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Quality of Life and Health Status of Female and Male Vegetarian, Vegan, and Omnivorous Endurance Runners

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Quality of Life and Health Status of Female and Male Vegetarian, Vegan, and Omnivorous Endurance Runners Aus dem Institut für Laboratoriumsmedizin und Pathobiochemie, Molekulare Diagnostik Geschäftsführender Direktor: Prof. Dr. Harald Renz des Fachbereichs Medizin der Philipps-Universität Marburg in Zusammenarbeit mit der Pädagogischen Hochschule Innsbruck, Österreich Geschäftsführender Direktor: Prof. Mag. Thomas Schöpf und dem Institut für Hausarztmedizin der Universität Zürich, Schweiz Geschäftsführender Direktor: Prof. Dr. Thomas Rosemann, PhD Quality of life and health status of female and male vegetarian, vegan, and omnivorous endurance runners Inaugural-Dissertation zur Erlangung des Doktorgrades der gesamten Humanmedizin dem Fachbereich Medizin der Philipps-Universität Marburg vorgelegt von Patrick Boldt aus Düsseldorf Marburg, 2019 Angenommen vom Fachbereich Medizin der Philipps-Universität Marburg am: 15.10.2019 Gedruckt mit Genehmigung des Fachbereichs Medizin Dekan: Herr Prof. Dr. H. Schäfer Referent: Herr Prof. Dr. H. Renz 1. Korreferent: Herr Prof. Dr. S. Bösner For my beloved wife and my wonderful daughters. The present work is a cumulative dissertation and consists of the following published articles: 1. Boldt P, Knechtle B, Nikolaidis P, Lechleitner C, Wirnitzer G, Leitzmann C, Rosemann T, Wirnitzer K. Quality of life of female and male vegetarian and vegan endurance runners compared to omnivores - results from the NURMI Study (step 2). J Int Soc Sports Nutr. 2018; 15:33. 2. Boldt P, Knechtle B, Nikolaidis P, Lechleitner C, Wirnitzer G, Leitzmann C, Wirnitzer K. Sex differences in the health status of endurance runners: results from the NURMI Study (Step 2). J Strength Cond Res. 2019. doi: 10.1519/JSC.0000000000003010 3. Wirnitzer K, Boldt P, Lechleitner C, Wirnitzer G, Leitzmann C, Rosemann T, Knechtle B. Health status of female and male vegetarian and vegan endurance runners compared to omnivores-results from the NURMI Study (step 2). Nutrients. 2018; 11. pii: E29. Table of contents 1. Introduction .................................................................................................................. 1 1.1 Race distances ....................................................................................................... 1 1.2 Sex differences...................................................................................................... 2 1.3 Health-related effects ............................................................................................ 3 1.4 Diet choice ............................................................................................................ 4 1.5 Quality of life........................................................................................................ 6 1.6 Aims and hypotheses ............................................................................................ 6 2. Summary of the published results ................................................................................ 7 2.1 Quality of life of female and male vegetarian and vegan endurance runners compared to omnivores - results from the NURMI Study (step 2) ...................... 7 2.1.1 Method ............................................................................................................. 7 2.1.2 Sex differences ................................................................................................ 8 2.1.3 Diet choice ....................................................................................................... 8 2.1.4 Race distance and diet×race distance interaction ............................................ 8 2.2 Sex differences in the health status of endurance runners – results from the NURMI Study (step 2) .......................................................................................... 9 2.2.1 Method ............................................................................................................. 9 2.2.2 Body mass ....................................................................................................... 9 2.2.3 Stress perception ............................................................................................ 10 2.2.4 Chronic diseases ............................................................................................ 10 2.2.5 Allergies and food intolerances ..................................................................... 10 2.2.6 Regular medication intake ............................................................................. 10 2.2.7 Smoking habits .............................................................................................. 10 2.2.8 Supplement intake .......................................................................................... 11 2.2.9 Food choice .................................................................................................... 11 2.2.10 Healthcare utilization .................................................................................... 11 2.3 Health status of female and male vegetarian and vegan endurance runners compared to omnivores - results from the NURMI Study (step 2) .................... 12 2.3.1 Methods ......................................................................................................... 12 2.3.2 Health-related indicators................................................................................ 13 2.3.2.1 Body weight/BMI ................................................................................... 13 2.3.2.2 Mental health .......................................................................................... 13 2.3.2.3 Chronic diseases and hypersensitivity reactions .................................... 13 2.3.2.4 Medication intake ................................................................................... 13 2.3.3 Health-related behavior ................................................................................. 13 2.3.3.1 Smoking habits ....................................................................................... 13 2.3.3.2 Supplement intake .................................................................................. 14 2.3.3.3 Food choice ............................................................................................ 14 2.3.3.4 Healthcare utilization .............................................................................. 14 2.4 Declaration of my contributions ......................................................................... 14 3. Discussion ................................................................................................................... 15 3.1 Limitations and implications for future research ................................................ 20 3.2 Conclusions ........................................................................................................ 21 4. References .................................................................................................................. 22 5. Appendix ..................................................................................................................... 29 1 1. Introduction Humans have been running since the beginning of history. The ability to walk upright was the beginning in the evolution from the climbing anthropoid to the walking and running Homo species (Sollas, 1924). Today, endurance running is of high popularity and can be performed in different distances, such as 10 kilometers, half-marathon, marathon, and ultramarathon (Knechtle et al., 2011). In particular, the number of recreational runners who participate in road running events, such as marathons, has consistently been on a high level in the last years (Scheerder et al., 2015). For example, two of the largest marathons take place in Paris and Berlin. In 2018, there were 42,522 participants in Paris (Paris Marathon’s Organization Committee, 2019), and 40,650 runners in Berlin (Berlin Marathon’s Organization Committee, 2019). The high number of running competitions, which are arranged all over the world would enable, interested athletes to compete in a race nearly every week (Scheerder et al., 2015). 1.1 Race distances 10-kilometer races are of one of the most popular race distances (Cushman et al., 2014). In particular, recreational runners prefer this distance, as it is a serious challenge; meanwhile not much training is necessary to be able to cover the distance. Beyond that, it contributes to a good fitness level, and does not require much time (Cushman et al., 2014). In competitions, running pace is usually close to maximal oxygen intake (Fay et al., 1989). The world track record of 10,000 meters is 29:43 minutes in women and 26:44 minutes in men (IAAF, 2018). In addition to single 10-kilometer races, a 10- kilometer race is a part of an Olympic triathlon (Bentley et al., 2002). A half-marathon is a race of 21.0975 kilometers and is usually performed on the road. It is pretty popular particularly among recreational athletes, since it is supposed to be a greater challenge than a 10-kilometer-race, but it does not require as much training as a marathon. Well-trained athletes use to have a running pace, which is close to lactate threshold (Gómez-Molina et al., 2017). Therefore, a half marathon can be regarded as both as a competition and as a training distance for a full marathon (Karp, 2007). The world record is 01:04:51 hours in women and 00:58:23 hours in men (IAAF, 2018). 2 A marathon is a race of 42.195 kilometers and is usually performed on the road. Running pace is usually chosen close to aerobic-anaerobic threshold. Performance- limiting factors
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