Author(s): LUNDSTROM, E.A., MCLAGAN, B., MATTHEWS, N.D., WHITNEY, K., SIGWARD, S., SCHROEDER, E.T., Institution: UNIVERSITY OF SOUTHERN CALIFORNIA, Country: UNITED STATES, Abstract-ID: 458

INTRODUCTION:
It is well-established that low energy availability (LEA), defined as insufficient dietary energy intake relative to exercise energy expenditure, is associated with negative health and performance outcomes in physically active women. Existing research in the LEA space has historically focused on homogenous, affluent and elite athletic populations, or has not included the race/ethnicity or socioeconomic status of participants, limiting generalizability to the broader and increasingly diverse population of recreational endurance athletes. The purpose of this exploratory study was to describe the prevalence of LEA indicators (LEA-I) in a racially and ethnically, socioeconomically, and performance-level diverse cohort of female runners competing in a U.S. half-marathon.
METHODS:
107 female runners aged ≥18 years competing in a U.S. half-marathon in 2025 completed pre-race surveys assessing demographics, running history, socioeconomic status, stress and recovery, and validated LEA-I screening tools (Low Energy Availability in Females Questionnaire (LEAF-Q), Eating Disorder Examination Questionnaire (EDE-Q), and self-reported history of eating disorder and/or disordered eating diagnosis). Descriptive statistics and frequency analysis were used to describe LEA-I prevalence across racial/ethnic and socioeconomic subgroups.
RESULTS:
73.8% (79/107) of female runners met at least one LEA-I criteria, with 28% (30/107) meeting multiple criteria. LEA-I prevalence was high across all race/ethnic groups: Caucasian 71.4 % (15/21), African American/Black 80% (8/10), Asian American/Asian 65.5% (19/29), Latinx/Hispanic 79.5% (35/44), and Other 66.7% (2/3). Multiple LEA-I criteria were most frequently observed in Latinx/Hispanic (42% of those with LEA-I) and Asian runners (42.1%). Across income strata, runners earning <$50,000 annually demonstrated the highest prevalence of LEA-I (86.4%, 19/22) and multiple LEA-I criteria (52.6%, 10/19). LEA-I prevalence remained substantial among middle- and high-income runners, including 77.3% (17/22) in the $50,000-$84,999 group, 59.4% (19/32) in the $85,000-$150,000 group, and 77.4% (24/31) among those earning >$150,000. Elevated psychosocial stress followed a socioeconomic gradient, with higher stress observed in lower-income runners.
CONCLUSION:
LEA indicators are highly prevalent among female recreational-to-highly trained endurance runners across diverse racial/ethnic and socioeconomic backgrounds. These results challenge the historic assumption that LEA primarily affects white, affluent, and elite athletes, and emphasize the need for inclusive LEA screening and prevention strategies that reflect the diversity of women participating in endurance sport and exercise.