Family Medicine, McMaster University Michael G DeGroote School of Medicine, Waterloo, Ontario, Canada
Games Group, International Olympic Committee, Lausanne, Switzerland.
Br J Sports Med. 2023 Sep;57(17):1073-1097. doi: 10.1136/bjsports-2023-106994.
Relative Energy Deficiency in Sport (REDs) was first introduced in 2014 by the International Olympic Committee's expert writing panel, identifying a syndrome of deleterious health and performance outcomes experienced by female and male athletes exposed to low energy availability (LEA; inadequate energy intake in relation to exercise energy expenditure). Since the 2018 REDs consensus, there have been >170 original research publications advancing the field of REDs science, including emerging data demonstrating the growing role of low carbohydrate availability, further evidence of the interplay between mental health and REDs and more data elucidating the impact of LEA in males. Our knowledge of REDs signs and symptoms has resulted in updated Health and Performance Conceptual Models and the development of a novel Physiological Model. This Physiological Model is designed to demonstrate the complexity of either problematic or adaptable LEA exposure, coupled with individual moderating factors, leading to changes in health and performance outcomes. Guidelines for safe and effective body composition assessment to help prevent REDs are also outlined. A new REDs Clinical Assessment Tool-Version 2 is introduced to facilitate the detection and clinical diagnosis of REDs based on accumulated severity and risk stratification, with associated training and competition recommendations. Prevention and treatment principles of REDs are presented to encourage best practices for sports organisations and clinicians. Finally, methodological best practices for REDs research are outlined to stimulate future high-quality research to address important knowledge gaps.
运动性相对能量不足(REDs)于 2014 年由国际奥林匹克委员会的专家写作小组首次提出,确定了一种综合征,即暴露于低能量状态(能量摄入不足与运动能量消耗有关)的女性和男性运动员会出现有害的健康和表现结果。自 2018 年 REDs 共识以来,已有超过 170 项原始研究出版物推进了 REDs 科学领域的发展,包括新兴数据表明碳水化合物供应不足的作用越来越大,进一步证明心理健康与 REDs 的相互作用,以及更多数据阐明低能量状态对男性的影响。我们对 REDs 体征和症状的了解导致了更新的健康和表现概念模型的发展,以及新的生理模型的开发。该生理模型旨在展示有问题或适应性的低能量状态暴露的复杂性,加上个体调节因素,导致健康和表现结果的变化。还概述了用于安全有效地评估身体成分的指南,以帮助预防 REDs。引入了新的 REDs 临床评估工具版本 2,以根据累积严重程度和风险分层,方便 REDs 的检测和临床诊断,并提供相关的训练和比赛建议。提出了 REDs 的预防和治疗原则,以鼓励体育组织和临床医生采用最佳实践。最后,概述了 REDs 研究的方法学最佳实践,以激发未来高质量的研究,解决重要的知识空白。