title: Female athlete health: The silent risks of high performance

authors: MacKay, Kelsi

abstract: Despite female athlete health becoming a growing area of interest in sport science reasearch, there are still gaps to be filled in the literature. Low energy availabilty (LEA) and iron deficiency are two prevalent issues in women (or female athletes)  that are under high loads of exercise stress from training. Thus, it is critical that measurement and identification of these parameters is accurate. The first part of this thesis reviews the literature surrounding LEA and iron deficiency with a focus on current identification techniques used in research and clinical settings. The second part of this thesis includes two original investigations. The first study, Chapter 2, had two aims; 1) to investigate the test-retest reliabilty of an indirect calorimetry analyser (Parvo Medics TrueOne), and 2) compare measured RMR with three RMR-predictive (pRMR) equations in female athletes. To address the first aim, 12 recreationally-exercising women (mean ± SD; age 27.5 ± 12.3 y) performed two RMR assessments, on separate days, utilising the Parvo Medics TrueOne analyser. To address the second aim, 25 females (mean ± SD; age 30.1 ± 10.2 y) underwent an RMR assessment using the Parvo Medics TrueOne analyser, which was compared to three calculated pRMR equations (Harris-Benedict [H-B], Mifflin-St Jeor [M], World Health Organisation [WHO]). Test-retest reliability for the TrueOne analyser was deemed acceptable (CV = 5.3%, ICC = 0.92). The validity of pRMR when compared to measured RMR showed low levels of agreement in all 3 predictive equations (M: CV = 21.4%, TEE = 269 kcal•day⁻¹, r = 0.16, WHO: CV = 21.5%, TEE = 270 kcal•day⁻¹, r = 0.13 H-B: CV = 21.6%, TEE = 270 kcal•day⁻¹, r = 0.13).  
The second study, Chapter 3, was designed to investigate specific health parameters related to iron, resting metabolic rate and energy balance in a cohort of highly-trained women. Thirteen highly-trained female endurance athletes (mean ± SD; age 32 ± 7 y, training volume 18.5 ± 4.1 hrs) provided a blood test to assess iron markers (haemoglobin [Hb], haematocrit [Hct], C-reactive protein [Crp], serum iron, serum ferritin and transferrin). Additional measures included resting metabolic rate (RMR) assessment, dual-energy x-ray absorptiometry (DXA) scans, diet and training diaries and menstrual cycle tracking to identify any additional risk factors which may be associated with relative energy deficiency in sport. Analysis revealed that 46% (6/13) of this population had iron levels below optimal. Serum iron, serum ferritin and transferrin were all significantly decreased in the iron deficient (ID) group (p < 0.05). When compared to the non-iron deficient (non-ID) group haemoglobin (Hb) and haematocrit (Hct) were significantly lower in the ID group compared with the non-ID group (p < 0.05). The relationship between Crp and serum iron revealed a large negative correlation (r = -0.66), Crp and serum ferritin a very large negative correlation (r = -0.72) and transferrin presented a large correlation with Crp (r = 0.70). In conclusion, the outcomes of these studies demonstrate the need for greater stratification of risk thresholds for this (emerging) group of highly-trained, non-professional female athletes.

text: Female athlete health: The silent risks of high performance Despite female athlete health becoming a growing area of interest in sport science reasearch, there are still gaps to be filled in the literature. Low energy availabilty (LEA) and iron deficiency are two prevalent issues in women (or female athletes)  that are under high loads of exercise stress from training. Thus, it is critical that measurement and identification of these parameters is accurate. The first part of this thesis reviews the literature surrounding LEA and iron deficiency with a focus on current identification techniques used in research and clinical settings. The second part of this thesis includes two original investigations. The first study, Chapter 2, had two aims; 1) to investigate the test-retest reliabilty of an indirect calorimetry analyser (Parvo Medics TrueOne), and 2) compare measured RMR with three RMR-predictive (pRMR) equations in female athletes. To address the first aim, 12 recreationally-exercising women (mean ± SD; age 27.5 ± 12.3 y) performed two RMR assessments, on separate days, utilising the Parvo Medics TrueOne analyser. To address the second aim, 25 females (mean ± SD; age 30.1 ± 10.2 y) underwent an RMR assessment using the Parvo Medics TrueOne analyser, which was compared to three calculated pRMR equations (Harris-Benedict [H-B], Mifflin-St Jeor [M], World Health Organisation [WHO]). Test-retest reliability for the TrueOne analyser was deemed acceptable (CV = 5.3%, ICC = 0.92). The validity of pRMR when compared to measured RMR showed low levels of agreement in all 3 predictive equations (M: CV = 21.4%, TEE = 269 kcal•day⁻¹, r = 0.16, WHO: CV = 21.5%, TEE = 270 kcal•day⁻¹, r = 0.13 H-B: CV = 21.6%, TEE = 270 kcal•day⁻¹, r = 0.13).  
The second study, Chapter 3, was designed to investigate specific health parameters related to iron, resting metabolic rate and energy balance in a cohort of highly-trained women. Thirteen highly-trained female endurance athletes (mean ± SD; age 32 ± 7 y, training volume 18.5 ± 4.1 hrs) provided a blood test to assess iron markers (haemoglobin [Hb], haematocrit [Hct], C-reactive protein [Crp], serum iron, serum ferritin and transferrin). Additional measures included resting metabolic rate (RMR) assessment, dual-energy x-ray absorptiometry (DXA) scans, diet and training diaries and menstrual cycle tracking to identify any additional risk factors which may be associated with relative energy deficiency in sport. Analysis revealed that 46% (6/13) of this population had iron levels below optimal. Serum iron, serum ferritin and transferrin were all significantly decreased in the iron deficient (ID) group (p < 0.05). When compared to the non-iron deficient (non-ID) group haemoglobin (Hb) and haematocrit (Hct) were significantly lower in the ID group compared with the non-ID group (p < 0.05). The relationship between Crp and serum iron revealed a large negative correlation (r = -0.66), Crp and serum ferritin a very large negative correlation (r = -0.72) and transferrin presented a large correlation with Crp (r = 0.70). In conclusion, the outcomes of these studies demonstrate the need for greater stratification of risk thresholds for this (emerging) group of highly-trained, non-professional female athletes.

year: 2018

title: Provisional chronology of a late Quaternary core from Lake Waikare, North Island, New Zealand

authors: Lowe, David J.

abstract: Lake Waikare is a shallow ( < 2 m), 34. 4 km² riverine lake near Hamilton, North Island, New Zealand (175° 12' S, 37° 24'E). Ac. 12.5 m long (corrected depth) sediment core taken from the lake in 1990 comprises mainly green-grey lacustrine clays with interbedded layers of peat, brownish clays, occasional fluvial sandy layers, and several thin tephra deposits. Lake sediment at the base of the core has been dated at 26 000 ± 1600 years BP (old half life basis) using the C-14 method; charcoal fragments at c. 11.7 m depth were dated at 17 300 ± 400 years BP; and a tephra layer at c. 8.5 m depth has been provisionally identified, using major element composition of glass, as the Rerewhakaaitu Tephra with an age of 14 700 ± 110 years BP. These ages accord with previous work in the area.

text: Provisional chronology of a late Quaternary core from Lake Waikare, North Island, New Zealand Lake Waikare is a shallow ( < 2 m), 34. 4 km² riverine lake near Hamilton, North Island, New Zealand (175° 12' S, 37° 24'E). Ac. 12.5 m long (corrected depth) sediment core taken from the lake in 1990 comprises mainly green-grey lacustrine clays with interbedded layers of peat, brownish clays, occasional fluvial sandy layers, and several thin tephra deposits. Lake sediment at the base of the core has been dated at 26 000 ± 1600 years BP (old half life basis) using the C-14 method; charcoal fragments at c. 11.7 m depth were dated at 17 300 ± 400 years BP; and a tephra layer at c. 8.5 m depth has been provisionally identified, using major element composition of glass, as the Rerewhakaaitu Tephra with an age of 14 700 ± 110 years BP. These ages accord with previous work in the area.

year: 1992

title: Creating an environment to inform, build, and sustain a Māori health research workforce

authors: Barrett, Nikki Maree

subjects: Kaupapa Māori

abstract: Ensuring the growth and development of the Māori health research workforce is key to achieving health equity for Māori and enabling positive change for all New Zealanders. The purpose of this study was to identify enablers and barriers to research for Māori staff in a large health organisation, and to understand how research is developed and undertaken. A Kaupapa Māori mixed-methods study was undertaken, using an electronic survey comprised of quantitative data and open-ended responses delivered to all Māori staff at the Waikato District Health Board. Following the survey were 10 one on one interviews. Survey data were analysed using descriptive statistics and open-ended responses summarised. A descriptive thematic analysis was undertaken of the interview data. Each of the interview responses was coded and five themes emerged. Frontline Māori staff affirmed their desire to conduct, design, and undertake health research. Challenges to staff included a lack of information on research opportunities, unclear processes for initiating research, and lack of support and resource. The evidence from participants provides insights into Māori health research priorities, considerations for those wanting to undertake research, and solutions for informing, building, and sustaining the Māori health research workforce.

text: Creating an environment to inform, build, and sustain a Māori health research workforce Ensuring the growth and development of the Māori health research workforce is key to achieving health equity for Māori and enabling positive change for all New Zealanders. The purpose of this study was to identify enablers and barriers to research for Māori staff in a large health organisation, and to understand how research is developed and undertaken. A Kaupapa Māori mixed-methods study was undertaken, using an electronic survey comprised of quantitative data and open-ended responses delivered to all Māori staff at the Waikato District Health Board. Following the survey were 10 one on one interviews. Survey data were analysed using descriptive statistics and open-ended responses summarised. A descriptive thematic analysis was undertaken of the interview data. Each of the interview responses was coded and five themes emerged. Frontline Māori staff affirmed their desire to conduct, design, and undertake health research. Challenges to staff included a lack of information on research opportunities, unclear processes for initiating research, and lack of support and resource. The evidence from participants provides insights into Māori health research priorities, considerations for those wanting to undertake research, and solutions for informing, building, and sustaining the Māori health research workforce.

year: 2023