TY - JOUR
T1 - The utility of the low energy availability in females questionnaire to detect markers consistent with low energy availability-related conditions in a mixed-sport cohort
AU - Rogers, Margot A.
AU - Drew, Michael K.
AU - Appaneal, Renee
AU - Lovell, Greg
AU - Lundy, Bronwen
AU - Hughes, David
AU - Vlahovich, Nicole
AU - Waddington, Gordon
AU - Burke, Louise M.
N1 - Funding Information:
This study was designed by M.A. Rogers, M.K. Drew, and L.M. Burke; data were collected and analyzed by M.A. Rogers, M.K. Drew, and L.M. Burke; data interpretation and manuscript preparation were undertaken by M.A. Rogers, M.K. Drew, L.M. Burke, G. Waddington, N. Vlahovich, R. Appaneal, G. Lovell, B. Lundy, and D. Hughes. All authors approved the final version of the article. All data presented are part of the “Stay Healthy” project, an initiative that supports Australia’s elite athletes. We acknowledge the contribution of the broader project team: David Pyne, Shona Halson, Nic West, and Marijke Welvaert. We thank the contributions of the NSOs of the participating athletes, the staff who facilitated the data collection, and the athletes for donating their time to participate. We also acknowledge Trent Garrett for his assistance with electronic data management. The authors declare no conflicts of interest. This work was supported by the AIS High Performance Research Fund (Immune Health Multiple Sports, 2017) and the University of Canberra Research Institute for Sport and Exercise (internal grant).
Publisher Copyright:
© 2021 Human Kinetics, Inc.
PY - 2021/9
Y1 - 2021/9
N2 - The Low Energy Availability in Females Questionnaire (LEAF-Q) was validated to identify risk of the female athlete triad (triad) in female endurance athletes. This study explored the ability of the LEAF-Q to detect conditions related to low energy availability (LEA) in a mixed sport cohort of female athletes. Data included the LEAF-Q, SCOFF Questionnaire for disordered eating, dual-energy X-ray absorptiometry-derived body composition and bone mineral density, Mini International Neuropsychiatric Interview, blood pressure, and blood metabolic and reproductive hormones. Participants were grouped according to LEAF-Q score (≥8 or <8), and a comparison of means was undertaken. Sensitivity, specificity, and predictive values of the overall score and subscale scores were calculated in relation to the triad and biomarkers relevant to LEA. Fisher's exact test explored differences in prevalence of these conditions between groups. Seventy-five athletes (18-32 years) participated. Mean LEAF-Q score was 8.0 ± 4.2 (55% scored =8). Injury andmenstrual function subscale scores identified low bone mineral density (100% sensitivity, 95% confidence interval [15.8%, 100%]) and menstrual dysfunction (80.0% sensitivity, 95% confidence interval [28.4%, 99.5%]), respectively. The gastrointestinal subscale did not detect surrogate markers of LEA. LEAF-Q score cannot be used to classify athletes as "high risk"of conditions related to LEA, nor can it be used as a surrogate diagnostic tool for LEA given the low specificity identified.Our study supports its use as a screening tool to rule out risk of LEA-related conditions or to create selective low-risk groups that do not need management as there were generally high negative predictive values (range 76.5-100%) for conditions related to LEA.
AB - The Low Energy Availability in Females Questionnaire (LEAF-Q) was validated to identify risk of the female athlete triad (triad) in female endurance athletes. This study explored the ability of the LEAF-Q to detect conditions related to low energy availability (LEA) in a mixed sport cohort of female athletes. Data included the LEAF-Q, SCOFF Questionnaire for disordered eating, dual-energy X-ray absorptiometry-derived body composition and bone mineral density, Mini International Neuropsychiatric Interview, blood pressure, and blood metabolic and reproductive hormones. Participants were grouped according to LEAF-Q score (≥8 or <8), and a comparison of means was undertaken. Sensitivity, specificity, and predictive values of the overall score and subscale scores were calculated in relation to the triad and biomarkers relevant to LEA. Fisher's exact test explored differences in prevalence of these conditions between groups. Seventy-five athletes (18-32 years) participated. Mean LEAF-Q score was 8.0 ± 4.2 (55% scored =8). Injury andmenstrual function subscale scores identified low bone mineral density (100% sensitivity, 95% confidence interval [15.8%, 100%]) and menstrual dysfunction (80.0% sensitivity, 95% confidence interval [28.4%, 99.5%]), respectively. The gastrointestinal subscale did not detect surrogate markers of LEA. LEAF-Q score cannot be used to classify athletes as "high risk"of conditions related to LEA, nor can it be used as a surrogate diagnostic tool for LEA given the low specificity identified.Our study supports its use as a screening tool to rule out risk of LEA-related conditions or to create selective low-risk groups that do not need management as there were generally high negative predictive values (range 76.5-100%) for conditions related to LEA.
KW - Female athlete triad
KW - Relative energy deficiency in sport
KW - Screening
UR - http://www.scopus.com/inward/record.url?scp=85114097554&partnerID=8YFLogxK
U2 - 10.1123/IJSNEM.2020-0233
DO - 10.1123/IJSNEM.2020-0233
M3 - Article
C2 - 34284349
AN - SCOPUS:85114097554
SN - 1526-484X
VL - 31
SP - 427
EP - 437
JO - International Journal of Sport Nutrition and Exercise Metabolism
JF - International Journal of Sport Nutrition and Exercise Metabolism
IS - 5
ER -