Factors influencing dietary inequalities among adolescents in Madrid and Bilbao: a qualitative research project.

OBJECTIVE: To describe the design and methodology of a qualitative study to explore the main factors influencing dietary inequalities in adolescents in Madrid and Bilbao, Spain. METHOD: The study area included six neighborhoods (three in each city) of different socioeconomic status (SES): low, medium, and high. We sampled 12 secondary schools (six in each city: two per socioeconomic level). Our methodology comprised: 1) developing an ad hoc index to classify all neighborhoods according to their SES; 2) selecting the study area and sample; 3) conducting semi-structured interviews (n=36) and focus groups (n=24). Grounded theory and phenomenological analysis will be employed in data analysis. Initially, we found factors influencing in adolescents' diet such as gender, family environment, and SES. CONCLUSIONS: Systematizing the selection of neighborhoods and secondary schools, along with using appropriate methods, could serve as a foundation for future studies on health inequalities among adolescents.

Correlates of eating behaviors in adolescence: a systematic review of qualitative studies.

CONTEXT: Nutrition plays a critical role in adolescence. Adolescents are vulnerable to the impact of different factors that distance them from healthy habits, increasing their risk of chronic diseases in adulthood. Qualitative methodologies allow for a better understanding of these factors. OBJECTIVE: This systematic review aims to consolidate qualitative research evidence from the past 10 years to analyze the facilitators and barriers influencing adolescents' eating behaviors. DATA SOURCES: Databases searched for relevant studies were Scopus, Medline/PubMed, PsycINFO, and Web of Science. DATA EXTRACTION: A total of 4176 records were identified. The authors used the GRADE-CERQual (Confidence in Evidence from Reviews of Qualitative Research) quality-assessment tool. RESULTS: Fifty articles with qualitative or mixed methodologies were finally included. The most applied techniques were focus groups and semi-structured interviews. The factors influencing adolescents' diets were classified into 4 dimensions: individual, social, community, and macrosystem factors. The most influential were the following-(1) at the individual level: gender (facilitator or barrier), taste and appearance of food (barrier), and lack of time (barrier); (2) at the social level: parents' and caregivers' influence (facilitator or barrier), peer group influence (barrier), and socioeconomic position (barrier); (3) at the community level: school food environment (facilitator or barrier), neighborhood food environment (barrier), household food environment (facilitator or barrier), food insecurity (barrier), and availability and affordability of ultra-processed foods (barrier); and (4) at the macrosystem level: digital tools (facilitator or barrier). CONCLUSIONS: This systematic review identified several facilitators and barriers influencing eating behaviors among adolescents. Qualitative research provides a rich source of knowledge to inform interventions aimed at improving adolescents' diets. Qualitative research is very useful for collecting researches that help to implement intervention programs that improve adolescent nutrition.

[Factors related to sleep quality in Emergency Medical Technicians and their sleep habits during COVID-19 pandemic.] / Factores relacionados con la calidad de sueño de los técnicos en emergencias sanitarias y sus hábitos de sueño durante la pandemia de COVID-19.

OBJECTIVE: Emergency Medical Technicians (EMTs) show a high prevalence of sleep problems. Adding to these problems, another factor appeared two years ago: the COVID-19 pandemic. The objectives of this study were to describe the sleep quality and habits in a sample of EMTs in Spain during COVID-19 pandemic considering the factors related to them. METHODS: A national cross-sectional study was carried out in Spain between October 2020 and February 2021. EMTs who worked in basic and advanced life support ambulances were invited to participate in an online survey. Several sociodemographic variables were analyzed, as well as sleep quality, stress symptoms, pain, food consumption and physical activity. Logistic regression models were used to examine the associations between these variables and sleep quality. RESULTS: 340 EMTs participated in the study. Of them, 59.4% had poor sleep quality and the habits of 32.2% got worse during the pandemic. The EMTs with a poor sleep quality presented in higher proportion stress symptoms (OR: 4.19; 95% CI: 2.16-8.11; p<0.001), pain (OR: 3.19; 95% CI: 1.7-6.01; p<0.001) and a weekly consumption of sugar-sweetened beverages greater than two glasses (OR: 3.6; 95% CI: 1.86-6.98; p<0.001). CONCLUSIONS: EMTs show a high prevalence of poor sleep quality, which got worse during the pandemic. The factors related to them are stress, pain and consumption of sugar-sweetened beverages. This study provides important information so that the emergency services can develop health promotion programs focused on these professionals.

OBJETIVO: Los Técnicos en Emergencias Sanitarias (TES) presentan una alta prevalencia de problemas de sueño. A estos problemas se sumó otro factor hace dos años: la pandemia de la COVID-19. Los objetivos de este estudio fueron describir la calidad y hábitos de sueño en una muestra de TES en España durante la pandemia, teniendo en cuenta sus factores relacionados. METODOS: Se realizó un estudio transversal de carácter nacional, que fue desarrollado en España entre octubre de 2020 y febrero de 2021. Los TES que trabajaban en ambulancias de Soporte Vital Básico o Avanzado fueron invitados a participar en un cuestionario online. Se analizaron varias variables sociodemográficas, la calidad del sueño, los síntomas de estrés, el dolor, el consumo alimentario y la actividad física. Se utilizaron modelos de regresión logística para examinar las asociaciones entre estas variables y la calidad de sueño. RESULTADOS: Participaron 340 TES en el estudio. La calidad de sueño del 59,4% era mala y los hábitos de sueño del 32,2% empeoraron durante la pandemia. Aquellos con un sueño de mala calidad presentaban en mayor proporción síntomas de estrés (OR: 4,19; IC 95%: 2,16-8,11; p<0,001), dolor (OR: 3,19; IC 95%: 1,7-6,01; p<0,001) y un consumo semanal de bebidas azucaradas superior a dos vasos semanales (OR: 3,6; IC 95%: 1,86-6,98; p<0,001). CONCLUSIONES: Los TES presentan una alta prevalencia de mala calidad de sueño, habiendo empeorado además durante la pandemia. Entre sus factores relacionados se encuentran el estrés, el dolor y el consumo de bebidas azucaradas. Este estudio aporta información importante para que los servicios de emergencias puedan desarrollar programas de promoción de la salud centrados en estos profesionales.

Factores relacionados con la calidad de sueño de los técnicos en emergencias sanitarias y sus hábitos de sueño durante la pandemia de COVID-19 / Factors related to sleep quality in Emergency Medical Technicians and their sleep habits during COVID-19 pandemic

Fundamentos: Los Técnicos en Emergencias Sanitarias (TES) presentan una alta prevalencia de problemas de sueño. A estosproblemas se sumó otro factor hace dos años: la pandemia de la COVID-19. Los objetivos de este estudio fueron describir la calidad yhábitos de sueño en una muestra de TES en España durante la pandemia, teniendo en cuenta sus factores relacionados.Métodos: Se realizó un estudio transversal de carácter nacional, que fue desarrollado en España entre octubre de 2020 y febrerode 2021. Los TES que trabajaban en ambulancias de Soporte Vital Básico o Avanzado fueron invitados a participar en un cuestionarioonline. Se analizaron varias variables sociodemográficas, la calidad del sueño, los síntomas de estrés, el dolor, el consumo alimentario yla actividad física. Se utilizaron modelos de regresión logística para examinar las asociaciones entre estas variables y la calidad de sueño.Resultados: Participaron 340 TES en el estudio. La calidad de sueño del 59,4% era mala y los hábitos de sueño del 32,2%empeoraron durante la pandemia. Aquellos con un sueño de mala calidad presentaban en mayor proporción síntomas de estrés (OR:4,19; IC 95%: 2,16-8,11; p<0,001), dolor (OR: 3,19; IC 95%: 1,7-6,01; p<0,001) y un consumo semanal de bebidas azucaradas superior a dosvasos semanales (OR: 3,6; IC 95%: 1,86-6,98; p<0,001).Conclusiones: Los TES presentan una alta prevalencia de mala calidad de sueño, habiendo empeorado además durante lapandemia. Entre sus factores relacionados se encuentran el estrés, el dolor y el consumo de bebidas azucaradas. Este estudio aportainformación importante para que los servicios de emergencias puedan desarrollar programas de promoción de la salud centradosen estos profesionales.(AU)

Bacjkground: Emergency Medical Technicians (EMTs) show a high prevalence of sleep problems. Adding to these problems,another factor appeared two years ago: the COVID-19 pandemic. The objectives of this study were to describe the sleep quality andhabits in a sample of EMTs in Spain during COVID-19 pandemic considering the factors related to them.Methods: A national cross-sectional study was carried out in Spain between October 2020 and February 2021. EMTs who workedin basic and advanced life support ambulances were invited to participate in an online survey. Several sociodemographic variableswere analyzed, as well as sleep quality, stress symptoms, pain, food consumption and physical activity. Logistic regression modelswere used to examine the associations between these variables and sleep quality.Results: 340 EMTs participated in the study. Of them, 59.4% had poor sleep quality and the habits of 32.2% got worse during thepandemic. The EMTs with a poor sleep quality presented in higher proportion stress symptoms (OR: 4.19; 95% CI: 2.16-8.11; p<0.001),pain (OR: 3.19; 95% CI: 1.7-6.01; p<0.001) and a weekly consumption of sugar-sweetened beverages greater than two glasses (OR: 3.6;95% CI: 1.86-6.98; p<0.001).Conclusions: EMTs show a high prevalence of poor sleep quality, which got worse during the pandemic. The factors relatedto them are stress, pain and consumption of sugar-sweetened beverages. This study provides important information so that theemergency services can develop health promotion programs focused on these professionals.(AU)

Factors influencing dietary inequalities among adolescents in Madrid and Bilbao: a qualitative research project / Factores que influyen en las desigualdades alimentarias en Madrid y Bilbao: un proyecto de estudio cualitativo

Objective: To describe the design and methodology of a qualitative study to explore the main factorsinfluencing dietary inequalities in adolescents in Madrid and Bilbao, Spain.Method: The study area included six neighborhoods (three in each city) of different socioeconomic status(SES): low, medium, and high. We sampled 12 secondary schools (six in each city: two per socioeconomiclevel). Our methodology comprised: 1) developing an ad hoc index to classify all neighborhoods accordingto their SES; 2) selecting the study area and sample; 3) conducting semi-structured interviews (n = 36)and focus groups (n = 24). Grounded theory and phenomenological analysis will be employed in dataanalysis. Initially, we found factors influencing in adolescents’ diet such as gender, family environment,and SES.Conclusions: Systematizing the selection of neighborhoods and secondary schools, along with usingappropriate methods, could serve as a foundation for future studies on health inequalities among adolescents.(AU)

Objetivo: Describir el dise ˜no y la metodología de un estudio cualitativo que explora los factores principalesque influyen en la desigualdad alimentaria en los adolescentes en Madrid y Bilbao, Espa ˜na.Método: Se seleccionaron seis barrios (tres en cada ciudad) de diferente estatus socioeconómico (ESE):bajo, medio y alto. Obtuvimos una muestra de 12 institutos (seis en cada ciudad y dos por nivel socioe-conómico). La metodología consistió en: 1) desarrollo de un índice ad hoc para clasificar los barrios segúnsu ESE; 2) selección de las áreas de estudio y de institutos; 3) realización de entrevistas semiestructuradas(n = 36) y grupos de discusión (n = 24). En el análisis se utilizarán la teoría fundamentada y el análisisfenomenológico. Inicialmente, encontramos factores que influyen en la alimentación de los adolescentes,como el género, el entorno familiar y el ESE.Conclusiones: La sistematización en la selección de barrios e institutos, y la utilización de metodologíaadecuada, pueden servir como base para futuros estudios sobre las desigualdades de salud en adolescentes.(AU)

Análisis de la dieta y la adherencia a la dieta mediterránea de los Técnicos en Emergencias Sanitarias y su evolucióndurante la pandemia COVID-19 en relación con factores sociodemográficos y de salud / Analysis of Emergency Medical Technicians’ diet and adherence to the Mediterranean diet, and their evolution during the COVID-19pandemic in relation to sociodemographic and health factors

Introducción: Los Técnicos en Emergencias Sanitarias presentan una alta prevalencia de sobrepeso y obesidad, lo que se ha relacionado con una menor adherencia a la dieta mediterránea y varios problemas de salud.Objetivos: Describir la dieta y la adherencia a la dieta mediterránea en una muestra de Técnicos en Emergencias Sanitarias en España y su evolución durante la pandemia COVID-19 teniendo en cuenta los factores sociodemográficos y de salud relacionados.Material y Métodos: Los participantes cumplimentaron un cuestionario online en el que se recogían: datos sociodemográficos y antropométricos, frecuencia de consumo alimentario, elección de platos saludables, autoeficacia para consumir frutas y verduras, cambios en la alimentación durante la pandemia, calidad de sueño y síntomas de estrés. Se calculó la adherencia a la dieta mediterránea y la relación entre estas variables.Resultados: Participaron 340 profesionales. Menos de un 25% cumplía las recomendaciones de consumo de verdura, fruta y cereales, y menos de un 35%, las de dulces, carne roja y frutos secos. Los técnicos con baja adherencia a la dieta mediterránea elegían menos platos saludables (p<0,001) y tenían un menor nivel de autoeficacia (p<0,001). Asimismo, los técnicos cuya alimentación empeoró durante la pandemia presentaban un sueño de peor calidad (p=0,025) y más síntomas de estrés (p<0,001).Discusión: Los Técnicos en Emergencias Sanitarias presentan una baja adherencia a la dieta mediterránea, la cual se asoció con una menor autoeficacia y una peor elección alimentaria.Conclusiones: Las intervenciones dirigidas a mejorar la alimentación de los Técnicos en Emergencias Sanitarias deben centrarse en mejorar su autoeficacia, su elección de platos saludables, su calidad de sueño y su nivel de estrés.(AU)

Introduction: Emergency Medical Technicians show ahigh prevalence of overweight and obesity, which have beenrelated to a low adherence to the Mediterranean diet and several health problems.Objetives: Describe the diet and the adherence to the Mediterranean diet in a sample of Emergency Medical Technicians in Spain and their evolution during the COVID-19pandemic considering the sociodemographic and health fac-tors related to them.Material and Methods: The participants completed anonline survey which collected: sociodemographic variables,food consumption, food choice, self-efficacy consumption offruits and vegetables, changes in diet during the pandemic, sleep quality and stress symptoms. Adherence to theMediterranean diet and the relationship between these variables were calculated. Results: 340 professionals participated. Less than 25%met the recommended intake of vegetables, fruits and ce-reals, and less than 35%, the intake of confectionery, redmeat and nuts. Technicians with a low adherence to the Mediterranean diet chose less healthy dishes (p<0.001)and had lower self-efficacy (p<0.001). Besides, technicianswhose diet quality got worse during the pandemic pre-sented poorer sleep quality (p=0.025) and more stresssymptoms (p<0.001).Discussion: Emergency Medical Technicians show a lowadherence to the Mediterranean diet, which was associatedwith a low self-efficacy and poor food choices. Conclusions: Interventions to improve Emergency MedicalTechnicians’ diet quality should focus on improving their self-efficacy, food choice, sleep quality and stress levels.(AU)

Residents' Insights on Their Local Food Environment and Dietary Behaviors: A Cross-City Comparison Using Photovoice in Spain.

Perceptions of local food environments and the ability of citizens to engage in participatory research may vary, even if participants share similar cultural and socioeconomic contexts. In this study, we aimed to describe participants' narratives about their local food environment in two cities in Spain. We used the participatory methodology of Photovoice to engage participants in Madrid (n = 24) and Bilbao (n = 17) who took and discussed photographs about their local food environment (Madrid; n = 163 and Bilbao; n = 70). Common themes emerged across both cities (food insecurity, poverty, use of public spaces for eating and social gathering, cultural diversity and overconsumption of unhealthy foods); however, in Bilbao citizens perceived that there was sufficient availability of healthy foods despite that living in impoverished communities. Photovoice was a useful tool to engage participating citizens to improve their local food environments in both cities. This new approach allowed for a photovoice cross-city comparison that could be useful to fully understand the complexity and diversity of residents' perceptions regardless of their place of residence.

Exploring the effect of two different teaching strategies on first-year nursing students' understanding of nutritional concepts: A mixed-method approach.

AIM: The aim of the study was twofold. First, to explore understanding difficulties in nutritional concepts among nursing students and second, to analyse the effect of two teaching strategies on the level of understanding. BACKGROUND: Previous studies have pointed out the need to improve the nutritional care education offered to undergraduates in health sciences. As nurses play a crucial role in lifestyle counselling and nutrition assessment, it is essential to identify the learning difficulties that can impair their learning capacity and the more effective teaching strategy in the nutrition area during the nursing degree. DESIGN: A pretest-posttest study was conducted with a mixed-method conversion design. METHODS: 146 first-year-nursing students were included. Two teaching methods, debate-based learning and lecture-based learning were used for instruction on the effect of macronutrient intake on an individual's state of health. Each group completed two open-ended questions before and after the intervention. Firstly, phenomenographic analysis was performed to identify the learning categories representing variations in students' understanding. Secondly, qualitative data were quantised and statistically analysed to address differences in learning improvement. RESULTS: More than 40% of students struggled with the idea that proteins are associated with weight gain independently of the teaching strategy applied. In the first evaluation question, the debate-based learning teaching method improved students' learning, achieving higher levels of understanding (p < 0.05). In the second evaluation question, no significant differences were found between the two groups. CONCLUSIONS: Areas of problematic knowledge in nutrition education have been identified for the first time that will allow nurse educators to design research-based teaching strategies. Further studies are necessary not only on how to address these misconceptions in nursing students, but also to investigate how nurse educators can contribute to deeper levels of student learning.

Residents' perceptions of their local food environment in socioeconomically diverse neighborhoods: A photovoice study.

The influence of unhealthy food environments on residents' eating behaviors has been previously documented. Yet, socioeconomic differences across areas are less studied. Participatory studies provide relevant knowledge to better inform future nutrition interventions. We conducted a participatory Photovoice project in which residents interpreted the influence of the local food environment on eating behaviors across three neighborhoods of contrasting area-level socioeconomic status (SES) in Bilbao, Spain. From April to July 2017, a total of 23 residents participated in the three Photovoice groups. Each group critically discussed their photographs (N = 110) in groups of 6-9 participants along six group sessions. Through a consensus-building process, participants identified 27 emerging categories choosing finally 39 related photographs, which followed six conceptual main themes characterizing their local food environment: 1) unhealthy eating behaviors, 2) cultural diversity, 3) retail transformation, 4) social relationships, 5) precariousness, and 6) healthy eating. Although high food quality and fresh products may portray a general healthy food environment in all three neighborhoods, participants discussed why some residents still adopt unhealthy eating behaviors characterized by an excessive consumption of alcohol (high-SES area), sugar loaded foods (high- and middle-SES) and fast food (middle and low-SES). This photovoice participatory methodology helps highlighting important similarities and differences regarding food environment perceptions in the whole socioeconomic spectrum of any given city. This type of participatory approach helps guiding local policies and interventions promoting healthier local food environments.

n-3 Fatty Acid Supplementation During 4 Weeks of Training Leads to Improved Anaerobic Endurance Capacity, but not Maximal Strength, Speed, or Power in Soccer Players.

Omega-3 fatty acid (n-3 FA) supplementation could promote adaptation to soccer-specific training. We examined the impact of a 4-week period of n-3 FA supplementation during training on adaptations in 1RM knee extensor strength, 20-m sprint speed, vertical jump power, and anaerobic endurance capacity (Yo-Yo test) in competitive soccer players. Twenty six soccer players were randomly assigned to one of two groups: n-3 FA supplementation (n-3 FA; n = 13) or placebo (n = 13). Both groups performed two experimental trial days. Assessments of physical function and respiratory function were conducted pre (PRE) and post (POST) supplementation. Training session intensity, competitive games and nutritional intake were monitored during the 4-week period. No differences were observed in respiratory measurements (FEV1, FVC) between groups. No main effect of treatment was observed for 1RM knee extensor strength, explosive leg power, or 20 m sprint performance, but strength improved as a result of the training period in both groups (p < .05). Yo-Yo test distance improved with training in the n-3 FA group only (p < .01). The mean difference (95% CI) in Yo-Yo test distance completed from PRE to POST was 203 (66-340) m for n-3 FA, and 62 (-94-217) m for placebo, with a moderate effect size (Cohen's d of 0.52). We conclude that 4 weeks of n-3 FA supplementation does not improve strength, power or speed assessments in competitive soccer players. However, the increase in anaerobic endurance capacity evident only in the n-3 FA treatment group suggests an interaction that requires further study.

Basketball Performance Is Related to Maturity and Relative Age in Elite Adolescent Players.

During a national championship, the anthropometric, physiological, and maturation characteristics of 13- to 14-year-old players of elite basketball teams and their association with sport performance were analyzed. Body parameters (weight, height, skinfold thicknesses, and lengths) were measured and physiological capacities assessed by sprint (20 m) and jump tests (i.e., countermovement jump with arm swing). Chronological age (CA) and maturity offset (years from age at peak height velocity; YAPHV) were calculated, and then predicted age at peak height velocity, as the difference between CA and YAPHV. Game performance was assessed with point averages and the performance index rating (PIR). The birth-date distribution of players was biased, those born early in the selection year outnumbering those born later. Anthropometric analysis indicated that players who performed better had longer body lengths. Physiological testing showed that semi-finalists had better sprint performance than quarter-finalists and those players with greater jump capacity scored more points. Early maturation and advanced maturity status were also associated with better PIR and scored points per game. Multiple blockwise regression analysis showed that, among the factors analyzed, YAPHV was the best predictor of basketball performance. In conclusion, around puberty, physical and physiological parameters associated with maturity and CA are important in determining the success of elite basketball players. Consequently, boys who are born in the second half of the year and/or late maturing tend to be marginalized or totally excluded, and not given the chance to play under equal conditions; their careers may then be held back by the relative disadvantage associated with inexperience.

Relationship between the relative age effect and anthropometry, maturity and performance in young soccer players.

The presence of the relative age effect (RAE) has been widely reported; however, its underlying causes have not yet been determined. With this in mind, the present study examined if anthropometry and performance were different amongst older and younger soccer players born in the same year. Eighty-eight young soccer players participated in the study (age 9.75 ± 0.30). Anthropometric measurements, physical tests (sprint, agility, endurance test, jump and hand dynamometry) and the estimation of the maturity status were carried out. Most players (65.9%) were born in the first half of the year. Older players were taller (P < 0.05), had longer legs (P < 0.01) and a larger fat-free mass (P < 0.05). Maturity offset was smaller in the older boys (P < 0.05); however, age at peak height velocity was similar. Older boys performed better in velocity and agility (P < 0.05) and particularly in the overall score of performance (P < 0.01). Stepwise regression analysis revealed that chronological age was the most important variable in the agility test and the overall score, after the skinfolds (negative effect). We report differences in anthropometry and physical performance amongst older and younger pre-pubertal soccer players. These differences may underlie the RAE.

Influence of nutrient intake on antioxidant capacity, muscle damage and white blood cell count in female soccer players.

BACKGROUND: Soccer is a form of exercise that induces inflammatory response, as well as an increase in free radicals potentially leading to muscle injury. Balanced nutritional intake provides important antioxidant vitamins, including vitamins A, C and E, which may assist in preventing exercise-related muscle damage. The purpose of the present study was to determine the effect of macro/micronutrient intake on markers of oxidative stress, muscle damage, inflammatory and immune response in female soccer players. METHODS: Twenty-eight female players belonging to two soccer teams of the same professional soccer club participated in this study after being informed about the aims and procedures and after delivering written consent. Each team completed an 8-day dietary record and played one competition match the same week. Participants were divided into two groups: the REC group (who complied with recommended intakes) and the NO-REC group (who were not compliant). Laboratory blood tests were carried out to determine hematological, electrolytic and hormonal variables, as well as to monitor markers of cell damage and oxidative stress. Blood samples were obtained 24 h before, immediately after and 18 h after official soccer matches. Student t-test or Mann-Whitney U-test was used to compare both groups throughout the match. RESULTS: At rest, we observed that the REC group had higher levels of total antioxidant status (TAS), glutathione peroxidase (GPx), and lower levels of creatine kinase (CK) and lactate dehydrogenase (LDH) in comparison to the NO-REC group. Immediately after the match, levels of TAS, GPx, superoxide dismutase (SOD), LDH and % lymphocytes were higher and the % of neutrophils were lower in the REC group compared to the NO-REC group. These differences were also maintained 18 h post-match, only for TAS and GPx. CONCLUSIONS: Our data reveal an association between nutritional intake and muscle damage, oxidative stress, immunity and inflammation markers. The benefit of the intake of specific nutrients may contribute to preventing the undesirable physiological effects provoked by soccer matches.

Metabolic impact of a soccer match on female players.

The aim of this study was to examine the metabolic effect of a female soccer match in elite and sub-elite teams. Blood samples were taken (24 h before, immediately after and 18 h after official soccer matches) to determine haematological, electrolytic and hormonal variables, as well as the levels of cell damage and oxidative stress in 14 elite and 14 sub-elite players. Our results show increases in white blood cell count (P < 0.001) and the percentage of neutrophils (P < 0.001), and decreases in the percentage of lymphocytes (P < 0.05), eosinophils (P < 0.001), monocytes (P < 0.001) and basophils (P < 0.05) immediately post-match. Increases were also found in lactate dehydrogenase activity (P < 0.001), uric acid (P < 0.001), albumin (P < 0.001), total antioxidant status (P < 0.001) and free testosterone levels (P < 0.01). Creatine kinase activity significantly increased 18 h post-match (P < 0.01) and the concentrations of several ions, glucose and proteins were found to be altered immediately post-match. Overall, our results show that playing a soccer match exerts specific metabolic effects on female players, resulting in muscle damage, oxidative stress and biochemical and hormonal variations. On the basis of some interesting correlations, we also suggest that exercise-induced cell breakdown may enhance antioxidant capacity of the soccer players.

Cell damage, antioxidant status, and cortisol levels related to nutrition in ski mountaineering during a two-day race.

The aim of this study was to measure the effect of nutrition on cell damage, antioxidant enzymes, and cortisol during a two-day ski mountaineering competition. Twenty-one male skiers participated in the study. Creatine kinase (CK), aspartate aminotransferase (AST), alanine aminotransferase (ALT), γ-glutamyl transpeptidase (GGT), lactate dehydrogenase (LDH), alkaline phosphatase (AP), cortisol and C-reactive protein (CRP), glutathione peroxidase (GPx) and reductase activities (GR) and C-reactive protein (CRP) levels, total antioxidant status, and cortisol levels were measured in serum the day before and immediately after the race. Their diet was also analysed during the competition. Enzymes and cortisol levels significantly increased after the competition. CK and LDH and cortisol levels were negatively correlated to total energy, protein, and fat intake. Intake of vitamin A, B1, B2, B6 and niacin was negatively correlated to LDH and AP. A negative correlation was also found between CK activity and Na, Fe, and Zn intake. Cortisol levels were negatively correlated to the intake of vitamins C, B1 and B2, and niacin. A positive correlation was found between serum GPx and intake of energy, carbohydrates, proteins, A and B vitamins, and folic acid. Skiers with the lowest nutrient intake during the competition were the ones who showed greater cell damage and lower antioxidant enzyme activity and cortisol levels, which may impair performance and also cause injuries and accidents. Particularly, skiers should have high intakes of total energy, macronutrients, vitamins A and B, Na, Zn, and Fe in order to decrease the deleterious effect of strenuous exercise. Key pointsA two-day ski mountaineering race produced muscle cell damage and oxidative stress and an increase in cortisol levels.There was a marked insufficient intake of carbohydrates which has been shown to affect performanceThose skiers with lowest nutrient intake showed greater cell damage, lower antioxidant activity and higher cortisol levels.Nutrition should be carefully monitored and assessed in order to minimize the mentioned blood changes to avoid fatigue, injuries and also accidents in this type of sport; particularly when skiers must carry their own food.