Risk of Low Energy Availability, Disordered Eating, and Menstrual Dysfunction in Female Collegiate Runners.

CONTEXT: Collegiate female distance runners may be at risk for low energy availability (LEA) due to increased exercise energy expenditure with or without decreased energy intake. Furthermore, this population has increased risk of disordered eating (DE), which can lead to LEA and negative health consequences, such as menstrual dysfunction (MD). OBJECTIVE: 1) investigate risk of LEA and DE, 2) compare DE, training volume, and weight dissatisfaction among female collegiate runners at risk vs not at risk for LEA, and 3) compare risk for LEA between NCAA (National Collegiate Athletics Association) Division I, II, and III female collegiate runners. DESIGN: Cross-sectional study. SETTING: Free-living. PATIENTS OR OTHER PARTICIPANTS: Female runners (n = 287) who competed on an NCAA (National Collegiate Athletics Association) Division I, II, or III cross-country and/or track team. MAIN OUTCOME MEASURE(S): A 45 question questionnaire was completed which included the Low Energy Availability in Females Questionnaire (LEAF-Q) and the Disordered Eating Screening Assessment (DESA-6). RESULTS: 54.5% (n = 156) of runners were at risk for LEA (score ≥ 8 on LEAF-Q), and 40.8% (n = 117) were at risk for DE (DESA-6 score ≥ 3), and 56.5% (n = 162) reported MD (LEAF-Q subsection MD score ≥ 4). Athletes "at risk" for LEA had significantly higher DESA-6 scores than athletes "not at risk" for LEA (p < 0.001). Athletes "at risk" for LEA had significantly greater weight dissatisfaction than those not at risk for LEA (X23, 156 = 15.92, p = 0.001). Higher weekly training volumes was not associated with risk for LEA (X22, 156 = 4.20, p = 0.112). CONCLUSIONS: A substantial percentage of collegiate female runners were found to be at risk for LEA, DE, and report MD. These findings demonstrate that risk for DE, MD, and weight dissatisfaction are associated with risk for LEA.

Longitudinal monitoring of workloads in women's division I (DI) collegiate basketball across four training periods.

Women's collegiate basketball is a fast-growing, dynamic sport that spans 8 or more months, with athletes competing in 30 + games in a season. The aim of this study was to quantify and profile the external load of practices and games during a Power-5 DI Women's Collegiate Basketball season. Specifically, Average PlayerLoad (PL), PlayerLoad per minute (PL*min-1), High Inertial Movement Analysis (High-IMA), and Jumps were quantified using Catapult Openfield software during four distinct training periods of the year: 8-hour preseason, 20-hour preseason, non-conference, and conference game play. Weekly variations and acute to chronic workload ratios (ACWR) were also examined. Eleven subjects participated in daily external load monitoring during practice and games via Catapult's ClearSky T6 inertial measurement units (IMU). Averages, standard deviations, and confidence intervals were calculated for training period comparisons, and Cohen's d was calculated as a measure of effect size. Findings include normative values to provide context for the demands experienced across an entire season. PL was significantly higher during non-conference play than during any of the other three training periods (p < 0.05). Descriptive data enumerate percent change and ACRW variations throughout the season. These data can be used to describe the physical demands across a season and provide physical profile guidelines for coaches.

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.

Self Reported History of Eating Disorders, Training, Weight Control Methods, and Body Satisfaction in Elite Female Runners Competing at the 2020 U.S. Olympic Marathon Trials.

Athletes participating in endurance sports report frequent attempts to lose weight and greater training volumes in attempt to gain a competitive advantage. Increased exercise energy expenditure through training, weight periodization, and prevalence of eating disorder (ED) may affect energy availability. Low energy availability (LEA) is associated with negative physiological effects and an increased risk of bone fractures and illness in athletes. This study investigated the relationship between self-reported history of an ED with training, body satisfaction, and weight-control methods among female Olympic marathon trials participants. Female runners (n = 146; 30.8 ± 5.0 years of age) who participated in the 2020 U.S. Olympic Team Trials Marathon completed an online questionnaire examining training volume, weight-control methods, and self-reported diagnosis of an ED. 32% of participants reported previous ED while 6% reported a current ED and were grouped together based on a self-reported lifetime diagnosis of ED (current or past) or no ED for further analysis. A Chi-square analysis indicated a statistical difference when p ≤ 0.05. Runners who reported ED were significantly more likely to experience weight dissatisfaction (χ2 3,146 = 9.59, p = .022) and restricting or reducing food in the three months prior to the marathon (χ2 5,146 = 17.58, p = .004). Consistent with previous literature, a substantial percentage of participants reported ED. This investigation suggests that ED may be associated with weight control methods and feelings of body dissatisfaction in competitive female runners.

Resilience, Psychological Stress, Physical Activity, and BMI among United States Air National Guardsmen: The COVID-19 Pandemic.

Background: Military service members carry the responsibility to maintain physical and psychological readiness. As such, it is critical for researchers to begin unravelling the widespread impact of the COVID-19 pandemic on service member's mental and physical wellbeing. The aim of this research was to investigate the complex relationships between BMI, physical activity, psychological stress and resilience among United States Air National Guardsmen (USANG), specifically during the pandemic. Methods: An online survey was distributed to USANG members. The survey included measures of resilience (CD-RISC-25), perceived psychological stress (PSS), perceived psychological stress brought on by COVID-19 (COVID-19 PSL), current levels of physical activity (IPAQ-SF), perceived impact on physical activity brought on by COVID-19 (COVID-19 PAL), and BMI. Pearson's correlation coefficients (r) were used to assess correlation significance (α ≤ 0.05), direction, and magnitude. Results: A total of 110 responses met inclusion criteria for data interpretation. A majority reported a decline in physical activity 54.5%, while 60% reported an increase in psychological stress. According to BMI classifications, 60.9% were considered overweight or obese. Seven meaningful (effect size ≥ |2.0|) and statistically significant salient associations were identified resilience-PSS r = -0.38; resilience-COVID-19 PAL r = 0.21; PSS-COVID-19 PSL r = 0.35; PSS-COVID-19 PAL r = -0.23; COVID-19 PSL COVID-19 PAL r = -0.24; IPAQ-SF-BMI r = -0.23; BMI-Covid-19 PAL r = -0.32. Conclusion: Key outcomes suggest resilience is inversely associated with assessed and perceived stress, resilience may influence health-related behaviour which subsequently might aid as a protective factor against psychological stress. Knowledge regarding the relationships between the aforementioned variables may help inform decisions by military leadership regarding future lockdowns.

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.

Acute Supplementation with Molecular Hydrogen Benefits Submaximal Exercise Indices. Randomized, Double-Blinded, Placebo-Controlled Crossover Pilot Study.

BACKGROUND: Clinical studies have reported hydrogen-rich water (HRW) to have therapeutic and ergogenic effects. The aim of this study was to determine the effect of acute supplementation with HRW on exercise performance as measured by VO2, respiratory exchange ratio (RER), heart rate (HR), and respiratory rate (RR). METHODS: Baseline levels of all exercise indices were determined in nineteen (4 female, 23.4 ± 9.1 yr; 15 male, 30.5 ± 6.8 yr) healthy subjects using a graded treadmill exercise test to exhaustion. Each subject was examined two additional times in a randomized double-blinded, placebo-controlled crossover fashion. Subjects received either HRW or placebo, which was consumed the day before and the day of the testing. HRW was delivered using the hydrogen-producing tablets, DrinkHRW (5 mg of H2). All data was analyzed with SPSS using pairwise comparisons with Bonferroni adjustment. RESULTS: HRW supplementation did not influence maximal or minimal indices of exercise performance (VO2, RER, HR and RR) (p < 0.05). However, HRW significantly decreased average exercising RR and HR (p < 0.05). HRW decreased exercising HR during minutes 1-9 of the graded exercise test (121 ± 26 bpm) compared to placebo (126 ± 26 bpm) and baseline (124 ± 27 bpm) (p < 0.001) without substantially influencing VO2. CONCLUSION: Acute supplementation of DrinkHRW tablets may benefit submaximal aerobic exercise performance by lowering exercising HR. Further studies are needed to determine the influence and practical significance of HRW on varying exercise intensities as well as optimal dosing protocols and the effects of chronic use.

The Prevalence of Depression and Concussions in a Sample of Active North American Semi-Professional and Professional Football Players.

BACKGROUND: Concussive events frequently occur in high impact sports such as North American football. The long term effects of concussive events on physical and psychological wellbeing are the focus of ongoing research. The purpose of this study was to determine if concussive events increase the incidence of depression in active semi-professional and professional North American football players. METHODS: An anonymous online survey was sent to 200 players to collect the following self-reported data: position played, years played, number of concussions sustained and subsequent depressive symptoms using the Center for Epidemiologic Studies Depression (CESD-R) scale. An independent T-test was used to determine differences in the number of concussive events in those with CESD-R scores <16 vs. ≥16, where scores ≥16 are indicative of a depressed state. Likewise, an independent T-test was used to compare CESD-R scores between players with ≥3 concussions vs. ≤2. RESULTS: Individuals with a CESD-R score ≥16, sustained a significantly greater number of concussions (3.8 vs. 1.6) than those who scored <16 (p < 0.001). Further analysis also revealed significantly higher CESD-R scores in players who had sustained ≥3 concussions (24.0 vs. 15.6) than those with ≤2 (p < 0.05). CONCLUSION: Within the parameters of this study, players that were classified as depressed had sustained significantly more concussions compared to those who were not classified as depressed. Further, multiple concussive events (≥3) appears to increase symptoms of depression.

Acute, quercetin-induced reductions in blood pressure in hypertensive individuals are not secondary to lower plasma angiotensin-converting enzyme activity or endothelin-1: nitric oxide.

Quercetin (Q) reduces blood pressure (BP) in hypertensive individuals, but the mechanism is unknown. We hypothesized that acute Q aglycone administration reduces BP in hypertensive men by decreasing angiotensin-converting enzyme (ACE) activity and/or by lowering the ratio of circulating endothelin-1 (ET-1) to nitric oxide and that these alterations will improve endothelial function. Using a double-blind, placebo-controlled, crossover design Q or placebo (P) was administered to normotensive men (n = 5; 24 ± 3 years; 24 ± 4 kg/m(2)) and stage 1 hypertensive men (n = 12; 41 ± 12 years; 29 ± 5 kg/m(2)). As anticipated, ingesting 1095 mg Q did not affect BP in normotensive men but resulted in maximal plasma Q (2.3 ± 1.8 µmol/L) at approximately 10 hours, with Q returning to baseline concentrations (0.4 ± 0.08 µmol/L) by approximately 17 hours. Results from this study provided rationale for determining end-points of interest in stage 1 hypertensive men 10 hours after ingesting Q or P. In stage 1 hypertensive individuals, plasma Q increased(0.6 ± 0.4 vs. 0.05 ± 0.02 µmol/L), and mean BP decreased (103 ± 7 vs 108 ± 7 mm Hg; both P < .05) 10 hours after Q vs P, respectively. Plasma ACE activity (16 ± 10 vs 18 ± 10 U/L), ET-1 (1.6 ± 0.9 vs 1.6 ± 0.8 pg/ml), nitrites (57.0 ± 3.0 vs 56.7 ± 2.6 µmol/L), and brachial artery flow-mediated dilation (6.2 ± 2.9 vs. 6.3 ± 3.2%) were unaffected by Q. A single dose of Q aglycone reduces BP in hypertensive men through a mechanism that is independent of changes in ACE activity, ET-1, or nitric oxide bioavailability and without affecting vascular reactivity.

Therapeutic potential of quercetin to decrease blood pressure: review of efficacy and mechanisms.

Epidemiological studies beginning in the 1990s have reported that intake of quercetin, a polyphenolic flavonoid found in a wide variety of plant-based foods, such as apples, onions, berries, and red wine, is inversely related to cardiovascular disease. More recent work using hypertensive animals and humans (>140 mm Hg systolic and >90 mm Hg diastolic) indicates a decrease in blood pressure after quercetin supplementation. A number of proposed mechanisms may be responsible for the observed blood pressure decrease such as antioxidant effects, inhibition of angiotensin-converting enzyme activity, and improved endothelium-dependent and -independent function. The majority of these mechanisms have been identified using animal models treated with quercetin, and relatively few have been corroborated in human studies. The purpose of this review is to examine the evidence supporting the role of quercetin as a potential therapeutic agent and the mechanisms by which quercetin might exert its blood pressure-lowering effect.

Quercetin: A Treatment for Hypertension?-A Review of Efficacy and Mechanisms.

Quercetin is a polyphenolic flavonoid. Common sources in the diet are apples, onions, berries, and red wine. Epidemiological studies have found an inverse relationship between dietary quercetin intake and cardiovascular disease. This has led to in vitro, in vivo, and clinical research to determine the mechanism by which quercetin exerts cardioprotective effects. Recent studies have found a reduction in blood pressure when hypertensive (>140 mm Hg systolic and >90 mm Hg diastolic) animals and humans are supplemented with quercetin. Proposed mechanisms for the antihypertensive effect of quercetin include decreased oxidative stress, inhibition of angiotensin converting enzyme activity, improved endothelial function, direct action on the vascular smooth muscle, and/or modulation in cell signaling and gene expression. Although in vitro and in vivo evidence exists to support and refute each possibility, it is likely that quercetin influences multiple targets via a combination of known and as yet undiscovered mechanisms. The purpose of this review is to examine the mechanisms whereby quercetin might reduce blood pressure in hypertensive individuals.

Variations in heart rate at blood lactate threshold due to exercise mode in elite cross-country skiers.

This study attempted to quantify the difference in heart rate and exercise stage at which blood lactate threshold (T(bla)) occurs using 3 different modes of exercise: running, double poling (DP) on roller skis, and skating (SK) on roller skis. Nine elite collegiate cross-country ski racers (4 men, 5 women) served as test subjects. Testing was conducted on a motorized FitNex treadmill, specially designed for roller skiing. Heart rate was monitored via telemetry with values averaged over the last 30 seconds of each stage. A 40-micro l blood sample was obtained at the fingertip at the end of each 4-minute stage, and 25 micro l was analyzed for whole blood lactate concentration. The T(bla) was determined by the first exercise stage that elicited a concentration over 4.0 mmol.L(-1). The same test protocol was used for all 3 exercise modes. Mean heart rate, in beats per minute (b.min(-1)), at T(bla) was not significantly different (P < or = 0.05) for SK (mean 187 +/- 14 b.min(-1) SD) vs. running (mean 187 +/- 12 b.min(-1) SD); however, heart rate was significantly lower at T(bla) for DP (mean 161 +/- 17 b.min(-1) SD) vs. running and DP vs. SK. The mean exercise protocol stage that induced a blood lactate value which exceeded T(bla) was significantly different (P < or = 0.05) for running (5.22 +/- 1.20 mmol.L(-1) SD) vs. DP (1.89 +/- 0.78 mmol.L(-1) SD), running vs. SK (3.67 +/- 0.71 mmol.L(-1) SD), and SK vs. DP. It was concluded that T(bla) occurs at a lower heart rate and exercise stage during DP as compared with SK or running. Therefore, it stands to reason that the heart rate at T(bla) may vary based on mode of exercise, and when using heart rate to estimate blood lactate concentration, coaches and athletes should be aware that different modes of exercise elicit a different blood lactate concentration at a given heart rate depending on exercise mode used.