The 44% you keep seeing about female athletes has a second number attached

By Sarah Lee · 2026-07-28

If you read much about fueling and female athletes, you've probably seen a number around 44%. It gets passed around as the share of us who aren't eating enough for the training we do.

I went looking for where it came from, the same way I did with the iron numbers. This time I found the study right away.

What surprised me was the number sitting next to it.

Where the 44% comes from

It's a real figure from real work. In 2025, researchers gathered up 46 separate studies covering 6,118 athletes, across all kinds of sports and all kinds of levels, and pooled the results into one. Out of all that, 44.2% of the female athletes got flagged as possibly not eating enough for their training.¹

One thing to hold onto: those 46 studies didn't all check the same way. Some handed athletes a questionnaire called the LEAF-Q. Some did the math directly, comparing how much someone ate against how much they burned training. Some used a clinical checklist called the RED-S CAT.¹

That matters further down.

The number I'd never seen

Same study. Same 46 studies pooled together, same mix of sports and levels, same three ways of checking.

The male athletes came out at 49.4%.¹

Higher. By about five points.

I sat with that for a while, because I've read the 44% in a lot of places and I have never once seen the 49.4% printed next to it.

Now, I don't want to overcorrect. This is one study. The checks weren't done the same way across it. I wouldn't build an argument on a five-point gap between two groups measured three different ways, and I'm certainly not saying men have it worse.

But it rules one thing out, and that's the useful part.

The 44% almost always shows up attached to the idea that under-fueling is a women's problem, something about our bodies or our sports. Whatever's true about those pressures, and plenty is, this number isn't the proof of it. In this pile of studies, checked these ways, the women didn't get flagged more often than the men did.¹

"Flagged" and "has it" are not the same thing

Here's the other thing I want to be careful about.

What the study counted is how many athletes got flagged by a check. That's what a questionnaire, or that direct math, or that clinical checklist each give you.¹ It's a warning light. It isn't a diagnosis.

I'm not going to tell you how often a warning light turns out to be right in general, because this study doesn't answer that and I'd be making it up. Here's what I can say: 44.2% is how many of the female athletes got flagged, across 46 studies covering all sorts of sports and levels, using those three checks.¹ Saying that's how many have low energy availability is a bigger claim, and it isn't the one the researchers made.

That might sound like splitting hairs. It isn't. There's a real difference between "a lot of athletes got flagged by a questionnaire" and "a lot of athletes are under-fueled," and people trade those two sentences for each other constantly.

Three different checks, one number

That's the second reason I'd hold this figure loosely.

A questionnaire, a calculation, and a clinical checklist are three different questions. They can easily disagree with each other about the same person. The study pooled results from studies using all three into one number.¹

The researchers are open about that and they report it honestly. It just means the 44.2% is an average across several different ways of checking, rather than one check repeated a lot.¹ Whether those three would agree about the same athletes isn't something this number can tell you, and I don't have the breakdown by check in front of me, so I'm not going to guess.

What it can and can't tell you

It can tell you that a lot of the athletes in those 46 studies got flagged by one of those three checks, in both groups, across a wide mix of sports and levels.¹

It can't tell you anything about one person. A pooled number like this describes a crowd. Nothing in the study was built to say something about a single athlete, me included.

And it can't carry the "this is a women's problem" framing it usually gets handed, for the reason further up.

How I read a number like this

Two questions get me most of the way. Who did they measure, and how did they check?

Here it's a big mixed group of athletes across lots of sports and levels, checked three different ways depending on the study. That's a broad answer, which makes the number decent for a broad point and poor for a specific one.

I read this one in the full paper instead of the summary at the top, because who and how are exactly the details a summary leaves out, and they're the ones that decide what a number is allowed to mean.

None of this means under-fueling doesn't matter. It matters a great deal, and it's most of the reason Idunia exists. It means the particular number people reach for to prove it is doing more work than it can hold up, and the honest version of the argument doesn't need it anyway.

The 44.2% is real. The 49.4% next to it is just as real, from the same 46 studies and the same three checks, and it changes what the first one actually proves.¹

Sources

Gallant TL, Ong LF, Wong L, et al. Low Energy Availability and Relative Energy Deficiency in Sport: A Systematic Review and Meta-analysis. Sports Medicine 2025;55(2):325-339. Systematic review and meta-analysis; 59 articles, with low energy availability pooled from 46 studies and 6,118 athletes across mixed sports and competitive levels; screening instruments varied across included studies (LEAF-Q, direct energy availability calculation, RED-S CAT). Female athletes 44.2% screened positive, male athletes 49.4%. DOI: 10.1007/s40279-024-02130-0