scholarly journals Awareness and indicators of low energy availability in male and female dancers

2020 ◽  
Author(s):  
Nicola Keay ◽  
AusDancers Overseas ◽  
Gavin Francis
Keyword(s):  
At Risk ◽  
Relative Energy ◽  
Low Energy ◽  
List Type ◽  
Energy Availability ◽  
Full Time ◽  
Male And Female ◽  
Dance Training ◽  
And Performance ◽  
Low Energy Availability

AbstractObjectivesTo investigate awareness and indicators of low energy availability (LEA) in male and female dancersMethodsA dance-specific energy availability questionnaire (DEAQ) was developed and administered online internationally to dancers in full time training. The DEAQ drew on current validated, published questionnaires for LEA, linked to the clinical outcomes of relative energy deficiency in sport (RED-S). Questions addressed recognised physiological indicators and consequences of LEA in the context of dance, together with psychological drivers and aetiological factors specific to dance training. LEA was quantified using a scoring system to include these characteristics.Results247 responses to the DEAQ were analysed (225 female and 22 male), mean age 20.7 years (SD 7.9) with transition to full time training at 15.0 years (SD 7.9) and 85% practising ballet. Psychological, physiological and physical characteristics consistent with LEA were reported by 57% of the female dancers and 29% of male dancers, indicating a risk of RED-S. The unique nature of dance training, in terms of demands and environment, was found to be potentially influential in development of this situation. Less than a third (29%) of dancers were aware of RED-S.ConclusionThis study found dancers to be a specific group of high-level exercisers displaying indicators of LEA and consequently at risk of developing the adverse clinical health and performance consequences of RED-S. Awareness of RED-S was low. The DEAQ has the potential to raise awareness and be a practical, objective screening tool to identify dancers in LEA, at risk of developing RED-S.Summary boxesWhat are the new findings?Dancers reported many recognised indicators of low energy availability (LEA) and consequently are at risk of developing the adverse health and performance outcomes of relative energy deficiency in sport (RED-S).Few dancers in this study demonstrated an awareness of RED-S.The unique nature of dance training, in terms of demands and environment, was found to be influential in the development of LEA in dancersThe DEAQ is the first questionnaire specific to dancers. Applying a scoring system to the responses from the DEAQ can provide an objective assessment of LEAHow might this study impact on clinical practice in the future?As LEA and subsequent risk of RED-S is not matched by awareness, providing educational resources for dancers is important. A British Association of Sport and Exercise Medicine website has been developed by the research team for both athletes and dancers www.health4performance.co.ukThe DEAQ has the potential to be a practical, objective, screening tool to identify male and female dancers worldwide in LEA. By identifying these dancers, support could be targeted to modify dancer behaviours to reduce the risk of dancers developing the adverse health and performance sequelae of RED-SEarly identification of dancers at risk of developing RED-S is of particular importance when situations arise out of dancers’ control, such as lock down in pandemics COVID-19 or time off dancing due to illness/injury. Targeted support may be required as a dancer’s tendencies towards exercise dependence and disordered eating patterns may increase as a way to seek control and combat uncertainty.

scholarly journals Indicators and correlates of low energy availability in male and female dancers

2020 ◽  
Vol 6 (1) ◽  
pp. e000906
Author(s):  
Nicola Keay ◽  
AusDancers Overseas ◽  
Gavin Francis
Keyword(s):  
At Risk ◽  
Relative Energy ◽  
Low Energy ◽  
Energy Availability ◽  
Male And Female ◽  
Energy Deficiency ◽  
Physiological Indicators ◽  
Dance Training ◽  
High Level ◽  
Low Energy Availability

ObjectivesTo investigate indicators and correlates of low energy availability (LEA) in male and female dancers.MethodsA Dance-Specific Energy Availability Questionnaire (DEAQ) was developed and administered online internationally to dancers training at preprofessional, professional or advanced amateur level. The DEAQ drew on current validated, published questionnaires for LEA, linked to the clinical outcomes of relative energy deficiency in sport (RED-S). Questions addressed recognised physiological indicators and consequences of LEA in the context of dance, together with potential correlates. LEA was quantified using a scoring system to include these characteristics.Results247 responses to the DEAQ were analysed (225 female and 22 male), mean age 20.7 years (SD 7.9) with 85% practising ballet. Psychological, physiological and physical characteristics consistent with LEA were reported by 57% of the female dancers and 29% of male dancers, indicating a risk of RED-S. The unique nature of dance training, in terms of demands and environment, was found to be potentially influential in development of this situation. Less than one-third (29%) of dancers were aware of RED-S.ConclusionThis study found dancers to be a specific group of high-level artistic performers displaying indicators of LEA and consequently at risk of developing the adverse clinical health and performance consequences of RED-S. Awareness of RED-S was low. The DEAQ has the potential to raise awareness and be a practical, objective screening tool to identify dancers in LEA, at risk of developing RED-S.

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 Risk of Low Energy Availability in National and International Level Paralympic Athletes: An Exploratory Investigation

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 979
Author(s):  
Kelly Pritchett ◽  
Alicia DiFolco ◽  
Savannah Glasgow ◽  
Robert Pritchett ◽  
Katy Williams ◽  
...  
Keyword(s):  
At Risk ◽  
National Level ◽  
Relative Energy ◽  
Low Energy ◽  
Assessment Tools ◽  
Energy Availability ◽  
Mineral Density ◽  
Menstrual Dysfunction ◽  
Energy Deficiency ◽  
Low Energy Availability

(1) Background: The purpose of this study was to examine the symptoms of low energy availability (LEA) and risk of relative energy deficiency in sport (RED-S) symptoms in para-athletes using a multi-parameter approach. (2) Methods: National level para-athletes (n = 9 males, n = 9 females) completed 7-day food and activity logs to quantify energy availability (EA), the LEA in Females Questionnaire (LEAF-Q), dual energy X-ray absorptiometry (DXA) scans to assess bone mineral density (BMD), and hormonal blood spot testing. (3) Results: Based on EA calculations, no athlete was at risk for LEA (females < 30 kcal·kg−1 FFM·day−1; and males < 25 kcal·kg−1 FFM·day−1; thresholds for able-bodied (AB) subjects). Overall, 78% of females were “at risk” for LEA using the LEAF-Q, and 67% reported birth control use, with three of these participants reporting menstrual dysfunction. BMD was clinically low in the hip (<−2 z-score) for 56% of female and 25% of male athletes (4) Conclusions: Based on calculated EA, the risk for RED-S appears to be low, but hormonal outcomes suggest that RED-S risk is high in this para-athlete population. This considerable discrepancy in various EA and RED-S assessment tools suggests the need for further investigation to determine the true prevalence of RED-S in para-athlete populations.

scholarly journals Low Energy Availability and Relative Energy Deficiency in Sport: What Coaches Should Know

2022 ◽  
pp. 174795412110544
Author(s):  
Braeden T. Charlton ◽  
Sara Forsyth ◽  
David C. Clarke
Keyword(s):  
Energy Expenditure ◽  
Female Athlete ◽  
Relative Energy ◽  
Low Energy ◽  
Energy Availability ◽  
Female Athlete Triad ◽  
Energy Deficiency ◽  
Research Findings ◽  
And Performance ◽  
Low Energy Availability

The Female Athlete Triad (Triad) and the more encompassing Relative Energy Deficiency in Sport (RED-S) are disorders caused by low energy availability (LEA). LEA is a state of insufficient energy intake by an athlete relative to their energy expenditure. Persistent LEA results in the deleterious consequences to health and performance that comprise RED-S. With respect to both the Triad and RED-S, researchers have called for more education of those involved with sport, particularly coaches, to help reduce the incidence of these disorders. Recent studies have shown that as few as 15% of coaches are aware of the Triad, with up to 89% unable to identify even one of its symptoms. RED-S is a more recently established concept such that coach knowledge regarding it has only begun to be assessed, but the results of these initial studies indicate similar trends as for the Triad. In this review, we synthesize research findings from 1986 to 2021 that pertains to LEA and RED-S, which coaches should know so they can better guide their athletes.

scholarly journals Low Energy Availability in Athletes 2020: An Updated Narrative Review of Prevalence, Risk, Within-Day Energy Balance, Knowledge, and Impact on Sports Performance

Nutrients ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 835 ◽  
Author(s):  
Danielle M. Logue ◽  
Sharon M. Madigan ◽  
Anna Melin ◽  
Eamonn Delahunt ◽  
Mirjam Heinen ◽  
...  
Keyword(s):  
At Risk ◽  
Relative Energy ◽  
Narrative Review ◽  
Low Energy ◽  
Screening Tools ◽  
Energy Availability ◽  
Energy Deficiency ◽  
Exercise Energy Expenditure ◽  
And Gender ◽  
Low Energy Availability

Low energy availability (EA) underpins the female and male athlete triad and relative energy deficiency in sport (RED-S). The condition arises when insufficient calories are consumed to support exercise energy expenditure, resulting in compromised physiological processes, such as menstrual irregularities in active females. The health concerns associated with longstanding low EA include menstrual/libido, gastrointestinal and cardiovascular dysfunction and compromised bone health, all of which can contribute to impaired sporting performance. This narrative review provides an update of our previous review on the prevalence and risk of low EA, within-day energy deficiency, and the potential impact of low EA on performance. The methods to assess EA remain a challenge and contribute to the methodological difficulties in identifying “true” low EA. Screening female athletic groups using a validated screening tool such as the Low Energy Availability in Females Questionnaire (LEAF-Q) has shown promise in identifying endurance athletes at risk of low EA. Knowledge of RED-S and its potential implications for performance is low among coaches and athletes alike. Development of sport and gender-specific screening tools to identify adolescent and senior athletes in different sports at risk of RED-S is warranted. Education initiatives are required to raise awareness among coaches and athletes of the importance of appropriate dietary strategies to ensure that sufficient calories are consumed to support training.

scholarly journals A Review of Prevention, Diagnosis, and Treatment of Relative Energy Deficiency in Sport in Artistic (Synchronized) Swimming

2018 ◽  
Vol 28 (4) ◽  
pp. 375-384 ◽  
Author(s):  
Sherry Robertson ◽  
Margo Mountjoy
Keyword(s):  
Dietary Habits ◽  
Female Athletes ◽  
Assessment Tool ◽  
Relative Energy ◽  
Low Energy ◽  
Energy Availability ◽  
Energy Deficiency ◽  
Synchronized Swimming ◽  
And Performance ◽  
Low Energy Availability

The syndrome of relative energy deficiency in sport (RED-S) is a clinical entity characterized by low energy availability, which can negatively affect the health and performance of both male and female athletes. The underlying mechanism of RED-S is an inadequacy of dietary energy to support optimal health and performance. This syndrome refers to impaired physiological function, including metabolic rate, menstrual function, bone health, immunity, protein synthesis, and cardiovascular health, with psychological consequences that can either precede (through restrictive dietary habits) or result from RED-S. The term RED-S extends beyond the condition termed the “Female Athlete Triad.” Formerly known as synchronized swimming, artistic swimming is an Olympic sport requiring a high level of fitness as well as technical skill and artistry. The risk of RED-S is high in artistic swimming as it is an aesthetic, judged sport with an emphasis on a lean physique. RED-S is of significant concern in the sport of artistic swimming because of the potential negative effects on physical and mental health as well as consequences on athletic performance. This paper reviews health and performance consequences associated with low energy availability resulting in RED-S in artistic swimming. Medical and nutritional considerations specific to artistic swimming are reviewed, and methods to help detect and manage RED-S are discussed. Prevention and management of RED-S in this athlete population should be a priority for coaches, and the sport medicine professionals working with artistic swimming athletes should utilize the RED-S CAT, a Clinical Assessment Tool for screening and managing RED-S.

scholarly journals A Proposal for a Standardized Approach to Inducing Low Energy Availability in Athletes

2021 ◽  
Vol 11 (15) ◽  
pp. 6679
Author(s):  
Iva Jurov ◽  
Nicola Keay ◽  
Vedran Hadžić ◽  
Samo Rauter
Keyword(s):  
Well Being ◽  
Low Energy ◽  
Critical Duration ◽  
Future Research ◽  
Research Approach ◽  
Energy Availability ◽  
Negative Effects ◽  
Future Research Directions ◽  
And Performance ◽  
Low Energy Availability

Low energy availability in athletes is an insufficiently researched phenomenon due to lack of a universal methodology. Current objective and subjective methods for assessing low energy availability lack in accuracy, are not used with a standardized approach and fail to provide comparable, consistent results. Research in male athletes is even more challenging than in females. It is still not known what the threshold for low energy availability is when negative effects on health and performance occur. This is why in this paper a two-way standardized, systematic and controlled protocol for inducing low energy availability in free-living athletes is proposed. Ways of inducing low energy availability in athletes are described with a systematic approach to ensure accurate results. We suggest this is how new tools for assessing low energy availability can be developed with less burden on the athlete and the scientist. Analysis of each proposed protocol provides a rationale for their use. Future research directions are suggested for determining the threshold for low energy availability and determining the critical duration for its negative effects. Finally, we suggest a practical outcome of using the proposed research approach for health practitioners and coaches in order to protect athlete’s well-being.

scholarly journals Risk of Low Energy Availability among Female and Male Elite Runners Competing at the 26th European Cross-Country Championships

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 873
Author(s):  
Filipe Jesus ◽  
Inês Castela ◽  
Analiza M Silva ◽  
Pedro A. Branco ◽  
Mónica Sousa
Keyword(s):  
At Risk ◽  
Female Athletes ◽  
Low Energy ◽  
Multidisciplinary Teams ◽  
Energy Availability ◽  
High Prevalence ◽  
Bowel Movements ◽  
Cross Country ◽  
Low Energy Availability ◽  
Normal Menstruation

Low energy availability (LEA) causes impaired physiological functioning. Cross-country running is a weight-sensitive sport, making athletes more prone to LEA. We aimed to estimate the prevalence of elite European cross-country athletes at risk of LEA using the LEA in Females Questionnaire (LEAF-Q) and to analyze demographic and physical characteristics that are associated with LEA. Athletes ≥ 18 years competing at the 26th European Cross-Country Championships (n = 602) were invited to complete a questionnaire (sociodemographic, training, anthropometric characteristics, and LEAF-Q). A total of 207 valid surveys were collected (83 females, 22.1 (4.0) years, and 124 males, 22.3 (4.1) years), and 16 surveys were excluded. A high prevalence of athletes at risk of LEA (64.3%) was observed, being higher in females than in males (79.5 and 54.0% respectively, p < 0.001). More than half of athletes (54.1%, n = 112) reported bowel movements once a week or more rarely, while 33 female athletes (41.3%) did not report normal menstruation. Overall, cross-country athletes are at high risk of LEA. Moreover, a high prevalence of gastrointestinal and menstrual impairments was reported. Hence, athletes should be followed by multidisciplinary teams to inform, prevent, and treat LEA and its effects.

Low RMRratio as a Surrogate Marker for Energy Deficiency, the Choice of Predictive Equation Vital for Correctly Identifying Male and Female Ballet Dancers at Risk

2018 ◽  
Vol 28 (4) ◽  
pp. 412-418 ◽  
Author(s):  
Sarah Staal ◽  
Anders Sjödin ◽  
Ida Fahrenholtz ◽  
Karen Bonnesen ◽  
Anna Katarina Melin
Keyword(s):  
Bone Mineral Density ◽  
At Risk ◽  
Disordered Eating ◽  
Surrogate Marker ◽  
Low Energy ◽  
Energy Availability ◽  
Mineral Density ◽  
Energy Deficiency ◽  
Ballet Dancers ◽  
Low Energy Availability

Ballet dancers are reported to have an increased risk for energy deficiency with or without disordered eating behavior. A low ratio between measured (m) and predicted (p) resting metabolic rate (RMRratio < 0.90) is a recognized surrogate marker for energy deficiency. We aimed to evaluate the prevalence of suppressed RMR using different methods to calculate pRMR and to explore associations with additional markers of energy deficiency. Female (n = 20) and male (n = 20) professional ballet dancers, 19–35 years of age, were enrolled. mRMR was assessed by respiratory calorimetry (ventilated open hood). pRMR was determined using the Cunningham and Harris–Benedict equations, and different tissue compartments derived from whole-body dual-energy X-ray absorptiometry assessment. The protocol further included assessment of body composition and bone mineral density, blood pressure, disordered eating (Eating Disorder Inventory-3), and for females, the Low Energy Availability in Females Questionnaire. The prevalence of suppressed RMR was generally high but also clearly dependent on the method used to calculate pRMR, ranging from 25% to 80% in males and 35% to 100% in females. Five percent had low bone mineral density, whereas 10% had disordered eating and 25% had hypotension. Forty percent of females had elevated Low Energy Availability in Females Questionnaire score and 50% were underweight. Suppressed RMR was associated with elevated Low Energy Availability in Females Questionnaire score in females and with higher training volume in males. In conclusion, professional ballet dancers are at risk for energy deficiency. The number of identified dancers at risk varies greatly depending on the method used to predict RMR when using RMRratio as a marker for energy deficiency.

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