| 1. |
- Fahrenholtz, Ida L, et al.
(författare)
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Effects of a 16-Week Digital Intervention on Sports Nutrition Knowledge and Behavior in Female Endurance Athletes with Risk of Relative Energy Deficiency in Sport (REDs)
- 2023
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Ingår i: Nutrients. - Basel : MDPI. - 2072-6643. ; 15:5
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Tidskriftsartikel (refereegranskat)abstract
- Female endurance athletes are considered a high-risk group for developing Relative Energy Deficiency in Sport (REDs). Due to the lack of educational and behavioral intervention studies, targeting and evaluating the effects of the practical daily management of REDs, we developed the Food and nUtrition for Endurance athletes—a Learning (FUEL) program, consisting of 16 weekly online lectures and individual athlete-centered nutrition counseling every other week. We recruited female endurance athletes from Norway (n = 60), Sweden (n = 84), Ireland (n = 17), and Germany (n = 47). Fifty athletes with symptoms of REDs and with low risk of eating disorders, with no use of hormonal contraceptives and no chronic diseases, were allocated to either the FUEL intervention (n = 32) (FUEL) or a 16-week control period (n = 18) (CON). All but one completed FUEL, while 15 completed CON. We found strong evidence for improvements in sports nutrition knowledge, assessed via interviews, and moderate to strong evidence in the ratings concerning self-perceived sports nutrition knowledge in FUEL versus CON. Analyses of the seven-day prospective weighed food record and questions related to sports nutrition habits, suggested weak evidence for improvements in FUEL versus CON. The FUEL intervention improved sports nutrition knowledge and suggested weak evidence for improved sports nutrition behavior in female endurance athletes with symptoms of REDs.
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| 2. |
- Fahrenholtz, Ida Lysdahl, et al.
(författare)
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Short-term effects and long-term changes of FUEL - a digital sports nutrition intervention on REDs related symptoms in female athletes
- 2023
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Ingår i: Frontiers in Sports and Active Living. - Lausanne : Frontiers Media S.A.. - 2624-9367. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- Female endurance athletes are at high risk for developing Relative Energy Deficiency in Sport (REDs), resulting in symptoms such as menstrual dysfunction and gastrointestinal (GI) problems. The primary aim of this study was to investigate effects of the FUEL (Food and nUtrition for Endurance athletes-a Learning program) intervention consisting of weekly online lectures combined with individual athlete-centered nutrition counseling every other week for sixteen weeks on REDs related symptoms in female endurance athletes at risk of low energy availability [Low Energy Availability in Females Questionnaire (LEAF-Q) score >= 8]. Female endurance athletes from Norway (n = 60), Sweden (n = 84), Ireland (n = 17), and Germany (n = 47) were recruited. Fifty athletes with risk of REDs (LEAF-Q score >= 8) and with low risk of eating disorders [Eating Disorder Examination Questionnaire (EDE-Q) global score <2.5], with no use of hormonal contraceptives and no chronic diseases, were allocated to either the FUEL intervention (n = 32) (FUEL) or a sixteen-week control period (n = 18) (CON). All but one completed FUEL and n = 15 completed CON. While no evidence for difference in change in LEAF-Q total or subscale scores between groups was detected post-intervention (BFincl < 1), the 6- and 12-months follow-up revealed strong evidence for improved LEAF-Q total (BFincl = 123) and menstrual score (BFincl = 840) and weak evidence for improved GI-score (BFincl = 2.3) among FUEL athletes. In addition, differences in change between groups was found for EDE-Q global score post-intervention (BFincl = 1.9). The reduction in EDE-Q score remained at 6- and 12- months follow-up among FUEL athletes. Therefore, the FUEL intervention may improve REDs related symptoms in female endurance athletes.
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| 3. |
- Lundy, Bronwen, et al.
(författare)
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Screening for Low Energy Availability in Male Athletes : Attempted Validation of LEAM-Q
- 2022
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Ingår i: Nutrients. - : MDPI. - 2072-6643. ; 14:9
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Tidskriftsartikel (refereegranskat)abstract
- A questionnaire-based screening tool for male athletes at risk of low energy availability (LEA) could facilitate both research and clinical practice. The present options rely on proxies for LEA such screening tools for disordered eating, exercise dependence, or those validated in female athlete populations. in which the female-specific sections are excluded. To overcome these limitations and support progress in understanding LEA in males, centres in Australia, Norway, Denmark, and Sweden collaborated to develop a screening tool (LEAM-Q) based on clinical investigations of elite and sub-elite male athletes from multiple countries and ethnicities, and a variety of endurance and weight-sensitive sports. A bank of questions was developed from previously validated questionnaires and expert opinion on various clinical markers of LEA in athletic or eating disorder populations, dizziness, thermoregulation, gastrointestinal symptoms, injury, illness, wellbeing, recovery, sleep and sex drive. The validation process covered reliability, content validity, a multivariate analysis of associations between variable responses and clinical markers, and Receiver Operating Characteristics (ROC) curve analysis of variables, with the inclusion threshold being set at 60% sensitivity. Comparison of the scores of the retained questionnaire variables between subjects classified as cases or controls based on clinical markers of LEA revealed an internal consistency and reliability of 0.71. Scores for sleep and thermoregulation were not associated with any clinical marker and were excluded from any further analysis. Of the remaining variables, dizziness, illness, fatigue, and sex drive had sufficient sensitivity to be retained in the questionnaire, but only low sex drive was able to distinguish between LEA cases and controls and was associated with perturbations in key clinical markers and questionnaire responses. In summary, in this large and international cohort, low sex drive was the most effective self-reported symptom in identifying male athletes requiring further clinical assessment for LEA.
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| 4. |
- Lysdahl Fahrenholtz, Ida, et al.
(författare)
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Short-term effects and long-term changes of FUEL—a digital sports nutrition intervention on REDs related symptoms in female athletes
- 2023
-
Ingår i: Frontiers in Sports and Active Living. - Lausanne : Frontiers Media S.A.. - 2624-9367. ; 5
-
Tidskriftsartikel (refereegranskat)abstract
- Female endurance athletes are at high risk for developing Relative Energy Deficiency in Sport (REDs), resulting in symptoms such as menstrual dysfunction and gastrointestinal (GI) problems. The primary aim of this study was to investigate effects of the FUEL (Food and nUtrition for Endurance athletes—a Learning program) intervention consisting of weekly online lectures combined with individual athlete-centered nutrition counseling every other week for sixteen weeks on REDs related symptoms in female endurance athletes at risk of low energy availability [Low Energy Availability in Females Questionnaire (LEAF-Q) score ≥8]. Female endurance athletes from Norway (n = 60), Sweden (n = 84), Ireland (n = 17), and Germany (n = 47) were recruited. Fifty athletes with risk of REDs (LEAF-Q score ≥8) and with low risk of eating disorders [Eating Disorder Examination Questionnaire (EDE-Q) global score <2.5], with no use of hormonal contraceptives and no chronic diseases, were allocated to either the FUEL intervention (n = 32) (FUEL) or a sixteen-week control period (n = 18) (CON). All but one completed FUEL and n = 15 completed CON. While no evidence for difference in change in LEAF-Q total or subscale scores between groups was detected post-intervention (BFincl < 1), the 6- and 12-months follow-up revealed strong evidence for improved LEAF-Q total (BFincl = 123) and menstrual score (BFincl = 840) and weak evidence for improved GI-score (BFincl = 2.3) among FUEL athletes. In addition, differences in change between groups was found for EDE-Q global score post-intervention (BFincl= 1.9). The reduction in EDE-Q score remained at 6- and 12- months follow-up among FUEL athletes. Therefore, the FUEL intervention may improve REDs related symptoms in female endurance athletes. Clinical Trial Registration: www.clinicaltrials.gov (NCT04959565). 2023 Fahrenholtz, Melin, Garthe, Wasserfurth, Ivarsson, Hollekim-Strand, Koehler, Logue, Madigan, Gräfnings and Torstveit.
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| 5. |
- Fahrenholtz, Ida Lysdahl, et al.
(författare)
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Risk of Low Energy Availability, Disordered Eating, Exercise Addiction, and Food Intolerances in Female Endurance Athletes
- 2022
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Ingår i: Frontiers in Sports and Active Living. - : Frontiers Media S.A.. - 2624-9367. ; 4
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Tidskriftsartikel (refereegranskat)abstract
- Relative energy deficiency in sport (RED-S) is a complex syndrome describing health and performance consequences of low energy availability (LEA) and is common among female endurance athletes. Various underlying causes of LEA have been reported, including disordered eating behavior (DE), but studies investigating the association with exercise addiction and food intolerances are lacking. Therefore, the aim of this cross-sectional study was to investigate the association between DE, exercise addiction and food intolerances in athletes at risk of LEA compared to those with low risk. Female endurance athletes, 18-35 years, training >= 5 times/week were recruited in Norway, Sweden, Ireland, and Germany. Participants completed an online-survey comprising the LEA in Females Questionnaire (LEAF-Q), Exercise Addiction Inventory (EAI), Eating Disorder Examination Questionnaire (EDE-Q), and questions regarding food intolerances. Of the 202 participants who met the inclusion criteria and completed the online survey, 65% were at risk of LEA, 23% were at risk of exercise addiction, and 21% had DE. Athletes at risk of LEA had higher EDE-Q and EAI scores compared to athletes with low risk. EAI score remained higher in athletes with risk of LEA after excluding athletes with DE. Athletes at risk of LEA did not report more food intolerances (17 vs. 10%, P = 0.198), but were more frequently reported by athletes with DE (28 vs. 11%, P = 0.004). In conclusion, these athletes had a high risk of LEA, exercise addiction, and DE. Exercise addiction should be considered as an additional risk factor in the prevention, early detection, and targeted treatment of RED-S among female endurance athletes.
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| 6. |
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| 7. |
- Karlsson, Elin, et al.
(författare)
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Symptoms of eating disorders and low energy availability in recreational active female runners
- 2023
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Ingår i: BMJ Open sport & exercise medicine. - : BMJ Publishing Group Ltd. - 2055-7647. ; 9:3
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesThis retrospective, cross-sectional study aimed to investigate symptoms of eating disorders (EDs) and low energy availability (LEA) among recreational female runners.MethodsFemales (18-39 years) (n=89) participating in running group sessions organised by running clubs and companies were recruited via social media and completed an anonymous online survey compromising the Eating Disorder Examination Questionnaire (EDE-Q) and Low Energy Availability in Females Questionnaire (LEAF-Q). An EDE-Q global score & GE;2.3 and a LEAF-Q total score & GE;8 (in combination with an injury score & GE;2 and/or menstruation dysfunction score & GE;4) were used to categorise subjects as having symptoms of EDs and LEA, respectively.ResultsAmong the subjects fulfilling the age criteria (n=85), 18% (n=15) had symptoms of EDs and 19% (n=16) had symptoms of LEA. Of those with symptoms of EDs, 13% (n=2) had concomitant symptoms of LEA. The higher the EDE-Q dietary restraint score, the higher the gastrointestinal problem score (r=0.23, p=0.04), otherwise no other associations were found between EDE-Q global or subscale scores and LEAF-Q scores. ConclusionOur results indicate that symptoms of EDs and LEA are frequent among adult females at all athletic levels, including the recreational level. Hence, to prevent the negative health consequences of EDs and LEA, preventative initiatives are also needed in recreational running communities.
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| 8. |
- Kuettel, Andreas, et al.
(författare)
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Depressive Symptoms in Danish Elite Athletes Using the Major Depressive Inventory (MDI) and the Center for Epidemiological Studies Depression Scale (CES-D)
- 2022
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Ingår i: Scandinavian Journal of Sport and Exercise Psychology. - : Dansk Idrætspsykologisk Forum. - 2596-741X. ; 4:1, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- The prevalence of depressive symptoms among athletes is an ongoing debate inthe scientific literature. The aim of the current study was to assess the prevalence of depressive symptoms in Danish elite athletes and to evaluate the psychometric properties of the Major Depressive Inventory (MDI) and the Center for Epidemiological Studies Depression Scale (CES-D) in athletes.The total sample comprised 996 athletes from two cross-sectional studies using the MDI (n= 409) and the CES-D (n= 587). Using the original cut-off points, the MDI found 8.6% and the CES-D found 24.9% at risk of depression. Using alternative cut-off points, both instruments detected 10-11% of athletes at risk. No statistically significant differences were found related to age, injury, and type of sport between high risk and low risk groups, whereas female athletes were overrepresented in the high-risk groups. Principal component analyses confirmed a single factor structure in both instruments with sufficient item loadings on the first component and Cronbach αvalues of .89 and .88. We recommend regular screening of depressive symptoms in elite athletes, with MDI and CES-D as valid instruments for that purpose. The appropriateness of using different cut-off points in athletic samples is discussed.
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| 9. |
- Laxdal, Aron, et al.
(författare)
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FIDES Athlete Development Programme : project background and study protocol of an embedded multiple case study
- 2024
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Ingår i: BMJ Open sport & exercise medicine. - : BMJ Publishing Group Ltd. - 2055-7647. ; 10:1
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Tidskriftsartikel (refereegranskat)abstract
- Most sports science research revolves around male subjects. As a result, most of the knowledge and practices within sports are male-centric. Failing to take the biological, psychological and social (biopsychosocial) particularities of females into account is believed to hinder optimal sports participation, development and performance, with potential negative effects on the health and well-being of females. To close the knowledge gap and alleviate these issues, we aim to develop and evaluate a 12-video educational intervention that addresses female-specific subject matter: the FIDES Athlete Development Programme. The study is designed as an embedded multiple case study where at least 1320 Swedish female athletes aged 13-16 will participate, in addition to their parents and their coaches. The girls will be recruited through their sports clubs, with half being exposed to the FIDES Athlete Development Programme and the other half serving as control cases. The primary outcomes are well-being and sporting experience. To further increase our understanding of the intervention and its implications, interviews and focus group interviews with a reference group of girls and focus group interviews with a randomly selected subsample of coaches and parents will also be performed. The project is approved by the Swedish ethics committee (number: 2023-05264-01) and will be carried out in compliance with the Declaration of Helsinki. Results from the project will be published open access in peer-reviewed journals, at national and international conferences, in mass media, and a PhD thesis. The anonymised data will be made openly available in a data repository.
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| 10. |
- Lichtenstein, Mia Beck, et al.
(författare)
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The Prevalence of Exercise Addiction Symptoms in a Sample of National Level Elite Athletes
- 2021
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Ingår i: Frontiers in Sports and Active Living. - : Frontiers Media S.A.. - 2624-9367. ; 3
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Tidskriftsartikel (refereegranskat)abstract
- Exaggerated exercise volumes, lack of control, withdrawal symptoms and conflicts with family and friends are core symptoms of exercise addiction. The condition can lead to health problems and social isolation because exercise is given the highest priority in any situation. The prevalence of the risk of exercise addiction has mostly been assessed in leisure time exercisers such as runners, fitness attendees and cyclists. The prevalence proportion ranges from 3 to 42% depending on the type of sport and the assessment tool. The proportion is greater among elite athletes, and increases with the level of competition. This study's primary aim was to assess the prevalence of exercise addiction among elite athletes competing at national level and its secondary aim was to evaluate the psychometric properties of the Exercise Addition Inventory (EAI) in elite sports. Participants (n = 417) from 15 sports disciplines and with 51% women completed an online survey. Results showed that 7.6% were at risk of exercise addiction. This group was younger, exhibited tendency to exercise despite pain and injury, felt guilty if not exercising enough, and reported substantial eating disorder symptoms. The reliability and validity of the EAI was good suggesting that the scale is appropriate for measuring the risk of exercise addiction in elite athletes.
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