High prevalence of subclinical energy availability and poor diet quality among paralympic basketball athletes.

Background: The aim of this study was to evaluate the pre-season nutritional status, diet quality, and energy availability levels of Paralympic athletes competing in wheelchair basketball.

Methods: Thirty-two male paralympic athletes, aged 18-63 years, from the Turkish Wheelchair Basketball League participated in the study. Body composition was assessed using dual-energy X-ray absorptiometry (DEXA), while resting metabolic rate (RMR) was measured through indirect calorimetry. Seven-day dietary intake and physical activity records were also collected. Diet quality was analyzed using the Healthy Eating Index- 2020 (HEI- 2020), and energy availability levels were calculated based on the collected data.

Results: The findings revealed that 81.8% of the athletes exhibited poor diet quality. On average, the athletes dietary carbohydrate intake was 2.75 ± 1.22 g/kg/day, while their protein intake was 1.04 ± 0.49 g/kg/day. The proportion of energy derived from dietary fat was 38.81 ± 6.7%, with 13.39 ± 2.99% coming from saturated fat. Intake levels of thiamine, folate, vitamin A, calcium, potassium, magnesium, and zinc were found to be inadequate. The average energy level among paralympic athletes was 37.41 ± 11.01 kcal/kg FFM/day, with 21.2% classified as having low energy availability levels and 57.5% as having subclinical energy availability levels. The athletes demonstrated a negative energy balance (- 560.02 ± 593.43 kcal/day), which was more pronounced on training days (- 889.04 ± 683.84 kcal/day).

Conclusions: These results suggest that paralympic athletes had insufficient dietary intake of energy, macronutrients, and micronutrients, alongside a high prevalence of low and subclinical energy availability levels. Developing nutrition recommendations tailored specifically for paralympic athletes, combined with implementing nutrition education programs led by qualified dietitians, could play a crucial role in safeguarding and improving their health, enhancing training adaptations, and optimizing athletic performance.