The effects of short-term low energy availability, achieved through diet or exercise, on cognitive function in oral contraceptive users and eumenorrheic women

Dan Martin, Maria Papageorgiou, Hannah Colgan, Stephen Bandelow, Julie Greeves, Jonathan C. Y. Tang, William D. Fraser, Simon B. Cooper, Craig Sale, Kirsty J. Elliott-Sale

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To date, no research has explored the effects of low energy availability on cognitive performance using dietary and exercise regimens relevant to athletes. Twenty female participants (10 eumenorrheic, 10 oral contraceptive [OC] users) completed three 3-day conditions: 1) controlled-balanced energy availability without exercise (BAL; 45 kcal·kg lean body mass [LBM] 1·day 1); 2) diet-induced low energy availability without exercise (DIET; 15 kcal·kg LBM 1·day 1); and 3) exercise-induced low energy availability (EX; 15 kcal·kg LBM 1·day 1, including 30 kcal·kg LBM 1·day 1 treadmill running at 70% maximal oxygen uptake). A cognitive test battery was completed before and after each 3-day condition. Mental rotation test accuracy improved in the BAL condition, but there was a decline in accuracy in the EX condition (BAL, +2.5%; EX, 1.4%; P = 0.042, d = 0.85). DIET (+1.3%) was not different to BAL or EX (P > 0.05). All other measures of cognitive performance were not affected by condition (P > 0.05) and OC use did not affect cognitive responses (P > 0.05). Accuracy in the mental rotation test was impaired when low energy availability was induced through increased exercise energy expenditure. All other aspects of cognition were unaffected by 3 days of low energy availability through diet or exercise. OC use did not mediate the effect of low energy availability on cognition. Novelty: Cognitive function was not affected by 3 days of diet-induced low energy availability. Only spatial awareness was impaired during 3 days of exercise-induced low energy availability. Reproductive hormones affected spatial awareness independent of energy availability.

Original languageEnglish
Pages (from-to)781-789
Number of pages9
JournalApplied Physiology, Nutrition, and Metabolism
Issue number7
Early online date5 Jan 2021
Publication statusPublished - Jul 2021


  • Cognition
  • Diet
  • Energy availability
  • Exercise
  • Females
  • Oral contraceptives

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