Energy status plays a key role in the health of athletes and exercising individuals. Energy deficiency/low energy availability (EA), referring to a state in which insufficient energy intake and/or excessive exercise energy expenditure has resulted in compensatory metabolic adaptations to conserve fuel, can affect numerous physiological systems in women and men. The Female Athlete Triad, Male Athlete Triad, and Relative Energy Deficiency in Sport (RED-S) models conceptualize the effects of energy deficiency in athletes, and each model has strengths and limitations. For instance, the Female Athlete Triad model depicts relationships between low EA, reproductive, and bone health, underpinning decades of experimental evidence, but may be perceived as limited in scope, while the more recent RED-S model proposes a wider range of potential health effects of low EA, though many model components require more robust scientific justification. This critical review summarizes current evidence regarding the effects of energy deficiency on athlete health by addressing the quality of the underlying science, the strengths and limitations of each model, and highlighting areas where future research is needed to advance the field. With the health and wellness of athletes and exercising individuals as the overarching priority, we conclude with specific steps that will help focus future research on the Female and Male Athlete Triad and RED-S, and encourage all researchers, clinicians, and practitioners to collaborate to support the common goal of promoting the highest quality science and evidence-based medicine in pursuit of the advancement of athletes’ health, well-being, and performance.

能量状态在运动员和锻炼者的健康中起着关键作用。能量缺乏/低能量可用性 (EA) 是指能量摄入不足和/或运动能量消耗过多导致代偿性代谢适应以节省燃料的状态，可影响女性和男性的许多生理系统。女运动员三合会、男运动员三合会和运动中的相对能量缺乏 (RED-S) 模型概念化了运动员能量缺乏的影响，每个模型都有优点和局限性。例如，女性运动员三合会模型描述了低 EA、生殖和骨骼健康之间的关系，支撑了数十年的实验证据，但可能被认为范围有限，而最近的 RED-S 模型提出了低 EA 的更广泛的潜在健康影响，尽管许多模型组件需要更强大的科学依据。这篇批判性评论通过解决基础科学的质量、每种模型的优势和局限性，并强调需要未来研究来推动该领域发展的领域，总结了有关能量缺乏对运动员健康影响的当前证据。以运动员和锻炼个人的健康和保健为首要任务，我们总结了具体步骤，这将有助于将未来的研究重点放在女性和男性运动员三联征和 RED-S 上，并鼓励所有研究人员、临床医生、