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to be submitted. SZW and QQ participated in the design of the study, performed the statistical

analysis, searched and selected the trials, drafted and revised the article. QW participated in the design of the study and helped to revise the article. All authors read and approved the final version of the manuscript.”
“Introduction In a variety of competitive sports, it is considered advantageous to achieve low levels of body fat while retaining lean body mass. The BCKDHA metabolic effects of this IWR-1 nmr process have been given little context within athletics, such as physique sports (i.e. bodybuilding, figure), combat sports (i.e. judo, wrestling), aesthetic sports (i.e. gymnastics, figure skating), and endurance sports. Previous literature has documented cases of male bodybuilders reducing body fat to less than 5% of total body mass [1, 2], and studies documenting physiological profiles of male wrestlers [3] and judo athletes [4] present body fat ranges that extend below 5%. A study on elite female gymnasts and runners reported an average body fat percentage (BF%) of 13.72% for the entire sample, with subgroups of middle-distance runners and artistic gymnasts averaging 12.18% and 12.36%, respectively [5]. Elite female runners have also reported percent body fat levels below 10% [6]. Energy deficits and extremely low levels of body fat present the body with a significant physiological challenge.