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A Modern Understanding of the Models of Energy Deficits in Athletes

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The Active Female

Abstract

Energy deficits are a serious and ongoing problem in the female athletic population. Deficits in energy intake may be acquired through excessive energy expenditure or insufficient caloric consumption. Two separate but interrelated conceptualizations and models of energy deficiency exist in the female athlete population. The seminal model, the female athlete triad, is defined as the interrelationships among energy availability, menstrual function, and bone density. A novel conceptualization, the relative energy deficiency in sport (RED-S), expands on the female athlete triad (energy availability, menstrual function, and bone density) by broadening our understanding of the impact of low energy in female athletes to factors such as psychological, immunological, endocrine, metabolic, gastrointestinal, cardiovascular, and growth and development factors. In both models, these dynamic components may transcend various clinical manifestations, including eating disorders, functional hypothalamic amenorrhea, and osteoporosis. This chapter will serve to review the two models and discuss the implications of each for the female athlete, including health and performance outcomes.

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Author information

Authors and Affiliations

  1. William Beaumont Army Medical Center, Desert Sage Medical Home, El Paso, TX, USA

    Andrew Cisneros

  2. Department of Psychology, Western University, London, ON, Canada

    Danika A. Quesnel

  3. Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA

    Jacalyn J. Robert-McComb

Authors
  1. Andrew Cisneros
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  2. Danika A. Quesnel
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  3. Jacalyn J. Robert-McComb
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Editor information

Editors and Affiliations

  1. Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA

    Jacalyn J. Robert-McComb

  2. Orthopedic Surgery and Rehabilitation, Texas Tech University Health Sciences Center, Lubbock, TX, USA

    Mimi Zumwalt

  3. Functional Biology, University of Oviedo, Oviedo, Asturias, Spain

    Maria Fernandez-del-Valle

Chapter Review Questions

Chapter Review Questions

  1. 1.

    What is the energy availability (EA) formula?

    1. (a)

      Daily energy intake − exercise expenditure = EA

    2. (b)

      Daily energy intake + exercise expenditure = EA

    3. (c)

      Daily energy intake + body mass index = EA

    4. (d)

      Daily energy intake × exercise expenditure = EA

  2. 2.

    The female athlete triad is a term which describes

    1. (a)

      Muscular endurance, cardiovascular endurance, and muscular strength

    2. (b)

      Amenorrhea, oligomenorrhea, and eumenorrhea

    3. (c)

      Speed, agility, and power

    4. (d)

      Disordered eating, amenorrhea, and osteoporosis

  3. 3.

    The relative energy deficiency in sport is a term which describes

    1. (a)

      Limited to disordered eating, amenorrhea, and osteoporosis

    2. (b)

      Inclusion of more interrelated physiological and psychological changes

    3. (c)

      Only psychological, cardiovascular health, and metabolic features

    4. (d)

      Related to sports performance to maximize function

  4. 4.

    Athletes at greatest risk for developing signs and symptoms associated with the Triad are

    1. (a)

      Female power lifters training for strength

    2. (b)

      Female basketball players under tremendous pressure to perform

    3. (c)

      Athletes competing in sports that emphasize leanness or low body weight

    4. (d)

      Female soccer goalie during the peak of their season

  5. 5.

    In this particular eating disorder, even though the weight and shape concerns persist, the individual’s body weight is typically normal throughout the disorder:

    1. (a)

      Bulimia Nervosa

    2. (b)

      Anorexia Nervosa

    3. (c)

      Binge eating disorder

    4. (d)

      Compulsive overeating

  6. 6.

    Luteinizing hormone (LH) pulsatility is likely to be disrupted when energy availability is reduced below:

    1. (a)

      30 kilocalories (kcal) per kilogram (kg) of body weight (BW) per day (kcal/kgBW/day)

    2. (b)

      45 kilocalories (kcal) per kilogram (kg) of body weight (BW) per day (kcal/kgBW/day)

    3. (c)

      45 kilocalories (kcal) per kilogram (kg) of fat-free mass (FFM) per day (kcal/kgFFM/day)

    4. (d)

      30 kilocalories (kcal) per kilogram (kg) of fat-free mass (FFM) per day (kcal/kgFFM/day)

  7. 7.

    In regard to bone health, hormonal changes in females with amenorrhea lead to

    1. (a)

      Reduced bone mineral density, improved bone microarchitecture, reduced bone turnover markers

    2. (b)

      Significant increased risk in lumbar spine fractures

    3. (c)

      Reduced bone mineral density, reduced bone microarchitecture, reduced bone turnover markers

    4. (d)

      Negative effects only in the cardiovascular system

  8. 8.

    Which describes the best first-line treatment for a female athlete with the Triad:

    1. (a)

      Immediate pharmacology intervention

    2. (b)

      10-min educational video on the Triad and psychological counseling

    3. (c)

      Education, reversal of weight loss, and increasing dietary intake

    4. (d)

      Pharmacology intervention, education, and increasing dietary intake

  9. 9.

    Effective eating disorder prevention programs should be:

    1. (a)

      Multimodal

    2. (b)

      Interactive

    3. (c)

      Target athletes, along with coaching staff and allied health professionals

    4. (d)

      All of the above

  10. 10.

    Luteinizing hormone (LH) pulsatility has a rhythm that would be characterized as having ____________ pulses during the follicular stage of the menstrual cycle.

    1. (a)

      High frequency, low amplitude

    2. (b)

      High frequency, high amplitude

    3. (c)

      Low frequency, low amplitude

    4. (d)

      Low frequency, high amplitude

Answers

  1. 1.

    a

  2. 2.

    d

  3. 3.

    b

  4. 4.

    c

  5. 5.

    a

  6. 6.

    d

  7. 7.

    c

  8. 8.

    c

  9. 9.

    d

  10. 10.

    a

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Cisneros, A., Quesnel, D.A., Robert-McComb, J.J. (2023). A Modern Understanding of the Models of Energy Deficits in Athletes. In: Robert-McComb, J.J., Zumwalt, M., Fernandez-del-Valle, M. (eds) The Active Female. Springer, Cham. https://doi.org/10.1007/978-3-031-15485-0_5

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  • DOI: https://doi.org/10.1007/978-3-031-15485-0_5

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-031-15485-0

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