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Dietary records are often biased, especially those of overweight individuals. The purpose of the study was to investigate underreporting among persons of normal weight with a very high energy intake (El).
The total energy expenditure (TEE) of 16 elite athletes (BMI 24 +/- 2 kg/m(2)) and 17 controls (BMI 23 3 kg/m2) was measured using the doubly-labeled water technique (DLW, 14d). El was estimated using 2 x 3-day dietary records. Underreporters were identified by BLACK'S cut-off (El:TEE < 0.76). 44% of athletes (El: 3584 824 kcal/d; TEE: 4621 1460 kcal/d) and 29% of controls (El: 2552 680 kcal/d; TEE: 3151 822 kcal/d) were identified as underreporters. TEE explains 52% of underreporting. In summary, a high energy intake seems to strongly predict underreporting. Prevalence and magnitude of underreporting increase with increasing energy intake.
Since the legend of the ancient Marathon run, the risk of endurance exercise-induced cardiovascular damage or sudden cardiac death is discussed. In recent studies, the exercise-induced increases in cardiac biomarkers in endurance athletes as well as acute alterations in cardiac function and cardiovascular abnormalities have been reported. As elevations of the cardiac biomarkers troponin and BM) have been observed frequently for the vast majority of athletes after Marathon runs or strenuous exercise bouts followed by a decrease within a short period, a physiological reaction rather than a pathologicial cause is presumed. Also a transient decrease of cardiac function demonstrated by newer echocardiographic techniques (tissue Doppler or speckle tracking imaging, 3D echocardiography) after strenuous exercise often termed "cardiac fatigue" should not be considered necessarily as pathologic, as cardiac function also depends on hemodynamic load and heart rate. Furthermore, exercise-induced changes in cardiac function did not correlate with exercise-induced increases in cardiac biomarkers in most studies. The functional cardiac alterations can also be detected by magnetic resonance imaging (MRI) after Marathon runs. However, no signs of acute or chronic myocardial damage have been demonstrated in MRI studies in cardiovascular healthy athletes after running a Marathon, although especially in older athletes undetected cardiovascular diseases such as coronary artery disease or myocardial necrosis or fibrosis can be present. hi conclusion, according to recent studies. there seems to be a lack of evidence to support endurance exercise-induced cardiac damage in the healthy heart which is adapted tostrenous exercise by regular endurance training. Nevertheless, as running a Marathon results in a high cardiac load, a sufficient endurance training period as well as a preparticipation or regular medical screening to exclude relevant congenital or aquired cardiovascular diseases is recommended from a sports cardiology perspective to exclude relevant congenital or acquired cardiovascular diseases