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Risk and prevention of low energy availability (LEA) in female athletes

15 / 07 / 19

Finding: Despite severe negative health and performance consequences, awareness of low energy availability in female athletes is low.

Summary: This review examines the factors contributing to low energy availability in female athletes and offers practical tips for working with female athletes.

Low energy availability (LEA) is the amount of energy per kg of fat-free mass that is remaining after energy expended during exercise. When this is too low, it can lead to suboptimal physiological function, altered hormone levels and eventual amenorrhoea (loss of menstruation).

Related to the previous described ‘athlete triad’, LEA has adverse impacts on bone health and reproductive function. Prevalence rates vary from 2% in club-level endurance athletes to 77% in professional ballet dancers. The mismatch between energy needs and food intake can occur due to purposeful restriction for performance or aesthetic reasons or unintentionally through high training demands and lack of knowledge about an appropriate diet to meet the demands of their sport, such as following a ketogenic diet.

Appetite and food intake can be influenced by hormonal factors across cross the menstrual cycle and training phases. Appetite does not increase with training volume so increasing energy dense foods and liquid based recovery options can be helpful.

Citation: Black K, Baker D, Sims S. Nutritional needs of the female athlete: risk and prevention of low energy availability. Strength and Conditioning Journal. 2019 Feb DOI: 10.1519/SSC.0000000000000464