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Physical Therapists and Nutritionists, in general, are seeing an increase in athletes who are not fueling their bodies properly. While it may seem counterintuitive, under-eating can actually lead to reduced bone mineral density, and eventually, REDS (Relative Energy Deficiency in Sport) and/or Female Athlete Triad (FAT). In this post, we will discuss the risk factors for athletes’ bone health and reproductive health, how REDS might present for athletes who aren’t getting enough nutrition, which sports are most susceptible to REDS and FAT, and recent research on the long-term effects of REDS.
When an athlete is not consuming enough calories, their body prioritizes vital functions, such as brain and heart function, over the maintenance of bone health. This can lead to decreased bone density, which puts the athlete at risk for stress fractures and other injuries. Additionally, female athletes who do not consume enough calories may experience a disruption in their menstrual cycle, which can lead to a decrease in estrogen levels. This decrease in estrogen can further contribute to decreased bone density, leading to an increased risk of osteoporosis later in life.
REDS is a syndrome that occurs when an athlete is not consuming enough calories to meet their energy needs. This can lead to a host of symptoms, including decreased bone density, menstrual dysfunction, and decreased performance. Female Athlete Triad is a similar syndrome, but it includes the additional symptoms of disordered eating and decreased body weight. It’s important to note that males can also develop REDS and FAT, although it is more common in female athletes because they genetically have a higher Body Mass Index (BMI) requirement, as where males can genetically support a more lean BMI without injury.
REDS can present in a variety of ways, including decreased performance, increased injuries, and menstrual dysfunction. Athletes who are not consuming enough calories may also experience fatigue, depression, and decreased motivation. It’s important to seek medical attention if you are experiencing any of these symptoms, as they can be indicative of a larger issue.
Certain sports are more susceptible to REDS and FAT than others. Sports that require a lean body type, such as gymnastics, cheer leading, dance, and figure skating, are particularly at risk. Endurance sports, such as long-distance running and cycling, also have a higher incidence of REDS. However, any athlete who is not consuming enough calories to meet their energy needs is at risk.
Recent research has shown that the long-term effects of REDS can be devastating. In addition to decreased bone density and menstrual dysfunction, athletes who experience REDS may be at a higher risk for cardiovascular disease, diabetes, and other chronic illnesses later in life. It’s important to address REDS and FAT as early as possible to prevent these long-term consequences.
In conclusion, under-eating can lead to decreased bone density, REDS, and Female Athlete Triad, which can have serious consequences for athletes’ bone and reproductive health. It’s important for athletes to consume enough calories to meet their energy needs and seek medical attention if they are experiencing any symptoms of REDS or FAT. Any athlete, regardless of sport, is at risk if they are not consuming enough calories to meet their energy needs.
Sources:
Barrack MT, Gibbs JC, De Souza MJ, et al. Higher incidence of bone stress injuries with increasing female athlete triad-related risk factors: a prospective multisite study of exercising girls and women. Am J Sports Med. 2014;42(4):949-958.
Mountjoy M, Sundgot-Borgen J, Burke L, et al. The IOC consensus statement: beyond the Female Athlete Triad–Relative Energy Deficiency in Sport (RED-S). Br J Sports Med. 2014;48(7):491-497.