Relative energy deficiency syndrome - 2018 update from the IOC


In 2014, the IOC published a consensus statement entitled ‘Beyond the Female Athlete Triad: Relative Energy Deficiency in Sport (RED-S)’.

The syndrome of RED-S refers to ‘impaired physiological functioning caused by relative energy deficiency and includes, but is not limited to, impairments of metabolic rate, menstrual function, bone health, immunity, protein synthesis and cardiovascular health’. The aetiological factor of this syndrome is low energy availability (LEA).

The publication of the RED-S consensus statement stimulated activity in the field of Female Athlete Triad science, including some initial controversy followed by numerous scientific publications addressing:

  • The health parameters identified in the RED-S conceptual model (figure 1)
  • Relative energy deficiency in male athletes.
  • The measurement of LEA.
  • The performance parameters identified in the RED-S conceptual model (figure 2)

Simon Bartold
Director of Bartold Clinical