{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:34:50Z","timestamp":1777944890834,"version":"3.51.4"},"reference-count":49,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Japan Keirin Autorace Foundation","award":["2023P-385"],"award-info":[{"award-number":["2023P-385"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Womens Health (Lond Engl)"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Energy intake (EI) from daily meals, corresponding to total energy expenditure (TEE), is essential for maintaining good physical condition and performance in athletes. Athletes who continue high-intensity training while consuming insufficient energy from their daily diet are at risk for health problems, such as iron deficiency anemia, endocrine dysfunction, and energy metabolism disorders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>This study aimed to examine the altered health risks in athletes when EI was increased to meet TEE from a daily diet.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Case series study with dietary intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Participants were six female long-distance runners classified as Tier 3. TEE was measured before the nutritional intervention using the doubly labeled water technique to determine the individual target EI and meal content during the intervention. The nutritional intervention was implemented for 6\u2009weeks; sports dietitians provided weekly nutritional advice to each participant on how to eat to meet TEE, in addition to providing appropriate meals (breakfast and dinner) throughout the intervention period. Body composition measurements, resting metabolic rate (RMR) measurements, and blood tests were performed before and after the 6-week nutrition intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A mean negative energy balance before the intervention in all participants (\u2212548\u2009kcal\/day) improved to \u221231\u2009kcal\/day during the intervention. Carbohydrate intake improved to recommended levels (&gt;7\u2009g\/kg body weight\/day). Five participants were classified as having stage 1 anemia before the intervention, but the condition of four participants improved or was in a recovery process after the intervention. In addition, the suppression of RMR (21.8 and 24.2\u2009kcal\/kg fat-free mass\/day) in two participants returned to the normal range.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In this case series, consciously increasing daily EI from meals to meet TEE was associated with a favorable change in health risks, such as improved iron status, recovered from RMR suppression, and decreased cortisol levels. Additionally, practical nutritional advice from sports dietitians appeared to support athletes in overcoming EI challenges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registration:<\/jats:title>\n                    <jats:p>\n                      Effect of the diet avoiding relative energy deficiency on physical condition in female long-distance runners.\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/center6.umin.ac.jp\/cgi-open-bin\/ctr\/ctr_view.cgi?recptno=R000055221;UMIN000048455\">https:\/\/center6.umin.ac.jp\/cgi-open-bin\/ctr\/ctr_view.cgi?recptno=R000055221;UMIN000048455<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17455057251385372","type":"journal-article","created":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T12:18:45Z","timestamp":1761567525000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Energy intake to meet total energy expenditure improves iron deficiency and metabolic suppression in female long-distance runners: A case series study with dietary intervention"],"prefix":"10.1177","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5525-0136","authenticated-orcid":false,"given":"Motoko","family":"Taguchi","sequence":"first","affiliation":[{"name":"Faculty of Sport Sciences, Waseda University, Saitama, Japan"},{"name":"Research Institute for Sports Nutrition, Waseda University, Saitama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0249-2964","authenticated-orcid":false,"given":"Tatsuya","family":"Ishizu","sequence":"additional","affiliation":[{"name":"Faculty of Sport Sciences, Waseda University, Saitama, Japan"},{"name":"Research Institute for Sports Nutrition, Waseda University, Saitama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3124-9103","authenticated-orcid":false,"given":"Mika","family":"Goshozono","sequence":"additional","affiliation":[{"name":"Faculty of Sport Sciences, Waseda University, Saitama, Japan"},{"name":"Research Institute for Sports Nutrition, Waseda University, Saitama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9606-5284","authenticated-orcid":false,"given":"Kuniko","family":"Moto","sequence":"additional","affiliation":[{"name":"Research Institute for Sports Nutrition, Waseda University, Saitama, Japan"},{"name":"Faculty of Human Nutrition, Seitoku University, Chiba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nozomi","family":"Miura","sequence":"additional","affiliation":[{"name":"Graduate School of Sport Sciences, Waseda University, Saitama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sumire","family":"Endo","sequence":"additional","affiliation":[{"name":"Research Institute for Sports Nutrition, Waseda University, Saitama, Japan"},{"name":"Aim Services Co., Ltd., Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eriko","family":"Yasuda","sequence":"additional","affiliation":[{"name":"Research Institute for Sports Nutrition, Waseda University, Saitama, Japan"},{"name":"Aim Services Co., Ltd., Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suguru","family":"Torii","sequence":"additional","affiliation":[{"name":"Faculty of Sport Sciences, Waseda University, Saitama, Japan"},{"name":"Research Institute for Sports Nutrition, Waseda University, Saitama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,10,27]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1080\/17461391.2021.1922508"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1080\/0264041031000140518"},{"key":"e_1_3_3_4_2","first-page":"111","article-title":"The importance of energy balance","volume":"9","author":"Hill JO","year":"2010","unstructured":"Hill JO, Wyatt HR, Peters JC. 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