{"id":8248,"date":"2023-10-20T01:11:40","date_gmt":"2023-10-19T18:11:40","guid":{"rendered":"https:\/\/loudhdtv.com\/?p=8248"},"modified":"2023-10-20T01:11:40","modified_gmt":"2023-10-19T18:11:40","slug":"what-to-know-about-relative-energy-deficiency-in-sport","status":"publish","type":"post","link":"https:\/\/loudhdtv.com\/?p=8248","title":{"rendered":"What To Know About Relative Energy Deficiency in Sport"},"content":{"rendered":"<p> <script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-3711241968723425\"\r\n     crossorigin=\"anonymous\"><\/script><br \/>\n<\/p>\n<div>\n<div class=\"drop-cap text-big text-gray\"> <span class=\"drop-cap__first text-dropcap \">A<\/span>s a division 1 cross-country and track runner at the University of Michigan, <a href=\"https:\/\/www.instagram.com\/erinefinn\/?hl=en\" target=\"_blank\" rel=\"noopener nofollow\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/www.instagram.com\/erinefinn\/?hl=en\">Erin Finn<\/a> became an NCAA All-American and Big Ten Champion. But multiple injuries slowed her down, and at a certain point, her body stopped responding well to training. By the time she learned it was because she wasn\u2019t eating or resting enough, which had led to a syndrome called Relative Energy Deficiency in Sport (REDs, and formerly RED-S), it was too late. Looking back, she wonders what more she could have achieved as a runner if she had been fueling properly.<\/div>\n<p>\u201cMy career might have looked very different if I had been able to internalize these concepts earlier,\u201d she says. \u201cI suffered many injuries, and probably have lifelong consequences with bone density that I&#8217;m working on fixing.\u201d Now a medical resident, Finn started an educational resource and virtual community called <a href=\"https:\/\/www.outofthered-s.com\/\" target=\"_blank\" rel=\"noopener nofollow\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/www.outofthered-s.com\/\">Out of the RED-S<\/a> to help other athletes avoid the same fate.<\/p>\n<h2>What is REDs?<\/h2>\n<p>REDs happens when athletes don\u2019t eat enough to fuel their bodies. At the center of this syndrome is <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7483688\/#:~:text=Low%20energy%20availability%20(LEA)%20represents,reasons%20for%20this%20are%20manifold.\" target=\"_blank\" rel=\"noopener\" referrerpolicy=\"no-referrer-when-downgrade\" class=\"no-underline citation\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7483688\/#:~:text=Low%20energy%20availability%20(LEA)%20represents,reasons%20for%20this%20are%20manifold.\"><span>low energy availability<\/span><sup>1<\/sup><\/a>: Essentially, if you\u2019re not taking in enough food, your body will use up your calories on exercise, leaving you without enough left in the tank to support your day-to-day bodily functions\u2014and leading to a cascade of health problems.<\/p>\n<p>It doesn\u2019t take much of a deficit to happen. REDs-related dysfunction can start to set in when the body has 250 calories less than what it needs daily, over a five-day period, says sports dietitian <a href=\"https:\/\/beccamcconville.com\/\" target=\"_blank\" rel=\"noopener nofollow\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/beccamcconville.com\/\">Rebecca McConville, RD, LD, CSSD, CEDS<\/a>, who wrote the book <a href=\"https:\/\/www.amazon.com\/Finding-Your-Sweet-Spot-Optimizing\/dp\/1091089051\/\" target=\"_blank\" rel=\"noopener nofollow\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/www.amazon.com\/Finding-Your-Sweet-Spot-Optimizing\/dp\/1091089051\/\"><em>Finding Your Sweet Spot: How to Avoid RED-S by Optimizing Your Energy Balance<\/em><\/a>. \u201cThat can kind of start a cascade\u2014if we don&#8217;t put the brakes on early, then we start to see long-term consequences of REDs,\u201d she says.<\/p>\n<div class=\"related-content \" style=\"\" data-module-init=\"related-content\" data-module-immediate=\"\" v-cloak=\"\">\n<div class=\"related-content__wrapper \" v-cloak=\"\" :class=\"{'is-loaded':isLoaded}\">\n<p> <span class=\"inline pr-6 text-seafoam-dark\">Related Stories<\/span> <\/p>\n<p> <related-content class=\"related-content__links\" parent-article-permalink=\"https:\/\/www.wellandgood.com\/red-s\/\" current-title=\"Yes, Even Recreational Athletes Can Get REDs\u2014Here\u2019s What Anyone Who\u2019s Active Should Know\" current-image=\"https:\/\/www.wellandgood.com\/wp-content\/uploads\/2023\/10\/GettyImages-1550399402-425x285_418x278_true_70.webp\" v-on:parsely-posts-loaded=\"onPostsLoaded\" start-date=\"2023-04-19\" tag=\"div\" inline-template=\"\" url=\"https:\/\/www.wellandgood.com\/red-s\/\" secret=\"w5ztterVB03LGZJLfXS0hf3EvQBuFFIWew9hmVQxthU\" apikey=\"wellandgood.com\" limit=\"3\"> <\/p>\n<div>\n<div class=\"related-content__card mb-[10px] sm:mb-[20px]\" :class=\"{'related-content__card--full':posts.length === 1}\" v-for=\"(post, key) in posts\"> <a v-on:click.prevent=\"trackLinkGA($event, key)\" :href=\"https:\/\/www.wellandgood.com\/red-s\/post.url\" data-url-source=\"related-content\" class=\"related-content__link\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"\"> <\/p>\n<div class=\"related-content__card--image bg-tan\" :style=\"{ backgroundImage: 'url(' + post.image_url + ')' }\"> <img :src=\"https:\/\/www.wellandgood.com\/red-s\/post.image_url\" :alt=\"post.title\"\/> <\/div>\n<p> <\/a>  <\/div>\n<\/p><\/div>\n<p> <\/related-content> <\/div>\n<\/p><\/div>\n<p>This problem was once considered the \u201c<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3435916\/#:~:text=The%20female%20athlete%20triad%20(the,young%20women%20participating%20in%20sports.\" target=\"_blank\" rel=\"noopener\" referrerpolicy=\"no-referrer-when-downgrade\" class=\"no-underline citation\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3435916\/#:~:text=The%20female%20athlete%20triad%20(the,young%20women%20participating%20in%20sports.\"><span>female athlete triad<\/span><sup>2<\/sup><\/a>\u201d\u2014low energy availability, menstrual dysfunction, and low bone mass. But in 2014, the International Olympic Committee (IOC) recognized it as a broader syndrome that can affect people of any gender, and can cause many additional effects: impaired gastrointestinal, cardiovascular, and neurocognitive function, as well as reduced immunity, increased injury risk, and mental health issues, among other problems.<\/p>\n<p>It can also backfire on athletes\u2019 performance through decreased muscle strength, endurance, power, training response, recovery, and motivation, according to a new <a href=\"https:\/\/bjsm.bmj.com\/content\/57\/17\/1073\" target=\"_blank\" rel=\"noopener nofollow\" referrerpolicy=\"no-referrer-when-downgrade\" class=\"no-underline citation\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/bjsm.bmj.com\/content\/57\/17\/1073\"><span>consensus statement<\/span><sup>3<\/sup><\/a> released by the IOC last month. Ironically, athletes may <a href=\"https:\/\/www.childrenshospital.org\/conditions\/red-s\" target=\"_blank\" rel=\"noopener\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/www.childrenshospital.org\/conditions\/red-s\">respond to this downturn by training even harder<\/a>, which can deplete even more of the energy they need to function.<\/p>\n<p>Healthcare providers look at several criteria to diagnose REDs, though the IOC statement points out diagnosing it has been inconsistent. \u201cAs a dietitian, we can assess where their energy status is. A medical provider can assess their physiological functioning. If dysfunction is noted and they are in a low energy availability, they are generally diagnosed with REDs,\u201d McConville says.<\/p>\n<h2>Despite growing awareness, misconceptions persist<\/h2>\n<p>In the last several years, awareness of REDs has grown significantly among athletes at all levels, says McConville. This is likely thanks to the fact that <a href=\"https:\/\/www.womensrunning.com\/culture\/people\/in-her-power-mary-cain\/\" target=\"_blank\" rel=\"noopener nofollow\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/www.womensrunning.com\/culture\/people\/in-her-power-mary-cain\/\">several<\/a> <a href=\"https:\/\/www.runnersworld.com\/health-injuries\/a40567828\/elise-cranny-world-championships\/\" target=\"_blank\" rel=\"noopener nofollow\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/www.runnersworld.com\/health-injuries\/a40567828\/elise-cranny-world-championships\/\">high-profile<\/a> <a href=\"https:\/\/www.runnersworld.com\/nutrition-weight-loss\/a40303925\/red-s-in-male-runners\/\" target=\"_blank\" rel=\"noopener nofollow\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/www.runnersworld.com\/nutrition-weight-loss\/a40303925\/red-s-in-male-runners\/\">athletes<\/a> have spoken out about their struggles with REDs, and created networks and <a href=\"https:\/\/red-s.com\/\" target=\"_blank\" rel=\"noopener nofollow\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/red-s.com\/\">campaigns<\/a> to raise recognition and <a href=\"https:\/\/recovery.mykajabi.com\/\" target=\"_blank\" rel=\"noopener nofollow\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/recovery.mykajabi.com\/\">provide resources<\/a>.<\/p>\n<p>But the overall population remains unfamiliar with the syndrome, and some misperceptions persist, like that REDs affects only elite athletes, underweight athletes, or those with disordered eating. In reality, McConville says REDs is likely to be pretty common among recreational athletes\u2014and maybe even <em>more<\/em> prevalent than in professional sports since everyday people don\u2019t have the same coaching or medical support available. Because it\u2019s not always intentional: We may not even realize how much energy we&#8217;re burning up in our workouts, creating a deficit without being aware of it.<\/p>\n<p>Estimates of REDs prevalence vary widely, from 23 to 79.5 percent in female athletes and from 15 to 70 percent for male athletes, according to the IOC statement, which drew from studies that mostly (but not exclusively) focused on elite athletes. McConville says it\u2019s probably on the higher end of that range, more like 65 to 80 percent, because so many cases of REDs are overlooked.<\/p>\n<p>\u201cSome of my most underfueled athletes have been ones that were [at a healthy weight], and so they were overlooked for years,\u201d she says. Sometimes athletes with REDs don\u2019t lose weight at all\u2014instead, the primary symptoms have to do with missed menstrual cycles, or their digestion, or their sleep is a mess, McConville says.<\/p>\n<h2>This influence of diet culture<\/h2>\n<p>When Finn decided to start Out of the RED-S, she says, \u201cI saw a problem that was unaddressed, that was very, very common.\u201d One major contributing factor is clearly diet culture, and how much of the messaging around fitness and healthy eating is focused on weight loss. \u201cThe dialogue and the culture around fueling to perform, versus even fueling for general health, is so radically different than fueling for weight loss,\u201d Finn says.<\/p>\n<p>McConville agrees, noting that \u201cour weight-focused, diet-centered culture\u201d has gotten in the way of more widespread understanding of REDs. \u201cIt\u2019s a little bit too normalized, especially in some of these boutique-type gyms that really promote constantly being in a caloric deficit,\u201d she says.<\/p>\n<p>When athletes prioritize losing weight\u2014believing that lighter is faster or that they need to look like the stereotypical star in their sport\u2014they may put their health at risk. REDs is most common in endurance sports, like running and cycling, that require athletes to expend a lot of energy in workouts; sports that idealize thin body types, like figure skating and gymnastics; and sports with weight categories, like lightweight rowing and wrestling.<\/p>\n<p>\u201cMany sports have engrained cultures where coaches and members of the athlete health and performance team exert subtle to extreme pressure on athletes to regulate body weight and composition,\u201d the IOC statement says. Yet many of these people lack knowledge about how to go about doing that safely, it adds.<\/p>\n<blockquote>\n<p>&#8220;A well-fed body is a resilient body.&#8221; \u2014Rebecca McConville, RD<\/p>\n<\/blockquote>\n<p>Even in healthcare, REDs may not be fully appreciated. \u201cBecause healthcare is under so much time constraint, they tend to not put puzzle pieces together,\u201d McConville says. For example, if a patient comes in with GI issues, the healthcare provider may focus only on that, \u201cand they don&#8217;t really have enough time to assess energy availability, carbohydrate availability, sleep\u201d\u2014things that indicate REDs may be the cause, she says.<\/p>\n<p>Also, Finn says, \u201cthe majority of the healthcare world is focused on obesity, inactivity, and metabolic\/insulin resistance,\u201d and these patients\u2019 needs are completely different from those of athletes with REDs.<\/p>\n<p>\u201cAnother issue is that medicine is swept up in that same diet culture as the exercise world, [which] sees being thin and eating less and exercising more as being healthier,&#8221; Finn says. It\u2019s well-documented that doctors <a href=\"https:\/\/www.wellandgood.com\/medical-fatphobia\/\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/www.wellandgood.com\/medical-fatphobia\/\">all too often focus on weight<\/a> when they\u2019re caring for patients in larger bodies. And on the flip side, if a patient comes in with REDs symptoms but is otherwise healthy and thin, their symptoms may not seem like cause for concern.<\/p>\n<h2>The path forward<\/h2>\n<p>So what can be done? Treatment for REDs involves eating more food. But sometimes that\u2019s more complicated than it sounds. \u201cIt&#8217;s like an interest on a credit card, when you&#8217;ve been in that energy deficit, so you have to make that up first\u2014then you work on figuring out where they&#8217;re at that place of proper energy availability,\u201d McConville says. Depending on how long the person has had REDs, the body can be \u201cpretty volatile for about a year,\u201d she says.<\/p>\n<p>Healing can also require a mindset shift. Finn points out that a well-informed coach and team are essential in building accountability \u201cabout regularly getting enough fuel or regularly eating breakfast before you work out, or regularly taking a rest day.\u201d And enjoying it.<\/p>\n<p>McConville says, \u201cWe really have to start having some institutional culture changes.\u201d This includes the language used on teams, such as body-positive communication that focuses more on what the athlete\u2019s body can do than what it looks like, she says.<\/p>\n<p>Athletes shouldn\u2019t accept these REDs symptoms as normal. \u201cWhen I think about the athletes sitting across from me, it&#8217;s like they settle for dysfunction,\u201d McConville says. \u201cA well-fed body is a resilient body that won&#8217;t have all these issues when it&#8217;s taken care of.\u201d<\/p>\n<div class=\"block-thin post-citations mt-[40px] mb-[30px]\" data-module-init=\"main-2020\/post-citations\" data-module-immediate=\"true\">\n<hr class=\"!border-seafoam-dark mb-[24px]\"\/>\n<div class=\"post-citations-content flex flex-col gap-[24px]\">\n<p>Well+Good articles reference scientific, reliable, recent, robust studies to back up the information we share. You can trust us along your wellness journey.<\/p>\n<div>\n<ol class=\"!ml-[18px] !mt-0\">\n<li>\n              Wasserfurth, Paulina et al. \u201cReasons for and Consequences of Low Energy Availability in Female and Male Athletes: Social Environment, Adaptations, and Prevention.\u201d\u00a0<i>Sports medicine \u2013 open<\/i>\u00a0vol. 6,1 44. 10 Sep. 2020, doi:10.1186\/s40798-020-00275-6            <\/li>\n<li>\n              Nazem, Taraneh Gharib, and Kathryn E Ackerman. \u201cThe female athlete triad.\u201d\u00a0<i>Sports health<\/i>\u00a0vol. 4,4 (2012): 302-11. doi:10.1177\/1941738112439685            <\/li>\n<li>\n              Mountjoy, M., et al. \u2018Et Al2023 International Olympic Committee\u2019s (IOC) Consensus Statement on Relative Energy Deficiency in Sport\u2019.\u00a0<i>REDs)British Journal of Sports Medicine<\/i>, vol. 57, 2023, pp. 1073\u20131097.            <\/li>\n<\/ol><\/div>\n<\/p><\/div>\n<hr class=\"!border-seafoam-dark mt-[24px]\"\/>\n  <\/div>\n<div class=\"disclaimers__after_content mb-[18px] mt-[16px] pt-[16px]\">\n<div class=\"outline-earmark relative mt-[8px] pt-[10px] pl-[20px]\">\n<p>\n            Our editors independently select these products. Making a purchase through our links may earn Well+Good a commission.          <\/p>\n<\/p><\/div>\n<\/p><\/div>\n<\/p><\/div>\n<p><script async defer src=\"https:\/\/platform.instagram.com\/en_US\/embeds.js\"><\/script><br \/>\n<br \/><div data-type=\"_mgwidget\" data-widget-id=\"1675549\">\r\n<\/div>\r\n<script>(function(w,q){w[q]=w[q]||[];w[q].push([\"_mgc.load\"])})(window,\"_mgq\");\r\n<\/script>\r\n<\/p>\n","protected":false},"excerpt":{"rendered":"<p>As a division 1 cross-country and track runner at the University of Michigan, Erin Finn became an NCAA All-American and Big Ten Champion. But multiple injuries slowed her down, and at a certain point, her body stopped responding well to training. By the time she learned it was because she wasn\u2019t eating or resting enough, &hellip;<\/p>\n","protected":false},"author":3,"featured_media":8249,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4],"tags":[],"class_list":["post-8248","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/loudhdtv.com\/index.php?rest_route=\/wp\/v2\/posts\/8248","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/loudhdtv.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/loudhdtv.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/loudhdtv.com\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/loudhdtv.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=8248"}],"version-history":[{"count":0,"href":"https:\/\/loudhdtv.com\/index.php?rest_route=\/wp\/v2\/posts\/8248\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/loudhdtv.com\/index.php?rest_route=\/wp\/v2\/media\/8249"}],"wp:attachment":[{"href":"https:\/\/loudhdtv.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=8248"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/loudhdtv.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=8248"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/loudhdtv.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=8248"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}