What is REDS?
Relative Energy Deficiency in Sport
A syndrome of impaired physiological and psychological functioning caused by low energy availability (LEA) from inadequate dietary intake relative to exercise expenditure
What is LEA?
Low Energy Intake
A mismatch between energy intake and exercise expenditure, leaving inadequate energy for optimal health and performance
Athletes at highest risk for LEA
Teens, young women, endurance sports, lean physique sports (dance, gymnastics), weight-class sports, athletes with disordered eating, vegan/vegetarian athletes
Prevalence of disordered eating in athletes
15-62% of female athletes use pathological weight-control behaviours
What is eumenorrhea
Regular 21-35 day cycles
Describe the disordered-eating continuum
Healthy dieting → Restrictive eating → Abnormal eating → Clinical eating disorder
What is primary amenorrhea?
No period by age 15
What is secondary amenorrhea?
≥3 missed cycles
What is oligomenorrhea?
Cycles lasting >35 days (45 days in adolescents)
What is functional hypothalamic amenorrhea?
LEA-related suppression of menstruation
Consequences of REDS in males
Hormonal disruption (drop in testosterone)
Impaired immunity
Low bone density
Poor performance
REDS health consequences for females
Impaired metabolic rate
Menstrual dysfunction
Poor bone health
Gastrointestinal issues
Immune dysfunction
Psychological symptoms
Cardiovascular impairment
Poor growth/development
REDS performance consequences
Decreased: endurance, strength, power, coordination, concentration
Increased: injury risk, irritability
How does REDS affect body composition?
Decreased muscle and bone mass
Increased injury risk
Impaired recovery
Treatment of REDS
Restore energy availability (increase intake, decreased load)
Monitor menstrual function
Psychological therapy
Gradual, monitored return to training
REDS return to play protocol
Uses IOC CAT2 traffic-light system:
Green: Full participation
Yellow: Participation with modifications
Red: No participation until medically cleared
DE (Disordered eating) vs ED (Eating disorders)
DE are subclinical unhealthy eating behaviours, EDs are clinical eating disorders (anorexia, bulimia, binge-eating)
