before and during puberty do, if fact, have
marked stunting of growth (Theintz et al. 1993).
Theintzet al. (1993) also pointed out that, if this
intensive exercise schedule occurred before
puberty, the gymnasts would permanently alter
the growth rate and keep them from ever reach-
ing full adult height. It was particularly noted in
this study that leg length was significantly
stunted in gymnasts, resulting in a marked
difference in sitting height/leg-length ratio
when compared to age-equivalent swimmers.
This stunting of leg length was associated with a
related reduction in predicted height. However,
these data do not agree with those of Claessens et
al.(1992), who found that artistic gymnasts do
not differ from non-athletes in leg length, but do
have broader shoulders relative to hips. The data
of Claessens et al. (1992) and Theintz et al. (1993)
do agree in the area of height and weight. These
data demonstrate that gymnasts between the
ages of 13 and 20 are considerably shorter and
lighter with narrower hips than age-matched
non-gymnasts.
It is unclear whether the reduced growth in
gymnasts is due to a diet-related inhibition of the
hypothalamic–pituitary–gonadal axis from inad-
equate energy and nutrient intake, or from the
combination of inadequate energy and nutrients
coupled with a heavy training regimen (Lind-
holmet al. 1994). It is possible that iron status
plays a role in this reduced growth. Anaemia,
which is seen in about one-third of the gymnasts
evaluated, is associated with poor growth veloc-
ity in children (Lifshitz et al. 1987; Benardot et al.
1989; Lindholm et al. 1995). Gymnasts have sig-
nificantly delayed age of menarche when com-
pared to non-gymnasts, and are also shorter and
lighter.
It has been suggested that, because gymnasts
fail to achieve normal growth velocity during
what should be the adolescent growth spurt,
gymnastic training should be decreased (Mans-
field & Emans 1993). It is hypothesized that
decreased training would reduce the incidence of
athletic amenorrhoea and the associated hypo-
oestrogenaemia that is associated with decreased
bone density and delayed puberty.
Summary recommendations
General guidelines
Exercise causes two fundamental physiological
events: the body burns energy at a faster rate,
and the increase in energy usage causes body
temperature to rise, causing a greater rate of
water loss through sweat. Therefore, gymnasts
should consume sufficient energy to meet the
needs of activity plusthe needs of growth, and
should consume sufficient fluids to ensure ade-
quate hydration. Both the provision of sufficient
energy and fluids will improve athletic perfor-
mance by assuring sufficient glycogen and
normal muscle function (muscles are approxi-
mately 70% water when optimally hydrated)
(Hargreaves 1996).
The majority of food consumed should be
from complex carbohydrates, but the consump-
tion of fibrous vegetables should be avoided
for several hours before training or competition
because they are gas causing and may make the
gymnast feel uncomfortable from distention. It is
not necessary to avoid fat consumption, but a
slight lowering of fat intake coupled with an
increase in carbohydrate intake may be a desir-
able dietary change for many gymnasts. This can
most easily be achieved through limited con-
sumption of fried foods, visible fats (butter, mar-
garine, meat fat, etc.), and fatty dairy products.
There should be a reliance on food rather than
vitamin and mineral supplements for obtaining
needed nutrients, but the intake of certain
mineral supplements (calcium and iron in par-
ticular) may be advisable under some circum-
stances. Periodic consumption of lean red meat is
advisable, in that it is an excellent source of iron
and zinc, and may improve the availability of
creatine or its precursors (amino acids).
Restrained eating behaviours are counterpro-
ductive and may initiate more serious pathologic
disordered eating patterns. Therefore, gymnasts
should try to maintain a frequent eating and
snacking pattern to maintain metabolic rate
and blood glucose, and improve total energy and
nutrient intake. Small but frequent meals and