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Risk of Low Energy Availability, Disordered Eating, Exercise Addiction, and Food Intolerances in Female Endurance Athletes.

ABSTRACT: Relative energy deficiency in sport (RED-S) is a complex syndrome describing health and performance consequences of low energy availability (LEA) and is common among female endurance athletes. Various underlying causes of LEA have been reported, including disordered eating behavior (DE), but studies investigating the association with exercise addiction and food intolerances are lacking. Therefore, the aim of this cross-sectional study was to investigate the association between DE, exercise addiction and food intolerances in athletes at risk of LEA compared to those with low risk. Female endurance athletes, 18-35 years, training ≥5 times/week were recruited in Norway, Sweden, Ireland, and Germany. Participants completed an online-survey comprising the LEA in Females Questionnaire (LEAF-Q), Exercise Addiction Inventory (EAI), Eating Disorder Examination Questionnaire (EDE-Q), and questions regarding food intolerances. Of the 202 participants who met the inclusion criteria and completed the online survey, 65% were at risk of LEA, 23% were at risk of exercise addiction, and 21% had DE. Athletes at risk of LEA had higher EDE-Q and EAI scores compared to athletes with low risk. EAI score remained higher in athletes with risk of LEA after excluding athletes with DE. Athletes at risk of LEA did not report more food intolerances (17 vs. 10%, P = 0.198), but were more frequently reported by athletes with DE (28 vs. 11%, P = 0.004). In conclusion, these athletes had a high risk of LEA, exercise addiction, and DE. Exercise addiction should be considered as an additional risk factor in the prevention, early detection, and targeted treatment of RED-S among female endurance athletes.

SUBMITTER: Fahrenholtz IL

PROVIDER: S-EPMC9110838 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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Risk of Low Energy Availability, Disordered Eating, Exercise Addiction, and Food Intolerances in Female Endurance Athletes.

Fahrenholtz Ida Lysdahl IL Melin Anna Katarina AK Wasserfurth Paulina P Stenling Andreas A Logue Danielle D Garthe Ina I Koehler Karsten K Gräfnings Maria M Lichtenstein Mia Beck MB Madigan Sharon S Torstveit Monica Klungland MK

Frontiers in sports and active living 20220503

Relative energy deficiency in sport (RED-S) is a complex syndrome describing health and performance consequences of low energy availability (LEA) and is common among female endurance athletes. Various underlying causes of LEA have been reported, including disordered eating behavior (DE), but studies investigating the association with exercise addiction and food intolerances are lacking. Therefore, the aim of this cross-sectional study was to investigate the association between DE, exercise addic ...[more]

PMID: 35592590

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Project description:IntroductionThe effects of low energy availability (LEA) on the immune system are poorly understood. This study examined the effects of 14 days of LEA on immune cell redox balance and inflammation at rest and in response to acute exercise, and exercise performance in female athletes.MethodsTwelve female endurance athletes (age: 26.8 ± 3.4 yrs, maximum oxygen uptake (V˙O2max): 55.2 ± 5.1 mL × min-1 × kg-1) were included in a randomized, single-blinded crossover study. They were allocated to begin with either 14 days of optimal energy availability diet (OEA, 52 ± 2 kcal × kg fat free mass (FFM)-1 × day-1) or LEA diet (22 ± 2 kcal × kg FFM-1 × day-1), followed by 3 days of refueling (OEA) with maintained training volume. Peripheral blood mononuclear cells (PBMCs) were isolated, and plasma obtained at rest before and after each dietary period. The PBMCs were used for analysis of mitochondrial respiration and H2O2 emission and specific proteins. Exercise performance was assessed on cycle by a 20-min time trial and time to exhaustion at an intensity corresponding to ∼110 % V˙O2max).ResultsLEA was associated with a 94 % (P = 0.003) increase in PBMC NADPH oxidase 2 protein content, and a 22 % (P = 0.013) increase in systemic cortisol. LEA also caused an alteration of several inflammatory related proteins (P < 0.05). Acute exercise augmented H2O2 emission in PBMCs (P < 0.001) following both OEA and LEA, but to a greater extent following LEA. LEA also reduced the mobilization of white blood cells with acute exercise. After LEA, performance was reduced in both exercise tests (P < 0.001), and the reduced time trial performance remained after the 3 days of refueling (P < 0.001).Conclusion14 days of LEA in female athletes increased cortisol levels and had a pronounced effect on the immune system, including increased capacity for ROS production, altered plasma inflammatory proteome and lowered exercise induced mobilization of leukocytes. Furthermore, LEA resulted in a sustained impairment in exercise performance.

Project description:BackgroundLow energy availability (EA) can be detrimental for athlete health. Currently, it is not known what the threshold for low EA in men is, and what effects it may have on performance.MethodsThis study was set to determine potential effects of low EA by modulating male participants' exercise energy expenditure and controlling energy intake and consequently manipulating EA in three progressive stages (reducing EA by 25%%, and 75 %). Performance was measured with three specific tests for explosive power, endurance, and agility. Blood was drawn, resting energy expenditure was monitored and two questionnaires were repetitively used to address any changes in eating behaviors and well-being.ResultsRepeated measured design showed poorer performance (power output 391.82 ± 29.60 vs. 402.5 ± 40.03 W, p = 0.001; relative power output 5.53 ± 0.47 vs. 5.60 ± 0.47 W/kg, p = 0.018; explosive power 0.28 ± 0.04 vs. 0.32 ± 0.05 m, p = 0.0001, lactate concentration 7.59 ± 2.29 vs 10.80 ± 2.46 mmol/L, p = 0.001). the quartile range for testosterone was lower (2.33 ± 1.08 vs. 2.67 ± 0.78, p = 0.026) and there was a tendency for lower triiodothyronine (4.15 ± 0.61 vs. 4.46 ± 0.54 pmol/L, p = 0.072). Eating behaviors and well-being were worse (46.64 ± 7.55 vs. 24.58 ± 7.13, p = 0.011 and 15.18 ± 2.44 vs. 17.83 ± 3.54, p = 0.002). The intervention also resulted in lower body fat (8.44 ± 3.15 vs. 10.2 ± 2.5%, p = 0.013).ConclusionsAnalysis showed that most of the negative effects occurred in the range of 9-25 kCal·kg∙FFM·d-1. This is the range where we suggest a threshold for LEA in men could be. Reducing EA impaired explosive power first, then endurance. It was associated with a reduction in testosterone, triiodothyronine and there was a tendency for reduced IGF-1, but hormones were more resilient to changes in EA. Psychological assessment of eating behaviors and well-being proved to be very useful, whereas monitoring resting energy expenditure did not.

Dataset Information

Risk of Low Energy Availability, Disordered Eating, Exercise Addiction, and Food Intolerances in Female Endurance Athletes.

Publications

Risk of Low Energy Availability, Disordered Eating, Exercise Addiction, and Food Intolerances in Female Endurance Athletes.

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