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Energy Availability and the Female Athlete

By USA Hockey, 04/21/17, 8:30AM MDT


RED-S and athlete health and wellness

Meeting energy requirements for female athletes is often challenging, especially teen athletes who are still growing. Athletes, parents, coaches, and health-care practitioners should be aware of the health implications that can arise when calorie intake does not meet the energy needs of training, competition, and normal growth.

Energy Availability (EA) is the term that describes the amount of calories remaining for body functions after deducting for calories used during exercise. When an athlete has low EA, performance can suffer, injuries can increase, and most importantly – normal health can be adversely affected.    

The International Olympic Committee (IOC) has combined these factors into the Relative Energy Deficiency in Sports (RED-S) – an evolution from the Female Athlete Triad. Although RED-S affects both genders, it has a higher prevalence in females.

The Female Athlete Triad consists of three inter-related components:  energy availability, menstrual function, and bone health. RED-S adds these three components to several physiological impairments, including metabolic rate, immunity, protein synthesis, and cardiovascular health. In simple terms, RED-S results when caloric intake is insufficient to support daily activity, healing, and health.

Bone health is a major concern in female athletes, specifically growing teens, because the ability to build bone mass is at its highest during teenage years. Insufficient EA can decrease bone mass, and a diet focused on intentionally restricting calories can be low in calcium and vitamin D, two nutrients essential to bone health.

When EA is low, estrogen levels can fall, leading to irregular or missed menstrual cycles and hormonal changes. Athletes should be aware of changes in their EA caused by such factors as training load, performance goals, in-season versus off-season needs, intentional or unintentional decreases in caloric intakes, and response to injury or illness.

Athletes often notice a change in performance before they recognize a health-related issue. The IOC position statement on RED-S identifies multiple negative effects:

  • Decreased muscle strength
  • Decreased glycogen stores
  • Decreased endurance performance
  • Decreased training response
  • Increased injury risk
  • Decreases in coordination
  • Decreased concentration
  • Depression and irritability

RED-S puts every athlete at risk. While most of the research is on female athletes, low EA can impact testosterone levels in men. Unlike missed menstrual cycles in female athletes, hormonal changes in male athletes can go unnoticed.

The IOC identifies the following factors to help ensure low-risk participation in sports:

  • Healthy eating habits with appropriate EA
  • Normal hormonal and metabolic function
  • Healthy bone density
  • Healthy musculoskeletal system

Moderate-risk factors in sports participation include:

  • Prolonged low percent body fat
  • Weight loss between 5-10 percent in one month
  • Changes in expected growth and development in adolescent athletes
  • Abnormal menstrual cycle in females
  • Abnormal hormone profile in males
  • Reduction in bone density
  • History of one or more stress fractures associated with hormonal dysfunction and/or low EA
  • Physical/psychological complications related to low EA/disordered eating
  • Prolonged relative energy deficiency
  • Disordered eating behaviors negatively affecting team members
  • Lack of progress in treatment and/or non-compliance

Athletes and their parents should work with their coaches and health-care practitioners to assess the demands of their sport and its training, and adapt caloric intakes to best meet the performance and health needs of the athlete.


The IOC Consensus Statement: Beyond the Female Athlete Triad – Relative Energy Deficiency in Sport (RED-S). National Center for Biotechnology Information, U.S. National Library of Medicine,

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COVID-19 and the 2020-21 Season

By Matt Leaf 04/02/2020, 11:30am MDT

Even with almost 50 years of involvement in hockey, you can’t plan for the current state of the world and the impact coronavirus has had on our game. I think it is safe to say that nothing prepares you for the changes that have taken place in our daily lives and the uncertainty of when things might return to normal. Or in this case, what will become the new “normal.”

Our expertise is hockey, so what we’ll address in this piece: the impact of the global pandemic on our game and how likely it will affect our game in the immediate future. 

USA Hockey continues to post information on COVID-19 on the main website. These updates keep our membership informed of specific programs and the changing safety recommendations that will be in place when hockey returns. Be sure to check back regularly for updates and other hockey information.

On the officiating front, much of what we are able to do from a program standpoint is connected to player events like national tournaments and player development camps. As you know, the national tournaments (along with the March, April and May IIHF World Championship events) were cancelled. The Officiating Program then canceled our two instructor training programs that were planned for late April and early May in Lake Placid, N.Y., and Colorado Springs, Colo. 

At this time, details for any potential summer development camps are still being determined. On the player side, several camps we are connected to were cancelled, and the few camps that are still in planning have been dramatically downsized. The Officiating Program continues to monitor the decisions made for players and will take advantage of any opportunity we have to salvage our summer camp program and maximize participation.

The good news is, we are confident we will have a 2020-21 season. All indications show no reason to delay registration. It will open as scheduled on or around May 26, followed by the open book exams and online seminar curriculum on June 1. 

SafeSport Training (required for anyone born in the year 2003 or earlier) and background screening (learn about the new national level screening program in the Q & A section) will also be available to complete at that time. If COVID-19 still has things slowed down in early June, it would be an ideal time to get these requirements completed.

The biggest unknown will be the timing in which we will be able to conduct seminars. The vast majority of rinks are currently closed, and many of them took this opportunity to remove ice to save operating costs and do maintenance. There is now doubt they will be prepared to quickly ramp up once they are allowed to do so, but as with most everything right now, the timing is uncertain. As a result, some of the earlier seminars may be pushed back a few weeks. The District Referees-in-Chief will secure ice times and facilities so we can provide seminar dates and locations as quickly as possible. We are also encouraging our instructors to think outside the box by providing some weeknight seminar options, and to look at other ways to best meet the needs of our members.

The Advanced Officiating Symposium, scheduled for Providence, R.I. in late July, is still going to plan. We will continue to monitor the situation, including local restrictions and travel advisories in the coming weeks, and we will announce any changes in advance to allow for alterations to travel arrangements. Click here for up-to-date information or to reserve your seat at the 2020 Advanced Officiating Symposium.

These are difficult times for everyone, and although our hockey family is important to us, it is a small fraction of the big picture that is impacting our daily lives. To quote Andy Dufresne in his letter for Red that he left under the big oak tree in The Shawshank Redemption: “Hope is a good thing, maybe the best of things, and no good thing ever dies.”

We hope you and your loved ones are safe and healthy. We hope the coronavirus is conquered with minimal loss of lives and a return to a prosperous normal as soon as possible. We hope your passion for the game of hockey will only grow as a result of its absence. We hope we are back on the ice in the coming months and that the 2020-21 season will be our best yet.

Thank you for your continued support of USA Hockey and don’t hesitate to contact us if there is anything we can do to make your hockey experience a better one. In the meantime, stay safe, stay healthy and be prepared to be back on the ice soon.

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By Tom Robinson 04/08/2020, 8:45am MDT

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USA Hockey Announces National Background Screening Program

By USA Hockey 04/02/2020, 12:00pm MDT

In order to comply with new requirements from the United States Olympic & Paralympic Committee (USOPC), USA Hockey will be implementing a national level background screening program. This program will replace all USAH Affiliate coordinated background screen programs.

Why must officials be screened?
Per USA Hockey and USOPC policy, all coaches, officials, board members, employees, volunteers, billets and anyone else who will have regular contact with, or authority over, minor athletes are required to submit a background screen before any contact with minor athletes.

Who is required to be screened?
Officials who are 18 years-old (or older) prior to June 1 of the current year.

Any official, 18 years-old (or older) without a completed valid background screen (national or USAH Affiliate coordinated) after April 1, 2019.

All national background screens are valid for two seasons, and starting on June 1, 2020 a national background screen must be completed and in good standing before receiving an officiating card and crest.

What are the timelines for launching the national background screen program?
Beginning on April 1, 2020, background screening will be conducted by our national background screen vendor, National Center for Safety Initiatives (NCSI), and information on background screening will be included following your registration.

As of March 22, 2020, applicants will no longer be able to submit new USA Hockey background screens through USAH Affiliate vendors, and will not be able to submit new screens through NCSI until April 1, 2020.

If you were screened after April 1, 2019 for the 2019-20 season, your screen is valid for the 2020-21 season, and you will not need to be screened under the new system until prior to the 2021-22 season. If your most recent screen is from prior to April 1, 2019, you will need to be screened under the new system, after April 1, 2020, in order to participate in the upcoming season.

All new screens submitted through the new NCSI national screening program after April 1, 2020 will be valid for two seasons.  For example, a screen submitted and approved on April 15, 2020 will be valid through the end of the 2021-22 season, which is August 31, 2022.

How can members complete their required background screen?
A link to submit for screening will be included in your membership registration confirmation email and posted in the drop-down menu under the OFFICIALS tab at

Background screens through NCSI under the national program will cost $30 for all domestic screens. For international screens (members who have lived outside of the U.S. for six consecutive months in any one county during the past 7 years) the flat rate fee is $150. If that country is solely Canada, the flat rate fee is $75.

Where can members go with questions about the national background screen program?
Please refer to the USA Hockey Background Screen webpage at

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