Low energy availability and female athlete Triad risk in Black collegiate track and field athletes

This study evaluated energy availability, menstrual function, bone mineral density (BMD), and female athlete Triad (Triad) risk among Black collegiate female track and field athletes. Study participants were female athletes (n = 18) on the track and field team at a Historically Black College/University. Energy intake and expenditure were estimated using an 8-day doubly labeled water protocol. Body composition was measured using dual-energy X-ray absorptiometry. Energy availability (EA) was calculated as (energy intake - activity energy expenditure)/fat free mass (FFM). Triad risk was assessed using female athlete Triad cumulative risk assessment. Survey responses captured eating behaviors, menstrual history, and food security status. Among these athletes, 56% exhibited EA below 45 kcal/kgFFM/day, and 17% were classified with clinical low energy availability (LEA) (<30 kcal/kgFFM/day). Forty-four percent of athletes met criteria for moderate Triad risk, though none were at high risk and none met criteria for low BMD. EA was inversely associated with body mass index (BMI) (r = -0.48, p = 0.04). Athletes reporting disordered/binge eating had significantly lower EA (p = 0.02). Food insecurity was identified among 22% of the study population but was not significantly associated with LEA or Triad risk. Over half of the Black female collegiate track and field athletes exhibited LEA, with nearly half meeting criteria for moderate Triad risk despite normal BMD and BMI. These findings highlight the need for routine screening and tailored interventions addressing LEA, menstrual dysfunction, and disordered eating in underrepresented athlete populations. ClinicalTrials.gov Identifier: NCT07631312.