Examination of Athlete Triad Symptoms Among Endurance-Trained Male Athletes: A Field Study
Open accessAbstract
Background: Studies examining the physiological consequences associated with deficits in energy availability (EA) for male athletes are sparse. Purpose: To examine male athlete triad components; low energy availability (LEA) with or without an eating disorder risk (ED), reproductive hormone [testosterone (T)], and bone mineral density (BMD) in endurance-trained male athletes during different training periods. Methods: A cross-sectional design with 14 participants (age: 26.4 ± 4.2 years; weight: 70.6 ± 6.4 kg; height: 179.5 ± 4.3 cm; BMI: 21.9 ± 1.8 kg/m2) were recruited from the local community. Two separate training weeks [low (LV) and high (HV) training volumes] were used to collect the following: 7-day dietary and exercise logs, and blood concentration of T. Anthropometric measurements was taken prior to data collection. A one-time BMD measure (after the training weeks) and VO 2max-HR regressions were utilized to calculate EEE. Results: Overall, EA presented as 27.6 ± 10.7 kcal/kgFFM·d-1 with 35% (n = 5) of participants demonstrating increased risk for ED. Examining male triad components, 64.3% presented with LEA (≤ 30 kcal/kgFFM·d-1) while participants presented with T (1780.6 ± 1672.6 ng/dl) and BMD (1.31 ±.09 g/cm 2) within normal reference ranges. No differences were found across the 2 training weeks for EI, with slight differences for EA and EEE. Twenty-five participants (89.3%) under-ingested CHO across both weeks, with no differences between weeks. Conclusion: Majority of endurance-trained male athletes presented with one compromised component of the triad (LEA with or without ED risk); however, long-term negative effects on T and BMD were not demonstrated. Over 60% of the participants presented with an EA ≤ 30 kcal/kgFFM·d-1, along with almost 90% not meeting CHO needs. These results suggest male endurance-trained athletes may be at risk to negative health outcomes similar to mechanistic behaviors related to EA with or without ED in female athletes.
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Two studies on cheerleaders (n = 19) and young athletic males (n = 14) found that no athletes had low BMD, although the majority of subjects in both studies had LEA.
“Two of the studies on cheerleaders (n = 19) [33] and young athletic males (n = 14) [34] found that no athletes had low BMD, although the majority of subjects in both studies had LEA.”
From Low Energy Availability and Relative Energy Deficiency in Sport: A Systematic Review and Meta-analysis (2025) · cites this paper as [34]
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- Authors
- Moore, E. M., Drenowatz, C., Stodden, D. F., Pritchett, K., Brodrick, T. C., Williams, B. T., Goins, J. M., & Torres-McGehee, T. M.
- Affiliations
- University of Virginia (US)
- University of South Carolina (US)
- Central Washington University (US)
- Corresponding author
- Moore, Erin M.
- Venue
- Frontiers in Nutrition
- Publisher
- Frontiers Media SA
- Published
- 2021-11-26
- Volume
- 8
- Pages
- 737777-737777
- ISSN
- 2296-861X (ISSN-L)
- PMC
- PMC8664375
- OpenAlex
- W3217506930
- Cited by
- 11
- References
- 48
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 5 · 2023: 1
- FWCI
- 1.02
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Nutrition (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- ScholarWorks (Central Washington University) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
- Physical Sciences › Engineering › Biomedical Engineering › Lower Extremity Biomechanics and Pathologies
- Keywords
- low energy availability, eating disorder risk, testosterone, bone mineral density, training volume, carbohydrate intake, energy expenditure, energy balance, VO2max
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