794 EP050 – Consensus, compromise, or concession? balancing expert opinions and knowledges in relative energy deficiency in sport (red-s)

Background In response to growing international attention to relative energy deficiency in sport (RED-S), which is a syndrome that occurs due to low energy availability and is influenced by environmental and societal factors, sport organizations such as the International Olympic Committee (IOC) have generated consensus statements to help prevent, identify, and treat such conditions. However, developing consensus for such documents, particularly in the case of RED-S, remains a contentious issue given the heterogenous number of experts, organizations, and knowledges involved. Objective To understand how sociocultural and biological components are balanced in RED-S knowledge production and dissemination to develop "consensus." Design Textual analysis and interviews, both as qualitative research methods. Setting The current regulatory and sport medicine landscape on RED-S, particularly in IOC consensus statements. Participants Existing IOC consensus statements on RED-S (2014, 2015, 2018) and interviews with international experts on RED-S. Interventions To identify potential incongruences between expert knowledge and document texts, particularly in terms of preventing, diagnosing, and treating RED-S. Main Outcome Measurements To understand how and where document texts, especially those ostensibly meant to diagnose, treat, and prevent harmful situations and medical conditions, can be expanded or improved. Results Document texts often present a simplified version of expert knowledge(s), both in terms of the problem(s) presented and the corresponding solution(s), particularly in terms of the relationship between health and performance and who should be (most) "protected" through these documents. Conclusions Consensus statements on RED-S often prioritize medical and scientific interventions and knowledges, at the expense of widely recognized social, cultural, and political factors, which both illustrates the trends in expert knowledge and mitigates their acknowledgement of such considerations. Doing so minimizes the potential to prevent RED-S from manifesting in athletes, which is heavily influenced by environmental and cultural dimensions.