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Assessing Knowledge of Relative Energy Deficiency in Sport (REDs) in Health Professionals, Athletes and Coaches.

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Date

2025

Authors

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Hume, Patria
Horan, Jacinta
Sims, Stacy

Item type

Thesis

Degree name

Master of Health Science

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Publisher

Auckland University of Technology

Abstract

Relative energy deficiency in sport (REDs) is a syndrome characterised by impaired physiological function due to an extended period of low energy availability (LEA). LEA occurs when energy intake fails to meet the demands of exercise, triggering a cascade of negative health issues. Up to 60% of physically active women may experience menstrual irregularities in their lifetime, with LEA affecting between 22-58% of females, with some papers even estimating higher levels of LEA in the research (1-4). During periods of energy insufficiency, the body prioritises specific physiological systems, leading to negative effects on health and performance (5). Key concerns associated with REDs include bone stress injuries, hormonal and immune dysfunction, and negative psychological responses, potentially resulting in serious clinical outcomes like amenorrhea, eating disorders, and osteoporosis (5, 6). Social pressures to achieve a particular body shape and psychological factors can further exacerbate the condition. Firstly, through a systematic review, this thesis explored the current knowledge of REDs among athletes, coaches, and healthcare professionals. By identifying gaps in the existing literature, the research sought to contribute additional data and findings to enhance the current area of knowledge and further recommendations to improve this topic. The systematic review of nine eligible papers determined a lack of knowledge about REDs due to limited education regarding REDs across all subgroups of athletes, coaches, and healthcare professionals. However, the review was limited in scope, reflecting the current poor state of research on this topic. Secondly, 471 athletes, 29 coaches, and 134 healthcare professionals were surveyed, and the results reinforced the lack of knowledge surrounding REDs which was reviewed and discussed within this thesis. The study showed that 38.5% (n=329) of individuals learned about REDs independently, reflecting the current lack of courses and educational systems. This was apparent from the 49.3% of athletes who noted they did not feel supported by their coach or healthcare professionals, which is understandable considering that 70% of coaches and healthcare professionals reported not feeling confident in REDs referral pathways and discussion symptoms. As athletes are among the highest-risk groups and there are social pressures to maintain a particular physique, it is crucial to understand the knowledge and awareness that healthcare professionals, coaches, and athletes have on REDs. This thesis review and research data on REDs has identified gaps in education and support that need to be addressed to better support athletes. Additionally, the review found that informative resources are lacking across healthcare professionals, coaches, and athletes, with both systematic reviews and surveys indicating a demand for improved pathways to provide better overall care and education.

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http://hdl.handle.net/10292/19255

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Masters Theses