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Table 2 Independent triggers of OTS

From: Novel causes and consequences of overtraining syndrome: the EROS-DISRUPTORS study

Scenario Independent variables included Results (* = positive for independent risk factors and triggers) Interpretation
Scenario 1 – All modifiable variables CHO, PROT, CAL, WORK, SLEEP PERFECT SEPARATION Together, modifiable patterns were able to explain all cases of OTS in the athletes studied.
Scenario 2 – All modifiable variables, except WORK CHO, PROT, CAL, SLEEP PERFECT SEPARATION Dietary patterns together with sleep quality were also able to fully explain all cases of OTS in the studied population of athletes.
Scenario 3 – All modifiable variables, except CAL CHO, PROT, WORK, SLEEP CHO: p = 0.036
OR/CL = 1.61 (1.03–2.50)
PROT: p = 0.029
OR/CL = 16.7 (1.34–208.1)
WORK: p = n/s
SLEEP: p = 0.069
OR/CL = 2.19 (0.94–5.09)
When daily caloric intake is not accounted, not all cases of OTS may be justified. However, in this scenario both CHO and PROT were shown to be independent triggers of OTS.
Scenario 4 – Without specification of each macronutrient CAL, WORK, SLEEP CAL: p = 0.004
OR/CL = 1.13 (1.04–1.23)
WORK: p = n/s
SLEEP: p = n/s
When each macronutrient intake is not specified, not all cases of OTS may be justified. However, in this scenario CAL was enough to independent etiology of OTS.
Scenario 5 – Only dietary patterns CHO, PROT, CAL CHO: p = n/s
PROT: p = 0.066
OR/CL = 25.85 (0.81–825.3)
CAL: p = 0.045
OR/CL = 1.27 (1.01–1.61)
When only dietary patterns are evaluated, we cannot explain all cases of OTS in the studied population. However, in this scenario, overall caloric intake, but not each macronutrient, was able to
  1. CHO Daily carbohydrate intake (g/kg/day), PROT Daily protein intake (g/kg/day), CAL Mean daily caloric intake (kcal/kg/day), WORK Average number of working or studying hours a day, besides training sessions (h/day), SLEEP Self-reported sleep quality (0–10), OTS Overtraining syndrome, OR Odds ratio, CL 95% Confidence Limits, p Level of significance, n/s non-significant (p > 0.1)