The Role of Social Factors in Relative Energy Deficiency Risk for Female Collegiate Athletes


  • Lauren Masden, BA Department of Exercise Science, Bellarmine University, Louisville, Kentucky, USA
  • Allison Tripure BA, CSCS Department of Exercise Science, Bellarmine University, Louisville, Kentucky, USA
  • Sara Mahoney, PhD, FACSM Department of Exercise Science, Bellarmine University, Louisville, Kentucky, USA



RED-S, female athlete, low energy availability


BACKGROUND: Relative Energy Deficiency in Sport (RED-S) refers to compromised functioning of one’s metabolism, reproductive system, immune system, cardiovascular system and more due to a relative energy deficiency. Most prevailing RED-S research has focused on its physiological symptoms, yet little data exists regarding the psychological and social aspects that might contribute to its development.  The purpose of this study is to determine the role of psychosocial      factors in RED-S risk for female collegiate athletes.

METHODS: 105 female collegiate athletes under National Collegiate Athletic Association (NCAA) jurisdiction were surveyed representing a variety of varsity sports. All participants were assessed for low energy availability using the Low Energy Availability in Females Questionnaire (LEAF-Q) through an online survey battery, which also included sources of nutrition information scale (SONI scale), the revised group environment questionnaire (GEQ), and the revised exercise group social provisions scale (EXSPS questionnaire).      The participants were sorted into an At Risk (AR) and Not At Risk (NAR) group based on their LEAF-Q scores. One-tailed independent t-tests and chi square tests were used to determine the difference between AR and NAR for dependent measures, and multiple linear regression determined the relationship between risk of LEA and GEQ, EXSPS, and SONI.

RESULTS: Overall, 66 participants (62.8%) were at risk for LEA based on LEAF-Q scores. Significant differences were identified between the AR (11.5%; 66.7%) and NAR (40.0%; 37.0%) groups regarding comfort with discussing nutrition with coaches or teammates, respectively (p = 0.034, p = 0.035). However, none of the social measures predicted LEA risk (group cohesion: R = 0.04,  p = 0.92; social support: R = 1.85, p = 0.09; SONI: p = 0.136) Awareness of RED-S (using a Yes (1) or No (0) question) was also found to be not significantly different between the AR (0.28  ± 0.45, 29%) and NAR (0.39 ± 0.50, 41%) groups (p = 0.12).

CONCLUSION: Overall, risk for RED-S is high in female collegiate athletes, however group cohesion, social support, and the athletes’ sources of nutrition information did not predict RED-S incidence.


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How to Cite

The Role of Social Factors in Relative Energy Deficiency Risk for Female Collegiate Athletes. (2023). Journal of Women’s Sports Medicine, 3(3), 30-38.

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