Module 3: Nutrition for Bone Health

Nutrition and bone health are closely connected, with low energy availability (LEA) presented as the main risk factor. LEA is explained as the gap between energy intake and the body’s needs after accounting for exercise and basic physiological functions. The teaching highlights that this is highly individual and influenced by training load, growth, sex, timing of meals, and how well nutrients are absorbed. Key nutritional issues include poor overall calorie intake, missed breakfasts, inadequate protein, low vitamin D, and low intakes of calcium, magnesium, and iron. Gut health and food intolerances such as lactose intolerance and coeliac disease are also important because they can limit nutrient absorption. Post-exercise fueling is emphasized as important for bone recovery, even if the timing is not immediate. The material also explains how LEA affects hormones, menstrual function, testosterone, bone density, and injury risk, linking it to bone stress injuries, the female and male athlete triad, and relative energy deficiency in sport (RED-S). Practical examples show both unintentional and intentional under-fueling, and the need for careful screening, medical assessment, and multidisciplinary support.