Global attention has recently grown around the challenges faced by female athletes, not just on the field but also in terms of their health and well-being. Low Energy Availability (LEA) is a pressing issue being studied. This condition is often hidden but can have serious consequences for athletic performance, long-term health and quality of life.
LEA occurs when the body lacks sufficient energy to support basic physiological functions, such as hormone production, bone health, and mental well-being, after exercise. This energy shortfall often occurs unintentionally, especially when athletes are training intensely and not consuming enough food to meet their energy needs. Over time, LEA can lead to conditions such as the Female Athlete Triad, which includes menstrual dysfunction, low bone mineral density, and energy deficiency, as well as the broader condition known as Relative Energy Deficiency in Sport (RED-S). RED-S affects not just female athletes but also males and can impair cardiovascular, gastrointestinal, metabolic and immune function.
Although LEA and RED-S have been widely studied in North America and Europe, research in the Caribbean has been limited until now. As a graduate student in the Faculty of Sport, my research has been uncovering important insights into the knowledge, awareness and prevalence of LEA among adult female athletes in Barbados. Twenty athletes have completed a survey exploring their eating habits, training loads, menstrual cycles, fatigue, and overall knowledge of energy availability. The findings were both revealing and concerning.
While all participants had at least heard of the term “LEA,” only 20% reported being very familiar with it, and 25% were not familiar with it at all. This fragmented understanding of a major health risk highlights a significant gap in athlete education, particularly given that these women are competing at some of the highest levels in sport in the region. Most participants reported symptoms consistent with LEA. These included chronic fatigue, low stamina, emotional exhaustion, and disruptions to their menstrual cycle, which are all red flags for energy deficiency.
Decreased performance was the most recognised consequence among the athletes, followed by an increased risk of injury. Fewer athletes identified the risks of hormonal imbalance or mental health issues, even though these are well-documented outcomes of LEA and RED-S in scientific literature.
These findings highlight a crucial disconnect between awareness and application. Many athletes may not realise that the symptoms they are experiencing are linked to a more profound energy imbalance. This underscores the need for targeted education that not only raises awareness but also empowers athletes to act, whether by seeking medical advice, adjusting their training routines, or improving their nutrition.
This research has significant implications not only for individual athletes but also for the future of sport in Barbados and across the Caribbean. Female athletes in the region are gaining more opportunities and recognition, but health support systems have not always kept pace with their growth. There is a pressing need for better athlete education, more accessible nutritional and psychological support, and policies that recognise the unique health risks female athletes face.
LEA is particularly dangerous because it often goes unnoticed until serious problems emerge, like stress fractures, burnout, or long-term reproductive issues. By the time these symptoms appear, the damage may already be done. Early detection and prevention are key. Athletes at every level deserve to understand how their bodies function and what they need to maintain optimal health. Awareness of LEA should be as fundamental as knowing how to warm up or recover after a training session.
The study also asked athletes how they would prefer to learn more about LEA. Workshops, group discussions, and short educational articles were the most popular methods, showing that athletes are eager to learn but need the right tools and environment to do so. For sports federations, coaches and health professionals, this is a call to action. There must be a coordinated effort to integrate LEA and RED-S awareness into training programmes, coaching certification, and athlete wellness strategies. Schools, clubs, and national sporting bodies all play a crucial role in protecting the well-being of athletes.
This research is just the beginning, and it opens the door for larger, region-wide studies and interventions. As the Caribbean continues to build its presence on the international sports stage, safeguarding the health of its athletes must be a priority. LEA is not just a medical issue; it is a matter of equity, representation, and long-term athlete development. By listening to the experiences of female athletes and responding with science-backed, culturally relevant solutions, Barbados and its neighbours can set a powerful example in sports health education. For now, the message is clear: understanding LEA is not optional. It is essential to the success and safety of every female athlete, on and off the field.
Dr Chloe Thompson is a medical doctor pursuing the MSc Sports Medicine in the Faculty of Sport at The UWI