Sport Differences in Fat-Free Mass Index Among a Diverse Sample of NCAA Division III Collegiate Athletes.

ABSTRACT: Brandner, CF, Harty, PS, Luedke, JA, Erickson, JL, and Jagim, AR. Sport differences in fat-free mass index among a diverse sample of NCAA Division III collegiate athletes. J Strength Cond Res 36(8): 2212-2217, 2022-Fat-free mass index (FFMI) is becoming a popular metric to determine an athlete's potential for future fat-free mass accrual or to identify athletes who may be at risk for low fat-free mass (FFM). The aim of the current study was to examine sport-specific differences in FFMI among a cohort of collegiate athletes. NCAA Division III male ( n = 98; age: 20.1 ± 1.6 years, height: 1.82 ± 0.06 m, body mass: 92.7 ± 17.5 kg, %BF: 15.6 ± 8.8%) and female ( n = 92; age: 19.45 ± 1.1 years, height: 1.68 ± 0.06 m, body mass: 65.16 ± 11.04 kg, %BF: 22.71 ± 5.9%) athletes completed a body composition assessment using air displacement plethysmography. Fat-free mass index was calculated by dividing FFM by height squared. The mean ± SD FFMI was significantly higher ( p < 0.05) for males (23.37 ± 2.41 kg·m -2 ) compared with females (17.54 ± 1.8 kg·m -2 ). There was a significant main effect for sport category. Post hoc analysis indicated that throwers had a higher ( p < 0.001) FFMI (mean difference, 95% confidence interval) compared with sprinters and soccer athletes (4.17, 2.03-6.32 kg·m -2 ), endurance and weight-sensitive athletes (4.91, 2.67-7.14 kg·m -2 ), and court sport athletes (4.39, 1.97-6.81 kg·m -2 ), respectively, among female athletes. Post hoc analysis indicated that football players had a higher ( p < 0.01) FFMI than distance runners (3.89, 2.15, 5.62) and wrestlers (2.23, 0.78, 3.68), among male athletes. These findings indicate that sex differences in FFMI exist, with differences identified between sports. These findings can guide strength and nutritional programming decisions by providing sport-specific normative data profiles.

Basic recovery aids: what's the evidence?

This review summarizes the evidence base for using compression, massage, caloric replacement, cold, and heat as exercise recovery aids in sport.

Examining Changes in Shoulder Strength, Lower Body Power, and Body Composition among Collegiate Baseball Players after Completion of a Summer Baseball League Season.

The strength of the shoulder musculature involved with internal rotation and arm extension plays an important role in the overhead throwing motion for baseball athletes, both for throwing-related performance and injury risk. The maintenance of shoulder strength is a high priority for baseball athletes throughout a season; however, little is known in regards to the expected changes in strength throughout a season. To examine pre-post changes in shoulder strength, lower body power, and body composition among collegiate baseball players after the completion of a summer baseball league season. Amateur baseball players (n = 12; age: 20.9 ± 1.0 years.; height: 181.6 ± 5.6 cm; body mass: 86.4 ± 11.1 kg; BMI: 26.0 ± 2.6 kg/m2) participated in the current study. Pre- and post-competitive season, the participants completed shoulder strength assessments and body composition and countermovement vertical jump (CMJ) tests. An upper-body isometric test (athletic shoulder [ASH] test) was used to evaluate shoulder strength for each arm. Each subject completed maximal isometric contractions for both the throwing and non-throwing arms at four separate angles of abduction (180°, 'I'; 135°, 'Y'; 90°, 'T'; and -180°, 'A') while lying in a prone position. For shoulder strength, the primary dependent variable of interest was a composite measure that represented the average of the forces produced across all four positions of the ASH test (I, Y, T, A). For the ASH test composite measure, there was a trend toward a significant arm-by-time interaction effect (p = 0.08), as shoulder strength decreased by 9.03% for the throwing arm (ES = 0.72; 95% CI = [-0.27, -0.01]), compared to only 2.03% for the non-throwing arm (ES = 0.15; 95% CI = [-0.16, 0.09]), over the course of the season. The main effects of time (p = 0.16) and arm (p = 0.58) were not significant for the ASH test composite measure. There was no relationship between lower body power and throwing arm strength at baseline (r = 0.20, p = 0.56), and only a non-significant weak relationship at post-test (r = 0.28, p = 0.41). Throughout a season, baseball players may experience reductions in shoulder strength of the throwing arm with minimal changes in shoulder strength in the non-throwing arm.

Sex Differences in Resting Metabolic Rate among Athletes and Association with Body Composition Parameters: A Follow-Up Investigation.

The purpose of this study was to examine sex differences in resting metabolic rate (RMR) and associations between measured RMR and body composition parameters in athletes. One-hundred and ninety collegiate men (n = 98; age: 20.1 ± 1.6 yr.; body mass: 92.7 ± 17.5 kg; height: 181.6 ± 6.2 cm, body mass index: 28.0 ± 4.7 kg/m2) and women (n = 92; age: 19.4 ± 1.1 yr.; body mass: 65.2 ± 11.0 kg; height: 168.0 ± 6.6 cm, body mass index: 23.0 ± 3.6 kg/m2) athletes volunteered to participate in this study. Athletes completed a body composition assessment using air displacement plethysmography and RMR using indirect calorimetry. Assessments were completed in a fasted state and after refraining from intense physical activity > 24 h prior to testing. Data were collected during the 2016-2019 seasons. Men had a higher RMR compared to women (2595 ± 433 vs. 1709 ± 308 kcals; p < 0.001); however, when adjusted for body mass (p = 0.064) and fat-free mass (p = 0.084), the observed differences were not significant. Height, body mass, body mass index, fat-free mass, and fat mass were positively associated with RMR in both men and women athletes (r = 0.4-0.8; p < 0.001). Body mass (men: ß = 0.784; women: ß = 0.832)) was the strongest predictor of RMR. Men athletes have a higher absolute RMR compared to their women counterparts, which is influenced by greater body mass and fat-free mass. Body mass is the strongest predictor of RMR in both men and women athletes.

Prevalence of adulteration in dietary supplements and recommendations for safe supplement practices in sport.

The prevalence of dietary supplement use among athletes continues to rise with 60-80% of athletes often reporting current or previous use of dietary supplements. While select dietary ingredients have been shown to improve acute performance and enhance training adaptations over time, it is important to still consider the risk vs. reward for athletes before opting to consume a dietary supplement. Previous work has indicated that certain dietary supplements may pose risks for inadvertent doping, may be susceptible to mislabelling, could be banned by certain governing bodies of sport, or pose health risks for certain populations. The purpose of the current narrative review is to summarize the prevalence of adulteration in dietary sport supplement products, outline the risks of inadvertent doping for athletes, and highlight best practices regarding safe supplementation strategies. Analytical studies have found anywhere from 14 to 50% of samples analyzed from dietary supplement products have tested positive for anabolic agents or other prohibited substances. It is important for the consumer to adhere to safe supplementation strategies, which include following serving size recommendations, cross-referencing ingredient profiles with the list of prohibited substances, choosing quality products that have been verified by a third-party certification program, and being cognizant of consuming multiple dietary supplement products with overlapping ingredient profiles. Once these practices have been considered, it is reasonable for an athlete to utilize dietary supplements as a strategy to optimize performance and health, with a low risk of failing a drug test (adverse analytical finding) and experiencing adverse events.

Physiological Demands of a Self-Paced Firefighter Air-Management Course and Determination of Work Efficiency.

Firefighters often complete air management courses (AMC) to assess the ability to tolerate personal protective equipment, appropriately manage the breathing system and assess occupational performance. Little information is known relative to the physiological demands of AMCs, nor how to assess work efficiency in order to characterize occupational performance and evaluate progress. PURPOSE: To assess the physiological demands of an AMC and examine differences across BMI categories. A secondary aim was to develop an equation to assess work efficiency in firefighters. METHODS: Fifty-seven firefighters (Women, n = 4; age: 37.2 ± 8.4 yr.; height: 182.0 ± 6.9 cm; body mass: 90.8 ± 13.1 kg; BMI: 27.8 ± 3.6 kg·m-2) completed an AMC per routine evaluation while wearing a department issued self-contained breathing apparatus and full protective gear. Course completion time, starting pounds per square inch (PSI) on the air cylinder, changes in PSI, and distance traveled were recorded. All firefighters were equipped with a wearable sensor integrated with a triaxial accelerometer and telemetry to assess movement kinematics, heart rate, energy expenditure, and training impulse. The AMC consisted of an initial section involving a hose line advance, rescue (body drag), stair climb, ladder raise, and forcible entry. This section was followed by a repeating loop, which consisted of a stair climb, search, hoist, and recovery walk. Firefighters repeated the course loop until the self-contained breathing apparatus air supply pressure reached 200 PSI, at which time they were instructed to lay down until the PSI reached zero. RESULTS: Average completion time was 22.8 ± 1.4 min, with a mean distance of 1.4 ± 0.3 km and an average velocity of 2.4 ± 1.2 m·s-1. Throughout the AMC, the mean heart rate was 158.7 ± 11.5 bpm equating to 86.8 ± 6.3% of the age-predicted max heart rate and a training impulse of 55 ± 3 AU. Mean energy expenditure was 464 ± 86 kcals and work efficiency was 49.8 ± 14.9 km·PSI-1·s. Regression analysis determined that fat-free mass index (R2 = 0.315; ß = -5.069), body fat percentage (R2 = 0.139; ß = -0.853), fat-free mass (R2 = 0.176; ß = -0.744), weight (R2 = 0.329; ß = -0.681), and age (R2 = 0.096; ß = -0.571) were significant predictors of work efficiency. CONCLUSIONS: The AMC is a highly aerobic task with near-maximal heart rates reached throughout the course. Smaller and leaner individuals achieved a higher degree of work efficiency during the AMC.

Validation of skinfold equations and alternative methods for the determination of fat-free mass in young athletes.

Intoduction: To cross-validate skinfold (SKF) equations, impedance devices, and air-displacement plethysmography (ADP) for the determination of fat-free mass (FFM). Methods: Male and female youth athletes were evaluated (n = 91[mean ± SD] age: 18.19 ± 2.37 year; height: 172.1 ± 9.8 cm; body mass: 68.9 ± 14.5 kg; BMI: 23.15 ± 3.2 kg m-2; body fat: 19.59 ± 6.9%) using underwater weighing (UWW), ADP, and SKF assessments. A 3-compartment (3C) model (i.e., UWW and total body water) served as the criterion, and alternate body density (Db) estimates from ADP and multiple SKF equations were obtained. Validity metrics were examined to establish each method's performance. Bioelectrical impedance analysis (BIA), bioimpedance spectroscopy (BIS), and the SKF equations of Devrim-Lanpir, Durnin and Womersley, Jackson and Pollock (7-site), Katch, Loftin, Lohman, Slaughter, and Thorland differed from criterion. Results: For females, Pearson's correlations between the 3C model and alternate methods ranged from 0.51 to 0.92, the Lin's concordance correlation coefficient (CCC) ranged from 0.41 to 0.89, with standard error of the estimate (SEE) ranges of 1.9-4.6 kg. For SKF, the Evans 7-site and J&P 3 Site equations performed best with CCC and SEE values of 0.82, 2.01 kg and 0.78, 2.21 kg, respectively. For males, Pearson's correlations between the 3C model and alternate methods ranged from 0.50 to 0.95, CCC ranges of 0.46-0.94, and SEE ranges of 3.3-7.6 kg. For SKF, the Evans 3-site equation performed best with a mean difference of 1.8 (3.56) kg and a CCC of 0.93. Discussion: The Evans 7-site and 3-site SKF equations performed best for female and male athletes, respectively. The field 3C model can provide an alternative measure of FFM when necessary.

The Impact of Early Morning Training Sessions on Total Sleep Time in Collegiate Athletes.

Early morning training sessions may affect sleep quantity in athletes. The purpose of this study is to examine differences in total sleep time of collegiate athletes on nights prior to early morning training sessions relative to non-training nights. Wristwatch monitors equipped with photoplethysmography and accelerometer technology were worn by 18 NCAA Division III collegiate athletes (Age: 20.1 ± 1.6 years, Height: 1.81 ± 0.02 m, Body Mass: 91.2 ± 6.5 kg, Body Fat %: 20.8 ± 1.6%) during a two-week period of training to monitor total sleep times. Athletes recorded time in and out of bed using a sleep diary, anxiety levels due to having to wake up in the morning, and perceived recovery status (PRS) upon waking the next day. The data were divided into: nights before non-training days (NT) and Training days (TD). Data were analyzed using univariate analysis. All athletes obtained significantly less total sleep on nights before TD relative to NT (NT: 8:15 ± 1:03 vs. TD: 6:08 ± 0:59 hh:mm; p < 0.05). There was a positive relationship between total sleep time and recovery status (p < 0.01). Anxiety scores were inversely related to total sleep time (p < 0.01). Next-day recovery status was inversely related to anxiety scores (p < 0.001). College athletes obtained significantly less total sleep time on nights before early morning training sessions (< 0700) during the off-season, regardless of sex and sport. Coaches should consider later training sessions or promote optimal sleep quantity in order to minimize the risks associated to early morning training sessions.

Seasonal Accumulated Workloads in Collegiate Women's Soccer: A Comparison of Starters and Reserves.

Research quantifying the unique workload demands of starters and reserves in training and match settings throughout a season in collegiate soccer is limited. Purpose: The purpose of the current study is to compare accumulated workloads between starters and reserves in collegiate soccer. Methods: Twenty-two NCAA Division III female soccer athletes (height: 1.67 ± 0.05 m; body mass: 65.42 ± 6.33 kg; fat-free mass: 48.99 ± 3.81 kg; body fat %: 25.22 ± 4.78%) were equipped with wearable global positioning systems with on-board inertial sensors, which assessed a proprietary training load metric and distance covered for each practice and 22 matches throughout an entire season. Nine players were classified as starters (S), defined as those playing >50% of playing time throughout the entire season. The remaining 17 were reserves (R). Goalkeepers were excluded. A one-way ANOVA was used to determine the extent of differences in accumulated training load throughout the season by player status. Results: Accumulated training load and total distance covered for starters were greater than reserves ((S: 9431 ± 1471 vs. R: 6310 ± 2263 AU; p < 0.001) and (S: 401.7 ± 31.9 vs. R: 272.9 ± 51.4 km; p < 0.001), respectively) throughout the season. Conclusions: Starters covered a much greater distance throughout the season, resulting in almost double the training load compared to reserves. It is unknown if the high workloads experienced by starters or the low workloads of the reserves is more problematic. Managing player workloads in soccer may require attention to address potential imbalances that emerge between starters and reserves throughout a season.

Prevalence and Amounts of Common Ingredients Found in Energy Drinks and Shots.

BACKGROUND: Energy drinks are one of the most popular packaged beverage products consumed within the United States (US). Energy drinks are considered a functional beverage, a category that also includes sports drinks and nutraceutical beverages. PURPOSE: The focus of the current study was to examine the nutrition fact panels of the top selling commercially available energy drink and energy shot products within the US to characterize common ingredient profiles to help establish a standard definition and ingredient profile of energy drinks and energy shots for consumers, health care practitioners, and researchers. METHODS: The top 75 commercially available energy drinks and shots were identified and compiled from multiple commercial retail websites as of September 2021. For the purpose of this study, an energy drink must have met the following criteria: (A) marketed as an energy drink; (B) purported to improve energy, focus, or alertness; (C) not sold as a dietary supplement (no supplement fact panels); (D) manufactured as a pre-packaged and ready-to-drink beverage; and (E) contains at least three of (1) caffeine, (2) B-vitamins, (3) sugar, (4) taurine, (5) creatine, (6) quercetin, (7) guarana, (8) ginseng, (9) coenzyme Q10, or (10) branched chain amino acids. Energy shots must have met similar criteria to be included: (A) marketed as an energy shot; (B) purported to improve energy, focus, or alertness; (C) sold as a dietary supplement; (D) manufactured as a pre-packaged beverage with a small volume (<3.5 mL); and (E) contains at least three of the ingredients stated above. RESULTS: Twenty energy shots and fifty-five energy drinks were included in this analysis. The number of ingredients per product (mean ± SD) was 18.2 ± 5.7, with 15 products containing proprietary blends with undisclosed ingredient amounts. The relative prevalence and average amounts of the top ingredients were as follows: caffeine (100%; 174.4 ± 81.1 mg), vitamin B6 (72%; 366.9 ± 648.1 percent daily value (%DV)), vitamin B3 (67%; 121.44 ± 69.9% DV), vitamin B12 (67%; 5244.5 ± 10,474.6% DV), vitamin B5 (37.3%; 113.6 ± 76.6% DV), and taurine (37.3%; amounts undisclosed). CONCLUSIONS: Our findings suggest a high prevalence of caffeine and B-vitamins in these energy products, with many of the formulations containing well above the recommended daily value of B-vitamins.

The accuracy of fitness watches for the measurement of heart rate and energy expenditure during moderate intensity exercise.

BACKGROUND: As new technology emerges and updated fitness watches are released to the market, it is important to examine their accuracy. The aim of the current study was to examine the accuracy of three commercially available activity trackers in assessing heart rate (HR) and energy expenditure (EE) during moderate intensity exercise. METHODS: Twenty healthy participants (Age: 20.5±0.7 yrs., Ht: 173.4±10.8 cm, BM: 72.8±13.9 kg, BMI: 24.0±2.5 kg/m2) wore two fitness watches (FB: Fitbit VersaTM, San Francisco, CA, USA; and PI: Polar IgniteTM, Polar Electro Oy, Kempele, Finland) and a chest-worn HR monitor (PTP: Polar TeamPro SensorTM, Polar Electro) during a 12-minute exercise protocol at incremental speeds. An electrocardiogram (ECG) and indirect calorimetry were used as criterion measures for HR and EE. Mean absolute percentage error (MAPE) was calculated to determine measurement error. RESULTS: The MAPE values for HR were 11.6±8.7% for the FB, 11.0±10.0% for the PI, and 6.3±5.2% for the PTP. For EE, MAPE values were 9.6±7.2% for the FB, 16.7±19.6% for the PI and 13.8±13.0% for the PTP. CONCLUSIONS: Fitness watches relying on optical measures of HR underestimate HR compared to criterion measures during moderate intensity exercise. Despite providing a more accurate measure of HR, a chest-worn monitor does not provide a more accurate estimate of EE compared to fitness watches. The Fitbit provided the most accurate measure of EE when compared to the Polar Ignite watch and chest-worn device.

Session Rating of Perceived Exertion (sRPE) Load and Training Impulse Are Strongly Correlated to GPS-Derived Measures of External Load in NCAA Division I Women's Soccer Athletes.

PURPOSE: The purpose of this study was to determine whether session rating of perceived exertion-derived training load (sRPE-TL) correlates with GPS-derived measures of external load in National Collegiate Athletics Association (NCAA) Division I female soccer athletes. METHODS: Twenty-one NCAA Division 1 collegiate women's soccer athletes (11 starters, 10 non-starters; 65.1 ± 7.2 kg, 168.4 ± 7.9 cm, 20.3 ± 1.5 yrs) volunteered to take part in this study. Data for this study were collected over the course of 16 weeks during the 2018 NCAA women's soccer season. External load and heart rate (HR) data were collected during each training session and match during the season. At least 30 min after the end of an activity (e.g., match or practice), athletes were prompted to complete a questionnaire reporting their perceived exertion for the session. sRPE-TL was calculated at the end of the season by multiplying perceived exertion by the respective session duration. RESULTS: sRPE-TL was very strongly correlated with total distance, distance covered in velocity zones 1-3, the number of accelerations in zones 4 and 5, total PlayerLoad™, and PlayerLoad™. For internal load, sRPE-TL correlated very strongly (0.70 ≤ |r| < 0.90) with Edward's and Bannister's TRIMP and strongly (0.50 ≤ |r| < 0.70) with duration spent in in heart rate zones 5 and 6 (80-90% and 90-100% max HR, respectively) while correlations with maximum HR (bpm), mean HR (bpm), and mean HR (%) and sRPE-TL were moderate (0.30 ≤ |r| < 0.50). CONCLUSIONS: In NCAA Division I women soccer, sRPE-TL is strongly associated with external measures of workload. These relationships were stronger during match play, with acceleration load and total distance exhibiting the strongest relationship with sRPE-TL.

Use of Electrocardiographic Screening to Clear Athletes for Return to Sports Following COVID-19 Infection.

OBJECTIVE: To quantify the occurrence rate of abnormal electrocardiographic (ECG) findings and symptoms following coronavirus disease 2019 (COVID-19) infection. PATIENTS AND METHODS: In this retrospective analysis, we studied adult patients (>18 years old) who were participating in collegiate athletics and previously tested positive for COVID-19 between August 1, 2020, and December 30, 2020. The athletes underwent general examinations and ECG screening prior to being medically cleared for a return to sports following their COVID-19 diagnosis. Predetermined predictors were grouped into categorical variables including (1) sex, (2) symptom severity, and (3) body mass index (normal vs overweight [≥24 kg/m2]). These variables were used to examine differences of abnormal rates that occurred between different predictor categories. RESULTS: Of the 170 athletes screened, 6 (3.5%) presented with abnormal ECG findings and were referred to cardiologists. We found no evidence that sex, symptom severity, and body mass index category were associated with a higher rate of abnormal ECG findings (all P>.05). Greater severity of COVID-19 symptoms was associated with a higher percentage of ST depression, T-wave inversion, ST-T changes, and the presence of fragmented QRS complex. Loss of smell, loss of taste, headache, and fatigue were the most prevalent symptoms, with 38.8% (66), 36.5% (62), 32.9% (56), and 25.3% (43), respectively, of the 170 athletes reporting each symptom. CONCLUSION: Preliminary findings indicate a low risk of myocardial injury secondary to COVID-19 infection, with less than 4% of the 170 patients in our study presenting with abnormal ECG findings and a total of 16 patients (9.4%) requiring referral to a cardiologist. Although viral myocarditis was not detected in any athlete referred for cardiological assessment, 2 patients experienced effusive viral pericarditis.

Ultrasonic Tenotomy and Debridement for Calcific Tendinopathy of the Shoulder: A Pilot Case Series.

Calcific tendinopathy of the rotator cuff is a common cause of shoulder pain and debility. Minimally invasive treatment options have been employed for management; however, ultrasonic tenotomy has not been previously described for management of calcific tendinopathy of the shoulder. The purpose of the current case series was to provide preliminary evidence in support of a novel treatment modality for calcific tendinopathy of the rotator cuff. This descriptive pilot case series included a total of 8 patients with calcific tendinopathy of the supraspinatus that underwent ultrasound-guided ultrasonic debridement in the sports medicine clinic. All procedures were performed by the same physician (JLE). All patients had confirmation of the diagnosis with MRI and ultrasound imaging. Pain was measured pre-procedure and followed until 3-months post-procedure. Very large, statistically significant, reductions (P < .01) in pain scores were observed at 1 (ES = 1.93), 2 (ES = 1.84) and 3 (ES = 2.20) months post-procedure, respectively. All patients experienced a significant reduction in pain scores, regardless of hardness of the calcium deposit, at 1 month post-procedure with pain scores remaining lower than at baseline at 2 and 3 months post-procedure. No adverse events were noted in any patients. Ultrasonic tenotomy and debridement appears to be a safe and effective treatment option for patients with calcific tendinopathy of the supraspinatus.

Recent Trends in Youth Concussions: A Brief Report.

OBJECTIVES: Concussions and mild traumatic brain injuries are important medical issues, particularly among youth as the long-term health consequences of these injuries can become increasingly problematic. The purpose of this study was to examine recent trends in diagnosed concussions among pediatric patients in a large health care system. METHODS: This was a retrospective, population-based epidemiology study design that queried all patient files (pediatrics included) using electronic medical health records and further stratified patients based on type of concussion, age, sex, and year from 2013 to 2018. RESULTS: Electronic health records from a cohort of 8 832 419 (nmales = 4 246 492; nfemales = 4 585 931) patient visits were assessed for concussion diagnosis and filtered for those whose concussive event led to a loss of consciousness (LOC) or not (nLOC). Of these patients, 12 068 were diagnosed with a concussion (LOC = 3 699; nLOC = 8 369) with an overall incidence rate of 1.37 concussions per 1000 patients. Overall, the number of patients diagnosed with a concussion increased by 5063 (LOC = 1351; nLOC = 3712) from 2013 to 2018. Males and females presented with similar rates of concussions 5919 (49.05%) and 6149 concussions (50.95%), respectively. Of total diagnosed concussions, 4972 (LOC = 815; nLOC = 4157) were under the age of 18 and represented 41.2% of all diagnosed concussions with an incidence rate of 6.79 per 1000 patients. CONCLUSION: The number of concussions diagnosed appear to be on the rise with the largest number of concussions being diagnosed in those under the age of 18. Future studies should seek to determine primary causality and the long-term health implications of concussions with or without LOC.

Adverse Events Reported to the United States Food and Drug Administration Related to Caffeine-Containing Products.

OBJECTIVE: To examine differences in the frequency and severity of federally reported adverse events between caffeine-containing and non-caffeine-containing products while also identifying the category of caffeine-containing products associated with the highest frequency and severity of adverse events. PATIENTS AND METHODS: All adverse event reports that met specified eligibility criteria and were submitted to the Center for Food Safety and Applied Nutrition Adverse Event Reporting System between January 1, 2014, and June 29, 2018, were extracted. In this retrospective observational study, the most severe adverse event experienced, an ordinal variable, was categorized into death, life-threatening, hospitalization/disability, and emergency department visit. A nonproportional odds model was used to compare the odds of caffeine-containing products being associated with more severe adverse events relative to a noncaffeine group. The analysis is of data only from those reporting adverse events and may or may not be representative of the entire population exposed to these products, which is not known from the examined data. RESULTS: Energy and preworkout products saw a significant increase in the odds of the adverse event experienced being death rather than the other less severe outcomes relative to the noncaffeinated group. Those products, along with weight loss products, had greater odds of the adverse event being death or life-threatening vs the less severe outcomes relative to the noncaffeinated group. CONCLUSION: Caffeine-containing products have a greater association with severe adverse events compared with non-caffeine-containing products. Exposure to preworkout and weight loss products had greater odds of being associated with a more serious adverse event relative to noncaffeinated products. Health care practitioners should use these outcomes to better inform and educate patients about the many factors related to caffeine intake and adverse outcomes.

The Impact of COVID-19-Related Shutdown Measures on the Training Habits and Perceptions of Athletes in the United States: A Brief Research Report.

The purpose of the current study was to examine the impact of COVID-19 government-enforced shutdown measures on the training habits and perceptions of athletes. A web-based electronic survey was developed and distributed online to athletes. The survey contained questions regarding currently available resources, changes in weekly training habits, and perceptions of training such as intensity, motivation, and enjoyment. A total of 105 (males: n = 31; females: n = 74) athletes completed the survey (mean ± SD age = 19.86 ± 2.13 years). Ninety-nine (94.3%) athletes continued to receive guidance from their primary sport coach or strength training staff. There was a significant (p < 0.001) decrease (mean ± SD) in self-reported participation time for strength training (-1.65 ± 4.32 h. week-1), endurance (-1.47 ± 3.93 h. week-1), and mobility (-1.09 ± 2.24 h. week-1), with the largest reduction coming from participation time in sport-specific activities (-6.44 ± 6.28 h. week-1) pre- to post-shutdown. When asked to rate their current state of emotional well-being using a visual analog scale of 0-100, with 100 being exceptional, the mean score was 51.6 ± 19.6 AU. Athletes experienced notable reductions in training frequency and time spent completing various training related activities. In the future, practitioners should have preparations in place in the event of another lockdown period or future pandemic to avoid or minimize significant disruptions in training. Special considerations may be needed when athletes are allowed to return to sport in the event of significant levels of detraining that may have occurred.

Match Demands of Women's Collegiate Soccer.

Research describing the match and specific positional demands during match play in women's collegiate soccer is limited. The purpose of the study was to quantify the match demands of National Collegiate Athletic Association (NCAA) Division III soccer and assess position differences in movement kinematics, heart rate (HR), and energy expenditure. Twenty-five Division III women soccer players (height: 1.61 ± 0.3 m; body mass: 66.7 ± 7.5 kg; fat-free mass: 50.3 ± 6.5 kg; body fat%: 25.6 ± 5.1%) were equipped with a wearable global positioning system to assess the demands of 22 matches throughout a season. Players were categorized by position (goal keepers (GK), center defenders (CB), flank players (FP), forwards (F), and center midfielders (CM)). Players covered 9807 ± 2588 m and 1019 ± 552 m at high speeds (>249.6 m·m-1), with an overall average speed of 62.85 ± 14.7 m·m-1. This resulted in a mean HR of 74.2 ± 6% HR max and energy expenditure of 1259 ± 309 kcal. Significant and meaningful differences in movement kinematics were observed across position groups. CM covered the most distance resulting in the highest training load. FP covered the most distance at high speeds and mean HR values were highest in CM, CB, and FP positions.

Prevalence of Low Energy Availability in Collegiate Women Soccer Athletes.

(1) Background: Limited information exists on the prevalence of low energy availability (LEA) in collegiate team sports. The purpose of this study was to examine the prevalence of LEA in collegiate women soccer players. (2) Methods: Collegiate women soccer athletes (n = 18, height: 1.67 ± 0.05 m; body mass: 65.3 ± 7.9 kg; body fat %: 24.9 ± 5.6%) had their body composition and sport nutrition knowledge assessed in the pre-season. Energy availability was assessed mid-season using a 4-day dietary log and activity energy expenditure values from a team-based monitoring system. A validated screening tool was used to screen for LEA. (3) Results: The screening tool classified 56.3% of athletes as at risk of LEA (<30 kcal/kg of FFM); however, the actual dietary intake identified 67% as LEA. Athletes identified as non-LEA consumed significantly more absolute (p = 0.040) and relative (p = 0.004) energy than LEA athletes. (4) Conclusions: There was a high prevalence of LEA among collegiate women soccer athletes. Although previously validated in women endurance athletes, the LEA screening tool was not effective in identifying those at risk of LEA in this sample of athletes.

The acute effects of a multi-ingredient pre-workout supplement on resting energy expenditure and exercise performance in recreationally active females.

BACKGROUND: The use of dietary supplements to improve performance is becoming increasingly popular among athletes and fitness enthusiasts. Unfortunately, there is a tremendous lack of research being done regarding female athletes and the use of sport supplements. The purpose of this study was to examine the acute effects of multi-ingredient pre-workout supplement (MIPS) ingestion on resting metabolism and exercise performance in recreationally-active females. METHODS: Fifteen recreationally-active females participated in a randomized, double-blind, placebo controlled study. Subjects completed baseline, and two experimental testing sessions in a cross-over design fashion. Experimental testing included assessment of resting energy expenditure (REE), heart rate, and blood pressure following the ingestion of a MIPS or placebo. Subjects also completed a repetition to failure test for the back squat (BS) and bench press (BP) at 85% of their 5-repetition maximum followed by the assessment of anaerobic power using a counter-movement vertical jump test and a sprint test on a force-treadmill. Subjective measurements of energy, focus, and fatigue were also assessed using a 5-point Likert scale. Separate repeated measures analysis of variance (ANOVA) were used to assess differences in REE, cardiovascular responses, and subjective markers between conditions. Performance data were analyzed using paired Student's T-tests. RESULTS: A significant main effect for condition was observed for REE (p = 0.021) and diastolic blood pressure (p = 0.011) following ingestion of the MIPS. The supplement condition resulted in a greater number of BP repetitions to failure and total work completed during treadmill test (p = 0.039) compared to placebo (p = 0.037). A significant condition x time interaction for focus was observed with the supplement treatment exhibiting improved focus at 80-min post ingestion (p = 0.046). CONCLUSIONS: Consumption of a MIPS increased resting metabolism following a single dose accompanied by an increase in diastolic blood pressure. Furthermore, acute MIPS ingestion improved upper body muscular endurance and anaerobic capacity while improving feelings of focus following high-intensity exercise in recreationally active females.