Energy is the currency needed to perform every activity in the body, both at rest and during exercise. In athletes, energy plays a crucial role in maintaining health and performance. However, it is widely known that not all athletes across different disciplines maintain sufficient energy intake to support their training and competition levels.
This leads to the concept of energy availability, which is the dietary energy remaining and available for optimal functioning of the body's systems after accounting for energy expended during physical exercise [1]. When dietary energy intake does not match energy expended through exercise, this produces a state called low energy availability ( LEA), in which there is not enough energy to support the body's health and performance functions. Low energy availability can occur acutely without negative effects, or become prolonged and chronic, causing substantial deterioration in health and performance.
When athletes experience prolonged, severe low energy availability, they can develop a syndrome involving impaired physiological and psychological functioning called Relative Energy Deficiency in Sport (RED-S) [1,2].
What Effects Does It Have on Health?
Without adequate energy availability, all body systems are compromised, mainly through a survival mechanism. When the body is in a serious state and lacks enough energy to carry out its normal functions, those functions are prevented or slowed.
This impairs reproductive function—absence of the menstrual cycle in women and reduced testosterone and libido in men— bone health, increasing the risk of osteoporosis and fractures; blood function, increasing anemia risk; muscle function, causing loss of muscle mass and strength; growth and development in children and adolescents; immunity , increasing the risk of infection and illness; gastrointestinal function, causing digestive problems; neurological function, including reduced concentration; and psycho-emotional health, including athlete stress or anxiety [1,2]. Together, these symptoms put the athlete's health at risk because every body system is affected.
What Effects Does It Have on Performance?
Performance consequences may arise directly from insufficient energy availability to sustain performance, and indirectly from its effects on health. If an athlete's health is compromised, a basic survival mechanism prevents maximal performance because running, jumping, swimming, cycling or lifting weights is not the body's priority. Protecting health is the priority.
This can lead to a reduced response to training, meaning athletes do not adapt to training sessions; poorer recovery after training; reduced cognitive performance and skills, mainly because of poorer concentration; and a lack of motivation in the athlete [1,2]. It can also cause reduced muscular strength, power and endurance performance. Together, these symptoms prevent athletes from performing at their best.
What Nutritional Strategies Can Increase Energy Intake?
Low energy availability can have several causes, but a common limitation is the inability to consume sufficient dietary energy [3]. In practical terms, several strategies can help achieve sufficient intake: 1) include carbohydrate-rich intra-workout intake such as bars, drinks or gels; 2) do not overuse low-energy preparations that provide a large volume of food, such as raw vegetables or large portions of soup; 3) include culinary preparations with soft textures or blended foods, such as hummus instead of whole chickpeas or purées instead of potatoes; 4) include liquid preparations, such as shakes or carbohydrate-rich drinks; and 5) use snacks with greater energycontent, especially carbohydrate around training, such as bars, nuts and shakes.
Conclusion
Energy is fundamental to athletes' performance and health. Adequate energy intake must therefore be ensured to prevent the potential negative consequences of insufficient intake. When low energy intake is a problem, several dietary strategies can be used to increase it.
Author
Lucas Jurado Fasoli – PhD in Biomedicine (UGR). Dietitian-Nutritionist. Postdoctoral researcher at the Joint University Institute of Sport and Health and the Department of Physiology, University of Granada.
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References
[1] Mountjoy M, Ackerman KE, Bailey DM, Burke LM, Constantini N, Hackney AC, et al. 2023 International Olympic Committee’s (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs). Br J Sports Med 2023;57:1073–97. https://doi.org/10.1136/bjsports-2023-106994.
[2] Burke LM, Ackerman KE, Heikura IA, Hackney AC, Stellingwerff T. Mapping the complexities of Relative Energy Deficiency in Sport (REDs): development of a physiological model by a subgroup of the International Olympic Committee (IOC) Consensus on REDs. Br J Sports Med 2023;57:1098–108.
[3] Torstveit MK, Ackerman KE, Constantini N, Holtzman B, Koehler K, Mountjoy ML, et al. Primary, secondary and tertiary prevention of Relative Energy Deficiency in Sport (REDs): a narrative review by a subgroup of the IOC consensus on REDs. Br J Sports Med 2023;57:1119–26.
