Relative Energy Deficiency in Sport (RED-S)

[Andy]

Stumbled on this and thought it might be of interest to some.

From Wikipedia,

"Relative energy deficiency in sport (RED-S)[1][2] is a syndrome in which disordered eating (or low energy availability),[3] amenorrhoea/oligomenorrhoea (in women), and decreased bone mineral density (osteoporosis and osteopenia) are present.[4] It is caused by eating too little food to support the amount of energy being expended by an athlete, often at the urging of a coach or other authority figure who believes that athletes are more likely to win competitions when they have an extremely lean body type. RED-S is a serious illness with lifelong health consequences and can potentially be fatal.[5]

RED-S is the broader, more comprehensive name for what was formerly known as the female athlete triad (or simply the triad), which was a condition seen in females participating in sports that emphasize leanness or low body weight.[1][6] As the non-menstrual components are also seen in males, the name was changed to the comprehensive term RED-S"

....

"Clinical symptoms of RED-S may include disordered eating, fatigue, hair loss, cold hands and feet, dry skin, noticeable weight loss, increased healing time from injuries (e.g., lingering bruises), increased incidence of bone fracture and cessation of menses.[12] Affected athletes may also struggle with low self-esteem and depression.

Upon physical examination, a physician may also note the following symptoms: elevated carotene in the blood, anemia, orthostatic hypotension, electrolyte irregularities, hypoestrogenism, vaginal atrophy, and bradycardia."

https://en.wikipedia.org/wiki/Relative_energy_deficiency_in_sport

 

[Andy]

Relative energy deficiency in sports (RED-S): elucidation of endocrine changes affecting the health of males and females, 2020, Dipla et al

"The purpose of this review is to present a different perspective of the relative energy deficiency syndrome, to improve understanding of associated endocrine alterations, and to highlight the need for further research in this area. The term “female athlete triad” was coined over 25 years ago to describe three interrelated components: disordered eating, menstrual dysfunction, and low bone mass. The syndrome’s etiology is attributed to energy intake deficiency relative to energy expenditure required for health, function, and daily living. Recently, it became clear that there was a need to broaden the term, as the disorder is not an issue of only three interrelated problems but of a whole spectrum of insults resulting from low energy availability (LEA; i.e., insufficient energy availability to cover basic physiological demands) that can potentially affect any exerciser, irrespective of gender.

The new model, termed relative energy deficiency in sport (RED-S), has received greater scrutiny in sports medicine due to its effects on both health and performance in athletes of both sexes. RED-S results from low-energy diets (intentional or unintentional) and/or excessive exercise. Energy deficiency reduces hypothalamic pulsatile release of gonadotropin-releasing hormone, this impairing anterior pituitary release of gonadotropins. In women, reduced FSH and LH pulsatility produces hypoestrogenism, causing functional hypothalamic amenorrhea and decreased bone mass. In men, it reduces testosterone and negatively affects bone health. Moreover, LEA alters other hormonal pathways, causing physiological consequences, such as alteration of the thyroid hormone signaling pathways, leptin levels, carbohydrate metabolism, the growth hormone/insulin-like growth factor-1 axis, and sympathetic/parasympathetic tone. This review explains and clarifies the effects of RED-S in both sexes."

Paywall, https://link.springer.com/article/10.1007/s42000-020-00214-w

 

[Sly Saint]

Merged thread

RED-S: The condition all runners need to know about
You've heard it a million times before – if you want to run faster, you need to run more.

In a culture that promotes a ‘no excuses’ attitude towards working out, pushing yourself beyond your limits is often celebrated as a sign of discipline, grit and physical strength.

As we fixate on improving our performance and reaching new goals, we rarely consider the future losses of our present gains.

An unhealthy endurance athlete may seem like the ultimate paradox, but it’s a lot more common than you may think. RED-S is a syndrome that affects countless sports fanatics – many of whom don’t even know it exists.

What is RED-S?
RED-S refers to Relative Energy Deficiency in Sport, and it is exactly what it sounds like. Previously called the Female Athlete Triad, it is characterised by low energy availability due to a calorie deficit.

The condition, which was termed in 2014 by the International Olympic Committee, can affect both males and females, including elite and non-elite athletes. It can lead to irreparable damage, impairing almost every system in the body if left untreated.

With little known about RED-S in the general medical and athletic community, it often goes overlooked. It exists under the radar, only drawing attention after a drastic injury or mental collapse.

'It is still a relatively new condition,' explains Sports and Eating disorder specialist dietitian, Renee McGregor. 'It is a clinical condition within a sporting community, so only practitioners trained in both clinical and sports science/medicine will have a full understanding.'

However, as the evidence of its dangers mount, more people are speaking out to raise awareness about the syndrome.

One of these voices belongs to Team GB runner Pippa Woolven, who suffered from the debilitating condition for over five years. Woolven’s full-time job is now focused on improving awareness, prevention and recovery outcomes among sports and medical communities. Her recently established organisation, Project RED-S, provides a web platform signposting athletes to the right medical, nutritional and psychological support.

Here, she shares her own experience with RED-S with Runner’s World and tell us more about the project…

Warning signs of RED-S
RED-S manifests in a variety of physical and psychological symptoms, which unfortunately, often go unnoticed. Creeping up in the form of benign colds and general fatigue, it’s unlikely to sound any alarm bells at first.

'It was worryingly easy to dismiss the initial warning signs, since they were all relatively subtle in isolation,' Woolven says.

These seemingly minor symptoms are in fact indicative of the body slowly breaking down. 'Biological processes become depressed,' McGregor explains. 'When there is not enough energy in the system, digestion slows, resulting in bloating, discomfort and IBS symptoms.'

Stubborn sniffles and chronic coughs are another side effect of this deficit.

'The immune system also becomes impacted, which puts the individual at a higher risk of infections and illness.'

full article here
https://www.runnersworld.com/uk/health/a33589189/red-s-relative-energy-deficiency-running/

 

[Shadrach Loom]

This is going to sound horribly like gatekeeping, but I don’t like the potential consequences for pwME when things that sound like over-exertion or burnout get sympathetic attention and symptomatic definition.

 

[CRG]

The IOC consensus statement: beyond the Female Athlete Triad—Relative Energy Deficiency in Sport (RED-S)

Abstract

Protecting the health of the athlete is a goal of the International Olympic Committee (IOC). The IOC convened an expert panel to update the 2005 IOC Consensus Statement on the Female Athlete Triad. This Consensus Statement replaces the previous and provides guidelines to guide risk assessment, treatment and return-to-play decisions. The IOC expert working group introduces a broader, more comprehensive term for the condition previously known as ‘Female Athlete Triad’. The term ‘Relative Energy Deficiency in Sport’ (RED-S), points to the complexity involved and the fact that male athletes are also affected. The syndrome of RED-S refers to impaired physiological function including, but not limited to, metabolic rate, menstrual function, bone health, immunity, protein synthesis, cardiovascular health caused by relative energy deficiency. The cause of this syndrome is energy deficiency relative to the balance between dietary energy intake and energy expenditure required for health and activities of daily living, growth and sporting activities. Psychological consequences can either precede RED-S or be the result of RED-S. The clinical phenomenon is not a ‘triad’ of the three entities of energy availability, menstrual function and bone health, but rather a syndrome that affects many aspects of physiological function, health and athletic performance. This Consensus Statement also recommends practical clinical models for the management of affected athletes. The ‘Sport Risk Assessment and Return to Play Model’ categorises the syndrome into three groups and translates these classifications into clinical recommendations.