Jonvik, Kristin L.Varðardóttir, BirnaBroad, Elizabeth2025-11-202025-11-202022-03-03Jonvik, K L, Varðardóttir, B & Broad, E 2022, 'How Do We Assess Energy Availability and RED-S Risk Factors in Para Athletes?', Nutrients. https://doi.org/10.3390/nu140510682072-6643592635019fdd605a-ddee-46ed-8b2c-a434da9c3fc9ORCID: /0000-0002-3117-6215/work/10967776385125951497https://hdl.handle.net/20.500.11815/6753Low energy availability (LEA) is considered to be the underlying cause of a number of maladaptations in athletes, including impaired physiological function, low bone mineral density (BMD), and hormonal dysfunction. This is collectively referred to as ‘Relative Energy Deficiency in Sport’ (RED-S). LEA is calculated through assessment of dietary energy intake (EI), exercise energy expenditure (EEE) and fat-free mass (FFM). The incidence of LEA in Paralympic athletes is relatively unknown; however, there are legitimate concerns that Para athletes may be at even higher risk of LEA than able-bodied athletes. Unfortunately, there are numerous issues with the application of LEA assessment tools and the criterion for diagnosis within the context of a Para population. The calculation of EEE, in particular, is limited by a distinct lack of published data that cover a range of impairments and activities. In addition, for several RED-S-related factors, it is difficult to distinguish whether they are truly related to LEA or a consequence of the athlete’s impairment and medical history. This narrative review outlines deficits and complexities when assessing RED-S and LEA in Para athletes, presents the information that we do have, and provides suggestions for future progress in this important area of sports nutrition.866358eninfo:eu-repo/semantics/openAccessLow energy availabilityResting metabolic rateHormonesBone healthAssessment/dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/article10.3390/nu14051068