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IOC consensus statement on elite youth athletes competing at the Olympic Games: essentials to a healthy, safe and sustainable paradigm
Open accessAbstract
With the pronounced ongoing growth of global youth sports, opportunities for and participation of youth athletes on the world sports stage, including the Olympic Games, are expected to escalate. Yet, adolescence is a vulnerable period of development and inherently dynamic, with non-linear and asynchronous progression of physical, physiological, psychological and social attributes. These non-concurrent changes within and between individuals are accompanied by irregular and unpredictable threats and impediments. Likewise, the evident age-based criteria and conventional path for those youth athletes deemed eligible candidates for the Olympic Games are not well or consistently defined. Furthermore, the unstructured and largely varying policies and practices across the sporting International Federations specific to youth participation underscore the need to establish a contemporary universal paradigm that would enable elite youth athletes to navigate an individualised healthy pathway to personal, athletic and sport success. First, we reviewed and summarised key challenges facing elite youth athletes and the relevant evidence fundamental to facilitating and supporting central aspects of health and well-being, while empowering safe, sustainable and positive engagement during athletic and personal advancement and competition. Second, we developed and present a modern elite youth athlete model that emphasises a child-centred, practical framework with corresponding guidelines and recommendations to protect health and well-being while safely and favourably managing international sport competition. Our proposed evidence-informed paradigm will enable and support individualised pathways for healthy, well-rounded and sustainable positive engagement while achieving sport success for youth contending or aiming to compete at world-class international sporting events.
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Overview
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TL;DR
This IOC consensus statement argues that elite youth participation in the Olympic Games requires a child-centred, rights-respecting, developmentally informed paradigm rather than reliance on age eligibility alone. It synthesises scoping reviews and expert consensus to propose nine recommendations for safeguarding, health, mental well-being, and sustainable athletic development.
Key findings
- The statement proposes a contemporary paradigm for elite youth athletes competing internationally, with nine implementation recommendations: a centralised youth-athlete health learning hub; coach education/accreditation; youth-specific safeguarding frameworks; child-friendly codes of conduct; flexible competition formats; mental and psychosocial well-being definitions; parent/coach guidance; healthy adult–youth relationships; and nutrition considerations.
- Age eligibility remains variable and not fully scientifically informed. IOC internal data show just over 30% of U18 Olympic participants from 2012–2022 returned to compete as adults, and the authors state it is premature to make or confidently speculate on a specific age eligibility requirement recommendation.
- The growth/maturation–injury scoping review retained 30 articles, mostly in soccer (n=19) and male-only samples (23 studies; 7 mixed; none female-only). Reported overuse injury prevalence ranged from 17% across endurance/technical/team sports to 37% in skiing and handball and 68% in running; ACL injuries occur approximately 3.5 times more often in female athletes after puberty.
- The mental-health scoping review included 33 records and data from 5826 youth athletes (2538 boys, 3288 girls). Disordered eating was most studied (k=16), followed by anxiety (k=7) and depression (k=5); caseness estimates were 0–14.4% for disordered eating in boys and 11–34% in girls, 6% mixed/14% boys/40% girls for depression, and 8% boys/28% girls for anxiety; self-reported mental health symptoms ranged from nearly 7% to just over 20%.
Methods
- The IOC convened a consensus meeting in Lausanne, Switzerland, on 24–26 May 2023, with a deliberately multidisciplinary faculty covering youth athletic health, growth and maturation, sports medicine, mental health, safeguarding, coaching, and sport administration.
- The panel relied predominantly on expert narrative reviews and three scoping reviews: (a) growth and maturation changes and injury risk, (b) mental health and well-being, and (c) positive athlete engagement and development. Searches generally adhered to PRISMA-ScR; final included sets were 30 growth/maturation–injury articles, 33 mental-health records, and 43 positive-engagement articles.
- Consensus was developed through online discussion, an in-person meeting, and a Delphi-like anonymous Likert scoring process (1–9), with recommendations included only if ≥80% of participants scored ≥7, followed by editing and repeated voting as needed.
Limitations
- Stated: the panel considered systematic evaluation of International Federation policies premature and relied predominantly on expert narrative reviews; it explicitly states that no specific age eligibility recommendation can be confidently made and that age-determination proxies have limited validity and reliability.
- Stated: mental-health evidence is limited—few studies, none from the Youth Olympic Games, mainly cross-sectional designs, no published prospective studies, a paucity of research on youth travelling and competing at world-class events, and a dearth of developmentally and contextually appropriate measures; intervention effectiveness for mental health in elite youth sport is unstudied.
- Stated/evident: the growth/maturation–injury scoping review had no female-only studies (23 male-only, 7 mixed, 0 female-only), and mental-health risk factors varied between studies; the consensus recommendations were developed via expert consensus and Delphi-like voting rather than prospective validation (evident from the text).
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“However, given the nascent nature of the existing literature, these factors varied between studies (eg, higher competition level was associated with higher and lower rates of disordered eating).32 42”
§ IOC consensus statement on elite youth athletes competing at the Olympic Games: essentials to a healthy, safe and sustainable paradigm > Consensus statement
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“The IOC data further indicate just over 30% of those U18 youth participating in the Olympics returned to participate as an adult.”
§ IOC consensus statement on elite youth athletes competing at the Olympic Games: essentials to a healthy, safe and sustainable paradigm > Consensus statement
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“Risk factors for mental health outcomes included sex, elite athlete status, coach/parent relationship factors and mental health comorbidity.”
§ IOC consensus statement on elite youth athletes competing at the Olympic Games: essentials to a healthy, safe and sustainable paradigm > Consensus statement
plainstates an association- Asserted: passes — The authors put it forward as true.
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In the paper
“Most of these investigations were conducted in soccer (n=19), with the others focusing on gymnastics (n=3), dance, skiing, track and field (for each, n=2), squash and handball (for each, n=1).”
§ IOC consensus statement on elite youth athletes competing at the Olympic Games: essentials to a healthy, safe and sustainable paradigm > Evidence reviews
plainn = 19- Asserted: passes — The authors put it forward as true.
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In the paper
“Caseness estimates (referring to mental health symptoms at a level that would usually warrant treatment by a health professional) for disordered eating ranged from 0% to 14.4% for boys 31 34 and 11% to 34% for girls.32 43”
§ IOC consensus statement on elite youth athletes competing at the Olympic Games: essentials to a healthy, safe and sustainable paradigm > Consensus statement
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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In the paper
§ IOC consensus statement on elite youth athletes competing at the Olympic Games: essentials to a healthy, safe and sustainable paradigm > Search strategy and screening-positive athlete engagement and development
“All articles were exported to Covidence to remove duplicates (75), leaving 474 articles for review.”
§ IOC consensus statement on elite youth athletes competing at the Olympic Games: essentials to a healthy, safe and sustainable paradigm > Search strategy and screening-positive athlete engagement and development
“Two members of the research team examined all 549 articles at the title and abstract level while a third member was the deciding vote for inclusion, resolving decisional conflicts (54 conflicts).”
Citations
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Cited by
Mental health in elite athletes: International Olympic Committee consensus statement (2019)
Reardon, C. L., Hainline, B., Aron, C. M., Baron, D., Baum, A. L., Bindra, A., Budgett, R., Campriani, N., Castaldelli-Maia, J. M., Currie, A., et al. (2019) · British Journal of Sports Medicine · doi:10.1136/bjsports-2019-100715 · Cited by 1,277
Self-citationParry, G., Williams, S., McKay, C. D., Johnson, D. J., Bergeron, M. F., & Cumming, S. P. (2024) · British Journal of Sports Medicine · doi:10.1136/bjsports-2024-108233 · Cited by 86
Self-citationMental health and well-being of elite youth athletes: a scoping review
Gwyther, K., Pilkington, V., Bailey, A. P., Mountjoy, M. L., Bergeron, M. F., Rice, S., & Purcell, R. (2024) · British Journal of Sports Medicine · doi:10.1136/bjsports-2024-108244 · Cited by 59
Self-citationTorvaldsson, K., Fagher, K., Derman, W. E., Engebretsen, L., Lindblom, H., Lópes, A. D., Runciman, P., Schwellnus, M. P., Soligard, T., Sonesson, S., et al. (2025) · British Journal of Sports Medicine · doi:10.1136/bjsports-2025-109980 · Cited by 29
Self-citationBody composition and fitness in elite Spanish children tennis players
Berdejo-del-Fresno, D., Vicente‐Rodríguez, G., González‐Ravé, J. M., MORENO, L. A. C., & Rey-López, J. P. (2010) · Journal of Human Sport and Exercise · doi:10.4100/jhse.2010.52.13 · Cited by 17
Metadata
- Authors
- Bergeron, M. F., Côté, J., Cumming, S. P., Purcell, R., Armstrong, N., Basilico, L., Burrows, K., Charrin, J.-B., Felix, A., Groesswang, H., Iwasaki, Y., Kocher, M. S., Martowicz, M., McConnell, K., Moran, J., Holm Moseid, C., Mountjoy, M., Soligard, T., Tetelbaum, E., Thiel, A., Vertommen, T., Viseras, G., Budgett, R., Engebretsen, L., & Erdener, U.
- Affiliations
- University of Hartford (US)
- Queen's University (CA)
- University of Bath (GB)
- The University of Melbourne (AU)
- University of Exeter (GB)
- World Skate, Maison du Sport International, Lausanne, Switzerland
- International Olympic Committee (CH)
- International Bobsleigh & Skeleton Federation (IBSF), Salzburg, Austria
- Anti-Doping, Medical and Scientific Commission, Fédération Internationale de Gymnastique, Lausanne, Switzerland
- Boston Children's Hospital (US)
- University of British Columbia (CA)
- Oslo Sports Trauma Research Center, Institute of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
- McMaster University (CA)
- German Sport University Cologne (DE)
- Corresponding author
- Bergeron, Michael F
- ORCID
- Venue
- British Journal of Sports Medicine
- Publisher
- BMJ
- Published
- 2024-08-28
- Volume
- 58
- Issue
- 17
- Pages
- 946-965
- ISSN
- 0306-3674 (ISSN-L)
- 1473-0480
- OpenAlex
- W4401946345
- Semantic Scholar
- 3d10b2c670be79db5f9db127ca1d9d8d86aca989
- Cited by
- 73
- References
- 272
- Citations by year
- 2026: 43 · 2025: 24 · 2024: 4
- FWCI
- 25.82
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- other-oa
- Locations
- British Journal of Sports Medicine (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Pure (University of Bath) (submittedVersion, other-oa)
- NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
- Funders
- IOC
- Topics
- Social Sciences › Psychology › Developmental and Educational Psychology › Sport Psychology and Performance
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports injuries and prevention
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
- Keywords
- elite youth athletes, Olympic Games, adolescent development, youth sport participation, athlete safety
- MeSH terms
- Youth Sports, Adolescent, Athletic Injuries, Child, Competitive Behavior, Humans, Consensus, Athletic Performance, Athletes
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