Relative Energy Deficiency in Sport (RED-S)

The condition known as the “female athlete triad” has been acknowledged since 1997 and is characterized by a set of three medical conditions: inadequate energy intake (with or without disordered eating), amenorrhea (the absence of menstruation), and decreased bone health.

In 2014, the International Olympic Committee (IOC) introduced what we now know as Relative Energy Deficiency in Sport (RED-S), which is a more comprehensive, and more inclusive condition as it can be diagnosed in both males and females. RED-S includes a series of impairments such as the above mentioned with female athlete triad (metabolic dysfunction, amenorrhea, and decreased bone health), along with reduced cardiovascular health, decreased protein synthesis, and a weakened immune system.

Why does this Happen?

RED-S can occur as a result of many factors such as the desire to enhance performance with inadequate nutrition, poor coaching, weight cycling, and overtraining. While there is limited research on RED-S due to it being a relatively new diagnosis, it is important to be aware of the consequences of underfeeding, overtraining, etc. in sport. Even if an individual does not present with all of the above-mentioned characteristics of RED-S, they could still be experiencing this deficiency, and an appropriate intervention must be implemented.

Mending the Issue

The importance of fueling the body correctly, experiencing signs of functioning hormones (having a period), maintaining bone and heart health, optimizing protein synthesis, and maintaining a strong immune system cannot be overstated. As coaches, we often have to have the hard conversation with clients that some of the methods they have been implementing for years (whether it be undereating, overtraining, etc.) must come to an end in order to reestablish health.

If you are currently experiencing any of the above-mentioned issues, it is highly likely that it is time to make a shift in your approach. Being that falling victim to inappropriate coaching is a risk factor for developing RED-S or for the deficiency persisting, it is of the utmost importance that you solicit the health of a qualified individual (or interdisciplinary team) in order to correct these adverse effects.

Your health is number one, do not let anything you see on social media tell you otherwise. Undereating and overtraining will not lead to you a long or healthy life. Be smart and listen to your body, you know when something isn’t right, and it is your job to be proactive with your health.