels that deviated from the reference values in the 2018 study, in the current study, they were found to be within referenced ranges (i.e., iron status was markedly improved). This kind of screening toolbox, using valid, sensitive, and affordable methods and with rapid organizational implementation, may be a viable format for regular monitoring.

Body Composition, Training Volume/Pattern and Injury Status of Slovenian Adolescent Female High-Performance Gymnasts

Body composition (BC), training volume/pattern, and injury status are a few important factors affecting training quality and sport performance in female artistic gymnastics. We aimed to examine BC status, training volume/pattern, and injury status during the first competition period. Our cross-sectional study included 17 female gymnasts (age: 17.4 ± 4.1 years, body height: 159.8 ± 6.2 cm, and body weight: 54.8 ± 5.3 kg) who were high performance at the international and national level. The BC (measured by dual-energy X-ray absorptiometry) parameters included body height and mass, body fat percentage (BF %), lean body mass (LBM), body mass index (BMI), total bone mineral density (BMD total), and total bone mineral content (BMC total). Training volume and pattern were assessed via an author-developed questionnaire, while injury status (i.e., anatomical location, symmetry and rate of injuries) was assessed via a modified questionnaire on overuse injuries used in sports injury epidemiology studies with elite-level athletes. Body composition parameters were as follows: the BMI was 21.5 ± 1.4 kg/m², BF % was 21.9 ± 4.7%, LBM was 41.2 ± 3.4 kg, BMD total was 1.22 ± 0.08 g/cm², and BMC total was 2486 ± 344 g. Furthermore, the average weekly volume of training was 23.5 ± 1.4 h, with the highest training volume occurring on Monday and Tuesday and high variability within gymnasts. Our study also revealed that the most frequently injured joints that had the most negative impact on training volume, sport performance and pain status were the ankles and low back, followed by the knees and shoulders. This kind of yearly screening method is warranted to allow more definitive conclusions to be made on adjusted training and preventive strategies.

Nutritional Status and Cardiovascular Health in Female Adolescent Elite-Level Artistic Gymnasts and Swimmers: A Cross-Sectional Study of 31 Athletes

OBJECTIVE

Nutritional status is important for health and competitive achievement. This area remains understudied among elite-level female athletes and is appropriate for research. We examined nutritional status and cardiovascular health markers of two groups of female athletes of the same age and competition period, involved in weight-bearing and a non-weight-bearing sport: gymnasts (n = 17) and swimmers (n = 14); mean age 17.4 and 16.6 years.

METHODS

Body composition and dietary intake were assessed by bioelectrical impedance and Food Frequency Questionnaire. The concentrations of serum micronutrients (B12, 25-hydroxyvitamin D (25 (OH) D), calcium, magnesium, phosphorus, potassium, and iron), blood lipids, and blood pressure (BP) were measured. Setting and Participants. A cross-sectional study of 31 athletes from Slovenia.

RESULTS

Gymnasts had higher body mass index (21.5 vs. 20.1 kg/m2, p=0.043) and lower fat free mass (42.4 vs. 46.6 kg, p=0.024) than swimmers and comparable body fat percentage (22.5 vs. 22.8%). Both groups had low intake of carbohydrates, fibre, polyunsaturated fats, protein (only gymnasts), and micronutrients (11/13 micronutrients gymnasts and 4/13 swimmers) and high intake of free sugars and saturated fats. Both groups also had significantly lower-than-recommended serum levels of 25 (OH) D. All cardiovascular risk factors were within recommended ranges. Gymnasts had higher LDL cholesterol (2.7 vs. 2.2 mmol/L, p < 0.011), and swimmers had higher systolic BP (126 vs. 107 mmHg, p < 0.001).

CONCLUSIONS

Dietary intake especially in gymnasts was suboptimal, which may reflect in anthropometric and cardiovascular marker differences between gymnasts and swimmers.

Dietary Intake, Body Composition and Iron Status in Experienced and Elite Climbers

Climbing has developed into a popular recreational and elite sport, evidenced by a growing number of licenced competition athletes, and the acceptance into the Olympic calendar for Tokyo 2020. A nutritional assessment, including the evaluation of anthropometric and biochemical data, has not been previously reported in climbing athletes. Therefore, the aim of this study was to assess the dietary intake, body composition, and iron status in experienced climbers, across a range of performance levels. Forty climbers (n = 20 male, n = 20 female; 8.8 ± 6.6 years' experience; BMI 21.6 ± 1.7) aged 18–46 (30.3 ± 6.7 years) participated in the study. Dietary intake was recorded in a 3-days diet diary. Body composition was assessed using a skinfold profile and iron status via blood markers. Mean energy intake was 2154.6 ± 450 kcal·day⁻¹, with 30% of male climbers and 5% of female climbers failing to meet predicted resting metabolic rate. Furthermore, 77.5% of participants failed to meet a predicted energy requirement to support a “moderate” training programme. There were no significant correlations between daily energy intake and exercise volume. Mean intake of carbohydrate, protein and fat was 3.7 ± 0.9 g·kg⁻¹·day⁻¹, 1.6 ± 0.5 g·kg⁻¹·day⁻¹, and 1.4 ± 0.4 g·kg⁻¹·day⁻¹, respectively, with no significant difference between genders. Approximately 17% of males (n =3) and 45% of females (n = 9) had a sub-optimal iron status. Thirty percent of females met the classification criteria for iron deficiency. Mean serum ferritin was significantly greater in males, compared to females (102.7 ± 54.9 vs. 51.4 ± 24.2 μg·L⁻¹; p ≤ 0.01) and significantly lower in vegan/vegetarians vs. omnivores, in female climbers only (33.2 ± 14.8 vs. 57.5 ± 24 μg·L⁻¹; p = 0.05). No significant differences were observed between climbing ability groups (intermediate-advanced/elite-higher elite) for body composition, dietary intake, or iron status, for males or females. These findings suggest that experienced climbers are at risk of energy restriction and iron deficiency, therefore, routine assessment of nutritional status is warranted. Future research should consider iron status in relation to energy availability and investigate additional factors which may predispose this population to iron deficiency, as well as the risk of relative energy deficiency in sport (RED-S).

Assessment of Dietary Under-Reporting in Italian College Team Sport Athletes

BACKGROUND

Nutrition is an important factor for sports performance and the assessment of dietary intakes in athletes can correct unhealthy eating habits. However, dietary assessment may be biased due to misreporting. The aim of our study was to investigate the occurrence of misreporting in a sample of collegiate team sport athletes.

METHODS

A total of 50 athletes participated. Each athlete filled in food records for seven days. Reported energy intake (EI) was considered in relation to the predicted basal metabolic rate (BMR) and expressed as the ratio EI/ BMR. All participants with EI/BMRestd ≤1.23 were classified as "low energy reporters" (LER), and those with an EI/BMRestd ratio >1.23 were classified as "adequate energy reporters" (AER).

RESULTS

According to cut-off values for under-reporting, 28 out of 50 athletes (56%) were classified as LER. The LER (16 M/12 F) had significantly higher BMI (23.17 ± 3.46 kg/m2 compared to 21.41 ± 1.91 kg/m2; p = 0.038) than the AER. The EI/kg fat free mass (FFM) was significantly lower in LER than the AER (33.34 ± 6.56 kcal/FFM compared to 48.51 ± 8.59 kcal/FFM, p < 0.0001). Nutrient intake was also significantly different between the two groups.

CONCLUSIONS

Our results suggest that under-reporting of energy intake by collegiate team sport athletes may occur frequently and needs to be taken into consideration in the interpretation of nutrient intake.

Validity of Dietary Assessment in Athletes: A Systematic Review

Dietary assessment methods that are recognized as appropriate for the general population are usually applied in a similar manner to athletes, despite the knowledge that sport-specific factors can complicate assessment and impact accuracy in unique ways. As dietary assessment methods are used extensively within the field of sports nutrition, there is concern the validity of methodologies have not undergone more rigorous evaluation in this unique population sub-group. The purpose of this systematic review was to compare two or more methods of dietary assessment, including dietary intake measured against biomarkers or reference measures of energy expenditure, in athletes. Six electronic databases were searched for English-language, full-text articles published from January 1980 until June 2016. The search strategy combined the following keywords: diet, nutrition assessment, athlete, and validity; where the following outcomes are reported but not limited to: energy intake, macro and/or micronutrient intake, food intake, nutritional adequacy, diet quality, or nutritional status. Meta-analysis was performed on studies with sufficient methodological similarity, with between-group standardized mean differences (or effect size) and 95% confidence intervals (CI) being calculated. Of the 1624 studies identified, 18 were eligible for inclusion. Studies comparing self-reported energy intake (EI) to energy expenditure assessed via doubly labelled water were grouped for comparison (n = 11) and demonstrated mean EI was under-estimated by 19% (-2793 ± 1134 kJ/day). Meta-analysis revealed a large pooled effect size of -1.006 (95% CI: -1.3 to -0.7; p < 0.001). The remaining studies (n = 7) compared a new dietary tool or instrument to a reference method(s) (e.g., food record, 24-h dietary recall, biomarker) as part of a validation study. This systematic review revealed there are limited robust studies evaluating dietary assessment methods in athletes. Existing literature demonstrates the substantial variability between methods, with under- and misreporting of intake being frequently observed. There is a clear need for careful validation of dietary assessment methods, including emerging technical innovations, among athlete populations.

Changes in Anthropometry and Selected Metabolic Parameters in Young Men During Their First Year of Study at a University of Physical Education

This study aims to determine main health-related anthropometric and metabolic parameters in young physically active male students in their first year of study. Sixty one male students from a Polish university of physical education were studied twice–at the beginning of their first and second academic years. Body weight, height, waist circumference, and body composition were measured. Plasma levels of thyroid-stimulating hormone (TSH), leptin, cortisol, and insulin, as well as insulin resistance (IR) using the homeostatic model assessment (HOMA) were determined. In 64% of the participants body weight and body mass index (BMI) significantly increased during the study. An average students’ weight gain amounted to 1.2 kg. In most of the subjects it resulted from the increase of fat-free mass (r = .886, p < .001). TSH and leptin levels did not change, but a significant increase of cortisol levels and a tendency toward decreased insulin levels and also HOMA-IR values were observed. However, there were no significant correlations identified between the changes in anthropometric and biochemical parameters. The study revealed that body weight gain seen in male students during their first year at the university of physical education was mainly due to the increase in fat-free mass. Apart from anthropometrics, changes in their insulin and cortisol levels were also detected, but further studies are required to evaluate these findings. The documented insufficient energy and carbohydrates consumption in physically active male students proves the need for nutritional education among them.

Effect of glycemic index on satiety and body weight

Despite extensive study, the practical significance of the glycemic index of food is still debatable. The purpose of this review paper was to evaluate the effect of glycemic index on food intake and body weight based on the analysis of published studies about this topic. According to some authors, ingestion of high glycemic index diets tends to enhance appetite and promote positive energy balance. The increase of appetite associated with the ingestion of these diets is attributed to an especially sharp early post-prandial rise of blood glucose followed by a marked release of insulin and subsequent rebound relative hypoglycemia and low levels of blood fatty acids, suggesting the difficulty that the body has to access its stored metabolic fuels. Short-term investigations have generally demonstrated that ingestion of low glycemic index foods results in greater satiety and lower energy intake than high glycemic index foods. However, less is known about the importance of glycemic index to energy balance and weight control associated with chronic ingestion of foods differing in glycemic index. Carefully designed long-term studies are required to assess the efficacy of glycemic index in the treatment and prevention of obesity in humans.

Nutritional status of teenage female competitive figure skaters

OBJECTIVE

To assess the nutritional status of female competitive figure skaters during preseason, competitive season, and off-season.

SUBJECTS

Eighteen female competitive figure skaters, age range 14 to 16 years, from the New England region.

STATISTICS

Data was analyzed by repeated measures analysis of variance, Duncan Multiple Range Tests, one-sample t tests, and confidence intervals.

DESIGN

Nutrient intakes were determined from 3-day diet records. Body composition was assessed through heights, weights, and underwater weighing. Blood samples were drawn for analysis of selected indexes of nutritional status.

RESULTS

Height and weight did not differ significantly among the seasons. Body fat was 1.1 kg higher off-season compared with preseason. Energy intake over the 3 seasons did not vary significantly (mean preseason: 1,678 kcal/day; competitive season, 1,630 kcal/day; off-season: 1,673 kcal/day) (P>.05). During the competitive season 78%, 50%, and 44% of the skaters had intakes less than 67% of RDA for folate, iron, and calcium, respectively. Most of the biochemical indexes of nutritional status were within normal limits.

CONCLUSIONS

The results indicate that teenage female skaters have relatively low energy intake and inadequate intakes of certain nutrients, which may account for some of the observed seasonal variations in blood markers of nutritional status. These findings point to the need for nutrition education for these athletes, especially during their competitive season when nutritional status may be compromised.