Dataset Information

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

ABSTRACT: 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.

SUBMITTER: Logue DM

PROVIDER: S-EPMC7146210 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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

Logue Danielle M DM Madigan Sharon M SM Melin Anna A Delahunt Eamonn E Heinen Mirjam M Donnell Sarah-Jane Mc SM Corish Clare A CA

Nutrients 20200320 3

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 ...[more]

PMID: 32245088

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Project description:The purpose of this narrative review is to identify health and performance consequences associated with LCA in female endurance athletes. The intake of carbohydrates (CHO) before, during, and after exercise has been demonstrated to support sport performance, especially endurance activities which rely extensively on CHO as a fuel source. However, low energy availability (LEA) and low carbohydrate availability (LCA) are common in female athletes. LEA occurs when energy intake is insufficient compared to exercise energy expenditure, and LEA-related conditions (e.g., Female Athlete Triad (Triad) and Relative Energy Deficiency in Sport (RED-S)) are associated with a myriad of health and performance consequences. The RED-S model highlights 10 health consequences and 10 performance consequences related to LEA. The independent effect of LCA on health and performance has been under-researched, despite current CHO intake being commonly insufficient in athletes. It is proposed that LCA may not only contribute to LEA but also have independent health and performance consequences in athletes. Furthermore, this review highlights current recommendations for CHO intake, as well as recent data on LCA prevalence and menstrual cycle considerations. A literature review was conducted on PubMed, Science Direct, and ResearchGate using relevant search terms (i.e., "low carbohydrate/energy availability", "female distance runners"). Twenty-one articles were identified and twelve met the inclusion criteria. The total number of articles included in this review is 12, with 7 studies illustrating that LCA was associated with direct negative health and/or performance implications for endurance-based athletes. Several studies included assessed male athletes only, and no studies included a female-only study design. Overall, the cumulative data show that female athletes remain underrepresented in sports science research and that current CHO intake recommendations and strategies may fail to consider female-specific adaptations and hormone responses, such as monthly fluctuations in estrogen and progesterone throughout the menstrual cycle. Current CHO guidelines for female athletes and exercising women need to be audited and explored further in the literature to support female athlete health and performance.

Project description:BackgroundThe Nutrition for Sport Knowledge Questionnaire (NSKQ) is an 89-item, valid and reliable measure of sports nutrition knowledge (SNK). It takes 25 min to complete and has been subject to low completion and response rates. The aim of this study was to develop an abridged version of the NSKQ (A-NSKQ) and compare response rates, completion rates and NK scores of the NSKQ and A-NSKQ.MethodsRasch analysis was used for the questionnaire validation. The sample (n?=?181) was the same sample that was used in the validation of the full-length NSKQ. Construct validity was assessed using the known-group comparisons method. Temporal stability was assessed using the test-retest reliability method. NK assessment was cross-sectional; responses were collected electronically from members of one non-elite Australian football (AF) and netball club, using Qualtrics Software (Qualtrics, Provo, UT).ResultsValidation - The A-NSKQ has 37 items that assess general (n?=?17) and sports (n?=?20) nutrition knowledge (NK). Both sections are unidimensional (Perc5%?=?2.84% [general] and 3.41% [sport]). Both sections fit the Rasch Model (overall-interaction statistic mean (SD)?=?-?0.15?±?0.96 [general] and 0.22?±?1.11 [sport]; overall-person interaction statistic mean (SD)?=?-?0.11?±?0.61 [general] and 0.08?±?0.73 [sport]; Chi-Square probability?=?0.308 [general] and 0.283 [sport]). Test-retest reliability was confirmed (r?=?0.8, P?<?0.001 [general] and r?=?0.7, P?<?0.001 [sport]). Construct validity was demonstrated (nutrition students?=?77% versus non-nutrition students?=?60%, P?<?0.001 [general] and nutrition students?=?60% versus non-nutrition students?=?40%, P?<?0.001 [sport]. Assessment of NK - 177 usable survey responses from were returned. Response rates were low (7%) but completion rates were high (85%). NK scores on the A-NSKQ (46%) are comparable to results obtained in similar cohorts on the NSKQ (49%). The A-NSKQ took on average 12 min to complete, which is around half the time taken to complete the NSKQ (25 min).ConclusionsThe A-NSKQ is a valid and reliable, brief questionnaire designed to assess general NK (GNK) and SNK.

Project description:BackgroundLow energy availability (EA) can be detrimental for athlete health. Currently, it is not known what the threshold for low EA in men is, and what effects it may have on performance.MethodsThis study was set to determine potential effects of low EA by modulating male participants' exercise energy expenditure and controlling energy intake and consequently manipulating EA in three progressive stages (reducing EA by 25%%, and 75 %). Performance was measured with three specific tests for explosive power, endurance, and agility. Blood was drawn, resting energy expenditure was monitored and two questionnaires were repetitively used to address any changes in eating behaviors and well-being.ResultsRepeated measured design showed poorer performance (power output 391.82 ± 29.60 vs. 402.5 ± 40.03 W, p = 0.001; relative power output 5.53 ± 0.47 vs. 5.60 ± 0.47 W/kg, p = 0.018; explosive power 0.28 ± 0.04 vs. 0.32 ± 0.05 m, p = 0.0001, lactate concentration 7.59 ± 2.29 vs 10.80 ± 2.46 mmol/L, p = 0.001). the quartile range for testosterone was lower (2.33 ± 1.08 vs. 2.67 ± 0.78, p = 0.026) and there was a tendency for lower triiodothyronine (4.15 ± 0.61 vs. 4.46 ± 0.54 pmol/L, p = 0.072). Eating behaviors and well-being were worse (46.64 ± 7.55 vs. 24.58 ± 7.13, p = 0.011 and 15.18 ± 2.44 vs. 17.83 ± 3.54, p = 0.002). The intervention also resulted in lower body fat (8.44 ± 3.15 vs. 10.2 ± 2.5%, p = 0.013).ConclusionsAnalysis showed that most of the negative effects occurred in the range of 9-25 kCal·kg∙FFM·d-1. This is the range where we suggest a threshold for LEA in men could be. Reducing EA impaired explosive power first, then endurance. It was associated with a reduction in testosterone, triiodothyronine and there was a tendency for reduced IGF-1, but hormones were more resilient to changes in EA. Psychological assessment of eating behaviors and well-being proved to be very useful, whereas monitoring resting energy expenditure did not.

Project description:BackgroundNutrition knowledge (NK) is a modifiable determinant of diet intake and can positively influence athletic performance. This study aimed to (1) adapt and translate a validated general and sports NK questionnaire into Arabic (2) assess the NK of Jordanian sportspeople, and (3) evaluate the relationship between NK and various sociodemographic factors.MethodsThe Abridged Nutrition for Sport Knowledge Questionnaire (ANSKQ) was translated into Arabic using forward-backward translation and underwent pilot testing and psychometric validation (internal consistency, test-retest reliability, inter-rater agreement) using a convenience sample of 30 individuals. Following ANSKQ validation, athletes a from 50 sport institutes in Jordan were invited (via email) to complete the Arabic ANSKQ online. Differences in NK based on demographics were analysed using t-test or ANOVA for continuous variables and chi-square tests for categorical variables. The ability of demographic factors to predict NK score-category (poor/good/average/excellent) was assessed using multivariate logistic regression.ResultsThe Arabic ANSKQ had excellent internal consistency (Cronbach's alpha = 0.92), test-retest reliability (Pearson r = 0.926) and inter-rater agreement (Cohen's k statistic = 0.89). A total of 3636 eligible participants completed the Arabic ANSKQ. Participants were mostly athletes (91.4%), female (68.0%), had normal BMI (50.6%), and played high-intensity sports (59.6%). 88.3% of participants had poor NK (<50%). There were statistically significant differences in NK score based on participant role (athlete vs coach), age, gender, BMI, nationality, smoking, years playing sport, sport frequency, sport intensity, and nutrition training. Multivariate modelling showed participant role, BMI, education level, sport frequency and nutrition training were predictors of NK category.ConclusionsIn conclusion, Jordanian sportspeople have poor NK and may benefit from increased nutrition training.

Project description:A questionnaire-based screening tool for male athletes at risk of low energy availability (LEA) could facilitate both research and clinical practice. The present options rely on proxies for LEA such screening tools for disordered eating, exercise dependence, or those validated in female athlete populations. in which the female-specific sections are excluded. To overcome these limitations and support progress in understanding LEA in males, centres in Australia, Norway, Denmark, and Sweden collaborated to develop a screening tool (LEAM-Q) based on clinical investigations of elite and sub-elite male athletes from multiple countries and ethnicities, and a variety of endurance and weight-sensitive sports. A bank of questions was developed from previously validated questionnaires and expert opinion on various clinical markers of LEA in athletic or eating disorder populations, dizziness, thermoregulation, gastrointestinal symptoms, injury, illness, wellbeing, recovery, sleep and sex drive. The validation process covered reliability, content validity, a multivariate analysis of associations between variable responses and clinical markers, and Receiver Operating Characteristics (ROC) curve analysis of variables, with the inclusion threshold being set at 60% sensitivity. Comparison of the scores of the retained questionnaire variables between subjects classified as cases or controls based on clinical markers of LEA revealed an internal consistency and reliability of 0.71. Scores for sleep and thermoregulation were not associated with any clinical marker and were excluded from any further analysis. Of the remaining variables, dizziness, illness, fatigue, and sex drive had sufficient sensitivity to be retained in the questionnaire, but only low sex drive was able to distinguish between LEA cases and controls and was associated with perturbations in key clinical markers and questionnaire responses. In summary, in this large and international cohort, low sex drive was the most effective self-reported symptom in identifying male athletes requiring further clinical assessment for LEA.

Dataset Information

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

Publications

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

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