Nutrients · 10 authors, 7 centres
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This cross-sectional study of 94 young athletes found that 52.1% of female athletes were at risk for low energy availability (LEA), and 68.6% of females and 42.9% of males were at risk for eating disorders. Higher body fat percentage was associated with lower risk for both eating disorders and LEA in female athletes. Both male and female athletes demonstrated poor sport nutrition knowledge, with no significant differences between sexes or school levels.
{"Background": "Young athletes frequently fail to meet recommended dietary guidelines, increasing their risk for low energy availability (LEA) and relative energy deficiency in sport (RED-S). Previous estimates of LEA prevalence among collegiate and young-adult athletes range from 20\u201360%, depending on sport, competition level, and season phase. Eating disorders are more prevalent in athletes than the general population, with reported ranges of 0\u201319% for men and 4\u201345% for women, though these may be underestimates due to underreporting. A lack of sport nutrition knowledge may further contribute to inadequate dietary habits. The study aimed to investigate the prevalence of LEA among young female athletes and eating disorder risk in both sexes, and to examine relationships between sport nutrition knowledge, body composition, and risk status.", "Methods": "A total of 94 young athletes (42 male, 52 female; mean age 18.09 \u00b1 2.44 years; BMI 22.91 \u00b1 3.3 kg\u00b7m\u207b\u00b2) from 15 sports participated prior to the 2021\u20132022 athletic season. Athletes completed a single-day laboratory visit including body composition assessment via air displacement plethysmography (ADP) using the Brozek equation, and three electronic questionnaires: the abridged sports nutrition knowledge questionnaire (ASNK-Q; 35 questions, scored as poor [0\u201349%], average [50\u201365%], good [66\u201375%], excellent [75\u2013100%]), the brief eating disorder in athletes questionnaire (BEDA-Q; 9 questions, weighted score >0.27 considered at risk; sensitivity 82.1%, specificity 84.6%), and the low energy availability for females questionnaire (LEAF-Q; 25 questions, score >8 indicative of LEA risk; sensitivity 78%, specificity 90%). Athletes reported fasted (>12 h) and refrained from strenuous activity (>24 h). Statistical analyses included independent samples t-tests, binary logistic regression, and Spearman rank-order correlation coefficients.", "Key Results": "Among female athletes, 52.1% were classified as at risk for LEA based on LEAF-Q scores. High school females showed a higher prevalence (53.8%) compared to collegiate females (48.5%), though this difference was not statistically significant (p = 0.107). Moderate inverse relationships were found between LEAF-Q scores and BMI (r = \u22120.394; p < 0.01) and body fat percentage (r = \u22120.411; p < 0.01). For eating disorder risk, 42.9% of males (n = 18) and 68.6% of females (n = 35) were classified as at risk, with females at significantly higher risk (p < 0.01). The logistic regression model (including ASNK-Q score, BMI, and body fat percentage) accurately predicted eating disorder risk 84.6% of the time. Body fat percentage was a significant predictor (\u03b2 = \u22120.095; p = 0.01); for every 1 unit increase in body fat percentage, athletes were 0.909 (95% CI: 0.845\u20130.977) times less likely to be classified as at risk for an eating disorder. Both male (46.5 \u00b1 13.9) and female (46.9 \u00b1 11.4) athletes scored poorly on the ASNK-Q, with no sex differences (p = 0.895). High school (44.9 \u00b1 10.7) and collegiate (48.9 \u00b1 14.0) athletes also scored poorly, with no significant difference by school level (p = 0.103). A moderate association was observed between age and ASNK-Q scores in males (r = 0.317) and females (r = 0.341). No other relationships between ASNK-Q scores and body composition parameters or BEDA-Q/LEAF-Q scores were observed (p > 0.05).", "Clinical Implications": "The high prevalence of LEA risk (52.1%) and eating disorder risk (68.6% females, 42.9% males) in this young athlete cohort underscores the need for routine screening in high school and collegiate athletic programs. The finding that higher body fat percentage was associated with lower risk for both eating disorders and LEA suggests that leanness may be a risk marker, particularly in sports emphasizing low body fat. The uniformly poor sport nutrition knowledge across sexes and school levels indicates a critical gap that could be addressed through structured nutrition education interventions. Practitioners working with young athletes should implement screening protocols using validated tools (LEAF-Q, BEDA-Q) and refer at-risk athletes to registered dietitians and mental health professionals. The lack of association between nutrition knowledge and body composition or risk status suggests that knowledge alone is insufficient; behavioral and environmental factors also need targeting. Limitations include unequal sport representation, lack of diagnostic confirmation for eating disorders, and absence of direct dietary intake data."}