Eating disorders in athletes: Overview of prevalence,risk factors and recommendations for prevention and treatment

Abstract

The prevalence of disordered eating and eating disorders vary from 0–19% in male athletes and 6–45% in female athletes. The objective of this paper is to present an overview of eating disorders in adolescent and adult athletes including: (1) prevalence data; (2) suggested sport- and gender-specific risk factors and (3) importance of early detection, management and prevention of eating disorders. Additionally, this paper presents suggestions for future research which includes: (1) the need for knowledge regarding possible gender-specific risk factors and sport- and gender-specific prevention programmes for eating disorders in sports; (2) suggestions for long-term follow-up for female and male athletes with eating disorders and (3) exploration of a possible male athlete triad.     

湖北省重竞技运动员营养知识-态度-行为（KAP）调查

目的了解湖北省重竞技项目运动员的营养知识知晓、饮食态度和饮食行为的现状,以便采取相应的措施达到合理营养。方法据营养＂知-信-行＂行为模式,设计营养KAP问卷,对冬训期间湖北省重竞技项目全体在训运动员进行调查。结果重竞技项目运动员营养知识平均得分4.23±1.92,营养知识处于普遍缺乏状态;81.6%运动员按自己的口味习惯选择食物,仅有17.1%考虑到营养搭配,2.3%考虑到营养合理;部分运动员不吃早餐,水果、牛奶摄入频次少,饮食行为不规范;但有着较好的接受营养知识教育的态度。结论采取各种有效措施对运动员加强营养知识教育,使运动员的膳食行为健康合理。     

Risk and protective factors for mental health in elite athletes: a scoping review

ABSTRACT

The purpose of this scoping review was to provide an overview of studies concerning the mental health (MH) of elite athletes and to provide a methodological, conceptual, and applied overview of factors affecting elite athletes’ MH. A total of nine reviews and 43 empirical studies were evaluated and are reported in three sections: sample characteristics, research design, and factors affecting elite athletes’ MH. These factors were grouped into risk and protective factors and divided into a personal and sport-environmental domain. The studies used quantitative (84%), qualitative (11%), and mixed-method (5%) designs and examined a wide range of sports in different countries. Our review shows that researchers have predominantly examined the prevalence of athletes’ mental ill-health (e.g. depression) and the related factors compromising MH. Potential protective factors such as the feeling of autonomy, positive relations in sport and private life, and adequate recovery were highlighted in the qualitative studies. The discussion appraises the findings through a critical lens, focuses on the current state of the research area and the MH definition, limitations, suggested practical implications (e.g. to provide MH literacy to both athletes and coaches), and future research directions (e.g. examining environments that foster elite athletes’ MH).     

Young,talented and injured: Injury perceptions,experiences and consequences in adolescent elite athletes

Even though injury is common in elite sports, there is still a lack of knowledge of young athletes’ injury perception both during and after injury. The aim of this mixed-method study was, therefore, to explore, in-depth, data on injury consequences and adolescent elite athletes’ perceptions and experience of injury. Three hundred and forty adolescent elite athletes (age range 15–19), from 16 different sports, were bi-weekly monitored over 52 weeks using a valid questionnaire. Twenty athletes from the same cohort were interviewed in focus groups about injury experience and perceptions. The results show that the average bi-weekly prevalence of injury was 38.7% (95% CI 37.3–40.1), with 30.0% (n?=?102) of the athletes injured for more than half of all reporting times. An overarching theme from the focus groups highlighted the risk among young athletes of a loss of identity while injured. The findings support several suggestions that may improve the rehabilitation process and enhance rehabilitation outcomes: (a) provide clear pathways to the medical team, (b) recognize the identity loss, (c) involve the injured athletes with the rest of the teammates and (d) educate athletes about how to interpret pain signals. Future research should explore and evaluate the effectiveness and generalization of such interventions.     

Exercise-induced bronchospasm among athletes in Lower Silesia Province

Abstract

A few studies have reported data on the prevalence of exercise-induced bronchospasm in high school and university athletes. Recently published data suggest that exercise-induced bronchospasm may affect up to 39% of American university athletes. To date, no data describing this pathology in athletes from Central Europe have been published. The aim of the present study was to establish the prevalence of exercise-induced bronchospasm in pupils attending sports mastership classes in secondary school as well as students of the University of Physical Education in Wroclaw. The participants were 77 athletes (30 women and 47 men) aged 16–27 years (mean 17.3 years). Only one athlete (1.29%) diagnosed with atopic asthma before testing experienced a fall in forced expiratory volume in one second (12.9% FEV₁) compared with baseline, which showed that the exercise test result was positive. From a clinical point of view, the ventilation disturbance was asymptomatic. In the other participants, there were slight but statistically significant rises in FEV₁ (P < 0.02). The results of our study indicate a very low prevalence of exercise-induced bronchospasm in the population of athletes examined.     

Dehydration and sodium deficit during indoor practice in elite European male team players

Abstract

Aspects of team players' performance are negatively affected when ~ 2% body mass is lost by perspiration. Although such dehydration is likely reached during summer practice in outdoors sports, it is unclear if such dehydration is achieved during the practice of indoor sports. We assessed the fluid and electrolyte deficits of elite team players during practice for the following indoor sports: indoor soccer (n=9), basketball (n=11), volleyball (n=10), and handball (n=13). Morning hydration status was estimated by measuring urine specific gravity. Sweat rate was calculated from body mass changes and fluid intake. Sweat sodium concentration from the forearm was used to estimate whole-body sodium losses. Over 91% of the players were moderately hypohydrated (urine specific gravity>1.020) at waking 3 h before practice. Indoor soccer players sweated at a higher rate (1.8 litres · h^?1) than volleyball and handball players (1.2 and 1.1 litres · h^?1, respectively; P<0.05), whereas sweat rate was not different between basketball players (1.5 litres · h^?1) and the other team sport players (P>0.05). In average, 62±13% of sweat losses were replaced and teams' body mass loss did not exceed 1.2±0.3%. Sodium losses were similar among teams, averaging 1.2±0.2 g. The exercise fluid replacement habits of professional indoor team players are adequate to prevent 2% dehydration. However, most players could benefit from increasing fluid intake between workouts to offset the high prevalence of morning hypohydration.     

体育锻炼知、信、行干预对大学生心理健康的影响

目的:本文从体育锻炼知、信、行干预与心理健康的内在关系等不同角度进行研究,以寻求改善和提高大学生心理健康的措施,为充分发挥学校体育教学的特殊功能,不断促进在校大学生的身心健康水平提供参考依据。方法:通过随机对照干预研究,比较实验组与对照组干预前后的心理症状的变化,探讨干预的效果。结果:用SCL-90测量发现,干预后大多数症状因子及总症状指数均出现下降。另外通过多因素分析,最终筛选出5个因素与总症状指数相关,其中4个因素,即:对专业感趣、母亲文化程度高、有固定体育爱好、对体育和健康有积极的态度均可以降低总症状指数,是保护性因素。而对学费担忧则可以提高总症状指数,是危险性因素。结论:本研究发现体育锻炼的知、信、行干预不仅可以明显提高大学生对体育锻炼及健康知识的认识水平和接受程度,而且能够改善大学生心理健康水平。     

Sport injuries as the main cause of sport career termination among Finnish top-level athletes

Abstract

Injuries are common among athletes, and are sometimes so severe that they affect an athlete's career in sport. As studies on sport career termination are few, we conducted a study to investigate the role of injuries as a reason for ending a sport career. The study group consisted of 574 male and female top-level cross-country skiers, swimmers, long-distance runners and soccer players who responded to a retrospective postal questionnaire in 2006. Twenty-seven athletes (4.9%, 27/548) reported ending their sport career because of injury. A follow-up interview was conducted by telephone in 2007 (n=20 volunteered to be interviewed) to confirm sport career termination and the reasons for this. Fifteen of the interviewed athletes terminated and five continued their sport on the same level as earlier. Female athletes (12/15) terminated their sport career more frequently than male athletes (3/15). Athletes who reported terminating their sport career because of injury were on average two and a half years older (24.1 years vs. 21.6 years, P=0.006) than athletes who continued the sport. All the swimmers (n=5) who were interviewed terminated their career because of a shoulder injury. All the soccer players who ended their career (n=4) were female and had a severe knee injury, such as anterior cruciate ligament injury. Most of the athletes who terminated their sport career (70.4%, 19/27) reported that the injury caused them mild or moderate permanent disability. We found that sports injuries play a significant role in terminating a career in sport, and in some sports events injuries may commonly be the main reason for sport career termination. Injury prevention and adequate treatment and rehabilitation of injuries are thus essential to avoid the long-term consequences of severe sport injuries.     

Patterns of performance development in elite athletes

Abstract

This investigation sought to contrast generalised models of athlete development with the specific pathway trajectories and transitions experienced by 256 elite athletes across 27 different sports. All participants completed the National Athlete Development Survey and within it, the Athlete Development Triangle featuring the differentiation of junior and senior competition experience and progression. Developmental initiation; prevalence, magnitude and direction of pathway trajectory; extent of concurrent junior and senior competitive experience; and variability between sports were examined. Three major trajectories were identified in relation to athlete transition from Nil competition to Elite competition, via junior and senior competition phases. These included Pure ascent (16.4%), Mixed ascent (26.2%) and Mixed descent (57.4%). These were further partitioned into eight sub-trajectories, demonstrating a mix of linear, crossover and concurrent competition profiles. Substantial variability with regard to starting age, pattern of ascent and magnitude of transition was apparent. Non-linear trajectories were experienced by the majority of athletes (83.6%), with pure junior to senior developmental linearity evident in less than 7% of cases. Athletes in cgs sports (those measured in centimetres, grams or seconds) were less likely (43%) to experience a descending trajectory in comparison with non-cgs athletes (70%; p<0.001). The collective findings of this investigation demonstrate that, contrary to the popular pyramidal concept of athlete development, a single linear assault on expertise is rare, and that the common normative junior to senior competition transition is mostly characterised by complex oscillations featuring highly varied transitions. More developmental ‘granularity’ is needed to advance our understanding of sport expertise.     

Elite athletes' attitudes towards the use of placebo-induced performance enhancement in sports

Abstract

While an increasing number of research is devoted to the understanding of placebo effects in sports, athletes' experiences with and attitudes towards the use of placebo for performance enhancement remain poorly understood. In this study, 79 elite athletes from different sports were surveyed on five issues related to placebo use in sports. Results showed that 47% of the athletes have experienced placebo effects in the past. A majority of the athletes (82%) thought that placebos could affect their sports performances. A wider use of placebos in sport settings was endorsed more by those who have experienced placebo effects in the past than those who did not (P = .005). Regardless of past experience with placebo, more than half of the athletes (53%) would accept an unknown but legitimate substance from the coach, and 67% of them would not mind a placebo-linked deception if that was effective. These findings confirm that most elite athletes believe in the power of placebos in enhancing sports performance, and those having a positive past experience exhibit slightly more favourable attitudes in contrast to those without such experiences.     

Sleep/wake behaviours of elite athletes from individual and team sports

Abstract

Sleep is an essential component for athlete recovery due to its physiological and psychological restorative effects, yet few studies have explored the habitual sleep/wake behaviour of elite athletes. The aims of the present study were to investigate the habitual sleep/wake behaviour of elite athletes, and to compare the differences in sleep between athletes from individual and team sports. A total of 124 (104 male, 20 female) elite athletes (mean ± s: age 22.2 ± 3.0 years) from five individual sports and four team sports participated in this study. Participants' sleep/wake behaviour was assessed using self-report sleep diaries and wrist activity monitors for a minimum of seven nights (range 7–28 nights) during a typical training phase. Mixed-effects analyses of variances were conducted to compare the differences in the sleep/wake behaviour of athletes from two sport types (i.e. individual and team). Overall, this sample of athletes went to bed at 22:59 ± 1.3, woke up at 07:15 ± 1.2 and obtained 6.8 ± 1.1 h of sleep per night. Athletes from individual sports went to bed earlier, woke up earlier and obtained less sleep (individual vs team; 6.5 vs 7.0 h) than athletes from team sports. These data indicate that athletes obtain well below the recommended 8 h of sleep per night, with shorter sleep durations existing among athletes from individual sports.     

Compelling overuse injury incidence in youth multisport athletes

The present investigation was carried out to examine the incidence and pattern of injuries in adolescent multisport athletes from youth sports academy. Injury data were prospectively collected from 166 athletes during the seasons from 2009 to 2014. A total of 643 injuries were identified, 559 (87.0%) were time-loss injuries. The overall injury incidence was 5.5 (95% confidence interval CI: 5.1–6.0), the incidence of time-loss injuries was 4.8 (95% CI: 4.4–5.2), the incidence of growth conditions was 1.2 (95% CI: 1.0–1.4) and incidence of serious injuries was 0.6 (95% CI: 0.5–0.8) per 1000?h of exposure. The prevalence of overuse injuries was 50.3%. Growth conditions represented 20.0%. Most of the injuries (67.0%) involved the lower extremities, and both foot and ankle were the most predominant injured body parts (22.0%). Knee injuries were mostly from overuse (50 vs. 23, p?=?.02), whereas foot and ankle injuries resulted from an acute mechanism (94 vs. 31, p?<?.0001). Minor and moderate injuries accounted for 87.0%. Muscle, tendon and osteochondrosis injuries accounted for 52.0% of all injuries. Comparing groups, squash sport was having the highest injury incidence (8.5 injuries per athlete). Higher exposure was associated with greater overuse relative risk (RR?=?1.03, 95% CI: 1.01–1.014, p?<?.001). In conclusion, the results of this study identified a high incidence of injuries in this youth sports population. Striking was the prevalence of overuse injuries of 50%, which suggests the need for injury prevention protocols for adolescent highly trained athletes.     

Associations Between Self-Control,Practice, and Skill Level in Sport Expertise Development

Purpose: The purpose of this study was to test the association between self-control (SC) variables and (a) sport-specific practice amounts, (b) engagement in various practice contexts, (c) threats to commitment to one's sport, and (d) skill development using the Brief Self-Control Scale (BSCS) in a diverse sport sample. Method: Two hundred forty-four athletes (47% female; M_age = 21.96 years, SD = 6.98 years; 68.8% individual sports and 31.2% team sports; 13.77 [SD = 8.12] hr/week of sport-specific practice) completed a survey composed of the BSCS and practice-related measures. Three skill groups (basic/intermediate, advanced, expert) were informed by athletes' self-reported highest level of competition. Separate analyses were conducted for juniors (aged 12–17 years) and seniors (aged 18–43 years). Results: A 2-factor model (self-discipline and impulse control) fit the BSCS data. Fewer thoughts of quitting from one's sport were associated with higher self-discipline in juniors and seniors and were also related to higher impulse control in seniors. Greater practice amounts were associated with higher self-discipline; however, only seniors showed such associations in voluntary practice contexts. For juniors and seniors, impulse control was associated with more voluntary practicing. There were, however, no skill-group differences for levels of self-discipline or impulse control. Conclusions: Self-discipline and impulse control may be dispositional characteristics associated with how athletes engage in practice and avert conditions that threaten their sport commitment. SC dispositions may relate to practice amounts differently in juniors and seniors, depending on the requirements for self-regulation in a practice context.     

广西高校教师营养KAP及健康状况调查分析

目的：了解广西高校教师的营养知识-态度-行为（KAP）及健康现状,为今后对高校教师进行营养健康教育提供依据。方法：采用问卷调查方法,对广西柳州师专和南宁师专在校教师110人进行营养KAP及健康现况调查。结果：广西高校教师营养知识得分8.16±3.23,及格率为43.6%,且性别、年龄、学校、学历之间存在显著差异;营养态度分为17.72±2.84,及格率90.9%,柳专高于南专教师,差异显著;营养习惯和行为得分33.26±4.82,及格率64.6%;KAP总体分为59.15±8.26,低于及格水平,柳专教师明显高于南专教师,且差异非常显著;健康分2.74±1.91,及格率46.3%;运动分2.41±1.60,及格率55.5%,且性别、年龄、专业之间存在着非常显著差异;BMI在标准范围的有65人,占59.1%,体重不足、超重、肥胖45人,占40.9%;营养知识（K）、态度（A）、行为（P）、健康、运动之间呈明显正相关关系。结论：高校教师饮食营养知识普遍缺乏,日常饮食营养习惯和行为不够合理,运动锻炼时间明显不足,健康状况令人担忧,但饮食营养态度非常积极,应开展有效的营养健康教育提高他们的营养保健知识,为其健康行为的形成提供支持。     

Acute kinematic and kinetic adaptations to wearable resistance during vertical jumping

One variation of vertical jump (VJ) training is resisted or weighted jump training, where wearable resistance (WR) enables jumping to be overloaded in a movement specific manner. A two-way analysis of variance with Bonferroni post hoc contrasts was used to determine the acute changes in VJ performance with differing load magnitudes and load placements. Kinematic and kinetic data were quantified using a force plate and contact mat. Twenty sport active subjects (age: 27.8?±?3.8 years; body mass (BM): 70.2?±?12.2?kg; height: 1.74?±?0.78?m) volunteered to participate in the study. Subjects performed the counter movement jump (CMJ), drop jump (DJ) and pogo jump (PJ) wearing no resistance, 3% or 6% BM affixed to the upper or lower body. The main finding in terms of the landing phase was that the effect of WR was non-significant (P?>?.05) on peak ground reaction force. With regard to the propulsive phase the main findings were that for both the CMJ and DJ, WR resulted in a significant (P?<?.05) decrease in jump height (CMJ: ?12% to ?17%, DJ: ?10% to ?14%); relative peak power (CMJ: ?8% to ?17%, DJ: ?7% to ?10%); and peak velocity (CMJ: ?4% to ?7%, DJ: ?3% to ?8%); while PJ reactive strength index was significantly reduced (?15% to ?21%) with all WR conditions. Consideration should be given to the inclusion of WR in sports where VJ’s are important components as it may provide a novel movement specific training stimulus.

Highlights

• WR of 3 or 6 % BM provided a means to overload the subjects in this study resulting in decreased propulsive power and velocity that lead to a reduced jump height and landing force.

• Specific strength exercises that closely mimic sporting performance are more likely to optimise transference, therefore WR with light loads of 3–6% body mass (BM)appear a suitable tool for movement specific overload training and maximising transference to sporting performance.

• Practitioners can safely load their athletes with upper or lower body WR of 3–6% BM without fear of overloading the athletesover and above the landing forces they are typically accustomed too.

• As a training stimulus it would seem the WR loading provides adequate overload and athletes should focus on velocity of movement to improve power output and jump height i.e. take-off velocity.

     

Body composition and nutritional profile of male adolescent tennis players

Abstract

In this cross-sectional study, we evaluated the body composition and dietary intake of 44 adolescent tennis players. After being divided into two groups (age 10–13 years and age 14–18), the players had their weight, height, and sexual maturation assessed. Dual-energy X-ray absorptiometry was used to assess body composition. Food intake was obtained from a non-consecutive 4-day food record. The data were analysed using the Virtual Nutri v.1.0 software and compared with the present recommendations for adolescent athletes or dietary reference intakes. Body mass index and body fat for tennis practice were adequate for 89% and 71% of the tennis players respectively, regardless of age group. A calorie deficit greater than 10% of energy expenditure was observed in 32% of the sample. Fifty percent of the athletes consumed carbohydrates in accordance with recommended values. Protein and lipid intakes were above recommended values, while fibre, calcium, potassium, magnesium, and folic acid intakes were below recommendation for 98%, 80%, 100%, 100%, and 98% of the tennis players respectively. The observed nutritional deficiencies represent an additional barrier for adolescents engaged in competitive sports to achieve an optimum nutrition to maintain growth, health, and performance.     

Chronic participation in externally paced,but not self-paced sports is associated with the modulation of domain-general cognition

Abstract

The present study investigated the role of chronic sport participation in the modulation of vigilance and inhibitory control. We also aimed to disentangle the relative contribution of different types of sport expertise and sport-related fitness to the exercise-cognition relationship. Three groups of young adults differing in their chronic sport expertise (externally-paced sports, n?=?22, self-paced sports, n?=?22, non-athletes, n?=?22) took part in the study. Participants completed a cardiovascular fitness test, a hand-eye coordination test and two different types of vigilance tasks: (1) Psychomotor Vigilance Task (PVT) and (2) Oddball Task, which were designed to gain insight into the cognitive processes involved in sustaining attention over time and allocating selective attention by exerting inhibitory control, respectively. No differences were found in PVT performance between the two athlete groups and between self-paced sports athletes and non-athletes, whereas athletes from externally-paced sports outperformed non-athletes. Crucially, athletes from externally-paced sports also differed from those of self-paced sports and non-athletes in the Oddball task, showing less omission and commission errors. The sport expertise effect was independent of participant’s cardiovascular fitness while hand-eye coordination modulated vigilance and inhibitory control performance. Our findings add novel empirical evidence to the role of expertise in cognitively demanding sports as an important factor in the relationship between exercise and cognition.     

Childhood practice and play as determinants of adolescent intrinsic and extrinsic motivation among elite youth athletes

Abstract

The study empirically tested the postulate of the Developmental Model of Sport Participation (DMSP; Côté, J., Baker, J., & Abernethy, B. (2007). Practice and play in the development of sport expertise. In R. Eklund & G. Tenenbaum (Eds.), Handbook of sport psychology (pp. 184–202). Hoboken, NJ: Wiley) that diversified childhood self-led sport play will beneficially affect future, adolescent intrinsic motivation. Participants were 178 elite youth athletes (age 15.3?±?1.5 years) from several game and non-game sports; 117 were members of the federal state or national junior squad in their respective sport. A questionnaire measured current (adolescent) intrinsic and extrinsic motivation of the youth athletes using the Sport Motivation Scale (Pelletier, L. G., Fortier, M. S., Vallerand, R. J., Tuson, K. M., Brière, N. M., & Blais, M. R. (1995). Towards a new measure of intrinsic motivation, extrinsic motivation, and amotivation in sports: The sport motivation scale (SMS). Journal of Sport & Exercise Psychology, 17, 35–53) and their earlier volume of childhood engagement (through 12 years) in coach-led practice and self-led play in their respective main sport and other sports. Analyses revealed that adolescent intrinsic motivation was not significantly correlated with earlier childhood self-led sport activities, self-led play in particular, or childhood sports diversification. Furthermore, considering all different types of childhood sport activities together in multiple regression analyses, they did not provide meaningful explanatory power regarding adolescent intrinsic or extrinsic motivation. In summary, the results did not provide support for the postulate of the DMSP among elite youth athletes. The findings suggest that future research may seek to enable more robust empirical substantiation of the DMSP postulate.     

Parental Behavior,Cognitive Appraisal,and Motivation in Young Athletes

Purpose: This study tested two hypotheses relating young athletes’ sports motivations to parental behaviors and cognitive appraisal: (1) young athletes’ motivation in sports is related to their parents’ behavior; and (2) this relationship is mediated by cognitive appraisal, even after controlling for competitive level and sports records. Method: This cross-sectional study included 673 young athletes and it measured the athletes’ perceptions of parental behaviors, cognitive appraisal, and sports motivation. Results: Structural equation modeling confirmed Hypothesis 1–the mother’s behaviors accounted for 15 to 16% of the variance in sports motivation, and the father’s behaviors accounted for 12 to 21% of the variance. The correlation patterns differed according to whether the athletes were evaluating the mother’s or father’s behaviors. Hypothesis 2 also was confirmed, for cognitive appraisal partially mediated the relationship between the perception of parental behaviors and sports motivation (34% of the variance was accounted for by the perception of the mother’s behavior; 30% by the father’s). The mediating model did not vary with competitive level or sports records. Conclusion: Parental behaviors and cognitive appraisal need to be taken into account to understand young athletes’ sports motivations.