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In the world of athletics, where milliseconds and millimeters often separate victory from defeat, athletes can push their bodies to the limits of human performance. The pursuit of excellence a lot of times includes disciplines such as grueling training sessions and meticulous meal planning. Unfortunately, for some athletes, they end up dealing with a silent struggle known as Relative Energy Deficiency in Sport or RED-S. RED-S usually occurs in athletes who are not eating enough to support both their training and basic metabolic needs and can increase the likelihood of hormonal imbalances, bone density loss, impaired metabolism, and injury risk

Thanks to some funding from the Texas Chapter of the American College of Sports Medicine and from the Toulouse Graduate School, Diana Kolb, a second-year master’s student as well as a standout member of the UNT swimming and diving team, came up with a project for her thesis. The project compares RED-S Risk Factors in physique-focused and non-physique-focused female collegiate athletes in North Texas. Kolb said she really wanted to focus on RED-S because it was important to her as an athlete.

“As athletes, we’re always wanting to be better, as athletes, you always want to be able to be the best and there’s always ways and other external factors that can influence that and I think RED-S was a really good way of adding the physiology part of it,” Kolb said.

Dr. Sarah Deemer, who is an Assistant Professor in the Kinesiology, Health Promotion and Recreation Department, acted as Diana’s supervising faculty member for her thesis and is also the Principal Investigator of the Integrative Metabolism and Disease Prevention Research Group lab. She says RED-S is a serious issue that often leads to athletes having to take a break from competing.

“If an athlete has RED-S, it is my understanding that generally you have to just remove them from the sport for a while,” Deemer said. “You have to get them healthy again because if they continue to participate in the sport, they are putting themselves at more and more risk for injury and for really detrimental health outcomes.”

Earlier this year, Diana defended her thesis which found that the prevalence of RED-S risk factors was not different between physique-focused and non-physique-focused female athletes competing at universities in the North Texas region. Although overall risk was low in this group of athletes, her results highlight that factors beyond sport type—such as training demands, nutrition education, and individual behaviors—may play a crucial role in RED-S development, emphasizing the need for broader prevention strategies and education across all sports.