Unintentional Underfuelling and Protein Prioritisation: A Multi-Methods Exploration of Nutrition Practices and Behaviours in Female Endurance Athletes

Fortis, HO; Cronin, CJ; Johnson, KO; Shepherd, SO; Hackney, AC; Strauss, JA

Unintentional Underfuelling and Protein Prioritisation: A Multi-Methods Exploration of Nutrition Practices and Behaviours in Female Endurance Athletes

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Fortis, HO, Cronin, CJ ORCID: 0000-0002-1687-4437, Johnson, KO ORCID: 0000-0002-7395-5129, Shepherd, SO, Hackney, AC ORCID: 0000-0002-7437-6225 and Strauss, JA ORCID: 0000-0001-7175-2494 (2025) Unintentional Underfuelling and Protein Prioritisation: A Multi-Methods Exploration of Nutrition Practices and Behaviours in Female Endurance Athletes. Nutrients, 17 (23). pp. 1-26. ISSN 2072-6643

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Publisher URL: https://doi.org/10.3390/nu17233773

Abstract

Background/Objectives: Despite increasing awareness of best sports nutrition practices, discrepancies persist between knowledge and behaviour amongst female endurance athletes. Methods: To understand this discrepancy study investigated dietary practices, macronutrient intakes, and influencing factors using a multi-method approach. Seventy-two female endurance athletes (42 ± 9 y) completed four-day weighed food diaries, and a subset of twenty athletes (40 ± 10 y) then participated in semi-structured interviews. Quantitative analysis revealed that athletes met the lower end of carbohydrate (CHO) guidelines on rest days (3.0 g·kg−1), but intake fell short on training days, with deficits increasing as training volume rose (moderate: −1.4 g·kg−1, high: −3.5 g·kg−1, very high: −5.5 g·kg−1). Despite awareness of CHO’s role in performance, athletes unintentionally underfuelled, leading to a cumulative energy deficit. Energy intake increased by 473 kcal·day−1 per 1000 kcal·day−1 of exercise energy expenditure. In contrast, protein intake was prioritised, with mean in-takes of 1.7 ± 0.7 g·kg−1·day−1 aligning with recommendations. Results: Qualitative findings identified barriers to CHO intake, including time constraints, diet culture influences and body image concerns. Social and environmental factors, such as household environments and professional nutrition guidance, played a critical role in behaviours. Conclusions: These findings highlight the need for practical, evidence-based nutrition interventions to support fe-male endurance athletes. Personalised education addressing CHO requirements, the psychology/emotions around nutrition, and the influence of social environments may bridge the gap between knowledge and practice, optimising both performance and long-term health outcomes.

Item Type:	Article
Uncontrolled Keywords:	Humans; Dietary Carbohydrates; Dietary Proteins; Diet; Health Knowledge, Attitudes, Practice; Feeding Behavior; Energy Metabolism; Energy Intake; Physical Endurance; Adult; Middle Aged; Diet Records; Female; Athletes; Sports Nutritional Physiological Phenomena; carbohydrate intake; dietary behaviour; endurance; energy availability; female athletes; nutrition practices; protein intake; sports nutrition; Humans; Female; Athletes; Adult; Dietary Proteins; Energy Intake; Physical Endurance; Dietary Carbohydrates; Sports Nutritional Physiological Phenomena; Middle Aged; Feeding Behavior; Diet Records; Diet; Health Knowledge, Attitudes, Practice; Energy Metabolism; 32 Biomedical and Clinical Sciences; 3210 Nutrition and Dietetics; 42 Health Sciences; Nutrition; Humans; Female; Athletes; Adult; Dietary Proteins; Energy Intake; Physical Endurance; Dietary Carbohydrates; Sports Nutritional Physiological Phenomena; Middle Aged; Feeding Behavior; Diet Records; Diet; Health Knowledge, Attitudes, Practice; Energy Metabolism; 0908 Food Sciences; 1111 Nutrition and Dietetics; 3202 Clinical sciences; 3210 Nutrition and dietetics; 4206 Public health
Subjects:	T Technology > TX Home economics > TX341 Nutrition. Foods and food supply R Medicine > RC Internal medicine > RC1200 Sports Medicine
Divisions:	Sport and Exercise Sciences
Publisher:	MDPI AG
Date of acceptance:	26 November 2025
Date of first compliant Open Access:	23 December 2025
Date Deposited:	23 Dec 2025 10:30
Last Modified:	23 Dec 2025 10:30
DOI or ID number:	10.3390/nu17233773
URI:	https://researchonline.ljmu.ac.uk/id/eprint/27778

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