Nutrition, body composition and metabolic status in Paralympic athletes with locomotor impairments

Introduction: Paralympic athletes (PA) may be at risk for inadequate dietary intakes. Despite lower energy needs, athletes with spinal cord injury (SCI) consumed too few calories, probably due to medications commonly used by these individuals that may cause unwanted side effects that influence diet, energy intake, and nutrient absorption of these athletes. However, not only the energy intake, but also body composition is a crucial component of physical fitness. Purpose: The aim of this study was to evaluate the energy intake, body composition and metabolic status of a population of PA, and the possible relationship between nutrition and fat free mass (FFM). Methods: A retrospective chart review of 68 male Paralympic athletes (PA) from preparticipation examinations’ records (London 2012 and Sochi 2014 Paralympics) was performed. PA were divided in two health conditions groups (34 with SCI, mean age 37.7 ± 8.5, and 34 with different health conditions, mean age 33.8 ± 9.3) and in four sport type groups (skill, power, intermittent – mixed metabolism – and endurance). They were evaluated through anthropometric measurements, laboratory blood tests, and nutritional visit report. Results: Significant differences were found between SCI and those with different health conditions for energy (1978 ± 409.0 vs 2263 ± 648.6 kcal/die), carbohydrate (259.7 ± 57.5 vs 301.0 ± 99.1 g/die), protein (93.0 ± 26.5 vs 110.0 ± 40.9 g/die) and lipid (70.5 ± 16.9 vs 77.1 ± 24.5 g/die) intakes. Furthermore, body mass index and fat mass were significantly higher in athletes of skill sports than in those of power, intermittent of endurance sports (25.6 ± 5.0 vs 22.6 ± 3.9, p<0.01 and 19.4 ± 7.9 vs 13.3 ± 7.0 kg, p<0.0001, respectively), as well as blood glucose and triglycerides levels (101.6 ± 8.5 vs 98.0 ± 7.3 mg/dl, p<0.05 and 128.4 ± 64.9 vs 92.5 ± 49.9 mg/dl, p<0.001, respectively). No relationship has been found between energy intake and FFM. Conclusions: There is a wide variation in energy intake among PA athletes, likely due to differences in body weight, disability, and injury level. While more research needs to be done, actual energy intake among athletes with SCI is considerably lower compared to recommendations for able-bodied athletes. Future studies should evaluate the impact of the level of impairment on energy and macronutrient intakes to work towards recommendations. In order to adequately support these athletes, educational programs and counseling from sport nutrition professionals are urgently needed.