Risk of Low Energy Availability, Disordered Eating, and Menstrual Dysfunction in Female Collegiate Runners

Context Collegiate female distance runners may be at risk for low energy availability (LEA) due to increased exercise energy expenditure with or without decreased energy intake. Furthermore, this population has an increased risk of disordered eating (DE), which can lead to LEA and negative health consequences, such as menstrual dysfunction (MD). Objective To (1) investigate risk of LEA, DE, and MD; (2) compare DE, training volume, and weight dissatisfaction between female collegiate runners at risk and those not at risk for LEA; and (3) compare the risk for LEA between National Collegiate Athletic Association Division I, II, and III female collegiate runners. Design Cross-sectional study. Setting Free-living conditions. Patients or Other Participants A total of 287 female runners who competed on a National Collegiate Athletic Association Division I, II, or III cross-country team, track team, or both. Main Outcome Measure(s) Participants completed a 45-item questionnaire that included the Low Energy Availability in Females Questionnaire (LEAF-Q) and the Disordered Eating Screen for Athletes (DESA-6). Results We observed that 54.4% (n = 156) of runners were at risk for LEA (LEAF-Q score ≥ 8), 40.8% (n = 117) were at risk for DE (DESA-6 score ≥ 3), and 56.5% (n = 162) reported MD (LEAF-Q menstrual function subsection score ≥ 4). Athletes at risk for LEA had higher DESA-6 scores than athletes not at risk for LEA (P < .001). Athletes at risk for LEA had greater weight dissatisfaction than those not at risk for LEA ( = 15.92, P = .001). Higher weekly training volume was not associated with risk for LEA ( = 4.20, P = .11). Conclusions A substantial percentage of collegiate female runners were found to be at risk for LEA and DE and to report MD. These findings demonstrate that the risks for DE, MD, and weight dissatisfaction are associated with risk for LEA.