Effects of Low Energy Availability on Bone Health in Exercising Premenopausal Women

2018 ◽  
pp. 109-125
Author(s):  
Nancy I. Williams ◽  
Mary Jane De Souza
Keyword(s):  
Bone Health ◽  
Premenopausal Women ◽  
Low Energy ◽  
Energy Availability ◽  
Low Energy Availability

Low energy availability, menstrual dysfunction, and impaired bone health: A survey of elite para athletes

2019 ◽  
Vol 29 (5) ◽  
pp. 678-685 ◽  
Author(s):  
Emily M. Brook ◽  
Adam S. Tenforde ◽  
Elizabeth M. Broad ◽  
Elizabeth G. Matzkin ◽  
Heidi Y. Yang ◽  
...  
Keyword(s):  
Bone Health ◽  
Low Energy ◽  
Energy Availability ◽  
Menstrual Dysfunction ◽  
Low Energy Availability

scholarly journals Effects of Low Energy Availability on Bone Health in Endurance Athletes and High-Impact Exercise as A Potential Countermeasure: A Narrative Review

2020 ◽  
Author(s):  
Mark J. Hutson ◽  
Emma O’Donnell ◽  
Katherine Brooke-Wavell ◽  
Craig Sale ◽  
Richard C. Blagrove
Keyword(s):  
Bone Health ◽  
Bone Structure ◽  
High Impact ◽  
Low Energy ◽  
Endurance Athletes ◽  
Energy Availability ◽  
Stress Injury ◽  
Bone Stress ◽  
Impact Exercise ◽  
Low Energy Availability

AbstractEndurance athletes expend large amounts of energy in prolonged high-intensity exercise and, due to the weight-sensitive nature of most endurance sports, often practice periods of dietary restriction. The Female Athlete Triad and Relative Energy Deficiency in Sport models consider endurance athletes at high-risk for suffering from low energy availability and associated health complications, including an increased chance of bone stress injury. Several studies have examined the effects of low energy availability on various parameters of bone structure and markers of bone (re)modelling; however, there are differences in findings and research methods and critical summaries are lacking. It is difficult for athletes to reduce energy expenditure or increase energy intake (to restore energy availability) in an environment where performance is a priority. Development of an alternative tool to help protect bone health would be beneficial. High-impact exercise can be highly osteogenic and energy efficient; however, at present, it is rarely utilized to promote bone health in endurance athletes. Therefore, with a view to reducing the prevalence of bone stress injury, the objectives of this review are to evaluate the effects of low energy availability on bone health in endurance athletes and explore whether a high-impact exercise intervention may help to prevent those effects from occurring.

scholarly journals Male Flat Jockeys Do Not Display Deteriorations in Bone Density or Resting Metabolic Rate in Accordance With Race Riding Experience: Implications for RED-S

2018 ◽  
Vol 28 (4) ◽  
pp. 434-439 ◽  
Author(s):  
George Wilson ◽  
Dan Martin ◽  
James P. Morton ◽  
Graeme L. Close
Keyword(s):  
Lumbar Spine ◽  
Metabolic Rate ◽  
Bone Health ◽  
Resting Metabolic Rate ◽  
Low Energy ◽  
Fat Free Mass ◽  
Published Data ◽  
Energy Availability ◽  
Mineral Density ◽  
Low Energy Availability

Despite consistent reports of poor bone health in male jockeys, it is not yet known if this is a consequence of low energy availability or lack of an osteogenic stimulus. Given the rationale that low energy availability is a contributing factor in low bone health, we tested the hypothesis that both hip and lumbar bone mineral density (BMD) should progressively worsen in accordance with the years of riding. In a cross-sectional design, male apprentice (n = 17) and senior (n = 14) jockeys (matched for body mass and fat-free mass) were assessed for hip and lumbar spine BMD, as well as both measured and predicted resting metabolic rate (RMR). Despite differences (p < .05) in years of race riding (3.4 ± 2 vs. 16.3 ± 6.8), no differences were apparent (p > .05) in hip (−0.9 ± 1.1 vs. −0.8 ± 0.7) and lumbar Z-scores (−1.3 ± 1.4 vs. −1.5 ± 1) or measured RMR (1,459 ± 160 vs. 1,500 ± 165 kcal/day) between apprentices and senior jockeys, respectively. Additionally, years of race riding did not demonstrate any significant correlations (p > .05) with either hip or lumbar spine BMD. Measured RMR was also not different (p > .05) from predicted RMR in either apprentice (1,520 ± 44 kcal/day) or senior jockeys (1,505 ± 70 kcal/day). When considered with previously published data examining underreporting of energy intake and direct assessments of energy expenditure, we suggest that low BMD in jockeys is not due to low energy availability per se but rather the lack of an osteogenic stimulus associated with riding.

scholarly journals The Role of Energy Availability in Reproductive Function in the Female Athlete Triad and Extension of its Effects to Men: An Initial Working Model of a Similar Syndrome in Male Athletes

2019 ◽  
Vol 49 (S2) ◽  
pp. 125-137 ◽  
Author(s):  
Mary Jane De Souza ◽  
Kristen J. Koltun ◽  
Nancy I. Williams
Keyword(s):  
Bone Health ◽  
Female Athlete ◽  
Reproductive Function ◽  
Low Energy ◽  
Energy Availability ◽  
Female Athlete Triad ◽  
Male Athlete ◽  
Menstrual Dysfunction ◽  
Working Model ◽  
Low Energy Availability

Abstract The Female Athlete Triad represents three interrelated conditions of (i) low energy availability (energy deficiency), presenting with or without disordered eating, (ii) menstrual dysfunction, and (iii) poor bone health, each of which can exist along a continuum of severity ranging from mild and moderate subclinical health concerns to severe clinical outcomes, including eating disorders, amenorrhea, and osteoporosis. This review provides a brief overview of the Female Athlete Triad, including updating the current thinking regarding energy availability and how it relates to reproductive function, and sets the stage for an initial working model of a similar syndrome in males that will be based on currently available evidence and will later be defined and referred to as a Male Athlete Triad by the newly re-named Female and Male Athlete Triad Coalition. A primary focus of this paper will be on the physiology of each Triad model with an emphasis on low energy availability and its role in reproductive function, with a brief introduction on its effects on bone health in men. From the data reviewed, (i) a specific threshold of energy availability below which menstrual disturbances are induced is not supported; (ii) it appears that the energetic, reproductive, and bone systems in men are more resilient to the effects of low energy availability compared to those of women, requiring more severe energetic perturbations before alterations are observed; and (iii) it appears that recovery of the hypothalamic pituitary gonadal axis can be observed more quickly in men than in women.

scholarly journals Body Composition, Dietary Intake and the Risk of Low Energy Availability in Elite-Level Competitive Rhythmic Gymnasts

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 2083
Author(s):  
María Villa ◽  
José G. Villa-Vicente ◽  
Jesus Seco-Calvo ◽  
Juan Mielgo-Ayuso ◽  
Pilar S. Collado
Keyword(s):  
Body Composition ◽  
Dietary Intake ◽  
Body Fat ◽  
Low Energy ◽  
Energy Availability ◽  
Future Health ◽  
Elite Level ◽  
Low Energy Availability ◽  
Rhythmic Gymnasts ◽  
Recommended Level

The aim of this study was to analyze dietary intake and body composition in a group of elite-level competitive rhythmic gymnasts from Spain. We undertook body composition and nutritional analysis of 30 elite gymnasts, divided into two groups by age: pre-teen (9–12 years) (n = 17) and teen (13–18 years) (n = 13). Measures of height, weight, and bioimpedance were used to calculate body mass index and percent body fat. Energy and nutrient intakes were assessed based on 7-day food records. The two groups had similar percentages of total body fat (pre-teen: 13.99 ± 3.83% vs. teen: 14.33 ± 5.57%; p > 0.05). The energy availability values for pre-teens were above the recommended values (>40 kcal/FFM/day) 69.38 ± 14.47 kcal/FFM/day, while those for the teens were much lower (34.7 ± 7.5 kcal/FFM/day). The distribution of the daily energy intake across the macronutrients indicates that both groups ingested less than the recommended level of carbohydrates and more than the recommended level of fat. Very low intakes of calcium and vitamin D among other micronutrients were also noted. The main finding is that teenage gymnasts do not consume as much energy as they need each day, which explains their weight and development. Moreover, they are at a high risk of developing low energy availability that could negatively impact their performance and future health.

Low energy availability surrogates correlate with health and performance consequences of Relative Energy Deficiency in Sport

2018 ◽  
Vol 53 (10) ◽  
pp. 628-633 ◽  
Author(s):  
Kathryn E Ackerman ◽  
Bryan Holtzman ◽  
Katherine M Cooper ◽  
Erin F Flynn ◽  
Georgie Bruinvels ◽  
...  
Keyword(s):  
Female Athletes ◽  
Relative Energy ◽  
Low Energy ◽  
Clinical Population ◽  
Energy Availability ◽  
Energy Deficiency ◽  
Increased Risk ◽  
Performance Consequences ◽  
And Performance ◽  
Low Energy Availability

Low energy availability (EA) is suspected to be the underlying cause of both the Female Athlete Triad and the more recently defined syndrome, Relative Energy Deficiency in Sport (RED-S). The International Olympic Committee (IOC) defined RED-S as a syndrome of health and performance impairments resulting from an energy deficit. While the importance of adequate EA is generally accepted, few studies have attempted to understand whether low EA is associated with the health and performance consequences posited by the IOC.ObjectiveThe purpose of this cross-sectional study was to examine the association of low EA with RED-S health and performance consequences in a large clinical population of female athletes.MethodsOne thousand female athletes (15–30 years) completed an online questionnaire and were classified as having low or adequate EA. The associations between low EA and the health and performance factors listed in the RED-S models were evaluated using chi-squared test and the odds ratios were evaluated using binomial logistic regression (p<0.05).ResultsAthletes with low EA were more likely to be classified as having increased risk of menstrual dysfunction, poor bone health, metabolic issues, haematological detriments, psychological disorders, cardiovascular impairment and gastrointestinal dysfunction than those with adequate EA. Performance variables associated with low EA included decreased training response, impaired judgement, decreased coordination, decreased concentration, irritability, depression and decreased endurance performance.ConclusionThese findings demonstrate that low EA measured using self-report questionnaires is strongly associated with many health and performance consequences proposed by the RED-S models.

scholarly journals Do paralympic track and field athletes have low energy availability?

2018 ◽  
Vol 20 (1) ◽  
pp. 71-81 ◽  
Author(s):  
Daniel Paduan Joaquim ◽  
Claudia Ridel Juzwiak ◽  
Ciro Winckler
Keyword(s):  
Body Composition ◽  
Low Energy ◽  
Track And Field ◽  
Fat Free Mass ◽  
Motion Sensor ◽  
Energy Availability ◽  
Energy Demands ◽  
Physiological Processes ◽  
Limb Deficiency ◽  
Low Energy Availability

One of the greatest challenges when working with athletes is to achieve the energy demands for physiological processes and exercise expenditure. The aim of this study was to assess the energy availability (EA) of Paralympic track and field athletes (sprinters). Seventeen athletes (9 male and 8 female) with visual impairment (VI, n=10), cerebral palsy (CP, n=4) and limb deficiency (LD, n=3) were assessed for energy intake (EI) (4-day food photographic record), energy expenditure with exercise (EEex) (motion sensor), and body composition (skinfolds method). Energy availability was estimated using the equation: EA = (EIkcal - EEexkcal) / fat-free mass (FFM) / day, and values ≤ 30kcal/kgFFM/day were considered as low energy availability (LEA). EEex varied from 130 to 477kcal/h and athletes trained in average for 3.2 hours per day. Mean EA for VI, LD and CP were 36 (2.19), 37 (1.90) and 38 (3.38) kcal/kgFFM/day, respectively. Most (82.3%) participants presented EA below ≥ 45kcal/kgFFM/day, throughout the days, which are the recommended values for athletes without disability. Athletes should be encouraged to consume adequate EA to avoid consequences related to low energy availability. There is need of further research to identify cut-off values adequate for this population.

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