The risk of low energy availability in Chinese elite and recreational female aesthetic sports athletes

Abstract

Background Low energy availability (LEA) is a medical condition observed in athletes, with a higher prevalence in aesthetic sports. For the first time, this study evaluated the relative prevalence of LEA in female elite athletes (ELA) and recreational athletes (REA) in aesthetic sports in China. Methods Female athletes from 6 sports (trampolining, rhythmic gymnastics, aerobics, dance sport, cheerleading and dance) were recruited, including ELA (n = 52; age = 20 ± 3) on Chinese national teams and REA (n = 114; Age = 20 ± 2) from Beijing Sport University. Participants completed 2 online questionnaires to assess LEA and eating disorder risk. These included the Low Energy Availability in Females Questionnaire (LEAF-Q), which provided information on injury history, gastrointestinal function and menstrual history, and the Eating Disorder Inventory-3 Referral Form (EDI-3 RF). For a sub-group of elite athletes (n = 14), body composition, bone mineral density, and blood serum were also quantified. Results A total of 41.6% of participants (n = 69) were at increased risk of LEA, and 57.2% of participants (n = 95) were classified as high in eating disorder risk. For ELA vs. REA, there was a significantly higher prevalence of LEA risk (55.8% vs. 35.1%; p = 0.012) and amenorrhea (53.8% vs. 13.3%; p < 0.001). Elite athletes at increased risk of LEA had significantly lower estradiol (p = 0.021) and whole-body BMD (p = 0.028). Pearson correlations indicated that the whole-body BMD (r = − 0.667, p = 0.009) correlated negatively with LEAF-Q score. Conclusions Results of this study indicate that there is a risk of LEA in female Chinese athletes within aesthetic sports, and significantly higher prevalence of increased LEA risk observed in ELA than in REA. Chinese coaches and sports medicine staff working elite female athletes in aesthetic sports should develop strategies to reduce the prevalence of LEA.

Risk of Low Energy Availability among Female and Male Elite Runners Competing at the 26th European Cross-Country Championships

“…On the one hand, when compared to other studies that assessed the risk of LEA using the LEAF-Q, our results are higher than the ones reported in the majority of previous studies (29.6–63.2%) [ 17 , 18 , 19 , 20 , 21 , 22 , 23 ]. However, some studies were conducted in recreational athletes [ 19 , 22 , 23 ], and none have been conducted in elite cross-country athletes. In a population of female athletes competing in an ultra-marathon ( n = 306), Folscher et al [ 20 ] observed a prevalence of LEA of 44.1%.…”

Body Composition, Dietary Intake and the Risk of Low Energy Availability in Elite-Level Competitive Rhythmic Gymnasts

“…Some authors have indicated that gymnasts have decreased adipose tissue and delayed skeletal maturation and pubertal development [ 16 , 47 ]. This is attributed to gymnasts generally being exposed to high levels of physical and psychological stress and subjected to many hours of training from preadolescence [ 42 ].…”

“…Moreover, athletes’ motivation to maintain a low weight to achieve particular results drives them to maintain a thin somatotype [ 41 ], which is evidently associated with a body aesthetic characterized by low fat mass percentages. Due to the major role of body shape and appearance in this type of sport, athletes often limit their energy intake and/or increase their energy expenditure through excessive exercise training to achieve body composition goals, meaning that they fail to satisfy their energy requirements [ 16 ], and this may elevate the risk of LEA [ 8 ].…”

“…An energy deficit is commonly reported in athletes [ 48 , 49 ], but it is extremely difficult to accurately assess energy needs in young athletes [ 49 , 50 ], and self-reported dietary records are limited. It appears that LEA in adolescent athletes undertaking heavy training is common [ 16 , 51 ].…”

“…LEA may affect the often-immature musculoskeletal system of gymnasts, increasing the risk of injury to growth or articular cartilage and bones, and its impact on this and other systems gives rise to wider concerns about the risk of health problems including injury [ 14 ]. Further, excessive weight loss during growth has negative effects on body and bone composition, and LEA may affect the female reproductive system, delaying menarche and/or resulting in irregular menses [ 15 , 16 ].…”