Evaluating the Prevalence of Relative Energy Deficiency in Sport (RED-S) Among Varsity Athletes at the University of Windsor
Janelle Bykowski
Schulich School of Medicine & Dentistry
FUNDER: Schulich-UWindsor Opportunities for Research Excellence Program (SWORP)
GRANT DURATION: 2024-2025
Relative Energy Deficiency in Sport (RED-S) has been identified as a serious health condition among individuals competing in high performance athletics. The underlying cause of RED-S is low energy availability (LEA), which occurs when there is a sustained energy imbalance between dietary energy intake and the energy required to maintain daily activities and optimal physiological functioning. Several contributors to LEA have been recognized, including disordered eating, poor nutritional awareness, increased training volume, reduced food availability, and extensive competition schedules. Due to the myriad of negative health consequences associated with advanced RED-S (i.e. decreased bone health, reduced immunity, and impaired reproductive and neurocognitive function), early identification of individuals with multiple RED-S risk factors is important to optimize health outcomes and promote longevity in sport. Individuals competing in varsity sports are particularly susceptible to developing RED-S not only due to high training demands, but also due to added stressors associated with being student-athletes. Accordingly, the objective of the present study is to determine the prevalence of RED-S risk factors among varsity athletes at the University of Windsor to better support the health and performance goals of Lancer teams. Previously validated questionnaires (LEAF-Q for females and LEAM-Q for males) will be administered online to members of Lancer varsity teams during their off-season training. The questionnaires will be scored according to standard protocols, and the results will be used to assess the need for increased RED-S awareness and improved RED-S educational opportunities for University of Windsor athletes and healthcare professionals alike
To our knowledge, the prevalence of RED-S risk factors among different racial and ethnic groups has not been previously investigated. Nevertheless, since considerable racial and ethnic differences have been identified in regard to body composition (Vasishta et al., 2022), hormone profiles (Kim et al., 2012), and metabolism of carbohydrates, lipids and amino acids (Wulan et al., 2010), it is possible that individuals of certain races and ethnicities may be more susceptible to developing RED-S. To account for potential discrepancies due to social inequalities, we will also screen for pertinent markers of socioeconomic status (i.e. food insecurity). In addition, it will be interesting to determine whether there is a statistically significant association between the prevalence of RED-S risk factors and eligibility year. We might expect more senior athletes to have lower risk scores due to their demonstrated ability to compete at a high level in varsity sports over several years. However, it is also possible that their long-lasting participation in sport has resulted in the accumulation of RED-S risk factors that may have gone unrecognized due to insufficient understanding of RED-S symptomology. Lastly, this study will also contribute to better understanding the differences in low energy availability presentations and susceptibilities between males and females. While our understanding of bone health, menstrual dysfunction, and energy availability is fairly well established for female athletes, a comparable understanding of male athlete triad symptoms has not yet been well elucidated (Dave and Fisher, 2022).