Prevalence of Surrogate Markers of Relative Energy Deficiency in Male Norwegian Olympic-Level Athletes.

The syndrome of Relative Energy Deficiency in Sport (RED-S) includes wide-ranging effects on physiological and psychological functioning, performance, and general health. However, RED-S is understudied among male athletes at the highest performance levels. This cross-sectional study aimed to investigate surrogate RED-S markers prevalence in Norwegian male Olympic-level athletes. Athletes (N=44) aged 24.7±3.8 years, body mass 81.3±15.9kg, body fat 13.7±5.8%, and training volume 76.1±22.9 hours/month, were included. Assessed parameters included resting metabolic rate (RMR), body composition, and bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA) and venous blood variables (testosterone, free triiodothyronine (fT3), cortisol and lipids). Seven athletes (16%) grouped by the presence of low RMR (RMRratio <-1) was found in 16% of the athletes, all with normal RMR. Subclinical low testosterone and fT3 levels were found in nine (25%) and two (5%) athletes, respectively. Subclinical high cortisol was found in 23% of athletes while 34% had elevated LDL cholesterol levels. Seven of twelve athletes with 2 or more RED-S markers had normal RMR. In conclusion, this study found that multiple RED-S markers also exist in male Olympic-level athletes. This highlights the importance of regular screening of male elite athletes, to ensure early detection and treatment of RED-S.