Low Energy Availability in Athletes

Abstract

Relative Energy Deficiency in Sport (REDs) is a syndrome of impaired physiological function due to low energy availability (LEA) such that there is insufficient energy intake after subtracting the cost of energy expended through exercise. There are no universal criteria to identify an athlete with REDs. Rather, physiological outcomes and functional impairments that occur because of LEA are used for identification purposes. Once an athlete is identified with REDs, treatment should focus on addressing the underlying cause of LEA. This may include increasing energy intake and/or decreasing exercise energy expenditure as well as addressing factors that may exacerbate LEA. Much has been uncovered about the negative consequences of LEA. Early models were for women, whereas newer models include athletes of both sexes. More research is needed to increase the understanding of LEA so that the model of REDs and best practice guidelines to prevent, identify, and treat REDs will continue to evolve.

Resting Metabolic Rate and Substrate Utilization during Energy and Protein Availability in Male and Female Athletes

“…The concept of EA is more beneficial than the concept of energy balance when prescribing diets for athletes [6]. Notably, low EA (LEA) can lead to the development of a syndrome called Relative Energy Deficiency in Sports (REDs) [7]. The female athlete triad model with menstrual dysfunction and impaired bone health was the first described form of REDs [8].…”

“…The disturbed functions include decreased resting metabolic rate (RMR), reproductive function, bone health, cardiovascular health, immune system, and hematological parameters, as well as psychological and behavioral manifestations and negative consequences in performance [9]. The extended model of REDs included the affection of both male and female athletes [7,10]. However, sex differences remain a point for discussion.…”