Relative Energy Deficiency in Sport in Male Athletes: A Commentary on Its Presentation Among Selected Groups of Male Athletes

in International Journal of Sport Nutrition and Exercise Metabolism
Restricted access

Purchase article

USD  $24.95

Student 1 year subscription

USD  $87.00

1 year subscription

USD  $116.00

Student 2 year subscription

USD  $165.00

2 year subscription

USD  $215.00

Low energy availability (LEA) is a key element of the Female Athlete Triad. Causes of LEA include failure to match high exercise energy expenditure (unintentional) or pathological behaviors of disordered eating (compulsive) and overzealous weight control programs (misguided but intentional). Recognition of such scenarios in male athletes contributed to the pronouncement of the more inclusive Relative Energy Deficiency in Sport (RED-S) syndrome. This commentary describes the insights and experience of the current group of authors around the apparently heightened risk of LEA in some populations of male athletes: road cyclists, rowers (lightweight and open weight), athletes in combat sports, distance runners, and jockeys. The frequency, duration, and magnitude of the LEA state appear to vary between populations. Common risk factors include cyclical management of challenging body mass and composition targets (including “making weight”) and the high energy cost of some training programs or events that is not easily matched by energy intake. However, additional factors such as food insecurity and lack of finances may also contribute to impaired nutrition in some populations. Collectively, these insights substantiate the concept of RED-S in male athletes and suggest that a specific understanding of a sport, subpopulation, or culture may identify a complex series of factors that can contribute to LEA and the type and severity of its outcomes. This commentary provides a perspective on the range of risk factors that should be addressed in future surveys of RED-S in athletic populations and targeted for specific investigation and modification.

Burke and Lundy are with Sports Nutrition, Australian Institute of Sport, Belconnen, Australian Capital Territory, Australia; and Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia. Close and Morton are with the Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom. Mooses is with the Institute of Sport Sciences and Physiotherapy, Faculty of Medicine, University of Tartu, Tartu, Estonia. Tenforde is with Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA.

Address author correspondence to Louise M. Burke at Louise.burke@ausport.gov.au.
  • Ackerman, K., & Tenforde, A. (2018). Endocrine review. International Journal of Sport Nutrition and Exercise Metabolism. Manuscript in preparation.

    • Search Google Scholar
    • Export Citation
  • Alderman, B., Landers, D.M., Carlson, J., & Scott, J.R. (2004). Factors related to rapid weight loss practices among international-style wrestlers. Medicine & Science in Sports & Exercise, 36(2), 249–252. PubMed ID: 14767247 doi:10.1249/01.MSS.0000113668.03443.66

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Areta, J.L., Burke, L.M., Camera, D.M., West, D.W., Crawshay, S., Moore, D.R., … Coffey, V.G. (2014). Reduced resting skeletal muscle protein synthesis is rescued by resistance exercise and protein ingestion following short-term energy deficit. American Journal of Physiology: Endocrinology and Metabolism, 306(8), 989–997. PubMed ID: 24595305

    • Search Google Scholar
    • Export Citation
  • Armstrong, L. (2000). It’s not about the bike: My journey back to life (p. 224). Sydney, Australia: Allen & Unwin.

  • Barrack, M.T., Fredericson, M., Tenforde, A.S., & Nattiv, A. (2017). Evidence of a cumulative effect for risk factors predicting lower bone mass among male adolescent athletes. British Journal of Sports Medicine, 51, 200–205. PubMed ID: 29461218 doi:10.1136/bjsports-2016-096698

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Barrack, M.T., Rauh, M.J., & Nichols, J.F. (2008). Prevalence of and traits associated with low BMD among female adolescent runners. Medicine & Science in Sports & Exercise, 40(12), 2015–2021. PubMed ID: 18981950 doi:10.1249/MSS.0b013e3181822ea0

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Barry, D.W., & Kohrt, W.M. (2008). BMD decreases over the course of a year in competitive male cyclists. Journal of Bone and Mineral Research, 23, 484–491. PubMed ID: 18072875 doi:10.1359/jbmr.071203

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Beis, L.Y., Willkomm, L., Ross, R., Bekele, Z., Wolde, B., Fudge, B., & Pitsiladis, Y.P. (2011). Food and macronutrient intake of elite Ethiopian distance runners. Journal of the International Society of Sports Nutrition, 8, 7. PubMed ID: 21595961 doi:10.1186/1550-2783-8-7

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Boardman, C. (2000). The complete book of cycling (pp. 45–46). London, UK: Partridge.

  • Brugh, D.D., Williford, J.H., Chibucos, T.R., & Shewokis, P.A. (2001). The frequency of eating disorder tendencies among male high school wrestlers, non wrestler athletes, and nonathletes. Journal of the American Dietetic Association, 101(9), A86. doi:10.1016/S0002-8223(01)80294-7

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Burke, L.M., Melin, A., Fahrenholtz, I., & Lundy, B. (2018). Pitfalls and problems with measuring energy availability. International Journal of Sport Nutrition and Exercise Metabolism. Manuscript in preparation.

    • Search Google Scholar
    • Export Citation
  • Campion, F., Nevill, A.M., Karlsson, M.K., Lounana, J., Shabani, M., Fardellone, P., & Medelli, J. (2010). Bone status in professional cyclists. International Journal of Sports Medicine, 31(7), 511–515. PubMed ID: 20432201 doi:10.1055/s-0029-1243616

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Christensen, D.L., Van Hall, G., & Hambraeus, L. (2002). Food and macronutrient intake of male adolescent Kalenjin runners in Kenya. The British Journal of Nutrition, 88(6), 711–717. PubMed ID: 12493093 doi:10.1079/BJN2002728

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Close, G.L., Russell, J., Cobley, J.N., Owens, D.J., Wilson, G., Gregson, W., … Morton, J.P. (2013). Assessment of vitamin D concentration in non-supplemented professional athletes and healthy adults during the winter months in the UK: Implications for skeletal muscle function. Journal of Sports Sciences, 31(4), 344–353. PubMed ID: 23083379 doi:10.1080/02640414.2012.733822

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Crighton, B., Close, G.L., & Morton, J.P. (2016). Alarming weight cutting behaviours in mixed martial arts: A cause for concern and a call for action. British Journal of Sports Medicine, 50(8), 446–447. PubMed ID: 26459278 doi:10.1136/bjsports-2015-094732

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Daniele, G., Weinstein, R.N., Wallace, P.W., Palmieri, V., & Bianco, M. (2016). Rapid weight gain in professional boxing and correlation with fight decisions: Analysis from 71 title fights. The Physician and Sportsmedicine, 44(4), 349–354. PubMed ID: 27564844 doi:10.1080/00913847.2016.1228421

    • Crossref
    • Search Google Scholar
    • Export Citation
  • da Silva Santos, J.F., Takito, M.Y., Artioli, G.G., & Franchini, E. (2016). Weight loss practices in Taekwondo athletes of different competitive levels. Journal of Exercise Rehabilitation, 12(3), 202–208. PubMed ID: 27419116 doi:10.12965/jer.1632610.305

    • Crossref
    • Search Google Scholar
    • Export Citation
  • De Souza, M.J., Nattiv, A., Joy, E., Misra, M., Williams, N.I., Mallinson, R.J., … American Bone Health Alliance. (2014). 2014 Female Athlete Triad Coalition consensus statement on treatment and return to play of the female athlete triad: 1st International Conference held in San Francisco, CA, May 2012, and 2nd International Conference held in Indianapolis, IN, May 2013. Clinical Journal of Sport Medicine, 24(2), 96–119. PubMed ID: 24569429 doi:10.1097/JSM.0000000000000085

    • Search Google Scholar
    • Export Citation
  • De Sousa, M.V., Pereira, R.M., Fukui, R., Caparbo, V.F., & da Silva, M.E. (2014). Carbohydrate beverages attenuate bone resorption markers in elite runners. Metabolism: Clinical and Experimental, 63(12), 1536–1541. doi:10.1016/j.metabol.2014.08.011

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Dolan, E., Crabtree, N., McGoldrick, A., Ashley, D.T., McCaffrey, N., & Warrington, G.D. (2012). Weight regulation and bone mass: A comparison between professional jockeys, elite amateur boxers, and age, gender and BMI matched controls. Journal of Bone and Mineral Metabolism, 30(2), 164–170. PubMed ID: 21773703 doi:10.1007/s00774-011-0297-1

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Dolan, E., O’Connor, H., McGoldrick, A., O’Loughlin, G., Lyons, D., & Warrington, G. (2011). Nutritional, lifestyle, and weight control practices of professional jockeys. Journal of Sports Sciences, 29(8), 791–799. PubMed ID: 21506039 doi:10.1080/02640414.2011.560173

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Dulloo, A.G. (1997). Regulation of body composition during weight recovery: Integrating the control of energy partitioning and thermogenesis. Clinical Nutrition, 16(Suppl. 1), 25–35. doi:10.1016/S0261-5614(97)80046-5

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Dulloo, A.G., Jacquet, J., Miles-Chan, J.L., & Schutz, Y. (2017). Passive and active roles of fat-free mass in the control of energy intake and body composition regulation. European Journal of Clinical Nutrition, 71(3), 353–357. PubMed ID: 27966570 doi:10.1038/ejcn.2016.256

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Filaire, E., Rouveix, M., Pannafieux, C., & Ferrand, C. (2007). Eating attitudes, perfectionism and body-esteem of elite male judoists and cyclists. Journal of Sports Science & Medicine, 6, 50–57. PubMed ID: 24149224

    • Search Google Scholar
    • Export Citation
  • Fredericson, M., Chew, K., Ngo, J., Cleek, T., Kiratli, J., & Cobb, K. (2007). Regional bone mineral density in male athletes: A comparison of soccer players, runners and controls. British Journal of Sports Medicine, 41(10), 664–668. PubMed ID: 17473003 doi:10.1136/bjsm.2006.030783

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Friedl, K.E., Moore, R.J., Hoyt, R.W., Marchitelli, L.J., Martinez-Lopez, L.E., & Askew, E.W. (2000). Endocrine markers of semistarvation in healthy lean men in a multistressor environment. Journal of Applied Physiology, 88(5), 1820–1830. doi:10.1152/jappl.2000.88.5.1820

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Fudge, B.W., Easton, C., Kingsmore, D., Kiplamai, F.K., Onywera, V.O., Westerterp, K.R., … Pitsiladis, Y.P. (2008). Elite Kenyan endurance runners are hydrated day-to-day with ad libitum fluid intake. Medicine & Science in Sports & Exercise, 40(6), 1171–1179. PubMed ID: 18460986 doi:10.1249/MSS.0b013e318169cdda

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Fudge, B.W., Westerterp, K.R., Kiplamai, F.K., Onywera, V.O., Boit, M.K., Kayser, B., & Pitsiladis, Y.P. (2006). Evidence of negative energy balance using doubly labelled water in elite Kenyan endurance runners prior to competition. The British Journal of Nutrition, 95(1), 59–66. PubMed ID: 16441917 doi:10.1079/BJN20051608

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Haakonssen, E.C., Ross, M.L., Knight, E.J., Cato, L.E., Nana, A., Wluka, A.E., … Burke, L.M. (2015). The effects of a calcium-rich pre-exercise meal on biomarkers of calcium homeostasis in competitive female cyclists: A randomised crossover trial. PLoS ONE, 10(5), e0123302. PubMed ID: 25970439 doi:10.1371/journal.pone.0123302

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hamilton, T., & Coyle, D. (2012). The secret race: Inside the hidden world of the Tour de France: Doping, cover-ups, and winning at all costs. London, UK: Transworld Publishers Ltd.

    • Search Google Scholar
    • Export Citation
  • Hatton, R. (2013). War and peace: My story. London, UK: Pan MacMillan.

  • Jeukendrup, A.E., Craig, N.P., & Hawley, J.A. (2000). The bioenergetics of World Class Cycling. Journal of Science and Medicine in Sport, 3(4), 414–433. PubMed ID: 11235007 doi:10.1016/S1440-2440(00)80008-0

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Jurimae, J. (2003). Hormonal response to maximal rowing during heavy training in male rowers. Acta Kinesiologiae Universitatis Tartuensis, 8, 51–60.

    • Search Google Scholar
    • Export Citation
  • Jurimae, J., Maestu, J., & Jurimae, T. (2003). Leptin as a marker of training stress in highly trained male rowers? European Journal of Applied Physiology, 90, 533–538. PubMed ID: 12905045 doi:10.1007/s00421-003-0879-2

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kelsey, J.L., Bachrach, L.K., Procter-Gray, E., Nieves, J., Greendale, G.A., Sowers, M., … Cobb, K.L. (2007). Risk factors for stress fracture among young female cross-country runners. Medicine & Science in Sports & Exercise, 39(9), 1457–1463. PubMed ID: 17805074 doi:10.1249/mss.0b013e318074e54b

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kerr, D.A., Ross, W.D., Norton, K., Hume, P., Kagawa, M., & Ackland, T.R. (2007). Olympic lightweight and open-class rowers possess distinctive physical and proportionality characteristics. Journal of Sports Sciences, 25(1), 43–53. PubMed ID: 17127580 doi:10.1080/02640410600812179

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lanagan-Evans, C., Close, G.L., & Morton, J.P. (2011). Making weight in combat sports. Strength and Conditioning Journal, 33, 25–39. doi:10.1519/SSC.0b013e318231bb64

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lombardi, G., Lanteri, P., Graziani, R., Colombini, A., Banfi, G., & Corsetti, R. (2012). Bone and energy metabolism parameters in professional cyclists during the Giro d’Italia 3-weeks stage race. PLoS ONE, 7(7), e42077. PubMed ID: 22848709 doi:10.1371/journal.pone.0042077

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Loucks, A.B. (2004). Energy balance and body composition in sports and exercise. Journal of Sports Sciences, 22(1), 1–14. PubMed ID: 14974441 doi:10.1080/0264041031000140518

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Loucks, A.B., Kiens, B., & Wright, H.H. (2016). Energy availability in athletes. Journal of Sports Sciences, 29(Suppl. 1), S7–S15. doi:10.1080/02640414.2011.588958

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lundy, B. (2006). Dietary studies of athletes: An interview with sports dietitian Bronwen Lundy. International Journal of Sport Nutrition and Exercise Metabolism, 16(2), 226–228. PubMed ID: 16779928

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Marfell-Jones, M.J., Stewart, A.D., Olds, T., & de Ridder, J.H. (2012). International standards for anthropometric assessment. Wellington, New Zealand: International Society for the Advancement of Kinanthropometry.

    • Search Google Scholar
    • Export Citation
  • Martin, D., Wilson, G., Morton, J.P., Close, G.L., & Murphy, R.C. (2017). The horseracing industry’s perception of nutritional and weight-making practices of professional jockeys. Qualitative Research in Sport, Exercise and Health, 9(5), 568–582. doi:10.1080/2159676X.2017.1340330

    • Crossref
    • Search Google Scholar
    • Export Citation
  • McMahon, D. (2016). After Chris Froome cut back on carbs for more protein, he lost 20 pounds, started winning the Tour de France, and became a millionaire. Retrieved from http://www.businessinsider.my/chris-froome-weight-loss-tour-de-france-2016-7/?r=US&IR=TFroomearticle

    • Export Citation
  • Mooses, M., & Hackney, A.C. (2017). Anthropometrics and body composition in East African runners: Potential impact on performance. International Journal of Sports Physiology and Performance, 12(4), 422–430. PubMed ID: 27631418 doi:10.1123/ijspp.2016-0408

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Mooses, M., Haile, D.W., Ojiambo, R., Suvi, S., Lane, A.R., Pind, R., & Hackney, A.C. (2017). Bone mineral density of elite level Kenyan male and female runners: Preliminary data from RED-S study. Paper presented at the 22nd Annual Congress of the European College of Sport Science, Essen, Germany.

    • Search Google Scholar
    • Export Citation
  • Morton, J.P., Robertson, C., Sutton, L., & MacLaren, D.P. (2010). Making the weight: A case study from professional boxing. International Journal of Sport Nutrition and Exercise Metabolism, 20(1), 80–85. PubMed ID: 20190355 doi:10.1123/ijsnem.20.1.80

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Mountjoy, M., Sundgot-Borgen, J., Burke, L., Carter, S., Constantini, N., Lebrun, C., … Ljungqvist, A. (2014). The IOC consensus statement: Beyond the Female Athlete Triad—Relative Energy Deficiency in Sport (RED-S). British Journal of Sports Medicine, 48(7), 491–497. PubMed ID: 24620037 doi:10.1136/bjsports-2014-093502

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Muia, E.N., Wright, H.H., Onywera, V.O., & Kuria, E.N. (2016). Adolescent elite Kenyan runners are at risk for energy deficiency, menstrual dysfunction and disordered eating. Journal of Sports Sciences, 34(7), 598–606. PubMed ID: 26153433 doi:10.1080/02640414.2015.1065340

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Nindl, B.C., Friedl, K.E., Frykman, P.N., Marchitelli, L.J., Shippee, R.L., & Patton, J.F. (1997). Physical performance and metabolic recovery among lean, healthy men following a prolonged energy deficit. International Journal of Sports Medicine, 18(5), 317–324. PubMed ID: 9298770 doi:10.1055/s-2007-972640

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Olds, T., Norton, K., Craig, N., Olive, S., & Lowe, E. (1995). The limits of the possible: Models of power supply and demand in cycling. Australian Journal of Science and Medicine in Sport, 27(2), 29–33. PubMed ID: 8521030

    • Search Google Scholar
    • Export Citation
  • Olmedillas, H., Gonzalez-Aguero, A., Moreno, L.A., Casajus, J.A., & Vicente-Rodriguez, G. (2012). Cycling and bone health: A systematic review. BMC Medicine, 10, 168. PubMed ID: 23256921 doi:10.1186/1741-7015-10-168

    • Crossref
    • Search Google Scholar
    • Export Citation
  • O’Loughlin, G., Cullen, S.J., McGoldrick, A., O’Connor, S., Blain, R., O’Malley, S., & Warrington, G.D. (2013). Using a wearable camera to increase the accuracy of dietary analysis. American Journal of Preventive Medicine, 44(3), 297–301. doi:10.1016/j.amepre.2012.11.007

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Onywera, V.O., Kiplamai, F.K., Boit, M.K., & Pitsiladis, Y.P. (2004). Food and macronutrient intake of elite Kenyan distance runners. International Journal of Sport Nutrition and Exercise Metabolism, 14(6), 709–719. PubMed ID: 15657475 doi:10.1123/ijsnem.14.6.709

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Onywera, V.O., Scott, R.A., Boit, M.K., & Pitsiladis, Y.P. (2006). Demographic characteristics of elite Kenyan endurance runners. Journal of Sports Sciences, 24(4), 415–422. PubMed ID: 16492605 doi:10.1080/02640410500189033

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Pollock, N., & Hamilton, B. (2008). Osteoporotic fracture in an elite male Kenyan athlete. British Journal of Sports Medicine, 42(12), 1000–1001. PubMed ID: 18048427 doi:10.1136/bjsm.2007.039818

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Poon, E.T., O’Reilly, J., Sheridan, S., Cai, M.M., & Wong, S.H. (2018). Markers of bone health, bone-specific physical activities, nutritional intake and quality of life of professional jockeys in Hong Kong. International Journal of Sport Nutrition and Exercise Metabolism, 28(4). doi:10.1123/ijsnem.2016-0176

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Poslusna, K., Ruprich, J., de Vries, J.H., Jakubikova, M., & van’t Veer, P. (2009). Misreporting of energy and micronutrient intake estimated by food records and 24 hour recalls, control and adjustment methods in practice. The British Journal of Nutrition, 101(Suppl. 2), S73–S85. doi:10.1017/S0007114509990602

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Prouteau, S., Pelle, A., Collomp, K., Benhamou, L., & Courteix, D. (2006). Bone density in elite judoists and effects of weight cycling on bone metabolic balance. Medicine & Science in Sports & Exercise, 38(4), 694–700. PubMed ID: 16679985 doi:10.1249/01.mss.0000210207.55941.fb

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Reale, R., Cox, G.R., Slater, G., & Burke, L.M. (2016). Regain in body mass after weigh-in is linked to success in real life judo competition. International Journal of Sport Nutrition and Exercise Metabolism, 26(6), 525–530. PubMed ID: 27206272 doi:10.1123/ijsnem.2015-0359

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Reale, R., Cox, G.R., Slater, G., & Burke, L.M. (2017a). Weight regain: No link to success in a real-life multiday boxing tournament. International Journal of Sports Physiology and Performance, 12(7), 856–863. doi:10.1123/ijspp.2016-0311

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Reale, R., Slater, G., & Burke, L.M. (2017b). Individualised dietary strategies for Olympic Combat Sports: Acute weight loss, recovery and competition nutrition. European Journal of Sports Sciences, 17(6), 727–740. doi:10.1080/17461391.2017.1297489

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Reale, R., Slater, G., & Burke, L.M. (2018). Weight management practices of Australian Olympic combat sport athletes. International Journal of Sports Physiology and Performance, 13(4), 459–466. PubMed ID: 28872383 doi:10.1123/ijspp.2016-0553

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Rector, R.S., Rogers, R., Ruebel, M., & Hinton, P.S. (2008). Participation in road cycling vs running is associated with lower bone mineral density in men. Metabolism: Clinical and Experimental, 57(2), 226–232. doi:10.1016/j.metabol.2007.09.005

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Rouveix, M., Bouget, M., Pannafieux, C., Champely, S., & Filaire, E. (2007). Eating attitudes body esteem, perfectionism and anxiety of judo athletes and nonathletes. International Journal of Sports Medicine, 28, 340–345. PubMed ID: 17024652 doi:10.1055/s-2006-924334

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Saarni, S.E., Rissanen, A., Sarna, S., Koskenvuo, M., & Kaprio, J. (2006). Weight cycling of athletes and subsequent weight gain in middleage. International Journal of Obesity, 30(11), 1639–1644. PubMed ID: 16568134 doi:10.1038/sj.ijo.0803325

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Saris, W.H., van Erp-Baart, M.A., Brouns, F., Westerterp, K.R., & ten Hoor, F. (1989). Study on food intake and energy expenditure during extreme sustained exercise: The Tour de France. International Journal of Sports Medicine, 10(Suppl. 1), S26–S31. doi:10.1055/s-2007-1024951

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Scott, R.A., Georgiades, E., Wilson, R.H., Goodwin, W.H., Wolde, B., & Pitsiladis, Y.P. (2003). Demographic characteristics of elite Ethiopian endurance runners. Medicine & Science in Sports & Exercise, 35(10), 1727–1732. PubMed ID: 14523311 doi:10.1249/01.MSS.0000089335.85254.89

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Slater, G.J., Rice, A.J., Mujika, I., Hahn, A.G., Sharpe, K., & Jenkins, D.G. (2005). Physique traits of lightweight rowers and their relationship to competitive success. British Journal of Sports Medicine, 39(10), 736–741. PubMed ID: 16183770 doi:10.1136/bjsm.2004.015990

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Stellingwerff, T. (2018). Case study: Body composition periodization in an Olympic-level female middle-distance runner over a 9-year career. International Journal of Sport Nutrition and Exercise Metabolism, 28(4). doi:10.1123/ijsnem.2017-0312

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Tam, N., Santos-Concejero, J., Tucker, R., Lamberts, R.P., & Micklesfield, L.K. (2018). Bone health in elite Kenyan runners. Journal of Sports Sciences, 36(4), 456–461. PubMed ID: 28406358 doi:10.1080/02640414.2017.1313998

    • Search Google Scholar
    • Export Citation
  • Tanser, T. (1997). Train hard, win easy: The Kenyan way. Mountain View, CA: Track & Field News.

  • Tenforde, A.S., Barrack, M.T., Nattiv, A., & Fredericson, M. (2016). Parallels with the female athlete triad in male athletes. Sports Medicine, 46(2), 171–182. PubMed ID: 26497148 doi:10.1007/s40279-015-0411-y

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Tenforde, A.S., Fredericson, M., Sayres, L.C., Cutti, P., & Sainani, K.L. (2015). Identifying sex-specific risk factors for low BMD in adolescent runners. American Journal of Sports Medicine, 43, 1494–1504. PubMed ID: 25748470 doi:10.1177/0363546515572142

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Tenforde, A.S., Parziale, A.L., Popp, K.L., & Ackerman, K.E. (2018). Low bone mineral density in male athletes is associated with bone stress injuries at anatomic sites with greater trabecular composition. The American Journal of Sports Medicine, 46(1), 30–36. PubMed ID: 28985103 doi:10.1177/0363546517730584

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Tucker, R., Onywera, V.O., & Santos-Concejero, J. (2015). Analysis of the Kenyan distance-running phenomenon. International Journal of Sports Physiology and Performance, 10(3), 285–291. PubMed ID: 25115138 doi:10.1123/ijspp.2014-0247

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Vervoorn, C., Quist, A.M., Vermulst, L.J., Erich, W.B., de Vries, W.R., & Thijssen, J.H. (1991). The behaviour of the plasma free testosterone/cortisol ratio during a season of elite rowing training. International Journal of Sports Medicine, 12(3), 257–263. PubMed ID: 1889932 doi:10.1055/s-2007-1024677

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Viner, R.T., Harris, M., Berning, J.R., & Meyer, N.L. (2015). Energy availability and dietary patterns of adult male and female competitive cyclists with lower than expected bone mineral density. International Journal of Sport Nutrition and Exercise Metabolism, 25(6), 594–602. PubMed ID: 26131616 doi:10.1123/ijsnem.2015-0073

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Vinther, A., Kanstrup, I.L., Christiansen, E., Alkjaer, T., Larsson, B., Magnusson, S.P., … Aagaard, P. (2006). Exercise-induced rib stress fractures: Potential risk factors related to thoracic muscle co-contraction and movement pattern. Scandinavian Journal of Medicine & Science in Sports, 16(3), 188–196. PubMed ID: 16643197 doi:10.1111/j.1600-0838.2005.00473.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Vinther, A., Kanstrup, I.L., Christiansen, E., Ekdahl, C., & Aagaard, P. (2008). Testosterone and BMD in elite male lightweight rowers. International Journal of Sports Medicine, 29(10), 803–807. PubMed ID: 18401806 doi:10.1055/s-2008-1038430

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Waldron-Lynch, F., Murray, B.F., Brady, J.J., McKenna, M.J., McGoldrick, A., Warrington, G., … Barragry, J.M. (2010). High bone turnover in Irish professional jockeys. Osteoporosis International, 21(3), 521–525. PubMed ID: 19271097 doi:10.1007/s00198-009-0887-0

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Wilson, G., Chester, N., Eubank, M., Crighton, B., Drust, B., Morton, J.P., & Close, G.L. (2012). An alternative dietary strategy to make weight while improving mood, decreasing body fat, and not dehydrating: A case study of a professional jockey. International Journal of Sport Nutrition and Exercise Metabolism, 22(3), 225–231. PubMed ID: 22693243 doi:10.1123/ijsnem.22.3.225

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Wilson, G., Drust, B., Morton, J.P., & Close, G.L. (2014a). Weight-making strategies in professional jockeys: Implications for physical and mental health and well-being. Sports Medicine, 44(6), 785–796. doi:10.1007/s40279-014-0169-7

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Wilson, G., Fraser, W.D., Sharma, A., Eubank, M., Drust, B., Morton, J.P., & Close, G.L. (2013a). Markers of bone health, renal function, liver function, anthropometry and perception of mood: A comparison between Flat and National Hunt Jockeys. International Journal of Sports Medicine, 34(5), 453–459. doi:10.1055/s-0032-1321898

    • Search Google Scholar
    • Export Citation
  • Wilson, G., Hawken, M.B., Poole, I., Sparks, A., Bennett, S., Drust, B., … Close, G.L. (2014b). Rapid weight-loss impairs simulated riding performance and strength in jockeys: Implications for making-weight. Journal of Sports Sciences, 32(4), 383–391. doi:10.1080/02640414.2013.825732

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Wilson, G., Hill, J., Sale, C., Morton, J.P., & Close, G.L. (2015a). Elite male Flat jockeys display lower bone density and lower resting metabolic rate than their female counterparts: Implications for athlete welfare. Applied Physiology, Nutrition, and Metabolism, 40(12), 1318–1320. doi:10.1139/apnm-2015-0354

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Wilson, G., Martin, D., Morton, J.P., & Close, G.L. (2018). Male flat jockeys do not display deteriorations in bone density or resting metabolic rate in accordance with race riding experience: Implications for RED-S. International Journal of Sport Nutrition and Exercise Metabolism, 28(4). doi:10.1123/ijsnem.2017-0371

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • Wilson, G., Pritchard, P.P., Papageorgiou, C., Phillips, S., Kumar, P., Langan-Evans, C., … Close, G.L. (2015b). Fasted exercise and increased dietary protein reduces body fat and improves strength in jockeys. International Journal of Sports Medicine, 36(12), 1008–1014. doi:10.1055/s-0035-1549920

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Wilson, G., Sparks, S.A., Drust, B., Morton, J.P., & Close, G.L. (2013b). Assessment of energy expenditure in elite jockeys during simulated race riding and a working day: Implications for making weight. Applied Physiology, Nutrition, and Metabolism, 38(4), 415–420. doi:10.1139/apnm-2012-0269

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Woods, A.L., Garvican-Lewis, L.A., Lundy, B., Rice, A.J., & Thompson, K.G. (2017). New approaches to determine fatigue in elite athletes during intensified training: Resting metabolic rate and pacing profile. PLoS ONE, 12(3), e0173807. PubMed ID: 28296943 doi:10.1371/journal.pone.0173807

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Yates, A., Edman, J.D., Crago, M., & Crowell, D. (2003). Eating disorder symptoms in runners, cyclists and paddlers. Addictive Behaviors, 28(8), 1473–1480. PubMed ID: 14512070 doi:10.1016/S0306-4603(02)00263-0

    • Crossref
    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 920 920 198
Full Text Views 84 84 17
PDF Downloads 50 50 8