Paralympic athletes, especially those performing in a wheelchair, reflect a special group within the sports community. The underlying disease or incidence not only leads to loss of sensory and motor function and impaired autonomous nervous system function but also results in a reduction in fat-free mass and increased fat mass due to immobility 1, 2. Consequently, resting energy expenditure (REE) and the m+etabolic cost of exercise and other activities is reduced, making proper fueling of these athletes a major challenge. This case study aimed to provide data from a professional wheelchair badminton player with the desire to loose fat mass. The athlete presented for a yearly check-up whereas REE was measured by indirect calorimetry. Additionally, body composition was assessed using DXA scan. Furthermore, dietary intake was checked by using a 3-day food record in addition to a training diary. The athlete showed indicators of low energy availability 3, namely a reduced REE ratio (measured REE / predicted REE = 0.65-0.70) in addition to the low energy availability calculated based on the diaries (energy availability range: 14.8, 24.8 kcal/kg fat-free mass/day). REE was reduced compared to the previous year (1255 kcal/d to 926 kcal/d). The nutritional intervention included more frequent meals and an increased protein intake and was combined with additional endurance training at the arm crank ergometer to increase energy turnover. The intervention resulted in a normalization of REE (1.00–1.09) over a one year period, and the athlete lost 11.8 kg of body weight, the vast majority of which represented fat mass. To conclude, the nutritional consultations were successful in terms of energy restoration. In a second step, the increase in endurance training helped to increase energy turnover and induce reduction in body mass. Moreover, this case is interesting in terms of diagnosis of relative energy deficiency whereas signs from the able-bodied literature such as menstrual function or bone mineral density are often impaired 4.
1. Price M. Energy expenditure and metabolism during exercise in persons with a spinal cord injury. Sports Med. 2010
2. Flueck JL. Body Composition in Swiss Elite Wheelchair Athletes. Frontiers in nutrition. 2020
3. Mountjoy M, et al. IOC consensus statement on relative energy deficiency in sport (RED-S): 2018 update. Br J Sports Med. 2018
4. Blauwet CA, et al. Low Energy Availability, Menstrual Dysfunction, and Low Bone Mineral Density in Individuals with a Disability: Implications for the Para Athlete Population. Sports Medicine. 2017
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Paralympic athletes, especially those performing in a wheelchair, reflect a special group within the sports community. The underlying disease or incidence not only leads to loss of sensory and motor function and impaired autonomous nervous system function but also results in a reduction in fat-free mass and increased fat mass due to immobility 1, 2. Consequently, resting energy expenditure (REE) and the m+etabolic cost of exercise and other activities is reduced, making proper fueling of these a...
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