Body Composition and Mediterranean Diet Quality in Athletes With Organ Transplants, Hemophilia, and Hemodialysis: A Comparative Cross-Sectional Study Publisher



Nezhad S R ; Mohammadi Sartang M ; Nasiri M ; Mortezapour E ; Djafarian K
Source: Sport Sciences for Health Published:2026

Abstract

Background: Athletes with chronic medical conditions such as organ transplantation, hemodialysis, or hemophilia face unique physiological and nutritional challenges. Organ transplant recipients, in particular, experience the adverse effects of immunosuppressive therapy, including muscle atrophy and metabolic disturbances, which can negatively affect body composition and physical performance. The Mediterranean diet is known for its anti-inflammatory and cardioprotective effects and may play an important role in improving health outcomes in this population. This study aimed to compare body composition and Mediterranean Diet Quality Index (Med-DQI) among Iranian athletes with and without solid organ transplants. Methods: This comparative cross-sectional study was conducted on 136 Iranian athletes, including those with kidney or liver transplantation, hemodialysis, and hemophilia. Anthropometric indices were measured using both bioelectrical impedance analysis (BIA) and 7-site skinfold methods. Dietary intake was assessed using a validated food frequency questionnaire (FFQ), and the Med-DQI score was calculated according to Gerber’s method. Statistical analyses were performed using SPSS version 28, applying ANOVA, ANCOVA, and nonparametric tests, with p < 0.05 considered significant. Results: The mean age of participants was 36 years. The mean body mass index (BMI) was 24.14, and the mean total calorie intake was 3121 kcal/day. Fat mass percentage measured by BIA (21.65%) was significantly higher than by skinfold method (18.25%) (p < 0.001). No significant difference in BMI or waist-to-hip ratio was found among groups. However, fat mass (BIA and skinfold) and fat-free mass differed significantly between hemodialysis and transplant athletes (p = 0.002, p = 0.001). After adjusting for confounders, Med-DQI scores were significantly different between these two groups (p = 0.02). Conclusion: Organ transplant athletes showed higher body fat, lower fat-free mass percent (FFM%), and poorer adherence to the Mediterranean diet compared to hemodialysis and hemophilic athletes. These findings emphasize the need for tailored nutritional strategies focusing on Mediterranean diet principles and optimal protein intake to improve the health and performance of athletes with transplants. © The Author(s), under exclusive licence to Springer-Verlag Italia S.r.l., part of Springer Nature 2026.