Sex, Gender, and Sexuality in Sport

Seed Grant Awardee: Tamiko Azuma

Anonymous — Tue, 06 Sep 2022 17:01:12 +0000

Seed Grant Awardee: Tamiko Azuma

Anonymous (not verified) Tue, 09/06/2022 - 10:01

Tamiko Azuma | College of Health Solutions

Background Military service members and elite athletes share overlapping profiles, including intensive training experiences, increased risk for concussions, and established cultural identities. Researchers examining performance outcomes for athletes have focused on physiological variables, such as sleep (Silva et al., 2020), training intensity (Jayanthi et al., 2015), and movement parameters (e.g., Dorrel et al., 2018). Recently, researchers have shifted their research to include psychological measures, including well-being measures (e.g., Codonhato et al., 2018). In both athlete and veteran research, relatively few studies specifically examine the characteristics of, and outcomes for, female participants. Indeed, in most studies, females comprise a small subgroup of the sample, which limits quantitative analyses and generalizability of results. Additionally, there is almost no research on transgender females and nonbinary individuals in these two populations. Studies of female athletes and service members have often focused on sex-related physiological issues, such as menstrual cycle (e.g., Mitchell et al., 2016) and the female triad (e.g., Finley et al., 2015; Kroshus et al., 2018). The proposed study will employ targeted recruitment of cisgender/transgender female student veterans and athletes as well as non-binary individuals.

Aims. The aims of the proposed study are 1) To compare cisgender/transgender female and male college athletes and veterans on their self-ratings of cognition, self-ratings of academic performance, standardized well-being measures, and resilience measures; 2) To examine the group differences in the relationships between those measures and self-reported injury prevalence and outcomes.

Method. Participants will include cisgender/transgender female and male student-athletes and veterans recruited from ASU. The quantitative study will include a comprehensive survey containing demographic questions, sport- or military-specific questions, self-ratings of cognition (e.g., memory), self-perceptions of academic performance, self-report of concussion and other injuries, Ryff Psychological Well-Being Scale (Ryff et al., 2007), Connor-Davidson Resilience Scale (Connor & Davidson, 2003), the Health-Related Quality of Life Scale (Moriarty et al., 2003), the Perceived Stress Scale (Cohen et al., 1983), and the Generalized Anxiety Disorder Scale (Spitzer et al., 2006). COVID-19-related questions regarding pre/post-pandemic self-perceptions will also be included. The data from the proposed study will be used to establish group profiles of cognitive self-perception, well-being, and resilience for cisgender/transgender female and male college athletes and Military Veterans. Correlation and regression analyses will be used to examine the relationships among the measures and injury outcome measures.

Outcomes. The findings will be incorporated into larger external funding proposals to examine the relevant significant factors longitudinally in college athletes and veterans. The results will potentially inform the development of resources specific to the needs of cisgender/transgender female athletes and veterans, which could enhance academic success, wellness, resilience, and injury outcomes. This study supports current work at the ASU Global Sport Institute in examining the post-sport and military service experiences of student-athletes and veterans.

The results of this study will be presented at national and international professional conferences and submitted to peer-reviewed journals. The redacted results will also be shared with Sun Devil Athletics. Findings will be interpreted for Global Sport Matters content related to Title IX and other foci.

Last updated April 2021.

Sex, Gender, and Sexuality in Sport

Seed Grant Awardee: Sydney Schaefer

Anonymous — Tue, 06 Sep 2022 17:01:12 +0000

Seed Grant Awardee: Sydney Schaefer

Anonymous (not verified) Tue, 09/06/2022 - 10:01

Sydney Schaefer | School of Biological and Health Systems Engineering

Noninvasive brain stimulation is becoming popular within sport as a way to improve motor performance, so much so that this ‘neuro-doping’ may provide a competitive edge in the future of sport. For example, Halo Sports is a popular commercialized product for delivering transcranial direct current stimulation (tDCS), which has been used by professional basketball players, NFL prospects, and US Ski and Snowboard athletes. tDCS is by far the most affordable and accessible stimulation technique by essentially applying very low electrical current (1-3 mA) to one’s scalp, and costs only ~$100-200 on Amazon (Halo Sports retails for $399). The low price and high access of tDCS make it a promising performance enhancement tool within recreational and professional sports.

The science behind tDCS, however, has not consistently shown that it outperforms placebo treatment in improving motor performance or training. What has been consistently demonstrated is widely varying responses to tDCS: some individuals improve following tDCS, while others do not. And still, others even show decrements. We think that such paradoxical findings may be due to an important, yet understudied factor: expectations about the effects of tDCS. Our central hypothesis is that people’s expectations about tDCS are partly responsible for how much they benefit from it. If a person expects a benefit from tDCS, there will be a positive outcome associated with tDCS, and the magnitude of the outcome is proportional to the level of expectation. The power of this expectancy effect has been well-documented in pain research, pharmacological studies, and psychiatry, but has been largely ignored by studies on tDCS and motor performance, despite motor performance itself being especially susceptible to expectations.

Thus, our proposed research will, by design, directly measure and control for expectations of tDCS using validated measures, and test whether higher expectations are associated with more improvement after tDCS. Our research is significant because we are among the first to explore the influence of expectations of tDCS for the purpose of enhancing motor performance. Our very preliminary data show that the general public does in fact show a wide range of expectations about how much tDCS would positively affect their motor performance. This strongly supports our hypothesis that the mixed effects of tDCS in previous studies can be attributed to unmeasured and widely variable expectations. Our preliminary data also show an important trend regarding gender differences in expectation: females’ expectations that brain stimulation will improve their motor performance are higher than that of males. This is very consistent with published reports of a female-specific effect of tDCS, and we argue that this is likely, not due to differences in brain anatomy/physiology, but rather gender differences in expectation. Thus, our research sits at the intersection of the current and past themes of the Global Sport Institute (namely, Sport 2036). This research is the first of its kind and can stimulate knowledge of whether, and how, brain stimulation enhances performance. This line of work will also inform how gender-dependent expectancy effects can be ethically leveraged for enhancing sports performance.

Read the final paper from this GSI-funded project here.

Last updated July 2021.

Sex, Gender, and Sexuality in Sport

Seed Grant Awardee: Stavros Kavouras

Anonymous — Tue, 06 Sep 2022 17:01:12 +0000

Seed Grant Awardee: Stavros Kavouras

Anonymous (not verified) Tue, 09/06/2022 - 10:01

Stavros Kavouras | College of Health Solutions

Since 1944 we know that even mild (

Research data suggest that the state of underhydration and its concomitant increase in plasma vasopressin is associate with a higher risk for diabetes and chronic kidney disease. It is also suggested that increase water intake suppresses vasopressin, resulting in improved glucose regulation, lower risk of urinary tract infections, and kidney stones formation. Additionally, children with concentrated urine seem to improve their cognitive performance by consuming adequate water intake.

Since most of the athletes do not show up to a competition dehydrated (water deficit) but underhydrated (concentrated urine), the important question is whether adequate water intake can improve performance in underhydrated individuals. To our knowledge, there is only one study (published from our group in 2012, Scand J of Sports Medicine) that examined the effect of increased water intake on underhydrated children on exercise performance. We found that increasing the water intake in free-living underhydrated children improved their endurance exercise performance by 12%.

In our recent publication (Suh, British Journal Nutrition), we found that responses to dehydration stimulus might be affected by sex. More specifically, when blood osmolality was raised by intravenous hypertonic saline infusion, women had greater vasopressin responses compared to men, while mood significantly worsened only in women but not in men.

The aim of our proposed study is to examine if increased water intake in underhydrated individuals improves aerobic exercise performance in both women and men. Trained adult subjects will be recruited to participate in a 4-day water intervention program in order to achieve adequate water intake and euhydration. Subjects will classify as euhydrated based on urine osmolality (800 mol/kg). Hydration will be assessed based on urine (osmolality) and blood (plasma osmolality, copeptin, sodium, potassium, plasma volume, and cortisol) at baseline and at the end of the intervention. Exercise performance will be assessed pre- and post-intervention in a cycle ergometer via a validated 5-km test.

Read the final paper from this GSI-funded project here.

Last updated July 2021.

Sex, Gender, and Sexuality in Sport

Seed Grant Awardee: Mark Sprowls

Anonymous — Tue, 06 Sep 2022 17:01:12 +0000

Seed Grant Awardee: Mark Sprowls

Anonymous (not verified) Tue, 09/06/2022 - 10:01

Mark Sprowls | Biodesign Center for Bioelectronics and Biosensors

Physical fitness assessments provide immense value to athletes in both terms of direct sport practice by tracking the effectiveness of training and also in research informing coaching decisions for the most effective training regiments. The most common type of physical fitness assessment, a VO2 Max test, works by measurement of a person’s maximal oxygen consumption. Despite accepted validity, the test is cumbersome and consequently limited in application for 2 primary reasons: (1) it requires the usage of wearable equipment that interferes with true free-living exercise patterns (do you run the same wearing a mask with connected tubes?) and therefore accuracy of true free-living VO2 (additionally, wearable equipment significantly increases the risk of SARS-CoV-2 transmission) and (2) many persons cannot safely reach maximal effort levels on a fixed bike (e.g. post-surgery individuals, respiratory illness affected individuals, at-risk populations for heart attacks). As such, our team proposes to use GSI seed funding to investigate the viability of a completely novel physical fitness assessment, the first-ever “contactless physical fitness assessment”, hereby referred to as the “contactless thermodynamic efficiency test” or cTET. cTET is based on an intuitive scientific quantity, the thermodynamic efficiency of a body, which is the ratio of the energy “investment” of a system (the “calories burned”, i.e. energy expenditure [kcal/min]) to the energy output of that system (thermodynamic work done by the person on a treadmill, fixed bike, etc.) obtained under unconstrained physical condition. Our SmartPad system is able to measure energy expenditure with no wearable equipment by measurement of breath gas accumulation rates in the ambient environment of a room with over 90% accuracy (validated in a randomized controlled trial involving 20 subjects and a gold standard reference instrument). The power output can be calculated using the load resistance and speed on a bike or treadmill. The ratio of these two terms, energy exergy expenditure to power output, results in a simple and intuitive cTET value. In this proposal, we propose to test 24 subjects using our contactless physical fitness assessment, using a Modified Bruce Protocol where treadmill speed is ramped up in a stepwise fashion and simultaneous lactic acid blood concentrations are measured after each step. Twenty-four subjects are asked to continuously ramp up their speed and be measured for lactic acid (via fingerprick) until their maximum allowable thermodynamic efficiency value to minimize subject risk for subjects that cannot achieve high effort levels. An analysis of cTET and lactic acid threshold (determined from contactless assessed energy expenditure from SmartPad (kcal/day) vs lactic acid levels) will be performed in connection with age segments and sex, using 12 males and 12 females. The results of this comparison will help the scientific community unveil differences in physical performance for low-intensity exercise. This system and a new method for physical fitness assessment will provide a massive benefit to the sports research community, as high-risk individuals can finally track physical fitness over time after medical intervention, e.g. progression of an injured athlete recovering from surgery.

Last updated April 2021.

Sex, Gender, and Sexuality in Sport

Seed Grant Awardee: Qiong Nian

Anonymous — Tue, 06 Sep 2022 17:01:12 +0000

Seed Grant Awardee: Qiong Nian

Anonymous (not verified) Tue, 09/06/2022 - 10:01

Qiong Nian | School for Engineering of Matter, Transport and Energy

Background: Women have become more involved in both recreational and competitive sports and are therefore receiving more attention in the sports medicine literature. Recent studies suggest that some lower extremity injuries are encountered more often by female athletes. Most impressive is the two to eight times higher risk for anterior cruciate ligament (ACL) tears in females than in male basketball and soccer players. The ACL injuries occur in a non-contact fashion, such as quickly changing directions to dodge a defender in soccer or landing from a layup in basketball. The sudden force from a twist or landing may cause the ligament to tear.

The gender differences in ACL injury rate might be attributed to the lower extremity structure difference between males and females. For example, when compared with men, women exhibit greater amounts of static external knee rotation alignment and active hip internal rotation, which may result in greater rotational motion and work at both the hip and knee. Female athletes also often have less muscle mass around the knee, contributing to more instability, which can lead to a ligament tear if the ligament gets overstretched. In addition, when coming down from a jump, female athletes tend to land in a collapsing pattern, moving their knees inward and often not bending them enough. The combination of these factors makes an ACL tear more likely occurring in female athletes.

Goal: To enhance the performance of female athletes, proper techniques when training and playing a sport have been recommended to help minimize the risk factors of ACL injuries. For instance, wearing knee orthotics to reduce the strain on the ACL and limit the rotational motion on the knee has been considered as a promising potential solution. However, the application of current structural knee orthotics is generally restricted by its high unit cost and low effectiveness due to un-customization for specific athletes. To tackle these challenges, the goal of this proposal is to study a potential 3D printing process for manufacturing cost-effective and customized alternatives to present structural knee orthotics. The research objective is to design a knee orthotic according to the specific dimensional requirement of individual female athletes and evaluate its manufacturing cost and effectiveness. Fig. 1 shows a potential design of the 3D printable structural knee orthotic with limited rotational motion allowance.

Alignment and Significance: This project promotes research that explores gender in connection with sport, aligning with one of the key research priorities of Global Sports Institute - “the technology used to enhance performance for particular sexes”. The technical advancement and fundamental knowledge obtained in this research will benefit multiple fields, including additive manufacturing, inverse design, and structural biomechanics. The support to this project will allow the principal investigator to train undergraduate/graduate students, collect preliminary data, and seek external funding support.

Last updated April 2021.

Sex, Gender, and Sexuality in Sport

Seed Grant Awardee: Mako Ward

Anonymous — Tue, 06 Sep 2022 17:01:12 +0000

Seed Grant Awardee: Mako Ward

Anonymous (not verified) Tue, 09/06/2022 - 10:01

Mako Ward | School of Social Transformation

This study proposes to examine the experiences of Black professional womxn working within the sports industry. This includes collegiate and professional sports organizations, traditional and digital sports media platforms, personal life coaching, advertising and branding, and other related fields. “Black Womxn Thriving” is a larger national study to examine how professional Black womxn across the gender spectrum find joy, success, and stability at work, along with the role of organizations to cultivate environments of care that promote the values of inclusion, equity, and diversity in the workplace. Key research questions include: What are the personal and organizational barriers for Black womxn advancing in sports-related organizations? How do the work climates in sports-related organizations contribute to Black womxn’s personal and professional success? What are the personal and network strategies that Black womxn employ to find joy, success, and stability in the sports industry?

This research draws from the transdisciplinary, intersectional literature on race, gender, and labor within the fields of women and gender studies, sociology, and African American studies. The national project is led by Ericka Hines, Principal of Every Level Leadership, inclusion and equity firm that provides strategies to help corporate, nonprofit, philanthropic, and governmental organizations implement thoughtful leadership pathways and organizational cultures based on diversity, equity, and inclusion (DEI) models. This project is a university-corporate sponsorship led by Black womxn researchers and DEI strategists. As a collaborative project, the study will use a participatory action research methodology to develop data-driven solutions for Black womxn workers and organizations committed to promoting this stakeholder group. Data collection methods will include a survey, focus groups, and semi-structured interviews with key informants. Seed funding from the Global Sport Institute will be used to seek foundation and corporate funding to support the dissemination of the research findings and strategies. Dissemination efforts will include a research report, development of a website, virtual conference, and webinar series, a podcast, journal publications, and op-eds.

This research will contribute to understanding the experiences of Black womxn across the sports industry. Their narratives and the data will inform new pathways to leadership and drive increased participation of diverse voices in the workplace. This study enhances the existing work of the Global Sport Institute and this year’s theme of “Sex, Gender, and Sexuality in Sport” by engaging an intersectional approach to collecting data from cisgender, transgender, and gender non-conforming Black womxn in the sports fields. This project expands the research on sports and society through its robust engagement with gender and labor studies during a time where professional athletes and organizations are standing with the Black Lives Matter movement. This public spectacle of social transformation creates the conditions to examine questions of accountability to underrepresented Black workers across the sports industry, especially Black womxn.

Last updated April 2021.

Sex, Gender, and Sexuality in Sport

Seed Grant Awardee: Madelaine Adelman

Anonymous — Tue, 06 Sep 2022 17:01:12 +0000

Seed Grant Awardee: Madelaine Adelman

Anonymous (not verified) Tue, 09/06/2022 - 10:01

Madelaine Adelman | School of Social Transformation

Competing ideas about gender are not new. Consider David Bowie’s lyrics from his 1974 hit song “Rebel, Rebel:” “You’ve got your mother in a whirl. She’s not sure if you’re a boy or a girl.” Or notice the popularity of “gender reveal” parties. Maybe you live in one of the ten states in the U.S. that now includes three gender-marker options on birth certificates: M, F, and X. These examples illustrate how gender – and sex and sexuality along with it -- vary by geography and generation. Today, we observe the growing visibility of trans, gender nonbinary, intersex, and queer youth, while U.S. legislatures debate over whether such gender and sexual minority (GSM) youth can participate in sports and physical education classes.

As an anthropologist, I understand that the sex-gender-sexuality concept is widespread, although, when present, not universal in its application. In other words, how many genders are recognized, whether sex is distinguished from gender, how sex-gender-sexuality converges in meaning, what role(s) they play in organizing society, and how the sex-gender-sexuality system interacts with other classifications (e.g. race/ethnicity), will vary. Yet, although there are embodied elements to gender, “[t]he reality of human biology is that males and females are shockingly similar. There is arguably more variability within than between each gender, especially taking into account the enormous variability in human physical traits among human populations globally” (Mukhopadhyay and Blumenfield 2020, 235). Sex-gender-sexuality is culturally constructed, a human invention, which we are socialized into – and may embrace or resist - throughout our lives. That said, as a sociolegal and justice studies scholar, I also understand that social categories such as sex-gender-sexuality are neither static nor contained within state borders. Ideas travel, as does their regulation. Binary-based approaches to gender, as well as rejection of non-heterosexuality, have been exported from the U.S. and the U.K., mainly to formerly colonized nations. As a result, we find anti-GSM laws and policies in many states around the globe (ILGA 2017, 2019). Yet, much of what we know about the regulation of sex-gender-sexuality and sports centers on individual professional athletes, and technicalities such as testosterone levels. Biologist Anne Fausto-Sterling (2014) argues that this tends to reproduce “how scientists nonconsciously wove cultural concepts of gender into the production of scientific and technological knowledge.”

Instead, the proposed pilot project examines contextualized perspectives on and advocacy strategies associated with GSM youth in sports. I will analyze how the overarching state apparatus of legal gender recognition and criminalization of consensual same-sex relations shapes the ability of GSM youth to play sports (law and policy analysis). I will then use these results to compare how local arguments regarding GSM inclusion in sports are framed (content analysis). Based on findings from this exploratory stage, I will produce a journal article and a messaging primer on effectively talking about these contested issues, akin to those produced by Movement Advancement Project. Ultimately, I envision that the long-term project would measure how the exclusion of GSM youth from sports contributes to long-term education and health disparities.

Last updated April 2021.

Sex, Gender, and Sexuality in Sport

Seed Grant Awardee: Kenan Song

Anonymous — Tue, 06 Sep 2022 17:01:12 +0000

Seed Grant Awardee: Kenan Song

Anonymous (not verified) Tue, 09/06/2022 - 10:01

Kenan Song | School of Engineering

The pelvic organ prolapse (POP) is a hot topic in women’s health but rarely discussed within the sport.1 POP is a disorder in which one or more pelvic organs drop from their normal position. It is caused by injury to the muscles or tissues that support the pelvic organs. The leading cause of this injury is pregnancy and childbirth, especially vaginal childbirth (i.e., 75% of mothers).2 However, similar pelvic floor dysfunction (PFD) also occurs in those who have never given birth (i.e., 12.5-80% of nulliparous athletes).3 Sportswomen with PFD generally suffer from stress urinary incontinence (SUI), the involuntary leakage of urine resulting from increased intra- abdominal pressure (IAP). Athletes are at greater risk of SUI due to their continued exposure to increases in IAP throughout the training. General exercises, such as jumping, landing, weight lifting, holding deep breaths, or even coughing, exert different deformations upon the pelvic floor, especially for females and some transgender sportspersons, putting this athletic population at higher risk for POP.4

I propose in this GSI project to use regenerative medicine as an effective and highly customizable treatment for POP. My project will focus on the material selection, design of cellular structures, and characterizations of personalized tissue scaffolds. Problems with current PP mesh and PS mesh for temporarily holding organs will be their unmatched stiffness and a lack of biocompatibility. For example, PP, as the most frequently used scaffolds to treat POP, has been criticized for causing pain and erosion into adjacent structures, with the FDA warning issued and an un-classification of meshes from class II to III devices. Therefore, this project aims to use biocompatible and biodegradable polymers for tissue engineering as a replacement for current PP scaffolds. Additive manufacturing from our lab will provide a powerful tool for customizing scaffolds for athletes with different physical conditions, including the sizes, stiffness, biodegradability speeds, and drug release rates. Our design of the scaffold morphologies and microstructures is critical in tuning the mechanical, thermal, and biological properties of these scaffolds. I also propose to work with doctors from Mayo Clinic (already built collaborations) on the in-vivo tests to understand the tissue scaffold performance and possibly clinical studies beyond the period of this proposed project. The rapid prototyping of these tissue scaffolds will lighten pressure on the pelvic floor and enable high-efficient training and performance on the sports field.

Last updated April 2021.

Sex, Gender, and Sexuality in Sport

Seed Grant Awardee: Hyunglae Lee

Anonymous — Tue, 06 Sep 2022 17:01:12 +0000

Seed Grant Awardee: Hyunglae Lee

Anonymous (not verified) Tue, 09/06/2022 - 10:01

Hyunglae Lee | School for Engineering of Matter, Transport and Energy

Significance: It has been repeatedly demonstrated that female athletes have lower ankle stability and an increased risk of ankle injury when compared to male counterparts participating in similar sports activities. In order to reduce the risk of ankle injury in female athletes and help them maximize performance during sports activities, it is significant to understand mechanisms underlying the sex differences in ankle stability and utilize this knowledge in intervention to reduce the risk of an ankle injury.

Objectives: In the previous and current GSI seed grant cycles, we have 1) characterized ankle mechanics and stability and identified sex differences during postural balance, and 2) developed a soft robotic ankle brace that is capable of adaptively changing its mechanical properties, in particular, stiffness at the ankle joint. Building upon these successful accomplishments, this proposal aims to 1) understand mechanisms of sex differences in ankle stability during dynamic tasks simulating sports activities, and 2) evaluate how the soft robotic brace that incorporates this knowledge could improve ankle stability and reduce the risk of ankle injury in female athletes.

Challenges and Solutions: First, while we have recently demonstrated clear and significant sex differences in ankle mechanics and stability during various postural balance tasks, it is unknown whether the differences persist or further increase during dynamic walking and running tasks that are common in many sports activities. Our innovative research method, which integrates a patent-pending robotic balance platform and advanced machine learning algorithms, will provide a transformative solution to quantify ankle stability during various tasks simulating sports activities and identify its sex differences. Second, while passive ankle braces have been widely used to prevent potential injuries during sports activities, they cannot adjust the level of support and thus limiting their effectiveness. Our award-winning soft robotic ankle brace will provide a unique and innovative solution to adaptively adjust the level of support, i.e., the magnitude of brace stiffness at the ankle, based on real-time prediction of ankle stability, in a sex-dependent manner.

Impact and Future Directions: The research outcomes will advance our scientific knowledge on sex differences in ankle stability and risk of an ankle injury during sports activities and their underlying neuromuscular mechanisms. This advanced knowledge will directly benefit the operation of the soft robotic ankle brace, which we expect will significantly improve ankle stability in female athletes compared to conventional passive braces. It will also serve as a basis to develop an injury risk assessment tool and sex-specific training programs for effective ankle injury prevention and rehabilitation. Furthermore, successful completion of this research will lay the groundwork for future research to evaluate the effectiveness of the soft robotic ankle brace on reducing the risk of an ankle injury and improving ankle performance in both male and female athletes during sports games such as basketball and soccer. Findings in this research will not only lead to publication in highly selective biomechanics journals but also contribute to the development of competitive proposals to the National Institute of Child Health and Human Development and the NSF Smart Connected Health program.

Read the final paper from this GSI-funded project here.

Last updated July 2021.

Sex, Gender, and Sexuality in Sport

Seed Grant Awardee: Floris C. Wardenaar

Anonymous — Tue, 06 Sep 2022 17:01:12 +0000

Seed Grant Awardee: Floris C. Wardenaar

Anonymous (not verified) Tue, 09/06/2022 - 10:01

Floris C. Wardenaar | College of Health Solutions

Lactose malabsorption affects ~70% of the world adult population with consumption of milk and milk-based products in susceptible individuals often inducing gastrointestinal (GI) dysfunction compromising health. Additionally, athletes may experience (GI) symptoms exacerbated by the intensity of the exercise, jeopardizing performance and exercise recovery. Many of these athletes represent minority populations, including African Americans, who may be particularly vulnerable to nutrition-related GI issues. As African Americans contribute largely to the American Football roster, the standard, often dairy-based, recovery products provided by the athletic department may not always fit the need of a large part of the team as they may cause GI dysfunction and decrease athletic performance.

According to the current body of literature, lactose malabsorption is dictated by the amount of lactase enzyme in the small intestine, gut-transit time, and composition of gut microbiota (GM). Moreover, the ability of GM to harvest energy, affect metabolism, and influence GI health is expected to play an important role in sports performance. Therefore, there is a significant need to identify and correct the consequences of lactose malabsorption-induced GI dysfunction and composition of the GM in susceptible minority athletes.

The aim of the study is to identify the prevalence of GI dysfunction in ASU football athletes and assess the GM and lactose malabsorption of affected athletes compared to athletes not displaying symptoms.

The study will be cross-sectional where consenting ASU football athletes ≥18 years of age will first be screened for GI dysfunction by the 15-item Gastrointestinal Symptom Rating Scale (GSRS) to determine eligibility for lactose malabsorption and GM evaluation. This will occur in two phases. Phase one: Identify the prevalence of GI dysfunction in the athletes. Athletes reporting ≥1 GSRS symptom will be considered eligible for the second phase. Phase two: Assess the GM and breath hydrogen levels (lactose malabsorption test) of the symptomatic athletes compared to non-symptomatic athletes. Based on the current ASU football roster and in collaboration with the ASU athletic department, we will expect to recruit 40-50 participants.

GM analysis will be conducted on the athlete's fecal samples. Stool samples will be assessed for microbial community diversity and taxonomic frequencies following the sequencing of the 16S rRNA gene, common to all bacteria in the gut. Within a week after the stool sample collection, five breath hydrogen concentrations samples will be measured after the ingestion of a lactose load using the standard clinical methodology. In addition, a brief questionnaire reviewing the subject’s current level of GI disturbance, 24 h dietary intake recall, and physical activity questionnaire will be collected.

At the completion of this project, we will have identified lactose malabsorption and differences in the GM in high-level football players prone to GI dysfunction. Advice has been provided to football players and staff for the use of food products that can help to improve their gut microbial community, and consequently, reduce their GI discomfort. Results contribute to the continuous development of an easy and quick detection protocol for athletes who experience GI discomfort.

Last updated April 2021.

Sex, Gender, and Sexuality in Sport