Sports Dietitian practices for assessing and managing athletes at risk of low energy availability (LEA)

Bowler, Amy-Lee; Coffey, Vernon G.; Cox, Gregory R.

doi:10.1016/j.jsams.2022.02.002

Cited by 4 publications

(9 citation statements)

References 29 publications

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“…Because of the substantial impact of relative energy deficiency in sport or the triad on an athlete's health and career, there is interest in early detection and prevention of problematic LEA (Bowler et al, 2022). Screening tools include the LEA in females questionnaire (Melin et al, 2014) and its male counterpart (Lundy et al, 2022), which might be followed up with assessments of metabolic health (e.g., resting metabolic rate), reproductive health, bone mineral density, and other health issues (Logue et al, 2020).…”

Section: Lea and Existing Screening Toolsmentioning

confidence: 99%

The Use of Continuous Glucose Monitors in Sport: Possible Applications and Considerations

Bowler

Whitfield

Marshall

et al. 2023

International Journal of Sport Nutrition and Exercise Metabolism

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This review discusses the potential value of tracking interstitial glucose with continuous glucose monitors (CGMs) in athletes, highlighting possible applications and important considerations in the collection and interpretation of interstitial glucose data. CGMs are sensors that provide real time, longitudinal tracking of interstitial glucose with a range of commercial monitors currently available. Recent advancements in CGM technology have led to the development of athlete-specific devices targeting glucose monitoring in sport. Although largely untested, the capacity of CGMs to capture the duration, magnitude, and frequency of interstitial glucose fluctuations every 1–15 min may present a unique opportunity to monitor fueling adequacy around competitive events and training sessions, with applications for applied research and sports nutrition practice. Indeed, manufacturers of athlete-specific devices market these products as a “fueling gauge,” enabling athletes to “push their limits longer and get bigger gains.” However, as glucose homeostasis is a complex phenomenon, extensive research is required to ascertain whether systemic glucose availability (estimated by CGM-derived interstitial glucose) has any meaning in relation to the intended purposes in sport. Whether CGMs will provide reliable and accurate information and enhance sports nutrition knowledge and practice is currently untested. Caveats around the use of CGMs include technical issues (dislodging of sensors during periods of surveillance, loss of data due to synchronization issues), practical issues (potential bans on their use in some sporting scenarios, expense), and challenges to the underpinning principles of data interpretation, which highlight the role of sports nutrition professionals to provide context and interpretation.

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Section: Lea and Existing Screening Toolsmentioning

confidence: 99%

The Use of Continuous Glucose Monitors in Sport: Possible Applications and Considerations

Bowler

Whitfield

Marshall

et al. 2023

International Journal of Sport Nutrition and Exercise Metabolism

Self Cite

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show abstract

“…In addition, significant psychological barriers can present a challenge to increasing EI (6,34,42,46). In a study investigating the implementation of a nutrition education program aimed to maintain adequate EA in competitive male cyclists, psychological barriers were reported by those that did not adhere to the program (34).…”

Section: Increasing Energy Intakementioning

confidence: 99%

“…Therefore, it is important to emphasize to athletes that only a modest change in body weight (1-5 kg) may be required to induce menstrual recovery (3,13,37,77). To help reduce the concerns regarding body composition changes, careful and consistent reinforcement of the importance of fueling appropriately to support training demands, performance, and health to the athlete and all members of their support team is advised (6,46).…”

Section: Increasing Energy Intakementioning

confidence: 99%

“…Therefore, it is recommended that nutritional interventions not only consider quantity but also the energy spread across the day, with a particular focus on fueling around training (39,65,71). Accordingly, a review of Australian sports dietitian practices for assessing and managing athletes at risk of LEA found the use of pretraining, during, and posttraining snacks was the predominate practice for improving EI (6).…”

Section: Within-day Energy Availabilitymentioning

confidence: 99%

“…They also advised that nutritionists and dietitians may need to integrate behavior change approaches to enable athletes to overcome internal and external triggers (e.g., beliefs, feelings, and opinions) which may play a role in implementing an increased EI (4). Therefore, athletes, coaches, and support teams must understand the importance of appropriate fueling to meet the demands of training, the timing of intake around exercise and recovery, and the associated health and performance consequences of failing to do so (6,15,45,46,65). Providing educational resources and seminars to coaches, athletes, and medical and support teams in a group environment would provide a consistent message, encourage collaboration, and enable an athlete to recover RED-S.…”

Section: Educationmentioning

confidence: 99%

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RED-S: A Review of the Screening, Diagnosis, Treatment, and Recovery

Matkin-Hussey,

Baker,

Ogilvie

et al. 2023

Strength &Amp; Conditioning Journal

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Relative energy deficiency in sport (RED-S) is a complex syndrome of endocrine, metabolic, and physiological maladaptation. Adverse effects on physiological and psychological health and the performance of the athlete may occur due to a prolonged exposure to low-energy availability (LEA). LEA occurs when there is an energy intake (EI) deficiency relative to exercise energy expenditure (EEE) and normal physiological functioning. Early detection of the state of LEA and RED-S is crucial to prevent long-term negative health consequences. Given that LEA is the underlying cause of RED-S, increasing the athlete's energy availability (EA) to an optimal level is the recommended treatment. This paper reviews the current evidence and recommendations for the screening and diagnostic tools of LEA and RED-S, the recommended treatment strategies including reducing EEE, increasing EI, carbohydrate availability, within-day EA, psychological support, and the multidisciplinary team's role, and finally, it reviews the literature on its recovery process. It aims to provide a comprehensive summary of the research to date, with practical recommendations for the identification, management, and treatment of RED-S.

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Low energy intake (RED-S), hamstring injuries in cricketeers and exercise during pregnancy - relevant (clinical) topics from sports practice

Meyer¹

2022

Journal of Science and Medicine in Sport

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Sports Dietitian practices for assessing and managing athletes at risk of low energy availability (LEA)

Cited by 4 publications

References 29 publications

The Use of Continuous Glucose Monitors in Sport: Possible Applications and Considerations

The Use of Continuous Glucose Monitors in Sport: Possible Applications and Considerations

RED-S: A Review of the Screening, Diagnosis, Treatment, and Recovery

Low energy intake (RED-S), hamstring injuries in cricketeers and exercise during pregnancy - relevant (clinical) topics from sports practice

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