Commonly Used Indicators of Low Energy Availability Risk Fail to Identify Female Amateur Soccer Players With Measured Low Energy Availability During Preseason

This study aimed to determine energy availability (EA) and within-day energy balance (WDEB) in female soccer players during preseason and also explored eating disorder risk and athlete food choice. We hypothesized commonly used indicators of low energy availability (LEA) risk would correlate with measured EA and WDEB variables, and that food choice determinants would differ according to EA. Eleven National Premier League female soccer players participated in this observational cross-sectional study over 3 weeks. Assessment of resting metabolic rate and physique traits, including bone mineral density, was conducted during Weeks 1 or 3. During Week 2, dietary intake, energy expenditure, and continuous monitor-derived glucose were measured for 5 days. EA was calculated daily and WDEB calculated hourly with deficits/surpluses carried continuously. Questionnaires were administered throughout the 3 weeks, including the Athlete Food Choice Questionnaire, the Eating Disorders Screen for Athletes, and the Low Energy Availability in Females Questionnaire. Resting metabolic rate ratio, bone mineral density, Low Energy Availability in Females Questionnaire, and Eating Disorders Screen for Athletes scores were used as indicators of LEA risk. EA averaged 30.7 ± 7.5 kcals·kg fat-free mass-1·day-1. Approximately one-third (36%) of athletes were at risk of an eating disorder, while approximately half (45%) were identified at risk of the female athlete triad via Low Energy Availability in Females Questionnaire, compared with approximately one-third (36%) of athletes identified with EA < 30 kcal·kg fat-free mass-1·day-1. No athlete achieved EA >45 kcal·kg fat-free mass-1·day-1, and no indicator of LEA risk was associated with calculated EA or WDEB. However, overnight glycemic variability was positively correlated with measured EA (r = .722, p = .012).