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- relative energy deficiency in sport (RED-S)
- low energy availability
- female athlete triad
- disordered eating
- amenorrhea
- low testosterone
- low bone mineral density
Introduction
In 2014, the IOC published a consensus statement entitled ‘Beyond the Female Athlete Triad: Relative Energy Deficiency in Sport (RED-S)’. The syndrome of RED-S refers to ‘impaired physiological functioning caused by relative energy deficiency and includes, but is not limited to, impairments of metabolic rate, menstrual function, bone health, immunity, protein synthesis and cardiovascular health’. The aetiological factor of this syndrome is low energy availability (LEA).1
The publication of the RED-S consensus statement stimulated activity in the field of Female Athlete Triad science, including some initial controversy2 3 followed by numerous scientific publications addressing:
The health parameters identified in the RED-S conceptual model (figure 1).1 4
Relative energy deficiency in male athletes.
The measurement of LEA.
The performance parameters identified in the RED-S conceptual model (figure 2).1 4
The IOC RED-S consensus authors have reconvened to provide an update summary of the interim scientific progress in the field of relative energy deficiency with the ultimate goal of stimulating advances in RED-S awareness, clinical application and scientific research to address current gaps in knowledge.
Low energy availability
LEA, which underpins the concept of RED-S, is a mismatch between an athlete’s energy intake (diet) and the energy expended in exercise, leaving inadequate energy to support the functions required by the body to maintain optimal health and performance. Operationally, energy availability (EA) is defined as:
where exercise energy expenditure (EEE) is calculated as the additional energy expended above that of …