The study evaluated the dietary habits in two groups of young athletes, practicing two different sports: soccer players and cycling. The dietary habits of 47 athletes were investigated by questionnaire. Body Mass Index, Fat Mass, Free Fat Mass, Total Body, Intracellular, Extracellular Water and Phase Angle were measured by bioimpedance. The t-Student test for unpaired data was used. Significance was set at P. I. INTRODUCTION Proper nutrition supports the achievement of optimum athletic performance.

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A balanced diet should ensure adequate caloric, macro- and micro-nutrients intake (, ). Especially in adolescent athletes, in addition to the energy requirements arising from exercise, appropriate dietary habits will be carried on to adulthood and in parallel in presence of physical activity, the risk of incorrect lifestyle can be reduced. Specific guidelines have been developed for athletes. Despite strong commercial pressure, physically active individuals generally do not need supplements in addition to a normal diet (, ). This study has been conducted in adolescent, practicing two popular sports and characterized by a different workload in terms of resistance and aerobic work load and with potential diverse training such as soccer players and cyclists.

The present investigation is aimed to evaluate their habits, using detailed medical history, to ascertain the knowledge of nutrition in sport and to verify adhesion to the recommendations of the Italian Nutrition Agency (Reference Levels of Nutrients identified by LARN) , and also to compare nutritional habits of these two groups of athletes, assessing any possible differences in energy intake, choice of food, and distribution of food intake. It has been also investigated the adherence to the reference levels of nutrients and energy for the Italian population. II. METHODOLOGY We studied two groups of elite athletes: 17 male cyclists aged between 14 and 16, belonging to four different teams with similar levels of competition and training loads, and 30 young soccer players from Fiorentina Football Club youth team, aged between 15 and 16. All athletes were training regularly and competing in national competitions for their age group.

The cyclists trained 11 months a year for an average of 3 hours per day in addition to competing during the racing season. The soccer players trained about 10 months a year, with a frequency of 4 sessions a week with a weekend game. The investigation was performed during the sports season.

All subjects underwent a full medical check up and were questioned extensively regarding food intake. They underwent bioimpedenziometry and answered a questionnaire on nutritional knowledge. None of them assumed nutritional supplements or ergogenic substances. Food habits analysis All the young athletes were invited to answer questions about the type of food, the portions and frequency of consumption of various foods and beverages, and the possible use of dietary supplements. We used a dedicated software (Winfood, Medimatica Srl; Colonella (Te)-Italy) to calculate the daily intake of macronutrients and micronutrients.

The quantification of food intake was undertaken using pictures of food depicted in different portions with known weights from a dedicated photographic archive. The software allowed to identify the following parameters:. Body composition analysis Body composition was analyzed using bioelectrical impedance to estimate the state of hydration, free fat mass and fat mass. The data were obtained according to the recommendations of the NIH Consensus Statement.

The measurements were carried out on the right side of the body through the tetra-polar device model 101S RJL system, through the bioelectrical method Vector impedance Akern srl Florence with an alternating electric current of 800 µA at a frequency of 50 kHz. All measurements were taken in a room with temperature of 22–24 °C. The data were processed through a software system to derive estimates of total body water, extracellular water, intracellular water, body cell mass and fat mass, expressed as weight in kilograms and percentage. The results obtained from the two groups were then compared.

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The values related to the desirable range for the body impedance analysis are reported in Table 1. Anthropometric and water distribution parameters All data are expressed as mean ± SD. No significant differences were found among the general characteristics of the two groups analyzed: the average weight of the cyclists was 4.9 kg less than the soccer players (cyclists 65.7 ± Kg 8.0; soccer player 70.6 ±6.5 Kg). Cyclists were also less tall (cyclists 174.8 ±7.4 cm; soccer players 177.8 ± 6.4 cm). The Body Mass Index was within normal range , and no significant differences (soccer players 22.3 ± 0.9Kg.m −2; cyclists 21.46 ± 2.0) were found between the two groups of athletes. Bioelectrical impedance analysis data are reported in Table 2. The average value of phase angle derived from the ratio between resistance and reactance, whose normal values range between 6 and 9, is significantly different between the two groups of athletes (soccer players 7.1±0.5; cyclists 7.3±0.6 p.

Evaluation of the food intake Caloric intake and consumption of macronutrients in the two groups as well as the recommended percentages are reported in Table 3, while the profile of fat intake and micronutrients such as minerals and vitamins intake are reported in Tables 4. Calcium intake is low in both groups, but especially in the cyclists, whose ingestion is about half of what recommended. Potassium intake is below the LARN in soccer players but not in cyclists (Table 5). Both groups show insufficient daily intake of folic acid and vitamin B6, and extremely high intake of Vitamin C in soccer players (Table 4). The daily energy intake and meal distribution were comparable between the two groups. Most athletes showed a balanced energy intake between main meals and snacks, except for breakfast, which results to be appropriate for the nutrients and with a good choice of foods, but scarce from the point of view of energy intake (Table 5). Comparing the annual distribution of energy components, cyclists consumed large amounts of carbohydrates, especially complex carbohydrates, and proteins; on the other hand, soccer players had a greater fat intake.

There were no differences in dietary habits between the two types of sport. IV. CONCLUSION Nutritional and eating habits have been of particular interest in sports, especially given their effects on athletic performance (,). General recommendations need to be adjusted by sports nutrition experts to accommodate the unique concerns of individual athletes regarding health, sports, nutrient needs, food preferences, and body weight and body composition goals (,). Investigations on dietary and nutritional habits play an important role in the analysis of athletes’ lifestyle. Questionnaires are commonly used to ascertain the adherence to recommendations. The present investigation should be considered a pilot study. Nevertheless, the results suggest that teenage athletes tend to adhere to the international guidelines on nutrition (, ).

Nutritional issues seem to be of great importance in younger athletes. The average caloric intake of all athletes was slightly lower than the estimated requirements, while the intake of macro and micronutrients was in agreement with the relevant guidelines (, ).

In both groups, the amount of vitamins and minerals, with the exception of folic acid was higher than the recommended requirements. The consumption of fruit and vegetables was adequate, and in agreement with the recommendations for the general population. Body composition data were different between the two groups of athletes studied, particularly if hydration status is considered Despite the broadly similar food intake and daily meal distribution, the differences could be attributed to the diverse type of sport practiced and therefore to the impact that sports training can exert on anthropometrics variables (, ). These anthropometrics parameters are partially in contrast with the data normally reported in the literature.

We however underline that the population investigated was composed of non-professional athletes. In addition they were young athletes, not yet completely mature, and therefore the differences in the body composition can be attributed to this aspect. Further investigations involving several types of different sports and larger samples will be needed to confirm and extend our knowledge on these preliminary aspects of the relationship between food intake and sport activity.

Also, female athletes should be investigated. Some other aspects about a possible association between nutrition and cardiovascular performance may be useful, as would be the evaluation of the prevalence and incidence of musculoskeletal injuries in the presence of specific eating habits.

Objective: To establish the accuracy of bioelectrical impedance analysis (BIA) for the assessment of total and appendicular body composition in peritoneal dialysis (PD) patients. Design: Cross-sectional study. Setting: University Nephrology Clinic. Subjects: In all, 20 PD patients and 77 healthy controls matched for gender, age and body mass index. Methods: Whole-body fat-free mass (FFM) and appendicular lean tissue mass (LTM) were measured by dual-energy X-ray absorptiometry. Resistance ( R) of arms, trunk and legs was measured by eight-polar BIA at frequencies of 5, 50, 250 and 500 kHz. Whole-body resistance was calculated as the sum of R of arms, trunk and legs.

The resistance index (RI) was calculated as the ratio between squared height and whole-body or segmental R. Results: RI at 500 kHz was the best predictor of FFM, LTM arm and LTM leg in both PD patients and controls.

Equations developed on controls overestimated FFM and LTM arm and underestimated LTM leg when applied to PD patients. Specific equations were thus developed for PD patients. Using these equations, the percent root mean-squared errors of the estimate for PD patients vs controls were 5 vs 6% for FFM, 8 vs 8% for LTM arm and 7 vs 8% for LTM leg.

Conclusion: Eight-polar BIA offers accurate estimates of total and appendicular body composition in PD patients, provided that population-specific equations are used. Sponsorship: University of Modena and Reggio Emilia.

The body composition of peritoneal dialysis (PD) patients may differ substantially from that of healthy individuals of the same age and gender. PD patients may have in fact a lower total body potassium, a lower total body nitrogen, and a lower or higher extra- to intracellular water ratio as compared to healthy individuals (;,; ). These abnormalities render many body composition methods inadequate for the study of PD patients. An assessment of body composition is nonetheless important in PD patients because protein-energy malnutrition is a strong predictor of morbidity and mortality in dialysis patients (;; ). Dual-energy X-ray absorptiometry (DXA) is presently regarded as the most practical means of obtaining an accurate assessment of fat-free mass (FFM) and fat mass (FM) in dialysis patients.

The three-compartment DXA model separates body mass into FM, lean tissue mass (LTM) and bone mineral content (BMC), with the sum of LTM and BMC representing FFM. At the appendicular level, LTM is synonym with muscle mass so that DXA provides also a means of evaluating arm and leg muscularity. Interestingly, clinically stable PD patients may have a lower appendicular LTM than healthy controls.

A major limitation of DXA is, however, that it cannot be employed outside of specialized centers because of technical and logistical constraints. Bioelectrical impedance analysis (BIA) is a portable technique that has been crossvalidated against DXA for the assessment of FFM in PD patients (;,; ). In healthy subjects, segmental BIA has been shown to offer accurate estimates of appendicular body composition (,; ). However, segmental BIA has never been evaluated for the assessment of appendicular muscle mass in PD patients. Eight-polar BIA is a recently introduced technique with three interesting characteristics: (1) the use of very practical tactile electrodes, (2) the absence of need to standardize subject's posture before BIA, and (3) the rapidity of measurement. We have shown that eight-polar BIA offers accurate estimates of total body water, extracellular water, FFM and appendicular LTM in healthy and obese subjects (;; ).

The present study aimed to establish the accuracy of eight-polar BIA for the assessment of whole-body FFM and appendicular LTM in PD patients. Subjects In all, 20 patients with chronic kidney disease treated by continuous ambulatory PD were consecutively studied at the Peritoneal Dialysis Unit of the Nephrology Clinic of Modena and Reggio Emilia University (Modena, Italy). PD treatment had been started at a median of 119 (range: 58–684) days before the enrollment into the study. All patients were performing four cycles of PD every day, three during day and one at night, with a dextrose-based dialysis solution. A total of 77 healthy individuals matched for age, gender and BMI with PD patients, recruited among the personnel of the University, served as controls. All measurements were performed in the morning after an overnight fast (≥8 h). PD patients were measured with the dialysis solution in the peritoneum, coherently with their treatment program.

Fertile women were measured between the 6th and 10th day of the menstrual cycle. The study procedures had been approved by the local Ethical Committee and all subjects gave informed consent. Anthropometry All anthropometric measurements were performed by the same operator following the Anthropometric Standardization Reference Manual.

Weight (Wt) was measured to the nearest 0.01 kg and height (Ht) to the nearest 0.001 m. BMI was calculated as Wt (kg)/Ht (m) 2.

Eight-polar BIA The resistance ( R) of arms, trunk and legs was measured at frequencies of 5, 50, 250 and 500 kHz with an eight-polar tactile-electrode impedance meter (InBody 3.0, Biospace, Seoul, Korea). This instrument makes use of eight tactile electrodes: two are in contact with the palm (E1, E3) and thumb (E2, E4) of each hand and two with the anterior (E5, E7) and posterior aspects (E6, E8) of the sole of each foot. The subject stands with her or his soles in contact with the foot electrodes and grabs the hand electrodes. The sequence of measurements, controlled by a microprocessor, proceeds as follows. An alternating current (a.c.) of 250 μA of intensity ( I) is applied between E1 and E5. The recorded voltage difference ( V) between E2 and E4 is divided for I to obtain the resistance of the right arm ( R RA).

The same sequence is performed with V recorded between E4 and E8 to obtain trunk resistance ( R T) and with V recorded between E6 and E8 to obtain the resistance of the right leg ( R RL). Is then applied between E3 and E7 and the value of V measured between E2 and E4 is used to calculate the resistance of the left arm ( R LA).

Lastly, the value of V measured between E6 and E8 is used to calculate the resistance of the left leg ( R LL). No caution was taken to standardize the posture of the subjects before BIA, as suggested by the manufacturer. Whole-body resistance at frequency x ( R sum x) was calculated as the sum of segmental R x (right arm+left arm+trunk+right leg+left leg). The whole-body resistance index (RI sum x) was calculated as Ht (cm) 2/ R sum x (Ω), the arm resistance index (RI arm x) as Ht (cm) 2/ R arm x (Ω) and the leg resistance index (RI leg x) as Ht (cm) 2/ R leg x (Ω). Mean values of appendicular LTM and RI were used due to the absence of significant RI × hemisome interactions in the relationship between body composition and RI in both PD patients and controls.

The within-day precision of InBody in three PD patients and five controls was ≤2.0%. DXA DXA scans were performed by the same operator using a Lunar DPX-L densitometer and adult software version 3.6 (Lunar Corporation, Madison, WI, USA). The precision of whole-body LTM and BMC assessment, as determined by three repeated weekly measurements on three healthy subjects, was 2.5 and 1.0%, respectively. Delta 1010 drivers linux.

In the same subjects, the precision of appendicular LTM assessment was ≤2.5% and that of FM was 2.0%. The difference between body mass measured by DXA and Wt measured by scale in the pooled sample was −1.0±1.0 kg. In spite of its statistical significance ( P. The measurements of PD patients and controls are given in. As a result of the matching procedure, gender ( P=0.999), age ( P=0.947) and BMI ( P=0.773) were similar in PD patients and controls. Even if PD patients were lighter ( P=0.034) and shorter ( P=0.0007) than controls, their FFM ( P=0.524), LTM arm ( P=0.442) and LTM leg ( P=0.179) were similar to those of controls. FM was lower in PD patients than controls, but the difference did not reach statistical significance ( P=0.081).

At all frequencies, R sum, R arm and R leg were lower in PD patients than in controls (values of R at 500 kHz are given in ). The variance of FFM, LTM arm and LTM leg explained by R and RI is given in. As expected from electrical theory , the variance of FFM, LTM arm and LTM leg explained by R and RI increased for increasing frequencies. Even if R was a more accurate predictor of body composition in PD patients than in controls, the accuracy of RI was similar in PD patients and controls. On balance, the best predictions of total and appendicular body composition were obtained from RI 500 in both PD patients and controls. As compared to RI sum500, Wt explained 51% less variance of FFM in PD patients ( R adj 2=0.41, P=0.003) and 32% less in controls ( R adj 2=0.60, P. When the algorithms developed on controls were applied to PD patients, they overestimated FFM (4.1±3.4 kg, mean±s.d., P.

In this study, we evaluated the accuracy of eight-polar BIA for the assessment of whole-body FFM and appendicular LTM in PD patients. BIA was crossvalidated against DXA, which allows an accurate assessment of body composition in dialysis patients. The use of DXA is nonetheless restricted to selected centers because of technical and logistical reasons. On the contrary, BIA is portable and can be employed in field studies of body composition. The body composition of our PD patients was not significantly different from that of healthy subjects of the same age, sex and body mass index.

The FFM:Wt ratio tended, however, to be higher in PD patients than in controls (76±9 vs 72±9, P=0.075), partly because of the lower FM ( P=0.081). The fact that our patients were undergoing PD from a median of only 4 months may partly explain why we were not able to detect gross differences in body composition between PD patients and controls. Patients undergoing PD from longer periods have been in fact found to have lower whole-body FFM, appendicular LTM and higher FM than healthy controls.

Interestingly, the values of whole-body and segmental R were lower in PD patients than in controls at all frequencies. As R is inversely related to TBW , this can be taken as indirect evidence of TBW expansion in PD patients, at least as compared to controls. This may have contributed to the higher FFM:Wt ratio of PD patients in addition to their lower FM. As in our previous studies of eight-polar BIA (;; ), R and RI were highly associated with total and appendicular body composition and the strength of this association increased with increasing frequencies. The fact that R was a better predictor of body composition in PD patients than in controls was unexpected, but may be partly explained by a different interindividual variability in body composition between PD patients and controls.

For instance, the coefficient of variation of FFM was lower in PD patients than in controls (16 vs 21%). RI was, however, an equally accurate predictor of body composition in PD patients and controls and was clearly the best indicator of body composition in the two groups. We consider of great importance the fact that RI (and to some extent R) was superior to Wt as a predictor of FFM and that Wt did not add to the prediction of FFM obtained from RI. A critique correctly raised to BIA is in fact that it should contribute to the estimate of body composition substantially more than Wt or other anthropometric parameters.

The present study extends to PD patients our previous demonstration of the superiority of eight-polar BIA to Wt in the prediction of body composition in healthy and obese individuals (;; ). It is also of some interest that Wt explained only 41% of the variance of FFM in PD patients as compared to a value of 60% in controls. This finding suggests that Wt is a less adequate indicator of body composition in PD patients than it is in healthy subjects and highlights the potential of BIA for the assessment of body composition in disease states. The relationships between RI 500 and total and appendicular body composition were different in PD patients and controls, as shown by different regression slopes and by the overestimation of FFM and LTM arm and the underestimation of LTM leg observed when the equations developed on controls were applied to PD patients.

However, using population-specific algorithms, the accuracy of the estimate was similar in PD patients vs controls, as shown by values of RMSE% of 5 vs 6% for FFM, 8 vs 8% for LTM arm and 7 vs 8% for LTM leg. More importantly, also the individual bias was similar in patients vs controls, with values of 0.0±2.3 vs 0.0±3.0 kg for FFM, 0.0±0.2 vs 0.0±0.2 kg for LTM arm and 0.0±0.5 vs 0.0±0.7 kg for LTM leg. As is true of every predictive algorithm , the equations developed in this study should undergo crossvalidation in external samples before being employed for research purposes. Such crossvalidation should consider that these algorithms were developed in patients undergoing PD from only few months and whose body composition did not differ substantially from that of healthy subjects of the same age and sex. In conclusion, eight-polar BIA provides accurate estimates of total and appendicular body composition in PD patients. These estimates are as accurate as those obtained in healthy subjects. However, population-specific equations have to be employed for this purpose.

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