Sports Dietitian practices for assessing and managing athletes at risk of low energy availability (LEA)

To characterise the assessment and management practices employed by Sports Dietitians when assessing and managing athletes at risk of low energy availability (LEA).55 Sports Dietitians participated in an online questionnaire that captured the typical methods used to identify and manage LEA in athletic populations.The questionnaire consisted of 27 questions which explored common methods used to identify and manage LEA, as well as dietary methods employed and barriers experienced by Sports Dietitians.Broadly, the top 3 nutrition-related priorities for respondents were nutrition strategies to support training, competition, and recovery while 'LEA' was ranked fifth. 'Dietary intake', 'menstrual function' and 'training load (km/week)' were the primary methods used to assess LEA and respondents were 'confident' in their ability to correctly identify athletes at risk. Among support personnel, coaches were rarely a referral source for management of LEA but did present frequent communication difficulties. Respondents indicated athletes have concerns about undesirable changes in body composition when providing recommendations of increased energy intake for LEA management.Sport Dietitians appear to recognise and prioritise LEA management in athletes, but assessments are limited to dietary intake and training load (km/week); with collaborative approaches to LEA management lacking. Sports Dietitian may be overconfident in their ability to identify LEA as only a limited number of assessment methods are commonly used. Access to reliable assessments methods and collaborative management approaches are needed to improve athlete care when suspected of LEA.