The impact of low carbohydrate diets on bone health – Athlete survey

Athlete nutritional practices are very often primarily concerned with improving performance via weight loss and/or a metabolic adaption while bone health is often given less consideration. A proactive approach to bone health can be more beneficial for both athlete and practitioners allowing the athlete to stay injury free and ensure good bone health later in life. A PhD project entitled: ‘The impact of low carbohydrate diets on bone health and (re)modelling in elite endurance athletes’ is being carried out within the Department of Physical Education and Sport Sciences at the University of Limerick in conjunction with the Sport Ireland Institute.

The first study is survey-based and has 2 primary aims:

  1. To determine the extent to which low carbohydrate dietary practices are followed by endurance athletes.
  2. How low carbohydrate diets might be associated with bone health and injury in endurance athletes.

The study is recruiting male and female endurance athletes between the age of 18 and 35 who consistently train more than 8 hours per week and have competed in a national championships event at a minimum. Ethical approval has been received from the University of Limerick research ethics committee and information collected in the survey is anonymous. The survey takes between 5 – 10 min to complete and can be accessed at the link below. The results of this study will help form part of our recommendations to both coaches, practitioners and athletes regarding the impact of low carbohydrate dietary practices and bone health. If you have any questions or queries please contact

Survey Link: 

Why should athletes be concerned about their bone health?

Bone loss and bone injury is a major clinical issue for many populations, including elite athletes. Roughly 90% of bone mass is accrued by the age of 20 and after the age of 30 there is a steady decline in bone mass as we progress later in life. Within the athletic population there can be a misconception that frequent bone injury or poor bone health can be rectified in retirement. However, it is very difficult to generate a stimulus that is both sufficient and sustained enough to offset the age-related loss of bone mass as well as a career of poor bone health. Lower impact, repetitive, higher frequency loads typically seen in endurance sport have less of a positive impact on bone health compared to sports with high impact and multidirectional movements, therefore, it is important for athletes to consider their bone health in the short term to prevent injury but also in the long term to prevent the onset of condition such as osteoporosis later in life.

What role does nutrition play?

Although training load has arguably the greatest impact on bone health it can be equally important to focus on the athlete’s nutritional practices. Endurance sports typically have a high energy demand and there is an increased risk of a reduction in energy availability within this population. Low energy availability can affect bone health both directly and indirectly due leading to increases on bone resorption and decreases in bone formation. Low energy availability can be caused by low dietary intake, excessive caloric expenditure or a combination of both and nutritional practices such as fasting or periodic reductions in carbohydrate intake can have a negative impact on bone health, especially if unmanaged or managed incorrectly.

Who is carrying out this research project?

Conor Raleigh is a PhD researcher at the University of Limerick and part of the Performance Physiology and Nutrition teams at the Sport Ireland Institute. He is studying the interaction between low carbohydrate dietary practices and bone health in elite endurance athletes. The supervision team for the research project is made up of Dr. Sharon Madigan, Sport Ireland Institute, Dr. Brian Carson and Dr. Catherine Norton, University of Limerick and Prof. Craig Sale, Nottingham Trent University. The overall aim of the Performance Nutrition team at the Sport Ireland Institute is to develop and integrate nutritional practices and strategies which maximise an athlete’s ability to train and perform. This aim, along with the aims of Conor’s project, involves an integrated approach as the project pulls together expertise from nutrition, physiology, strength and conditioning, physiotherapy and medicine to ensure a well-rounded and calibrated approach.

Conor Raleigh completed his undergraduate degree in Physiology at Trinity College Dublin (TCD) and an MSc. in Exercise Physiology at Loughborough University in the UK. During his time in TCD and Loughborough he has worked in various sport science support services including physiology with cyclists and triathletes and in performance analysis with British Tennis. He has published his undergraduate research project in the International Journal of Exercise and presented it at numerous conferences including ECSS 2018 in Dublin. He was awarded sport science volunteer of the year at the Loughborough University for his work with the performance tennis programme at the university.  View Conor’s research profiles on Linked-In, Orcid, Twitter: @conorjraleigh

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