The Low Energy Availability in Females Questionnaire (LEAF-Q) was validated to identify risk of the female athlete triad (triad) in female endurance athletes. This study explored the ability of the LEAF-Q to detect conditions related to low energy availability (LEA) in a mixed sport cohort of female athletes. Data included the LEAF-Q, SCOFF Questionnaire for disordered eating, dual-energy X-ray absorptiometry-derived body composition and bone mineral density, Mini International Neuropsychiatric Interview, blood pressure, and blood metabolic and reproductive hormones. Participants were grouped according to LEAF-Q score (≥8 or <8), and a comparison of means was undertaken. Sensitivity, specificity, and predictive values of the overall score and subscale scores were calculated in relation to the triad and biomarkers relevant to LEA. Fisher’s exact test explored differences in prevalence of these conditions between groups. Seventy-five athletes (18–32 years) participated. Mean LEAF-Q score was 8.0 ± 4.2 (55% scored ≥8). Injury and menstrual function subscale scores identified low bone mineral density (100% sensitivity, 95% confidence interval [15.8%, 100%]) and menstrual dysfunction (80.0% sensitivity, 95% confidence interval [28.4%, 99.5%]), respectively. The gastrointestinal subscale did not detect surrogate markers of LEA. LEAF-Q score cannot be used to classify athletes as “high risk” of conditions related to LEA, nor can it be used as a surrogate diagnostic tool for LEA given the low specificity identified. Our study supports its use as a screening tool to rule out risk of LEA-related conditions or to create selective low-risk groups that do not need management as there were generally high negative predictive values (range 76.5–100%) for conditions related to LEA.

女性低能量可用性问卷 (LEAF-Q) 经验证可识别女性耐力运动员中女性运动员三联征 (triad) 的风险。本研究探讨了 LEAF-Q 在女运动员混合运动队列中检测与低能量可用性 (LEA) 相关状况的能力。数据包括 LEAF-Q、饮食失调的 SCOFF 问卷、双能 X 射线吸收测定法衍生的身体成分和骨矿物质密度、迷你国际神经精神病学访谈、血压以及血液代谢和生殖激素。参与者根据 LEAF-Q 评分（≥8 或 <8）分组，并进行均值比较。总分和子量表分的敏感性、特异性和预测值是根据与 LEA 相关的三元组和生物标志物计算的。Fisher 精确检验探讨了这些疾病在各组之间的患病率差异。75 名运动员（18-32 岁）参加了比赛。平均 LEAF-Q 评分为 8.0 ± 4.2（55% 评分≥8）。损伤和月经功能分量表评分分别确定低骨密度（100% 敏感性，95% 置信区间 [15.8%，100%]）和月经功能障碍（80.0% 敏感性，95% 置信区间 [28.4%，99.5%]） . 胃肠道分量表未检测到 LEA 的替代标志物。LEAF-Q 评分不能用于将运动员归类为 LEA 相关病症的“高风险”，也不能用作 LEA 的替代诊断工具，因为其特异性较低。