Low Energy Availability and Risk of Relative Energy Deficiency in Sport (RED-s):

Sarah Amorim de Morais Santos; Karen Carolina Martins Julião; Marcos Daniel Motta Drummond

doi:10.46642/efd.v30i327.7764

Sarah Amorim de Morais Santos Universidade Federal de Minas Gerais (UFMG) https://orcid.org/0009-0003-0704-054X
Karen Carolina Martins Julião Universidade Federal de Minas Gerais (UFMG) https://www.scopus.com/authid/detail.uri?authorId=58421711900 https://orcid.org/0009-0008-5331-0236
Marcos Daniel Motta Drummond Universidade Federal de Minas Gerais (UFMG) https://www.scopus.com/authid/detail.uri?authorId=55832789300 https://orcid.org/0000-0002-5622-1297

DOI: https://doi.org/10.46642/efd.v30i327.7764

Abstract

This study aimed to evaluate food consumption and the prevalence of Low Energy Availability (LEA) and Relative Energy Deficiency in Sport (RED-s) within a group of women practitioners of resistance training. The sample consisted of 23 women, with a mean age of 23 ± 4.73 years, average body mass of 59.6 ± 5.26 kg and average height of 163 ± 6.61 cm. They underwent anamnesis, a daily dietary record to assess caloric intake and a daily activity record, and with this information the total energy expenditure (TEE) was determined. Body composition was assessed using skinfolds. The Low Energy Availability in Females Questionnaire (LEAF-Q) was applied and the energy availability (EA) of each subject was calculated. The results showed that the average total caloric intake was 1757 ± 557 kcal (95% CI 1516 - 1998), while the TEE was 2064 ± 185 kcal (95% CI 1983 - 2144). The mean EA was 38.6 ± 11.8 kcal/kg FFM/day (95% CI 33.5 - 43.7). LEA was present in 21.74% of the sample. The average score obtained in the LEAF-Q questionnaire was 4.13 ± 2.52 (95% CI 2.82 - 5.0), with 8.7% of volunteers classified at risk of RED-s. It is concluded that LEA and high risk for RED-s are not prevalent among women practitioners of resistance training.

Keywords: Energy intake, Female athlete triad syndrome, Fertile period, Nutrition in sport

References

Areta, J.L., Taylor, H.L., & Koehler, K. (2021). Low energy availability: history, definition and evidence of its endocrine, metabolic and physiological effects in prospective studies in females and males. European Journal of Applied Physiology, 121(1), 1-21. https://doi.org/10.1007/s00421-020-04516-0

Black, K., Slater, J., Brown, R.C., & Cooke, R. (2018). Low energy availability, plasma lipids, and hormonal profiles of recreational athletes. The Journal of Strength & Conditioning Research, 32(10), 2816-2824. https://doi.org/10.1519/jsc.0000000000002540

Canhestro, J.P., Carvalhaes, A.L.D., Martins Júnior, F. de A.D., & Drummond, M.D.M. (2025). Influence of professional nutritional support on dietary profile of strength-trained women. Lecturas: Educación Física y Deportes, 29(321), 108-126. https://doi.org/10.46642/efd.v29i321.7864

De Souza, M.J., Koltun, K.J., & Williams, N.I. (2019). The role of energy availability in reproductive function in the female athlete triad and extension of its effects to men: an initial working model of a similar syndrome in male athletes. Sports Medicine, 49(Suppl 2), 125-137. https://doi.org/10.1007/s40279-019-01217-3

Fahrenholtz, IL, Melin, AK, Wasserfurth, P., Stenling, A., Logue, D., Garthe, I., Koehler, K., Gräfnings, M., Lichtenstein, MB, Madigan, S., & Torstveit, M. K. (2022). Risk of low energy availability, disordered eating, exercise addiction, and food Intolerances in female endurance athletes. Frontiers in sports and active living, 4, 869594. https://doi.org/10.3389/fspor.2022.869594

Hagstrom, A.D., Marshall, P.W., Halaki, M., & Hackett, D.A. (2020). The effect of resistance training in women on dynamic strength and muscular hypertrophy: a systematic review with meta-analysis. Sports Medicine, 50(6), 1075-1093. https://doi.org/10.1007/s40279-019-01247-x

Heikura, I.A., Stellingwerff, T., & Areta, J.L. (2021). Low energy availability in female athletes: from the lab to the field. European Journal of Sport Science, 22(5), 709-719. https://doi.org/10.1080/17461391.2021.1915391

Lamonte, M.J., & Ainsworth, B.E. (2001). Quantifying energy expenditure and physical activity in the context of dose response. Medicine and science in sports and exercise, 33(6 Suppl), S370-8. https://doi.org/10.1097/00005768-200106001-00006

Liu, Y., Ajami, NJ, El-Serag, HB, Hair, C., Graham, DY, White, DL, Chen, L., Wang, Z., Plew, S., Kramer, J., Cole, R., Hernaez, R., Hou, J., Husain, N., Jarbrink-Sehgal, ME, Kanwa, F., Ketwaroo, G., Natarajan, Y., Shah, R., Velez, M., Mallepally, N., Petrosino, JF, & Jiao, L. (2019). Dietary quality and the colonic mucosa–associated gut microbiome in humans. The American journal of clinical nutrition, 110(3), 701-712. https://doi.org/10.1093/ajcn/nqz139

Logue, D., Madigan, S.M., Delahunt, E., Heinen, M., Mc Donnell, S.J., & Corish, C.A. (2018). Low energy availability in athletes: a review of prevalence, dietary patterns, physiological health, and sports performance. Sports medicine, 48, 73-96. https://doi.org/10.1007/s40279-017-0790-3

Loucks, A.B., & Thuma, J.R. (2003). Luteinizing hormone pulsatility is disrupted at a threshold of energy availability in regularly menstruating women. The Journal of Clinical Endocrinology & Metabolism, 88(1), 297-311. https://doi.org/10.1210/jc.2002-020369

Maria, U.P. de, & Juzwiak, C.R. (2021). Cultural adaptation and validation of the low energy availability in females questionnaire (leaf-q). Revista Brasileira de Medicina do Esporte, 27(2), 184-188. https://doi.org/10.1590/1517-869220212702223889

McHaffie, SJ, Langan-Evans, C., Strauss, JA, Areta, JL, Rosimus, C., Evans, M., Waghorn, R., & Morton, JP (2023). Under-Fuelling for the work required? Assessment of dietary practices and physical loading of adolescent female soccer players during an intensive international training and game schedule. Nutrients, 15(21), 4508. https://doi.org/10.3390/nu15214508

Melin, A., Tornberg, Å.B., Skouby, S., Faber, J., Ritz, C., Sjödin, A., & Sundgot-Borgen, J. (2014). The LEAF questionnaire: a screening tool for the identification of female athletes at risk for the female athlete triad. British journal of sports medicine, 48(7), 540-545. https://doi.org/10.1136/bjsports-2013-093240

Moss, SL, Randell, RK, Burgess, D., Ridley, S., ÓCairealláin, C., Allison, R., & Rollo, I. (2021). Assessment of energy availability and associated risk factors in professional female soccer players. European Journal of Sport Science, 21(6), 861-870. https://doi.org/10.1080/17461391.2020.1788647

National Health Council (2012). Resolution No. 466, of December 12, 2012: Guidelines and regulatory standards for research involving human beings. Ministry of Health. http://conselho.saude.gov.br/resolucoes/2012/Reso466.pdf

Sands, R. (2000). Reconceptualization of body image and drive for thinness. International journal of eating disorders, 28(4), 397-407. https://doi.org/10.1002/1098-108x(200012)28:4%3C397::aid-eat7%3E3.0.co;2-u

Slater, J., McLay-Cooke, R., Brown, R., & Black, K. (2016). Female recreational exercisers at risk for low energy availability. International journal of sport nutrition and exercise metabolism, 26(5), 421-427. https://doi.org/10.1123/ijsnem.2015-0245

Wasserfurth, P., Palmowski, J., Hahn, A., & Krüger, K. (2020). Reasons for and consequences of low energy availability in female and male athletes: social environment, adaptations, and prevention. Sports medicine-open, 6(1), 44. https://doi.org/10.1186/s40798-020-00275-6

Witkos, J., Luberda, E., Błażejewski, G., Strój, E. (2024). Menstrual cycle disorders as an early symptom of energy deficiency among female physique athletes assessed using the Low Energy Availability in Females Questionnaire (LEAF-Q). PLoS One, 19(6), 1-17. https://doi.org/10.1371/journal.pone.0303703