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Sleep and diet's contribution to the risk of injury in adolescent elite athletes

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Summary of a survey study discussing how sleep and diet influence a risk of injury in adolescent elite athletes.


340 (Females: 162 Males: 178) high school elite athletes aged 17.1 (±0.9) (Females: 17.1 (±0.9) Males: 17.1 (±1.0)) (Sweden).

Sports: athletics, cross-country skiing, downhill skiing, freestyle skiing, handball, orienteering, ski orienteering.


Web-based survey (2 times: autumn and spring semester).

Outcome measures

  • sports injuries (“any physical complaint resulting in reduced training volume, the experience of pain, difficulties participating in normal training or competition, or reduced performance in sports”, self-reported)
  • sports participation
  • training variables
  • alcohol intake
  • sleep (average hours on weekdays and weekends)
  • stress (Perceived Stress Scale)
  • nutrition (Swedish Nutrition Food Agency Index)
  • self-esteem (Competence-Based Self-Esteem Scale)

Main results

  • 313 (92%) athletes in the autumn semester and 260 (76%) athletes in the spring semester provided complete data. Additionally, 105 (31%) athletes responded once (in autumn or spring semester only).
  • Female athletes reported higher stress. 18-19 years old athletes reported higher stress than 16-year-olds.
  • 45.1% of females and 46.1% of males consumed alcohol. 0.9% smoked.
  • No differences between gender or ages for the Swedish Nutrition Food Agency Index.
  • Guidelines for fruit and vegetable intake (once a day) and fish (twice a week) were not met by 20%, 39%, and 43% of athletes, respectively. A higher proportion of males than females did not meet the fruit and vegetable recommendations. A lower proportion of 18-19-year-olds did not meet vegetable recommendations than 16-year-olds.
  • Females had higher Competence-Based Self-Esteem Scale scores than males, with no age differences (lower scores are better).
  • 18.5% of athletes did not sleep 8 or more hours on weekdays, and 1.0% on weekends.
  • 32.9% of athletes got injured during the autumn season and 28.4% during the spring season.
  • Athletes sleeping more than 8 hours during weekdays and meeting nutritional recommendations (fruits and vegetables once a day, fish twice a week) had lower odds of sustaining a new injury. 61% reduction for athletes who slept and 64% reduction for athletes who met nutrition recommendations.

Take home message

For a clinician & coach
Adolescent elite athletes sleeping more than 8 hours per weekday and meeting nutritional recommendations (fruits and vegetables once a day, fish twice a week) had lower odds of sustaining a new injury, 61% and 64% reduction in odds ratio, respectively.
For a parent
Eating fruit and vegetable every day, and fish twice a week, and sleeping more than 8 hours on weekdays, can reduce injuries in adolescent elite athletes.
For an athlete
Aim at sleeping more than 8 hours per day, and eat fruit and vegetables daily, and fish twice a week to reduce the risk of injury.

Original article

Von Rosen P, Frohm A, Kottorp A, Friden C, Heijne A. Too little sleep and an unhealthy diet could increase the risk of sustaining a new injury in adolescent elite athletes. Scandinavian journal of medicine & science in sports. 2017 Nov;27(11):1364-71.

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