Markers of Low Energy Availability in Overreached Athletes: A Systematic Review and Meta-analysis,Sports Medicine

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Markers of Low Energy Availability in Overreached Athletes: A Systematic Review and Meta-analysis
Sports Medicine ( IF 9.3 ) Pub Date : 2022-07-11 , DOI: 10.1007/s40279-022-01723-x
Megan A Kuikman ₁ , Alexandra M Coates ₁ , Jamie F Burr ₁

Affiliation

Background

Overreaching is the transient reduction in performance that occurs following training overload and is driven by an imbalance between stress and recovery. Low energy availability (LEA) may drive underperformance by compounding training stress; however, this has yet to be investigated systematically.

Objective

The aim of this study was to quantify changes in markers of LEA in athletes who demonstrated underperformance, and exercise performance in athletes with markers of LEA.

Methods

Studies using a ≥ 2-week training block with maintained or increased training loads that measured exercise performance and markers of LEA were identified using a systematic search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Changes from pre- to post-training were analyzed for (1) markers of LEA in underperforming athletes and (2) performance in athletes with ≥ 2 markers of LEA.

Results

From 56 identified studies, 14 separate groups of athletes demonstrated underperformance, with 50% also displaying ≥ 2 markers of LEA post-training. Eleven groups demonstrated ≥ 2 markers of LEA independent of underperformance and 37 had no performance reduction or ≥ 2 markers of LEA. In underperforming athletes, fat mass (d = − 0.29, 95% confidence interval [CI] − 0.54 to − 0.04; p = 0.02), resting metabolic rate (d = − 0.63, 95% CI − 1.22 to − 0.05; p = 0.03), and leptin (d = − 0.72, 95% CI − 1.08 to − 0.35; p < 0.0001) were decreased, whereas body mass (d = − 0.04, 95% CI − 0.21 to 0.14; p = 0.70), cortisol (d = − 0.06, 95% CI − 0.35 to 0.23; p = 0.68), insulin (d = − 0.12, 95% CI − 0.43 to 0.19; p = 0.46), and testosterone (d = − 0.31, 95% CI − 0.69 to 0.08; p = 0.12) were unaltered. In athletes with ≥ 2 LEA markers, performance was unaffected (d = 0.09, 95% CI − 0.30 to 0.49; p = 0.6), and the high heterogeneity in performance outcomes (I² = 84.86%) could not be explained by the performance tests used or the length of the training block.

Conclusion

Underperforming athletes may present with markers of LEA, but overreaching is also observed in the absence of LEA. The lack of a specific effect and high variability of outcomes with LEA on performance suggests that LEA is not obligatory for underperformance.

中文翻译：

过度运动运动员能量可用性低的标志：系统回顾和荟萃分析

背景

过度训练是训练超负荷后发生的短暂性能下降，是由压力和恢复之间的不平衡引起的。低能量可用性 (LEA) 可能会增加训练压力，从而导致表现不佳；然而，这还没有得到系统的调查。

客观的

本研究的目的是量化表现不佳的运动员 LEA 标志物的变化，以及具有 LEA 标志物的运动员的运动表现。

方法

使用 ≥ 2 周的训练块并保持或增加训练负荷来测量运动表现和 LEA 标记的研究是使用系统搜索确定的，遵循系统评价和荟萃分析的首选报告项目指南。分析了训练前到训练后的变化，以了解 (1) 表现不佳的运动员的 LEA 标志物和 (2) 具有 ≥ 2 个 LEA 标志物的运动员的表现。

结果

从 56 项已确定的研究中，14 个不同的运动员组表现不佳，其中 50% 的运动员在训练后还表现出 ≥ 2 个 LEA 标记。11 个小组表现出 ≥ 2 个 LEA 标志，与表现不佳无关，37 个小组没有表现下降或 ≥ 2 个 LEA 标志。在表现不佳的运动员中，脂肪量（d = − 0.29，95% 置信区间 [CI] − 0.54 至 − 0.04；p = 0.02），静息代谢率（d = − 0.63，95% CI − 1.22 至 − 0.05；p = 0.03）和瘦素（d = − 0.72，95% CI − 1.08 至 − 0.35；p < 0.0001）降低，而体重（d = − 0.04，95% CI − 0.21 至 0.14；p = 0.70）、皮质醇( d = − 0.06, 95% CI − 0.35 至 0.23；p = 0.68）、胰岛素（d = − 0.12、95% CI − 0.43 至 0.19；p = 0.46）和睾酮（d = − 0.31、95% CI − 0.69 至 0.08；p = 0.12）未改变。在具有 ≥ 2 个 LEA 标记的运动员中，表现未受影响（d = 0.09，95% CI − 0.30 至 0.49；p = 0.6），并且表现结果的高度异质性 ( I ² = 84.86%) 无法用表现来解释使用的测试或训练块的长度。