Energy availability in female athletes with disabilities: a narrative review

Research on female athletes has increased, with the main focus on Low Energy Availability ( LEA) and Female Athlete Triad ( TRIAD), however there is a gap in knowledge about LEA and related conditions such as eating disorder, menstrual dysfunction and bone health in athletes with disabilities. The literature suggests that those athletes, depending on the type of disability, have a higher risk of developing LEA. In this way, the objective of this review is to describe the impact of LEA on health and performance of female athletes, with special focus on athletes with disabilities. A narrative review of the literature was conducted using as search terms LEA and TRIAD components - bone health and menstrual dysfunction - in female athletes. The narrative review yielded 24 studies on the subject, of those, 10 original studies, in which LEA was diagnosed in female athletes, only one referring to athletes with disabilities. Literature indicates the complexity in estimating EA, since the methods used to determine its components may present inaccuracies, especially for athletes with disabilities. Further researched is needed to assess EA in female athletes, especially with disabilities, as well as the improvement of EA's assessment and screening methods.Univ Fed Sao Paulo Unifesp, Undergrad Degree Nutr, Santos, SP, BrazilUniv Fed Sao Paulo Unifesp, Brazilian Paralymp Comm, Sao Paulo, SP, BrazilUniv Fed Sao Paulo Unifesp, Santos, SP, BrazilUniv Fed Sao Paulo Unifesp, Undergrad Degree Nutr, Santos, SP, BrazilUniv Fed Sao Paulo Unifesp, Brazilian Paralymp Comm, Sao Paulo, SP, BrazilUniv Fed Sao Paulo Unifesp, Santos, SP, BrazilWeb of Scienc

Análise do gasto energético com o exercício e estimativa da energia disponível de atletas paralímpicos de atletismo

There is a gap in the knowledge about the exercise energy expenditure (GEex) and the energy needs of athletes with disabilities. The purpose of this study was to evaluate the GEex and the adequacy of the energy consumption through the evaluation of the Energy Availability (EA) of track & field Paralympic athletes. This study took place in two stages, following the calendar of the periodized evaluations of the High-Performance Program of the Brazilian Paralympic Committee. In the first stage, 23 athletes (15 men and 08 women) with visual impairment (VI, n=10), cerebral palsy (CP, n=4), limb deficiency (LD, n=3) and guides (GUIDE, n=6) had their GEex evaluated. Of the 23 athletes participating in the first stage, only 16 athletes of the VI and GUIDE groups (10 men and 6 women) were assessed in the second stage with the aim to identify the adequacy of energy consumption through the evaluation of EA. The assessment of body composition was performed using the skinfold method. The analysis of the food intake was carried out through a 4-day food photographic record. Dietary analysis was conducted using the software Avanutri® version 4.0. A multidirectional accelerometer Actical® version 3.10. Respironics, Inc. (USA), fixed to the body throughout their sports activities by an elastic tape on the hip, was used to monitor movements by means of acceleration, which allowed the estimation of the GEex. Statistical processing was performed using the SPSS version 20.0 software. The descriptive analysis results are presented as median, standard error and confidence interval. The Wilcoxon test (p=0.05) was used to identify differences between women and men for each functional class. The Friedman test (p=0.05) was used to identify differences between the groups? medians of each variable, as well as to verify the difference between days. In the first stage, the results demonstrate that the consumption of energy in kcal/kg/day was below the recommendation for sprinters to all groups evaluated. The carbohydrate intake (g/kg) and lipids (% of VET) is in accordance with the recommendation. Daily protein intake (g/kg) was higher than recommended for all groups. The GEex was of 135 (14.6) kcal/hour, 5.3 MET; 102 (9.3) kcal/hour, 4.9 MET; 83 (11) kcal/hour, 5.9 MET and 97 (8.3) kcal/hour, 4.5 MET for GUIDE, VI, LD and CP, respectively. In the second stage of the study, EA values for both groups ranged from 23.7 to 48.7 kcal/kg/MLG/day, classified as being adequate for 56.3% of the athletes evaluated, being considered as adequate values higher than 30 kcal/kgMLG/day. However, VI group?s EA was higher than that of the GUIDE group (p=0.03). Three athletes of the GUIDE group presented an EA below 30kcal/kgMLG/day. Only in the VI group, two athletes had EA values above 45 kcal/kgMLG/day.Há uma lacuna no conhecimento sobre o gasto energético com o exercício (GEex) e a necessidade energética em atletas com deficiência. O propósito deste estudo é avaliar o GEex e a adequação no consumo de energia a partir da avaliação da Energia Disponível (ED) de atletas paralímpicos da modalidade do atletismo. A pesquisa ocorreu em duas etapas, acompanhando o ciclo de avaliações do Programa de Alto Rendimento do Comitê Paralímpico Brasileiro. Na primeira etapa, 23 atletas (15 homens e 08 mulheres) com deficiência visual (DV, n=10), paralisia cerebral (PC, n=4), amputação (AMP, n=3) e os atletas-guias (GUIAS, n=6) foram avaliados quanto ao GEex. Dos 23 atletas participantes da primeira etapa, apenas atletas com DV e GUIA, totalizando 16 atletas (10 homens e 6 mulheres), foram avaliados na segunda etapa, cujo objetivo foi avaliar a adequação no consumo de energia a partir da avaliação da ED. Foi realizada a avaliação da composição corporal, utilizando o método de dobras cutâneas. Para análise do consumo alimentar foi realizado o registro fotográfico dos alimentos, coletados por 4 dias consecutivos. A análise dietética deu-se por meio do software de avaliação dietética Avanutri® versão 4.0. Utilizou-se o acelerômetro multidirecional Actical® versão 3.10, marca Respironics, Inc. (USA), fixado ao corpo durante todas as atividades esportivas realizadas, por uma fita elástica sobre o quadril, a fim de monitorar a ocorrência do movimento por meio da aceleração, e permitir a estimativa do GEex. O processamento estatístico foi realizado utilizando-se o software SPSS® versão 20.0. Os resultados foram apresentados em mediana, erro padrão e intervalo de confiança. O teste de Wilcoxon (p?0,05) foi utilizado para identificar diferenças entre homens e mulheres para cada classe funcional. O teste Friedman (p?0,05) foi usado para identificar diferenças entre as medianas de cada variável para os grupos, assim como para verificar a diferença entre os dias. Na primeira etapa, os resultados demonstram que o consumo de energia em kcal/kg/dia estava abaixo da recomendação para velocistas para todos os grupos avaliados. O consumo de carboidratos (g/kg) e lípidios (% do VET) estava de acordo com a recomendação. O consumo proteico diário (g/kg) foi maior que a recomendação para todos os grupos. O GEex foi de 135 (14,6) kcal/hora, 5,3 MET; 102 (9,3) kcal/hora, 4,9 MET; 83 (11) kcal/hora, 5,9 MET e 97 (8,3) kcal/hora, 4,5 MET para GUIA, DV, AMP e PC, respectivamente. Na segunda etapa, os valores de ED para ambos os grupos variou de 23,7 a 48,7 kcal/kg/MLG, sendo classificada como adequada para 56,3% dos atletas avaliados, tendo sido considerado como adequado valores superiores a 30 kcal/kg/MLG/dia. No entanto, A ED do grupo DV foi superior a do grupo GUIA (p=0,03). Três atletas do grupo GUIA apresentaram a ED inferior a 30 kcal/kgMLG/dia, enquanto. Apenas no grupo DV, dois atletas apresentaram valores de ED acima de 45 kcal/kgMLG/dia.Dados abertos - Sucupira - Teses e dissertações (2013 a 2016

Do paralympic track and field athletes have low energy availability?

<div><p>Abstract One of the greatest challenges when working with athletes is to achieve the energy demands for physiological processes and exercise expenditure. The aim of this study was to assess the energy availability (EA) of Paralympic track and field athletes (sprinters). Seventeen athletes (9 male and 8 female) with visual impairment (VI, n=10), cerebral palsy (CP, n=4) and limb deficiency (LD, n=3) were assessed for energy intake (EI) (4-day food photographic record), energy expenditure with exercise (EEex) (motion sensor), and body composition (skinfolds method). Energy availability was estimated using the equation: EA = (EIkcal - EEexkcal) / fat-free mass (FFM) / day, and values ≤ 30kcal/kgFFM/day were considered as low energy availability (LEA). EEex varied from 130 to 477kcal/h and athletes trained in average for 3.2 hours per day. Mean EA for VI, LD and CP were 36 (2.19), 37 (1.90) and 38 (3.38) kcal/kgFFM/day, respectively. Most (82.3%) participants presented EA below ≥ 45kcal/kgFFM/day, throughout the days, which are the recommended values for athletes without disability. Athletes should be encouraged to consume adequate EA to avoid consequences related to low energy availability. There is need of further research to identify cut-off values adequate for this population.</p></div

Comparison of Measured and Predictive Values of Basal Metabolic Rate in Brazilian Paralympic Track and Field Athletes

To compare basal metabolic rate (BMR) predicted by different equations with measured BMR of the Brazilian paralympic track & field team aiming to verify which of these equations is best suited for use in this group. Method: 19 male and 11 female athletes grouped according to functional classification (vision impairment-VI, limb deficiency-LD, and cerebral palsy-CP) had their BMR measured by indirect calorimetry and compared with values predicted by different equations: Cunningham, Owen, Harris-Benedict, FAO/OMS, Dietary Reference Intakes, and Mifflin. Body composition data were obtained by skinfold measurements. Results were reported as mean and standard deviation and analyzed using the Wilcoxon test and Pearson's Correlation Coefficient. The Root Mean Squared Prediction Error (RMSPE) was calculated to identify the similarity between the estimated and predicted BMR. Results: Mean measured BMR was 25 +/- 4.2, 26 +/- 2.4, and 26 +/- 2.7 kcal/kg of fat free mass/day for VI, LD, and CP, respectively. Owen's equation had the best predictive performance in comparison with measured BMR for LD and CP athletes, within 104 and 125 kcal/day, while Mifflin's equation predicted within 146 kcal/day for VI athletes. Conclusion: for this specific group of athletes the Owen and Mifflin equations provided the best predictions of BMR.Univ Fed Sao Paulo, Dept Human Movement Sci, Sao Paulo, SP, BrazilBrazilian Paralymp Comm, Brasilia, DF, BrazilUniv Fed Minas Gerais, Belo Horizonte, MG, BrazilSch Phys Educ, Belo Horizonte, MG, BrazilUniv Fed Sao Paulo, Dept Human Movement Sci, Sao Paulo, SP, BrazilWeb of Scienc

Individual study of anthropometric variation, energy and macronutrients intakes in Paralympic Track and Field athletes in different phases of the season

Abstract Aims: a) to measure individual variations in body mass (BM), sum of skinfolds (SSF) and energy intake of Paralympic track and field athletes b) to evaluate whether individual consumption of macronutrients meets recommended levels in three distinct periods of training. Methods: Ten Paralympic track and field athletes were evaluated during three periods: 1) end of season, 2) after vacation, and 3) preparation for the Paralympic Games London 2012. Food history and the 24-hour Dietary Recall methods provided information on daily food intake. To assess changes in body composition, we measured skinfolds and BM. Descriptive statistics were utilized to describe individual results. Results: BM varied among athletes and phases, but most (n=8) had higher SSF after vacation. Four athletes reported an increase in energy intake of more than 500 kcal during their vacation period, while eight athletes reported maintaining their intake in the preparatory phase for the competition. Carbohydrate intake was adequate for most athletes in the end of season period and in the preparatory phase for competition, and most athletes had reduced lipid intake after vacation and in the preparatory phase. Conclusion: We observed important variations in BM and SSF, in food intake and macronutrients between the three evaluated periods. The nutritional status of the athletes suggests that inadequacies that might affect the performance of sprinters and middle-distance runners are more likely to occur during the preparatory period before competitions