Cognition on a Caloric Cliff: Analyzing the Impact of Self-Reported RED-S Risk Factors on Female Adolescent Athlete’s Cognition
Lila Fenimore
09/09/2026
Women are more susceptible to developing Alzheimer’s disease. Specifically, women are two to three times more likely to develop Alzheimer’s compared to their counterparts (Aggarwal, 2023). Estrogen levels in the female body have been studied by previous researchers to attempt to address the disparity. Their findings suggest that estrogen acts as a protective barrier from neurological decline for peri-menopausal women and may lead to a different chance for developing Alzheimer’s disease (McCellan, 2025). If the depletion of estrogen has a monumental impact on cognition in adulthood, the neurological role of estrogen in adolescence must also be examined. A biological driver of estrogen suppression in adolescence is hormonal imbalance. While the causes of a disruption of hormonal levels in young females may vary, a common incidence is inadequate nutrition. Many active female youth develop Relative Energy Deficiency in Sport (RED-S) - a condition that develops due to a caloric imbalance in the body (Mountjoy et al., 2014) - which in some cases, may lead to a decrease in estrogen levels throughout a woman’s reproductive system (Gibson, 2025). This may mirror a similar sense of estrogen depletion that occurs in post-menopausal women, calling to question a similar relationship between cognitive decline and estrogen in adolescent females. This study aims to fill the gap in previous literature by examining RED-S lead and cognitive decline in female adolescent athletes. This inquiry led the researcher to arrive at their ultimate research question, “to what extent are self-reported RED-S risk factors associated with cognitive performance in adolescent female athletes?”