Document Type

Thesis

Date of Degree Completion

Spring 2025

Degree Name

Master of Science (MS)

Department

Nutrition

Committee Chair

Kelly Pritchett

Second Committee Member

Katy Williams

Third Committee Member

Robert Pritchett

Abstract

Context: Alterations in energy intake (EI) and high exercise energy expenditure (EEE) may increase the risk of low energy availability (LEA) in Division II female collegiate ball sport athletes. Furthermore, chronic LEA can transition to problematic LEA, leading to Relative Energy Deficiency in Sport (REDs).

Objective: The purpose of this study was to assess the current severity and prevalence of REDs using the REDs CAT2 Tool and the Female Athlete Triad using the FAT CRA in Division II collegiate female volleyball, basketball, soccer, and rugby athletes.

Design: Cross-sectional design.

Setting: Research laboratory.

Patients or Other Participants: Twenty-seven, 18–24-year-old, Division II collegiate female athletes competing in volleyball, soccer, basketball, and rugby at Central Washington University.

Main Outcome Measure(s): Participants reported demographics; history of injuries, depression, and eating disorders (EDs); EDE-Q, LEAF-Q and DXA of the lumbar spine, hips, and whole body to determine REDs risk using the REDs CAT2 Tool and Triad risk using the FAT CRA.

Results: 85.2% (n=23) of athletes had no or low risk of REDs (green), while 15% (n=4) had a mild risk (yellow) based on the REDs CAT2 Tool. No athletes had a moderate (orange) or severe (red) risk of REDs. 88.9% of athletes had a low risk and 11.1% were at risk for the Triad based on the FAT CRA. An elevated EDE-Q global score was the most prevalent primary indicator. An increased EDE-Q global, dietary restraint, shape concern, and weight concern scores

Conclusion: Most ball sport athletes had no, or low risk of REDs based on the REDs CAT2 Tool, with similar results using the FAT CRA. However, nutrition education by a Registered Sports Dietitian is warranted for Division II NCAA athletes due to increased risk of DE in these athletes.

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