ReviewEuropean journal of nutrition2018
Reduced energy availability: implications for bone health in physically active populations.
Review in European journal of nutrition, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
59 citing papers in PubMed, 5 syntheses or guidelines pooled it, 127 citations in OpenAlex.
- Pharmacological interventions to improve bone density in functional hypothalamic amenorrhea: a systematic review and network meta-analysis of randomized clinical trials.The Journal of clinical endocrinology and metabolism · 2026Pooled it
- The Influence of Nutrition Intervention on the P1NP and CTX-1 Response to an Acute Exercise Bout: A Systematic Review with Meta-Analysis.Sports medicine (Auckland, N.Z.) · 2024Pooled it
- A literature review of biomarkers used for diagnosis of relative energy deficiency in sport.Frontiers in sports and active living · 2024Pooled it
- Bone Quality in Competitive Athletes: A Systematic Review.Journal of musculoskeletal & neuronal interactions · 2023Pooled it
- Geometric and "True" Densitometric Characteristics of Bones in Athletes with Stress Fracture and Menstrual Disturbances: A Systematic Review.Sports medicine (Auckland, N.Z.) · 2019Pooled it
- The gut-bone axis: impact of diet on gut microbiome and osteoporosis.Bone research · 2026Review
- Energy availability as an integrative framework: reinterpreting the energy balance and carbohydrate-insulin models in athletes.Physical activity and nutrition · 2026Article
- Regulating Glucose Metabolism Enzymes for Osteoporosis Therapy: Current and Future Approaches.International journal of molecular sciences · 2026Review
- From amenorrhea to pregnancy: spontaneous recovery of the female athlete triad during the COVID-19 pandemic.Archives of endocrinology and metabolism · 2026Article
- Relationships Between Hematological Variables and Bone Metabolism in Elite Female Trail Runners.Healthcare (Basel, Switzerland) · 2026Article
- Low energy availability, the gut microbiome, and bone health in athletes: a mechanistic narrative review based on athlete evidence and clinical analogues.Frontiers in nutrition · 2026Review
- Energy Expenditure Exceeds Nutritional Intake of ROTC Members During a Field Training Exercise.Journal of functional morphology and kinesiology · 2025Article
- Hormone Profiles After Planned Low Energy Availability Exposure in Naturally Menstruating and Hormonal Contraceptive Using Physique Athletes.European journal of sport science · 2025Observational
- Conservative and Pharmacological Strategies for Preventing Osteoporotic Stress Fractures in Older Recreational Competitors.Healthcare (Basel, Switzerland) · 2025Review
- Optimizing Performance Nutrition for Adolescent Athletes: A Review of Dietary Needs, Risks, and Practical Strategies.Nutrients · 2025Review
- Resistance and Aerobic Preconditioning Delays Unloading-Induced Multisystemic Physiological Changes: The NEBULA Project.FASEB journal : official publication of the Federation of American Societies for Experimental Biology · 2025Article
- Evaluating the prevalence of eating disorder risk and low energy availability risk in collegiate athletes.Journal of eating disorders · 2025Article
- Muscle, Fat, Bone, and Lungs: Unlocking the Fitness and Health Equation of Firefighters in Porto, Portugal.Life (Basel, Switzerland) · 2025Article
- Relative Energy Deficiency in Sport-Multidisciplinary Treatment in Clinical Practice.Nutrients · 2025Article
- The relationship between screen time, screen content for children aged 1-3, and the risk of ADHD in preschools.PloS one · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe present review critically evaluates existing literature on the effects of short- and long-term low energy availability (EA) on bone metabolism and health in physically active individuals.
methodsWe reviewed the literature on the short-term effects of low EA on markers of bone metabolism and the long-term effects of low EA on outcomes relating to bone health (bone mass, microarchitecture and strength, bone metabolic markers and stress fracture injury risk) in physically active individuals.
resultsAvailable evidence indicates that short-term low EA may increase markers of bone resorption and decrease markers of bone formation in physically active women. Bone metabolic marker responses to low EA are less well known in physically active men. Cross-sectional studies investigating the effects of long-term low EA suggest that physically active individuals who have low EA present with lower bone mass, altered bone metabolism (favouring bone resorption), reduced bone strength and increased risk for stress fracture injuries.
conclusionsReduced EA has a negative influence on bone in both the short- and long-term, and every effort should be made to reduce its occurrence in physically active individuals. Future interventions are needed to explore the effects of long-term reduced EA on bone health outcomes, while short-term low EA studies are also required to give insight into the pathophysiology of bone alterations.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.