Elite Athletes Research Articles

Anxiety and Generalized Anxiety Disorder in Elite Athletes

Physical activity is recommended as a strategy for promoting mental health, and it can even be integrated into treatment plans for psychiatric disorders affecting the general population. However, elite athletes are a subpopulation with protective and risk factors inherent to high-level competition and are not shielded from psychiatric symptoms and conditions. The mental health of elite athletes has been the subject of increasing attention, driven in part by the initiatives of the International Olympic Committee and the growing importance of sports psychiatry. This article is a narrative review that provides an overview regarding anxiety, in particular generalized anxiety disorder in elite athletes. Our assessment concluded that competitive anxiety may affect an elite athlete's performance in both harmful and beneficial ways. Assessing the duration, frequency, and functional impact of anxiety symptoms is crucial for ruling out generalized anxiety disorder. Elite athletes do not show a significantly different prevalence of generalized anxiety disorder compared to the general population. Identifying specific protective and risk factors can contribute to adopting more effective preventive and intervention strategies. As in the general population, psychotherapy is recommended for elite athletes as the initial treatment for this condition, combined, if necessary, with pharmacotherapy, according to the World Anti-Doping Agency Code.

The relationship between life satisfaction and risk preferences of couch potatoes, recreational and elite athletes: the impact of mental dispositions and attitudes

IntroductionThis study examines the relationship between physical activity and mental wellbeing among students not playing any sport (“couch potatoes”), recreational athletes and “dual career students”, i.e., students who are at the same time elite athletes. It addresses three closely related, yet different questions: (i) Do couch potatoes, recreational and elite athletes differ in their level of affective well-being or happiness? (ii) Are there any differences in cognitive wellbeing or life satisfaction between these groups? and (iii) Are there any differences in risk preferences and attitudes?MethodsIn our empirical analysis, we use a large cross-section dataset with detailed information on nearly 4,700 students enrolled at 24 different universities and universities of applied sciences all over Germany to identify the relationship between the individuals' personalities and their life satisfaction and risk preferences using standard regression models.ResultsOur findings indicate that, first, elite athletes report higher levels of happiness and life satisfaction than recreational athletes and couch potatoes. Second, both groups of athletes display higher levels of risk tolerance than couch potatoes. Third, and most important, we find significant personality differences between elite athletes and the other two groups of students that drive most, yet not all of our results.DiscussionSince dual career students are often role models for other students, universities should consider investing in their sports facilities and offering sports classes on campus to increase the athletic involvement of the general student body.

The Effects of Vitamin D Deficiency on Physical Fitness and Sport Performance – A Review

Introduction: Deficiency or insufficiency of vitamin D affects all individuals, of both sexes and all ages, and consequently brings a series of negative health consequences for them. This deficiency seems to be a very widespread problem in the population in general and also among physically active individuals and particulary in athletes. Currently, the insufficiency of vitamin D is a problem appearing worldwide. While in the population the main source of deficiencies are insufficient exposure to the sun and deficiency in the food diet, in individuals who participate in physical activity and sports it seems that the main factors are high use and depletion of reserves from muscle and adipose tissue. Vitamin D deficiency has an important role not only in bone and muscle health, but also negatively affects physical fitness and sports performance. Therefore, continuing measurement and monitoring of free vitamin D and/or its bioavailable 25(OH)D metabolites is the best way to determine the true vitamin D status for preventive reasons or supplementation in all individuals. Objectives: This review aims to highlight the current situation of the status of vitamin D, especially in subjects participate in physical activity and sports, and its importance and role in the health of athletes and in sports performance. Methods: For this review, we used the database in Scopus and PubMed, searching with key words: vitamin D deficiency - vitamin D status - elite athletes - sports performance. Full articles in English, published from 2016 to 2024, that evidenced the association between vitamin D status and health outcomes and sports performance were included. Results and Conclusions: The results of the study showed that the deficiency of vitamin D in the general population, but also in those who are actively involved in sports and even elite sports, is present at worrying levels. In different groups and populations, the deficiency factors are partly different, but the results show that the lack of food in the diet today constitutes one of the main factors that has almost taken the same weight as insufficient exposure to the sun. For physically active subjects and those involved in various types of sports, deficiencies are present at an unpredictably high rate, putting in serious danger in some cases the lives of the athletes. This comes from a low attention regarding the deficiencies of this vitamin, compared to other elements that are usually taken in the form of supplements in sports. The results show that maintaining an optimal level of vitamin D affects not only the bone and muscle health, the optimal physical fitness of physically active individuals, but also the health and improvement of sports performance (not only physical) of athletes. Therefore, the measurement, monitoring, ensuring a balanced food diet and supplementing with this vitamin, if needed, should accompany the entire course and activity of the subjects of this category in a strict and consistent manner.

Role of Nutrition and Hydration in Injury Prevention and Recovery: A Review

Introduction and Purpose: Nutrition and hydration play critical roles in supporting athletic performance, injury prevention, and effective recovery, impacting both amateur and elite athletes. This literature review explores current evidence on nutritional and hydration strategies that promote musculoskeletal health, reduce injury risk, and optimize recovery following injury. Material and Methods: A comprehensive literature review was conducted using the PubMed and Google Scholar databases, focusing on articles published up until the end of 2023. Keywords used in the search included: “nutrition strategies”, “hydration”, “injury prevention”, “nutrition” and “recovery”. Articles were selected based on their relevance to the topic and quality of evidence. Results: The review reveals that hydration plays a critical role in reducing the risk of injury and optimizing recovery. Dehydration is associated with increased muscle fatigue, cramps, and a greater likelihood of heat-related injuries, impairing physical performance. Furthermore, nutritional strategies, particularly protein intake post-exercise, are essential for muscle recovery, reducing inflammation, and speeding up the healing process. Conclusions: Implementing appropriate dietary strategies, including adequate hydration, balanced macronutrient intake, and electrolyte replenishment, can significantly reduce the risk of injury, enhance performance, and accelerate recovery times.

The Significance of U23 Competitions in Wrestling Career

Background. Designing the training of athletes should be based on specific goals and objectives at each stage of the long-term development. Each age stage in the development of an elite athlete has its own significance. The U23 competitions are organized to facilitate a smoother and more effective transition of wrestlers from junior to senior levels. The aim of the study is to determine the significance of performances in the U23 competitions for the subsequent development process of wrestlers. Materials and Methods. The following research methods have been used in the paper: the analysis of the scientific and methodological literature, the analysis of the official results, and methods of mathematical statistics. We have studied the sports careers of participants in the 2017, 2018, and 2019 World Championships in freestyle, Greco-Roman, and women's wrestling. A total of 1277 wrestlers’ sporting biographies have been analyzed. Results. The majority of participants (73.7 %) in the U23 age category competitions previously competed at the junior level. Moreover, more than half of the athletes (58.4 %) had prior experience of participating in cadet competitions. It is worth noting that 63.7 % of all wrestlers participated in senior-level competitions, and 31.5 % of them achieved podium finishes. Among women, a higher percentage of athletes continue their careers (46.3 %) and achieve success (20.1 %) on the international stage after the U23 competitions. For male freestyle wrestlers, the figures are lower, with only 38.2 % continuing their careers. Conclusion. The analysis demonstrated that the U23 competitions, which serve as a continuation of the cadet and junior age groups, are part of the overall sequence of competitions in the development of wrestlers at the international level. However, the importance of the U23 competitions varies depending on the level of athletes, and they serve both as preparatory and main competitions within the athletes' training system.

Comparing Population-General and Sport-Specific Correlates of Disordered Eating Amongst Elite Athletes: A Cross-Sectional Study.

Despite the high prevalence of disordered eating and eating disorders amongst elite athletes, it remains unclear whether risk factors and psychological processes align with those in the general population or if there are unique sport-factors associated with heightened risk. This cross-sectional study investigated if sport-specific factors (including pressures and psychological processes) explained additional variance in elite athletes' disordered eating symptoms, controlling for established population-general risk factors. Current elite athletes (N = 178, 72.4% female, mean age = 23.9, standard deviation age = 7.0) completed online surveys assessing disordered eating, body dissatisfaction, perfectionistic traits, population-general and sport-specific pressures, as well as general (thin-ideal, muscular-ideal) and athlete-specific (drive for leanness for performance, athletic identity) psychological processes. Disordered eating was highly prevalent, with 78.2% of athletes reporting at least moderate risk, 46.4% at least high risk, and 20.6% very high risk. Controlling for demographic covariates and population-general pressures, sport-specific pressures explained significant additional variance (13.5%) in disordered eating. Even when controlling for perfectionistic traits, greater weight pressures in sport (β = .35) was uniquely associated with greater disordered eating. In a separate multivariate analysis controlling for covariates and general psychological processes, athlete-specific psychological processes explained significant additional variance (15.5%) in disordered eating. Even when controlling for body dissatisfaction, greater drive for leanness for performance (β = .17) and athletic identity (β = .13) were uniquely associated with greater disordered eating. These findings support evidence that elite athletes may experience dual pressures and psychological processes associated with disordered eating: those congruent with appearance-oriented models and others independent of appearance. This duality should be considered in the modification of interventions for disordered eating in elite athletes. 1. Disordered eating was highly prevalent in a sample of 178 elite adult athletes, with 78.2% reporting at least moderate risk for having related symptoms or behaviours. 2. Greater weight pressures in sport was significantly associated with greater disordered eating, even when controlling for demographic covariates and population-general appearance-related pressures from family and the media. 3. Both appearance-based (drive for thinness, body dissatisfaction) and non-appearance (drive for leanness for performance, athletic identity) psychological processes were uniquely associated with greater disordered eating.

Effects of a Combined Method of Normobaric Hypoxia on the Repeated Sprint Ability Performance of a Nine-Time World Champion Triathlete: A Case Report

Elite athletes are an under-represented population in scientific studies, and there are no works analysing the influence of hypoxia in elite triathletes. The aim of this study was to analyse the influence of different methods of normobaric hypoxia on repeated sprint ability (RSA) performance. This study was a case study with an elite triathlete who has won nine triathlon world championships. The study used a combination of different methods of normobaric hypoxia. The three methods combined were as follows: live high-train low interspersed; intermittent hypoxic training; and intermittent hypoxic exposure. This study analysed the influence of these methods on RSA performance in variables such as power output, saturation of muscular oxygen, heart rate and ventilatory variables (VO2 and VCO2). The triathlete was measured before the training protocol (PRE), just after (POST-D3) and 21 days after the end of the protocol (POST-D21). This type of protocol has shown that it can lead to an improvement in RSA performance in the number of sprints (PRE vs. POST-D3 vs. POST-D21: 19 vs. 24 vs. 28), power output (PRE 615 W vs. POST-D3 685 W vs. POST-D21 683W) and efficiency of the triathlete. This work may be useful in improving power output and repeated sprint ability for elite triathletes.

Hight return-to-sport rate following traumatic spine injury in amateur athletes.

Data on the resumption of sporting activity (return-to-sport, RTS) after traumatic spine injuries are mainly available for elite athletes. This study aimed to determine the RTS rate in amateurs after spine injury and to identify factors possibly influencing RTS. First, a retrospective analysis of clinical data of patients with traumatic spine injuries receiving inpatient treatment at a national trauma center from 2016 to 2020 was performed. Patients up to the age of 60 who were active in sports before the injury were included. Patients with the following relevant concomitant injuries were excluded: spinal cord injury, pelvic injury, extremity injuries, as well as craniocerebral trauma grade 2 or higher. A telephone interview on participants' RTS within the first year after the injury was conducted. Participants with early and those with late or no RTS were compared in univariate analysis regarding potential influencing factors. The level of significance was set to p < .05. Thirty-seven women (39%) and 57 men (61%) were included. The mean age was 44 years (16-60). The numbers of patients per injured segment of the spine were: cervical 15 (16%), thoracic 28 (30%), lumbar 33 (35%), multiple spine segments 18 (19%). Thirty patients (32%) were treated conservatively and 64 (68%) surgically. The RTS rate after six months was 62%, corresponding to 57 patients. Compared to patients with late or no RTS, patients with RTS within six months had a significantly lower BMI (24.6 vs. 27.4kg/qm, p = .004), had isolated cervical spine injuries significantly more often (24% vs. 6%, p = .020), and had undergone outpatient or inpatient rehabilitation significantly less often (35% vs. 72%, p < .001). There were non-significant trends regarding mean age (42 vs. 46 years, p = .175), surgical therapy (66% vs. 75%, p = .333), and the proportion of patients who, before the injury, had been physically active for at least five hours per week (50% vs. 33%, p = .113). Patients with RTS within six months had sustained their spinal injury in a sports accident twice as often (28% vs. 14%, p = .121). Gender, preexisting medical or spinal conditions, severe injuries (types A4, B or C according to AO Spine), and surgical therapy were not significantly associated with RTS. The RTS rate within twelve months was 81% (76 patients). The RTS rate in amateur athletes after an isolated spinal injury without spinal cord injury was high, with 62% after six and 81% after twelve months. This reflects the effectiveness of the existing treatment and posttreatment concepts. Normal-weight patients and isolated cervical injury are favorable factors for RTS. The use of inpatient rehabilitation as a marker of protracted healing is associated with delayed or no RTS.

How is coaches’ social identity leadership related to mental health in elite athletes? The mediating role of satisfaction with performance

ABSTRACT It has been found that the way high-performance coaches lead influences both athletes’ performance and mental health. However, limited research exists on the Social Identity Approach to leadership in elite sports, despite growing interest in coaching science regarding interpersonal behaviours and leadership. This study investigates the empirical links between coaches’ leadership, sport performance and mental health from a social identity approach. One hundred and forty-five elite athletes (M age = 20.6 years; SD = 4.1; 62% women, 38% men) answered questionnaires measuring coaches’ social identity leadership, sport performance satisfaction and mental health. The overall structural equation model (SEM) accounted for 36% and 19% of the variances in athletes’ mental health and mental illness dimensions, respectively. There was a positive association between perceived coaches’ social identity leadership and sport performance satisfaction, explaining 10% of its variance. Coaches’ social identity leadership predicted athletes’ mental health but not mental illness. Sport performance satisfaction positively influenced mental health and negatively impacted mental illness. Fostering a sense of “we” and “us” within elite sport training groups is instrumental in promoting sport performance satisfaction and, consequently, enhancing the mental health of athletes. Coaching educational courses may benefit from social identity leadership in interpersonal behaviours.

The Biomechanical differences in maximum snatch weight between elite and sub-elite weightlifters: A one-dimensional statistical parameter mapping study

Background: Current research primarily relies on discrete data collected at specific time points to analyze the weightlifting process, often overlooking the impact of continuous temporal changes on athletic performance. Purpose: This study aimed to quantitatively analyze the one-dimensional kinematic patterns of maximum snatch weight actions in elite and sub-elite weightlifters using statistical parameter mapping (SPM). It explores kinematic differences in snatch actions between elite and sub-elite weightlifters, which assists in summarizing the technical characteristics of elite athletes. Methods: Two cameras recorded three successful maximum snatch attempts of 10 elite and 10 sub-elite weightlifters at the World Weightlifting Championships and Chinese Olympic selection competitions. Simi Motion 10.2 was used for kinematic analysis. SPM was employed for comparative analysis of snatch kinematics among different levels of weightlifters, and independent sample t-tests were used for phase duration proportions. Results: Elite weightlifters showed significant advantages in multiple movement phases: smaller knee joint angles in M1 phase (p &lt; 0.001, 35.82%–78.45%) and M3 phases (p = 0.047, 17.47%–24.74%; p = 0.036, 30.92%–49.38%; p = 0.040, 50.93%–65.85%); lower vertical body center of gravity (COG) height in M1 phase (p = 0.019, 0.00%–51.08%), M3 phase (p = 0.046, 48.27%–100.00%), and M5 phase (p = 0.045, 38.49%–59.54%); closer displacement between barbell COG and body COG in M1 phase (p = 0.006, 0%–38.18%; p = 0.048, 43.91%–48.94%) and M2 phase (p = 0.026, 0%–100%); greater barbell acceleration in M5 phase (p &lt; 0.001, 0%–94.61%); and slower barbell descent speed in M6 phase (p = 0.001, 0%–30.58%; p = 0.046, 44.57%–51.37%; p = 0.048, 67.16%–72.41%). Moreover, elite weightlifters exhibited significantly higher phase duration proportions in M1 phase (p = 0.034, d = 1.03) than sub-elite weightlifters. Conclusion: Elite weightlifters demonstrated longer distance and time exerting work on the barbell in M1 phase, less energy consumption in barbell ascent in M2 phase, and greater upward power gain for the barbell in M1 and M3 phases. They showed faster squat-to-barbell catching speed in M4 phase and excellent braking and precise squat-to-barbell catching capabilities in M5 and M6 phases.

Asymmetry of the Trunk and Lower Extremity Joint Frontal Plane Kinematics During Single-Leg Standing and Squat in Paralympic Athletes With Upper Limb Deficiency Compared With Intact Athletes

OBJECTIVES: To compare trunk and lower extremity asymmetries in frontal and sagittal kinematics, between athletes with upper limb deficiency (ULD) and intact athletes, during bilateral-leg standing (BLST), single-leg standing (SLST), and single-leg squat (SLSQ). DESIGN: Cross-sectional study METHODS: Eleven elite Paralympic athletes with ULD, and eleven intact elite athletes performed BLST, SLST, and SLSQ. Angles of the trunk, pelvis, hip, knee, and ankle were recorded using fixed cameras in the frontal and sagittal planes. Kinematic asymmetries between groups, and the relationship between loss of mass relative to body mass (LM%) and ipsilateral trunk tilt were analyzed. RESULTS: Paralympic athletes exhibited greater ipsilateral trunk tilt during ULD side SLSQ (∆ = 7.1°, p = .02, d = 1.26) than intact athletes, but not during intact side SLSQ. No significant correlation was found between LM% and bilateral angle differences in the frontal plane among paralympic athletes ( p &gt; .05, .06 ≤ | r| ≤ .27) CONCLUSION: Athletes with ULD compensated for missing body mass by tilting their trunk over their support leg when performing SLSQ only on the ULD side. The amount of trunk tilt did not seem to depend on the amount of missing mass.

Exploring employable profiles of elite student athletes through fsQCA: unleashing the power of their soft skills

PurposeTo analyse the degree to which elite student athletes acquire different soft skills (resilience, creativity, proactivity and problem solving) and the role they play in their perceived employability.Design/methodology/approachThe study assessed 163 elite Spanish student athletes. A validated survey to measure perceived employability and the degree of acquisition of soft skills was employed. Fuzzy-set qualitative comparative analysis (fsQCA) was used to analyse the data.FindingsStudents and athletes perceived a high degree of development of these skills and employability. Six solutions accounting for 64% of the cases were identified for achieving high employability levels. Three profiles emphasised combinations of elevated resilience with either creativity or problem-solving skills. Education and competition levels differed depending on the skill combination. Identifying and promoting the transferability of student athletes’ sports skills to the labour market was important for enhancing their employability. Collaboration with academic institutions and increased awareness of social media can facilitate the successful integration of elite athletes into the labour market.Originality/valueThe development and analysis of soft skills in the context of sports provide a foundation for future research in the field of athlete employability. This paper provides important information for academic institutions, through a novel method in the field, on the development and transfer of student-athlete soft skills from sports to the labour market.

Association of self-reported health problems and interpersonal violence in sport: a cross-sectional study in world-level performing athletes

ObjectivesA paucity of studies assesses the intersection of physical health (injury and illness), mental health and experiences of interpersonal violence (IV, also known as harassment and abuse) in sport. The...

Age and Sex Differences in IRONMAN World Championship Performance.

Gries, KJ and Witto, PE. Age and sex differences in IRONMAN world championship performance. J Strength Cond Res XX(X): 000-000, 2024-There has been an increasing number of masters athletes, particularly women, who have been competing in ultra-endurance events. With this in mind, we sought to determine the influence of age and sex on IRONMAN World Championship performances from 2014 to 2023. The final times of each component (swim, bike, and run) and overall time were collected for places 1st to 10th in each age group (18-69 years). Sex differences in performance were calculated for each age group. Depth of field (time of nth place/first place), a surrogate for participation, was also calculated for each age group and sex. Significance was set at p < 0.05. These data show a ∼12% sex difference in the performance of the swim, bike, run, and final (p < 0.05), which increased to 20% in the 65-69 years age group (p < 0.05). The differences appeared driven by the bike and run. Depth of field was greater in men than in women (p < 0.05), and the sex difference increased with age. Sex differences in performance trended to be related to depth of field (p = 0.08; R2 = 0.32), suggesting a moderate role of participation in performance sex differences. Although speculative, the performance data can give us an insight into the physiology and sociology of these elite athletes and warrants future research.

Situational and Dispositional Achievement Goals and Measures of Sport Performance: A Systematic Review with a Meta-Analysis

The purposes of this systematic review (PROSPERO ID: CRD42024510614, no funding source) were to quantify relationships between situational and dispositional dichotomous achievement goals and sport performance and explore potential relationship moderators. Published studies that reported at least one situational or dispositional achievement goal and a performance score were included. Studies without performance scores or based in a non-sport context were excluded. Information sources consisted of studies found in relevant published meta-analyses and EBSCOhost databases (finalized September 2024). The following statistics were conducted to assess the risk of bias: class-fail-safe n, Orwin’s fail-safe n, and funnel plots with trim and fill estimates. The summary statistics were r and d. Thirty studies from 1994 to 2024 met all inclusion criteria with 8708 participants from Europe, Asia, North America, and Oceania. The majority of samples were non-elite male youths and adolescents. The random-effects relationships (r) between task climate, 0.20 [0.14, 0.25], task orientation, 0.17 [0.12, 0.23], ego orientation, 0.09 [0.03, 0.16], and sport performance were small and significantly different (p &lt; 0.05) from zero, while the ego motivational climate relationship was not, −0.00 [−0.48, 0.05]. The random-effects standard differences in means (d) for both the task orientation, 0.08 [0.02, 0.14], and ego orientation, 0.11 [−0.05, 0.26] were minimal in meaningfulness. Mixed-effects moderator analyses resulted in the following significant (p &lt; 0.05) sub-group differences: subjective compared to objective performance measures (task orientation), elite compared to non-elite samples (task climate), and athlete-completed compared to coach-completed performance measures and performance records (task orientation). Finding only 30 studies meeting the inclusion criteria, which limited sub-group samples for moderation analyses, was the main limitation. Despite this limitation, AGT provides athletes and practitioners performance enhancement strategies. However, caution is warranted regarding relationship expectations given the small mean effect size values and the true prediction interval ranging from negative to positive, perhaps as a result of the heterogeneous samples and performance measures. A clear line of future research, considering the reviewed studies, with elite athletes is needed to verify the performance benefits of the task climate and ego orientation as well as the use of the ego goal orientation in selection decisions.

Self-Reported Use of Prohibited Substances and Methods Among Athletes of the Brazilian Delegations.

Use of prohibited substances and methods (doping) by elite athletes is a complex and multifactorial behavior. Understanding the factors associated with doping behavior is crucial to identifying potential intervention targets to reduce doping among this group. However, there are limited data on the prevalence and correlations of self-reported prohibited substance use among Brazilian Olympic athletes. We present data from a cross-sectional, self-reported online survey. Participants were elite Brazilian athletes who participated in the 2020 Olympic and Paralympic Games. A total of 209 athletes (52.6% females) from both Brazilian delegations were surveyed. The self-reported doping use of prohibited substances or methods was found to be 7.2%. Receiving a recommendation from a medical doctor, even knowing that the substance is prohibited, was associated with an increased risk of self-reported doping use (OR = 17.474; 95% CI = 4.664-65.470, P < 0.001). Nearly 1 in 10 athletes reported use in their careers. Medical recommendation to use substances was the only factor associated with an increased risk of doping among elite athletes.

Advocating individual-based profiles of elite athletes to capture the multifactorial nature of elite sports performance

Elite athletes are high-performance outliers within their specific sports. Even though science seeks to understand the nature of expertise and elite performance, much knowledge remains compartmentalized within subdisciplines. Despite this multidimensionality being acknowledged, an interdisciplinary approach to understanding elite athletes is still rare. This paper synthesizes insights across scientific domains in order to describe the population and individual characteristics of elite athletes. We analyzed diagnostic data from approximately 300 German squad athletes across eight different sports (e.g., gymnastics, volleyball, ice hockey, 3 × 3 basketball etc., agefemale = 18.95 ± 4.84 years, agemale = 19.32 ± 4.19 years) with expertise values ranging from 2 (low expertise) to 16 (high expertise). Data covered muscular strength, lower-body dynamics, muscle-power genetics, blood micronutrients, basic cognitive function, mental health, social support, and training conditions. Results of logistic regressions identified basic cognitive function (B = 0.89) and well-balanced blood micronutrients (B = 1.22) as critical factors distinguishing elite athletes. Additionally, multiple linear regressions suggested that lower-body dynamics (ß = 0.72) is related to increasing expertise values. We examined interactions between determinants of elite performance, and found that social support is positively associated with mental health and training conditions, whereas muscular strength correlates with lower-body dynamics. Focusing on top elite athletes in contrast to semi-elite athletes, we found higher within-group similarities in basic cognitive function and blood micronutrients. Findings indicate the need for a systemic, individualized, and comprehensive model using individual-based profiles.

Original salivary sex hormone data of naturally menstruating athletes and hormonal contraceptive users

ObjectivesThere is a lack of data on salivary sex hormones across the menstrual cycle (MC) or hormonal contraceptive (HC) cycle of elite athletes. We aimed to provide original data on salivary sex hormones (17β-estradiol, progesterone and free testosterone) in naturally menstruating female athletes with a regular cycle or irregular cycle and using combined HC. A secondary purpose was to compare these data with published data from the general population according to the menstrual status (MC or HC or irregularly menstruating).Methods367 saliva tests were performed on 44 elite athletes during 6 months of follow-up to certify for cycle regularity. Athletes were grouped into regular MC, n=13; irregular MC, n=5; and HC, n=26. We compared salivary data of regular MC across six cycle phases (menses, mid-follicular, late follicular, early luteal, mid-luteal and late luteal phases) with published data from women with a similar MC or HC status from the general population.ResultsWe provided salivary original data according to six sub-phases among elite athletes with regular MC. HC athletes showed lower salivary sex hormonal levels, markedly after the first week of active HC compared with regular MC. Athletes with irregular cycles do not show a progesterone rise from the first half to the second half of the cycle (Δirregular=0.38 (1.90), a rise detectable within regular MC group ΔregularMC=2.86 (2.88)).ConclusionsWe provided original data for salivary sex hormone levels in elite female athletes. These references may be valuable for research investigating MC or combined HC data, particularly in longitudinal follow-ups requiring repeated measurements.

Carbon monoxide supplementation: evaluating its potential to enhance altitude training effects and cycling performance in elite athletes.

Altitude training is a cornerstone for endurance athletes for improving blood variables and performance, with optimal effects observed at ∼2,300-2,500 meters above sea level (m.a.s.l.). However, elite cyclists face challenges such as limited access to such altitudes, inadequate training facilities, and high expenses. To address these issues, a novel method involving daily exposure to carbon monoxide (CO) has been proposed to amplify altitude training adaptations at suboptimal altitudes. Thirty-one male cyclists were assigned to three groups: Live-High Train-High with CO inhalation (LHTHCO), Live-High Train-High (LHTH), and Live-Low Train-Low (LLTL). The LHTHCO group underwent CO inhalation twice daily in the afternoon/evening to elevate carboxyhemoglobin concentration to ∼10%. Hematological variables, in vivo muscle oxidative capacity, and physiological indicators of cycling performance were assessed before and after a 3-week altitude training camp at 2,100 m.a.s.l. LHTHCO demonstrated a larger increase in hemoglobin mass (Hbmass) compared to both LHTH and LLTL. Although there were no statistical differences between LHTHCO and LHTH in submaximal and maximal performance measures, LHTHCO displayed greater improvements in 1-min maximal power output during incremental testing (Wmax), power output at lactate threshold, and maximal oxygen consumption (V̇o2max) compared to LLTL. LHTH demonstrated a larger improvement than LLTL in Wmax and V̇o2max, with no group differences in Hbmass or submaximal measures. Muscle oxidative capacity did not differ between groups. These findings suggest that combining moderate-altitude training with daily CO inhalation promotes hematological adaptations more effectively than moderate altitude alone and enhances cycling performance metrics in cyclists more than sea-level training.NEW & NOTEWORTHY Three weeks of training at moderate altitude with exposure to low doses of CO can significantly enhance hematological adaptations in elite cyclists compared to moderate-altitude training alone. Cycling performance determinants improved more with CO inhalation at moderate altitude compared to sea-level training, whereas there were no differences in submaximal and maximal performance measures compared to moderate-altitude training alone. This study highlights the potential of CO supplementation as an effective adjunct to altitude training regimens.

Slovenian Translation, Cross-Cultural Adaptation, and Content Validation of the Updated Oslo Sports Trauma Research Center Questionnaire on Health Problems (OSTRC-H2).

The updated Oslo Sports Trauma Research Questionnaire on Health Problems (OSTRC-H2) has been translated into a limited set of languages and lacks full validation of its new measures. To (1) translate, cross-culturally adapt, and evaluate the measurement properties of the OSTRC-H2 for the Slovenian population and (2) investigate the construct validity for the severity score and time lost due to a health problem. Cohort study (diagnosis); Level of evidence, 3. The OSTRC-H2 was translated from English to Slovenian (OSTRC-H2-SLO) according to international guidelines. A 15-week study was conducted among 188 elite athletes, with a test-retest performed in the 10th week. Internal consistency, reliability, content validity, feasibility, and potential ceiling effects were investigated. Internal consistency was measured using the Cronbach alpha coefficient, while reliability was measured with the intraclass correlation coefficient (ICC). Construct validity was measured with the Spearman rank correlation coefficient (r S). There was a 95% response rate and an 18% mean weekly prevalence of health problems. The OSTRC-H2-SLO showed excellent test-retest reliability (ICC, 0.94 [95% CI, 0.67-0.99]), with a Cronbach α of .93. A strong positive correlation was found between the OSTRC-H2-SLO severity score and days lost due to an acute injury (r S = 0.754), overuse injury (r S = 0.785), and illness (r S = 0.894) (P < .001 for all). Moderate to strong negative correlations were observed between severity score and total load (training and competition load in hours) as well as between days lost and total load (P < .001 for all). The OSTRC-H2-SLO was found to be valid, reliable, and well accepted among Slovenian athletes. The authors confirmed the questionnaire's construct validity and identified total load as an indicator of an increase in the severity score. NCT05471297 (ClinicalTrials.gov identifier).