Study the Effect of Relative Energy Deficiency on Physiological and Physical Variables in Professional Women Athletes: A Randomized Controlled Trial

Abstract

Energy deficits are often observed in athletes, especially in female athletes, due to the high expenditure of sport and strict diets. Low energy availability can cause serious health problems and affect sport performance. The aim of this study was to evaluate the effects of different personalized dietary plans on physiological and physical factors related to energy deficit syndrome in female professional handball players. Twenty-one professional female handball players, aged 22 ± 4 years, 172.0 ± 5.4 cm and 68.4 ± 6.7 kg, divided into three groups (FD: free diet; MD: Mediterranean diet; and AD: high antioxidant diet), participated in this 12-week randomized controlled trial. Energy expenditure through indirect calorimetry, energy availability, 7 day dietary intake analysis, blood pressure, cholesterol, menstrual function, body composition by both anthropometry and bioelectrical impedance, and strength performance were assessed. All participants showed low energy availability (< 30 kcal/lean mass per day); despite this, all had eumenorrhea. Significant improvements were found after the intervention in all components of body composition (p <0.05). In the remaining variables, despite slight improvements, none were significant neither over time nor between the different groups. Low energy availability has been observed in all professional female handball players, which may lead to serious consequences. A longer period of intervention is required to assess the differences between diets and improvements in other parameters.

Dietary habits in adolescent male and female handball players: the Swedish Handball Cohort

“…REDs is a serious syndrome impacting for example, reproductive, metabolic, cardiovascular and mental health 23. Low energy availability and REDs have historically been mostly discussed in relation to weight-sensitive sports, however, a recent study shows that these conditions are prevalent also in female handball players 24. Although energy and nutrient requirements can be met through well-balanced meals,9 timing of carbohydrate and protein intake is key for enhancing adaptive responses to exercise 6.…”

“…23 Low energy availability and REDs have historically been mostly discussed in relation to weight-sensitive sports, however, a recent study shows that these conditions are prevalent also in female handball players. 24 Although energy and nutrient requirements can be met through well-balanced meals, 9 timing of carbohydrate and protein intake is key for enhancing adaptive responses to exercise. 6 This is particularly important in athletes with a high training load as in this study, with a weekly training volume of on average 12 hours.…”

“…Meal timing and comparison with respect to sex and school grade is presented in online supplemental appendix tables 1 and 2. Eighty-eight per cent reported having a meal within 3 hours before training and 90% (24) 166 (31) 85 (17) Open access within 1 hour after. Of these, 54% and 76% reported having a main meal before morning and evening training, respectively (not in table).…”