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

Heikura, IA, Stellingwerff, T and Areta, JL (2021) Low energy availability in female athletes: From the lab to the field. European Journal of Sport Science. ISSN 1536-7290

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LEA in Females-EJSS invited review-Revision 18-03-21 with author names (2).pdf - Accepted Version
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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.HIGHILIGHTS Direct application of short-term laboratory-based findings in the field is problematic.Calculation of energy availability (EA) in the field is methodologically challenging and prone to errors.The use of several biomarkers may allow the detection of early exposure to low EA in the female athlete.

Item Type: Article
Additional Information: “This is an Accepted Manuscript version of the following article, accepted for publication in European Journal of Sport Science. Ida A. Heikura,Trent Stellingwerff & Jose L. Areta. Low energy availability in female athletes: From the lab to the field. European Journal of Sport Science. https://dx.doi.org/10.1080/17461391.2021.1915391 It is deposited under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Uncontrolled Keywords: 0913 Mechanical Engineering, 1106 Human Movement and Sports Sciences
Subjects: Q Science > QP Physiology
R Medicine > RC Internal medicine > RC1200 Sports Medicine
Divisions: Sport & Exercise Sciences
Publisher: Taylor & Francis
Related URLs:
Date Deposited: 23 Jun 2021 08:38
Last Modified: 04 Sep 2021 05:19
DOI or Identification number: 10.1080/17461391.2021.1915391
URI: https://researchonline.ljmu.ac.uk/id/eprint/15167

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