Staying the Course: Low Energy Availability Risk and Knowledge Do Not Change in Female Cross-Country Athletes over a Season

Low energy availability (LEA) and disordered eating/eating disorders (DE/ED) are common in female athletes and associated with numerous health and performance consequences. This study assessed changes in LEA factors (i.e., LEA and DE/ED risk, energy intake (EI), macronutrient intake, exercise energy expenditure (EEE), weekly mileage) over a collegiate cross-country season and explored associations between LEA factors and knowledge. Using an observational longitudinal design, EI and macronutrient intake via dietary records, EEE, and weekly mileage via training logs, the Low Energy Availability in Females Questionnaire, the Female Athlete Screening Tool (FAST), the Eating Disorder Examination Questionnaire, and LEA knowledge were measured preseason and postseason in 15 National Collegiate Athletic Association Division I female cross-country athletes. Proportions of at-risk athletes were not significantly different preseason and postseason (LEA, 26.7% vs 20.0%; DE, 40.0% vs 26.7%; and ED, 20.0%). LEA factors and knowledge did not change, except FAST scores (70.13 ± 15.48 vs 66.40 ± 15.56; P = 0.02) and EEE (660.33 ± 141.99 vs 326.31 ± 230.95 kcal; P < 0.001). ED risk was the only factor correlated with LEA knowledge at either time point. Fueling practices and nutrition knowledge remained stable across a season in female cross-country athletes. Targeted interventions should aim to reduce LEA factors and improve LEA knowledge.