Physical health and symptoms of relative energy deficiency in female fitness athletes

Abstract

Introduction: Competing in aesthetic sports increases the risk of low energy availability and associated health impairments. Fitness physique sport is a popular, but understudied aesthetic sport. We evaluated health and symptoms of relative energy deficiency in sport (RED-s) in female fitness athletes (FA) and female references (FR) during a competitive season. Methods: Totally, 25 FA and 26 FR, mean (SD) age of 28.9 (5.7), were included. Assessments were at baseline (T1), 2-weeks pre-competition (T2), and 1-month post-competition (T3), by dual-energy x-ray absorptiometry scan, indirect calorimetry, diet registration, The Low Energy Availability in Females Questionnaire, The Beck Depression Inventory, and Eating Disorder Examination Questionnaire (EDE-Q). Results: A history of eating disorders was reported by 35% FA and 12% FR. There were no between-group differences at T1, besides less mean (99% CI) fat mass (FM) of 3.1 kg (−0.4, 6.5) in FA (P =.02). At T2, FA had lower BW of 6.7 kg (−12.0, −1.3), fat mass of −9.0 kg (−12.5, −5.5), and resting heart rate of −8.0 beats per minute (−14.5, −1.5) compared to FR (P ≤.006). FA reduced resting metabolic rate by −191 kcal (−11, −371) and increased symptoms of gastrointestinal dysfunction (GD) by 1.4 points (0.3, 2.5) and prevalence of amenorrhea from 8% to 24%, (P