REDs (part 1) Flashcards
energy availability (EA)
amount of energy remaining after energy requirements for exercise training is removed
- remaining for all other physiological functions
EA (kcal/day)=
EI (kcal/day) - EEE (kcal/day)/kg FFM
energy intake
exercise energy expenditure
what is hard to measure in EA calculation
energy intake
what can chronic low EA lead to
- hormone disruption/menstrual disturbances (hypoestrogenemia)
- suppressed bone formation
- suppressed metabolic function (reduced measured RMR)
- increased bone resorption
important things to remember when assessing EA
- weight loss not always present
- with chronic low EA, weight maintenance may be achieved
- low EA is keeping the individual at a lower BW and other risk factors are still in play (no menstrual, poor bone health)
over signs of low EA
- BMI <17.5 or <85% of expected BW for adolescents
- if BW is not low look at current patterns of food intake (24h recall, 3-5 day food records) compared to current level of PA
how to measure energy intake from food intake
24 h recall
3 to 7 day food record
diet history w/ RD
Self reported eating routine
how to measure exercise energy expenditure
HR monitors
activity monitors
indirect equations
how to measure fat free mass
skinfolds
DEXA/DXA
underwater weighing
what is hard to do with measuring energy intake, exercise energy expenditure, and fat free mass
hard to measure with accuracy
if EA is equal what does it support
health and performance
how does EA support health
hormones, bone, GI, cellular maintenance, circulation, thermoregulation, immunity, mental health
how does positive EA support performance
muscle strength, lean mass gains, concentration, coordination, glycogen stores, recovery, adaptation, aerobic performance, injury protection and recovery
if low EA what does it sacrifice
health and performance
LEA
Any mismatch between dietary energy intake and energy expended in exercise that leaves the body’s total energy needs unmet
in LEA what is there inedequate energy to support
the functions required by the body to maintain optimal health and performance
what does LEA occur as
a continuum
what is the continuum of LEA
Scenarios in which effects are benign and others where there are substantial and potentially long-term impairments of health and performance
adaptable LEA
short-term experience with minimal (or no) impact on long term health, wellbeing or performance
- moderating factors may alter expression of outcomes
problematic LEA
associated with greater and potentially persistent disruption of various body systems, often presenting with signs/symptoms and represents maladaptive response
what type of LEA is more common
chronic issue (problematic)
examples of causes of adaptable LEA
- cut weight (planned phase)
- recovery after LEA
what are the characteristics of problematic LEA exposure
duration, magnitude, frequency
what may the chracteristics of problematic LEA exposure vary according to
body system and the individual
examples of moderating factors of LEA
Characteristics of individual athletes, environment or behaviour/activities, gender, age, genetics
what can moderating factors do
may offer protection or additional risk in the progression from LEA exposure to expression of disturbances to health, wellbeing or performance
what can moderating factor vary according to
the body system and amplify or attenuate LEA
What influences dietary intake
determinant of food consumption
- person related factors
- environmetal related factors
person related factors of the determinants of food consumption
- nutrition knowledge
- taste and food preferences
- appetite
- influencers (family, teammates, coaches, sport, culture)
- psychological
- biological
- medical history
environmental related factors of the determinants of food consumption
- time available/schedule
- economic/food security
- cultural background
- cooking skills
- access to food
- cooking and kitchen equipment
What is REDs
syndrome of impaired physiological and/or psychological functioning experienced by females and male athletes
what is REDs caused by
exposure to problematic (prolonged and/or severe) LEA
What are the detrimental outcomes of REDs
decreases in energy metabolism, reproductive function, musculoskeletal health, immunity, glycogen synthesis and cardiovascular and haematological health
what can all the outcomes of REDs synergistically lead to
impaired wellbeing, increased injury risk and decreased sports performance
disordered eating
- abnormal eating behaviours
- includes restrictive eating, compulsive eating or irregular or inflexible eating patterns, excessive exercise, use of purgatives
- behaviours do not meet clinical criteria for eating disorder
eating disorder
- mental illnesses clinically diagnosed by meeting defined criteria characterized by abnormal eating behaviours
examples of eating disorders
self-induced restricting food intake, ppreoccupation wiht body shape or weight, bingeing and purging (self induced emesis, laxative use, excessive exercise, diuretic use)
what is the female athlete triad
the interrelationships among energy availability, menstrual function, and bone mineral density
what are the three components of the female athlete triad
- LEA (with or wihtout ED)
- amenorrhea/menstrual dysfunction
- osteoporosis/low bone mineral density
what is the triad on
spectrums
what is the optimal side of the triad spectrum
optimal energy availability, eumenorrhea, optimal bone health
what is the bad side of the triad spectrum
low energy availability with or without eating disorder, functional hypothalamic amenorrhea, osteoporosis
what is the middle of the triad spectrum
reduced energy availability, subclinical menstrual disorders, low BMD
what is amennorhea
absence of menstrual period (1 and 2)
primary amenorrhea
delay in the onset of puberty and the menarche (first period @ > 15yrs)
secondary amenorrhea
disruption in a normal menstrual cycle, missing a period for >3 months
what happens to hormones with amenorrhea
low estrogen, progesterone, and testosterone levels
what may amenorrhea be related to
infertility and other long term health problems
causes of low BMD
- decreased estrogen from ovaries (estrogen increases uptake of calcium into blood and deposit in bone)
- reduced intake of important nutrients for bone health (protein, calcium, vit d)
when does BMD decrease
as # of menstrual cycles missed increases
what increases with low BMD
stress fractures
when does peak bone mass occur
for females 19 yrs
males 20.5 yrs
what is the bone loss for athletes
may be irreversible
how long is recovery of triad
can be years
warning signs of REDs or LEA in PA or sport
- inconsistent training
- poor training response
- decreased performance at training and competitions
warning signs of REDs or LEA in sleep
- high levels of fatigue= increased hrs of sleep
- poor sleep quality
warning signs of REDs or LEA for body
- <9 menstrual cycles per 12 month period
- low libido
- > 2 bone injuries
- low ferritin not responding to proper supplementation
- restrictive eating habits
- GI problems
- weight loss or consistent BW
- drop in muscle mass and strength
- change in mood/irritable
other factors that impact fatigue
- dehydration
- poor sleep quality
- under fueling (intentional or unintentional)
- doing workouts fasted
- stress (emotional and physical)
- low carb intake (could be enough cals)
- illness
- poor planning with school/work and training schedule
- low iron stores
- caffeine withdrawal
what is a symptom of LEA that also can worsen LEA
Mental health issues
REDs symptoms caused by LEA
- Impaired reproductive function
- impaired bone health
- impaired GI function
- impaired energy metabolism/regulation
- impaired haematological function
- urinary incontinence
- impaired glucose and lipid metabolism
- mental health issues
- impaired neurocognitive function
- sleep disturbances
- impaired cardiovascular function
- reduced skeletal muscle function
- impaired growth and development
- reduced immunity
REDs symptoms that affect sport that are caused by LEA
Decreased:
- athlete availability
- training response
- recovery
- cognitive performance/skill
- motivation
- muscle strength
- endurance performance
- power performance
what is needed to screen and diagnosis REDs
special focus on the athlete at risk is needed
why is the screening and diagnosis of REDs challenging
symptomology can be subtle and further complicated by the diverse list of potential different diagnosis
measurement of energy availability and exercise expenditure if challenging
what needs to be considered when screening and diagnosing for REDs
health, performance, moderating factors, exposure, the individual
