
Establishing the ideal weight and body composition for each sport is important for athletic performance, but concurrently, dissatisfaction with body image and an obsession with thinness may result in poorer performance and health issues (Hagmar et al., 2008).
Artistic swimming (AS, previously referred to as synchronized swimming) is a unique sport due to its physical requirements (Mountjoy et al., 2009; Schaal et al., 2017). Despite its significant aesthetic component, body appearance is not judged, but coaches and swimmers do consider it to be an important factor. Coupling this aspect with intense training, it follows that the nutritional and psychological demands on artistic swimmers are complex.
Some studies indicate that a greater incidence of eating disorders is found in AS (ED, Robertson et al., 2014). The consequences may be particularly serious in young and adolescent girls, both for their health and development and for their athletic performance. Therefore, early detection and prevention is important, but there are no publications on the relationship between AS and eating disorders in girls.
Given that fact, a multidisciplinary research team at Universidad Europea comprised of Dr. María Ascensión Blanco, Dr. Laura de la Calle, Dr. María Gaibar, Dr. Apolonia Novillo, Dr. Ana Fernández Santander, Dr. Cristina Andreu, and Dr. Alicia Romero Lorca, from the School of Biomedical and Health Sciences and the School of Physical Activity and Sports Science, believed a study of school-aged girl artistic swimmers needed to be conducted. To this end, a sample of 60 girls between the ages of nine and 17 who participate in national-level artistic swimming in the Autonomous Region of Madrid was used, comparing them to a control group of 90 girls. The objective was to compare the somatometric measurements, menarche data, genetic data related to stress and muscle fiber, and eating habits of the swimmers with the control group. Additionally, the study aimed to link the different data points of the swimmers to their athletic performance.
A very important objective was to contribute to the early detection and prevention of ED and development problems in artistic swimmers and to their athletic performance, primarily through communication with the athletes themselves and with their parents and coaches.
The young female swimmers belonged to three AS clubs in the region of Madrid (CN Arcadia, Real Canoe NC, and AD Sincro Retiro), which participated in national competitions and represented 70% of all artistic swimmers in the Madrid area for the 2016-2017 season. Age subgroups were established in accordance with the International Swimming Federation (FINA) for both the swimmers and the control groups: under 12 (Grade-schoolers), 12-15 years old (Early-teens), and 16-17 years old (Adolescents).
Artistic swimmers tend to be thinner
The swimmers underwent monitoring of measurements for height, weight, body fat percentage, and skinfold testing, which also measures body fat. Questionnaires were also used to collect data about their menstrual cycles.
The results reveal a lower body mass index (figure 1), skinfold, and fat content in the swimmers compared to the non-swimmers, as well as a later age of menstruation, 1.2 years later.

Selective pressure on genotypes resistant to stress and mixed strength and endurance sports
The question was posed whether, over the course of years practicing this demanding sport, there would have been any type of genotype selection that would facilitate greater success in sports. An analysis was carried out of the gene 5-HTTLPR, which is the serotonin transporter, related to ED, responsible for resistance to stress and aggression; and the gene ACTN3, of α-actinin-3, which is related to the type of sport, strength or endurance.
As can be seen in figure 2, in the case of the older girls, the swimmers exhibited a tendency to be carriers of a genotype related to resistance to stress (genotype LL of the serotonin transporter); this result may be explained by the fact that the practice of AS selects those girls with the genotype most equipped to endure stress.

In figure 3 something similar can be seen for the heterozygous RX genotype of the α-actinin-3 gene, which is related to sports requiring a mix of strength and endurance.

Artistic swimming can in fact be considered to be a strength sport, given that exercises last just a few minutes, but the long training sessions result in the development of endurance as well.
Greater risk of eating disorders
The questionnaire EDI-3-RF was used to measure ED risk (risk screening, Garner, 2012). The EDI-3 is a standardized, easy to use and review measurement that provides objective scores and highly useful profiles for case approach and treatment planning for people suspected of having or who have been diagnosed with an ED. In addition, it facilitates the determination of five scale types: body dissatisfaction, risk of bulimia, obsession with thinness, maturity fears, and general risk of ED.
In total, of the 140 girls, 23 were observed to be in the clinically elevated range for one of the scales evaluated. Although the difference between the groups is not statistically significant (p=0.19), probably due to the sample size, the percentage of girls with clinically elevated ranges is higher among the swimmers (12 of 59, 20.34%) than in the control group of girls (11 of 89, 12.36%)
The most prevalent clinical attributes were maturity fears in the early-teen swimmers and the risk of bulimia in all the girls. Given that the early-teen swimmers are subjected to difficult training despite their young age (12-15 years), the researchers interpret this result as a desire on the part of the girls to return to the comfort of early childhood.
The physical data are not associated with better performance
To analyze the swimmers’ athletic performance, the girls underwent some tests: swimming the 25m crawl and throwing a medicine ball; both tests are similar to what they would do in training sessions or federation control checks. The first test measured their time and the second the distance they threw the ball. Scores from the last four figure competitions (individual trials) were also factored in, using data obtained on the websites of the Federación Madrileña de Natación (Madrid Swimming Federation) and the Real Federación Española de Natación (Spanish Swimming Federation).
The most important result obtained was that, with the exception of correlations between percentage of fat and BMI with the result of the ball throw, there was no correlation between specific anthropometric measurements and athletic performance, especially in the official scores from figure competitions, which allows us to separate thinness or other body attributes from AS success. This result is important given that the false link assumed by the girls and their coaches could be contributing to the increased incidence of ED among AS swimmers.
Disseminating our results
In order to contribute to the early detection and prevention of ED and development problems in synchronized swimmers, as well as contribute to their enhanced athletic performance, this study’s research team has held lectures and released reports for parents, coaches, and athletes in participating clubs and schools, and at the headquarters of the Federación Madrileña de Natación (Madrid Swimming Federation), all of which were well-received. Additionally, the parents of those girls for whom some risk was detected were personally informed of the finding. In doing so, it is hoped that the study’s results will have an impact on the girls who participated.
The results of the project have been reported to participating clubs and schools and to the 14th International Congress of Sports Science and Health held in Pontevedra in May, 2018.
BIBLIOGRAPHY
Hagmar, M; Lindén Hirschberg, A; Berglund, L; Berglund, B; 2008. Special Attention to the Weight-Control Strategies Employed by Olympic Athletes Striving for Leanness Is Required. Clin J Sport Med. 18, 5-9. doi: 10.1097/JSM.0b013e31804c77bd.
Mountjoy M.; 2009. Injuries and medical issues in synchronized Olympic sports. Curr Sports Med Rep. 8(5):255-61. doi: 10.1249/JSR.0b013e3181b84a09.
Schaal K, Tiollier E, Le Meur Y, Casazza G, Hausswirth C, 2017. Elite synchronized swimmers display decreased energy availability during intensified training. Scan. J. Sci. Sports 27: 925- 934. doi:10.1111/sms.12716
Robertson, S; Benardot, D; Moun, M; 2014. Nutritional Recommendations for Synchronized Swimming. International Journal of Sport Nutrition and Exercise Metabolism 24:4, 404-
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Garner, 2012. EDI-3. Manual. Ed. Tea SA. Madrid.