The role of athlete support staff in the development and management of relative energy deficiency in sport (REDs) in female university endurance athletes

Relative energy deficiency in sports (REDs) occurs when energy intake is insufficient to support energy expenditure, impacting health and performance. Support staff – particularly coaches, can significantly influence athlete eating and training behaviors. This research aims to explore female athletes’ perspectives on support staff's role in the development and management of REDs, seeking to create guidelines for coaches and other support staff members that align with athlete comfort. This study utilized ego-centric network mapping followed by qualitative interviews with 20 female Canadian University cross-country athletes to explore: 1) what support staff are available for athletes and 2) athletes’ perspectives on how their support system relates to the prevention and management of REDs. Thematic analysis revealed four themes: 1) Athletes’ experiences and awareness of REDs 2) Factors relating to athlete comfort discussing REDs 3) Barriers to disclosure, and 4) Proactive and multidisciplinary care. Although the culture around REDs is improving, greater awareness and open dialogue is needed. Gender plays a role in athlete comfort, however, interpersonal relationships, and support staff's knowledge and openness to discuss REDs appear to be greater factors. Coaches hold a critical role in creating environments that facilitate open dialogue around REDs, emphasizing the long-term performance and health detriments.