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Cited by 59Eating Disorders and BehaviorsSports Performance and TrainingRegulation of Appetite and Obesity

Mapping the complexities of Relative Energy Deficiency in Sport (REDs): development of a physiological model by a subgroup of the International Olympic Committee (IOC) Consensus on REDs

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Burke, Louise M, Ackerman, Kathryn E, Heikura, Ida A, Hackney, Anthony C, Stellingwerff, Trent·2023·British Journal of Sports Medicine
DOI 10.1136/bjsports-2023-107335
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Abstract

The 2023 International Olympic Committee (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) notes that exposure to low energy availability (LEA) exists on a continuum between adaptable and problematic LEA, with a range of potential effects on both health and performance. However, there is variability in the outcomes of LEA exposure between and among individuals as well as the specific manifestations of REDs. We outline a framework for a ‘systems biology’ examination of the effect of LEA on individual body systems, with the eventual goal of creating an integrated map of body system interactions. We provide a template that systematically identifies characteristics of LEA exposure (eg, magnitude, duration, origin) and a variety of moderating factors (eg, medical history, diet and training characteristics) that could exacerbate or attenuate the type and severity of impairments to health and performance faced by an individual athlete. The REDs Physiological Model may assist the diagnosis of underlying causes of problems associated with LEA, with a personalised and nuanced treatment plan promoting compliance and treatment efficacy. It could also be used in the strategic prevention of REDs by drawing attention to scenarios of LEA in which impairments of health and performance are most likely, based on knowledge of the characteristics of the LEA exposure or moderating factors that may increase the risk of harmful outcomes. We challenge researchers and practitioners to create a unifying and dynamic physiological model for each body system that can be continuously updated and mapped as knowledge is gained.

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Cited by

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Authors
Burke, L. M., Ackerman, K. E., Heikura, I. A., Hackney, A. C., & Stellingwerff, T.
Affiliations
  • Australian Catholic University (AU)
  • Boston Children's Hospital (US)
  • University of Victoria (CA)
  • University of North Carolina at Chapel Hill (US)
Corresponding author
Burke, Louise M
ORCID
Venue
British Journal of Sports Medicine
Publisher
BMJ
Published
2023-09
Volume
57
Issue
17
Pages
1098-1110
ISSN
  • 0306-3674 (ISSN-L)
  • 1473-0480
DOI
10.1136/bjsports-2023-107335
OpenAlex
W4387036475
Cited by
59
References
21
Citations by year
2026: 23 · 2025: 18 · 2024: 14 · 2023: 4
FWCI
2.99
Type
journal article
Language
en
Open access
Licence
Locations
  • British Journal of Sports Medicine (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • HighWire Press Open Archive (submittedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
Keywords
relative energy deficiency in sport, low energy availability, systems biology, athlete health, athletic performance, moderators, interindividual variability
MeSH terms
Relative Energy Deficiency in Sport, Consensus Statements as Topic, Humans, Sports, Athletes

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