Abstract：
A high prevalence of low energy availability (LEA) has been reported in female football players. This is of concern as problematic LEA may evolve into a syndromic pattern known as relative energy deficiency in sport (REDs). Given the difficulties in accurately assessing LEA, our study shifts emphasis to measurable indicators of REDs, serving as proxies for health detriments caused by LEA. The present cross-sectional study aimed to quantify the risk of REDs and to assess the prevalence of indicators indicative of the syndrome. 60 players (tiers 3 and 4) from three Norwegian football teams were analyzed as a single cohort but also stratified based on player position and menstrual status. The proportion of players at risk for REDs was 22%, that is, 17% with mild, 3% with moderate to high, and 2% with very high/extreme risk, respectively. The majority of the cohort (71%) presented with no primary indicators, while 20%, 7%, and 2% presented with one, two, and three primary indicators, respectively. Regarding secondary indicators, 57% had none, 33% had one, and 10% had two indicators. For associated indicators, 30% had none, 42% had one, 18% had two, 8% had three, and 2% had four indicators. Player position did not affect the prevalence of REDs indicators. Among noncontraceptive users (n = 27), secondary amenorrhea (AME) was reported by 30%. These findings indicate that health and performance teams should prioritize universal health promoting strategies rather than selective or indicative strategies. Particularly, focus on nutritional periodization to secure sufficient energy availability, mitigating the risk of problematic LEA and REDs should be addressed.
摘要：
据报道，女子足球运动员普遍存在低能量可用性（LEA）。这是令人担忧的，因为有问题的LEA可能演变成一种称为运动中相对能量缺乏（REDs）的综合征模式。鉴于准确评估LEA的困难，我们的研究将重点转移到REDs的可衡量指标上，作为由LEA引起的健康损害的代理。本横断面研究旨在量化REDs的风险并评估指示该综合征的指标的患病率。将来自三个挪威足球队的60名球员（第3和第4层）作为一个队列进行了分析，但也根据球员的位置和月经状态进行了分层。处于RED风险中的玩家比例为22％，也就是说,17％，温和，3%与中等至高，2%的风险非常高/极端，分别。大多数队列(71%)没有主要指标，而20%,7%,2%的人提出了一个，两个,和三个主要指标，分别。关于二级指标，57%的人没有，33%有一个，10%有两个指标。对于相关指标，30%没有，42%有一个，18%有两个，8%有三个，2%有四项指标。球员位置不影响REDs指标的患病率。在非避孕使用者中（n=27），继发性闭经(AME)占30%.这些发现表明，卫生和绩效团队应优先考虑全民健康促进策略，而不是选择性或指示性策略。特别是,专注于营养周期化，以确保足够的能量供应，减轻有问题的LEA和RED的风险应该得到解决。
