What is RED-S?
RED-S stands for Relative Energy Deficiency in Sport. It’s a somewhat new term that was introduced by the International Olympic Committee (IOC) to give a name to the complex collection of impaired physical functions that occur due to a low energy intake in athletes (both male and female). RED-S is a more comprehensive term that builds on the condition known as the “Female Athlete Triad”.
According to the IOC, RED-S refers to “an energy deficiency relative to the balance between energy intake in the form of food and energy expenditure required for activities of daily living, healthy bodily functions, growth and sport activities such as training and competition”.
The amount of energy left over after exercise is called “Energy Availability”, and ideally we want a adequate Energy Availability otherwise health consequences can arise.
Possible signs of RED-S?
It is important to note that weight loss and/or a low body fat percentage are not good indications of RED-S. The body is very adaptable and will conserve itself for survival. The body is able to maintain weight even though Energy Availability is low. This is common in female athletes with menstrual disorders. The signs and symptoms listed below might be your body’s way of telling you to look closer at how you are managing your energy intake.
Health signs and symptoms of RED-S can include:
- Disordered thoughts and practices around food
- Slower metabolic rate
- Decreased immunity
- Impaired hormonal health (in males and females)
- Compromised menstrual function (in females)
- Poor bone health
- Problems with protein synthesis
- Cardiovascular complications
- Gastrointestinal issues.
Sporting/performance signs and symptoms of RED-S can include:
- Ongoing fatigue
- Inability to gain muscle
- Increased fat stores in the body and an inability to lose weight (especially pertinent to athletes who need to “make weight” for their sport)
- Stress fractures
- Increased injury risk
- Decreased strength, speed, agility, endurance
- Overall poor performance.
What can you do if you think you are experiencing RED-S? Nutrition might be a key factor! However, first and foremost it is important to receive a medical assessment to ensure your health is stable.
If nutrition is found to be the underlying cause, treatment should include increasing dietary intake of energy and/or decreasing energy expenditure by limiting exercise duration or quantity. One way to achieve this is to incorporate one or two additional snacks into the day, especially around exercise. Examples include a small tub of yoghurt, a handful of nuts and a banana. Or perhaps two slices of fruit toast topped with peanut butter and followed with an icy cold glass of milk.
Alternatively, small changes can be made to your regular meals – add cheese and avocado to sandwiches; roast vegetables in oil; eat fatty fish such as salmon instead of chicken, etc. These small changes shouldn’t affect gastrointestinal comfort, however they are a good start to increasing overall energy intake. Also remember to eat regularly, and incorporate both carbohydrates and protein into every meal.
If an athlete is experiencing RED-S on a more serious level, it is imperative that a treatment plan is devised and implemented via a medical team that includes a physician, qualified dietitian, and psychologist (if need be).
Although not every athlete and sports person is at risk of RED-S, it is still important to be aware of the signs and symptoms, and act accordingly if suspected. Sports should be beneficial for our bodies – not detrimental! By maintaining an adequate energy balance, you can enjoy good health and longevity in your sporting endeavours for many years to come.