Preventing RED-S: The Dangers of Low Energy Availability in Male and Female Athletes

Abstract

Background: Relative Energy Deficiency in Sport (RED-S) is a syndrome characterized by impaired physiological and psychological funding, resulting from low energy availability (LEA) in which dietary energy is insufficient to meet the demands of exercise and normal physiological processes. RED-S affects both male and female athletes and extends beyond the original "Female Athlete Triad" by impacting multiple body systems-metabolic, endocrine, reproductive, skeletal, immune and cardiovascular function. Methods: A literature search was conducted on peer-reviewed, English language studies published between 2020 and 2026, using keywords such as "RED-S and injury," "macronutrients and micronutrients and athletes, "RED-S and injuries," and "RED-S and stress fractures," and "antioxidants and athletes." Results: Thirty-nine articles meeting criteria were retrieved and analyzed to paint a picture of the manifestation of RED-S through LEA in men and women. Conclusions: Evidence supports the importance of maintaining adequate energy availability (EA), balanced macronutrient and sufficient micronutrient status to prevent physiological dysfunction and injury. Nutrition education and practical fueling are strategies are essential for supporting athlete health, minimizing injury risk and optimizing performance.