low energy availability
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Author(s):  
Braeden T. Charlton ◽  
Sara Forsyth ◽  
David C. Clarke

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.


2022 ◽  
Vol 8 (1) ◽  
pp. e001219
Author(s):  
Jan H Rosenvinge ◽  
Marcus Smavik Dasa ◽  
Morten Kristoffersen ◽  
Gunn Pettersen ◽  
Jorunn Sundgot-Borgen ◽  
...  

Enduring low energy availability (LEA) is associated with several potentially serious physiological and mental conditions. LEA has been found highly prevalent among female elite athletes within endurance sports, thus hampering athletes’ health and performance. The prevalence and the underpinning risk factors of LEA among female elite football players are less studied. One reason is that the existing self-report measures and technological devices to monitor energy intake and expenditure are inadequately adapted to capture the nature of the physical activity and energy expenditure among football players and are thus inaccurate.The present paper outlines a study protocol addressing the prevalence of LEA, the measurement of LEA and the correlations of LEA in terms of health and performance in female football players. Four studies will be conducted with the following aims (1) to evaluate the accuracy of global positioning systems (GPS)-based devices to monitor energy expenditure with indirect calorimetry as the gold standard, (2) to assess energy intake, quantify energy expenditure and investigate energy availability through self-report instruments, double labelled water (DLW) and GPS monitoring devices, (3) to determine the point prevalence of LEA using self-report instruments, DLW, dual-X-ray-absorptiometry (DXA) to quantify muscle and bone mass distribution and density, and a battery of hormonal analyses, and (4) to explore whether the prevalence of LEA varies across a full football season. Measures covering mental symptoms and psychological resources will be included, and a selection of biological measures derived from study 3.Measurements of DXA and DLW are resource-demanding and will be collected from one professional club (N~20 women). In contrast, the remaining data will be collected from four professional clubs (N~60 women) located in Bergen, the largest city within the Western region of Norway. Overall procedures and biobank storage procedures have been approved for data collection that will end in December 2024.


Author(s):  
Iva Jurov ◽  
Nicola Keay ◽  
Darjan Spudić ◽  
Samo Rauter

Abstract Purpose Low energy availability in males needs more original research to understand its health and performance consequences. The aim of the study was to induce low energy availability in previously healthy male endurance athletes by reducing energy availability by 25% for 14 consecutive days and measure any potential changes in performance, health, mental state or energy markers. Methods Energy availability was reduced in 12 trained, well-trained and elite endurance athletes by increasing energy expenditure and controlling energy intake. After intervention, health was assessed by blood draw, body composition was measured, energy markers by measuring resting energy expenditure, performance with three specific tests (measuring endurance, agility and explosive power) and two questionnaires were used for psychological assessment (the Three Factor Eating Questionnaire and Well-being questionnaire). Results Reduced energy availability (22.4 ± 6.3 kcal/kg FFM/day) caused significantly lower haemoglobin values (t(12) = 2.652, p = 0.022), there was a tendency for lower iron and IGF-1 (p = 0.066 and p = 0.077, respectively). Explosive power was reduced (t(12) = 4.570, p = 0.001), lactate metabolism was altered and athletes reported poorer well-being (t(12) = 2.385, p = 0.036). Cognitive restriction was correlated with energy availability (r = 0.528, p = 0.039). Conclusion This is the first research providing direct evidence that suboptimal energy availability negatively impacts explosive power before hormonal changes occur in male endurance athletes. It is also the first to show direct association of low energy availability and higher cognitive restriction. We also observed worse well-being and lower haemoglobin values. 25% of energy availability reduction as not enough to elicit changes in resting energy expenditure.


2021 ◽  
Author(s):  
Nicola Keay ◽  
Martin Lanfear ◽  
Gavin Francis

AbstractObjectivesThe purpose of this study was to assess the effectiveness of monitoring professional female dancer health with a variety of subjective and objective monitoring methods, including application of artificial intelligence (AI) techniques to modelling menstrual cycle hormones and delivering swift personalised clinical advice.MethodsFemale dancers from a ballet company completed a published online dance-specific health questionnaire. Over the study period, dancers recorded wellbeing and training metrics, with menstrual cycle tracking and blood tests. For menstrual cycle hormones AI-based techniques modelled hormone variation over a cycle, based on capillary blood samples taken at two time points. At regular, virtual, clinical interviews with each dancer, findings were discussed, and personalised advice given.Results14 female dancers (mean age 25.5 years, SD 3.7) participated in the study. 10 dancers recorded positive scores on the dance health questionnaire, suggesting a low risk of relative energy deficiency in sport (RED-S). 2 dancers were taking hormonal contraception. Apart from 1 dancer, those not on hormonal contraception reported current eumenorrhoeic status. The initiative of monitoring menstrual cycles and application of AI to model menstrual cycle hormones found that subclinical hormone disruption was occurring in 6 of the 10 dancers reporting regular cycles. 4 of the 6 dancers who received personalised advice, showed improved menstrual hormone function, including one dancer who had planned pregnancy.ConclusionsMultimodal monitoring facilitated delivery of prompt personalised clinical medical feedback specific for dance. This strategy enabled the early identification and swift management of emergent clinical issues. These innovations received positive feedback from the dancers.Summary boxesWhat are the new findings?Monitoring female dancers with a variety of interactive methods – dance specific questionnaire, online tracking and blood testing – together with individual clinical discussion, facilitates comprehensive, personalised support for dancer health.The clinical application of artificial intelligence (AI) techniques to endocrine function provides the finer detail of female hormone network function.This novel approach to monitoring dynamic hormone function enabled the detection of subtle female hormone dysfunction as a result of changes in training and nutrition patterns, which occurred before change in menstruation pattern from menstrual tracking.This multifaceted clinical approach was also effective and helpful in supporting dancers restore full hormone network function through personalised training and nutritional strategies.How might this study impact on clinical practice in the future?Personalised, dance specific health advice based on subjective and objective measures can support sustainable individual dancer health.Clinical application of artificial intelligence (AI) to menstrual cycle hormones can provide a dynamic and complete picture of hormone network function, without the need to do daily blood tests to measure all four key menstrual cycle hormones.This AI approach to modelling hormones enables early detection of subtle, subclinical endocrine dysfunction due to low energy availability in female exercisers. This clinical tool can also facilitate the close clinical monitoring of the restoration of full hormone network function in recovery from low energy availability.Using AI to model female hormones can be an important clinical tool for female athletes, including those athletes where it is difficult to distinguish between perimenopause symptoms and those associated with low energy availability.


Author(s):  
Takeshi Iwasa ◽  
Saki Minato ◽  
Junki Imaizumi ◽  
Atsuko Yoshida ◽  
Takako Kawakita ◽  
...  

2021 ◽  
Vol 20 (9) ◽  
pp. 489-493
Author(s):  
Rachel Goldstein ◽  
Jennifer Carlson ◽  
Adam Tenforde ◽  
Neville Golden ◽  
Michael Fredericson

Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 2963
Author(s):  
Madoka Tokuyama ◽  
Jun Seino ◽  
Keishoku Sakuraba ◽  
Yoshio Suzuki

Low energy availability (LEA) may persist in rugby players. However, timely assessment of energy balance is important but is difficult. Therefore, a practical index that reflects energy availability (EA) is essential. A total of 19 male college rugby players participated in a 2-week pre-season summer camp. Their blood sample was collected after overnight fast prior to (Pre), in the middle (Middle), and after (Post) the camp. Their physical activity in the first half of the camp was calculated using the additive factor method in the forwards (FW; numbers 1–8) and backs (BK; numbers 9–15). The participants were categorized as tight five (T5; numbers 1–5), back row (BR; numbers 6–8), and BK for analysis. All the participants lost weight during the camp (range: from −5.9% to −0.1%). Energy balance in the first half of the camp was negative. Transferrin saturation (TSAT) and serum iron levels significantly decreased to half, or even less, compared with the Pre levels at week 1 and remained low. The changes in TSAT and serum iron levels exhibited a significant positive correlation with the changes in body weight (R = 0.720; R = 0.627) and with energy intake (R = 0.410; R = 461) in T5. LEA occurs in rugby summer camp but is difficult to assess using weight change. Alternately, TSAT and serum iron levels after overnight fast may be better predictors of LEA.


Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2601
Author(s):  
Megan A. Kuikman ◽  
Margo Mountjoy ◽  
Jamie F. Burr

Both dietary and exercise behaviors need to be considered when examining underlying causes of low energy availability (LEA). The study assessed if exercise dependence is independently related to the risk of LEA with consideration of disordered eating and athlete calibre. Via survey response, female (n = 642) and male (n = 257) athletes were categorized by risk of: disordered eating, exercise dependence, disordered eating and exercise dependence, or if not presenting with disordered eating or exercise dependence as controls. Compared to female controls, the likelihood of being at risk of LEA was 2.5 times for female athletes with disordered eating and >5.5 times with combined disordered eating and exercise dependence. Male athletes with disordered eating, with or without exercise dependence, were more likely to report signs and symptoms compared to male controls-including suppression of morning erections (OR = 3.4; p < 0.0001), increased gas and bloating (OR = 4.0–5.2; p < 0.002) and were more likely to report a previous bone stress fracture (OR = 2.4; p = 0.01) and ≥22 missed training days due to overload injuries (OR = 5.7; p = 0.02). For both males and females, in the absence of disordered eating, athletes with exercise dependence were not at an increased risk of LEA or associated health outcomes. Compared to recreational athletes, female and male international caliber and male national calibre athletes were less likely to be classified with disordered eating.


Author(s):  
Sharayu S. Tambe ◽  
Anjali S. Puntambekar

Background: The aim of this study was to assess adolescent Bharatanatyam female dancers for female athlete triad (FAT) which includes low energy availability (LEA), musculoskeletal injury profile, gastrointestinal function and menstrual dysfunction using in females LEAF questionnaire.Methods: The approval was taken from the institutional review board of K. J. Somaiya college of physiotherapy. A pre-designed, pre-validated, questionnaire was distributed in the google form layout, among population according to the inclusion and exclusion criteria; asking for consent to confirm their willingness to participate voluntarily. After confirmation, the participants were directed to complete the LEAF questionnaire, maintaining their confidentiality. Data collected was analyzed using descriptive statistics.Results: A total of 82 participants took part in this study. The cumulative incidence of musculoskeletal injuries is about 50%. 35.4% of population experienced gaseous or bloated abdomen apart from menstrual function and 32.9% experienced cramps or stomach ache which were not related to menses. 7.3% of population reported primary amenorrhea, 35.8% reported secondary amenorrhea and 18.6% reported oligomenorrhea. Thus, overall, 34.5% population reported all the components of FAT.Conclusions: Prevalence of LEA in Bharatanatyam female dancers was reported amongst which prevalence of musculoskeletal injuries was high amongst the participants followed by menstrual dysfunction. LEA might have been interpreted as a usual or needed procedure to achieve better performance in past, but now it is recognized that it may lead to several negative consequences. Therefore, timely screening of dancers along with adequate training protocol will help alleviate LEA.


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