The Health of Competitive Fitness Athletes

The Health of Competitive Fitness Athletes, a Cohort Study of Female Fitness Athletes and Physical Active Control's During and After Three Months of Fitness Contest Dieting

Fitness athletes emphasize the value of staying lean, muscular and defined, and motivates and inspires followers through social media. We want to study the effect of such lifestyle on selected aspects of psychological and physical health in female fitness athletes, and compare the outcomes to a healthy, physically active female population.

Study Overview

• Status: Completed
• Conditions: Depression; Exercise Addiction; Perfectionism; Binge Eating; Body Image; Eating Disorder; Resting Metabolic Rate; Dietary Deficiency; Bone Mineral Density, Low, Susceptibility to; Exercise-Related Amenorrhea; Dietary Amenorrhea
• Intervention / Treatment: Other: Psychological health; Other: Physiological health

Detailed Description

Little is known about the mental and physical health effect from following the modern, idealized fitness lifestyle. The lifestyle is characterized by selective and restrictive eating behavior, strength training and use of supplements. The athletes emphasize the value of staying lean, muscular and defined, and motivates and inspires followers through social media. This study will recruit and observe a group of competitive female fitness athletes over their typical 3 month dieting period when preparing for contest. Before their contest diet is initiated, the athletes will be screened on selected aspects of psychological and physical health. The screening is repeated two weeks prior to their first seasonal contest, and then finally one month post-contest season. During the diet period of 3 months, the athletes answers brief questionnaires by email on eating- and training behavior and on mood, while also reporting dietary intake by telephone interview.

Recreational physically females, not planning to do any fitness contest, will be recruited to serve as a parallel control group. They will perform the same physical and psychological screening, and answer the same questionnaires throughout the fitness contest diet period.

• Study Type: Observational
• Enrollment (Actual): 47

Contacts and Locations

Study Locations

• Norway
  • Oslo, Norway, 0806
    • Norwegian School of Sports Sciences

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 40 years (ADULT)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: Female

• Sampling Method: Non-Probability Sample

Study Population

Female, fitness athletes are being recruited through social media, Fitness team leaders and the Norwegian national federation for Bodybuilding and Fitness.

Physically active, female controls are being recruited through social media, training facilities and through colleagues at the Norwegian School of Sport Sciences

Description

Inclusion Criteria:

• Fitness athletes: planning to compete in fitness sport during spring or fall 2017
• Controls: being regular physically active (exercise >2 times/week during last year) with a BMI between 17,5-30

Exclusion Criteria:

• Controls: having competed in fitness sports previously or planning to do in the future, or working as a personal trainer.
• Not able to meet at the Norwegian School of Sport Sciences for baseline and follow up screenings.
• Being pregnant or nursing
• Metabolic related diseases

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Female Fitness Athletes; Psychological health and physiological health of fitness athletes	Other: Psychological health; Observing and measuring baseline, and changes in, psychological health through a fitness contest preparation period; Other: Physiological health; Observing and measuring baseline, and changes in, physiological health through a fitness contest preparation period
Female, physically active Controls; Psychological health and physiological health of female controls	Other: Psychological health; Observing and measuring baseline, and changes in, psychological health through a fitness contest preparation period; Other: Physiological health; Observing and measuring baseline, and changes in, physiological health through a fitness contest preparation period

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Body composition	Baseline values, change from pre-test to mid-test, and finally change from mid- to post-test, for lean body mass and fat mass, measured with Dual Xray absorptiometry (DXA)	Pre-test (3 months before contest), mid-test (2 weeks before contest) and post-test (one month post-contest)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Resting Metabolic Rate	Baseline values, change from pre-test to mid-test, and finally change from mid- to posttest, for resting metabolic rate, measured with indirect calorimetry	Pre-test (3 months before contest), mid-test (2 weeks before contest) and post-test (one month post-contest)
Bone Mineral Density	Baseline values, change from pre-test to mid-test, and finally change from mid- to post-test, for bone mineral density measured with Dual Xray absorptiometry (DXA)	Pre-test (3 months before contest), mid-test (2 weeks before contest) and post-test (one month post-contest)
Perfectionism	Comparing scores on perfectionism between case and controls, and individual changes in scores through study period, with Child Adolescent Perfectionism Scale (CAPS 22 items)	Pre-test (3 months before contest), mid-test (2 weeks before contest) and post-test (one month post-contest)
Depression	Baseline values, change from pre-test to mid-test, and finally change from mid- to post-test, for scores on depressive mood, measured with Becks Depression Inventory (BDI)	Pre-test (3 months before contest), mid-test (2 weeks before contest) and post-test (one month post-contest)
Eating disorders	Baseline values, change from pre-test to mid-test, and finally change from mid- to post-test, for scores on Eating disorder examination questionnaire (EDE-q)	Pre-test (3 months before contest), mid-test (2 weeks before contest) and post-test (one month post-contest)
Eating behavior; binge eating	Baseline values, change from pre-test to mid-test, and finally change from mid- to post-test, for scores on Binge Eating Scale (BES)	Pre-test (3 months before contest), mid-test (2 weeks before contest) and post-test (one month post-contest)
Eating behavior; restrictive eating and sensation of hunger	Baseline values, change from pre-test to mid-test, and finally change from mid- to post-test, for scores on Three Factor Eating Questionnaire (TFEQ-21)	Pre-test (3 months before contest), mid-test (2 weeks before contest) and post-test (one month post-contest)
Menstrual Status, self-reported	Baseline status, change from pre-test to mid-test, and finally change from mid- to post-test, for self-reported menstruation health (Low Energy Availability in Females questionnaire, LEAF)	Pre-test (3 months before contest), mid-test (2 weeks before contest) and post-test (one month post-contest)
Dietary intake, weighed diet registration	Change in dietary intake. Baseline status, change from pre-test to mid-test, and finally change from pre- to post-test, evaluated with weighed dietary registration and analysed with national analytical software (Kostholdsplanleggeren.no)	Pre-test (3 months before contest), mid-test (2 weeks before contest) and post-test (one month post-contest)
Exercise dependency	Baseline status, change from pre-test to mid-test, and finally change from pre- to post-test, evaluated with Exercise Dependency Scale (EDS)	Pre-test (3 months before contest), mid-test (2 weeks before contest) and post-test (one month post-contest)
Reason for Exercise	Baseline status, change from pre-test to mid-test, and finally change from pre- to post-test, evaluated with Reason for Exercise Inventory (REI)	Pre-test (3 months before contest), mid-test (2 weeks before contest) and post-test (one month post-contest)
Depression	Changes in reported state of depression during the dieting period of fitness athletes, measured with BDI	Each 2nd week during the 3 month contest dieting period (between pre-test and mid-test)
Dietary intake, 24-hour recall interview	Changes in energy and nutrient intake during the dieting period of fitness athletes, measured with dietary 24-hour recall interview and analysed with national analytical software (Kostholdsplanleggeren.no)	Each 2nd week during the 3 month contest dieting period (between pre-test and mid-test)
Menstrual cycle, self reported	Self reported menstrual bleeding's during the dieting period of fitness athletes (LEAF)	Each 2nd week during the 3 month contest dieting period (between pre-test and mid-test)
Eating disordered behavior	Changes in eating behavior during the dieting period of fitness athletes, measured with the behavioral aspects of EDE-q	Each 2nd week during the 3 month contest dieting period (between pre-test and mid-test)
Eating behavior; binge eating behavior	Changes in eating behavior during the dieting period of fitness athletes, measured with BES	Each 2nd week during the 3 month contest dieting period (between pre-test and mid-test)
Eating behavior; restrictive eating and sensation of hunger	Changes in eating behavior during the dieting period of fitness athletes, measured with TFEQ-21	Each 2nd week during the 3 month contest dieting period (between pre-test and mid-test)
Training volume, self reported	Reporting number of training sessions pr week and type of exercise (endurance related exercise or strength training)	Each 2nd week during the 3 month contest dieting period (between pre-test and mid-test)
Training history, self reported	Reporting experience with training, giving details on specific sport activity and typical intensity	Retrospective
Dietary Supplements	Reporting usage of dietary supplements during the dieting period	Pre-test (3 months before contest), mid-test (2 weeks before contest) and post-test (one month post-contest), and each 2nd week during the 3 month contest dieting period (between pre-test and mid-test)
Eating disorders, history	Reporting previous eating disorder and whether treatment were recieved or not	Retrospective
Drive for Muscularity	Baseline status, change from pre-test to mid-test, and finally change from pre- to post-test, evaluated with Drive for Muscularity (DM) (McCreary & Sasse 2000)	Pre-test (3 months before contest), mid-test (2 weeks before contest) and post-test (one month post-contest)
Drive for Leanness	Baseline status, change from pre-test to mid-test, and finally change from pre- to post-test, evaluated with Drive for Leanness (DL) (Smolak & Murnen 2008)	Pre-test (3 months before contest), mid-test (2 weeks before contest) and post-test (one month post-contest)
Body Weight, history	Reporting lowest and highest bodyweight after 18 yr's of age (excluding periods of pregnancy)	Retrospective

Collaborators and Investigators

• Sponsor: Norwegian School of Sport Sciences
• Collaborators: National Dairy Council
• Investigators: Study Director: Jorunn K Sundgot-Borgen, Professor, Professor

Publications and helpful links

General Publications

• Mathisen TF, Engen KM, Sundgot-Borgen J, Stensrud T. Evaluation of a short protocol for indirect calorimetry in females with eating disorders and healthy controls. Clin Nutr ESPEN. 2017 Dec;22:28-35. doi: 10.1016/j.clnesp.2017.09.003. Epub 2017 Oct 5.

Study record dates

Study Major Dates

• Study Start (ACTUAL): November 1, 2016
• Primary Completion (ACTUAL): November 1, 2017
• Study Completion (ACTUAL): December 1, 2017

Study Registration Dates

• First Submitted: December 24, 2016
• First Submitted That Met QC Criteria: December 29, 2016
• First Posted (ESTIMATE): January 2, 2017

Study Record Updates

• Last Update Posted (ACTUAL): March 29, 2018
• Last Update Submitted That Met QC Criteria: March 28, 2018
• Last Verified: March 1, 2018

More Information

Terms related to this study

• Keywords: Depression; Body composition; Bone mineral density; Binge Eating; Eating Disorder; Perfectionism; Exercise Dependency; Body building; Drive for Muscularity; Drive for leanness
• Additional Relevant MeSH Terms: Behavioral Symptoms; Mental Disorders; Pathologic Processes; Disease Attributes; Signs and Symptoms, Digestive; Nutrition Disorders; Hyperphagia; Menstruation Disturbances; Depression; Bulimia; Feeding and Eating Disorders; Binge-Eating Disorder; Disease Susceptibility; Amenorrhea; Malnutrition
• Other Study ID Numbers: 3281

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data are not planned to be available to other than the research group.