The use of dual-energy X-ray absorptiometry (DXA) may be invalid for assessing athletes with larger bodies, larger lean body mass, and thicker trunks. This study compared the athletes' visceral adipose tissue (VAT) assessed using DXA and magnetic resonance imaging (MRI). Eighty-two Japanese male collegiate athletes from 18 sports participated in this study. VAT was assessed using the dual-energy scan that coincided with the 4th lumbar vertebra. The sum of eight magnetic resonance slices corresponding to the region of the dual-energy scan was used for comparison. The VAT volume was higher with the dual-energy scan than with MRI (difference: 35 cm³, p<0.01). A significant correlation was noted between the volumes measured using both modalities (r=0.88, p<0.01). Magnetic resonance-derived volumes less than 600 cm³ showed a stronger significant correlation with dual-energy-derived volumes. However, magnetic resonance-derived VAT volumes exceeding 600 cm³ were not significantly correlated with dual-energy-derived volumes. In conclusion, VAT volumes derived from DXA were larger and significantly correlated with those derived from MRI across a wide range of values. Methods using DXA for assessing the visceral fat volume may require adjustment to estimate abdominal visceral fat volume in athletes, with care taken when using such methods for heavyweight athletes. Received: 13 May 2021 Accepted: 17 November 2021 Article published online: 02 February 2022 © 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/). Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

Low energy availability (EA) can impair physiological function in athletes. The purpose of this study was to investigate EA status, metabolic status, and bone metabolism with biochemical analysis in Korean male soccer players. Twelve male athletes (18–20 years) completed the study. Body composition and bone mineral density were measured using dual energy X-ray absorptiometry (DXA), while VO₂ max was determined by an incremental exercise test. Blood samples were taken for bone marker and hormone analyses. Resting energy expenditure (REE) was measured using the Douglas bag method and predicted using the DXA method. Food diaries and heart rates (HR) during training were recorded, and the Profile of Mood States 2 and Eating Attitude Test 26 were completed. Group differences between low EA (LEA <30 kcal/kg FFM/d, n = 5) and high EA (HEA ≥30 kcal/kg FFM/d, n = 7) were evaluated. The mean EA of the all participants was 31.9 ± 9.8 kcal/kg FFM/d with only two participants having an EA above 45 kcal/kg FFM/d. LEA showed suppressed REE (LEA: 26.0 ± 1.7 kcal/kg/d, HEA: 28.8 ± 1.4 kcal/kg/d, p = .011) with a lower REE_ratio (LEA: 0.91 ± 0.06, HEA: 1.01 ± 0.05, p = .008) as well as a lower insulin-like growth factor 1 (IGF-1) level (LEA: 248.6 ± 51.2 ng/mL, HEA: 318.9 ± 43.4 ng/mL, p = .028) compared to HEA. There were no group differences in bone markers or other hormone levels. Korean male athletes exhibited low EA status with suppressed metabolism, but there was limited evidence on the effect of EA on bone metabolism, endocrine system, and psychological parameters.

It has been reported that male athletes face increased risk for low energy availability and resulting health consequences similar to female athletes. The present study aimed to reveal the energy status of Japanese male runners and to examine the association between energy deficiency and physiological characteristics such as energy metabolism, bone health, and hormonal status. Six male collegiate long-distance runners during a training season participated in this study. Energy intake (EI) was assessed using 3-day dietary records with food pictures. Exercise energy expenditure (EEE) was determined by the HR-VO₂ method. Body composition and bone status were measured by dual-energy X-ray absorptiometry. Energy availability (EA) was calculated by subtraction of EEE from EI and normalized by fat-free mass (FFM). Energy balance (EB) was calculated EI minus estimated total energy expenditure (TEE). Resting energy expenditure (REE) was measured by indirect calorimetry using the Douglas bag technique, and blood sampling was conducted to assess hormonal status. The mean EA of the subjects was 18.9 ± 6.8 kcal/kg FFM/day, and severe negative EB (range: −1444 ~ −722 kcal/d) was observed. REE of four runners was suppressed, and moreover, bone resorption was promoted in all subjects. The data in our study suggested that energy deficiency could promote bone resorption and energy metabolism suppression in Japanese male endurance runners. Additional short- and long-term studies are needed to clarify the health risks caused by energy deficiency in male athletes and explore strategies to prevent health problems related to energy deficiency in long-distance runners.

Medium-chain triglycerides (MCT) are useful for increasing fat utilization during exercise. The highest rate of fat oxidation during submaximal exercise tends to precede the lactate threshold in untrained adults. In our previous study, blood lactate concentration was more than 4 mmol/L (onset of blood lactate) in recreational athletes during exercise at a workload corresponding to 60% peak O2 uptake (V･o2), which was below ventilation threshold. In the present study, we investigated the effect of 2 week of ingestion of food containing 6 g MCT on substrate oxidation during moderate-intensity (50% peak V･o2) exercise and high-intensity (70% peak V･o2) exercise in recreational athletes. For comparison, two experimental trials were conducted after participants had been administered isoenergic test foods (MCT-supplemented food with mainly maltodextrin-containing carbohydrate (MCT + CHO) or CHO) for 2 weeks, with a washout period between trials. Participants were instructed to perform cycle ergometer exercise at a workload corresponding to 50% peak V･o2 for 40 min followed by a workload corresponding to 70% peak V･o2 until exhaustion. Fat oxidation was significantly increased in the MCT + CHO trial (13.3 ± 2.7 g/40 min, mean ± SD, p < 0.05) during moderate-intensity exercise and the duration was extended significantly (23.5 ± 19.4 min, p < 0.05) during subsequent high-intensity exercise, compared with that observed in the CHO trial (fat oxidation; 11.7 ± 2.8 g/40 min, duration; 17.6 ± 16.1 min). In conclusion, continuous ingestion of 6 g MCT with maltodextrin could increase fat oxidation during moderate-intensity exercise and extend the duration of subsequent high-intensity exercise in recreational athletes, compared with the ingestion of isoenergic maltodextrin alone.

Metabolic suppression due to relative energy deficiency can cause various physiological impairments in athletes. The purpose of this study was to evaluate within-day energy balance (WDEB) and the ratio between measured and predicted resting energy expenditure (REE_ratio) and to investigate the relationships between the markers of metabolic suppression. Ten male collegiate soccer players completed a 7-day food diary, physical activity, and heart rate records during the training and rest days. Energy intake (EI) and energy expenditure (EE) were analyzed to evaluate WDEB components. Body composition was measured using dual-energy X-ray absorptiometry (DXA), and blood sampling was conducted for hormonal analysis. The REE was measured using the Douglas bag method and predicted using the DXA-predicted method to calculate the REE_ratio. Participants were categorized into the normal (REE_ratio ≥ 0.94, n = 5) and suppressed (REE_ratio < 0.94, n = 5) groups. There were no group differences in the components of WDEB, except diet-induced thermogenesis (DIT), but EI was significantly higher in the normal group than in the suppressed group (7-day total: 3660 ± 347 vs. 3024 ± 491 kcal/day, p = 0.046 and rest days: 3772 ± 463 vs. 2796 ± 800 kcal/day, p = 0.046). Analysis of hormonal markers of metabolic suppression only showed a significant positive association between insulin-like growth factor-1 (IGF-1) and REE_ratio (r = 0.771, p = 0.009). The relationships between metabolic suppression and the markers of energy deficiency were inconclusive. There are possible associations of insufficient EI and IGF-1 levels with metabolic suppression, and further study is required to understand energy deficiency in male soccer players.

Daily muscle glycogen recovery after training is important for athletes. Few studies have reported a continuous change in muscle glycogen for 24 h. We aimed to investigate the changes in carbohydrate intake amount on muscle glycogen recovery for 24 h after exercise using ¹³C-magnetic resonance spectroscopy (¹³C-MRS). In this randomized crossover study, eight male participants underwent prolonged high-intensity exercise, and then consumed one of the three carbohydrate meals (5 g/kg body mass (BM)/d, 7 g/kg BM/d, or 10 g/kg BM/d). Glycogen content of thigh muscle was measured using ¹³C-MRS before, immediately after, and 4 h, 12 h and 24 h after exercise. Muscle glycogen concentration decreased to 29.9 ± 15.9% by exercise. Muscle glycogen recovery 4–12 h after exercise for the 5 g/kg group was significantly lower compared to those for 7 g/kg and 10 g/kg groups (p < 0.05). Muscle glycogen concentration after 24 h recovered to the pre-exercise levels for 7 g/kg and 10 g/kg groups; however, there was a significant difference for the 5 g/kg group (p < 0.05). These results suggest that carbohydrate intake of 5 g/kg BM/d is insufficient for Japanese athletes to recover muscle glycogen stores 24 h after completing a long-term high-intensity exercise.