» Articles » PMID: 28983802

Low Energy Availability in Athletes: A Review of Prevalence, Dietary Patterns, Physiological Health, and Sports Performance

Overview
Journal Sports Med
Specialty Orthopedics
Date 2017 Oct 7
PMID 28983802
Citations 75
Authors
Affiliations
Soon will be listed here.
Abstract

In a high-performance sports environment, athletes can present with low energy availability (LEA) for a variety of reasons, ranging from not consuming enough food for their specific energy requirements to disordered eating behaviors. Both male and female high-performance athletes are at risk of LEA. Longstanding LEA can cause unfavorable physiological and psychological outcomes which have the potential to impair an athlete's health and sports performance. This narrative review summarizes the prevalence of LEA and its associations with athlete health and sports performance. It is evident in the published scientific literature that the methods used to determine LEA and its associated health outcomes vary. This contributes to poor recognition of the condition and its sequelae. This review also identifies interventions designed to improve health outcomes in athletes with LEA and indicates areas which warrant further investigation. While return-to-play guidelines have been developed for healthcare professionals to manage LEA in athletes, behavioral interventions to prevent the condition and manage its associated negative health and performance outcomes are required.

Citing Articles

International society of sports nutrition position stand: nutrition and weight cut strategies for mixed martial arts and other combat sports.

Ricci A, Evans C, Stull C, Peacock C, French D, Stout J J Int Soc Sports Nutr. 2025; 22(1):2467909.

PMID: 40059405 PMC: 11894756. DOI: 10.1080/15502783.2025.2467909.


Nutrition educational interventions for athletes related to low energy availability: A systematic review.

DeJong Lempke A, Reece L, Whitney K PLoS One. 2025; 20(2):e0314506.

PMID: 39951403 PMC: 11828352. DOI: 10.1371/journal.pone.0314506.


The Role of Nutrition in Maintaining the Health and Physical Condition of Sports Volunteers.

Rozmiarek M Nutrients. 2024; 16(19).

PMID: 39408303 PMC: 11479065. DOI: 10.3390/nu16193336.


Energy availability and its association with health-related outcomes among national athletes at risk of relative energy deficiency in sports (REDs).

Marzuki M, Jamil N, Mohamad M, Chai W, Farah N, Safii N BMJ Open Sport Exerc Med. 2024; 10(4):e002193.

PMID: 39371412 PMC: 11448153. DOI: 10.1136/bmjsem-2024-002193.


Does Relative Energy Deficiency in Sport (REDs) Syndrome Exist?.

Jeukendrup A, Areta J, Van Genechten L, Langan-Evans C, Pedlar C, Rodas G Sports Med. 2024; 54(11):2793-2816.

PMID: 39287777 PMC: 11561064. DOI: 10.1007/s40279-024-02108-y.


References
1.
De Souza M, Miller B, Loucks A, Luciano A, Pescatello L, Campbell C . High frequency of luteal phase deficiency and anovulation in recreational women runners: blunted elevation in follicle-stimulating hormone observed during luteal-follicular transition. J Clin Endocrinol Metab. 1998; 83(12):4220-32. DOI: 10.1210/jcem.83.12.5334. View

2.
Martin B, Golden E, Carlson O, Egan J, Mattson M, Maudsley S . Caloric restriction: impact upon pituitary function and reproduction. Ageing Res Rev. 2008; 7(3):209-24. PMC: 2634963. DOI: 10.1016/j.arr.2008.01.002. View

3.
Hoch A, Dempsey R, Carrera G, Wilson C, Chen E, Barnabei V . Is there an association between athletic amenorrhea and endothelial cell dysfunction?. Med Sci Sports Exerc. 2003; 35(3):377-83. DOI: 10.1249/01.MSS.0000053661.27992.75. View

4.
Mackinnon L . Special feature for the Olympics: effects of exercise on the immune system: overtraining effects on immunity and performance in athletes. Immunol Cell Biol. 2000; 78(5):502-9. DOI: 10.1111/j.1440-1711.2000.t01-7-.x. View

5.
El Ghoch M, Soave F, Calugi S, Dalle Grave R . Eating disorders, physical fitness and sport performance: a systematic review. Nutrients. 2013; 5(12):5140-60. PMC: 3875919. DOI: 10.3390/nu5125140. View