Clinical trial NCT06487260: Mental Health and Symptoms of Energy Deficiency (REDs) in Young Biathletes
Official title: Mental Health and Symptoms of Energy Deficiency (REDs) in Young Biathletes.
Study type: OBSERVATIONAL
Overall status: RECRUITING
Conditions: Mental Health Issue
Physical Health
Keywords: biathlon
biathletes
nordic skiing
REDs
LEA
Mental health
IBU
DXA
Eating Disorders
Blood work
Lead sponsor: Ostfold University College
Sponsor class: OTHER
Collaborators: name: Norwegian School of Sport Sciences
name: Inland Norway University of Applied Sciences
name: International Biathlon Union
First posted: 2024-07-05
Enrollment: 150
Sex: ALL
Minimum age (years): 16
Maximum age (years): 20
Standard ages: CHILD
ADULT
Accepts healthy volunteers: yes
Observational model: CASE_ONLY
Time perspective: CROSS_SECTIONAL
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Young, competetive biathletes in age-range 16-20 years of age, living in Norway.

Brief summary: Participation in weight-sensitive sports has been identified as a significant risk factor for low energy availability (LEA), relative energy deficiency in sport (REDs), and eating disorders. However, there is limited knowledge regarding the symptoms of LEA, REDs, and mental health issues in young biathletes. This study investigates the prevalence of these symptoms in young, talented biathletes from one of the leading nations in the sport. By including athletes of both sexes aged 16, 17, and 18, this study aim to determine whether symptom severity is associated with age, sex, or performance level. Furthermore, this study will explore the experiences of biathletes aged 18 and older with the new best practice guidelines for body composition assessment, designed by an IOC working group on the REDs consensus update of 2023 to safeguard athletes from negative experiences. The insights gained from this study may enhance the understanding of the frequency of health symptoms, the age or performance level at which symptoms typically increase, and the specific needs of athletes to ensure their safety and well-being in the sport.

Detailed description: Being physically active is associated with a range of positive mental, physical, and psychosocial health benefits. Although athletes might be expected to enjoy these positive health effects, studies also show that high-level competitive athletes have a similar prevalence of certain mental disorders as the general population. Beyond reflecting the normal occurrence of mental health challenges in the population, performance expectations related to participation in competitive sports may contribute to many athletes experiencing periods or persistent mental health issues. Despite the increased openness in recent years about top athletes experiencing mental stress and disorders, there is little knowledge about the overall prevalence, especially among younger athletes at sub-elite performance levels. In 2023, Norwegian media highlighted a serious concern about the mental health of young biathletes, underscored by an alarming and unexpectedly high incidence of suicide among young biathlon talents.

Ski sports are among many weight-sensitive sports challenged by a high prevalence of eating disorders, particularly among female athletes. Eating disorders are linked to a high risk of low energy availability (LEA) and the syndrome relative energy deficiency (REDs) in athletes. REDs involve a variety of health challenges that follow LEA, and mental health issues can be both contributing factors to and effects of LEA. Knowledge about the prevalence of LEA, eating disorders, and REDs specifically among biathletes is very limited. A recent study found that a group of young female skiers (17 years old), including biathletes, on average consumed too little energy and carbohydrates relative to their athletic needs, and that 17% had LEA. A previous study recruited female athletes aged 25 years with self-expressed concern for REDs. This study found an overall prevalence of eating disorders corresponding to 21.3%, and that 65% in the sub-group of biathletes had LEA. Athletes with LEA symptoms had both lower weight and BMI, and the highest prevalence of eating disorders. At the same time, there is a study with young male skiers (including biathletes) aged 16 years, which finds a high prevalence of low bone mass and loss of bone mass through puberty. Low bone mass is one of the cardinal signs of LEA and REDs.

There is a need to map the prevalence of mental health issues and symptoms of REDs in young biathletes. Such knowledge can be used to understand the extent, specific vulnerable periods, and potentially explain why some are more affected than others. This knowledge can be used to more easily identify those who may need help and to initiate early interventions before the severity and complexity increase. In this exploratory national cross-sectional study, the aim is to map mental health and symptoms of REDs in young biathlon talents aged 16-19 years. In connection with mapping the physical symptoms of REDs, this study also aim to evaluate athlete experiences when closely following the new proposed guidelines and recommendations for measuring body composition in athletes. The guidelines (three members of this project group contributed in producing those guidelines) were given to protect athletes from negative experiences with body evaluation, so fewer are at risk of developing a negative body image and disordered eating behaviors or eating disorders.

This study works from the following hypotheses: 1) The prevalence of body dissatisfaction, depression, eating disorders, and symptoms of REDs (hereafter: outcome measures) is low in 16-year-old biathletes; 2) the prevalence of outcome measures increases with age and is therefore higher in 18-year-old biathletes; 3) the prevalence of eating disorders and symptoms of REDs is higher in girls than boys in all age groups; 4) young biathletes aged 18 years experience a professional and safe implementation of body composition evaluation when recommended guidelines are followed.

Eligibility criteria: Inclusion Criteria:

* competetive biathlete
* live in Norway, speaks or understand written and oral Norwegian

Exclusion Criteria:

* injured and prevented from regular training (3 months leading up to recruitement)

Primary outcomes:
measure: Diagnosis of Eating Disorder
timeFrame: September 2024
measure: Symptom of Eating Disorders
timeFrame: September 2024
measure: Symptoms of Depression
timeFrame: September 2024
measure: Symptoms of Low Energy Availability (LEA)
timeFrame: September 2024
measure: Body composition
timeFrame: September 2024
measure: Bone mineral Density
timeFrame: September 2024
Secondary outcomes:
measure: Blood work, energy metabolism
timeFrame: September 2024
measure: Blood pressure, orthostatic
timeFrame: September 2024
measure: Blood pressure, resting
timeFrame: September 2024
measure: Resting heart rate
timeFrame: September 2024
measure: Indirect calorimetry
timeFrame: September 2024
Other outcomes:
measure: Body appreciation
timeFrame: September 2024
measure: Blood work, iron status
timeFrame: September 2024
measure: Blood work, cholesterol
timeFrame: September 2024
measure: Experience from body composition assessment
timeFrame: September 2024
measure: Demographics
timeFrame: September 2024
measure: Urinary incontinence
timeFrame: September 2024
Locations:
city: Lillehammer
country: Norway
facility: Inland Norway University of Applied Sciences
state: Inland
city: Oslo
country: Norway
facility: Norwegian School of Sport Sciences
Study officials:
affiliation: Associate Professor
name: Therese F Mathisen, PhD
role: PRINCIPAL_INVESTIGATOR
References: