The impact of REDs on periods and athletic performance.
Exercising and playing sports is a great way to maintain both physical and mental wellbeing. However, when an athlete is following tough training regimes and not consuming enough dietary energy to support this, issues with their periods and health can arise. REDs or Relative Energy Deficiency in sport, is a condition that can affect anyone, regardless of the type of sport played, or level of competition. REDs is caused by exposure to prolonged or severe low energy availability (LEA), which happens when energy expenditure is higher than dietary energy intake.
Why does REDs happen?
Underfuelling for sport
Your body needs energy from food to maintain many biological processes like pumping blood, digesting food, repairing cells, and growing muscle. If you are playing sports, your body needs even more energy to account for the energy used during practices and games. A lack of understanding of energy requirements, from the athlete, coach, and parents, may lead to the development of REDs.
Disordered eating behaviours
Those who struggle with disordered eating or behaviours such as restricting food, cutting out food groups, or using purging techniques such as laxatives, may be at risk of developing REDs. Disordered eating behaviours range widely, usually with the individual’s intention to reduce energy intake in the hopes of losing weight or looking smaller in size.
Psychological factors
Mental health challenges and conditions can contribute to the risk of developing REDs. Examples include general depression or anxiety and athletes who are struggling with body weight requirements or recovering from an injury, are also at risk. Societal pressures can also play into this with social media portraying an ‘ideal’ body image for athletes to aspire to, which in most cases is unrealistic and unhealthy to achieve.
What can REDs do to your body?
How can REDs affect my sporting goals?
Your body needs enough energy during training to perform at your best, and enough energy afterwards as well to help your muscles recover and repair from any injuries. A decrease in sporting performance can include missing practices or games, a decrease in muscle strength and stamina, and longer recovery times.
My period has disappeared, why is that?
When there is low energy availability, including in individuals with REDs, the body switches into survival mode, ensuring energy from food is used for essential body processes to keep them alive. As the reproductive system isn’t ‘essential for survival’, ovulation and menstruation can stop temporarily. However, our period is an important function of the female body. Reproductive hormones produced during different phases of our menstrual cycle are needed for many functions in the body including heart and bone health.
What can REDs mean in the long term?
REDs can lead to a decline in bone mineral density (BMD), which means that your bones are not as strong as they should be, and may break easier, including stress fractures. This is particularly important for young athletes whose bones have not finished fully growing. For females, our bones should get progressively stronger until we are between 25-35 years old, when BMD starts to decrease. If your BMD starts to decline before this point, you may be at an even higher risk of bone injury and experience longer recovery times earlier in life.
Three strategies to manage REDs
1. Seek help from a health professional
Athletes should work with a Registered Dietitian or Registered Nutritionist who has experience working with athletes to evaluate their current dietary intake and ensure they are consuming enough calories to support their energy needs and nutrients for optimal health. There may be other underlying nutritional deficiencies present in someone recovering from REDs so it is important to get the whole picture to ensure effective management of the athlete’s nutrition requirements.
2. Education initiatives for coaches and parents
To reduce the prevalence of REDs, it is important to educate both the athlete and their support system about the signs, risk factors and consequences of REDs, both in the short term and the long term. Coaches and parents tend to have a high influence on the athletes nutritional intake and their exercise output, which must be considered as important factors for the athletes health.
3. Improving mental health
Figuring out the psychological factors that may have led to disordered eating behaviours, is an important step in recovery for athletes with REDs. This may involve working with a sports psychologist or therapist to develop coping strategies, improve body image, and promote a healthy relationship with food and exercise.
Relative Energy Deficiency in Sport poses a significant threat to the health and performance of athletes, regardless of their gender or level of sporting competition. By recognising the risk factors and potential consequences for an individual with REDs, we are able to tailor a multidisciplinary approach to their recovery. This approach can include input from a nutritionist, a psychologist, and the parents and coaches of the athlete, keeping in mind their long-term health and sporting goals.
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