Energy Availability in Male and Female Elite Wheelchair Athletes over Seven Consecutive Training Days

Abstract

Background: Low energy availability (LEA) is a major problem as athletes often restrict their energy intake. It has been shown that LEA occurs often in female and endurance athletes and in athletes from weight-sensitive or aesthetic sports. The purpose of this study was to investigate energy availability (EA) in elite wheelchair athletes. Methods: Fourteen elite wheelchair athletes (8 males; 6 females) participated. Data were collected using a weighed seven-day food and training diary to estimate energy intake and exercise energy expenditure. Resting energy expenditure and body composition were measured, whereas energy balance (EB) was calculated. Results: Measured over 7 days, EA was significantly different (36.1 ± 6.7 kcal kg−1 FFM day−1) in male compared to female (25.1 ± 7.1 kcal kg−1 FFM day−1) athletes (p < 0.001). From all analyzed days, LEA occurred in 73% of the days in female athletes and in 30% of the days in male athletes. EB was positive in male athletes (+169.1 ± 304.5 kcal) and negative (−288.9 ± 304.8 kcal) in female athletes. Conclusions: A higher prevalence of LEA was found in female compared to male athletes. A higher energy intake would be recommended to meet energy needs and to maximize training adaptation.

Risk of Low Energy Availability in National and International Level Paralympic Athletes: An Exploratory Investigation

“…Assessing EA in the field in AB athletes presents many opportunities for error, as calculating EA via EI and EEE recording is challenging and lacks sensitivity as a preferred diagnostic tool for the assessment of LEA [ 5 , 14 ]. While food records have been found to be the most preferred method of obtaining estimates of EI, the approach is also highly variable and prone to under-reporting, which may account for 10–45% variability in energy intake [ 30 , 31 ], especially when athletes are unfamiliar with the practice of intricate daily food recording of metrics around training [ 32 ].…”

“…Two female participants were considered to have moderate 7-day average EA (30–45 kcal·kg FFM −1 ·day −1 ), while the other six participants were considered to have optimal 7-day average EA (>45 kcal·kg FFM −1 ·day −1 ), but very large day to day variability existed, with some individuals demonstrating low EA on certain days ( Figure 1 ). However, it should be noted that these thresholds for EA were developed in recreationally active AB females with full body functioning FFM, which may not be relevant for the para-athlete [ 14 ]. Indeed, most wheelchair athletes will present with lower body muscle atrophy, resulting in reduced whole-body FFM—thus, our calculated EA values in this cohort are likely to be artificially elevated in relation to AB clinical EA cut-offs.…”

“…Table 1 highlights the procedures, adapted from Heikura et al (2018), for estimating EI and EEE. Dietary intake and activity were recorded by participants, whom were instructed and reminded (via a training video) to maintain typical habits, over seven consecutive days [ 5 , 14 ]. Upon completion of the food log, a registered dietitian nutritionist (RDN) reviewed the food journals and had an opportunity to clarify any questions pertaining to food portions/intake from participants, and then entered data into nutrient analysis software (Elizabeth Stewart Hands and Associates (ESHA) Food Processor, Salem, OR, USA) to analyze caloric intake and macronutrients, including fiber.…”

“…The heterogenous nature of this population makes it difficult to determine a generalized LEA threshold, but these differences (between AB and para-athletes, and within the para-athlete population due to injury-related factors) underscore the importance of this research in order to provide safe and effective nutrition recommendations unique to the para-athlete [ 11 , 12 , 13 ]. Egger et al (2020) examined the prevalence of LEA in ( n = 14) elite wheelchair athletes over a seven-day period and found a higher prevalence of LEA in female athletes than males, with LEA occurring on 73% and 30% of days, respectively [ 14 ]. However, the impact and prevalence of LEA symptoms in para-athletes needs further investigation, with the consideration of baseline effects of the athlete’s underlying impairment and the impact this may have on the assessment process [ 2 , 11 ].…”

“…However, the impact and prevalence of LEA symptoms in para-athletes needs further investigation, with the consideration of baseline effects of the athlete’s underlying impairment and the impact this may have on the assessment process [ 2 , 11 ]. As the Paralympic movement continues to grow, this research is warranted to provide assessment and treatment recommendations for the sports medicine team and coaches [ 11 , 14 ]. Therefore, this exploratory investigation aimed to examine elements of RED-S symptom prevalence and the assessment process of LEA including menstrual health, hormonal disturbances, bone mineral density (BMD), and metabolic and physiological functioning amongst national and international level para-athletes.…”