Table 2.

Independent triggers of OTS

Scenario	Independent variables included	Results (* = positive for independent risk factors and triggers)	Interpretation
Scenario 1 – All modifiable variables	CHO, PROT, CAL, WORK, SLEEP	PERFECT SEPARATION	Together, modifiable patterns were able to explain all cases of OTS in the athletes studied.
Scenario 2 – All modifiable variables, except WORK	CHO, PROT, CAL, SLEEP	PERFECT SEPARATION	Dietary patterns together with sleep quality were also able to fully explain all cases of OTS in the studied population of athletes.
Scenario 3 – All modifiable variables, except CAL	CHO, PROT, WORK, SLEEP	CHO: p = 0.036 OR/CL = 1.61 (1.03–2.50) PROT: p = 0.029 OR/CL = 16.7 (1.34–208.1) WORK: p = n/s SLEEP: p = 0.069 OR/CL = 2.19 (0.94–5.09)	When daily caloric intake is not accounted, not all cases of OTS may be justified. However, in this scenario both CHO and PROT were shown to be independent triggers of OTS.
Scenario 4 – Without specification of each macronutrient	CAL, WORK, SLEEP	CAL: p = 0.004 OR/CL = 1.13 (1.04–1.23) WORK: p = n/s SLEEP: p = n/s	When each macronutrient intake is not specified, not all cases of OTS may be justified. However, in this scenario CAL was enough to independent etiology of OTS.
Scenario 5 – Only dietary patterns	CHO, PROT, CAL	CHO: p = n/s PROT: p = 0.066 OR/CL = 25.85 (0.81–825.3) CAL: p = 0.045 OR/CL = 1.27 (1.01–1.61)	When only dietary patterns are evaluated, we cannot explain all cases of OTS in the studied population. However, in this scenario, overall caloric intake, but not each macronutrient, was able to

CHO Daily carbohydrate intake (g/kg/day), PROT Daily protein intake (g/kg/day), CAL Mean daily caloric intake (kcal/kg/day), WORK Average number of working or studying hours a day, besides training sessions (h/day), SLEEP Self-reported sleep quality (0–10), OTS Overtraining syndrome, OR Odds ratio, CL 95% Confidence Limits, p Level of significance, n/s non-significant (p > 0.1)