{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T17:40:03Z","timestamp":1756662003916,"version":"3.44.0"},"reference-count":37,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,3,20]],"date-time":"2025-03-20T00:00:00Z","timestamp":1742428800000},"content-version":"unspecified","delay-in-days":19,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005350","name":"Centrum f\u00f6r idrottsforskning","doi-asserted-by":"publisher","award":["2020\/3 P2021-0147","2021\/9 P2022-0167","2022\/10 P2023-0105"],"award-info":[{"award-number":["2020\/3 P2021-0147","2021\/9 P2022-0167","2022\/10 P2023-0105"]}],"id":[{"id":"10.13039\/501100005350","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Sport Exerc Med"],"accepted":{"date-parts":[[2025,2,24]]},"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To assess the association between (1) dietary habits and knee\/shoulder injury incidence in male and female adolescent handball players and (2) menstrual dysfunction and injury incidence in females.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This study is based on seasons 2020\u20132022 of the Swedish Handball Cohort including 1144 participants (1703 player seasons) free from a substantial knee and shoulder injury. Participants self-reported meal frequency, meal timing, nutritional intake and menstrual function (season 2022\/2023) at baseline. Weekly follow-ups throughout the season assessed training and matches, and substantial knee\/shoulder injuries. Cox regression analyses estimated a hazard rate ratio (HRR) with the first event of a knee\/shoulder injury (combined), with minutes of handball training and matches as the timescale.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In females, adjusted analyses generated an HRR for knee\/shoulder injuries of 1.46 (95% CI 1.08, 1.98) for moderate-high nutritional quality compared with low quality and an HRR of 1.38 (95% CI 1.02, 1.86) for \u22652 unfavourable dietary habits compared with 1 unfavourable dietary habit. For poor meal timing, adjusted analyses generated an HRR of 1.20 (95% CI 0.90, 1.61) compared with adequate timing in females. In males, adjusted analyses generated an HRR of 1.23 (95% CI 0.69, 2.17) for low meal frequency and an HRR of 0.83 (95% CI 0.60, 1.15) for poor meal timing.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In adolescent female handball players, moderate-high nutritional quality and \u22652 unfavourable dietary habits are associated with higher knee\/shoulder injury incidence; whereas, no or unprecise associations were found for other dietary habits in females and males and for menstrual dysfunction in females.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjsem-2024-002332","type":"journal-article","created":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T02:03:00Z","timestamp":1742781780000},"page":"e002332","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Dietary habits and knee and shoulder injury incidence in adolescent male and female handball players: the Swedish Handball Cohort"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4410-0981","authenticated-orcid":false,"given":"Clara","family":"Onell","sequence":"first","affiliation":[{"name":"Handball Research Group, Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva","family":"Skillgate","sequence":"additional","affiliation":[{"name":"Handball Research Group, Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden"},{"name":"Unit for Intervention and Implementation Research in Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, 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Science, Sophiahemmet University, Stockholm, Sweden"},{"name":"Department of Public Health, Analysis and Data Management, Public Health Agency of Sweden, Solna, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6883-1471","authenticated-orcid":false,"given":"Martin","family":"H\u00e4gglund","sequence":"additional","affiliation":[{"name":"Sport Without Injury Programme (SWIPE), Department of Health, Medicine and Caring Sciences, Link\u00f6ping University, Link\u00f6ping, Sweden"},{"name":"Unit of Physiotherapy, Department of Health, Medicine and Caring Sciences, Link\u00f6ping University, Link\u00f6ping, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2614-5174","authenticated-orcid":false,"given":"Klara","family":"Edlund","sequence":"additional","affiliation":[{"name":"Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, 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