WHAT IS RED-s?
In this article, Coach Alan writes about how too little energy for athletes can lead to a negative spiral of health and performance. What is RED-s and how can it affect athletes?
RED-s
A small energy deficit that is planned, timed, and considered in light of an overall training plan may decrease body fat percentage. But where is the tipping point between creating a deliberate deficit in calorie intake to make a planned change in body composition and too much deficit?
Low Energy Availability or LEA is a state that an athlete is in when the body does not have enough energy to support all the physiological functions needed to maintain optimal health. This is particularly common when ‘dieting’ or when increasing training load; this can be more likely in endurance sports with high energy expenditure. ‘Weight’ consideration and ultimately the power to weight conversations are often confused or misinterpreted as a reduced weight can initially be hidden by performance gains which quickly end up in poor health.
The first point, ‘dieting’, is well known, but what about that second point, ‘increasing training load’? Often as athletes get towards race day or seek higher and more ambitious goals, the drive and motivation and pressure increase, and the search for any way to improve performance can increase, as can the calorie burn with high levels of training. At this point, having the idea to improve body composition leads to a drift in both directions away from optimal calorie consumption. Increasing training load whilst decreasing calorie intake is a sure way to underperform and possibly deteriorate performance. An athlete in this situation would be at risk of performance loss at best and risk of serious illness.
What is RED-s?
In 2014 the International Olympic Committee released a consensus statement regarding RED-s, but what is it?
Relative Energy Deficiency in Sport (or formerly the female triad) is a relative energy deficiency that affects many aspects of physiological function, including metabolic rate, menstrual function, bone health, immunity, protein synthesis, cardiovascular and physiological health.
Warning signs/effects include;
Physiological
Lack of three consecutive periods in females or a change to a previously regular menstrual cycle
A decline in morning erectile function in male athletes
Poor development of muscle mass
Difficulties staying warm in the winter and cool in the summer months
Downy growth of hair all over the body
Constipation or feeling bloated
Reduced metabolic rate
Behavioural
Pre-occupation and constantly talking about food
Poor sleep patterns
Restricting or strict control of food intake
Overtraining or difficulties taking rest days
Psychological
Irrational behaviour
Fear of food and weight restoration
Severe anxiety
Becoming withdrawn and reclusive
Performance
Poor recovery between training sessions
Digestive issues –athletes often become constipated and bloated
Increase in incidence of illness
Decreased endurance and muscle strength
Recurrent injuries
Decrease in bone health - stress fractures
Ensure you are fuelled with carbohydrates to train and minimise any calorie deficits, especially in hard blocks of training and/or when looking to improve absolute rather than relative performance. Make sure you look after that foundation of nutrition.
Non-binary approach
Often athletes will talk about making a change in behaviour around nutrition or about creating a calorie deficit. This can often lead to a black and white or binary way of thinking about nutrition, fuelling and food. In reality, what we eat, when we eat and how much we eat varies as much as our training load does. Our approach to training also varies, and as age-group athletes, other demands in our life often dictate changes in our approach to training as well. It is imperative to have a good perspective and flexible approach to training as an age-grouper. The same perspective and flexibility are critical when it comes to nutrition.
We need a lot of fuel for some days and sessions, and for others, we don’t. On some days, we need to be kind to ourselves because there have been other challenges in our life and that intervals session perhaps should be done easier. On some days, we need to remember that nutrition in any form can also be as much for our mental health as it can be for our physical health. Indeed, some foods have been shown to affect our mental health directly, caffeine, for example, can affect our anxiety levels, and dark chocolate has had links with lower recordings of depressive symptoms. An athlete who is anxious about their calorie counting may consume excess coffee and exclude treats such as dark chocolate and find that their overall health, and performance, suffers.
Food isn’t just fuel; it’s health and its enjoyment as well. Much like training, however, though if you do zero training, the balance isn’t quite right.
Accuracy
I feel it is also crucial to mention accuracy. Those of you reading this who have had to study statistical analysis or fair testing for science as part of your education or working lives will understand that there can be many variables that can affect readings and affect the perspective given by ‘data’. Data needs to be digested in a firmly understood context and applied in that context. In some situations, it can be all too easy to believe a fundamental piece of data to be accurate and use it vigorously rather than generally and slightly sceptically. When it comes to the accuracy of calorie counting, a little bit of scepticism can be a helpful thing. Simply googling calorie amounts and using MyFitnessPal in conjunction with a gender-based generic calorie amount, even with the calorie burn data from a training device, may be wildly inaccurate in terms of their energy balance calculation. Habitually counting with a significant margin for error can lead to substantial differences between an intended action and an unintended outcome. This considerable difference can lead an athlete down the road of RED-s; Coach Philip has written a little more about the calculations here.
How can you/we avoid RED-s?
By taking a holistic approach to nutrition
By understanding the energy demands of training and competition
By taking a holistic approach to body composition (not ‘weight’)
By making athletes aware by writing this blog
By writing about the accuracy and calculations in detail
By maintaining health before performance mindset
Individuals and coaches create an environment and culture that encourages a ‘healthy approach to performance.’
This includes language used.
This also includes social media follows.
Plan out our nutrition for each day as we would training, be organised and ensure that food that is suitable and balanced with our training and life load is prepped for before, during and after training. Often a lack of organisation can mean missed meals or poor choices made, which would be the same as wondering why our body didn’t respond well to a session without a warm-up! Nutrition is part of the training session.
Alan has worked with Tri Training Harder since 2014. During this time working with a wide spectrum of athletes from beginner, to youth and junior elite athletes through to 70.3 and Ironman AG winners and Ironman Kona Qualifiers.
An active Triathlon coach since 2007 Alan has been fortunate enough to work with athletes, peers and support staff who have continutally challenged him to evolve and develop. Building on a solid foundation in swimming teaching, Alan has specifically developed swimming coaching experience having worked in High Performance Swimming environments. Alan's other passion is all things fast on a bicycle!
Since 2015 Alan has worked in conjunction with the other Tri Training Harder Coaches to significantly develop collective coaching practice both on camp and online.
Visit Alan's
Coach profile
We’re here to help
Tri Training Harder are one of the leading Triathlon coaching providers in the UK, using our wealth of experience to unite scientific and technological research with already well-established and successful best practices, to create a formula for triathlon and endurance coaching that works.
The result is an honest, dynamic, yet simple new way of constructing an athlete’s training to allow them to reach their potential.
If you’re planning your next season, just starting out in the sport or are looking for extra guidance at the very top end of the field, we are here to help, and our coaches would be delighted to hear from you. You can contact us via the website, and one of the team will be in touch.