When Paralympic athletes don’t eat enough to fuel their training, their hormones get thrown off, which weakens their bones and makes them more likely to get stress fractures.
Evidence from Studies
No evidence studies found yet.
What Would Prove This
Per GRADE and EBM methodology, here is what ideal scientific evidence would look like to definitively prove or disprove this claim, ordered from strongest to weakest.
The strength and consistency of the association between LEA, hormonal changes, and bone health outcomes across studies.
A systematic review of longitudinal studies measuring energy availability, sex hormones, and bone mineral density in at least 1,000 athletes over 2+ years, with meta-analysis of effect sizes.
Whether LEA precedes and predicts hormonal disruption and bone loss over time.
A 3-year prospective cohort of 400 paralympic athletes with quarterly assessments of energy intake, training load, hormone panels, and annual DXA scans to track changes in bone density.
Whether increasing energy availability improves hormonal profiles and bone health.
A randomized controlled trial of 120 paralympic athletes with LEA, assigned to either nutritional intervention (increase intake by 300–500 kcal/day) or control, measuring testosterone, estrogen, LH, FSH, and BMD changes over 12 months.
The prevalence of hormonal and bone abnormalities in athletes with vs without LEA.
A cross-sectional study of 300 paralympic athletes assessing energy availability via diet logs, hormone levels via blood tests, and BMD via DXA, comparing groups with and without LEA.
Theoretical integration of existing evidence into a plausible biological model.
A narrative review by endocrinology and sports medicine experts synthesizing data on energy availability, hormones, and bone metabolism in disabled athletes.