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.
- relative energy deficiency
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Twitter @MargotRogers_, @PrepareNPerform, @_mickdrew
Contributors This study was designed by MAR, MD and LMB; data were collected and analysed by MAR, MD, LMB and RNA; data interpretation and manuscript preparation were undertaken by MAR, MD, LMB, GW, NV, RNA and DH. All authors approved the final version of the paper. All data presented are part of the ‘Stay Healthy’ project, an initiative that supports Australia’s elite athletes.
Funding This work was supported by the Australian Institute of Sport High Performance Research Fund (Immune Health Multiple Sports, 2017) and the University of Canberra Research Institute for Sport and Exercise (internal grant).
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval Approval for this study, which adheres to the Declaration of Helsinki, was obtained through the AIS and University of Canberra Human Research Ethics Committees (approval number: AIS 20170402).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement No data are available. Due to the personal nature of the health data collected from participants, no data are available to be shared.
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