In the last decade, there has been greater appreciation of the harmful consequences of Relative Energy Deficiency in Sport (RED-S), particularly in adolescent female athletes. Coaches act as both important moderators in the development of the condition and as identifiers of athletes at risk. Research suggests that coaches lack knowledge on this topic. At present, it is unclear if RED-S education is incorporated into coach accreditation pathways. The aim of this scoping review was to describe the extent to which RED-S education is incorporated into the coach accreditation pathways of endurance sporting organizations. Five national sporting organizations (Cycling Australia, Athletics Australia, Swimming Australia, Triathlon Australia, and Rowing Australia) were contacted to participate. First, each sporting organization’s website was scoped, then semi-structured interviews were conducted online. One investigator transcribed each interview verbatim. Transcripts were analyzed for thematic content. Four of the sporting organizations provided little to no RED-S education. Rowing Australia delivered a program of RED-S content via an affiliated sports dietitian. The barriers identified for implementation of RED-S content were: limited time, resources, and coaches’ preexisting knowledge and beliefs. Based on these results, RED-S education is, indeed, lacking in some coach accreditation programs for endurance-based sporting organizations. Support for these organizations is required to overcome existing barriers and to facilitate inclusion of RED-S education within the coaching curriculum to support female athlete health.
Jennifer Hamer, Ben Desbrow, and Chris Irwin
Ben Desbrow, Katelyn Barnes, Caroline Young, Greg R. Cox, and Chris Irwin
Immediate postexercise access to fruit/fluid via a recovery “station” is a common feature of mass participation sporting events. Yet little evidence exists examining their impact on subsequent dietary intake. The aim of this study was to determine if access to fruit/water/sports drinks within a recovery station significantly alters dietary and fluid intakes in the immediate postexercise period and influences hydration status the next morning. 127 (79 males) healthy participants (M ± SD, age = 22.5 ± 3.5y, body mass (BM) = 73 ± 13kg) completed two self-paced morning 10km runs separated by 1 week. Immediately following the first run, participants were randomly assigned to enter (or not) the recovery station for 30min. All participants completed the alternate recovery option the following week. Participants recorded BM before and after exercise and measured Urine Specific Gravity (USG) before running and again the following morning. For both trial days, participants also completed 24h food and fluid records via a food diary that included photographs. Paired-sample t tests were used to assess differences in hydration and dietary outcome variables (Recovery vs. No Recovery). No difference in preexercise USG or BM change from exercise were observed between treatments (p’s > .05). Attending the recovery zone resulted in a greater total daily fluid (Recovery = 3.37 ± 1.46L, No Recovery = 3.16 ± 1.32L, p = .009) and fruit intake (Recovery = 2.37 ± 1.76 servings, No Recovery = 1.55 ± 1.61 servings, p > .001), but had no influence on daily total energy (Recovery = 10.15 ± 4.2MJ, No Recovery = 10.15 ± 3.9MJ), or macronutrient intakes (p > .05). Next morning USG values were not different between treatments (Recovery = 1.018 ± 0.007, No Recovery = 1.019 ± 0.009, p > .05). Recovery stations provide an opportunity to modify dietary intake which promote positive lifestyle behaviors in recreational athletes.
Ben Desbrow, Danielle Cecchin, Ashleigh Jones, Gary Grant, Chris Irwin, and Michael Leveritt
The addition of 25 mmol·L−1 sodium to low alcohol (2.3% ABV) beer has been shown to enhance post exercise fluid retention compared with full strength (4.8% ABV) beer with and without electrolyte modification. This investigation explored the effect of further manipulations to the alcohol and sodium content of beer on fluid restoration following exercise. Twelve male volunteers lost 2.03 ± 0.19% body mass (mean ± SD) using cycling-based exercise. Participants were then randomly allocated a different beer to consume on four separate occasions. Drinks included low alcohol beer with 25 mmol·L−1 of added sodium [LightBeer+25], low alcohol beer with 50 mmol·L−1 of added sodium [LightBeer+50], midstrength beer (3.5% ABV) [Mid] or midstrength beer with 25 mmolL−1 of added sodium [Mid+25]. Total drink volumes in each trial were equivalent to 150% of body mass loss during exercise, consumed over a 1h period. Body mass, urine samples and regulatory hormones were obtained before and 4 hr after beverage consumption. Total urine output was significantly lower in the LightBeer+50 trial (1450 ± 183 ml) compared with the LightBeer+25 (1796 ± 284 ml), Mid+25 (1786 ± 373 ml) and Mid (1986 ± 304 ml) trials (allp < .05). This resulted in significantly higher net body mass following the LightBeer+50 trial (-0.97 ± 0.17kg) compared with all other beverages (LightBeer+25 (-1.30 ± 0.24 kg), Mid+25 (-1.38 ± 0.33 kg) and Mid (-1.58 ± 0.29 kg), all p < .05). No significant changes to aldosterone or vasopressin were associated with different drink treatments. The electrolyte concentration of low alcohol beer appears to have more significant impact on post exercise fluid retention than small changes in alcohol content.
Ben Desbrow, Katelyn Barnes, Gregory R. Cox, Elizaveta Iudakhina, Danielle McCartney, Sierra Skepper, Caroline Young, and Chris Irwin
This study assessed voluntary dietary intake when different beverages were provided within a recovery area following recreational exercise. Participants completed two 10-km runs 1 week apart. Immediately after the first run, “beer drinkers” (n = 54; mean ± SD: age = 23.9 ± 5.8 years, body mass [BM] = 76 ± 13 kg) randomly received low-alcohol beer (Hahn Ultra® [Lion Co.], 0.9% alcohol by volume) or sports drink (SD; Gatorade® [PepsiCo]), whereas “nonbeer drinkers” (n = 78; age = 21.8 ± 2.2 years, BM = 71 ± 13 kg) received water or SD. Participants remained in a recovery area for 30–60 min with fluid consumption monitored. The following week, participants received the alternate beverage. Participants recorded all food/fluid consumed for the remainder of both trial days (diary and photographs). Fluid balance was assessed via BM change and urine specific gravity. Paired t tests were used to assess differences in hydration and dietary variables. No differences were observed in preexercise urine specific gravity (∼1.01) or BM loss (∼2%) between intervention groups (ps > .05). Water versus SD: No difference in acute fluid intake was noted (water = 751 ± 259 ml, SD = 805 ± 308 ml, p = .157). SD availability influenced total energy and carbohydrate intakes (water = 5.7 ± 2.5 MJ and 151 ± 77 g, SD = 6.5 ± 2.7 MJ and 187 ± 87 g, energy p = .002, carbohydrate p < .001). SD versus beer: SD availability resulted in greater acute fluid intake (SD = 1,047 ± 393 ml, beer = 850 ± 630 ml; p = .004), which remained evident at the end of trial days (SD = 3,337 ± 1,100 ml, beer = 2,982 ± 1,191 ml; p < .01). No differences in dietary variables were observed. Next day, urine specific gravity values were not different between water versus SD. However, a small difference was detected between SD versus beer (SD = 1.021 ± 0.009, beer = 1.016 ± 0.008, p = .002). Consuming calorie-containing drinks postexercise appears to increase daily energy and carbohydrate intake but has minimal impact on next-day hydration.
Alan J. McCubbin, Bethanie A. Allanson, Joanne N. Caldwell Odgers, Michelle M. Cort, Ricardo J.S. Costa, Gregory R. Cox, Siobhan T. Crawshay, Ben Desbrow, Eliza G. Freney, Stephanie K. Gaskell, David Hughes, Chris Irwin, Ollie Jay, Benita J. Lalor, Megan L.R. Ross, Gregory Shaw, Julien D. Périard, and Louise M. Burke
It is the position of Sports Dietitians Australia (SDA) that exercise in hot and/or humid environments, or with significant clothing and/or equipment that prevents body heat loss (i.e., exertional heat stress), provides significant challenges to an athlete’s nutritional status, health, and performance. Exertional heat stress, especially when prolonged, can perturb thermoregulatory, cardiovascular, and gastrointestinal systems. Heat acclimation or acclimatization provides beneficial adaptations and should be undertaken where possible. Athletes should aim to begin exercise euhydrated. Furthermore, preexercise hyperhydration may be desirable in some scenarios and can be achieved through acute sodium or glycerol loading protocols. The assessment of fluid balance during exercise, together with gastrointestinal tolerance to fluid intake, and the appropriateness of thirst responses provide valuable information to inform fluid replacement strategies that should be integrated with event fuel requirements. Such strategies should also consider fluid availability and opportunities to drink, to prevent significant under- or overconsumption during exercise. Postexercise beverage choices can be influenced by the required timeframe for return to euhydration and co-ingestion of meals and snacks. Ingested beverage temperature can influence core temperature, with cold/icy beverages of potential use before and during exertional heat stress, while use of menthol can alter thermal sensation. Practical challenges in supporting athletes in teams and traveling for competition require careful planning. Finally, specific athletic population groups have unique nutritional needs in the context of exertional heat stress (i.e., youth, endurance/ultra-endurance athletes, and para-sport athletes), and specific adjustments to nutrition strategies should be made for these population groups.