An investigation of energy availability and relative energy deficiency in sport in an athletic population

Meeting training demands with adequate energy intake can be challenging for athletes, and evidence suggests that low energy availability (LEA) is a common occurrence, with potentially negative consequences for health and performance. A review of energy availability (EA) and its effects on performance highlights that paradoxical deconditioning syndrome (PDS) is caused by a lack of EA and the dysfunctions of overtraining syndrome (OTS), relative energy deficiency in sport (RED-s) and burnout syndrome of athletes (BSA) (Chapter 1). In addition, an experimental study investigated the prevalence of high-risk of RED-s and the relationship between self-assessed EA status via questionnaire and BSA using a widespread athletic population (n = 234) (Chapter 2). A further experimental study investigated the physiological symptoms of RED-s including anthropometric measures, resting metabolic rate (RMR) , bone mineral density (BMD), blood measures and questionnaires assessing EA status, BSA and psychological strain in endurance athletes (n = 55) (Chapter 3). There was a high prevalence of risk of RED-s among athletes in both experimental studies. Psychological measures of BSA, or any parameters including body composition, cardiovascular and metabolic health or bone health were not significantly different in athletes classified at high risk of RED-s compared to those with adequate energy availability (AEA) when determined by self-assessed EA status or lumbar BMD z-score. However, a significant proportion of male athletes at high risk of RED-s were experiencing psychological strain.