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Health, SubjectiveNCT04766203

Relative Energy Deficiency in Sport Multicenter Study

A study testing Treatment of REDS using a holistic treatment arm in people with Health, Subjective and Nutrition Disorders, run by Trent Stellingwerff at 1 site in Canada.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Relative Energy Deficiency in Sport (RED-S) characterizes a range of negative health and performance outcomes that result from chronically low energy availability. RED-S concerns high performance junior and senior athletes across Canada and has a prevalence rate of 3-60%. Read more about this study

Who is it for?
Ages 15 years and olderHealthy volunteers can take part
What is being tested?
Treatment of REDS using a holistic treatment arm
Could I receive a placebo?
No, everyone receives an active treatment
How many people
2,000 participants
Where
1 siteCanada
Study dates
5 May 2021to 31 Jul 2022
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 15 years and older
  • All sexes
  • Healthy volunteers accepted
  • Child, Adult, Older adult

Who may be able to join

  • International or Canadian elite (National Sport Organization identified) and (Provincial Sport Organization / University varsity identified) Next Generation, or recreational athlete or para-athlete
  • Female or male athlete or para-athlete currently and actively training for and racing in an Olympic sports event
  • Age >15 years

Who cannot join

  • Under 15 years old
  • Pregnant

Trial locations and contacts

1 site in 1 country.

Trent Stellingwerff, Ph.D. contact

250-208-6674

tstellingwerff@csipacific.ca

Ida A Heikura, Ph.D. contact

778-587-8508

iheikura@csipacific.ca

Canada1 site, 1 recruiting
  • University of Victoria

    Victoria, British Columbia, V8W 2Y2

    Trent Stellingwerff, Ph.D., 250-220-6674, tstellingwerff@csipacific.ca

    Ida A Heikura, Ph.D., 778-587-8508, iheikura@csipacific.ca

    Recruiting

Other trials in Canada

About this study

Official title: Relative Energy Deficiency in Sport (RED-S) in International and Canadian High Performance Athletes: Prevalence, Health and Performance Implications

Relative Energy Deficiency in Sport (RED-S) characterizes a range of negative health and performance outcomes that result from chronically low energy availability. RED-S concerns high performance junior and senior athletes across Canada and has a prevalence rate of 3-60%. Our ability to assess and diagnose RED-S remains poor. Accordingly, we aim to create the best parameters to diagnose and manage RED-S; along with information of the prevalence and severity across Canada and globally. These outcomes are expected to have a significant positive impact on the health and performance of Canadian athletes in preparation for the Olympic Games in 2022 and beyond.

Read the detailed description

Purpose:

Our aim is to improve our understanding of the prevalence and symptoms of RED-S in international and Canadian athletes and para-athletes, along with developing screening tools and treatment protocols to manage RED-S in order to improve athlete health, availability and performance.

Objectives:

  1. Assess the prevalence of self-reported RED-S health outcomes in international and Canadian elite female and male athletes and para-athletes as well as recreational athletes (Study A);
  2. Assess the prevalence and severity of measured standard/basic RED-S health outcomes including biomarkers and potential longitudinal (6-mo) tracking of outcomes across the Canadian Olympic and Paralympic Sport Institute Network (COPSI) (Study B);
  3. Implement a more advanced assessment, using novel RED-S assessment parameters in a smaller cohort of key athletes, including potential longitudinal tracking over a 6-mo period (Study C);
  4. Assess longitudinal changes and the treatment of RED-S symptoms across a 6-month follow-up period in a small cohort of elite Canadian athletes willing to partake in an 'holistic' RED-S treatment intervention arm (Study D);
  5. Utilize the data created from Studies A,B,C,and D to develop and validate potentially novel RED-S assessment parameters in order to further validate the 'new' IOC RED-S clinical assessment tool (CAT) version 2 to aid in the diagnosis of RED-S.

Justification:

This study will be the first to systematically assess the prevalence and severity of outcomes of RED-S in a large group of international and Canadian athletes and para-athletes (A), and within the COPSI network (B,C), utilising physiological and performance tests and training metrics for a more holistic assessment of potential outcomes (B,C,). This study will also aim to strengthen the literature regarding to the time-course of changes in these outcomes (B,C,D) and the efficacy of a simple nutritional intervention arm on these changes (D). Finally, this multicentre project will be the largest to date in Canada and globally, and the first to produce data on the prevalence of RED-S within the COPSI network (across A,B,C,D).

Research Design:

This is an observational study including online survey and physiological testing with potential for follow-up in a subset of athletes. A separate study arm (study D) will be an intervention arm with follow-up.

Statistical analysis:

Analysis will be a combination of basic statistics such as t-tests and ANOVA's, as well as more advanced statistical modelling (e.g. stepwise regression modelling, with first identifying collinearity among independent variables via the implementation of variance inflation factors (VIFs)) as well as questionnaire-based statistics and potentially principal components analysis (PCA) will be implemented.

Physiological data will be plotted against survey data to create links between RED-S symptoms among various athlete groups (female vs male, able bodied vs disabled, sports groups, age categories, etc.)

Being tested
Treatment of REDS using a holistic treatment arm
Medical subject headings
Nutrition Disorders, Athletic Injuries, Endocrine System Diseases, Feeding and Eating Disorders, Sleep Hygiene, Cardiovascular Abnormalities, Fractures, Bone, Bone Diseases, Metabolic

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Treatment of REDS using a holistic treatment armBehavioural

    This arm aims to treat athletes with REDS symptoms by implementing a holistic, individualized nutrition intervention to improve energy availability and thus restore impaired body function due to REDS.

Study groups in NCT04766203
Study groupRoleWhat they receive
Global screening of high-performance athletes for REDSNo interventionThis arm collects data with an online survey to assess prevalence and signs and symptoms of REDS in elite female and male elite and recreational athletes and para-athletes over the age of 15 years across the world.
Basic screening of Canadian high-performance athletes for REDSNo interventionIn this study arm, varsity level to elite Canadian athletes and para-athletes will complete a baseline blood sample and potentially (where abnormalities are present) a follow-up 6 months later.
Advanced screening of Canadian high-performance athletes for REDSNo interventionIn this study arm, varsity level to elite Canadian athletes and para-athletes will complete a baseline test for bone density (DXA scans), resting metabolic rate and exercise testing. Potentially (where abnormalities are present) a follow-up 6 months later.
Treatment of Canadian athletes with REDS: a holistic intervention armExperimentalIn this arm, varsity level to elite Canadian athletes and para-athletes with REDS will participate in a nutritional intervention aiming to improve energy availability and thus, REDS status.
Receives: Behavioral: Treatment of REDS using a holistic treatment arm

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. REDS clinical assessment tool and REDS risk score

    a combination of validated and semi-validated questionnaires

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  2. Menstrual function in females

    via Low Energy Availability in Females Questionnaire (higher scores reflect higher risk of RED-S) and use of urinary ovulation strips to measure LH surge

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  3. Triiodothyronine concentrations

    Venous blood samples

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  4. Estrogen concentrations

    Venous blood samples

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  5. Testosterone concentrations

    Venous blood samples

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  6. Luteinizing hormone concentrations

    Venous blood samples

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  7. Follicle-stimulating hormone concentrations

    Venous blood samples

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  8. Sex-hormone binding globulin concentrations

    Venous blood samples

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  9. Hemoglobin concentrations

    Venous blood samples

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  10. Ferritin concentrations

    Venous blood samples

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  11. Serum iron concentrations

    Venous blood samples

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  12. Total iron binding capacity

    Venous blood samples

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  13. Iron saturation

    Venous blood samples

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  14. Total cholesterol concentrations

    Venous blood samples

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  15. LDL cholesterol concentrations

    Venous blood samples

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  16. HDL cholesterol concentrations

    Venous blood samples

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  17. Triglycerides concentrations

    Venous blood samples

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  18. Bone mineral density

    Dual energy x ray scan of lumbar spine and femoral neck bone density

    Measured: Baseline

  19. Resting metabolic rate

    Assessment done with a metabolic cart by collecting respiratory gases

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  20. Aerobic capacity

    maximal oxygen uptake test

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  21. Strength

    Maximal strength tests

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  22. Insulin like growth factor 1 concentrations

    Venous blood samples

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  23. Resting heart rate

    Heart rate monitor (Polar electro)

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  24. Blood pressure (systolic and diastolic)

    Blood pressure monitor

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  25. Bone stress injury history

    online questionnaire on type and number of injuries

    Measured: Baseline and possibly change after 6 months for a subset of athletes

Secondary outcomes (19)
  1. Body composition

    Via DXA or skinfold calipers

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  2. Complete blood count

    Venous blood samples

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  3. Insulin concentrations

    Venous blood samples

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  4. Glucose concentrations

    Venous blood samples

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  5. Cortisol concentrations

    Venous blood samples

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  6. Prolactin concentrations

    Venous blood samples

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  7. 25(OH)D concentrations

    Venous blood samples

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  8. illness history

    online questionnaire on frequency of illness in the past 24 months

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  9. Soft-tissue injury history

    online questionnaire on the type and number of injuries in the past 24 months

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  10. Sleep hygiene

    Athlete Sleep Screening Questionnaire (higher scores reflect sleep impairments)

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  11. Mental health

    Depression, anxiety and stress scale 21 (higher scores reflect increased mental challenges)

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  12. Male athlete health

    Low Energy Availability in Males Questionnaire (scoring is under development but higher scores reflect higher risk of REDS)

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  13. Gut health

    Sections from the LEAF-Q (higher scores reflect higher risk of REDS)

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  14. Cardiac health

    Questions from the Pre-Participation Examination questionnaire (higher scores reflect higher risk of cardiac symptoms)

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  15. Mood state

    Brunel Mood Scales (higher scores reflect higher mood disturbance)

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  16. Eating disorder assessment

    Eating Disorder Examination 3 (higher scores reflect higher risk of eating disorders)

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  17. History of weight change

    online questionnaire

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  18. History of anemia

    online questionnaire

    Measured: Baseline and possibly change after 6 months for a subset of athletes

  19. REDS treatment arm

    holistic nutrition based treatment of REDS symptoms including increasing energy availability via nutrition counselling

    Measured: Individualised but likely 3-6 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted23 Feb 2021
  2. Study start5 May 2021
  3. Primary completion31 Jul 2022 (estimated)
  4. Study completion31 Jul 2022 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Screening
Allocation
Non-randomised
Intervention model
Parallel groups
Model description
This study will be comprised of: 1) screening of athletes for symptoms of REDS; and 2) treating athletes diagnosed with REDS with a nutritional intervention
Masking
None (open label)
Enrolment
2,000 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04766203
Sponsor's protocol ID
RED-S multicenter 2020-22
Status last verified
Jun 2021
First submitted
16 Feb 2021
Last updated
2 Jun 2021
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: No data will be shared with researchers outside of the study team.

Questions about this trial

What is this clinical trial studying?

A study testing Treatment of REDS using a holistic treatment arm in people with Health, Subjective and Nutrition Disorders, run by Trent Stellingwerff at 1 site in Canada.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 2 Jun 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Trent Stellingwerff, Ph.D. (250-208-6674, tstellingwerff@csipacific.ca), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

REDS clinical assessment tool and REDS risk score (time frame: Baseline and possibly change after 6 months for a subset of athletes). The study lists 25 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Jun 2021.

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