{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T01:48:56Z","timestamp":1789177736473,"version":"build-2803163510"},"reference-count":53,"publisher":"BMJ","issue":"1","funder":[{"DOI":"10.13039\/501100001802","name":"University of Canberra","doi-asserted-by":"publisher","award":["Research Institute for Sport and Exercise (interna"],"award-info":[{"award-number":["Research Institute for Sport and Exercise (interna"]}],"id":[{"id":"10.13039\/501100001802","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009064","name":"Australian Institute of Sport","doi-asserted-by":"publisher","award":["High Performance Research Fund (Immune Health Mult"],"award-info":[{"award-number":["High Performance Research Fund (Immune Health Mult"]}],"id":[{"id":"10.13039\/100009064","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Sports Med"],"accepted":{"date-parts":[[2020,10,26]]},"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Athlete health, training continuity and performance can be impeded as a result of Relative Energy Deficiency in Sport (RED-S). Here we report the point prevalence of symptoms described by the RED-S model in a mixed-sport cohort of Australian female athletes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Elite and pre-elite female athletes (n=112) from eight sports completed validated questionnaires and underwent clinical assessment to assess the point prevalence of RED-S symptoms. Questionnaires included the Depression, Anxiety and Stress Questionnaire (DASS-21), Generalized Anxiety Disorder (GAD-7), Center for Epidemiological Studies Depression Scale (CES-D), SCOFF questionnaire for disordered eating, Low Energy Availability in Females Questionnaire (LEAF-Q), and a custom questionnaire on injury and illness. Clinical assessment comprised resting metabolic rate (RMR) assessment, dual-energy X-ray absorptiometry-derived body composition and bone mineral density, venous and capillary blood samples, and the Mini International Neuropsychiatric Interview (MINI 7.0.2). Descriptive prevalence statistics are presented.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Almost all (80%) participants (age 19 (range 15\u201332) years; mass 69.5\u00b110.3\u2009kg; body fat 23.1%\u00b15.0%) demonstrated at least one symptom consistent with RED-S, with 37% exhibiting between two and three symptoms. One participant demonstrated five symptoms. Impaired function of the immunological (28%, n<jats:italic>=<\/jats:italic>27), haematological (31%, n<jats:italic>=<\/jats:italic>33) and gastrointestinal (47%, n<jats:italic>=<\/jats:italic>51) systems were most prevalent. A moderate to high (11%\u201355%) prevalence of risk of low energy availability was identified via RMR and LEAF-Q, and identified mental illnesses were prevalent in one-third of the assessed cohort.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Symptoms described by the RED-S model were prevalent in this cohort, supporting the need for improved awareness, monitoring and management of these symptoms in this population.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bjsports-2019-101517","type":"journal-article","created":{"date-parts":[[2020,11,16]],"date-time":"2020-11-16T17:21:25Z","timestamp":1605547285000},"page":"38-45","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":69,"title":["Prevalence of impaired physiological function consistent with Relative Energy Deficiency in Sport (RED-S): an Australian elite and pre-elite cohort"],"prefix":"10.1136","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2566-4244","authenticated-orcid":false,"given":"Margot Anne","family":"Rogers","sequence":"first","affiliation":[{"name":"Sports Nutrition, Australian Institute of Sport, Bruce, Australian Capital Territory, Australia"},{"name":"Research Institute for Sport and Exercise, University of Canberra, Bruce, Australian Capital Territory, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3971-8303","authenticated-orcid":false,"given":"Renee Newcomer","family":"Appaneal","sequence":"additional","affiliation":[{"name":"Research Institute for Sport and Exercise, University of Canberra, Bruce, Australian Capital Territory, Australia"},{"name":"Applied Technology and Innovation, Australian Institute of Sport, Bruce, Australian Capital Territory, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Hughes","sequence":"additional","affiliation":[{"name":"Sports Medicine, Australian Institute of Sport, Bruce, Australian Capital Territory, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3996-3264","authenticated-orcid":false,"given":"Nicole","family":"Vlahovich","sequence":"additional","affiliation":[{"name":"Sports Medicine, Australian Institute of Sport, Bruce, Australian Capital Territory, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gordon","family":"Waddington","sequence":"additional","affiliation":[{"name":"Research Institute for Sport and Exercise, University of Canberra, Bruce, Australian Capital Territory, Australia"},{"name":"Sports Medicine, Australian Institute of Sport, Bruce, Australian Capital Territory, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8866-5637","authenticated-orcid":false,"given":"Louise M","family":"Burke","sequence":"additional","affiliation":[{"name":"Sports Nutrition, Australian Institute of Sport, Bruce, Australian Capital Territory, Australia"},{"name":"Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Drew","sequence":"additional","affiliation":[{"name":"Research Institute for Sport and Exercise, University of Canberra, Bruce, Australian Capital Territory, Australia"},{"name":"Applied Technology and Innovation, Australian Institute of Sport, Bruce, Australian Capital Territory, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,11,16]]},"reference":[{"key":"2025080115154255000_55.1.38.1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2014-093502"},{"key":"2025080115154255000_55.1.38.2","doi-asserted-by":"crossref","unstructured":"Mountjoy M , Sundgot-Borgen JK , Burke LM , et al . 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