Energy availability in athletes: How important is the concept of inadequate energy intake?
Energy availability in athletes is a growing area of focus for sports nutritionists. But how important is the concept of inadequate energy intake for both health and performance?
- Background & Objective
- What They Did
- What They Found
- Practical Takeaways
- Reviewer’s Comments
- About the Reviewer
Charlton, B. T., Forsyth, S., & Clarke, D. C. (2022). Low Energy Availability and Relative Energy Deficiency in Sport: What Coaches Should Know. International Journal of Sports Science & Coaching, 17479541211054458.
Background & Objective
I have worked in professional sport for nine years now and have certainly seen elements of disordered eating and eating disorders with the athletes I have supported in rugby, football and boxing. I’m not convinced many of the athletes knew they had various traits of disordered eating patterns, nonetheless, let’s dive into this area a little deeper.
Since 1992, the term Female Athlete Triad has been used to describe the combination of amenorrhea, osteoporosis, and disordered eating. However, developments have been made and as of 2007, the Triad is now described as a disorder that features menstrual dysfunction, altered bone health and low energy availability (LEA) with or without an eating disorder.
In 2014, the International Olympic committee produced a consensus statement which encompasses the full scope of this symptomology and was given a new term, the Relative Energy Deficiency in Sport (RED-S). Importantly it was highlighted that this new framework includes males and recreational athletes. The video link below is an outstanding listen on this.
The purpose of this review was to synthesise available evidence and provide coaches with the scientific basis underlying the concepts of LEA disorders. An overview of RED-S is provided and importantly nutritional guidelines to help prevent LEA.
What They Did
The authors synthesised evidence from peer-reviewed studies published between 1986 and 2021 that they believe are essential for coaches to know so they can better guide their athletes and prevent LEA.
The review is split into the following sections:
- The female athlete triad and relative energy deficiency in sport: diagnosis, mechanism, and prevalence
- Performance and health impairments of LEA and RED-S which is then further broken down to:
A) Hormonal and metabolic function
B) Bone health
C) Cognitive ability and mental health
- Nutritional practices to help prevent LEA and RED-S
- Monitoring athletes for risk of LEA
- Supporting athletes at risk of LEA
What They Found
James Morehen’s Comments
“All athletes are at risk of LEA but is it a problem for everyone? Some of the boxers I work with experience elements of under-fuelling, but this is strategically planned into their overall nutritional strategy to help them make weight. Personally, I think acute bouts of LEA are ok, but if this transitions into chronic periods of time, then that’s when the health and performance problems will arise.
“As nutritionists, we are uniquely positioned to be able to spot the early signs of eating disorders or disordered eating before these manifest into LEA and RED-S. I would encourage other practitioners to quickly get to know their athletes’ habitual eating behaviours at meal times and observe if these change from the norm.”
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