Impact of relative energy deficiency related to sport (RED-S) on biochemical parameters in professional handball athletes from a community university in the Itajaí Valley – SC

  • Bruno Frantz Safanelli Discente do Curso de Nutrição da Universidade do Vale do Itajaí (UNIVALI), Itajaí, Santa Catarina, Brasil.
  • Enrico de Oliveira Becker Discente do Curso de Nutrição da Universidade do Vale do Itajaí (UNIVALI), Itajaí, Santa Catarina, Brasil.
  • Giovana Vechi Docente do Curso de Nutrição da Universidade do Vale do Itajaí (UNIVALI), Itajaí, Santa Catarina, Brasil.
Keywords: Biochemical markers, Athletes, Sports nutrition, Nutritional evaluation, Handball

Abstract

Energy deficit presents deleterious physiological consequences, which in the sports context may lead to Relative Energy Deficiency in Sport (RED-S), impacting both health and athletic performance. Aiming to understand if the energy deficit can influence the levels of biochemical parameters in handball athletes, this quantitative cross-sectional study was conducted with adult male handball athletes. All adult athletes from the handball team of a community university in Itajaí-SC were invited to participate in the research. Based on their dietary intake, body composition, and energy expenditure during exercise, energy availability (EA) was calculated, and according to the results, the athletes were divided into two groups: low energy availability (LEA), being athletes with EA below 30 kcal/kg, and adequate energy availability (AEA), being those with EA above 30 kcal/kg. Biochemical tests were collected simultaneously. 14 participants completed all stages of the study, of which 10 were assigned to the LEA group and 4 to the AEA group. Disparity was observed between the groups in the results of lipid profile, cortisol, total testosterone and free testosterone. Both groups presented low levels of vitamin D. The parameters of complete blood count, white blood cell count, platelets, platelet volume, ferritin, thyroid-stimulating hormone, creatinine, urea, SGOT, SGPT, and glucose showed no alterations. It was concluded that there was a tendency for reduced testosterone levels and worse lipid profile results in the DEB group, suggesting a physiological impact of this energy imbalance on biochemical parameters.

References

-Anderson, T.; Vrshek-Schallhorn, S.; Adams, W.M.; Goldfarb, A.H.; Wideman, L. The effect of acute exercise on the cortisol awakening response. European Journal of Applied Physiology. Vol. 123. Num. 05. 2023. p. 1027-1039.

-Arnaoutis, G.; Alepoudea, M.; Tambalis, K.D.; Sidossis, L.S. Dietary Intake, Body Composition, and Nutritional Knowledge of Elite Handball Players. Nutrients. Vol. 16. Num. 16. 2024. p. 1-16.

-Bezuglov, E. The relationship of testosterone levels with sprint performance in young professional track and field athletes. Physiology & Behavior. Vol. 271. 2023. p. 1-14.

-Burke, L.M.; Close, G.L.; Lundy, B.; Mooses, M.; Morton, J.P.; Tenforde, A.S. Relative Energy Deficiency in Sport in Male Athletes: A Commentary on Its Presentation Among Selected Groups of Male Athletes. Int J Sport Nutr Exerc Metab. Vol. 28. Num. 4. 2018. p. 364-374.

-Cupka, M.; Sedliak, M. Hungry runners - low energy availability in male endurance athletes and its impact on performance and testosterone: mini-review. Eur J Transl Myol. Vol. 33. Num. 2. 2023. p. 1-9.

-Fontana, L.; Villareal, D.T.; Das, S.K.; Smith, S.R.; Meydani, S.N.; Pittas, A.G.; Klein, S.; Bhapkar, M.; Rochon, J.; Ravussin, E.; Holloszy, J.O. Effects of 2-year calorie restriction on circulating levels of IGF-1, IGF-binding proteins and cortisol in nonobese men and women: a randomized clinical trial. Aging Cell. Vol. 15. Num. 1. 2015. p. 22-27.

-González, F.J.; Darido, S.C.; Oliveira, A.A.B. Esportes de invasão. 2a edição. Maringá. Editora da Universidade Estadual de Maringá. 2017.

-Heikura, I.A.; Stellingwerff, T.; Areta, J.L. Low energy availability in female athletes: From the lab to the field. Eur J Sport Sci. Vol. 22. Num. 5. 2022. p. 709-719.

-Herrmann, S.D.; Willis, E.A.; Ainsworth, B.E.; Barreira, T.V.; Hastert, M.; Kracht, C.L.; Schuna Junior, J.M.; Cai, Z.; Quan, M.; Tudor-Locke, C.; Whitt-Glover, M.C.; Jacobs Junior, D. R. 2024 Adult Compendium of Physical Activities: A third update of the energy costs of human activities. Journal of Sport and Health Science. Vol.13. Num. 1. 2024. p. 6-12.

-Holick, M.F.; Binkley, N.C; Bischoff-Ferrari, H.A.; Gordon, C.M.; Hanley, D.A.; Heaney, R.P.; Murad, M.H.; Weaver, C.M.. Evaluation, Treatment, and Prevention of Vitamin D Deficiency: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. Vol. 96. Num. 7. 2011. p. 1911-1930.

-Isola, V.; Hulmi, J.J.; Mbay, T.; Kyröläinen, H.; Häkkinen, K.; Ahola, V.; Helms, E.R.; Ahtiainen, J.P. Changes in hormonal profiles during competition preparation in physique athletes. Eur J Appl Physiol. Vol. 125. Num. 2. 2025. p. 393-408.

-Krzywański, J.; Mikulski, T.; Pokrywka, A.; Młyńczak, M.; Krysztofiak, H.; Frączek, B.; Ziemba, A. Vitamin B12 Status and Optimal Range for Hemoglobin Formation in Elite Athletes. Nutrients. Vol. 12. Num. 4. 2020. p. 1-13.

-Logue, D.M.; Madigan, S.M.; Melin, A.; Delahunt, E.; Heinen, M.; Mc Donnell, S.J.; Corish, C.A. Low Energy Availability in Athletes 2020: An Updated Narrative Review of Prevalence, Risk, Within-Day Energy Balance, Knowledge, and Impact on Sports Performance. Nutrients. Vol. 12. Num. 3. 2020. p. 1-19.

-Li, X.; Liu, Y.; Chen, X.; Reichetzeder, C.; Elitok, S.; Krämer, B.K.; Hocher, B. Target Values for 25-Hydroxy and 1,25-Dihydroxy Vitamin D Based on Their Associations with Inflammation and Calcium-Phosphate Metabolism. Nutrients. Vol. 16. Num. 16. 2024. p. 1-16.

-Loucks, A.B. Chapter 5: energy balance and energy availability. IN MAUGHAN, R. The encyclopaedia of sports medicine. New Jersey. John Wiley & Sons Ltd. 2013.

-Mountjoy, M.; Ackerman, K.E.; Bailey, D.M.; Burke, L.M.; Constantini, N.; Hackney, A.C.; Heikura, I.A.; Melin, A.; Pensgaard, A.M.; Stellingwerff, T.; Sundgot-Borgen, J.K.; Torstveit, M.K.; Jacobsen, A.U.; Verhagen, E.; Budgett, R.; Engebretsen, L.; Erdener, U. 2023 International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs). British Journal of Sports Medicine. Vol. 57. Num. 17. 2023. p. 1073-1097.

-Perrier, J.; Langeard, A.; Ouma, C.K.; Sesboüé, B.; Clochon, P.; Prevost, J.N.; Bertran, F.; Davenne, D.; Bessot, N. Effects of acute bouts of evening resistance or endurance exercises on sleep EEG and salivary cortisol. Front. Physiol. Vol. 15. 2024. p. 1-8.

-Quaresma, M.V.L.S.; Trindade, M.C.C.; Oliveira, E.P.; Dátillo, M.; Pimentel, G.D.; Brros, A.R.Z.; Barrella, A.B.; Mendes, R.R.; Campanholi, R.A.; Alvarenga, M.L.; Braggion, G.F.; Longo, S.; Santos, K.G.M.; Melo, C.M.; Gonçalves, L.S.; Juzwiak, C.R.; Joaquim, D.P.; Gonçalves, D.C.; Marins, J.C.B.; Buzzachera, C.F.; Carvalho, A.; Souza, H.S.; Costa, R.F.; Pinheiro, M.N.; Chináglia, C.F.P.; Stancanelli, M.; Lazarim, F. L.; Marchiori, V.; Reis e Silva, E. A.; Niehues, L.P.; Marques, C.G.; Nakamoto, F.P.; Mello, M.T.; Artioli, G.G.; Saunders, B.; Rogero, M.M.; Burini, R.C.; Ribeiro, S.M.L.; Santos, T.R. Diretrizes de prática clínica para nutrição esportiva: associação brasileira de nutrição esportiva. J. Phys. Educ. Vol. 36. 2025. p. 1-95.

-Schoeneck, M.; Iggman, D. The effects of foods on LDL cholesterol levels: A systematic review of the accumulated evidence from systematic reviews and meta-analyses of randomized controlled trials. Nutrition, Metabolism & Cardiovascular Diseases. Vol. 31. Num. 5. 2021. p. 1325-1338.

-Shabkhizan, R.; Haiaty, S.; Moslehian, M.S.; Bazmani, A.; Sadeghsoltani, F.; Bagheri, H.S.; Rahbarghazi, R.; Sakhinia E. The Beneficial and Adverse Effects of Autophagic Response to Caloric Restriction and Fasting. Advances in Nutrition. Vol. 14. Num. 4. 2023. p. 1211-1225.

-Sim, M.; Garvican-Lewis, L.A.; Cox, G.R.; Govus, A.; McKay, A.K.A.; Stellingwerff, T.; Peeling, P. Iron considerations for the athlete: a narrative review. European Journal of Applied Physiology. Vol. 119. Num. 7. 2019. p. 1463-1478.

-Solberg, A.; Reikvam, H. Iron Status and Physical Performance in Athletes. Life. Vol. 13. Num. 10. 2023. p. 1-18.

-Mafra, R.C.; Martins, I.; Vechi, G. Análise da composição corporal de atletas de handebol profissional de uma Universidade Comunitária do Vale do Itajaí antes e após intervenção nutricional. 2024. TCC. Universidade do Vale do Itajaí. Itajaí. 2024.

-Villareal, D.T.; Fontana, L.; Das, S.K.; Redman, L.; Smith, S.R.; Saltzman, E.; Bales, C.; Rochon, J.; Pieper, C.; Huang, M.; Lewis, M.; Schwartz, A.V. Effect of Two-Year Caloric Restriction on Bone Metabolism and Bone Mineral Density in Non-Obese Younger Adults: A Randomized Clinical Trial. Journal of Bone and Mineral Research. Vol. 31. Num. 1. 2016. p. 40-51.

-Wang, M.; Chee, J.; Tanaka, M.J.; Lee, Y.H.D. Relative Energy Deficiency in Sport (REDs) and knee injuries: current concepts for female athletes. Journal of ISAKOS. Vol. 9. Num. 4. 2024. p. 781-787.

-Yagüe, M.P.; Yurrita, L.C.; Cabañas ,M.J.C.; Cenzual, M.A.C. Role of Vitamin D in Athletes and Their Performance: Current Concepts and New Trends. Nutrients. Vol. 12. Num. 2. 2020. p. 1-17.

Published
2026-03-28
How to Cite
Safanelli, B. F., Becker, E. de O., & Vechi, G. (2026). Impact of relative energy deficiency related to sport (RED-S) on biochemical parameters in professional handball athletes from a community university in the Itajaí Valley – SC. RBNE - Brazilian Journal of Sports Nutrition, 20(121), 203-211. Retrieved from https://www.rbne.com.br/index.php/rbne/article/view/2594
Section
Scientific Articles - Original