Research

Energy balance

Maintaining an energy availability of 45 kcal/kg lean body mass per day is ideal for optimizing bone health, though achieving levels above 30 kcal/kg lean body mass per day is a more realistic target to minimize negative effects.

To protect your bones, aim for an energy availability above 30 kcal per kg of lean body mass daily. While 45 kcal/kg is ideal, it is often unrealistic for endurance athletes. Focus on eating enough to support your training load rather than restricting energy, as chronic low energy availability directly suppresses bone formation and increases fracture risk.

GoodConditionalHIGH confidence
An energy availability of 45 kcal kg of lean body mass (LBM)−1·day−1 is ideal to support bone health in the athlete, although this is an unrealistic target for many. Current knowledge would suggest trying to achieve an energy availability above 30 kcal·kgLBM−1·day−1 to minimise negative effects on the bone.
Craig Sale et al. · Sports Medicine · 2019

Why this rating

Based on controlled laboratory studies (Ihle and Loucks; Sale et al.) showing dose-dependent effects on bone turnover markers.

Source

Nutrition and Athlete Bone Health

Craig Sale et al. · Sports Medicine · 2019

DOI 10.1007/s40279-019-01161-2

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DOI resolved against Crossref · corpus check 2026-06-10

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