Solfrid Bratland-Sanda

Dieting to win or to be thin? A study of dieting and disordered eating among adolescent elite athletes and non-athlete controls

Objective: To examine the prevalence of dieting, reasons for dieting and prevalence of disordered eating among adolescent elite athletes and age-matched controls, and to examine the differences between athletes competing in leanness and non-leanness sports. Methods: First-year students of 16 different Norwegian Elite Sport High Schools (athlete group, nu200a=u200a682) and two randomly selected ordinary high schools from a county representative of the general Norwegian population (control group, nu200a=u200a423) were invited to participate in this cross-sectional study. A total of 606 athletes and 355 controls completed the questionnaire, giving a response rate of 89% and 84%, respectively. The questionnaire contained questions regarding training patterns, menstrual status and history, dieting, use of pathogenic weight control methods and the drive for thinness (DT) and body dissatisfaction (BD) subscales from the Eating Disorders Inventory. Main outcome measure: Disordered eating, defined as meeting one or more of the following criteria: DT score ⩾15 (girls) and ⩾10 (boys), BD score ⩾14 (girls) and ⩾10 (boys), body mass index <17.9 kg/m2 (girls) and <17.5 kg/m2 (boys), current and/or ⩾3 previous efforts to lose weight, use of pathogenic weight control methods and self-reported menstrual dysfunction. Results: A higher prevalence of control subjects were dieting and classified with disordered eating compared with the athletes. An improvement of appearance was a more common reason for dieting among controls compared with athletes. No differences in dieting or disordered eating were found between leanness and non-leanness sports athletes. Conclusions: Self-reported disordered eating is more prevalent among controls than adolescent elite athletes, and losing weight to enhance performance is an important reason for dieting among adolescent elite athletes.

Eating disorders in athletes: Overview of prevalence, risk factors and recommendations for prevention and treatment

Abstract The prevalence of disordered eating and eating disorders vary from 0–19% in male athletes and 6–45% in female athletes. The objective of this paper is to present an overview of eating disorders in adolescent and adult athletes including: (1) prevalence data; (2) suggested sport- and gender-specific risk factors and (3) importance of early detection, management and prevention of eating disorders. Additionally, this paper presents suggestions for future research which includes: (1) the need for knowledge regarding possible gender-specific risk factors and sport- and gender-specific prevention programmes for eating disorders in sports; (2) suggestions for long-term follow-up for female and male athletes with eating disorders and (3) exploration of a possible male athlete triad.

Physical activity and exercise dependence during inpatient treatment of longstanding eating disorders: An exploratory study of excessive and non‐excessive exercisers

OBJECTIVEnTo describe changes in physical activity (PA) and exercise dependence score during treatment of eating disorders (ED), and to explore correlations among changes in PA, exercise motivation, exercise dependence score and ED psychopathology in excessive and non-excessive exercisers.nnnMETHODnThirty-eight adult females receiving inpatient treatment for anorexia nervosa, bulimia nervosa or ED not otherwise specified participated in this prospective study. Assessments included accelerometer assessed PA, Exercise Dependence Scale, Reasons for Exercise Inventory, ED Examination, and ED Inventory.nnnRESULTSnAmount of PA was significantly reduced in non-excessive exercisers during treatment, in excessive exercisers there was a trend towards reduced amount of PA from admission to discharge. In excessive exercisers, reduced ED psychopathology was correlated with reduction in exercise dependence score and perceived importance of exercise to regulate negative affects, but not with importance of exercise for weight/appearance. These associations were not found in non-excessive exercisers.nnnDISCUSSIONnExcessive exercise is an important issue in longstanding ED, and the excessive exercising patients need help to develop alternative strategies to regulate negative affects.

I'm not physically active - I only go for walks: physical activity in patients with longstanding eating disorders.

OBJECTIVEnTo examine self reported versus objectively assessed moderate-to-vigorous physical activity (MVPA), and different reasons for exercise, in patients with longstanding eating disorders (ED) when compared with controls.nnnMETHODnInpatient females (n = 59, mean 30.1 years) and nonclinical age matched controls (n = 53, mean 31.3 years) accepted participation in this cross sectional study. Instruments included accelerometer ActiGraph, physical activity diary, Reasons for Exercise Inventory, and Eating Disorders Examination interview.nnnRESULTSnSelf reported and objectively assessed MVPA were higher across all ED diagnoses when compared with controls. The patients self reported MVPA was lower than the objectively assessed MVPA; no difference was found in controls. Regulation of negative affects, not weight/appearance, was a more important, whereas fitness/health was a less important reason for exercise in patients than controls.nnnDISCUSSIONnThe underreporting of MVPA in some patients with ED may warrant clinical attention.

Symptoms of eating disorders, drive for muscularity and physical activity among Norwegian adolescents.

PURPOSEnThe aim of this study was to examine symptoms of eating disorders (ED), drive for muscularity and physical activity in a Norwegian adolescent population.nnnMETHODSnA total of 722 adolescents aged 12-18u2009years (response rate: 83%) filled out a questionnaire containing the Drive for Muscularity Scale, Eating Disorders Inventory subscales Drive for Thinness (EDI-DT), Body Dissatisfaction (EDI-BD) and Bulimia (EDI-B), and questions about amount of and motives for physical activity.nnnRESULTSnEating Disorders Inventory subscale scores were higher, and Drive for Muscularity Scale Score (DMS) scores were lower among girls compared with boys. EDI and DMS were correlated with motives for, but not amount of, physical activity. EDI and DMS were associated in boys, not girls.nnnDISCUSSIONnThe associations between EDI and DMS among boys call for a wider approach when examining ED among boys.

Urinary incontinence among group fitness instructors including yoga and pilates teachers

Controversies exist on the role of physical activity on urinary incontinence (UI), and search on PubMed revealed no studies on UI in fitness instructors. The aim of this study was to investigate the prevalence of UI among female group fitness instructors, including Pilates and yoga teachers.

Exercise dependence score in patients with longstanding eating disorders and controls: The importance of affect regulation and physical activity intensity

OBJECTIVEnTo examine associations among exercise dependence score, amount of physical activity and eating disorder (ED) symptoms in patients with longstanding ED and non-clinical controls.nnnMETHODSnAdult female inpatients (nu2009=u200959) and 53 age-matched controls participated in this cross sectional study. Assessments included the eating disorders examination, eating disorders inventory, exercise dependence scale, reasons for exercise inventory, and MTI Actigraph accelerometer.nnnRESULTSnPositive associations were found among vigorous, not moderate, physical activity, exercise dependence score and ED symptoms in patients. In the controls, ED symptoms were negatively associated with vigorous physical activity and not correlated with exercise dependence score. Exercise for negative affect regulation, not weight/appearance, and amount of vigorous physical activity were explanatory variables for exercise dependence score in both groups.nnnCONCLUSIONSnThe positive associations among exercise dependence score, vigorous physical activity and ED symptoms need proper attention in the treatment of longstanding ED.

Improved VO2max and time trial performance with more high aerobic intensity interval training and reduced training volume: a case study on an elite national cyclist.

Abstract Støren, Ø, Bratland-Sanda, S, Haave, M, and Helgerud, J. Improved V[Combining Dot Above]O2max and time trial performance with more high aerobic intensity interval training and reduced training volume: a case study on an elite national cyclist. J Strength Cond Res 26(10): 2705–2711, 2012—The present study investigated to what extent more high aerobic intensity interval training (HAIT) and reduced training volume would influence maximal oxygen uptake (V[Combining Dot Above]O2max) and time trial (TT) performance in an elite national cyclist in the preseason period. The cyclist was tested for V[Combining Dot Above]O2max, cycling economy (Cc), and TT performance on an ergometer cycle during 1 year. Training was continuously logged using heart rate monitor during the entire period. Total monthly training volume was reduced in the 2011 preseason compared with the 2010 preseason, and 2 HAIT blocks (14 sessions in 9 days and 15 sessions in 10 days) were performed as running. Between the HAIT blocks, 3 HAIT sessions per week were performed as cycling. From November 2010 to February 2011, the cyclist reduced total average monthly training volume by 18% and cycling training volume by 60%. The amount of training at 90–95% HRpeak increased by 41%. V[Combining Dot Above]O2max increased by 10.3% on ergometer cycle. TT performance improved by 14.9%. Cc did not change. In conclusion, preseason reduced total training volume but increased amount of HAIT improved V[Combining Dot Above]O2max and TT performance without any changes in Cc. These improvements on cycling appeared despite that the HAIT blocks were performed as running. Reduced training time, and training transfer from running into improved cycling form, may be beneficial for cyclists living in cold climate areas.

Physical activity in treatment units for eating disorders: Clinical practice and attitudes

Objective: Physical activity (PA) in eating disorders (ED) may be harmful, but in a therapeutic setting also beneficial. The purpose of this survey was to examine these contradictory aspects of PA in ED specialist treatment settings. We examined whether 1) PA is assessed by the unit, 2) the units have guidelines for managing excessive PA, 3) the units have staff with higher education and special competence in PA and exercise science, 4) how units regard PA in ED, 5) whether regular PA is integrated in the treatment programs, and 6) how the units rate the role of PA in the treatment of ED compared with other mental disorders. Methods: Of the 49 units located in Scandinavia and the United Kingdom, 41 (84%) responded to a questionnaire. Results: In 28 units (68%) PA was assessed regularly. Excessive PA was considered a harmful symptom in ED, and most units reported guidelines to manage excessive PA. Thirty-two units included PA in their treatment programmes. Clinicians found PA most relevant in the treatment of obesity and, except for binge eating, less for ED. Conclusion: PA was more commonly integrated in treatment compared to previous studies. Future research should address how to manage excessive PA, and the potential beneficial role of PA in the treatment of ED.

High-intensity aerobic interval training improves aerobic fitness and HbA1c among persons diagnosed with type 2 diabetes

PurposeIt remains to be established how high-intensity aerobic interval training (HAIT) affects risk factors associated with type 2 diabetes (TD2). This study investigated effects of HAIT on maximal oxygen uptake (VO2max), glycated Hemoglobin type A1C (HbA1c), insulin resistance (IR), fat oxidation (FatOx), body weight (BW), percent body fat (%BF), lactate threshold (LT), blood pressure (BP), and blood lipid profile (BLP) among persons with T2D. Results were compared to the effects after a moderate-intensity training (MIT) program.MethodsThirty-eight individuals with T2D completed 12xa0weeks of supervised training. HAIT consisted of 4u2009×u20094xa0min of walking or running uphill at 85–95% of maximal heart rate, and MIT consisted of continuous walking at 70–75% of maximal heart rate.ResultsA 21% increase in VO2max (from 25.6 to 30.9xa0mlxa0kg−1xa0min−1, pu2009<u20090.001), and a reduction in HbA1c by −0.58% points (from 7.78 to 7.20%, pu2009<u20090.001) was found in HAIT. BW and body mass index (BMI) was reduced by 1.9% (pu2009<u20090.01). There was a tendency towards an improved FatOx at 60% VO2max (14%, pu2009=u20090.065). These improvements were significant different from MIT. Both HAIT and MIT increased velocity at LT, and reduced %BF, waist circumference, hip circumference, and BP, with no significant differences between the two groups. Correlations were found between change in VO2max and change in HbA1c when the two intervention groups were combined (Ru2009=u2009−0.52, pu2009<u20090.01).ConclusionHAIT is an effective exercise strategy to improve aerobic fitness and reduce risk factors associated with T2D.