The DOI matches its Crossref record; 442 of the 454 references it cites were found in a registry or an index; 68 of the 152 sources its claims cite were checked for support.
2023 international olympic committee's (IOC) consensus statement on relative energy deficiency in sport (REDs)
Open accessAbstract
Relative Energy Deficiency in Sport (REDs) was first introduced in 2014 by the International Olympic Committee’s expert writing panel, identifying a syndrome of deleterious health and performance outcomes experienced by female and male athletes exposed to low energy availability (LEA; inadequate energy intake in relation to exercise energy expenditure). Since the 2018 REDs consensus, there have been >170 original research publications advancing the field of REDs science, including emerging data demonstrating the growing role of low carbohydrate availability, further evidence of the interplay between mental health and REDs and more data elucidating the impact of LEA in males. Our knowledge of REDs signs and symptoms has resulted in updated Health and Performance Conceptual Models and the development of a novel Physiological Model. This Physiological Model is designed to demonstrate the complexity of either problematic or adaptable LEA exposure, coupled with individual moderating factors, leading to changes in health and performance outcomes. Guidelines for safe and effective body composition assessment to help prevent REDs are also outlined. A new REDs Clinical Assessment Tool-Version 2 is introduced to facilitate the detection and clinical diagnosis of REDs based on accumulated severity and risk stratification, with associated training and competition recommendations. Prevention and treatment principles of REDs are presented to encourage best practices for sports organisations and clinicians. Finally, methodological best practices for REDs research are outlined to stimulate future high-quality research to address important knowledge gaps.
Overview
AI snapshot
Written from the paper’s full text.
TL;DR
This 2023 IOC consensus statement updates the 2018 REDs consensus, redefining Relative Energy Deficiency in Sport as a syndrome of impaired physiological and/or psychological functioning in female and male athletes caused by exposure to problematic (prolonged and/or severe) low energy availability. It introduces a novel REDs Physiological Model, an updated four-colour IOC REDs Clinical Assessment Tool-Version 2 (CAT2), and methodological guidelines for future research.
Key findings
- Since 2018 there have been ~178 REDs and/or LEA original research publications featuring ~23,822 participants (80% female), with ~62% cross-sectional, ~14% longitudinal observational and ~12% longitudinal intervention designs.
- Reported estimated prevalence of LEA/REDs indicators ranges widely: 23%–79.5% in female athletes and 15%–70% in male athletes across sports, attributed to lack of a singular definitive diagnosis and methodological variation.
- Six emerging themes are highlighted: (1) additive/magnifying impact of low carbohydrate availability (LCA) with LEA; (2) symptom overlap between REDs and overtraining syndrome (OTS); (3) time-course of biomarker responses; (4) mental health associations; (5) REDs in male athletes; and (6) para athletes.
- LCA studies show deleterious effects sometimes in the absence of LEA — e.g., a 3-day intervention in young females showed a 264% increase in hepcidin with a low energy, low CHO diet versus only 69% with isocaloric low energy but higher CHO; ~3.5 weeks of LCHF diet impaired bone remodelling markers.
- A universal LEA threshold of 30 kcal/kg FFM/day is debated; the threshold at which males experience REDs-related symptoms appears lower (e.g., ~9 to 25 kcal/kg FFM/day).
- In para athletes, among US para athletes preparing for Paralympic Games, 62% attempted to alter weight/body composition, 32% had elevated EDE-Q pathological behaviour subscale scores, and 44% of female athletes reported menstrual dysfunction.
Methods
- Consensus methodology used the RAND-UCLA Appropriateness Method (RAM) with a diverse expert panel (sports medicine physicians, sports endocrinologist, sports dietitians, physiologists, scientists, an athlete, a coach, a mental performance consultant; 10 females and 7 males from four continents).
- Working groups prepared referenced literature summaries and voting statements; these underwent online confidential Delphi voting, in-person discussion at the Olympic House in Lausanne (September 2022), and a second round of electronic voting.
- Agreement thresholds: agreement = ≥80% agreeing without any disagreement; agreement with minority disagreement = ≥80% agreeing but with one or more disagreeing; disagreement = <80% agreeing. Round 1 presented 135 statements (76 full agreement); round 2 presented 44 statements; overall 144 statements, of which 27 remained with minority disagreement.
Limitations
- The paper states there is no singular validated diagnostic method for REDs, requiring exclusion of other aetiologies in the differential diagnosis for each indicator; the IOC REDs CAT2 guidelines are "less reliable when it is impossible to assess all indicators" and are not to be used in isolation or solely for diagnosis.
- The paper notes the REDs education and behaviour modification research field is underdeveloped, and that specific REDs education programmes require further exploration and validation; time-course cut-offs for LEA require further scientific validation and may differ between males and females.
- The paper states that only 20% of original studies from 2018 to 2022 include male athletes, and that the picture remains unclear regarding mental health and DE behaviour dynamics by sex, level of competition, and in athletes with physical disabilities; the estimated prevalence of REDs in para athletes is unknown.
- Evident from the text: the consensus is based largely on cross-sectional studies with acknowledged limitations (lack of standardisation of recruitment and assessment protocols, poor characterisation of menstrual status, poor or non-existent assessment of EA), and the one cited 12-month intention-to-treat RCT had a high drop-out rate (57%).
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Claims the paper makes
36 Own interpretation · 28 Partly supported · 22 No full text of the sources · 14 Supported · 14 No basis given · 12 Supported so far · 8 Own method · 4 Own result · 2 Sources not found · accuracy not yet measured
Every source the paper cites for this claim was checked and supports it.
In the paper
“Inadequate EI or an increased energy commitment to one biological process favours trade-offs that allocate energy away from other processes, especially growth, reproduction or maintenance.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Abstract
What the sources say
- Supportedcites [32] Shirley, 2022, Life history perspective on athletes with low energy availability, Sports Med source
The Key Points (p. 3) say that scarce energy heightens trade-offs because energy used for one process cannot support another. The background section (p. 6) says that inadequate intake or training demands force allocation among processes and identifies growth, reproduction, and somatic maintenance among them. (LLM, conf=0.93)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
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- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Six studies since 2019 have shown an energy-independent and/or magnifying impact of LCA in the accelerated development of REDs outcomes.[52][53][54][55][56][57]”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Key scientific advances since the 2018 rEds consensus statement
What the sources say
- Partly supportedcites [52] Hammond, 2019, Post-exercise carbohydrate and energy availability induce independent effects on Skeletal muscle cell signalling and bone turnover: implications for training adaptation, J Physiol sourceExperimental — accuracy not yet measured
The Bone metabolism results and Discussion (page unavailable) show that low carbohydrate availability affected an acute marker of bone resorption independently of overall energy availability. The paper does not establish accelerated development of RED-S outcomes: its Discussion says the acute study could not determine whether the regimen causes longer-term changes to bone. The claim about six studies belongs to the citing paper’s collective summary, not a finding this single source must establish. (LLM, conf=0.86)
- Partly supportedcites [53] Fensham, 2022, Short-term carbohydrate restriction impairs bone formation at rest and during prolonged exercise to a greater degree than low energy availability, J Bone Miner Res sourceExperimental — accuracy not yet measured
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
- Not checked — no full text of the sourcecites [54] McKay, 2022, Six days of low carbohydrate, not energy availability, alters the iron and immune response to exercise in elite athletes, Med Sci Sports Exerc source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“In the real world, the magnitude of LCA is likely to be even greater considering the emphasis on protein intake during periods of calorie restriction.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Key scientific advances since the 2018 rEds consensus statement
What the sources say
- Not checked — no full text of the sourcecites [49] source
- Not checked — no full text of the sourcecites [50] Pardue, 2017, Case study: unfavorable but transient physiological changes during contest preparation in a drug-free male bodybuilder, Int J Sport Nutr Exerc Metab source
- Supportedcites [51] Hector, 2018, Protein recommendations for weight loss in elite athletes: a focus on body composition and performance, Int J Sport Nutr Exerc Metab source
The 'Optimal Protein Intake During Caloric Restriction' section discusses elevated protein recommendations for athletes in an energy deficit, and 'Protein for Performance During Dietary Energy Restriction' says higher-protein diets are important during weight loss. The prediction about LCA is the citing authors’ inference; the source supports the protein-intake premise used for it. (LLM, conf=0.87)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In the real world, athletes experience exposure to LEA (purposefully or inadvertently) in various manners along the continuum from adaptable to problematic.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Consensus statement
What the sources say
- Partly supportedcites [3] Areta, 2021, Low energy availability: history, definition and evidence of its endocrine, metabolic and physiological effects in prospective studies in females and males, Eur J Appl Physiol sourceExperimental — accuracy not yet measured
The Introduction describes athletes at risk of chronic LEA, while Perspectives and future research describes substantial day-to-day variation in free-living athletes and proposes periodising energy availability for weight loss while maintaining health and performance. The paper also contrasts limited effects of short exposure with possible harms of prolonged LEA. These passages support varied exposure and outcomes, but do not establish that athletes encounter LEA both purposefully and inadvertently or define an adaptable-to-problematic continuum. (LLM, conf=0.82)
- Partly supportedcites [40] Heikura, 2022, Low energy availability in female athletes: from the lab to the field, Eur J Sport Sci sourceExperimental — accuracy not yet measured
The Figure 2 legend describes several ways athletes may experience LEA in real-world settings, and the Introduction describes a continuum from health to disease. Our copy does not say whether exposure is purposeful or inadvertent, or specifically describe an adaptable-to-problematic continuum. (LLM, conf=0.84)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“More recently, a 3-day intervention in young females also showed a 264% increase in hepcidin with a low energy, low CHO diet compared with only a 69% increase in hepcidin with isocaloric low energy but higher CHO diet.55”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Key scientific advances since the 2018 rEds consensus statement
What the sources say
- Supportedcites [55] Hayashi, 2022, Influence of an energy deficient and low carbohydrate acute dietary manipulation on iron regulation in young females, Physiol Rep source
The Results (Hormonal and inflammatory variables) report a 264.3% increase in hepcidin in the energy-deficient, low-carbohydrate group versus 68.9% in the energy-deficient, moderate-carbohydrate group after the three-day intervention. The Abstract describes the groups as having similar energy intakes (1123 and 1162 kcal/day), consistent with the claim’s isocaloric comparison. (LLM, conf=0.94)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Many forms of performance pressure contribute to scenarios that either, intentionally or unintentionally, alter energy intake (EI) and exercise energy expenditure (EEE), resulting in low energy availability (LEA).”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > InTroduCTIon
What the sources say
- Not checked — no full text of the sourcecites [2] source
- Partly supportedcites [3] Areta, 2021, Low energy availability: history, definition and evidence of its endocrine, metabolic and physiological effects in prospective studies in females and males, Eur J Appl Physiol sourceExperimental — accuracy not yet measured
The Introduction explains that insufficient dietary intake combined with the energy demands of sport and exercise can produce low energy availability. The energy-availability section also identifies energy intake and exercise energy expenditure as its components. Our copy does not establish the claimed role of performance pressure or distinguish intentional from unintentional changes. (LLM, conf=0.85)
- Not checked — no full text of the sourcecites [4] Loucks AB . Chapter 5: energy balance and energy availability. In: Maughan R , ed. The encyclopaedia of sports medicine. New Jersey, USA: John Wiley & Sons Ltd, 2013. doi:10.1002/9781118692318 source
plaindirect- Asserted: passes — The authors put it forward as true.
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Every source the paper cites for this claim was checked and supports it.
In the paper
“Therefore, humans, like other animals, are adapted to cope with periods of LEA by downregulating biological processes that are temporarily unnecessary or reducible.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Consensus statement
What the sources say
- Supportedcites [32] Shirley, 2022, Life history perspective on athletes with low energy availability, Sports Med source
The Introduction (p. 5) describes the response to LEA as an evolved trait in humans and other species. Section 2 (p. 6) explains that scarcity prompts adaptive reallocation of energy toward processes with the greatest immediate survival value; the Bone section (p. 9) gives a temporarily expendable process as an example. (LLM, conf=0.93)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“There is a wide range in the reported estimated prevalence of LEA/REDs indicators in female (23%-79.5% [7][8][9][10][11][12][13][14][15][16] ) and male (15%-70% [12][13][14][15][16][17][18][19][20] ) athletes across a variety of sports”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > EA [Energy Availability] = {EI Energy Intake (kcal)-EEE [Exercise Energy Expenditure (kcal)]} FFM [Fat-Free Mass (kg) / day]
What the sources say
- Partly supportedcites [7] Condo, 2019, Nutritional intake, sports nutrition knowledge and energy availability in female Australian rules football players, Nutrients sourceExperimental — accuracy not yet measured
The Results report that 8 of 27 female Australian rules football players (30%) screened as at risk of low energy availability, a figure within the cited female range. The Introduction also reports a 33–46% range from other female-athlete studies. This paper does not establish the claimed 23%–79.5% range or provide prevalence estimates for male athletes. (LLM, conf=0.87)
- Not checked — no full text of the sourcecites [8] source
- Not checked — no full text of the sourcecites [9] Staal, 2018, Low RMRRatio as a Surrogate marker for energy deficiency, the choice of predictive equation vital for correctly identifying male and female ballet dancers at risk, Int J Sport Nutr Exerc Metab source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“This is especially the case in endurance sports (often >30 hours of training/week), 37 which can sometimes result in extreme EEE that exceeds the capacity of the human alimentary tract for sustained energy absorption.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Consensus statement
What the sources say
- Not checked — no full text of the sourcecites [37] Stellingwerff, 2021, Overtraining syndrome (OTS) and relative energy deficiency in sport (RED-S): shared pathways, symptoms and complexities, Sports Med source
- Partly supportedcites [38] sourceExperimental — accuracy not yet measured
The Discussion reports that endurance-event energy expenditure above roughly 2.5× basal metabolic rate cannot be met by additional intake and instead draws on energy stores, consistent with an alimentary limit that cannot be exceeded indefinitely. The paper does not establish that endurance sports often involve more than 30 hours of training per week. (LLM, conf=0.86)
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Another study of EA estimates in wheelchair athletes reported that nearly the entire cohort fulfilled criteria of LEA across at least one 24-hour period during the week-long study.114”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > REDs in para athletes
What the sources say
- Partly supportedcites [114] Egger, 2020, Energy availability in male and female elite wheelchair athletes over seven consecutive training days, Nutrients sourceExperimental — accuracy not yet measured
The Results (section 3; page unavailable) report LEA on 73% of analyzed days for female athletes and 30% for male athletes during the seven-day study. The paper does not state that nearly all 14 athletes had at least one day of LEA. Its conclusion that 13 of 14 had suboptimal EA concerns a different threshold and does not establish the claimed count. (LLM, conf=0.86)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
- Probably not a substantial claim. 54
- It may state two separate claims as one. 51
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“a syndrome of impaired physiological and/or psychological functioning experienced by female and male athletes that is caused by exposure to problematic (prolonged and/or severe) low energy availability.”
- Also stated in: § Consensus statement · plain
“the updated 2023 definition of REDs is: a syndrome of impaired physiological and/or psychological functioning experienced by female and male athletes that is caused by exposure to problematic (prolonged and/or severe) low energy availability.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Consensus statement
What the sources say
- Not checked — no full text of the sourcecites [5] source
- Partly supportedcites [6] sourceExperimental — accuracy not yet measured
The Introduction defines RED-S as impaired physiological functioning caused by relative energy deficiency and identifies low energy availability as its cause. The Conclusions figure caption extends the concept to male athletes and says psychological consequences can be a result of RED-S. The copy does not define the causative exposure as specifically ‘problematic (prolonged and/or severe)’ low energy availability; the male-athlete section says the threshold and duration required to induce RED-S in men are unknown. Page numbers are unavailable in the indexed passages. (LLM, conf=0.84)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
- Also stated in: § Consensus statement · plain
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“due to the lack of a singular definitive diagnosis, mistaken use of LEA and REDs as interchangeable terms, lack of standardisation and accuracy of research methodologies (eg, inaccurate EA measurements), variation in physiological demands among the study populations and participant study volunteering biases.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > EA [Energy Availability] = {EI Energy Intake (kcal)-EEE [Exercise Energy Expenditure (kcal)]} FFM [Fat-Free Mass (kg) / day]
What the sources say
- Partly supportedcites [21] Ackerman KE , Rogers MA , Heikura IA , et al . Methodology for studying relative energy deficiency in sport (REDs): a narrative review by a sub-group of the IOC consensus on REDs. Br J Sports Med bjsports-2023-107359 [Preprint] 2023. sourceExperimental — accuracy not yet measured
The Review and Data collection methods sections describe inconsistent REDs assessment methods, measurement limitations, and the need for standardisation. The Introduction also cautions that findings from narrow athlete samples may not apply to all athletes. Our copy does not establish that these factors explain a wide range of prevalence estimates, or identify participant volunteering bias or interchangeable use of LEA and REDs as causes. (LLM, conf=0.83)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Most LEA intervention studies are also accompanied by a substantial reduction (25%-60%, depending on magnitude of LEA) in carbohydrate (CHO) ingestion, resulting in concurrent LCA.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Key scientific advances since the 2018 rEds consensus statement
What the sources say
- Not checked — no full text of the sourcecites [45] source
- Not checked — no full text of the sourcecites [46] Koehler, 2016, Low energy availability in exercising men is associated with reduced leptin and insulin but not with changes in other metabolic hormones, J Sports Sci source
- Partly supportedcites [47] Papageorgiou, 2017, Effects of reduced energy availability on bone metabolism in women and men, Bone sourceExperimental — accuracy not yet measured
The Experimental Diets section says this study halved dietary energy intake while maintaining participants’ habitual dietary composition, which supports a substantial reduction in carbohydrate intake in this intervention. The paper does not establish that most LEA intervention studies reduce carbohydrate intake by 25%–60%, or explicitly characterize the resulting intake as concurrent low carbohydrate availability. (LLM, conf=0.84)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Life History Theory proposes that various biological processes related to growth, health, activity and reproduction compete for finite energy resources, with different priorities depending on the phase in the life cycle and other circumstances.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Abstract
What the sources say
- Supportedcites [32] Shirley, 2022, Life history perspective on athletes with low energy availability, Sports Med source
Split into 2 atoms — 2 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
- Not checked — no full text of the sourcecites [33] source
- Not matchedcites [34] Stearns SC . The evolution of life histories. Oxford, NY: Oxford University Press, 1992.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“These studies have reported increases in bone resorption biomarkers 52 53 with a concomitant impairment in biomarkers of bone formation, 53 as well as increased postexercise concentrations of interleukin-6 (IL-6) and hepcidin after LCA.54”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Key scientific advances since the 2018 rEds consensus statement
What the sources say
- Partly supportedcites [52] Hammond, 2019, Post-exercise carbohydrate and energy availability induce independent effects on Skeletal muscle cell signalling and bone turnover: implications for training adaptation, J Physiol sourceExperimental — accuracy not yet measured
The Interleukin-6 (IL-6) responses section (page unavailable) reports a greater postexercise IL-6 increase in the low-carbohydrate, low-energy (LCAL) condition than in either comparison condition. The Discussion says carbohydrate availability alone did not apparently affect IL-6. Citation 54 is attached to the IL-6 and hepcidin claim, but our copy does not report hepcidin measurements or an increase in hepcidin. (LLM, conf=0.88)
- Supportedcites [53] Fensham, 2022, Short-term carbohydrate restriction impairs bone formation at rest and during prolonged exercise to a greater degree than low energy availability, J Bone Miner Res source
The Abstract describes a 6-day intervention in elite racewalkers, and Participant characteristics states that all athletes were male. The Abstract reports increased CTX, a bone-resorption marker, alongside reduced P1NP, a bone-formation marker, after the low-carbohydrate diet. The sentence assigns the IL-6 and hepcidin clause to citation 54, not to this source. (LLM, conf=0.93)
- Not checked — no full text of the sourcecites [54] McKay, 2022, Six days of low carbohydrate, not energy availability, alters the iron and immune response to exercise in elite athletes, Med Sci Sports Exerc source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Additionally, ~3.5 weeks of LCHF diet in elite endurance athletes resulted in impaired markers of bone remodelling both at rest as well as around exercise (up to 3 hours postexercise), 56 and elevated postexercise IL-6 concentrations compared with an isocaloric high CHO treatment.57”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Key scientific advances since the 2018 rEds consensus statement
What the sources say
- Supportedcites [56] Heikura, 2019, A short-term ketogenic diet impairs markers of bone health in response to exercise, Front Endocrinol (Lausanne) source
The Conclusions report that a 3.5-week ketogenic LCHF diet negatively affected markers of bone modeling/remodeling at rest and during exercise in elite endurance athletes. The Methods specify measurements through 3 hours postexercise and an energy-matched high-carbohydrate comparison diet. Citation 56 is attached to the bone-marker claim; the IL-6 claim is attached to citation 57, so it is not judged here. (LLM, conf=0.93)
- Not checked — no full text of the sourcecites [57] McKay, 2019, Acute carbohydrate ingestion does not influence the post-exercise iron-regulatory response in elite Keto-adapted race Walkers, J Sci Med Sport source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“The estimated prevalence of REDs in para athletes is unknown; however, there are concerns that para athletes may be at even higher risk of problematic LEA than able-bodied athletes.112”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > REDs in para athletes
What the sources say
- Supportedcites [112] Jonvik, 2022, How do we assess energy availability and RED-S risk factors in para athletes?, Nutrients source
The Abstract says the incidence of LEA in Paralympic athletes is relatively unknown and raises concern that they may be at higher risk than able-bodied athletes. The Introduction and Conclusions also describe limited research and difficulty distinguishing RED-S from effects of an athlete’s impairment, supporting the claim that its prevalence is not established. (LLM, conf=0.86)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“A parallel focus has been the increased awareness of the risk factors for and the consequences of REDs, where psychological factors contributing to LEA and mental health consequences have been highlighted, 5 although less well understood.6 35 66”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Mental health outcomes of REDs
What the sources say
- Not checked — no full text of the sourcecites [5] source
- Supportedcites [6] source
The figure caption in the Conclusions identifies psychological consequences as both possible precursors and results of RED-S, supporting the claim that psychological factors and mental-health consequences have been highlighted. The Conclusions also say that much remains to be learned about RED-S’s psychological health risks and long-term consequences. Page numbers are not available in our copy. (LLM, conf=0.90)
- Not checked — no full text of the sourcecites [35] De Souza, 2022, The path towards progress: a critical review to advance the science of the female and male athlete Triad and relative energy deficiency in sport, Sports Med source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Two emerging potential indicators of REDs in males are the presence of low libido and decreased morning erections, which have been identified as physiological consequences of LEA.[108][109][110][111]”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > REDs in male athletes
What the sources say
- Partly supportedcites [108] Lundy, 2022, Screening for low energy availability in male athletes: attempted validation of LEAM-Q, Nutrients sourceExperimental — accuracy not yet measured
The Results (section 3.3) report that low sex-drive scores distinguished LEA cases from controls, and the Methods (section 2.3) show that the score included questions about morning erections. The paper does not establish decreased morning erections as an independent indicator or demonstrate that either symptom is a physiological consequence caused by LEA. (LLM, conf=0.84)
- Partly supportedcites [109] Hackney, 2022, Marathon running and sexual libido in adult men: exercise training and racing effects, J Endocrinol Sci sourceExperimental — accuracy not yet measured
The Discussion links reduced libido and fewer erections to possible RED-S development and suggests sexual drive may indicate energy status. But it calls that link speculative, and the study did not measure energy availability or establish that low libido and decreased morning erections are physiological consequences of LEA. (LLM, conf=0.88)
- Not checked — no full text of the sourcecites [110] Hackney, 2017, Endurance exercise training and male sexual libido, Med Sci Sports Exerc source
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“While a universal cut-off of 30 kcal/kg FFM/day as a threshold of LEA leading to some REDs outcomes in females is debated, 88 such a cut-off or range at which males experience REDs-related symptoms is even less understood, 89 but appears to be lower (eg, ~9 to 25 kcal/kg FFM/day).17 46 72 90 91”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > REDs in male athletes
What the sources say
- Partly supportedcites [17] Lane, 2019, Prevalence of low energy availability in competitively trained male endurance athletes, Medicina (Kaunas) sourceExperimental — accuracy not yet measured
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
- Not checked — no full text of the sourcecites [46] Koehler, 2016, Low energy availability in exercising men is associated with reduced leptin and insulin but not with changes in other metabolic hormones, J Sports Sci source
- Partly supportedcites [72] Langan-Evans, 2021, The psychological and physiological consequences of low energy availability in a male combat sport athlete, Med Sci Sports Exerc sourceExperimental — accuracy not yet measured
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“DE behaviours and EDs may be exacerbated by social media influence, societal pressures, the athlete's training/coaching entourage, a belief that a specific physique/weight/appearance will improve performance and/or overall body dissatisfaction.69”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Consensus statement
What the sources say
- Supportedcites [69] Wasserfurth, 2020, Reasons for and consequences of low energy availability in female and male athletes: social environment, adaptations, and prevention, Sports Med Open source
The Coaches’ Role and Teammates’ Role sections describe weight and appearance pressures from coaches and fellow athletes, including pressures that may lead to body dissatisfaction and disordered eating. The Introduction links performance-oriented body ideals with dieting and eating disorders, while The Role of Social Media describes appearance pressures that may affect dietary behaviour and accompany eating disorders. Page numbers are unavailable in our copy. (LLM, conf=0.91)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Psychological indicators associated with problematic LEA and REDs are mood disturbances/fluctuations, 8 71 72 cognitive dietary restraint, 73 drive for thinness, 74 75 reduced sleep quality 50 76 and perfectionistic tendencies.77”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Consensus statement
What the sources say
- Not checked — no full text of the sourcecites [8] source
- Could not verifycites [71] Schaal, 2021, Decreased energy availability during training overload is associated with non-functional overreaching and suppressed ovarian function in female runners, Appl Physiol Nutr Metab sourceExperimental — accuracy not yet measured
The Results report increased perceived fatigue in non-functionally overreached runners, and the Discussion reports no baseline difference in restrictive eating attitudes. Our copy does not report reduced sleep quality or establish the listed psychological indicators as markers of problematic low energy availability or REDs; searches for sleep quality and mood found no supporting passage. (LLM, conf=0.75)
- Supportedcites [72] Langan-Evans, 2021, The psychological and physiological consequences of low energy availability in a male combat sport athlete, Med Sci Sports Exerc source
Citation 8 is attached to mood disturbances/fluctuations, not to the other indicators in the sentence. The Results passage (section “Changes in Anthropometric Measurements”) reports elevated total mood disturbance at weigh-in, driven by reduced vigour and increased fatigue, during the period of very low energy availability. It also notes that mood scores showed no major fluctuations across most other phases. (LLM, conf=0.85)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Emerging definitions highlight short-term LEA as a few days to weeks, mediumterm as weeks to months and long-term as months to years.37 40”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Symptomology overlap between REDs and OTS
What the sources say
- Not checked — no full text of the sourcecites [37] Stellingwerff, 2021, Overtraining syndrome (OTS) and relative energy deficiency in sport (RED-S): shared pathways, symptoms and complexities, Sports Med source
- Partly supportedcites [40] Heikura, 2022, Low energy availability in female athletes: from the lab to the field, Eur J Sport Sci sourceExperimental — accuracy not yet measured
The Introduction defines medium-term LEA as weeks to under three months and long-term LEA as more than three months to years, matching the claim broadly. It defines short-term LEA as less than seven days, however, so the claim's 'few days to weeks' extends that category beyond the paper's definition. (LLM, conf=0.87)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Although the 2014 IOC REDs consensus statement 5 and the 2018 update paper 6 alluded to the impact of LEA and REDs in male athletes, the available research on males at the time was scant.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > REDs in male athletes
What the sources say
- Not checked — no full text of the sourcecites [5] source
- Supportedcites [6] source
The 2018 update has a section on low energy availability in male athletes that describes its potential health consequences. Its Conclusions (page not provided) identify substantial remaining gaps in understanding RED-S in male athletes, supporting the characterization that research on males was limited at the time. (LLM, conf=0.86)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
Every source the paper cites for this claim was checked and supports it.
In the paper
“Undoubtedly, these outcomes occur over different timeframes and with different severity and significance to the individual athlete due to various moderating factors.24”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > REDs Conceptual Models
What the sources say
- Supportedcites [24] Burke LM , Ackerman KE , Heikura I , et al . Mapping the complexities of relative energy deficiency in sport (REDs): development of a physiological model by a subgroup of the IOC consensus on REDs. Br J Sports Med bjsports-2023-107335 [Preprint] 2023. source
The ‘Investigation of LEA duration’ and ‘Severity and duration’ sections describe outcomes emerging over different exposure periods and with varying severity. The ‘Constructing the model: moderating factors’ section reports differences in the number and severity of outcomes between and within athlete cohorts, while the model overview describes individual factors that alter risk. The paper thus supports the claim as a broad paraphrase, although it notes that systematic studies of longer-term outcome sequences are unavailable. (LLM, conf=0.88)
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Nevertheless, problematic LEA can occur in male athletes and is associated with negative effects on the hypothalamic-pituitary-gonadal (HPG) axis and associated hormones 72 92-100 ; changes in metabolic hormones 46 101-103 ; impairments to immune function 104 ; detriments to bone health 105 ; as well as negative performance outcomes 18 90 104 106 and decreased lean body mass accrual.107”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > REDs in male athletes
What the sources say
- Partly supportedcites [72] Langan-Evans, 2021, The psychological and physiological consequences of low energy availability in a male combat sport athlete, Med Sci Sports Exerc sourceExperimental — accuracy not yet measured
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
- Not checked — no full text of the sourcecites [92] source
- Not checked — no full text of the sourcecites [93] Roberts, 1993, Overtraining affects male reproductive status, Fertility and Sterility source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“The sports community has prioritised the mental health of elitelevel athletes as evidenced by a sharp rise in consensus statements [60][61][62] and prevalence studies [63][64][65] on this theme.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Mental health outcomes of REDs
What the sources say
- Not checked — no full text of the sourcecites [60] source
- Not checked — no full text of the sourcecites [61] Henriksen, 2020, Athlete mental health in the Olympic/Paralympic Quadrennium: a multi-societal consensus statement, Int J Sport Exerc Psychol source
- Supportedcites [62] Henriksen, 2020, Consensus statement on improving the mental health of high performance athletes, Int J Sport Exerc Psychol source
The citation is attached to “consensus statements,” and this source is itself a consensus statement on elite-athlete mental health (Abstract). Its Conclusions also say the topic has become increasingly prominent. The source serves as an example of such a statement, rather than evidence measuring the size of the rise. (LLM, conf=0.88)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Disordered eating (DE) behaviours, eating disorders (EDs) and/or REDs are common among certain athlete cohorts.68”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Mental health outcomes of REDs
What the sources say
- Partly supportedcites [68] sourceExperimental — accuracy not yet measured
The Background section, under “Prevalence and contributing factors to DE in athletes” (page not provided), reports substantial variation in DE and ED prevalence and identifies aesthetically judged, gravitational and weight-class sports as high-risk cohorts. The copy links DE and EDs to possible RED-S but does not establish that RED-S itself is common in those cohorts. (LLM, conf=0.84)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“The IOC REDs CAT2 25 introduces a four-colour traffic-light severity/risk categorisation, in contrast to the three-colour stratification in the 2015 RED-S CAT, 141 due to the appreciation that the 2015 yellow zone had an extensive clinical severity/risk range of very low (a few minor symptoms) to very high (a few indicators away from removal from sport).”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > IOC REDs Clinical Assessment Tool-Version 2 (IOC REDs CAT2)
What the sources say
- Supportedcites [25] Stellingwerff T , Mountjoy M , McCluskey W , et al . The scientific rationale, development and validation of the Internaional Olympic Committee Relative Energy Deficiency in Sport Clinical Assessment Tool 2 (IOC REDs CAT2) - a review by a subgroup of the IOC consensus on REDs. Br J Sports Med bjsports-2023-106914 [Preprint] 2023. doi:10.1007/s00223-023-01120-0 source
Split into 2 atoms — 2 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
- Supportedcites [141] Mountjoy, 2015, The IOC relative energy deficiency in sport clinical assessment tool (RED-S CAT), Br J Sports Med source
Split into 2 atoms — 2 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Body composition assessment and management are important for optimising health and athletic performance, particularly in weight-sensitive and leanness-demanding sports.130”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Body composition assessment and management
What the sources say
- Supportedcites [130] source
The Introduction says body weight and composition are crucial performance variables in various sports and describes health risks associated with extreme weight control in weight-sensitive sports. The Body composition assessment and Guidelines sections recommend measuring and monitoring composition changes to manage those risks. (LLM, conf=0.91)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“which has undergone internal expert voting statement validation (see online supplemental files 2-4) and external REDs expert clinical cross-agreement validation.25”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > IOC REDs Clinical Assessment Tool-Version 2 (IOC REDs CAT2)
What the sources say
- Supportedcites [25] Stellingwerff T , Mountjoy M , McCluskey W , et al . The scientific rationale, development and validation of the Internaional Olympic Committee Relative Energy Deficiency in Sport Clinical Assessment Tool 2 (IOC REDs CAT2) - a review by a subgroup of the IOC consensus on REDs. Br J Sports Med bjsports-2023-106914 [Preprint] 2023. doi:10.1007/s00223-023-01120-0 source
The IOC REDs CAT2 Development and Validation section describes expert validation through voting statements. It also reports that independent REDs-expert physicians, who were not involved in the consensus process, assessed case studies and that their ratings were compared with CAT2 outcomes. (LLM, conf=0.93)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Unlike earlier REDs models, 5 6 LEA is placed at the centre of the hub to note its role as an exposure variable.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > REDs Conceptual Models
What the sources say
- Not checked — no full text of the sourcecites [5] source
- Supportedcites [6] source
The Introduction (page unavailable) identifies the earlier RED-S conceptual models in figures 1 and 2 and calls LEA the syndrome’s aetiological factor. The Low energy availability section says LEA underpins RED-S. The citation follows “earlier REDs models”; the hub placement is the citing authors’ description of their new model, not a claim attributed to this source. (LLM, conf=0.86)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Some easy-to-use methods are 'doubly indirect', relying on regression equations to derive a body fat per cent; they do not provide valid data, use spurious assumptions and/ or are influenced greatly by athlete presentation (eg, hydration levels).136”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Consensus statement
What the sources say
- Partly supportedcites [136] Kasper, 2021, Come back skinfolds, all is forgiven: a narrative review of the efficacy of common body composition methods in applied sports practice, Nutrients sourceExperimental — accuracy not yet measured
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Athletes may experience internal and/or external pressure to attain an 'athletic look' (aesthetic), potentially leading to body dissatisfaction and LEA, and then to symptoms of REDs, DE behaviours or EDs.76 131”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Body composition assessment and management
What the sources say
- Partly supportedcites [76] Gillbanks, 2022, Lightweight rowers' perspectives of living with relative energy deficiency in sport (RED-S), PLoS One sourceExperimental — accuracy not yet measured
The Results sections report societal pressure to have a masculine physique, negative body image, restricted intake, excessive exercise, disordered eating, and RED-S implications among lightweight rowers (pages not provided). They do not establish the claimed pathway from pressure to attain an ‘athletic look’ through body dissatisfaction to low energy availability and RED-S; the reported weight-loss practices were primarily tied to making competition weight. (LLM, conf=0.85)
- Partly supportedcites [131] Kontele, 2022, Weight pressures and eating disorder symptoms among adolescent female gymnasts of different performance levels in Greece, Children (Basel) sourceExperimental — accuracy not yet measured
The Discussion (§4.3) links appearance and performance weight pressures in female gymnasts to body dissatisfaction and eating-disorder symptoms. The Introduction (§1) says unhealthy weight-control practices may put gymnasts at risk of both low energy availability (LEA) and disordered eating or eating disorders, but does not establish the claimed sequence from LEA to those symptoms; it does not address REDs. (LLM, conf=0.87)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Though costlier, DXA is a reliable method for assessing BMD and estimating fat and lean masses, provided standard test protocols are used.[138][139][140]”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Consensus statement
What the sources say
- Partly supportedcites [138] sourceExperimental — accuracy not yet measured
The DXA discussion (section ‘Insert Table II near here’; page unavailable) describes bone-mineral assessment and estimates of fat and fat-free soft tissue, and calls DXA a reasonably precise whole-body method. But it explicitly says DXA is not reliable for accurate fat estimates in lean athletes; the cited passages do not establish that following standard test protocols removes this limitation. (LLM, conf=0.88)
- Not checked — no full text of the sourcecites [139] source
- Not checked — no full text of the sourcecites [140] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“However, the REDs education and behaviour modification research field is underdeveloped, and specific REDs education programmes targeting athletes and other key personnel require further exploration and validation.27”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Consensus statement
What the sources say
- Supportedcites [27] Torstveit MK , Ackerman KE , Constantini N , et al . Primary, secondary, and tertiary prevention of Relative Energy Deficiency in sport (REDs): a narrative review by a sub-group of the IOC consensus on REDs. Br J Sports Med bjsports-2023-106932 [Preprint] 2023. doi:10.3389/fpsyg.2023.1168423 source
The Review says there is little evidence for the efficacy of REDs primary-prevention programmes and that it remains unclear whether education changes behaviour. The Primary prevention strategies section calls for educational initiatives targeting athletes’ health and performance teams and entourage. Together, these support the need to develop and evaluate programmes for athletes and other key personnel. (LLM, conf=0.88)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Indeed, in the one intention-to-treat 12-month, randomised controlled clinical trial that implemented dietary changes to increase EI in exercising females with REDs-related biomarkers, there was a high drop-out rate (57%), and improvement in some (eg, menstrual function resumption in select participants), 161 but not all symptoms (eg, inability to retard bone loss).162”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Treatment (tertiary prevention) principles of REDs
What the sources say
- Supportedcites [161] De Souza, 2021, Randomised controlled trial of the effects of increased energy intake on Menstrual recovery in exercising women with Menstrual disturbances: the 'REFUEL' study, Hum Reprod source
Split into 2 atoms — 2 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
- Not checked — no full text of the sourcecites [162] De Souza, 2022, Bone mineral density in response to increased energy intake in exercising women with oligomenorrhea/amenorrhea: the REFUEL randomized controlled trial, Am J Clin Nutr source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“emerging data demonstrating the growing role of low carbohydrate availability”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > AbsTrACT
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Since the 2018 REDs consensus, there have been >170 original research publications advancing the field of REDs science”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > AbsTrACT
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“further evidence of the interplay between mental health and REDs”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > AbsTrACT
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“There has been significant growth in the number of studies clearly showing that problematic LEA is the underlying aetiology of REDs.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Key scientific advances since the 2018 rEds consensus statement
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“All voting statements reached an agreement or minority disagreement after two rounds of voting, providing a total of 144 statements of which 27 remained with a minority disagreement”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Consensus results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“more data elucidating the impact of LEA in males”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > AbsTrACT
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In the second round of confidential voting, 44 statements were presented to the authors.Of these, 24 were previous statements with disagreement that required a revote, and 20 were new statements.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Consensus results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In the first round of online voting, we presented 135 evidence statements to the panel.Full agreement was reached for 76 of the statements.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Consensus results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Since 2018, there have been considerable scientific advancements in the REDs research field including ~178 REDs and/ or LEA original research publications featuring ~23 822 participants; (80% female), with ~62% of these studies implementing a cross-sectional design, ~14% as longitudinal observational and ~12% longitudinal intervention”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > EA [Energy Availability] = {EI Energy Intake (kcal)-EEE [Exercise Energy Expenditure (kcal)]} FFM [Fat-Free Mass (kg) / day]
plainn = 23,822- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“(5) advances in knowledge pertaining to REDs in male athletes”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Key scientific advances since the 2018 rEds consensus statement
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“(3) the time-course of biomarker responses to problematic LEA in the development of REDs”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Key scientific advances since the 2018 rEds consensus statement
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“(4) improved understanding of mental health associations of REDs”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Key scientific advances since the 2018 rEds consensus statement
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“(6) para athletes.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Key scientific advances since the 2018 rEds consensus statement
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“(2) the overlap of REDs and overtraining syndrome (OTS) symptomology”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Key scientific advances since the 2018 rEds consensus statement
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Depressive symptoms and affective disorders, 8 78 79 subjectively reported reduced well-being, 73 primary or secondary exercise dependence/addiction, 80 81 anxiety related to injury and/or recovery, sport-specific issues such as difficulty coping with weight requirements 67 76 and the development of EDs 1 82 are additional adverse mental health outcomes associated with problematic LEA and REDs.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Consensus statement
What the sources say
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Among US para athletes preparing for Paralympic Games, 62% attempted to alter weight or body composition to enhance performance, 32% had elevated scores on the Eating Disorder Examination Questionnaire (EDE-Q) pathological behaviour subscale scores and 44% of the female athletes reported menstrual dysfunction.113”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > REDs in para athletes
What the sources say
- Not checked — no full text of the sourcecites [113] Brook, 2019, Low energy availability, menstrual dysfunction, and impaired bone health: a survey of elite para athletes, Scand J Med Sci Sports source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The detrimental outcomes include, but are not limited to, decreases in energy metabolism, reproductive function, musculoskeletal health, immunity, glycogen synthesis and cardiovascular and haematological health, which can all individually and synergistically lead to impaired well-being, increased injury risk and decreased sports performance.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Abstract
What the sources say
- Not checked — no full text of the sourcecites [5] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Authors were invited based on their expertise, as demonstrated by previous research, clinical and/or coaching experiences with REDs.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Methodology and consensus results
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“This REDs consensus statement used the RAND-UCLA Appropriateness Method (RAM).”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Methodology and consensus results
What the sources say
- Not matchedcites [43] Fitch K , Bernstein SJ , Aguilar MD . The RAND/UCLA appropriateness method user’s manual. Santa Monica, CA: Rand Corp, 2001.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
In the paper
“Athletes are driven by strong internal and external pressure to achieve optimal performance.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > InTroduCTIon
What the sources say
- Not checked — no full text of the sourcecites [1] source
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“A diverse (ie, gender, geographic location, expertise) expert panel of authors was invited, consisting of sports medicine physicians, a sports endocrinologist, registered sports dietitians, sports physiologists, sports scientists, an athlete, a coach and a mental performance consultant.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Methodology and consensus results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Authors were allowed to write a minority opinion in the event of disagreement with a statement when the consensus threshold was reached.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Methodology and consensus results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Some of these perturbations to body systems might be considered mild and/or transient, representing physiological plasticity 35 and could be termed adaptable LEA”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Consensus statement
What the sources say
- Not checked — no full text of the sourcecites [35] De Souza, 2022, The path towards progress: a critical review to advance the science of the female and male athlete Triad and relative energy deficiency in sport, Sports Med source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“REDs is a clinically diagnosed, multifactorial syndrome characterised by the accumulation of the deleterious health and performance outcomes resulting from exposure to problematic LEA.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Consensus statement
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This Physiological Model is designed to demonstrate the complexity of either problematic or adaptable LEA exposure, coupled with individual moderating factors, leading to changes in health and performance outcomes.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > AbsTrACT
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“REDs and OTS are syndromes involving the hypothalamicpituitary-adrenal axis and have no single validated diagnostic biomarker; they feature a complex overlap of symptoms that hinge on a diagnosis utilising exclusion criteria.37 58”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Symptomology overlap between REDs and OTS
What the sources say
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Scenarios commonly encountered in sport include extreme volumes of EEE, attempts to improve power-to-weight ratios, desire for excessive leanness and sport-specific physique alterations.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > EA [Energy Availability] = {EI Energy Intake (kcal)-EEE [Exercise Energy Expenditure (kcal)]} FFM [Fat-Free Mass (kg) / day]
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These scientific advances have improved our understanding of the underpinning physiology and psychology of REDs and the different clinical presentations between the sexes.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > EA [Energy Availability] = {EI Energy Intake (kcal)-EEE [Exercise Energy Expenditure (kcal)]} FFM [Fat-Free Mass (kg) / day]
plaindirectn = 822- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“We defined three levels of agreement based on which subsequent discussions were held: 1. Agreement: ≥80% of authors agreeing on the voting statement, without any author disagreeing.2. Agreement with minority disagreement: ≥80% of authors agreeing on the voting statement, but with one or more authors disagreeing.3. Disagreement: <80% of authors agreeing on the voting statement.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Methodology and consensus results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These findings suggest deleterious effects on bone, immunity and iron biomarkers as a result of LCA, sometimes in the absence of LEA.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Key scientific advances since the 2018 rEds consensus statement
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“All of these scenarios can lead to problematic LEA (see Definitions box 1), which can result in negative health and performance implications known as 'Relative Energy Deficiency in Sport' (REDs).”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > EA [Energy Availability] = {EI Energy Intake (kcal)-EEE [Exercise Energy Expenditure (kcal)]} FFM [Fat-Free Mass (kg) / day]
What the sources say
- Not checked — no full text of the sourcecites [5] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Importantly, some short-term signs or symptoms during the acute assessment may only represent a snapshot of a current LEA state and require the exclusion of other potential aetiologies (differential diagnoses).”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Symptomology overlap between REDs and OTS
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, time-course cut-offs require further scientific validation, may differ between males and females and change with the severity and duration of LEA dose.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Symptomology overlap between REDs and OTS
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“It is important to note that LEA and/or LCA, although challenging to assess, should be excluded from an OTS diagnosis as LEA is the underlying aetiology for a REDs diagnosis.37 59”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Symptomology overlap between REDs and OTS
What the sources say
- Not checked — no full text of the sourcecites [37] Stellingwerff, 2021, Overtraining syndrome (OTS) and relative energy deficiency in sport (RED-S): shared pathways, symptoms and complexities, Sports Med source
- Not checked — no full text of the sourcecites [59] Kuikman, 2022, Markers of low energy availability in overreached athletes: a systematic review and meta-analysis, Sports Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Although acute mild periods of LEA do not always lead to adverse outcomes, problematic LEA exposure leads to REDs.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Symptomology overlap between REDs and OTS
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Figure 1 (REDs Health Model) and figure 2 (REDs Performance Model) are conceptual models that demonstrate the range of body systems for which there is theoretical, empirical, and/or clinical evidence of impairments that manifest in different ways.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > REDs Conceptual Models
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“A prior history of DE behaviours or an ED might perpetuate a continued under-fuelling of energy 1 and must therefore be considered an important risk factor for developing REDs.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Consensus statement
What the sources say
- Not checked — no full text of the sourcecites [1] source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The REDs Conceptual Models were developed to raise awareness of the athletic, coach, sports science and sports medicine communities to this syndrome.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > REDs Conceptual Models
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Although changes are comparable to those REDs outcomes found in female athletes, the magnitude of the effects on some physiological parameters and the threshold at which these effects manifest appear to be variable between the sexes.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > REDs in male athletes
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The risk of bone stress injury (BSI) is of particular concern in athletes with spinal cord injury who experience a substantial loss of BMD immediately postinjury and hence have a high incidence of low BMD for age and/ or osteoporosis.118”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > REDs in para athletes
What the sources say
- Not checked — no full text of the sourcecites [118] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The development of a physiological model for each body system, underpinned by a 'systems biology mindset', 124 will enable a more nuanced assessment of the individual athlete and whether their specific combination of LEA exposure and secondary moderators is likely to lead to positive, neutral or negative health and/or performance outcomes.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > REDs Physiological Model
What the sources say
- Not checked — no full text of the sourcecites [124] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It is important to note that despite diagnostic progress, there is no singular validated diagnostic method for REDs, as the syndrome has a complex mosaic of signs and symptoms, necessitating the exclusion of other potential aetiologies in the differential diagnosis for each REDs indicator.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > IOC REDs Clinical Assessment Tool-Version 2 (IOC REDs CAT2)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This is of concern, especially for young athletes, due to potentially long-lasting negative physical and psychological outcomes.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Body composition assessment and management
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Experts in the field have long realised that applying LEA exposure (ie, severity, duration, frequency) on subsequent REDs short, medium and long-term outcomes is complex and dependent on many moderating factors.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > REDs Physiological Model
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It is important to note that the REDs Health and Performance Conceptual Models are not separate entities; they involve considerable overlap.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Consensus statement
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Therefore, the exclusion of primary aetiologies (differential diagnoses) should occur when diagnosing REDs”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Consensus statement
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“Graded arrows illustrate a continuum from adaptable LEA to problematic LEA exposure, with the former representing benign physiological adaptations to energy fluctuations (ie, physiological plasticity), 44 while the outer region of the hub notes the range of health and performance concerns which can be associated with the latter.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > REDs Conceptual Models
What the sources say
- Not checked — no full text of the sourcecites [44] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“A spectrum of energy mismatches, with differing severity of consequences, was part of the original concept of EA. 2 4”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > REDs Conceptual Models
What the sources say
- Not checked — no full text of the sourcecites [2] source
- Not checked — no full text of the sourcecites [4] Loucks AB . Chapter 5: energy balance and energy availability. In: Maughan R , ed. The encyclopaedia of sports medicine. New Jersey, USA: John Wiley & Sons Ltd, 2013. doi:10.1002/9781118692318 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“but these can be better managed in the future by implementing a standardised approach.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Consensus statement
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Future use of standardised methodologies should assist in better assessment of EA, more nuanced interpretation of past and future data, and better replication or comparison of work in this area.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Consensus statement
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Protocols that achieve a harmonised time-course for assessment and the individual components of EA may assist in future LEA and REDs activities by standardising the errors and limitations of the assessment, and balancing the issues of time and resource burden, feasibility and measurement precision.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Consensus statement
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, the updated model uses qualitative terms (adaptable, problematic) as an alternative to the previous focus on quantitative assessments with universally applied thresholds of concern.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > REDs Conceptual Models
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“To progress the REDs scientific field forward, we need integrated dynamic physiological models that can help explain the biological complexity and interaction within and between various body systems, as well as the inconsistencies in the manifestation of REDs signs and symptoms resulting from problematic LEA.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > REDs Physiological Model
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Accordingly, and novel to this 2023 consensus update, a more researched and clinically based unifying physiological model has been developed.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > REDs Physiological Model
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Cross-sectional studies are useful for clinical REDs assessment and prevalence, but an analysis of this literature reveals multiple limitations (eg, lack of a classification of subject calibre/training status; lack of a standardisation of recruitment and assessment protocols; poor characterisation of menstrual status and hormonal contraceptive use; varied use of indicators of physiological, Hormon”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Consensus statement
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“While some exposure to LEA is mild and transient termed adaptable LEA (arrow depicted in white)”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Consensus statement
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Furthermore, these guidelines are less reliable when it is impossible to assess all indicators in table 4.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Consensus statement
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“overall outcome | 144 | 117 | 27”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Consensus statement
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“By the triangulation of data from these various approaches (cross-sectional/longitudinal/interventional studies), the complexity of the relationship between LEA and REDs can be realised.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Consensus statement
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“round 1 voting | 135 | 76 | 29 | 30”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Consensus statement
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“round 2 voting | 44 | 41 | 3”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Consensus statement
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“*Mental Health Issues can either precede REDs or be the result of REDs.”
§ International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) > Consensus statement
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
It may state two separate claims as one.
The paper relies on this without support.
The expert panel's consensus reflects the best available evidence on REDs.
“consensus methodology also harnesses experts' insights to enable more validated recommendations to be made when the published evidence ranges from insufficient to adequate.”
The paper relies on this without support.
The RAND-UCLA Appropriateness Method is a valid method for developing consensus recommendations on REDs.
“This REDs consensus statement used the RAND-UCLA Appropriateness Method (RAM).43”
The paper relies on this without support.
The literature search identified all relevant studies on REDs and LEA.
“Since 2018, there have been considerable scientific advancements in the REDs research field including ~178 REDs and/ or LEA original research publications featuring ~23 822 participants; (80% female), with ~62% of these studies implementing a cross-sectional design, ~14% as longitudinal observational and ~12% longitudinal intervention (see literature summary in online supplemental file 1).”
The paper relies on this without support.
The measurement of EA in free-living athletes is challenged by a high level of burden (eg, time, effort) to the participant and assessor.
“Unfortunately, the measurement of EA in free-living athletes is challenged by a high level of burden (eg, time, effort) to the participant and assessor.”
The paper relies on this without support.
Many members of the athlete entourage lack the knowledge of safe regulation of body weight and composition and how it can be utilised to improve performance while maintaining health.
“many members of the athlete entourage appear to ( 1) lack the knowledge of safe regulation of body weight and composition and how it can be utilised to improve performance while maintaining health;”
The paper relies on this without support.
Many members of the athlete entourage have ignorance of the suitability of various body composition methods and the possible negative health effects consequent to inappropriate assessment.
“(2) have ignorance of the suitability of various body composition methods and the possible negative health effects consequent to inappropriate assessment”
The paper relies on this without support.
Many members of the athlete entourage have inadequate communication skills, with lack of optimised protocols on how to manage and safely implement the data to promote health and performance without the added risk of developing REDs, DE behaviours or EDs.
“(3) have inadequate communication skills, with lack of optimised protocols on how to manage and safely implement the data to promote health and performance without the added risk of developing REDs, DE behaviours or EDs.”
The paper relies on this without support.
Choosing an appropriate body composition assessment method involves consideration of its accuracy, repeatability, utility and cost.
“Choosing an appropriate body composition assessment method involves consideration of its accuracy, repeatability, utility and cost.”
The paper relies on this without support.
For para athletes, adjustments of the assessment protocol and analysis of results may be needed.
“For para athletes, adjustments of the assessment protocol and analysis of results may be needed.”
The paper relies on this without support.
Problematic LEA is the underlying aetiology for the health and performance outcomes of REDs.
“Because problematic LEA is the underlying aetiology for the health and performance outcomes of REDs”
The paper relies on this without support.
Various LEA indicators (signs and symptoms) have emerged as the current best practice for clinical assessment and research purposes.
“various LEA indicators (signs and symptoms) have emerged as the current best practice for clinical assessment and research purposes.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“the prevalence of relative energy deficiency in endurance sport athletes (REDs) (Mountjoy et al., 2023; Dasa et al., 2024), especially in females, may also impact SmO2 kinetics.”
From Monitoring skeletal muscle oxygen saturation kinetics during graded exercise testing in NCAA division I female rowers (2025) · cites this paper as Mountjoy et al., 2023
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“For example, in 2023, the International Olympic Committee estimated that the prevalence of REDs was somewhere between 15-80% among elite athletes [29].”
From Low Energy Availability and Relative Energy Deficiency in Sport: A Systematic Review and Meta-analysis (2025) · cites this paper as [29]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Independent studies report variable rates of LEA and REDs among athletes, and the most recent consensus statement from the International Olympic Committee in 2023 provided a wide range (15-80%) for the estimated prevalence of these conditions among elite athletes [29].”
From Low Energy Availability and Relative Energy Deficiency in Sport: A Systematic Review and Meta-analysis (2025) · cites this paper as [29]
Experimental — accuracy not yet measured
Citations
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“For example, in 2023, the International Olympic Committee estimated that the prevalence of REDs was somewhere between 15 and 80% among elite athletes [29].”
Metadata
- Authors
- Mountjoy, M., Ackerman, K. E., Bailey, D. M., Burke, L. M., Constantini, N., Hackney, A. C., Heikura, I. A., Melin, A., Pensgaard, A. M., Stellingwerff, T., Sundgot-Borgen, J. K., Torstveit, M. K., Jacobsen, A. U., Verhagen, E., Budgett, R., Engebretsen, L., & Erdener, U.
- Affiliations
- International Olympic Committee (CH)
- Boston Children's Hospital (US)
- Australian Catholic University (AU)
- Hebrew University of Jerusalem (IL)
- University of North Carolina at Chapel Hill (US)
- University of Victoria (CA)
- Linnaeus University (SE)
- Norwegian School of Sport Sciences (NO)
- University of Agder (NO)
- Amsterdam University Medical Centers (NL)
- Hacettepe University (TR)
- ORCID
- Venue
- British Journal of Sports Medicine
- Publisher
- BMJ
- Published
- 2023-09
- Volume
- 57
- Issue
- 17
- Pages
- 1073-1098
- ISSN
- 0306-3674 (ISSN-L)
- 1473-0480
- OpenAlex
- W4387036470
- Cited by
- 724
- References
- 454
- Citations by year
- 2026: 279 · 2025: 243 · 2024: 179 · 2023: 22
- FWCI
- 198.49
- Type
- journal article
- Language
- en
- Update notices
- correction (2024-02-07)
- Open access
- hybrid
- doi.org
- Licence
- other-oa
- Locations
- British Journal of Sports Medicine (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (acceptedVersion, other-oa)
- NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
- HighWire Press Open Archive (submittedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (submittedVersion, other-oa)
- NORA - Norwegian Open Research Archives (submittedVersion, cc-by-nc)
- VUBIR (Vrije Universiteit Brussel) (submittedVersion)
- Funders
- International Olympic Committee
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Keywords
- relative energy deficiency in sport, low energy availability, athletes, female athletes, male athletes, mental health, physiological modeling, body composition assessment, risk stratification, prevention and treatment
- MeSH terms
- Relative Energy Deficiency in Sport, Body Composition, Female, Humans, Male, Sports, Exercise, Athletes
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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