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dc.contributor.authorHeikura, Ida A.
dc.contributor.authorUusitalo, Arja L. T.
dc.contributor.authorStellingwerff, Trent
dc.contributor.authorBergland, Dan
dc.contributor.authorMero, Antti
dc.contributor.authorBurke, Louise M.
dc.date.accessioned2018-08-06T08:55:50Z
dc.date.available2018-08-06T08:55:50Z
dc.date.issued2018
dc.identifier.citationHeikura, I. A., Uusitalo, A. L. T., Stellingwerff, T., Bergland, D., Mero, A., & Burke, L. M. (2018). Low Energy Availability is Difficult to Assess But Outcomes Have Large Impact on Bone Injury Rates in Elite Distance Athletes. <i>International Journal of Sport Nutrition and Exercise Metabolism</i>, <i>28</i>(4), 403-411. <a href="https://doi.org/10.1123/ijsnem.2017-0313" target="_blank">https://doi.org/10.1123/ijsnem.2017-0313</a>
dc.identifier.otherCONVID_27784315
dc.identifier.otherTUTKAID_76178
dc.identifier.urihttps://jyx.jyu.fi/handle/123456789/59103
dc.description.abstractWe aimed to (a) report energy availability (EA), metabolic/reproductive function, bone mineral density, and injury/illness rates in national/world-class female and male distance athletes and (b) investigate the robustness of various diagnostic criteria from the Female Athlete Triad (Triad), Low Energy Availability in Females Questionnaire, and relative energy deficiency in sport (RED-S) tools to identify risks associated with low EA. Athletes were distinguished according to benchmarks of reproductive function (amenorrheic [n = 13] vs. eumenorrheic [n = 22], low [lowest quartile of reference range; n = 10] versus normal testosterone [n = 14]), and EA calculated from 7-day food and training diaries (< or >30 kcal·kg−1 fat-free mass·day−1). Sex hormones (p < .001), triiodothyronine (p < .05), and bone mineral density (females, p < .05) were significantly lower in amenorrheic (37%) and low testosterone (40%; 15.1 ± 3.0 nmol/L) athletes, and bone injuries were ∼4.5-fold more prevalent in amenorrheic (effect size = 0.85, large) and low testosterone (effect size = 0.52, moderate) groups compared with others. Categorization of females and males using Triad or RED-S tools revealed that higher risk groups had significantly lower triiodothyronine (female and male Triad and RED-S: p < .05) and higher number of all-time fractures (male Triad: p < .001; male RED-S and female Triad: p < .01) as well as nonsignificant but markedly (up to 10-fold) higher number of training days lost to bone injuries during the preceding year. Based on the cross-sectional analysis, current reproductive function (questionnaires/blood hormone concentrations) appears to provide a more objective and accurate marker of optimal energy for health than the more error-prone and time-consuming dietary and training estimation of EA. This study also offers novel findings that athlete health is associated with EA indices.fi
dc.format.mimetypeapplication/pdf
dc.language.isoeng
dc.publisherHuman Kinetics Publications
dc.relation.ispartofseriesInternational Journal of Sport Nutrition and Exercise Metabolism
dc.rightsIn Copyright
dc.subject.otherbone health
dc.subject.othermetabolic hormones
dc.subject.otherreproductive hormones
dc.subject.otherRED-S
dc.subject.otherTriad
dc.titleLow Energy Availability is Difficult to Assess But Outcomes Have Large Impact on Bone Injury Rates in Elite Distance Athletes
dc.typearticle
dc.identifier.urnURN:NBN:fi:jyu-201808023722
dc.contributor.laitosLiikuntatieteellinen tiedekuntafi
dc.contributor.laitosFaculty of Sport and Health Sciencesen
dc.contributor.oppiaineLiikuntafysiologiafi
dc.contributor.oppiaineExercise Physiologyen
dc.type.urihttp://purl.org/eprint/type/JournalArticle
dc.date.updated2018-08-02T09:15:10Z
dc.type.coarhttp://purl.org/coar/resource_type/c_2df8fbb1
dc.description.reviewstatuspeerReviewed
dc.format.pagerange403-411
dc.relation.issn1526-484X
dc.relation.numberinseries4
dc.relation.volume28
dc.type.versionacceptedVersion
dc.rights.copyright© 2017 Human Kinetics, Inc
dc.rights.accesslevelopenAccessfi
dc.subject.ysoluusto
dc.subject.ysoluuntiheys
dc.subject.ysoenergiansaanti
dc.subject.ysoaineenvaihdunta
dc.subject.ysohormonit
dc.format.contentfulltext
jyx.subject.urihttp://www.yso.fi/onto/yso/p7233
jyx.subject.urihttp://www.yso.fi/onto/yso/p22879
jyx.subject.urihttp://www.yso.fi/onto/yso/p27286
jyx.subject.urihttp://www.yso.fi/onto/yso/p3066
jyx.subject.urihttp://www.yso.fi/onto/yso/p2589
dc.rights.urlhttp://rightsstatements.org/page/InC/1.0/?language=en
dc.relation.doi10.1123/ijsnem.2017-0313
dc.type.okmA1


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