Since the original publication of the IOC consensus statement on RED-S in 2014, there have been many scientific advances to improve our understanding of the health and performance effects of LEA in both female and male athletes. To address remaining gaps, the IOC RED-S consensus authors encourage scientific activity in the following domains: 1. Identification of athletes at risk for RED-S: It is evident that there is no practical tool for the measurement of EA, therefore, there is a recognized need to develop a methodology to screen and identify athletes at risk for RED-S that is both scientifically validated as well as relevant and applicable in clinical sport practice. 2. Prevention of RED-S: Improved awareness of RED-S is required through educational initiatives for athletes, coaches, members of the entourage, and sport organizations. The development of scientifically validated prevention interventions is encouraged. 3. Male athletes: Despite the improvement in the knowledge base of RED-S in male athletes, there remains a gap in our understanding of RED-S in specific sports with differing energy demands, performance criteria, ethnicities and cultural perspectives. 4. Health and performance consequences of RED-S: There is still much to be learned about the psychological and physiological health risks and long-term consequences of RED-S in all athletes, particularly male athletes, para athletes, and athletes of various races. To best engage the attention of athletes and coaches, it is imperative to further increase our understanding of the performance effects of RED-S. 5. Treatment and `return to play`: Practical guidelines for the treatment and safe return to play for athletes with RED-S need to be further developed to improve athletes` health and performance.
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