Dietary Determinants Associated with Low Energy Availability among Athletes: A Scoping Review

Globally, a high prevalence of Low Energy Availability (LEA) (< 30 kcal·kg⁻¹ FFM) is observed among competitive athletes. A comprehensive review of various factors associated with dietary intake will provide a better perception of management strategies for improving food intake and population-specific areas of future research. Thus, this study is aimed at identifying the diverse factors that influence dietary energy intake in relation to Energy Availability (EA) among male and female athletes who engage in training and competition across various sports.

Five search engines were searched using nine keywords, and original papers were extracted spanning over two decades (2003-2023). A predetermined participant-concept-context criterion was used for the inclusion of studies on competitive athletes.

A total of 1462 studies were identified, of which 53 were deemed suitable for inclusion in this review. LEA was prevalent among 24% of male and 58% of female athletes globally and in 87.5% of adolescents in India.

LEA was influenced by factors classified in six themes: training/performance demands, psychosocial/cultural influences, dietary practices/nutritional beliefs, environmental/logistical/educational factors, physiological considerations, and methodological issues, requiring culturally tailored biomarkers.

The significant prevalence of LEA globally necessitates culturally tailored causal research and biomarker-informed, standardised Randomized Controlled Trial (RCT) interventions that address multifaceted determinants to effectively prevent LEA.