Melin Anna K, Heikura Ida A, Tenforde Adam, Mountjoy Margo
1 University of Copenhagen.
2 Australian Institute of Sport.
Int J Sport Nutr Exerc Metab. 2019 Mar 1;29(2):152-164. doi: 10.1123/ijsnem.2018-0201. Epub 2019 Feb 26.
The reported prevalence of low energy availability (LEA) in female and male track and field athletes is between 18% and 58% with the highest prevalence among athletes in endurance and jump events. In male athletes, LEA may result in reduced testosterone levels and libido along with impaired training capacity. In female track and field athletes, functional hypothalamic amenorrhea as consequence of LEA has been reported among 60% of elite middle- and long-distance athletes and 23% among elite sprinters. Health concerns with functional hypothalamic amenorrhea include impaired bone health, elevated risk for bone stress injury, and cardiovascular disease. Furthermore, LEA negatively affects recovery, muscle mass, neuromuscular function, and increases the risk of injuries and illness that may affect performance negatively. LEA in track and field athletes may occur due to intentional alterations in body mass or body composition, appetite changes, time constraints, or disordered eating behavior. Long-term LEA causes metabolic and physiological adaptations to prevent further weight loss, and athletes may therefore be weight stable yet have impaired physiological function secondary to LEA. Achieving or maintaining a lower body mass or fat levels through long-term LEA may therefore result in impaired health and performance as proposed in the Relative Energy Deficiency in Sport model. Preventive educational programs and screening to identify athletes with LEA are important for early intervention to prevent long-term secondary health consequences. Treatment for athletes is primarily to increase energy availability and often requires a team approach including a sport physician, sports dietitian, physiologist, and psychologist.
据报道，男女田径运动员中低能量可利用性（LEA）的患病率在18%至58%之间，耐力和跳跃项目的运动员患病率最高。在男性运动员中，低能量可利用性可能导致睾酮水平和性欲降低，以及训练能力受损。在女子田径运动员中，据报道，60%的精英中长跑运动员和23%的精英短跑运动员因低能量可利用性而出现功能性下丘脑性闭经。功能性下丘脑性闭经引发的健康问题包括骨骼健康受损、骨应力损伤风险增加以及心血管疾病。此外，低能量可利用性对恢复、肌肉量、神经肌肉功能产生负面影响，并增加受伤和患病风险，可能对运动表现产生负面影响。田径运动员出现低能量可利用性可能是由于体重或身体成分的有意改变、食欲变化、时间限制或饮食行为紊乱。长期的低能量可利用性会引起代谢和生理适应，以防止体重进一步减轻，因此运动员体重可能稳定，但因低能量可利用性继发生理功能受损。因此，如运动相对能量缺乏模型所提出的，通过长期低能量可利用性来实现或维持较低体重或脂肪水平可能会导致健康和运动表现受损。预防性教育计划和筛查以识别低能量可利用性的运动员对于早期干预以防止长期的继发健康后果很重要。对运动员的治疗主要是增加能量可利用性，通常需要团队协作，包括运动医生、运动营养师、生理学家和心理学家。
