Case Study: Extreme Weight Making Causes Relative Energy Deficiency, Dehydration and Acute Kidney Injury in a Male Mixed Martial Arts Athlete.

The aim of the present case study was to quantify the physiological and metabolic impact of extreme weight cutting by an elite male MMA athlete. Throughout an 8-week period, we obtained regular assessments of body composition, resting metabolic rate (RMR), VO2peak and blood clinical chemistry to assess endocrine status, lipid profiles, hydration and kidney function. The athlete adhered to a "phased" weight loss plan consisting of 7 weeks of reduced energy (ranging from 1300 - 1900 kcal.d-1) intake (phase 1), 5 days of water loading with 8 L per day for 4 days followed by 250 ml on day 5 (phase 2), 20 h fasting and dehydration (phase 3) and 32 h of rehydration and refuelling prior to competition (phase 4). Body mass declined by 18.1 % (80.2 to 65.7 kg) corresponding to changes of 4.4, 2.8 and 7.3 kg in phase 1, 2 and 3, respectively. We observed clear indices of relative energy deficiency, as evidenced by reduced RMR (-331 kcal), inability to complete performance tests, alterations to endocrine hormones (testosterone: 6 mmol.L-1). Moreover, severe dehydration (reducing body mass by 9.3%) in the final 24 hours prior to weigh-in induced hypernatremia (plasma sodium: 148 mmol.L-1) and acute kidney injury (serum creatinine: 177 μmol.L-1). These data therefore support publicised reports of the harmful (and potentially fatal) effects of extreme weight cutting in MMA athletes and represent a call for action to governing bodies to safeguard the welfare of MMA athletes

Perceptions of Current Issues in Female Sport Nutrition From Elite Athletes, Practitioners, and Researchers

In response to the ongoing sex data gap, the present study provides a qualitative exploration of females’ nutritional experiences in elite sporting environments. Semistructured interviews were conducted with multiple participant groups (n = 18), including athletes (n = 7), practitioners (n = 6), and researchers (n = 5) across differing disciplines within professional sporting organiza-tions and/or national governing bodies. Combined content and thematic analysis provided an insight into the specific factors influencing current sport nutrition practices. A common theme highlighted among all participant groups was the paradoxical struggle between adequate fueling for training and competition demands, and the fear this may impact body mass and body composition goals. This tension was identified as being rooted within athletes’ perceptions of body image and driven by other participant groups and wider societal ideals. Each participant group also highlighted influences on cravings and approaches to food and dietary supplementation, centered around individual perceptions and challenges driven by symptomology associated with the female menstrual cycle and contraceptive use. To address these challenges, all participant groups called for more research to inform future change and continuing education pathways. In summary, this study contributes to providing a more complete understanding of elite female athlete sport nutrition experiences than currently exists. Multiple perspectives highlight the complexity of providing sport nutrition support to elite female athlete populations and directs future research, and practice, to reconsider one-size-fits-all approaches and acknowledge unique individual contexts which may influence these areas

Whey Protein Augments Leucinemia and Post-Exercise p70S6K1 Activity Compared to a Hydrolysed Collagen Blend When in Recovery From Training With Low Carbohydrate Availability

We examined the effects of whey versus collagen protein on skeletal muscle cell signalling responses associated with mitochondrial biogenesis and protein synthesis in recovery from an acute training session completed with low carbohydrate (CHO) availability. In a repeated measures design (after adhering to a 36-h exercise-dietary intervention to standardise pre-exercise muscle glycogen), eight males completed a 75-min non-exhaustive cycling protocol and consumed 22 g of a hydrolysed collagen blend (COLLAGEN) or whey (WHEY) protein 45 min prior to exercise, 22 g during exercise and 22 g immediately post-exercise. Exercise decreased (P0.05) was observed for p53, Parkin and Beclin1 mRNA. Exercise suppressed (P<0.05) p70S6K1 activity in both conditions immediately post-exercise (≈ 25 fmol.min-1.mg-1). Post-exercise feeding increased p70S6K1 activity at 1.5 h post-exercise (P<0.05), the magnitude of which was greater (P <0.05) in WHEY (180 ± 105 fmol.min-1.mg-1) versus COLLAGEN (73 ± 42 fmol.min-1.mg-1). We conclude that protein composition does not modulate markers of mitochondrial biogenesis when in recovery from a training session deliberately completed with low CHO availability. In contrast, whey protein augments post-exercise p70S6K activity compared with hydrolysed collagen, as likely mediated via increased leucine availability

A 5-Year Analysis of Weight Cycling Practices in a Male World Champion Professional Boxer: Potential Implications for Obesity and Cardiometabolic Disease

Weight cycling is thought to increase the risk of obesity and cardiometabolic disease in nonathletic and athletic populations. However, the magnitude and frequency of weight cycling is not well characterized in elite athletes. To this end, we quantified the weight cycling practices of a male World Champion professional boxer competing at super middleweight (76.2 kg). Over a 5-year period comprising 11 contests, we assessed changes in body mass (n = 8 contests) and body composition (n = 6 contests) during the training camp preceding each contest. Time taken to make weight was 11 ± 4 weeks (range: 4–16). Absolute and relative weight loss for each contest was 12.4 ± 2.1 kg (range: 9.8–17.0) and 13.9% ± 2.0% (range: 11.3–18.2), respectively. Notably, the athlete commenced each training camp with progressive increases in fat mass (i.e., 12.5 and 16.1 kg for Contests 1 and 11) and reductions in fat-free mass (i.e., 69.8 and 67.5 kg for Contests 1 and 11, respectively). Data suggest that weight cycling may lead to “fat overshooting” and further weight gain in later life. Larger scale studies are now required to characterize the weight cycling practices of elite athletes and robustly assess future cardiometabolic disease risk. From an ethical perspective, practitioners should be aware of the potential health consequences associated with weight cycling

Perceptions of Current Issues in Female Sport Nutrition From Elite Athletes, Practitioners, and Researchers

In response to the ongoing sex data gap, the present study provides a qualitative exploration of females’ nutritional experiences in elite sporting environments. Semistructured interviews were conducted with multiple participant groups (n = 18), including athletes (n = 7), practitioners (n = 6), and researchers (n = 5) across differing disciplines within professional sporting organiza-tions and/or national governing bodies. Combined content and thematic analysis provided an insight into the specific factors influencing current sport nutrition practices. A common theme highlighted among all participant groups was the paradoxical struggle between adequate fueling for training and competition demands, and the fear this may impact body mass and body composition goals. This tension was identified as being rooted within athletes’ perceptions of body image and driven by other participant groups and wider societal ideals. Each participant group also highlighted influences on cravings and approaches to food and dietary supplementation, centered around individual perceptions and challenges driven by symptomology associated with the female menstrual cycle and contraceptive use. To address these challenges, all participant groups called for more research to inform future change and continuing education pathways. In summary, this study contributes to providing a more complete understanding of elite female athlete sport nutrition experiences than currently exists. Multiple perspectives highlight the complexity of providing sport nutrition support to elite female athlete populations and directs future research, and practice, to reconsider one-size-fits-all approaches and acknowledge unique individual contexts which may influence these areas

Longitudinal Changes in Body Composition and Resting Metabolic Rate in Male Professional Flat Jockeys: Preliminary Outcomes and Implications for Future Research Directions.

Jockeys are unique given that they make weight daily and, therefore, often resort to fasting and dehydration. Through increasing daily food frequency (during energy deficit), we have reported short-term improvements in jockey's body composition. While these changes were observed over 6-12 weeks with food provided, it is unclear whether such improvements can be maintained over an extended period during free-living conditions. We, therefore, assessed jockeys over 5 years using dual X-ray absorptiometry, resting metabolic rate, and hydration measurements. Following dietary and exercise advice, jockeys reduced fat mass from baseline of 7.1 ± 1.4 kg to 6.1 ± 0.7 kg and 6.1 ± 0.6 kg (p < .001) at Years 1 and 5, respectively. In addition, fat-free mass was maintained with resting metabolic rate increasing significantly from 1,500 ± 51 kcal/day at baseline to 1,612 ± 95 kcal/day and 1,620 ± 92 kcal/day (p < .001) at Years 1 and 5, respectively. Urine osmolality reduced from 816 ± 236 mOsmol/L at baseline to 564 ± 175 mOsmol/L and 524 ± 156 mOsmol/L (p < .001) at Years 1 and 5, respectively. The percent of jockeys consuming a regular breakfast significantly increased from 48% at baseline to 83% (p = .009) and 87% (p = .003) at Years 1 and 5, alongside regular lunch from 35% to 92% (p < .001) and 96% (p < .001) from baseline to Years 1 and 5, respectively. In conclusion, we report that improved body composition can be maintained in free-living jockeys over a 5-year period when appropriate guidance has been provided

The Psychological and Physiological Consequences of Low Energy Availability in a Male Combat Sport Athlete.

PURPOSE: To evaluate the effects of low energy availability (EA) on health and performance indices associated with the Male Athlete Triad and Relative Energy Deficiency in Sports (RED-S) models. METHODS: Over an 8 week period, a male combat sport athlete adhered to a phased body mass (BM) loss plan consisting of 7 weeks energy intake (EI) equating to resting metabolic rate (RMR) (1700 kcal·day) (Phase 1), 5 days of reduced EI (1200-300 kcal·day) prior to weigh-in (Phase 2) and one week of ad libitum EI post-competition (Phase 3). EA fluctuated day by day due to variations in exercise energy expenditure. Regular assessments of body composition, RMR, cardiac function, cardiorespiratory capacity, strength & power, psychological state and blood clinical chemistry for endocrine, bone turnover, hydration, electrolyte, renal, liver and lipid profiles were performed. RESULTS: BM was reduced over the 8 week period by 13.5% (72.5 to 62.7 kg). No consequences of Male Athlete Triad or RED-S were evident during phase 1, where mean daily EA equated to 20 kcal·kg·FFM·day (range: 7 to 31 kcal·kg·FFM·day) and BM and fat mass (FM) losses were 6.5 and 4.4 kg, respectively. However, consequences did present in phase 2 when mean daily EA was consistently <10 kcal·kg·FFM·day, as evidenced by alterations to endocrine hormones (e.g. testosterone: <5 nmol.L) and reduced RMR (-257 kcal·day). CONCLUSION: Data demonstrate that 7 weeks of daily fluctuations in EA equating to a mean value of 20 kcal·kg·FFM·day permits reductions of BM and FM without perturbations to physiological systems associated with the Male Athlete Triad and RED-S. In contrast, a subsequent period of 5 consecutive days of EA <10 kcal·kg·FFM·day induced consequences of Male Athlete Triad and RED-S

Hormonal contraceptive use, menstrual cycle characteristics and training/nutrition related profiles of elite, sub-elite and amateur athletes and exercisers: One size is unlikely to fit all

The aim of the present study was to simultaneously audit hormonal contraceptive (HC) use, menstrual cycle characteristics and training/nutrition related profiles in pre-menopausal women from varying athletic and exercise backgrounds. Elite (n = 51), sub-elite (n = 118) and amateur (n = 392) female athletes and exercisers were examined via an anonymous quantitative/qualitative survey tool. All analyses for ratio data were conducted utilising one- and two-way ANOVA/ANCOVA and odds ratio models, with ordinal data analysed via Pearson's Chi-squared tests. HC use was similar across elite, sub-elite and amateurs (34–44%). Menstrual cycle length was not different (P = 0.08) between competitive levels (28 ± 13 days), but 66% of respondents reported cycle variability (10 ± 11 days). Training profiles were not different based on contraceptive status (P > 0.05) yet were across competitive groups (P 0.05), though elite and sub-elite groups reported a higher daily meal consumption compared to amateurs (P < 0.01). Forty percent of all respondents skipped meals, attributed to lack of time, schedule and alterations in appetite, with reported changes in taste preferences during pre-menses (14–35%) and menses (15–25%) towards sweet foods (60%), with cravings for chocolate and other confectionary (25%). Prevalence of dietary supplement use was not influenced by contraceptive status (P = 0.31), though elites (76%) reported higher use (P = 0.04) than amateurs (63%). Data demonstrates that in female athletes and exercisers, competitive level appears to affect simple markers of training and nutrition practice, yet contraceptive status does not

Patterns of energy availability of free-living athletes display day-to-day variability that is not reflected in laboratory-based protocols: Insights from elite male road cyclists

The physiological effects of low energy availability (EA) have been studied using a homogenous daily EA pattern in laboratory settings. However, whether this daily EA pattern represents those of free-living athletes and is therefore ecologically valid is unknown. To investigate this, we assessed daily exercise energy expenditure, energy intake and EA in 10 free-living elite male road cyclists (20 min Mean Maximal Power: 5.27 ± 0.25 W · kg−1) during 7 consecutive days of late pre-season training. Energy intake was measured using the remote-food photography method and exercise energy expenditure estimated from cycling crank-based power-metres. Seven-day mean ± SD energy intake and exercise energy expenditure was 57.9 ± 10.4 and 38.4 ± 8.6 kcal · kg FFM−1 · day−1, respectively. EA was 19.5 ± 9.1 kcal · kg FFM−1 · day−1. Within-participants correlation between daily energy intake and exercise energy expenditure was .62 (95% CI: .43 – .75; P < .001), and .60 (95% CI: .41 – .74; P < .001) between carbohydrate intake and exercise energy expenditure. However, energy intake only partially compensated for exercise energy expenditure, increasing 210 kcal · day−1 per 1000 kcal · day−1 increase in expenditure. EA patterns displayed marked day-to-day fluctuation (range: −22 to 76 kcal · kg FFM−1 · day−1). The validity of research using homogenous low EA patterns therefore requires further investigation