Low energy availability in female athletes : From the lab to the field

Journal article


Heikura, Ida A., Stellingwerff, Trent and Areta, Jose L.. (2022). Low energy availability in female athletes : From the lab to the field. European Journal of Sport Science. 22(5), pp. 709-719. https://doi.org/10.1080/17461391.2021.1915391
AuthorsHeikura, Ida A., Stellingwerff, Trent and Areta, Jose L.
Abstract

Decades of laboratory research have shown impairments to several body systems after only 4–5 days of strictly controlled consistent low energy availability (LEA); where energy availability (EA) = Energy Intake (EI) − Exercise Energy Expenditure (EEE)/Fat-Free Mass. Meanwhile, cross-sectional reports exist on the interrelatedness of LEA, menstrual dysfunction and impaired bone health in females (the Female Athlete Triad). These findings have demonstrated that LEA is the key underpinning factor behind a broader set of health and performance outcomes, recently termed as Relative Energy Deficiency in Sport (RED-S). There is utmost importance of early screening and diagnosis of RED-S to avoid the development of severe negative health and performance outcomes. However, a significant gap exists between short-term laboratory studies and cross-sectional reports, or clinically field-based situations, of long-term/chronic LEA and no definitive, validated diagnostic tests for RED-S exist. This review aims to highlight methodological challenges related to the assessment of the components of EA equation in the field (e.g. challenges with EI and EEE measures). Due to the uncertainty of these parameters, we propose the use of more chronic “objective” markers of LEA (i.e. blood markers). However, we note that direct extrapolations of laboratory-based outcomes into the field are likely to be problematic due to potentially poor ecological validity and the extreme variability in most athlete’s daily EI and EEE. Therefore, we provide a critical appraisal of the scientific literature, highlighting research gaps, and a potential set of leading objective RED-S markers while working in the field.

Keywordslow energy availability; relative energy deficiency in sport; diagnosis; female athletes
Year2022
JournalEuropean Journal of Sport Science
Journal citation22 (5), pp. 709-719
PublisherRoutledge
ISSN1746-1391
Digital Object Identifier (DOI)https://doi.org/10.1080/17461391.2021.1915391
PubMed ID33832385
Scopus EID2-s2.0-85105130216
Open accessPublished as green open access
Page range709-719
Author's accepted manuscript
License
File Access Level
Open
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online03 May 2021
Publication process dates
Accepted09 Apr 2021
Deposited17 Nov 2021
Permalink -

https://acuresearchbank.acu.edu.au/item/8x155/low-energy-availability-in-female-athletes-from-the-lab-to-the-field

Download files


Author's accepted manuscript
AM_Heikura_2022_Low_energy_availability_in_female_athletes.pdf
License: CC BY-NC-ND 4.0
File access level: Open

Restricted files

Publisher's version

  • 63
    total views
  • 315
    total downloads
  • 2
    views this month
  • 10
    downloads this month
These values are for the period from 19th October 2020, when this repository was created.

Export as

Related outputs

Energetic demands and nutritional strategies of elite cross-country skiers during Tour de Ski : A narrative review
Heikura, Ida A., Kettunen, Oona, Garthe, Ina, Holmlund, Heidi, Sandbakk, Silvana Bucher, Valtonen, Maarit and Ihalainen, Johanna K.. (2021). Energetic demands and nutritional strategies of elite cross-country skiers during Tour de Ski : A narrative review. Journal of Science in Sport and Exercise. 3(3), pp. 224-237. https://doi.org/10.1007/s42978-020-00105-x
Neither beetroot juice supplementation nor increased carbohydrate oxidation enhance economy of prolonged exercise in elite race walkers
Burke, Louise M., Hall, Rebecca, Heikura, Ida A., Ross, Megan L., Tee, Nicolin, Kent, Georgina L., Whitfield, Jamie, Forbes, Sara F., Sharma, Avish P., Jones, Andrew M., Peeling, Peter, Blackwell, Jamie R., Mujika, Iñigo, Mackay, Karen, Kozior, Marta, Vallance, Brent and McKay, Alannah K. A.. (2021). Neither beetroot juice supplementation nor increased carbohydrate oxidation enhance economy of prolonged exercise in elite race walkers. Nutrients. 13(8), p. Article 2767. https://doi.org/10.3390/nu13082767
Acute ketogenic diet and ketone ester supplementation impairs race walk performance
Whitfield, Jamie, Burke, Louise M., McKay, Alannah K. A., Heikura, Ida A., Hall, Rebecca, Fensham, Nikita and Sharma, Avish P.. (2021). Acute ketogenic diet and ketone ester supplementation impairs race walk performance. Medicine and Science in Sports and Exercise. 53(4), pp. 776-784. https://doi.org/10.1249/MSS.0000000000002517
Sustained Exposure to High Carbohydrate Availability Does Not Influence Iron-Regulatory Responses in Elite Endurance Athletes
McKay, A., Peeling, P., Pyne, D.B., Tee, N., Welveart, M., Heikura, I., Sharma, A.P., Whitfield, J., Ross, M., van Swelm, R.P.L., Laarakkers, C.M. and Burke, L.. (2021). Sustained Exposure to High Carbohydrate Availability Does Not Influence Iron-Regulatory Responses in Elite Endurance Athletes. International Journal of Sport Nutrition and Exercise Metabolism. 31(2), pp. 101-108. https://doi.org/10.1123/ijsnem.2020-0224
Adaptation to Low Carbohydrate High Fat diet is rapid but impairs endurance exercise metabolism and performance despite enhanced glycogen availability
Burke, Louise M., Whitfield, Jamie, Heikura, Ida A., Ross, Megan L. R., Tee, Nicolin, Forbes, Sara F., Hall, Rebecca, McKay, Alannah K. A., Wallett, Alice M. and Sharma, Avish P.. (2021). Adaptation to Low Carbohydrate High Fat diet is rapid but impairs endurance exercise metabolism and performance despite enhanced glycogen availability. Journal of Physiology. 599(3), pp. 771-790. https://doi.org/10.1113/JP280221
Low energy availability is difficult to assess but outcomes have large impact on bone injury rates in elite distance athletes
Heikura, Ida A., Uusitalo, Arja L. T., Stellingwerff, Trent, Bergland, Dan, Mero, Antti A. and Burke, Louise M.. (2018). Low energy availability is difficult to assess but outcomes have large impact on bone injury rates in elite distance athletes. International Journal of Sport Nutrition and Exercise Metabolism. 28(4), pp. 403-411. https://doi.org/10.1123/ijsnem.2017-0313
Self-reported periodization of nutrition in elite female and male runners and race walkers
Heikura, Ida, Stellingwerff, Trent and Burke, Louise. (2018). Self-reported periodization of nutrition in elite female and male runners and race walkers. Frontiers in Physiology. 9, pp. 1 - 16. https://doi.org/10.3389/fphys.2018.01732