Search

Background: Research findings indicate a concerning prevalence of physical inactivity among Saudi females, which has been associated with low physical performance levels. To address this challenge, it is crucial to promote sports participation, particularly in activities such as basketball. However, despite its potential benefits, the specific effects of basketball engagement among Saudi females remain largely unexplored. Therefore, this study investigated the relationship between physical performance and basketball playing among female collegiate players compared to non-basketball players in Saudi Arabia. Also, this study examined the effect of years of playing basketball on the basketball players group's speed, agility, and physical activity levels., Methods: The participants were divided into two groups: a non-athletic control group of 20 participants (age: 22 ± 2.0 years; weight: 55.6 ± 7.7 kg; height: 157.7 ± 5.5 cm) and a basketball group of 18 participants (age: 20 ± 3.3 years; weight: 60.6 ± 12 kg; height: 163.8 ± 6.3 cm).To examine the relationship between playing basketball and physical performance levels, this study included 38 female participants divided into a non-athletic control group (N = 20) and a basketball group (N = 18). To evaluate physical performance, the 10-Meter Walk Test (10MWT), Modified Agility T-Test (MAT), and International Physical Activity Questionnaire (IPAQ) were used., Results: Basketball players demonstrated significantly superior performance in the 10-MWT (Mann-Whitney-test = 1.7, p < .05) and MAT (Mann-Whitney-test = 9.6, p < .001) compared to the non-athletic participants. Furthermore, IPAQ scores were significantly correlated with speed and agility (p < 0.05)., Conclusion: Women who regularly played basketball exhibited superior physical activity levels and higher physical performance in speed and agility compared to those who were less active. However, no significant differences between the years of playing and any other variables were found. Nevertheless, these findings seek to contribute valuable insights into the potential benefits of basketball playing among Saudi women., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2024 Alaa M. Albishi. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Ultramarathon running is of increasing popularity, where the time-limited 24-hour run is one of the most popular events. Although we have a high scientific knowledge about different topics for this specific race format, we do not know where the best 24-hour runners originate from and where the fastest races are held. The purpose of the present study was to investigate the origin of these runners and the fastest race locations. A machine learning model based on the XG Boost algorithm was built to predict running speed based on the athlete´s age, gender, country of origin and the country where the race takes place. Model explainability tools were used to investigate how each independent variable would influence the predicted running speed. A sample of 171,358 race records from 63,514 unique runners from 73 countries participating in 24-hour races held in 57 countries between 1807 and 2022 was analyzed. Most of the athletes originated from the USA, France, Germany, Great Britain, Italy, Japan, Russia, Australia, Austria, and Canada. Tunisian athletes achieved the fastest average running speed, followed by runners from Russia, Latvia, Lithuania, Island, Croatia, Slovenia, and Israel. Regarding the country of the event, the ranking looks quite similar to the participation by the athlete, suggesting a high correlation between the country of origin and the country of the event. The fastest 24-hour races are recorded in Israel, Romania, Korea, the Netherlands, Russia, and Taiwan. On average, men were 0.4 km/h faster than women, and the fastest runners belonged to age groups 35-39, 40-44, and 45-49 years. In summary, the 24-hour race format is spread over the world, and the fastest athletes mainly originate from Eastern Europe, while the fastest races were organized in European and Asian countries., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Ethics approval: This study was approved by the Institutional Review Board of Kanton St. Gallen, Switzerland, with a waiver of the requirement for informed consent of the participants as the study involved the analysis of publicly available data (EKSG 01/06/2010). The study was conducted in accordance with recognized ethical standards according to the Declaration of Helsinki adopted in 1964 and revised in 2013., (© 2024. The Author(s).)

Background: Sporting success relies not only on athletes' physical qualities but also involves psychological, technical, and environmental factors. Given the lack of effective tools to comprehensively measure sporting success in the Chinese context, this study aimed to validate the Chinese version of the Sport Success Scale (SSS-C)., Methods: A total of 604 adolescent basketball players, comprising 301 (49.8%) males and 303 (50.2%) females aged between 12 and 19 (M = 15.53, SD = 1.42), were recruited from secondary schools across 17 cities in Shandong Province, China, to answer the questionnaire, which measured their views on 29 items through a six-point Likert scale. The SSS was translated into Chinese language (SSS-C) using forward-backward translation techniques. Confirmatory Factor Analysis (CFA) was performed using Mplus 8.0 software to assess the structural validity of SSS-C. The reliability and convergent validity were also evaluated., Results: CFA results demonstrated an excellent fit to the hypothesized six-factor model based on the fit indices (CFI = 0.997, TLI = 0.997, RMSEA = 0.016 [90% CI: 0.005, 0.022], SRMR = 0.018). All items displayed significant factor loadings above 0.40, supporting the robustness of the model. The SSS-C exhibited high internal consistency reliability (Cronbach's α ranged from 0.95 to 0.96; Composite Reliability ranged from 0.95 to 0.96) and strong convergent validity (Average Variance Extracted values > 0.50)., Conclusion: The SSS-C with 29 items was a valid and reliable instrument for comprehensively assessing sport success among Chinese adolescent athletes. The multidimensional approach of the SSS-C provides a new perspective for understanding the psychological factors contributing to athletes' success, which can inform the development of targeted interventions., (© 2024. The Author(s).)

Tennis, a widely enjoyed sport, motivates athletes and coaches to optimize training for competitive success. This retrospective predictive study examines anthropometric features and statistics of 1990 tennis players in the 2022 season, using 20,040 data points retrospectively obtained from the ATP official source after the end of the season. These data were cross-verified with information from other sources before categorisation to address any discrepancies. Employing various analytical methods, the results emphasize the strategic importance of tournament participation and gameplay for financial gains and higher rankings. Prize money analysis reveals a significant disparity favoring top players. Multivariate Analysis of Variance highlights the need to consider multiple variables for understanding ATP rankings. Multinomial Logistic Regression identifies age, height, and specific service-related metrics as key determinants, with older and taller players more likely to secure top positions. Neural Network models exhibit potential in predicting ATP Rank outcomes, particularly for ATP Rank (500). Our results argue for the use of Artificial Intelligence (AI), specifically Neural Networks, in handling complex interactions and emphasize that AI is a supportive tool in decision-making, requiring careful consideration by experienced individuals. In summary, this study enhances our understanding of ATP ranking factors, providing actionable insights for coaches, players, and stakeholders in the tennis community., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Bozděch et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: This study investigated the influence of sociodemographic factors on the dietary habits of athletes of the Polish Biathlon Association. Focusing on age, education, employment status, and gender, this research assesses food choices, meal preparation, and nutritional awareness within a structured sports environment. A cross-sectional survey of 54 athletes was conducted using a modified "Eating Habits of Poles" questionnaire to explore food selection, preparation methods, consumption patterns, and nutritional perspectives. This focus on biathletes emphasizes their distinct dietary needs, which arise from the demanding combination of endurance and precision in their sport, providing valuable insights for tailored dietary strategies to enhance their performance and overall health., Results: The results indicate that age, education, and employment status significantly influence Polish biathletes' dietary habits and nutritional awareness. Older athletes (under 23 years) demonstrated significantly higher nutritional awareness regarding modern dietary trends ( p = 0.015). In contrast, 50% of higher-education athletes were more engaged in meal planning and healthier food choices than those with elementary education ( p = 0.031). Employment status also played a role; 70% of the athletes were students who exhibited more convenience-based food choices, whereas 30% were employed and maintained more structured eating patterns ( p = 0.008). Minimal gender differences were found, with 50% of male and 50% of female athletes showing similar dietary habits, likely due to standardized nutrition programs provided to all athletes., Conclusions: This indicates a potential need for further research to determine whether professional dietary support can effectively address typical gender-related variations in food behavior and lead to improvements in dietary outcomes. This study highlights the importance of targeted nutrition education and professional support for optimizing the nutritional habits of professional athletes. This emphasizes that socio-demographic factors such as age, education, and employment status significantly shape these behaviors, underscoring the need for personalized nutritional strategies within athletic programs.

Abstract: Willingham, BD, Daou, M, VanArsdale, J, Thomas, M, and Saracino, PG. Energy availability in female collegiate beach volleyball athletes. J Strength Cond Res 38(11): 1941-1950, 2024-Low energy availability (LEA) is a present risk for many female athletes. Yet, the literature on LEA is often reliant on single, short-term, snapshots, which may not be reflective of the chronic energy balance surrounding female athletes in sport. Therefore, the purpose of this study was to establish the current prevalence of LEA in female collegiate beach volleyball athletes during the preseason and across the competitive season. One-way repeated measures analysis of variance was used to compare measures of EA (i.e., dietary intake, activity energy expenditure [EE], body composition) and EE (i.e., resting metabolic rate and thermic effect of feeding) at 4 timepoints-once in the preseason (i.e., Fall), and 3 times across the 10-week competitive season in Spring (i.e., week 1, week 5, and week 9). Significance was set at p ≤ 0.05. Although mean EA was in the subclinical zone (i.e., 30-45 kcal·kg FFM-1·d-1) at each timepoint, the prevalence of LEA for individuals was 30.8% in the preseason, 37.5% at week 1, 25.0% at week 5, and 62.5% at week 9. Further, carbohydrate intake was below the recommended range for power athletes at each timepoint, suggesting that female beach volleyball athletes with LEA may benefit from increasing carbohydrate intake. Despite no statistical differences in body mass across the season (p = 0.577), there was a trend for increasing fat-free mass (p = 0.062) as the season progressed. Importantly, LEA is not a team-wide condition but an individual one. Therefore, approaches to mitigate LEA should be individualized., (Copyright © 2024 National Strength and Conditioning Association.)

Importance: Urinary incontinence (UI) occurs in 40-50% of nulliparous female elite athletes. However, causative factors, management, and perceptions of UI in this population are suboptimally understood., Objectives: The objectives of this study were to (1) identify factors that precipitate UI in nulliparous female elite athletes and (2) explore management strategies for UI and its effect on sports performance and quality of life., Study Design: This was a cross-sectional, mixed-methods study in Division 1, college-aged nulliparous female athletes. Surveys assessed demographics, sport characteristics, relevant medical history, bladder symptoms during exercise, and validated genitourinary symptom questionnaires (Lower Urinary Tract Dysfunction Network Symptom Index-29, Female Genitourinary Pain Index). Data were compared between symptomatic athletes (who had ever experienced urinary leakage during exercise) and asymptomatic athletes. Symptomatic athletes discussed their experiences with UI in focus groups., Results: Symptomatic athletes (33/67, 49%) had more asthma (21% vs. 2.9%, P = 0.027) and constipation (15% vs. 0%, P = 0.025), were more sexually active (76% vs. 44%, P = 0.008), and had worse overall urinary symptoms and genitourinary pain than asymptomatic athletes. They described both stress and urgency incontinence precipitated by various factors, including running, jumping, sustained efforts, and stressful situations. Many described voiding frequently before and during exercise. Despite increasing normalization of UI in the female athlete population since the onset of adolescence and variable degrees of bother, interest in improving symptom management was common., Conclusions: Urinary incontinence in nulliparous female elite athletes may be multifactorial given its association with medical, behavioral, exercise-specific, and environmental conditions, which may be explored longitudinally to inform prevention and treatment strategies., Competing Interests: The authors have declared they have no conflicts of interest., (Copyright © 2024 American Urogynecologic Society. All rights reserved.)

Abstract: Yeargin, SW, Meyer, CM, Hirschhorn, RM, Lane, AD, Arent, SM, and Haggard, CR. Characterization of health and safety resources for athletes with sickle cell trait at NCAA institutions. J Strength Cond Res 38(11): 1967-1973, 2024-The purpose of this study was to report the prevalence of student-athletes with sickle cell trait (SCT), determine which screening practices are most commonly used, describe the health and human performance services provided to athletes, and ascertain if differences between National Collegiate Athletic Association (NCAA) designations or divisions exist. A cross-sectional survey design was used to query healthcare administrators regarding SCT resources at their institution. The independent variables were designation (historically Black colleges or universities [HBCUs] or non-HBCU) and Division (DI, DII, and DIII). The dependent variables were SCT prevalence, and the health and human performance services provided to athletes. Of the 60 respondents, HBCU ( n = 16) reported 4.9 ± 2.7% of athletes with SCT, which was higher than non-HBCU (1.1 ± 0.8%; p = 0.022). Historically Black colleges or university reported a higher percentage of student-athletes supplying their own screening results than non-HBCU (52.5 ± 39.2 vs. 12.9 ± 24.0%; p = 0.022). Division III reported higher proportions of waivers than DI (68.3 ± 38.4 vs. 16.9 ± 31.0%; p = 0.010). Most schools ( n = 42, 70.0%) reported having policy and procedures regarding exertional sickling, but none ( n = 60, 100.0%) involved strength and conditioning coaches (SCCs) during development. Practically, a greater proportion of DII and DIII institutions do not have supplemental oxygen available compared with DI but not statistically ( p = 0.058). Pragmatically, the prevalence should be considered when ordering and preparing resources annually. NCAA institutions need to create policy and procedure sections beyond screening. Athletic trainers and SCCs need to have a strong collaborative relationship to optimize health and human performance services., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the National Strength and Conditioning Association.)

Objective: The present study investigated the association between social media engagement and factors related to well-being (e.g., depression, anxiety, sleep, loneliness, self-esteem). Participants: A sample of 1120 college student-athletes (338 males, 777 females, 5 identified as non-binary) from nine universities participated in this study. Method: Data were collected through self-report measures and screen shots of participants' screen time in the previous week. Results: Overall screen time taken from devices was not associated with self-reported well-being, whereas use of social media during daily activities was related to worse well-being across domains (e.g., lower self-esteem, higher fear of missing out, stress, anxiety, depression). In addition, student-athlete perceptions that social media interfere with their lives were related to worse well-being. Conclusions: The implications of these findings, including the possibility of using protective behavioral strategies (PBS) to reduce negative impacts of social media in college students, are discussed.

Background: Elite sport is a potentially pathogenic environment due to stressors like dual-career, high training demands, and performance pressure. Recent evidence suggests that athletes are at high risk of mental health issues. Even though the FIFA is increasingly paying attention, efforts directed towards young talented footballers are scarce. Few studies have even been conducted on young talented footballers in Africa. The majority of epidemiological studies on athletes also suffer from an analytical approach that does not highlight athletes' mental health profiles. This study aims to describe the mental health profile and their prevalence of young talented footballers in three African representative countries., Methods: The study applied an observational-based cross-sectional research design with aspiring footballers from three sub-regions of Africa and aged between 10 and 23. The data was collected face-to-face from March to November 2022. Three screening tools were used to measure three mental health outcomes: Satisfaction With Life Scale (subjective well-being), Patient Health Questionnaire 9-item (depression), and Generalized Anxiety Disorder 7-item scale (anxiety). The mental health outcomes were rates and scores of well-being, depression, and anxiety, used in latent profile analysis., Findings: 507 male young talented footballers (263[51∙9%] Cameroonians, 73[14∙4%] Moroccans, and 171[33∙7%] Ivorians) were included in the analysis with a mean age of 15∙1 (SD 2∙37) years. Screening of mental health states revealed that 367(72∙3%) and 412(81∙8%) of these players experienced anxiety and depressive symptoms respectively and 155(30∙7%) experienced low well-being. Differences in mental health outcomes were noted between countries, age groups and competition levels. Three profiles of mental health condition were also identified, namely moderate mental health (Profile 1), languishing (Profile 2) and flourishing (Profile 3)., Interpretation: The youth of football academies in the three African countries studied have a specific mental health profile, revealing a high prevalence of common mental disorders in the African context. These findings underline the need to enhance the awareness of mental health issues in young African players and provide tailored support., Funding: FIFA., Competing Interests: Declaration of competing interest We declare no competing interests., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective: Determine the impact of the COVID-19 pandemic on student-athletes. Participants: Participants (n = 238) were Division III student-athletes (18-24yrs) enrolled at a Pennsylvania State University campus during the Fall 2020 semester. Methods: Student-athletes were emailed a link of a 43-question survey which was deployed using Qualtrics®. The survey asked questions about collegiate experience, health, well-being, sport related training, and physical fitness before and during the pandemic. Results: Approximately 94% of student-athletes reported that COVID-19 worsened their college experience. About 52 and 59% of student-athletes believed that COVID-19 had a negative impact on their health and well-being, respectively. Nearly 79% of student-athletes reported that their sport-related training decreased during the pandemic. Over half of participants believed that their physical fitness, endurance, and strength decreased during the pandemic. Conclusion: The implications of the COVID-19 pandemic on Division III collegiate student-athletes include a worsened college experience as well as worsened health and well-being.

Objective: The current study tested whether proposed sport-related risk factors for disordered eating behaviors were associated with increases in disordered eating over first-year college athletes' first four months of collegiate sport participation., Participants: Participants included a sample of first-year college athletes ( N  = 59, 45% female) from a Division I National Collegiate Athletics Association (DI) university., Method: This follow-up study tested whether 1) wearing a uniform that emphasizes body concerns, 2) participating in a lean sport, and 3) perceived pressure for thinness from coaches and teammates would lead to increases in weight/shape concerns and disordered eating behaviors over the first four months of collegiate sport participation., Results: Wearing a uniform that emphasizes body concerns and perceived coach pressure for thinness predicted increases in weight/shape concern. Both teammate and coach pressure for thinness predicted increases in restrained eating behaviors., Conclusion: Findings suggest that there are identifiable, athlete-specific risk factors for the development of disordered eating behaviors among first-year college athletes.

Objective: Determine how a) masculinity, b) optimism bias, and c) perceived pressure from stakeholders predict concussion reporting intentions and behavior. Participants: Collegiate student-athletes ( n  = 369). Methods: Student-athletes completed surveys of Conformity to Masculine Norms Inventory-46 (nine sections), optimism bias (optimist, neutral, pessimist), perceived pressure from stakeholders (six stakeholder sections), reporting intentions (symptom and concussion), and behavior (symptom and concussion). Four separate stepwise multivariate regression analyses were conducted. Results: A one-point increase in playboy, heterosexual self-preservation, being neutral or optimist compared to a pessimist symptom reporting intention decreased. A one-point increase in sport primacy, perceived pressure from athletic administration, being neutral or optimist compared to pessimist concussion reporting intentions increased 0.05, and decreased 0.23, 0.35, and 0.32, respectively. A one-point increase in violence and playboy increased the odds of being a "non-reporter" by 30% and 40%. Conclusions: Pessimistic views regarding concussion risks may result in greater concussion reporting intentions, however these findings did not influence behavior.

Objective: The main objective of this study was to investigate the risk of eating disorders, exercise addiction, depression, and low energy availability (LEA) in Danish female and male elite compared with sub-elite athletes., Design: A cross-sectional study., Setting: An online survey., Participants: A total of 410 elite athletes (mean age 20.1 years, 51% females) and 206 sub-elite athletes (mean age 21.3 years, 52% females) from 15 different sports.Assessment of Risk Factors: Eating Disorders, exercise addiction, depression, and LEA., Main Outcome Measures: The Sick Control, One Stone (6.5 kg), Fat, Food, the Eating Disorder Examination-Questionnaire, the Exercise Addiction Inventory, the Major Depression Inventory, and the Low Energy Availability in Females Questionnaire or the Low Energy Availability in Males Questionnaire., Results: We found that more female sub-elite athletes compared with elite athletes had risk of eating disorders (EDs) (37.4% vs 23.4%; P < 0.012) and the same was found for males (23.2% vs 10.4%; P = 0.005). More athletes with risk of EDs had risk of exercise addiction (12.8 vs 5.4%, P = 0.006), depression (27.3 vs 4.2%, P < 0.001), and LEA (females 55.1 vs 40.7%, P = 0.024, and males 29.4 vs 13.7%, P = 0.036, respectively) compared with athletes without risk of EDs., Conclusions: Sub-elite athletes have a higher risk of eating disorders compared with elite athletes. Regular screening of ED symptoms and associated conditions in elite and especially sub-elite athletes may ensure early identification., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Literature suggests a high prevalence of mental health disorders among athletes practicing elite and extreme sports. One of the most commonly encountered disorders in this group of individuals is depression., Objective: The aim of this study was to examine the prevalence, severity, and risk factors of symptoms of self-reported depression among ultra-distance runners., Methods: Data was collected using an online survey (February to April 2023) and included 265 (age 48.35 ± 10.52 years) adult ultra-runners. The Beck Depression Inventory-II (BDI-II) was used to measure self-reported depression. Additional variables comprised basic sociodemographic information and information regarding training, ultramarathon experience, and previous injury. Descriptive and interferential statistics were performed using JASP Version 0.16.4., Results: We found that 21.9 % (n = 58) of ultra-runners suffered from self-reported depression (i.e., BDI-II score ≥ 14) with an average BDI-II score of 22.7 ± 7.1 (moderately severe symptoms). Female ultra-runners had a higher prevalence (30.8 %) of self-reported depression than males (16.2 %, p = .001). Logistic regression revealed that ultra-runners without previous sports injury (p = .01) and those of increasing age (p = .003) had a significantly lower risk of self-reported depression. Similarly, linear regression showed the absence of injury (p < .001) and increasing age (p = .02) resulted in significantly lower BDI-II scores. Training volume in distance and hours per week as well as ultra-running experience did not show any significant association., Conclusions: Affecting more than one-fifth of our collective, depressive symptoms appear to be highly prevalent among ultra-runners. Our findings underline the importance of screening for clinical depression, especially among injured athletes. However, the previously assumed peculiarities of the sport in the area of high training volume do not appear to be a significant factor., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2024. Published by Elsevier Ltd.)

Background: Athletes display a high prevalence of undesired sleep characteristics that may affect both performance and wellbeing., Objectives: This scoping review aimed to identify and map the existing evidence of behavioral sleep interventions and their effects on sleep outcomes in athletes, and retrospectively code the behavior change techniques (BCTs) implemented using the Behavior Change Technique Taxonomy (BCTTv1)., Methods: Conducted following the JBI methodology for scoping reviews, four online databases were used to identify prospective interventions with at least one behavioral component in competitive athletes, and reporting a sleep outcome pre- and post-intervention., Results: Thirty-three studies met the inclusion criteria, encompassing 892 participants with a median age of 23. Five intervention categories were identified (education, mind-body practices, direct, multi-component, and other), with each demonstrating mixed efficacy but the potential to improve sleep outcomes. The BCTs varied in type and frequency between each category, with only 18 unique BCTs identified across all studies., Conclusions: The varied efficacy of previous studies at improving sleep outcomes may be attributed to the lack of behavior change theory applied during intervention development. Designing interventions following a targeted specification of the behavioral problem, and the integration of corresponding BCTs should be considered in future research.

The study aimed to identify precompetitive anxiety profiles and analyze the impact of those profiles in their reasons to adhere to running. A sample of 473 Spanish Amateur Athletes participated in the study. Results revealed the emergence of three profiles: (a) a high precompetitive anxiety profile characterized by high cognitive and somatic anxiety and low self-confidence; (b) a precompetitive medium-low anxiety profile characterized by medium-low scores in cognitive and somatic anxiety and medium self-confidence; (c) a precompetitive low anxiety profile characterized by low scores in cognitive and somatic anxiety and medium self-confidence. Results showed that most of the working runners, who participate in ten-kilometer races, who practice three days a week, and most experienced runners, belonged to the extremely low anxiety profile. In conclusion, the precompetitive low anxiety profile reported the most suited outcomes which mean that is a more adaptive profile.

Background: This study's purpose was to evaluate the relationship between dance training volume, body composition, and habitual diet in female collegiate dancers., Methods: Thirty-three female collegiate dancers from three dance programs (20.4 ± 1.05 yrs.; 165.4 ± 11.3 cm, BMI 21.3 ± 3.4 kg/m 2 ) participated in "The Intercollegiate Artistic Athlete Research Assessment (TIAARA)" study. We assessed dance training volume, body composition, and habitual diet. Data were analyzed using descriptive statistics (means ± SD). Two-sample t -tests were conducted to compare reported intake values versus sports nutrition recommendations. Two-tailed Pearson correlations (r) were computed for body composition and dietary intake ( p < 0.05)., Results: Collegiate dancers were enrolled in 16 ± 2.09 semester credits, with 7.7 ± 3.8 credits as dance movement courses and an additional 3.0 ± 1.5 h/week of rehearsal time. Body composition assessments included fat mass (24.4 ± 6.8%), lean mass (LM) (42.4 ± 10.1 kg), and total body water (32.6 ± 4.6 L). Habitual diets reflected a low-calorie diet (1399 ± 648 kcal/d), with ~20% of dancers consuming a very low-calorie diet (≤1000 kcal/d). Dancers reported under-consuming dietary protein (54.3 ± 26.2 g) and carbohydrate (171.8 ± 77.8 g). LM was positively correlated with daily total energy (r = 0.333), fat (r = 0.37), protein (r = 0.349), and leucine intake (r = 0.352)., Conclusions: Our findings emphasize the positive effect of adequate nutritional quantity and quality on body composition in female collegiate dancers.

Background: This study investigated the effects of decreased energy availability (EA) and carbohydrate availability (CA) on reproductive and metabolic hormones in male endurance-trained athletes., Methods: Thirteen athletes (age: 26.08 ± 4.3 years; weight: 70.9 ± 6.5 kg; height: 179.9 ± 4.2 cm) participated in two training weeks with varying training volumes (low [LV] and high [HV]). The participants logged their diet and exercise for seven days and provided blood samples to measure hormone levels (Testosterone [T], insulin, leptin, cortisol, and interleukin-6 [IL-6])., Results: Results showed that 46.2% (HV) and 38.5% (LV) of participants were at risk for low EA (≤25 kcal/kg FFM·d-1), while 53.8% (HV) and 69.2% (LV) had low CA (<6 g/kg). Strong positive correlations were found between leptin and body fat percentage (DXABFP) in both weeks (HV: r(11) = 0.88, p < 0.001; LV: r(11) = 0.93, p < 0.001). Moderate correlations were observed between T and DXABFP (r(11) = 0.56, p = 0.05) and negative correlations between leptin and fat intake (r(11) = -0.60, p = 0.03). Regression analyses indicated significant relationships between DXABFP and T (F(1,11) = 4.91, p = 0.049), leptin (HV: F(1,11) = 40.56, p < 0.001; LV: F(1,11) = 74.67, p < 0.001), and cortisol (F(1,11) = 6.69, p = 0.025)., Conclusions: These findings suggest that monitoring body composition and macronutrients can be clinically useful for male athletes, especially those without access to blood testing. Ultimately, a greater understanding of health and performance outcomes for male athletes is needed.

Background: Tennis, the second-largest ball game in the world, has a particularly wide audience. To date, little research has been conducted on the biomechanics of female serves., Purpose: The purpose of this study was to capture the key moments by using 1,000 frames/s high-speed video analysis, to analyze the kinematics of the serving techniques of national athletes and provincial athletes, to determine the differences between the two levels of athletes, and to provide theoretical references for the improvement of scientific training level., Methods: Ten female athletes were selected as participants for this study, five of whom are national athletes, and the other are provincial athletes. Three-dimensional filming techniques were employed to capture videos of the first and second serve techniques. Simi Motion was applied to obtain the 3D kinematic data. Statistical analyses were performed using IBM SPSS Statistics 27.0, and Mann-Whitney U tests were conducted to determine differences between groups., Results: Significant differences in kinematics were found between national and provincial athletes. At the moment of the left knee's minimum flexion (T2), in the first serve, national athletes had a smaller shoulder-hip vertical plane angle (-18.281 ± 6.142° vs . -25.631 ± 3.497°; p = 0.047) and a larger hip vertical plane rotation angle (-9.378 ± 4.263° vs . -0.470 ± 4.724°; p = 0.047). In the second serve, national athletes had a smaller hip horizontal plane rotation angle (-1.720 ± 4.683° vs . 24.146 ± 24.014°; p = 0.047) but a larger hip vertical plane rotation angle (-11.553 ± 1.949° vs . -0.422 ± 4.958°; p = 0.009). At the moment of impact (T4), in the second serve, national athletes' batting position (0.296 ± 0.088 m vs . 0.446 ± 0.094 m; p = 0.047) was further back. Additionally, in the second serve, national athletes consistently had their body center of gravity further back at T2 (-0.106 ± 0.052 m vs . -0.018 ± 0.048 m; p = 0.028), T3 (0.002 ± 0.038 m vs . 0.132 ± 0.039 m; p = 0.009), and T4 (0.073 ± 0.050 m vs . 0.217 ± 0.034 m; p = 0.009)., Conclusions: The results of this study indicated several significant kinematic differences between national and provincial athletes, these variations were noted in the shoulder, hip, and body center of gravity. In summary, for the overall first and second serves, it is recommended that national athletes increase the horizontal plane angle of the shoulders and hips at T2, whereas provincial athletes decrease the horizontal plane angle of the shoulder-hip. In addition, provincial athletes need to increase the vertical plane angle of the hip joint, so that the top of the hip can be increased more, and provincial athletes need to be careful not to have the center of gravity too far in front of the body at T2, T3, and T4, so that it can hit the ball at a higher position to increase the swing speed., Competing Interests: The authors declare that they have no competing interests., (© 2024 Chen et al.)

Background and Objective: Nutrition is a basic need for athletes; thus, adequate dietary intake is crucial for maintaining overall health, facilitating training adaptations and boosting athletic performance. Accurate dietary assessment tools are required to minimize the challenges faced by athletes. This study verifies the validity and reproducibility of a 157 item semi-quantitative food frequency questionnaire (FFQ) among Lebanese athletes. This is the only Arabic questionnaire in Lebanon that estimates food consumption for athletes which can also be used in Arabic speaking countries. There has been no previous validated food frequency questionnaire that estimated food consumption for athletes in Lebanon., Methods: A total of 194 athletes were included in the study to assess the validity of the food frequency questionnaire against four days dietary recalls by comparing the total nutrient intake values from the food frequency questionnaire with the mean values of four 24-hour dietary recalls using Spearman correlation coefficient and Bland Altman plots. In order to measure the reproducibility, the intra class correlation coefficients were calculated by repeating the same food frequency questionnaire after one month., Results: The intra-class correlation coefficient between the two-food frequency questionnaires ranged from average (0.739 for carbohydrates) to good (0.870 for energy (Kcal)), to excellent (0.919 for proteins) concerning macronutrients and ranged from average (0.688 for vitamin D), to excellent (0.952 for vitamin B12), indicating an acceptable reproducibility. Spearman's correlation coefficients of dietary intake estimate from the food frequency questionnaire and the four dietary recalls varied between 0.304 for sodium, 0.469 for magnesium to 0.953 for caloric intake (kcal). Bland-Altman plots illustrated a percentage of agreement ranging between 94.3% for fats to 96.4% for proteins., Conclusion: This food frequency questionnaire has a reliable validity and reproducibility to evaluate dietary assessments and is an appropriate tool for future interventions to ensure the adoption of adequate eating strategies by athletes., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Sannan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Investigating sport persistence can make a significant contribution to a thorough examination and understanding of the factors underlying an athlete's activity, integrating physical activity, sports motivation and commitment. This systematic review aimed to detect the papers focusing on the factors influencing sport persistence following the levels of Bronfenbrenner's and Bauman's ecological models. Following the PRISMA guidelines, by the EBSCO Discovery Service Search Engine, 512 records were detected, of which 21 met the criteria. Factors influencing sport persistence show a huge variety. Individual factors and micro-system level were overrepresented. Meso- and macro-level factors are underrepresented and measured only with other (individual or micro-system level) factors. Most factors detected at the individual (e.g. gender, age, career-related variables and positive psychological factors), micro- (e.g. family, peers and coaches), meso- (e.g. climate), and macro-level (cultural, societal, and institutional influences) were positively correlated with sport persistence, i.e. supporting the persistent behaviour of the athletes regarding participating in one's sporting activity. In conclusion, there is still room for further research concerning sport persistence. Including variables belonging to the meso- and macro-system and conducting longitudinal research should be considered which would allow us to better understand the nature of sport persistence., (© 2024. The Author(s).)

Objectives: Career duration is often used as a metric of neurotrauma exposure in studies of elite athletes. However, as a proxy metric, career length may not accurately represent causal factors, and associations with health outcomes may be susceptible to selection effects. To date, relationships between professional American-style football (ASF) career length and postcareer health remain incompletely characterised., Methods: We conducted a survey-based cross-sectional cohort study of former professional ASF players. Flexible regression methods measured associations between self-reported career duration and four self-reported health conditions: pain, arthritis, mood and cognitive symptoms. We also measured associations between career duration and four self-reported ASF exposures: prior concussion signs and symptoms (CSS), performance enhancing drugs, intracareer surgeries and average snaps per game. Models were adjusted for age and race., Results: Among 4189 former players (52±14 years of age, 39% black, 34% lineman position), the average career length was 6.7±3.9 professional seasons (range=1-20+). We observed inverted U-shaped relationships between career duration and outcomes (all p<0.001), indicating that adverse health effects were more common among men with intermediate career durations than those with shorter or longer careers. Similar findings were observed for play-related exposures (eg, CSS and snaps)., Conclusions: Relationships between ASF career duration and subsequent health status are non-linear. Attenuation of the associations among longer career players may reflect selection effects and suggest career length may serve as a poor proxy for true causal factors. Findings highlight the need for cautious use of career duration as a proxy exposure metric in studies of former athletes., Competing Interests: Competing interests: ALB has received funding from the National Institute of Health/National Heart, Lung and Blood Institute, the National Football Players Association and the American Heart Association and receives compensation for his role as team cardiologist from the US Olympic Committee/US Olympic Training Centers, US Soccer, US Rowing, the New England Patriots, the Boston Bruins, the New England Revolution and Harvard University. GLI has a clinical and consulting practice in forensic neuropsychology, including expert testimony, involving individuals who have sustained mild TBIs (including former athletes). He has received past research support or funding from several test publishing companies, including ImPACT Applications, CNS Vital Signs and Psychological Assessment Resources (PAR). He receives royalties from the sales of one neuropsychological test (WCST-64). He has received research funding as a principal investigator from the National Football League, and subcontract grant funding as a collaborator from the Harvard Integrated Program to Protect and Improve the Health of National Football League Players Association Members. He has received research funding from the Wounded Warrior Project. He acknowledges unrestricted philanthropic support from ImPACT Applications, the Mooney-Reed Charitable Foundation, the National Rugby League, Boston Bolts and the Schoen Adams Research Institute at Spaulding Rehabilitation. RDZ reported receiving royalties from Springer/Demos publishing for serving as coeditor of the text Brain Injury Medicine; serving on the scientific advisory board of Myomo, and onecare.ai; evaluating patients in the Massachusetts General Hospital Brain and Body–TRUST Programme, which is funded by the NFL Players Association and receiving grants from the NIH. MGW reported receiving grants from the NFL Players Association and the NIH during the conduct of the study. DPT serves on the Scientific Advisory Board for HitIQ and previously consulted for REACT Neuro. JDT serves as CEO of Mastery Development, Chief Health Innovation and Performance officer NESTRE Health and Performance, as Vice President of the Society for Sports Neuroscience, RG, HD, AJW and DM received grant funding from the NFL Players Association. No other disclosures were reported., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background/objectives: Energy availability (EA) is essential for maintaining physiological functions, significantly influencing athletes' health and performance. Nutritional behaviors, however, vary across sports. This study aims to assess EA levels in athletes from different disciplines, focusing on the relationship between EA and body composition in endurance athletes compared to rugby players., Methods: This study involved 18 endurance athletes (15 men, 3 women) and 36 rugby players (all men). Data were gathered through interviews, questionnaires, and bioimpedance analysis. Energy intake (EI) was measured with a 24 h dietary recall, and exercise energy expenditure (EEE) was calculated using the IPAQ questionnaire. EA was calculated as EA = (EI - EEE)/fat-free mass (FFM), with results categorized into clinical, subclinical, and optimal ranges., Results: The endurance group had a lower average FFM (57.81 kg) compared to the rugby players (67.61 kg). EA was also significantly lower in endurance athletes (11.72 kcal/kg FFM) than in rugby players (35.44 kcal/kg FFM). Endurance athletes showed more restrictive nutritional behavior with lower EI and higher EEE, but both groups maintained body composition within normal ranges., Conclusions: Endurance athletes exhibit greater nutritional restrictions compared to rugby players, though their body composition remains healthy. Further research is required to investigate the long-term effects of low EA on performance, injury risk, and potential impairment when EA falls below the optimal threshold of 45 kcal/kg FFM/day.

Objectives: The inclusion of rock-climbing in the Olympic Games has increased participation in the sport and attention to athletes' health. In sports where the importance of low body weight is considerate, there is an increased risk of developing eating disorders (EDs). There is sparse research on EDs among rock-climbers. The primary aim was to map ED symptoms among rock-climbers compared with controls. The secondary aim was to analyze differences in body dissatisfaction. Comparisons between rock-climbing levels and sexes were performed., Design: This is a cross-sectional study in a larger prospective longitudinal study series, CLIMB: Climber's Longitudinal attitudes towards Injury, Mental health and Body image, using baseline data., Participants: Swedish rock-climbers, at an advanced and elite level according to the International Rock Climbing Research Association, participated. Participants were at least 13 years old. 183 rock-climbers partook with a mean age of 29.5 (SD=9.1) with two participants under 15 years old. 180 controls partook with a mean age of 29.0 (SD=8.9). There were no control participants under 15 years of age., Primary and Secondary Outcome Measures: Data was gathered through a self-report questionnaire collecting the primary outcome measure, ED symptoms (Eating Disorders Examination Questionnaire (EDE-Q) V.6.0) and the secondary outcome measure, body dissatisfaction (Body Shape Questionnaire-8C)., Results: There were no differences between rock-climbers and controls regarding ED symptoms. Symptoms were higher among female rock-climbers (26%) than male (5.8%). Regarding body dissatisfaction, the control group reported higher levels compared with rock-climbers. At least a mild concern was observed in 13.3% of male rock-climbers, compared with 47.4% of females., Conclusions: Although there was no difference in the EDE-Q V.6.0 between rock-climbers and controls, females reported significantly more symptoms than men. Regarding body dissatisfaction, female rock-climbers exhibited higher levels of dissatisfaction than males. Further, higher levels of dissatisfaction were reported in controls, especially in men, where symptoms were three times higher than rock-climbers., Trial Registration Number: NCT05587270., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: College athletes are often overlooked for metabolic syndrome (MetS), as their increased physical activity is assumed to reduce their disease risk. However, energy or macronutrient imbalance has been shown to increase risk independent of activity. The purpose of this investigation was to assess the current dietary habits of Division III female athletes and determine their associations with body composition and MetS. Secondly, we sought to determine whether dietary intake and dietary protein source (i.e., animal- and plant-based, ABP and PBP) and quality were associated with MetS, as estimated by the Simple Method for Quantifying Metabolic Syndrome (siMS) score and the siMS risk score, and whether protein pacing was associated with body composition in Division III female athletes., Methods: Stepwise linear regression determined whether age (years), body mass (kg), body mass index (BMI; kg/m 2 ), ABP (g/d), PBP (g/d), ABP:PBP, ratio of high-quality to low-quality ABP (ABP QR), relative energy intake (kcal/kg/d), and relative protein, carbohydrate, and fat intake (g/kg/d) were predictors of siMS score and siMS risk score., Results: Twenty-five athletes (19.6 ± 1.3 years; 65.9 ± 7.0 kg; 23.5 ± 2.0 kg/m 2 ; ABP 71.7 ± 28.2 g/d; PBP 30.0 ± 12.2 g/d) were included in the analyses. An inverse relationship was observed between PBP and the siMS score (F 1, 22 = 5.498, p = 0.028) and siMS risk score (F 1, 22 = 7.614, p = 0.011). The models explained 20% and 26% of the variance in siMS score and siMS risk score, respectively., Conclusions: PBP was associated with lower MetS risk in Division III female athletes, while ABP, regardless of quality, was unrelated. These associations were independent of physical activity in this cohort of Division III female athletes.

Background/objectives: Eating disorders (EDs) pose a significant health issue affecting athletes, with risk factors varying by sport level, sex, and social media use. This study assesses the risk of EDs among professional and amateur football players, considering these factors, and compares findings with a control group of non-athletes., Methods: The study involved 170 participants, including non-athletes as a control group, categorized by sex and sport level. The mean age of participants was 24.3 ± 4.20, with an age range of 18-36. The Eating Attitudes Test (EAT-26) and body mass index (BMI) assessments were used to determine ED risk., Results: Results showed a higher prevalence of ED risk among professional athletes, especially women, compared to amateurs and non-athletes. Social media use and body comparisons were linked to increased ED risk, with professional athletes exhibiting higher vulnerability due to performance pressures. Women, particularly those in professional sports, showed a higher risk of EDs than men, influenced by social and aesthetic pressures., Conclusions: The findings highlight the need for targeted interventions, promoting healthier body image perceptions and addressing social media's role in shaping body dissatisfaction. Psychological support and sex-specific strategies should be integrated into athlete care programs to mitigate these risks.

Importance: Sport-related concussions (SRC) can significantly impact students' attendance and academic performance, highlighting the importance of gradual return-to-learn protocols for recovery. Understanding the association between missed school days and recovery, especially across genders, is vital for effective concussion management in high school athletes., Objectives: To describe missed school days in high school athletes with SRC and to determine associations between missed school days and authorized clearance to return to competition; secondarily, to determine whether school days missed differed by gender., Design, Setting, and Participants: Cohort study among student athletes participating in athletics sponsored by the Michigan High School Athletic Association (MHSAA) during academic years 2015 to 2023. SRC was a participant eligibility criterion and was defined as a head injury during participation in a MHSAA-sanctioned event. Data were analyzed from August 2015 to June 2023., Exposures: Primary exposure was missed school days; additional exposures included gender, year of season, concussion history, event type, sport level, contact level, and athletic trainer involvement., Main Outcome and Measure: The primary outcome was time to full unrestricted clearance following SRC., Results: The analysis included a total of 20 934 individuals with SRC (13 869 boys [66.25%]). Gender (χ23 = 167.40; P < .001), season (χ221 = 57.41; P < .001), event type (χ23 = 99.29; P < .001), sport level (χ29 = 68.15; P < .001), contact level (χ26 = 56.73; P < .001), and initial evaluation (χ23 = 147.13; P < .001) were independently associated with missed school days. Athletes took a median (IQR) of 11 (7-16) days to return to full unrestricted clearance. Relative to no missed school days, there was a significant mean increase of 57% (incidence rate ratio, 1.57; 95% CI, 1.52-1.62) in time to full unrestricted clearance for 3 or more missed school days. The estimated mean days to return to sport were 12.15 (95% CI, 12.00-12.30) for 0 missed school days, 12.68 (95% CI, 12.39-12.96) for 1 missed school day, 15.47 (95% CI, 15.06-15.87) for 2 missed school days, and 19.08 (95% CI, 18.55-19.62) for 3 or more missed school days., Conclusions and Relevance: This cohort study found that high school athletes typically missed 2 or fewer school days after SRC, suggesting that concussion management teams adhered to current recommendations of 24 to 48 hours of initial rest. The dose association, with more missed school days associated with slower return to play, suggests athletes' missing more school days (eg, ≥3) may be associated with severity of concussion and warrant additional support to return to school and/or sport.

Aim: To (1) compare QT dispersion (QTd) and echocardiographic features between athletes with concentric left ventricular (LV) hypertrophy, athletes with eccentric LV hypertrophy, and sedentary controls with a normal LV geometric pattern and (2) quantify associations between QTd and echocardiographic features within these groups., Methods: Male athletes competing in different sports and sedentary men were stratified into groups according to their LV geometric pattern. These groups included eccentric LV hypertrophy (LV index > 115 g/m 2 , relative wall thickness [RWT] < 0.42) consisting of 38 athletes, concentric LV hypertrophy (LV index > 115 g/m 2 , RWT > 0.42) consisting of 40 athletes, and normal LV geometric pattern (LV index < 115 g/m 2 , RWT < 0.42) consisting of 40 sedentary controls. Following a cross-sectional design, participants underwent electrocardiographic (ECG) and echocardiographic screening. Data were compared between groups using one-way analyses of variance with Bonferroni post hoc tests. Associations between corrected QTd and echocardiographic variables were quantified using Pearson correlations., Results: Alongside structural disparities between groups, corrected QTd was significantly (p < 0.001) lower in athletes with eccentric LV hypertrophy compared to athletes with concentric LV hypertrophy and sedentary controls. Significant, moderate-to-very-large correlations were found between corrected QTd and interventricular septal wall thickness in athletes with concentric (r = 0.416, p = 0.008) or eccentric LV hypertrophy (r = 0.734, p < 0.001), and sedentary controls (r = 0.464, p = 0.003)., Conclusion: The provided comparative and relationship data may inform the development of more precise approaches for ECG and echocardiographic screening in athletes, particularly in those with concentric LV hypertrophy who may be at greater risk for developing prolonged QTd., (© 2024 Wiley Periodicals LLC.)

Background: Supraventricular extra beats (SVEB) are frequently observed in athletes but data on significance, prognostic role and correlation with cardiac remodeling are contrasting. It is uncertain whether SVEB may indicate the development of more complex arrhythmias and the need for closer monitoring is undetermined. The aim was to assess the prevalence and clinical significance of BESV in Olympic athletes of different sporting disciplines, evaluating potential correlations with cardiac remodeling and clinical features., Methods: We enrolled athletes who participated at 2012-2022 Olympic Games, submitted to physical examination, blood tests, echocardiography and exercise tests, categorized into power, skills, endurance and mixed disciplines., Results: We studied 1492 elite athletes: 56% male individuals, mean age 25.8 ± 5.1 years; 29.5% practiced power, 12.3% skills, 21% endurance and 37.2% mixed disciplines. At exercise-stress tests, 6.2% had SVEB, mostly single beats. SVEB were not influenced by anthropometrics or blood test results. They were more common in male individuals (77.4 vs. 54.6%, P < 0.0001) and older athletes (27.1 ± 5.7 vs. 25.7 ± 5.1, P = 0.01). In male athletes with SVEB, higher left atrial volumes were observed (24.2 ± 7.3 vs. 22.2 ± 7.1 ml/m2, P = 0.03). No differences were found in terms of sporting discipline: despite larger left atrial dimensions in aerobic disciplines, SVEB rates were similar in different sporting disciplines (6.1% endurance, 6.3% mixed, 5.2% power and 8.7% skills; P = 0.435)., Conclusion: SVEB were more common in older, male athletes and associated with higher left atrial volume (especially in male individuals) regardless of sport practiced. Athletes with greater left atrial volume and SVEB are supposed to have higher risk, in middle age, of developing more complex arrhythmias., (Copyright © 2024 Italian Federation of Cardiology - I.F.C. All rights reserved.)

Background: Iron is an important micronutrient in pathways of energy production, adequate nutrient intake and its balance is essential for optimal athletic performance. However, large studies elucidating the impact of iron deficiency on athletes' performance are sparse., Methods: Competitive athletes of any age who presented for preparticipation screening 04/2020-10/2021 were included in this study and stratified for iron deficiency (defined as ferritin level <20 µg/l with and without mild anemia [hemoglobin levels ≥11 g/dl]). Athletes with and without iron deficiency were compared and the impact of iron deficiency on athletic performance was investigated., Results: Overall, 1190 athletes (mean age 21.9 ± 11.6 years; 34.2% females) were included in this study. Among these, 19.7% had iron deficiency. Patients with iron deficiency were younger (18.1 ± 8.4 vs. 22.8 ± 12.1 years, P < 0.001), more often females (64.5% vs. 26.8%, P < 0.001), had lower VO 2 peak value (43.4 [38.5/47.5] vs. 45.6 [39.1/50.6]ml/min/kg, P = 0.022) and lower proportion of athletes reaching VO 2 peak of >50 ml/min/kg (8.5% vs. 16.1%, P = 0.003). Female sex (OR 4.35 [95% CI 3.13-5.88], P > 0.001) was independently associated with increased risk for iron deficiency. In contrast, the risk for iron deficiency decreased by every life year (OR 0.97 [95% CI 0.95-0.99], P = 0.003). Iron deficiency was independently associated with reduced VO 2 peak (OR 0.94 [0.91-0.97], P < 0.001) and lower probability to reach VO 2 peak >50 ml/min/kg (OR 0.42 [95% CI 0.25-0.69], P = 0.001)., Conclusions: Iron deficiency is common in athletes (predominantly in female and in young athletes). Iron deficiency was independently associated with reduced VO 2 peak during exercise testing and lower probability to reach a VO 2 peak >50 ml/min/kg., Competing Interests: Declaration of competing interest KK, OF, JT, AQ, and BFB report no conflict of interests., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Objective: To examine the relationships between Ramadan fasting observance (RFO) and sleep-wake patterns, daytime sleepiness, and insomnia levels in student-athletes., Methods: Sleep was measured using wrist-actigraphy in 25 semi-professional student-athletes (mean ± SD; age = 22 ± 2 years, height = 182.0 ± 5.8 cm, body mass = 81.3 ± 15.2 kg) during seven nights before RFO (academic study period), during the first half of RFO (14 nights, holiday period), and the second half of RFO (14 nights, academic study period). Additionally, participants completed the Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI) questionnaires seven days before RFO and on the last day of RFO., Results: Actigraphy results indicated RFO was associated with significant decreases in sleep duration during the second half of RFO vs. before and during the first half of RFO (p < 0.001). However, the first half of RFO was associated with a delay of ⁓ 2.5 h in sleep onset compared to before RFO; this delay persisted during the second half of RFO (p < 0.001). The total PSQI score before RFO (6.6 ± 2.3 AU) and during RFO (8.2 ± 2.3 AU) suggested poor overall sleep quality. ISI and ESS scores were greater during than before RFO (p = 0.002 and p = 0.041, respectively)., Conclusions: The second half of RFO was associated with decreases in objectively assessed sleep duration among student-athletes. RFO was also associated with impaired sleep quality, excessive daytime sleepiness, and increased insomnia symptoms. Personalized interventions to address sleep-related issues in student-athletes during RFO are warranted., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier B.V. All rights reserved.)

This study compared lower extremity (LE) muscular strength by 3 groups of female athletes using chronological age and consideration of age of peak height velocity (PHV). Isometric quadriceps, hamstrings, and hip abductors strength were assessed from physically active, pediatric females. The body mass normalized isometric strength (N m/kg) was compared by the 3 age groups. There were 388 young female athletes (<10 years [14.2%], 11-14 years [48.7%], and 15-18 years [37.1%]). The body mass normalized LE strength was lower in 11-14 years compared with <10 years (quadriceps [ P = .001], hamstrings [ P = .001], and hip abductors [ P = .037]) as well as in 15-18 years relative to <10 years in quadriceps ( P = .001) and hamstrings ( P = .001). The analysis results were consistent with both chronological age alone and incorporating effects of age of PHV. In short, body mass normalized LE strength (quadriceps, hamstrings, and hip abductors) of 11-14 years females was lower than <10 years females., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: To identify (1) university educators' perceptions of academic adjustments (AA), and (2) if teaching experience correlated with AA perceptions following concussion. Participants: Two hundred twenty educators. Methods: University educators were invited to complete a survey containing four subsections; this manuscript focuses on AA following concussion. Objective 1 was descriptive; we conducted spearman's rho correlations between years of teaching experience and AA perceptions to address objective 2. Results: Educators were moderately familiar with AA but were not confident in their knowledge about AA following concussion. Participants who provided AA following concussion most often allowed excused absences and extra time for exams/assignments. There were no significant relationships between teaching experience and perceptions of AA. Conclusions: University educators largely feel unprepared to provide or recommend AA following concussion but had favorable AA perceptions following concussion. Standardized policies or referral sites within the university system may be warranted to improve post-concussion AA.

Importance: Racial disparities in cardiovascular health, including sudden cardiac death (SCD), exist among both the general and athlete populations. Among competitive athletes, disparities in health outcomes potentially influenced by social determinants of health (SDOH) and structural racism remain inadequately understood. This narrative review centers on race in sports cardiology, addressing racial disparities in SCD risk, false-positive cardiac screening rates among athletes, and the prevalence of left ventricular hypertrophy, and encourages a reexamination of race-based practices in sports cardiology, such as the interpretation of screening 12-lead electrocardiogram findings., Observations: Drawing from an array of sources, including epidemiological data and broader medical literature, this narrative review discusses racial disparities in sports cardiology and calls for a paradigm shift in approach that encompasses 3 key principles: race-conscious awareness, clinical inclusivity, and research-driven refinement of clinical practice. These proposed principles call for a shift away from race-based assumptions towards individualized, health-focused care in sports cardiology. This shift would include fostering awareness of sociopolitical constructs, diversifying the medical team workforce, and conducting diverse, evidence-based research to better understand disparities and address inequities in sports cardiology care., Conclusions and Relevance: In sports cardiology, inadequate consideration of the impact of structural racism and SDOH on racial disparities in health outcomes among athletes has resulted in potential biases in current normative standards and in the clinical approach to the cardiovascular care of athletes. An evidence-based approach to successfully address disparities requires pivoting from outdated race-based practices to a race-conscious framework to better understand and improve health care outcomes for diverse athletic populations.

Context: The 2019-2020 NBA season was altered significantly by the COVID-19 pandemic with a midseason suspension of games, the NBA 'bubble' tournament, and a shortened offseason. Concerns were raised regarding player conditioning and the potential increased risk of injury due to the schedule changes. The purpose of this study was to determine the impact of the COVID-19 pandemic and associated schedule changes on NBA injuries. It was hypothesized that injury rates would be higher in the year following the pandemic and teams who participated in the bubble would have higher injury rates in the following season than non-bubble teams. Furthermore, the types of injuries would shift toward more severe injuries in the condensed 2019-20 season and the following 2020-21 season., Design: Retrospective Cohort Study., Methods: The NBA's public injury reports were queried to identify players listed on an injury report. Standardized injury events were calculated for four pre-COVID-19 seasons (2015-2019), the COVID-19 season (2019-2020), and the post-COVID-19 season (2020-2021). Injury characteristics including type and location were extracted for each year and differences within each period were calculated., Results: When excluding injury events related to COVID-19 health and safety protocols, the overall injury events per 1000 exposures were not significantly different between time periods of pre-COVID-19, COVID-19, and post-COVID-19 seasons; ( p  = 0.199), and no difference was found in the rates of teams who participated in the bubble. Injuries, including soreness and strains, significantly decreased while fracture injuries significantly increased in the COVID-19 year., Conclusions: The COVID-19 pandemic led to an increased number of games missed, but no increase in injury rates when accounting for health and safety protocols. Additionally, bubble participation had no impact on injury rates. However, despite no changes in injury rates, the types of injuries changed with an increased proportion of severe injuries and decreased proportion of minor injuries.

Background: While studies have identified the negative cardiovascular effects of obesity, the effects of obesity on youth athletes are less studied. This study investigates the associations between obesity in youth athletes and exercise activity and exertional cardiac symptoms. Methods: The HeartBytes National Youth Database produced by Simon's Heart, a nonprofit that organizes adolescents' sports pre-participation examinations (PPEs), was used. This database contains demographic data, exercise-related symptoms, and electrocardiogram data obtained during PPEs. BMI was converted to percentiles, with obesity defined as BMI ≥95th percentile. Outcomes were evaluated using a chi-squared test with odds ratios (ORs) and 95% confidence intervals (CIs). Results: Of 7363 patients, there were 634 individuals with obesity. Youth athletes within normal weight ranges (5th-85th percentile) had higher exercise rates than those with underweight, overweight, or obesity ( p  < 0.001 for each). Athletes with obesity had higher odds of exertional symptoms overall (OR: 1.63 [CI: 1.36-1.96]; p  < 0.001). However, for athletes who exercised >10 hours a week, there was no association between obesity and exertional symptoms. Athletes with obesity had higher odds of elevated blood pressure (OR: 5.35 [CI: 2.00-14.30]; p  < 0.001) and hypercholesterolemia (OR: 3.84 [CI: 2.51-5.86]; p  < 0.001). Conclusions: In this dataset, obesity in youth athletes is associated with decreased physical activity and increased exertional symptoms in general. Obesity is not associated with exertional symptoms in athletes who participated in higher weekly physical activity. Further studies are needed to elucidate the cause-effect relationship of these findings.

Purpose: Despite the introduction of Relative Energy Deficiency in Sport (RED-s) in 2014, there is evidence to suggest that male endurance athletes still present with a high prevalence of low energy availability (LEA). Previous findings suggest that energy availability (EA) status is strongly correlated with impairments in endocrine function such as reduced leptin, triiodothyronine (T 3) , and insulin, and elevated bone loss. This study aimed to report the current EA status, endocrine function and bone health of highly trained Irish male endurance athletes., Methods: In this cross-sectional study, participants (n = 3 triathletes; n = 10 runners) completed a 7-day testing period during the competition season using lab-based measures, to ascertain EA status, hormone level and rates of bone metabolism. Serum blood samples were obtained to assess hormone levels and markers of bone metabolism., Results: Mean EA was < 30 kcal/kg lean body mass (LBM)/day in 76.9% of athletes. There was a strong association between LEA and low carbohydrate intake, and lower LBM. Mean levels of insulin, IGF-1 and leptin were significantly lower than their reference ranges. Elevated mean concentrations of β-CTX and a mean P1NP: β-CTX ratio < 100, indicated a state of bone resorption., Conclusion: The EA level, carbohydrate intake, hormone status and bone metabolism status of highly trained male endurance athletes are a concern. Based on the findings of this study, more frequent assessment of EA across a season is recommended to monitor the status of male endurance athletes, in conjunction with nutritional education specific to EA and the associated risks., (© 2024. The Author(s).)

Objective: This cross-sectional study evaluated de-identified data from the National Collegiate Athletic Association-Department of Defense Grand Alliance from 2014 to 2020 to determine the prevalence of migraine and migraine medication and to describe differences in migraine prevalence by sex, race, and sport., Background: Epidemiological studies can help identify underdiagnosed and undertreated populations. Understanding migraine prevalence in collegiate student-athletes is essential for positive healthcare outcomes including development of prevention and treatment plans., Methods: From a concussion baseline assessment, participant's self-reported demographics (e.g., age, sex, sport), migraine diagnosis (i.e., yes/no), and migraine medication usage (e.g., yes/no, type) determined prevalence of migraine and medication use in collegiate student-athletes., Results: Migraine was reported in 5.6% (2617/47,060; 95% confidence interval [CI] 5.4%-5.8%) of the student-athletes, with higher prevalence in females, 7.5% (1319/17,628; 95% CI 7.1%-7.9%), than males, 4.6% (1298/28,116; 95% CI 4.4%-4.9%). Medication usage was reported by 36.2% (947/2617; 95% CI 34.3%-38.0%) of individuals with migraine. Migraine reporting differed by race, with Caucasian reporting highest (5.9%; 1990/33,913; 95% CI 5.6%-6.1%) and Asian the lowest (2.7%; 55/2027; 95% CI 2.1%-3.5%). Women's sports, including golf, gymnastics, and lacrosse, and men's diving and squash had higher migraine reporting than other sports., Conclusion: Caucasian females reported higher rates than other groups and sport influenced rates of migraine diagnosis., (© 2024 American Headache Society.)

This study's aim was an analysis regarding selected determinants of diet health quality in a group of elite Polish female team sport players. Relationships were assessed between age, sport experience, personal resources and personality traits with regard to the Big Five model and the pro-Health (pHDI-10) and non-Healthy (nHDI-14) Diet Indices. This study was conducted among 181 women (median age-25 years; sport experience-7 years) with the use of the Beliefs and Eating Habits Questionnaire (KomPAN), Generalised Self-Efficacy Scale (GSES), Multidimensional Health Locus of Control Scale (MHLC-B) and NEO-PI-R personality inventory. Statistical analysis was carried out via the Wilcoxon signed-rank test, Kruskal-Wallis's ANOVA, Spearman's rank correlation coefficient and forward stepwise regression at a significance level of α = 0.05. Multivariate regression analysis indicated that the value of the pro-Health Diet Index (pHDI-10) was positively explained by professional experience and extraversion, while negatively by openness to experiences (12% of the pHDI-10 variance). In turn, a higher value of the non-Healthy Diet Index (nHDI-14) was associated with the discipline of basketball (2% of the nHDI-14 variance). In summary, the demonstrated diet health quality was low and the predictive significance of competitive experience as well as type of discipline and selected personality traits was exhibited for diet quality among female team sport players.

Objective: Tennis is characterised by repetitive serves and strokes predominately performed with one arm. This can lead to differences in upper quarter mobility/stability between the stroke and non-stroke arm, which could even enlarge with increasing training experience and negatively affect serve velocity. Thus, we determined side differences (i.e., limb symmetry index) in upper quarter mobility/stability and their association with flat and slice serve velocity in advanced (ITN ≤ 4) female and male tennis players (N = 42, mean age = 23.9 ± 9.3 years) with different levels of training experience (< 2 years: n = 14, 2-5 years: n = 17, 6-8 years: n = 11)., Results: Y Balance Test-Upper Quarter (YBT-UQ) side difference (i.e., composite score) and performances (i.e., medial reach) were largest in players with the lowest level of training experience (i.e., < 2 years). Further, YBT-UQ performances (i.e., medial reach and composite score) but not side differences were significantly correlated with flat and slice serve velocity, particularly in less experienced players. Our results suggest that significant side differences in upper quarter mobility/stability occur in less experienced players (indicative of increased injury risk) but they are not related to tennis-specific performance (i.e., serve velocity)., (© 2024. The Author(s).)

Background/objectives: Orthorexia Nervosa (ON) is an emerging behavioral pattern characterized by an obsessive focus on healthy eating. Despite its prevalence, ON lacks formal diagnostic criteria in major classification systems like the DSM-5 and the ICD-10. This study aims to investigate the impact of socio-cultural attitudes towards body image and the role of social media on the risk of ON among female football players from Poland, Turkey, and India. This study hypothesizes that socio-cultural pressures and media usage significantly influence the risk of developing ON, particularly in cultures more exposed to Western beauty ideals., Methods: The study was conducted from May to August 2024, employing the Computer-Assisted Web Interview method. A total of 142 female football players aged 16-36 from Poland, Turkey, and India participated. Data were collected using a structured questionnaire that included demographic information and health metrics, the Socio-Cultural Attitudes Towards Appearance Questionnaire, and the Duesseldorf Orthorexia Scale. Statistical analyses included an ANOVA, the Kruskal-Wallis test, the chi-square test, and Pearson's correlation coefficient., Results: The study found that nearly half of the participants were at risk of or presented with ON, with the highest prevalence being among Indian athletes. Statistically significant relationships were observed between the risk of ON and factors such as age, dietary exclusions, social media usage, and sources of nutritional information. However, no significant correlation was found between socio-cultural attitudes and the risk of ON, suggesting that other factors may play a more critical role., Conclusions: While socio-cultural pressures and media use are contributing factors to the risk of ON, psychological factors and individual behaviors appear to be equally, if not more, significant. This study highlights the importance of targeted educational programs and psychological support for young athletes, with a focus on promoting healthy dietary practices and positive body image perceptions across varying cultural contexts. Additionally, the results suggest the need for further research into the specific psychological and behavioral mechanisms underlying ON.

Background and Objectives : Orienteering is a sport characterized by high physical exertion and intense mental demands, which increase susceptibility to errors. Understanding the impact of such errors on psychophysiological responses, particularly on heart rate variability (HRV), is essential. This study aimed to investigate the relationship between psychophysiological indicators and checkpoint errors made by elite orienteers during official competition. Materials and Methods : Fifty-three orienteers participated in this study, and their performance was continuously monitored and recorded by using a global positioning system (GPS) and HRV data. Errors made during the orienteering events were identified and analyzed. HRV data were examined in three temporal segments: before, during, and after the identified and standardized errors. Results : The analyses indicated that errors significantly impacted HRV indices across multiple domains: the time domain, frequency domain, and nonlinear domain. Additionally, a significant effect of sex on the normalized the root mean square of successive differences (r-MSSD) before and after the error was observed. Conclusions : The findings of this study underscore the significant impact of errors made by orienteers on cardiovascular responses, as evidenced by measurable alterations in HRV metrics. Cardiovascular activity, represented by the HRV, can provide useful information for coaches and sport psychologists to adopt effective training programs for athletes.

The present research investigated the association between a series of motivational factors and burnout syndrome among elite skiers at the contextual level within the Hierarchical Model of Intrinsic and Extrinsic Motivation (HMIEM). There are 352 subjects (258 males, 94 females, aged 18 to 25 years) across five skiing events from three sport universities in this study. Four psychological scales related to motivational factors and burnout syndrome were completed by subjects. Overall, the result showed that a task-involving climate had a positive relationship with basic psychological needs, eliciting a positive pathway to autonomous motivation, and thus negatively affecting burnout syndromes. On the other hand, an ego-involving climate had a negative relationship with basic psychological needs, eliciting a negative pathway to amotivation, and then positively affecting burnout syndromes. The results underscore the intricate associations between a variety of motivational factors and athletes' burnout syndrome, supporting the need to incorporate burnout syndrome elements into the outcomes of HMIEM sequence., (© 2024. The Author(s).)

The prevalence of sexual harassment and abuse in school sport, specifically by coaches against their athletes, remains a concerning and pervasive issue. In an attempt to better understand and prevent specific coach-behaviours associated with such sexual misconduct, researchers have developed the Sexual Violence Questionnaire in Sport. While the reliability of this measurement tool has been tested in Anglo-Saxon cultural contexts, it is not known whether the questionnaire is applicable to other cultural contexts. This study aimed to analyse the internal consistency and reliability of the questionnaire on sexual harassment in sport, originally designed and developed in English. A sample of 146 (52 female, 94 male) undergraduate students from a university in the Basque Country participated in this cross-sectional study. The questionnaire was administered twice over a two-week period to assess test-retest reliability. The internal consistency of the Sexual Violence Questionnaire in Sport was high, with Cronbach's alpha values of 0.891 for perceptions and 0.813 for experiences across all participants. Gender-specific analysis showed similar reliability, with females having slightly lower alpha values for perceptions. Although significant differences were observed between the test and the retest on eight perception items and one experience item, Cohen's kappa analysis indicated agreement on all items; however, some of them were low (e.g., 0.13). In conclusion, the study highlights the questionnaire's overall reliability and suggests its effectiveness as a tool for measuring sexual violence in sport within the Spanish context. Nonetheless, the findings of this study underscore the need for further research to enhance the instrument's stability and to better understand gender differences in perceptions and experiences of sexual violence in sport contexts.

Objectives: The aim of this work is to initiate or revive a scientific discussion on the impact of professional life on the parameters of human lifespan., Material and Methods: Presented analysis is based on 8578 Polish elite or well-known person who died in 2001-2021., Results: The results of the conducted analysis indicate that in the case of men the highest values of the median age at death were characteristic of freelancers (median [Me] ± quartile deviation [QD] 85.5±8.5 years), followed by scientists and academic teachers of the biological and medical specialty (Me±QD 84.0±7.5 years) and officers of power structures (Me±QD 83.5±8.5 years). Subsequently, the highest value of the median age at death was recorded for social activists (Me±QD 83.0±9.5 years), clergy (Me±QD 82.0±7.5 years) and scientists and academic teachers of specialties other than biological and medical (Me±QD 82.0±8.0 years). Significantly, at the very end of this list are athletes (Me±QD 77.0±9.0 years). Nevertheless, the results of the analysis confirm that professional athletes are characterized by higher median age at death compared to the general population. Analysis made only within athletes group demonstrated that the parameters of lifespan of athletes of endurance disciplines (Me±QD 78.0±8.0 years) are the most favorable compared to athletes of other disciplines, in particular in compare to team sports athletes (Me±QD 75.0±10.0 years) or combat sports athletes (Me±QD 75.0±7.1 years)., Conclusions: What is new and innovative in this paper is comparing the lifespan characteristics of athletes in comparison to widely represented group of other professions with higher socio-economic status. Unexpectedly, the lifespan of athletes occurred to be lower than for fast all other analyzed occupational groups, except mainly of entertainment musicians. Finally, the results presented in this paper emphasize the need to analyze the lifespan characteristics of athletes in a broader scope than only in relation to the general population. Int J Occup Med Environ Health 2024;37(3):335-50., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)

Objective: Our aim was to report time-loss match injuries in Portugal's "Divisão de Honra" (Portuguese first tier) in the 2022/2023 season, focusing on injury incidence, burden, anatomical region, and type, to assess their impact on athletes' health and availability to play., Methods: A prospective cohort study was conducted monitoring injuries via an online form filled in by each team's medical department, categorizing player position, as well as injury type, location, and severity. Incidence and burden were calculated per 1000 player-match-hours., Results: The overall injury incidence was 54.4 injuries per 1000 player-match-hours (95% CI 30.3-96.2). Forwards had higher injury incidence than backs. Lower limbs were the most affected locations-29 injuries/1000 h of exposure (95% CI 13.7-52.0). Sprain/ligaments injuries were the most common type of injury (14.4 injuries/1000 h (95% CI 3.7-30.0), followed by muscle injuries (8.1 injuries/1000 h 95% CI 4.9-11.5)., Discussion: Injury incidence was higher than what is reported in amateur competitions and lower than for professionals. Injury severity was similar to that in other studies. Our study suggests a lower injury burden than in other semi-professional and elite leagues. These findings highlight the need for targeted injury prevention strategies in the Portuguese Rugby Union to increase athletes' availability by decreasing injury incidence and/or burden. Further research with broader participation and training injury data is needed.

Objectives: The objectives of this study are to describe the prevalence of therapeutic use exemptions (TUEs) among athletes competing in four Olympic and four Paralympic games. The secondary objective was to present the prohibited substance and methods classes associated with TUEs., Methods: Data from the Anti-Doping Administration and Management System were extracted for this cross-sectional observation study. Eight cohorts were created to include athletes with TUEs who competed in the Rio 2016, Pyeongchang 2018, Tokyo 2020 and Beijing 2022 Olympic and Paralympic games. Prevalence of TUEs and proportion of prohibited substance and methods classes were defined as percentages among all athletes competing at each games., Results: 28 583 athletes competed in four editions of the Olympic games. Total prevalence of athletes with TUEs was 0.90% among all competitors. At the four Paralympic games, a total of 9852 athletes competed and the total TUE prevalence was 2.76%. The most frequently observed substances associated with TUEs at the Summer Olympics were glucocorticoids (0.50% in Rio) and stimulants (0.39% in Tokyo). At the Summer Paralympics, diuretics (0.79% in Rio) and stimulants (0.75% in Tokyo) were the most common. Winter games had somewhat similar trends, although TUE numbers were very low., Conclusions: The number of athletes competing with valid TUEs at the Olympic and Paralympic games was <1% and <3%, respectively. Variations in substances and methods associated with TUEs for different medical conditions were identified. Nevertheless, numbers were low, further reaffirming that TUEs are not widespread in elite sport., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Climbing is an Olympic discipline in full development and multidisciplinary in nature, where the influences of body composition and nutritional status on performance have not yet been clarified despite the quest for a low weight in anti-gravity disciplines such as climbing. The present cross-sectional study aimed to conduct nutritional (3-day dietary diaries) and body composition (ISAK profile) assessments on sport climbing athletes by gender and climbing level during the months of February and March 2024. The t -test for independent samples and the Mann-Whitney U-test, as well as an ANOVA and the Kruskal-Wallis H-test, were used to compare the distributions of two or more groups, respectively, and Pearson's and Spearman's correlation coefficients were used to estimate the correlations between the different variables. The mean age of the 46 Spanish climbers (22 men and 24 women) was 30 years (SD: 9) with 7.66 years of experience (SD: 6.63). The mean somatotype of the athletes was classified as balanced mesomorph. Negative correlations were observed between fat mass variables and climbing level ( p < 0.010), and positive correlations were observed with forearm circumference ( p < 0.050). The mean energy availability (EA) was 33.01 kcal-kg FFM -1 d -1 (SD: 9.02), with 55.6% of athletes having a suboptimal EA status and 35.6% having low energy availability (LEA). The carbohydrate and protein intakes were below the recommendations in 57.8% and 31.1% of athletes, respectively. There were deficient intakes of all micronutrients except phosphorus in males. These findings suggest that climbing athletes are at a high risk of developing low energy availability states and concomitant problems. Optimal nutritional monitoring may be advisable in this type of athlete to try to reduce the risk of LEA.

Background: Suicide is a major public health concern that affects all demographics. Risk factors for suicide in professional athletes are poorly understood compared with the general population. The goal of this study was (1) to explore the current literature on risk factors for suicide in the population of professional athletes and (2) to formulate a proposed suicide risk identification tool as the first step in the production of a validated screening method specific to this population., Methods: A comprehensive literature search for relevant publications was carried out through 7 databases., Results: There is some evidence to suggest that retirement, anabolic androgenic steroid use, sexual abuse victimization, health problems, financial issues, relationship issues, having immigrant parents, having a financially disadvantaged childhood, using self-blame or behavioral disengagement as a coping strategy, changes in appetite or weight, sleep problems, reduced competitiveness, and thinking about a career after retirement are potential risk factors for suicide in this population. There is limited evidence to suggest that having a career in elite or professional sports, participation in contact sports, and participating in specific sports that are not associated with a higher suspected prevalence of performance-enhancing drug use are potential risk factors., Conclusions: This study identified potential risk factors for suicide among elite and professional athletes. These findings were used to help formulate a proposed suicide risk identification tool. Future research is recommended to explore and clarify specific risk factors for suicide in this population and to test the validity of the proposed tool., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)