New Opportunities to Advance Sport Nutrition

Sports nutrition is a relatively new discipline; with ~100 published papers/year in the 1990s to ~3,500+ papers/year today. Historically, sports nutrition research was primarily initiated by university-based exercise physiologists who developed new methodologies that could be impacted by nutrition interventions (e.g., carbohydrate/fat oxidation by whole body calorimetry and muscle glycogen by muscle biopsies). Application of these methods in seminal studies helped develop current sports nutrition guidelines as compiled in several expert consensus statements. Despite this wealth of knowledge, a limitation of the current evidence is the lack of appropriate intervention studies (e.g., randomized controlled clinical trials) in elite athlete populations that are ecologically valid (e.g., in real-life training and competition settings). Over the last decade, there has been an explosion of sports science technologies, methodologies, and innovations. Some of these recent advances are field-based, thus, providing the opportunity to accelerate the application of ecologically valid personalized sports nutrition interventions. Conversely, the acceleration of novel technologies and commercial solutions, especially in the field of biotechnology and software/app development, has far outstripped the scientific communities' ability to validate the effectiveness and utility of the vast majority of these new commercial technologies. This mini-review will highlight historical and present innovations with particular focus on technological innovations in sports nutrition that are expected to advance the field into the future. Indeed, the development and sharing of more “big data,” integrating field-based measurements, resulting in more ecologically valid evidence for efficacy and personalized prescriptions, are all future key opportunities to further advance the field of sports nutrition

New Ideas: Ordinary is Extraordinary

With the initial issue of this journal, a new challenge has been offered tothe world of sports nutrition: initiate "team oriented" research and clinical trials in order to make dynamic progress in terms of understandingand applying nutrition principals to the field of competitive sports. It is our further challenge that these teams think "outside the box" in terms of their approach to elucidating new concepts through which nutritional interventions might play a role in the regulation of muscle growth and repair, athletic performance and endurance, and mental acuity. What was once thought of as extraordinary might now be approached as ordinary, if the correct composition of "teams" were formed

A LATENT CLASS ANALYSIS PREDICTIVE MODELING APPROACH TO PROFILE DIVISION I COLLEGIATE ATHLETES FOR NUTRITION AND RELATIVE ENERGY DEFICIENCY IN SPORT (RED-S) CONCERN

Screening collegiate athletes for nutrition-related concerns and low energy syndromes such as Relative Energy Deficiency in Sport (RED-S) provides insight for nutrition care and can lead to necessary referrals in the sports medicine team. Screening may be a part of an athletic department’s protocol, but there is a lack of consensus on a validated tool for this population. The goal of this cross-sectional research was to use a Latent Class Analysis (LCA) predictive modeling approach to determine classes of collegiate athletes who present with nutrition and RED-S concern. LCA is a person-centered approach, intending to uncover subgroups of a population with common characteristics. A total of 216 athletes (144 female, 72 male) at a Division I university competing in various team sports completed a pre-participation nutrition screening survey prior to participation in athletic sports. Measures such as menstrual function, bone health, disordered eating, restrictive diets, food insecurity, body image, and nutrition knowledge were collected. For female athletes, the LCA model provided some clinical relevance that female athletes can be profiled into a two-class solution, providing practitioners and sports dietitians insight into profiling athletes who may be at risk for low energy syndromes. For male athletes, there was not enough evidence that a two-class solution was superior to a one-class solution, highlighting the need for high-quality low energy syndrome tools to be developed in the male collegiate athlete population. Future research should consider large sample sizes of athletes to conduct predictive modeling techniques along with high quality, validated measurement tools

Disordered Eating in Collegiate Athletes: Prevalence and Relationships with Body Composition

Performance pressures and emphasis on body weight and shape put collegiate athletes at risk for disordered eating. If not identified early, disordered eating behaviors could develop into a clinical eating disorder. While such behaviors are a known problem, prevalence rates are not well established in collegiate athletes. Disordered eating may also relate to physiological changes in athletes, such as body composition and performance, although this relationship is not well understood. The aims of this research were to 1) determine the prevalence of disordered eating risk in NCAA Division I student-athletes and 2) determine if such behaviors are related to baseline and changes in body composition over a competitive season. Athletes (n=58) competing in eight different sports (football, men’s and women’s soccer, women’s basketball, gymnastics, men’s and women’s track and field, and women’s diving), from an urban university, completed the Eating Attitudes Test (EAT-26) questionnaire and two dual-energy X-ray absorptiometry (DXA) body composition scans, one at preseason and another at postseason. While no risk for disordered eating was found in this sample, visceral adipose tissue (VAT) was positively correlated with EAT-26 scores (r=0.661, p=0.038) among female gymnasts. Reasons for these findings are unclear; however, it is thought that the ethnic diversity of the sample played a role in the absence of disordered eating risk in this study. Further research is needed to better understand if ethnicity plays a role in disordered eating risk

Nutritional Practices of National Female Soccer Players: Analysis and Recommendations.

The aim of the study was to establish the nutritional practices and activity patterns of elite female soccer players. The nutritional intake of 16 female England Soccer players was self-reported over a seven-day period. Participants were provided with written and verbal guidelines for the completion of the diaries. Training details were also recorded, and used in combination with BMR predictions to calculate daily energy expenditure. Energy, macronutrient and micronutrient intakes were determined using DietMaster 4.0 software. Results suggest that energy intake was low (1904 ± 366.3 kcal) in relation to previous recommendations for soccer players. Energy expenditure (2153.5 ± 596.2 kcal) was not significantly different (p > 0.05) from intake, suggesting energy balance was achieved. Carbohydrate (53.8 ± 6.8%), protein (16.8 ± 2.1%) and fat (28.8 ± 6.6%) intakes were in line with recommendations. Fluid intake (2466 ± 1350.5ml·day-1) was sufficient to meet baseline recommendations, but would need to be higher to meet the additional requirement of training and competition. With the exception of vitamin A and iron, all micronutrient intakes were higher than the DRI. In conclusion, recommendations for female soccer players are to encourage consumption of carbohydrate-electrolyte beverages to enhance carbohydrate intake and increase fluid intake, and ensure sufficient iron rich foods are included in the diet to meet the DRI

Looking Beyond the Marketing Claims of New Beverages: Health Risks of Consuming Sports Drinks, Energy Drinks, Fortified Waters, and Other Flavored Beverages

Consumption of several new categories of beverages has increased significantly in recent years. Sold in cans and bottles in many venues and heavily marketed as health and strength enhancing, these beverages have become popular among children and adolescents as well as adults. Energy drinks, sports drinks, fruit drinks, flavored waters, and sweetened teas and coffees are known collectively as fortified beverages due to the natural and artificial ingredients that are added in the processing of their main ingredient, water. In view of their rising popularity, it is important to assess the healthfulness of these beverages and the implications of their consumption by the general public. Consumption by youth, to whom marketing is often targeted, is of particular interest in view of children's potentially increased vulnerability to chemicals and other added substances. Further, the possible contribution of these beverages to the high prevalence of childhood obesity merits attention.This report will discuss the major categories of fortified beverages, presenting data on their nature, their ingredients, their similarities and differences, the possible effects on children of their consumption, and areas for further research

Effect of electrolyzed high-pH alkaline water on blood viscosity in healthy adults.

BACKGROUND: Previous research has shown fluid replacement beverages ingested after exercise can affect hydration biomarkers. No specific hydration marker is universally accepted as an ideal rehydration parameter following strenuous exercise. Currently, changes in body mass are used as a parameter during post-exercise hydration. Additional parameters are needed to fully appreciate and better understand rehydration following strenuous exercise. This randomized, double-blind, parallel-arm trial assessed the effect of high-pH water on four biomarkers after exercise-induced dehydration. METHODS: One hundred healthy adults (50 M/50 F, 31 ± 6 years of age) were enrolled at a single clinical research center in Camden, NJ and completed this study with no adverse events. All individuals exercised in a warm environment (30 °C, 70% relative humidity) until their weight was reduced by a normally accepted level of 2.0 ± 0.2% due to perspiration, reflecting the effects of exercise in producing mild dehydration. Participants were randomized to rehydrate with an electrolyzed, high-pH (alkaline) water or standard water of equal volume (2% body weight) and assessed for an additional 2-h recovery period following exercise in order to assess any potential variations in measured parameters. The following biomarkers were assessed at baseline and during their recovery period: blood viscosity at high and low shear rates, plasma osmolality, bioimpedance, and body mass, as well as monitoring vital signs. Furthermore, a mixed model analysis was performed for additional validation. RESULTS: After exercise-induced dehydration, consumption of the electrolyzed, high-pH water reduced high-shear viscosity by an average of 6.30% compared to 3.36% with standard purified water (p = 0.03). Other measured biomarkers (plasma osmolality, bioimpedance, and body mass change) revealed no significant difference between the two types of water for rehydration. However, a mixed model analysis validated the effect of high-pH water on high-shear viscosity when compared to standard purified water (p = 0.0213) after controlling for covariates such as age and baseline values. CONCLUSIONS: A significant difference in whole blood viscosity was detected in this study when assessing a high-pH, electrolyte water versus an acceptable standard purified water during the recovery phase following strenuous exercise-induced dehydration

Dietary factors associated with obesity indicators and level of sports participation in Flemish adults : a cross-sectional study

BACKGROUND: Obesity develops when energy intake continuously exceeds energy expenditure, causing a fundamental chronic energy imbalance. Societal and behavioural changes over the last decades are held responsible for the considerable increase in sedentary lifestyles and inappropriate dietary patterns. The role of dietary fat and other dietary factors in the aetiology and maintenance of excess weight is controversial. The purposes of the present study were to investigate the dietary factors associated with body mass index (BMI) and waist circumference (WC), and to analyse whether dietary intake varies between subjects with different levels of sports participation. METHODS: Data for this cross-sectional study, including anthropometric measurements, 3-day diet diary and physical activity questionnaire, were collected by the Flemish Policy Research Centre Sport, Physical Activity and Health (SPAH) between October 2002 and April 2004. Results of 485 adult men and 362 women with plausible dietary records were analysed. Analyses of covariance were performed to determine the differences in dietary intake between normal weight, overweight and obese subjects, and between subjects with different levels of sports participation. RESULTS: Total energy intake, protein and fat intake (kcal/day) were significantly higher in obese subjects compared to their lean counterparts in both genders. Percentage of energy intake from fat was significantly higher in obese men compared to men with normal weight or WC. Energy percentages from carbohydrates and fibres were negatively related to BMI and WC in men, whereas in women a higher carbohydrate and fibre intake was positively associated with obesity. Alcohol intake was positively associated with WC in men. Subjects participating in health related sports reported higher intake of carbohydrates, but lower intake of fat compared to subjects not participating in sports. CONCLUSION: This study supports the evidence that carbohydrate, fat, protein and fibre intake are closely related to BMI and WC. The sex differences for dietary intake between obese men and women might reflect the generally higher health consciousness of women. Alcohol intake was only associated with WC, emphasizing the importance of WC as an additional indicator in epidemiological studies. Besides enhancing sports and physical activity, it is necessary to improve the knowledge about nutrition and to promote the well-balanced consumption of wholesome food

Impact of exercise-nutritional state interactions in patients with type 2 diabetes

Introduction This study examines the role of nutritional status during exercise training in patients with type 2 diabetes mellitus by investigating the effect of endurance-type exercise training in the fasted versus the fed state on clinical outcome measures, glycemic control, and skeletal muscle characteristics in male type 2 diabetes patients. Methods Twenty-five male patients (glycated hemoglobin (HbA1c), 57 ± 3 mmol·mol−1 (7.4% ± 0.3%)) participated in a randomized 12-wk supervised endurance-type exercise intervention, with exercise being performed in an overnight-fasted state (n = 13) or after consuming breakfast (n = 12). Patients were evaluated for glycemic control, blood lipid profiles, body composition and physical fitness, and skeletal muscle gene expression. Results Exercise training was well tolerated without any incident of hypoglycemia. Exercise training significantly decreased whole-body fat mass (−1.6 kg) and increased high-density lipoprotein concentrations (+2 mg·dL−1), physical fitness (+1.7 mL·min−1·kg−1), and fat oxidation during exercise in both groups (PTIME 0.05). HbA1c concentrations significantly decreased after exercise training (PTIME < 0.001), with a significant greater reduction after consuming breakfast (−0.30% ± 0.06%) compared with fasted state (−0.08% ± 0.06%; mean difference, 0.21%; PTIME × GROUP = 0.016). No interaction effects were observed for skeletal muscle genes related to lipid metabolism or oxidative capacity. Conclusions Endurance-type exercise training in the fasted or fed state do not differ in their efficacy to reduce fat mass, increase fat oxidation capacity, and increase cardiorespiratory fitness and high-density lipoprotein concentrations or their risk of hypoglycemia in male patients with type 2 diabetes. HbA1c seems to be improved more with exercise performed in the postprandial compared with the postabsorptive state