scholarly journals Examination of Energy Balance, Eating Disorder Risk, and Pathogenic Behaviors among Athletic Trainers

2020 ◽  
Author(s):  
Toni M. Torres-McGehee ◽  
Dawn M. Emerson ◽  
Erin M. Moore ◽  
Stacy Walker ◽  
Kelly Pritchett ◽  
...  

Abstract CONTEXT: Research exists on energy balance (EB) and eating disorder (ED) risk in physically active populations and occupations by settings, but EB and ED in athletic trainers (ATs) has not been investigated. OBJECTIVE: To assess ATs' energy needs, including macronutrient profile, and to examine ED risk and pathogenic behavior between sex (males, females), job status (part-time=PT-AT; full-time=FT-AT) and setting (college/university, high school, non-traditional). DESIGN: Cross-sectional and descriptive. SETTING: Free-living in job settings. PARTICIPANT: ATs (n=46; males PT-AT n=12, males FT-AT n=11; females PT-AT n=11, female FT-AT n=12) in Southeastern United States. MAIN OUTCOME MEASURES: Anthropometric measurements (age, height, weight, body composition), resting metabolic rate (RMR), energy intake (EI), total daily energy expenditure (TDEE), exercise energy expenditure (EEE), EB, macronutrients (carbohydrates, protein, fats), Eating Disorder Inventory-3, and the Eating Disorder Inventory-3 Symptom Checklist. RESULTS: Majority (84.8%, n=39) had ED risk, with 26.1% (n=12) engaging in at least 1 pathogenic behavior, 50% (n=23) in 2 pathogenic behaviors, and 10.8% (n=5) in more than 2 pathogenic behaviors. 82.6% of ATs (n=38) presented in negative EB (EI<TDEE). Significant differences were found for sex and job status for RMR (F(1,45)=16.48, P=.001), EI (F(1,45)=12.01, P=.001), TDEE (F(1,45)=40.36, P<.001) and EEE (F(1,38)=5.353, P=.026). No significant differences were found in EB, sex and job status (F(1.45)=1.751, P=.193); Chi-squared analysis revealed no significant differences between ATs' sex and EB [χ2(1,46)=0.0, P=1.00] and job status and EB χ2(1,46) = 2.42, P= 0.120]. No significant difference found between Daily Reference Intakes recommendations for all macronutrients and sex or job status. CONCLUSIONS: Athletic trainers experience negative EB, similar to other high-demand occupational professions. Regardless of sex or job status, ATs have a high ED risk and participate in unhealthy pathogenic behaviors. The physical and mental concerns associated with these findings indicates a need for interventions targeted toward ATs' health behaviors.

2021 ◽  
Vol 56 (3) ◽  
pp. 311-320
Author(s):  
Toni Marie Torres-McGehee ◽  
Dawn M. Emerson ◽  
Erin M. Moore ◽  
Stacy E. Walker ◽  
Kelly Pritchett ◽  
...  

Context Research exists on energy balances (EBs) and eating disorder (ED) risks in physically active populations and occupations by settings, but the EB and ED risk in athletic trainers (ATs) have not been investigated. Objective To assess ATs' energy needs, including the macronutrient profile, and examine ED risk and pathogenic behavioral differences between sexes (men, women) and job statuses (part time or full time) and among settings (college or university, high school, nontraditional). Design Cross-sectional study. Setting Free living in job settings. Patients or Other Participants Athletic trainers (n = 46; male part-time graduate assistant ATs = 12, male full-time ATs = 11, female part-time graduate assistant ATs = 11, female full-time ATs = 12) in the southeastern United States. Main Outcome Measure(s) Anthropometric measures (sex, age, height, weight, body composition), demographic characteristics (job status [full- or part-time AT], job setting [college/university, high school, nontraditional], years of AT experience, exercise background, alcohol use), resting metabolic rate, energy intake (EI), total daily energy expenditure (TDEE), EB, exercise energy expenditure, macronutrients (carbohydrates, protein, fats), the Eating Disorder Inventory-3, and the Eating Disorder Inventory-3 Symptom Checklist. Results The majority of participants (84.8%, n = 39) had an ED risk, with 26.1% (n = 12) engaging in at least 1 pathogenic behavior, 50% (n = 23) in 2 pathogenic behaviors, and 10.8% (n = 5) in >2 pathogenic behaviors. Also, 82.6% of ATs (n = 38) presented in negative EB (EI < TDEE). Differences were found in resting metabolic rate for sex and job status (F1,45 = 16.48, P = .001), EI (F1,45 = 12.01, P = .001), TDEE (F1,45 = 40.36, P < .001), and exercise energy expenditure (F1,38 = 5.353, P = .026). No differences were present in EB for sex and job status (F1,45 = 1.751, P = .193); χ2 analysis revealed no significant relationship between ATs' sex and EB (\(\def\upalpha{\unicode[Times]{x3B1}}\)\(\def\upbeta{\unicode[Times]{x3B2}}\)\(\def\upgamma{\unicode[Times]{x3B3}}\)\(\def\updelta{\unicode[Times]{x3B4}}\)\(\def\upvarepsilon{\unicode[Times]{x3B5}}\)\(\def\upzeta{\unicode[Times]{x3B6}}\)\(\def\upeta{\unicode[Times]{x3B7}}\)\(\def\uptheta{\unicode[Times]{x3B8}}\)\(\def\upiota{\unicode[Times]{x3B9}}\)\(\def\upkappa{\unicode[Times]{x3BA}}\)\(\def\uplambda{\unicode[Times]{x3BB}}\)\(\def\upmu{\unicode[Times]{x3BC}}\)\(\def\upnu{\unicode[Times]{x3BD}}\)\(\def\upxi{\unicode[Times]{x3BE}}\)\(\def\upomicron{\unicode[Times]{x3BF}}\)\(\def\uppi{\unicode[Times]{x3C0}}\)\(\def\uprho{\unicode[Times]{x3C1}}\)\(\def\upsigma{\unicode[Times]{x3C3}}\)\(\def\uptau{\unicode[Times]{x3C4}}\)\(\def\upupsilon{\unicode[Times]{x3C5}}\)\(\def\upphi{\unicode[Times]{x3C6}}\)\(\def\upchi{\unicode[Times]{x3C7}}\)\(\def\uppsy{\unicode[Times]{x3C8}}\)\(\def\upomega{\unicode[Times]{x3C9}}\)\(\def\bialpha{\boldsymbol{\alpha}}\)\(\def\bibeta{\boldsymbol{\beta}}\)\(\def\bigamma{\boldsymbol{\gamma}}\)\(\def\bidelta{\boldsymbol{\delta}}\)\(\def\bivarepsilon{\boldsymbol{\varepsilon}}\)\(\def\bizeta{\boldsymbol{\zeta}}\)\(\def\bieta{\boldsymbol{\eta}}\)\(\def\bitheta{\boldsymbol{\theta}}\)\(\def\biiota{\boldsymbol{\iota}}\)\(\def\bikappa{\boldsymbol{\kappa}}\)\(\def\bilambda{\boldsymbol{\lambda}}\)\(\def\bimu{\boldsymbol{\mu}}\)\(\def\binu{\boldsymbol{\nu}}\)\(\def\bixi{\boldsymbol{\xi}}\)\(\def\biomicron{\boldsymbol{\micron}}\)\(\def\bipi{\boldsymbol{\pi}}\)\(\def\birho{\boldsymbol{\rho}}\)\(\def\bisigma{\boldsymbol{\sigma}}\)\(\def\bitau{\boldsymbol{\tau}}\)\(\def\biupsilon{\boldsymbol{\upsilon}}\)\(\def\biphi{\boldsymbol{\phi}}\)\(\def\bichi{\boldsymbol{\chi}}\)\(\def\bipsy{\boldsymbol{\psy}}\)\(\def\biomega{\boldsymbol{\omega}}\)\(\def\bupalpha{\bf{\alpha}}\)\(\def\bupbeta{\bf{\beta}}\)\(\def\bupgamma{\bf{\gamma}}\)\(\def\bupdelta{\bf{\delta}}\)\(\def\bupvarepsilon{\bf{\varepsilon}}\)\(\def\bupzeta{\bf{\zeta}}\)\(\def\bupeta{\bf{\eta}}\)\(\def\buptheta{\bf{\theta}}\)\(\def\bupiota{\bf{\iota}}\)\(\def\bupkappa{\bf{\kappa}}\)\(\def\buplambda{\bf{\lambda}}\)\(\def\bupmu{\bf{\mu}}\)\(\def\bupnu{\bf{\nu}}\)\(\def\bupxi{\bf{\xi}}\)\(\def\bupomicron{\bf{\micron}}\)\(\def\buppi{\bf{\pi}}\)\(\def\buprho{\bf{\rho}}\)\(\def\bupsigma{\bf{\sigma}}\)\(\def\buptau{\bf{\tau}}\)\(\def\bupupsilon{\bf{\upsilon}}\)\(\def\bupphi{\bf{\phi}}\)\(\def\bupchi{\bf{\chi}}\)\(\def\buppsy{\bf{\psy}}\)\(\def\bupomega{\bf{\omega}}\)\(\def\bGamma{\bf{\Gamma}}\)\(\def\bDelta{\bf{\Delta}}\)\(\def\bTheta{\bf{\Theta}}\)\(\def\bLambda{\bf{\Lambda}}\)\(\def\bXi{\bf{\Xi}}\)\(\def\bPi{\bf{\Pi}}\)\(\def\bSigma{\bf{\Sigma}}\)\(\def\bPhi{\bf{\Phi}}\)\(\def\bPsi{\bf{\Psi}}\)\(\def\bOmega{\bf{\Omega}}\)\({\rm{\chi }}_{1,46}^2\)= 0.0, P = 1.00) and job status and EB (\({\rm{\chi }}_{1,46}^2\) = 2.42, P = .120). No significant relationship existed between Daily Reference Intakes recommendations for all macronutrients and sex or job status. Conclusions These athletic trainers experienced negative EB, similar to other professionals in high-demand occupations. Regardless of sex or job status, ATs had a high ED risk and participated in unhealthy pathogenic behaviors. The physical and mental concerns associated with these findings indicate a need for interventions targeted at ATs' health behaviors.


1998 ◽  
Vol 84 (4) ◽  
pp. 1333-1340 ◽  
Author(s):  
R. T. Withers ◽  
D. A. Smith ◽  
R. C. Tucker ◽  
M. Brinkman ◽  
D. G. Clark

This study examined differences between long-term exercising (LE) and long-term nonexercising (LNE) women [ n = 24; age 56.4 ± 6.2 (SD) yr] for resting metabolic rate (RMR) and energy expenditure in the free-living state by using doubly labeled water (DLW). There was a statistically significant difference ( P = 0.0002) between the 12 LE (94.85 ± 8.44 kJ ⋅ kg−1 ⋅ day−1) and 12 LNE (81.16 ± 6.62 kJ ⋅ kg−1 ⋅ day−1) for RMR, but this difference was only marginally significant ( P = 0.06) when the data (MJ/day) were subjected to an analysis of covariance with fat-free mass as the covariate. The DLW data indicated that the eight most active LE (12.99 ± 3.58 MJ/day) expended significantly ( P = 0.01) more energy than did the eight least active LNE (9.30 ± 1.15 MJ/day). Energy expenditures ranged from 7.64 to 18.15 MJ/day, but there was no difference ( P = 0.96) between the LE and LNE in energy expenditure during activity that was not designed to either improve or maintain fitness. These cross-sectional data on 49- to 70-yr-old women therefore suggest that 1) aerobic-type training results in a greater RMR per unit of body mass and also when statistical control is exerted for the effect of the metabolically active fat-free mass, 2) there is a large range in the energy intake necessary to maintain energy balance, and 3) aerobic training does not result in a compensatory reduction in energy expenditure during the remainder of the day.


2015 ◽  
Vol 75 (3) ◽  
pp. 319-327 ◽  
Author(s):  
David J. Clayton ◽  
Lewis J. James

The belief that breakfast is the most important meal of day has been derived from cross-sectional studies that have associated breakfast consumption with a lower BMI. This suggests that breakfast omission either leads to an increase in energy intake or a reduction in energy expenditure over the remainder of the day, resulting in a state of positive energy balance. However, observational studies do not imply causality. A number of intervention studies have been conducted, enabling more precise determination of breakfast manipulation on indices of energy balance. This review will examine the results from these studies in adults, attempting to identify causal links between breakfast and energy balance, as well as determining whether consumption of breakfast influences exercise performance. Despite the associations in the literature, intervention studies have generally found a reduction in total daily energy intake when breakfast is omitted from the daily meal pattern. Moreover, whilst consumption of breakfast supresses appetite during the morning, this effect appears to be transient as the first meal consumed after breakfast seems to offset appetite to a similar extent, independent of breakfast. Whether breakfast affects energy expenditure is less clear. Whilst breakfast does not seem to affect basal metabolism, breakfast omission may reduce free-living physical activity and endurance exercise performance throughout the day. In conclusion, the available research suggests breakfast omission may influence energy expenditure more strongly than energy intake. Longer term intervention studies are required to confirm this relationship, and determine the impact of these variables on weight management.


Author(s):  
Heidi K. Byrne ◽  
Jack H. Wilmore

The present cross-sectional study was designed to investigate the relationship between exercise training and resting metabolic rate (RMR). The focus of this investigation was to compare RMR in aerobically trained (AT), resistance trained (RT), and untrained (UNT) women. Subjects were also classified as highly trained (HT), moderately trained (MT), or untrained (UNT) in order to examine the relationship between RMR and level of training. Sixty-one women between the ages of 18 and 46 years volunteered to serve as subjects in this study. Each subject completed measurements of body composition, maximal oxygen uptake (V̇O2max), and two consecutive measurements of RMR. The data presented show that there was no significant difference in resting metabolic rate between resistance-trained, aerobically trained, and control subjects. However, when grouped by intensity of training, there was a trend for an increased resting metabolic rate (kcal/day) in the highly trained subjects, regardless of mode of training.


2018 ◽  
Vol 30 (4) ◽  
pp. 506-515 ◽  
Author(s):  
Keren Susan Cherian ◽  
Ashok Sainoji ◽  
Balakrishna Nagalla ◽  
Venkata Ramana Yagnambhatt

Purpose: To evaluate energy expenditure, energy intake, and nutrient adequacy of Indian junior soccer players. Method: Forty junior national-level soccer players (Under-12 and Under-16 age groups) were assessed for 3-day weighed food records and 3-day energy expenditure. Energy and nutrient intake was analyzed from food records, and energy expenditure was measured using a portable metabolic analyzer and activity records. Nutrient adequacy was determined by comparing intake with prevailing recommendations. Results: Players exhibited no significant difference between energy intake (boys = 3062 [340.9] and girls = 2243 [320.3] kcal·d−1) and expenditure (boys = 2875 [717.3] and girls = 2442 [350.3] kcal·d−1). Across age groups, the Under-12 boys showed positive energy balance as against energy deficits in Under-16. Girls showed energy deficits, although not significant. There were 58% of girls showing energy availability <30 kcal·kg−1 fat-free mass, of which 37% were Under-16 players. Carbohydrates contributed to >60% of energy expenditure among 95.2% boys and 73.7% girls. Among 52.4% boys and 47.4% girls, <25% of energy expenditure was contributed by fat. More than 95% players consumed <1 g·kg−1 carbohydrates pretraining and 100% of them consumed >1.2 g·kg−1 carbohydrates posttraining. Conclusion: Junior soccer players consumed more than recommended carbohydrates in the diet, although not aligning with the pretraining, during training, and posttraining meal requirements. Considering the energy deficits observed among Under-16 players, a suitable dietary modification is warranted.


Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3394
Author(s):  
Sarah A. Purcell ◽  
Ryan J. Marker ◽  
Marc-Andre Cornier ◽  
Edward L. Melanson

Many breast cancer survivors (BCS) gain fat mass and lose fat-free mass during treatment (chemotherapy, radiation, surgery) and estrogen suppression therapy, which increases the risk of developing comorbidities. Whether these body composition alterations are a result of changes in dietary intake, energy expenditure, or both is unclear. Thus, we reviewed studies that have measured components of energy balance in BCS who have completed treatment. Longitudinal studies suggest that BCS reduce self-reported energy intake and increase fruit and vegetable consumption. Although some evidence suggests that resting metabolic rate is higher in BCS than in age-matched controls, no study has measured total daily energy expenditure (TDEE) in this population. Whether physical activity levels are altered in BCS is unclear, but evidence suggests that light-intensity physical activity is lower in BCS compared to age-matched controls. We also discuss the mechanisms through which estrogen suppression may impact energy balance and develop a theoretical framework of dietary intake and TDEE interactions in BCS. Preclinical and human experimental studies indicate that estrogen suppression likely elicits increased energy intake and decreased TDEE, although this has not been systematically investigated in BCS specifically. Estrogen suppression may modulate energy balance via alterations in appetite, fat-free mass, resting metabolic rate, and physical activity. There are several potential areas for future mechanistic energetic research in BCS (e.g., characterizing predictors of intervention response, appetite, dynamic changes in energy balance, and differences in cancer sub-types) that would ultimately support the development of more targeted and personalized behavioral interventions.


2014 ◽  
Vol 6 (3) ◽  
pp. 49-57 ◽  
Author(s):  
Fiekumo Igbida Buseri ◽  
Charity Ngozi Okonkwo

Background: This study aims at investigating the seroprevalence of HIV infection among status naive pregnant women and probable vertical transmission in Sokoto, Nigeria.Materials and Methods: This cross-sectional study examined 13,026 apparently healthy pregnant women aged between 14 and 45 years and 312 mother-baby pairs in 4 different hospital settings in Sokoto State, North West, Nigeria between March, 2011 and February, 2013. The babies were aged between 8 and 16 months. HIV screening was performed using qualitative rapid tests and ELISA and HIV-DNA polymerase chain reaction (PCR) techniques. Measurement of CD4+ T-lymphocytes was carried out by the BD FACScount System. All seropositive pregnant women were immediately placed on triple antiretroviral therapy (ART) throughout the duration of the pregnancy and beyond.Results: An overall 2.4% prevalence of HIV-1 infection among the pregnant women and 20.5% incident of mother-to-child transmission were found. Of the seropositive pregnant women, 75.0% were full-time house wives, 13.8% and 11.2% were traders and civil servants respectively; of which, 70.2% were within the ages of 14 and 27 years (youthful predominance). Pearson’s χ2analysis did not show any statistically significant difference in the Mean values in the 4 health facilities (χ2 =2.084, df=3, P-value=0.555). Similarly, no significant difference in HIV seropositivity in the demographic data of the pregnant women were observed (P>0.05). Infection was recorded in all age groups but there was no statistical significance between age groups and infection (P = 0.833). Of the 64 seropositive babies, 62 (92.5%) contracted HIV from antiretroviral therapy non-adherence mothers (χ2 =271.457, df=1, P<0.01), OR=1506.6 (95%CI=285.5-7950.4). Conclusion: This study found high prevalence of vertical transmission due to ART non-adherence. Intervention initiatives should, therefore, focus seriously on ART non-adherence. DOI: http://dx.doi.org/10.3126/ajms.v6i3.11530Asian Journal of Medical Sciences Vol.6(3) 2015 49-57  


2019 ◽  
Vol 25 (1) ◽  
pp. 20-23 ◽  
Author(s):  
Mateus Ahlert ◽  
Fernando Matzenbacher ◽  
José Carlos dos Santos Albarello ◽  
Gustavo Henrique Halmenschlager

ABSTRACT Objectives: The objective of this study was to compare EPOC - excess post-exercise oxygen consumption and recovery energy expenditure between high intensity interval aerobic exercise (HIIT) and continuous aerobic exercise in adult amateur runners. Methods: The study included 10 runners, with a mean age of 35.7 ± 5.87 years, height 1.69 ± 0.11 m; body mass 74.13 ± 11.26 kg; fat percentage 19.31 ± 4.27% and maximal oxygen consumption (VO2max) of 3.50 ± 0.64 l/kg/min-1. The continuous aerobic exercise protocol consisted of 20 minutes of running with intensity of 70-75% HRmax. Two 20-second cycles of 8 sprints were performed for HIIT at the highest possible speed, with 10 seconds of rest and a 3-minute interval between cycles. The sample group performed the two protocols at least 48 hours and at most one week apart. EPOC was observed using ergospirometry after the running protocols, and mean consumption was analyzed between 25-30 minutes after exercise. Oxygen consumption at 9-10 minutes was used for resting consumption. The study has a cross-sectional experimental design. Results: Oxygen consumption of 0.57 ± 0.29l/kg/min1 and energy expenditure of 2.84 ± 1.44 kcal/min were observed for continuous aerobic exercise, with values of 0.61 ± 0.62 l/kg/min−1 and 3.06 ± 1.10 kcal/min respectively (p <0.05) for HIIT. Conclusion: The protocols performed did not show a statistically significant difference in terms of EPOC and energy expenditure, but the performance of HIIT increased lipid metabolism for exercise recovery, which may favor the weight loss process. Moreover, this activity model takes up less time. Level of evidence I, randomized clinical trial.


1994 ◽  
Vol 75 (1) ◽  
pp. 51-56 ◽  
Author(s):  
Michael J. Herkov ◽  
Richard A. Greer ◽  
Burton I. Blau ◽  
John M. McGuire ◽  
Donald Eaker

This study examined two aspects of psychodynamic theory concerning bulimia nervosa, that bulimic patients ascribe to a traditionally feminine sex-role and that bulimic women have difficulty differentiating emotional from visceral sensations. 18 bulimic and 18 control women were administered the Bern Sex-role Inventory and the Eating Disorder Inventory. Contrary to dynamic theory, bulimic women were not more likely classified as traditionally feminine than control subjects; however, significantly more controls than bulimic women were classified as androgynous. Analysis of scores on the Eating Disorder Inventory's Interoceptive Awareness scale indicated a significant difference between bulimic persons and controls, providing strong support for the hypothesis that bulimic women have a difficult time differentiating emotional from visceral sensations.


Author(s):  
Sarah L McLennan ◽  
Amanda Henry ◽  
Lynne M Roberts ◽  
Sai S Siritharan ◽  
Melissa Ojurovic ◽  
...  

Abstract Background Preeclampsia is a major pregnancy complication associated with long-term maternal cardiometabolic disease. Research generally is focused on metabolic and pathophysiological changes during pregnancy, however, there is much less focus on the early postpartum period in subjects who suffered preeclampsia. The aim of this study was to (a) characterise energy intake and expenditure six months following normotensive and preeclamptic pregnancies, and (b) examine associations between energy balance, body composition, insulin resistance measures (HOMA-IR), and clinical characteristics. Design A cross-sectional study six months following normotensive (n=75) and preeclamptic (n=22) pregnancies was performed. Metabolic measurements included: anthropometrics measures, body composition via bioelectrical impedance analysis, 24-hour energy expenditure via SenseWear Armbands, energy intake via a three-day food diary, and serum metabolic parameters. Results Six months following preeclampsia, women had a significantly higher weight (77.3±20.9kg versus 64.5±11.4kg, p=0.01), fat mass percentage (FM%) (40.7±7.4% versus 34.9±8.1%, p=0.004), and insulin resistance (HOMA-IR 2.2±1.5 versus 1.0±0.7, p=0.003), as well as reduced HDL levels (1.5±0.4 mmol/L versus 1.8±0.4 mmol/L, p=0.01) compared to normotensive women. Women post-preeclampsia had lower activity-related energy expenditure (p=0.02) but a decreased total energy intake (p=0.02), leading to a more negative energy balance compared to their normotensive counterparts (-1,942 kJ/24-hours versus -480 kJ/24-hours; p=0.02). Conclusion Increases in insulin resistance and FM%, reduced HDL, and more sedentary lifestyles characterise the postpartum period following preeclamptic compared with normotensive pregnancies. Early post-preeclampsia interventions, such as lifestyle behaviour change, should be implemented and assessed to determine whether they reduce long-term cardiometabolic risk in women who experienced preeclampsia during pregnancy.


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