Correlates of health in adolescent elite athletes and adolescents: A cross-sectional study of 1016 adolescents.

The primary aim of this cross-sectional study was to compare subjective correlates of health, such as nutrition, self-esteem, sleep and stress, between adolescent elite athletes (n = 625) and a reference group of adolescents (n = 391) not involved in elite sports. A secondary aim was to study predictors for self-perceived stress. A questionnaire was e-mailed to all participants containing valid questions about competence-based self-esteem, nutrition, self-perceived stress and sleep. Our results show that adolescent elite athletes reported significantly (p < .001) lower self-perceived stress, competence-based self-esteem, a more varied diet and more time of sleep, compared to adolescents not involved in elite sports (Hedges'g 0.31-0.82). Female adolescent elite athletes and female adolescents, compared to their male peer group, reported poorer values for competence-based self-esteem (elite, Hedges'g 0.29; adolescents, Hedges'g 0.30) and self-perceived stress (elite, Hedges'g 0.63; adolescents, Hedges'g 0.60). The linear mixed effect model revealed several significant (p < .05) predictors (sex, general well-being, competence-based self-esteem, sleep during weekdays, BMI, training volume) associated with self-perceived stress in adolescent elite athletes. In conclusion, differences in correlates of health with a moderate to strong effect sizes were found between the two groups, where elite athletes surprisingly reported less stress, competence-based self-esteem, a more varied diet and more time of sleep. Even if injury risk is high in adolescent elite athletes and pressure from multiple stakeholders is evident, it appears that the athletes still have better conditions for a good subjective health, based on self-reported measures, compared to adolescents not involved in elite sports.