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Kin 428 > REDs (part 2) > Flashcards

REDs (part 2) Flashcards

1
Q

although any athlete or active person can suffer from REDs, who is particularly at risk

A
  • female athletes
  • those in weight-sensitive and leanness-demanding sports
  • aesthetically judged sports
  • sports in which low BW might provide a performance advantage
  • sports with high exercise energy expenditure
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2
Q

what is IOC REDs three step protocol

A
  1. sceening
  2. severity and risk assessment and stratification
  3. clinical diagnosis and treatment
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3
Q

what are example of step 1 screening

A

population specific questionnaires or clinical interviews

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4
Q

who proceeds to step 2 from screening

A

individuals with greater than low risk

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5
Q

step 2 of REDs severity/risk assessment characteristics

A
  • high sensitivity
  • more expensive
  • clear scoring allows for easy and reliable implementation
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6
Q

who proceeds to step 3 REDs clinical diagnosis and treatment

A

yellow, orange, or red

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7
Q

characteristics of step 3 REDs clinical diagnosis and treatment

A
  • physician diagnosis based on info from steps 1 and 2 along with clinical history and examination
  • individualized treatment plan implemented by the multi-disciplinary athlete health and performance team
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8
Q

characteristics of step 1 REDs screening

A
  • lower sensitivity and specificity
  • inexpensive and easy to use
  • questionnaires allow for large athlete group screening
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9
Q

when can screening tools be undertaken

A

part of annual periodic health examination when athlete presents with symptoms

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10
Q

what symptoms will ahtlete present with to use a REDs screening

A
  • disordered eating/eating disorders
  • weight loss and/or fluctuations
  • lack of normal growth and development
  • endocrine dysfunction
  • recurrent injuries and illnesses
  • bone stress injury
  • decreased performance/performance variability
  • mood changes
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11
Q

what does REDs not always mean

A

huge loss in weight

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12
Q

sensitivity/specificity of the tests for REDs

A

ability to accurately distinguish between patients who have or do not have the condition

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13
Q

what does disordered eating not always equal

A

they have LEA but does increase your risk

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14
Q

what does the DSM-5 recognize as ED

A
  • anorexia nervosa
  • bulimia nervosa
  • binge eating disorder
  • other specified feeding and eating disorders
  • avoidant/restrictive food intake disorder (ARFID)
  • other
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15
Q

what is the spectrum of eating behaviour that can change day to day or week to week

A

<-optimised nutrition - disorder eating- eating disorder->

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16
Q

eating disorder

A

behaviour that meets DSM-5 diagnostic criteria for a feeding and eating disorder

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17
Q

disordered eating

A

problematic eating behaviour that fails to meet the clinical diagnosis for an eating disorder

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18
Q

optimized nutrition

A

safe, supported, purposeful and individualized nutrition practices that best balance health and performance

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19
Q

diagnostic criteria for anorexia nervosa

A

a. restriction of energy intake relative to requirements
b. intense fear of gaining weight or becoming fat or persistent behaviour that interferes with weight gain
c. disturbed by one’s body weight or shape, self worth influences by BW or shape, or persistent lack of recognition of seriousness of low BW

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20
Q

what does restriction of energy intake relative to requirements lead to

A

significant low BW in the context of the age, sex, developmental trajectory, and physical health

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21
Q

what is not required anymore for the diagnostic criteria in menstruating females

A

absence of at least 3 consecutive non-synthetically induced menstrual cycle

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22
Q

what is taste fatigue

A
  • type of anorexia that happens with athletes
  • if eating same thing over and over, don’t want to eat it
  • very common phenomena and can lead to restricting energy but not does mean you have fear of weight
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23
Q

what is the diagnostic criteria of bulimia nervosa

A

recurrent episodes of binge eating

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24
Q

in bulimia nervosa what are the recurrent episodes of binge eating characterized by

A
  1. eating within any 2 hr period, an amount of food that is definitively larger than most individuals would eat in a similar period of time under similar circumstances
  2. a feeling that one cannot stop eating or control what or how much one is eating
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25
Q

what are the 4 other disagnostic criteria of bulimia nervosa

A
  • recurrent innapropriate compensatory behaviours in order to prevent weight gain
  • binge eating and innapropriate compensatory behaviours occur at least once a week for 3 months
  • self evaluation in unjustifiably influenced by body shape and weight
  • disturbance does not occur exclusively during episode of anorexia nervosa
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26
Q

what are examples of recurrent inappropriate compensatory behaviours in order to prevent weight gain

A

self-induced vomiting, misuse of laxatives, diuretics, or other meds, fasting or excessive exercise

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27
Q

how many people have bulimia nervosa

A

~2-3% general population

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28
Q

side effects of bulimia nervosa

A

erosion of tooth enamel
tears in esophagus
aspiration pneumonia
electrolyte imbalances
heart failure

29
Q

warning signs of AN

A
  • dramatic loss in weight
  • a preoccupation with food, kcal, weight
  • wearing baggy or layered clothing
  • relentless, excessive exercise
  • mood swings
  • avoiding food related social activities
30
Q

warning signs of BN

A

-a noticeable weight loss or gain
- excessive concern about weight
- bathroom visits after meals
- depressive moods
- strict dieting followed by eating binges
- increasing criticism of one’s body

31
Q

binge eating disorder

A

eat an unusually large amount of food and feel out of control during the binge

32
Q

binge may include

A
  • eat more quickly than usual during binge episodes
  • eat until they are uncomfortably full
  • eat when they are not hungry
  • eat alone because of embarrassment
  • feel disgusted, depressed, or guilty after eating
33
Q

what is not the same as binge eating

A

overeating
- many people overeat on occasion

34
Q

binge eating episode characterized by

A

consumption of an unusually large amount of food during a short period of time
feeling out of control over what and how much is eaten and when to stop

35
Q

binge eating is not followed by

A

compensating behaviours seen in other EDs (exercise, vomiting, laxatives, diuretics)

36
Q

when is binge eating seen as a disorder

A

when occurs at least once a week for three months or more

37
Q

what is the difference between other specified feeding and eating disorders and AN or BN

A

does not meet criteria
Exhibit some but not all, characteristics associated with clinical eating disorders

38
Q

OSFED

A
  • regular use of inappropriate compensatory behaviour by an individual of normal body weight after eating small amounts of food (vomiting after two cookies)
  • repeatedly chewing and spitting out, not swallowing, large amounts of food
  • night eating syndrome
39
Q

what is night eating syndrome

A

eating in excess following evening meal or waking from sleep which causes extreme psychological distress and interferes with daily functioning

40
Q

anorexia athletica

A

disordered eating that impacts athletes
take on a limited number of calories despite high level of PA
become overly concerned with weight and exibit some diagnostic criteria of AN and BN

41
Q

5 criteria of anorexia athletica

A
  • excessive fear of becoming obese
  • restriction of kcal intake
  • weight loss
  • no medical disorder to explain leanness/weight loss
  • GI complaints
42
Q

when do symptoms of ARFID usually show up

A

infancy or childhood, child may avoid food with certain textures or colours
traumatic response involving food, such as becoming physically ill

43
Q

what does ARFID not include

A

feelings of body dissatisfaction in way BW or shape are perceived

44
Q

what can happen if ARFID is left untreated

A

can develop into AN or BN later in adolescence or adulthood

45
Q

orthorexia nervosa

A

unhealthy fixation about eating so-called “healthful foods”

46
Q

what is term orthorexia derived from

A

greek word ortho which means right or correct

47
Q

what may orthorexia lead to

A

elimination of entire food groups (dairy or grain products) later eliminating another group or food
all in quest for a perfect and clean eating diet

48
Q

in severe cases what does orthorexia lead to

A

malnourisment when critical nutrients are elminated

49
Q

what is the difference for orthorexics from anorexia

A

the quality instead of quantity of food is severely restricted

50
Q

which eating disorder does not officially recognized in current APA diagnostics manual

A

orthorexia nervosa

51
Q

4 level traffic system of step 2 REDs severity/risk assessment

A

green, yellow, orange, red

52
Q

where does everyone want to be in 4 level traffic system

A

green
severity/risk: none to very low

53
Q

yellow of REDs diagnosis severity/risk assessment

A

risk is mild
1 or 2 primary indicators and max 1 secondary

54
Q

treatment, training and competition reccomendations for yellow

A
  • treatment, monitoring and regular follow up at appopriate intervals
  • full training and comp
55
Q

treatment, training and competition reccommnedations for orange

A
  • treatment, close monitoring and follow-up required
  • some aspects of training and/or comp may need to be modified
56
Q

treatment, training and competition reccomendatiosn for red

A
  • immediate treatment at daily to monthly intervals depending on severity
  • significant training and comp modifications required and in majority of cases removal of training or comp is indicated
57
Q

what is treatment of REDs depending on

A

severity and risk

58
Q

what does REDs require

A

interdisciplinary team (athlete in middle)
- medical
- mental health
- sport dietician support

59
Q

what is treatment of REDs

A

increase EA via increased intake or decreased energy output (reduce training volume/intensity)

60
Q

when increasing EA for REDs what should focus be on

A

increase by 300-600 kcal/day
focus on energy intake timing around training sessions

61
Q

what is critical foundation of training diet

A

energy intake

62
Q

nutritional treatments of REDs that are mental

A
  • flexibility around eating and thoughts about food
  • ability to eat in social settings
  • healthy body image
  • no restrictive or rigid behaviours
  • identification of influencers
63
Q

nutritional treatments of REDs that involve eating

A
  • eating practices that meet the physical and mental health needs
  • ability to adapt dietary intake to meet the specific and changing demands of sport
  • enjoyment of foods
  • a well balanced diet with slow and steady increase in caloric intake
  • increase in CHO intake
  • improved within-day energy balance, meal and snack timing and inclusion of energy dense foods
64
Q

Supplementation for treatment of REDs

A

may be indicated with medical supervision
- B12 or iron if indicated
- vit d may be needed for athletes in northern latitudes and who train indoors

65
Q

treatment targets with LEA

A
  • reversal of recent weight loss
  • return to normal BW with normal menses
  • weight gain to achieve BMI >18.5 or >90% predicted BW
  • energy intake at 2000 kcal/day or more for training demands (slow increase in cal intake)
66
Q

what should coaches or support staff look for for prevention

A
  • unexplained weight loss
  • frequent weight fluctuations
  • sudden increases in training volume
  • obsession with exercise
  • excessive concern with BW and body comp
  • appearance and evidence of bizarre eating practices
  • chronic injuries
  • delayed recovery
67
Q

prevention strategies from NCAA coach handbook

A
  • de emphasize weight
  • recognize individual difference in athletes
  • coach supported education: awareness is first step in changing behaviour
  • involvement by sport governing bodies
68
Q

how to de emphasize weight as coach

A
  • avoid player comparisons for weight, body composition and performance markers
  • weight does not equal good performance and does not equal health
69
Q

what moderating factors with problematic LEA exposure can lead to various REDs symptoms

A
  • personal characteristics
  • medical history
  • training characteristics
  • dietary/nutritional characteristics
  • other (stress)

Kin 428 (13 decks)

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