Prevalence Of Low Energy Availability In High Level Kenyan Middle- And Long-distance Runners

Because of the negative health consequences of low energy availability (LEA), researchers have developed criteria based on energy availability (EA) to determine when athletes are at threat of physiological and performance disturbances. The proposed LEA criteria are: ≤30 kcal/kg/LBM/day - high risk, 30-45 kcal/kg/LBM/day - moderate risk and ≥ 45 kcal/kg/LBM/day - no risk (Melin et al., IJSNEM, 2019). These criteria, however, are based almost entirely on White (Caucasian) racial populations. PURPOSE: This study evaluated the prevalence of LEA and its potential impact on the hormonal profile of high-level Kenyan male and female middle- and long-distance runners. METHODS: A cross-sectional observational design approach was used in which high-level Kenyan male and female (n = 30 and n = 26 respectively) middle- and long-distance runners were examined (IAAF scores >1000 points). For LEA, food and training diaries were collected from the participants and exercise energy expenditure was calculated from the VO2max results and training diaries. To be conservative and not underestimate EA, we examined the three highest energy intake days in our analysis, and to compensate for potential underreporting, applied a previously published dietary correction factor (Õnnik et al., EJAP 2021). Resting blood hormonal measurements consisted of luteinizing hormone, follicle-stimulating hormone, prolactin, oestradiol, free thyroxine, thyroid-stimulating hormone, testosterone, triiodothyronine, insulin and cortisol. RESULTS: For the female sample ~ 13% were at no risk, ~31% were at moderate risk, and ~ 66% at a high risk for LEA. For the male sample ~ 4% were at no risk, ~9% were at a moderate risk, and ~ 87% were at a high risk for LEA. The hormonal values observed were variable, but within the normal expected range for healthy men and women in each of the respective measures (Feingold et al., Endotext 2000). CONCLUSIONS: Our main findings were 1) the majority of our runners (men and women) were at high risk for LEA and, 2) surprisingly no abnormalities in the hormonal values were evident even though LEA risk was high and hormonal disturbances are a hallmark of LEA. Perhaps EA criteria for deciding LEA risk level, which are based primarily on White racial populations, are not appropriate for African-based populations.