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Martin Mooses and Anthony C. Hackney

Maximal oxygen uptake (V̇O2max), fractional utilization of V̇O2max during running, and running economy (RE) are crucial factors for running success for all endurance athletes. Although evidence is limited, investigations of these key factors indicate that East Africans’ superiority in distance running is largely due to a unique combination of these factors. East African runners appear to have a very high level of RE most likely associated, at least partly, with anthropometric characteristics rather than with any specific metabolic property of the working muscle. That is, evidence suggest that anthropometrics and body composition might have important parameters as determinants of superior performance of East African distance runners. Regrettably, this role is often overlooked and mentioned as a descriptive parameter rather than an explanatory parameter in many research studies. This brief review article provides an overview of the evidence to support the critical role anthropometrics and body composition has on the distance running success of East African athletes. The structural form and shape of these athletes also has a downside, because having very low BMI or body fat increases the risk for relative energy deficiency in sport (RED-S) conditions in both male and female runners, which can have serious health consequences.

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Louise M. Burke, Graeme L. Close, Bronwen Lundy, Martin Mooses, James P. Morton and Adam S. Tenforde

Low energy availability (LEA) is a key element of the Female Athlete Triad. Causes of LEA include failure to match high exercise energy expenditure (unintentional) or pathological behaviors of disordered eating (compulsive) and overzealous weight control programs (misguided but intentional). Recognition of such scenarios in male athletes contributed to the pronouncement of the more inclusive Relative Energy Deficiency in Sport (RED-S) syndrome. This commentary describes the insights and experience of the current group of authors around the apparently heightened risk of LEA in some populations of male athletes: road cyclists, rowers (lightweight and open weight), athletes in combat sports, distance runners, and jockeys. The frequency, duration, and magnitude of the LEA state appear to vary between populations. Common risk factors include cyclical management of challenging body mass and composition targets (including “making weight”) and the high energy cost of some training programs or events that is not easily matched by energy intake. However, additional factors such as food insecurity and lack of finances may also contribute to impaired nutrition in some populations. Collectively, these insights substantiate the concept of RED-S in male athletes and suggest that a specific understanding of a sport, subpopulation, or culture may identify a complex series of factors that can contribute to LEA and the type and severity of its outcomes. This commentary provides a perspective on the range of risk factors that should be addressed in future surveys of RED-S in athletic populations and targeted for specific investigation and modification.

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Louise M. Burke, Asker E. Jeukendrup, Andrew M. Jones and Martin Mooses

Distance events in Athletics include cross country, 10,000-m track race, half-marathon and marathon road races, and 20- and 50-km race walking events over different terrain and environmental conditions. Race times for elite performers span ∼26 min to >4 hr, with key factors for success being a high aerobic power, the ability to exercise at a large fraction of this power, and high running/walking economy. Nutrition-related contributors include body mass and anthropometry, capacity to use fuels, particularly carbohydrate (CHO) to produce adenosine triphosphate economically over the duration of the event, and maintenance of reasonable hydration status in the face of sweat losses induced by exercise intensity and the environment. Race nutrition strategies include CHO-rich eating in the hours per days prior to the event to store glycogen in amounts sufficient for event fuel needs, and in some cases, in-race consumption of CHO and fluid to offset event losses. Beneficial CHO intakes range from small amounts, including mouth rinsing, in the case of shorter events to high rates of intake (75–90 g/hr) in the longest races. A personalized and practiced race nutrition plan should balance the benefits of fluid and CHO consumed within practical opportunities, against the time, cost, and risk of gut discomfort. In hot environments, prerace hyperhydration or cooling strategies may provide a small but useful offset to the accrued thermal challenge and fluid deficit. Sports foods (drinks, gels, etc.) may assist in meeting training/race nutrition plans, with caffeine, and, perhaps nitrate being used as evidence-based performance supplements.