Understanding and avoiding RED-S (Relative Energy Deficit in Sport)

What is RED-S?

Long little known, it’s only recently that experts have labeled and recognized it as a physiological dysfunction caused by a sport-related energy deficiency. In 2014, the International Olympic Committee (IOC) published a consensus statement alerting to the risks of this syndrome in order to inform and warn sportsmen and women of a syndrome affecting health and performance.

In concrete terms, RED-S (Relative Energy Deficiency in Sports) is when your body doesn ‘t have enough energy to function properly, due to an imbalance between what you eat and what you expend in sport. If you burn more calories than you consume, you increase your risk of developing this syndrome!

Why is this important?

Your body is a beautiful creation of nature that needs fuel to function. If you don’t give it enough energy, it starts to draw on its reserves and modify its functioning to try to compensate. This can lead to numerous health problems.

How does it work?

Your body is constantly seeking to maintain a balance, called homeostasis. It seeks to regulate internal processes in order to function optimally. The energy you consume through food is used to support your metabolism (all your body’s chemical reactions), growth, tissue repair, hormone regulation and, of course, physical performance.

When you practice a sport, you increase your energy expenditure, and your body must adjust its metabolism to meet this increased demand. In the event of a drop in energy availability due to insufficient energy intake, or excessive physical expenditure, your body will set up an adaptation system to try and maintain a state of equilibrium. To do this, it will make compromises and modify its hormonal secretions. The result is altered physiological functioning, which is how RED-s syndrome can arise (cuckoo)!

RED-s and consequences?

The low energy availability that causes RED-S leads to hormonal imbalances with consequences for health and physical performance. The consequences are many and varied, affecting body function, psychology and performance. They can appear individually or in synergy. Here are just a few of the possible effects!

Physical consequences

• Menstrual problems: Menstrual periods may become irregular or even disappear (amenorrhea). This can affect your long-term fertility. The absence of menstrual periods is a sign that your body doesn’t have enough energy to support reproductive functions.
• Bone health : A lack of energy can weaken your bones, increasing the risk of stress fractures and osteoporosis. Bones require specific nutrients and hormones to maintain their density and strength.
• Frequent injuries: You’re more likely to injure yourself because your body doesn’t have the resources to recover properly. Muscle and tendon tissues need energy to repair the microtrauma caused by exercise.
• Weakened immune system: You may get sick more often, because your body is less able to fight off infections. Insufficient energy intake can reduce the production of white blood cells and other components of the immune system.

Psychological consequences

• Mood: RED-S can cause irritability, anxiety and even depression. The lack of energy affects the production of neurotransmitters (small chemical molecules) that regulate mood.
• Fatigue : Persistent fatigue can set in, making you more vulnerable to stress and reducing your motivation. Chronic fatigue can also interfere with sleep, making the situation even worse.
• Cognitive disorders: Difficulty concentrating, or reaction time. Your brain uses a lot of energy to function properly, and a deficiency can impair its performance.

Sporting consequences

• Decreased performance: You may notice a reduction in your sporting performance, with a feeling of increased fatigue and slower recovery. Without sufficient energy, your muscles can’t produce the strength and endurance you need.
• Loss of strength and endurance: Without sufficient energy, your muscles can’t work at full capacity. This can translate into reduced muscle strength and a diminished ability to sustain prolonged efforts.
• Increased recovery times : Your body takes longer to recover between training sessions, which can slow down your progress. Recovery is essential for tissue repair and improved performance.

Which profile is more at risk of RED-S?

Mostly affecting women more than men, all sportswomen can be affected, but some are more at risk than others. If you have eating disorders, play sports where thinness is valued, or do a lot of endurance sports, you need to be particularly vigilant.

• Women with eating disorders : restrictive diets and disordered eating patterns can lead to insufficient energy intake, thus creating a breeding ground for REDs.
• Endurance sports : Sports such as running, triathlon or cycling require high volumes of training, which can make it difficult to compensate for energy expenditure through diet.

How to protect yourself?

1. Eat enough: Make sure your diet covers your energy needs. Unintentional under-eating can happen very quickly. Don’t neglect calories and, above all, their quality – they’re essential! A diet adapted to your training program is essential. If necessary, enlist the help of professional nutritionists.

2. Listen to your body: If you feel excessive fatigue, unusual pain or changes in your menstrual cycle, it’s time to consult a health professional. The signals your body sends you are important.

3. Talk it over : Discuss your concerns with a doctor, nutritionist or physiotherapist. They can help you adjust your diet and training program, and guide you along the road to recovery. A multidisciplinary approach is often required to manage RED-S.

4. Adapt your training : If necessary, reduce the intensity, duration or frequency of your sports sessions to allow your body to recover. It is sometimes beneficial to take periods of rest or active recuperation (doing a physical activity with different constraints from those of the sport you are doing, for example).

5. Take care of yourself: Rest and recovery are just as important as training. Take care of your sleep – it’s crucial to your body’s regeneration! Go to bed at regular times and listen for the first signs of fatigue.

How to prevent RED-S

Preventing RED-S means making sportspeople more aware of the need for adequate energy availability. Here are some practical tips:

• Track your menstrual cycles: Use a mobile app or diary to track your menstrual cycles and note any changes. This can help you detect early signs of RED-S.
• Plan your meals : Prepare balanced meals adapted to your daily and sporting energy requirements. Include healthy snacks between main meals and hydrate properly before, during and after exercise.
• Avoid restrictive diets: Extreme diets can lead to nutritional deficiencies. Instead, opt for a varied, balanced diet.
• Monitor your weight in a healthy way : Avoid setting unrealistic weight targets. Rapid, steady weight loss can also be a sign of RED-S. Focus on your well-being rather than the number on the scale.

To sum up, for a fit sporting life!

RED-S is a serious but preventable problem. By taking care of your diet and listening to your body’s signals, you can continue to enjoy your sporting activities while staying in good health. Don’t hesitate to ask for help if you feel you need it. By taking a proactive approach, you can prevent the harmful effects of RED-S and maintain optimum performance. Take care of yourself and enjoy your outdoor activities to the full! =)

Alice’s testimonial

Alice talks about the RED-S on our podcast. Read her RED-S testimonial in this article or listen to it directly.