Nutritional Interventions for Treatment of REDs Aimed at LEA factors

University courses Physical Sciences
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Given that Low Energy Availability (LEA) is the underlying cause of REDs. treatment must correct LEA through increasing energy intake, reducing energy expenditure and/or a combination of both. However, due to the significant error in calculating energy availability, treatment should also focus on factors that exacerbate and/or independently affect the health outcomes of LEA.

Exacerbating Factors:

  1. Within day energy deficiency
  2. Low carbohydrate availability
  3. Excessive fiber intake
  4. Inadequate intake of bone-building nutrients

Mechanism

  1. The more time over 24 hrs spent in an energy deficit is associated with LEA markers
  2. Low carb availability may impair bone turnover and immune function, even independent of energy availability
  3. High fiber diet may increase satiety, making it difficult to meet energy requirements. Excessive fiber intake may reduce oestrogen reabsorption and contribute to menstrual dysfunction
  4. Lack of bone-building nutrients which may occur due to LEA or independent energy availability may compromise bone health

Nutrition Intervention

  1. Consume adequate energy around training. Consume breakfast upon waking & a meal or snack every 3-5 hours throughout the day
  2. Ensure total daily carb requirements are being met. Ensure adequate carb intake before/during/after training. Only undertake specific sessions of training with low glycogen / overnight fasting with extreme care and only when properly integrated into a periodised training programme.
  3. Consider replacing high-fiber foods with lower fiber options.
  4. Ensure adequate intake of nutrients important for b0ne health (e.g. calcium, vitamin D). Consider having Vitamin D status of an athlete assessed. Consider supplementation if intake is insufficient.
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