ArticleBMJ open sport & exercise medicine2018
Low energy availability assessed by a sport-specific questionnaire and clinical interview indicative of bone health, endocrine profile and cycling performance in competitive male cyclists.
Article in BMJ open sport & exercise medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
41 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A literature review of biomarkers used for diagnosis of relative energy deficiency in sport.Frontiers in sports and active living · 2024Pooled it
- Effects of Short-Term Low Energy Availability on Metabolism and Performance-Related Parameters in Physically Active Adults.Nutrients · 2025Trial
- Impact of a 4-Week Intensified Endurance Training Intervention on Markers of Relative Energy Deficiency in Sport (RED-S) and Performance Among Well-Trained Male Cyclists.Frontiers in endocrinology · 2020Trial
- Mental health in elite athletes: International Olympic Committee consensus statement (2026).British journal of sports medicine · 2026Article
- Ageing, Sex Differences, and REDs Risk in Endurance Runners: An Integrated Cross-Sectional Study Protocol.Sports (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
- Low Energy Availability and Its Impact on Bone Health and Metabolism in Athletes: A Narrative Review.Physiological research · 2025Review
- Assessing the risk of low energy availability, bone mineral density and psychological strain in endurance athletes.Journal of the International Society of Sports Nutrition · 2025Article
- Short-Term Severe Low Energy Availability in Athletes: Molecular Mechanisms, Endocrine Responses, and Performance Outcomes-A Narrative Review.Scandinavian journal of medicine & science in sports · 2025Review
- Article
- Does Relative Energy Deficiency in Sport (REDs) Syndrome Exist?Sports medicine (Auckland, N.Z.) · 2024Review
- Assessment of entropy accumulation in human subjects when exposed to low energy availability.Heliyon · 2024Article
- Multi-organ transcriptome atlas of a mouse model of relative energy deficiency in sport.Cell metabolism · 2024Article
- Relationship between fat-free mass index and nutrient intake in protein supplement user among Japanese collegiate soccer athletes.Physical activity and nutrition · 2024Article
- High prevalence of stress fractures and long-term amenorrhoea in high endurance female athletes: The misleading lack of correlation with bone mineral density.Journal of orthopaedics · 2024Article
- Identifying and Analyzing Low Energy Availability in Athletes: The Role of Biomarkers and Red Blood Cell Turnover.Nutrients · 2024Review
- Body Mass Index Trends for the Top Five Finishers in Men's Grand Tour and Monument Cycling Events from 1994-2023: Implications for Athletes and Sporting Stakeholders.Sports (Basel, Switzerland) · 2024Article
- Physiological Perturbations in Combat Sports: Weight Cycling and Metabolic Function-A Narrative Review.Metabolites · 2024Review
- Article
- Energy availability and its association with health-related outcomes among national athletes at risk of relative energy deficiency in sports (REDs).BMJ open sport & exercise medicine · 2024Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo evaluate the efficacy of a sport-specific energy availability (EA) questionnaire, combined with clinical interview, for identifying male athletes at risk of developing bone health, endocrine and performance consequences of relative energy deficiency in sports (RED-S).
methodsFifty competitive male road cyclists, recruited through links of participants in a pilot study, were assessed by a newly developed sport-specific questionnaire and clinical interview (SEAQ-I) and received dual energy X-ray absorptiometry (DXA) bone mineral density (BMD) and body composition scans and blood tests for endocrine markers.
resultsLow EA as assessed using the SEAQ-I, was observed in 28% of cyclists. Low lumbar spine BMD (Z-score<-1.0) was found in 44% of cyclists. EA was the most significant determinant of lumbar spine BMD Z-score (p<0.001). Among low EA cyclists, lack of previous load-bearing sport was associated with the lowest BMD (p=0.013). Low EA was associated with reduced total percentage fat (p<0.019). The 10 cyclists with chronic low EA had lower levels of testosterone compared with those having adequate EA (p=0.024). Mean vitamin D concentration was below the level recommended for athletes (90 nmol/L). Training loads were positively associated with power-to-weight ratios, assessed as 60 min functional threshold power (FTP) per kg (p<0.001). Percentage body fat was not significantly linked to cycling performance.
conclusionsThis study demonstrates that a SEAQ-I is effective for identifying male road cyclists with acute intermittent and chronic sustained low EA. Cyclists with low EA, particularly in the long-term, displayed adverse quantifiable measures of bone, endocrinology and performance consequences of RED-S.
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