The impact of relative low energy intake on testosterone and cortisol biochemical biomarkers in athletes: an integrative review

  • Júlia Farret Refosco Zanatta Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brasil.
  • Giuseppe Potrick Stefani Grupo de Pesquisa em Estudos Olímpicos (GPEO), Escola de Ciências da Saúde e da Vida, PUC Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brasil.
Keywords: Relative Energy Deficiency in Sport, RED-S, Athletes, Testosterone, Cortisol

Abstract

The concept of Relative Energy Deficiency in Sport (RED-S), introduced in 2014, expanded the Female Athlete Triad to both sexes, resulting in low energy availability and causing hormonal, metabolic and reproductive dysfunctions, negatively affecting health and performance. Therefore, the objective was to conduct an integrative literature review on the impact of low relative energy intake on the biochemical biomarkers of testosterone and cortisol in athletes. Articles regarding the impact of low relative energy intake on the biochemical biomarkers of testosterone and cortisol in athletes on the subject were collected using the PubMed and Web of Science databases, with indexed terms such as "Athletes", "RED-S", "Biomarkers", "Cortisol" and "Testosterone". Of the 15 articles initially found, 8 were excluded, resulting in 7 articles included for the integrative review, covering a total of 267 athletes, 229 men and 38 women, with an average age of around 30 years. Most studies have shown that low energy availability leads to an increase in cortisol and a decrease in testosterone, especially in elite and endurance athletes, highlighting the risks of RED-S and the impact on sports performance and health. Low energy availability negatively impacts hormonal biomarkers, such as increased cortisol and decreased testosterone, particularly in elite and endurance athletes, reinforcing the need for adequate nutritional strategies to optimize performance and prevent the risks associated with RED-S.

Author Biography

Giuseppe Potrick Stefani, Grupo de Pesquisa em Estudos Olímpicos (GPEO), Escola de Ciências da Saúde e da Vida, PUC Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brasil.

Possui Graduação em Nutrição pela Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Especialização em Nutrição Clínica e Esportiva pelo Instituto de Pesquisas e Gestão em Saùde (iPGS), Mestrado em Ciências da Saúde com ênfase em Fisiologia e Fisiopatogênese (UFCSPA) e Doutorado em Ciências da Reabilitação com ênfase em Fundamentação da Reabilitação Cardiopulmonar e Metabólica (UFCSPA). Atualmente é docente de graduação da Escola de Ciências da Saúde e da Vida da Pontifí­cia Universidade Católica do Rio Grande do Sul (PUCRS). Também é coordenador do curso de Especialização em Nutrição Esportiva pela PUCRS. Tem experiência na área de Nutrição Esportiva com ênfase em Fisiologia do Exercí­cio, Fisiologia Cardiovascular atuando principalmente nos seguintes temas: suplementação, aminoácidos, treinamento de força, treinamento aeróbio, estresse oxidativo e insuficiência cardí­aca. Atualmente é revisor de periódicos nacionais e internacionais como The Journal of Nutrition, PLoS One, Journal of Physiology and Biochemistry, Biology Open, Ecological Indicators, Toxicology Mechanisms and Methods e International Journal of Cardiology. Possui qualificação internacional concedida pela Sociedade Internacional para Avanço da Cineantropometria (ISAK), sendo cineantropometrista ní­vel II.

References

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Published
2025-07-27
How to Cite
Zanatta, J. F. R., & Stefani, G. P. (2025). The impact of relative low energy intake on testosterone and cortisol biochemical biomarkers in athletes: an integrative review. RBNE - Brazilian Journal of Sports Nutrition, 19(116), 257-265. Retrieved from https://www.rbne.com.br/index.php/rbne/article/view/2439
Issue
Vol. 19 No. 116 (2025)
Section
Scientific Articles - Original

Copyright (c) 2025 Júlia Farret Refosco Zanatta, Giuseppe Potrick Stefani

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