Dietary and lifestyle patterns of pre and professional dancers: An international survey

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1 International Symposium on Performance Science ISBN The Author 2013, Published by the AEC All rights reserved Dietary and lifestyle patterns of pre and professional dancers: An international survey Derrick D. Brown 1,2 and Matthew Wyon 2 1 Dance Academy, ArtEZ Institute for the Arts, The Netherlands 2 Research Centre for Sport, Exercise, and Performance, University of Wolverhampton, UK The importance of nutrition in dancers is well established, and its influence on health, lifestyle, body composition, energy availability, and especially dance performance is widely accepted among dance and nutrition scientists. However, the aesthetics of some dance genres expose dancers to body image ideals that may be considered unhealthy and often result in students and professionals taking unnecessary risks to achieve those stereotypes. This study investigated dietary and lifestyle habits in student and professional dancers. 411 participants started this survey, and 350 (F=272, M=78) completed all questions, representing an 81% response rate. Student and professional dancers from 53 countries on five continents completed a cross-sectional survey detailing demography, anthropometry, professional status, dietary patterns, and lifestyle questions. In terms of diet, 35% considered themselves carnivore and 36% omnivore, while 2% were vegan. 30% ingested three or more servings of vegetables per day, 61% reported 1 to 2 servings of protein daily, and 14% ingested no dairy products daily. 62% considered themselves very healthy. These findings suggest no detrimental dietary or lifestyle patterns in this cohort, though continued efforts should be encouraged to educate dancers on more healthful behaviors and lifestyle choices. Keywords: nutrition; dance science; international; lifestyle; health Dance is currently enjoying a veritable explosion in popularity. From street dance to Bollywood, ballroom to ballet, all have helped bring dance to a larger, more diverse audience. This increased exposure to dance, as with other forms of physical activity, raises concerns about the health of dancers, which may be compromised due to inadequate diet. Dietary patterns may be

2 150 influenced by myriad factors, such as lack of time, hectic class and rehearsal schedules, and lack of nutritional knowledge. Several studies have shown that many dancers do not ingest enough nutrients or calories, which can impact both health and dance performance. Bonbright (1990) studied the dietary practices of elite female ballet dancers. The typical dancer consumed 1584 kcal/d with 70% failing to meet the 2000 kcal/d recommendation. Frederick and Hawkins (1992) evaluated the nutritional knowledge, attitudes, dietary practices, and bone densities of four groups of women, one of which consisted of female collegiate dancers. Results revealed that the dancers mean food frequency score was significantly lower than those of the other three groups. In particular, the dancers reported fewer calcium-rich foods in their diets over a longer period. This indicated reduced caloric intake and a poor dietary choice. Whole grains, complete proteins, and a variety of dietary fats are of particular importance in a population with a propensity towards lean body mass and disordered eating behavior. In dance, additional pressure from choreographers, instructors, and peers, anxiety during performance and competition, and the need for control are factors that may only exacerbate attempts to make healthier dietary choices (Yannakoulia et al. 2004). Given that aspiring students and professionals may be prepared to take risks to achieve their ideals, investigating food choices and lifestyle patterns could prove crucial in improving educational and nutritional advice provided to this vulnerable cohort. Therefore, this study investigated dietary and lifestyle patterns and attitudes in student and professional dancers. Participants METHOD A total of 411 participants started our survey with 334 completing the questions, indicating a response rate of 81%. Participants anthropometric and dance genera characteristics can be found in Tables 1 and 2. To enhance compliance and alleviate anxiety, the aims were clearly stated on an introductory page, which also carried a statement ensuring anonymity. Consent was obtained from all participants. The study gained ethical approval from the School of Sport, Performing Arts and Leisure, University of Wolverhampton Ethics Committee.

3 INTERNATIONAL SYMPOSIUM ON PERFORMANCE SCIENCE 151 Materials A survey consisting of thirty-five questions aimed to glean information on different variables: dance education, professional status, dance genre, activity and dance training schedules, basic dietary choices, and patterns of dietary supplementation. A certified athletic trainer, an exercise physiologist, a certified sports nutritionist, and two dance educators reviewed the questionnaire for inconsistencies. Table 1. Summary of participant characteristics. Characteristic Males Females Age category (years) Frequency, n (%) <18 1 (1) 9 (4) (12) 47 (20) (45) 127 (53) (30) 33 (14) (11) 15 (6) (1) 8 (3) (0) 1 (0.5) Height (m), M±SD (range) 1.78±8.86 ( ) 1.65±6.9 ( ) Weight (kg), M±SD (range) 73±8.79 (49-97) 57±8.35 (38-98) Table 2. Dance profession or educational status (N=280). Category N of respondents % of respondents Pre-professional student/university Pre-professional student/academy or conservatoire Recreational dance student Professional dancer (classical) Professional dancer (contemporary) Professional dancer (hip-hop/urban/street) 2 1 Professional dancer (style/ballroom) 2 1 Professional dancer (world dance) 3 1 Dancing/performing choreographer Dancer/entertainer 4 1 Dance teacher 18 6

4 152 Procedure To test for English language comprehension and applicability, a version was circulated to twelve non-native English-speaking participants before distribution of the questionnaire commenced. Their answers were not included in the statistical analysis. Several distribution channels were utilized in order to recruit participants, including social media, dance-specific websites, and communication with company teachers, rehearsal directors, and dance school/university department administrators. All questionnaires were filled in online via an SSL IP-address secure survey system. All data were entered into StatsPlus (v.5.8). Analyses were calculated for all participants, age groups, dance categories, and genders separately. Associations between age, gender, dance group, and motives were assessed via Chi-square (X 2 ) tests. Associations and differences were considered statistically significant if the probability of error was less than p=0.05. All data are presented as frequency (in %) or as M±SD. RESULTS In terms of diet, 35% considered themselves carnivore, 36% omnivore, 19% were flexitarian (i.e. semi-vegetarian), and 2% were vegan. 30% had three or more servings of vegetables per day, 61% had 1 to 2 servings of protein daily, and 14% ingested no dairy products daily. 51% of participants took dietary supplements ranging from vitamin/mineral supplements (67%) to omega 3/6 fish oils (47%). 33% of participants consumed wine while 39% ingested hard liquor or spirits in the last month. 14% of respondents reported smoking on occasion, 76% never smoked, 12% smoked daily, and 5% smoked to control their weight. 33% danced six days per week while 22% did some kind of sport or physical activity at least twice per week. 62% considered themselves very healthy. Chi-square (X 2 ) tests revealed no significant associations between age, gender, and dance genre. DISCUSSION Participants from fifty-three countries on five continents represent, to our knowledge, the first international study describing lifestyle and dietary patterns in student and elite dancers. Results reported by our respondents appear in line with the general U.K. Food Standard Agency recommendations for maintaining good health (2002). Interestingly, 14% of our cohort (n=41), twenty-eight of whom were female, reported no ingestion of dairy products on a daily basis. Similar findings have been seen elsewhere (Doyle-Lucas et

5 INTERNATIONAL SYMPOSIUM ON PERFORMANCE SCIENCE 153 al. 2010). While this number is relatively small, failure to ingest adequate amounts of dairy products or substitutes a major source of calcium could lead to insufficient calcium in the diet (Warren et al. 1991). As calcium has been shown to increase bone mineral density, sufficient dietary calcium is particularly important for female dancers and all vegetarians with sub-optimal diets. Notably, 26% of our respondents smoked. These results contrast with earlier research where 33% reported to be smokers (Wilmerding et al. 2002). Reasons for this difference could lie in recent changes in anti-smoking regulations in many countries, or that only select respondents felt comfortable answering this question. However, health professionals have attributed poor cardiovascular health, diminished stamina, and increased fatigue levels to this lifestyle habit (Brinson and Dick 1996). In conclusion, the present study highlighted dietary and lifestyle patterns internationally. As with most dietary and lifestyle research, our study was limited to self-reported data, thus actual patterns may prove different. Finally, results from this study could update valuable work done by dietetic and nutrition educators, nutrition and dance scientists, and physicians working with dancers to implement educational programs with a more research-based perspective. Address for correspondence Derrick Brown, Dance Academy, ArtEZ Institute for the Arts, Onderlangs 9, Arnhem 6800 AA, The Netherlands; de.brown@artez.nl References Bonbright J. M. (1990). Physiological and nutritional concerns in dance. Journal of Physical Education and Recreation and Dance, 61, pp Brinson P. and Dick F. (1996). Fit to Dance: The Report of the National Inquiry into Dancers' Health and Injury. London: Calouste Gulbenkian Foundation. Doyle-Lucas A. F., Akers J. D., and Davy B. M. (2010). Energetic efficiency, menstrual irregularity, and bone mineral density in elite professional female ballet dancers. Journal of Dance Medicine & Science, 14, pp Food Standards Agency (2002) McCance and Widdowson's the Composition of Foods (sixth summary edition). London: Royal Society of Chemistry. Frederick L. and Hawkins S. T. (1992). A comparison of nutrition knowledge and attitudes, dietary practices, and bone densities of postmenopausal women, female college athletes, and nonathletic college women. Journal of the American Dietetic Association, 92(3), pp

6 154 Warren M. P., Brooks-Gunn J., Fox R. P. et al. (1991). Lack of bone accretion and amenorrhea: evidence for a relative osteopenia in weight-bearing bones. The Journal of Clinical Endocrinology and Metabolism, 72, pp Wilmerding V., Robson B., and Book A. (2002). Cigarette smoking in the adolescent dance population. Medical Problems of Performing Artists, 6, pp Yannakoulia M., Keramopoulos A., and Matalas A. L. (2004). Bone mineral density in young active females: the case of dancers. International Journal of Sport Nutrition and Exercise Metabolism, 14(3), pp