Abstract
Research on female athletes has increased, with the main focus on Low Energy Availability (LEA) and Female Athlete Triad (TRIAD), however there is a gap in knowledge about LEA and related conditions such as eating disorder, menstrual dysfunction and bone health in athletes with disabilities. The literature suggests that those athletes, depending on the type of disability, have a higher risk of developing LEA. In this way, the objective of this review is to describe the impact of LEA on health and performance of female athletes, with special focus on athletes with disabilities. A narrative review of the literature was conducted using as search terms LEA and TRIAD components - bone health and menstrual dysfunction - in female athletes. The narrative review yielded 24 studies on the subject, of those, 10 original studies, in which LEA was diagnosed in female athletes, only one referring to athletes with disabilities. Literature indicates the complexity in estimating EA, since the methods used to determine its components may present inaccuracies, especially for athletes with disabilities. Further researched is needed to assess EA in female athletes, especially with disabilities, as well as the improvement of EA's assessment and screening methods.
Highlights
In the last decades, the idea about women being less capable of engaging in sports at all levels has changed (Slater et al, 2016), with an increase in their participation in Olympic and Paralympic sports (Matzkin, Curry & Whitlok, 2015; Blauwet, 2015)
Energy Availability (EA) is defined as the energy intake (EI in kcal) minus the energy expenditure with exercise (EEex in kcal), divided by Fat Free Mass (FFM in kg), with values equal and above 45kcal/kgFFM/day considered as adequate (Broad & Burke, 2013; Souza et al, 2014), while values below 30kcal/kgFFM/day are considered as Low Energy Availability (LEA) (Broad & Burke, 2013)
This concept distinguishes itself from the energy balance (EB) concept, since athletes can be in negative energy balance due to suppression of physiological functions, in an attempt to restore the energy balance (EB = 0 kcal) and/or the stability of the body mass (Souza et al, 2014; Slater et al, 2016)
Summary
The idea about women being less capable of engaging in sports at all levels has changed (Slater et al, 2016), with an increase in their participation in Olympic and Paralympic sports (Matzkin, Curry & Whitlok, 2015; Blauwet, 2015). In London 2012 Olympics, there was an increase of 44% in women's participation in comparison with the last two decades (IOC, 2017). With the greater participation of female in sports, especially athletes with disabilities, there is a growing need for a deeper understanding and attention to minimize athletes' health problems and injury risk. In the case of athletes with disabilities, there may be specific problems related to the different types of impairments that should be taken into consideration (Blauwet, 2015; Slater et al, 2016)
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