Role of Nutrition Education in Preventing Low Energy Availability Among Adolescent Female Athletes: A Scoping Review

Relative Energy Deficiency in Sport (REDs), a health-deteriorating syndrome caused by problematic low energy availability (LEA), is increasingly prevalent among adolescent athletes. LEA may stem from intentional and unintentional energy deficits, often linked to poor nutrition knowledge and practices, as well as body image concerns. Although nutrition education has been proposed as a strategy to prevent and manage LEA, evidence of its effectiveness in this vulnerable population remains inconclusive. This scoping review synthesized the existing literature on nutrition education interventions related to LEA in adolescent female athletes and identified gaps for future research and interventions. A systematic search was conducted across 4 databases (PubMed, Web of Science, Scopus, and EBSCOhost). Studies were included if they involved adolescent female athletes (mean age: 10-19 years) and had at least 1 intervention group receiving nutrition education covering either LEA, REDs, or Female Athlete Triad (Triad). Of the 7 eligible studies, education was mostly delivered face-to-face, combining interactive lectures and practical activities (n = 3). Nutritionists/dietitians were frequently involved in the development of educational materials and/or content delivery (n = 5). Limited use of digital technology and behavioral frameworks was observed. All studies reported immediate gains in both LEA/REDs/Triad knowledge and general sports nutrition following the interventions. Higher adherence (≥80%) and lower attrition were observed in shorter programs, face-to-face dietitian-led education, and those adopting a multicomponent approach, such as school-based integration. However, long-term impacts and LEA-specific outcomes, such as energy availability, were rarely evaluated. Finally, the considerable variation in the outcome measurements, intervention designs, and education delivery approaches restricted the ability to draw firm conclusions about overall effectiveness. Findings of this review highlight the need for more methodologically rigorous research to develop effective nutrition education programs that address the prevention and management of LEA in adolescent female athletes.