{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T23:11:39Z","timestamp":1789081899904,"version":"build-2803163510"},"reference-count":36,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int J Sports Med"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This study aims to explore the impact of energy availability on body composition,\n                    dietary intake, sleep quality, and subjective well-being in free-living Spanish\n                    athletes across different sports disciplines. A total of 75 elite and pre-elite\n                    athletes (27 women; 24.9\u00b15.9 y) were included. Body composition was assessed by\n                    dual-energy x-ray absorptiometry, bioimpedance, and anthropometry; the diet was\n                    assessed using dietary recalls and food-frequency questionnaires; sleep quality\n                    was determined using a wrist-worn accelerometer; and subjective well-being was\n                    evaluated through validated questionnaires. We observed, counter to common\n                    hypothesis, that athletes with low energy availability showed higher levels of\n                    bone-related markers (i.e., bone mineral content, bone mineral density, and\n                        Z-score) compared to those with adequate energy availability (all\n                        p&lt;0.05). Despite higher protein intake, athletes with low energy\n                    availability consumed fewer carbohydrates than those with adequate energy\n                    availability (all p&lt;0.05). No relationship was observed between energy\n                    availability and other body composition parameters, sleep quality, or subjective\n                    well-being markers (all p&gt;0.05). Overall, these results suggest that\n                    factors like metabolic adaptations, activity patterns, and individual behaviors\n                    may influence the relationship between energy availability and athletic\n                    performance in real-world settings. Low energy availability's complexities\n                    extend beyond simple nutritional deficiencies, emphasizing the need for a\n                    holistic approach to managing energy availability and optimizing athletes\u2019\n                    performance and health.<\/jats:p>","DOI":"10.1055\/a-2884-0122","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T23:08:15Z","timestamp":1779836895000},"source":"Crossref","is-referenced-by-count":0,"title":["Relationship between Energy Availability and Phenotype in Free-Living\n                    Athletes"],"prefix":"10.1055","author":[{"given":"Marcos","family":"Rueda-C\u00f3rdoba","sequence":"first","affiliation":[{"name":"University of Granada, Andaluc\u00eda, Spain","place":["Granada"],"department":["Department of Physical Education and Sports, Faculty of Sports Science,\n                    Sport and Health University Research Institute (iMUDS)"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8072-0116","authenticated-orcid":false,"given":"Juan J.","family":"Martin-Olmedo","sequence":"first","affiliation":[{"name":"University of Granada, Andaluc\u00eda, Spain","place":["Granada"],"department":["Department of Physiology, Faculty of Medicine, Sport and Health\n                    University Research Institute (iMUDS)"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Espinar","sequence":"additional","affiliation":[{"name":"Catholic University of Murcia, Spain","place":["Murcia"],"department":["Faculty of Health Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonatan R.","family":"Ruiz","sequence":"additional","affiliation":[{"name":"University of Granada, Andaluc\u00eda, Spain","place":["Granada"],"department":["Department of Physical Education and Sports, Faculty of Sports Science,\n                    Sport and Health University Research Institute (iMUDS)"]},{"name":"Instituto de Investigaci\u00f3n Biosanitaria de\n                    Granada, Spain","place":["Granada"],"department":["ibs.GRANADA"]},{"name":"Instituto de Salud Carlos III, Community of Madrid, Spain","place":["Madrid"],"department":["Centro de Investigaci\u00f3n Biom\u00e9dica en Red Fisiopatolog\u00eda de la Obesidad y\n                    Nutrici\u00f3n"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5254-1816","authenticated-orcid":false,"given":"Lucas","family":"Jurado-Fasoli","sequence":"additional","affiliation":[{"name":"University of Granada, Andaluc\u00eda, Spain","place":["Granada"],"department":["Department of Physiology, Faculty of Medicine, Sport and Health\n                    University Research Institute (iMUDS)"]},{"name":"Instituto de Investigaci\u00f3n Biosanitaria de\n                    Granada, Spain","place":["Granada"],"department":["ibs.GRANADA"]},{"name":"Instituto de Salud Carlos III, Community of Madrid, Spain","place":["Madrid"],"department":["Centro de Investigaci\u00f3n Biom\u00e9dica en Red Fisiopatolog\u00eda de la Obesidad y\n                    Nutrici\u00f3n"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"ref1","first-page":"121","article-title":"Low energy availability: History, definition and evidence of its endocrine,\n                    metabolic and physiological effects in prospective studies in females and\n                    males","author":"J L Areta","year":"2021","journal-title":"Eur J Appl Physiol"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1016\/S8756-3282(97)00026-4","article-title":"Bone mass and bone turnover in power athletes, Endurance athletes, and controls:\n                    A 12-month longitudinal 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Primaria"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1123\/ijsnem.2016-0332","article-title":"Negative consequences of low energy availability in natural male bodybuilding: A\n                    review","volume":"28","author":"P Fagerberg","year":"2018","journal-title":"Int J Sport Nutr Exerc Metab"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1177\/1941738116677732","article-title":"Bone health in athletes: The role of exercise, nutrition, and hormones","volume":"9","author":"M A Goolsby","year":"2017","journal-title":"Sports Health"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1080\/17461391.2021.1915391","article-title":"Low energy availability in female athletes: From the lab to the field","volume":"22","author":"I A Heikura","year":"2022","journal-title":"Eur J Sport Sci"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1123\/ijsnem.2017-0313","article-title":"Low energy availability is difficult to assess but outcomes have large impact on\n                    bone injury rates in elite distance athletes","volume":"28","author":"I A Heikura","year":"2018","journal-title":"Int J Sport Nutr Exerc Metab"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/j.clinthera.2020.01.016","article-title":"Menses requires energy: A review of how disordered eating, excessive exercise,\n                    and high stress lead to menstrual irregularities","volume":"42","author":"K Huhmann","year":"2020","journal-title":"Clin Ther"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1359\/JBMR.040410","article-title":"Dose-response relationships between energy availability and bone turnover in\n                    young exercising women","volume":"19","author":"R Ihle","year":"2004","journal-title":"J Bone Mineral Res"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"2793","DOI":"10.1007\/s40279-024-02108-y","article-title":"Does Relative Energy Deficiency in Sport (REDs) syndrome exist?","volume":"54","author":"A E Jeukendrup","year":"2024","journal-title":"Sports Med"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1249\/MSS.0000000000002098","article-title":"Muscle glycogen content during endurance training under low energy\n                    availability","volume":"52","author":"C Kojima","year":"2020","journal-title":"Med Sci Sports Exerc"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"238","DOI":"10.24985\/ijass.2023.35.2.238","article-title":"Validating athletes\u2019 subjective performance scale: A rasch model analysis","volume":"35","author":"S Lee","year":"2023","journal-title":"Int J Appl Sports Sci"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"4457","DOI":"10.3390\/nu15204457","article-title":"Considerations of Low Carbohydrate Availability (LCA) to Relative Energy\n                    Deficiency in Sport (RED-S) in Female Endurance Athletes: A narrative\n                    review","volume":"15","author":"M T Lodge","year":"2023","journal-title":"Nutrients"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"4457","DOI":"10.3390\/nu15204457","article-title":"Considerations of Low Carbohydrate Availability (LCA) to Relative Energy\n                    Deficiency in Sport (RED-S) in female endurance athletes: A narrative\n                    review","volume":"15","author":"M T Lodge","year":"2023","journal-title":"Nutrients"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1007\/s40519-021-01258-6","article-title":"Psychometric properties of a Silhouette Rating Scale assessing current and ideal\n                    body size and body dissatisfaction in adults","volume":"27","author":"C Lombardo","year":"2022","journal-title":"Eating Weight Disord"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"1067","DOI":"10.1007\/s40279-024-02167-1","article-title":"Fibre: The forgotten carbohydrate in sports nutrition recommendations","volume":"55","author":"L Mancin","year":"2025","journal-title":"Sports Med"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"1421950","DOI":"10.3389\/fnut.2024.1421950","article-title":"Validity and agreement between dual-energy X-ray absorptiometry,\n                    anthropometry and bioelectrical impedance in the estimation of fat mass in young\n                    adults","volume":"11","author":"Mecherques-Carini","year":"2024","journal-title":"Front Nutr"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1136\/bjsports-2013-093240","article-title":"The LEAF questionnaire: A screening tool for the identification of female\n                    athletes at risk for the female athlete triad","volume":"48","author":"A Melin","year":"2014","journal-title":"Br J Sports Med"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"e14327","DOI":"10.1111\/sms.14327","article-title":"Direct and indirect impact of low energy availability on sports performance","volume":"34","author":"A K Melin","year":"2024","journal-title":"Scand J Med Sci Sports"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1123\/ijsnem.2018-0201","article-title":"Energy availability in athletics: Health, performance, and physique","volume":"29","author":"A K Melin","year":"2019","journal-title":"Int J Sport Nutr Exerc Metab"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1038\/ijir.2009.35","article-title":"The quantitative ADAM questionnaire: A new tool in quantifying the severity of\n                    hypogonadism","volume":"22","author":"O Mohamed","year":"2010","journal-title":"Int J Impot 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Oxfeldt","year":"2023","journal-title":"J Physiol"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1123\/ijsnem.2017-0064","article-title":"Case study: Unfavorable but transient physiological changes during contest\n                    preparation in a drug-free male bodybuilder","volume":"27","author":"A Pardue","year":"2017","journal-title":"Int J Sport Nutr Exerc Metab"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"2853","DOI":"10.1007\/s40279-022-01733-9","article-title":"Mechanisms of estrogen influence on skeletal muscle: Mass, regeneration, and\n                    mitochondrial function","volume":"52","author":"A Pellegrino","year":"2022","journal-title":"Sports Med"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1136\/bjsports-2019-101517","article-title":"Prevalence of impaired physiological function consistent with Relative Energy\n                    Deficiency in Sport (RED-S): An Australian elite and pre-elite cohort","volume":"55","author":"M A Rogers","year":"2021","journal-title":"Br J Sports Med"},{"key":"ref32","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1007\/s40279-019-01161-2","article-title":"Nutrition and athlete bone health","volume":"49","author":"C Sale","year":"2019","journal-title":"Sports Med"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"2251","DOI":"10.1007\/s40279-021-01491-0","article-title":"Overtraining Syndrome (OTS) and Relative Energy Deficiency in Sport (RED-S):\n                    Shared pathways, symptoms and complexities","volume":"51","author":"T Stellingwerff","year":"2021","journal-title":"Sports Medicine"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"1849","DOI":"10.1080\/02640414.2022.2115676","article-title":"Patterns of energy availability of free-living athletes display day-to-day\n                    variability that is not reflected in laboratory-based protocols: Insights from\n                    elite male road cyclists","volume":"40","author":"H L Taylor","year":"2022","journal-title":"J Sports Sci"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3390\/nu12113561","article-title":"Development and validation of a short sport nutrition knowledge questionnaire\n                    for athletes","volume":"12","author":"K V\u00e1zquez-Espino","year":"2020","journal-title":"Nutrients"},{"key":"ref36","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1186\/s40798-020-00275-6","article-title":"Reasons for and consequences of low energy availability in female and male\n                    athletes: Social environment, adaptations, and prevention","volume":"6","author":"P Wasserfurth","year":"2020","journal-title":"Sports Med Open"},{"key":"ref37","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pone.0173807","article-title":"New approaches to determine fatigue in elite athletes during intensified\n                    training: Resting metabolic rate and pacing profile","volume":"12","author":"A L Woods","year":"2017","journal-title":"PLoS One"},{"key":"ref38","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1123\/ijsnem.2018-0142","article-title":"Pitfalls of Conducting and Interpreting Estimates of Energy Availability in Free-Living Athletes","volume":"28","author":"L M Burke","year":"2018","journal-title":"Int J Sport Nutr Exerc Metab"}],"container-title":["International Journal of Sports Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2884-0122.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T22:57:37Z","timestamp":1789081057000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2884-0122"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,26]]},"references-count":36,"URL":"https:\/\/doi.org\/10.1055\/a-2884-0122","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0172-4622","1439-3964"],"issn-type":[{"value":"0172-4622","type":"print"},{"value":"1439-3964","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,5,26]]},"published":{"date-parts":[[2026,5,26]]}}}