scholarly journals Reasons for and Consequences of Low Energy Availability in Female and Male Athletes: Social Environment, Adaptations, and Prevention

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Paulina Wasserfurth ◽  
Jana Palmowski ◽  
Andreas Hahn ◽  
Karsten Krüger
Keyword(s):  
At Risk ◽  
Social Media ◽  
Social Environment ◽  
High Energy ◽  
The Body ◽  
Low Energy ◽  
Energy Availability ◽  
Male Athletes ◽  
Social Media Platforms ◽  
Low Energy Availability

Abstract Low energy availability (LEA) represents a state in which the body does not have enough energy left to support all physiological functions needed to maintain optimal health. When compared to the normal population, athletes are particularly at risk to experience LEA and the reasons for this are manifold. LEA may result from altered dietary behaviours that are caused by body dissatisfaction, the belief that a lower body weight will result in greater performance, or social pressure to look a certain way. Pressure can also be experienced from the coach, teammates, and in this day and age through social media platforms. While LEA has been extensively described in females and female athletes have started fighting against the pressure to be thin using their social media platforms, evidence shows that male athletes are at risk as well. Besides those obvious reasons for LEA, athletes engaging in sports with high energy expenditure (e.g. rowing or cycling) can unintentionally experience LEA; particularly, when the athletes’ caloric intake is not matched with exercise intensity. Whether unintentional or not, LEA may have detrimental consequences on health and performance, because both short-term and long-term LEA induces a variety of maladaptations such as endocrine alterations, suppression of the reproductive axis, mental disorders, thyroid suppression, and altered metabolic responses. Therefore, the aim of this review is to increase the understanding of LEA, including the role of an athlete’s social environment and the performance effects related to LEA.

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 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 Association of Low Energy Availability and Suppressed Metabolic Status in Korean Male Collegiate Soccer Players: A Pilot Study

2020 ◽  
Vol 14 (6) ◽  
pp. 155798832098218
Author(s):  
Sihyung Lee ◽  
Moto Kuniko ◽  
Seungah Han ◽  
Taewoong Oh ◽  
Motoko Taguchi
Keyword(s):  
Bone Metabolism ◽  
Low Energy ◽  
Metabolic Status ◽  
Soccer Players ◽  
Eating Attitude ◽  
Group Differences ◽  
Energy Availability ◽  
Mineral Density ◽  
Male Athletes ◽  
Low Energy Availability

Low energy availability (EA) can impair physiological function in athletes. The purpose of this study was to investigate EA status, metabolic status, and bone metabolism with biochemical analysis in Korean male soccer players. Twelve male athletes (18–20 years) completed the study. Body composition and bone mineral density were measured using dual energy X-ray absorptiometry (DXA), while VO2 max was determined by an incremental exercise test. Blood samples were taken for bone marker and hormone analyses. Resting energy expenditure (REE) was measured using the Douglas bag method and predicted using the DXA method. Food diaries and heart rates (HR) during training were recorded, and the Profile of Mood States 2 and Eating Attitude Test 26 were completed. Group differences between low EA (LEA <30 kcal/kg FFM/d, n = 5) and high EA (HEA ≥30 kcal/kg FFM/d, n = 7) were evaluated. The mean EA of the all participants was 31.9 ± 9.8 kcal/kg FFM/d with only two participants having an EA above 45 kcal/kg FFM/d. LEA showed suppressed REE (LEA: 26.0 ± 1.7 kcal/kg/d, HEA: 28.8 ± 1.4 kcal/kg/d, p = .011) with a lower REEratio (LEA: 0.91 ± 0.06, HEA: 1.01 ± 0.05, p = .008) as well as a lower insulin-like growth factor 1 (IGF-1) level (LEA: 248.6 ± 51.2 ng/mL, HEA: 318.9 ± 43.4 ng/mL, p = .028) compared to HEA. There were no group differences in bone markers or other hormone levels. Korean male athletes exhibited low EA status with suppressed metabolism, but there was limited evidence on the effect of EA on bone metabolism, endocrine system, and psychological parameters.

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.

scholarly journals Low Energy Availability May Cause REE Suppression and Bone Loss In Japanese Male Athletes

2019 ◽  
Vol 51 (Supplement) ◽  
pp. 284
Author(s):  
Motoko Taguchi ◽  
Kuniko Moto ◽  
Sihyung Lee ◽  
Suguru Torii ◽  
Nobuko Hongu
Keyword(s):  
Bone Loss ◽  
Low Energy ◽  
Energy Availability ◽  
Male Athletes ◽  
Japanese Male ◽  
Low Energy Availability

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 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.

scholarly journals Nutritional Intake, Sports Nutrition Knowledge and Energy Availability in Female Australian Rules Football Players

Nutrients ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 971 ◽  
Author(s):  
Dominique Condo ◽  
Rachel Lohman ◽  
Monica Kelly ◽  
Amelia Carr
Keyword(s):  
At Risk ◽  
Assessment Tool ◽  
Nutrition Knowledge ◽  
Sports Nutrition ◽  
Low Energy ◽  
Nutritional Intake ◽  
Football Players ◽  
Energy Availability ◽  
Australian Rules Football ◽  
Low Energy Availability

This study aimed to assess nutritional intake, sports nutrition knowledge and risk of Low Energy Availability (LEA) in female Australian rules football players. Victorian Football League Women’s competition (VFLW) players (n = 30) aged 18–35 (weight: 64.5 kg ± 8.0; height: 168.2 cm ± 7.6) were recruited from Victoria, Australia. Nutritional intake was quantified on training days using the Automated 24 h Dietary Assessment Tool (ASA24-Australia), and sports nutrition knowledge was measured by the 88-item Sports Nutrition Knowledge Questionnaire (SNKQ). The risk of LEA was assessed using the Low Energy Availability in Females Questionnaire (LEAF-Q). Daily mean carbohydrate intake in the current investigation was 3 g⋅kg−1⋅d−1, therefore, below the minimum carbohydrate recommendation for moderate exercise of approximately one hour per day (5–7 g⋅kg−1⋅d−1) and for moderate to intense exercise for 1–3 h per day (6–10 g⋅kg−1⋅d−1) for 96.3% and 100% of players, respectively. Daily mean protein intake was 1.5 g⋅kg−1⋅d−1, therefore, consistent with recommendations (1.2–2.0 g⋅kg−1⋅d−1) for 77.8% of players. Daily mean calcium intake was 924.8 mg⋅d−1, therefore, below recommendations (1000 mg⋅d−1) for 65.5% of players, while mean iron intake was 12.2 mg⋅d−1, also below recommendations (18 mg⋅d−1) for 100% of players. Players answered 54.5% of SNKQ questions correctly, with the lowest scores observed in the section on supplements. Risk of LEA was evident in 30% of players, with no differences in carbohydrate (p = 0.238), protein (p = 0.296), fat (p = 0.490) or energy (p = 0.971) intakes between players at risk of LEA and those not at risk. The results suggest that female Australian rules football players have an inadequate intake of carbohydrate and calcium and low sports nutrition knowledge. Further investigation to assess the risk of LEA using direct measures is required.

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