Screening for risk of low energy availability in female Gaelic game athletes in Ireland

Background: Low energy availability (LEA), a feature of the female athlete triad (menstrual dysfunction, LEA and decreased bone mineral density), arises when insufficient calories are consumed to support energy expenditure potentially resulting in reproductive, gastrointestinal, cardiovascular, bone health and sports performance compromise. Aims: The aims of this study were to determine the prevalence and awareness of LEA using the Low Energy Availability in Females Questionnaire (LEAF-Q) in female GAA athletes. Methods: Adult female GAA club teams in Ireland were invited to participate in this cross-sectional cohort study. A total of 16 clubs participated in an online survey, which captured LEAF-Q and demographic data. Results: Data was available for 122 athletes; 77 (63%) played Gaelic Football alone, 23 (19%) played Camogie alone and 22 (18%) played both. The median age was 22 years (IQR = 9), mean BMI was 24.55 kg/m² (± 4.94), and mean training duration 5.14 h/week (± 2.67). Forty-seven (38.5%) participants had a LEAF-Q score of ≥ 8 indicating risk of LEA. Younger age and participation in other sports were associated with increased risk of LEA. Forty-two women (34.4%) reported a change in menstruation during intervals of increased exercise intensity. Awareness of LEA and access to multidisciplinary supports were low. Conclusions: The prevalence of increased LEA risk is high in female GAA athletes with poor knowledge of this consequence, emphasising the importance of education, access to resources and prevention and early detection to ensure safe participation for women in these sports.