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Relative Energy Deficiency in Sports (RED-S)

In sports, where every ounce of energy counts, a silent enemy exists, and threatens the well-being and performance of athletes—Relative Energy Deficiency in Sports (RED-S).

In the post below I will be exploring the complexities of RED-S, explaining its intricate nature, its impact on athletes, and how to develop strategies to prevent and manage it.

Understanding RED-S:

While RED-S is often talked about in relation to professional and high performance sports, it is important to understand and acknowledge that RED-S is a condition that can affect individuals across various levels of activity, not just elite athletes. It occurs when there's an imbalance between energy intake and energy expenditure. This imbalance can lead to a range of physiological and psychological issues, regardless of whether someone is a professional athlete or simply engaging in regular physical activity.

At its core, RED-S emerges from an imbalance between energy intake and usage. It goes beyond the field of caloric deficits, which gives an shortage to nutrient intake, which is essential for sustaining the rigorous demands of training and competition. Originally known as the Female Athlete Triad, RED-S does not apply to gender boundaries, affecting both male and female athletes across diverse sporting disciplines.

Consequences of RED-S:

1. Menstrual Dysfunction:

The repercussions of energy deficiency manifest cleary in female athletes, often happening in menstrual irregularities or even complete stop—a phenomenon clinically termed amenorrhea. This disturbance in hormonal equilibrium not only impairs reproductive health but also poses a threat to bone density over the long haul.

2. Impaired Bone Health:

Energy deprivation is a major factor to skeletal integrity, compromising bone health and predisposing athletes to the potential stress fractures and osteoporosis. Such vulnerabilities are particularly worrying for athletes engaged in activities that include repetitive impact or weight-bearing exertions.

3. Diminished Performance:

The subtle grip of RED-S extends its reach to reduce athletic performance—muscle function, endurance, and overall performance. Athletes find themselves caught in a web of fatigue, worsening strength, and increased recovery periods, limiting their athletic achievements to train efficaciously and compete at the max of their capabilities.

4. Compromised Immunity:

Energy insufficiency worsens the body's immune system and make athletes receptive to a variety of infections and illnesses. The reoccuring disruptions limit training frequency, stopping progress towards their goals.

Prevention and Management:

1. Education and Awareness:

The main limiting factor against RED-S lies in the spreading of knowledge and awareness amongst coaches, parents, and athletes. A mutual understanding of the danger of RED-S serves as the cornerstone to prevent lack of knowledge.

2. Nutritional Support:

Athletes and clubs work with registered dietitians or nutritionists to make personal nutritional blueprints tailored to the specifications of their sport and training regimen. Especially on the diversity of foods that are nutrient-dense and sensible fueling practices for energising the athlete before, during and after their workout.

3. Monitoring and Screening:

Monitoring of menstrual cycles, bone health, and performance metrics is a major part of the RED-S philosophy. Screening tools such as the Female Athlete Triad Cumulative Risk Assessment and the RED-S Clinical Assessment Tool serve as potential warning signs, lowering the time taken for intervention.

4. Individualized Approach:

Recognizing the individuality of the athlete, interventions can be made with greater accuracy, being aware of the factors of different sports, training volume, body type, and metabolic rate.


Relative Energy Deficiency in Sports (RED-S) poses a threat to the well-being and performance of athletes. With the understanding of energy stability, a commitment to nutritional needs, and guided by a strong framework of prevention and management, athletes will not have to worry about RED-S.

But instead they can create a pathway to optimal performance and continuing progression.

If we adopt an ethos that pushes bodily nourishment and promotes athletic performance and holistic well-being instead of being corrupted by social media and people with no knowledge about what's needed to become the best athlete you can be, you can reach your potential.

The Five Elements of 5ESC is technique, tactic, psychological, social and physical. They all belong together and it doesn't matter which one you put in front of the other. They are all equally important and if you remove one of them, then you will not reach your potential.

Food, or fueling is built into the five elements.

  1. Socially, do you look at food as something you do as a group?

  2. Psychologically, do you struggle with eating food?

  3. Tactically, how do you use food before, during or after activities?

  4. Physically, how do you feel after fueling?

  5. Technically, without food, your technique will suffer.

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