232: EXPERT EDITION: Dr Margo Mountjoy (Clinical Prof, Sports Medicine Physician) Relative Energy Deficiency in Sport (RED-S)
Aug 19, 2020
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Dr. Margo Mountjoy discusses the concept of Relative Energy Deficiency in Sports (RED-S) and its impact on athletes' performance and health. She explains the signs and symptoms of RED-S, screening methods, and treatment options. The podcast also covers topics such as weight loss while maintaining energy balance, returning to sport post-pregnancy, and the challenges in measuring energy intake and expenditure. Dr. Mountjoy emphasizes the importance of recovery nutrition and the need for strategic energy intake for endurance athletes. Overall, the podcast provides valuable insights into recognizing and reversing low energy availability in athletes.
Low energy availability can have significant repercussions on an athlete's health and performance, affecting various aspects such as menstrual function, bone health, metabolism, and cardiovascular function.
Relative energy deficiency in sport (REDS) is a term coined in 2014 to replace the outdated term 'female athlete triad', recognizing the impact on male athletes and performers, and highlighting the range of health consequences beyond the triad components.
Treating and managing REDS involves increasing energy intake and availability through dietary changes, addressing disordered eating patterns, and working with professionals to create an individualized plan.
Deep dives
The Concept of Low Energy Availability
Low energy availability refers to the deficit between energy intake and energy expenditure. It takes into account not only the energy spent on exercise but also the energy expended on basic bodily functions like digestion and metabolism. This state can have significant repercussions on an athlete's health and performance, affecting various aspects such as menstrual function, bone health, metabolism, cardiovascular function, gastrointestinal system, mental health, and more. It is important for athletes to be aware of the signs and symptoms of low energy availability and to ensure that they are fueling their bodies adequately throughout the day.
The Origins of Relative Energy Deficiency in Sport (REDS)
Relative energy deficiency in sport (REDS) is a term coined in 2014 to replace the outdated term 'female athlete triad.' The term 'relative' emphasizes the balance between energy intake and energy expenditure, considering factors such as timing and intensity of exercise. REDS encompasses not only the effects on female athletes but also recognizes the impact on male athletes and performers in various sports. The consensus statement highlighted how low energy availability can lead to a range of health consequences, beyond the traditionally recognized components of the triad. REDS has spurred an increase in scientific research in this field, leading to a better understanding of the syndrome and its implications.
Addressing and Reversing REDS
It is possible to treat and manage REDS to bring athletes back to optimal health and performance. The key is to focus on increasing energy intake and availability while considering the source, timing, and quantity of food consumed. This may involve making dietary changes, such as incorporating energy-dense foods, spreading out meals and snacks throughout the day, and ensuring a sufficient range of macronutrients and micronutrients. It is also crucial to address any disordered eating patterns and to work with experienced professionals, such as sports nutritionists and clinicians, to create an individualized plan. By addressing the underlying cause of low energy availability, athletes can recover and regain their physical well-being and performance capabilities.
The Importance of Energy Availability for Athletes
Low energy availability can have negative effects on both health and performance in athletes. Psychological challenges like eating disorders can lead to a low energy availability state by restricting energy intake. Decreased adaptation to training, increased risk of injury, and illness are some of the performance consequences of low energy availability.
Measuring and Assessing Energy Availability
Measuring low energy availability is not as simple as a blood test. It requires calculations of energy expenditure and intake, which can be cumbersome and prone to recall bias. Clinicians use screening tools like the LEAF-Q questionnaire to detect low energy availability. Risk assessment models can categorize athletes into green, yellow, or red zones based on the severity of their low energy availability. It is important to listen to your body, pay attention to signs and symptoms, and seek medical advice if necessary.
On this episode, we discuss with Dr Margo Mountjoy all about RED-S (Relative Energy Deficiency in Sports). Now the consequences of an athlete being in this state can include not only performance detriments but also health side effects.
In 2014, the International Olympic Committee led by today's featured expert Dr Margo Mountjoy, published a consensus statement entitled “Beyond the female athlete triad relative energy deficiency in sport”, and this paper explored the syndrome of RED-S being impaired physiology caused by relative energy deficiency resulting impairments was stated to include effects on metabolic right menstrual function, bone health, immunity, protein synthesis and cardiovascular health with the key driving factor of this syndrome relative energy deficiency in sport being low energy availability.
During this episode Dr Margo Mountjoy shares around the origins of coining the phrase relative energy efficiency in sport as she worked with the IOC medical committee, we explore the signs and symptoms of RED-S for athletes. Dr Mountjoy outlines the incidence and prevalence of relative energy deficiency in sport amongst endurance athletes and athletes in general and the prevalence has been reported to be up to 60% amongst athletes in endurance events. Dr Mountjoy outlines how to screen for RED-S, the treatment of RED-S once it's been identified, how to lose weight and stay in energy balance, returning to sport post pregnancy and of course there's the issuing of this week's physical challenge as well.
Show Sponsor: Dr Shona Halson Livestream
We are excited to put the spotlight on the Science of Recovery with this upcoming Livestream event on 24th October 2020 with Dr Shona Halson.
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