BACKGROUND: Collegiate athletes commonly fail to meet daily dietary recommendations for their energy expenditure, which may lead to low energy availability (LEA). Chronic LEA can affect the body characterized as relative energy deficiency syndrome (RED-S) including the gastrointestinal (GI), reproductive, and muscular systems. Severe LEA can lead to amenorrhea or oligomenorrhea, decreased bone mineral density, and GI distress. PURPOSE: To investigate the prevalence of injuries, GI distress, and abnormal menstruation risk factors in DI collegiate volleyball athletes. METHODS: Athletes were sampled: (N=17; Ht:175.0±7.9cm, Wt: 77.9±20.6kg, BF%: 24.8±10.2%, and FFM: 57.0±7.7kg). Athletes attended pre-season testing that included demographic information and self-reported LEA using the Low Energy Availability Females Questionnaire (LEAFQ). Height was measured using a wall-mounted stadiometer and body weight and composition via bioelectrical impedance. LEAFQ evaluates LEA risk of athletes by separating questions into three sections: injuries, GI, and reproductive functions. LEAFQ has a 90% specificity and 78% sensitivity in accurately identifying LEA. A risk score of ≥8 is the threshold for LEA risk. Person correlations compared LEAFQ and demographic data. RESULTS: The LEAFQ composition score indicated that 50% of athletes were positive for LEA risk (8.2±3.5). No significant correlations were found despite a negative moderate relationship with body mass (r= -0.39 p =0.14, CI: 0.14,-0.74). 14/16 of athletes reported feeling gaseous/bloated independent of the menstrual cycle. However, of the 14 observed with GI distress 50% (7/14) were also at risk for LEA while 37% reported cramps or stomach ache unrelated to menstruation. Of those with LEA risk, 50% (4/8) experienced menstrual changes with increased exercise intensity, duration, and frequency while 44% of all athletes reported having lost their period for at least 3 months. CONCLUSION: 100% of those with LEA risk experienced symptoms of RED-S. GI distress symptoms seem to be a more prevalent indicator of LEA risk, while abnormal menstruation shows a smaller prevalence in LEA risk. LEA did not seem to impact injury risk. LEA can adversely affect athletes’ health. It is important for coaches, staff, and athletes to be educated about the negative effects and preventative measures of LEA.

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