Nutritional status and weight making practices of professional male South African mixed martial arts fighters

Abstract

Background - Weight category combat sport athletes, including mixed martial arts (MMA) fighters, often ‘make weight’ or ‘cut weight’ to fight in lower weight divisions. Common weight-making practices include restriction of food and/or fluid intake and intentional fluid loss/sweating (e.g. sauna). However, a number of these weight-making practices can be detrimental to the performance, health and nutritional status of the fighters. MMA fighters are usually weighed-in 24 hours prior to competition, and then have a subsequent 24 hours to adequately recover/rehydrate for the match (Jetton et al., 2013). Due to the fact that fighters have time to recover/rehydrate, it allows fighters to make use of extreme weight-making practices (i.e. extreme dehydration) to rapidly lose the last bit of unwanted body weight, usually being water weight, in a short time. Although literature is available on the weight making practices of MMA fighters, limited information is available regarding their general nutritional status. Since MMA is a rapidly growing sport with a lot of interest amongst youngsters as well, information on weight-making practices and the nutritional status of these athletes is warranted to enable coaches and allied health professionals to optimise their health and performance. This study therefore aimed to describe the nutritional status (dietary intake and body composition) and weight-making practices of professional male South African MMA fighters. Objectives - The first objective was to determine the nutritional status, including dietary intake and body composition, of professional male South African MMA fighters at baseline (6-weeks prior to competition), 1-week prior to competition and at weigh-in (24-hours prior to weigh-in). The second objective was to determine the weight-making practices of professional male South African MMA fighters prior to weigh-in. The final objective was to determine the hydration status at weigh-in (proxy for fluid loss / extent of fluid weight-making practices). Methods - Seventeen male South African MMA athletes (aged 28.0±1.0 years, and competitive experience 7.0±1.0 years) participated in this observational study with a descriptive longitudinal study design. Dietary intake was recorded by means of a validated quantified food frequency questionnaire at baseline (6-weeks prior to competition) and again 1-week prior to competition. Anthropometric measures (weight, height and skinfold measurements) were performed by an ISAK level 1 anthropometrist at baseline (6-weeks prior to competition), 1-week prior to competition, and at weigh-in (24-hours prior to weigh-in for weight). A previously validated weight-making practices questionnaire was adjusted and administered to the MMA athlete’s 1-week prior to competition. Urine samples were collected at weigh-in, and hydration status was determined with urine specific gravity using a digital hand-held compact refractometer (P10S). Main findings - Median dietary energy intake at baseline was 17170 (15598-26376) kJ. Macronutrient intake for carbohydrate (CHO), protein and fat were 411 (291-632) g, 194(134-216) g, and 209 (161-305) g, respectively. Dietary protein intake (expressed in g/kg body mass) was in-line with the recommendations for athletes, however median CHO intake at baseline [5.2 (3.2-11.7) g/kg] and 1-week prior to competition [3.1 (2.1-10.5) g/kg] was below the recommendations of 6-10g CHO/kg body mass for athletes performing one to three hours of moderate to high-intensity exercise. Fat intake (expressed in percentage) at baseline [44.0 (32.3-61.5)%] and 1-week prior to competition [40.9 (32.8-47.2)%] were above the recommended macronutrient distribution range (>35% of total energy), however athletes that do regular high-volume training may increase their fat intake up to 50% of total energy intake. Vitamin D intake at baseline [8(1-22) μg/d] and1-week prior to completion [5(0-9) μg/d] were both below the RDA of 15 μg/d. Calcium intake 1-week prior to competition [826 (522-1120) mg/d] was below the RDA of 1000mg/d. Magnesium at baseline [26 (21-334) mg/d] was below the RDA of 400 mg/d. The median body mass index (BMI) of the participants at baseline was classified as overweight (>24.9kg/m2), however, their median body fat percentage was low [7.6 (6.5-8.5) %]. All (100%) of the fighters reported the use of one or more weight-making practice to make weight before competition. Gradual weight loss was the most common weight-making practice reported in this study, with a prevalence of 88%, followed by hot baths (82%), water loading (71%), increasing exercise more than usual (59%) and training in rubber or plastic suits (59%). Seventy one percent (71%) of the MMA fighters restricted fluid intake in order to lose weight. Although body mass decreased significantly from baseline [80.4 (73.3-86.5) kg] to 1-week prior to weigh-in [76.9 (71.8- 81.2) kg], with an additional significant decrease to weigh-in 24-hours prior to competition [70.4 (66.8- 106.6) kg], body fat percentage did not change between baseline and pre-competition. At weigh-in 24-hours prior to competition, all of the participants that provided a voluntary urine sample were classified as moderately (57%) to severely (43%) dehydrated. Conclusion - The MMA fighters in the present study had a borderline high BMI but a healthy body fat percentage. Their dietary intake was in line with the macronutrient recommendations for athletes for protein, fat and the majority of micronutrients, however, CHO intake as well as vitamin D and calcium were below the recommended amounts. It is clear that MMA fighters in the present study are engaging in weight-making practices, particularly rapid weight loss practices that involve fluid loss and/or fluid restriction and that their influence on how to make weight mainly from their coaches and training colleagues, and not from a registered dietitian.. Although the MMA fighters lost a significant amount of weight from baseline to 1-week prior to weigh-in, they continued losing weight during the few days leading up to weigh-in 24-hours prior to competition. Based on the fact that all the MMA fighters who provided a urine sample at weigh-in were moderately to severely dehydrated, the weight lost during the few days prior to weigh-in was presumably water weight as a result of rapid weight loss practices. It should be recommended that the rule changes made by the California State Athletic Commission (CSAC) for Ultimate Fighting Championships (American based) that only allow a maximum of 8% weight difference between a week prior to weigh-in and weigh-in, should be implemented in Extreme Fighting Championships (in South Africa) as well to encourage fighters to enter realistic weight categories and limit the use of extreme weight making practices resulting in dehydration prior to weigh-in.