Evidence map›Paper›PMID 42544120›Full record

ReviewCureus2026

Relative Energy Deficiency in Sport (REDs) in Ultra-Trail Running: Implications for Performance, Injury, and Long-Term Health.

Rachael Cullinan

Abstract readReview
In one paragraph

Review in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

1 author.

Rachael CullinanOrthopaedics, Golden Jubilee National Hospital, Glasgow, GBR.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Ultra-trail running has experienced substantial global growth, yet the nutritional and physiological consequences of prolonged participation remain incompletely understood. Relative energy deficiency in sport (REDs), resulting from problematic low energy availability (LEA), has emerged as an important concern within endurance sports; however, evidence specific to ultra-trail athletes remains fragmented. This narrative review synthesises current evidence relating to the development, manifestations, and consequences of REDs in ultra-trail running. Available literature suggests that the combination of high training volumes, prolonged competition, inadequate energy intake, gastrointestinal limitations, sleep disruption, and environmental stressors may place ultra-trail athletes at heightened risk of chronic LEA. Consequences extend beyond impaired performance and recovery to include endocrine dysfunction, compromised bone health, increased injury susceptibility, immune disturbance, and adverse psychological outcomes. Despite growing recognition of REDs within endurance sport, prevalence estimates in ultra-trail populations remain poorly defined, and validated sport-specific screening and management strategies are lacking. Greater awareness among athletes, coaches, and healthcare professionals is required to facilitate earlier recognition and intervention. Future research should prioritise prospective studies, sport-specific diagnostic approaches, and targeted prevention strategies to better support athlete health, performance, and long-term participation in ultra-trail running.

Indexed as

athlete healthathlete health and performanceendurance runningendurance sportlow energy availabilityredsrelative energy deficiency in sportsports nutritiontrail runningultra marathon

Identifiers

PMID42544120
PMCPMC13428976

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.