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Determining the Contribution of the Energy Systems During Exercise
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Low Energy Availability and Relative Energy Deficiency in Sport: A Systematic Review and Meta-analysis.

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Low energy availability (LEA) affects nearly half of athletes, impacting performance and increasing injury risk. Early identification and intervention are crucial for athlete health and optimal training benefits.

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Area of Science:

  • Sports Medicine
  • Exercise Physiology
  • Nutritional Science

Background:

  • Low energy availability (LEA) is an energy deficit where energy expenditure exceeds intake, impacting athletic performance and injury risk.
  • Relative energy deficiency in sport (REDs) is a severe form of LEA causing metabolic, hormonal, and physiological dysfunctions.
  • Endurance, aesthetic, and weight-class athletes are particularly vulnerable to LEA and REDs.

Purpose of the Study:

  • To determine the prevalence of LEA and REDs in athletes.
  • To conduct a secondary analysis of the impacts of LEA and REDs on athletic performance and injury risk.

Main Methods:

  • Systematic review registered on PROSPERO (CRD42023469253).
  • PRISMA guidelines followed for literature searches in PubMed, Embase, and Cochrane.
  • Inclusion criteria focused on prevalence, performance impacts, and injury risks associated with LEA/REDs.

Main Results:

  • 44.7% of 6118 athletes across 59 studies had LEA (44.2% females, 49.4% males).
  • 63.0% of 730 athletes in 8 studies were at risk of REDs.
  • LEA negatively affected performance (run, endurance, coordination, concentration, power, agility) and increased illness-related training absence; bone health and stress injury risks were elevated.

Conclusions:

  • This is the first systematic review on LEA/REDs impacts on performance and injury.
  • High LEA prevalence necessitates screening tools like the LEAF-Q for early detection.
  • Intervention can prevent REDs, mitigate bone health issues, and optimize athletic performance.