Relative Energy Deficiency in Sport Flashcards
American College of Sports Medicine defined Triad as
clinical entity that refers to the relationship between three interrelated components: energy availability, menstrual function and bone health
what was added to the triad definition?
understanding of the pathophysiology - over a period of time the athlete moves along on a continuous spectrum ranging from healthy with optimal EA, regular menses and healthy bones to amenorrhoea, low EA and osteoporosis
aetiological factor underpinning the triad
energy deficiency relative to the balance between dietary energy intake and energy expenditure to support homeostasis, health and the ADL, growth, and sporting activities
a syndrome resulting form relative energy deficiency
affects many aspects of physiological function including metabolic rate, menstrual function, bone health, immunity, protein synthesis, CV and psych health - even in men
what did the IOC coined as a new term for the female athlete triad?
relative energy deficiency in sport
calculation for energy availability
EI - energy cost of exercise relative to FFM - 45kcal/kg FFM/day - energy balance
requires expertise and is generally imprecise
what underpins a large proportion of cases of low EA?
disordered eating
what are other reasons for low EAs (without psychological overlay)
mismanaged programme to quickly reduce body mass/fat or inability to track EI with an extreme exercise commitment
Low EA in men
same at risk sports as female athletes - weight sensitive sports in which leanness and/or weight are important due to their role in performance, appearance or requirement to meet a competition weight category
disordered eating
continuum starting with appropriate eating and exercise behaviours (occasional use of more extreme weight loss methods such as short term restrictive <30kcal/kg FFM) and ends with clinical eating disorders, abnormal eating behaviours, distorted body image, weight fluctuations, medical complications and variable athletic performance
secondary amenorrhoea
absence of three consecutive cycle post menarche
oligomenorrhea
cycle length greater than 45 days
Aetiological factors in menstrual disorders in athletes - 5
abnormal levels of hormones, LH pulsatility, inadequate body fat stores, low EA and exercise stress
marked reduction in EA and LH pulsatility
may disrupt it by affecting the hypothalamic hormone gonadotropin releasing hormone output which subsequently alters the menstrual cycle
Low EA alters
levels of metabolic hormones and substrates - insulin, cortisol, GH, insulin like growth factor I, 3,3,5 - triiodothyroxine, grehlin, leptin, peptide tyrosine-tyrosine, glucose, FA, and ketones
REDS have serious implications for
many body systems - short and long term compromise of optimal health and performance
long term low EA - 3
nutrient deficiencies (including anaemia), chronic fatigue and increased risk of infections and illnesses, - harming health and performance
physiological and medical complications of REDS - 7
CV, GI, endocrine, reproductive, musculoskeletal, renal and CNS
Psychological aspects of REDS
Psychological stress and/or depression
at what kcal/kg FFM is MPS reduced?
30
Total energy expenditure = 4
Resting metabolic rate + thermos effect of food + non-exercise activity thermogenesis + energy expenditure from exercise
Resting metabolic rate represents _% of total energy
38-47%
Resting metabolic rate in elite athletes vs sedentary ind
60-80%
Two equations to estimate energy requirement
Harris Benedict
- Men = 66.5 + (13.7 X weight in kg) + (5 x height in cm) - (6.8 X age) = BMR
- women = 655 + (9.6 X kg) + (1.8 X cm) - (4.7 x age) = BMR
Cunningham
- men and women = (370+ 21.6 X lean mass in kg) = BMR
