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Cited by 45Sports Performance and TrainingEating Disorders and BehaviorsMuscle metabolism and nutrition

Prevalence of low energy availability in competitively trained male endurance athletes

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Lane, Amy R., Hackney, Anthony C., Smith-Ryan, Abbie, Kucera, Kristen, Registar-Mihalik, Johna, Ondrak, Kristin·2019·Medicina
DOI 10.3390/medicina55100665PMC PMC6843850
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Abstract

Background and Objectives: Relative energy deficiency in sport (RED-S) has been introduced as a broad-spectrum syndrome leading to possible dysfunction in numerous physiological systems, driven primarily by low energy availability (EA). Research in females has identified specific EA cut-points indicative of risk level for developing physiological and performance disturbances. Cut-points in males have yet to be evaluated. This study examined the prevalence of low EA in competitive (non-elite), recreationally trained (CRT) male endurance athletes. Materials and Methods: Subjects were 108 CRT (38.6 ± 13.8 y; 12.2 ± 5.4 h/wk training) male endurance athletes (runners, cyclists, triathletes) who completed a descriptive survey online via Qualtrics® and returned 3 day diet and exercise training records. EA was calculated from returned surveys and training records. Resting metabolic rate (RMR) and lean body mass (LBM) were estimated from self-reported survey data. Prevalence of risk group was categorized based on the female cut-points: At risk (AR) ≤30 kcal/kg LBM, moderate risk (MR) = 30–45 kcal/kg LBM, or no risk (NR) ≥45 kcal/kg LBM. Results: In this sample, 47.2% (n = 51) were classified as AR, 33.3% (n = 36) as MR, and 19.4% (n = 21) as NR for low EA. Cyclists had lower EA (26.9 ± 17.4 kcal/kg LBM, n = 45) than runners (34.6 ± 13.3 kcal/kg LBM, n = 55, p = 0.016) and all other sport categories (39.5 ± 19.1 kcal/kg LBM, n = 8, p = 0.037). Conclusions: The findings indicate this sample had a high prevalence of risk for low EA, at 47.2%. Only 19.4% of participants were at no risk, meaning ~80% of participants were at some degree of risk of experiencing low EA. Cyclists were at greater risk in this cohort of low EA, although why this occurred was unclear and is in need of further investigation. Future research should address whether the current female cut-points for low EA are appropriate for use in male populations.

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  • While a universal cut-off of 30 kcal/kg FFM/day as a threshold of LEA leading to some REDs outcomes in females is debated, such a cut-off or range at which males experience REDs-related symptoms is even less understood, but appears to be lower (eg, ~9 to 25 kcal/kg FFM/day).

    “While a universal cut-off of 30 kcal/kg FFM/day as a threshold of LEA leading to some REDs outcomes in females is debated, 88 such a cut-off or range at which males experience REDs-related symptoms is even less understood, 89 but appears to be lower (eg, ~9 to 25 kcal/kg FFM/day).17 46 72 90 91”

    From 2023 international olympic committee's (IOC) consensus statement on relative energy deficiency in sport (REDs) (2023) · cites this paper as [17]

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  • There is evidence that most males can sustain a lower EA before physiological and psychological disturbances manifest.

    “Indeed, there is evidence that most males can sustain a lower EA before physiological and psychological disturbances manifest.”

    From 2023 international olympic committee's (IOC) consensus statement on relative energy deficiency in sport (REDs) (2023) · cites this paper as [17]

    Section 4.2 suggests that men may require a greater reduction in energy availability before dysfunction occurs, but says the appropriate male thresholds remain unknown. It does not establish that most males can sustain a lower level, or assess when psychological disturbances manifest. (LLM, conf=0.84)

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Authors
Lane, A. R., Hackney, A. C., Smith-Ryan, A., Kucera, K., Registar-Mihalik, J., & Ondrak, K.
Affiliations
  • University of North Carolina at Chapel Hill (US)
  • Curriculum of Human Movement Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27516, USA
Corresponding author
Hackney, Anthony C.
ORCID
Venue
Medicina
Publisher
MDPI AG
Published
2019-10-01
Volume
55
Issue
10
Pages
665
ISSN
  • 1010-660X (ISSN-L)
  • 1648-9144
DOI
10.3390/medicina55100665
PMC
PMC6843850
OpenAlex
W2438393107
Cited by
45
References
35
Citations by year
2026: 3 · 2025: 5 · 2024: 9 · 2023: 9 · 2022: 6 · 2021: 8 · 2020: 5
FWCI
5.05
Type
journal article
Language
en
Open access
Licence
Locations
  • Medicina (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Muscle metabolism and nutrition
Keywords
low energy availability, relative energy deficiency in sport, recreational athletes, prevalence, cyclists, runners, triathletes, resting metabolic rate, lean body mass, sex differences
MeSH terms
Adult, Cross-Sectional Studies, Humans, Male, North Carolina, Nutritional Requirements, Surveys and Questionnaires, Running, Exercise, Prevalence, Malnutrition, Young Adult, Athletes, Sports Nutritional Physiological Phenomena

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