ArticleJournal of the International Society of Sports Nutrition2020
The risk of low energy availability in Chinese elite and recreational female aesthetic sports athletes.
Article in Journal of the International Society of Sports Nutrition, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 3 of them syntheses that pooled it.
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Who cites it
38 citing papers in PubMed, 3 syntheses or guidelines pooled it, 95 citations in OpenAlex.
- Key Factors Impacting Performance Health During Growth and Maturation in Adolescent Competitive Aesthetic and Acrobatic Athletes: A Systematic Review.Sports medicine (Auckland, N.Z.) · 2026Pooled it
- Low Energy Availability and Relative Energy Deficiency in Sport: A Systematic Review and Meta-analysis.Sports medicine (Auckland, N.Z.) · 2025Pooled it
- The Prevalence of Menstrual Cycle Disorders and Menstrual Cycle-Related Symptoms in Female Athletes: A Systematic Literature Review.Sports medicine (Auckland, N.Z.) · 2023Pooled it
- Primary functional hypothalamic amenorrhoea in the context of feeding and eating disorders or excessive exercise: Insights from non-athletic and elite athletic populations.Journal of neuroendocrinology · 2026Review
- 2025 Update to the Female Athlete Triad Coalition Consensus Statement Part 1: State of the Science and Introduction of a New Adolescent Model.Sports medicine (Auckland, N.Z.) · 2026Review
- 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
- Article
- Protecting women's health in sport: the role of low energy availability in the Female Athlete Triad and RED-S.Frontiers in sports and active living · 2026Review
- The impact of low energy availability risk on pre-competition physiological function in Chinese female combat athletes.Journal of the International Society of Sports Nutrition · 2025Article
- Does Relative Energy Deficiency in Sport (REDs) Syndrome Exist?Sports medicine (Auckland, N.Z.) · 2024Review
- Menstrual Dysfunction in Adolescent Female Athletes.Sports (Basel, Switzerland) · 2024Review
- A systematic review, meta-analysis, and meta-regression of the prevalence of self-reported disordered eating and associated factors among athletes worldwide.Journal of eating disorders · 2024Article
- Dietary intake, energy availability, and power in men collegiate gymnasts.Frontiers in sports and active living · 2024Article
- The relationship between low energy availability, injuries, and bone health in recreational female athletes.PeerJ · 2024Article
- 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
- Article
- Eating Disorder Risk and Pathogenic Behaviors Among Collegiate Student-Athletes.Journal of athletic training · 2023Article
- Prevalence of Relative Energy Deficiency in Sport (RED-S) among National Athletes in Malaysia.Nutrients · 2023Article
- Article
- Untangling risk factors including discipline-specific exposure for injuries in preprofessional and professional circus artists in the USA.BMJ open sport & exercise medicine · 2023Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 3 countries.
Funding
Abstract
backgroundLow energy availability (LEA) is a medical condition observed in athletes, with a higher prevalence in aesthetic sports. For the first time, this study evaluated the relative prevalence of LEA in female elite athletes (ELA) and recreational athletes (REA) in aesthetic sports in China.
methodsFemale athletes from 6 sports (trampolining, rhythmic gymnastics, aerobics, dance sport, cheerleading and dance) were recruited, including ELA (n = 52; age = 20 ± 3) on Chinese national teams and REA (n = 114; Age = 20 ± 2) from Beijing Sport University. Participants completed 2 online questionnaires to assess LEA and eating disorder risk. These included the Low Energy Availability in Females Questionnaire (LEAF-Q), which provided information on injury history, gastrointestinal function and menstrual history, and the Eating Disorder Inventory-3 Referral Form (EDI-3 RF). For a sub-group of elite athletes (n = 14), body composition, bone mineral density, and blood serum were also quantified.
resultsA total of 41.6% of participants (n = 69) were at increased risk of LEA, and 57.2% of participants (n = 95) were classified as high in eating disorder risk. For ELA vs. REA, there was a significantly higher prevalence of LEA risk (55.8% vs. 35.1%; p = 0.012) and amenorrhea (53.8% vs. 13.3%; p < 0.001). Elite athletes at increased risk of LEA had significantly lower estradiol (p = 0.021) and whole-body BMD (p = 0.028). Pearson correlations indicated that the whole-body BMD (r = - 0.667, p = 0.009) correlated negatively with LEAF-Q score.
conclusionsResults of this study indicate that there is a risk of LEA in female Chinese athletes within aesthetic sports, and significantly higher prevalence of increased LEA risk observed in ELA than in REA. Chinese coaches and sports medicine staff working elite female athletes in aesthetic sports should develop strategies to reduce the prevalence of LEA.
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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.