Prevalence of impaired physiological function consistent with Relative Energy Deficiency in Sport (RED-S): an Australian elite and pre-elite cohort

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Abstract

Objectives

Athlete health, training continuity and performance can be impeded as a result of Relative Energy Deficiency in Sport (RED-S). Here we report the point prevalence of symptoms described by the RED-S model in a mixed-sport cohort of Australian female athletes.

Methods

Elite and pre-elite female athletes (n=112) from eight sports completed validated questionnaires and underwent clinical assessment to assess the point prevalence of RED-S symptoms. Questionnaires included the Depression, Anxiety and Stress Questionnaire (DASS-21), Generalized Anxiety Disorder (GAD-7), Center for Epidemiological Studies Depression Scale (CES-D), SCOFF questionnaire for disordered eating, Low Energy Availability in Females Questionnaire (LEAF-Q), and a custom questionnaire on injury and illness. Clinical assessment comprised resting metabolic rate (RMR) assessment, dual-energy X-ray absorptiometry-derived body composition and bone mineral density, venous and capillary blood samples, and the Mini International Neuropsychiatric Interview (MINI 7.0.2). Descriptive prevalence statistics are presented.

Results

Almost all (80%) participants (age 19 (range 15–32) years; mass 69.5±10.3 kg; body fat 23.1%±5.0%) demonstrated at least one symptom consistent with RED-S, with 37% exhibiting between two and three symptoms. One participant demonstrated five symptoms. Impaired function of the immunological (28%, n =27), haematological (31%, n =33) and gastrointestinal (47%, n =51) systems were most prevalent. A moderate to high (11%–55%) prevalence of risk of low energy availability was identified via RMR and LEAF-Q, and identified mental illnesses were prevalent in one-third of the assessed cohort.

Conclusion

Symptoms described by the RED-S model were prevalent in this cohort, supporting the need for improved awareness, monitoring and management of these symptoms in this population.

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Author and article information

Contributors

Margot Anne Rogers: (View ORCID Profile)

Renee Newcomer Appaneal: (View ORCID Profile)

Nicole Vlahovich: (View ORCID Profile)

Louise M Burke: (View ORCID Profile)

Journal

Title: British Journal of Sports Medicine

Abbreviated Title: Br J Sports Med

Publisher: BMJ

ISSN (Print): 0306-3674

ISSN (Electronic): 1473-0480

Publication date Created: December 16 2020

Publication date Created: January 2021

Publication date (Print): January 2021

Publication date (Electronic): November 16 2020

Volume: 55

Issue: 1

Pages: 38-45

Article

DOI: 10.1136/bjsports-2019-101517

PubMed ID: 33199358

SO-VID: 471ce444-112d-479c-b64b-570861540ec7

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