Under-fuelling is a much bigger problem than we thought...
The Prevalence of Under-Fuelling: A Troubling Reality
With the women's Rugby World Cup in full swing, we're hearing a lot from these elite players about body image, and how stereotypes and online comments have impacted them.
Because the thing that's easy to forget is; Even the best of the best lose confidence and struggle with body image sometimes!
And what do we tend to do when we're feeling insecure and unhappy in our bodies? For a lot of us, the solution is just to stop eating, or at least cut down calories.
So really it's unsurprising that chronic under-fuelling is common in female athletes across a wide range of sports, particularly those that emphasize leanness or aesthetic appeal, such as gymnastics, figure skating, distance running, and, unfortunately, even rugby [1]. Studies have shown that a significant percentage of female athletes fail to meet their daily energy requirements, leading to a state of relative energy deficiency (RED-S) [2].
Research highlights the alarming extent of this problem:
A review published in the Journal of the International Society of Sports Nutrition found that up to 69% of female athletes may be under-fuelling, depending on the sport and the criteria used to define energy deficiency [3].
Studies focusing on endurance athletes have reported that as many as 50% of female runners may be chronically energy-deficient [4].
Even in team sports, such as soccer and basketball, where body image pressures may be less pronounced, studies have shown that a substantial proportion of female athletes do not consume enough calories to support their training demands [5].
The insidious nature of chronic under-fuelling lies in its gradual onset and the fact that athletes may not initially recognize the signs and symptoms. It often begins with a well-intentioned effort to manage weight or improve body composition, but over time, it can spiral into a pattern of restrictive eating and insufficient energy intake.
Spotting the Signs: Recognizing the Red Flags of Under-Fuelling
Identifying chronic under-fuelling can be challenging, as its manifestations are often subtle and can be easily attributed to other factors, such as overtraining or stress. However, being aware of the red flags is crucial for early detection and intervention. Key signs and symptoms include:
Persistent Fatigue and Low Energy Levels: Feeling tired despite adequate sleep is a hallmark of under-fuelling.
Decreased Athletic Performance: Noticeable decline in strength, speed, endurance, or agility.
Increased Injury Rate: Higher susceptibility to stress fractures, muscle strains, and other overuse injuries.
Irregular or Absent Menstrual Cycles (Amenorrhea): A disrupted menstrual cycle is a significant indicator of hormonal imbalances caused by energy deficiency.
Bone Loss (Osteoporosis or Osteopenia): Chronic under-fuelling can impair bone health and increase the risk of stress fractures and long-term bone problems.
Mood Disturbances: Increased irritability, anxiety, depression, or difficulty concentrating.
Frequent Illnesses: A weakened immune system due to inadequate nutrition.
Eating Disorder Behaviours: Restrictive eating, excessive exercise, or preoccupation with weight and body image.
Difficulty Recovering from Workouts: Prolonged muscle soreness and fatigue after training sessions.
It's important to note that not all athletes will experience all of these symptoms, and the severity of the symptoms can vary depending on the individual and the extent of the energy deficit. However, if you or someone you know is experiencing multiple of these red flags, it's essential to seek professional help.
Why Does Under-Fuelling Happen? Understanding the Root Causes
Chronic under-fuelling is a complex issue with a variety of contributing factors:
Body Image Pressures: Societal pressures to be thin and conform to unrealistic body ideals can lead female athletes to restrict their calorie intake in an attempt to achieve a perceived "ideal" athletic physique.
Misinformation and Lack of Education: Many athletes lack accurate knowledge about their energy needs and how to properly fuel their bodies for optimal performance. They may rely on outdated or misleading information about nutrition and weight management.
Fear of Weight Gain: Some athletes fear that increasing their calorie intake will lead to weight gain, which they believe will negatively impact their performance. This fear can be particularly strong in sports where leanness is perceived as an advantage.
Overtraining and Inadequate Recovery: Pushing the body too hard without adequate rest and recovery can increase energy expenditure and make it difficult to meet energy needs.
Pressure from Coaches and Teammates: In some cases, athletes may feel pressure from coaches or teammates to maintain a certain body weight or composition, leading to restrictive eating behaviours.
Eating Disorders: In more severe cases, chronic under-fuelling may be a manifestation of an underlying eating disorder, such as anorexia nervosa or bulimia nervosa.
Reversing the Trend: Strategies for Fuelling Success
Addressing chronic under-fuelling requires a multifaceted approach that includes education, support, and individualized nutrition guidance. Here are some key strategies:
Education and Awareness: Increase awareness among athletes, coaches, and parents about the risks of under-fuelling and the importance of proper nutrition.
Individualized Nutrition Counselling: Work with a registered dietitian or sports nutritionist to assess your energy needs and develop a personalized fuelling plan.
Prioritize Whole Foods: Focus on consuming a balanced diet rich in whole, unprocessed foods, including fruits, vegetables, whole grains, lean protein, and healthy fats.
Fuel Before, During, and After Workouts: Strategically consume carbohydrates and protein before, during, and after training sessions to optimize energy levels and recovery.
Don't Fear Carbohydrates: Carbohydrates are the primary fuel source for athletes, and restricting them can lead to fatigue and impaired performance.
Monitor Menstrual Cycles: Track your menstrual cycles and be aware of any irregularities. Seek medical attention if you experience prolonged amenorrhea.
Promote a Positive Body Image: Foster a healthy body image and challenge unrealistic beauty standards. Focus on performance and overall well-being rather than solely on weight or appearance.
Seek Professional Help: If you suspect you have an eating disorder or are struggling with restrictive eating behaviours, seek help from a qualified mental health professional.
It's time to break the cycle of chronic under-fuelling and empower female athletes to prioritize their health and well-being. By understanding the risks, recognizing the signs, and implementing proactive strategies, we can help them fuel their bodies adequately and achieve their full athletic potential.
The LiftHer Strength App provides resources to assist in your recovery journey, and support any nutritional concerns, with our range of training plans, support system and expert advice. Download now and take charge .https://coach.everfit.io/package/NK157296
Citations:
De Souza, M. J., et al. "2014 Female Athlete Triad Coalition Consensus Statement on Treatment and Return to Play of the Female Athlete Triad: 1st International Conference held in San Francisco, California, May 2012 and 2nd International Conference held in Indianapolis, Indiana, May 2013." British Journal of Sports Medicine 48.4 (2014): 289-291.
Mountjoy, M., et al. "IOC consensus statement on relative energy deficiency in sport (RED-S): 2018 update." British Journal of Sports Medicine 52.11 (2018): 687-697.
Sims, S. et al, 2023. International society of sports nutrition position stand: nutritional concerns of the female athlete
Deldicque L, Francaux M. Recommendations for Healthy Nutrition in Female Endurance Runners: An Update. Front Nutr. 2015 May 26;2:17. doi: 10.3389/fnut.2015.00017. PMID: 26075206; PMCID: PMC4443719.
Li Q, Li H, Zhang G, Cao Y, Li Y. Athlete Body Image and Eating Disorders: A Systematic Review of Their Association and Influencing Factors. Nutrients. 2024 Aug 13;16(16):2686. doi: 10.3390/nu16162686. PMID: 39203822; PMCID: PMC11356870.
