ReviewEuropean journal of applied physiology2021
Low energy availability: history, definition and evidence of its endocrine, metabolic and physiological effects in prospective studies in females and males.
Review in European journal of applied physiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 105 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.
Energy Availability, Eating Disorder and RED-S Risk, Health Biomarkers, Gut Microbiota Composition and Performance in Competitive Male Athletes Across the Season
Low Energy Availability and Cardiovascular Disease
Who cites it
105 citing papers in PubMed, 5 syntheses or guidelines pooled it, 176 citations in OpenAlex.
- Impaired neuromusculoskeletal response to training stimuli associated with low energy availability: a systematic review.British journal of sports medicine · 2026Pooled it
- Nutrition educational interventions for athletes related to low energy availability: A systematic review.PloS one · 2025Pooled it
- A literature review of biomarkers used for diagnosis of relative energy deficiency in sport.Frontiers in sports and active living · 2024Pooled it
- Nutritional Strategies in the Rehabilitation of Musculoskeletal Injuries in Athletes: A Systematic Integrative Review.Nutrients · 2023Pooled it
- Markers of Low Energy Availability in Overreached Athletes: A Systematic Review and Meta-analysis.Sports medicine (Auckland, N.Z.) · 2022Pooled it
- Low Carbohydrate Availability in Energy Balance Alters Bone Turnover and Muscle Proteomic Response With Limited Endocrine Disruption.FASEB journal : official publication of the Federation of American Societies for Experimental Biology · 2026Trial
- Metabolic signature of short-term low energy availability.Physiological reports · 2025Trial
- Reducing energy availability in male endurance athletes: a randomized trial with a three-step energy reduction.Journal of the International Society of Sports Nutrition · 2022Trial
- Trial
- Post-competition recovery in natural physique athletes: body composition, metabolic adaptation, and refeeding responses.Journal of the International Society of Sports Nutrition · 2026Article
- Association between dietary intake, energy availability, and recovery in young sub-elite Moroccan football players.Journal of the International Society of Sports Nutrition · 2026Article
- Exercise and Fat: A Primer.Sports medicine - open · 2026Review
- 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
- Comparing RMR-Derived Proxy Indicators and LEAF-Q for Detecting Low Energy Availability Risk in Mixed-Sport Female Athletes.Sports (Basel, Switzerland) · 2026Article
- Relative Energy Deficiency in Sport (REDs) and Body Composition.Sports (Basel, Switzerland) · 2026Review
- Metabolic pattern across energy imbalance: An exploratory metabolomics study of female body weight extremes including anorexia nervosa and athletes.Experimental physiology · 2026Article
- Sub-Optimal Nutritional Knowledge and Dietary Intake in Gaelic Team Sport Athletes: Limited Associations Between Knowledge and Dietary Adequacy.Nutrients · 2026Article
- From Routine Blood Tests to Metabolomics: A Contextual Framework for Interpreting Biomarkers of Training Load, Recovery, and Metabolic Stress in Athletes.Metabolites · 2026Review
- Impact of United States marine corps recruit training on the stress response and menstrual function in female marine recruits.Physiological reports · 2026Article
- Energy availability as an integrative framework: reinterpreting the energy balance and carbohydrate-insulin models in athletes.Physical activity and nutrition · 2026Article
45 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Energy availability (EA) is defined as the amount of dietary energy available to sustain physiological function after subtracting the energetic cost of exercise. Insufficient EA due to increased exercise, reduced energy intake, or a combination of both, is a potent disruptor of the endocrine milieu. As such, EA is conceived as a key etiological factor underlying a plethora of physiological dysregulations described in the female athlete triad, its male counterpart and the Relative Energy Deficiency in Sport models. Originally developed upon female-specific physiological responses, this concept has recently been extended to males, where experimental evidence is limited. The majority of data for all these models are from cross-sectional or observational studies where hypothesized chronic low energy availability (LEA) is linked to physiological maladaptation. However, the body of evidence determining causal effects of LEA on endocrine, and physiological function through prospective studies manipulating EA is comparatively small, with interventions typically lasting ≤ 5 days. Extending laboratory-based findings to the field requires recognition of the strengths and limitations of current knowledge. To aid this, this review will: (1) provide a brief historical overview of the origin of the concept in mammalian ecology through its evolution of algebraic calculations used in humans today, (2) Outline key differences from the 'energy balance' concept, (3) summarise and critically evaluate the effects of LEA on tissues/systems for which we now have evidence, namely: hormonal milieu, reproductive system endocrinology, bone metabolism and skeletal muscle; and finally (4) provide perspectives and suggestions for research upon identified knowledge gaps.
Indexed as
Identifiers
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.