Low Energy Availability and Hypertension in Division I HBCU Athletes

NCT07583940 | Recruiting DMC

• 2 other identifiers: R16HL179144-011R16HL179144
• Study Type: observational
• Target: 150
• Locations: 1 country
• Sites: 1

Brief Summary

Low energy availability (LEA) occurs when the body does not get enough calories to support both daily life and exercise. This can happen when athletes train hard but do not eat enough to match their energy needs. In both 2012 and 2023, the International Olympic Committee on Sports Nutrition recognized LEA as an important factor that can increase the risk of cardiometabolic disease (CMD), which includes conditions like high blood pressure, diabetes, and heart disease. LEA can affect many systems in the body. It may disrupt hormones (such as menstrual cycles), cause changes in blood sugar and cholesterol levels, weaken bones, impair digestion, and negatively impact mental health. Over time, these changes may be linked to chronic inflammation, which plays a key role in the development of disease. Maintaining proper energy balance can be especially challenging for athletes because they often train at levels well above general health recommendations. As a result, even highly fit athletes may unintentionally remain in a calorie deficit. Our recent pilot research found a significant relationship between LEA and high blood pressure in Black Division I collegiate athletes. This is important because this group has historically been understudied and may face a higher risk of serious heart-related events, including sudden cardiac death. Despite assumptions that collegiate athletes are uniformly healthy, there is a need to better understand hidden health risks in this population. Our research aims to improve how we identify and monitor early signs of cardiometabolic disease by examining markers such as inflammation, blood sugar, and cholesterol levels. These insights will help healthcare providers, athletes, and families make more informed decisions about nutrition, training, and long-term health. Ultimately, this work seeks to develop practical, evidence-based strategies to protect athlete health and reduce the risk of serious cardiovascular outcomes.

Conditions

Hypertension (HTN); Vascular Stiffness; Nutritional Deficiency Related Cardiovascular Risk in Athletes

Keywords

vascular stiffness,; hypertension; nutritional deficiency; energy balance; RED-S; SDOH

Outcome Measures

Primary Outcomes (2)

• Pulse wave velocity (PWV)

  Pulse wave velocity (PWV) will be calculated by dividing the arterial path length by the pulse transit time (PTT) between the brachial and femoral arteries using the Vicorder® AS Testing System (80Beats Medical, Berlin, DE). Using a custom-built caliper, arterial path length will be calculated as 80% of the straight-line distance between the brachial and femoral artery measurement sites. To measure PTT, blood pressure cuffs will be simultaneously inflated to a sub-diastolic pressure over a 10-15s period to acquire the foot of the proximal and distal pressure waveforms. The closest two of three recordings will be averaged.

  Enrollment to the second time point will not exceed 26 weeks. Testing once within the competitive season and once outside the competitive season (off season).

• Energy availability

  Energy availability (EA) will be calculated as: EA = (EI - TDEE) / FFM, where EI is energy intake (kcal·day-¹), TDEE is total daily energy expenditure (kcal·day-¹), and FFM is fat-free mass (kg). TDEE will be estimated as the sum of resting metabolic rate (RMR) and activity-related energy expenditure. RMR (kcal·day-¹) will be measured via indirect calorimetry. Activity energy expenditure will be quantified using metabolic equivalents (METs), expressed as hours per day and converted to kilocalories. Energy intake (EI) will be assessed using 3-day nonconsecutive food records (two weekdays, one weekend day) to capture habitual variability while minimizing participant burden. To reduce reporting bias, records will be collected using dietitian-administered multiple-pass interviews, which improve accuracy relative to unassisted methods. Dietary data will be analyzed using Nutrition Data System for Research (NDSR; University of Minnesota).

  Enrollment to the second time point will not exceed 26 weeks. Testing once within the competitive season and once outside the competitive season (off season).

Secondary Outcomes (4)

• Social Determinants of Health (SDOH)

  Enrollment to the second time point will not exceed 26 weeks. Testing once within the competitive season and once outside the competitive season (off season).

• Health Literacy

  Enrollment to the second time point will not exceed 26 weeks. Testing once within the competitive season and once outside the competitive season (off season).

• Sport Nutrition Knowledge

  Enrollment to the second time point will not exceed 26 weeks. Testing once within the competitive season and once outside the competitive season (off season).

• Discrimination

  Enrollment to the second time point will not exceed 26 weeks. Testing once within the competitive season and once outside the competitive season (off season).

Other Outcomes (1)

• Demographics

  Enrollment to the second time point will not exceed 26 weeks. Testing once within the competitive season and once outside the competitive season (off season).

Study Arms (1)

Division I HBCU Athletes

Division I athletes with a minimum of \>3yrs experience tested once inside the competitive season and once outside of the competitive season beginning January 2026.

Eligibility Criteria

• Age: 18 Years - 26 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)
• Sampling Method: Probability Sample

Study Population

Men and women (n = 120, aged 18-26yrs) who are actively cleared to compete in division I sports at a historically black college or university. Participants will have at least 3yrs previous competitive experience. Participants will be recruited for testing once during the competitive season and once outside of the competitive season. The rationale for including these team Athletes is that the level of vigorous cardiovascular exercise training associated with these sports is significant and consistent.

You may qualify if:

• Age: 18-25yrs Sex: Male and Female Training Status/Experience: HBCU Division I collegiate athletes with \>3yrs of previous competitive experience

You may not qualify if:

• Persons who self-report any known disease, or unknown issue precluding collegiate competitive participation: Excluded
• Those who have any orthopedic injuries, concussions, or conditions which would preclude safe testing: Excluded
• Individuals who are not yet adults \<18yrs (e.g.: infants, children, teenagers):
• Excluded
• Persons who have a pacemaker: Excluded
• Persons who are pregnant: Excluded

Sponsors & Collaborators

• North Carolina Agriculture & Technical State University: lead
• National Heart, Lung, and Blood Institute (NHLBI): collaborator

Study Sites (1)

North Carolina Agricultural & Technical State University

Greensboro, North Carolina, 27411, United States

RECRUITING

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Related Links

• HHS tracking accountability in government grants (TAGGS)

MeSH Terms

Conditions

Hypertension; Malnutrition; Relative Energy Deficiency in Sport

Condition Hierarchy (Ancestors)

Vascular Diseases; Cardiovascular Diseases; Nutrition Disorders; Nutritional and Metabolic Diseases; Feeding and Eating Disorders; Mental Disorders

Central Study Contacts

Troy M Purdom, PhD

CONTACT

13362853552; tpurdom@ncat.edu

Catherine Bush, PhD

CONTACT

3363347712; cmbush@ncat.edu

Study Design

• Study Type: observational
• Observational Model: CASE ONLY
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: April 9, 2026
• First Posted: May 13, 2026
• Study Start: January 6, 2026
• Primary Completion (Estimated): May 30, 2027
• Study Completion (Estimated): June 30, 2028
• Last Updated: May 13, 2026

Record last verified: 2026-05

Locations

US (1)