Application of Relative Energy Deficiency in Sport (REDs) Guidelines: A Scoping Review

Abstract

Introduction: Relative Energy Deficiency in Sport (REDs) is a multifactorial syndrome arising from low energy availability (LEA), leading to physiological, psychological, and performance impairments. Despite established clinical guidelines, integration into research is uneven, demonstrating a research-translation delay. This scoping review aimed to map how REDs guidelines have been operationalised in research and assess the consistency of their application across studies.Methods: Following the Preferred Reporting Items for Scoping Reviews, a systematic search of Medline, CINAHL, SPORTDiscus, and Scopus was conducted on 21 September 2025.Results: Thirty-two studies met the inclusion criteria. Twenty-six used mixed Triad/RED-S/REDs terminology, and twenty-six post-2014 studies continued using Triad terms. Five studies followed the Triad framework alone, seventeen studies followed a parallel use of Triad-based models alongside the 2014 and/or later IOC REDs guidelines. LEAF-Q appeared in fifteen studies, only one CAT2. REDs awareness ranged from 10% to 92% across samples.Discussion: Overall, inconsistency in REDs terminology, screening and operational use of REDs guidelines is apparent in research, highlighting the need for standardised concepts and improved temporal delays in research-translation to support contemporary REDs research and ultimately strengthening athlete health outcomes.