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Open AccessReview

Low Energy Availability in Athletes 2020: An Updated Narrative Review of Prevalence, Risk, Within-Day Energy Balance, Knowledge, and Impact on Sports Performance

1
School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, V04 V1W8 Dublin 4, Ireland
2
Sport Ireland Institute, Sports Campus Ireland, Abbotstown, D15 PNON Dublin, Ireland
3
Department of Sports Science, Linnaeus University, 392 34 Kalmar, Sweden
4
School of Public Health, Physiotherapy and Sports Science and Institute for Sport and Health, University College Dublin, V04 V1W8 Dublin, Ireland
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Assistant Professor Mirjam Heinen, School of Public Health, Physiotherapy and Sports Science, University College Dublin, V04 V1W8 Dublin, Ireland
6
Associate Professor Clare Corish, School of Public Health, Physiotherapy and Sports Science, University College Dublin, V04 V1W8 Dublin, Ireland
*
Author to whom correspondence should be addressed.
Nutrients 2020, 12(3), 835; https://doi.org/10.3390/nu12030835
Received: 27 February 2020 / Revised: 14 March 2020 / Accepted: 18 March 2020 / Published: 20 March 2020
(This article belongs to the Special Issue Nutrition for Human Health, Performance and Recovery)
Low energy availability (EA) underpins the female and male athlete triad and relative energy deficiency in sport (RED-S). The condition arises when insufficient calories are consumed to support exercise energy expenditure, resulting in compromised physiological processes, such as menstrual irregularities in active females. The health concerns associated with longstanding low EA include menstrual/libido, gastrointestinal and cardiovascular dysfunction and compromised bone health, all of which can contribute to impaired sporting performance. This narrative review provides an update of our previous review on the prevalence and risk of low EA, within-day energy deficiency, and the potential impact of low EA on performance. The methods to assess EA remain a challenge and contribute to the methodological difficulties in identifying “true” low EA. Screening female athletic groups using a validated screening tool such as the Low Energy Availability in Females Questionnaire (LEAF-Q) has shown promise in identifying endurance athletes at risk of low EA. Knowledge of RED-S and its potential implications for performance is low among coaches and athletes alike. Development of sport and gender-specific screening tools to identify adolescent and senior athletes in different sports at risk of RED-S is warranted. Education initiatives are required to raise awareness among coaches and athletes of the importance of appropriate dietary strategies to ensure that sufficient calories are consumed to support training. View Full-Text
Keywords: low energy availability; relative energy deficiency in sport; health and performance low energy availability; relative energy deficiency in sport; health and performance
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MDPI and ACS Style

Logue, D.M.; Madigan, S.M.; Melin, A.; Delahunt, E.; Heinen, M.; Donnell, S.-J.M.; Corish, C.A. Low Energy Availability in Athletes 2020: An Updated Narrative Review of Prevalence, Risk, Within-Day Energy Balance, Knowledge, and Impact on Sports Performance. Nutrients 2020, 12, 835.

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