Nura Alwan
Lecturer in Sport Nutrition and Physiology
School of Sport, Nutrition and Allied Health Professions
Publications
Journal articles
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Alwan N, Moss SL, Davies IG, Elliott-Sale KJ, Enright K, 'Weight loss practices and eating behaviours among female physique athletes: Acquiring the optimal body composition for competition'
PLoS ONE 17 (1) (2022)
ISSN: 1932-6203 eISSN: 1932-6203AbstractPublished here Open Access on RADARLittle is known about weight loss practices and eating behaviours in female physique athletes. This study investigated the weight loss history, practices, and key influences during the pre-competition period in a large cohort of female physique athletes stratified by division and experience level. Eating attitudes and behaviours were assessed to identify whether athletes were at risk of developing an eating disorder. Using a cross-sectional research design, female physique athletes (n = 158) were recruited and completed an anonymous online self-reported survey consisting of two validated questionnaires: Rapid Weight Loss Questionnaire and Eating Attitudes Test-26. Irrespective of division or experience, female physique athletes used a combination of weight loss practices during the pre-competition phase. Gradual dieting (94%), food restriction (64%) and excessive exercise (84%), followed by body water manipulation via water loading (73%) were the most commonly used methods. Overall, 37% of female physique athletes were considered at risk of developing an eating disorder. Additionally, 42% of female physique athletes used two pathogenic weight control methods with 34% of Figure novice athletes indicating binge eating once a week or more. The coach (89%) and another athlete (73%) were identified as key influences on athletes’ dieting practices and weight loss. The prevalence of athletes identified with disordered eating symptoms and engaging in pathogenic weight control methods is concerning. In future, female physique athletes should seek advice from registered nutritionists to optimise weight management practices and minimise the risk of developing an eating disorder.
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Alwan N, Moss SL, Elliott-Sale KJ, Davies IG, Enright K, 'A Narrative Review on Female Physique Athletes: The Physiological and Psychological Implications of Weight Management Practices'
International Journal of Sport Nutrition and Exercise Metabolism 29 (6) (2019) pp.682-689
ISSN: 1526-484X eISSN: 1543-2742AbstractPublished herePhysique competitions are events in which aesthetic appearance and posing ability are valued above physical performance. Female physique athletes are required to possess high lean body mass and extremely low fat mass in competition. As such, extended periods of reduced energy intake and intensive training regimens are used with acute weight loss practices at the end of the precompetition phase. This represents an increased risk for chronic low energy availability and associated symptoms of relative energy deficiency in sport, compromising both psychological and physiological health. Available literature suggests that a large proportion of female physique athletes report menstrual irregularities (e.g., amenorrhea and oligomenorrhea), which are unlikely to normalize immediately postcompetition. Furthermore, the tendency to reduce intakes of numerous essential micronutrients is prominent among those using restrictive eating patterns. Following competition, reduced resting metabolic rate, and hyperphagia, is also a concern for these female athletes, which can result in frequent weight cycling, distorted body image, and disordered eating/eating disorders. Overall, female physique athletes are an understudied population, and the need for more robust studies to detect low energy availability and associated health effects is warranted. This narrative review aims to define the natural female physique athlete, explore some of the physiological and psychological implications of weight management practices experienced by female physique athletes, and propose future research directions.
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Owens DJ, Sharples AP, Polydorou I, Alwan N, Donovan T, Tang J, Fraser WD, Cooper RG, Morton JP, Stewart C, Close GL, 'A systems-based investigation into vitamin D and skeletal muscle repair, regeneration, and hypertrophy'
Endocrinology and Metabolism 309 (12) (2015) pp.E1019-E1031
ISSN: 0193-1849 eISSN: 1522-1555AbstractPublished hereSkeletal muscle is a direct target for Vitamin D. Observational studies suggest that 25[OH]D correlates with recovery of skeletal muscle following eccentric contractions in humans and crush injury in rats. However, a definitive association is yet to be established. In order to address this gap in knowledge in relation to damage repair, a randomised, placebo-controlled trial was performed in twenty males with low serum 25[OH]D (45 ± 25 nmol.L(-1)). Prior to and following 6-weeks of supplemental Vitamin D3 (4,000 IU.day(-1)) or placebo (50 mg cellulose), participants performed 20×10 damaging eccentric contractions of the knee extensors with peak torque measured over the following 7 days of recovery. Parallel experimentation using isolated human skeletal muscle derived myoblast cells from biopsies of 14 males with insufficient serum 25[OH]D (37 ± 11 nmol.L(-1)) were subjected to mechanical wound injury, which enabled corresponding in vitro studies of muscle repair, regeneration and hypertrophy in the presence and absence of 10 nmol or 100 nmol 1α,25[OH]2D3. Supplemental Vitamin D3 increased serum 25[OH]D and improved recovery of peak torque at 48 hours and 7 days post-exercise. In vitro, 10 nmol 1α,25[OH]2D3 improved muscle cell migration dynamics and resulted in improved myotube fusion/differentiation at the biochemical, morphological and molecular level together with increased myotube hypertrophy at 7 and 10 days post-damage. Together, these preliminary data are the first to characterise a role for Vitamin D in human skeletal muscle regeneration and suggest that maintaining serum 25[OH]D may be beneficial for enhancing reparative processes and potentially for facilitating subsequent hypertrophy.
Conference papers
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Pope L, Douglas J, Alwan N, 'History and Knowledge of Menstrual Cycle Status and Hormonal Contraceptive Use in Female Equestrian Athletes'
International Journal of Sport Nutrition and Exercise Metabolism 32 (S1) (2022) pp.S1-S8
ISSN: 1526-484X eISSN: 1543-2742AbstractPublished hereThere is a high prevalence of hormonal contraceptive (HC) use in athletic populations despite reported impacts on performance such as cognitive control and muscle functions. Whilst research is emerging in female athletes, there is a paucity of evidence concerning female equestrian athletes. Therefore, the objectives of this study were to: 1) identify the prevalence of HC use, menstrual cycle disturbances and symptoms of their cycle and HC use in female equestrian athletes and 2) to assess knowledge of the menstrual cycle and oral contraceptives. One hundred sixty-six female semi- and professional equestrian athletes (mean ± SD; age, 27 ± 8 years; body mass, 65.8 ± 13.6 kg; height, 166.6 ± 7.8 cm) completed an online survey using two adapted questionnaires from Oxfeldt et al. (2020) and Larsen et al. (2020). In total 57% of athletes were currently using HC, with the majority using the combined pill (51%). Over half (67%) of HC users reported using HC to avoid bleeding. While 30% of non-HC users reported menstrual disturbances in the last three months, 14% and 4% were classified as being secondary amenorrhoeic and primary amenorrhoeic, respectively. Although 57% of all athletes reported that negative menstrual cycle symptoms caused them not to participate or complete their scheduled training, non-HC users experienced more negative physical symptoms across their menstrual cycle compared to HC users pill cycle (p10 points (classed as a good knowledge score). There was a significant difference reported between HC and non-HC users in their total knowledge score (p
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Alwan N, Davies IG, Moss SL, McVeigh J, Enright K, 'Novel insights into methods practiced among female physique athletes to acquire optimal body compositions. '
28 (Issue S1) (2018)
ISSN: 1526-484XAbstractPublished hereFemale physique athletes are a growing population aiming to achieve low levels of fat free mass whilst sustaining lean muscle mass. These athletes typically display an aesthetic symmetrical and well-proportioned body peaking for physique competitions. However, the practices used to achieve this required body composition are poorly understood. In a cross-sectional study design, we examined the pre-competition body mass loss behaviors in amateur physique athletes competing in the 2016-17 season. Weight loss history, and aesthetic and weight loss practices were determined using a validated and self-reported questionnaire. After exclusion criteria were met, a total of 125 completed questionnaires (age 30 ± 8.0 years; body mass 55.7 ± 8.9 kg; and stature 162.9 ± 15.9 cm) were analysed using descriptive statistics and chi-square analysis. Athletes reported losing 12.5 ± 4.9% body mass over a preparation period of 15 ± 6.5 weeks (range 4-32 weeks), and a 2.7 ± 1.7 % body mass loss (range = 0-8.9%) during the week prior to the competition, respectively. Although athletes reported gradual dieting (77.9%), food restrictions (49.7%) and excessive exercising (66.4%) as methods to reduce fat mass, an experimental dehydration method of ‘water loading’ (57.7%) and electrolyte manipulation (28.2%) in the acute period prior to competition were commonly reported. Only 14.1% of athletes were influenced by a qualified nutritionist/dietitian, whereas the majority received advice from coaches, peers and internet sources. Water loading was significantly more common among regional athletes (70.7%) compared to international athletes (52.9%) (p = 0.04). Consequently, the practices used to reduce body mass were likely to be more severe at regional level, which supports the unhealthy and extreme weight management behaviors previously shown in novice physique athletes. These novel findings show engagement by female physique athletes in various practices in an attempt to acquire an optimal body composition for competition. Moreover, the prevalence and occurrence of these differ between competitive levels. The implications of which combined with the growing popularity of the sport and media influences warrant further work to better determine the health risks involved in this population of athletes.