Lecture 8: REDS Flashcards
What does REDS stand for?
Relative energy deficiency in sport
What are the 4 pillars of Te Whare Tapa Wha?
Mental, Social, Physical and Spiritual Wellbeing
What is an eating disorder?
Clinically diagnosable illness where there are severe disturbances in eating behaviours and related thoughts and emotions
What are examples of eating disorders?
Anorexia nervosa, bulimia nervosa, binge eating, avoidant/restrictive food intake disorder (ARFID)
What are the biggest populations of people with eating disorders?
15-19 year olds, second biggest is women in their 40s and 50s
What is the percentage of athletes with eating disorders in sports which are weight classed, aesthetic and advantagous to being lighter?
25-42%
What are rates of eating disorders in athletes of other sports?
12-17%
Where are eating disorders in athletes seen at the highest rate?
Sports which have weight classes (rowing), aesthetic (gymnastics or figure skating) or sports where having a low body mass is seen as advantageous (cycling)
What do rates look like today?
Rates are only getting higher, especially after COVID
Individuals affected by eating disorders commonly suffer from other mental health conditions such as…
depression, anxiety, OCD and substance abuse
What is the treatment for eating disorders?
Cannot be tackled by a dietitian alone, eating disorder specialists are best - need a team including therapists etc.
What does LEA stand for?
Low energy availability
What is the female athlete triad?
low energy availability, low oestrogen, low bone density
What is low energy availability?
a term we use to describe something which drives the physiological processes which result in the syndrome of REDS
What is energy availability?
amount of energy available following the energy used for exercise for normal physiological functions per kg of fat free mass
How is energy availability calculated?
(Energy intake - energy expenditure) / (Fat free mass)
What energy availability is classified as weight gain?
> 45 kcal/kg FFM/d
What energy availability is classified as optimal?
45 kcal/kg FFM/d
What energy availability is classified as a deficiency?
30 kcal/kg FFM/d
What energy availability is classified as a moderate deficiency?
20 kcal/kg FFM/d
What energy availability is classified as a severe deficiency?
10 kcal/kg FFM/d
Energy availability of less than 30kcal/kg of FFM per day results in an impairment of…
Reproductive hormones and bone health. Also affected T3, IGF-1, Insulin, Glucose and increased cortisol
How does the female athlete triad work?
The combination of exercise and diet causes low estrogen and then low bone density.
Low energy availability decreases what?
Reproductive hormones, insulin, glucose, IGF-1, T3, leptin, bone protein synthesis and mineralisation
Low energy availability increases what?
Ghrelin, cortisol, growth hormone resistance
How do men compare to women when encountering low energy availability?
males tend to be more robust, they can manage better compared to females, but if they do go to low they will get decreases in testosterone and abnormal sperm
What happens to metabolic rate due to low energy availability?
it gets lower
What reproductive hormones are most effected by low energy availability?
estrogen, progesterone, LH and FSH
Why are reproductive processes shut down?
because it is not vital for survival
What is the scientific term for REDS?
Functional hypothalamic amenorrhea
What are the main symptoms of REDS in females?
Impaired menstrual cycle, immune system, bone density, hormones
What are the main symptoms of REDS in males?
Decreased hormone levels, protein synthesis - response to resistance training
Is eating disorder prevalence higher in individual or team sports?
Individual
What is the LEAF questionnare?
A screening tool for female athletes at risk for the female athlete triad - score 8 or greater indicates a risk of LEA
Why do people have REDS or LEA?
- Clinical eating disorder
- Disordered eating
- Inadvertent undereating
- Intentional weight loss without disordered eating
What is orthorexia?
An obsession with healthy eating
How do diet trends effect athletes?
Just as much if not more as the general population, athletes have more access than ever before to nutrition information
What are 3 threats to athletes energy intakes?
Confusion, diet ‘gurus’, quick fixes and pyramid marketing
Why can athletes not eat the same thing everyday?
Need variety in their diet to account for different activity and exercise
What percent of elite rugby player had poor body image?
Indicated in nearly half
Is there a correlation between body image and EA?
Those who had the worst body image, had the worst energy availability - correlation
What are reasons to measure body composition?
- Identify physical characteristics
- Monitor growth
- Monitor training/dietary interventions
Red flags to look out for when it comes to LEA and eating disorders…
- Fussy eating
- Avoidant of entire food groups
What percent of exercising females are at risk of RED-S?
50%
What recovers first in the body from the female athlete triad?
First energy status, second menstrual status, last bone mineral density
