Abstract
BackgroundThe impact of the type and the severity of disability on whole-body and regional body composition (BC), and bone mineral density (BMD) must be considered for dietary advice in athletes with a physical impairment (PI). This study aimed to investigate the impact of the type and the severity of disability on BC, the pattern of distribution of fat mass at the regional level, and BMD in athletes with a PI.MethodsForty-two male athletes with spinal cord injury (SCI, n = 24; age = 40.04 ± 9.95 years, Body Mass Index [BMI] = 23.07 ± 4.01 kg/m2) or unilateral lower limb amputation (AMP, n = 18; age = 34.39 ± 9.19 years, BMI = 22.81 ± 2.63 kg/m2) underwent a Dual-Energy X-Ray Absorptiometry scan. Each athlete with a PI was matched by age with an able-bodied athlete (AB, n = 42; age = 37.81 ± 10.31 years, BMI = 23.94 ± 1.8 kg/m2).ResultsOne-Way Analysis of Variance showed significant differences between the SCI, AMP and AB groups for percentage fat mass (%FM) (P < 0.001, eta squared = 0.440). Post-hoc analysis with Bonferroni’s correction showed that athletes with SCI had significantly higher %FM vs. the AMP and AB groups (25.45 ± 5.99%, 21.45 ± 4.21% and 16.69 ± 2.56%, respectively; P = 0.008 vs. AMP and P < 0.001 vs. AB). The %FM was also significantly higher in the AMP vs. the AB group (P < 0.001). Whole-body BMD was negatively affected in SCI athletes, with about half of them showing osteopenia or osteoporosis. In fact, the mean BMD and T-score values in the SCI group (1.07 ± 0.09 g/cm2 and −1.25 ± 0.85, respectively) were significantly lower in comparison with the AB group (P = 0.001 for both) as well as the AMP group (P = 0.008 for both). The type of disability affected BC and BMD in the trunk, android, gynoid and leg regions in SCI athletes and the impaired leg only in AMP athletes.ConclusionsIn conclusion, the type of disability and, partly, the severity of PI impact on BC and BMD in athletes with a PI. Nutritionists, sports medicine doctors, clinicians, coaches and physical conditioners should consider athletes with SCI or AMP separately. Athletes with a PI would benefit from specific nutrition and training programs taking into account the type of their disability.
Highlights
Increased fat mass (FM) and/or loss of lean mass (LM) leading to an increase in fat-to-lean mass ratio (FM/LM) ratio often takes place in people with a physical impairment (e.g., spinal cord injury caused by paralysis (SCI) or lower limb amputation (AMP)) (Dionyssiotis et al, 2008; Sherk, Bemben & Bemben, 2010)
This study is the first investigation of the degree of alteration in DXA-measured wholebody and regional body composition and bone mineral density (BMD) in athletes with a physical impairment according to the type of disability (i.e., SCI vs. AMP) and the degree of severity (i.e., TETRA vs. PARA and AKA vs. BKA)
In athletes with AMP the results showed that the severity of the physical impairment has an impact on whole-body body composition resulting in lower total mass, LM and bone mineral content (BMC) in AKA vs. BKA
Summary
Increased fat mass (FM) and/or loss of lean mass (LM) leading to an increase in fat-to-lean mass ratio (FM/LM) ratio often takes place in people with a physical impairment (e.g., spinal cord injury caused by paralysis (SCI) or lower limb amputation (AMP)) (Dionyssiotis et al, 2008; Sherk, Bemben & Bemben, 2010). In these individuals exercise training improves body composition (Liu, Wang & Niebauer, 2021) and its accurate measure is fundamental for a personalized nutrition and training programs, in particular in athletes with a physical impairment (Bernardi et al, 2020). Athletes with a PI would benefit from specific nutrition and training programs taking into account the type of their disability
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