Question 1

What is the Meaning of Low Energy Availability?

Accepted Answer

Low Energy Availability (LEA) defines a state where dietary energy intake is insufficient to cover energy expended in exercise and that required for optimal physiological function. When remaining energy, after exercise, falls below a critical threshold, typically 30 kcal/kg fat-free mass per day, it compromises systemic health and vital bodily processes.

Question 2

What is the Context of Low Energy Availability?

Accepted Answer

LEA primarily impacts the neuroendocrine system, disrupting hypothalamic-pituitary axes, including reproductive, thyroid, and growth hormone. This triggers systemic physiological adaptations aimed at conserving energy. While prevalent in athletic populations, LEA can affect any individual experiencing a chronic imbalance between energy intake and expenditure.

Question 3

What is the Significance of Low Energy Availability?

Accepted Answer

Identifying LEA is critical for preventing and managing health complications like functional hypothalamic amenorrhea, reduced bone mineral density, impaired immune function, and cardiovascular issues. Prompt recognition allows interventions that mitigate long-term physiological consequences and improve patient well-being.

Question 4

What is the Mechanism of Low Energy Availability?

Accepted Answer

Chronic energy deficit triggers adaptive physiological responses, primarily suppressing pulsatile Gonadotropin-Releasing Hormone (GnRH) from the hypothalamus. This reduces Luteinizing Hormone (LH) and Follicle-Stimulating Hormone (FSH) secretion, decreasing sex hormone production. LEA also impairs thyroid hormone conversion and reduces Insulin-like Growth Factor 1 (IGF-1), impacting metabolism and bone health.

Question 5

What is the Application of Low Energy Availability?

Accepted Answer

Clinically, LEA manifests as menstrual dysfunction in females, diminished libido, chronic fatigue, recurrent injuries, and impaired physical performance. Health professionals diagnose LEA by assessing dietary intake, exercise load, and relevant physiological markers. Management involves increasing caloric intake, adjusting exercise volume, or a combination, often alongside nutritional counseling.

Question 6

What is the Metric of Low Energy Availability?

Accepted Answer

Directly measuring energy availability requires meticulous dietary records and precise calculations of exercise energy expenditure, normalized to fat-free mass. Indirectly, clinicians assess hormonal profiles, including estradiol, testosterone, LH, FSH, thyroid hormones, and IGF-1. Bone mineral density scans (DEXA) monitor skeletal health. Clinical diagnosis integrates these objective measures with patient symptoms.

Question 7

What is the Risk of Low Energy Availability?

Accepted Answer

Unmanaged LEA presents substantial health risks, including severe bone density loss, increasing the likelihood of stress fractures and osteoporosis. It can cause persistent reproductive dysfunction, cardiovascular complications, and impaired immune system function, heightening susceptibility to illness. Prolonged LEA may also worsen mental health conditions, necessitating timely clinical intervention.

Low Energy Availability

Meaning

Context

Significance

Mechanism

Application

Metric

Risk

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