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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

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 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
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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

Estimations of nutrient intakes and energy balance
Nutrient intakes were obtained during a week of
regular training and weight maintenance (baseline
week), a pre-competition week, when boxers from
the Weight Loss Group reduced their body weight
adhering to their individual methods and boxers
from the Control Group performed their usual pre-
competition training, respectively, and during the
post-competition week. During each period, the
boxers recorded their food intake over seven conse-
cutive days by using a food record as introduced by
Koehler et al. (2010). This record contains an exten-
sive list of foods, which are commonly consumed in
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Germany and particularly used by athletes. Each
food item was specified in standard serving sizes
and the athletes were only required to tick off the
number of daily servings. If the athletes consumed
any other foods which were not listed, they were
required to record the amount, type and/or the spe-
cific brand mark. All participants were asked to fol-
low their habitual eating and drinking pattern and to
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-
tionist who supervised them throughout the study.
Furthermore, colour photos of commonly consumed
foods were handed out to assist in estimating the
amounts consumed. Compliance was monitored by
regular requesting and questions were resolved indi-
vidually with each participant. All nutrient intakes
were calculated by the software DGE PC (version
4.0, 2008, German Nutrition Society, Bonn,
Germany), which is based on the German nutrient
database. In addition, the athletes were asked to
record their daily time spent in exercise, school/
work, leisure activities, sleep, etc. using standardised
activity diaries in order to determine their physical
activity level and subsequently, to assess total energy
expenditure and energy balance (Ainsworth et al.,
2000). Activity records were only fully completed
by 9 participants (5 from the Weight Loss Group
and 4 from the Control Group). In these 9 partici-
pants, total energy expenditure was calculated by
multiplying the estimated physical activity level
value with the basal metabolic rate, which was calcu-
lated according to the Cunningham equation
(Cunningham, 1980) as well as determined via indir-
ect calorimetry using a spirometer (ZAN 600, nSpire
Health GmbH, Oberthulba, Germany) during the
post-competition week. For this purpose, partici-
pants were placed in supine position in a quiet,
well-tempered, dimly lit room. After a settling-in
period, oxygen consumption and carbon dioxide
production were measured for 30 min and the aver-
age values were taken to determine the 24-h basal
metabolic rate according to Weir (1949).
Rapid weight loss in boxing 3
Anthropometric measurements
During the baseline week, 2 days before competition
(after 5 days of weight reduction in the Weight Loss
Group) and 1 week after competition, height and
body weight were measured after an overnight fast
using a standard stadiometer and a calibrated scale
(Seca, Hamburg, Germany), respectively. The per-
centage of body fat as well as fat-free mass were
determined using a caliper (Holtain, Crymych,
UK) to measure skinfolds at 3 sites according to
the method of Lohman (1981). This method was
found to be accurate and suitable for body composi-
tion assessment in male athletes (Clark et al., 1993;
Sinning et al., 1985; Thorland, Johnson, Tharp,
Fagot, & Hammer, 1984) and is used to determine
the minimal wrestling weight in US high school and
collegiate wrestling (Clark et al., 1993; Utter et al.,
2003). Parts of the descriptive anthropometric data
were recently published in the context of another
part of this study (Reljic, Hässler, Jost, &
Friedmann-Bette, 2013).
Blood analyses
At each time point, blood samples were collected
between 8:00 and 9:00 in the morning after an over-
night fast of at least 10 h and after at least 12 h had
elapsed since the last exercise session. After 15 min
rest in supine position, ~35 mL of blood were drawn
from the antecubital vein into different collection
tubes. All blood samples, except for vitamin C and
glutathione assays, were processed on the same day.
Samples for vitamin C and glutathione determina-
tion were stored frozen for subsequent analysis.
Serum concentrations of vitamins A and E were
measured by high performance liquid chromatogra-
phy with UV detection using a reagent kit from
Chromsystems (VWR GmbH, Darmstadt,
Germany). The same reagent kit was used to deter-
mine vitamin B1 concentrations from whole blood
samples and vitamin B6 plasma concentrations with
fluorescence detection. Serum concentrations of
vitamin B12 and folate were measured by a chemilu-
minescence immunoassay using an ADVIA Centaur
XP analyzer (Siemens HealthCare, Erlangen,
Germany). Vitamin C serum concentrations were
determined by the liquid chromatography mass-
spectrometry method using a Quattro-Ultima analy-
zer (Waters GmbH, Eschborn, Germany). For mea-
surements of total glutathione and oxidised
glutathione, directly after collecting the blood with
ethylenediaminetetraacetic acid tubes and centrifu-
gation, the plasma samples were immediately depro-
teinised with sulfosalicylic acid (final concentration
3.5%), centrifuged and the supernatant immediately
frozen and stored at −80°C. This procedure
 4 D. Reljic et al.
minimises artefactual oxidation of glutathione. All
plasma samples for determination of total and oxi-
dised glutathione were identically treated. In detail,
plasma concentrations of total glutathione and oxi-
dised glutathione were measured using a spectro-
photometer (ULTROSPEC II, LKB Biochrom,
Freiburg, Germany) according to the assay reported
by Tietze (1969). Reduced glutathione was com-
puted by subtraction. In one participant from the
Weight Loss Group, glutathione values could not
be determined because of insufficient sample
material.
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Statistical analysis
All analyses were performed using the software pro-
gram SigmaStat 3.5 for Windows (Jandel Scientific,
San Rafael, CA, USA). Data are presented as means,
standard deviations (SD), and (where appropriate)
95% confidence intervals. Unpaired t-tests were per-
formed to compare selected values between both
groups. A repeated measure analysis of variance
(ANOVA) was applied to compare the dietary
intakes, physical activity levels, total energy expendi-
ture values as well as the anthropometric and blood
biochemical values between the three assessed weeks
and the three time points, respectively. If significant
effects were found, pairwise comparisons were per-
formed using the Holm-Sidak post-hoc test. For not
normally distributed data (vitamin C intake and
blood concentrations of vitamins B6 and C in the
Weight Loss Group), the non-parametric Friedman
test was applied. Additionally, effect sizes were cal-
culated for several variables (partial eta-squared, ɳp2,
for ANOVA and Cohen’s d for t-tests) in accordance
to Cohen (1988). Relationships between selected
parameters were determined using Pearson’s corre-
lation tests. Statistical significance was declared
when P < 0.05.
Results
Body mass and body composition
Baseline anthropometric characteristics and aerobic
performance capacity (VO2max) were similar in both
groups of elite boxers. In the Weight Loss Group,
there were significant differences in body weight
(P < 0.001, ɳp2 = 0.90) and fat-free mass
(P < 0.001, ɳp2 = 0.89) among the three time points.
The weight loss period resulted in a significant
reduction of body weight and fat-free mass
(P < 0.001) by 5.6 ± 1.7% and 4.9 ± 1.3%, respec-
tively. One week after competition, body weight and
fat-free mass had increased again significantly
(P < 0.001) by 4.9 ± 1.9% and 4.6 ± 1.7%, respec-
tively, to almost baseline values. The percentage of
body fat tended to decrease slightly during the pre-
competition week, but the changes were not statisti-
cally significant. No significant changes of body
weight, fat-free mass and percentage of body fat
were observed in the Control Group (Table I).
Macronutrient intakes and energy balance
In the Weight Loss Group, energy (P < 0.001,
ɳp2 = 0.82), carbohydrate (P < 0.001, ɳp2 = 0.79),
protein (P < 0.001, ɳp2 = 0.70), fat (P < 0.001,
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)
decreased during the pre-competition week com-
pared to the baseline and the post-competition
week. In the Control Group, energy, macronutrient
and water intakes did not change significantly
between the three weeks (Table II).
Measured basal metabolic rate was not signifi-
cantly different between the Weight Loss Group
and the Control Group, but it was significantly
lower compared with the predicted basal metabolic
rate in both groups (P-values < 0.001, d-values >
4.5) (Table I). In the Weight Loss Group, physical
activity level values differed significantly (P < 0.001,
ɳp2 = 0.86) among the three weeks of observation.
Activity levels were lower during the post-competi-
tion week compared to the baseline week (P < 0.001)
and the pre-competition week (P < 0.05). In the
Control Group, physical activity levels showed a
tendency for such a decrease (Figure 1(A)). In the
Weight Loss Group, total energy expenditure was
significantly (P < 0.001, d = 2.6) higher than energy
intake during the pre-competition week, indicating a
negative energy balance (Figure 1(B)). When total
energy expenditure was estimated by applying the
Cunningham equation, both groups demonstrated a
significant negative energy balance throughout the
three periods (except for the post-competition week
in the Control Group) (Figure 1(C)).
Vitamin intakes and blood biochemical measures
In the Weight Loss Group, the intakes of vitamins A
(P < 0.05, ɳp2 = 0.39), C (P < 0.05, ɳp2 = 0.34), B1
(P < 0.05, ɳp2 = 0.44), B6 (P < 0.01, ɳp2 = 0.44), B12
(P < 0.05, ɳp2 = 0.38) and folate (P < 0.05,
ɳp2 = 0.38) were significantly different among the
three weeks. During the pre-competition week, vita-
min A, vitamin C, vitamin B6 and vitamin B12
intakes were significantly (P < 0.05) lower compared
to the baseline week and the post-competition week,
and vitamin B1 intakes were significantly (P < 0.05)
lower compared to the post-competition week,
respectively. Except for the vitamin B6 intake,
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).

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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.
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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-

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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.
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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
Weight Loss Group, when caloric intakes were sig-
nificantly lower than total energy expenditure by
more than ~50% (i.e., negative energy balance).
However, it is a limitation of the study that physical
activity records were only obtained from 9 partici-
pants (5 from the Weight Loss Group and 4 from the
Control Group) and therefore, the sample size for
the estimation of energy balance was rather small.
Regarding macronutrients, there are currently no
specific recommended values for combat athletes
available. According to general recommendations
for athletes (American College of Sports Medicine
et al., 2009), both groups of boxers consumed a low-
carbohydrate diet throughout the study with a mean
daily value of ~3.7 g·kg−1 (pre-competition week in
the weight loss group not included) while the recom-
mendations for protein and fat were reached (except

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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
Group). Low habitual carbohydrate intakes were
also described in elite judo athletes (~4.8 g·kg−1,
Filaire et al., 2001), taekwondo athletes (~4.0 g·kg−1,
Fleming & Costarelli, 2007) and collegiate wrestlers
(~4.5 g·kg−1, Lingor & Olson, 2010). There is grow-
ing evidence that a low-carbohydrate/high-protein
diet may be advantageous for weight making athletes
and that therefore, the recommended high carbohy-
drate intakes (6–10 g·kg−1·day−1, American College
of Sports Medicine et al., 2009) probably need to be
reconsidered for athletes with needs to maintain low
body weight (Burke, Hawley, Wong, & Jeukendrup,
2011; Langan-Evans, Close, & Morton, 2011;
Mettler, Mitchell, & Tipton, 2010; Morton,
Robertson, Sutton, & MacLauren, 2010).
However, during weight loss, the carbohydrate
intake further decreased in the Weight Loss Group
up to ~2.2 g·kg−1, which in combination with exer-
cise probably resulted in a depletion of glycogen
stores. In this context, Artioli, Iglesias, et al. (2010)
assumed that weight-cyclers might be metabolically
adapted to chronic weight-cycling, including a faster
muscle glycogen restoration. These considerations
remain speculative as it was not possible to deter-
mine muscle glycogen content nor did the boxers
agree to performance tests prior to competition,
which is another limitation of the present study.
Rapid weight loss in boxing 9
However, the significant pre-competition loss of
fat-free mass in the Weight Loss Group might to
great extent be attributed to glycogen depletion and
dehydration. Besides, the suboptimal mean protein
intake of ~0.8 g·kg−1 has to be mentioned as an
important factor since increased protein intakes
were found to be superior for the maintenance of
fat-free mass during a hypocaloric diet (Mettler
et al., 2010; Pasiakos et al., 2013).
It is important to note that self-reported food
records, as applied in this investigation and widely
used in research, are associated with potential
sources of error. Participants often tend to under-
report their food intake and the mere act of record-
ing may affect the individual eating patterns (Hill &
Davies, 2001; Koehler et al., 2010). Thus, under-
reporting may have also occurred in the present
study to some extent, although the boxers were
highly motivated to learn how to improve their nutri-
tion and the careful briefing as well as the frequent
monitoring and requesting throughout the record-
ing-process, should have minimised the extent of
theoretical errors.
The boxers’ total water intake was very modest
with an average value of ~2.2 L·day−1 (excluding
pre-competition week in the Weight Loss Group).
During weight loss, water consumption further
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-
vious studies. The water intakes of the judo athletes
observed by Filaire et al. (2001) were ~2.7 L during
the weight maintenance period and ~1.9 L during
food restriction, respectively. Fleming and Costarelli
(2007) assessed even lower intakes in the taekwondo
athletes (~1.4 L·day−1). However, based on the
guidelines set by the National Research Council
(1989), recommending a water ingestion of
~1 mL·kcal−1 of energy expended, the intakes of
the boxers appeared to be quite appropriate due to
their decreased total energy expenditure, except for
the pre-competition week in the Weight Loss Group,
when water consumption further declined by ~33%.
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Accordingly, estimations of body water and plasma
volume changes recently conducted in our labora-
tory revealed that rapid weight loss induced hypohy-
dration in the Weight Loss Group while all the
boxers were normally hydrated during the other per-
iods of investigation (Reljic et al., 2013).
Both groups did not meet the generally recom-
mended intakes for vitamins A, E and folate
throughout the whole period of investigation but,
surprisingly, despite the extreme malnutrition
found in the Weight Loss Group during the pre-
competition week, the assessed blood vitamin con-
centrations remained within or were even above
(vitamins B6 and C) the normal ranges. This could
indicate that nutritional changes over such a small
period of time might not have any effect on vitamin
status. However, it has also to be mentioned that
participants were not allowed to take any supple-
ments during the study but, unfortunately, it was
not possible to include a standardised “washout”
period prior to the study, so that the initial blood
concentrations could have been affected by former
supplement consumption, which is the major limita-
tion of this investigation. It should also be noted that
the relationship between dietary intake and biochem-
ical indicators of vitamins is still controversial.
Several other studies found no or only weak correla-
tions between the ingestion of vitamins and the
respective blood concentrations, and also failed to
detect biochemical deficiencies despite insufficient
intakes(Fogelholm, Koskinen, Laakso, Rankinen, &
Ruokonen, 1992; Guilland et al., 1989; Millet,
Guilland, Fuchs, & Klepping, 1989). It was assumed
that this may be due to the complexity of intervening
factors, such as absorption, bioavailabilty, transfer,
storage, etc. (Millet et al., 1989).
Besides the serum levels of the antioxidative vita-
mins A, C and E, mean plasma levels of total,
reduced and oxidised glutathione as well as the aver-
age ratio of reduced glutathione and oxidised glu-
tathione were stable throughout the study. These
findings suggest that antioxidant capacity was not
compromised due to the hypocaloric diet observed
in both groups and that rapid weight loss did not
induce increased oxidative stress in the Weight Loss
Group. Previous studies investigating effects of rapid
weight loss on oxidative stress markers have found
divergent results. In accordance with our findings,
Finaud et al. (2006) observed no alterations in oxi-
dative stress in judo athletes, who reduced weight
rapidly prior to a simulated competition, and they
assumed that this was related to an increase in the
efficiency of the antioxidant system. However, other
investigators reported enhanced oxidative burst
activity in judo athletes (Kowatari et al., 2001;
Suzuki et al., 2003) and a significant rise in urinary
stress markers in wrestlers (Yanagawa et al., 2010),
in response to rapid weight loss. The lack of oxida-
tive stress in the present study could be related to
several factors. As well as in vitamin status, perhaps
the duration of food restriction was too short to
induce substantial changes in glutathione plasma
levels. Also, it appears that rapid weight loss in the
Weight Loss Group was primarily achieved by
energy restriction and passive methods to induce
sweating (sauna) and probably to a lesser extent by
intensive exercise which increases production of
reactive oxygen species. The significant decrease of
physical activity level during the pre-competition
week and the finding that the Weight Loss Group
and the Control Group did not differ significantly in
their mean physical activity level suggest that there
was no difference in reactive oxygen species produc-
tion in both groups. In agreement with this observa-
tion, Kowatari et al. (2001) reported that the
oxidative burst activity observed in male judo ath-
letes was only increased by intense exercise but not
affected by energy restriction. Furthermore, it was
found that a hypocaloric diet may even beneficially
alter oxidative status because caloric restriction
decreases metabolic rate and thus oxygen consump-
tion, which could consequently reduce reactive oxy-
gen species production (Heilbronn & Ravussin,
2003). Finally, there is strong evidence that endur-
ance-trained athletes, such as the boxers in this
study, may have an improved tolerance against exer-
cise-induced oxidative damage due to physiological
adaptations to exercise (Sen, 1999). However, it
cannot be excluded that oxidative stress might have
been detected in the boxers of the present study if
other methods than the measurement of the ratio of
reduced glutathione and oxidised glutathione could
have been applied. Therefore, the assumptions con-
cerning oxidative stress have to be treated with
caution.
In conclusion, the elite boxers, regardless of
whether participating in rapid weight loss or not,
consumed a low-carbohydrate, hypocaloric diet –
presumably to keep their body weight constantly
low throughout the competitive season. During the

weight loss period, nutrient intakes were further
decreased to levels considerably below the current
recommendations. Despite this inappropriate dietary
pattern, neither vitamin deficiencies nor indications
of increased oxidative stress were found in the box-
ers. However, the observation period was rather
short and further research is needed to find out if
long-term adherence to such unbalanced diets might
induce an impairment of health and performance.
Acknowledgements
The authors would like to thank to thank Dr. Eike
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Hässler, Judith Strunz, Dr. Rüdiger Schmieder,
Christiane Herth and Anette Hegewald for their
excellent assistance with the processing of the
blood samples.
Funding
The study was financially supported by the German
Federal Institute of Sports Science (IIA1-070118/09).
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