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Biochemical Responses to Experimentally Induced Short‐Term Low Energy Availability in Athletes: A Systematic Review.

Low energy availability (LEA) occurs when dietary energy intake is insufficient to meet the combined demands of exercise and essential physiological functions. Problematic LEA is recognized as the primary driver of Relative Energy Deficiency in Sport (RED‐S), but the short‐term physiological consequ...

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Published in:Scandinavian Journal of Medicine & Science in Sports (John Wiley & Sons, Inc.) Vol. 36; no. 3; pp. 1 - 15
Main Authors: Guisado‐Cuadrado, Isabel, Recacha‐Ponce, Paula, Peinado, Ana B., Romero‐Parra, Nuria
Format: research systematic review tables/charts Journal Article
Published: John Wiley & Sons, Inc. Mar2026
Online Access:View this record in EBSCOhost
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      jtl: Scandinavian Journal of Medicine & Science in Sports (John Wiley & Sons, Inc.)
      issn: 16000838
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      dt: Mar2026
      vid: 36
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      pid: 52269
      pub: John Wiley & Sons, Inc.
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        192478223
        192478223
        10.1111/sms.70249
        192478223
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        atl: Biochemical Responses to Experimentally Induced Short‐Term Low Energy Availability in Athletes: A Systematic Review.
      aug:
        au:
          Guisado‐Cuadrado, Isabel
          Recacha‐Ponce, Paula
          Peinado, Ana B.
          Romero‐Parra, Nuria
        affil: LFE Research Group, Departamento de Salud y Rendimiento Humano, Facultad de Ciencias de la Actividad Física y del Deporte (INEF), Universidad Politécnica de Madrid, Madrid, Spain
      sug:
        subj:
          Athletes
          Biological Markers Blood
          Bone Remodeling
          Calcium Metabolism
          Energy Intake
          Energy Metabolism
          Relative Energy Deficiency in Sport
          Endocrine System Physiology
          Human
          Spain
          Systematic Review
          PubMed
          Inflammation
          Interleukins
          C-Reactive Protein
          Iron Metabolism
          Sex Hormones Blood
          Leptin Blood
          Hydrocortisone Blood
          Ghrelin
          Checklists
          Testosterone Blood
          Thyroid Hormones Blood
          Nutrition Disorders
          Food Intake
          Exercise
      ab: Low energy availability (LEA) occurs when dietary energy intake is insufficient to meet the combined demands of exercise and essential physiological functions. Problematic LEA is recognized as the primary driver of Relative Energy Deficiency in Sport (RED‐S), but the short‐term physiological consequences of LEA remain less clearly defined. Thus, this systematic review aimed to synthesize evidence from experimental studies examining the short‐term effects of experimentally induced LEA on biochemical markers in athletic populations. A systematic search was conducted in PubMed, Web of Science, and Scopus in accordance with PRISMA guidelines. Eligible studies included experimental designs, with pre–post assessments of an LEA intervention (> 24 h). Outcomes included biomarkers of bone metabolism, calcium metabolism, energy regulation, inflammation, iron status, sex hormones, and thyroid function. Thirteen studies (145 participants) were included. Approximately half of the interventions reported significant increases in βCTX‐1 and reductions in P1NP. Leptin consistently decreased following LEA, whereas IGF‐1 and T3 remained stable in most studies, and testosterone decreased in 50% of interventions. No consistent changes were observed in estradiol, progesterone, calcium metabolism, inflammatory markers, or iron status. Short‐term experimentally induced LEA elicits early endocrine and metabolic adaptations, particularly affecting bone remodeling, leptin, and testosterone. However, these responses should be interpreted in the context of the frequent coexistence of low carbohydrate availability, which may contribute to or exacerbate the observed effects. These findings emphasize the relevance of monitoring key biochemical markers during periods of potential LEA risk and underscore the need for standardized, sex‐specific protocols in future research.
      pubtype: Academic Journal
      doctype:
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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