Prevalence of Low Energy Availability in U.S. Collegiate Athletes: A Systematic Review

Low Energy Availability (LEA) can contribute to broad negative impacts on an athlete’s physical health, mental health, and performance. The purpose of this systematic review was to determine the prevalence of Lower Energy Availability in US intercollegiate NCAA or NAIA athletes. Secondarily, this review aimed to compare the potential difference in the prevalence of LEA in male and female athletes. Five databases were searched for peer-reviewed journal articles. Articles eligible for inclusion met the following criteria: 1) investigated U.S. intercollegiate athletes participating in an NCAA or NAIA-sanctioned sport, 2) investigated the prevalence of LEA in participants using self-reported or objective outcome measures, 3) were peer-reviewed, and 4) were a randomized control trial, observational study, prospective cohort study, or cross-sectional cohort study. Ten articles met the inclusion criteria. Prevalence of LEA in athletes varied greatly ranging from 15% to 100% with six studies reporting 50% or greater prevalence. There was limited data on the prevalence of LEA in male athletes, but it ranged from 15% to 45%. In females, the prevalence of LEA ranged from 26.3% to 100%. Comparison between sports was difficult due to differences in reporting methods. Despite the variations in reporting, it appears LEA may be high in both male and female collegiate athletes across a variety of sports; thus, it is important to screen for LEA in all athletes. A gold standard assessment is needed to standardize the literature on LEA and allow for better analysis.

Keywords: Energy, Health, Nutrition, Physical Activity, Sport.