Low Energy Availability in New Zealand Recreational Athletes

Abstract

Background: An insufficient energy intake combined with exercise means the body cannot undergo normal physiological functions. This is termed low energy availability (LEA). To conserve energy LEA triggers a range of endocrine systems, consequently impairing health and athletic performance. LEA is thought to be common among athletes, however the prevalence among New Zealand athletes is unknown. Determining those at risk of LEA may help to maximise prevention, early diagnosis and treatment. Aim: The aim of this study is to estimate the prevalence of recreational New Zealand athletes at risk of LEA. Methods: Participants aged between 18 and 56 years were recruited (109 female, 61 male) via gyms and fitness centres throughout New Zealand. Participants were all classified as recreational athletes, undertaking at least 2.5 hours of moderate physical activity on weekly basis. Participants completed an anonymous online questionnaire comprising of 98 questions from validated eating disorder (Eating Disorder Inventory 3) and LEA questionnaires (Low Energy Availability in Females Questionnaire). Outcomes: A total of 33.5% (95% CI 26.5%,41.2%) of participants were classified as at risk of LEA. Females had approximately 5.4 times greater probability of being at risk of LEA when compared to males (p<0.001). For every one unit decrease in BMI the odds of being at risk of LEA were 11% higher (OR 0.89, 95% CI 0.80, 1.00, p=0.045). The dose response relationship between training volume (hours per week) and risk of LEA was found to be significant among female athletes but not males. For every extra hour of exercise female participants undertook per week the odds of being at risk of LEA were 1.13 times greater (95% CI 1.02, 1.25, p=0.016). Further, the majority of participants (males 87.5%, 95% CI, 47.3%, 99.7%, n=7, females, 89.8%, 95% CI 77.8%, 96.6%, n=44) who were classified as at risk of LEA were considered not at risk of an eating disorder. Conclusion: This study provides important information on the prevalence and predictors of LEA in New Zealand athletes. Considering the high prevalence of New Zealand recreational athletes at risk of LEA this emphasises the importance of prevention and early detection, so treatment can be implemented before health and performance is severely compromised.