Evaluating the suitability of the Low Energy Availability in Females Questionnaire (LEAF-Q) for female footballers

Background - The Low Energy Availability in Females Questionnaire (LEAF-Q) is a screening tool developed to detect endurance athletes and dancers at risk for development of persistent low energy availability (LEA) and the female athlete triad (Triad). This study investigated the applicability of the LEAF-Q in a cohort of sixty professional female football players. Methods - The participants were classified as at risk (≥ 8) or not at risk ( Results - Thirty-two percent of participants were classified as at risk by the LEAF-Q. We found no statistically significant differences between the two groups for any markers associated with persistent LEA. Except for acceptable accuracy in determining menstrual status, all other LEAF-Q components exhibited poor accuracy and predictive values. Youden’s index scores imply that increasing the overall and injury cut-off values to ≥ 10 and ≥ 5 respectively, would yield increased performance. Conclusions - Our findings do not support the use of the LEAF-Q for the purpose of detecting LEA and Triad conditions among female football players