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Interrelationships between stress, eating attitudes, and metabolism in endurance athletes across a competitive season

Publication: Applied Physiology, Nutrition, and Metabolism
23 September 2024

Abstract

A competitive sport season represents a multidimensional stressor where physical and psychological stress may render an athlete susceptible to energy deficiency (ED). Downstream effects of ED can include a reduction in measured-to-predicted resting metabolic rate (RMRratio), indicating metabolic compensation. A pathway linking stress, eating attitudes, and metabolic compensation has not been explored. To test if sport-specific stress is associated with eating attitudes and metabolism in endurance athletes (18–22 years) at different phases of a competitive season, we assessed two groups of athletes: 26 swimmers (15 female and 11 male) during peak season (PEAK), and 26 runners (female) across pre- (PRE) and off-season (OFF). Stress (RESTQ-52), eating attitudes (cognitive restraint (CR), drive for muscularity (DM), and body dissatisfaction), and metabolism (RMRratio) were assessed. In PRE, sport-specific stress and CR were negatively correlated with RMRratio (R = −0.58; p < 0.05, and R = −0.57; p < 0.05, respectively). In PEAK, sport-specific stress and DM were negatively correlated with RMRratio (R = −0.64; p < 0.05; R = −0.40; p < 0.05, respectively). DM was positively related to sport-specific stress (R = 0.55; p < 0.05). During OFF, there was no relation between RMRratio and sport-specific stress. In runners, there was a change in stress from PRE-to-OFF with highest reported stress during PRE (p < 0.05) versus OFF. Regression analyses revealed that sport-specific stress and CR were significant predictors of RMRratio during PRE and PEAK (p < 0.05), but not OFF (p > 0.05). Associations between stress, eating attitudes, and metabolic compensation in endurance athletes during PRE and PEAK season suggest that during heavier training, metabolic compensation may be linked to upstream eating attitudes associated with sport-stressors.

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References

Ainsworth B. E., Haskell W. L., Whitt M. C., Irwin M. L., Swartz A. M., Strath S. J., et al. 2000. Compendium of physical activities: an update of activity codes and MET intensities. Med. Sci. Sports Exercise, 32: S498–S504.
Amstrup T., Rysgaard T., Johansen J. V., Bangsbo J., Pedersen P. K. 2002. Seasonal changes in heart rate variability and profile of mood states in professional soccer players. Med. Sci. Sports Exercise, 34: S198.
Anderson C., Petrie T. A. 2012. Prevalence of disordered eating and pathogenic weight control behaviors among NCAA division I female collegiate gymnasts and swimmers. Res. Q. Exerc. Sport, 83: 120–124.
Arcelus J., Mitchell A. J., Wales J., Nielsen S. 2011. Mortality rates in patients with anorexia nervosa and other eating disorders. A meta-analysis of 36 studies. Arch. Gen. Psychiatry, 68: 724–731.
Arthur-Cameselle J. N., Quatromoni P. A. 2011. Factors related to the onset of eating disorders reported by female collegiate athletes. Sport Psychol. 25: 1–17.
Blair L., Aloia C. R., Valliant M. W., Knight K. B., Garner J. C., Nahar V. K. 2017. Association between athletic participation and the risk of eating disorder and body dissatisfaction in college students. Int. J. Health Sci. (Qassim), 11: 8–12.
Boerner L. M., Spillane N. S., Anderson K. G., Smith G. T. 2004. Similarities and differences between women and men on eating disorder risk factors and symptom measures. Eat. Behav. 5: 209–222.
Bond M. J., Mcdowell A. J., Wilkinson J. Y. 2001. The measurement of dietary restraint, disinhibition and hunger: an examination of the factor structure of the Three Factor Eating Questionnaire (TFEQ). Int. J. Obes. 25: 900–906.
Chapa D. A. N., Johnson S. N., Richson B. N., Bjorlie K., Won Y. Q., Nelson S. V., et al. 2022. Eating-disorder psychopathology in female athletes and non-athletes: a meta-analysis. Int. J. Eat. Disord. 55: 861–885.
Chou C. C., Wang F. T., Wu H. H., Tsai S. C., Chen C. Y., Bernard J. R., et al. 2021. The competitive season and off-season: preliminary research concerning the sport-specific performance, stress, and sleep in elite male adolescent basketball athletes. Int. J. Environ. Res. Public Health, 18.
Currie A. 2010. Sport and eating disorders—understanding and managing the risks. Asian J. Sports Med. 1: 63–68.
de Souza M. J., Hontscharuk R., Olmsted M., Kerr G., Williams N. 2007. Drive for thinness score is a proxy indicator of energy deficiency in exercising women. Appetite, 48: 359–367.
de Souza M. J., Nattiv A., Joy E., Misra M., Williams N. I., Mallinson R. J., et al. 2014. 2014 female athlete triad coalition consensus statement on treatment and return to play of the female athlete triad: 1st international conference held in San Francisco, California, May 2012 and 2nd international conference held in Indianapolis, Indiana, May 2013. Br. J. Sports Med. 48: 289.
Defreese J. D., Smith A. 2014. Athlete social support, negative social interactions, and psychological health across a competitive sport season. J. Sport Exercise Psychol. 36: 619–630.
Donohoe T. P. 1984. Stress-induced anorexia: implications for anorexia nervosa. Life Sci. 34: 203–218.
Dubois R., Lyons M., Paillard T., Maurelli O., Prioux J. 2020. Influence of weekly workload on physical, biochemical and psychological characteristics in professional rugby union players over a competitive season. J. Strength Cond. Res. 34: 527–545.
Elia M. 1992. Organ and tissue contribution to metabolic rate. In Energy metabolism: tissue determinants and cellular corollaries. Edited by Kinney J.M., Tucker H.N. Raven Press, New York.
Fortes L. D. S., Ferreira M. E. C., de Oliveira S. M. F., Cyrino E. S., Almeida S. S. 2015. A socio-sports model of disordered eating among Brazilian male athletes. Appetite, 92: 29–35.
Fritz M. S., Mackinnon D. P. 2007. Required sample size to detect the mediated effect. Psychol. Sci. 18: 233–239.
Gao Y., Bagheri N., Furuya-Kanamori L. 2022. Has the COVID-19 pandemic lockdown worsened eating disorders symptoms among patients with eating disorders? A systematic review. J. Public Health, 30: 2743–2752.
Garner D. M. 1991. Eating disorder inventory-2: professional manual, Psychological Assessment Resources.
Garner D. M. 2004. EDI 3: eating disorder inventory-3: professional manual, Lutz, Florida, Psychological Assessment Resources.
Garner D. M., Olmstead M. P., Polivy J. 1983. Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia. Int. J. Eat. Disord. 2: 15–34.
Gibbs J. C., Williams N. I., Scheid J. L., Toombs R. J., de Souza M. J. 2011. The association of a high drive for thinness with energy deficiency and severe menstrual disturbances: confirmation in a large population of exercising women. Int. J. Sport Nutr. Exercise Metab. 21: 280–290.
Goris A. H., Westerterp K. R. 1999. Underreporting of habitual food intake is explained by undereating in highly motivated lean women. J. Nutr. 129: 878–882.
Green M., Herrick A., Kroska E., Reyes S., Sage E., Miles L. 2019. Cardiac biomarkers of disordered eating: A case for decreased mean R wave amplitude. Psychiatry Res. 272: 555–561.
Hayes M., Chustek M., Wang Z., Gallagher D., Heshka S., Spungen A., et al. 2002. DXA: potential for creating a metabolic map of organ-tissue resting energy expenditure components. Obes. Res. 10: 969–977.
Hellard P., Avalos-Fernandes M., Lefort G., Pla R., Mujika I., Toussaint J.-F., Pyne D. B. 2019. Elite swimmers’ training patterns in the 25 weeks prior to their season’s best performances: insights into periodization from a 20-years cohort. Front. Physiol. 10.
Hellard P., Avalos M., Hausswirth C., Pyne D., Toussaint J. F., Mujika I. 2013. Identifying optimal overload and taper in elite swimmers over time. J. Sports Sci. Med. 12: 668–678.
Heydenreich J., Kayser B., Schutz Y., Melzer K. 2017. Total energy expenditure, energy intake, and body composition in endurance athletes across the training season: a systematic review. Sports Med. Open, 3: 8.
Hooper D. R., Mallard J., Wight J. T., Conway K. L., Pujalte G. G. A., Pontius K. M., et al. 2021. Performance and health decrements associated with relative energy deficiency in sport for division I women athletes during a collegiate cross-country season: a case series. Front. Endocrinol. 12.
Issurin V. B. 2010. New horizons for the methodology and physiology of training periodization. Sports Med. 40: 189–206.
Jurov I., Keay N., Hadžić V., Spudić D., Rauter S. 2021. Relationship between energy availability, energy conservation and cognitive restraint with performance measures in male endurance athletes. J. Int. Soc. Sports Nutr. 18: 24.
Kallus K. 1995. The recovery-stress questionnaire.
Kantanista A., Glapa A., Banio A., Firek W., Ingarden A., Malchrowicz-Mośko E., et al. 2018. Body image of highly trained female athletes engaged in different types of sport. Biomed. Res. Int. 2018: 6835751.
Kiely J. 2018. Periodization theory: confronting an inconvenient truth. Sports Med. 48: 753–764.
Koltun K. J., Strock N. C. A., Southmayd E. A., Oneglia A. P., Williams N. I., de Souza M. J. 2019. Comparison of female athlete triad coalition and RED-S risk assessment tools. J. Sports Sci. 37: 2433–2442.
Kong P., Harris L. M. 2015. The sporting body: body image and eating disorder symptomatology among female athletes from leanness focused and nonleanness focused sports. J. Psychol. 149: 141–160.
Lafrance Robinson A., Kosmerly S., Mansfield-Green S., Lafrance G. 2014. Disordered eating behaviours in an undergraduate sample: associations among gender, body mass index, and difficulties in emotion regulation. Can. J. Behav. Sci. 46: 320–326.
Logue D., Madigan S. M., Delahunt E., Heinen M., Mc Donnell S. J., Corish C. A. 2018. Low energy availability in athletes: a review of prevalence, dietary patterns, physiological health, and sports performance. Sports Med., 48: 73–96.
Lopes dos Santos M., Uftring M., Stahl C. A., Lockie R. G., Alvar B., Mann J. B., Dawes J. J. 2020. Stress in academic and athletic performance in collegiate athletes: a narrative review of sources and monitoring strategies. Front. Sports Act. Living, 2.
Loucks A. B., Heath E. M. 1994. Induction of low-T3 syndrome in exercising women occurs at a threshold of energy availability. Am. J. Physiol. 266: R817–R823.
Lovell G., Townrow J., Thatcher R. 2010. Mood states of soccer players in the English leagues: reflections of an increasing workload. Biol. Sport, 27: 83–88.
Martinsen M., Sundgot-Borgen J. 2013. Higher prevalence of eating disorders among adolescent elite athletes than controls.Med. Sci. Sports Exercise, 45: 1188–1197.
Mccreary D. R., Sasse D. K. 2007. Drive for muscularity scale. J. Am. Coll. Health.
Mccreary D. R., Sasse D. K., Saucier D. M., Dorsch K. D. 2004. Measuring the Drive for Muscularity: Factorial Validity of the Drive for Muscularity Scale in Men and Women. 5: 49–58.
Mclean J. A., Barr S. I. 2003. Cognitive dietary restraint is associated with eating behaviors, lifestyle practices, personality characteristics and menstrual irregularity in college women. Appetite, 40: 185–192.
Meeusen R., Duclos M., Foster C., Fry A., Gleeson M., Nieman D., et al. 2013a. Prevention, diagnosis and treatment of the overtraining syndrome: joint consensus statement of the European College of Sport Science (ECSS) and the American College of Sports Medicine (ACSM). Eur. J. Sport Sci. 13: 1–24.
Meeusen R., Duclos M., Foster C., Fry A., Gleeson M., Nieman D., et al. 2013b. Prevention, diagnosis, and treatment of the overtraining syndrome: joint consensus statement of the European College of Sport Science and the American College of Sports Medicine. Med. Sci. Sports Exercise, 45: 186–205.
Melin A. K., Areta J. L., Heikura I. A., Stellingwerff T., Torstveit M. K., Hackney A. C. 2024. Direct and indirect impact of low energy availability on sports performance. Scand. J. Med. Sci. Sports, 34: e14327.
Monteleone A. M., Ruzzi V., Patriciello G., Cascino G., Pellegrino F., Vece A., et al. 2020. Emotional reactivity and eating disorder related attitudes in response to the trier social stress test: an experimental study in people with anorexia nervosa and with bulimia nervosa. J. Affect. Disord. 274: 23–30.
Morgan W. P., Hammer W. M. 1974. Influence of competitive wrestling upon state anxiety. Med. Sci. Sports, 6: 58–61.
Mujika I., Halson S., Burke L. M., Balagué G., Farrow D. 2018. An integrated, multifactorial approach to periodization for optimal performance in individual and team sports. Int. J. Sports Physiol. Perform. 13: 538–561.
National Collegiate Athletic, A. 1997. NCAA Division I manual.
Nattiv A., de Souza M. J., Koltun K. J., Misra M., Kussman A., Williams N. I., et al. 2021. The male athlete triad-A consensus statement from the female and male athlete triad coalition part 1: definition and scientific basis. Clin. J. Sport Med. 31: 335–348.
Nunes J. A., Moreira A., Crewther B. T., Nosaka K., Viveiros L., Aoki M. S. 2014. Monitoring training load, recovery-stress state, immune-endocrine responses, and physical performance in elite female basketball players during a periodized training program. J. Strength Cond. Res. 28: 2973–2980.
Paddon-Jones D., Westman E., Mattes R. D., Wolfe R. R., Astrup A., Westerterp-Plantenga M. 2008. Protein, weight management, and satiety. Am. J. Clin. Nutr. 87: 1558S–1561S.
Pons V., Riera J., Capó X., Martorell M., Sureda A., Tur J. A., et al. 2018. Calorie restriction regime enhances physical performance of trained athletes. J. Int. Soc. Sports Nutr. 15: 12.
Reed J. L., de Souza M. J., Williams N. I. 2013. Changes in energy availability across the season in Division I female soccer players. J. Sports Sci. 31: 314–324.
Roete A. J., Elferink-Gemser M. T., Otter R. T. A., Stoter I. K., Lamberts R. P. 2021. A systematic review on markers of functional overreaching in endurance athletes. Int. J. Sports. Physiol. Perform. 1–9.
Saw A. E., Main L. C., Gastin P. B. 2016. Monitoring the athlete training response: subjective self-reported measures trump commonly used objective measures: a systematic review. Br. J. Sports Med. 50: 281–291.
Schaal K., Tiollier E., le Meur Y., Casazza G., Hausswirth C. 2017. Elite synchronized swimmers display decreased energy availability during intensified training. Scand. J. Med. Sci. Sports, 27: 925–934.
Schaal K., Vanloan M. D., Hausswirth C., Casazza G. A. 2021. Decreased energy availability during training overload is associated with non-functional overreaching and suppressed ovarian function in female runners. Appl. Physiol. Nutr. Metab. 46: 1179–1188.
Selmi O., Ouergui I., Castellano J., Levitt D., Bouassida A. 2020. Effect of an intensified training period on well-being indices, recovery and psychological aspects in professional soccer players. Eur. Rev. Appl. Psychol. 70: 100603.
Smolak L., Murnen S. K. 2008. Drive for leanness: assessment and relationship to gender, gender role and objectification. Body Image, 5: 251–260.
Stanford S. C., Lemberg R. 2012. A clinical comparison of men and women on the eating disorder inventory-3 (EDI-3) and the eating disorder assessment for men (EDAM). Eating Disord. 20: 379–394.
Stellingwerff T. 2018. Case study: body composition periodization in an olympic-level female middle-distance runner over a 9-year career. Int. J. Sport Nutr. Exercise Metab. 28: 428–433.
Stoyel H., Shanmuganathan-Felton V., Meyer C., Serpell L. 2020. Psychological risk indicators of disordered eating in athletes. PLoS One, 15: e0232979.
Strock N. C. A., de Souza M. J., Williams N. I. 2020a. Eating behaviours related to psychological stress are associated with functional hypothalamic amenorrhoea in exercising women. J. Sports Sci. 38: 2396–2406.
Strock N. C. A., Koltun K. J., Southmayd E. A., Williams N. I., de Souza M. J. 2020b. Indices of resting metabolic rate accurately reflect energy deficiency in exercising women. Int. J. Sport Nutr. Exercise Metab. 1–11.
Stunkard A. J., Messick S. 1985. The three-factor eating questionnaire to measure dietary restraint, disinhibition and hunger. J. Psychosom. Res., 29: 71–83.
Sundgot-Borgen J. 1994. Risk and trigger factors for the development of eating disorders in female elite athletes. Med. Sci. Sports Exercise, 26: 414–419.
Sundgot-Borgen J., Torstveit M. K. 2004. Prevalence of eating disorders in elite athletes is higher than in the general population. Clin. J. Sport Med. 14: 25–32.
Sundgot-Borgen J., Torstveit M. K. 2010. Aspects of disordered eating continuum in elite high-intensity sports. Scand. J. Med. Sci. Sports, 20: 112–121.
Tønnessen E., Sylta Ø., Haugen T. A., Hem E., Svendsen I. S., Seiler S. 2014. The road to gold: training and peaking characteristics in the year prior to a gold medal endurance performance. PLoS One, 9: e101796.
Vanheest J. L., Rodgers C. D., Mahoney C. E., de Souza M. J. 2014. Ovarian suppression impairs sport performance in junior elite female swimmers. Med. Sci. Sports Exercise, 46: 156–166.
Vescovi J. D., Scheid J. L., Hontscharuk R., de Souza M. J. 2008. Cognitive dietary restraint: impact on bone, menstrual and metabolic status in young women. Physiol. Behav. 95: 48–55.
Wade G. N., Schneider J. E. 1992. Metabolic fuels and reproduction in female mammals. Neurosci. Biobehav. Rev. 16: 235–272.
Wasserfurth P., Palmowski J., Hahn A., Krüger K. 2020. Reasons for and consequences of low energy availability in female and male athletes: social environment, adaptations, and prevention. Sports Med. Open, 6: 44.
Wood K. L., Barrack M. T., Gray V. B., Cotter J. A., van Loan M. D., Rauh M. J., et al. 2021. Cognitive dietary restraint score is associated with lower energy, carbohydrate, fat, and grain intake among female adolescent endurance runners. Eat. Behav. 40: 101460.
Woods A. L., Garvican-Lewis L. A., Lundy B., Rice A. J., Thompson K. G. 2017. New approaches to determine fatigue in elite athletes during intensified training: resting metabolic rate and pacing profile. PLoS One, 12: e0173807.
Woods A. L., Rice A. J., Garvican-Lewis L. A., Wallett A. M., Lundy B., Rogers M. A., et al. 2018. The effects of intensified training on resting metabolic rate (RMR), body composition and performance in trained cyclists. PLoS One, 13: e0191644.

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Published In

cover image Applied Physiology, Nutrition, and Metabolism
Applied Physiology, Nutrition, and Metabolism
Volume 49Number 11November 2024
Pages: 1558 - 1572

History

Received: 23 December 2023
Accepted: 2 July 2024
Accepted manuscript online: 7 August 2024
Version of record online: 23 September 2024

Data Availability Statement

Data will be made available for access upon reasonable request to the corresponding author.

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Key Words

  1. stress
  2. eating attitudes
  3. metabolic compensation
  4. athletes

Authors

Affiliations

Pennsylvania State University, Department of Kinesiology, University Park, PA 16803, USA
Author Contributions: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Writing – original draft, and Writing – review & editing.
Pennsylvania State University, Department of Kinesiology, University Park, PA 16803, USA
Author Contributions: Project administration, Resources, Software, Supervision, and Writing – review & editing.
Prabhani Kuruppumullage Don
Pennsylvania State University, Department of Statistics, University Park, PA 16803, USA
Nancy I. Williams [email protected]
Pennsylvania State University, Department of Kinesiology, University Park, PA 16803, USA
Author Contributions: Conceptualization, Project administration, Resources, Software, Supervision, and Writing – review & editing.

Author Contributions

Conceptualization: EAL, NIW
Data curation: EAL
Formal analysis: EAL, PKD
Investigation: EAL
Methodology: EAL
Project administration: EAL, MJDS, NIW
Resources: MJDS, NIW
Software: MJDS, NIW
Supervision: MJDS, NIW
Writing – original draft: EAL
Writing – review & editing: EAL, MJDS, PKD, NIW

Competing Interests

The authors declare there are no competing interests.

Funding Information

This study was not funded.

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