CoChat
Sign Up
Cited by 63Diversity and Impact of DanceEating Disorders and BehaviorsNutrition, Health and Food Behavior

Assessment of Dietary Intake, Energy Status, and Factors Associated With RED-S in Vocational Female Ballet Students

Open access
Civil, Rita, Lamb, Antonia, Loosmore, Diana, Ross, Louisa, Livingstone, Kerry, Strachan, Fiona, Dick, James R., Stevenson, Emma J. +2 more·2019·Frontiers in Nutrition
DOI 10.3389/fnut.2018.00136PMC PMC6333673
Open this paper in CoChat — free accountOpen PDF

Abstract

Elite ballet dancers are at risk of health issues associated with Relative Energy Deficiency in Sport (RED-S). This study determined the nutritional status, estimated energy status, and assessed factors related to RED-S in vocational female ballet students. Using a cross-sectional study design, we measured dietary intake (n=20; food diaries and 24hr dietary-recall) and energy expenditure (n=18; accelerometry) in vocational female ballet students (age: 18.1±1.1 years; body mass index: 19.0±1.6 kg·m2; body fat: 22.8±3.4 %) over 7 days, including 5 weekdays (with dance training) and 2 weekend days (without scheduled dance training). Furthermore, we assessed eating behaviours, menstrual function, risk of RED-S (questionnaires), and body composition (dual x-ray absorptiometry). Energy and macronutrient intakes of vocational ballet students were similar during weekdays and weekend days (P>0.050), whereas total energy expenditure was greater on weekdays than weekend days (P<0.010; 95% CI: 212, 379). Energy balance was lower on weekdays (-425±465 kcal·day-1) than weekend days (-6±506 kcal·day-1, P=0.015; 95% CI: -748, -92). Exercise energy expenditure was greater on weekdays (393±103 kcal·day-1) than weekend days (213±129 kcal·day-1; P<0.010; 95% CI: 114, 246), but energy availability was similar between time periods (weekdays 38±13 kcal·kg FFM·day-1; weekend days 44±13 kcal·kg FFM·day-1; P=0.110). Overall, 35% of participants had an energy intake <1800 kcal·day-1, 44% had reduced energy availability (30-45 kcal·kg FFM·day-1), and 22% had low energy availability (<30 kcal·kg FFM·day-1). Menstrual dysfunctions were reported in 40% of participants; 15% and 25% reported oligomenorrhea and secondary amenorrhea, respectively; while 65% were classified at risk of RED-S (based on the Low Energy Availability in Females Questionnaire). All participants had adequate bone health (bone mineral density Z-score: 1.1±0.9 SD), but 20% had <85% expected body weight. The observation of an energy deficit in vocational female ballet students was primarily attributed to an inability to plan energy intake and thereby meet higher energy requirements during ballet training weekdays. Screening for factors associated with RED-S and tailoring education programs to inform energy and nutrition requirements for health and training are recommended in elite young ballet students.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.3389/fnut.2018.00136

Cites

56 of 56 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

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?

  • Civil et al. identified a 60% rate of REDS among full-time vocational female ballet students aged 17-19 training at the Royal Conservatoire of Scotland in Glasgow.

    “This study by Civil et al. identified a 60% rate of REDS among full-time vocational female ballet students aged 17-19 training at the Royal Conservatoire of Scotland in Glasgow [45].”

    From Low Energy Availability and Relative Energy Deficiency in Sport: A Systematic Review and Meta-analysis (2025) · cites this paper as [45]

    The Participants and Ethical Approval section describes full-time vocational ballet students at the Royal Conservatoire of Scotland in Glasgow, with a mean age of 18 ± 1 years. The Discussion reports that 60% may have been slightly at risk of RED-S because they had one or two associated factors; it does not report that 60% had RED-S. The quoted age range of 17–19 is also not given as the participants’ age range. (LLM, conf=0.89)

    Experimental — accuracy not yet measured

  • One study defined athletes as at risk of REDs if their LEAF-Q score was ≥ 8.

    “For example, one study stated that athletes were at risk of REDs if their LEAF-Q score was ≥ 8 [45].”

    From Low Energy Availability and Relative Energy Deficiency in Sport: A Systematic Review and Meta-analysis (2025) · cites this paper as [45]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

1 of the 57 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. [28]Laws H Fit to Dance 2—Report of the Second National Inquiry into Dancers' Health and Injury in the UK. London: Newgate Press (2005).

Cited by

Sorted by citations

Related

Authors
Civil, R., Lamb, A., Loosmore, D., Ross, L., Livingstone, K., Strachan, F., Dick, J. R., Stevenson, E. J., Brown, M. A., & Witard, O. C.
Affiliations
  • University of Stirling (GB)
  • Royal Conservatoire of Scotland (GB)
  • Newcastle University (GB)
  • University of Gloucestershire (GB)
Corresponding author
Witard, Oliver C.
ORCID
Venue
Frontiers in Nutrition
Publisher
Frontiers Media SA
Published
2019-01-09
Volume
5
Pages
136-136
ISSN
2296-861X (ISSN-L)
DOI
10.3389/fnut.2018.00136
PMC
PMC6333673
OpenAlex
W2910247090
Cited by
63
References
57
Citations by year
2026: 5 · 2025: 7 · 2024: 9 · 2023: 7 · 2022: 21 · 2021: 3 · 2020: 10 · 2019: 1
FWCI
10.32
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Nutrition (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research Repository (University of Gloucestershire) (acceptedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Stirling Online Research Repository (University of Stirling) (submittedVersion, cc-by)
  • University of Birmingham Research Portal (University of Birmingham) (submittedVersion, other-oa)
  • Newcastle University ePrints (Newcastle Univesity) (cc-by)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Diversity and Impact of Dance
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
  • Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
Keywords
relative energy deficiency in sport, ballet dancers, energy availability, energy balance, menstrual disorders, oligomenorrhea, secondary amenorrhea, dietary intake, energy expenditure, macronutrient intake, eating behaviour, body composition, female athletes, weekend effect, exercise energy expenditure, body fat percentage, body mass index, eating disorder risk, eating disorder symptoms

About these checks

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.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review