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Melin, Anna K., Assistant ProfessorORCID iD iconorcid.org/0000-0002-8249-1311
Publications (10 of 24) Show all publications
Logue, D. M., Madigan, S. M., Melin, A. K., Delahunt, E., Heinen, M., McDonnell, S.-J. & Corish, C. A. (2020). Low Energy Availability in Athletes 2020: An Updated Narrative Review of Prevalence, Risk, Within-Day Energy Balance, Knowledge and Impact of Sports Performance. Nutrients, 12(3), Article ID 835.
Open this publication in new window or tab >>Low Energy Availability in Athletes 2020: An Updated Narrative Review of Prevalence, Risk, Within-Day Energy Balance, Knowledge and Impact of Sports Performance
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2020 (English)In: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 12, no 3, p. -19, article id 835Article in journal (Refereed) Published
Abstract [en]

Low energy availability (EA) underpins the female and male athlete triad and relative energy deficiency in sport (RED-S). The condition arises when insufficient calories are consumed to support exercise energy expenditure, resulting in compromised physiological processes, such as menstrual irregularities in active females. The health concerns associated with longstanding low EA include menstrual/libido, gastrointestinal and cardiovascular dysfunction and compromised bone health, all of which can contribute to impaired sporting performance. This narrative review provides an update of our previous review on the prevalence and risk of low EA, within-day energy deficiency, and the potential impact of low EA on performance. The methods to assess EA remain a challenge and contribute to the methodological difficulties in identifying "true" low EA. Screening female athletic groups using a validated screening tool such as the Low Energy Availability in Females Questionnaire (LEAF-Q) has shown promise in identifying endurance athletes at risk of low EA. Knowledge of RED-S and its potential implications for performance is low among coaches and athletes alike. Development of sport and gender-specific screening tools to identify adolescent and senior athletes in different sports at risk of RED-S is warranted. Education initiatives are required to raise awareness among coaches and athletes of the importance of appropriate dietary strategies to ensure that sufficient calories are consumed to support training.

Place, publisher, year, edition, pages
MDPI, 2020
National Category
Sport and Fitness Sciences
Research subject
Social Sciences, Sport Science
Identifiers
urn:nbn:se:lnu:diva-93636 (URN)10.3390/nu12030835 (DOI)
Available from: 2020-04-21 Created: 2020-04-21 Last updated: 2020-04-22Bibliographically approved
Logue, D. M., Madigan, S. M., Melin, A. K., McDonnell, S.-J., Delahunt, E., Heinen, M. & Corish, C. A. (2020). Self-reported reproductive health of athletic and recreational active males in Ireland: potential health effects interfering with perfromance. European Journal of Sport Science, 1-10
Open this publication in new window or tab >>Self-reported reproductive health of athletic and recreational active males in Ireland: potential health effects interfering with perfromance
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2020 (English)In: European Journal of Sport Science, ISSN 1746-1391, E-ISSN 1536-7290, p. 1-10Article in journal (Refereed) Epub ahead of print
Abstract [en]

Introduction: The syndrome of Relative Energy Deficiency in Sport (RED-S) consensus statements recognise that male athletes might have impaired fertility in terms of the Exercise Hypogonodal Male Condition (ExHMC). Thus, the aims of this study were to (1) identify risk of ExHMC in active males in various sports and (2) determine if associations between risk of ExHMC and health problems interfering with training and competition exist. Methods: A questionnaire was distributed online (November 2018–January 2019) using questions derived from the “Androgen Deficiency in the Aging Male Questionnaire” (ADAM-Q) to assess risk of ExHMC. Additional questions were included to collect information on participant demographics, injury and illness history and dietary habits. Logistic regression analyses explored differences between groups. Results: Risk of ExHMC was identified in 23.3% (n= 185) of 794 questionnaire participants. Following multivariate analyses, risk of ExHMC was independently associated with a lower than normal sex drive rating within the last month (OR 7.62, 95%CI 4.99–11.63) and less than three morning erections per week within the last month (OR: 4.67, 95%CI 3.23–6.76). Risk of ExHMC was associated with 15–21 days absence from training or competition during the previous 6 months due to overload injuries in the univariate analysis (OR = 2.69, 95% CI = 1.24–5.84). Conclusion: Risk of ExHMC and associated symptoms in this heterogeneous sample may be indicative of RED-S. Confounding factors such as over-training, medication use, fatigue and psychological stress need to be considered. Identification of male athletes exhibiting physiological symptoms associated with RED-S requires more research.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2020
Keywords
Relative energy deficiency in sport; nutrition
National Category
Sport and Fitness Sciences
Research subject
Social Sciences, Sport Science
Identifiers
urn:nbn:se:lnu:diva-93638 (URN)10.1080/17461391.2020 (DOI)
Available from: 2020-04-21 Created: 2020-04-21 Last updated: 2020-04-22
Logue, D. M., Madigan, S. M., Melin, A. K., McDonnell, S.-J., Delahunt, E., Heinen, M. & Corish, C. A. (2020). Self-reported reproductive health of athletic and recreationally active males in Ireland: potential health effects interfering with performance. European Journal of Sport Science, 1-10
Open this publication in new window or tab >>Self-reported reproductive health of athletic and recreationally active males in Ireland: potential health effects interfering with performance
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2020 (English)In: European Journal of Sport Science, ISSN 1746-1391, E-ISSN 1536-7290, p. 1-10Article in journal (Refereed) Epub ahead of print
Abstract [en]

Introduction: The syndrome of Relative Energy Deficiency in Sport (RED-S) consensus statements recognise that male athletes might have impaired fertility in terms of the Exercise Hypogonodal Male Condition (ExHMC). Thus, the aims of this study were to (1) identify risk of ExHMC in active males in various sports and (2) determine if associations between risk of ExHMC and health problems interfering with training and competition exist. Methods: A questionnaire was distributed online (November 2018-January 2019) using questions derived from the "Androgen Deficiency in the Aging Male Questionnaire" (ADAM-Q) to assess risk of ExHMC. Additional questions were included to collect information on participant demographics, injury and illness history and dietary habits. Logistic regression analyses explored differences between groups. Results: Risk of ExHMC was identified in 23.3% (n = 185) of 794 questionnaire participants. Following multivariate analyses, risk of ExHMC was independently associated with a lower than normal sex drive rating within the last month (OR 7.62, 95%CI 4.99-11.63) and less than three morning erections per week within the last month (OR: 4.67, 95%CI 3.23-6.76). Risk of ExHMC was associated with 15-21 days absence from training or competition during the previous 6 months due to overload injuries in the univariate analysis (OR = 2.69, 95% CI = 1.24-5.84). Conclusion: Risk of ExHMC and associated symptoms in this heterogeneous sample may be indicative of RED-S. Confounding factors such as over-training, medication use, fatigue and psychological stress need to be considered. Identification of male athletes exhibiting physiological symptoms associated with RED-S requires more research.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2020
Keywords
Relative energy deficiency in sport, nutrition
National Category
Sport and Fitness Sciences
Research subject
Social Sciences, Sport Science
Identifiers
urn:nbn:se:lnu:diva-94796 (URN)10.1080/17461391.2020.1748116 (DOI)000527214500001 ()32212923 (PubMedID)
Available from: 2020-05-18 Created: 2020-05-18 Last updated: 2020-05-18
Melin, A. K., Heikura, I. A., Tenforde, A. & Mountjoy, M. (2019). Energy Availability in Athletics: Health, Performance, and Physique. International Journal of Sport Nutrition & Exercise Metabolism, 29(2), 152-164
Open this publication in new window or tab >>Energy Availability in Athletics: Health, Performance, and Physique
2019 (English)In: International Journal of Sport Nutrition & Exercise Metabolism, ISSN 1526-484X, Vol. 29, no 2, p. 152-164Article, review/survey (Refereed) Published
Abstract [en]

The reported prevalence of low energy availability (LEA) in female and male track and field athletes is between 18% and 58% with the highest prevalence among athletes in endurance and jump events. In male athletes, LEA may result in reduced testosterone levels and libido along with impaired training capacity. In female track and field athletes, functional hypothalamic amenorrhea as consequence of LEA has been reported among 60% of elite middle- and long-distance athletes and 23% among elite sprinters. Health concerns with functional hypothalamic amenorrhea include impaired bone health, elevated risk for bone stress injury, and cardiovascular disease. Furthermore, LEA negatively affects recovery, muscle mass, neuromuscular function, and increases the risk of injuries and illness that may affect performance negatively. LEA in track and field athletes may occur due to intentional alterations in body mass or body composition, appetite changes, time constraints, or disordered eating behavior. Long-term LEA causes metabolic and physiological adaptations to prevent further weight loss, and athletes may therefore be weight stable yet have impaired physiological function secondary to LEA. Achieving or maintaining a lower body mass or fat levels through long-term LEA may therefore result in impaired health and performance as proposed in the Relative Energy Deficiency in Sport model. Preventive educational programs and screening to identify athletes with LEA are important for early intervention to prevent long-term secondary health consequences. Treatment for athletes is primarily to increase energy availability and often requires a team approach including a sport physician, sports dietitian, physiologist, and psychologist.

Place, publisher, year, edition, pages
Human Kinetics, 2019
National Category
Sport and Fitness Sciences
Research subject
Social Sciences, Sport Science
Identifiers
urn:nbn:se:lnu:diva-81735 (URN)10.1123/ijsnem.2018-0201 (DOI)30632422 (PubMedID)
Available from: 2019-04-08 Created: 2019-04-08 Last updated: 2019-05-17Bibliographically approved
Torstveit, M. K., Fahrenholtz, I. L., Lichtenstein, M. B., Stenqvist, T. B. & Melin, A. K. (2019). Exercise dependence, eating disorder symptoms and biomarkers of Relative Energy Deficiency in Sports (RED-S) among male endurance athletes. BMJ Open Sport & Exercise Medicine, 5(1), 1-8, Article ID e000439.
Open this publication in new window or tab >>Exercise dependence, eating disorder symptoms and biomarkers of Relative Energy Deficiency in Sports (RED-S) among male endurance athletes
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2019 (English)In: BMJ Open Sport & Exercise Medicine, E-ISSN 2055-7647, Vol. 5, no 1, p. 1-8, article id e000439Article in journal (Refereed) Published
Abstract [en]

Objectives To explore associations betweenexercise dependence, eating disorder (ED) symptoms and biomarkers of Relative Energy Deficiency in Sports (RED-S) among male endurance athletes.

Methods Fifty-three healthy well-trained male cyclists, triathletes and long-distance runners recruited from regional competitive sports clubs were included in this cross-sectional study. The protocol comprised the Exercise Dependence Scale (EXDS), the ED Examination Questionnaire (EDE-Q), measurements of body composition, resting metabolic rate, energy intake and expenditure and blood analysis of hormones and glucose.

Results Participants with higher EXDS score displayed a more negative energy balance compared with subjects with lower EXDS score (p<0.01). EXDS total score was positively correlated with EDE-Q global score (r=0.41, p<0.05) and the subscale score for restraint eating (r=0.34, p<0.05) and weight concern (r=0.35, p<0.05). EXDS total score and the subscales lack of control and tolerance were positively correlated with cortisol (r=0.38, p<0.01, r=0.39, p<0.01 and r=0.29, p<0.05, respectively). The EXDS subscales withdrawal and tolerance were negatively correlated with fasting blood glucose (r=−0.31 and r=−0.32, p<0.05, respectively), while intention effect was negatively correlated with testosterone:cortisol ratio (r=−0.29, p<0.05) and positively correlated with cortisol:insulin ratio (r=0.33, p<0.05).

Conclusion In this sample of healthy male athletes, we found associations between higher EXDS scores, ED symptoms and biomarkers of RED-S, such as a more pronounced negative energy balance and higher cortisol levels.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019
National Category
Sport and Fitness Sciences
Research subject
Social Sciences, Sport Science
Identifiers
urn:nbn:se:lnu:diva-81732 (URN)10.1136/bmjsem-2018-000439 (DOI)2-s2.0-85059898974 (Scopus ID)
Available from: 2019-04-08 Created: 2019-04-08 Last updated: 2019-08-29Bibliographically approved
Melin, A. K., Ritz, C., Faber, J., Skouby, S., Pingel, J., Sundgot-Borgen, J., . . . Tornberg, Å. (2019). Impact of Menstrual Function on Hormonal Response to Repeated Bouts of Intense Exercise. Frontiers in Physiology, 10, 1-8, Article ID 942.
Open this publication in new window or tab >>Impact of Menstrual Function on Hormonal Response to Repeated Bouts of Intense Exercise
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2019 (English)In: Frontiers in Physiology, ISSN 1664-042X, E-ISSN 1664-042X, Vol. 10, p. 1-8, article id 942Article in journal (Refereed) Published
Abstract [en]

Background: Strenous exercise stimulates the hypothalamic-pituitary (HP) axis in order to ensure homeostasis and promote anabolism. Furthermore, exercise stimulates a transient increase in the neurotrophin brain-derived neurotrophic factor (BDNF) suggested to mediate the anxiolytic effects of exercise. Athletes with secondary functional hypothalamic amenorrhea (FHA) have been reported to have lower BDNF, and a blunted HP axis response to exercise as athletes with overtraining syndrome. Aim: The aim of the study was to investigate the hormonal and BDNF responses to a two-bout maximal exercise protocol with four hours of recovery in between in FHA and eumenorrheic (EUM) athletes. Methods: Eumenorrheic (n = 16) and FHA (n = 14) endurance athletes were recruited from national teams and competitive clubs. Protocols included gynecological examination; body composition (DXA); 7-day assessment of energy availability; blood sampling pre and post the two exercises tests. Results: There were no differences between groups in hormonal responses to the first exercise bout. After the second exercise bout IGFBP-3 increased more in FHA compared with EUM athletes (2.1 +/- 0.5 vs. 0.6 +/- 0.6 mu g/L, p = 0.048). There were non-significant trends toward higher increase in IGF-1 (39.3 +/- 4.3 vs. 28.0 +/- 4.6 mu g/L, p = 0.074), BDNF (96.5 +/- 22.9 vs. 34.4 +/- 23.5 mu g/L, p = 0.058), GH to cortisol ratio (0.329 +/- 0.010 vs. 0.058 +/- 0.010, p = 0.082), and decrease in IGF-1 to IGFBP-3 ratio (-2.04 +/- 1.2 vs. 0.92 +/- 1.22, p = 0.081) in athletes with FHA compared with EUM athletes. Furthermore, there was a non-significant trend toward a higher increase in prolactin to cortisol ratio in EUM athletes compared with athletes with FHA (0.60 +/- 0.15 vs. 0.23 +/- 0.15, p = 0.071). No differences in the hormonal or BDNF responses between the two exercise bouts as a result of menstrual function were found. Conclusion: No major differences in the hormonal or BDNF responses between the two exercise bouts as a result of menstrual function could be detected.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2019
Keywords
amenorrhea, energy availability, overtraining syndrome, female athlete, brain derived neuronal factor
National Category
Sport and Fitness Sciences
Research subject
Social Sciences, Sport Science
Identifiers
urn:nbn:se:lnu:diva-88797 (URN)10.3389/fphys.2019.00942 (DOI)000478027900001 ()31417414 (PubMedID)
Available from: 2019-08-28 Created: 2019-08-28 Last updated: 2019-08-28Bibliographically approved
Needleman, I., Rankin, A., Ashley, P., Fairbrother, T., Fine, P., Gallagher, J., . . . Naylor, M. (2019). Infographic. Nutrition and oral health in sport: time for action. British Journal of Sports Medicine, 53(22), 1432-1433
Open this publication in new window or tab >>Infographic. Nutrition and oral health in sport: time for action
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2019 (English)In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 53, no 22, p. 1432-1433Article in journal, Editorial material (Refereed) Published
Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019
National Category
Sport and Fitness Sciences
Research subject
Social Sciences, Sport Science
Identifiers
urn:nbn:se:lnu:diva-81734 (URN)10.1136/bjsports-2018-100358 (DOI)30670378 (PubMedID)
Available from: 2019-04-08 Created: 2019-04-08 Last updated: 2020-02-18Bibliographically approved
Burke, L. M., Castell, L. M., Casa, D. J., Close, G. L., Costa, R. J., Desbrow, B., . . . Stellingwerff, T. (2019). International Association of Athletics Federations Consensus Statement 2019: Nutrition for Athletics.. International Journal of Sport Nutrition & Exercise Metabolism, 29(2), 73-84
Open this publication in new window or tab >>International Association of Athletics Federations Consensus Statement 2019: Nutrition for Athletics.
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2019 (English)In: International Journal of Sport Nutrition & Exercise Metabolism, ISSN 1526-484X, E-ISSN 1543-2742, Vol. 29, no 2, p. 73-84Article in journal (Refereed) Published
Abstract [en]

The International Association of Athletics Federations recognizes the importance of nutritional practices in optimizing an Athlete's well-being and performance. Although Athletics encompasses a diverse range of track-and-field events with different performance determinants, there are common goals around nutritional support for adaptation to training, optimal performance for key events, and reducing the risk of injury and illness. Periodized guidelines can be provided for the appropriate type, amount, and timing of intake of food and fluids to promote optimal health and performance across different scenarios of training and competition. Some Athletes are at risk of relative energy deficiency in sport arising from a mismatch between energy intake and exercise energy expenditure. Competition nutrition strategies may involve pre-event, within-event, and between-event eating to address requirements for carbohydrate and fluid replacement. Although a "food first" policy should underpin an Athlete's nutrition plan, there may be occasions for the judicious use of medical supplements to address nutrient deficiencies or sports foods that help the athlete to meet nutritional goals when it is impractical to eat food. Evidence-based supplements include caffeine, bicarbonate, beta-alanine, nitrate, and creatine; however, their value is specific to the characteristics of the event. Special considerations are needed for travel, challenging environments (e.g., heat and altitude); special populations (e.g., females, young and masters athletes); and restricted dietary choice (e.g., vegetarian). Ideally, each Athlete should develop a personalized, periodized, and practical nutrition plan via collaboration with their coach and accredited sports nutrition experts, to optimize their performance.

Place, publisher, year, edition, pages
Human Kinetics, 2019
Keywords
RED-S, performance supplements, track and field
National Category
Sport and Fitness Sciences
Research subject
Social Sciences, Sport Science
Identifiers
urn:nbn:se:lnu:diva-81794 (URN)10.1123/ijsnem.2019-0065 (DOI)000465085500001 ()30952204 (PubMedID)2-s2.0-85064997056 (Scopus ID)
Available from: 2019-04-10 Created: 2019-04-10 Last updated: 2019-08-29Bibliographically approved
Carr, A., McGawley, K., Govus, A., Andersson, E. P., Shannon, O. M., Mattsson, S. & Melin, A. K. (2019). Nutritional Intake in Elite Cross-Country Skiers During Two Days of Training and Competition. International Journal of Sport Nutrition & Exercise Metabolism, 29(3), 273-281
Open this publication in new window or tab >>Nutritional Intake in Elite Cross-Country Skiers During Two Days of Training and Competition
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2019 (English)In: International Journal of Sport Nutrition & Exercise Metabolism, ISSN 1526-484X, E-ISSN 1543-2742, Vol. 29, no 3, p. 273-281Article in journal (Refereed) Published
Abstract [en]

This study investigated the energy, macronutrient, and fluid intakes, as well as hydration status (urine specific gravity), in elite cross-country skiers during a typical day of training (Day 1) and a sprint skiing competition the following day (Day 2). A total of 31 (18 males and 13 females) national team skiers recorded their food and fluid intakes and urine specific gravity was measured on Days 1 and 2. In addition, the females completed the Low Energy Availability in Females Questionnaire to assess their risk of long-term energy deficiency. Energy intake for males was 65 ± 9 kcal/kg on Day 1 versus 58 ± 9 kcal/kg on Day 2 (p = .002) and for females was 57 ± 10 on Day 1 versus 55 ± 5 kcal/kg on Day 2 (p = .445). Carbohydrate intake recommendations of 10-12 g·kg-1·day-1 were not met by 89% of males and 92% of females. All males and females had a protein intake above the recommended 1.2-2.0 g/kg on both days and a postexercise protein intake above the recommended 0.3 g/kg. Of the females, 31% were classified as being at risk of long-term energy deficiency. In the morning of Day 1, 50% of males and 46% of females were dehydrated; on Day 2, this was the case for 56% of males and 38% of females. In conclusion, these data suggest that elite cross-country skiers ingested more protein and less carbohydrate than recommended and one third of the females were considered at risk of long-term energy deficiency. Furthermore, many of the athletes were dehydrated prior to training and competition.

Place, publisher, year, edition, pages
Birmingham: Human Kinetics, 2019
Keywords
carbohydrate, energy deficiency, hydration status, protein, winter sports
National Category
Sport and Fitness Sciences
Research subject
Social Sciences, Sport Science; Social Sciences, Sport Science
Identifiers
urn:nbn:se:lnu:diva-81804 (URN)10.1123/ijsnem.2017-0411 (DOI)29989466 (PubMedID)
Available from: 2019-04-10 Created: 2019-04-10 Last updated: 2019-05-17Bibliographically approved
Mountjoy, M., Sundgot-Borgen, J., Burke, L., Ackerman, K. E., Blauwet, C., Constantini, N., . . . Budgett, R. (2018). International Olympic Committee (IOC) Consensus Statement on Relative Energy Deficiency in Sport (RED-S): 2018 Update. International Journal of Sport Nutrition & Exercise Metabolism, 28(4), 316-331
Open this publication in new window or tab >>International Olympic Committee (IOC) Consensus Statement on Relative Energy Deficiency in Sport (RED-S): 2018 Update
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2018 (English)In: International Journal of Sport Nutrition & Exercise Metabolism, ISSN 1526-484X, E-ISSN 1543-2742, Vol. 28, no 4, p. 316-331Article in journal (Refereed) Published
Place, publisher, year, edition, pages
Human Kinetics, 2018
Keywords
amenorrhea, disordered eating, female athlete triad, low bone mineral density, low energy availability, low testosterone, relative energy deficiency in sport (RED-S)
National Category
Sport and Fitness Sciences
Research subject
Social Sciences, Sport Science
Identifiers
urn:nbn:se:lnu:diva-81797 (URN)10.1123/ijsnem.2018-0136 (DOI)000440444600002 ()29972091 (PubMedID)
Available from: 2019-04-10 Created: 2019-04-10 Last updated: 2019-06-05Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0002-8249-1311

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