Russia has seen a steady increase in children's participation in organized sports. Aesthetic sports, which impose strict requirements on body shape and weight, are particularly popular among young female athletes. Intensive training combined with dietary restrictions creates a risk of relative energy deficiency in sport, a condition that negatively affects the reproductive, cardiovascular, and skeletal systems. This study assessed the prevalence and patterns of health disorders in adolescent girls aged 15–18 years engaged in aesthetic sports using healthcare utilization data from children's polyclinics in Vladikavkaz and in-depth clinical examinations. The study was conducted in two stages. The first analyzed healthcare visit records of 1,840 girls. The second involved a comprehensive examination of 240 aesthetic sport athletes, including questionnaires, anthropometry, bioimpedance analysis, ECG, echocardiography, lipid profile, vitamin D level, and bone mineral density. Among aesthetic sport athletes, 68.3% sought care for menstrual cycle disorders and 26.9% for musculoskeletal pain. Cycle disorders were identified in 47.9%, vitamin D deficiency in 78.3%, and body fat below 18% in 42.1%. Bradycardia was recorded in 22.9%, mitral valve prolapse in 15.8%, and dyslipidemia in 28.3%. Girls with cycle disorders had higher atherogenic lipid levels. Risk factors included low body fat, vitamin D deficiency, early training initiation, and meal skipping. These findings demonstrate a high prevalence of reproductive dysfunction, cardiovascular abnormalities, and deficiency conditions among adolescent girls in aesthetic sports, underscoring the need for RED-S screening in pediatric practice.
