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Cited by 93Eating Disorders and BehaviorsSports Performance and TrainingLower Extremity Biomechanics and Pathologies

Relative energy deficiency in sport (RED-S): scientific, clinical, andpractical implications for the female athlete

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Cabre, HE, Moore, SR, Smith-Ryan, AE, Hackney, AC·2022·Deutsche Zeitschrift für Sportmedizin/German Journal of Sports Medicine
DOI 10.5960/dzsm.2022.546PMC PMC9724109
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Abstract

Problem: If athletes develop low energy availability (LEA), it can lead to a Relative Energy Deficiency in Sport (RED-S) syndrome which has severe health consequences if not treated. Methodology: A narrative review of the most recent and pertinent literature on the topic, with special emphasis on women. Results: In assessing the current literature, we have synthesized: i) the scientific implications of LEA and RED-S, ii) the clinical manifestations of the conditions currently available for detection, as well as iii) the practical implications for healthcare and support for female athletes and teams in planning intervention or prevention strategies (maintaining EA >45 kcal/kg FFM/day). Discussion: The ‘Female Athlete Triad” emerged in the 1990s as researchers understood more of the etiological adaptation of female athlete health to sports training. In the last 10 years, the scientific community has recognized that the ‘Triad’ approach was too narrow in focus, and the broader concept of RED-S emerged. Both the Triad and RED-S are consequences of a frequently prevalent LEA in athletes (<30 kcal/kg FFM/day). Developing LEA and RED-S compromises training adaptation, performance capacity, and health in athletes. For these reasons, it is critical that an athlete’s support team recognize the behaviors that may indicate RED-S evolution. In this way, we can assist female athletes in reaching their full potential in sports while protecting their health. Key Words: Energy Availability, Stress, Performance, Hormones, Menstrual Health

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Cited by

Sorted by citations

Authors
Cabre, H., Moore, Sr., Smith-Ryan, A., & Hackney, A.
Venue
Deutsche Zeitschrift für Sportmedizin/German Journal of Sports Medicine
Publisher
Deutsche Zeitschrift Fur Sportmedizin/German Journal of Sports Medicine
Published
2022-07-01
Volume
73
Issue
7
Pages
225-234
ISSN
  • 0344-5925 (ISSN-L)
  • 2510-5264
DOI
10.5960/dzsm.2022.546
PMC
PMC9724109
OpenAlex
W4311023048
Cited by
93
References
7
Citations by year
2026: 36 · 2025: 33 · 2024: 18 · 2023: 6
FWCI
13.02
Type
journal article
Language
en
Open access
Licence
cc-by-nc-sa
Locations
  • German Journal of Sports Medicine (publishedVersion, cc-by-nc-sa)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion, cc-by-nc-sa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
National Institute of Arthritis and Musculoskeletal and Skin Diseases (R03AR055262)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
  • Physical Sciences › Engineering › Biomedical Engineering › Lower Extremity Biomechanics and Pathologies
Keywords
relative energy deficiency in sport, low energy availability, female athletes, female athlete triad, energy balance, clinical features, training effects, performance capacity, prevention

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