Underfueling in athletes; Symptoms of Relative Energy Deficiency in Sport (REDs)

Underfueling in athletes is defined as inadequate energy intake relative to the athletes energy expenditure in their training and sport. Statistics reveal that up to 45% of female athletes struggle with underfueling. Many athletes, especially youth and teen athletes, are unintentionally doing so or are not eating an appropriate nutrient balance for their growth and development. Additionally, underfuelng can be due to disordered eating or an eating disorder in athletes.  

You might be wondering, what is relative energy deficiency in sport (RED-S)? 

RED-S is a very concerning issue that has a great impact on sportspersons of all ages, but it is especially important to address in youth and teen athletes. 

I mentioned this unfamiliar concept in my previous blog post, Sports Nutrition for Youth and Teen Athletes, called energy balance and how athletes should consistently make an effort to match energy intake with energy expenditure. In other words, the amount of kilocalories (kcals) consumed should match the amount of energy expended. Athletes should strive for energy balance not only in their daily activities but also in their training and exercise regimens. 

So, how does this energy balance concept relate to RED-S? What are the adverse consequences of negative energy balance i.e. low energy availability?

First, let’s talk about energy balance. If you consume more energy than you are expending, you are in a positive energy balance. If you expend more energy than you are consuming, then you are in a negative energy balance. Often, sportspersons intentionally restrict their energy intake hoping that becoming leaner might improve their athletic performance. At other times, athletes might unintentionally fail to match their energy intake with their higher, more excessive, training load. This negative energy balance puts the body in an ‘alert mode’ and forces it to trigger hormonal responses that lead to substandard health and subsequently, poor performance and recovery.

As I’ve mentioned before in How dieting harms athletes, I am still surprised by the fact that we live in a diet-obsessed culture that promotes thinness in the name of health and performance. Plus, if you put the additional pressure of a ‘no pain, no gain’ attitude that is often honored as an indication of physical power, dedication, and discipline… you have the perfect recipe for feeling the consequences of RED-S. This condition is incredibly common nowadays, affecting countless athletes that might not even be aware of it. Unfortunately, this issue continuously goes unnoticed and it only attracts attention after a severe injury or mental breakdown.

My advice is to not remain colorblind to the red flags! Don’t overlook your fatigue, bloating, discomfort, headaches, mood swings, or the loss of your period, if you are a woman. The long-term aftermath of RED-S can alter many systems in your body, including decreased bone density, protein synthesis, cardiovascular issues, gastrointestinal disturbances, and decreased immunity.

There is no fast lane to success or recovery! Keep up your energy balance by consuming the right portion sizes from all food groups, following a timed frequent meals pattern (at regular intervals throughout the day), and making healthy beverage choices to stay hydrated.

If you need help from an experienced Registered Dietitian, Certified Strength and Conditioning Specialist, and Certified Personal Trainer with over two decades of experience offering nutrition counseling and sports and lifestyle coaching, sports performance nutrition and endurance athlete nutrition, I am here for you! Begin your journey with practical and individualized performance nutrition guidance towards the results you work hard for. Learn to develop a healthier relationship with food while also properly fueling for any level of activity, and achieve lasting lifestyle changes! 

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