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Andreas M. Kasper, Ben Crighton, Carl Langan-Evans, Philip Riley, Asheesh Sharma, Graeme L. Close and James P. Morton

. Although we also acknowledge our inability to assess energy availability (owing to the lack of assessments of daily energy expenditure and exercise energy expenditure), we observed that the athlete exhibited clear symptoms of the relative energy deficiency in sport syndrome (RED-S; Mountjoy et al., 2014

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contraceptive pill or pharmaceutical agents for treating low bone density in female athletes. Rather, increasing energy availability and weight gain are more effective strategies, with bone strength improvements reported over one to six years. There is scant evidence on the long-term bone health in female

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-body oxidative capacity and endurance exercise performance following prolonged endurance exercise training in healthy, young males. Low Energy Availability Assessed by a Sport-Specific Questionnaire and Clinical Interview Indicative of Bone Health, Endocrine Profile and Cycling Performance in Competitive Male

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Amy J. Hector and Stuart M. Phillips

calories too severely, particularly below 30 kcal/kg fat-free mass, which would be roughly equivalent to resting metabolic rate for most people ( Loucks et al., 2011 ). For example, in natural male body builders, prolonged low energy availability can result in loss of LBM, hormonal imbalances

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Taylor K. Wise

athletic trainers), be educated on energy availability, healthy eating, nutrition, and the risks of dieting so that they are better able to detect unhealthy eating behaviors and explore treatment options ( Mountjoy et al., 2014 ). Another risk specific to athletes is that DE can be maintained by approval

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Ben Desbrow, Nicholas A. Burd, Mark Tarnopolsky, Daniel R. Moore and Kirsty J. Elliott-Sale

in growing tissues) for adolescent populations with different levels of physical activity and/or training have been published ( Torun, 2005 ). It appears that low energy availability (EA) in adolescent athletes undertaking heavy training is common ( Muia et al., 2016 ). This may lead to a number of

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Eric Tsz-Chun Poon, John O’Reilly, Sinead Sheridan, Michelle Mingjing Cai and Stephen Heung-Sang Wong

endocrine profiles involved in growth and repair ( Dolan et al., 2012b ). Key hormones related to bone metabolism, such as testosterone, cortisol, and vitamin D, may be downregulated at times of low energy availability to allow the body to conserve energy for essential processes ( Dolan et al., 2011 ). Yet

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Daniel P. Joaquim, Claudia R. Juzwiak and Ciro Winckler

requirement and supply found in many of these studies can lead to low energy availability with consequences to athletes’ performance and health ( da Silva Gomes et al., 2005 , 2006 ; Eskici & Ersoy, 2016 ; Goosey-Tolfrey & Crosland, 2010 ; Mountjoy et al., 2014 ). However, no study with para athletes

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bike-pack trip through South America. Conclusions.— Unexpected fractures in endurance athletes should prompt evaluation for underlying medical conditions. While low energy availability, secondary amenorrhea, and low bone density are common in endurance athletes, rare medical conditions should also be

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Alba Reguant-Closa, Margaret M. Harris, Tim G. Lohman and Nanna L. Meyer

were set at E (1 g·kg −1  BM·day −1 ), M (1.5 g·kg −1  BM·day −1 ), and H (2 g·kg −1  BM·day −1 ). Energy It is difficult to give general recommendations for the EI in athletes due to individual variability and the differential nature of the sport. In addition, a minimum energy availability (EA) is