Low Energy Availability, Plasma Lipids, and Hormonal Profiles of Recreational Athletes
Abstract
Black, K, Slater, J, Brown, RC, and Cooke, R. Low energy availability, plasma lipids, and hormonal profiles of recreational athletes. J Strength Cond Res 32(10): 2816–2824, 2018—It has been postulated that low energy availability (LEA) impacts bone health, hormonal concentrations, and cardiovascular function. This study describes the lipid levels, hormonal profiles, and nutrient intakes of recreationally active adults at risk of LEA compared with those not at risk. Thirty-eight women who meet or exceed the New Zealand guidelines for physical activity participated. Each participant completed an online questionnaire including the Low Energy Availability in Females questionnaire (LEAF-Q), demographic questions, and daily exercise to determine energy expenditure. Participants also provided a weighed 3-day diet record, a blood sample analyzed for total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, and cortisol, and a saliva sample analyzed for testosterone. Body composition was assessed using bioelectrical impedance. Those classed as at risk of LEA according to the LEAF-Q showed very likely lower energy availability (at risk: mean, 36.3 [95% confidence interval, 30.8–41.7] kcal·kg −1 ·FFMd −1 vs. not at risk: mean, 47.5 [95% CI, 39.5–55.4] kcal·kg −1 ·FFMd −1 ) and lower calcium intakes (mean, 847 [95% CI, 695–998] mg, vs. mean, 1488 [95% CI, 690–2,286] mg). Those at risk also had a likely small lower T3 concentration of 1.78 ( SD : 0.36) nmol·L −1 compared with 2.01 ( SD : 0.53) nmol·L −1 for those not at risk. These data suggest that recreationally active female subjects classed as at risk of LEA according to the LEAF-Q also have lower energy availability as determined by diet records and exercise diaries. The results also suggests that those at risk of LEA have reductions in T3, and their low energy intake, in addition to a low calcium intake, could put them at an increased risk of poor bone health.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Caloric restriction is prevalent among recreationally active to elite female athletes.
“which has been shown to be prevalent among recreationally active to elite female athletes [113,124,233–236]”
From International society of sports nutrition position stand: nutritional concerns of the female athlete (2023) · cites this paper as [234]
Cites
Friedewald, W. T., Levy, R. I., & Fredrickson, D. S. (1972) · Clinical Chemistry · doi:10.1093/clinchem/18.6.499 · Cited by 32,423 · see citing works
Expert Panel on Detection, E. (2001) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.285.19.2486 · Cited by 26,011 · see citing works
Progressive Statistics for Studies in Sports Medicine and Exercise Science
HOPKINS, W. G., MARSHALL, S. W., BATTERHAM, A. M., & HANIN, J. (2009) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e31818cb278 · Cited by 9,128 · see citing works
2011 Compendium of Physical Activities: A Second Update of Codes and MET Values
AINSWORTH, B. E., HASKELL, W. L., HERRMANN, S. D., MECKES, N., BASSETT, D. R., TUDOR-LOCKE, C., GREER, J. L., VEZINA, J., WHITT-GLOVER, M. C., & LEON, A. S. (2011) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e31821ece12 · Cited by 6,317 · see citing works
Normal Bone Anatomy and Physiology
Clarke, B. (2008) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.04151206 · Cited by 2,192 · see citing works
Mountjoy, M., Sundgot-Borgen, J., Burke, L., Carter, S., Constantini, N., Lebrun, C., Meyer, N., Sherman, R., Steffen, K., Budgett, R., et al. (2014) · British Journal of Sports Medicine · doi:10.1136/bjsports-2014-093502 · Cited by 1,469 · see citing works
Carbohydrates for training and competition
Burke, L. M., Hawley, J. A., Wong, S. H. S., & Jeukendrup, A. E. (2011) · Journal of Sports Sciences · doi:10.1080/02640414.2011.585473 · Cited by 985 · see citing works
Loucks, A. B., & Thuma, J. R. (2003) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2002-020369 · Cited by 760 · see citing works
De Souza, M. J., Nattiv, A., Joy, E., Misra, M., Williams, N. I., Mallinson, R. J., Gibbs, J. C., Olmsted, M., Goolsby, M., Matheson, G., et al. (2014) · British Journal of Sports Medicine · doi:10.1136/bjsports-2013-093218 · Cited by 661 · see citing works
Ackland, T. R., Lohman, T. G., Sundgot-Borgen, J., Maughan, R. J., Meyer, N. L., Stewart, A. D., & Müller, W. (2012) · Sports Medicine · doi:10.2165/11597140-000000000-00000 · Cited by 599 · see citing works
Low energy availability, not stress of exercise, alters LH pulsatility in exercising women
Loucks, A. B., Verdun, M., Heath, E. M., & (With the Technical Assistance of T. Law, S. A. J. R. T. (1998) · Journal of Applied Physiology · doi:10.1152/jappl.1998.84.1.37 · Cited by 539 · see citing works
Dietary protein for athletes: From requirements to optimum adaptation
Phillips, S. M., & Van Loon, L. J. C. (2011) · Journal of Sports Sciences · doi:10.1080/02640414.2011.619204 · Cited by 530 · see citing works
Dose-Response Relationships Between Energy Availability and Bone Turnover in Young Exercising Women
Ihle, R., & Loucks, A. B. (2004) · Journal of Bone and Mineral Research · doi:10.1359/jbmr.040410 · Cited by 523 · see citing works
Lappe, J. M., Cullen, D. M., Haynatzki, G. R., Recker, R. R., Ahlf, R. L., & Thompson, K. L. (2008) · Journal of Bone and Mineral Research · doi:10.1359/jbmr.080102 · Cited by 476 · see citing works
Melin, A., Tornberg, Å. B., Skouby, S., Faber, J., Ritz, C., Sjödin, A., & Sundgot-Borgen, J. (2014) · British Journal of Sports Medicine · doi:10.1136/bjsports-2013-093240 · Cited by 435 · see citing works
Low Bone Density Is an Etiologic Factor for Stress Fractures in Athletes
Myburgh, K. H., Hutchins, J., Fataar, A. B., Hough, S. F., & Noakes, T. D. (1990) · Annals of Internal Medicine · doi:10.7326/0003-4819-113-10-754 · Cited by 425 · see citing works
Neuroendocrine Aberrations in Women With Functional Hypothalamic Amenorrhea*
BERGA, S. L., MORTOLA, J. F., GIRTON, L., SUH, B., LAUGHLIN, G., PHAM, P., & YEN, S. S. C. (1989) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem-68-2-301 · Cited by 337 · see citing works
Endocrine markers of semistarvation in healthy lean men in a multistressor environment
Friedl, K. E., Moore, R. J., Hoyt, R. W., Marchitelli, L. J., Martinez-Lopez, L. E., & Askew, E. W. (2000) · Journal of Applied Physiology · doi:10.1152/jappl.2000.88.5.1820 · Cited by 316 · see citing works
De Souza, M. J., Miller, B. E., Loucks, A. B., Luciano, A. A., Pescatello, L. S., Campbell, C. G., & Lasley, B. L. (1998) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.83.12.5334 · Cited by 315 · see citing works
Dietschy, J. M. (1998) · Journal of Nutrition · doi:10.1093/jn/128.2.444s · Cited by 247 · see citing works
The female athlete triad: are elite athletes at increased risk?
Torstveit, M. K., & Sundgot-Borgen, J. (2005) · Medicine & Science in Sports & Exercise · doi:10.1249/01.mss.0000152677.60545.3a · Cited by 237 · see citing works
Methodology of dietary assessment in athletes: concepts and pitfalls
Magkos, F., & Yannakoulia, M. (2003) · Current Opinion in Clinical Nutrition & Metabolic Care · doi:10.1097/00075197-200309000-00007 · Cited by 204 · see citing works
Jebb, S. A., Lovegrove, J. A., Griffin, B. A., Frost, G. S., Moore, C. S., Chatfield, M. D., Bluck, L. J., Williams, C. M., & Sanders, T. A. (2010) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.2009.29096 · Cited by 192 · see citing works
Induction of low-T3 syndrome in exercising women occurs at a threshold of energy availability
Loucks, A. B., & Heath, E. M. (1994) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.1994.266.3.r817 · Cited by 187 · see citing works
Nieves, J. W., Melsop, K. A., Curtis, M., Kelsey, J. L., Bachrach, L. K., Greendale, G. A., Sowers, M. F., & Sainani, K. L. (2010) · PM&R · doi:10.1016/j.pmrj.2010.04.020 · Cited by 187 · see citing works
Souza, M. D. D., & Williams, N. (2004) · Human Reproduction Update · doi:10.1093/humupd/dmh033 · Cited by 182 · see citing works
Koehler, K., Hoerner, N. R., Gibbs, J. C., Zinner, C., Braun, H., De Souza, M. J., & Schaenzer, W. (2016) · Journal of Sports Sciences · doi:10.1080/02640414.2016.1142109 · Cited by 164 · see citing works
Availability of Metabolic Fuels Controls Estrous Cyclicity of Syrian Hamsters
Schneider, J. E., & Wade, G. N. (1989) · Science · doi:10.1126/science.2734610 · Cited by 161 · see citing works
Fueling strategies to optimize performance: training high or training low?
Burke, L. M. (2010) · Scandinavian Journal of Medicine & Science in Sports · doi:10.1111/j.1600-0838.2010.01185.x · Cited by 153 · see citing works
Drew, M. K., Vlahovich, N., Hughes, D. C., Appaneal, R., Burke, L. M., Lundy, B., Rogers, M. A., Toomey, M., Watts, D., Lovell, G. A., et al. (2017) · British Journal of Sports Medicine · doi:10.1136/bjsports-2017-098208 · Cited by 152 · see citing works
Mechanisms of Exercise-Induced Cardioprotection
Powers, S. K., Smuder, A. J., Kavazis, A. N., & Quindry, J. C. (2014) · Physiology · doi:10.1152/physiol.00030.2013 · Cited by 146 · see citing works
Souza, M. D. D., Williams, N., Nattiv, A., Joy, E., Misra, M., Loucks, A., Matheson, G., Olmsted, M., Barrack, M., Mallinson, R. J., et al. (2014) · British Journal of Sports Medicine · doi:10.1136/bjsports-2014-093958 · Cited by 90 · see citing works
Low‐energy density and high fiber intake are dietary concerns in female endurance athletes
Melin, A., Tornberg, Å. B., Skouby, S., Møller, S. S., Faber, J., Sundgot‐Borgen, J., & Sjödin, A. (2016) · Scandinavian Journal of Medicine & Science in Sports · doi:10.1111/sms.12516 · Cited by 89 · see citing works
Lamon‐Fava, S., Fisher, E. C., Nelson, M. E., Evans, W. J., Millar, J. S., Ordovás, J. M., & Schaefer, E. J. (1989) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem-68-1-17 · Cited by 84 · see citing works
Exercise‐Induced Amenorrhea and Bone Health in the Adolescent Athlete
Warren, M., & Chua, A. T. (2008) · Annals of the New York Academy of Sciences · doi:10.1196/annals.1429.025 · Cited by 73 · see citing works
Energy intake and expenditure assessed ‘in‐season’ in an elite European rugby union squad
Bradley, W. J., Cavanagh, B. P., Douglas, W., Donovan, T. F., Twist, C., Morton, J. P., & Close, G. L. (2015) · European Journal of Sport Science · doi:10.1080/17461391.2015.1042528 · Cited by 72 · see citing works
Ultra-Marathon Athletes at Risk for the Female Athlete Triad
Folscher, L.-L., Grant, C. C., Fletcher, L., & van Rensburg, D. J. (2015) · Sports Medicine - Open · doi:10.1186/s40798-015-0027-7 · Cited by 69 · see citing works
Obstacles in the Optimization of Bone Health Outcomes in the Female Athlete Triad
Ducher, G., Turner, A. I., Kukuljan, S., Pantano, K. J., Carlson, J. L., Williams, N. I., & Souza, M. J. D. (2011) · Sports Medicine · doi:10.2165/11588770-000000000-00000 · Cited by 69 · see citing works
Female Recreational Exercisers at Risk for Low Energy Availability
Slater, J., McLay-Cooke, R., Brown, R., & Black, K. (2016) · International Journal of Sport Nutrition and Exercise Metabolism · doi:10.1123/ijsnem.2015-0245 · Cited by 62 · see citing works
Self-citationMeasurement of morning saliva cortisol in athletes
Lippi, G., Vita, F. D., Salvagno, G. L., Gelati, M., Montagnana, M., & Guidi, G. C. (2009) · Clinical Biochemistry · doi:10.1016/j.clinbiochem.2009.02.012 · Cited by 61 · see citing works
Friday, K. E., Drinkwater, B. L., Bruemmer, B., Chesnut, C. H., & Chait, A. (1993) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.77.6.8263148 · Cited by 59 · see citing works
Low Energy Availability in Exercising Women: Historical Perspectives and Future Directions
Slater, J., Brown, R., McLay-Cooke, R., & Black, K. (2017) · Sports Medicine · doi:10.1007/s40279-016-0583-0 · Cited by 59 · see citing works
Self-citationTarpenning, K. M., WISWELL, R. A., Hawkins, S. A. C., & MARCELL, T. J. (2001) · Journal of science and medicine in sport · doi:10.1016/s1440-2440(01)80052-9 · Cited by 53 · see citing works
Obmiński, Z., & STUPNICKI, R. (1997) · PubMed · Cited by 52 · see citing works
Exercised-induced increase in lipid peroxidation parameters in amenorrhelc female athletes
Ayres, S. A., Baer, J. T., & Subbiah, M. T. R. (1998) · Fertility and Sterility · doi:10.1016/s0015-0282(97)00428-7 · Cited by 52 · see citing works
Testosterone concentrations in female athletes and ballet dancers with menstrual disorders
Łagowska, K., & Kapczuk, K. (2015) · European Journal of Sport Science · doi:10.1080/17461391.2015.1034786 · Cited by 35 · see citing works
Lippi, G., Dipalo, M., Buonocore, R., Gnocchi, C., Aloe, R., & Delsignore, R. (2016) · Journal of Clinical Laboratory Analysis · doi:10.1002/jcla.21929 · Cited by 27 · see citing works
Lane, A. R., & Hackney, A. C. (2014) · HORMONES · doi:10.14310/horm.2002.1561 · Cited by 25 · see citing works
Serum Lipid Levels and Steroidal Hormones in Women Runners With Irregular Menses
Thompson, D. L., Snead, D. B., Seip, R. L., et al. (1997) · Canadian Journal of Applied Physiology · doi:10.1139/h97-007 · Cited by 15 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Logue, D. M., Madigan, S. M., Melin, A., Delahunt, E., Heinen, M., Donnell, S.-J. M., & Corish, C. A. (2020) · Nutrients · doi:10.3390/nu12030835 · Cited by 321 · see citing works
International society of sports nutrition position stand: nutritional concerns of the female athlete
Sims, S. T., Kerksick, C. M., Smith-Ryan, A. E., Janse de Jonge, X. A. K., Hirsch, K. R., Arent, S. M., Hewlings, S. J., Kleiner, S. M., Bustillo, E., Tartar, J. L., et al. (2023) · Journal of the International Society of Sports Nutrition · doi:10.1080/15502783.2023.2204066 · Cited by 91 · see citing works
Gallant, T. L., Ong, L. F., Wong, L., Sparks, M., Wilson, E., Puglisi, J. L., & Gerriets, V. A. (2025) · Sports Medicine · doi:10.1007/s40279-024-02130-0 · Cited by 75 · see citing works
Kuikman, M. A., Mountjoy, M., & Burr, J. F. (2021) · Nutrients · doi:10.3390/nu13082601 · Cited by 50 · see citing works
- Authors
- Black, K., Slater, J., Brown, R. C., & Cooke, R.
- Affiliations
- University of Otago (NZ)
- Corresponding author
- Black, Katherine
- Venue
- Journal of Strength and Conditioning Research
- Published
- 2018-10
- Volume
- 32
- Issue
- 10
- Pages
- 2816-2824
- ISSN
- 1064-8011 (ISSN-L)
- OpenAlex
- W2795481054
- Cited by
- 41
- References
- 49
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 4 · 2023: 6 · 2022: 6 · 2021: 13 · 2020: 5 · 2019: 1 · 2018: 1
- FWCI
- 5.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Strength and Conditioning Research (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Muscle metabolism and nutrition
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
- Keywords
- low energy availability, recreational athletes, plasma lipids, hormonal profile, cortisol, testosterone, T3, calcium intake, energy intake, bone health, women, LEAF-Q, dietary intake
- MeSH terms
- Adolescent, Adult, Body Composition, Energy Intake, Cholesterol, Cross-Sectional Studies, Energy Metabolism, Female, Humans, Hydrocortisone, Cholesterol, HDL, Cholesterol, LDL, New Zealand, Surveys and Questionnaires, Recreation, Saliva, Testosterone, Triglycerides, Exercise, Diet Records, Electric Impedance, Young Adult, Athletes
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review