Which Athlete Is More Likely to Be at Higher Risk for Vitamin Deficiency?

October 24, 2025 •

4 min read

Studies indicate that athletes in sports emphasizing low body weight, such as gymnastics and ballet, are often at heightened risk for nutrient deficiencies. These and other athletes who routinely reduce their overall energy intake face a higher likelihood of developing vitamin deficiency and related health problems.

Quick Summary

Athletes in weight-sensitive and aesthetic sports, like gymnastics and wrestling, are at greater risk of vitamin deficiencies due to chronic low energy availability. This intentional energy restriction compromises nutrient intake, affecting bone health, immunity, and athletic performance.

Key Points

High-Risk Athletes: Gymnasts, dancers, and wrestlers are at higher risk for vitamin deficiency due to intentional energy restriction to meet aesthetic or weight class requirements.
Low Energy Availability (LEA): The intentional or unintentional imbalance between energy intake and expenditure, leading to the syndrome known as RED-S, is the root cause of these deficiencies.
Critical Nutrients: Common deficiencies include iron, calcium, vitamin D, and B vitamins, all vital for performance, immunity, and bone health.
Health Consequences: Under-fueling can cause fatigue, stress fractures, weakened immunity, menstrual dysfunction in females, and negative psychological effects.
Mitigation Strategy: The best approach is to address the underlying low energy availability through nutritional education and guidance, focusing on a balanced, nutrient-dense diet rather than supplementation alone.
Interdisciplinary Care: Management of severe deficiencies or RED-S often requires a team of professionals, including sports dietitians, physicians, and psychologists.

Identifying High-Risk Athletes from Energy Restriction

The relationship between energy intake, nutrient status, and athletic performance is complex. While many athletes maintain a high caloric intake to fuel intense training, certain sports and situations—particularly those with aesthetic requirements or weight classes—can drive intentional energy restriction. This practice, especially when sustained, significantly increases the risk of micronutrient deficiencies, compromising overall health and performance. The condition is now formally recognized as Relative Energy Deficiency in Sport (RED-S), affecting both male and female athletes.

Aesthetic Athletes: Gymnasts and Dancers

For sports where a lean physique is prized, such as gymnastics and dance, there is immense pressure to maintain a low body weight and body fat percentage. This often leads to restrictive eating patterns and chronic low energy availability (LEA). In fact, one study found that a significant portion of pre-professional ballet dancers showed signs of LEA, placing them at higher risk for poor nutrient status. The consequences extend beyond just aesthetics, impacting critical health markers like bone density.

Weight-Class Athletes: Wrestlers

Wrestlers frequently engage in rapid, drastic weight cutting to meet specific weight classes for competition. These extreme practices involve severe energy restriction and dehydration, which directly lead to an inadequate intake of essential vitamins and minerals. Unlike aesthetic sports where restriction may be chronic, the acute nature of a weight cut can cause severe short-term stress on the body's systems, leading to health issues and decreased performance.

Common Vitamin and Mineral Deficiencies from Low Energy Intake

When athletes consume insufficient calories, they often miss out on the vitamins and minerals necessary for optimal function. Key deficiencies prevalent in restricting athletes include:

Iron: Crucial for oxygen transport, iron deficiency can lead to fatigue, shortness of breath, and impaired performance. Female athletes, in particular, face additional risk due to menstruation.
Calcium and Vitamin D: These are essential for bone health. Low intake, especially combined with insufficient sun exposure in indoor sports like gymnastics, increases the risk of stress fractures and osteoporosis later in life.
B Vitamins: The B-vitamin complex is vital for energy metabolism. Restriction can lead to low levels of B12 and folate, which are important for red blood cell production, potentially causing anemia and reduced endurance.
Zinc: Important for immune function and tissue repair, zinc can also be lost through sweat, exacerbating risk in under-fueled athletes.

Comparative Risk: Weight-Sensitive vs. Endurance Sports

Comparing athletes who restrict energy with those whose high energy expenditure often necessitates a high intake helps clarify the risk factors. While endurance athletes have high energy demands, their motivation is typically to fuel performance, not to restrict. As a result, their diet often includes a wide range of foods, potentially mitigating deficiency risks compared to weight-sensitive athletes who intentionally limit intake.


Feature	Weight-Sensitive/Aesthetic Sports (e.g., Gymnastics, Wrestling)	Endurance Sports (e.g., Marathon Running)
Energy Intake	Often intentionally and chronically restricted to maintain low body mass.	Typically high and focused on fueling performance needs.
Primary Risk Factor	Low Energy Availability (LEA) and nutrient dilution due to overall calorie restriction.	High expenditure and nutrient loss through sweat, but offset by higher intake.
Associated Health Syndrome	High prevalence of Relative Energy Deficiency in Sport (RED-S) and Female Athlete Triad.	Potential for low energy availability if intake doesn't match expenditure, but less severe overall restriction is common.
Common Deficiencies	Iron, Calcium, Vitamin D, Zinc, B Vitamins.	Iron, Vitamin D, Sodium, B Vitamins.
Performance Impact	Increased risk of fatigue, stress fractures, and poor training adaptation.	Often related to depleted stores and metabolic inefficiency.

The Broader Impact of Under-Fueling

Low energy availability, the root cause of RED-S, affects more than just performance and bone health. It can lead to a cascade of negative health consequences, including:

Impaired immune function, leading to increased susceptibility to illness.
Cardiovascular issues, including changes in heart rate and blood pressure.
Compromised mental health, including anxiety and depression.
In females, menstrual dysfunction, which can further compound bone density loss.
Impaired growth and development in young athletes.

Mitigation Strategies and Professional Guidance

For athletes identified as high-risk, a proactive approach is critical. The foundation of treatment and prevention is normalizing energy availability. This involves:

Nutritional Education: Teaching athletes, coaches, and parents about the energy and nutrient requirements for their specific sport.
Dietary Adjustments: Moving away from restrictive practices toward a balanced, nutrient-dense diet. For instance, focusing on quality iron sources like red meat, fish, and fortified grains, or incorporating calcium and vitamin D-rich foods.
Supplementation: In cases of confirmed deficiency, a targeted supplementation plan may be necessary. Supplements should be used to augment, not replace, a healthy diet and should always be approved by a qualified professional to avoid banned substances.
Interdisciplinary Team: Managing RED-S or severe deficiencies often requires collaboration between sports dietitians, physicians, and possibly mental health professionals.

For athletes concerned about weight, working with a sports nutritionist can help them find a healthy balance that supports both performance and long-term health, rather than resorting to dangerous restrictive practices. The key is understanding that proper fueling is an asset, not a detriment, to achieving peak athletic condition.

Conclusion

While any athlete can face nutrient deficiencies, those in weight-sensitive and aesthetic sports who intentionally reduce their overall energy intake are at a significantly higher risk for vitamin deficiency. Practices common in sports like gymnastics, dance, and wrestling often lead to chronic low energy availability and serious health problems like RED-S. Addressing these risks requires a multi-faceted approach focusing on education, proper fueling, and professional support to ensure athletes can perform at their best while protecting their long-term health. The danger of under-fueling for a lean physique or weight class far outweighs any perceived performance benefits. To learn more about the broader impact of low energy availability, you can consult resources like this article on Relative Energy Deficiency in Sport from PubMed Central.

Frequently Asked Questions

Athletes in aesthetic and weight-class sports are at higher risk because they often intentionally restrict their food intake to maintain a low body weight or body fat percentage, leading to inadequate vitamin and mineral consumption.

While endurance athletes have high energy demands, their typically high overall food intake often provides sufficient nutrients. In contrast, weight-sensitive athletes intentionally restrict calories, leading to nutrient dilution and a more concentrated risk of deficiency.

Symptoms can include persistent fatigue, muscle weakness, frequent stress fractures, weakened immune function resulting in frequent illness, and in female athletes, irregular or absent menstrual cycles.

No. While supplements can help address specific deficiencies, they cannot correct the underlying problem of low energy availability. The primary focus must be on increasing overall caloric and nutrient-dense food intake.

RED-S stands for Relative Energy Deficiency in Sport. It is a syndrome caused by low energy availability that affects multiple physiological systems, including metabolic and endocrine function. Vitamin deficiency is a direct consequence of the low energy intake that drives RED-S.

Yes, female athletes are often at an even higher risk due to factors like menstrual blood loss, particularly for iron, and societal pressures for leanness that may lead to greater energy restriction.

Coaches and parents can help by promoting a healthy body image, discouraging restrictive dieting, and ensuring access to a qualified sports dietitian who can provide proper nutritional guidance and education.