Low Energy Availability and Cardiovascular Disease

Low energy availability (LEA) signifies a condition where the body lacks sufficient energy to support essential physiological functions crucial for maintaining optimal health (1). This energy insufficiency can be exacerbated by the demands of sports and exercise, resulting in negative impacts on various physiological, psychological, and sports performance (11, 8, 2). While LEA is commonly associated with cardiovascular abnormalities, such as early atherosclerosis, endothelial dysfunction, and lower blood pressure, the existing body of research faces limitations, including small sample sizes and primarily exploratory approaches (2). Additionally, despite a growing body of evidence suggesting a strong link between DNA methylation (an epigenetic modification influencing gene expression by tagging specific parts of the DNA code) and cardiovascular disease (9, 6), there has been no prior investigation exploring the interplay between DNA methylation, cardiovascular disease, and LEA. To better understand LEA and its effects on cardiovascular health, it is imperative to address these limitations through further research. Utilising more comprehensive markers of cardiovascular disease and expanding the scope of investigations will contribute to a great understanding of LEA and its implications on cardiovascular health (10).

Inclusion Criteria: * Cisgender females * Aged 18 to 35 to avoid recruiting peri or postmenopausal females * Trained to elite female athletes based on McKay and colleagues\' (2021) criteria for participation classification framework. For example, trained (local-level representation), highly trained (competing at the national level) and elite (competing at the international level). * Females living in the United Kingdom. Exclusion Criteria: * Biological Males * Females aged over 35 * Sedentary females * Habitual smokers * Volunteers with any previous experience with Syncope * Volunteers with any previous diagnosis of ischaemic heart disease, myopathy or any neuromuscular disorder * Anticoagulants users * Pregnant women * Volunteers on lipid-lowering medication * Taking hormonal contraception (copper IUDs are acceptable)