Gallant et al. 2024, Low Energy Availability and Relative Energy Deficiency in Sport, a systematic review and meta-analysis

Systematic review and meta-analysis (Gallant TL, Ong LF, Wong L, Sparks M, Wilson E, Puglisi JL, Gerriets VA), published in Sports Medicine. Pooled prevalence of low energy availability across athletes was about 45%. Athletes with low energy availability showed impaired bone health, altered bone turnover and a higher rate of bone stress injuries, though evidence on general (non-bone) injury risk was mixed. Moderate to strong for the bone-health link (large evidence base, mostly observational).