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WHAT IS THE EFFECT OF DIETARY PATTERN ON THE

INCIDENCE AND SEVERITY OF STRESS FRACTURES IN


COLLEGIATE CROSS-COUNTRY RUNNERS?
Proposal Defense Presentation
Sydnie Leroy
10/7/16

Statement of the Problem


Diet Pattern
Vegan/ Vegetarian
Omnivore

Sex
Training
Age
Body Weight
Protein (g)

Protein Type
Animal Vs Plant

Stress Fractures
Incidence/ Severity

Why is this Study Important?


Vegan/ Vegetarian Diet and Lifestyle

Increasing in prevalence, challenging to attain high enough intake of calories, protein, and
certain vitamins

Protein Recommendations and Importance of Protein

Current recommendations for vegetarian athletes vague and inconsistent

No recommendations specifically about obtaining protein of high biological value

Stress Fractures in Endurance Athletes

Account for 50% of all the injuries obtained by endurance athletes (and rates up to 2x
higher in females)

Average stress fracture will sideline an endurance runner for 12 weeks

Effect of Protein on fracture prevention and fracture healing time

Protective effect of protein in preventing stress fractures in elderly

In elderly who already have fractures, healing time decreased by protein supplementation

Research Questions
Research Question

What is the effect of a vegan or vegetarian diet on


the incidence and severity of stress fractures in
collegiate cross-country runners, compared to
runners who consume an omnivorous diet?

Major Sub-Questions

What is the difference in dietary protein intake


between the two dietary patterns?

What is the difference in supplementary protein


intake between the two dietary patterns?

What is the difference in incidence of stress


fractures between the two dietary patterns?

What is the difference in severity of stress


fractures between the two dietary patterns?

Protein
(type/amount)

Study
Design

The study is a cross-sectional


retrospective survey.

Males

Dietary Pattern
(Vegan/Vegetar
ian)

The independent variable of this study


will be the dietary pattern of each athlete
and the dependent variable will be the
severity and incidence of stress fracture
Athletes will be divided into 2 groups
based on dietary pattern (meat-eaters
and non). These will then be divided into
males and females. Within each of these
groups, the amount/ type of protein and
the incidence/ severity of stress fractures
will be analyzed.
Other factors to control for will include
body weight, training volume, and age

Injuries
(Severity/Incid
ence)
Protein
(type/amount)
Females
Injuries
(severity/incide
nce)
Protein
(type/amount)
Males
Injuries
(Severity/incid
ence)

Dietary Pattern
(Omnivorous)

Protein
(type/amount)
Females
Injuries
(severity/incide
nce)

Participants and Recruitment


Participants

Recruitment

Collegiate Division 1 cross country runners ages


18-26

Approximately 300 runners from:

Contact Coaches

Columbia, Georgetown,
Harvard, Oregon, Princeton,
Syracuse, University of
Central Connecticut,
University of New Mexico,
University of Virginia, Yale

Obtain permission letters


Obtain access to team emails

Email athletes

Incentive: 1 $15 Amazon gift


card per university (potential
total of 10 gift cards)
randomly selected

Exclusion- athletes who


smoke or are on medications
that affect bone health

Materials
Survey is hosted in RedCap
A Secure online platform specifically designed for research data
collection.
Makes data entry, retrieval, and exportation simple, easy, and clean
Demographics
Stress Fracture Classification
PrimeScreen
Supplemental Protein Intake

Procedure and Timeline


Obtain
Marywoo
d IRB
approval
and ERC
approval
from
each
school

Collect
Permissio
n Letters

Distribut
e Survey
Via team
email
lists
10/25/16

Send
Reminder
email
with 2
weeks
left
11/8/16

Send
final
reminder
email
with 3
days left
11/18/16

Close
survey
11/22/16

Determin
e gift
card
winners
& alert
appropria
te
students

Data Analysis
Students T-test and ANOVA will be used to analyze differences
between dietary pattern groups for stress fractures as well as protein
intake and supplemental protein intake.
Pearsons correlations will be used to examine associations between
variables. To investigate the effects of dietary pattern on our stress
fracture, multiple regression analysis (MIXED procedure with School as
a random effect) between reported stress fracture incidence and
dietary pattern group with potential confounders included as
covariates in the regression models (sex, body weight, mileage,
protein amount, age).

A significance level of p<0.05 will be used to test the main effects of the
primary hypotheses, and p<0.10 was the level of statistical significance used
to test interaction effects.

Conclusions
It is hypothesized that there will be a difference in the incidence and
severity of stress fractures between dietary pattern groups.

Expecting that vegans/ vegetarians will have higher incidence of stress fractures

Major Limitations

Small sample size

Self-reported data

Recall bias

Social desirability bias

Not considering the female athlete triad

Limiting study to macronutrients

Difficult to control for training volume, genetics, other factors that can contribute to
injuries

If necessary (due to lack of participants) study will be repeated in the


spring