The RED-S Protocol: A Standardized Approach for Female College Athletics

Relative Energy Deficiency in Sport (RED-S) is an insidious but sinister condition that will affect a significant amount of female college athletes during their careers. Despite its prevalence, there is no standardized approach to screening for and managing this disorder in college athletics. In a novel protocol implemented at a college in the Mountain West, 86% (n=44) of the total female student-athlete population was screened for RED-S and its precursors using validated questionnaires (LEAF-Q and EAT-26). Inclusion criteria were all female athletes over the age of 18. Following the screening questionnaires, subjects were encouraged to attend a follow-up interview to discuss their results. The questionnaires identified 70% (n=31) of participants deemed at risk for this syndrome and should receive follow-up guidance. Of the 70% considered at risk, only 41% (n=13) attended the follow-up interview. Only 3% (n=1) sought help from the Wellness Center or Athletic Trainer after the interview. The results of this project confirmed that female college athletes are at risk for this threatening condition and are not receiving appropriate screening and care. This project also showed that a standardized approach to RED-S is a critical yet efficient and feasible option to improve the health and performance of female college athletes.