Page 159 - Safe Wrestling

Rapid Weight Loss and Low Energy Availability

al clinical manifestations of LEA include alterations in growth hormone
and insulin-like growth factor-1 (IGF-1) secretion, elevated cortisol and
ghrelin concentrations, reduced triiodothyronine (T3), decreased resting
metabolic rate, dyslipidaemia and other cardiovascular risk factors, in-
creased susceptibility to infections, gastrointestinal dysfunction, haema-
tological abnormalities, and mental health disturbances (Salobir et al.,
2023).

Relative Energy Deficiency in Young Athletes
Regular physical activity is unequivocally important for adolescent he-
alth, provided that it occurs under conditions of adequate energy bal-
ance (Gould et al., 2023). Beyond impairments in physiological function-
ing, relative energy deficiency in sport in children and adolescents also
poses a significant risk for adverse effects on growth and pubertal devel-
opment (Salobir et al., 2023). Menstrual function represents an essential
component of female adolescent development. Functional hypothalam-
ic amenorrhea arises from suppression of the hypothalamic-pituitary-
gonadal axis due to low energy availability and is the most common
cause of both primary and secondary amenorrhea in adolescent girls
(Golden & Carlson, 2008). In males, suppression of the same axis may
lead to reduced testosterone concentrations and impaired spermatoge-
nesis (Loucks et al., 2011).
Prolonged LEA has also been associated with disturbances in bone
metabolism. Notably, nearly 70% of female high-school athletes present-
ing with clinical indicators of LEA were reported to have low bone min-
eral density (Barrack et al., 2023), which may subsequently increase the
risk of bone stress injuries (Hutson et al., 2021). Hormonal disturbances
associated with LEA, including alterations in leptin, thyroid hormones,
growth hormone, and growth factors, are particularly important during
childhood and adolescence because they may impair normal growth and
contribute to growth retardation (Salobir et al., 2023).

Identification of Low Energy Availability and Relative Energy
Deficiency in Sport
RED-S is a medical condition that should be diagnosed by a qualified
healthcare professional (Dipla et al., 2021). Low energy availability is
viewed as a key factor underlying disruptions in reproductive and skele-
tal health. This energy deficit may occur unintentionally, intentionally,
or psychopathologically. Many adverse effects are most commonly ob-
served when energy availability falls below approximately 30 kcal/kg fat-

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