Purpose:
Our aim is to improve our understanding of the prevalence and symptoms of RED-S in
international and Canadian athletes and para-athletes, along with developing screening tools
and treatment protocols to manage RED-S in order to improve athlete health, availability and
performance.
Objectives:
Assess the prevalence of self-reported RED-S health outcomes in international and
Canadian elite female and male athletes and para-athletes as well as recreational
athletes (Study A);
Assess the prevalence and severity of measured standard/basic RED-S health outcomes
including biomarkers and potential longitudinal (6-mo) tracking of outcomes across the
Canadian Olympic and Paralympic Sport Institute Network (COPSI) (Study B);
Implement a more advanced assessment, using novel RED-S assessment parameters in a
smaller cohort of key athletes, including potential longitudinal tracking over a 6-mo
period (Study C);
Assess longitudinal changes and the treatment of RED-S symptoms across a 6-month
follow-up period in a small cohort of elite Canadian athletes willing to partake in an
'holistic' RED-S treatment intervention arm (Study D);
Utilize the data created from Studies A,B,C,and D to develop and validate potentially
novel RED-S assessment parameters in order to further validate the 'new' IOC RED-S
clinical assessment tool (CAT) version 2 to aid in the diagnosis of RED-S.
Justification:
This study will be the first to systematically assess the prevalence and severity of outcomes
of RED-S in a large group of international and Canadian athletes and para-athletes (A), and
within the COPSI network (B,C), utilising physiological and performance tests and training
metrics for a more holistic assessment of potential outcomes (B,C,). This study will also aim
to strengthen the literature regarding to the time-course of changes in these outcomes
(B,C,D) and the efficacy of a simple nutritional intervention arm on these changes (D).
Finally, this multicentre project will be the largest to date in Canada and globally, and the
first to produce data on the prevalence of RED-S within the COPSI network (across A,B,C,D).
Research Design:
This is an observational study including online survey and physiological testing with
potential for follow-up in a subset of athletes. A separate study arm (study D) will be an
intervention arm with follow-up.
Statistical analysis:
Analysis will be a combination of basic statistics such as t-tests and ANOVA's, as well as
more advanced statistical modelling (e.g. stepwise regression modelling, with first
identifying collinearity among independent variables via the implementation of variance
inflation factors (VIFs)) as well as questionnaire-based statistics and potentially principal
components analysis (PCA) will be implemented.
Physiological data will be plotted against survey data to create links between RED-S symptoms
among various athlete groups (female vs male, able bodied vs disabled, sports groups, age
categories, etc.)