| 1. |
- Hogberg, L, et al.
(author)
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The impact of active intervention on the spread of penicillin-resistant streptococcus pneumoniae in Swedish day-care centres
- 2004
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In: Scandinavian Journal of Infectious Diseases. - : Informa UK Limited. - 1651-1980 .- 0036-5548. ; 36:9, s. 629-635
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Journal article (peer-reviewed)abstract
- Policies for handling cases of penicillin-non-susceptible Streptococcus pneumoniae (PNSP) in day-care groups vary between different counties in Sweden. The aim of this study was to evaluate the epidemiological effect of excluding PNSP-carriers from children's day-care centres (DCC). We followed the incidence in 14 DCC groups with ongoing PNSP-spread, by repeated group screens until no further cases could be identified. All identified carriers were excluded from DCC attendance in study area A (Skane region) while they remained in the group in study area B (Goteborg and Orebro), according to local policies. The intervention effect was evaluated by comparing the number of additional cases after the baseline screen (start of the intervention period) between the 2 study areas. All PNSP-isolates were characterized by resistance pattern, serotype and pulse-field gel electrophoresis. The relative risk for children in DCCs without active intervention was 6.4 (95% CI: 2.0-20.7). Each prevented case in area A can be estimated to have demanded the exclusion of 2 other children from day care for approximately 4 weeks each. The total cost-benefit outcome of this action has to be seen in the light of the local situation with regard to the population prevalence and the distribution of other risk factors.
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| 2. |
- Hanstock, Helen, 1989-, et al.
(author)
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Influence of Immune and Nutritional Biomarkers on Illness Risk During Interval Training
- 2020
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In: International Journal of Sports Physiology and Performance. - : Human Kinetics. - 1555-0265 .- 1555-0273. ; 15:1, s. 60-67
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Journal article (peer-reviewed)abstract
- Intensive training periods may negatively influence immune function, but the immunological consequences of specific high-intensity training (HIT) prescriptions are not well defined. Purpose: This study explored whether three different HIT prescriptions influence multiple health-related biomarkers and whether biomarker responses to HIT were associated with upper respiratory illness (URI) risk. Methods: Twenty-five male cyclists and triathleteswere randomised to three HIT groups and completed twelve HIT sessions over four weeks. Peak oxygen consumption (V̇O2peak) was determined using an incremental cycling protocol, while resting serum biomarkers (cortisol, testosterone, 25(OH)D and ferritin), salivary immunoglobulin-A (s-IgA) and energy availability (EA) were assessed before and after the training intervention. Participants self-reported upper respiratory symptoms during the interventionand episodes of URI were identified retrospectively. Results: Fourteen athletes reported URIs, but there were no differences in incidence, duration or severity between groups. Increased risk of URI was associated with higher s-IgA secretion rates (odds ratio=0.90, 90% CI:0.83-0.97). Lower pre-intervention cortisol and higher EA predicted a 4% increase in URI duration. Participants with higher V̇O2peak reported higher total symptom scores (incidence rate ratio=1.07, 90% CI:1.01-1.13). Conclusions: Although multiple biomarkers wereweakly associated with risk of URI, the direction of associations between s-IgA, cortisol, EA and URI risk were inverse to previous observations and physiological rationale. There was a cluster of URIs within the first week of the training intervention, but no samples were collected at this time-point. Future studies should incorporate more frequent sample time-points, especially around the onset of new training regimes, and include athletes with suspected or known nutritional deficiencies.
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| 3. |
- Hanstock, Helen, 1989-, et al.
(author)
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Influence of interval duration on immunological responses to 4-weeks’ high-intensity interval training
- 2018
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In: Journal of Sports Sciences. - : Routledge. - 0264-0414 .- 1466-447X. ; , s. 1-94
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Conference paper (peer-reviewed)abstract
- High-intensity interval training (HIT) encompasses a wide range of training prescriptions where up to nine variables can be manipulated (Buchheit and Laursen, 2013, Sports Medicine, 43(5), 313–338). Four weeks of HIT with longer intervals and accumulated work durations (AWD) has been shown to elicit greater improvements in peak oxygen consumption (V O 2peak ) despite more modest physiological, hormonal and perceptual responses (Sylta et al., 2017, Medicine & Science in Sports & Exercise, 49(6), 1137–1146). However, immunological responses to different HIT pre- scriptions have rarely been investigated. The purpose of this study was to compare the cumulative effects of a four-week HIT intervention, performed either as short or long intervals with the same AWD, on V O 2peak , the immunological biomarker salivary secretory IgA (s-IgA) and upper respiratory illness (URI) incidence. In addition, we explored the influence of HIT on serum cortisol, testosterone, 25(OH)D and ferritin as biomarkers related to immune competence. Following local ethics committee approval, twenty-five well-trained male cyclists and triath- letes provided written consent to take part and were randomised to one of three HIT groups (Long Intervals [LI]: 4 × 8min; Short Intervals 1 [SI1]: 4×[12 × 40/20s]; Short Intervals 2 [SI2]: 4×[8 ×40/20s]). Participants per- formed three cycling HIT sessions per week for four weeks at maximal session effort (“isoeffort”) intensity, supplemented with ad libitumlow-intensity training. Participants recorded upper respiratory symptoms (URS) daily using the Jackson Common Cold Scale; episodes of URI were identified retrospectively. V O 2peak as well as rested saliva and blood biomarkers were analysed before and after the training period. Fourteen of twenty-five participants reported an episode of URI (LI: 4/8, SI1: 4/8, SI2: 6/9) but there were no differences in URI incidence, severity or duration between groups. Following the train- ing intervention, we observed a moderate increase in V O 2peak across the cohort (mean± SD: 4.75 ± 0.42 to 4.86 ± 0.43 L· min−1 ,Cohen’s d= 0.65, 90% confidence intervals: [0.16, 1.13]) but the change in V O 2peak was not different between groups. Serum cortisol displayed a moderate increase (367 ± 98 to 415 ± 108 nmol· L −1 ,d=0.60 [0.12, 1.08]) and 25(OH)D a large decrease (79.2 ± 17.1 to 70.4 ± 17.6 nmol· L −1 ,d= -0.87 [−1.36,−0.37]) from pre- to post-training, but there were no differences in the magnitude of the responses between groups. Four weeks’HIT did not influence s-IgA secretion rate, serum testosterone or ferritin. We conclude that four weeks’ AWD-matched HIT performed as short- or long-intervals at isoeffort intensity does not differentially influence ill- ness incidence, immunological responses to training nor other immune-related biomarkers. This observation can be viewed as a positive finding for training planning, since it could allow coaches some flexibility in constructing AWD-matched isoeffort HIT sessions to achieve performance goals, without concern about detrimental effects on athletes’ immune status.
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| 4. |
- Lundy, Bronwen, et al.
(author)
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Screening for Low Energy Availability in Male Athletes : Attempted Validation of LEAM-Q
- 2022
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In: Nutrients. - : MDPI. - 2072-6643. ; 14:9
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Journal article (peer-reviewed)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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| 5. |
- Nygård, K, et al.
(author)
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Imported rocket salad partly responsible for increased incidence of hepatitis A cases in Sweden, 2000-2001
- 2001
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In: Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin. - : European Centre for Disease Control and Prevention (ECDC). - 1560-7917. ; 6:10, s. 151-3
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Journal article (peer-reviewed)abstract
- An increased incidence of domestic hepatitis A without any obvious source of infection in Sweden and a small outbreak in late spring 2001 led to the undertaking of a case-control study. Consumption of imported rocket salad was clearly associated with disease (odds ratio 9.1, 95% confidence interval 1.5 to 69). The importation of vegetables from countries where hepatitis A is endemic to countries where this disease is not endemic continues to be a public health problem.
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| 6. |
- Torstveit, Monica K, et al.
(author)
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Exercise dependence, eating disorder symptoms and biomarkers of Relative Energy Deficiency in Sports (RED-S) among male endurance athletes
- 2019
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In: BMJ Open Sport & Exercise Medicine. - : BMJ Publishing Group Ltd. - 2055-7647. ; 5:1, s. 1-8
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Journal article (peer-reviewed)abstract
- Objectives To explore associations betweenexercise dependence, eating disorder (ED) symptoms and biomarkers of Relative Energy Deficiency in Sports (RED-S) among male endurance athletes.Methods Fifty-three healthy well-trained male cyclists, triathletes and long-distance runners recruited from regional competitive sports clubs were included in this cross-sectional study. The protocol comprised the Exercise Dependence Scale (EXDS), the ED Examination Questionnaire (EDE-Q), measurements of body composition, resting metabolic rate, energy intake and expenditure and blood analysis of hormones and glucose.Results Participants with higher EXDS score displayed a more negative energy balance compared with subjects with lower EXDS score (p<0.01). EXDS total score was positively correlated with EDE-Q global score (r=0.41, p<0.05) and the subscale score for restraint eating (r=0.34, p<0.05) and weight concern (r=0.35, p<0.05). EXDS total score and the subscales lack of control and tolerance were positively correlated with cortisol (r=0.38, p<0.01, r=0.39, p<0.01 and r=0.29, p<0.05, respectively). The EXDS subscales withdrawal and tolerance were negatively correlated with fasting blood glucose (r=−0.31 and r=−0.32, p<0.05, respectively), while intention effect was negatively correlated with testosterone:cortisol ratio (r=−0.29, p<0.05) and positively correlated with cortisol:insulin ratio (r=0.33, p<0.05).Conclusion In this sample of healthy male athletes, we found associations between higher EXDS scores, ED symptoms and biomarkers of RED-S, such as a more pronounced negative energy balance and higher cortisol levels.
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| 7. |
- Ahlman, Håkan, 1947, et al.
(author)
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Management of disseminated midgut carcinoid tumours.
- 1991
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In: Digestion. - 0012-2823. ; 49:2, s. 78-96
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Journal article (peer-reviewed)abstract
- Forty-one patients with disseminated midgut carcinoid tumours were treated over a 6-year period according to a strict programme including primary surgical treatment. In 10 patients, a total remission of the disease was obtained. Patients with bilobar hepatic disease had ischaemic treatment of their liver metastases by hepatic arterial embolisation after primary surgical and medical treatment (low dose octreotide). Thus, by combining surgical, radiological and medical treatment modalities, we wanted to offer these patients optimal palliation. This treatment programme resulted in good symptomatic relief in all patients accompanied by a marked reduction in 5-hydroxyindoleacetic acid (5-HIAA) levels. At recurrence of symptoms in combination with rising 5-HIAA levels, embolisation was repeated. Ten of the treated patients have deceased during the observation period, but only 5 from their carcinoid disease.
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| 8. |
- Cautela, Jacopo, et al.
(author)
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Supracolloidal Atomium
- 2020
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In: ACS Nano. - : American Chemical Society (ACS). - 1936-086X .- 1936-0851. ; 14:11, s. 15748-15756
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Journal article (peer-reviewed)abstract
- Nature suggests that complex materials result from a hierarchical organization of matter at different length scales. At the nano- and micrometer scale, macromolecules and supramolecular aggregates spontaneously assemble into supracolloidal structures whose complexity is given by the coexistence of various colloidal entities and the specific interactions between them. Here, we demonstrate how such control can be implemented by engineering specially customized bile salt derivative-based supramolecular tubules that exhibit a highly specific interaction with polymeric microgel spheres at their extremities thanks to their scroll-like structure. This design allows for hierarchical supracolloidal self-assembly of microgels and supramolecular scrolls into a regular framework of “nodes” and “linkers”. The supramolecular assembly into scrolls can be triggered by pH and temperature, thereby providing the whole supracolloidal system with interesting stimuli-responsive properties. A colloidal smart assembly is embodied with features of center-linker frameworks as those found in molecular metal–organic frameworks and in structures engineered at human scale, masterfully represented by the Atomium in Bruxelles.
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| 9. |
- Domeika, Marius, et al.
(author)
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Implementation of a national electronic reporting system in Lithuania
- 2009
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In: Euro surveillance. - 1560-7917. ; 14:13, s. 19165-
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Journal article (peer-reviewed)abstract
- Electronic reporting systems improve the quality and timeliness of the surveillance of communicable diseases. The aim of this paper is to present the process of the implementation and introduction of an electronic reporting system for the surveillance of communicable diseases in Lithuania. The project which started in 2002 was performed in collaboration between Lithuania and Sweden and was facilitated by the parallel process of adapting the surveillance system to European Union (EU) standards. The Lotus-based software, SmittAdm, was acquired from the Department of Communicable Diseases Control and Prevention of Stockholm County in Sweden and adopted for Lithuania, resulting in the Lithuanian software, ULISAS. A major advantage of this program for Lithuania was the possibility to work offline. The project was initiated in the two largest counties in Lithuania where ULISAS had been installed and put in use by January 2005. The introduction was gradual, the national level was connected to the system during late 2005, and all remaining counties were included during 2006 and 2007. The reporting system remains to be evaluated concerning timeliness and completeness of the surveillance. Further development is needed, for example the inclusion of all physicians and laboratories and an alert system for outbreaks. The introduction of this case-based, timely electronic reporting system in Lithuania allows better reporting of data to the European Centre for Disease Prevention and Control (ECDC) and the World Health Organization (WHO) compared to the former reporting system with paper-based, aggregated data.
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| 10. |
- Fridlund, Veronika, 1980-, et al.
(author)
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Condom use: The discrepancy between practice and behavioral expectations
- 2014
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In: Scandinavian Journal of Public Health. - London : SAGE Publications. - 1403-4948 .- 1651-1905. ; 42:8, s. 759-765
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Journal article (peer-reviewed)abstract
- Aim: The overall aim of this paper is to examine sexually active young people's behavioral expectations of condom use. Methods: We collected data at nine youth clinics and one sexually transmitted infections (STI) clinic in Sweden. We included participants whom had been sexually active during the past 12 months: A total of 1022 participants between the ages of 15 and 31 were included. We analyzed the data separately, for different types of sexual practices and types of sexual partners. Multinomial logistic regression was used to analyze age and gender differences for discrepancies. Results: The behavioral expectation of condom use differed, depending on the type of sexual practice and the type of partner. For all types of sex, the overall pattern showed that the participants were most likely to use a condom with a casual unknown partner, followed by a casual known partner, regular partner and lastly, a main partner. Our results also demonstrated that there is a discrepancy between the behavioral expectation of condom use and the self-reported condom use. The lowest discrepancy was for oral sex, especially with a main partner, and the largest discrepancy was for anal sex and vaginal sex with a casual partner. Conclusions: Our results imply that the participants had a greater expectation of condom use than actually occurs, especially for casual unknown partners. There is a lack of knowledge about the risks associated with oral sex, which is evident in the results of the participants' behavioral expectations of condom use under those conditions.
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| 11. |
- Hanstock, Helen, 1989-, et al.
(author)
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Evaluation of physiological and nutritional risk factors for upper respiratory illness using a zero-inflated negative binomial model
- 2018
-
In: Journal of Sports Sciences. - : Routledge. - 0264-0414 .- 1466-447X. ; , s. 44-45
-
Conference paper (peer-reviewed)abstract
- Intensified training periods may increase incidence of upper respiratory illness (URI) in athletes (Meeusen et al., 2013,Medicine and Science in Sports and Exercise, 45(1), 186–205). Many physiological and nutritional risk factors have beenassociated with increased risk of URI (Bermon et al., 2017, Exercise Immunology Review, 23, 8–50), including reductionsin salivary IgA (sIgA), elevated cortisol, vitamin D insufficiency, iron deficiency and low energy availability (EA). However, few studies have explored the relative importance of each of thesehealth-related biomarkers in a multivariate model. Our aimwas therefore to investigate the relationship between multiplebiological risk factors for illness and incidence, duration andseverity of URIs that present during intensified training. 3815Twenty-five well-trained male cyclists and triathletes (age 30 ± 9 y, VO2peak 64 ± mL· kg−1· min−1) performed one ofthree different high-intensity interval training (HIT) programmes for three sessions per week over four weeks in November-December. The study received local ethical approval and participants provided written, informed consentto participate. Participants performed each HIT session at “isoeffort” intensity and sessions were matched for total accumulated work duration. Participants logged upper respiratorysymptoms (URS) daily using the Jackson Common Cold Scale; episodes of URI were identified retrospectively using the followinga priori criteria: weekly symptom score > 14 or selfreportedcommon cold for > 2 consecutive days (Jacksonet al., 1958, American Medical Association Archives of Internal Medicine, 101, 267–278). Before commencing the training period, VO2peak was determined using an incremental maximal cycling protocol and participants provided rested, fasted blood and saliva samples prior to the training period foranalysis of plasma 25(OH)D, ferritin, cortisol, testosterone and sIgA secretion rate. EA was calculated based on a 3-day registration of energy intake and expenditure relative to fat-free mass measured in a rested, fasted state using indirect calorimetry (Torstveit et al., 2018 February, International Journal of Sport Nutrition and Exercise Metabolism, 1–28). We used a zero-inflated negative binomial model to investigate the relationship between baseline VO2peak, health-related biomarkers and URI incidence/duration/global URS severity. Fourteen athletes(56%) reported an episode of URI during the four-week monitoring period. Higher sIgA was associated with reduced risk of URI (odds ratio = 0.90, 90% confidence interval (CI): [0.83,0.97]). Lower plasma cortisol (P = 0.02) and higher EA (P = 0.02) were associated with longer URI duration; holding cortisol constant, the incidence risk ratio (IRR) for a one-unit increase in EA was 1.04 (90% CI: [1.01, 1.07]). Participants with higher VO2peak reported higher total symptom scores during the intervention period (P = 0.03, IRR = 1.07, 90% CI: [1.01,1.13]). Several health-related biomarkers and physiological parameters may therefore be associated with risk and severityof URI, including sIgA, cortisol, EA and VO2peak.
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| 12. |
- Sand, Lena, et al.
(author)
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Effect of patient position and PEEP on hepatic, portal and central venous pressures during liver resection.
- 2011
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In: Acta anaesthesiologica Scandinavica. - : Wiley. - 1399-6576 .- 0001-5172. ; 55:9, s. 1106-12
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Journal article (peer-reviewed)abstract
- It has been suggested that blood loss during liver resection may be reduced if central venous pressure (CVP) is kept at a low level. This can be achieved by changing patient position but it is not known how position changes affect portal (PVP) and hepatic (HVP) venous pressures. The aim of the study was to assess if changes in body position result in clinically significant changes in these pressures.
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| 13. |
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| 14. |
- Stenqvist, A., et al.
(author)
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Impact of antioxidant treatment on DNA fragmentation index : a double-blind placebo-controlled randomized trial
- 2018
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In: Andrology. - : Wiley. - 2047-2919. ; 6:6, s. 811-816
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Journal article (peer-reviewed)abstract
- Background: Previous reports on effect of antioxidants on sperm DNA integrity were equivocal, and there is a lack of randomized, placebo-controlled studies. Objectives: To evaluate the efficacy of combined antioxidant treatment in subfertile men with normal reproductive hormone levels and high sperm DNA fragmentation index (DFI). Materials and methods: This placebo-controlled, double-blind, randomized study evaluated the effects of combined antioxidant treatment in 77 men from infertile couples, with normal testosterone, LH and FSH levels and DFI ≥25%. All participants were randomly assigned to receive combined antioxidant treatment (vitamins, antioxidants and oligoelements) or placebo for six months. The primary outcome measured was DFI. Secondary outcomes were standard semen parameters. DFI and other semen parameters were, at each time point (pre-treatment, and after three and six months of treatment), compared between the treatment and the placebo group using Mann–Whitney U-test. Results: Antioxidant group had higher sperm concentration after three months of treatment (median: 24.4 × 106/mL vs. 27.2 × 106/mL; P = 0.028) and borderline statistically significant higher concentration after six months of treatment (median: 24.4 × 106/mL vs. 33.3 × 106/mL; P = 0.053) compared to pre-treatment values. The DFI did not change during the 6 months of antioxidant therapy. No statistically significant difference between the antioxidant and placebo group was seen for any of the semen parameters including sperm DFI at any of the three time points. Discussion: The increase in sperm concentration was more pronounced in the antioxidant treated group but not statistically significantly higher than among controls, perhaps due to insufficient statistical power. Previous studies have shown positive effect of antioxidant treatment on DFI and other semen parameters. However, our findings indicate that men with normal reproductive hormone levels may not be the primary target group for such therapy. Conclusion: Six months treatment with antioxidants had no effect on sperm DFI.
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| 15. |
- Stenqvist, Thomas Birkedal, et al.
(author)
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Impact of a 4-Week Intensified Endurance Training Intervention on Markers of Relative Energy Deficiency in Sport (RED-S) and Performance Among Well-Trained Male Cyclists
- 2020
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In: Frontiers in Endocrinology. - : Frontiers Media S.A.. - 1664-2392. ; 11, s. 1-11
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Journal article (peer-reviewed)abstract
- Cyclists often apply block periodization to high training volumes in meso- and macrocycles to optimize training adaptation and to prepare for competition. Body mass influences performance in many sports, including endurance disciplines, and conditions related to the syndrome Relative Energy Deficiency in Sports (RED-S) such as metabolic adaptations and premature osteoporosis have also been reported in male cyclists. This study aimed to determine how a 4-week mesocycle of intensified endurance training designed to increase performance, would affect markers of RED-S in well-trained male cyclists. Twenty-two participants (age: 33.5 +/- 6.6 years, height: 181.4 +/- 5.2 cm, weight: 76.5 +/- 7.4 kg, peak oxygen uptake (VO2peak): 63.5 +/- 6.6 mL center dot kg(-1)center dot min(-1)) were recruited and instructed to maintain their background training load and to follow a supervised training protocol consisting of three high-intensity interval training sessions per week with a work duration of 32 min per session. Protocols included pre- and postintervention assessment of resting metabolic rate (RMR) using a ventilated hood, body composition and bone health by dual-energy X-ray absorptiometry (DXA), blood samples, energy intake, and aerobic performance. The interval training increased participants' aerobic performance-peak power output [4.8%,p< 0.001], VO2peak[2.4%,p= 0.005], and functional threshold power [6.5%,p< 0.001] as well as total testosterone levels [8.1%,p= 0.011]-while no changes were observed in free testosterone [4.1%,p= 0.326]. Bodyweight, body composition, and energy intake were unchanged from pre- to post-test. Triiodothyronine (T-3) [4.8%,p= 0.008], absolute RMR [3.0%,p= 0.010], relative RMR [2.6%,p= 0.013], and RMRratio[3.3%,p= 0.011] decreased, and cortisol levels increased [12.9%,p= 0.021], while no change were observed in the total testosterone:cortisol ratio [1.6%,p= 0.789] or the free testosterone:cortisol (fT:cor) ratio [3.2%,p= 0.556]. A subgroup analysis of the five participants with the largest increase in fT:cor ratio, revealed a greater improvement in functional threshold power (9.5 vs. 2.5%,p= 0.037), and higher relative RMR (0.6 vs. -4.2%p= 0.039, respectively). In conclusion, 4 weeks of intensified endurance interval training increased the athletes' aerobic performance and testosterone levels. However, negative changes in markers related to RED-S, such as a reduction in RMR and T-3, and an increase in cortisol were observed. These results indicate the complexity involved, and that male athletes are at risk of developing clinical indications of RED-S even during a short 4-week endurance training mesocycle.
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| 16. |
- Stenqvist, Thomas Birkedal, et al.
(author)
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Prevalence of Surrogate Markers of Relative Energy Deficiency in Male Norwegian Olympic-Level Athletes
- 2021
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In: International Journal of Sport Nutrition & Exercise Metabolism. - : Human Kinetics. - 1526-484X .- 1543-2742. ; 31:6, s. 497-506
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Journal article (peer-reviewed)abstract
- The syndrome of Relative Energy Deficiency in Sport (RED-S) includes wide-ranging effects on physiological and psychological functioning, performance, and general health. However, RED-S is understudied among male athletes at the highest performance levels. This cross-sectional study aimed to investigate surrogate RED-S markers prevalence in Norwegian male Olympic-level athletes. Athletes (n = 44) aged 24.7 +/- 3.8 years, body mass 81.3 +/- 15.9 kg, body fat 13.7% +/- 5.8%, and training volume 76.1 +/- 22.9 hr/month were included. Assessed parameters included resting metabolic rate (RMR), body composition, and bone mineral density by dual-energy X-ray absorptiometry and venous blood variables (testosterone, free triiodothyronine, cortisol, and lipids). Seven athletes (16%) grouped by the presence of low RMR (RMRratio < 0.90) (0.81 +/- 0.07 vs. 1.04 +/- 0.09, p <.001, effect size 2.6), also showed lower testosterone (12.9 +/- 5.3 vs. 19.0 +/- 5.3 nmol/L, p =.020) than in normal RMR group. In low RMRratio individuals, prevalence of other RED-S markers (-subclinical-low testosterone, low free triiodothyronine, high cortisol, and elevated low-density lipoprotein) was (N/number of markers): 2/0, 2/1, 2/2, 1/3. Low bone mineral density (z-score < -1) was found in 16% of the athletes, all with normal RMR. Subclinical low testosterone and free triiodothyronine levels were found in nine (25%) and two (5%) athletes, respectively. Subclinical high cortisol was found in 23% of athletes while 34% had elevated low-density lipoprotein cholesterol levels. Seven of 12 athletes with two or more RED-S markers had normal RMR. In conclusion, this study found that multiple RED-S markers also exist in male Olympic-level athletes. This highlights the importance of regular screening of male elite athletes, to ensure early detection and treatment of RED-S.
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| 17. |
- Stenqvist, Thomas Birkedal, et al.
(author)
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Relative Energy Deficiency in Sport (REDs) Indicators in Male Adolescent Endurance Athletes : A 3-Year Longitudinal Study
- 2023
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In: Nutrients. - : MDPI. - 2072-6643. ; 15:24
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Journal article (peer-reviewed)abstract
- Longitudinal measurements of Relative Energy Deficiency in Sport (REDs) among adolescent male elite athletes are lacking. We aimed to monitor REDs indicators and their possible impact on performance in elite high-school cross-country skiing and biathlon athletes (n = 13) (16.3 +/- 0.4 years, 179.4 +/- 7.6 cm, 63.6 +/- 8.2 kg body mass (BM), and peak oxygen uptake (VO2peak): 61.5 +/- 5.3 mL/kg BM/min) every 6 months for 3 years. Protocols included assessments of energy availability (EA), body composition and bone mineral density (BMD), resting metabolic rate (RMR), disordered eating behavior, exercise addiction, VO2peak, and muscle strength. Data were analyzed using a linear mixed model. At baseline, 38% had low lumbar BMD (Z-score <= -1), and overall, bone health increased only slightly. VO2peak and muscle strength improved (p < 0.001), RMR decreased (p = 0.016), and no change was observed in EA or physiological or psychological REDs indicators. Conclusively, many of these young male athletes had poor bone health at baseline, and most either lost or did not achieve the expected pubertal bone mineral accrual, although no other indication of REDs was observed, while performance improved during the study period. Our findings highlight the importance of elite sports high schools focusing on screening for early detection of impaired bone health in male athletes.
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| 18. |
- Torstveit, Monica Klungland, et al.
(author)
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Within-Day Energy Deficiency and Metabolic Perturbation in Male Endurance Athletes
- 2018
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In: International Journal of Sport Nutrition & Exercise Metabolism. - : Human Kinetics. - 1526-484X .- 1543-2742. ; 28:4, s. 419-427
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Journal article (peer-reviewed)abstract
- Endurance athletes are at increased risk of relative energy deficiency associated with metabolic perturbation and impaired health. We aimed to estimate and compare within-day energy balance in male athletes with suppressed and normal resting metabolic rate (RMR) and explore whether within-day energy deficiency is associated with endocrine markers of energy deficiency. A total of 31 male cyclists, triathletes, and long-distance runners recruited from regional competitive sports clubs were included. The protocol comprised measurements of RMR by ventilated hood and energy intake and energy expenditure to predict RMR-ratio (measured RMR/predicted RMR), energy availability, 24-hr energy balance and within-day energy balance in 1-hr intervals, assessment of body composition by dual-energy X-ray absorptiometry, and blood plasma analysis. Subjects were categorized as having suppressed (RMRratio < 0.90, n = 20) or normal (RMRratio > 0.90, n = 11) RMR. Despite there being no observed differences in 24-hr energy balance or energy availability between the groups, subjects with suppressed RMR spent more time in an energy deficit exceeding 400 kcal (20.9 [18.8-21.8] hr vs. 10.8 [2.5-16.4], p =.023) and had larger single-hour energy deficits compared with subjects with normal RMR (3,265 +/- 1,963 kcal vs. -1,340 +/- 2,439, p =.023). Larger single-hour energy deficits were associated with higher cortisol levels (r = -.499, p =.004) and a lower testosterone: cortisol ratio (r =.431, p =.015), but no associations with triiodothyronine or fasting blood glucose were observed. In conclusion, within-day energy deficiency was associated with suppressed RMR and catabolic markers in male endurance athletes.
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