Relative Energy Deficiency in Sport

1. See Also
   1. Female Athlete Triad
2. 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
3. Epidemiology
   1. More common in female gender, but also occurs in males
4. Risk Factors
   1. Eating Disorder (e.g. Anorexia Nervosa)
   2. Sport type
      1. Judged sports (appearance, aesthetics)
      2. Weight category sports
      3. Endurance sports
5. 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
6. Differential Diagnosis
   1. Endocrine abnormalities
   2. Female Athlete Triad
   3. Eating Disorder
7. Management
   1. Multi-disciplinary team
      1. Sports medicine provider
      2. Sports dietician
      3. Sports psychologist
8. References
   1. MacDonald (2021) Am Fam Physician 103(9): 539-46 [PubMed]