Masters Theses/Capstone Projects
ORCID
0009-0001-9410-9087
Date of Award
Spring 4-30-2026
Document Type
Thesis
Degree Name
Master of Science in Allied Health (MS)
First Committee Member
Dr. Allison Smith
Advisor
Dr. Allison Smith
Second Committee Member
Dr. Kalyn Jasinski
Third Committee Member
Angelo Lamatrice
Keywords
LEA Risk, Female Athlete Triad, RED-S, Division III, endurance athletes, female
Subject Categories
Higher Education | Medical Sciences | Sports Sciences
Abstract
Context
Low energy availability (LEA) occurs when energy intake is insufficient to support normal physiological functions after exercise (Loucks, 2011). Prolonged LEA can negatively affect metabolic functions, reproductive health, and bone density, and contribute to the development of the female athlete triad and relative energy deficiency in sport (RED-S) (Papageorgiou, 2017).
Objective
The objective of this study was to explore the prevalence of LEA among Division III female distance athletes.
Design
Cross-sectional study
Setting
Online questionnaire administered through Qualtrics
Participants
A total of 12 Division III female distance athletes (ages 18-23).
Intervention
Anonymous, electronic questionnaire assessing symptoms associated with low energy availability.
Main Outcome Measurement
Low energy availability was assessed using scores from the Low Energy Availability Questionnaire (LEAF-Q). Chi-Square analysis and Fisher’s Exact Test were used to examine the relationship between risk of LEA and occurrence of injury/illness, primary amenorrhea, and menstrual dysfunction.
Results
The mean LEAF-Q score was 14.25 (SD=6.50) with scores ranging from 4 to 27. 83.3% (n=10) were classified at risk for LEA. 16.7% (n=2) were classified as not at risk. Of the 12 participants, 91.7% (n=11) reported experiencing an injury or illness, while 8.3% (n=1) reported no injury or illness. Both athletes considered not at risk reported experiencing an injury or illness. There was no statistically significant association between LEA risk and illness or injury (χ²=0.218, p=.640, p= 1.00). 58.3% (n=7) reported no history of primary amenorrhea, while 41.7% (n=5) reported experiencing primary amenorrhea. There was no statistically significant relationship between LEA and primary amenorrhea (χ²= 1.71, p=.190, p=.470). 75% (n=9) reported experiencing menstrual dysfunction, and 25% (n=3) reported having normal menstrual cycles. There was no statistically significant association between LEA risk and menstrual dysfunction (χ²= 0.80, p=.371, p=1,00).
Conclusion
Most athletes in this sample were classified at risk for low energy availability based on LEAF-Q scores. Although no statistically significant relationships were found between LEA risk, injury/illness, primary amenorrhea, or menstrual dysfunction, symptoms associated with LEA were present in this sample. These findings suggest that LEA may be a prevalent concern within the Division III female distance population. The results support the need for further research on LEA risk within this population.
Key words
Low energy availability (LEA), distance athletes, Division III, relative energy deficiency in sport (RED-S), female athlete triad, menstrual dysfunction, primary amenorrhea, injury, illness.
Licensing Permission
Copyright, some rights reserved. Attribution – Noncommercial – No Derivative Works
Acknowledgement 2
1
Recommended Citation
Murphy, Ciara, "Prevalence of Low Energy (LEA) Risk In Division III Female Distance Athletes" (2026). Masters Theses/Capstone Projects. 145.
https://digitalcommons.otterbein.edu/stu_master/145