Introduction
In 2014, the International Olympic Committee defined Relative Energy Deficiency in Sport (REDS), the revised version of the female athlete triad, as "impaired physiological functioning caused by relative energy deficiency, and includes but is not limited to impairments on metabolic rate, menstrual function, bone health, immunity, protein synthesis, and cardiovascular health."
The female athlete triad, which describes the connection between poor energy availability, decreased bone mineral density, and menstrual dysfunction, has been replaced by REDS. This is because it is now known that low energy availability affects both male and female sufferers of this medical condition and that the consequences of low energy availability go well beyond issues with menstruation and bone health.
What Is Relative Energy Deficiency in Sport?
REDS affects people of all genders and abilities and is characterized by deteriorating health and a decline in athletic performance. It occurs when athletes do not consume enough food to satisfy their daily energy needs and training demands. After demanding workouts, many athletes have low energy availability, which may be resolved with rest and nourishing meals. However, continuing without sufficient fuel causes a more serious energy deficit, which negatively impacts strength, endurance, and general health. If left untreated, REDS can have a deleterious effect on the immune system, the reproductive system, the metabolism, the cardiovascular system, the bone structure, and the psychological well-being of the body. It can cause menstrual irregularities, heightened vulnerability to stress fractures, weakened immunity, slowed metabolism, cardiovascular problems, and psychological symptoms like depression and mood swings.
Who Is at Risk of Relative Energy Deficiency in Sport?
Athletes are more susceptible to REDS if their sport correlates success with a lean physique. Figure skating, gymnastics, and diving are a few examples of sports that frequently highlight extremely slender body types that are unattainable for a lot of athletes. Athletes who compete in weight-lifting or sports like light rowing are more likely to drastically reduce their caloric intake in an attempt to put on weight. REDS is also quite common in endurance athletes, such as bikers and marathon runners. A team's culture can also contribute to REDS, regardless of the sport. Sportsmen may be encouraged to train too much and under fuel, disregarding hunger and other bodily cues, to the expense of their health, in a culture that denigrates their weight or physical form.
What Are the Symptoms of Relative Energy Deficiency in Sport?
Stress fractures are a critical occurrence symptomatic of REDS, and they commonly lead to a diagnosis in athletes. Furthermore, symptoms including increased tiredness, abnormal menstrual periods, and decreased performance may be utilized to identify REDS. Additional symptoms include being underweight or weight loss, irregular or ceased menstruation, frequent colds, and flu, decreased athletic performance, mood swings, delayed or disordered growth and development in children and teenagers, iron deficiency, and, in extreme situations, possible negative effects on heart health.
How Does Relative Energy Deficiency in Sport Affect Sports Performance?
RED-S negatively impacts sports performance in several ways. Fatigue sets in earlier when there is less energy available to work the functioning muscles. Numerous variables, such as neuromuscular dysfunction (the way the nerve system regulates muscles), changes in the stress hormone cortisol, and decreased testosterone (in both men and women), can lead to a reduction in the growth of muscles and strength. When an athlete chases extreme leanness, these reductions typically outweigh any gains in the "power to weight ratio." Recovery is hampered. This raises the possibility of overtraining and persistent weariness by impeding the body's capacity to provide adequate energy for the next training sessions. It takes energy to adjust to training. Insufficient energy availability hinders the effectiveness of muscle and cardiovascular adaptation and development.
How Does Relative Energy Deficiency in Sport Affect Injury Risk?
Impairment in training recovery and degradation in muscle, tendon, and bone adaptation and the progressive strengthening brought on by exercise both raise the risk of injury. The risk of harm is further increased by impaired concentration and coordination. Reduced bone density can lead to stress fractures, which are common and may result in weeks or months of missed training.
How Is Relative Energy Deficiency in Sport Diagnosed?
It is common to ignore low energy availability, which might be challenging to identify. An athlete with REDS symptoms should ideally consult with a sports medicine professional who evaluates the athlete's whole health and well-being when planning the course of treatment, rather than merely focusing on a specific injury. A medical history is usually required before making a diagnosis. If the athlete experiences any symptoms, such as weakness, exhaustion, recurrent colds, or irregular menstruation, the physician may inquire regarding such. Inquiries will be made on the athlete's sport, training regimen, frequency of training, recent rise in training load, and notice of a decline in performance. Inquiries concerning the athlete's eating patterns and perspectives on food will also be made. Following the medical history, the doctor will do a physical examination as well as measure the blood pressure and heart rate. The athlete may be categorized by the physician as having a high, moderate, or low risk of suffering significant injury from REDS, depending on the findings. This will assist in deciding on the athlete's course of treatment.
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If an athlete uses drastic methods to reduce weight or exhibits symptoms of a major REDS-related medical problem, it may be deemed high risk.
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If an athlete has lost five to ten percent of their body weight in the last month, has irregular periods, or has a history of stress fractures, it can be deemed to be at intermediate risk.
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If an athlete is in good general health, follows a healthy diet, and refrains from harmful workout techniques, it is considered low risk.
How Is Relative Energy Deficiency in Sport Treated?
Given that each athlete with REDS is unique, treatment plans are tailored to their specific symptoms (such as decreased performance, irregular menstruation, recurring infections, and bone stress injuries), sports, objectives, and personal circumstances.
Resolving the discrepancy between energy intake and expenditure is crucial. To get back to optimal health and, consequently, ideal performance, the athlete, coach, and sports dietitian collaborate with a physician who is knowledgeable about the athlete's condition and the demands associated with the sport. Athletes frequently fear becoming "fatter" or "slower" when their energy availability increases. The knowledgeable Sports and Exercise Physicians will assist with exercises that have an emphasis on both performance and health as they are well aware of the demands of competitive and elite sports.
Conclusion
Given that REDS has major effects on performance and physical and mental health, screening for the illness regularly is crucial for providing comprehensive, patient-centered care. Medical professionals must take into account REDS not only in athletic populations but also in any individual who is susceptible to a persistent imbalance between energy intake and expenditure (female and male).
