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Cited by 50Eating Disorders and BehaviorsNutrition, Health and Food BehaviorHealth and Lifestyle Studies

Examining the Relationship between Exercise Dependence, Disordered Eating, and Low Energy Availability

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Kuikman, Megan A., Mountjoy, Margo, Burr, Jamie F.·2021·Nutrients
DOI 10.3390/nu13082601PMC PMC8398044
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Abstract

Both dietary and exercise behaviors need to be considered when examining underlying causes of low energy availability (LEA). The study assessed if exercise dependence is independently related to the risk of LEA with consideration of disordered eating and athlete calibre. Via survey response, female (n = 642) and male (n = 257) athletes were categorized by risk of: disordered eating, exercise dependence, disordered eating and exercise dependence, or if not presenting with disordered eating or exercise dependence as controls. Compared to female controls, the likelihood of being at risk of LEA was 2.5 times for female athletes with disordered eating and >5.5 times with combined disordered eating and exercise dependence. Male athletes with disordered eating, with or without exercise dependence, were more likely to report signs and symptoms compared to male controls-including suppression of morning erections (OR = 3.4; p < 0.0001), increased gas and bloating (OR = 4.0–5.2; p < 0.002) and were more likely to report a previous bone stress fracture (OR = 2.4; p = 0.01) and ≥22 missed training days due to overload injuries (OR = 5.7; p = 0.02). For both males and females, in the absence of disordered eating, athletes with exercise dependence were not at an increased risk of LEA or associated health outcomes. Compared to recreational athletes, female and male international caliber and male national calibre athletes were less likely to be classified with disordered eating.

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  • Higher protein diets (>2.0 g·kg−1·day−1), coupled with heavy resistance training, are important for maintaining lean mass and resting energy expenditure under periods of intentional and unintentional caloric restriction.

    “higher protein diets (>2.0 g·kg−1·day−1), coupled with heavy resistance training, have been shown to be important for maintaining lean mass and resting energy expenditure under periods of intentional and unintentional caloric restriction [231,232]”

    From International society of sports nutrition position stand: nutritional concerns of the female athlete (2023) · cites this paper as [232]

    The Introduction discusses how insufficient energy intake can cause low energy availability, but does not address preserving lean mass or resting energy expenditure. Searches for the >2.0 g·kg−1·day−1 protein threshold and for protein intake combined with resistance training found no supporting passage in our copy. (LLM, conf=0.76)

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Authors
Kuikman, M. A., Mountjoy, M., & Burr, J. F.
Affiliations
  • University of Guelph (CA)
  • McMaster University (CA)
Corresponding author
Burr, Jamie F.
ORCID
Venue
Nutrients
Publisher
MDPI AG
Published
2021-07-28
Volume
13
Issue
8
Pages
2601
ISSN
2072-6643 (ISSN-L)
DOI
10.3390/nu13082601
PMC
PMC8398044
OpenAlex
W3184467557
Cited by
50
References
191
Citations by year
2026: 9 · 2025: 11 · 2024: 9 · 2023: 17 · 2022: 4
FWCI
5.11
Type
journal article
Language
en
Open access
Licence
Locations
  • Nutrients (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • The Atrium (University of Guelph) (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
University of Guelph
Topics
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
  • Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
  • Health Sciences › Health Professions › General Health Professions › Health and Lifestyle Studies
Keywords
exercise addiction, disordered eating, low energy availability, athletes, female athletes, male athletes, stress fractures, sexual dysfunction, bloating, recreational athletes, elite athletes
MeSH terms
Adult, Feeding and Eating Disorders, Energy Intake, Diet, Female, Humans, Male, Surveys and Questionnaires, Wounds and Injuries, Exercise, Gastrointestinal Tract, Fractures, Bone, Young Adult, Athletes, Sports Nutritional Physiological Phenomena

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