Relative Energy Deficiency in Sport among a Collegiate Cross-Country Team

Objective: To investigate risk for relative energy deficiency in sports (RED-S) among a team of female and male collegiate long-distance runners. Methods: North Dakota State University (Fargo, ND, USA) female and male competitive long-distance runners who agreed to participate during fall semester, 2019, completed an electronic survey containing the LEAF-Q and EAT-26 surveys and additionally completed a DXA scan, to screen for low energy availability and RED-S, disordered eating/eating disorders, and bone health, respectively. Participants were required to be 18 - 25 years old, not injured, training a mini-mum of five hours per week, and currently participating as part of a collegiate competitive team. Thirteen participants (male = 3) finished the study which also included energy intake and exercise expenditure self-reported with a three-day food diary and exercise log and estimated with ESHA Food Processor. Response rate was 42% of entire team; mean age 19.8. Results: The LEAF-Q significantly predicted risk for RED-S (p < 0.007). Correlations using the participants EAT-26 score, energy availability levels (p < 0.508), and whether they were at risk for RED-S (p < 0.208) or not were non-significant for all comparisons, although there was a moderate positive correlation between EAT-26 and RED-S risk (R = 0.454). Participants at risk for RED-S had higher occurrences of injuries (p < 0.022) and lower DXA measured Z-scores (p < 0.063) than those not at risk for RED-S. Conclusion: Long distance runners at risk for RED-S may have higher occurrences of injuries and lower bone mineral density, which can be easily measured using available screeners and DXA technology. What are the new findings: · Long distance runners at risk for RED-S may have higher occurrences of injuries and lower bone mineral density then age- and sex-matched individuals. How might it impact on clinical practice in the near future: · This is important for future clinical practice to be aware of the potential negative impacts on the bone development in young adults; · Particularly long-distance runners or athletes in leanness focused sports should be screened for energy availability which can impact performance, and future bone density.