Best practice recommendations for body composition considerations in sport to reduce health and performance risks: a critical review, original survey and expert opinion by a subgroup of the IOC consensus on Relative Energy Deficiency in Sport (REDs)

Therese Fostervold Mathisen; Timothy Ackland; Louise M Burke; Naama Constantini; Judith Haudum; Lindsay S Macnaughton; Nanna L Meyer; Margo Mountjoy; Gary Slater; Jorunn Sundgot-Borgen

doi:10.1136/bjsports-2023-106812

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Best practice recommendations for body composition considerations in sport to reduce health and performance risks: a critical review, original survey and expert opinion by a subgroup of the IOC consensus on Relative Energy Deficiency in Sport (REDs)

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Best practice recommendations for body composition considerations in sport to reduce health and performance risks: a critical review, original survey and expert opinion by a subgroup of the IOC consensus on Relative Energy Deficiency in Sport (REDs)

Therese Fostervold Mathisen, Timothy Ackland, Louise M Burke, Naama Constantini, Judith Haudum, Lindsay S Macnaughton, Nanna L Meyer, Margo Mountjoy, Gary Slater and Jorunn Sundgot-Borgen

British Journal of Sports Medicine, Vol.57(17), pp.1148-1160

2023

DOI: https://doi.org/10.1136/bjsports-2023-106812

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Abstract

Background: The assessment of body composition (BC) in sport raises concern for athlete health, especially where an overfocus on being lighter or leaner increases the risk of Relative Energy Deficiency in Sport (REDs) and disordered eating. Methods: We undertook a critical review of the effect of BC on performance (29 longitudinal, prospective or intervention studies) and explored current practice related to BC considerations via a follow-up to a 2013 internationally distributed survey. Results: The review found that a higher level of body fat was negatively associated with endurance performance, while a gain in muscle mass resulted in performance benefits across sports. BC did not contribute to early talent identification, and no unique cut-off to signify a performance advantage for BC was identified. BC appears to be one of an array of variables impacting performance, and its influence should not be overstated. The survey (125 practitioners, 61 sports and 26 countries) showed subtle changes in BC considerations over time, such as an increased role for sport dietitian/nutrition practitioners as BC measurers (2013: 54%, 2022: 78%); less emphasis on reporting of body fat percentage (2013: 68%, 2022: 46%) and reduced frequency of BC assessment if ≥every fourth week (2013: 18%, 2022: 5%). Respondents remained concerned about a problematic focus on BC (2013: 69%, 2022: 78%). To address these findings, we provide detailed recommendations for BC considerations, including an overview of preferable BC methodology. Conclusions: The ‘best practice’ guidelines stress the importance of a multidisciplinary athlete health and performance team, and the treatment of BC data as confidential medical information. The guidelines provide a health focus around BC, aiming to reduce the associated burden of disordered eating, problematic low energy availability and REDs.

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Title: Best practice recommendations for body composition considerations in sport to reduce health and performance risks: a critical review, original survey and expert opinion by a subgroup of the IOC consensus on Relative Energy Deficiency in Sport (REDs)
Authors: Therese Fostervold Mathisen (Corresponding Author) - Østfold University College
Timothy Ackland (Author) - The University of Western Australia
Louise M Burke (Author) - Australian Catholic University
Naama Constantini (Author) - Hebrew University of Jerusalem
Judith Haudum (Author) - University of Salzburg
Lindsay S Macnaughton (Author) - Durham University
Nanna L Meyer (Author) - University of Colorado Colorado Springs
Margo Mountjoy (Author) - McMaster University
Gary Slater (Author) - University of the Sunshine Coast, Queensland, School of Health - Nutrition & Dietetics
Jorunn Sundgot-Borgen (Author) - Norwegian School of Sport Sciences
Publication details: British Journal of Sports Medicine, Vol.57(17), pp.1148-1160
Publisher: BMJ Group
Date published: 2023
DOI: 10.1136/bjsports-2023-106812
ISSN: 1473-0480; 0306-3674
Copyright note: This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial.
Organisation Unit: University of the Sunshine Coast, Queensland; School of Health - Nutrition & Dietetics
Language: English
Record Identifier: 99970798302621
Output Type: Journal article

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