Tag: athletes

Development of “Sport and Disordered Eating” Research Category In Nutritional Psychology

Posted on by CNP Staff

Athletes are under immense pressure. Athletes feel the pressure to perform their best to win, attain coveted scholarships, be selected in a draft, and even to look a certain way (i.e. achieve perfection). As we’ve seen within the sporting culture, this pressure can compel athletes to engage in tactics that may improve their chances in sport, but can be detrimental to their overall health.

Athletes may use drugs to deal with the mounting pressure they feel to succeed. Lance Armstrong used in the Tour de France and Sha’Carri Richardson and Kamila Valieva used at the Olympics. Some athletes may resort to other behaviors that can have detrimental effects on both health and athletic performance, such as dieting, disordered eating, and binge eating. Let’s explore, in depth, the eating disorder prevalence in athletes, risk factors associated with these disorders, and important treatment considerations for all at-risk athletes.

 

Athletes may resort to behaviors that can have detrimental effects on health and athletic performance such as dieting, disordered eating, and binge eating.

 

Eating Disorders in Athletes
According to research, elite athletes are at higher risk for developing an eating disorder (ED) than the general population (Mancine et al., 2020; Martinsen & Sundgot-Borgen, 2013). This risk is high for youth and adolescent athletes, but these practices can also be carried into college. One study found that 32.5% of the collegiate female athletes had eating disorders (Canbolat & Cakiroglu, 2020). EDs that are developed during adolescence can even be carried into adulthood sport participation (Sundgot-Borgen, 1994). Unfortunately, these practices are not abandoned once the athletes “retire” from their sport, as ED may continue to appear within a retired athletes’ life (DeZiel & DeBeliso, 2020).

 

Elite athletes are at higher risk for developing an eating disorder (ED) than the general population.

 

ED are defined as “behavioral conditions characterized by severe and persistent disturbance in eating behaviors and associated distressing thoughts and emotions” (American Psychiatric Association, 2021). Whereas the prevalence of EDs in the general population is 5% (American Psychiatric Association, 2021), the prevalence is higher in athletes with 6-45% of female athletes suffering from this type of disorder (Bratland-Sanda & Sundgot-Borgen, 2013). Male athletes have a higher rate of ED compared to male non-athletes as well (Karrer et al., 2020).

 

Why (i.e., Risk Factors)
Why are athletes at greater risk for ED than the general population? They embody certain personality characteristics that put them at risk for developing an ED. For example, perfectionism, achievement motivation, and competitiveness are necessary traits for improvement in one’s sport. These same characteristics, especially perfectionism, make athletes vulnerable to developing disordered eating (Prnjak et al., 2019). Female athletes are at a greater risk for developing ED than male athletes.

 

Perfectionism is the greatest risk factor for disordered eating among female athletes.

 

The type of sport that females participate in might also increase their risk of developing an ED. Gymnastics and figure skating emphasize leanness, flexibility and balance; cross country running emphasizes low body weight and percentage body fat. The female athletes who compete in any of these sports may be at higher risk for developing disordered eating or obsessive dieting as compared to athletes who compete in a sport like soccer (de Oliveira et al., 2017). This may be due to the notion that being thin in these sports leads to greater success (Aleksic Veljkovic et al., 2020). According to UK Sport, the sports with the highest risk of ED for both female and male athletes are swimming, running, gymnastics, diving, synchronized swimming, wrestling, judo, and lightweight rowing (Bashforth, 2022).

 

The type of sport that females participate in might also increase their risk of developing an ED.

 

There are several risk factors relating to this idea of thinness equals success. It can depend on whether or not someone else is “judging” their performance (as in a gymnastics routine), whether or not there is a competitive advantage in having a smaller body mass for the sport, dominant aesthetic patterns, and the size of the uniforms used in competition (Aleksic Veljkovic et al., 2020).

Some argue that the sporting environment may actually encourage or normalize these disorders through certain usual and customary practices. Daily or weekly weigh-ins or weight-monitoring practices that are common in sports, such as wrestling, may promote an over-fixation on weight which can result in EDs (Bashforth, 2022). Athletes are also encouraged to remain “healthy” and adhere to strict diet and training practices, which may also cause an over-fixation on eating behaviors. Some athletes such as Olympic diver Tom Daley have explained that a drive for thinness or the pressure to achieve a lower weight was “hammered into him” in order to perform optimally (Bashforth, 2022).

 

Consequences of ED in Athletes
ED are serious conditions that can have severe detrimental effects on one’s physical and mental health. The term “Female Athlete Triad” was previously used to explain the consequences of ED or disordered eating among female athletes. These consequences included loss of menstrual cycles (amenorrhea), and decreased levels of endogenous oestrogen and other hormones which together resulted in a loss of bone density and a higher risk for osteoporosis (Mountjoy et al., 2014).

 

The term “Female Athlete Triad” was previously used to explain the consequences of ED or disordered eating among female athletes.

 

It has since been recognized that the consequences of ED reach far beyond this “triad” and affect both male and female athletes with low energy availability. A new term called Relative Energy Deficit in Sport (RED-S) has been established to reflect these developments (Mountjoy et al., 2014).

 

Relative Energy Deficit in Sport (RED-S) has since replaced “Female Athlete Triad” to recognize that these consequences are broader than a “triad,” and that male athletes can be affected as well.

 

RED-S is a term used to describe the physiological consequences that are associated with athletes consuming too little calories for their activity levels (Mancine et al., 2020). These consequences can include: reduced hormone levels such as T3, insulin, leptin, and testosterone, and an increase in cortisol and cholesterol levels (Torstveit et al., 2018). More consequences include a disruption in menstrual cycles in females, impaired bone health, decreased resting metabolic rate, iron deficiency, impaired growth and development in adolescents, early atherosclerosis, impaired gastrointestinal functioning, and impaired immune system functioning (Mountjoy et al., 2018).

ED or RED-S can result in psychological challenges as well, including mood, anxiety, and substance abuse disorders (Mancine et al., 2020). It is important to note that while ED can result in psychological consequences, it can also be preceded by these factors as well (Mountjoy et al., 2014). For example, stress and depression might increase the risk of developing ED, but can also be a result of having low energy available (Mountjoy et al., 2014).

Athletes have much higher energy demands than nonathletes, so the consequences of low-calorie intake resulting from ED or disordered eating can be detrimental to both their health and athletic performance. The International Olympic Committee (IOC) releases regular consensus statements with recent developments, hoping to spread awareness of the risk factors, consequences, and treatment options for athletes who are suffering from such disorders.

EDs have the highest fatality rate of any mental health disorder, regardless of whether someone is an athlete or not. The fatality rate is higher in men than women, and one in five people struggling with anorexia die by suicide (Markey, 2022).

 

In Conclusion
Eating disorders are just one piece of a larger picture of overall mental health concerns of athletes. This has been a hot topic lately, as we are seeing more elite athletes, like Simone Biles in the 2020 Summer Olympics, willing to open up about their own personal mental health challenges. Athletes may be at high risk for developing ED, along with other mental health disorders, due to the intense physical and mental demands placed on them, increased public scrutiny resulting from social media, team dynamics, and potential for injury (Rice et al., 2016).

The Nutritional Psychology Research Library Sport and Disordered Eating Research Category has been developed as a tool to help coaches, trainers, parents of youth athletes, and athletes themselves, to gain a better awareness of these disorders. This increased awareness, along with knowledge of the risk factors and treatment options available, will help those who work with athletes to gain a better understanding of the mental health challenges facing them. This insight can help to support their physical and mental well-being.

 

References
Aleksić Veljković, A., ĐUrović, D., Biro, F., Stojanović, K., & Ilić, P. (2020). Eating attitudes and body image concerns among female athletes from aesthetic sports. Annales Kinesiologiae, 3–16. https://doi.org/10.35469/ak.2020.242

American Psychiatric Association (2021). What Are Eating Disorders? https://www.psychiatry.org/patients-families/eating-disorders/what-are-eating-disorders

Bashforth, E. (2022, March 21). Eating disorders in athletes: how can we tackle them? Patient. https://patient.info/news-and-features/eating-disorders-in-sport-why-are-they-so-common-and-how-can-we-tackle-them

Bratland-Sanda, S., & Sundgot-Borgen, J. (2013). Eating disorders in athletes: Overview of prevalence, risk factors and recommendations for prevention and treatment. European Journal of Sport Science, 13(5), 499–508. https://doi.org/10.1080/17461391.2012.740504

Canbolat, E., & Cakiroglu, F. P. (2020). Eating Disorders and Nutritional Habits of Female University Athletes. Turkish Journal of Sports Medicine, 55(3), 231–238. https://doi.org/10.5152/tjsm.2020.181

de Oliveira, G. L., de Oliveria, T. A. P., de Pinho Goncalves, P. S., Silva, J. R. V., Fernandes, P. R., & Filho, J. F. (2017). Body Image and Eating Disorders in Female Athletes of Different Sports. Journal of Exercise Physiologyonline, 20(2).

DeZiel, J., & DeBeliso, M. (June 2020). Eating disorders in former NCAA division 1 collegiate gymnasts and their behaviors after graduating. Journal of Physical Education Research, 7(2), 35-44.

Karrer, Y., Haliousa, R., Mötteli, S., Iff, S., Seifritz, E., Jäger, M., Claussen, M.C. (2020). Disordered eating and eating disorders in male elite athletes: a scoping review. BMJ Open Sport & Exercise Medicine, 0. doi:10.1136/bmjsem-2020-000801

Mancine, R. P., Gusfa, D. W., Moshrefi, A., & Kennedy, S. F. (2020). Prevalence of disordered eating in athletes categorized by emphasis on leanness and activity type – a systematic review. Journal of Eating Disorders, 8(1). https://doi.org/10.1186/s40337-020-00323-2

Mancine, R., Kennedy, S., Stephan, P., & Ley, A. (2020). Disordered Eating and Eating Disorders in Adolescent Athletes. Spartan Medical Research Journal. https://doi.org/10.51894/001c.11595

Markey, C. (2022). Eating Disorders Affect Boys and Men Too. U.S. & World Report News. https://health.usnews.com/health-news/blogs/eat-run/articles/eating-disorders-and-body-image-issues-in-boys-and-men

Martisen, M., & Sundgot-Borgen, J. (2013). Higher Prevalence of Eating Disorders among Adolescent Elite Athletes than Controls. Medicine & Science in Sports & Exercise, 45(6), 1188–1197. https://doi.org/10.1249/mss.0b013e318281a939

Mountjoy, M., Sundgot-Borgen, J. K., Burke, L. M., Ackerman, K. E., Blauwet, C., Constantini, N., Lebrun, C., Lundy, B., Melin, A. K., Meyer, N. L., Sherman, R. T., Tenforde, A. S., Klungland Torstveit, M., & Budgett, R. (2018). IOC consensus statement on relative energy deficiency in sport (RED-S): 2018 update. British Journal of Sports Medicine, 52(11), 687–697. https://doi.org/10.1136/bjsports-2018-099193

Mountjoy, M., Sundgot-Borgen, J., Burke, L., Carter, S., Constantini, N., Lebrun, C., Meyer, N., Sherman, R., Steffen, K., Budgett, R., & Ljungqvist, A. (2014). The IOC consensus statement: beyond the Female Athlete Triad—Relative Energy Deficiency in Sport (RED-S). British Journal of Sports Medicine, 48(7), 491–497. https://doi.org/10.1136/bjsports-2014-093502

Prnjak, K., Jukic, I., & Tufano, J. J. (2019b). Perfectionism, Body Satisfaction and Dieting in Athletes: The Role of Gender and Sport Type. Sports, 7(8), 181. https://doi.org/10.3390/sports7080181
Rice, S. M., Purcell, R., de Silva, S., Mawren, D., McGorry, P. D., & Parker, A. G. (2016). The Mental Health of Elite Athletes: A Narrative Systematic Review. Sports Medicine, 46(9), 1333–1353. https://doi.org/10.1007/s40279-016-0492-2

Sundgot-Borgen J. (1994). Risk and trigger factors for the development of eating disorders in female elite athletes. Medicine and science in sports and exercise, 26(4), 414–419.

Can the Probiotics Found in Yogurt Give Athletes an Edge?

Posted on by CNP Staff

Elite athletes are under immense pressure to perform well. In many instances, their very livelihoods rely on them winning or performing optimally in competition. This pressure often results in an athlete feeling stressed and anxious before and during competition, something that sport psychologists refer to as pre-competitive anxiety. The majority of athletes consider anxiety to be debilitating to performance, and over 50% of sport psychology consultants working with Olympic athletes reported using techniques that help athletes to manage this anxiety during competition (Parnabas et al., 2014).

 

Pre-competitive anxiety that athletes experience, if left unmanaged, can have severe negative consequences on their overall performance.

 

The pre-competitive anxiety that athletes experience, if left unmanaged, can have severe negative consequences on their overall performance. These negative consequences can include lapses in concentration, muscle tightness, and diminished perception (Parnabas et al., 2014). In some cases, it can result in a complete breakdown of skilled technical movements, often referred to as the phenomenon of “choking” (Dong et al., 2020). 

Big sports fans (and athletes, themselves), know all too well what “choking” looks like in sport. An infamous example of this phenomenon is from Super Bowl LI, when the Atlanta Falcons were winning 28-3 in the third quarter only to end up losing by 6 points in overtime, after letting Tom Brady and the New England Patriots score 31 unanswered points for the win. Still a touchy subject for many Falcon fans out there!

Sport psychologists have been studying the phenomenon of “choking” for decades, and working with athletes to utilize techniques that lessen the impact that their anxiety has on their ability to perform. There have been several theories developed suggesting why this phenomenon occurs, many of which offer insight into how sport psychologists can work with athletes to improve their anxiety symptoms and lessen the instances of “choking” under pressure (Martens, 1990; Woodman et al., 2003; Yerkes & Dodson, 1908). Most of the skills that sport psychologists use to help their athletes manage their anxiety are relaxation techniques including deep breathing, meditation, imagery, and progressive muscle relaxation (Parnabas et al., 2014). However, even more recently researchers are beginning to investigate the impact that an athlete’s diet may have on the instances of “choking” in sport. 

 

Researchers are beginning to investigate the impact that an athlete’s diet may have on the instances of “choking” in sport.

 

Researchers in China sought to find out diet’s relationship to “choking” by studying elite divers’ performance under pressure. Dong et al. (2020), examined whether the consumption of a cultured probiotic yogurt containing live strains of beneficial bacteria could influence both the contents of an athlete’s gut microbiome and the instances of them choking under pressure in a simulated competition situation. 

Why yogurt? To understand why the researchers chose this food source, it’s important to have some background knowledge on the gut microbiome. According to the World Health Organization, probiotics are “live microorganisms which when administered in adequate amounts confer health benefits to the host” (Reid et al., 2019). When looking at several fermented foods, they found yogurt to be one of the best sources of probiotics. 

The human intestines are home to trillions of bacteria, together called the gut-microbiome. These bacteria have an impact on human physical health, and are more recently being implicated in mental health and performance (Liang et al., 2018). How does something so far away from the brain have any control over our mental processes? Well, gut bacteria produce substances such as neurotransmitters and hormones that make their way up to the brain and play a role in an individual’s response to stress, anxiety, and depression (Dong et al., 2020), something that athletes who are under pressure to perform optimally know well! Probiotics have been shown to ameliorate depression and anxiety scores in several studies because of their impact on the gut microbiome (Mohajeri et al., 2021). 

Dong et. al (2020), hypothesized that the “choking” phenomena in sport may be related to the composition of an athlete’s gut microbiome, and that supplementing an athlete’s diet with probiotics found in yogurt could both alter the composition of the gut microbiome, and lessen the instances of “choking” under pressure.

 

The “choking” phenomena in sport may be related to the composition of an athlete’s gut microbiome.

 

Because of the technical nature of their sport, elite divers are at high risk for experiencing “choking.” The researchers in this study wanted to find out if supplementing these diver’s diets with probiotics found in yogurt would help to regulate the athletes’ gut microbiome, and whether this would impact the likelihood of them “choking” under the pressure in a stimulated competition situation. This study explored two different experiments: the first being the correlation between the gut microbiome and the instances of “choking” in the athletes, and the second being the potential cause-effect relationship between supplementing the athletes’ diet with yogurt containing probiotics, and subsequent changes in the gut microbiome and the “choking” phenomena. 

To determine the correlation between the gut microbiome and instances of “choking,” researchers collected fecal matter samples to determine the microbiome contents of athletes at baseline, and then tested their performance in both high and low pressure competition-like situations. They found that there was a significant negative correlation between higher levels of the bacteria strains Bifidobacteriaceae and Lactobacillaceae, commonly thought of as beneficial bacteria strains in the gut, and the lowered instances of “choking.” They also found a significant positive correlation between the instances of bacteria Prevotellaceae in the gut, which is commonly referred to as a pathogenic bacteria strain, and “choking” (Dong et al., 2020). 

After this initial measurement, the researchers then divided the group between a high yogurt consumption group that received a higher intake of probiotic yogurt for 15 days, and a control group which did not receive extra yogurt supplementation. They then tested their gut microbiome content and their choking index, and found significant differences between the two groups in their gut-microbiome composition and their instances of “choking” under pressure! 

After the 15 day experiment, athletes in the high yogurt group had significantly lower amounts of Prevotellaceae bacteria, significantly higher amounts of Bifidobacteriaceae bacteria, and significantly lower instances of choking under pressure when compared to the control group. 

Studies like these illuminate that many aspects of human performance are impacted by the diet-mental health relationship, including sport. To find out how dietary intake patterns affect all aspects of human psychological, behavioral, cognitive, sensory-perceptual, interoceptive, and psychosocial well-being, visit the CNP Research Libraries.

 

References

Dong, W., Wang, Y., Liao, S., Lai, M., Peng, L., & Song, G. (2020). Reduction in the choking phenomenon in elite diving athletes through changes in gut microbiota induced by yogurt containing bifidobacterium animalis subsp. lactis BB-12: A quasi experimental study. Microorganisms, 8(4), 597. https://doi.org/10.3390/microorganisms8040597 

Liang, S., Wu, X., & Jin, F. (2018). Gut-Brain Psychology: Rethinking Psychology from the microbiota–gut–brain axis. Frontiers in Integrative Neuroscience, 12. https://doi.org/10.3389/fnint.2018.00033 

Martens, R., Burton, D., Vealey, R.S., Bump, L.A. and Smith, D.E. (1990) Development and Validation of the Competitive State Anxiety Inventory-2 (CSAI-2). In: Martens, R., Vealey, R.S. and Burton, D., Eds., Competitive Anxiety in sport, Human Kinetics, Chapaign, 117-190.

Mohajeri, M. H., La Fata, G., Steinert, R. E., & Weber, P. (2018). Relationship between the gut microbiome and brain function. Nutrition Reviews, 76(7), 481–496. https://doi.org/10.1093/nutrit/nuy009 

Parnabas, V. A., Mahamood, Y., Parnabas, J., & Abdullah, N. M. (2014). The relationship between relaxation techniques and sport performance. Universal Journal of Psychology, 2(3), 108–112. https://doi.org/10.13189/ujp.2014.020302 

Woodman, Tim & Hardy, Lew. (2003). The relative impact of cognitive anxiety and self-confidence upon sport performance: A meta-analysis. Journal of Sports Sciences, 21, 443-57. https://doi.org/10.1080/0264041031000101809  

Yerkes, R.M. and Dodson, J.D. (1908), The relation of strength of stimulus to rapidity of habit-formation. The Journal of Comparative Neurology and Psychology, 18, 459-482. https://doi.org/10.1002/cne.920180503

 

Diet and Sport Psychology in Nutritional Psychology

Posted on by CNP Staff

Gatorade, Muscle Milk, Protein Powders, and Carb-Loading — all things elite athletes know well. Nutrition is not a new topic as it relates to sports performance. It’s no secret to athletes, coaches, and trainers that diet impacts an athlete’s physical health and their ability to physically train, perform, and recover. But what is a newer, more novel concept is how diet can impact an athlete’s mental health and their ability to perform. 

The field of Sport Psychology has been helping athletes to develop psychological skills that allow them to unlock their potential for years. Sport Psychology can be defined as “the scientific study of the psychological factors that are associated with participation and performance in sport, exercise, and other types of physical activity.” (APA, 2021). Professionals in this field are trained in techniques such as mindfulness, Cognitive Behavioral Therapy (CBT), and counseling to empower athletes to develop the focus, confidence, and motivation they need to perform optimally in their sport. Only now are we beginning to establish the evidence base showing how diet can influence the mental performance of athletes.

 

Improving an athlete’s mindset through mental training can help improve their athletic performance.

 

It has well been established that improving an athlete’s mindset through mental training can help improve their athletic performance. Research is now showing that a person’s diet plays a strong role in the cognitive processes that are important to peak performance, including maintaining focus (Baker et al., 2014), learning and remembering (Hepsomali et al., 2021), controlling emotions (Dorthy, 2019), and even handling pressure in high-stress situations. In fact, one study found that adding probiotics in the form of yogurt to an elite diver’s diet actually decreased the risk of “choking” under the pressure of competition (Dong et al., 2020). Choking is a phenomenon that occurs often in sports, one that Mental Performance Coaches and Sport Psychologists work with athletes to regulate, and a circumstance that we now know can be improved through dietary changes. 

 

In sport, athletes face intense physical and cognitive demands.

 

In sport, athletes face intense physical and cognitive demands. These demands require unique nutritional needs to support optimal athletic performance, as well as physical and mental health. Current dietary guidelines for athletes take their physical performance into consideration but fail to account for how dietary habits may impact one’s overall physical and mental well-being. For example, it has been shown that endurance athletes may be at higher risk for intestinal permeability (Mach & Fuster-Botella, 2017). Intestinal lining permeability has recently been implicated in several mental disorders and cognitive processes (Mohajeri et al., 2018).

 

The Diet and Sport Psychology research category has been created in CNP’s Nutritional Psychology Research Library (NPRL).

 

The Diet and Sport Psychology research category has been created in CNP’s Nutritional Psychology Research Library (NPRL) to bring awareness of current research to coaches, trainers, athletes, and sport psychologists regarding the connection between athletic performance and nutrition. This research category is contributing to the field of Sport Psychology by making the connection between an athlete’s diet and their ability to perform psychologically, cognitively, and behaviorally. 

 

References 

Baker, L. B., Nuccio, R. P., & Jeukendrup, A. E. (2014). Acute effects of dietary constituents on motor skill and cognitive performance in athletes. Nutrition Reviews, 72(12), 790–802. https://doi.org/10.1111/nure.12157

Clark, A., Mach, N. Exercise-induced stress behavior, gut-microbiota-brain axis and diet: A systematic review for athletes. J Int Soc Sports Nutr, 13, 43 (2016). https://doi.org/10.1186/s12970-016-0155-6

Defining the practice of Sport and … – APA divisions. (n.d.). Retrieved October 15, 2021, from https://www.apadivisions.org/division-47/about/resources/defining.pdf. 

Dong, W., Wang, Y., Liao, S., Lai, M., Peng, L., & Song, G. (2020). Reduction in the Choking Phenomenon in Elite Diving Athletes Through Changes in Gut Microbiota Induced by Yogurt Containing Bifidobacterium animalis subsp. lactis BB-12: A Quasi-Experimental Study. Microorganisms, 8(4), 597. https://doi.org/10.3390/microorganisms8040597

Du, Dorothy. (2019). You may be what you eat, can you be violent due to your food?. European Journal of Biomedical and Phramaceutical Sciences, 6(7), 20-28. 

Hepsomali P, Greyling A, Scholey A and Vauzour D (2021) Acute Effects of Polyphenols on Human Attentional Processes: A Systematic Review and Meta-Analysis. Frontiers in Neuroscience, 15, 678769. DOI: 10.3389/fnins.2021.678769

Mach, N., Fuster-Botella, D. (2017). Endurance exercise and gut microbiota: A review. Journal of Sport and Health Science, 6 (2), 179-197. https://doi.org/10.1016/j.jshs.2016.05.001

Mohajeri, M. H., La Fata, G., Steinert, R. E., & Weber, P. (2018). Relationship between the gut microbiome and brain function. Nutrition Reviews, 76(7), 481–496. https://doi.org/10.1093/nutrit/nuy009

 

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