scholarly journals Performance and Health Decrements Associated With Relative Energy Deficiency in Sport for Division I Women Athletes During a Collegiate Cross-Country Season: A Case Series

2021 ◽  
Vol 12 ◽  
Author(s):  
David R. Hooper ◽  
Jared Mallard ◽  
Jeff T. Wight ◽  
Kara L. Conway ◽  
George G.A. Pujalte ◽  
...  
Keyword(s):  
Vitamin D ◽  
Body Composition ◽  
Body Mass ◽  
Case Series ◽  
Relative Energy ◽  
Nutritional Intake ◽  
Division I ◽  
Energy Availability ◽  
Energy Deficiency ◽  
Cross Country

The purpose of this case series was to evaluate the presence of low Energy Availability (EA) and its impact on components of Relative Energy Deficiency in Sport (RED-S) in a population of female collegiate runners. Seven female NCAA Division I athletes (age: 22.3 ± 1.5 yrs; height: 169.7 ± 5.7 cm; weight: 58.3 ± 4.1 kg) were tracked from August until February, covering the beginning (Pre XC), end (Post XC) of their competitive cross country season, and beginning of the following track season (Pre Track). The athletes were assessed for female athlete triad (Triad) risk, energy availability, body composition, resting metabolic rate (RMR), nutritional intake, and blood markers (including vitamin D, ferritin, and triiodothyronine (T3)). From Pre XC to Post XC there were no significant differences in body mass, fat free mass or body fat percentage. At Pre XC, mean EA was 31.6 ± 13.3 kcal/kg FFM∙d-1. From Post XC to Pre Track, there was a significant increase in body mass (59.1 ± 5.1 to 60.6 ± 5.7 kg, p<0.001,d=0.27). From Post XC to Pre Track, there was a significant increase in RMR (1466 ± 123.6 to 1614.6 ± 89.1 kcal·d-1, p<0.001,d=2.6). For 25(OH) vitamin D, there was a significant reduction from Pre XC to Post XC (44.1 ± 10.6 vs 39.5 ± 12.2 ng·mL-1, p=0.047,d=-0.4), and a significant increase from Post XC to Pre Track (39.5 ± 12.2 vs. 48.1 ± 10.4 ng·mL-1, p=0.014,d=0.75). For ferritin, there was a trend towards a decrease from Pre XC to Post XC (24.2 ± 13.2 vs. 15.7 ± 8.8 ng·mL-1, p=0.07, d=-0.75), as well as a trend toward an increase from Post XC to Pre Track (15.7 ± 8.8 vs. 34.1 ± 18.0 ng·mL-1, p=0.08, d=1.3). No differences in T3 were observed across time points. Average Triad risk score was 2.3 ± 1.4. Notably, 5 of 7 athletes met criteria for moderate risk. Despite many athletes meeting criteria for low EA and having elevated Triad risk assessment scores, most were able to maintain body mass and RMR. One athlete suffered severe performance decline and a reduced RMR. Surprisingly, she was the only athlete above the recommended value for ferritin. Following increased nutritional intake and reduced training volume, her performance and RMR recovered. Changes in body mass and body composition were not indicative of the presence of other concerns associated with RED-S. This exploratory work serves as a guide for future, larger studies for tracking athletes, using RMR and nutritional biomarkers to assess RED-S.

scholarly journals The LEAF questionnaire is a good screening tool for the identification of the Female Athlete Triad/Relative Energy Deficiency in Sport among young football players

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e12118
Author(s):  
Edyta Łuszczki ◽  
Pawel Jagielski ◽  
Anna Bartosiewicz ◽  
Maciej Kuchciak ◽  
Katarzyna Dereń ◽  
...  
Keyword(s):  
At Risk ◽  
Body Composition ◽  
Energy Intake ◽  
Female Athlete ◽  
Relative Energy ◽  
Screening Tools ◽  
Football Players ◽  
Female Athlete Triad ◽  
Energy Deficiency ◽  
Not At Risk

Background It has been noticed that Female Athlete Triad (Fat) and Relative Energy Deficiency (Red-S) in Sport are characterized by the symptoms of impaired endocrine-metabolic function and bone health in female athletes. In addition, it may be evaluated with a qualitative tool, such as Low Energy Availability in Females questionnaire (LEAF-Q) and quantitative measurements: bone mineral density (BMD), resting energy expenditure (REE), body composition, 24-hour dietary recall. Methods The aim of this study was to assess the prevalence of Triad and Red-S using the LEAF-Q in youth female football players. Additionally, the difference in the BMD, body composition, REE and energy intake (EI) were assessed between the Triad/Red-S risk and not at-risk groups. Results Almost two thirds (64.7%) of participants are classified as being at-risk for the triad according to their LEAF-Q scores. There were no statistically significant differences (p > 0.05) between most of the values among children from the analyzed groups. There was a statistically significant difference (p < 0.001) between the EI values among girls from the two analyzed groups: at-risk (1,773.18 kcal ±  232.57) and not at-risk (2,054.00 kcal ±  191.39). Girls who did not meet the energy intake recommendations were 10.00 as likely to be in the Triad/Red-S risk group. Conclusion Early identification of Fat/Red-S symptoms by screening tools such as the LEAF questionnaire is important in protecting young athletes from long-term damage due to the progression of the risk factors associated with the Fat/Red-S.

Low energy availability surrogates correlate with health and performance consequences of Relative Energy Deficiency in Sport

2018 ◽  
Vol 53 (10) ◽  
pp. 628-633 ◽  
Author(s):  
Kathryn E Ackerman ◽  
Bryan Holtzman ◽  
Katherine M Cooper ◽  
Erin F Flynn ◽  
Georgie Bruinvels ◽  
...  
Keyword(s):  
Female Athletes ◽  
Relative Energy ◽  
Low Energy ◽  
Clinical Population ◽  
Energy Availability ◽  
Energy Deficiency ◽  
Increased Risk ◽  
Performance Consequences ◽  
And Performance ◽  
Low Energy Availability

Low energy availability (EA) is suspected to be the underlying cause of both the Female Athlete Triad and the more recently defined syndrome, Relative Energy Deficiency in Sport (RED-S). The International Olympic Committee (IOC) defined RED-S as a syndrome of health and performance impairments resulting from an energy deficit. While the importance of adequate EA is generally accepted, few studies have attempted to understand whether low EA is associated with the health and performance consequences posited by the IOC.ObjectiveThe purpose of this cross-sectional study was to examine the association of low EA with RED-S health and performance consequences in a large clinical population of female athletes.MethodsOne thousand female athletes (15–30 years) completed an online questionnaire and were classified as having low or adequate EA. The associations between low EA and the health and performance factors listed in the RED-S models were evaluated using chi-squared test and the odds ratios were evaluated using binomial logistic regression (p<0.05).ResultsAthletes with low EA were more likely to be classified as having increased risk of menstrual dysfunction, poor bone health, metabolic issues, haematological detriments, psychological disorders, cardiovascular impairment and gastrointestinal dysfunction than those with adequate EA. Performance variables associated with low EA included decreased training response, impaired judgement, decreased coordination, decreased concentration, irritability, depression and decreased endurance performance.ConclusionThese findings demonstrate that low EA measured using self-report questionnaires is strongly associated with many health and performance consequences proposed by the RED-S models.

Pitfalls of Conducting and Interpreting Estimates of Energy Availability in Free-Living Athletes

2018 ◽  
Vol 28 (4) ◽  
pp. 350-363 ◽  
Author(s):  
Louise M. Burke ◽  
Bronwen Lundy ◽  
Ida L. Fahrenholtz ◽  
Anna K. Melin
Keyword(s):  
Energy Intake ◽  
Good Health ◽  
Relative Energy ◽  
Fat Free Mass ◽  
Energy Availability ◽  
Response Patterns ◽  
Male Athletes ◽  
Energy Deficiency ◽  
Definition Of ◽  
Residual Errors

The human body requires energy for numerous functions including, growth, thermogenesis, reproduction, cellular maintenance, and movement. In sports nutrition, energy availability (EA) is defined as the energy available to support these basic physiological functions and good health once the energy cost of exercise is deducted from energy intake (EI), relative to an athlete’s fat-free mass (FFM). Low EA provides a unifying theory to link numerous disorders seen in both female and male athletes, described by the syndrome Relative Energy Deficiency in Sport, and related to restricted energy intake, excessive exercise or a combination of both. These outcomes are incurred in different dose–response patterns relative to the reduction in EA below a “healthy” level of ∼45 kcal·kg FFM−1·day−1. Although EA estimates are being used to guide and monitor athletic practices, as well as support a diagnosis of Relative Energy Deficiency in Sport, problems associated with the measurement and interpretation of EA in the field should be explored. These include the lack of a universal protocol for the calculation of EA, the resources needed to achieve estimates of each of the components of the equation, and the residual errors in these estimates. The lack of a clear definition of the value for EA that is considered “low” reflects problems around its measurement, as well as differences between individuals and individual components of “normal”/“healthy” function. Finally, further investigation of nutrition and exercise behavior including within- and between-day energy spread and dietary characteristics is warranted since it may directly contribute to low EA or its secondary problems.

2 The prevalence of musculoskeletal injuries, menstrual irregularity and disordered eating in junior elite athletics in the UK

2021 ◽  
Vol 55 (16) ◽  
pp. 940.2-941
Author(s):  
J Wilkinson ◽  
L Mayhew
Keyword(s):  
Disordered Eating ◽  
Sports Medicine ◽  
Injury Risk ◽  
Relative Energy ◽  
Track And Field ◽  
Energy Availability ◽  
Female Athlete Triad ◽  
Menstrual Dysfunction ◽  
Energy Deficiency ◽  
The Uk

The prevalence of injury in adolescent elite track and field competitors is high,1 however only one study has been conducted with UK athletes.2 Relative Energy Deficiency in Sport (RED-S), encapsulating the Female Athlete Triad, is a syndrome whereby decreased energy availability affects health and performance, potentially leading to an increased injury risk; particularly to bone (3). Calculating decreased energy availability is difficult, however identifying contributing factors, such as disordered eating and menstrual dysfunction, is more viable.3AimThis study was conducted to identify the prevalence of musculoskeletal injury, disordered eating and menstrual dysfunction in elite junior UK track and field athletes.MethodData was collected from track and field athletes ranked within the top 10 of the UK U17 rankings in 2017 or 2018, with 138 athletes participating. Participants completed a self-reported musculoskeletal injury, disordered eating and menstrual dysfunction questionnaire relating to a 12-month time period.ResultsThis study found a 12-month retrospective injury prevalence of 43.5%. 13% of participants presented with disordered eating, whilst 37.7% of female participants presented with menstrual dysfunction. There was a statistically significant difference in injury prevalence according to gender, with more male athletes sustaining an injury compared with female athletes. No differences in injury prevalence were noted according to event group, menstrual dysfunction or disordered eating. The anatomical location displaying the highest prevalence of injury was the ankle and foot (22.5%). The anatomical structure displaying the highest 12-month injury prevalence was muscle (43.6%), followed by bone (30.9%). Additionally, 21.7% of respondents reported having previously sustained a stress fracture prior to taking part in this study.ConclusionThere is a high prevalence of injuries in junior UK track and field athletes, with most injuries affecting the lower limb. Although there was no difference noted in injury risk for athletes with menstrual dysfunction or disordered eating, the prevalence of bone injuries was alarmingly high. This study indicates the requirement for future research investigating RED-S within this population.ReferenceZemper, E. Track andField Injuries. In: Caine DJ, Maffulli N. (eds). Epidemiology of Pediatric Sports Injuries. Individual Sports. Med Sport Science: Volume 48. Basel, Karger; 2005. p. 138–151D’Souza D. Track and field athletics injuries - a one-year survey. British Journal of Sports Medicine 1994; 28 (3): 197–202.Mountjoy M, Sundgot-Borgen J, Burke L, et al. The IOC consensus statement: beyond the Female Athlete Triad—Relative Energy Deficiency in Sport (RED-S). British Journal of Sports Medicine 2014; 48: 491–497.

Effect of Vitamin D Supplementation on Body Composition and Physical Fitness in Healthy Adults: A Double-Blind, Randomized Controlled Trial

2019 ◽  
Vol 75 (4) ◽  
pp. 231-237 ◽  
Author(s):  
Xiaomin Sun ◽  
Kumpei Tanisawa ◽  
Yuping Zhang ◽  
Tomoko Ito ◽  
Satomi Oshima ◽  
...  
Keyword(s):  
Vitamin D ◽  
Body Composition ◽  
Physical Fitness ◽  
Lean Body Mass ◽  
Body Mass ◽  
Vitamin D3 ◽  
Vitamin D Supplementation ◽  
Healthy Adults ◽  
Double Blind ◽  
Vitamin D3 Supplementation

Introduction: This study aimed to clarify whether 1 year of vitamin D3 supplementation has a direct effect on body composition and physical fitness in healthy adults. Methods: Ninety-five participants randomly received either 420 IU vitamin D3 per day (n = 48) or placebo (n = 47) in a double-blind manner for 1 year. Lean body mass and percentage body fat were determined. Physical fitness including hand grip strength, leg extension power and cardiorespiratory fitness (CRF) were assessed. Serum 25-hydroxyvitamin D (25[OH]D) and 1,25-dihydroxyvitamin D (1,25[OH]2D) concentrations were assessed using ELISA kits. Results: Serum 25(OH)D and (1,25[OH]2D) concentrations significantly increased by approximately 11.2 ± 9.2 ng/mL (pinteraction <0.001)and 7.0 ± 7.8 pg/mL (pinteraction <0.001) after 1 year of vitamin D3 supplementation respectively. Lean body mass significantly increased from 43.8 ± 9.6 to 44.3 ± 9.8 kg in vitamin D group, while no change was observed in placebo group (from 42.6 ± 8.9 to 42.4± 8.9 kg) after 1 year intervention. Furthermore, no treatment effects on other indicators of body composition and physical fitness were observed. Conclusions:One year of vitamin D supplementation effectively improves lean body mass, but not muscle strength and CRF in healthy adults.

Association of serum 25-hydroxy vitamin D and body mass index in cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 6625-6625
Author(s):  
D. Gupta ◽  
K. Trukova ◽  
P. G. Vashi ◽  
A. Adams ◽  
G. M. Lambert ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Vitamin D ◽  
Cancer Patients ◽  
Body Mass ◽  
Case Series ◽  
Spearman Correlation ◽  
Dietary Recommendations ◽  
25 Hydroxy Vitamin D ◽  
The Mean ◽  
The Relationship

6625 Background: The association between vitamin D and obesity remains unsettled with studies reporting conflicting findings on the relationship between the two. This association assumes even greater importance in cancer because of the alleged role of vitamin D in cancer risk and survival. Currently, the dietary recommendations for Vitamin D do not take into account a person's body mass index (BMI). We investigated the relationship between serum 25-hydroxy-vitamin D [25(OH)D] and BMI in a large sample of cancer patients. Methods: A consecutive case series of 740 cancer patients seen at Cancer Treatment Centers of America from Jan 08 to June 08. Serum 25(OH)D was measured at presentation to the hospital. The cohort was divided in 4 BMI groups (<18.5, 18.5–24.9, 25–29.9, and >30.0 kg/m2). Correlation between 25(OH)D and BMI was evaluated using Spearman correlation coefficient. Mean 25(OH)D was compared across the 4 BMI groups using ANOVA. Linear regression was used to quantify the relationship between BMI and 25(OH)D. Results: Of 740 patients, 303 were males and 437 females. The mean age at presentation was 55.7 years (SD = 10.2). The mean BMI was 27.9 kg/m2 (SD = 6.7). Most common cancers were lung (134, 18.1%), breast (131, 17.7%), colorectal (97, 13.1%), pancreas (86, 11.6%), prostate (45, 6.1%) and ovarian (39, 5.3%). The mean serum 25(OH)D was 21.9 ng/ml (SD = 13.5). Analysis revealed that as BMI groups increased from normal to overweight or obese classifications, there was a significant decrease in 25(OH)D (Table). The Spearman correlation between 25(OH)D and BMI was -0.20 (p = 0.001). Every 1 kg/m2 increase in BMI was significantly associated with a 0.43 ng/ml decline in serum 25(OH)D (p = 0.001). Conclusions: We found that obese cancer patients (BMI >=30 kg/m2) had significantly lower levels of serum 25(OH)D as compared to nonobese patients (BMI <30 kg/m2). BMI should be taken into account when assessing a patient's vitamin D status and more aggressive vitamin D supplementation should be considered in obese cancer patients. [Table: see text] No significant financial relationships to disclose.

scholarly journals Seasonal Body Composition Changes in Division I Cross Country Runners

2019 ◽  
Vol 51 (Supplement) ◽  
pp. 909
Author(s):  
Katie R. Hirsch ◽  
Malia N.M. Blue ◽  
Gabrielle J. Brewer ◽  
Austin M. Peterjohn ◽  
Abbie E. Smith-Ryan
Keyword(s):  
Body Composition ◽  
Division I ◽  
Cross Country ◽  
Cross Country Runners ◽  
Composition Changes

Characterization of Risk Quantification Differences Using Female Athlete Triad Cumulative Risk Assessment and Relative Energy Deficiency in Sport Clinical Assessment Tool

2019 ◽  
Vol 29 (6) ◽  
pp. 569-575 ◽  
Author(s):  
Bryan Holtzman ◽  
Adam S. Tenforde ◽  
Allyson L. Parziale ◽  
Kathryn E. Ackerman
Keyword(s):  
Female Athlete ◽  
Assessment Tool ◽  
Cumulative Risk ◽  
Relative Energy ◽  
Risk Level ◽  
Energy Availability ◽  
Female Athlete Triad ◽  
Mineral Density ◽  
Energy Deficiency ◽  
Low Energy Availability

This study’s objective was to identify differences in risk for low energy availability and athletic clearance level by comparing scores on Female Athlete Triad Cumulative Risk Assessment (Triad CRA) and Relative Energy Deficiency in Sport Clinical Assessment Tool (RED-S CAT). A total of 1,000 female athletes aged 15–30 years participating in ≥4 hr of physical activity/week for the previous ≥6 months completed an extensive survey assessing health, athletic history, family disease history, and specific Triad/RED-S risk factors. Retrospective chart review ascertained laboratory and bone mineral density measures. Triad CRA and RED-S CAT were used to assign each athlete’s risk level (low, moderate, and high), and case-by-case comparison measured the level of agreement between the tools. We hypothesized that the tools would generally agree on low-risk athletes and that the tools would be less aligned in the specific elevated risk level (moderate or high). Most of the sample was assigned moderate or high risk for Triad CRA and RED-S CAT (Triad: 54.7% moderate and 7.9% high; RED-S: 63.2% moderate and 33.0% high). The tools agreed on risk for 55.5% of athletes. Agreement increased to 64.3% when only athletes with bone mineral density measurements were considered. In conclusion, Triad CRA and RED-S CAT provide consensus on the majority of athletes at elevated (moderate or high) risk for low energy availability, but have less agreement on the specific risk level assigned.

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