ECSS Paris 2023: OP-PN09
INTRODUCTION: Endurance athletes with high training loads have increased risk of low energy availability (LEA) and Relative Energy Deficiency in sport (REDs). The aim of this study was to evaluate the effects of a 16-week nutritional digital intervention on sports nutrition knowledge and REDs markers among Swiss national team cross-country skiers and biathletes. METHODS: Swiss national team cross-country skiers and biathletes (21 females, 13 males; 24 ±4 years, training 19 hours/week, VO2max 63 ±8 ml/kg/min) were evaluated of REDs severity using the International Olympic Committee Clinical Assessment Tool (CAT) 2; menstrual disturbances (MD), risk of eating disorders (Eating Disorder Examination Questionnaire (EDE-Q)), levels of testosterone (males), triiodothyronine (T3), cholesterol, bone mineral density (DXA) and bone stress injury (BSI) history. Nutrition knowledge was assessed by a validated 78-item questionnaire for endurance athletes. The Food and nUtrition for Endurance athletes—a Learning (FUEL) program, comprising 16 weekly online lectures and individual athlete-centered nutrition counseling every other week, was administered to athletes both with and without REDs. Data was analyzed with McNemar test, Repeated Measures ANOVA and dependent t-tests. RESULTS: Four males and nine females (39%) were categorized with REDs (12 mild, 1 moderate, 0 severe) PRE intervention and two males and three females (15%) (5 mild, 0 moderate, 0 severe) POST the intervention (p=0.02). Nutrition knowledge improved from PRE to POST for athletes with REDs (p=0.002, d=1.4 95% CI [0.50, 2.2]) and without REDs (n=9 males and 12 females), (p=0.007, d=1.2 95% CI [0.6, 1.8]). Athletes with REDs decreased their (EDE-Q) total global score (1.0±0.9 versus 0.5±0.6; p =0.03, d = -0.8 95% CI [-1.3, -0.08]) while no changes were seen among the athletes without REDs. Male athletes with REDs increased their testosterone levels (free 280 ± 94 vs. 418±37pmol/l; p=0.01, d=1.9) 95% CI [0.1, 3.5], and total 14±6 vs 20±4 nmol/L; p =0.003, d = 2.9 95% CI [0.50, 5.3]), from PRE to POST while no changes were seen among male athletes without REDs. The number of female athletes with MD (24 %, n=5) PRE decreased to 10 % n=2 POST intervention. No changes in T3, BSI, body weight, body composition estimates, or cholesterol levels were found in either group. CONCLUSION: Athletes with REDs improved their sport nutrition knowledge and decreased their eating disorder pathology after participating in the FUEL program. Furthermore, male and female athletes with REDs improved testosterone levels and menstrual status, respectively, indicating a decreased risk of clinical markers of REDs after participation in the FUEL program. However, further research with a larger sample is needed to confirm these findings.
Read CV Maria GraefningsECSS Paris 2023: OP-PN09
INTRODUCTION: The assessment of phase angle (PhA) is significant in the context of sports, as it plays a crucial role in potentially identifying functional impairments, such as overtraining syndrome (OTS), muscle injury, and related changes in fluid distribution. OTV and Relative Energy Deficiency in Sport (REDs) share symptom similarities initiating from a hypothalamic-pituitary origin, that can be influenced by low energy availability (LEA). Thus, the aim of the study is to verify if the PhA may be used as T3, leptin, and IGF-1 predictor in the scenario of LEA. METHODS: This is a cross-sectional study with nonprobability sampling. Inclusion criteria: healthy female CrossFit® (CF) practitioners aged 18-39 years, training experience ≥1 year; 5-7 training sessions (5-7 hours) per week for ≥6 months for the recreational practitioners’ group (RG); ≥12 hours of practice per week for ≥6 months for the elite group (EG). Subjects visited the laboratory once. They answered health, sociodemographic, and the Low Energy Availability in Females (LEAF-Q) questionnaires. Resting energy expenditure (REE) via indirect calorimetry and body composition (bioelectrical impedance analysis) were assessed in a fasting state, followed by blood test. Data were analyzed using Jamovi® 2.3.21 version. RESULTS: Data of 43 subjects are presented as mean (SD). Students t-test showed no differences regarding age (33.1 (5.2) and 30.3 (6.2) years), body mass index (24.0 (1.8) and 25.9 (1.5) kg/m2), and REE (1618.8 (168.9) and 1647.8 (173.2) kcal/day) between RG (n=30) and EG (n=13), respectively. Body fat percentage (BF%: 23.3 (3.4) and 19.1 (2.7); p < 0.001), T3 levels (1.0 (0.3) and 0.8 (0.1) ng/mL; p < 0.05), and leptin levels (10.4 (7.5) and 2.4 (1.3) ng/mL; p < 0.001) were significantly lower in the EG. Fat free mass (FFM: 48.5 (4.2) and 55.2 (3.8) kg; p < 0.001) and IGF-1 levels (168.8 (48.6) and 207.2 (42.4) ng/mL; p = 0.018) were significantly higher in the EG. Energy availability was 22.0 (9.8) for RG and 21.4 (12.9) kcal/kg of FFM for EG. PhA was significantly different between EG and RG (t=4.94; p<0.001; MD: 1.20; d=1.66). PhA was positively correlated to FFM (r=0.56; p=0.005), FFM% (p < 0.001), and LEAF-Q score (r=0.341; p=0.029), and IGF-1 levels (r=0.318; p=0.045), but negatively correlated to T3 (r=-0.342; p=0.029) and leptin (r=-0.372; p=0.017) levels. After controlling for group, the linear regression model showed that group (EG) was positively associated with PhA, independently of FFM (B: 0.87; 95% CI: 0.31-3.16; 0.003). However, when controlling for variables of adjustment, PhA was not associated to T3 (B=-0.04; p=0.400), leptin (B=0.778; p=0.571), and IGF-1 (B=8.2; p=0.435) levels. CONCLUSION: PhA was positively correlated to female CF athletes’ FFM, the LEAF-Q score, and levels of T3, leptin, and IGF-1 and positively associated to the EG, but no association to hormone levels was found. More studies are necessary to verify the usefulness of PhA as a predictor of hormone levels in the LEA scenario.
Read CV FERNANDA PATTI NAKAMOTOECSS Paris 2023: OP-PN09
INTRODUCTION: Quality of life (QOL) is an important research outcome measuring an individual’s perception of their position in life. However, evidence concerning QOL in female endurance sports is lacking. Female endurance athletes are at high risk of Relative Energy Deficiency in Sport (REDs), a syndrome of impaired physiological and/or psychological functioning caused by problematic low energy availability (LEA). Thus. the aim of this study was to assess QOL in female endurance athletes with symptoms of REDs and investigate whether the Food and nUtrition for Endurance athletes – a Learning (FUEL) program affected QOL in this group of athletes. METHODS: Female endurance athletes from Norway (n=60), Sweden (n=84), Ireland (n=17), and Germany (n=47) were recruited to the FUEL intervention consisting of 16 weekly online lectures combined with sports nutrition counseling every-other-week. Fifty athletes with symptoms of REDs [LEA in Females Questionnaire (LEAF-Q) score ≥ 8] and with low risk of eating disorders, no use of hormonal contraceptives, and no chronic diseases, were allocated to either the intervention (FUEL) condition (n=32) or the control (CON) condition (n=18). All but one completed the FUEL intervention, while three participants dropped out of the CON condition. Athletes completed the WHOQOL-BREF pre- and post-intervention and data were analyzed using a Bayesian mixed factor analysis of variance. RESULTS: Self-rated QOL were 4.3 ± 0.5 for CON and 4.3 ± 0.8 for FUEL at pretest, which did not change after the intervention period (CON: 4.2 ± 0.7, FUEL: 4.4 ± 0.9). Likewise, satisfaction with one’s health were 4.2 ± 0.8 for CON and 4.0 ± 0.7 for FUEL at pretest and did not change after the intervention period (CON: 4.1 ± 0.5, FUEL: 4.2 ± 0.9). Comparing CON and FUEL, no evidence for differences in change were found for Physical domain (CON pre: 79.6 ± 7.0, CON post: 82.7 ± 6.9; FUEL pre: 76.8 ± 13.5, FUEL post: 82.4 ± 13.0), Psychological domain (CON pre: 71.5 ± 10.6, CON post: 74.3 ± 12.2; FUEL pre: 73.6 ± 10.3, FUEL post: 75.9 ± 15.7), Social domain (CON pre: 68.1 ± 17.3, CON post: 65.4 ± 18.4; FUEL pre: 72.5 ± 15.7, FUEL post: 76.4 ± 16.1), or Environmental domain (CON pre: 80.7 ± 8.6, CON post: 84.6 ± 10.4; FUEL pre: 81.7 ± 10.9, FUEL post: 85.3 ± 12.8). CONCLUSION: When comparing the FUEL and CON conditions, the results revealed that QOL did not change after the intervention period. This finding might be attributed to the context-specific nature of the FUEL intervention. The intervention content focused exclusively on information related to health and performance outcomes in endurance sport. Another explanation might be attributed to the complexity between various psychological reactions to problematic LEA exposure as they interact with other factors, such as the social environment and level of competition. Nevertheless, future studies need to focus on investigating prospective variability of QOL among female endurance athletes at risk of REDs.
Read CV Bård Erlend SolstadECSS Paris 2023: OP-PN09