What Is Low Energy Availability (LEA)?
Low energy availability (LEA) is a state in which the energy consumed through food is insufficient to support the body's energy needs for both exercise and basic physiological functions. It's more than just feeling tired; it's a chronic energy deficit that forces the body to prioritize immediate survival over other non-essential systems. When this occurs, vital processes like bone health, reproductive function, immune system strength, and metabolic rate are all compromised. LEA is the underlying cause of a broader condition known as Relative Energy Deficiency in Sport (RED-S), which affects both male and female athletes.
Why athletes are especially at risk
Athletes are particularly susceptible to LEA for several reasons, including the sheer volume of their energy expenditure. Many athletes may not intentionally restrict their food intake but fall into an energy deficit due to a lack of nutritional knowledge, a busy schedule that makes proper meal preparation difficult, or an unexpected increase in training load. In other cases, LEA can be intentional due to pressure to maintain a certain body weight or aesthetic, influenced by coaches, teammates, or social media. This can blur the line between unintentional underfueling and disordered eating behaviors.
Key Signs and Symptoms of Low Energy Availability
Recognizing the signs of LEA can be challenging because many symptoms are vague and could be attributed to other factors like stress or general fatigue. However, chronic or repeated occurrences of these indicators are strong red flags.
Physical signs
- Chronic Fatigue: Persistent and excessive tiredness that doesn't improve with rest. You may feel lethargic and sluggish, even after a full night's sleep.
- Decreased Performance: A noticeable and unexplainable drop in athletic performance, including decreased endurance, muscle strength, coordination, and concentration.
- Frequent Illness and Injury: A compromised immune system can lead to more frequent colds and infections. Additionally, LEA can cause poor bone health, increasing the risk of stress fractures and other overuse injuries.
- Hormonal Changes: In females, this can manifest as irregular or absent menstrual periods (amenorrhea). In males, it can lead to reduced libido and low testosterone levels.
- Gastrointestinal Distress: Symptoms such as stomach pain, bloating, or general digestive issues.
- Difficulty Regulating Body Temperature: Always feeling cold, even in warm conditions.
Psychological and behavioral signs
- Mood Swings: Increased irritability, anxiety, and low mood or depression.
- Altered Relationship with Food: This may include obsessive thoughts about food and calories, or a complete absence of normal hunger cues.
- Poor Concentration: Experiencing brain fog or difficulty focusing during training and daily tasks.
- Social Withdrawal: A reduced interest in training, competing, or spending time with others.
How to Assess Your Risk for LEA
While formal diagnosis requires a medical professional, several self-assessment strategies can help you determine if you are at risk. A doctor will typically assess a combination of factors, including your medical and training history, dietary patterns, and a physical exam.
Self-assessment questionnaire
Answer the following questions to help identify potential indicators of LEA. Be honest with your responses.
- Have you noticed a drop in your athletic performance despite consistent or increased training? Yes / No
- Are your energy levels consistently low, even after rest days? Yes / No
- Do you experience frequent illnesses or injuries, especially bone-related ones like stress fractures? Yes / No
- (For females) Have you experienced irregular or missed menstrual periods? Yes / No
- (For males) Have you noticed a decrease in libido? Yes / No
- Do you have a preoccupation with food, body weight, or calories? Yes / No
- Are you often irritable, anxious, or have low mood? Yes / No
- Do you have persistent gastrointestinal issues like bloating or stomach pain? Yes / No
If you answered 'yes' to multiple questions, it is highly recommended to seek professional guidance.
Comparison table: LEA vs. Typical Fatigue
| Feature | Low Energy Availability (LEA) | Typical Fatigue |
|---|---|---|
| Cause | Chronic, severe energy deficit from underfueling relative to activity. | Temporary energy imbalance due to acute exertion, stress, or lack of sleep. |
| Duration | Persistent and long-term; does not resolve with a few days of rest. | Short-lived; usually resolves within a day or two with rest. |
| Performance | Noticeable decline in muscle strength, endurance, and coordination over time. | Temporary sluggishness, but performance can recover quickly with adequate rest. |
| Health Consequences | Impairs immune system, bone density, hormonal balance, and psychological health. | Few to no lasting negative health effects; indicates a need for recovery. |
| Recovery | Requires a more significant intervention involving dietary changes and reduced training. | Simple lifestyle changes, such as getting more sleep or a rest day, are sufficient. |
What to Do If You Suspect Low Energy Availability
Addressing LEA requires a systematic and often multidisciplinary approach. Here are the key steps to take:
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Seek Professional Guidance: Consult a sports dietitian, sports medicine physician, or other qualified healthcare professional. They can provide an accurate diagnosis, rule out other potential medical causes for your symptoms (like anemia or thyroid issues), and develop a personalized treatment plan.
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Increase Energy Intake: A core component of treatment is increasing your caloric intake to match your energy expenditure. A sports dietitian can help you calculate your needs and create a structured eating plan to ensure you get enough energy throughout the day, especially around training sessions.
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Adjust Training Load: Working with a coach and healthcare provider, you may need to temporarily reduce your training volume or intensity to allow your body to recover and re-establish proper function. Adding rest days is critical.
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Prioritize Recovery: Ensure you are getting adequate sleep, managing stress, and incorporating active recovery techniques. Relaxation activities like yoga can be beneficial.
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Address Psychological Factors: If body image concerns or disordered eating behaviors are present, a sports psychologist or mental health professional can provide essential support. LEA is a complex issue, and addressing the mental component is crucial for long-term health.
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Monitor Your Progress: Regularly check in with your healthcare team to track your progress. This may involve monitoring body composition, menstrual cycle regularity (for females), and hormone levels. For more information, see the resources provided by the American Sports and Performance Dietitians Association.
Conclusion
Understanding how to tell if you have low energy availability is a vital skill for anyone who is physically active. It moves beyond simple fatigue and encompasses a serious metabolic and hormonal state that can undermine both your athletic potential and long-term health. By paying close attention to your body's signals—including physical symptoms like recurrent injuries and persistent fatigue, as well as psychological indicators such as irritability and mood changes—you can recognize the early warning signs. The key is to take these signals seriously and seek professional help to re-establish a healthy energy balance. Prioritizing proper fueling and recovery is not just about maximizing performance; it is about protecting your overall well-being. Prompt recognition and intervention are the best defense against the adverse health consequences associated with LEA.
