Objective: Our objective was to explore the training-related knowledge, beliefs, and practices of athletes and the influence of lockdowns in response to the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods: Athletes (n = 12,526, comprising 13% world class, 21% international, 36% national, 24% state, and 6% recreational) completed an online survey that was available from 17 May to 5 July 2020 and explored their training behaviors (training knowledge, beliefs/attitudes, and practices), including specific questions on their training intensity, frequency, and session duration before and during lockdown (March–June 2020). Results: Overall, 85% of athletes wanted to “maintain training,” and 79% disagreed with the statement that it is “okay to not train during lockdown,” with a greater prevalence for both in higher-level athletes. In total, 60% of athletes considered “coaching by correspondence (remote coaching)” to be sufficient (highest amongst world-class athletes). During lockdown, < 40% were able to maintain sport-specific training (e.g., long endurance [39%], interval training [35%], weightlifting [33%], plyometric exercise [30%]) at pre-lockdown levels (higher among world-class, international, and national athletes), with most (83%) training for “general fitness and health maintenance” during lockdown. Athletes trained alone (80%) and focused on bodyweight (65%) and cardiovascular (59%) exercise/training during lockdown. Compared with before lockdown, most athletes reported reduced training frequency (from between five and seven sessions per week to four or fewer), shorter training sessions (from ≥ 60 to < 60 min), and lower sport-specific intensity (~ 38% reduction), irrespective of athlete classification. Conclusions: COVID-19-related lockdowns saw marked reductions in athletic training specificity, intensity, frequency, and duration, with notable within-sample differences (by athlete classification). Higher classification athletes had the strongest desire to “maintain” training and the greatest opposition to “not training” during lockdowns. These higher classification athletes retained training specificity to a greater degree than others, probably because of preferential access to limited training resources. More higher classification athletes considered “coaching by correspondence” as sufficient than did lower classification athletes. These lockdown-mediated changes in training were not conducive to maintenance or progression of athletes’ physical capacities and were also likely detrimental to athletes’ mental health. These data can be used by policy makers, athletes, and their multidisciplinary teams to modulate their practice, with a degree of individualization, in the current and continued pandemic-related scenario. Furthermore, the data may drive training-related educational resources for athletes and their multidisciplinary teams. Such upskilling would provide athletes with evidence to inform their training modifications in response to germane situations (e.g., COVID related, injury, and illness).

Elevated mortality rates have been reported in individuals with eating disorders (EDs). However, no meta-analysis in the past decade has provided an updated, comprehensive synthesis of mortality across all ED diagnoses while exploring potential moderating factors. We conducted a systematic search in four databases (PsycINFO, MEDLINE, Embase and Web of Science) from 2010 to 29 Oct 2024. Studies that reported standardized mortality ratios (SMRs) in individuals with a diagnosed ED (including formal diagnoses and self-reports) were included. Random-effects meta-analyses were conducted to pool estimates across studies. Meta-regression was conducted to examine predictors of heterogeneity. Meta-analysis of SMRs of effect sizes revealed elevated mortality risk for individuals with an ED (regardless of ED subtype); weighted SMR = 3.39 (95 % CIs: 2.90, 3.95), p < .001, I² = 95.1 %, Q_(df=73) = 1492.39, p < .001. SMRs were highest for individuals with anorexia nervosa (5.21; k = 30), followed by eating disorder not otherwise specified (2.51; k = 8); bulimia nervisa (2.20; k = 18) and binge eating disorder (1.46; k = 3). Individuals with EDs demonstrate markedly heightened mortality rates, especially among those with anorexia nervosa. Our findings are crucial for identifying key factors influencing mortality in EDs, guiding targeted interventions to reduce preventable deaths.

The objective of this article was to examine lifestyle behaviours in eating disorder (ED) patients and healthy controls. A total of 801 ED patients and 727 healthy controls from five European countries completed the questions related to lifestyle behaviours of the Cross-Cultural Questionnaire (CCQ). For children, the ED sample exhibited more solitary activities (rigorously doing homework [p<0.001] and watching TV [p<0.05] and less socializing with friends [p<0.05]) than the healthy control group and this continued in adulthood. There were minimal differences across ED sub-diagnoses and various cross-cultural differences emerged. Reduced social activities may be an important risk and maintaining factor for ED symptomatology.