Objectives To determine the prevalence of REDs risk and sport-specific patterns of REDs-related indicators in Finnish national- and international-level female athletes and active non-athletes. Design Cross-sectional comparison of female baseline data from the NoREDS (Athletic Performance and Nutrition) cohort across endurance (n=50), speed and power (n=50), team and interval sports (n=37), and habitually active non-athletes (n=20). Methods REDs risk was assessed using the four-level REDs-CAT2 framework (green=no/low risk; yellow/orange/red=at risk). Clinical, hormonal, metabolic, and bone-related indicators were also examined descriptively. Group differences were tested using ANOVA/Kruskal-Wallis and U+03C7 ^2 tests, and odds of REDs risk were estimated using logistic regression. Results Overall, 70% of participants were classified as at risk of REDs. Prevalence was 82% among endurance athletes and 65% among non-endurance athletes, with endurance athletes having 2.4-fold higher odds of being at risk. Severe REDs risk occurred in 17.9% of endurance athletes, whereas none of the non-athletes were classified in the most severe category. Endurance athletes also showed the least favorable pattern of REDs-related indicators: 30% had self-reported amenorrhea, 48.9% had low triiodothyronine, and 44% had a low resting metabolic rate ratio. Bone stress injury was present in 47.6% of endurance athletes and 50% of speed and power athletes, compared with less than 20% in the other groups. Conclusions REDs risk was highly prevalent in Finnish Tier 3-4 female athletes across sport disciplines, but was most pronounced in endurance, speed, and power sports, supporting the need for sport-specific REDs screening and interpretation.
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