New A&T Study Links Hypertension, Low Energy in Black DI Athletes

EAST GREENSBORO, N.C. (Aug. 17, 2023) – A first-of-its-kind study led by North Carolina Agricultural and Technical State University researchers shows for the first time a clear relationship between low-energy availability (LEA) and hypertension in Black Division I athletes.

Although research has shown Black Americans are at elevated risk for cardiovascular disease, only two prior studies – both using outdated methods – focused on Black athletes, said Troy Purdom, Ph.D., assistant professor in the Department of Kinesiology in N.C. A&T’s John R. and Kathy R. Hairston College of Health and Human Sciences and the study’s principal investigator.

Of the 23 Black athletes recruited to participate in the study, 14 were shown to have high blood pressure. Additionally, of those 14 athletes, 87% were found to be calorically deficient, with deficiencies in all micronutrient measured among all 23 participants.

LEA is defined as the under-consumption of energy, or nutrients, to meet activity demands. Therefore, the inherent nature of not eating enough is likely to accompany nutrient deficiencies. Some nutrient deficiencies such as shortages in calcium, vitamin D, poly-unsaturated fatty acids, omega-3 fatty acids, and iron are shown to negatively affect cardiovascular health.

“LEA puts the athlete in starvation mode, which creates a systemwide physiological response that when consistently reoccurring can perpetuate deterioration of several systems – gastrointestinal distress, compromised reproductive health in women and men, psychological health, and as it turns out, cardiovascular health,” said Purdom.

“This study is the first to investigate nutritional deficiencies and cardiovascular health. It is also the first to investigate an all-Black cohort. Despite 16% of all NCAA athletes being Black – more than 80,000 students – this is the first to investigate the problem in Black athletes.”

Energy deficiencies are common among athletes at all levels. But research shows that collegiate athletes lack an understanding of how much and what nutrients they need to support peak performance, leading to false perceptions and unhealthy eating behaviors that can perpetuate LEA conditions and related cardiovascular disease.

Black athletes have a cardiovascular disease risk 10 times greater than their white counterparts, with hypertension being the most prevalent risk factor, Purdom said. “The elevated risk of hypertension puts athletes at an increased risk of sudden cardiac death, as well as experiencing about a two times greater risk of hypertension development in a five-year follow up.”

Purdom conducted the study with colleagues:

• Marc Cook, Ph.D., an associate professor in the Department of Kinesiology and associate director for the Hairston College’s new Center of Excellence in Integrative Health Disparities and Equity Research (CIHDER)
• Heather Colleran, Ph.D., an associate professor, and Lauren San Diego, a research assistant, both in the Department of Family and Consumer Sciences in the College of Agriculture and Environmental Sciences
• Paul Stewart, Ph.D., a professor emeritus in the Department of Biostatistics at the University of North Carolina at Chapel Hill’s Gillings School of Public Health

“Our hope is to heighten awareness of the prevalence of cardiovascular disease as a result of nutritional deficiencies in athletes and why those deficiencies occur, which historically has not been prioritized by the research community,” said Purdom.

A&T’s Department of Athletics is pursuing nutritional support staff based on these findings.

Purdom, Cook, Colleran and San Diego also are conducting longitudinal testing to better understand the transient stresses student athletes are experiencing. At the same time, the researchers are working to educate these Aggies on the energy their bodies require to maintain health and promote performance.

Together, the researchers and athletics department staff are investigating the implementation of social determinants to improve their understanding of who Aggie athletes are and how to serve them better.

“Our goal is for all N.C. A&T athletes to participate in a healthy, resilient and thriving culture built on evidence-based practice,” said Purdom.