Dehydration and Acute Weight Gain in Mixed Martial Arts Fighters Before Competition

DEHYDRATION AND ACUTE WEIGHT GAIN IN MIXED MARTIAL ARTS FIGHTERS BEFORE COMPETITION

ADAM M. JETTON,1 MARCUS M. LAWRENCE,1 MARCO MEUCCI,2 TRACIE L. HAINES,1 SCOTT R. COLLIER,1 DAVID M. MORRIS,1 AND ALAN C. UTTER1 1Department of Health, Leisure, and Exercise Science; Appalachian State University, Boone, North Carolina; and 2Department of Health Sciences, University of Rome “Foro Italico,” Rome, Italy

ABSTRACT INTRODUCTION

Jetton, AM, Lawrence, MM, Meucci, M, Haines, TL, Collier, SR, ixed Martial Arts (MMA) is a complex combat Morris, DM, and Utter, AC. Dehydration and acute weight gain sport that integrates many fighting styles in mixed martial arts fighters before competition. J Strength M including boxing, wrestling, judo, muay thai, Cond Res 27(5): 1322–1326, 2013—The purpose of this study and Brazilian jiu-jitsu as its main components. All athletes in MMA are required to attain a specific body was to characterize the magnitude of acute weight gain (AWG) weight (weight class) before competing in a regulated bout. and dehydration in mixed martial arts (MMA) fighters before The purpose for weight classes is to match athletes that are of competition. Urinary measures of hydration status and body a similar size to create an equal playing level and minimize the mass were determined approximately 24 hours before and then risk of injury between opponents. Similar to MMA, the sport again approximately 2 hours before competition in 40 MMA of wrestling also incorporates weight classes for competition. fighters (mean 6 SE,age:25.26 0.65 years, height: 1.77 6 Previous studies with wrestlers have demonstrated that man- 0.01 m, body mass: 75.8 6 1.5 kg). The AWG was defined as dating weight classes can lead to subsequent participation in the amount of body weight the fighters gained in the approxi- acute rapid body water loss and dehydration just before official mately 22-hour period between the official weigh-in and the weigh-ins (8,11,14) by means of excessive exercise, sweat suits, actual competition. On average, the MMA fighters gained and extreme environments. The strategy of acute rapid weight 3.40 6 2.2 kg or 4.4% of their body weight in the approximately loss is used with hopes of gaining a competitive advantage of 22-hour period before competition. Urine specific gravity signif- strength and power over an opponent who does not reduce icantly decreased (p , 0.001) from 1.028 6 0.001 to 1.020 6 body weight to meet the same weight class. Acute rapid weight loss can lead to extreme dehydration. 0.001 during the approximately 22-hour rehydration period. Dehydration or excess body water loss has negative physiolog- Results demonstrated that 39% of the MMA fighters presented ical consequences that impair performance and also can be with a U of .1.021 immediately before competition indicating sg hazardous to one’s health. These adverse effects include significant or serious dehydration. The MMA fighters undergo impaired glycogen use, central nervous system dysfunction, significant dehydration and fluctuations in body mass (4.4% increases in core temperature and cardiovascular strain (9). In avg.) in the 24-hour period before competition. Urinary meas- the year 1997, water loss levels ranging from 6.7 to 10% body ures of hydration status indicate that a significant proportion of weight contributed to heat-related deaths in 3 collegiate wres- MMA fighters are not successfully rehydrating before competi- tlers (8). The deaths of these 3 wrestlers resulted in significant tion and subsequently are competing in a dehydrated state. public attention to the unsafe rapid weight loss measures, which Weight management guidelines to prevent acute dehydration ultimately led to regulation rule changes in collegiate wrestling in MMA fighters are warranted to prevent unnecessary adverse including: manipulation of weight classes, week-to-week weight health events secondary to dehydration. loss limits, body composition assessment, validation of minimal competitive weight class through body composition assessment, KEY WORDS wrestling, combative sports, body composition, and prohibiting extreme rapid weight loss methods (10). The fat-free mass, body fat, rapid weight loss new regulations were later investigated for their effectiveness and were reported to be successful by minimizing unhealthy weight loss of collegiate wrestlers (17). During competitive MMA events, the official weigh-in is Address correspondence to Alan C. Utter, [email protected]. typically held 10–24 hours before competition for both the 27(5)/1322–1326 amateur and professional athletes. This is similar to the time Journal of Strength and Conditioning Research period between the official weigh-in and competition of Ó 2013 National Strength and Conditioning Association amateur wrestling before the deaths of the 3 collegiate 1322 Journalthe of Strength and Conditioning ResearchTM

wrestlers in 1997 (17). In the USA, current regulations now require high-school (HS) and collegiate aged wrestlers to TABLE 1. Baseline subject (N = 40) weigh-in 1–2 hours before competition depending on the characteristics taken at approximately 22 hours event. The time period between the official weigh-in and before competition.* competition is when athletes attempt to rehydrate and 6 regain as much body weight back as possible. Aside from Age 25.2 0.7 Height (m) 1.77 6 0.01 the time period between weigh-in and competition other Mass (kg) 75.8 6 1.5 differences between MMA and wrestling include a smaller Urine specific gravity 1.028 6 0.001 number of weight classes, which results in a greater weight Fighting experience (y) 4.8 6 3.5 interval between them, which may lead athletes to adopt Skinfolds (mm) 6 more severe weight loss behaviors. Other differences include Abdominal 14.7 1.2 Triceps 10.7 6 0.8 number of competition per year; length of the competitive Subscap 12.4 6 0.6 season; and scheduling, organization, and compensation for Skinfolds (% fat) 13.4 6 0.5 competition all of which will drive weight loss behaviors. 6 Consequently, findings from previous studies conducted on *Values are expressed as mean SE. wrestlers cannot be exclusively extended to MMA athletes. Unlike HS and collegiate wrestling, there are currently no guidelines or rules to minimize rapid weight loss and sub- states of North and South Carolina. Written, voluntary, sequent adverse health events in the sport of MMA fighting. informed consent was obtained from each subject before all Given the popularity of MMA around the word, the number testing, and all the procedures were approved by the Appala- of athletes at risk of health-related injuries because of rapid chian State University’s Institutional Review Board for human weight loss has become a growing concern among the sports subject experimentation. All the subjects had a minimum of 1 medicine profession. If MMA athletes are engaging in significant year of MMA fighting experience. Confidentiality of the data rapid weight loss before competition, coupled with a time period was strictly maintained with respect to each subject. that may be insufficient for complete rehydration, MMA competitors could be increasing their likelihood of an untoward Measurements health event both before and during competition. To our Acute Weight Gain. The official weigh-in was held the day knowledge, this is the first study to evaluate the magnitude of before the event approximately 24 hours before the fight. rapid weight gain and changes in hydration status in MMA Actual body mass (kilograms) was obtained for all fighters fighters before competition. Therefore, the purpose of the using a calibrated digital scale (Tanita Corporation of present investigation was to quantify the extent of dehydration, America, Arlington Heights, IL, USA), that is, official acute weight gain (AWG; defined as the amount of weight weight. The boxing commission personnel on site recorded gained between the official weigh-in and competition), and all body mass measurements. In both North and South rehydration in MMA fighters before competition. It is hoped Carolina, the boxing commission regulates all rules and that results of this investigation will provide the impetus for body policies associated with MMA competition. weight management guidelines for MMA fighters that promote Approximately 22 hours after the official weigh-in, and safe participation and prevent unhealthy weight loss behaviors. approximately 2 hours before the start of competition, all fighters were reweighed to determine the body mass at the METHODS

Experimental Approach to the Problem The specific aim of this study was to evaluate the magnitude of AWG and dehydration in MMA fighters before competition in an actual competitive environment. Urinary measures of hydration status and body mass were determined approximately 24 hours before and then again approximately 2 hours before competition in 40 competitive MMA fighters. The research experiment was descriptive in nature and followed a repeated-measures design in which each subject served as his or her own control.

Subjects Forty male (N = 38) and female (N = 2) MMA ﬁghters

participated in this study. All the fighters were required to Figure 1. Changes in body mass in the approximately 22-hour period pass a prefight physical to be eligible for this investigation. before competition among mixed martial arts (MMA) fighters. * p , 0.001. Data were collected during 2 separate MMA events in the

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D ¼½1:09822ðsum SKÞ30:000815 b h i þ ðsum SKÞ130:00000084

(13). Percent body fat (%BF) was determined from Db using the Brozek equation (6).

Hydration Status Assessment. Each ﬁghter supplied a urine sample immediately before each of the body mass assess- ments. The urine was placed in a plastic cup, and the speciﬁc

gravity (Usg) of the samples was determined by an optical refractometer (NSG Precision Cells Inc., Farmingdale, NY,

USA). Once the urine samples were analyzed for Usg, they Figure 2. Changes in the urine specific gravity (Usg)inthe approximately 22-hour period before competition among mixed martial were immediately discarded. arts (MMA) fighters. * p , 0.001. Statistical Analyses Statistics were analyzed using SPSS software. Descriptive statistics were used to characterize the subjects. A repeated- time of competition, that is, fight weight. All reweighing was measures 1-way analysis of variance was performed to detect done on the same scale that was used to determine the significant differences in body mass and Usg. Pearson product official weight. Using the official weight and fight weight, the moment correlations coefficients were used to examine and following variables were calculated (19): compare the changes in body mass to Usg. Significance was # Acute weight gain ¼ Fight weight2Official weight set at a p value 0.05 for all variables. Acute weight gain RESULTS %Weight gain ¼ 3100: Official weight Descriptive data for mean baseline subject characteristics are found in Table 1. Significant differences (p , 0.001) were found in body mass from the official weigh-in to 2 hours before com- Body Composition Assessment. Body composition was assessed petition. Body mass increased by 3.4 6 2.2kgor4.4%inthe according to skinfold analysis (SK) methods for descriptive approximately 22-hour period before competition (Figure 1). A

purposes only. The SK measurements were taken once at the significant decrease (p , 0.001) was also found for Usg from the official weigh-in. The SK measures were recorded with official weigh-in to 2 hours before competition. The Usg Lange SK calipers at 3 sites: triceps, subscapular, and decreased from 1.028 6 0.001 to 1.020 6 0.001 (Figure 2).

abdomen. Body density (Db) was determined from the Results further demonstrated that 39% of the subjects were 3 SK measures using the prediction equation signiﬁcantly dehydrated (Usg . 1.021), and of those subjects 11% were seriously dehydrated

(Usg . 1.030) when assessed 2 hours before competition (Figure 3). It was also determined that only 23% of the subjects were classiﬁed as “well

hydrated” (Usg , 1.010) in the 2-hour period before competition. No signiﬁcant correlations were found between the changes in body weight and changes in

Usg throughout the investigation.

DISCUSSION The results of this study are the first to measure dehydration and AWG in MMA fighters before competition. The findings of the ; Figure 3. Hydration status immediately before competition ( 2 hours) as determined by the Usg measurements. present investigation are similar to previous investigations of 1324 Journalthe of Strength and Conditioning ResearchTM

amateur wrestlers (12,16–19). Our results indicate that in the 1997, which resulted in heat-related deaths (8). Aside from the time period between the official weigh-in to just before com- health consequences, dehydration or excess body water loss petition (;22 hours), AWG was 3.4 6 2.2 kg or 4.4% of the has negative physiological implications that impair perfor- body weight. These results are consistent with the findings of mance capabilities (2,7,20). Recent attention has been given Scott et al. (19) who measured the magnitude of AWG in to the strength and conditioning considerations of MMA ath- collegiate wrestlers between the official weigh-in and competi- letes (5). Future research should employ studies to investigate tion (;20 hours) at the 1992 National Collegiate Athletic Asso- the effects of acute dehydration on the performance attributes ciation (NCAA) Division I wrestling tournament. The results of of MMA athletes. that study found on average that AWG was 3.7 6 1.3kgor Although there is a paucity of research on dehydration- 4.9% of the body weight. Results of the current investigation are related health or performance effects before, during or after an also in agreement with data reported in a study by Alderman MMA event as a result of intentional rapid weight loss, the et al. (1). In their study, AWG was measured in 2,638 HS previous tragedies in collegiate wrestling coupled with the Freestyle (international style) wrestlers. Results found that HS results of this study warrant regulation of “weight cutting” Freestyle wrestlers gained on average 3.4 kg, which represented practices in MMA athletes. The MMA is a unique sport that 4.81% of the body weight. The results of the present investiga- does not have a specified “season” and lacks a national gov- tion should be viewed in comparison to the recently reported erning body such as the NCAA. Competition rules and official 0.9 6 0.8 kg or 1.3 6 1.2% AWG found in 811 collegiate weigh-in procedures vary state to state within the USA, and as wrestlers during the 1999–2004 NCAA championships after such, it is difficult to make overarching weight management the implementation of NCAA’s weight management program, recommendations for MMA from a national perspective. which demonstrated significantly less AWG and unhealthy However, wrestling weight management recommendations weight loss behaviors (17). The similarity in AWG between from the American College of Sports Medicine (15) and sim- MMA athletes and wrestlers suggests that weight management ilar weight-classified sports can provide possible regulatory policies like those recently implemented by the NCAA and the changes that could be implemented within the MMA com- National Federation of State High-School (NFHS) Association munity. In one such sport, Judo, a martial art integrated into for wrestling are warranted for MMA. MMA, a recent study that demonstrated rapid weight loss In the present investigation, hydration status was mea- practices by its 822 competitors found that 86% reported that

sured by means of urine specific gravity (Usg), which was they have lost weight to compete with an average reduction of found to significantly decrease from 1.028 6 0.001 to 5% of their body weight (4). Using the experience and 1.020 6 0.001 from the time period between the official research from the scientific wrestling community and combin- weigh-in and just before competition. The NCAA and ing it with the current practices of Judo competitors, weight

others have chosen a Usg measurement of #1.020 to identify management regulations for Judo have been proposed (3). a state of euhydration (7,10,21) for weight certiﬁcation and PRACTICAL APPLICATIONS physiological purposes. Zambraski et al. (21) measured changes in the urinary proﬁles of HS wrestlers before com- Overall, it is evident from the results of the present investiga-

petition at the state HS championships. In that study, the Usg tion that MMA fighters undergo a significant amount of AWG values on average were 1.028 6 0.0007 at the official weigh- from the official weigh-in to just before competition as a result in. Just before wrestling (;5 hours after official weigh-in), of rapid weight loss confirmed through significant changes in 6 Usg values on average were 1.026 0.0005 indicating that body weight and Usg. It was found that 39% of fighters the subjects were not in a euhydrated state just before com- recorded a Usg value .1.021, indicating that the athletes were petition. These findings are similar to those of our study in competing in a dehydrated state. It has been reported in other

which Usg values averaged 1.028 6 0.001 at the ofﬁcial combative sports, that is, wrestling, that dehydration inhibits weigh-in indicating dehydration via urinary measures. As performance and results in health risks that can potentially highlighted in the National Athletic Trainer’s Association lead to untoward health events including death. The sport

position paper, a Usg value . 1.021 is associated with signif- of wrestling has previously faced personal tragedy that threat- icant dehydration (7). ened its existence in 1997 when 3 athletes lost their lives as Rapid weight loss is a concern for MMA ﬁghters because it a result of intentional dehydration. The subsequent rule can ultimately lead to dehydration-related health issues and changes implemented by the NCAA and the NFHS athletic impaired performance. Results of this study demonstrated that associations have assisted in preventing additional health-

39% of the subjects were significantly dehydrated (Usg . 1.021), related incidents in the sport of wrestling in the USA. and of those subjects, 11% were seriously dehydrated (Usg . Other combative sports such as Judo and International- 1.030) when assessed just 2 hours before competition. One style wrestling have similar weight management issues than subject in this study demonstrated an AWG of 9.81 kg or those that were identified in the current investigation with 10% of his body weight in the approximately 22-hour period MMA athletes. The individuals who are the most influential before competition. This value is consistent with the 6.7–10% of in teaching athletes strategies for weight loss are typically the rapid weight loss demonstrated by the collegiate wrestlers in coach, training partners or former athletes (11). Because the

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coach is generally the most frequent source of information for 7. Casa, DJ, Armstrong, LE, Hillman, SK, Montain, SJ, Reiff, RV, athletes, educational programs should focus on providing Rich, BSE, Roberts, WO, and Stone, JA. National Athletic Trainer’s Association position statement: Fluid replacement for athletes. J them with full explanations of how to properly advise Athl Train 35: 212–224, 2000. MMA fighters about health weight management procedures. 8. Center for Disease Control and Prevention. Hyperthermia and Results of the present investigation demonstrate that weight dehydration-related deaths associated with intentional rapid weight management regulations for MMA competitors are warranted loss in three collegiate wrestlers—North Carolina, Wisconsin, and to aid in preventing adverse health events (i.e., exertional rhab- Michigan, November–December 1997. JAMA 279: 824–825, 1998. domyolysis, hyperthermia, and death) that have previously 9. Cheuvront, SN, Carter, R, and Sawka, MN. Fluid balance and endurance exercise performance. Curr Sports Med Rep 2: 202–208, been documented in the sport of wrestling. MMA governing 2003. bodies at the national and international levels along with 10. Committee refines wresting safety rules. NCAA News 35: 1, 1998. coaches should take a proactive approach in education and 11. Kiningham, RB and Gorenflo, DW. Weight loss methods of high implementation of weight management regulations that pre- school wrestlers. Med Sci Sports Exerc 33: 810–813, 2001. vent rapid weight loss among MMA athletes. 12. Lakin, JA, Steen, SN, and Oppliger, RA. Eating behaviors, weight loss methods, and nutrition practices among high school wrestlers. ACKNOWLEDGMENTS J Community Health Nurs 7: 223–234, 1990. Funding was provided by the Appalachian State University, 13. Lohman, TG. Skinfolds and body density and their relation to body fatness: A review. Hum Biol 53: 181–225, 1981. Office of Student Research. 14. Marquart, LF and Sobal, J. Weight loss beliefs, practices and support systems for high school wrestlers. JAdolescHealth15: 410–415, 1994. REFERENCES 15. Oppliger, RA, Case, HS, Horswill, CA, Landry, GL, and Shelter, AC. American College of Sports Medicine position stand. 1. Alderman, BL, Landers, DM, Carlson, J, and Scott, JR. Factors Weight loss in wrestlers. Med Sci Sports Exerc 28: ix–xii, 1996. related to rapid weight loss practices among international-style wrestlers. Med Sci Sports Exerc 36: 249–252, 2004. 16. Oppliger, RA, Landry, GL, Foster, SW, and Lambrecht, AC. Bulimic behaviors among interscholastic wrestlers: A statewide 2. Armstrong, LE, Casa, DJ, Millard-Stafford, M, Moran, DS, survey. Pediatrics 91: 826–831, 1993. Pyne, SW, and Roberts, WO. American College of Sports Medicine position stand. Exertional heat illness during training and 17. Oppliger, RA, Utter, AC, Scott, JR, Dick, RW, and Klossner, D. competition. Med Sci Sports Exerc 39: 556–572, 2007. NCAA rule change improves weight loss among national championship wrestlers. Med Sci Sports Exerc 38: 963–970, 2006. 3. Artioli, GG, Franchini, E, Nicastro, H, Sterkowicz, S, Solis, MY, and Lancha, AHJ. The need of a weight management control program 18. Ransone, J and Hughes, B. Body-weight fluctuation in collegiate in judo: A proposal based on the successful case of wrestling. J Int Wrestlers: Implications of the National Collegiate Athletic Soc Sports Nutr 7: 15, 2010. Association weight-certification program. J Athl Train 39: 162–165, 2004. 4. Artioli, GG, Gualano, B, Franchini, E, Scagliusi, FB, Takesian, M, Fuchs, M, and Lancha, AH. Prevalence, magnitude, and methods of 19. Scott, JR, Horswill, CA, and Dick, RW. Acute weight gain in rapid weight loss among judo competitors. Med Sci Sports Exerc 42: collegiate wrestlers following a tournament weigh-in. Med Sci Sports 436–442, 2010. Exerc 26: 1294–1298, 1994. 5. Bounty, PL, Campbell, BI, Galvan, E, Cooke, M, and Antonio, J. 20. Webster, S, Rutt, R, and Weltman, A. Physiological effects of Strength and conditioning considerations for mixed martial arts. a weight loss regimen practiced by college wrestlers. Med Sci Sports Strength Cond J 33: 56–69, 2011. Exerc 22: 229–234, 1990. 6. Brozek, J, Grande, F, Anderson, JP, and Kemp, A. Densitometric 21. Zambraski, EJ, Foster, DT, Gross, PM, and Tipton, CM. Iowa analysis of body composition: Revision of some quantitative wrestling study: Weight loss and urinary profiles of collegiate assumptions. Ann NY Acad Sci 110: 113–140, 1963. wrestlers. Med Sci Sports 8: 105–108, 1976.

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