Performance Tips

How to Avoid Low Energy Availability

A female basketball player turns to her coach after a demanding practice. "Coach, I'm not sure what I am doing wrong. I can't seem to recover as well as I did at the beginning of the season!? I think I eat enough, but I am a few pounds lighter without trying to lose weight. I also haven't had my period for the last two months. Could you please help me figure out what's going on?"

This athlete may be experiencing Low Energy Availability (LEA). Research supports that in as little as five days of energy restriction, the hormonal profiles of female athletes can be negatively impacted (1). Energy availability is defined as the energy (calories) consumed through food minus the energy expended during exercise (2). This energy deficit can occur because of increased energy expenditure, such as a demanding practice or competition, without the athlete replenishing their energy stores through proper intake of carbohydrates, proteins and fats (2).

Food Energy Intake – Exercise Energy Expenditure = Energy Availability

LEA can also occur because athletes don’t feel like eating or have an upset stomach after a hard, hot practice and fails to consume calories consistently after exercise (2). Athletes may feel pressure to lose weight or body fat to improve performance or look a certain way, which can also inadvertently or purposefully lead to LEA. Finally, many athletes are extremely busy and fail to realize how many calories are required to fuel their growth and development while supporting their performance and recovery needs. Regardless of the reason for LEA, this energy deficit can become consistent over days and weeks, ultimately impacting an individual’s strength, endurance, health and overall well-being (2).

Who is at risk?

Essentially, all male and female athletes are at risk for low energy availability. Due to the increased expenditure of all sport types, any exercising individual must consume appropriate calories. However, LEA can be more common in individuals who participate in the following types of sports (2):

• Those that are endurance-based and anti-gravitational (e.g., triathlon, track, cross-country, high-jumpers, long-jumpers, etc.).
• Those in which a lean or lighter body type is associated with better performance (either realistically or anecdotally) or for aesthetic reasons (e.g. cycling, gymnastics, swimming, ballet, competitive dance etc.)
• Those with a weight class component where sport requirements dictate the athlete meets a certain weight or weight range to compete (e.g. light-weight rowing, weightlifting, wrestling, combat sports, etc.)

Negative Consequence of Low Energy Availability (LEA):

A variety of symptoms can signal athletes that their body is in a state of energy deficit. Proper energy management is critical when assessing daily needs and how athletes can cover all their requirements to place them in a positive energy balance! A few of the symptoms athletes may experienced associated with LEA are (2):

The most devastating and significant long-term consequence within females because of chronic LEA is the impact on the hormonal profile and subsequent menstrual cycle adaptations. Female athletes who miss over three consecutive menstrual cycles should talk to their coach and team physician about this change. Proper circulating estrogen is imperative for bones to rebuild and strengthen under the stress of weight-bearing activity. LEA can decrease estrogen and eventually negatively impact bone mineral density, possibly leading to stress fractures and lower bone mineral density over time. Most peak bone mass is built between ages 7 and 20 years in women, with peak bone mass reaching a maximum between 20 and 30 years in both males and females (3). If this critical window of opportunity to build bone is missed, females and males may have a lifetime of health-related implications resulting from LEA.

Essential Tips to Avoid LEA include athletes focus on:

• Eating enough: Eat a diet with enough energy to support their exercise and life demands. This includes increasing energy intake when the volume or intensity of training increases.
• Planning meals & Snacks: Create a structured eating plan for heavy training cycles and include extra snacks to prevent long periods without eating during the day.
• Getting enough sleep and rest: Proper recovery and sleep can help reduce fatigue.
• Being mindful of body composition goals: Develop realistic, performance-oriented goals for body composition and weight, ideally with the assistance of a sports dietitian and a coach.
• Working with a professional: A sports dietitian can help with nutrition planning and goal setting. In addition, a sports dietitian can provide a realistic framework for setting up a consistent eating schedule, focusing on key nutrition times such as before and after workouts.

A quick way to determine your estimated daily caloric needs for male and female athlete is outlined in the table below.

1. Determine your weight in pounds
2. Divide your weight in pounds by 2.2 to obtain your weight in kilograms
3. Multiple your kilograms (kg) by the factor that matches your activity level in the table below to estimate your average daily caloric needs in kcal based on Table 3.3 of Nancy Clarks Sports Nutrition Guidebook (4).

References:

1. Williams, N. I., Leidy, H. J., Hill, B. R., Lieberman, J. L., Legro, R. S., & De Souza, M. J. (2015). Magnitude of daily energy deficit predicts frequency but not severity of menstrual disturbances associated with exercise and caloric restriction. American Journal of Physiology-Endocrinology and Metabolism, 308(1). https://doi:10.1152/ajpendo.00386.2013
2. De Souza, M. J., Nattiv, A., Joy, E., Misra, M., Williams, N. I., Mallinson, R. J., Gibbs, J.C., Olmsted, M., Goolsby, M. & Matheson, G. (2014a). 2014 female athlete triad coalition consensus statement on treatment and return to play of the female athlete triad. British Journal of Sports Medicine, 48(4), 289–289. https://doi: 10.1136/bjsports-2013-093218
3. Lu, J., Shin, Y., Yen, M.-S., & Sun, S. S. (2016). Peak bone mass and patterns of change in total bone mineral density and bone mineral contents from childhood into young adulthood. Journal of Clinical Densitometry, 19(2), 180–191. https://doi: 10.1016/j.jocd.2014.08.001

Clark, N. (2020). Nancy Clark’s sports nutrition guidebook. Human Kinetics.