Barrack, MT, Fredericson, M, Dizon, F, Tenforde, AS, Kim, BY, Kraus, E, Kussman, A, Singh, S, and Nattiv, A. Dietary supplement use according to sex and Triad risk factors in collegiate endurance runners. J Strength Cond Res 35(2): 404–410, 2021—This cross-sectional study evaluated the prevalence in the use of dietary supplements among elite collegiate runners among 2 NCAA Division I cross-country teams. At the start of each season from 2015 to 2017, male and female endurance runners were recruited to complete baseline study measures; the final sample included 135 (male n = 65, female n = 70) runners. Runners completed a health survey, web-based nutrition survey, and Triad risk assessment. The prevalence of dietary supplement use and Triad risk factors, including disordered eating, low bone mass, amenorrhea (in women), low body mass index, and stress fracture history, was assessed. A total of 78.5% (n = 106) runners reported taking 1 or more supplements on ≥4 days per week over the past month, 48% (n = 65) reported use of ≥3 supplements. Products used with highest frequency included multivitamin/minerals 46.7% (n = 63), iron 46.7% (n = 63), vitamin D 34.1% (n = 46), and calcium 33.3% (n = 45). More women, compared with men, used iron (61.4 vs. 30.8%, p < 0.001) and calcium (41.4 vs. 24.6%, p = 0.04); men exhibited higher use of amino acids and beta-alanine (6.2 vs. 0%, p = 0.04). Runners with bone stress injury (BSI) history, vs. no previous BSI, reported more frequent use of ≥3 supplements (61.5 vs. 32.8%, p = 0.001), vitamin D (49.2 vs. 19.4%, p < 0.001), and calcium (47.7 vs. 19.4%, p = 0.001). Low bone mineral density was also associated with higher use of vitamin D and calcium. Most runners reported regular use of 1 or more supplements, with patterns of use varying based on sex, history of BSI, and bone mass.
The ability to manipulate and customize the genetic code of living organisms has brought forth the production of genetically modified organisms (GMOs) and consumption of genetically modified (GM) foods. The potential for GM foods to improve the efficiency of food production, increase customer satisfaction, and provide potential health benefits has contributed to the rapid incorporation of GM foods into the American diet. However, GM foods and GMOs are also a topic of ethical debate. The use of GM foods and GM technology is surrounded by ethical concerns and situational judgment, and should ideally adhere to the ethical standards placed upon food and nutrition professionals, such as: beneficence, nonmaleficence, justice and autonomy. The future of GM foods involves many aspects and trends, including enhanced nutritional value in foods, strict labeling laws, and potential beneficial economic conditions in developing nations. This paper briefly reviews the origin and background of GM foods, while delving thoroughly into 3 areas: (1) GMO labeling, (2) ethical concerns, and (3) health and industry applications. This paper also examines the relationship between the various applications of GM foods and their corresponding ethical issues. Ethical concerns were evaluated in the context of the code of ethics developed by the Academy of Nutrition and Dietetics (AND) that govern the work of food and nutrition professionals. Overall, there is a need to stay vigilant about the many ethical implications of producing and consuming GM foods and GMOs.
Background The prevalence of dietary supplement intake among preadolescent endurance runners is currently unknown.Objective Our aim was to describe use of dietary supplements, higher-risk supplements, and sport foods among preadolescent endurance athletes and identify associated characteristics of dietary supplement users in this population.Design This was a retrospective, cross-sectional study. Participants/setting Participants were 2,113 preadolescent endurance runners (male: n ¼ 1,255, female: n ¼ 858; mean age AE standard deviation ¼ 13.2 AE 0.9 years).Main outcome measures Use of dietary supplements, higher-risk dietary supplements, and sport foods on 2 or more days per week during the past year. Statistical analyses performedMann-Whitney U tests, c 2 tests, univariate and multivariate analyses.Results Twenty-six percent (n ¼ 551) of preadolescent runners used dietary supplements on 2 or more days per week during the past year; 1.3% (n ¼ 27) reported taking higher-risk supplements. Compared with male runners, female runners reported higher use of 1 or more supplements (32.5% vs 21.7%; P < .001) and 4 or more supplements (4.0% vs 1.9%; P ¼ 0.005), multivitamin/minerals (24.2% vs 14.4%; P < .001), vitamin D (12.4% vs 5.6%; P < .001), calcium (8.9% vs 4.8%; P < .001), iron (3.1 vs 1.1%; P < .001), probiotic supplements (8.2% vs 1.3%; P < .001), and diet pills (0.5% vs 0.0%; P ¼ .02). Male runners reported higher use of creatine (1.3% vs 0.0%; P < .001) and sport foods, including protein bars and drinks (19.5% vs 8.4%; P < .001), energy bars (23.5% vs 9.7%; P < .001), and carbohydrate-electrolyte drinks (27.9% vs 13.3%; P < .001) than female runners. Factors independently associated with a higher likelihood for dietary supplement use included weight loss in the past year, female (vs male) gender, following a vegetarian diet, skipping meals, attempting to gain weight, and history of a runningrelated bone stress injury.Conclusions More than one-quarter of preadolescent runners regularly consumed dietary supplements. Behaviors consistent with dietary restriction and history of bone stress injury were associated with higher likelihood for supplement use. Further work to understand supplement use patterns and potential value for nutrition education is advised to optimize health of preadolescent runners.
BackgroundLow serum albumin and a high dietary phosphorus to dietary protein ratio (PPR) have been tied to malnutrition among maintenance hemodialysis (MHD) patients. In turn, malnutrition is an alarming risk factor for increased mortality amongst this population. The administration of high protein/high calorie meals during dialysis in tandem with modified nutrition education may help alleviate hypoalbuminemia and an elevated PPR. Research on these strategies is limited.MethodsAn 8‐week randomized control trial of 110 MHD participants (18 to 85 years, mean age = 54±15 SD, 48 males, 62 females) with serum albumin <4.0 g/dL from DaVita Dialysis centers in the greater Los Angeles area was conducted. The intervention group (n=55) was provided with high protein/high calorie meals during MHD as well as outpatient nutrition education that focused on lowering dietary phosphorus intake, while the control group (n=55) received low protein/low calorie meals and minimal nutrition education. Dietary intake data were collected from a 3‐day food diary or 24‐hour recall and meal intake forms during MHD treatment. Independent samples t‐tests were used to examine pre‐ and post‐study changes in 1) dietary intake in MHD patients expressed by PPR and 2) serum albumin, with a significance level of p ≤ 0.05.ResultsNo significant association was found between intervention (meal provision during MHD treatment and modified nutrition education) and serum albumin (t = −0.21, p = 0.84). While not significant at p ≤ 0.05, there was a near significant difference in changes in PPR (t = −1.71, p = 0.09) between the intervention and control groups. PPR was shown to decrease in the intervention group post‐study.ConclusionThis study found a near significant association between meal provision during MHD treatment combined with modified nutrition education and changes in PPR post‐study, but not with serum albumin levels. These results indicate a need for further studies of meal provision during MHD treatment as well as longer‐term studies on modified nutrition education in an effort to establish dietary behavior change and decrease PPR.Support or Funding InformationThis study was supported by the Los Angeles Biomedical Research Institute, as part of the Fosrenol for Enhancing Dietary Protein Intake in Hypoalbuminemic Dialysis Patients Study
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