Sie sind auf Seite 1von 13

This article was downloaded by: [University of Illinois at Urbana-Champaign]

On: 01 October 2014, At: 16:23


Publisher: Routledge
Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House,
37-41 Mortimer Street, London W1T 3JH, UK

Journal of Sports Sciences


Publication details, including instructions for authors and subscription information:
http://www.tandfonline.com/loi/rjsp20

Effects of pre-competitional rapid weight loss on


nutrition, vitamin status and oxidative stress in elite
boxers
ab b b c c
Dejan Reljic , Joachim Jost , Kirsten Dickau , Ralf Kinscherf , Gabriel Bonaterra & Birgit
a
Friedmann-Bette
a
Department of Sports Medicine, University Hospital Heidelberg, Heidelberg, Germany
b
Olympic Training Centre Rhein-Neckar, Heidelberg, Germany
c
Institute of Anatomy & Cell Biology, University of Marburg, Marburg, Germany
Published online: 26 Sep 2014.

To cite this article: Dejan Reljic, Joachim Jost, Kirsten Dickau, Ralf Kinscherf, Gabriel Bonaterra & Birgit Friedmann-Bette
(2014): Effects of pre-competitional rapid weight loss on nutrition, vitamin status and oxidative stress in elite boxers, Journal
of Sports Sciences, DOI: 10.1080/02640414.2014.949825

To link to this article: http://dx.doi.org/10.1080/02640414.2014.949825

PLEASE SCROLL DOWN FOR ARTICLE

Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained
in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no
representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the
Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and
are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and
should be independently verified with primary sources of information. Taylor and Francis shall not be liable for
any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever
or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of
the Content.

This article may be used for research, teaching, and private study purposes. Any substantial or systematic
reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any
form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http://
www.tandfonline.com/page/terms-and-conditions
Journal of Sports Sciences, 2014
http://dx.doi.org/10.1080/02640414.2014.949825

Effects of pre-competitional rapid weight loss on nutrition, vitamin


status and oxidative stress in elite boxers

DEJAN RELJIC1,2, JOACHIM JOST2, KIRSTEN DICKAU2, RALF KINSCHERF3, GABRIEL


BONATERRA3 & BIRGIT FRIEDMANN-BETTE1
1
Department of Sports Medicine, University Hospital Heidelberg, Heidelberg, Germany, 2Olympic Training Centre
Rhein-Neckar, Heidelberg, Germany and 3Institute of Anatomy & Cell Biology, University of Marburg, Marburg, Germany
Downloaded by [University of Illinois at Urbana-Champaign] at 16:23 01 October 2014

(Accepted 25 July 2014)

Abstract
Dietary intake, vitamin status and oxidative stress were evaluated in 17 elite male boxers. Ten of them frequently reduced
body weight rapidly before competitions (Weight Loss Group) and 7 did not practice rapid weight loss (Control Group).
Food record checklists, blood samples for determination of vitamin status and plasma glutathione levels were obtained
during a week of weight maintenance, a pre-competition week and a post-competition week. The average dietary intakes in
both groups were 33 ± 8 kcal·kg−1, 3.7 ± 1.1 g·kg−1 carbohydrates, 1.5 ± 0.4 g·kg−1 protein, 1.2 ± 0.4 g·kg−1 fat and
2.2 ± 1.0 L water per day (excluding pre-competition week in Weight Loss Group). Energy (18 ± 7 kcal·kg−1), carbohydrate
(2.2 ± 0.8 g·kg−1), protein (0.8 ± 0.4 g·kg−1), fat (0.6 ± 0.3 g·kg−1) and water (1.6 ± 0.6 L) consumption (P-values <0.001)
and intakes of most vitamins (P-values < 0.05) were significantly reduced during the pre-competition week in the Weight
Loss Group. In both groups, the intakes of vitamins A, E and folate were below recommended values throughout the three
periods; however, blood vitamin and plasma glutathione levels did not change significantly. Our findings indicate a low-
caloric and low-carbohydrate diet in elite boxers, regardless of participating in rapid weight loss or not. Apparently, the pre-
competitional malnutitrition in the Weight Loss Group did not induce alterations in the vitamin and glutathione status.

Keywords: combat sports, nutrient intake, energy restriction, antioxidants

Introduction nutrients during such periods of weight loss may


put these athletes at increased risk for vitamin
It is well established that an adequate nutrient
deficiencies. Low intakes of antioxidant nutrients
intake is essential for optimal health and exercise
(e.g., vitamins A, C, E), in particular, can attenu-
performance of elite athletes (American College of
ate the body’s antioxidant defence system to cope
Sports Medicine, American Dietetic Association, &
with reactive oxygen species, which are increas-
Dietitians of Canada, 2009). However, many ath-
ingly produced during strenuous exercise
letes participating in sports with specific weight
(American College of Sports Medicine et al.,
categories may have difficulties to maintain an
2009; Ji, 1995; Packer, 1997). It may therefore
appropriate diet because most of them try to keep
also be assumed that combined effects of severe
a chronically low body weight or repeatedly reduce
food restriction and heavy exercise during rapid
weight in order to qualify for competitions in a
weight loss will increase oxidative stress, which is
lower weight-class (American College of Sports
known to initiate damage on lipids, proteins and
Medicine et al., 2009). Particularly among combat
other cell components (Packer, 1997; Sen, 1995).
athletes, it is a common practice to “cut weight”
Most of the previous research on the effects of
rapidly within a few days before competition by a
rapid weight loss in combat sports was conducted
combination of food/fluid restriction and various
in laboratory settings, that is, the nutrition and the
methods to promote perspiration (e.g., exercise
methods to reduce body mass were standardised. To
with rubber/plastic suits and repeated sauna appli-
our knowledge, only three studies assessed the nutri-
cations) (Artioli, Gualano, et al., 2010; Oppliger,
ent intake in elite combat athletes during rapid
Case, Horswill, Landry, & Shelter, 1996).
weight loss prior to a real-life competition. Filaire,
Consequently, severe deprivation of energy and
Maso, Degoutte, Jouanel, and Lac (2001) and

Correspondence: Dejan Reljic, Department of Sports Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 710, Heidelberg, 69120 Germany.
E-mail: Dejan.Reljic@med.uni-heidelberg.de

© 2014 Taylor & Francis


2 D. Reljic et al.

Fleming and Costarelli (2007) observed low intakes

± 9.4 (54.3–71.7)

± 7.5 (50.1–64.0)

± 8.4 (17.3–32.8)
± 2.1 (7.2–11.3)
of carbohydrates and water in elite judo athletes and
taekwondo athletes, respectively, during a period of
weight maintenance as well as a reduction in the

t−3

± 134
intake of most nutrients before competition.

± 85
Similarly, Lingor and Olson (2010) also observed a

-
64.9

58.7
9.5


1372
1856
25.1
sharp pre-competitional decrease of caloric, carbo-

basal metabolic rate: only determined in n = 9 (Weight Loss Group: n = 5, Control Group: n = 4). ***Significant difference between t−2 versus t−1 and t−3 (P < 0.001).
hydrate and water intakes in collegiate wrestlers and

± 9.5 (54.3–71.7)

± 7.5 (50.2–63.9)

± 8.3 (17.5–32.8)
estimated a considerable energy deficit during two

Control Group (n = 7)

± 2.0 (7.2–11.3)
separate weeks within a competitive season.
However, blood vitamin levels or markers of oxida-

t−2
tive stress were not determined in either of these
studies and thus it is still unclear, how rapid weight

Table I. Participant characteristics (mean ± standard deviations and 95% confidence intervals in parentheses).
loss conducted under authentic conditions affects
Downloaded by [University of Illinois at Urbana-Champaign] at 16:23 01 October 2014

9.5
65.0

58.7

25.1



vitamin and antioxidative status, respectively, in
combat athletes.

(54.7–71.4)

(50.4–63.5)

(17.5–33.8)
(7.2–11.6)
In the present study, we therefore assessed in a
real-life setting the dietary intake during a week of
weight maintenance and ordinary training, a pre-

t−1
competition week and a post-competition week in

2.2
8.9
7.4
7.1
2.1
8.8
4.4
elite boxers who regularly reduced body weight as

±
±
±
±
±
±
±
18.4
64.8
174.6
58.5
9.5


25.6
59.9
well as in boxers who did not practice rapid weight
loss. Within these periods, we determined blood
vitamin concentrations as well as plasma levels of

± 9.5 (60.2–73.7)

± 8.1 (55.4–67.0)

± 5.3 (18.3–25.9)
total glutathione, oxidised glutathione, reduced glu-

± 1.6 (7.3–9.6)
tathione and the ratio of reduced and oxidised glu-
tathione, which served as a marker of oxidative t−3

± 188
± 120
stress. We hypothesised that rapid weight loss
would induce a severe energy deficit and vitamin


66.9

61.2
8.5


22.1

1310
1807
deficiencies due to inadequate nutrient intakes,
which will subsequently increase oxidative stress.
± 9.3*** (57.1–70.3)

± 8.1*** (52.7–64.8)

Notes: t−1 = baseline, t−2 = 2 days before competition, t−3 = 7 days after competition.
Weight Loss Group (n = 10)

± 5.1 (17.4–24.6)
± 1.6 (7.0–9.3)

Methods
t−2

Participants
Seventeen male elite amateur boxers (anthropo-
63.7

58.4
8.2
21.0


metric data in Table I) and their parents (if athletes


were <18 years) gave their written consent to parti-
cipate in this study, which was approved by the local
(60.6–74.2)

(55.5–67.2)

(19.2–26.6)

ethics committee. Their mean boxing experience


(7.5–9.9)

was 7.5 ± 3.5 years and all of them participated


regularly in national or international tournaments.
t−1

Ten boxers, who had regularly reduced their body


9.4
3.2

7.0
8.1
1.7
5.1
3.1

weight voluntary before competitions (by a combina-


±
±

±
±
±
±
±

tion of food and fluid restriction, exercising with


3 sites (triceps + scapula + abdomen).
67.4
19.7

175.5
61.4
8.7
23.0
63.3

sweat suits and sauna applications), were defined as


the Weight Loss Group. The remaining 7 boxers had
not engaged in any rapid weight loss procedure and
BMRmeasured (kcal·24 h−1)b
BMRpredicted (kcal·24 h−1)b
VO2max (mL·min−1·kg−1)

formed a Control Group. Full physical checks were


Sum of skinfolds (mm)a

performed to ensure that all participants were in


Fat-free mass (kg)

good condition. The athletes were not allowed to


Body weight (kg)

take any medication or dietary supplements during


Body fat (%)
Height (cm)

the study as we wanted to find out which vitamins


Age (years)

are most affected by rapid weight loss and which


supplements may be needed during such a period.
b
a
Rapid weight loss in boxing 3

Estimations of nutrient intakes and energy balance Anthropometric measurements


Nutrient intakes were obtained during a week of During the baseline week, 2 days before competition
regular training and weight maintenance (baseline (after 5 days of weight reduction in the Weight Loss
week), a pre-competition week, when boxers from Group) and 1 week after competition, height and
the Weight Loss Group reduced their body weight body weight were measured after an overnight fast
adhering to their individual methods and boxers using a standard stadiometer and a calibrated scale
from the Control Group performed their usual pre- (Seca, Hamburg, Germany), respectively. The per-
competition training, respectively, and during the centage of body fat as well as fat-free mass were
post-competition week. During each period, the determined using a caliper (Holtain, Crymych,
boxers recorded their food intake over seven conse- UK) to measure skinfolds at 3 sites according to
cutive days by using a food record as introduced by the method of Lohman (1981). This method was
Koehler et al. (2010). This record contains an exten- found to be accurate and suitable for body composi-
sive list of foods, which are commonly consumed in tion assessment in male athletes (Clark et al., 1993;
Downloaded by [University of Illinois at Urbana-Champaign] at 16:23 01 October 2014

Germany and particularly used by athletes. Each Sinning et al., 1985; Thorland, Johnson, Tharp,
food item was specified in standard serving sizes Fagot, & Hammer, 1984) and is used to determine
and the athletes were only required to tick off the the minimal wrestling weight in US high school and
number of daily servings. If the athletes consumed collegiate wrestling (Clark et al., 1993; Utter et al.,
any other foods which were not listed, they were 2003). Parts of the descriptive anthropometric data
required to record the amount, type and/or the spe- were recently published in the context of another
cific brand mark. All participants were asked to fol- part of this study (Reljic, Hässler, Jost, &
low their habitual eating and drinking pattern and to Friedmann-Bette, 2013).
be as accurate as possible in their recording. They
were given detailed verbal and written instructions
how to fill in the records by an experienced nutri- Blood analyses
tionist who supervised them throughout the study. At each time point, blood samples were collected
Furthermore, colour photos of commonly consumed between 8:00 and 9:00 in the morning after an over-
foods were handed out to assist in estimating the night fast of at least 10 h and after at least 12 h had
amounts consumed. Compliance was monitored by elapsed since the last exercise session. After 15 min
regular requesting and questions were resolved indi- rest in supine position, ~35 mL of blood were drawn
vidually with each participant. All nutrient intakes from the antecubital vein into different collection
were calculated by the software DGE PC (version tubes. All blood samples, except for vitamin C and
4.0, 2008, German Nutrition Society, Bonn, glutathione assays, were processed on the same day.
Germany), which is based on the German nutrient Samples for vitamin C and glutathione determina-
database. In addition, the athletes were asked to tion were stored frozen for subsequent analysis.
record their daily time spent in exercise, school/ Serum concentrations of vitamins A and E were
work, leisure activities, sleep, etc. using standardised measured by high performance liquid chromatogra-
activity diaries in order to determine their physical phy with UV detection using a reagent kit from
activity level and subsequently, to assess total energy Chromsystems (VWR GmbH, Darmstadt,
expenditure and energy balance (Ainsworth et al., Germany). The same reagent kit was used to deter-
2000). Activity records were only fully completed mine vitamin B1 concentrations from whole blood
by 9 participants (5 from the Weight Loss Group samples and vitamin B6 plasma concentrations with
and 4 from the Control Group). In these 9 partici- fluorescence detection. Serum concentrations of
pants, total energy expenditure was calculated by vitamin B12 and folate were measured by a chemilu-
multiplying the estimated physical activity level minescence immunoassay using an ADVIA Centaur
value with the basal metabolic rate, which was calcu- XP analyzer (Siemens HealthCare, Erlangen,
lated according to the Cunningham equation Germany). Vitamin C serum concentrations were
(Cunningham, 1980) as well as determined via indir- determined by the liquid chromatography mass-
ect calorimetry using a spirometer (ZAN 600, nSpire spectrometry method using a Quattro-Ultima analy-
Health GmbH, Oberthulba, Germany) during the zer (Waters GmbH, Eschborn, Germany). For mea-
post-competition week. For this purpose, partici- surements of total glutathione and oxidised
pants were placed in supine position in a quiet, glutathione, directly after collecting the blood with
well-tempered, dimly lit room. After a settling-in ethylenediaminetetraacetic acid tubes and centrifu-
period, oxygen consumption and carbon dioxide gation, the plasma samples were immediately depro-
production were measured for 30 min and the aver- teinised with sulfosalicylic acid (final concentration
age values were taken to determine the 24-h basal 3.5%), centrifuged and the supernatant immediately
metabolic rate according to Weir (1949). frozen and stored at −80°C. This procedure
4 D. Reljic et al.

minimises artefactual oxidation of glutathione. All body fat tended to decrease slightly during the pre-
plasma samples for determination of total and oxi- competition week, but the changes were not statisti-
dised glutathione were identically treated. In detail, cally significant. No significant changes of body
plasma concentrations of total glutathione and oxi- weight, fat-free mass and percentage of body fat
dised glutathione were measured using a spectro- were observed in the Control Group (Table I).
photometer (ULTROSPEC II, LKB Biochrom,
Freiburg, Germany) according to the assay reported
Macronutrient intakes and energy balance
by Tietze (1969). Reduced glutathione was com-
puted by subtraction. In one participant from the In the Weight Loss Group, energy (P < 0.001,
Weight Loss Group, glutathione values could not ɳp2 = 0.82), carbohydrate (P < 0.001, ɳp2 = 0.79),
be determined because of insufficient sample protein (P < 0.001, ɳp2 = 0.70), fat (P < 0.001,
material. ɳp2 = 0.76) and water (P < 0.001, ɳp2 = 0.67) intakes
differed significantly between the three weeks. The
intakes were significantly (P-values <0.001)
Downloaded by [University of Illinois at Urbana-Champaign] at 16:23 01 October 2014

Statistical analysis decreased during the pre-competition week com-


All analyses were performed using the software pro- pared to the baseline and the post-competition
gram SigmaStat 3.5 for Windows (Jandel Scientific, week. In the Control Group, energy, macronutrient
San Rafael, CA, USA). Data are presented as means, and water intakes did not change significantly
standard deviations (SD), and (where appropriate) between the three weeks (Table II).
95% confidence intervals. Unpaired t-tests were per- Measured basal metabolic rate was not signifi-
formed to compare selected values between both cantly different between the Weight Loss Group
groups. A repeated measure analysis of variance and the Control Group, but it was significantly
(ANOVA) was applied to compare the dietary lower compared with the predicted basal metabolic
intakes, physical activity levels, total energy expendi- rate in both groups (P-values < 0.001, d-values >
ture values as well as the anthropometric and blood 4.5) (Table I). In the Weight Loss Group, physical
biochemical values between the three assessed weeks activity level values differed significantly (P < 0.001,
and the three time points, respectively. If significant ɳp2 = 0.86) among the three weeks of observation.
effects were found, pairwise comparisons were per- Activity levels were lower during the post-competi-
formed using the Holm-Sidak post-hoc test. For not tion week compared to the baseline week (P < 0.001)
normally distributed data (vitamin C intake and and the pre-competition week (P < 0.05). In the
blood concentrations of vitamins B6 and C in the Control Group, physical activity levels showed a
Weight Loss Group), the non-parametric Friedman tendency for such a decrease (Figure 1(A)). In the
test was applied. Additionally, effect sizes were cal- Weight Loss Group, total energy expenditure was
culated for several variables (partial eta-squared, ɳp2, significantly (P < 0.001, d = 2.6) higher than energy
for ANOVA and Cohen’s d for t-tests) in accordance intake during the pre-competition week, indicating a
to Cohen (1988). Relationships between selected negative energy balance (Figure 1(B)). When total
parameters were determined using Pearson’s corre- energy expenditure was estimated by applying the
lation tests. Statistical significance was declared Cunningham equation, both groups demonstrated a
when P < 0.05. significant negative energy balance throughout the
three periods (except for the post-competition week
in the Control Group) (Figure 1(C)).
Results
Body mass and body composition Vitamin intakes and blood biochemical measures
Baseline anthropometric characteristics and aerobic In the Weight Loss Group, the intakes of vitamins A
performance capacity (VO2max) were similar in both (P < 0.05, ɳp2 = 0.39), C (P < 0.05, ɳp2 = 0.34), B1
groups of elite boxers. In the Weight Loss Group, (P < 0.05, ɳp2 = 0.44), B6 (P < 0.01, ɳp2 = 0.44), B12
there were significant differences in body weight (P < 0.05, ɳp2 = 0.38) and folate (P < 0.05,
(P < 0.001, ɳp2 = 0.90) and fat-free mass ɳp2 = 0.38) were significantly different among the
(P < 0.001, ɳp2 = 0.89) among the three time points. three weeks. During the pre-competition week, vita-
The weight loss period resulted in a significant min A, vitamin C, vitamin B6 and vitamin B12
reduction of body weight and fat-free mass intakes were significantly (P < 0.05) lower compared
(P < 0.001) by 5.6 ± 1.7% and 4.9 ± 1.3%, respec- to the baseline week and the post-competition week,
tively. One week after competition, body weight and and vitamin B1 intakes were significantly (P < 0.05)
fat-free mass had increased again significantly lower compared to the post-competition week,
(P < 0.001) by 4.9 ± 1.9% and 4.6 ± 1.7%, respec- respectively. Except for the vitamin B6 intake,
tively, to almost baseline values. The percentage of which was significantly (P < 0.05, ɳp2 = 0.50) lower
Rapid weight loss in boxing 5

during the pre-competition week, mean vitamin

Note: BASE = baseline (period of ordinary training and weight maintenance), PRE-COMP = pre-competition week (weight loss period in Weight Loss Group), POST-COMP = post-competition
1.3 (2.2–4.7)
0.4 (1.2–1.9)
0.2 (1.0–1.3)
0.9 (1.1–2.8)
POST-COMP
intakes did not differ significantly between the three

8 (23–38)
weeks in the Control Group. The recommended
intakes of vitamins B1, B6 and B12 were reached
during all three periods in both groups (except for

±
±
±
±
±
3.5
1.5
1.2
1.9
31
the pre-competition week in the Weight Loss
Group), whereas mean vitamin C intakes were
below the recommended value during the baseline
Control Group (n = 7)
Table II. Daily intakes of energy, macronutrients and total water (mean ± standard deviations and 95% confidence intervals in parentheses).

week and the pre-competition week in the Weight


1.2 (1.9–4.1)
0.4 (1.0–1.7)
0.4 (0.6–1.4)
0.9 (0.9–2.7)
Loss Group and during the pre-competition week in
PRE-COMP

8 (23–39)

the Control Group, respectively. The recommended


intakes for vitamins A, E and folate were not reached
throughout the whole period of investigation in both
±
±
±
±
±

1.8
31
3.0
1.3
1.0

groups (Table III).


Downloaded by [University of Illinois at Urbana-Champaign] at 16:23 01 October 2014

There were no significant differences between the


two groups in any measured blood parameter (P-
values > 0.05). In the Weight Loss Group as well
0.8 (3.3–4.8)
0.3 (1.3–1.8)
0.3 (0.9–1.5)
1.4 (1.1–3.7)

as in the Control Group, all assessed blood vitamin


6 (28–40)

concentrations did not change significantly during


BASE

the three weeks and were within the normal range,


except for vitamin C and vitamin B6, which were, in
±
±
±
±
±34
4.1
1.5
1.2
2.4

part, considerably above the upper norm value


(Figure 2). Correlation analyses revealed no signifi-
cant relationships between the intakes of vitamins
and their respective concentrations in blood
1.0 (3.1–4.6)
0.5 (1.2–2.0)
0.5 (1.0–1.7)
0.9 (1.8–3.1)

(r = 0.03–0.26, P-values > 0.05). However, the


10 (28–42)
POST-COMP

intakes of vitamins A (r = 0.79, P < 0.001), C


(r = 0.66, P < 0.001), E (r = 0.85, P < 0.001), B1
week. *** Significant difference between PRE-COMP versus BASE and POST-COMP (P < 0.001).

(r = 0.80, P < 0.001), B6 (r = 0.91, P < 0.001), B12


±
±
±
±
±

(r = 0.86, P < 0.001) and folate (r = 0.90, P < 0.001)


35
3.9
1.6
1.4
2.5

were significantly correlated with energy intake. In


both groups, plasma levels of total, oxidised and
Weight Loss Group (n = 10)

reduced glutathione as well as the ratio of reduced


0.8*** (1.7–2.8)
0.4*** (0.6–1.1)
0.3*** (0.4–0.8)
0.6*** (1.1–2.0)

and oxidised glutathione did not change significantly


7*** (13–23)

during the whole period of investigation (Figure 3).


PRE-COMP

No significant correlations were found between


plasma glutathione levels and vitamin intake
(r = 0.01–0.22, P-values > 0.05) or blood vitamin
±
±
±
±
±

concentrations (r = 0.02–0.25, P-values > 0.05).


18
2.2
0.8
0.6
1.6

Discussion
1.1 (3.0–4.6)
0.4 (1.2–1.8)
0.3 (1.0–1.5)
0.8 (1.6–2.8)

To our knowledge, this is the first study that has


8 (27–38)

concomitantly assessed in a real life setting, dietary


BASE

intakes, the vitamin status and indices of oxidative


stress in elite combat athletes during rapid weight
±
±
±
±
±

loss.
32
3.8
1.5
1.3
2.2

It became evident that the boxers who practiced


rapid weight loss as well as the boxers of the Control
Group experienced a chronic caloric deficit while
Carbohydrates (g·kg−1)

consuming a low-carbohydrate diet throughout the


study. Both groups did not meet the recommended
Energy (kcal·kg )
−1

Protein (g·kg−1)

intakes for vitamins A, E and folate. During the


Total water (L)

period of weight loss, nutrient intake was sharply


Fat (g·kg−1)

reduced in the Weight Loss Group, which led to a


negative energy balance and a marked failure to meet
recommendations for several vitamins. However,
6 D. Reljic et al.
Downloaded by [University of Illinois at Urbana-Champaign] at 16:23 01 October 2014

Figure 1. (A) Physical activity level, (B) energy balance estimated via measured basal metabolic rate and (C) energy balance estimated via
calculated basal metabolic rate (Cunningham equation) in the Weight Loss Group (n = 5) and the Control Group (n = 4), mean ± SD.
+
Significant difference between pre-competition week versus baseline week (P < 0.05); ‡significant difference between post-competition
week versus pre-competition week (P < 0.05); ###significant difference between post-competition week versus baseline week (P < 0.001);
Significant difference between total energy expenditure versus total energy intake = §§ (P < 0.01) and §§§ (P < 0.001).
Rapid weight loss in boxing 7

based on the blood biochemical measures, we did

Recommended intakea

Notes: BASE = baseline (period of ordinary training and weight maintenance), PRE-COMP = pre-competition week (weight loss period in Weight Loss Group), POST-COMP = post-competition
not detect vitamin deficiencies or indications of oxi-
dative stress in both groups of boxers. It should be

1.2 mg
1.3 mg
900 µg

2.4 µg
90 mg
15 mg
400 µg
pointed out that in the real-life setting of this inves-
tigation, desirable randomisation and blinding could
not be realised.
During the 7 days of rapid weight loss, a marked
reduction of energy intake up to ~18 kcal·kg−1·day−1

*Significant difference between PRE-COMP versus BASE and POST-COMP (P < 0.05); ‡Significant difference between PRE-COMP versus POST-COMP (P < 0.05).
133 (184–430)

5.4 (4.2–14.2)
0.7 (0.9–2.1) was observed in the Weight Loss Group. Such very
0.6 (1.3–2.5)
2.9 (3.0–8.4)
38 (54–125)

85 (85–242)
POST-COMP

low caloric intakes have previously been reported in


combat athletes who also reduced body weight in a
real-life setting (Filaire et al., 2001; Fleming &
Costarelli, 2007) or who were asked to lose weight
±
±
±
±
±
±
±
307
1.5
1.9
5.7
90
9.2
163
Table III. Daily vitamin intake (mean ± standard deviations and 95% confidence intervals in parentheses).

by self-selected methods before simulated competi-


Downloaded by [University of Illinois at Urbana-Champaign] at 16:23 01 October 2014

tions (Artioli, Iglesias, et al., 2010; Finaud et al.,


133 (143–472)
Control Group (n = 7)

4.6 (4.8–13.3)
0.5* (1.1–1.9)

2006; Tarnopolsky et al., 1996). Not only during


0.5 (0.8–1.7)

1.7 (3.8–6.9)
39 (34–105)

77 (78–221)
PRE-COMP

the phase of rapid weight loss but also during the


other examined periods, the mean energy intake did
by far not meet the estimated total energy expendi-
ture in both groups of elite boxers when calculated
±
±
±
±
±
±
±
307

69

149
1.3
1.5
5.3

9.1

by multiplying the physical activity level with the


estimated basal metabolic rate by the Cunningham
201 (138–510)

5.0 (6.2–15.5)

equation. However, total energy expenditure was


76 (105–247)
0.5 (1.0–1.9)
0.6 (1.4–2.4)
2.2 (4.0–8.1)
47 (56–144)

apparently overestimated by applying the


Cunningham equation as basal metabolic rate mea-
BASE

surement and the according total energy expenditure


estimation produced significantly lower data in both
±
±
±
±
±
±
±

groups of boxers, probably due to their chronically


324
1.5
1.9
6.1
100
10.9
176

low caloric intake. Numerous studies have demon-


strated that caloric restriction decreases basal meta-
165 (265–501)

4.9 (5.9–13.0)
84 (135–255)
0.9 (1.0–2.3)
0.8 (1.3–2.5)
3.8 (4.0–9.4)
70 (65–165)

bolic rate due to physiological adaptations to


POST-COMP

conserve energy (Brownell, Steen, & Wilmore,


1987; Leibel, Rosenbaum, & Hirsch, 1995; Melby,
Schmidt, & Corrigan, 1990; Steen, Oppliger, &
±

±
±
±
±

±
±

Brownell, 1988; Thompson, Manore, Skinner,


383

115

195
1.6
1.9
6.7

9.5

Ravussin, & Spraul, 1995). Adolescent wrestlers


Weight Loss Group (n = 10)

who frequently reduced their body weight had a


128* (128–310)

0.5* (0.8–1.4)
2.1* (2.5–5.5)
0.4‡ (0.5–1.1)

lower basal metabolic rate than non-weight cyclers


47* (83–150)
2.6 (5.3–9.0)
20* (51–80)

according to National Academy of Sciences (1998, 2000, 2002).


PRE-COMP

(Steen et al., 1988), and in collegiate wrestlers, basal


metabolic rate was found to be lowered by 17%
during the competitive season, when food intakes
and body mass were decreased compared to the
±
±
±
±
±
±
±
210

65
0.8
1.1
4.0

7.1
117

pre-season values (Melby et al., 1990). Moreover,


the boxers expended relatively little energy in non-
training phases. The mean physical activity level in
148 (244–456)

3.3 (8.5–13.1)
59 (132–217)
0.5 (0.9–1.6)
0.6 (1.3–2.1)
2.6 (4.5–8.3)
33 (56–103)

both groups of ~1.87 during the baseline week is


considered as a “moderate active lifestyle”. During
BASE

the post-competition week, mean physical activity


level decreased up to ~1.56, a value reported for
±

±
±
±

±
±

mainly sedentary individuals (FAO/WHO/UNU,


350

80
10.8
1.3
1.7
6.4

174

1985). Such decreases of spontaneous physical activ-


ity in response to reduced energy intake have also
Vitamin B12 (µg)
Vitamin B1 (mg)
Vitamin B6 (mg)

Vitamin C (mg)
Vitamin E (mg)

been reported by others (Friedlander et al., 2005;


Vitamin A (µg)

Heyman et al., 1992). Apparently, the low energy


Folate (µg)

intakes were to a great extent compensated by com-


week.

bined physiological (reduced basal metabolic rate)


and behavioural changes (decreased physical activity
a
8 D. Reljic et al.
Downloaded by [University of Illinois at Urbana-Champaign] at 16:23 01 October 2014

Figure 2. Blood concentrations of (A) vitamin A, (B) vitamin C, (C) vitamin E, (D) vitamin B1, (E) vitamin B6, (F) vitamin B12 and, (G)
folate (dashed lines indicate the upper and solid lines the lower reference range, Kratz, Ferraro, Sluss, & Lewandrowski, 2004) in the
Weight Loss Group (n = 10) and the Control Group (n = 7), mean ± SD.

level), except for the pre-competition week in the Regarding macronutrients, there are currently no
Weight Loss Group, when caloric intakes were sig- specific recommended values for combat athletes
nificantly lower than total energy expenditure by available. According to general recommendations
more than ~50% (i.e., negative energy balance). for athletes (American College of Sports Medicine
However, it is a limitation of the study that physical et al., 2009), both groups of boxers consumed a low-
activity records were only obtained from 9 partici- carbohydrate diet throughout the study with a mean
pants (5 from the Weight Loss Group and 4 from the daily value of ~3.7 g·kg−1 (pre-competition week in
Control Group) and therefore, the sample size for the weight loss group not included) while the recom-
the estimation of energy balance was rather small. mendations for protein and fat were reached (except
Rapid weight loss in boxing 9
Downloaded by [University of Illinois at Urbana-Champaign] at 16:23 01 October 2014

Figure 3. Plasma levels of (A) total glutathione (tGSH), (B) oxidised glutathione (GSSG), (C) reduced glutathione (GSH) and (D) the ratio
of reduced glutathione and oxidised glutathione (GSH/GSSG) in the Weight Loss Group (n = 9) and the Control Group (n = 7),
mean ± SD.

for the pre-competition week in the Weight Loss However, the significant pre-competition loss of
Group). Low habitual carbohydrate intakes were fat-free mass in the Weight Loss Group might to
also described in elite judo athletes (~4.8 g·kg−1, great extent be attributed to glycogen depletion and
Filaire et al., 2001), taekwondo athletes (~4.0 g·kg−1, dehydration. Besides, the suboptimal mean protein
Fleming & Costarelli, 2007) and collegiate wrestlers intake of ~0.8 g·kg−1 has to be mentioned as an
(~4.5 g·kg−1, Lingor & Olson, 2010). There is grow- important factor since increased protein intakes
ing evidence that a low-carbohydrate/high-protein were found to be superior for the maintenance of
diet may be advantageous for weight making athletes fat-free mass during a hypocaloric diet (Mettler
and that therefore, the recommended high carbohy- et al., 2010; Pasiakos et al., 2013).
drate intakes (6–10 g·kg−1·day−1, American College It is important to note that self-reported food
of Sports Medicine et al., 2009) probably need to be records, as applied in this investigation and widely
reconsidered for athletes with needs to maintain low used in research, are associated with potential
body weight (Burke, Hawley, Wong, & Jeukendrup, sources of error. Participants often tend to under-
2011; Langan-Evans, Close, & Morton, 2011; report their food intake and the mere act of record-
Mettler, Mitchell, & Tipton, 2010; Morton, ing may affect the individual eating patterns (Hill &
Robertson, Sutton, & MacLauren, 2010). Davies, 2001; Koehler et al., 2010). Thus, under-
However, during weight loss, the carbohydrate reporting may have also occurred in the present
intake further decreased in the Weight Loss Group study to some extent, although the boxers were
up to ~2.2 g·kg−1, which in combination with exer- highly motivated to learn how to improve their nutri-
cise probably resulted in a depletion of glycogen tion and the careful briefing as well as the frequent
stores. In this context, Artioli, Iglesias, et al. (2010) monitoring and requesting throughout the record-
assumed that weight-cyclers might be metabolically ing-process, should have minimised the extent of
adapted to chronic weight-cycling, including a faster theoretical errors.
muscle glycogen restoration. These considerations The boxers’ total water intake was very modest
remain speculative as it was not possible to deter- with an average value of ~2.2 L·day−1 (excluding
mine muscle glycogen content nor did the boxers pre-competition week in the Weight Loss Group).
agree to performance tests prior to competition, During weight loss, water consumption further
which is another limitation of the present study. decreased up to ~1.6 L·day−1 in the Weight Loss
10 D. Reljic et al.

Group. These findings are again in line with pre- in both groups and that rapid weight loss did not
vious studies. The water intakes of the judo athletes induce increased oxidative stress in the Weight Loss
observed by Filaire et al. (2001) were ~2.7 L during Group. Previous studies investigating effects of rapid
the weight maintenance period and ~1.9 L during weight loss on oxidative stress markers have found
food restriction, respectively. Fleming and Costarelli divergent results. In accordance with our findings,
(2007) assessed even lower intakes in the taekwondo Finaud et al. (2006) observed no alterations in oxi-
athletes (~1.4 L·day−1). However, based on the dative stress in judo athletes, who reduced weight
guidelines set by the National Research Council rapidly prior to a simulated competition, and they
(1989), recommending a water ingestion of assumed that this was related to an increase in the
~1 mL·kcal−1 of energy expended, the intakes of efficiency of the antioxidant system. However, other
the boxers appeared to be quite appropriate due to investigators reported enhanced oxidative burst
their decreased total energy expenditure, except for activity in judo athletes (Kowatari et al., 2001;
the pre-competition week in the Weight Loss Group, Suzuki et al., 2003) and a significant rise in urinary
when water consumption further declined by ~33%.
Downloaded by [University of Illinois at Urbana-Champaign] at 16:23 01 October 2014

stress markers in wrestlers (Yanagawa et al., 2010),


Accordingly, estimations of body water and plasma in response to rapid weight loss. The lack of oxida-
volume changes recently conducted in our labora- tive stress in the present study could be related to
tory revealed that rapid weight loss induced hypohy- several factors. As well as in vitamin status, perhaps
dration in the Weight Loss Group while all the the duration of food restriction was too short to
boxers were normally hydrated during the other per- induce substantial changes in glutathione plasma
iods of investigation (Reljic et al., 2013). levels. Also, it appears that rapid weight loss in the
Both groups did not meet the generally recom- Weight Loss Group was primarily achieved by
mended intakes for vitamins A, E and folate energy restriction and passive methods to induce
throughout the whole period of investigation but, sweating (sauna) and probably to a lesser extent by
surprisingly, despite the extreme malnutrition intensive exercise which increases production of
found in the Weight Loss Group during the pre- reactive oxygen species. The significant decrease of
competition week, the assessed blood vitamin con- physical activity level during the pre-competition
centrations remained within or were even above week and the finding that the Weight Loss Group
(vitamins B6 and C) the normal ranges. This could and the Control Group did not differ significantly in
indicate that nutritional changes over such a small their mean physical activity level suggest that there
period of time might not have any effect on vitamin was no difference in reactive oxygen species produc-
status. However, it has also to be mentioned that tion in both groups. In agreement with this observa-
participants were not allowed to take any supple- tion, Kowatari et al. (2001) reported that the
ments during the study but, unfortunately, it was oxidative burst activity observed in male judo ath-
not possible to include a standardised “washout” letes was only increased by intense exercise but not
period prior to the study, so that the initial blood affected by energy restriction. Furthermore, it was
concentrations could have been affected by former found that a hypocaloric diet may even beneficially
supplement consumption, which is the major limita- alter oxidative status because caloric restriction
tion of this investigation. It should also be noted that decreases metabolic rate and thus oxygen consump-
the relationship between dietary intake and biochem- tion, which could consequently reduce reactive oxy-
ical indicators of vitamins is still controversial. gen species production (Heilbronn & Ravussin,
Several other studies found no or only weak correla- 2003). Finally, there is strong evidence that endur-
tions between the ingestion of vitamins and the ance-trained athletes, such as the boxers in this
respective blood concentrations, and also failed to study, may have an improved tolerance against exer-
detect biochemical deficiencies despite insufficient cise-induced oxidative damage due to physiological
intakes(Fogelholm, Koskinen, Laakso, Rankinen, & adaptations to exercise (Sen, 1999). However, it
Ruokonen, 1992; Guilland et al., 1989; Millet, cannot be excluded that oxidative stress might have
Guilland, Fuchs, & Klepping, 1989). It was assumed been detected in the boxers of the present study if
that this may be due to the complexity of intervening other methods than the measurement of the ratio of
factors, such as absorption, bioavailabilty, transfer, reduced glutathione and oxidised glutathione could
storage, etc. (Millet et al., 1989). have been applied. Therefore, the assumptions con-
Besides the serum levels of the antioxidative vita- cerning oxidative stress have to be treated with
mins A, C and E, mean plasma levels of total, caution.
reduced and oxidised glutathione as well as the aver- In conclusion, the elite boxers, regardless of
age ratio of reduced glutathione and oxidised glu- whether participating in rapid weight loss or not,
tathione were stable throughout the study. These consumed a low-carbohydrate, hypocaloric diet –
findings suggest that antioxidant capacity was not presumably to keep their body weight constantly
compromised due to the hypocaloric diet observed low throughout the competitive season. During the
Rapid weight loss in boxing 11

weight loss period, nutrient intakes were further Filaire, E., Maso, F., Degoutte, F., Jouanel, P., & Lac, G. (2001).
decreased to levels considerably below the current Food restriction, performance, psychological state and lipid
values in judo athletes. International Journal of Sports Medicine,
recommendations. Despite this inappropriate dietary 22, 454–459.
pattern, neither vitamin deficiencies nor indications Finaud, J., Degoutte, F., Scislowski, V., Rouveix, M., Durand,
of increased oxidative stress were found in the box- D., & Filaire, E. (2006). Competition and food restriction
ers. However, the observation period was rather effects on oxidative stress in judo. International Journal of
short and further research is needed to find out if Sports Medicine, 27, 834–841.
Fleming, S., & Costarelli, V. (2007). Nutrient intake and body
long-term adherence to such unbalanced diets might composition in relation to making weight in young male taek-
induce an impairment of health and performance. wondo players. Nutrition & Food Science, 37, 358–366.
Fogelholm, G. M., Koskinen, R., Laakso, J., Rankinen, T., &
Ruokonen, I. (1992). Gradual and rapid weight loss: Effects
Acknowledgements on nutrition and performance in male athletes. Medicine and
Science in Sports and Exercise, 25, 371–377.
The authors would like to thank to thank Dr. Eike Friedlander, A. L., Braun, B., Pollack, M., MacDonald, J. R.,
Downloaded by [University of Illinois at Urbana-Champaign] at 16:23 01 October 2014

Hässler, Judith Strunz, Dr. Rüdiger Schmieder, Fulco, C. S., Muza, S. R., … Cymerman, A. (2005). Three
weeks of caloric restriction alters protein metabolism in nor-
Christiane Herth and Anette Hegewald for their
mal-weight, young men. AJP: Endocrinology and Metabolism,
excellent assistance with the processing of the 289, E446–E455.
blood samples. Guilland, J. C., Penaranda, T., Gallet, C., Boggio, V., Fuchs, F.,
& Klepping, J. (1989). Vitamin status of young athletes includ-
ing the effects of supplementation. Medicine and Science in
Funding Sports and Exercise, 21, 441–449.
Heilbronn, L. K., & Ravussin, E. (2003). Calorie restriction and
The study was financially supported by the German aging: A review of the literature and implications for studies in
Federal Institute of Sports Science (IIA1-070118/09). humans. The American Journal of Clinical Nutrition, 78, 361–
369.
Heyman, M. B., Young, V. R., Fuss, P., Tsay, R., Joseph, L., &
Roberts, S. B. (1992). Underfeeding and body weight regula-
References tion in normal-weight young men. American Journal of
Ainsworth, B. E., Haskell, W. L., Whitt, M. C., Irwin, M. L., Physiology–Regulatory, Integrative and Comparative Physiology,
Swartz, A. M., Strath, S. J., … Leon, A. S. (2000). 263, R250–R257.
Compendium of physical activities: An update of activity Hill, R. J., & Davies, P. S. (2001). The validity of self-reported
codes and MET intensities. Medicine and Science in Sports and energy intake as determined using the doubly labelled water
Exercise, 32, S498–S516. technique. British Journal of Nutrition, 85, 415–430.
American College of Sports Medicine, American Dietetic Ji, L. L. (1995). Oxidative stress during exercise: Implication of
Association, & Dietitians of Canada. (2009). Joint position antioxidant nutrients. Free Radical Biology & Medicine, 18,
statement: Nutrition and athletic performance. Medicine and 1079–1086.
Science in Sports and Exercise, 41, 709–731. Koehler, K., Braun, H., De Marées, M., Fusch, G., Fusch, C.,
Artioli, G. G., Gualano, B., Franchini, E., Scagliusi, F. B., Mester, J., & Schaenzer, W. (2010). Parallel assessment of
Takesian, M., Fuchs, M., & Lancha, A. H. (2010). nutrition and activity in athletes: Validation against doubly
Prevalence, magnitude, and methods of rapid weight loss labelled water, 24-h urea excretion, and indirect calorimetry.
among judo competitors. Medicine and Science in Sports and Journal of Sports Sciences, 28, 1435–1449.
Exercise, 42, 436–442. Kowatari, K., Umeda, T., Shimoyama, T., Nakaji, S.,
Artioli, G. G., Iglesias, R. T., Franchini, E., Gualano, B., Yamamoto, Y., & Sugawara, K. (2001). Exercise training
Kashiwagura, D. B., Solis, M. Y., … Lancha Junior, A. H. and energy restriction decrease neutrophil phagocytic activity
(2010). Rapid weight loss followed by recovery time does not in judoists. Medicine and Science in Sports and Exercise, 33,
affect judo-related performance. Journal of Sports Sciences, 28, 519–524.
21–32. Kratz, A., Ferraro, M., Sluss, P. M., & Lewandrowski, K. B.
Brownell, K. D., Steen, S. N., & Wilmore, J. H. (1987). Weight (2004). Normal reference laboratory values. The New England
regulation practices in athletes: Analysis of metabolic and Journal of Medicine, 351, 1548–1563.
health effects. Medicine and Science in Sports and Exercise, 19, Langan-Evans, C., Close, G. L., & Morton, J. P. (2011). Making
546–556. weight in combat sports. Strength & Conditioning Journal, 33,
Burke, L. M., Hawley, J. A., Wong, S. H., & Jeukendrup, A. 25–39.
(2011). Carbohydrates for training and competition. Journal of Leibel, R. L., Rosenbaum, M., & Hirsch, J. (1995). Changes in
Sports Sciences, 29, S17–27. energy expenditure resulting from altered body weight. The
Clark, R. R., Kuta, J. M., Sullivan, J. C., Bedford, W. M., Penner, New England Journal of Medicine, 332, 621–628.
J. D., & Studesville, E. A. (1993). A comparison of methods to Lingor, R. J., & Olson, A. (2010). Fluid and diet patterns asso-
predict minimal weight in high school wrestlers. Medicine and ciated with weight cycling and changes in body composition
Science in Sports and Exercise, 25, 151–158. assessed by continuous monitoring throughout a college wres-
Cohen, J. (1988). Statistical power analysis for the behavioural tling season. Journal of Strength and Conditioning Research, 24,
sciences. Hillsdale, NJ: Lawrence Erlbaum Associates. 1763–1772.
Cunningham, J. J. (1980). A reanalysis of the factors influencing Lohman, T. G. (1981). Skinfolds and body density and their
basal metabolic rate in normal adults. The American Journal of relation to body fatness: A review. Human Biology, 53, 409–
Clinical Nutrition, 33, 2372–2374. 414.
FAO/WHO/UNU. (1985). Energy and protein requirements. Report Melby, C. L., Schmidt, W. D., & Corrigan, D. (1990). Resting
of a Joint FAO/WHO/UNU consultation. Geneva: Author. metabolic rate in weight-cycling collegiate wrestlers compared
12 D. Reljic et al.

with physically active, noncycling control subjects. The Sen, C. K. (1999). Glutathione homeostasis in response to exer-
American Journal of Clinical Nutrition, 52, 409–414. cise training and nutritional supplements. Molecular and
Mettler, S., Mitchell, N., & Tipton, K. D. (2010). Increased Cellular Biochemistry, 196, 31–42.
protein intake reduces lean body mass loss during weight loss Sinning, W. E., Dolny, D. G., Little, K. D., Cunningham, L. N.,
in athletes. Medicine and Science in Sports and Exercise, 42, Racaniello, A., Siconolfi, S. F., & Sholes, J. L. (1985). Validity
326–337. of “generalized” equations for body composition analysis in
Millet, P., Guilland, J. C., Fuchs, F., & Klepping, J. (1989). male athletes. Medicine and Science in Sports and Exercise, 17,
Nutrient intake and vitamin health status of healthy French 124–130.
vegetarians and nonvegetarians. The American Journal of Steen, S. N., Oppliger, R. A., & Brownell, K. D. (1988).
Clinical Nutrition, 50, 718–727. Metabolic effects of repeated weight loss and regain in adoles-
Morton, J. P., Robertson, C., Sutton, L., & MacLauren, D. P. cent wrestlers. JAMA: The Journal of the American Medical
(2010). Making the weight: A case study from professional Association, 260, 47–50.
boxing. International Journal of Sports Nutrition and Exercise Suzuki, M., Nakaji, S., Umeda, T., Shimoyama, T., Mochida, N.,
Metabolism, 20, 80–85. Kojima, A., … Sugawara, K. (2003). Effects of weight reduc-
National Academy of Sciences. (1998). Dietary reference intakes for tion on neutrophil phagocytic activity and oxidative burst activ-
thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, pan- ity in female judoists. Luminescence, 18, 214–217.
Downloaded by [University of Illinois at Urbana-Champaign] at 16:23 01 October 2014

tothenic acid, biotin, and choline. Washington, DC: The National Tarnopolsky, M. A., Cipriano, N., Woodcroft, C., Pulkkinen, W.
Academies Press. J., Robinson, D. C., Henderson, J. M., & MacDougall, J. D.
National Academy of Sciences. (2000). Dietary reference intakes for (1996). Effects of rapid weight loss and wrestling on muscle
vitamin C, vitamin E, selenium, and carotenoids. Washington, glycogen concentration. Clinical Journal of Sport Medicine, 6,
DC: The National Academies Press. 78–84.
National Academy of Sciences. (2002). Dietary reference intakes Thompson, J. L., Manore, M. M., Skinner, J. S., Ravussin, E., &
for vitamin A, vitamin K, arsenic, boron, chromium, copper, Spraul, M. (1995). Daily energy expenditure in male endur-
iodine, iron, manganese, molybdenum, nickel, silicon, vana- ance athletes with differing energy intakes. Medicine and Science
dium, and zinc. Washington, DC: The National Academies in Sports and Exercise, 27, 347–354.
Press. Thorland, W. C., Johnson, G. O., Tharp, G. D., Fagot, T. G., &
National Research Council. (1989). Recommended dietary allowan- Hammer, R. W. (1984). Validity of anthropometric equations
ces. Washington, DC: The National Academies Press. for the estimation of body density in adolescent athletes.
Oppliger, R. A., Case, H. S., Horswill, C. A., Landry, G. L., & Medicine and Science in Sports and Exercise, 16, 77–81.
Shelter, A. C. (1996). ACSM position stand: Weight loss in Tietze, F. (1969). Enzymic method for quantitative determination
wrestlers. Medicine & Science in Sports & Exercise, 28, 135–138. of nanogram amounts of total and oxidized glutathione:
Packer, L. (1997). Oxidants, antioxidant nutrients and the athlete. Applications to mammalian blood and other tissues.
Journal of Sports Sciences, 15, 353–363. Analytical Biochemistry, 27, 502–522.
Pasiakos, S. M., Cao, J. J., Margolis, L. M., Sauter, E. R., Utter, A. C., Goss, F. L., Swan, P. D., Harris, G. S., Robertson,
Whigham, L. D., McClung, J. P., … Young, A. J. (2013). R. J., & Trone, G. A. (2003). Evaluation of air displacement for
Effects of high-protein diets on fat-free mass and muscle pro- assessing body composition of collegiate wrestlers. Medicine and
tein synthesis following weight loss: A randomized controlled Science in Sports and Exercise, 35, 500–505.
trial. The FASEB Journal, 27, 3837–3847. Weir, J. B. (1949). New methods for calculating metabolic rate
Reljic, D., Hässler, E., Jost, J., & Friedmann-Bette, B. (2013). with special reference to protein metabolism. Journal of
Rapid weight loss and the body fluid balance and hemoglobin Physiology, 109, 1–9.
mass of elite boxers. Journal of Athletic Training, 48(1), Yanagawa, Y., Morimura, T., Tsunekawa, K., Seki, K., Ogiwara,
109–117. T., Kotajima, N., … Murakami, M. (2010). Oxidative stress
Sen, C. K. (1995). Oxidants and antioxidants in exercise. Journal associated with rapid weight reduction decreases circulating
of Applied Physiology, 79, 675–686. adiponectin concentrations. Endocrine Journal, 57, 339–345.