Understanding RED-S: What Athletes, Coaches, Parents, and Providers Need to Know
Understanding RED-S:
If you’re an athlete, a fitness enthusiast, or someone working closely with active populations, you may have come across the term RED-S. Short for Relative Energy Deficiency in Sport, RED-S is a syndrome that can impact performance, health, and long-term well-being. It’s a condition that goes beyond the traditional understanding of the Female Athlete Triad and includes all genders and a wide range of physiological systems.
What is RED-S?
RED-S occurs when there is an imbalance between energy intake (the calories you consume) and energy expenditure (the calories you burn through exercise, daily living, and physiological functions). When your body consistently doesn’t get enough energy to support both training and basic bodily functions, it can begin to shut down non-essential systems to conserve energy.
This energy mismatch might be intentional (such as during periods of dieting or weight-cutting) or unintentional (due to underestimating fuel needs). Either way, the consequences can be serious.
Signs and Symptoms of RED-S
RED-S affects multiple systems in the body, including:
Hormone Health: irregular or absent periods in female athletes and low testosterone in male athletes, decreased libido
Bone Health: Increased risk for stress fractures or low bone mineral density
Metabolic Rate: Slower metabolism
Immunity: Increased frequency of illness or infections, poor recovery
Cardiovascular Health: Decreased heart rate and low blood pressure
Psychological Health: Mood changes, irritability, or increased anxiety
Gastrointestinal Health: Bloating, constipation, or discomfort
Who is at Risk?
Anyone involved in high-level physical activity, especially those in sports that emphasize leanness (like distance running, dance, gymnastics, or cycling), can be at risk. RED-S can occur at any body size and isn’t always visible from the outside.
How is RED-S Diagnosed and Treated?
There isn’t a single test for RED-S. Diagnosis typically involves a thorough assessment by a multidisciplinary team, including a sports dietitian, physician, and possibly a psychologist. Treatment focuses on restoring energy balance through increased nutrition, decreased training load, and addressing any underlying psychological factors such as disordered eating or perfectionism.
Why Awareness Matters
Ignoring RED-S doesn’t just hurt performance; it can have long-term consequences for bone health, fertility, cardiovascular function, and mental health. Early identification and intervention are key.
To learn more, check out Project RED-S for information and support for RED-S - whether you’re an athlete, parent, coach, or provider!
What You Can Do
Monitor your energy levels, mood, and performance
Fuel adequately before, during, and after workouts
Work with a sports dietitian to understand your individual needs
Advocate for yourself or others if you notice signs of under-fueling
RED-S is preventable, manageable, and reversible with proper care. By spreading awareness and having open conversations about fueling and recovery, we can help athletes of all levels stay strong, healthy, and resilient.
If you’re struggling with RED-S or concerned you might be under-fueling, reach out to a qualified professional who specializes in sports nutrition and understands the demands of your sport. Your health and performance are worth protecting!