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. 2025 May 10;17(1):121.
doi: 10.1186/s13102-025-01139-w.

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

Murat Urhan  1 , Ceren Akanalçı  1 , Özge Küçükerdönmez  1 , Ezgi Karataş  1 , Rana Nagihan Akder  1 , Mesut Nalçakan  2 , Reci Meseri  3
Affiliations

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

Murat Urhan et al. BMC Sports Sci Med Rehabil. .

Abstract

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.

Keywords: Body composition; Energy availability; Nutritional status; Paralympic athletes; Wheelchair basketball.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The present study was conducted in accordance with the Helsinki Declaration. It was approved by an independent review board of the Ege University (Medical Ethics Committee decision no: 22–4.1 T/27 and 21.04.2022). All participants were informed of the study’s purpose, procedures, potential risks, and benefits, and they voluntarily agreed to participate. Written informed consent was obtained before data collection. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Assessment of athletes according to the HEI- 2020 classification
See this image and copyright information in PMC

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