Assessment of Dietary Intake and Eating Attitudes in Recreational and Competitive Adolescent Rock Climbers: A Pilot Study

Nutrition knowledge, weight loss practices, and supplement use in senior competition climbers

Introduction

Sport climbing has gained increased scientific attention, including studies investigating the dietary habits and nutritional requirements of climbers; however, significant gaps in the literature remain. An assessment of nutritional knowledge, weight loss for competition, and supplement use has not been previously reported in senior competition climbing athletes.

Methods

Fifty climbers (26 male, 24 female; BMI 21.6 ± 1.9; 23.7 ± 5.2 years) participated in the study. Participants answered a 72-item questionnaire, comprised of demographic data and three main sections to assess general and sports nutrition knowledge, weight loss strategies, and supplement use.

Results

The mean nutrition knowledge score was 'average', with considerable individual variation (53.5 ± 11.1 %). There were no significant sex differences in the general (GNK) or sport (SNK) nutrition knowledge scores, or effect of age. Significantly higher knowledge was demonstrated by national vs. international athletes for the GNK scores (11.09 ± 1.58 vs. 9.58 ± 1.75; p = 0.028). Participants scored well in questions concerning protein, carbohydrates, alcohol, and supplements, and conversely, performed poorly in hydration and micronutrient related questions. Less than one-fifth of respondents had access to a dietitian. Forty-six percent of males and 38% of female climbers reported intentional weight loss for competition on at least one occasion. Of those, ~76% reported utilizing concerning practices, including methods that conform with disordered eating and/or eating disorders, dehydration, vomiting, and misuse of laxatives. Approximately 65% of athletes reported using at least one nutritional supplement in the previous 6 months, with 44% reporting multiple supplement use. There was no significant difference in supplement use between sexes or competition level.

Discussion

Due to the established importance of nutritional intake on athlete health and performance, educational support should be employed to improve knowledge in climbers and address shortcomings. Moreover, intentional weight loss for climbing competition is common, with most athletes achieving ~3-8% body weight loss over ≥2 weeks. It is crucial that professionals working with competitive climbers are vigilant in identifying athletes at risk of concerning weight management and establish referral pathways to the appropriate specialist services. High quality intervention trials to assess the efficacy of ergogenic aids in climbing remains inadequate.

Physiological Characteristics, Dietary Intake, and Supplement Use in Sport Climbing

PURPOSE OF REVIEW

As sport climbing has become an Olympic sport and keeps gaining in popularity, there is growing interest in the role of diet and the effect of dietary supplements on climbing performance. The aim of this review is to provide an insight into the dietary intake of climbers and discuss ergogenic aids that could improve their performance.

RECENT FINDINGS

Limited information is available regarding the dietary intake and eating habits of climbers, and the studies conducted are few and far between. The diet of climbers is apparently suboptimal, with inadequate energy intakes often owning to insufficient carbohydrate consumption. Likewise, supplement use and ergogenic aids for climbing performance are largely unexplored. Several ergogenic aids have been suggested to improve climbing performance; however, only two have been examined directly on climbing-specific outcomes. The dietary intake, eating behaviors, and supplement use in sport climbers are not well studied, and available information is most likely outdated. Considerably, more work is needed to determine which ergogenic aids can be beneficial for climbing performance.

The Evaluation of Energy Availability and Dietary Nutrient Intake of Sport Climbers at Different Climbing Levels

Proper nutrition is the basis for athletes' performances when competing or training. The increasing training volume accompanying the increase in advancement should go hand in hand with the appropriate supply of energy as well as macro and micronutrients. The diet of climbing representatives due to the desire to achieve a low body weight may be deficient in energy and micronutrients. Our study aimed to evaluate the differences in energy availability and nutrient intake of female and male sport climbers at different climbing levels. Anthropometric parameters and the resting metabolic rate were measured, the questionnaire about climbing grade and training hours was filled, and a 3-day food diary was fulfilled by 106 sport climbers. Based on the collected data, the energy availability as well as the macro- and micronutrient intake was calculated. Low energy availability (EA) was observed among both genders of sport climbing representatives. A significant difference between EA in various levels of advancement was found in the male group (p < 0.001). Differences in carbohydrate intake (g/kg/BW) between sexes were observed (p = 0.01). Differences in nutrients intake between climbing grade were found in both the female and male groups. In the group of female elite athletes, the adequate supply of most of the micronutrients can imply a high-quality diet despite the low calorie content. It is necessary to educate sport climbing representatives about the importance of proper nutrition as well as the consequences of insufficient energy intake.

Dietary Intakes and the Risk of Low Energy Availability in Male and Female Advanced and Elite Rock Climbers

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.

Eating disorder risks and awareness among female elite cyclists: an anonymous survey

Background

Eating disorders (EDs) are an increasingly recognized concern in professional sports. Previous studies suggests that both female gender and endurance sports put athletes at risk. Female elite cyclists are hence of specific interest. The present study aimed at evaluating the distribution of the individual risk of ED in this group. Further the association between individual risk and both the awareness for the topic ED and the deviation from “normal” weight was depicted.

Methods

Female cyclists registered with the Union Cycliste Internationale were contacted via email or facebook and asked to complete a survey comprising age, weight, the Eating-Attitude-Test (EAT-26), and questions regarding ED awareness. The observed distribution of the EAT-26 score was compared to results from previous studies in normal subjects and athletes. The distribution of the ED awareness was described and ED awareness was correlated with the EAT-26 score. Both the deviation from ideal weight and the body mass index (BMI) were correlated with the EAT-26 score.

Results

Of the 409 registered athletes 386 could be contacted, 122 completed the questionnaire. Age ranged from 20-44yrs, BMI from 17.0 to 24.6 kg/m². In the EAT-26, 39 cyclists (32.0%) scored above 20 points indicating a potential benefit from clinical evaluation, 34 cyclists (27.9%) scored 10–19 points suggesting disordered eating. Sixteen athletes (13.2%) had been treated for an ED. About 70% of athletes had been pressured to lose weight. The mean EAT-26 score was above the average observed in normal female populations. It was also above the average observed in many female athlete populations, but lower than in other leanness focussed sports. More than 80%of athletes perceived elite cyclists at risk for developing ED. Increased ED awareness and deviation from the ideal weight were associated with higher EAT-26 scores, but not the body mass index.

Conclusion

Female cyclists are at risk of developing ED and they are aware of this risk. To improve their health and well-being, increased efforts to support elite cyclists and their teams in preventive activities and early detection are crucial.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13102-022-00563-6.

Prevalence of amenorrhea in elite female competitive climbers

Elite competitive sport climbers exhibit a high strength-to-weight ratio and are reported in the literature to be lighter and leaner than their athletic counterparts. Current research regarding nutrition among climbers is sparse but suggests that they may be at high risk for low energy availability and Relative Energy Deficiency in Sport (RED-S). The prevalence of amenorrhea, one of the primary indicators of RED-S, is unknown in this athletic population. The purpose of this study was to determine the prevalence of current (previous 12 months) amenorrhea among elite level competitive sport climbers.

Methods

An anonymous online survey was distributed via email to 1,500 female climbers registered as competitors within the International Federation of Sport Climbing to assess the prevalence of amenorrhea over the past 12 months.

Results

A total of 114 female sport climbers answered all survey questions regarding menstrual function and 18 athletes (15.8%) presented with current amenorrhea. The majority of the athletes (72%; n = 82) were categorized with eumenorrhea. An additional 14 athletes (12.3%) provided information that indicated irregular cycles, but answers to all menstrual cycle questions were not congruent to elicit a classification of amenorrhea and these athletes were categorized with a menstrual status of unsure. The average BMI for climbers with eumenorrhea was 20.8 ± 1.8 kg/m2 and 19.9 ± 2.4 kg/m2 for those with amenorrhea. A higher percentage of climbers with amenorrhea revealed they currently struggle with an eating disorder compared to those without amenorrhea (13.5 vs. 22.2%, respectively).

Conclusion

This study indicates that some female climbers competing at the World Cup level do have menstrual disturbances with relatively normal BMIs and some currently struggle with one or more eating disorders. Even though World Cup competitions use BMI critical margins to screen competitors, this research highlights the need for more medical supervision of competitive elite female sport climbers in order to protect their overall health, including menstrual function. Further research is required to clarify how many climbers suffer from endocrine abnormalities related to RED-S. With more scientific evidence in this area practitioners will be better equipped to educate the athlete and coach with evidence-based nutrition recommendations.

Attitudes towards disordered eating in the rock climbing community: a digital ethnography

BACKGROUND

Rock climbing is an antigravitational sport in which a low body weight may intuitively seem beneficial. A small number of studies have found an increased prevalence of disordered eating among adolescent and adult climbers. However, to date there has been no qualitative research into the attitudes towards disordered eating and body image in the rock climbing community.

METHODS

This explorative study employed a netnographic approach with the aim of understanding how topics related to food, dieting, and disordered eating in the climbing community are addressed in online conversations. Discussion forums on nine major climbing websites as well as three climbing-related forums on the online community Reddit were searched for posts and comments related to the research question. The collected data were then assessed through thematic analysis, generating a number of themes and subthemes.

RESULTS

Five overarching themes, labelled "Is there a problem?", "Subjective experiences", "Why and how is weight an issue?", "The importance of context", and "What can be done?", were identified among the forum posts. Most forum users acknowledge that eating disorders are indeed a problem relevant to the climbing community, although a significant minority disagrees. While the assumed benefits of a low weight are clearly a dominant idea among climbers, weight may have become less important over time. Forum users also attest to ways in which climbing may in fact be helpful in fostering a positive body image, such as highlighting performance over aesthetics or emphasizing wholesome community values.

CONCLUSIONS

This study demonstrates that the topic of disordered eating and negative body image is far from a blind spot or a "dark secret" within the rock climbing community, as is sometimes claimed. An undue focus on low body weight among climbers must be balanced by proper nutritional advice and healthy role models, not least for young climbers who may feel pressured to lose weight as a quick but short-sighted way to boost performance. Clinicians should be aware of the prevailing 'weight talk' in the climbing community and be attentive to negative body image and disordered eating in their patients.

Barriers and potential facilitators to implement nutrition care program in athletes' training centers in Indonesia

Background: In order to improve national sport achievement in Indonesia, a new policy of nutritionist placement in every training center in Indonesia was proposed. The understanding of barriers and potential facilitators was needed to identify problems and arrange policy implementation strategies. Aim: This study aims to determine the barriers in nutrition intervention practices for athletes and opportunities in implementing the proposed policy of sport nutritionist placement in athlete training centers. Methods: The study was conducted using Consolidated Framework of Implementation Research (CFIR) as the guideline for data collection and analysis. In-Depth Interview (IDI) and Focus Group Discussion (FGD) were conducted on 9 participants from the Ministry of Youth and Sport, the Republic of Indonesia. Results: This study indicates that there are several potential barriers, which are influential on the implementation of nutrition support for athletes. These include the lack of facilitation of athletes' nutritional needs, lack of supervision for food catering service, lack of communication, and limited funding. In contrast, the potential facilitators are strong relationship with sport-related stakeholders, compatibility with the existing policy, relative advantages, and trialability of the proposed policy. Conclusions: The Indonesia Ministry of Youth and Sports should utilize these facilitators as opportunities to design, develop, and implement a policy that requires nutrition support available for all athletes at every PPLP in Indonesia.

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).

Prevalence of Disordered Eating Among International Sport Lead Rock Climbers

Disordered eating (DE) is characterized as a range of irregular eating patterns or behaviors, which may lead to pathological eating or a clinical eating disorder diagnosis. DE patterns are associated with a variety of negative health outcomes. The prevalence of DE is highest in female athletes who participate in aesthetic or weight dependent sports. Elite rock climbers tend to be strong, small and lean, but the prevalence of DE in rock climbers is unknown. The purpose of the present study was to assess DE prevalence in a large group of international rock climbers and to explore the relationship between sport rock climbing ability and DE. A web-based survey assessed both DE (Eating Attitudes Test-26) and climbing ability based on the International Rock Climbing Research Association's position statement on comparative grading scales. The survey was distributed to international climbing communities; 810 individuals attempted the survey; 604 completed all questions; 498 identified as sport lead climbers. The majority of sport lead climbers were lower grade/intermediate (57.8%), compared to advanced (30.7%) and elite/higher elite (11.4%), and male (76.9%). Forty-three sport lead climbers reported a score of 20 or above on the EAT-26 indicating an 8.6% prevalence of DE in this sample. Male climbers had a DE prevalence of 6.3% (24 of 383) and female climbers more than doubled that with 16.5% (19 of 115). Chi-square analysis revealed that DE was associated with climbing ability level [χ2 (2, n = 498, 8.076, p = 0.02)], and when analyzed by sex, only the female climbers had a significant relationship of DE with climbing ability [χ2 (2, n = 115, 15.640, p = 0.00)]. These findings suggest sport lead rock climbers are not immune to DE and that the risk is elevated in female climbers, particularly at the elite/high elite climbing ability level. Our research indicates further investigations are warranted to determine if and how disordered eating behaviors affect health and performance of adult rock climbers.