VI-th National Nutrition Conference, Bulgaria 2013

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Bulgarian Society of Nutrition and Dietetics

VI-th National Nutrition Conference

Bulgaria 2013

Bulgaria Bulgaria, City of Varna, St. Constantine and Elena


The National Nutrition Conference is organised by the Bulgarian Society of Nutrition and Dietetics, and it is the biggest academic conference in Bulgaria in the field of nutrition.


Assessment of the nutrition and physical development of pre-school and primary school children practising artistic gymnastics

Presentation at an Academic Conference

Assessment of the nutrition and the physical development of pre-school and initial school-age children practising artistic gymnastics

VI-th National Nutrition Conference

Assessment of the nutrition and physical development of pre-school and primary school children practising artistic gymnastics

S. Kolimechkov, L. Petrov, A. Alexandrova, L. Andreeva & P. Atanasov,
National Sports Academy 'Vassil Levski', Bulgaria
(Department of Physiology & Biochemistry)

Nutrition and the physical development of gymnasts


According to the National Centre of Public Health and Analysis (NCPHA) in Bulgaria, 200 000 children (or 20 % of the population) were overweight, of whom 65 000 were obese, in 2008.

It is recommended that youngsters spend at least one hour per day engaged in light to moderate physical activity, such as jogging, jumping, dancing and different kinds of sport (Booth et al., 2005).


Gymnastics - strength, speed, endurance and flexibility

Artistic gymnastics is one of the few sports which children from pre-school and primary school can practise. It develops those main qualities which define physical fitness: strength, speed, endurance and flexibility.

The repeated physical activities require a proper nutritional regimen, providing the right amount of proteins, fats and carbohydrates, maintaining energy intake and optimal amounts of vitamins and minerals.

Recommended nutrient intake for young athletes

The recommended nutrient intake for children and adolescents who are engaged in extra physical activity is higher than that in ones who are not involved in sports. Child athletes need more protein than the recommended intake for those children who are not involved in physical activity.

The American Dietetic Association (ADA) has set the following daily recommendations of carbohydrates for young athletes (Nisevich, 2008):
- for very light intensity training : 3-5 grams (g) carbohydrates per kilogram (carb/kg);
- for moderate or heavy training: 5-8 g carb/kg;
- for pre-event 'loading' (24-48 hours prior): 8-9 g carb/kg;
- for postevent refueling (within 2-3 hours): 1.7 g carb/kg.



The aim of this study was to assess, using accessible methods, the diet and the physical development of pre-school and young school children practising artistic gymnastics.

Gymnastics study



The study included 40 children (22 boys and 18 girls) between the ages of 4 and 12 years, attending gymnastics classes (3 to 5 times per week) at the ‘Sports Centre Levski’ in the capital of Bulgaria - Sofia. They were divided into two groups: pre-school (3-6 years of age) and primary school (7-11 years of age).

The standing height of the children was measured to the nearest 0.1 cm with a stadiometer, and their weight with an electronic scale to the nearest 50g. The body mass index (BMI) was also calculated, and in order to determine body composition and body fat percentage, we used the skinfold measurement test, which was carried out with a caliper (Lange Skinfold Caliper, Cambridge) to an accuracy of 1 mm.

skinfold measurement test for children

We used specialised software prepared by the World Health Organisation (WHO) – ‘WHO Anthro’ (for children under six years of age) and ‘WHO Anthro Plus’ (for children over 6 years of age), to assess height, weight and BMI in children. For each variable we calculated the Z-score and percentile score for the relevant age.

WHO Anthro software for assessing height weight and BMI

To distinguish the BMI scores, we used references provided by the WHO for children from 5 to 19 years of age.
overweight > +1 SD, obese > +2 SD, underweight < -2SD, mortality <-3SD
For percentile score : 85-95 percentile – overweight and >95 percentile – obese.

The upper arm muscle area – (UAMA) was calculated using the formulae:
UAMA = [ (mid-) upper arm circumference - (π x triceps skin fold )]2/4π

Body fat percentage (% fat) was determined by the sum (Sum) of the two skin folds – triceps and scapula, using the equations of Slaughter:
Boys under 10 years of age: %Fat = 1.21 x Sum - 0.008 x Sum2 - 1.7
Boys between age of 11-13: %Fat = 1.21 x Sum - 0.008 x Sum2 – 3.4
Girls – all ages: %Fat = 1.33 x Sum - 0.013 x Sum2 – 2.5

The basal metabolic rate (kcal/24h) was calculated using the formulae of Harris-Benedict. The estimated daily energy expended (kcal/24h) was derived by employing the basal metabolic rate (BMR) coefficient for physical activity, for which we adopted a figure of 1.4 for children practising 3 times per week, and 1.6 for children practising 6 times a week.

The nutrition questionnaire which had been used for adult athletes (Zaikova 2010, 2011, 2012) was adapted for our purposes in order to assess the nutrient intake in children. The Food Frequency Questionnaire (FFQ) was completed by the children’s parents. It included 24 questions relating to the weekly consumption of basic foodstuffs. Based on the results, the daily intake of proteins, carbohydrates and fats, protein/kg body weight, in addition to the total daily energy intake (kcal/24h) was calculated.

nutrition assessment of children



Anthropometric data of the studied children
Average ±SD

Anthropometric data of the studied children


Food intake data of the children from our study (aged 3-10 years) and children of the same age group from the Nutritional Survey of the population of Bulgaria – 1997

Food intake data

Baikova et al., Nutritional Survey of the population of Bulgaria, 1997


Body Mass Index Z-scores

BMI Z-scores for all children


Anthropometric data of the overweight children (BMI Z-score > 1)

Anthropometric data of the overweight children


Gymnastics assessment


energy proportion of the essential nutrients, energy intake, energy expenditure, age, experience

Average age, sports experience (months), calculated energy expenditure, energy intake and energy proportion of the essential nutrients in overweight children (n=5) and young athletes (n=12)


Energy expenditure and energy intake; protein, fat and carbohydrate / kg body weight (Average ± SE) in the overweight children (n=5) and children who were competitors (n=12).

Energy expenditure and energy intake in the overweight and athletes


BMI Z-score and ratio (energy intake)/(energy expenditure) in the overweight children (n=5) and the children who were competitors (n=12)
* - p < 0.05; *** p < 0.001


Gymnastics Nutrition Presentation


  • The volume of aerobic exercise in the preparatory part of the gymnastics session should be increased, in addition to various games and different athletic exercises which might be included.
  • Foods with high energy content (bakery products, chocolate, candy, etc.) should be minimized, and those of fruits and vegetables maximized.
  • Children should be stimulated to eat more healthily.
  • BMI is not an adequate indicator for child athletes with greater muscle mass. In these cases, more anthropometric data (% fat, skin folds) should be taken, as well as strength indicators (data for muscle hypertrophy and dynamometers).
  • The nutrition questionnaire which was used gives a good indication of the average intake of the main food groups, nutrients and energy. This conclusion is confirmed by the close accordance between the data obtained in our study and that from others which have been conducted.
  • Information about extra physical activities, which is not part of the PE lessons or sports training, should be collected in order to assess correctly the energy expenditure in child athletes.
  • The amount of aerobic exercise in training sessions should be increased for overweight children, and a healthy way of eating should be promoted for them and their parents.



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  3. Nisevich, P. Sports Nutrition for Young Athletes, IDEA Fitness Journal, April, 2008, 65-67
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  7. Zaekov, N., D. Zaikova, L. Petrov, L. Andreeva, P. Atanasov. WEB-based method of assessing diet in active athletes, Nutrition Science, 4, 2012, 4-7
  8. Harris, J., F. Benedict. A Biometric Study of Basal Metabolism in Man, Washington DC, Carnegie Institute of Washington, 1919, 266
  9. Blinman, T., R. Cook. Allometric Prediction of Energy Expenditure in Infants and Children, 3, 2011, №4, 216-224


Full Presentation: Assessment of the nutrition and physical development of pre-school and primary school children practising artistic gymnastics

Date & time: Friday, 17th May 2013

First Scientific Meeting, Hall 1, city of Varna (Bulgaria)

Assessment of the nutrition and physical development of pre-school and initial school-age children practising artistic gymnastics

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Assessment of the Nutrition and Physical Development of Children
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National Nutrition Conference 2013


This scientific presentation is also available in BulgarianBulgarian language (on PDF file, on PPTX file), as well as the full program (.pdf file) of the Bulgarian Nutrition Conference 2013.




VI-th National Nutrition Conference, 16-18 May 2013

National Nutrition Conference 2013

We were represented by Dr Petrov and Dr Alexandrova (on the photo above with all other participants in this scientific conference).



VI-th National Nutrition Conference 2013