By Lorianne Lavoie MS RD 

Are You Eating Enough for Your Workouts?

For active people, food is often perceived as the fuel that propels our body, our machine. It’s true, our food choices have a great impact on our energy levels, on our performance and on our recovery. However, sometimes, a person’s food intake does not always match their energy expenditure. In other words, the calories they take in aren’t always enough for their body’s needs. Sometimes this happens voluntarily, because a person is limiting their food intake but often times it happens unknowingly, because it’s easy to underestimate how much energy the body requires when we’re performing at a high level. So what happens then? Not eating enough, in the context of training may have serious impacts on health. So how do you know if you’re at risk? 

What is Relative Energy Deficiency in Sport (RED-S)?

First and foremost, in order to understand RED-S, let’s imagine a monthly budget. Every month, you have a set amount of money that comes in and a set of fundamental expenses you need to cover, no matter what. Similarly, our body must manage daily calories to perform its vital functions. If, however, you decide to spend money you don’t have on something such as, say, a new purse, you’ve just either gone into debt for it or needed to downgrade the allotted budget for all your other expenses. Because no matter what you decide to spend your money on, fundamental, fixed expenses don’t disappear. 

Our body is the same. If you are not providing enough energy (calories) for the body to perform all its daily tasks but are still pushing the body through exercise, then something will have to give. The body will have to find balance by giving less attention to the bodily systems he judges less necessary, to make sure its vital functions and the immediate demands of exercise are covered. It’s at this precise moment that we are referring to relative energy deficiency. All active people, both women and men, are at risk of RED-S. This risk is heightened when it is question of high-level sports, endurance training and aesthetic sports. 

What are the signs?

It isn’t always easy to assess whether we’re providing the body with all that it needs, unless a professional assesses us. Sometimes, athletes underestimate just how many calories they require on a daily basis to properly perform and will experiment RED-S unknowingly. Here are some of the possible physical and psychological signs of RED-S:

• -Amenorrhea (absence or loss of menstrual cycle)
• -Hypothermia  
• -Stress fractures
• -Significant weight-loss
• -Digestive symptoms 
• -Muscular cramps, weakness and/or tiredness
• -Anxiety/ depression
• -Difficulty to concentrate
• -Excessive concern about weight and food

How does this affect health and performance?

In terms of health, being in a relative energy deficiency in sport can impact many systems, such as the endocrine system and the skeletal system. This relation is known as the Female Athlete Triad. This occurs when estrogen production is reduced, going so far as to provoke the stopping of the menstrual cycle as the result of inadequate calories and/or a significant energy expenditure. One of the effects of this decrease of estrogen is the reduction of bone mineral density, which weakens bones. The risk of stress fractures is therefore heightened. Moreover, the nutritional status being suboptimal, healing of fractures is slowed down. Some effects of RED-S are observed in both men and women at metabolic, cardiovascular, digestive, immunological and psychological levels. 

In terms of exercise performance, presenting with RED-S will reduce your recovery capacity and affect the muscle mass.  You will feel tired, sluggish and struggle through your training.

How to prevent RED-S?

Some strategies can be used in order to prevent relative energy deficiency in sport and excessive concern about weight. Here are some potential solutions: 

• -Choose exercise that compliments your strengths; 
• -Surround yourself with people that care about your well-being;
• -Do not compare your body to media standards. The ideal weight for performance is different for each;
• -Be a role model. Compliment others based on their talent and effort, regardless of weight; 
• -Consult a sports dietitian who can establish personalized recommendations to target a healthy body composition and the optimization of performance. 

References

Mountjoy, Margo, Jorunn Sundgot-Borgen, Louise Burke, Kathryn E. Ackerman, Cheri Blauwet, Naama Constantini, Constance Lebrun, et al. 2018. “International Olympic Committee (IOC) Consensus Statement on Relative Energy Deficiency in Sport (RED-S): 2018 Update.” International Journal of Sport Nutrition and Exercise Metabolism 28 (4): 316–31.

Keay, Nicola, and Gavin Francis. 2019. “Infographic. Energy Availability: Concept, Control and Consequences in Relative Energy Deficiency in Sport (RED-S).” British Journal of Sports Medicine 53 (20): 1310–11.

Statuta, Siobhan M., Irfan M. Asif, and Jonathan A. Drezner. 2017. “Relative Energy Deficiency in Sport (RED-S).” British Journal of Sports Medicine 51 (21): 1570–71.

Relative Energy Deficiency in Sports (RED-S). https://www.brown.edu/campus-life/health/services/promotion/nutrition-eating-concerns-sports-nutrition/relative-energy-deficiency-sport-red-s. Page consultée le 18 octobre 2020.