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Body Weight Regulation, Disordered Eating Behaviour, and Experiences of Sexual Harassment in Female Martial Art Athletes (FMAB)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details. Identifier: NCT04559542
Recruitment Status : Recruiting
First Posted : September 23, 2020
Last Update Posted : September 23, 2020
Ostfold University College
University of Oslo
Information provided by (Responsible Party):
Professor Jorunn Sundgot-Borgen, Norwegian School of Sport Sciences

Brief Summary:

Athletes in martial arts compete in categories separated by body weight, hence, many athletes need to adjust their habitual body weight during periods with competition preparation. Athletes competing in weight sensitive sports are previously identified with an increased risk for symptoms of low energy availability and of disordered eating. The methods used for body weight regulation are varied, and athletes without professional competent support, are prone to rely on harmful methods. And of importance, female athletes respond more negatively to attempts of body weight reduction with regards to health effects.

Athletes of martial art are not surrounded by the same professional competence seen in other organized sports within the international sport federations, and specifically health competence is lacking. Additionally, numbers of females competing in martial art have increased the last decade, but they still practice in a sport culture dominated by males; both with reference to the high number of male participants, and with reference to the coaches within this sport. Sports involving practice in intimate, physical interaction with coaches or opposing athletes, and in sports where clothing is minimal, may be a high risk of experiences of sexual harassment. There have been a few reports on harmful methods of body weight regulation within martial arts, however, little knowledge exists on the practice by female martial art athletes, and the related health effects. Information on experiences of sexual harassment have been sparse in sport generally, with very little knowledge from sports like martial arts specifically. This study aims to explore the practice of female martial art athletes on body weight regulation, recovery strategies, their body acceptance and symptoms of eating disorders, and any experiences of sexual harassment. Additionally, with regards to the recent onset of the Covid-19 pandemic, this study also explores the related experiences by the athletes on training- and eating routines.

Condition or disease
Body Weight Changes Eating Disorder Symptom Sexual Harassment Covid19 RED S

Detailed Description:

Low energy availability is a situation triggered by a low energy intake relatively to the total energy needs. It may typically occur when energy expenditure is increased by sporting activities concurrently to an unconscious or voluntarily insufficient increase in energy intake. This may cause a condition called Relative energy deficiency in sport (RED-s), indicating a high risk for several negative health effects and performance deterioration. Athletes competing in body weight sensitive sports or sports categorized by body weight, have been identified with higher prevalence of RED-s, and specifically young females. Although it is the total difference between energy needs and energy availability that causes such scenario, the methods used to regulate body weight do also matter. Athletes without proper guidance on nutritional needs, recovery strategies, and optimal body weight regulation have previously reported use of harmful dieting methods, like purging methods, dehydration methods, and use of pharmaceuticals. Thus, young females competing in weight sensitive sport, not receiving any professional health and performance coaching are at specific risk for acutely and longterm negative health effects from chronic or repeated cycles of body weight reduction.

In a rapidly expanding martial arts industry in the US, there have been several reports on sexual assault. Still, no systematic and first-hand documentation on this issue has been completed. In Norway the same increase in popularity of material arts are noticed, an interest also seen among females. With regards to the limited knowledge on exercise practice, eating routines and health symptoms in female material art athletes, this study aims to expand this. By relying on a cross sectional cohort design with systematic registration of outcomes, this study also aim to expand on current limited knowledge on experiences of sexual harassment among females in material arts.

All females aged 16-35 practicing material arts in Oslo (Norway) at the time of recruitment (september-december 2020) will be invited (estimated to be between 200-300 athletes). All participants will receive information on the aim of this study, and must sign informed consent before participation. All data will be measured once per athlete.

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Study Type : Observational
Estimated Enrollment : 200 participants
Observational Model: Cohort
Time Perspective: Cross-Sectional
Official Title: Management of Body Weight Regulation, Symptoms of Low Energy Availability, Body Acceptance, Eating Disorders, and Sexual Harassment Among Female Martial Art Athletes, and Impact of COVID-19 on Training and Sport Participation
Actual Study Start Date : September 10, 2020
Estimated Primary Completion Date : November 30, 2020
Estimated Study Completion Date : December 31, 2020

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Body Weight

Female material art athletes
Females practicing material art during recruitment time, in Oslo-area in Norway

Primary Outcome Measures :
  1. Low energy availability for females questionnaire (LEAF-Q) [ Time Frame: Autumn 2020 ]
    Evaluating intensity in symptoms of low energy availability, with one general score, one subscale measuring symptoms of menstrual irregularities, and one subscale measuring symptoms of gastrointestinal dysfunction; the three scales having cut-off scores of ≥8 , ≥4 and ≥2, with higher scorings indicating higher clinical severity.

  2. Eating disorder examination questionnaire (EDE-q) [ Time Frame: Autumn 2020 ]
    Measuring symptoms of eating disorders and frequency of eating disordered behavior, resulting in one total score, and four subscales (figure concern, weight concern, eating concern and eating restriction). A total score of ≥2.5 indicates high probability of having an eating disorder. Additionally, the scales measures frequency of disordered eating behavior, for which ≥1 episode per week of binge-eating and/or ≥1 episode per week of purging behavior, over a total period of ≥3 months, qualifies for an diagnosis of eating disorder.

  3. Body Weight regulation strategies, selfreported [ Time Frame: Autumn 2020 ]
    Reports on methods complied with, to achieve body weight reduction (Predefined answers, including an "other" option)

  4. Body appreciation scale (BAS-2) [ Time Frame: Autumn 2020 ]
    Evaluates the level of body appreciation and acceptance. Questionnaire contains 10-items with a Likert scale ranging from 1 (Never) to 5 (Always), with a higher average score indicating a higher level of body appreciation.

Secondary Outcome Measures :
  1. Exercise frequency, selfreported according to a designed questionnaire [ Time Frame: Autumn 2020 ]
    Information on exercise frequency (number of sessions per week)

  2. Exercise duration, selfreported according to a designed questionnaire [ Time Frame: Autumn 2020 ]
    Information on duration of sessions (minutes per session)

  3. Exercise motivation, selfreported according to a designed questionnaire [ Time Frame: Autumn 2020 ]
    Information on motivation for material arts (reason for choosing the sport, and what level of performance one aims for)

  4. Exercise program variation, selfreported according to a designed questionnaire [ Time Frame: Autumn 2020 ]
    Information on the different physical activities performed (reports number of different sport activities undertaken during a typical week)

  5. Physical activity level, objectively measured [ Time Frame: Autumn 2020 ]
    Level of physical activity (counts/minute) objectively measured for seven consecutive days using the ActiGraph accelerometer (ActiGraph GT3x and GT3x+, Actigraph, LCC, Pensacola, Florida, USA)

  6. Four day weighed diet registration; energyintake [ Time Frame: Autumn 2020 ]
    Four day diet registration by pictures and detailed notes, for analyses of energyintake.

  7. Four day weighed diet registration; nutrient intake [ Time Frame: Autumn 2020 ]
    Four day diet registration by pictures and detailed notes, for nutrient analyses. The outcomes will specifically be analysed for total intake of protein, carbohydrate, and fat (gram per kg bodyweight)

  8. Four day weighed diet registration; nutrient intake [ Time Frame: Autumn 2020 ]
    Four day diet registration by pictures and detailed notes, for nutrient analyses. The outcomes will be analysed for total intake of micronutrients specifically found to be in risk of insufficient intake among young norwegian females (calcium, vit-D, folic acid, iodine) and considering their specific needs due to high levels of physically activity (iron and vitamin C) (all given by mg nutrient consumed)

  9. Experiences of sexual harassment [ Time Frame: Autumn 2020 ]
    Questions on experiences of sexual harassment, current experience of such, and frequency of such episodes.

  10. Effects from Covid-19 pandemic on exercise- and eating routines, designed questionnaire [ Time Frame: Autumn 2020 ]
    Questions on whether covid-19 changed their normal exercise and diet routines (yes/no), if this related to increased or decreased training volume or change in activity preferences. Additionally, whether the pandemic period has changed their energy intake (increased/decreased).

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   16 Years to 40 Years   (Child, Adult)
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   Yes
Sampling Method:   Probability Sample
Study Population
Female martial art athletes within sports of boxsing, thaiboxing, kickboxsing, judo, jui jitsu, brasilian jui jitsu, submission wrestling, mixed martial arts, taekwondo og karate.

Inclusion Criteria:

  • martial art athlete
  • living and training in Oslo-area (main capital) in Norway

Exclusion Criteria:

  • not matching sex, age or sport criteria

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT04559542

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Contact: Jorunn Sundgot-Borgen, PhD +47 922 41 745

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Norwegian school of sport sciences Recruiting
Oslo, Norway, 0806
Contact: Jorunn Sundgot-Borgen, PhD    +4792241745   
Sub-Investigator: Therese F Mathisen, Phd         
Sponsors and Collaborators
Norwegian School of Sport Sciences
Ostfold University College
University of Oslo
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Study Director: Jorunn Sundgot-Borgen, PhD Norwegian School of Sport Sciences
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Responsible Party: Professor Jorunn Sundgot-Borgen, Professor, Norwegian School of Sport Sciences Identifier: NCT04559542    
Other Study ID Numbers: 20/00378
First Posted: September 23, 2020    Key Record Dates
Last Update Posted: September 23, 2020
Last Verified: September 2020
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No
Plan Description: Data are kept within the scientific group

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Professor Jorunn Sundgot-Borgen, Norwegian School of Sport Sciences:
Mental health
Eating disorders
female athletes
physical health
Body dissatisfaction
Body acceptance
body weight
Additional relevant MeSH terms:
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Body Weight
Body Weight Changes
Feeding and Eating Disorders
Mental Disorders