Original research

International Journal of Sports Science

& Coaching
Nutrition and body composition of elite 0(0) 1–9
! The Author(s) 2019
rhythmic gymnasts from Bulgaria Article reuse guidelines:
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DOI: 10.1177/1747954119892803
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Silvia Miteva1, Iliya Yanev1, Stefan Kolimechkov2 ,

Lubomir Petrov2, Lubomir Mladenov3, Veneta Georgieva3 and
Petar Somlev4

Abstract
Rhythmic gymnastics is a sport in which special consideration is given to diet and body appearance. The purpose of this
study was to assess the nutrient intake and body composition of elite rhythmic gymnasts in comparison with guidelines
for female gymnasts. Twenty-one elite rhythmic gymnasts from Bulgaria were divided into three groups: First National
Team, mean age 24.2; Second National Team, mean age 17.8; and Junior National Team, mean age 12.6. Body fat and
muscle mass were estimated by skinfold methods, and a food frequency questionnaire was applied to assess the nutrient
intake. The gymnasts showed low per cent of body fat (13.9% for the First National Team, 17.0% for the Second National
Team, and 15.6% for the Junior National Team) and high per cent muscle mass (44.0, 40.5, and 37.6%, respectively). They
kept their weight close to the ideal one, as recommended by the coaches, and the following equation best corresponded
to the recommended ideal weight: height (cm)
118. The energy intake was lower than the calculated energy require-
ments, in addition to low intake of fat and carbohydrates. The relative protein intake was 1.7 g/kg for the First National
Team, 1.7 g/kg for the Second National Team, and 1.9 g/kg for Junior National Team, and the energy contribution of
proteins was higher than the recommended 15%. Rhythmic gymnasts should be encouraged to maintain their ideal
weight without great variance from the health-related guidelines, and coaches should consider not only the body image,
but also the norms relating to body composition in women when determining ideal weight.

Keywords
Body fat, diet, energy intake, gymnastics, ideal weight

Introduction
Moreover, the pressure to be thin by the gymnasts’
Rhythmic gymnastics is a female-only Olympic sport in parents can negatively influence the body esteem of
which the gymnasts perform movements and dance on the gymnasts.4 Furthermore, rhythmic gymnasts are
the floor, in harmony with the music, while working often believed to be at risk from inadequate nutrition
with a rope, hoop, ball, clubs, or ribbon. At Olympic
and elite levels, this sport has been mainly dominated
by Russia, Bulgaria, Belarus, and Ukraine, as well as Reviewer: Adam Baxter-Jones (University of Saskatchewan, Canada)
Katarzyna Sterkowicz (University of Physical Education in
newly successfully advancing countries, such as Spain, Krakow, Poland)
Italy, and Israel.1,2
Special consideration is given to the body image of 1
Department of Gymnastics, National Sports Academy, Sofia, Bulgaria
2
the competitors performing in this sport, and this Department of Physiology and Biochemistry, National Sports Academy,
Sofia, Bulgaria
demands particular adherence by the gymnasts to 3
Department of Sports Medicine, National Sports Academy, Sofia,
their diet and body composition. All of this puts pres- Bulgaria
sure on the gymnasts, such as the concern of the 4
Department of Physiology, Medical University of Sofia, Sofia, Bulgaria
coaches regarding the gymnasts’ weight; the pressure
Corresponding author:
of the judges, who give a mark for aesthetic abilities Stefan Kolimechkov, Elite Gymnastics Academy CIC, 46 Kingsmead
and appearance; and the pressure of accumulating Barnet, Hertfordshire, London EN5 5AY, UK.
more weight, which may reduce their physical abilities.3 Email: dr.stefan.kolimechkov@gmail.com
2 International Journal of Sports Science & Coaching 0(0)

due to the fact that they make a conscious effort to Methods

keep their weight low and their appearance lean,
The study was performed in accordance with the
and because they start intensive training at a very
Declaration of Helsinki for Human Research.22
young age.5–7
Institutional ethics approval was granted by the
The mean BMI of rhythmic gymnasts has been
National Sports Academy in Sofia, and informed con-
reported to be close to the lower end of ‘normal
sent was obtained from all gymnasts, as well as the
weight’ (BMI ¼ 18.5 kg/m2),8–11 and below that espe-
parents of those under the age of 18. The study was
cially for elite rhythmic gymnasts.12–16 The mean per
conducted during the preparatory training period of
cent of body fat (%BF) is also reported to be low, with
the competitive season of the gymnasts.
the majority of studies using different methods, and
showing that it ranges between 10.5 and
16.5%.5,9,10,14,15,17 However, females should have at
Participants
least 17–22% body fat for normal pubertal hormonal This study included 21 elite rhythmic gymnasts between
development.18 Jemni3 points out that the gymnasts’ the ages of 12 and 27 from the Bulgarian national team
unbalanced diet, associated with their high energy in a unique sample of world-class competitors:
expenditure, could partly explain their low body mass Olympic, elite, and high performance gymnasts, who
index (BMI), low %BF, as well as late pubertal devel- were divided into three groups: First National Team
opment and irregular menstrual patterns. (FNT) (2016 Olympic bronze medallists and gold med-
Differences between energy intake and energy allists at the 2014 World Championship, n ¼ 5, mean
expenditure in elite gymnasts are often presented in age 24.2  2.7), Second National Team (SNT) (2017
the scientific literature.5,19 D’Alessandro et al.5 sug- World Silver Medallists and 2018 World Gold
gested that energy under-reporting or overestimation Medallists, n ¼ 8, mean age 17.8  2.4), and Junior
of energy requirements could explain this negative National Team (JNT) (n ¼ 8, mean age 12.6  0.5).
energy difference, but most authors who reviewed a The average sports experience of all participants in
number of studies on rhythmic gymnasts concluded rhythmic gymnastics was 12.2  4.8 years. All of the
that the total energy consumption and nutritional participants were group competitors and practised
intake are insufficient for those athletes.3,20 In 2017, gymnastics 10 times per week, which consisted of
Dallas et al.21 published a review which provides nutri- four days of two sessions and two days of one session
tional guidelines for elite female gymnasts. Those per week.
guidelines prioritise strengthening the immune system
of the female gymnasts and aim to accomplish energy Body composition
recovery during the annual training season. This review The anthropometric assessment was conducted on all
highlights that females involved in gymnastics should participants on an empty stomach between 8 and 10 am
adhere to the following relative macronutrient intake at the National Centre of Sports Medicine in Sofia,
per day:  1.5 g/kg of protein,  1.5 g/kg of fat, Bulgaria. The height of the rhythmic gymnasts was
and  5.0 g/kg of carbohydrates. Additionally, the rec- measured to the nearest 0.1 cm with a stadiometer;
ommended energy needs of the female gymnasts per body weight was recorded to within an accuracy of
day are  1800 kcal ( 40 kcal/kg as relative energy 0.1 kg; and arm, thigh, and calf circumferences were
needs (RENs)), and the contribution of each macronu- measured to the nearest 0.1 cm with the
trient (E%) is as follows: 15% from proteins,  30% LufkinW606PM tape measure. BMI was calculated as
from fat, and  50% from carbohydrates.21 body weight in kilograms/height in metres squared.
Most studies on diet and body composition in rhyth- Moreover, the percentile scores (PRs) of height and
mic gymnasts are concentrated on mean results of sam- BMI for the gymnasts younger than 19 years of age
ples, but little is reported about those elite individual were computed and assessed by using the WHO
rhythmic gymnasts who are below the anthropometric AnthroPlus specialised software, provided by the
and nutritional guidelines as far as their health is con- World Health Organisation.23 The following classifica-
cerned. Moreover, the methods for determining the tion of the BMI PRs for children and adolescents
ideal weight in rhythmic gymnasts are not defined, between the ages of 5 and 19, provided by the WHO,
especially with regards to the health of females. was applied: BMI > 97th PRs is classified as ‘obesity’,
Therefore, the purpose of this study was to assess the BMI > 85th PRs is ‘overweight’, BMI < 15th PRs is
body composition and nutrient intake of top level ‘thinness’, and BMI < 3rd PRs is ‘severe thinness’.24
Olympic and elite rhythmic gymnasts from Bulgaria, The rhythmic gymnasts older than the age of 19 were
in comparison with published international guidelines assessed by using the standard BMI classification:
for gymnasts and the healthy norms for females. BMI > 30.0 is classified as ‘obesity’, BMI between
Miteva et al. 3

25.0 and 29.9 is ‘pre-obesity’, BMI between 18.5 and gymnasts. The actual FFQ, which was applied in this
24.9 is ‘normal weight’, and BMI < 18.5 is ‘under- study, as well as the data tables needed for calculations,
weight’.25 In addition to that, information from the are available on the internet.40 The questionnaires were
coaches about what the ideal weight of the gymnasts completed by the children’s parents for those under the
should be was collected, where the ideal weight was age of 16, which is common practice when assessing
determined visually for each gymnast by identifying nutrition in children and elderly people.41
the presence of excess fat, which might negatively influ- The daily intake of proteins, carbohydrates and fats,
ence the aesthetics of their performance. relative protein intake per kg body weight (RPI), rela-
The following skinfolds were measured to an accu- tive carbohydrate intake (RCI), relative fat intake
racy of 1 mm: pectoral, triceps, axilla, suprailiac, abdo- (RFI), and the energy contribution of each nutrient
men, subscapular, thigh, and calf by using the Lange (E%), in addition to the total daily energy intake
Skinfold Calliper, Beta Technology Inc., Cambridge, (DEI) and relative energy intake (REI), were calculat-
USA. In addition, the following girths were also mea- ed, based on the results from the questionnaire. In
sured: arm, thigh, and calf to the nearest 0.1 cm with addition, the per cent of protein which comes from
the Lufkin W606PM tape measure. All of the measure- animal sources (animal protein%) was also calculated.
ments were taken on the right side of the body. The equations of Harris–Benedict,42 which are com-
Body fat percentage (%BF) of the gymnasts in the monly applied in research,43 were used in order to cal-
FNTs and SNTs was calculated based on the sum of culate the basal metabolic rate (BMR kcal/24 h). The
the first seven measured skinfolds by using Jackson estimated daily energy needs (kcal/24 h) were derived
et al.’s26 equations for women. The PRs of %BF by employing the following formula: BMR kcal/24 h 
were calculated by using the international norms for (1.2 þ 0.08  number of sessions).42
adolescents27 and adults.28 The %BF of the partici-
pants of the JNT was calculated based on the sum of Body weight management
the triceps and subscapular skinfolds, and determined
by using Slaughter’s equations.29,30 This method is The rhythmic gymnasts filled in a questionnaire con-
highly recommended in the literature to assess body cerning their weight control and its management. This
composition in children and adolescents because of questionnaire consisted of the following six questions:
its accuracy and simplicity.31–33 In addition, the PRs
of %BF were also calculated by using the international 1. For how much time before a competition do you
norms for Caucasian children and adolescents.27 The follow a strict diet to reach your ideal weight?
%BF was classified by the following cut-offs: ‘under- 2. Which nutrients do you avoid in your diet? (a)
weight’ (%BF > 85th PRs), ‘obese’ (%BF > 95th), and Carbohydrates (e.g. bread, rice, baked products,
‘underfat’ (%BF < 2nd PRs).27 sweets, sugar); (b) fats (e.g. oil, chocolate, fatty
The total body skeletal muscle mass was calculated meat); (c) proteins (e.g. meat, fish, eggs, cheese);
by using the equations of Poortmans et al.34 for the (d) salt; (e) others
JNT, and the equations of Lee et al.35 for the FNTs 3. What methods do you apply for dehydration? (a)
and SNTs (for those gymnasts who were above the Sauna; (b) sauna effect suit; (c) aerobic activities
age of 18). (running, cycling, etc.); (d) diuretics; (e) other
The maximal oxygen uptake (VO2max) was methods
obtained by applying the maximal aerobic test on a 4. Do you use any other methods to reduce your body
cycle ergometer. The gymnasts from the JNT per- weight?
formed the PWC 170 test, and VO2max values were 5. Where do you get information on diet and weight
calculated in accordance with Franz et al.36 The PRs management before a competition? (a) Coaches, (b)
of VO2max were calculated by using the international team members, (c) literature, (d) internet, (e) dieti-
norms for adolescents37 and those for adults.28 tian, (f) other sources
6. For how many days after a competition do you
Nutrition assessment allow yourself a free nutritional regimen and eat
without food restrictions?
The food frequency questionnaire (FFQ), which was
used in other nutritional surveys on gymnasts38,39 was
applied in this study in order to assess the nutrient
Statistical analyses
intake of the rhythmic gymnasts. This questionnaire The statistical analyses were conducted with SPSS
consists of questions relating to the weekly consump- Statistics 19 software, using test of normality
tion of different types of food, in addition to questions (Shapiro–Wilk), descriptive statistics, and one-way
about the physical activity and height and weight of the ANOVA with the Bonferroni post hoc test. The data
4 International Journal of Sports Science & Coaching 0(0)

Table 1. Anthropometric parameters and maximum oxygen uptake of the rhythmic gymnasts, divided into their teams (mean  SD).

First National Team (n¼5) Second National Team (n¼8) Junior National Team (n¼8)

Age (years) 24.2  2.68 BC 17.8  2.38 C 12.6  0.52

Sports experience (years) 18.4  1.14 BC 13.3  2.12 C 7.3  1.91
Height (cm) 172.0  4.12 C 169.1  3.00 C 155.3  4.43
Percentile score 83.0  9.40 41.0  23.56
Effect size versus 50 PRs 3.51 D NS
Weight (kg) 54.6  2.41 C 52.4  2.68 C 38.1  4.33
Ideal weight (kg) 53.4  3.36 C 51.4  1.97 C 37.4  3.70
BMI (kg/m2) 18.5  0.40 C 18.2  0.61 C 15.8  1.09
Percentile score 14.2  7.56 8.7  7.45
Effect size versus 50 PRs 4.74 D 5.54 D
%BF 13.9  6.75 17.0  5.62 15.6  2.21
Percentile score 14.3  21.87 17.3  26.61 4.3  4.85
Effect size versus 50 PRs 1.63d 1.23d 9.42 D
Muscle mass (%) 44.0  2.28 bC 40.5  1.21 c 37.6  1.07
VO2max (ml/kg/min) 44.0  3.08b 52.0  4.97 C 38.6  2.47
Percentile score 62.0  11.58 bc 97.8  3.54 C 32.7  19.19
Effect size versus 50 PRs NS 13.50 D 0.90d
b
– p < 0.05 versus Second National Team; b – p < 0.01 versus Second National Team; B – p < 0.001 versus Second National Team.
c – p < 0.01 versus Junior National Team; C – p < 0.001 versus Junior National Team.
d
– p < 0.05 versus 50th percentile; D – p < 0.001 versus 50th percentile.
NS: not significant.

in the text and the tables are presented as mean  SD. were found in any of the three groups. The gymnasts
One sample t-test and Cohen’s effect size (d) of the PRs showed low mean %BF (13.9% for the FNT, 17.0%
for the anthropometric parameters versus their 50th for the SNT, and 15.6% for the JNT), which was sig-
percentile, as well as the mean values of the nutrients nificantly lower than the 50th percentile of the interna-
and energy intake versus international guidelines for tional norms, but within the observed values (10–16%)
female gymnasts,21 were calculated. Effect size was cal- for female gymnasts.17 The FNT had significantly
culated as t values/SQRT (n), and evaluated as d higher per cent muscle mass (44.0%, p < 0.01) in com-
(0.01) ¼ very small, d (0.20) ¼ small, d (0.50) ¼ parison with the SNT and JNT (40.5 and 37.6%,
medium, d (0.80) ¼ large, d (1.20) ¼ very large, and d respectively). The SNT showed the highest VO2max
(2.00) ¼ huge.44,45 results (52.0 ml/kg/min, p < 0.05) versus the FNT
(44.0 ml/kg/min) and the JNT (38.6 ml/kg/min)
(Table 1).
Results
The daily intake of protein, fat, and carbohydrates,
The anthropometric parameters and the maximum in addition to the energy contribution of each nutrient
oxygen uptake of the rhythmic gymnasts, divided into (E%) of the diet in the rhythmic gymnasts, as well as
their groups, are presented in Table 1. The average the effect size of those values versus international
height-for-age PR in the SNT was 83.0, which was sig- guidelines for female gymnasts,21 are presented in
nificantly higher than the 50th percentile (PR) of the Table 2. The mean REI of the gymnasts did not
WHO international norms for adolescents at this age differ significantly from the lower recommended guide-
(p < 0.001, effect size d ¼ 3.5), and that in the JNT did lines for female gymnasts; however, it was lower than
not differ significantly from the 50th PR. The average the calculated RENs in all groups, and significantly
BMI of the FNT was at the lower end of ‘normal lower for the SNT and JNT groups (Table 2). The
weight’ (BMI ¼ 18.5 kg/m2), as determined by the mean energy contribution of proteins was higher than
WHO for adults. The average BMI PRs for the SNT the recommended 15% in all three groups (significantly
and JNT were significantly lower than the 50th percen- higher for the SNT and JNT: 17.6 and 19.4%, respec-
tile of the WHO norms (p < 0.001, effect size d ¼ 4.7 tively), and there was no significant difference between
and p < 0.001, effect size d ¼ 5.5, respectively), and the RPI per day between the groups (1.7 g/kg versus
were both assessed as ‘thinness’ (BMI PR < 15). No 1.7 g/kg versus 1.9 g/kg). The energy contribution of
significant differences between the measured weight fats was slightly above the guidelines for the FNT,
and the ideal weight recommended by the coaches while that in the other groups was within the lower
Miteva et al. 5

Table 2. Daily intake of macronutrients and energy contribution of each nutrient (E%) in the diet of the rhythmic gymnasts (mean
 SD), in addition to effect size versus international guidelines for female gymnasts.21

First National Second National Junior National Guidelines for

Team (n¼5) Team (n¼8) Team (n¼8) female gymnasts

Energy needs (kcal/24 h) 2612  71.0 C 2620  64.5 C 2358  90.3  1800.0
Relative energy needs (REN) (kcal/kg/24 h) 47.9  1.0 C 50.3  1.5 C 62.3  4.8  40.0
Energy intake (kcal/24 h) 2177  648.5 2016  571.4 1563  451.5  1800.0
Relative energy intake (REI) (kcal/kg/24 h) 40.3  13.53 38.7  11.85* 40.7  9.34**  40.0
Energy needs/Energy intake 0.84  0.27 0.77  0.22 0.66  0.18 1.0
Protein (g/24 h) 92.0  29.03 86.8  19.40 75.2  26.20 –
Relative protein intake (RPI) (g/kg/24 h) 1.70  0.58 1.68  0.41 1.95  0.56  1.5
Effect size versus guidelines NS NS NS
Protein-ð% 17.4  2.30 17.6  1.51 19.4  1.77 15.0
Effect size versus guidelines NS 1.74 d 2.47 D
Fat (g/24 h) 86.8  22.16c 69.6  24.40 49.8  17.95 –
Relative fat intake (RFI) (g/kg/24 h) 1.62  0.46 1.40  0.48 1.27  0.37  1.5
Effect size versus guidelines NS NS NS
Fat-E% 36.8  3.49 c 31.4  5.13 28.8  2.92  30.0
Effect size versus guidelines 1.95d NS NS
Carbohydrates (g/24 h) 246.8  89.40 249.9  74.39 195.9  46.77 –
Relative carbohydrates intake (RCI) (g/kg/24 h) 4.58  1.83 4.95  1.33 5.11  0.99  5.0
Effect size versus guidelines NS NS NS
Carbohydrates-E% 45.8  3.70c 50.9  4.12 51.8  3.69  50.0
Effect size versus guidelines NS NS NS
Animal protein (%) 62.8  10.76 57.0  8.78 59.9  6.90 –
NS: not significant.
*p < 0.05 versus REN; **p < 0.01 versus REN.
c
– p < 0.05 versus Junior National Team; c – p < 0.01 versus Junior National Team; C – p < 0.001 versus Junior National Team.
d
– p < 0.05 versus the Guidelines; d – p < 0.01 versus the Guidelines; D – p < 0.001 versus the Guidelines.

recommended values. The RFI, RPI, and RCI were gymnasts indicated that they increased the volume of
close to the lower recommended amounts from the their water intake. The results from the questionnaire
guidelines for female gymnasts (Table 2). showed that the main sources of information, which
Two-thirds of all the 21 rhythmic gymnasts (n ¼ 14) are used by the gymnasts about their diet and weigh
reported that they were taking different vitamins and management, come mainly from their coaches, dieti-
minerals as supplements. tians, or the internet (Figure 1(b)). The gymnasts indi-
The methods most frequently applied by the gym- cated that they had only 1–2 days of a free nutritional
nasts for weight management were investigated by regimen after competitions (Figure 1(c)).
applying a specialised questionnaire, provided in the
‘Methods’ section of this article. Eight of the rhythmic
Discussion
gymnasts, with body weight which was very close to the
ideal one (recommended by the expert opinions of the In contrast to artistic gymnasts,20,46,47 the height PRs
coaches), did not indicate any specific number of days of the rhythmic gymnasts were within the norms and
in which they followed the pre-competition nutritional even way above the 50th percentile, especially in the
regimen. Those athletes actually followed the necessary older competitors (Table 1). Other studies have already
diet to maintain their weight throughout the season. clearly demonstrated that elite rhythmic gymnasts
The other 13 gymnasts indicated that they followed a achieve normal final height in accordance with their
strict pre-competition diet from one to four weeks genetic predisposition.48–50 Moreover, a recent review
(mean 11.8  9.6 days) before their competition. concluded that gymnastics training does not appear to
In order to maintain their ideal weight, the rhythmic restrict pubertal growth and maturation.51
gymnasts are shown to have restricted carbohydrates, There were no significant differences between the
fats, and salt (Figure 1(a)). Twelve of the gymnasts ideal weight and the measured weight in the mean
indicated the following additional methods for weight values of all three groups in our study (Table 1),
management: aerobic activities (n ¼ 10), sauna (n ¼ 6), which shows that the rhythmic gymnasts managed to
and a sauna effect suit (n ¼ 1). In addition, three of the keep their weight low. However, there is no
6 International Journal of Sports Science & Coaching 0(0)

Figure 1. Results of weight management questionnaire. (a) Restricted nutrients (Question 2), (b) information sources about weight
management (Question 5), and (c) number of days with free nutritional regimen straight after competition (Question 6).

information about a precise methodology to calculate rhythmic gymnasts of national level (mean age of
ideal weight (desirable weight) of rhythmic gymnasts in 17.5 years) from Brazil was 20.7 kg/m2,8 and from
the literature. The ideal weight of the gymnasts from Chile (mean age 17.0 years) was 20.1 kg/m2.11
our study was prescribed by the coaches, who apply However, Silva and Paiva16 reported much lower
their expertise and assess visually the body image and mean values of BMI in elite rhythmic gymnasts from
performance of the gymnasts. The mean ideal weight different countries: 17.1 kg/m2 for 16- to 18-year-old
for the FNT and SNT corresponds with a BMI of 18.0 gymnasts, and 17.7 kg/m2 for 19- to 26-year-old
 0.5, which is below the lower end of ‘normal weight’ gymnasts.
(BMI ¼ 18.5 kg/m2). Thus, the determined ideal weight Sixteen of the 21 elite rhythmic gymnasts in our
reflected the low values of body weight in the rhythmic study were below the lower limit of recommended
gymnasts from our study (Table 1). No methodology values for %BF (17–22%), which is required in order
on calculating the ideal weight of rhythmic gymnasts to maintain normal female hormonal functions,
was found in the literature, with which to compare the according to McArdle et al.18 Moreover, four gymnasts
values of ideal weight as determined by the coaches, were below the lower limit of essential fat (13%)
from our study. After analysing the individual results needed for normal physiological functions in
of the ideal weight and other anthropometric variables women.18 However, the published data in the literature
of the gymnasts from all three groups, we formulated a for %BF in rhythmic gymnasts at elite level53 are sim-
single basic equation, which is similar to the Broka ilar to those of our study. For instance, elite Japanese
index: height in cm
100.52 Our equation best corre- gymnasts (mean age of 18.1 years) were reported to
sponds to the individual values of ideal weight deter- have 15.5%BF9 by using bioelectrical impedance ana-
mined by the coaches, and it is as follows lyser (BIA), and elite international gymnasts (mean age
of 20.5 years) had 16.3%BF (skinfold method),10 and
Ideal weight ¼ height ðcmÞ
118 even as low as 9.1%BF (BIA) for some elite gymnasts
before their competition.16 At the national level, the
The individual results of the BMI assessment reported values for %BF show greater variation:
showed that 8 of the 13 rhythmic gymnasts from the 16.5%BF (skinfold method and BIA) for Italian rhyth-
FNT and SNT had their BMI below the lower ‘normal mic gymnasts with a mean age of 15.2 years,5 18.8%BF
weight’ (<18.5). Moreover, seven out of the eight gym- for junior (mean age of 13.7 years) and 20.3%BF (skin-
nasts from the JNT had PR of their BMI below the fold method) for senior Brazilian rhythmic gymnasts
15th percentile, which is assessed as ‘thinness’ by the with a mean age of 17.5 years,8 and 30.5%BF (skinfold
WHO.24 The mean BMI in the rhythmic gymnasts method) for Chilean rhythmic gymnasts with a mean
from all three groups in our study was lower than age of 17.0 years.11 Therefore, in our opinion, the ideal
most data published by other authors. For instance, weight, at least for non-elite rhythmic gymnasts, should
the BMI of international rhythmic gymnasts (mean be great enough, so that the %BF can reach the rec-
age of 20.5 years) competing at the World Cup was ommended minimum of 17%.
19.0 kg/m2,10 the BMI of elite Japanese rhythmic gym- The obtained mean VO2max of the rhythmic gym-
nasts (mean age of 18.1 years) was 18.9 kg/m2,9 those nasts from the FNT and SNT (Table 2) were close to
Miteva et al. 7

the reported maximal oxygen uptake for international was lower (13.8%). The protein consumed by the
level artistic gymnasts – around 50 ml/kg/min.3 rhythmic gymnasts in our study that comes from
However, results of VO2max in rhythmic gymnasts animal sources was also high (around 60% in each
are less reported in the literature. Published individual group, Table 2), due to the high intake of meat and
studies of young rhythmic gymnasts showed the follow- dairy products. However, a recent review revealed that
ing values of VO2max: 43.5 ml/kg/min in elite Greek a well-planned vegan diet is capable of meeting the
rhythmic gymnasts with a mean age of 11.0 years;14 protein needs of competitive gymnasts, in addition to
54.8 ml/kg/min in elite and 45.1 ml/kg/min in non- helping them lose excess weight and reducing the risk
elite rhythmic gymnasts (mean age of 13.4 years) from of chronic diseases in the long term.56
Greece and Cyprus.54 Those values were higher
than the predicted VO2max of the gymnasts from the
JNT in our study (mean age: 12.6 years, Conclusions
VO2max ¼ 38.6 ml/kg/min). The anthropometric parameters of some rhythmic
Overestimation of energy needs might lead to a neg- gymnasts from our study were below the recommended
ative energy balance in rhythmic gymnasts,5 but the norms for women at their age. Therefore, when deter-
calculated RENs of the gymnasts in our study were mining the ideal weight of rhythmic gymnasts, coaches
within the recommended guidelines for energy expen- should consider not only the body image and sports-
diture. The results from the FFQ showed that there was related criteria, but also the recommended health-
a deficiency in the energy intake of the gymnasts from related norms for body composition in women.
the SNT and JNT groups (Table 2). Such a deficiency On the whole, the Bulgarian elite rhythmic gymnasts
in rhythmic gymnasts is often reported in the litera- showed a higher intake of protein and a lower intake of
ture.5,14,19,55 Although the mean REI of the rhythmic fat and carbohydrates than that evidenced in most of
gymnasts in our study did not differ significantly from the published data in the literature. Overall, the mean
the lowest recommended values within the guidelines, values of the nutrient intake in the groups correspond
12 of the 21 gymnasts had values lower than that rec- to the guidelines for female gymnasts; however,
ommended (40 kcal/kg/24 h). Therefore, mean values, coaches should focus on individual competitors who
as well as individual results, should be considered when show values below the recommended guidelines. Such
making nutritional assessments. rhythmic gymnasts should work with a registered die-
The RFI in the rhythmic gymnasts from the FNT titian in order to maintain their ideal weight without
was within the guidelines ( 1.5 g/kg/24 h), but the diverging greatly from the recommended nutritional
other two groups (SNT and JNT) had lower values guidelines.
(Table 2). Those low values of fat intake, combined
with the high proportion of animal fat (>70% of all Declaration of Conflicting Interests
fat), might lead to a deficiency in essential unsaturated
The author(s) declared no potential conflicts of interest with
fatty acids. Low fat intake (< 30% of the energy con-
tribution) was reported in Italian5 and Greek rhythmic respect to the research, authorship, and/or publication of this
gymnasts.14 Therefore, rhythmic gymnasts might ben- article.
efit from taking essential fatty acids as supplements.
The RCI and the energy contribution of carbohy- Funding
drates in the rhythmic gymnasts from our study were The author(s) received no financial support for the research,
slightly lower than published results in the literature for authorship, and/or publication of this article.
rhythmic gymnasts,5,9,14 but they were within the lower
recommended values from the guidelines for female ORCID iD
gymnasts.21 This low intake of carbohydrates and Stefan Kolimechkov https://orcid.org/0000-0003-0112-
fats in the gymnasts from our study can be explained 2387
by the results from the weight management question-
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