Assessment of Dietary Intake, Energy Status, and Factors Associated With RED-S in Vocational Female Ballet Students

Abstract

Elite ballet dancers are at risk of health issues associated with Relative Energy Deficiency in Sport (RED-S). This study determined the nutritional status, estimated energy status, and assessed factors related to RED-S in vocational female ballet students. Using a cross-sectional study design, we measured dietary intake (n=20; food diaries and 24hr dietary-recall) and energy expenditure (n=18; accelerometry) in vocational female ballet students (age: 18.1±1.1 years; body mass index: 19.0±1.6 kg·m2; body fat: 22.8±3.4 %) over 7 days, including 5 weekdays (with dance training) and 2 weekend days (without scheduled dance training). Furthermore, we assessed eating behaviours, menstrual function, risk of RED-S (questionnaires), and body composition (dual x-ray absorptiometry). Energy and macronutrient intakes of vocational ballet students were similar during weekdays and weekend days (P > 0.050), whereas total energy expenditure was greater on weekdays than weekend days (P < 0.010; 95% CI: 212, 379). Energy balance was lower on weekdays (-425±465 kcal·day-1) than weekend days (-6±506 kcal·day-1, P=0.015; 95% CI: -748, -92). Exercise energy expenditure was greater on weekdays (393±103 kcal·day-1) than weekend days (213±129 kcal·day-1; P