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John Petrizzo, Frederick J. DiMenna, Kimberly Martins, John Wygand and Robert M. Otto

To achieve the criterion appearance before competing in a physique competition, athletes undergo preparatory regimens involving high-volume intense resistance and aerobic exercise with hypocaloric energy intake. As the popularity of “drug-free” competition increases, more athletes are facing this challenge without the recuperative advantage provided by performance-enhancing drugs. Consequently, the likelihood of loss of lean body and/or bone mass is increased. The purpose of this investigation was to monitor changes in body composition for a 29-year-old self-proclaimed drug-free female figure competitor during a 32-week preparatory regimen comprising high-volume resistance and aerobic exercise with hypocaloric energy intake. We used dual-energy x-ray absorptiometry (DXA) to evaluate regional fat and bone mineral density. During the initial 22 weeks, the subject reduced energy intake and engaged in resistance (4–5 sessions/week) and aerobic (3 sessions/week) training. During the final 10 weeks, the subject increased exercise frequency to 6 (resistance) and 4 (aerobic) sessions/week while ingesting 1130–1380 kcal/day. During this 10-week period, she consumed a high quantity of protein (~55% of energy intake) and nutritional supplements. During the 32 weeks, body mass and fat mass decreased by 12% and 55%, respectively. Conversely, lean body mass increased by 1.5%, an amount that exceeded the coefficient of variation associated with DXA-derived measurement. Total bone mineral density was unchanged throughout. In summary, in preparation for a figure competition, a self-proclaimed drug-free female achieved the low body-fat percentage required for success in competition without losing lean mass or bone density by following a 32-week preparatory exercise and nutritional regimen.

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Joseph M. Kindler, Hannah L. Ross, Emma M. Laing, Christopher M. Modlesky, Norman K. Pollock, Clifton A. Baile and Richard D. Lewis

Assessment of physical activity in clinical bone studies is essential. Two bone-specific physical activity scoring methods, the Bone Loading History Questionnaire (BLHQ) and Bone-Specific Physical Activity Questionnaire (BPAQ), have shown correlations with bone density and geometry, but not architecture. The purpose of this study was to determine relationships between physical activity scoring methods and bone architecture in non-Hispanic white adolescent females (N = 24; 18-19 years of age). Bone loading scores (BLHQ [hip and spine] and past BPAQ) and energy expenditure (7-day physical activity recall) were determined from respective questionnaires. Estimates of trabecular and cortical bone architecture at the nondominant radius and tibia were assessed via magnetic resonance imaging. Total body and regional areal bone mineral density (aBMD), as well as total body fat mass and fat-free soft tissue (FFST) mass were assessed via dual energy X-ray absorptiometry. Pearson’s correlations and partial correlations adjusting for height, total body fat mass, and FFST were performed. Hip BLHQ scores were correlated with midtibia cortical volume (r = .43; p = .03). Adjusted hip and spine BLHQ scores were correlated with all midtibia cortical measures (r = .50-0.58; p < .05) and distal radius apparent trabecular number (r = .46-0.53; p < .05). BPAQ scores were correlated with all midtibia cortical (r = .41-0.51; p < .05) and most aBMD (r = .47-0.53; p < .05) measures. Energy expenditure was inversely associated with femoral neck aBMD only after statistical adjustment (r = .49, p < .05). These data show that greater load-specific physical activity scores, but not energy expenditure, are indicative of greater midtibia cortical bone quality, thus supporting the utility of these instruments in musculoskeletal research.

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Deborah Fearnley, Louise Sutton, John O’Hara, Amy Brightmore, Roderick King and Carlton Cooke

The Vendée Globe is a solo round-the-world sailing race without stopovers or assistance, a physically demanding challenge for which appropriate nutrition should maintain energy balance and ensure optimum performance. This is an account of prerace nutritional preparation with a professional and experienced female racer and assessment of daily nutritional intake (NI) during the race using a multimethod approach. A daily energy intake (EI) of 15.1 MJ/day was recommended for the race and negotiated down by the racer to 12.7 MJ/day, with carbohydrate and fluid intake goals of 480 g/day and 3,020 ml/day, respectively. Throughout the 99-day voyage, daily NI was recorded using electronic food diaries and inventories piloted during training races. NI was assessed and a postrace interview and questionnaire were used to evaluate the intervention. Fat mass (FM) and fat-free mass (FFM) were assessed pre- (37 days) and postrace (11 days) using dual-energy X-ray absorptiometry, and body mass was measured before the racer stepped on the yacht and immediately postrace. Mean EI was 9.2 MJ/day (2.4–14.3 MJ/day), representing a negative energy balance of 3.5 MJ/day under the negotiated EI goal, evidenced by a 7.9-kg loss of body mass (FM –7.5 kg, FFM –0.4 kg) during the voyage, with consequent underconsumption of carbohydrate by ~130 g/day. According to the postrace yacht food inventory, self-reported EI was underreported by 7%. This intervention demonstrates the practicality of the NI approach and assessment, but the racer’s nutrition strategy can be further improved to facilitate meeting more optimal NI goals for performance and health. It also shows that evaluation of NI is possible in this environment over prolonged periods, which can provide important information for optimizing nutritional strategies for ocean racing.

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Robyn S. Mehlenbeck, Kenneth D. Ward, Robert C. Klesges and Christopher M. Vukadinovich

Calcium intake in adolescent and young adult female athletes often is inadequate to optimize peak bone mass, an important determinant of osteoporosis risk. The purpose of this study was to determine if calcium supplementation in eumenorrheic female collegiate athletes increases intake to recommended levels and promotes increases in bone mineral density (BMD). Forty-eight eumenorrheic female athletes from several college teams (15 soccer, 7 crosscountry, 8 indoor track, and 18 basketball) were randomized at the beginning of a competitive season to receive either an oral calcium supplement (1000 mg calcium citrate/400 I.U. Vitamin D) or placebo daily throughout the training season (16 weeks). Self-reported daily pill intake was obtained every 2 weeks to assess adherence. Calcium intake was evaluated using the Rapid Assessment Method, and total body and leg BMD was measured at pre-, mid-, and postseason using dual energy x-ray absorptiometry (DEXA; Hologic QDR-2000). Pre-season calcium intake was lower than national recommendations for this age group (12), averaging 842 mg/d (SD = 719) and was lower in the placebo group compared to the supplemented group (649 ± 268 vs. 1071 ± 986 mg/d, respectively; p = .064). Adherence to supplementation was good, averaging 70% across the training season. Supplementation boosted total calcium intake to a mean of 1397 ± 411 mg/d, which is consistent with recommended levels for this group (37). Supplementation did not influence BMD change during this 16-week intervention. Across teams, a small increase of 0.8% was observed in leg BMD. Change in total body BMD was modified by team, with a significant increase of 1.5% observed in basketball players. These results indicate that providing calcium supplements of 1000 mg/d is adequate to boost total intake to recommended levels during athletic training. Longer intervention trials are required to determine whether calcium supplementation has a positive effect on BMD.

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Claudia Ridel Juzwiak, Olga Maria Silverio Amancio, Maria Sylvia Souza Vitalle, Vera Lúcia Szejnfeld and Marcelo Medeiros Pinheiro

In this prospective, cross-sectional study male adolescent tennis players (44) and nonathletic controls (32) were evaluated to determine the effects of physical activity, dietary nutrient intakes, sexual maturation, and body composition on bone-mineral density (BMD). Dietary nutrient intakes and physical activity expenditure were estimated by 4-d diaries. Total body composition, bone-mineral content (BMC), and BMD (L1–L4, femur, and nondominant forearm) were assessed by dual-energy X-ray absorptiometry. Tennis players had significantly greater lean body mass (mean [SEM] 50.6 [1.6] kg vs. 45.1 [1.7] kg, p = .022), trochanter BMD (1.0 [0.02] g/cm2 vs. 0.9 [0.03] g/cm2, p = .032), and dominant forearm BMC (173.7 [7.4] g vs. 146.5 [9.3] g) but lower BMD in the nondominant forearm (0.7 [0.02] g/cm2 vs. 0.8 [0.03] g/cm2, p = .028). Daily average calcium intake was below the recommendation in both groups. No correlation was found between BMD and calcium intake and exercise. Lean body mass was the best predictor of BMD and BMC for both tennis players and controls (R 2 = .825, .628, and .693 for L1–L4, total femur, and nondominant forearm, respectively). Based on these results the authors conclude that lean body mass is the best predictor of BMD and BMC for both tennis players and others. Tennis exerts a site-specific effect, and training should focus on ways minimize this effect. Although calcium intake showed no effect on BMD, nutrition education for young athletes should focus on promoting a balanced diet, providing energy and nutrients in adequate amounts.

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Laurel Wentz, Pei-Yang Liu, Jasminka Z. Ilich and Emily M. Haymes

Purpose:

To compare female runners with and without a history of stress fractures to determine possible predictors of such fractures.

Methods:

27 female runners (age 18–40 yr) who had had at least 1 stress fracture were matched to a control sample of 32 female runners without a history of stress fractures. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (iDXA). Subjects answered questionnaires on stress-fracture history, training, menstrual status, and diet.

Results:

No significant differences were found in menstrual characteristics, diet and dairy intake, or bone measurements. Weekly servings of milk during middle school significantly predicted BMD at the femur (p = .010), femoral neck (p = .002), Ward’s triangle (p = .014), and femoral shaft (p = .005). Number of menstrual cycles in the previous year predicted femoral-neck BMD (p = .004). Caffeine intake was negatively associated with BMD of the femur (p = .010), femoral neck (p = .003), trochanter (p = .038), and femoral shaft (p = .035). Weekly hours of training were negatively associated with total-body BMD (p = .021), total-body bone mineral content (p = .028), and lumbar-spine BMD (p = .011). Predictors for stress fractures included the number of years running, predominantly running on hard ground, irregular menstrual history, low total-body BMD, and low current dietary calcium intake when controlling for body-mass index (Nagelkerke R 2 = .364).

Conclusions:

Servings of milk during middle-school years were positively correlated with hip BMD, although current calcium intake, low BMD, irregular menstrual history, hard training surface, and long history of training duration were the most important predictors of stress fractures.

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Nuno M. Pimenta, Helena Santa-Clara, Xavier Melo, Helena Cortez-Pinto, José Silva-Nunes and Luís B. Sardinha

Central accumulation and distribution of body fat (BF) is an important cardiometabolic risk factor. Waist-to-hip ratio (WHR), commonly elevated in nonalcoholic fatty liver disease (NAFLD) patients, has been endorsed as a risk related marker of central BF content and distribution, but no standardized waist circumference measurement protocol (WCmp) has been proposed. We aimed to investigate whether using different WCmp affects the strength of association between WHR and BF content and distribution in NAFLD patients. BF was assessed with dual energy X-ray absorptiometry (DXA) in 28 NAFLD patients (19 males, 51 ± 13 years, and 9 females, 47 ± 13 years). Waist circumference (WC) was measured using four different WCmp (WC1: minimal waist; WC2: iliac crest; WC3: mid-distance between iliac crest and lowest rib; WC4: at the umbilicus) and WHR was calculated accordingly (WHR1, WHR2, WHR3 and WHR4, respectively). High WHR was found in up to 84.6% of subjects, depending on the WHR considered. With the exception of WHR1, all WHR correlated well with abdominal BF (r = .47 for WHR1; r = .59 for WHR2 and WHR3; r = .58 for WHR4) and BF distribution (r = .45 for WHR1; r = .56 for WHR2 and WHR3; r = .51 for WHR4), controlling for age, sex and body mass index (BMI). WHR2 and WHR3 diagnosed exactly the same prevalence of high WHR (76.9%). The present study confirms the strong relation between WHR and central BF, regardless of WCmp used, in NAFLD patients. WHR2 and WHR3 seemed preferable for use in clinical practice, interchangeably, for the diagnosis of high WHR in NAFLD patients.

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Johann C. Bilsborough, Kate Greenway, Steuart Livingston, Justin Cordy and Aaron J. Coutts

The purpose of this study was to examine the seasonal changes in body composition, nutrition, and upper-body (UB) strength in professional Australian Football (AF) players. The prospective longitudinal study examined changes in anthropometry (body mass, fat-free soft-tissue mass [FFSTM], and fat mass) via dual-energy X-ray absorptiometry 5 times during an AF season (start preseason, midpreseason, start season, midseason, end season) in 45 professional AF players. Dietary intakes and strength (bench press and bench pull) were also assessed at these time points. Players were categorized as experienced (>4 y experience, n = 23) or inexperienced (<4 y experience, n = 22). Fat mass decreased during the preseason but was stable through the in-season for both groups. %FFSTM was increased during the preseason and remained constant thereafter. UB strength increased during the preseason and was maintained during the in-season. Changes in UB FFSTM were related to changes in UB-strength performance (r = .37−.40). Total energy and carbohydrate intakes were similar between the experienced and inexperienced players during the season, but there was a greater ratio of dietary fat intake at the start-preseason point and an increased alcohol, reduced protein, and increased total energy intake at the end of the season. The inexperienced players consumed more fat at the start of season and less total protein during the season than the experienced players. Coaches should also be aware that it can take >1 y to develop the appropriate levels of FFSTM in young players and take a long-term view when developing the physical and performance abilities of inexperienced players.

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James P. Veale, Alan J. Pearce, David Buttifant and John S. Carlson

Purpose:

Body structure and physical development must be addressed when preparing junior athletes for their first season in a senior competition. The aim of this preliminary study was to measure the extent of the assumption that final year junior Australian Football (AF) athletes are at a physical mismatch to their senior counterparts.

Methods:

Twenty-one male participants (17.71 ± 0.27 y) were recruited from one state based elite junior AF competition and forty-one male participants (22.80 ± 4.24 y) were recruited from one club competing in the senior elite Australian Football League (AFL), who were subsequently divided into two groups; professional rookies aged 18-20 y (19.44 ± 0.70 y; n = 18) and professional seniors aged 21+ y (25.43 ± 3.98 y; n = 23). Dual energy X-ray absorptiometry (DEXA) scans of all participants were completed.

Results:

Despite being an average 6.0% and 6.1% lighter in total weight and lean mass respectively, no significant difference was found between the elite junior athletes and their professional AFL rookie counterparts. However, significant differences were demonstrated in comparison with the professional AFL senior athletes (P < .01). Both professional AFL groups demonstrated greater than 0.3 kg total bone mineral content (BMC) than the elite junior athletes (P < .01) and significantly greater segmental BMC and bone mineral density (BMD) results (P < .05).

Conclusion:

While the results identify the differences in body composition of the elite junior athletes, development in a linear fashion is noted, providing useful information for the creation of age appropriate expectations and training programs.

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David Travis Thomas, Laurie Wideman and Cheryl A. Lovelady

Purpose:

To examine the effect of yogurt supplementation pre- and postexercise on changes in body composition in overweight women engaged in a resistance-training program.

Methods:

Participants (age = 36.8 ± 4.8 yr) with a body-mass index of 29.1±2.1 kg/m2 were randomized to yogurt supplement (YOG; n = 15) or isoenergetic sucrose beverage (CONT; n = 14) consumed before and after exercise for 16 wk. Participants were also instructed to reduce energy intake daily (–1,046 kJ) during the study. Body composition was assessed by dual-energy X-ray absorptiometry, waist circumference, and sagittal diameter. Strength was measured with 1-repetition maximum. Dietary recalls were obtained by a multipass approach using Nutrition Data System software. Insulin-like growth factor-1 and insulin-like growth-factor-binding protein-3 were measured with ELISA.

Results:

Significant weight losses of 2.6 ± 4.5 kg (YOG) and 1.2 ± 2.5 kg (CONT) were observed. Total lean weight increased significantly over time in both YOG (0.8 ± 1.2 kg) and CONT (1.1 ± 0.9 kg). Significant reductions in total fat (YOG = 3.4 ± 4.1 kg vs. CONT = 2.3 ± 2.4 kg) were observed over time. Waist circumference, sagittal diameter, and trunk fat decreased significantly over time without group differences. Both groups significantly decreased energy intake while maintaining protein intake. Strength significantly increased over time in both groups. No changes over time or between groups were observed in hormone levels.

Conclusions:

These data suggest that yogurt supplementation offered no added benefit for increasing lean mass when combined with resistance training and modest energy restriction.