Key result
Low energy availability drives RED-S, impairing bone health, reproductive function, and athletic performance.
Why the study?
RED-S affects male and female athletes by causing physiological and psychological dysfunction due to low energy availability, impacting multiple body systems including cardiovascular function.
Does maintaining adequate energy availability and proper nutrition prevent physiological dysfunction and injury in athletes with RED-S?
Does maintaining adequate energy availability and proper nutrition prevent physiological dysfunction and injury in athletes with RED-S?
Maintaining adequate energy availability and proper nutrition is essential for preventing physiological dysfunction and injury associated with RED-S in athletes.
01 · ABSTRACT Abstract Background: Relative Energy Deficiency in Sport (RED-S) is a syndrome characterized by impaired physiological and psychological funding, resulting from low energy availability (LEA) in which dietary energy is insufficient to meet the demands of exercise and normal physiological processes. RED-S affects both male and female athletes and extends beyond the original "Female Athlete Triad" by impacting multiple body systems-metabolic, endocrine, reproductive, skeletal, immune and cardiovascular function. Methods: A literature search was conducted on peer-reviewed, English language studies published between 2020 and 2026, using keywords such as "RED-S and injury," "macronutrients and micronutrients and athletes, "RED-S and injuries," and "RED-S and stress fractures," and "antioxidants and athletes." Results: Thirty-nine articles meeting criteria were retrieved and analyzed to paint a picture of the manifestation of RED-S through LEA in men and women. Conclusions: Evidence supports the importance of maintaining adequate energy availability (EA), balanced macronutrient and sufficient micronutrient status to prevent physiological dysfunction and injury. Nutrition education and practical fueling are strategies are essential for supporting athlete health, minimizing injury risk and optimizing performance. ↓ Read PDF
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Cooper et al. (2026) conducted a review in Relative Energy Deficiency in Sport (RED-S) (n=36). Low energy availability vs. Adequate energy availability was evaluated. Low energy availability in male and female athletes leads to Relative Energy Deficiency in Sport (RED-S), causing physiological dysfunction, impaired bone and reproductive health, and decreased athletic performance.
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