What We Do

Our Areas of Research

Current Research on Female Athletes

  • Examining Biomarkers and RED-S Risk Profiles Across Training in Ultramarathoners
  • Women's Athletics Team Talks
  • Multi Omics of Relative Energy Deficiency in Sport
  • FASTR Pilot Study & Education Study
  • The Female Athlete Voice Project
  • Western States Ultramarathon Study
  • Pac-12 Healthy Runner Project
  • Assessing Triad/RED-S Return to Play Tools

Through this study we seek to learn more about the relationship between training volume and intensity and serum biomarkers as well as the prevalence of risk factors for Relative Energy Deficiency in Sport (REDs) in male and female ultramarathoners to improve health and performance. This study is currently underway and includes both a longitudinal and cross-sectional cohort of athletes participating in the 2024 Western States Endurance Run, a 100-mile running race from Olympic Valley, CA to Auburn, CA. We are following 15 female athletes in the 4 months leading up Western States. Participants complete 4 blood draws over the course of the study, track all training, complete 3 surveys, and 1 DXA scan for bone density. The cross-sectional cohort will be composed of 25 males and 25 additional females, all of whom will complete a baseline survey, 1 blood draw, and a DXA for bone density.

Are you a female athlete who is racing the 2024 Western States and is interested in participating in the cross-sectional cohort? Email fastrprogram@stanford.edu for more information!

This study utilizes feedback and perspectives from collegiate athletes on Stanford’s Women’s teams to guide athlete-driven team talks about sports science and sports medicine topics specific to female athlete health, performance, and well-being. To do this, athletes will first complete a pre-talk survey assessing topics of interest and interest in the field of female athlete research.  Then a 1 hour, round table discussion on topics chosen based on the survey responses will take place. After that, athletes will fill out a post-talk survey to determine feasibility and gain qualitative feedback. Some of the aims of this study are to determine what female athlete sports medicine and sports science topics collegiate female athletes feel are important and what topics they feel that they would benefit from learning more about as well as to determine areas of improvement where needs are not being met from the athlete perspective with regards to the information and knowledge they receive that is specific to the female athlete.

The Multi Omics of Relative Energy Deficiency in Sport (RED-S) study, led by Dr. Morgan Smith, Wu Tsai Human Performance Alliance postdoctoral fellow, is investigating molecular and non-molecular markers associated with RED-S in female endurance athletes. This study features four main arms: participant-completed questionnaires, imaging and exercise visits, physician interviews, and a 3-month at-home data collection, including menstrual cycle tracking and ovulation testing. The two primary aims of this study are to identify relationships between standard measures and molecular data, and to characterize molecular profiles of the various RED-S risk levels. Ultimately, this will allow for earlier detection and treatment for this syndrome, improving the overall health of female athletes impacted by RED-S.

The Female Athlete Science and Translational Research (FASTR) Pilot study aims to deliver a series of five educational videos with content from experts in the field and stories from top athletes to female athletes to reduce incidence of the Female Athlete Triad and bone stress injuries. In this pilot study we will measure engagement of female high school runners with the content as well as changes in their Triad knowledge, body image, self-compassion, and perspective on longevity in sport.

In a second round of recruitment, the FASTR Education Study included participants from 13 high schools across the US. Half of participants received the five educational videos and the other half received written handouts covering the same five female athlete specific topics. We measured engagement of female high school runners with the content as well as changes in their knowledge, body image, self-compassion, and self-reported impact on future behavior.

View the FASTR Educational Videos

The aim of the study is to utilize athlete voice and perspective to inform sports medicine, sports science research, and translational practice for female athletes. To hear directly from athletes, the study will use a 3-round Delphi survey of approximately 40 female USOPC athlete participants, ages 18 years of age or older, across a range of sports and demographics. This is a first step in developing a research agenda and translational processes that are co-constructed with elite female athletes with the goal of guiding future research projects and translational practices for female athletes at any age. This work is in collaboration with Julie McCleery, PhD out of the University of Washington and the Female Athlete Program at Boston Children’s Hospital. 

This study explores risk factors for low bone mineral density and prior bone stress injury in male and female ultramarathon runners participating in the Western States Endurance Run. This cross-sectional study incorporated a saliva genetic test, a DXA scan to measure bone mineral density of the lumbar spine, femoral neck, and total hip; lab draws to measure ferritin, vitamin D, estradiol, and total and free testosterone; and a pre-race survey to assess disordered eating traits, bone stress injuries, menstrual dysfunction in women, and training volume. Based on data from 2019 and 2021, the study showed that the genetic risk score in men was significantly correlated with BMD z-scores, but not in females. This suggests that other factors, including sex hormone levels and low energy availability, could be affecting bone health in female ultramarathon runners.

This study was featured in an Outside Magazine article about developing a “grand theory injury prevention” and looking beyond simple risk factors for injury.

Read the full scientific journal article in the Clinical Journal of Sports Medicine. 

In 2016, co-PI’s Dr. Michael Fredericson at Stanford and Dr. Aurelia Nattiv at UCLA received funding by the Pac-12 and AMSSM for the “Healthy Runner Project,” a prospective study at Stanford and UCLA in varsity distance runners to evaluate whether a nutritional intervention to increase energy availability could help improve bone mineral density and decrease the incidence and severity of bone stress injuries. Following promising results from the Healthy Runner Project, Stanford and UCLA received additional funding through a Pac-12 Student Athlete Health and Well-Being Grant to expand the program to other Pac-12 schools beginning Fall 2021. The two-year prospective study with a nutrition intervention was completed in 2022. Participating Pac-12 institutions included Stanford, UCLA, University of Washington, University of Utah, and Oregon State University. 

Read the results of this study in our journal article published in BMJ Open.

This study, in collaboration with the Female Athlete Program at Boston Children’s Hospital, will assess the use of two screening tools designed to identify female and male athletes as at risk for the Female Athlete Triad or RED-S and the efficacy of their use in a clinical setting. Our survey was designed to address these measures and take the first steps in determining how to apply them in a clinical setting. We recruited female and male athletes, ages 15-30 within Stanford and Boston Children’s clinics.

Translating Female Athlete Research for the Public

            → Click on each image to learn more or to contact the FASTR team

WE ARE HIRING! The FASTR Team is accepting applications for a Postdoctoral Fellowship in female athlete health and performance! Head on over to the link in our bio for more information about the role and how to apply. 

Don't forget to share this post and encourage any PhD students to apply! It will be a Summer 2025 start date! Deadline to apply is July 1st, 2024!
We're recruiting! We are looking for female athletes racing the 2024 Western States 100 to participate in the cross-sectional group of our research study! If you are eligible and interested please email us at fastrprogram@stanford.edu for more information.

Thank you to the @wutsaialliance for supporting this study.

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