ReviewSports medicine (Auckland, N.Z.)2021
Effects of Low Energy Availability on Bone Health in Endurance Athletes and High-Impact Exercise as A Potential Countermeasure: A Narrative Review.
Review in Sports medicine (Auckland, N.Z.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 3 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
28 citing papers in PubMed, 3 syntheses or guidelines pooled it, 57 citations in OpenAlex.
- 2025 Update to the Female Athlete Triad Coalition Consensus Statement Part 2: Clinical Guidelines for Screening, Diagnosis, Treatment, and Return to Play for Adolescents and Adults.Sports medicine (Auckland, N.Z.) · 2026Guideline
- Does Swimming Exercise Impair Bone Health? A Systematic Review and Meta-Analysis Comparing the Evidence in Humans and Rodent Models.Sports medicine (Auckland, N.Z.) · 2024Pooled it
- Nutritional Strategies in the Rehabilitation of Musculoskeletal Injuries in Athletes: A Systematic Integrative Review.Nutrients · 2023Pooled it
- Propionibacterium cheese and bone turnover in active young adults: a randomized-controlled trial.Journal of bone and mineral metabolism · 2026Article
- From Routine Blood Tests to Metabolomics: A Contextual Framework for Interpreting Biomarkers of Training Load, Recovery, and Metabolic Stress in Athletes.Metabolites · 2026Review
- Menstrual status and bone health in athletes from different sports - a retrospective analysis.BMC sports science, medicine & rehabilitation · 2026Article
- Testosterone status and bone mineral density in Finnish male endurance athletes: Baseline associations and 1-year follow-up.Physiological reports · 2026Article
- 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
- Determinants of forearm bone mineral density in male athletes with different osteogenic index of training.Scientific reports · 2025Article
- Dietary Protein Intake and Its Associations With Bone Properties Using Peripheral Quantitative Computed Tomography and Dual-Energy X-Ray Absorptiometry in Endurance-Trained Individuals.Current developments in nutrition · 2025Article
- New approach to identifying elite winter sport athletes' risk of relative energy deficiency in sport (REDs).BMJ open sport & exercise medicine · 2025Article
- Measurement of energy availability in highly trained male endurance athletes and examination of its associations with bone health and endocrine function.European journal of nutrition · 2024Article
- Multi-organ transcriptome atlas of a mouse model of relative energy deficiency in sport.Cell metabolism · 2024Article
- Beyond Menstrual Dysfunction: Does Altered Endocrine Function Caused by Problematic Low Energy Availability Impair Health and Sports Performance in Female Athletes?Sports medicine (Auckland, N.Z.) · 2024Review
- Criteria and Guidelines for Returning to Running Following a Tibial Bone Stress Injury: A Scoping Review.Sports medicine (Auckland, N.Z.) · 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
- Review
- Article
- Short-term effects and long-term changes of FUEL-a digital sports nutrition intervention on REDs related symptoms in female athletes.Frontiers in sports and active living · 2023Article
- Bone health in Norwegian female elite runners: a cross-sectional, controlled study.BMJ open sport & exercise medicine · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Endurance athletes expend large amounts of energy in prolonged high-intensity exercise and, due to the weight-sensitive nature of most endurance sports, often practice periods of dietary restriction. The Female Athlete Triad and Relative Energy Deficiency in Sport models consider endurance athletes at high-risk for suffering from low energy availability and associated health complications, including an increased chance of bone stress injury. Several studies have examined the effects of low energy availability on various parameters of bone structure and markers of bone (re)modelling; however, there are differences in findings and research methods and critical summaries are lacking. It is difficult for athletes to reduce energy expenditure or increase energy intake (to restore energy availability) in an environment where performance is a priority. Development of an alternative tool to help protect bone health would be beneficial. High-impact exercise can be highly osteogenic and energy efficient; however, at present, it is rarely utilized to promote bone health in endurance athletes. Therefore, with a view to reducing the prevalence of bone stress injury, the objectives of this review are to evaluate the effects of low energy availability on bone health in endurance athletes and explore whether a high-impact exercise intervention may help to prevent those effects from occurring.
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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.