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  • 1.
    Burke, Louise M
    et al.
    Australian Institute of Sport, Australia;Australian Catholic University, Australia.
    Castell, Linda M
    University of Oxford, UK.
    Casa, Douglas J
    University of Connecticut, USA.
    Close, Graeme L
    Liverpool John Moores University, UK.
    Costa, Ricardo J S
    Monash University, Australia.
    Desbrow, Ben
    Griffith University, Australia.
    Halson, Shona L
    Australian Catholic University, Australia.
    Lis, Dana M
    University of California Davis, USA.
    Melin, Anna K.
    Linnaeus University, Faculty of Social Sciences, Department of Sport Science.
    Peeling, Peter
    The University of Western Australia, Australia.
    Saunders, Philo U
    Australian Institute of Sport, Australia;University of Canberra, Australia.
    Slater, Gary J
    Australian Institute of Sport, Australia;University of theSunshine Coast, Australia.
    Sygo, Jennifer
    Athletics Canada, Canada.
    Witard, Oliver C
    University of Stirling, UK.
    Bermon, Stéphane
    International Association of Athletics Federations, Monaco;Université Côte d'Azur, France.
    Stellingwerff, Trent
    Canadian Sport Institute - Pacific, Canada;Athletics Canada, Canada;University of Victoria, Canada.
    International Association of Athletics Federations Consensus Statement 2019: Nutrition for Athletics.2019In: International Journal of Sport Nutrition & Exercise Metabolism, ISSN 1526-484X, E-ISSN 1543-2742, Vol. 29, no 2, p. 73-84Article in journal (Refereed)
    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.

  • 2.
    Burke, Louise M.
    et al.
    Australian Inst Sport, Australia;Australian Catholic Univ, Australia.
    Lundy, Bronwen
    Australian Inst Sport, Australia;Australian Catholic Univ, Australia.
    Fahrenholtz, Ida L.
    Univ Copenhagen, Denmark.
    Melin, Anna K.
    Univ Copenhagen, Denmark.
    Pitfalls of Conducting and Interpreting Estimates of Energy Availability in Free-Living Athletes2018In: International Journal of Sport Nutrition & Exercise Metabolism, ISSN 1526-484X, E-ISSN 1543-2742, Vol. 28, no 4, p. 350-363Article, review/survey (Refereed)
    Abstract [en]

    The human body requires energy for numerous functions including, growth, thermogenesis, reproduction, cellular maintenance, and movement. In sports nutrition, energy availability (EA) is defined as the energy available to support these basic physiological functions and good health once the energy cost of exercise is deducted from energy intake (EI), relative to an athlete's fat-free mass (FFM). Low EA provides a unifying theory to link numerous disorders seen in both female and male athletes, described by the syndrome Relative Energy Deficiency in Sport, and related to restricted energy intake, excessive exercise or a combination of both. These outcomes are incurred in different dose-response patterns relative to the reduction in EA below a "healthy" level of similar to 45 kcal.kg FFM-1.day(-1). Although EA estimates are being used to guide and monitor athletic practices, as well as support a diagnosis of Relative Energy Deficiency in Sport, problems associated with the measurement and interpretation of EA in the field should be explored. These include the lack of a universal protocol for the calculation of EA, the resources needed to achieve estimates of each of the components of the equation, and the residual errors in these estimates. The lack of a clear definition of the value for EA that is considered "low" reflects problems around its measurement, as well as differences between individuals and individual components of "normal"/"healthy" function. Finally, further investigation of nutrition and exercise behavior including within-and between-day energy spread and dietary characteristics is warranted since it may directly contribute to low EA or its secondary problems.

  • 3.
    Carr, Amelia
    et al.
    Mid Sweden University, Sweden;Deakin University, Australia.
    McGawley, Kerry
    Mid Sweden University, Sweden.
    Govus, Andrew
    Mid Sweden University, Sweden.
    Andersson, Erik P.
    Mid Sweden University, Sweden.
    Shannon, Oliver M.
    Newcastle University, UK.
    Mattsson, Stig
    Örebro University, Sweden.
    Melin, Anna K.
    University of Copenhagen, Denmark.
    Nutritional Intake in Elite Cross-Country Skiers During Two Days of Training and Competition2019In: International Journal of Sport Nutrition & Exercise Metabolism, ISSN 1526-484X, E-ISSN 1543-2742, Vol. 29, no 3, p. 273-281Article in journal (Refereed)
    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.

  • 4.
    Melin, Anna K.
    et al.
    Univ Copenhagen, Denmark.
    Torstveit, Monica Klungland
    Univ Agder, Norway.
    Burke, Louise
    Australian Inst Sport, Australia.
    Marks, Saul
    Univ Toronto, Canada.
    Sundgot-Borgen, Jorunn
    Norwegian Sch Sport Sci, Norway.
    Disordered Eating and Eating Disorders in Aquatic Sports2014In: International Journal of Sport Nutrition & Exercise Metabolism, ISSN 1526-484X, E-ISSN 1543-2742, Vol. 24, no 4, p. 450-459Article in journal (Refereed)
    Abstract [en]

    Disordered eating behavior (DE) and eating disorders (EDs) are of great concern because of their associations with physical and mental health risks and, in the case of athletes, impaired performance. The syndrome originally known as the Female Athlete Triad, which focused on the interaction of energy availability, reproductive function, and bone health in female athletes, has recently been expanded to recognize that Relative Energy Deficiency in Sport (RED-S) has a broader range of negative effects on body systems with functional impairments in both male and female athletes. Athletes in leanness-demanding sports have an increased risk for RED-S and for developing EDs/DE. Special risk factors in aquatic sports related to weight and body composition management include the wearing of skimpy and tight-fitting bathing suits, and in the case of diving and synchronized swimming, the involvement of subjective judgments of performance. The reported prevalence of DE and EDs in athletic populations, including athletes from aquatic sports, ranges from 18 to 45% in female athletes and from 0 to 28% in male athletes. To prevent EDs, aquatic athletes should practice healthy eating behavior at all periods of development pathway, and coaches and members of the athletes' health care team should be able to recognize early symptoms indicating risk for energy deficiency, DE, and EDs. Coaches and leaders must accept that DE/EDs can be a problem in aquatic disciplines and that openness regarding this challenge is important.

  • 5. Mountjoy, M
    et al.
    Maughan, R
    Benardot, D
    Costill, D
    Cox, G
    Derave, W
    Koivstu, A
    Melin, Anna K.
    Univ Copenhagen, Denmark.
    Mujika, I
    Pyne, D
    Robertson, S
    Sharpe, R
    Shaw, G
    Stellingwerff, T
    Verhagen, E
    Zimmermann, W
    Van Den Hoogenband, C
    Marks, S
    Gerrard, D
    Boyd, K
    Miller, J
    FINA-Yakult consensus statement on nutrition for the aquatic sports.2014In: International Journal of Sport Nutrition & Exercise Metabolism, ISSN 1526-484X, E-ISSN 1543-2742, Vol. 24, no 4, p. 349-350Article in journal (Other academic)
  • 6.
    Mountjoy, Margo
    et al.
    McMaster Univ, Canada.
    Sundgot-Borgen, Jorunn
    Norwegian Sch Sport Sci, Norway.
    Burke, Louise
    Australian Inst Sport, Australia;Mary MacKillop Inst Hlth Res, Australia.
    Ackerman, Kathryn E.
    Harvard Med Sch, USA;Boston Childrens Hosp, USA;Massachusetts Gen Hosp, USA.
    Blauwet, Cheri
    Harvard Med Sch, USA;Brigham & Womens Hosp, USA;Spaulding Rehabil Hosp, USA.
    Constantini, Naama
    Hebrew Univ Jerusalem, Israel.
    Lebrun, Constance
    Univ Alberta, Canada.
    Lundy, Bronwen
    Australian Inst Sport, Australia.
    Melin, Anna K.
    Univ Copenhagen, Denmark.
    Meyer, Nanna
    Univ Colorado, USA.
    Sherman, Roberta
    Independent researcher, USA.
    Tenforde, Adam S.
    Harvard Med Sch, USA.
    Torstveit, Monica Klungland
    Univ Agder, Norway.
    Budgett, Richard
    IOC Med & Sci Dept, Switzerland.
    International Olympic Committee (IOC) Consensus Statement on Relative Energy Deficiency in Sport (RED-S): 2018 Update2018In: International Journal of Sport Nutrition & Exercise Metabolism, ISSN 1526-484X, E-ISSN 1543-2742, Vol. 28, no 4, p. 316-331Article in journal (Refereed)
  • 7.
    Staal, Sarah
    et al.
    Univ Copenhagen, Denmark.
    Sjödin, Anders
    Univ Copenhagen, Denmark.
    Fahrenholtz, Ida
    Univ Copenhagen, Denmark.
    Bonnesen, Karen
    Royal Danish Ballet, Denmark.
    Melin, Anna K.
    Univ Copenhagen, Denmark.
    Low RMRratio as a Surrogate Marker for Energy Deficiency, the Choice of Predictive Equation Vital for Correctly Identifying Male and Female Ballet Dancers at Risk2018In: International Journal of Sport Nutrition & Exercise Metabolism, ISSN 1526-484X, E-ISSN 1543-2742, Vol. 28, no 4, p. 412-418Article in journal (Refereed)
    Abstract [en]

    Ballet dancers are reported to have an increased risk for energy deficiency with or without disordered eating behavior. A low ratio between measured ((m)) and predicted ((p)) resting metabolic rate (RMRratio < 0.90) is a recognized surrogate marker for energy deficiency. We aimed to evaluate the prevalence of suppressed RMR using different methods to calculate pRMR and to explore associations with additional markers of energy deficiency. Female (n = 20) and male (n = 20) professional ballet dancers, 19-35 years of age, were enrolled. mRMR was assessed by respiratory calorimetry (ventilated open hood). pRMR was determined using the Cunningham and Harris-Benedict equations, and different tissue compartments derived from whole-body dual-energy X-ray absorptiometry assessment. The protocol further included assessment of body composition and bone mineral density, blood pressure, disordered eating (Eating Disorder Inventory-3), and for females, the Low Energy Availability in Females Questionnaire. The prevalence of suppressed RMR was generally high but also clearly dependent on the method used to calculate pRMR, ranging from 25% to 80% in males and 35% to 100% in females. Five percent had low bone mineral density, whereas 10% had disordered eating and 25% had hypotension. Forty percent of females had elevated Low Energy Availability in Females Questionnaire score and 50% were underweight. Suppressed RMR was associated with elevated Low Energy Availability in Females Questionnaire score in females and with higher training volume in males. In conclusion, professional ballet dancers are at risk for energy deficiency. The number of identified dancers at risk varies greatly depending on the method used to predict RMR when using RMRratio as a marker for energy deficiency.

  • 8.
    Torstveit, Monica Klungland
    et al.
    Univ Agder, Norway.
    Fahrenholtz, Ida
    Univ Copenhagen, Denmark.
    Stenqvist, Thomas B.
    Univ Agder, Norway.
    Sylta, Oystein
    Univ Agder, Norway.
    Melin, Anna K.
    Univ Copenhagen, Denmark.
    Within-Day Energy Deficiency and Metabolic Perturbation in Male Endurance Athletes2018In: International Journal of Sport Nutrition & Exercise Metabolism, ISSN 1526-484X, E-ISSN 1543-2742, Vol. 28, no 4, p. 419-427Article in journal (Refereed)
    Abstract [en]

    Endurance athletes are at increased risk of relative energy deficiency associated with metabolic perturbation and impaired health. We aimed to estimate and compare within-day energy balance in male athletes with suppressed and normal resting metabolic rate (RMR) and explore whether within-day energy deficiency is associated with endocrine markers of energy deficiency. A total of 31 male cyclists, triathletes, and long-distance runners recruited from regional competitive sports clubs were included. The protocol comprised measurements of RMR by ventilated hood and energy intake and energy expenditure to predict RMR-ratio (measured RMR/predicted RMR), energy availability, 24-hr energy balance and within-day energy balance in 1-hr intervals, assessment of body composition by dual-energy X-ray absorptiometry, and blood plasma analysis. Subjects were categorized as having suppressed (RMRratio < 0.90, n = 20) or normal (RMRratio > 0.90, n = 11) RMR. Despite there being no observed differences in 24-hr energy balance or energy availability between the groups, subjects with suppressed RMR spent more time in an energy deficit exceeding 400 kcal (20.9 [18.8-21.8] hr vs. 10.8 [2.5-16.4], p =.023) and had larger single-hour energy deficits compared with subjects with normal RMR (3,265 +/- 1,963 kcal vs. -1,340 +/- 2,439, p =.023). Larger single-hour energy deficits were associated with higher cortisol levels (r = -.499, p =.004) and a lower testosterone: cortisol ratio (r =.431, p =.015), but no associations with triiodothyronine or fasting blood glucose were observed. In conclusion, within-day energy deficiency was associated with suppressed RMR and catabolic markers in male endurance athletes.

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