scholarly journals Relative Energy Deficiency in Sport among a Collegiate Cross-Country Team

2021 ◽  
Vol 11 (02) ◽  
pp. 81-90
Author(s):  
Regina L. Schimek ◽  
Elizabeth Blodgett Salafia ◽  
Sherri Stastny
Keyword(s):  
Relative Energy ◽  
Energy Deficiency ◽  
Cross Country

scholarly journals Performance and Health Decrements Associated With Relative Energy Deficiency in Sport for Division I Women Athletes During a Collegiate Cross-Country Season: A Case Series

2021 ◽  
Vol 12 ◽  
Author(s):  
David R. Hooper ◽  
Jared Mallard ◽  
Jeff T. Wight ◽  
Kara L. Conway ◽  
George G.A. Pujalte ◽  
...  
Keyword(s):  
Vitamin D ◽  
Body Composition ◽  
Body Mass ◽  
Case Series ◽  
Relative Energy ◽  
Nutritional Intake ◽  
Division I ◽  
Energy Availability ◽  
Energy Deficiency ◽  
Cross Country

The purpose of this case series was to evaluate the presence of low Energy Availability (EA) and its impact on components of Relative Energy Deficiency in Sport (RED-S) in a population of female collegiate runners. Seven female NCAA Division I athletes (age: 22.3 ± 1.5 yrs; height: 169.7 ± 5.7 cm; weight: 58.3 ± 4.1 kg) were tracked from August until February, covering the beginning (Pre XC), end (Post XC) of their competitive cross country season, and beginning of the following track season (Pre Track). The athletes were assessed for female athlete triad (Triad) risk, energy availability, body composition, resting metabolic rate (RMR), nutritional intake, and blood markers (including vitamin D, ferritin, and triiodothyronine (T3)). From Pre XC to Post XC there were no significant differences in body mass, fat free mass or body fat percentage. At Pre XC, mean EA was 31.6 ± 13.3 kcal/kg FFM∙d-1. From Post XC to Pre Track, there was a significant increase in body mass (59.1 ± 5.1 to 60.6 ± 5.7 kg, p<0.001,d=0.27). From Post XC to Pre Track, there was a significant increase in RMR (1466 ± 123.6 to 1614.6 ± 89.1 kcal·d-1, p<0.001,d=2.6). For 25(OH) vitamin D, there was a significant reduction from Pre XC to Post XC (44.1 ± 10.6 vs 39.5 ± 12.2 ng·mL-1, p=0.047,d=-0.4), and a significant increase from Post XC to Pre Track (39.5 ± 12.2 vs. 48.1 ± 10.4 ng·mL-1, p=0.014,d=0.75). For ferritin, there was a trend towards a decrease from Pre XC to Post XC (24.2 ± 13.2 vs. 15.7 ± 8.8 ng·mL-1, p=0.07, d=-0.75), as well as a trend toward an increase from Post XC to Pre Track (15.7 ± 8.8 vs. 34.1 ± 18.0 ng·mL-1, p=0.08, d=1.3). No differences in T3 were observed across time points. Average Triad risk score was 2.3 ± 1.4. Notably, 5 of 7 athletes met criteria for moderate risk. Despite many athletes meeting criteria for low EA and having elevated Triad risk assessment scores, most were able to maintain body mass and RMR. One athlete suffered severe performance decline and a reduced RMR. Surprisingly, she was the only athlete above the recommended value for ferritin. Following increased nutritional intake and reduced training volume, her performance and RMR recovered. Changes in body mass and body composition were not indicative of the presence of other concerns associated with RED-S. This exploratory work serves as a guide for future, larger studies for tracking athletes, using RMR and nutritional biomarkers to assess RED-S.

scholarly journals Knowledge of Triad and RED-S in Female Cross-Country Athletes and Support Staff

2021 ◽  
Author(s):  
Melissa T. Lodge ◽  
Kathryn E Ackerman ◽  
Jessica Garay
Keyword(s):  
Sports Medicine ◽  
Online Survey ◽  
Athletic Trainers ◽  
Cross Sectional Study ◽  
Relative Energy ◽  
Cross Sectional ◽  
Energy Deficiency ◽  
Increased Risk ◽  
Cross Country ◽  
And Performance

ABSTRACT CONTEXT: Female endurance athletes exhibit an increased risk of Female Athlete Triad (Triad) and Relative Energy Deficiency in Sport (RED-S). Triad and RED-S are conditions that explore the health and performance consequences of low energy availability (LEA). Few studies to date have assessed the knowledge that athletes, coaches, and athletic trainers (ATs) have regarding Triad/RED-S. Proper education has been shown to be effective in increasing knowledge of sports medicine concerns for athletes. Yet, there are no known continuing education programs for Triad/RED-S at collegiate institutions. OBJECTIVE: The primary purpose of this study was to assess the knowledge, confidence, and impact of identifying, screening, treating, and preventing Triad/RED-S. DESIGN: Cross-sectional study. SETTING: An evidence-based online survey was developed and administered via QualtricsTM. PARTICIPANTS: Female collegiate cross-country athletes (n = 275; 20 ± 1 yrs.), collegiate cross-country coaches (n = 55, 34 ± 9 yrs.), and ATs working with cross-country teams (n = 30, 36 ± 11 yrs.). MAIN OUTCOME MEASURE: Knowledge, confidence, and impact scores were assessed between groups using ANOVA. Independent t-tests were used to determine differences in impact scores between people who had or had not received education. RESULTS: Female cross-country athletes' total knowledge, confidence, and impact scores (mean scores of 25.00 ± 5.27, 95.42 ± 28.83, 18.81 ± 7.05 respectively) were significantly different from scores of coaches (mean scores of 26.92 ± 5.02, 111.35 ± 24.14 and 22.41 ± 6.33) and ATs (mean scores of 28.66 ± 4.02, 117.67 ± 22.53, and 23.93 ± 5.69) (p < 0.05). CONCLUSIONS: Knowledge, confidence, and impact scores of Triad/RED-S were lowest in female cross-country athletes and highest in ATs. These findings support the call for education, which should be regarded as the primary tool to increase knowledge to improve the prevention and treatment of Triad/RED-S.

scholarly journals Knochengesundheit und Hochleistungssport

2021 ◽  
Author(s):  
Lisa-Maria Wallwiener ◽  
Barbara Kapfer ◽  
Vanadin Seifert-Klauss
Keyword(s):  
Clinical Assessment ◽  
Medikamentöse Therapie ◽  
Assessment Tool ◽  
Relative Energy ◽  
Sich Eine ◽  
Energy Deficiency ◽  
Körperliche Betätigung

ZusammenfassungRegelmäßige körperliche Betätigung trägt zu einer gesunden Knochendichte bei, Leistungssportlerinnen in einigen Sportarten weisen jedoch eine erhöhte Prävalenz erniedrigter Knochendichte sowie vermehrt Stressfrakturen auf. Häufig liegt dem ein relatives Energiedefizit (RED), verbunden mit hoher mechanischer Belastung und intensivem Trainingsalltag, zugrunde. Das Vorliegen eines RED im Sport ist oft unterdiagnostiziert, daher hat sich eine systematische multidisziplinäre Zusammenarbeit unter Zuhilfenahme standardisierter Tests, z. B. des RED‑S CAT (Relative Energy Deficiency in Sport Clinical Assessment Tool) als hilfreich erwiesen. Therapieansätze zielen primär auf eine Behebung der negativen Energiebilanz der Patientin als auch auf psychotherapeutische Interventionen ab. Darüber hinaus kann in schweren Fällen eine medikamentöse Therapie zur Unterstützung sowohl einer ausgeglichenen hormonellen Situation als auch des Knochenstoffwechsels notwendig sein.

scholarly journals The LEAF questionnaire is a good screening tool for the identification of the Female Athlete Triad/Relative Energy Deficiency in Sport among young football players

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e12118
Author(s):  
Edyta Łuszczki ◽  
Pawel Jagielski ◽  
Anna Bartosiewicz ◽  
Maciej Kuchciak ◽  
Katarzyna Dereń ◽  
...  
Keyword(s):  
At Risk ◽  
Body Composition ◽  
Energy Intake ◽  
Female Athlete ◽  
Relative Energy ◽  
Screening Tools ◽  
Football Players ◽  
Female Athlete Triad ◽  
Energy Deficiency ◽  
Not At Risk

Background It has been noticed that Female Athlete Triad (Fat) and Relative Energy Deficiency (Red-S) in Sport are characterized by the symptoms of impaired endocrine-metabolic function and bone health in female athletes. In addition, it may be evaluated with a qualitative tool, such as Low Energy Availability in Females questionnaire (LEAF-Q) and quantitative measurements: bone mineral density (BMD), resting energy expenditure (REE), body composition, 24-hour dietary recall. Methods The aim of this study was to assess the prevalence of Triad and Red-S using the LEAF-Q in youth female football players. Additionally, the difference in the BMD, body composition, REE and energy intake (EI) were assessed between the Triad/Red-S risk and not at-risk groups. Results Almost two thirds (64.7%) of participants are classified as being at-risk for the triad according to their LEAF-Q scores. There were no statistically significant differences (p > 0.05) between most of the values among children from the analyzed groups. There was a statistically significant difference (p < 0.001) between the EI values among girls from the two analyzed groups: at-risk (1,773.18 kcal ±  232.57) and not at-risk (2,054.00 kcal ±  191.39). Girls who did not meet the energy intake recommendations were 10.00 as likely to be in the Triad/Red-S risk group. Conclusion Early identification of Fat/Red-S symptoms by screening tools such as the LEAF questionnaire is important in protecting young athletes from long-term damage due to the progression of the risk factors associated with the Fat/Red-S.

Low energy availability surrogates correlate with health and performance consequences of Relative Energy Deficiency in Sport

2018 ◽  
Vol 53 (10) ◽  
pp. 628-633 ◽  
Author(s):  
Kathryn E Ackerman ◽  
Bryan Holtzman ◽  
Katherine M Cooper ◽  
Erin F Flynn ◽  
Georgie Bruinvels ◽  
...  
Keyword(s):  
Female Athletes ◽  
Relative Energy ◽  
Low Energy ◽  
Clinical Population ◽  
Energy Availability ◽  
Energy Deficiency ◽  
Increased Risk ◽  
Performance Consequences ◽  
And Performance ◽  
Low Energy Availability

Low energy availability (EA) is suspected to be the underlying cause of both the Female Athlete Triad and the more recently defined syndrome, Relative Energy Deficiency in Sport (RED-S). The International Olympic Committee (IOC) defined RED-S as a syndrome of health and performance impairments resulting from an energy deficit. While the importance of adequate EA is generally accepted, few studies have attempted to understand whether low EA is associated with the health and performance consequences posited by the IOC.ObjectiveThe purpose of this cross-sectional study was to examine the association of low EA with RED-S health and performance consequences in a large clinical population of female athletes.MethodsOne thousand female athletes (15–30 years) completed an online questionnaire and were classified as having low or adequate EA. The associations between low EA and the health and performance factors listed in the RED-S models were evaluated using chi-squared test and the odds ratios were evaluated using binomial logistic regression (p<0.05).ResultsAthletes with low EA were more likely to be classified as having increased risk of menstrual dysfunction, poor bone health, metabolic issues, haematological detriments, psychological disorders, cardiovascular impairment and gastrointestinal dysfunction than those with adequate EA. Performance variables associated with low EA included decreased training response, impaired judgement, decreased coordination, decreased concentration, irritability, depression and decreased endurance performance.ConclusionThese findings demonstrate that low EA measured using self-report questionnaires is strongly associated with many health and performance consequences proposed by the RED-S models.

Endocrine Effects of Relative Energy Deficiency in Sport

2018 ◽  
Vol 28 (4) ◽  
pp. 335-349 ◽  
Author(s):  
Kirsty J. Elliott-Sale ◽  
Adam S. Tenforde ◽  
Allyson L. Parziale ◽  
Bryan Holtzman ◽  
Kathryn E. Ackerman
Keyword(s):  
Current Knowledge ◽  
Relative Energy ◽  
Gonadal Hormones ◽  
Female Athlete Triad ◽  
Hormonal Changes ◽  
Male Athletes ◽  
Potential Health ◽  
Future Directions ◽  
Energy Deficiency ◽  
And Performance

The term Relative Energy Deficiency in Sport was introduced by the International Olympic Committee in 2014. It refers to the potential health and performance consequences of inadequate energy for sport, emphasizing that there are consequences of low energy availability (EA; typically defined as <30 kcal·kg−1 fat-free mass·day−1) beyond the important and well-established female athlete triad, and that low EA affects populations other than women. As the prevalence and consequences of Relative Energy Deficiency in Sport become more apparent, it is important to understand the current knowledge of the hormonal changes that occur with decreased EA. This paper highlights endocrine changes that have been observed in female and male athletes with low EA. Where studies are not available in athletes, results of studies in low EA states, such as anorexia nervosa, are included. Dietary intake/appetite-regulating hormones, insulin and other glucose-regulating hormones, growth hormone and insulin-like growth factor 1, thyroid hormones, cortisol, and gonadal hormones are all discussed. The effects of low EA on body composition, metabolic rate, and bone in female and male athletes are presented, and we identify future directions to address knowledge gaps specific to athletes.

Pitfalls of Conducting and Interpreting Estimates of Energy Availability in Free-Living Athletes

2018 ◽  
Vol 28 (4) ◽  
pp. 350-363 ◽  
Author(s):  
Louise M. Burke ◽  
Bronwen Lundy ◽  
Ida L. Fahrenholtz ◽  
Anna K. Melin
Keyword(s):  
Energy Intake ◽  
Good Health ◽  
Relative Energy ◽  
Fat Free Mass ◽  
Energy Availability ◽  
Response Patterns ◽  
Male Athletes ◽  
Energy Deficiency ◽  
Definition Of ◽  
Residual Errors

The human body requires energy for numerous functions including, growth, thermogenesis, reproduction, cellular maintenance, and movement. In sports nutrition, energy availability (EA) is defined as the energy available to support these basic physiological functions and good health once the energy cost of exercise is deducted from energy intake (EI), relative to an athlete’s fat-free mass (FFM). Low EA provides a unifying theory to link numerous disorders seen in both female and male athletes, described by the syndrome Relative Energy Deficiency in Sport, and related to restricted energy intake, excessive exercise or a combination of both. These outcomes are incurred in different dose–response patterns relative to the reduction in EA below a “healthy” level of ∼45 kcal·kg FFM−1·day−1. Although EA estimates are being used to guide and monitor athletic practices, as well as support a diagnosis of Relative Energy Deficiency in Sport, problems associated with the measurement and interpretation of EA in the field should be explored. These include the lack of a universal protocol for the calculation of EA, the resources needed to achieve estimates of each of the components of the equation, and the residual errors in these estimates. The lack of a clear definition of the value for EA that is considered “low” reflects problems around its measurement, as well as differences between individuals and individual components of “normal”/“healthy” function. Finally, further investigation of nutrition and exercise behavior including within- and between-day energy spread and dietary characteristics is warranted since it may directly contribute to low EA or its secondary problems.

Anorexia nervosa and relative energy deficiency syndrome causing extreme bradycardia, growth failure and pituitary failure

2021 ◽  
Author(s):  
Lauren SH Chong ◽  
Mushira Mokhtar ◽  
Gail Anderson ◽  
Linette Gomes ◽  
Basiliki Lampropoulos ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Growth Failure ◽  
Deficiency Syndrome ◽  
Relative Energy ◽  
Energy Deficiency

2 The prevalence of musculoskeletal injuries, menstrual irregularity and disordered eating in junior elite athletics in the UK

2021 ◽  
Vol 55 (16) ◽  
pp. 940.2-941
Author(s):  
J Wilkinson ◽  
L Mayhew
Keyword(s):  
Disordered Eating ◽  
Sports Medicine ◽  
Injury Risk ◽  
Relative Energy ◽  
Track And Field ◽  
Energy Availability ◽  
Female Athlete Triad ◽  
Menstrual Dysfunction ◽  
Energy Deficiency ◽  
The Uk

The prevalence of injury in adolescent elite track and field competitors is high,1 however only one study has been conducted with UK athletes.2 Relative Energy Deficiency in Sport (RED-S), encapsulating the Female Athlete Triad, is a syndrome whereby decreased energy availability affects health and performance, potentially leading to an increased injury risk; particularly to bone (3). Calculating decreased energy availability is difficult, however identifying contributing factors, such as disordered eating and menstrual dysfunction, is more viable.3AimThis study was conducted to identify the prevalence of musculoskeletal injury, disordered eating and menstrual dysfunction in elite junior UK track and field athletes.MethodData was collected from track and field athletes ranked within the top 10 of the UK U17 rankings in 2017 or 2018, with 138 athletes participating. Participants completed a self-reported musculoskeletal injury, disordered eating and menstrual dysfunction questionnaire relating to a 12-month time period.ResultsThis study found a 12-month retrospective injury prevalence of 43.5%. 13% of participants presented with disordered eating, whilst 37.7% of female participants presented with menstrual dysfunction. There was a statistically significant difference in injury prevalence according to gender, with more male athletes sustaining an injury compared with female athletes. No differences in injury prevalence were noted according to event group, menstrual dysfunction or disordered eating. The anatomical location displaying the highest prevalence of injury was the ankle and foot (22.5%). The anatomical structure displaying the highest 12-month injury prevalence was muscle (43.6%), followed by bone (30.9%). Additionally, 21.7% of respondents reported having previously sustained a stress fracture prior to taking part in this study.ConclusionThere is a high prevalence of injuries in junior UK track and field athletes, with most injuries affecting the lower limb. Although there was no difference noted in injury risk for athletes with menstrual dysfunction or disordered eating, the prevalence of bone injuries was alarmingly high. This study indicates the requirement for future research investigating RED-S within this population.ReferenceZemper, E. Track andField Injuries. In: Caine DJ, Maffulli N. (eds). Epidemiology of Pediatric Sports Injuries. Individual Sports. Med Sport Science: Volume 48. Basel, Karger; 2005. p. 138–151D’Souza D. Track and field athletics injuries - a one-year survey. British Journal of Sports Medicine 1994; 28 (3): 197–202.Mountjoy M, Sundgot-Borgen J, Burke L, et al. The IOC consensus statement: beyond the Female Athlete Triad—Relative Energy Deficiency in Sport (RED-S). British Journal of Sports Medicine 2014; 48: 491–497.

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