Energy balance during outdoor education winter training: a pilot study

Learning in the mountains during winter prepares upcoming guides for tough environments by placing demands on their energy intake and enabling them to cope with a complex environment. However, few studies have explored energy intake and expenditure in outdoor education. Thus, energy intake during a 24-hour winter mountain course was investigated in a Norwegian educational context, where students must absorb large volumes of information in a challenging environment. Twenty university students (11 men, 9 women) underwent body composition, weighed energy intake, and accelerometry-based energy expenditure measurements. Overall, the students had an energy deficit of>2,300 kilo-calories/day, corresponding to an energy balance of 62% for men and 54% for women (p > 0.05), despite having received lectures on energy requirements in advance. This sustained stress context combined with challenging environmental conditions and insufficient energy intake can predispose students to early exhaustion, injury risk, and potentially reduced information processing that may limit learningEnergy balance during outdoor education winter training: a pilot studypublishedVersio

Prevalence of relative energy deficiency in sport among well-trained male Norwegian cyclists and long-distance runners

Masteroppgave i idrettsvitenskap - Universitetet i Agder 2016Introduction Relative Energy Deficiency in Sport (RED-S) links low and reduced energy availability (EA) with negative health and performance consequences, though not well investigated in male endurance athletes. The aim of this study was to investigate the prevalence of RED-S and associated health consequences in well-trained male endurance athletes. Methods Forty-one subjects, cyclists (n=21) and runners (n=20) [age: 40 (31-45) years; BMI: 23.5 (21.4-24.0) kg/m2; body-fat: 14.0% (10.0-16.5%); training volume: 12 (9-16) h/week presented as median + interquartile range] were recruited. Protocol included assessment of bone health, body composition, resting metabolic rate (RMR), blood pressure, energy intake, energy expenditure, hormonal biomarkers, blood glucose and lipids. 27 subjects were included in the final analysis. Results Eighteen subjects had reduced EA (<40kcal/kgFFM/day) and showed a trend of lower RMR ratio compared to the optimal EA group (0.83 vs. 0.86, P=0.026). Six subjects had low bone mineral density (BMD), but not related to EA status. The reduced EA group showed a trend of higher BMD in femur (P=0.037), hip (P=0.057), lumbar spine (P=0.01) and total body (P=0.035). No associations between groups were observed in hormonal biomarkers, blood glucose or blood lipids. Conclusion We found high prevalence of reduced EA accompanied by metabolic alterations in this group of well-trained athletes. However, no differences were observed between EA groups in either anthropometric, hormonal biomarkers, blood glucose, blood lipids or BMD. This may indicate that well-trained male endurance athletes are better protected against associations to negative health consequences in combination with reduced EA, compared to female endurance athletes. Keywords Athlete health, bone health, energy availability, hormonal biomarkers, male endurance athletes, resting metabolic rate Due to word limitations in the master thesis, the following will only be present in the article (part 2); results, discussion regarding results and conclusio

Impact of a 4-Week Intensified Endurance Training Intervention on Markers of Relative Energy Deficiency in Sport (RED-S) and Performance Among Well-Trained Male Cyclists

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Screening for Low Energy Availability in Male Athletes: Attempted Validation of LEAM-Q

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Exercise dependence, eating disorder symptoms and biomarkers of Relative Energy Deficiency in Sports (RED-S) among male endurance athletes

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Relative Energy Deficiency in Sport (RED-S) among Norwegian male athletes. Energy availability, health, and performance among male athletes at different age and performance levels

Relative Energy Deficiency in Sport (RED-S) is a syndrome where low energy availability (LEA) has a negative impact on health [e.g., endocrine and metabolic alterations, reproductive dysfunction, impaired bone mineral density (BMD)] and performance. In females, the development and prevalence of RED-S have been well-investigated. However, research on males of all ages and performance levels is lacking. The overall aim of this dissertation was therefore to investigate RED-S among Norwegian male athletes at different age and performance levels. Three independent studies have been performed, and three original papers are included in this dissertation. The aims of Studies I and II were to investigate RED-S in well-trained and Olympic-level adult athletes, whereas Study III investigated RED-S among adolescent athletes attending elite sport high schools. Study I investigated how a four-week intensified endurance training period specifically designed to increase aerobic performance would affect markers of RED-S, including resting metabolic rate (RMR), body composition and bone health, energy intake (EI), and metabolic and endocrine markers in well-trained cyclists. Study II investigated the prevalence of surrogate RED-S markers in a cohort of Norwegian Olympic-level athletes using similar markers as in Study I, including RMR, body composition, bone health, and altered metabolic and endocrine markers. Study III investigated RED-S in adolescent endurance athletes attending Norwegian elite sport high schools over a three-year period, with special attention to bone health, energy availability (EA), RMR, as well as aerobic performance and muscular strength

Screening for Low Energy Availability in Male Athletes: Attempted Validation of LEAM-Q

A questionnaire-based screening tool for male athletes at risk of low energy availability (LEA) could facilitate both research and clinical practice. The present options rely on proxies for LEA such screening tools for disordered eating, exercise dependence, or those validated in female athlete populations. in which the female-specific sections are excluded. To overcome these limitations and support progress in understanding LEA in males, centres in Australia, Norway, Denmark, and Sweden collaborated to develop a screening tool (LEAM-Q) based on clinical investigations of elite and sub-elite male athletes from multiple countries and ethnicities, and a variety of endurance and weight-sensitive sports. A bank of questions was developed from previously validated questionnaires and expert opinion on various clinical markers of LEA in athletic or eating disorder populations, dizziness, thermoregulation, gastrointestinal symptoms, injury, illness, wellbeing, recovery, sleep and sex drive. The validation process covered reliability, content validity, a multivariate analysis of associations between variable responses and clinical markers, and Receiver Operating Characteristics (ROC) curve analysis of variables, with the inclusion threshold being set at 60% sensitivity. Comparison of the scores of the retained questionnaire variables between subjects classified as cases or controls based on clinical markers of LEA revealed an internal consistency and reliability of 0.71. Scores for sleep and thermoregulation were not associated with any clinical marker and were excluded from any further analysis. Of the remaining variables, dizziness, illness, fatigue, and sex drive had sufficient sensitivity to be retained in the questionnaire, but only low sex drive was able to distinguish between LEA cases and controls and was associated with perturbations in key clinical markers and questionnaire responses. In summary, in this large and international cohort, low sex drive was the most effective self-reported symptom in identifying male athletes requiring further clinical assessment for LEA

Prevalence of Surrogate Markers of Relative Energy Deficiency in Male Norwegian Olympic-Level Athletes

The syndrome of Relative Energy Deficiency in Sport (RED-S) includes wide-ranging effects on physiological and psychological functioning, performance, and general health. However, RED-S is understudied among male athletes at the highest performance levels. This cross-sectional study aimed to investigate surrogate RED-S markers prevalence in Norwegian male Olympic-level athletes. Athletes (n = 44) aged 24.7 ± 3.8 years, body mass 81.3 ± 15.9 kg, body fat 13.7% ± 5.8%, and training volume 76.1 ± 22.9 hr/month were included. Assessed parameters included resting metabolic rate (RMR), body composition, and bone mineral density by dual-energy X-ray absorptiometry and venous blood variables (testosterone, free triiodothyronine, cortisol, and lipids). Seven athletes (16%) grouped by the presence of low RMR (RMRratio < 0.90) (0.81 ± 0.07 vs. 1.04 ± 0.09, p < .001, effect size 2.6), also showed lower testosterone (12.9 ± 5.3 vs. 19.0 ± 5.3 nmol/L, p = .020) than in normal RMR group. In low RMRratio individuals, prevalence of other RED-S markers (—subclinical—low testosterone, low free triiodothyronine, high cortisol, and elevated low-density lipoprotein) was (N/number of markers): 2/0, 2/1, 2/2, 1/3. Low bone mineral density (z-score < −1) was found in 16% of the athletes, all with normal RMR. Subclinical low testosterone and free triiodothyronine levels were found in nine (25%) and two (5%) athletes, respectively. Subclinical high cortisol was found in 23% of athletes while 34% had elevated low-density lipoprotein cholesterol levels. Seven of 12 athletes with two or more RED-S markers had normal RMR. In conclusion, this study found that multiple RED-S markers also exist in male Olympic-level athletes. This highlights the importance of regular screening of male elite athletes, to ensure early detection and treatment of RED-S