Relative Energy Deficiency in Sport, known as REDs, is something we see in clinic all the time. It was first introduced in 2014 by the International Olympic Committee’s expert writing panel. The International Olympic Committee’s (IOC) consensus statement on REDs has recently been updated, so we thought it was timely to chat about what REDs is and how we can manage it.
What is REDs?
REDs is as a syndrome characterised by impaired physical and/or psychological functioning. It is caused by prolonged and/or severe low energy availability (LEA). LEA occurs when there is a mismatch between energy intake and energy expended. This is typically either from not eating enough (unintentionally or intentionally) or increasing exercise without increasing food intake.
Who is impacted by REDs?
REDs can occur in both male and females, and is common amongst athletes. It’s important to note, however, everyday active individuals can also experience REDS, and anyone can experience low energy availability. Previously more of an emphasis was placed on females experiencing REDs, however, we now know it is also common in males, but some symptoms may differ.
Symptoms of REDs Symptoms of REDs can be incredibly widespread and vary between individuals. Some symptoms include:
· Poorer sports and exercise performance (e.g. may notice you can’t train for as long, lift as heavy, or fatigue more quickly during exercise)
· Gut symptoms such as diarrhoea, constipation, bloating, nausea and abdominal pain – particularly common to occur around exercise
· Absent or irregular menstrual cycle. It doesn’t matter how active you are, it’s NOT normal to have an absent or irregular cycle.
· Frequent bouts of illness/injury and/or taking longer than normal to recover
· Poor energy levels and concentration
· Low libido
· Disrupted sleep
· Changes in mood e.g. depression, feeling more irritable
What are the health impacts?
REDs can have detrimental health outcomes, especially if left unmanaged. As there isn’t enough energy available for our body to function at it’s best, it will downregulate some ‘less essential’ body systems to preserve energy for more vital systems like the heart and the brain. Some of these impacts include:
· Reduction in metabolism (slowed metabolic rate)
· Low heart rate and impact on heart health
· Low bone mineral density, which can lead to fracture risk and osteoporosis
· Immune health – often more prone to illness and struggle to recover from illness
· Mental health – poorer mental health can occur before REDs but also be a result of REDs. This includes depression, anxiety, low mood and eating disorders/disordered eating
Where to seek help
If you suspect you suffer from REDs or low energy availability, there is so much help available. Some key professionals in your support team should be:
· Dietitian – working with a dietitian to optimise nutrition will improve energy availability, resolve nutritional deficiencies and help you to feel and perform at your best. Getting personalised advice and support is so important. Book in with one of our expert sports dietitians/dietitians here.
· GP – have a supportive GP is important in the management of REDs, particularly with navigating different areas of health that REDs can impact
· Psychologist – if REDs is a result of intentionally under-fuelling and/or disordered eating, psychology input is extremely important
· Physiotherapist – having a physio can help with adjusting your training load where required and monitoring and managing any injuries.
Written by Amanda Smith, Dietitian (APD), Sports Dietitian