WIR IM SPORT 03.2022
Magazine of the Landessportbund NRW
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What is it about the so-called "relative energy deficit in sport" (RED-S) that causes sports physicians and athletes to worry? To anticipate this in one sentence: RED-S is a serious health disorder in athletes.
Weight reduction is generally regarded as positive. Then there is talk of the "negative energy balance", which is intended to deliberately lead to weight loss in overweight people. On the other hand, critical weight loss as a result of too extensive and intensive training, for example, is associated with the risk of being underweight.
If athletes eat too little food to compensate for what they consume, this has consequences: The weight can develop towards underweight and the system goes into an economy mode, a kind of emergency program to ensure vital functions for survival.
The symptom complex of disordered eating behavior, menstrual cycle disorders and osteoporosis, which was described in the 1990s as the "female athlete triad" in women who play sports, can be seen as a precursor to the term RED-S. Over the years, however, it has been recognized that men can be affected as well as women and that the symptoms are more diverse than those initially described.
Less efficient
In most cases, a reduction in performance or an increased susceptibility to injury or infection is initially noticed during training. Other abnormalities may include a lack of motivation, depressive phases or changes in the cardiovascular system. Laboratory tests may show reduced concentrations of hormones. If, for example, a constellation of hypothyroidism is found, this should not be seen as a disease of the thyroid gland, but as a result of the energy-saving program described above.
RED-S typically occurs in sports in which a low weight initially represents an advantage. These can be, for example, endurance sports, sports with weight classes or aesthetic sports such as gymnastics or ballet. However, if a low weight is initially an advantage, the symptoms mentioned above occur with increasing low energy intake.
Symptoms are often misinterpreted and not associated with low weight. In this case, external support is required in collaboration with doctors, psychologists, trainers and nutritionists.
