Rapid Weight Change Research Articles

Is there a relationship between rapid weight changes and self-reported injury in combat sports athletes? A 14-month study of 24 combat sports events.

To explore the potential association between rapid weight changes and self-reported injury status (presence or absence of injury) 7 days following competitive events among male and female combat sports competitors. A 14-month study of 24 events. A weight management questionnaire was completed 1-day post-competition, and an injury questionnaire was completed 7 days post-competition. These online questionnaires provided data on body mass and injury status. Mixed effects logistic regression models were used to analyse the odds ratios of rapid weight change variables and their impact on athletes' self-reporting as injured or non-injured. There were 172 responses (155 athletes) to both questionnaires (37 females (24 %) and 118 males (76 %)); 88 athletes (51 %) reported no injury, and 84 (49 %) reported injury. Rapid weight loss 7 days (RWL -7 days) and 24 h (RWL -24 h) before weigh-ins was 4.9 % ± 3.4 % and 2.6 % ± 2.1 % for females, and 6.1 % ± 3.2 % and 3.0 % ± 1.9 % for males. Mixed effects logistic regression models returned the highest odds ratio for male RWL -24 h (odds ratio: 1.20, 95 % confidence interval: 1.00-1.43, p = 0.044). This indicates that for a 1 % increase in male RWL -24 h before official weigh-ins, the likelihood of reporting an injury increases by a factor of 1.2. Male RWL -24 h before weigh-ins is associated with reporting an injury at 7 days post-competition. Therefore, athletes and coaches should carefully consider and aim to limit pre-competition rapid weight loss to minimise the likelihood of injury.

Rapid Weight Changes and Competitive Outcomes in Muay Thai and Mixed Martial Arts: A 14-Month Study of 24 Combat Sports Events.

This study investigates the rapid weight loss (RWL) and rapid weight gain (RWG) of contest winners and losers from Muay Thai (MT) and mixed martial arts (MMA) events. The relationship between rapid weight change variables of males and females, and competitive success is also examined. Data from a weight management questionnaire was collected one day post-competition from 185 participants across 24 fight events, resulting in 263 responses (MMA: n = 78, MT: n = 185). Official and secondary weigh-in data were provided by the Combat Sports Commission. The results show that in MT, contest winners compared to losers had significantly greater RWL-7 days (5.9 ± 2.6% vs. 4.6 ± 2.7%, p = 0.01), RWG (6.2 ± 2.9% vs. 4.7 ± 2.8%, p = 0.003), and RWG/RWL ratio (108% [86-132%] vs. 86% [60-119%], p = 0.038), while no significant differences were observed for MMA. Mixed logistic regression models that controlled for age showed that a 1% increase in female RWL-24 h ([OR = 1.57, R2 = 0.105, p = 0.001]) was associated with a 1.6 times higher likelihood of winning compared to female athletes without this increase. We emphasise that associations do not imply causation, and it is possible that other factors which align with rapid weight change practices may impact the observed relationship. Nonetheless, MT contest winners show greater RWL, RWG, and RWG/RWL ratio than losers, and female rapid weight changes appear to be associated with competitive success in this cohort.

Stretch marks: Efficacy of herbal remedies (Cocoa and shea butter, vitamin E, calendula oils) and student survey

The study sought to assess the efficacy of herbal remedies for treating stretch marks by conducting a comprehensive literature review and administering a survey to gauge the knowledge and opinions of pharmacy students. This initiative aimed to bridge existing gaps in understanding and perceptions surrounding stretch marks and available treatment modalities. The survey was conducted among 40 first-year pharmacy students and comprised two sets of questions and demographic data: knowledge-based and opinion-based. Descriptive statistical analysis and Chi-square tests were performed using SPSS software were conducted to determine statistical significance. Among the participants, 75% were female with 90% of them within the age range of 18 to 30 years. The knowledge-based survey revealed a solid understanding of aspects related to stretch marks among participants. Almost all (97%) of respondents correctly identified that stretch marks usually appear on the skin due to rapid weight changes. Eighty percent correctly acknowledged stretch marks as a type of scar, while two-thirds answered affirmatively regarding their potential to cause irritation and itching. Misconceptions were identified, such as respondents incorrectly believing that stretch marks are exclusively formed through pregnancy. In the opinion-based survey, participants expressed varying viewpoints on stretch marks and herbal treatments. Statistical analysis revealed several significant correlations between demographic factors and participants' understanding of stretch marks. The survey findings provide valuable insights into stretch mark management and students' perceptions of herbal remedies. Overall, the study underscores the significance of further research and targeted educational initiatives in dermatological conditions like stretch marks.

Weight Categories, Trajectories, Eating Behavior, and Metabolic Consequences during Pregnancy and Postpartum in Women with GDM.

Pre-pregnancy overweight and obesity are associated with increased risk for adverse outcomes, such as gestational diabetes mellitus (GDM). This study investigated weight trajectories, eating behaviors, and metabolic consequences in women with GDM during pregnancy and postpartum according to pre-pregnancy BMI. We prospectively included 464 women with GDM. Intuitive eating (Intuitive Eating Scale-2 questionnaire), gestational weight gain (GWG), postpartum weight retention (PPWR) at 6-8 weeks and 1-year postpartum, and glucose intolerance (prediabetes and diabetes) at 1-year were assessed. Women with obesity (WOB) had lower GWG but gained more weight in the postpartum (p < 0.0001). PPWR at 1-year did not differ across BMI categories (p = 0.63), whereas postpartum weight loss was most pronounced in women with normal weight (p < 0.0001), and within this category, in their lowest tertile (p < 0.05). Intuitive eating was not linked to perinatal weight changes but differed among BMI categories. PPWR predicted a 2.5-fold increased risk of glucose intolerance at 1-year independent of pre-pregnancy BMI (p < 0.001), and the adverse metabolic impact of PPWR was most pronounced in WOB with odds of increased risk of glucose intolerance 8.9 times higher (95% CI 2.956;26.968). These findings suggest an adaptive capacity to relatively rapid weight changes in the perinatal period that is less present with higher BMI.

Rapid weight change as a predictor of disability among community-dwelling Japanese older adults.

To fill the knowledge gap regarding weight change and the onset of disability in community-dwelling Japanese older adults, we investigated the potential effects of rapid weight change on disability risk as defined by Japan's long-term care insurance (LTCI) system. We analyzed data from a longitudinal study of 10 375 community-dwelling older Japanese adults (≥65 years) who were not LTCI needs certified at baseline and joined the study from 2002 to 2005. Weight change (percentage) was calculated by subtracting participants' weight in the previous year from that measured during a physical examination at study commencement. The five weight-change categories ranged from sizable weight loss (≤ -8.0%) to sizable weight gain (≥ +8.0%). Disability was defined according to LTCI certifications at follow-up. Hazard ratios (HRs) and 95% confidence intervals were calculated for new-onset disability using a Cox proportional hazards model that fitted the proportional subdistribution hazards regression model with weights for competing risks of death. During the mean 10.5-year follow-up, 2994 participants developed a disability. Sizable weight loss (HR [95% confidence intervals], 1.41 [1.17-1.71]) and weight loss (1.20 [1.05-1.36]) were significant predictors of disability onset. Sizable weight gain (1.45 [1.07-1.97]) corresponded to severe disability. Stratified analyses by lifestyle and initial body mass index categories revealed more pronounced associations between weight change and disability risk in the unhealthy lifestyle and below initial normal body mass index groups. Rapid and sizable weight gain could be additional criteria for disability risk in older adults. Geriatr Gerontol Int 2023; 23: 809-816.

Nutrition and oncology: best practice and the development of a traffic light system

Malnutrition is common in oncology patients, with age, disease stage and tumour type all influencing malnutrition risk. There are several detrimental effects of malnutrition in oncology patients, including weight loss, which is associated with negative oncological outcomes, and reduced survival. The causes of malnutrition in this group may be multifactorial and include effects from the tumour itself, altered metabolism, increased nutritional requirements, and cancer treatments and their associated side effects, which can impact on an individual's ability and desire to eat. Nutritional screening to identify early nutritional risk is essential and should involve the use of a validated screening tool, with commonly used tools usually assessing nutritional risk and weight loss over a period of months, for example a 3- to 6-month period. It is also important to consider weight changes over a shorter time period to identify rapid weight changes. Multidisciplinary teamworking is essential in tackling malnutrition, with collaborative working between the dietitians and the nutrition nurses shown to be beneficial in the authors' practice to develop community pathways and improve their service and manage increasing patient numbers. Malnutrition within oncology can often be managed with additional supplementation with oral nutritional supplements or enteral nutrition, where indicated. A low-volume, energy-dense, high-protein supplement can help to meet nutritional needs and to achieve dietetic aims, with compliance improved by the use of a low-volume product.

An update in the etiopathogenesis of striae distensae: A review article.

Striae distensae (SD), also known as stretch marks, are common skin lesions causing significant psychological stress and cosmetic disfigurement. They are common to be seen during pregnancy, rapid weight change, puberty and many other pathological conditions including Cushing disease, anorexia nervosa or even excessive use of certain drugs. Clinically, they appear as either red raised linear bands known as striae rubrae (SR) or white depressed atrophic bands known as striae albae (SA). They were first described histopathologically in 1889. Many theories have been established to explain the etiopathogenesis of SD, yet the exact mechanism is still unclear. Also, many treatment modalities have been applied to reach the maximum efficacy with the least side effects. The aim of this review article is to optimize the most recent and accepted concepts on etiopathogenesis and pathophysiology of SD which may help in finding the best lines of management with the most satisfactory outcomes.

Nutrition and oncology: best practice and the development of a traffic light system.

Malnutrition is common in oncology patients, with age, disease stage and tumour type all influencing malnutrition risk. There are several detrimental effects of malnutrition in oncology patients, including weight loss, which is associated with negative oncological outcomes, and reduced survival. The causes of malnutrition in this group may be multifactorial and include effects from the tumour itself, altered metabolism, increased nutritional requirements, and cancer treatments and their associated side effects, which can impact on an individual's ability and desire to eat. Nutritional screening to identify early nutritional risk is essential and should involve the use of a validated screening tool, with commonly used tools usually assessing nutritional risk and weight loss over a period of months, for example a 3- to 6-month period. It is also important to consider weight changes over a shorter time period to identify rapid weight changes. Multidisciplinary teamworking is essential in tackling malnutrition, with collaborative working between the dietitians and the nutrition nurses shown to be beneficial in the authors' practice to develop community pathways and improve their service and manage increasing patient numbers. Malnutrition within oncology can often be managed with additional supplementation with oral nutritional supplements or enteral nutrition, where indicated. A low-volume, energy-dense, high-protein supplement can help to meet nutritional needs and to achieve dietetic aims, with compliance improved by the use of a low-volume product.

Rapid Weight Change Over Time Is a Risk Factor for Adverse Outcomes in Patients With Predialysis Chronic Kidney Disease: A Prospective Cohort Study

Both obesity and being underweight are risk factors for adverse outcomes in chronic kidney disease (CKD) patients. However, the effects of longitudinal weight changes on patients with predialysis CKD have not yet been studied. In this study, we analyzed the effects of weight change over time on the adverse outcomes in predialysis CKD population. Longitudinal data from a multicenter prospective cohort study (KNOW-CKD) were analyzed. In a total of 2,022 patients, the percent weight change per year were calculated using regression analysis and the study subjects were classified into five categories: group 1, ≤ -5%/year; group 2, -5< to≤ -2.5%/year; group 3, -2.5< to <2.5%/year; group 4, 2.5≤ < 5%/year; and group 5, ≥5%/year. The incidences of end-stage renal disease (ESRD) and the composite outcome of cardiovascular disease (CVD) and death were calculated in each group and compared to group 3 as reference. During a median 4.4years of follow-up, 414 ESRD, and 188 composite of CVD and mortality events occurred. Both weight gain and loss were independent risk factors for adverse outcomes. There was a U-shaped correlation between the degree of longitudinal weight change and ESRD (hazard ratio 3.61, 2.15, 1.86 and 3.66, for group 1, 2, 4 and 5, respectively) and composite of CVD and death (hazard ratio 2.92, 2.15, 1.73 and 2.54, respectively), when compared to the reference group 3. The U-shape correlation was most prominent in the subgroup of estimated glomerular filtration rate <45mL/min/1.73m2. Both rapid weight gain and weight loss are associated with high risk of adverse outcomes, particularly in the advanced CKD.

Rapid Weight Change Following Heart Transplantation is Associated with Adverse Outcomes: An Analysis of the ISHLT Transplant Registry

<h3>Purpose</h3> Substantial total body weight (TBW) gain is frequently observed after heart transplant (HT), but little is known about the effect of the rate of weight change on outcomes. We assessed the pattern of post-HT change in TBW and its impact on outcomes. <h3>Methods</h3> Post-HT changes in TBW, fat mass (FM) and fat-free mass (FFM) were examined for 15,182 adult recipients in the ISHLT Registry transplanted between 1996 and 2016 who survived to 1 year and for whom serial body weight data were recorded. Patients were stratified into quartiles of 1-year TBW percent change. Endpoints included treated rejection (TR), cardiac allograft vasculopathy (CAV), and all-cause mortality. <h3>Results</h3> TBW gain was seen in a large number of patients after HT, such that the proportion of obese patients increased from 21% at HT to 30% at 1 year after HT (<i>p</i> <0.05). FM, rather than FFM, was responsible for most of the TBW change (Figure 1A). Lower freedom from CAV, TR, and higher mortality were seen in patients in the upper quartile of TBW change in unadjusted survival analyses (Figure 1B-D) and after adjustment in multivariable analysis - HR=1.37, p<0.001 for TR, HR=1.24, p<0.001 for CAV and HR=1.15, p=0.02 for mortality. Gain in FM was predominantly responsible for the increased risk, and this risk associated with weight gain was independent of absolute weight attained. <h3>Conclusion</h3> A large proportion of HT recipients are at risk of weight gain. Significant weight gain in the first year after transplant is associated with a risk of adverse outcomes, independent of absolute weight or BMI. Mitigation of the rate of weight gain, and especially the FM contribution to weight gain, could reduce post-transplant morbidity and mortality.

Combined effects of weight change trajectories and eating behaviors on childhood adiposity status: A birth cohort study

Previous studies have suggested that infant rapid weight change can be associated with an increased weight later in life. However, the weight change trajectory in early life over time and which childhood lifestyle behaviors may modify the risk of rapid weight change have not been characterized. Using our ongoing birth cohort study, we have addressed these issues. Nine follow-up time points (birth, 3, 6, 9, 12, 18, 24, 36, and 48 months) were used to calculate the change between two adjacent weight-for-age z-scores (WAZ-change), and then WAZ-change trajectories were defined via group-based trajectory modeling. The solitary, independent and combined effects of WAZ-change trajectories and each lifestyle factor (eating behaviors, physical activity, media exposure time and total sleep duration) on childhood adiposity measures at age 4 years were determined using multivariate regression analysis. Overall, 84 (38%) children had a steady growth trajectory from birth to 4 years, while the other 137 (62%) children had an early infancy rapid growth trajectory, particularly in the first three months. Compared to children with steady growth, children with early infancy rapid growth had a significantly higher body mass index, waist circumference, and subcutaneous fat. Moreover, weight change trajectory and three eating behaviors (i.e. food responsiveness, satiety responsiveness and food fussiness), not only had independent effects, but also combined (synergistic) effects on the majority of adiposity measures. Our results extend the current literature and provide a potentially valuable model to aid clinicians and health professionals in designing early-life interventions targeting specific populations, specific ages and specific lifestyle behaviors to prevent childhood overweight/obesity.

560 Postpartum transient elastography in patients with metabolic disorders of pregnancy

Nonalcoholic fatty liver disease (NAFLD) affects 30% of the U.S. and is a risk factor for cirrhosis, liver cancer, and is the leading cause for liver transplant among women. Physiologic estrogen fluctuations and rapid weight change in pregnancy may play important roles in NAFLD. Data regarding NAFLD in pregnancy, and its association with metabolic disorders in pregnancy, is limited. Transient elastography (TE)(Fibroscan) with continued attenuation parameter (CAP) is a noninvasive way to diagnose steatosis and liver stiffness/fibrosis. IRB approved prospective study in which TE and liver function tests were performed 1-2 days postpartum. CAP ≥300 was classified as significant steatosis. Elevated liver stiffness/fibrosis was defined as ≥7 kilopascals(KPA). Chi-square analysis was used to compare differences between groups. Univariate and bivariate logistic regression was used to determine significant predictors of elevated CAP and KPA. 91 patients were included: 20(22%) had gestational diabetes (GDM), 13(14%) had gestational hypertension (gHTN), and 15(17%) had preeclampsia (PEC). Women with these metabolic disorders of pregnancy were more likely to be Black, and undergo C-section, but had lower median weight gain (Table 1). Women with KPA≥7 were more likely to have ALT≥25, Type 2 diabetes, and PEC(p<0.05)(Table 2). Pre- and post-gravid BMI, and GDM were not associated with increased KPA. Overweight pregravid BMI, and chronic hypertension were associated with CAP≥300(p<0.05). GDM, PEC, and gHTN were not associated with CAP≥300. In logistic regression analysis, PEC(OR 4.32,p=0.033) and ALT>25(OR of 5.59,p=0.007) were associated with KPA≥7 independent of BMI. Women with preeclampsia and elevated ALT were more likely to have elevated postpartum liver stiffness. Pregravid BMI≥25 and ≥30 were associated with increased liver steatosis, although did not appear to impact liver stiffness. Consideration should be made for screening women with PEC and obesity for liver disease during pregnancy with potential for lifestyle intervention. Implementation of TE postpartum is feasible.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Effects of Initial Body Mass Index and Weight Change on All-Cause Mortality: A 10-Year Cohort Study in Korea.

We evaluated the effects of baseline body mass index (BMI) and its changes over 4 years on all-cause mortality in Korean population. We analyzed 351 735 participants whose BMI was measured in both 2002/2003 and 2006/2007. Mortality was assessed until 2013. Multivariate hazard ratios for all-cause mortality were estimated. Underweight and severe obesity with BMI >30 kg/m2 were significantly associated with higher mortality. Similarly, >5% decrease or >10% increase of BMI for 4 years was associated with the increased risk of death. Comparing the results between baseline BMI and BMI change, the BMI change showed more stable associations with mortality than the baseline BMI in subgroup analysis such as nonsmokers and healthy participants. This study suggests that BMI change could be a useful health indicator along with obesity level by BMI. In addition, maintaining a healthy weight is needed for longevity, but rapid weight change should be carefully monitored.

High intensity, short duration pulling in heavy horses: physiological effects of competition and rapid weight change

BackgroundThe Heavy Horse Pull is a competition where teams of two horses pull an increasingly heavy sled for a short distance. Similar to human wrestlers, some horses may undergo rapid weight change in order to enter a lower weight category. The objectives were to study the physiological effects of this practice as well as of the pulling competition in draft horses.ResultsFifty horses were divided into light-, middle- and heavyweight categories based on their arrival weights and competed 1–3 days after. Body weight was measured upon arrival and pre-competition. Blood was sampled for chemistry and high sensitivity cardiac troponin T (hscTnT) at arrival, pre- and post-competition in 34, 26 and 20 horses, respectively. Body weight increased significantly between arrival and pre-competition for light (7.2% (Median: 62.8Kg (41.7–77.0)) and middle (8.6% (Median: 80.5Kg (62.7–90.9)) weight categories. Change in body weight was correlated (r = 0.69, p = 0.002) with competition ranking for middleweights. The ratios of weight pulled to team body weight were 2.7 (1.9–2.8), 2.6 (2.5–2.6) and 2.4 (2.2–2.5) for the lightweights, middleweights and heavyweights, respectively. Blood chemistry indicated hemoconcentration on arrival in the middleweight and lightweight horses. Hemoconcentration was not seen on arrival in some horses with marked rapid weight change. Overall, no chemistry parameter changed between pre- and post-competition. The hscTnT stayed within normal range post-competition.ConclusionsWhile horses arrived to the event with indications of hemoconcentration, they appeared to have sufficient time to rehydrate prior to competition, and the effects of the competition were reversible within 3 h.

Laser and Light Treatments for Striae Distensae: A Comprehensive Review of the Literature.

Striae distensae (SD) are common dermatologic lesions that often arise as a result of rapid weight change, certain endocrine conditions, or prolonged exposure to steroids. SD initially present as raised edematous plaques (striae rubra), after which they become white and atrophic (striae alba) owing to local breakdown and reorganization of collagen and elastin. There currently exists no reliable treatment option, though numerous topical applications have been attempted. Lasers and light represent emerging noninvasive therapies that have demonstrated some success targeting vascular chromophores in striae rubra and stimulating collagen and elastin production in striae alba. An extensive literature review was performed to gather all available articles studying laser and light treatments for SD. Lasers and light can significantly improve the appearance of both striae rubra and striae alba. Generally, striae rubra are more responsive to therapy and can be treated successfully with a variety of lasers without major adverse effects. Fractional lasers exhibit the strongest results for striae alba repigmentation and collagen induction, and several other lasers produce temporary repigmentation. Lasers in combination with other modalities such as topical agents and additional energy devices have also demonstrated promising preliminary results; however, large comparative studies are necessary to validate these outcomes.

Preservation of Fat-free Mass after Bariatric Surgery: A Comparison of Malabsorptive and Restrictive Procedures

The Roux-en-Y gastric bypass (RYGB) has been shown to cause significant weight loss. However, fat-free mass (FFM) is often lost with this rapid weight change. It is suggested that the loss of FFM is minimized with restrictive-only procedures, such as the vertical sleeve gastrectomy (VSG), when compared with malabsorptive surgery. The purpose of the study was to determine the difference in the postoperative loss of FFM between RYBG and VSG patients. We reviewed all patients who underwent RYGB or VSG between May 2012 and January 2013. Patients were evaluated one month before their procedure and 12 months after for comparison of results. Preoperative and postoperative body analysis data were procured using a body composition analysis device. Within the study period, 33 patients underwent a RYGB procedure and 20 patients a VSG. After 12 months, RYGB patients had an average increase of 38.15 per cent in their proportion of FFM, whereas VSG patients had an average FFM increase of 22.09 per cent, a statically significant difference (P = 0.004). The RYGB helps preserve overall FFM as compared with the VSG. These findings are unexpected because malabsorptive procedures require increased protein intake, resulting in a stronger likelihood of inadequate protein intake, which may lead to protein malnutrition.

Tail autotomy and subsequent regeneration alter the mechanics of locomotion in lizards.

Animals can undergo significant weight change for a variety of reasons. Autotomy, the voluntary shedding of an appendage in response to a predator stimulus, provides an effective model for measuring the effects of rapid weight change on locomotor behavior and the responses to more gradual weight gain, particularly in lizards capable of both autotomizing and regenerating their tail. Although the general effects of autotomy on locomotor performance are commonly explored, we investigated changes in locomotor mechanics associated with tail loss and long-term regeneration for the first time by measuring morphology, 3D kinematics and ground reaction forces (GRFs) in the leopard gecko Eublepharis macularius. Tail autotomy resulted in a 13% anterior shift in the center of mass (CoM), which only partially recovered after full regeneration of the tail. Although no changes in body or forelimb kinematics were evident, decreases in hindlimb joint angles signify a more sprawled posture following autotomy. Changes in hindlimb GRFs resulted in an increase in weight-specific propulsive force, without a corresponding change in locomotor speed. Hindlimb kinematics and GRFs following autotomy recovered to pre-autotomy values as the tail regenerated. These results suggest an active locomotor response to tail loss that demonstrates the causal relationships between variations in morphology, kinematics and force.

Trajectory calculation of a trapped particle in electro-dynamic balance for study of chemical reaction of aerosol particles

Electrodynamic balance (EDB) is a powerful tool for investigating the chemical reactions between a fine particle and gaseous species. But the EDB device alone is inadequate to match the rapid weight change of a fine particle caused by chemical reactions, because it takes a few seconds to set a fine particle at null point. The particle trajectory calculation for the trapped particle added to the EDB is thus a very useful tool for the measurement of the transient response of a particle weight change with no need to adjust the applied DC voltage to set the null point. The purpose of this study is to develop the trajectory calculation method to track the particle oscillation pattern in the EDB and examine the possibility for kinetic studies on the reaction of a single aerosol particle with gaseous species. The results demonstrated the feasibility of applying particle trajectory calculation to realize the research purpose.

Impact of intense training and rapid weight changes on salivary parameters in elite female Taekwondo athletes

The aim of this study is to examine the cumulative effects of prolonged intensive training with or without rapid weight changes (RWC) on salivary parameters of elite female Taekwondo (TKD) athletes. Ten elite female Taiwanese TKD athletes (ages: 21.3 ± 1.2 years of age, Ht 164.4 ± 5.6 cm) volunteered to participate in this study. Resting saliva samples were collected at 28-, 14-, 7-, and 1 day before and 1-, 7-, 21 days after a national competition. The levels of salivary immunoglobulin A (sIgA), cortisol, and lactoferrin were measured. In analyzing the anthropometric data, we found that a significant proportion (50%) of elite female TKD athletes had RWC shortly before and after a national competition. The participants were allocated either to the RWC or to the non-RWC group according to their weight change profiles. Our results showed that levels of sIgA and cortisol of athletes with RWC were significantly modulated during the study period. However, athletes without RWC only showed reduced lactoferrin after competition. The results presented here demonstrate that intensive training in combination with RWC affects the mucosal immunity and disrupts the cortisol stress response of elite female TKD athletes.

A ‘Weight-Listing’ Paradox for Candidates of Renal Transplantation?

Research suggests that end-stage renal disease patients with elevated body mass index (BMI) have superior outcomes on dialysis. In contrast, low and high BMI patients represent the highest risk cohorts for kidney transplant recipients. The important question remains concerning how to manage transplant candidates given the potentially incommensurate impact of BMI by treatment modality. We conducted a retrospective analysis of waitlisted and transplanted patients in the United States from 1990 to 2003. We constructed Cox models to evaluate the effect of BMI on mortality of waitlisted candidates and identified risk factors for rapid weight change. We then assessed the impact of weight change during waitlisting on transplant outcomes. Decline in BMI on the waiting list was not protective for posttransplant mortality or graft loss across BMI strata. Substantial weight loss pretransplantation was associated with rapid gain posttransplantation. The highest risk for death was among listed patients with low BMI (13-20 kg/m(2), adjusted hazard ratio = 1.47, p < 0.01). Approximately one-third of candidates had a change in BMI category prior to transplantation. While observed declines in BMI may be volitional or markers of disease processes, there is no evidence that candidates have improved transplant outcomes attributable to weight loss. Prospective trials are needed to evaluate the efficacy of weight loss protocols for candidates of kidney transplantation.