Energy Availability In Athletes Research Articles

Identifying and Analyzing Low Energy Availability in Athletes: The Role of Biomarkers and Red Blood Cell Turnover.

Low energy availability (LEA) is a growing concern that can lead to several problems for athletes. However, adaptation to LEA occurs to maintain balance over time, making diagnosis difficult. In this review, we categorize LEA into two phases: the initial phase leading to adaptation and the phase in which adaptation is achieved and maintained. We review the influence of LEA on sports performance and health and discuss biomarkers for diagnosing LEA in each phase. This review also proposes future research topics for diagnosing LEA, with an emphasis on the recently discovered association between red blood cell turnover and LEA.

New Epidemic of Malnutrition in Young Slovenian Athletes.

The syndrome of relative energy deficiency in sports (RED-S) is the result of a prolonged period of low energy availability in athletes and leads to the deterioration of health and physical performance. Our study aimed to investigate the prevalence of RED-S-related health and performance problems in young Slovenian athletes, comparing middle (14-17 years) with late (18-21 years) adolescents. We analysd data of 118 young athletes (61 females, 57 males) who had nutritional assessments. Statistical analysis was carried out to determine the prevalence of RED-S-related problems. RED-S was diagnosed using the Relative Energy Deficiency Tool and the Sports Clinical Assessment Tool. Nutrition-related risk factors for RED-S were assessed with the use of a questionnaire and analysis of a three-day food diary. The majority of athletes had at least one RED-S-related health disorder. The number of health-related disorders was significantly higher in females 3.0 (0.2) compared to males 1.6 (0.2). It was also significantly higher in middle 2.6 (0.2) compared to 1.9 (0.3) late adolescents. Potential nutritional risk factors for RED-S were low carbohydrate intake, skipping meals before and after practice, a desire to lose weight, and a history of weight loss in the past year. The prevalence of health-related RED-S disorders and performance problems in young athletes is concerning, and our study indicates that middle adolescents are more vulnerable to this than late adolescents. Our findings suggest that screening for RED-S symptoms and nutrition-related risk factors for RED-S should be included in regular medical examination of young athletes.

Low Energy Availability in Athletes

Relative Energy Deficiency in Sport (REDs) is a syndrome of impaired physiological function due to low energy availability (LEA) such that there is insufficient energy intake after subtracting the cost of energy expended through exercise. There are no universal criteria to identify an athlete with REDs. Rather, physiological outcomes and functional impairments that occur because of LEA are used for identification purposes. Once an athlete is identified with REDs, treatment should focus on addressing the underlying cause of LEA. This may include increasing energy intake and/or decreasing exercise energy expenditure as well as addressing factors that may exacerbate LEA. Much has been uncovered about the negative consequences of LEA. Early models were for women, whereas newer models include athletes of both sexes. More research is needed to increase the understanding of LEA so that the model of REDs and best practice guidelines to prevent, identify, and treat REDs will continue to evolve.

Low Energy Availability in Athletes: Understanding Undereating and its Concerns

Low Energy Availability in Athletes: Understanding Undereating and its Concerns

A review exploring coach knowledge, attitudes/beliefs and behaviours towards low energy availability in athletes

Coaches are important figures of influence with potential to create environments that influence athlete health and performance outcomes. Ideally, coaches provide supportive environments that lead to performance optimisation and long-term health. Coaches who employ language and behaviours that overemphasise body composition and/or provide misinformed nutrition advice may predispose athletes to low energy availability (LEA) and the associated health consequences. Having a clear understanding of current knowledge, attitudes and beliefs of coaches with regard to LEA is required to guide future coach education/support initiatives to optimise athlete health and performance. Thus, the aim of this investigation was to systematically review published literature regarding coach knowledge, attitudes/beliefs and behaviours of LEA. Data from 20 eligible studies was extracted into predetermined categories according to coach ‘knowledge‘; ‘attitudes/ beliefs’; and ‘behaviours’ regarding LEA/Relative Energy Deficiency in Sport/Female Athlete Triad and/or eating disorders and/or disordered eating. Any single study could provide outcomes to inform one or multiple of these categories. The majority of results were drawn from studies conducted prior to LEA being defined as a concern for athlete health, which limited our understanding of the contemporary knowledge, attitudes/eliefs and behaviours of coaches on this important issue. That said, indications of gaps in coach knowledge and the employment of inappropriate attitudes/beliefs and behaviours regarding issues associated with LEA were evident. An opportunity exists for key stakeholders to develop comprehensive coach education frameworks, which equip coaches with the adequate capability, opportunity and motivation to support athlete health and avoid the consequences of LEA.

RMR Ratio as a Surrogate Marker for Low Energy Availability.

Low energy availability (EA) poses severe consequences to athlete performance and overall health. Suppressed resting metabolic rate (RMR) has been observed during periods of low EA. Thus, it has been suggested that the ratio of RMR measured via indirect calorimetry to predictive RMR using a standard predictive equation (RMR ratio) may be a useful assessment of EA in athletes. This review evaluated the use of RMR ratio as a surrogate marker for low EA in athletes and compared methodologies for measuring RMR ratio. Decreased RMR ratio in recent studies often correlates with signs of low EA; however, athletes with less severe cases of energy deficiency may not present with a low RMR ratio. Additionally, the methodology for RMR ratio measurements lacks standardization and varies in recent studies. Use of RMR ratio has promise as a complementary EA measurement when used in combination with other assessment tools.

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

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.

Iron Metabolism: Interactions with Energy and Carbohydrate Availability.

The provision or restriction of select nutrients in an athlete’s diet can elicit a variety of changes in fuel utilization, training adaptation, and performance outcomes. Furthermore, nutrient availability can also influence athlete health, with one key system of interest being iron metabolism. The aim of this review was to synthesize the current evidence examining the impact of dietary manipulations on the iron regulatory response to exercise. Specifically, we assessed the impact of both acute and chronic carbohydrate (CHO) restriction on iron metabolism, with relevance to contemporary sports nutrition approaches, including models of periodized CHO availability and ketogenic low CHO high fat diets. Additionally, we reviewed the current evidence linking poor iron status and altered hepcidin activity with low energy availability in athletes. A cohesive understanding of these interactions guides nutritional recommendations for athletes struggling to maintain healthy iron stores, and highlights future directions and knowledge gaps specific to elite athletes.

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

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.

Resting metabolic rate prediction equations and the validity to assess energy deficiency in the athlete population.

What is the topic of this review? We review the issues with using predicted resting metabolic rate equations in athletic populations. What advances does it highlight? The use of dated predicted resting metabolic rate equations is not appropriate for athletic populations until more studies have been conducted among these unique populations. Resting metabolic rate (RMR) is the amount of energy the body uses at rest. A suppressed RMR has been correlated with low energy availability and therefore used as an indicator of an individual's energy state. Furthermore, confounding identification of low energy availability within an athletic population are the physiological measures required, which can be time consuming and require professional expertise. To negate the demands of laboratory protocols in measuring RMR, predicted RMR (p RMR) equations were developed. Caution should be exercised when applying the p RMR equations for determining low energy availability in athletes owing to the population used to develop the equations and the higher metabolic cost of fat-free mass, thus elevated RMR, associated with athletes. Moreover, a low ratio of measured RMR to p RMR is often used as an alternative marker for energy deficiency. Predictive equations should implement fat-free mass within the algorithm when estimating RMR in athletic populations. The purpose of this paper is to describe p RMR equation development and the issues associated with use of p RMR equations for athletic populations. As professional sport increases, validation of p RMR equations in the modern athlete population is needed to monitor energy availability for athletic health and performance.

Low Energy Availability in Athletes: A Review of Prevalence, Dietary Patterns, Physiological Health, and Sports Performance.

In a high-performance sports environment, athletes can present with low energy availability (LEA) for a variety of reasons, ranging from not consuming enough food for their specific energy requirements to disordered eating behaviors. Both male and female high-performance athletes are at risk of LEA. Longstanding LEA can cause unfavorable physiological and psychological outcomes which have the potential to impair an athlete's health and sports performance. This narrative review summarizes the prevalence of LEA and its associations with athlete health and sports performance. It is evident in the published scientific literature that the methods used to determine LEA and its associated health outcomes vary. This contributes to poor recognition of the condition and its sequelae. This review also identifies interventions designed to improve health outcomes in athletes with LEA and indicates areas which warrant further investigation. While return-to-play guidelines have been developed for healthcare professionals to manage LEA in athletes, behavioral interventions to prevent the condition and manage its associated negative health and performance outcomes are required.

Energy availability in athletes

This review updates and complements the review of energy balance and body composition in the Proceedings of the 2003 IOC Consensus Conference on Sports Nutrition. It argues that the concept of energy availability is more useful than the concept of energy balance for managing the diets of athletes. It then summarizes recent reports of the existence, aetiologies, and clinical consequences of low energy availability in athletes. This is followed by a review of recent research on the failure of appetite to increase ad libitum energy intake in compensation for exercise energy expenditure. The review closes by summarizing the implications of this research for managing the diets of athletes.