Project: LEAF long
The aim of the LEAF-long study is to investigate whether Relative Energy Deficiency in Sport (REDs) during the athletic career leads to impaired fertility, reduced bone and cardiovascular health, and psychosocial well-being later in life.
Project information
Project manager
Anna Melin
Other project members
Ylva Hellsten, Kamine Jacobsen, August Krogh, Section for Molecular Physiology, University of Copenhagen, Katarina Steding Ehrenborg, Department of Clinical Physiology, Lund University, Bård Solstad, Department of Sport Science and Physical Activity, University of Agder, Norway
Participating organisations
Linnaeus University, University of Copenhagen, Lund University
Financier
Centre for Sports Research
Timetable
1 Nov 2025 – 31 Dec 2026
Subject
Sport Science (with a fokus on eating disorders, relative energy deficiency, physiology, medicine) (Department of Sport Science, Faculty of Social Sciences)
Research group
Sustainable sport, performance and leadership
Knowledge Environment
Linnaeus Knowledge Environment: Sustainable Health
More about the project
REDs, caused by long-term low energy availability (LEA) with or without an eating disorder, can lead to menstrual disturbances, reduced protein synthesis, impaired bone health, cardiovascular risk factors, and negative effects on athletic performance and well-being.
Although REDs is common in sports — especially in disciplines where body weight and low fat mass can influence sport performance — knowledge about REDs remains limited. Only about 50% of coaches and physicians can correctly identify common clinical indicators of REDs, such as eating disorders and menstrual disturbances.
Infertility is a growing global public health issue. New research suggests that prolonged menstrual disturbances during an athletic career may contribute to fertility problems after retirement. Therefore, it is important to investigate the potential long-term consequences of REDs, not only regarding fertility but also bone and cardiovascular health, as well as psychosocial well-being.
The purpose of is therefore to conduct a longitudinal clinical follow-up study on a cohort of female endurance athletes who were examined in 2012–2013 (n=45; age 26.2 ± 5.5 years; BMI 20.6 ± 2.0 kg/m²; training volume 11.4 ± 4.5 hours/week). At that time, 63% of the athletes had clinically verified LEA, which was associated with gastrointestinal issues and dyslipidemia. Additionally, 25% had a diagnosed eating disorder, 60% had menstrual disturbances, and 45% had low bone mineral density, of which 17% met the criteria for osteoporosis.
The study will evaluate fertility and pregnancy-related outcomes, as well as bone, gastrointestinal, cardiovascular, and psychosocial health.
The project is part of the research conducted within the research group Sustainable sport, performance and leadership and the Linnaeus Knowledge Environment: Sustainable Health