Treatment of Low EA and Related Health Indexes
Depending upon the medical and nutritional status of the athlete, participation in sport may be discontinued until the individual is at a more medically and nutritionally stable place. Table 8.1 provides an assessment that can be used to determine if continued participation in sport is recommended, keeping in mind the health of the athlete must be the number one priority. Regardless of participation status, addressing and correcting EA is the cornerstone of treatment for these athletes.
Treatment of low EA needs to include an increase in EI, a decrease in energy expenditure, or both. The goal is to get an athlete’s EA to at least 45 kcal/kg of FFM per day, keeping in mind this value pertains to calories needed in addition to those expended during physical activity. If FFM can be determined, the athlete’s energy needs can be calculated and estimated. However, since there are limitations to accurately assessing EA in athletes, a more practical recommendation for increasing EA is to increase caloric intake by 300 to 600 kcals/day and to decrease energy expenditure as appropriate (Mountjoy et al. 2014).
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Once EA is sufficient (a process that my take several months or more), menstrual function typically normalizes since weight regain is one of the
Athletes with physical complications based upon medical assessment Includes electrolyte imbalances, stress fractures, and fatigue
Uncooperative athletes or those showing a lack of progress
Athletes having a negative effect on other team members such as unhealthy dieting behaviors and unstable mood Includes behaviors such as binging, purging, restrictive eating, excessive focus on food and weight
Athletes unable to maintain positive energy balance over time, lack of responsiveness to training, or consistent fatigue and intolerance.
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