Relative energy deficiency in female dancers : doktorska disertacija

Pruš, Daša (author), Zaletel, Petra (mentor), Hadžić, Vedran (comentor)

Relative Energy Deficiency in Sport (REDs) is a clinically diagnosed, multifactorial syndrome characterized by insufficient caloric intake and/or excessive energy expenditure, leading to health and performance issues associated with low energy availability (LEA). This research aimed to assess the prevalence of LEA and REDs related health risks, evaluate the impact of energy availability (EA) on menstrual health, bone health, and injury prevalence, and validate the Slovenian version of the Dance Energy Availability Questionnaire (DEAQ). We employed a comprehensive approach that included all currently used screening tools (e.g., LEAF-Q and DEAQ) alongside objective assessments (e.g., RMR, blood tests, accelerometry, and dietary recording) of energy availability. Findings revealed that approximately 29% of dancers met the criteria for LEA. Although artistic dancers exhibited lower EA than sport dancers, no statistically significant differences were found between the two groups (p = ,421). Menstrual disturbances were observed in 47.6% of dancers, with a significant association between the occurrence of oligomenorrhea and the presence of LEA (p = ,044). While 60.4% of dancers exhibited vitamin D deficiency, this was not significantly correlated with bone injuries (p = ,716). However, artistic dancers had 5.1 times higher odds of sustaining bone injuries, whereas sport dancers were more prone to soft tissue injuries, suggesting that training load and biomechanical demands may play a greater role in injury risk than EA alone. The Slovenian DEAQ demonstrated excellent reliability (ICC = 0.98, 95% CI [0.967,0.993]), confirming its validity as a screening tool for LEA and REDs risk assessment. Given the high prevalence of inadequate carbohydrate intake (90.5%) and restrictive eating behaviours (34%), the study highlights the need for early detection and preventive strategies. Integrating nutrition specialists into dance training programs could help optimize energy intake, monitor LEA risk, and prevent long-term health consequences.

• Language: Slovenian
• Keywords: Energy availability, Relative Energy Deficiency in Sport, dance, female, DEAQ
• Work type: Doctoral dissertation
• Typology: 2.08 - Doctoral Dissertation
• Organization: FŠ - Faculty of Sport
• Year: 2025
• PID: 20.500.12556/RUL-171868
• COBISS.SI-ID: 253434115
• Publication date in RUL: 04.09.2025

Secondary language

• Language: English
• Title: Relativni energijski primanjkljaj pri plesalkah

Abstract

Sindrom relativnega energijskega pomanjkanja v športu (REDs) je klinično diagnosticiran multifaktorski sindrom, za katerega sta značilna nezadosten energijski vnos in/ali prekomerna poraba energije, kar vodi do zdravstvenih in zmogljivostnih posledic, povezanih z nizko energijsko razpoložljivostjo (LEA). Cilj te raziskave je bil oceniti prevalenco LEA in tveganj, povezanih z REDs, raziskati vpliv EA na menstrualno zdravje, zdravje kosti in pojavnost poškodb ter validirati slovensko različico vprašalnika Dance Energy Availability Questionnaire (DEAQ). Uporabljen je bil celostni pristop, ki je vključeval presejalna orodja (npr. LEAF-Q, DEAQ) in objektivne meritve (npr. RMR, krvne analize, pospeškometri, prehranski dnevnik). Rezultati so pokazali, da 29 % plesalk izpolnjuje kriterije za LEA. Čeprav so plesalke umetniških disciplin kazale nižjo EA kot športne plesalke, razlika ni bila statistično značilna (p = ,421). Menstrualne motnje so bile prisotne pri 47,6 % plesalk, pri čemer je bila prisotnost oligomenoreje statistično značilno povezana s pojavnostjo LEA (p = ,044). Čeprav je 60,4 % plesalk imelo pomanjkanje vitamina D, nismo ugotovili statistično značilne povezave med nizkimi vrednostmi vitamina D in pojavnostjo kostnih poškodb (p = ,716). Plesalke umetniških disciplin so imele 5,1-krat večjo verjetnost za kostne poškodbe, medtem ko so bile plesalke športnih disciplin bolj nagnjene k poškodbam mehkega tkiva, kar nakazuje, da imata trening in biomehanske obremenitve verjetno večji vpliv na tveganje za poškodbe kot EA. Slovenska različica DEAQ je pokazala odlično zanesljivost (ICC = 0,98, 95% CI [0,967,0,993]), kar potrjuje njeno uporabnost kot presejalno orodje za oceno tveganja za LEA in REDs. Glede na visoko prevalenco neustreznega vnosa ogljikovih hidratov (90,5 %) in restriktivnih prehranjevalnih vzorcev (34 %) rezultati poudarjajo nujnost zgodnjega odkrivanja in preventivnih ukrepov. Integracija prehranskih strokovnjakov v plesne trenažne programe bi lahko pripomogla k optimizaciji energijskega vnosa, rednemu spremljanju tveganja za LEA ter preprečevanju dolgoročnih zdravstvenih posledic REDs.

• Keywords: energijska razpoložljivost, sindrom relativnega energijskega pomanjkanja v športu, ples, ženske, DEAQ