INTRODUCTION

As a collective game, handball involves two teams of seven players each, according to international handball federation rules. Handball is defined as an intermittent high-intensity exercise. Importantly, it also indicates that team handball may potentially result in widespread positive health and physical fitness effects due to the high demands imposed on the aerobic and anaerobic energy systems (^{Randers et al., 2010}; ^{Hornstrup et al., 2020}).

Healthy food choices and adequate nutrition for team sports athletes is a challenge. Cultural, economic, and psychological factors can influence but are essential for supporting training and enhancing the physical performance of athletes (^{Holway & Spriet, 2011}).

The players perform various activities such as running (speeding up, slowing down, changing direction and sprint), jumping (jumping and throwing and blocking), throwing balls (giving passes and pitching), and reciprocal physical struggle during the game (^{Povoas et al., 2012}). Anthropometric characteristics of these athletes, such as height, weight and body composition (^{Ghobadi, Rajabi, Farzad, Bayati, & Jeffreys, 2013}), and physical capacities such as speed, power, strength and endurance, and motor action, as the change of direction and jumping, are prerequisites which should be carried out (^{Molina-Lopez, Barea Zarzuela, Saez-Padilla, Tornero-Quinones, & Planells, 2020}). Given its influence on performance, body composition should be appropriate, which depends to a large extent on proper eating habits (^{Hosseinzadeh et al., 2017}).

Adequate food intake is crucial to capable growth and maturity and is associated with physical exercise (^{Cotunga, Vickery, & McBee, 2005}; ^{Bonci, 2010}). According to sports nutrition guidelines, protein intake should be between 1.2g/kg/day and 1.7g/kg/day, carbohydrates (^{Kaur et al., 2006}) ingestion may range from 3 to 12 g/kg/day depending on the duration and type of exercise (^{Burke, Hawley, Wong, & Jeukendrup, 2011}), and fat should contribute to 20–35% of total energy value (^{Desbrow et al., 2014}; ^{Jenner, Buckley, Belski, Devlin, & Forsyth, 2019}). Moreover, athletes should reach, at least, the dietary reference intakes for all micronutrients.

The studies of elite and young handball players’ anthropometric nutritional intake tend to be inconsistent. And in a practical context, due to the few nutritional information, this work is a pioneer in assessing the food intake of this group.

As, due to specificity on training according to their position (wings, pivots and backcourt players and goalkeepers), that during the game consequential to field zones and phases of the game, each position player has specific technical and tactical requirements. Athletes from different positions differ in morphological parameters, especially in body weight (between backcourts and wings) and subcutaneous fat (goalkeepers and the other players) (^{Hermassi, Laudner, & Schwesig, 2019}). However, according to the scarce information and competition and rest days in young athletes, it is essential to characterise this population regarding these variables.

This is the first transversal observational study, with the following objectives:

It was hypothesised that nutritional intake (macronutrients and micronutrients) are according to the nutritional recommendations according to the age and regardless of position on the game, all athletes have adequate nutritional intake, being higher in males than in female athletes.

METHODS

This study is a transversal observational study.

RESULTS

DISCUSSION

This study assessed the nutritional intake (macronutrients and micronutrients) of young handball athletes as well according to their position in the game and between females and males. The main findings were that young female, and male handball athlete’s energy intake is 2,167.4± 1,185.0 and 2,952.9± 1,315.8 kcal/day, respectively (Figure 1). Average energy, protein, carbohydrate, fat, vitamin E, thiamin, folate, magnesium, calcium, zinc and iron intake in males was significantly higher than that of females (p< 0.05). Regarding the position in the game, female athletes in wing position have a higher energy intake compared to the other positions. And according to macronutrients intake, wing athletes had a significantly higher protein intake (g/day) than other positions and carbohydrate and lipids intake (g/day). In male athletes, the goalkeepers had a higher energy intake and carbohydrate intake. Pivot’s athletes have a higher protein and lipid intake compared to other positions.

Figure 1 Mean values of energy (kcal/day), macronutrients (proteins and carbohydrates) per kg per day of young handball athletes between female and male. 

According to our results, average body weight, height, and BMI of all athletes in the current study were normal or healthy weight but were higher than standard values for young athletes (^{Collaboration, 2017}; ^{Mascherini, Galanti, Massetti, Cala, & Modesti, 2019}), and according to global age-standardised mean BMI of children and adolescents aged 5–19 years in 2016 was 18.6 kg/m² for females and 18.5 kg/m² for males (^{Collaboration, 2017}). And consistent with physiological, there are differences between the sexes, since men are, in general, taller, heavier, have larger muscle mass, and are stronger than women (^{Michalsik & Aagaard, 2015}).

Physical training in handball should be designed and performed to reflect the specific demands placed on male and female athletes, respectively. To the best of our knowledge, no previous study has examined the nutritional differences according to different sexes and positions in Portuguese athletes.

When comparing the ingestion of macronutrients between sex, the mean energy intake was significantly higher in males than in females (2,952.9± 1,315.8 kcal/day and 2,167.4± 1,185.0, respectively (p= 0.015)). The energy intake-adjusted to weight was 39.3± 19.3 kcal/kg/day for males and 34.8± 19.7 kcal/kg/day for females. According to other studies, handball players at the beginning of and during the sports season has been around 2,700–3,200 kcal/day and 3,100–3,600 kcal/day, respectively, for males and 1,800–2,400 kcal/day for women (^{Molina-Lopez et al., 2013}). On the other hand, a study among 16 Brazilian female players had an energy intake of 1,883 per day (comparable with the 1,690 kcal per day found here), which was mentioned to be at least 220−440 kcal less than the recommended range (^{Hermassi et al., 2019}).

The athlete’s energy need will depend on the training and competition cycle, duration, frequency of matches, length of the season, training phase, and the number of players and substitutions. Energy balance, therefore, occurs when energy consumption is equal to total energy expenditure or the sum of the energy expended as the basal metabolic rate, the thermal effect of the food, the thermal effect of the activity (energy expended on planned physical activity), and thermogenesis of resting activity (^{Molina-Lopez et al., 2013}).

The contribution of macronutrients (carbohydrates, proteins and lipids) in handball athletes is fundamental. The protein intake may be a priority in the diet of a handball player due to the difference in weight, height, fat percentage, and muscle mass according to different positions. According to recommendations from the American College of Sports Medicine (ACSM) and International Society of Sports Nutrition Position Stand (ISSN) organisations, the protein intake ranges from 1.2 to 2.0 g/kg/day (^{Thomas, Erdman, & Burke, 2016}; ^{Jager et al., 2017}). In our study, the weight-adjusted protein intake found in females and males (1.6± 0.8 and 1.8± 0.9 g/kg/day, respectively), the male group’s intake was near the upper recommendation limit (^{American Dietetic Association, Dietitians of Canada, & American College of Sports Medicine, 2009}). And it is important to take into account that all of these intake values are according to food intake. This means that many of the incentives given to this population for supplementation have to be rethought and viewed individually if whether or not there is a need.

Regarding carbohydrate intake, young male athletes showed higher weight-adjusted ingestion, 4.3± 2.5 and 4.9± 2.8, respectively, being below the recommended for the studied sample: 6–10 g/kg/day (^{Thomas et al., 2016}). According to different authors, male handball players reported ingesting an average of 4.1–4.8 g/kg/day, while female players consumed about 3.7–4.0 g/ kg/day (^{Molina-Lopez et al., 2013}). The ACSM has estimated a range between 20% and 35% for fats total energy intake in athletes, and according to our study’s data, women had a fat intake higher (37.3%) than men (33.5%). It exceeds the recommendations, while the fat intake by men is within the recommendations.

Therefore, these athletes might benefit from specific nutritional guidance to increase CHO ingestion and implement strategies to adjust protein and lipid intake.

Considering the game position, our study found that athletes in wing positions have a higher energy intake compared to the other positions. And according to macronutrients intake, wing athletes had a significantly higher protein intake (g/day) than other positions and carbohydrate and lipids intake (g/day).

Given the scarcity of information on dietary intake in athletes of different positions, it is not possible to relate these results with other works. Considering the demand of these athletes’ work on the field and other informations about anthropometric measures, such as wing athletes are significantly smaller and have significantly lower body mass (^{Hermassi et al., 2019}). Our study was in accordance with these results since female, and male athletes in this position have a lower BMI. This happens because the wings cover the largest field area and carry out most of the counterattacks, therefore they need lighter and faster bodies with the capacity for rapid changes of movement and agility (^{Hermassi et al., 2019}). Female goalkeepers are the heaviest of all players according to their position in the game (^{Hermassi et al., 2019}), however, in the present study, the heaviest female players were the pivots. Considering that we only have the BMI value, we do not know which value corresponds to the percentage of fat mass or muscle mass. Pivots must catch the passes during an attack, and high defence players hinder them, therefore, high body height values can give them an advantage over those (^{Hermassi et al., 2019}). In our study, the goalkeepers’ male athletes had a higher energy intake and carbohydrate intake. Pivot’s athletes have a higher protein and lipid intake compared to other positions.

Although macronutrient ingestion probably reflecting an adequate energy intake, several micronutrients were below the dietary reference intake, such as calcium and vitamin E in females and vitamin C and D in both sexes. Vitamins have also been widely studied to help athletes reduce stress damage, maintain a healthy immune system, and play a beneficial role in injury prevention and tissue repair in response to exercise (^{Walsh, 2019}). These values were also found in other athletic groups, namely triathletes, runners, water polo players, and female junior and adolescents soccer players. Concerning vitamin D, that in our study in both sexes had an intake below dietary recommendation, is important in handball athletes due to its possible negative impact on bone health, immune function, inflammatory modulation, and muscle function and performance.

This study had some limitations, considering the time of evaluations, which did not permit the asessement of more parameters, such as the use of accelerometers to measure the physical activity, biochemical parameters, and body fat mass and skinfolds. Concerning the use of FFQ, although it has an acceptable validity, the interpretation of questions through young athletes was difficult, and the interpretation of the results should be made with caution. Nevertheless, this study allowed the collection of information regarding the young handball athletes’ dietary intake.

CONCLUSIONS

In conclusion, this study is a big step in the future of handball because it allowed us to analyse young handball athlete’s nutritional intake. According to the recommendations from food, most of the athletes reported a generally higher nutritional intake (protein intake was near to the upper recommendation limit; the carbohydrate intake was below and the fat intake higher) and a lower for some micronutrients. According to their positions in the game, energy intake is higher in wing female athletes and goalkeepers’ male athletes. The female wing athletes have a higher significantly protein intake than other positions.

Considering these results, it seems plausible that specific nutritional training and education, especially with the involvement of experts in sports nutrition, would yield higher percentages of athletes fulfilling the recommendations according to their position and their expenditure in the game, since nutrition in these athletes may influence their future in the selection process and their professional life as handball athletes.