Are Coaches of Female Athletes Informed of Relative Energy Deficiency in Sport? A Scoping Review

Abstract

In the last decade, there has been greater appreciation of the harmful consequences of Relative Energy Deficiency in Sport (RED-S), particularly in adolescent female athletes. Coaches act as both important moderators in the development of the condition and as identifiers of athletes at risk. Research suggests that coaches lack knowledge on this topic. At present, it is unclear if RED-S education is incorporated into coach accreditation pathways. The aim of this scoping review was to describe the extent to which RED-S education is incorporated into the coach accreditation pathways of endurance sporting organizations. Five national sporting organizations (Cycling Australia, Athletics Australia, Swimming Australia, Triathlon Australia, and Rowing Australia) were contacted to participate. First, each sporting organization’s website was scoped, then semi-structured interviews were conducted online. One investigator transcribed each interview verbatim. Transcripts were analyzed for thematic content. Four of the sporting organizations provided little to no RED-S education. Rowing Australia delivered a program of RED-S content via an affiliated sports dietitian. The barriers identified for implementation of RED-S content were: limited time, resources, and coaches’ preexisting knowledge and beliefs. Based on these results, RED-S education is, indeed, lacking in some coach accreditation programs for endurance-based sporting organizations. Support for these organizations is required to overcome existing barriers and to facilitate inclusion of RED-S education within the coaching curriculum to support female athlete health.

Effects of a 16-Week Digital Intervention on Sports Nutrition Knowledge and Behavior in Female Endurance Athletes with Risk of Relative Energy Deficiency in Sport (REDs)

“…In addition, due to increased knowledge of RED-S also among male athletes [2], future studies should also include male participants. Further, coaches from endurance sports who dictate the energy demands of training and are in a prime position to observe changes in athletes' health and performance, are not well enough educated about RED-S [77]. Cultural revolutions and changes in social norms are needed [25], and therefore, future studies should not only include individual athletes, but also their coaches, health professionals, entire teams, clubs, and sports organizations.…”

Relative Energy Deficiency in Sport (RED-S) in Adolescents – A Practical Review

“…Contributing factors may include the perceived low priority of RED-S amongst coaches and within organisations, as well as lack of coach education [33]. Many high school coaches in the US lack formal health education [28], and a review of five national sporting organisations in Australia found only one (rowing) had formal education on RED-S within their coach accreditation pathways [34]. Only 7 % of Summer Olympic International Sports Federations undertake health-related programmes, guidelines or research activity into RED-S [35].…”

Perspectives on relative energy deficiency in sport (RED-S): A qualitative case study of athletes, coaches and medical professionals from a super league netball club

“…These results corroborated those of Tenforde et al [ 13 ] and Gillbanks et al [ 10 ] who reported that over half of health care providers (doctor, nurse practitioners, physical therapist, athletic trainer) had not heard of RED-S. In specific reference to coaches, fewer studies exist, but the findings from those that have explored this group suggest that knowledge of RED-S is limited, and that coaches are more concerned with performance outcomes than the long-term health of athletes [ 6 , 14 , 15 ]. Whilst the limited knowledge and awareness might be justifiable in many instances given RED-S is relatively new and many perceived this topic to fall outside of their scope of practice, there is little doubt that greater knowledge and awareness could be integral to minimising the risk of RED-S and support the recovery process [ 16 ].…”