TY - CHAP M1 - Book, Section TI - Low Energy Availability: Challenges and Approaches to Measurement and Treatment A1 - Burke, Louise A1 - Fahrenholtz, Ida A1 - Garthe, Ina A1 - Lundy, Bronwen A1 - Melin, Anna A2 - Burke, Louise A2 - Deakin, Vicki A2 - Minehan, Michelle PY - 2021 T2 - Clinical Sports Nutrition, 6e AB - The past three decades have seen an evolution in our understanding of problems involved with energy deficiency in athletes. The first defining step involved the formalisation of the Female Athlete Triad syndrome by the American College of Sports Medicine in 1997 (see Figure 6.1A), with advocacy for the recognition of a common presentation and interrelationship of eating disorders, amenorrhoea and osteoporosis/bone injuries in female athletes (Otis et al. 1997). The formation of the Female Athlete Triad Coalition and further refining of the American College of Sports Medicine model in 2007 (Nattiv et al. 2007) focused awareness that each corner of the Triad involves a spectrum between health and a disease (see Figure 6.1B). Furthermore, each athlete can ‘travel’ along each continuum at different times and rates, and there is a need for concern about any movement towards ill-health, rather than waiting for a clinical diagnosis to be reached. Additional insights included an expansion of the dietary contribution to the Triad, with recognition that energy deficiency rather than an eating disorder per se creates hormonal and metabolic perturbations and can be caused by a range of scenarios. It has been more clearly articulated that the particular type of energy deficiency in the Triad is low energy availability (LEA); the particular type of reproductive disorder is functional hypothalamic menstrual disorders (hereafter known as menstrual disorder/disturbance); and the particular type of skeletal impairment is the uncoupling of bone turnover, with an increased rate of bone resorption and a reduced rate of bone formation (Loucks 2015). SN - PB - McGraw Hill Education (Australia) Pty Ltd CY - New York, NY Y2 - 2024/04/23 UR - accessphysiotherapy.mhmedical.com/content.aspx?aid=1185563249 ER -