Risk of Low Energy Availability in Elite Male Athletes with Spinal Cord Injury

Recent research examining male able-bodied athletes has suggested that males are at risk for low energy availability (LEA); however, there is a paucity of research pertaining to prevalence amongst male athletes with an impairment. Therefore, the purpose of this study was to examine the risk of LEA and prevalence of symptoms related to Relative Energy Deficiency in Sport (RED-S), including risk of disordered eating, hormonal profiles, and bone mineral density (BMD) scans, in male wheelchair para athletes. Collegiate- and national-level male athletes (n = 9) with spinal cord injury (SCI) completed 7-day concurrent diet and training logs, Eating Disorder Examination Questionnaire (EDE-Q), Dual Energy X-Ray Absorptiometry (DXA) scans, and hormonal blood spot testing. Zero (0) athletes were considered “at-risk” for LEA via EDE-Q score. Useable data to calculate energy availability (EA) was only available for 4 athletes, none of which presented with LEA (using a threshold of ≤ 25 kcal·kg FFM-1·day-1). Testosterone was low in 100% of athletes (mean: 7.9 ± 2.3 nmol/L). 25% of subjects had clinically low hip Z-scores (Z-score \u3c -2), and 63% of subjects were at an increased risk for fracture (Z-score \u3c -1). Based on the EDE-Q and calculated EA, the risk for LEA appears to be low; however, the risk for LEA appears to be high based on DXA scans and hormonal profiles. These results are consistent with literature examining LEA in able-bodied athletes, which shows calculated EA to be a poor field assessment tool for LEA. These results also underscore the need for additional research to establish para athlete-specific thresholds for LEA, assessments for disordered eating, and normal clinical hormone ranges