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Susan C. Davies and Brenna M. Bird

Student-athletes often fail to report concussion signs and symptoms, thereby putting themselves at risk for delayed recovery and permanent impairment. The present study examined motivations for underreporting concussion symptoms among college athletes enrolled at an NCAA Division I university. One hundred and ninety-three student-athletes in high-risk sports completed a multiple-choice survey related to self-reporting of suspected concussion symptoms and reporting of teammates’ symptoms. Results indicated that 45% of participants did not report their own suspected concussions during the present season and 50% did not report suspected concussions in teammates. Responses revealed that the primary reason for underreporting a suspected concussion was the belief that the blow to the head was not serious enough. Suggestions are provided for athletes, athletic staff, and coaches to improve players’ awareness of the signs, symptoms, and consequences of concussions, as well as how to report suspected concussions appropriately.

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Satya S. Jonnalagadda, Dan Benardot, and Marian N. Dill

This study examines the degree of under-reporting of energy intake by elite, female gymnasts, and the impact this predicted under-reporting has on associated macro and micro nutrient intake. Twenty-eight female U.S. national team artistic gymnasts participated in the study. Dietary intake was assessed using 3-day food records, and the degree of under-reporting was predicted from the ratio of reported energy intake (EI) to predicted basal metabolic rate (BMRestd), using the standards described by Goldberg et al. (10). Sixty-one percent of the subjects had an EI/BMRestd ratio of < 1.44, and were classified as under-reporters. The under-reporters had higher BMIs and percent body fat, and lower reported total energy intakes than the adequate energy reporters. Additionally, under-reporting of energy intake had a significant impact on reported micro nutrient intake. The under-reporting of energy intake seen in these subjects has an impact on the reported intake of macro and micro nutrients that can influence the interpretation of the nutritional status of these athletes and the strategy for nutrition intervention. Therefore, when assessing dietary intakes of elite gymnasts, some means of determining the accuracy of the reported energy and nutrient intake should be employed to more accurately identify the true nutritional problems experienced by these elite athletes.

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Harry E. Routledge, Stuart Graham, Rocco Di Michele, Darren Burgess, Robert M. Erskine, Graeme L. Close, and James P. Morton

( Bilsborough et al., 2016 ). However, the low CHO intakes reported on the remainder of the training days do not seem conducive to supporting the daily energetic requirement of male athletes (ranging from 80 to 90 kg), even when considering rest days. As such, we acknowledge the potential of underreporting as a

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Emily Kroshus, Sara P.D. Chrisman, Jeffrey J. Milroy, and Christine M. Baugh

hypothesis that experiences during the concussion recovery process (i.e., history of concussion) would impact whether an athlete continued to play while symptomatic with potential concussive symptoms. Additionally, this study also explored reasons for concussion under-reporting in athletes with and without a

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Samuel W. Logan, Christina M. Hospodar, Kathleen R. Bogart, Michele A. Catena, Heather A. Feldner, Jenna Fitzgerald, Sarah Schaffer, Bethany Sloane, Benjamin Phelps, Joshua Phelps, and William D. Smart

usage data between parent-reported activity logs and FIT system (Difference Between Activity Log and FIT). This is a calculation of the time recorded by the log minus the time recorded by the FIT system. Positive values indicate over-reporting by parents; negative values indicate under-reporting by

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George Wilson, Dan Martin, James P. Morton, and Graeme L. Close

underreporting ( Poslusna et al., 2009 ). Moreover, energy intakes of jockeys are significantly higher when food intake has been monitored via a wearable camera as opposed to the traditional food diary approach ( O’Loughlin et al., 2013 ). Further evidence for likely underreporting of energy intake is also

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Samantha M. Ross, Ellen Smit, Joonkoo Yun, Kathleen Bogart, Bridget Hatfield, and Samuel W. Logan

experienced by children with disabilities has been previously challenged by underreporting and variability in the subsampling of this population. Using the National Survey of Children’s Health (NSCH), this study aimed to establish updated population-level estimates of PA disparities concerning disability

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Jorunn Sundgot-Borgen

This study examined the prevalence of eating disorders (ED) and the possible difference between ED symptoms and true ED by using questionnaires as compared with an interview and clinical evaluation in Norwegian elite female athletes (n=522) from 35 sports and nonathletic controls (n=448). In addition to the 117 athletes classified as "at risk" to develop ED, 90 subjects were randomly chosen, comprising 30 athletic controls, 30 at-risk nonathletes, and 30 nonathletic controls. All weIe interviewed and clinically examined. A significantly higher number of athletes (18%) than controls (5%) were found to actually suffer from ED, particularly athletes competing in sports in which leanness or a specific weight were considered important. When results from the screening study were compared to those from the interviews and clinical examinations, a significant underreporting of ED among athletes was demonstrated. The athletes also reported the use of other pathogenic methods in the screening study compared to what they reported in the interview. Nonathletes more correctly reported the use of pathogenic methods but overreported the prevalence of ED. Thus the issue of using questionnaires alone or in combination with personal interview/clinical examination merits further investigation.

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Kristen MacKenzie, Gary Slater, Neil King, and Nuala Byrne

Evidence suggests that increasing protein distribution may be desirable to promote muscle protein synthesis (MPS) in combination with resistance exercise. However, there is a threshold above which additional protein consumption has limited benefit for MPS and may promote protein loss due to increased oxidation. This study aimed to measure daily protein intake and protein distribution in a cohort of rugby players. Twenty-five developing elite rugby union athletes (20.5 ± 2.3 years, 100.2 ± 13.3 kg, 184.4 ± 7.4 cm) were assessed at the start and end of a rugby preseason. Using a 7-day food diary the reported daily protein intake was 2.2 ± 0.7 g·kg·day-1 which exceeds daily recommendations. The reported carbohydrate intake was 3.6 ± 1.3 g·kg·day-1 which may reflect a suboptimal intake or dietary underreporting. In general, the rugby athletes were regularly consuming more than 20 g of protein; 3.8 ± 0.9 times per day (68 ± 18% of eating occasions). In addition to documenting current dietary intakes, an excess protein estimation score was calculated to determine how frequently the rugby athletes consumed protein above a known effective dose with a margin of error. 2.0 ± 0.9 eating occasions contained protein in excess of doses (20 g) known to promote MPS. Therefore, it is currently unclear whether the consumption of regular large doses of protein will benefit rugby athletes via increasing protein distribution, or whether high protein intakes may have unintended effects including a reduction in carbohydrate and/or energy intake.

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Christina Yannetsos, Mario C. Pacheco, and Danny G. Thomas

Key Points ▸ There is a widespread underreporting of concussion in athletes. ▸ Red-flag symptoms were often mistaken for common concussive symptoms by judo coaches. ▸ Coaches’ concussion education, judo equipment, and legislature are potential areas of improvement. Sport-related concussion has an