II. Definitions

  1. Relative Energy Deficiency in Sport (RED-S)
    1. Relative energy deficiency
    2. Results in impaired physiologic functioning
      1. Impaired metabolic rate, protein synthesis
      2. Amenorrhea or Oligomenorrhea
      3. Impaired cardiovascular health
      4. Low Bone Mineral Density

III. Epidemiology

  1. More common in female gender, but also occurs in males

IV. Risk Factors

  1. Eating Disorder (e.g. Anorexia Nervosa)
  2. Sport type
    1. Judged sports (appearance, aesthetics)
    2. Weight category sports
    3. Endurance sports

V. Pathophysiology

  1. Low energy availability
    1. Dietary Energy Intake is insufficient for Energy Expenditure needs (given sports activity)
  2. Complications
    1. Decreased glycogen stores
    2. Decreased Motor Strength
    3. Decreased endurance Exercise performance
    4. Increased Musculoskeletal Injury risk
    5. Fatigue and difficult recovery from Exercise
    6. Impaired concentration, judgement and coordination
    7. Increased irritability and depressed mood

VI. Differential Diagnosis

  1. Endocrine abnormalities
  2. Female Athlete Triad
  3. Eating Disorder

VII. Management

  1. Multi-disciplinary team
    1. Sports medicine provider
    2. Sports dietician
    3. Sports psychologist

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