运动员的整体健康是国际奥委会(IOC)提出的优先事项。然而,运动员很难安全地平衡营养需求,训练负荷,recovery,社交互动,期望和其他要求。能量摄入的影响,尤其是,低能量可用性(LEA)对运动员心理健康的影响,研究不足。在这篇叙述性评论中,在调查LEA的影响时,我们检查了包括心理因素和心理健康变量的研究,节食/限制性饮食和运动中相对能量不足(REDs),自2018年国际奥委会关于RED的共识声明以来。根据现有数据,与有问题的LEA相关的早期心理指标是情绪变化,疲劳和心理冲突。与REDs相关的更严重的心理健康结果是幸福感降低,焦虑加剧,抑郁症状和饮食失调。我们提出了一个心理模型,该模型有助于构建可能的风险因素(例如,身体不满,环境需求或增加的训练负荷)和适度(例如,性别,运动)和/或潜在的中介(例如,社会风气,自尊)因素与LEA和最终RED相关。当前的科学文献强调了在筛查REDs时包括心理健康因素的重要性,以及开发一种临床方法来解决一旦诊断出REDs的心理后遗症的重要性。建议采用跨学科的观点。最后,而且重要的是,运动员的观点敦促临床医生不要低估运动员在追求运动目标时表现出的成功动力和对健康后果的否认。
Overall athlete health is a stated priority by the International Olympic Committee (IOC), yet it can be difficult for athletes to safely balance nutritional needs, training load, recovery, social interactions, expectations and other demands. The effect of energy intake and, especially, low energy availability (LEA) on athlete mental health, is understudied. In this narrative review, we examine research that has included psychological factors and mental health variables when investigating the effect of LEA, dieting/restrictive eating and Relative Energy Deficiency in Sport (REDs), since the 2018 IOC
consensus statement on REDs. Based on currently available data, early psychological indicators associated with problematic LEA are mood changes, fatigue and psychological conflict. More severe mental health outcomes associated with REDs are reduced well-being, elevated anxiety, depressive symptoms and eating disorders. We propose a psychological model that helps structure how possible risk factors (eg, body dissatisfaction, environmental demands or increased training load) and moderating (eg, gender, sport) and/or potential mediating (eg, social climate, self-esteem) factors are associated with LEA and ultimately REDs. The current scientific literature underscores the importance of including mental health factors when screening for REDs and for developing a clinical approach to address the psychological sequelae of REDs once diagnosed. An interdisciplinary perspective is recommended. Lastly, and importantly, the athlete perspective urges clinicians to not underestimate the drive for success and denial of health consequences that athletes demonstrate when pursuing their sport goals.