1
|
Nicholas J, Grafenauer S. Investigating pre-professional dancer health status and preventative health knowledge. Front Nutr 2023; 10:1271362. [PMID: 38130445 PMCID: PMC10733861 DOI: 10.3389/fnut.2023.1271362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 11/13/2023] [Indexed: 12/23/2023] Open
Abstract
Introduction Dance is a highly demanding physical pursuit coupled with pressure to conform to aesthetic ideals. Assessment of health status and preventative health knowledge of pre-professional dancers may help inform educational strategies promoting dancers' health and career longevity. The aim of this research was to establish a baseline understanding of dance students at a single pre-professional institution based on metrics focused on current health, nutrition, lifestyle, and wellbeing while also gauging knowledge of longer-term health implications. Methods Adopting a cross-sectional study design, the Dance-Specific Energy Availability Questionnaire was tailored for Australian participants and administered online. Results The response rate was 59.5% (69/116 eligible students) and the survey was completed in full by 63 students. Mean BMI was 20 kg/m2, although among females, 47% had a BMI < 20 (range 16 to 25 kg/m2), and at their lowest reported weight BMI was 14 to 25 kg/m2. Over a third had either experienced (31%) or were currently experiencing (3.4%) secondary amenorrhea (period absence ≥ 3 consecutive months). Most dancers did not exclude food groups, however, 24% had been advised to exclude particular foods in the past, mostly by dance teachers. A large percentage used nutritional supplements (68%) with 60% supplementing with iron and more than half (53%) taking two or more supplements. Only 25% had ever utilised a qualified dietitian, although 16% reported a history of eating disorders and 25% reported vegetarian or vegan eating patterns. REDs risk scores ranged from -16 to +16 points with negative scores indicating LEA and higher risk of REDs. The mean score for males was 5.2 (SD = 3.9) and 2.1 (SD = 5.9) for females, with 33.3% producing a negative score. Conclusion Results provide insight to health knowledge and particular issues pertinent for dancers and highlights the need for specific education strategies to promote a preventative health focus for those entering a pre-professional programme. This study also highlights the need for improved awareness of LEA and REDs among all practitioners working with dancers along with cultural and structural changes within the broader dance community to help protect and promote the wellbeing of dancers.
Collapse
Affiliation(s)
- Joanna Nicholas
- Western Australian Academy of Performing Arts, Edith Cowan University, Mount Lawley, WA, Australia
| | - Sara Grafenauer
- School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Randwick, NSW, Australia
| |
Collapse
|
2
|
Attwell C, McKay A, Sim M, Dugan C, Nicholas J, Hopper L, Peeling P. Timing is everything, but does it really matter? Impact of 8-weeks morning versus evening iron supplementation in ballet and contemporary dancers. Eur J Sport Sci 2023; 23:2275-2282. [PMID: 37291690 DOI: 10.1080/17461391.2023.2224285] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
ABSTRACTThe effectiveness of a morning versus evening oral iron supplement strategy to increase iron stores was explored. Ballet and contemporary dancers with serum ferritin (sFer) < 50μg/L (n = 14), were supplemented daily with 105 mg elemental oral iron in either the morning (FeAM) or evening (FePM) for 8 weeks. A control group (n = 6) with sFer >50μg/L were given no supplement over the same period. Dancers' sFer were measured at baseline and post-intervention. Assessment of daily training load, dietary intake, and menstruation were made. A significant interaction (p < 0.001) showed the within group sFer change over the 8-week intervention in FeAM (+25.9 ± 10.5μg/L) and FePM, (+22.3 ± 13.6μg/L) was significantly different to CON (-30.17 ± 28.7μg/L; both p = 0.001). This change was not different between FeAM and FePM (p = 0.778). sFer levels within FeAM and FePM significantly increased over the 8-weeks; however, they significantly decreased in the CON group (all p < 0.05). Post-intervention sFer levels were no longer different between the three groups (p > 0.05). Training load, dietary intake, and number of menstrual cycles incurred were similar between FeAM and FePM (p > 0.05). Oral iron supplementation in either the morning or evening appears equally effective in increasing sFer levels in dancers with sub-optimal iron status.
Collapse
Affiliation(s)
- Caitlin Attwell
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Crawley, Australia
| | - Alannah McKay
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Marc Sim
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
- Medical School, The University of Western Australia, Crawley, Australia
| | - Cory Dugan
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Crawley, Australia
| | - Joanna Nicholas
- Western Australian Academy of Performing Arts, Edith Cowan University, Mount Lawley, Australia
| | - Luke Hopper
- Western Australian Academy of Performing Arts, Edith Cowan University, Mount Lawley, Australia
| | - Peter Peeling
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Crawley, Australia
- Western Australian Institute of Sport, Mt Claremont, Australia
| |
Collapse
|
3
|
Çetiner-Okşin B, Güzel Y, Aktitiz S, Koşar ŞN, Turnagöl HH. Energy balance and energy availability of female basketball players during the preparation period. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2023; 42:807-813. [PMID: 36847823 DOI: 10.1080/27697061.2023.2183432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 02/17/2023] [Indexed: 03/01/2023]
Abstract
OBJECTIVE To determine the level of energy balance and energy availability (EA) in female basketball players during the preparation period. METHODS Fifteen basketball players (age: 19.53 ± 1.3 years; height: 173.6 ± 8.95 cm; weight: 67.55 ± 14.34 kg; training experience: 9.6 ± 2.7 years) and 15 age and body mass index-matched controls (age: 19.53 ± 1.1 years; height: 169.4 ± 5.06 cm; weight: 63.10 ± 6.14 kg) participated in the study. Resting metabolic rate (RMR) and body composition were measured by the indirect calorimetric method and dual-energy x-ray absorptiometry, respectively. A 3-day food diary was used to determine macronutrients and energy intake while a 3-day physical activity log was used to determine energy expenditure. Independent Samples t-test was used for data analysis. RESULTS The daily energy intake and expenditure of female basketball players were 2136.5 ± 594.9 kcal·day-1 and 2953.8 ± 614.5 kcal·day-1, respectively, indicating 817 ± 779 kcal·day-1 of negative energy balance. One hundred percent and 66.6% of the athletes failed to meet the carbohydrate and protein intake recommendations, respectively. EA of female basketball players was 33.04 ± 15.69 kcal·fat free mass-1·day-1 and the percentages of athletes who had negative energy balance, low EA, and reduced EA were 80%, 40%, and 46.7%, respectively. However, despite the low and decreased EA, the measured RMR to predicted RMR ratio (RMRratio) was 1.31 ± 0.17 and the body fat percentage (BF%) was 31.00 ± 5.21%. CONCLUSION This study shows that female basketball players have a negative energy balance during the preparation period which can be partly explained by insufficient carbohydrate intake. Although most of the athletes experienced low or reduced EA during the preparation period, the physiologically normal RMRratio and relatively high BF% indicate that this is a transient situation. In this regard, strategies to prevent the development of low EA and negative energy balance during the preparation period will contribute to positive training adaptations throughout the competition period.
Collapse
Affiliation(s)
- Bengisu Çetiner-Okşin
- Division of Exercise Nutrition and Metabolism, Faculty of Sport Sciences, Hacettepe University, Ankara, Türkiye
| | - Yasemin Güzel
- Division of Exercise Nutrition and Metabolism, Faculty of Sport Sciences, Hacettepe University, Ankara, Türkiye
| | - Selin Aktitiz
- Division of Exercise Nutrition and Metabolism, Faculty of Sport Sciences, Hacettepe University, Ankara, Türkiye
| | - Şükran Nazan Koşar
- Division of Exercise Nutrition and Metabolism, Faculty of Sport Sciences, Hacettepe University, Ankara, Türkiye
| | - Hüseyin Hüsrev Turnagöl
- Division of Exercise Nutrition and Metabolism, Faculty of Sport Sciences, Hacettepe University, Ankara, Türkiye
| |
Collapse
|
4
|
Liu X, Soh KG, Omar Dev RD. Effect of Latin dance on physical and mental health: a systematic review. BMC Public Health 2023; 23:1332. [PMID: 37434149 PMCID: PMC10337058 DOI: 10.1186/s12889-023-16221-6] [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] [Received: 04/04/2023] [Accepted: 06/30/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Latin dance is a well-liked physical activity. It has gained increasing attention as an exercise intervention for improving physical and mental health outcomes. This systematic review examines the effects of Latin dance on physical and mental health. METHODS Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) were used to report the data for this review. To gather research from the literature, we used recognized academic and scientific databases such SportsDiscus with Full Text, PsycINFO, Cochrane, Scopus, PubMed, and Web of Science. The systematic review only included 22 studies out of the 1,463 that matched all inclusion criteria. The PEDro scale was used to rate each study's quality. 22 research received scores between 3 and 7. RESULTS Latin dance has been demonstrated to promote physical health by helping people lose weight, improve cardiovascular health, increase muscle strength and tone, and improve flexibility and balance. Furthermore, Latin dance can benefit mental health by reducing stress, improving mood, social connection, and cognitive function. CONCLUSIONS Finding from this systematic review provide substantial evidence that Latin dance has effect on physical and mental health. Latin dance has the potential to be a powerful and pleasurable public health intervention. SYSTEMATIC REVIEW REGISTRATION CRD42023387851, https://www.crd.york.ac.uk/prospero .
Collapse
Affiliation(s)
- Xutao Liu
- Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, Malaysia
| | - Kim Geok Soh
- Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, Malaysia
| | - Roxana Dev Omar Dev
- Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, Malaysia
| |
Collapse
|
5
|
Monedero J, Duff C, Egan B. Dietary Intakes and the Risk of Low Energy Availability in Male and Female Advanced and Elite Rock Climbers. J Strength Cond Res 2023; 37:e8-e15. [PMID: 35836334 DOI: 10.1519/jsc.0000000000004317] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Monedero, J, Duff, C, and Egan, B. Dietary intakes and the risk of low energy availability in male and female advanced and elite rock climbers. J Strength Cond Res 37(3): e8-e15, 2023-There is a culture among rock climbers of striving to maintain low body mass and percentage body fat to enhance performance. Diet practices based on this belief might lead to increased risk of low energy availability (LEA) or eating disorders (EDs). Twenty-five advanced or elite rock climbers (male, n = 14; female, n = 11) had body composition measured, completed 4-day food intake and physical activity diaries while wearing an accelerometer and heart rate monitor, and completed the Eating Attitudes Test (EAT)-26 and the Low Energy Availability in Females Questionnaire (LEAF-Q; n = 11 female subjects only). EAT-26 scores of 3.5 (1.8, 7.0) [median (IQR)] and 9.3 ± 6.4 (mean ± SD ) for male and female subjects, respectively, indicated low risk of ED in this cohort, but 4 female subjects were at high risk of LEA according to LEAF-Q scores. Suboptimal (<45 kcal·kg·FFM -1 ·d -1 ) and LEA (<30 kcal·kg·FFM -1 ·d -1 ) were evident in 88 and 28%, respectively, of climbers. However, only the female climbers had energy intakes (1775 ± 351 kcal·d -1 ) significantly lower than their calculated energy requirements (2056 ± 254 kcal·d -1 ; p = 0.006). In all subjects, carbohydrate intakes were lower (male subjects: 3.8 ± 1.2 g·kg -1 ·d -1 , p = 0.002; female subjects: 3.4 ± 0.7 g·kg -1 ·d -1 , p < 0.001), and fat intakes were higher (male subjects: 1.6 ± 0.5 g·kg -1 ·d -1 , p < 0.001; female subjects: 1.4 ± 0.4 g·kg -1 ·day -1 , p < 0.001) than current sports nutrition recommendations, and inadequate intakes of calcium, magnesium, and vitamin D were observed. Female subjects specifically had lower than recommended intakes of protein and iron. These results show that advanced and elite rock climbers have a high prevalence of LEA and have a risk of having nutritional deficiencies as result of their diet.
Collapse
Affiliation(s)
- Javier Monedero
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- Department of Clinical Sciences and Nutrition, University of Chester, Chester, England; and
| | - Christina Duff
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Brendan Egan
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| |
Collapse
|
6
|
(Low) Energy Availability and Its Association with Injury Occurrence in Competitive Dance: Cross-Sectional Analysis in Female Dancers. Medicina (B Aires) 2022; 58:medicina58070853. [PMID: 35888572 PMCID: PMC9319529 DOI: 10.3390/medicina58070853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/19/2022] [Accepted: 06/23/2022] [Indexed: 11/16/2022] Open
Abstract
Background and objectives: The risk of low energy availability is related to various health problems in sports. This cross-sectional study aimed to identify a possible association between various dance factors, anthropometrics/body build, and energy availability with injury occurrence in contemporary dancers. Materials and Methods: The participants were 50 female competitive dancers (19.8 ± 4.1 years of age). The independent variables included age, dance factors (amount of training and competitions per week–exposure time, experience in dance), anthropometrics/body composition (body height, mass, BMI, body fat percentage (BF%), and fat-free mass (FFM)), and energy availability score (EAS; evaluated by accelerometer-based measurement of energy expenditure and Dance Energy Availability Questionnaires). The dependent variables were the occurrence of (i) soft-tissue injuries and (ii) bone injuries. The measurements were obtained by experienced technicians during the pre-competition period for each specific dance discipline. Univariate and multivariate logistic regressions were calculated to identify the associations between independent variables and injury prevalence. Results: The results showed that EAS (OR = 0.81, 95% CI:0.65–0.91), age (OR = 1.65, 95% CI: 1.1–2.46), higher BF% (OR = 1.23, 95% CI: 1.04–1.46) and BMI (OR = 1.61, 95% CI: 1.05–2.47) were correlated with soft-tissue injuries. Dancers who suffered from bone injuries reported higher exposure time (OR = 1.21, 95% CI: 1.05–1.37) and had lower values of FFM (OR = 0.73, 95% CI: 0.56–0.98). Multivariate regression analyses evidenced a higher likelihood of soft-tissue injuries in older dancers (OR = 1.75, 95% CI: 1.21–2.95) and the ones who had lower EAS (OR = 0.84, 95% CI: 0.71–0.95) while the exposure time was associated with a higher likelihood of bone injuries (OR = 1.21, 95% CI: 1.05–1.39). Conclusions: In order to decrease the injury prevalence among dancers, special attention should be paid to maintaining adequate nutrition that will provide optimal available energy for the demands of training and performing. Additionally, the control of training volume should be considered in order to reduce traumatic bone injuries.
Collapse
|
7
|
Management of Stress Fractures in Ballet. J Am Acad Orthop Surg 2022; 30:543-553. [PMID: 35394992 DOI: 10.5435/jaaos-d-21-01021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 02/23/2022] [Indexed: 02/01/2023] Open
Abstract
Stress fractures are highly prevalent in ballet dancers and lead to notable time loss from dancing. Nutritional status, body composition, bone mineral density, and rate of increase in activity are among the components that influence risk for stress fractures. Proper evaluation and management of stress fractures is essential including a review of the causative factors involved in each stress injury. The purpose of this article was to summarize current evidence for risk factors involved in dancers' stress fractures to optimize prevention and treatment. Identified associated factors include low energy availability, low bone mineral density, low fat body composition, abnormal lower extremity biomechanics, genetic factors, and high training loads.
Collapse
|
8
|
Uchizawa A, Kondo E, Lakicevic N, Sagayama H. Differential Risks of the Duration and Degree of Weight Control on Bone Health and Menstruation in Female Athletes. Front Nutr 2022; 9:875802. [PMID: 35571936 PMCID: PMC9094681 DOI: 10.3389/fnut.2022.875802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 03/28/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- Akiko Uchizawa
- Graduate School of Comprehensive Human Science, University of Tsukuba, Ibaraki, Japan
| | - Emi Kondo
- Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan.,Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan
| | - Nemanja Lakicevic
- Sport and Exercise Sciences Research Unit, University of Palermo, Palermo, Italy
| | - Hiroyuki Sagayama
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan
| |
Collapse
|
9
|
Dietary Iron and the Elite Dancer. Nutrients 2022; 14:nu14091936. [PMID: 35565904 PMCID: PMC9105128 DOI: 10.3390/nu14091936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 04/28/2022] [Accepted: 05/03/2022] [Indexed: 12/10/2022] Open
Abstract
Dancers are an athlete population at high risk of developing iron deficiency (ID). The aesthetic nature of the discipline means dancers potentially utilise dietary restriction to meet physique goals. In combination with high training demands, this means dancers are susceptible to problems related to low energy availability (LEA), which impacts nutrient intake. In the presence of LEA, ID is common because of a reduced mineral content within the low energy diet. Left untreated, ID becomes an issue that results in fatigue, reduced aerobic work capacity, and ultimately, iron deficient anaemia (IDA). Such progression can be detrimental to a dancer’s capacity given the physically demanding nature of training, rehearsal, and performances. Previous literature has focused on the manifestation and treatment of ID primarily in the context of endurance athletes; however, a dance-specific context addressing the interplay between dance training and performance, LEA and ID is essential for practitioners working in this space. By consolidating findings from identified studies of dancers and other relevant athlete groups, this review explores causal factors of ID and potential treatment strategies for dancers to optimise absorption from an oral iron supplementation regime to adequately support health and performance.
Collapse
|
10
|
Popp KL, Cooke LM, Bouxsein ML, Hughes JM. Impact of Low Energy Availability on Skeletal Health in Physically Active Adults. Calcif Tissue Int 2022; 110:605-614. [PMID: 35171303 DOI: 10.1007/s00223-022-00957-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 02/04/2022] [Indexed: 12/13/2022]
Abstract
For decades researchers reported that pre-menopausal women who engage in extensive endurance exercise and have menstrual dysfunction can develop low bone mineral density (BMD) or osteoporosis. More recently, low energy availability has been recognized as the initiating factor for low BMD in these women. Furthermore, the relationship between low energy availability and poor skeletal health is not exclusive to women engaging in endurance exercise. Rather, both males and females commonly experience endocrine dysfunction resulting from low energy availability and high exercise levels that degrades skeletal health. Consequences to skeletal health can range from short-term changes in bone metabolism and increased risk of bone stress injuries to long-term consequences of low BMD, such as osteoporosis and related fragility fractures. The degree to which low energy availability degrades skeletal health may be dependent on the length and extent of the energy deficit. However, the complex relationships between under-fueling, short- and long-term skeletal consequences and the factors that mediate these relationships are not well described. In this review, we discuss the consequences of low energy availability on sex hormones and skeletal health in two highly-active populations-athletes and military trainees-and provide a summary of existing knowledge gaps for future study.
Collapse
Affiliation(s)
- Kristin L Popp
- United States Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA.
- Massachusetts General Hospital, Boston, MA, 02114, USA.
- Harvard Medical School, Boston, MA, 02215, USA.
| | - Laura M Cooke
- Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Mary L Bouxsein
- United States Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA
- Massachusetts General Hospital, Boston, MA, 02114, USA
- Harvard Medical School, Boston, MA, 02215, USA
- Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA
| | - Julie M Hughes
- United States Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA
| |
Collapse
|
11
|
Witkoś J, Hartman-Petrycka M. The Female Athlete Triad-the impact of running and type of diet on the regularity of the menstrual cycle assessed for recreational runners. PeerJ 2022; 10:e12903. [PMID: 35256915 PMCID: PMC8898003 DOI: 10.7717/peerj.12903] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 01/17/2022] [Indexed: 01/11/2023] Open
Abstract
Background The Female Athlete Triad (FAT) included three interrelated conditions including disordered eating, amenorrhea, and osteoporosis. The American College of Sports Medicine updated the definition of FAT to reflect the interdependence of low energy availability with or without eating disorders. The main aim of the study was to assess the impact of recreational running on potential disturbances in the regularity of women's menstrual cycles. Additionally, this work compared differences in the menstrual cycle between women runners and women who did not regularly practice sports. The respondents were also asked about the type of diet they consumed. Methods A total of 360 women took part in the research. This group included 217 runners and 143 control. The authors' questionnaire was used in the research. Results When compared to the control group, the runners had an increased frequency of menstrual cycles of <24 days (10.14% vs. 3.50%), fewer typical cycles of 25-31 days (75.58% vs. 86.71%), had fewer regular cycles per year (9.62 vs. 11.22), shorter duration of bleeding (4.79 vs. 5.27 days), and an increased frequency of painless menstruation (23.96% vs. 7.69%). A positive predictor of menstrual cycle disorders was the use of a 'special diet' (R:1.67; 95% C:0.47-2.87). Conclusions The runners had shorter and less regular monthly cycles and shorter and more often painless menstrual bleeding when compared to the control group. The frequency of menstrual disorders in runners was increased by following a 'special diet'. The frequency of menstrual cycle disorders in runners, however, did not differ significantly from the control group.
Collapse
Affiliation(s)
- Joanna Witkoś
- Faculty of Medicine and Health Science, Andrzej Frycz Modrzewski Krakow University, Kraków, Poland
| | - Magdalena Hartman-Petrycka
- Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Poland
| |
Collapse
|
12
|
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
|
13
|
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
|
14
|
Stellingwerff T, Heikura IA, Meeusen R, Bermon S, Seiler S, Mountjoy ML, Burke LM. Overtraining Syndrome (OTS) and Relative Energy Deficiency in Sport (RED-S): Shared Pathways, Symptoms and Complexities. Sports Med 2021; 51:2251-2280. [PMID: 34181189 DOI: 10.1007/s40279-021-01491-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2021] [Indexed: 12/14/2022]
Abstract
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.
Collapse
Affiliation(s)
- Trent Stellingwerff
- Pacific Institute for Sport Excellence, Canadian Sport Institute-Pacific, 4371 Interurban Road, Victoria, BC, V9E 2C5, Canada.
- Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada.
| | - Ida A Heikura
- Pacific Institute for Sport Excellence, Canadian Sport Institute-Pacific, 4371 Interurban Road, Victoria, BC, V9E 2C5, Canada
- Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
| | - Romain Meeusen
- Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Stéphane Bermon
- Université Côte d'Azur, LAMHESS Nice, Nice, France
- World Athletics, Health and Science Department, Monte Carlo, Monaco
| | - Stephen Seiler
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
| | - Margo L Mountjoy
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
- IOC Medical Commission Games Group, Lausanne, Switzerland
| | - Louise M Burke
- Australian Institute of Sport, Bruce, ACT, Australia
- Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| |
Collapse
|
15
|
Dipla K, Kraemer RR, Constantini NW, Hackney AC. Relative energy deficiency in sports (RED-S): elucidation of endocrine changes affecting the health of males and females. Hormones (Athens) 2021; 20:35-47. [PMID: 32557402 DOI: 10.1007/s42000-020-00214-w] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 05/20/2020] [Indexed: 12/26/2022]
Abstract
The purpose of this review is to present a different perspective of the relative energy deficiency syndrome, to improve understanding of associated endocrine alterations, and to highlight the need for further research in this area. The term "female athlete triad" was coined over 25 years ago to describe three interrelated components: disordered eating, menstrual dysfunction, and low bone mass. The syndrome's etiology is attributed to energy intake deficiency relative to energy expenditure required for health, function, and daily living. Recently, it became clear that there was a need to broaden the term, as the disorder is not an issue of only three interrelated problems but of a whole spectrum of insults resulting from low energy availability (LEA; i.e., insufficient energy availability to cover basic physiological demands) that can potentially affect any exerciser, irrespective of gender. The new model, termed relative energy deficiency in sport (RED-S), has received greater scrutiny in sports medicine due to its effects on both health and performance in athletes of both sexes. RED-S results from low-energy diets (intentional or unintentional) and/or excessive exercise. Energy deficiency reduces hypothalamic pulsatile release of gonadotropin-releasing hormone, this impairing anterior pituitary release of gonadotropins. In women, reduced FSH and LH pulsatility produces hypoestrogenism, causing functional hypothalamic amenorrhea and decreased bone mass. In men, it reduces testosterone and negatively affects bone health. Moreover, LEA alters other hormonal pathways, causing physiological consequences, such as alteration of the thyroid hormone signaling pathways, leptin levels, carbohydrate metabolism, the growth hormone/insulin-like growth factor-1 axis, and sympathetic/parasympathetic tone. This review explains and clarifies the effects of RED-S in both sexes.
Collapse
Affiliation(s)
- Konstantina Dipla
- Department of Sports Science, Exercise Physiology and Biochemistry Laboratory, Serres, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Robert R Kraemer
- Department of Kinesiology and Health Studies, Exercise Physiology Laboratory, Southeastern Louisiana University, Hammond, LA, USA.
| | - Naama W Constantini
- Heidi Rotberg Sport Medicine Center, Shaare Zedek Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Anthony C Hackney
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC, USA
| |
Collapse
|
16
|
Kulshreshtha M, Babu N, Goel NJ, Chandel S. Disordered eating attitudes and body shape concerns among North Indian Kathak dancers. Int J Eat Disord 2021; 54:148-154. [PMID: 33283330 DOI: 10.1002/eat.23425] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 11/09/2020] [Accepted: 11/14/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To determine the prevalence and association between disordered eating attitudes and body shape concerns in a sample of North Indian Kathak dancers. METHOD Participants were 206 Kathak female dancers and 235 healthy controls, ages 18-45 years. Participants completed questionnaires assessing demographics, disordered eating attitudes, and body dissatisfaction. Pearson correlations assessed the association between the disordered eating attitudes and body dissatisfaction, and binary logistic regression identified the risk of having a possible eating disorder. RESULTS Kathak dancers reported significantly greater disordered eating attitudes compared to controls (12.1% vs. 5.9%, p = .023). Dancers endorsed greater dieting behaviors (M = 5.6 vs. 4.5, p = .031), and binge eating episodes (p < .001) relative to their counterparts. Body dissatisfaction was significantly positively correlated with disordered eating attitudes among the dancers (p < .001). Dancers with elevated body shape concerns were five times more likely to report disordered eating attitudes, relative to their peers (p < .001). DISCUSSION Disordered eating attitudes and body shape concerns are prevalent among North Indian Kathak dancers. Future research should aim to develop targeted prevention and intervention programs that focus on reducing these behaviors and promoting a positive body image to mitigate the risk of disordered eating among this group.
Collapse
Affiliation(s)
| | - Nandita Babu
- Department of Psychology, University of Delhi, Delhi, India
| | - Neha J Goel
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Shivani Chandel
- Department of Anthropology, University of Delhi, Delhi, India
| |
Collapse
|
17
|
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
|
18
|
Benardot D. Nutritional Concerns for the Artistic Athlete. Phys Med Rehabil Clin N Am 2020; 32:51-64. [PMID: 33198898 DOI: 10.1016/j.pmr.2020.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Performing artists are similar to sports athletes, with repeated patterns of training and performing. This requires that artistic athletes manage the dynamic interaction between energy/nutrient/fluid utilization and provision to assure long, healthful, and successful careers. Although sports athletes have an abundance of science-based nutritional guidance available, there are few nutrition-focused resources available to artistic athletes, which can result in failure to optimally satisfy the artistic athlete's individual nutritional needs. The purpose of this article is to review common nutritional issues faced by artistic athletes and to present science-based nutrition strategies that can aid in lowering nutrition-associated health and performance risks.
Collapse
Affiliation(s)
- Dan Benardot
- Center for the Study of Human Health, Candler Library, Emory University, Suite 107, Atlanta, GA 30323, USA; Emeritus, Georgia State University, Atlanta, GA, USA.
| |
Collapse
|
19
|
Keeler CE. Access to Health Care Among Dancers. Phys Med Rehabil Clin N Am 2020; 32:21-33. [PMID: 33198896 DOI: 10.1016/j.pmr.2020.08.004] [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] [Indexed: 11/19/2022]
Abstract
Dancers require a unique blend of artistry and athleticism, and have specific medical problems that require the expertise of health care professionals who understand the demands of the performing arts. There is often a lack of alignment between health care systems and dancers' perceptions of care. Factors including country of residence, socioeconomic status, and local infrastructure can affect dancers' access to health care. Efforts to improve access are evident, and specialized care for dancers has grown significantly in recent decades. By developing and refining systems of care delivery, there are opportunities to ensure optimal health of the dancer population.
Collapse
Affiliation(s)
- Carolyn E Keeler
- Department of Neurosurgery, Duke University Medical Center, DUMC Box 3807, Durham, NC 27710, USA.
| |
Collapse
|
20
|
Low Energy Availability in Athletes 2020: An Updated Narrative Review of Prevalence, Risk, Within-Day Energy Balance, Knowledge, and Impact on Sports Performance. Nutrients 2020; 12:nu12030835. [PMID: 32245088 PMCID: PMC7146210 DOI: 10.3390/nu12030835] [Citation(s) in RCA: 113] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 03/14/2020] [Accepted: 03/18/2020] [Indexed: 01/11/2023] Open
Abstract
Low energy availability (EA) underpins the female and male athlete triad and relative energy deficiency in sport (RED-S). The condition arises when insufficient calories are consumed to support exercise energy expenditure, resulting in compromised physiological processes, such as menstrual irregularities in active females. The health concerns associated with longstanding low EA include menstrual/libido, gastrointestinal and cardiovascular dysfunction and compromised bone health, all of which can contribute to impaired sporting performance. This narrative review provides an update of our previous review on the prevalence and risk of low EA, within-day energy deficiency, and the potential impact of low EA on performance. The methods to assess EA remain a challenge and contribute to the methodological difficulties in identifying “true” low EA. Screening female athletic groups using a validated screening tool such as the Low Energy Availability in Females Questionnaire (LEAF-Q) has shown promise in identifying endurance athletes at risk of low EA. Knowledge of RED-S and its potential implications for performance is low among coaches and athletes alike. Development of sport and gender-specific screening tools to identify adolescent and senior athletes in different sports at risk of RED-S is warranted. Education initiatives are required to raise awareness among coaches and athletes of the importance of appropriate dietary strategies to ensure that sufficient calories are consumed to support training.
Collapse
|
21
|
Gastrich MD, Quick V, Bachmann G, Moriarty AM. Nutritional Risks Among Female Athletes. J Womens Health (Larchmt) 2020; 29:693-702. [PMID: 32040354 DOI: 10.1089/jwh.2019.8180] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Limited research studies have been conducted on nutritional risks among female athletes. Therefore, this literature review focuses on rigorously designed studies that examined nutritional risks among female athletes with further recommendations for athletes, coaches, parents, and health professionals, which would help improve the health of female athletes. Methods: This review evaluates the most recent research on nutritional risk among female athletes. Inclusion criteria included peer-reviewed studies of original research on human subjects 13 years of age or older; sample size of N ≥ 19; and studies with a thorough description of their sample and methods. A systematic search of the databases PubMed and Cochrane for published studies (from year 2000 to year 2019) was conducted to identify articles that met inclusion criteria. Bibliographies of identified articles were also searched for relevant articles. Results: Of the 11 studies that met our inclusion criteria, most were mainly cross-sectional in design with few rigorous controls. Findings reveal that strategies to enhance nutrition patterns among female athletes may be important to avoid risks of disordered eating, eating disorders, low energy availability, and symptoms of relative energy deficiency in sports. In addition, general nutrition knowledge is lacking among athletes, sports teams, and coaches. Conclusions: This review highlights the scarcity of evidence-based, rigorous studies examining nutritional risks among female athletes. Findings suggest that interdisciplinary working groups, comprising physicians, sports dietitians, and other supportive health professionals, would be beneficial for female athletes in helping to improve their overall diet, performance, and health.
Collapse
Affiliation(s)
- Mary Downes Gastrich
- Department of Ob/Gyn and Reproductive Sciences, Rutgers, Robert Wood Johnson Medical School, Cardiovascular Institute, New Brunswick, New Jersey
| | - Virginia Quick
- Didactic Program in Dietetics, Rutgers University, New Brunswick, New Jersey
| | - Gloria Bachmann
- Department of Ob/Gyn and Reproductive Sciences, Rutgers, Robert Wood Johnson Medical School, Women's Health Institute, New Brunswick, New Jersey
| | - Alexa McDonald Moriarty
- McCosh Health Center, University Health Services Sports Nutrition Services, Princeton University, Princeton, New Jersey
| |
Collapse
|
22
|
Leal LLA, Barbosa GSL, Ferreira RLU, Avelino EB, Bezerra AN, Vale SHDL, Maciel BLL. Cross-validation of prediction equations for estimating body composition in ballet dancers. PLoS One 2019; 14:e0219045. [PMID: 31265484 PMCID: PMC6605673 DOI: 10.1371/journal.pone.0219045] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 06/16/2019] [Indexed: 11/26/2022] Open
Abstract
Introduction In sports related to low body weight, such as classical ballet, the assessment of body composition is important for monitoring performance and health status. This study aimed to cross-validate anthropometry and bioelectrical impedance (BIA) predictive equations for estimating body composition of non-professional classical ballet dancers, using dual-energy-X-ray absorptiometry (DXA) as a reference method. Materials and methods Thirty-seven female non-professional classical dancers (median age of 19 years), at intermediate/advanced level, were evaluated in a cross-sectional study. Body composition was evaluated by DXA, anthropometry and tetrapolar BIA. Twenty different predictive equations of anthropometry (n = 8) and BIA (n = 12) were used to estimate Body Fat (BF) and Fat-Free Mass (FFM), testing their validity against DXA using the Bland-Altman statistics. Results For BF estimated by anthropometry equations, just one equation showed agreement with DXA (r = 0.852, p < 0.0005; p = 0.600 for one sample T-test). According to the Bland-Altman analysis, this equation also showed validity, with the absence of proportional bias. Regarding the predictive BIA equations tested, none were valid for our study group. Conclusion Only one of the anthropometric equations, the one proposed by Durnin and Womerley (1974), but none of the BIA equations analyzed, was valid for the evaluation of body composition of the studied classical dancers. Our results emphasize the importance of previous cross-validation of existing equations or the development of specific equations for body composition assessment in specific populations.
Collapse
Affiliation(s)
- Leilane Lilian Araújo Leal
- Nutrition Department, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Postgraduate Nutrition Program, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | | | | | - Erikarla Baracho Avelino
- Postgraduate Nutrition Program, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Adriana Nunes Bezerra
- Endocrinology Department, Onofre Lopes University Hospital, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Sancha Helena de Lima Vale
- Postgraduate Nutrition Program, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Bruna Leal Lima Maciel
- Nutrition Department, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Postgraduate Nutrition Program, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- * E-mail:
| |
Collapse
|