Objective To determine the association between survey-based self-reported problematic low energy availability indicators (LEA-I) and race performance and intra-event medical encounters during the Boston Marathon. Methods 1030 runners who were registered for the 2022 Boston Marathon completed an electronic survey (1–4 weeks pre-race) assessing LEA-I, training and medical history. De-identified survey data were linked to event wearable timing chips and medical encounter records. LEA-I was defined as: an elevated Eating Disorder Examination Questionnaire score, elevated Low Energy Availability (LEA) in Females Questionnaire score, LEA in Males Questionnaire with a focus on gonadal dysfunction score and/or self-report of diagnosed eating disorder/disordered eating. Results The prevalence of LEA-I was 232/546 (42.5%) in females and 85/484 (17.6%) in males. Athletes without LEA-I (non-LEA-I) achieved significantly better race times versus those with LEA-I (accounting for demographic and anthropomorphic data, training history and marathon experience), along with better division finishing place (DFP) mean outcomes (women’s DFP: 948.9±57.6 versus 1377.4±82.9, p<0.001; men’s DFP: 794.6±41.0 versus 1262.4±103.3, p<0.001). Compared with non-LEA-I athletes, LEA-I athletes had 1.99-fold (95% CI: 1.15 to 3.43) increased relative risk (RR) of an intra-event medical encounter of any severity level, and a 2.86-fold increased RR (95% CI:1.31 to 6.24) of a major medical encounter. Conclusion This is the largest study to link LEA-I to intra-event athletic performance and medical encounters. LEA-I were associated with worse race performance and increased risk of intra-event medical encounters, supporting the negative performance and medical risks associated with problematic LEA-I in marathon athletes. Data are available upon reasonable request.

中文翻译：

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波士顿马拉松运动员表现结果和与低能量可用性指标相关的赛事内医疗接触风险


目的 确定基于调查的自我报告有问题的低能量可用性指标 （LEA-I） 与波士顿马拉松期间比赛表现和赛事内医疗接触之间的关联。方法 1030 名报名参加 2022 年波士顿马拉松的跑步者完成了一项电子调查（赛前 1-4 周），评估 LEA-I、训练和病史。去识别化的调查数据与事件可穿戴计时芯片和医疗就诊记录相关联。LEA-I 被定义为：饮食失调检查问卷评分升高，女性问卷评分低能量可用性 （LEA） 升高，男性问卷 LEA 侧重于性腺功能障碍评分和/或诊断为饮食失调/饮食失调的自我报告。结果 LEA-I 的患病率在女性中为 232/546 （42.5%），在男性中为 85/484 （17.6%）。与有 LEA-I 的运动员相比，没有 LEA-I（非 LEA-I）的运动员取得了明显更好的比赛时间（考虑人口统计和拟人化数据、训练历史和马拉松经验），以及更好的分区完赛名次 （DFP） 平均结果（女子 DFP：948.9±57.6 对 1377.4±82.9，p<0.001;男子 DFP：794.6±41.0 对 1262.4±103.3，p<0.001）。与非 LEA-I 运动员相比，LEA-I 运动员发生任何严重程度的赛事内医疗事故的相对风险 （RR） 增加了 1.99 倍（95% CI：1.15 至 3.43），重大医疗事故的 RR 增加了 2.86 倍（95% CI：1.31 至 6.24）。结论 这是将 LEA-I 与赛事内运动表现和医疗接触联系起来的最大规模的研究。 LEA-I 与较差的比赛表现和赛事内医疗接触的风险增加有关，支持与马拉松运动员有问题的 LEA-I 相关的负面表现和医疗风险。数据可根据合理要求提供。