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Trial registered on ANZCTR
Registration number
ACTRN12624000164594
Ethics application status
Approved
Date submitted
18/01/2024
Date registered
21/02/2024
Date last updated
12/04/2024
Date data sharing statement initially provided
21/02/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Refeeding Physique Athletes Post-Competition
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Scientific title
The effect of refeeding strategies on body composition and resting metabolic rate of physique athletes post-competition.
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Secondary ID [1]
311353
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
decreased metabolic rate
332616
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symptoms associated with low energy availability
332617
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Condition category
Condition code
Metabolic and Endocrine
329319
329319
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0
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Normal metabolism and endocrine development and function
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Diet and Nutrition
329465
329465
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0
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Other diet and nutrition disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
A parallel-group, randomised controlled trial will be conducted to evaluate the effectiveness of refeeding nutrition strategies in physique athletes post-competition. This study will be conducted in accordance with the CONSORT statement for randomised controlled trials.
Approximately 30 male and female natural physique athletes will be recruited to participate in a 9-month study across their competitive season. Participant baseline testing at the beginning of the athlete’s individual competition preparation phase, which generally starts between 20-25 weeks pre-competition. Key observational time points consist of a baseline measure at T0 (20-25 weeks pre-competition), T1 (1-2 weeks pre-competition), T2 (1-2 weeks post-competition), T3 (6 weeks post-competition) and T4 (12 weeks post-competition). In the event that a participant plans to compete at multiple competitions spanning greater than 4 weeks between the first and final competition, an additional time point (T1.5) will be added 1-2 weeks prior to their last competition of the season.
Participants will follow the guidance of their own coach leading into competition. After completing their final show of the season, participants will be randomly assigned electronically, by block design into two arms (ARM-1 or ARM-2).
ARM-2 Individualised Dietary Support:
Participants will consult with the lead researcher who is an Accredited Sports Dietitian (CB) to develop an individualised dietetic intervention for 12 weeks post-competition. Daily energy targets will be based on predicted energy requirements (Cunningham Equation and NHMRC Physical Activity Levels) in conjunction with consideration of each athlete’s reported energy intake.
A 30-min counselling session will be held by a research dietitian to educate participants on the use of Easy Diet Diary (EDD) (Xyris Software Australia Pty Ltd) before beginning the study. Training logs (type, timing, intensity using rate of perceived exertion) and food records (kilojoules (kJ) and macronutrients) will be collected for 7-days at T0, T1, and T1.5. Accuracy of entries will be verified at face-to-face laboratory visits.
At T1: A 1-hour face-to-face introductory session will be held to discuss post-competition body composition and health goals with the participant. Immediately post-competition to 12 weeks post-competition, participants will conduct weekly 30-minute phone or Zoom meetings with an Accredited Practicing Dietitian to review progress and provide additional support as required. During this time, participants will track daily dietary intake using EDD and conduct weekly training logs.
Food advice will align with the principles of the Australian Guide to Healthy Eating and evidence-based sports nutrition practice. Each athlete’s food preferences will also be considered. In general, athletes will be encouraged to meet their individualised energy and nutrient goals through consuming a variety of foods from all food groups. Unprocessed foods will be given priority.
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Intervention code [1]
327798
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Treatment: Other
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Intervention code [2]
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Behaviour
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Comparator / control treatment
ARM-1 Athlete’s Usual Practice:
Participants will consult with the research dietitian to discuss monitoring their dietary intake for 12 weeks post-competition as follows:
A 30-min counselling session will be held by a research dietitian to educate participants on the use of Easy Diet Diary (EDD) (Xyris Software Australia Pty Ltd) before beginning the study. Training logs (type, timing, intensity using rate of perceived exertion) and food records (kilojoules (kJ) and macronutrients) will be collected for 7-days at T0, T1, and T1.5. Accuracy of entries will be verified at face-to-face laboratory visits.
From the day after competition to 12 weeks post-competition, participants will be asked to report daily dietary intake using EDD and conduct weekly training logs. During this time, weekly 20-minute phone or Zoom meetings will be scheduled with a research dietitian to check compliance with dietary monitoring and verify accuracy of entries.
Participants in this group will not be given any dietary guidance as part of this study. They will be asked to resume their normal practices. They will be free to seek dietary advice from external sources to the study (coach, provoke dietitian etc.) as per their usual practice.
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Control group
Active
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Outcomes
Primary outcome [1]
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Primary outcome 1: Body fat
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Assessment method [1]
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Body fat will be assessed using Dual-Energy X-ray Absorptiometry (DXA). DXA scans will be conducted by a qualified DXA technician according to AIS Best Practice Protocol for GE DXA scans, using Lunar Prodigy Advance (Encore Version 13.60 software)
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Timepoint [1]
337136
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T0 (baseline 20-25 weeks pre-competition), T1 (1-2 weeks pre-competition), T3 (6 weeks post-competition) and T4 (primary timepoint, end of intervention, 12-weeks post-competition).
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Primary outcome [2]
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Primary outcome 2: Resting metabolic rate
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Assessment method [2]
337137
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Resting metabolic rate (RMR) will be collected using indirect calorimetry (Parvo Truemedics 2400 Hans Rudolph)
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Timepoint [2]
337137
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T0 (baseline 20-25 weeks pre-competition), T1 (1-2 weeks pre-competition), T2 (1-2 weeks post-competition), T3 (6 weeks post-competition) and T4 (primary timepoint, end of intervention, 12-weeks post-competition).
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Primary outcome [3]
337415
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Primary outcome 3: Total body weight
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Assessment method [3]
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Labratory-based calibrated digitial scales will be used to asses body weight.
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Timepoint [3]
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T0 (baseline 20-25 weeks pre-competition), T1 (1-2 weeks pre-competition), T2 (1-2 weeks post-competition), T3 (6 weeks post-competition) and T4 (primary timepoint, end of intervention, 12-weeks post-competition).
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Secondary outcome [1]
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Serum thyroid marker: TSH
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Assessment method [1]
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Thyroid-stimulating hormone (TSH) will be collected using Intelligent Screening (Pty) Ltd, Australia (I-Screen).
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Timepoint [1]
430833
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T0 (baseline 20-25 weeks pre-competition),
T1 (1-2 weeks pre-competition),
T4 (secondary timepoint, end of intervention, 12-weeks post-competition).
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Secondary outcome [2]
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Menstrual function
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Assessment method [2]
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Menstrual function will be self-reported through an online questionnaire (Qualtrics Core XM). Female participants will be asked about menstrual regularity, hormonal contraceptive use, and the date of their last menstrual period.
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Timepoint [2]
430834
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T0 (baseline 20-25 weeks pre-competition), T1 (1-2 weeks pre-competition), T3 (6 weeks post-competition) and T4 (secondary timepoint, end of intervention, 12-weeks post-competition).
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Secondary outcome [3]
430835
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Pyschological scores - Mood
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Assessment method [3]
430835
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Mood will be monitored to by the Abbreviated Profile of Mood States questionnaire (A-POMS) at each time point from T0-T4. The A-POMS scores mood using 7 mood subscales and a Total Mood Disturbance score (TMD) that can be calculated to reflect an overall measure of mood disturbance, with higher scores indicating greater disturbance.
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Timepoint [3]
430835
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T0 (baseline 20-25 weeks pre-competition), T1 (1-2 weeks pre-competition), T2 (1-2 weeks post-competition), T3 (6 weeks post-competition) and T4 (secondary timepoint, end of intervention, 12-weeks post-competition).
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Secondary outcome [4]
430836
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Sleep
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Assessment method [4]
430836
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Sleep will be assessed using the Athlete Sleep Screening Questionnaire (ASSQ) to evaluate how the refeeding protocol may influence changes in sleep quality and quantity.
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Timepoint [4]
430836
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T0 (baseline 20-25 weeks pre-competition), T1 (1-2 weeks pre-competition), T2 (1-2 weeks post-competition), T3 (6 weeks post-competition) and T4 (secondary timepoint, end of intervention, 12-weeks post-competition).
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Secondary outcome [5]
430837
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Disordered behaviours
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Assessment method [5]
430837
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The Eating Disorder Examination-Questionnaire Short (EDE-QS) will be used to assess eating behaviours related to restraint, eating concerns, and body composition concerns. The EDE-QS provides an overall global score, with a higher score indicating a greater prevalence of disordered behaviours.
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Timepoint [5]
430837
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T0 (baseline 20-25 weeks pre-competition), T2 (1-2 weeks post-competition), T3 (6 weeks post-competition) and T4 (secondary timepoint, end of intervention, 12-weeks post-competition).
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Secondary outcome [6]
430838
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Strength
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Assessment method [6]
430838
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Strength will be assessed using a portable isometric mid-thigh pull (IMTP) device equipped with a single-axial load cell at each timepoint. This will provide measures of peak performance at selected time points.
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Timepoint [6]
430838
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T0 (baseline 20-25 weeks pre-competition), T1 (1-2 weeks pre-competition), T2 (1-2 weeks post-competition), T3 (6 weeks post-competition) and T4 (secondary timepoint, end of intervention, 12-weeks post-competition).
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Secondary outcome [7]
430839
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Qualitative experiences
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Assessment method [7]
430839
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Qualitative semi-structured interviews will be conducted upon completion of the refeeding protocol at T4. Participants will be asked about their experiences related to both the refeeding protocol and their competition preparation phase. This will include aspects of how they structured their diet during competition preparation, tools used to maximise adherence and body composition changes, challenges faced, perceived changes to health and mental function, and acceptability of the intervention. The interview will take approximately 1 hour.
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Timepoint [7]
430839
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T4 (secondary timepoint, end of intervention, 12-weeks post-competition).
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Secondary outcome [8]
431297
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Lean body mass
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Assessment method [8]
431297
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Lean body mass will be assessed using Dual-Energy X-ray Absorptiometry (DXA).
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Timepoint [8]
431297
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T0 (baseline 20-25 weeks pre-competition), T1 (1-2 weeks pre-competition), T3 (6 weeks post-competition) and T4 (secondary timepoint, end of intervention, 12-weeks post-competition).
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Secondary outcome [9]
431780
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Fat free mass
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Assessment method [9]
431780
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Fat free mass will be assessed using Dual-Energy X-ray Absorptiometry (DXA).
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Timepoint [9]
431780
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T0 (baseline 20-25 weeks pre-competition), T1 (1-2 weeks pre-competition), T3 (6 weeks post-competition) and T4 (secondary timepoint, end of intervention, 12-weeks post-competition).
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Secondary outcome [10]
431782
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Serum thyroid marker: T3
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Assessment method [10]
431782
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Triiodothyronine (T3) will be collected using Intelligent Screening (Pty) Ltd, Australia (I-Screen).
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Timepoint [10]
431782
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T0 (baseline 20-25 weeks pre-competition),
T1 (1-2 weeks pre-competition),
T4 (secondary timepoint, end of intervention, 12-weeks post-competition).
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Secondary outcome [11]
431783
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Serum thyroid marker: T4
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Assessment method [11]
431783
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Thyroxine (T4) will be collected using Intelligent Screening (Pty) Ltd, Australia (I-Screen).
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Timepoint [11]
431783
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T0 (baseline 20-25 weeks pre-competition),
T1 (1-2 weeks pre-competition),
T4 (secondary timepoint, end of intervention, 12-weeks post-competition).
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Eligibility
Key inclusion criteria
1. Biologically male or female aged 18-45 years,
2. Have prepared for at least 1 natural bodybuilding show in the past 10 years,
3. Be committed to competing in Season B natural bodybuilding (any category) 2024,
4. Currently >10-15% above estimated stage weight for competition,
5. Have engaged a coach for the competitive season.
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Minimum age
18
Years
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Maximum age
45
Years
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
1. Any participants under 18 or over 45 years of age.
2. Any participants who declare current or historical use of performance-enhancing substances.
3. Any participants with a history of clinically diagnosed eating disorders.
4. Any participants who are pregnant, breastfeeding, or planning on becoming pregnant within the next year.
5. Any participants with medical conditions and/or taking medications that may affect body weight, body composition, appetite, heart rate, metabolic rate, and/or endocrine function.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Randomisation will be completed by an investigator who has not had contact with participants before randomisation and is not involved in the implementation of interventions. The block sizes will not be disclosed to investigators administering the intervention to ensure allocation concealment.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
A computer-generated randomisation process will be used to assign participants, with a 1:1 allocation ratio, to either ARM-1 or ARM-2. Participants will be stratified by sex and age, using permuted blocks of random sizes.
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
18/03/2024
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Actual
21/03/2024
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Date of last participant enrolment
Anticipated
28/06/2024
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Actual
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Date of last data collection
Anticipated
1/04/2025
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Actual
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Sample size
Target
30
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Accrual to date
4
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Final
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Recruitment in Australia
Recruitment state(s)
ACT,NSW
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Funding & Sponsors
Funding source category [1]
315609
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University
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Name [1]
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University of Canberra Research Institute for Sport and Exercise
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Address [1]
315609
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11 Kirinari St, Bruce ACT 2617
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Country [1]
315609
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Australia
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Primary sponsor type
University
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Name
University of Canberra Research Institute for Sport and Exercise
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Address
11 Kirinari St, Bruce ACT 2617
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Country
Australia
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Secondary sponsor category [1]
317708
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None
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Name [1]
317708
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Address [1]
317708
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Country [1]
317708
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Secondary sponsor category [2]
318482
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University
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Name [2]
318482
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Australian Catholic University
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Address [2]
318482
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Country [2]
318482
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
314497
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University of Canberra Research Integrity and Ethics
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Ethics committee address [1]
314497
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Building 1 Level D 83 Kirinari Street, Bruce University of Canberra, ACT, 2617
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Ethics committee country [1]
314497
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Australia
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Date submitted for ethics approval [1]
314497
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28/11/2023
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Approval date [1]
314497
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15/02/2024
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Ethics approval number [1]
314497
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Summary
Brief summary
This study is a randomised controlled trial investigating the effectiveness of refeeding strategies post-competition in natural physique athletes. Athletes will be measured at baseline before beginning their competition preparation phase that typically lasts between 20-25 weeks. Following competition, they will be randomly allocated into one of the following nutrition strategies; ARM-1 Ad Libitum or ARM-2 Dietitian Intervention, to follow for 12 weeks post-competition. Primary outcomes assessed will included changes in metabolic rate and body composition. Investigators hypothesize that individualised dietetics intervention will result in faster recovery of physiological markers post-competition.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Miss Claire Buechel
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Address
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University of Canberra Research Institute for Sport and Exercise, Bruce, ACT 2617
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Country
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Australia
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Phone
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+61 433940204
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Fax
131794
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Email
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[email protected]
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Contact person for public queries
Name
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Claire Buechel
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Address
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University of Canberra Research Institute for Sport and Exercise, Bruce, ACT 2617
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Country
131795
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Australia
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Phone
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+61 433940204
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Fax
131795
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Email
131795
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[email protected]
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Contact person for scientific queries
Name
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Claire Buechel
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Address
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University of Canberra Research Institute for Sport and Exercise, Bruce, ACT 2617
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Country
131796
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Australia
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Phone
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+61 433940204
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Fax
131796
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Email
131796
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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