Foundational Publications
Explore fundamental REDs publications that summarize both the research conducted on REDs thus far, as well as future directions of research. Find the key health and performance takeaways of these REDs papers among our summarized educational resources.
The IOC consensus statement: beyond the Female Athlete Triad—Relative Energy Deficiency in Sport
“The clinical phenomenon is not a ‘triad’ of the three entities of energy availability, menstrual function and bone health, but rather a syndrome that affects many aspects of physiological function, health and athletic performance.”
IOC consensus statement on relative energy deficiency in sport (RED-S): 2018 update
“An update(d) summary of the interim scientific progress in the field of relative energy deficiency with the ultimate goal of stimulating advances in RED-S awareness, clinical application and scientific research to address current gaps in knowledge.”
2023 International Olympic Committee’s (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs)
The 2023 IOC REDs Consensus statement builds upon the 2014 and 2018 papers, providing an overview of scientific progress, updated definitions and Conceptual Models, and introduces updated screening tools and a physiological model.
Avoiding the ‘REDs Card’. We all have a role in the mitigation of REDs in athletes
“We all have a role to play. Educate yourself and act through your role of influence in sport to prevent, recognise and mitigate the outcomes of REDs in your athletes. Avoiding the ‘REDs card’ will ultimately result in improved short-term and long-term athlete health and well-being, as well as safe optimisation of sports performance.”
Review of the scientific rationale, development and validation of the International Olympic Committee Relative Energy Deficiency in Sport Clinical Assessment Tool: V.2 (IOC REDs CAT2)—by a subgroup of the IOC consensus on REDs
“The aim of the IOC REDs CAT2 is to assist qualified clinical professionals in the early and accurate diagnosis of REDs, with an appropriate clinical severity and risk assessment, in order to protect athlete health and prevent prolonged and irreversible outcomes of REDs.”
Primary, secondary and tertiary prevention of Relative Energy Deficiency in Sport (REDs): a narrative review by a subgroup of the IOC consensus on REDs
“This narrative review addresses REDs primary, secondary and tertiary prevention strategies and recommends best practice prevention guidelines targeting the athlete health and performance team, athlete entourage (eg, coaches, parents, managers) and sport organisations.”
Methodology for studying Relative Energy Deficiency in Sport (REDs): a narrative review by a subgroup of the International Olympic Committee (IOC) consensus on REDs
“Researchers can use the compiled information herein when planning studies to more consistently select the proper tools to investigate their domain of interest. Thus, the goal of this review is to standardise REDs research methods to strengthen future studies and improve REDs prevention, diagnosis and care.”
Mapping the complexities of Relative Energy Deficiency in Sport (REDs): development of a physiological model by a subgroup of the International Olympic Committee (IOC) Consensus on REDs
“The REDs Physiological Model may assist the diagnosis of underlying causes of problems associated with LEA, with a personalised and nuanced treatment plan promoting compliance and treatment efficacy. It could also be used in the strategic prevention of REDs by drawing attention to scenarios of LEA in which impairments of health and performance are most likely, based on knowledge of the characteristics of the LEA exposure or moderating factors that may increase the risk of harmful outcomes.”
Best practice recommendations for body composition considerations in sport to reduce health and performance risks: a critical review, original survey and expert opinion by a subgroup of the IOC consensus on Relative Energy Deficiency in Sport (REDs)
“The ‘best practice’ guidelines stress the importance of a multidisciplinary athlete health and performance team, and the treatment of BC data as confidential medical information. The guidelines provide a health focus around BC, aiming to reduce the associated burden of disordered eating, problematic low energy availability and REDs.”
Intersection of mental health issues and Relative Energy Deficiency in Sport (REDs): a narrative review by a subgroup of the IOC consensus on REDs
“Overall athlete health is a stated priority by the International Olympic Committee (IOC), yet it can be difficult for athletes to safely balance nutritional needs, training load, recovery, social interactions, expectations and other demands. The effect of energy intake and, especially, low energy availability (LEA) on athlete mental health, is understudied. In this narrative review, we examine research that has included psychological factors and mental health variables when investigating the effect of LEA, dieting/restrictive eating and Relative Energy Deficiency in Sport (REDs), since the 2018 IOC consensus statement on REDs.”
REDs and the lactating athlete: an evidence gap
However, elite athletes have reported several barriers to training and competing while lactating, including (1) lack of access to lactation consultants, (2) lack of knowledge among healthcare providers on guiding lactation while meeting the training requirements of an elite athlete and (3) fear of sustaining a bone stress injury (BSI) while lactating.
#REDS: time for a revolution in sports culture and systems to improve athlete health and performance
“We need to implement awareness education adapted to female and male athletes of all ages and sport levels, and tailored for support staff, coaches and parents.”
Endocrine Effects of Relative Energy Deficiency in Sport
“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 energy availability.”
Relative Energy Deficiency in Sport: The Tip of an Iceberg
“The problems associated with RED-S resemble an iceberg: its true magnitude is largely hidden, and its devastating impact is likely underestimated.”
Low energy availability surrogates associated with lower bone mineral density and bone stress injury site
“Altogether, these data suggest that there could be a physiologic driver for why these high-risk bones are more commonly injured in energy deficient athletes than energy replete athletes.”