Are Coaches of Female Athletes Informed of Relative Energy Deficiency in Sport? A Scoping Review

Click name to view affiliation

Jennifer Hamer Griffith University

Search for other papers by Jennifer Hamer in
Current site
Google Scholar
PubMed
Close
*
,
Ben Desbrow Griffith University

Search for other papers by Ben Desbrow in
Current site
Google Scholar
PubMed
Close
*
, and
Chris Irwin Griffith University

Search for other papers by Chris Irwin in
Current site
Google Scholar
PubMed
Close
*
Restricted access

In the last decade, there has been greater appreciation of the harmful consequences of Relative Energy Deficiency in Sport (RED-S), particularly in adolescent female athletes. Coaches act as both important moderators in the development of the condition and as identifiers of athletes at risk. Research suggests that coaches lack knowledge on this topic. At present, it is unclear if RED-S education is incorporated into coach accreditation pathways. The aim of this scoping review was to describe the extent to which RED-S education is incorporated into the coach accreditation pathways of endurance sporting organizations. Five national sporting organizations (Cycling Australia, Athletics Australia, Swimming Australia, Triathlon Australia, and Rowing Australia) were contacted to participate. First, each sporting organization’s website was scoped, then semi-structured interviews were conducted online. One investigator transcribed each interview verbatim. Transcripts were analyzed for thematic content. Four of the sporting organizations provided little to no RED-S education. Rowing Australia delivered a program of RED-S content via an affiliated sports dietitian. The barriers identified for implementation of RED-S content were: limited time, resources, and coaches’ preexisting knowledge and beliefs. Based on these results, RED-S education is, indeed, lacking in some coach accreditation programs for endurance-based sporting organizations. Support for these organizations is required to overcome existing barriers and to facilitate inclusion of RED-S education within the coaching curriculum to support female athlete health.

The authors are with Griffith University, Gold Coast, Queensland, Australia.

Hamer (Jennifer.hamer@griffithuni.edu.au) is corresponding author.
  • Collapse
  • Expand
  • Ackerman, K.E., Stellingwerff, T., Elliott-Sale, K.J., Baltzell, A., Cain, M., Goucher, K., … Mountjoy, M.L. (2020). #REDS (Relative Energy Deficiency in Sport): Time for a revolution in sports culture and systems to improve athlete health and performance. British Journal of Sports Medicine, 54(7), 369370. PubMed ID: 31924625 doi:10.1136/bjsports-2019-101926

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bengtsson, M. (2016). How to plan and perform a qualitative study using content analysis. NursingPlus Open, 2, 814. doi:10.1016/j.npls.2016.01.001

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Braun, V., & Clark, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77101. doi:10.1191/1478088706qp063oa

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Coppola, A., Ward, R., & Freysinger, V. (2014). Coaches’ communication of sport body image: Experiences of female athletes. Journal of Applied Sport Psychology, 26(1), 116. doi:10.1080/10413200.2013.766650

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Corbin, J., & Strauss, A. (2014). Basics of qualitative research: Techniques and procedures for developing grounded theory (4th ed.). Thousand Oaks, CA: SAGE Publications.

    • Search Google Scholar
    • Export Citation
  • Day, J., Wengreen, H., & Heath, E. (2016). Prevalence of low energy availability in collegiate female runners and implementation of nutrition education intervention. Sports Nutrition and Therapy, 1(1), 101. doi:10.4172/2473-6449.1000101

    • Crossref
    • Search Google Scholar
    • Export Citation
  • de Oliveira Coelho, G., de Abreu Soares, E., Ribeiro, B., & Gonçalves, B. (2010). Are female athletes at increased risk for disordered eating and its complications? Appetite, 55(3), 379387. PubMed ID: 20709126 doi:10.1016/j.appet.2010.08.003

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Desbrow, B., McCormack, J., Burke, L., Cox, G., Fallon, K., Hislop, M., … Leveritt, M. (2014). Sports dietitians Australia position statement: Sports nutrition for the adolescent athlete. International Journal of Sport Nutrition and Exercise Metabolism, 24(5), 570584. PubMed ID: 24668620 doi:10.1123/ijsnem.2014-0031

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Eime, R., Young, J., Harvey, J., Charity, M., & Payne, W. (2013). A systematic review of the psychological and social benefits of participation in sport for children and adolescents: Informing development of a conceptual model of health through sport. International Journal of Behavioral Nutrition and Physical Activity, 10(1), 98. PubMed ID: 23945179 doi:10.1186/1479-5868-10-98

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Galli, N., Petrie, T.A., Reel, J.J., Chatterton, J.M., & Baghurst, M. (2014). Assessing the validity of the weight pressures in sport scale for male athletes. Psychology of Men & Masculinity, 15(2), 170. doi:10.1037/a0031762

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Gastrich, M., Quick, V., Bachmann, G., & Moriarty, A. (2020). Nutritional risks among female athletes. Journal of Women’s Health, 29(5), 693702. PubMed ID: 32040354 doi:10.1089/jwh.2019.8180

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Gymnastics Australia. (2019). Gymnastics Australia body positive guidelines. Retrieved from http://www.gymnastics.org.au/Ga/Athletes/Body_Positive.aspx

    • Search Google Scholar
    • Export Citation
  • Heffner, J., Ogles, B., Gold, E., Marsden, K., & Johnson, M. (2003). Nutrition and eating in female college athletes: A survey of coaches. Eating Disorders, 11(3), 209220. PubMed ID: 16801252 doi:10.1080/10640260390218666

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Holtzman, B., Tenforde, A., Parziale, A., & Ackerman, K. (2019). Characterization of risk quantification differences using female athlete triad cumulative risk assessment and relative energy deficiency in sport clinical assessment tool. International Journal of Sport Nutrition and Exercise Metabolism, 29(6), 569575. doi:10.1123/ijsnem.2019-0002

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hughes, R., & Margetts, B. (2012). The public health nutrition intervention management bi-cycle: A model for training and practice improvement. Public Health Nutrition, 15(11), 19811988. PubMed ID: 21859511 doi:10.1017/S1368980011002011

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Keay, N., Francis, G., & Hind, K. (2018). Low energy availability assessed by a sport-specific questionnaire and clinical interview indicative of bone health, endocrine profile and cycling performance in competitive male cyclists. BMJ Open Sport & Exercise Medicine, 4(1), e000424. PubMed ID: 30364549 doi:10.1136/bmjsem-2018-000424

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kroshus, E., DeFreese, J., & Kerr, Z. (2018). Collegiate athletic trainers’ knowledge of the female athlete triad and relative energy deficiency in sport. Journal of Athletic Training, 53(1), 5159. PubMed ID: 29251536 doi:10.4085/1062-6050-52.11.29

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lassiter, J.W., & Watt, C.A. (2007). Student coaches’ knowledge, attitudes, skills, and behaviors regarding the female athlete triad. The Physical Educator, 64(3), 142151.

    • Search Google Scholar
    • Export Citation
  • Logue, D., Madigan, S., Delahunt, E., Heinen, M., Mc Donnell, S., & Corish, C. (2018). Low energy availability in athletes: A review of prevalence, dietary patterns, physiological health, and sports performance. Sports Medicine, 48(1), 7396. PubMed ID: 28983802 doi:10.1007/s40279-017-0790-3

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Logue, D., Madigan, S., Melin, A., Delahunt, E., Heinen, M., Donnell, S., & Corish, C. (2020). Low energy availability in athletes 2020: An updated narrative review of prevalence, risk, within-day energy balance, knowledge, and impact on sports performance. Nutrients, 12(3), 835. PubMed ID: 32245088 doi:10.3390/nu12030835

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Mallett, C., Trudel, P., Lyle, J., & Rynne, S. (2009). Formal vs. informal coach education. International Journal of Sports Science & Coaching, 4(3), 325364. doi:10.1260/174795409789623883

    • Crossref
    • Search Google Scholar
    • Export Citation
  • McMahon, J., & Penney, D. (2013). Body pedagogies, coaching and culture: Three Australian swimmers’ lived experiences. Physical Education and Sport Pedagogy, 18(3), 317335. doi:10.1080/17408989.2012.666786

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Melin, A., Heikura, I., Tenforde, A., & Mountjoy, M. (2019). Energy availability in athletics: Health, performance, and physique. International Journal of Sport Nutrition and Exercise Metabolism, 29(2), 152164. PubMed ID: 30632422 doi:10.1123/ijsnem.2018-0201

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Mountjoy, M., Costa, A., Budgett, R., Dvorak, J., Engebretsen, L., Miller, S., … Carr, J. (2018). Health promotion through sport: International sport federations’ priorities, actions and opportunities. British Journal of Sports Medicine, 52(1), 5460. PubMed ID: 28701361 doi:10.1136/bjsports-2017-097900

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Mountjoy, M., Sundgot-Borgen, J., Burke, L., Ackerman, K., Blauwet, C., Constantini, N., … Budgett, R. (2018). International Olympic Committee (IOC) consensus statement on relative energy deficiency in sport (RED-S): 2018 update. International Journal of Sport Nutrition & Exercise Metabolism, 28(4), 316331. PubMed ID: 29771168 doi:10.1123/ijsnem.2018-0136

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Mukherjee, S., Chand, V., Wong, X., Choong, P., Lau, V., Wang, S., … Ng, K. (2016). Perceptions, awareness and knowledge of the female athlete triad amongst coaches—Are we meeting the expectations for athlete safety? International Journal of Sports Science & Coaching, 11(4), 545551. doi:10.1177/1747954116654781

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Rocco, T. (2003). Qualitative research interviewing: Biographic narrative and semi-structured methods, by Tom Wengraf. Thousand…. Human Resource Development Quarterly, 14(1), 117122. doi:10.1002/hrdq.1054

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Thein-Nissenbaum, J., & Hammer, E. (2017). Treatment strategies for the female athlete triad in the adolescent athlete: Current perspectives. Open Access Journal of Sports Medicine, 8, 8595. PubMed ID: 28435337 doi:10.2147/OAJSM.S100026

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Torres-McGehee, T., Pritchett, K., Zippel, D., Minton, D., Cellamare, A., & Sibilia, M. (2012). Sports nutrition knowledge among collegiate athletes, coaches, athletic trainers, and strength and conditioning specialists. Journal of Athletic Training, 47(2), 205211. PubMed ID: 22488287 doi:10.4085/1062-6050-47.2.205

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Torstveit, M., Fahrenholtz, I., Lichtenstein, M., Stenqvist, T., & Melin, A. (2019). Exercise dependence, eating disorder symptoms and biomarkers of relative energy deficiency in sports (RED-S) among male endurance athletes. BMJ Open Sport & Exercise Medicine, 5(1), e000439. PubMed ID: 30792881 doi:10.1136/bmjsem-2018-000439

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Troy, K., Hoch, A., & Stavrakos, J. (2006). Awareness and comfort in treating the female athlete triad: Are we failing our athletes? The Wisconsin Medical Journal, 105(7), 2124. PubMed ID: 17163082

    • Search Google Scholar
    • Export Citation
  • Valois, R.F., Zullig, K.J., Huebner, E., & Drane, J.W. (2004). Physical activity behaviors and perceived life satisfaction among public high school adolescents. Journal of School Health, 74(2), 5965. PubMed ID: 15077500 doi:10.1111/j.1746-1561.2004.tb04201.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Wells, K., Jeacocke, N., Appaneal, R., Smith, H., Vlahovich, N., Burke, L., & Hughes, D. (2020). The Australian Institute of Sport (AIS) and National Eating Disorders Collaboration (NEDC) position statement on disordered eating in high performance sport. British Journal of Sports Medicine, 54(21), 12471258. PubMed ID: 32661127 doi:10.1136/bjsports-2019-101813

    • Crossref
    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 3318 1246 74
Full Text Views 1449 120 3
PDF Downloads 675 34 1