RT Book, Section
A1 Burke, Louise
A1 Fahrenholtz, Ida
A1 Garthe, Ina
A1 Lundy, Bronwen
A1 Melin, Anna
A2 Burke, Louise
A2 Deakin, Vicki
A2 Minehan, Michelle
SR Print(0)
ID 1185563249
T1 Low Energy Availability: Challenges and Approaches to Measurement and Treatment
T2 Clinical Sports Nutrition, 6e
YR 2021
FD 2021
PB McGraw Hill Education (Australia) Pty Ltd
PP New York, NY
SN 9781743767900
LK accessphysiotherapy.mhmedical.com/content.aspx?aid=1185563249
RD 2024/04/19
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).