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Effect of nutritional intervention on body composition

and performance in elite athletes
a a b a
Ina Garthe , Truls Raastad , Per Egil Refsnes & Jorunn Sundgot-Borgen
a
Department of Sports Medicine , Norwegian School of Sport Sciences , Oslo , Norway
b
Department of Strength and Power , The Norwegian Olympic Sports Centre , Oslo , Norway
Published online: 01 Mar 2012.

To cite this article: Ina Garthe , Truls Raastad , Per Egil Refsnes & Jorunn Sundgot-Borgen (2013): Effect of nutritional
intervention on body composition and performance in elite athletes, European Journal of Sport Science, 13:3, 295-303

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 European Journal of Sport Science, 2013
Vol. 13, No. 3, 295
303, http://dx.doi.org/10.1080/17461391.2011.643923

ORIGINAL ARTICLE

Effect of nutritional intervention on body composition and

performance in elite athletes

INA GARTHE1, TRULS RAASTAD1, PER EGIL REFSNES2, &

JORUNN SUNDGOT-BORGEN1
1
Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway, and 2Department of Strength and
Power, The Norwegian Olympic Sports Centre, Oslo, Norway
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Abstract
Strength training and positive energy intake are the most important factors related to lean body mass (LBM) gain. Most
studies investigating weight-gain interventions are based recreationally active subjects and less is known about optimal
weight-gain protocols in elite athletes. The purpose of this study was to evaluate the effect of nutritional guidance in an 8- to
12-week weight-gain period in elite athletes. Thirty-nine elite athletes were randomised to either a ‘nutritional counseling
group’ (NCG, n 21, 19.192.9 years, 70.998.9 kg) or ‘ad libitum group’ (ALG, n 18, 19.692.7 years, 75.095.9 kg).
All athletes continued their sport-specific training which included an additional four strength-training sessions per week.
NCG followed a meal plan providing a positive energy balance, while the ALG athletes had an ad libitum energy intake.
Body weight (BW), body composition, one repetition maximum (1RM), 40 m sprint and counter movement jump (CMJ)
were measured pre- and post-intervention. Energy intake was higher in the NCG than in the ALG (35859601 vs.
29649884 kcal) and consequently BW increased more in NCG than in ALG (3.990.6% vs. 1.590.4%). Fat mass (FM)
increased more in NCG than in ALG (1594 vs. 393%), but gain in LBM was not different between groups. All 1RM
results improved in both groups (6
12%), whereas 40 m sprint and CMJ remained unchanged, except for a significant
decrease in 40 m sprint for the athletes in NCG. Athletes with nutritional guidance increased BW more, however, excess
energy intake in a weight-gain protocol should be considered carefully due to undesirable increases in body fat.

Keywords: Energy intake, strength training, hypertrophy

Introduction depends on an athlete’s genetics and strength training

history (ACSM, 2009b). A positive energy balance
Muscle mass is an important determinant of perfor-
alone has been shown to have an important anabolic
mance in sports that depend on muscular strength or
power. Our experience indicate that athletes attempt- effect (Forbes, Brown, Welle, & Lipinski, 1986), but
ing to gain weight and lean body mass (LBM) combining strength training and a positive energy
emphasise strength training but fail to focus on balance provides the most effective method to increase
nutrition and positive energy balance. The reason muscle mass (Kreider et al., 1996; Rozenek, Ward,
for this might be the practical challenge related to Long, & Garhammer, 2002). Studies on sedentary
increased energy intake, fear of gaining excess body subjects show that LBM contributes 38
46% of the
fat, and/or lack of knowledge. Many athletes strive to total weight gain associated with excess energy intake
increase muscle mass due to a busy training schedule (Bouchard et al., 1990; Forbes et al., 1986). Excess
and lack of time to buy, prepare and eat the amount of energy intake combined with strength training may
food needed. Thus, for many athletes, diets high in increase the contribution from changes in LBM to
saturated fat and dietary supplements advertised to 100% of the total weight gain (Kreider et al., 1996;
increase LBM, may be an easy solution (Rankin, Rozenek et al., 2002). Due to the fact that an increase
2002). In addition, the potential for muscle growth in fat mass (FM) is undesirable for many athletes, the

Correspondence: Ina Garthe, Department of Sports Medicine, Norwegian School of Sport Sciences, Postboks 4014, Ullevål Stadion, Oslo,
Norway. E-mail: [email protected]

# 2013 European College of Sport Science

 296 I. Garthe et al.

weight-gain protocol should be carefully planned. A Ratios of males to females were 91% vs 9% in the
combination of a well-designed strength-training nutritional counseling group (NCG) and 92% vs 8%
programme and an energy dense diet with adequate in the ALG. The physical and anthropometrical
protein and carbohydrate, and strategically timed characteristics of the athletes are shown in Table I.
protein intake, is recommended for optimal results The secretary general of each sport federation, the
(ACSM, 2009a, 2009b; Rankin, 2002; Tipton & national team coach, and the head of the healthcare
Wolfe, 2004). team for each of the national teams received detailed
Based on the few studies completed on elite written information about the aims and procedures
athletes and weight gain, a maximal increase in of the study. The athletes were informed about the
LBM of 0.25
0.5 kg per week may be realistic purpose and experimental procedures before written
(ACSM, 2009b; Houston, 1999). It has been consent was obtained. The study was conducted
suggested that the athlete would have a positive according to the Declaration of Helsinki and ap-
energy balance of 500
1000 kcal per day to increase proved by the Data Inspectorate and the Regional
LBM (Houston, 1999; Rankin, 2002). However, Ethic Committee of Southern Norway. Permission
athletes with a long history of heavy strength training to conduct the study was provided by the Norwegian
may have less capacity for increasing LBM and Olympic Committee and the Norwegian Confedera-
strength-related performance (ACSM, 2009b). The tion of Sports.
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excess energy intake in a weight gain protocol should

therefore be considered carefully and individually
because greater rates of weight gain are likely to Experimental design
include increments in body fat storage in trained The athletes were screened and block randomised
athletes. Therefore, the aim of this study was to into NCG and ALG. All athletes followed 8- to 12-
examine whether a controlled positive energy bal- week weight-gain period. The length of the inter-
ance through nutritional counselling could give a vention period for each subject depended on the
greater increase in LBM and strength-related per- athlete’s weight gain goal and length of the off-season
formance than ad libitum intake during 8- to 12-week period. Athletes in both groups were aiming for a
high-intensity strength-training period. We hypothe- weekly gain of 0.7% of total BW. This corresponds to
sised that the athletes in the intervention group, with a weekly weight gain of 0.5 kg in a 70 kg athlete.
daily excess energy intake corresponding to 500 Thus, if a 70 kg athlete were to increase his/her
kcal, would have greater gains in body weight (BW), weight by 5 kg, he/she would participate in the
LBM, and greater strength-related performance intervention for 10 weeks.
enhancement than the ad libitum group (ALG),
despite similar strength-training stimuli.
Pre-participation screening
The purpose of the screening was to evaluate
Methods
whether the athletes met the inclusion criteria. The
Subjects inclusion criteria were as follows: 1. elite athlete, 2.
age 17
35 years and 3. desired weight gain of ] 4%
Forty-seven elite athletes (17
31 years) were re-
of BW. The main exclusion criteria were as follows:
cruited, and 39 athletes completed the study. An
1. diseases and conditions that are known to affect
elite athlete was defined as one who qualified for the
Norwegian national team at the junior or senior
Table I. Physical and anthropometrical characteristics of athletes
level, or who was a member of a recruiting squad for presented as mean9SD
that team (students at the Norwegian Top-Level
Sports College). The given reasons for dropping out NCG ALG
were as follows: the project was too time consuming
(n 21) (n 18)
(n 3), strength training programme interfered with
sport-specific training techniques (n1), and an Age (years) 19.192.9 19.692.7
injury not related to the intervention (n 4). The Height (cm) 17997.4 18097.9
BW (kg) 70.798.5 74.995.7
athletes were recruited by invitation from the De-
FM (kg) 7.391.6 10.393.5*
partment of Sports Nutrition at the Norwegian Total body fat (%) 1193 1495
Olympic Sport Center when they contacted the Experience as athletes (years) 11.892.8 13.193.2
center to get assistance with weight gain, or by Training per week (h) 18.095.8 15.294.7
invitation letters to sport federations. The following Strength training last season 3.890.5 3.990.3
(h×week  1)
sports were represented: rowing (n1), kayaking
(n 1), soccer (n 4), volleyball (n1), tae kwondo Note: BW  Body weight, FM  fatmass.
(n 1), skating (n 5) and ice hockey (n26). *p B 0.05 significantly different between groups.
 Weight gain in elite athletes 297

metabolic functions in muscle, 2. use of pharmaceu- were instructed to eat ad libitum during the inter-
ticals that may affect any of the measurements and 3. vention period, with the goal of gaining 0.7%
pregnancy. The pregnancy criterion was based on BW×week 1.
blood tests and self-reports. The athletes were not allowed to use creatine
The screening was a clinical interview and medical supplements during the last 6 weeks prior to inclu-
examination according to the standard for pre- sion, and they did not take any supplements other
season health evaluation at the Norwegian Olympic than those given by the nutritionist during the
Sports Center. Athletes were also screened for intervention (e.g., if blood samples taken during
disordered eating and eating disorders by using the the screening at the Olympic Centre indicated any
Eating Disorder Inventory (Garner, 1991) and other specific micronutrient needs, these vitamins or
medical examination by a sports medicine physician. minerals were provided to the athletes and biochem-
ical changes were monitored). However, based on
the blood samples, none of the athletes needed
Intervention supplements during intervention. Athletes in both
groups had free access to sports products such as
Diet. Diet registrations were obtained using a 4- sports drinks and recovery shakes (30% protein/
day weighed food record (3 weekdays 1 weekend 70%carbohydrate drink) from Maxim (MaximTM,
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day) which was analysed by the national food Ishøj, Denmark).

database ‘Mat På Data’ (version 5.0. LKH, Nor-
Nutritional counselling. The NCG athletes received
way). The athletes’ weights were stable during diet
nutritional counselling from a team of two experi-
registration. The record served as a basis for the
enced nutritionists, whereas one was a clinical
development of each athlete’s individualised diet
dietician and one was an exercise physiologist
plan in the NCG, promoting weekly BW gain of
specialised in sports nutrition (IOC Diploma in
0.7% of total BW. In ALG, 24 hour recall was done
Sports Nutrition), once a week for the duration of
mid- and post-test to monitor changes in the
the intervention. The counselling covered basic
nutritional variables during the period. The 24
nutrition, sports physiology and possible adjust-
hour recall data were collected during meetings
ments in the dietary plan or weight regimen,
with the athletes. A standardised manual for ques-
depending on progress. The ALG athletes did not
tions and a visual guide of dinner plates/glass/cup/
receive any nutritional counselling before or during
bowl sizes were used, to ensure correct portion sizes.
intervention.
The macronutrient distribution of the total energy
intake in the meal plans for NCG was designed to Training. The intervention period started in the
have a protein intake corresponding to 1.4
2.0 off-season for all athletes (during their basic training
g ×kg×BW 1, a carbohydrate intake corresponding period) to be able to add additional training to their
to 5
7 g×kg×BW 1 and 25
30% fat (ACSM, 2009a; schedule and to prevent interference with competi-
Tipton & Wolfe, 2004). The focus was on energy- tion and travelling. Because strength training experi-
and nutrient-dense foods as well as high food variety ence is an important variable affecting the expected
and a frequent meal pattern to ensure energy intake increase in LBM during a period of high-intensity
every 3 hour, corresponding to 5
7 meals per day. strength training (ACSM, 2009b), we screened the
The dietary plan was tailored to meet each athlete’s athletes for their strength training background. The
specific needs and was designed to be as optimal as athletes in NCG and ALG reported spending
possible for both health and athletic performance. 3.890.5 h×week 1 and. 3.990.3 h×week 1, respec-
All NCG athletes ingested a recovery meal contain- tively, on strength training during the last year. All
ing carbohydrates (40
50 g) and protein of high athletes continued their sport-specific training sche-
biological value (15
20 g) within 30 minutes after dule (16.795.4 h ×week 1, presented as a mean of
training sessions, and a balanced meal within 1
2 the training during the previous year). Four strength
hours after training to optimise recovery (ACSM, training sessions ×week 1 were included to empha-
2009a; Tipton & Wolfe, 2004). All athletes in NCG sise muscle strength and hypertrophy. The strength
used food scales the first week to get familiar with training programme was a 2-split periodised pro-
portion sizes acquired for the intervention plan, and gramme. Each muscle group was exercised twice a
they were encouraged to use the food scale repeat- week with two exercises in each session, one multiple
edly during intervention to avoid changes in portion joint exercise (e.g. squat) and one isolated exercise
sizes. If the athletes were unable to follow the dietary (e.g. knee extension). Exercises for lower body
plan during the week, they were instructed to write included clean (whole body), squat, hack squat and
down any deviance from the plan. Athletes in the dead lift, and upper-body exercises included bench
ALG did not get feedback on their diet registration press, bench pull, rowing, chins, shoulder press and
before they had completed the study. ALG athletes 4
5 core exercises focusing on balance and stability.
 298 I. Garthe et al.

The athletes followed a 38-12 repetition max- The athletes were reminded to drink adequately the
imum (RM) regimen for the first four weeks, a 4 6- day before testing to avoid possible dehydration or
12RM for the next 4 weeks, and a 5 6-10RM for hyper hydration, however, hydration status was not
the final four weeks. For the athletes who partici- measured.
pated for fewer than 10 weeks (n 14), the pro-
gramme was adjusted with shorter periods. The rest
Performance variables
period between sets lasted 1
3 minutes dependent
on the exercise. As the athletes exceeded the RM- Since the aim of the study was to increase LBM and
goal, they increased the load by 2.5 kg or more to strength, the following performance indicators were
ensure progress throughout the 3 periods. Athletes chosen: 40 m sprint time, counter movement jump
were supervised by a sports physiologist once per height (CMJ) and one repetition maximum (1RM)
week during training at the Olympic Sports Center in bench press, bench pull and squat. Prior to the
to ensure correct technique and adequate progress. sprint, CMJ and 1RM strength tests (in that order
A computerised exercise diary made for the Olympic the same day), the athletes performed a standardised
athletes by the Olympic Sports Centre, was used warm-up consisting of 15 minutes low intensity
during the entire intervention period. running or cycling. Following the warm-up session,
the athletes performed three maximal 40 m sprints
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and the best result was used in the data analysis.

Experimental assessments
CMJ was performed on an AMTI force platform
All tests were conducted by the same test investiga- (SG 9, Advanced Mechanical Technology Inc.,
tors at both pre- and post-intervention, and the test Newton, MA, USA), and the best of three jumps
day was standardised. Athletes were not allowed to was used in the data analysis. 1RM was assessed in
perform heavy training 48 hours prior to testing. bench press, bench pull and squat. For 1RM the
weight was progressively increased until the athlete
could not move the weight through the full range of
Body weight. Body weight was measured in a fasted motion on at least two attempts with a 3 minutes rest
state, after emptying the bladder, with a balance between. Lifting belts was used as lifting-equipment
scale (Seca mod. 708, Seca Ltd., Birmingham, UK) in squat.
to the nearest 100 g on the test day in the morning
between 8.00
9.00 am. During the intervention
period, athletes used their own scales to monitor Statistical analyses
BW since their weekly meetings with the nutritionist Data are presented as mean9SD for pre- and post-
were at different times during the day and the weight intervention measurements and mean9SE for
fluctuated depending on food and liquid intake. changes within and between groups. The computer
They were instructed to weigh themselves without software Graphpad Prism 5.0 (CA, USA) and SPSS
clothes and with an empty bladder immediately after 15 (Illinois, Chicago, USA) were used for statistical
waking up and before breakfast. To control for the analysis. Pre- to post-intervention changes within
test-weight vs. their home-weight, athletes were groups were analysed with paired samples two-tailed
instructed to weigh themselves at their own scales Student’s t-test, and independent two-tailed Stu-
on the morning, right before they entered ‘weigh-in’ dent’s t-test was used for comparisons between
for the DXA measurement. groups. PB0.05 was considered statistically signifi-
Dual-energy X-ray absorptiometry (DXA). Fat cant.
mass, % body fat and LBM were measured with
DXA (GE Medical Systems, Lunar Prodigy, Wis-
Results
consin, USA) by a trained technician. The measure-
ments areas were (upper [trunk arms] and lower The mean time spent in intervention was 9.991.6
[legs]), total body, lumbar spine (L2
L4), femoral weeks for NCG and 9.991.3 weeks for ALG. There
neck, Ward’s Triangle, trochanter, femoral shaft and were no significant differences between groups in any
total femur in addition to BM, FM, LBM and of the baseline measurements except for the signifi-
calculation of fat percentage. The DXA system was cantly higher FM in ALG (Tables I
III).
calibrated everyday before testing and the test was
conducted in a fasted state between 8.30 am
Diet
and10.00 am. For DXA reproducibility, 10 male
and female athletes did two repeated measurements Energy intake for NCG was higher during interven-
within 24 hours, and the coefficient of variation in tion than at baseline (Table II). ALG had the same
DXA Lunar Prodigy total body scan for repeated weight-gain goal, energy intake did not change
measurements was 3% for FM and 0.7% for LBM. (Table II). Consequently, except for protein intake
 Weight gain in elite athletes 299

Table II. Energy and nutrition variables presented as mean9SD for pre intervention recordings, for meal plan in NCG during
interventions and for the 24-h recall during intervention in ALG. The change scores are given as mean9SE

NCG ALG

Diet Meal plan during Diet 24-h recall during

registration intervention Change registration intervention Change

Energy intake (kcal) 30419578 35859600 544931* 30329771 29649884 1289418**

Protein (g/kgBW) 1.890.4 2.490.4 0.690.1* 1.790.5 1.790.4 0.0390.2**
Protein (E%) 17.493.4 19.691.4 2.390.2* 17.493.2 18.593.5 1.290.7
CHO (g/kgBW) 5.491.1 6.891.3 1.490.8* 5.491.7 4.591.9 0.7391.3**
CHO (E%) 52.296.5 55.194.0 3.091.4 52.2910.3 47.496.1 5.092.4**
Fat (E%) 29.895.8 25.093.8 4.891.4* 30.099.2 34.193.8 3.892.3**
Fat (g/kgBW) 1.490.4 1.490.3 0.0390.3 1.490.6 1.590.4 0.0690.8

Note: BW  Body weight, CHO  carbohydrate, E%  per cent of total energy intake.
*p B 0.05 significantly different within groups.
**p B 0.05 significantly different between groups.
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(E%) and fat intake (g/kg BW), the intake of energy 0.290.9%, p B0.05) (Table III). Because only two
and macronutrients was higher for NCG than for females were included in each group, tests for
ALG (Table II). possible gender differences were not performed.
When doing the analyses without data from the
females, the results did not change significantly.
Body composition
Body weight increased more in NCG than in ALG Indicators of physical performance
(p B0.01), (Figure 1 and Table III). The average
weekly rate of weight gain was 0.490.1% for NCG No significant change was observed in CMJ in either
and 0.290.0% for ALG (p B0.01). FM increased of the groups (Figure 2 and Table III). Performance
more in NCG than in ALG (p B0.05) (Figure 1). in 40 m sprint decreased in NCG (p 0.03), but was
Total LBM increased by 2.890.4% in NCG unchanged in ALG. Strength improved in both
(p B0.001) and 1.990.4% in ALG (p B0.001) NCG and ALG in all three exercises tested (6

with no significant differences between groups 12%, Figure 2 and Table III). There were no
(p0.1) (Figure 1 and Table III). Individual significant differences between groups in any of the
changes in LBM from pre to post in NCG were performance variables.
more similar within the group than in ALG, where
one athlete had a more positive response compared
Compliers versus non-compliers
to the other athletes in the group (Figure 3).
Separating LBM measurements into upper body The predetermined weight gain goal for NCG and
and leg LBM revealed that NCG had significantly ALG was 4.990.8% and 5.290.9%, respectively,
higher gains in leg LBM than ALG (2.590.8% vs. with a weekly gain of 0.7% of initial BW, but not all

Table III. Body composition and performance variables presented as mean9SD for pre- and post-intervention and mean9SE for change

NCG ALG

Pre Post Change Pre Post Change

BW (kg) 70.798.5 73.498.4 2.790.4* 74.995.2 76.195.5 1.290.3* **

LBM total (kg) 61.298.7 62.998.9 1.790.3* 62.096.3 63.196.6 1.290.3*
LBM leg (kg) 21.290.7 21.790.7 0.590.2* 21.590.7 21.590.7 0.090.2**
LBM upper body (kg) 35.991.2 37.091.2 1.190.2* 36.490.9 37.591.0 1.190.2
FM (kg) 7.391.6** 8.492.1 1.190.3* 10.393.5 10.593.5 0.290.3**
CMJ (cm) 38.796.2 36.2910.7 0.6390.5 37.895.9 38.2919.8 0.4391.3
40 m sprint (s) 5.2892.20 5.3990.27 0.0790.03* 5.0991.39 5.0591.37 0.0290.04
1RM bench press (kg) 77.4921.2 85.2921.3 7.991.0* 82.2918.3 90.1918.4 6.9914*
1RM bench pull (kg) 69.3914.3 78.8913.6 5.590.8* 71.9921.8 76.1922.7 4.291.9*
1RM squat (kg) 114.5926.6 121.9925.5 9.691.5* 117.9930.3 128.5932.0 10.792.5*

Note: BW  Body weight, LBM  lean body mass, FM  fat mass, CMJ  counter movement jump, 1RM  one repetition maximum.
*p B 0.05 significant change within groups.
**p B 0.05 significantly different between groups.
 300 I. Garthe et al.

20 * elite athletes. We hypothesised that the athletes in

NCG ** NCG would gain more weight and LBM than ALG,
15 ALG and have a greater increase in strength-related
Change (%)
performance. Only 38% of the athletes in NCG
10 and 6% in ALG reached their predetermined weight
* ** gain goal. In accordance with our hypothesis,
5 * *
* athletes in NCG had a greater weight gain than the
athletes in ALG and a greater gain in leg LBM.
0 However, the greater total weight gain was mainly
BW LBM FM
due to greater gain in FM and there were no
Figure 1. Changes in body weight (BW), fat mass (FM), and lean significant differences between NCG and ALG in
body mass (LBM) in the nutritional counseling group (NCG) and changes in performance.
the ad libitum group (ALG). Data are presented as mean9SE.
*p B 0.05 significantly different from pre-intervention,
**p B 0.05 significant difference between groups.
Diet
athletes reached their goal. All athletes are included Both underreporting and undereating are common
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in the present results according to the intention to measurement errors in self-reported dietary intake,
treat principle. In NCG, 13 athletes did not accom- and have to be taken into consideration (Magkos &
plish their weight goal (with a cut-off value in weekly Yannakoulia, 2003). In order to reduce the errors of
weight gain between 0.5 and 1.0%). No significant underreporting or undereating, a thorough informa-
differences were found between compliers and non- tion session with every athlete was given before the
compliers in training hours, baseline values in LBM, food registration. This session was very practical and
or strength training experience. Although the ALG included instructions on how to easily weigh the food
athletes did not have any meal plans or nutritional in different situations, information about how to
guidance, their goal was also a weekly weight gain of avoid undereating due to the ‘hassle’ of weighing
0.7% of BW. Only one athlete in ALG accomplished everything and consequences of underreporting (in-
his weight-gain goal (with a cut-off value between 0.5 accurate meal plan). We chose a 4-day weighed food
and 1.0%). The mean gain in LBM and FM was registration at baseline for all and 24 hours recall
3.790.83% and 30.893.8% for compliers, respec- mid- and post-test for ALG in order to minimise the
tively, and 1.990.3% and 3.392.0 for non-com- burden, improve compliance and to reduce the risk
pliers, respectively. of alteration of the subject’s usual intake. The
calculated energy surplus for NCG was 544931
kcal×day 1. The mean carbohydrate intake during
Discussion intervention was 6.891.3 g ×kg 1 and 4.591.9
The aim of this study was to compare the effects of g×kg 1 for NCG and ALG, respectively, and within
nutritional counselling and ad libitum energy intake the recommended carbohydrate intake for athletes
on changes in body composition and performance (ACSM, 2009a). The mean protein intake was
during a high-intensity strength training period in 2.490.4 g×kg 1 for NCG and 1.790.4 g×kg 1 for
ALG. Protein intake for NCG was slightly higher
15 * * * NCG than the recommended protein intake for athlete-
* * ALG s (ACSM, 2009a; Tipton & Wolfe, 2004). Adequate
10 *
Change (%)

protein intake was considered important to ensure

5
sufficient amino acid supply to the muscles and to
* enhance the recovery. Further, the protein intake
0 was equally distributed throughout the day thru both
main meals and snacks. Although it was considered
–5 beneficial for the athletes to increase their fat intake
s

J
ul

ua

rin
es

to increase energy density, and thereby reduce

p

C
sq

sp
pr

n ch

the amount of food consumed, it was important

h

m
be
nc

40
be

that the athlete had confidence in the meal plan.

R
M

1
R

Thus, the meal plans for NCG were based on the

1

dietary registrations and general guidelines for each

Figure 2. Changes in 1RM bench press, bench pull, squat,
counter movement jump (CMJ) and 40 m sprint performance
nutrient, and the athletes were involved in the
in the nutritional counseling group (NCG) and the ad libitum development of their own meal plan. This included
group (ALG). Data are presented as mean9SE. choice of food and drinks and timing of intakes.
*p B 0.05 significantly different from pre-intervention. We consider personal involvement in planning to be
 Weight gain in elite athletes 301

Relative change in LBM (%)

Pre Post Pre Post

NCG ALG
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Figure 3. Relative changes in lean body mass (LBM) for athletes in the nutritional counseling group (NCG) and the ad libitum group
(ALG).

crucial for compliance and motivation for the better to strength training stimuli than leg muscles
athletes. (Wernbom, Augustsson, & Thomee, 2007). Further-
Although NCG athletes were closely monitored, more, all athletes already had a heavy load on leg
13 (62%) athletes did not accomplish their weight muscles in their sport-specific training, likely redu-
gain goal (with a cut-off value between 0.5 and cing the training potential in these muscles. It is
1.0%). Compared with the group allowed ad libitum unclear why NCG increased leg LBM more than
food intake, in which only one athlete (6%) accom- ALG. However, the greater increase in BW in NCG
plished his weight gain goal, the athletes in NCG than in ALG put a greater load on leg muscles in all
were more successful in reaching their weight gain activities involving moving one’s BW. Adding this
goal. However, we had expected a higher number of load to the strength training stimulus may therefore
athletes in NCG to meet the cut-off value. All have contributed to greater increase in leg LBM in
athletes had tried to gain weight one or more times NCG.
earlier in their athletic career. Some of the athletes The finding that athletes in NCG did not accom-
had succeeded in periods, but were not able to plish even greater gains in total LBM despite an
maintain the weight gain during season. Oral feed- energy surplus corresponding to 500 kcal may
back from the athletes in NCG indicated that have several explanations. First, all athletes had some
although they considered the meal plan and nutri- strength training experience, with power and
tional guidance a great help, compared with trying to strength as important factors for their sport-specific
increase BW by themselves, it was occasionally hard performance. Thus, we could not expect large
to eat the calculated amount within the tight time increases in LBM from 8
12 weeks of heavy strength
schedule. Feedback from athletes in ALG indicated training. As opposed to other weight gain studies
that they found it challenging to increase energy that have added extra energy corresponding to
intake, mostly because of practical implications such 1000
2000 kcal ×day 1 (Forbes et al., 1986; Leibel,
as planning meals and finding time to eat, but also Rosenbaum, & Hirsch, 1995; Rozenek et al., 2002;
because of the insecurity about food choice and Dériaz, Tremblay, & Bouchard, 1993), we mini-
amount of food for some athletes who tried to avoid mised the amount of excess energy. In the study by
gaining excess body fat. Rozenek et al. (2002), untrained subjects gained 3
kg in 8 weeks, and LBM contributed to almost 100%
of the weight gain when they combined strength
Body composition
training and energy surplus corresponding to 2000
The increase in LBM contributed to 72% of kcal×day 1. Because our athletes most likely had
weight gain in NCG. LBM was significantly higher used more of their potential for LBM growth due to
in NCG and the gain in LBM in ALG was mainly years of strength training, we decided to add only
caused by an increase in upper body LBM. There 500 kcal×day 1.
may be several explanations for this finding, but is Another reason for not accomplishing greater
seems like upper body muscles generally respond gains in LBM in our study may be that athletes in
 302 I. Garthe et al.

both groups continued their sport-specific training except for FM, it is important to keep in mind that
during intervention. Although the intervention per- athletes from different sports may have different
iod was completed in off-season and the athletes training regimens and methods. However, when
emphasised strength training during the period, rerunning the analyses with only athletes from ice-
some technical and endurance training to maintain hockey (n26), which was the most represented
sport-specific skills was necessary. When strength sport in the study, the results did not change
and endurance training are performed simulta- significantly.
neously, a potential interference in strength devel-
opment may occur caused by alterations in the
Performance
adaptive protein synthesis (Nader, 2006). For ex-
ample, acute resistance exercise induces the activa- Strength improved in all three tests in both groups,
tion of mammalian target of rapamycin (mTOR), but neither 40 m sprint nor CMJ performance
which modulates muscle protein synthesis (Nader, improved. When weight gain occurs due to increased
2006). Endurance exercise, on the other hand, is FM, performance is not expected to increase in anti
associated with signalling mechanisms related to gravity-related tests such as jumping and sprinting
metabolic adaptations, such as the activation of the since the excess load as FM is considered non
AMP-activated protein kinase (AMPK) (Nader, functional. The improvements in strength were
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2006). Thus, activation of AMPK by endurance smaller in this study than other studies that included
training may reduce skeletal muscle-protein synth- subjects with less strength training experience (Krei-
esis by inhibiting mTOR signalling and may thus der et al., 1996; Rozenek et al., 2002). This may be
limit hypertrophy and strength increases in response due to the greater strength training experience in our
to strength training. athletes and the concurrent sport-specific training
Individual changes in LBM from pre to post show during intervention. A challenge in most studies is to
that the athletes responded differently to the inter- measure sport-specific performance. Because of the
vention (Figure 3). Two athletes in NCG and two heterogeneous group of athletes in this study, we
athletes in ALG had slightly different interventions included more general tests as predictors of sports
than the other athletes, due to increased endurance performance. Nevertheless, the more general impact
training (n 2) and injury/illness (n 2) during the on physical capacity measured in this study, gives
last 3
4 weeks in the intervention. This resulted in a important information on how function is affected
net loss of LBM in these athletes (all other athletes by the interventions.
maintained or increased LBM). We decided to
include these athletes in the study because they
Compliers
were able to complete the strength training pro-
gramme as described, although they reported fatigue It may be discussed whether the non-compliers in
and loss of appetite. Three of these athletes also had NCG were actually non-responders to the interven-
a net weight loss during that period. When excluding tion due to counter regulatory mechanisms (i.e.,
the four athletes from the analysis, the results did not increased metabolism or other mechanisms decreas-
change significantly for any of the variables. ing food efficiency) (Bouchard et al., 1990; Leibel et
The increase in FM seen in NCG may be al., 1995; Weyer et al., 2000). If the athletes were
problematic for some athletes during a weight gain unable to follow the dietary plan during the week, they
period for a variety of reasons, from hindering sport- were instructed to write down any deviance from the
specific performance to not fitting the stereotype of plan. However, the athletes might have left out or
the lean and muscular athlete. A negative effect of forgot to report to the nutritionist and there was no
increased FM on performance was observed with the other control for food intake during the week than the
reduction in sprint performance in NCG. Our counselling and weight report. In addition, they
results indicate that experienced strength-trained reported that it was challenging to eat the amount of
athletes can only increase LBM to a limited extent. food as planned. The number of dropouts was 1 in
Consequently, an energy surplus has to be indivi- NCG and 7 in ALG, which may have influenced the
dualised to avoid large increases in FM for this group results in ALG. The reasons for dropping out in ALG
of athletes. were: project was too time consuming (n 3),
strength training programme interfered with sport-
specific training techniques (n 1), and injury not
Training
related to the intervention (n 3). Even though both
The strength training programme implemented in groups had weekly follow-up with a personal strength
this study was designed in order to stimulate muscle trainer, the NCG received additional follow-up on
gain in all athletes. Although there were no differ- nutrition, which may have contributed to increased
ences between groups in baseline measurements commitment to the project.
 Weight gain in elite athletes 303

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