OBJECTIVE

Understanding the energy requirements of Paralympic athletes is vital to develop an effective nutrition strategy. At present there is a lack of research investigating the energy expenditure in Paralympic sport. Furthermore, no study has used the gold standard doubly labelled water (DLW) approach to measure energy expenditure.

Therefore, the purpose of this study was to investigate the nutritional intake and energy expenditure of Paralympic athletes across different sports and disabilities using the DLW method.

WHAT THEY DID

48 Dutch and Norwegian Paralympic athletes (19 male, 29 female) from various sports including Para-cycling (13), wheelchair tennis (10), wheelchair basketball (13), Para Nordic skiing (7) and alpine skiing (5) took part in the study. Of all participants, 54% were classified as wheelchair users.

Total daily energy expenditure (TDEE) was assessed using the doubly labelled water method over 14 days.

Other measurements recorded included resting metabolic rate using a ventilated hood, energy intake using 24-hour dietary analysis, body composition using dual-energy x-ray absorptiometry (DEXA) and training duration using a training diary.

WHAT THEY FOUND

During the 14 days, the average TDEE was 2908 ± 797 kcal·d–1. Energy expenditure varied from 2322 ± 340 kcal·d–1 for wheelchair basketball players to 3607 ± 1001 kcal·d–1 for Para cyclists.

Regression analysis identified fat-free mass (FFM), exercise duration and presence of a spinal cord injury as predictors of TDEE.

Athletes reported energy intake was 2363 ± 905 kcal·d–1. Energy intake was 19% ± 20% lower compared with the TDEE. Carbohydrate intake was 4.1 ± 1.9 g·kg–1 body mass. Protein intake was 1.8 ± 0.6 g·kg–1 body mass.

Practical Takeaways

This was the first study to assess TDEE using the doubly labeled water method which showed an average TDEE of 2900 kcal·d–1 with several factors identified as predictors of TDEE.

Dietary analysis identified that carbohydrate intake was low whereas athletes were consuming enough protein. However, it should be noted that nutrient recommendations for Paralympic athletes are mainly based on able-bodied athletes as nutrient requirements have not been assessed in Paralympic athletes thus far. The reported low carbohydrate intake could have also been due to a lack of nutrition knowledge and a lack of suitable foods available.

Based on the results of this study, the authors developed a series of energy prediction equations to predict TDEE:

Predicted TDEE = (measured RMR + (-861.931 + (30.893 x FFM) + (6.345 x exercise duration) - (266.949 x SCD))) x 1.111

If RMR cannot be measured accurately TDEE can be predicted using the following equation:

Predicted TDEE = -323.921 + (57.660 x FFM) + (6.203 x exercise duration) - (441.684 x SCD)

The TDEE data from this study is considerably higher compared to previous estimates derived from analysing energy intake of weight stable athletes and wheelchair athletes.

James' Comments

The results of this study provide early insight into the energy expenditure and nutritional requirements of Paralympic athletes using the doubly labelled water method to assess energy expenditure. This study has provided a foundation from which athletes and practitioners can form their nutrition strategy however further research is still required to fully understand the nutrition requirements of Para-athletes.

Due to the expense of using DLW, the development of predictive TDEE equations may provide practitioners with an easier method to calculate para-athlete energy requirements.

Although this was the first study to use the DLW method to assess energy intake in Paralympic athletes, this study is not without its limitations. The data was collected at two different research sites meaning that measurements were taken using different equipment.

Furthermore, not all Paralympic sports were represented in this study therefore further research is required to quantify TDEE in other Paralympic sports.

In addition, further research is required to investigate the macronutrient requirements of para-athletes to help optimise their performance and training goals.