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Objective: The objectives of the study were (1) to assess whether resting energy expenditure (REE) equations have comparable validity for adolescents with overweight/obesity vs. adolescents with healthy weight and (2) to examine determinants of measured REE in adolescents with overweight/obesity vs. adolescents with healthy weight. Methods: Ten equations were used to predict REE for 109 adolescents (70% males; 36.7% with overweight/obesity); 95% equivalence testing was used to assess how well each equation agreed with the criterion measure of indirect calorimetry. Linear regression models were fitted to examine how much REE variance was accounted for by age, sex, race, fat-free mass (FFM), and fat mass. Results: For adolescents with healthy weight, all ten equations were significantly equivalent to the criterion measure within ±8.4% ( p < 0.05), whereas for participants with overweight/obesity, only three equations were equivalent within the same range ( p < 0.05). Controlling for age, sex, race, fat mass, and FFM accounted for 74% of REE variance. FFM explained the greatest amount (26%) of variance in REE, while weight status itself explained an additional 22%. Conclusions: Prediction equations tend to be more accurate for adolescents with healthy weight than adolescents with overweight/obesity unless the original sample specifically included participants with overweight/obesity. Determinants of REE are similar regardless of weight status.

Abstract: Tinsley, GM, Meyer, MK, Ptak, SM, Yu, D, Provost, JA, Hansen, NJ, and Carbuhn, AF. Body composition changes over a collegiate playing career in NCAA Division I women's soccer players. J Strength Cond Res 39(1): e40-e55, 2025-Although body composition is known to influence success in organized sport, the longitudinal body composition changes produced by sport specialization are not well characterized for women's soccer. To address this need, this study reports the body composition changes of NCAA Division I women's soccer players over their entire collegiate playing career. Serial dual-energy x-ray absorptiometry (DXA) scans were performed throughout players' involvement in collegiate women's soccer. Analyses of all players with multiple DXA scans (n = 80) and players with ≥3 years of DXA data (n = 17) were performed using linear mixed-effects models that included effects of time, playing position, game minutes, and interactions. In all athletes (n = 80; 2.1 ± 1.2 years of participation), significant increases in bone mass (1.4%), total lean mass (1.7%), and fat-free mass index (0.3 kg·m-2) occurred. These changes coincided with increased arm and leg bone mass, increased lean mass in all regions, and decreased body fat percentage and leg fat mass. In athletes with ≥3 years of collegiate data (n = 17; 3.5 ± 0.4 years of participation), larger increases in bone mass (3.0%), bone mineral density (2.2%), total lean mass (2.5%), fat-free mass index (0.4 kg·m-2), and segmental bone and lean mass were observed. Larger decreases in body fat percentage and leg fat mass were also noted. Although playing position was related to body composition characteristics, changes in outcomes were generally unrelated to position or game minutes. In summary, beneficial changes in multiple aspects of body composition were observed over years of participation in a collegiate women's soccer program., (Copyright © 2024 National Strength and Conditioning Association.)

Abstract: Dengel, DR, Studee, HR, Juckett, WT, Bosch, TA, Carbuhn, AF, Stanforth, PR, and Evanoff, NG. Muscle-to-bone ratio in NCAA Division I collegiate football players by position. J Strength Cond Res 38(9): 1607-1612, 2024-The purpose of this study was to compare the muscle-to-bone ratio (MBR) in National Collegiate Athletic Association Division I football players (collegiate football players [CFP]) to healthy, age-matched controls. In addition, we examined MBR in CFP by position. A total of 553 CFP and 261 controls had their total and regional lean mass (LM), fat mass (FM), and bone mineral content (BMC) determined by dual x-ray absorptiometry (DXA). College football players were categorized by positions defined as offensive linemen (OL), defensive linemen (DL), tight end, linebacker (LB), running back (RB), punter or kicker, quarterback (QB), defensive back (DB), and wide receiver (WR). There were significant differences between CFP and controls for total LM (80.1 ± 10.0 vs. 56.9 ± 7.8 kg), FM (22.2 ± 12.5 vs. 15.2 ± 7.1 kg), and BMC (4.3 ± 0.5 vs. 3.1 ± 0.5 kg). Although there were significant differences in body composition between CFP and controls, there was no significant differences in total MBR between CFP and controls (18.6 ± 1.4 vs. 18.8 ± 1.7). Regionally, CFP had significantly lower trunk MBR than controls (26.7 ± 2.7 vs. 28.7 ± 4.2), but no difference was seen in leg or arm MBR. Positional differences in CFP were noted as total MBR being significantly higher in DL (19.0 ± 1.4) than in DB (18.1 ± 1.3), WR (18.1 ± 1.3), and LB (18.2 ± 1.3). OL had a significantly higher total MBR (19.2 ± 1.3) than DB (18.1 ± 1.3), LB (18.2 ± 1.3), QB (18.1 ± 1.0), and WR (18.1 ± 1.3). In addition, RB had significantly higher total MBR (18.8 ± 1.3) than DB (18.1 ± 1.3) and WR (18.1 ± 1.3). This study may provide athletes and training staff with normative values when evaluating total and regional MBR with DXA., (Copyright © 2024 National Strength and Conditioning Association.)

Background: Frequent soccer heading negatively affects brain health. Omega-3 fatty acids are neuroprotective against head impacts. A biomarker of omega-3 tissue status, red blood cell (RBC) omega-3 content is reduced during soccer activity. However, whether these changes are associated with frequent heading impacts is unknown. Aim: Explore the association between soccer heading frequencies and RBC omega-3 status. Methods: A prospective cohort study in collegiate women soccer players ( n   =  16). Players' RBC omega-3 status, Omega-3 Index, and self-reported gameplay header frequencies collected during a competitive season. Results: Mean Omega-3 Index (i.e., pre/postseason) was low (3.95  ±  0.44%). Postseason Omega-3 Index negatively correlated ( r   =  -0.545, p   =  0.029) with heading frequencies. Change in Omega-3 Index negatively correlated ( r   =  -0.663, p   =  0.005) with average headers per game. Conclusion: RBC omega-3 status is negatively influenced by frequent soccer heading throughout a competitive season which may have concerning implications for player brain health., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Alzheimer's disease (AD) is the most prevalent neurodegenerative disease, affecting approximately 6.5 million older adults in the United States. Development of AD treatment has primarily centered on developing pharmaceuticals that target amyloid-β (Aβ) plaques in the brain, a hallmark pathological biomarker that precedes symptomatic AD. Though recent clinical trials of novel drugs that target Aβ have demonstrated promising preliminary data, these pharmaceuticals have a poor history of developing into AD treatments, leading to hypotheses that other therapeutic targets may be more suitable for AD prevention and treatment. Impaired brain energy metabolism is another pathological hallmark that precedes the onset of AD that may provide a target for intervention. The brain creatine (Cr) system plays a crucial role in maintaining bioenergetic flux and is disrupted in AD. Recent studies using AD mouse models have shown that supplementing with Cr improves brain bioenergetics, as well as AD biomarkers and cognition. Despite these promising findings, no human trials have investigated the potential benefits of Cr supplementation in AD. This narrative review discusses the link between Cr and AD and the potential for Cr supplementation as a treatment for AD., (© 2023 The Authors.)

Background: Lower limb bone stress injury (BSI) of the pelvis, femur, and tibia is prevalent in collegiate track and field distance runners. Bone mineral density (BMD), body composition (BComp), and anthropometric parameters before initial collegiate injury have not been compared between runners with BSI and their noninjured counterparts., Purpose: To characterize bone health in relation to BComp and anthropometric measurements from total-body dual x-ray absorptiometry (DXA) scans in collegiate male and female distance runners before BSI and develop BMD prediction models., Study Design: Case-control study; Level of evidence, 3., Methods: Distance runners (N = 79) from a single university track and field team were retrospectively enrolled into this study. The runners completed a DXA scan during the fall season (August-November) and participated in sport activities before the scan. Three months after scanning, electronic medical records were reviewed for the occurrence of BSI. An independent-sample t test was used to compare BMD (total and regional [spine, pelvis, and legs]), BComp (% body fat, fat mass, and lean mass), and anthropometric measurements (shoulder width and leg, arm, and trunk length) between runners with versus without BSI (included subgroup analysis by sex). Multiple linear regression with stepwise removal was used to determine variables most predictive of BMD., Results: Of the 79 enrolled participants (42 male, 37 female), 18 runners (22.8%; 11 female, 7 male) sustained a lower limb BSI. Compared with the noninjured group, injured runners had lower total and regional BMD ( P < .001 for all) and shorter leg and arm lengths ( P < .05 for both), whereas injured male runners had lower fat mass and injured female runners had lower lean mass in the legs ( P < .05 for both). Injured runners' age-matched total BMD Z score (-0.1 ± 0.6) was considered clinically normal. BComp and anthropometric measures were predictive of total and regional BMD ( P < .05; R 2 = 0.64-0.80; percentage error = 3.8%-4.8%)., Conclusion: The DXA scans of injured runners prior to incidence indicated lower BMD compared with noninjured runners. Shorter limb lengths, lower fat mass (male), and lower leg lean mass (female) may also be indicative of risk. Certain BComp and anthropometric measures were predictive of BMD., Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: P.C.M. has received education payments from Arthrex and Smith & Nephew, consulting fees from Smith & Nephew, and honoraria and nonconsulting fees from Vericel. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto., (© The Author(s) 2022.)

Background: American-style football (ASF) athletes are at risk for cardiovascular disease (CVD) and exhibit elevated levels of serum neurofilament light (Nf-L), a biomarker of axonal injury that is associated with repetitive head impact exposure over the course of a season of competition. Supplementation with the w-3 fatty acid (FA) docosahexaenoic acid (DHA) attenuates serum Nf-L elevations and improves aspects of CVD, such as the omega-3 index (O3I). However, the effect of combining the w-3 FA eicosapentaenoic acid (EPA) and docosapentaenoic acid (DPA) with DHA on, specifically, serum Nf-L in ASF athletes is unknown. Therefore, this study assessed the effect of supplemental w-3 FA (EPA+DPA+DHA) on serum Nf-L, plasma w-3 FAs, the O3I, and surrogate markers of inflammation over the course of a season., Methods: A multi-site, non-randomized design, utilizing two American football teams was employed. One team (n = 3 1) received supplementation with a highly bioavailablew-3 FA formulation (2000mg DHA, 560mg EPA, 320mg DPA, Mindset®, Struct Nutrition, Missoula, MT) during pre-season and throughout the regular season, while the second team served as the control (n = 35) and did not undergo supplementation. Blood was sampled at specific times throughout pre- and regular season coincident w ith changes in intensity, physical contact, and changes in the incidence and severity of head impacts. Group differences were determined via a mixed-model between-within subjects ANOVA. Effect sizes were calculated using Cohen's dfor all between-group differences. Significance was set a priori at p< .05., Results: Compared to the control group, ASF athletes in the treatment group experienced large increases in plasma EPA (p < .001, d = 1.71) and DHA (p < .001, d = 2.10) which contributed to increases in the O3I (p < .001, d = 2.16) and the EPA:AA ratio (p = .001, d = 0.83) and a reduction in the w-6: w-3 ratio (p < .001, d = 1.80). w-3 FA supplementation attenuated elevations in Nf-L (p = .024). The control group experienced a significant increase in Nf-L compared to baseline at several measurement time points (T2, T3, and T4 [p range < .001 - .005, drange = 0.59-0.85])., Conclusions: These findings suggest a cardio- and neuroprotective effect of combined EPA+DPA+DHA w-3 FA supplementation in American-style football athletes., Trial Registration: This trial was registered with the ISRCTN registry ( ISRCTN90306741 )., (© 2021. The Author(s).)

Objective: Develop a prediction model for lower extremity long bone injuries (LBIs) in male endurance running athletes using dual-energy x-ray absorptiometry (DEXA)., Design: Retrospective., Setting: Sports medicine department in a university athletic setting., Participants: National Collegiate Athletic Association (NCAA) Division 1 white male endurance athletes (n = 27)., Independent Variables: Backward stepwise elimination was used to achieve a model that predicts LBI, by removing noncontributory variables (P > 0.10), using binary logistic regression. Independent prediction variables analyzed for model were as follows: (1) height (cm), body mass index (BMI) (kg/m), and total mass (kg); and (2) regional and total lean mass, fat mass, and bone density assessed using DEXA., Main Outcome Measures: Dichotomous dependent variable was LBI., Results: Final constructed model predicted 96.3% of athletes with and without LBI. Prediction model were as follows: predict lower extremity long bone stress injury = 23.465 - 0.896 BMI + 1.043 (total upper-body mass) TUB - 34.536 leg bone mineral density (BMD). Predict lower extremity long bone stress injury is the LBI prediction, and TUB (kg) is total fat, muscle, and bone weight in trunk and arms., Conclusions: These preliminary data suggest that Division 1 white male endurance running athletes are at risk of LBI with higher relative TUB and lower BMI in combination with a lower leg BMD.

Bosch, TA, Carbuhn, AF, Stanforth, PR, Oliver, JM, Keller, KA, and Dengel, DR. Body composition and bone mineral density of Division 1 collegiate football players: a consortium of college athlete research study. J Strength Cond Res 33(5): 1339-1346, 2019-The purpose of this study was to generate normative data for total and regional body composition in Division 1 collegiate football players using dual-energy x-ray absorptiometry (DXA) and examine positional differences in total and regional measurements. Data were used from the Consortium of College Athlete Research (C-CAR) group. Four hundred sixty-seven players were included in this study. Height, body mass, total and regional fat mass, lean mass, and bone mineral density were measured in each athlete in the preseason (June-August). Players were categorized by their offensive or defensive position for comparisons. Linemen tended to have the higher fat and lean mass measures (p ≤ 0.05 for all) compared with other positions. Positions that mirror each other (e.g. linemen) had similar body composition and body ratios. All positions were classified as overweight or obese based on body mass index (BMI) (>25 kg·m), yet other than offensive and defensive linemen, all positions had healthy percent body fat (13-20%) and low visceral fat mass (<500 g). The data presented here provide normative positional data for total and regional fat mass, lean mass, and bone density in Division 1 collegiate football players. Player position had a significant effect on body composition measures and is likely associated with on-field positional requirements. From a player's health perspective, although all positions had relatively high BMI values, most positions had relatively low body fat and visceral fat, which is important for the health of players during and after their playing career. The increased accuracy and reliability of DXA provides greater information, regarding positional differences in college football players compared with other methods.

Our aim was to determine the effects of probiotic supplementation ( Bifidobacterium longum 35624; 1 billion CFU·d -1 ) on exercise performance, immune modulation, and cognitive outlook in collegiate female athletes during six weeks of offseason training. Seventeen National Collegiate Athletic Association (NCAA) Division 1 collegiate female swimmers participated in this two-group matched, double-blind, placebo controlled design. Via stratified randomization, participants were assigned to probiotic ( B. longum 35624; n = 8) or placebo ( n = 9) groups. Pre, mid, and post-training, all participants completed exercise performance testing (aerobic/anaerobic swim time trials and force plate vertical jump) as well as provided serum (cytokine and gastrointestinal inflammatory markers) and salivary immunoglobulin A samples. Recovery-stress questionnaire for athletes (RESTQ-Sport) was administered at baseline and conclusion of each week. Data were analyzed by analysis of covariance (ANCOVA) by time point with the respective baseline values of each dependent variable being the covariate. No significant differences in exercise performance and biochemical markers were observed between groups following offseason training. Recovery-Stress Questionnaire for Athletes (RESTQ-sport) values in B. longum 35624 group had significantly higher (i.e., more desired; p < 0.05) values in sport recovery (weeks five and six) than placebo. Probiotic supplementation in collegiate female swimmers did not affect exercise performance or immune function throughout offseason training, but did indicate alterations in cognitive outlook.

We compared cardiorespiratory responses to exercise on an underwater treadmill (UTM) and land treadmill (LTM) and derived an equation to estimate oxygen consumption (VO2) during UTM exercise. Fifty-five men and women completed one LTM and five UTM exercise sessions on separate days. The UTM sessions consisted of chest-deep immersion, with 0, 25, 50, 75, and 100% water-jet resistance. All session treadmill velocities increased every 3 min from 53.6 to 187.8 m x min(-1). Cardiorespiratory responses were similar between LTM and UTM when jet resistance for UTM was 50%. Using multiple regression analysis, weight-relative VO2 could be estimated as: VO2 (mLO2 c kg(-1) x min(-1)) = 0.19248 x height (cm) + 0.17422 x jet resistance (% max) + 0.14092 x velocity (m x min(-1)) -0.12794 x weight (kg)-27.82849, R2 = .82. Our data indicate that similar LTM and UTM cardiorespiratory responses are achievable, and we provide a reasonable estimate of UTM VO2.

This is a novel descriptive study to characterize off-season, preseason, and postseason bone and body composition measures in women collegiate athletes. From 2006 through 2008, 67 women collegiate athletes from 5 sports, softball (n = 17), basketball (n = 10), volleyball (n = 7), swimming (n = 16), and track jumpers and sprinters (n = 17) were scanned using dual energy X-ray absorptiometry (DXA) at 3 seasonal periods: (a) off-season = before preseason training, (b) preseason = after preseason training, and (c) postseason = after competitive season. Dual energy X-ray absorptiometry scans were analyzed for total body mass, lean mass (LM), fat mass (FM), percent body fat (%BF), bone mineral content, bone mineral density (BMD), arm BMD, leg BMD, pelvis BMD, and spine BMD. Data were analyzed between sports using analysis of variance (ANOVA) with Tukey post hoc follow-ups, and within each sport using repeated-measures ANOVA and LSD; alpha < 0.05. Significant off-season to preseason or postseason changes in %BF, LM, and BMD within each sport were as follows, respectively: softball, -7, +4, +1%; basketball, -11, +4, +1%; volleyball, unchanged, unchanged, +2%; swimming, unchanged, +2.5%, unchanged; track jumpers and sprinters, -7, +3.5, +1%. Comparisons among athletes in each sport showed bone measurements of swimmers averaged 4-19% lower than that of athletes in any other sport, whereas for track jumpers and sprinters, %BF and FM averaged 36 and 43% lower compared with other sports at all seasonal periods. Values for athletes playing basketball and volleyball were most similar, whereas softball athletes' values fell between all other athletes. These data serve as sport-specific reference values for comparisons at in-season and off-season training periods among women collegiate athletes in various sports.

Purpose: No known previous research has been published to explore the efficacy of underwater treadmill (UTM) exercise training for the obese. Thus, the purpose of this study was to compare changes in physical fitness, body weight, and body composition in physically inactive, overweight, and obese adults after 12 wks of land treadmill (LTM) or UTM training., Methods: Fifty-seven physically inactive, overweight, and obese men (n = 25) and women (n = 32) participated in this investigation. The mean +/- SEM age, weight, body mass index (BMI), and V O2max upon entry were 44 +/- 2 yr, 90.5 +/- 2.4 kg, 30.5 +/- 0.7 kg.m, and 27.1 +/- 0.7 mL O2.kg.min, respectively. Subjects were randomly assigned to exercise three times per week for 12 wk on either LTM (n = 29) or UTM (n = 28) matched for intensity and volume. Session volume was progressively increased from 250 to 500 kcal per session by week 6 and remained at 500 kcal through week 12. Before and after training, V O2max was assessed by the Bruce treadmill protocol with open-circuit calorimetry, and body composition was assessed by dual-energy ray absorptiometry. Data were analyzed by a 2 (training) x 2 (exercise mode) x 2 (gender) ANOVA repeated across training (alpha = 0.05)., Results: Training responses were not different between genders. After either UTM or LTM training, V O2max was significantly increased (+3.6 +/- 0.4 mL O2.kg.min), whereas body weight (-1.2 +/- 0.3 kg), BMI (-0.56 +/- 0.11 kg.m), body fat percentage (-1.3% +/- 1.3%), and fat mass (-1.1 +/- 0.3 kg) were significantly reduced (pooled means for UTM and LTM). Regional leg lean body mass (LBM) was significantly increased with both CTM and UTM (0.4 +/- 0.3 and 0.8 +/- 0.2 kg, respectively). An increase in total LBM approached significance with UTM training only (+0.6 +/- 0.3 kg, P = 0.0599)., Conclusions: UTM and LTM training are equally capable of improving aerobic fitness and body composition in physically inactive overweight individuals, but UTM training may induce increases in LBM.

The authors were aware of no published studies in which the performance characteristics of first-year National Collegiate Athletic Association Division I collegiate football players were reported. From 2003 to 2006, 73 freshman and 12 transfer football recruits were tested before twice-a-day practices for bench press (BP), squat (SQ), power clean (PC), vertical jump (VJ), calculated jump power (CP), treadmill endurance capacity (Vo2peak), and maximal treadmill time (MTT). Individuals were grouped by player position for descriptive statistical analysis. As a group, offensive linemen (OL), defensive linemen (DL), linebackers (LB), tight ends (TE), and running backs (RB) averaged 152.8 kg for BP, 210.5 kg for SQ, 127.3 kg for PC, and 224.2 W for CP. These values were 22% to 30% higher than those for quarterbacks (QB), wide receivers (WR), defensive backs (DB), and kickers (K), who together averaged 120.2 kg for BP, 163.4 kg for SQ, 104.6 kg for PC, and 172.4 W for CP. Quarterbacks, WR, DB, and K as a group showed the highest MTT (13:13 m.s) and Vo2peak values (47.24 mL.kg.min), 15% to 20% higher than those for OL, DL, LB, RB, and TE, who averaged 11:27 m.s for MTT and 39.51 mL.kg.min for Vo2peak. Running backs, TE, LB, DB, and WR averaged 82.56 cm for VJ, which was 14% higher than that for DL, QB, K, and OL, who averaged 72.72 cm. On the basis of average resting blood pressure, 23.5% (20 players) were categorized as hypertensive (i.e., >/=140/90 mm Hg), 54% (46 players) as prehypertensive (i.e., 120-139/80-89 mm Hg), and 22.5% (19 players) as normal (i.e., <120/80 mm Hg). These data serve as a basis for comparisons among other Division I programs, benchmarking development and improvement through training, and creating position performance norms for incoming football athletes.