Relative Energy Deficiency in Sport (RED-S) is a term expanded from the female athlete triad the is inclusive to males and females and the negative physiological symptoms impacting athlete health and performance from low energy availability. Bone health is one of the ten health consequences of RED-S. Therefore, the purpose of this study is to investigate RED-S in female and male collegiate athletes and determine if there is an association with bone health. Thirteen participants completed an electronic survey containing the LEAF-Q and EAT-26, a three-day food diary and exercise log, and a DXA scan. Energy intake and exercise expenditure was analyzed using an ESHA food analysis processor. Participants at risk for RED-S had higher occurrences of injuries (p<0.022) and lower Z-scores (p<0.063) than those not at risk for RED-S. In conclusion, athletes at risk for RED-S may have higher occurrences of injuries and lower bone mineral density.

Syfte och frågeställningar Studien syfte var att undersöka kunskapen om RED-S bland tränare inom svensk truppgymnastik och få en översikt om tränarna kände till Svenska Gymnastikförbundets eller Internationella Olympiska Kommitténs åtgärdsplan för identifiering, behandling och återgång till idrottande. Detta undersöktes med följande frågeställningar: 1) ”Hur mycket kunskap om RED-S har dagens tränare inom truppgymnastik?” 2) ”Skiljer tränares kunskaper åt beroende på kön, division och erfarenhet i år?” och 3) ”Har tränarnas förening en åtgärdsplan för RED-S?”. Metod En digital enkät baserad på liknande studier och IOC’s rekommendationer, skickades ut till både en sluten Facebookgrupp och via mail till föreningar på subelitnivå. Enkäten bestod av 28 frågor där de första åtta frågorna riktade sig mot tränarnas karaktärsdrag och de följande tjugo frågorna riktade sig mot kunskaper kring RED-S enligt IOC’s rekommendationer. All data analyserades i Google Excel och via SPSS. För att avgöra kunskapsnivån bland tränarna skapades ett poängsystem för frågorna om RED-S medan en icke parametriskt T-test genomfördes för att upptäcka eventuella kunskapsskillnader mellan gruppfördelningarna kön, division och erfarenhet. Resultat Inga tränare följde en åtgärdsplan för RED-S och ingen kände till Gymnastikförbundets eller IOC’s åtgärdsplan för RED-S. Det fanns inga kunskapsskillnader mellan gruppfördelningarna och utifrån resultaten är tränarnas kunskaper högre i frågor om återgång och behandling, men lägre i frågor om identifiering och grundläggande kunskaper. Av 35 deltagande var det endast 20% som tidigare hört talas om RED-S. Slutsats Denna studie upptäckte att det fanns kunskaper om RED-S men inte tillräckligt för att tränare skulle kunna hjälpa gymnaster som är utsatta eller löper risk för RED-S. Däremot var intresset att lära sig mer om ämnet högt bland deltagarna. På grund av bristande deltagande är studien inte representativ för svenska trupptränare på subelitnivå och kräver fler studier för att fastställa resultaten. / Aim The aim of the study was to investigate how much knowledge Swedish teamgym coaches have about the syndrome called RED-S. The study was also used to gather an overview of how many teamgym coaches that follow the action plan made to identify, treat and return to play, by either the Swedish gymnastics association or the International Olympic Committee. To reach the aim, three questions of the issue were made: 1) ”How much knowledge does teamgym coaches have about RED-S?” 2) ”Is there any difference between the coaches knowledge based on their gender, division or experience?” och 3) ”Does the coaches union have an action plan for RED-S?”. Method A digital survey based on similar studies and the recommendations by IOC, was shared on a private Facebook platform and also by email to unions competing in the sub-elite series. The survey included 28 questions where the first eight focused on the characteristics of the coach, while the next twenty questions were related to RED-S based on the recommendations from IOC. All data was analysed with Google Excel and run by SPSS. A point-system was created to determine the coaches knowledge of RED-S, while a non-parametric T-test was used to discover any differences between the coaches based on their characteristics; gender, division and experience. Result No coaches followed an action plan or were acknowledged about the action plan made by either the Swedish gymnastics association or IOC. There were no differences in knowledge based on the coaches characteristics and according to the results, the coaches had a higher knowledge with questions related to return to play and treatment, but lower in questions related to identification and basic information. Only 20% of the participants had ever heard of the syndrom RED-S before. Conclusion This study discovered that the coaches have some knowledge of RED-S, but not enough to be able to help gymnasts that have or are at risk to develop RED-S. There was a high interest among the coaches to learn more of the subject, but because of few participants these results won’t be able to represent Swedish teamgym coaches in the sub-elite. More studies needs to determine the results.

Bakgrund: Relative energy deficiency in sports (RED-S) är ett syndrom som förekommer inom många idrotter och olika idrottsliga nivåer. Konsekvenserna av detta syndrom är mångfacetterad, det kan påverka prestationen långsiktigt och kan orsaka skador och avslut på idrottskarriären. I forskningen är idrotter såsom löpning, estetiska idrotter och friidrottare de som är överrepresenterade i förhållande till RED-S. Kvinnor är generellt en underrepresenterad grupp inom idrottsmedicinsk forskning och detta motiverar till att studera just denna grupp.  Syfte: Syftet med denna undersökning var att undersöka i vilken utsträckning respondenterna hört talats om RED-S, samt att identifiera riskgrupper utifrån träningsmängd och idrottsutförande hos idrottande kvinnor inom fotboll, innebandy, friidrott och ridning, oavsett idrottslig nivå. Metod: Data insamlades med hjälp av en digitalbaserad enkät som besvarades av 44 deltagare. Enkäten bestod av 35 frågor och distribuerades i en sluten grupp som bestod av 16 000 + medlemmar samt en öppen grupp med 3 000 medlemmar och även via egna sociala medier. Resultat: Av totalt 44 deltagare fick 24 deltagare en poäng ≥8 utifrån frågeformuläret Low Energy availability in females questionnaire (LEAF-Q), enligt enkätens poängssystem indikerar detta en förhöjd risk att utveckla RED-S. Den överrepresenterade idrotten var ridsporten med 22 deltagare. Den ojämna fördelningen gjorde det svårt att generalisera några resultat för träningsmängd och idrottskategori. Av totalt 44 deltagare var det endast sex deltagare som tidigare hade hört talats om RED-S i utbildningssyfte.  Diskussion: Mer än 50% av deltagarna hade en LEAF-Q poäng högre ≥8 och majoriteten var användare av någon form av preventivmedel vilket påverkade det slutgiltiga resultatet.  Konklusion: Av cirka 19 000 potentiella deltagare var det 44 svaranden, bortfallet var högt vilket innebär att resultatet blev missvisande. Det tenderar att finnas ett kunskapsglapp bland kvinnliga idrottare vad gäller kännedom om syndromet RED-S. Trots att resultatet av denna undersökning inte går att generalisera på en större population så finns det andra studier som indikerar liknande resultat. / Background: Relative energy deficiency in sports (RED-S) is a syndrome that occurs in many sports and different sports levels. The consequences of this syndrome are multifaceted, it can affect performance in the long term and can cause injuries and the end of the sports career. In the research, sports such as running, aesthetic sports and track and field athletes are those that are overrepresented in relation to RED-S. Women are generally an underrepresented group in sports medicine research and this motivates to study this particular group. Purpose: The purpose of this survey was to investigate the extent to which the respondents had heard about RED-S, and to identify risk groups based on the amount of training and sports performance of female athletes in football, floorball, athletics and horse riding, regardless of the level of sport. Method: Data were collected using a digital-based questionnaire that was answered by 44 participants. The survey consisted of 35 questions and was distributed in a closed group consisting of 16,000+ members as well as an open group with 3,000 members and via own social media. Results: Out of a total of 44 participants, 24 participants received a score ≥8 based on the Low Energy availability in females questionnaire (LEAF-Q), according to the questionnaire's scoring system, this indicates an increased risk of developing RED-S. The over-represented sport was equestrian with 22 participants. The uneven distribution made it difficult to generalize any results for training amount and sport category. Out of a total of 44 participants, only six participants had previously heard of RED-S for educational purposes. Discussion: More than 50% of the participants had a LEAF-Q score higher than ≥8 and the majority were users of some form of contraception, which affected the result. Conclusion: Out of approximately 19,000 potential participants, there were 44 respondents, the dropout rate was high, which means that the results were misleading. There tends to be a knowledge gap among female athletes in terms of awareness of RED-S syndrome. Although the results of this study cannot be generalized to a larger population, there are other studies that indicate similar results.

ABSTRACT Title: Relative Energy Deficiency in Female Collegiate Track & Field Athletes. Background: Energy deficiency and its consequences have long been studied in female athletes because of it’s potential for increasing risks of illness and injury. Sustaining an energy deficient diet while training and during competition may result in muscle loss and reduction in performance. Studies suggest that athletes competing in sports focusing on appearance or a lean physique are at high risk for energy deficiency. In 2014, the IOC developed the concept of ‘Relative Energy Deficiency in Sport’ (RED-S) to include new components not previously included in the Female Athlete Triad. A study has not yet been completed applying the RED-S paradigm in collegiate track and field athletes. Objective: The purpose of this study was to examine the prevalence of RED-S in female collegiate track and field athletes. It was hypothesized that the majority of collegiate track and field athletes experience RED-S. It was also hypothesized that a greater percentage of distance runners experience RED-S than other track and field athletes, including throwers, jumpers, and sprinters. The components of RED-S assessed were menstrual function, bone health, and energy expenditure. Methods: This study was a descriptive cross-sectional study, obtaining data through the use of a questionnaire and a relative energy expenditure index on a population of 12 female collegiate track and field athletes. Data were obtained through the use of a LEAF-Q questionnaire, a three-day food and exercise recall, and body composition analysis. Results: The 12 athletes were a combination of distance runners (n=5), throwers (n=2), and sprinters (n=5). Average subject characteristics were: age (20.6 ±1. 44 years), height (165.6 ±7.5cm), weight (63.58 ± 16.97kg), and body fat percentage (20.9± 7.2). Average energy intake over three days was 2146 kcal (±627), and the average predicted energy expenditure was 2380 kcal (±458). Average hours spent in a catabolic (52.8 ± 24.0), highly catabolic (37.5 ± 25.0), anabolic (19.2 ± 24.0), and highly anabolic state (12.4 ± 21.0). Subjects were in a negative energy balance state the majority of the days analyzed, and 75% of the population had at least one day of dietary recall below 45 kcal/kg FFM/day. Spearman’s rho analysis found a significant inverse correlation between Day 1 hours spent in optimal energy balance (± 400 kcal) and body fat percent (p=0.024, rs= -0.643), and significant positive correlation between Day 1 hours spent in optimal energy balance (± 400 kcal) and fat free mass percentage (p=0.03, rs=0.625). Spearman’s rho analysis also found an inverse correlation between Day 1 hours spent in an energy deficit (s= -0.626), and a positive correlation between Day 1 hours spent in an energy deficit and body fat percentage (p=0.026, rs=0.636). Seven out of twelve participants scored ≥ 8 on the LEAF-Q putting them at risk for RED-S. Conclusion: The study highlights the misleading effect of averaging multiple days of dietary recall on energy balance. When participant’s dietary recalls were assessed day by day the majority of hours were spent in a catabolic state, however when the three days of the recall were averaged the severity of the hours spent in a catabolic state lessened. The associations in this study are consistent with previous studies evaluating the relationships between energy balance deficits and body composition, indicating that longer duration spent in an energy deficit is associated with lower lean and higher fat mass. The findings from the LEAF-Q show that 58% of participants were at risk for RED-S, and half of all participants had or were experiencing menstrual dysfunction.

RED-S is a syndrome that stems from low energy availability (LEA) in athletes. It can impact numerous physiological and psychological functions, as well as negatively affect performance. Because RED-S is a relatively new syndrome, there are few studies showing the impact of RED-S on performance and physiological factors. The aim of this systematic review was to examine the consequences of induced LEA in relation to RED-S in male athletes. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, Five studies were deemed eligible based on inclusion and exclusion criteria. Studies measured risk of RED-S through body composition, bone mineral density, clinical biomarkers, and performance. Studies ranged in duration from 2- 8 weeks with a decrease in energy availability of 50% or 25%. Of the five studies investigated, data showed significant changes lactate metabolism and IGF-1,non-significant changes in body composition, and inconclusive changes in performance.

No description available.

O vermelho de alizarina S é um corante cuja cor é função do pH. É uma antraquinona sulfonada que possui dois grupos fenólicos ligados ao mesmo anel onde se encontra o grupo sulfônico. Usualmente é comercializado sob a forma de sal monossódico, também chamado alizarinossulfonato de sódio ou simplesmente vermelho de alizarina. Esse corante pode ser sintetizado pela oxidação e hidroxilação do antraceno, seguida de sua sulfonação. Ele é largamente empregado em histoquímica, análises quantitativas e em indústrias têxtil e de couros. Na indústria de couros, esse corante vem acompanhado de grandes cargas de íon cloreto, o que é vantajoso para a aplicação de eletrodos ADE&reg no tratamento eletroquímico e fotoquímico eletro-assistido desse corante, haja vista que esses eletrodos são capazes de produzir espécies de cloro ativo altamente oxidantes, como gás cloro em pH fortemente ácido (< 2,00). Nesse trabalho foram empregados tratamentos eletroquímicos (puro e eletroquímico foto-assistido) para tratar o vermelho de alizarina S. Foram feitos estudos de densidade de corrente, concentração de cloreto de sódio, temperatura e investigação da natureza dos processos eletroquímicos irradiados. Para monitorar as degradações foram empregadas as técnicas de UV-Vis, DQO, COT, AOX e CLAE-MS. Percebeu-se que a concentração de cloreto de sódio e a corrente influenciam diretamente na velocidade de descoloração. Também foi possível notar que a regra de Van\'t Hoff equilibra-se com a regra de solubilidade dos gases em estudos de temperatura. Observou-se ainda que a irradiação aumenta muito o rendimento oxidativo das degradações, além de diminuir a quantidade de AOX gerados no produto final. Notou-se também que diminuindo a concentração de corante, a constante de velocidade de descoloração aumenta. Para monitorar os materiais eletródicos, foram empregadas as técnicas de VC, EDX e MEV. Constatou-se que eletrodos de composição Ti/Ir1-xSb1-ySn1-zO2 com baixo teor de Ir não são mecânica e eletroquimicamente resistentes, sendo necessário aumentar a concentração desse elemento e de Sb no material eletródico para incrementar a eficiência e a estabilidade. Palavras chave: Vermelho de alizarina S, ânodo dimensionalmente estável, cloreto, tratamento eletroquímico, tratamento eletroquímico irradiado / Alizarin red S is a dye whose color is a function of pH. It is a sulfonated anthraquinone which has two phenolic groups connected to the same ring where there is the sulphonic group. It is usually commercialized in the form of monossodic salt, also called sodium alizarinessulphonate or simply alizarin red. This dye can be synthesized by oxidation and hidroxilation of anthracene, followed by sulphonation reaction. It is largely used in histochemistry, quantitative analysis, textile and leather industries. In leather industry, this dye is accompanied by large quantities of chloride ions, which is advantageous for the application of DSA&reg electrodes in electrochemical or photo-assisted electrochemical treatment. This electrodes are capable of producing chlorine species, highly active oxidants such as chlorine gas in strongly acid pH (< 2.00). In this work we employed pure electrochemical and photo-assisted electrochemical treatments to degrade alizarin red S. The current density, concentration of sodium chloride, temperature parameters and the nature of irradiated electrochemical process were studied. To monitor the degradation were employed techniques of UV-Vis, COD, TOC, AOX and HPLC-MS. It was noticed that the sodium chloride concentration and the current directly influence in the rate of discoloration. It was also possible to note that the Van\'t Hoff rule is balanced with the gases solubility rule in temperature studies. It was observed that irradiation increases the efficiency of oxidation and reduce the amount of AOX generated in the final product. It was also noted that lowering the concentration of dye, the discoloration rate constant increases. To monitor the electrodic materials were used CV, SEM and EDX techniques. It was found that electrodes of Ti/Ir1-(x+y)SbxSnyO2 with low quantities of Ir are not mechanically and electrochemically resistant. Because this, it is necessary to increase the concentration of Sb and Ir elements in electrodic material to increase efficiency and stability. Key words: Alizarin red S, dimensionally stable anode, chloride, electrochemical treatment, irradiated electrochemical treatment

O vermelho de alizarina S é um corante cuja cor é função do pH. É uma antraquinona sulfonada que possui dois grupos fenólicos ligados ao mesmo anel onde se encontra o grupo sulfônico. Usualmente é comercializado sob a forma de sal monossódico, também chamado alizarinossulfonato de sódio ou simplesmente vermelho de alizarina. Esse corante pode ser sintetizado pela oxidação e hidroxilação do antraceno, seguida de sua sulfonação. Ele é largamente empregado em histoquímica, análises quantitativas e em indústrias têxtil e de couros. Na indústria de couros, esse corante vem acompanhado de grandes cargas de íon cloreto, o que é vantajoso para a aplicação de eletrodos ADE&reg no tratamento eletroquímico e fotoquímico eletro-assistido desse corante, haja vista que esses eletrodos são capazes de produzir espécies de cloro ativo altamente oxidantes, como gás cloro em pH fortemente ácido (< 2,00). Nesse trabalho foram empregados tratamentos eletroquímicos (puro e eletroquímico foto-assistido) para tratar o vermelho de alizarina S. Foram feitos estudos de densidade de corrente, concentração de cloreto de sódio, temperatura e investigação da natureza dos processos eletroquímicos irradiados. Para monitorar as degradações foram empregadas as técnicas de UV-Vis, DQO, COT, AOX e CLAE-MS. Percebeu-se que a concentração de cloreto de sódio e a corrente influenciam diretamente na velocidade de descoloração. Também foi possível notar que a regra de Van\'t Hoff equilibra-se com a regra de solubilidade dos gases em estudos de temperatura. Observou-se ainda que a irradiação aumenta muito o rendimento oxidativo das degradações, além de diminuir a quantidade de AOX gerados no produto final. Notou-se também que diminuindo a concentração de corante, a constante de velocidade de descoloração aumenta. Para monitorar os materiais eletródicos, foram empregadas as técnicas de VC, EDX e MEV. Constatou-se que eletrodos de composição Ti/Ir1-xSb1-ySn1-zO2 com baixo teor de Ir não são mecânica e eletroquimicamente resistentes, sendo necessário aumentar a concentração desse elemento e de Sb no material eletródico para incrementar a eficiência e a estabilidade. Palavras chave: Vermelho de alizarina S, ânodo dimensionalmente estável, cloreto, tratamento eletroquímico, tratamento eletroquímico irradiado / Alizarin red S is a dye whose color is a function of pH. It is a sulfonated anthraquinone which has two phenolic groups connected to the same ring where there is the sulphonic group. It is usually commercialized in the form of monossodic salt, also called sodium alizarinessulphonate or simply alizarin red. This dye can be synthesized by oxidation and hidroxilation of anthracene, followed by sulphonation reaction. It is largely used in histochemistry, quantitative analysis, textile and leather industries. In leather industry, this dye is accompanied by large quantities of chloride ions, which is advantageous for the application of DSA&reg electrodes in electrochemical or photo-assisted electrochemical treatment. This electrodes are capable of producing chlorine species, highly active oxidants such as chlorine gas in strongly acid pH (< 2.00). In this work we employed pure electrochemical and photo-assisted electrochemical treatments to degrade alizarin red S. The current density, concentration of sodium chloride, temperature parameters and the nature of irradiated electrochemical process were studied. To monitor the degradation were employed techniques of UV-Vis, COD, TOC, AOX and HPLC-MS. It was noticed that the sodium chloride concentration and the current directly influence in the rate of discoloration. It was also possible to note that the Van\'t Hoff rule is balanced with the gases solubility rule in temperature studies. It was observed that irradiation increases the efficiency of oxidation and reduce the amount of AOX generated in the final product. It was also noted that lowering the concentration of dye, the discoloration rate constant increases. To monitor the electrodic materials were used CV, SEM and EDX techniques. It was found that electrodes of Ti/Ir1-(x+y)SbxSnyO2 with low quantities of Ir are not mechanically and electrochemically resistant. Because this, it is necessary to increase the concentration of Sb and Ir elements in electrodic material to increase efficiency and stability. Key words: Alizarin red S, dimensionally stable anode, chloride, electrochemical treatment, irradiated electrochemical treatment