scholarly journals Effects of Low Energy Availability on Bone Health in Endurance Athletes and High-Impact Exercise as A Potential Countermeasure: A Narrative Review

2020 ◽  
Author(s):  
Mark J. Hutson ◽  
Emma O’Donnell ◽  
Katherine Brooke-Wavell ◽  
Craig Sale ◽  
Richard C. Blagrove
Keyword(s):  
Bone Health ◽  
Bone Structure ◽  
High Impact ◽  
Low Energy ◽  
Endurance Athletes ◽  
Energy Availability ◽  
Stress Injury ◽  
Bone Stress ◽  
Impact Exercise ◽  
Low Energy Availability

AbstractEndurance athletes expend large amounts of energy in prolonged high-intensity exercise and, due to the weight-sensitive nature of most endurance sports, often practice periods of dietary restriction. The Female Athlete Triad and Relative Energy Deficiency in Sport models consider endurance athletes at high-risk for suffering from low energy availability and associated health complications, including an increased chance of bone stress injury. Several studies have examined the effects of low energy availability on various parameters of bone structure and markers of bone (re)modelling; however, there are differences in findings and research methods and critical summaries are lacking. It is difficult for athletes to reduce energy expenditure or increase energy intake (to restore energy availability) in an environment where performance is a priority. Development of an alternative tool to help protect bone health would be beneficial. High-impact exercise can be highly osteogenic and energy efficient; however, at present, it is rarely utilized to promote bone health in endurance athletes. Therefore, with a view to reducing the prevalence of bone stress injury, the objectives of this review are to evaluate the effects of low energy availability on bone health in endurance athletes and explore whether a high-impact exercise intervention may help to prevent those effects from occurring.

scholarly journals Low Energy Availability Associated With Lower BMD And Bone Stress Injury Site In Female Athletes

2018 ◽  
Vol 50 (5S) ◽  
pp. 742-743
Author(s):  
Bryan Holtzman ◽  
Allyson L. Parziale ◽  
Katherine M. Cooper ◽  
Erin Flynn ◽  
Adam S. Tenforde ◽  
...  
Keyword(s):  
Female Athletes ◽  
Low Energy ◽  
Energy Availability ◽  
Stress Injury ◽  
Injury Site ◽  
Bone Stress ◽  
Low Energy Availability

Low Energy Availability And The Female Athlete Triad In Endurance Athletes Versus Controls

2011 ◽  
Vol 43 (Suppl 1) ◽  
pp. 68 ◽  
Author(s):  
Jade Garneau-Fournier ◽  
Nanna Meyer ◽  
Andrew Subudhi ◽  
Jacqueline Berning
Keyword(s):  
Female Athlete ◽  
Low Energy ◽  
Endurance Athletes ◽  
Energy Availability ◽  
Female Athlete Triad ◽  
Low Energy Availability

Low energy availability, menstrual dysfunction, and impaired bone health: A survey of elite para athletes

2019 ◽  
Vol 29 (5) ◽  
pp. 678-685 ◽  
Author(s):  
Emily M. Brook ◽  
Adam S. Tenforde ◽  
Elizabeth M. Broad ◽  
Elizabeth G. Matzkin ◽  
Heidi Y. Yang ◽  
...  
Keyword(s):  
Bone Health ◽  
Low Energy ◽  
Energy Availability ◽  
Menstrual Dysfunction ◽  
Low Energy Availability

scholarly journals Prevalence of Low Energy Availability in Competitively Trained Male Endurance Athletes

Medicina ◽  
2019 ◽  
Vol 55 (10) ◽  
pp. 665 ◽  
Author(s):  
Lane ◽  
Hackney ◽  
Smith-Ryan ◽  
Kucera ◽  
Registar-Mihalik ◽  
...  
Keyword(s):  
Resting Metabolic Rate ◽  
Relative Energy ◽  
Low Energy ◽  
Endurance Athletes ◽  
Risk Level ◽  
Future Research ◽  
Energy Availability ◽  
Energy Deficiency ◽  
Cut Points ◽  
Low Energy Availability

Background and Objectives: Relative energy deficiency in sport (RED-S) has been introduced as a broad-spectrum syndrome leading to possible dysfunction in numerous physiological systems, driven primarily by low energy availability (EA). Research in females has identified specific EA cut-points indicative of risk level for developing physiological and performance disturbances. Cut-points in males have yet to be evaluated. This study examined the prevalence of low EA in competitive (non-elite), recreationally trained (CRT) male endurance athletes. Materials and Methods: Subjects were 108 CRT (38.6 ± 13.8 y; 12.2 ± 5.4 h/wk training) male endurance athletes (runners, cyclists, triathletes) who completed a descriptive survey online via Qualtrics® and returned 3 day diet and exercise training records. EA was calculated from returned surveys and training records. Resting metabolic rate (RMR) and lean body mass (LBM) were estimated from self-reported survey data. Prevalence of risk group was categorized based on the female cut-points: at risk (AR) ≤30 kcal/kg LBM, moderate risk (MR) = 30–45 kcal/kg LBM, or no risk (NR) ≥45 kcal/kg LBM. Results: In this sample, 47.2% (n = 51) were classified as AR, 33.3% (n = 36) as MR, and 19.4% (n = 21) as NR for low EA. Cyclists had lower EA (26.9 ± 17.4 kcal/kg LBM, n = 45) than runners (34.6 ± 13.3 kcal/kg LBM, n = 55, p = 0.016) and all other sport categories (39.5 ± 19.1 kcal/kg LBM, n = 8, p = 0.037). Conclusions: The findings indicate this sample had a high prevalence of risk for low EA, at 47.2%. Only 19.4% of participants were at no risk, meaning ~80% of participants were at some degree of risk of experiencing low EA. Cyclists were at greater risk in this cohort of low EA, although why this occurred was unclear and is in need of further investigation. Future research should address whether the current female cut-points for low EA are appropriate for use in male populations.

scholarly journals Inducing low energy availability in trained endurance male athletes results in poorer explosive power

2021 ◽  
Author(s):  
Iva Jurov ◽  
Nicola Keay ◽  
Darjan Spudić ◽  
Samo Rauter
Keyword(s):  
Energy Expenditure ◽  
Resting Energy Expenditure ◽  
Well Being ◽  
Low Energy ◽  
Endurance Athletes ◽  
Energy Availability ◽  
Explosive Power ◽  
Cognitive Restriction ◽  
Low Energy Availability ◽  
Resting Energy

Abstract Purpose Low energy availability in males needs more original research to understand its health and performance consequences. The aim of the study was to induce low energy availability in previously healthy male endurance athletes by reducing energy availability by 25% for 14 consecutive days and measure any potential changes in performance, health, mental state or energy markers. Methods Energy availability was reduced in 12 trained, well-trained and elite endurance athletes by increasing energy expenditure and controlling energy intake. After intervention, health was assessed by blood draw, body composition was measured, energy markers by measuring resting energy expenditure, performance with three specific tests (measuring endurance, agility and explosive power) and two questionnaires were used for psychological assessment (the Three Factor Eating Questionnaire and Well-being questionnaire). Results Reduced energy availability (22.4 ± 6.3 kcal/kg FFM/day) caused significantly lower haemoglobin values (t(12) = 2.652, p = 0.022), there was a tendency for lower iron and IGF-1 (p = 0.066 and p = 0.077, respectively). Explosive power was reduced (t(12) = 4.570, p = 0.001), lactate metabolism was altered and athletes reported poorer well-being (t(12) = 2.385, p = 0.036). Cognitive restriction was correlated with energy availability (r = 0.528, p = 0.039). Conclusion This is the first research providing direct evidence that suboptimal energy availability negatively impacts explosive power before hormonal changes occur in male endurance athletes. It is also the first to show direct association of low energy availability and higher cognitive restriction. We also observed worse well-being and lower haemoglobin values. 25% of energy availability reduction as not enough to elicit changes in resting energy expenditure.

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

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2601
Author(s):  
Megan A. Kuikman ◽  
Margo Mountjoy ◽  
Jamie F. Burr
Keyword(s):  
Disordered Eating ◽  
Female Athletes ◽  
Signs And Symptoms ◽  
Low Energy ◽  
Exercise Dependence ◽  
Energy Availability ◽  
Recreational Athletes ◽  
Bone Stress ◽  
Increased Risk ◽  
Low Energy Availability

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.

scholarly journals Male Flat Jockeys Do Not Display Deteriorations in Bone Density or Resting Metabolic Rate in Accordance With Race Riding Experience: Implications for RED-S

2018 ◽  
Vol 28 (4) ◽  
pp. 434-439 ◽  
Author(s):  
George Wilson ◽  
Dan Martin ◽  
James P. Morton ◽  
Graeme L. Close
Keyword(s):  
Lumbar Spine ◽  
Metabolic Rate ◽  
Bone Health ◽  
Resting Metabolic Rate ◽  
Low Energy ◽  
Fat Free Mass ◽  
Published Data ◽  
Energy Availability ◽  
Mineral Density ◽  
Low Energy Availability

Despite consistent reports of poor bone health in male jockeys, it is not yet known if this is a consequence of low energy availability or lack of an osteogenic stimulus. Given the rationale that low energy availability is a contributing factor in low bone health, we tested the hypothesis that both hip and lumbar bone mineral density (BMD) should progressively worsen in accordance with the years of riding. In a cross-sectional design, male apprentice (n = 17) and senior (n = 14) jockeys (matched for body mass and fat-free mass) were assessed for hip and lumbar spine BMD, as well as both measured and predicted resting metabolic rate (RMR). Despite differences (p < .05) in years of race riding (3.4 ± 2 vs. 16.3 ± 6.8), no differences were apparent (p > .05) in hip (−0.9 ± 1.1 vs. −0.8 ± 0.7) and lumbar Z-scores (−1.3 ± 1.4 vs. −1.5 ± 1) or measured RMR (1,459 ± 160 vs. 1,500 ± 165 kcal/day) between apprentices and senior jockeys, respectively. Additionally, years of race riding did not demonstrate any significant correlations (p > .05) with either hip or lumbar spine BMD. Measured RMR was also not different (p > .05) from predicted RMR in either apprentice (1,520 ± 44 kcal/day) or senior jockeys (1,505 ± 70 kcal/day). When considered with previously published data examining underreporting of energy intake and direct assessments of energy expenditure, we suggest that low BMD in jockeys is not due to low energy availability per se but rather the lack of an osteogenic stimulus associated with riding.

scholarly journals The Role of Energy Availability in Reproductive Function in the Female Athlete Triad and Extension of its Effects to Men: An Initial Working Model of a Similar Syndrome in Male Athletes

2019 ◽  
Vol 49 (S2) ◽  
pp. 125-137 ◽  
Author(s):  
Mary Jane De Souza ◽  
Kristen J. Koltun ◽  
Nancy I. Williams
Keyword(s):  
Bone Health ◽  
Female Athlete ◽  
Reproductive Function ◽  
Low Energy ◽  
Energy Availability ◽  
Female Athlete Triad ◽  
Male Athlete ◽  
Menstrual Dysfunction ◽  
Working Model ◽  
Low Energy Availability

Abstract The Female Athlete Triad represents three interrelated conditions of (i) low energy availability (energy deficiency), presenting with or without disordered eating, (ii) menstrual dysfunction, and (iii) poor bone health, each of which can exist along a continuum of severity ranging from mild and moderate subclinical health concerns to severe clinical outcomes, including eating disorders, amenorrhea, and osteoporosis. This review provides a brief overview of the Female Athlete Triad, including updating the current thinking regarding energy availability and how it relates to reproductive function, and sets the stage for an initial working model of a similar syndrome in males that will be based on currently available evidence and will later be defined and referred to as a Male Athlete Triad by the newly re-named Female and Male Athlete Triad Coalition. A primary focus of this paper will be on the physiology of each Triad model with an emphasis on low energy availability and its role in reproductive function, with a brief introduction on its effects on bone health in men. From the data reviewed, (i) a specific threshold of energy availability below which menstrual disturbances are induced is not supported; (ii) it appears that the energetic, reproductive, and bone systems in men are more resilient to the effects of low energy availability compared to those of women, requiring more severe energetic perturbations before alterations are observed; and (iii) it appears that recovery of the hypothalamic pituitary gonadal axis can be observed more quickly in men than in women.

scholarly journals Body Composition, Dietary Intake and the Risk of Low Energy Availability in Elite-Level Competitive Rhythmic Gymnasts

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 2083
Author(s):  
María Villa ◽  
José G. Villa-Vicente ◽  
Jesus Seco-Calvo ◽  
Juan Mielgo-Ayuso ◽  
Pilar S. Collado
Keyword(s):  
Body Composition ◽  
Dietary Intake ◽  
Body Fat ◽  
Low Energy ◽  
Energy Availability ◽  
Future Health ◽  
Elite Level ◽  
Low Energy Availability ◽  
Rhythmic Gymnasts ◽  
Recommended Level

The aim of this study was to analyze dietary intake and body composition in a group of elite-level competitive rhythmic gymnasts from Spain. We undertook body composition and nutritional analysis of 30 elite gymnasts, divided into two groups by age: pre-teen (9–12 years) (n = 17) and teen (13–18 years) (n = 13). Measures of height, weight, and bioimpedance were used to calculate body mass index and percent body fat. Energy and nutrient intakes were assessed based on 7-day food records. The two groups had similar percentages of total body fat (pre-teen: 13.99 ± 3.83% vs. teen: 14.33 ± 5.57%; p > 0.05). The energy availability values for pre-teens were above the recommended values (>40 kcal/FFM/day) 69.38 ± 14.47 kcal/FFM/day, while those for the teens were much lower (34.7 ± 7.5 kcal/FFM/day). The distribution of the daily energy intake across the macronutrients indicates that both groups ingested less than the recommended level of carbohydrates and more than the recommended level of fat. Very low intakes of calcium and vitamin D among other micronutrients were also noted. The main finding is that teenage gymnasts do not consume as much energy as they need each day, which explains their weight and development. Moreover, they are at a high risk of developing low energy availability that could negatively impact their performance and future health.

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