Total energy expenditure of elite female cheerleaders assessed by doubly labeled water

BACKGROUND: This study aimed to quantify total energy expenditure (TEE) and physical activity level (PAL) in elite female competitive cheerleaders during the in-season period using the doubly labeled water (DLW) method. METHODS: Fifteen Division 1 collegiate female competitive cheerleaders in Japan were included in the analysis. TEE was measured over seven consecutive days under free-living conditions using the DLW method. Body mass (BM) and body composition were assessed using dual-energy X-ray absorptiometry. PAL was calculated as the ratio of TEE to resting metabolic rate estimated from fat-free mass. No significant change in BM was observed over the measurement period. CONCLUSIONS: This study provides the first direct assessment of TEE in elite female cheerleaders using the DLW method. The high TEE and PAL observed during the in-season period indicate that competitive cheerleading imposes substantial energetic demands comparable to those of other high-intensity sports. These findings contribute essential reference data for understanding the energy expenditure characteristics of competitive cheerleaders and may support the development of evidence-based training and health management strategies for this population.