Low Energy Intake and Availability
Although running is a high-energy consuming physical activity, many endurance runners tend to keep their total energy intake very low to reduce body fat and weight (5). As running is a weight-
bearing discipline, it is believed that the lighter the body weighs, the better the performance, which is far too simplistic and can lead to dramatic situations of leanness and nutritional deficiencies. While also present in male runners, the fight for a low percentage of body fat and a low body weight is most often observed in female athletes (6, 7). Likely because female runners need to challenge their body composition further from their natural shape than males to achieve the leanness that is considered optimal for the discipline. Trying to eliminate body fat beyond the biological disposition can have direct negative effects as for example disturbances of the adipose tissue secretome. Restricted energy, protein,
carbohydrate, and micronutrients intakes are other more subtle and more indirect consequences from nutritional strategies aiming at decreasing weight and body fat (1), which may finally have significant effects on health and physical performance (8). Some athletes develop clear medical and/or psychological troubles such as eating disorders, osteopenia, and chronic menstrual dysfunction whereas others develop sub-clinical versions of these diseases (1).
The expression “female athlete triad” encompasses the spectrum of restrained eating, menstrual dysfunction, and poor bone health from the lighter manifestation to the more severe. For those who are interested in this topic, we recommend the consensus statement published in 2014 (8, 9). A recent epidemiological study shows that the prevalence of sportswomen presenting simultaneously the three components of the female athlete triad is rather low, between 0 and 16%. However, those presenting one or two concurrent components, with different degrees of severity, approach 50–60% among certain athlete groups, including female
endurance runners (10).