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Energy Availability in Athletics: Health, Performance, and Physique
Open accessAbstract
The reported prevalence of low energy availability (LEA) in female and male track and field athletes is between 18% and 58% with the highest prevalence among athletes in endurance and jump events. In male athletes, LEA may result in reduced testosterone levels and libido along with impaired training capacity. In female track and field athletes, functional hypothalamic amenorrhea as consequence of LEA has been reported among 60% of elite middle- and long-distance athletes and 23% among elite sprinters. Health concerns with functional hypothalamic amenorrhea include impaired bone health, elevated risk for bone stress injury, and cardiovascular disease. Furthermore, LEA negatively affects recovery, muscle mass, neuromuscular function, and increases the risk of injuries and illness that may affect performance negatively. LEA in track and field athletes may occur due to intentional alterations in body mass or body composition, appetite changes, time constraints, or disordered eating behavior. Long-term LEA causes metabolic and physiological adaptations to prevent further weight loss, and athletes may therefore be weight stable yet have impaired physiological function secondary to LEA. Achieving or maintaining a lower body mass or fat levels through long-term LEA may therefore result in impaired health and performance as proposed in the Relative Energy Deficiency in Sport model. Preventive educational programs and screening to identify athletes with LEA are important for early intervention to prevent long-term secondary health consequences. Treatment for athletes is primarily to increase energy availability and often requires a team approach including a sport physician, sports dietitian, physiologist, and psychologist.
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“Briefly, the known consequences of LEA cause a myriad of complications, which include reproductive dysfunction and impairments to skeletal, cardiovascular, gastrointestinal, endocrine, and neurological function [113,115,127,128].”
From International society of sports nutrition position stand: nutritional concerns of the female athlete (2023) · cites this paper as [128]
Experimental — accuracy not yet measuredIn the citing paper
“Problems associated with chronic or severe low energy availability, known as relative energy deficiency in sports, are well known (Mountjoy et al., 2018); specific issues in relation to Athletics are covered by Melin et al. (2019).”
From Contemporary Nutrition Strategies to Optimize Performance in Distance Runners and Race Walkers (2019) · cites this paper as Melin et al., 2019
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Metadata
- Authors
- Melin, A. K., Heikura, I. A., Tenforde, A., & Mountjoy, M.
- Affiliations
- University of Copenhagen (DK)
- Australian Catholic University (AU)
- Spaulding Rehabilitation Hospital (US)
- International Olympic Committee (CH)
- Venue
- International Journal of Sport Nutrition and Exercise Metabolism
- Publisher
- Human Kinetics
- Published
- 2019-03-01
- Volume
- 29
- Issue
- 2
- Pages
- 152-164
- ISSN
- 1526-484X (ISSN-L)
- 1543-2742
- OpenAlex
- W2908767208
- Cited by
- 258
- References
- 84
- Citations by year
- 2026: 39 · 2025: 32 · 2024: 37 · 2023: 41 · 2022: 39 · 2021: 32 · 2020: 26 · 2019: 10
- FWCI
- 4.21
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- International Journal of Sport Nutrition and Exercise Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (publishedVersion)
- Research Bank (Australian Catholic University) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
- Keywords
- low energy availability, track and field athletes, functional hypothalamic amenorrhea, relative energy deficiency in sport, bone health, bone stress injuries, cardiovascular risk, disordered eating, body mass reduction, testosterone, athletic performance, injury risk, screening and prevention, multidisciplinary treatment
- MeSH terms
- Feeding and Eating Disorders, Body Composition, Body Weight, Energy Intake, Energy Metabolism, Humans, Nutritional Requirements, Athletic Performance, Athletes, Reproductive Health, Sports Nutritional Physiological Phenomena
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