Understanding Relative Energy Deficiency in Sport (REDs)
REDs, or Relative Energy Deficiency in Sport, is a syndrome caused by prolonged low energy availability (LEA). It is not a classic eating disorder, though it can overlap with disordered eating patterns. Fundamentally, REDs occurs when an athlete consistently fails to consume enough calories to meet the energy demands of their intense training plus their normal daily activities. This forces the body to conserve energy by slowing down or shutting down essential biological functions, which can have devastating consequences for overall health and athletic performance.
The Shift from Female Athlete Triad to REDs
Originally, experts focused on a condition known as the 'Female Athlete Triad,' which described a combination of three interrelated conditions in female athletes: disordered eating, irregular menstruation, and bone loss. However, in 2014, the International Olympic Committee expanded this concept to encompass the broader and more inclusive term REDs. This change recognized that:
- The consequences of low energy availability extend beyond menstrual and bone health, affecting multiple bodily systems.
- This syndrome affects athletes of all genders, not just females, with males also experiencing significant health implications like low libido and compromised bone health.
Causes and Risk Factors of REDs
REDs can result from various factors, often a combination of intentional and unintentional energy deficits. Athletes in sports that emphasize a lean body type, such as gymnastics, figure skating, or ballet, may intentionally restrict calories to meet aesthetic standards. Similarly, athletes in weight-class sports like wrestling or rowing may engage in severe calorie cutting. However, the energy imbalance can also be unintentional, resulting from a lack of education about proper sports nutrition or simply underestimating the energy required to support an increased training load. Intense training without sufficient refueling is a key driver.
Common Risk Factors Include:
- Intense Training Regimens: Elite and endurance athletes are at high risk due to the sheer volume and intensity of their training.
- Weight-Sensitive Sports: Participation in sports where low body weight is emphasized, aesthetically or for performance.
- Body Image Pressure: Psychological pressure, whether internal or from coaches and teammates, to achieve or maintain a certain body shape.
- Lack of Nutrition Knowledge: Athletes, especially young ones, may not understand their increased energy needs.
- Sudden Increases in Training: An abrupt rise in training intensity or volume can outpace an athlete's energy intake.
Diverse Symptoms Across Bodily Systems
The symptoms of REDs are wide-ranging and can be easy to miss, often manifesting as issues that athletes or coaches might dismiss as normal fatigue. They impact physical, physiological, and psychological health.
Common Signs and Symptoms:
- Physical: Unexplained fatigue, weight loss, increased injury risk (especially stress fractures), brittle nails, hair loss, feeling constantly cold, and recurring illnesses.
- Physiological: In females, menstrual irregularities like amenorrhea (missed periods) or oligomenorrhea. In males, low testosterone and decreased libido. Other issues include gastrointestinal problems, reduced muscle mass, and a slowed metabolic rate.
- Psychological: Mood changes, irritability, anxiety, depression, poor concentration, and disordered eating patterns.
Diagnosis and Treatment of REDs
Diagnosing REDs requires a multidisciplinary approach involving medical assessment and an understanding of the athlete's training and nutritional habits. A healthcare provider will take a comprehensive history, conduct a physical exam, and may order blood tests or bone scans (DEXA). The diagnosis is based on the constellation of symptoms, not just one single factor. Treatment focuses on restoring a positive energy balance by increasing calorie intake and, in some cases, temporarily reducing training volume. A team of specialists is often involved.
Multidisciplinary Treatment Team
- Physician: Monitors overall physical health, including blood tests and bone density, and oversees the overall treatment plan.
- Registered Dietitian: Helps the athlete understand their specific energy needs and develops a personalized nutritional plan to ensure adequate fueling.
- Psychologist/Therapist: Addresses any underlying psychological factors, such as body image issues, stress, or disordered eating behaviors.
- Coach/Trainer: Plays a critical role in supporting the athlete and adjusting training load under medical guidance.
| Aspect | REDs Syndrome | Eating Disorder (e.g., Anorexia) |
|---|---|---|
| Core Cause | Insufficient energy intake to meet high energy expenditure, often unintentional. | Significant psychological distress, fear of gaining weight, and distorted body image. |
| Diagnosis | A medical diagnosis based on physiological and performance impairments caused by low energy availability. | A psychiatric diagnosis defined by specific behavioral and psychological criteria outlined in the DSM-5. |
| Affected Population | Athletes of all genders who engage in regular, intense exercise. | Can affect anyone, regardless of athletic status. |
| Weight Concern | While weight loss can occur, it's not always the primary concern driving the behavior. The focus is on energy deficit. | A central feature is the intense fear of weight gain and preoccupation with body shape. |
Conclusion
What is the Reds food disorder? It is a serious, often misunderstood, syndrome resulting from chronic low energy availability that impacts an athlete's health and performance. By understanding the broad physiological and psychological effects of REDs, athletes, coaches, and parents can better identify the signs and seek prompt, multidisciplinary treatment. Prioritizing health, balanced nutrition, and appropriate rest is key to preventing REDs and ensuring long-term athletic success and well-being. Raising awareness is vital, as early detection and intervention can prevent severe and enduring consequences. The ultimate goal is to foster a sports culture that emphasizes health over aesthetics, allowing athletes to achieve their potential safely. For more information, the National Association of Anorexia Nervosa and Associated Disorders (ANAD) is a helpful resource regarding REDs.
