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Understanding RED-S: Symptoms, Risks, and more

Updated: Jun 12, 2023

what is red-s

As an athlete, your body requires optimal fuel to perform at its best. Whether you're a professional athlete, an avid gym-goer, or a recreational sports enthusiast, your body needs adequate energy to meet the physical demands of your training routine.

That being said, it is worth knowing about a condition that can negatively impact your performance and overall health, known as RED-S, or Relative Energy Deficiency in Sports. In this article, we will delve into what RED-S is, its symptoms, who is most likely at risk, how to combat its symptoms, and its relationship with the female athlete triad.

What is RED-S?

RED-S, formerly known as the Female Athlete Triad, is a condition that occurs due to an energy deficiency in athletes, it affects both male and female athletes of all ages and levels of performance.

RED-S is characterised by an inadequate energy intake that is insufficient to meet the energy demands of the body due to exercise, training, and other physical activities. This deficiency can have detrimental effects on various physiological systems in the body, leading to a range of symptoms and health issues.

RED-S syndrome

Symptoms of RED-S

RED-S can manifest in various symptoms, which can differ from person to person. Some common symptoms of RED-S include, but are not limited to:

Decreased performance: RED-S can lead to a decline in physical performance, including reduced strength, endurance, and stamina. Athletes may experience decreased speed, power, and agility, which can hinder their ability to achieve their performance goals.

Hormonal imbalances: Energy deficiency can disrupt the hormonal balance in the body, leading to irregular menstrual cycles in females or even loss of menstrual periods altogether, a condition known as amenorrhea. In males, RED-S can cause a decrease in testosterone levels, leading to decreased muscle mass, bone density, and libido.

Disordered eating patterns: Athletes with RED-S may develop disordered eating patterns, such as restricting food intake, excessive exercising, or engaging in other unhealthy behaviours to control weight or body image. These patterns can further exacerbate the energy deficiency and worsen the symptoms of RED-S.

Bone health issues: RED-S can have detrimental effects on bone health, leading to decreased bone density and increased risk of stress fractures, osteoporosis, and other bone-related injuries.

Fatigue and low energy levels: Athletes with RED-S may experience chronic fatigue, low energy levels, and difficulty recovering from exercise or training sessions. This can negatively impact overall performance and well-being.

Who is Most Likely at Risk of RED-S?

While RED-S can affect athletes of all genders and ages, certain populations may be at a higher risk. Athletes participating in sports that emphasise low body weight or aesthetic appearance, such as gymnastics, dance, figure skating, and endurance sports like long-distance running or cycling, are more susceptible to RED-S.

Additionally, athletes who engage in intense training regimens, have high training volumes, or participate in multiple sports simultaneously may also be at risk.

Similarly, athletes who have a history of disordered eating, poor nutrition, or have experienced previous injuries may also be more susceptible to developing RED-S.

the female athlete triad

Combatting Symptoms of RED-S

The good news is that RED-S is preventable and treatable. Here are some strategies that could help to combat the symptoms of RED-S:

Adequate energy intake: Ensuring that athletes consume enough energy to meet the energy demands of their training routine is crucial. Athletes should work with a qualified sports dietitian or nutritionist to develop a personalised meal plan that provides sufficient energy for their training, competition, and recovery needs.

Balanced nutrition: Athletes should aim to consume a well-balanced diet that includes all essential macronutrients (carbohydrates, proteins, and fats) and micronutrients (vitamins and minerals) to support their overall health and performance. This can help in preventing energy deficiencies and hormonal imbalances associated with RED-S.

Regular monitoring: Athletes should regularly monitor their energy intake, body weight, menstrual cycle (in females), and overall well-being to detect any early signs of RED-S. Keeping a journal or working with a sports healthcare professional can help in tracking these parameters and identifying any potential issues.

Rest and recovery: Rest and recovery are essential for athletes to allow their bodies to repair and regenerate. Athletes should prioritise getting adequate sleep, taking rest days, and managing stress to prevent overtraining and reduce the risk of energy deficiencies associated with RED-S.

Education and support: Athletes, coaches, and other members of the sports community should be educated about the risks and symptoms of RED-S. Athletes should seek support from qualified healthcare professionals, including sports nutrition coaches, sports physicians, and psychologists, who can provide guidance on nutrition, training, and mental health to prevent and manage RED-S effectively.

relative energy deficiency syndrome

The Relationship between RED-S and the Female Athlete Triad

RED-S is closely related to the Female Athlete Triad, which is a condition that includes three interrelated components: energy deficiency, menstrual disturbances (such as irregular or absent menstrual cycles), and decreased bone density.

The Female Athlete Triad was initially recognised as a condition that mainly affects female athletes, hence the name, but it is now understood that RED-S can affect both males and females.

The Female Athlete Triad is often considered as a spectrum, where energy deficiency can lead to menstrual disturbances, which can further affect bone health, etc.

It's important to note that not all athletes with RED-S will experience all three components of the Female Athlete Triad, and the severity of each component can vary from mild to severe. However, it's crucial to recognise the relationship between these conditions and take steps to prevent and manage them effectively.

Before you Go…

RED-S is preventable and treatable through strategies such as adequate energy intake, balanced nutrition, regular monitoring, rest and recovery, and seeking education and support from qualified healthcare professionals. So, the more you know, the better!

Remember, fuelling your body properly is essential for optimal performance and overall well-being. Prioritise your nutrition, rest, and recovery to ensure that you're taking care of your body and preventing energy deficiencies that can lead to RED-S or other related conditions.

Your body deserves the best care to help you excel in your athletic pursuits. If you need help in understanding this further, or help combating symptoms, then get in touch with Infinity Performance today to find out how we can help.


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