Validation of a Novel Perceptual Body Image Assessment Method Using Mobile Digital Imaging Analysis: A Cross-Sectional Multicenter Evaluation in a Multiethnic Sample.

Given that mobile digital imaging analyses (DIA) are equipped to automate body composition and subsequently alter one's appearance at a given objective body fat percent (BF%), the purpose of this study was to validate the use of this tool for assessments of body image. Participants (f = 134, m = 89) from two separate centers underwent body composition scans using a mobile DIA and completed the Multidimensional Body Self-Relations Questionnaire-Appearance Scale (MBSRQ-AS). Using a DIA-generated avatar, participants altered their figure so that it represented their perceived body, ideal body, and what a partner would find attractive. Distortion was calculated as perceived minus actual BF% and dissatisfaction was calculated as either ideal or partner minus perceived BF%. The total sample and females (p < 0.050), but not males, had significantly lower perceived BF% compared to their actual. Ideal and partner BF% was significantly lower than the perceived BF% for all groups (all p < 0.050). Ideal and partner BF% mean differences (MD) from perceived were positively associated with appearance evaluation (AE) and body area satisfaction (BAS) and negatively associated with overweight preoccupation and self-classified weight for the total sample (all p < 0.050). PerceivedMD demonstrated negative associations with AE and BAS (p < 0.050), but only for females when separated by sex. Perceptual body image measured by DIA is significantly associated with attitudinal body image and may allow practitioners to better quantify this growing issue.

Differences in Relaxation and Imagery among NCAA Division I Sport Types.

Athletes use psychological skills such as imagery and relaxation to decrease stress, cope with competitive anxiety, and achieve an optimal state of arousal. There is conflicting literature on how team and individual sport athletes use these skills, with some saying that individual sport athletes have better capabilities and others saying team sport athletes use imagery more frequently. The current study analyzed sport type differences in the use of relaxation and performance imagery among NCAA Division I (DI) athletes. This study included 117 NCAA DI athletes, including team sport (n = 72) and individual sport (n = 45). Participants completed a modified version of The Deliberate Relaxation for Sport Survey through Qualtrics. Results indicated there is a statistically significant difference in the type of relaxation technique used based on the individual's sport type. Team sport athletes used muscle relaxation (p = 0.034), eastern relaxation (p = 0.014), and stretching (p = 0.020) more frequently than individual sport athletes. Additionally, individual sport athletes used performance imagery more often for mental focus than team sport athletes (p = 0.012). There were no differences between sport types in the level of deliberate practice of relaxation and performance imagery. Athletes used a variety of methods to learn both imagery and relaxation skills and have been using these for an average of four years. The majority of participants (n = 67) did not work with a sport psychology professional, but their school has one. This study supports the use of individualized intervention programs to help athletes use relaxation and imagery in the most effective ways for their performances.

Differences in Perceptual and Attitudinal Body Image Between White and African-American Adults Matched for Sex, Age, and Body Composition.

PURPOSE: The purpose of this study was to evaluate the differences in perceptual and attitudinal body image between White and African-American males and females matched for sex, age, BMI, and other body composition components using a combination of 3-dimensional mobile digital imaging analysis (DIA) and the Multidimensional Body-Self Relations Questionnaire-Appearance Scale (MBSRQ-AS). METHODS: One-hundred non-Hispanic White (n=50) and non-Hispanic African-American (n=50) adults (M=34, F=66) matched for sex, age, BMI, and body composition components completed this cross-sectional study. Participants underwent several anthropometric assessments, completed the MBSRQ-AS, and rated their perceived appearance, ideal appearance, and the appearance they believed a partner would find societally attractive using a state of the art mobile 3-dimensional DIA produced using broad developmental populations. Body image distortion was measured as the perceived minus actual appearance, and body image dissatisfaction was defined as the ideal appearance and appearance a partner would find attractive minus the perceived appearance. RESULTS: Using the DIA, only African-American females demonstrated significant body image distortion (p<0.001); reporting perceived appearances significantly lower their than their actual. Further, AA females demonstrated significantly larger differences between their ideal and perceived appearance (p=0.009), perceived larger bodies as more attractive to a potential partner (p=0.009), and reported higher ratings of appearance evaluation (p=0.001) and body area satisfaction (p=0.011) compared to White females. CONCLUSIONS: After accounting for all anthropometric determinants of body image, perceptual and attitudinal body image differs between White and African-American adults with differences supporting larger body size acceptance for African-American individuals, particularly African-American females.

Nutrient Adequacy in Endurance Athletes.

Proper nutrition is critical for optimal performance in endurance athletes. However, it is unclear if endurance athletes are meeting all their energy and nutrient needs. We examined if endurance athletes are meeting their nutritional requirements and if this differed by sex. Ninety-five endurance athletes (n = 95; 50.5% men; 34.9 ± 12.9 y) participated in the study. Dietary intake was evaluated using the 24 h dietary recall method. Energy and nutrient intakes were calculated using the ESHA Food Processor Diet Analysis Software and compared against reference nutrient intakes. Endurance athletes did not consume the recommended amount of energy (76.8% of athletes), carbohydrates (95.8%), linoleic acid (75.8%), α-linolenic acid (ALA) (77.9%), eicosatetraenoic and docosahexaenoic acid (96.8%), dietary fiber (49.5%), vitamins D (93.7%), E (71.6%), and K (54.7%), folate (54.7%), pantothenic acid (70.5%), biotin (83.2%), manganese (58.9%), magnesium (56.8%), chromium (91.6%), molybdenum (93.7%), choline (85.3%), and potassium (56.8%), and consumed too much saturated fat (50.5%) and sodium (94.7%) than recommended. Fisher's Exact test showed that the requirements for dietary fiber (70.8% vs. 27.7%), ALA (87.5% vs. 68.1%), and total water (70.8% vs. 44.7%) were not met by more men versus women (p < 0.05). The needs for protein (70.2% vs. 25%) and vitamin B12 (46.8% vs. 22.9%) were not met by more women compared to men (p < 0.05). These findings need to be confirmed by a larger study.

Chronic and Postprandial Metabolic Responses to a Ketogenic Diet Compared to High-Carbohydrate and Habitual Diets in Trained Competitive Cyclists and Triathletes: A Randomized Crossover Trial.

Extreme carbohydrate deficits during a ketogenic diet (KD) may result in metabolic adaptations reflective of low energy availability; however, the manifestation of these adaptations outside of exercise have yet to be elucidated in cyclists and triathletes. The purpose of this study is to investigate the chronic and postprandial metabolic responses to a KD compared to a high-carbohydrate diet (HCD) and habitual diet (HD) in trained competitive cyclists and triathletes. For this randomized crossover trial, six trained competitive cyclist and triathletes (F: 4, M: 2) followed an ad libitum KD and HCD for 14 d each after their HD. Fasting energy expenditure (EE), respiratory exchange ratio (RER), and fat and carbohydrate oxidation (FatOx and CarbOx, respectively) were collected during their HD and after 14 d on each randomly assigned KD and HCD. Postprandial measurements were collected on day 14 of each diet following the ingestion of a corresponding test meal. There were no significant differences in fasting EE, RER, FatOx, or CarbOx among diet conditions (all p > 0.050). Although postprandial RER and CarbOx were consistently lower following the KD meal, there were no differences in peak postprandial RER (p = 0.452), RER incremental area under the curve (iAUC; p = 0.416) postprandial FatOx (p = 0.122), peak FatOx (p = 0.381), or FatOx iAUC (p = 0.164) between the KD and HD meals. An ad libitum KD does not significantly alter chronic EE or substrate utilization compared to a HCD or HD; postprandial FatOx appears similar between a KD and HD; this is potentially due to the high metabolic flexibility of cyclists and triathletes and the metabolic adaptations made to habitual high-fat Western diets in practice. Cyclists and triathletes should consider these metabolic similarities prior to a KD given the potential health and performance impairments from severe carbohydrate restriction.

Age Drives the Differences in Dietary Supplement Use in Endurance Athletes: A Cross-Sectional Analysis of Cyclists, Runners, and Triathletes.

Most athletes use dietary supplements (DS) to improve health and performance beyond what can be achieved through diet. Improvements in health and exercise performance through the use of DS are especially attractive to older athletes (OA) challenged with age-related declines. However, there are few DS shown to improve endurance performance, and the prevalence of DS in OA are unknown. Two-hundred cyclists, runners, and triathletes (females = 108; age = 39.4 ± 13.5) completed a questionnaire regarding the prevalence and type of DS currently used, in addition to variables associated with using DS such as motivation and sources of information. Overall, 78.0% of athletes reported current DS use. OA used more DS (Total DS = 4.3 ± 3.0) than younger athletes (2.7 ± 1.8, p < 0.001), with ages 40-49 and 50-59 using more DS than ages 18-29 and 30-39 (p < 0.05). The majority of athletes (53.8%) used ≥ 3 DS. Age was the only significant predictor of total DS use (p = 0.002); OA used ≥ 3 DS more than younger (p < 0.001). Specifically, more athletes 40-49 (67.5%) and 50-59 (76.2%) used ≥ 3 DS compared to 18-29 (33.3%, p = 0.003). More OA used electrolytes (p = 0.005), probiotics (p = 0.045), melatonin (p = 0.004), and vitamin D (p = 0.016) than younger athletes. Motivations to use DS were related to age and were supplement specific. Sources of DS information varied by sex more than age. Age is a significant determining factor for DS use in a sample of cyclists, runners, and triathletes. The prevalence and trends of DS warrant further investigation into the benefits and risks of DS to develop safe, targeted, and age-specific DS strategies on a recreative competitive level.Supplemental data for this article is available online at https://doi.org/10.1080/19390211.2022.2056670 .

The impact of dieting culture is different between sexes in endurance athletes: a cross-sectional analysis.

BACKGROUND: Frequent dieting is common in athletes attempting to achieve a body composition perceived to improve performance. Excessive dieting may indicate disordered eating (DE) behaviors and can result in clinical eating disorders. However, the current nutrition patterns that underly dieting culture are underexplored in endurance athletes. Therefore, the purpose of this study was to identify the sex differences in nutrition patterns among a group of endurance athletes. METHODS: Two-hundred and thirty-one endurance athletes (females = 124) completed a questionnaire regarding their dieting patterns and associated variables. RESULTS: The majority of athletes did not follow a planned diet (70.1%). For endurance athletes on planned diets (n = 69), males were more likely follow a balanced diet (p = 0.048) and females were more likely to follow a plant-based diet (p = 0.021). Female endurance athletes not on a planned diet (n = 162) were more likely to have attempted at least one diet (p < 0.001). Male athletes attempted 2.0 ± 1.3 different diets on average compared to 3.0 ± 2.0 for females (p = 0.002). Female athletes were more likely to attempt ≥ three diets (p = 0.022). The most common diet attempts included carbohydrate/energy restrictive, plant-based, and elimination diets. Females were more likely to attempt ketogenic (p = 0.047), low-carbohydrate (p = 0.002), and energy restricted diets (p = 0.010). Females made up the entirety of those who attempted gluten-/dairy-free diets (F = 22.0%, M = 0.0%). CONCLUSIONS: Being a female athlete is a major determinant of higher dieting frequency and continual implementation of popular restrictive dietary interventions. Sports dietitians and coaches should prospectively assess eating behavior and provide appropriate programming, education, and monitoring of female endurance athletes.

The Effects of Face Coverings on Perceived Exertion and Attention Allocation during a Stepping Task.

The COVID-19 pandemic has impacted the entire world from lockdowns to various recommended restrictions including social distancing and wearing face coverings. In a safe environment, cardiovascular exercise is important for both physical health and mental health. The current study examined the effects of face coverings on rating of perceived exertion and attention allocation during an exertive stepping task. Participants completed a stepping task with a weighted vest at 20% of their bodyweight until volitional fatigue with a face covering (n = 23) or without a face covering (n = 31). Results revealed a non-significant difference (p = 0.25) in the duration of the stepping task (in seconds) between the no face covering (M = 455.81, SD = 289.77) and face covering (M = 547.83, SD = 285.93) conditions. Results indicated increases in perceived exertion (p < 0.001) and heart rate (p < 0.001) as time progressed across the four time points (i.e., 30 s, 1/3 time to exhaustion, 2/3 time to exhaustion, and exhaustion) in both conditions. No significant differences were found between the conditions for RPE (p = 0.09) and heart rate (p = 0.50). Participants wearing a face covering were more internally focused across the duration of the stepping task (p = 0.05). This study has relevance for applied practitioners implementing physical activity interventions that require face coverings.

Caffeine Supplementation Strategies Among Endurance Athletes.

Caffeine is widely accepted as an endurance-performance enhancing supplement. Most scientific research studies use doses of 3-6 mg/kg of caffeine 60 min prior to exercise based on pharmacokinetics. It is not well understood whether endurance athletes employ similar supplementation strategies in practice. The purpose of this study was to investigate caffeine supplementation protocols among endurance athletes. A survey conducted on Qualtrics returned responses regarding caffeine supplementation from 254 endurance athletes (f = 134, m =120; age = 39.4 ± 13.9 y; pro = 11, current collegiate athlete = 37, recreational = 206; running = 98, triathlon = 83, cycling = 54, other = 19; training days per week = 5.4 ± 1.3). Most participants reported habitual caffeine consumption (85.0%; 41.2% multiple times daily). However, only 24.0% used caffeine supplements. A greater proportion of men (31.7%) used caffeine supplements compared with women (17.2%; p = 0.007). Caffeine use was also more prevalent among professional (45.5%) and recreational athletes (25.1%) than in collegiate athletes (9.4%). Type of sport (p = 0.641), household income (p = 0.263), education (p = 0.570) or working with a coach (p = 0.612) did not have an impact on caffeine supplementation prevalence. Of those reporting specific timing of caffeine supplementation, 49.1% and 34.9% reported consuming caffeine within 30 min of training and races respectively; 38.6 and 36.5% used caffeine 30-60 min before training and races. Recreational athletes reported consuming smaller amounts of caffeine before training (1.6 ± 1.0 mg/kg) and races (2.0 ± 1.2 mg/kg) compared with collegiate (TRG: 2.1 ± 1.2 mg/kg; RACE: 3.6 ± 0.2 mg/kg) and professional (TRG: 2.4 ± 1.1 mg/kg; RACE: 3.5 ± 0.6 mg/kg) athletes. Overall, participants reported minor to moderate perceived effectiveness of caffeine supplementation (2.31 ± 0.9 on a four-point Likert-type scale) with greatest effectiveness during longer sessions (2.8 ± 1.1). It appears that recreational athletes use lower caffeine amounts than what has been established as ergogenic in laboratory protocols; further, they consume caffeine closer to exercise compared with typical research protocols. Thus, better education of recreational athletes and additional research into alternative supplementation strategies are warranted.

The Relationship Between Dietary Intake and Sleep Quality in Endurance Athletes.

Many endurance athletes have poor sleep quality which may affect performance and health. It is unclear how dietary intake affects sleep quality among athletes. We examined if sleep quality in endurance athletes is associated with consumption of fruit, vegetables, whole grains, dairy milk, and caffeinated beverages. Two hundred thirty-four endurance athletes (39.5 ± 14.1 year) participated in a survey. Participants provided information on demographics, anthropometry, sleep behavior and quality, and dietary intake via questionnaires. Sleep quality was assessed using the Athlete Sleep Screening Questionnaire (ASSQ) with a global score (ASSQ-global) and subscales including sleep difficulty (ASSQ-SD), chronotype (ASSQ-C), and disordered breathing while sleeping (ASSQ-SDB). A general linear model (GLM), adjusted for age, body mass index, sleep discomfort, sleep behavior, gender, race, and ethnicity, showed that higher caffeinated beverage intake was related to poorer global sleep quality (p = 0.01) and increased risk for disordered breathing while sleeping (p = 0.03). Higher whole grain intake was associated with a morning chronotype and lower risk for sleep issues (p = 0.01). The GLM did not reveal a relationship between sleep quality and dairy milk, fruit, and vegetable intake. In conclusion, caffeinated beverages and whole grain intake may influence sleep quality. This relationship needs to be confirmed by further research.

Recovery Strategies in Endurance Athletes.

In order to achieve optimal performance, endurance athletes need to implement a variety of recovery strategies that are specific to their training and competition. Recovery is a multidimensional process involving physiological, psychological, emotional, social, and behavioral aspects. The purpose of the study was to examine current implementation, beliefs, and sources of information associated with recovery strategies in endurance athletes. Participants included 264 self-identified endurance athletes (male = 122, female = 139) across 11 different sports including placing top three overall in competition (n = 55) and placing in the top three in their age group or division (n = 113) during the past year. Endurance athletes in the current study preferred hydration, nutrition, sleep, and rest in terms of use, belief, and effectiveness of the recovery strategy. Female endurance athletes use more recovery strategies for training than males (p = 0.043, d = 0.25), but not in competition (p = 0.137, d = 0.19). For training, top three finishers overall (p < 0.001, d = 0.61) and by division (p < 0.001, d = 0.57), used more recovery strategies than those placing outside the top three. Similar findings were reported for competition in top three finishers overall (p = 0.008, d = 0.41) and by division (p < 0.001, d = 0.45). These athletes are relying on the people around them such as coaches (48.3%) and fellow athletes (47.5%) along with websites (32.7%) for information and recommendations. Endurance athletes should be educated on other strategies to address the multidimensionality of recovery. These findings will be useful for healthcare professionals, practitioners, and coaches in understanding recovery strategies with endurance athletes.

The Effectiveness of Virtual Reality on Anxiety and Performance in Female Soccer Players.

With the increased use of technology, relaxation interventions are finding their way into technology devices like virtual reality head-mounted displays (VR HMDs). However, there is a lack of evidence on the efficacy of VR relaxation interventions to reduce anxiety in athletes and how that is portrayed in their movement patterns. The purpose of the current study was to examine how a VR relaxation intervention affected perceived anxiety levels and penalty kick performance of female soccer players. Thirteen female soccer players took five penalty kicks in baseline, stress-induced, and VR relaxation conditions. Perceived levels of anxiety, self-confidence, mental effort, heart rate (HR), accelerometry of the lumbar spine and thigh, and performance in each condition was obtained. Results indicated that the VR intervention significantly reduced cognitive anxiety and somatic anxiety from baseline (p = 0.002; p = 0.001) and stress (p < 0.001; p < 0.001) with large effect sizes (Kendall's W = 0.72; 0.83). VR significantly increased self-confidence from baseline (p = 0.002) and stress (p = 0.001) with a large effect size (Kendall's W = 0.71). Additionally, all participants felt that VR helped them relax. Mental effort was significantly higher in the stress condition compared to that in baseline (p = 0.007) with moderate effect size (Kendall's W = 0.39). Peak acceleration and performance were not significantly influenced by stress or VR. This study serves as an initial step to evaluate VR relaxation interventions on performance in female soccer players.

Perceptions of appetite do not match hormonal measures of appetite in trained competitive cyclists and triathletes following a ketogenic diet compared to a high-carbohydrate or habitual diet: A randomized crossover trial.

Endurance athletes may implement rigid dietary strategies, such as the ketogenic diet (KD), to improve performance. The effect of the KD on appetite remains unclear in endurance athletes. This study analyzed the effects of a KD, a high-carbohydrate diet (HCD), and habitual diet (HD) on objective and subjective measures of appetite in trained cyclists and triathletes, and hypothesized that the KD would result in greater objective and subjective appetite suppression. Six participants consumed the KD and HCD for 2-weeks each, in a random order, following their HD. Fasting appetite measures were collected after 2-weeks on each diet. Postprandial appetite measures were collected following consumption of a ketogenic meal after the KD, high-carbohydrate meal after the HCD, and standard American/Western meal after the HD. Fasting total ghrelin (GHR) was lower and glucagon-like peptide-1 (GLP-1) and hunger were higher following the KD versus HD and HCD. Fasting insulin was not different. Mixed-effects model repeated measures analysis and effect sizes and 95% confidence intervals showed that postprandial GHR and insulin were lower and GLP-1 was higher following the ketogenic versus the standard and high-carbohydrate meals. Postprandial appetite ratings were not different across test meals. In conclusion, both fasting and postprandial concentrations of GHR were lower and GLP-1 were higher following the KD than the HC and HD, and postprandial insulin was lower on the KD. Subjective ratings of appetite did not correspond with the objective measures of appetite in trained competitive endurance athlete. More research is needed to confirm our findings.

The Effects of Heart Rate Monitoring on Ratings of Perceived Exertion and Attention Allocation in Individuals of Varying Fitness Levels.

There has been a rapid increase in the use of wearable technology-based physical activity trackers. Most of these physical activity trackers include tracking and displaying the individual's heart rate (HR). There is little known about how HR monitoring influences the perception of exertion and attention allocation. Shifting attentional focus toward the body (association), such as monitoring HR, instead of environmental stimuli (dissociation) may increase one's perceived level of exertion. The purpose of the study was to examine the effects of HR monitoring on ratings of perceived exertion (RPE) and attention allocation during an exertive stepping task in individuals of varying fitness levels. The YMCA stepping task normative values determined fitness levels. For the experimental condition, participants were randomly assigned to one of two conditions (i.e., HR monitoring or control) and completed a stepping task with a weighted vest at 20% of their bodyweight. HR, RPE, and attention allocation were collected at 30-s intervals. Performing the stepping task resulted in a gradual increase of HR and RPE along with a shift from dissociative to associative attention across all conditions. Monitoring one's HR during the task resulted in more dissociative attention allocation, however, no RPE differences were reported between the two conditions. Unfit individuals reported lower levels of RPE during the first time point compared to fit individuals despite having higher HR throughout the task. The results of this study have relevance for applied practitioners implementing physical activity interventions with individuals who monitor their HR.