Low Energy Availability and Relative Energy Deficiency in Sport: What Coaches Should Know

Charlton, Braeden T.; Forsyth, Sara; Clarke, David

doi:10.1177/17479541211054458

Cited by 14 publications

(16 citation statements)

References 209 publications

(550 reference statements)

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“…Females were thought to be more vulnerable to LEA than males, as most studies on body dissatisfaction, restrictive dieting, and eating disorders focused on female athletes [ 21 ]. Furthermore, a more severe energy deficiency or LEA state is required to affect male reproductive and skeletal health compared to females [ 6 , 22 ]. However, further research is needed to clarify and quantify this relationship.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Relative Energy Deficiency in Sport (RED-S) among National Athletes in Malaysia

et al. 2023

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Relative energy deficiency in sport (RED-S), which underpins the concept of low energy availability (LEA), can negatively affect athletes’ health and performance. This study aims to investigate the prevalence of RED-S among national athletes in Malaysia. A total of 192 national athletes (97 males, 18–39 years old) responded to an online survey regarding the RED-S risk. Most athletes (67.2%) were classified as having a medium/high RED-S risk. Female (41.2%), weight-class (23.9%), and intermittent sports (20.3%) had the highest prevalence of medium/high RED-S risk. Overall, most athletes spent 2–5 h daily (55.2%) and 6–7 days weekly (53.6%) practicing or playing their sport, and 47.9% reported feeling tired recently. The athletes were also terrified of being overweight (61.5%), worried about what they eat (64.7%), concerned about having fat on their bodies (62.6%), and thinking about burning calories while exercising (69.3%). Only 16.7% of the athletes had a prior history of stress fractures, and 40.6% continued to participate in activities 6–7 days per week while injured. The majority of female athletes (88.3%) had regular menstrual cycles. These findings support the notion that RED-S screening should be addressed in the athletic community. Future research is needed to clinically assess these athletes and investigate the impacts of RED-S on their health and sports performance.

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Section: Discussionmentioning

confidence: 99%

Prevalence of Relative Energy Deficiency in Sport (RED-S) among National Athletes in Malaysia

et al. 2023

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“…There is increased recognition of the need for cultural change and systematic structural modifications in sport to better protect athlete health. 6,18,22,23 This work has commenced in some sports (e.g. Gymnastics Australia Body Positive Guidelines, 24 Australian Institute of Sport Disordered Eating in High Performance Sport 11 ).…”

Section: Directions For Enhancing Coach Knowledge Attitudes Beliefs A...mentioning

confidence: 99%

“…sports medicine physician, sports dietician) to appropriately manage athletes with or at risk of LEA. 6,11,13,18 This review suggests that strategies to enhance coach, knowledge/attitudes, beliefs and behaviours towards LEA are likely to require a sport specific focus. That is, considering the context in which coaches work, exploring formal and informal learning opportunities, offering seminars and workshops, creating awareness campaigns, understanding coach–athlete relationships, and addressing gender imbalances in the coaching environment.…”

Section: Directions For Enhancing Coach Knowledge Attitudes Beliefs A...mentioning

confidence: 99%

“…coaches) are appropriately educated and supported. 18,19 Since coaches play an important role in an athlete's performance trajectory, it is crucial there is a clear understanding of their current knowledge regarding LEA. To date this has not been consolidated in a review of existing evidence.…”

Section: Introductionmentioning

confidence: 99%

“…[15][16][17] Coaches have continuous engagement with athletes, hence can play a purposeful role to mitigate risks, detect and support the management of LEA and associated health complications. 11,[17][18][19] Ideally, coaches should provide supportive environments, encouraging exercise and eating behaviours that lead to performance optimisation and long-term health. 11,13,19,20 However, some coaches have been identified to prioritise 'high performance' at the cost of long-term health and wellbeing of their athletes.…”

Section: Introductionmentioning

confidence: 99%

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A review exploring coach knowledge, attitudes/beliefs and behaviours towards low energy availability in athletes

Hamer

Desbrow

Irwin

2022

International Journal of Sports Science & Coaching

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Coaches are important figures of influence with potential to create environments that influence athlete health and performance outcomes. Ideally, coaches provide supportive environments that lead to performance optimisation and long-term health. Coaches who employ language and behaviours that overemphasise body composition and/or provide misinformed nutrition advice may predispose athletes to low energy availability (LEA) and the associated health consequences. Having a clear understanding of current knowledge, attitudes and beliefs of coaches with regard to LEA is required to guide future coach education/support initiatives to optimise athlete health and performance. Thus, the aim of this investigation was to systematically review published literature regarding coach knowledge, attitudes/beliefs and behaviours of LEA. Data from 20 eligible studies was extracted into predetermined categories according to coach ‘knowledge‘; ‘attitudes/ beliefs’; and ‘behaviours’ regarding LEA/Relative Energy Deficiency in Sport/Female Athlete Triad and/or eating disorders and/or disordered eating. Any single study could provide outcomes to inform one or multiple of these categories. The majority of results were drawn from studies conducted prior to LEA being defined as a concern for athlete health, which limited our understanding of the contemporary knowledge, attitudes/eliefs and behaviours of coaches on this important issue. That said, indications of gaps in coach knowledge and the employment of inappropriate attitudes/beliefs and behaviours regarding issues associated with LEA were evident. An opportunity exists for key stakeholders to develop comprehensive coach education frameworks, which equip coaches with the adequate capability, opportunity and motivation to support athlete health and avoid the consequences of LEA.

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Prevalence of reducing carbohydrate intake and fasted training in elite endurance athletes and association with bone injury

Raleigh,

Madigan,

Sinnott‐O’Connor

et al. 2024

European Journal of Sport Science

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There are conflicting reports both within the lay media and scientific literature regarding the use and benefit of dietary practices that aim to reduce CHO intake in endurance athletes. This study aimed to determine the prevalence of intentional reduction of CHO intake and fasted training in elite endurance‐based athletes using a semi‐quantitative questionnaire. Bone is a nutritionally modulated tissue; therefore, this study also aimed to explore if these dietary practices are potentially associated with bone injury incidence. The reported reduction of CHO intake was prevalent (28%) with the primary motivation being maintenance or manipulation of body composition. However, discrepancies in athletes' awareness of CHO intake were identified providing a potential avenue of intervention especially within applied practice. The use of fasted training was more prevalent (38%) with athletes using this practice for both body composition manipulation and promoting a desired adaptive response. Forty‐four per cent of participants had suffered a radiographically confirmed bone injury at some point in their career. There was no association between reduction in CHO intake and bone injury incidence; however, the incidence of bone injury was 1.61 times higher in those who currently use fasted training compared to those who have never used it or who have used it in the past. Although a direct causal link between these dietary practices and the incidence of bone injury cannot be drawn, it provides robust justification for future investigations of the potential mechanisms that could explain this finding.

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Low Energy Availability and Relative Energy Deficiency in Sport: What Coaches Should Know

Cited by 14 publications

References 209 publications

Prevalence of Relative Energy Deficiency in Sport (RED-S) among National Athletes in Malaysia

Prevalence of Relative Energy Deficiency in Sport (RED-S) among National Athletes in Malaysia

A review exploring coach knowledge, attitudes/beliefs and behaviours towards low energy availability in athletes

Prevalence of reducing carbohydrate intake and fasted training in elite endurance athletes and association with bone injury

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