REDs Flashcards
How does food relate to Te Whare Tapa Whā?
- Physical - gaining/losing weight
- Social - going out for lunch, coffee etc., brings people together
- Mental - can make you feel good and bad
- Spiritual - linked to history, traditions
What is an eating disorder?
- Clinically diagnosable conditions
- Eating disorders are illnesses
- Not necessarily a nutritional problem
What are different examples of eating disorders?
- Anorexia nervosa
- Bulimia nervosa
- Binge eating
- Avoidant/restrictive food intake disorder
- Non specificized eating disorder
Whats the order of the continuum of eating patterns? (from green to red)
- Healthy eating
- Restrictive diets
- Chronic dieting
- Disordered eating
- Fasting, dehydrating
- Laxatives, diuretics, vomiting, diet pills, and/or excessive exercise
- Eating disorders
What age group has the highest proportion of eating disorders?
20-24 year olds
What sports have higher numbers of eating disorders?
- Weight classes (such as rowing), aesthetic sports (such as gymnastics or figure skating)
- Sports where having a low body mass is seen as advantageous (such as cross-country or cycling)
What are the rates of eating disorders amongst athletes?
- Varies by sport
- Rates = 25-42%
- Team sports = 12-17%
What are common commodities with eating disorders?
Individuals affected by eating disorders commonly suffer from other mental health conditions: depression, anxiety, obsessive-compulsive disorder, substance use disorder
What is the treatment for eating disorders?
- Clinical eating disorders should not be tackled by a dietician/nutritionist alone
- If you suspect an eating disorder refer onto eating disorder specialists
- Can’t treated lightly as they have really serious consequences
What are the 3 athlete specific eating disorders?
- Female athlete triad
- Low energy availability
- Relative energy deficiency in sport
What is energy availability?
- The amount of energy available following the energy used for exercise and for normal physiological functions per kg of fat free mass
- Energy availability = (energy intake - energy expenditure) / fat free mass
When does energy deficiency occur?
<30kcal/kg FFM/day
What is the optimal energy availability?
45kcal/kg FFM/day
What effect does LEA have on luteinising hormone (LH)?
LH pulse frequency decreased over 24hours by 10%
What effect does LEA have on reproductive hormones?
Impairs them in such a short period of time
What is the effect of the female athlete triad?
- Negative energy balance
- Disrupts the hypothalamic pituitary ovarian axis (HPO)
- Causes low estrogen
- Leads to low bone mineral density
What causes REDs?
Prolonged low energy availability often leads to relative energy deficiency in sport (REDs)
What happens in REDs?
Our body thinks its starving so goes into starvation mode. Meaning it starts to shut down things which reduces your RMR and also alters the hormones (especially LH, FSH, estrogen and progesterone) and impacts protein synthesis and our hunger hormones which leads to functional hypothalamic amenorrhea (clinical term for REDs)
Whats the relationship between LEA and mental health?
LEA has a negative impact on your mental health and having mental health conditions can have an impact on your LEA (like not wanting to eat)
What are the symptoms of REDs in females?
- Impaired menstrual cycle
- Impaired immune system
- Impaired bone density
- Reduced female hormones
What are the symptoms of REDs in males?
- Reduced hormone levels
- Reduced protein synthesis-response to training
- Direct impact on bone metabolism
Whats important to realise in regards to GI issues?
Athletes tend to suffer from GI impacts and quite often they’ll look at their diet and try to cut something out. But LEA can cause these issues so you don’t want to cut anything out, because if its due to LEA you’ll make the problem worse.
What are the issues in calculating energy availability intakes?
- Under or over reporting
- Burden
- Representative?
What are the issues in calculating energy availability expenditure?
- Under or over reporting
- What counts as exercise?
- Representative?
What are the reasons for LEA/REDs (intentional or unintentional)?
- Clinical eating disorder
- Disordered eating
- Inadvertent underrating
- Intentional weight loss without disordered eating
What is the LEAF questionnaire?
- Assess their menstrual function, gastrointestinal function and injuries
- Score of 8 or higher indicates a risk of LEA and should undergo further investigation
What are the influences on intake for athletes?
- Athletes are influenced just as much if not more as the general population with current diet trends
- Currently athletes have more access than ever before to nutrition information
- Can this non-specific information affect performance?
What is orthorexia?
An obsession with healthy eating
What are the threats to athletes energy intake?
- Complete confusion
- Diet gurus
- Nutrient demonisation
- Quick fixes and pyramid marketing
What do you need to look out for to identify a poorly built nutrition plan?
If you have a meal plan where everyday is pretty much the same, then its not a well built nutrition plan - because energy expenditure changes day to day
Why measure body composition?
- Identify physical characteristics of elite performers
- Assess and monitor growth
- Monitor training programs/dietary interventions
- Determine optimal BC for weight category sports
- Monitor the relationship to health and performance
What are the considerations for body composition testing?
- Be aware of vulnerable athletes
- Have coaches on board and be clear on metrics reported
- Focus on performance
- Treat data confidentially
- Longitudinal monitoring for at risk athletes
- De-emphasise the importance of body composition
- Educate on body composition methods and metrics
- Let senior athletes with good habits be role models
What questions do you need to ask a fussy eater?
- Menstrual history
- Potential food intolerances
- Food groups avoided
- Lifestyle
- Gut health
- Stress
What sort of questions do you need to ask around dietary choices?
- Any dietary restrictions?
- Beliefs around diet and supplements
What sort of questions do you need to ask around training?
- Days per week
- Times per day
- Changes in load
- Recovery
What sort of OTHER questions do you need to ask athletes?
- Injury history
- Growth/weight history
- Menstrual history
- Pressures
What are the 4 pieces of advice for clients who may be at risk of REDs?
- Ensure you fuel well around training
- If you are hungry eat
- Regularly eating throughout the day should help reduce hunger, and also keep you adequately fuelled
- Take at least one rest/recovery day a week
What is the recovery of energy status?
- Process: days or weeks
- Outcomes: increasing energy status will stimulate anabolic hormones (IGF-1) and bone formation and will reverse energy conservation adaptations
What is the recovery of menstrual status?
- Process: months
- Outcomes: increase reproductive hormones and estrogen exerts an anti-resorptive effect on bone
What is the recovery of bone mineral density?
- Process: years
- Outcomes: increased estrogen continues to inhibit bone resorption and increased energy status will stimulate anabolic hormones and bone formation
How many exercising females are at risk of REDs?
50%
