This is why carbs are important for bone health.

You’ve probably heard of low energy availability (LEA) and its potential consequences on an athlete’s performance and health, but if you haven’t, here’s a quick recap– 

LEA occurs when an athlete is significantly underfueling and their body does not have the necessary amount of caloric intake to properly fuel their physiological systems. This is why we often see things like loss of menstrual cycle and impaired bone health in athletes who have LEA. 

If you want to learn more about LEA, check out our LEA Webinar.

What LEA doesn’t exactly tell us is whether an overall caloric restriction leads to health consequences or if specific macronutrient deficiencies are the main cause.

In a recent study published in 2022, researchers investigated whether the restriction of only carbs would affect bone health. 

To do so, they first had all 28 of their elite racewalkers complete a 6 day baseline phase where the individuals ate high carb/high energy availability diets. After this baseline phase, the racewalkers were divided into 3 groups. One group ate a low carb/high fat/high energy availability diet; Another group ate a LEA diet; The final group continued the initial high carb/high energy availability diet. 

To test bone health, researchers tested specific biomarkers within the athletes’ blood after completing a racewalk event. 

Researchers found that only the low carb group showed reduced bone formation markers both at rest and during exercise. The bone formation markers for those individuals in the LEA diet group actually stayed the same, however, they did see an increase in bone resorption. There was no change in any markers for the group that continued the baseline diet.

Based on this study, researchers concluded that short term carb restriction could lead to reduced bone formation, so endurance athletes should fuel with adequate caloric intake that includes an adequate carb intake, in order to reduce unwanted changes in bone formation. 

So, what’s the takeaway message here? 

Make sure you’re eating enough carbs each and every day to fuel your body and your sport! 

If you’re not sure if you’re eating enough to meet your body’s unique needs, click here to schedule a FREE 15 minute call with one of our team members today to get your sports nutrition dialed in. 


  • Fensham, N. C., Heikura, I. A., McKay, A. K. A., Tee, N., Ackerman, K. E., & Burke, L. M. (2022). Short-Term Carbohydrate Restriction Impairs Bone Formation at Rest and During Prolonged Exercise to a Greater Degree than Low Energy Availability. Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research37(10), 1915–1925.
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