Iron Deficiency and Anemia in Male and Female Adolescent Athletes Who Engage in Ball Games.

The aim of this study was to assess the prevalence of iron deficiency (ID) and iron deficiency anemia (IDA) among male adolescent athletes who participate in non-calorie-restricting sports, and to compare the results with female athletes of the same age and sports. Data of the hemoglobin concentration (Hb) and serum ferritin (sFer) levels of male (n = 350) and female (n = 126) basketball and football players, aged 11-18, from two sport medicine centers in Israel were gathered and analyzed. Mild ID was defined as sFer ≤ 30 µg/L, moderate as sFer ≤ 20 µg/L, and severe as sFer ≤ 10 µg/L. IDA was defined as sFer ≤ 20 µg/L and Hb < 13 g/dL for males and sFer ≤ 20 µg/L and Hb < 12 g/dL for females. The prevalence of mild ID was 41.1% and 53.2%, moderate was 17.4% and 27.8%, and severe was 2% and 4.8% in males and females, respectively. The prevalence of IDA was 2.6% in males and 4% in females. Mild and moderate ID was significantly higher among females. In conclusion, non-anemic ID, which is known to be common among female athletes, especially in sports requiring leanness, is also highly prevalent among adolescent males playing ball games. Therefore, screening for hemoglobin and sFer is recommended for young athletes of both genders and in all sports.

Improving the quality of foods available in a rural kibbutz cafeteria in Israel to align with a freshly prepared Mediterranean-style diet through a community culinary coaching programme.

OBJECTIVE: To examine the impact of a community culinary coaching programme (CCCP) on cafeteria food alignment with a freshly prepared Mediterranean-style diet, and diners' consumption habits and satisfaction. DESIGN: A non-randomized, controlled, community-based participatory research programme. CCCP included eight 90 min coaching sessions with a community steering committee, 22 h of kitchen staff training, 12 h of pre-school staff training and 30 h of education for diners; control communities received no intervention. Outcomes, measured before and 12 months after programme initiation, included cafeteria food alignment with a freshly prepared Mediterranean-style diet through a food items list derived from the cafeteria food purchasing software, and adult diners' consumption habits and satisfaction through questionnaires. SETTING: Communal cafeterias of rural kibbutzim. PARTICIPANTS: Intervention: kibbutz with 493 adults and 214 children. Control: Two kibbutzim with a total of 487 adults and 206 children. RESULTS: Intervention cafeteria food improved significantly in all Mediterranean index categories except nuts (legumes, wholegrain products, fish, MUFA/SFA P < 0·0001; fruits, vegetables P < 0·001; processed meats P = 0·004), and in the proportion of ultra-processed and unprocessed or minimally processed foods categories of the NOVA classification (-22 %, P < 0·001 and +7 %, P < 0·001, respectively), compared with the control community. The intervention group's satisfaction was significantly improved in twenty-five (83 %) out of the thirty satisfaction items, compared with twelve (40 %) in the control group. No changes were identified in diners' consumption habits in either intervention or control communities. CONCLUSIONS: CCCP might be useful in improving alignment of cafeteria food with a freshly prepared Mediterranean-style diet.

Improving Adherence to Mediterranean-Style Diet With a Community Culinary Coaching Program: Methodology Development and Process Evaluation.

The Community Culinary Coaching Program is a community-based participatory program aimed at improving communal settlement residents' nutrition. The residents, central kitchens, preschools, and communal dining rooms were identified as areas for intervention. Evaluation included goals accomplishment assessed by food purchases by the central kitchens, and residents' feedback through focus groups. Purchasing included more vegetables (mean (standard error) percent change), (+7% (4); P = .32), fish (+115% (11); P < .001), whole grains, and legumes (+77% (9); P < .001); and less soup powders (-40% (9); P < .05), processed beef (-55% (8); P < .001), and margarine (-100% (4); P < .001). Residents recommended continuing the program beyond the project duration. This model might be useful in organizations with communal dining facilities.

[ERGOGENIC SPORT SUPPLEMENTS FOR ATHLETES].

Use of performance-enhancing supplements occurs at all levels of sports, from recreational athletes to professional athletes. Although some supplements do enhance athletic performance, many have no proven benefits and have adverse effects. Nutritional supplements are categorized into the following categories: I. Apparently Effective. II. Possibly Effective. III. Too Early To Tell. IV. Apparently Ineffective. This article will review 4 ergogenic supplements which are categorized in the first category--"Apparently Effective"--1) Buffer agents 2) Creatine 3) Caffeine and 4 Nitric Oxide. Given the widespread use of performance enhancing supplements, physicians, and dietitians should be prepared to counsel athletes about their effectiveness, safety and legality.

[EATING ATTITUDES AND PRE-COMPETITION RAPID WEIGHT LOSS IN YOUNG TAEKWONDO FIGHTERS].

BACKGROUND: Taekwondo is a martial art and a combat Olympic sport. Similar to other types of combat sports, Taekwondo fights are conducted between opponents grouped by sex, age and weight classes. Disordered eating behaviors are common in combat sports with weight classes, attributed to the athletes' need to remain within a specific weight range. Pre-competition rapid weight loss (RWL) is also common, and entails a health risk. AIM: To assess the eating attitudes and the prevalence and techniques of RWL among young Taekwondo fighters. METHODS: A total of 112 competitive Taekwondo fighters in national championships and regional competitions aged 12-21.5 years completed questionnaires pertaining to eating attitudes (EAT-26) and RWL techniques. RESULTS: A total of 38% of the respondents reported precompetition RWL, with no significant between-sex difference. Common practices were training harder and eating less, but several potentially dangerous techniques were also described. Findings showed that: 70% of those reporting RWL were not assisted by another person, and the degree of RWL reached -5.5kg; 23%-40% of participants reporting RWL felt an improvement in some physical measure, yet 16% reported a decrease in subjective sport performance; 2.7% had abnormal scores on the EAT-26 questionnaire. CONCLUSIONS: There is a high rate of pre-competition RWL in young Taekwondo fighters, even in lower levels of competition. Most athletes performing RWL were unassisted, and some utilized potentially dangerous techniques. Most athletes did not feel that RWL affected their sport performance, yet a significant proportion felt decreased levels of performance. Weight-class athletes should be consulted by personnel trained in sports nutrition, in both training and competition states.

[Energy balance among female athletes].

Athletes need to consume sufficient energy to meet their training demands, maintain their health, and if young, to ensure their growth and development. Athletes are often preoccupied by their body weight and shape, and in some sports might be subjected to pressure to lose weight by coaches, peers or themselves. Eating disorders and poor eating habits are prevalent among female athletes, especially in sport disciplines where low body weight is required to improve performance or for "aesthetic" appearance or in weight category sports. Low energy intake has deleterious effects on many systems, including the cardiovascular system, several hormonal pathways, musculoskeletal system, fluids and electrolytes, thermoregulation, growth and development. Various fitness components and overall performance are also negatively affected. All these, together with poor nutritional status that causes vitamin and mineral deficiencies, poor concentration and depression, put the athlete at an increased injury risk. Energy availability is now recognized as the primary factor initiating these health problems. Energy availability is defined as dietary energy intake minus exercise energy expenditure. If below 30 kcal/kg fat free mass per day, reproductive system functions, as well as other metabolic systems, might be suppressed. The case presented is of a young female Judoka, who complained of fatigue and weakness. Medical and nutritional assessment revealed that she suffered from low energy availability, which slowed her growth and development, and negatively affected her health and athletic performance. This case study emphasizes the importance of adequate energy availability in young female athletes in order to ensure their health.

Acanthosis nigricans and truncal fat in overweight and obese children.

BACKGROUND: Screening for acanthosis nigricans (AcN) in overweight children is repeatedly recommended. The significance of AcN, and its relation to central obesity in children, is unclear. OBJECTIVE: To compare clinical and anthropometric parameters associated with adiposity, between overweight and obese children with and without AcN. METHODS: One hundred and forty-nine overweight and obese children were screened for AcN. Height, weight, waist and hip circumferences, triceps skinfold thickness and segmental body fat amounts were measured. RESULTS: Twenty-two (14.8%) children had AcN. Children with AcN had greater height, weight, BMI, waist circumference, waist-to-height-ratio, triceps skinfold thickness, and total and truncal body fat percentage, compared to those without AcN. After adjustment for age and BMI, no adiposity measure was increased in children with AcN. CONCLUSION: Overweight and obese children with AcN basically have greater overall and central adiposity, than those without it. Adjusting for BMI, there is no evidence for increased abdominal fat in these children.

High prevalence of vitamin D insufficiency in athletes and dancers.

OBJECTIVE: Vitamin D insufficiency is prevalent in various populations worldwide but with scarce data on physically active individuals. Vitamin D is important to athletes, affecting bone mass, immunity, and physical performance. This study evaluated the prevalence of vitamin D insufficiency and deficiency among young athletes and dancers. DESIGN: Cross-sectional study. SETTING: : Sport medicine clinic. PATIENTS: Data on 98 athletes and dancers (age, 14.7 +/- 3.0 years; range, 10-30 years; 53% men), who had undergone screening medical evaluations, were extracted from medical records. INDEPENDENT VARIABLE: Serum 25(OH)D concentrations. MAIN OUTCOME MEASURES: Serum 25(OH)D concentrations, age, sex, sport discipline, month of blood test, and serum ferritin. Vitamin D insufficiency was defined as serum 25(OH)D concentration <30 ng/mL. RESULTS: Mean serum 25(OH)D concentration was 25.3 +/- 8.3 ng/mL. Seventy-three percent of participants were vitamin D insufficient. Prevalence of vitamin D insufficiency was higher among dancers (94%), basketball players (94%), and Tae Kwon Do fighters (67%) and among athletes from indoor versus outdoor sports (80% vs 48%; P = 0.002). 25(OH)D levels adjusted for age and sex correlated with serum ferritin and season. CONCLUSIONS: In this study, conducted among young athletes and dancers from various disciplines in a sunny country, a high prevalence of vitamin D insufficiency was identified. A higher rate of vitamin D insufficiency was found among participants who practice indoors, during the winter months, and in the presence of iron depletion. Given the importance of vitamin D to athletes for several reasons, we suggest that athletes and dancers be screened for vitamin D insufficiency and treated as needed.

Immediate post-exercise energy intake and macronutrient preferences in normal weight and overweight pre-pubertal children.

OBJECTIVE: To examine the immediate effect of three different types of popular exercise activities on food intake and preferences in normal weight and overweight children. SUBJECTS AND METHODS: Forty-four (22 overweight) age and gender matched, pre-pubertal children participated in four separate visits. All performed three typical, 45 min, aerobic, indoor resistance and swimming exercise sessions and a control visit (no exercise). A similar buffet lunch was served immediately after each visit to both groups. The total energy intake and relative consumption of carbohydrates, fat and protein were recorded. RESULTS: In the normal weight children, total energy intake was reduced following exercise. This difference reached statistical significance only following the resistance-type exercise (14.0 + or - 1.4 [58.6 + or - 5.9] versus 19.4 + or - 1.7 [81.2 + or - 7.1] kcal/kg [kJ/ kg], in resistance exercise and control, respectively; p<0.008). The different types of exercise were associated with increased relative consumption of carbohydrate and decreased consumption of fat. In contrast, in the overweight children, total energy intake was increased following exercise. This increase reached statistical significance following the swimming exercise session (23.0 + or - 2.4 [96.3 + or - 10.0] versus 18.5 + or - 1.5 [77.4 + or - 6.3] kcal/kg [kJ/kg] in swimming and control, respectively; p<0.02). All types of exercise lead to a significant increase in the relative consumption of proteins in the overweight children. Finally, the total energy intake was significantly greater in the overweight children following the control (i.e., no exercise), and all types of exercise sessions. After normalization of the total energy intake to body mass, this difference remained significant only following the swimming practice (23.0 + or - 2.4 [96.3 + or - 10.0] versus 15.9 + or - 1.6 [66.6 + or - 6.7] kcal/kg [kJ/kg] in overweight and normal weight, respectively; p<0.04). CONCLUSIONS: Understanding the complicated relationship between exercise, appetite, and food choices may help us to optimize exercise interventions for this unique population, and to select the best exercise protocols to achieve a desired energy balance. Food intake and preferences in response to acute exercise are different in normal weight and obese children.